A châng chuan chau leh luak chhuak mai mai i ni em? A nih loh leh, i vun chu a sen deuh a, i mit var pawh a sen ang maiin i inhria em? Hei hi i thisen chhunga cell chi hrang hrang pawimawh ber pakhat, i thisen sen (red blood cells) nena inzawm thil a ni thei. Vawiin hian hemolysis tih dinhmun kan sawi dawn a, chu chu thisen sen (red blood cells) a chhiat a, a hun hmaa a tihchhiat vang a ni. Lungngai suh, hei hi hriat chian a pawimawh.
Hemolysis hi eng nge ni tak tak?
A awlsam zawngin, hemolysis chu kan taksaa thisen sen (red blood cells) tihchhiatna a ni . I hria em, heng thisen sen (red blood cells) te hi kan thisena hnathawk te te ang mai an ni. Kan thaw laia lung atanga oxygen la chhuakin taksa chhunga cell dang zawng zawng leh tissue dang zawng zawng hnena thlentu an ni. Gas cylinder in lama rawn hruai ang mai a ni. Chuvangin, kan taksa hian he oxygen hi hmangin a mamawh chakna a siam chhuak thin. Tin, heng thisen sen vek hian kan taksaa carbon dioxide lo awm khawm duh loh chu lungah a phur kir leh a, a thawk chhuak thei bawk.
A tlangpuiin kan taksa hian thisen sen hlui emaw, chak lo emaw chu a tichhia chhunzawm zel a, chu chu thisen sen thar, hrisel tak takin a thlak a ni. Hei hi a hlui paih bo leh thar chhuah ang a ni. Hetianga tihchhiat leh siam chhuah cycle hi kan taksaah hian thisen sen (red blood cells) dik tak kan nei fo thin.
Mahse, a châng chuan heng thisen sen (red blood cells) te hi a hun hmain, chu chu a chhe rang lutuk tihna a ni . Hei hi kan taksain a hmun ruak luah khat turin cell thar siam hun a neih hmain a thleng thei a ni. Hetianga thisen zam (red blood cells) tihchhiat chak lutuk hi hemolysis an ti a. He hemolysis avang hian taksaa thisen sen zat a tlahniam nasa hle a nih chuan, chu dinhmun chu hemolytic anemia , a nih loh leh anemia kan ti a ni.
Engvangin nge hetiang hian thisen sen (red blood cells) hi tihchhiat a nih?
Thisen sen (red blood cell) hi ni 120 vel a dam tlangpui. Hemi hun tawp lamah hian chu cell-te chu an lo upa tawh chuan signal bik an pe chhuak thin. Heng signal te hian kan taksa chhunga spleen (abdomen veilam a awm) te hian heng cell hlui te hi mumal takin a tichhia a ni. Kan in chhunga furniture hlui, chhe tawh tak tak kan paih chhuah ang bawkin.
Kan ruh spongy part bone marrow an tih ah hian thisen sen thar siam a ni . Chumi hnuah chuan he ruhroa thisen sen thar siamte hi thisenah a chhuak leh thin.
Mahse, a châng chuan thisen sen (red blood cell) pianzia emaw, a awm dân emaw a chhiat chuan a dam rei thei hle. A nih loh leh, thisen sen (red blood cells) te hi pawn lam thilin a tichhe thei a, taksain cell thar a siam hmain a thi thei bawk.
Hemolysis chi hrang hrangte chu engte nge ni?
Hemolysis hi chi hnih ah then theih a ni. Heng hmingte hian thisen sen (red blood cells) tihchhiatna hmun a kawk a ni.
1. Extravascular hemolysis: Hei hi kan thisen kalna (i.e., vein, arteries, leh capillaries) pawn lama thisen sen (red blood cells) a tihchhiat hun a ni. A tam zawkah chuan hei hi spleen -ah a thleng thin . Thisen a kal pelh rual hian thisen var chi khat bik macrophages an tih (hengte hi kan taksa venhimna vengtu ang an ni) chuan thisen sen hlui, chhe tawhte chu a hrechhuak a, a tichhe vek a ni.
