Kuyini i-pancytopenia, yiziphi izimpawu, yiziphi ezibangela, nokuthi ziphathwa kanjani? Ake sibheke leyo mibuzo.
I-Pancytopenia ichazwa njengamazinga aphansi angavamile zonke izinhlobo zamangqamuzana egazi akhiqizwa ngumnkantsha wamathambo. Lokhu kubandakanya amangqamuzana egazi abomvu, amangqamuzana egazi amhlophe, namaplatelet.
Amaseli Egazi Ethintekayo ePancytopenia
Ngokuqondile, i-pancytopenia ibhekisela ekuntulekeni kwe:
- Amangqamuzana egazi elibomvu (ama-RBC): ama-RBC angama cell ahlanganisa futhi athathe i-oxygen emathisini omzimba.
- Amaseli amhlophe egazi (ama-WBCs): Kunezinhlobo eziningana zamangqamuzana egazi amhlophe (ama-WBCs) aphinde aphulwe abe ama-granulocytes (kufaka phakathi i-neutrophils, i-eosinophils, ne-basophils), nama-agranulocytes (kufaka phakathi i-lymphocytes nama-monocytes). Lawa maseli anesibopho sokulwa nezifo phakathi kweminye imisebenzi.
- Ama-Platelets: Ama-Platelets aphethwe ukugubha igazi.
Ukuchaza amazinga aphansi egazi
- Izinga eliphansi lamangqamuzana egazi obomvu libhekwa njenge- anemia . Kubalulekile ukuqaphela ukuthi kunezinhlobo ezahlukene ze-anemia. Esinye isizathu sizinga eliphansi lamaseli abomvu, kepha kungenzeka futhi ngenxa yokulahlekelwa igazi, izinga eliphansi le-hemoglobin, ukungabi khona kwevithamini B12, nezinye izimbangela.
- Izinga eliphansi lamangqamuzana egazi elimhlophe libizwa ngokuthi i-leukopenia (ungase uzwe nge-neutropenia, ebhekisela ezingeni eliphansi lohlobo oluthile lwamaseli amhlophe egazi aziwa njenge-neutrophils).
- Izinga eliphansi lamaplatelet libizwa ngokuthi i-thrombocytopenia, njenge- thrombocytopenia ye-immune , kanye ne-thrombocytopenia eyenziwa yi-chemotherapy .
Ukwakhiwa kwamaseli egazi e-Bone Marrow noma eHematopoiesis
Amangqamuzana egazi asuka esitokisini esisodwa esivamile emnothweni wethambo okuthiwa i-hematopoietic stem cell (HSM) noma amaseli we-pleuripotential stem (okusho ukuthi une "amandla" okuba izinhlobo eziningi zamaseli.
Lawa maseli ahlukana futhi aqhubeke ngokukhethekile ngokuqhubekayo enqubo ebizwa nge-hematopoiesis kuwo wonke amaseli egazi emzimbeni.
Izivivinyo ze-Lab
I-pancytopenia ivame ukutholakala ngokubuka inani eliphelele legazi (i-CBC). Imiphumela izobonisa amazinga ahlulekile azo zonke izinhlobo zamaseli egazi afaka:
- Iseli legazi elibomvu lilinganiselwa ngaphansi kwezigidi ezingu-4.2 zamaseli / cc kubantu besifazane noma ngaphansi kwama-4.7 million amaseli / cc emadodeni (Lokhu kungabuye kuchazwe ngezinga eliphansi le-hemoglobin).
- Inani elimhlophe legazi ngaphansi kwama-4,000 amaseli / cc (evamile liphakathi kuka 4,000 no-10,000 amaseli / cc).
- Inani leplatelet lingaphansi kuka-150,000 amaseli / cc (evamile liphakathi kuka-150,000 no-400,000 amaseli / cc).
Izimbangela
I-pancytopenia ingabangelwa yinoma yini ephazamisa ukubunjwa kwamaseli egazi emnothweni wamathambo noma ukutholakala kwabo emzimbeni wegazi (njengokuthi babanjwa epeni).
