Ingabe amangqamuzana akho egazi aphuka ngokushesha? Ake sixoxe nge-hemolysis!

Ingabe ngezinye izikhathi uzizwa ukhathele futhi unesiyezi? Noma ngezinye izikhathi uzizwa sengathi isikhumba sakho siphuzi kancane, kanti amhlophe amehlo akho aphuzi? Lokhu kungaba yinto ehlobene namaseli akho abomvu egazi, enye yezinhlobo ezibaluleke kakhulu zamaseli egazini lakho. Namuhla sizokhuluma ngesimo esibizwa ngokuthi i-hemolysis , okuyilapho amaseli abomvu egazi ephuka khona futhi ebhujiswa ngaphambi kwesikhathi. Ungakhathazeki, kubalulekile ukuqaphela lokhu.

Kuyini ngempela i-hemolysis?

Kalula nje, i-hemolysis ukubhujiswa kwamangqamuzana abomvu egazi emzimbeni wethu . Uyazi, lawa maseli abomvu egazi afana nezisebenzi ezincane egazini lethu. Yiwo athatha umoya-mpilo emaphashini lapho siphefumula bese ewuyisa kuwo wonke amanye amaseli nezicubu emzimbeni. Kufana nokuletha isilinda segesi ekhaya. Ngakho-ke, umzimba wethu usebenzisa lo moya-mpilo ukukhiqiza amandla owadingayo. Futhi, lawa maseli abomvu egazi asiza ukuthwala i-carbon dioxide engafuneki enqwabelana emzimbeni wethu ibuyele emaphashini bese eyikhipha.

Ngokuvamile, imizimba yethu iqhubeka nokubhubhisa amangqamuzana abomvu amadala noma abuthakathaka bese iwafaka esikhundleni sawo amangqamuzana abomvu amasha, anempilo. Lokhu kufana nokususa amadala bese uthola amasha. Lo mjikelezo wokubhujiswa nokukhiqizwa yingakho sihlala sinenani elifanele lamangqamuzana abomvu emizimbeni yethu.

Kodwa-ke, ngezinye izikhathi lawa maseli abomvu egazi aqala ukuwohloka ngaphambi kwesikhathi, okungukuthi, ngokushesha kakhulu . Lokhu kungenzeka ngaphambi kokuba imizimba yethu ibe nesikhathi sokwenza amaseli amasha ukugcwalisa isikhala. Lokhu kubhujiswa okusheshayo kwamangqamuzana abomvu egazi kubizwa ngokuthi i-hemolysis. Uma inani lamangqamuzana abomvu egazi emzimbeni lehla kakhulu ngenxa yalokhu kubola, sibiza leso simo ngokuthi i-hemolytic anemia , noma i-anemia.

Kungani amangqamuzana abomvu egazi ebhujiswa ngale ndlela?

Iseli elibomvu legazi livame ukuphila cishe izinsuku eziyi-120. Ekupheleni kwalesi sikhathi, lapho lawo maseli eguga, akhipha izimpawu ezikhethekile. Lezi zimpawu zibangela ukuthi udengezi (olutholakala ohlangothini lwesobunxele lwesisu) emzimbeni wethu lubhubhise la maseli amadala ngendlela ehlelekile. Njengoba nje sisusa ifenisha endala, ephukile endlini yethu.

Amaseli egazi abomvu amasha akhiwa engxenyeni ethambile yamathambo ethu ebizwa ngokuthi umnkantsha . Amaseli egazi abomvu amasha enziwe kulo mnkantsha abe esekhishwa egazini.

Kodwa-ke, ngezinye izikhathi isici esimweni noma ekwakhekeni kweseli elibomvu legazi singanciphisa isikhathi sokuphila kwalo. Noma, amangqamuzana abomvu egazi angonakaliswa yizinto zangaphandle futhi afe ngaphambi kokuba umzimba ukwazi ukwenza amangqamuzana amasha.

Yiziphi izinhlobo eziyinhloko ze-hemolysis?

I-Hemolysis ingahlukaniswa ngezinhlobo ezimbili eziyinhloko. La magama abhekisela lapho amangqamuzana abomvu egazi ebhujiswa khona.

1. I-Extravascular hemolysis: Lokhu kwenzeka lapho amangqamuzana abomvu egazi ebhujiswa ngaphandle kwemithambo yegazi yethu (okungukuthi, imithambo yegazi, imithambo yegazi, kanye nama-capillaries). Ngokuvamile, lokhu kwenzeka ku -spleen . Njengoba igazi lidlula ku-spleen, uhlobo olukhethekile lwamangqamuzana amhlophe egazi abizwa ngokuthi ama-macrophages (lawa afana nonogada bomzimba wethu) aqaphela amangqamuzana abomvu egazi amadala, onakele futhi awabhubhise.

