Ingabe unamaseli abomvu egazi amaningi kakhulu? Ake sixoxe nge-erythrocytosis!

Ingabe ngezinye izikhathi uzizwa ukhathele, uphethwe yikhanda, noma uzizwa ubuthakathaka? Ngokuvamile asizinaki kakhulu lezi zinto ezincane, akunjalo? Kodwa-ke, uma inani lamaseli abomvu egazi emzimbeni wakho likhuphuka ngaphezu kwezinga elinconywayo, okuyinto odokotela abayibiza ngokuthi i-erythrocytosis noma i-polycythemia , lezi zimpawu zingase zivele. Lokhu kuyinto okufanele ukhathazeke ngayo ngezinye izikhathi. Ngakho-ke, namuhla sizokhuluma ngokuningiliziwe ngokuthi iyini i-erythrocytosis, kungani yenzeka, nokuthi yini engenziwa ngayo.

Kuyini ngempela i-erythrocytosis?

Kalula nje, i-Erythrocytosis yilapho igazi lakho linenani eliphakeme kunejwayelekile lama-Red Blood Cells (ama-Erythrocytes). Njengoba wazi, igazi lethu lakhiwe izingxenye ezimbili. Enye ingxenye eqinile, okungamaseli abomvu egazi, amaseli amhlophe egazi, nama-platelet. Enye ingxenye yingxenye ewuketshezi, esiyibiza ngokuthi i-plasma. Ku-erythrocytosis, inani lamaseli abomvu egazi liyakhula uma kuqhathaniswa nengxenye ewuketshezi, okuyi-plasma.

Uma uthola ukuhlolwa kwegazi, uzobona amanani amabili embikweni: i-Hematocrit kanye ne-Hemoglobin .

• I-Hematocrit (HCT): Lokhu kukutshela ukuthi iphesenti elingakanani legazi lakho elingamaseli abomvu egazi.
• I-Hemoglobin (HB): Lena iphrotheni ebaluleke kakhulu etholakala ngaphakathi kwamangqamuzana abomvu egazi ethwala umoya-mpilo emizimbeni yethu yonke.

Ku-erythrocytosis, noma yikuphi kwalawa manani e-hematocrit kanye ne-hemoglobin kungaba phezulu kunokuvamile.

Lokhu kwanda kwamangqamuzana abomvu egazi kuwuthinta kanjani umzimba?

Amangqamuzana egazi abomvu abalulekile emizimbeni yethu. Athwala umoya-mpilo ovela emaphashini uye kuwo wonke amaseli nezicubu zomzimba. Yingakho izicubu zethu zondlekile futhi ziphilile.

Kodwa-ke, uma la maseli abomvu enyuka kakhulu, izinkinga zingavela. Kuye ngesizathu sokwanda kwamangqamuzana abomvu egazi. Eminye imiphumela mincane kakhulu. Ungase uzizwe izinto ezifana nekhanda elibuhlungu nokukhathala. Kodwa-ke, uma amangqamuzana abomvu enyuka ngezizathu ezithile ezingathi sína, igazi liqala ukujiya. Bese kuba khona ingozi yezimo eziyingozi njengezinhlayiya zegazi, ukuhlaselwa yinhliziyo noma isifo sohlangothi .

Yingakho, uma unezimpawu ezinjalo, kubaluleke kakhulu ukubona udokotela ukuze uthole imbangela eqondile. Yilapho kuphela lapho ungathola khona ukwelashwa okufanele, ukunciphisa izimpawu, noma ukuvimbela izimo eziyingozi.

Yiziphi izinhlobo eziyinhloko ze-erythrocytosis?

I-Erythrocytosis ingahlukaniswa ngezinhlobo ezimbili kuye ngokuthi la maseli abomvu anda kanjani:

1. I-Absolute Erythrocytosis: Lokhu kwenzeka lapho inani lamaseli abomvu egazi akhiqizwa emzimbeni wakho empeleni liphakeme kunejwayelekile.

2. I-Relative Erythrocytosis: Yilapho inani lamaseli abomvu egazi lingase libe elijwayelekile, kodwa inani le-plasma egazini liyancipha, ngakho-ke ukuhlushwa kwamaseli abomvu egazi kubonakala sengathi kuyanda. Isibonelo, uma uhlanza kakhulu futhi unesifo sohudo futhi ulahlekelwa amanzi amaningi emzimbeni wakho, uketshezi lwegazi lakho luyehla. Lesi simo singavela ngezikhathi ezinjengalezi.

