bilirubin 1. Increased total bilirubin and direct bilirubin: intrahepatic and extrahepatic obstructive jaundice, pancreatic head cancer, cholangiocapillary hepatitis and other bile stasis syndrome.
2. Increased total bilirubin and indirect bilirubin: hemolytic anemia, incompatible blood type transfusion, malignant disease, neonatal jaundice, etc.
3. Total bilirubin, direct bilirubin and indirect bilirubin increased: acute icteric hepatitis, chronic active hepatitis, cirrhosis, toxic hepatitis, etc.
Schematic diagram of bilirubin metabolism (1) Liver diseases: acute icteric hepatitis, acute yellow liver necrosis, chronic active hepatitis, cirrhosis, etc.
(2) Extrahepatic diseases: hemolytic jaundice, transfusion reaction with incompatible blood group, cholecystitis, cholelithiasis, etc;
It can judge whether there is jaundice, the degree of jaundice and the evolution process. When the total bilirubin is>17.1 μ mol/L, but L is recessive jaundice or subclinical or subclinical jaundice; 3.42~171 μ mol/L is mild jaundice, 171~342 μ mol/L is moderate jaundice, and>342 μ mol/L is severe jaundice.
The etiology of jaundice can also be inferred according to the degree of jaundice: hemolytic jaundice is usually L, hepatocyte jaundice is 17.1-171 μ mol/L, incomplete obstructive jaundice is 171-265 μ mol/L, and complete obstructive jaundice is usually>342 μ mol/L.
At the same time, the type of jaundice can be judged according to the degree of increase of total bilirubin, direct bilirubin and indirect bilirubin: if total bilirubin increases with significant increase of indirect bilirubin, it indicates hemolytic jaundice; if total bilirubin increases with significant increase of direct bilirubin, it indicates cholestatic jaundice, and all three increase are hepatocyte jaundice.
Pay attention to distinguish the increase of bilirubin caused by drugs.
Most of the bilirubin in the body comes from hemoglobin released from the decomposition of aging red blood cells, including indirect bilirubin and direct bilirubin. Indirect bilirubin is transported to the liver through blood, and generates direct bilirubin through the action of hepatocytes. The increase of bilirubin can be seen in:
(1) Liver diseases: acute icteric hepatitis, acute yellow liver necrosis, chronic active hepatitis, cirrhosis, etc.
(2) Extrahepatic diseases: hemolytic jaundice, transfusion reaction with incompatible blood group, cholecystitis, cholelithiasis, etc;
It can judge whether there is jaundice, the degree of jaundice and the evolution process. When the total bilirubin is>17.1 μ mol/L, but L is recessive jaundice or subclinical or subclinical jaundice; 3.42~171 μ mol/L is mild jaundice, 171~342 μ mol/L is moderate jaundice, and>342 μ mol/L is severe jaundice.
The etiology of jaundice can also be inferred according to the degree of jaundice: hemolytic jaundice is usually L, hepatocyte jaundice is 17.1-171 μ mol/L, incomplete obstructive jaundice is 171-265 μ mol/L, and complete obstructive jaundice is usually>342 μ mol/L.
