Pakuita bhizinesi rekuongorora ropa, zvitatu zvebilirubin zvinoratidzika: chikamu chakajeka, chikamu chisina kutarisana, bilirubin yakazara (chiyero chezvikamu zvakananga uye zvisingaoneki). Kuumbwa kwezvakajeka uye zvisingaenzaniswi bilirubin kunowedzera maererano nenzira dzakasiyana-siyana, naizvozvo, kuitira kuti tinyatsogadzirisa kuongororwa muhupenyu hwehupenyu hwehutachiona hwemhepo, zvinodikamwa kusiyanisa kuti bilirubin inowedzerwa - yakananga kana isina kujeka. Chimbofunga izvo zvakananga (zvakasungwa, zvakagadziriswa) bilirubin, ndezvipi zvakanakira tsika dzechiratidzo ichi, uye zvinorevei kana iyo yakananga bilirubin muropa yakakwirira.
Kuumbwa kwehuwandu hwebilirubin mumuviri
Chikamu ichi chebilirubin pigment isakemikari inoumbwa mu hepatocytes (chiropa masero), mushure mezvo yakawanda iyo inowanikwa pamwe ne bile mumatumbo. Iko, inoparadzaniswa uye yakanyanyiswa kubva mumuviri, kunyanya nemidziyo uye mumaduku maduku - kuburikidza neitsvo. Chikamu chiduku chebilirubin chakananga chinobva pamasero emuropa kusvika muropa.
Kutungamira bilirubin hachina hutachiona (zvichienzaniswa nehuwandu husina kunzi bilirubin), chikamu ichi chakanaka mvura yakasvibiswa. Zita rokuti "rinotungamira" bilirubin rinobva pakuti icho chinhu chinopa zvakananga ne diazo reagent (inonzi aqueous solution ye diazophenylsulphonic acid) inoshandiswa mukutsvakurudza kwehupenyu.
Chimiro uye kuongororwa kunokosha kwezviri pachena bilirubin
Chiratidzo chekurondedzera bilirubin yeropa chiratidzo chekushaya chiropa chechiropa. Chimiro chayo kuvanhu vakuru chiri munharaunda kubva pa 0.86 kusvika ku53 μmol / l, iyo inenge chikamu chechina chekukosha kwehuwandubin rose muropa. Zvakakosha kuziva kuti iyo chaiyo yepamusoro yemiganhu inowanzoenderana nemagadzirirwo ayo anoshandiswa kugadzirisa urongwa huno, asi kukanganisa hakupfuuri 10-15%.
Nayo pachayo, kurondedzera bilirubin haisi mungozi yakakosha kuhutano hwevanhu, tk. iye akabatana, uye, nokudaro, anoshandiswa kusina maturo uye anofanira kusiya ropa. Asi zvakakosha kuti hapachina zvipingamupinyi mumugwagwa wayo, uye kubatana kunofanirwa kubviswa hakudzokeri zvakare.
Kuwedzera kwepfungwa yezviri pachena bilirubin chikamu (conjugation hyperbilirubinemia) inoratidza zvirwere zvehutano. Muchiitiko ichi, kurisa bilirubin inounganidza muzvisungo zvemuviri, maziso eziso, ganda. Muchipatara kune varwere, izvi zvinogona kuratidzirwa nezviratidzo zvakadai sokusviba kwemuguta, kurwadziwa mune zvakanaka hypochondrium, kupisa ganda, jaundice.
Chii chakakwiridzirwa chinonzi bilirubin chinoreva?
Kana iyo bilirubin yakananga iri muropa ichiwedzerwa, zvikonzero zveizvi zvingave zvakabatana nenzira dzakasiyana-siyana dzehutano, kureva:
- ine hemolysis yakawanda (kuparadzwa) kwemasero eropa eerythrocytes, zvichiita kuwedzera bilirubin;
- nekuputsa kushandiswa kwemagetsi kwebilirubin mu hepatocytes;
- uye kuputika kwe mechanical excretion ya bilirubin kubva mumuviri.
Zvirwere zvinogona kunzi zvikonzero zvekuwedzera kwehuwandu hwehuwandu hwebilirubin muropa dzinosanganisira:
- hutachiona hunokanganisa (kusanganisira viral uye bhakitiriya hepatitis);
- toxic and drug-induced hepatitis;
- autoimmune hepatitis (kusanganisira iyo inobatanidzwa nemagadzirirwo emakumbo emamwe nhengo);
- intrahepatic cholestasis;
- biliary cirrhosis ;
- pancreatic tumors;
- cholelithiasis;
- helminthic mutsutso;
- chiropa chechiropa (kusanganisira chirwere);
- metastases kusvika kuchiropa;
- Dabin-Johnson syndrome;
- Rotor syndrome;
- sclerosing cholangitis;
- jaundice yevakadzi vane pamuviri, nezvimwewo.