What the total blood protein can tell about: the norm, the reasons for its decrease and increase. Nine blood counts that will tell you everything about you What the general says

27.05.2020

The liver performs detoxifying, protein synthesis and other functions. With her diseases, her activity changes. When part of the hepatocytes (liver cells) is destroyed, the enzymes they contain enter the blood. All these processes are reflected in the biochemical study of the so-called liver tests.

The main functions of the liver

The liver is a vital organ. When its functions are violated, the entire body suffers.

The liver performs vital functions, in particular:

removes harmful substances from the blood;
transforms nutrients;
retains useful minerals and vitamins;
regulates blood clotting;
produces proteins, enzymes, bile;
synthesizes factors to fight infection;
removes bacteria from the blood;
neutralizes toxins that have entered the body;
maintains the balance of hormones.

Liver disease can significantly undermine a person's health and even cause death. That is why it is necessary to consult a doctor in time and take an analysis for liver function tests when such signs appear:

weakness;
fast fatiguability;
unexplained weight loss;
abdomen, legs and around the eyes;
darkening of urine, discoloration of feces;
nausea and vomiting;
persistent loose stools;
heaviness or pain in the right hypochondrium.

Indications for research

Liver tests provide information about the condition of the liver. They are determined in such cases:

diagnostics of chronic diseases, for example, hepatitis C or;
monitoring possible side effects of certain medications, in particular antibiotics;
monitoring the effectiveness of therapy for already diagnosed liver disease;
determining the degree of this organ;
the appearance of the patient's severity in the right hypochondrium, weakness, nausea, bleeding and other symptoms of liver pathology;
the need for surgical treatment for any reason, as well as planning a pregnancy.

Many studies are used to assess liver function, but most of them are aimed at determining any one function, and the results do not reflect the activity of the entire organ. That is why such liver tests are most commonly used in practice:

alanine aminotransferase (ALT or ALT);
aspartate aminotransferase (AST or AST);
albumen;
bilirubin.

ALT and AST levels increase when liver cells are damaged as a result of a disease of this organ. Albumin reflects how well the liver synthesizes protein. The level of bilirubin shows whether the liver is coping with the function of detoxification (neutralization) of toxic metabolic products and their excretion with bile into the intestines.

Changes in liver function tests do not always mean that the patient has a disease of this organ. Only a doctor can evaluate the result of the analysis, taking into account complaints, anamnesis, examination data and other diagnostic tests.

Most common liver function tests

ALT and AST are the most important indicators that allow, in combination with patient complaints and data from other research methods, to assess liver function.

Liver tests are the determination of specific proteins or enzymes in the blood. A deviation from the norm of these indicators can be a sign of liver disease.

ALT

This enzyme is found inside hepatocytes. It is necessary for protein metabolism, and when cells are damaged, it enters the bloodstream. Its rise is one of the most specific signs of liver cell decay. However, due to the peculiarities of laboratory determination, not for all pathology, its concentration increases. So, in persons with alcoholism, the activity of this enzyme is reduced, and when analyzed, false normal values \u200b\u200bare obtained.

AST

In addition to hepatocytes, this enzyme is present in the cells of the heart and muscles, therefore its isolated determination does not provide information about the state of the liver. Most often, not only the AST level is determined, but also the ALT / AST ratio. The latter indicator more accurately reflects the damage to hepatocytes.

Alkaline phosphatase

This enzyme is found in the cells of the liver, bile ducts and bones. Therefore, its increase may indicate damage not only to hepatocytes, but also a blockage of the bile ducts or, for example, a bone fracture or tumor. It also increases during periods of intensive growth in children, and an increase in alkaline phosphatase concentration is possible during pregnancy.

Albumen

It is the main protein synthesized by the liver. It has many important features, for example:

retains fluid inside blood vessels;
nourishes tissues and cells;
carries hormones and other substances throughout the body.

Low albumin levels indicate impaired protein-synthetic liver function.

