High total bilirubin

Introduction Total bilirubin includes indirect bilirubin and direct bilirubin. The normal value is 1.7-17.1 mol/L (0.1 mg/dl~1.0 mg/dl), which is mainly used to diagnose whether there is liver disease or abnormal biliary tract. When this normal range is exceeded, total bilirubin is elevated.

Cause

Since total bilirubin is the sum of indirect bilirubin and direct bilirubin, elevated indirect bilirubin or elevated direct bilirubin can cause an increase in total bilirubin.

First, the increase of total bilirubin, indirect bilirubin increased: when suffering from hemolytic jaundice, causing massive destruction of red blood cells, indirect bilirubin increased, exceeding the liver's ability to transform, making indirect bilirubin in the blood Retention in the middle, resulting in an increase in total bilirubin. It is common in hemolytic jaundice, blood transfusion reaction, neonatal jaundice and other diseases.

Second, the total bilirubin increased, direct bilirubin increased: If there is a problem with the biliary tract, direct bilirubin can not be discharged into the intestine, but reverse flow into the blood, leading to elevated serum bilirubin, total erythropoietin Higher height will increase, causing stenosis-negative jaundice. The increase in total bilirubin caused by such causes is common in biliary diseases such as cholecystitis and cholelithiasis.

Third, the total bilirubin is elevated, both direct and indirect bilirubin are elevated: if the liver has problems, that is, the liver cells are damaged, the liver's ability to convert indirect bilirubin into direct bilirubin is reduced, which will cause The phenomenon of direct bilirubin and indirect bilirubin is high at the same time, and the total bilirubin is also high, that is, hepatic jaundice. When suffering from acute jaundice hepatitis, acute yellow liver necrosis, chronic active hepatitis, cirrhosis and other liver diseases, it will cause an increase in total bilirubin.

an examination

Related inspection

Total bilirubin (TBIL, STB) direct bilirubin indirect bilirubin

1, serum total bilirubin examination.

2. Serum direct bilirubin.

3. Serum indirect bilirubin.

4. Liver function tests.

Differential diagnosis

1, the normal human serum total bilirubin quantitative determination results should be less than 17mol / L, including direct and indirect bilirubin, where the ratio of direct bilirubin to serum total bilirubin should be less than 35%. When serum total bilirubin When the pigment exceeds 34 mol/L, yellowing of the sclera and skin may occur. The detection of total bilirubin can determine the presence or absence of jaundice, jaundice and the type of jaundice, which is of great value for the diagnosis and identification of jaundice.

2, when total bilirubin < 85.5mol / L, mild jaundice, 85.5 ~ 171mol / L for moderate jaundice, > 172mol / L for severe jaundice.

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