Exceeded bilirubin. How to downgrain bilirubin in blood
Upon receipt of the results biochemical analysis Some patients can learn that the direct bilirubin fraction in their body is raised. Do not everyone know about the presence of this substance and its role, but the phrase itself " high level"Immediately makes you think about the presence of any disease. What it means if direct bilirubin is elevated, what are the causes of this state and how to deal with it, considered in the article.
Bile pigment Bilirubin - a substance formed in the human body after the destruction of the red forming elements blood (erythrocytes). This is an absolutely normal physiological process that accompanies the destruction of old cells and the emergence of new ones.
The substance may exist in two types:
- direct fraction (conjugated, associated form);
- indirect fraction (unrelated, free).
After the erythrocytes are destroyed, hemoglobin from their composition comes out. It is from it that is formed bilirubin. The process occurs in liver cells, bone marrow and spleen. This pigment is indirect, it does not dissolve in water and is toxic for the human body, therefore, during chemical reactions, it is converted to a bound form, which is considered small-toxic and ready to eliminate.
Chemical transformations occur in liver hepatocytes, where bilirubin binds to glucuronic acid. Now it acquires the kind of direct fraction. This type of substance enters bile, and from it - in the intestine. Part of the pigment is derived from the human body with urine, the rest is with the wheel masses.
There is a collective concept - bilirubin common. This is the total amount of the entire pigment, which is in the body (straight + indirect fraction). As a rule, this indicator indicates laboratory technicians when conducting diagnostic studies.
However, there are times when the attending physician suspects the presence of a certain disease in the patient, because it needs to learn the level of exactly the pigment fraction. W. healthy man Direct bilirubin in the blood is approximately 20-23% of the total amount of substance. Normal numbers - less than 3.4 μmol / l.
Causes of raising indicators
There are a number of pathological conditions, against the background of which direct bilirubin (hyperbilirubinemia) can be increased. Next about each of the factors.
Laughing liver
This etiological factor is considered the most common, since diseases of the liver of infectious and non-infectious nature violate not only the process of bile outflow, but also the mechanism of its formation.
Laboratory signs that bilirubin directly increased against the background of liver pathology:
- the discoloration of the carts is partial or full;
- the numerals of the indirect fraction of bilirubin are normal or elevated slightly;
- the direct fraction of the pigment is increased significantly;
- transaminase level, alkaline phosphatase above the norm;
- timol sample +;
- direct bilirubin in the urine;
- indicators of urobinogen in the urine sharply above the norm, however, can be zero with intrahepatic cholestasis.
Liver diseases, against which the direct rifle fraction is above normal:
- Acute hepatitis of viral origin:
- hepatitis A;
- hepatitis B;
- inflammation provoked by infectious mononucleosis.
- Chronic hepatitis C.
- Inflammation of the liver of bacterial origin:
- hepatitis, whose causative agent is leptospira;
- hepatitis on the background of infection Brubelyla.
- The inflammation of toxic or medication is caused by the action of alcohol, drugs (anti-tuberculosis, antitumor, hormones, oral contraceptives, psychotropic means).
- An autoimmune liver damage - the body produces antibodies to their own hepatocytes.
Other reasons in which the level of direct pigment may increase, are associated with jaundice pregnant women, primary biliary cirrhosis, tumor processes.
There are inheritance reasons. Examples are Dabind-Johnson Syndrome and the Rotor Syndrome. Dabind-Johnson syndrome occurs due to gene mutations in the protein structure, which is an ion channel. As a result, there is a violation of the removal of pigment from the body.
The rotor syndrome resembles the first pathological state, but the degree of violation of the bilirubin is expressed to a lesser extent. The enzymatic activity of the liver is preserved, but changes occur in the process of transporting bilirubin from the cells of the gland against the background of the inability to normally capture the substance with a sinusoidal pole of hepatocytes.
Violation of eradicate bile ducts
Laboratory signs of such a condition:
- discoloration of carts;
- the indirect fraction of pigment is normal, straight - sharply increased;
- alkaline phosphatase is increased;
- transaminases normally;
- thymol sample -;
- direct bilirubin in the urine;
- urobilinogen in the urine is absent.
The reasons for bilirubin are enhanced, bind to the squeezing of bile ducts outside and inside. Outdoor transfer comes due to inflammatory processes Pancreas of acute or chronic character, liver echinococcus, diverticula duodenal gut, Hepatic artery aneurisms, tumor processes of nearby organs.
From the inside the patency of biliary tract can disrupt the concrections, cholangitis (with inflammatory processes there is a swelling and a narrowing of the lumen) or a neoplasm.
