Udindo ndi ntchito ya chiwindi m'thupi la munthu

| Sinthani code

Chiwindi chimakhala ndi lobes ziwiri: kumanja ndi kumanzere. Ma loboti ena achiwiri amadziwika bwino ndi lobe lamanja: lalikulu ndi caudate. Malinga ndi gawo lamakono lomwe a Claude Quino (1957), chiwindi chimagawika m'magulu asanu ndi atatu, ndikupanga nkhonya zakumanzere kumanzere. Gawo la chiwindi ndi gawo la piramidi la hepatic parenchyma, lomwe limalekanitsa magazi mokwanira, malo okhala ndi bile. Ma lobudate ndi ma lobes a mraba omwe ali kumbuyo ndi kutsogolo kwa chipata cha chiwindi, malinga ndi chiwembuchi, chikugwirizana ndi S_Ine ndi S_IV lamanzere lobe. Kuphatikiza apo, mu lobe lamanzere, S_II ndi S_III chiwindi, lobe yakumanja imagawidwa ndi S_V - S_VIIIkuwerenga pafupi ndi chipata cha chiwindi kulowera kwawotchi.

Ntchito zazikulu

Ntchito yolimbitsa thupi ndi munthu sizingatheke popanda chiwindi. Imagwira ntchito zina zomwe zimathandizira kuyeretsa magazi, kulimbikitsa kugaya bwino, komanso kuyang'anira kugaya chakudya. Ichi ndichifukwa chake ndikofunikira kuwunika momwe thupi ili liliri.

Poyamba, muyenera kudziwa zomwe chiwindi chimachita:

Qualitative biosynthesis ya urea.
Kuchotsa poizoni, xenobiotic, ziphe, michere ya biogenic m'thupi.
Kusinthana kwa chakudya cham'mimba, mapuloteni, ma acid a nucleic, lipoproteins, mavitamini, lipids.
Chinsinsi chobisidwa ndi hepatocytes.
Mu thupi, chiwindi chimagwira ntchito zomwe ndi zamtundu wa catabolic. Chiwindi chimayang'anira ndikupanga mahomoni, komanso kuwonongeka kwa hemoglobin.
Biosynthetic ntchito. Glandular organic ndiyo imayendetsa kaphatikizidwe kazinthu zomwe ndizofunikira pakukhazikitsa kwachilengedwe chonse: triacylglycerol, glucose, phospholipids, lipoproteins, acid acid apamwamba.
Kudzikundikira kwa mavitamini ndi michere yofunika: glycogen, iron, mavitamini osungunuka a mafuta.
Maselo a Kupffer m'chiwindi amatenga nawo phagocytosis.
Mapuloteni ambiri.
Mbale ndi bilirubin, cholesterol, bile acid, chitsulo.

Matumbo oyenda

Chiwindi ndi chiwalo chogwira ntchito, ntchito yayikulu ndikupanga bile. Madzi amtunduwu amakhala ndi mtundu wachikasu wobiriwira, chifukwa chomwe kusintha kwa chimbudzi m'matumbo kumatsimikiziridwa. Chiwindi chimapitiriza kupanga mitundu ya bile mothandizidwa ndi kupindika kwa maselo a hemoglobin.

Musanagwiritse ntchito mankhwalawa kapena mankhwalawa, muyenera kudziwa zomwe chiwindi chimagwira kuti chimbidwe chabwinobwino:

Kuwonjezeka kwakukulu kwa ntchito ya michere yamatumbo.
Kutsatsa kwapamwamba kwambiri kwamafuta ndi kuwonjezeka kwapang'onopang'ono m'dera lawo la lipase hydrolysis.
Ndi bile yemwe amachititsa kuti amino acids, cholesterol ndi mchere zizichotsa mchere.
Kusintha kwa lipid hydrolysis zopangira.
Kuthandizira matumbo abwinobwino.
Matenda a acidity zizindikiro za msuzi.

Ngati munthu anyalanyaza chakudya chamagulu nthawi zonse, ndiye kuti izi zimabweretsa kuti bile limadziunjikira mu chikhodzodzo ndikuwonjezera kuchuluka. Zachidziwikire, madzi amtunduwu ndi osiyana ndi munthu aliyense. Koma mtundu wa chakudya, kununkhira kwake komanso phwando lokha nthawi zonse kumapangitsa kupuma kwa ndulu ndikutulutsa kotsatira.

Kugwiritsa ntchito bwino

Ngati chiwindi sichichita ntchito zomwe thanzi la ziwalo zina zimadalira, ndiye kuti matenda osiyanasiyana amayamba kukula mthupi. Muzochita zachipatala, matenda osiyanasiyana a gland omwewo amadziwika. Matenda onsewa akhoza kugawidwa m'magulu akulu akulu:

Kuchepetsa magazi m'mitsempha ya chiwindi.
Kuwonongeka kwa maselo a gland mwa njira zowonjezera kapena zotupa.
Kukula kwa khansa.
Zowonongeka zamakina zingapo.
Kuwonongeka kwa bile ducts.
Kusintha kwachisokonezo kapena chiwindi.
Matenda ovuta a matenda opatsirana.
Kuphwanya kwamapangidwe a ziwalo zathupi, komwe kumayambitsa kuperewera kwa chiwindi, matenda enaake.
Matenda omwe adayamba motsutsana ndi maziko a ma virus a autoimmune.

Ndizofunikira kudziwa kuti matenda aliwonse omwe atchulidwawa adzatsagana ndi kuperewera kwa chiwindi ndi kupweteka, ndipo izi ndizodzaza ndi matenda amitsempha.

Zizindikiro

Ntchito yolumikizidwa ya machitidwe ambiri amthupi imatengera zomwe chiwindi chimagwira. Ngati chiwalochi chawonongeka, ndiye kuti chikuwopsa kwambiri. Nthawi zambiri, anthu amadwala matenda am'mimba, kapamba ndi ziwalo zina. Ngati simukufuna thandizo la madokotala munthawi yake, ndiye kuti moyo wamunthu ungawonongeke.

Akatswiri amalimbikitsa kutsatira malamulo ochepa. Chiwindi chimagwira ntchito zonse pokhapokha munthu akatha kudziwa matendawa m'magawo oyamba ndikuchotsa. Ma pathologies onse a glandular lachigawo koyambirira akuwonetsedwa ndi zisonyezo wamba:

Kusasinthasintha kwa mpando.
Kupweteka pachimake, chiwonetsero cholimba ndi kupezeka kwa hepatitis.
Chotupa chaching'ono kumaso kapena pachifuwa.
Kusintha kwa khungu ndi khungu la maso (mtundu wachikaso).
Zodziwika bwino zovuta ndimitsempha yamagazi.

Ngati chisonyezo chimodzi chikaoneka, muyenera kufunsa dokotala. Pambuyo poti aunike mozama ndikudutsa mayeso onse ndi pomwe katswiri angadziwitse matenda ake.

Njira zopewera

Kuti chiwindi chizigwira ntchito zonse zamagulu am'mimba, muyenera kutsatira malingaliro ochepa. Zakudya zoyenera zimakhala ndi mphamvu zochiritsa: wodwalayo ayenera kusiyiratu zakudya zake zokazinga, mafuta, osuta, amchere, okoma komanso mowa. Onetsetsani kuti mwadya zipatso ndi masamba atsopano. Batala amasankhidwa m'malo ndi masamba kapena maolivi. Tsiku lomwe muyenera kumwa osachepera lita imodzi ya madzi oyera.

Chiwindi chimagwira ntchito zabwino ngati munthu amadya madzi atsopano tsiku lililonse. Mutha kugwiritsa ntchito mankhwala pokhapokha poikidwa ndi katswiri. Pokhapokha mutakumana ndi dokotala mungapezeko njira zabwino zochizira. Chifukwa cha izi, mutha kuyeretsa chiwindi. Komanso, yoga imakhudzanso thupi.

