Matenda a chikasu ndiyo conjugation: matenda osiyanasiyana, chithandizo

Matenda a chikasu ndiyo si matenda osiyana, si chizindikiro cha pathologies ena. Nthawi zambiri, kungakhale thupi, kuti ndi zifukwa kwa matenda aliwonse (makanda). Chifukwa chikhalidwe ichi ndi kuwonjezeka bilirubin, amene amapereka icteric ochekenera khungu, zikopa mucous ndi sclera.

Matenda a chikasu ndiyo: Mitundu

boma Izi inextricably zogwirizana ndi nkhani za bilirubin m'magazi. Komabe, izo zimayambitsa kuwonjezeka angakhale osiyana. Nthawi zina, kupeza chifukwa cha kulola amaganiziridwa kudwala mu thupi, amene amafuna mankhwala mwamsanga. Malinga ndi buku la matenda bilirubin kagayidwe muli mitundu yambiri ya matenda a chikasu ndiyo:

1. Conjugation matenda a chikasu ndiyo, yomwe ndi chotsatira cha chakhungu conjugation wa bilirubin. Kuti amapezeka akhanda.
2. Parenchymal matenda a chikasu ndiyo akufotokozera zingapo za pathologies chiwindi. Kugonjetsedwa kwa parenchyma wa thupi (imfa ya maselo zinchito - hepatocytes) kukhala kosatheka kugwila bilirubin ndi kuwombola wake zina.
3. Obstructive matenda a chikasu ndiyo, lomwe limapezeka kuphwanya outflow wa ya ndulu. Iwo amagwirizana ndi matenda amene amathandiza kuti kutseka kapena kuchepetsa wa lumen wa ya ndulu ritsa. chodabwitsa kumachitika cholelithiasis ndi mapangidwe chotupa.
4. Hemolytic matenda a chikasu ndiyo - kudwala kugwirizana ndi azingokhala maselo a magazi. Bilirubin - pigment umene umachitika kuwonongedwa kwa hemoglobin, kotero okwera erythrocyte lysis kumabweretsa mungawonjezerere ake.
5. Kernicterus - palokha ndipo mtundu owopsa. Kumachitika mu ngati mwana wosabadwayo anaonekera kwa hypoxia pa chitukuko kapena kubadwa asphyxia. Komanso, chifukwa angakhale matenda amayi apakati. Kuopsa ndi pigment ndi amasonkhana maselo mitsempha ya ubongo imene imbaenda ku matenda osiyanasiyana osokoneza bongo, ndiponso mwina chakupha.

Conjugation matenda a chikasu ndiyo mu akhanda

Matenda a chikasu ndiyo amapezeka mu makanda ndi thupi, chifukwa kumphatikiza ndi ndondomeko pathological. Akufotokozera, zambiri masiku 3-5 atabadwa. Mwachibadwa, maselo ofiira ongoyendayenda watsopano nthawi zonse, amene anatsagana ndi hemolysis - kuonongeka kwawo. Akuluakulu, chiwindi ndi athanzi, kotero bilirubin, amene anamasulidwa ndi kuvunda kwa maselo amenewa ndi nthawi yolankhula ndi si kudziunjikira m'mwazi.

Chithunzi matenda makanda amagwirizana ndi kukonzedwanso kwambiri maselo a magazi ndi wachibale kulephera chiwindi. Thupi ili ndi zisanathe kupangidwa, nthawi zambiri matenda a chikasu ndiyo amenewa amapezeka obadwa nthawi yawo isanakwane. Bilirubin ukuyamba mu magazi, ndiyeno amasonkhana mu khungu ndi mucous zimagwira ntchito zosiyanasiyana, kuwapatsa mtundu khalidwe. Peaking wachitatu ndi lachisanu tsiku. zizindikiro izi ndiye kuchokera nzeru bilirubin pang'onopang'ono kubwerera mwakale.

Kodi vuto limeneli?

Conjugation matenda a chikasu ndiyo (ICD-10) payokha mu gulu la mayiko si allocated. Iwo ali P59.0 kabisidwe onse neonatal matenda a chikasu ndiyo, yomwe ndi chotsatira cha yobereka isanakwane, ndipo amagwirizana ndi hyperbilirubinemia. Mwatsatanetsatane ndondomeko tafotokozazi.

