Bilirubin yog ib qho kua kab mob, uas yog ib qho khoom seem ntawm kev ua puas ntawm cov laus cov ntshav liab. Feem ntau, ib tus neeg laus hauv plab ntshav muaj tsawg tsawg ntawm cov khoom no (3,4 - 22,2 μmol / l), thiab kuj muaj qee yam zis rau hauv urobilinogens (4 mg) txhua hnub.
Kwv yees li ntawm 96% ntawm bilirubin nyob rau hauv cov ntshav yog ib qho tsis txuam yuaj tiv thaiv bilirubin, uas yog cov dej tsis haum thiab muaj tshuaj lom, vim hais tias nws muaj peev xwm yooj yim nkag mus ntawm cell membranes thiab cuam tshuam cov haujlwm tseem ceeb ntawm cov hlwb. Qhov seem ntawm 4% yog ncaj nraim rau hauv bilirubin, soluble hauv dej, lim los ntawm ob lub raum thiab tso tawm hauv cov zis. Tag nrho cov bilirubin yog kev sib luag ntawm txoj kev ncaj thiab indirect bilirubin.
Hauv qee qhov pathologies, cov ntsiab lus ntawm bilirubin nyob rau hauv cov ntshav, thiab ntxiv rau hauv cov zis, nce. Qhov no ua rau jaundice thiab darkening ntawm cov zis.
Qhov ua rau cov neeg laus paub ntau dua
Cia peb xav li cas, vim li cas cov neeg los yog ib txwm paub bilirubin hauv tus kabmob ntawm tus tibneeg tuaj yeem tsa lossis nce siab ntxiv.
Qhov ua rau ntawm txoj kev ncaj nce ncaj qha bilirubin
Qib ntawm qhov ncaj qha rau hauv cov ntshav tau nce vim yog ua txhaum txoj kev tawm ntawm lub cev. Vim li ntawd, cov kua mis yog xa mus rau cov ntshav, tsis yog hauv plab. Vim li cas qhov no feem ntau yog cov kab mob hauv qab no:
- kab mob siab kheesxaws ntawm tus kab mob viral etiology hauv daim ntawv mob (kabmob A, B, nrog rau kev kis tus kab mob mononucleosis);
- kab mob siab (hepatitis) ntawm kab mob bacterial etiology (leptospirosis, brucellosis);
- kab mob siab ntsws ntev ntev;
- autoimmune kab mob siab;
- tshuaj tua kab mob (vim yog tshuaj hormone therapy, cov tshuaj tsis yog cov tshuaj tua kab mob, tshuaj siv tshuaj tiv thaiv thiab tshuaj tiv thaiv kev mob ntsws);
- lom cov kab mob siab (lom cov tshuaj hu ua fungal poisons, muaj tshuaj lom neeg muaj tus kab mob);
- mob kheesxaws ntawm lub gallbladder, lub siab lossis pancreas;
- cholelithiasis;
- biliary cirrhosis;
- syndromes ntawm Rotor, Dabin-Johnson.
Qhov ua rau muaj kev tiv thaiv kom tsis muaj zog
Ib qho kev nce rau hauv cov ntsiab lus ntawm kev txheeb ze bilirubin tuaj yeem txuam nrog txoj kev puas tsuaj ntawm cov ntshav liab los yog muaj kev cuam tshuam rau kev ua haujlwm ntawm cov kis ntawm kev tshawb fawb. Nws yog tsim nyog sau cia tias, txij li thaum Indirect bilirubin nyob hauv dej tsis yaj, txawm tias muaj qhov nce hauv nws qib nyob rau hauv cov ntshav, tsis muaj kev hloov hauv kev ntsuam xyuas zis. Yog li, vim li cas qhov no yuav yog:
- Cov kab mob hu ua congenital hemolytic anemia (sickle cell, spherocytic, nesferocytic, thallasemia, Marciyafawa-Michele disease);
- theem nrab (hemolytic anemia) (tiv thaiv rheumatoid kev mob caj dab, kev mob lupus erythematosus, lymphocytic leukemia, lymphanganulmatosis, thiab lwm yam);
- medicinal hemolytic anemia (txuam nrog cov tshuaj insulin, aspirin, levomycetin, levofloxacin, cephalosporins, thiab lwm yam);
- syndromes ntawm Lucy-Driskol, Gilbert, Kriegler-Nayyar;
- kab mob kis kab mob (malaria, typhoid, sepsis);
- lom cov kab mob hu ua hemolytic anemia ( lom cov tshuaj lom, poisons, kab tom, nab, lom nrog nceb, txhuas, tooj liab ntsev, thiab lwm yam).
Qhov ua rau kom paub bilirubin thaum cev xeeb tub
Kev paub bilirubin feem ntau pom cov poj niam cev xeeb tub (jaundice thaum cev xeeb tub). Qhov laj thawj ntawm qhov no yog muab faib ua ob pawg:
- vim yog qhov kev xeeb tub ntawm cev xeeb tub (mob ua kom lub siab hloov ntawm lub siab, mob ntsws, ntau ntuav, thiab lwm yam);
- tshwm sim los ntawm ntau cov kab mob sib kis (kab mob siab, mob tsis tuag, thiab lwm yam).
Qhov ua rau kom paub bilirubin nyob rau hauv cov zis
Ib theem zuj zus ntawm cov kaus poom hauv cov zis yog pom hauv cov kab mob nrog rau kev puas tsuaj rau lub hlwb
- kab mob siab;
- cirrhosis ntawm lub siab ;
- metastatic daim siab puas;
- daim siab mob, thiab lwm yam.
Kev kho mob ntawm cov bilirubin
Yog tias kev tshuaj ntsuam pom tias bilirubin nyob rau hauv cov ntshav los yog nyob rau hauv cov zis, cov ntsiab lus ntawm kev kho yuav yog nyob ntawm seb qhov kev tawm ntawm cov kab mob no li cas. Feem ntau, txoj kev kho muaj xws li kev noj tshuaj thiab kho txoj kev noj haus.