Ingaba iiseli zakho zegazi ziyawohloka ngokukhawuleza? Masithethe nge-hemolysis!

Ngaba ngamanye amaxesha uziva udiniwe kwaye unesiyezi? Okanye ngamanye amaxesha uziva ngathi ulusu lwakho lutyheli kancinci, kwaye amhlophe emehlweni akho atyheli? Oku kusenokuba yinto enxulumene neeseli zakho ezibomvu zegazi, enye yezona ntlobo zibalulekileyo zeeseli egazini lakho. Namhlanje siza kuthetha ngemeko ebizwa ngokuba yi -hemolysis , apho iiseli ezibomvu zegazi ziqhekeka khona kwaye zitshatyalaliswe ngaphambi kwexesha. Ungakhathazeki, kubalulekile ukuqaphela oku.

Yintoni kanye kanye i-hemolysis?

Ngamafutshane, i-hemolysis kukutshatyalaliswa kweeseli ezibomvu zegazi emzimbeni wethu . Uyazi, ezi seli zibomvu zegazi zifana nabasebenzi abancinci egazini lethu. Zizo ezithatha ioksijini emiphungeni xa siphefumla size siyithumele kuzo zonke ezinye iiseli kunye nezicubu emzimbeni. Kufana nokuzisa isilinda segesi ekhaya. Ngoko ke, umzimba wethu usebenzisa le oksijini ukuvelisa amandla owadingayo. Kwakhona, ezi seli zibomvu zegazi zinceda ekuthwaleni i-carbon dioxide engafunekiyo eqokelelana emzimbeni wethu ibuyele emiphungeni ize iyikhuphe.

Ngokwesiqhelo, imizimba yethu isoloko itshabalalisa iiseli ezibomvu zegazi ezindala okanye ezibuthathaka ize izithathele indawo ngeeseli ezibomvu zegazi ezintsha neziphilileyo. Oku kufana nokususa ezindala uze ufumane ezintsha. Lo mjikelo wokutshatyalaliswa nokuveliswa yingakho sisoloko sinenani elifanelekileyo leeseli ezibomvu zegazi emizimbeni yethu.

Nangona kunjalo, ngamanye amaxesha ezi seli zibomvu zegazi ziqala ukubola ngaphambi kwexesha, oko kukuthi, ngokukhawuleza kakhulu . Oku kunokwenzeka ngaphambi kokuba imizimba yethu ibe nexesha lokwenza iiseli ezintsha ukuvala umsantsa. Oku kutshatyalaliswa ngokukhawuleza kweeseli ezibomvu zegazi kubizwa ngokuba yi-hemolysis. Ukuba inani leeseli ezibomvu zegazi emzimbeni liyancipha kakhulu ngenxa yokubola, sibiza loo meko ngokuba yi-hemolytic anemia , okanye i-anemia.

Kutheni iiseli ezibomvu zegazi zitshatyalaliswa ngolu hlobo?

Iseli ebomvu yegazi idla ngokuhlala malunga neentsuku ezili-120. Ekupheleni kweli xesha, xa ezo seli zigugile, zikhupha iimpawu ezikhethekileyo. Ezi zimpawu zibangela ukuba i-spleen (ekwicala lasekhohlo lesisu) emzimbeni wethu itshabalalise ezi seli zindala ngendlela ehlelekileyo. Njengokuba sisusa ifenitshala endala, ephukileyo endlwini yethu.

Iiseli ezibomvu zegazi ezintsha zenziwa kwindawo ethambileyo yamathambo ethu ebizwa ngokuba yi-bone marrow . Iiseli ezibomvu zegazi ezintsha ezenziwe kulo mongo wethambo emva koko zikhutshwa ziye egazini.

Nangona kunjalo, ngamanye amaxesha isiphene kwimo okanye ukwakheka kweseli ebomvu yegazi sinokunciphisa ubomi bayo. Okanye, iiseli ezibomvu zegazi zinokonakala zizinto zangaphandle kwaye zife ngaphambi kokuba umzimba ukwazi ukwenza iiseli ezintsha.