I-Absolute Erythrocytosis ihlukaniswe ngezinhlobo ezimbili, kuye ngokuthi imbangela:

I-Erythrocytosis Eyinhloko

Inkinga isemongweni wethu wamathambo. Njengoba wazi, umongo wamathambo uyifektri eyinhloko emzimbeni wethu eyenza amangqamuzana abomvu egazi. Ngakho-ke, kule erythrocytosis eyinhloko, ngenxa yephutha lofuzo kumaseli okuqala (amangqamuzana okuzala) emmongweni wamathambo, ukukhiqizwa kwamangqamuzana abomvu egazi kuyanda ngokungalawuleki. Lokhu kukhubazeka kofuzo kungazuzwa njengefa (njengephutha lokuzalwa), noma kungenzeka futhi ngesikhathi sokuphila.

• I-Erythrocytosis Eyinhloko Etholakale: Isibonelo esihle salokhu yisimo esibizwa ngokuthi i-Polycythemia Vera . Abantu abaningi badidanisa i-Erythrocytosis ne-Polycythemia Vera njengesifo esifanayo. Kodwa-ke, azifani. I-Polycythemia Vera yisimo esithile futhi esibucayi esibangela i-Erythrocytosis.
• I-Erythrocytosis Eyinhloko Ezuzwe Njengefa: Ngezinye izikhathi, amaphutha ezakhiweni zofuzo ezizuzwe kubazali angabangela ukuthi umongo wethambo ukhiqize amangqamuzana abomvu amaningi kakhulu.

I-Erythrocytosis yesibili

Inkinga lapha ayikho emnkantsheni wethambo, kodwa kwenye into engaphandle komnkantshe wethambo. Isikhathi esiningi, i-erythrocytosis yesibili ibangelwa ukuthi umzimba wethu ukhiqiza i-hormone eningi kakhulu ebizwa ngokuthi i-erythropoietin , noma i-EPO . I-'EPO' iyisithunywa samakhemikhali. Yilokho okutshela umnkantshe ukuthi "wenze amangqamuzana abomvu engeziwe."

Cabanga nje, unesifo samaphaphu noma isifo senhliziyo. Khona-ke inani lomoya-mpilo elitholwa ngumzimba liphansi. Ngaleso sikhathi, umzimba uzama ukwenza i-hormone ethi 'EPO' eningi, futhi ngayo, ivuselela umongo wamathambo ukuze wenze amangqamuzana abomvu engeziwe. Ngoba amangqamuzana abomvu athwala umoya-mpilo. Kodwa-ke, uma ukukhiqizwa kwamangqamuzana abomvu ngale ndlela kukhuphuka kakhulu, kubangela i-erythrocytosis yesibili. Le-erythrocytosis yesibili ingabangelwa nayizinye izimo zofuzo, kodwa lawo maphutha ofuzo akuzona lawo asemongo wamathambo.

Uhlola kanjani amanani egazi ukuze ubone ukuthi une-erythrocytosis?

Eqinisweni, izinga lokuhlushwa kwamangqamuzana abomvu egazini elibhekwa njengelijwayelekile lingahluka kumuntu nomuntu. Izinto eziningi zithinta lokhu, okuhlanganisa iminyaka yakho, kungakhathaliseki ukuthi ungowesilisa noma owesifazane, kanye nokuphakama kwendawo ohlala kuyo (kungakhathaliseki ukuthi usezindaweni zolwandle noma endaweni enezintaba).

I-Erythrocytosis kubantu abadala ivame ukutholakala ngokwanda kwe-hematocrit (HCT) kanye/noma i-hemoglobin (HB). La manani angalinganiswa ngokuhlolwa kwegazi okubizwa ngokuthi ``I-Complete Blood Count (CBC)``.

Kwabesilisa:

• I-Hematocrit (HCT): Uma ingaphezu kuka-50%
• I-Hemoglobin (HB): Uma ingaphezu kuka-17.5 g/dL

Kwabesifazane abangakhulelwe:

• I-Hematocrit (HCT): Uma ingaphezu kuka-45%
• I-Hemoglobin (HB): Uma ingaphezu kuka-15.3 g/dL

Okubalulekile: Lezi zindinganiso ziyisiqondiso esijwayelekile nje. Udokotela wakho uzonquma ngqo ukuthi une-erythrocytosis yini ngemva kokucabangela impilo yakho iyonke.

