肝脏疾病的实验室检查ppt课件

,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,肝脏疾病的实验室检查,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,肝脏疾病的实验室检查,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,肝脏疾病的实验室检查,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,肝脏疾病的实验室检查,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,肝脏疾病的实验室检查,*,肝脏疾病的实验室检查,LABORATORY EXAMINATION OF LIVER DISEASE,肝脏疾病的实验室检查,1,肝脏疾病的实验室检查LABORATORY EXAMINATI,Emphasis,To understand:,The function of the liver,The classification of jaundice,The laboratory assessment of liver disease,肝脏疾病的实验室检查,2,EmphasisTo understand:肝脏疾病的实验室,The function of the liver,肝脏疾病的实验室检查,3,The function of the liver肝脏疾病的,Carbohydrate metabolism:,Synthesis and storage of glycogen,Glycogenolysis and gluconeogenesis,Protein metabolism:,Synthesis and degradation of proteins ( not immunoglobulins),Amino acid metabolism and urea formation,Lipid metabolism:,Synthesis of lipoproteins, phospholipids, cholesterol,Fatty acid metabolism,Bile acid synthesis,肝脏疾病的实验室检查,4,Carbohydrate metabolism:肝脏疾病的实,Excretion and detoxification:,Bilirubin and bile acid excretion,Drug detoxification and excretion,Steroid hormone inactivation and excretion,Miscellaneous:,Iron storage,Vitamin A, D, E, B,12,storage and metabolism,肝脏疾病的实验室检查,5,Excretion and detoxification:肝,肝脏病常用的实验室检查,肝脏的基本功能,一,.,碳水化合物的代谢,1.,糖原的合成和储存,2.,糖原的分解和糖异生,二,.,蛋白质的代谢,1.,蛋白质的合成和降解,2.,氨基酸的代谢和尿素的生成,三,.,脂类代谢,1.,脂蛋白,磷脂和胆固醇的合成,2.,脂肪酸的代谢,3.,胆汁酸的代谢,四,.,生物转化,分泌和排泄,1.,胆红素和胆汁酸的排泌,2.,药物的解毒和排泌,3.,激素的灭活和排泌,五,.,其他,1.,铁储存,2.,维生素,A,D,E,B,12,的储存和代谢,肝脏疾病的实验室检查,6,肝脏病常用的实验室检查肝脏的基本功能一.碳水化合物的代谢肝,Laboratory investigation of liver diseases,肝脏疾病的实验室检查,7,Laboratory investigation of l,Laboratory investigation:,Routine liver function tests,True liver function tests,Special tests,肝脏疾病的实验室检查,8,Laboratory investigation:Routi,Routine,liver function tests,Bilirubins,Total protein,Albumin,Transaminases,Alkaline phosphatase,-glutamyltransferase,Bile acid levels,肝脏疾病的实验室检查,9,Routineliver function testsB,True,liver function tests:,Bilirubin,Albumin,Bile acid levels,Bromosulfophthalein(,四溴酚酞磺酸钠,),excretion test,Coagulation studies,blood ammonia,肝脏疾病的实验室检查,10,True liver function tests:Bi,Special tests:,1,-antitrypsin,-fetoprotein,Hepatitis markers,Specific autoantibodies,Immunoglobulins,Caeruloplasmin,(,铜蓝蛋白,),ferritin,肝脏疾病的实验室检查,11,Special tests: 1-antitrypsin肝,肝脏病常用的实验室检查,一,.,常规肝功能实验,1.,胆红素,2.,总蛋白,3.,白蛋白,4.,转氨酶,5.,碱性磷酸酶,6.,r,-,谷氨酰转移酶,二,.