Kana kuongorora kwezvinhu zvipenyu kunoratidza hupamhi hwebilirubin muropa, saka pane zvingava nezvikonzero zvakawanda. Kuti uzvinzwisise, zvakakosha kufunga nezvekugadzirisa kwechigadzirwa chezvinhu izvi.
Metabolism ye bilirubin
Bilirubin is enzyme bile bile. Iripo muropa mune zvikamu zviviri: zvisina kuratidza (pasina) uye zvakananga.
Masero matsvuku eropa (erythrocytes) muhupenyu hwevanhu nguva dzose anofa uye anotsiviwa nemitsva. Zvitunha zvinosunungura hemoglobin, iyo inoputsika mumaketani e globin uye heme molecule. Iyo yekupedzisira inoshandurwa nemakemikari muhusununguko (isina kuratidza bilirubin). Mune chimiro, chinhu chacho chinotyisa, nokuti inoputika mumafuta (asi kwete mumvura), inopinda nyore mumasero uye inokuvadza basa ravo rinowanzoitika. Nokuti zvisikwa zvakapa nzira ye "neutralizing" isina kuratidza bilirubin: iyo, kuwirirana ne albumins yeropa, inofamba kuchiropa, uye zvino pasi pekuita kwevane enzymes inenge isina kusvibiswa nemvura uye inogadziriswa ne bile kuburikidza nemukomana muduku. Izvi zvakananga bilirubin. Muchidimbu, zvikamu zviviri zviri zviviri zvinopa bilirubin yakafanana, uye kana yakakwirira, zvinokonzera zvinofanira kutsvakwa mukuputsa mhando inotsanangurwa pamusoro apa.
Nei bilirubin yakamutswa?
Tinopa sarudzo yakaoma.
Indirect bilirubin inogona kuwedzerwa nekuda kwe:
- kushungurudzika mu hematopoietic system;
- zvirwere zveropa.
Chikamu chakananga che enzyme chinowanikwa muropa riri pamusoro pemaitiro apo:
- chiropa zvirwere;
- impassability ye extrahepatic bile ducts.
Iye zvino funga nezveboka rimwe nerimwe zvakadzama.
High indirect bilirubin
Kuputsika kwehemopoietic system kunosanganisira hemolytic anemia, iyo yakawanda ye erythrocytes inoparadzwa. Vanosunungura akawanda hemoglobin, uye nenzira iyi iyi ndiyo chikonzero nei zvisina kukodzera bilirubin yakawedzerwa. Chiropa hachina nguva yekutarisana nekushandurwa kwaro kuva mutsara wakarurama (chikamu ichi chinoramba chichigara) uyezve kuwedzera.
Zviratidzo zvekushaya ropa kwakadaro:
- chizoro;
- kushaya simba uye kuneta;
- pallor;
- pasi hemoglobin uye nhamba yemasero matsvuku eropa;
- akawedzera spleen.
Izvozvo zvakasvetuka mu enzyme zvingavewo zvichibva pamarariya uye sepsis.
Pakati pezvirwere zvinotyisa, nekuda kwekuti chiyero chebhareubin chisinganzwisisi chakakwirira, chinosanganisira:
- Gilbert's syndrome ;
- the Kriegler-Nayyar syndrome;
- Lucy-Driskol syndrome;
- akawana kwete-hemolytic jaundice.
Matambudziko akadaro haawanzoitiki.
High direct bilirubin
Muzvirwere zveropa, kubuda kwebhinzi kunogona kuvhiringidzika, nokuti iyo bilirubin iri mairi haina kunyatsopfigirwa mukati mudumbu duku, asi inokandwa muropa. Izvi zvinokonzerwa nehepatitis HIV, bhakitiriya, chepfu uye yega autommune.
Zvimwe zvinokonzera zvakanyanya zvakanyanya bilirubin muropa:
- intrahepatic cholestasis;
- primary biliary cirrhosis;
- jaundice yevakadzi vane pamuviri nekuda kwekunzwa kwevamwe vakadzi kune yakakwirira yeestrogen;
- chiropa chiropa.
Bhiri rinosiya chiropa mu duodenum kuburikidza nehuro imwe, uye kana chigadziko chayo chikavharwa, zvakananga bilirubin inopindwa muropa. Izvi zvinoitika apo:
- kudzvinyirira kwe bile bile ducts kubva kunze nekuda kwekugara kwenguva refu kana kunetseka kwepancreas (pancreatitis);
- echinococcus chiropa (parasite);
- diverticulum ye duodenum (congenital anomaly);
- matumbo e duodenum kana pancreas;
- aneurysm yeropatic artery;
- cholelithiasis;
- acute uye asingagumi cholangitis ;
- tumora ye bile bile ducts.
Mishonga yepamusoro yebilirubin muropa inorayirwa zvichienderana nezvikonzero izvo zvakakonzera kuwedzera mumusanganiswa wei enzyme iyi.