Yiziphi izimbangela ze-Relative Erythrocytosis?

Lokhu kubangelwa ukwehla kwenani lamanzi emzimbeni, okubangela ukuthi uketshezi lwegazi (i-plasma) lwehle kanye nokuhlushwa kwamaseli abomvu egazi kwande. Ngakho-ke, isizathu esiyinhloko salokhu ukuphelelwa amanzi emzimbeni .

• Ukuhlanza okukhulu
• Uhudo
• Imithi ethile, isibonelo, imithi yokukhipha amanzi emzimbeni (imithi ekhipha amanzi emzimbeni) (Lena inikezwa ngenxa yomfutho wegazi ophakeme noma ukugcinwa koketshezi emzimbeni).

Ngenxa yezizathu ezinjalo, inani loketshezi emzimbeni lingancipha futhi libangele i-erythrocytosis ehlobene.

Yiziphi izimbangela ze-Absolute Erythrocytosis?

Kunezimbangela ezimbili ezihlukene zalokhu: eyokuqala neyesibili.

Izimbangela ze-erythrocytosis eyinhloko:

Lokhu kuvame ukubangelwa ukukhubazeka kwezakhi zofuzo okuthinta umongo wamathambo.

• I-Polycythemia Vera kanye nezinye i-Myeloproliferative Neoplasms: Lezi yizimo lapho umongo wamathambo ukhiqiza khona ngokweqile amaseli abomvu egazi kanye namanye amaseli egazi. I-Polycythemia Vera iyona evame kakhulu kulezi.
• Ukukhubazeka kokuzalwa: Abanye abantu bangazalwa benesici sofuzo esibangela ukuthi umongo wethambo ukhiqize amangqamuzana egazi abomvu amaningi kakhulu.

Izimbangela ze-erythrocytosis yesibili:

Lokhu kuvame ukubangelwa ukwanda kwe-hormone ethi `EPO`.

• Izimo ezinciphisa umoya-mpilo ezicutshini:
• Isifo samaphaphu (isb. i-bronchitis engapheli, i-emphysema)
• Isifo Senhliziyo (isib. ukukhubazeka kwenhliziyo okuzalwa nakho)
• Ukuphefumula komoya ngesikhathi sokulala
• I-Hemoglobinopathy: Lezi yizimo lapho iphrotheni ye-hemoglobin emangqamuzaneni abomvu egazi ingakwazi ukuthwala umoya-mpilo kahle ngenxa yesici.
• Izifo zezinso kanye nokufakelwa izitho:
• I-Renal Artery Stenosis (ukuncipha kwemithambo yegazi ehlinzeka ngezinso)
• I-Hydronephrosis (ukuvuvukala kwezinso ngenxa yokuqongelela komchamo)
• Lesi simo singase senzeke ngezinye izikhathi ngisho nangemva kokufakelwa izinso.
• Izimila: Ezinye izimila ezinomdlavuza nezingezona umdlavuza zingakhipha i-hormone ye-EPO eningi.
• Izimila ezinomdlavuza: I-Renal Cell Carcinoma, i-Hemangioblastoma, i-Hepatocellular Carcinoma, i-Parathyroid Carcinoma.
• Izimila ezingezona ezomdlavuza: Ama-fibroid esibeletho, i-Pheochromocytoma, i-Meningioma.
• Ubuthi be-carbon monoxide nokubhema: Ukubhema kakhulu kungabangela ubuthi be-carbon monoxide, okunganciphisa umoya-mpilo ezicutshini.
• Eminye imithi nemithi:
• Ama-Anabolic Steroid (athathwa abasubathi ukuze bandise amandla)
• Ukuthatha i-hormone ye-testosterone.

Yiziphi izimpawu umuntu one-erythrocytosis angase azibone?

