Mkodzo: zikuchokera ndi katundu

The mankhwala kungotaya thupi ndi mkodzo. kapangidwe kake, komanso chiwerengero cha thupi katundu ndi mankhwala, ngakhale anthu abwino ndi wosakhazikika ndipo amadalira zifukwa zambiri palibe vuto lililonse kuti si owopsa ndipo amayambitsa matenda aliwonse. Koma pali zizindikiro wofotokozedwa ndi zasayansi pa mayesero amene amasonyeza zosiyanasiyana matenda. The kopanda kuti thupi si chabwino, mukhoza kudzipereka ndi ochepa okha kuti Atchule ena mwa makhalidwe a mkodzo wawo.

Monga likukhalira mkodzo

Mapangidwe ndi zikuchokera wa mkodzo wa munthu wathanzi chimadalira kwenikweni impso ndi katundu (mitsempha, zakudya m'thupi ndi zina), amene amalandira thupi. Tsiku lirilonse, impso ndi anadutsa yekha malita 1500 magazi. Kodi kwambiri, chifukwa munthu pafupifupi ake 5 malita yekha? chakuti minofu imeneyi madzi kapena thupi madzimadzi (kotero, nawonso, amatchedwa magazi) kwa tsiku kudutsa impso pafupifupi 300 nthawi.

Ndi aliyense kudutsa capillaries maselo aimpso amapezeka kuti lidzayeretsedwa ku thupi zinyansi zapathengo, ndi mapuloteni ena. Bwanji? The capillaries pamwamba ndi zipupa woonda kwambiri. maselo awo constituent ntchito ngati mtundu wa fyuluta wamoyo. Iwo kusunga particles lalikulu ndi madzi wapita, ena salt, amino zidulo kuti seep mu kapisozi wapadera. madzimadzi akutchedwa mkodzo chachikulu. Magazi akulowa tubules aimpso kumene kuchokera makapisozi angapo kubwerera thunthu osasankhidwa, ndipo linanena bungwe otsala mwa ureters ndi mkodzo kunja. Ndi bwino kuti ife tonse mkodzo sekondale. Zikuchokera (physico-mankhwala ndi kwachilengedwenso komanso pH) anatsimikiza zasayansi, koma ena ndondomeko kuyambirira zikhoza kuchitika kunyumba. Kuti tichite zimenezi, bwinobwino ena mwa makhalidwe a mkodzo wawo.

zizindikiro kachulukidwe

Wa umadutsa ndi malita theka zikwi a impso magazi kuwathothola za 180. Pamene kachiwiri kusefera, ndalamazo yafupika malita 1.5-2, chomwe ndi chizindikiro cha makonzedwe kuchuluka komwe kwa tsiku limodzi munthu wathanzi ayenera allocated mkodzo. Kapangidwe ndi kuchuluka kwa izo zingasiyane malingana:

• nthawi ya chaka ndi nyengo (m'chilimwe ndi kutentha mu pakafukufuku);
• fiznagruzok;
• wamsinkhu;
• kuchuluka kwa maola madzi ataledzera (pafupifupi mkodzo buku ndi 80% ya madzi kulowa m'thupi);
• mankhwala ena.

Kupatuka pa malamulo kachulukidwe malangizo mwina kungakhale chizindikiro cha matenda otsatirawa:

• polyuria (oposa 2 malita a mkodzo patsiku) kungathe kukhala chizindikiro cha matenda mitsempha, matenda a shuga, edema, exudate, i.e. madzi olekanitsa ziwalo;
• oliguria (mkodzo 0.5 L kapena zochepa) ndi mu mtima ndi kulephera aimpso ndi matenda ena aimpso, dyspepsia, nephrosclerosis;
• anuria (0.2 L kapena zochepa) - nephritis chizindikiro, kakhosi, pachimake aimpso kulephera, zotupa, urolithiasis, spasms kapepala kakuti mkodzo.

