Lub siab yog ib lub cev loj tshaj plaws. Nws muaj kev koom tes ncaj qha rau hauv cov metabolism, ntxuav cov kua hauv cov ntaub so ntswg ntawm cov tshuaj lom, thiab tseem tswj tau qee cov txheej txheem biochemical. Tag nrho cov kev ua no tshwm sim vim yog cov enzymes (enzymes) tsim los ntawm lub siab nws tus kheej. Lawv cov ntsuas ntsuas tseem ceeb hauv kev kuaj mob. Yog hais tias daim siab enzymes nce siab, qhov no qhia tau hais tias kev loj hlob ntawm cov txheej txheem pathological hauv lub cev. Xws li cov txiaj ntsig ntawm kev tshuaj xyuas biochemical yog lub hauv paus rau kev kuaj xyuas.
Enzyme pawg
Txhua cov enzymes uas tsim los ntawm lub siab muaj qee yam ua ke. Cov tom kawg yog cov txheej txheem tseem ceeb ntawm kev faib tawm.
Cov pab pawg siab enzyme:
- Indicator. Lawv qib deviates los ntawm cov cai nyob rau hauv qhov kev tshwm sim uasthaum lub hlwb puas lawm. Cov enzymes no muaj xws li: ALT (alanine aminotransferase), AST (aspartate aminotransferase), LDH (lactate dehydrogenase), GDH (glumatate dehydrogenase), GGT (gammaglutamyl transpeptidase). Cov enzymes ALT thiab AST muaj qhov tseem ceeb tshaj plaws hauv kev kho mob.
- Secretory. Tsim los tswj cov ntshav khov index. Cov no suav nrog: prothrombinase, cholinesterase.
- Kev tawm dag zog. Clinically tseem ceeb yog qhov taw qhia ntawm alkaline phosphatase. Yog tias nws deviates nce lossis nqis, nws yog ib txwm hais txog kev ua txhaum cai hauv cov kab mob biliary.
Qhov xaus ntawm kev kuaj ntshav biochemical tsis cuam tshuam tag nrho cov enzymes, tab sis tsuas yog cov uas tseem ceeb tshaj plaws hauv kev kuaj kab mob pathological.
ntsuas ntsuas ib txwm
Ua ntej, cov kws kho mob ntsuas cov qib AST thiab ALT enzymes. Ntxiv mus, thawj yog muaj tsis tau tsuas yog nyob rau hauv daim siab. AST tuaj yeem pom hauv cov leeg pob txha, myocardium, thiab ob lub raum. ALT yog ib qho enzyme uas muaj nyob hauv daim siab. Ib qho piv txwv ntawm AST yog ib qho uas tsis pub tsawg tshaj 10 thiab tsis ntau tshaj 30 U / l. Rau ALT nws txawv ntawm 10 txog 40 U / L.
Cov kws kho mob kuj ntsuas qhov piv ntawm alanine aminotransferase thiab aspartate aminotransferase. Yog tias daim siab enzyme ALT nce siab thiab sib npaug ntawm qib AST, qhov no qhia txog kev txhim kho kab mob siab. Thaum thawj zaug 2 zaug ntau dua qhov thib ob, nws yog ib txwm hais txog kev haus cawv. Yog tias, ntawm qhov tsis sib xws, AST siab dua ALT, qhov no qhia tias muaj mob cirrhosis. Cov no yog cov laj thawj tseem ceebnce nyob rau hauv cov ntshav ntawm daim siab enzymes teej tug mus rau qhov taw qhia pawg.
GGT, LDH thiab ALP enzymes kuj tseem ceeb heev. Cov qauv ntawm gamma-glutamyl transpeptidase hauv cov ntshav tsis ntau tshaj 40 U / l. GGT pom tsis tau tsuas yog nyob rau hauv daim siab, tab sis kuj nyob rau hauv lub raum, cov phab ntsa ntawm cov kua tsib ducts thiab lub txiav. Cov enzyme yog qhov qhia tau zoo tshaj plaws, tshwj xeeb tshaj yog nyob rau hauv cov menyuam yaus thiab thaum cev xeeb tub. Piv txwv li, yog tias AST thiab ALT nyob hauv thaj tsam ib txwm muaj thaum raug tshuaj lom, ces GGT yuav twv yuav raug nce ntxiv.