Ziziphi iintlobo eziphambili ze-hemolysis?

I-Hemolysis inokwahlulwa ibe ziintlobo ezimbini eziphambili. La magama abhekisa apho iiseli ezibomvu zegazi zitshatyalaliswa khona.

1. I-Extravascular hemolysis: Oku kwenzeka xa iiseli ezibomvu zegazi zitshatyalaliswa ngaphandle kwemithambo yegazi yethu (oko kukuthi, imithambo yegazi, imithambo yegazi, kunye nee-capillaries). Oku kwenzeka rhoqo kwi -spleen . Njengoko igazi lidlula kwi-spleen, uhlobo oluthile lweeseli ezimhlophe zegazi ezibizwa ngokuba zii-macrophages (ezi zifana noonogada bomzimba wethu) ziyazibona iiseli ezibomvu zegazi ezindala, ezonakeleyo kwaye ziyazitshabalalisa.

2. I-Intravascular hemolysis: Oku kuxa iiseli ezibomvu zegazi zitshatyalaliswa ngaphakathi kwemithambo yegazi. Xa zitshatyalaliswa, iziqwenga zezo seli zihamba emzimbeni wonke kunye negazi lethu.

Zithini izizathu ze-hemolysis?

Akukho nto inye kuphela ebangela i-hemolysis, kodwa kukho izinto ezininzi ezinokuyichaphazela. Makhe sijonge ngokweenkcukacha ezithe vetshe.

1. Iziphene kwiiseli ezibomvu zegazi ngokwazo

Ngamanye amaxesha, ukuba kukho ukungaqheleki okanye isiphene kwimo okanye kwisakhiwo seseli ebomvu yegazi, loo seli inokutshatyalaliswa ngokukhawuleza. Iziphene ezinjalo zihlala zibangelwa zizifo ezithile zokuzalwa, okanye ezizuzwe njengelifa .

• Ukungazinzi kwe-hemoglobin: I-hemoglobin yiproteni enceda ekuthwaleni ioksijini ngaphakathi kwiiseli ezibomvu zegazi. Iimeko ezibangela oku kungazinzi ziquka i-sickle cell anemia (apho iiseli ezibomvu zegazi zitshintsha zibe yimilo efana neyesickle) kunye ne-thalassemia .
• Ukunqongophala kwee-enzyme: Le meko inokwenzeka naxa ii-enzyme ezithile ezifunekayo ekusebenzeni kweeseli ezibomvu zegazi zingekho. Imizekelo ibandakanya ukunqongophala kwe-G6PD kunye nokunqongophala kwe-pyruvate kinase .
• Iziphene zeMembrane: Iimeko apho kukho iziphene kwisigqubuthelo sangaphandle seeseli ezibomvu zegazi, i-membrane yeseli. Imizekelo ibandakanya i-spherocytosis yelifa ( iiseli ziba yi-sphere) kunye ne-elliptocytosis yelifa (iiseli ziba zinde).

2. Izifo ezinxulumene nenkqubo yomzimba yokuzikhusela

Ngamanye amaxesha inkqubo yethu yokuzikhusela (inkqubo esikhusela kwizifo) iqala ngempazamo ukuhlasela iiseli zethu ezibomvu zegazi. Oku kubizwa ngokuba yi-autoimmune hemolytic anemia (AIHA) . Le yimeko engaqhelekanga. Kukwakho neentlobo zale meko:

• Isifo se-cold agglutinin ( iimpawu ziya zisiba mbi xa zibonakaliswa ngumkhuhlane)
• Isifo se-agglutinin esifudumeleyo

Ezinye iimeko ezinokubangela i-AIHA ziquka iMycoplasma pneumonia , i-lymphoma , i-leukemia (ezi ziintlobo zomhlaza), i-lupus, kunye ne -rheumatoid arthritis (ezi zikwazifo ezizikhusela ngokwazo).