Izimpawu ozizwayo (nokuthi zimbi kangakanani) zincike embangela ye-erythrocytosis yakho. Isibonelo, umuntu one-erythrocytosis yesibili angase abe nezimpawu ezifana nalezi:

• Ikhanda elibuhlungu
• Isimo sokudideka, isimo sobunzima bokugxila
• Ubunzima bokulala
• Ukuzizwa ubuthakathaka, ukhathele

Umuntu one-erythrocytosis eyinhloko (ikakhulukazi i-polycythemia vera) angase abe nezimpawu ezinzima kakhulu:

• Umfutho Wegazi Ophakeme
• Ukujuluka ngokweqile ebusuku
• Ukwehlisa isisindo ngaphandle kwesizathu
• Ubuhlungu obukhulu, ukuvuvukala, kanye nokubomvu emalungeni (okubizwa nangokuthi i-gout )
• Izinkinga zokopha (ukuphuma kwegazi njalo ekhaleni, ukuphuma kwegazi noma ukushayeka ngisho noma ukulimala okuncane)
• Isikhumba esilumayo (ukuluma kunganda, ikakhulukazi ngemva kokugeza ngamanzi ashisayo)
• Ukuba ndikindiki emilenzeni, umuzwa ofana nezintuthwane ezigijima nxazonke
• Ubomvu obuhambisana nokuvuvukala ebusweni, ezandleni nasezinyaweni.

Odokotela bakuthola kanjani i-erythrocytosis?

Udokotela wakho uzoqala azame ukuthola imbangela yokubalwa kwamaseli akho abomvu aphezulu egazini, esebenzisa izivivinyo nezinqubo ezahlukahlukene.

Okokuqala, bazobuza imibuzo mayelana nomlando wakho wezokwelapha, imithi oyiphuzayo, indlela yakho yokuphila (isib., uyabhema yini), kanye nezimpawu zakho, bese behlola i-erythrocytosis ehlobene (ebangelwa ukwehla kwe-plasma egazini). Bazophinde benze ukuhlolwa ngokomzimba.

Into elandelayo okufanele uyihlole ukuthi unayo yini i-primary noma i-secondary . Ungenza nezinye izivivinyo ezimbalwa ngolwazi olushiwo ngenhla.

Yiziphi izivivinyo ezenziwayo?

• Ukubalwa Kwegazi Okuphelele (i-CBC): Lokhu kungahlola inani lamaseli akho abomvu egazi, i-hemoglobin (HB), kanye namazinga e-hematocrit (HCT).
• Ukuskena Kwegazi Okungajwayelekile (i-PBS): Lokhu kuhilela ukuthatha ithonsi legazi bese ubheka amangqamuzana ngaphansi kwesibonakhulu ukuze ubone ukuthi awajwayelekile yini ngesimo noma ngobukhulu. Uma unesifo esifana ne-Polycythemia Vera, ungase ubone amangqamuzana angajwayelekile.
• Ukuhlolwa Kokusebenza Kwezinso Nesibindi: Lokhu kunganikeza umbono wokuthi ngabe kukhona isifo sezinso noma isimila esenza i-EPO eningi kakhulu.
• I-Pulse Oximetry: Inzwa encane ebekwe emunweni ilinganisa izinga lomoya-mpilo egazini. Lokhu kungasiza ekunqumeni ukuthi lesi simo sibangelwa yini yizinto ezifana nesifo senhliziyo noma isifo samaphaphu.
• Ukuhlola izinga le-erythropoietin (EPO): Uma izinga le-`EPO` liphansi, kungaba yi-primary erythrocytosis, uma izinga le-`EPO` liphezulu, kungaba yi-secondary erythrocytosis.
• Ukuhlolwa komchamo: Kuthathwa isampula yomchamo ukuze kuhlolwe ukukhubazeka. Uma kukhona amangqamuzana abomvu emchameni, kungenzeka ukuthi kungenxa yesifo sezinso.

Uma udokotela esola isimo esithile, njenge-polycythemia vera, angenza nezinye izivivinyo, njenge- bone marrow biopsy .

Iphathwa kanjani i-erythrocytosis?

Ezimweni eziningi, imbangela ye-erythrocytosis ayikwazi ukwelapheka ngokuphelele. Kodwa-ke, ukwelashwa kungalawula futhi kunciphise izimpawu. Ezimweni ze-erythrocytosis ebangelwa yizimbangela ezinkulu, ukwelashwa kusetshenziselwa nokuvimbela izimo eziyingozi njengokuqhekeka kwegazi.

• I-Phlebotomy noma i-Venesection:

Lokhu ukwelashwa okuvame kakhulu kwe-polycythemia vera. Kufana nokunikela ngegazi, kodwa kuhilela ukuthatha inani elincane legazi emthanjeni nokunciphisa inani lamaseli abomvu egazi kanye nomthamo wegazi ophezulu kakhulu. I-erythrocytosis yesibili ivame ukungadingi lokhu kwelashwa.

