Home Hernias What is ast in a biochemical blood test. A blood test for ast and what does it mean if this indicator is elevated

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What is ast in a biochemical blood test. A blood test for ast and what does it mean if this indicator is elevated

In the course of a preventive examination, monitoring of chronic patients or diagnosing the causes of certain disorders, patients are often prescribed a blood biochemistry test. The content of ALT and AST, the norm of which indicates the absence of severe pathologies of internal organs, is a valuable diagnostic criterion.

What it is

Alanine and aspartate aminotransferase are enzymes that are present in the cells of visceral organs and blood plasma. They take an active part in the exchange of individual amino acids (alanine and aspartic acid). An increase or decrease in ALT and AST in the blood indicates the destruction of functional cells due to a necrotic, cancerous or inflammatory process.

Alanine transferase is found predominantly in hepatocytes (liver cells) and myocardiocytes (heart cells), but is also present in the kidneys, skeletal muscle, and pancreas. Its main function is the transfer of the amino group of alanine acid to ketoglutaric acid with the further formation of pyruvic and glutamic acids, which play an important role in the biochemical reactions of the body.

Aspartic transferase is found in hepatocytes, cardiomyocytes, muscle and kidney tissues, etc. Its function is the formation of aspartate and ketoglutarate by transferring the amino acid group. The metabolism of these acids is necessary for the implementation of the urea cycle and the endogenous formation of glucose.

Aspartic transferase is present in the same tissues as the first enzyme, but due to a different functional purpose, it is found in them at different concentrations. This means that not only the nature of the deviations from the norm, but also the ratio between AST and ALT helps to make a correct diagnosis for violations in biochemistry.

Analysis for AST and ALT is mandatory when checking liver function (liver tests), investigating the causes of dyspepsia, diagnosing the condition of the myocardium, muscle fibers and other internal organs.

Norms and deviations

Norms of ALT and AST in the blood differ depending on gender and age. A change in the normal concentration of enzymes is noted with large sports loads and bearing a child.

Due to the large number of influencing factors, a slight deviation upward or downward from the norm is not a pathology.

In adults

In patients over 18 years of age, AST and ALT are normally:

Alanine aminotransferase: up to 31 U / l in adult women outside the period of bearing a child, up to 32 U / l in pregnant women, up to 45 U / l in men.
Aspartate aminotransferase: up to 31 U / l in non-pregnant women, up to 30 U / l in expectant mothers, up to 47 U / l in men.

Reference values depend on the sensitivity of the laboratory equipment. Normal blood levels of AST and ALT are listed on the test form next to the patient results column.

A valuable diagnostic indicator is the ratio of ALT to AST: normally it is 0.77. More common is the Ritis coefficient, which is the inverse ratio (AST to ALT): its value ranges from 0.88 to 1.72 (1.3 with possible deviations of no more than 0.42).
In other words, ideally, if AST is 1.5 times higher than ALT.

In children

The norm of ALT and AST in the blood of children is determined mainly by their age, and not by gender.

In adolescents over 15 years of age, the norm of aminotransferases gradually comes into line with adult indicators.

Causes and symptoms of an increase

The reason for the abnormal concentration of alanine and aspartic aminotransferases are pathological processes in the internal organs, proceeding with the massive decay of functional cells. The size of the excess of the enzyme content indicates the nature of the course of the disease and the localization of the lesion.

Small deviations in the blood test for ALT and AST are allowed only with normal other blood parameters: urea (2.8-7.2), bilirubin (3.4-17.1), alkaline phosphatase (up to 38 in women, up to 55 in men) and albumin (32-52). They are measured in mmol/l, µmol/l, U/l and g/l, respectively.

Increased only AST

An isolated increase in the blood test for AST is observed under the following conditions:

acute myocardial infarction (increase in enzyme concentration);
myocarditis;
angina pectoris of high severity;
acute heart failure;
rehabilitation after cardiological operations;
recent angiocardiography;
thrombosis of the pulmonary artery;
acute rheumatic heart disease;
cardiomyopathy of various etiologies.

A change in the biochemical index may be accompanied by shortness of breath, chest pain, cyanosis of the lips and other symptoms characteristic of heart pathologies.

In addition, an increase in AST with normal ALT levels may indicate the destruction of muscle mass. The reason for this may be the problem of digestion of proteins, difficulties in obtaining energy. As a result, muscles are destroyed as a source of energy.

Elevated only ALT

A pathological blood test for ALT is observed in diseases such as:

acute and chronic viral hepatitis;
alcoholic and toxic damage to hepatocytes, incl. medications (sulfonamides, antibiotics, NSAIDs, psychotropic drugs, cytostatics, etc.);
oncological processes in the liver;
fatty hepatosis;
pancreatitis;
infectious mononucleosis, complicated by damage to the spleen and liver;
burns;
shock etc.

An isolated increase in the concentration of alanine aminotransferase is observed in rare cases. Most often, in lesions of the liver and other areas with a high concentration of the enzyme, an increase in the content of both transferases is observed with a sharp decrease in the Ritis coefficient.

An increase in ALT may be accompanied by pain in the right and left hypochondrium, a feeling of heaviness in the abdomen, yellowness of the skin and whites of the eyes, darkening of the urine, loss of strength, weakness and dyspeptic symptoms (diarrhea, flatulence, appetite disorders). In the early stages of hepatitis without jaundice, a change in the concentration of the alanine enzyme may be the only sign of the disease.

joint enhancement

A simultaneous increase in ALT and AST is typical for the following conditions:

gestosis of pregnant women;
extensive injuries and inflammatory processes in muscle tissue;
active heavy sports;
diseases of the kidneys, liver and heart.

An increase in the concentration of transaminases can be observed in children and adolescents during the period of active growth.

How to prepare and donate blood

The concentration of liver enzymes can be affected by physical activity, eating, taking medications and other toxic substances (ethanol, nicotine, etc.). To obtain the most reliable result, you should follow the rules of preparation, excluding the influence of these factors.

You need to know how to properly take a blood test for AST and ALT:

within 8 hours before taking the biomaterial (blood from a vein), use only non-carbonated water, exclude meals;
2-3 days before the examination, reduce the intensity of sports activities, exclude strength exercises and avoid stress;
3 days before taking blood, refuse fatty foods, smoked meats, industrially processed meat, fast food and other harmful products;
within a week before the test, refrain from smoking and drinking alcoholic beverages;
for 8-9 days, stop taking dietary supplements and medications (antibiotics, NSAIDs, etc.), if therapy suggests the possibility of a break.

