Umchamo: ukwakheka kanye izakhiwo

Imikhiqizo imfucuza somzimba umchamo. Ukwakheka kwalo, kanye nenani izindawo ngokomzimba futhi amakhemikhali, ngisho abantu okunempilo engazinzile futhi ancike izizathu eziningi engalimazi ukuthi akuzona eziyingozi futhi akavumi ukuba noma yimuphi izifo. Kodwa zikhona eziningi izinkomba, kuchazwe elabhorethri luvivinywa ezibonisa ezihlukahlukene nezifo. Ngoba kucatshangwa ukuthi umzimba akukhona konke kulungile, ungenza wena badinga kuphela ukuze badonsele ukunaka ezinye izici umchamo wabo.

Njengoba kuvela umchamo

Ukwakheka kanye nokwakheka umchamo umuntu enempilo kuncike ngokuyinhloko izinso okuseqophelweni (kwenzwa ukudla, ngokomzimba kanye nezinye), okuyinto uthola emzimbeni. Nsuku zonke, izinso is badabula efake 1500 amalitha igazi. Lapho kangaka, ngoba umuntu e isilinganiso yayo 5 amalitha kuphela? Iqiniso lokuthi leli izicubu liquid noma uketshezi lomzimba (ngakho-ke, ubizwa ngokuthi igazi) ngoba usuku idlule izinso mayelana 300 izikhathi.

Nge Engxenyeni ngayinye ngokusebenzisa capillary lamaseli kwezinso kwenzeka ke zihlanjululwa kusukela engadingeki umzimba, izibulala nezinye amaprotheni. Kwenzeka kanjani? Capillary ngenhla kufanele izindonga mncane kakhulu. amaseli wabo abamelwe isebenze njengendlela uhlobo ophilayo zokuhlunga. Bona ukugcina izinhlayiya ezinkulu namanzi sidlulile, ezinhlotsheni ezithile zikasawoti, amino acid seep ku capsule ekhethekile. Lolu ketshezi ubizwa ngokuthi umchamo eyinhloko. Igazi engena tubules kwezinso lapho kusuka amaphilisi amaningana ukubuyela ketshezi licwengwe okukhiphayo asele ngokusebenzisa ureters futhi urethra kwangaphandle. Kuyinto ejwayelekile kithi sonke umchamo yesibili. Ukwakheka (physico-zamakhemikhali nezinto eziphilayo kanye pH) inqunywa endaweni yokucwaninga, kodwa ezinye uhlaka kwangaphambilini kungenziwa ekhaya. Ukuze wenze lokhu, bahlolisise ezinye izici umchamo wabo.

izinkomba bobukhulu

Of sidlula ayinkulungwane amalitha kwesigamu izinso igazi ususe mayelana 180. Lapho kabusha filtration, leli nani liye ku 1.5-2 amalitha, okuyinto kube inkomba yokuthi amalungiselelo e mali usuku olulodwa umuntu enempilo kufanele zabelwe umchamo. Ukwakheka kanye nenani ingahluka, kuye ngokuthi:

• isikhathi sonyaka kanye sezulu (ehlobo futhi ukushisa kwezinga eliphansi);
• fiznagruzok;
• mbuzeni
• inani amahora ketshezi odakiwe (isilinganiso ivolumu umchamo uba 80% ketshezi engena emzimbeni);
• eminye imikhiqizo.

Ukuphambuka yamazinga belinani noma isiqondiso kungaba uphawu lezi zifo ezilandelayo:

• polyuria (angaphezu kuka-2 amalitha umchamo ngelanga) kungaba uphawu okungabangela inkinga yezinzwa, isifo sikashukela, edema, exudate, isb ngokwahlukana ketshezi izitho;
• oliguria (umchamo 0.5 l noma ngaphansi) okusenhliziyweni futhi ukwehluleka kwezinso nezinye izifo kwezinso, dyspepsia, nephrosclerosis;
• anuria (0.2 l noma ngaphansi) - nephritis uphawu, meningitis, ukwehluleka oyingozi so-renal, izimila, urolithiasis, zibe ngomgudu womchamo.

