I-Bilirubin iyinhlanganisela yamakhemikhali, enye yezingxenye eziyinhloko ze-bile ezikhiqizwa ngamangqamuzana wesibindi futhi zibandakanya izinqubo zokugaya ukudla. I-pigment enobuthi ehlanganiswa lapho i-erythrocyte ebhujisiwe noma eyonakalisiwe yizingxenye zegazi, futhi lokhu kwenzeka esitezini. Ngaphezu kwalokho, i-bilirubin ingena emangqamuzaneni wesibindi futhi iphenduke ibe enye, ifomu elununcibilika kwamanzi.
Iziqephu ze-bilirubin
I-Bilirubin emzimbeni womuntu futhi, ikakhulukazi egazini legazi, limelelwa izinhlobo ezimbili zezingxenyana:
- Ingqikithi engaqondakali (mahhala) , okuyi-pigment ye-bile, engenawo emanzini futhi enekhono lokudlula i-membranes yeseli nokuphazamisa umsebenzi wayo.
- Ingqikithi eqondile (eboshwe) , etholakala ngokuhlanganisa i-bilirubin yamahhala e-hepatocytes futhi enezindawo ezingenawo amanzi.
Isamba se-bilirubin engacacile futhi eqondayo egazini liphelele (inani) li-bilirubin, ukuzimisela okwenziwe ngesikhathi sokucwaninga kwegazi ngegazi elimnyama. Ake sicabangele, yikuphi okujwayelekile noma isilinganiso se-bilirubin jikelele egazini labesifazane nokuthi yikuphi ukuhlaziywa kwenkomba enikeziwe kungatshela.
Umkhuba we-bilirubin ephelele egazini
Ukuze unqume inani le-bilirubin elisekhompyutheni yokujikeleza, igazi lithathwe emthanjeni we-ulnar ngesikhathi sokusa esibelethweni esingenalutho. Kusetshenziswe izindlela ezehlukene zokuhlaziywa. Kufanele kucatshangelwe ukuthi izici ezihlukahlukene zithinta izinga lokuhlaziywa. Ngakho-ke, imiphumela ingase ibe yinkinga enkulu uma ngaphambi kokutadisha isiguli sithathe amalungiselelo e-steroid, i-erythromycin, i-phenobarbital, ukudla okudliwayo okuqukethwe okuphezulu kwe-carotenoids (izaqathe, ama-apricot). Izindinganiso ezingalinganiselwe zinganqunywa yiphutha labasebenzi bezempilo abavumela ukuma isikhathi eside kokufunda ngaphansi kokucwaninga ekukhanyeni, ngaleyo ndlela babangele uketshezi lwe-serum.
Isimiso sabesifazane yizilinganiso ze-bilirubin esiphelele, eguquguqukayo phakathi kuka 3.4 - 17.1 μmol / l (okuyi-80% ewela engxenyeni engavamile). Kubantu, umkhawulo ongaphezulu wezindinganiso ezijwayelekile zalesi sibonakaliso kuphakeme kakhulu. Lokhu kungenxa yokuthi inombolo encane yama-erthrocyte ikhiqizwa emzimbeni wesifazane. Kumele kuqashelwe ukuthi phakathi nesikhathi sokubeletha, ikakhulukazi ku-trimester yokugcina, kungase kube nokunciphisa okuncane kwesimiso senkomba ebhekene nombuzo, ngenxa yokuphulwa kwe-bile esesibindi. Nokho, emva kokulethwa, inani livamile.
Inani lokuxilongwa lenkomba ye-bilirubin esiphelele
Ukuhlushwa kwe-bilirubin ephelele ekusakazeni kwegazi kunikeza ulwazi olubalulekile mayelana nekhwalithi ye-metabolism ye-pigment emzimbeni, amakhono asebenzayo ezitho ezibandakanyeka kule nguquko, evumela odokotela bezobuchwepheshe ezihlukahlukene ukuthi bahlolisise futhi bahlole ukuphumelela kokwelashwa kwezifo eziningi. Ngokuvamile, lokhu kuhlaziywa kunconywa ukuthi i-pathology engasolwa, isibindi se-hemolytic. Kumele kucatshangwe ukuthi isibonakaliso sezinga le-bilirubin esiphelele asivumeli ukuba sibone ngokucacile imbangela yokwanda kwayo. Ngakho-ke, lolu cwaningo kufanele luhlanganiswe ngokutadisha izingxenyana ze-bilirubin egazini.
Uma phakathi nokuhlaziywa kunqunywa ukuthi ukwanda kwe-bilirubin engqikithi kubangelwa okuqukethwe okwandisiwe kwengxenyana engavamile, lokhu kungase kubonise:
- i-hemolytic anemia ;
- i-malaria;
- Isifo sikaGilbert;
- i-Kriegler-Nayar syndrome, njll.
Lapho inani le-bilirubin likhuphuka ngenxa yengxenyana eboshiwe, umuntu angasolisa mayelana:
- i-Dabin-Johnson syndrome;
- i-hepatitis;
- i-cirrhosis;
- i-cholelithiasis, njll.
Ukwedlulisa izimiso zombili izingxenye kungatshela ngalezi zifo ezinjengalezi:
- umdlavuza wesibindi;
- i-alveococcosis yesibindi;
- i-hepatitis yegciwane, nabanye.
Ukunciphisa i-bilirubin ephelele egazini kuyabonakala emva kokulahlekelwa kwegazi okukhulu komzimba, ngokumelene nesimo sokudonswa komzimba jikelele.