Ukusabela Leukemoid ezinganeni: izinhlobo (zinhlobo), izimbangela, uphethwe ukwelashwa algorithm. ukusabela Leukemoid futhi wegazi: umehluko

ukuphendula Leukemoid - eshintsha hematopoiesis, efana isithombe igazi e wegazi nezinye izimila kohlelo hematopoietic. Kufanele kuqashelwe ukuthi ngokucacile yale miphumela kuyinto nabuphi esebenzayo kanye nokuntuleka shintsho umdlavuza. Lezi ukusabela kungenziwa senziwa ezihlukile intoxications, izimila, izifo, metastatic umdlavuza ubuchopho.

Mechanism yentuthuko siyahlukahluka izinhlobo ezahlukahlukene ukusabela: kwezinye izimo kuba okukhipha e beya lwengqamuzana yegazi izakhi, kwabanye - umkhiqizo wawanda kwamangqamuzana egazi noma ukuvinjelwa okukhipha amaseli izicubu, noma ukuba khona izindlela eziningana ngesikhathi esisodwa.

Yini kungaba umthombo zesifo?

Kunezici eziningi ezingase zenzeke ngenxa yokusabela leukemoid. Izizathu nentuthuko yabo yilezi:

• kwethonya ionizing emisebeni;
• sofuba;
• sepsis;
• izinqubo ubovu;
• uhudo;
• isifo Hodgkin sika;
• ukuhlukumezeka cranial;
• ukushaqeka;
• lobar i-pneumonia,
• Erysipelas;
• idiphtheria;
• scarlet fever;
• acute isibindi sokuwohloka;
• ukwelashwa corticoid;
• carbon monoxide poisoning.

izinhlobo isifo

Lezi zinhlobo ezilandelayo ukusabela leukemoid:

• ukuphendula Myeloid.
• Lymphocytic.
• Psevdoblastnye.

Ake sicabangele ngayinye yalezi zinkulumo ngokuningiliziwe.

myeloid

Ngu le ndlela yokusabela zihlanganisa ezifana neutrophil, eosinophil futhi promyelocytic. imiphumela Leukemoid ezifanayo nalezo ezingamahlalakhona wegazi myeloid, ephelezelwa adakwe ngamagciwane okunzima. leukocytosis Active ngokuyisisekelo njalo has inkiyankiya yenkinga ephelezelwa khona sepsis, foci ukuvuvukala futhi ngakhula nezinga lokushisa komzimba.

Exposure okweqa eosinophils egazini bathambekele kwenzeke lapho sensitization ukuba izimuncagazi nezidakamizwa, diathesis iguliswa, akuvamile - at izifo oncological (isifo Hodgkin futhi lymphosarcoma). Lezi ukusabela leukemoid isidingo ucwaningo olunzulu ukuze izifo nekheli isimiso sokujikeleza kwegazi, nezibungu.

amaseli Isabele like eritremii. polycythemia izici - ngokuvamile kwehla ephashini izifo oxygenation (oxygenation) negazi, izinso izimila, futhi yesifo senhliziyo azalwa naso. Lesi simo sidinga ikhompyutha kanye ultrasound.

Mielemiya efana erythroleukemia acute, okuyinto ihlukile kuphela lapho kuntuleka kuqhuma erythrocyte e umnkantsha futhi igazi. Ngokuvamile kungenzeka ukuthola metastases e isifo ithambo.

lymphocytic

Lezi ukusabela zinezikhathi nokwanda okuphawulekayo inani eliphelele lama-lymphocyte egazini neuropathy, okuyinto evame obhekene ukwanda isibindi, izindlala zamanzi kanye ubende.

Ukuze lolu hlobo eyakhe mononucleosis, ezithathelwanayo lymphocytosis, monocyte-macrophage ukusabela leukemoid nezingane izifo ezibangelwa amagciwane kanye ezibangelwa amagciwane, kanye nezifo yisinanakazana nomfutho ophakeme eosinophilia (isib helminthiasis).

ukusabela Lymphocytic zenzeka:

• izifo ezibangelwa amagciwane (inkukhu Pox, rubella, mumps, ukutheleleka adenovirus, isimungumungwana mononucleosis esithathelanayo);
• izifo yisinanakazana (rikketsiozah, toxoplasmosis, i-chlamydia);
• izifo ezithathelwanayo ezibangelwa amagciwane (ugcunsula, pertussis, isifo sofuba);
• mycoses ezihlukahlukene;
• izifo sokuhlasela kwamasosha omzimba (isifo serum, omzimba izicubu erythematosus).

uhlobo Lymphocytic landile macroglobulinemia Waldenstrom, ukuvuvukala, sarcoidosis. Zonke izifo ngenhla ziphathwa kakhulu futhi ingase yibe yinto exakayo isiguli isikhathi esingaphezu konyaka.