Ezinye iimeko ezingezizo ezokuzikhusela komzimba:

• I-hemoglobinuria ebandayo ye-Paroxysmal
• I-Paroxysmal nocturnal hemoglobinuria

3. Iintsholongwane

Ezinye iiparasite, iintsholongwane, kunye neebhaktheriya ezingena emizimbeni yethu zingonakalisa iiseli zethu ezibomvu zegazi, zizitshabalalise ngaphambi kokuba ziphinde zitshintshwe. Umzekelo omhle woku yimalariya . Iparasite ebangela umalaleriya ihlasela ngokuthe ngqo iiseli ezibomvu zegazi.

Ezinye izizathu zosulelo:

• I-Babesiosis
• Isifo sikaCarrion
• Umkhuhlane onamabala eentaba zaseRocky
• Umkhuhlane weHaemophilus
• Intsholongwane yokungakwazi ukuzikhusela komzimba womntu (i-HIV)

4. Amanye amayeza

Amanye amayeza esiwasebenzisayo, nangona engaqhelekanga, anokuvuselela amajoni ethu omzimba ukuba ahlasele iiseli ezibomvu zegazi aze azitshabalalise ngokukhawuleza. Oku kubizwa ngokuba yi-drug-induced immune hemolytic anemia (DIHA) . Oku kunqabile kakhulu.

Amanye amayeza anokubangela i-hemolysis:

• I-Acetaminophen ( i-paracetamol)
• Amanye amayeza okubulala iintsholongwane e-cephalosporin
• I-Clopidogrel
• I-Dapsone
• I-Heparin
• I-Levodopa
• I-Levofloxacin
• I-Methyldopa
• I-Nitrofurantoin
• I-Penicillin
• I-Phenazopyridine
• I-Quinidine
• I-Quinine
• I-Rifampin
• Ezinye ii-sulfonamides

Kubalulekile: Musa ukothuka lolu luhlu lwamayeza. La mayeza awafane abangele i-hemolysis. Ukuba ugqirha ukunike la mayeza, landela imiyalelo yakhe. Ukuba unemibuzo, thetha nogqirha wakho.

5. Iingxaki ngexesha lokukhulelwa

Ezinye iingxaki ngexesha lokukhulelwa zinokubangela ukuba iiseli ezibomvu zegazi ziqhekeke ngokukhawuleza.

• isifo se-HELLP
• I-Preeclampsia
• I-Eclampsia

Ngenxa yokuba ezi ziimeko ezinzima ezinokwenzeka ngexesha lokukhulelwa, kubalulekile ukufuna ingcebiso kagqirha ngokukhawuleza ukuba iimpawu ziyavela.

6. Izixhobo zonyango kunye nonyango

Oku nako kunqabile. I-Hemolysis inokwenzeka xa izixhobo ezithile zonyango zifakelwe emzimbeni, okanye ngexesha lonyango oluthile, de umzimba uziqhelanise nazo.

• I-Hemodialysis kwizigulana zezintso
• Umatshini wokudlula intliziyo nemiphunga (osetyenziswa kwiindlela ezinkulu zotyando)
• Ukutshintshwa kweevalvu zentliziyo
• Ezinye izixhobo ezisetyenziswa kwiimeko ezifana nokusilela kwentliziyo, umzekelo iimpompo zebhaluni ze-intra-aortic kunye nezixhobo ze-Impella .
• Utofelo-gazi (njengaxa kunikwa igazi elingahambelaniyo)

7. Iityhefu kunye neetyhefu

Ezinye iityhefu, xa zityiwe, zingonakalisa iiseli ezibomvu zegazi kwaye zibangele i-hemolysis.