Symptoms of pathology
The following manifestations can be indicated about high direct bilirubin.
- yellow tint skin Pokrov, mucous membranes;
- hyperthermia (not always);
- an increase in the size of the spleen, which is manifested by the feeling of gravity in the left hypochondrium and is diagnosed by a palpation doctor;
- brown urine;
- white or lightweight;
- weakness, reduced performance;
- soreness in the field of chest, lower back;
- attacks of nausea and vomiting;
- belching, bloating;
- feeling severity, discomfort or pain on the ribs.
The totality of symptoms that represent a specific clinical picturemay vary depending on the reason for raising the level of direct bilirubin.
Raise direct fraction in pregnant women
Such a condition when you wear a child can occur at a woman against the background of an intrahepatic cholestasis or liver hepatosis. If hyperbilirubinemia arose against the background of cholestasis, pregnant people complain about the attacks of nausea, heartburn, the itching of the skin. The jaggility is not pronounced, it can occur periodically.
Acute fat Hepatosis usually arises from those women who have the first pregnancy. A rude stage lasts up to 2 months. Patients complain about sharp weakness, malaise, heartburn, dyspeptic manifestations, pain in the stomach. The body weight is reduced, itching sebums.
The second stage of pathology is characterized by a pronounced jaundice, a pathological decrease in the amount of urine allocated, edema lower extremities, ascites, bleeding of various localization, intrauterine fetal death.
Laboratory signs are talking about a minor increase in the indicators of ALT, AST, alkaline phosphatase, high level of bilirubin due to direct fraction (indirect form of pigment in normal), low protein level.
Help pregnant
Medical measures:
- Power correction.
- Purpose of vegetable choleretic drugs, fatty acid-based agents.
- Infusion therapy, the use of hepatoprotectors.
- For blood purification - Plasmapheresis.
- Decide on an urgent delivery.
Direct Bilirubin Reduction Methods
Those specialists who are enjoyed by non-traditional methods of therapy claim that it is possible to lower the pigment indicators in patients with nutrition correction, therapeutic physical education and homeopathic remedies. However, representatives traditional medicine Do not agree with such an opinion.
The fact is that the high figures of the bilirubine are not a separate disease, but are considered to be the manifestation of the total symptoms of several pathologies that require adequate diagnosis and treatment.
Disinfective measures - one of the stages of helping patients. For this in stationary conditions spend infusion therapy. It is necessary in order to speed up the process of exchanging a direct fraction of pigment, changes in the volume of circulating blood and its composition, between and intracellular fluid. As a rule, experts prescribe a solution of glucose, suspension of amino acids, saline, refooliglukin.
Efficient treatment can be phototherapy. This is the use of ultraviolet with a therapeutic goal. To stop intoxication, enterosorbents are also used (smell activated or white coal, Enterosgel).
Be sure to determine the etiological factor that caused the development pathological state. When it is eliminated, the Bilirubin rate will decrease, restored general state Organism:
- viral hepatitis - antiviral drugs, enzymes, vitamin complexes, immunostimulants;
- liver cirrhosis - hepatoprotectors, vitamins, antioxidants;
- cONCRINENTS - operational intervention, the procedure of lithotripsy, the use of drugs based on ursodoxicole acid and means normalizing bile outflow;
- tumor processes - operational intervention, chemotherapy, radiation therapy;
- helmintosis - anthelmintic drugs.
It is important to remember that painkillers, golden drugs It is impossible to take if the cause of pathology has become a neoplasm or blockage of grooves of biliary paths by concretions.
Self-treatment is not allowed. Only compliance with recommendations qualified specialist For food correction, compliance with the right lifestyle and drug treatment is the key to a favorable outcome for the patient.
Probably, each of us knows that if the skin and eye proteins have acquired a yellow color, it says that bilirubin is elevated in the blood. Jaundice is the first specific sign of increasing the yellow pigment. Why can be elevated bilirubin in the body, and what diseases are accompanied by jaundice. Why people with yellowed skin recommended immediate hospitalization and is it possible without doctors to determine the reason for the increase. What is dangerous as an increase in the pigment and its norms in healthy people.
Description
Bilirubin is a yellow dye of blood, which is synthesized during the decay of hemoglobin. It is contained in the body of healthy people within the limits of permissible indicators. What does the pigment say about? The high level of bilirubin indicates violations of the liver, biliary tract or blood.
The content of yellow pigment in the blood is due to the destruction of red blood cells. It is in them is hemoglobin that, with the death of cells, forms a yellow pigment. The destruction of the erythrocytes occurs in the body constantly, and in a day in a healthy person can be formed up to 300 mg of bilirubin. Next, the substance is neutralized in the liver, and together with bile leaves our body, so that no intoxication comes. The increased amount of yellow pigment in the blood may indicate the mass death of red blood cells.