2. Intravascular hemolysis: Hei hi thisen kalna kawng chhunga thisen sen (red blood cells) a tihchhiat hun a ni. An tihchhiat chuan chu cell chi hrang hrangte chu kan thisen nen taksa pum puiah an kal kual a ni.
Hemolysis awm chhan hi engte nge ni?
Hemolysis thlentu pakhat chauh a awm lo va, a nghawng thei thil engemaw zat a awm bawk. Tlem a chipchiar deuhin han thlir ila.
1. Thisen sen (red blood cells) ngeia chhiatna awm
A châng chuan thisen sen hring (red blood cell) pianzia emaw, a insiam danah emaw thil danglam emaw, a tlin lohna emaw a awm chuan chu cell chu a chhe thuai thei a ni. Chutiang tlin lohna chu pianpui, a nih loh leh thlahtu natna ṭhenkhat avânga lo awm a ni fo .
- Hemoglobin instability: Hemoglobin hi protein a ni a, thisen sen chhunga oxygen phur turin a pui a ni. Hetiang dinhmun nghet lo thlentu dinhmunte chu sickle cell anemia (thisen sen chu sickle ang maia siamna) leh thalassemia .
- Enzyme tlakchhamna: Thisen sen hnathawhna atana mamawh enzyme thenkhat a tlakchham pawhin he natna hi a awm thei bawk. Entirnan G6PD tlakchhamna leh pyruvate kinase tlakchhamna te hi a ni .
- Membrane defects: Thisen sen (red blood cells), cell membrane pawn lam khuhna (defects) awmna dinhmun. Entirnan, hereditary spherocytosis ( cell te chu spherical a lo ni ta) leh hereditary elliptocytosis (cell te chu a sei deuh) te hi a ni.
2. Immune system nena inzawm natna
A chang chuan kan taksa hriselna (natna laka min humhimtu system) hian kan thisen sen (red blood cells) te hi a rawn bei sual tan thin. Hei hi autoimmune hemolytic anemia (AIHA) an ti a. Hei hi thil awm lo tak a ni. Hei hi chi hrang hrang a awm bawk:
- Cold agglutinin disease ( khawsik a awm chuan a natna lan chhuah dan a na zual) .
- Warm agglutinin natna a ni
AIHA thlen thei dinhmun dang thenkhat chu Mycoplasma pneumonia , lymphoma , leukemia (hengte hi cancer chi hrang hrang an ni), lupus, leh rheumatoid arthritis (hengte hi autoimmune natna pawh an ni) te an ni.
Autoimmune ni lo natna dangte:
- Paroxysmal cold hemoglobinuria a awm thin
- Zan lama paroxysmal hemoglobinuria a awm thin
3. Hri kai te
Kan taksaa parasite, virus leh bacteria thenkhat lo lutte hian kan thisen sen (red blood cells) te chu a tichhe thei a, a thlak hmain a tichhia a ni. Hei hi entirnan tha tak chu malaria hi a ni . Malaria thlentu parasite hian thisen sen (red blood cells) chu direct-in a bei a.
Hri kai chhan dangte: 1.1.
- Babesiosis natna (babesiosis) a ni
- Carrion natna a ni
- Rocky Mountain-ah chuan khawsik a awm
- Haemophilus influenza natna a ni
- Mihring taksa chak lohna hrik (HIV) .
4. Damdawi thenkhat
Damdawi thenkhat kan ei hian, a tlem hle nachungin, kan taksa hriselna (immune system) chu thisen sen (red blood cells) bei turin a tichak thei a, a tichhe nghal vat thei bawk. Hei hi damdawi-induced immune hemolytic anemia (DIHA) an ti a. Hei hi a tlem hle.
Hemolysis thlen thei damdawi thenkhat:
- Acetaminophen ( paracetamol) tih hi a awm lo.
