La bilirubin he ʻ kālaʻa ʻaʻole hiki ke hoʻoheheʻe ʻia i ka wai o ka waihoʻoluʻu melemele, ma muli o ka hoʻohaʻahaʻa ʻana ohemoglobin. ʻO ia ke kala nui o pāpaʻa. Hana ʻia ia i loko o nā keʻena o ka holo 'awelika a me ka iwi iwi, a laila lawe ʻia ma ke kahe koko e ka albumin i ke ake. Aia i loko o ke akepaʻa, hoʻohui ʻia me ka waika gluconic a lilo i ka wai. I loko o ka ʻōpū, hāʻawi ka bilirubin conjugated i ka waiho ʻana i kahi kala ʻeleʻele.

E kauoha ke kauka i ka ho'āʻo koko no ka bilirubin inā kānalua ʻo ia, no ka laʻana:

• nā maʻi hepatobiliary: nā kūlana e pili ana i ka ate (ʻo ka maʻi maʻi hepatitis ka mea maʻamau) a / a i ʻole nā ​​duct bile
• nā maʻi hemolytic (ʻike ʻia e ka luku ʻole ʻia o nā ʻāpana koko ʻulaʻula)
• or jaundice o ke keiki hānau hou, also called jaundice of the newborn

No ka hoʻāʻo ʻana i ka bilirubin, pono e hana ʻia kahi hoʻāʻo koko, ʻo ia hoʻi kahi hoʻāʻo koko venous. Manaʻo ʻia ʻaʻole ʻoe e ʻai a inu ʻole ma kahi o 4 mau hola ma mua o ka hoʻāʻo koko. Hiki i ke kauka ke noi i ka mea maʻi e hoʻōki i ka lawe ʻana i kekahi mau lāʻau e pili ana i nā hopena o ka hoʻāʻo bilirubin.

ʻO ka nui o ka bilirubin i loko o ke koko maʻamau ma waena o 0,3 a me 1,9 mg / dl (miligrams per deciliter). ʻO ka nui o ka bilirubin conjugated (i kapa ʻia ʻo bilirubin pololei) ma waena o 0 a me 0,3 mg / dl. 

E hoʻomaopopo he ʻokoʻa paha nā mea i kapa ʻia ʻo bilirubin maʻamau i loko o ke koko ma muli o ke keʻena hana e hana ana i nā loiloi.

Hiki i ke kauka ke wehewehe i nā hopena a hāʻawi iā ʻoe i kahi hōʻailona.

Inā kiʻekiʻe ka pae bilirubin, kapa ʻia iahyperbilirubinémie.

Hiki ke lilo i:

• ka nui o ke ʻano manuahi (ma ka hana nui a i ʻole ka nele o ka conjugation):

- nā ulia pōpilikia

- nā anemia hemolytic: ʻona, lāʻau lapaʻau, parasitic hemolysis, etc.

- ʻO ka maʻi o Gilbert (ka maʻi ʻino o ka bilirubin metabolism)

- jaundice o ke keiki hānau hou

- Criggler-Najjar syndrome (ka maʻi hoʻoilina o ka bilirubin metabolism)

• ka nui o ke ʻano conjugated (ua hoʻokuʻu ʻia ka bilirubin conjugated i ke kahe i ka wā i pāpā ʻia ai ke ala maʻamau o ka excretion):

– pōhaku ʻōpū

- neoplasia (kani maʻi)

- ka maʻi pancreatitis

- ka maʻi hepatitis, ka maʻi hepatitis, ka hepatitis viral

- ka maʻi maʻi maʻi

Hoʻokaʻawale kekahi i ka "jaundice me ka bilirubin manuahi", ma muli o ka nui o ka luku ʻana o nā keʻena koko ʻulaʻula (hemolysis) o "ka jaundice me ka bilirubin conjugated", pili i kahi maʻi biliary a i ʻole hepatic.