Koj cov qe ntshav puas tawg sai sai? Cia peb tham txog kev tawg ntawm cov ntshav!

Puas muaj tej lub sij hawm koj tsuas xav tias koj nkees thiab kiv taub hau xwb? Los yog tej lub sij hawm koj xav tias koj daim tawv nqaij daj me ntsis, thiab koj lub qhov muag dawb daj? Qhov no yuav yog vim koj cov qe ntshav liab, yog ib hom qe ntshav tseem ceeb tshaj plaws hauv koj cov ntshav. Hnub no peb yuav tham txog ib qho mob hu ua hemolysis , uas yog thaum cov qe ntshav liab tawg thiab raug rhuav tshem ua ntej lub sij hawm. Tsis txhob txhawj, nws yog ib qho tseem ceeb uas yuav tsum paub txog qhov no.

Qhov tseeb, hemolysis yog dab tsi?

Hais yooj yim xwb, hemolysis yog kev puas tsuaj ntawm cov qe ntshav liab hauv peb lub cev . Koj paub, cov qe ntshav liab no zoo li cov neeg ua haujlwm me me hauv peb cov ntshav. Lawv yog cov uas coj cov pa oxygen los ntawm lub ntsws thaum peb ua pa thiab xa mus rau txhua lub cell thiab cov nqaij hauv lub cev. Nws zoo li coj lub thoob roj los tsev. Yog li, peb lub cev siv cov pa oxygen no los tsim lub zog uas nws xav tau. Tsis tas li ntawd, cov qe ntshav liab no pab nqa cov pa roj carbon dioxide uas tsis xav tau uas tsim nyob rau hauv peb lub cev rov qab mus rau lub ntsws thiab ua pa tawm.

Feem ntau, peb lub cev pheej rhuav tshem cov qe ntshav liab qub lossis tsis muaj zog thiab hloov lawv nrog cov qe ntshav liab tshiab, noj qab nyob zoo. Qhov no zoo li tshem tawm cov qub thiab tau txais cov tshiab. Lub voj voog ntawm kev rhuav tshem thiab tsim tawm no yog vim li cas peb thiaj li muaj cov qe ntshav liab txaus hauv peb lub cev.

Txawm li cas los xij, qee zaum cov qe ntshav liab no pib tawg ua ntej lub sijhawm, uas yog, sai dhau . Qhov no tuaj yeem tshwm sim ua ntej peb lub cev muaj sijhawm los tsim cov qe ntshav tshiab los sau qhov sib txawv. Qhov kev puas tsuaj sai ntawm cov qe ntshav liab no hu ua hemolysis. Yog tias tus lej ntawm cov qe ntshav liab hauv lub cev txo qis vim yog qhov hemolysis no, peb hu qhov mob ntawd tias hemolytic anemia , lossis anemia.

Vim li cas cov qe ntshav liab thiaj raug rhuav tshem li no?

Feem ntau cov qe ntshav liab muaj sia nyob li ntawm 120 hnub. Thaum kawg ntawm lub sijhawm no, thaum cov qe ntshav ntawd laus zuj zus, lawv tso tawm cov cim tshwj xeeb. Cov cim no ua rau lub qhov ntswg (nyob rau sab laug ntawm lub plab) hauv peb lub cev rhuav tshem cov qe ntshav qub no raws li kev txiav txim. Ib yam li peb tshem tawm cov rooj tog qub thiab tawg hauv peb lub tsev.

Cov qe ntshav liab tshiab raug tsim tawm hauv ib feem ntawm peb cov pob txha hu ua pob txha pob txha . Cov qe ntshav liab tshiab uas tsim tawm hauv cov pob txha pob txha no ces raug tso tawm mus rau hauv cov ntshav.

Txawm li cas los xij, qee zaum qhov tsis zoo ntawm cov duab lossis cov khoom sib xyaw ntawm cov qe ntshav liab tuaj yeem ua rau nws lub neej luv dua. Los yog, cov qe ntshav liab tuaj yeem raug puas tsuaj los ntawm cov yam sab nraud thiab tuag ua ntej lub cev tuaj yeem tsim cov qe ntshav tshiab.

