Ese uturemangingo tw'amaraso yawe turimo gusenyuka vuba? Reka tuvuge ku bijyanye no gusohora amaraso mu maraso!

Ese hari igihe wumva unaniwe gusa kandi ukagira isereri? Cyangwa hari igihe wumva uruhu rwawe rusa n'umuhondo, kandi umweru w'amaso yawe ari umuhondo? Ibi bishobora kuba bifitanye isano n'uturemangingo tw'amaraso dutukura, kamwe mu bwoko bw'ingenzi bw'uturemangingo mu maraso yawe. Uyu munsi tugiye kuvuga ku ndwara yitwa hemolysis , ari na yo ituma uturemangingo dutukura dusenyuka tugapfa imburagihe. Ntugahangayike, ni ngombwa kubimenya.

Mu by'ukuri hemolysis ni iki?

Muri make, hemolysis ni ugusenya uturemangingo dutukura tw’amaraso mu mubiri wacu . Urabizi, utwo turemangingo dutukura tw’amaraso tumeze nk’udukora duto mu maraso yacu. Ni two dufata ogisijeni mu bihaha iyo duhumeka tukayigeza ku tundi turemangingo twose n’uturemangingo two mu mubiri. Ni nko kuzana silinda ya gaze mu rugo. Bityo rero, umubiri wacu ukoresha iyi ogisijeni kugira ngo utange ingufu ukeneye. Nanone, utwo turemangingo dutukura dufasha gutwara dioxyde de carbone idakenewe yiyongera mu mubiri wacu ikayisubiza mu bihaha ikayisohora.

Ubusanzwe, imibiri yacu ihora isenya uturemangingo dutukura dushaje cyangwa dufite intege nke, ikadusimbuza uturemangingo dushya kandi dufite ubuzima bwiza. Ibi ni nko gukuraho uturemangingo dushaje tukabona uturemangingo dushya. Uru rugendo rwo gusenyuka no gukorwa niyo mpamvu duhora dufite uturemangingo dutukura dukwiye mu mibiri yacu.

Ariko, hari igihe izi selile zitukura zitangira gusenyuka imburagihe, ni ukuvuga vuba cyane . Ibi bishobora kubaho mbere yuko umubiri wacu ubona umwanya wo gukora selile nshya zo kuzuza icyuho. Uku gusenyuka vuba kw'uturemangingo dutukura tw'amaraso byitwa hemolysis. Iyo umubare w'uturemangingo dutukura mu mubiri ugabanutse cyane bitewe n'uku kugabanuka kw'amaraso, icyo kibazo tucyita hemolytic anemia , cyangwa anemia.

Kuki uturemangingo dutukura tw’amaraso twangirika muri ubu buryo?

Uturemangingo dutukura tw’amaraso ubusanzwe tubaho iminsi igera ku 120. Iyo utwo turemangingo tumaze gusaza, dusohora ibimenyetso byihariye. Ibi bimenyetso bituma uturemangingo (turi ku ruhande rw’ibumoso rw’inda) mu mubiri wacu turimbura utwo turemangingo dushaje mu buryo bunoze. Nk’uko tuvana ibikoresho bishaje, byangiritse mu nzu yacu.

Uturemangingo dushya tw’amaraso dutukura turemwa mu gice cy’amagufwa yacu kitwa uturemangingo tw’amagufwa . Uturemangingo dushya tw’amaraso dutukura twakozwe muri uyu musengo w’amagufwa turekurwa mu maraso.

Ariko, hari igihe inenge mu miterere cyangwa imiterere y'uturemangingo dutukura tw'amaraso ishobora kugabanya igihe cyo kubaho kwatwo. Cyangwa, uturemangingo dutukura tw'amaraso dushobora kwangirika bitewe n'ibintu byo hanze hanyuma tugapfa mbere y'uko umubiri ukora uturemangingo dushya.

Ni ubuhe bwoko bw'ingenzi bwa hemolysis?

Hemolysis ishobora kugabanywamo ubwoko bubiri bw'ingenzi. Aya mazina yerekeza aho uturemangingo dutukura tw'amaraso twangiritse.

1. Gukuraho amaraso mu mitsi: Ibi bibaho igihe uturemangingo dutukura twangiritse hanze y’imitsi yacu (ni ukuvuga imitsi, imitsi, n’imitsi mito). Akenshi, ibi biba mu turemangingo . Uko amaraso anyura mu turemangingo, ubwoko bwihariye bw’uturemangingo tw’amaraso tw’umweru twitwa macrophages (nk’aba bashinzwe umutekano w’umubiri wacu) tumenya uturemangingo dutukura twangiritse, tugakora akazi katwo.