Zinthu zosasangalatsa

Tanthauzo la chiwindi kwa munthu wamunthu wathunthu ndilopanda phindu. Koma chiwalochi chimakonda kwambiri zovuta zosiyanasiyana. Kafukufuku wambiri awonetsa kuti chitsulo chimakhala ndi vuto kwambiri pazinthu izi:

Kusuta.
Kulemera kwambiri.
Khalidwe labwino.
Kuphwanya zakudya zotsekemera.
Kugwiritsa ntchito mphamvu molakwa komanso mowa.
Zakudya zopanda pake: zamafuta, okazinga, amchere, osuta komanso zakudya zazonunkhira zimakhazikika mu chakudya.
Mankhwala osalamulirika.
Zakudya zamafuta ochepa komanso zamasamba.
Gwirani ntchito mubizinesi yoyipa.
Zamakhalidwe oyipa.
Kupezeka kwa parasitic komanso matenda opatsirana.

Kudziwitsidwa nthawi yayitali chimodzi kapena zingapo mwazomwezi pamwambapa zimapangitsa kuti ziwalo zisagwire ntchito. Ngati wodwala anyalanyaza chithandizo chakanthawi, ndiye kuti kufa kwa maselo a chiwindi sikungapewereke, malingaliro awa a hepatitis kapena cirrhosis atha.

Kuthekera kosinthika

Ndi nzika zochepa zomwe zidaganizapo zakufunika kwa chiwalo chilichonse. Chiwindi chimagwira ntchito zambiri zomwe sizingokhala ndi moyo wa munthu zimadalira, komanso kugwira ntchito kwa machitidwe ena onse amthupi. Koma mpaka pakabuka mavuto akulu azaumoyo, njira zopewera zimayiwalika nthawi zambiri.

Chiwindi chimakhala ndi katundu wosiyana ndi ena: imatha kusinthika, ngakhale akatswiri atangopulumutsa 20-25% yokha ya gawo lonse. M'malo azachipatala pali zambiri zidziwitso zakuti pambuyo poti resection (kuchotsa malo omwe ali ndi matenda), kubwezeretsanso kukula koyambirira kwa chiwalo kunawonedwa mobwerezabwereza. Inde, njirayi ndiyosachedwa, chifukwa zimatha kutenga miyezi iwiri mpaka zaka zingapo. Zonse zimatengera zaka komanso moyo wa munthu.

Chochititsa chidwi

Chiwindi chimakonda kuyankha mopitirira muyeso komanso kusowa kwa kukula. Madokotala oyenerera adziwona mobwerezabwereza odwala omwe apatsirana ziwalo zina. Ndizosangalatsa kuti pambuyo poti kuchira kwachakudwala ndikuchira ndikukula, gawo la woperekalo likufupika. Zachidziwikire, ngakhale maphunziro angapo sanathe kufotokoza kwathunthu mawonekedwe onse obadwanso mwatsopano. Koma kuchira kumachitika pokhapokha maselo atalimba atayamba kugawikana. Amaganizanso zodabwitsa kuti atachotsa 90% ya minofu yomwe yakhudzidwa, kubereka hepatocytes ndikosatheka. Ngati ochepera 40% a chiwalo adakhazikikanso, ndiye kuti kugawanika kwa maselo sikudzakhalanso.

Physiology ya chiwindi

Kukula kwa chiwindi chaumunthu kumayambira sabata lachitatu la kubereka ndikufika pazomangamanga zokhwima mpaka zaka 15. Imafika pamlingo waukulu kwambiri, 10% ya kulemera kwa mwana wosabadwayo, kuzungulira sabata la 9. Uku ndi pafupifupi 5% ya kulemera kwa thupi kwa wakhanda wathanzi. Chiwindi chimakhala pafupifupi 2% ya kulemera kwa thupi mwa munthu wamkulu. Zimalemera pafupifupi 1400 g mwa mkazi wamkulu komanso pafupifupi 1800 g mwa munthu.

Imakhala pafupi ndi khola, koma m'munsi m'munsi imatha kumveka mbali yoyika mtengo yoyenera nthawi ya kudzoza. Tinthu tating'onoting'ono totchedwa Glisson kapisozi komwe kumakhudza chiwindi. Chipewa chimafikira kwa onse koma ziwiya zazing'ono kwambiri mu chiwindi. Mitsempha ya crescent imalumikiza chiwindi kukhoma ndi m'mimba, ndikugawika mu lobe lalikulu lamanzere ndi lobe yaying'ono kumanzere.

Mu 1957, dokotala wothandizira wa ku France, a Claude Kuynaud, adafotokoza magawo 8 a chiwindi. Kuyambira pamenepo, kafukufuku wa radiographic walongosola pafupifupi magawo makumi awiri kutengera kugawa kwa magazi. Gawo lililonse lili ndi nthambi zake zokha. Ntchito yowonjezera chiwindi imayimiriridwa ndi nthambi za bile.

Gawo lililonse limagawidwanso m'magawo. Amaperekedwa nthawi zambiri m'magulu a hepatocytes a discrete. Hepatocytes amatenga mawonekedwe a mbale omwe amachokera kumtunda wamkati.

Kodi malovu amtundu uliwonse amachititsa chiyani? Amatumizira ziwiya zamtundu, venous ndi biliary pazowunikira. Magawo a chiwindi cha munthu amakhala ndi timinofu ting'onoting'ono tomwe timalekanitsa lobule wina ndi mnzake. Kuperewera kwa minyewa yolumikizira kumapangitsa kuti zikhale zovuta kudziwa matepi a portal komanso malire a lobules. Mitsempha yapakati ndiyosavuta kuzindikira chifukwa cha lumen yayikulu komanso chifukwa sakhala ndi minyewa yolumikizira yomwe imakwirira zombo za portal process.

Ntchito ya chiwindi m'thupi la munthu ndi yosiyanasiyana ndipo imagwira ntchito zoposa 500.
Zimathandizira kusunga shuga wamagazi ndi mankhwala ena.
Kubisala mwakachetechete kumathandizira kuti pakhale chimbudzi ndi kutulutsa chimbudzi.

Chifukwa cha kuchuluka kwa ntchito, chiwindi chimatha kuwonongeka msanga.

Kodi ntchito za chiwindi ndi ziti?

Chiwindi chimagwira gawo lofunikira pakugwira ntchito kwa thupi, kuchepa kwa thupi, kagayidwe (kuphatikizapo lamulo la kusungidwa kwa glycogen), malamulo a mahomoni, kaphatikizidwe ka mapuloteni, komanso kuwonongeka ndi kuwonongeka kwa maselo ofiira a magazi, mwachidule. Ntchito zazikuluzikulu za chiwindi zimaphatikizapo kupanga bile, mankhwala omwe amawononga mafuta ndikuwapangitsa kuti asatengeke mosavuta. Imapanga ndikupanga zinthu zingapo zofunika za m'magazi, komanso imasunga michere ina yofunika, kuphatikizapo mavitamini (makamaka A, D, E, K ndi B-12) ndi chitsulo. Ntchito yotsatira ya chiwindi ndikusunga shuga wosavuta wa glucose ndikusintha kukhala glucose yothandiza ngati shuga yamagazi yatsika. Chimodzi mwazinthu zodziwika bwino za chiwindi ndi detoxification dongosolo, lomwe limachotsa zinthu zakupha m'magazi, monga mowa ndi mankhwala osokoneza bongo. Amawonongeranso hemoglobin, insulini ndikuwonetsetsa kuti mahomoni azikhala bwino. Kuphatikiza apo, amawononga maselo akale amwazi.

Kodi ziwindi zina zimagwira ntchito yanji mthupi la munthu? Chiwindi ndikofunikira kuti ntchito ya metabolic ikhale ndi thanzi. Amasintha ma carbohydrate, lipids ndi mapuloteni kukhala zinthu zopindulitsa monga glucose, cholesterol, phospholipids ndi lipoproteins, omwe amagwiritsidwa ntchito m'maselo osiyanasiyana m'thupi lonse. Chiwindi chimawononga mbali zosafunikira za mapuloteni ndikuwasandutsa ammonia ndipo pamapeto pake urea.