Before taking the biomaterial, you should inform the doctor about medications taken for a long course.

In order to prevent the latent course of diseases, a biochemical blood test must be taken annually during a preventive examination.

How to reduce performance

Depending on the reasons for the increase in ALT and AST in blood tests, the patient may be recommended a diet, correction of the daily routine (excluding heavy physical exertion and bad habits), medication and folk remedies.

A diet with an increased concentration of liver enzymes suggests:

refusal of alcoholic and carbonated drinks, fatty meats, sausages, smoked meats, spicy and fried foods, marinades;
limiting salt intake;
active consumption of plant foods, lean meats and fish, dairy products.

In the treatment of pathologies that cause an increase in the content of enzymes in the blood, the following drugs are used:

antispasmodics (Drotaverine, No-shpa, Spazmalgon);
hepatoprotectors (Heptral, Phosphogliv, Karsil);
enzymatic agents (Creon, Pancreatin, Mezim);
glucocorticosteroids (Prednisolone, Dexamethasone, Hydrocortisone);
antiviral agents (Entecavir, Telaprevir, Sofosbuvir);
interferons (Viferon, Pegasys);
anticoagulants (sodium heparin);
antianginal and antihypertensive drugs (Amlodipine, Timolol, Nitroglycerin);
vitamin complexes (vitamins of groups B, C and E).

For liver pathologies, decoctions of burdock root, immortelle and St. John's wort, as well as milk thistle seeds, are used. If the cause of the increase in transferases is heart disease, the patient is recommended to take an infusion of Adonis.

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A blood test is the main study by which the doctor evaluates the general condition of the patient. One of the key indicators in the analysis is the markers of liver damage ALT and AST. An increase relative to the norm of these indicators often means that diseases are developing in the body that require immediate treatment.

ALT (full name "alanine aminotransferase") is an enzyme, mainly located in the tissues of the liver and kidneys, with the help of which the amino acid alanine is exchanged, immunity is increased, and lymphocytes are intensively produced. ALT.

Like ALT, AST or aspartate aminotransferase is an intracellular enzyme. AST is involved in the transfer of the amino acid aspartate. This is a building protein that is responsible for the synthesis of amino acids. AST is most concentrated in the tissues of the heart, kidneys, muscle and nerve tissues. The activity of aminotransferases accelerates vitamin B6.

During the normal functioning of the body, aminotransferases practically do not enter the bloodstream. An increase in performance occurs when the integrity of cells is violated in large numbers, when enzymes are released.

Often, liver disease develops asymptomatically. A biochemical blood test for ALT and AST is designed to promptly identify violations in the work of internal organs in order to eliminate violations at an early stage. Donating blood for ALT and AST is recommended once every 6 months for preventive purposes.

Blood levels in men, women and children

The normal ALT and AST levels differ by gender and children of different ages. A slight abnormality in aminotransferases may be due to diet, exercise, lifestyle, long-term use of certain drugs and is not a cause for concern.

Enzyme	AST	ALT
In men	Up to 47 units/l	Up to 45 units/l
Among women	Up to 35 units/l	Up to 31 units/l
For children under one year old	Up to 60 units/l	54 - 56 units / l
In children under 3 years old	40 - 45 units / l	33 units/l
In children under 6 years old		29 units/l
In children under 12 years old		Up to 39 units/l

Patients often worry if ALT and AST are elevated. What this means determines how many times the result differs from the norm. Pathologies are indicated by indicators that are several times higher than the norm. A slight increase occurs with varieties of viral hepatitis, fatty liver hepatosis. Up to 20 times in inflammatory processes of the liver, cirrhosis.

With an increase in the level of more than 20 times, destruction of the liver is observed. In severe conditions of the liver, ALT reaches a critical level, in myocardial infarction - AST.

Hepatitis is usually diagnosed with an increased amount of bilirubin. In adolescents, changes in ALT and AST during growth are considered normal. Exceeding the norm in infancy is also not a pathology.

Causes of increased ALT in adults

An increase in ALT is mainly caused by abnormalities in the liver or the ingestion of substances that affect its functioning:

The use of alcoholic beverages before taking the test.
The use of certain medications: antibiotics, antifungal agents, hypoglycemic, anticonvulsant drugs.
The use of narcotic substances.
Taking herbal preparations.
Unhealthy food.
Exposure to stressful situations and heavy workloads.
Surgical intervention shortly before the study.
The presence of malignant tumors in the liver.
Chemotherapy and its consequences up to 3 months.
Lead poisoning.
Viral hepatitis.
Toxic hepatitis caused by self-medication, the use of dietary supplements and herbal preparations.
Acute form of pancreatitis.
Inflammatory myocardial injury.
Myocardial infarction.
Obstruction of the biliary tract and their compression.
cholestasis.
Hemochromatosis is an inherited liver disease.
Cirrhosis of the liver.
muscle dystrophy.

Causes of increased AST in adults

Exceeding the level of AST over ALT is most common in heart disease:

Acute myocardial infarction. Odds increase after 2-3 days.
Heart injury.
Myocarditis.
Destruction of heart tissue.
Myositis is inflammation of the muscles.
Hepatitis of various types.

ALT and AST levels are elevated in various types of hepatitis.

Damage to the liver by toxic substances.
The presence of malignant tumors of the liver.
Metastases.
Partial cirrhosis of the liver.
Liver damage caused by prolonged or high alcohol consumption.
Extensive damage to muscle tissue.
Violation of the blood flow of the liver.
Damage to the intestinal mucosa.
Wilson-Konovalov disease is a hereditary disorder of copper metabolism.
Hyperthyroidism is a hormonal disease characterized by an increase in thyroid function.
cholestasis.
Syndrome of prolonged compression, mechanical damage.
Obesity.

Reasons for high rates in childhood

ALT and AST elevated: what this means in children depends on age and hormonal processes. Before the study, the child is examined, the presence of complaints is taken into account.

