Lekarz zlecił wykonanie badania aminotransferazy alaninowej? Sprawdź, co to może oznaczać wynik wyższy niż przyjęte wartości referencyjne. Następnie z wynikami udaj się do specjalisty, by opracował plan dalszego postępowania medycznego.
Aminotransferaza alaninowa to wewnątrzkomórkowy enzym niezbędny do prawidłowego funkcjonowania komórek. Chociaż mniejsze jego stężenie występuje w mięśniu sercowym oraz mięśniach szkieletowych, najwyższe wartości stężenia związane są z komórkami wątroby (hepatocytami). Dlatego oznaczenie jego poziomu służy do wykrywania nieprawidłowości w pracy wątroby.
Dlaczego obecność aminotransferazy alaninowej we krwi jest groźna?
Jako że aminotransferaza alaninowa jest enzymem wewnątrzkomórkowym, w osoczu krwi znajduje się jedynie w śladowych ilościach. Dlatego badanie wskazujące na obecność we krwi w wysokim stężeniu jest powodem do niepokoju. Oznacza to, że mogło dojść m.in. do uszkodzenia komórek.
Oznaczenia poziomu aminotransferazy alaninowej dokonuje się najczęściej podczas testów przesiewowych służących do rozpoznania oraz kontrolowania przebiegu stanów zapalnych wątroby (przede wszystkim związanych z występowaniem wirusa HBV oraz wirusa HCV). Ponadto badanie wykonuje się u osób dotkniętych alkoholizmem, spożywających nadmierną ilość leków oraz przy podejrzeniu zapalenia dróg żółciowych.
Aminotransferaza alaninowa – normy
Aminotransferaza alaninowa oznaczana jest w standardowym badaniu, którym materiał stanowi surowica oraz osocze. Najbardziej wiarygodne wyniki daje pobranie krwi rano, na czczo.
Normy dla aminotransferazy alaninowej przedstawiają się następująco:
- dzieci (1-15 lat) < 25 U/l
- kobiety < 35 U/l
- mężczyźni < 45 U/l.
O czym świadczy podwyższone stężenie aminotransferazy?
Zaobserwowanie wzrostu aminotransferazy alaninowej w surowicy sugeruje martwicę komórek wątroby. Podwyższone aktywności enzymu są w stanie wyprzedzić wystąpienie żółtaczki nawet o 14 dni w przypadku wirusowego zapalenia wątroby.
Jeśli aminotransferaza alaninowa przekracza wartości referencyjne, w zależności od wielkości tego przekroczenia, może to świadczyć m.in. o:
- toksycznym uszkodzeniu wątroby (np. spowodowanym zatruciu grzybami).
- alkoholowym zapaleniu wątroby,
- polekowym zapaleniu wątroby,
- stłuszczeniu wątroby,
- cholestazie zewnątrzwątrobowej,
- zapaleniu dróg żółciowych.
Wzrost poziomu aminotransferazy alaninowej jest typowy także u osób otyłych (odnotowuje się średnio 1-3-krotny wzrost stężenia). Ponadto może wskazywać na szybko postępującą białaczkę limfoblastyczną, zawał mięśnia sercowego, chorobę Wilsona, niektóre nowotwory, hemolizę wewnątrznaczyniową.
Istnieje również fałszywie podwyższone stężenie aminotransferazy alaninowej, które dotyczy: osób wykonujących ciężką pracę fizyczną, kobiet w ciąży i po porodzie, osób zażywających niektóre leki.
Podwyższonego stężenia aminotransferazy nie można bagatelizować
Chociaż wysokie stężenie aminotransferazy alaninowej może być efektem zafałszowanego wyniku, przekroczenia wartości referencyjnych nie można bagatelizować. Należy niezwłocznie skonsultować się z lekarzem w celu dalszej diagnostyki.
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