“,真正的”肝功能实验,1.,四溴酚酞磺酸钠或靛氰绿排泌实验,2.,血浆胆汁酸浓度,3.,凝血研究,4.,血氨,5.,胆红素,6.,白蛋白,三,.,特殊实验,1.,抗胰蛋白酶,2.,甲胎蛋白,3.,肝炎标志物,4.,特异性自身抗体,5.,免疫球蛋白,6.,铜蓝蛋白,7.,铁蛋白,肝脏疾病的实验室检查,12,肝脏病常用的实验室检查一.常规肝功能实验肝脏疾病的实验室检查,肝脏病常用的实验室检查,目的,:,1.,了解肝细胞有无损伤以及损伤程度,2.,对肝胆系统疾病进行病原、病种、病型的诊断,3.,对肝脏功能状态作动态比较,观察疗效及估计预后,4.,手术前的准备和用药监护,评价肝脏的储备功能,5.,健康普查,肝脏疾病的实验室检查,13,肝脏病常用的实验室检查目的:1.了解肝细胞有无损伤以及损伤,BILIRUBIN METABOLISM,肝脏疾病的实验室检查,14,BILIRUBIN METABOLISM肝脏疾病的实验,1.,Production2. Transport to the liver3. Hepatocyte uptake4. Conjugation5. Biliary secretion6. Gut degradation and excretion,肝脏疾病的实验室检查,15,1. Production2. Transport,胆红素的代谢过程,肝脏疾病的实验室检查,16,胆红素的代谢过程肝脏疾病的实验室检查16,Classification of bilirubin (HPLC),1.,(Alpha)fraction bilirubin: unconjugated bilirubin+albumin,free bilirubin-kernicterus,2.,(Beta)fraction bilirubin: monoconjugated bilirubin,3.,(Gamma)fraction bilirubin: biconjugated bilirubin,4.,(Delta)fraction bilirubin: conjugated bilirubin+albumin,肝脏疾病的实验室检查,17,Classification of bilirubin (H,Classification of jaundice,Pre-hepatic : liver diseases not present,Hepatic : hepatocellular disease,Posthepatic : cholestasis (obstruction),肝脏疾病的实验室检查,18,Classification of jaundicePre-,溶血性黄疸时的胆红素代谢,肝脏疾病的实验室检查,19,溶血性黄疸时的胆红素代谢肝脏疾病的实验室检查19,肝细胞性黄疸时的胆红素代谢,肝脏疾病的实验室检查,20,肝细胞性黄疸时的胆红素代谢肝脏疾病的实验室检查20,梗阻性黄疸时的胆红素代谢,肝脏疾病的实验室检查,21,梗阻性黄疸时的胆红素代谢肝脏疾病的实验室检查21,Laboratory findings in different types jaundices,Serum total bilirubin(,mol/L),Examination of urine,direct,indirect,urobilinogen,bilirubin,Normal subjects,Hemolytic jaundice,Hepatocellular jaundice,Obstruct jaundice,0,6.8,High,High,High,1.7,13.7,High,High,High,Normal,High,High,down,Negative,Negative,positive,Strongly positive,肝脏疾病的实验室检查,22,Laboratory findings in differe,Case example,Spherocytosis in a female aged 16 years, patient was jaundiced, with enlargment of the spleen, bilirubin was not in the urine.,Total Bili,54,mol/L,(20),Direct Bili,10,mol/L,(10),Alb,40,g/L,(30,50),ALT,14,U/L,(35),ALP,106,U/L,(30,120),肝脏疾病的实验室检查,23,Case exampleTotal Bili54mol/L,Pre-hepatic,：,liver diseases not present,When the liver is presented with bilirubin in an amount that exceeds the conjugating mechanism,1.increased bilirubin production,Haemolysis,2.congenital hyperbilirubinaemia,Ineffective erythropoiesis,Gilberts syndrome,肝脏疾病的实验室检查,24,Pre-hepatic：liver diseases not,Case example,An 11-year-old boy was jaundiced and generally unwell. his urine, which become dark the day before the onset of jaundice, was positive for bilirubin.,Total