Elevated levels of enzymes in the analysis of the child mainly indicates:

various liver damage;
chronic or acute viral form of hepatitis;
congenital pathologies of the biliary tract or liver;
metabolic disease;
liver hypoxia;
celiac disease - damage to the mucous membrane of the small intestine;
liver damage by toxic substances or drugs;
the presence of viral diseases;
blood diseases;
low potassium content;
thrombosis;
mononucleosis;

pathological conditions of the heart;
heart disease;
obstruction of the bile ducts;
muscular dystrophy;
polymyositis;
diseases of the pituitary gland;
the presence of malignant tumors;
kidney infarction;
consequences of heart surgery.

The decoding of the child's analyzes is different from the decoding for adults.

What does a high level in pregnant women mean?

During pregnancy, changes occur in a woman's body, which can be expressed in changes in test results. This is primarily due to hormonal changes. A slight increase in the level of coefficients in the blood at the beginning of pregnancy or in the 3rd trimester is not a pathology.

If the indicators do not normalize over time, we can talk about diseases of the heart, liver, or a violation of their functioning. The work of the liver can be disturbed by compression caused by the growth of the fetus. The pressure on the organs also leads to stagnation of bile, which increases the levels of ALT and AST.

Pregnancy can exacerbate chronic diseases. It is necessary to pay attention to the condition of the woman. If shortness of breath, weakness, discoloration of the skin or abdominal pain occurs, you should immediately take an analysis and determine the cause of the ailment.

The appearance of severe injuries and burns also provokes an increase in the level of enzymes in the blood.

In addition to serious conditions, the intake of certain medications affects the indicators. In the absence of obvious reasons, elevated ALT and AST indicate that the load on the woman's body is too great. In this case, urgent delivery is necessary. If the condition is stable, the pregnant woman is observed in the hospital.

If the values are elevated with normal bilirubin

Along with ALT and AST, other liver parameters also increase. This means that with liver pathologies, bilirubin will be elevated. Bilirubin is one of the main components of bile. An increase in bilirubin is associated with liver damage or a violation of the patency of the bile ducts. The norm of bilirubin with an increase in other indicators makes it possible to exclude the likelihood of liver diseases.

How serious is the decrease in ALT and AST activity

Any change in the level of ALT and AST indicates a violation in the body. A decrease in indicators is possible with a severe form of liver damage, cirrhosis, extensive necrosis, oncological diseases, genitourinary infections, and a lack of vitamin B6. Vitamin deficiency is especially acute in pregnant women.

Each individual case should be considered by a doctor, as self-medication will lead to a worsening of the condition. A decrease in ALT and AST during necrosis indicates a decrease in the number of healthy cells and is a dangerous condition for health. Vitamin B6 deficiency will be replenished with food: nuts, legumes, cereals, dairy products, meat, fish.

Indications for testing: symptoms

A biochemical blood test for ALT and AST is mainly prescribed for suspected pathological conditions. The presence of symptoms indicates the severity of the disease.

Since an increase in the level of aminotransferases is primarily associated with diseases of the liver and heart, The most common symptoms of pathologies are as follows:

abdominal pain;
heaviness in the right hypochondrium;
yellowing of the skin, whites of the eyes, mucous membranes;
prolonged weakness, increased fatigue - signs of myocarditis;
conditions caused by intoxication;
causeless nausea and vomiting;
weak appetite;
violation of the functioning of the gastrointestinal tract: diarrhea, flatulence, belching;
discoloration of stools;
dyspnea;
pain in the region of the heart;
pain in the limbs;
bleeding.

In other cases, elevated ALT and AST mean a violation of the integrity of the bone or muscles. These conditions can be both overt and asymptomatic, but recent injuries suggest rates will increase.

Control of ALT and AST levels is carried out as a preventive measure in patients with diabetes mellitus, overweight and a predisposition to liver disease, during pregnancy. The analysis is also prescribed as a way to monitor treatment with drugs that affect the liver.

How to prepare for the test for ALT and AST

For analysis, blood is taken from a vein. Indicators of ALT and AST are subject to third-party influence.

So that external factors do not affect the result of the biochemical analysis, the patient must follow the recommendations for preparing for the procedure:

The study is carried out in the morning.
Before the analysis, it is forbidden to eat food for 8-10 hours, it is allowed to drink non-carbonated water.
It is necessary to refrain from alcoholic beverages, smoking and taking medications at least a week before the procedure. If it is impossible to stop taking the drugs, you should inform your doctor about it.
To avoid microtrauma of muscle tissue, it is recommended to limit physical activity 2-3 days before the analysis.
Limit the amount of dairy products.
Do not eat fatty foods. You don't have to change your diet completely.
Do not smoke before analysis.
Arrive early, don't rush. Before the procedure, it is recommended to sit quietly for 10 minutes.
Protect yourself from stressful conditions, do not be nervous before analysis.
Do not undergo X-ray examinations the day before the procedure.

What to do with elevated rates

The results of the analysis are ready, ALT and AST are elevated. What does this mean, is the condition dangerous and what sequence of actions will the doctor who deciphered tell you. To determine an effective way to normalize enzyme levels, you first need to identify the cause of the condition.

For this, the doctor prescribes additional studies of the liver, heart and other organs:

tests for various types of viral hepatitis;
tests for autoimmune types of hepatitis;
analysis for Wilson's disease;
iron content for hemochromatosis;
liver biopsy;
repeated blood test;
computed tomography, ultrasound, ECG.

In addition to further examination, measures should be taken so as not to aggravate the condition:

give up alcohol;
balance nutrition;
avoid radioactive radiation;
spend more time in an environmentally friendly environment.

Depending on the severity of the disease, hospitalization or monitoring of the condition is carried out.

Medical treatment

If the ALT and AST levels change, drug treatment of the symptoms of the disease is possible. However, self-medication will aggravate the condition, you can only take drugs prescribed by a doctor.

With autoimmune hepatitis, Dufalac and antiviral drugs are prescribed.
When changes in the level of enzymes are associated with liver disease, Hepatoprotectors are prescribed - drugs that help restore the structure of liver cells. Enzyme preparations eliminate inflammation.
Magnesium is prescribed to maintain the normal functioning of the heart muscle.
In case of muscle rupture, the doctor may recommend drugs that accelerate protein synthesis and cell regeneration. Calcium preparations contribute to the restoration of bone integrity.
To strengthen the immune system, it is possible to use anti-inflammatory drugs or interferons. As soon as the infectious process is suppressed, cell restoration begins.
Acute attacks of pain are suppressed with the help of analgesics.

In addition to medicines, you can ask your doctor about herbal supplements that stimulate the liver.

