Protein is an important element and the main material of the body; it occupies 85 percent of organs and tissues. Without it, the process of protein and plasma construction is impossible.
It has a large number of varieties. May include amino acids or proteins, as well as combine with breakdown products.
The synthesis of its main share is carried out by the liver – the main body that regulates protein metabolism.
The usefulness of the latter depends on the level of total protein. To determine it, identification of the concentration of this element in plasma or blood serum is required.
Total protein is the total content of components such as globulin, fibrinogen and albumin.
Lymphocytes are involved in the synthesis of globulins, hepatocytes are responsible for the remaining elements. Globulins protect the human body, albumin is involved in the recovery process, and fibrinogen is responsible for blood coagulation.
The main functions of the protein are as follows:
- synthesizes hemoglobin, antibodies, hormones and enzymes;
- acts as a building material of the plasma and regulates the pH balance;
- responsible for the viscosity, fluidity and coagulability of blood;
- accumulates basic amino acids and monitors the immune system;
- participates in the transport of medications and nutrients to organs and tissues;
- maintains blood volume in vessels at the proper level.
Since OBK is so important, it is necessary to constantly monitor it. Determination of its concentration shows the state of the human body.
blood coagulation inhibitors play
an important role in maintaining hemostasis,
since they retain blood in liquid
condition and inhibit the spread of
blood clot outside the damaged area
resulting from reactions
procoagulant and contact paths
blood coagulation, washed away by current
blood from a blood clot. It can be inactivated
when interacting with inhibitors
blood clotting enzymes or
activate the anticoagulant phase,
inhibiting the formation of a blood clot.
Blood coagulation should be limited.
not only in space, but also in time.
The anticoagulant phase limits
active factors lifetime
in the blood and is initiated by thrombin itself.
This stage is a short
cascade of reactions in which in addition to thrombin
thrombomodulin activator protein involved
(Tm), vitamin K-dependent serine
protease protein C, protein activator S and
factors Va and VIIIa (Fig. 14-16).
14-16. Anticoagulant phase. Tm –
thrombomodulin; C – protein C; Ca – active
protein C; S is protein S; bold lines –
membrane-bound complex. 1 – thrombin
(On) forms a membrane complex with
thrombomodulin protein (Tm); 2 – thrombin
as part of a membrane complex
IA-Tm-Ca2 activates protein C;
cascade of anticoagulant phase reactions
2 membranes are formed sequentially
IIa-Tm-Ca2 and Ca-S-Ca2.
– integral protein of endothelial membranes
cells. It does not require proteolytic
activation and serves as an activator protein
thrombin. Thrombin gains ability
after interaction with thrombomodulin,
and associated with thrombomodulin
thrombin cannot convert fibrinogen
in fibrin does not activate factor V and
C – proenzyme,
containing residues of γ-carboxyglutamate.
Thrombin in the membrane complex IIa-Tm-Ca2
activates by partial proteolysis
Protein C. Activated Protein C
(Ca) forms with activator protein S
membrane-bound Ca-S-Ca2 complex. Sa
as part of this complex hydrolyzes
in factors Va and VIIIa, two peptide bonds
and inactivates these factors.
protein C and S deficiency leads to a decrease
inactivation rates of factors VIIIa and Va
and is accompanied by thrombotic
a disease. Mutation of the factor V gene, when
which factor V is synthesized
protein C resistant also
phase causes inhibition of the cascade of reactions
blood coagulation, and enzyme inhibitors
coagulation inactivates active
enzymes in the bloodstream.
blood coagulation enzymes. Physiological
clotting enzyme inhibitors
restrict the spread of a blood clot
the place of damage to the vessel. Plasma protein
blood antithrombin III – the most powerful
blood clotting inhibitor; on his
the share is about 80-90% anticoagulant
It inactivates a number
serine blood proteases: thrombin, factors
IXa, Xa, XIIa, kallikrein, plasmin and
urokinase. Antithrombin III does not inhibit
factor VIIIa and does not affect factors in
the composition of membrane complexes, and
eliminates plasma enzymes
preventing blood from spreading
blood clots in the bloodstream.
antithrombin with clotting enzymes
blood speeds up in the presence of heparin.