Cov hom hemolysis tseem ceeb yog dab tsi?

Kev tawg ntshav muaj ob hom loj. Cov npe no hais txog qhov chaw uas cov qe ntshav liab raug rhuav tshem.

1. Kev tawg ntshav sab nraud ntawm cov hlab ntsha: Qhov no yog thaum cov qe ntshav liab raug rhuav tshem sab nraud ntawm peb cov hlab ntsha (piv txwv li, cov leeg ntshav, cov hlab ntsha, thiab cov hlab ntsha me). Feem ntau, qhov no tshwm sim hauv lub qhov ntswg . Thaum cov ntshav hla lub qhov ntswg, ib hom qe ntshav dawb tshwj xeeb hu ua macrophages (cov no zoo li peb lub cev cov neeg saib xyuas kev ruaj ntseg) paub txog cov qe ntshav liab qub, puas tsuaj thiab rhuav tshem lawv.

2. Kev tawg ntshav hauv cov hlab ntsha: Hauv qhov no, cov qe ntshav liab raug rhuav tshem hauv cov hlab ntsha. Thaum lawv raug rhuav tshem, cov qe ntshav ntawd mus thoob plaws lub cev nrog peb cov ntshav.

Dab tsi yog cov ua rau cov ntshav tsis khov?

Tsis yog muaj ib qho ua rau cov ntshav tsis khov xwb, tiam sis muaj ntau yam ua rau muaj qhov no. Cia peb saib ntxiv me ntsis.

1. Cov teeb meem hauv cov qe ntshav liab lawv tus kheej

Qee zaum, yog tias muaj qhov tsis zoo lossis qhov tsis zoo ntawm cov duab lossis cov qauv ntawm cov qe ntshav liab, cov qe ntshav ntawd tuaj yeem raug rhuav tshem sai. Cov kev tsis zoo no feem ntau yog tshwm sim los ntawm qee yam kab mob uas yug los, lossis los ntawm noob caj noob ces .

• Kev tsis ruaj khov ntawm cov ntshav liab (hemoglobin): Cov ntshav liab yog ib hom protein uas pab nqa cov pa oxygen mus rau hauv cov qe ntshav liab. Cov mob uas ua rau muaj qhov tsis ruaj khov no suav nrog cov ntshav liab tsis muaj zog (qhov twg cov qe ntshav liab zoo li cov ntshav liab) thiab thalassemia .
• Tsis Muaj Enzyme Txaus: Qhov mob no kuj tseem tuaj yeem tshwm sim thaum qee cov enzymes uas xav tau rau kev ua haujlwm ntawm cov qe ntshav liab tsis txaus. Piv txwv li suav nrog G6PD tsis txaus thiab pyruvate kinase tsis txaus .
• Qhov tsis zoo ntawm daim nyias nyias: Cov mob uas muaj qhov tsis zoo ntawm sab nraud ntawm cov qe ntshav liab, daim nyias nyias ntawm lub qe. Piv txwv li suav nrog hereditary spherocytosis ( cov qe ua lub voos xwmfab) thiab hereditary elliptocytosis (cov qe ua ntev).

2. Cov kab mob ntsig txog lub cev tiv thaiv kab mob

Qee zaum peb lub cev tiv thaiv kab mob (lub cev uas tiv thaiv peb ntawm kab mob) pib tawm tsam peb cov qe ntshav liab tsis raug. Qhov no hu ua autoimmune hemolytic anemia (AIHA) . Qhov no yog ib qho mob tsis tshua muaj. Kuj tseem muaj hom mob no:

• Kab mob agglutinin txias ( cov tsos mob hnyav zuj zus thaum raug cua txias)
• Kab mob agglutinin sov

Qee yam mob uas ua rau AIHA muaj xws li Mycoplasma pneumonia , lymphoma , leukemia (cov no yog hom mob qog noj ntshav), lupus, thiab rheumatoid arthritis (cov no kuj yog cov kab mob autoimmune).