Folk remedies for lowering the level of indicators

Changes are insignificant, but still ALT and AST are increased. What this means in a particular case, will reveal additional research. Treatment with folk remedies should not replace medications and medical supervision.

However, there are decoctions and infusions, the use of which, with a slight increase normalizes the functioning of internal organs and lowers the level of aminotransferases:

Infusion of herbs for liver pathologies. Mix and grind 20 g of celandine, 40 g of immortelle, 40 g of St. John's wort. Pour into a thermos, add 1.5 liters. water brought to a boil. Ready for use in 12 hours. Drink for 2 weeks 4 times a day. The infusion promotes the regeneration of liver cells.
Infusion for heart disease. For a glass of boiling water 1 tsp. adonis. Leave warm for 2 hours. Take on an empty stomach 1 tbsp. l. several spoons a day for 2 weeks.
Dandelion infusion. In a container of 0.5 liters. Put the flowers, pour 150 ml. vodka. Take after 24 hours every day 2 tbsp. l. 3 times. The duration of treatment is 2 - 3 weeks.
Milk thistle infusion. Grind the seeds, brew 1 tsp. for 250 ml. Leave warm for 20 minutes. Strain. Drink 3 weeks 2 times a day 30 minutes before meals. The broth is drunk slowly. Indications: hepatitis, liver disease.
Corn broth. Dry and grind the corn hairs. 1 tsp 200 ml. boiling water. Let it brew for 15 minutes. Take 1 glass 2 times a day for 3 weeks.

Features of nutrition at high coefficients

Proper nutrition is an extremely important part of treatment.

The following rules must be observed:

The diet should predominantly consist of plant-based foods that are high in nutrients. This will cleanse the liver of toxins and speed up cell regeneration.
Drink jelly for breakfast.
Eat fresh vegetables and fruits of different colors.
Diversify your diet with lean meat, fish. The high fat content makes it difficult for the liver to function.
Limit the amount of salt in food. Salt retains fluid in the body, causing swelling.
Follow the diet: do not overeat and do not starve.
Eat freshly prepared food.
Chew thoroughly.
Enrich your diet with proteins: cereals, eggs, dairy products.
Avoid fried foods cooked in oil.
Limit the consumption of processed foods: canned food, sausages.
Limit your consumption of carbonated drinks.
Do not include foods high in salt in your diet.
Exclude alcoholic drinks. Alcohol contains toxins that cause liver damage when filtered.
Maintain water balance: drink clean water without gas, green tea.
Eat at least 2 hours before bedtime with light foods.
Pay close attention to vitamin B6. It is found in soybeans, bananas, walnuts, spinach, avocados, and liver.
Eat more vitamin D. Vitamin protects the liver from damage and normalizes its functions. Natural sources - apples, leafy vegetables, dairy products, zucchini, mushrooms, oysters, cod liver. To get the daily dose of the vitamin, a fruit or vegetable per day is enough.

In addition to changes in diet, it is also necessary to maintain a healthy lifestyle. Quit smoking and avoid passive intoxication. It is necessary to adhere to the daily routine, spend as much time as possible in the fresh air. Strengthen the body with moderate physical activity.

In order to exclude the possibility of inflammatory processes, it is recommended to have a permanent sexual partner.

Violation of indicators in the blood test often forces you to reconsider your diet and lifestyle. To stay healthy, you should check your ALT and AST periodically. This does not mean that you need to take action only when the level of enzymes increases. It is not necessary to wait until the body indicates the development of pathologies. You can start taking care of yourself now.

Video about elevated ALT and AST levels and ways to normalize

More about ALT and AST:

Specialist on increasing AST and ALT:

In case of health problems, it is very important to identify the disease in time. To make an accurate diagnosis, it is not enough just to see a doctor. You need to get tested and get tested. Today, patients are increasingly being prescribed an AST test. What is the norm of AST in the blood and why is this study needed? How the analysis is carried out, and what diseases it can show.

What is this substance

So what is AST? AST or the enzyme aspartate aminotransferase is a special substance that is involved in the synthesis of amino acids in the cells of our body. This is a very important component of the cell, contained in individual organs and tissues of a person. Normally, the content of ALT and AST in the blood should be negligible. It can be ejected from the blood only when the tissues in which it is localized die. Thus, if the enzyme is found in the blood, it means that one of the organs that synthesizes it is sick. Cells die in it, releasing the enzyme.

Aspartate aminotransferase is not synthesized in all tissues of our body. In large quantities, it is found in the heart muscle, liver, muscle tissue and brain neurons. Thus, when AST is detected in the blood, the criteria for searching for a diseased organ can be significantly narrowed. An AST blood test is prescribed for suspected liver or heart disease.

How the analysis is done

Aspartic transaminase is detected in the biochemical analysis of venous blood. This study is now carried out by any laboratory, both in district clinics and in private medical centers.

Before blood sampling, you can not smoke and eat food and other products for 8-10 hours.

When summing up the results of the analysis, it is important to take into account additional factors, such as the sex and weight of the patient, the physical activity of the person, lifestyle, and the presence of concomitant diseases. When taking the test, you need to tell the doctor your height and weight.

The study shows not only the content of AST in a biochemical analysis in the blood, but also the presence of another enzyme - ALT. The ratio of ALT and AST to each other is a determining factor for making a preliminary diagnosis. The ratio of ALT and AST should normally not exceed 1.3, but slight deviations are possible.

Who is this procedure for?

Today, doctors prescribe an ast test for suspected diseases of the heart, liver, or muscle tissue. Considering the fact that the study can show the presence of an enzyme in the blood long before the first specific symptoms appear, the analysis can be attributed to the means of early diagnosis.

A blood test for AST may be prescribed for the following patient complaints:

Unreasonable chronic fatigue.
Apathy and long-term loss of appetite.
Regular nausea or vomiting.
Decreased work capacity.
Pain in the region of the heart.
Pain in the right hypochondrium.
Muscular chronic pain.
Yellowness of the skin.

Also, the analysis is carried out for suspected injuries of internal organs, before surgical interventions, during therapy with potent drugs, in the treatment of alcoholism and myocardial infarction. In addition, the analysis can be prescribed in the treatment of other diseases to exclude pathologies of the heart and liver.

What can the survey indicate?