Kodi kagayidwe kake kamagwira ntchito bwanji? Ndi gawo lofunikira la metabolic, ndipo ntchito yake ya metabolic imayendetsedwa ndi insulin ndi mahomoni ena a metabolic. Glucose imasinthidwa kukhala pyruvate kudzera pa glycolysis mu cytoplasm, ndipo pyruvate imaphatikizidwa mu mitochondria kuti ipange ATP kudzera muzungulira kwa TCA ndi oxosative phosphorylation. Mu boma loperekedwa, zinthu zamtundu wa glycolytic zimagwiritsidwa ntchito popanga mafuta acids kudzera mwa lipogenesis. Mafuta ambiri amafuta amodzi amaphatikizidwa mu triacylglycerol, phospholipids ndi / kapena cholesterol esters mu hepatocytes. Ma lipids ovuta awa amasungidwa m'malovu a lipid ndi ma membrane kapangidwe kake kapena amawasungitsa m'magazi a magazi momwe amapangira ma lipoproteins otsika kwambiri. Pokhala ndi vuto lanjala, chiwindi chimachepetsa glucose kudzera glycogenolysis ndi gluconeogeneis. Munthawi yanjala yochepa, gluconeogeneis wa hepatic ndiye gwero lalikulu la glucose wopatsa.

Njala imalimbikitsanso lipolysis mu minofu ya adipose, zomwe zimatsogolera kumasulidwa kwamafuta osagwiritsidwa ntchito, omwe amasinthidwa kukhala matupi a ketone mu mitochondria ya chiwindi, ngakhale β-oxidation ndi ketogeneis. Matupi a Ketone amapereka mafuta a metabolic a zimakhala zowonjezera. Kutengera kukhazikika kwaumunthu, mphamvu ya kagayidwe kake ka chiwindi imayendetsedwa bwino ndi mauthenga a neural ndi mahomoni. Ngakhale pulogalamu yachifundo imalimbikitsa kagayidwe, parasympathetic system inhibits gluconeogenesis ya hepatic. Insulin imathandizira glycolysis ndi lipogenesis, koma amalepheretsa gluconeogeneis, ndipo glucagon imatsutsa zochita za insulin. Zinthu zambiri zolembedwa komanso ma coactivator, kuphatikizapo CREB, FOXO1, ChREBP, SREBP, PGC-1α ndi CRTC2, zimayang'anira mawu a ma enzymes omwe amathandizira njira zazikulu za metabolic, potero amawongolera kagayidwe ka mphamvu m'chiwindi. Kagayidwe kachakudya kagayidwe mu chiwindi kumapangitsa kukana insulin, matenda ashuga komanso mafuta osagwirizana ndi mafuta chiwindi matenda.

Ntchito yolepheretsa chiwindi ndikupereka chitetezo pakati pamitsempha ya portal ndi kufalitsidwa kwadongosolo. Mu reticuloendothelial system, iyi ndi njira yolepheretsa kupewa matenda. Imathandizanso ngati kagayidwe kazakudya pakati pamatumbo osiyanasiyana ndi magazi a portal, ndikuwongolera mwamphamvu kayendedwe kazinthu. Mwa kuyamwa, kusunga ndi kumasula shuga, mafuta ndi ma amino acid, chiwindi chimagwira ntchito yofunika kwambiri ku homeostasis. Imasunganso ndikuchotsa mavitamini A, D ndi B12. Imapanga kapena kutsegulitsa mankhwala opanga zinthu zambiri zotengedwa m'matumbo, monga mankhwala osokoneza bongo ndi ma bacteria. Imagwira ntchito zambiri zofananira popereka magazi a dongosolo kuchokera ku magazi a chiwindi, pokonza okwanira 29% ya zotulutsa zamtima.

Ntchito yoteteza chiwindi ndikuchotsa zinthu zovulaza m'magazi (monga ammonia ndi poizoni), kenako ndikuzisintha kapena kuzisintha kukhala zosavulaza. Kuphatikiza apo, chiwindi chimatembenuza mahomoni ambiri ndikusintha kukhala zinthu zina zambiri kapena zomwe sizigwira ntchito kwenikweni. Mbali yolepheretsa chiwindi imayimiriridwa ndi maselo a Kupffer - omwe amatenga mabakiteriya ndi zinthu zina zakunja kwa magazi.

Synthesis ndi Cleavage

Mapuloteni ambiri a plasma amapangidwa ndipo amabisidwa ndi chiwindi, omwe ambiri ndi albumin. Makina a kapangidwe kake ndi katulutsidwe kafotokozedwa posachedwapa mwatsatanetsatane. Kuphatikizika kwa unyolo wa polypeptide kumayambitsidwa pama polyribosomes aulere ndi methionine ngati amino acid yoyamba. Gawo lotsatira la mapuloteni omwe amapangidwa ndiwambiri ma hydrophobic amino acids, omwe mwina amatha kuyimilira kumangiriza kwa albumin-synthesizing polyribosomes to the endoplasmic membrane. Albumin, yotchedwa preproalbumin, imasamutsidwira mkati mwa danga la granular endoplasmic reticulum. Preproalbumin imachepetsedwa kukhala proalbumin ndi hydrolytic cleavage ya 18 amino acid kuchokera ku N-terminus. Proalbumin imatengedwa kupita ku zida za Golgi. Pomaliza, imasinthidwa kukhala albumin kutatsala pang'ono kubisidwa m'magazi ndikuchotsedwa kwa zina zisanu ndi chimodzi ma N-terminal amino acid.

Ntchito zina za metabolism za chiwindi m'thupi zimapanga kaphatikizidwe kazakudya. Chiwindi chimayang'anira ma protein ambiri osiyanasiyana. Mapuloteni a Endocrine omwe amapangidwa ndi chiwindi amaphatikiza angiotensinogen, thrombopoietin, ndi kukula kwa insulin. Mu ana, chiwindi ndi chomwe chimayambitsa kuphatikizira kwa heme. Akuluakulu, mafuta m'mafupa si zida zopangira heme. Komabe, chiwindi chachikulu chimachita 20% heme synthesis. Chiwindi chimagwira ntchito yofunika kwambiri popanga pafupifupi mapuloteni onse a plasma (albin, alpha-1-acid glycoprotein, makhadi osakanikirana ambiri ndi njira za fibrinolytic). Kupatula komwe kumadziwika: gamma globulins, factor III, IV, VIII. Mapuloteni opangidwa ndi chiwindi: mapuloteni S, mapuloteni C, mapuloteni Z, plasminogen activator inhibitor, antithrombin III. Mapuloteni odalirika a Vitamin K omwe amapangidwa ndi chiwindi amaphatikizapo: Zinthu II, VII, IX ndi X, mapuloteni S ndi C.

Endocrine

Tsiku lililonse, pafupifupi 800-1000 ml ya bile amatulutsidwa m'chiwindi, chomwe chimakhala ndi mchere wofunikira wa bile kuti pakhale chimbudzi chamafuta.

Bile komanso sing'anga kuti amasulidwe zinyalala zina za metabolic, mankhwala osokoneza bongo komanso zinthu zoopsa. Kuchokera ku chiwindi, ngalande imasinthira bile kupita ku duct yotchuka ya bile, yomwe imathira mu duodenum yamatumbo ang'ono ndikulumikizana ndi chikhodzodzo cha ndulu, komwe imakhazikika ndikusungidwa. Kupezeka kwa mafuta mu duodenum kumalimbikitsa kutuluka kwa ndulu kuchokera ku ndulu.

Ntchito za endocrine za chiwindi cha munthu zimaphatikizapo kupanga mahomoni ofunikira kwambiri:

Kukula kwa Insulin-monga Kukula kwa Factor 1 (IGF-1). Kukula kwamahoni komwe kumamasulidwa ku pituitary gland kumamangiriza ku ma cell a chiwindi, omwe amawapangitsa kuti apange ndikusintha IGF-1. IGF-1 imakhala ndi zotsatira zofanana ndi insulin, chifukwa imatha kumangiriza ku insulin receptor komanso imathandizira kukula kwa thupi. Pafupifupi mitundu yonse yamaselo imayankha ku IGF-1.
Angiotensin. Ndizotsatira kwa angiotensin 1 ndipo ndi gawo la machitidwe a Renin-Angiotensin-Aldosterone. Amasandulika kukhala angiotensin ndi renin, yomwe, imasandulika magawo ena, omwe amathandizira kuthamanga kwa magazi pa hypotension.
Supombopoietin. Njira zoyankhira zoipa zimagwira ntchito kuti izisungitsa timadzi tambiri m'njira yoyenera. Imalola maselo a progenitor m'mafupa kuti apange megakaryocyte, othandizira kupatsidwa zinthu za m'magazi.

