Huina bilirubin māhuahua. Nā kumu o ke kiekie bilirubin i loko o ke koko. Aʻai me ka mahuahua bilirubin

No ka maʻamau pūnao a me ka ikehu i loko o ke kino, ka mea pono e he mau lako hou o substrates mai ka waho, i mea, me ka ai, ka wai a me ka makani. Lākou nui nā mea hoʻohui i ke aloha i huiʻia, nā wikamina a me ka mea pōhaku eiiiiiaiou - potasiuma, makanekiuma, paʻakai, keleawe, hao, a he nui na mea e ae. I ka hope o kēia mau mea kekahi hapa o ka ula koko keena, hookahi-aeea nā moku halihali mokulele o ka o oxygen i loko o mākou koko, a nolaila hao pūnao mea no laila, nui no ke kino. A i ka wā aʻe 'Hehe e hoʻomōhala ana i icteric maʻi pale, wehewehe aku i loko i ka huina bilirubin hoalaia. Ano, e ka nānā aku i nā mea a pau i ka nui wahi.

hao pūnao

Man loaʻa ka hao wale nō me ka ai. Kona kiekie loa ae hākilo lehulehu i loko o ke akepaa o ka holoholona, i kekahi mau kukui (hua pisetakia, peanuts, tidara, cashew), legumes (nā pāpapa, peas), kiliala (buckwheat, hua palaoa, ota, bale), spinach, maize. Ma keia hihia ka mea, ua na mea mua a me ka pono nui no ka heme aha ke kumu o ka erythrocyte, a wale laila e kau i ka palapala moʻopane o ka hao i loko o kona nei i loko o ke kino, i mea e pili ana i 3.4 nā huna, e ho Ion,ʻano nui e pili pū ana i ka wai koko nā polokina a me nā'ūhū (ferritin, transferrin, xanthine oxidase, ferroflavoproteiny, succinate a me ka NADH-dehydrogenase, a me na mea e ae). Akā, i ka hana maʻamau, akā,'ānō e i ka nana aku i kona poho, a me kekahi mau pathological ano.

Ke kumu no ka lilo ana o ka nui nā minelala hao

Kekahi o ka physiological keʻano o ka hanaʻana i loko o a he mea poho o ka hao i menstruation a me ka hāpai keiki i loko o nā wāhine. Naʻe, paha ka loa nui wahi, i hiki i ke koko poho, kaʻapu kōheoheo, anaemia o na kêia kanaka, loa na maʻi, malignant neoplasms. Inā uaʻaʻole nui ka poho, ka mea, ka manawa e hoʻolakoʻia i loko o ka pōkole manawa, a ma keia hihia i ka hoʻomanawanui i ole symptoms o deficiency (sideropenic maʻi pale). Eia naʻe, loaʻa nō maʻi ma i ka nui o ka hao, hoopaa mai, akā, kona mail mea nuiʻehaʻeha. Na hihia nā icteric maʻi pale kekahi Kin, ka wā ka mea, ua 'akomi i like ka nui metabolite māhuahua - bilirubin. E hoʻomaka, ho'āʻo e ike i kona pūnao i loko o ke kino a me nā kumu o ke kiekie bilirubin i loko o ke koko: ka mea, he pono no i ka naauao o ka pathogenesis o kēia mau maʻi.

Pānaʻi hemoglobin: ka mua pae

Bilirubin pili i ka nui pigments komo i loko o ka haku mele 'ana o ka bile, a excreted mai i ke kino o i kona uku. Ua hele ma na ipu nō i loko o ka lōʻihiʻaoʻao i ke ano o ka hemoglobin, i loli nui i loko o hepatocytes, a pee i loko o ka naʻau liʻiliʻi no aku i loko o me feces ke kaiapuni hope. Penei, keia waiwai ua hana ma ka hoʻopöʻino 'ia o ka ulaula koko keena a koke pio ma ka lawe nā polokina no ka amo ana i ka papa kuhikuhiE Keʻena - ke akepaʻa. Keia hapa ua kapaiaʻauhau'ēʻaʻe paha unrelated, no ka mea, o ka bilirubin i loko o ia mea ua hoʻololiʻia. Keia hana no ka mea, i loko o ka noa palapala, ka mea hiki eaaei komo iloko ma kaʻili lahilahi o kekahi halepaahao, a mai ka ikaikaʻawahia ia kuhikuhi ma neurons. Penei, kona loaʻa mea maʻamau kūlana pale NaI.

