Lipidosis hepatic hepatic

La lipidosis hepatic dameerku waa mid ka mid ah cudurrada ugu badan ee bisadaha.

Waa cudur lagu garto a ururinta xad-dhaaf ah ee triglycerides beerka oo farageliya shaqada beerka oo inta badan keenta shaqada xubnaha.

Isku-ururinta Triglyceride ee beerka dhib maaha ilaa heerka faaruqinta uu noqdo mid aad u daran. Bisadaha qaba cudurrada habaysan waxay inta badan yeeshaan baruurta hepatocellular.

Beerka caadiga ah, dufanka ku jira ayaa ka yar 5% miisaanka guud ee xubinta, halka bisadda leh cagaarshow lipidosis syndrome qiimihiisu xitaa saddex jibaarmi karaa. Hepatic triglycerides waxaa laga soo saaraa asiidh dufan ah oo ka soo jeeda wareegga nidaamka (lipids-ka cuntada ama dukaamada adipose) iyo ka soo baxa beerka beerka.

Waa inaad aad uga taxadartaa buurnaanta

Joogtee miisaanka bisaddaada oo la xakameeyo iyo bixinta cunto caafimaad leh oo dheellitiran waxay ka hortagi kartaa lipidosis cagaarshow. Bisadaha, nafaqo-xumo, taas oo inta badan ay sababto gaar ahaan karbohaydraytyada xad dhaafka ah ee cuntada, waxaa sabab u ah ururinta dufanka gudaha hepatocytes. Dhab ahaantii, qaar badan oo ka mid ah bisadaha ku dhaca beerka beerka waa cayil.

Maxaa dhacaya?

Lipidosis-ka cagaarshowga waxay ka tarjumaysaa awood la'aanta xubinta in ay isku dheelitirto dufanka lumay iyo qaadashada ilaha nidaamka. Isku dheelitirka u dhexeeya lipolysis iyo ururinta triglyceride waxaa habeeya hababka hormoonnada iyo neerfaha. Si gaar ah ayaan taas u dhihi karnaa lipase xasaasiga ah hormoonka (HSL), oo kor u qaada lipolysis, iyo llipoprotein-lipase (LPL), oo kor u qaada qaadashada dufanka, waxay si toos ah u nidaamisaa dheef-shiid kiimikaadka adipocyte.

Catecholamines sida norepinephrine, epinephrine, GH, glucagon, corticosteroids, iyo thyroxine waxay kordhiyaan dhaqdhaqaaqa HSL, halka insulintu ay joojiso. Bisadaha, Cadaadisku waxa uu keenaa in si degdeg ah loo sii daayo catecholamines, taasoo kordhisa dhaqdhaqaaqa HSL. Marka la eego xaaladaha soonka ee dabadheeraada, in kasta oo dhaqdhaqaaqa LPI hoos u dhaco, waxqabadka HSL wuu kordhaa, taas oo door bida ururinta baruurta ee heerka hepatocellular.

Kee baa sababi kara?

lipidosis waxay noqon kartaa aasaasiga ah, taas oo ah, kac si kedis ah, iyada oo aan la helin sabab sax ah oo la ogaan karo (qaabka idiopathic), ama labaad cudurada kale ee keena anorexia iyo miisaan kedis ah oo hoos u dhaca.

Soonka heerka labaad ee cudurrada cudurrada kala duwan ama kuwa aan cudurada ahayn, sida diidmada cunto cusub oo aan cunto lahayn, waxay keenaysaa abaabulka bakhaarrada baruurta iyo korodhka shaqada dheef-shiid kiimikaadka ee beerka..

Xaaladaha caadiga ah, beerku wuxuu leeyahay shaqada isku-darka dufanka, sida triglycerides, kolesteroolka, lipoprotein iyo fosfoolipids, iyo dheef-shiid kiimikaadka dufanka (fatty acids) ee ku jira jirka (dukaamada jirka). Isku-ururinta dufanku waxay dhacdaa marka beer-ku-samaynta ama kaydinta beerku ay aad uga weyn tahay awoodda isticmaalka.

Khatarta sii kordheysa ee lipidosis ee bisadaha cayilan oo aan cunin

Sidaas awgeed, a Bisad cayilan oo la soo deristay walaac iyo soonka "is-daba-joog". Si sax ah walaaca awgiis, waxa ay la soo gudboonaatay khatar weyn oo ah abaabulida dufanka durugsan iyo qaadashada heerka hepatocellular.

