Feem ntau tom qab tau txais kev soj ntsuam ntawm cov ntshav ntawm venous, tus neeg mob kawm paub tias nws tau nce tag nrho bilirubin - uas txhais tau tias tsuas yog los txiav txim siab tag nrho tus nqi yog tsis yooj yim sua. Qhov tseeb yog tias tagnrho concentration ntawm cov kabmob no yog ibqho kev ntsuas ntawm kev qhia ncaj thiab tsis paub txog bilirubin. Nws yog cov kev tshwm sim uas ua kom paub tias yam twg hauv lub cev ntawm lub cev tsis ua hauj lwm tshwm sim, thiab dab tsi yog vim li cas rau qhov sib txawv ntawm kev ntsuam xyuas los ntawm cov cai.
Vim li cas thiaj yuav paub bilirubin nyob rau hauv ib txoj kev kuaj ntshav?
Txhua yam teebmeem uas tshaj qhov qub ntawm qhov tseem ceeb ntawm bilirubin tau muab cais ua 4 pawg. Kev sib txawv yog ua raws cov theem ntawm kev sib pauv ntawm cov khoom nug, nrog rau 2 kom paub cov txheej xwm:
- Kev thaj tsam ntawm qhov ua rau lub ntsiab lus ntawm lub daj thiab ntsuab pigment nce (nyob rau hauv daim siab los yog sab nraud no hloov).
- Daim ntawv ntawm kev nce bilirubin (ncaj qha los yog tsis ncaj).
Raws li qhov kev cais ntawm no, cov pawg hauv qab no yog vim li cas thiaj li nce tag nrho cov xim daj-ntsuab xim:
- Hepatic nce ntawm bound bilirubin - nyob rau hauv lub hlwb ntawm lub siab, zus tau los ntawm cov kab mob tseem yuav cuam tshuam, vim tias nws cov outflow tau deteriorated ncaj qha rau hauv lub bile ducts hauv lub siab.
- Extrahepatic nce ntawm bound bilirubin - outflow ntawm bile yog disturbed hauv extrahepatic ducts.
- Hepatic nce ntawm dawb bilirubin - nyob rau hauv lub siab lub hlwb muaj ib qho kev hloov siab tshiab ntawm cov dawb pigment mus rau ib daim ntawv ncaj qha.
- Extrahepatic nce nyob dawb bilirubin - sab nraum lub siab, ntau xim daj-ntsuab xim ntau heev.
Txhua tus ntawm cov pab pawg no muaj cov yam ntxwv tshwm sim, vim tias nws yog ib qho ua tau rau kev kuaj mob ua ntej.
Nws yog tsim nyog teev tias txawm tias tag nrho cov bilirubin me ntsis ntxiv me ntsis, kev tshawb nrhiav ntau dua. Tsis yog qhov qhia tau hais tias cov lej thiab cov pigment dawb yog qhov tseem ceeb, tab sis tseem qhov feem pua ntawm qhov sib ntxiv ntawm cov khoom.
Dab tsi yog qhov ntxiv tag nrho cov bilirubin nyob rau hauv cov ntshav nrog kev nce hauv kev ncaj qha feem?
Cov kab mob nrog los ntawm cov mob uas tau piav qhia tau yog intrahepatic thiab extrahepatic.
Thawj pab pawg muaj xws li:
- Kab Mob Siab:
- mob vwm;
- kab mob;
- mob ntev;
- medicinal;
- lom;
- autoimmune;
- daim siab hlav;
- intrahepatic cholestasis;
- biliary thawj lub siab qhov ntswg;
- jaundice ntawm cov poj niam cev xeeb tub;
- Rotor Syndrome;
- Dabin-Johnson syndrome.
Qhov thib ob pab pawg muaj xws li cov kab mob:
- mob thiab mob pancreatitis;
- echinococcosis ntawm lub siab ;
- aneurysm ntawm txoj hlab ntsws;
- diverticulitis ntawm duodenum;
- tus txiav qhov hnyuv;
- mob ntev, mob ntsws thiab mob cholangitis;
- cholelithiasis;
- o ntawm duodenum;
- neoplasm hauv qhov kab mob hauv lub cev.
Ntxiv cov bilirubin nrog cov cim qhia ntawm kev nce hauv cov xim tsis ncaj - txhais li cas?
Yog hais tias cov concentration ntawm bilirubin dawb zuj zus ntxiv nrog ib qho kev sib txig sib ntxiv hauv cov nyiaj tag nrho ntawm cov xim, qhov ua rau tuaj yeem them rau ob sab hauv daim siab nqaij thiab sab nraud.
Nyob rau hauv thawj cov ntaub ntawv, muaj xws li cov kab mob:
- Kriegler-Nayyar syndrome;
- nrhiav cov tsis-hemolytic jaundice;
- Gilbert's syndrome;
- Lucy-Driscola syndrome.
Extrahepatic kab mob muaj xws li:
- nrhiav tau tus kab mob ntshav tsis txaus, feem ntau ntawm cov keeb kwm autoimmune;
- congenital hemolytic anemia
- sepsis ;
- hemolysis ntawm erythrocytes rau cov menyuam yug tshiab;
- malaria;
- mob ntshav tsis txaus ntseeg;
- medicinal hemolytic anemia.