2. Gusesa amaraso mu mitsi: Ibi ni igihe uturemangingo dutukura tw’amaraso twangiritse mu mitsi. Iyo twangiritse, ibice by’utwo turemangingo bizenguruka umubiri wose hamwe n’amaraso yacu.

Ni izihe mpamvu zitera hemolysis?

Nta mpamvu imwe gusa itera hemolysis, ahubwo hari ibintu byinshi bishobora kuyigiraho ingaruka. Reka tubirebe mu buryo burambuye.

1. Ubusembwa mu turemangingo dutukura tw'amaraso ubwatwo

Hari igihe, iyo habayeho ikibazo cyangwa inenge mu miterere y’ingirabuzimafatizo itukura, iyo ngirabuzimafatizo ishobora kwangirika vuba. Inenge nk’izo akenshi ziterwa n’indwara zimwe na zimwe zivukanwa, cyangwa indwara z’uruhererekane .

• Kudahuza kwa Hemoglobini: Hemoglobini ni poroteyine ifasha gutwara ogisijeni mu turemangingo dutukura tw'amaraso. Ibintu biteza uku kudahuza birimo indwara ya sickle cell anemia (aho uturemangingo dutukura duhinduka nk'uturemangingo) na thalassemia .
• Kubura enzyme: Iyi ndwara ishobora no kubaho iyo hari enzyme zimwe na zimwe zikenewe kugira ngo uturemangingo dutukura dukore neza. Urugero, harimo kubura G6PD no kubura pyruvate kinase .
• Ubusembwa bw'uturemangingo: Ingeso zigaragaza ubusembwa mu gice cyo hanze cy'uturemangingo dutukura tw'amaraso, membrane y'uturemangingo. Ingero zirimo spherocytosis y'uruhererekane ( uturemangingo tuba uruziga) na elliptocytosis y'uruhererekane (uturemangingo tuba ndende).

2. Indwara zijyanye n'ubudahangarwa bw'umubiri

Hari igihe ubudahangarwa bwacu bw'umubiri (uburyo buturinda indwara) butangira kwibeshya kwibasira uturemangingo dutukura tw'amaraso yacu. Ibi byitwa indwara yo mu bwoko bwa autoimmune hemolytic anemia (AIHA) . Iyi ni indwara idasanzwe. Hariho kandi ubwoko bw'iyi ndwara:

• Indwara ya agglutinine irimo ibicurane ( ibimenyetso birarushaho kwiyongera iyo umuntu ahuye n'ibicurane)
• Indwara ya agglutinine ishyushye

Izindi ndwara zishobora gutera AIHA zirimo Mycoplasma pneumonia , lymphoma , leukemia (izi ni ubwoko bwa kanseri), lupus, na rheumatoid arthritis (izi nazo ni indwara ziterwa n’ubwiyongere bw’umubiri).

Izindi ndwara zitari iz’ubwirinzi bw’umubiri:

• Hemoglobiniyuriya irimo ibicurane bya Paroxysmal
• Hemoglobini yo mu rukerera itera indwara ya paroxysmal nijoro

3. Kwandura indwara

Hari udukoko, virusi na bagiteri byinjira mu mibiri yacu bishobora kwangiza uturemangingo dutukura tw’amaraso, bikadusenya mbere yuko dusimburwa. Urugero rwiza rw’ibi ni malariya . Udukoko dutera malariya twibasira uturemangingo dutukura tw’amaraso mu buryo butaziguye.

Izindi mpamvu zitera kwandura:

• Babesiosis
• Indwara ya Carrion
• Umuriro w'amabara ya Rocky Mountain
• Ibicurane bya Haemophilus
• Virusi itera SIDA (HIV)

4. Imiti imwe n'imwe

Imiti imwe n'imwe dufata ishobora kandi, nubwo idakunze kubaho cyane, gutuma ubudahangarwa bwacu bw'umubiri butera uturemangingo dutukura no kutwica vuba. Ibi byitwa anemia y'ubudahangarwa bw'umubiri iterwa n'imiti (DIHA) . Ibi ni gake cyane.

Imiti imwe ishobora gutera hemolysis:

• Acetaminophen ( parasetamol)
• Amwe mu ma antibiyotike ya cephalosporin
• Clopidogrel
• Dapsone
• Heparin
• Levodopa
• Levofloxacin
• Methyldopa
• Nitrofurantoin
• Penicilline
• Phenazopiridine
• Quinidine
• Quinine
• Rifampine
• Sulfonamides zimwe na zimwe

Icy'ingenzi: Ntugahangayikishwe n'uru rutonde rw'imiti. Iyi miti ntabwo itera hemolysis. Niba muganga yakwandikiye iyi miti, kurikiza amabwiriza ye. Niba ufite ikibazo, vugana na muganga wawe.