Hematopoietic

Kodi chiwindi chimagwira ntchito yotani ya hematopoiesis? Mu zolengedwa zoyamwitsa, maselo a progenitor a chiwindi atalowa mu mesenchyme, chiwindi cha fetal chimapangidwa ndi maselo a hematopoietic progenitor ndipo kenako amakhala gawo lalikulu la hematopoietic. Kafukufuku wokhudzidwa ndi nkhaniyi adawonetsa kuti maselo a progenitor osakhazikika amatha kupanga sing'anga yomwe imathandizira hematopoiesis. Komabe, maselo a progenitor a chiwindi akayamba kukhwima, maselo omwe amayambitsa sangathenso kuthandizira kukula kwa maselo amwazi, omwe amagwirizana ndi kayendedwe ka masentimita a hematopoietic tsinde kuchokera pachiwindi cha fetal kupita kwa m'mafupa akulu. Kafukufukuyu akuwonetsa kuti pali kulumikizana kwakukulu pakati pa magazi ndi ma fayilo am'mimba mkati mwa chiwindi cha fetal, chomwe chimayang'anira nthawi ya zonse hepatogenesis ndi hematopoiesis.

Katemera

Chiwindi ndi chida chofunikira cha immunological chokhala ndi mphamvu yambiri yozungulira ma antigen ndi endotoxins kuchokera m'matumbo microbiota, makamaka ophatikizidwa ndi maselo oteteza khungu (macrophages, maselo obadwa nawo a cymphoid, maselo obwera a T omwe amaphatikizidwa ndi nembanemba ya mucous). Ku homeostasis, njira zambiri zimachepetsa mayankho amthupi, zomwe zimapangitsa kuti munthu azolowere (kulekerera). Kuleza mtima kumathandizanso pakulimbana kwachilengedwe kwa ma hepatotropic ma virus kapenanso kutenga vuto limodzi pambuyo pakupandidwa kwa chiwindi. Ntchito yothandizirana ndi chiwindi imatha kuyambitsa chitetezo chokwanira poyankha matenda kapena kuwonongeka kwa minofu. Kutengera matenda oyipa a chiwindi, monga hepatitis, cholestasis kapena steatohepatitis osakhala mowa, zosokoneza zingapo zimayambitsa kukhwima kwa chitetezo cha mthupi.

Njira zopewera, monga ma cell a ngozi, ma sign-like receptor signals, kapena activation of kutupa, zimayambitsa kuyankha kwamphamvu mu chiwindi. Kutulutsa kosangalatsa kwa maselo a hepatocellulose ndi Kupffer kumapangitsa kuti ma cellokitis aphatikizidwe ndi ma neutrophils, monocytes, wakupha zachilengedwe (NK) ndi maselo amtundu wakupha wa T (NKT). Zotsatira zakuthana kwa mayankho a intrahepatic immune fibrosis zimatengera magwiridwe antchito a macrophages ndi maselo a dendritic, komanso mulingo pakati pa pro-yotupa komanso anti-yotupa ya maselo a T. Kupita patsogolo kwakukulu kwamankhwala kwathandizira kumvetsetsa bwino mayankho a chitetezo mthupi m'chiwindi kuchokera ku homeostasis mpaka matenda, zomwe zikuwonetsa zolinga zabwino zamtsogolo zamankhwala othandizira matenda owopsa komanso osachiritsika.

Chiwindi chimagwira ntchito m'thupi la munthu

Chiwindi - imodzi mwazinthu zazikulu mthupi la munthu. Kuchita ndi zakunja zimathandizidwa ndikugwira nawo gawo lamanjenje, kupuma, matumbo, m'mimba, endocrine kachitidwe ka kayendedwe kazinthu.

Njira zosiyanasiyana zomwe zimachitika mkati mwa thupi ndi chifukwa cha metabolism, kapena metabolism. Chofunikira kwambiri pakuwonetsetsa kuti thupi lizigwira ntchito ndi manjenje, endocrine, mtima komanso kugaya chakudya. M'matumbo, chiwindi chimakhala m'gulu la malo otsogola, ndikuchita ntchito ya malo opangira mankhwala, kapangidwe (kaphatikizidwe) ka zinthu zatsopano, likulu la kusaloletsa kwa zinthu zakupha (zoopsa), ndi gawo la endocrine.

Chiwindi chimagwira nawo magwiridwe antchito ndi kuwumbika kwa zinthu, pakuphatikizika kwa chinthu chimodzi kupita kwina, posinthana ndi zigawo zikuluzikulu za thupi, monga kusinthana ndi mapuloteni, mafuta ndi chakudya (Sugars), ndipo nthawi yomweyo ndi gawo lothandizira la endocrine. Choyeneradi chidwi ndi kusweka, kaphatikizidwe ndi mawonekedwe (mawonekedwe) a chakudya ndi mafuta, kuwonongeka kwa mapuloteni kupita ku ammonia, kapangidwe ka gemma (maziko a hemoglobin), kapangidwe ka mapuloteni ambiri amwazi ndi kusinthana kwakukulu kwa amino acid m'chiwindi.

Zakudya zomwe zimapangidwa m'migawo yapitayi ya zakonzedwe zimayamwa m'magazi ndikupatsidwa chiwindi. M'pofunika kudziwa kuti ngati zinthu zakupha zalowa m'zakudya, ndiye kuti zimalowetsanso chiwindi. Chiwindi ndi fakitale yayikulu kwambiri yopanga zinthu mthupi mwa munthu, momwe ma metabolic ake amachitika omwe amakhudza thupi lonse.

Ganizirani ntchito ya chiwindi pakapangidwe kazakudya zathupi.

1. Amino Acid (Protein) Kusinthana. Maphatikizidwe a albumin ndi ma globulin pang'ono (mapuloteni amwazi). Mwa zinthu zomwe zimachokera ku chiwindi kupita m'magazi, poyambira pakufunika kwa thupi, mapuloteni amatha kuyikidwa. Chiwindi ndi malo akuluakulu omwe amapanga mapuloteni angapo amwazi omwe amapereka zovuta kuchitidwa kwa magazi.

Mapuloteni angapo amapangidwira m'chiwindi, omwe amathandizira pakuyamba ndi kutulutsa kwa zinthu m'magazi. Ichi ndichifukwa chake gawo la chiwindi pamlingo waukulu limakhudza gawo lamapulidwe amwazi, kayendedwe ka thupi pazotsatira zilizonse zomwe zimatsutsana ndi chotupa.

Kudzera pakupanga mapuloteni, chiwindi chimatenga gawo limodzi pazochita zoyipa za thupi, zomwe ndi maziko oteteza thupi la munthu mokhudzana ndi matenda opatsirana kapena zinthu zina zomwe zimapanga thupi. Komanso, njira immunological kuteteza mucous nembanemba zam'mimba thirakiti limaphatikizidwa mwachindunji kukhudzidwa kwa chiwindi.

Mu chiwindi, ma protein a protein amapangika ndi mafuta (lipoproteins), ma carbohydrate (glycoproteins) ndi ma carriers ma processor (otumiza) a zinthu zina (mwachitsanzo, transerrin, chonyamulira chitsulo).

