Makhalidwe a RBC amathandizira kudziwa zomwe zimayambitsa matenda a m'thupi ndi matenda ena
Ngati mukuyang'ana selo lanu lofiira la magazi likuyang'ana pa CBC, mukhoza kuwona zoyambirira zosiyana siyana kuphatikizapo chiŵerengero chonse. Maselo ofiira a magazi, otchedwa MCHC, MCV, MCH, ndi RDW amapereka zambiri zokhudzana ndi maselo ofiira anu ndipo zingakuthandizeni kudziwa chomwe chimayambitsa matenda a magazi ndi zina.
Tiyeni tiwone zambiri zomwe zili mu chiwerengero chanu cha magazi ( CBC ), kuphatikizapo chiwerengero chanu cha maselo ofiira a magazi, ndiyeno kambiranani tanthauzo ndi kufunika kwa zizindikiro izi.
Yanu Yonse Yopereka Magazi (CBC)
Kuwerenga kwa magazi nthawi zonse (CBC) ndi kuyesa kwa magazi kolamulidwa ndi madokotala kotero kuti athe kuyesa maonekedwe ndi khalidwe la maselo a m'thupi lanu. Maselo a magazi awa ndi awa:
- Maselo oyera (leukocyte) omwe amathandiza kuthana ndi matenda
- Maselo ofiira ofiira (erythrocytes) omwe amagawira oksijeni m'thupi lonse
- Mipata (thrombocytes) yomwe imatulutsa magazi
Red Blood Cell Count (RBC)
Nambala yofiira ya magazi (RBC) ndi nambala ya maselo ofiira a magazi omwe amapezeka m'magazi anu. Kawirikawiri chiwerengero cha RBC chimadalira zaka ndi ubwamuna:
- Kwa amayi, 4.2 - 5.4 miliyoni / mcL
- Kwa amuna, 4.7 - 6.1 miliyoni / mcL
- Kwa ana 4.1 - 5.5 miliyoni / mcL
Chiwerengero chochepa cha maselo ofiira magazi chimatchedwa kuti magazi . Pali zifukwa zosiyanasiyana zomwe zimayambitsa matenda a kuchepa kwa magazi, zomwe zimasowa chitsulo ndi chimodzi chokha. Maselo ofiira a maselo ofiira amathandiza kwambiri kusiyanitsa zifukwa izi.
Chiwerengero cha maselo ofiira a m'magazi amatchedwa erythrocytosis kapena polycythemia .
Zifukwa zimaphatikizapo kutaya madzi m'thupi (momwe msinkhu suli wotsika kwambiri, koma umawoneka motero chifukwa cha kuchepa kwa madzi m'magazi), kufunikira kwa oxygen yambiri yokwanira yonyamula magazi, monga kukhala kumtunda wapamwamba, COPD, kapena kuperewera kwa mtima, komanso kuchulukitsidwa kwa maselo ofiira mumtambo chifukwa cha zinthu monga polycythemia vera.
Pamene kuyang'ana pa chiwerengero chonse cha RBC chingakuuzeni ngati nambala yanu ya maselo ofiira ndi otsika, mwachibadwa, kapena apamwamba, sikukuuzani chifukwa chake chiŵerengerocho si chachilendo. Choncho pakufunika kupitiliza kuunika kwa maselowa. Ngakhale kuti RBC chiwerengero ndi chachilendo, kuyang'ana pa zikhombo za RBC nthawi zina zimapereka zidziwitso zofunika pakuzindikira za matenda.
Nkhope za Red Blood Cell (RBC)
Pamodzi ndi chiwerengero chonse cha RBC, zikhombo za RBC zimapereka chidziwitso chokhudzana ndi kukula kwa maselo ofiira a magazi. Izi zikhoza kugwiritsidwa ntchito kuti azindikire chifukwa chomwe zimayambitsa matenda ochepetsa magazi m'thupi komanso kupereka zizindikiro zofunika zokhudzana ndi matenda ena omwe mungakhale nawo.
Zizindikiro za RBC zimakhala ndi zigawo zinayi zosiyana zomwe zimatchedwa kuti corpuscular corpuscular volume (MCHC), kutanthauza kuchuluka kwa mphamvu yamagetsi (MCV), kutanthauza hemoglobin (MCH), komanso red cell distribution distribution (RDW).
Kutanthauza Mavuto a Hemoglobini Amtundu Wathu (MCHC)
Maganizo otchedwa hemoglobin concentration (MCHC) ndi a hemoglobin ambiri omwe ali ndi maselo ofiira.
Hemoglobini ndi mapuloteni othandiza zitsulo m'maselo ofiira ofiira omwe amayendetsa oksijeni. Ndicho chinthu chomwe chimapereka maselo ofiira a mtundu wawo. Kusintha kwina kulikonse kungayambitse maselo kuoneka wofiira.