5. Ingorane mu gihe cyo gutwita

Ingorane zimwe na zimwe mu gihe cyo gutwita zishobora gutuma uturemangingo dutukura dushwanyagurika vuba.

• Indwara ya HELLP
• Preeclampsia
• Eclampsia

Kubera ko izi ari indwara zikomeye zishobora kubaho mu gihe utwite, ni ngombwa kwihutira gushaka inama kwa muganga mu gihe ibimenyetso bigaragaye.

6. Ibikoresho byo kwa muganga n'uburyo bwo kuvura

Ibi nabyo ntibikunze kubaho. Kubura amaraso mu mubiri bishobora kubaho iyo ibikoresho bimwe na bimwe by’ubuvuzi byashyizwe mu mubiri, cyangwa mu gihe cy’ubuvuzi bumwe na bumwe, kugeza igihe umubiri uzaba wabimenye.

• Hemodialysis ku barwayi b'impyiko
• Imashini ikoresha umutima n'ibihaha (ikoreshwa mu kubaga bikomeye)
• Gusimbuza imiyoboro y'umutima
• Ibindi bikoresho bikoreshwa mu ndwara nko kunanirwa k'umutima, urugero nk'imashini zikoresha imiyoboro y'amaraso yo mu mutima (intra-aortic balloon pumps) n'ibikoresho bya Impella .
• Guterwa amaraso (nk'igihe hatanzwe amaraso adahuye n'ayo umuntu ahabwa)

7. Uburozi n'uburozi

Uburozi bumwe na bumwe, iyo bunyowe, bushobora kwangiza uturemangingo dutukura tw’amaraso no gutera hemolysis.

• Arsenic
• Umuringa ( iyo unyoye byinshi)
• Umuyobozi
• Arsine ( imyuka y'uburozi)
• Stibine ( imyuka y'uburozi)
• Ubumara bw'inzoka

Byongeye kandi, indwara iyo ari yo yose ituma urwagashya rukora cyane (hypersplenism) na yo ishobora gutera hemolysis. Mu buryo nk'ubwo, umuvuduko w'amaraso uri hejuru cyane ushobora gutuma uturemangingo dutukura ducika uko amaraso agenda mu miyoboro y'amaraso vuba cyane.

Ni ibihe bimenyetso by'indwara yo gucika kw'amaraso mu maraso?

Ibimenyetso biterwa n'uburyo uturemangingo tw'amaraso dutukura turi hasi cyane. Niba uturemangingo tw'amaraso dutukura turi hasi cyane, ushobora kutagaragaza ibimenyetso. Akenshi, ibimenyetso bibaho kubera ko uturemangingo n'ingingo z'umubiri bitabona ogisijeni ihagije bitewe n'uko uturemangingo tw'amaraso dutukura turi hasi cyane.

Ibimenyetso bisanzwe:

• Umunaniro
• Kuzungera
• Uruhu rwerurutse
• Umutima utera cyane / tachycardia
• Kubura umwuka / kubura umwuka
• Guhinduka umuhondo k'uruhu n'umweru by'amaso (Jaundice) (Ibi biterwa no kwirundanya kwa bilirubin, ikintu gisohoka iyo uturemangingo dutukura tw'amaraso twangiritse, mu maraso)
• Uduheri twinshi / splenomegali

Ibimenyetso bimwe na bimwe bishobora gutandukana bitewe n’indwara runaka itera hemolysis. Urugero, umuntu urwaye indwara y’ibicurane ya agglutinine ashobora kugira ikibazo cyo kugabanuka kw’amaraso mu ntoki no mu mano, bigatuma ahinduka ubururu kandi agacika intege (Raynaud's phenomenon) .

Ni ibihe bizamini bikorwa kugira ngo hamenyekane niba hari ibibazo bifitanye isano no gucika kw'amaraso mu maraso?

Muganga azagufata icyitegererezo cy'amaraso yawe maze agukorere ibizamini byinshi kugira ngo arebe niba uturemangingo dutukura dufite amaraso make duterwa no kubura amaraso mu mubiri.

