Bilirubin. Ndozvakajairwa kwayo kugutsikana. mhando jaundice

vanhu vose vane zvimwe yakawanda yaiva bilirubin muropa. Norm unofanira kuva asina kupfuura 17.1 mmol / L. Dzimwe nguva mamiriro ezvinhu akadaro panomuka kana bilirubin mumuviri anogadzirwa vakawanda kupfuura zvinogona kuva chiropa utano chaiye kutoshanda. Simuka bilirubin kugutsikana kunogona kukonzerwa kukuvara chiropa, izvo zvinogona kuvhiringidza excretion kuti bilirubin. Uyezve, kana plugging Biliary chiropa zvishoma nezvishoma uye zviduku zvakawanda yaiwana bilirubin. Ndozvakajairwa yawo tigutsikane muropa riri kupfuura. Ichi chirwere inonzi hyperbilirubinemia. In bilirubin izvi vaunganidza muviri akafanorongerwa wevasungwa, uye ipapo chinopinda iri rinenge achichipa yero ruvara. Ichi chirwere inonzi jaundice.

Kuti zvizere uye zvakanyatsorurama kunzwisisa jaundice kunogona kuitika chero chikonzero, unofanira kutanga kufunga kuti kuita kupanana bilirubin. Bilirubin kunobva heme, iyo muviri dzinowanzotsigi- kuwanikwa sezvo hemoprotein. Chizenga akabudiswa munguva kuora noruzivo masero matsvuku eropa, chinonyanya kukosha tsime bilirubin (70-80%). The chasara bilirubin munzvimbo anenge zvakaenzana mativi aumba kubva Chizenga saibva erythrocytes vavo Precursors mu mumwongo uye heme tubhokisi makemikari akadai catalase, cytochrome, etc. In iyi, 250-400 MG -. Ko yaipedzerwa umo inopfurwa rimwe zuva mukuru bilirubin kwevanhu. Normal panguva Kuongororwa - indekisi pamusoro 0.2-1.0 MG / Canada.

Kana bilirubin huri yeplasma kwazvo chikumbaridzo, ipapo jaundice. Izvi zvinoitika nokuti bilirubin, izvo yekudyidzana vakapfuura ndozvakajairwa, anotanga kukurukurirana kwakavharwa nenyama fibers ganda uye conjunctiva. Maererano mashandiro ayo inotungamirwa jaundice iri nezvezvikwata matatu:

1. Hemolytic (kana suprarenal).
2. kukuvara chiropa parenchymal kunokonzerwa (hepatocellular).
3. Kutemeswa biliary turakiti mhingaidzo (obstructive kana zvemaziso).

Hemolytic jaundice dzinoratidzwa zhinji chimiro unconjugated bilirubin, kana kurega kunotanga mumuviri. Plasma zvachose bilirubin inokwira nokuda unconjugated. Weti bilirubin vasipo zvachose. Izvi zvinotsanangurwa nokuda kutadza kwakaita unconjugated bilirubin dawo kuburikidza renal Sefa, usina zvaparadzwa. Hemolytic jaundice zvinogona kukonzerwa hemolytic dambudziko, marariya, intravascular hemolysis kuitwa tsvina, vhitamini B12 kushaikwa, uye kuisira sawirirana ropa. Vakawedzera kwevari unconjugated bilirubin ngaave Gilbert kuti syndrome. Vanhu vane chirwere ichi zvinenge nguva dzose munyaya yake tsvuku mucous uye ganda. Chikonzero ichi iri chokwadi kuti chiropa haisi kukwanisa kubata, govera uye conjugated bile capillaries bilirubin.

Kana parenchymal jaundice unowedzerawo vose conjugated uye unconjugated bilirubin. The chikonzero vakawanda izvi zvingafananidzwa kuvhiringidzwa kubudikidza Clearance kubva paropa unconjugated bilirubin excretion mu bile kwakakanganiswa capillaries conjugated bilirubin kubva chiropa masero uyewo ingress pamusoro conjugated bilirubin hepatic bile yakatsvikinyidzana ropa capillaries, kuburikidza ukama chiropa masero. Panguva iyoyowo akakwidziridzwa kwevari bilirubin iri muropa serum achabatsirwa kuwedzera zvayo excretion kupinda weti. Zvisinei, pakutanga nzendo zvirwere weti bilirubin iri anenge kwatemwa, saka nemuedzo wakadaro haagoni kunzi mangwanani kuongorora chirwere.

Jaundice kwakakonzera hepatic biliary turakiti mhingaidzo, havachanyatsogoni water drainage bile kana kuvhara yakazara gwara nduru (bundu, kuzvimba, Stone and unto.). With kwakadai jaundice hepatic capillaries rwakatambanudzwa nokuti rinoungana iri chiropa bile, hepatocytes anotanga nepavaigona uye zvakaitika munzvimbo capillaries ropa conjugated bilirubin. Ndozvakajairwa mu plasma kunowedzera, uye kana ini kusapfuudza bvumidzwa renal chikumbaridzozve (anenge 30 mmol / l), kuti bilirubin iri weti.