勞工健檢常見肝功能檢驗異常之病因探討及處理原則

Approaches to abnormal liver function test in periodic health examinations for laborers

柯逸青(Yi-Ching Ko) ； 胡宛屏(Wan-Ping Hu) ； 蘇世斌(Shih-Bin Su)

《中華職業醫學雜誌》 9卷4期 (2002/10) Pp. 283-288

https://doi.org/10.30027/CJOM.200210.0002

摘要

肝功能檢驗是勞工健康檢查的重點項目之一。第一線的臨床健檢醫師經常會面臨許多勞工被發現aspartate aminotransferase(AST)、alanine aminotransferase (ALT)、alkaline phosphatase (ALP)、以及γ-glutamyltransferase(γ-GT)值異常，但病患本身並無任何臨床症狀的情形，以致解說病情、安排進一步檢查或轉介其他專科處理上，常面臨困擾。同時，此類病患也常因缺乏完整的追蹤及評估而延誤治療。一般勞工健檢發現之肝功能異常狀況，歸納出常見的因素包括慢性病毒性肝炎、酒精濫用、非酒精性脂肪肝疾病、自體免疫性肝炎、血色素沈著症、化學毒物以及藥物等等。臨床醫師應參考受檢者其他相關疾病及健康狀態，深入評估其病因並適當處理之，以維護勞工之健康。

關鍵字

肝功能 ； 病毒性肝炎 ； 非酒精性脂肪肝疾病 ； 週期性健康檢查

並列摘要

Liver function test is one of the important parts in periodic health examinations for laborers. The physician often faces the situations that liver function tests about aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and Y-glutamyltransferase (Y-GT) of the patients are abnormal, but no clinical signs of the patients are found. The treatment for this patients is often delayed because of poor tracing and further evaluation. The major causes of abnormal liver function include chronic viral hepatitis, alcohol abuse, nonalcoholic fatty liver disease, autoimmune hepatitis, hemochromatosis, chemical agents and medications. The physician should further evaluate the underlying disease of abnormal liver function to maintain the health of the laborers.

並列關鍵字

liver function ； viral hepatitis ； nonalcoholic fatty liver disease ； periodic health examinations