Conjugated vs Unconjugated Bilirubin
Bilirubin yog ib qho chaw uas muaj plaub pyrrole rings txuas nrog lub nplhaib porphyrin loj dua. Nws yog tshwm sim los ntawm kev puas tsuaj hemoglobin. Nws zoo ib yam li phytochrome thiab phycobilin ntawm qee cov nroj tsuag thiab algae. Nws muaj nyob rau hauv ob isomers. Daim ntawv tshwm sim yog ZZ-isomer. Bilirubin isomerizes thaum raug lub teeb. Ntau cov dej soluble EZ-isomer cov ntaub ntawv thaum ZZ-isomer ntsib teeb. Qhov no yog lub hauv paus ntawm phototherapy nyob rau hauv cov me nyuam mos. Cov qe ntshav liab tso hemoglobin thaum lawv tuag hauv tus po. Hemoglobin faib ua heme thiab globin. Enzymes rhuav tshem cov saw globin. Reticuloendothelial hlwb ntawm tus spleen hloov heme rau hauv unconjugated bilirubin. Unconjugated bilirubin yog dej insoluble. Albumin khi unconjugated bilirubin thiab thauj mus rau daim siab. Hauv daim siab, ib qho enzyme hu ua glucuronyltransferase conjugates bilirubin nrog glucuronic acid. 95% ntawm conjugated bilirubin nkag mus rau hauv cov kua tsib. Ntawm cov kua tsib nws nkag mus rau hauv cov hnyuv. Terminal ileum reabsorbs conjugated bilirubin, thiab lub portal ncig nqa nws rov qab mus rau lub siab. Qhov no yog hu ua enterohepatic ncig ntawm bilirubin. 5% tshuav nyob rau hauv txoj hnyuv loj hloov mus rau hauv urobilinogen vim qhov kev ua ntawm cov kab mob plab. Lub plab absorbs urobilinogen ib yam li conjugated bilirubin. 95% nkag mus rau enterohepatic ncig. Lwm 5% tseem nyob rau hauv daim ntawv stercobilin uas muab cov xim xim av rau cov quav. Ib qho me me ntawm urobilinogen reabsorbed los ntawm plab mus rau ob lub raum. Ntxiv oxidization ua rau urobilin uas muab cov xim daj rau cov zis. Feem ntau tag nrho cov qib bilirubin yuav tsum tsawg dua 2.1 mg/dl. Cov qib siab dua tuaj yeem qhia cov kab mob.
Unconjugated Bilirubin
Unconjugated bilirubin cov ntsiab lus nce siab thaum muaj cov qe ntshav liab ntau dhau. Kev khiav ntawm bilirubin nqes cov tshuaj tiv thaiv cascade overwhelms lub siab glucuronylranferase. Yog li ntawd, unconjugated bilirubin accumulates nyob rau hauv cov hlab ntsha uas khi rau albumin. Cov qe ntshav liab tawg hauv cov kab mob spherocytosis, elliptocytosis, kab mob mob hlwb, G6PD tsis txaus, thiab vim qee yam tshuaj. Cov kab mob tshwm sim zoo li glucuronylranferase deficiency kuj ua rau tsis muaj kev sib txuas ntawm hyperbilirubinemia.
YConjugated Bilirubin
Conjugated bilirubin nkag mus rau hauv cov ntshav ntau ntau thaum lub biliary outflow raug thaiv. Mob qog nqaij hlav hauv lub siab kis mus rau hauv cov kua tsib thiab thaiv cov kua tsib. Cov pob zeb hauv cov pob zeb, cov kab mob ntawm cov ducts, mob qog noj ntshav ntawm lub taub hau ntawm cov txiav, pancreatic pseudocyst, thiab cov qog nqaij hlav periampulary kuj tseem thaiv cov ducts thiab ua rau muaj kev sib txuas ntawm hyperbilirubinimia.
Dab tsi yog qhov txawv ntawm Conjugated thiab Unconjugated Bilirubin?
• Unconjugated bilirubin yog dej insoluble thaum conjugated bilirubin yog dej-soluble.
• Unconjugated bilirubin cov ntaub ntawv nyob rau hauv cov hlwb reticuloendothelial thaum lub siab ua conjugated bilirubin.
• Conjugated bilirubin nkag mus rau hauv cov hnyuv me nrog cov kua tsib thaum unconjugated bilirubin tsis.
Nyeem ntxiv:
1. Qhov txawv ntawm Pancreatic Cancer thiab Pancreatitis
