is the peak season of physical examinations again. I believe everyone knows the importance of regular physical examinations, but many people are still confused when they receive physical examination reports. If they face obscure medical terms and dense numbers, they will be even more nervous if they see the arrows floating up and down behind the indicators, and the stimulation is comparable to "opening a blind box". How to correctly interpret the physical examination report by
? Next, we will teach you step by step to understand the meaning of common indicators.
Indicator 1: Blood pressure
systolic blood pressure normal limit is 140 mmHg , and diastolic blood pressure normal limit is 90 mmHg. If this standard exceeds this standard, blood pressure is considered to be higher than normal. During the physical examination of
, you should pay attention to sitting in advance for 10 minutes to keep your mood stable. In addition, the blood pressure increases once, and the diagnosis cannot be confirmed by hypertension . The diagnosis requires at least three blood pressure measurements on different dates.
Health prescription: Low-salt diet, exercise appropriately, quit smoking and limit alcohol; blood pressure should be monitored regularly, and antihypertensive drugs should be taken as prescribed by the doctor to avoid sudden stopping or reducing medication.
Indicator 2: Blood sugar
Blood sugar detection mainly includes fasting blood sugar and glycated hemoglobin (saccharified HGB). The normal value of fasting blood sugar (intake of sugar-free and any sugar-containing foods within 8 hours) is 3.9-6.1 mmol/liter. When fasting blood sugar is higher than the normal range of 6.1 mmol/liter, it is called hyperglycemia .
Glycoated HGB reflects the average level of blood sugar control in the past 90 days and is used to evaluate the long-term blood sugar control.
blood sugar is non-fixed. Due to various factors, a single indulgent meal, high-intensity exercise or emotional excitement will cause blood sugar to increase. These conditions are transient hyperglycemia, but if you are in a state of high blood sugar for a long time and are not controlled, you may eventually wear the " diabetes " hat.
Health prescription: controls total calories, eats less and eats more, quits smoking and limits alcohol, and avoids excessive fatigue; monitors blood sugar, long-term drug treatment as prescribed by doctors, and regular outpatient follow-up.
indicator 3: aminotransferase
aminotransferase is the most directly reflecting the harm of liver cells, focusing mainly on alanine aminotransferase (ALT) and aspartate aminotransferase (AST).
ALT normal value range is 0U/L-40U/L. However, ALTh lacks specificity, and various reasons such as fatigue, alcohol consumption, colds, and emotional factors can cause changes in the permeability of hepatocyte membranes, but the resulting increase in aminotransferase will generally not be higher than 60U/L. Once the ALT value is higher than 80U/L, it has diagnostic value and you need to go to the hospital for treatment.
AST normal value range is 0U/L-40U/L. The significance of elevated AST is similar to ALT in the diagnosis of hepatitis. Generally speaking, the increase in AST is not as high as that of ALT. Once the AST value is higher than the ALT value, it means that the degree of hepatocyte damage and necrosis is more important. At this time, it is more meaningful to determine isoenzymes (ASTs and ASTm). Only AST is elevated in mild liver damage, and ASTm is significantly elevated in severe liver damage. The increase in
is significantly more common in hepatitis, liver tumors, and the use of liver damage drugs. However, in some physiological situations, " false positive " will also occur, and it is necessary to rule out large amounts of alcohol, vigorous exercise, overwork, fever, pregnancy, etc.
liver function test is blood drawn when the patient is fasting, and the fasting time is generally 8-12 hours. It is recommended to check that you should not eat after 9:00 the night before. Avoid eating high in fat, high protein, and foods rich in carotene and lutein for dinner, and ensure adequate sleep. On the day of the inspection, you cannot eat breakfast, drink water, nor do you have physical exercise or vigorous exercise before the inspection. After arriving at the hospital, you should rest quietly for 20 minutes before taking blood tests.
Drinking alcohol will affect the indicators of transaminase in liver function. You cannot drink alcohol the night before the examination. At the same time, try to avoid liver function tests during intravenous infusion or within 4 hours of medication. If your physical condition allows, it is best to stop the medication 3-5 days before the liver function test.