Choncho pokodza kungakhale yosowa kwambiri kapena, Tikawonetsetsa pafupipafupi kupweteka kuwonjezeka usiku. Ndi zolakwika muyenera kuwona dotolo.

mtundu

The zikuchokera mkodzo anthu mwachindunji zokhudzana ndi mtundu. Last kutifotokozera zinthu zenizeni urochrome tochoka ya ndulu inki. Kodi Nthawi zambiri, yellower ndi zambiri zimalimbikitsa (apamwamba kachulukidwe) ya mkodzo. Amaona mtundu yachibadwa ku udzu chikasu. Ena zakudya (Beets, kaloti) ndi mankhwala ( "Amidopyrine", "ndi aspirin", "furadonin" ndi ena) kusintha mtundu wa mkodzo ndi pinki kapena lalanje, amenenso ali ponseponse. zimakwana kuyesa mtundu wa mkodzo.

Disease alipo anatsimikiza mtima kusintha otsatirawa mtundu:

• wofiira, nthawizina mu mawonekedwe a slops nyama (glomerulonephritis, porphyria, hemolytic mavuto);
• kunachita mdima wa mkodzo pamodzi mpweya mpaka wakuda (homogentisuria);
• woderapo (a chiwindi, matenda a chikasu ndiyo);
• imvi woyera (Piura, mwachitsanzo pamaso pa mafinya);
• Kamaoneka, bluish (inali kuwola mu intestine ya).

fungo

Pa zikuchokera kusinthidwa wa mkodzo anthu ndipo angasonyeze njirayi. Choncho, pamaso pa matenda akhoza kapadera ngati fungo zotsatirazi zilamulire:

• acetone (ketonuria chizindikiro);
• ndowe (Escherichia coli matenda);
• amoniya (zikutanthauza cystitis);
• zosasangalatsa kwambiri chonunkha (mu mkodzo thirakiti purulent ali fistula mu M'mimbamo a);
• kabichi, anakweranso (pamaso malabsorption methionine);
• thukuta (isovaleric acidemia kapena asidi glutaric);
• decomposing nsomba (matenda Trimethylaminuria);
• "Mbewa" (phenylketonuria).

Mwachibadwa, mkodzo ali ndi fungo Fungo lamphamvu lamankhwala komanso ndi mandala. Komanso, nyumba akhoza kuyezedwa mkodzo kapena thovu. Chifukwa chaichi m'pofunika kusonkhanitsa mu chidebe ndipo Gwiranani. Kuoneka zambiri, nthawi yothetsa thovu limasonyeza kukhalapo kwa mapuloteni mu izo. Komanso mudziwe zambiri, kusanthula iyenera kuchitikira ndi akatswiri.

Turbidity, kachulukidwe, acidity

Zasayansi, ndi mkodzo akufunsidwa mafunso kwa mtundu ndi fungo. Limasonyanso chilungamo chake. Ngati wodwala turbid mkodzo, zikuchokera akhoza monga mabakiteriya, salt, ntchofu, mafuta, ma zinthu erythrocytes.

anthu mkodzo kachulukidwe ayenera kukhala mu uthunthu 1010-1024 g / lita. Ngati ndi apamwamba, izo zikusonyeza madzi m'thupi, ngati m'munsi - pachimake aimpso kulephera.

Acidity (pH) ayenera kukhala mu osiyanasiyana 5 mpaka 7. chiwerengerochi siyana malingana ndi munthu analandira chakudya ndi mankhwala. Ngati zinthu izi sakuikidwamo, pansipa pH 5 (acidic mkodzo) zingasonyeze wodwala ketoacidosis, hypokalemia, kutsekula m'mimba, lactic acidosis. Pa pH pamwamba 7 akhoza kupezeka mu pyelonephritis mtima, cystitis, hyperkalemia, aakulu kulephera aimpso, chithokomiro hyperfunction ndi matenda ena.

Albuminuria

Thunthu kwambiri osafunika kulimbikitsa kapangidwe ndi katundu wa mkodzo, ndi mapuloteni. Bwinobwino izo ziyenera kukhala munthu wamkulu 0.033 g / lita, i.e. 33 mg wa pa lita. Makanda chithunzi angakhale 30-50 mg / L. Mu amayi apakati, mapuloteni mu mkodzo pafupifupi nthawi zonse amatanthauza ena zosokonezeka. M'mbuyomu ankaganiza kuti kukhalapo kwa chigawo ichi mu osiyanasiyana kuchokera 30 mpaka 300 mg microalbuminuria njira, ndi pamwamba 300 mg - macroalbuminuria (matenda a impso). Tsopano kudziwa kupezeka kwa mapuloteni mu mkodzo ndi tsiku, osati amodzi, ndi kuchuluka kwake kwa 300 mg mu mimba si kudwala.