The synthesis of the final decay product is a complex multistage process that continuously occurs in our body. A failure at any stage of metabolism may entail an increased bilirubin in the blood.
This indicator is very important to determine the work of several organs and systems of the human body.
Today, doctors define two types of pigment - direct and indirect:
- The direct bilirubube is formed in the spleen, then falls with blood flow to the liver, where it is neutralized. It is non-toxic and easily collapsed in water. This connection is not dangerous for our health and is excreted from the blood along with bile.
- The indirect pigment is formed during the decay of red blood cells and is not yet neutralized in the liver. This is a complex compound that is very toxic and can only be dissolved in fats. With the increase in its blood content, it can freely penetrate into healthy tissues of the body and destroy them, this ability and fear doctors at a high level of indicator.
Normal indicators in accordance with age
To determine the health of a person, doctors must take into account the indicators of the general, direct and indirect bilirubin in the blood, if they increase, can be suspected of serious pathology. Today, doctors are used by the following table standards in accordance with age category Patient:
A pregnant woman is recommended that she makes an analysis when registering and further on schedule. When determining the content of the general, direct and indirect bilirubin, doctors can significantly narrow the circle possible diseases. This makes diagnostics faster and accurate. It should be noted that the scool and skin and skin appears when the total bilirubin increases 2 times.
Diagnosis of diseases
Many patients ask a question that means elevated bilirubin in the blood. Answer uniquely without deciphering the analysis to this question is impossible. For accurate diagnosis, if the bilirubin level occurred, it is necessary to compare the values \u200b\u200bof the general, direct and indirect indicator and only after that it is possible to draw conclusions about which pathologies caused a high level of bilirubin.
The increased content of bilirubin in general, with an equal ratio of the direct and indirect indicator, most often indicate the following pathologies:
- Hepatitis of any origin.
- Infectious liver diseases.
- Cirrhosis.
- Cancer or liver metastasis.
- Hepatosis of any origin.
- Genetic diseases.
- Pylefribrech.
- Disease of Badda Kiaari.
Symptoms of liver diseases when bilirubin is generally elevated, most often are the severity in the region of ribs on the right side, nausea, headache, general malaise, change in the color of feces and urine, the jaundice of the scool eyes and skin. At the first signs of liver disease, you need to consult a doctor, only a specialist can assign adequate comprehensive treatment. What to do to reduce greater pigment? Bilirubin Common can be reduced only by eliminating the cause of the disease.
Increasing the level of bilirubin in the blood, and in particular direct, can be caused by the following pathologies:
- Cholelithiasis.
- Artresia of biliary tract.
- Mirization disease.
- Oncology of the gallbladder.
- Cholangitis.
- Caroli syndrome.
- Pancreatitis in chronic form.
- Oncology of the pancreas.
The increase in bilirubin indirect may indicate the presence of the following pathologies:
- Zhilbera syndrome.
- Infectious diseases.
- Hemolytic type anemia.
- Increase bilirubin can intoxication of the liver.
- Blood incompatibility after transfusion.
- Hyperplaneism.
- Splenomegaly.
All these diseases are characterized by increased destruction of erythrocytes, as a result of which bilirubin in the blood is strongly elevated. Data of pathology treats a hematologist's doctor.
What affects an increase in the level of bilirubin in the blood? In addition to the listed diseases, a slight increase is observed in the lack of vitamins of the group B and when infected with worms. Also, the analysis can show deviation from the effects of certain medicines and toxic substances. As you see the main reasons for the increase in yellow pigment not so much, these are problems with the liver, with bubble or blood. Primary diagnosis A specific disease, as a rule, does not cause difficulties. However, the final diagnosis, which means, if the pigment is overestimated in the analysis, can be put only after additional surveys.
Analysis
The level of bilirubin in the blood is determined in the biochemical analysis of blood. This study is carried out in a specialized laboratory on modern equipment. To study, it is necessary to take the patient's blood from the elbow vein in adults and from the heel in children on the first day of life. Bilirubin indicator is very important in the diagnosis of liver disease. Its significance in diagnostics cannot be overestimated. Together with other indicators, he gives a complete picture of the work of this body, which allows specialists to put an accurate diagnosis, and begin immediate treatment.
Bilirubin blood test is shown to all patients with inpatient treatment and people who applied for help in medical institution With any complaints. Also, the analysis urgently conduct patients with the jaggility of the skin and the scool of the eye to determine the ailment led to high indicators.
