Umchamo: ukwakheka kunye neempawu

Iimveliso inkunkuma somzimba yokuchama. nokubunjwa kwayo, kwakunye nenani iipropati emzimbeni amachiza, nkqu abantu sisempilweni iyahlozinga kwaye baxhomekeke nezizathu kwezinye ezininzi ingeyongozi kwaye musa esingenakubangela naliphi na izifo. Kodwa kukho inani izikhombisi, echazwa elabhoratri ngexesha iimvavanyo ezibonisa iintlobo zezifo. Ingqikelelo ukuba umzimba ilungile, ungenza wena kudingeka nje ukuba ukutsalela ingqalelo ezinye iimpawu womchamo.

Njengoba kuvela umchamo

Ukwenziwa kunye nokwakhiwa umchamo lomntu sempilweni kuxhomekeka ubukhulu becala izintso nemithwalo (luvo, okunesondlo, emzimbeni kunye nezinye), yona efumana umzimba. Yonke imihla, i-kidney igqithiselwa kwi wagabadela iilitha 1500 igazi. Apho kangaka, ngenxa yokuba umntu avareji yawo 5 iilitha kuphela? Isibakala sokuba eli izihlunu elulwelo okanye incindi yomzimba (kunjalo, kakhulu, ubizwa ngokuba igazi) usuku uwele izintso malunga 300 amaxesha.

Nge sicatshulwa ngalinye ngokusebenzisa emithanjeni iiseli sezintso lwenzeka yento ukusuka yinkangala umzimba engafunwayo, kunye nezinye iiprothini. Njani na? Le emithanjeni ngasentla kufuneka neendonga mncane kakhulu. iiseli zabo abamelwe zisebenze uhlobo filter ophilileyo. Bona kugcina amasuntswana ezinkulu namanzi Busisiwe, iityuwa ezithile, ii-asidi acid osalayo capsule okhethekileyo. Olu lwelo kuthiwa umchamo zaseprayimari. Igazi ungena tubules sezintso apho avela njengezingxobo eziliqela abuyele iziyobisi yahluzwa; kwaye output eseleyo ngokusebenzisa ureters kunye urethra ngaphandle. Kuyinto eqhelekileyo kuthi sonke umchamo aphakamileyo. Ukwakhiwa (physico-iikhemikhali kunye yebhayoloji ngokunjalo pH) imiselwa elebhu, kodwa ezinye ulwandlalo lokuqala lungenziwa ekhaya. Ukuze wenze oku, sihlolisise ngenyameko ezinye iimpawu womchamo.

Iimpawu belinani

Of udlula isiqingatha neelitha eliwaka kidney ususe igazi malunga 180. Xa kwakhona ukuhluza, esi sixa lancitshiswa iilitha 1.5-2, nto leyo sisalathisi amalungiselelo imali leyo ukuba ngenye imini umntu esempilweni kufuneka zabelwe uchama. Yenziwe ngoobani kunye imali ingahluka, kuxhomekeke:

• ixesha lonyaka kunye yemozulu (ehlotyeni nobushushu kwesantya asezantsi);
• fiznagruzok;
• ubudala;
• imali iiyure ulwelo enxilile (avareji volume umchamo yi-80% yamanzi engena umzimba);
• ezinye iimveliso.

Ukwahluka nezithethe zobulunga nobuninzi naliphi icala kungaba uphawu kwezi zifo zilandelayo:

• polyuria (iilitha ezingaphezu kwama-2 umchamo ngosuku) kube ngumqondiso ukuphazamiseka-luvo, isifo seswekile, nokudumba, exudate, ngamanye ukwahlukana engamanzi amalungu;
• oliguria (umchamo 0.5 l okanye ngaphantsi) kusentliziyweni yaye ukusilela kwezintso kunye nezinye izifo kwezintso, ukuqunjelwa, nephrosclerosis;
• anuria (0.2 l okanye ngaphantsi) - nephritis induna, meningitis, ukusilela etsolo kwezintso, nangezilonda, urolithiasis, ziba kwi womchamo.

