Do you know about the liver function items in the pre-employment physical examination?

The pre-employment physical examination is a physical examination that people do before entering a work unit according to the requirements of the unit. There are differences in the specific examination items, but the examination of liver function items is basically necessary. The liver function examination mainly includes alanine aminotransferase, aspartate aminotransferase, total protein, blood protein, globulin, hemoglobulin ratio and total bilirubin. People can refer to the normal values ​​of these items and then judge their own examination results. This is an issue that everyone needs to pay attention to, so it is very necessary to learn more about it.

1 Alanine aminotransferase (ALT)

Normal reference value: 0-40IU/L

Clinical significance: It is of great significance for the diagnosis of liver parenchymal lesions and the observation of disease course changes.

Note: Blood should be collected on an empty stomach and the specimen should avoid hemolysis. Severe jaundice and turbid serum may also increase the result. Serum should not be frozen.

2Aspartate aminotransferase (AST)

Normal reference value: 0-40IU/L

Clinical significance: Increased during acute myocardial infarction. It also often rises in cases of liver disease and other organ inflammation.

Note: The specimen should avoid hemolysis and serum should not be frozen.

3Total Protein (TP)

Normal reference value: 60-85g/L

Clinical significance: Understand the general situation of protein metabolism in the body. It has certain diagnostic and differential significance for liver and kidney damage, multiple myeloma, etc. Elevated total protein is often caused by blood concentration due to severe dehydration, shock, chronic adrenocortical insufficiency, etc.; decreased total protein is often caused by malnutrition and increased consumption (such as severe tuberculosis, hyperthyroidism, malignant tumors and chronic intestinal diseases), synthesis disorders (such as cirrhosis) and protein loss (such as nephrotic syndrome, ulcerative colitis, burns and blood loss).

Note: Blood should be collected on an empty stomach and the specimen should avoid hemolysis.

4. Albumin (ALB)

Normal reference value: 35-55g/L

Clinical significance: Albumin has a wide range of physiological functions, including nutritional value; maintenance of effective colloid osmotic pressure; transport of serum calcium, unconjugated bilirubin, free fatty acids, drugs, and thyroid hormones. The multiple physiological functions of albumin make it an important indicator for detecting liver diseases. Increased albumin is common in severe water loss, which leads to plasma concentration and increased albumin concentration. The decrease in albumin is basically the same as the total protein, especially in liver and kidney diseases.

Note: Blood should be collected on an empty stomach and the specimen should avoid hemolysis.

5. Globulin (GLB)

Normal reference value: 20-30g/L

Clinical significance: Elevated globulin is common in cirrhosis, lupus erythematosus, scleroderma, rheumatism and rheumatoid arthritis, tuberculosis, malaria, kala-azar, schistosomiasis, leprosy, myeloma, lymphoma, etc. Decreased globulin levels are common in patients with physiological hypoglobulinemia (infants), hyperadrenocortical function, and congenital immune deficiency, where globulin synthesis in the body is reduced.

6. Albumin/globulin ratio (A/G)

Normal reference value: 1.5-2.5:1

Clinical significance: When the albumin:globulin ratio is less than 1, it is called an inverted A/G ratio, which is commonly seen in nephrotic syndrome, chronic hepatitis, and cirrhosis.

7Total bilirubin (TBIL)

Normal reference value: 3.42-20.5μmol/L

Clinical significance: Due to the close relationship between bilirubin metabolism and liver function, it has always been used as an important routine liver function indicator.

Causes of jaundice:

① Excessive bilirubin formation, such as congenital hereditary defects of red blood cell membranes, enzymes or hemoglobin; acquired sepsis, hypersplenism; hematopoietic system dysfunction, such as pernicious anemia and lead poisoning.

② Decreased liver cell processing capacity, such as physiological jaundice of newborns, drug-induced jaundice, intrahepatic stasis jaundice, metabolic disorders and liver diseases caused by tumors.

③Excretion disorder of hepatocytes outside the liver. Biliary obstruction caused by stones, tumors, stenosis, inflammation, parasites, etc.

8 Direct bilirubin (DBIL)

Normal reference value: 0-6.84μmol/L

Clinical significance: Direct bilirubin is important in diagnosing and differentiating the types of jaundice. In hemolytic jaundice, total bilirubin is elevated, while direct bilirubin is normal or slightly elevated. In hepatocellular jaundice, both total and direct bilirubin are elevated. In obstructive jaundice, both total and direct bilirubin are elevated. Elevated direct bilirubin may also be seen in liver cancer, pancreatic head cancer, cholelithiasis, etc.

Note:

① Take blood on an empty stomach and measure as soon as possible after taking blood;

② Bilirubin is light-sensitive, so the specimen should be kept away from light as much as possible;

③Severe hemolysis will cause the test results to be low.