Ngā hua whakamātautau mahi ate kua whakamāramatia, he tohu i ia wā

He rite pea te rōpū whakamātautau ate ki te hupa arapū: ALT, AST, ALP, GGT, bilirubin, albumin. Kei tēnei aratohu ngā hua whakamātautau mahi ate kua whakamāramatia ki ngā kupu māmā, he tohu i ia wā, kia mōhio ai koe he aha tā ia tau e aroturuki ana, he aha hoki hei pātai ā muri ake. He kōrero whānui tēnei, ehara i te tautohu mate. Ka pānui tō tākuta i ō hua i te taha o ō tohumate me tō hītori.

Tuatahi, ētahi mea ka iti iho ai te whakamataku o te whārangi

He paku whakapōauau te ingoa. Ko te nuinga o ēnei tohu e whakaatu ana mēnā kei te taumaha ngā pūtau ate, ngā ngongo wai kawa (bile ducts) rānei, kaua te pai o te mahi a te ate. Koinā i pai ake ai ki ngā rōpū atawhai ate ināianei te kupu "whakamātautau toto ate" (liver blood tests). He maha ngā tāngata he hua kāore i te noa ō rātou, he pai noa te mahi a te ate.

He maha ngā hua kāore i te noa. Kua whakaritea ia awhe tohutoro kia noho tata ki te 19 i ia 20 o ngā tāngata hauora ki roto. Nō reira, tata ki te 1 i ia 20 o ngā tāngata hauora ka taka ki waho tata i ia whakamātautau. E ai ki a Liver UK, i te tata ki te hautoru o ngā take, ka hoki noa ngā hua ate kāore i te noa ki te noa i roto i ngā wiki e toru pea. Koinā i maha ai ngā wā ko te whakamātautau anō te hīkoi tuatahi.

Ka rerekē ngā awhe i ia taiwhanga, i te pakeke, i te ira tangata. He rerekē ngā tau ka puta i ngā mīhini me ngā tikanga rerekē. Whakatauritea tonutia tō hua ki te awhe kua tāia ki tō ake pūrongo, ā, whakatauritea ngā pūrongo nō te taiwhanga kotahi ina taea.

Ehara te hua noa i te tohu kua pai katoa. Ka taea e tētahi tangata te whai mate ate taumaha, ā, he noa tonu ōna hua toto. Mēnā he take tūraru ōu, ka tūtohu pea tō tākuta i ētahi atu whakamātautau ahakoa tonu.

Ngā hua whakamātautau mahi ate kua whakamāramatia: ngā tohu matua

ALT (alanine aminotransferase)

He enzyme te ALT e kitea ana i roto i ngā pūtau ate te nuinga. Ina whakapōrearea, ina whara rānei aua pūtau, ka turuturu te ALT ki roto i te toto. Nā tēnā ko ia te enzyme e tino hāngai ana ki te ate, ā, ko te ALT teitei tētahi o ngā tohu noa rawa i ngā pūrongo katoa.

He maha ngā wā he poto noa te wā o ngā pikinga iti. Mā te korikori kaha, mā te inu waipiro nui rānei i te rā kotahi, e rua rānei i mua i te whakamātautau, mā tētahi māuiui tata nei, mā ētahi rongoā me ētahi kai tāpiri (supplements) hoki e piki ai te ALT mō tētahi wā. Ko ngā take mau tonu, ko te ate ngako (fatty liver), te hepatitis huaketo (viral hepatitis), te waipiro me te whara ate nā te rongoā.

AST (aspartate aminotransferase)

Ka tukuna hoki te AST ina taumaha ngā pūtau ate, engari ka hangaia hoki i te manawa, i ngā uaua me ētahi atu kiko. Ko te AST teitei anake, ka puta pea i te ate, i te manawa, i ngā uaua rānei.

Te ōwehenga AST/ALT

He maha ngā wā ka tirohia tahitia e ngā tākuta ngā enzyme e rua. E ai ki a Cleveland Clinic:

• Kua piki ōrite rāua e hāngai ana ki ngā take ehara i te waipiro, pērā i te pokenga, i ētahi atu paitini rānei.
• Ko te AST tata ki te rua taima te teitei ake i te ALT ka tohu kē ki te whara nā te waipiro.

He tohu āwhina te ōwehenga, ehara i te whakataunga. Ka whai tikanga anake ina pānuitia me ō atu hua me tō hītori.

