Ngaba uvakalelwa kukuba uneeseli ezibomvu zegazi ezininzi kakhulu? Masithethe nge-erythrocytosis!

Ngaba ngamanye amaxesha uziva udiniwe, uneentloko ezibuhlungu, okanye uzive ubuthathaka? Sihlala singazinaki kakhulu ezi zinto zincinci, akunjalo? Nangona kunjalo, ukuba inani leeseli ezibomvu emzimbeni wakho liyanda ngaphaya kwenqanaba elicetyiswayo, elibizwa ngoogqirha ngokuba yi-erythrocytosis okanye i-polycythemia , ezi mpawu zinokuvela. Le yinto ekufuneka ukhathazeke ngayo ngamanye amaxesha. Ngoko ke, namhlanje siza kuthetha ngokweenkcukacha malunga nokuba yintoni i-erythrocytosis, kutheni isenzeka, kunye nento enokwenziwa ngayo.

Yintoni kanye kanye i-erythrocytosis?

Ngamafutshane, i-Erythrocytosis iyenzeka xa igazi lakho linomlinganiselo ophezulu kunesiqhelo weeSeli zeGazi eziBomvu (ii-Erythrocytes). Njengoko usazi, igazi lethu lenziwe ngamacandelo amabini. Elinye licandelo eliqinileyo, eliziiseli zegazi ezibomvu, iiseli zegazi ezimhlophe, kunye neeplatelets. Elinye licandelo elilulwelo, esilibiza ngokuba yiplasma. Kwi-erythrocytosis, inani leeseli zegazi ezibomvu liyanda xa kuthelekiswa necandelo elilulwelo, eliyiplasma.

Ukuba ufumana uvavanyo lwegazi, uza kubona amaxabiso amabini kwingxelo: iHematocrit kunye neHemoglobin .

• I-Hematocrit (HCT): Oku kukuxelela ukuba yipesenti engakanani yegazi lakho eyenziwe ziiseli ezibomvu zegazi.
• I-Hemoglobin (HB): Le yiproteni ebaluleke kakhulu efumaneka ngaphakathi kwiiseli ezibomvu zegazi ezithwala ioksijini emizimbeni yethu.

Kwi-erythrocytosis, nokuba yeyiphi okanye zombini ezi hematocrit kunye ne-hemoglobin values ​​​​zinokuba phezulu kunesiqhelo.

Oku kwanda kweeseli ezibomvu zegazi kuwuchaphazela njani umzimba?

Iiseli ezibomvu zegazi zibalulekile emizimbeni yethu. Zithwala ioksijini esuka emiphungeni ukuya kuzo zonke iiseli kunye nezicubu zomzimba. Yiyo loo nto izicubu zethu zondliwe kwaye zisempilweni.

Nangona kunjalo, ukuba ezi seli zibomvu zegazi zanda kakhulu, iingxaki zinokubakho. Kuxhomekeke kwisizathu sokonyuka kweeseli ezibomvu zegazi. Ezinye iziphumo zincinci kakhulu. Usenokuziva izinto ezifana nentloko ebuhlungu kunye nokudinwa. Nangona kunjalo, ukuba iiseli ezibomvu zegazi zanda ngezizathu ezithile ezinzulu, igazi liqala ukujiya. Emva koko kukho umngcipheko weemeko eziyingozi ezifana nokuqhekeka kwegazi, ukuhlaselwa yintliziyo okanye isifo sohlangothi .

Yiyo loo nto, ukuba uneempawu ezinjalo, kubaluleke kakhulu ukubona ugqirha ukuze ufumane unobangela ochanekileyo. Kulapho kuphela apho unokufumana unyango olufanelekileyo, unciphise iimpawu, okanye uthintele iimeko eziyingozi.

Ziziphi iintlobo eziphambili ze-erythrocytosis?

I-Erythrocytosis inokwahlulwa ibe ziintlobo ezimbini ngokuxhomekeke kwindlela ezi seli ezibomvu ezikhula ngayo:

1. I-Absolute Erythrocytosis: Oku kuxa inani leeseli ezibomvu zegazi eziveliswa emzimbeni wakho liphezulu kunesiqhelo.

2. I-Relative Erythrocytosis: Kulapho inani leeseli ezibomvu zegazi linokuba liqhelekileyo, kodwa ubungakanani beplasma egazini buyancipha, ngoko ke uxinaniso lweeseli ezibomvu zegazi lubonakala lunyukile. Umzekelo, ukuba uhlanza kakhulu kwaye unesifo sohudo kwaye ulahlekelwe ngamanzi amaninzi emzimbeni wakho, ulwelo lwegazi lakho luyehla. Le meko inokwenzeka ngamaxesha anje.