Bilirubin

The term “total bilirubin” includes the sum of indirect (unconjugated) and direct (conjugated) bilirubin. During the physiological breakdown of erythrocytes, the hemoglobin contained in them is metabolized to form indirect bilirubin. It enters the liver cells and is rendered harmless there. In hepatocytes, indirect bilirubin is converted into a harmless straight bilirubin, which is excreted with bile into the intestine.

An increase in indirect bilirubin in the blood indicates either an increased breakdown of erythrocytes (for example, with), or a violation of the detoxifying function of the liver. An increase in the content of direct bilirubin is a sign of impaired patency of the biliary tract, for example, when part of this substance does not come out with bile, but is absorbed into the blood.

Research execution

If necessary, the doctor will give special instructions on which drugs should be canceled before the blood test. It is usually recommended not to take fatty and fried foods for 2-3 days, if possible, stop taking medications.

Blood is drawn in the treatment room from the cubital vein in the usual way.

Complications are rare. After taking a blood sample, you may experience:

hemorrhage under the skin at the site of a vein puncture;
prolonged bleeding;
fainting;
infection of a vein with the development of phlebitis.

After taking blood, you can lead a normal life. If the patient has felt, it is better for him to rest a little before leaving the clinic. Analysis results are usually ready the next day. According to these data, the doctor will not be able to say exactly what kind of liver disease there is, but he will draw up a further diagnostic plan.

Assessment of results

In the form of a blood test, the concepts of "general", "indirect", "direct bilirubin" may appear. A deviation from the norm of any of the indicators is a sign of any pathological process in the liver or the body as a whole.

The normal content of the studied parameters may differ in different laboratories and is noted on the result form. However, there are guidelines.

ALT: 0.1-0.68 μmol / L or 1.7-11.3 IU / L.
AST: 0.1-0.45μmol / L or 1.7-7.5 IU / L.

The reasons for the increase in the level of both enzymes:

acute or, cirrhosis,;
obstructive jaundice (for example, with gallstone disease);
or toxic damage to this organ;
acute fatty degeneration in pregnant women;
strong;
hemolytic anemia;
side effects, drugs for anesthesia, oral contraceptives;
muscle injury, myopathy.

Reasons for an increase in ALT with a normal or slightly elevated AST level:

pulmonary or mesenteric infarction;
the action of chloroform, carbon tetrachloride, vitamin C, dopegite, salicylates and the poison of the pale toadstool.

The AST / ALT ratio is called the de Ritis ratio, and it is 1.33. In liver pathology, it decreases, in heart and muscle diseases, it increases by more than 1.

Alkaline phosphatase: 0.01-0.022 IU / L.

Reasons for the increase:

hepatitis, cirrhosis, liver cancer;
cholangitis;
neoplasm of the gallbladder;
liver abscess;
primary biliary cirrhosis;
metastatic liver damage;
bone fractures;
tumor and metastatic bone lesions;
microbial intestinal infections, such as dysentery;
the action of drugs for anesthesia, albumin, barbiturates, dopegit, nicotinic acid, methyltestosterone, methylthiouracil, papaverine, sulfonamides.

Albumin: the norm in serum is 35-50 g / l.

Reasons for the decline:

fasting and other causes of impaired absorption of proteins in the body;
acute and chronic hepatitis, cirrhosis;
malignant tumors;
severe infectious diseases;
pancreatitis;
diseases of the kidneys, intestines, skin (burns);
a significant increase in the activity of the thyroid gland;
itsenko-Cushing's disease.

Bilirubin: total 8.5-20.5 μmol / L, direct 2.2-5.1 μmol / L.

hepatitis, cirrhosis, liver tumors;
hemolytic anemia;
intolerance to fructose;
crigler-Nayyar or Dabin-Johnson syndrome;
gilbert's disease;
jaundice of newborns.