Isdhexgalka ka dhexeeya acids dufanka iyo L-carnitine ee heerka xuubka mitochondrial, si loogu sii daayo gudaha mitochondria laftiisa iyo samaynta asiidh dufan firfircoon, lagama maarmaan u ah beta oxidation, ayaa sidoo kale laga yaabaa inay door ka ciyaaraan horumarinta xanuunka. lipidosis hepatic.

Intaa waxaa dheer, yaraanta GSH ee hepatocytes waxay ku lug leedahay pathogenesis of lipidosis, oo ka dhigan cillad la'aanta dariiqa transsulfuration.

Faytamiin B12 ayaa isna door muhiim ah ka ciyaara

Ugu dambeyntii, marar badan ayaa la helay yaraanta fitamiin B12 bisadaha leh lipidosis cagaarshow.

Sababaha suurtagalka ah ee lipidosis cagaarshowga ee bisadaha, sidaas darteed iyo soo koobid, dib ugu noqo kororka soo bandhigida dufanka ee beerka, natiijada buurnaanta, kicinta dhacdooyinka muhiimka ah ee catabolic sababtoo ah cudurrada hoose, nafaqo-xumo dabadheeraad ah, xoojinta de novo hepatic synthesis of dufanka, ama oksaydhka oo bedelay ama kala firdhiyey VLDL.

Soo koobid ...

• nafaqo-xumo, gaar ahaan karbohaydraytyada, waxay guud ahaan kordhisaa ururinta dufanka.
• Cayilka xad dhaafka ah Waa arrin soo jiidasho leh, oo aad muhiim ugu ah horumarinta lipidosis hepatic. Bisadda buuran ee aan cunto cunid lahayn, siidaynta wayn ee aysiidhka dufanka leh ee unugyada kaydsan ayaa cadaadis saaraya awoodda beerka ee isticmaalka iyo ka saarida. 
• Samaynta lipoproteins cufnaanta aadka u hooseeya (VLDL) Waxay lagama maarmaan u tahay baabi'inta iyo kala firdhinta lipids. Awoodda cagaarshowga ee daciifka ah si loo sameeyo VLDL (oo u baahan helitaan tamar ah oo ka maqan lipidosis) waxay keentaa ururin weyn oo triglyceride ah.
• Isdhexgalka ee acids dufan leh L-carnitine waxa ay lama huraan u tahay in aysiidh dufan ah u rarto mitochondria, si ay beta-oxidations (ie, falcelinta ka faa'iidaysiga tamarta lipid) ay u dhacaan. Bisadaha qaba lipidosis cagaarshow waxay inta badan la kulmaan yaraanta carnitine. 
• Vitamin B12 yaraanta (cobalamin) aad bay u badan tahay inta lagu jiro lipidosis. 

Dhib malaha haddii ay yar yihiin ama ay weyn yihiin.

lipidosis hepatic waxay saameyn kartaa bisadaha da 'kasta, iyada oo aan si gaar ah loo eegin jinsiyadda iyo jinsiga. Si kastaba ha ahaatee, dheddigga da'da dhexe ama waayeelka waxay u muuqdaan inay saameeyaan si ka badan ragga iyo maaddooyinka yaryar.

Sideen ku ogaan karnaa?

Calaamadaha ugu caansan guud ahaan inta lagu jiro koorsada lipidosis cagaarshow waa matag, niyad-jab, anorexia, iyo miisaan lumis degdeg ah. Calaamad kale oo aad muhiim u ah oo inta badan soo baxda waa cagaarshow, taas oo ah, midabka jaalaha ah ee maqaarka iyo xuubabka.

Bisadaha qaba lipidosis cagaarshow badanaa aad bay u daciif yihiin waxayna xitaa muujin karaan ventroflexion ee qoorta ama soo kabashada joogtada ah. Xaaladaha qaarkood, calaamadaha hepatic encephalopathy ayaa la iftiimin karaa, taas oo ah, calaamadaha neerfaha ee u sarreeya sakhraannimada jidhka. Mararka qaarkood encephalopathy hepatic waxaa lagu arki karaa hypersalivation.

Waxaa laga yaabaa inay jiraan cuduro kale oo keena lipidosis-kan ...

Waxaa jiri kara cudurro kale sida cudurrada beerka qaarkood (tusaale cholangitis), pankreatit, cudurrada caloosha iyo mindhicirka (oo lagu sifeeyo matag iyo shuban), burooyin ama sonkorowga mellitus oo ka mid ah dhibaatooyinka ugu badan ee la xidhiidha lipidosis.

