Total bilirubin karu. A Sanadin dagagge bilirubin a cikin jini. A rage cin abinci tare da ƙara bilirubin

Ga al'ada metabolism da kuma makamashi a jikin shi dole ne akai samar da substrates daga waje, cewa shi ne, da abinci, da ruwa da kuma iska. Su da muhimmanci sinadaran kwayoyin mahadi, bitamin da kuma ma'adinai da aka gyara - potassium, magnesium, sodium, jan, da baƙin ƙarfe, da yawa wasu. A karshe na wadannan ne wani ɓangare na ja da maikacin jini, guda-cell dako na oxygen a cikin jini, kuma haka baƙin ƙarfe metabolism ne don haka muhimmanci ga jiki. Kuma a lokacin da take hakki ta wata hanya tasowa icteric ciwo, halin a cewa jimlar bilirubin tãyar da su. Yanzu bari mu dubi dukkan muhimman maki.

baƙin ƙarfe metabolism

Man samun baƙin ƙarfe na musamman tare da abinci. Its mafi lura maida hankali a cikin hanta da dabbobi, da wasu kwayoyi (pistachio kwayoyi, gujiya, Pine, cashew), legumes (lentils, Peas), hatsi (buckwheat, alkama, hatsi, sha'ir), alayyafo, masara. A wannan yanayin shi ne na farko a bayansa da tare da wani zama dole adadin for heme da ke cikin Dalili na erythrocyte, kuma kawai sai daukan sanya shaida na baƙin ƙarfe a cikin daffo a cikin jiki, wanda yake game da 3.4 grams, tana wakiltar ions, yafi alaka jini sunadaran enzymes (ferritin, transferrin, xanthine oxidase, ferroflavoproteiny, succinate da NADH-dehydrogenase, da sauransu). Amma da ta faru kullum, amma yanzu bari mu dubi hasarori, da kuma wasu pathological yanayin.

A dalilan da asarar muhimmanci ma'adanai

Daya daga cikin physiological matakai a cikinsa akwai asarar baƙin ƙarfe ne da haila kuma ciki a mata. Duk da haka, watakila mafi muhimmanci yanayi ne jini hasara, guba, anemia na daban-daban asalin, mai tsanani ciki cututtuka, m neoplasms. Idan da asarar da aka ba da muhimmanci, shi ne lokacin da za a bayansa da a cikin wani gajeren lokaci, da kuma a cikin wannan yanayin da mãsu haƙuri yana da wani bayyanar cututtuka na rashi (sideropenic ciwo). Duk da haka, akwai cututtuka a cikin abin da adadin da baƙin ƙarfe riƙe, amma ta canza ne ƙwarai damuwa. Irin wannan lokuta hada icteric ciwo wani Farawa, idan aka gano a matsayin babban metabolite karuwa - bilirubin. Don fara, kokarin fahimtar metabolism a cikin jiki da kuma Sanadin dagagge bilirubin a cikin jini: yana da muhimmanci ga fahimtar da pathogenesis daga wadannan cututtuka.

Exchange haemoglobin: rukunin farko

Bilirubin da dangantaka da muhimmanci pigments kunshe a cikin abun da ke ciki na bile kuma excreted daga jiki ne a da kudi. Yana ke dogon hanya ta hanyar tasoshin har yanzu a cikin nau'i na haemoglobin, da ke sa muhimmanci canje-canje a hepatocytes kuma a karshe secreted cikin hanji ga saki a cikin yanayi tare da tumbi. Saboda haka, wannan abu da aka kafa ta lalace na ja da maikacin jini, da nan da nan ya kama da m sunadaran don kai ga babban Lab - hanta. Wannan sulusi da murabba'i ne ake kira kai tsaye ba, ko da alaqa, saboda bilirubin a shi ne canzawa. Wannan ya faru saboda a wani free tsari, shi iya shiga ta hanyar da membrane na wani cell, kuma yana da karfi da mai guba sakamako da farko a kan neurons. Saboda haka, ta riko ne na al'ada tsaron gida dauki.

Phase neutralization da kadaici da bilirubin

Duk da haka, wadannan sunadarai ba zai iya bi da shi zuwa ga hanji, saboda har yanzu suna bukatar da jiki domin da yawa wasu ayyuka, da kuma haka bilirubin kamata a hõre wannan canji, cewa ya rasa dukiya izinin cikin Kwayoyin. Domin wannan dalili, da hepatocytes (hanta parenchyma Kwayoyin tsarin) ne ta Tasrifu, cewa shi ne, da dauri na glucuronic acid, wanda, quite kawai, aggravates shi. Saboda haka, a karkashin mataki na enzyme UDP-glucuronyl-diglucuronide bilirubin kafa. Next, daga hepatocytes shi shiga cikin bile kuma cikin an saki a cikin hanjinsu a lokacin narkewa. Yanzu wucewa hanyar da farko bolus bakin ciki, sa'an nan zuwa ga ciwon, rinjayi kwayan Flora shi ne sake saki da kuma tuba zuwa urobilinogen, sa'an nan urobilin stercobilin cewa kai tsaye excreted a cikin tumbi. Amma ko da yaushe musamman kananan adadin bilirubin koma ga portal jijiya da aka gudanar a koda, inda fitsari an cire.