heteropolysaccharide that is synthesized
in mast cells. As a result
interactions with heparin antithrombin
III acquires a conformation in which
increases its affinity for serine
blood proteases. After education
antithrombin III-heparin-enzyme complex
heparin is released from it and may
join other molecules
hereditary antithrombin deficiency
III at a young age observe thrombosis
and vascular embolism, life-threatening.
forms a complex with serine proteases
blood. In such a complex, their active
the center is not completely blocked and they
can interact with substrates
small size. However, high molecular weight
substrates, for example fibrinogen, become
inaccessible to the action of proteases in
(tissue pathway inhibitor
coagulation) is synthesized in the endothelium
vessels. It specifically connects
with the enzyme complex TF-VIIa-Ca2, after
what is captured by the liver and destroyed
inhibits thrombin, factor XIa, kallikrein,
however, it is not considered important
coagulation factor inhibitor
α1-Antitrypsin mainly on tissue
level inhibits pancreatic and
leukocyte proteases, collagenase,
resulting from proteolytic
activation of proenzymes and pro-factors,
also have pronounced anticoagulant
properties, but their mechanism of action in
currently not clarified.
Pokrovsky minute). I think it is necessary
just know those anticoagulants that
mentioned in the text and be able to distinguish
primary from secondary. Just if everything
– there are many of them (see below)
anticoagulants are divided into primary and
secondary. Primary anticoagulants
always present in circulating
blood, secondary – are formed as a result
proteolytic cleavage of factors
blood coagulation during education
and dissolving the fibrin clot.
proteglycans, cofactor of heparin II,
A1-antitrypsin, C1-esterase inhibitor
or a compliment inhibitor I,
annexin 5, protein C, protein S,
thrombomodulin, floating receptors,
an antibody to coagulation factors.
“Worked out” coagulation factors
blood (taking part in coagulation)
and fibrinogen degradation products and
fibrin (PDF) with powerful
antiaggregational and anticoagulant
action as well as stimulating
fibrinolysis. The role of secondary anticoagulants
boils down to intravascular restriction
blood coagulation and spread
blood clot in the vessels.
congenital antioxidant mechanisms,
that is, mechanisms to protect the body from
toxic effect of oxygen.
antioxidant neutralizing enzymes
reactive oxygen species.
2) substances with
antioxidant activity, embedded
into biological membranes and protecting
unsaturated fatty acid molecules
from a free radical attack.
3) water soluble
biological fluid antioxidants
systems outside of biomembranes.
whole body systems implementing
stress activation protection
higher brake systems of the central nervous system.
Under normal conditions
number of reactive oxygen species
small and antioxidant systems
successfully block the development of a reaction
lipid peroxidation. At
exposure to extreme factors
oxidative disturbance occurs
homeostasis. Some time is possible
compensation. However antioxidant sizes
systems are depleted, leading to
disturbance of a stationary state and to
autocatalytic peroxide growth
lipid oxidation. This in turn
accompanied by cellular destruction
structures and health problems.
The rate of total protein in the blood
blood serum protein is
laboratory indicator reflecting
state of homeostasis. Whey proteins
blood play a very important and diverse
role. Thanks to them it is supported
viscosity and fluidity and forms
its volume in the vascular bed, and the concentration
protein provides plasma density
blood that allows shaped elements
kept in suspension.
Serum proteins carry
transport (hormone binding,
mineral components, lipids,
pigments, etc.) and protective (immunoglobulins,
opsonins, acute phase proteins, etc.) functions,
involved in the regulation of acid-base
body conditions are regulators
blood coagulation and antibodies.
clinical practice quite often
there are conditions characterized by
a change in the concentration of total protein
blood serum. Increase in concentration
total protein in serum wears
and a decrease in hypoproteinemia.
Each of the indicators of the biochemical analysis of blood has its own units of measurement and standard values with which the results obtained during the study should be compared. In relation to the total protein and its fractions, the following norm indicators are considered generally accepted:
Depending on the type of protein fraction:
They are determined only if necessary and only by fractions and types.
