A comprehensive analysis of cirrhosis of the liver!
I work in Jinan, Chinese New Year finds his father returned home looking good, always rickets the waist, and some had no confidence. Not long ago, house calls, said his father Jiaozhong Needless, to the hospital to check is kidney inflammation, and later said yes schistosomiasis cirrhosis. I went to online search of the information before I know that some of this knowledge, I am Sister, Medical School graduate, also know some, and asked her she said later, the liver has narrowed, and portal hypertension, splenomegaly.
I am afraid, afraid of his father not to enjoy a modicum of happiness away from us! Want him to come to the hospital in Jinan diagnosed about, but his sister said that was unnecessary, and county hospitals, or be able to check it out.
My home inspection results, and now what the condition is not very understanding, so do not worry! Are now big penicillin anti-inflammatory, that is to injection of albumin to maintain, it is not already a very serious effect?
I do not know how to do now, is not the father should take over the diagnosis and see how comprehensive this help? Thanks in advance啦!
Liver Disease, Jinan, Zhongshan Hospital:
Depending on your father’s situation, it is best to a specialist hospital to check if problems, timely treatment to correct abnormal liver function, to avoid the appearance of ascites.
What led to cirrhosis of the liver?
Cirrhosis of the liver is a common chronic liver disease, may be one or more causes liver damage, liver showed progressive, diffuse, fibrous lesions. Concrete manifestation of diffuse degeneration and necrosis of liver cells was followed by fibrous tissue hyperplasia, and nodular regeneration of liver cells, these three changes in repeatedly staggered, the results of hepatic lobule structure and blood circulation channels have been gradually converted, so that the liver deformation, hardening the lead to cirrhosis of the liver. Early stage of this disease may be no obvious symptoms, later appeared in a series of different degrees of portal hypertension and liver dysfunction, until the emergence of upper gastrointestinal bleeding, hepatic encephalopathy and other complications of death.
Decompensated liver cirrhosis, based on clinical manifestations and diagnosis can be made on regular inspections. The main diagnosis of cirrhosis was based on: ① a viral hepatitis, schistosomiasis, long-term drinking and other relevant medical history; ② the liver may be larger, late often narrow, texture hardens, the surface uneven. ③ liver dysfunction. ④ clinical manifestations of portal hypertension. ⑤ pseudolobule the formation of a liver biopsy.
Cirrhosis Treatment
Diagnosis of liver cirrhosis in patients with symptoms typical of easy, but it can no typical clinical symptoms or in the occult compensatory period, diagnosed difficulties. Therefore, the diagnosis of liver cirrhosis is a comprehensive diagnosis. Have passed the liver function tests, hemogram, esophageal endoscopy or barium permeability, B-ultrasonography, liver histological examination. At present, the treatment of cirrhosis of the liver in an integrated therapy. Mainly for the maintenance of early cirrhosis of the liver and prevent further aggravate the condition; decompensated liver protection in addition to restore liver function, but also for aggressive prevention of complications. In general, the principles of treatment are as follows:
(1) diet therapy: Liver cirrhosis in patients with a reasonable diet and nutrition, there is conducive to restoring liver cell function and stable disease. Should be given high-protein, can reduce the body break down proteins, promoting protein synthesis in the liver to maintain the balance of protein metabolism. Adequate supply of high-calorie and high vitamins, both to protect the liver, but also enhance the body resistance, the reduction of protein breakdown. 1g/kg protein per day, body weight, and fresh vegetables and fruits. General propositions source of food energy supply, according to 20% of protein, fat and carbohydrate, 40% of each distribution. Impaired liver function, fat metabolism disorders, require a low-fat diet, or easy to form a fatty liver. High-diet rich in vitamins and trace elements to meet the body needs.
(2) The cause of treatment: According to a special cause of cirrhosis of early treatment. Schistosomiasis patients in early stages of diseases with praziquantel, which is a more thorough insecticide treatment, can improve liver function, spleen reduced. Animal studies confirm that early treatment can be reversed by praziquantel or suspension of liver fibrosis induced by schistosome infection. Alcohol-induced liver disease, and drug-induced liver disease, should stay out drinking and drug intoxication.
(3) General drug therapy: According to the patient’s need for major multi-vitamin supplement. In addition, Hugan drugs such as inosine for cell activator, in the body to improve the level of ATP, into a variety of nucleotides, involved in energy metabolism and protein synthesis. Blood circulation can be achieved with traditional Chinese medicine, qi effects such as Salvia miltiorrhiza, Astragalus and so on. Most authors believe that patients with early liver cirrhosis, blindly over-medication but will also increase the load on the liver drug metabolism, while unknown or known adverse drug reactions may increase the damage to the body, it should not be too early in patients with cirrhosis Multi-blind long-term medication.
(4) to improve liver function and liver fibrosis: liver function abnormalities in transaminase and bilirubin revealed multiple liver cell damage, shall be given in accordance with the principles in the treatment of hepatitis Treatment of western medicine.
