Bilirubin ndi mankhwala amodzi, chimodzi mwa zigawo zikuluzikulu za bile zopangidwa ndi maselo a chiwindi komanso kutenga nawo mbali m'thupi. Ndi nkhumba zoopsa zomwe zimapangidwa pamene erythrocyte zowonongeka kapena zowonongeka ndizozigawo za magazi, ndipo izi zimachitika mu mphutsi. Komanso, bilirubin imalowa m'kati mwa maselo a chiwindi ndikusanduka mawonekedwe ena, osungunuka madzi.
Zagawo za bilirubin
Bilirubin mu thupi la munthu ndipo, makamaka m'magazi, amaimiridwa ndi mitundu iwiri ya tizigawo:
- Gawo losalongosoka (laulere) , lomwe ndi bile pigment, losasunthika m'madzi ndipo amatha kudutsa mu memphane ndikusokoneza ntchito yawo.
- Gawo lachindunji , lomwe limapezeka pophatikiza bilirubin yaulere mu hepatocytes komanso kukhala ndi madzi osungunula madzi.
Chiwerengero cha bilirubin mwachindunji ndi mwachindunji m'magazi ndi totali (totalika) bilirubin, zomwe zimapangidwa panthawi yophunzira za biochemical blood blood venous. Tiyeni tione, chikhalidwe kapena chiwerengero cha bilirubin mumagazi a amayi ndi momwe kusanthula chizindikiro chomwe wapatsidwa chinganene.
Kawirikawiri ya bilirubin yonse m'magazi
Kuti mudziwe kuchuluka kwa bilirubin yomwe ili mu dongosolo lozungulira, magazi amachotsedwa ku mitsempha yam'mimba m'mawa m'mawa opanda kanthu. Njira zosiyanasiyana zimagwiritsidwa ntchito pofufuza. Tiyenera kulingalira kuti zifukwa zosiyanasiyana zimakhudza ubwino wa kusanthula. Choncho, zotsatira zingakhale zovuta kwambiri ngati asanayambe phunzirolo wodwala anatenga zozizwitsa za steroid, erythromycin, phenobarbital, amadya chakudya chokwanira cha carotenoids (kaloti, apricots). Malingaliro osadziŵika bwino angadziŵike ndi vuto la ogwira ntchito zachipatala omwe analola nthawi yaitali kuti aziphunzira mozama, motero amachititsa okosijeni a seramu.
Chizoloŵezi cha amai ndi chiwerengero cha bilirubin, kutembenuka pakati pa 3.4 - 17.1 μmol / l (omwe 80% amagwera pang'onopang'ono). Kwa amuna, malire apamwamba a chikhalidwe ichi ndi apamwamba kwambiri. Izi zimatheka chifukwa chakuti ang'onoang'ono a erythrocyte amapangidwa mu thupi lachikazi. Tiyeneranso kukumbukira kuti pa nthawi ya kugonana, makamaka m'miyezi itatu yomaliza, pangakhale zochepa zochepa zomwe zimakhalapo, chifukwa cha kuphwanya bile ku chiwindi. Komabe, mutatha kubereka, mtengowo umakhala wovomerezeka.
Chiwerengero cha chiwerengero cha bilirubin
Mavuto onse a bilirubin m'magazi amapereka chidziwitso chofunika kwambiri pokhudzana ndi momwe thupi limagwirira ntchito m'thupi, mphamvu zogwirira ntchito za ziwalo zomwe zimagwira nawo ntchitoyi, zimalola madokotala osiyanasiyana kuti adziwe ndi kuyesa momwe chithandizo cha matenda ambiri chikuyendera. Kawirikawiri, kufufuza uku kulimbikitsidwa chifukwa cha chiwerengero cha chiwindi cha chiwindi, hemolytic anemia. Tiyenera kumvetsetsa kuti chizindikiro cha chiwerengero cha bilirubin sichingatilole kuti tiwone bwinobwino chifukwa chake chikuwonjezeka. Choncho, phunzirolo liyenera kuphatikizidwa ndi kuphunzira za tizigawo ta bilirubin m'magazi.
Ngati pakufufuza kuti chiwerengero cha bilirubin chikuwonjezeka chifukwa cha kuchulukitsidwa kwa gawo lachindunji, izi zikhoza kusonyeza:
- hemolytic anemia ;
- malaria;
- Matenda a Gilbert;
- matenda a Kriegler-Nayar, ndi zina zotero.
Pamene chiwerengero cha bilirubin chiwonjezeka chifukwa cha gawo lochepa, munthu akhoza kukayikira za:
- Matenda a Dabin-Johnson;
- chiwindi;
- chiwindi;
- cholelithiasis, ndi zina zotero.
Kupitiliza zikhalidwe za magulu onse awiri kungathe kunena za matenda monga:
- khansa ya chiwindi;
- alveococosis ya chiwindi;
- tizilombo toyambitsa matenda, ndi ena.
Kuchepetsa chiwerengero cha bilirubin m'magazi kumawoneka pambuyo poti magazi ambiri ataya thupi, pambali pa chiwonongeko chachikulu.