Ngaloo echama inokuba kunqabile kakhulu, okanye, icala, rhoqo, ukwanda esibuhlungu nasebusuku. Kuzo zonke ezi ukuphambuka kufuneka ubone ugqirha.

umbala

Ukubunjwa umchamo bomntu kunxulumene ngqo umbala wayo. Last ukuchaza izinto ezithile uphawu zombala inyongo secreted. Ngaphezu koko, lo (ezininzi) yellower igcwaliswe ngakumbi umchamo. Kucingwa umbala eqhelekileyo ukusuka enomququ tyheli. Okunye ukutya (beetroot, iminqathe) kunye neziyobisi ( "Amidopyrine", "aspirin", "furadonin" kunye nabanye) ukutshintsha umbala umchamo pink okanye orenji, naye kuyinto eqhelekileyo. Lo mzobo ukuvavanya umbala umchamo.

Sifo langoku emiselwe utshintsho lombala ilandelayo:

• ebomvu, maxa wambi ngohlobo ngekofu inyama (glomerulonephritis, porphyria, crisis hemolytic);
• mnyama umchamo iqokelelwe emoyeni ukuya abamnyama (homogentisuria);
• limnyama (hepatitis, senyongo);
• ezingwevu-mhlophe (Piura, okt phambi ubofu);
• zana, esiluhlaza (ukubola ethunjini).

iphunga

On sisincoko elungisiweyo umchamo oluntu kwaye abonise olu khetho. Ngaloo ndlela, ubukho nezifo kuthathwa ukuba scents zilandelayo kulawula:

• acetone (ketonuria uphawu);
• ilindle (Escherichia usuleleko coli);
• ammonia (mean Ngokuzimela);
• libe libi zingambi kakhulu (kwisiqwenga ubovu wokuchama uba fistula em-);
• ikhaphetshu, galo (ubukho malabsorption methionine);
• xhopho (acidemia isovaleric okanye glutaric acid);
• ukubola fish (disease Trimethylaminuria);
• "Mouse" (phenylketonuria).

Ngokuqhelekileyo, umchamo abe ivumba elitsarhayo kwaye ngaphaya. Kwakhona, ungakwazi kuvavanywa indlu umchamo okanye amagwebu. Ukulungiselela le njongo kufuneka ukuba baqokelele kwisingxobo, kwaye Shake. Imbonakalo luninzi, kudala yokulungisa amagwebu ibonisa ubukho iiprothini kuyo. Ngaphezu koko, eneenkcukacha ngakumbi, uhlalutyo kufuneka kuqhutywa ziingcali.

Turbidity, ukuxinana, iasidi

Elabhoratri, umchamo lo kuvavanywa umbala kunye nevumba. Kwakhona utsalela ingqalelo elubala yayo. Ukuba isigulane umchamo turbid, ukwakhiwa ingaquka iibhaktheriya, iityuwa, yencindi, amafutha, cellular iziqalelo erythrocytes.

yabantu umchamo mninzi kufuneka kuluhlu 1010-1024 g / ilitha. Ukuba ngaphezulu, ibonisa emzimbeni, ukuba ephantsi - ukusilela oyingozi kwezintso.

Asidi (pH) kufuneka sibe iindidi ukususela-5 ukuya ku-7 Eli nani kunokwahluka ngokuxhomekeka umntu bafumana ukutya kunye namayeza. Ukuba ezi zinto ababandakanywa, ngezantsi pH 5 (umchamo asidi) inokuba sikombisa ketoacidosis, hypokalemia, urhudo, lactic nomonde acidosis. Xa pH ngaphezulu 7 kuba umnikelo wokudla pyelonephritis nomonde, Ngokuzimela, hyperkalemia, ukusilela ezondeleyo kwezintso, lengqula hyperfunction kunye nezinye izifo.

Albuminuria

Eyona into izezona kunganqwenelekiyo ukuba zenzeke eziphembelela isakhiwo neempawu umchamo, i ziiprotein. Ngokuqhelekileyo oku kufuneka kube omdala 0.033 g / ilitha, ngamanye 33 mg ilitha nganye. Kwiintsana eli nani ibe malunga ne30-50 mg / l. Xa abafazi abakhulelweyo, iiprothini umchamo phantse lonke lithetha ezinye iingxaki. Kwaye into ngaphambili ekwakucingwa ukuba ubukho eli candelo ku ezahlukene ukususela 30 ukuya 300 mg microalbuminuria kuthetha, kwaye ngaphezu 300 mg - macroalbuminuria (isifo sezintso). Ngoku ukufumanisa ubukho iiprothini umchamo ngemihla, kungekhona iyunithi, kunye nemali yayo mg 300 lokukhulelwa akujongwa ngezifo.