Psevdoblastnye

Lezi zenzo kuthiwa leukemoid uma isiguli kuphela sekuqala ukuvela kusukela agranulocytosis mzimba, imbangela okungase senziwa yokwamukela sulfonamides, "aminopyrine," "butadiene" nezinye izidakamizwa.

Ukuze imiphumela enjalo iqembu libhekene khona egazini futhi umnkantsha inombolo neuropathy enkulu izingxenye yeselula ne core eyohlobo, nokuluhlaza nucleoli olulodwa, mncane, ungayembethe cytoplasm luyimbudumbudu.

Ngokungafani kuqhuma ejwayelekile erythrocyte kulezi amanethiwekhi babe ithambe futhi kulinganiswa chromatin Imicu yotshani ethize. blastosis Irregular anyamalale ngaphandle imiphumela emibi yokwelashwa ngamakhemikhali namathonya leukemoid ahlobene atholakala izinsana ne zofuzo chromosomal iziyaluyalu (isib, i-Down Syndrome).

Leukemoid izinhlobo ukuphendula okuye ethulwa ngenhla, okuyinto akhiwa ngemuva kwanoma yiluphi zokugula, ngokuvamile musa abangele yezinkinga eziyingozi. Ngezinye izikhathi kakhulu uvele thrombocytopenia bangase baphethe ngokungeyikho kumelwe libhekwe njengelingcwele omunye izimpawu wegazi oyingozi. I ukuthola immunoblastic lymphadenites okumqoka ukuphepha isakhiwo engokwemvelo engeyokuqala lymph kanye ngokunembile ukunquma umugqa we follicle.

ukusabela Leukemoid futhi wegazi: umehluko

Kukhona ezinye umehluko phakathi imiphumela enjalo futhi wegazi, okuyilezi:

1. Lapho leukemoid rejuvenation ukusabela ku-intanethi okusheshayo umnkantsha, kuba metamielotsitarnym futhi Kutholwe ukwanda amafomu wegazi kuqhuma. Lapho imiphumela leukemoid ukulondolozwa erythroid lwegciwane, kukhona evamile leykoeritroblasticheskoe isilinganiso - 3: 1 no-4: 1.
2. Hhayi ukubonakaliswa Ukwethwasa ka anaplasia nge imihlola leukemoid njengoba kwenzeka e wegazi uma kukhona ezinkulu we protoplasm futhi anomaly-nucleus.
3. Ngo samuntu sokuqala, egazini neuropathy bekulokhu yokwanda kwenani eliphelele iphesenti ukwanda neutrophil abavuthiwe wegazi okuqukethwe incipha neutrophil ovuthiwe kwenzeka ekwandeni ngokweqile abasha, amafomu abonisa ukungavuthwa.
4. Lapho ukusabela leukemoid njalo waphawula lobumbudumbudu ezinobuthi of neutrophil.
5. Lapho cytochemical cwaningo leukocyte e wegazi ukwehla noma ukungabi khona i phosphatase ane-alikhali, ngesikhathi ukusabela leukemoid - umsebenzi owengeziwe.
6. Phakathi exacerbation of ezingamahlalakhona myeloid wegazi kuqhuma crisis umanduleli kuyinto eosinophilic, inhlangano basophilic ukusabela leukemoid ke ku-intanethi.
7. Lapho wegazi myeloid ngokuvamile has a thrombocytosis okusezingeni eliphezulu, ukusabela leukemoid platelet ukubala esezingeni evamile.
8. Ezigabeni kokuqala ezingamahlalakhona wegazi myeloid ukuthola ubende esikhulu aminyene ngaso ukusabela leukemoid kwenzeka ngezinye izikhathi splenomegaly, kodwa umzimba uthambile futhi ayifiki usayizi esikhulu kakhulu.
9. Lapho ukusabela leukemoid ukuze inqubo neoplastic zitholiwe amangqamuzana omdlavuza umnkantsha.

ukusabela Leukemoid ezinganeni: algorithm zokuxilonga

indima ebalulekile sitholakele isifo kunikezwa histopathology ukuthi ihlola biopsy impahla. Kodwa ukuze ugweme amaphutha ungalungiseki, le sezifo kumele siqoqe ulwazi oluyilona olumayelana nokuhlenga isiguli, mnike isiqondiso nokuvivinywa okuhlukahlukene futhi aqoke nokwelashwa cytostatic, okususa yonke imiphumela lymphadenitis. Uma konke lokhu akwenzelwa, inkinga itholakala lapho kahle, ngakho-ke ukuze ubhekane ngokuphumelelayo nalesi sifo kuyoba nzima kakhulu. Phela, lesi sifo kuyingozi kakhulu. Ngezinye izikhathi, i-isiphelo sesimiso imininingwane edingekayo ukuze wenze biopsy uphinda.

okumqoka ekuhlonzweni ukubukeka smear ka-lymph node biopsies futhi bafaka. Lapho iningi lymphosarcoma erythrocyte (okungenani amaphesenti angu-30) azisizi njalo kuqhuma amaseli. Nge erythrocyte enjalo lymphadenitis immunoblastic, ngokuvamile esingaphansi ngamaphesenti angu-10, sihluke ngokuya basophilia ka cytoplasm nokuvuthwa-nucleus.

