Alkaline phosphatase. The norm in women increased, decreased blood age. Table, causes in adults, treatment

Alkaline phosphatase is an enzymeThat participates in the metabolism of phosphorus, calcium. The enzyme helps to cleave the phosphate group from the organic substances. Normally, it is contained within the cells.

There, the main activity of the enzyme is detected. In women during pregnancy or breast-feeding an enzyme found in the placenta and breast tissues. Enzyme works inside hepatocytes (liver cells), epithelial cells of gallbladder, bile ducts, osteoblasts (cells responsible for bone formation), the cells lining the intestines.

What does the analysis on alkaline phosphatase

There are several types of analysis. The most common of these is the definition of the level of alkaline phosphatase in the blood serum.

Normally, the cells of the intestine, bone, liver and bile duct are constantly updated. Therefore, the portion of the enzyme reaches the systemic circulation. Increased destruction of cell membranes due to different pathologies leading to an increase in the enzyme concentration in the blood. In some cases, blood alkaline phosphatase diseases may be less than optimal values. This is also taken into account in the analysis.

Thus, as a result of the study may be three options: normal, low and high phosphatase levels. The doctor further generates the necessary number of additional examination in detecting abnormalities.

When the prescribed study

Very often, doctors recommend to take this analysis before performing elective surgery, as well as within the framework of routine inspection. But it is considered more appropriate designation delivery of alkaline phosphatase in the presence of complaints, anamnesis.

The first group of diseases, which may be valuable phosphatase definition - is accompanied by bile stagnation.

Therefore, the doctor has the right to assign the analysis of the presence of the following signs and symptoms:

• yellowness of the skin;
• ikterichnost sclera and mucous membranes (a slight yellow staining);

  

• the presence of discolored feces;
• abdominal pain, more on the right and from the top;
• weakness;
• nausea;
• pronounced itching, in which even the antihistamines do not always help.

Doctors recommend tested for alkaline phosphatase to confirm or rule out the liver. Parallel to this, it is important to know the level of cholesterol, aspartate aminotransferase, alanine aminotransferase, and spend thymol and determine protein content, its fractions.

To exclude bone diseases, tumors of bone metastases, as recommended by conducting the analysis described. Examination supplemented by determining the amount of phosphorus and calcium in the serum under biochemical analysis.

Norms rates among women by age, pregnancy and hepatitis B

Alkaline phosphatase (rate of women is different at different ages) from the representatives of different sexes is different.

Age	The norm for men, U / L	Norma women U / L.
0-1 years	80-470	80-470
1-10 years	150-450	150-450
10-12 years	180-470	180-470
12-15 years	140-400	140-400
15-18 years	80-350	80-350
18-40 years	100-400	30-90
40-60 years	100-145	100-140
Over 60 years	180-200	150-170

During pregnancy and breast-feeding is acceptable, that the level of alkaline phosphatase is greater than 2 times table. Sometimes it is considered that an increase of 2.5 p. It is not a pathology in the clinical situation.

Alkaline phosphatase (rate of women in the table corresponds to the WHO) in childhood has a relatively high value. This is due to greater activity of osteoblasts and incomplete osteogenesis.

How much is a study where they spend

Any biochemical laboratory can carry out this analysis. The main thing is to have available the necessary reagents.

Price range varies in different institutions. According to the agreement, the tariff value of the MLA drawing blood from a vein - 40 rubles, and the analysis of costs 120 rubles.. In private clinics the price exceeds this value, as these institutions are working on their own price lists.

How to prepare for the study

Special training for the delivery of blood to the alkaline phosphatase is not required. But do not be superfluous to remember the safety precautions that must be followed when taking any blood test.

The most important thing is that the blood pass on an empty stomach. This means that the last meal should be no later than 4 hours prior to the study. The result will be the most significant, if the stand 8 hour interval. Dinner the night before the study should be easy, not abundant.

Refusal of alcohol at least one day before the planned delivery of blood prevent falsely elevated test results. The same applies to smoking. Nicotine is unjustified and unexplained increase in the enzyme concentration in the blood.