Reasons for the increase in direct bilirubin in the blood:

jaundice of mechanical origin;
various hepatitis;
cholestasis;
the action of androgens, mercazolil, penicillin, aminoglycosides, sulfonamides, oral contraceptives and nicotinic acid;
dabin-Johnson or Rotor syndrome;
decreased activity of the thyroid gland in newborns;
an abscess in the liver tissue;
leptospirosis;
inflammation of the pancreas;
liver dystrophy in pregnant women;
intoxication with the poison of a pale toadstool.

The reasons for the increase in the blood of indirect bilirubin:

anemia of hemolytic origin;
prolonged compression syndrome;
crigler-Nayyard syndrome, Gilbert's disease;
erythroblastosis;
galactosemia and fructose intolerance;
paroxysmal hemoglobinuria;
botkin's disease (hepatitis A);
leptospirosis;
spleen vein thrombosis;
the action of benzene, vitamin K, dopegit, anesthetics, NSAIDs, nicotinic acid, tetracycline, sulfonamides, fly agaric poison.

Biochemical syndromes

Changes in liver function tests are possible with different pathologies. To isolate liver damage, doctors use the appropriate biochemical syndromes:

cytolytic (disintegration of hepatocytes);
inflammatory (inflammation, including of an autoimmune nature);
cholestatic (bile stasis).

The cytolytic variant of the lesion is assumed with an increase in ALT and AST. To confirm it, additional analyzes are used for the content of fructose-1-phosphataldolase, sorbitol dehydrogenase, ornithylcarbamoyltransferase, succinate dehydrogenase.

By the concentration of ALT and AST, you can determine the activity of hepatitis and cirrhosis:

If an autoimmune process is suspected, signs of mesenchymal-inflammatory lesions are determined.

Blood test. What do the indicators say?

Each of us donated blood for analysis, but not everyone knows what the indicators of this analysis indicate.

A complete blood count is one of the most common diagnostic methods that allows a doctor to diagnose inflammatory and infectious diseases, and assess the effectiveness of the treatment.

For the analysis, capillary blood (from a finger) or venous blood (from a vein) is used. It is not required to prepare for this examination, but it is recommended to carry it out in the morning on an empty stomach.

The main indicators of a general blood test

Hemoglobin

Hemoglobin is the main component of red blood cells, staining the blood red and delivering oxygen to all organs and tissues.

Hemoglobin rate for men - 130-160 g / l, for women - 120-140 g / l

Increased hemoglobin may indicate polycythemia, excessive physical exertion, dehydration, and blood clots. Decreased hemoglobin may indicate anemia.

Color index

The color index is determined by the ratio of the amount of hemoglobin in erythrocytes. This indicator is used to determine the type of anemia.

Color index rate for men - 0.85-1.15, for women - 0.85-1.15

An excess of the norm may indicate spherocytosis, a decrease in the norm - about iron deficiency anemia.

Erythrocytes

Erythrocytes are red blood cells that have lost their nucleus, contain hemoglobin, and transport oxygen.

Erythrocyte rate for men - 4-5.1x10 12, for women - 3.7-4.7x10 12

An increase in the rate of red blood cells may indicate polycythemia (bone marrow disease) and dehydration, a decrease - about anemia due to blood loss, lack of iron, vitamins.

Reticulocytes

Reticulocytes are young, immature erythrocytes with remnants of the nucleus. Only an insignificant part of such erythrocytes enters the blood, and the main one is contained in the bone marrow.

The rate of reticulocytesfor men - 0.2-1.2%, for women - 0.2-1.2%

An excess content of reticulocytes in the blood speaks of anemia, blood loss. A decrease in the number of reticulocytes can be a sign of kidney disease, erythrocyte metabolism disorders, aplastic anemia.

Platelets

Platelets are blood cells that are made from cells in the bone marrow. Thanks to these cells, the blood can clot.

Platelet rate for men - 180-320x10 9, for women - 180-320x10 9

An increase in platelets may indicate an inflammatory process, polycythemia, and also be a consequence of surgery. A decrease in the number of platelets can indicate systemic autoimmune diseases, aplastic anemia, hemolytic anemia, hemolytic disease, isoimmunization for the Rh factor and blood groups.