(5) positive control complications: cirrhosis more complications can lead to serious consequences. For the esophageal varices, ascites, hepatic encephalopathy, concurrent infections and other complications, according to the patient’s specific situation, choose an effective method.
Liver stem cells in treatment of cirrhosis of the definition of
Liver stem cell technology that is to implant stem cells in vivo, induced to differentiate into functional cells in real terms to replace due to degeneration, injury, genetic defect or damaged by its own immune cells for therapeutic purposes. This is the only international one comparable with liver transplantation to treat cirrhosis of the new technology, known as “the ultimate way to a second treatment of cirrhosis of the liver.”
Transplantation in the treatment of liver cirrhosis of the liver stem cell technology Principle
Currently used in clinical treatment of cirrhosis of the liver stem cells, there are mainly two: First, autologous bone marrow stem cells, and second, autologous peripheral blood stem cells. Autologous peripheral blood stem cells to be later than autologous bone marrow stem cells used in clinical treatment, but autologous peripheral blood stem cells in liver cirrhosis, and autologous bone marrow stem cells to treat cirrhosis of the liver compared to the more obvious advantage. The reason is: Autologous peripheral blood stem cells have the large number of transplanted cells (which is ten times higher than bone marrow stem cells), stem cell variety (including a bone marrow stem cells), no loss of support for stem cell growth factors such as the advantages of active ingredients, excellent clinical results in the bone marrow stem cells.
Due to the differentiation of stem cells with powerful functions, we will be ported to the liver so that in the liver microenvironment and cell differentiation inducing agent under the effect of the normal growth of liver cells, liver cells to re-play function for therapeutic purposes.
Liver stem cells in treatment of cirrhosis of the liver edge
1, treatment effect is good, effective up to 85% or so. To improve liver function after treatment, reducing mortality and improving quality of life;
2, minimally invasive treatment, the risk is small, less pain;
3, treatment side effects;
4, treatment, low cost, or about one-twentieth of the cost of liver transplantation.
5, no immune rejection and ethical problems.
Patients after treatment may be given the change in clinical status
,2-4 weeks after treatment, loss of appetite, fatigue, ascites and other symptoms reduce or even disappear; 8-12 weeks, stem cells start to differentiate, eight key biochemical indicators of expected recovery; 3-6 months, with the new increased liver cells damaged liver tissue to be repaired, the gradual return of liver function, the patient may be an overall improvement in signs and enters the recovery phase.
Which patients are suitable for liver stem cell therapy?
1, severe hepatitis.
2, early, middle and late in patients with cirrhosis, including alcoholic cirrhosis, hepatitis, cirrhosis, autoimmune cirrhosis, drug-induced liver cirrhosis, biliary cirrhosis patients were eligible for treatment.
In patients with cirrhosis of the day care and health care
For the treatment of patients with liver cirrhosis not only rely on drugs or therapy, usually in daily life care is also very important, let’s look at how to care for daily living in patients with cirrhosis.
1 and resting
Liver for metabolism and synthesis of protein in the body a major hub, when the proliferation of liver cells were separated by fibrous tissue to form a nodular pseudolobule, that cirrhosis will lead to loss of normal relations between the various types of blood vessels, liver cell dystrophy, leading to liver functional compensation insufficiency, and thus there was a series of pathological changes, such as endocrine disorders, such as protein upside down. Overload physical activity will increase the burden on the liver cells and increased the disease development. Therefore, in patients with decompensated should not overwork and decompensated patients should be bed rest, so in order to protect the liver. Experts believe that resting better than drug treatment alone, can increase the liver’s own immune system.
2, emotional
Wrath of liver injury, this is the first bad news. Easy irritability in patients with cirrhosis angered rage mood changes, will stimulate the body’s stress response occurs, so that the human endocrine system change. The liver and endocrine function of solidarity, can promote the synthesis of certain hormones to change and decomposition. Adrenaline secretion caused when angered, to stimulate the liver cells within the liver cells, secreted into the serum GPT, so that even more damage to liver cells.
In addition, depression, thorough consideration, sadness and other emotions may also lead to liver qi stagnation. Qi stagnation is blood stasis, caused by cholestasis of Health, mass (cirrhosis); Qi stagnation Shuxie negative, then the body fluid is not cloth, watercourses do not lose health caused by swelling (ascites), both to make sicker. Patients must be protected open-minded mood, with medical treatment or even if we have a panacea, but also in vain.
3, Temperance
In patients with cirrhosis must be an absolute prohibition. Is almost due to alcohol liver metabolism, decomposition of the only places. A large number of studies have shown that alcohol has a direct damage of the liver, the patient must not be taken lightly. Some people think that a small amount of drinking or occasional drinking is not all right, it is not. Any solution containing alcohol, even if the contents of a small re-enter the body needs after the decomposition of the liver. In its decomposition process, the coenzyme I changed NAD I, was also reduced coenzyme I, increased, so that the central zone of liver lobule due to hypoxia and cell necrosis and fibrosis. Laboratory shows that alcohol can inhibit the synthesis of glycoproteins and albumin secretion discharge, in the severely damaged liver cells, the liver itself has emerged fiber hardens, and then drinking heavier burden of the liver is no different from the fire poured oil. In conclusion, in patients with cirrhosis alcohol consumption, 100 harm and no benefit should be taken with caution.
