Ntau tus neeg mob xav txog cov lus nug - dab tsi yog biochemistry ntawm cov ntshav, nrog rau cov nitrogen seem, kev txiav txim siab ntawm kev kuaj ntshav. Kev tshuaj xyuas biochemical tau siv dav hauv kev kuaj mob, lawv pab txheeb xyuas cov kab mob loj xws li ntshav qab zib, kev loj hlob ntawm qog noj ntshav, ntau yam ntshav tsis txaus, thiab ntsuas raws sijhawm hauv kev kho mob. Residual nitrogen muaj nyob rau hauv urea, creatinine, amino acids, indican. Nws qib kuj tseem tuaj yeem qhia txog kev hloov pauv pathological hauv tib neeg lub cev.
ntshav chemistry
Ib qho kev tshuaj ntsuam xyuas ntawm biochemical muaj pes tsawg leeg ntawm cov ntshav ua rau nws muaj peev xwm txiav txim siab, nrog rau qib siab ntawm qhov yuav tshwm sim, ntau yam kev hloov pauv hauv cov ntaub so ntswg thiab cov kabmob thaum ntxov. Kev npaj rau biochemistry yog ua tiav ib yam li nrog kev kuaj ntshav tsis tu ncua. Rau kev tshawb fawb, ntshav yog muab los ntawm cov hlab ntsha cubital. Cov txheej txheem tseem ceeb muaj raws li hauv qab no:
• Muajprotein;
• nitrogenous feem - residual nitrogen, creatinine, urea cov ntsiab lus, inorganic compounds;
• cov ntsiab lus bilirubin; • rog metabolism.
Residual blood nitrogen - yog dab tsi?
Hauv kev kuaj ntshav biochemical, tag nrho cov ntsuas ntawm cov ntsiab lus ntawm cov ntshav, uas suav nrog nitrogen, tsuas yog ntsuas tom qab tag nrho cov protein tau muab rho tawm. Cov sum ntawm cov ntaub ntawv yog hu ua residual ntshav nitrogen. Qhov ntsuas no tau sau tseg tsuas yog tom qab cov protein raug tshem tawm, vim tias lawv muaj nitrogen ntau tshaj plaws hauv tib neeg lub cev. Yog li, qhov seem nitrogen ntawm urea, amino acids, creatinine, indican, uric acid, ammonia yog txiav txim siab. Nitrogen kuj tseem muaj nyob rau hauv lwm yam khoom uas tsis yog-protein keeb kwm: peptides, bilirubin, thiab lwm yam tebchaw. Cov ntaub ntawv txheeb xyuas nitrogen seem muab lub tswv yim ntawm tus neeg mob txoj kev noj qab haus huv, qhia txog cov kab mob ntev, feem ntau cuam tshuam nrog cov teeb meem hauv excretory thiab lim dej ua haujlwm ntawm lub raum. Feem ntau, cov khoom seem nitrogen yog los ntawm 14.3 txog 28.5 mmol / liter. Qhov nce hauv qhov ntsuas no tshwm sim tawm tsam keeb kwm ntawm:
• polycystic;
• mob raum mob;
• hydronephrosis;
• ureteral pob zeb;• kab mob raum tuberculous.
Diagnosis
Txij li thaum qhov kev sim rau cov nitrogen seem muaj nyob rau hauv biochemical tsom xam, kev npaj yog ua raws li tib lub hauv paus ntsiab lus ua ntej dhau mus rau lwm cov khoom ntawm qhov kev kuaj mob no. Kom tau txais txiaj ntsig zoo dua, koj xav tauUa raws li ntau txoj cai thaum pub ntshav rau biochemistry:
• Yog tias koj yuav tsum ua qhov kev soj ntsuam thib ob, nws yog qhov zoo dua los ua nws hauv tib lub chaw kuaj ntshav li thawj zaug. Txij li txhua lub chaw kuaj mob muaj cov qauv kuaj mob sib txawv, lawv sib txawv hauv cov txheej txheem rau kev ntsuas qhov tshwm sim.
• Cov ntshav coj los ntawm cov hlab ntsha cubital, tej zaum los ntawm tus ntiv tes yog tias cov leeg tsis tuaj yeem nkag los yog puas. • Kev soj ntsuam yog tsim nyog ntawm lub plab khoob, tsis pub tsawg dua 9-12 teev tom qab noj mov kawg. Koj tuaj yeem haus dej, tab sis tsis muaj roj.