Ngakho ukuchama kungenzeka ezingavamile kakhulu noma, Ngakolunye uhlangothi, njalo, ukwanda ubuhlungu nasebusuku. Nge zonke lezi ngeziphambeko kudingeka ukuba aye kudokotela.

umbala

Ukwakheka umchamo womuntu kuhlobene umbala waso. Kugcine ukuchaza izinto ezithile urochrome ethakwa Bile zombala. Ngaphezu kwalokho, i-(ukuminyana ngaphezulu) yellower nokuningi ayegcwele umchamo. Kuthathwa umbala evamile kusukela utshani ukuze ophuzi. Okunye ukudla (beet, izaqathe) nezidakamizwa ( "Amidopyrine", "ukuphuza ama-aspirin", "furadonin" kanye nabanye) ukushintsha umbala umchamo uba pink noma orange, okuyilona elisebenzayo futhi bengahloniphani. Isibalo ukuhlola umbala umchamo.

Izifo likhona kunqunywa izinguquko umbala ezilandelayo:

• obomvu, ngezinye izikhathi ngendlela inyama slops (glomerulonephritis, porphyria, crisis hemolytic);
• ukuhwalala we umchamo eqoqwe emoyeni kuze kube abamnyama (homogentisuria);
• konsundu (i-hepatitis, i-jaundice);
• empungana (Piura, okusho khona ubomvu);
• ogqamile, bluish (elibi emathunjini).

iphunga

On laqanjwa sokulungisa umchamo womuntu futhi kungase kubonise le ndlela. Ngakho, khona izifo kungenziwa bazitshela uma ngephunga elandelayo linqobe:

• acetone (ketonuria uphawu);
• indle (Escherichia coli ukutheleleka);
• ammonia (Kusho cystitis);
• nephunga elibi kubuhlungu ngempela (in the pheshana urinary ubovu has a fistula kule ingaphakathi);
• iklabishi, Uphinde agibele (khona malabsorption methionine);
• umjuluko (acidemia isovaleric noma glutaric acid);
• ukubola izinhlanzi (Trimethylaminuria isifo);
• "Igundane" (phenylketonuria).

Ngokuvamile, umchamo has a nephunga okunoshukela futhi kuba sobala. Futhi, indlu kungenziwa bahlola umchamo noma Foam. Ngenxa yale njongo kubalulekile ukuqoqa esitsheni, futhi Shake. Ukubukeka obuningi, igwebu eside sokuxazulula kubonisa khona amaprotheni kuwo. Ngaphezu kwalokho, eningiliziwe, ukuhlaziywa okufanele iqhutshwe ongoti.

Turbidity, ukuminyana, asidi

Ngo-laboratory, umchamo uphenywa ngoba umbala nephunga. Futhi kuqhakambisa ngale. Uma isiguli umchamo turbid, ukwakheka ingase ihlanganise bacterium, nosawoti, isikhwehlela, amafutha, izakhi yeselula erythrocyte.

womuntu umchamo ukuminyana kufanele sibe ububanzi 1010-1024 g / ilitha. Uma kuwukuthi ephakeme, kubonisa amanzi emzimbeni, uma ephansi - ukwehluleka oyingozi kwezinso.

Asidi (pH) kufanele ibe uhla kusuka 5 kuya ku-7 Lesi sibalo ziyahlukahluka kuye umuntu ayethola ukudla nemithi. Uma lezi zici bayakhishwa, ngezansi pH 5 (umchamo esidi) kungase kubonise isiguli ketoacidosis, hypokalemia, uhudo, lactic acidosis. Ngezinye pH ngenhla 7 zingase a pyelonephritis nesineke, cystitis, hyperkalemia, ezingamahlalakhona ukwehluleka kwezinso, yegilo hyperfunction namanye izifo.

Albuminuria

Ingqikithi engathandeki kakhulu ezinomthelela isakhiwo nezakhiwo emchamweni, kuyinto amaprotheni. Ngokuvamile-ke kumelwe abe umuntu omdala 0.033 g / ilitha, isb 33 mg ilitha. Ngo izinsana lesi sibalo kungenzeka 30-50 mg / l. Kwabesifazane abakhulelwe, amaprotheni ku umchamo cishe njalo kusho yezinkinga ezithile. Kwakuthinta kwakucatshangwa ukuthi khona kwale ingxenye uhla kusuka 30 kuya 300 mg microalbuminuria izindlela, futhi ngaphezu 300 mg - macroalbuminuria (isifo sezinso). Manje ukucacisa khona amaprotheni ku umchamo nsuku zonke, hhayi ngokuziqhathanisa iyunithi, kanye lemali yayo ukuze mg 300 ekukhulelweni akubhekwa egunjini lokuhlolwa kwezifo.

