Kei te tere te pakaru o ō pūtau toto? Me kōrero tātou mō te hemolysis!

He ngenge, he pōuri rānei tō kiri i ētahi wā? He kōwhai rānei tō kiri i ētahi wā, ā, he kōwhai te mā o ō kanohi? Tērā pea he take tēnei nō ō toto whero, tētahi o ngā momo toto tino nui o roto i ō toto. I tēnei rā ka kōrero tātou mō tētahi āhuatanga e kiia nei ko te hemolysis , arā, ko te wā e pakaru ai ngā toto whero, ā, ka whakangaromia wawetia. Kaua e manukanuka, he mea nui kia mōhio koe ki tēnei.

He aha tonu te hemolysis?

Ki te kī ngāwari, ko te hemolysis te whakangaromanga o ngā toto whero i roto i tō tātou tinana . Kei te mōhio koe, he rite ēnei toto whero ki ngā kaimahi iti i roto i ō tātou toto. Ko rātou te hunga e tango ana i te hāora mai i ngā pukahukahu ina manawa tātou, ka tukuna ki ngā pūtau me ngā kiko katoa o te tinana. He rite ki te kawe mai i tētahi rango hau ki te kāinga. Nō reira, ka whakamahia e tō tātou tinana tēnei hāora hei whakaputa i te pūngao e hiahiatia ana. Waihoki, ka āwhina ēnei toto whero ki te kawe i te hauhā waro kāore e hiahiatia ana e kohikohi ana i roto i ō tātou tinana ki ngā pukahukahu ka tukuna atu.

I te nuinga o te wā, ka whakangaromia tonutia e ō tātou tinana ngā toto whero tawhito, ngoikore rānei, ka whakakapia ki ngā toto whero hou, hauora. He rite tēnei ki te tango i ngā mea tawhito, ka whiwhi i ngā mea hou. Nā tēnei huringa o te whakangaromanga me te whakaputanga, he aha i mau tonu ai te nui o ngā toto whero i roto i ō tātou tinana.

Heoi, i ētahi wā ka tīmata te pakaru wawe o ēnei toto whero, arā, he tere rawa . Ka tupu pea tēnei i mua i te wā e hanga ai e te tinana he pūtau hou hei whakakī i te āputa. Ko tēnei whakangaromanga tere o ngā toto whero ka kiia ko te hemolysis. Mena ka tino heke te maha o ngā toto whero i roto i te tinana nā tēnei hemolysis, ka kiia taua āhuatanga ko te anemia hemolytic , te anemia rānei.

He aha i whakangaromia ai ngā pūtau toto whero pēnei?

E 120 pea ngā rā e ora ai te toto whero. I te mutunga o tēnei wā, ina koroheke aua pūtau, ka tukuna e rātou he tohu motuhake. Mā ēnei tohu ka whakangaromia e te whēkau (kei te taha maui o te puku) i roto i tō tātou tinana ēnei pūtau tawhito i runga i te tikanga tika. Pērā i tā tātou whakakorenga i ngā taonga tawhito, pakaru o roto i tō tātou whare.

Ka hangaia ngā toto whero hou i roto i tētahi wāhanga hautai o ō tātou wheua e kiia nei ko te hinu wheua . Kātahi ka tukuna ngā toto whero hou e hangaia ana i roto i tēnei hinu wheua ki roto i te toto.

Heoi, i ētahi wā ka taea e te hapa o te āhua, o te hanganga rānei o te toto whero te whakapoto i tōna roanga ora. Tērā rānei, ka taea e ngā pūtau toto whero te pakaru e ngā āhuatanga o waho, ā, ka mate i mua i te hanga pūtau hou e te tinana.

He aha ngā momo matua o te hemolysis?

E rua ngā momo matua o te hemolysis. E pā ana ēnei ingoa ki te wāhi e whakangaromia ai ngā toto whero.

1. Te hemolysis o waho o te toto: Koinei te wā e whakangaromia ai ngā toto whero i waho o ō tātou oko toto (arā, ngā uaua, ngā uaua toto, me ngā capillaries). I te nuinga o te wā, ka puta tēnei i roto i te whēkau . I te rerenga o te toto mā roto i te whēkau, ka kitea e tētahi momo toto mā motuhake e kiia nei ko ngā macrophages (he rite ēnei ki ngā kaitiaki haumaru o tō tātou tinana) ngā toto whero tawhito, kua pakaru, ā, ka whakangaromia.