Mapuloteni mu mkodzo kungakhale mongoyembekezera (kamodzi) kuonjezera pa zifukwa zotsatirazi:

• postural (thupi udindo mu mlengalenga);
• fiznagruzki;
• febrile (malungo ndi malungo ena);
• zifukwa bwinobwino anthu athanzi.

Mapuloteni mu mkodzo ndi kafukufuku mobwerezabwereza amatchedwa proteinuria. Ndi:

• (. Mapuloteni 150 mpaka 500 mg / d) wofatsa - ndi zizindikiro akuwuka mu nephritis, obstructive uropathy, poststreptococcal pachimake ndi aakulu glomerulonephritis, tubulopathy;
• (. 500 2000 mg / tsiku mapuloteni mu mkodzo) zolimbitsa - ndi poststreptokokovogo zizindikiro za glomerulonephritis pachimake; cholowa nephritis ndi glomerulonephritis aakulu;
• kutchulidwa (zoposa 2,000 mg / tsiku. mapuloteni mu mkodzo), kuonetsa kuti wodwalayo ali amyloidosis, nephrotic syndrome.

Erythrocytes ndi leukocytes

The zikuchokera sekondale zikuphatikizapo mkodzo otchedwa bungwe (organic) precipitate. Pamafunikanso pamaso pa erythrocytes, leukocytes, particles wa mosabisa, cylindrical kapena kiyubiki epithelium selo. Pakuti aliyense wa iwo malamulo yake.

1. Red maselo magazi. Mwachibadwa, si amuna ndi akazi ali chitsanzo 1-3. A owonjezera yaing'ono amatchedwa tosaoneka haematuria ndi chidwi - aakulu hematuria. Ndi chizindikiro:

• matenda a impso;
• Kudwala a chikhodzodzo;
• kumaliseche magazi mu dongosolo urogenital.

2. White maselo magazi. Ponseponse kwa akazi - amuna 10 - mpaka 7 chitsanzo. Kuchuluka owonjezera anatchula leykotseturiey. Izo nthawizonse limasonyeza kuti panopa yotupa ndondomeko (a matenda a limba ndi). Ndipo ngati leukocytes mu chitsanzo 60, ndi zambiri mkodzo umakhala wachikasu wonyezimira mtundu, ndi fungo zosauma amakhala turbid. Kupeza leukocytes, zasayansi Mzimuyo khalidwe lawo. Ngati ndi bakiteriya, ndiye wodwalayo ali ndi matenda opatsirana, ndiponso ngati si bakiteriya, chifukwa leykotseturii mavuto ndi minofu impso.

3. maselo a epithelium squamous. Mwachibadwa, amuna ndi akazi, kuti mwina alibe kapena accrued mu chitsanzo 1-3. Owonjezera zikusonyeza cystitis, mankhwala kapena dismetabolic nephropathy.

4. tinthu epithelium cylindrical kapena cubical. Mwachibadwa, palibe. Owonjezera limasonyeza matenda yotupa (cystitis, urethritis, etc.).

salt

Komanso bungwe, zikuchokera mayeso mkodzo Mzimuyo osati wa bungwe (zochita kupanga) precipitate. zosiyanasiyana kumanzere kwake salt, chimenenso chimafotokoza sayenera. Pa pH 5, kupatula mchere mwina motere.

1. Urata (chifukwa - zakudya osauka, gout). Iwo amayang'ana ngati wandiweyani precipitate njerwa-pinki.
2. Oxalate (asidi oxalic ndi mankhwala kapena matenda - shuga, pyelonephritis, matenda a m'matumbo, kutupa mu peritoneum a). Michere imeneyi si utoto, amaoneka ngati octagons.
3. asidi Uric. index Izi imatengedwa zachilendo kwa makhalidwe a ku 3 mpaka 9 mmol / l. Owonjezera kulankhula za kulephera impso ndi mavuto ndi kapepala kakuti m'mimba. Angagwiritsidwenso kuposa mwapanikizika. The makhiristo asidi uric, zosiyanasiyana. Mu kusodza, iwo kukhala ndi mtundu wa mchenga golide.
4. Sulphate ya laimu. Kawirikawiri woyera precipitate.

