Usanda kuthiwa unenqwaba yensimbi (ebizwa nangokuthi i-hemosiderosis) eyesibili kuya ekumpompheni okubomvu kwamangqamuzana egazi obuningi okumele uwuthole. Kungenzeka ukuthi wazi mayelana nalokhu engcupheni ekuqaleni kohlelo lwakho lwezokwelapha kodwa mhlawumbe awuzange. Ukwehla kwensimbi kungabangela izinkinga eziningi ngakho kubalulekile ukuba ube nesiphakamiso esihle sokwelapha.
Ama-chelators e-Iron (imithi esusa insimbi emzimbeni) ngokuvamile asetshenziselwa abantu abane- thalassemia noma ezinye izinhlobo ze-anemia ezidinga igazi elibomvu eliningi.
Abantu abane- hemochromatosis ye-heredit baphathwa nge-serial phlebotomy (ukususwa ngokomzimba kwegazi).
Izinketho ze-Iron Chelation
Njengamanje, e-United States, kunezinhlobo ezintathu zama-iron chelator ezihlukile. Ngamunye unezinzuzo zayo kanye nokuqeda. Izici eziningi zilinganiswa uma kunquma ukuthi imiphi imithi okufanele isetshenziswe.
Deferoxamine
I-Deferoxamine (igama lesikhwama sokudluliselwa kwegama) lisetshenziswe iminyaka engaphezu kwamashumi amane e-United States. I-Deferoxamine inganikezwa njenge-intravenous (IV) esibhedlela esibhedlela kodwa ngokuvamile abantu abanenqwaba yensimbi banikeza deferoxamine ngaphansi (ngaphansi kwesikhumba) ekhaya. Ukumnika kunikwa amahora angama-8 kuya kwangu-12 ebusuku ngokusebenzisa ipompo elincane elibhekiswe kwebhethri. Ukusabela kwesikhumba sendawo kungenziwa kodwa kungaphathwa ngokunciphisa isilinganiso somthamo / izinga lokukhipha noma ukhilimu we-hydrocortisone.
Iningi labantu libekezelela kahle i-deferoxamine kodwa ngoba izifo ezincane kufanele zinikezwe isikhathi eside, abantu abaningi bakhathele ngale ndlela yokwelashwa.
Ukuzwa nokulahlekelwa ngombono kungenziwa ngamazinga aphezulu, ngakho-ke ngenkathi uphathwa nge-deferoxamine kufanele ube nokuzwa kwonyaka kanye nokuhlolwa kombono.
Deferasirox
I-chelator yensimbi ejwayelekile kakhulu esetshenziswa e-United States i-deferasirox. Kuphumelela ekukhipheni insimbi esibindiwe nasenhliziyweni, izitho ezimbili ezingase zibe nenqwaba yensimbi.
I-Deferasirox ivela ezinhlokweni ezimbili: ithebhulethi engahlakazeki (ecibilikisiwe ketshezi) ebizwa nge-Exjade kanye nebhebhulethi engagwinwa okuthiwa i-Jadenu.
Enye yezinzuzo ezinkulu ze-deferasirox yukuthi imithi yomlomo ethathwe kanye ngosuku. Ngeshwa, ayikho ifomu le-deferasirox. Nakuba uJadenu efika njengokulula ukugwinya ithebhulethi, izingane eziningi ezine-anemias ezincike ekumpontshelwa igazi zizothuthukisa insimbi ngaphambi kokuba zikwazi ukugwinya amaphilisi. Kulezi zingane, i-Exjade ingasetshenziswa.
Ukuphazamiseka kwalokhu ukubunjwa ukuthi ukuthanda nje icky. Ithebhulethi ikhiqizwa ketshezi kodwa kaningi ayikuqedi ngokugcwele futhi uketshezi luthinta ukuthungwa kwe-chalky. Ukunambitheka kunganciphisa kancane ngokuyibeka ku-apula noma ijusi le-orange. Kukhona ukuhlolwa okuqhubekayo komtholampilo ukuhlola ukuphumelela kwama-granules ase-deferasirox angafafazwa ngaphezu kokudla. I-Deferasirox ingasetshenziselwa abantu abane-thalassemia engaphansi kokungeniswa kwegazi ngaphezu kweminyaka engu-10.
Deferiprone
I-Deferiprone (i-Ferriprox) iyona yamuva i-chelator yensimbi evunyelwe e-United States. Nakuba i-deferiprone imithi yomlomo, okwamanje ithathwa kathathu ngosuku. Kuza njengepilisi noma uketshezi. Kubonakala sengathi i-deferiprone ingaba yimithi emihle yokususa insimbi esuka enhliziyweni.
Nakuba iningi labantu libekezelela i-deferiprone ngaphandle kwezinkinga, okuphathelene nomphumela ohlangothini olungaba khona yi-agranulocytosis, izibalo ezincane kakhulu ze-neutrophil ezingakhuphula ingozi yezifo. Ngenkathi kule mithi, inani le-neutrophil kufanele lilandelwe eduze ngokubala kwegazi eliphelele lamasonto onke (CBC).
Ukwelapha Ukuhlanganiswa
Abanye abantu abanenqwaba yensimbi bangadinga ukwelashwa nge-chelator engaphezu kweyodwa ngesikhathi esisodwa. Lokhu kungathatha i-deferasirox noma i-deferiprone nsuku zonke nge-deferoxamine infusions izikhathi ezintathu kuya kwezi-4 ngesonto.
Uma unemibuzo mayelana nokuthi i-iron chelator ethile ikulungele yini, yixoxisane nomhlinzeki wakho wezempilo.
Qinisekisa ukuthi uthatha imithi njengoba iqondiswe futhi utshele udokotela wakho nganoma yikuphi ukukhathazeka onakho.
> Umthombo:
> Schrier SL kanye neBacon BR. Ukwelashwa kwe-Chelation ye-thalassemia kanye nezinye izifundazwe ezingaphezu kwensimbi. > Ku: UpToDate, Post TW (Ed), UpToDate, Waltham, MA.