Conjugation mtundu wa matenda limapezeka nthawi zambiri ana. Izi matenda a chikasu ndiyo chosakhalitsa mu akhanda, komanso chikhalidwe chimene akufotokozera makanda msanga ndi ana ongoyendayenda asphyxia. Zimayambitsa mavuto kawirikawiri cholowa ndiponso endocrine kudwala (mwachitsanzo, syndromes Lyutseya-Driskopa ndi Gilbert). gulu Izi zikuphatikizapo mankhwala matenda a chikasu ndiyo.

Bilirubin - ndichiyani?

Dzina anapatsidwa ndi pigment, amene ndi chipatso cha kuwonongedwa hemoglobin. Pa woipa ena amachititsa ochekenera khungu ndipo zimagwira ntchito zosiyanasiyana mucous. Bilirubin - zofunika kwambiri matenda muyezo, monga kuchuluka kwake limafotokoza ndondomeko pathological ndi kuyamba chithandizo. Kuchuluka kwa pigment amasonyeza boma la chiwindi ndi kapepala biliary.

Mu thupi, bilirubin chikupezeka m'njira ziwiri - mwachindunji kapena kudzera m'njira zina. Origin mutuluka chachiwiri kutembenuka mankhwala. Sitipereka bilirubin ndi poizoni ndi odzipereka mafuta. Iye sali excreted thupi. matenda kagayidwe kachakudya, mawonekedwe akhoza anasonkhanitsa, kupereka zotsatira poizoni m'thupi. Mwachibadwa, izo n'kukhala bilirubin mwachindunji ndi nontoxic. Conjugation matenda a chikasu ndiyo kumachitika chifukwa kuyan'anila za kagayidwe ake.

Kusinthana bilirubin

Gwero la pigment izi hemoglobin - waukulu chigawo maselo a magazi. Mu oipa a Selo lofiira la magazi hemoglobin adzamasulidwa ndi poyera pogawanikana pamawere. Zimenezi ikuchitika macrophages apadera ziwalo (mafupa, chiwindi ndi ndulu). Chifukwa cha pogawanikana pamawere anapanga heme ndi globin. Woyamba lidzasinthidwa biliverdin - kuloŵedwa m'malo a bilirubin zina. mapangidwe ake a biliverdin chokhudzana ndi ntchito za michere yeniyeni pakati pawo - ndi cytochrome P-450, heme oxygenase. Komanso mozungulira bilirubin chimatsogoleredwa maselo chiwindi kumene chimango kuti glucuronic acid. Choncho anapanga bilirubin mwachindunji, amene kusungidwa mu chikhodzodzo ndulu Ndiyeno anavulidwa excretion mu duodenum ndi. Matumbo microflora kumathandiza kuchepetsa yake urobilinogen. Gawo la izo umamumvera mayamwidwe, zatsalira ali n'kukhala sterkobilinogena ndi excreted mu ndowe zinapereka mtundu khalidwe.

mayesero Laboratory angasonyeze kuti bilirubin ali m'mwamba. Kodi zikutanthauza chiyani? Kuwonjezeka mlingo wake ukhoza kulumikizidwa ndi matenda aliwonse, napempha mwamsanga matenda kuwunika. Thupi kuwonjezeka bilirubin anati mu akhanda.

chithunzi matenda

Ngakhale kuti wakhanda yodziwika ndi kuchuluka bilirubin, mawonetseredwe matenda chili konse. Zizindikiro anapatsidwa boma - mtundu maonekedwe icteric. Limatifotokozera osati khungu komanso zimagwira ntchito zosiyanasiyana pa mucous. Physiologic matenda a chikasu ndiyo conjugation akudutsa padera, koma ngati ayi, ayenera amaganiziridwa kudwala.

diagnostics

Matenda a chikasu ndiyo kungakhale osati boma thupi, koma chizindikiro cha matenda. Ngati mwana ali ndi mtundu yeniyeni ya pakhungu ndipo zimagwira ntchito zosiyanasiyana mucous, pamafunika polojekiti zonse ndi dokotala wa ana. Komanso mu Zikatero amafunika kulamulira mlingo wa bilirubin. Childs, mu masiku oyambirira a nambala moyo wake ukufika 60 mmol / l, koma kenanso. Komanso, mlingo ukuwonjezeka (maola 3-7).