2. I-Intravascular hemolysis: Lokhu kwenzeka lapho amangqamuzana abomvu ebhujiswa ngaphakathi kwemithambo yegazi. Uma ebhujiswa, izingcezu zalawo maseli zihamba emzimbeni wonke negazi lethu.

Ziyini izimbangela ze-hemolysis?

Akukhona nje imbangela eyodwa ye-hemolysis, kodwa kunezici eziningana ezingayithinta. Ake sibheke ngokuningiliziwe.

1. Amaphutha kumaseli abomvu egazi ngokwawo

Ngezinye izikhathi, uma kukhona ukungajwayelekile noma isici esimweni noma esakhiweni seseli elibomvu legazi, lelo seli lingabhujiswa ngokushesha. Amaphutha anjalo avame ukubangelwa izifo ezithile zokuzalwa, noma ezizuzwe njengefa .

• Ukungazinzi kwe-hemoglobin: I-hemoglobin iyiprotheni esiza ukuthwala umoya-mpilo ngaphakathi kwamangqamuzana abomvu egazi. Izimo ezibangela lokhu kungazinzile zifaka phakathi i-sickle cell anemia (lapho amangqamuzana abomvu egazi eba nesimo se-sickle) kanye ne -thalassemia .
• Ukuntuleka kwama-enzyme: Lesi simo singase senzeke nalapho ama-enzyme athile adingekayo ekusebenzeni kwamaseli abomvu egazi entuleka. Izibonelo zifaka phakathi ukuntuleka kwe-G6PD kanye nokuntuleka kwe-pyruvate kinase .
• Ukukhubazeka kwe-membrane: Izimo lapho kukhona khona ukukhubazeka embozweni wangaphandle wamaseli abomvu egazi, i-membrane yeseli. Izibonelo zifaka phakathi i-spherocytosis yefa ( amaseli aba yindilinga) kanye ne-elliptocytosis yefa (amaseli aba made).

2. Izifo ezihlobene nesimiso somzimba sokuzivikela

Ngezinye izikhathi amasosha omzimba wethu (uhlelo olusivikela ezifweni) aqala ngephutha ukuhlasela amangqamuzana ethu abomvu egazi. Lokhu kubizwa ngokuthi i-autoimmune hemolytic anemia (AIHA) . Lesi yisimo esingavamile. Kukhona nezinhlobo zalokhu:

• Isifo se-cold agglutinin ( izimpawu ziya ziba zimbi kakhulu uma zibekwe emakhazeni)
• Isifo se-agglutinin esifudumele

Ezinye izimo eziyisisekelo ezingabangela i-AIHA zifaka phakathi i-Mycoplasma pneumonia , i-lymphoma , i-leukemia (lezi yizinhlobo zomdlavuza), i-lupus, kanye ne-rheumatoid arthritis (lezi futhi ziyizifo ezizimele).

Ezinye izimo ezingezona ezokulwa nomzimba:

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

3. Ukutheleleka

Ezinye izimuncagazi, amagciwane, kanye namabhaktheriya angena emizimbeni yethu angalimaza amangqamuzana ethu abomvu egazi, awabhubhise ngaphambi kokuba ashintshwe. Isibonelo esihle salokhu yi -malaria . I-parasite ebangela umalaleveva ihlasela ngqo amangqamuzana abomvu egazi.

Ezinye izimbangela zokutheleleka:

• I-Babesiosis
• Isifo sikaCarrion
• Umkhuhlane onamabala e-Rocky Mountain
• Umkhuhlane we-Haemophilus
• Igciwane le-HIV (i-HIV)

4. Eminye imithi

Eminye imithi esiyithathayo, nakuba ingavamile, ingavuselela amasosha omzimba ethu ukuba ahlasele amangqamuzana abomvu egazi futhi awabhubhise ngokushesha. Lokhu kubizwa ngokuthi i-drug-induced immune hemolytic anemia (DIHA) . Lokhu akuvamile kakhulu.

Eminye imithi engabangela i-hemolysis:

• I-Acetaminophen ( i-paracetamol)
• Amanye ama-antibiotic 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
• Amanye ama -sulfonamides

Okubalulekile: Ungakhathazeki ngalolu hlu lwemithi. Le mithi ayivamile ukubangela i-hemolysis. Uma udokotela ekunike le mithi, landela imiyalelo yakhe. Uma unemibuzo, khuluma nodokotela wakho.

