Serum bile acid assay (TBA)

Bile acid is the main component in human bile and is the final product of cholesterol metabolism in liver tissue. Determination of serum total bile acids is mainly used for the diagnosis of liver diseases and is one of the most sensitive liver function tests. When the liver cells are damaged, the bile acid absorbed from the intestinal tract cannot be efficiently taken up, and the blood bile acid concentration is increased. In addition, when cholestasis occurs, hepatocytes secrete bile dysfunction and do not discharge bile acids well, so blood bile acids are also high. It is currently considered that the determination of bile acids in serum has a sensitivity of 76% and a specificity of 93% for the diagnosis of hepatobiliary diseases. Some people think that in chronic liver diseases such as cirrhosis, the increase in bile acid is earlier than the changes in albumin, cholesterol, cholesterol esters, and bilirubin, so it is important for the diagnosis of chronic liver disease. Basic Information Specialist classification: Digestive examination classification: liver function test Applicable gender: whether men and women apply fasting: fasting Analysis results: Below normal: No clinical significance. Normal value: Enzyme colorimetric method: 0.14-9.66μmol/L Enzyme cycle method: 0-9.67μmol/L Above normal: Found in acute and chronic hepatitis, liver cancer, cirrhosis and other diseases. negative: Positive: Tips: Do not eat too greasy, high-protein foods the day before the blood draw, avoid heavy drinking. The alcohol content in the blood directly affects the test results. After 8 pm on the day before the medical examination, you should start fasting for 12 hours to avoid affecting the test results. Normal value Enzyme cycle method: serum bile acid concentration in healthy adults is 0-9.67 μmol/L. >10.00 μmol/L is elevated. Enzyme colorimetric method: The concentration of fasting serum bile acid in healthy adults was 0.14～9.66μmol/L, and the serum total bile acid concentration was 2.4～14.0μmol/L 2 hours after meal. (Note the specific reference value depends on each laboratory.) Clinical significance (1) Mild (10～20μmol/L) elevation: seen in acute hepatitis (recovery period), chronic hepatitis (inactive, active), cirrhosis (compensatory period), liver cancer, constitutional jaundice, Gilbert disease (Congenital non-hemolytic jaundice), Dubin-Johnson syndrome (black liver-jaundice syndrome). (2) Moderate (20 ~ 40μmol / L) increase: seen in acute hepatitis (acute phase), chronic hepatitis (active phase), cirrhosis (compensatory period), liver cancer. (3) Height (40μmol/L) elevation: seen in acute hepatitis (acute phase), cirrhosis (compensatory, decompensated), liver cancer, bile stasis (intrahepatic, extrahepatic), severe hepatitis. High results may be diseases: bile reflux gastritis, liver cancer, cirrhosis, congenital non-hemolytic jaundice First, the precautions before blood draw 1, do not eat too greasy, high-protein food the day before the blood, to avoid heavy drinking. The alcohol content in the blood directly affects the test results. 2. After 8 pm on the day before the medical examination, you should start fasting for 12 hours to avoid affecting the test results. 3, should relax when taking blood, to avoid the contraction of blood vessels caused by fear, increase the difficulty of blood collection. Second, should pay attention after blood draw 1. After blood is drawn, local compression is required at the pinhole for 3-5 minutes to stop bleeding. Note: Do not rub, so as not to cause subcutaneous hematoma. 2, the pressing time should be sufficient. There is a difference in clotting time for each person, and some people need a little longer to clotting. Therefore, when the surface of the skin appears to be bleeding, the compression is stopped immediately, and the blood may be infiltrated into the skin due to incomplete hemostasis. Therefore, the compression time is longer to completely stop bleeding. If there is a tendency to bleed, the compression time should be extended. 3, after the blood draw symptoms of fainting such as: dizziness, vertigo, fatigue, etc. should immediately lie down, drink a small amount of syrup, and then undergo a physical examination after the symptoms are relieved. 4. If there is localized congestion, use a warm towel after 24 hours to promote absorption. Inspection process Immediately after venous blood collection, the test is performed. Test GPT (alanine aminotransferase) or compound iodine test. The urinary tricholic test, the serum whitening test, and the bilirubin quantification were performed, and plasma prothrombin time was measured as necessary to understand the liver condition. Not suitable for the crowd Generally 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, bruising and swelling.