Ukuba uhlalutyo lwe-biochemical lubonisa i-bilirubin ephakamileyo egazini, ngoko kukho izizathu ezininzi. Ukuze uziqonde, kuyafaneleka ukuqwalasela ukusetyenziswa kwezinto ezikhoyo.
I-metabolism ye-bilirubin
I-Bilirubin yi-enzyme ye-bile. Kukho egazini kwiingxenyana ezimbini: ngokungathanga ngqo (ngaphandle) kunye ngqo.
Iiseli zegazi ezibomvu (i-erythrocyte) kwinkqubo yobomi babantu zihlala zifa kwaye zatshintshwa ngabantu abatsha. Izidumbu ezidumbulayo zikhulula i-hemoglobin, ehla iinqwelo ze-globin kunye ne-molecule ye-heme. Olu hlobo lokugqibela luguqulwa ngama-enzyme kumahhala (i-bilirubin engathanga ngqo). Kule fomu, le nkunkuma inetyhefu, kuba ichitheka kumafutha (kodwa kungekhona emanzini), ilula ngokungena kwiiseli kwaye iyonakalise umsebenzi wayo oqhelekileyo. Ngenxa yokuba indalo inikezele indlela yokwenza i-bilirubin engathanga ngqo kuyo: ukuxhuma kunye ne-albinini yegazi, ishukumisela kwisibindi, kwaye ngoko phantsi kwezenzo ze-enzymes, i-soluble yamanzi kwaye ixutywe nge-bile ngokusebenzisa intliziyo encinci. Oku kuhambelana ne-bilirubin. Ngokomlinganiselo, zombini izicatshulwa zinika i-bilirubin efanayo, kwaye xa iphakanyisiwe, izizathu kufuneka zifunwe ngokuphula umthetho ochazwe ngasentla.
Kutheni i-bilirubin iphakanyisiwe?
Sinika uluhlu olulula.
I-bilirubin engacacanga inganyuswa ngenxa yokuba:
- iziphazamiso kwi-hematopoietic system;
- izifo zesibindi.
Ingxenyana ngqo ye-enzyme itholakala egazini elingaphezu kwesiqhelo xa:
- izifo zesibindi;
- ukungaphumeleli kwintsimbi ye-extrahepatic bile.
Ngoku qwalasela iqela ngalinye ngokubanzi.
I-bilirubin
Ukuphulwa kwenkqubo ye-hemopoietic kubandakanya i-hemolytic anemia, apho inani elikhulu le-erythrocytes libhujiswa. Bakhulula i-hemoglobin eninzi, kwaye ngoko ke isizathu sokuba i-bilirubin engabonakaliyo yanda. Isibindi asinalo ixesha lokuhlangabezana nokuguqulwa kwayo ibe yindlela eqondekileyo (eli qhekeza lihlala liqhelekileyo) kunye nokugqithisa okuqhubekayo.
Iimpawu zokuphelelwa kwesifo esinjalo:
- ukungcola;
- ubuthathaka kunye nokukhathala;
- iphosa;
- i-hemoglobin ephantsi nenani lamaseli obomvu;
- ipeni ekhulisiweyo.
Ukuxhuma okufanayo kwi-enzyme kungakho ngenxa ye-malaria kunye ne-sepsis.
Phakathi kwezifo ezinobungozi, ngenxa yeli nqanaba le-bilirubin elingathanga ngqo libandakanya:
- Isifo sikaGilbert ;
- i-Kriegler-Nayyar syndrome;
- Isifo seLucy-Driskol;
- fumana i-hemolytic jaundice engeyona i-hemolytic.
Iintlungu ezinjalo azifaneki.
Ephezulu i-bilirubin
Kwizifo zesibindi, ukuphuma kwebhile kungaphazamiseka, ngenxa yokuba i-bilirubin equlethwe kuyo ayigcini ngokupheleleyo emathunjini amancinci, kodwa iphonswa egazini. Oku kwenzeka nge-virus ye-hepatitis, ibhakteria, inetyhefu kunye ne-autoimmune.
Ezinye izizathu ze-bilirubin ephezulu egazini:
- cholestasis intrahepatic;
- i-cirrhosis yebhiliyali ephambili;
- I-jaundice yabasetyhini abakhulelweyo ngenxa yobubele besifazana abathile kwisiqulatho esiphezulu se-estrogens;
- izibilini zesibindi.
Ibhili ishiya isibindi kwi-duodenum ngokusebenzisa enye ipayipi, kwaye ukuba i-lumen yayo ivaliwe, i-bilirubin ngqo ijojowe egazini. Oku kwenzeka xa:
- Ukunyanzeliswa kweengxube ze-bile ezivela ngaphandle ngenxa yokuvuvukala okungapheliyo okanye okukrakra kwepascreas (pancreatitis);
- i-ecinocus (isibindi);
- i-diverticulum ye-duodenum (i-anomaly ye-congenital);
- izicubu ze-duodenum okanye i-pancreas;
- aneurysm yeerpiyiti;
- cholelithiasis;
- i- cholangitis enomdla kwaye engapheliyo;
- izicubu ze-bile ducts.
Utyando lwe-bilirubin ephakamileyo egazini limiselwe kuxhomekeke kwizizathu ezibangele ukwanda kwe-enzyme.