Bili,85,mol/L,(20),Direct Bili,25,mol/L,(10),TP,78,g/L,(60,80),Alb,41,g/L,(30,50),ALT,3140,U/L,(35),ALP,144,U/L,(30,120),肝脏疾病的实验室检查,25,Case exampleTotal Bili85mol/L,Hepatic,：,hepatocellular disease,When the causal abnormality is in the liver,1.hepatitis,acute: viral,hepatotoxins,chronic: chronic active,chronic persistent,2.Intra-hepatic cholestasis,Cirrhosis,space occupying lesions,3.congenital hyperbilirubinaemia,Dubin-Johnson syndrome,Rotor syndrome,肝脏疾病的实验室检查,26,Hepatic：hepatocellular disease,Case example,A 45-year-old female with a past history of cholelithiasis, now presenting with right upper abdominal pain. At operation several stones were removed from the common bile duct.,Total Bili,139,mol/L,(20),Direct Bili,75,mol/L,(10),TP,77,g/L,(60,80),Alb,41,g/L,(30,50),ALT,35,U/L,(35),ALP,550,U/L,(30,120),肝脏疾病的实验室检查,27,Case exampleTotal Bili139mol/,Posthepatic :cholestasis (obstruction),When there is obstruction to the biliary system,1.extrahepatic,cholelithiasis,胆石症,tumours,stricture,狭窄,biliary atresia,闭锁,cholangitis,胆管炎,2.intrahepatic,viral hepatitis,drugs,infiltrations,浸润,cirrhosis,cholangitis,biliary atresia,肝脏疾病的实验室检查,28,Posthepatic :cholestasis (obs,Laboratory findings in different types jaundices,Serum total bilirubin(,mol/L),Examination of urine,direct,indirect,urobilinogen,bilirubin,Normal subjects,Hemolytic jaundice,Hepatocellular jaundice,Obstruct jaundice,0,6.8,High,High,High,1.7,13.7,High,High,High,Normal,High,High,down,Negative,Negative,positive,Strongly positive,肝脏疾病的实验室检查,29,Laboratory findings in differe,ENZYMES,肝脏疾病的实验室检查,30,ENZYMES 肝脏疾病的实验室检查30,血清酶及同功酶检查,肝细胞内酶的定位,肝脏疾病的实验室检查,31,血清酶及同功酶检查肝脏疾病的实验室检查31,血清酶及同功酶检查,肝脏酶的器官定位,酶,存在浓度较高的器官,肝细胞与血浆相对比值,AST,ALT,LDH,ALP,GGT,心脏,肝脏,肌肉,肾,肝脏,肾,肝脏,红细胞,心脏,肌肉,白细胞,肿瘤,肝脏,骨,肠道,胎盘,肝脏,胰腺,肾脏,前列腺,7800,2850,150,正常,/,异常,正常,/,异常,肝脏疾病的实验室检查,32,血清酶及同功酶检查酶存在浓度较高的器官肝细胞与,Alkaline phosphatase,(ALP),肝脏疾病的实验室检查,33,Alkaline phosphatase肝脏疾病的实验室检查,Alkaline phosphatase,1. Tissue non-specific protein,2. Intestinal protein,3. Placental protein,4. placental-like protein,肝脏疾病的实验室检查,34,Alkaline phosphatase1. Tissue,Alkaline phosphatase,Typical RIs for ALP activity,New born,1 month,1 month,3 years,3,16years,16,60years,Pregnancy,(3rd,trimester,),30,100U/L,70,250U/L,70,220U/L,70,350U/L,30,120U/L,50,250U/L,肝脏疾病的实验室检查,35,Alkaline phosphataseNew born30,Alkaline phosphatase,Serum ALP activity is raised in:,1. physiological: children/teenagers, pregnancy,2. Liver disease: cholestasis,3. Bone disease: Pagets disease,Hyperparathyroidism, osteomalasia (,骨软化）, malignancy,4. malignancy: bronchus, gut, testes,5. other: transient hyperphosphatasaemia of infancy,肝脏疾病的实验室检查,36,Alkaline phosphataseSerum ALP,碱性磷酸酶,原理,碱性磷酸酶存在于细胞表面，梗阻和药物直接引起的反应损害胆小管，引起细胞膜破裂溶解，导致碱性磷酸酶在到达高峰前几天逐渐上升，升高程度与梗阻期限正相关。