Lokhu kungabandakanya ukubhujiswa komnkantsha wamathambo ngama-toxin, ukususwa komnkantsha wamathambo, njengokungathi ngesikhathi se-chemotherapy, noma ukuguqulwa kwamathambo ngamanye amangqamuzana okubangelwa ukuphazanyiswa kokukhiqizwa kwamaseli wegazi njengoba kungenzeka nakwamanye amagciwane. Ukubhujiswa noma ukususwa kungase kuvele ukuvuvukala , izifo, noma izimo ezizenzakalelayo .
Iningi lalezi zimo zitholakala kamuva ekuphileni, kodwa bambalwa bazuzwa njengefa futhi bavela kusukela ekuzalweni.
Okungenani amaphesenti angu-50 yesikhathi asikho imbangela ecacile-okuthiwa odokotela babhekisela ngokuthi "idiopathic ." Ezinye zezimbangela ezikhona ze-pancytopenia zingabandakanya:
- Ukususwa komnyofu we-bone okwelashwa kwe-Chemotherapy
- Ukudakwa kwezidakamizwa: Izidakamizwa ngaphandle kwezidakamizwa ze-chemotherapy, kusukela kuma-antibiotic kuya emithi esetshenziselwa isifo senhliziyo, ziye zachazwa njengezimbangela.
- Izifo ezinjenge-mononucleosis ezithathelwanayo ne-HIV, kanye nokutheleleka okukhulu kwezifo (sepsis).
- I-anemia ye-aplastic
- Ukwehliswa kwe-splenic (ukugcinwa kwamaseli egazi ngepeni ukuze bangakwazi ukufinyelela emzimbeni wonke).
- Ubuthi kanye nokuchayeka kwamakhemikhali njengokudonswa kwe-arsenic noma i-benzene.
- Amagciwane egazi emnothweni wamathambo afana ne-leukemia, i-lymphoma, i-myeloma, noma umdlavuza we-metastatic ukuze athole umongo.
- Ukusakaza ezinye izicubu eziqinile emnothweni wamathambo, ikakhulukazi umdlavuza webele, umdlavuza wesifo sofuba, umdlavuza we-colon, umdlavuza wesisu, ne-melanoma. Ngomnkantsha wamathambo isifo esivamile kakhulu i-anemia elandelwa yi-thrombocytopenia.
- I-Myelodysplastic syndrome (isimo "esingaphambi komdlavuza" somnyofu wethambo)
- Izifo ezizenzakalelayo ezifana ne-lupus
- Ukugula kwezifo
- Ama-syndromes anembile, njenge-Fanconi anemia, i- Diamond Blackfan i-anemia .
Iziningi Ezivamile
Ucwaningo lwango-2014 lubekwe ukucacisa izimbangela ezivame kakhulu ze-pancytopenia kubantu ababengakatholakali ukuthi banesimo. Isibonelo, akekho kulaba bantu abadala abaye bathola i-chemotherapy noma babe nezizathu ezicacile ze-pancytopenia yabo. Kulaba bantu:
- Amaphesenti angaphezu kuka-60 anesifo esithile somdlavuza ohlobene negazi. Okuvamile kakhulu kwakuyi -leukemia ephawulekayo ye-myelogenous , i-myelodysplasia, i-non-Hodgkin's lymphoma, i-leyemia ye-leyemia ekhanda, ne-acute lymphocytic leukemia.
- Kulabo ababengenayo umdlavuza ohlobene negazi njengesizathu se-pancytopenia yabo, ukuxilongwa kuhlanganisa i-aplastic anemia, i-megaloblastic anemia, ne-HIV. i-anemia, ne-HIV.
Izimpawu
Izimpawu ze-pancytopenia zingabandakanya ubuthakathaka, ukuhlupha, noma ipeni ekhulisiwe ngaphezu kwezimpawu ezihlobene nokuntuleka kwegazi elithile. Ezinye zalezi zimpawu zihlanganisa:
- Izimpawu ezihlobene ne-anemia (isibalo esincane esibomvu segazi) kufaka phakathi i-pallor, ukukhathala, izinga lokushaya kwenhliziyo ngokushesha, nokuphefumula.