In order for the doctor to be able to properly decipher your analysis, be sure to inform him if you have taken an antibiotic or any other drug. Also, do not forget to tell about the available chronic or innate diseases. The doctor should be known any fact affecting the rising pigment. Only after mapping of these facts, a specialist can inform you the normal bilirubin, or overstated.
Treatment
The high figure is not an independent disease, and reduce it with diet and various decoctions is simply absurd. With an elevated bilirubin, it is extremely important to identify the disease as soon as possible, which caused a deviation from the norms. What is dangerous high bilirubin? In case of untimely treatment, the body may be subjected to strong intoxication, which leads to the development of additional complications.
In the case when bilirubin in the blood is raised by the first thing to the patient, therapy is appointed, which will suppress the reasons for raising the pigment. So, when decaying erythrocytes therapy will be to introduce glucose and albumin. In addition, plasmapheres is needed.
In case of insufficiency of hepatic enzymes, phenobarbital is prescribed, the action of which is based on increasing enzyme activity and so on.
In the treatment of liver diseases, it is very important to observe the diet, because any forbidden product may affect the increase in bilirubin. In this case, you can only with those products that the doctor allowed. With timely treatment, most liver diseases are successfully treated.
Prevention
Among the prevention measures, the bilirubin increase can be distinguished compliance with the basics of proper nutrition and an active lifestyle. It is worth it less to eat fatty and fried food, it is impossible to be carried away with alcohol and smoking. Make sure that you do not develop anemia, and a sufficient number of vitamins of group V. All these measures will help preserve your health, and you will not be disturbed by the liver and gallbladder diseases, which most often carry the risk of raising bilirubin.
Increase bilirubin in blood What does this mean? Only a specialist is able to answer this question. No forums, acquaintances and girlfriends will never be able to put your correct diagnosis, moreover, they do not have the right to do this. Does the army take in the army if the bill is exceeded? Each patient may have its own illness boosting bilirubin and this failure can be detected only with careful diagnosis. If serious pathology has been revealed, they do not take into the army. Pigment can also increase with third-party factors. Do not self-medicate, take care of your life and turn to the doctor in a timely manner.
In contact with
The physiological role of Bilirubin in the human body is large enough, this is evidenced by numerous scientific research, which show that bilirubin is necessary for the organism to utilize hemoglobin. This pigment it is formed due to the decay of hemoglobin. Its traces are in blood serum and bile.
Deviations of the substance from the norm can lead to serious diseases – hemolytic anemia, cancer, hepatitis and others.
Common Bilirubin Blood Serum in adults has such types:
- straight;
- indirect.
It all depends on the results of a laboratory reaction with a specific reagent. Direct fraction is substance, neutralized liver. The second variety is a toxic high bilirubin, which has managed to contact the liver.
Simple and understandable about bilirubin
Norma
To determine which level of bilirubin, you need to spend. For analysis, venous blood is needed. The selection of material for the study is required by an empty stomach. The last meal before visiting the laboratory should be no earlier than 8 hours.
- for a common pigment - 5.1-17 mmol / l;
- for indirect - 3.4-12 mmol / l;
- for direct - 1.7-5.1 mmol / l.
Main reasons
Provocate a state at which the norm of the general bilirubin is raised, such reasons may be:
- accelerated destruction or;
- violation of the function of the outflow of bile;
- liver problems.
In addition, a bad effect on the indicator of general bilirubin can have a continuous reception. medicines, such as:
Antibiotics
- Phenitoin.
- Diazepam.
- Ideetacin.
- Frazepam and others.
Similar problem may hide in hereditary disadvantage That liver enzyme, which is involved in the transformation of a common bilirubin.
The increase can also lead to Zhilbera syndrome.
Symptoms
The main symptoms when high the overall pigment rate becomes:
- reduced appetite;
- non-permanent painfulness in the right hypochondrium;
- bloating;
- skin itch due to irritation of nervous roots bilirubin;
- dark shade of urin;
- liver colic;
- fatigue;
- migraine;
- heart palpitations.
Treatment
When a person often experiences symptoms uncharacteristic for his body, it is necessary to urgently turn to a specialist who decides how to lower the bilirubin in the blood of a particular patient. To quickly cope with the problem, you need a complex approach. Patient during treatment may be needed:
- medications;
- diet;
- cooks from medicinal plants.
Medicine
When the reasons for increased value - bile outflow violationIn this case, choleretic drugs are prescribed to the patient. If the reason lies in hereditary predisposition, he will have to hold symptomatic treatmentwhich implies the reception of sorbents, choleretic equipment, vitamins, medicines that reduce bilirubin in the blood.