Before commissioning it is better not to get nervous, eliminate stress. If this was done before exercise, it is recommended to rest at least 5 minutes. Ignoring this advice can also cause spurious results and their interpretation.

How does the biomaterial fence

Under steady-state conditions in the laboratory department comes and carries out blood sampling in a treatment room. At the clinic, patients are assigned in the early morning hours, where they were in a queue spend fence material for research.

In a clean, dry vial technician places the patient to 15 ml of venous blood. The puncture the vein is treated with an antiseptic swab, which is then recycled.

How to wait for the study results

The execution of the analysis depends on the schedule of the laboratory and domestic policy institutions. As a rule, if the sampling was carried out in the morning, then the results are known on the same day. Reported results are usually the next day.

The exception is a situation where the analysis takes on Cito! (Urgently). Here they are known at 3 hours after giving blood.

Explanation responses analysis

Interpretation has been treating doctor. Attempts to independently deal with what is happening in the body without medical education are doomed to failure.

Alkaline phosphatase (the norm for women - up to 400 U / L) does not show a complete picture of the pathology and is a relative concept. First, you need to keep in mind situations where the excess of the normal range is physiologically determined.

Secondly, medicines, the influence on the level of enzyme in the blood. Therefore, the doctor should help sort out which of the received funds may potentially have an impact on the results of the analysis.

Reasons for deviations from normal performance

It is not always the indicator level change indicates the presence of pathology. There are a number of situations where the excess of the norm less than 1.5 times the clinically insignificant, and says that there is no pathology, and look for it impractical.

This applies to:

• children and adolescents;
• young men up to 30 years;
• women during breastfeeding;
• pregnant women;
• who gave birth within the last month before the women analysis.

Alkaline phosphatase reacts to medication intake. The norm in this case is relative. Men and women take antibiotics, analgesics, muscle relaxants may distort the picture.

Even taking oral contraceptives can raise the level of phosphatase. This is taken into account in the interpretation. At the time of drug overturned. Then retake the analysis and determine whether the drug caused the increase or decrease in the indicator.

increased level

This situation should first doctor to touch up on the idea that there is a pathology of the hepatobiliary zone. First of all, the gallbladder.

Most often, an increase in the concentration of alkaline phosphatase in the blood caused by lesions of the gallbladder. Basically, it is cholelithiasis. At least - the primary organ tumor.

To identify this pathology allows abdominal ultrasound. Supplemented by at least a diagnostic blood test, urine, feces, and biochemistry. Be sure to check the contents of AST, ALT, protein, GGT, cholesterol.

Cancerous tumor of the liver, pancreas or stomach, large size reached, causes compression of the biliary ducts. These conditions cause the majority of cases obstructive jaundice. In the framework of cholestasis increases the concentration of alkaline phosphatase.

Less common causes compression of the bile ducts can become parasitic diseases, formation of scars and strictures (including after surgery). Identify these states helps ultrasound and computed tomography.

In gastroenterology and hepatology known two dangerous disease when the blood level of alkaline phosphatase rolls. This primary biliary cirrhosis and primary sclerosing cholangitis. When they reveal a marked increase in parallel with the content of GGT. Used to confirm the diagnosis of liver biopsy.

In some diseases of bone tissue showed increased blood alkaline phosphatase. This applies mainly tumors. Greatest level of AP is registered with Paget's disease.

Sometimes he dramatically increased within the metastasis of malignant tumors:

• osteosarcoma;

  

• osteoblastoma;
• mammary cancer;
• prostate cancer;
• lungs' cancer.

Confirm bone diseases and their defeat metastases will oncologist. He appoints scintigraphy imaging (CT or MRI), densitometry. It is best to complete this series of commissioning tests for tumor markers.

Among other diseases, which may be accompanied by an increase in the content of the alkaline phosphatase is present bowel pathology. These primarily include inflammatory and autoimmune diseases. For example, ulcerative colitis and Crohn's disease.

Inflammation of the liver tissue is necessarily accompanied by the destruction of the membrane of hepatocytes. The contents of the cells into the blood stream, and along with it - and a fraction of the enzyme phosphatase. This laboratory syndrome called cytolysis. In addition to increased levels of alkaline phosphatase AST, ALT and bilirubin.