• Lub sijhawm zoo rau kev kuaj ntshav yog suav tias yog 7-10 teev sawv ntxov.
• Peb hnub ua ntej kev tshuaj ntsuam, nws yog qhov zoo dua los tswj koj cov kev noj haus ib txwm muaj., koj yuav tsum tshem tawm tsuas yog rog, kib.
• kev ua si kis las yuav tsum raug cais tawm rau peb hnub, tshwj xeeb tshaj yog tias lawv cuam tshuam nrog lub cev ntau dhau.
• Yog tias koj yuav tsum tau soj ntsuam rau residual ntshav nitrogen, biochemistry xav kom koj tsis txhob noj tshuaj. Cov ntsiab lus no yuav tsum tau tham nrog tus kws kho mob uas tuaj koom.
• Kev ntxhov siab thiab kev ntxhov siab tuaj yeem cuam tshuam cov txiaj ntsig, yog li tsawg kawg ib nrab teev ua ntej qhov kev xeem koj yuav tsum tau zaum hauv qhov chaw ntsiag to.
Yog tias npaj rau biochemistry mus zoo, tom qab ntawd cov txiaj ntsig kev xeem yuav muaj kev ntseeg siab dua. Tsuas yog cov kws kho mob tshwj xeeb yuav tsum cuam tshuam nrog kev txiav txim siab. Cov duab feem ntau hloov pauv mus rau tus qauv, yog li lawv tuaj yeem txhais tsis raug ntawm lawv tus kheej.
Norm of residual nitrogen hauv cov ntshav
Ib txwm nyeem hauv cov ntshav ntawm cov khoom seem nitrogen haum rau cov lej ntawm 14.3 txog 26.8 mmol / l. Nws pab tau kom nco ntsoov,tias qhov nce ntawm qhov ntsuas txawm tias mus txog 30-36 mmol / L tsis tau txhais tam sim ntawd raws li kev tshwm sim ntawm pathology. Residual nitrogen, tus qauv uas tsawg dua, tuaj yeem nce thaum noj zaub mov uas muaj nitrogen, thaum noj zaub mov qhuav, thiab thaum muaj kev tsis txaus ntawm cov khoom siv thaum muaj xwm txheej ceev. Kev dhia hauv qhov ntsuas kuj tuaj yeem tshwm sim ua ntej yug menyuam, tom qab kev cob qhia kev ua kis las, thiab rau ntau yam laj thawj. Tias yog vim li cas nws thiaj li yuav tsum ua tib zoo npaj rau kev xa cov qauv rau cov ntshav biochemistry. Yog tias qhov kev ntsuam xyuas ntau dhau los yog qis dua qhov ntsuas thiab tib lub sijhawm muaj kev npaj tsim nyog ua ntej kuaj ntshav, qhov no yuav qhia tau tias muaj ntau yam kab mob hauv lub cev.
Residual nitrogen feem suav nrog:
• urea nitrogen (46-60%);
• creatine (2.5-2.7%);
• amino acid nitrogen (25%); • uric acid (4%);
• creatinine (2.6-7.5%);
• lwm cov khoom lag luam protein metabolism.
Residual nitrogen yog qhov sib txawv ntawm residual nitrogen thiab urea nitrogen. Ntawm no cov feem dawb yog sawv cev los ntawm cov amino acids dawb.
pathologies
Residual nitrogen pathologies suav nrog:
- hyperasotemia - thaum theem ntawm cov nitrogen seem hauv cov ntshav siab dhau lawm;
- hypoazotemia - seem nitrogen nyob rau hauv cov ntshav yog underestimated.
Hypoazotemia feem ntau pom nrog kev noj zaub mov tsis zoo lossis tsis tshua muaj thaum cev xeeb tub.
Hyperasotemia muab faib ua kev khaws cia thiab tsim khoom.
