Uma ukuhlaziywa kwezinto eziphilayo kubonisa i-bilirubin ephakeme egazini, khona-ke kungenzeka kube nezizathu eziningana. Ukuze uziqonde, kufanelekile ukucabangela ukugaya umzimba kwalesi sici.
I-metabolism ye-bilirubin
I-Bilirubin iyi-enzyme ye-bile. Ikhona egazini ezingxenyeni ezimbili: ngokungaqondile (mahhala) nangokuqondile.
Amaseli aphuzi egazi (i-erythrocytes) enkambweni yokuphila komuntu ahlale efa futhi ashintshwa yizintsha. Izidumbu zikhulula i-hemoglobin, ewela ngaphansi kwamaketanga e-globin kanye ne-heme molecule. Lesi siphendu saguqulwa yi-enzyme mahhala (ngokungaqondakali bilirubin). Kule fomu, into enobuthi iyingozi, ngoba ihlakazeka emafutheni (kodwa hhayi emanzini), kalula angene emangqamuzaneni futhi ahlukumeze umsebenzi wawo ojwayelekile. Ngenxa yokuthi imvelo inikeze indlela yokwenza "i-neutralizing" ye-bilirubin engaqondile: it, ukuxhuma ne-albinini yegazi, ishukumisela esibindi, bese-ke ngaphansi kwesenzo se-enzyme iba incibilika emanzini futhi igxiliwe ne-bile ngokusebenzisa amathumbu amancane. Lokhu yi-bilirubin eqondile. Ngokulinganiselwe, zombili izingxenyana zinikeza i-bilirubin ejwayelekile, futhi uma iphakanyisiwe, izimbangela kufanele zifunwe ngokwephula indlela echazwe ngenhla.
Kungani i-bilirubin iphakanyisiwe?
Sinikeza isigaba esenziwe lula.
I-indirect bilirubin inganyuswa ngenxa ye:
- ukuphazamiseka ohlelweni lwe-hematopoietic;
- izifo zesibindi.
Ingxenyana eqondile ye-enzyme itholakala egazini ngaphezu kwesijwayelekile lapho:
- izifo zesibindi;
- ukungapheli kwemithwalo ye-extrahepatic bile.
Manje cabangela iqembu ngalinye ngokuningiliziwe.
I-bilirubin ephezulu engacacile
Ukwephulwa kwesistimu ye-hemopoietic kubandakanya i-hemolytic anemia, lapho inani elikhulu le-erythrocyte libhujiswa khona. Bakhulula i-hemoglobin eningi, ngakho-ke lokhu kungesizathu sokuthi kungani i-birectubin engaqondile ikhuphuka. Isibindi nje asinaso isikhathi sokubhekana nokuguqulwa kwayo sibe yindlela eqondile (le ngxenyana ihlala ingavamile) futhi iqhubekela phambili.
Izimpawu ze-anemia enjalo:
- isiyezi;
- ubuthakathaka jikelele nokukhathala;
- i-pallor;
- i-hemoglobin ephansi nenombolo yamaseli abomvu egazi;
- ipeni ekhulisiwe.
Ukungena okufanayo kule enzyme kungase kube ngenxa ye-malaria ne-sepsis.
Phakathi kwezifo ze-hepatic, ngenxa yokuthi izinga le-bilirubin elingavamile liphakeme kangakanani, faka:
- Isifo sikaGilbert sika ;
- i-Kriegler-Nayyar syndrome;
- I-Lucy-Driskol syndrome;
- wathola i-jaundice engeyona i-hemolytic.
Izinkinga ezinjalo azivamile.
I-bilirubin ephezulu ephezulu
Ezifo zesibindi, ukuphuma kwe-bile kungaphazanyiswa, ngenxa yokuthi i-bilirubin equkethwe kuyo ayikhiphi ngokuphelele emathunjini amancane, kodwa iphonswa egazini. Lokhu kwenzeka ngegciwane lesandulela ngculaza, uhlobo lwebhaktheriya, oluyingozi kanye nolwemvelo.
Ezinye izimbangela ze-bilirubin ephezulu egazini:
- i-cholestasis ye-intrahepatic;
- i-cirrhosis eyinhloko ye-biliary;
- i-jaundice yabesifazane abakhulelwe ngenxa yobuzwe besifazane abathile kuya kokuqukethwe okuphezulu kwe-estrogens;
- izicubu zesibindi.
Ibile ushiya isibindi ku-duodenum ngokusebenzisa umzila owodwa, futhi uma i-lumen yayo ivaliwe, i-bilirubin eqondile ifakwe egazini. Lokhu kwenzeka uma:
- ukucindezela kwamadaysi ensimbi ngenxa yangaphandle kokuvuvukala okungapheli noma okunamandla kwamaphancase (pancreatitis);
- isibindi se-echinococcus (ama-parasite);
- i-diverticulum ye-duodenum (i-anomaly congenital);
- izicubu ze-duodenum noma ama-pancreas;
- i-aneurysm ye-arter hepatic;
- i-cholelithiasis;
- i- cholangitis enesifo esibi nesiguli ;
- izicubu ze-bile ducts.
Ukwelashwa kwe-bilirubin ephakeme egazini kunqunywe kuye ngezimbangela ezenza ukwanda kwe-enzyme.