,参考值,连续监测法：成人,40-100U/L,，儿童,250U/L,临床意义,1,、肝胆系统疾病,2,、黄疸的鉴别诊断,3,、骨骼疾病,4,、生长中儿童、妊娠中晚期血清,ALP,生理性升高。,5,、其他,6,、碱性磷酸酶的活性需要阳离子（锌、镁等），输血和,EDTA,抗凝可引起假性碱性磷酸酶降低。,肝脏疾病的实验室检查,37,碱性磷酸酶肝脏疾病的实验室检查37,Case example,A 26-year-old woman with jaundice, and a dark urine.,ALT,1495,U/L,(50),ALP,242,U/L,(30,120),Total bili,89,mol/L,(20),TP,75,g/L,(60,80),Alb,42,g/L,(30,50),Glob,33,g/L,(25,35),肝脏疾病的实验室检查,38,Case exampleALT 1495U/L(50)AL,Case example,A 61-year-old woman with advanced carcinoma of the breast, and radiological evidence of metastatic liver disease.,ALT,30,U/L,(50),ALP,637,U/L,(30,120),-GT,599,U/L,(30),Ca,2.27,mmol/L,(2.15,2.55),Total bili,13,mol/L,(20),TP,70,g/L,(60,80),Alb,37,g/L,(30,50),Glob,33,g/L,(25,35),肝脏疾病的实验室检查,39,Case exampleALT 30U/L(50)ALP6,Case example,A 51-year-old woman presenting with deep jaundice, biliary colic and a history of cholelithiasis.,ALT,181,U/L,(50),ALP,1075,U/L,(30,120),Total bili,340,mol/L,(20),TP,69,g/L,(60,80),Alb,36,g/L,(30,50),Glob,33,g/L,(25,35),肝脏疾病的实验室检查,40,Case exampleALT 181U/L(50)ALP,-glutamyl,transpeptidase,（,-glutamyltransferase,）,肝脏疾病的实验室检查,41,-glutamyl transpeptidase肝脏疾病的,原理,在肝脏，,GGT,存在于胆小管的表面和微粒体内，胆小管损伤和暴露于微粒体酶诱导剂（如乙醇，甲氰咪胍，巴比妥酸盐等）后，,GGT,升高。,参考值,连续监测法：,50U/L,临床意义,1,、胆道阻塞性疾病,2,、急,、,慢性病毒性肝炎、肝硬化,3,、急慢性酒精性肝炎、药物性肝炎,4,、其他,肝脏疾病的实验室检查,42,原理在肝脏，GGT存在于胆小管的表面和微粒体内，胆小管,Case example,A 78-year-old woman with advanced carcinoma that has metastasized to the liver.,ALT,134,U/L,(50),ALP,806,U/L,(30,120),-GT,3130,U/L,(30),Ca,2.47,mmol/L,(2.15,2.55),Total bili,42,mol/L,(20),TP,65,g/L,(60,80),Alb,32,g/L,(30,50),Glob,33,g/L,(25,35),肝脏疾病的实验室检查,43,Case exampleALT 134U/L(50)ALP,Case example,Acute infectious hepatitis in a 25-year-old man.,ALT,1050,U/L,(50),ALP,150,U/L,(30,120),-GT,65,U/L,(30),Total bili,200,mol/L,(20),肝脏疾病的实验室检查,44,Case exampleALT 1050U/L(50)AL,Case example,The following results were obtained from three male heavy drinkers aged in their early thirties.,A,B,C,ALT,33,113,31,U/L,(50),AST,24,33,40,U/L,(25),-GT,86,148,342,U/L,(30),肝脏疾病的实验室检查,45,Case exampleABCALT 3311331U/L(,Transaminases,aspartate aminotransferase alanine aminotransferase,肝脏疾病的实验室检查,46,Transaminasesaspartate