Blood chemistry. ALT and AST: decoding of indicators

Alanine aminotransferase, or ALT, and aspartate aminotransferase, or AST, are enzymes that are contained in the cells of the body and which participate in the amino acid exchange. They are located only in the cells of the tissues of organs, and enter the blood only when the cell disintegrates with traumatic injuries or pathologies.

Types of diseases

Excessive content of ALT indicates the development of organ pathology, in cells of which there is its largest number. The causes of increased alanine aminotransferase are liver pathologies. Feeling of discomfort and painful sensation in the right hypochondrium, diarrhea, icteric staining of the skin and mucous membranes, flatulence, belching bitter - these are signs of an increase in ALT. When carrying out a blood test for increased ALT and AST, an increase in the level of bilirubin is added when there is a development of hepatitis. More often the increase in the content of ALT indicates the occurrence of other diseases. The concentration of ALT is directly dependent on the degree of severity of the pathology.

Necrotic process in the heart muscle causes the release of these enzymes into the blood. Their increased content in the serum also indicates the development of other cardiopathologies: insufficiency, inflammation of the heart muscle. In addition, the reasons for increasing serum ALT concentration can be the injuries in the body, which involve damage to muscle tissue, and pancreatitis.

Biochemical analysis of blood on ALT and AST can talk about the pathology of the liver, pancreas, heart. With cardioinfarction, the concentration of AST increases several times, and ALT - a little.

Indications for conduction

The organs of the human body contain different amounts of ALT and AST enzymes, so increasing the concentration of a certain enzyme indicates the defeat of a particular organ:

• ALT is mainly found in the liver, heart, kidney and pancreatic cells. In case of destruction of these organs, a lot of ALT is released into the blood. Then, to confirm the diagnosis, it is necessary to study specifically for alanine aminotransferase.

• ACT is mainly found in the nerve, muscle, liver and heart cells, and in small numbers in cells of the pancreas, pulmonary and renal tissues. Therefore, in this case, research on aspartate aminotransferase is necessary.

The analysis of blood ALT and AST (decoding) indicates the state of organs. Increasing them indicates damage to the tissues of the organs in which these enzymes are located. And, accordingly, the decrease indicates a cure. A slight increase in ALT in the first trimester of pregnancy is entirely acceptable, but it is necessary to re-examine the blood for aminotransferases to exclude liver damage.

Biochemical blood test ( ALT, AST) is prescribed when a cardioinfarct is suspected, they serve as an early sign in this acute pathology. Decoding of AST in biochemical analysis makes it possible to diagnose and monitor the dynamics of other changes in the heart muscle, liver diseases and diseases of the striated muscle.

Preparation for blood sampling for the study

Blood for biochemical analysis is taken in the morning on an empty stomach from the vein. At the time of the analysis, it should be 8 hours. From the last use of food. For 24 hours. Before taking blood, alcohol and fried and fatty foods are not allowed. It is recommended to reduce the customs clearance. Immediately after the ultrasound, radiographic, fluorography, colonoscopy or physiotherapy procedures, blood is also not recommended for analysis, otherwise the decoding of biochemistry will be distorted. For 1-2 weeks. Before the biochemical study you need to stop taking medication. When this condition is not met, a note is made in the direction of the doctor's analysis about taking the drugs and their dose. The biochemical analysis of blood (interpretation of ALT, AST) can be influenced by severe physical activities, as well as alcohol consumption and hemolysis.

