Tus qauv ntawm bilirubin rau cov me nyuam mos

Thawj thawj hnub ntawm tus menyuam mosliab lub neej, daim tawv nqaij ntawm daim tawv nqaij thiab daim tawv nqaij ntawm nws lub qhov muag yuav pom tshwm tuaj-tus kabmob ua rau tus menyuam mosliab tshwm tuaj. Nws yog vim lub fact tias nyob rau hauv thawj hnub ntawm lub neej fetal hemoglobin ntawm cov ntshav dissolves, hloov lub niaj zaus, thiab cov khoom ntawm decomposition ntawm hemoglobin yog bilirubin. Thaum lub sij hawm rhuav tshem ntawm tus kab mob hemoglobin, yog tus kab mob ua kom tsis pub muaj kabmob, uas khi rau cov protein nyob hauv lub siab thiab hloov dua siab tshiab kom paub ncaj qha bilirubin. Indirect bilirubin yog insoluble, nws tsis yog secreted nrog zis, mus ncaj soluble, nws yog excreted nrog bile.

Tus qauv ntawm bilirubin nyob rau hauv cov ntshav ntawm ib tug me nyuam mos

Txoj cai ntawm cov ncaj qha bilirubin muaj tsis ntau tshaj 25% ntawm tag nrho bilirubin. Nyob rau hauv kev lwj ntawm fetal hemoglobin, qib ncaj ncaj ntawm cov bilirubin nce, uas tsis muaj sij hawm los khi nrog albumin. Qhov siab tshaj plaws yog hnub 3 ntawm lub neej, tom qab uas nws txo rau 1-2 lub lis piam. Thaum lub sij hawm no, lub cev nqaij daim tawv tshwm tuaj thiab ploj, uas, tsis zoo li tus kab mob pathological, kis tsis muaj kab thiab tsis tas yuav kho.

1. Thaum tus me nyuam yug hauv txoj hlab ntaws qoob, cov kev paub txog cov tshuaj hu ua bilirubin hauv cov me nyuam mos muaj txij li 51 μmol / l.
2. Thawj thawj hnub ntawm lub neej, qhov nce ntawm qib bilirubin yuav tsum tsis txhob siab tshaj 5.1 μmol / l tauj ib teev. Tib lub sij hawm, qhov siab tshaj plaws nyob rau hauv qib bilirubin nyob rau hauv cov me nyuam uas muaj hnub nyoog tag nrho yog txog 256 μmol / L txog li 3-4 hnub ntawm lub neej, hauv cov me nyuam mos liab preterm - tsis ntau tshaj 171 μmol / l.
3. Qhov nruab nrab ntawm bilirubin nyob rau hauv thawj hnub ntawm lub neej feem ntau tsis tshaj 103-137 μmol / l, thiab qhov nce yog vim yog indirir bilirubin.

Thaum cev nqaij daim tawv tsis hloov pauv ntawm tus me nyuam, xim zis thiab quav, thiab qhov loj ntawm daim siab thiab paj hlwb, daim tawv nqaij muaj txiv kab ntxwv tint, thiab jaundice ploj tsis muaj kev kho mob ntawm 2-3 lub lim tiam ntawm lub neej. Cov qib ntawm cev nqaij daim tawv:

• 1 degree (icteric xim ntawm lub ntsej muag thiab caj dab xwb);
• 2 degree (icteric xim ntawm lub ib nrab ntawm lub cev mus rau puj ntaws);
• 3 degree (icteric complexion ntawm lub ntsej muag, pob tw thiab sab qhov loj ntawm caj npab thiab txhais ceg);
• 4 degree (ua kom tiav lub cev xim nyob rau hauv cov xim icteric, xws li taw thiab txhuam).

Qhov ua rau kom paub bilirubin rau cov me nyuam mos

Ntxiv rau cev nqaij daim tawv, muaj cov kab mob hauv cov me nyuam yug tshiab, uas yuav muaj lub siab tshaj plaws ntawm cov tawv nqaij thiab daj daj ntawm daim tawv nqaij thiab cov xoos mucous. Hom mob ntawm cev nqaij daim tawv:

1. Hemolytic. Vim yog lub cev qhuav dej ntawm cov ntshav liab hauv kev sib haum xeeb los ntawm cov pab pawg neeg ntshav lossis Rhais ntawm leej niam thiab tus menyuam, cov kab mob caj ces - microspherocytosis, sickle cell anemia.
2. Parenchymal - vim yog lub siab ua rau lub siab mob ntsws nrog tus kab mob, cytomegalovirus, co toxins.
3. Conjugation - nyob rau hauv cov ntaub ntawv ntawm txawv txav nyob rau hauv lub enzyme system thiab lub binding ntawm ncaj qha bilirubin.
4. Mechanical - nyob rau hauv rooj plaub ntawm kev ua txhaum ntawm lub outflow ntawm bile vim ntawm obturation ntawm gallbladder los yog daim siab ducts nrog lawv congenital anomalies, piv txwv li, atresia.

Thaum siab ntau ntawm bilirubin nyob rau hauv cov ntshav (ntau tshaj li 324 μmol / l), nws nkag mus rau cov ntshav-hlwb barrier thiab ua zoo li lub xaim ntawm lub hlwb ntawm ib tug menyuam mos (nuclear jaundice). Qhov no ua rau cov tshuaj lom encephalopathy nrog txo qis tag nrho cov reflexes, apathy, convulsions thiab txawm tuag ntawm ib tug me nyuam. Tej teeb meem ntawm nuclear jaundice tuaj yeem ua rau tuag tes tuag taw thiab tawg, hlwb ruamqauj thiab lag ntseg.

Kev kho mob ntawm tus kab mob bilirubin ntxiv hauv cov me nyuam mos

Mob cev nqaij tawv tsis muaj mob feem ntau yuav tsum tau kho, nrog rau cov xim tawv nqaij ntawm cov tawv nqaij siv tau cov koob yees duab, thaum lub hnub ci ua kom zoo li qhov sib txig ntawm bilirubin. Cov kab mob hu ua jaundice, ntxiv nrog rau cov kws kho mob, tus kws kho mob feem ntau tau qhia txog kev kho mob hauv tsev kho mob thiab tseem txuam nrog ntshav ntxiv.