Lub LDH enzyme tsis tsuas yog pom hauv daim siab xwb. Vim li no, nws tseem raug txheeb xyuas siv cov lej ntawm 1 txog 5. Yog tias xav tias ua txhaum ntawm cov kab mob biliary, yuav tsum tau kuaj ntshav rau LDH-5. Enzyme tus nqi - txog 250 U / L.
Alkaline phosphatase yog ib qho enzyme tseem pom nyob rau hauv ob lub raum, pob txha pob txha, thiab cov phab ntsa ntawm cov kua tsib. Nws qhov kev nce ntxiv qhia tias ua txhaum ntawm kev ua haujlwm ntawm hepatobiliary system. Cov qauv ntawm alkaline phosphatase - txog 270 U / l.
Ua kom nce siab enzymes hauv cov ntshav
Tsis yog txhua qhov xwm txheej, qhov sib txawv ntawm qhov ntsuas los ntawm tus qauv qhia txog kev txhim kho cov txheej txheem pathological hauv lub cev. Siab siab enzymes hauv cov ntshav yog qee zaum tshwm sim los ntawm kev rog dhau los lossis noj qee yam tshuaj. Cov tshuaj tua kab mob thiab tshuaj tua kab mob, nrog rau cov tshuaj muaj feem xyuam nrog statins thiab sulfonamides, muaj kev cuam tshuam loj tshaj plaws ntawm cov ntsuas.
Ntxiv rau, siab siab enzymes hauv cov ntshav qee zaum qhia txog cawvlom thiab tsim txom cov khoom noj rog dhau. Tsis tas li ntawd, qhov sib txawv ntawm cov enzymes los ntawm cov qauv hauv qee qhov tshwm sim tawm tsam keeb kwm yav dhau los ntawm lwm txoj kev kho mob ntawm tus kab mob. Nws yog ib qho tseem ceeb kom paub tias kev siv cov khoom raws li cov quav nyab, pob txha taub hau thiab ephedra pab txhawb rau kev nce hauv daim siab enzymes hauv cov ntshav.
Lwm yam ua rau muaj kev sib txawv ntawm cov qauv:
- Pathology nyob rau hauv daim ntawv ntawm cirrhosis, mob siab kab mob siab, lub cev nqaij daim tawv necrosis, fatty degeneration, obstructive jaundice. Nyob rau hauv tas li ntawd, lub siab enzymes ALT thiab AST yog siab.
- Lub xub ntiag ntawm cholestasis, neoplasms, cholangitis, cawv qaug cawv. Cov no yog cov laj thawj rau kev nce hauv siab enzyme GGT. Qhov taw qhia ntawm cov enzyme no nce siab tuaj yeem sib txawv ntawm keeb kwm ntawm kab mob siab, obstructive jaundice thiab cirrhosis.
Qib LDH thiab alkaline phosphatase nce tawm tsam keeb kwm ntawm tag nrho cov kab mob saum toj no.
Kev kho mob tshwm sim
Qhov sib txawv ntawm cov ntsuas no los ntawm tus qauv yog nrog los ntawm cov tsos mob ntawm tus neeg mob. Tawm tsam keeb kwm yav dhau los ntawm kev nce hauv daim siab enzymes, cov cim ceeb toom hauv qab no tshwm sim:
- txo qis hauv kev ua tau zoo.
- Zoo pib ntawm qaug zog.
- Nyob ib leeg.
- Kev tshaib plab.
- mob plab.
- khaus thiab daj ntawm daim tawv nqaij.
- Txoj kab mob uas tshwm sim yam tsis muaj laj thawj.
