Bilirubin: the rate in women over the age of, what it is, the table of indicators. Direct or indirect in the blood, urine, pregnant. Diet and treatment level violations

Bilirubin - chemical element is a dye and yellow-brown color, which is the result of processing of red blood cells - red blood cells containing hemoglobin.

The process of reaching this dye occurs in the gall bladder and liver. The normal value of bilirubin in women varies slightly, due to age (except newborns). The following table is shown the article, which shows the bilirubin standards in accordance with the age category.

The role of bilirubin in the body

The analysis takes into account not only the general index of the pigment, but his faction - direct and indirect. The excess of the total concentration may indicate toxicity in the body, cirrhosis, viral hepatitis, malignant neoplasms in the liver or genetic disorders.

concentration increase due to dysfunction of the gallbladder and biliary tract, or indicates a failure in the functioning of the pancreas.

Increasing indirect type pigment may be explained by the presence of Gilbert's syndrome, previous infection, hemolytic anemia, splenic dysfunction. The value of this chemical element is indicative of the recognition of a newly born child anemia and jaundice.

What analysis have to take on bilirubin

Most often to detect bilirubin concentration is carried out biochemical blood. The analysis will help establish the overall importance of the dye and its related species. A kind of indirect simply calculated from these two values.

Bilirubin is measured in micromoles per liter with very high accuracy, so that it becomes possible to identify malfunctions of the body even before the onset of disease symptoms. More often than not the result of the study is ready the next day, but there is a possibility for an urgent analysis, in which all the figures will be known within a few hours.

Indications for depositing analysis

Due to the improper functioning of liver and biliary tract bilirubin is excreted derived not fully, there toxication and visceral tissues become characteristic icteric coloration. This does not necessarily mean that a person is sick with hepatitis.

Assign a study to determine the level of pigment, if:

• It assumed hepatitis or cirrhosis;
• jaundice;
• suspected liver cancer;
• patient abuse alcohol;
• concrements present in the gall bladder;
• failure of the spleen;
• you have to confirm hemolytic anemia.

Preparation for delivery of analysis

Bilirubin - rate of women by age (see table below) - indicates proper operation of the organs such as the spleen, liver and bile duct. But sometimes the research results can be distorted. This is due to the violation of certain conditions to the delivery of the analysis.

The reasons that may affect the results of the study:

• abuse of coffee, alcohol and fatty food prior to analysis;
• long exposure to the sun;
• hormonal drugs and contraceptives;
• receiving diuretics;
• taking medication, containing in its composition codeine, caffeine, alcohol;
• receiving sedatives containing barbiturates;
• heavy exercise or tough diet before delivery of the analysis;
• Deposit of analysis after the completion of chemotherapy or after the last dose of antibiotics (must complete a minimum of 14 days).

Blood dealt from a vein in the morning before breakfast. If we abandon the meal did not work for some reason, her hand over 4-5 hours after the morning meal.

The rules of the urine for bilirubin are no different from the usual, used for the delivery of the overall analysis. Before examining the need to take a bath or shower. The primary portion of the urine passed and the next is collected in a sterile container.

types of bilirubin

Red blood cells, whose "lifetime" (approximately 90 days) comes to an end, begin to decompose. The main task of bilirubin excretion is spent hemoglobin protein component of the organism. Initially formed indirect type bilirubin, which can not leave the body independently and is toxic to it.

Then the bloodstream indirect type penetrates into the liver, where after completion of its further decay it joins easily soluble glucuronic acid. The transformation of the indirect type in a straight line, which can be easily deduced with urine and feces.

How to determine the amount of bilirubin

There are several ways to determine the level of this chemical element in the blood:

colorimetric method It is to identify the amount of pigment, with the color intensity of the pigment by diazotization sulphate solution and acid.

This method is also called the method of Van Den Berg. Direct view reacts quickly enough, and indirect form only after the introduction of auxiliary substances - acetic acid, sodium benzoate, caffeine, methanol, urea or other reagents.

To calculate the concentration of bilirubin are also used by medical diagnostic devices - Bilirubinometers.

At the heart of some of them is the photometric method of research.

The advantage of such devices is the speed of analysis and the minimum error in the results, as in this case, the human factor can be completely eliminated.

To carry out the analysis Bilirubinometers enough to pass a small amount of blood from a finger (capillary). To operate such a device requires special small disposable containers, containing anticoagulants. Biological material for the study contained in the vessel is placed in a centrifuge, where the red blood cells settle.

After that the device produces a count of the number of bilirubin in the blood. Modern instruments are able to give the result of 7-15 seconds.

