Ufuna ukwazi ngento ephuzi egazini lakho? Ake sixoxe ngokuhlolwa kwe-bilirubin!

O, wake waphawula ukuthi ngezinye izikhathi, ikakhulukazi ezinganeni ezisanda kuzalwa, umzimba uphenduka ophuzi? Noma ingabe udokotela wake wakutshela noma othile omaziyo ukuthi enze isivivinyo se-`(Bilirubin)`? Kuvamile ukuzizwa ukhathazekile kancane uma uzwa igama elithi bilirubin. Kodwa ungakhathazeki! Namuhla, sizokhuluma ngalokhu kalula, ngendlela ongayiqonda.

Kuyini i-bilirubin? Masiyiqonde kalula!

Cabanga ngakho, amangqamuzana abomvu egazi (abizwa nangokuthi amangqamuzana egazi) emizimbeni yethu ahlala eshintshwa. Lapho amangqamuzana abomvu egazi amadala ephuka, akhiqiza into ephuzi ebizwa ngokuthi i-bilirubin . Kufana nalokho okusele lapho ulahla izinto ezindala.

Manje le bilirubin ihamba egazini lethu iye esibindini. Isibindi sifana nefektri emzimbeni wethu, sihlanza izinto ezingafuneki. Isibindi siqoqa le bilirubin, siyihlanganise neminye imikhiqizo engcolile, bese senza uketshezi olubizwa ngokuthi "i-bile." Uyazi, le bilirubin yilokho okunikeza i-bile umbala ophuzi. Bese le bilirubin idlula emathunjini ethu iphume emzimbeni. Yebo, le bilirubin iyingxenye enkulu yalokho okunikeza indle yakho umbala wayo.

Ngakho-ke, kuyini ukuhlolwa kwegazi kwe-bilirubin?

Kulula kakhulu. Udokotela uthatha isampula encane yegazi emthanjeni osengalweni yakho bese eyithumela elabhorethri ukuze ihlolwe. Ilabhorethri ilinganisa ukuthi ingakanani i-bilirubin egazini lakho. Babheka ukuthi izinga lingaphakathi kwesilinganiso esijwayelekile, noma ukuthi liphezulu kakhulu noma liphansi kakhulu. Uma izinga le-bilirubin lingajwayelekile, kusho ukuthi kungase kube nenkinga endaweni ethile enqubweni eqala ngokuwohloka kwalawo maseli abomvu egazi amadala bese iphetha ngokuthi i-bilirubin isuswe emzimbeni.

Amazinga e-bilirubin egazini asitshelani?

Odokotela bavame ukwenza lokhu kuhlolwa kwe-bilirubin ukuhlola impilo yesibindi sakho . Lokhu kumane kungenye yezivivinyo eziningi zokusebenza kwesibindi. Uma lezi zindinganiso ziphezulu noma ziphansi, kungabonisa ukuthi isibindi singaphansi kohlobo oluthile lokucindezeleka. Kodwa-ke, amazinga e-bilirubin angajwayelekile akusho ngaso sonke isikhathi ukuthi kunenkinga ngesibindi. Ngezinye izikhathi inkinga ingase ibe kwenye indawo.

Kungani leli zinga le-bilirubin likhuphuka? (I-Hyperbilirubinemia)

Kungaba nezizathu eziningana zokuthi kungani i-bilirubin inqwabelana egazini lakho. Ake sibheke ukuthi ziyini:

• Amaseli akho abomvu egazi aphuka ngokushesha kakhulu: Ezinye izifo zegazi, njenge-hemolytic anemia, zibangela ukuba amaseli abomvu egazi aqhekeke ngokushesha kakhulu, okuholela ekwandeni kwe-bilirubin. Cabanga ngakho njengemboni ethola umkhiqizo omningi kakhulu.
• Isibindi sakho singase sibe nobunzima bokususa ngisho nenani elijwayelekile le-bilirubin: Ngezinye izikhathi lokhu kungenzeka uma isibindi sivele sitholakale entweni enobuthi ngokuzumayo. Noma, isibindi singase singasebenzi kahle ngenxa yesifo sesibindi sesikhathi eside (`(Isifo sesibindi esingamahlalakhona)`).
• Uhlelo lwakho lwenyongo alukhiphi inyongo ngendlela efanele:Kungase kube nokuvaleka kwemisele yenyongo noma inyongo, okubangela ukuthi inyongo ibuye egazini. Lokhu kungenzeka nalapho kukhona amatshe enyongo.

