serum alkaline phosphatase

The alkaline phosphatase in normal human serum is mainly from the liver and bone. The alkaline phosphatase assay is mainly used to diagnose hepatobiliary and skeletal diseases. It is an important indicator reflecting extrahepatic biliary obstruction, intrahepatic space-occupying lesions and rickets. Basic Information Specialist classification: Digestive examination classification: liver function test Applicable gender: whether men and women apply fasting: fasting Analysis results: Below normal: Decreased ALP activity is common in cretinism, vitamin C deficiency, and phosphatase hypothyroidism. Occasionally seen in hypothyroidism, pernicious anemia and malnutrition. Normal value: Adult: 3-13 Kim's unit children: 5-28 Jin's unit Above normal: Elevation is common in diseases such as jaundice, hepatitis, and cirrhosis. negative: Positive: Tips: Blood should be taken on an empty stomach. A high-fat diet can increase the synthesis of ALP in the small intestine, a high-sugar diet can also increase the enzyme activity, and a high-protein diet can reduce the enzyme activity. Normal value (1) Colorimetric method Adult 3 to 13 jin units; Children 5 to 28 gold units. (2) Continuous monitoring method 37 ° C Women 1 to 12 years old <500U / L, > 15 years old 40 ~ 150U / L. Males 1 to 12 years old <500 U / L, 12 to 15 years old <750 U / L, > 25 years old 40 ~ 150 U / L. Clinical significance Serum ALP measurement is mainly used for the diagnosis of hepatobiliary system and bone diseases, especially for the identification of jaundice type. (1) Obstructive jaundice patients with obstructive jaundice inside and outside the liver due to poor bile excretion, ALP retention in the blood and increased, the degree of increase is proportional to the degree of obstruction, duration. Extrahepatic obstruction > intrahepatic obstruction, complete obstruction > incomplete obstruction, malignant tumor > cholelithiasis. (2) ALP activity such as acute and chronic hepatitis with jaundice, liver cirrhosis, and liver necrosis is also increased. It is generally believed that ALP in patients with hepatic jaundice continues to rise at a low level, if bilirubin is gradually increased, and ALP is decreased, indicating that liver cells are severely damaged. On the contrary, it indicates that the liver cells gradually recover. ALP activity is reduced in severe diffuse liver injury. (3) About half of primary liver cancer and 90% of metastatic liver cancer ALP in liver cancer are elevated, and the most significant increase in liver disease. Abnormally elevated ALP in patients without jaundice should be alert to the possibility of liver cancer. Other tumor ALP can also be elevated. (4) Skeletal system diseases Osteomalacia, rickets, fracture recovery period, etc., ALP activity is increased due to hyperactivity of ALP. (5) ALP activity is reduced in cretinism, vitamin C deficiency, and phosphatase deficiency. Occasionally seen in hypothyroidism, pernicious anemia and malnutrition. High results may be diseases: chronic hepatitis, eosinophilia, primary hyperparathyroidism and nephropathy (1) Colorimetric method: 1 The matrix solution should not contain free phenol. If the blank tube is red, it indicates that the phenyl phosphate disodium has been decomposed and should be reconstituted. 2 Potassium ferricyanide should be stored in the dark, and blue will be ineffective. After the addition, it should be mixed quickly to fully develop color. 3 Hemolysis and jaundice serum should be used as a self-control tube to clear the error. (2) Continuous monitoring method: 1 should be taken on an empty stomach. A high-fat diet can increase the synthesis of ALP in the small intestine, a high-sugar diet can also increase the enzyme activity, and a high-protein diet can reduce the enzyme activity. 2 serum and heparin anticoagulated plasma results were consistent. The activity of the hemolytic specimen enzyme is decreased, and the anticoagulant of the complex enzyme can inhibit the enzyme activity. 3 temperature can affect the measurement results. The enzyme activity can be increased at room temperature and in the refrigerator, and the enzyme activity is increased by 3% to 6% for 1 to 4 days. The enzyme activity of the frozen serum is reduced, and the recovery is resumed after rewarming, so the specimen is preferably fresh and timely measured. 4 The type of buffer and the purity of the reagent can affect the measurement results. Different types of buffers have different reference intervals. It is used as a standard for the correction of the molar absorptivity - p-nitrophenol and phosphoric acid p-nitrophenol used as a substrate must meet certain specifications. Inspection process Immediately after venous blood collection, the test is performed. (1) Colorimetric method: Mix well, adjust to zero at 510 nm with distilled water, record the absorbance of each tube to determine the difference between the absorbance of the tube and the control tube, and check the standard curve. (2) Continuous monitoring method: Each laboratory can be determined according to the analyzer model and operation manual. The main parameters are: incubation time 30s, continuous monitoring time 60s, wavelength 405nm, liquid absorption 500μl, temperature 37°C, specimen and reagent volume The ratio is 1:50 with a factor of 2757. Not suitable for the crowd There are no taboos. Adverse reactions and risks 1. Infection: Pay attention to aseptic operation when collecting blood, avoid contamination of water and other parts at the blood collection site to avoid local infection. 2, bleeding: after the blood is given a full compression time, especially coagulopathy, bleeding tendency, to avoid local subcutaneous oozing, bruises and swelling

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