With the inflammatory nature of the functioning of the liver, the infection of the body or immune disorders may be assigned to such medications:
- antibacterial;
- antiviral;
- immunomodulating;
- enzyme;
- hepatoprotectors.
The latter are prescribed first because they contribute to improving liver condition And its activities lead to normal. To reduce bilirubin, when the reasons for it are caused by the housing syndrome, the reception of phenobarbital and Ziksorina is appropriate at 0.05-0.2 g per day. The course is designed for a period of 14 days to a month. Patients also recommended enzyme preparations that facilitate the general condition.
These include:
- Pancreatin;
- Mesim;
- Festal.
Take these funds 1-2 tablets three times a day 20 minutes before meals. For the overall maintenance of liver activity, drugs based on natural components can be involved:
- military extract;
- Esssential Forte;
- Carsil;
- LIV52.
To enhance the effect of the bilirubin output, it is necessary to additionally use absorbent preparations that differ in good ability to bind bilirubin and output from the body. These include:
- Enterosgel;
- Absorbent;
- activated carbon other.
A lot of useful bilirubin, test for it + very useful advice
Diet
Disassembled the question of how to reduce bilirubin in the blood, it should be understood that some drugs taken at home is not enough. Additionally, a special diet is needed.
Healthy food favorably affects the liver. It allows you to remove an extra load from it and at the same time medical treatment It acts well for the causes of the failure of the liver.Powered during the treatment performed at home is aimed at limiting or eliminating some of the diet of the patient who can cause a failure in the system. Such are:
- coffee and salt;
- citrus;
- heavy food, fried, sharp, salt and smoked dishes;
- alcohol;
- mushrooms;
- radish.
It is necessary to abandon all the products, which contains tears, acids, preservatives.
Patients useful to eat:
- eggs protein;
- fruit (only sweet);
- lean meat;
- vegetable and dairy soups;
- rice, Hercules, as well as buckwheat porridge;
- mors;
- mineral water;
- things herbal.
Popular treatment
Treatment performed at home folk remediesWhen there is such a problem, it is recommended to perform with a tincture of birch leaves. For the recipe you will need 1 tbsp. l. Dry crumpled product and glass of boiling water. Decoration to insist half an hour and take before bedtime. Such a drug is distinguished by sedative properties and helps to quickly remove toxic substances from the liver, including indirect bilirubin.
Broth based on the Hypericum, chamomile and dyeing - one of the most effective drugs When treating folk remedies. The result from such tea can be seen after 10 days after the reception. To prepare a healing drink, you need a dried grass of the above plants in the amount of 1 tbsp. l. on a glass of boiling water. Infusion must be left for 30 minutes so that it acquires strength, and then use twice a day 20 minutes before meals.
Reduce the bilirubin level only by folk remedies will help fresh beet juice. This drink is distinguished by a choleretic effect. Eating beet juice is recommended for 1/3 cup before meal.
An excellent properties among those called folk remedies are cornflowers. For the recipe you will need 2 d. L. Raw materials and a glass of boiling water. The decoction must be insisted within 30 minutes, then strain and take twice a day by half a cup.
Nice results Shows use in the treatment of nutrhemnel people. To the glass of boiling water you need to take 1 tbsp. l. Dry grass. The mixture is left half an hour for insteading. It is necessary to use a liquid with a hungry stomach of 60 ml.
Effects
When the patient delays with treatment or ignores him at all, they are waiting for big problems.Oversaturated by bilirubin blood has a negative impact on brain activityBecause it is attacked toxic exchange products. In addition, liver cells suffer, causing even greater violations in the body's activities. All load during this period falls on the kidneys, which are no longer able to fully cope with the task. As a result, they become vulnerable, unwanted processes begin to occur in them.
Reduced level of bilirin
Low bilirubin may occur in case of acute leukemia, renal failure, tuberculosis intoxication. In the case of such diseases, its concentration decreases, since the number of erythrocytes decreases.
Important: Low bilirubin is diagnosed very rarely.Features of the treatment of children and pregnant women
The newborn often has elevated bilirubin. Such a phenomenon arises due to the destruction of fruit hemoglobin. It is slightly different from the newborn in the structure of the one that is formed before childbirth. Since the pemoglobin fetal is actively destroyed, the bilirubine level increases according to the newborn.
Pregnant women bilirubin increases due to the growth of the fetus and its location. As the child presses on the liver, the outflow of her bile is difficult, so it arises its accumulation.
IMPORTANT: during pregnancy, you should refuse drugs that reduce bilirubin, and the cleaning procedure must be carried out with herbs that do not affect the fetus, as well as observing the diet.Prevention
- eat right;
- get rid of bad habits;
- observe hygiene.
