Amaseli ayinhloko esibindi, ama-hepatocyte enza inani elikhulu lemisebenzi ebalulekile: ukuhlunga igazi, ukuqedwa kobuthi, ukugcinwa kanye nokuhlanganiswa koshukela, njll.

Iningi lesibindi liqukethe ama-hepatocyte ahlelwe ngezikhathi, phakathi kwawo ajikeleza ama-capillaries egazi kanye namagagasi okushisa e-biliary. Amafektri weqiniso we-biochemical, lawa maseli ngakho-ke angakwazi ukubamba ubuthi obuzungeza egazini futhi aqede le nkunkuma enyameni. Kepha lokhu akuwona umsebenzi wabo kuphela, ngoba futhi bagcina futhi bakhiqize izinto eziningi ezibalulekile emzimbeni: i-glucose, i-triglycerin, i-albumin, i-bile salts, njll.

Ngaphandle kwama-hepatocyte asebenzayo, isikhathi sokuphila komzimba asidluli emahoreni ambalwa. Lawa maseli ngempela ahlinzeka ngemisebenzi eminingi ebalulekile, okuhlanganisa:

• lukuphathwa kukashukela egazini : uma kwenzeka i-hyperglycemia, i-pancreas ikhiqiza i-insulin, ezokwenza kusebenze ukutholwa nokugcinwa kweglucose yegazi ngama-hepatocytes. Ngokuphambene nalokho, uma kwenzeka i-hypoglycemia, ikhipha i-glucagon, ukukhuthaza ama-hepatocyte ukukhulula la mandla egazini;
• ukukhishwa kwegazi emzimbeni : ama-hepatocyte asusa igazi lezinto ezinobuthi (utshwala, izidakamizwa, izidakamizwa, njll.), bese uzikhipha nge-bile; 
• ukukhishwa kwe-bile okuzogcinwa esiswini senyongo, kuzokhishelwa emathunjini ngesikhathi sokugaya. Le nto iqukethe imfucumfucu ekhishwe egazini nase-bile acid, ekwazi ukwephula ama-lipids afakwe ukudla abe yi-triglycerides, elinye “iphethiloli” lomzimba;
• ukwakheka kwe-triglycerides kusuka kushukela notshwala. Lawa ama-fatty acids afanayo njengoba kushiwo ngenhla. Njengazo, ngakho-ke zihanjiswa ngegazi kumaseli azidingayo (imisipha, njll.) noma zigcinwe kuzicubu ze-adipose;
• ukukhiqizwa kwezici zokujiya, okungukuthi amaprotheni abandakanyeka ekunqandeni igazi.

I-steatosis yesibindi

Kuwukuqoqwa kwe-triglycerides kuma-hepatocytes. Lesi sifo singabangelwa ukuphuza kakhulu utshwala kodwa futhi - futhi kuvame ukuvela - kwenzeka ezigulini ezingaphuzi kodwa ezikhuluphele ngokweqile noma ezinesifo sikashukela sohlobo 2. isifo se-non-alcoholic fatty liver (NAFLD).

I-Hepatic steatosis ihlala ingabonakali isikhathi eside ngaphambi kokubangela i-hepatitis. Yile mpendulo yokuvuvukala evame ukuholela ekutholakaleni kwe-pathology.

ukusha kwesibindi kohlobo

Ukuvuvukala kwesibindi, isifo sokusha kwesibindi kohlobo singabangelwa isifo sesibindi esinamafutha, kodwa futhi nayigciwane eliphindaphindeka ku-hepatocytes (i-hepatitis A, B noma C virus), ngokudakwa izidakamizwa, ngokuchayeka emkhiqizo onobuthi noma, okungajwayelekile, isifo se-autoimmune.

Izimpawu ziyahlukahluka kakhulu kuye kwelinye icala: 

• umkhuhlane;
• ukuphelelwa isifiso sokudla .
• isifo sohudo;
• isicasuli;
• ukungakhululeki esiswini;
• i-jaundice;
• njll

Zingaba mnene noma zibe nzima, zihambe zodwa, noma ziphikelele. I-Hepatitis C, isibonelo, iba yisifo esingelapheki kuma-80% ezimweni, kuyilapho i-hepatitis A ingaxazulula ngokuzenzakalelayo. Ukutheleleka nakho kungabonakala, futhi kutholakala kuphela ngemuva kokuba sekuthuthuke kwaba yi-cirrhosis noma umdlavuza.