Imiphumela yaloku kuhlola okungenhla Histopathological ku ukuhlaziywa lymph node kumele kube enemininingwane kakhulu futhi ngaphandle isiphetho olungalungile. Ngenxa histopathology izifundo ezihlukahlukene igazi kufanele ichaze ngokucacile uphethwe, futhi lokhu kubonakala nasesiphethweni. Ngokwesibonelo, ukuze kuhlonzwe kokuqala lymphoma kungavamile ukuba ingozi, kwezinye izimo, isikhathi eside ukuze bagcine nesineke futhi uhlole zamanzi futhi.

Sifo ukusabela leukemoid esolwa lapho uzingela immunoglobulin monoclonal ngezinye izikhathi lowo ufuna ube ulokhu futhi eside kokuma ka umnkantsha wokubhoboza. Ngaphambi ukuvunyelwa komdlavuza nokwelashwa ngamakhemikhali is contraindicated.

isifo ukuqabulana

Esinye isifo okuthiwa filatov - Pfeyferra, imfiva yezindlala kanye angina monocytic. Lesi isifo yegciwane eziphawulwa lymphocyte kuqhuma ukuguqulwa, lakhulisiwe lymph node kanye ubende, lymphadenitis esisheshayo, okuvela kuyo amaseli ethize abomvu egazini neuropathy. I-ejenti causative ubhekwa Epstein-Barr igciwane. Ngesisekelo isifo - ukuguqulwa ukufutha lymphocyte kubangelwa ukutheleleka ekhethekile ezibangelwa amagciwane.

Isimo emitholampilo lihlukile. Ngo amafomu onomoya omnene rhinitis ngenxa kuya ngokuphela. izici Imashi:

• angina ( "evutha emphinjeni");
• kweNdikimba ubende kanye lymph node kanye ubuhlungu;
• acinene kube nzima ukuphefumula ezinsukwini zakuqala lesi sifo ngenxa ukuvuvukala mucosa.

Isimo legazi: ukwanda kwamaphesenti eosinophils, ama-lymphocyte futhi monocytes.

yezinkinga

Ezidingekayo futhi ezanele ukuze kube isiphelo sesimiso kube inkomba yokuthi lesi sifo khona egazini mononuclear yokuqala (phezu 10-20%) - amaseli ahlukene lymphocyte nucleus esikhulu ububanzi cytoplasm basophilic nge umbala Lilac nge liphinyiselwe ukukhanyiselwa perinuclear. ukusabela Kugcine leukemoid ezinganeni nakubantu abadala amasonto ambalwa, kodwa izinyanga uyaqhubeka ezimweni ezithile, ukuzinza isimo igazi.

Futhi umuntu uyahluleka uma elwa kuyagcinwa nge imnene, ngezinye izikhathi ngezikhathi iminyaka eminingana ngemva kokuzalwa isikhathi sokuqala oyingozi. Izinkinga zingase zihlanganise:

• ukusha kwesibindi kohlobo acute;
• encephalitis;
• agranulocytosis;
• ukudabuka splenic kubangelwa izithelo zawo okusheshayo;
• hemolysis sokuhlasela kwamasosha omzimba.

Ukwelashwa ukusabela leukemoid

Njengomthetho, iziguli angadingi imithi ekhethekile, ngoba ezinsukwini ezimbalwa izimpawu eziyinhloko zesifo zinyamalale futhi isimo igazi kokuvamile. Lapho kuqhubeka isikhathi eside nokugula kanye nesineke bazizwe ezizwa engaphilile esetshenziswa yokwelapha pathogenetic - uqoke "prednisolone" at umthamo 20-30 mg ngosuku noma ezinye izidakamizwa glucocorticoid ukuze aqede ukuphendula leukemoid. Ukwelashwa Kunoma yikuphi, uqoka uchwepheshe kuphela.

ukuba nombono ongafani ngeke

Ngokuvamile omuhle: contagiousness akuyona okusezingeni eliphezulu, kanjalo isiguli ayidingekile ngokuhlukaniswa. Nokho, kuyingozi kakhulu ukudabuka we ubende. Elungisa ivolumu ukunciphisa kunqunywa izici ukubukeka umzimba kanye ukunyamalala angina futhi ukuzinza of lokushisa lomzimba. Uma mononucleosis ezithathelwanayo kubonakala ngesimo kwesibindi, isiguli edingekayo esibhedlela.