Amanani we-RBC asiza ukukhomba amaphuzu we-anemia nezinye izifo
Uma ubheka iseli lakho elibomvu legazi libala ku-CBC, ungabona izinombolo zokuqala ezahlukahlukene ezihlanganisiwe kanye nenani eliphelele. Ama-red indices indices, okuthiwa i-MCHC, i-MCV, i-MCH, ne-RDW inikeza ulwazi oluthe xaxa ngamaseli akho abomvu egazi futhi angasiza ekunqumeni imbangela ye-anemia nezinye izimo zezokwelapha.
Ake sibheke ulwazi oluqukethwe ekubaleni kwakho kwegazi okuphelele ( CBC ), kufaka phakathi inani lakho elibomvu le-cell, bese uxoxisana nencazelo nokubaluleka kwalowo nalowo muntu.
I-Complete Complete Blood Count (CBC)
Inani eliphelele legazi (i-CBC) lihlolwa ngegazi elawulwa odokotela ukuze bakwazi ukuhlola ukubunjwa nekhwalithi yamaseli egazi emzimbeni wakho. La maseli egazi ahlanganisa:
- Amangqamuzana egazi elimhlophe (i-leukocytes) elisiza ukulwa nokutheleleka
- Amangqamuzana egazi abomvu (i-erythrocytes) ehambisa i-oxygen kuwo wonke umzimba
- Ama-platelets (thrombocyte) aphezu kwegazi
I-Red Blood Cell Count (i-RBC)
I- red cell count count (RBC) yinombolo yamaseli obomvu abonakala egazini lakho. Ukubala okujwayelekile kwe-RBC kuncike eminyakeni yobudala nobulili:
- Kwabesifazane, 4.2 - 5.4 million / mcL
- Kubantu, 4.7 - 6.1 million / mcL
- Kubantwana 4.1 - 5.5 million / mcL
Ukubalwa kwesibalo segazi obomvu kubizwa ngokuthi yi- anemia . Kunezimbangela eziningi ezihlukahlukene ze-anemia, lapho ukuntuleka kwensimbi kuyedwa kuphela. Ama-indices e-Red cell asebasiza kakhulu ekuhlukaniseni lezi zimbangela ezihlukahlukene.
Inani eliphakeme elibomvu lamasosha egazi libizwa nge-erythrocytosis noma i- polycythemia .
Izimbangela zingase zibandakanye ukuphelelwa amandla kwamanzi (lapho izinga lingekho ngempela, kodwa kubonakala ngaleyo ndlela ngenxa yevolumu encane egazini egazini), isidingo esikhulu se-oxygen esithwala amandla egazi, njengokuhlala ezindaweni eziphakeme, i-COPD, noma ukuhluleka kwenhliziyo, nokukhiqizwa kwamaseli abomvu emnothweni wethambo ngenxa yezimo ezifana ne-polycythemia vera.
Ngesikhathi ubheka inani le-RBC lingakutshela ukuthi inani lakho lamaseli abomvu aphansi, ajwayelekile, noma aphezulu, akutshele ukuthi kungani isibalo singavamile. Ngakho-ke isidingo sokuhlolwa okuqhubekayo kwalawa maseli. Ngisho noma inani le-RBC lingavamile, ukubheka izinkomba ze-RBC ngezinye izikhathi kunganika izici ezibalulekile ekutholeni izimo zezokwelapha.
Izinkomba ze-Red Blood (RBC)
Kanye nenani eliphelele le-RBC, izinkomba ze-RBC zinikeza ulwazi mayelana nosayizi kanye nekhwalithi yamaseli akho abomvu egazi obomvu. Lokhu kungasetshenziselwa ukuxilonga imbangela nokuqina kwe-anemia futhi unikeze izici ezibalulekile mayelana nezinye izimo zezempilo ongase ube nazo.
