Ukumpontshelwa ngegazi okuningi kuyiqiniso lokuphila kwezinye iziguli ezine-leukemia, i-lymphoma ne-myeloma. Ukuguqulwa kusetshenziselwa ukuthuthukisa ukubala kwegazi kanye nokwelapha izimpawu nezimpawu ze- anemia - njengokukhathala , ukucabanga okungenangqondo, ukuphefumula nokuphefumula . Kodwa-ke, ukumpontshelwa igazi okwedlule ngokuhamba kwesikhathi kungase kubangele ukuxiliswa kwensimbi - isimo sokuthi, uma singalashwa, singalimaza inhliziyo nesibindi.
Kwenzeka Kanjani
I-iron inendima ebaluleke kakhulu emizimbeni yethu. Idlala indima ezinhlobonhlobo eziningi zezinto eziphilayo, kuhlanganise nokuhlanganiswa kwe-DNA lapho amangqamuzana ehlukanisa, nokuhamba kwe-oxygen emaphashini kuya emangqamuzaneni nasezicukeni zethu. I-iron esiyithatha ngokudla kwethu ngokuvamile ibophezela kuphrotheni ebizwa ngokuthi i-transferrin futhi ijikeleze egazini lethu le-plasma.
Ngokuyinhloko, le nsimbi isetshenziselwa ukwakha i- hemoglobin, into ekhona emangqamuzana egazi abomvu adlulisa umoya-mpilo esiwuphefumulela ezingosini zethu . I-Leftover insimbi igcinwa esibindi, ukuze isebenzise esikhathini esizayo.
Umzimba womuntu awunalo ikhono lokususa ngenhloso noma ukukhipha insimbi eyengeziwe, nakuba enye insimbi ilahlekile ezinkambweni ezijwayelekile njengokuchitha kwamaseli esikhumba. Lapho umthamo wesitoreji esiphezulu somzimba wensimbi utholakala, insimbi iqala ukwakha kwezinye izingxenye zomzimba, okuholela enqwabeni yensimbi.
Ukumpontshelwa kwegazi okubomvu kuhlinzeka ngenani elikhulu kakhulu lensimbi.
Kubantu abanempilo, kuphela u- 1-2 mg we-iron uguqulwa ngosuku olunikeziwe - okungukuthi, insimbi ethathwe ekudleni futhi ilahlekelwe ngokuchithwa kwamaseli esikhumba namaseli omzimba, isibonelo. I-unit eyodwa yamaseli abomvu aphuziwe (PRBCs), noma kunjalo, aqukethe cishe 200-250mg . Ngokuvamile, iziguli zithola ama-unit amabili njalo uma ziphasiswa, ngakho-ke lokho okungaphezulu kuka-500 mg ngosuku olulodwa nje.
Imiphumela
Uma insimbi ikhukhumeze ikhono lomzimba lokulondoloza ngokuphepha, lingabangela ukulimala ngezindlela eziningi. Okokuqala, uma kukhona insimbi eningi emzimbeni ukudlula i-transfrinti ukuze ibophe, ihamba yodwa njengensimbi engeyona i-transfrin-bound (NTBI). Leli fomu lensimbi linobuthi emzimbeni wethu, futhi lidala ukulimala kwezicubu nezitho zethu ezingeni leselula.
Ngaphezu kwalokho, insimbi eningi kakhulu ihlanganisa inhliziyo, amaphaphu, ubuchopho, izilonda ze-endocrine, isibindi ngisho nomnkantsha wamathambo.
Ukungaboni, lokhu kuqoqa kungaholela ku:
• Ukuhluleka kwenhliziyo
• Ukungenzi lutho
• Isifo sikashukela
• I-cirrhosis yesibindi
• I-arthritis
• I-Hypothyroidism (i-thyroid engasebenzi)
• Ukukhula okungaphelele
• Ukungasebenzi kahle kwe-Erectile
• I-Cancer
• Ukucindezeleka
Olunye ubufakazi lubuye lubonise ukuthi ukutheleleka kwebhaktheriya kungaba yinye yemiphumela yokwehla kwensimbi.
Ubani Osesengozini?
Abantu abasengozini yokuxilongwa nge-transfusional iron yibo abaye bathola ukumpontshelwa okuningi kwamaseli abomvu. Abantu abadala abavame ukutholwa igazi basengozini ngemuva kweyunithi ye-PRBCs engaba ngu-20 yokuphila, noma ukumpompela okungu-10 uma uthola amayunithi amabili ngesikhathi.