Cabanga nje, uma ipayipi eliletha amanzi ethangini lamanzi likhuliswa futhi ipayipi elikhipha amanzi ethangini livalekile, ithangi lizobila.

Ingabe amazinga e-bilirubin angaba phansi? (Hypobilirubinemia)

Yebo, ngezinye izikhathi amazinga e-bilirubin angaba phansi. Eminye imithi ingabangela lokhu. Isibonelo, amanye ama-antibiotic, amaphilisi okuvimbela inzalo, amaphilisi okulala, kanye nemithi yokuxhuzula kungabangela ukwehla kwamazinga e-bilirubin. Kodwa-ke, amazinga aphansi e-bilirubin ngokuvamile awayona into okufanele ukhathazeke ngayo.

Kwenzekani ngempela ku-bilirubin emizimbeni yethu?

I-Bilirubin iwumkhiqizo ongcolile osuswa emangqamuzaneni egazi abomvu amadala. Ngokuvamile, imizimba yethu iyikhipha ngamathumbu. Kodwa-ke, sekutholakale ukuthi inezinzuzo ezincane njengoba ikhishwa. Ucwaningo olusha lusikisela ukuthi i-bilirubin isebenza njenge-antioxidant futhi ingasiza ekusivikeleni ezifweni zenhliziyo nemithambo yegazi.

Kodwa, njenganoma yini, uma ikhuphuka kakhulu, ingaba yingozi . Uma i-bilirubin eningi inqwabelana egazini lakho, ungase uzizwe ungakhululekile. Ingavuselela nezinzwa ezingaphansi kwesikhumba sakho futhi ikubangele ukulunywa.

Yiziphi izimpawu ze-bilirubin ephezulu?

Uphawu oluyinhloko lwe-bilirubin ephezulu yi -jaundice . Lokhu kuwukuba phuzi kwesikhumba sakho kanye nokumhlophe kwamehlo akho. Lokhu kuvame ukuba uphawu lokuqala udokotela azolubheka lapho ehlola amazinga akho e-bilirubin.

Futhi, lapho amazinga e-bilirubin egazini ekhuphuka, izama ukuphuma ngomchamo. Lokhu kungabangela ukuthi umchamo ube mnyama ngombala (njengombala wetiye).

Futhi, uma i-bilirubin ingakhishwa kahle esitulweni, indle ingaba nombala okhanyayo (njengobumba) .

Abanye abantu bangaze baklwebhe imizimba yabo kakhulu .

Ukuhlolwa kwegazi le-bilirubin kwenziwa kanjani?

Lokhu kulula kakhulu.

• Ngokuvamile, kumuntu omdala, udokotela noma umhlengikazi uzothatha isampula yegazi elincane emthanjeni osengalweni yakho . Ungase ucelwe ukuthi ungadli noma uphuze lutho amahora ambalwa ngaphambi kokuhlolwa. Ungase uzwe ubuhlungu obuncane lapho inaliti ifakwa futhi ikhishwa, kodwa izophela ngemizuzu embalwa. Isampula yegazi bese ithunyelwa elabhorethri. Kuthatha isikhathi ukuthi umbiko ubuyeke.
• Uma umntwana osanda kuzalwa ene-jaundice , udokotela uzohlola izinga le-bilirubin ukuqinisekisa ukuthi aliphezulu kakhulu. I-jaundice ijwayelekile ezinganeni ezisanda kuzalwa futhi ngokuvamile ayiyona into okufanele ikhathazeke ngayo. Kodwa-ke, uma izinga le-bilirubin liphezulu kakhulu, lingaba yingozi enganeni.Igazi livame ukuthathwa ezinganeni ngokuzihlaba izithende ngenaliti encane (induku yesithende) . Lokhu ukuhlolwa okuvamile okwenziwa ezinganeni ezisanda kuzalwa.