Norms of total protein by age:
Children of the first month of life
Children of the first year of life
There are no special norms for the total protein indicator for men and women due to the wide enough scatter of the upper and lower boundaries of the standard values. But in women, the total protein can be reduced to 10% compared with men of a similar age group. This can be explained by the high needs of the female body for protein, which is spent on the synthesis of sex hormones. The synthetic properties of the liver in women are lower than in men;
In pregnant women, fluctuations in total protein are subject to even greater scatter downward. Normal and completely logical can be considered its decrease to 30% compared with the generally accepted norm.
This may be a natural consequence:
Increases in circulating plasma volume due to fluid retention in the vascular space;
The increased needs of the body of a pregnant woman in plastic material for the synthesis of sex and other hormones of the endocrine glands;
The need for plastic material for the growth and development of the fetus.
In the case of detecting an increase in total protein in a biochemical blood test, they speak of hyperproteinemia.
It may indicate:
Dehydration due to pathological loss of fluid or its redistribution between the vascular space and tissues during intoxication, infections and septic conditions;
Enhanced antibody synthesis during the formation of immunity after vaccination or previous infectious diseases. As a rule, such an increase is not significant;
Myeloma. Such cases of hyperproteinemia are represented by a marked increase in protein levels due to pathological proteins (Bence-Jones protein);
DIC-syndrome with hypercoagulation on the background of intoxication and various critical conditions.
Lowering the level of total blood protein is called hypoproteinemia. Its presence may indicate the following conditions:
Pathology of the liver, accompanied by hepatocellular insufficiency: viral and toxic hepatitis, cirrhosis;
Alimentary protein deficiency with malnutrition and exhaustion in severe diseases;
Enhanced loss of protein in the urine with decompensated renal pathology and severe proteinuria;
Complications of diabetes
Chronic severe anemia and massive bleeding;
Diseases of the stomach and intestines with malabsorption of nutrients;
Enzymatic and secretory pancreatic insufficiency in chronic pancreatitis;
HIV infection and other immunodeficiencies;
Endocrine pathology in the form of hypothyroidism;
The progression of cancer and their metastasis.
Article author: Mochalov Pavel Aleksandrovich | D.M.N. general practitioner
Education: Moscow Medical Institute I. M. Sechenov, specialty – “Medical business” in 1991, in 1993 “Occupational diseases”, in 1996 “Therapy”.
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Total protein in the blood (OBK) – a combination of different protein compounds, each of which has its own functions and properties. Albumins are necessary to maintain the osmotic pressure of the blood, as well as to bind and transport various compounds, globulins are responsible for immune processes, fibrinogen ensures normal blood coagulation. The rate of total protein is the total value of all protein components.
The main functions of blood plasma proteins:
- transport nutrients, drugs to organs and tissues;
- provide osmotic blood pressure;
- maintain an optimal level of pH in the blood;
- retain iron, copper, calcium in plasma;
- participate in the synthesis of hormones, enzymes, hemoglobin, antibodies;
The level of BAC shows how correctly protein metabolism occurs in the body.
The scatter of the maximum and minimum indicators of total blood protein is quite wide. This is due to a wide range of physiological reasons that affect the activity of protein metabolism in the body. In addition, there are reasons why the norm of this indicator may change in one direction or another. This mainly depends on different physiological conditions and processes in the body (pregnancy), gender and age of the subject. Generally accepted standards are given in table form. The units of protein metabolism are presented in grams per liter of plasma (g/l).
|Adults||64 – 84||35 – 55||The norm is 2-4 g/l for all age groups.||The total amount is not determined. Only an analysis of their various types is carried out if there is evidence.|
|Teens||59 – 77||30 – 50|
|Children up to 6 years old||60 – 76||29 – 52|
|Children up to a year||47 – 73||22 – 49|
|Children up to a month||48 – 75||24 – 50|
In women, the total protein level can be slightly reduced compared to men (up to 10%). During pregnancy, such a decrease is even more likely and can reach about 30% of the norm. The main condition indicating that these changes are physiological and due to the normal change in the hormonal background is the absence of any complaints and pathological symptoms. If they accompany any decrease in protein, this can no longer be the norm.