• I-Arsenic
• I-Copper ( ukuba ityiwe kakhulu)
• Inkokeli
• I-Arsine ( igesi enobuthi)
• I-Stibine ( igesi enobuthi)
• Ityhefu yenyoka

Ukongeza, nayiphi na imeko apho i-spleen isebenza kakhulu (hypersplenism) inokubangela i-hemolysis. Ngokufanayo, uxinzelelo lwegazi oluphezulu kakhulu lunokubangela ukuba iiseli ezibomvu zegazi ziqhekeke njengoko igazi lihamba ngemithambo yegazi ngokukhawuleza.

Zithini iimpawu ze-hemolysis?

Iimpawu zixhomekeke ekubeni inani leeseli ezibomvu zegazi lakho liphantsi kangakanani. Ukuba inani leeseli ezibomvu zegazi lakho aliphantsi kakhulu, usenokungabi nazo naziphi na iimpawu. Uninzi lwexesha, iimpawu zenzeka kuba iiseli zomzimba kunye nezicubu azifumani ioksijini eyaneleyo ngenxa yokuba inani leeseli ezibomvu zegazi liphantsi.

Iimpawu eziqhelekileyo:

• Ukudinwa
• Isiyezi
• Ulusu olukhanyayo
• Intliziyo ebetha ngamandla/i-tachycardia
• Ukuphefumla nzima/ukuphelelwa ngamandla
• Ukutyheli kolusu kunye namhlophe emehlweni (i-Jaundice) (Oku kubangelwa kukuqokelelana kwe-bilirubin, into ekhutshwa xa iiseli ezibomvu zegazi ziqhekeka, egazini)
• I-spleen ekhulisiweyo / i-splenomegaly

Ezinye iimpawu zinokwahluka ngokuxhomekeke kwimeko ethile ebangela i-hemolysis. Umzekelo, umntu onesifo se-cold agglutinin unokufumana ukuhamba kwegazi okunciphileyo kwiinwele zeminwe kunye neenzwane, okubangela ukuba ajike abe luhlaza okwesibhakabhaka aze abe ndindisholo (into kaRaynaud) .

Zeziphi iimvavanyo ezenziwayo ukuze kuchongwe ukuba kukho iingxaki ezinxulumene ne-hemolysis?

Ugqirha uza kuthatha isampuli yegazi lakho aze enze iimvavanyo ezininzi ukuze abone ukuba iiseli zakho ezibomvu ezisezantsi zibangelwa yi-hemolysis.

• Ubalo lwegazi olupheleleyo (CBC): Oku kunokukuxelela okuninzi malunga nazo zonke iintlobo zeeseli egazini lakho, ingakumbi iiseli zakho ezibomvu zegazi. Kunokujonga izinto ezifana nenqanaba le-hemoglobin yakho kunye nokuba iiseli zakho ezibomvu zegazi zithatha indawo engakanani egazini lakho (i-hematocrit).
• Inani lee-reticulocyte: Eli liyinxalenye yovavanyo lwe-CBC. Ii-reticulocyte ziiseli ezibomvu zegazi ezisandula ukwenziwa ezingakavuthwa ngokupheleleyo. Xa kukho i-hemolysis, inani lee-reticulocyte linokwanda njengoko umzimba ukhawulezisa ukuveliswa kweeseli ezintsha ukuze zithathe indawo yezo zitshatyalalisiweyo.
• I-smear yegazi engaphandle: Olu vavanyo lunokujonga ukungaqheleki kwimilo nobukhulu beeseli zakho zegazi. Iiseli ezimile ngendlela engaqhelekanga zinokutshatyalaliswa ngokukhawuleza.
• I-Lactate dehydrogenase (LDH): I-LDH yi-enzyme efumaneka ngaphakathi kwiiseli ezibomvu zegazi. Xa iiseli ezibomvu zegazi ziqhekeka ngokukhawuleza kunesiqhelo, amanqanaba e-LDH egazini anokunyuka.
• Uvavanyo lweHaptoglobin: IHaptoglobin yiproteni enxulunyaniswa nehemoglobin. Xa iiseli ezibomvu zegazi ziqhekekile (njengakwi-hemolysis), inani elikhulu lehemoglobin likhutshwa egazini. Amanqanaba eHaptoglobin ayancipha.
• I-bilirubin engadibaniyo: I-Bilirubin iveliswa xa i-hemoglobin kwiiseli ezibomvu zegazi iqhekeka. Amanqanaba aphezulu e-bilirubin egazini abonisa ukuba inani elikhulu leeseli ezibomvu zegazi liyatshatyalaliswa (yile nto ibangela i-jaundice).
• Uvavanyo lwe-Direct Coombs: Olu vavanyo lunokufumanisa ukuba unazo na ii-antibodies ezinamathela kwiiseli zakho ezibomvu zegazi kwaye zikhawuleze zitshabalalise (oku kunokunceda ekuchongeni iimeko ezifana ne-AIHA).

