Mayesero Ambiri ndi Odziwika Amagazi Amagwiritsidwa Ntchito Kufufuza Arthritis
Kuyesera magazi kumagwiritsidwa ntchito kuthandiza kuthandizira matenda a nyamakazi , kuyang'anira njira zothandizira, komanso kuyang'anira matenda. Pamene ma laboratory magazi ayesa zida zamtengo wapatali, sizitsimikizika pamene zikuwoneka zokha. Kuti apange chidziwitso cholondola, mbiri yachipatala ya wodwalayo iyenera kuyesedwa, pamodzi ndi zotsatira za kuyesa ma laboratory ndi maphunziro ojambula.
Pali mayeso ambiri a magazi komanso mayesero apadera a magazi omwe amagwiritsidwa ntchito pofufuza nyamakazi.
Mayesero Amagazi Ambiri
Complete Blood Count (CBC)
Kuwerengera kwathunthu kwa magazi ndi kuyesa kwa magazi komwe kumawerengetsera chiwerengero cha maselo ofiira a magazi, maselo oyera a magazi , ndi mapulogalamu . Zigawo zatchulidwa pamwambazi zimayimitsidwa mu plasma (gawo lakuda, lachikasu, la magazi a magazi). Makina odzigwiritsira ntchito m'ma laboratori amatha kuwerengera mitundu yosiyanasiyana ya selo.
Maselo oyera
Maselo oyera amtunduwu nthawi zambiri amakhala pakati pa 5,000-10,000 ndi microliter ya magazi. Kuwonjezeka kwabwino kumatanthauza kutupa kapena matenda. Zinthu monga kuchita masewera olimbitsa thupi, kuzizira, ndi kupanikizika zimatha kukweza khungu la selo yoyera.
Maselo ofiira
Zizolowezi zowerengeka za maselo ofiira ofiira amasiyana ndi chiwerewere.
- Amuna amakhala ndi makhalidwe abwino pafupi ndi maselo ofiira 5-6 miliyoni pa microliter.
- Mkazi amakhala ndi pakati pa 3.6-5.6 miliyoni maselo ofiira pa microliter.
Hemoglobin / Hematocrit
Hemoglobin, chigawo chokhala ndi chitsulo cha maselo ofiira omwe amanyamula mpweya, chimayambanso kuwerengedwa kwathunthu kwa magazi. Kulemera kwake kwa hemoglobin kwa amuna ndi 13-18 g / dl. Hemoglobini yachibadwa ya akazi ndi 12-16 g / dl.
Matenda a hematocrit kuchuluka kwa maselo ofiira monga peresenti ya magazi athunthu.
Hemocitis yowonongeka kwa amuna ali pakati pa 40-55% ndipo hematocrit yachibadwa kwa akazi ndi 36-48%. Kawirikawiri, hematocrit imakhala pafupifupi maulendo atatu a hemoglobini. Kuchepetsa miyezo ndikutanthauza kuchepa kwa magazi m'thupi .
MCV, MCH, MCHC ndi zizindikiro zofiira zomwe zimasonyeza kukula ndi hemoglobin zomwe zili ndi maselo ofiira. Zizindikirozi zingapereke zifukwa zokhudzana ndi chifukwa chomwe chilili m'thupi.
Platelets
Mipata ya pulasitiki ndizofunikira kwambiri pa mapangidwe a nsalu . Mankhwala ambiri omwe amachiritsira matenda a nyamakazi angachepetse chiwerengero cha platelet kapena amatha kugwira ntchito yamapiritsi. Makhalidwe abwino a platelet amatha kuchokera 150,000-400,000 pa microliter.
Kusiyana
Peresenti ndi nambala yeniyeni ya mtundu uliwonse wa selo loyera la magazi imatchedwa kusiyana.
- Matenda a neutrophils amachulukitsidwa ku matenda a bakiteriya komanso kutupa kwakukulu.
- Lymphocytes akuwonjezeka mu matenda opatsirana.
- Ma monocyte amachulukitsidwa mu matenda opatsirana.
- Mavitaminiwa amachulukitsidwa mu chifuwa ndi zina. Chiwerengero chokwanira cha eosinophils chimadziwika ngati eosinophilia .
- Ma Basophil , omwe kawirikawiri amakhala 1 kapena 2% a kusiyana koyera, nthawi zambiri siwonjezeka.
