胆红素检测方法研究进展

doi:10.3969/j.issn.1673-8640.2026.05.016

摘要/Abstract

摘要：

血清胆红素在评估肝功能和诊断消化系统疾病中发挥着重要作用。胆红素检测方法主要有重氮法、氧化法、高效液相色谱法、直接分光光度法、质谱分析法和经皮测定法等，这些方法因原理不同而各有优劣。文章介绍不同胆红素检测方法的原理、特点和最新研究进展，以及胆红素检测校准体系，并探讨胆红素检测方法和标准化的发展需求和趋势。随着胆红素检测方法的不断更新，室间质量评价材料的互换性与不同检测系统间的可比性目前仍面临一系列挑战。

关键词: 胆红素, 临床意义, 检测方法, 标准化

Abstract:

Serum bilirubin plays a role in evaluating liver function and diagnosing digestive system diseases. The main methods for bilirubin determination include diazotization method，oxidation method，high-performance liquid chromatography，direct spectrophotometry，mass spectrometry analysis and transcutaneous measurement. These methods have their own advantages and disadvantages due to different principles. This review introduces the principles，characteristics and latest research progress of different bilirubin determination methods，as well as the bilirubin determination calibration system，and discusses the development needs and trends of bilirubin determination methods and standardization. With the continuous update of bilirubin determination methods，the interchangeability of inter-laboratory quality evaluation materials and the comparability between different determination systems still face a series of challenges at present.

Key words: Bilirubin, Clinical significance, Determination method, Standardization

中图分类号:

R446.1

周小匀, 朱晶, 邵文琦, 王蓓丽, 潘柏申, 郭玮. 胆红素检测方法研究进展[J]. 检验医学, 2026, 41(5): 505-512.

ZHOU Xiaoyun, ZHU Jing, SHAO Wenqi, WANG Beili, PAN Baishen, GUO Wei. Research progress on methods for determining bilirubin[J]. Laboratory Medicine, 2026, 41(5): 505-512.

图/表 1

参考文献 47

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方法	原理	灵敏度（检测限）	特异性	检测时间	检测成本^①	应用场景
重氮法	胆红素与重氮试剂反应生成偶氮色素，采用分光光度法测定530/598 nm处的吸光度（A）值	较高（1.7 μmol·L^-1）	中等（受溶血、维生素C等干扰）	快速（自动化，每小时数百测试）	中等偏高（8~12元）	大型医院、临床实验室常规检测（TB和DBil）
氧化法（主要为钒酸盐法）	胆红素被氧化为胆绿素，通过测定450~460 nm处的A值来定量	高（0.5 μmol·L^-1）	高（抗干扰能力强）	快速（自动化， 5~15 min）	中等（2~25元）	大型医院、临床实验室（可能存在干扰物质的样本）
HPLC法	色谱柱分离胆红素组分，采用紫外检测器定量	高（0.1~0.5 μmol·L^-1）	极高（可区分各亚型）	长（含前处理约 20~40 min）	极高（50~ 150元）	鉴定δ-Bil、光疗后胆红素异构体、药物分析、国标修订
直接分光光度法	基于胆红素在437 nm处的特征吸收峰，采用双波长消除血红蛋白干扰	较高[波长精度高（±0.3 nm），杂散光低]	低（易受血红蛋白干扰）	快速（≤5 s）	较低	实验室快速筛查，适合微量样本
质谱分析法	离子化后通过质荷比（m/z）分析，如采用LC-TOF MS^②检测胆红素-白蛋白结合位点	极高（高分辨质谱可达 0.05 μmol·L^-1）	极高（高分辨质谱通过精确质量区分胆红素异构体）	较长（5~10 min）	极高（50~ 150元，批量检测可降至30~80元）	精准检测、研究领域（如新生儿疾病筛查、代谢研究）
经皮检测法	通过皮肤反射光谱强度间接推算血清胆红素水平	较低	低（受胎龄、体重和肤色影响）	极快（≤1 min）	低（1~5元）	新生儿动态监测、基层医院、家庭随访

方法	原理	灵敏度（检测限）	特异性	检测时间	检测成本^①	应用场景
重氮法	胆红素与重氮试剂反应生成偶氮色素，采用分光光度法测定530/598 nm处的吸光度（A）值	较高（1.7 μmol·L^-1）	中等（受溶血、维生素C等干扰）	快速（自动化，每小时数百测试）	中等偏高（8~12元）	大型医院、临床实验室常规检测（TB和DBil）
氧化法（主要为钒酸盐法）	胆红素被氧化为胆绿素，通过测定450~460 nm处的A值来定量	高（0.5 μmol·L^-1）	高（抗干扰能力强）	快速（自动化， 5~15 min）	中等（2~25元）	大型医院、临床实验室（可能存在干扰物质的样本）
HPLC法	色谱柱分离胆红素组分，采用紫外检测器定量	高（0.1~0.5 μmol·L^-1）	极高（可区分各亚型）	长（含前处理约 20~40 min）	极高（50~ 150元）	鉴定δ-Bil、光疗后胆红素异构体、药物分析、国标修订
直接分光光度法	基于胆红素在437 nm处的特征吸收峰，采用双波长消除血红蛋白干扰	较高[波长精度高（±0.3 nm），杂散光低]	低（易受血红蛋白干扰）	快速（≤5 s）	较低	实验室快速筛查，适合微量样本
质谱分析法	离子化后通过质荷比（m/z）分析，如采用LC-TOF MS^②检测胆红素-白蛋白结合位点	极高（高分辨质谱可达 0.05 μmol·L^-1）	极高（高分辨质谱通过精确质量区分胆红素异构体）	较长（5~10 min）	极高（50~ 150元，批量检测可降至30~80元）	精准检测、研究领域（如新生儿疾病筛查、代谢研究）
经皮检测法	通过皮肤反射光谱强度间接推算血清胆红素水平	较低	低（受胎龄、体重和肤色影响）	极快（≤1 min）	低（1~5元）	新生儿动态监测、基层医院、家庭随访