Yibilirubin. Udidi lwesiqulatho yayo. iintlobo senyongo

Bonke abantu babe isixa esithile eziqulathwe yibilirubin egazini. Liyana kufuneka ungabi ngaphezu kwe-17.1 mmol / L. Maxa wambi kuvela iimeko ezinjalo xa yibilirubin emzimbeni iveliswa ngamanani mkhulu inokuvelisa isibindi esempilweni ekusebenzeni eqhelekileyo. Rise isiqulatho yibilirubin nayo ngenxa nomonakalo wesibindi, nto leyo ukuphazamisana kukhuthaza yibilirubin. Ukongezelela koko, xa wokufaka Biliary isibindi kancinci hi mpimo lowutsongo lithathelwe yibilirubin. Udidi lwesiqulatho layo igazi eliqingqiweyo. Esi simo kuthiwa hyperbilirubinemia. Kule yibilirubin okongezeleke emzimbeni ukuya yoxinaniso kwangaphambili, uze ingena izihlunu, amnike umbala omthubi. Esi simo kuthiwa senyongo.

Ukuze ngokupheleleyo nangokuchanekileyo ukuqonda senyongo kunokwenzeka ngenxa yaso nasiphi na isizathu, kufuneka kuqala bana phandle ukuba ukwenza njani na utshintshiselwano yibilirubin. Yibilirubin uvela heme, apho umzimba kakhulu bafumana kunjengoko hemoprotein. Athwala akhululwe ngexesha ukubola iiseli legazi elibomvu, ngowona mthombo obalulekileyo yibilirubin (70-80%). Intsalela yibilirubin kwiindawo malunga alinganayo wabumba erythrocytes haemoglobin ubuntwana kunye uhlobo zabo umongo kunye enqanda heme aqulethe ezifana catalase, cytochrome, njl Kulo mzekelo, 250-400 mg -. Ingaba isixa apho asekwa suku ngalunye omdala yibilirubin kwabantu. Yesiqhelo ngexesha analysis - index ye 0.2-1.0 mg / DL.

Ukuba yibilirubin equlethwe plasma idlula kunongeno, ngoko ke senyongo. Oku kwenzeka ngenxa yokuba yibilirubin, oluthe lwagqitha kakhulu mmiselo, iqala ukunxibelelana imicu elastic ulusu kunye conjunctiva. Ngokutsho indlela senyongo yayo Ukwakheka ngeentlobo ezintathu:

1. Hemolytic (okanye suprarenal).
2. nomonakalo wesibindi parenchymal ebangelwe (hepatocellular).
3. Eyabangelwa iphecana kokuphazamiseka biliary (obstructive okanye mechanical).

senyongo Hemolytic luphawulwa ifomu intabalala yibilirubin unconjugated, okanye ngxi emzimbeni. I-plasma yibilirubin iyonke ngenxa yesehlo unconjugated. Umchamo yibilirubin engekho kwaphela. Oku kuchazwe yi lulungiselele yibilirubin unconjugated ukungena ngokusebenzisa lokucoca kwezintso, nto leyo yonakele. senyongo Hemolytic ingabangelwa ntlekele hemolytic, imalariya, intravascular hemolysis isenzo ityhefu novithamini B12 izivuka, kunye ukutofelwa igazi ezingahambelaniyo. Amanqanaba Ukwanda yibilirubin unconjugated babe Gilbert engqondweni. Abantu nalo sifo phantse lonke kwaphawuleka yangaphakathi bakhe tyheli ulusu. Isizathu soku usendleleni yokuba isibindi lingenako thatha, ukubeka emithanjeni inyongo conjugated yibilirubin.

Xa parenchymal senyongo ukunyuka kokubini yibilirubin conjugated kunye unconjugated. Unobangela uqhelekileyo le meko anokuphazamiseka kugqitywe egazini zinomgutyulo unconjugated yibilirubin kwi inyongo miseka emithanjeni conjugated yibilirubin kwiiseli isibindi kwakunye kokungena conjugated yibilirubin hepatic inyongo ezixineneyo emithanjeni igazi, ngenxa iiseli isibindi yonakele. Ngelo xesha kumanqanaba eziphakamileyo of yibilirubin kwi serum igazi ihamba kukwanda zinomgutyulo lwalo yokuchama. Nangona kunjalo, kwi zigaba yokuqala sifo umchamo yibilirubin phantse uzimisele, ngoko ke uvavanyo ayide ikwazi kubizwa ngokuba isigulo kwangethuba.

Senyongo yabangela hepatic biliary iphecana isithintelo, nokuphazamiseka lokuphuma bile duct okanye ukuvalwa ngokupheleleyo inyongo channel (ithumba, nangokurhala, Stone et al.). Nale hlobo emithanjeni senyongo hepatic nangengalo ngenxa oluhlala kuzo enyongweni isibindi, hepatocytes uqala yalugudla kwaye zingena emithanjeni igazi conjugated yibilirubin. Ummiselo egazini plasma ukunyuka, ukuba ndithe ngaphezulu embundwini obuvumelekileyo sezintso (malunga 30 mmol / l), lo yibilirubin livela yokuchama.