Senyongo conjugation: sifo, oonobangela, unyango

Senyongo ayikho isifo eyahlukileyo, oko luphawu kuphela ezimbi ezithile. Kwiimeko ezininzi, kusenokuba komzimba, oko kukuthi ezinganxulumananga nasiphi na isifo (kwiintsana). Isizathu sokuba le meko kukuba ukwanda yibilirubin, nto leyo enika imibala icteric yesikhumba, inwebu yangaphakathi kunye sclera.

Senyongo: Iindidi

Le meko kuhlangene okubhalwe yibilirubin egazini. Noko ke, loo nto ibangela ukwanda zinokuba nomahluko. Kwezinye iimeko, nokumisela ityala yokuvumela ngezifo kurhanelwa emzimbeni, esifuna unyango ngoko nangoko. Kuxhomekeka kwinguqulelo ukuphazamiseka yokucolwa yibilirubin iindidi eziliqela senyongo:

1. Conjugation senyongo, nto leyo ngenxa conjugation kakuhle of yibilirubin. Oko kwenzeka kubelekwa.
2. senyongo Parenchymal iqalisa inani ezimbi zesibindi. Ekubulaleni parenchyma lomzimba (ukufa kweeseli ezisebenzayo - hepatocytes) yenza kube nzima ukuba zifake yibilirubin kwemalike yayo engaphezulu.
3. senyongo Obstructive, olwenzeka xa besaphula nencindi inyongo. Inxulunyaniswa nezifo ezinegalelo ukuvalwa okanye licuthe le mithambo we bile duct. Le meko yenzeka cholelithiasis kunye ekumisweni nethumba.
4. senyongo Hemolytic - ngezifo ezinxulumene sokonakalisa iiseli ezibomvu zegazi. Yibilirubin - sombala olwenzeka xa yokuwa mpilo, ngoko ophakamileyo erythrocyte lysis kukhokelela ukunyusa izinga layo.
5. Kernicterus - elizimeleyo kunye nohlobo kakhulu yingozi. Oku kwenzeka kwimeko xa le mveku ndazi hypoxia ngexesha kuphuhliso okanye zizalwa. Kwakhona, unobangela isenokuba usulelo kwabasetyhini abakhulelweyo. Ingozi kukuba kombala oluhlala phakathi kwiiseli zemithambo-luvo lobuchopho, nto leyo ekhokelela zezigulo ezahlukeneyo luvo, kwaye zinokude yingozi.

Conjugation senyongo ku kubelekwa

Senyongo kwenzeka kwiintsana na ukusebenza komzimba, kuba akukho lu dityanisiwe yinkqubo yezifo. Uqala, ngokuqhelekileyo iintsuku 3-5 emva kokuzalwa. Ngokuqhelekileyo, iiseli ezibomvu egazini zibethwa uhlaziyo rhoqo, nto leyo sikhatshwa hemolysis - intshabalalo yabo. Xa abadala, isibindi kwenziwa ngokupheleleyo, ngoko ke yibilirubin, nto leyo Bakhahlelwa ukubola ezi seli ixesha ukunxibelelana yaye angakhuli egazini.

Lo mfanekiso kwezonyango kwiintsana kunokuba- uhlaziyo kakhulu iiseli ezibomvu kunye nokusilela kwesibindi isalamane. Le nomzimba angekayazi eyona nto ngokupheleleyo, amaxesha amaninzi loo senyongo kwenzeka kwiintsana ngaphambi kwexesha. Yibilirubin uqalisa ukwakha phezulu igazi, yaye emva koko oluhlala eluswini kwakunye nomkhwinya imifinya, lubanike umbala isici. Ayokufikelela kwi ngomhla wesithathu-wesihlanu. ezi mpawu ke ezipaswe ukusukela ngo ngokutshintshiselana yibilirubin ngokuthe ubuyele esiqhelweni.

Yintoni na le meko?

Conjugation senyongo (ICD-10) ngokwahlukileyo ulwahlulohlulo ngamazwe awabelwa. It has P59.0 khowudi zombini senyongo lweentsana, nto leyo ngenxa yonikezelo ngaphambi kwexesha, kwaye ezinxulumene ne hyperbilirubinemia. Ichaza inkqubo echazwe apha ngasentla.

uhlobo Conjugation kwesifo lwenzeka kakhulu ebantwaneni. Le senyongo ezidlulayo e kubelekwa, kwakunye imeko ukuvela kwiintsana ngaphambi kwexesha kunye nabantwana baboniswa zizalwa. Izizathu iingxaki isoloko ilifa ezidalwe ngezifo (umzekelo, syndromes Lyutseya-Driskopa kunye Gilbert). Eli qela libandakanya senyongo iziyobisi.