- Yellowness ntawm sclera.
- Ntuj ntuas ntshav ntswg.
Qee zaumLub siab enzymes tsis cuam tshuam nrog cov tsos mob.
Diagnosis
Qib enzymes tau tshwm sim hauv qhov xaus ntawm kev kuaj ntshav biochemical. Hom kev kawm no yog ib txoj kev kuaj mob hauv chaw kuaj mob uas tus kws kho mob tuaj yeem ntsuas qhov kev ua haujlwm ntawm cov kabmob hauv nruab nrog cev thiab tau txais cov ntaub ntawv tiav tshaj plaws txog cov txheej txheem metabolic.
Kev kuaj ntshav biochemical yog qhov yuav tsum tau ua hauv kev kuaj xyuas tus neeg mob, txawm tias tom kawg tsis muaj qhov tshwm sim ntawm cov kab mob.
Ua ntej pub khoom siv roj ntsha (venous lossis capillary kua txuas cov ntaub so ntswg), yuav tsum tau ua raws li qee cov cai. Kev kuaj ntshav yog nqa tawm ntawm lub plab khoob, thiab yog li noj mov zaum kawg yuav tsum tsis pub dhau 8 teev ua ntej mus ntsib chav kuaj. Psycho-kev xav tsis txaus ntseeg thiab lub cev overstrain tuaj yeem ua rau cov txiaj ntsig tsis tseeb. Ib hnub ua ntej pub ntshav, nws raug nquahu kom zam txhua yam kev tawm dag zog. Tam sim ntawd ua ntej noj cov khoom siv biomaterial, nws raug nquahu kom zaum rau 15 feeb nyob rau hauv qhov chaw ntsiag to kom normalize lub hlwb-kev xav.
txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau nce siab enzymes hauv cov ntshav, tus kws kho mob tau sau ntau qhov kev sim thiab ntsuas ntsuas. Cov npe ntawm cov kev ntsuas tsim nyog tau muab tso ua ke los ntawm tus kws tshaj lij raws li tus neeg mob cov lus tsis txaus siab, cov ntaub ntawv anamnesis thiab cov txiaj ntsig ntawm kev tshuaj xyuas biochemical.
kev kho mob
Nws yog ib qho tseem ceeb kom nkag siab tias nce enzymesdaim siab yog cov tsos mob ntawm ib qho ntawm cov kab mob ntawm lub cev. Tsuas yog tom qab txheeb xyuas cov hauv paus hauv paus, tus kws kho mob kos cov kev kho mob zoo tshaj plaws.
Txhua tus kab mob siab xav tau ib txoj hauv kev tshwj xeeb. Txoj kev kho mob rau cirrhosis muaj cov hauv qab no:
- Noj tshuaj tiv thaiv kab mob, immunomodulating lossis tshuaj hormonal (nyob ntawm seb tus kab mob etiology).
- Txhaj lossis siv qhov ncauj ntawm interferons ("Viferon", "Genferon", "Cycloferon").
- YVitamin therapy.
- Reception of hepaprotectors ("Gepabene", "Karsil", "Ursosan", "Heptral").
Tsis tas li ntawd, tus kws kho mob tshem tawm txhua yam tshuaj rau kev siv uas tsis muaj qhov qhia meej. Nws kuj tseem yuav tsum tau ua raws li kev noj zaub mov zoo thiab tso tseg cov dej haus uas muaj cawv tag.
Kev kho tus kab mob siab mob siab nrog rau cov haujlwm hauv qab no:
- Kev tswj hwm txoj hlab ntshav ntawm kev daws cov piam thaj thiab ascorbic acid.
- YVitamin therapy.
- Kev noj lossis siv tshuaj uas ua kom lub cev tshem tawm cov teeb meem hauv lub cev (nrog rau kab mob siab mob siab).
- Hemodialysis.
- Noj tshuaj tiv thaiv kab mob (Zodak, Zyrtec, Fenistil).