4, a balanced diet
(1) carbohydrate food: adequate supply of sugar.
In general, the proportion of carbohydrate in the diet accounted for 40%, sugar not only protect the liver, strengthen the body resistance, but also the reduction of protein decomposition, cirrhosis patients should pay attention to carbohydrate in the diet intake. Damage due to liver function of patients, and too much sugar can cause obesity, and even the formation of fatty liver and increased the burden of the liver, so in food intake of carbohydrates in moderation.
(2) protein foods: For patients with liver cirrhosis, the protein supplement should be the lack of protein level and condition the decision to eat were treated with oral, severe indigestion, poor absorption, shall consider the type of amino acids, proteins and plasma. There are 60g a day high protein diet to meet the needs, they may turn food fish, lean meat, eggs, dairy, soy products. When there is tendency of liver damage, the day should not exceed 20g.
(3) fatty food: cirrhosis of the liver, the lipid metabolism are affected, while lipid metabolism can also cause liver damage, so obviously impaired liver function, the strict low-fat diet, reduce the burden of the liver, strengthening of the complementary protein and sugar class, to prevent the occurrence of fatty liver.
(4), added vitamins and trace elements: cirrhosis of the liver due to various factors can cause a lack of vitamins and trace elements, fresh vegetables and fruits rich in vitamins, minerals, trace elements, is the best food. Note that vitamin B1, B2, C, E and K, trace elements such as zinc, selenium, vitamin deficiency symptoms have occurred should be taken orally or muscle, subcutaneous injection.
(5) limit of water and salt: For patients with ascites or edema, we must control the sodium and water intake.
(6) the esophageal-gastric varices, fast hard food, fried, crude fiber foods.
Liver Diseases, Zhongshan Hospital, Jinan, director of liver disease to remind you Professor Zhang Wenyan
Cirrhosis of the liver are frequently-occurring disease in our country, is one or more of several causes of repeated, long-term damage liver cells, leading to liver cell degeneration and necrosis appeared diffuse fibrous tissue hyperplasia, disruption of normal hepatic lobule structure and angiogenesis, the formation of regenerative nodules, After long-term development, the liver gradually deform, texture hardens, forming cirrhosis of the liver. In the leading cause of cirrhosis, the majority of chronic hepatitis, a few are caused by alcohol abuse and chronic schistosomiasis, individual cases have been linked to genetic, metabolic diseases; in food is an important cause of aflatoxin contamination, water pollution is also a possible cause . Through aggressive prevention and early cirrhosis can be reversed or is no longer made, but later it will seriously affect people’s quality of life, even life-threatening, so prevention and treatment of cirrhosis of the liver is very important.
First of all, prevention is the primary cause. Of chronic hepatitis B and hepatitis C is a major cause of cirrhosis, while the anti-viral treatment of chronic hepatitis B and hepatitis C is the most critical treatment measures. However, there is no completely eradicate hepatitis B and hepatitis C virus drugs, and not all have hepatitis B and hepatitis C will eventually develop into cirrhosis, liver cancer, and therefore, in determining the cause of treatment (ie antiretroviral therapy) before predict the effectiveness of the treatment must be the cause. For the effect of antiretroviral therapy is expected to better patient should take active measures to antiretroviral therapy. For the expected effects of antiretroviral therapy in patients with poor, it is necessary to take further measures such as liver biopsy evaluation of the risk of developing cirrhosis of the liver biopsy confirmed the existence of severe liver fibrosis or early cirrhosis patients, regardless of how effective anti-viral treatment, must adhere to the long-term anti-viral therapy. Confirmed effective anti-viral drug lamivudine and interferon therapy. Should be noted that the current anti-viral treatment of hepatitis B virus carriers (ie, liver function tests normal) is invalid, such groups the incidence of cirrhosis and liver cancer is very low, and therefore do not recommend anti-viral treatment, but must be regular monitoring of liver function status, in order to detect active hepatitis.
Second, regular medical examinations for the prevention of cirrhosis is also essential. Most no obvious clinical symptoms of hepatitis must be found by examining the hepatitis activity; recurrent hepatitis activity, in terms of patients must also have regular ultrasound scans, or other indicators of cirrhosis of the liver examination; for patients with cirrhosis of the liver must also be half-yearly ultrasound examination and Serum AFP testing for early detection of liver cancer, early treatment.
Thirdly, with regard to drug treatment cirrhosis of the liver. Of TCM in anti-hepatic fibrosis and cirrhosis has a wealth of experience, but must not be an alternative to traditional Chinese medicine treatment of antiretroviral therapy, or may be adversely affected by illness. Chinese and Western medicine combine to play each other’s merits, after all prevention and treatment of cirrhosis of the liver sound strategy.