Thaum tuav hyperazotemia tshwm sim, kev ua txhaum ntawm kev ua haujlwm ntawm lub raum raug kuaj pom qhov no, lub raum.ua tsis tiav. Feem ntau, qhov ua rau kev txhim kho ntawm kev khaws cia hyperazotemia yog cov kab mob hauv qab no:
• glomerulonephritis;
• pyelonephritis;
• hydronephrosis lossis raum tuberculosis;• polycystic;
• nephropathy thaum cev xeeb tub;
• arterial hypertension nyob rau hauv txoj kev loj hlob ntawm lub raum kab mob;
• muaj kev lom los yog txhua yam teeb meem rau cov zis tawm (pob zeb, xuab zeb, malignant los yog benign formations nyob rau hauv lub raum, urinary tract).
YProduction hyperazotemia
Ntau cov ntshav cov ntshav nitrogen ntau ntxiv tuaj yeem qhia txog kev tsim cov hyperazotemia, thaum cov kab mob pathological nrog rau cov kab mob endogenous intoxication. Nws kuj tseem pom nrog kev ntxhov siab ntev hauv lub sijhawm postoperative. Muaj ntau ntau hyperazotemia nyob rau hauv cov kab mob sib kis uas tshwm sim nrog kub taub hau, thaum muaj kev loj hlob ntawm cov ntaub so ntswg, cov no muaj xws li kab mob: diphtheria, typhus, scarlet fever, lobar pneumonia. Cov khoom tsim tawm hyperazotemia yog tus cwj pwm los ntawm kev nce ntxiv ntawm cov khoom seem ntawm nitrogen los ntawm thawj hnub ntawm kev mob mus txog qhov kawg tshwm sim ntawm kub taub hau.
Cov txheeb ze tuaj yeem pom nrog kev tawm hws ntau ntxiv, ntshav khov, nrog rau raws plab, thaum cov dej sib npaug hauv lub cev cuam tshuam.
sib xyaw hom hyperazotemia
Muaj cov xwm txheej thaum cov nitrogen seem nce siab thiab sib xyaw hyperazotemia raug txiav txim. Nws feem ntau tshwm sim thaum muaj tshuaj lom nrog tshuaj lom.tshuaj: dichloroethane, mercury ntsev, lwm yam tshuaj lom neeg. Qhov ua rau tuaj yeem yog kev raug mob uas cuam tshuam nrog cov ntaub so ntswg ntev. Hauv cov xwm txheej zoo li no, necrosis ntawm lub raum cov ntaub so ntswg tuaj yeem tshwm sim, thaum khaws cia hyperazotemia pib nrog rau kev tsim khoom. Nyob rau theem siab tshaj plaws ntawm hyperazotemia, residual nitrogen nyob rau hauv qee kis tshaj li cov cai los ntawm nees nkaum zaug. Cov ntsuas no tau sau tseg rau hauv qhov mob hnyav heev ntawm lub raum puas.
Cov ntsuas ntawm cov khoom seem nitrogen yog overestimated tsis tsuas yog nrog rau lub raum puas. Nyob rau hauv Addison tus kab mob (adrenal dysfunction), cov kev cai kuj dhau lawm. Qhov no kuj tshwm sim nrog lub plawv tsis ua hauj lwm, nrog kub hnyiab ntawm qhov hnyav, nrog lub cev qhuav dej, nrog rau cov kab mob loj ntawm cov kab mob, nrog rau kev ntxhov siab hnyav thiab los ntshav hauv plab.
Nws tuaj yeem tshem tawm qhov tshwm sim ntawm cov khoom seem nitrogen siab los ntawm kev txheeb xyuas qhov ua rau tus mob no nyob rau lub sijhawm. Rau kev kho mob ntxiv, tus kws kho mob yuav tsum tau sau ntau cov kev tshawb fawb ntxiv, raws li cov txiaj ntsig ntawm nws yuav ua qhov kev txiav txim siab, tsim kev kuaj mob kom raug thiab sau cov tshuaj tsim nyog lossis lwm yam kev kho mob. Txhawm rau kuaj pom tus kab mob nyob rau lub sijhawm thiab kho nws, nws yog ib qho tsim nyog yuav tsum tau kuaj xyuas raws sijhawm thiab dhau txhua qhov kev xeem. Yog tias pom muaj cov kab mob pathology, kev kho kom raug yuav tiv thaiv cov teeb meem los ntawm kev txhim kho, tus kab mob los ntawm kev hloov mus rau hauv qhov hnyav thiab ib qho mob ntev.
