Ma Labs Amodzi ndi Zomwe Amatanthauza
Musanadziŵe kuti muli ndi vuto la myeloproliferative neoplasm simungasowe ntchito ya magazi, mwina kamodzi pa chaka ndi mayeso anu a pachaka. Tsopano inu mukhoza kudabwa-kodi magazi onsewa amagwira ntchito yanji? Kodi dokotala wanga akufuna chiyani? Ntchito yonse yamagazi yomwe ingathe kulamulidwa ndi yoposa momwe tikhoza kuwerengera pano, koma tiyeni tiyang'ane pazowona.
Complete Blood Count (CBC)
CBC ndi imodzi mwa ntchito yosavuta kwambiri yomwe amagwiritsa ntchito poyang'anira matenda a magazi.
CBC imayang'anitsa maselo anu a magazi: maselo oyera a magazi, maselo ofiira a magazi, ndi mapuloletsiti. Chiyesochi nthawi zambiri chimakhala choyamba chodziwitsa zomwe zimayambitsa zizindikiro zanu, ndizo gawo la ntchito yothandizira, ndipo imatha kukopa nthawi zambiri panthawi ya chithandizo.
Maselo oyera (WBC) ndi mbali ya chitetezo cha mthupi lanu ndipo amathandiza kuthana ndi matenda. Pali mitundu 5 ya WBC : neutrophils, lymphocytes, monocytes, eosinophils, ndi basophils. Chiwerengero cha WBCs m'magazi anu kawirikawiri ndi chiwerengero choyamba chofotokozedwa pa CBC. Gawo la CBC, lotchedwa kusiyana kapena kusiyana, likuwoneka kuti chiwerengero cha mtundu uliwonse wa WBC ulipo.
Mu polycythemia vera ( PV ) kapena thrombocythemia ( ET ), chiwerengero chanu cha WBC chikhoza kukwera (leukocytosis). Pachiyambi myelofibrosis ( PMF ), anthu ena omwe ali ndi chiwerengero cha WBC chiwerengero, ena amakhala achilendo, pamene ena adzakhala ndi WBC count (leukopenia).
Maselo ofiira a m'magazi (RBC) amanyamula mpweya kuchokera m'mapapo kupita ku ziwalo.
Pali njira zingapo zoyang'anira maselo ofiira a m'magazi a CBC. Choyamba, chiwerengero cha RBC ndi chiwerengero cha maselo ofiira a magazi. Hemoglobin ndi mapuloteni omwe amapezeka mu RBC yomwe imatenga mpweya. Hematocrit ikuimira kuchuluka kwa magazi omwe amapangidwa ndi ma RBC (poyerekeza ndi WBC ndi mapuleti).
Pazifukwa zomwe zimayambitsa kuchuluka kwa ma CRBC, monga polycythemia vera, hemoglobin ndi hematocrit zili pamwamba. Matenda a hematocrit amagwiritsidwa ntchito poyang'anira momwe chithandizo chikuyendera mu PV. Mankhwala ndi phlebotomy (kuchotsedwa kwa magazi) zimasinthidwa malinga ndi mtundu wofunika wa hematocrit (makamaka osachepera 45 peresenti mwa amuna ndi osachepera 42 peresenti mwa akazi).
Mu PMF, hemoglobin yanu ndi gawo la ndondomeko yogwiritsira ntchito ndondomeko yanu. Izi zingasinthe pa nthawi ya matenda anu. Hemoglobini yosachepera 10 gramu pa deciliter (g / dL) pazotsatira, imawerengera ngati zigawo ziwiri muzowonjezereka (zizindikiro zambiri zofanana ndi zoopsa). Ikhoza kugwiritsidwanso ntchito kuti mudziwe ngati mukufuna kuika magazi.
Kuikidwa magazi kumaperekedwa nthawi zambiri pamene hemoglobin imadutsa pansi pa magalamu asanu ndi atatu pa deciliter kapena ngati muli ndi chizindikiro (kutopa, chizungulire, kuthamanga kwa mtima). Kufuna kuikidwa magazi kumaphatikizapo mfundo yowonjezerapo mu ndondomeko yoyenera.
Chiwerengero cha platelet chiphatikizidwanso mu CBC. Mofanana ndi hematocrit mu PV, mwa anthu okhala ndi ET akusowa chithandizo, chiwerengero cha platelet chimagwiritsidwa ntchito kuti asinthe machiritso omwe amafunika kuwerengera. Mu PMF, mapaleti amawerengera osachepera 100,000 maselo pa microliter akuwonjezera mfundo imodzi potsata yanu.
Smear ya Magazi
ET ndi PV zingasinthe kukhala myelofibrosis ndi khansa ya m'magazi, zizindikiro zoyambirira za kusinthaku zikhoza kuzindikiridwa pa CBC, makamaka kuchepa kwa hemoglobin ndi countlet count. Selo lofiira m'magazi ndi mapuloteni zimakhala zosaoneka mofanana mu myelofibrosis zomwe zingathe kuwonedwa pamagazi a magazi (maselo a microscope a maselo a magazi).
von Willebrand Panel
Anthu okhala ndi ET ali pangozi yotenga matenda a von Willebrand, matenda a magazi. Mng'onoting'ono uwu umakwera mmwamba momwe chiwerengero cha platelet chikwera mmwamba (oposa milioni imodzi platelets pa microliter). Ngati muli ndi ET ndi magazi, gulu la von Willebrand lingatumizedwe kuti mudziwe ngati ichi ndi chifukwa.
Kuchiza kuli kuchepetsa chiwerengero cha platelet.
Mukayamba kugwira ntchito yamagazi, zingakhale zokhumudwitsa komanso zovuta kuona chifukwa. Kambiranani ndi dokotala wanu nkhawazi kuti mutha kukhala pa tsamba limodzi.
> Chitsime:
> Teferri A. Kupatsirana ndi Kupatsirana kwa Mavuto Ofunika a Thrombocythemia, Matenda a Myelofibrosis Oyambirira ndi Kuyang'anira Myelofibrosis Oyambirira, ndi Kugonjetsa ndi Kuchiza kwa Polycythemia Vera. Mu: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. 2016.