Polycythemia - polycythemia kuyinto ...: Izimpawu kanye Ukwelashwa

Polycythemia - isifo esingelapheki lapho okuqukethwe inyuka amangqamuzana egazi abomvu (amangqamuzana abomvu egazi) egazini. Futhi, uma zokugula anjalo 70% eziguli kuyahlukahluka inani zegazi kanye leukocyte ngendlela enkulu.

Ukugula ayinayo ovame kakhulu - ngonyaka ngamunye million labantu ukubhalisa akukho kuka izikhathi ezinhlanu. Ngokuvamile lesi sifo eba polycythemia asebeqinile abantu abadala. Ngokwezibalo, kukhona abesilisa ahlupheke lesi sifo kuthiwa kahlanu kakhulu ukudlula abantu besifazane. Namuhla, sihlolisise ngalesi simo njengoba polycythemia, izimpawu kanye nokwelashwa kwezifo kuchazwe lapha ngezansi.

Izimbangela zesifo

Polycythemia - isifo non-ebulalayo. Kuze kube manje, lo Imbangela sifo akwaziwa. Kukholakala ukuthi lesi sifo sibangelwa ukushintsha izakhi zofuzo okuqondiswa ukuthuthukisa ekhethekile umnkantsha enzyme. izinguquko zofuzo kuholela ekwakhekeni division ngokweqile nokukhula kwamangqamuzana egazi, ikakhulukazi emangqamuzaneni abomvu egazi.

Ukwahlukaniswa izifo

Amaqembu amabili isifo:

• Polycythemia vera noma Vakeza isifo, okuyinto esikhundleni salokho ihlukaniswe oyinhloko (isb, uba isifo ezimele) nokwesibili (polycythemia yesibili eba ngenxa izifo zamaphaphu okungamahlalakhona, izimila, hydronephrosis, ukuphakama ephakamisa).

• polycythemia Isihlobo (ukucindezeleka noma amanga) - uma lokhu isimo lisezingeni elinjani egazi abomvu uhla evamile.

Polycythemia: izimpawu zokugula

Isikhathi esining impela, lesi sifo singumbulali asymptomatic. Ngezinye izikhathi, ngenxa inhlolovo aboshelwe izizathu ezingafani nhlobo kungase ngengozi wembula polycythemia. Izimpawu, okuyinto kufanele sinake, sibheke esilandelayo.

Ukunwetshwa emithanjeni ongama

Lapho polycythemia esikhumbeni, avame entanyeni, osuke usuvulekile emithanjeni ongama ubonakale. Nalesi sifo isikhumba kuba ngokubomvu cherry umbala, kwaphawuleka ngokukhethekile ezindaweni ezivulekile zomzimba - entanyeni, izingalo, ubuso. Ulwelwesi lwamafinyila sezindebe futhi nolimi umbala bluish-bomvu, abamhlophe samehlo kwakubonakala bloodshot.

Kubangela izinguquko igazi ukuchichima ocebile erythrocyte, nezitsha zonke ebusweni futhi ekunqandeni impahla yayo rheological (ijubane lokuya) whereupon ingxenye eyinhloko-hemoglobin (ukwakheka kombala obomvu) iba ifomu encishisiwe (ngamanye amazwi, sibhekana nezinguquko chemical) kanye noshintsho umbala.

ukulunywa

Cishe ingxenye ye iziguli polycythemia, kukhona ukulunywa eqinile, lezizifo sizibona ikakhulukazi ngemva ukugeza umzimba ngamanzi afudumele. Lesi simo esiyingqayizivele sibangelwa ukhonza njengelungu isici eqondile polycythemia vera. Itch kwenzeka ngenxa ukukhulula izidakamizwa esebenzayo egazini, e histamine ethile, elikwaziyo ukwandisa capillary isikhumba, okuholela anda ukugeleza kwegazi kuzo futhi ukubukeka emizweni ethize.

Eritromelalagiya

Lesi simo esiyingqayizivele sibangelwa libhekene eziqine nobuhlungu besikhashana ku kalula. Kuphakamisa ukwanda amazinga abo platelet ezitsheni ezincane shayela, okuholela kwetinhlavu microthrombuses eziningi, arteriole ekuvaleni futhi ivimbela igazi ligeleze izicubu iminwe. izici sangaphandle isimo esinjalo siyisivikelo ububomvu kanye ukubukeka esikhumbeni izindawo bluish. Ngenjongo ekuvimbeleni thrombosis Kunconywa aspirin.