Pae neutralization a me ka hoʻokaʻawale o bilirubin

Eia naʻe, i kēia mau nā polokina hiki ole hele pu aku la ia ia i ka naʻau liʻiliʻi, no ka mea, i no e pono ai ma ke kino no ka nui no hoi na oihana, a pela bilirubin E e koiia mai ia ia i ka loli, i ka mea i nalowale i kona waiwai a pau i loko o na keena. No keia mea, i ka hepatocytes (ake parenchyma keena mall) o kona conjugation, i ka mea, i ka paa ana o glucuronicʻakika, a,ʻano wale, aggravates ia. Ke'ī mai, ma lalo o ka hana o ka'ūhū UDP-glucuronyl-diglucuronide bilirubin hana. Next, mai na hepatocytes e komo i ka bile, a loko o ka mea, ua hoʻokuʻuʻia i loko o ka naʻau liʻiliʻi i digestion. Ano, maalo ae la oia alanui me ka mua bolus lahilahi, a laila, i ka AeXIeAaOIePEAaI, 'ole ma ka mea koʻohune flora ka mea, ua hou hookuu a ua hoohuliia mai i ka urobilinogen, a laila, urobilin stercobilin i pololei excreted ma na feces. Akā, mau loa uuku ka nui o ka bilirubin hoi aku la a hiki i ka nū aa koko, a ua mālama 'ia i loko o ka hakuʻala, ma ka mimi ua wehe.

kali o ka maʻamau

'Aʻe' ana i kēia nui pigment mail ke hana i ka ekolu nui kahua o ka hoʻonaʻauao: i ka holo ana o ke koko i loko o ka hoʻopöʻino 'ia o erythrocytes, i ka hopu a me ka hoʻokaʻawale o hepatic bile. Eia naʻe, i loko o nā mea a pau kēia mau nā kinolau, ka mea e e 'akomi i loko o ke koko: huina bilirubin ua kiʻekiʻe, kaʻoi loa kekahi ma ka pololei a me kaʻauhau'ēʻaʻe kona mahele. Penei, kona maʻamau lehulehu ma ka wai koko ua manaoia e e pili ana i 8,5-20,5 micromoles no hano. Inā keia helu maoli he 85, alaila, i ka noho ana o ka mehana hyperbilirubinemia, mai ka 86 a hiki i 169 - waena, a mahope aku ma mua o 170 mmol / H - loa. O e pili ana i ka hihia, ina oe e hōʻike i ke kiekie huina bilirubin. Naʻe, i ka noho aliʻi i koe kaawale no mahele: pololei - i 5.1, MAKAHIKI MDCCCXVI NU - 16,5 pmol / ho'āo ai.

Suprarenalʻano o ka jaundice

No laila, ma ka 'aʻe ana i ke kahua mua o ka huina bilirubin i loko o ke koko ua hoalaia kuhikuhi maʻauhau'ēʻaʻe mahele. Keia ua wehewehe ia e ka etiology o ka moku'āina,ʻo ka hoʻokāʻoi 'noho male' ana o kaʻulaʻula koko aeee i loko o ke koko. Kēia hiki ana i ka hihia o congenital ano o hemolytic anaemia (mā ma ka aaiaoe kiʻekiʻe o kaʻulaʻula koko aeee ia lakou iho, i ko lākou nā'ūhū, hemoglobin) a lilo (immunological hoouka i ka maʻi a me kona mau erythrocytes, waiū i toxins, a hoomake iho no hoi, nā mea hoʻomaʻi, koʻohune a me nā meaola). Pela, ua mahuahua ka pathogenesis kahua o ka bilirubin ma muli o ke ake aeee i wale mai i manawa e paʻa ia i ka nui dala o ka ia, a me ka mea accumulates i loko o kaʻili, a mucous membranes, a laila, i loko o ka na nā loko, ma o na la ia nā palapū nui. Pela i hana i ka suprarenalʻano o ka jaundice.