ALP (alkaline phosphatase)

Ka ahu mai te ALP i ngā ngongo wai kawa o te ate me ngā kōiwi te nuinga. Ko te ALP teitei, ka tohu pea kāore te wai kawa e rere pai ana, engari ka ahu mai pea i ngā mate kōiwi. Ina piki te ALP anake, ka tirotiro pea ngā tākuta i ngā mea pērā i te huaora D i mua i te aro ki te ate.

GGT (gamma-glutamyl transferase)

Kei te ate te nuinga o te GGT, ā, ka piki ina whara te ate, ngā ngongo wai kawa rānei. Ko te GGT teitei i te taha o te ALP teitei, ka nui ake te tūponotanga o tētahi raru rere wai kawa. He tairongo hoki te GGT ki te waipiro. I te hunga e inu nui ana, me heke i muri i ngā wiki e whā pea kāore he waipiro, e ai ki te NHS Specialist Pharmacy Service. Mēnā e inu waipiro nui ana koe ia rā, ka wiri rānei koe, ka werawera, ka rongo rānei i te ruaki ina kāore koe e inu, kaua e whakamutu ohorere i te inu, nā te mea ka mōrearea pea tēnā. Tikina tuatahitia he āwhina hauora.

Bilirubin

He tae kōwhai te bilirubin ka hangaia ina pakaru ngā pūtau toto whero tawhito. Mā te ate e whakawātea ki roto i te wai kawa. Ki te kohi, ka kōwhai pea te kiri me te mā o ngā karu (jaundice).

Ko te bilirubin kua piki me ētahi atu hua noa, he maha ngā wā ko Gilbert's syndrome, he āhuatanga tuku iho noa. Ka puta pea he kōwhaitanga iti, ka haere, ka hoki mai, he maha ngā wā i muri i te moe kino, te matewai (dehydration), te waipiro, te korikori nui rawa rānei. E ai ki te NHS, kāore e whara i te ate, kāore hoki e whakapoto i te ora.

Albumin me te pūmua katoa

He pūmua te albumin ka hangaia e te ate. Ka āwhina ia ki te pupuri i te wai ki roto i ō ngongo toto. Nā te mea e tata ana ki te 20 rā tōna noho i te toto, he pōturi tana huri. Ko te albumin hakahaka me ētahi atu hua ate kāore i te noa, ka tohu pea ki te mate ate mō te wā roa. Engari ko te albumin hakahaka anake, he maha ngā wā kāore rawa e pā ana ki te ate. Ka taea e te pokenga, te mumura (inflammation), ngā raru whatukuhu me te kino o te ngote kai a te tinana te whakaheke.

PT me te INR (te wā tepe toto)

Mā te ate ngā pūmua tepe toto e hanga, nō reira kei ētahi rōpū whakamātautau te prothrombin time (PT), te INR rānei. Ko te wā tepe toto roa ake, ka ahu mai pea i te mate ate, engari i te warfarin, i te huaora K hakahaka rānei hoki.

Ngā awhe pakeke noa (he tauira anake)

He awhe tauira ēnei mai i ngā puna kua whakaputaina, kotahi te huinga ki ngā waeine ā-US, kotahi ki ngā waeine ā-UK. He ōrite te tikanga o te U/L me te IU/L. Ko te awhe a tō taiwhanga te mea whai mana.

Tohu	Awhe tauira (waeine ā-US)	Awhe tauira (waeine ā-UK)
ALT	7 ki te 56 U/L	0 ki te 40 IU/L
AST	10 ki te 40 U/L	0 ki te 35 IU/L
ALP	44 ki te 147 U/L	ka rerekē i te tikanga a te taiwhanga
GGT	ka rerekē i te pakeke me te ira tangata	0 ki te 50 IU/L
Bilirubin katoa	0.1 ki te 1.2 mg/dL	5 ki te 21 µmol/L
Albumin	3.5 ki te 5.0 g/dL	35 ki te 50 g/L

Ko ngā tau ā-US nō Testing.com. Ko ngā tau ā-UK nō te NHS Specialist Pharmacy Service, hāunga te AST, nō Cleveland Clinic. Tirohia te nui o te rerekē, ahakoa mō te tohu kotahi.