A biochemical blood test for determining ALT and AST can indicate to doctors about problems with the patient's heart or liver. So with the help of this study, the following diseases can be detected:

Oncological diseases of the liver.
Metastases in the liver.
cirrhosis at an early stage.
Steatosis.
Hepatitis of any origin.
Mononucleosis.
Autoimmune diseases.
Myocardial infarction, etc.

Today, this diagnostic method is widely used in medicine. It helps to significantly narrow the scope of the search for diseases. When diagnosing, it is extremely important to take into account the human karyotype and the average norms of ALT and AST in the blood for people of different sex, age and build. The indicators denoting the norms in the table are only approximate, and relying on them is 100% wrong.

Average optimal values

A biochemical blood test for AST is also carried out for children. When examining a child's blood, it is very important to take into account his age. The organs and tissues of children are constantly developing, and their AST levels can change very often. So the average norms for children are:

At birth - up to 70 units / liter of blood.
From 1 year to 4 years - up to 59 units / liter of blood.
From 5 to 7 years - up to 48 units / liter of blood.
From 7 to 13 years - up to 44 units / liter of blood.
From 13 to 16 years old - up to 39 units / liter of blood.

There are also differences in the norms of indicators for men and women. So in the male half, the norm is considered to be up to 41 units / liter of blood, and in the female half up to 31 units / liter of blood. However, in women, AST levels may be below normal during pregnancy. When diagnosing diseases, only elevated indicators matter.

Increasing the level of the enzyme

If the AST enzyme is elevated in the blood test, it is urgent to identify the cause of this deviation. The reasons for the increase in AST, which is common, can be varied. Even in a healthy person, sometimes this analysis shows an excess of the norm several times.

One of the most common reasons for a false result is non-compliance with the rules of preparation for analysis.

To eliminate errors in the study, it is necessary:

24 hours before blood sampling, you need to refrain from physical activity.
For 7 days before the analysis, the use of alcohol and drugs should be excluded.
7 days before the analysis, you must exclude the use of drugs or inform your doctor about their intake.
You must refrain from smoking 60 minutes before donating blood.
For 8-10 hours, refuse to eat any food. Imply that you can drink only plain water.
Don't be nervous on the day of blood donation.

However, it also happens that all the conditions for preparing for the analysis are met, and blood tests still show AST is not normal. The reason for this may be:

Body burns.
Chemical poisoning.
Muscle tissue injury.
Toxic poisoning.
The presence of allergies.
Pregnancy.
Receiving intramuscular injections.
Karyotype (heredity).

Many people, having learned that they have elevated AST in the blood, immediately tend to attribute non-existent diseases to themselves. You don't need to do this. It is not practical to make a diagnosis based on a blood test alone. This study can only be regarded as a primary diagnosis. If your AST level is elevated, you will be prescribed additional examinations that can either confirm or refute the primary diagnosis. It is possible to lower the level of the enzyme by eliminating the main deviation.

Decryption

Having received a form from the laboratory in our hands, many of us first of all run not to the attending physician, but to the Internet. We ourselves put terrible diagnoses and pass death sentences. We suffer from this ourselves and make our loved ones suffer. Stop, a blood test, deciphering AST on your own is simply impossible.

When deciphering biochemistry, you need to take into account a number of important factors that only your doctor can do. The level of AST directly depends on your weight and age, heredity and gender. In addition, it is necessary to correctly calculate the ratio of ALT and AST, as well as convert the units of an individual laboratory into generally accepted ones.

Another important factor in deciphering the results is the patient's medication intake. So, for example, the use of harmless echinacea or valerian can provoke an increase in AST in the blood. In addition, there are a number of drugs that also affect the content of the enzyme in the assays.

Only an experienced doctor will be able to put all these facts together and determine the real threat of the disease.

What is the AST norm in a blood test? This is an analysis of the totality of factors affecting the fact that aspartic transaminase enters the blood. Exceeding the norm does not always mean that you have a dangerous disease. Most often, to reduce the level of the enzyme in the blood, it is enough to adjust your lifestyle and eliminate risk factors. Decoding AST is subject only to specialists. Despite this, the role of AST analysis in the early diagnosis of diseases of the cardiovascular system and the gastrointestinal tract should not be underestimated. For many, AST analysis has become a salvation, because dangerous diseases were detected at an early stage, which made it possible to start timely treatment.

Reducing the amount of enzyme

Low AST in the blood is not regarded by doctors as a reason to continue the examination. Very often, AST in healthy people is not detected at all in a blood test and this is considered normal. For physicians, only the determination of a high level of the enzyme is important, which is a signal for a more thorough diagnosis.

Most often, AST is lowered during pregnancy or exhaustion of the body. This is due to a lack of B vitamins, which the body begins to take from muscle tissue.

To treat this pathology, patients are prescribed vitamin complexes to replenish valuable substances in the body.

However, there are cases when low AST can signal advanced liver disease, but ALT analysis plays a more important role in the diagnosis of hepatic necrosis. A local decrease in AST cannot be indicative of this disease. Also, in the diagnosis of late stages of cirrhosis, liver cancer and other extensive damage, additional tests and tests are used that can show the real picture of the disease.

If you have a higher or lower AST or ALAT in your blood, this is not a reason to panic. And even if the fears of the doctors were confirmed and you were diagnosed with a latent disease of the liver or heart, you should not run to a notary and write a will. Early diagnosis is the guarantor of successful treatment of most diseases. All that is required of you is to follow the recommendations of the doctor and be an optimist. In this case, all diseases will recede, and you will be able to enjoy life again.

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Amino acid intercellular metabolism occurs with the participation of alanine aminotransferase and aspartate aminotransferase, and is called transamination. The enzymes enzymes ALT and AST are enclosed in cells of various organs, and their excess in plasma analysis always indicates cell necrosis. Why ALT and AST are elevated must be found out by a specialist, but let's try to figure out why this happens.

ALT is seen in:

Liver tissue (most of all).
pancreas.
Muscles.
Kidney.
Heart.

The analysis for ALT is increased with the disease of these organs in an adult, most often with pathological changes in the liver.

The places of concentration of AST are:

Heart (most of all).
Liver.
Muscular skeleton.
Brain.

When ALT and AST are elevated, what does this mean? At the beginning of the study, with elevated transaminase, the doctor evaluates other plasma parameters, in particular bilirubin. If other deviations in the test results are observed, a series of diagnostic procedures must be completed in order to identify the organ affected by the pathology.

In medical practice, with a serious increase in ALT, the liver is examined, and with an increase in AST, the heart of the patient.

