Alvarez Lucia, Whittemore Jacqueline
University of Tennessee, USA.
Compend Contin Educ Vet. 2009 Sep;31(9):416-8, 420, 422, 424; quiz 425.
Increased liver enzyme activities are sensitive indicators of hepatic disease, but their limited specificity can make their interpretation a challenge. A stepwise approach to diagnosing the source of increased liver enzyme activity involves characterization of the clinical picture, identification of the predominant enzyme activity pattern, elimination of common extrahepatic diseases, and a systematic diagnostic workup for hepatobiliary disease. Comprehensive hepatobiliary testing includes a complete blood count, biochemical profile, and urinalysis; coagulation and liver function tests; abdominal imaging; bile cytology and culture; and liver biopsy for histopathology, culture, and metal analysis.
肝酶活性升高是肝脏疾病的敏感指标，但其特异性有限，这使得对其解读具有挑战性。逐步诊断肝酶活性升高来源的方法包括临床情况的特征描述、主要酶活性模式的识别、常见肝外疾病的排除以及针对肝胆疾病的系统诊断检查。全面的肝胆检查包括全血细胞计数、生化指标、尿液分析；凝血和肝功能检查；腹部影像学检查；胆汁细胞学和培养；以及用于组织病理学、培养和金属分析的肝活检。
