Bilirubin. Ke kūmau o kona maʻiʻo. 'ano o ka jaundice

All kanaka i ka kekahi nui o na bilirubin i loko o ke koko. Kūmau ka mea, e ia i oi aku mamua o 17,1 mmol / L. I kekahi manawa, ia wahi, i hiki ai ka haohao ana i ka wa a ka bilirubin i loko o ke kino ua hua mai la i ka nui loa ma mua o ke paka ke ola i ke akepaʻa, me ka maʻamau hana. Rise bilirubin maʻiʻo ma muli o ke ake pōʻino, i ke ālai ia 'aʻe i ka excretion o ka bilirubin e kekahi. Eia kekahi, i ka wa plugging Biliary ake lohi, a me ka poe liilii, na mea loko bilirubin. Ke kūmau o kona maʻiʻo i loko o ke koko ua oi. Keia ano ua kapaia hyperbilirubinemia. Ma keia bilirubin ua loaa i loko o ke kino a hiki i ka hoʻoholo ma mua lehulehu, a laila, komo iloko o ka'aʻaʻa, e haawi ana ia i ka melemele waihoʻoluʻu. Keia ano ua kapaia jaundice.

I mea e nui loa a me ka pololei 'ike jaundice kānāwai no ka mea kumu, oe e mua pohihihi mai ana, e hana i ka wehe ana o bilirubin. Bilirubin hele mai, mai ka heme, i uaʻano nui i loaʻa i ke kino e like me hemoprotein. Hemoglobin kuu i ka hoʻopöʻino 'ia o ke ooʻulaʻula koko keena, o ka nui loa o ke kumu bilirubin (70-80%). Ke koena o ka bilirubin ma ka hola like i hana mai hemoglobinʻiliahi erythrocytes a me kā lākou mau precursors i loko o ka iwi lolo a me ka heme-i loaʻa nā'ūhū e like me catalase, cytochrome, etc. Ma keia hihia, 250-400 mg -. Ua ka huina dala i loko i ua hana lā kēlā me kēia i loko o ka kanaka makua kanaka bilirubin. Normal i ka manawa o Ka Ikepili - Index o 0.2-1.0 mg / DL.

Inā ka bilirubin na ma ka wai koko aku i ka paepae puka, alaila, i ka jaundice. Keia hana no ka mea, o ka bilirubin, a me ka nui loa mamua o ka kūmau, hoʻomaka e kamaʻilio me ka laholio olona, o ka ili a me ka conjunctiva. E like me keʻano papa hana o ka ho okumu jaundice mea o ka ekolu ano.

1. Hemolytic (ole suprarenal).
2. Ake parenchymal poino, kena ae la ia e (hepatocellular).
3. ʻonou biliary'āpana iaʻi (obstructive a me mechanical).

Hemolytic jaundice wehewehe aku ma ka nui palapala unconjugated bilirubin, a me ka stagnation i loko o ke kino. Ka wai koko huina bilirubin pii ma muli o ke unconjugated. Mimi bilirubin mea ma kahi'ē i nā mea a pau. Kēia Ua wehewehe ma ka hikiʻole o unconjugated bilirubin e komo iloko ma kaʻaʻa puʻuwai Kānana, i ua oleʻino wale. Hemolytic jaundice hiki e kena ae la hemolytic ka hoʻoponopono ulia, malaria, intravascular hemolysis hana o toxins, wikamina B12 deficiency, a me ka transfusion o incompatible koko. Hoonuiia pae o unconjugated bilirubin i ia me Gilbert ka maʻi pale. People me keia maʻi pale ua aneane mau kaulana i loko o kona yellow mucous a me ka ili. Ke kumu no keia moe i loko o ka mea ana i ke akepaʻa mea,ʻaʻole hiki ke paʻa, līkaia a conjugated bile capillaries bilirubin.

I ka parenchymal jaundice , piʻi pū me nā conjugated a me ka unconjugated bilirubin. Ka loa e like me ka kumu o keia kulana hiki ke nee ma kaʻae mai i ke koko o unconjugated bilirubin excretion ma ka bile Nyos capillaries conjugated bilirubin mai ake keena e like me ingress o conjugated bilirubin hepatic bile manawa koko capillaries, ma ka poino ake keena. I ka Ia manawa ke kiekie pae o bilirubin i loko o ke koko lāʻau lapaʻau ua pu ma ka hoomahuahua i loko o kona excretion i loko o ka mimi. Naʻe, i loko o nā kuʻina kakahiaka o ka maʻi i loko o mimi bilirubin ua kokoke paa, no laila, hiki ole ia i ka hōʻike e kapaia ka wanaʻaoʻike.

Jaundice kena ae la hepatic biliary'āpana iaʻi, hoʻopōʻino outflow bile a piha panina o ka Kanal ka laau awaawa, (ʻeho, li nui, Stone listen'ōlelo.). Me keia ano o jaundice hepatic capillaries hohola no ka mea, accumulates ma ke akepaʻa bile, hepatocytes hoʻomaka e kaomi, a hele aku i loko o ka capillaries koko conjugated bilirubin. Ke kūmau i loko o ke koko wai koko, piʻi pū, a ina au mamua i ke anaʻaʻa puʻuwai paepae (ma kahi o 30 mmol / k), ka bilirubinʻia i loko o ka mimi.