Clinic and cost
You can get the exact result of the level of bilirubin by visiting one of the independent laboratories of Invitro LLC. The cost of diagnosis is 265 rubles, plus will have to pay for another 199 rubles Behind the procedure for taking blood from blood to the analysis.
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Elevated bilirubin.
Part 1. Is the elevated bilirubin always indicate problems with the liver?
Start: "You have increased bilirubin"
- The phrase, which is often heard at the reception at the therapist, is actually almost deprived of a concrete meaning, since the list of reasons that can cause an increase in bilirubin is too wide and diverse.Analysis on bilirubin in the blood is considered to belong to the "liver". Really, that's for the most part (But not always) rightly with respect to direct bilirubin. But the reason for increasing the indirect bilirubin often should be searched far beyond the liver.
To narrow and rather outline the range of diseases, due to which bilirubin is elevated in a specific case, it will help knowledge of some features of the exchange of bilirubin in the body, as well as attracting several simple surveys available in each polyclinic - general analysis blood, activity, sometimes some others. Typically, a biochemical blood test includes them along with bilirubin.
Brief information about Bilirubina
Scheme 1. Bilirubin exchange in the body. Bilirubin passes in the body a long way (in the diagram it is extremely simplified), and the reason for the disorder of its elimination can be on any of its plot - in blood system, in hepatic cells, in the glandy ways.
In detail about the ways of education of bilirubin, as well as about the differences and interrelation of indirect and direct bilirubin, you can find out in the article. For a more complete understanding of the material of this article, it is strongly recommended to read it.
Bilirubin is a blood hemoglobin processing product. It is constantly produced in the body in many organs and tissues.
The lead in the formation of bilirubin plays the liver.
The bilirubin body is present in the form of two main forms:
- indirect bilirubin, or free
- direct bilirubin, or associated
Bilirubin is not common as such, but reflects the total amount of direct and indirect bilirube of blood.
In this scheme, a bilirubin is submitted in the maximum simplified form.
Initially, the process of recycling hemoglobin is produced indirect bilirubin. This happens in the reticulous endothelial system, most of which is placed in the liver. After that, the indirect bilirubin enters the bloodstream, then in the hepatic cells is transformed into direct bilirubin and in this form through the horizontal ducts is derived to the intestine.
Elevated blood bilirubin is called hyperbilirubiney, The presence of bilirubin in the urine - bilirubinuria.
Significant accumulation of bilirubin in the body leads to jaundice.
Bilirubin - normal
Before talking about increased bilirubin, it should be declared what its normal indicators should be.
Such a high bilirubin in newborns is called "physiological jaundice". It is due to the presence of hemoglobin, etc. N. Fetal hemoglobin, which is subject to rapid replacement for the usual, "adult" hemoglobin. The immaturity of the newborn babies of enzyme liver systems has a certain influence, designed to transform indirect bilirubin in a straight line.
Indicators of a normal bilirubin can differ slightly depending on the technique of its definition adopted in a specific laboratory.
How to interpret the result of the analysis
Diagram 1.
Very important proper interpretation, or decoding the result of analyzing on bilirubin.
For example, we take such a result (see chart 1):
- - Common bilirubin - 29.5 μmol / l
- - indirect - 19.3 μmol / l
- - Direct - 10.2 μmol / l
Chart 2.
At first glance it may seem that indirect bilirubin is increased significantly more than straight.
But if you compare these results with the norm, then you can see a true picture (see chart 2) - indirect bilirubin is increased compared with the norm by 25%, while the direct is for as much as 100%.
This result It is characteristic of intraferential cholestasis, that is, disorders of the production of yellow in the liver and its outflows on intrahepatic hand painters, which happens when chronic hepatitis toxic, medicinal, alcoholic, viral origin. Read more about this in the third part of the article "Increased Bilirubin" -.
However, it is easy to fall in a mistake, making a conclusion one analysis. A comprehensive assessment of all available laboratory studies (, sedimentary samples, etc.), and above all clinical data.
The reason for the elevated bilirubin can be both in the liver and abroad
IN general The reason for the increase in bilirubin consists in a violation of equilibrium between the speed of its formation and the removal rate.
To the violation of this balance and accumulation of bilirubin in the body can lead:
- on the one hand, its increased formation in certain diseases, as a result, even a healthy liver cannot cope with the removal function;
- on the other hand, an obstacle to the removal of bilirubin, which can occur both in the liver and in the extra-enerk biliary tract.
As we can see on the above scheme 1, bilirubin in the body overcomes a long and complex path. At the same time, most of his part twice passes through the liver.