Izinkomba zeRBC zinezingxenye ezine ezihlukene ezibizwa ngokuthi i-mean corpuscular hemoglobin concentration (MCHC), ivolumu ye-corpuscular mean (MCV), i-mean corpuscular hemoglobin (MCH), kanye nobubanzi obubanzi bokusabalalisa amaselula (RDW).
Ukujula Kwe-Hemoglobin Corpuscular (MCHC)
Ukuhlushwa kwe-hemoglobin (corpuscular hemoglobin concentration) (i-MCHC) yi-concentration ye- hemoglobin e-red cells.
I-Hemoglobin yiprotheni ephethe i-iron emangqamuzana egazi abomvu okusebenza ngayo ukuphatha umoya-mpilo. Kubuye kube isici esinika amangqamuzana abomvu wegazi umbala wabo. Noma yikuphi okunye ukuhlushwa kungabangela ukuthi amangqamuzana abonakale abomvu noma ngaphezulu.
I-MCHC ikutshela ukuthi ngabe amangqamuzana egazi abomvu ane-hemoglobin engaphansi noma engaphansi kwalokho engalindelwe. Uhlobo olujwayelekile lwe-MCHC luphakathi kuka-33.4 no-35.5 amagremu ngayinye ku-deciliter ngayinye kubantu abadala. Noma yiliphi inani ngaphandle kwebala lokubhekisela lichazwe kanje:
I-MCHC ephezulu: Uma i-MCHC iphakeme, amaseli abomvu abizwa ngokuthi abekhomikhali . Izimbangela ezikhona ze-MCHC ephezulu (okungavamile) zifaka:
- Yenza i-autoemmune i- hemolytic anemia , isimo lapho izidumbu zamasosha omzimba zihlasela amaseli akhe abomvu egazi
- I-seredrocytosis ye-Hereditary, isimo sezakhi zofuzo esibonakala yi-anemia kanye ne-gallstones
I-MCHC ephansi: Uma i-MCHC iphansi, amangqamuzana abizwa ngokuthi yi- hypochromic . Izimbangela ezikhona zingabandakanya:
- Ukuntula i-Iron okunempilo . Noma yiliphi inani lemibandela lingabangela ukungenwa kwe-iron enemia, kuhlanganise nokukhulelwa, ukulahlekelwa igazi, ukungenwa kwensimbi emathunjini (okubangelwa isibonelo, ngesifo seCeliac noma ngesifo sikaCrohn), nokudla okungenayo okunomsoco wensimbi.
Kungakhathaliseki ukuthi i-hyperchromic noma hypochromic, ukwelashwa ngokuyinhloko kugxile ekwelapheni isimo esibucayi. Ukwengezwa kwe-Iron kanye nokudla okwenyuka kokudla kwensimbi kungasiza ekubhekaneni nokuntuleka kwe-anemia yensimbi, kodwa ukuxhaswa kwensimbi akunconywa kubantu abangenayo insimbi engenayo (ukungaphezu kwensimbi kungagcinwa esibindi nasenhliziyweni). Ukumpontshelwa igazi kungasetshenziswa ezimweni ezimbi kakhulu.
Umbhalo we-Corpuscular Mean (MCV)
Okusho ivolumu ye-corpuscular (MCV) isilinganiso sevolumu yesisindo segazi elibomvu, okusho usayizi wangempela wamaseli ngokwawo.
Uhlobo olujwayelekile lwe-MCV luphakathi kwama-femitolitha angu-80 no-96 ngeselula ngayinye.
I-MCV ephansi: I-MCV ephansi ibonisa ukuthi amangqamuzana egazi abomvu amancane, noma ama- microcytic . Izimbangela ezikhona zingabandakanya:
- Ukuhogela ubuthi
- I-Thalassemia (i- thalassemias yizifo zofuzo ezivezwa yi-hemoglobin engavamile)
- I-anemia yesifo esingapheliyo
- I-rheumatoid arthritis
- I-giant cell arteritis .
