Liver function is a very important clinical indicator, but there are often problems in clinical evaluation, for example, some patients with elevated “transaminase levels” are simply considered to have “abnormal liver function”. In fact, the indicators reflecting liver function should include the synthesis, excretion, metabolism of drugs, immunity and other functions of the liver, not only the level of transaminases. The liver is the only place where albumin is synthesized, and serum albumin level is one of the good indicators to reflect chronic liver injury. Decreased serum albumin level is seen in: insufficient nutritional intake, impaired synthesis, excessive consumption and increased loss. The serum albumin level in patients with chronic liver disease can reflect the ability of the liver to synthesize albumin and changes in the volumetric distribution of albumin, and if the serum albumin level is reduced and not easily recovered, the prognosis is often poor. (ii) Prothrombin time In hepatic impairment, the associated impaired synthesis of coagulation factors can lead to prolonged PT, which is one of the early predictors of liver function abnormalities. prolonged PT and uncorrectable vitamin K predicts extremely poor liver function. In fulminant liver failure, PT is an important early diagnostic indicator. (iii) Lipids and lipoproteins Lipids and lipoproteins are not sensitive indicators of liver damage, but serum cholesteryl ester levels decrease in the presence of hepatocellular damage and are proportional to the degree of liver damage. In chronic liver disease, lipoproteins are reduced and their levels are negatively correlated with transaminases and bilirubin. (a) Bilirubin Bilirubin is one of the important indicators of liver function, normal total bilirubin TBIL level is 4 times normal: cholestasis syndrome 2. ALP>2.5 times normal, ALT, AST 2.5 times normal, ALT, AST>8 times normal: 90% of viral hepatitis (c) Glutamyl transpeptidase GGT 90% of patients with hepatobiliary disease have elevated GGT GGT > 10 times normal, mostly due to alcoholic liver, intrahepatic and extrahepatic biliary sludge, primary hepatocellular carcinoma. Evaluation of liver enzymatic indicators 1. A survey of a large sample of healthy people in the UK found that: 6% of asymptomatic normal people had elevated ALT and AST, and 5% of normal people had all test results outside the “normal value” range. Therefore, some abnormal liver test results are not really abnormal. 2. The treatment of elevated single transaminase level is: check once, if the elevation exceeds 2 times the normal, further examination is needed. IV. Interpretation of hepatitis B two pair half Major triplet and minor triplet HBsAg (+) HBsAg (+) HBeAg (+) HBeAb (+) HBcAb (+) HBcAb (+) Single HBsAg (+) is a hepatitis B carrier V. Key points 1. elevated single unconjugated bilirubin is likely to be Gilbert’s syndrome. 2. persistent elevated transaminase levels with negative viral indicators and no alcohol consumption may be fatty liver or non-alcoholic fatty liver hepatitis. 3. In acute fulminant liver failure, PT is an important early diagnostic indicator. 4. In patients with abnormal transaminases and jaundice, the possibility of pharmacologic liver disease should not be overlooked. In patients on drug therapy, weekly follow-up is required when ALT levels are less than 3 times the normal upper line, and it is best to discontinue drugs when greater than 3 times. 5. When the liver function index is abnormal, do not blindly take medication to correct it, but go to a specialist hospital for consultation. Because drugs for liver disease have certain indications and are expensive, and there are individual differences in specificity, there is still no specific and absolutely effective drug