He nui ake te tikanga o ngā tauira i tētahi tau kotahi

He uaua ka urupare ngā tākuta ki tētahi tohu kotahi anake. Ka rapu rātou i ngā tauira:

• Ko te ALT me te AST te nuinga kua piki: te taumaha i ngā pūtau ate tonu.
• Ko te ALP me te GGT te nuinga kua piki: he raru pea i te rere wai kawa.
• Albumin hakahaka me te wā tepe toto roa: tērā pea kāore te ate e hanga ana i ngā pūmua e nui ana, ā, me āta tirohia tēnei.
• Ko te bilirubin anake kua piki: he maha ngā wā he harakore, pērā i te Gilbert's syndrome.

Te tawhiti ki waho i te awhe he mea nui anō. Ki ngā aratohu a te NHS mō ngā ngaio, ko te hua i raro i te rua taima o te rohe o runga, he paku kāore i te noa, ā, i te nuinga o te wā e tika ana kia whakamātauria anō. Ko ngā hua neke atu i te rua ki te toru taima o te rohe o runga, i te nuinga o te wā ka ārahi ki ētahi atu whakamātautau. Ko ngā taumata enzyme tino teitei, neke atu i te 1000, ka tohu pea ki tētahi whara ohorere, pērā i tā tētahi rongoā, i tā tētahi huaketo rānei, ā, i te nuinga o te wā me tere te whai āwhina a tētahi mātanga.

Ngā mahi noa ā muri ake

Mēnā kāore i te tika ō hua ate, ka pēnei pea tō tākuta:

1. Ka whakamātautau anō i roto i ētahi wiki, i ētahi wā i muri i te okiokinga mai i te waipiro. Mēnā e inu waipiro nui ana koe, tikina he tohutohu hauora i mua i tō whakamutu.
2. Ka arotake i ō rongoā me ō kai tāpiri, tae atu ki ngā mea ka hokona e koe me te kore tono rongoā. Kaua e whakamutu i tētahi rongoā kua tonoa, māu anake.
3. Ka tono i ētahi atu whakamātautau toto, pērā i ngā tirotiro hepatitis B me C, i tētahi kaute nawe (scarring score) rānei e kīia ana ko FIB-4.
4. Ka whakarite matawai, pērā i te ultrasound, i te FibroScan rānei.
5. Ka tuku i a koe ki tētahi mātanga ate, whēkau rānei mēnā ka noho tonu ngā hua kāore i te noa, kāore rānei e mārama te tauira.

I mua i te whakamātautau, pātaihia mēnā me nohopuku koe. E tono ana ētahi taiwhanga kia 10 ki te 12 hāora kāore he kai, he inu rānei; kāore e hiahiatia ana e ētahi atu mō te rōpū whakamātautau ate anake.

Ngā pātai mō ō hua

• Ko ēhea tohu kei waho i te awhe, ā, e hia te tawhiti?
• He tauira pūtau ate tēnei, he tauira rere wai kawa, ehara rānei i ēnei e rua?
• Ka taea e ōku rongoā, ōku kai tāpiri, te waipiro, te korikori tata nei rānei te whakamārama?
• Āhea me whakamātautau anō, ā, he aha ka huri i te mahere?

Āhea me whai āwhina kōhukihuki

Waea atu ki te nama ohotata o tō rohe, haere tonu rānei ki te tari ohotata mēnā kei te ruaki toto koe, mēnā he tino pōuri, he pango rānei tō tūtae, mēnā rānei ka pōrauraha ohorere koe, kāore rānei e mārama tō kōrero. Ko ēnei pea ngā tohu o tētahi raru ate taumaha, ā, he ohotata te kiri kōwhai me te pōrauraha ohorere.

Mēnā ka kōwhai tō kiri, te mā rānei o ō karu, ā, kāore koe e mōhio he aha ai, whakaritea he toronga kōhukihuki i taua rā tonu ki tētahi tākuta.

Te aroturuki i roto i te wā

He tino whai hua ngā hua ate hei ia. Ki te tukuake koe i ō pūrongo ki a Saluvo, e rua ngā tauira AI ka pānui i ia pūrongo, ka whakaū koe i ngā uara e kore e whakaae ana rāua, ā, ka taea e koe te kite i te neke o ngā tohu pērā i te ALT, i te GGT rānei puta noa i ngā pūrongo i mua i tō toronga e whai ake nei. Mā tō tākuta tonu e whakatau te tikanga.