O‘t kislotalari
Kod:8053|CPT:82239|LOINC:14628-2
| Kabi | O‘t kislotalari |
|---|
Tahlil ma'lumotlari
Tadqiqot usuli
- Fermentativ usul
- Fermentativ kolorimetrik usul
Kutilayotgan natija topshirish vaqti
1 kun
Maxsus tayyorlik
—
Qanday foydalanish
O‘t kislotalari testi (o‘t tuzlari testi deb ham ataladi) gepatositlar, biliar daraxt, ichakdan so‘rilish va portal venoz qaytish bo‘ylab enterohepatik aylanishning yaxlitligini baholaydi. Umumiy o‘t kislotalarini o‘lchash jigar funksiyasini baholash doirasida xolestaz diagnostikasiga, jumladan homiladorlikning intrahepatik xolestaziga, yordam beradi. Rutindagi jigar biokimyoviy tahlillari bilan birga, umumiy o‘t kislotalari surunkali virusli gepatit va xolestatik buzilishlar kabi turli holatlarda jigar kasalligi faolligini baholashga yordam beradi.
Cheklovlar
O‘t kislotalari xolesterindan gepatositlarda sintezlanadi, o‘t pufagida kontsentratsiyalanadi va ratsiondagi lipidlarni emulsiyalash hamda so‘rilishini osonlashtirish uchun o‘n ikki barmoqli ichakka ajratiladi. Taxminan 90% ichakda qayta o‘zlashtiriladi va portal vena orqali jigarga qaytadi, bu enterohepatik zaxirani saqlab turadi hamda ichak mikrobiomi gomeostaziga hissa qo‘shadi. O‘t hosil bo‘lishi yoki oqimi buzilganda (xolestaz), o‘t kislotalari qon oqimida to‘planadi. Klinik ko‘rinishlar qatoriga ko‘pincha kechasi kuchayadigan qichishish, sariqlik va toliqish kiradi. Xolestaz ekstrahepatik bo‘lishi mumkin (masalan, yo‘llarning toshlar yoki o‘smalar bilan to‘silib qolishi), yoki gepatosellyular yoki duktyulyar kasallik tufayli intrahepatik bo‘lishi mumkin. Keltirilgan sabablar qatoriga mexanik obstruksiya; gepatosellyular disfunksiya, masalan gepatit yoki sirroz; genetik xolestatik sindromlar (benign qaytalanuvchi intrahepatik xolestaz, progressiv oilaviy intrahepatik xolestaz, ABCB4 yetishmovchiligi, eritropoetik protoporfiriya); biliar malformatsiyalar (biliar hamartomalar, Karoli sindromi); va parazitar infeksiyalar (opistorxoz, fasciolyoz, askaridoz, klonorxoz, exinokokkoz) kiradi. Homiladorlikning intrahepatik xolestazi uchun laborator o‘lchovlar ichida zardobdagi umumiy o‘t kislotalari eng sezgir ko‘rsatkichlar qatoriga kiradi; och qoringa konsentratsiyalar ≥40 µmol/L muddatidan oldin tug‘ruq va noxush perinatal natijalar xavfining oshishi bilan bog‘liq. Ushbu sharoitda aminotransferaza faolliklari normal yoki faqat yengil oshgan bo‘lishi mumkin, ishqoriy fosfataza esa odatda oshgan bo‘ladi; biroq homiladorlikda uni talqin qilish yo‘ldosh izofermentlari ishlab chiqarilishi bilan cheklanadi.
| O'lchov birligi | µmol/L | ||||
|---|---|---|---|---|---|
| Referens oraliq |
| ||||
| Ko'rsatmalar | Evaluation when cholestasis is suspected, Assessment of suspected intrahepatic cholestasis of pregnancy, Workup of pruritus without an identified cause |
Natija og'ishlarining mumkin sabablari
Oshgan daraja
- cholestatic liver disease
- postprandial state
Namunangiz talablari
| Namunangiz | Zardob |
|---|---|
| Container | Oltin/yo'lbars qopqoqli probirka (SST, gel ajratgich) |
| Hajm | 1 mL (min 0.2 mL) |
| Saqlash tayyorlik | Sovutilgan, Muzlatilgan |
References
Block E, Rutner H. Efficacy of postprandial bile acid levels as diagnostic tool for hepatobiliary disease. Clin Chem. 1979;25:1081. 31st National Meeting of the American Association for Clinical Chemistry, July 15-20, 1979, New Orleans, LA.
Korman MG, Hofmann AF, Summerskill WH. Assessment of activity in chronic liver disease: Serum bile acids compared with conventional tests and histology. N Engl J Med. 1974 Jun 20;290(25):1399-1402. PubMed 4133590.
Mashige F, Tanaka N, Maki A, Kamei S, Yamanaka M. Direct spectrophotometry of total bile acids in serum. Clin Chem. 1981 Aug;27(8):1352-1356.
Skrede S, Solberg HE, Blomhoff JP, Gjone E. Bile acids measured in serum during fasting as a test for liver disease. Clin Chem. 1978 Jul;24(7):1095-1099. PubMed 657487.
Savelieva GM, Sukhikh GT, Serov VN, Radzinsky VE, editors. Obstetrics: National Guideline. 2nd ed. Moscow: GEOTAR-Media; 2018.
Evsyutina YV, Ivashkin VT. Bile acid metabolism, liver diseases, and the microbiome. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2018;28(2):4-10.
Russian Society of Obstetricians and Gynecologists; Ministry of Health of the Russian Federation. Clinical guidelines: Intrahepatic cholestasis of pregnancy. 2020.
Lindor KD, Bowlus CL, Boyer J, et al. Primary biliary cholangitis: 2021 practice guidance update from the American Association for the Study of Liver Diseases. Hepatology. 2022;75:1012.
Burtis CA, Bruns DE. Tietz Fundamentals of Clinical Chemistry and Molecular Diagnostics. Elsevier; 2014.
Gardiner FW, et al. The prevalence and pregnancy outcomes of intrahepatic cholestasis of pregnancy: A retrospective clinical audit review. Obstetric Medicine. 2019;12(3):123-128.
Ovadia C, et al. Association of adverse perinatal outcomes of intrahepatic cholestasis of pregnancy with biochemical markers: results of aggregate and individual patient data meta-analyses. The Lancet. 2019;393(10174):899-909.