Yibilirubin - ntoni na?

Eli gama yanikwa kombala, nto leyo imveliso yokuwa mpilo. Kwi ezithile lamanani yenza imibala yesikhumba kunye ngenwebu yangaphakathi. Yibilirubin - isibaluli ibalulekileyo diagnostic, njengoko ungeniselo lwayo ibonisa inkqubo zophendlo lwezifo kwaye uqale unyango. Isixa mbala ibonisa imo wesibindi kunye phecana biliary.

Emzimbeni, le yibilirubin ifumaneka iintlobo ezimbini - ngqo nengxelo-ntetho. Imvelaphi iphumele imveliso ukuguqulwa yesibini. yibilirubin ngokungathanga ngqo amafutha eziyityhefu efunda. Yena akayi kwazona ivela emzimbeni. ukuphazamiseka pathways, le fom eziyintlanganisela, ngokubonelela isiphumo yityhefu kwi emzimbeni. Ngokuqhelekileyo, oko iguqulelwa kwi yibilirubin ngqo ngu ubuthi. Conjugation senyongo kwenzeka ngenxa ukutyeshelwa emzimbeni wayo.

Exchange yibilirubin

Eli ebala yi athwala - ingxenye engundoqo iiseli ezibomvu zegazi. Xa ekonakaleni legazi elibomvu cell haemoglobin iyekelela nezivele cleavage. Le nkqubo oluqhutywa macrophage amalungu ezizodwa (lomongo wethambo, isibindi kunye udakada). Ngenxa yoko le cleavage kwakhiwa heme kunye globin. Eyokuqala similise biliverdin - owandulela yibilirubin ngqo. lasungulwa of biliverdin onxulumene umsebenzi enqanda ezithile, phakathi kwabo - le cytochrome P-450, heme oxygenase. yibilirubin Further ngqo olulawulwa ngayo iiseli esibindini apho enebana glucuronic acid. Ngaloo kwakhiwa yibilirubin ngqo, apho igcinwa kwi esinyini inyongo abese elibeka zinomgutyulo kungena duodenum. microflora isisu negalelo ekuhleni kwayo urobilinogen. Inxalenye oko kuxhomekeke edalwayo, iintsalela eziguqulelwe kwi sterkobilinogena kwaye kwazona kwi ituwa, amnike umbala isici.

iimvavanyo zeLebhu unakho ukubonisa ukuba yibilirubin leyo eziphakamileyo. Kuthetha ukuthini? Ukwanda kwinqanaba yaso ezinxulumene nasiphi na isifo, efuna uvavanyo ngokukhawuleza diagnostic. ukwanda period e yibilirubin awayezibona kubelekwa.

picture clinical

Nangona ukuba usana lalidume ngokwanda yibilirubin, ibonwa lwezonyango Iqinisekile ayikho kwaphela. karhulumente uphawu banikwa - umbala imbonakalo icteric. Libonisa kuphela isikhumba kodwa inwebu yangaphakathi. Physiologic senyongo conjugation udlula akazubhaqwa, kodwa ukuba akunjalo, kufuneka eko ngezifo.

ekuxilongweni

Senyongo ingaba urhulumente komzimba nje kuphela, kodwa iliphawu yokugula. Ukuba umntwana lowo umbala ethile ulusu kunye inwebu yangaphakathi, kufuna esweni rhoqo yi wabantwana. Kwakhona Kwiimeko ezinjalo kufuneka ukuba ubenemboniselo yangaphezulu yazo yibilirubin. Ngokuqhelekileyo, emihleni yokuqala Inombolo yobomi yayo ifikelela 60 mmol / l, kodwa akukho ngaphezulu. Ngaphezu koko, eli nqanaba ukunyuka (iiyure 3-7).