Iiprothini ungakwazi umchamo okwexeshana (ngexesha elinye-) ukwandisa ngenxa yezi zizathu zilandelayo:

• postural (umzimba isikhundla space);
• fiznagruzki;
• febrile (umkhuhlane kunye nezinye lemikhuhlane);
• ngenxa yezizathu ayicacanga kubantu abasempilweni.

Protein ngu zePCR iyaphindwa umchamo kuthiwa proteinuria. It is:

• (. Iproteni-150 ukuya 500 mg / d) enomoya - na iimpawu evela nephritis, uropathy obstructive, poststreptococcal glomerulonephritis etsolo kwaye ezingapheliyo, tubulopathy;
• (. 500 ukuya 2000 mg / ngomhla iiprothini nomchamo) eliphakathi - na iimpawu poststreptokokovogo of glomerulonephritis ahlekise; nephritis sofuzo kwaye glomerulonephritis ezingapheliyo;
• libizwa (ngaphezu kwama 2,000 mg / imini. iiprothini umchamo), ebonisa ukuba ogulayo amyloidosis, nephrotic syndrome.

Erythrocytes kunye leukocytes

Ukubunjwa eziziisekondari singaquka umchamo-ebizwa kucwangciswa (organic) kwenze. Oku kuquka ubukho erythrocytes, leukocytes, amasuntswana eflethini, zezindlu okanye cubic cell epithelium. Kuba ngamnye kubo imithetho yayo.

1. egazi oluBomvu. Ngokuqhelekileyo, bengengabo ngamadoda namabhinqa equlethwe kwisampulu 1-3. A excess encinane kuthiwa haematuria esasinokubonwa ezibalulekileyo - hematuria gross. Kuyinto uphawu:

• isifo sezintso;
• Pathology lwesinye;
• Blood kukhululeka kwinkqubo enzala.

2. egazi White. Ummiselo for abafazi - 10 namadoda - ku-7 kwisampulu. Le mali agqithise wabhekisela leykotseturiey. Njalo ubonisa indlela inkqubo yangoku ukudumba (a isifo ngumbutho). Ke ukuba leukocytes kwisampulu 60, kunye nomchamo engaphezulu umbala otyheli oluhlaza, yaye ivumba elinukayo uba turbid. Ukufumana leukocytes, ilabhoratri umisela isimilo babo. Ukuba ngokudluliselwa kwentsholongwane, isigulane ke ngoko abe sisifo esosulelayo, ukuba virus, isizathu leykotseturii ukuba iingxaki ijwabu sezintso.

3. kwiiseli ze epithelium carcinomas. Ngokuqhelekileyo, amadoda kunye nabafazi, ukuba mhlawumbi abanayo okanye eliqokelelweyo kwisampulu 1-3. Uchatha lubonisa Ngokuzimela, iziyobisi okanye nephropathy dismetabolic.

4. Amasuntswana epithelium zezindlu okanye lwezindlu. Ngokuqhelekileyo, akukho. Uchatha ibonisa izifo ukudumba (Ngokuzimela, urethritis, njalo njalo).

iityuwa

yaququzelelwa, ukwakhiwa kovavanyo umchamo imisela abadibenanga (ezingaphiliyo) kwenze. iityuwa bakhe ngasekhohlo ezahlukeneyo, akufuneki leyo ngokwesiqhelo. Xa pH 5, ngaphantsi ityuwa inokuba ngolu hlobo.

1. Urata (unobangela - ukungatyi ukutya okunesondlo, sifo). Zibonakala ngathi isitena-epinki kwenze ashinyeneyo.
2. Oxalate (oxalic acid kunye iimveliso okanye izifo - isifo seswekile, pyelonephritis, ukudumba, nangokurhala kwi peritoneum). Ezi iityuwa angadyojwa, bakhangeleka ngathi octagons.
3. Uric acid. Esi salathisi ithathwa eqhelekileyo amaxabiso ukususela-3 ukuya ku-9 mmol / l. libange kwemfuneko malunga ukungaphumeleli kunye neengxaki iphecana zesisu kidney. Kananjalo kufuneka kugqithiswe phantsi koxinzelelo. Le ziikristale of uric acid, iintlobo ngeentlobo. Xa idrafti, zinaso umbala zentlabathi segolide.
4. Ammonium sulphate kwi lime. kwenze emhlophe Ayifane.