- Kev tswj hwm ntawm cov tshuaj tiv thaiv kab mob thiab desensitizing agents.
Nyob ntawm tus kab mob etiology thiab nws qhov hnyav, tus kws kho mob tuaj yeem hloov kho cov kev kho mob.
Kev kho cov rog rog degeneration ntawm lub cev muaj cov kauj ruam hauv qab no:
- Txais tos ntawm qhov tseem ceeb phospholipids ("Essentiale Forte", "Phospholipiale"). Cov kev npaj uas muaj nyob rau hauv pab pawg no pab txhawb kev kho cov kab mob siab.
- Txais tos ntawm cov neeg muaj zog hepaprotectors ("Rezalyut", "Antral", "Phosphogliv"). Lawv muaj txiaj ntsig zoo rau lub cev.
- Txais tos ntawm immunomodulators ("Kogocel", "Amiksin", "Arbidol").
- Kev siv cov tshuaj choleretic ("Allohol", "Flamin").
- Kev siv cov khoom noj khoom haus ("Zosterin-Ultra", "Tantalum", "Silymarin").
Kev kho mob jaundice suav nrog detoxification, tshuaj tua kab mob thiab infusion kho kev ntsuas. Yog tias lawv ua tsis tiav, kev phais raug qhia. Thaum muaj tus kab mob no, nws tseem yuav tsum tau ua raws li kev noj zaub mov nruj thiab tsis suav nrog kev siv cov dej qab zib uas muaj cawv tag.
Cov kev kho mob rau cholestasis suav nrog cov khoom hauv qab no:
- Kev noj tshuaj uas nws cov khoom xyaw nquag yog ursodeoxycholic acid (Ursofalk, Ursodez, Ursosan).
- Siv cytostatics ("Casodex", "Cisplacel").
- Kev txais tos lossis kev tswj hwm cov tshuaj hepaprotectors.
- YVitamin therapy.
- noj tshuaj tiv thaiv kab mob.
Yog li, cov tswv yim ntawm kev kho cov neeg mob siab siab enzymes (AST, ALT, alkaline phosphatase, LDH, thiab lwm yam) ncaj qha nyob ntawm lub hauv paus ua rau cov kab mob pathological.xeev. Nyob rau hauv txhua rooj plaub, tus kws kho mob, tsis tas tos rau cov txiaj ntsig ntawm kev ntsuam xyuas, pom zoo kom hloov kho cov khoom noj thiab kev noj haus. Lub hom phiaj ntawm kev ua raws li kev noj zaub mov zoo yog txhawm rau txo lub nra ntawm lub cev cuam tshuam, nrawm tshem tawm cov teeb meem sib txuas, thiab tiv thaiv cov rog rog.
Lub sijhawm rov qab los: noj zaub mov zoo
Rau kab mob siab, cov kws kho mob tau sau cov lus 5. Qhov no yog ib qho nyuaj heev, tab sis tib lub sij hawm sib npaug kev noj haus. Nws lub hauv paus ntsiab lus tseem ceeb yog kev cais tawm ntawm kev noj zaub mov ntawm cov khoom noj uas muaj roj ntau, "phem" cholesterol, purine thiab oxalic acid. Cov tshuaj no muaj kev cuam tshuam tsis zoo rau lub siab thiab tiv thaiv kev rov ua dua ntawm nws cov hlwb.
Cov ntsiab cai tseem ceeb ntawm kev noj haus:
- Nws yog ib qho tsim nyog yuav tsum tau zom kom ntau li ntau tau (nws yog qhov zoo dua rau zom) cov zaub mov uas muaj fiber ntau. Nqaij yuav tsum tau txiav rau hauv me me.
- Koj yuav tsum noj 5 zaug hauv ib hnub. Nyob rau tib lub sijhawm, qhov loj ntawm ib qho kev pabcuam yuav tsum tsis pub tshaj 200 g.
- tsuas yog zaub mov sov xwb. Cov zaub mov uas txias lossis kub dhau tsis pom zoo.