Mu chiwindi, zopangidwa ndi mapuloteni omwe amalowa m'matumbo ndi chakudya zimagwiritsidwa ntchito popanga mapuloteni atsopano omwe thupi limafunikira. Njira imeneyi imatchedwa transamination of amino acids, ndipo ma enzyme omwe amakhudzidwa ndi metabolism amatchedwa transaminases,

2. Kutenga nawo gawo pakuphulika kwa mapuloteni ku zinthu zawo zomalizai.e. ammonia ndi urea. Amoni ndi mankhwala osokoneza bongo omwe amapezeka nthawi zonse, pomwe ali ndi poizoni. dongosolo. Chiwindi chimapereka njira yosinthira kusintha kwa ammonia kukhala chinthu chochepa kwambiri cha urea, chomeracho chimapukusidwa ndi impso.

Ndi kuchepa kwa mphamvu ya chiwindi kusokoneza ammonia, amadziunjikira m'magazi ndi mantha dongosolo, lomwe limayendetsedwa ndi matenda amisala ndikutha ndi kutsekeka kwathunthu kwamanjenje - Chifukwa chake, titha kunena mosapita m'mbali kuti pali kudalirika kwamphamvu ya ubongo wa munthu pakuchita bwino kwa chiwindi chake,

3. Lipid (mafuta) kagayidwe. Njira zofunika kwambiri ndikuphwanya kwamafuta kwa triglycerides, kapangidwe ka mafuta acid, glycerol, cholesterol, bile acid, etc. Panthawiyi, mafuta achepetsa ma cell amapangidwa kokha m'chiwindi. Mafuta achilengedwe oterowo ndi ofunikira pakugwira ntchito konse kwa minofu yamatumbo ndi minofu ya mtima ngati njira yopezera gawo lalikulu lamphamvu.

Ma asidi omwewo amagwiritsidwa ntchito popanga kutentha mthupi. Kuchokera pa mafuta, cholesterol imakhala 80-90% yopanga m'chiwindi. Kumbali imodzi, cholesterol ndi chinthu chofunikira kwa thupi, kumbali ina, cholesterol imayikidwa m'matumbo pazovuta m'mayendedwe ake ndipo imayambitsa chitukuko cha atherosulinosis. Zonsezi pamwambapa zimapangitsa kutsata ubale ndi chiwindi ndikupanga matenda a mtima.

4. Carbohydrate kagayidwe. Kuphatikizika ndi kuwonongeka kwa glycogen, kutembenuka kwa galactose ndi fructose kukhala glucose, makutidwe ndi okosijeni a shuga, etc.

5. Kutenga nawo gawo pakukonzekera, kusunga ndi kupanga mavitamini, makamaka A, D, E ndi gulu B,

6. Kutenga nawo gawo pakusinthana kwachitsulo, mkuwa, cobalt ndi zinthu zina zofunika kuti magazi apangidwe,

7. Kuchita kwa chiwindi pochotsa poizoni. Zinthu zapoizoni (makamaka zakunja) zimagawidwa, ndipo zimagawidwa mthupi lonse. Gawo lofunika la kusaloŵererapo kwawo ndi gawo lasintha katundu wawo (kusinthika). Kusintha kumabweretsa kupangika kwa mankhwala okhala ndi mphamvu yotsika kapena yayikulu poyerekeza ndi poizoni amene adalowetsedwa.

Kuthetsa

1. Kusinthana kwa bilirubin. Bilirubin nthawi zambiri amapangidwa kuchokera ku zopangidwe zopangidwa ndi hemoglobin zomwe zimamasulidwa m'maselo ofiira a magazi. Tsiku lililonse, ma1.1,5% am'magazi ofiira amawonongeka m'thupi la munthu, kuphatikiza, pafupifupi 20% ya bilirubin amapangidwa m'maselo a chiwindi.

Kagayidwe kachakudya ka bilirubin kamapangitsa kuti zinthu zikhale zambiri m'magazi - hyperbilirubinemia, yomwe imawonetsedwa ndi jaundice,

2. Kutenga mbali mu njira zopangira magazi. M'maselo a chiwindi, zinthu zofunika kuphatikizika kwa magazi (prothrombin, fibrinogen) zimapangidwa, komanso zinthu zingapo zomwe zimachepetsa njirayi (heparin, antiplasmin).

Chiwindi chimakhala pansi pa chithunzi pamwambapa pamimba pamimba ndipo kumakhala kwabwinobwino mwa achikulire sichimagwira, chifukwa chimakutidwa ndi nthiti. Koma mwa ana aang'ono, amatha kutuluka kuchokera pansi pa nthiti. Chiwindi chimakhala ndi ma lobes awiri: kumanja (kwakukulu) ndi kumanzere (yaying'ono) ndikuphimbidwa ndi kapisozi.

Pamwamba pachiwindi pali mawonekedwe, ndipo m'munsi mumakhala pang'ono. Pamunsi pansipa, pakati, pali zipata zachiwindi zodabwitsa zomwe ziwiya, mitsempha ndi ma ducts a bile zimadutsa. Mu recess pansi pa lobe lamanja ndi ndulu, yomwe imasungira bile yotulutsa ma cell a chiwindi yotchedwa hepatocytes. Chiwindi chimatulutsa mamililita 500 mpaka 1200 a bile patsiku. Bile imapangidwa mosalekeza, ndipo kulowa kwake m'matumbo kumalumikizidwa ndi kudya.

Bile ndimadzimadzi achikasu, omwe amakhala ndi madzi, ma bile bile ndi ma acid, cholesterol, mchere wamchere. Kupyola mu wamba duct, imabisidwa mu duodenum.

Kupanga kwa bilirubin kudzera mu ndulu kumachotsa bilirubin, komwe kumakhala poizoni m'thupi, chifukwa cha kusokonekera kwachilengedwe kwa hemoglobin - mapuloteni a maselo ofiira amwazi) m'magazi. Pankhani ya kuphwanya. Nthawi iliyonse ya bilirubin excretion (m'chiwindi pakokha kapena bile katulutsidwe kudzera mu ma hepatic ducts), bilirubin imadziunjikira m'magazi ndi zimakhala, zomwe zimawonetsedwa pakhungu la chikasu pakhungu ndi sclera, i.e., pakupanga jaundice.

Ma acid acilemba (cholates)

Ma bile acids (cholates) osakanikirana ndi zinthu zina amapereka kuchuluka kwa cholesterol metabolism ndi chimbudzi chake ndi bile, pomwe cholesterol mu bile ili mu mawonekedwe osungunuka, kapena, m'malo mwake, imangirizidwa tinthu tating'onoting'ono tomwe timapereka mafuta a cholesterol. Kuphwanya kusinthana kwa ma asidi a bile ndi zinthu zina zomwe zimatsimikizira kuti kuchotsedwa kwa cholesterol kumayendera limodzi ndi mpweya wa cholesterol mu bile ndi mapangidwe a gallstones.

Mukukhazikika kosinthana kwa bile acids, osati chiwindi chokha, komanso matumbo. M'magawo oyenera am'matumbo akulu, kuyamwa kwa cholates kubwerera m'magazi kumachitika, zomwe zimatsimikizira kufalikira kwa ma bile acid mthupi la munthu. Chosungira chachikulu cha bile ndi chikhodzodzo.

Chikhodzodzo

Ndi kuphwanya kwa ntchito yake, kuphwanya malamulo obisika a bile ndi ma acids amadziwikanso, zomwe ndi zina zomwe zimapangitsa kuti pakhale gallstones. Nthawi yomweyo, zinthu za bile ndizofunikira kuti chimbudzi chokwanira cha mafuta ndi mavitamini osungunuka a mafuta.

Ndi kusakhalapo kwa nthawi yayitali ya bile acid ndi zinthu zina za bile, kuperewera kwa mavitamini (hypovitaminosis) kumapangidwa. Kuchuluka kwa bile acids m'magazi ndikuphwanya kubisika kwawo ndi ndulu kumayendera limodzi ndi kuyabwa kwambiri kwa khungu ndikusintha kwamtima.

Mbali ya chiwindi ndikuti imalandira magazi am'mimba kuchokera ku ziwalo zam'mimba (m'mimba, kapamba, matumbo, ndi zina), zomwe, kudzera mu mitsempha ya portal, imayesedwa ndi zinthu zovulaza ndi maselo a chiwindi ndikulowa m'munsi mwa vena cava, yomwe imapita kumtima. Ziwalo zina zonse zamunthu zimalandira magazi ochepa, ndipo magazi amayamba kupatsidwa.

