Tag nrho cov bilirubin nce. Cov ua rau kom bilirubin nyob rau hauv cov ntshav. Ib tug noj cov zaub mov uas muaj muaj zog bilirubin

Rau ib txwm metabolism thiab lub zog nyob rau hauv lub cev nws yuav tsum yog ib qhov mov ntawm substrates los ntawm sab nraum, uas yog, cov zaub mov, dej thiab huab cua. Lawv tseem ceeb cov khoom xyaw yog organic tebchaw, vitamins thiab mineral Cheebtsam - poov tshuaj, magnesium, sodium, tooj liab, hlau thiab ntau lwm tus neeg. Qhov kawg ntawm no yog ib feem ntawm cov ntshav liab, ib leeg-cell muaj ntawm cov pa nyob rau hauv peb cov ntshav, thiab yog li ntawd hlau metabolism yog li ntawd ib qho tseem ceeb rau lub cev. Thiab thaum ua txhaum lawm muaj icteric syndrome, yus nyob rau hauv hais tias tag nrho bilirubin tsa. Tam sim no cia saib tag nrho cov ntsiab lus tseem ceeb.

hlau metabolism

Tus txiv neej twg thiaj li raug hlau heev dua lwm yam rau cov zaub mov. Nws siab tshaj plaws cai concentration nyob rau hauv lub siab ntawm cov tsiaj, ib txhia ceev (pistachio ceev, txiv laum huab xeeb, ntoo thuv, cashew), legumes (lentils, taum mog), cereals (buckwheat, nplej, oats, barley), spinach, maize. Nyob rau hauv cov ntaub ntawv no nws yog thawj Iwj nrog ib tug tsim nyog tus nqi rau heme constituting lub hauv paus ntawm lub erythrocyte, thiab xwb ces yuav siv sij hawm muab cov deposition ntawm hlau nyob rau hauv nws lub tsev nyob rau hauv lub cev, uas yog hais txog 3.4 grams, nws nruab nrab yog ions, mas muaj feem xyuam rau ntshav cov nqaijrog thiab enzymes (ferritin, transferrin, xanthine oxidase, ferroflavoproteiny, succinate thiab NADH-dehydrogenase, thiab lwm tus). Tab sis nws tshwm sim feem ntau, tab sis tam sim no cia saib nws losses, thiab ib co pathological mob.

Yog vim li cas vim txoj kev poob ntawm ib qho tseem ceeb minerals

Ib tug ntawm cov physiological dab nyob rau hauv uas muaj yog tsis hlau yog ua poj niam thiab cev xeeb tub rau cov poj niam. Txawm li cas los, tej zaum cov feem ntau tseem ceeb lub sijhawm yog ntshav poob, raug tshuaj lom, anemia ntawm ntau yam keeb kwm, mob hauv cov kab mob, malignant neoplasms. Yog hais tias tsis tau yog tsis tseem ceeb, nws yog lub sij hawm yuav tsum tau Iwj nyob rau hauv ib tug luv luv lub sij hawm, thiab nyob rau hauv cov ntaub ntawv no rau tus neeg mob twb tsis muaj cov tsos mob ntawm tsis muaj peev xwm (sideropenic syndrome). Txawm li cas los, muaj cov kab mob nyob rau hauv uas tus nqi ntawm cov hlau muab khaws cia tseg, tab sis nws pauv yog heev disturbed. Xws li mob muaj xws li icteric syndrome tej genesis, thaum nws nrhiav tau raws li lub ntsiab metabolite nce - bilirubin. Yuav pib, sim to taub nws metabolism hauv lub cev thiab ua rau kom bilirubin nyob rau hauv cov ntshav: nws yog ib qho tseem ceeb rau qhov kev nkag ntawm lub pathogenesis ntawm cov kab mob.

