Bile yog zais cia ntawm daim siab hlwb ntawm hepatocytes. Nws accumulates nyob rau hauv lub me me ducts, thiab ces nkag mus rau hauv lub duct thiab los ntawm nws mus rau hauv lub gallbladder thiab duodenum. Lub luag haujlwm ntawm cov kua tsib rau lub cev yog qhov tseem ceeb heev. Ib qho ntawm nws lub luag haujlwm tseem ceeb yog kev koom tes hauv cov txheej txheem ntawm kev zom zaub mov.
cov kua tsib nyob qhov twg?
Lub gallbladder yog ib qho chaw cia rau cov kua tsib. Thaum lub sijhawm ua haujlwm ntawm kev zom zaub mov, thaum qee cov zaub mov digested nkag mus rau hauv duodenum los ntawm lub plab, qhov siab tshaj plaws ntawm nws tso tawm. Lub luag haujlwm tseem ceeb ntawm tib neeg cov kua tsib yog kev koom tes hauv kev zom zaub mov thiab txhawb kev ua haujlwm zais cia thiab kev ua haujlwm ntawm cov hnyuv me, uas tseem ua kom cov txheej txheem ntawm cov zaub mov bolus.
Cov kua tsib uas tso rau hauv lub plab zom mov los ntawm lub gallbladder yog hu ua mature, thiab cov kua tsib tso ncaj qha los ntawm daim siab hu ua hluas, los yog hepatic.
txheej txheem ntawm cov kua tsib tsim thiab tso kua tsib
Cov txheej txheem ntawm kev tsim cov hepatocyte secretion (choleresis) yog tas li. Lawv lim ntau cov tshuaj los ntawm cov ntshav mus rau hauv cov kua tsibcapillaries. Tsis tas li ntawd, vim yog reabsorption ntawm dej thiab ntxhia ntsev, qhov kawg tsim ntawm cov kua dej secretory no tshwm sim. Cov txheej txheem no tshwm sim nyob rau hauv cov kua tsib ducts thiab gallbladder. Ib feem ntawm cov kua tsib tam sim ntawd nkag mus rau hauv cov hnyuv, nws yog hu ua hepatic, los yog hluas. Tab sis nws feem ntau accumulates nyob rau hauv lub gallbladder, qhov twg nws txav mus los ntawm cov kua tsib ducts. Cystic bile accumulates, ua tuab thiab concentrated. Nws tsaus dua daim siab.
Nyob nruab hnub, lub siab hlwb hauv ib tug neeg laus tsim tawm txog ob litres ntawm secretion. Ntawm lub plab khoob, nws xyaum tsis nkag mus rau hauv cov hnyuv. Tom qab noj mov, cov kua tsib tso tawm (cholekinesis) tshwm sim hauv duodenum. Nyob rau ntawd, cov kua tsib ua haujlwm digestive, nrog rau cov kab mob bacteriostatic thiab tswj ib qho. Ntawd yog, nws yog nws tus kheej tus tswj hwm ntawm cov txheej txheem ntawm cov kua tsib tsim thiab tso kua tsib.
Yog li, ntau cov kua tsib tso tawm mus rau hauv lub portal ncig (portal leeg), qhov siab dua lawv cov concentration hauv cov kua tsib thiab, raws li, qhov tsawg dua yog synthesized los ntawm hepatocytes. Kev ua haujlwm ntawm cov kua tsib thiab kua txiv pancreatic yog qhov tseem ceeb hauv kev zom zaub mov.
Cov kua tsib
Bile acids yog cov khoom tseem ceeb ntawm cov kua tsib. Feem ntau (67%) yog cholic acid thiab chenodeoxycholic acid. Cov acids uas tseem tshuav yog theem nrab, piv txwv li, cov txiaj ntsig ntawm ob cov kua qaub no: deoxycholic, allocholic, lithocholic thiab ursodeoxycholic.
Txhua cov kua tsib kua qaub nyob hauv qhov zais cia hauv daim ntawv sib txuas nrog taurine thiab glycine. Cov ntsiab lus siab ntawm sodium thiab potassium ionsua rau cov kua tsib alkaline.
Ntxiv rau, cov kua tsib muaj qee cov tshuaj organic:
phospholipids
Cholesterol.
Thiab tseem muaj qee cov hlau ions (zinc, tooj liab, lead, magnesium, indium, mercury), vitamins A, B, C.
Tag nrho cov khoom teev muaj nyob rau hauv ob qho tib si hauv lub siab thiab lub gallbladder bile, tab sis nyob rau hauv yav dhau los lawv cov concentration yog li 5 npaug qis dua li yav tas los.
Kev ua haujlwm ntawm cov kua tsib
Lawv feem ntau cuam tshuam nrog kev ua haujlwm ntawm lub plab zom mov. Kev ua haujlwm ntawm cov kua tsib hauv kev zom zaub mov yog txuam nrog ntau cov tshuaj tiv thaiv enzymatic.
- Raws li nws cov cawv, cov rog yog emulsified, yog li ua kom yooj yim rau lawv nqus.
- Nws neutralizes qhov teeb meem ntawm pepsin (lub ntsiab ntawm cov kua txiv hmab txiv ntoo), uas tuaj yeem rhuav tshem cov enzymes pancreatic.