I-Absolute Erythrocytosis yahlulwe kabini, kuxhomekeke kwisizathu:

I-Erythrocytosis ephambili

Ingxaki ikumongo wethu wethambo. Njengoko usazi, umongo wethambo ngumthombo oyintloko emzimbeni wethu owenza iiseli ezibomvu zegazi. Ngoko ke, kule erythrocytosis iphambili, ngenxa yesiphene semfuza kwiiseli ze-stem (iiseli zokuzalwa) kumongo wethambo, ukuveliswa kweeseli ezibomvu zegazi kuyanda ngokungalawulekiyo. Esi siphene semfuza sinokufunyanwa njengelifa (njengesiphene sokuzalwa), okanye sinokwenzeka nakwixesha lobomi.

• I-Acquired Primary Erythrocytosis: Umzekelo omhle wale meko yimeko ebizwa ngokuba yiPolycythemia Vera . Abantu abaninzi babhidanisa i-Erythrocytosis kunye nePolycythemia Vera njengesifo esifanayo. Nangona kunjalo, azifani. I-Polycythemia Vera yimeko ethile kwaye imbi kakhulu ebangela i-Erythrocytosis.
• I-Erythrocytosis Ephambili Ezuzwe Njengelifa: Ngamanye amaxesha, iziphene kwiijini ezizuzwe ngabazali zinokubangela ukuba umongo wethambo uvelise iiseli ezibomvu ezininzi kakhulu.

I-Erythrocytosis yesibini

Ingxaki apha ayikho kwi-bone mongo, kodwa ikwenye into engaphandle kwe-bone mongo. Uninzi lwexesha, i-secondary erythrocytosis ibangelwa kukuvelisa i-hormone eninzi ebizwa ngokuba yi-erythropoietin , okanye i-EPO . I-'EPO' sisithunywa seekhemikhali. Yiyo exelela i-bone mongo ukuba "yenze iiseli ezibomvu ezingaphezulu."

Khawucinge nje, unesifo semiphunga okanye isifo sentliziyo. Emva koko umlinganiselo weoksijini ofunyanwa ngumzimba uphantsi. Ngelo xesha, umzimba uzama ukwenza i-hormone ethi 'EPO' engaphezulu, kwaye ngayo, ivuselela umongo wethambo ukuba wenze iiseli ezibomvu ezingaphezulu. Kuba iiseli ezibomvu zithwala ioksijini. Nangona kunjalo, ukuba ukuveliswa kweeseli ezibomvu ngale ndlela kuyanda kakhulu, kubangela i-erythrocytosis yesibini. Le erythrocytosis yesibini inokubangelwa naziimeko ezithile zemfuza, kodwa ezo ziphene zemfuza azikho kwezo zikwimongo wethambo.

Uzijonga njani ixabiso legazi ukuze ubone ukuba unayo na i-erythrocytosis?

Enyanisweni, inqanaba loxinano lweeseli ezibomvu zegazi elithathwa njengeliqhelekileyo linokwahluka kumntu nomntu. Zininzi izinto ezichaphazela oku, kuquka ubudala bakho, nokuba uyindoda okanye ungumfazi, kunye nokuphakama kwendawo ohlala kuyo (nokuba ukwinqanaba lolwandle okanye kwindawo enentaba).

I-Erythrocytosis kubantu abadala idla ngokuchongwa ngokwanda kwe-hematocrit (HCT) kunye/okanye i-hemoglobin (HB). La maxabiso anokulinganiswa ngovavanyo lwegazi olubizwa ngokuba yi-``Complete Blood Count (CBC)``.

Kwamadoda:

• I-Hematocrit (HCT): Ukuba ingaphezulu kwe-50%
• I-Hemoglobin (HB): Ukuba ingaphezulu kwe-17.5 g/dL

Kwabasetyhini abangakhulelwanga:

• I-Hematocrit (HCT): Ukuba ingaphezulu kwe-45%
• I-Hemoglobin (HB): Ukuba ingaphezulu kwe-15.3 g/dL

Kubalulekile: La maxabiso asisikhokelo nje esiqhelekileyo. Ugqirha wakho uya kugqiba ngokuchanekileyo ukuba unayo na i-erythrocytosis emva kokuqwalasela impilo yakho iyonke.