I-cirrhosis

Uma ukuvuvukala kwabo okungapheli kunganakekelwa, ama-hepatocyte agcina efa ngokulandelana. Isibindi bese siphelelwa imisebenzi yaso kancane kancane.

Ukubonakala kwenkinga eyodwa noma ngaphezulu okuvame ukuholela ekutholakaleni kwe-cirrhosis: ukopha kokugaya ukudla, ama-ascites (ukuvuvukala kwesisu okuhlobene nokunqwabelana koketshezi emgodini we-peritoneal), i-jaundice (i-jaundice yesikhumba nomhlophe weso, umchamo omnyama), umdlavuza, njll.

Umdlavuza wesibindi

I-Hepatocarcinoma, noma i-hepatocellular carcinoma, iqala ku-hepatocyte okuthi, ngemva kokungajwayelekile, iqale ukwanda ngendlela engavamile futhi yakhe isimila esiyingozi. Kuyivelakancane ukuthi lolu hlobo lokulimala lwenzeke esibindini esingenayo i-steatosis, i-hepatitis noma i-cirrhosis.

Ukuncipha kwesisindo esingaqondakali, ukulahlekelwa ukudla, ubuhlungu besisu, isicanucanu nokuhlanza, ukukhathala okuvamile, ukubonakala kwesigaxa endaweni yesibindi, ikakhulukazi uma kuhlotshaniswa ne-jaundice , kufanele ikuxwayise. Kodwa qaphela: lezi zimpawu zivamile kwamanye ama-pathologies esibindi. Udokotela kuphela ongaxilonga.

I-hyperplasia ye-nodular ejwayelekile

I-focal nodular hyperplasia ukwanda kwenani lama-hepatocyte esibindini, okubangela ukuthi lenyuke ngosayizi. Amaqhuqhuva ane-fibrous 1 kuya ku-10 cm angavela. Lezi zimila, ezingavamile futhi eziyingozi, zithandwa ngokuthatha izivimbela-nzalo zomlomo noma imithi yokwelapha esekelwe ku-estrogen. Izinkinga zabo azivamile. Yingakho kungavamile ukuwasusa ngokuhlinzwa.

Ngokulapha ngempumelelo nangokuqina izimbangela zesifo sokusha kwesibindi (ukwelashwa ngama-antiviral, ukuhoxiswa kotshwala, ukudla okwehlisa isisindo, ukulawula isifo sikashukela, njll.), I-cirrhosis ingavinjelwa noma imiswe. Uma izicubu sezicekeleke phansi, ngeke ziphole, kodwa ingxenye esele yesibindi ngeke isabambeka. Uma i-cirrhosis isithuthuke kakhulu, ukufakelwa kuphela okungabuyisela ukusebenza kahle kwesibindi, inqobo nje uma kutholakala igraft.

Uma kwenzeka umdlavuza, iphaneli yokwelapha ibanzi:

• ukususwa kwesibindi ngokwengxenye;
• ukukhishwa okuphelele okulandelwa ukufakelwa kabusha;
• ukubhujiswa kwe-tumor ngama-radiofrequency noma ama-microwaves;
• electroporation;
• ukwelashwa ngamakhemikhali;
• njll 

Isu lokwelapha lincike ezicini eziningana, kuhlanganise nenani lezilonda, ubukhulu bazo, isigaba sabo kanye nesimo sesibindi.

Lapho ubhekene nezimpawu eziphakamisa i-hepatic pathology, ukuhlolwa kwegazi kuqinisekisa ukubandakanyeka kwesibindi (hypoalbuminemia, njll.). Uma kungekho gciwane elitholakala kusampula yegazi, kuzobekwa i-ultrasound, yengezwe uma kunesidingo nge-MRI, i-CT scan noma i-Doppler ultrasound. Ngaphezu kwalokho, i-biopsy ingacelwa.