Bilirubin i -yellow-brown bile pigment iyo inoumbwa nekuparadzwa kwehemoglobin nezvimwe mapuroteni eropa uye iri mu plasma. Chimiro chebilirubin muropa revanhu vakuru nechechecheche vanosiyana. Muvanhu vakuru uye vana vakwegura kupfuura mwedzi mumwe, zvinyorwa zvaro zvakasiyana pakati pe8,5 uye 20.5 μmol / l. Muzvitsva, uwandu hwebilirubin hunogona kuwedzerwa kusvika 205 μmol / l kana kupfuura.
Izvozvo zvakakwirira zvebilirubin muzvitsva zvinonzwisisika. Apo mwana ari mudumbu, haafungi oga. Oxygen inopinda maviri ayo nerubatsiro rwe erythrocytes ine fetal hemoglobin (fetal hemoglobin). Mushure mokuberekwa, iyi hemoglobin inoparadzwa, sezvo isingazodiwi. Somugumisiro, imwe nhengo bilirubin inogona kuonekwa mumucheche. Izvi hazvisi pachena (pasina) bilirubin, iyo isingasvikiki, haikwanisi kuderedzwa neitsvo uye ichapararira muropa remwana kusvikira zvirongwa zvayo zve enzyme zvichinyatsozara. Mushure mechinguva, apo masangano aya muchecheche angagona kushanda nesimba, asinganzwisisiki bilirubin ichashandurwa kuve yakananga uye yakabviswa mumuviri.
Jaundice yevana vachangoberekwa
Kuwedzera bilirubin pamusoro pezvakakonzera kunokonzera kuonekwa kwe jaundice muzvitsva, izvo zvinogona kuva:
- physiological;
- pathological.
Physiological jaundice
Izvi zvinoitika munenge makumi manomwe kubva muzana zvevana vose, zvinowanikwa mumazuva 3-4 uye pakupedzisira zvinonyangarika pasina tsvaga pasina kukuvadza muviri. Kuwedzera kwebilirubin muropa rechecheche kunobva pauwandu hwekukura kwemucheche, uyewo kuti sei kubata nemadzimai: kana pane zvirwere kana zvimwe zvinetso. Kazhinji kuitika kwe jaundice kunokonzera intrauterine fetal hypoxia, asphyxia, chirwere cheshuga chechirwere cheshuga.
Pathological icterus
Nekuwedzerwa kukuru kwebilirubin muropa mumana achangoberekwa kunowedzera hutachiona hwehutachiona, izvo zvinokonzera izvo zvinogona kuva:
- kusawirirana kweamai nevana kuburikidza nemapoka eropa kana Rh factor;
- kuparadzwa kwemagetsi eerythrocytes;
- hutachiwana hwechiropa;
- mechanical jaundice;
- matumbo okudzivirira;
- Gilbert's syndrome (constitutional hepatic dysfunction);
- hormonal disorders, nezvimwewo.
Sezvatinoona, pane zvikonzero zvakawanda, uye chete nyanzvi inogona kuzvinzwisisa.
Imwe nzira inokosha yekuongororwa ndeyekudzidza kuongorora ropa mune zvitsva zvebilirubin uye zvikamu zvayo. Kubva pane izvi uye zvimwe zviedzo uye miedzo, chiremba achaongorora uye anopa kurapa kwakakodzera.
Ngozi yepamusoro-soro yeBrilirubin muchechecheche ndeyekuti haikwanisi kudziviswa zvachose neropa reAlbumin uye inopinda muurongwa hwekutya, huchiisa pachena kune zvinosvibisa. Izvi zvine ngozi kune uropi uye nzvimbo dzinokosha dzenzara. Izvi zvinonzi "bilirubin (nuclear) encephalopathy" uye inozviratidza mumaawa 24 ekutanga mushure mokuberekwa nenzira yezviratidzo zvinotevera:
- kugona kukuru;
- kunyorera reflex inoyamwa;
- kushungurudzika uye kufunganya motokari;
- kuderedza ropa;
- kuwedzera kwechiropa uye spleen.
Nenguva yemwedzi mitanhatu, mwana anogona kunzwa kunzwa kurasikirwa, kutadza mupfungwa, kuora mwoyo. Nokudaro, huwandu hwakawanda hwebilirubin muzvitsva nguva dzose hunoda kurapwa kwakanyanya, uye munguva yemberi, kutarisa kwemashoko kubva kune veuropistori.
Nzira yekuderedza bilirubin sei muchecheche?
Ne chirwere chemuviri, chirwere chinonyanya kushandiswa pakuderedza bilirubin yakakwirira chirwere chisina kunaka (phototherapy). Pasi pesimba risina kunyatsojeka, bilirubin inoshandurwa kuva "risirino" lumirubin uye yakanyanyisa mukati meawa gumi nemaviri nemafuta uye urini. Asi phototherapy inogona kupa migumisiro yechirwere: ganda rinotarisa, zvigaro zvakasununguka, izvo zvinopfuura mushure mokupera kwekurapa. Kuzvidzivirira uye kurapa kwakanaka kwehupenyu hwejeri ndekushandiswa kwepakutanga kuenda kumazamu uye kunowedzera kudya. Colostrum inokurudzira excretion ye meconium (yekutanga yemhuka) pamwechete ne bilirubin.
Mune chirwere chechirwere chepachirwere, kuwedzera pane phototherapy uye kudya nguva dzose nemukaka wemvere, kurapwa kunokosha kuve uchifunga nezvechikonzero chechirwere. Iyi kurapwa inoitwa muchipatara chevana neonatologists.
Usakanganwa, yakakwirira bilirubin muchechecheche inogara iri nyaya yekucherechedza nekucherechedza zvakasimba.