Mwachidziwikiratu muli ndi mphamvu yowonjezera (yomwe imatchedwanso hemosiderosis) yachiwiri ku magazi ambiri ofiira magazi omwe munayenera kulandira. Mwinamwake mwadzidzidzi za chiopsezo ichi musanayambe dongosolo lanu la mankhwala koma mwina simunatero. Kulemera kwa Iron kungayambitse mavuto ambiri kotero ndikofunikira kukhala ndi dongosolo labwino la mankhwala.
Zizindikiro za Iron (mankhwala omwe amachotsa chitsulo kuchokera m'thupi) amagwiritsidwa ntchito kwa anthu omwe ali ndi thalassemia kapena mitundu ina ya kuchepa kwa magazi yomwe imafuna kuika magazi ambiri m'magazi.
Anthu omwe ali ndi hemochromatosis mwachibadwidwe amachizidwa ndi phlebotomy (kuchotsedwa kwa magazi).
Zosankha za Iron Chelation
Pakalipano, ku United States, pali zitsulo zitatu zachitsulo zomwe zimapezeka. Aliyense ali ndi ubwino wake. Zinthu zambiri zimayesedwa posankha mankhwala omwe angagwiritse ntchito.
Deferoxamine
Deferoxamine (dzina lakuti Deferral) wakhala akugwiritsidwa ntchito kwa zaka zoposa 40 ku United States. Deferoxamine ikhoza kuperekedwa ngati mankhwala opatsirana (IV) ku chipatala koma makamaka anthu omwe ali ndi chitsulo chowopsa amapereka deferoxamine pansi pamtambo (pansi pa khungu) kunyumba. Kulowetsedwa kumaperekedwa kwa maola 8 mpaka 12 usiku pogwiritsa ntchito batiri yaying'ono yamagetsi. Zomwe zimachitika khungu la m'deralo zingathe kuchitika koma zingachiritsidwe pothandizira kuchepa kwa mlingo kapena kutsekemera kwa hydrocortisone.
Anthu ambiri amalekerera bwino deferoxamine koma chifukwa chakuti infusions ayenera kuperekedwa kwa nthawi yaitali, anthu ambiri amalefuka chifukwa cha mankhwalawa.
Kumva ndi kutayika kwa masomphenya kumachitika pa mlingo waukulu, kotero pamene mukupatsidwa mankhwala ndi deferoxamine muyenera kumvetsera mwachidwi chaka ndi chaka.
Deferasirox
Chitsulo chodziwika kwambiri cha iron chelator chomwe chikugwiritsidwa ntchito ku United States ndi deferasirox. Zimathandiza pakuchotsa chitsulo ku chiwindi ndi mtima, ziwalo ziwiri zomwe zimakhala ndi chitsulo chowopsa.
Deferasirox imabwera m'njira ziwiri: pulogalamu yosabalalitsa yomwe imatchedwa Exjade ndi piritsi yomwe ingamezedwe yotchedwa Jadenu.
Chimodzi mwa zothandiza kwambiri za deferasirox ndikuti ndi mankhwala amlomo omwe amamwa kamodzi patsiku. Tsoka ilo, palibe mtundu wamadzi wa deferasirox. Ngakhale kuti Jadenu amabwera mosavuta piritsilo, ana ambiri omwe ali ndi anemias odalira magazi, amakhala ndi chitsulo chosakanikirana asanathe kumwa mapiritsi. Mwa ana awa, Exjade angagwiritsidwe ntchito.
Zotsutsana ndi chiganizo ichi ndikuti zimakonda kwambiri icky. Pulogalamuyi imathera mumadzi koma nthawi zambiri imatha kusungunuka ndipo madzi amatha kuyika. Zakudya zingakhale bwino pang'ono mwa kuziika mu apulo kapena madzi a lalanje. Pali mayesero omwe amapitilira kuchipatala kuti aone momwe zowonongeka za deferasirox zingapangidwire. Chokhachokha chingagwiritsidwenso ntchito kwa anthu omwe ali ndi thalassemia osadalira magazi omwe ali ndi zaka zoposa 10.
Deferiprone
Deferiprone (Ferriprox) ndi yatsopano ya iron chelator yomwe ikuvomerezedwa ku United States. Ngakhale kuti deferiprone ndi mankhwala opatsirana pakamwa, pakali pano amatengedwa katatu patsiku. Amadza ngati mapiritsi kapena madzi. Zikuwoneka kuti deferiprone angakhale mankhwala abwino kwambiri kuchotsa chitsulo kuchokera mumtima.
Ngakhale kuti anthu ambiri amalekerera deferiprone popanda nkhani, zambiri zokhudzana ndi zotsatira zake ndi agranulocytosis, chiwerengero chochepa cha neutrophil chomwe chingapangitse chiopsezo cha matenda. Pogwiritsa ntchito mankhwalawa, chiwerengero cha neutrophil chiyenera kutsatiridwa mwatsatanetsatane ndi chiwerengero cha magazi chodzaza mlungu ndi mlungu (CBC).
Thandizo Labungwe
Anthu ena okhala ndi chitsulo chowopsa angafune chithandizo ndi oposa one chelator nthawi yomweyo. Izi zikhoza kutenga deferasirox kapena deferiprone tsiku lililonse ndi deferoxamine infusions 3 mpaka 4 pa sabata.
Ngati muli ndi mafunso okhudza ngati iron chelator ndi yoyenera kwa inu, kambiranani ndi wothandizira zaumoyo wanu.
Onetsetsani kuti mumamwa mankhwala monga momwe mwalangizira ndikudziwitsa dokotala wanu nkhawa zilizonse zomwe muli nazo.
> Chitsime:
> Schrier SL ndi Bacon BR. Chithandizo chamakono cha thalassemia ndi zina zowonjezera zitsulo. > Mu: UpToDate, Post TW (Ed), UpToDate, Waltham, MA.