- Activates txoj hnyuv motility.
- Timulates mucus production.
- Ua kom muaj cov tshuaj hormones hauv plab hnyuv: secretin thiab cholecystokinin, uas yog tsim los ntawm cov hlwb ntawm cov hnyuv me thiab pab txhawb rau kev tswj hwm kev ua haujlwm ntawm lub txiav.
- Tiv thaiv adhesion (adhesion) ntawm cov kab mob thiab cov protein ntau.
- Muaj tshuaj tua kab mob rau cov hnyuv thiab koom nrog hauv kev tsim cov quav.
Yog li, txoj haujlwm ntawm cov kua tsib hauv plab zom mov yog overestimatedua tsis tau. Nws yog ua tsaug rau cov kua tsib uas cov txheej txheem digestive, pib hauv plab, txuas ntxiv thiab xaus rau hauv cov hnyuv.
Tus nqi ntawm cov kua tsib rau tib neeg lub cev
Yog li, peb pom tias lub luag haujlwm tseem ceeb ntawm cov kua tsib muaj feem cuam tshuam nrog cov txheej txheem digestive. Yuav ua li cas yog, vim li cas, muaj pes tsawg leeg ntawm cov kua tsib hloov los yog nws tsis nkag mus rau hauv lub digestive ib ntsuj av? Tsis muaj lossis tsis muaj nws ua rau muaj mob hnyav:
- YCholelithiasis.
- Steatorrhea.
- Kab mob Gastroesophageal reflux (GERD) thiab lwm yam
YCholelithiasis
Cov kab mob no tuaj yeem tshwm sim vim muaj cov kua tsib tsis sib npaug. Cov kua tsib no hu ua lithogenic. Nws tuaj yeem tau txais cov khoom zoo li no nrog kev ua tsis tu ncua hauv kev noj zaub mov, uas yog tias tsiaj rog muaj nyob hauv cov zaub mov. Kev ua haujlwm ntawm cov kua tsib ntawm daim siab tuaj yeem cuam tshuam los ntawm cov kab mob endocrine. Tsis tas li ntawd, cov kab mob siab no tuaj yeem tau txais cov khoom lithogenic raws li kev cuam tshuam ntawm lipid metabolism, uas, raws li txoj cai, yog nrog los ntawm kev nce hauv tus neeg mob lub cev hnyav. Yog vim li cas rau qhov kev hloov pauv ntawm cov kua tsib kuj tuaj yeem kis tau thiab ua rau lub siab puas tsuaj lossis kev ua neej tsis txaus (lub cev tsis ua haujlwm).
Steatorrhea
Raws li tau hais los saum no, cov haujlwm ntawm cov kua tsib muaj feem cuam tshuam rau cov emulsification ntawm cov rog. Yog tias, vim qee yam, cov kua tsib tsis ntws mus rau hauv cov hnyuv, cov rog tsis tau nqus, thiab lawv pib ua.raug tshem tawm hauv cov quav. Tib yam tuaj yeem tshwm sim nrog qhov tsis muaj cov kua tsib acids hauv cov kab mob siab no (hloov hauv nws cov muaj pes tsawg leeg). Nyob rau hauv cov ntaub ntawv no, cov quav tau ib tug dawb los yog grey xim thiab ib tug greasy kev ntxhib los mos. Qhov no pathology hu ua steatorrhea. Nrog rau cov kab mob zoo li no, lub cev tsis muaj cov rog tseem ceeb, fatty acids thiab qee cov vitamins. Raws li qhov tshwm sim ntawm steatorrhea, cov hnyuv qis raug kev txom nyem, vim lawv tsis tau yoog rau cov chyme.
Yuav kuaj cov kua tsib li cas?
txhawm rau txhawm rau tshawb xyuas qhov muaj pes tsawg leeg thiab kev ua haujlwm ntawm cov kua tsib, cov txheej txheem ntawm fractional multi-theem duodenal sounding yog siv. Cov txheej txheem no muaj tsib kauj ruam:
- Basal secretion ntawm cov kua tsib - tso tawm ntawm cov kab mob sib xws thiab duodenum tshwm sim. Ntev li 15 feeb.
- Phase ntawm secretory ncua lossis kaw sphincter ntawm Oddi. Lub sijhawm ntawm theem no yog 3 feeb.
- Cov kua tsib tso tawm theem ntawm ntu A. kav li 5 feeb.
- Cyccile bile tso theem ntawm ntu B. Lub sijhawm no kav li 30 feeb.
- Kev tshem tawm ntawm cov kab mob siab - ntu C. Lub sijhawm no kav li 20 feeb.
Yog li, tau 3 servings ntawm cov kua tsib. Tag nrho cov ntawm lawv txawv nyob rau hauv muaj pes tsawg leeg. Cov kua tsib feem ntau yog cov kua tsib feem B. Nws muaj cov roj ntsha ntau tshaj plaws, bilirubin thiab lwm yam kua tsib.
Txoj kev tshawb fawb no tso cai rau koj los txiav txim siab lub cev lub cev ntawm cov kua tsib, nws cov muaj pes tsawg leeg, ntim ntawm lub gallbladder, lub xeev ntawm cov kab mob biliary thiab txheeb xyuas thaj chaw. Cov txheej txheem pathological.