Splenomegaly (kweNdikimba ubende)

Ngaphandle ubende, isibindi, futhi zingashintshwa noma kunalokho lingakanani. Lemigwamanda abahileleke ngokuqondile kumiswa nokubhujiswa kwamangqamuzana egazi. Ukwandisa lokuhlushwa imikhondo yokugcina ekwandeni sesibindi ubende.

izilonda duodenal nasesiswini

Okunjalo zokugula ubuhlungu kuhlinzwa eba ngenxa encane umkhumbi thrombosis ipheshana yesisu ulwelwesi lwamafinyila. Waba yini umphumela wesibindi acute iziyaluyalu kwegazi kuyinto necrosis (necrosis) umzimba odongeni ingxenye nokwakha at indawo yayo isilonda. Ngaphezu kwalokho, encishisiwe ukumelana helicobacter esiswini (a silwanyana okubangela isilonda kanye kolwelwesi).

amahlule Igazi ezitsheni ezinkulu

Bethambekele ekubeni lesi sifo we ephansi esitho emithanjeni. Thrombi, breaking kude kusukela odongeni isitsha ungakwazi, ngokudlula inhliziyo, ukuze ukungena yokujikeleza kwegazi eliya emaphashini (emaphashini) futhi abangele embolism yamaphaphu (embolism yamaphaphu) - isimo aluhambisani nawo ekuphileni.

ukopha kwezinsini

Nakuba isibalo sabantwana zegazi igazi neuropathy kuyehluka futhi kwandisa coagulation yayo, ukopha gingival kungenzeka uma polycythemia.

sifo

Emazingeni aphezulu ka uric acid nosawoti awo imali emalungwini ahlukahlukene nokuvuselela ubuhlungu obuhlabayo.

• Nobuhlungu ezingalweni nasemilenzeni. Lokhu uphawu kubangela umonakalo umlenze lemithambo olugcwele kuzo futhi, ngenxa yalokho, kwegazi ompofu. Lokhu zokugula ibizwa ngokuthi "isifo occlusive"
• Ubuhlungu amathambo flat. umnkantsha bandisa inkonzo (ukuthuthukiswa isikhala kwamangqamuzana egazi) kuvusa nozwela amathambo flat ukucindezeleka mechanical.

Ukuwohloka isimo jikelele umzimba

Ngo isifo esinjengo polycythemia, izimpawu kungase kube khona ukufana izimpawu nezinye iziyaluyalu (isib, anaemia): ubuhlungu bekhanda, ukukhathala njalo, tinnitus, inzululwane, agqoke "esibuhlungu" phambi kwamehlo, iphika, igazi ekhanda. Ukwandiswa igazi viscosity izakhiwo oyenza izitsha ukuphendula compensatory, ngenxa yalokho, kukhona nokwanda wegazi. Lapho ezinalesisifo zijwayele ukuba yezinkinga ezifana senhliziyo futhi mikrokardioskleroza (esikhundleni sezicubu zezinzwa we imisipha yenhliziyo, igcwalisa isici, kodwa ingasebenzi imisebenzi kunesidingo).

ukuhlola

Polycythemia zembula imiphumela jikelele igazi ukuhlaziywa, esathola:

• Inani elikhulu amangqamuzana abomvu kusuka 6.5 kuya 7.5 • 10 ^ 12 / l;

• Amazinga aphakeme e-hemoglobin - 240 g / l;

• erythrocyte Imininingwane (OOE) idlula 52%.

Njengoba isibalo amangqamuzana abomvu egazi ayibaleki ngesisekelo okungenhla nesilinganiso amagugu, esetshenziselwa yokulinganisa uphethwe radionuclide. Uma mass kwamangqamuzana egazi abomvu mkhulu kunezinhliziyo 36 ml / kg kwaphetha ngokuthi amadoda kanye 32 ml / kg abesifazane, ke thembeke kubonisa khona Vakeza isifo.

Lapho polycythemia lalilokhu morphology kwamangqamuzana egazi abomvu, okusho ukuthi musa ukushintsha ukuma kwabo okuvamile kanye nosayizi. Nokho, ukuthuthukiswa anaemia ngenxa ukopha kakhulu noma bleedings njalo waphawula microcytosis (encishisiwe amangqamuzana abomvu egazi).

Polycythemia: ukwelashwa

umphumela Good zokwelapha has nomkhuba wokuchitha igazi. Kunconywe masonto onke 200-300 ml igazi isuswe kuze OOE kuze ezingeni lehla nenani oyifunayo. Uma kukhona Izimo for nomkhuba wokuchitha igazi, ukubuyisela iphesenti amangqamuzana abomvu egazi kungenzeka ngegazi dilution ngokungeza ingxenye ewuketshezi (izixazululo macromolecular iphathwa ngemithambo yegazi).

Kumele kukhunjulwe ukuthi kaningi ukopha kuholela ukuthuthukiswa yensimbi ukuntula anaemia lapho kukhona izimpawu elihambisana nokwenyuka platelet count.