Important to remember! Deviation of the obtained indicator of total protein from the upper or lower border of the norm by several units is not a pathology. A pronounced decrease in blood protein is much more common than its increase. If the cause of the first type of deviations can be many different factors, then the second type of change in the indicator is characteristic of a narrow circle of diseases!
Liver pathology is one of the main causes of protein decline
Total protein in children is determined to examine the functioning of all organs. Even for minor deviations, one can speak of certain disorders in the body that can be associated with hidden pathological processes, a deficiency of minerals and vitamins.
The norms of this indicator for infants and older children are presented in the table below.
The norm of protein, gram/liter
6 months – 1 year
From 1 to 4 years
Immediately after the baby is born, the values of the element can fluctuate. So, with prematurity, the indicator is slightly reduced, in contrast to the values of a child who was born at the appointed time. As you grow older, total protein also increases.
In adults, in a normal state, the protein indicator is the same for both sexes and varies between 65-85 grams per liter of blood fluid.
It should be noted that in plasma there is a higher content of the element than in serum. Do not forget about the age, which has a direct effect on the level of the enzyme in the blood.
The table below shows the OB norms for men and women.
Young people 20-30 years old
In adults under 60
In adults up to 60-75 years old
We should also pay attention to the level of protein during the period of gestation. During the formation of the fetus, most substances leave it from the mother’s body, which is necessary for the full development of the embryo. Against this background, a reduced level of total protein will be observed.
For example, during pregnancy, the norm is a value that deviates by 30 percent in a smaller direction from the normal framework. However, this condition is considered normal if the expectant mother is not concerned about any clinical symptoms associated with various diseases.
In the event that an increase in the concentration of total protein is associated with the development of the disease, self-administered treatment is strictly prohibited. Only a specialist can help after establishing the cause of the pathological condition.
All actions should be aimed primarily at eliminating the underlying disease, which provoked an increase in the protein element.
The use of traditional medicine is allowed only with the permission of the doctor.
If the protein in the blood is lowered, then you also need to first understand what could have caused this phenomenon. Based on the data obtained during the blood test, a therapeutic regimen is selected.
Subject to the presence of a non-pathological cause, an increase in the indicator is carried out with extreme caution. This is necessary in order not to provoke an upset stomach, weaned from protein foods.
If the protein is greatly reduced, then the doctor makes a certain diet, which includes a varied diet.
If the total protein is increased or decreased, it is necessary to eliminate the diseases that affected the change in indicators. Drug therapy is prescribed by a doctor based on the results of blood biochemistry, a general examination.
Proper nutrition will help increase protein levels – there should be more lean meat and fish, a liver, kidneys, cheese, eggs, milk and cottage cheese in the diet. A small amount of vegetable protein is found in soy, peanuts, almonds, chocolate, brown rice, bran bread, wholemeal pasta.
The average dose of protein for men is 100 g, for women – 70 g. Pregnant and lactating women, athletes, people who are constantly engaged in heavy physical labor, it is necessary to increase the daily intake of proteins by 2 times in order to avoid the development of hypoproteinemia.
How to normalize protein concentration:
- get enough sleep, avoid heavy physical exertion;
- with high protein, consume more vegetables and fruits;
- abandon addictions;
- minimize consumption of refined foods, fats, sodas, fried foods;
- cure all infectious pathologies of the gastrointestinal tract;
- regularly undergo a routine inspection.
Total protein in the blood shows how well the internal organs and systems work. There are certain standards for total blood protein for children and adults. Minor fluctuations should not cause anxiety, strong ones can indicate the development of serious diseases.
Explanation of the analysis
A biochemical blood test to determine this indicator is called a proteinogram. It is prescribed to clarify the diagnosis, identify the stage and duration of the pathological process, determine the level of effectiveness of drug treatment.
When a proteinogram is prescribed:
- with anemia;
- patients with acute, chronic bleeding, women with heavy menstruation;
- with signs of severe dehydration, intoxication;
- with renal and hepatic diseases;
- in the presence of malignant neoplasms.
To determine the level of OBK, blood is taken from a vein in the morning on an empty stomach, the last meal should be 8 hours before the examination. In the morning you can drink only water without gas, any other drinks are excluded. An hour before the material is taken, sharp movements cannot be made, any physical activity is contraindicated – a change in body position can distort values.