ESR - this abbreviation stands for erythrocyte sedimentation rate. Deviation of ESR from the norm can be a sign of an inflammatory or pathological process in the body.

ESR rate for men - 1-10 mm / h, for women - 2-15 mm / h

ESR can increase during pregnancy, an infectious disease, an inflammatory process, anemia, and tumor formation.

Leukocytes

Leukocytes are white blood cells. Their main function is to protect the body from microbes and foreign substances.

Leukocyte ratefor men - 4-9x10 9, for women - 4-9x10 9

An increase in the number of leukocytes can indicate leukemia, an inflammatory or infectious process, allergies, blood loss, and autoimmune diseases. A decrease in the number of leukocytes may indicate some infections (influenza, rubella, measles, etc.), genetic anomalies of immunity, increased spleen function, bone marrow pathology.

The rate of segmented neutrophilsfor men - 47-72%, for women - 47-72%

An increase in neutrophils indicates the presence of bacterial, fungal and some other infections, inflammatory processes due to tissue trauma, with arthritis, arthrosis, etc. Neutrophils can also increase due to physical exertion, temperature changes, during pregnancy.

Decrease in neutrophils can occur due to depletion of the body, afterbirth of long-term chronic diseases, thyroid disease.

Eosinophils

The rate of eosinophilsfor men - 0-5%, for women - 0-5%

Basophils

Basophils - take part in immediate allergic reactions.

Basophil normfor men - 0-1%, for women - 0-1%

The number of basophils increases with blood diseases, ulcerative colitis, chickenpox, food and drug intolerance. It decreases with hyperthyroidism, ovulation, pregnancy, stress, acute infections and increased production of adrenal hormones.

Lymphocytes

Lymphocytes - fight against foreign cells and proteins, viral infections, release antibodies into the blood and block antigens.

Lymphocyte ratefor men - 18-40%, for women - 18-40%

The number of lymphocytes increases with infectious monoculosis, hepatitis, tuberculosis and syphilis, viral infections, and leukemia. Decreases in acute infection, autoimmune diseases, cancer, immunodeficiency.

Monocytes

Monocytes - destroy foreign proteins and cells in tissues.

Basophil normfor men - 2-9%, for women -2-9%

The number of monocytes rises after acute infections, with tuberculosis, syphilis, rheumatic diseases. Decreases with damage to the bone marrow.