- Cov khoom raug tso cai rau boil, ci, ncu lossis stew. Cov zaub mov kib yuav tsum raug cais tawm ntawm kev noj haus.
- Qhov siab tshaj plaws ntawm ntsev ib hnub yog 10 g.
Nws yog ib qho tseem ceeb los saib xyuas kev haus dej haus cawv. Txog li 2.5 litres ntawm cov dej ntshiab uas tsis yog carbonated yuav tsum tau noj txhua hnub.
Thaum kho cov kab mob siab, nws raug nquahu kom muab qhov nyiam rau hauv qab nozaub mov:
- Bread (rye or bran).
- ncuav qab zib.
- Yeast-free ci.
- Nplej, semolina, oatmeal thiab buckwheat porridge.
- pasta.
- Berry.
- Fruit.
- Zephyr.
- Marmalade.
- Nyob zoo ib tsoom phooj ywg.
- Cabbage (Cauliflower thiab Beijing).
- Pumpkin.
- Beets.
- Carrots.
- Cucumbers.
- kab taum.
- Sweet kua txob.
- Dill.
- -parsley.
- Compote.
- YKim mis nyuj.
- Decoction of wild rose.
- Ryazhenka.
- Kefir.
- Natural yogurt.
- Cheese.
- Ntsib nqaij thiab ntses.
- qaib thiab quail qe.
- txiv roj roj.
Thaum kho thiab thaum lub sijhawm rov qab los, nws raug txwv tsis pub noj zaub mov uas ua rau lub siab ua rau lub siab thiab ua rau muaj kev noj qab haus huv hepatocytes. Nws yog qhov yuav tsum tau cais tawm ntawm cov ntawv qhia zaub mov:
- Muffin.
- Yeast ci.
- khoom noj khoom haus pastry.
- khob cij tshiab.
- Ntaus.
- Halva.
- noob.
- Chocolate.
- Nuts.
- Icecream.
- Ginger.
- Olives.
- dos ntsuab.
- Radishes.
- Mushrooms.
- -parsley.
- Spinach.
- Pickles.
- txiv lws suav.
- Cabbage Dawb (tsis thermally ua tiav).
- Raspberries.
- Grapes.
- fig.
- tshuaj yej dub thiab ntsuab thiab hibiscus.
- Packaged kua txiv.
- Coffee.
- Cov khoom noj mis nyuj uas muaj feem pua ntawm cov rog rog.
- Sauces.
- Nqaij thiab ntses rog.
Txhua cov kua zaub yuav tsum nyob hauv cov kua zaub tsis muaj zog. Nws raug nquahu kom noj cov nqaij nyias, tom qab ntawd txiav nws mus rau hauv me me thiab ntxiv rau lub tais tiav.
Txoj kev ua neeg
Cov kws kho mob tsis txwv tsis pub tig mus rau txoj kev kho mob uas tsis yog ib txwm ua. Txawm li cas los xij, koj yuav tsum xub sab laj nrog tus kws kho mob tshwj xeeb. Qhov no yog vim qhov tseeb tias qee cov khoom siv ntuj tuaj yeem ua rau cov kab mob hauv lub cev tsis zoo thiab, raws li, nce qib ntawm daim siab enzymes.
Lub hom phiaj ntawm lwm txoj kev kho mob yog los tiv thaiv kev puas tsuaj ntawm hepatocytes. Qhov zoo tshaj plaws yog cov zaub mov hauv qab no:
- Noj 150 g ntawm oat nplej thiab ncuav 1.5 liv ntawm boiling dej rau lawv. Muab lub ntim rau ntawm nruab nrab kub thiab ua noj rau li 20 feeb. Tso dej kom txias. Haus lub resulting decoction txhua hnub, 200 ml. Lub sijhawm kho yog 20 hnub.