Pa pH pamwamba 7 salt amenewa:

• phosphates (chifukwa kukhala mankhwala okhala kwambiri a calcium, phosphorous, vitamini D, kapena matenda - cystitis, hyperparathyroidism, malungo, kusanza, Fanconi syndrome); Michere imeneyi precipitate mu mkodzo woyera;
• tripelfosfaty (zifukwa mofanana mu phosphates ndi);
• ammonium urate.

Pamaso pa wambirimbiri salt kumabweretsa mapangidwe miyala impso.

zonenepa

Kusintha zikuchokera mkodzo ndi zinakhudza ndi matenda kugwirizana ndi impsozo. Ndiye, zitsanzo anasonkhana ali anaona maselo cylindrical. Iwo ndi mapuloteni uŵende ku aimpso tubular zaminyewa maselo, maselo a mwazi ndi ena. zodabwitsazi amatchedwa tselindruriey. Kusiyanitsa ndi zonenepa zotsatirazi.

1. Hyaline (curdled zedi kapena Tamm-Horsfall mucoproteins). Bwinobwino 1-2 pa chitsanzo. The muyeso ndi pa fiznagruzki lalikulu, zinthu thupi, matenda nephrotic, vuto la impso.
2. Granular (ogwirizana makoma akusokoneza maselo a tubules aimpso). Chifukwa - kuwonongeka choopsa cha nyumba ya impso.
3. Sera (uŵende mapuloteni). Kupezeka mu syndrome nephrotic, ndi chiwonongeko cha epithelium mu tubule lapansi.
4. Zaminyewa. anafikapo ku mkodzo limasonyeza kusintha pathological mu tubules impso.
5. Erythrocyte (maselo ofiira ndi, tigwiritsitse hyaline zonenepa). Umaoneka hematuria.
6. Leukocyte (ndi laminated kapena wakhungu maselo oyera). Iwo amapezeka molumikizana ndi mafinya ndi Ulimbo mapuloteni.

shuga

Mipweya ya mkodzo ndi kusonyeza pamaso pa shuga (shuga). Mwachibadwa, si. Kwa deta yolondola anafufuza DSA milandu, popeza deurinatsii chachiwiri (pokodza). Kudziwika kwa shuga 2.8-3 mmol / tsiku. Izo si matenda. owonjezera The bwino zimayamba ndi:

• shuga;
• matenda endocrinological chikhalidwe;
• mavuto ndi kapamba ndi chiwindi;
• matenda aimpso.

Mimba, mlingo wa shuga mu mkodzo pang'ono apamwamba ndi wofanana 6 mg / tsiku. Pa kudziwika shuga Chosiira mu mkodzo ndi magazi chiyeso shuga.

Bilirubin ndi urobilinogen

The zikuchokera yachibadwa mkodzo bilirubin sikuphatikizidwa. Kapena kani, zilibe kupeza chifukwa cha ndalama zochepa. Kupezeka kwa umboni wa matenda:

• chiwindi;
• matenda a chikasu ndiyo;
• matenda enaake;
• mavuto ndi chikhodzodzo ndulu.

Mkodzo bilirubin ali ndi mtundu kwambiri, kuyambira mdima zachikasu zofiirira, ndi kugwedeza ankasinthana chikasu thovu.

Urobilinogen, amene ndilochokera wa bilirubin conjugated, zopezeka mu mkodzo monga urobilin (chikasu pigment). Ponseponse mu mkodzo wa amuna 0,3-2,1 mayunitsi. Ehrlich ndi akazi 0.1 - 1.1 mayunitsi. Ehrlich (Ehrlich mayunitsi -. 1 mg urobilinogen 1 desilita iliyonse mkodzo nyemba). kuchuluka ndi pansipa yachibadwa chizindikiro cha matenda a chikasu ndiyo kapena mankhwalawo chifukwa cha mankhwala ena. Choposa mfundo amasonyeza vuto la chiwindi kapena hemolytic magazi m'thupi.