• Umubare wuzuye w'amaraso (CBC): Ibi bishobora kukubwira byinshi ku bwoko bwose bw'uturemangingo mu maraso yawe, cyane cyane uturemangingo dutukura tw'amaraso yawe. Bishobora kugenzura ibintu nk'urugero rwa hemoglobin yawe n'umwanya uturemangingo dutukura tw'amaraso yawe dufata mu maraso yawe (hematocrit).
• Umubare wa reticulocyte: Iki ni kimwe mu bipimo bya CBC. Reticulocyte ni uturemangingo dushya tw’amaraso dutukura tutarakura neza. Iyo habayeho hemolysis, umubare wa reticulocyte ushobora kwiyongera uko umubiri wihutisha ikorwa ry’uturemangingo dushya kugira ngo dusimbure utwangiritse.
• Gupima amaraso mu buryo budasanzwe: Iki kizamini gishobora gusuzuma ko hari ibitagenda neza mu miterere n'ingano y'uturemangingo tw'amaraso yawe. Uturemangingo dufite imiterere idasanzwe dushobora kwangirika vuba.
• Lactate dehydrogenase (LDH): LDH ni enzyme iboneka mu turemangingo dutukura tw'amaraso. Iyo uturemangingo dutukura tw'amaraso twangiritse vuba kurusha uko bisanzwe, urugero rwa LDH mu maraso rushobora kwiyongera.
• Ikizamini cya Haptoglobin: Haptoglobin ni poroteyine ifitanye isano na hemoglobine. Iyo uturemangingo dutukura tw’amaraso twangiritse (nk’uko bigenda mu maraso), hemoglobine nyinshi irekurwa mu maraso. Igipimo cya Haptoglobin kigabanuka.
• Bilirubini idafatanye: Bilirubini ikorwa iyo hemoglobine iri mu turemangingo dutukura tw’amaraso ivunitse. Ingano nyinshi ya bilirubini mu maraso igaragaza ko umubare munini w’uturemangingo dutukura tw’amaraso uri kwangirika (ibi nibyo bitera indwara y’umuhondo).
• Ikizamini cya Coombs kitaziguye: Iki kizamini gishobora kumenya niba ufite uturemangingo tw’umubiri dufata ku turemangingo tw’amaraso dutukura hanyuma kikadusenya vuba (ibi bishobora gufasha gusuzuma indwara nka AIHA).

Byongeye kandi, umuganga ashobora gukora isuzuma ry'inkari kugira ngo arebe niba amaraso na bilirubini biri mu nkari zawe, ibyo bikaba bishobora kuba ibimenyetso by'indwara yitwa hemolytic anemia.

Hemolysis ivurwa ite?

Uburyo bwo kuvura buzaterwa n'impamvu yateye kuva amaraso mu maraso yawe n'uburemere bw'ibimenyetso byawe. Uburyo bwo kuvura bushobora kuba burimo vitamine, imiti, kubagwa no guterwa amaraso.

Igikuru ni ukuganira na muganga wawe ku bijyanye n'ubuvuzi bukubereye, hashingiwe ku ndwara warwaye.

Imibiri yacu ihora igerageza kugumana umubare ukwiye w’uturemangingo dutukura tw’amaraso. Ariko, indwara zandura, indwara twavukanye, n’ingaruka zo hanze y’umubiri bishobora kubangamira iyi gahunda bigatuma uturemangingo dutukura twangirika vuba cyane. Kubera iyo mpamvu, hashobora kubaho kugabanuka kw’uturemangingo dutukura tw’amaraso, bigatera indwara yo kubura amaraso mu maraso.

Ariko, inkuru nziza ni uko impamvu nyinshi zitera hemolysis zishobora kuvurwa. Iyo umuganga amaze kumenya icyateye hemolysis yawe, azaguha uburyo bwo kugufasha kongera umubare w’uturemangingo dutukura tw’amaraso yawe.

Ibintu by'ingenzi ugomba kwibuka (Ubutumwa bwo kujyana mu rugo)

• Hemolysis ni ukurimbuka kw'uturemangingo dutukura tw'amaraso imburagihe.
• Ibi bishobora gutera ibimenyetso nko kunanirwa cyane, isereri, no guhinduka umuhondo w'uruhu (jaundice) .
• Hari impamvu nyinshi zishobora guterwa n’izi: inenge mu turemangingo dutukura tw’amaraso ubwatwo, ibibazo by’ubudahangarwa bw’umubiri, indwara zandura, imiti imwe n’imwe, ingorane mu gihe cyo gutwita, n’ibindi.
• Niba ufite ibi bimenyetso, shakisha inama kwa muganga .
• Gupima amaraso bishobora gufasha kumenya icyabiteye no gutanga ubuvuzi bukwiye.
• Impamvu nyinshi zishobora kuvurwa kugira ngo hagarurwe urugero rw'uturemangingo dutukura mu maraso. Bityo rero, ni ngombwa kudatinya no gushaka ubuyobozi bukwiye kwa muganga.

Ndizera ko aya makuru azaba ingirakamaro. Komeza ugire ubuzima bwiza!

Hemolysis , uturemangingo dutukura tw'amaraso, kubura amaraso, urwagashya, umwongo w'amagufwa, umuhondo w'umuhondo, ibizamini by'amaraso