2. Te hemolysis o roto i ngā oko toto: Koinei te wā e whakangaromia ai ngā pūtau toto whero i roto i ngā oko toto. Ina whakangaromia, ka haere ngā wahi o aua pūtau puta noa i te tinana me ō tātou toto.

He aha ngā take o te hemolysis?

Ehara i te mea kotahi anake te take o te hemolysis, engari he maha ngā āhuatanga ka whai wāhi ki tēnei. Me titiro tātou ki tēnei mea me ētahi atu taipitopito.

1. Ngā hapa o ngā toto whero tonu

I ētahi wā, mēnā he āhua rerekē, he hapa rānei kei roto i te āhua, i te hanganga rānei o te toto whero, ka taea te whakangaro wawe i taua pūtau. He maha ngā wā ka puta mai ēnei hapa i ētahi āhuatanga whānau, i ngā āhuatanga tuku iho rānei .

• Te kore pumau o te hemoglobin: Ko te hemoglobin he pūmua e āwhina ana ki te kawe i te hāora ki roto i ngā toto toto whero. Ko ngā āhuatanga e hua ai tēnei kore pumau ko te anemia pūtau maripi (ka huri te āhua o ngā toto toto whero hei maripi) me te thalassemia .
• Ngā ngoikoretanga o te whākōkī: Ka puta anō hoki tēnei āhuatanga ina kore ētahi whākōkī e hiahiatia ana mō te mahi a ngā toto whero. Hei tauira, ko te ngoikore o te G6PD me te ngoikore o te pyruvate kinase .
• Ngā hapa o te kiriuhi: Ngā āhuatanga e kitea ai he hapa i roto i te uhi o waho o ngā toto toto whero, arā, te kiriuhi pūtau. Ko ētahi tauira ko te spherocytosis tuku iho ( ka porowhita ngā pūtau) me te elliptocytosis tuku iho (ka roa ngā pūtau).

2. Ngā mate e pā ana ki te pūnaha ārai mate

I ētahi wā ka tīmata hē tā tātou ake pūnaha ārai mate (te pūnaha e tiaki ana i a tātou i te mate) ki te whakaeke i ō tātou ake toto whero. Ka kiia tēnei ko te mate toto totoro-ā-tinana (AIHA) . He mate onge tēnei. Tērā anō ētahi momo o tēnei:

• Te mate agglutinin makariri ( ka kino ake ngā tohu ina pāngia e te makariri)
• Mate agglutinin mahana

Ko ētahi atu mate pūtake ka puta ai te AIHA ko te Mycoplasma pneumonia , te lymphoma , te leukemia (he momo mate pukupuku ēnei), te lupus, me te rheumatoid arthritis (he mate pūnaha ārai mate anō hoki ēnei).

Ētahi atu āhuatanga kāore i te mate pūnaha ārai mate:

• Hemoglobinuria makariri paroxysmal
• Hemoglobinuria pō paroxysmal

3. Ngā mate urutā

Ka taea e ētahi pirinoa, huaketo, me ngā huakita e uru mai ana ki roto i ō tātou tinana te kino i ō tātou toto whero, ka whakangaro i a rātou i mua i te whakakapinga. Ko tētahi tauira pai o tēnei ko te malaria . Ko te pirinoa e hua ai te malaria ka whakaeke tika i ngā toto whero.

Ētahi atu take o te mate:

• Babesiosis
• Te mate a Carrion
• Te kirika kiriuhi o Rocky Mountain
• Rewharewha Haemophilus
• Huaketo ngoikore o te ārai mate tangata (HIV)

4. Ētahi rongoā

Ahakoa he onge noa iho, ka taea hoki e ētahi rongoā e tangohia ana e tātou te whakaoho i tō tātou pūnaha ārai mate ki te whakaeke i ngā toto toto whero me te whakangaro wawe i a rātou. Ka kiia tēnei ko te drug-induced immune hemolytic anemia (DIHA) . He tino onge tēnei.