Childs, kuchuluka bilirubin otetezeka ndipo alibe zotsatira poizoni thupi mwana Komabe, mlingo sayenera upambana otchedwa mmalire tanthauzo - 205 pmol / l. Bilirubin kuchuluka - kutanthauza kusintha mtima koteroko? Matenda a chikasu ndiyo ndi pathological ndipo amafuna chithandizo mwadzidzidzi. Ngati chithunzi ndi zolondola, koma matenda a chikasu ndiyo amalimbikira kwa nthawi yaitali, amaona ndi conjugation, ndiye amene ali chifukwa cha chosakhwima a dongosolo la chiwindi enzyme.

Chithandizo conjugation matenda a chikasu ndiyo

Pambuyo kumupima, amaonekera matenda a chikasu ndiyo thupi kapena pathological. Kodi woyamba popanda mankhwala alionse ndipo itha paokha popanda sanachite. Yaitali matenda a chikasu ndiyo (conjugation) chimafikira nayenso pamene dongosolo enzyme chiwindi potsiriza okhwima. Komabe, ngati chiwerengero kuposa yovuta bilirubin mlingo ayenera kuzindikiridwa kudwala. Zimakhala tizilombo matenda a chiwindi, ya ndulu ritsa kutsekeka kapena hemolytic matenda a chikasu ndiyo.

chiwindi tizilombo

kudwala izi zikhoza wadutsa kuchokera mwana kachilombo kwa mayi. Chifukwa cha zimenezi, mwana wabadwa ndi chikhalidwe chiwindi tizilombo. Zotsatira za HIV magawo oyambirira chitukuko yoopsa zimatha kupundula zina thupi. Mbali A matenda, mosiyana ndi matenda a chiwindi B akuluakulu, ndiyo njira aakulu. Kudwala chingathe kuonekera ngakhale pamaso pa isanayambike matenda a chikasu ndiyo. Nthawi zambiri pali kuwonjezeka kutentha, kuwonongeka kwa kudya ndi pang'ono catarrhal zochitika. Nthawi zina preicteric nthawi makanda asymptomatic.

Akuganiza kukhalapo kwa chiwindi B akhoza kukhala ndi kupeza kusintha mu mtundu wa mkodzo ndi ndowe. Complete magazi kusanthula yodziwika ndi kuchepa kwa leucocyte ndi erythrocyte mlingo sedimentation. Monocytes anali pang'ono kuchuluka. Pamene icteric mawonekedwe kwakhalapo kuwonjezereka kwambiri bilirubin, ndi thymol. Pakuti matenda oyambirira a matenda ikuchitika zophunzira michere chiwindi. Pa ndondomeko yokoka anati kuchepa zakuthwa prothrombin ndi kuonjezera ammonia.

Chithandizo cha ana ikuchitika, kawirikawiri kuchipatala. chithandizocho Chili mankhwala mavairasi oyambitsa gepatoprotektory, mavitamini, komanso cholagogue. Analimbikitsa kuti detoxification mankhwala. Mwa njira sanali mankhwala kuti zonse pharmacotherapy muyenera bedi zina ndi wachete.

hemolytic matenda a chikasu ndiyo

kudwala Izi amagwirizana ndi hemolysis maselo a magazi, ndi oopsa kwambiri. Chifukwa kulakwika mu mtima RH Chinthu ndi mayi a mwanayo, amene ali RH-nkhondo. Kudwala zambiri Umapha - mlingo imfa 60-80%. Komanso, pamaso pa RH nkhondo kungayambitse mimba lachibadwa.

kupewa

Kumathandiza matenda a chikasu ndiyo kutsatira mimba ndi yoyamwitsa komanso zanthawi zonse tizipima dokotala. Ngati matenda a chikasu ndiyo nthawi isanakwane koma kukhala, amafuna polojekiti zonse mlingo wa bilirubin m'magazi.

Odwala matenda a chikasu ndiyo yodziwika ndi mtundu chosiyana khungu ndipo zimagwira ntchito zosiyanasiyana mucous. Chizindikiro chimenechi zingasonyeze pamaso pa matenda kapena kusonyeza kusintha thupi mu thupi (chosakhalitsa neonatal matenda a chikasu ndiyo).

Pomaliza

Pa kudziwika matenda a chikasu ndiyo anapangidwa mwamsanga kudziwa mlingo wa bilirubin ndi matenda zina. Conjugation matenda a chikasu ndiyo mwa ana akudutsa yaitali kuposa chosakhalitsa, koma ndi otetezeka. The katswiri ayenera watsimikizira makolo ndi kusankha bwino. Monga ulamuliro, palibe mavuto omwe unkachitika.