Iziguli ezinegazi nekhanda lomdlavuza, ezifana ne-leukemia kanye ne-lymphoma, ngokuvamile zidinga inani elikhulu lokumpompela ngemva kwe-chemotherapy, ngemuva kwe-radiotherapy esifundeni sabo sezintambo, noma ngokulandela ukufakelwa kwe-stem cell .
Iziguli ezine- syndromes (myelodysplastic syndromes) (MDS) zivame ukuba ne- hemoglobin eqhubekayo ephansi futhi abaningi bancike ekumpomeni, bebeka engozini enkulu yokunqwabelana kwensimbi. I-MDS ene-anemia engasetshenziswa kahle ingase ibangele neziguli ukuba zithole inqwaba yensimbi ekudleni kwazo, okwenza le nkinga ibe yimbi nakakhulu.
Ukuxilongwa
Ukwedlula i-iron kwenzeka ngokuhamba kwesikhathi, futhi ngokuvamile iziguli ngeke zibonise izimpawu. Kungenzeka ukuthi ukutholakala kwensimbi kuyotholakala ngemiphumela yebhoratri ngaphambi kokuba umuntu abe nezimpawu.
Isivivinyo esivame kakhulu ukuhlola i-iron saturation kuthiwa ama-serum ferritin amazinga. Lokhu kuhlolwa kwegazi okungahle kwenzeke ngokujwayelekile kubantu abengozi kakhulu.
Izinga lika-Serum ferritin landa njengoba inani le-NTBI landa egazini. Amazinga e-ferritin ekhulu kune-1,000 mcg / L abonisa insimbi egcwala kakhulu. Amadoda enempilo ngokuvamile ane-serum ferritin yama-24-336 mcg / L nabesifazane abanempilo 12-307 mcg / L. Ezinye izifo kanye nemibandela kungabangela ukuthi inani elikhulu le-ferritin likhishwe ekusakazeni, noma kunjalo, okungawenza ukufundwa okuphakeme okungaqiniseki, ngakho-ke ukuhlolwa njalo kuvamile.
Odokotela bangase bakhethe ukwenza i-biopsy yesibindi ukuhlola ukugxila kwensimbi. Ngesikhathi lesi sivivinyo singanikeza imiphumela enembile kakhulu kunamazinga e-serum ferritin, kudinga inqubo evumelana kahle engabangela izinkinga, njengokutheleleka nokuphuma kwegazi. Imiphumela ye-Biopsy ngaphezu kwe-7 mg yensimbi yesigamu ngayinye yesibindi ibonisa ukuthi i-iron inload overload.
Ucwaningo lokucwaninga lungabonakalisa nokuthola okuphakanyiswayo kwe-iron overload. Ukufaneka kwemifanekiso ye-magnetic resonance (MRI) ingasetshenziselwa ukubona ukuqoqwa kwensimbi esibindi nasenhliziyweni. I-MRI ingahle isetshenziswe ndawonye nesibindi biopsy ukuze ihlolwe ukuxhuma kwensimbi noma ngokuzimela. Kodwa-ke, ukugcinwa kwesimbi akuqinisekisiwe ukubikezelwa yi-MRI kwezinye izimo, njengalapho i-iron deposition yenzeka ema-pancreas.
Ukwelapha
Kunezindlela ezimbili eziyinhloko okuphathwa ngayo insimbi: i-phlebotomy yokwelapha kanye ne-iron chelation therapy.
I-phlebotomy yokwelapha yindlela esheshayo futhi ephumelelayo kakhulu yokuthola amazinga ensimbi phansi kwesiguli. Ngeshwa, angeke isetshenziswe ezigulini ezisele-anemic. Ngakho-ke, kuvame ukugcinwa iziguli ezine-leukemia noma i-lymphoma ekukhulumeni.
Phakathi ne-phlebotomy yokwelashwa, umhlengikazi noma udokotela uzofaka inaliti enkulu emithanjeni yakho , ngokuvamile engqondweni yakho . Bese bayosusa cishe ama-500 ml wegazi emzimbeni wakho cishe imizuzu engu-15-30. Uma wake wanikela ngegazi, uthola umqondo. Lesi silinganiso segazi sine-250 mg wensimbi. Njengoba le nsimbi isuswe ngegazi lakho, isibindi sakho sishiya ezinye izitolo zayo futhi ekugcineni inani lokujikeleza insimbi lingabuyiselwa ezigabeni ezivamile. I-Phlebotomy ingenziwa kanye noma kabili ngesonto uma kudingeka ukuze ufinyelele umgomo wamazinga we-serum ferritin ka-50-100mcg / L.