Kutupa
Ndondomeko yotupa ingayambe kusintha m'magazi. Kuwerengera kwa maselo ofiira kungapite pansi, chiwerengero choyera cha selo chikhoza kukwera, ndipo kuwerengeka kwa platelet kungakwezeke.
Ngakhale kuperewera kwa magazi kumaphatikizapo nyamakazi yotupa ingayambitsidwe ndi zinthu zina, monga kutayika magazi kapena kusowa kwachitsulo. Pokhapokha ngati zifukwa zina zatulutsidwa kunja akhoza dokotala kutanthauzira zolakwika za magazi monga chizindikiro cha kutupa.
Chemistry Panels
Pulojekiti yamagetsi ndi mayesero angapo omwe amagwiritsidwa ntchito pofufuza ntchito zamagetsi. Gulu la mayesero amachitidwa pa seramu (gawo la magazi popanda maselo). Mchere wotchedwa electrolytes, m'madzi kapena minofu (mwachitsanzo, sodium, potaziyamu, chloride), ndi mbali ya chipangizo cha chemistry. Palinso mayesero omwe amakhala ngati zizindikiro zowopsa kwa mtima, shuga, ntchito ya impso , ndi chiwindi .
Mwachitsanzo, wodwala ali ndi mlingo waukulu wa creatinine akhoza kukhala ndi vuto la impso. Creatinine ndizowonongeka zomwe zimapezeka m'magazi. Mitundu ina ya kutupa nyamakazi ingakhudze ntchito ya impso. Mankhwala ena am'thupi angakhudze ntchito ya impso, nayonso. Uric acid ndi mayeso ena omwe akuphatikizidwa mu gawo la magazi. Ngati kukwera, uric acid angakhale chizindikiro cha gout. Izi ndi zitsanzo zochepa chabe. Ndipotu, chipangizo cha chemistry chimapereka zambiri zokhudza momwe thupi likugwirira ntchito.
Mayesero a Magazi Opadera
Mlingo wa Erythrocyte Sedimentation Rate (ESR)
Mlingo wa erythrocyte m'madzi ndi chiyeso chomwe chimaphatikizapo kuyika magazi mu chubu lapadera ndikudziwika momwe maselo ofiira amagawira mofulumira pansi pa ola limodzi. Pamene kutupa kulipo, thupi limapanga mapuloteni m'magazi omwe amapanga maselo ofiirawo pamodzi. Maselo olemera kwambiri a maselo akugwa mofulumira kuposa maselo ofiira ofiira. Kwa anthu wathanzi, mlingo woyenera ndi wa mamita 20 mu ola limodzi (0-15 mm / h kwa amuna ndi 0-20 mm / hr kwa akazi). Kutupa kumawonjezera mlingo kwambiri. Popeza kutupa kungagwirizane ndi zikhalidwe zina osati nyamakazi, kuyesedwa kwa mlingo wa sedimentation yokha kumaonedwa kuti sikunayake.
Chidule cha Rheumatoid (RF)
Chifuwa chachikulu ndi anti antibody yomwe imapezeka mwa odwala ambiri omwe ali ndi nyamakazi . Chifuwa chachikulu cha chifuwa chachikulu chinapezeka m'zaka za m'ma 1940 ndipo chinakhala chida chachikulu chogwiritsira ntchito matenda a rheumatology. Pafupifupi 80% ya odwala nyamakazi a nyamakazi ali ndi kachilombo ka magazi m'magazi awo. Matenda aakulu a chifuwa chachikulu amapezeka ndi matenda aakulu.
Chifuwa chachikulu chimatha kutenga miyezi yambiri kuti muwonetse magazi. Ngati atayesedwa mofulumira kwambiri pa matendawa, zotsatira zake zingakhale zolakwika ndi kuyesanso kuyenera kuganiziridwa patsiku lomaliza. Nthawi imene odwala amakhala ndi zizindikiro za matenda a nyamakazi koma ndizogwiritsira ntchito mphamvu ya chifuwa chachikulu, madokotala angaganize kuti matenda ena amatsanzira nyamakazi ya nyamakazi. Matenda a chifuwa chachikulu amatha kuchitika chifukwa cha zizindikiro zina zotupa kapena matenda opatsirana, ngakhale kuti nthawi zambiri pamakhala zovuta zoterezi, zimakhala zochepa kusiyana ndi nyamakazi.
Kulemba HLA
Maselo oyera angapangidwe kuti akhalepo HLA-B27. Chiyesochi ndichizolowezi kuzipatala zomwe zimapangidwira. HLA-B27 ndi kachilombo kamene kamakhudzana ndi mitundu ina ya nyamakazi, makamaka ankylosing spondylitis ndi Reiter's syndrome / Reactive Arthritis .