aminotr,Determination of serum enzymes and isoenzymes,relative activity of ALT and AST in human tissue,organ or tissue,ALT,AST,heart,liver,skeletal muscle,kidney,pancreas,spleen,lungs,erythrocytes,serum,450,2850,300,1200,130,80,45,7,1,7800,7100,5000,4500,1400,700,500,15,1,肝脏疾病的实验室检查,47,Determination of serum enzymes,血清氨基转移酶,及同功酶检查,包括,丙氨酸氨基转移酶,及,天门冬氨酸氨基转移酶, ,谷丙转氨酶,（,ALT,，,GPT,）,谷草转氨酶,（,AST,，,GOT,）,参考值,比色法（,Karmen,法） 连续监测法,ALT 5-25,卡门氏单位,10-40U/L,AST 8-28,卡门氏单位,10-40U/L,肝脏疾病的实验室检查,48,血清氨基转移酶及同功酶检查包括丙氨酸氨基转移酶及天门冬氨酸氨,血清氨基转移酶及同功酶检查,临床意义,（,1,）急性病毒性肝炎，二者均显著升高。,（,2,）慢性病毒性肝炎，转氨酶轻度上升或正常。,（,3,）酒精性肝病、药物性肝炎、脂肪肝、肝癌等非病毒性肝,炎,转氨酶轻度上升或正常。,（,4,）肝硬化，转氨酶活性取决于肝细胞进行性坏死程度。,（,5,）肝内外胆汁淤积，转氨酶轻度上升或正常。,（,6,）急性心肌梗塞后,6-8,小时，,AST,增高,18-24,小时达高峰。,肝脏疾病的实验室检查,49,血清氨基转移酶及同功酶检查临床意义肝脏疾病的实验室,Case example,Anicteric hepatitis,A 15-year-old girl complaining of an influenza-like illness. She attended a boarding school where an outbreak of hepatitis had recently occurred. There was no bilirubin in her urine.,ALT,325,U/L,(50),ALP,118,U/L,(30,120),Total bili,17,mol/L,(20),TP,65,g/L,(60,80),Alb,39,g/L,(30,50),Glob,26,g/L,(25,35),肝脏疾病的实验室检查,50,Case exampleALT 325U/L(50)ALP,Case example,Cholestatic acute hepatitis,A 35-year-old male, recently returned from south-east Asia, presented with 5 days of increasing jaundice.,ALT,1640,U/L,(50),ALP,500,U/L,(30,120),Total bili,220,mol/L,(20),TP,66,g/L,(60,80),Alb,37,g/L,(30,50),Glob,29,g/L,(25,35),肝脏疾病的实验室检查,51,Case exampleALT 1640U/L(50)AL,Case example,Chronic active hepatitis,A 36-year-old woman who had hepatitis 9 months before. The condition had not settled and she was admitted for further investigation.,ALT,350,U/L,(50),ALP,400,U/L,(30,120),Total bili,45,mol/L,(20),TP,113,g/L,(60,80),Alb,30,g/L,(30,50),Glob,83,g/L,(25,35),肝脏疾病的实验室检查,52,Case exampleALT 350U/L(50)ALP,Chronic active hepatitis,Chronic persistent hepatitis,ALT,Glob,Alb,2,10 times normal,Increased,Hypoalbuminaemia,2 times normal,Normal,Normal,肝脏疾病的实验室检查,53,Chronic active hepatitisChroni,PROTEIN METABOLISM,肝脏疾病的实验室检查,54,PROTEIN METABOLISM肝脏疾病的实验室,Hyperproteinaemia,1.Haemoconcentration,Dehydration,Venous stasis,2.Hypergammaglobulinaemia,polyclonal,Chronic infection,Chronic liver disease,Autoimmune disease,Sarcoidosis (,肉状瘤病,), monoclonal,Myelomatosis (,骨髓瘤病,),Waldenstrms macroglobulinaemia,Benign,肝脏疾病的实验室检查,55,Hyperproteinaemia1.Haemoconcen,蛋白质代谢功能检查,参考值：成人血清总蛋白,60-80g/L,，白蛋白,40-55 g/L,，球蛋白,20-30 g/L,，,A/G,为,1.5-2.5:1,临床意义,:,1,、血清总蛋白及白蛋白增高：急性失水、肾上腺皮质功能减退。