What can affect the result?

The level of transaminases in the blood is determined during a biochemical study of blood plasma. It often happens that an increased amount of enzymes is not a sign of illness. The following factors may influence the result of the study in the direction of increasing transominases:

Breakfast before plasma donation.
Drinking a cup of tea, coffee or other beverage other than water in the morning.
Taking certain medications 2 weeks before the test.
Eating fatty foods or alcohol 3 days before the test.
Intense physical activity 2 days before the analysis increases the level of AST.

All these factors increase the level of transominases in the blood, and therefore, the analysis for enzymes must be prepared with great care.

If you are unable to stop taking medications, you should tell your doctor about it to avoid misdiagnosis.

Ask your question to the doctor of clinical laboratory diagnostics

Anna Poniaeva. She graduated from the Nizhny Novgorod Medical Academy (2007-2014) and residency in clinical laboratory diagnostics (2014-2016).

Watch a video about ALT and AST

Test transcript

Deciphering the transaminase test should only be carried out by the attending physician. It is the specialist who will be able to take into account the factors that increase the level of transaminases and the individual characteristics of the body when deciphering the results. The accepted norms of transominases in plasma are:

ALT female - less than 34 units / l.
AST female. - less than 31 units / l.
ALT male. - less than 45 units / l.
AST husband. - less than 41 units / l.

In children, the indicators depend on the age category.

The highest rates are observed in babies up to 6 months of age. Also, a sharp jump in transaminases can happen in adolescence, which is associated with intensive growth of muscle tissue.

Decoding by the de Ritis coefficient

Analysis for the de Ritis coefficient is a specialized study, which shows the ratio of transaminases to each other. It is this analysis that allows you to identify a diseased organ and determine the risks for the patient. The analysis is prescribed for diagnosis with increased transominases.

Normally, the indicators of AST to ALT according to Ritis is 1.33 with a possible fluctuation in either direction by 0.42. With a larger deviation, doctors make a preliminary diagnosis. Possible diseases:

Coefficient 0.5-0.83 - early stages of hepatitis A or B.
Coefficient 1 - viral hepatitis.
Coefficient 1-2 - liver damage with tissue dystrophy, chronic hepatitis.
A coefficient above 2 is alcohol poisoning.

Most often, to determine the causes of the disease and make the correct diagnosis, it is sufficient to conduct an analysis exclusively on AST or ALT. Deciphering the biochemical analysis in the case when the norm of the content of enzymes is exceeded indicates the presence in the body of processes associated with damage to certain parts of the liver. Liver damage in this case can be quite diverse. These can be the following processes:

damage to liver cells as a result of alcohol or drug poisoning;
cirrhosis of the liver;
liver damage as a result of exposure to the organ of pathogens of viral hepatitis.

In addition to these factors, an increased rate of AST and ALT is observed as a result of exposure to excessive physical activity, mechanical or ischemic injury to body tissues, in the presence of severe burns.

Indications and interpretation of results

A blood test for AST is performed according to a standard procedure. The material for analysis is blood taken from a vein. The regulation prescribes that the sample is taken in the morning and on an empty stomach.

This means that the day before it is necessary to warn the patient about all the rules. Deviation from the norm can occur in pregnant women and in men after heavy physical exertion.

Indicators will be increased after drinking alcohol. In a real setting, side factors should not affect the reliability of the results.

If the interpretation showed a significant distortion of the data, then it is necessary to re-examine.

A blood test for AST shows the level and activity of the enzyme. Even in cases where the indicators are elevated, this does not mean the presence of a serious pathology.

Decoding is carried out taking into account not only fluctuations in the concentration of AST, but taking into account its relationship with other enzymes.

If the norm of the enzyme contained in the blood is sharply restored, and then drops to zero, then it is highly likely to suspect the presence of a serious pathology in the body.

With such a picture, it is very important to differentiate possible diseases and the next step is to prescribe the appropriate treatment. If a sharp increase in the concentration of AST is detected in a blood test, this means that the following pathologies can develop in the body:

If a sharp increase in the concentration of AST is detected in a blood test, this means that the following pathologies can develop in the body:

myocardial infarction;
hepatitis;
acute pancreatitis;
thrombosis of the pulmonary artery.

With the development of negative processes, enzymes accumulate in skeletal muscles. This means that it is difficult to make an accurate diagnosis after the first analysis.

The results obtained in this case serve as markers for more in-depth studies. In particular, this method is used to identify problems with the heart muscle.

A biochemical blood test is able to detect the concentration of AST in the early stages of the development of pathology.

When the level is elevated, it is imperative to evaluate the concentration of other components.

It is important to note that AST and ALT markers do not give a complete picture of the development of the disease, but they are the first to signal the occurrence of a particular pathology. Considering this feature of markers, experts recommend monitoring these indicators in order to carry out deep diagnostics at the first signals in order to identify still hidden pathologies.

Given this feature of the markers, experts recommend monitoring precisely these indicators in order to carry out deep diagnostics at the first signals in order to identify still hidden pathologies.

Increase in ALT and AST

Increase in AST and ALT

– It is necessary to diagnose diseases of the liver or biliary tract, in which specific treatment is indicated (chronic viral hepatitis, autoimmune hepatitis, hemochromatosis, Wilson-Konovalov disease, obstruction of the biliary tract). if the indicators remain abnormal for more than 6 months or during the observation period they worsen further. - ACT and ALT are sensitive indicators of liver damage. Alkaline phosphatase increases with cholestasis and diseases of the skeletal system.

Increased ALT and ACT causes

- Toxic liver damage (alcohol, anabolic steroids, *estrogens*, drugs). - Obesity and diabetes mellitus (fatty liver). - Heart failure (congestive liver). - Obstruction of the bile ducts. Tumors of the liver. - ACT also increases with damage to the myocardium.

- Initial research. Determination of the content of ALT, Alkaline Phosphatase, GGTP, bilirubin. Determination of prothrombin time, albumin content. Ultrasound of the abdominal organs is recommended. - If the level of transaminases remains elevated for 4-12 weeks, the following studies should be performed. Determination of HBsAg, antibodies to hepatitis C virus, IgG, IgM, IgA, antibodies to smooth muscles, mitochondrial antibodies, serum iron and transferrin levels.