Possible liver damage cells in cirrhosis of different etiology, as well as infectious pathologies, with that involves the body (for example, cytomegalovirus and Epstein-Barr virus within mononucleosis).

It is known that increased levels of the enzyme described in myocardial infarction. But without clinical signs of a positive troponin test and an ECG pattern that diagnosis is doubtful.

level is lowered

In women during pregnancy, this situation indicates the function of the placenta insufficiency. Should consult a gynecologist. The next possible factor is the severe anemia. This is especially true of situations after massive blood loss. Sometimes it is possible that the reason lies in the blood transfusion (transfusion of blood and its components).

Alkaline phosphatase (normal women controlled endocrinologists), with a slight decrease may indicate thyroid disease with the formation of T3 and T4 hormone deficiency. In these cases, appoint an ultrasound of the thyroid gland and hormone assays.

Sometimes, blood alkaline phosphatase reduced when emerging deficiency of magnesium, calcium. The group risk patients who have problems with food, malabsorption (gastric resection), alcoholism.

The children should think about the possibility of congenital disorders of bone metabolism. It is possible with the gene mutation coding for the synthesis of bone alkaline phosphatase. The result is abnormal softening of the tissue with the threat of fractures, forming defiguratsy, deformations.

Treatment of low levels of alkaline phosphatase

Causal therapy does not exist. The only condition in which the possible use of replacement therapy, it hypophosphatasia. Promising application asfotazy alpha. It is a synthetic analogue of the described enzyme. The drug is not used until today.

The treatment reduced the level of alkaline phosphatase is reduced to correct the causes that caused this condition. So, hypothyroidism requires the appointment of a synthetic analogue - Eutiroksa or levothyroxine.

Anemia requires a blood transfusion when severe iron-containing medications or destination, if diagnosed with anemia of moderate severity. Priority injectable form (Likfer). Tablets help with mild disease (Sideral, totem Sorbifer).

Magnesium and calcium deficiency is compensated infusions magnesium sulfate. It is useful to combine with Panangin or Asparkamom only under the control of the blood level of potassium.
elevated levels of alkaline phosphatase treatment

Jaundice is a cause to show the patient the surgeon to exclude acute surgical pathology. After all, first of all it can be a stone in the gall bladder or bowel obstruction.

Cholestasis as cause increase alkaline phosphatase, treated with ursodeoxycholic acid. The drug of choice - or Ursosan Ursofalk. The dose is titrated with a minimum rate of patient body weight. To avoid pain, the early days of the drug is best taken under the guise of antispasmodic (spazgan, Baralgin, No-spa).

Viral hepatitis require the appointment of causal antiviral therapy. Pathogenetically justified the appointment gepatoprotektorov: Gepabene, Essentiale, Geptral, Essliver. In the presence of toxic hepatitis have resorted to aggressive active dektoksikatsionnoy therapy.

bowel disease require the selection of adequate doses of hormones (prednisone), or immunosuppressive agents (sulfasalazine, Mesalazine). This deals with a gastroenterologist.

Complications Untreated

Changes themselves in the biochemical analysis of blood does not pose a threat to human life. Dangerous diseases which cause raising or lowering of alkaline phosphatase.

Tumors bone can flow aggressively. Early detection and early treatment of specific minimizes early morbidity and mortality in these cases and gives a chance for highest five-year survival. Identification of the primary tumor within the metastasis also allows you to start therapy in a timely manner and to achieve a favorable prognosis.

Hepatitis dangerous outcome in cirrhosis. This applies to hepatitis C, flowing long time unnoticed.

Cirrhosis of the liver is complicated by the loss of function development of bleeding, reduction of the protein level of cardiac function insufficiency.

Bone tumors are dangerous skeletal deformities. If there are metastases, the complications depend on their localization. Particularly dangerous lesions in the brain and liver.

Alkaline phosphatase is not a specific marker of any disease. But this figure indicates the skilled direction in which to look for abnormalities. It is important to understand that the rules of the men and women of different ages, different. To find the reasons for further examination is appointed. As a result, it turns out the causative factor, its specific treatment begins.

Registration of the article: Vladimir the Great

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