Lapho kuhlolwa ukuhlolwa kwegazi, ama-indices amathathu e-bilirubin ayahluka: ingxenyana eqondile, ingxenyenzana eqondile, inani le-bilirubin (isibalo sezingxenyana eziqondile noma ezingaqondile). Ukwakhiwa kwe-bilirubin eqondile neqondakali kuqhubeka ngokuya ngezindlela ezahlukene, ngakho-ke, ukuze kutholakale kahle ukuxilongwa ekuhlaziyweni kwegazi ngegazi elimnyama, kubalulekile ukuhlukanisa ukuthi iyiphi i-bilirubin eyanda - ngqo noma engaqondile. Cabanga ngalokho okuqondile (okuboshwe, okuhlanganisiwe) i-bilirubin, yiziphi izindinganiso ezijwayelekile zalesi sibonakaliso, futhi kusho ukuthini uma i-bilirubin eqondile egazini iphakanyisiwe.
Ukwakhiwa kwe-bilirubin eqondile emzimbeni
Le ngxenyana ye-pigment bilirubin iyinhlanganisela yamakhemikhali eyenziwa ngama-hepatocytes (amangqamuzana wesibindi), ngemva kwalokho iningi lalo lihlangana ne-bile emathunjini. Lapha, lihlukaniswa futhi lithengiswa emzimbeni, ikakhulukazi ngamanzi kanye namanani amancane - ngokusebenzisa izinso. Ingxenye encane ye-bilirubin eqondile ivela emangqamuzanini yesibindi eya egazini.
I-bilirubin eqondile ayinobuthi obuncane (uma kuqhathaniswa ne-indirect bilirubin), le ngxenyana imnandi kakhulu. Igama elithi "ngqo" i-bilirubin livela eqinisweni lokuthi lesi sici sinikeza ukusabela okuqondile nge-diazo reagent (isisombululo esimnandi se-diazophenylsulphonic acid) esetshenziselwa ukuhlaziywa kwemvelo.
Ukujwayelekile kanye nenani lokuxilonga le-bilirubin ngqo
Isibonakaliso se-bilirubin eqondile yegazi yisifo esibucayi se-pathologies yesibindi. Isimiso sabantu abadala sikhona kusuka ku-0.86 kuya ku-5.3 μmol / l, okungaba ingxenye yesine yenani le-bilirubin eliphelele egazini. Kumele uqaphele ukuthi umkhawulo oqondile wangempela wendabuko uncike kuma-reagents asetshenziselwa ukunquma le nkomba, kodwa iphutha alidluli ku-10-15%.
Ngokwayo, i-bilirubin eqondile ayiyona ingozi ekhethekile empilweni yabantu, i-tk. uxhumekile, futhi ngenxa yalokho, kungabi nengozi futhi kufanele ashiye igazi. Kodwa kubalulekile ukuthi azikho izithiyo endleleni yayo, futhi uxhumo oluhloselwe ukuhoxiswa alubuyiswa emuva.
Ukuhlushwa okuqhubekayo kweqanda le-bilirubin eliqondile (i-conjugation hyperbilirubinemia) libonisa izinqubo ze-pathological. Kulesi simo, i-bilirubin eqondile iqoqa izicubu ezithambile zomzimba, ama-eyeballs, isikhumba. Ngokwemitholampilo ezigulini, lokhu kungabonakaliswa izimpawu ezifana nokumnyama komchamo, ubuhlungu ku-hypochondrium enhle, ukukhwabanisa isikhumba, i-jaundice.
Yisho ukuthini i-bilirubin ephakeme ngokuqondile?
Uma i-bilirubin eqondile egazini ikhuphuka, izizathu zalokhu zingase zihlobene nezinqubo ezihlukahlukene ze-pathological, okungukuthi:
- nge- hemolysis eyanda (ukubhujiswa) kwamangqamuzana egazi we-erythrocytes, okwenza kube yi-bilirubin eyedlulele;
- ngokwephulwa kokuguqulwa kwamagciwane kwe-bilirubin kuma-hepatocytes;
- ngokuphulwa kwemishini ye-excretion ye-bilirubin emzimbeni.
Izifo ezingabizwa ngokuthi izimbangela zokukhula okwenziwe yi-bilirubin ngqo egazini zifaka:
- ukulimala kwesibindi esithathelwanayo (kuhlanganise nesifo se-virus nesibindi)
- isifo sofuba esibangelwa i-hepatitis;
- i-auto-immune hepatitis (kuhlanganise nalabo abahlotshaniswa nezilonda ezizimele zenye izitho);
- i-cholestasis ye-intrahepatic;
- i-cirrhosis biliary ;
- izicubu ze-pancreatic;
- i-cholelithiasis;
- izilonda ze-helminthic;
- izicubu zesibindi (kuhlanganise nomdlavuza);
- izidakamizwa zesibindi;
- I-Dabin-Johnson syndrome;
- I-Rotor syndrome;
- i-cholangitis ye-sclerosing;
- i-jaundice yabesifazane abakhulelwe, njll.