Ko ētahi rongoā ka taea te whakaputa hemolysis:

• Acetaminophen ( paracetamol)
• Ko ētahi paturopi cephalosporin
• Clopidogrel
• Tāpōne
• Heparin
• Levodopa
• Levofloxacin
• Methyldopa
• Nitrofurantoin
• Penicillin
• Phenazopyridine
• Kuinitini
• Kuinīni
• Rifampin
• Ko ētahi sulfonamides

He mea nui: Kaua e mataku ki tēnei rārangi rongoā. Kāore i te maha ngā wā ka puta te hemolysis i roto i ēnei rongoā. Mena kua tohua ēnei rongoā e te tākuta māu, whai i āna tohutohu. Mena he pātai āu, kōrero ki tō tākuta.

5. Ngā raruraru i te wā e hapu ana

Ka taea hoki e ētahi raruraru i te wā e hapū ana te meinga kia tere te pakaru o ngā pūtau toto whero.

• Te mate HELLP
• Te preeclampsia
• Eclampsia

Nā te mea he mate kino ēnei ka pā mai i te wā e hapū ana, he mea nui kia rapu tohutohu hauora tonu mēnā ka puta ngā tohu.

6. Ngā taputapu hauora me ngā maimoatanga

He mea onge hoki tēnei. Ka puta te hemolysis ina whakatōkia ētahi taputapu hauora ki roto i te tinana, i roto rānei i ētahi maimoatanga, kia taunga rā anō te tinana ki aua taputapu.

• He hemodialysis mō ngā tūroro whatukuhu
• Mīhini karo ngākau-pūkahukahu (e whakamahia ana i roto i ngā pokanga nui)
• Ngā whakakapinga takirere ngākau
• Ko ētahi atu taputapu e whakamahia ana i roto i ngā āhuatanga pēnei i te ngoikore o te ngakau, hei tauira, ngā papu poihau ā-roto-aortic me ngā taputapu Impella .
• Ngā whakawhiti toto (pērā i te wā e tukuna ana he toto kāore e hototahi)

7. Ngā paitini me ngā paitini

Ka taea e ētahi paitini te kino i ngā toto whero ina kainga, ā, ka puta he toto toto iti (hemolysis).

• Āheni
• Parahi ( mēnā ka nui rawa te horomia)
• Ārahi
• Arsine ( hau paitini)
• Stibine ( hau paitini)
• Paitini nakahi

Hei tāpiritanga, ko tētahi āhuatanga e kaha rawa ana te mahi a te whēkau (hypersplenism) ka taea hoki te whakaputa i te hemolysis. Waihoki, ko te toto toto tino teitei ka taea te pakaru i ngā pūtau toto whero i te tere rawa o te neke o te toto i roto i ngā oko toto.

He aha ngā tohu o te hemolysis?

Ko ngā tohumate e whakawhirinaki ana ki te iti o te maha o ngā toto toto whero. Mēnā kāore i te tino iti te maha o ngā toto toto whero, tērā pea kāore koe e kite i tētahi tohumate. I te nuinga o te wā, ka puta ngā tohumate nā te mea kāore e nui te hāora e whiwhihia ana e ngā pūtau me ngā kiko o te tinana nā te iti o te maha o ngā toto toto whero.

Ngā tohu noa:

• Ngenge
• Pōuriuri
• Kiri mā
• Te tere o te manawa / te takikardia
• Te poto o te manawa / te poto o te manawa
• Te kōwhai o te kiri me te mā o ngā kanohi (Jaundice) (Nā te kohikohinga o te bilirubin, he matū e tukuna ana i te wā e pakaru ai ngā pūtau toto whero, i roto i te toto tēnei)
• Te whēkau nui / te splenomegaly

Ka rerekē pea ētahi tohu i runga i te āhua motuhake e puta ai te hemolysis. Hei tauira, ko te tangata e pangia ana e te mate agglutinin makariri, ka heke pea te rere o te toto ki ngā pito o ngā maihao me ngā matimati, ka kikorangi, ka ngoikore hoki (te āhuatanga o Raynaud) .

He aha ngā whakamātautau e mahia ana hei whakatau mena he raruraru e pā ana ki te hemolysis?

Ka tangohia e te tākuta tētahi tauira o tō toto, ā, ka whakahaerehia he maha o ngā whakamātautau hei tirotiro mēnā ko te iti o ngā toto whero kei te take o te hemolysis.