Antinuclear Antibody (ANA)
Mayeso a ANA (antinuclear antibody) amachitidwa kuti athandizidwe kupeza matenda ena a rheumatic . Odwala omwe ali ndi matenda ena, makamaka lupus , amapanga tizilombo toyambitsa matenda kumtundu wa maselo a thupi. Matendawa amatchedwa antitinuclear antibodies ndipo amatha kuika seramu ya wodwalayo pamagetsi enaake omwe ali ndi maselo omwe amaoneka. Dothi lokhala ndi tizilombo tofiirasenti ndiwonjezeredwa. Dayi imamangiriza ma antibodies pa slide, kuwapangitsa kuti awoneke pansi pa kuwala kwa microscope.
- Oposa 95% odwala lupus ali ndi mayeso abwino a ANA.
- 50% ya odwala nyamakazi ya nyamakazi ndi ofunika kwa ANA.
Odwala omwe ali ndi matenda ena angakhalenso ndi mayeso abwino a ANA. Kuti mumvetsetse bwinobwino, ziyeneranso kuziganizira.
C-Reactive Protein (CRP)
Mapuloteni a C-Reactive amapanga mapuloteni apadera omwe amapangidwa ndi chiwindi. Puloteni imapezeka m'magazi a seramu panthawi yomwe imakhala yotupa kwambiri kapena matenda.
Monga kuyesa kwa magazi, CRP ikuwoneka kuti si yeniyeni. Chotsatira chachikulu ndicho chizindikiro cha kutupa kwakukulu. Pamene matenda a rheumatic inflammatory rheumatic, monga nyamakazi ya nyamakazi ndi lupus, madokotala angagwiritse ntchito mayeso a CRP kuti ayang'ane ntchito yothandizira ndi matenda.
Lupus Erythematosus (LE)
Mayeso a selo la LE sagwiritsidwanso ntchito. Komabe, zomwe anapeza poyamba zinatsegula malo onse opangira zida zankhondo. Vuto - okhawo 50% a odwala lupus amapezeka kuti ali ndi mayeso abwino a LE.
Anti-CCP
Anti-CCP (anti-cyclic citrullinated anti-peptide antibody) ndi imodzi mwa mayesero atsopano a magazi omwe amagwiritsidwa ntchito pofuna kutsimikizira kuti matenda a nyamakazi amapezeka. Ngati wodwalayo ali pamwambamwamba, zingatanthauzenso kuti pali ngozi yaikulu yowonongeka kwakukulu.
Anti-DNA ndi Anti-Sm
Odwala Lupus amapanga ma antibodies ku DNA (deoxyribonucleic acid). Chiyeso chilipo chomwe chimayang'ana kukhalapo kwa anti-DNA. Ndicho chida chothandizira kudziwa, makamaka popeza kuti anti-DNA sichipezeka mwa anthu opanda lupus. Chiyesochi ndi chida chabwino chowunika chifukwa njira zotsutsana ndi DNA zimakwera ndi kugwidwa ndi matenda.
Odwala a Lupus amakhalanso ndi ma antibodies kwa Sm (odana ndi Smith), chinthu china muchisumbu cha selo. Mankhwala a Sm omwe amapezeka ndi a lupus okha. Mayesowa sali othandiza kwambiri pakuwunika ntchito, ngakhale.
Aphatikizidwe
Njira yothandizirayi ndiyiyi yovuta ya mapuloteni a magazi amene ali mbali ya chitetezo cha thupi. Mapuloteniwo sagwira ntchito mpaka anti-antibody imangika kwa antigen ndipo imayambitsa dongosolo lothandizira. Njirayi imapanga zinthu zomwe zimathandizira kuwononga mabakiteriya komanso kumenyana ndi adani. Zomwe zimayambitsa zimaphatikizapo kumathandiza ndikusiya zipsinjo zomwe zimasonyeza kuti thupi limapangidwanso. Odwala Lupus kawirikawiri amachepetsa chiwerengero chokwanira . Kuyezetsa kothandizira kungathandizenso kufufuza matenda a lupus.
Zotsatira:
Kelley's Textbook ya Rheumatology. Elsevier. Kusindikiza kwachisanu ndi chinayi.
Buku la Duke University Medical Center Buku la Arthritis, David S. Pisetsky, MD, Ph.D.