• Imithi:
• Kubantu abasengozini enkulu yokuqhekeka kwegazi, udokotela angase atuse ukuthatha i- aspirin ephansi nsuku zonke.
• Kukhona nemithi enciphisa inani lamaseli abomvu egazi:
• I-Hydroxycarbamide `(Hydroxycarbamide)`
• I-Hydroxyurea `(Hydroxyurea)`
• I-Busulfan
• I-Interferon alfa `(Interferon alfa)`
• I-Ruxolitinib

Udokotela wakho uzokunikeza imithi efanele isimo sakho. Uzokunikeza nokwelashwa kwesimo esiyisisekelo, kuye ngokuthi imbangela eyinhloko ye-erythrocytosis yakho iyini.

Uma nginalesi simo, yini okufanele ngiyilindele?

Okuhlangenwe nakho kwakho kuzoncika embangela ye-erythrocytosis yakho nokuthi imbi kangakanani. Isibonelo, ezinye izimo zofuzo ze-erythrocytosis eyinhloko zibangela izimpawu ezincane kuphela futhi azisongeli impilo. Kodwa-ke, izimo ezibucayi kakhulu, njenge-polycythemia vera, zingadinga ukwelashwa impilo yonke.

Ngizinakekela kanjani?

Into ebaluleke kakhulu ukulandela imiyalelo kadokotela wakho ngqo. Okwamanje, kunezinguquko ezimbalwa zendlela yokuphila ezingakusiza:

• Uma ubhema, yeka.
• Gcina isisindo somzimba siphilile.
• Uma unomfutho wegazi ophakeme, lawula.
• Gwema ukuhamba usuka olwandle uye ezindaweni eziphakeme kakhulu (izindawo ezinezintaba) ngangokunokwenzeka.

Kufanele ngiye nini esibhedlela ngokushesha (ETU) ?

Uma unesifo esihlobene ne-erythrocytosis esikubeka engcupheni yokuqhekeka kwegazi, kubalulekile ukuqaphela izimpawu zokuqhekeka kwegazi. Uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo, funa usizo lwezokwelapha ngokushesha:

• I-Deep Vein Thrombosis (DVT): Ukuvuvukala, ubuhlungu, kanye nokubomvu emlenzeni owodwa.
• Ukugoba kwegazi emaphashini (Pulmonary Embolism - PE): Ubuhlungu besifuba, ubunzima bokuphefumula, ukuzizwa unesizungu.
• Isifo sohlangothi: Ukulahlekelwa yibhalansi ngokuzumayo, ukuhlangana komzimba, ubuthakathaka bemisipha noma ukuba ndikindiki kolunye uhlangothi lomzimba.
• Ukuhlaselwa Yinhliziyo: Ubuhlungu besifuba, ukuphelelwa umoya, ukuzizwa unesizungu, ukujuluka.

Uma unezinye zalezi zimpawu, sicela ubonane nodokotela ngokushesha ngaphandle kokulibala.

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

I-Erythrocytosis ukwanda kwenani lamaseli abomvu egazini lakho. Lokhu kungaba yisimo esincane, noma ngezinye izikhathi kungaba uphawu lwesimo esibucayi.

• Uma unezimpawu ezingavamile (ikakhulukazi ukukhathala okuqhubekayo, ikhanda elibuhlungu, ukuqubuka kwesikhumba, ubunzima bokuphefumula), bona udokotela.
• Udokotela uzonquma imbangela eqondile yenani eliphezulu lamaseli abomvu egazi lakho.
• Ngezinye izikhathi, izinguquko ezilula zendlela yokuphila (isib., ukunciphisa inani lemithi oyiphuzayo, ukwelapha ukuphelelwa amanzi emzimbeni) kungaxazulula le nkinga.
• Uma i-erythrocytosis ibangelwa yisimo esibucayi kakhulu, udokotela wakho uzokuqapha njalo futhi akunikeze ukwelashwa okudingekayo.

Kubaluleke kakhulu ukunakekela impilo yakho, ngakho-ke uma unenkinga, ungesabi ukukhuluma nodokotela.

I- Erythrocytosis, i-polycythemia, amaseli abomvu egazi, i-hemoglobin, i-hematocrit, ukujiya kwegazi, umongo wamathambo