Othmani Salah, Bahri Meriem, Bahri Mohamed
Service de médecine interne Hôpital Principal d'Instruction de Tunis, Tunisie.
Tunis Med. 2002 May;80(5):236-44.
Raised serum level of transaminases aspartate (aminotransferase and alanine aminotransferase) is a frequent situation in medical practice. It is considered as moderate when the level is under 10 times normal and as chronic when it lasts for more than 6 months. The most common etiologies for chronically elevated transaminases are alcohol use, viral hepatitis, liver steatosis, diabetes, obesity and medications. Many non invasive tests, including history, physical examination, blood tests (markers for hepatitis A and B, muscular enzymes), and imaging procedures (abdominal ultrasonography) are usually done and lead to a correct diagnosis in 80% of patients. When the diagnosis cannot be determined non invasively a liver biopsy is recommended in order to make diagnosis, to evaluate the prognosis and to start an adapted treatment.
血清中天冬氨酸转氨酶和丙氨酸转氨酶水平升高在医疗实践中是常见情况。当该水平低于正常上限10倍时被视为中度升高,持续超过6个月则被视为慢性升高。慢性转氨酶升高最常见的病因包括饮酒、病毒性肝炎、肝脂肪变性、糖尿病、肥胖和药物。通常会进行许多非侵入性检查,包括病史、体格检查、血液检查(甲型和乙型肝炎标志物、肌肉酶)以及影像学检查(腹部超声),80%的患者可借此得到正确诊断。当无法通过非侵入性检查确定诊断时,建议进行肝活检以明确诊断、评估预后并开始适当治疗。