So what does our blood tell us? We hand over a blood test for almost any disease. And a competent doctor will certainly send you "to the blood" first of all. For a general analysis, blood is taken either from a vein or from a finger. And the primary analysis can be taken on an empty stomach. But for the expanded, there is no way to eat! Remember this!
The reason for this requirement is simple: any food will change your blood sugar, and the analysis will not be objective. It is best to donate blood after a short rest (which is why we most often go to the test in the morning). Again for the purity of research.
A competent doctor will definitely take into account your gender and physiological condition. Because, say, in women during PMS, ESR increases and the number of platelets decreases.
General analysis indicators:
1. Hemoglobin (Hb)
It is a blood pigment contained in red blood cells, the main function of which is to transport oxygen from the lungs to the tissues and remove CO2 from the body. Normal values \u200b\u200bfor men are 130–160 g / l, for women - 120–140 g / l. If hemoglobin is low, this indicates possible anemia, blood loss or latent internal bleeding with damage to internal organs. An increase in hemoglobin, as a rule, is observed in blood diseases and some types of heart failure.
2. Erythrocytes
These are directly red blood cells containing hemoglobin. Normal values \u200b\u200bfor men are (4.0-5.1) * 10 in the 12th degree / l and for women - (3.7-4.7) * 10 in the 12th degree / l. An overabundance of erythrocytes occurs in healthy people at high altitudes in the mountains, as well as with heart defects, diseases of the bronchi, lungs, kidneys and liver. Sometimes this indicates an excess of steroid hormones in the body. The lack of red blood cells indicates anemia, acute blood loss, chronic inflammatory processes. And sometimes it happens in late pregnancy.
3. Leucrcites
White blood cells. They are produced in the bone marrow and lymph nodes and protect the body from external influences. The norm for all is (4.0-9.0) x 10 in the 9th degree / liter. Excess indicates the presence of infection and inflammation. A large number of them occur in different situations, sometimes not related to diseases. They can jump from physical exertion, stress, or pregnancy. But it happens that leukocytosis is associated with diseases, namely:
bacterial infections;
inflammatory processes;
allergic reactions;
leukemia;
taking hormonal drugs, some heart drugs (such as digoxin).
But leukopenia (lack of leukocytes) may indicate a viral infection (for example, with flu) or taking certain medications, for example, analgesics, anticonvulsants.
4. Platelets
The cells that provide blood clotting are involved in the formation of blood clots. The normal amount is (180-320) * 10 to the 9th degree / l. If they are more than normal, then you may have tuberculosis, ulcerative colitis, cirrhosis of the liver. This also happens after surgery or when using hormonal drugs. Their reduced content occurs with the action of alcohol, heavy metal poisoning, blood diseases, kidney failure, liver and spleen diseases, hormonal disorders. And also with the action of certain drugs: antibiotics, diuretics, digoxin, nitroglycerin, hormones.
5. ESR or ROE
Sedimentation rate of erythrocytes. This is an indicator of the course of the disease. Usually ESR increases by 2-4 days of the disease, and reaches a peak during the recovery period. The norm for men is 2-10 mm / h, for women - 2-15 mm / h. Increased rates are observed with infections, inflammation, anemia, kidney disease, hormonal disorders, shock after injuries and operations, during pregnancy, after childbirth, during menstruation, and decreased rates are observed with circulatory failure, anaphylactic shock.
6. Glucose
The concentration of glucose in a healthy body should be 3.5–6.5 mmol / liter. A lack of glucose indicates insufficient and irregular nutrition, hormonal diseases, an excess of diabetes.
7. Total protein
Its norm is 60-80 grams / liter. With the deterioration of the liver, kidneys, malnutrition, it decreases. This often happens after rigid diets.
8. Total bilirubin
Bilirubin should show no more than 20.5 mmol / liter. He is an indicator of liver function. With hepatitis, gallstone disease, or destruction of red blood cells, bilirubin increases.
9. Creatinine
Creatinine is in charge of your kidneys. Its normal concentration is 0.18 mmol / liter. Exceeding the norm is a sign of renal failure, if it does not reach the norm, it means that you need to increase immunity.

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What can you read about your health according to the most informative analysis

Whatever you fall ill, the first test, to which a competent doctor will send you, will be a general (general) blood test, says our expert - cardiologist, doctor of the highest category Tamara Ogieva.

Blood for general analysis is taken from venous or capillary, that is, from a vein or from a finger. The primary general analysis can be taken on an empty stomach. A detailed blood test is taken only on an empty stomach.

For biochemical analysis, blood will have to be donated only from a vein and always on an empty stomach. After all, if you drink, say, coffee with sugar in the morning, the blood glucose content will certainly change and the analysis will be incorrect.

A competent doctor will definitely take into account your gender and physiological condition. For example, in women during “critical days”, ESR increases and the number of platelets decreases.

A general analysis gives more information about inflammation and the state of the blood (tendency to blood clots, the presence of infections), and a biochemical analysis is responsible for the functional and organic state of internal organs - the liver, kidneys, and pancreas.

General analysis indicators:

1. HEMOGLOBIN (Hb) is a blood pigment, contained in erythrocytes (red blood cells), its main function is to carry oxygen from the lungs to tissues and remove carbon dioxide from the body.

Normal values \u200b\u200bfor men are 130-160 g / l, women are 120-140 g / l.

Decreased hemoglobin occurs with anemia, blood loss, latent internal bleeding, with damage to internal organs, for example, kidneys, etc.

It can increase with dehydration of the body, with blood diseases and some types of heart failure.

