Pochita mayeso a magazi, ziwerengero zitatu za bilirubin zimasiyanasiyana: gawo limodzi, gawo lochepa kwambiri, chiwerengero cha bilirubin (chiwerengero cha tizigawo tachindunji ndi osadziwika). Kupangidwira kwa bilirubin mwachindunji komanso mosalunjika kumapitirira mogwirizana ndi njira zosiyana siyana, chotero, pofuna kutsimikizira bwinobwino matendawa pofufuza kafukufuku wamagazi a m'magazi, ndikofunikira kusiyanitsa kuti bilirubin ikuwonjezeka - molunjika kapena mwachindunji. Taganizirani zomwe ziri zogwirizana (bizin, conjugated) bilirubin, ndi chikhalidwe chotani cha chizindikiro ichi, ndipo chikutanthauzanji ngati bilirubin yeniyeni m'magazi ikukwera.
Mapangidwe a bilirubin mwachindunji m'thupi
Gawoli la bilirubin pigment ndi mankhwala omwe amapangidwa mu hepatocytes (maselo a chiwindi), pambuyo pake ambiri amakhala pamodzi ndi bile m'matumbo. Kumeneko, amagawanika ndi kutambasulidwa kuchokera ku thupi, makamaka ndi nyansi zochepa komanso zochepa - kupyolera mu impso. Gawo laling'ono la bilirubin limachokera ku maselo a chiwindi kupita m'magazi.
Direct bilirubin ndi yocheperako poyerekeza (poyerekeza ndi bilirubin yosalunjika), kachigawo kameneka ndi madzi osungunuka. Dzina lakuti "molunjika" bilirubin limachokera ku mfundo yakuti izi zimapereka njira yodziwika ndi diazo reagent (njira yamadzimadzi ya diazophenylsulphonic acid) yomwe imagwiritsidwa ntchito pofufuza.
Chizoloŵezi ndi chidziwitso chofunika cha bilirubin mwachindunji
Chizindikiro cha mwachindunji bilirubin wa magazi ndi chodziwika bwino cha chiwindi. Zomwe zimachitikira anthu akuluakulu zimakhala zochokera ku 0.86 mpaka 5.3 μmol / l, zomwe ziri pafupi kotala mtengo wa bilirubin m'magazi. Ndikoyenera kuzindikira kuti malire omwe ali pamwambapo amadalira ma reagents omwe amagwiritsidwa ntchito kuti adziwe ndondomekoyi, koma kulakwa sikudutsa 10-15%.
Pokhapokha, kulongosola bilirubin sikusokoneza thanzi laumunthu, tk. iye akugwirizanitsidwa, ndipo, motero, amamasuliridwa opanda vuto ndipo ayenera kusiya magazi. Koma ndikofunika kuti palibe zolepheretsa mu njira yake, ndipo kugwirizana kumeneku koyenera kubwerera sikubwezeretsanso.
Kuwonjezereka kwapadera kwa bilirubin kachigawo (conjugation hyperbilirubinemia) zizindikiro zowonongeka. Pachifukwa ichi, kulongosola bilirubin kumagwiritsidwa ntchito mu zotupa za thupi, maso, khungu. Kachilombo kwa odwala, izi zikhoza kuwonetsedwa ndi zizindikiro monga mdima wamtendere, ululu mu hypochondrium yolondola, kuyabwa khungu, jaundice.
Kodi kutsogolera kwa bilirubin kumatanthauza chiyani?
Ngati bilirubin mwachindunji m'magazi yowonjezereka, zifukwa izi zingakhudzidwe ndi njira zosiyanasiyana za matenda, monga:
- ndi kuchuluka kwa hemolysis (chiwonongeko) cha maselo a magazi a erythrocytes, kuchititsa owonjezera bilirubin;
- ndi kuphwanya kusintha kwa kagayidwe ka bilirubin mu hepatocytes;
- ndi kuphwanya kosakaniza kwa excretion ya bilirubin kuchokera mu thupi.
Matenda omwe angatchedwe chifukwa cha kuchuluka kwa bilirubin m'magazi ndi awa:
- Kuwonongeka kwa chiwindi (kuphatikizapo tizilombo toyambitsa matenda a chiwindi);
- hepatitis;
- Kupweteka kwa chiwindi (kuphatikizapo zomwe zimagwirizana ndi zilonda za ziwalo zina);
- cholestasis ya intrahepatic;
- biliary cirrhosis ;
- mitsempha yamphongo;
- cholelithiasis;
- helminthic zotupa;
- zilonda za chiwindi (kuphatikizapo khansa);
- metastases ku chiwindi;
- Matenda a Dabin-Johnson;
- Matenda a Rotor;
- sclerosing cholangitis;
- jaundice ya amayi apakati, ndi zina zotero.