Nale Ukugula kufanele kubhekwe njengesitha polycythemia, impatho kudinga ukuhambisana izinhlobo ezithile zokudla. Kunconywa ukuthi ubeke umkhawulo ukusetshenziswa inyama kanye nenhlanzi imikhiqizo, njengoba equkethe inani eliphezulu lika amaprotheni, kuvusa umsebenzi igazi. Kufanele ayeke ukudla okunamafutha. Cholesterol kunomthelela ukuthuthukiswa isifo sokuqina kwemithambo yegazi, okubangela thrombi, okuyinto ngobuningi kangaka akhiwa abantu abaphethwe polycythemia.

Nalesi sifo, kutuswa ukuba makudle yobisi isitshalo imikhiqizo, futhi ukuthi ubeke umkhawulo womsebenzi womzimba.

Futhi, uma okwatholakala "polycythemia", ukwelashwa ingase ihlanganise ngamakhemikhali. Sebenzisa nganoma thrombocytosis kuphakame ukulunywa ezinzima. Njengoba ungalindela, le "ejenti cytoreductive" ( "Hydroxycarbamide" ukulungiselela).

Kuze kube muva nje, ukuze abantu bangazazi izinto umnkantsha umjovo we isotopes izinga lemisebe esetshenziswayo (ngokuvamisile, i-phosphorus-32). Namuhla, ngokuya lokukwenqaba ezinjalo ngenxa izinga okusezingeni eliphezulu ezinguquko leukemic.

Ukwelashwa sihlanganisa imijovo interferon ekwelapheni thrombocytosis yesibili wasebenzisa isidakamizwa "Anagrelide".

Kulesi sifo akuvamile wenziwa umnkantsha transplantation, kusukela polycythemia - ukugula akubulali, inqobo Yiqiniso, ukwelashwa okufanele kanye nokuqapha njalo.

Polycythemia e izinsana

Polycythemia - a zokugula, izimpawu zazo ingatholakala izinsana. Lesi sifo ukusabela komzimba kuya idluliselwe hypoxia imvuthu, okungase avuse esingamahlalakhona esinomhlapho. ingane umzimba ukulungisa hypoxia iqala synthesize inqwaba amangqamuzana abomvu egazi.

Ngaphandle ka zokuphefumula moya, usana angagcina futhi polycythemia vera. izingozi ezinjalo ikakhulukazi kakhulu obala amawele.

Polycythemia kule osanda kuzalwa eba emavikini embalwa yokuqala yokuphila, kuba ukubonakaliswa yokuqala yokwanda hematocrit (60%) kanye nokwanda okuphawulekayo amazinga e-hemoglobin.

Neonatal polycythemia ukugeleza has izigaba eziningana: okokuqala, isinyathelo poliferatsii nokukhathala. Chaza kafushane kubo.

Esigabeni sokuqala lesi sifo has cishe akukho yimuphi ukubonakaliswa emtholampilo. Polycythemia embule ingane kulesigaba kungenzeka kuphela ngokususa izifundo wegazi neuropathy: hematocrit, i-hemoglobin ezingeni kanye amangqamuzana abomvu egazi.

Ngezinye isinyathelo poliferatsii eba i isibindi lakhulisiwe futhi ubende. Pletoricheskie waphawula imihlola: isikhumba ukuthola isici "pletoricheski abomvu" imibala, umntwana ebonisa ukukhathazeka lapho bathinteka isikhumba. Pletorichesky syndrome kwahambisana thrombosis. Uhlaziyo ushintsho ebonwe inani namangqamuzana abomvu egazi, izinhlayiya zegazi kanye nezinguquko leukocyte. Izinkomba kwamangqamuzana egazi ingaphinda yanda, into enjalo ibizwa ngokuthi "panmieloza".

Isinyathelo Ukuwohloka libhekene eside kwesisindo, asthenia nokukhathala.

Ukuze izinguquko emitholampilo osanda kuzalwa enjalo esindayo kakhulu futhi kungaba avuse izinguquko ezingenakuhlehliswa nokufa okwalandela. Polycythemia kungase kube ukwephula ekuthuthukiseni uhlobo oluthile egazi amhlophe ukuthi banesibopho isimiso somzimba sokuzivikela ezifweni. Ngenxa yalokho, usana isifo okunzima imvelo webhaktheriya, okuholela ekugcineni ekufeni.

Ngemva kokufunda lesi sihloko, uzofunda kabanzi ngalesi sifo njengoba polycythemia. Izimpawu kanye nokwelashwa babebhekwa njengabangakufanelekeli yithi imininingwane ngangokunokwenzeka. Sithemba ulwazi olunikezwe kuyoba wusizo kuwe. Zinakekele futhi uhlale unempilo!