Hepaticʻano jaundice

Inā i ka 'aʻe' ia lŘlŘ ma ka lua o ka papa kuhikuhiE ke kahua, na hepatocytes mai ole i manawa eʻohi mai a me ke kō, a hiki i ka maʻamau dala a pau loa ia ia metabolite o hemoglobin, a ultimately ma ka lilo ana o nāʻaoʻao kiʻekiʻe huina bilirubin. Ke kumu no keia - kaumaha luku loli ma ke akepaʻa. Kēia nā hepatitis o kekahi mau Kin (ʻawahia, kanakaʻona mau, mea hoʻomaʻi) a me ka cirrhosis. Penei, i ke kumu o ke kiekie bilirubin i loko o ke koko moe i loko o ka mea i i ole hana ponoʻole hepatocytes, kekahi ma ka li nui i loko o ia, kekahi ma muli o ia kā lākou helu lawa. Ka loa, he pono ole kumu, o ka papa, o ka hepatitis A-type, B, C, aaeuoa, E a PP. Penei e hoʻomōhala ana i hepatic (parenchymal) 'ano o ka jaundice maʻi pale, i ua pu e ao alohilohi i na hoailona o ka mesenchymal li nui a me ka gepatotsiliarnoy ole.

Obstructive jaundiceʻano

A, o ka papa, i ka 'aʻe' ana o bilirubin pūnao hiki no hoi ana ma luna o ke kolu o ka papa kuhikuhi kahua, i ka mea i ka wa a ka excretion o ka bile. Hehe, a me keia hana ia ua wahi e na ao o ka auoiaea kuamoʻo a akepaa, a hiki mai ka vesicafellea. No ka mea, no kēia mau loli ma ka bile accumulates ma ka bladder a me ka ala, kona puʻe i nā maoli, a me ka ho'ōla ia mai hoʻi (keia kŰia ua kapaia regurgitation) i loko o ka intrahepatic ducts, a laila, - i loko o nā ipu koko, i mea no ke aha la ke kiekie huina bilirubin. I ka Ia manawa, o ka papa, ma laila nō nā loli i loko o biochemical assays. Pela, i loko o ke koko ia lŘlŘ cholehemia, a laila kiʻi i loko o ka mea bile nāʻakika a me nā'ūhū, a ma na ducts ia lakou iho i hana cholestasis, a laila stagnant secretions. Clinically, keia e e kāheaʻia jaundice sclera, mucous membranes a me ka ili (yellow ano me ka uliuli tint), a ma kālailai makemake ole wale huina bilirubin a me ka ala, a mahuahua nui, akā, i bile nāʻakika, naʻokoko, i ka nui o kona'ākilikai phosphatase, triglycerides, i ka ha awina o ka gamma-glutamyl transferase .

kumu o ka

Ke etiology o obstructive paha, e like me kona ua kapaia obstructive jaundice, mea he nui. Ka loa, he pono ole kumu o ka blockage o ka biliary'āpana pohaku ma calculous cholecystitis a cholelithiasis a helminthic infestations pōpō ka wā ilo IIeEeAIEUIeXAIIUE loko ducts paha i olelo ia cholangitis, a me ia mea e wela ai lumen occlusive ole no i ka nani o ka pā, a no ka infiltration o ia. A, o ka papa, ua wehewehe ka nui, e hoike ana i ka pololei a me ka huina bilirubin māhuahua. Ke kumu no ka mea'ē aʻe pathologies ma kekahi hihia, ua kena ae la ma ka mīkini'opihia o ka waho. Loa pinepine keia ia lŘlŘ no o ka mea ulu o kaʻeho, i hookuu mea e pono ai i ke poo o ka pancreas. Akā, i, keia kahua i hoʻomaka ai ka wā biliary cirrhosis, ka wā ducts i'uī e ulu mau mea e kukaʻi, a kaula makalii o connective'aʻaʻa.

