I. Peptic ulcer.
1. Blood count: often with anemic changes and reduced hemoglobin and red blood cells.
2. Stool occult blood test: active peptic ulcer is often positive.
3.Gastrin (Gas): increased in gastric ulcer, but no diagnostic significance.
4.Basal gastric acid secretion (BAO): increased in duodenal ulcers.
5.Maximum gastric acid secretion (MAO): increased in duodenal ulcer.
6.Gastric fluid analysis (GC): Gastric acid secretion is normal or slightly low in patients with gastric ulcer. While duodenal ulcer, compound ulcer BAO and gastric acid after irritation were significantly increased.
7.Helicobacter pylori (Hp): 80% of peptic ulcers are positive.
8, duodenal drainage (DJT): bloody bile may be present.
9, human epidermal growth factor (HGEF): often increased.
II. Chronic gastritis.
1.Blood count: Hemoglobin and red blood cells are decreased in those with upper gastrointestinal bleeding.
2, stool occult blood test (FOB): positive if there is upper gastrointestinal bleeding.
Gastric fluid secretion function (GAF): In chronic superficial gastritis, gastric acid secretion is approximately normal or mildly reduced, but if the wall cells are nearly gone, there may be no gastric acid secretion and the amount of gastric fluid is also reduced.
4.Pepsin assay (PeP): normal in chronic superficial gastritis and reduced in chronic atrophic gastritis.
5.Prolactase (La): decreased in chronic atrophic gastritis. Often measured simultaneously with PeP.
6, gastrin (Gas): increased in chronic atrophic gastritis, and even higher if there is also pernicious anemia.
Basal acid secretion (BAO): Decreased in chronic atrophic gastritis. It is lower if there is also pernicious anemia.
8.Maximum acid secretion (MAO): Decreased in chronic atrophic gastritis. It is lower if there is also pernicious anemia or iron deficiency anemia.
9, Anti-gastric lining cell antibodies (APCA): chronic atrophic gastritis, pernicious anemia is often positive.
10.Anti-internal factor antibody (AIFA): positive for pernicious anemia and iron deficiency anemia, but not as sensitive as APCA.
11, immunoglobulin A: increased in chronic superficial gastritis and chronic atrophic gastritis.
12, Helicobacter pylori (Hp): the positive rate is very high.
13, Human epidermal growth factor (HEGF): increased.
Cirrhosis of the liver
1.Immunological examination
2.Enzymatic examination: ALT and AST can be normal or mildly abnormal in compensated period, ALT and AST have different degrees of elevation in decompensated period, and ALT/AST 13 seconds. If it cannot be corrected with vitamin K, it indicates poor prognosis.
3.Indocyanine green clearance test (ICGT): It is a substitute test for BSP, and the retention of cirrhosis can reach 40%.
4.Check of liver fibrosis: including pre-collagen type III peptide (PIIIP), pre-collagen type III (PC III), collagen type IV (PC IV), prolyl hydroxylase, lysine oxidase, Fab fragment of pre-collagen type III antibody (Fab PIIIP), laminin determination. Cirrhosis is often significantly increased, and all kinds of collagen are increased, but the most important is the increase of collagen IV which constitutes the basement membrane, often >150μg/L, PIIIP often >120μg/L.
5.Blood picture examination: the decompensated stage of cirrhosis is characterized by decreased hemoglobin and red blood cells, decreased PLT, and decreased RBC, WBC and PLT in those with hypersplenism.
6.Urine and renal function: In complication of hepatorenal syndrome, renal function is impaired, manifested as BUN, Cr and Ccr decrease, and red blood cells, white blood cells, protein and tubular type can be found in urine.
7, ascites examination: generally leaky fluid, such as complications of spontaneous peritonitis, transparency decreased, specific gravity between leaky fluid and exudate, Levantine positive, increased cell count, often more than 300 per microliter, mainly neutrophils; if complications of tuberculous peritonitis, ascites is bloody, mainly lymphocytes. Bloody ascites should also be considered hepatocellular carcinoma, it is appropriate to do the cancer cell examination of ascites.
8, clotting time measurement: all can be prolonged.
9.AFP: If persistently elevated, hepatocellular carcinoma should be suspected.
10.Vasoactive intestinal peptide (VIP): often >150μg/L, predicts cirrhosis better than other items, and has a poor prognosis if constantly elevated.
11.Cyclic guanosine monophosphate (cGMP): often >8mmol/L 13.Glycocholic acid (CG): often >2.0μmol/L
IV. Acute pancreatitis
1. Leukocytes: early elevated. Neutrophils are significantly elevated.
2, amylase: blood amylase begins to rise 8 hours after the onset, 12-24 hours to reach a peak, 48-72 hours began to decline, 3-5 days to return to normal. If it continues to rise and does not fall, it indicates that the disease is serious, and there may be pancreatic necrosis or pancreatic duct obstruction, or tumor occurrence, or recurrent inflammation. Urinary amylase begins to rise 12-24 hours after the onset of the disease, and begins to fall after 4 days.