The norm of total protein in the blood in adults is 65–85 g/l, in children under 6 years of age the lower limit of values is 56 g/l. Separately, biochemical tests are carried out to determine the level of specific proteins – C-reactive protein (CRP) and rheumatoid factor. Rheumatoid factor (RF) shows the presence of rheumatoid arthritis, other collagenoses.
Analysis for C-reactive protein is carried out in the diagnosis of rheumatism, lupus erythematosus, heart attack, inflammatory pathologies in the acute form, which can disrupt the cardiovascular system. An increase in C – reactive protein indicates the presence of malignant tumors in the body, normally the level should be within 5 mg/l, in newborns – up to 15 mg/l. If the indicators are normal, they put a negative CRP mark on the form. Sometimes protein analysis is carried out in fractions.
|Age||Albumen||Globulin alpha 1||Globulin alpha 2||Globulin beta||Globulin gamma|
|Up to a year||34-42||1,2-4,4||7,1-11,5||4,6-7||3,3-8,7|
|1 – 5 years||33,5-43||2-4,3||7-13||4,6-8,5||5,1-10,2|
|5 – 8 years||37-47||2-4,2||8-11||5,2-8,2||5,3-12|
|8 – 11 years||41-45||2.2-4||7,5-10,2||5-7||6-12|
|11 – 21 years||39-46||2,3-5,4||7,2-10.5||6-9||7-14|
|Over 21 years old||40-47,5||2,1-3,6||5-8,5||6-9||8-13,5|
The protein content in a healthy middle-aged man is 66–88 g/l, the norm in women is about 10% lower due to some physiological characteristics – the female body needs more protein than men, but it is less synthesized in the liver.
|Age||Values for men (g/l)||Values for women (g/l)|
|Older than 70||69-77||73-78|
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Significant differences in the normal level of protein in the blood in adults and children are observed up to 6 years, then children’s indicators approach the adult level.
|Newborns up to 1 month old||46-75|
|Up to a year||48-73|
|1 – 4 of the year||50-75|
|7 – 16 years||58-85|
Total protein fraction
In addition to information about ordinary values, it is necessary to have an idea of the presence of a common protein in fractions.
This is especially important if it is planned to carry out surgical interventions, medical procedures, as well as when it became necessary to control the quality of ongoing therapeutic measures involving treatment with drugs.
What is the normal value for the fractions can be seen from the table below.
Protein fractions in grams per liter
From week to year
From one to five years
From five to eight years old
From eight to 11 years old
from 11 to the 21st year
In which cases is the
Indications for the analysis, which allows to identify the level of total protein in the blood, are the following violations:
- autoimmune system diseases;
- malignant neoplasms;
- infectious and inflammatory processes in acute or chronic form;
- prolonged vomiting, diarrhea and dehydration;
- pathology of the liver and kidneys, in particular this applies to cirrhosis, hepatitis and others;
- metabolic malfunctions;
- chronic and acute pancreatitis in the acute stage;
- improper nutrition (fasting for a long period of time or following a strict diet);
- thermal burns;
- malabsorption syndrome.
In addition, the study of total protein must be carried out among the fair sex during the period of gestation. It is especially important to do the procedure in the presence of pronounced puffiness.
Causes of High and Low Protein
Minor deviations of the total protein can be caused by active physical exertion, overwork, colds, dehydration. A long and significant decrease and increase in indicators indicates the presence of pathological processes in the body.
Increased protein in the blood – hyperproteinemia, is absolute and relative. Causes of absolute hyperproteinemia:
- melanoma – indicators of total protein increase to 110 or more units;
- malignant granuloma;
- infectious diseases of acute and chronic nature;
- autoimmune diseases;
- chronic polyarthritis;
- cirrhosis of the liver.
The relative form of hyperproteinemia develops against a background of a decrease in the water content in the blood plasma. In this case, the absolute amount of protein remains unchanged, but due to a decrease in the liquid part of the plasma, the relative protein content increases. A similar condition occurs with extensive burns, peritonitis, bowel obstruction, prolonged diarrhea and vomiting, hyperhidrosis, chronic pyelonephritis.