Kuyini embikweni engiwutholayo? Kusho ukuthini?

Umbiko wokuhlolwa owutholayo uzobonisa amazinga e-bilirubin egazini lakho ngezinombolo. Empeleni kunezinhlobo ezimbili ze-bilirubin egazini lakho: i-bilirubin eya esibindini ukuze ihlanzwe, kanye ne-bilirubin ephuma esibindini ngemva kokuhlanzwa. Umbiko wakho uzobonisa lezi zinhlobo ezimbili ngokwehlukana, kanye ne-bilirubin iyonke. Ngokuvamile iboniswa ngamayunithi abizwa ngokuthi ama-milligrams nge-deciliter (mg/dL).

Kuyini i-Bilirubin eqondile nengaqondile? (Ehlanganisiwe vs. Engahlanganisiwe)

Kalula nje:

• Uhlobo lwe-bilirubin oluya esibindini ukuze luhlanzwe yi -bilirubin "engaxutshwanga" . Ayincibiliki emanzini. Iya esibindini esiboshwe yiprotheni ebizwa ngokuthi i-albumin egazini. Yingakho ngezinye izikhathi ibizwa ngokuthi yi-bilirubin "engaqondile" embikweni. Ngoba ayinakulinganiswa ngqo. Itholakala ngokukhipha i-bilirubin ehlanganisiwe ku-bilirubin iyonke.
• Ngemva kokuba isibindi sihlanze le bilirubin, siyibopha ku-molecule kashukela bese siyenza incibilike emanzini. Kulapho-ke kuphela lapho ingadlula khona emathunjini axutshwe ne-bile. Le bilirubin ehlanzwe yisibindi ibizwa ngokuthi i-"conjugated" bilirubin . Embikweni, ibizwa nangokuthi i-"direct" bilirubin , ngoba ingalinganiswa ngqo.

Uyaqonda? Elinye ngaphambi kokuba liye esibindini, kanti elinye ngemva kokuba selihlanzwe yisibindi.

Yiliphi izinga le-bilirubin okufanele sikhathazeke ngalo?

Kungaba nokwehluka okuncane kulokho ilabhorethri ngayinye ekubheka njengamazinga ajwayelekile e-bilirubin. Kodwa ngokuvamile, izinga le-bilirubin eliphelele eliphakathi kuka-0.2 no-1.3 mg/dL libhekwa njengelijwayelekile kubantu abadala nezingane . Uma izinga lakho liphakeme kunalokhu, udokotela wakho angenza ezinye izivivinyo ukuthola imbangela. Kungabonisa isimo esidinga ukunakekelwa. Kodwa-ke, i-bilirubin ephakeme ngokwayo akuyona isimo esibucayi futhi ngokuvamile ayidingi ukwelashwa.

Kodwa-ke, ezinsaneni ezisanda kuzalwa, indaba ihlukile kancane. Amazinga ajwayelekile e-bilirubin ezinganeni angasukela ku-1.0 mg/dL kuya ku-12.0 mg/dL. Ezimweni eziningi, i-hyperbilirubinemia ezinsaneni ezisanda kuzalwa ilindelekile futhi izophela yodwa. Kodwa-ke, odokotela bazoqhubeka nokuqapha lesi simo ukuze babone ukuthi amazinga e-bilirubin akhuphuka ngokushesha kakhulu noma aphansi kakhulu. Uma bekwenza, kungaba yisimo esibi futhi sibe yingozi enganeni.

Yiliphi izinga le-bilirubin eliyingozi enganeni esanda kuzalwa?

Odokotela batusa ukuqala ukwelashwa kwezinsana ezisanda kuzalwa ngokusekelwe emazingeni e-bilirubin.Uma idlula u-15 mg/dL emahoreni okuqala angu-48, noma uma idlula u-20 mg/dL ngemva kwamahora angu-72. Kula mazinga, inani le-bilirubin engakahlanganiswa lidlula inani le-albumin elitholakalayo ukuze liyibophe. Le bilirubin engakahlanganiswa ingase iwele isithiyo segazi nobuchopho iye ebuchosheni bomntwana osanda kuzalwa futhi yonakalise ubuchopho obusakhula. Lokhu kungabangela amazinga ahlukahlukene okulimala kobuchopho, isimo esibizwa ngokuthi i-kernicterus .

