p*****m
发帖数: 2895 | 1 爸爸60多岁，最近体检差出总胆红素，直接，间接胆红素都高不少啊，以前查过也是这
样高，他肝功能查的是正常，肝部有点肥大心机有点肥大，其他也没什么大问题，请问
下步该怎么治疗，或者再查下什么呢？谢谢！ |
g*****j
发帖数: 1211 | 2 High bilirubin is usually resulted from two causes: 1) increased red blood
cell hemolysis; 2) decreased liver metabolism.
Not sure what do you mean by normal liver func. Normal AST/ALT doesn't mean
liver must be fine. You probably want to follow up with ultrasound. |
d***n
发帖数: 253 | 3 真是好同志。有问必答。
mean
【在 g*****j 的大作中提到】
: High bilirubin is usually resulted from two causes: 1) increased red blood
: cell hemolysis; 2) decreased liver metabolism.
: Not sure what do you mean by normal liver func. Normal AST/ALT doesn't mean
: liver must be fine. You probably want to follow up with ultrasound.
|
g*****j
发帖数: 1211 | 4 多谢夸奖，新版主上任总得来喷喷场吧！
【在 d***n 的大作中提到】
: 真是好同志。有问必答。
:
: mean
|
m****n
发帖数: 87 | 5 版主不承认胆红素吧？这都是洋鬼子骗人的玩意儿。
【在 g*****j 的大作中提到】
: 多谢夸奖，新版主上任总得来喷喷场吧！
|
n****w
发帖数: 424 | 6 我从来可没否定过西医啊。。
【在 m****n 的大作中提到】
: 版主不承认胆红素吧？这都是洋鬼子骗人的玩意儿。
|
p*****m
发帖数: 2895 | 7
mean
恩谢谢，你说这两个原因我也有网上看到过，总是胆红素高因该是肝胆方面的原因。
体检包括肝部功能检查和肺部功能检查啊，大概是通过验血检查吧，我爸爸这些方面都
是正常的，B超他也做过，肝部也没什么异常，但是这次和上次检查，胆红素3项都比正
常值高了很多，他现在也没什么不舒服，但是我总是担心，高这么多还是有点不正常，
不知道该从哪里入手。
【在 g*****j 的大作中提到】
: High bilirubin is usually resulted from two causes: 1) increased red blood
: cell hemolysis; 2) decreased liver metabolism.
: Not sure what do you mean by normal liver func. Normal AST/ALT doesn't mean
: liver must be fine. You probably want to follow up with ultrasound.
|
g*****j
发帖数: 1211 | 8 The most common cause of high bilirubin in a healthy adult is Gilbert
syndrome, which is completely benign and nothing to worry about. Gilbert is
usually exacerbated by stress, and indirect bilirubin is much higher than
direct bilirubin.
If your father takes a test again and it goes back to normal, chances are it
is Gilbert. If it is still high, his doctor may wanna to do further work
up, i.e. CT. |
p*****m
发帖数: 2895 | 9
is
it
谢谢你的回答，我爸爸已经做过两次体检了，去年一次，今年一次，胆红素一直是很高
，总胆红素因该是20内正常，他是41，直接和间接胆红素也都高。但是他现在没什么症
状，B超查的肝胆也都正常，不过肝稍微有点大，还有就是心机肥大，不知道一下步该
怎么查呢，主要因该查哪个部位呢？谢谢
【在 g*****j 的大作中提到】
: The most common cause of high bilirubin in a healthy adult is Gilbert
: syndrome, which is completely benign and nothing to worry about. Gilbert is
: usually exacerbated by stress, and indirect bilirubin is much higher than
: direct bilirubin.
: If your father takes a test again and it goes back to normal, chances are it
: is Gilbert. If it is still high, his doctor may wanna to do further work
: up, i.e. CT.
|
g*****j
发帖数: 1211 | 10 Bilirubin itself is not that informative. What about ALT, AST, ALP, GGT?
What do you mean by 心机肥大? How is it determined, echo? |
|
|
l***h
发帖数: 9308 | 11 碰到专家了，请教一下。
HBV多年，转氨酶一直处于正常状态，HBV DNA 10^4。07年初开始抗病毒治疗，2个月后
，HBV DNA降到不可测，持续到现在。
其他指标不正常的还有甘油三酯，过去5年基本上在250-300之间，年初甚至到468，经
过3个月运动后，现在降到144
总胆红素自始至终在1.3-2.2范围内波动，始终略高于正常范围0.2-1.2。不知道怎么解
释？
him
the
Jiangsu
【在 m****n 的大作中提到】
: 版主不承认胆红素吧？这都是洋鬼子骗人的玩意儿。
|
l***h
发帖数: 9308 | 12 男，近40，baraclude。最近的化验前面已经提过，其他未提的指标都基本正常。
服药也就这两年的事，可总胆红素持续5年超出范围，也不知道超出是多是少。
【在 m****n 的大作中提到】
: 版主不承认胆红素吧？这都是洋鬼子骗人的玩意儿。
|
g***r
发帖数: 285 | 13
depends on the test you use, i think one of the test methods in gilbert's
the conjugated bili would also be elevated somewhat,
【在 m****n 的大作中提到】
: 版主不承认胆红素吧？这都是洋鬼子骗人的玩意儿。
|
g***r
发帖数: 285 | 14
i have no idea what test method they use, just a blurb from long time ago,
【在 m****n 的大作中提到】
: 版主不承认胆红素吧？这都是洋鬼子骗人的玩意儿。
|
g***r
发帖数: 285 | 15
vaguely familiar, it has something to do with one of them is wet, the other
is dry, either wet method is more accurate for direct bili or it's the other
way around,
【在 m****n 的大作中提到】
: 版主不承认胆红素吧？这都是洋鬼子骗人的玩意儿。
|
w**********9
发帖数: 242 | 16 For both direct and indirect being elevated, is it possible that the patient
have HCV infection in addtion to HBV ? because simply HCV damage the
hepatocytes and causes hemolysis of RBCs as well. |
g*****j
发帖数: 1211 | 17 In theory it is possible. But I assume HCV induced hemolytic anemia will be
apparent on CBC. It looks like everything else is fine.
I also have the puzzle here. Mild increase of both direct & indirect
bilirubin is not that uncommon, so does ALT, AST. What can be the cause if
no apparent liver injury, i.e. HBV/HCV, chronic alcoholism, NAFLD,
autoimmune, hemochromatosis etc. |