5. Izinkinga ngesikhathi sokukhulelwa

Ezinye izinkinga ngesikhathi sokukhulelwa zingabangela nokuthi amaseli abomvu egazi aqhekeke ngokushesha.

• I-HELLP syndrome
• I-Preeclampsia
• I-Eclampsia

Ngenxa yokuthi lezi yizimo ezingathi sína ezingase zenzeke ngesikhathi sokukhulelwa, kubalulekile ukufuna iseluleko sezokwelapha ngokushesha uma kuvela izimpawu.

6. Imishini yezokwelapha kanye nokwelashwa

Lokhu futhi akuvamile. I-Hemolysis ingenzeka uma amadivayisi athile ezokwelapha efakwa emzimbeni, noma ngesikhathi sokwelashwa okuthile, kuze kube yilapho umzimba usuzijwayela.

• I-Hemodialysis yeziguli zezinso
• Umshini wokudlula inhliziyo namaphaphu (osetshenziswa ekuhlinzeni okukhulu)
• Ukufakwa esikhundleni kwama-valve enhliziyo
• Amanye amadivayisi asetshenziswa ezimweni ezifana nokwehluleka kwenhliziyo, isibonelo amaphampu ebhaluni angaphakathi kwe-aorta kanye namadivayisi e-Impella .
• ukumpontshelwa igazi (njengalapho kunikezwa igazi elingahambisani)

7. Ubuthi kanye nobuthi

Amanye ama-toxin, uma edliwa, angalimaza amangqamuzana abomvu egazi futhi abangele i-hemolysis.

• I-Arsenic
• Ithusi ( uma ligwinywe kakhulu)
• Umholi
• I-Arsine ( igesi enobuthi)
• I-Stibine ( igesi enobuthi)
• Ubuthi benyoka

Ngaphezu kwalokho, noma yisiphi isimo lapho udengezi lusebenza ngokweqile (i-hypersplenism) lungabangela nokuncipha kwegazi. Ngokufanayo, umfutho wegazi ophakeme kakhulu ungabangela ukuba amangqamuzana abomvu egazi aqhume njengoba igazi lihamba ngemithambo yegazi ngokushesha okukhulu.

Ziyini izimpawu ze-hemolysis?

Izimpawu zincike ekutheni inani lamaseli akho abomvu egazi liphansi kangakanani. Uma inani lamaseli akho abomvu egazi lingaphansi kakhulu, ungase ungabi nazo izimpawu. Esikhathini esiningi, izimpawu zenzeka ngoba amaseli nezicubu zomzimba azitholi umoya-mpilo owanele ngenxa yenani eliphansi lamaseli abomvu egazi.

Izimpawu ezivamile:

• Ukukhathala
• Isiyezi
• Isikhumba esikhanyayo
• Ukushaya kwenhliziyo okusheshayo / i-tachycardia
• Ukuphelelwa umoya / ukuphelelwa umoya
• Ukuphuzi kwesikhumba kanye nokumhlophe kwamehlo (i-Jaundice) (Lokhu kubangelwa ukunqwabelana kwe-bilirubin, into ekhishwa lapho amangqamuzana abomvu egazi ewohloka, egazini)
• Ubende/i-splenomegaly ekhulisiwe

Ezinye izimpawu zingase zihluke kuye ngesimo esithile esibangela i-hemolysis. Isibonelo, umuntu onesifo somkhuhlane i-agglutinin angase abhekane nokuncipha kokugeleza kwegazi ezinzwaneni nasezinzwaneni, okubangela ukuba aphenduke abe luhlaza okwesibhakabhaka futhi abe ndikindiki (isenzakalo sikaRaynaud) .

Yiziphi izivivinyo ezenziwayo ukuze kutholakale ukuthi zikhona yini izinkinga ezihlobene ne-hemolysis?

Udokotela uzothatha isampula yegazi lakho bese enza izivivinyo eziningana ukuze abone ukuthi amaseli akho abomvu aphansi yini ngenxa ye-hemolysis.