Txauv hemoglobin: cov thawj theem

Bilirubin koom tseem ceeb pigments muaj nyob rau hauv nyob tus yeees ntawm cov kua tsib thiab tas los rau ntawm lub cev yog nyob rau hauv nws them tus nqi. Nws mus ib tug ntev txoj kev los ntawm cov hlab ntsha tseem nyob rau hauv daim ntawv ntawm hemoglobin, ua rau kev hloov tseem ceeb nyob rau hauv hepatocytes thiab thaum kawg secreted mus rau hauv cov hnyuv rau tso tawm rau hauv lub cheeb tsam nrog quav. Yog li, qhov no tshuaj yog tsim los ntawm cov hniav lwj los ntawm cov ntshav liab thiab tam sim ntawd yuav los ntawm cov cab kuj nqaijrog kev thauj mus rau lub ntsiab lab - lub siab. Qhov no feem yog hu ua indirect los yog ncaj, vim hais tias cov bilirubin nyob rau hauv nws yog unchanged. Qhov no tshwm sim vim hais tias nyob rau hauv ib tug dawb daim ntawv no, nws yuav yooj yim txeem los ntawm daim nyias nyias ntawm tej cell, thiab muaj ib tug muaj zog tshuaj lom nyhuv feem ntau nyob rau hauv neurons. Yog li, nws tuav yog dab tsi tiv thaiv cov tshuaj tiv thaiv.

Theem neutralization thiab kev rho tawm ntawm bilirubin

Txawm li cas los, cov nqaijrog yuav tsis nrog nws mus rau lub hnyuv, vim hais tias lawv yog tseem yuav tsum tau los ntawm lub cev rau ntau ntau lwm yam kev khiav dej num, thiab yog li bilirubin yuav tsum tau raug mus rau xws li ib tug transformation, hais tias nws poob nws vaj tse pass mus rau hauv lub hlwb. Rau lub hom phiaj no, lub hepatocytes (daim siab parenchyma hlwb yam ntxwv) yog nws conjugation, uas yog, lub thwj toob ntawm glucuronic acid, uas, heev tsuas, aggravates nws. Yog li, nyob rau hauv qhov kev txiav txim ntawm lub enzyme UDP-glucuronyl-diglucuronide bilirubin tsim. Tom ntej no, los ntawm cov hepatocytes nws nkag mus rau hauv cov kua tsib thiab tsis pub dhau nws yog tso tawm nyob rau hauv cov hnyuv thaum lub sij hawm digestion. Tam sim no dua txoj kev nrog ib tug thawj bolus nyias, thiab ces mus rau cov nyuv, los ntawm cov kab mob muaj nws yog dua tso tawm thiab hloov dua siab tshiab rau urobilinogen, thiab ces urobilin stercobilin uas ncaj qha tas nyob hauv cov quav. Tab sis yeej ib txwm tsis tshua muaj neeg me me ntawm bilirubin rov qab mus rau lub portal cov hlab ntsha thiab yog ua nyob rau hauv lub raum, qhov chaw uas cov zis yog muab tshem tawm.

txwv ntawm ib txwm

Kev ua txhaum ntawm no tseem ceeb heev xim pauv yuav tshwm sim nyob rau hauv peb loj theem: cov kev ntawm cov ntshav nyob rau hauv cov hniav lwj ntawm erythrocytes, lub capture thiab kev rho tawm ntawm hepatic bile. Txawm li cas los, nyob rau hauv tag nrho cov embodiments, nws yuav yuav ntes tau nyob rau hauv cov ntshav: tag nrho bilirubin yog tsa, dua li yog los ntawm kev ncaj los yog los ntawm indirect nws fractions. Yog li, nws ib txwm nyob rau hauv concentration ntshav yog xav tau txog 8,5-20,5 micromoles ib liter. Yog hais tias qhov no xov tooj tsub kom mus 85, ces ib lub xeev ntawm me me hyperbilirubinemia, los ntawm 86 mus 169 - nruab nrab thiab thaum kawg ntau tshaj 170 mmol / l - mob hnyav. Nws yog hais txog cov ntaub ntawv, yog tias koj cia li qhia hais tias kom tag nrho cov bilirubin. Txawm li cas los, txoj cai no tshwm sim nyias rau fractions: ncaj - mus 5.1, unbound - 16.5 pmol / l.