Decoding of the blood test - ALT, AST: norm

How many of these enzymes should be contained in the blood of a healthy person? Carrying out a biochemical blood test (decoding ALT, AST), the norm for women is in the range of 31 to 35 units per liter of blood. For the stronger sex, this indicator is slightly different. The norm of ALT in the blood of men (decoding of biochemistry) is from 41 to 50 units / liter. In newborns (up to 1 month) the normal reading corresponds to 75 units, from 2 to 12 months. - no more than 60 units, and from one year to 14 years - less than 45 units. The analysis of blood (interpretation of ALT, AST) with an increased indication may indicate cirrhotic damage or acute inflammation of the liver, congestive or hemolytic jaundice, other liver pathologies (including neoplasms, etc.), angina at the stage of an attack, acute rheumatic carditis, myopathy, bile stasis , Thromboembolic pulmonary artery disease and acute pancreatitis. ALT and AST blood test (transcript) with an increase in indications is observed with traumatic injuries, cardiosurgical intervention or with angiocardiography. The increased AST index 20-50 times in some cases indicates a hepatic pathology accompanied by necrosis, and hepatitis of the viral etiology. The increase in the AST content in 2-5 times can talk about diseases with hemolysis, muscle injuries, acute pancreatitis and gangrene. At dystrophic phenomena in muscles and dermatomyositis, an 8-fold increase in AST is observed.

Ratis coefficient

In order to obtain accurate answers, the blood analysis of ALT and AST (decoding) shows the ratio of transferase rates. This ratio shows the de Ritis coefficient, performed in one serum study. In the case when the number is higher than the norm (N = 1,3), this indicates the presence of cardioinfarction, and when it is below the normative indices - about viral hepatitis.

Since aminotransferases have tissue localization, the interpretation of the AST blood test shows the pathology of the myocardium, and ALT - the pathology of the liver, that is, the presence of cell disintegration:

• When there is an excess of 2 or more times, a heart attack is determined in the heart.

• The blood test of ALT and AST (decoding) shows a significant excess - this is evidence of infectious hepatitis in the incubation period.

• With a decrease in the aminotransferase, there is a lack of pyridoxine in the body. It requires a diffodiagnosis with pregnancy.

Tactics

Normally in the blood serum, transferases exist in small volumes. All options for increasing the level of aminotransferase are mandatory for investigation.

To begin with, a repeated biochemical blood test (decoding ALT, AST) should be performed. A re-examination of some individuals (donors) in about a third of cases shows a normal level.

Next, you need to carefully collect the anamnesis and conduct a complete examination.

The role of anamnesis in carrying out the transcript

Anamnesis includes information about taking medications, blood transfusion, the presence of jaundice or hepatitis syndrome, family liver disease or the presence of a cirrhotic process in it, abdominal pain, cancer, diabetes, obesity or, conversely, rapid weight loss.

Family liver disease - it's alcohol dependence, Wilson's disease, etc.

If ALT and AST blood test (decoding) showed above normal parameters less than twice, it is necessary to organize observation and 2-fold examination. Such tactics are optimal for patients.

The analysis of blood ALT and AST - decoding with some diseases

A slight increase in transferases is indicative for non-alcoholic fatty liver damage, including "fatty liver", non-alcoholic steatohepatosis, viral hepatitis in chronic form.

Moderate increase can exist with viral or alcoholic inflammation of the liver and various chronic liver diseases with or without cirrhotic damage.

The elevated level is typical for acute hepatitis of severe degree, toxic or drug necrosis, shock or hepatic ischemia.

An excessively high level (more than 2000-3000 U / l) exists when acetaminophen is overdosed and when using the drug in alcohol dependent patients, with shock and / or hepatic ischemia.

It should be noted, since ALT is in the erythrocytes, it is necessary to prevent their disintegration when preparing the serum for analysis. ALT can decrease when storing the serum for several days.

The role of medical devices, herbs and other substances

Careful collection of anamnesis and interpretation of laboratory results are important for the detection of drug-induced increases in transferases. Similar liver damage is detected in 1-2% of cases of liver inflammation in chronic form. They are associated with the use of antibiotics, antiepileptic drugs, hydroxymethylglutaryl-CoA reductase inhibitors, non-steroidal anti-inflammatory drugs and medicines for the treatment of tuberculosis.

The easiest method to determine the dependence of the increase in aminotransferases with a certain remedy is to abolish it and observe the level of enzymes. Without the cancellation of funds, this dependence can not be determined.