Amaprotheni umchamo kungaba okwesikhashana (yesikhathi esisodwa) ukwandisa ngenxa yezizathu ezilandelayo:

• postural (umzimba isikhundla emkhathini);
• fiznagruzki;
• febrile (imfiva kanye nezinye ukushisa komzimba);
• ngenxa yezizathu okungacaci kubantu enempilo.

Amaphrotheni umchamo by assays okuphindaphindiwe libizwa proteinuria. Kuyinto:

• (. Iprotheni 150 500 mg / d) omnene - kuyinto izimpawu ezivela nephritis, uropathy obstructive, poststreptococcal glomerulonephritis oyingozi futhi ezingalapheki, tubulopathy;
• (. 500 2000 mg / usuku amaprotheni ku umchamo) ngokulinganisela - kuyinto izimpawu poststreptokokovogo ka glomerulonephritis acute; nephritis zenani elikhulu eziyifa kanye glomerulonephritis ezingamahlalakhona;
• liphinyiselwe (kuka 2,000 mg / usuku. amaprotheni ku umchamo), okubonisa ukuthi isiguli amyloidosis, nephrotic syndrome.

Erythrocyte futhi leukocyte

Ukwakheka yesibili kungafaka umchamo okuthiwa ihlelwe (organic) kwenze. Lihlanganisa khona erythrocyte, leukocyte, izinhlayiya of flat, cylindrical noma cubic iseli epithelium. Ukuze ngamunye wabo imithetho yayo siqu.

1. igazi Amangqamuzana abomvu. Ngokuvamile, awayona amadoda nabesifazane eziqukethwe isampula 1-3. A ngokweqile encane libizwa haematuria ezincane futhi okuphawulekayo - hematuria okwedlulele. Kuyinto uphawu:

• isifo sezinso;
• Pathology kwesinye;
• Igazi osenyameni uhlelo urogenital.

2. igazi Amangqamuzana amhlophe. Sivamile abesifazane - Amadoda 10 --7 isampuli. Inani ngokweqile okukhulunywe leykotseturiey. It njalo ukhomba inqubo yamanje ukuvuvukala (isifo esihlasela uhlaka). Futhi uma leukocyte e isampuli 60, futhi umchamo ngaphezulu kuba nombala ophuzi, yezwa nephunga Putrid iba turbid. Ukuthola ama-leukocyte, laboratory inquma uhlamvu yabo. Uma kuwukuthi webhaktheriya ke isiguli onesifo esithathelwanayo, futhi uma virus, isizathu leykotseturii ngokuba nezinkinga izicubu izinso.

3. amaseli epithelium squamous. Ngokuvamile, abesilisa nabesifazane, ukuthi noma ungenayo noma enqwabelene e isampuli 1-3. Okweqile kusikisela cystitis, izidakamizwa noma nephropathy dismetabolic.

4. izinhlayiyana epithelium cylindrical noma cubical. Ngokuvamile, akukho. Okweqile kubonisa Izifo ukuvuvukala (cystitis, urethritis, njll).

nosawoti

ihlelwe Ngaphezu kwalokho, indlela yokwakheka test umchamo inquma angahlelekile (wezinto) kwenze. nosawoti wakhe washiya ezihlukahlukene, ngokuvamile akufanele kube. Ngezinye pH 5, usawoti kancane kungenzeka kanje.

1. Urata (imbangela - ukudla okungenamsoco, sifo). Babukeka njengezihlahla a obukhulu kwenze isitini-pink.
2. Oxalate (oxalic acid nemikhiqizo noma isifo - sikashukela, pyelonephritis, nesifo, ukuvuvukala kule peritoneum). Lezi nosawoti kungukuthi ngesineke, Babukeka njengezihlahla octagons.
3. Uric acid. Kulolu hlu kubhekwa njengento evamile amagugu kusukela 3 kuya ku- 9 mmol / l. talking okweqile ngokuhluleka nezinkinga pheshana emathunjini izinso. Ingase futhi adlulwe ngaphansi kokucindezeleka. Zinhlayiya ka uric acid, ezihlukahlukene izinhlobo. Esikhathini okusalungiswa, bona ukuthola umbala isihlabathi segolide.
4. Sulphate lime. kwenze Akuvamile emhlophe.