,2,、,血清总蛋白及球蛋白增高,（,1,）慢性肝脏疾病,（,2,）,M,蛋白血症,（,3,）自身免疫性疾病,（,4,）慢性炎症与慢性感染,3,、,A/G,倒置：严重肝功能损伤,肝脏疾病的实验室检查,56,蛋白质代谢功能检查肝脏疾病的实验室检查56,Case example,A 23-year-old woman admitted unconscious with diabetic ketoacidosis. examination found poor skin turgor, dry mouth.,Na,136,mmol/L,(132,144),tCO,2,8,mmol/L,(23,33),TP,96,g/L,(60,80),Alb,55,g/L,(30,50),Glob,41,g/L,(25,35),Glu,23.0,mmol/L,(3.0,5.5),Crea,310,mol/L,(60,120),肝脏疾病的实验室检查,57,Case exampleNa 136mmol/L(1321,Case example,A 42-year-old woman diagnosed as having chronic active hepatitis.,Total Bili,12,mol/L,(20),Direct Bili,3.6,mol/L,(10),TP,93,g/L,(60,80),Alb,36,g/L,(30,50),Glob,57,g/L,(25,35),ALT,248,U/L,(130,mmol/L,(96,110),TP,39,g/L,(60,80),Alb,11,g/L,(30,50),Glob,28,g/L,(25,35),肝脏疾病的实验室检查,62,Case exampleNa 150mmol/L(1321,Case example,A 44-year-old man with advanced liver disease.,ALT,61,U/L,(50),ALP,555,U/L,(30,120),Total bili,128,mol/L,(20),TP,54,g/L,(60,80),Alb,19,g/L,(30,50),Glob,35,g/L,(25,35),肝脏疾病的实验室检查,63,Case exampleALT 61U/L(50)ALP5,胆汁酸代谢检查,原理：胆固醇 胆酸 脱氧胆酸,鹅脱氧胆酸 石胆酸,熊脱氧胆酸,初级胆酸,次级胆酸,生理作用：,1.,对胆汁分泌的影响：促进水和溶质排出，维持胆固醇和卵磷脂排泌,2.,对胆固醇代谢的影响：,1/3,胆固醇分解代谢，保持胆固醇的溶解性，调节,肝肠对胆固醇的合成。,3.,在脂肪的吸收，转运，分解代谢方面起重要作用：提高脂类的溶解度，促,进脂肪乳化，增强胰腺脂解作用，促进脂类吸收。,肝脏疾病的实验室检查,64,胆汁酸代谢检查肝脏疾病的实验室检查64,胆汁,-,回肠,-,门静脉,-,肝脏,80,90%,一次性清除，一次进餐后胆汁酸经历,2,4,次肠肝循环，一般,1,2,小时血清水平是空腹的,2,倍左右，,参考值：,总胆汁酸（酶法）,0-10 umol/L,临床意义：,1,、肝细胞功能损害,2,、胆道梗阻,3,、门脉分流,4,、进食后血清胆汁酸可一过性增高,肝脏疾病的实验室检查,65,胆汁-回肠-门静脉-肝脏肝脏疾病的实验室检查65,肝脏纤维化的检查,发生：,1.,肝细胞分泌,，,，,，,型胶原，蛋白多糖,2.,储脂细胞分泌,，,，,型胶原，蛋白多糖，层连蛋白,3.,血窦内皮细胞分泌,型胶原，纤维连结蛋白,4.,枯否细胞分泌胶原酶,指标,：,1.,透明质酸（,hyaluronic acid),2. ,型前胶原氨基端肽（,procollagen, N terminal peptide),3. ,型胶原,(collagen ),4.,层粘连蛋白,(laminin),肝脏疾病的实验室检查,66,肝脏纤维化的检查肝脏疾病的实验室检查66,DISORDERS OF THE LIVER,肝脏疾病的实验室检查,67,DISORDERS OF THE LIVER肝脏疾病的实验室,Congenital,Gilberts disease,Crigler-Najjar syndrome,Dubin-Johnson syndrome,Rotor syndrome,Hepatitis,Acute,Chronic,Cholestasis,Extrahepatic,Intrahepatic,Cirrhosis,Anoxia,缺氧症,Infiltration,Drug toxicity,肝脏疾病的实验室检查,68,Congenital 肝脏疾病的实验室检查68,项目,英文名,结果,单位,参考值,标志,1.,谷草转氨酶,2.,谷丙转氨酶,3.,谷草,/,谷丙,4.,谷氨酰转移酶,5.,碱性磷酸酶,6.,总蛋白,7.,白蛋白,8.,球蛋白,9.,白,/,球蛋白,10.,总胆红素,11.,直接胆红素,12.,间接胆红素,13.,总胆汁酸,AST,ALT,AST/ALT,GGT,ALP,TP,ALB,GLO,A/G,TBIL,DBIL,IBIL,TBA,85,73,1.16,178,150,62.3,31.9,30.4,1.05,22.8,7.3,15.5,26.2,U/L,U/L,U/L,U/L,g/L,g/L,g/L,mol/L,mol/L,mol/L,mol/L,10-42,10-60,8-58,37-140,60-83,35-55,16-35,1-2.5,1.71-20.50,0.1-3.42,1.61-20.4,0.0-20,肝脏疾病的实验室检查,69,项目英文名结果单位参考值标志1.谷草转氨酶AS,