The key item on this path is the hepatic cell, more precisely - its special formations, so on. Microsomes. There is a transformation of indirect bilirubin in a straight line.
The result of all violations of the exchange of bilirubin, occurring up to this point - increased bilirubin in indirect, and vice versa, after it - elevated bilirubin direct.
Classification of reasons for raising bilirubin
The reasons for the increase in bilirubin, like jaundice, are traditionally divided into three groups: "adventure", "liver" and "sunflower". Such a classification has a significant drawback - too heterogeneous diseases are related to the "liver" category. So, liver diseases, accompanied by increased indirect bilirubin, have predominantly hereditary origin. But direct bilirubin is elevated most often in diseases of the inflammatory liver and toxic nature. And manifestations, and diagnostic approaches with these diseases are completely different. Minimizing them in one common category only makes it difficult to diagnose.
Scheme 2. All the reasons for which bilirubin is increased, it is advisable to divide into 4 groups.
The most acceptable for practice is the classification that shares the reasons for the increase in bilirubin into four groups. The basis of the division was laid two main criteria:
- what bilirubin increased - indirect or direct
- where is the reason why bilirubin is elevated - in the liver or abroad
On these two criteria distinguish four groups of reasons for raising bilirubin, respectively, the main stages of its exchange (see scheme 2):
- caused by increased education Indirect bilirubin, as a result of which even a healthy liver is not able to cope with the function to eliminate it.
- caused by disruption of the transformation in the liver cells of indirect bilirubin in a straight line.
- caused by violation of the formation of hydrochnye cells and its outflow in intra-brand gall ducts.
- caused by a violation of the outflow of yellow in extra-erased gall ducts.
Preliminary diagnosis
So, in the previous paragraph, the conditional separation of all possible causeswho caused a high bilirubin of blood for four main groups.
Each of the four groups of reasons are inherent distinctive features. Due to this, already at this stage it is possible to preliminarily diagnose and outline the list of necessary additional analyzes. However, many of them are customary to do in conjunction with the study of Bilirubin. It is necessary to take into account and some clinical symptoms, identify that easy:
| |
|
|
|
|
|---|---|---|---|---|
| general characteristics | due to the increased formation of indirect bilirubin, exceeding the possibilities of the liver on its removal | due to disorder in the liver of the transformation process of indirect bilirubin in direct | due to violation of the formation of the boots and her outflow in intrahepatic rapids | due to a violation of the outflow of yellow in extrahepatic gall ducts |
| clinical signs of anemia (Malokrovia) - pallor, total weakness | there is | not | not | not |
| increased spleen (according to the results of the ultrasound) | there is | not | not | not |
| decorating Cala | not | not | may be complete or partial | there is |
| indirect Bilirubin | improved | improved | normally or somewhat elevated | norm |
| direct Bilirubin | norm | norm | improved | improved |
| hemoglobin | reduced | norm | norm | norm | reticulocytes in the blood | erected |
Bilirubin is a disposition of red blood cells. It refers to hemoglobinogenic pigments. Many people know about the existence of this pigment in human organism, But what does the increased bilirubin in the blood and whether it is not known to everyone.
Most of this pigment is formed due to the physiological decay of old erythrocytes, which is happening in the liver and the spleen of a person.
For one day in the human body, more than 1% of the red collapses blood cells. It is the red tales that contain hemoglobin, which, when decay, is converted to bilirubin. During the day, approximately 300 milligms of this pigment is formed.
Increased level of this component means partial lesion of the liver. If bilirubin is elevated, then the body is disturbed by the natural outflow of yellow, which leads to jaundice.
Note! The type of pigment variety means its danger to a person's life. The most dangerous is indirect bilirubin.
Table: Pigment varieties.
Bilirin rate
The level of bilirubin is determined by conducting a biochemical blood test. But many people who are not related to medicine do not know what the biochemistry says.
In terms of analysis, it is possible to judge whether there are disorders in metabolic and exchange processes in the human body. But to understand the limits of dangerous norms, it is worth knowing the allowable level of this pigment in the plasma.
The rate of bilirubin in the blood in women and men:
- The norm of unrelated pigment in an adult should not rise above the mark 16.2 micromol on the plasma liter.
- The permissible level of the associated bilirubin varies from 0 to 5.1 micromol on the liter of plasma.
- The norm of the total varies from 0.5 to 20.5 micromol per liter of plasma.
Important! The high level of this component is very dangerous for a person. Upon exceeding 34 micromol on a liter of plasma, jaundice is beginning to develop. Increased level of this pigment in medical terminology is called hyperbilirubinemia.