Nkhaniyi imagwiritsa ntchito zinthu kuchokera pagulu lotsegulira: Wolemba: Trofimov S.- Buku: "Matenda a Chiwindi"

Gawani positi "Ntchito za chiwindi m'thupi la munthu"

Kodi chiwindi cha munthu chili kuti

Anthu ambiri sadziwa komwe chiwindi cha munthu chili komanso momwe matendawa amayambira. Izi ndizofunikira kwa aliyense. Podziwa mbali yomwe chiwindi chili, mutha kupeza zofunkhira palpation ndikuwona kukula kwake. Kuwonjezeka kwa chiwindi kukuwonetsa kukula kwa matenda oopsa.

Zitsulo, titero, Iron "imamizidwa" m'mimba. Mwa anthu, chiwindi chili kumbali yakumanja, mu hypochondrium yoyenera. Pansi pake pali ndulu, ndipo imayang'anira kuwongolera kuchuluka kwa ndulu zomwe zimalowa m'mimba.

Pomwe chiwindi cha munthu chili, palinso ziwalo zina zofunika zam'mimba: duodenum, m'mimba. Pamodzi amatenga nawo mbali pang'onopang'ono pazakudya zomwe zikubwera komanso kuperewera kwa michere. Malire a kumtunda kwa chiwindi amadutsa pang'ono kuseri kwa mzere wa nipples, ndi kumbuyo - motsatira mzere wa diaphragm.

Kapangidwe ka chiwindi

Chiwindi ndi chithokomiro chachikulu cha katulutsidwe wakunja. Amatenga nawo mbali pafupifupi mkati ndipo amagwira ntchito yayikulu mthupi la munthu. Chiwindi chimakhala ndi ma lobes akumanja ndi kumanzere ndipo chimagawika m'magawo asanu ndi atatu. Lobe lamanja ndi lalikulu kwambiri kuposa lamanzere. Pamaso pa wina ndi mzake, loboti imagawidwa ndi crescent ligament, kumbuyo, ndi poyambira padera yomwe ili ndi venous ligament. Ma lobes apansi amagawidwa ndi ligament yozungulira.

Kapangidwe kake ka chiwindi ndi ubweya wambiri, womwe uliwonse umakhala ndimitsempha ndipo umakhala ndi mitsempha yambiri yamagazi - yayikulu ndi yaying'ono. Pakati pa lobules a chiwindi ndi minofu yolumikizana minofu.

Udindo wa chiwindi m'thupi la munthu

Udindo waukulu wa chiwindi:

kutaya zinthu zapoizoni, poizoni,
kutenga nawo mbali popanga mahomoni, mavitamini, ma acid, lipids, cholesterol, bilirubin, phospholipids,
kuonetsetsa kagayidwe kachakudya,
kapangidwe ka bile, kutengapo gawo pakukumba ndi kugaya zinthu zambiri,
kuchotsedwa kwa zinthu za metabolic, zinthu zoopsa (ammonia, acetone),
kubwezeretsanso glycogen nkhokwe komanso kupatsa thupi mphamvu.

Popanda chiwindi, kupezeka kwa anthu ndikosatheka. Ndi magazi otaya kulowa mthupi lapoizoni mankhwala osakanikirana, ma carcinogens, omwe salowerera pamenepo, amapulumutsidwa. Chiwindi chimakhudzidwa ndi metabolism, ndikusintha ma carbohydrate kukhala glycogen ndipo imayambitsa kupatsidwanso kwina.

Ntchito yolepheretsa

Chiwindi m'thupi la munthu chimagwira ntchito zambiri, koma chofunikira kwambiri ndichoteteza. Thupi limalepheretsa zotsatilapo zathanzi la zinthu zachilengedwe zophatikizika ndi ziphe. Ntchito yotchinga chiwindi ndikuteteza ziwalo zofunika mkati ndi machitidwe, komanso magazi kuzinthu zovulaza. Chifukwa cha izi, thupi lathu limagwira ntchito bwino.

Chiwindi sichimangolekerera zinthu zakunja, kuphatikiza ma allergen, mahomoni, zotsalira zamafuta osafunikira, komanso zimawasandutsa zinthu zopanda vuto zomwe zimachotsedwa mthupi mosavuta.

Ntchito yogaya

Kugaya ntchito kwa chiwindi ndi kapangidwe ka cholesterol, ma asidi a bile, lipids, kayendedwe ka mafuta kagayidwe. Chiwalo chimagwira gawo lalikulu pama metabolism a anthu komanso kuperewera kwa michere, kuphatikiza matumbo. Bile imakhala ndi antimicrobial. Ndi kuchepa kwa ntchito ya chiwindi, chiopsezo chotenga matenda opatsirana chikuchulukirachulukira.

Thupi limadzitchinjiriza motsutsana osati ndi zida zophatikizira poizoni, komanso ku ma virus ndi ma virus. Bile imakhudza mwachindunji kukhathamiritsa kwa michere, makamaka mavitamini osungunuka a mafuta, ma amino acid, mchere wamchere.

Kuyika magazi

Mwazi wambiri umasungidwa m'chiwindi, womwe umatha kulowa m'magazi panthawi yopanga zinthu zoopsa chifukwa chochepetsa ziwindi. Ntchitoyi imakhala yoteteza ndi kutaya magazi kwambiri, kukhazikika kwa mantha. Kuphatikiza apo, mu "fetus", chiwindi chimagwira ntchito ya hematopoiesis, imapanga mapuloteni a plasma, ma membala a mahomoni ndi mavitamini.

Ntchito ya mahormoni

Chiwindi cha munthu chimakhudzidwa mwachindunji ndi kapangidwe ka mahomoni. Ma cell a organic ndi omwe amachititsa kuti ma horoni azitha kugwira ntchito mwa chithokomiro cha chithokomiro, maliseche, kapamba.

Momwe chiwindi ndi kapamba zimalumikizirana

Chiwindi ndi kapamba zimagwirizana kwambiri, ndipo ntchito ya chiwalo chimodzi ikasokonekera, ntchito ya kusintha kwina. Zikondwererozo zimakhala kumbuyo kwa m'mimba, molimba moyandikana ndi duodenum. Amatulutsa michere yomwe imakhudzidwa ndi chimbudzi, imapatsa chimbudzi cha mafuta, mapuloteni, chakudya. Pankhani ya kukanika kwa pancreatic, ma metabolic ofunikira amasintha, omwe amakhala ndi zotsatira zovuta zaumoyo.

Chiwindi chimateteza m'thupi la munthu. Imatha kusinthitsa zinthu zovulaza kuchokera kunja, kuzisintha kukhala zotetezeka, kuchotsa zinthu zoyipa za metabolic, komanso kupha magazi.

Chitsulo chopangidwa ndi chiwalochi chimagwira gawo logaya, kuphwanya zakudya zamafuta. Zimakhudza kapamba, kuwonjezera ntchito za michere yake, makamaka lipase. Chiwindi chimapereka thupi la munthu ndi shuga, imatenga nawo kapangidwe ka cholesterol ndikuwongolera kagayidwe ka lipid. Ntchito za chiwindi ndi kapamba zimachulukana ndipo zimagwirizana kwambiri ndi ntchito ya chakudya chonse cha munthu.

Chiwindi ndi matumbo

M'matumbo a munthu, michere yofunika imalowetsedwa m'magazi. Zinthu za kagayidwe ndi zakudya zopanda chakudya zimasinthidwa ndowe, zomwe zimatsitsidwa m'thupi.

Zamoyo zonse ziwiri zopindulitsa komanso zamikhalidwe zimakhala m'matumbo. Pakakhala vuto pakati pawo (dysbiosis), zosokoneza zingachitike mu chimbudzi chonse. Izi zimawonekera pamimba, komanso pachiwindi, komanso pazinthu zina zam'mimba.