Lwm yam mob uas tsis yog autoimmune:

• Paroxysmal txias hemoglobinuria
• Paroxysmal nocturnal hemoglobinuria

3. Kev kis kab mob

Qee cov kab mob parasitic, cov kab mob virus, thiab cov kab mob bacteria uas nkag mus rau hauv peb lub cev tuaj yeem ua rau peb cov qe ntshav liab puas tsuaj, ua rau lawv puas tsuaj ua ntej lawv hloov tau. Ib qho piv txwv zoo ntawm qhov no yog malaria . Tus kab mob parasitic uas ua rau malaria ncaj qha tawm tsam cov qe ntshav liab.

Lwm yam ua rau muaj kev kis kab mob:

• Kab mob Babesiosis
• Kab mob Carrion
• Mob pob zeb Rocky Mountain
• Kab mob Haemophilus influenza
• Kab mob tiv thaiv kab mob tib neeg (HIV)

4. Qee cov tshuaj

Qee cov tshuaj uas peb noj kuj tseem tuaj yeem ua rau peb lub cev tiv thaiv kab mob tawm tsam cov qe ntshav liab thiab rhuav tshem lawv sai sai. Qhov no hu ua kev mob ntshav tsis txaus los ntawm tshuaj (DIHA) . Qhov no tsis tshua muaj.

Qee cov tshuaj uas ua rau hemolysis:

• Acetaminophen ( paracetamol)
• Qee cov tshuaj tua kab mob cephalosporin
• Clopidogrel
• Dapsone
• Heparin
• Levodopa
• Levofloxacin
• Methyldopa
• Nitrofurantoin
• Penicillin
• Phenazopyridine
• Quinidine
• Quinine
• Rifampin
• Qee cov tshuaj sulfonamides

Tseem Ceeb: Tsis txhob ntshai cov npe tshuaj no. Cov tshuaj no tsis tshua ua rau cov ntshav tsis khov. Yog tias tus kws kho mob tau sau cov tshuaj no rau koj, ua raws li lawv cov lus qhia. Yog tias koj muaj lus nug, nrog koj tus kws kho mob tham.

5. Teeb meem thaum cev xeeb tub

Qee qhov teeb meem thaum cev xeeb tub kuj tseem tuaj yeem ua rau cov qe ntshav liab tawg sai.

• HELLP syndrome
• Preeclampsia
• Kab mob Eclampsia

Vim tias cov no yog cov mob hnyav uas tuaj yeem tshwm sim thaum cev xeeb tub, nws yog ib qho tseem ceeb uas yuav tsum nrhiav kev pab kho mob tam sim ntawd yog tias muaj cov tsos mob tshwm sim.

6. Cov khoom siv kho mob thiab kev kho mob

Qhov no kuj tsis tshua muaj. Kev tawg ntshav tuaj yeem tshwm sim thaum muaj qee yam khoom siv kho mob raug cog rau hauv lub cev, lossis thaum lub sijhawm kho mob, kom txog thaum lub cev hloov kho rau lawv.

• Kev ntxuav ntshav rau cov neeg mob raum
• Lub tshuab bypass plawv-ntsws (siv rau hauv kev phais loj)
• Kev hloov pauv lub plawv
• Lwm cov khoom siv siv rau hauv cov mob xws li lub plawv tsis ua haujlwm, piv txwv li cov twj tso kua mis hauv aortic thiab Impella cov khoom siv .
• Kev hloov ntshav (xws li thaum muab cov ntshav tsis sib xws)

7. Cov tshuaj lom thiab cov tshuaj lom

Qee cov tshuaj lom, thaum noj, tuaj yeem ua rau cov qe ntshav liab puas tsuaj thiab ua rau hemolysis.

