Looking back at 202 1, some people are struggling, and some people are grateful in the harvest;
Some people go forward bravely for their careers, and some people take the initiative to change for their health.
Guarding, tenacity, hope and encouragement. ......
No matter how the world changes, from 202 1 to 2022, Ark Geeks will always be with you.
To this end, we have launched a special plan of "embracing health and going forward bravely", packaging health and giving it to everyone who is about to sail.
At the end of the year and the beginning of the year, we invited 10 famous doctors in the field of liver diseases to give you 10 health tips for nourishing and protecting the liver. I wish you good health in the Year of the Tiger.
1 Lu Junfeng: Active antiviral therapy can reduce the risk of liver cirrhosis and liver cancer.
Song Jianxin: Use antiviral drugs, and don't ignore the damage of bone and kidney function.
At present, there are mainly two kinds of drugs for treating chronic hepatitis B, one is long-acting interferon with immunomodulatory mechanism, and the other is nucleoside (acid) analogues. After years of exploration, it is found that some oral drugs can affect bone marrow and kidney, such as adefovir and tenofovir. Patients taking such drugs should pay attention to the detection of bone marrow and renal function when they return to the clinic.
For chronic hepatitis B patients with bone and kidney risks, it is suggested to choose drugs with high safety factor, such as propoxytenofovir disoproxil fumarate fumarate (TAF).
Xu Haifeng: "The key to eliminate hepatitis C is to screen out all screening, treat all patients and treat all diseases".
Interferon has dominated the whole hepatitis C market for a long time, but its side effects are common and the cure rate is very low. With the listing of domestic direct antiviral drugs (DAA) in recent two years, the cure rate of hepatitis C has also been significantly improved.
At present, hepatitis C can basically be completely cured. At the 69th World Health Assembly, the World Health Organization set the overall goal of "eliminating viral hepatitis by 2030". For China, the prevention and treatment of hepatitis C still faces multiple challenges, including low public awareness of hepatitis C and low diagnosis and treatment rate.
To achieve the overall goal, the key is to screen all screens, treat all patients and cure all diseases!
Zhang Yonghong: People over 40 years old should have regular screening for liver cancer.
For people all over the world, liver cancer is a disease that seriously endangers human life and health. In most countries, the average onset age of liver cancer is over 60 years old.
However, in China, liver cancer tends to be younger, with an average onset age of 52 years. Clinical studies have found that the risk of liver cancer will increase with every ten years of age in people over 40 years old. Therefore, people over the age of 40 who have any high risk factors for liver cancer should be screened for liver cancer as soon as possible.
5 Zhang Yi: There is no absolute "safe medicine" for treating hepatitis B, but the one that suits you is the best.
At present, there are two kinds of antiviral drugs for chronic hepatitis B, one is oral nucleoside drugs, and the other is interferon injection. For patients with antiviral signs, the conventional treatment is oral nucleoside drugs. The replication of hepatitis B virus can be inhibited by inhibiting reverse transcriptase, but the course of treatment is long and it is easy to relapse after stopping taking drugs. Interferon has a good effect of inhibiting virus, but it has large side effects and narrow application range. For example, it is not recommended for pregnant women, pregnant women, decompensated cirrhosis and autoimmune diseases (such as vitiligo and lupus erythematosus). At present, tenofovir disoproxil fumarate fumarate (TDF), TAF and entecavir are the first-line drugs for chronic hepatitis B recommended by domestic and foreign guidelines. These drugs have their own characteristics, and we will comprehensively consider them according to clinical experience and patient characteristics. Zhang Keqin: If we treat "regular review" correctly, we can fully understand the therapeutic effect.
Many people have this question: I had a B-ultrasound last year, and there was no problem. Why do you want to do it this year? In fact, this is because everyone has not correctly realized the importance of review. These tests are not useless, but very important. The reexamination indexes of patients with hepatitis B mainly include: liver and kidney function, hepatitis B halves, hepatitis B virus DNA detection, alpha-fetoprotein, liver elasticity detection and liver color Doppler ultrasound. For patients who are undergoing antiviral therapy, the review can fully understand the therapeutic effect. If there is poor response or drug resistance, doctors can adjust the medication plan in time to prevent the disease from getting worse.
Chen: These common symptoms may be a precursor to liver disease, so you should seek medical attention in time.
The most common sentence of patients who come to see a doctor is: I am not unwell, how can I get liver disease? The liver is a silent organ, the onset is hidden, and the early symptoms are atypical, so most people can't notice it. For example, fatigue, listlessness, fatigue, fatigue, lethargy, loss of appetite, abdominal distension and abdominal pain ... these may be signs of liver disease, but few people can react quickly.
If the disease continues to progress, there will be jaundice, splenomegaly, liver pain and other symptoms. Most patients didn't realize that they were sick until this time, so the result of going to the hospital for examination was very unsatisfactory and the prognosis was very poor.
Sun Long: Do a good job in the whole process of pregnancy management, hepatitis B mothers can also give birth to healthy babies.
After the baby is born, according to the "0 16 scheme", hepatitis B vaccine and hepatitis B immunoglobulin can almost block 100%. But at the same time, we should also do a good job in monitoring and management during pregnancy. Pre-pregnancy: The pregnancy of patients with chronic hepatitis B will not be affected during antiviral treatment, but the timing of pregnancy needs to be evaluated by doctors. At present, the first-line oral drugs are relatively safe, and as long as the condition is stable, it is possible to get pregnant. But if you use interferon, you need to stop taking it for six months to get pregnant. Pregnancy: In addition to routine examination, liver function should be monitored regularly. It is generally recommended to detect hepatitis B DNA from 24 weeks to 28 weeks of pregnancy. If the viral load is too high, it is recommended to directly carry out antiviral treatment.
Postpartum: liver function should be rechecked 1~3 months after delivery. If the index is abnormal, the drug should continue to be used. At the same time, we also need to monitor the liver function of newborns.
9 Li Yufang: The lower the HBV DNA, the better the antiviral treatment for chronic hepatitis B.
HBV DNA is an important indicator of hepatitis B virus load, which can judge the infection stage of patients and evaluate the efficacy of drugs. At present, clinical experts generally believe that the lower the level of HBV DNA, the lower the risk of liver cirrhosis and liver cancer.
It is generally believed that HBV DNA in patients' serum should be undetectable or below the detection limit (using standard and sensitive methods) after ideal antiviral drug treatment. The commonly used quantitative detection of HBV DNA has low sensitivity and poor accuracy, which can not meet the needs of clinical management of patients with chronic hepatitis B. Li Yufang suggested using a highly sensitive method to detect HBV DNA level, and the lower the value, the better.
10 sheng huiping: to improve simple fatty liver, you can try the Mediterranean diet.
Simple fatty liver can indeed be improved or even reversed through diet and exercise. However, if it develops into liver fibrosis, especially liver fibrosis of more than second degree, it can not completely reverse liver injury, and it may also develop into cirrhosis and liver cancer.
Studies have shown that a Mediterranean diet lasting more than 6 weeks can significantly reduce the fat content of liver tissue. Mediterranean diet is a diet style mainly composed of vegetables, fruits, fish, bean products, seafood, nuts, whole grains and olive oil.
It is characterized by reducing the intake of carbohydrates, especially sugar and refined carbohydrates, and increasing the intake of monounsaturated fatty acids and omega-3 fatty acids.
It is not difficult to have a healthy liver. Stay away from alcohol and tobacco, keep exercising and eat a balanced diet. I hope that in the new year, everyone can "clear the liver" and embrace health.