In the newborn kids in the first five days of their life there is an elevated bilirubin. This is a completely normal physiological phenomenon.
The norm for the child is 4.6 micromol per liter.
Nomes for newborn kids:
- For premature - 171 micromol per liter.
- For born on time - 256 micromol per liter.
Symptomatics
You need to know the symptoms increased level This component in the plasma. If this process is noticed in time, then the treatment of the disease or a decrease in the level of bilirubin will be faster.
Symptoms:
- Coloring Scler.
- Coloring the mucous membrane of the oral cavity.
- Shooting face, palm, eye.
An increase in the level of associated bilirubin is possible with diseases such as:
- Viral hepatitis of type A, B, C.
- Bacterial hepatitis.
- Toxic intoxication.
- Dosage intoxication.
- Jaundice during pregnancy.
- The presence of tumors and formations in the liver.
- Bilyary cirrhosis.
Unrelated bilirubin can increase with such a littleness as:
- Hemolytic anemia.
- Malaria.
- Sepsis.
Symptoms of jaundice:
- Increases body temperature.
- It is found in feces and urine of a large amount of sterrel - and urobilin.
- There is a rapid heartbeat.
- There is increased fatigue.
- The spleen increases. The increase in this organ flags the pain under the left edge.
- There appears the pallor of the skin.
- The skin and mucous membranes are painted in yellowish - lemon shade.
Signs of a tunny jaundice:
- It becomes itching on the skin.
- Cal light color.
- There is pain under the right edge.
- The work of the gastrointestinal tract is disturbed.
- Skin covers are painted in a yellowish hue.
Symptoms of hepatitis of different types:
- Increases body temperature.
- There is a weakness.
- There appears pain in the muscles and joints.
- Pain under the right edge.
- The color of Cala and urine changes.
Causes of high blood bilirubin
The reasons for increasing the level of fraction in the blood can be different.
Note! To clarify the reasons for increasing the component in the plasma, it is worth passing the biochemistry and take advice from a medical worker.
Table: Causes of raising the level of pigment in plasma.
| Cause | Description |
| Red blood tales are destroyed | Increased decay of blood cells is hemolysis. Distinguish two types of destruction: Accelerated. The decay arises due to: Infectious infectious diseases. |
| Violated natural outflow of yellow | Such a violation is called a tune jaundice. Disruption of the natural outflow of yellow diseases are characterized by such reasons: The presence of inflammatory processes in biliary tract. |
| Violates metabolism and the bilirubin removal process | Violation provokes hereditary or acquired jaundice. |
How to downgrade?
On the question of how to reduce bilirubin in the blood can only answer only the doctor. Medical workers call for patients with hyperbilirubinemia do not engage in self-medication, because it is very dangerous to health and life.
It is worth understanding that the high level of bilirubin is not a disease, but a sign of the disease. Therefore, it is necessary to treat the cause, as a result of which the level of this indicator in the blood will fall.
Treatment does not always imply a reception of medicines.
If a person has increased bilirubin not due to the disease, then it is possible to reduce the level using:
- Infusion therapy. Therapy implies infusion of glucose intravenously. In addition to glucose, intravenous disinfect drugs are prescribed to the patient, aimed at purifying the body from decay components.
- Phototherapy. This procedure is the irradiation of a patient person with lamps provoking the transformation of unbound pigment into the associated.
- Medical preparationsaimed at the normalization of bias.
- Diet. Proper nutrition and adherence to a strict diet appointed by the doctor reduces the load on the liver.
In addition to the diet prescribe medical means To purify the body and drugs that reduce the level of bilirubin in the plasma. Diet prohibits the use of roasted, salty, pepper, sharp and pickled.
Important! In hepatitis, a complex treatment is assigned, the basis of which drugs are becoming aimed at protecting the liver.
Treatment with folk remedies
To reduce bilirubin, you can use folk remedies that are easy to apply at home.
Funds of traditional medicine:
- Infusion of mint and chamomile. For the preparation of infusion will need dried herbs flowers. They are connected in the same proportions, and poured boiling water. 400 milliliters of water are taken on 4 tablespoons of the mixture.
The drink is used for 100 milliliters twice a day: in the morning and before bedtime.
- Infusion based on mother and hiceboy. For the preparation of grass is taken in the same quantity. By 50 grams of the mixture will require 500 milliliters of hot water. It insists a drink for 1 hour. It is recommended to consume it twice a day at 100 milliliters.
- Beet. The squeezes are used before each adoption of food.
- Navy based on distillation. 50 grams of seeds of milk thistle pour a liter of boiling water and negotiate 30 minutes on small fire. Infusion is taken on one teaspoon six times a day.
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