- Cephalosporin antibiotics thenkhat
- Clopidogrel a ni
- Dapsone a ni
- Heparin a ni
- Levodopa a ni
- Levofloxacin hmanga tihdam theih a ni
- Methyldopa hmanga siam a ni
- Nitrofurantoin a ni
- Penicillin hman a ni
- Phenazopyridine a ni
- Quinidine a ni
- Quinine a ni
- Rifampin a ni
- Sulfonamide thenkhat chu
Pawimawh: He damdawi list hian hlauthawng suh. Heng damdawi te hian hemolysis a thlen tam lo hle . Doctor-in heng damdawi te hi a lo pe che a nih chuan an thupek zawm rawh. Zawhna i neih chuan doctor nen inbia ang che.
5. Naupai laia harsatna awm thei
Naupai laia harsatna thenkhat chuan thisen sen (red blood cells) a ti chhe thuai thei bawk.
- HELLP syndrome a ni
- Preeclampsia a awm thin
- Eclampsia natna (Eclampsia) a awm
Hengte hi naupai laia natna khirh tak tak lo thleng thei a nih avangin natna lanchhuahna a lo lang a nih chuan damdawi lam thurawn lak nghal a pawimawh hle.
6. Damdawi hmanrua leh enkawl dan
Hei pawh hi a tlem hle. Hemolysis hi taksaah damdawi hmanraw thenkhat dah a nih hian emaw, enkawlna thenkhatah emaw taksain a insiamrem hma loh chuan a awm thei a ni.
- Kidney damlo tan hemodialysis tih a ni
- Heart-lung bypass machine (surgery lian tham takah hman thin) .
- Heart valve thlak danglam a ni
- Heart failure ang chi thil dang hman thin, entirnan intra-aortic balloon pump leh Impella device .
- Thisen pek (thisen inmil lo pek a nih hunah ang chi) .
7. Poison leh toxins
Toxin thenkhat chu ei a nih chuan thisen zam (red blood cells) a tichhe thei a, hemolysis a thlen thei bawk.
- Arsenic a ni
- Copper ( ei tam lutuk chuan) .
- Kaihruai
- Arsine ( gas rimchhia) .
- Stibine ( gas rimchhia) .
- Rul rimchhia
Tin, eng condition pawh hi spleen overactive (hypersplenism) hian hemolysis a thlen thei bawk. Chutiang bawkin thisen sang lutuk hian thisen kalna kawng a kal chak lutuk avangin thisen sen (red blood cells) a tikehsawm thei bawk.
Hemolysis natna lan chhuahna chu engte nge ni?
Symptoms chu i red blood cell count a hniam danah a innghat. I thisen zam (red blood cell count) a tlem lutuk loh chuan symptoms i nei lo mai thei. A tam zawkah chuan thisen sen (red blood cell count) a tlem avangin taksa cell leh tissue ten oxygen an dawn tlem vangin symptoms a awm thin.
A lan chhuah dan tlangpui:
- Chau
- Luak chhuak thei
- Vun dum (pale skin) a ni
- Lung natna / tachycardia
- Thâwk hah / thawk hah
- Vun leh mit var (Jaundice) (Hei hi thisenah thisen sen a chhiat huna thil chhuak bilirubin, thisenah a awm khawm vang a ni)
- Spleen lian / splenomegaly a awm
Symptom thenkhat chu hemolysis thlentu condition bik a zirin a danglam thei. Entirnan, cold agglutinin natna vei mi pakhat chuan kut zungtang leh ke ruh ah thisen kal a tlahniam thei a, chu chuan a rawn sen a, a ti hlim thei (Raynaud’s phenomenon) .
Hemolysis nena inzawm harsatna a awm leh awm loh hriat nan eng test nge tih thin?
Doctor chuan i thisen sample a la ang a, test eng emaw zat a kalpui ang a, i thisen sen tlahniam chu hemolysis vang a ni em tih a enfiah ang.
- Complete blood count (CBC): Hei hian i thisen chhunga cell chi hrang hrang, a bik takin i thisen sen (red blood cells) chungchang tam tak a hrilh thei che a ni. I hemoglobin level leh i thisen (hematocrit)-a i thisen sen (red blood cells) te hian hmun engzat nge an luah tih ang chi thil te a check thei a ni.