I-iron chelation therapy isebenzisa imithi ebopha, noma i-chelate, insimbi futhi ikwazi ukususa ukususwa kwayo emzimbeni. Umgomo walolu hlobo lwezokwelapha ukukhipha insimbi engaphezu kwegazi kusuka egazini nasezikhungweni zomzimba. Nakuba le thrapi isebenza kahle ensimbi ye-plasma nesibindi, ayikho ephumelelayo ekususeni i-deposit iron kusuka enhliziyweni.
I-Deferoxamine (Desferal), i-deferasirox (i-Exjade), ne-deferiprone (i-Ferriprox) imithi emithathu enjalo.
Imithi ye-Iron Chelator isebenza kahle ekunciphiseni amazinga we-NTBI, kodwa la mazinga aphuthuma ngokushesha uma ukwelashwa kuphelile. Ngakho-ke, le mithi kufanele ithathwe ngokuqondile njengoba iqondiswe ukuba isebenze kahle. Lokhu kungaba ukuzibophezela okukhulu kwezinye iziguli. I-iron chelators ayinayo imiphumela emibi, kanti izingozi nezinzuzo ze-iron chelation zidinga ukulinganiswa ngokucophelela.
Ngaphandle kwalezi zindlela zokwelashwa, umhlinzeki wakho wezempilo uyokwenza izincomo ukunciphisa inani lensimbi oyithatha ngokudla kwakho. Nakuba lokhu kuyindlela enengqondo enembile, ngezinye izinto ezimbalwa, izinzuzo zokuvimbela insimbi ekudleni ziyinto engabazekayo ngoba le ndlela ihlushwa "into ehlaselwa ebhakedeni," futhi njengoba ukwelashwa ngokweqile kwensimbi njenge-phlebotomy kude kakhulu ukuphumelela ngokwengeziwe ekunciphiseni amazinga ensimbi.
Amathiphu Ekuziphatheni
Ukumpontshelwa igazi ngokuvamile kuyisici esidingekayo futhi esisebenzayo se-leukemia kanye nokwelashwa kwe-lymphoma. I-anemia ingaba yingozi kakhulu, ngisho nokubulala, imiphumela emzimbeni wakho kanye nokumpompela kungenakugwema.
Noma kunjalo, kunezinto ongayenza ukuqinisekisa ukuthi amazinga akho ensimbi ahlolwe kahle. Qinisekisa ukuthi ithimba lakho lokunakekelwa kwezempilo lamanje liyazi konke ngomlando wakho wokumpontshelwa igazi ngaphambilini. Kungenzeka ukuthi wamukele eminyakeni ye-PRBCs edlule ngesimo esingavumelani ngokuphelele, kodwa udokotela wakho udinga ukwazi ngalokhu manje. Khumbula ukuthi insimbi ayinayo indlela yokudonswa emzimbeni wakho, ngakho ukumpontshelwa ngamunye owutholayo esikhathini sakho sokuphila kunakho konke okusemandleni okufaka isandla ekwenzeni insimbi namuhla.
Kufanele uzame futhi ukugcina ithrekhi yokumpontshelwa ngayinye owutholayo. Lokhu kungase kungabi lula, futhi kungase kube nezikhathi zokwelapha kwakho uma kubonakala sengathi konke okwenzayo kukhishwa igazi, kodwa kuyoba kubalulekile kamuva.
Ithimba lakho lezokunakekela impilo kufanele liqale ukuqapha amazinga wakho we-serum ferritin uma usuthole cishe amayunithi angu-20 egazi. Uma uvame ukuthola ama-unit amabili ngesikhathi, lokhu kungahle kube nokumpompela okungu-10 kuphela. Uma bengayilawuli ngokuzenzakalelayo, kufanele uyicele.
Ngaphansi
Iziguli ezithola igazi eziningi ezinsukwini zabo zokuphila zisengozini yokuphuca insimbi. Ngenxa yezifo zabo, kanye nezindlela zokwelashwa ezisetshenziselwa ukuphatha, iziguli zegazi nomdlavuza weMorrow zivame ukuxhomeka kwegazi ngenxa yesikhathi. Uma ungaphathwa kabi, ukuqubuka kwensimbi kungabangela umonakalo omkhulu wegciwane ngisho nokufa, kepha ukwelashwa okuphumelelayo kuyatholakala.
Yize kungenakwenzeka ukugwema ukumpontshelwa igazi, iziguli zingasiza ukuzivikela ngokukhumbula inani lezinyunithi ezitholayo futhi zicele ukuhlolwa kwe-iron overload uma kunesidingo.
Kubuyekezwe ngoMashi 2016, TI.
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