Ngezinye pH ngenhla 7 nosawoti ezifana:

• phosphate (imbangela babe nemikhiqizo equkethe okuningi calcium, phosphorus, uvithamini D, noma isifo - cystitis, hyperparathyroidism, imfiva, ukuhlanza, Fanconi syndrome); Lezi nosawoti kwenze e umchamo ezimhlophe;
• tripelfosfaty (izizathu efanayo phosphate);
• ammonium urate.

Ukuba khona semali nosawoti kuholela ekwakhekeni ezinso.

amasilinda

Ushintsho ukubunjwa nomchamo kakhulu kuthonywa yizifo ezihlobene nokungabikho nezinso. Khona-ke, amasampula eqoqwe kuyagcinwa amaseli cylindrical. Bakha amaprotheni coagulated kusukela kwezinso amaseli ijabulise EPITHELIAL, amangqamuzana egazi kanye nabanye. Lesi senzakalo ngokuthi tselindruriey. Hlukanisa amasilinda elandelayo.

1. Hyaline (curdled amaprotheni molecule noma Tamm-Horsfall mucoproteins). Ngokuvamile 1-2 isampula ngalinye. I ngokweqile isezingeni fiznagruzki ezinkulu, izimo okunomkhuhlane, nephrotic syndrome, izinso izinkinga.
2. Luyimbudumbudu (alahlane izindonga iphazamiseke amaseli tubules kwezinso). Isizathu - umonakalo ezinzima izinso izakhiwo.
3. Wax (amaprotheni coagulated). Vela ku-syndrome nephrotic, futhi lapho kubhujiswa lesi epithelium ku tubule.
4. EPITHELIAL. Ukuba khona kwabo e umchamo kubonisa izinguquko sokugembula kule izinso tubules.
5. Erythrocyte (amangqamuzana abomvu egazi is, ukunamathela hyaline amasilinda). Kubonakala uma hematuria.
6. Leukocyte (it is laminated noma impumputhe amangqamuzana amhlophe egazi). Avame ukutholakala ngokuhlanganyela ubomvu kanye fibrin amaprotheni.

ushukela

Ukwakheka kwamakhemikhali umchamo futhi ubonise ukuthi unoshukela (glucose). Ngokuvamile, akuyona. Ukuze idatha elungile wahlola DSA kuphela amacala, kusukela deurinatsii yesibili (ukuchama). Ukuthola ushukela 2.8-3 / ngosuku mmol. It akubhekwa isifo. I ngokweqile kungadalwa:

• sikashukela;
• izifo endocrinological nemvelo;
• izinkinga nge amanyikwe futhi isibindi;
• izifo kwezinso.

Ngo sokukhulelwa, ngesilinganiso ushukela kule umchamo ethe xaxa futhi ilingana 6 mg / usuku. Phezu ukuthola glucose edingekayo ukuchitha umchamo kanye kwegazi ushukela.

Bilirubin futhi urobilinogen

Ukwakheka evamile bilirubin umchamo Ayibalwa. Noma kunalokho, awusebenzi ukuthola ngenxa amanani okuncane. Ukutholakala ubufakazi izifo ezifana:

• ukusha kwesibindi kohlobo;
• jaundice;
• isifo sokusha;
• izinkinga esinyeni nenyongo.

Umchamo bilirubin ine umbala okukhulu, ezisukela oluphuzi omnyama ukuze ansundu kakhulu, njalo kunyakaze ematfuba Foam aphuzi.

Urobilinogen, okuyinto esuselwe a bilirubin conjugated, ngaso sonke isikhathi umchamo njengoba urobilin (sombala ophuzi). Kuyinsakavukela umchamo zabantu amayunithi 0,3-2,1. Ehrlich nabesifazane 0.1 - 1.1 amayunithi. Ehrlich (Ehrlich amayunithi -. 1 mg urobilinogen 1 deciliter umchamo isampula). Inani lingaphansi evamile uphawu jaundice noma imiphumela engemihle kubangelwa kunemithi noma amaphilisi owaphuzayo. amazinga okwedlulele ibonisa inkinga nge kwesibindi noma unenkinga yegazi eliphansi hemolytic.