Le ngozi ayifani kubantu abadala nezingane ezindala. Ubuchopho babantu abadala abuzweli kangako, futhi amazinga e-bilirubin angahlanganisiwe awavamile ukukhuphuka njengakwabantu abadala. Izingane ezisanda kuzalwa zikhiqiza i-bilirubin ngokushesha kunabantu abadala, futhi ziyihlanganisa kancane kakhulu.

Kunezizathu eziningi zokuthi kungani i-bilirubin ehlanganisiwe ``(Conjugated hyperbilirubinemia)`` inganda kubantu abadala. Kwabantu abadala, ukwanda kwe-bilirubin kungaba uphawu lwesimo esiyingozi, kodwa i-bilirubin ngokwayo ayiyona ingozi enkulu (ngokungafani nezingane).

Kusho ukuthini uma izinga lakho le-bilirubin liphezulu?

Uma umzimba wakho uphula amangqamuzana abomvu egazi ngokushesha kunokuba isibindi sakho singawahlanza, amazinga akho e-bilirubin angahlanganisiwe (angaqondile) angakhuphuka. Lokhu kungasho izinto ezifana nalezi:

• Isifo se-Hemolytic
• Isifo se-sickle cell
• Ukusabela okungekuhle ekumpontshelweni igazi

Izimbangela ezivamile zokwanda kwe-bilirubin engakahlanganiswa ezinganeni ezisanda kuzalwa:

• Ukuzalwa ngaphambi kwesikhathi
• Uhlobo lwegazi olungalingani phakathi komntwana nonina
• Ukusabela ezintweni ezithile ebisini lebele

Uma umzimba wakho unenkinga yokukhipha i-bilirubin kahle, izinga lakho le-bilirubin elihlanganisiwe (eliqondile) lingase likhuphuke. Lokhu kungasho ukuthi unesifo se-biliary noma amatshe enyongo. Izibonelo:

• Amatshe enyongo
• I-Cholecystitis
• Ukuvuvukala kwemisele yenyongo (i-Cholangitis)

Zombili izinhlobo ze-bilirubin zinganqwabelana egazini ngenxa yezimo ezithinta ikhono lesibindi sakho lokususa i-bilirubin.

Izinga lakho eliphelele le-bilirubin lingakhuphuka, kungaba lapho uqala umuthi omusha, noma uma uphuza utshwala obuningi, noma ngenxa yokucindezeleka kwesikhashana esibindini. Noma, kungase kube ngenxa yesifo sesibindi esibi noma esingamahlalakhona. Ezinye izimbangela zifaka:

• Izifo ezifana ne-hepatitis yegciwane kanye ne-mononucleosis.
• Izimo zofuzo ezithinta ukusebenza kwe-bilirubin, njenge-Gilbert's syndrome, isifo sikaWilson, kanye ne-Crigler-Najjar syndrome.
• I-hepatitis enobuthi (ebangelwa utshwala noma izidakamizwa)
• I-cirrhosis kanye nokwehluleka kwesibindi okungapheli

Uma kukhona okungajwayelekile embikweni wami wokuhlolwa, kuzokwenzekani ngokulandelayo?

Udokotela uzobheka izimpawu zakho kanye nomlando wezokwelapha ukuze azame ukuthola ukuthi yiziphi izimbangela ezingaba khona. Imbangela ngayinye inezindlela ezahlukene zokwelapha. Bangase bacele ukuhlolwa kwegazi okwengeziwe kanye nokuhlolwa kwezithombe ukuze bathole umbono ongcono ngesimo sakho. Bangase bahlole amazinga akho e-bilirubin futhi ukuze babone ukuthi ayakhuphuka yini. Uma amazinga e-bilirubin osana lwakho ephakeme kakhulu, bangase batuse ukwelashwa ukuze kwehliswe.

Yiziphi izindlela zokwelapha ukwanda kwe-bilirubin ezinganeni ezisanda kuzalwa?

