研究目的：肝功能檢查是目前國內一般勞工健康檢查及預防保健篩檢中的重點項目之一。除了常見的血清轉胺酶（AST與ALT）、血清膽紅素外，尿檢中的尿膽紅素及尿膽素原也是反應肝功能狀態的指標之一，然而過去相關的研究探討卻很少。本研究的目的即在分析尿膽紅素及尿膽素原異常的盛行率及其相關危險因子，並探討尿膽紅素及尿膽素原與血清肝功能檢查結果（包括AST, ALT, bilirubin, γ-GT）之關聯性。研究結果可供國內一般勞工健檢、預防保健篩檢及臨床醫師在判讀尿液檢查報告時的參考依據。研究方法：回顧台灣南部某電子公司2007年的員工健康檢查結果資料，分析尿膽紅素及尿膽素原異常的盛行率及其相關危險因子，並探討尿膽紅素及尿膽素原與血清肝功能檢查結果之關聯性。研究結果：總共有16121位受檢者，有8566位女性(53.14%)。發現尿膽紅素異常的盛行率為13.3%，年齡較小、高總膽紅素血症、高結合型膽紅素血症、尿中酮體呈陽性、尿膽素原異常為尿膽紅素異常的獨立危險因子。尿膽素原異常的盛行率為0.6%，男性、高結合型膽紅素血症、尿膽紅素異常為尿膽素原異常的獨立危險因子。以尿膽紅素及尿膽素原作為血清肝功能檢查異常的篩檢工具，發現敏感度介於0.79-27.54%，特異度介於86.44-99.52%，陽性預測值介於6.32-23.16%，陰性預測值介於83.31-96.88%。結論：在一般的勞工健檢或健康族群的篩檢中，尿膽紅素及尿膽素原的異常受多個相關因素所影響，臨床醫師在判讀尿檢報告時應列入考慮。對於尿膽紅素及尿膽素原檢查正常的受檢者，可初步排除其血清肝功能檢查異常的可能（高特異度、高陰性預測值）。然而，以尿膽紅素及尿膽素原作為血清肝功能檢查異常的篩檢工具，其效果並不佳（低敏感度、低陽性預測值），因此並不適合應用於肝臟疾病的篩檢上。

Objectives: Liver function test is one of the important part in health examination, especially among Taiwanese. Not only serum aminotransferase (AST, ALT) and serum bilirubin but also urine bilirubin and urobilinogen are indicators of liver function. The aim of this study was to investigate the prevalence and possible associated factors of abnormalities of urine bilirubin and urobilinogen assays. We also evaluated abnormalities of urine bilirubin and urobilinogen assays and their relation to abnormal results of serum liver function tests. Methods: We collected the results of 2007 annual health examination of a large company in southern Taiwan. We analyzed the abnormalities of urine bilirubin and urine urobilinogen assays and their relation to abnormal results of serum liver function tests and establish its related epidemiology data. Results: All 16121 workers were included this survey. There were 8566 women (53.14%). We found bilirubinemia, conjugated bilirubinemia, ketonuria, urobilinogen abnormality were independent risk factors of urine bilirubin abnormality. Male, bilirubinemia and urine bilirubin abnormality were independent risk factors of urobilinogen abnormality. The screening data were remarkable for the following: (1) sensitivity of both urine tets was 0.79% to 27.54% (2) specificity of both urine tets was 86.44% to 99.52%. (3) positive predictive value of both urine tets was 6.32% to 23.16%. (4) negative predictive value of both urine tets was 83.31% to 96.88%. Conclusion: In the general health examination, the possibility of abnormal serum liver function test can be initially excluded for those who have normal urine bilirubin and urobilinogen results due to high specificity and high negative predictive value of screening tools. However, urine bilirubin and urobilinogen assays are not useful for screening abnormal serum liver function tests when they are applied in the general health examination due to low sensitivity and low positive predictive value.