What are the signs of having hepatitis?
Hepatitis is generally divided into acute hepatitis and chronic hepatitis. The main difference lies in the degree of various symptoms and the duration of onset. First of all, many symptoms of hepatitis, such as weakness, anorexia, nausea, abdominal distension, etc., are more obvious in acute patients, while chronic patients have less obvious reactions, and some patients even have no symptoms at all.
1.Acute hepatitis
(1) Acute jaundice hepatitis
Pre-jaundice
Indigestion type: mainly digestive symptoms, mainly manifested as nausea, aversion to oil, appetite significantly reduced, etc., easily misdiagnosed as indigestion and other gastrointestinal diseases.
Influenza type: mainly respiratory symptoms, mainly manifested as nasal congestion, runny nose, cough, fever (up to 39℃), easily misdiagnosed as upper respiratory tract infection.
During the jaundice period most patients tend to have better self-conscious symptoms than before, nausea disappears, appetite begins to return, and other symptoms gradually diminish, but the patient’s urine is as dark as black tea, and the sclera and skin appear yellowish and itchy.
As the jaundice subsides, the patient enters the recovery period, and various symptoms gradually reduce and then disappear.
(2) Acute hepatitis without jaundice
2, chronic hepatitis, that is, the course of acute hepatitis has been more than
Many of the symptoms that appeared in the acute stage, such as weakness, loss of appetite, and pain in the liver area, are still retained in varying degrees. The symptoms are long-term loss of appetite, weight loss, sometimes constipation, sometimes diarrhea, depression, impatience and irritability, insomnia and dreaminess, spider nevus on the neck, face and upper limbs, liver palm on the palm of the hand, frequent liver pain, loss of libido or even disappearance, menstrual disorders, etc.
3.Heavy hepatitis: Generally speaking, heavy hepatitis has a more
The patient’s gastrointestinal symptoms are very obvious, with severe and stubborn nausea and vomiting, almost uncontrollable; most patients may have bleeding, in addition to the site of the injection, nose, teeth bleeding in small amounts, there will be vomiting blood (vomiting coffee-like stomach contents) and blood in the stool (stool tarry). The patient begins to develop ascites, which rapidly worsens, and if the disease continues to progress, a range of neurological symptoms of varying degrees of severity may occur. It starts with fluttering tremors in both hands, followed soon by pronounced behavioral movements, emotional perversion or high excitement or lack of expression, followed by a brief period of confusion, blurred consciousness, followed by loss of pain, unconsciousness, and drowsiness into coma.
How to know if you have hepatitis
Generally speaking, hepatitis is a contact infection, so if a person has been in close contact with a hepatitis patient for more than a week without isolation, and if symptoms such as gastrointestinal symptoms occur, it is important to be alert. But whether or not you really have hepatitis, you should not jump to conclusions based on your symptoms alone, but you need to analyze them through clinical observation, physical examination, liver function tests and other specific circumstances. If necessary, liver aspiration and other tests are required to confirm the diagnosis.
In general, the following aspects must be considered for the diagnosis of viral hepatitis.
(1) Whether there is a history of hepatitis exposure (including life contact, blood transfusion history, injection history, etc.);
(2) Whether the subject has abnormal liver function;
(3) whether there are clinical manifestations;
(4) whether the liver is enlarged or has unexplained pressure pain on physical examination;
(5) the status of virus testing.
Among the above aspects (2) is the most important; if (2) serum alanine aminotransferase (ALT) is abnormal, plus one or several abnormalities in (3), (4) and (5), you can be diagnosed with hepatitis; if only (3) and (4) are abnormal, you should make a suspected diagnosis of hepatitis first and observe further, and if necessary, liver biopsy is needed before making a formal diagnosis.
Why liver disease patients should have ultrasound examination on an empty stomach
Ultrasound examination requires fasting because liver disease often involves the gallbladder, bile ducts, pancreas and other organs. Food is the main factor stimulating the gallbladder and bile ducts to excrete bile, which also causes the gallbladder to contract; after eating, the presence of food in the stomach and intestines affects the ultrasound beam to pass through and affects the accuracy of ultrasound examination.
What does total serum bilirubin (TBiL) and 1-minute bilirubin (DBiL) indicate
Most of the bilirubin in the body comes from hemoglobin, called indirect bilirubin, after the breakdown of senescent red blood cells. Indirect bilirubin becomes direct bilirubin (also known as 1-minute bilirubin) when it is combined with glucuronic acid in the liver.
The normal value of total serum bilirubin is 11,7-17,1 micromol M l, and the normal value of 1-minute bilirubin is 0-6 micromol M l. Total bilirubin minus 1-minute bilirubin is indirect bilirubin. In normal people, 1-minute bilirubin accounts for 20% of the total bilirubin.
Both increased bilirubin production, impaired uptake of bilirubin by hepatocytes, and impaired intracellular binding and excretion can result in increased serum bilirubin.
What does the change in AFP mean?
Normal value of serum AFP: <20 µg M ml.
The amount of AFP in normal human serum is very small, and when the hepatocytes become malignant and tend to hypofractionate, they regain the ability to synthesize this protein, causing a significant increase in serum AFP content. Therefore, fetoprotein can be used as a serological indicator for the diagnosis of hepatocellular carcinoma. Clinically, for chronic hepatitis with cirrhosis with high AFP level, dynamic observation and regular review should be carried out, and it can also be combined with other laboratory indicators. If high levels persist, the possibility of hepatocellular carcinoma should be considered and further examination is needed. Such as ultrasound, CT, etc., in order to confirm the diagnosis as soon as possible. However, not all serum AFP is positive in liver cancer patients, according to statistics, about 10%-30% of liver cancer patients have negative serum AFP. Therefore, we should correctly understand the role of AFP in liver cancer diagnosis, and cooperate with other tests to make comprehensive judgment, so as not to misdiagnose and not to cause unnecessary panic.
How to detect liver cancer in early stage
First of all, we should pay attention to the high-risk group of liver cancer, that is, those who are over 40 years old and have one of the following conditions: those who have a history of hepatitis for more than five years or have positive markers of hepatitis B virus; those who have a history of alcohol abuse for more than 5-8 years and have clinical manifestations of chronic liver disease; and those who have been diagnosed with liver cirrhosis. If the AFP is elevated but less than 200ug/L, it should be rechecked once every half month for dynamic observation until it is excluded or clearly diagnosed. If necessary, CT examination should be performed.
Significance of ultrasound-guided liver biopsy
What is liver fibrosis serology index
Liver fibrosis refers to the pathological process of abnormal proliferation of fibrous connective tissue in the liver under the action of various pathogenic factors, which destroys the normal structure of liver lobules and thus affects the physiological function of the liver.
It includes pro-collagen type III peptide (PIIIP), laminin (LN), fibronectin (FN), hyaluronic acid (HA), and type IV collagen (IV-C).