The norm of bilirubin in the blood of women

Bilirubin, the rate of women by age, the table:

Age	Indirect view .mu.mol / l	Direct view .mu.mol / l	Total, mmol / l
Premature baby	3 – 3,5	27 – 31,5	30 – 35
Newborn	5 – 6	45 – 54	50 – 60
1 - 7 days	5,45 – 25,6	49,05 – 230,4	54,5 – 256
7 - 14 days	6 – 10	54 – 90	60 – 100
30 days	2,25 – 5	6,75 – 15	9 – 20
18 - 20 years	2,62 – 12,75	0,88 – 4,25	3,5 – 17
21 - 30 years	3 – 13,5	1 – 4,5	4 – 18
31- 40 years	2,85 – 13,35	0,95 – 4,45	3,8 – 17,8
41 - 50 years	2,95 – 13,2	0,98 – 4,4	3,9 – 17,6
51 - 60 years	2,77 – 13,05	0,93 – 4,35	3,7 – 17,4
61 - 70 years	2,55 – 12,82	0,85 – 4,28	3,4 – 17,1
older than 70	2,32 – 4,23	0,78 – 4,23	3,1 – 16,9

The ratio of direct and indirect type bilirubin in newborns in a rate of about 90% to 10%, and by the 1st month of life, it already accounts for 75% to 25%. In adult women, these values ​​are changed diametrically opposed - the amount of insoluble pigment is 75%, direct species - 25%.

By increasing the pigment concentration to 33-35 mol / l of ocular proteins acquire characteristic yellow hue. When the rate exceeds 50 mol / l, mucous membranes and integuments also begin to turn yellow. Elevated bilirubin accumulates in the tissues of organs, poisoning them and affecting the central nervous system.

Bilirubin and pregnancy

The amount of pigment should be carefully monitored during pregnancy. When a woman bears a child in the body of an aggravation of chronic diseases acquired before pregnancy (cholecystitis, anemia) can occur. Normally, the concentration of bilirubin should not increase.

Some previous infection may also increase bilirubin levels. Toxicosis in the 1st trimester signals the pigment exceeds the norm in the body of a pregnant woman. If the amount of pigment in mother's body reaches the critical value, is carried out early delivery.

Growing embryo is able to exert pressure on the liver and gallbladder, thus breaking the circulation of bile pigment and causing lifting level.

What additional tests pass

Additionally examine the urine for the presence of bilirubin. Such an analysis can not show a complete picture of the disease, but will help to evaluate the course of the disease and to make a forecast recovery of the patient. According to the norm, in the urine of the pigment should not be. It is manifested in the urine only when the amount of blood increases to 30-32 mol / l, indicating a serious failure in the body.

The reasons for the deviation from the norm

Basically pathological conditions leading to the pigment increase in the body, are acquired (hepatitis, oncology, cirrhosis, cholecystitis), but there are disturbances transmitted genetically - Gilbert syndrome and Crigler-Najjar.

Further diseases that lead to dysfunction of the gallbladder and liver, there are factors not affecting the operation of these bodies, however, and they contribute to the growth of bilirubin in the body.

These include:

• anemia of various etiology;
• diseases associated with accelerated destruction of red blood cells - malaria, blood poisoning;
• taking certain medications (antibiotics penicillin, diazepam, furosemide);
• getting serious soft tissue injuries involving bruises and broken bones.

As the table shows, the level of bilirubin in the newborn can be increased and at 3-4 hours and reaches its maximum - 256 mmol / l. Children born prematurely, this value should not exceed 170 mmol / l.

Symptoms of rejection parameters bilirubin and when to seek medical advice

Some factors may indicate an increase in the concentration of pigment in the blood even before receiving the results of the analysis.

What should pay attention:

• pain in the left upper quadrant after exercise or sports training;
• Cal gets lighter shade, and dark urine;
• occurrence of nausea and vomiting;
• yellowing of the whites of the eyes, skin and mucous membranes;
• dizziness or weakness;
• nausea, vomiting and loss of appetite;
• chronic fatigue and anxiety.

Which drugs are prescribed

Bilirubin, the rate of women by age (table given above) shall not exceed the limit value, in case of deviation from the norm gives a direct cause for destination therapy. If the cause is an increase of bilirubin liver dysfunction, gepatoprotektory used.

These funds can not solve the problem completely when such serious diseases such as hepatitis, cirrhosis, disorders caused by immoderate consumption of alcohol or drugs, obesity, however, they can alleviate the condition patient.

Hepatoprotectors related to pathogenic agents liver treatment. They regenerate cells, reduce inflammation, inhibit fibrosis, help cleanse the body of toxins.

Almost all medications related to hepatoprotectors have no proven medical efficacy.

An exception are products containing ademetionine - Geptral, Geptor.

Detoxifying effect ademetionina researched and scientifically proven. Also well-known herbal drug Kars.

In the case where the pigment concentration rises due to poisoning assigned therapy absorbent means which successfully absorb and remove toxins from the body. These include activated charcoal, smectite, Enterosgel.

