ʻO ka Bilirubin he pigle pigmenti,ʻo ia ka hua i koe o ka hanaʻana o nā pūnaele kokoʻeleʻele i hoʻohemoʻia. ʻO ka mea maʻamau, he kanaka olakino i loko o ka plasma toto e loaʻa kahi mea liʻiliʻi o kēia mea (3,4 - 22,2 μmol / l), a me kekahi nui o ka mimi i keʻano o urobilinogens (4 mg) i kēlā lā i kēia lā.
Paanei 96% o ka bilirubin i loko o ke koko he bilirubin liʻiliʻi hikiʻole ke hoʻopiliʻia, he mea hikiʻole keʻoluʻolu i ka wai a heʻawaʻawa, no ka mea hiki iā ia ke komo i loko o nā pūnaewele me ka hoʻopau i nā hana nui o nā pūnaewele. ʻO ke koena o 4%, he bilirubin kai kūikawā, hiki ke hoʻololiʻia i ka wai, i hoʻopauʻia e nā puʻupaʻa a holo i loko o ka mimi. ʻO ka billion bilirubin ka pae kiʻekiʻe o ka bilirubin pūnaewele.
I kekahi mau maʻi, ka piʻiʻana o ka bilirubin i loko o ke koko, a me ka mimi hou. ʻO kēia ke kumu o ka momona a me ka pouli o ka mimi.
ʻO nā kumu o ka pae bilirubin kiʻekiʻe i nā mākua
E noʻonoʻo, pehea nā kumu e hiki ai ke hoʻonui a hoʻonuiʻia paha ka lehulehu a iʻole nā bilirubin e pili ana i ke kino.
ʻO nā kumu o ka bilirubin hānai kiʻekiʻe
ʻO ka piʻiʻana o ka bilirubin pono i loko o ke koko ua hoʻonuiʻia ma muli o ka uhakiʻana i ka kahe o ka bile. ʻO ka hopena, ua hoʻounaʻia ka bile i ke koko,ʻaʻole i loko o ka'ōpū. ʻO nā kumu o kēia ka mea maʻamau i kēia mau maʻi:
- he pīpīpī o ke olaʻo olapili ma kahiʻanoʻano nui (he hepatitis A, B, me ka mononucleosis pipi);
- he pīpīpika o ka maʻi aiokika (leptospirosis, brucellosis);
- maʻi hepatitis;
- ʻo ia ka maʻi hepīpī;
- ʻo ia hoʻi he maʻi hepatitis (ma muli o ka hopena hormone therapy, nā kīʻaha anti-inflammatory non-steroidal, ka lāʻau antitumor a me nā lāʻau'aloʻolo.);
- nā meaʻawaʻawa hepatitis (ka lāʻau make me nā poisons fungal, mea lāʻauʻona);
- ka maʻiʻeha o ka gallbladder, ate, aiʻole ka pancreas;
- hihihihihihihihi;
- biliary cirrhosis;
- nā maʻi o Rotor, Dabin-Johnson.
Ke kumu o ka piʻi bilirubin liʻiliʻi
Hiki ke hoʻohuiʻia ka hoʻonui i ka helu o ka bilirubin liʻiliʻi me ka hoʻopau kokeʻia o nā pūpū koko uila a me ka haunaele i ka hanaʻana o ka bilirubin liʻiliʻi. He mea pono eʻike i kēia, mai ʻahaʻole bilirubin liʻiliʻi i loko o ka waiʻaʻole e pau, me ka piʻi nui o kona kūlana i ke koko,ʻaʻohe hewa ma ka hōʻiliʻili o ka mimi. No laila, nā kumu o kēia:
- ʻO ka anemia hemolytic ma keʻano (ka maile pū, ka spherocytic, ka nesferocytic, ka thallasemia, ka maʻi Marciyafawa-Michele);
- anemia haikolytic (e pili ana i ka arthritis rheumatoid, lupus erythematosus pūnaha, leukemia lymphocytic, lymphanganulmatosis, etc.);
- ka anemia palolytic me ka lāʻau (e pili ana me ka insulin, aspirin, levomycetin, levofloxacin, cephalosporins, a pēlā aku);
- nā maʻi o Lucy-Driskol, Gilbert, Kriegler-Nayyar;
- nā maʻiʻeha (malaria, typhoid, sepsis);
- ka anemia mai ka maʻi (i hoʻopukaʻia me nā'ōpū haʻona, nā poisons, nā pīpī pīpī, nā moʻo, ka make me nā haʻalulu, alakaʻi, me nā paʻakai keleawe, a me nā mea'ē aʻe).
ʻO nā kumu o ka nui o ka bilirubin i ka hāpaiʻana
ʻO ka nui o ka bilirubin i hoʻomanaʻoʻia i loko o nā wāhine hāpai (ke kau i ka'ōpū). Ua māheleʻia nā kumu no kēia maheleʻelua:
- ma muli o nāʻano pilikino o ka hāpaiʻana (ka liʻiliʻi momona o ke akepaʻa, gestosis, ka lūlū nui, a pēlā aʻe);
- i hanaʻia e nā maʻi likeʻole (hepatitis, heememictic anemia, a pēlā aku).
ʻO nā kumu o ka piʻiʻana o ka bilirubin i loko o ka mimi
Uaʻikeʻia ka nui o ka bilirubin i loko o ka mimi i nā maʻi me ka hōʻino i nā pūwaʻi o nā moʻo
- he pīpī;
- ka cirrhosis o ke akepaʻa ;
- haʻalē i nā mea make;
- ka hōʻeha o ka pale, a pēlā aku.
Hoʻomaʻoʻia o ka bilirubin kiʻekiʻe
Inā hōʻikeʻia nā hoʻokolohua i ka haʻaheo o ka bilirubin i loko o ke koko a iʻole i ka mimi, e pili ana nā kumulāʻau o ka hōʻailona i nā kumu o kēiaʻano pilikino. ʻO ka mea maʻamau,ʻo nā mea lapaʻau e pili ana i ka laweʻana i nā lāʻau a me ka hoʻololiʻana i ka meaʻai.