– Alcoholic liver disease can be suspected in the following cases. Daily consumption of more than 40 g of alcohol in women and more than 60 g in men. The ratio of ACT / ALT more than 1.5, an increase in the average volume of erythrocytes, an increase in the level of GGTP. Normalization of liver samples 2 weeks after alcohol withdrawal. The average volume of erythrocytes and the level of GGTP return to normal values later. Liver biopsy is performed to assess the extent of liver damage if laboratory values remain elevated for more than 3 months or there are signs of liver dysfunction, such as a decrease in blood clotting factors (increased prothrombin time) or albumin. The result of a liver biopsy does not affect treatment if there is indeed alcoholic liver disease, it only allows to rule out other chronic liver diseases.

– In case of drug-induced liver injury, the suspected drug should be discontinued. The use of some drugs (for example, statins) can be continued while monitoring liver function tests at intervals of 1-3 months.

– Fatty degeneration of the liver can be assumed in: severe obesity (body mass index above 30); diabetes mellitus type II; hyperechoic changes in the liver on ultrasound. A liver biopsy is indicated if the level of transaminases remains elevated for 6 months or more. - Biliary obstruction can be assumed in the presence of: colicky pain in the epigastric region; increase in the level of alkaline phosphatase in the blood serum; increase in the level of amylase in the blood serum; stones in the gallbladder, obstruction of the bile ducts (their dilatation), tumors of the liver and pancreas and complications of pancreatitis according to ultrasound of the upper half of the abdominal cavity.

Rare (but often treatable) liver disease

- Chronic autoimmune hepatitis (ALT is usually higher than ACT, high serum IgG levels, the presence of antinuclear antibodies and antibodies to smooth muscles). - Chronic viral hepatitis (HBsAg, antibodies to hepatitis C virus). transferrin saturation over 60%, ferritin). - Wilson-Konovalov's disease (low level of ceruloplasmin).

ALT is significantly increased (more than 3 times compared to the maximum value) - In the absence of clinical manifestations, it is necessary to repeat the analysis after 1-2 weeks and at the same time conduct studies aimed at identifying the cause (see above). - If the patient there are signs such as weakness, itching, jaundice or anorexia, then hospitalization is indicated.

Treatment of elevated ALT and AST levels

To reduce ALT and AST, you need to understand the parameters of the analysis. If the decoding of the analysis in the blood shows deviations, then this will indicate the presence of a particular disease in the body. To lower the level of ALT and AST, you must first remove the source of the disease, due to which there was an increase in the levels of ALT and AST in the blood.

It is necessary to organize a healthy diet

It is important to consume a large number of vegetables and fruits, brown rice will be extremely useful. These foods contain fiber

In addition, you should drink green tea or any herbal teas. They will help not only cleanse the liver, but also normalize the water balance of the whole organism. Tea from dandelion, burdock, milk thistle helps very well. Be sure to take foods that contain high levels of vitamin C. You can drink Revit medicine. For every kilogram of weight you need to drink at least 30 ml of pure water (not juices, drinks and tea). Breathing exercises help a lot. It is important to exercise in the morning or play sports.

It must be remembered that treatment should not be carried out to improve the parameters of the data in the blood test, but in order for the sick person to recover. The doctor should first of all think not about lowering the indicators, but about how to determine the focus of the disease and remove all inflammatory processes. Then the indicators will return to normal.

Given that ATL is elevated only when liver cells are damaged, the doctor must prescribe not only drugs for the treatment of damaged organs, but also those drugs that are called hematoprotectors. They make it possible to protect hepatocytes from the influence of other aggressive factors.

In addition, any doctor must remember that the liver is weakened during this period, it cannot be put at risk, because it can be even more damaged, therefore drugs that have a toxic effect on the liver are strictly prohibited. In other words, you can not use drugs that can cause liver cells to die even faster.

The best hepatoprotectors are those that are developed on a plant basis. These include hepabene, Essentiale H, legalon, tykveol, carsil. These medicines have a positive effect on the liver. First, they protect cells from further damage. Secondly, they have the ability to restore liver cells, that is, those cells that are damaged, but have not yet died, can be restored through the use of these drugs. In addition, they do not have a toxic effect on other organs. These drugs take on some of the functions of the liver, that is, they can perform a secretory function, participate in metabolism, and also perform a disinfecting function, partially destroying toxins in the body of the victim.

Biochemical blood test decoding, norm and deviation from it

In order to obtain accurate results of biochemical analysis for the content of enzymes, decoding should be carried out exclusively by an experienced highly qualified specialist. The norm of the amount of each of the enzymes contained in the blood corresponds to its specific concentration. The content of ALT in the blood ranges from 31 units/l to 41 units/l, depending on the gender of the patient. The norm for women corresponds to the content of ALT in an amount lower than that of men. To obtain accurate results, the ratio of the degree of activity of each of the enzymes is determined. An increase in the coefficient may indicate the emergence and development of prerequisites for myocardial infarction in the patient's body, and with a decrease in this indicator, the development of infectious hepatitis in the body.

Since aminotransferases have different tissue specializations (each of these enzymes is concentrated in a certain type of tissue), a deviation from the norm of the content of one or another enzyme almost instantly signals the presence of diseases associated with certain organs in which the maximum localization of ALT and AST is observed. The interpretation of the analysis can be used as a factor in diagnosing the condition of the heart muscle (myocardium) and abnormalities in the functioning of the liver tissue. In cases where the rate of the enzyme content is increased, there is a suspicion of the presence in the body of any problems in the functioning of certain organs.

In the process of death and destruction of tissue cells that make up the body, enzymes are released into the bloodstream. The concentration of substances increases, which determines the blood test and the subsequent interpretation of the results. Exceeded by 2 or more times the norm of the AST enzyme can be guaranteed to confirm the presence in the patient's body of prerequisites for the onset of an attack of myocardial infarction.

In cases where ALT in the blood is elevated, the body, as a rule, develops infectious hepatitis during its incubation period.

If the norm of indicators for AST and ALT is reduced, it can be stated that there is a lack of vitamin B group (giridoxin). However, it is worth remembering that the lack of giridoxin can be caused not only by pathological changes in the body, but also by the process of bearing a child by a woman.

What is the reason for the deviation from the norm of ALT and AST?