Neonatal jaundice

Naʻe, i nā mea a pau jaundice i pathological rula o ka meaola. No laila, ina nui bilirubin ua kiʻekiʻe i loko o ke kamaiki koke i hanau ai he mau hola ma hope o ia, a me ka ili, a mucous membranes i he ao alohilohi i jaundiced, oe eʻaʻole koke hoʻokani i ka pū waikaua. Ma hope o ke keiki o ka physiological ana i kapa transient no ka mea, mea transient. O ka holo ana, ke ninau aicieeaao mai kona pīhoihoi makuahine i aoiaʻi oe i ka mea o kona kamaiki bilirubin ua ke kiekie, "He aha lā hoʻi au e hana ai?" Ke pane Ua puni hoʻi: kali. A pau keia nae hōʻike wale nō expectant'ōnaehana, no ka mea he mau lā (IeAUPIIe, IAa IO ekolu i elima) yellowness i nā nalo. A wale ina mea ua hoopanee, i ke ano o ke keiki deteriorated a me ka huina bilirubin ua kiʻekiʻe, lapaʻau ua lawe mai urgently, o detoxification Inc ua hoʻohana 'ia a me ka ultraviolet irradiation. Ano, e ka noonoo i ka pathogenesis o keia kulana.

No circulatory nā pēpē i

Ka mea i ka fetal holo i loko o ka opu mea me ka nui loa okoa mai i ike i na keiki ano hanau. Ma hāpai keiki, i ka bebe ua bapetizo i loko o ka Oe me ka amniotic loli, a no ka mea, o kona mau maʻiʻaʻai mea,ʻaʻole i kama'āina i ka lewa, a ua wrinkled moku'āina, oa inoperative. Akā, he mea nui i ke ana kahe ana o oxygen i kona nā'aʻaʻa no ko lakou ho okumu, ka ulu a me ka differentiation i ke keiki. Ia mea ke kumu o kona koko mea i pili loa hōʻike ana me ka makua. I au mamuli, ka ula koko keena kao ponoʻo Desha i ka oxygen maiʻulaʻula koko keena o ka wahine, a no keia mea, pono i ka ikaika pūliki pono aʻelaʻo ia i kona mākaukau. No laila, ka mea, ua poe ma ka hemoglobin F-type, a 'o ia hoʻi Fetal. He hiki wawe ka loaʻa o ka oxygen ma, a hāpai ia i na keena o ka fetus.

hualoaʻa

Eia naʻe, ma hope o ka hanau ana o ia he superpower ia mea AND, no ka mea, mai laila, ma luna o kona mau maʻiʻaʻai hoike mai la oia i ua ha ma luna o lākou iho, a loaʻa lākou iho ka oxygen. A ina o kona hemoglobin e noho i ka ia, ka mea e ole e hiki ke haawi ia i ke keena. No laila, ma hope o ka mua hanu hoʻomaka e 'Imi hoʻololi i kēia ka papa kuhikuhiE kumuʻiʻo oʻulaʻula koko keena mai fetal i ka makua -' ano A. kēia mea ma muli o ke hoonuiia hemolysis oʻulaʻula koko keena, a me ka manaʻo 'ana o ka hou, pololei, mai ka iwi lolo. Pela, he mea jaundice i loko o ka mua, o ka suprarenalʻano, a mahana like koke i nā mea a pau me kaʻulaʻula koko keena kahiko e luku a me ka hou poʻe hoʻopiha i ke koko.

Inc

Ka loa ka hoʻokahuli i loko o ka hana maikaʻi i ke kiekie bilirubin mea, o ka papa, hana maikaʻiʻole o nń ku maʻi, kāna hana, kena ae la ia, e loaa hou, a laila antibiotics i mea hoʻomaʻi hepatitis, detoxification ma na hihia o kaʻapu kōheoheo hoomake iho no hoi, transfusion o ke koko a me ka pihaʻulaʻula keena a hemolysis oiai ake transplantation no loa kahua o ka cirrhosis. Naʻe, ka mea e hoʻopuʻipuʻi physiotherapy, gepatoprotektory, pono hale, me ka kamepiula kumumea a me kekahiʻai ma ke kiekie bilirubin. E hana i kēia, mua, e pono e haawi aku i ka uiki e a me ka waiʻona, excessive momona, naʻokoko, spicy a me ka palaiʻai. Ua Ua pololei papaia eʻai pickles a me pickled huahana. He mea pono e kali i kaʻai ana o ka paakai, a kī a me ka kope E ole inu i nā mea a pau. Akä naÿe, i kaʻai a me ke kiekie bilirubin kikowaena pinepine liʻiliʻi meaʻai me ka helu o ka meatless wela kiliala, hua compotes, ke kūapoʻana i ke keʻokeʻo berena e lauoho. Ua, mahalo e kuhikuhi ai ', e hoʻomaka i ka maikaʻi au, a e haʻalele ultimately maʻi oe.