Hemolytic anemia imatchula gulu lalikulu la zinthu zomwe zimawonongeke mwamsanga maselo ofiira a magazi. Pafupipafupi moyo wa maselo ofiira ndi masiku 120. Kumapeto kwa masiku 120, selo lofiira la magazi liphwasulidwa ndipo mbali zake zimagwiritsidwanso ntchito kuti apange zatsopano. Pamene maselo ofiira a magazi akuphwa mofulumira kuposa izi, amatchedwa hemolysis.
Hemolysis ingayambidwe ndi zinthu zambiri zosiyana. Mitundu ina yomwe mumalandira, monga choloŵa choloŵa cholowa ndi pyruvate kinase . Zina zimayambitsidwa ndi chitetezo cha mthupi lanu kumathyola maselo ofiira a magazi, monga magazi omwe amachititsa kuti magazi asapitirire magazi kapena matenda a hemolytic a mwana wakhanda . Mu mankhwala osokoneza bongo a hemolytic anemia, pali njira zosiyanasiyana zomwe zimayambitsa hemolysis mukalandira mankhwala kapena poizoni.
Zizindikiro ndi Zizindikiro
Zizindikilo za matenda a magazi omwe amachititsa kuti magazi asokonezeke ndi ofanana ndi mitundu ina ya magazi. Zizindikiro zimenezi zimasiyana pang'ono pokhapokha ngati maselo ofiira amagawanika pamene akupezeka (intravascular hemolysis) kapena kunja kwa mitsempha (makamaka chiwindi ndi ntchentche). Zizindikiro zanu zingakhalepo:
- Jaundice, khungu la chikasu
- Msuzi wamdima (wa tiyi kapena wa cola)
- Kuwala, utoto wotuwa wa khungu
- Kutopa, kutopa
- Chizungulire
- Kuchuluka kwa mtima wamtima
- Kupuma pang'ono
- Splenomegaly, phula lokulitsa
Kudziwa
Kuzindikira kwa mankhwala osokoneza bongo omwe amachititsa mankhwalawa kumayamba ngati njira zambiri za kuchepa kwa magazi, ndi kuchuluka kwa magazi (CBC). Matenda a m'mimba amasonyezedwa ndi hemoglobin yotsika komanso / kapena hematocrit. Mu hemolytic anemia, maselo ofiira a magazi amawonjezereka chifukwa cha kuchuluka kwa mankhwala a reticulocytes, omwe amakhala ndi maselo ofiira a magazi.
Chiyesochi chimatchedwa chiwonongeko ndipo chikhoza kufotokozedwa ngati peresenti kapena mtheradi wa reticulocyte count (ARC).
Kuti mupeze matenda a hemolytic anemias, ndikofunika kuti wina (kaya wodwala matenda a shuga kapena wodwalayo) ayang'ane maselo ofiira a m'magazi pansi pa microscope. Mayesowa amatchedwa "peripheral blood smear". Magazi ofiira amawoneka mozungulira, ofanana ndi donut pansi pa microscope, koma pamene khungu lofiira la magazi liwonongedwa msanga iwo amagawanika kapena amawoneka ngati magawo kapena ma globes.
Mankhwala ena amachititsa kuti magazi asapitirire kuteteza magazi m'thupi. Ngati muli ndi izi, mayesero omwe amatchedwa kuti antitiglobulin test (DAT kapena Direct Coombs) adzakhala otsimikiza kuti chitetezo chanu cha mthupi chikuyambitsa ndi kuwononga maselo ofiira a m'magazi mosayenera. Chifukwa selo lofiira m'magazi limatulutsa bilirubin, mtundu wa pigment umene umayambitsa jaundice, ziŵerengero zanu za bilirubin zikhoza kukwezedwa. Apo ayi, palibe mayesero enieni kuti mudziwe ngati mankhwala anu ndi omwe amachititsa kuti mukhale ndi magazi m'thupi. Kawirikawiri, matendawa amatsimikiziridwa ngati kuchepa kwa magazi kukuthandizani mukasiya mankhwala.
Zimayambitsa
Pali mankhwala ambiri omwe amagwirizanitsidwa ndi mankhwala osokoneza bongo amachititsa magazi.
Ambiri omwe amadziwika nawo ndi awa:
- Cephalosporins, mankhwala omwe amagwiritsidwa ntchito, kuphatikizapo ceftriaxone
- Penicillin, makamaka piperacillin
- Diclofenac, osati steroidal anti-inflammatory
- Oxaliplatin, mankhwala a chemotherapeutic
Mkhalidwe wokhudzana ndi matenda a glucose-6-phosphate dehydrogenase (G6PD) akusoŵa. Mu mtundu wamagazi wamtundu uwu, mukusowa mankhwala ofiira (chemical) mu selo lofiira m'magazi. Ngati mwapatsidwa mankhwala ena monga mankhwala a sulfa, maselo ofiira anu akhoza hemolyze kuchititsa magazi m'thupi. Ngati muli ndi vuto la G6PD, ndikofunikira kuti mudziwe mankhwala / zakudya zomwe muyenera kuzipewa .
Njira Zothandizira
Njira zochiritsira zimatsimikiziridwa ndi momwe magazi anu amathandizira kwambiri.
Choyamba, mankhwala / poizoni amene akuyambitsa magazi a hemolytic ayenera kuyimitsidwa. Kuikidwa magazi kungaperekedwe ngati kuli kofunikira. Ngati hemolysis ndi yoopsa, ikhoza kuvulaza impso. Mwamwayi, izi ndizokhalitsa ndipo zimakhala bwino nthawi yomwe hemolysis imayankha, koma izi zingafunike dialysis kwa nthawi.
Mawu Ochokera
Zingamve zachilendo kuti mudziwe kuti mankhwala omwe mumakhala nawo chifukwa cha matenda ena amachititsa kuti mukhale ndi magazi m'thupi. Mwamwayi, kuchotsa mankhwala okhumudwitsa amachititsa kuti hemolysis isapitirire kuwonjezeka. Ndikofunika kukambirana ndi dokotala wanu mankhwala omwe amachititsa kuchepa kwa magazi kuti mutha kuzigwiritsa ntchito mtsogolo.
> Zotsatira:
> Schrier SL ndi Brugnara C. Pathogenesis wa magazi omwe amadzimadzimadzimadzimadzimadzi: Wotentha agglutinins ndi mankhwala. Mu: UpToDate, Post, TW (Ed), UpToDate, Waltham, MA.
> Schrier SL. Hemolytic anemia chifukwa cha mankhwala ndi poizoni. Mu: UpToDate, Post, TW (Ed), UpToDate, Waltham, MA.