Suprarenal hom daj ntseg

Yog li ntawd, nyob rau hauv yuam cai ntawm tus thawj theem ntawm tag nrho cov bilirubin nyob rau hauv cov ntshav yog tsa feem ntau los ntawm indirect feem. Qhov no yog piav los ntawm tus etiology ntawm lub xeev, uas yog lub enhanced xaus ntawm cov ntshav liab nyob rau hauv cov hlab ntsha. Qhov no yuav tshwm sim nyob rau hauv tus neeg mob ntawm congenital ntaub ntawv ntawm hemolytic anemia (tsis xws luag nyob rau kev tshuaj ntsuam genetic theem ntawm cov ntshav liab rau lawv tus kheej, lawv enzymes, hemoglobin) los yog kis tau (immunological nres tus kab mob nrog nws tus kheej erythrocytes, raug toxins thiab tshuaj lom, cov kab mob, kab mob thiab lwm yam kab mob). Yog li, lub pathogenesis yog nce tsim ntawm bilirubin vim mob hlwb uas tsuas yog tsis muaj lub sij hawm mus ntes xws li ib tug lossis loj npaum li ntawm nws, thiab nws accumulates nyob rau hauv daim tawv nqaij thiab qog ua kua week, thiab ces nyob rau hauv lub hauv nruab nrog cev, ua rau lawv loj raug mob. Yog li tsim lub suprarenal hom daj ntseg.

Hepatic hom daj ntseg

Yog hais tias ua txhaum tshwm sim rau lub thib ob lub ntsiab theem, lub hepatocytes tsis muaj sij hawm los tos thiab ua txawm lub cev npaum li cas muab rau lawv metabolite ntawm hemoglobin, thiab thaum kawg nyob rau hauv cov nuj nqis ntawm ob tog tsa tag nrho bilirubin. Yog vim li cas rau qhov no - hnyav puas hloov nyob rau hauv lub siab. Cov no muaj xws tus kab mob siab uas muaj ntau yam genesis (toxic, dej, kis) thiab mob npuas paug. Yog li, cov ua kom bilirubin nyob rau hauv cov ntshav dag nyob rau hauv lub fact tias hepatocytes tej zaum yuav tsis ua hauj lwm txaus, yog los ntawm kev mob nyob rau hauv lawv, tog twg los vim lawv tsis txaus tus naj npawb. Cov uas keev ua, ntawm chav kawm, yog cov kab mob siab A-hom, B, C, raws, E los yog PP. Yog li npaj hepatic (parenchymal) hom ntawm daj ntseg syndrome, uas yog nrog kaj cim ntawm mesenchymal o thiab gepatotsiliarnoy tsis ua hauj lwm.