iyaka na al'ada

Take hakkin wannan muhimmanci pigment musayar iya faruwa a uku da manyan matakai: a wurare dabam dabam na jini a cikin lalata da erythrocytes, da kama da kadaici da hanta bile. Duk da haka, a cikin dukan waɗannan embodiments, shi za a gano a cikin jini: total bilirubin aka dagagge, zai fi dacewa ko dai ta kai tsaye ko ta kai tsaye ba ta kasarun adadi. Saboda haka, ta al'ada maida hankali a jini da aka dauke su game da 8,5-20,5 micromoles da lita. Idan wannan lambar qara zuwa 85, sa'an nan a Jihar m hyperbilirubinemia, daga 86 zuwa 169 - tsakiya da kuma karshe fiye da 170 mmol / l - mai tsanani. Yana game da yanayin, idan ka kawai ya bayyana cewa dagagge total bilirubin. Duk da haka, da mulki ta wanzu dabam ga kasarun adadi: madaidaiciya - to 5.1, Sakakken - 16,5 pmol / l.

Suprarenal irin jaundice

Saboda haka, a take hakkin mataki na farko total bilirubin a cikin jini ne ya tashe farko ta hanyar kai tsaye ba sulusi da murabba'i. Wannan bayani da etiology na jihar, wato inganta rushe ja jini Kwayoyin a cikin jini. Wannan na iya faruwa a lokuta da nakasar siffofin hemolytic anemia (lahani a kayyade matakin na ja jini Kwayoyin kansu, su enzymes, haemoglobin) ko samu (immunological hari da cutar tare da kansa erythrocytes, daukan hotuna zuwa gubobi da poisons, ƙwayoyin cuta, kwayoyin cuta da kuma wasu kwayoyin). Saboda haka, pathogenesis ne ta ƙara samuwar bilirubin saboda hanta Kwayoyin wanda kawai ba su da lokacin da za a kama da irin wannan babbar adadin shi, kuma shi accumulates a cikin fata da kuma mucous membranes, sa'an nan a cikin kayan ciki, haddasa su da tsanani samu rauni. Kamar wancan kafa suprarenal irin jaundice.

Hanta nau'in jaundice

Idan take hakkin ya auku a karo na biyu babban mataki, hepatocytes ba su da lokacin da za a karba da aiwatar da ko da al'ada adadin kawota zuwa gare su metabolite na haemoglobin, da kuma kyakkyawan a kudi na biyu ƙungiyõyin dagagge total bilirubin. A dalilan da wannan - m hallakaswa canje-canje a cikin hanta. Wadannan sun hada da hepatitis na daban-daban Farawa (mai guba, giya, kwayar) da kuma cirrhosis. Saboda haka, Sanadin dagagge bilirubin a cikin jini ƙarya a gaskiyar cewa hepatocytes iya aiki ba mayalwaci, ko dai ta hanyar kumburi a cikinsu, ko dai saboda su kasa lambar. Mafi na kowa hanyar, ba shakka, ne hepatitis A-type, B, C, Delta, E ko PP. Kamar wancan tasowa na hanta (parenchymal) irin jaundice ciwo, wanda yana tare da mai haske alamun mesenchymal kumburi da kuma gepatotsiliarnoy gazawar.

Obstructive jaundice irin

Kuma, ba shakka, a take hakkin bilirubin metabolism kuma iya faruwa a kan uku babban mataki, cewa shi ne lokacin da tukar tumbi da bile. Duk da haka dai, tare da wannan Hanyar shi ana katange da fitarwa hanyoyi ko hanta, ko ma daga vesicafellea. Saboda wadannan canje-canje a bile accumulates a cikin mafitsara da kuma hanyoyi, ta matsa lamba hankali qara, kuma ƙarshe ya zo da baya (wannan sabon abu ne ake kira regurgitation) a cikin intrahepatic ducts, sa'an nan - a cikin jini, wanda yake shi ne dalilin da ya sa dagagge total bilirubin. A daidai wannan lokaci, ba shakka, akwai wasu canje-canje a biochemical kima. Saboda haka, a cikin jini ya auku cholehemia, Ina nufin samun cikin da shi bile acid da kuma enzymes, da kuma a cikin ducts kansu kafa cholestasis, Ina nufin m secretions. Asibiti, wannan za a bayyana jaundice sclera, mucous membranes da kuma fata (yellow launi tare da kore tint), da kuma a ƙididdiga ba kawai total bilirubin da kuma kai tsaye ya karu, amma kuma bile acid, cholesterol, da matakin da alkaline phosphatase, triglycerides, na ayyuka na gamma-glutamyl transferase .