Zithini izizathu ze-Relative Erythrocytosis?

Oku kubangelwa kukwehla komthamo wamanzi emzimbeni, nto leyo ebangela ukuba ulwelo lwegazi (iplasma) lunciphe kwaye ukwanda koxinzelelo lweeseli ezibomvu zegazi. Ngoko ke, esona sizathu soku kukuphelelwa ngamanzi emzimbeni .

• Ukuhlanza okukhulu
• Urhudo
• Amayeza athile, umzekelo, amayeza okukhupha amanzi emzimbeni (amayeza asusa amanzi emzimbeni) (La mayeza anikwa uxinzelelo lwegazi oluphezulu okanye ukugcinwa kolwelo emzimbeni).

Ngenxa yezizathu ezinjalo, ubungakanani bolwelo emzimbeni bunokuncipha kwaye bubangele i-erythrocytosis enxulumeneyo.

Ziziphi izizathu ze-Absolute Erythrocytosis?

Kukho izizathu ezimbini ezahlukeneyo zoku: eyokuqala neyesibini.

Izizathu ze-erythrocytosis ephambili:

Oku kudla ngokubangelwa sisiphene semfuza esichaphazela umongo wethambo.

• I-Polycythemia Vera kunye nezinye ii-Myeloproliferative Neoplasms: Ezi ziimeko apho umongo wethambo uvelisa iiseli ezibomvu zegazi kunye nezinye iiseli zegazi ngokugqithisileyo. I-Polycythemia Vera yeyona ixhaphakileyo kwezi.
• Iziphene zokuzalwa: Abanye abantu banokuzalwa benesiphene semfuza esibangela ukuba umongo wethambo uvelise iiseli ezibomvu zegazi ezininzi kakhulu.

Izizathu ze-erythrocytosis yesibini:

Oku kudla ngokubangelwa kukwanda kwehomoni ethi `EPO`.

• Iimeko ezinciphisa ioksijini kwizicwili:
• Isifo seMiphunga (umz. i-bronchitis engapheliyo, i-emphysema)
• Isifo sentliziyo (umz. iziphene zentliziyo zokuzalwa)
• Ukuphelelwa ngamandla kokulala
• I-Hemoglobinopathy: Ezi ziimeko apho iproteni ye-hemoglobin kwiiseli ezibomvu zegazi ingakwaziyo ukuthwala ioksijini ngokufanelekileyo ngenxa yesiphene.
• Izifo zezintso kunye nokufakelwa izintso:
• I-Renal Artery Stenosis (ukuncitshiswa kwemithambo yegazi ehambisa izintso)
• I-Hydronephrosis (ukudumba kwezintso ngenxa yokuqokelelwa komchamo)
• Le meko inokwenzeka ngamanye amaxesha nasemva kokufakelwa izintso.
• Iithumba: Ezinye iithumba ezinomhlaza nezingengomhlaza zinokukhupha i-EPO hormone engaphezulu.
• Iithumba ezinomhlaza: I-Renal Cell Carcinoma, i-Hemangioblastoma, i-Hepatocellular Carcinoma, i-Parathyroid Carcinoma.
• Izimila ezingezizo zomhlaza: Iifibroids zesibeleko, iPheochromocytoma, iMeningioma.
• Ukutyhefa nge-carbon monoxide kunye nokutshaya: Ukutshaya kakhulu kunokubangela ubuthi be-carbon monoxide, nto leyo enokunciphisa ioksijini kwizicubu.
• Amanye amayeza kunye neziyobisi:
• Ii-Anabolic Steroids (ezithathwa ngabadlali ukuze bonyuse amandla)
• Ukuthatha i-hormone ye-testosterone.

Ziziphi iimpawu umntu one-erythrocytosis anokuzibona?

