I-Bilirubin iyi-pigment ye-bile, okuyinto umkhiqizo oshisayo wokucubungula amasosha omzimba obomvu adala. Ngokujwayelekile, umuntu omdala onempilo e-plasma yegazi uqukethe inani elincane le-substance (3,4 - 22,2 μmol / l), kanye nomthamo othile we-urine ngesimo se-urobilinogens (4 mg) nsuku zonke.
Cishe ngamaphesenti angu-96 e-bilirubin egazini yi-bilirubin engaqondakali engabonakali, engenawo amanzi futhi enobuthi, ngoba uyakwazi ukungena kalula ngokusebenzisa i-membrane yeseli futhi iphazamise imisebenzi ebalulekile yamaseli. I-4% esele i-bilirubin eqondile, i-soluble emanzini, ihlungiwe yizinso futhi igxiliwe emcinini. Ingqikithi ye-bilirubin iyinhlangano evamile ye-bilirubin eqondile neyodwa.
Ezilwaneni ezithile, okuqukethwe kwe-bilirubin egazini, futhi okuqhubekayo emcinini, kwanda. Lokhu kubangelwa i-jaundice ne-darkening yomchamo.
Izimbangela zezinga eliphakeme le-bilirubin kubantu abadala
Ake sicabangele, yiziphi izizathu ukuthi i-bilirubin ejwayelekile noma ejwayelekile emzimbeni womuntu ingakhuliswe noma yanda.
Izimbangela zokwanda kwe-bilirubin ngokuqondile
Izinga le-bilirubin eliqondile egazini landa ngenxa yokwephula ukuphuma kwebhala. Ngenxa yalokho, i-bile ithunyelwa egazini, hhayi esiswini. Izizathu zalokhu ngokuvamile ziyizibalo ezilandelayo:
- isifo sofuba esibangelwa yi-viral etiology ngesimo esibi (isibindi A, B, nesifo esithathelwanayo se-mononucleosis);
- isifo sofuba se-bacterium etiology (leptospirosis, brucellosis);
- i-hepatitis engapheli;
- i-autoimmune hepatitis;
- i-hepatitis yemithi (ngenxa yezokwelapha ze-hormone, izidakamizwa ezingezona izifo ezithinta izidakamizwa, izidakamizwa eziphikisana nezidakamizwa ezilwa nesifo sofuba);
- i-hepatitis enobuthi (ubuthi obuhlungu nge-fungal poisons, izinto ezinobuthi ezimboni);
- umdlavuza we-gallbladder, isibindi noma ama-pancreas;
- i-cholelithiasis;
- i-cirrhosis biliary;
- ama-syndromes e-Rotor, uDabin-Johnson.
Izimbangela zokwanda kwe-bilirubin engaqondile
Ukunyuka kokuqukethwe kwe-bilirubin engaqondile kungahlotshaniswa nokubhujiswa okusheshayo kwamangqamuzana egazi abomvu noma ukuphazamiseka ekusetshenzisweni kwe-indirect bilirubin. Kuyafaneleka ukuthi, kusukela I-birectubin engaqondile emanzini ayiqedi, ngisho nokwanda okwenyuka kwezinga layo egazini, akukho ukuphutha ekuhlaziyweni komchamo. Ngakho, izizathu zalokhu kungaba:
- Inemia ye-hemolytic yangasese (i-sickle cell, i-spherocytic, i-nesferocytic, i-thallasemia, isifo se-Marciyafawa-Michele);
- i-anemia yesibili ye-hemolytic (ngokumelene ne-arthritis ye-rheumatoid, i-systemic lupus erythematosus, i-lymphocytic leukemia, i-lymphanganulmatosis, njll);
- i-anemia ye-hemolytic yezokwelapha (ehlobene ne-insulini, i-aspirin, i-levomycetin, i-levofloxacin, i-cephalosporins, njll);
- ama-syndromes kaLucy-Driskol, uGilbert, uKriegler-Nayyar;
- izifo ezithathelwanayo (malariya, typhoid, sepsis);
- i-hemolytic anemia enobuthi ( uketshezi ngamakhowe anobuthi, ubuthi, izinambuzane ezinyoka, izinyoka, ubuthi ngamakhowe, ukuhola, usawoti wethusi, njll).
Izimbangela zokwanda kwe-bilirubin ekukhulelwe
Ukwandisa i-bilirubin kuvame ukubonakala kubesifazane abakhulelwe (i-jaundice ekukhulelwe). Izizathu zalokhu zihlukaniswe ngamaqembu amabili:
- ngenxa yokukhubazeka kokukhulelwa (ukuwohloka okukhulu kwamafutha kwesibindi, gestosis, ukuhlanza ngokweqile, njll);
- obangelwa izifo ezihlukahlukene ezihambisana nezifo (isifo sofuba, isibindi se-hemolytic, njll).
Izimbangela zokwanda kwe-bilirubin emcini
Izinga elikhudlwana le-bilirubin emcinini libhekwa ezifweni ezihambisana nokulimala kwamangqamuzana ebindi
- i-hepatitis;
- i-cirrhosis yesibindi ;
- ukulimala kwesibindi semetastatic;
- ukulimala kwesibindi, njll.
Ukwelashwa kwe-bilirubin ephakeme
Uma izivivinyo zibonisa ukuthi i-bilirubin egazini noma emcinini iphakanyisiwe, izimiso zokwelashwa ziyoncika ezimbangela zalesi sifo. Ngokuvamile, izindlela zokwelapha zihlanganisa ukuthatha imithi nokulungisa ukudla.