- Reticulocyte count: Hei hi CBC test-a tel a ni. Reticulocytes hi thisen sen thar lo piang chhuak, la puitling kim lo a ni. Hemolysis a awm chuan taksain a chhe tawhte thlaktu tur cell thar a siam chak avangin reticulocyte count a pung thei a ni.
- Peripheral blood smear: He test hian i thisen cell pianzia leh lian tham lo a awm leh awm loh a enfiah thei a ni. Cell pianzia pangngai lo chu a chhe thuai a rinawm zawk.
- Lactate dehydrogenase (LDH): LDH hi thisen sen chhunga enzyme awm a ni. Thisen sen (red blood cells) chu a pangngai aia rang zawka a chheh chuan thisenah LDH level a sang thei a ni.
- Haptoglobin test: Haptoglobin hi protein pakhat a ni a, hemoglobin nena inzawm a ni. Thisen sen (red blood cells) a chhiat chuan (hemolysis-ah ang bawkin) thisenah hemoglobin tam tak a chhuak thin. Chumi hnuah chuan Haptoglobin level a tlahniam leh thin.
- Unconjugated bilirubin: Thisen sen (red blood cells)-a hemoglobin a chhiat chuan bilirubin hi siam chhuah a ni. Thisenah bilirubin a tam chuan thisen zam (red blood cells) tam tak a chhe vek tih a tilang a (hei hi jaundice thlentu a ni).
- Direct Coombs test: He test hian i thisen sen (red blood cells) nena inzawm antibodies i neih leh neih loh a hriat theih a, rang takin a tichhia thei a ni (hei hian AIHA ang chi natna hriatchhuahna kawngah a pui thei a ni).
Tin, doctor chuan i zun chhunga thisen leh bilirubin awm leh awm loh enfiah turin urinalysis a ti thei bawk a, chu chu hemolytic anemia tih natna chhinchhiahna a ni thei bawk.
Hemolysis hi engtin nge enkawl a nih?
I enkawlna chu i hemolysis chhan leh i symptoms nasat danah a innghat ang. Enkawlna kawng hrang hrangte chu vitamin te, damdawi te, operation te, leh thisen pek te a ni thei.
A pawimawh ber chu i doctor nen i tana tha ber tur enkawlna chungchang sawipui la, i natna hmuhchhuah dan azirin.
Kan taksa hian thisen sen zat dik tak vawng reng turin a bei reng a. Mahse, hri kai, pianpui natna leh pawn lam thilte hian he kalphung hi a tibuai thei a, thisen sen (red blood cells) te chu a tichhe rang lutuk thei a ni. Chumi avang chuan thisen sen (red blood cells) a tlahniam thei a, hei hian hemolytic anemia a thlen thei a ni.
Mahse, chanchin lawmawm tak chu hemolysis thlentu tam tak hi enkawl theih a ni. Doctor chuan i hemolysis chhan a hriat chian hnuah, i thisen zam (red blood cell count) chu a pangngaia awm leh theihna tura pui turin enkawlna a pe ang che.
Thil pawimawh hriat reng tur (Take-Home Message) .
- Hemolysis hi thisen sen (red blood cells) a hun hmaa tihchhiat a ni.
- Hei hian symptoms a thlen thei a, chu chu hah lutuk, luak chhuak, leh vun sen (jaundice) .
- A chhan tam tak a awm thei a; thisen sen (red blood cells) ngeia chhiatna te, taksa hriselna lama harsatna te, natna hrik, damdawi thenkhat, naupai laia harsatna awm te, leh thil dang tam tak te.
- Heng symptoms te hi i neih chuan doctor advice zawng ngei ang .
- Thisen test hian a chhan hriat theihna leh enkawlna \ha tak a pe thei a ni.
- A chhan tam tak chu red blood cell level siam that nan enkawl theih a ni. Chuvangin hlauthawng lo va, damdawi lam kaihhruaina dik tak zawn a pawimawh.
He thu hi i tangkaipui ngei ka beisei. Hrisel takin awm rawh!
` Hemolysis, thisen sen (red blood cells), thisen tlakchhamna, ril, ruhro, jaundice, thisen test te
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