Iimpawu ozifumanayo (nokuba zinzima kangakanani) zixhomekeke kwisizathu se-erythrocytosis yakho. Umzekelo, umntu one-erythrocytosis yesibini unokufumana iimpawu ezifana nezi:

• Intloko ebuhlungu
• Imeko yokudideka, imeko yobunzima bokugxila
• Ubunzima bokulala
• Ukuziva ubuthathaka, udiniwe

Umntu one-erythrocytosis yokuqala (ingakumbi i-polycythemia vera) unokufumana iimpawu eziqatha ngakumbi:

• Igazi elonyukayo
• Ukubila kakhulu ebusuku
• Ukunciphisa umzimba ngaphandle kwesizathu
• Intlungu ebuhlungu, ukudumba, kunye nokubomvu kwamalungu (okubizwa ngokuba yi -gout )
• Iingxaki zokopha (ukuphuma igazi rhoqo empumlweni, ukopha okanye ukukrweleka nokuba kukwenzakala okuncinci)
• Ulusu olurhawuzelelayo (ukurhawuzelela kunokwanda, ingakumbi emva kokuhlamba ngamanzi ashushu)
• Ubungqindilili emalungeni, ukuziva ngathi ziimbovane zibaleka zijikeleza
• Ubomvu kunye nokuvuvukala ebusweni, ezandleni nasezinyaweni.

Oogqirha baxilonga njani i-erythrocytosis?

Ugqirha wakho uza kuqala azame ukufumanisa unobangela wokubala kwakho iiseli ezibomvu zegazi kuphezulu, esebenzisa uvavanyo kunye neenkqubo ezahlukeneyo.

Okokuqala, baza kubuza imibuzo malunga nembali yakho yezonyango, amayeza owasebenzisayo, indlela ophila ngayo (umz., uyatshaya), kunye neempawu zakho, baze bajonge ukuba kukho i-erythrocytosis enxulumeneyo (ebangelwa kukwehla kweplasma egazini). Baza kwenza novavanyo lomzimba.

Into elandelayo ekufuneka uyijonge kukuba ingaba unayo na i-primary okanye i-secondary . Ungenza nezinye iimvavanyo ezimbalwa ngolwazi olukhankanyiweyo apha ngasentla.

Zeziphi iimvavanyo ezenziwayo?

• Ubalo lweGazi olupheleleyo (CBC): Oku kunokujonga inani leeseli zakho ezibomvu zegazi, i-hemoglobin (HB), kunye namanqanaba e-hematocrit (HCT).
• Ukutshiza igazi okujikeleze umzimba (PBS): Oku kuquka ukuthatha ithontsi legazi uze ujonge iiseli ngemicroscope ukuze ubone ukuba aziqhelekanga na ngokwemilo okanye ngobukhulu bazo. Ukuba unesifo esifana nePolycythemia Vera, unokubona iiseli ezingaqhelekanga.
• Uvavanyo Lokusebenza Kwezintso Nesibindi: Oku kunokunika umbono wokuba kukho isifo sezintso okanye ithumba elenza i-EPO eninzi.
• I-Pulse Oximetry: I-sensor encinci ebekwe emnweni ilinganisa inqanaba leoksijini egazini. Oku kunokunceda ekuqinisekiseni ukuba imeko ibangelwa zizinto ezifana nesifo sentliziyo okanye isifo semiphunga.
• Ukujonga inqanaba le-erythropoietin (EPO): Ukuba inqanaba le-`EPO` liphantsi, isenokuba yi-primary erythrocytosis, ukuba inqanaba le-`EPO` liphezulu, isenokuba yi-secondary erythrocytosis.
• Uvavanyo lomchamo: Kuthathwa isampulu yomchamo ukuze kuhlolwe ukuba akukho ziphene na. Ukuba kukho iiseli ezibomvu kumchamo, kusenokwenzeka ukuba kungenxa yesifo sezintso.

Ukuba ugqirha urhanela ukuba kukho imeko ethile, efana ne-polycythemia vera, angenza nezinye iimvavanyo, ezifana ne -bone marrow biopsy .

Iphathwa njani i-erythrocytosis?

Kwiimeko ezininzi, unobangela we-erythrocytosis awunakunyangwa ngokupheleleyo. Nangona kunjalo, unyango lunokulawula nokunciphisa iimpawu. Kwiimeko ze-erythrocytosis ebangelwa zizizathu ezinzulu, unyango lukwasetyenziselwa ukuthintela iimeko eziyingozi ezifana nokuqhekeka kwegazi.

• I-Phlebotomy okanye i-Venesection:

Olu lolona nyango luqhelekileyo lwe-polycythemia vera. Kufana nokunikela ngegazi, kodwa kubandakanya ukuthatha igazi elincinci emthanjeni kunye nokunciphisa inani leeseli ezibomvu zegazi kunye nomthamo wegazi ophezulu kakhulu. I-erythrocytosis yesibini ayisoloko ifuna olu nyango.

