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The evaluation items mainly include:
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1. series of liver function indicators: alanine aminotransferase (alt), aspartate aminotransferase (ast), cholinesterase (che), transpeptidase (ggt), albumin (alb), globulin (glo), serum total bilirubin (tbil), direct bilirubin (dbil), prothrombin activity (pa), etc. According to the above indicators, we can comprehensively judge what stage the disease is in, whether it is mild or severe.
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2. Blood routine includes white blood cells, red blood cells, hemoglobin, platelets, etc. Once the disease enters the stage of cirrhosis, the change of hemogram can often indicate the severity of the disease. For example, in the early stage of liver cirrhosis, platelets decreased slightly; In the middle and late stage of liver cirrhosis, hypersplenism and whole blood decline; If it is only hemoglobin reduction, we should pay attention to whether there is gastrointestinal bleeding.
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3. Alpha-fetoprotein (afp) AFP in general hepatitis rarely rises, even if it rises, it rarely exceeds 200 nanograms. However, alpha-fetoprotein in liver cancer is often greater than 400 nanograms. If alpha-fetoprotein continues to decrease and remains above 400 ng, we should pay attention to the possibility of liver cancer.
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4.b-ultrasound Through regular examination of B-ultrasound, we can know the size, shape, echo, inner diameter of portal vein, thickness of spleen and whether there is ascites, and we can judge whether the disease changes to cirrhosis and whether there are space-occupying lesions.
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5. Gastroscope When it is impossible to judge whether there is cirrhosis according to the examination results, you can do a gastroscope to understand the esophageal mucosa, varicose veins around the esophagus, and varicose veins at the bottom of the stomach. If there are varicose veins, it means that cirrhosis has occurred.
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6. Liver fibrosis indicators: Blood tests of serum type ⅲ procollagen, laminin, hyaluronic acid, type ⅳ collagen, etc. The degree of hepatic fibrosis can be preliminarily judged.
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7.HBV virological indicators include HBV "two halves" and HBV dna. Understand the replication and infectivity of the virus.
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8. Blood sugar, urine sugar, urine routine, etc. To know whether there are hepatitis B-related diseases, such as hepatogenic diabetes and hepatitis B virus-related nephritis.
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9. Liver biopsy When other means and detection methods are unclear or suspicious of the severity of the disease, liver biopsy can be performed, which is helpful for diagnosis.
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Not every patient needs the above examination. Generally speaking, only a series of liver function tests can be performed routinely, and more tests are needed only in serious cases such as liver cirrhosis and liver cancer.