The level of transaminase does not fully represent the quality of liver function. More precisely, the level of transaminase is not parallel to the state of liver function. To sum up, there are several situations: ① The level of transaminase is normal and liver injury persists. It is found in some hepatitis patients, such as the so-called chronic hepatitis B virus carriers. These people have always been positive for hepatitis B virus, but transaminase has never increased. However, if such patients do liver biopsy, they can find that the inflammatory reaction of the liver is very serious, and some have already appeared fibrosis, even cirrhosis and liver cancer; There are also many patients with acute and chronic hepatitis C who have similar situations. ② The level of transaminase is very high, but it is only a temporary liver injury, which will not have a great impact on liver function, and the consequences are not very serious, such as taking drugs that are highly toxic to the liver. There used to be an old professor in our hospital. During his illness and hospitalization, transaminase rose to more than 2,000 units because of taking a medicine, and returned to normal after stopping taking the medicine for two days. In addition, most patients with acute hepatitis A have a high level of transaminase during the onset period, and soon return to normal after short-term rest and treatment. Drinking a lot at a time will have a similar phenomenon. ③ Jaundice is deep, transaminase is not high, even normal. There are three situations: first, biliary obstruction and poor bile excretion. When doing liver function examination, it is found that blood bilirubin is very high, while transaminase is not high or slightly elevated, which can be seen in tumor patients around bile duct stones, biliary tract and pancreatic head; The second type is severe hepatitis. This is a very serious liver disease with high mortality. At the beginning of the disease, transaminase increased in different degrees, and bilirubin was at a high level. However, with the progress of the disease, bilirubin is getting higher and higher, but transaminase is decreasing. When it is normal, it is called "bile enzyme separation" in medicine. This is a sign of serious illness, and it is useless to rely on drug treatment. It is best to do liver transplantation in time if conditions permit. In the past two years, our hospital has treated more than a dozen such patients, including a family of three, with severe liver disease and good recovery after liver transplantation. The third type is cholestatic hepatitis. It can be caused by many reasons, mainly the injury of small bile duct in the liver, leading to abnormal bile secretion, such as a few acute icteric hepatitis, drug-induced hepatitis, pregnancy and so on. ④ Although some patients with liver cirrhosis and liver cancer have advanced liver disease and poor liver function, their transaminase is normal. Many people know the primary disease because of a large number of ascites, gastrointestinal bleeding, or other abnormalities found during physical examination. It should be reminded that these so-called "minority" patients are not in the minority in our doctor's medical records. Nowadays, with the general improvement of people's living standards, it is essential to have a physical examination every year 1 ~ 2 times, and many diseases with hidden onset and slow progress can be found, among which cryptogenic cirrhosis is one. ⑤ Transaminase is abnormal for a long time, but its level is not high. This is more common in patients with chronic hepatitis, including chronic hepatitis B and C, autoimmune hepatitis and alcoholic hepatitis after long-term heavy drinking. Patients with chronic hepatitis whose transaminase level is not very high are mostly between 100 ~ 200 units, or lower than 100 units, which needs the most attention, because these patients have the largest number, the disease continues to develop, the prognosis is also the worst, and eventually they will develop into cirrhosis or liver cancer. Appropriate treatment should be taken as soon as possible, especially antiviral treatment for patients with viral hepatitis. ⑥ Finally, there is a modern civilized disease, namely fatty liver, which is characterized by a slight increase in transaminase, generally not exceeding 100 unit. Such people are generally overweight or seriously overweight. In recent years, the incidence of fatty liver in China has increased year by year, which is related to improper diet structure, overeating, excessive drinking and lack of exercise. It is a typical "rich disease". In the past, people called tuberculosis "the disease of the rich", which meant that only the rich could afford it. It's really ironic. Fatty liver, hypertension, diabetes, coronary heart disease and gallstones are real wealth diseases among modern people, which should arouse our vigilance!