Xa pH ngaphezu 7 ezinjalo iityuwa:

• phosphate (unobangela babe iimveliso equlethe okuninzi calcium, phosphorus, ivithamin D, okanye izifo - Ngokuzimela, hyperparathyroidism, ifiva, ukugabha, Fanconi syndrome); Ezi iityuwa kwenze Umchamo ezimhlophe;
• tripelfosfaty (yezizathu efanayo phosphate);
• ammonium urate.

Ubukho isixa esikhulu neetyuwa ekhokelela kuseko ngamatye zezintso.

cylinder

Utshintsho kwi nokwakhiwa umchamo iphenjelelwa kakhulu izifo ezinxulumene kunye nezintso. Emva koko, lo sampuli eziqokelelweyo waphawula iiseli zezindlu. Zakha iproteni ngobubende ukusuka sezintso iiseli tubular epithelial, iiseli zegazi kunye nabanye. Le nto ibizwa ngokuba tselindruriey. Ukwahlula iziqulathi zilandelayo.

1. Hyaline (curdled iimolekyuli iiproteins okanye mucoproteins wachaza oku-Horsfall). Ngesiqhelo 1-2 isampula nganye. Asele e fiznagruzki enkulu, iimeko bomkhuhlane, nephrotic syndrome, iingxaki zezintso.
2. Granular (wanamathela kunye neendonga baphazamise iiseli tubules sezintso). Isizathu - umonakalo omkhulu izakhiwo zezintso.
3. Wax (protein bububende). Vela ku syndrome nephrotic, kwaye ukutshatyalaliswa epithelium kwi tubule.
4. Epithelial. ubukho babo kule umchamo ibonisa utshintsho zophendlo lwezifo kwi tubules zezintso.
5. Erythrocyte (iiseli ezibomvu igazi, ebambelela iisilinda hyaline). Uyavela xa hematuria.
6. Leukocyte (kokuba ngaplastiki okanye iiseli oyimfama amhlophe). Bona afunyanwa rhoqo kwi kunye ububomvu kunye ziiprotein fibrin.

sugar

Le khemikhali Ukwakhiwa umchamo kwaye zibonisa ubukho yeswekile (glucose). Ngokuqhelekileyo, akukho. Kuba idatha elungile ndimncinile DSA iintlawulo kuphela, ekubeni deurinatsii yesibini (ukuchama). Efumanise neswekile 2.8-3 mmol / namhla. Oku akuthathwa sisifo. Le excess ezinokubangelwa:

• diabetes;
• izifo endocrinological nemvelo;
• iingxaki nepancreas wesibindi;
• izifo sezintso.

Xa ukhulelwe, izinga eswekile umchamo eliphezulu kancinci kwaye ilingana no-6 mg / ngosuku. Xa efumanise glucose efunekayo elincinane umchamo negazi uvavanyo ukuze iswekile.

Yibilirubin and urobilinogen

Ukubunjwa umchamo yibilirubin oluqhelekileyo azifakwanga. Okanye kunoko, akunamsebenzi ukufumana ngenxa mali omncinane. Ukufunyanwa kobungqina kwezifo ezifana:

• hepatitis;
• senyongo;
• ukuqina;
• iingxaki lwesinye nenyongo.

Umchamo yibilirubin ine mbala, ukusuka mnyama mthubi esintsundu, kwaye ungcangcazelise amathuba amagwebu elityheli.

Urobilinogen, nto leyo yemvelaphi a yibilirubin conjugated, uhlala kwi umchamo njengoko urobilin (ngombala otyheli). Ummiselo kwi umchamo babantu iiyunithi 0,3-2,1. Ehrlich nabafazi 0.1 - iiyunithi 1.1. Ehrlich (neeyunithi Ehrlich -. 1 mg urobilinogen yi-1 deciliter uchama isampuli). Isixa ungaphantsi eziqhelekileyo luphawu senyongo okanye imiphumela okubangelwa amayeza athile. imigangatho egqithayo kubonisa ingxaki esibindini okanye anemia hemolytic.