Matumbo amakhala ndi zigawo zoonda komanso zopyapyala. Duodenum ili m'matumbo ang'onoang'ono - imapanga gawo lake loyambirira. Udindo wake waukulu ndikusintha kwa pH ya chakudya cha m'mbali mwa zamchere. Izi ndizofunikira kuti zigawo zam'matumbo zisakwiyitsidwe chifukwa cha acidic malo a di-gruel oyimbidwa.

M'matumbo am'munsi, matumbo akulu, madzi amawamwa ndipo ndowe zimapangidwa. Chiwindi chimakhudza njira ya "mayamwidwe" a michere ndi matumbo villi, makamaka - mayamwidwe amafuta acids komanso njira ya mafuta metabolism.

Zimayambitsa matenda a chiwindi

Zomwe zimayambitsa matenda a chiwindi:

zizolowezi zoipa: bongo, uchidakwa, kusuta - zonsezi zimabweretsa kuwonjezeka kwa gland, kuwonongeka kwa hepatocytes, kuchepa kwamafuta ndi kulocha m'malo mwa parenchyma ndi minofu yolumikizana ndi kukula kwa fibrosis, cirrhosis ndi khansa,
Mavuto a chiwindi pakhungu la chiwindi, chomwe chimayambitsa matenda a necrosis komanso chiwindi chachikulu.
Zotsatira zoyipa za mankhwala osokoneza bongo komanso zowononga zachilengedwe zomwe zimayambitsa kuwonongeka kwa hepatocytes ndi kukula kwa chiwindi,
Mafuta ambiri omwe amapezeka muzakudya, zomwe zimabweretsa kuchuluka kwa mafuta m'maselo a chiwindi, kukula kwa dystrophy, mawonekedwe a kuyang'ana kwa kutupa ndi kuchuluka kwa minofu yolumikizidwa.

Udindo waukulu mu gawo la chiwindi umaseweredwa ndi zizolowezi zoyipa ndi kuchuluka kwa zakudya. Moyo wathanzi umasunga magwiridwe antchito mpaka okalamba. Anthu ambiri saganiza zokhudzana ndi ntchito ya chiwindi mpaka atakhala ndi mavuto azaumoyo.

Kugwiritsa ntchito zakudya zamafuta ndi mowa kumawononga maselo a chiwindi, omwe amachititsa zokha kuti chikhodzodzo chikhodzodzo, kapamba, matumbo. Ziwalo izi zimagwira ntchito molumikizana.

Kuzindikira matenda a chiwindi

Kuti mukhale ndi thanzi, ndikofunikira kudziwa osati malo enieni a chiwindi, komanso momwe mungayang'anire chiwalochi mwa anthu pogwiritsa ntchito njira zamakono zofufuzira. Mwa matenda, cirrhosis imabwera koyamba - matenda omwe amadziwika ndi kulowetsa kwa parenchyma wathanzi wokhala ndi minyewa ya fibrous. Zikatero, chiwindi chimatha kuchuluka kapena kucheperachepera, kukhala chachulu kwambiri komanso kachulukidwe kakang'ono, ndipo kuchepa kwa matendawa kumachitikanso.

Popanda kuthandizira panthawi yake, matendawa amakhala oopsa pamankhwala a kutupa kwa hepatocellular carcinoma. Cirrhosis ya chiwindi imayamba makamaka mwa anthu omwe amamwa ndipo adakhala ndi hepatitis B. Matendawa amapita patsogolo pazaka, koma nthawi zina nthawi ya chitukuko cha matenda amatsitsa imakhala miyezi yambiri. Mwa zina matenda a chiwindi, parasitic ndi non-parasic cysts, zotupa zopatsirana, hemangiomas amapezeka.

Kafukufuku wazotsatira

Kuzindikira matenda a chiwindi kumaphatikizapo maphunziro otsatirawa:

kuyezetsa magazi (akatswiri apeza thrombocytopenia, leukopenia, kuchuluka kwa bilirubin, urea, creatinine),
coagulogram (kutsika kwa prothrombin index),
magazi a biochemistry (kuchuluka kwa chiwindi michere),
Ultrasound yam'mimba ziwalo (kusintha kukula kwa chiwindi, kuzindikira kwa matenda a portal matenda oopsa, kuzindikira kwa cysts, zotupa, kusintha kwamkati mwa parenchyma),
Chiwindi MRI (kukhalapo kwa ma abscesses, puss, metastasis, zizindikiro za khansa ndi matenda amitsempha, kuphwanya kwa hepatic ndi portal vein patency),
dopplerometry yamitsempha yamagazi ya chiwindi (kuzindikira zopinga pakuyambitsa kuthamanga kwa magazi),
chiwindi biopsy (kutsimikizira kwa chosaopsa kapena chotupa chotupa),
PCR, ELISA (chizindikiritso cha tizilombo toyambitsa matenda omwe timayambitsa minofu ya chiwindi),
Ultrasound ya chiwindi (kuwonongeka kwa magwiridwe antchito a ziwalo, kuzindikira zotupa, zovuta mu kayendedwe ka magazi am'deralo).

Kafukufuku wapadera ayenera kuyikidwa ndi dokotala. Nthawi zambiri, katswiri amavomereza kuti matenda a chiwindi ayambe kudwala, chikhodzodzo, ndi kapamba. Kuphatikiza apo, njira zina zitha kufunikira, kuphatikizira kufufuza kwa magazi, komwe kumakuthandizani kuti muwone kusintha kwa ntchito ya enzymatic ya chiwindi.

Kodi matenda a chiwindi amawonetsedwa bwanji?

Matenda a chiwindi pachigawo choyambirira cha chitukuko amachitika pafupifupi popanda chiwonetsero chilichonse. Nthawi zambiri munthu samadziwa za vuto lakelo ndipo, mosadziwa, samachita zochizira. Chifukwa chake, madokotala amalangizidwa kuti nthawi ndi nthawi azichita kafukufuku wa ultrasound kuti adziwe zoyipa mu chiwindi. Kumayambiriro kwa chitukuko, minofu ya chiwindi imabwezeretseka bwino, makamaka paubwana.

Zizindikiro zamikhalidwe

Chizindikiro china cha matenda amchiwindi ndichikaso cha pakhungu ndi mucous nembanemba, komanso sclera. Chizindikiro ichi chimalumikizidwa ndi kuchuluka kwa bilirubin m'magazi. Matenda ambiri a chiwindi amadziwika ndi kuuma kwakumanja ndi kupweteka mu hypochondrium yoyenera. Zizindikirozi nthawi zambiri zimalumikizidwa ndikumva kuwawa mkamwa, nseru, nthawi zina kusanza, kuwonjezeka kwa kukula kwam'mimba chifukwa cha ascites (kuchuluka kwa madzimadzi mu peritoneum).

Ngati mukupeza chimodzi mwazizindikirozi, onetsetsani kuti mwapangana ndi gastroenterologist kapena hepatologist.

Ngati ndizosatheka kubwezeretsanso ntchito zomwe zidatayika, ndikuyika chiwindi ndikuwonjezera - ntchito yodula kuti mutulutse chiwalo chokhudzidwa. Ndizovuta kwambiri, makamaka m'dziko lathu. Sizophweka kupeza wopereka, ngakhale atakhala ndi mwayi wina wazachuma.

Ndikofunikira kwambiri kuyankha munthawi yake kuti chiwindi chitseguke komanso kupewa matenda. Ngati ma pathologies akupanga kale, ndikofunikira kulumikizana ndi akatswiri nthawi yomweyo ndikuyamba kulandira chithandizo.

Kubwezeretsa ntchito ya chiwindi

Mpaka nthawi ina, chiwindi sichisokonezeka kwathunthu, maselo ake amatha kupangidwanso. Koma pa ichi ndikofunikira kupanga zina:

kudya zamtundu wapamwamba komanso zosiyanasiyana, kotero kuti zakudya nthawi zonse zimakhala ndi masamba ndi zipatso zambiri, mapuloteni athanzi,
chepetsa zakudya zamafuta ndi zokutidwa zomwe zimalepheretsa thupi kupumula ndikuyambiranso ntchito zake,
lekani mowa
Gwiritsani ntchito zitsamba zathanzi nthawi zonse monga mankhwala ndi ma infusions omwe amayeretsa chiwindi, onetsetsani kutuluka kwa bile ndikuletsa mapangidwe a miyala.
pewani kudya kwambiri, chifukwa chakudya chochuluka chimakulitsa katundu pazinthu zonse zam'mimba, kuphatikizapo chiwindi.