Ukongeza, ugqirha angenza uvavanyo lomchamo ukujonga igazi kunye ne-bilirubin kumchamo wakho, nto leyo enokuba ziimpawu zesifo esibizwa ngokuba yi-hemolytic anemia.

Iphathwa njani i-hemolysis?

Unyango lwakho luya kuxhomekeka kwisizathu se-hemolysis yakho kunye nokuba iimpawu zakho zinzima kangakanani. Iindlela zonyango zingabandakanya iivithamini, amayeza, utyando kunye notofelo-gazi.

Eyona nto ibalulekileyo kukuthetha nogqirha wakho malunga nonyango olulungele wena, ngokusekelwe kwisifo sakho.

Imizimba yethu isoloko izama ukugcina inani elifanelekileyo leeseli ezibomvu zegazi. Nangona kunjalo, usulelo, izifo zokuzalwa, kunye neempembelelo zangaphandle zinokuphazamisa le nkqubo kwaye zibangele ukuba iiseli ezibomvu zegazi zitshatyalaliswe ngokukhawuleza. Ngenxa yoko, ukwehla kweeseli ezibomvu zegazi kunokwenzeka, okukhokelela kwi-hemolytic anemia.

Nangona kunjalo, iindaba ezimnandi zezokuba uninzi lwezizathu ze-hemolysis zinokunyangwa. Nje ukuba ugqirha afumanise unobangela we-hemolysis yakho, uza kukunika unyango oluza kunceda ukubuyisela inani leeseli zakho ezibomvu zegazi kwimeko eqhelekileyo.

Izinto ezibalulekileyo ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

• I-Hemolysis kukutshatyalaliswa kwangaphambi kwexesha kweeseli ezibomvu zegazi.
• Oku kunokubangela iimpawu ezinje ngokudinwa kakhulu, isiyezi, kunye nokutyheli kolusu (i-jaundice) .
• Zininzi izinto ezibangela oku; iziphene kwiiseli ezibomvu zegazi ngokwazo, iingxaki zenkqubo yomzimba yokuzikhusela, usulelo, amayeza athile, iingxaki ngexesha lokukhulelwa, nokunye.
• Ukuba unale mpawu, qiniseka ukuba ucela uncedo lwezonyango .
• Uvavanyo lwegazi lunokunceda ekufumaneni unobangela kwaye lubonelele ngonyango olufanelekileyo.
• Zininzi izinto ezinokunyangwa ukuze kubuyiselwe amanqanaba eeseli ezibomvu zegazi. Ngoko ke kubalulekile ukuba ungoyiki kwaye ufune ulwalathiso olufanelekileyo lwezonyango.

Ndiyathemba ukuba olu lwazi uza kulufumana luluncedo. Hlala usempilweni!

I- Hemolysis, iiseli ezibomvu zegazi, i-anemia, i-spleen, umongo wethambo, i-jaundice, uvavanyo lwegazi