Obstructive daj hom

Thiab, ntawm chav kawm, ib tug ua txhaum ntawm bilirubin metabolism kuj tshwm sim nyob rau hauv lub thib peb lub ntsiab theem, uas yog thaum lub feem ntawm bile. Xijpeem, nrog rau cov qauv nws yog sim los ntawm cov zis paths los yog siab, los yog txawm los ntawm vesicafellea. Vim hais tias ntawm cov kev hloov no nyob rau hauv cov kua tsib accumulates nyob rau hauv lub zais zis thiab txoj kev, nws siab maj tsub kom, thiab nws thiaj li nws rov qab los (qhov no tshwm sim yog hu ua regurgitation) nyob rau hauv lub intrahepatic ducts, thiab ces - nyob rau hauv cov hlab ntsha, uas yog vim li cas kom tag nrho bilirubin. Nyob rau tib lub sij hawm, ntawm chav kawm, muaj cov lwm yam kev hloov nyob rau hauv biochemical seev. Yog li, nyob rau hauv cov ntshav no tshwm sim cholehemia, i.e. tau mus rau hauv nws cov kua tsib acids thiab enzymes, thiab nyob rau hauv lub ducts lawv tus kheej tsim cholestasis, i.e. teev kua. Clinically, qhov no yuav qhia daj ntseg sclera, txheej week thiab daim tawv nqaij (daj xim nrog ntsuab zas), thiab nyob rau hauv ntsuam yuav tsis tau tsuas tag nrho bilirubin thiab ncaj zog, tab sis kuj cov kua tsib acids, cholesterol, cov theem ntawm alkaline phosphatase, triglycerides, cov kev ua ntawm gamma-glutamyl transferase .

ua rau

Lub etiology ntawm obstructive los yog, raws li nws yog hu ua obstructive daj ntseg, yog heev kim heev. Cov feem ntau ua yog ib tug txhaws ntawm lub biliary ib ntsuj av tau pob zeb rau calculous cholecystitis los yog cholelithiasis thiab helminthic infestations pob tsuas thaum cua nab laus hauv ducts los yog qhia cholangitis, thiab thaum lawv kub lug lumen occlusive los yog vim o ntawm cov phab ntsa, los yog vim infiltration ntawm lawv. Thiab, ntawm chav kawm, qhov no qhia txog qhov tseeb hais tias qhov ncaj thiab tag nrho cov bilirubin nce. Yog vim li cas rau lwm tus pathologies nyob rau hauv txhua rooj plaub, yog tshwm sim los ntawm compression ntawm sab nraum. Feem ntau cov feem ntau qhov no tshwm sim vim hais tias ntawm cov loj hlob ntawm lub qog, feem ntau yog rau lub taub hau ntawm lub pancreas. Tab sis kuj, qhov teeb meem no tej zaum yuav tshwm sim thaum biliary mob npuas paug, thaum ducts yog squeezed loj hlob plots thiab xaam cov connective cov ntaub so ntswg.

Neonatal daj ntseg

Txawm li cas los, tsis yog txhua txhua daj ntseg yog pathological tej yam kev mob ntawm tus kab mob. Li no yog tias tag nrho cov bilirubin yog tsa nyob rau hauv tus me nyuam mos tam sim ntawd thaum yug los los yog ib tug ob peb teev tom qab nws, thiab daim tawv nqaij thiab qog ua kua week muaj ib lub ci jaundiced, koj yuav tsum tsis tam sim ntawd lub suab lub tswb. Tom qab tus me nyuam mos yog ib tug muaj sia mob hu ua nraum vim hais tias nws yog nraum. Ntawm cov hoob kawm, rau lo lus nug tshwm sim los ntawm nws tus pog niam uas paub tias nws tus me nyuam bilirubin yog tsa, "Yuav ua li cas yuav tsum ua li cas?" Cov lus teb yog yooj yim: tos. Thaum zoo li no yeej qhia tau hais tias tos cov kev tswj, vim ob peb hnub (feem ntau yog peb mus rau tsib) yellowness maj disappears. Thiab tsuas yog hais tias nws yog ncua, tus mob ntawm tus me nyuam qub thiab tag nrho cov bilirubin yog tsa, kev kho mob yog nqa tawm urgently, namely detoxification txoj kev kho yog siv thiab ultraviolet irradiation. Tam sim no cia peb xav txog cov pathogenesis ntawm tus mob no.