Nthawi ndi nthawi, mumatha kuyeretsa chiwindi pogwiritsa ntchito zitsamba ndi zina. Koma kambilanani ndi dokotala wanu woyamba. Kwa kuyeretsa modekha kwa chiwindi ndi kupewa kunjenjemera kwa bile, msuzi wa oat ndi woyenera.

Ndipo pomaliza nkhaniyi tikupereka chidwi choonera kanema pomwe akatswiri amalankhula za kapangidwe kake ka chiwindi, ntchito yake pantchito ya ziwalo zina zam'mimba komanso chithupi cha munthu chonse.

Zambiri Zoyambira Za Ulamuliro

Chiwindi chimakhala mu hypochondrium yoyenera ndipo imatenga malo ambiri pamimba, chifukwa ndi chiwalo chachikulu kwambiri chamkati. Kulemera kwake kumachokera 1200 mpaka 1800 magalamu. Mawonekedwe, amafanana ndi chipewa cha bowa. Adatenga dzina lake kuchokera ku mawu oti "chitofu", popeza thupi ili ndi kutentha kwambiri. Njira zovuta kwambiri zamankhwala zimachitika kumeneko, ndipo ntchito ikuchitika popanda zosokoneza.

Ndikosatheka kuyankha mosakayikira funso loti chiwindi ndi chiani m'thupi la munthu, chifukwa ntchito zonse zomwe amagwira ndizofunikira kwa iye. Chifukwa chake, thupi ili ndi kubadwanso kwatsopano, ndiye kuti, limatha kudzipulumutsa lokha. Koma kuleka kwa ntchito zake kumabweretsa kuphedwa kwa munthu m'masiku angapo.

Ntchito yoteteza chiwindi

Koposa 400 patsiku, magazi onse amadutsa chiwalochi, ndikudziyeretsa poizoni, mabakiteriya, ziphe ndi ma virus. Mbali yolepheretsa chiwindi kuti maselo ake agwetse zinthu zonse zapoizoni, ndikuzipaka mu mawonekedwe osungunulira madzi ndikuwachotsa m'thupi. Amagwira ntchito ngati labot yovuta kupanga mankhwala, osasokoneza poizoni yemwe amalowa mthupi ndi chakudya komanso mpweya ndipo amapangidwa chifukwa cha zochita za metabolic. Kodi chiwindi chimadziyeretsa?

- Kuchokera kwa zoteteza, utoto ndi zina zowonjezera zomwe zimapezeka muzakudya.

- Kuchokera ku bacteria ndi ma virus omwe amalowa m'matumbo, komanso kuchokera kuzinthu zawo za metabolic.

- Kuchokera ku mowa, mankhwala osokoneza bongo komanso zinthu zina zapoizoni zomwe zimalowa m'magazi ndi chakudya.

- Kuchokera ku mpweya wamagetsi ndi zitsulo zolemera zochokera kumlengalenga.

- Kuchokera kowonjezera mahomoni ndi mavitamini.

- Kuchokera kuzinthu zapoizoni zochokera ku metabolism, monga phenol, acetone kapena ammonia.

Udindo wa chiwindi mu kagayidwe

Zakudya zomanga thupi zomwe zimabwera ndi chakudya chokhacho zimasandulika kukhala glycogen, momwe mawonekedwe a shuga amalowa m'magazi momwe amafunikira. Njira ya gluconeogeneis imapatsa thupi kuchuluka kwa shuga. Chiwindi chimawongolera kuchuluka kwa insulin m'mwazi, kutengera zosowa za munthu.

Chiwalochi chimaphatikizidwanso mu metabolism ya protein. Mu chiwindi pomwe albumin, prothrombin, ndi mapuloteni ena omwe ndiofunikira pamoyo wa thupi amapangidwa. Pafupifupi cholesterol yonse yomwe imakhudzidwa ndi kuwonongeka kwa mafuta ndikupanga mahomoni ena amapangidwanso pamenepo. Kuphatikiza apo, chiwindi chimatenga gawo limodzi mu madzi a mchere. Itha kudziunjikira mpaka 20% yamagazi ndipo

amagwira ntchito monga chosungira mchere wambiri ndi mavitamini.

Kuchita kwa chiwindi mu hematopoiesis

Thupi ili limatchedwa "depot yamagazi."Kuphatikiza poti amatha kusungidwa mpaka malita awiri, hematopoiesis imachitika m'chiwindi. Amapanga ma globulins ndi albumin, mapuloteni omwe amapereka magazi ndikuwonjezera magazi. Chiwindi chimakhudzidwa ndikupanga chitsulo, chomwe chiri chofunikira pakuphatikizidwa kwa hemoglobin. Kuphatikiza pa kuyeretsa magazi a poizoni, chiwalochi chimaphwanya maselo ofiira amthupi, zomwe zimapangitsa kupanga bilirubin. Muli m'chiwindi momwe mumapangidwa mapuloteni omwe amagwira ntchito zoyendera mahomoni ndi mavitamini.

Kusungidwa kwa michere

Polankhula za gawo la chiwindi m'thupi la munthu, ndizosatheka kutchula ntchito yake yopeza zinthu zofunika pamoyo. Kodi chosungira thupi ndi chiyani?

1. Awa ndi malo okhawo osungira glycogen. Chiwindi chimadziunjikira ndipo, ngati kuli kofunikira, chimaponyera m'magazi mu mawonekedwe a shuga.

2. Pafupifupi malita awiri a magazi alipo ndipo amangogwiritsidwa ntchito pokhapokha ngati magazi atayika kwambiri kapena ngati angadabwe.

3. Chiwindi ndi malo osungira mavitamini ofunikira kuti thupi lizigwira ntchito bwino. Makamaka mavitamini A ndi B12 ambiri amasungidwa mmenemo.

4. Thupi ili limapanga ndikudziunjikira zitsulo zofunika m'thupi, mwachitsanzo, chitsulo kapena mkuwa.

Zomwe zingayambitse vuto la chiwindi

Ngati pachifukwa china chake chiwalochi sichingagwire bwino ntchito, ndiye kuti pali matenda osiyanasiyana. Mutha kumvetsetsa zomwe gawo la chiwindi mthupi la munthu liri, ngati muwona zomwe kuphwanya kwake kukuyambitsa:

- adachepetsa chitetezo chokwanira komanso kuzizira kosatha,

- kusokonezeka kwa magazi komanso kutuluka magazi pafupipafupi,

- kuyabwa kwambiri, khungu louma,

- kusowa kwa tsitsi, ziphuphu,

- mawonekedwe a shuga ndi kunenepa kwambiri,

- matenda osiyanasiyana azachipatala, mwachitsanzo, kusamba,

- zovuta zakudya zam'mimba, zomwe zimawonetsedwa ndi kudzimbidwa pafupipafupi, mseru komanso kuwonda.

- Matenda amsempha - kukwiya, kukhumudwa, kusowa tulo komanso kupweteka kwa mutu pafupipafupi,

- Matenda amadzi a metabolism, owonetsedwa ndi edema.

Nthawi zambiri, adotolo amathandizira izi popanda kuzindikira kuti zomwe zimayambitsa ndikuwonongeka kwa chiwindi. Palibe mathero amitsempha mkati mwa chiwalo, chifukwa munthu sangamve kupweteka. Koma aliyense ayenera kudziwa zomwe chiwindi chimachita m'moyo wake, ndikuyesera kuchisamalira. Ndikofunikira kusiya mowa, kusuta, zokometsera komanso zakudya zamafuta. Chepetsani kugwiritsa ntchito mankhwala, mankhwala okhala ndi zoteteza komanso utoto.