MCHC imakuuzani inu ngati maselo ofiira a munthu ali ndi hemoglobin yosachepera kuposa zomwe zingayembekezere. Mtundu woyenerera wa MCHC uli pakati pa 33.4 ndi 35.5 magalamu pa deciliter pa akuluakulu. Mtengo uli wonse kunja kwa malo otanthauzira amafotokozedwa motere:
MCHC yapamwamba: Pamene MCHC ili pamwamba, maselo ofiira amatchulidwa ngati owonetsera . Zomwe zimayambitsa MCHC (zomwe si zachilendo) zimaphatikizapo:
- Kutaya magazi m'thupi mwachangu , momwe thupi limathamangira maselo ofiira a m'magazi
- Hereditary spherocytosis, matenda omwe amapezeka ndi matenda a magazi ndi amchere
Low MCHC: Pamene MCHC ili yotsika, maselo amatchulidwa kukhala achinyengo . Zovuta zowonjezera ndizo:
- Kuperewera kwa chuma kwa iron . Chiwerengero chilichonse cha matendawa chingayambitse kuchepa kwa magazi, kuphatikizapo mimba, kuwonongeka kwa magazi, kutayika kwa chitsulo m'matumbo (chifukwa cha matenda a Celiac kapena matenda a Crohn), komanso kusowa zakudya zowonjezera.
Kaya chithokomiro kapena chithokomiki, chithandizo chachikulu chimayang'ana kuthetsa vutoli. Iron supplementation ndi zakudya zowonjezera zowonjezera zingathandize kuthandizira kuchepa kwa magazi m'thupi, koma kupatsirana kwachitsulo sikovomerezeka kwa anthu omwe sali osowa chitsulo (zowonjezera chitsulo zingasungidwe m'chiwindi ndi mtima). Kuikidwa magazi kungagwiritsidwe ntchito pa milandu yovuta kwambiri.
Vuto Lachidule Limene Limaphatikizapo (MCV)
Kutanthauza mphamvu yamagulu (MCV) imayeza maselo ofiira a maselo ofiira, omwe amatanthauza kukula kwake kwa maselo okha.
Mtundu wodabwitsa wa MCV uli pakati pa akazi ndi azimayi okwana 80 ndi 96 pa selo.
Lowani MCV: MCV yochepa imasonyeza kuti maselo ofiira aang'ono ndi aang'ono, kapena a microcytic . Zovuta zowonjezera ndizo:
- Tsitsani poizoni
- Thalassemia (ma thalassemias ali ndi matenda omwe amadziwika ndi hemoglobin yosadziwika)
- Matenda a umoyo wambiri
- Matenda a nyamakazi
- Giant cell arteritis .
Mgwirizano wa MCV: MCV yochuluka imatanthauza kuti maselo ofiira a m'magazi ndi aakulu kusiyana ndi zachibadwa, kapena macrocytic . Zifukwa za macrocytic magazi m'thupi zimaphatikizapo:
- Vitamini B12 imalephera
- Kulephera kwa anthu (zonse zochepa za vitamini B12 ndi kulephera kwa anthu kumatchedwanso kuti megaloblastic anemia, chifukwa cha ma CRBC)
- Matenda a chiwindi
- Kumwa mowa
- Hypothyroidism
- Mankhwala monga chemotherapy mankhwala ndi retroviral mankhwala a HIV
MCV yachibadwa: Ndikofunika kuzindikira kuti munthu akhoza kukhala ndi magazi m'thupi komanso kukhala ndi MCV yachibadwa. Izi zimatchedwa normocytic anemia. Zifukwa zimaphatikizapo:
- Kutaya magazi mwadzidzidzi
- Kulephera kwa impso
- Hemolytic anemia
- Kufooka kwa zakudya
Hemoglobini Yamtundu Weniyeni (MCH)
Kutanthauza magazi a hemoglobin (MCH) ndi kuchuluka kwa hemoglobin pa selo lofiira m'magazi mu chitsanzo cha magazi. Mtundu woyenera wa MCH uli pakati pa 27.5 ndi 33.2 zithunzi pa selo.
MCH imayendera mwachindunji chiwerengero cha MCV, ndipo madokotala ena amapeza kuti mayeserowa ndi ochepa. Choncho, ngati kukula kwa maselo ofiira ndi aakulu (monga kuyesedwa ndi MCV), kuchuluka kwa hemoglobini pa maselo ofiira a m'magazi kudzakhala pamwamba (monga kuyeza kwa MCH), ndi mofananamo.
Ngakhale MCH ikhoza kugwiritsidwa ntchito yokha kuti mudziwe ngati magazi ali ndi hyper-, hypo-, kapena normocytic, MCV iyenera kuganiziridwa pamodzi ndi MCH popeza liwu la selo limakhudza kwambiri zomwe zili mu hemoglobin pa selo.