Sanadin

A etiology na obstructive ko, kamar yadda ta ne ake kira obstructive jaundice, shi ne quite m. Mafi na kowa hanyar shi ne blockage na biliary fili dutse a calculous cholecystitis ko cholelithiasis da helminthic infestations wasu itatuwa lokacin da tsutsotsi sarrafa ciki ducts ko bayyana cholangitis, kuma idan sun kasance inflamed lumen occlusive ko saboda kumburi da ganuwar, ko saboda infiltration na su. Kuma, ba shakka, wannan ya bayyana cewa da kai tsaye da kuma total bilirubin karu. A dalilai ga wasu pathologies a wani hali, suna lalacewa ta hanyar matsawa na waje. Mafi sau da yawa wannan yakan faru saboda girma da ƙari, yawanci shafi shugaban pancreas. Amma kuma, wannan halin da ake ciki na iya faruwa a lokacin da biliary cirrhosis, a lokacin da ducts an matse su girma mãkirci kuma strands na connective nama.

Neonatal jaundice

Duk da haka, ba duk jaundice ne pathological yanayin da kwayoyin. Saboda haka idan duka bilirubin aka ƙãgãwa a cikin baby nan da nan a haihuwa, ko 'yan sa'o'i bayan da shi, da kuma fata da kuma mucous membranes da haske jaundiced, ya kamata ka ba nan da nan sautin ƙararrawa. Bayan da jariri ne a physiological yanayin da ake kira mai shudewa domin shi ne mai shudewa. Hakika, tambaya taso daga m uwar ilmantuwa da cewa ta baby bilirubin aka dagagge, "Abin da ya kamata na yi?" Amsar mai sauki ce: jira. Lokacin da wannan a zahiri ya nuna kawai expectant management, tun a 'yan kwanaki (yawanci uku zuwa biyar) yellowness hankali vuya. Kuma idan aka jinkirta, da yanayin jariri rincabewa da total bilirubin aka dagagge, magani ne da za'ayi gaggawa, wato detoxification far da ake amfani da ultraviolet sakawa a iska mai guba. Yanzu bari la'akari da pathogenesis wannan yanayin.

Musamman Sistem jarirai

Gaskiyar cewa fetal wurare dabam dabam a cikin mahaifa ne muhimmanci daban-daban daga abin lura a yara riga haife. A lokacin daukar ciki, jaririn da aka nutsa cikin wani kumfa da ruwar, kuma domin da huhu ba tukuna saba da iska da kuma suna wrinkled jihar, watau inoperative. Amma da yaro yake da muhimmanci ga ci gaba da kwarara daga oxygen zuwa ga kyallen takarda ga su samuwar, girma da kuma bambantawa. Wannan shi ne dalilin da ya sa jininsa ne don haka a hankali Magana da iyaye. A daki-daki, da ja jini Kwayoyin yaro kawai kunsa oxygen daga ja jini Kwayoyin da mace, kuma domin wannan su bukatar wani karfi gripping ƙarfinsa. Saboda haka, yana wakilta haemoglobin F-type, wanda ke nufin Fetal. Ya saukin samun oxygen da kuma daukawa shi zuwa Kwayoyin da tayin.

sakamakon

Duk da haka, bayan haihuwar irin wannan superpower shi ne ba dole ba, saboda daga nan a cikin huhu saukar yana numfashi a kan nasu da aikatãwa nasu oxygen. Kuma idan ya haemoglobin zai zama guda, shi ba zai iya ba da shi ga Kwayoyin. Saboda haka, bayan na farko da numfashin fara rayayye canza wannan babban gina jiki na ja da maikacin jini daga fetal zuwa adult - irin A. Wannan shi ne saboda ya karu hemolysis na ja da maikacin jini da gaggawa cin gaban sabuwar, daidai, daga bargo. Saboda haka, akwai jaundice a farko, da suprarenal irin, wanda ya tsaya da zaran duk da haihuwa ja jini Kwayoyin suna hallaka da kuma sababbi cika jini.

far

A mafi muhimmanci mataki a cikin zalunta dagagge bilirubin ne, ba shakka, magani daga tamkar cuta, cuta sa irin wannan musayar, Ina nufin maganin rigakafi a kwayar hepatitis, detoxification a lokuta da guba poisons, transfussion na jini da cushe ja Kwayoyin ko hemolysis a lokacin hanta dasawa ga m mataki na cirrhosis. Duk da haka, ya kamata ƙarfafa physiotherapy, gepatoprotektory, dama abincinsu, ba tare da hadarin dalilai da kuma musamman rage cin abinci a dagagge bilirubin. Don yin wannan, na farko, dole ne ka daina shan taba da kuma shan barasa, ya wuce kima mai, cholesterol, yaji da soyayyen abinci. An tsananin haramta ci pickles, kuma pickled kayayyakin. Wajibi ne a iyakance ci na gishiri da kuma shayi da kuma kofi kamata ba sha a duk. A bambanci, rage cin abinci tare da dagagge bilirubin hada da m karami da abinci da yawan meatless zafi hatsi, da 'ya'yan itace compotes, ya maye gurbin fari burodi zuwa launin toka. Lalle ne, godiya ga takardar sayen magani kwayoyi za su fara wani tabbatacce Trend da kuma kyakkyawan cuta zai bar ka ba.