I-MCV ephezulu: I-MCV ephezulu ichaza ukuthi amangqamuzana egazi abomvu amakhulu kunokujwayelekile, noma ama- macrocytic . Izimbangela ze-anemia yama-macrocytic zihlanganisa:
- Ukuntuleka kwe-Vitamin B12
- Ukuntuleka kwe-Folate (kokubili ukuntuleka kwe-vitamin B12 nokuntuleka kwamalulwazi nakho kubizwa ngokuthi i-megaloblastic anemia, ngenxa ye-RBCs yama-macrocytic)
- Isifo sesibindi
- Utshwala
- I-Hypothyroidism
- Imithi efana nemithi ye-chemotherapy nemithi yokwelapha ye-HIV
I-MCV evamile: Kubalulekile ukuqaphela ukuthi umuntu angaba ne-anemia futhi abe ne-MCV evamile. Lokhu kubizwa ngokuthi i-anemia ye- normocytic . Izimbangela zingabandakanya:
- Ukulahleka kwegazi kungazelelwe
- Ukuhluleka kwezinso
- I-anemia ye-Hemolytic
- Ukuntuleka kokudla okunomsoco
I-Hemoglobin ye-Corpuscular (MCH)
I-hemoglobin ye-corpuscular (MCH) iyinani elilinganiselwe le-hemoglobin ngeseli elibomvu legazi kusampula yegazi. Uhlobo olujwayelekile lwe-MCH luphakathi kwama-27.5 no-33.2 amaphojamu ngamaseli.
Inani le-MCH liqondana ngokuqondile ne-MCV value, kanti abanye odokotela bathola ukuthi ukuhlolwa kukhululekile. Ngakho-ke, uma ubukhulu bamaseli abomvu obomvu bukhulu (njengoba kulinganiswa yi-MCV), inani le-hemoglobin ngamaseli abomvu egazi liyoba phezulu (njengoba kulinganiswa yi-MCH), futhi ngokufanayo.
Ngenkathi i-MCH ingasetshenziswa yodwa ukuthola ukuthi i-anemia ingama-hyper-, hypo-, noma i-normocytic, i-MCV kufanele icatshangelwe kanye ne-MCH ngoba ivolumu yeseli ithinta ngokuqondile okuqukethwe kwe-hemoglobin ngeselula.
Ububanzi be-Cell Distribution Distribution (RDW)
Ububanzi bokusabalalisa amaselula obomvu (RDW) buvivinyo obonisa ukuhlukahluka ngobukhulu bamaseli abomvu obomvu (futhi kufana nokuphambuka okujwayelekile kwe-MCV). I-RDW ejwayelekile izosho ukuthi amangqamuzana egazi abomvu ayonke afana nobukhulu, kanti i-RDW ephezulu itholakala ukuthi kukhona ukuhlukahluka okwenziwe ngobukhulu bamaseli abomvu obomvu.
Abanye odokotela bakholelwa ukuthi i-RDW ingenye yezinhlamvu ezibomvu ezisetshenziswa kakhulu ekwenzeni ukuxilongwa. Ngaphandle kwendima yayo ekusizeni ukuhlolisisa i-anemia, i-RDW ephakeme ingacacisa ukuthi kukhona ukugula komzimba we-coronary isifo kubantu abanegazi eliphezulu. Ibuye inikeze izinkomba zokuntula kokudla okunomsoco okungase kungabonakali nezinye izivivinyo kuphela. Okokugcina, kuyisivivinyo esihle sokunquma ukuthi ngabe kudingekile yini ukuhlola okudingekayo, njengokuthi igazi le-peripheral smear.
Uhlobo olujwayelekile lwe-RDW lungamaphesenti angu-10 kuya ku-14.5.