• Amayeza:
• Kubantu abasengozini enkulu yokuqhekeka kwegazi, ugqirha unokucebisa ukuba bathathe i-aspirin enesilinganiselo esiphantsi yonke imihla.
• Kukwakho namayeza anciphisa inani leeseli ezibomvu zegazi:
• I-Hydroxycarbamide `(Hydroxycarbamide)`
• I-Hydroxyurea `(Hydroxyurea)`
• IBusulfan
• I-Interferon alfa `(Interferon alfa)`
• I-Ruxolitinib

Ugqirha wakho uza kukunika amayeza afanelekileyo kwimeko yakho. Baza kukunika nonyango lwemeko engaphantsi, kuxhomekeke kwisizathu esibangela ukuba ube ne-erythrocytosis.

Ukuba ndinayo le meko, ndimele ndilindele ntoni?

Amava akho aya kuxhomekeka kwisizathu se-erythrocytosis yakho kunye nokuba imbi kangakanani. Umzekelo, ezinye iimeko zelifa ze-erythrocytosis eyintloko zibangela iimpawu ezincinci kwaye azisongeli ubomi. Nangona kunjalo, iimeko ezinzulu ngakumbi, ezifana ne-polycythemia vera, zinokufuna unyango lobomi bonke.

Ndingazinyamekela njani?

Eyona nto ibalulekileyo kukulandela imiyalelo kagqirha wakho ngokuchanekileyo. Okwangoku, kukho utshintsho oluthile kwindlela ophila ngayo olunokukunceda:

• Ukuba uyatshaya, yeka.
• Gcina ubunzima bomzimba busempilweni.
• Ukuba une-high blood pressure, yilawule.
• Kuphephe ukuhamba ukusuka kwinqanaba lolwandle ukuya kwiindawo eziphakamileyo kakhulu (iindawo ezineentaba) kangangoko kunokwenzeka.

Ndingaya nini esibhedlele ngokungxamisekileyo (ETU) ?

Ukuba unemeko enxulumene ne-erythrocytosis ekubeka emngciphekweni wokuqhekeka kwegazi, kubalulekile ukuba uqaphele iimpawu zokuqhekeka kwegazi. Ukuba ufumana naziphi na kwezi mpawu zilandelayo, funa uncedo lwezonyango ngokukhawuleza:

• I-Deep Vein Thrombosis (DVT): Ukudumba, iintlungu, kunye nokubomvu emlenzeni omnye.
• Ukuqhekeka kwegazi emiphungeni (Pulmonary Embolism - PE): Intlungu yesifuba, ubunzima bokuphefumla, ukuziva unesizungu.
• Istroke: Ukulahlekelwa yibhalansi ngequbuliso, ukulungelelaniswa komzimba, ubuthathaka bemisipha okanye ukuba ndindisholo kwelinye icala lomzimba.
• Ukuhlaselwa yintliziyo: Intlungu esifubeni, ukuphefumla nzima, ukuziva unesizungu, ukubila.

Ukuba unayo nayiphi na kwezi mpawu, nceda ubone ugqirha ngokukhawuleza ngaphandle kokulibazisa.

Okokugqibela, izinto ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

I-Erythrocytosis kukwanda kwenani leeseli ezibomvu zegazi egazini lakho. Oku kungaba yimeko encinci, okanye ngamanye amaxesha ingaba luphawu lwemeko enzima.

• Ukuba uneempawu ezingaqhelekanga (ingakumbi ukudinwa okungapheliyo, intloko ebuhlungu, ukurhawuzelela kolusu, ubunzima bokuphefumla), bona ugqirha.
• Ugqirha uza kufumanisa unobangela ochanekileyo wokubakho kweeseli ezibomvu zegazi eziphezulu.
• Ngamanye amaxesha, utshintsho olulula kwindlela ophila ngayo (umz., ukunciphisa amayeza owaselayo, ukunyanga ukuphelelwa ngamanzi emzimbeni) kunokusombulula le ngxaki.
• Ukuba i-erythrocytosis ibangelwa yimeko embi kakhulu, ugqirha wakho uza kukujonga rhoqo aze akunike unyango olufunekayo.

Ukunyamekela impilo yakho kubaluleke kakhulu, ngoko ke ukuba uneengxaki, ungoyiki ukuthetha nogqirha.

I- Erythrocytosis, i-polycythemia, iiseli ezibomvu zegazi, i-hemoglobin, i-hematocrit, ukujiya kwegazi, umongo wethambo