Haddii aad leedahay bisad buuran oo aad dareento xitaa mid ka mid ah calaamadahan, talada ayaa ah inaad si degdeg ah u booqato dhakhtarka xoolaha, ka dib baaritaan qotodheer iyo taxadar gaar ah taariikhda caafimaadka iyo muuqaalka calaamadaha, samee cudurka. Oo sidaas darteed waxaad qiimeyn kartaa darnaanta pathology-ga.

Tijaabooyin shaybaar iyo baaritaanno kale si loo ogaado lipidosis cagaarshow

Waxay samayn karaan dhowr baaritaan si ay u ogaadaan lipidosis sida kuwa aan hoos kaga hadalno.

Baaritaanka dhiigga:

• Tirada dhiigga oo dhammaystiran, astaanta guud ee biochemistry: gHyperbilirubinemia, korodhka enzymes beerka, gaar ahaan korodhka alanine aminotransferase (ALT), aspartate aminotransferase (AST), iyo serum alkaline phosphatase (SAP) ayaa badanaa la helaa. Gamma glutamyl transferase (GGT) waa caadi (haddii aanu jirin cholangitis) Dhibaatooyinka kale ee caadiga ah ee la helo waxaa matala hypokalemia, hoos u dhaca BUN, hypophosphatemia, mararka qaarkood hypoalbuminemia, iyo hypocalcemia (gaar ahaan kiisaska leh pankreatit wadajir ah).
• Tijaabada xinjirowga:  kororka waqtiyada xinjirowga ayaa la arki karaa tan iyo markii beerka uu ku lug leeyahay isku-dhafka walxaha kuwaas oo door bida hababka xinjirowga. Gaar ahaan, inta lagu jiro koorsada lipidosis cagaarshow, yaraanta fitamiin K waa mid soo noqnoqda, fitamiin lagama maarmaan u ah firfircoonida arrimaha xinjirowga.

Sawirada: hepatomegaly ( beerka wayn) ayaa laga yaabaa in lagu arko baaritaanka shucaaca.

Ultrasonography:  Baaritaanka Ultrasound wuxuu muujin karaa beerka aan caadiga ahayn (hyperechoic) iyo joogitaanka cudurada dhexmara (tusaale, pankreatit, cholangitis, ama neoplasia).

hamiga irbadda ee beerka: Hamiga irbaddu waa habraaca ugu yar ee soo gelitaanka kaas oo bixin kara macluumaad faa'iido leh oo ku saabsan joogitaanka dufanka ku urursan unugyada beerka (hepatocytes) oo ka saaraya wax kasta oo ka mid ah pathology burada.

Biyobsi Beerka: Ka-qaadista beerka ayaa lagula taliyaa bisadaha aan ka jawaabin daawaynta bilowga ah ama marka cad-cad-qaadid sidoo kale la tilmaamo si loo baaro isbeddellada kale ee xubnaha.

Daawaynta lipidosis cagaarshowga

lipidosis hepatic inta badan waa dib loo rogaa Haddii si habboon loo daweeyo, laakiin aan la daawayn waxay noqon kartaa mid aad halis u ah, mararka qaarkoodna keenta dhimasho. Haddaba, waa in aan la dhayalsan muddada dheer ee soonka. Gaar ahaan haddii bisaddaadu ay buuran tahay oo aysan wax cunin dhowr maalmood, waa inaad si degdeg ah ula tashataa dhakhtarkaaga xoolaha.

Daawaynta waxtarka leh, waa lagama maarmaan in la ogaado sababta asalka u ah (xanuunka xameetida, caloosha, mindhicirka, xiidmaha, iwm.), marka ay jiraan, kuwaas oo laga yaabaa in ay sababeen luminta rabitaanka cuntada oo ka soo jeeda beerka lipidosis.

Caadiyan, bisadaha qaba lipidosis cagaarshow iyo naafo aad u daran   Waxay marka hore u baahan yihiin daawayn isbitaal ka dibna isbitaal la seexiyaa si ay u helaan daryeelka ugu habboon.

Marka lagu daro daaweynta sababta asaasiga ah, marka la ogaado. daaweynta cilladaha elektrolytka ee la helay, fuuq-celinta iyo xakamaynta matagga, waa lagama maarmaan in la siiyo xayawaanka cunto dheellitiran iyada oo loo marayo quudinta khasabka ah.

Intaa waxaa dheer, dheellitirka fitamiinada ayaa lagula talinayaa kooxda Fiitamiinada biyaha ku milma, fiitamiin K iyo fitamiin E. Ugu dambeyntii, maamulka L-carnitine, taurine iyo S-adenosyl-methionine iyo / ama phytotherapeutic adjuvants ayaa lagula talinayaa in la soo celiyo shaqada beerka ee saxda ah.