Reducing blood protein levels – hypoproteinemia, often develops against the background of debilitating diets, starvation, severe intoxication, after surgery, a prolonged increase in body temperature.
Plasma protein decreases with:
- disorders in the digestive system, in which protein is poorly absorbed in the body – narrowing of the esophagus, enteritis, colitis;
- liver pathologies – hepatitis, cirrhosis;
- some congenital diseases in which protein elements are not synthesized or produced in small quantities;
- malignant tumors, extensive burns;
- disorders in the thyroid gland;
- long-term use of corticosteroids;
- diabetes, chronic diarrhea, nephrotic syndrome, glomerulonephritis – with these diseases, a lot of protein is excreted in the urine;
- accumulation of fluid in the body cavities – ascites, pleurisy;
- severe or prolonged bleeding;
- immunodeficiency conditions.
A temporary decrease in performance is observed with problems with urination, after massive intravenous glucose infusions.
How to detect the level of total protein
To get the most reliable results, you need to properly prepare for the procedure. If these recommendations are neglected, then the probability of distorting the data on the total protein content in the biochemical analysis of blood increases.
Donating blood fluid is recommended exclusively on an empty stomach in the morning.
8 hours before the procedure, you can not eat food, sweet and alcoholic beverages.
It is allowed to use purified water without gas.
Normal performance will not be affected by the fact that the patient will drink unsweetened green tea a couple of hours before the study. This can be done if a person cannot starve for such a long period of time.
If this is not possible, since the medicine contributes to the normal functioning of the patient’s body, then you must inform the doctor in advance.
In this case, the concentration of total protein will be determined in accordance with a special table.
To study the protein, blood is taken from a vein. The procedure itself is the same as for standard analysis. After taking the blood fluid, it is necessary to obtain plasma from it, for which the centrifugation method is used. Then, using a special reagent, protein is isolated from the obtained serum.
Decryption of the results should be done exclusively by a specialist. Based on the data obtained, the doctor makes a diagnosis and prescribes appropriate treatment, depending on the reason for which a deviation from normal values was detected.
This condition, in which the total protein can be increased, is called hyperproteinemia in medicine. An increase in the concentration of an element indicates the development of a pathology in the human body.
Among the absolute reasons that can provoke deviations, there are:
- infection or inflammation (the protein begins to enter the blood fluid from the destroyed tissues);
- rheumatoid arthritis;
- lupus erythematosus;
- oncological diseases;
- blood poisoning, when the synthesis and breakdown of protein occurs, having a different speed.
Physiological factors can also influence the level of total protein, when a specialist incorrectly collected the material, the patient abruptly changed the position of the body.
In addition, hyperproteinemia can begin to develop as a result of:
- vomiting and diarrhea, which contributes to dehydration;
- intestinal obstruction;
- acute bleeding.
If the results of the analysis showed that the total protein in the blood is reduced, this may indicate pathological conditions such as:
- exhaustion, which develops against the background of diseases of the infectious-purulent nature of origin;
- complications of diabetes;
- oncopathology of blood fluid;
- severe anemia;
- chronic bleeding;
- kidney pathology, as a result of which the protein is rapidly excreted from the body along with urine;
- disorders of the gastrointestinal tract;
- increased adrenal gland activity;
- malfunctions of the thyroid gland;
- pregnancy complicated by pathological processes;
- HIV infection and other immunodeficiency conditions.
An improper diet, starvation and strict diets can also lead to a lack of protein. In this case, all therapy will only consist in changing the menu, which involves the inclusion of a large amount of protein food.
Total protein in the blood – what is it
Total blood protein is one of the indicators of amino acid metabolism in the body, characterizing the concentration of protein molecules of all types and fractions in plasma. We can say that this indicator of the products of protein metabolism is a mirror image of the regenerative abilities of the body. After all, proteins play the role of a kind of framework or plastic material on which all other elements of cells and tissues are held. If this substrate is sufficient, any organ or system remains complete, both structurally and functionally.