If the reason for increasing the amount of bilirubin is a dysfunction of the gallbladder, prescribe cholagogue preparations. Diagnosis will determine the cause of the disease - a violation of the liver, gallstones or pathological changes in the biliary tract.

The action of these drugs is directed to increased secretion of bile and to facilitate its entry into the the intestine, which helps speed up the digestion process and reduces the risk of formation of stones in the gall bubble.

Bile products are distinguished by having an impact - holekinetiki activate the gall bladder, helping more Part of his reduction and holespazmolitiki which affect the bile duct, relaxing them, choleretic make less bile viscous. Cholagogue drugs may be mixed type.

The choleretic drugs may include not only synthetic, but natural ingredients. Chemical agents have analgesic effect, kill bacteria and eliminate inflammation, lower cholesterol. The action of these drugs affects the bowels - improves digestion, and decomposition process is suppressed.

The use of natural choleretic medication, which may include not only medical facilities but also herbal decoctions and infusions, based on the action of essential oils, resins, volatile, vitamins and other substances in their structure.

Herbal beneficial effect on the functioning of the liver, bile liquefied stimulate job stomach and pancreas, accelerates metabolism, have antibacterial and anti-inflammatory act. The most famous natural choleretic drugs include Allohol, holosas, Hofitol.

When serious violations cholagogue drugs are prescribed in conjunction with antibiotics. Also drugs possess choleretic action of some types of mineral water.

To reduce the burden on the liver and gall bladder, the doctor may prescribe preparations containing enzymes that improve the pancreas and accelerate metabolism. Examples of such agents can serve Mezim, Pancreatin, Festal.

The consequence of certain infectious diseases may be increased concentration of bilirubin. The doctor, to stop the inflammatory process, may prescribe antiviral treatment.

Pigment growth can be associated with vitamin B12 deficiency. It will suffice to compensate for the lack of this vitamin to reduce bilirubin.

In anemia observed reduction in the concentration of bilirubin, since the body is not a sufficient number of erythrocytes is produced, and, accordingly, the level of Hb also decreases. Tissue of internal organs dopoluchaet not required for normal operation of the oxygen.

It also entails a reduction in the level of bilirubin. Then prescribe iron supplements, such as Maltofer, Ferlatum, Aktiferrin.

In some cases, this lack of effect of hemoglobin can cause rigid low-calorie diet.

Bilirubin (the norm in women over the age of - table - shown above), namely, its performance may deviate from the norm, if present in the human body parasites.

They feed on the nutrients that fall with food, process them and output the human body in its toxic products vital functions, which have a feature to accumulate in tissues of internal organs, thus poisoning them and causing an increase in the concentration of pigment.

Feces analysis will help determine what type of worms in a patient, after which the doctor prescribe treatment. The most well-known means for combating helminths - Pyrantel, Worm, Gelmintoks, Nemozol.

Diet

The group of risk of exceeding norms of pigment in the body get people suffering from diabetes. In this case, the doctor often appoints a special diet.

The essence of this diet is to completely eliminate overeating. You must eat fractional portions 4-5 times a day. must be at least 2-2.5 hours between the last meal and bedtime. The amount of water consumed, juices, soups liquid should be at least 2 liters per day. From the diet completely eliminates fried foods. The salt should be limited and not to use it more than 10 grams per day.

Products, due to which the growth of pigment concentration occurs:

• sausage and smoked products;
• legumes;
• sorrel, radish, onion, garlic;
• hard cheese;
• biscuits, chocolate, ice cream, cakes and pastries;
• lamb and pork, fowl - Duck;
• types of fish with high fat content;
• berries or fruits that have a sour taste;
• alcoholic and soft drinks;
• spicy seasonings and sauces;
• pickles;
• mushrooms;
• canned.

There is another group of products that can help reduce bilirubin in the blood.

These include:

• low-fat sour-milk products;
• light diet soup with vegetables;
• boiled eggs (egg yolk should be excluded);
• sweet fruits and berries;
• porridge from cereals;
• veal, rabbit and turkey and chicken;
• honey;
• teas, homemade compotes and jelly;
• Some vegetables such as beet and carrot;
• a small amount of butter or vegetable oil;
• stale bread and homemade biscuits.

These products will relieve the liver and gallbladder, relieve pain and to increase the efficiency of taking medication.

In medicine, this diet is called a table №5.

For breakfast, you can cook porridge with milk or water - semolina, buckwheat, rice or oatmeal. The diet is also added to foods with cottage cheese - cheese cakes, puddings, dumplings. It is recommended to drink tea or weak coffee with milk.

Next meal should be 2-3 hours. It is recommended to eat a baked apple, sweet fruit or a handful of berries.

The lunch should eat a bowl of vegetable soup. Meat and fish, cutlets, vegetables should be either stewed or steamed. Second dish can be mashed or stewed vegetables. Drink juice, compote or jelly.