Ngokuqhelekileyo, ukwanda yibilirubin ekhuselekileyo kwaye alunasiphumo eyityhefu emzimbeni sana, ke, inqanaba kufuneka mayingagqithi ekuthiwa-ukubaluleka asemdeni - 205 pmol / l. Yibilirubin landa - nto leyo ithetha inguqulelo enjalo? Senyongo i lwezidumbu kwaye ifuna unyango olungxamisekileyo. Ukuba lo mzobo ilungile, kodwa senyongo sithatha ixesha elide, loo nto ithathwa le conjugation, oko kukuthi, leyo unobangela Ukungakhuli kweenkqubo zesibindi enzyme.

Treatment conjugation senyongo

Emva kokuba iimviwo, nto uzimisele senyongo nokomzimba okanye yezifo. Eyokuqala ayidingi unyango luze luphele ngokwabo zabo ngaphandle, azafunyanelwa ndawo. senyongo elide (conjugation) inabela ngokwayo xa inkqubo enzyme zesibindi ekugqibeleni abaqolileyo. Noko ke, ukuba nani likhulu kune inqanaba kakhulu yibilirubin kufuneka ezichongiweyo ngezifo. Kusenokuba hepatitis wentsholongwane egazini, bile duct isithintelo, okanye senyongo hemolytic.

hepatitis legciwane

Le ngezifo ukuhambisela ukusuka umntwana elosulelekileyo kunina. Ngenxa yoko, usana ozalwa hepatitis nature wentsholongwane egazini. Isiphumo yentsholongwane nisaqala Palsy kunokubangela ezingaqhelekanga ngokwasemzimbeni ngakumbi. Uphawu lwe sifo, ngokungafaniyo hepatitis B abadala, lelona khondo bumandundu. Pathology kunokuzibonakalisa phambi ekuqaleni senyongo. Amaxesha amaninzi kukho ukwanda iqondo lobushushu, ukonakala wokutya kancinane izenzakalo catarrhal. Kwezinye iimeko xesha preicteric kwiintsana nazimpawu.

Ukrokrela ubukho hepatitis B kungenziwa uzingela utshintsho umbala umchamo kunye ngendle. Uhlalutyo igazi olupheleleyo luphawulwa ukwehla leucocyte kunye erythrocyte rate neentlenge. Monocytes Kananjalo zinyuke kancinane. Xa icteric ifomu bekusoloko ukwanda okubonakalayo yibilirubin, kunye thymol. Moshilongo yokuqala esi sifo lwenziwa isifundo enzyme zesibindi. Kwi inkqubo gravity uthe ukuhla ezibukhali prothrombin nokwandisa ammonia.

Unyango lwabantwana kuliwa, ngokuqhelekileyo esibhedlele. Uthomalaliso idibanisa amachiza antiviral gepatoprotektory, iivithamini, ngokunjalo cholagogue. Kucetyiswa ukuba unyango ubuthi. Phakathi iindlela ezingezo-drug ukuba gqibezela pharmacotherapy kufuneka alale nenzolo.

senyongo hemolytic

Le ngezifo inxulunyaniswa hemolysis iiseli ezibomvu, oko kuyingozi kakhulu. Isizathu sokuba ukungangqinelani ngakwicala RH factor kunye nonina womntwana, oko kukuthi RH-ungquzulwano. Pathology kukhokelela ekufeni - izinga lokufa 60-80%. Ngaphezu koko, ubukho RH impixano kunokukhokelela isisu kulogo.

ukuvimbela

Inceda ukuthintela ukukhulelwa ukubambelela senyongo kunye nokuncancisa kufuneka bahlolwe njalo wabantwana. Ukuba senyongo kodwa yokuya ukuphuhlisa, kufuna esweni rhoqo inqanaba yibilirubin egazini.

Izigulane senyongo esibonakala ngebala ezikhethekileyo kunye ngenwebu yangaphakathi. Le uphawu asenokubonisa ukuba kukho izifo okanye ukubonakalisa utshintsho komzimba emzimbeni (zezomzuzwana senyongo lweentsana).

isiphelo

Xa efumanise senyongo zenziwa ngokukhawuleza ukuba ukuqinisekisa inqanaba yibilirubin kunye isifo ngakumbi. Conjugation senyongo ngo kuzalwa kudlula ixesha elide ngaphezu zezomzuzwana, ke olu lukwakhuselekile. Yingcali kufuneka aqinisekise abazali ukuba ukuqesha iimviwo. Ngokuqhelekileyo, akukho zingxaki mbaleko.