I-RDW iyasiza kakhulu uma ihlolwe kanye ne-MCV. Isibonelo sezimbangela ezithile zihlanganisa:
I-RDW ephezulu ne-MCV ephansi (microcytic):
- Ukuntula i-Iron okunempilo
- Isifo se-anemia yesifo
I-RDW ephezulu ne-MCV evamile (i-normocytic):
- Ukuntula i-Iron okunempilo
- Ama-anemias ahlangene
- Ukushona kwegazi (ezinsukwini ezimbalwa kamuva)
- Izinhlobonhlobo ze-Hemoglobin
I-RDW ephezulu ne-MCV ephezulu (macrocytic):
- Ukuntuleka kwe-Vitamin B12
- Ukuntuleka kwe-Folate
- Isifo se-cold agglutinin
- I-Myelodysplastic syndrome
- I-immune hemolytic anemia
I-RDW evamile ne-MCV ephezulu :
- Isifo sesibindi (esingapheli)
- I-anemia ye-aplastic
- Ukuhlobene nodoti
I-RDW evamile ne-MCV ephansi :
- I-anemia yesifo esingapheliyo
- Ezinye izinhlobo ze-thalassemia
- Ezinye ze-hemoglobins ezingavamile
Kubalulekile ukuqaphela ukuthi lezi zibonelo ezimbalwa kuphela, futhi kukhona amathuba amaningi.
Izwi elivela
I-CBC iyivivinyo elijwayelekile legazi futhi lifaka inani elibomvu lamasosha egazi ngaphezu kokubala kwamhlophe wegazi kanye namaplatelet. Ukubala kwesibalo segazi obomvu kungatshela odokotela ngenani lamaseli abomvu obomvu kodwa uncane okushiwo ngesizathu sanoma yikuphi okungajwayelekile.
Izinkomba ze-RBC, ngokubheka izici zamaseli abomvu wegazi, ziwusizo ekuhloliseni nje imbangela ye-anemia kodwa ekuhloleni izimo zezokwelapha ngisho nalapho inani elibomvu lamasosha egazi livamile.
Ukuhlanganiswa kwala ma-indices nakho kunikeza izinkomba ezibalulekile ekunciphiseni i-anemia. Izibonelo ezinikezwe ngenhla zimbalwa zezimbangela ezikhona, futhi ukucacisa isizathu esiqondile se-anemia ngezinye izikhathi kunzima kakhulu. Lezi zivivinyo zegazi zisetshenziswe kangcono ngokuhambisana nomlando oqaphile, ukuhlolwa okuphelele ngokomzimba, nanoma yikuphi ukuhlolwa kwe-imaging okuboniswayo.
Ukufunda ngalezi zivivinyo zegazi kungakusiza ukubuza imibuzo kadokotela wakho ukuze uqonde kahle ukuthi uhlolwe yini, noma uqhubeka nokuhlola ukuthi uyancoma. Ngokuqhubekayo, abantu bayabizwa ukuba babe yingxenye ekhuthele ekunakekelweni kwabo kwezempilo, futhi bafunde ukwenza izinqumo ezinolwazi mayelana nempilo yabo. Ukuthatha isikhathi sokufunda ngamanani wakho we-lab kungakusiza ukuba unikezwe amandla ekwenzeni izinqumo ezingcono kuwe kuphela.
> Imithombo:
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> Kumar, Vinay, Abul K. Abbas, noJon C. Aster. I-Robbins ne-Cotran Pathologic Basic of Disease. I-Philadelphia: Elsevier-Saunders, 2015. Phrinta.
> Nagao, T., noMnu Hirokawa. Ukuxilongwa Nokuphathwa Kwe-Anemia Yama-Macrocytic kubantu abadala. I-Journal of General and Family Medicine . 2017. 18 (5): 200-204.
> Shah, N., Pahuja, M., Pant, S. et al. Ububanzi be-Cell Cell Distribution and Risk of Death Cardiovascular: Insights kusuka ku-National Health and Nutrition Examination Survey (NHANES) -III. I-International Journal of Cardiology . 2017. 232: 105-110.