Qaytarish

Bilirubin, to‘g‘ridan-to‘g‘ri (kon'yugatsiyalangan)

Kod:8029|CPT:82248|LOINC:1968-7

Sinonimlar
Conjugated bilirubinDirect bilirubin
KabiBilirubin, to‘g‘ridan-to‘g‘ri (kon'yugatsiyalangan)

Tahlil ma'lumotlari

Tadqiqot usuli

  • Fotometrik usul

Kutilayotgan natija topshirish vaqti

1 kun

Maxsus tayyorlik

  • Fast for 12 hours before the blood draw.
  • Avoid strenuous physical activity and emotional stress for 30 minutes prior to collection.
  • Do not smoke during the 30 minutes before collection.

Qanday foydalanish

Bilirubin, to‘g‘ridan-to‘g‘ri (kon'yugatsiyalangan bilirubin) jigar va o‘t yo‘llari kasalliklarini baholashda hamda sariqlikni kon'yugatsiyalangan va kon'yugatsiyalanmagan giperbilirubinemiyani farqlash orqali tasniflashda qo‘llanadi. To‘g‘ridan-to‘g‘ri bilirubinning oshishi intrahepatik va ekstrahepatik xolestaz, gepatotsellyular kasalliklar (masalan, gepatit, siroz va ilg‘or neoplaziya), xolestatik dori reaksiyalari va irsiy kon'yugatsiyalangan giperbilirubinemiyalar (Dubin–Johnson va Rotor sindromlari) bilan bog‘liq. Ushbu test umumiy va bilvosita (kon'yugatsiyalanmagan) bilirubin bilan birga buyurilganda, neonatal sariqlikning differensial diagnostikasini va bilirubin ensefalopatiyasi xavfini baholashni, o‘t oqimining buzilishini tekshirishni, shuningdek jigar yoki o‘t yo‘llari kasalligi bo‘lgan yoki potensial hepatotoksik yoki gemolitik dori vositalarini qabul qilayotgan bemorlarda vaqt o‘tishi bilan dinamik kuzatuvni qo‘llab-quvvatlaydi.

Cheklovlar

Bilirubin gem katabolizmi natijasida, odatdagi eritrotsitlar almashinuvi chog‘ida hosil bo‘ladi. Kon'yugatsiyalanmagan (bilvosita) fraksiya albuminga zich bog‘langan holda qon aylanishida bo‘ladi va jigarга yetkaziladi; u yerda uridin difosfat–glyukuroniltransferaza uni glyukuron kislota bilan kon'yugatsiyalab, suvda eruvchan kon'yugatsiyalangan (to‘g‘ridan-to‘g‘ri) fraksiyani hosil qiladi. Tarixan ushbu fraksiyalarni aniqlashda qo‘llanilgan diazo reaksiyalarida, kon'yugatsiyalangan bilirubin suvli eritmada akseleratorsiz reaksiyaga kirishadi, kon'yugatsiyalanmagan bilirubin esa tezlatkichlarni talab qiladi. Umumiy, to‘g‘ridan-to‘g‘ri va bilvosita bilirubinni birgalikda talqin qilish sariqlikning pregepatik (gemolitik), gepatik (parenximatoz) va postgepatik (obstruktiv) sabablarini farqlashga yordam beradi. O‘t oqimining to‘silishi qon zardobida to‘g‘ridan-to‘g‘ri bilirubinning to‘planishiga olib keladi; u suvda eruvchan bo‘lgani uchun buyrak orqali chiqariladigan yagona fraksiya hisoblanadi va siydikni to‘q rangga kiritishi mumkin. Ikkala fraksiyaning birga oshishi qabul qilinishi va chiqarilishi buzilgan gepatotsellyular disfunktsiyani ko‘rsatadi. Yangi tug‘ilgan chaqaloqlarda fiziologik sariqlik ko‘pincha eritrotsitlar almashinuvining oshishi va kon'yugatsiya qobiliyatining cheklanganligini aks ettiradi, bu bilvosita bilirubinning ko‘tarilishiga olib keladi. Uzoq davom etuvchi yoki yaqqol ifodalangan sariqlik kon'yugatsiyalanmagan bilirubinning neyrotoksikligi sababli gemolitik kasallik, tug‘ma gepatobiliar buzilishlar (jumladan biliar atreziya) yoki neonatal gepatitga tekshiruv o‘tkazishni talab qiladi.

O'lchov birligimg/dL
Referens oraliq
MinMaks
317
Ko'rsatmalarEvaluation of suspected liver or biliary tract disease., Workup of jaundice to separate conjugated from unconjugated hyperbilirubinemia., Assessment for intrahepatic or extrahepatic cholestasis and biliary obstruction., Evaluation of hepatocellular injury, including hepatitis, cirrhosis, and advanced neoplasia., Investigation of possible cholestatic drug reactions., Assessment for hereditary conjugated hyperbilirubinemias (Dubin–Johnson syndrome, Rotor syndrome)., Neonatal jaundice evaluation with total and indirect bilirubin and appraisal of risk for bilirubin encephalopathy., Monitoring of impaired bile flow and follow‑up of liver or biliary disease over time., Surveillance in patients receiving potentially hepatotoxic or hemolytic medications.

Natija og'ishlarining mumkin sabablari

Oshgan daraja

  • allopurinol
  • anabolic steroids
  • antimalarials
  • ascorbic acid
  • atazanavir
  • azathioprine
  • chlorpropamide
  • cholinergic agents
  • codeine
  • dextran
  • diuretics
  • epinephrine
  • fasting (prolonged)
  • isoproterenol
  • levodopa
  • meperidine
  • methotrexate
  • methyldopa
  • monoamine oxidase inhibitors
  • morphine
  • nicotinic acid
  • oral contraceptives
  • phenazopyridine
  • phenothiazines
  • quinidine
  • rifampin
  • streptomycin
  • strenuous exercise
  • theophylline
  • tyrosine
  • vitamin a

Pasaygan daraja

  • amikacin
  • anticonvulsants
  • barbiturates
  • caffeine
  • chlorin
  • citrate
  • corticosteroids
  • ethanol
  • penicillin
  • protein
  • salicylates
  • sulfonamides
  • urea
  • ursodiol
  • valproic acid

Namunangiz talablari

NamunangizZardob
ContainerOltin/yo'lbars qopqoqli probirka (SST, gel ajratgich)
Hajm1 mL (min 0.7 mL)
Saqlash tayyorlikXona harorati, Sovutilgan, Muzlatilgan

References

Nazarenko G I, Kishkun A. Clinical Evaluation of Laboratory Test Results. Moscow: Meditsina; 2000:157-161.

Fischbach FT, Dunning MB. A Manual of Laboratory and Diagnostic Tests. 8th ed. Lippincott Williams & Wilkins; 2008.

Wilson D. McGraw-Hill Manual of Laboratory and Diagnostic Tests. 1st ed. McGraw-Hill; 2007.