• Ukubalwa kwegazi okuphelele (i-CBC): Lokhu kungakutshela okuningi ngazo zonke izinhlobo zamaseli egazini lakho, ikakhulukazi amaseli akho abomvu egazi. Kungahlola izinto ezifana nezinga le-hemoglobin yakho kanye nokuthi amaseli akho abomvu egazi athatha isikhala esingakanani egazini lakho (i-hematocrit).
• Inani lama-reticulocyte: Lokhu kuyingxenye yokuhlolwa kwe-CBC. Ama-reticulocyte amangqamuzana abomvu egazi asanda kwakheka angakavuthwa ngokugcwele. Uma kukhona i-hemolysis, inani lama-reticulocyte linganda njengoba umzimba usheshisa ukukhiqizwa kwamaseli amasha ukuze athathe indawo yalawo abhujisiwe.
• I-smear yegazi elingaphandle: Lokhu kuhlolwa kungahlola ukungalingani ngesimo nosayizi wamaseli akho egazi. Amaseli anomumo ongavamile anamathuba amaningi okubhujiswa ngokushesha.
• I-Lactate dehydrogenase (LDH): I-LDH iyi-enzyme etholakala ngaphakathi kwamaseli abomvu egazi. Lapho amaseli abomvu ehlukana ngokushesha kunokujwayelekile, amazinga e-LDH egazini anganda.
• Ukuhlolwa kwe-Haptoglobin: I-Haptoglobin iyiprotheni ehlotshaniswa ne-hemoglobin. Lapho amangqamuzana abomvu egazi ehlukana (njengase-hemolysis), inani elikhulu le-hemoglobin likhishwa egazini. Amazinga e-Haptoglobin abe esehla.
• I-bilirubin engahlanganisiwe: I-Bilirubin ikhiqizwa lapho i-hemoglobin emangqamuzaneni abomvu egazi iwohloka. Amazinga aphezulu e-bilirubin egazini abonisa ukuthi inani elikhulu lamangqamuzane abomvu egazi liyabhujiswa (yilokhu okubangela i-jaundice).
• Ukuhlolwa kwe-Direct Coombs: Lokhu kuhlolwa kungathola ukuthi unama-antibodies anamathela kumaseli akho abomvu egazi bese kuwabhubhisa ngokushesha (lokhu kungasiza ekuxilongeni izimo ezifana ne-AIHA).

Ngaphezu kwalokho, udokotela angenza ukuhlolwa komchamo ukuze ahlole igazi kanye ne-bilirubin emchameni wakho, okungaba izimpawu zesimo esibizwa ngokuthi i-hemolytic anemia.

Iphathwa kanjani i-hemolysis?

Ukwelashwa kwakho kuzoncika esibangweni se-hemolysis yakho nokuthi izimpawu zakho zimbi kangakanani. Izindlela zokwelapha zingase zihlanganise amavithamini, imithi, ukuhlinzwa kanye nokumpontshelwa igazi.

Into ebaluleke kakhulu ukukhuluma nodokotela wakho mayelana nokwelashwa okukulungele, ngokusekelwe ekuxilongweni kwakho.

Imizimba yethu izama njalo ukugcina inani elifanele lamaseli abomvu egazi. Kodwa-ke, ukutheleleka, izifo zokuzalwa, kanye namathonya angaphandle kungaphazamisa le nqubo futhi kubangele ukuthi amaseli abomvu egazi abhujiswe ngokushesha okukhulu. Ngenxa yalokho, ukwehla kwamaseli abomvu egazi kungenzeka, okuholela ekulahlekelweni kwegazi yi-hemolytic.

Nokho, izindaba ezinhle ukuthi izimbangela eziningi ze-hemolysis zingelashwa. Uma udokotela esethole imbangela ye-hemolysis yakho, uzokunikeza ukwelashwa ukusiza ukubuyisela inani lamaseli akho abomvu egazini esimweni esijwayelekile.

Izinto ezibalulekile okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

• I-Hemolysis ukubhujiswa kwamangqamuzana abomvu egazi ngaphambi kwesikhathi.
• Lokhu kungabangela izimpawu ezifana nokukhathala okukhulu, isiyezi, kanye nokuphuzi kwesikhumba (i-jaundice) .
• Kungaba nezimbangela eziningi; ukukhubazeka kwamangqamuzana abomvu egazi ngokwawo, izinkinga zesimiso sokuzivikela komzimba, izifo, imithi ethile, izinkinga ngesikhathi sokukhulelwa, nokuningi.
• Uma unalezi zimpawu, funa iseluleko sezokwelapha .
• Ukuhlolwa kwegazi kungasiza ekutholeni imbangela futhi kunikeze ukwelashwa okufanele.
• Izimbangela eziningi zingelashwa ukuze kubuyiselwe amazinga amangqamuzana abomvu egazi. Ngakho-ke kubalulekile ukungesabi futhi ufune isiqondiso esifanele sezokwelapha.

Ngithemba ukuthi lolu lwazi luwusizo. Hlala uphilile!

I- Hemolysis, amangqamuzana abomvu egazi, i-anemia, i-spleen, umongo wamathambo, i-jaundice, ukuhlolwa kwegazi