Kubwereza kwa Iron Kugonjetsedwa Kuchulukitsidwa Kambiri
Kulemera kwa chitsulo ndi malo omwe ali ndi chitsulo choposa mthupi kuposa momwe angachotsedwe ndi thupi. Chinthu chamakono chachitsulo chosakanizika ndi hemochromatosis. Pali zifukwa zikuluzikulu ziwiri zowonjezera chitsulo: 1) cholowa cha hemochromatosis kapena 2) kuika magazi kwa hemochromatosis. Hereditary hemochromatosis ndizochitika m'mabanja. Kutulutsa magazi a hemochromatosis kumachitika pamene munthu amafunika kuikidwa magazi ambiri (red blood cell (RBC).
Iron imapezeka mkati mwa hemoglobin , mapuloteni mkati mwa RBC. Ntchito yachitsulo kuthandiza kuthandizira oksijeni kumatenda onse. Kawirikawiri thupi limatenga zitsulo zokwanira kuchokera ku zakudya zanu kuti mukhale ndi RBC yopanga. Ngati simudya zakudya zokwanira ndi chitsulo, zida zanu zachitsulo zimakhala zochepa chifukwa cha kusowa kwa magazi m'thupi . Pamene ma CD amapita kumapeto kwa moyo wawo, chitsulo mkati mwawo chimagwiritsidwanso ntchito m'maboma atsopano opangidwa.
N'chifukwa Chiyani Ma ARV Ambiri Amachotsedwa Chifukwa cha Iron Overload?
Chitsulo chimapezeka mkati mwa ma CDs onse mu gawo la magazi. Choncho, magazi onse omwe ali ndi kachilombo ka RBC amalandila amadzimadzi (IV). Vuto ndilokuti thupi liri loperewera kuthekera kwake kuthetsa chitsulo chokwanira. Kuwonjezera apo, anthu okhala ndi thalassemia amamwa chitsulo chochuluka kuposa momwe amafunira chifukwa cha zakudya zawo zomwe zimaipitsa vutoli.
Ndani Ali Pangozi Yotumizira Zitsulo Zambiri?
Aliyense amene amalandira ma ARV ambiri ali pachiopsezo, koma anthu omwe amadalira kuikidwa magazi ali pangozi yaikulu.
Izi ziphatikizapo anthu omwe ali ndi matenda a sickle omwe agwidwa ndi stroke (kapena ali pangozi yaikulu ya kupweteka ), wamkulu wa beta thalassemia , Diamond Blackfan Anemia , kuchepa magazi m'thupi , ndi matenda a myelodysplastic pakati pa ena. Anthu omwe ali ndi khansa omwe amafunika kuikidwa magazi pakapita mankhwala ndi chemotherapy kapena kupaka mafuta a m'mafupa amakhalanso pangozi yowonjezera chitsulo.
Kodi Dokotala Wanga Akuwongolera Bwanji Iron?
Anthu omwe amafunikira kuikidwa magazi nthawi zonse amayang'anitsitsa mosamala kwambiri chifukwa chachitsulo chachitsulo. Odwalawa, kulemera kwachitsulo kumawoneka pambuyo pa 12 mpaka 15 RBC. Kawirikawiri kulemera kwa iron kumayang'aniridwa ndi mayeso a magazi otchedwa ferritin poyamba. Ferritin amaimira kuchuluka kwa kuchuluka kwa chitsulo chomwe chili m'thupi lanu. Ferritin amadziwika pa ndondomeko, miyezi itatu kapena itatu, kuti dokotala akhoze kuwona momwe ikugwirira ntchito (ndiko, kuwonjezeka kwake?). Chelation, mankhwala omwe amachotsa chitsulo, amayamba pambuyo pa ferritin kuposa 1000 ng / mL. Mwatsoka, mazinga a ferritin amakhudzidwa ndi zinthu zina osati zachitsulo cholemera. Mizere yowonjezera ya ferritin ikhoza kuwonedwa panthawi ya matenda ndi kutupa.
Chifukwa cha kuchepa kwa ferritin, njira zina zowonjezera chitsulo chowongolera zinapangidwa. Poyamba, kuyamwa kwachitsulo kunayang'aniridwa ndi ziopsezo za chiwindi kumene chidutswa chochepa cha chiwindi chinachotsedwa ndi kuyesedwa kwa chitsulo. Pakalipano, anthu ambiri amatha kuyang'anitsitsa pogwiritsa ntchito maginito (IMRI) a chiwindi ndi / kapena mtima. MRI ingathe kuwerengera chiwindi chachitsulo cha chiwindi (LIC) chofanana ndi zotsatira za chiwindi cha chiwindi.
Mchere umayambika pamene LIC iposa 3 mg pa gramu yowuma chiwindi. Mofananamo, MRI ya mtima ikhoza kuyeza kuchuluka kwa chitsulo chomwe chili pamtima.
Kodi Ndi Mavuto Otani Amene Angakhalepo Ndi Iron Overload?
Nthawi zonse malo omwe amasungirako chitsulo sichipezeka, chitsulo chimatha kusungidwa m'chiwindi, mtima, ziphuphu, ndi ziwalo za endocrine (zomwe zimatchedwa glands). Ngati chitsulo chimasungidwa m'malo amenewa, chimawononga chiwalo. Izi zingachititse fibrosis kapena kupweteka kwa chiwindi, matenda a mtima (matenda a mtima wa mitsempha), matenda a shuga (chifukwa cha chitsulo m'zipinda), hypothyroidism (otsika ma hormone) ndi hypogonadism (kuchititsa kuchepetsa libido ndi kupanda mphamvu kwa amuna ndi kusowa za kusamba kwa akazi).
Pofuna kuteteza mavutowa ndi omwe angakhale oopsa, zowonjezera zitsulo zimayambitsidwa.
Kodi Kupuma Kwachitsulo Kumatanganidwa Bwanji?
Kusungunuka kwachitsulo kuchokera ku magazi kumachitika ndi chelation therapy, mankhwala omwe amachotsedwa kuti achotse chitsulo m'thupi. Pali mankhwala atatu omwe alipo.
- Deferoxamine (Desferal)
- Deferasirox (Jadenu kapena Exjade)
- Deferiprone (Ferriprox)
Mankhwala a phlebotomy : Ngati panthawi ina mumatha kusiya kuikidwa magazi, chitsimikizo chachitsulo chingachiritsidwe ndi phlebotomy. Phlebotomy ndi ofanana ndi zopereka za magazi komwe magazi ochuluka amachotsedwa m'thupi. M'mabomawa amachotsedwa ndi chitsulo ndipo pamene izi zimalowetsedwa ndi fupa la mafupa zimagwiritsa ntchito zitsulo zochulukirapo m'thupi lanu.
> Zotsatira:
> Schrier SL ndi Bacon BR. Thandizo lachilombo kwa Thalassemia ndi Zina Zowonjezera Chitsulo Choponderezeka ndi Iron Kugonjetsa Syndromes Kupatula Hemochromatosis Yachilengedwe. Mu: UpToDate, Post TW (Ed), UpToDate, Waltham, MA.