After 2-3 hours can eat small amounts of marshmallow or cookie, a glass preheated fresh milk or juice.

Dining must be no later than 7 pm. For dinner you can eat a casserole, pasta, mashed potatoes, stewed cabbage and porridge of your choice.

The diet can be supplemented with a small piece of chicken or fish, steamed, and fresh vegetable salad. It is also possible to prepare the vinaigrette, the deletion of the pickled cucumbers and beans. For half an hour before bedtime can drink a cup of low-fat yogurt or kefir. The principle of the diet for pregnant women remains the same.

phototherapy

After the birth of the child's body is no longer the need for such a large number of blood cells, leading to their destruction and the strong increase of bilirubin in the blood of the newborn. It manifests as jaundice for 3-5 days after birth.

For the treatment of jaundice and hemolytic disease of the newborn is used phototherapy. It is carried out by means of special ultraviolet lamps that contribute to the transformation of indirect bilirubin is toxic in its direct non-hazardous to the child's body kind. This light therapy is safe for the baby, which can not be said about the treatment with medicines.

For phototherapy the baby is placed in a box, where lamps are installed. Genitals cover the bandage, and his eyes were protected by glasses. Usually, treatment is 4 nights. You can make short breaks for 2-3 hours in the case of jaundice is not pronounced. Irradiation is carried out on all sides, periodically shifting the baby, changing its position.

Feeding is not necessary to cancel the breast milk, as it stimulates the removal of pigment from the child's body. If you attach to the breast is not possible to use a bottle. During phototherapy every day carried out biochemical blood of the child, in order to determine the effectiveness of the procedure.

Adverse reactions include dryness and desquamation of the skin, diathesis, diarrhea, rash. Basically phototherapy used in neonates, but sometimes it is used for the treatment of adults.

Folk remedies

Normalize parameters bilirubin, in accordance with the table in the body of a woman at any age is possible through the use of traditional medicine recipes.

Infusion prepared from corn stigmas, stabilizes the liver, bile ducts and kidney. Take 1 dl stigmas, pour 200 ml of boiling water, and then kept on a steam bath for 15-17 min.

Then allowed to cool infusion for 45-50 minutes, then filtered and water was added so that the volume was 200 ml. Before use, the infusion heated and agitated. I drink it every 2-4 hours 1-3 tbsp adults, and 1-2 dl for children in the last month.

Effectively reduces bilirubin tea of ​​chamomile flowers. To do this, 1 tbsp grass was placed in a teapot, and pour 200 ml of boiled water, half an hour and filtered. The liquid is then separated into three equal parts to be taken after each main meal.

Adding 1 tsp mint leaf tea contributes to the normalization of digestion, improvement of liver function and gallbladder. This tea can be drunk for 1.5-2 months.

Decoction of birch leaves is effective in reducing the level of bilirubin in the blood. 3 tsp you must pour 1 tbsp. boiling water and infuse for 25-30 min. The resulting broth is divided into 8 equal parts. It is drunk by 1 of the 4 times a day. Store in the refrigerator.

For infusion of St. John's wort is necessary to take 2 tbsp herbs and pour 200 ml of boiling water. Infused for 30 minutes and then filtered. Drink infusion to the morning and evening after ingestion of 100 ml of food. The course of treatment is usually 1 month.

Surgical intervention

Prior to performing any surgical procedures are also exploring the pigment levels in the blood. If he reaches 55 mmol / l, but other indicators of liver function tests did not exceed normal values ​​and there are no signs of violation of the liver and gall bladder, the operation will not canceled.

In some cases, if the cause of increased bilirubin is a dysfunction of the gall bladder, surgery can be performed. Remove gallstones or the bubble itself. Stones are formed due to the fact that bile consistency becomes more viscous that it hinders the outflow from the body.

The prerequisites for the development of gallstone disease is:

• lack of exercise and obesity;
• pregnancy;
• inflammation of the biliary tract;
• female;
• elderly age;
• excessive alcohol consumption;
• operations carried out on the stomach and intestines.

Surgical intervention is done in several ways. The laparoscopic method is based on the use of specialized medical equipment - a laparoscope.

Such a method is the least traumatic and safest for the patient, since the incisions on the abdomen is very small, and other internal organs during surgery are not affected. The duration of this operation the average is 40-50 min.

Under certain conditions, only remove the stones, and the gall bladder are retained. Such an operation is performed, if the work of this body there are no violations and inflammatory processes, and the diameter of the largest stones of less than 3 cm.

An experienced doctor will be able to quickly determine the cause of the excess bilirubin values ​​in a woman's body in any age, based on the data in the table and figure out exactly what kind of performance the pigment exceeded norm. It is important to recognize the symptoms and conduct the necessary studies that will determine an effective course of treatment.

Registration of the article: Mila Friedan

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