Transaminase (alt/ast) is one of the indicators to determine whether the liver is damaged, in the clinic, there are a lot of misunderstandings about the perception of transaminase, mainly in the following categories. Myth 1: High transaminase is hepatitis There are many reasons for the elevation of transaminase, except hepatitis, acute soft tissue injury, alcohol, strenuous exercise, over fatigue, certain liver-damaging drugs, or biliary and pancreatic diseases, myocarditis, myocardial infarction, and infectious diseases, such as lobar pneumonia, can cause the transaminase to be elevated. Therefore, a simple high transaminase is not necessarily hepatitis. Myth 2: Jaundice is very deep, as long as the aminotransferase is normal, it is not a big problem Acute severe hepatitis, liver failure, due to fewer normal liver cells, so the release of aminotransferase into the bloodstream is reduced, there is a “bile enzyme separation” phenomenon, that is, bilirubin is very high, but aminotransferase instead of decreasing or even normal, in fact, this is the clinically dangerous sign, the mortality rate of 60% or more. In fact, this is a very dangerous sign in the clinic, and the mortality rate is more than 60%. In addition, bile duct obstruction, stasis bile type hepatitis, can also appear jaundice is very deep, but the transaminase is not high. Myth 3: The higher the transaminase is, the more serious the disease is In acute hepatitis, transaminase is often very high, up to 2000 units/liter or more (normal value <40 units/liter), but most of the prognosis is good. While most of the transaminases in chronic hepatitis B are mildly elevated (below 300 units/liter), some are even normal, but in fact they are much more serious, and are prone to progress to cirrhosis or even liver cancer. Myth 4: Normal aminotransferase, liver disease is well Elevated aminotransferase is a sign of liver injury, but aminotransferase down does not mean that the liver disease is well. Such as chronic hepatitis B, hepatitis C, autoimmune hepatitis and long-term alcohol consumption, aminotransferase is often normal or only mildly elevated, but in fact the liver has undergone serious lesions. For example, in some patients with cirrhosis and liver cancer, liver function is very bad, but transaminases are still normal. Myth 5: Normal aminotransferase can be stopped Chronic hepatitis B patients' aminotransferase often "fluctuating" changes, even if no treatment will be relieved, or even normal; and hepatitis C patients' aminotransferase is often normal, but if not treated in time, the same will be progressed to cirrhosis and hepatocellular carcinoma. The transaminase level can be considered before stopping the drug, but it is not the only indicator of stopping the drug, otherwise it may trigger the rebound of the disease. Myth 6: elevated transaminase must use enzyme-lowering drugs For most of the chronic hepatitis B or C, antiviral treatment is the "fundamental" method, the treatment of the root of the transaminase will naturally come down, there is no need to use enzyme-lowering drugs.