2. Erythrocytes - blood cells that contain hemoglobin.

Normal values \u200b\u200b(4.0-5.1) * 10 in the 12th degree / l and (3.7-4.7) * 10 in the 12th degree / l, for men and women, respectively.

An increase in red blood cells in the blood occurs, for example, in healthy people at high altitudes in the mountains, as well as in congenital or acquired heart defects, diseases of the bronchi, lungs, kidneys and liver. The increase may be due to an excess of steroid hormones in the body. For example, in case of illness and Cushing's syndrome, or in treatment with hormonal drugs.

Decrease - with anemia, acute blood loss, with chronic inflammatory processes in the body, as well as in late pregnancy.

3. LEUKOCYTES - white blood cells, they are formed in the bone marrow and lymph nodes. Their main function is to protect the body from adverse effects. The norm is (4.0-9.0) x 10 in the 9th degree / l. Excess indicates the presence of infection and inflammation.

There are five types of leukocytes (lymphocytes, neutrophils, monocytes, eosinophils, basophils), each of them has a specific function. If necessary, a detailed blood test is done, which shows the ratio of all five types of leukocytes. For example, if the level of leukocytes in the blood is increased, a detailed analysis will show due to which type their total number increased. If due to lymphocytes, then there is an inflammatory process in the body, if there are more eosinophils than the norm, then an allergic reaction can be suspected.

Why are there a lot of leukocytes?

There are many conditions in which there is a change in the level of leukocytes. This does not necessarily mean illness. Leukocytes, as well as all indicators of the general analysis, respond to various changes in the body. For example, during stress, pregnancy, after physical exertion, their number increases.

An increased number of leukocytes in the blood (in another way, leukocytosis) occurs with:

Infections (bacterial)

Inflammatory processes

Allergic reactions

Malignant neoplasms and leukemias,

Taking hormonal medications, certain heart medications (such as digoxin).

But a reduced number of leukocytes in the blood (or leukopenia): this condition often happens with a viral infection (for example, with the flu) or taking certain medications, for example, analgesics, anticonvulsants.

4. Platelets - blood cells, an indicator of normal blood clotting, are involved in the formation of blood clots.

Normal amount - (180-320) * 10 in the 9th degree / l

An increased amount occurs when:

Chronic inflammatory diseases (tuberculosis, ulcerative colitis, liver cirrhosis), after surgery, treatment with hormonal drugs.

Reduced at:

The effects of alcohol, heavy metal poisoning, blood diseases, kidney failure, liver diseases, spleen, hormonal disorders. And also with the action of certain drugs: antibiotics, diuretics, digoxin, nitroglycerin, hormones.

5. ESR or ROE - erythrocyte sedimentation rate (erythrocyte sedimentation reaction) is one and the same, an indicator of the course of the disease. Usually ESR increases by 2-4 days of the disease, sometimes it reaches its maximum during the recovery period. The norm for men is 2-10 mm / h, for women - 2-15 mm / h.

Increased at:

Infection, inflammation, anemia, kidney disease, hormonal disorders, shock after injuries and operations, during pregnancy, after childbirth, during menstruation.

Decreased:

With circulatory failure, anaphylactic shock.

Biochemical analysis indicators:

6. GLUCOSE - it should be 3.5-6.5 mmol / liter. Decrease - with insufficient and irregular nutrition, hormonal diseases. Increase - with diabetes.

7. TOTAL PROTEIN - norm - 60-80 grams / liter. Decreases with deterioration of the liver, kidneys, malnutrition (a sharp decrease in total protein is a frequent symptom that a strict restrictive diet clearly did not benefit you).

8. TOTAL BILIRUBIN - the norm - not higher than 20.5 mmol / liter shows how the liver works. Increase - with hepatitis, gallstone disease, destruction of erythrocytes.

9. CREATININE - should be no more than 0.18 mmol / liter. The substance is responsible for the functioning of the kidneys. Exceeding the norm is a sign of renal failure, if it does not reach the norm, it means that you need to increase immunity.