Neutropenia yamtunduwu ndi chikhalidwe chobadwa nacho chomwe chiwerengero cha neutrophil (maselo oyera a magazi omwe amamenyana ndi matenda a bakiteriya) amakhala otsika kwambiri (kawirikawiri osachepera 500 maselo / mL) pa kuzungulira pafupifupi masiku onse 21. Nthawi zambiri zimapereka chaka choyamba cha moyo. Zomwe zimayenda zimachepa ndi msinkhu ndipo zimatha kutha mwa odwala ena akuluakulu.
Kodi Zizindikiro Ndi Ziti?
Pamene chiwerengero cha neutrophil chiri chachilendo, palibe zizindikiro.
Zizindikiro zambiri zimatha kuseri kwa neutropenia (kuwerengeka kochepa kwa neutrophil) kutanthauza kuwerengera kwa neutrophil kwakhala kotsika kwambiri kwa masiku angapo isanachitike chitukuko cha zizindikiro. Kutsutsana ndi mitundu ina yobadwa nayo ya neutropenia (yoopsa kwambiri ya neutropenia, Shwachman Diamond Syndrome , etc.), zolephereka kubadwa sizikuwoneka. Zizindikiro zikuphatikizapo:
- Matenda a aphthous (zilonda zam'mimba)
- Kutupa kutupa (pharyngitis)
- Gum kutupa (gingivitis)
- Matenda a khungu
- Fever
Ndani Ali Pangozi?
Nthenda yotchedwa neutropenia yachangu imatanthauzanso kuti munthu amabadwa ndi vutoli. Zimadutsa m'mabanja mwa mafashoni amodzi omwe amachititsa kuti kholo limodzi lizikhudzidwa kuti lipereke kwa ana awo. Sikuti onse a m'banja angakhudzidwe mofanana ndi ena ndipo mwina ena sangakhale nawo zizindikiro.
Kodi Zimapezeka Bwanji?
Neutropenia yosavuta ingakhale yovuta kuti ipeze ngati neutropenia yowonjezera imatenga masiku 3 mpaka 6 panthawi iliyonse.
Pakati pa zochitikazi, ziwerengero za neutrophil ndi zachilendo. Matenda opatsirana amodzi ndi fever masiku 21 mpaka 28 ayenera kuwonetsa kukayikira kwa neutropenia. Pofuna kuthana ndi vuto la neutropenia, malipiro onse a magazi (CBC) amachitika 2 kapena 3 pa sabata kwa masabata 6 mpaka 8.
Kuphatikiza pa neutropenia yoopsa, pangakhale kuchepa kwa maselo ofiira a m'magazi (reticulocytopenia) ndi / kapena platelets (thrombocytopenia).
Kuwerengera kwa monocyte (mtundu wina wa maselo oyera a magazi) nthawi zambiri kumawonjezeka panthawi ya neutropenia.
Ngati nthenda ya cyclic neutropenia ikukayikira kuchokera kumagazi ambiri a magazi, kuyesedwa kwa majeremusi kuyenera kutumizidwa kukayang'ana kusintha kwa ELANE gene (pa chromosome 19). Odwala 90 - 100% omwe ali ndi neutropenia ali ndi ELANE mutation. Kusintha kwa thupi m'thupi la ELANE kunayanjanitsidwa ndi neutropenia komanso matenda osokoneza bongo. Chifukwa chofotokozera zachipatala ndi kuyesa koyambirira kwa ma genetic, fupa la mafupa silofunikira koma nthawi zambiri limachitika pa ntchito ya neutropenia.
Kodi Chithandizo Chachidule N'chiyani?
Ngakhale kuti nthenda ya cyclic neutropenia imatengedwa ngati matenda oopsa, imfa yachiwiri ndi matenda akuluakulu achitika. Chithandizo chimayesetsa kupewa ndi / kapena kuchiza matenda.
- Cholinga cha Granulocyte Colony-Chothandizira (G-CSF, yomwe imatchedwanso filgrastim): G-CSF imachititsa fupa la fupa kupanga ma neutrophils ambiri. Amagwiritsidwa ntchito kuteteza chiwerengero cha neutrophil kuchoka pansi pa maselo 500 / mL. G-CSF yasonyezedwa kuti ichepetse kuopsa kwa neutropenia ndi kuchepetsa chiwerengero cha matenda. G-CSF imayendetsedwa pansi pamsana (pansi pa khungu) masiku 1 - 2 aliwonse. Odwala ena amatha kusiya G-CSF ngati wamkulu chifukwa nthawi zina neutropenia imakula kwambiri.
- Kusamala kwa mano: Chifukwa chakuti matenda ambiri amabwera pakamwa, ndikofunikira kukhalabe ndi ukhondo wabwino. Mankhwala oletsa antibacterial akhoza kukulimbikitsidwa.
- Kuwunika kwa malungo: Chifukwa odwala omwe ali ndi mpweya wotchedwa neutropenia akhoza kukhala ndi matenda akuluakulu a bakiteriya, ndikofunika kuti zizindikiro za malungo zisamalidwe mosamala. Nthawi zina, zigawozi zidzasowa kuchipatala ndi mankhwala osokoneza bongo (IV) mpaka matenda aakulu atha kuwonetsedwa.