The whole protein of the human body is represented by more than a hundred different subspecies. These proteins can only consist of an amino acid set, but they can also contain various compounds of proteins of different molecular weights with other metabolic products (lipids, carbohydrates, electrolytes in the form of glycoproteins, lipoproteins and hemoglobin, etc.
The main components of the total protein, which are determined during a biochemical study, are:
Albumins are low molecular weight proteins that provide all the plastic needs of the body in building material to maintain the structure and synthesis of new cells. Make up the bulk of the total protein;
Globulins are large-molecular proteins necessary for the synthesis of antibodies, immunoglobulins and other immune proteins (complement components, c-reactive protein, inflammatory mediators, tumor necrosis factor, etc.) occupy slightly less than half of the total protein structure;
Fibrinogen is a high molecular weight protein that participates in the final stage of the formation of a platelet blood clot and is responsible for the usefulness of the blood coagulation system. It accounts for the smallest amount among all components of the total protein.
present to determine
serum bilirubin content
(plasma) blood use the proposed
in 1916, van der Berg determination method
serum bilirubin based
normal condition concentration
total bilirubin in plasma is
0,3-1 mg/dl (1,7-17 μmol/L), 75% of the total
the amount of bilirubin is in
unconjugated form (indirect
bilirubin). Clinic conjugated
bilirubin is called direct because
it is water soluble and can quickly
interact with a diazoreagent,
forming a pink compound, –
this is the direct reaction of van der Berg.
Unconjugated bilirubin is hydrophobic,
therefore, plasma contains
complex with albumin and does not react
with diazoreaktiv until
organic solvent added
for example ethanol, which precipitates
albumen. Unconjugated ilirubin,
interacting with azo dye
only after protein precipitation, called
the bilirubin content exceeds the norm,
talk about hyperbilirubinemia. IN
depending on what concentration
type of bilirubin is increased in plasma –
unconjugated or conjugated,
– hyperbilirubinemia is classified
as unconjugated and conjugated.
patients with hepatocellular pathology,
accompanied by a prolonged increase
conjugated bilirubin concentrations,
a third form is found in the blood
plasma bilirubin, in which
bilirubin is covalently bound to albumin,
and therefore it cannot be separated
in the usual way. In some cases
up to 90% of the total blood bilirubin content
may be in this form.
the diagnosis of jaundice must be borne in mind
that in practice jaundice is rarely noted
any one type in “pure”
form. More often a combination of
or other type. So, when expressed
hemolytic jaundice accompanied by
increased concentration of indirect
bilirubin inevitably suffer various
organs, including the liver, that can
introduce elements of parenchymal
increase in blood and urine
direct bilirubin. In turn,
parenchymal jaundice, usually
Includes mechanical elements.
With subhepatic (mechanical) jaundice,
for example, with pancreatic head cancer
glands, increased hemolysis is inevitable
as a result of cancer intoxication and,
as a result, an increase in blood as
direct and indirect bilirubin.
hyperbilirubinemia may be a consequence
excess of both bound and free
bilirubin. Measurement of their concentrations by
separately necessary when staging
the diagnosis of jaundice. If the concentration
plasma bilirubin lt; 100 μmol/L and
other liver function tests give
normal results maybe
suggest that the increase is due to
due to indirect bilirubin.
differential diagnosis of jaundice
content must be considered
urobilinogen in the urine. Normal per day
excreted in the urine
about 4 mg of urobilinogens. If with urine
an increased amount is allocated
urobilinogen, then this is evidence
liver failure, for example
with hepatic or hemolytic
jaundice. The presence in urine is not only
urobilinogen, but also direct bilirubin
indicates liver damage and impairment
the flow of bile into the intestines.
In order to prevent deviations from the norm, the level of total protein in the blood, you must adhere to the following simple rules:
- eat balanced;
- lead a healthy lifestyle;
- rest and not subject the body to increased physical exertion;
- regularly donate blood for biochemical analysis.
Total protein is important in the human body, which is directly involved in the functioning of many systems and organs. Its decrease or increase indicates the presence of deviations associated with ill health.
Only with timely access to medical care can one determine the cause of the pathology and normalization measures, which will protect the body from adverse effects.
total protein in serum can
be relative and absolute.
with a decrease in the water content in the vascular
which can lead to the following