Ukwelashwa okujwayelekile kokunciphisa amazinga e-bilirubin ezinsaneni ezisanda kuzalwa yi- phototherapy . Lokhu kusho ukuthi udokotela ubeka ingane yakho ngaphansi kokukhanya okukhethekile. Lokhu kukhanya kukhipha ukukhanya okuluhlaza okwesibhakabhaka. Lokhu kukhanya kuphula i-bilirubin futhi kuyenze incibilike emanzini. Lokhu kuvumela ukuthi ikhishwe emzimbeni ngaphandle kokuhlanganiswa esibindini. Lokhu kuvimbela i-bilirubin engahlanganisiwe ukuthi iqongelelane ezicutshini zobuchopho bomntwana.

Uwehlisa kanjani amazinga akho e-bilirubin?

Amazinga akho e-bilirubin azokwehla uma isimo esibangela amazinga akho e-bilirubin enyuka siphathwa kahle futhi silawulwa. Lokhu kuncike esibangweni. Udokotela wakho uzokhuluma nawe ngezinketho zokwelapha lesi simo noma ukunciphisa imiphumela yaso.

Ngokuvamile, unganciphisa ukucindezeleka esibindini sakho ngokuyeka utshwala nemithi engadingekile (ngisho nemithi ethengwa ngaphandle kwemithi kadokotela (OTC) ngangokunokwenzeka), nokudla ukudla okunempilo.

Kuyini ukuhlolwa komchamo we-bilirubin?

Ungase ube nokuhlolwa kwe-bilirubin yomchamo njengengxenye yokuhlolwa komchamo. Lokhu kungaba yingxenye yokuhlolwa kwempilo okuvamile. Noma, udokotela wakho angakuyalela ngokuqondile lokhu kuhlolwa uma une-jaundice noma umchamo omnyama . I-Bilirubin emchameni wakho (i-bilirubinuria) ayijwayelekile. Kodwa-ke, uma amazinga akho e-bilirubin ahlanganisiwe ephezulu kakhulu, lokhu kungenzeka.

Kulolu vivinyo, udokotela uzokunika ibhodlela elincane lokuqoqa isampula yomchamo. Bazokunikeza ne-"sanitary wipe" yokuhlanza indawo yakho yangasese ngaphambi kokuba uchame. Ibhodlela lizoba nophawu olubonisa ukuthi umchamo ongakanani okufanele uwuqoqe. Ngaphandle kokuthinta ingaphakathi lebhodlela, uzoqoqa isampula bese uyinika udokotela. Bazoyithumela elabhorethri ukuze ihlolwe.

Into Ebaluleke Kakhulu - Izinto Okufanele Uzikhumbule (Umyalezo Owuyisa Ekhaya)

Kulungile, ngakho-ke sesikhulume kakhulu nge-bilirubin manje, akunjalo?

Uma ubona umbala ophuzi emzimbeni wakho noma emehlweni (i-jaundice), kuwuphawu lokuthi kufanele nakanjani ubone udokotela futhi uthole ukuhlolwa kwe-bilirubin.I-jaundice iqala ukuvela lapho amazinga e-bilirubin efinyelela ezingeni elijwayelekile kabili noma kathathu. Ungase futhi uqaphele ukuthi umchamo wakho umnyama (unombala wetiye) kuleli zinga.

Kodwa-ke, ngezinye izikhathi amazinga e-bilirubin angaba phezulu ngaphandle kwezimpawu. Ukuhlolwa kwe-bilirubin kungasiza udokotela wakho ukuqinisekisa izimo ezithile ezisolisayo futhi athole ukuthi iyini imbangela.

Ngakho-ke, ungesabi uma uzwa igama elithi bilirubin. Liyingxenye yenqubo evamile emizimbeni yethu. Kodwa-ke, lapho amazinga ayo eshintsha, kubalulekile ukuthola imbangela nokuthola ukwelashwa uma kudingeka. Uma unemibuzo, ungalokothi unqikaze ukukhuluma nodokotela wakho. Bakhona ukukusiza.

I- Bilirubin, ukuhlolwa kwe-bilirubin, i-jaundice, umkhuhlane ophuzi, isibindi, amaseli abomvu egazi, izingane ezisanda kuzalwa