Ukulu wa Red Cell Distribution (RDW)
Kufiira kwa maselo ofiira ofiira (RDW) ndi mayeso omwe amasonyeza kusiyana kwa maselo ofiira a magazi (ndipo ndi ofanana ndi kusiyana kwa MCV). RDW yachibadwa imatanthauza kuti maselo ofiira ofiira onse ali ofanana ndi kukula, pamene RDW yapamwamba imatanthauza kuti pali kusiyana kwakukulu kwa kukula kwa maselo ofiira a magazi.
Madokotala ena amakhulupilira kuti RDW ndi imodzi mwa maofesi ofuniira othandiza kwambiri popanga matenda. Kuwonjezera pa udindo wake pothandiza kuthandizira kuchepetsa magazi m'thupi, RDW yakwezeka inganeneratu kukhalapo kwa matenda a mitsempha mwa anthu omwe ali ndi kuthamanga kwa magazi. Zimaperekanso chitsimikizo kwa kuchepa koyambirira kwa zakudya zomwe sizikudziwika ndi mayesero ena okha. Pomalizira pake, ndi mayeso abwino kuti mudziwe ngati pakufunika kuyesedwa koyenera, monga magazi amodzi.
Mtundu woyenera wa RDW ndi 10.2 mpaka 14.5 peresenti.
RDW imathandiza kwambiri poyesedwa pamodzi ndi MCV. Chitsanzo cha zifukwa zina ndizo:
High RDW ndi otsika MCV (microcytic):
- Kuperewera kwa chuma kwa iron
- Matenda a m'thupi
High RDW ndi MCV yachibadwa (normocytic):
- Kuperewera kwa chuma kwa iron
- Kuphatikiza anemias
- Kutaya magazi (patapita masiku angapo)
- Mitundu ya haemoglobin
High RDW ndi MCV (Macrocytic):
- Vitamini B12 imalephera
- Kulephera kwa anthu
- Cold agglutinin matenda
- Myelodysplastic syndrome
- Kuteteza thupi kwa thupi kumatenda
RDW yachilendo ndi MCV yapamwamba :
- Matenda a chiwindi (aakulu)
- Apulosi ya magazi
- Zotsatira za mowa
RDW ndi MCV yochepa :
- Matenda a umoyo wambiri
- Mitundu ina ya thalassemia
- Mahemoglobini ena osadziwika
Ndikofunika kuzindikira kuti izi ndi zitsanzo zochepa chabe, ndipo pali mwayi wambiri.
Mawu Ochokera
CBC ndiyeso yeniyeni ya magazi ndipo imaphatikizapo kuchuluka kwa maselo ofiira a magazi kuphatikizapo kuchuluka kwa maselo oyera ndi mapiritsi. Kuwerengera kwa maselo ofiira a magazi kungauze madokotala za chiwerengero cha maselo ofiira a m'magazi omwe muli nawo koma sunganene pang'ono za chifukwa china chilichonse chosawonongeka.
Zizindikiro za RBC, poyang'anitsitsa makhalidwe a maselo ofiira a magazi, zimathandiza osati kungoganizira chabe chifukwa cha kuchepa magazi m'thupi koma pozindikira momwe matenda amapezera ngakhale pamene maselo ofiira a magazi amadziwika bwino.
Kuphatikizidwa kwa zizindikirozi kumaperekanso zizindikiro zofunika pakuchepetsa kuchepa kwa magazi. Zitsanzo zomwe tatchula pamwambapa ndizochepa chabe zomwe zingayambitse, ndikudziwitseni chifukwa chomwe chimayambitsa kuchepa kwa magazi nthawi zina ndi chovuta kwambiri. Mayeso a magaziwa amagwiritsidwa bwino pophatikizapo mbiri yakale, kufufuza kwathunthu, ndi mayesero alionse omwe amasonyeza.
Kuphunzira za mayesero a magaziwa kungakuthandizeni kufunsa mafunso a dokotala kuti mumvetsetse bwino momwe akugwiritsira ntchito, kapena kuti ayesetse kuyesa. Powonjezereka, anthu akuitanidwira kuti athandize nawo paumoyo wawo, ndikuphunzira momwe angasankhire zokhudzana ndi thanzi lawo. Kupeza nthawi yophunzira za ma bukhu anu angakuthandizeni kukhala ndi mphamvu pakupanga zosankha zanu zokha.
> Zotsatira:
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> Nagao, T., ndi M. Hirokawa. Kusanthula ndi Chithandizo cha Macrocytic Anemia kwa Achikulire. Journal of General and Family Medicine . 2017. 18 (5): 200-204.
> Shah, N., Pahuja, M., Pant, S. et al. Kukula kwa Cell Red Red Distribution ndi Kuopsa kwa Kufa kwa Maganizo: Zofufuza za National Health and Nutrition Research Survey (NHANES) -III. International Journal of Cardiology . 2017. 232: 105-110.