- Noj 200 ml ntawm zib ntab. Ntxiv cov av cinnamon rau nws hauv qhov nyiaj ntawm 20 g. Sib tov cov khoom kom huv si. Noj cov tshuaj uas tshwm sim rau ntawm lub plab khoob ob zaug ib hnub twg (thaum sawv ntxov thiab yav tsaus ntuj) rau 1 tsp. Lub sijhawm kho yog tsis txwv.
- Ncua cag ntawm elecampane, ntxuav kom huv si thiab chop nws. Ncuav 5 g ntawm raw cov ntaub ntawv nrog boiling dej nyob rau hauv ib tug npaum li ntawm 200 ml. Cia nws brew rau 1 teev. Lim cov kua thiab noj cov tshuaj uas tshwm sim 4 zaug hauv ib hnub.
Cov tsos mob ntawm tus mob malaise ploj tom qab ob peb hnub. Yog tias tsim nyog, chav kho mob tuaj yeem rov ua dua.
nce qib enzyme hauv cov poj niam cev xeeb tub thiab menyuam yaus
Lub sijhawm cev xeeb tub, yuav tsum tau kuaj ntshav biochemical ntau zaus. Yog tias daim siab enzymes nce siab thaum cev xeeb tub, qhov no qhia txog kev txhim kho ntawm cov txheej txheem pathological lossis kev tswj tsis tau tshuaj.
feem ntau cov niam uas muaj kev cia siab tau kuaj pom muaj kab mob siab ua yeeb tshuaj. Thaum lub sij hawm yug me nyuam, lub cev muaj kev nce load thiab ib tug me ntsis nce nyob rau hauv ntau npaum ntawm txawm ib tug tshuaj uas kws kho mob sau tseg yuav ua rau intoxication. Yog tias daim siab enzymes nce siab thaum cev xeeb tub, nws yog ib qho tsim nyog yuav tsum tau kho cov tshuaj noj los yog tsis noj tshuaj. Cov tshuaj tua kab mob, glucocorticosteroids, NSAIDs, tshuaj tiv thaiv kab mob thiab tshuaj tua kab mob, diuretics tuaj yeem ua rau muaj kev sib txawv ntawm cov qauv.
siab siab siab enzymes hauv tus menyuam kuj tuaj yeem yog qhov tshwm sim ntawm kev noj tshuaj (painkillers, statins, sulfonamides). Tsis tas li ntawd, noj cov zaub mov muaj roj tuaj yeem ua rau muaj kev sib txawv ntawm cov qauv. Txhawm rau tshem tawm cov kab mob loj, tus kws kho mob tshwj xeeb tau sau ib qho kev ntsuam xyuas dav dav. Yog tias tus menyuam muaj lub siab enzymes siab, yuav tsum kuaj kab mob siab.
Nyob hauv kaw
Hauv kev kuaj mob ntau yam, kev kuaj ntshav biochemical tseem ceeb. Nws muaj peev xwm los ntsuas kev ua haujlwm ntawm lub siab vim qhov ntsuas ntawm cov enzymes tsim los ntawm nws. Lawv yogmuab faib ua pawg hauv qab no: qhia, excretory, secretory. Clinically tseem ceeb hauv kev ntsuas kev ua haujlwm ntawm lub cev yog cov cim ntawm ALT, AST, alkaline phosphatase, LDH.
Yog tias xav tias muaj cov txheej txheem pathological, tus kws kho mob tau sau ntau cov kev tshawb fawb thiab, raws li lawv cov txiaj ntsig, kos cov kev kho mob zoo tshaj plaws. Cov laj thawj tseem ceeb rau kev sib txawv ntawm daim siab enzymes los ntawm tus qauv yog kab mob siab, cirrhosis, obstructive jaundice, fatty degeneration, cholestasis. Hauv cov poj niam cev xeeb tub thiab menyuam yaus, qhov nce hauv enzymes feem ntau yog tshwm sim los ntawm kev noj tshuaj. Tab sis tib lub sijhawm, kev txhim kho ntawm cov kab mob txaus ntshai tsis tuaj yeem txiav tawm.