• Arsenic
• Tooj liab ( yog tias noj ntau dhau)
• Cov hlau lead
• Arsine ( cov pa roj lom)
• Stibine ( cov pa roj lom)
• Cov tshuaj lom nab

Tsis tas li ntawd xwb, txhua yam mob uas lub qhov ntswg ua haujlwm ntau dhau (hypersplenism) kuj tuaj yeem ua rau cov ntshav tsis khov. Ib yam li ntawd, cov ntshav siab heev tuaj yeem ua rau cov qe ntshav liab tawg thaum cov ntshav txav mus los ntawm cov hlab ntsha sai dhau.

Cov tsos mob ntawm cov ntshav tsis muaj zog yog dab tsi?

Cov tsos mob nyob ntawm seb koj cov qe ntshav liab qis npaum li cas. Yog tias koj cov qe ntshav liab tsis qis dhau, koj yuav tsis muaj tsos mob dab tsi. Feem ntau, cov tsos mob tshwm sim vim tias lub cev cov qe ntshav thiab cov nqaij tsis tau txais oxygen txaus vim tias cov qe ntshav liab qis.

Cov tsos mob feem ntau:

• Kev qaug zog
• kiv taub hau
• Daim tawv nqaij daj ntseg
• Lub plawv dhia ceev / tachycardia
• Ua tsis taus pa / ua tsis taus pa
• Tawv nqaij thiab qhov muag dawb daj (Jaundice) (Qhov no yog tshwm sim los ntawm kev sib sau ua ke ntawm bilirubin, ib yam khoom tso tawm thaum cov qe ntshav liab tawg, hauv cov ntshav)
• Tus po loj / tus po loj dua

Qee cov tsos mob yuav txawv nyob ntawm seb qhov mob twg ua rau cov ntshav tsis khov. Piv txwv li, ib tug neeg uas muaj tus kab mob agglutinin txias yuav tsis muaj ntshav ntws mus rau cov ntiv tes thiab cov ntiv taw, ua rau lawv xiav thiab loog (Raynaud's phenomenon) .

Yuav ua li cas thiaj paub seb puas muaj teeb meem ntsig txog kev tawg ntshav?

Tus kws kho mob yuav coj koj cov ntshav mus kuaj thiab kuaj ntau zaus seb koj cov qe ntshav liab qis puas yog vim muaj kev tawg ntawm cov ntshav.

• Kev suav cov ntshav tag nrho (CBC): Qhov no tuaj yeem qhia koj ntau yam txog txhua hom qe ntshav hauv koj cov ntshav, tshwj xeeb tshaj yog koj cov qe ntshav liab. Nws tuaj yeem kuaj xyuas tej yam xws li koj cov hemoglobin thiab seb koj cov qe ntshav liab siv qhov chaw ntau npaum li cas hauv koj cov ntshav (hematocrit).
• Kev suav cov reticulocyte: Qhov no yog ib feem ntawm qhov kev xeem CBC. Reticulocytes yog cov qe ntshav liab tshiab uas tseem tsis tau loj hlob tag. Thaum muaj kev tawg ntawm cov ntshav, cov reticulocyte suav yuav nce ntxiv thaum lub cev ua kom cov qe ntshav tshiab sai dua los hloov cov uas raug rhuav tshem.
• Kev kuaj ntshav ntawm cov hlab ntsha sab nraud: Qhov kev kuaj no tuaj yeem kuaj xyuas seb puas muaj qhov tsis zoo ntawm cov duab thiab qhov loj ntawm koj cov qe ntshav. Cov qe ntshav uas muaj duab tsis zoo yuav raug rhuav tshem sai dua.
• Lactate dehydrogenase (LDH): LDH yog ib qho enzyme pom nyob hauv cov qe ntshav liab. Thaum cov qe ntshav liab raug rhuav tshem sai dua li qub, cov theem LDH hauv cov ntshav tuaj yeem nce ntxiv.
• Kev kuaj Haptoglobin: Haptoglobin yog ib qho protein uas cuam tshuam nrog hemoglobin. Thaum cov qe ntshav liab raug rhuav tshem (zoo li hauv hemolysis), cov hemoglobin ntau heev raug tso tawm rau hauv cov ntshav. Cov theem Haptoglobin ces txo qis.
• bilirubin tsis sib txuas: Bilirubin raug tsim tawm thaum hemoglobin hauv cov qe ntshav liab tawg. Cov bilirubin ntau hauv cov ntshav qhia tias muaj ntau cov qe ntshav liab raug rhuav tshem (qhov no yog qhov ua rau mob daj ntseg).
• Kev kuaj Coombs ncaj qha: Qhov kev kuaj no tuaj yeem ntes tau seb koj puas muaj cov tshuaj tiv thaiv kab mob uas txuas rau koj cov qe ntshav liab thiab rhuav tshem lawv sai sai (qhov no tuaj yeem pab kuaj mob xws li AIHA).