The activity of ALT in the blood is directly dependent on the degree and severity of viral hepatitis. The more difficult the situation in the body with the development of the disease, the more elevated the level of ALT activity in the blood. In the event of particularly severe cases, a blood test may show ALT activity that is 5 times or more higher than normal. The use of a biochemical blood test will help identify the disease at the very initial stage of development in the patient's body, i.e. at the moment when the course of the disease passes without clearly expressed symptoms. The AST and ALT blood test allows you to determine with great accuracy the patient's condition and the complexity of the course of a particular disease.

Elevated levels of ALT and AST in the blood during the analysis may be in the case of the occurrence of such diseases in the body as:

cirrhosis of the liver;
liver cancer;
various forms of hepatitis
damage to the liver tissue as a result of toxic and drug poisoning.

In addition, deviations from the norm can cause diseases such as:

pancreatitis;
heart failure or myocardial infarction;
getting burns on large areas of the body;
necrosis of skeletal tissues;
shock states of various nature.

A decrease in ALT below normal is observed with a deficiency in the patient's body of vitamin B6, as well as with damage to the liver tissue as a result of extensive necrosis. As a rule, a decrease in ALT is observed due to the death and destruction of cells that make up the liver tissue and produce ALT.

Signs of an increase in the concentration of enzymes

An increase in ALT and AST is evidence of the presence of pathologies in precisely those organs where their highest concentration is.

Why can alanine aminotransferase and aspartate aminotransferase increase and how to lower their content?

ALT in the blood shows that the cause of this may be:

liver problems (hepatitis, cirrhosis, hepatosis);
pathology of the heart muscle (myocardial infarction, myocarditis, etc.);
diseases associated with injuries or burns;
inflammatory disease of the pancreas (pancreatitis).

Liver problems are not always manifested by pain or other sensations. Symptoms of the pathologies of this organ can be detected already in the later stages. To assess how the liver works, you need to take a test and find out the degree of activity of liver transaminases.

Transaminases act as catalysts in the process of nitrogen metabolism. They are actively involved in the formation of amino acids that occurs in the liver.

An increase in liver enzymes can be observed in some groups of people:

newborns.
Men.
People with increased body weight.

If the increase in ALT and AST occurs quickly, this is a dangerous sign. High levels of AST and ALT are not always associated with liver disease.

The heart can also be affected, this happens due to:

myocardial infarction;
severe attack of angina pectoris.

It happens that AlAt and AsAt are elevated for reasons of a different nature.

This is facilitated by:

Blood poisoning.
Inflammatory process in the gallbladder.
Burns.
Problems with the pancreas.

Based on this, it becomes clear why experts do not consider an increase in transaminases to be a specific test, although they show particular sensitivity to liver pathologies.

And although there are quite a few problems with the liver, the symptoms of these conditions have a lot in common. In this case, there is always an increase in the concentration of liver enzymes.

These symptoms include:

severe weakness;
fast fatiguability;
regardless of the nature of nutrition, nausea and vomiting;
pain in the liver;
an increase in the size of the abdomen;
yellowness of the skin, as well as mucous membranes;
dark color of urine;
light-colored feces;
possible bleeding from the nose and / or stomach.

Changes in the level of liver tests in cirrhosis of the liver

The liver is the body's biochemical laboratory. It performs many important functions, so monitoring the state of this organ is the task of everyone who cares about their health.

What are ALT, AST and bilirubin?

Also important is the ratio of the amount of AST to the content of ALT, it was named after Fernando de Ritis, who first introduced it into medical practice and determined its significance. The method was based on the knowledge that AST and ALT indicators are different in the cells of organs: for example, normally in a person, the liver contains the most enzyme ALT, while the heart contains AST. Thus, the de Ritis coefficient in case of heart diseases rises to a level of 2 and above, in case of liver pathologies, on the contrary, it falls below unity. Normally, it ranges from 0.91–1.75.

It is worth noting that even with liver diseases, a significant increase in AST can be observed in the blood, including the predominance of its amount over ALT. So this ratio should be evaluated in conjunction with other studies.

After penetrating the liver, bilirubin, passing through the biliary tract, reaches the intestine, where it turns into stercobilin, a pigment that stains feces. In the same place, a small amount of it is absorbed into the bloodstream and enters the kidneys, where it becomes urobilin and is excreted in the urine. Bilirubin is free (indirect) and bound (conjugated, direct). In addition to studying each indicator separately, the content of total bilirubin is determined.

Liver tests in cirrhosis

But in the terminal stages of the course of the disease, when there is multiple liver damage, the level of ALT and AST begins to drop rapidly. The reason for such changes lies in the fact that the process of necrosis reaches the stage when the liver cells become almost unable to synthesize these enzymes.

Another dangerous effect of bilirubin is that with the blood flow it can reach the blood-brain barrier, and at certain concentrations it begins to penetrate the central nervous system. Here, its toxic effects can lead to encephalopathy or even coma.

Biochemical blood test: methods and interpretation

You should consult with your doctor before taking any medication. For example, drugs such as paracetamol, birth control pills and aspirin can significantly affect the results. On the appointed day before donating blood, it is forbidden to eat. Coffee and tea are also prohibited, but some water is allowed. A blood test is taken from a vein.

To determine the content of bilirubin in the blood, the so-called Van den Berg reaction is used. It is from the results of this study that free and conjugated bilirubin received their second name. In an aqueous medium, only the conjugated pigment interacts with the reagent (Ehrlich's diazoreactive), which is why it was called direct. Indirect bilirubin begins to bind to the reagent only after the precipitation of proteins, usually this occurs under the influence of alcohol. Then the content of the total pigment is calculated, and by subtracting the already known content of bound bilirubin from this amount, the amount of free bilirubin is determined. This method is not entirely accurate, but due to its availability it is one of the most common.

The level of bilirubin in the blood is measured in mmol / l. In a healthy person, its total content is in the range of 5.1-17 mmol / l. Indirect bilirubin, which circulates in combination with albumin, is 75% of the total - 3.4-12 mmol / l, while direct, neutralized - the remaining 1.7-5.1 mmol / l.

An increase in the total content of this pigment due to free or bound may serve as the basis for a deep check of the state of the liver. In more rare cases, its increase may occur due to the following reasons:

some hereditary pathologies;
problems with the pancreas;
transfusion of incompatible blood;
administration of certain drugs.

But more often it is a direct indicator of cirrhosis or other liver problems.

Also, along with the study of these indicators, an analysis should be taken to determine the level of gamma-glutamyl transpeptidase, albumin and fibrin - they can provide additional information about the patient's condition.