3.Lipase: Increased in acute pancreatitis and pancreatic duct obstruction, which can last for 10-15 days.
4.Leucine aminopeptidase: significantly increased in pancreatic malignant lesions, mildly elevated or not elevated in inflammation.
5.GGT: can be mildly increased, and significantly increased in pancreatic cancer.
6.Total cholesterol: can be mildly increased.
7.Lipoprotein: may be mildly elevated, mainly HDL.
8.FBS: temporary elevation of blood glucose may occur, and return to normal in 4-7 days.
9, blood calcium: hemorrhagic necrotizing pancreatitis appears 2 days after the onset of temporary hypocalcemia.
10, blood potassium: mild to moderate disease is reduced, general pancreatitis can be mildly reduced.
V. Chronic pancreatitis
1, amylase: blood and urine amylase is often not increased, but in acute episodes can be increased.
2, fecal free fatty acid measurement: increased.
3, fecal routine: fat droplets and undigested muscle fibers can be seen.
4.Fasting blood sugar: increased.
5.Vitamin K: increased.
6.Insulin: Decreased in some patients.
7.Glucagon: may be reduced.
8, Lundh test: using a specific test meal as the stimulation of pancreatic secretions, extracting duodenal fluid or pancreatic fluid to determine the amount of secretion, bicarbonate water content and various pancreatic enzyme activities are seen to decrease.
9, pancreatic peptide test: when the exocrine function of the pancreas is reduced, chymotrypsin secretion is insufficient, which can lead to a decrease in urinary PABA content.
10. Since this disease is often accompanied by diabetes, diabetes-related items can be examined.
Sixth, cholecystitis
1. Leukocytes: increased in acute cholecystitis and chronic cholecystitis.
2.Fecal examination of roundworm eggs: biliary ascariasis can be positive.
3, duodenal drainage (DJT): if there is no bile drainage, suggesting that the common bile duct is obstructed by stones; if increased bile viscosity is found, suggesting inflammation of the gallbladder, bile ducts, gallstone disease; if a large number of epithelial cells are found, suggesting biliary inflammation, duodenitis; if a large number of white blood cells are found in the A duct, suggesting the possibility of duodenitis, stones; DJT can also find parasitic eggs, culture can find pathogenic bacteria, if the B duct If E. coli and Candida are found, the diagnosis is more significant.
4, bilirubin measurement: often divided into total bilirubin (TBiL), direct bilirubin (DBiL), indirect bilirubin (IBiL), all three are elevated suggests hepatocellular jaundice; gallbladder stones, cholecystitis, biliary obstruction with jaundice is often obstructive jaundice, TbiL and DbiL increased; if TbiL and IbiL increased is often hemolytic jaundice.
5.Alanine aminotransferase: increased.
6.Menthylate aminotransferase: increased in obstructive jaundice.
7.GGT: important value for the diagnosis of malignant tumors and biliary system diseases of the hepatobiliary system.
8.Alkaline phosphatase: increased.
9.Lipase: increased.
10.Aldolase: increased in cholecystitis.
11.Leucine aminopeptidase: increased.
12.Adenosine deaminase: increased in hepatobiliary disease.
13.5′-Nucleotidase: It can be used to identify whether ALP is elevated in hepatobiliary system disease or skeletal system disease, the former is elevated, the latter is not.
VII. Appendicitis
1.White blood cell: increased.
2.Pregnancy test: mainly to exclude the possibility of ectopic pregnancy.
3.Urinary routine: generally no abnormality, but posterior appendicitis of the appendix may irritate the adjacent ureter and a small amount of red blood cells may appear in the urine.
4.Amylase: may be increased.
VIII. Crohn’s disease.
1, blood routine: most patients have varying degrees of anemia, mainly reduced Hb of RBC. If the lesion is active, WBC is significantly higher and the proportion of neutrophils is increased.
2, stool occult blood test: often positive.
3.Fecal routine: large amount of fat droplets may appear.
4.Blood sedimentation; more than half of them may increase the speed.
5.ACE: decreased.
6.CIC: half of them are positive. Hanging colonic epithelial cell antibody may also appear.
7.CRP: increased.
8, Other such as PT, A, K, Na, Ca can be reduced. Lysozyme may be increased.
Esophageal cancer
1.Fecal occult blood test: it may be positive if there is bleeding.
2.Blood count: decreased hemoglobin and red blood cells.
3.CEA: increased.
4.SCC: increased. Its concentration tends to increase with the aggravation of the disease.
5.Vitamin C: decreased concentration.
6.Vitamin A: Decreased concentration.
7.Blood calcium: decreased.
X. Gastric cancer
1.Fecal occult blood test: often positive.
2.Blood count: Hb and RBC are decreased.
3.CEA: significantly increased.
4.CA19-9: increased.
5.CA72-4: increased.
6.CA50: increased.
7.Gastric fluid immunoglobulin A: increased.
8.Gastric fluid analysis: It is not used as a routine test at present because it has little diagnostic significance.
9.Anti-gastric lining cell antibody: the rate of gastric cancer is higher in positive than in negative.