Ngokuvamile ngemva kokuthola imiphumela yokuhlaziywa kwegazi elimnyama, isiguli sifunda ukuthi sesandise inani le-bilirubin eliphelele-okusho kuphela ukucacisa inani eliphelele elingenakwenzeka. Iqiniso liwukuthi ukuhlushwa okuphelele kwaleli pigment kuyinto iqoqo lezinkomba ze-bilirubin eqondile futhi engabonakali. Yilezi zindlela ezenza kube lula ukuthola ukuthi yiluphi uhlobo lwesimo sokuhluleka okwenzekile, futhi yisiphi isizathu sokuphambuka kokuhlaziywa okuvela kwendabuko.
Kungani i-bilirubin jikelele ingakhulelwa ekuhloleni kwegazi?
Zonke izici ezivusa ngokweqile izindinganiso ezijwayelekile ze-bilirubin zihlukaniswa ngezigaba ezine. Ukuhlukahluka kusekelwe ezinyathelweni zokushintshaniswa kwezinto ezikulo mbuzo, kanye nokuchaza okubili:
- Indawo yangakini imbangela yokuhlunga kwe-pigment eluhlaza okwesibhakabhaka iyanda (esibindi noma ngaphandle kwalesi sitho).
- Indlela yokwanda kwe-bilirubin (ngqo noma engaqondile).
Ngokwale ndlela yokuhlukanisa, lezi zinhlobo zezizathu ezilandelayo zokukhulisa inani lezingulube eziluhlaza okwesibhakabhaka zihluke:
- Ukuphakama kwe-hepatic kokubopha i-bilirubin - kumaseli esibindi, ukukhiqizwa kwe-bile kuphazanyiswa, ngenxa yalokho ukuphuma kwayo kuye kwehla ngokuqondile emadayini we-bile ngaphakathi kwesibindi.
- Ukwanda okweqile kokubopha i-bilirubin - ukuphuma kwebhili kuyaphazanyiswa emidayini ye-extrahepatic.
- Ukuphakama kwe-hepatic ye-bilirubin yamahhala - kumaseli wesibindi kunokuguqulwa okungalungile kwe-pigment yamahhala ibe ifomu eliqondile.
- Ukwanda okungaphezulu kwegazi ku-bilirubin yamahhala - ngaphandle kwesibindi, kukhishwa i-pigment eluhlaza okwesibhakabhaka okukhululekile.
Ngamunye wala maqembu anezici zokubonakaliswa kwemitholampilo, ngenxa yokuthi kungenzeka ukuthi uhlolwe kuqala.
Kumele uqaphele ukuthi ngisho noma inani le-bilirubin landa kancane, ucwaningo olwengeziwe luyadingeka. Akukona nje kuphela isibonakaliso sezinombolo semali yokubopha kanye nokugqwala okukhululekile, kodwa futhi nesilinganiso samaphesenti esilinganisweni sezinto ezibonakalayo.
Iyini i-bilirubin yenani elikhulayo egazini ngokunyuka kwengxenyana eqondile?
Izifo ezihambisana nesimo esichazwe kungaba intrahepatic ne-extrahepatic.
Iqembu lokuqala lihlanganisa:
- isifo sofuba:
- i-viral ekhulu;
- ibhaktheriya;
- i-chronic;
- imithi;
- i-toxic;
- i-autoimmune;
- izicubu zesibindi;
- i-cholestasis ye-intrahepatic;
- i-cirrhosis eyinhloko ye-biliary;
- i-jaundice yabesifazane abakhulelwe;
- I-Rotor syndrome;
- I-Dabin-Johnson syndrome.
Iqembu lesibili liqukethe izifo ezinjalo:
- i-pancreatitis eyingozi futhi engapheli;
- i-echinococcosis yesibindi ;
- i-aneurysm ye-arter hepatic;
- i-diverticulitis ye-duodenum;
- isifo se-pancreas;
- i-cholangitis engavamile, eyindilinga neyehlukene;
- i-cholelithiasis;
- ukuvuvukala kwe-duodenum;
- i-neoplasm e-bile duct.
Ukwandisa i-bilirubin yenani elikhombisa inani lokunyuka kwesigqoko esingacacile - kusho ukuthini?
Uma ukuhlushwa kwe-bilirubin yamahhala kukwandiswa ngokukhuphuka ngesikhathi esisodwa kwenani lezingulube, izimbangela zingabuye zihlanganiswe kokubili ngaphakathi kwezicubu zesibindi nangaphandle kwayo.
Esikhathini sokuqala, kunezifo ezinjalo:
- i-Kriegler-Nayyar syndrome;
- wathola i-jaundice engeyona i-hemolytic;
- Isifo sikaGilbert sika;
- I-Lucy-Driscola syndrome.
Izifo ze-extrahepatic zifaka:
- wathola i-hemolytic anemia, ngokuvamile yomsuka wokuzimela;
- i-anemia ye-hemolytic yangasese
- i-sepsis ;
- i-hemolysis ye-erythrocytes ezinsana;
- i-malaria;
- i-hemolytic anemia;
- i-anemia ye-hemolytic yezokwelapha.