Tshwj xeeb tshaj yog lub plawv cov me nyuam mos

Lub fact tias cov me nyuam hauv plab ncig nyob rau hauv lub plab yog ho txawv los ntawm uas cai nyob rau hauv cov me nyuam twb yug los. Thaum lub sij hawm cev xeeb tub, cov me nyuam mos raus nyob rau hauv ib tug npuas nrog lub amniotic kua, thiab vim hais tias nws lub ntsws tseem tsis tau paub ntawm cov huab cua thiab yog wrinkled lub xeev, xws li inoperative. Tab sis tus me nyuam no tseem ceeb heev los mus khiav ntawm oxygen mus rau nws cov nqaij rau lawv tsim, kev loj hlob thiab ntau yam zoo. Uas yog vim li cas nws cov ntshav yog li ntawd zoo communicates nrog rau niam txiv. Nyob rau hauv kev nthuav dav, cov ntshav liab kas cia li teeb oxygen los ntawm cov ntshav liab tus poj niam, thiab rau qhov no lawv xav tau ib tug muaj zog gripping nws muaj peev xwm. Yog li ntawd, nws yog sawv cev los ntawm hemoglobin F-yam, uas txhais tau tias Fetal. Nws yooj yim tau txais cov pa thiab yog nws mus rau lub hlwb ntawm lub fetus.

tau

Txawm li cas los, tom qab tus me nyuam yug ntawm xws li ib tug superpower nws yog ruaj, vim hais tias ntawm ces nyob rau hauv nws lub ntsws qhia nws yog ua pa rau lawv tus kheej thiab khwv tau lawv tus kheej oxygen. Thiab yog hais tias nws hemoglobin yuav nyob li qub, nws yuav tsis tau mus muab nws lub hlwb. Yog li ntawd, tom qab thawj zaug ua tsis taus pa pib los mus hloov qhov no tseem ceeb protein ntawm cov ntshav liab los ntawm me nyuam hauv plab rau cov neeg laus - hom A. Qhov no yog vim muaj zog hemolysis ntawm cov ntshav liab thiab ceev txoj kev loj hlob ntawm cov tshiab, yog, los ntawm cov hlwb pob txha. Yog li, muaj yog daj ntseg nyob rau hauv tus thawj, lub suprarenal yam, uas tsis sai li sai tau raws li tag nrho cov laus ntshav liab yog puas lawm thiab sawv daws yuav tshiab sau hauv cov hlab ntsha.

txoj kev kho

Qhov tseem ceeb tshaj kauj ruam nyob rau hauv kev kho kom bilirubin yog, ntawm chav kawm, kev kho mob ntawm lwm tus kab mob, mob tshwm sim los xws pauv, i.e. tshuaj tua kab mob nyob rau hauv kab kab mob siab, detoxification nyob rau hauv tus neeg mob ntawm lom tshuaj lom, ntshav ntawm cov ntshav thiab tau ntim rau liab hlwb los yog hemolysis thaum lub sij hawm lub siab hloov loj theem ntawm mob npuas paug. Txawm li cas los, nws yuav tsum pab txhawb ntxiv physiotherapy, gepatoprotektory, txoj cai livelihood, tsis muaj tej yam thiab khoom noj tshwj xeeb ntawm kom bilirubin. Ua li no, ua ntej, koj yuav tsum tso kev haus luam yeeb thiab haus dej haus cawv, ntau rog, roj, ntsim thiab kib zaub mov. Nws yog nruj me ntsis txwv tsis pub noj pickles thiab tsib khoom. Nws yog tsim nyog los txwv cov tsawg ntawm cov ntsev thiab tshuaj yej thiab kas fes yuav tsum tsis txhob haus dej haus nyob rau ntawm lub tag nrho. Rau hauv sib piv, noj cov zaub mov uas muaj txhawb bilirubin muaj xws li nquag me me noj mov nrog tus xov tooj ntawm nqaij nyob rau hauv kub cereals, txiv hmab txiv ntoo compotes, hloov lub khob cij dawb rau grey. Tseeb, ua tsaug rau cov tshuaj yuav pib ib tug zoo qauv thiab thaum kawg tus kab mob yuav tawm hauv koj.