Bilirubin wowongoka komanso wosalunjika: ndi chiyani ndipo chifukwa chiyani atha kukhala okwera

Zamkati

• Malingaliro owerengera a Bilirubin
• Nthawi yotenga mayeso a bilirubin
• Zingakhale zotani mkulu bilirubin
• Kuchuluka kwa bilirubin osalunjika
• Kuchuluka bilirubin mwachindunji

Mayeso a bilirubin amathandizira kuzindikira mavuto a chiwindi, ma ducts kapena magazi ochepa a hemolytic, mwachitsanzo, popeza bilirubin ndi chida chowononga maselo ofiira am'magazi ndipo kuti ichotsedwe ndi thupi imafunikira kuti ipangidwe ndi shuga m'chiwindi ndikuvutika zochita za bile.

Pali mitundu iwiri ikuluikulu ya bilirubin yomwe ingayesedwe ndi mayeso awa:

• Bilirubin yosadziwika kapena osapangidwanso: ndi chinthu chomwe chimapangidwa panthawi yomwe maselo ofiira am'magazi amawonongeka kenako amatengeredwa ku chiwindi. Pachifukwa ichi, kuchuluka kwake kumakhala kwakukulu m'magazi ndipo kumatha kusinthidwa pakakhala vuto lina lokhudzana ndi maselo ofiira, monga hemolytic anemia;
• Direct Bilirubin kapena conjugate: imafanana ndi kulumikizana pakati pa bilirubin ndi glucuronic acid, shuga, m'chiwindi. Direct bilirubin imagwira ntchito ya bile m'matumbo, ndikuchotsedwa ngati urobilinogen kapena stereobilinogen. Chifukwa chake, kuchuluka kwa bilirubin mwachindunji kumasinthidwa pakakhala kuvulala kwa chiwindi kapena kutsekeka kwa biliary.

Kuyezetsa kwa Bilirubin kumafunsidwa ndi cholinga chofufuza momwe chiwindi chimagwirira ntchito, kuwunika momwe ana obadwa ndi matenda a jaundiced ndikuwunika matenda omwe angasokoneze kupanga kwa bilirubin, kusungira, kagayidwe kake kapenanso kutulutsa. Nthawi zambiri dokotala amalamula bilirubin yathunthu, komabe ma laboratories nthawi zambiri amatulutsa milingo ya bilirubin yachindunji, kapena yosalunjika, popeza miyezo iwiriyi ndi yomwe imayambitsa kuchuluka kwa bilirubin. Onani mayesero ena omwe amathandiza kuzindikira mavuto a chiwindi.

Kuyezetsa magazi kwa bilirubin sikufuna kukonzekera ndipo kumachitika ndi magazi ochepa. Komabe, zotsatira za kuyesaku zitha kusokonekera ngati nyembayi itapukutidwa ndi magazi, ndiye kuti, kuchuluka kwa maselo ofiira owonongeka kumakhala kwakukulu kwambiri, zomwe zimachitika pomwe zosonkhanitsazo sizikuchitika molondola. Ichi ndichifukwa chake ndikofunikira kuti zosonkhanitsazo zichitidwe mu labotale yodalirika komanso ndi akatswiri ophunzitsidwa bwino.

Malingaliro owerengera a Bilirubin

Malingaliro ofotokozera a bilirubin m'magazi ndi awa:

Ana obadwa kumene amatha kukhala ndi bilirubin yambiri, yomwe imatha kukhala chifukwa cha kusakhwima kwa ziwalo zokhudzana ndi bilirubin metabolism kapena kupsinjika kwa ntchito. Malingaliro ofotokozera a bilirubin m'makanda amasiyana malinga ndi moyo wawo, kukhala:

• Mpaka maola 24 mutabadwa: 1.4 - 8.7 mg / dL;
• Mpaka maola 48 mutabadwa: 3.4 - 11.5 mg / dL;
• Pakati pa masiku 3 ndi 5 atabadwa: 1.5 - 12 mg / dL.

Pambuyo pa tsiku lachisanu ndi chimodzi, malingaliro omwe amafotokozedwayo amakhala ofanana ndi achikulire. Zomwe zili pamwambapa zikuwonetsa kuti mwana ali ndi matenda a jaundice, omwe ndi matenda omwe amapezeka kwambiri mwa ana obadwa kumene ndipo amatha kuchiritsidwa mosavuta pogwiritsa ntchito njira yothandizira, yomwe cholinga chake ndi kuchepetsa kuchuluka kwa bilirubin mthupi la mwanayo. Dziwani zambiri za matenda a chikodzo a neonatal, zomwe zimayambitsa komanso momwe amathandizira.

Nthawi yotenga mayeso a bilirubin

Mayeso a bilirubin nthawi zambiri amalamulidwa ndi adokotala pakakhala zizindikiro zamatenda a chiwindi, monga kutopa kwambiri, nseru pafupipafupi, kusanza, kupweteka kosalekeza m'mimba, mkodzo wakuda kapena khungu lachikaso, mwachitsanzo.

Komabe, kuyezaku kumatha kugwiritsidwanso ntchito ngati akuganiza kuti chiwindi, hepatitis ndi hemolytic anemia, zomwe zimayambitsa zizindikilo monga pallor, kugona pafupipafupi, khungu louma, tsitsi lochepera kapena misomali yofooka. Onani zizindikiro zina za kuchepa kwa magazi m'thupi.

Kutsika kwa milingo ya bilirubin nthawi zambiri kumachitika chifukwa chogwiritsa ntchito mankhwala ena, komabe, milingo yayikulu ya bilirubin nthawi zambiri imawonetsa zovuta zathanzi zomwe zingakhale zovuta ngati sizichiritsidwa.

Zingakhale zotani mkulu bilirubin

Zomwe zimayambitsa kuchuluka kwa bilirubin m'magazi zimasiyana malinga ndi mtundu wa bilirubin womwe umakulitsidwa:

Kuchuluka kwa bilirubin osalunjika

Pakadali pano, kusintha kwa milingo ya bilirubin nthawi zambiri kumachitika chifukwa chamagazi, komabe, zomwe zimayambitsa zazikuluzikulu ndi izi:

• Kuchepa kwa magazi;
• Kuchepa magazi;
• Hemoglobinopathies;
• Kuikidwa magazi.

Kuphatikiza apo, palinso milandu yomwe bilirubin yosawonekera imawonjezeka chifukwa cha matenda, omwe amadziwika kuti Gilbert's syndrome, momwe zimasinthira majini omwe amalepheretsa chiwindi kuthana ndi bilirubin. Dziwani zambiri za matenda a Gilbert.

Kuchuluka bilirubin mwachindunji

Pakakhala kuwonjezeka kwa bilirubin mwachindunji nthawi zambiri chimakhala chizindikiro kuti pali vuto m'chiwindi kapena m'mabulu am'mimba. Chifukwa chake, zina mwazifukwa zazikulu ndi monga:

• Matenda a chiwindi;
• Mowa chiwindi matenda;
• Mwala mu madontho a bile;
• Zotupa m'chiwindi kapena bile ducts.

Kugwiritsa ntchito mopitilira muyeso mankhwala omwe amakhudza chiwindi, monga Paracetamol, amathanso kuyambitsa kuchuluka kwa mtundu wa bilirubin m'magazi. Mvetsetsani bwino zomwe zimayambitsa kuchuluka kwa bilirubin ndi jaundice mwa akulu.