The normal value of ALT is 0~40U/L, 177U/L ALT is more than 4 times of the normal value, which is more serious, and the reasons for the elevation are physiological and pathological, which is common in myocarditis or viral hepatitis. 1. Physiological elevation: ALT is mainly found in myocardium, liver and kidney, etc. It is commonly found in bad habits such as overeating, excessive drinking before examination and staying up all night, etc., which may damage the corresponding cells and release intracellular ALT into the blood, and then make the blood ALT elevated. 2. Myocarditis: the damage of myocardial cells leads to the release of intracellular ghrelin into the blood, resulting in the elevation of ghrelin in the blood. 1~3 weeks ago, there are often prodromal symptoms, such as fever, malaise, nausea and vomiting, etc.; in acute attacks, there are often palpitations, chest tightness, or difficulty in breathing and other discomforts. 3. Viral hepatitis: Hepatitis virus infection damages the liver cells and releases ghrelin into the blood, causing ghrelin to rise in the blood, with symptoms such as fatigue, poor appetite, liver palms, spider moles and jaundice. There are many other causes of elevated ALT, such as other liver diseases or biliary diseases, etc. It is recommended to consult a doctor immediately for further examination to clarify the cause of the disease to avoid delay.