Health prescription: Avoid using liver toxic drugs, quit smoking and limit alcohol, and moderate work and rest; follow-up examination in the outpatient clinic after two weeks.
Indicator 4: Tumor marker
alpha-fetoprotein (AFP): is often used for monitoring liver metastasis of primary liver cancer and digestive tract tumors.One of the diagnostic criteria for liver cancer is AFP ≥400 micrograms/liter. Hepatitis B, cirrhosis , pregnancy or reproductive tumors can also experience different degrees of increase in AFP. For patients with low alpha-fetoprotein, dynamic observation should be performed in combination with imaging .
Carcinoembryonic Antigen (CEA): broad-spectrum tumor marker, which can be elevated in intestinal cancer, gastric cancer , lung cancer, and breast cancer . It is mainly used in clinical practice to monitor the recurrence and metastasis of gastrointestinal tumors.
carbohydrate antigen CA153: a specific marker for breast cancer. CA153 can be increased in 30%-50% of breast cancer patients, but the CA153 positive rate is low in the early stage of breast cancer.
Health prescription: most tumor markers are specific and have limited sensitivity. If you only have one increase, you don’t need to panic too much. It is recommended to visit the tumor specialist in one month and monitor the indicators dynamically.
Nodules , polyps, and placeholder lesions?
■Nodules/mass
nodules are relatively small tumors. A slightly larger one is called a mass and can occur in any part of the body. Most nodules are benign and can be followed up regularly. During the
physical examination, thyroid nodules is very common. On average, one in every five Chinese people suffers from thyroid nodules. Whether thyroid nodules need treatment is mainly determined by the nature of the nodules. Most of the thyroid nodules found during physical examinations are benign. However, in recent years, the incidence of thyroid cancer has increased year by year (related to factors such as radioactive contact, autoimmunity, and genetics). Therefore, it is very important to identify the benign and malignant nodules. The most important method is to judge through ultrasound examination.
If nodules/mass are found during physical examination, you need to pay attention to their hardness, mobility, boundaries and growth rate. If nodules/mass are found during physical examinations in middle-aged and elderly people, even if they are not painful or itchy or asymptomatic, they should be taken seriously and seek medical treatment in time.
■Polyp
polyp refers to a growth organism growing on the surface of the human mucosa. Most of them are benign and a small number of them tend to change malignantly. Taking gallbladder polyps as an example, non-tumor polyps account for 90% and basically do not become cancerous. 65% of non-tumor polyps are cholesterol polyps, which are highly related to diet. Patients with high cholesterol and diet or who have fatty liver are particularly prone to cholesterol polyps.
cholesterol polyps are mostly within 1 cm, and are common in multiple forms. For cholesterol polyps below 1 cm, you can check B ultrasound every six months to one year to observe changes in size, shape, and quantity without surgery. If cholesterol polyps are combined with gallbladder stones gallbladder inflammation, surgical resection is recommended. If the polyp diameter is greater than 1 cm and is older than 50 years old, it is recommended to seek medical treatment as soon as possible and surgical treatment can be considered.
■Placeholder lesions
usually appear in imaging results such as B-ultrasound, CT, MRI, etc. Placeholder lesions generally refer to tumors (benign/malignant), parasites, stones, etc. The placeholder lesions generally refer to tumors (benign/malignant), parasites, stones, etc. The situations vary according to different places. It is recommended that further examinations be conducted in specialized departments.
It should be noted that abnormalities in some indicators on the physical examination report do not mean that they are equated with "sick". There is no need to be afraid when you look at the physical examination report. For various nodules, polyps, space-occupying lesions found during physical examination, follow-up is still required. Especially if you suffer from irregular morphological calcifications, gradually enlarged gallbladder polyps, etc., this is often evidence of malignant degeneration. You should seek medical treatment in a timely manner and ask a professional doctor to formulate specific treatment plans.
In addition, the physical examination reports of previous years can be collected, and the "single-in-one" observation of changes in indicators can be conducted every year, and the regular review and further examinations can be made to ensure that the physical examination can truly keep a good eye for health.
Author: Wu Jingxin Fan Jingyan (Health Examination Department of Shanghai 10th People's Hospital)
Editor: Li Chenyan
Image source: Visual China
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-