• Te tatau toto katoa (CBC): Ka taea e tēnei te kōrero ki a koe mō ngā momo pūtau katoa o roto i tō toto, inā koa ō toto whero. Ka taea e ia te tirotiro i ngā mea pēnei i te taumata o tō hemoglobin me te nui o te wāhi e nohoia ana e ō toto whero i roto i tō toto (hematocrit).
• Te maha o ngā retikulosit: He wāhanga tēnei o te whakamātautau CBC. Ko ngā retikulosit he toto whero hou kua hangaia, kāore anō kia tino pakari. Ina he hemolysis, ka piki ake pea te maha o ngā retikulosit i te mea ka tere ake te hanga o ngā pūtau hou hei whakakapi i ngā mea kua ngaro.
• Te whakamātautau toto ā-taha: Ka taea e tēnei whakamātautau te tirotiro i ngā āhuatanga rerekē o te āhua me te rahi o ō pūtau toto. He nui ake te tūponotanga ka tere te whakangaromanga o ngā pūtau āhua rerekē.
• Lactate dehydrogenase (LDH): He whākōkī te LDH e kitea ana i roto i ngā toto whero. Ina tere ake te pakaru o ngā toto whero i te mea noa, ka piki ake ngā taumata LDH i roto i te toto.
• Whakamātautau Haptoglobin: He pūmua te Haptoglobin e hono ana ki te hemoglobin. Ina pakaru ngā pūtau toto whero (pērā i te hemolysis), ka tukuna he nui o te hemoglobin ki roto i te toto. Kātahi ka heke ngā taumata Haptoglobin.
• Bilirubin kore-honohono: Ka puta te bilirubin ina pakaru te hemoglobin i roto i ngā toto whero. Ko te nui o te bilirubin i roto i te toto e tohu ana kei te whakangaromia te tini o ngā toto whero (koinei te take o te jaundice).
• Whakamātautau Coombs Tika: Ka taea e tēnei whakamātautau te kite mēnā he paturopi kei a koe e piri ana ki ō toto whero, ā, ka tere te whakangaro i a rātou (ka āwhina tēnei ki te tautuhi i ngā mate pēnei i te AIHA).

Hei tāpiri, ka whakahaerehia pea e te tākuta he tātaritanga mimi hei tirotiro i te toto me te bilirubin i roto i tō mimi, he tohu pea ēnei o te mate e kiia nei ko te anemia hemolytic.

Me pēhea te rongoā mō te hemolysis?

Ka whakawhirinaki tō maimoatanga ki te pūtake o tō hemolysis me te kaha o ō tohu. Ko ngā kōwhiringa maimoatanga ka uru atu ki ngā huaora, ngā rongoā, te pokanga, me ngā whakawhiti toto.

Ko te mea nui ko te kōrero ki tō tākuta mō te maimoatanga e pai ana mōu, i runga i te tātaritanga kua tohua e koe.

Kei te ngana tonu ō tātou tinana ki te pupuri i te maha tika o ngā toto whero. Heoi, ka taea e ngā mate pāwera, ngā mate whānau, me ngā awe o waho te whakararuraru i tēnei tukanga, ā, ka tere rawa te whakangaromanga o ngā toto whero. Nō reira, ka heke te maha o ngā toto whero, ka hua ake he mate toto toto toto toto.

Heoi, ko te rongo pai, he maha ngā take o te hemolysis ka taea te rongoā. Kia kitea rā anō e te tākuta te take o tō hemolysis, ka tohua e rātou he maimoatanga hei āwhina i te whakahoki mai i te maha o ngā toto toto whero ki te āhua noa.

Ngā mea nui hei maumahara (Karere hei kawe ki te kāinga)

• Ko te hemolysis te whakangaromanga wawe o ngā toto toto whero.
• Ka puta pea ngā tohu pēnei i te ngenge nui, te whanoke, me te kōwhai o te kiri (jaundice) .
• He maha ngā take; he hapa kei roto i ngā toto whero, he raruraru pūnaha ārai mate, he mate pāwera, he rongoā, he raruraru i te wā e hapu ana, me ētahi atu.
• Mena kei a koe ēnei tohu, me rapu tohutohu hauora koe .
• Ka taea e ngā whakamātautau toto te āwhina ki te whakatau i te take me te whakarato i te maimoatanga tika.
• He maha ngā take ka taea te rongoā hei whakahoki mai i ngā taumata o ngā toto whero. Nō reira, he mea nui kia kaua e mataku, me rapu tohutohu hauora tika.

Ko tāku tumanako ka whai hua ēnei kōrero ki a koe. Kia ora tonu!

He toto toto iti, toto whero, anemia, whēkau, hinu wheua, jaundice, whakamātautau toto