Ngati kusanthula kwa biochemical kumasonyeza bilirubin yokwezeka m'magazi, ndiye pakhoza kukhala zifukwa zingapo. Kuti muwamvetsetse, ndi bwino kuganizira za kagayidwe ka mankhwalawa.
Metabolism ya bilirubin
Bilirubin ndi enzyme ya bile. Lilipo m'magazi mu magawo awiri: osalunjika (opanda) komanso molunjika.
Maselo ofiira ofiira (erythrocytes) m'kati mwa moyo waumunthu amafa nthawi zonse ndipo amasinthidwa ndi atsopano. Mitembo imatulutsa hemoglobini, yomwe imafalikira mu makina a globin ndi molekyulu ya heme. Wotsirizirayo amatembenuzidwa ndi michere kuti akhale mfulu (osadziwika bwino bilirubin). Mu mawonekedwe awa, chinthucho ndi poizoni, chifukwa imatayika mu mafuta (koma osati m'madzi), imalowa mopyolera mu maselo ndikuyipitsa ntchito yawo yachibadwa. Chifukwa chilengedwe chimapanga njira yothetsera "bizinubin" yosavomerezeka: i, kugwirizana ndi albumins ya magazi, imayambitsa chiwindi, ndipo kenaka pogwiritsa ntchito michere imakhala yosungunuka madzi ndipo imatulutsidwa ndi bile kudzera m'matumbo aang'ono. Izi ndizomwe zimayambitsa bilirubin. Mwachidule, zigawo zonsezi zimapereka bilirubin wamba, ndipo ngati zowonjezereka, zifukwa ziyenera kuyesedwa motsutsana ndi kayendedwe kotchulidwa pamwambapa.
Nchifukwa chiyani bilirubin imakulira?
Timapereka gawo losavuta.
Birectubin yosadziwika akhoza kuwonjezeka chifukwa cha:
- zovuta mu dongosolo la hematopoietic;
- matenda a chiwindi.
Gawo lachindunji la puloteni likupezeka m'magazi pamwamba pa chizolowezi pamene:
- matenda a chiwindi;
- Kupanda mphamvu kwa extrahepatic bile ducts.
Tsopano ganizirani gulu lirilonse mwatsatanetsatane.
Bilirubin yopanda malire
Kuphwanyidwa kwa kachirombo ka magazi kumaphatikizapo kuchepa kwa magazi m'thupi, komwe maeryerythrotesiti ambiri amawonongeka. Amamasula hemoglobini zambiri, ndipo chifukwa chake ndi chifukwa chake birectubin yowonjezera ikuwonjezeka. Chiwindi sichikhala ndi nthawi yothetsera kusinthika kwake kukhala mzere wolunjika (chidutswa ichi chimakhala chachilendo) ndikupitirira.
Zizindikiro za kuchepa kwa magazi m'thupi:
- chizungulire;
- kufooka kwathunthu ndi kutopa;
- phokoso;
- hemoglobin yotsika ndi chiwerengero cha maselo ofiira a magazi;
- phula lofutukuka.
Zomwe zimadumphira mu mimbayi zingakhalenso chifukwa cha malungo ndi sepsis.
Zina mwa matenda opatsirana, chifukwa cha chiwerengero cha bilirubin chomwe chili chowonekera, ndi monga:
- Matenda a Gilbert ;
- matenda a Kriegler-Nayyar;
- Matenda a Lucy-Driskol;
- analandira mankhwala osagwiritsa ntchito magazi.
Matenda oterewa ndi osowa.
Wapamwamba kwambiri bilirubin
Mu matenda a chiwindi, kutuluka kwa bile kungasokonezeke, chifukwa cha bilirubin yomwe ili mkati mwake sichidasulidwa kwathunthu m'matumbo aang'ono, koma imaponyedwa m'magazi. Izi zimachitika ndi kachilombo ka HIV, mabakiteriya, poizoni ndi chilengedwe.
Zina zomwe zimayambitsa bilirubin mwachindunji m'magazi:
- cholestasis ya intrahepatic;
- choyambirira cha biliary cirrhosis;
- chifuwa cha amayi apakati chifukwa cha chidwi cha amayi ena ku mapiri a estrogens;
- zilonda za chiwindi.
Chotsani chiwindi mu duodenum kudzera mu ndodo imodzi, ndipo ngati lumen yake yatsekedwa, molunjika bilirubin imayikidwa mu magazi. Izi zimachitika pamene:
- kupanikizika kwa mankhwala ochokera kunja chifukwa cha kutupa kwanthawi yaitali kapena koopsa kwapascreatitis;
- kansichikasi chiwindi (majeremusi);
- diverticulum wa duodenum (congenital anomaly);
- zotupa za duodenum kapena kapangidwe;
- Aneurysm ya mitsempha yodabwitsa;
- cholelithiasis;
- cholangitis choopsa komanso chosatha;
- zotupa za ma ducts.
Kuchiza kwa bilirubin yokwezeka m'magazi kumaperekedwa malinga ndi zomwe zinayambitsa kuchulukitsa kwa mavitaminiwa.