- Izimpawu ezihlobene neukopenia noma i-neutropenia (inani eliphansi elimhlophe) kubandakanya umkhuhlane kanye nezimpawu zokutheleleka ezifana nokukhwehlela noma ubuhlungu ngokuchama
- Izimpawu ezihlobene ne-thrombocytopenia (amapleletthi aphansi) kufaka phakathi ukulimaza okulula, nokugaya okukhulu.
Ukuxilongwa Nokuhlola
Ngemuva kokuphinda umsebenzi wakho webhu ukuze uqinisekise ukuthi une-pancytopenia ngempela, isinyathelo sokuqala ngokuvamile siwumongo we-bone marop.
Umbiko we- bone marrow biopsy unganika udokotela wakho ulwazi oluningi.
Ukwelapha
Umgomo wokwelapha i-pancytopenia ukuthola nokuphatha imbangela eyimbangela. Uma imbangela ingaziwa, noma uma kulindeleke, njenge-chemotherapy, ukwelashwa kuhloswe ukunciphisa izimpawu ezihlobene nokuntuleka kwamaseli egazi. Ezinye zokwelashwa ezingasetshenziswa zihlanganisa:
- Izidakamizwa ezishukumisa umongo wethambo. Nge -neutropenia eyenziwa yi-chemotherapy kanye nezinye izimbangela, izici zokukhula ze-Leukine, Neupogen, noma i-Neulasta zingasetshenziswa ukukhuthaza ukwakheka kwamangqamuzana egazi elimhlophe. Ukuze uthole i- chemotherapy-induced anemia , kukhona neminye imithi engacatshangwa.
- Ukumpontshelwa igazi
- Izidakamizwa ze-immunosuppressive uma kungenxa yesimo sokuzimela.
- Ukufakelwa kwe-bone marrow noma ukufakelwa kwe-cell stem .
Isibikezelo
Ukuchazwa kwe-pancytopenia kuxhomeke kakhulu ekubambeni kwayo. Siyabonga ukuthi manje sinezokwelapha ezifana nokumpompela kanye nezici ezishukumisayo zokusiza nge-specific cell deficiency lapho isimo sesimo sihlolwa futhi siphathwa.
Ngaphansi
Kunezimbangela eziningi ezingabangela i-pancytopenia, kodwa bonke baphatha izingozi. Nge-pancytopenia zonke izinhlobo zamaseli egazi ziyancishiswa, nakuba ukunciphisa kwabanye kungase kube nokukhathazeka okwengeziwe kunabanye.
Isibonelo: UDani wathola i-pancytopenia-izinga eliphansi lamaseli abomvu abomvu, amaseli egazi amhlophe, namaplatelet-emva kokuphathwa kwakhe kokugcina kwamakhemikhali.
> Imithombo:
> Devitt, K., Lunde, J., noM. Lewis. I-Pancytopenia Entsha Entsha Ekubuyiseni Kubantu Abadala: Ukubuyekezwa Kwama-Pathologies Obunamandla Nezibalo Zabo Ezihlobene Nezokwelapha Nezokwelapha. I-leukemia ne-Lymphoma . 2014. 55 (5): 1099-105.
> Miano, M., noC. Dufour. Ukuxilongwa Nokunakekelwa Kwe-Anemia Ye-Aplastic: Ukubuyekeza. I-International Journal of Hematology . 2015. 101 (6): 527-35.
> Sharma, R., noG. Nalepa. Ukuhlola nokuphathwa kwePanycytopenia engapheli. Izingane ezibuyiselwe ekubuyekezweni . 2016. 37 (3): 101-113.
> Weinzierl, E., no D. Arber. I-Bone Marrow Ukuhlola Ekuqaleni kwe-Pancytopenia. I-Human Pathology . 2013. 44 (6): 1154-64.
> Weinzierl, E., no D. Arber. Ukuxilongwa okuhlukile kanye ne-Bone Marrow Ukuhlolwa kwe-New-upt Pancytopenia. I-American Journal of Clinical Pathology . 2013. 139 (1): 9-29.