Tsis tas li ntawd xwb, tus kws kho mob yuav ua qhov kev kuaj zis kom paub seb puas muaj ntshav thiab bilirubin hauv koj cov zis, uas yog cov cim qhia tias muaj mob hu ua hemolytic anemia.

Yuav kho cov ntshav tsis muaj zog li cas?

Koj txoj kev kho mob yuav nyob ntawm seb ua rau koj cov ntshav tsis khov thiab koj cov tsos mob hnyav npaum li cas. Cov kev xaiv kho mob yuav suav nrog cov vitamins, tshuaj, phais, thiab kev hloov ntshav.

Qhov tseem ceeb tshaj plaws yog tham nrog koj tus kws kho mob txog kev kho mob uas zoo tshaj plaws rau koj, raws li koj qhov kev kuaj mob.

Peb lub cev yeej ib txwm sim ua kom muaj cov qe ntshav liab kom txaus. Txawm li cas los xij, kev kis kab mob, cov kab mob uas muaj txij thaum yug los, thiab tej yam sab nraud cuam tshuam rau cov txheej txheem no thiab ua rau cov qe ntshav liab raug rhuav tshem sai dhau. Yog li ntawd, cov qe ntshav liab yuav txo qis, ua rau muaj mob ntshav liab tsis txaus.

Txawm li cas los xij, qhov xov xwm zoo yog tias muaj ntau yam ua rau koj cov ntshav tsis khov kho tau. Thaum tus kws kho mob tau txiav txim siab qhov ua rau koj cov ntshav tsis khov kho, lawv yuav sau ntawv kom pab coj koj cov qe ntshav liab rov qab mus rau qhov qub.

Tej yam tseem ceeb uas yuav tsum nco ntsoov (Cov Lus Qhia Coj Mus Tsev)

• Hemolysis yog kev puas tsuaj ntawm cov qe ntshav liab ua ntej lub sijhawm.
• Qhov no tuaj yeem ua rau muaj cov tsos mob xws li qaug zog heev, kiv taub hau, thiab tawv nqaij daj (jaundice) .
• Muaj ntau yam ua rau; muaj qhov tsis zoo ntawm cov qe ntshav liab, teeb meem ntawm lub cev tiv thaiv kab mob, kev kis kab mob, qee yam tshuaj, teeb meem thaum cev xeeb tub, thiab ntau ntxiv.
• Yog tias koj muaj cov tsos mob no, nco ntsoov nrhiav kev pab kho mob .
• Kev kuaj ntshav tuaj yeem pab txiav txim seb muaj dab tsi ua rau muaj qhov teeb meem no thiab muab kev kho mob kom zoo.
• Muaj ntau yam ua rau muaj ntshav liab rov qab los. Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum tsis txhob ntshai thiab nrhiav kev pab kho mob kom zoo.

Vam tias koj pom cov ntaub ntawv no muaj txiaj ntsig. Nyob kom noj qab nyob zoo!

Kev tawg ntawm cov ntshav, cov qe ntshav liab, ntshav tsis txaus, tus po, pob txha, mob daj ntseg, kev kuaj ntshav