Izivivinyo Zegazi Ezijwayelekile Nezikhethekile Zisetshenziselwa Ukuhlola I-arthritis
Ukuhlolwa kwegazi kusetshenziselwa ukuxilonga i- arthritis , ukuqapha ukusebenza kwempatho, nokulandelela umsebenzi wesifo. Ngenkathi ukuhlolwa kwegazi le-laboratory kuyizinto ezibalulekile zokuhlonza amathuluzi, akuzona ezicacile uma kucatshangwa yedwa. Ukwenza i-diagnostic enembile, umlando wezokwelapha wesiguli kumele uhlolwe, kanye nemiphumela yokuhlolwa kwelabhutri kanye nezifundo zokucabanga.
Kukhona ukuhlolwa kwegazi jikelele kanye nokuhlolwa kwegazi okukhethekile okusetshenziselwa ukuhlola i-arthritis.
Izivivinyo zeGeneral General
Qedela i-Blood Count (CBC)
Ukubala kwegazi okuphelele ukuhlolwa kwegazi okubala inani lamaseli abomvu abomvu , amangqamuzana egazi amhlophe , namaplatelet . Izingxenye zegazi ezishiwo ngenhla zimiswa okwesikhashana eplasma (ingxenye egazini, ephuzi ephuzi, egazini yegazi). Imishini eyenziwe ngokuzenzakalelayo ebhokisithribhu ngokushesha ibala izinhlobo ezahlukene zeseli.
Amaseli Asemhlophe
Ukubalwa kwamaseli amhlophe kuvame ukuphakathi kuka-5,000-10,000 nge-microliter ngayinye yegazi. Izindinganiso ezikhulayo zikhomba ukuvuvukala noma ukutheleleka. Izinto ezinjengokuzivocavoca, ukubandayo nokucindezeleka zingakhulisa okwesikhashana ukubalwa kwamaseli amhlophe.
Amaseli alubomvu
Izindinganiso ezijwayelekile zokubala kwesibomvu ezibomvu zihluka ngobulili.
- Ngokuvamile abesilisa banamagugu azungeze ama-5-6 million amangqamuzana abomvu nge-microliter ngayinye.
- Amantombazane anesilinganiso esiphansi phakathi kwama-3.6-5.6 million amangqamuzana abomvu nge-microliter ngayinye.
I-Hemoglobin / i-Hematocrit
I-Hemoglobin, ingxenye elinezinsimbi zamaseli abomvu ephethe i-oksijeni, iphindwe futhi ngezinga eliphelele legazi. Inani elivamile le-hemoglobin yamadoda liyi-13-18 g / dl. I-hemoglobin evamile yabesifazane yi-12-16 g / dl.
I-hematocrit isilinganiso samangqamuzana abomvu njengephesenti yenani legazi eliphelele.
I-hematocrit evamile yabesilisa iphakathi kuka-40-55% kanti i-hematocrit evamile yabesifazane ingama-36-48%. Ngokuvamile, i-hematocrit cishe izikhathi ezingu-3 i-hemoglobin. Amagugu anciphayo abonisa ukuthi i- anemia .
I-MCV, i-MCH, i-MCHC yizinkomba ezibomvu zamangqamuzana ezibonisa ubukhulu nokuqukethwe kwe-hemoglobin yamaseli abomvu ngabanye. Ama-indices anganikeza izinkomba mayelana nomphumela obangela i-anemia ekhona.
Platelets
Ama-Platelet yizinto ezibalulekile ekubunjweni kwe-clot . Imithi eminingi esetshenziswa ekwelapheni i-arthritis inganciphisa inani leplatelet noma ithinte umsebenzi weplatelet. Amanani weplatelet evamile avela ku-150,000-400,000 nge-microliter ngayinye.
Ukuhluka
Iphesenti kanye nenani eliphelele lohlobo ngalunye lweseli legazi elimhlophe libizwa ngokuthi umehluko.
- Ama-neutrophils akhuliswa ukutheleleka kwebhaktheriya nokuvuvukala okukhulu.
- Ama-lymphocytes akhuliswa ngezifo ezithathelwanayo.
- Ama-monocytes anyuselwa kwizifo ezingelapheki.
- I-Eosinophils yanda emithonjeni yezinyosi kanye nezinye izimo. Inombolo ephakeme ye-eosinophils yaziwa ngokuthi i- eosinophilia .
- Ama-Basophils , okuvamile oku-1 noma 2% okuhlukana kwebala elimhlophe, okwenyuka ukwanda.
Ukuvuvukala
Inqubo yokuvuvukala ingabangela ushintsho ekubaleni kwegazi. Ukubalwa kwamaseli obomvu kungase kwehle, isibalo esincane se-cell singase sikhuphuke, futhi isibalo seplatelet singaphakanyiswa.
Nakuba i-anemia ingase ihambe ne- arthritis evimbayo ingabangelwa ezinye izinto, njengokulahlekelwa kwegazi noma ukungabi nensimbi. Kuphela uma ezinye izimbangela zikhishwe ngaphandle udokotela angachaza ukungafani kwegazi njengesibonakaliso sokuvuvukala.
I-Chemistry Panels
Iphaneli yamakhemikhali yichungechunge lwezivivinyo ezisetshenziselwa ukuhlola imisebenzi esemqoka yokusebenza. Iqembu lezivivinyo zenziwa nge-serum (ingxenye yegazi ngaphandle kwamaseli). Ama-electrolyte, ama-saloni e-ionized egazi noma amathisipulisi amanzi (isb., I-sodium, i-potassium, i-chloride), ayengxenye yephaneli yamakhemikhali. Kukhona nokuhlolwa okusebenza njengezinkomba zenhliziyo, isifo sikashukela, umsebenzi wezinso , nesibindi .
Isibonelo, isiguli esinamazinga aphezulu e-creinine singaba nesimo esingavamile sezinso. I-Creatinine ngumkhiqizo odoti otholakala egazini. Izinhlobo ezithile ze-arthritis evuthayo zingathinta umsebenzi wezinso. Izidakamizwa ezithile ze-arthritis zingathinta umsebenzi wezinso, futhi. I-acid yase-Uric yinye ukuhlolwa okufakwe kuphaneli yamakhemikhali egazi. Uma kuphakanyisiwe, i-uric acid ingase ibonise ukuthi i-gout. Lokho kungumane nje wezibonelo. Empeleni, iphaneli yamakhemikhali inikeza ulwazi oluningi mayelana nokuthi umzimba usebenza kanjani.
Izivivinyo zegazi ezikhethekile
Isilinganiso se-Erythrocyte Sedimentation (ESR)
Isilinganiso se- erythrocyte sediment is a test okubandakanya ukubeka isampula segazi esikhwameni esikhethekile futhi sinqume ukuthi amasosha omzimba obomvu agxila kanjani phansi ngehora elilodwa. Uma ukuvuvukala kukhona, umzimba uveza amaprotheni egazini okwenza amaseli abomvu ahlanganise ndawonye. Ama-aggregate anamandla kakhulu awela ngokushesha kunamaseli ajwayelekile abomvu. Kubantu abaphilile, izinga elijwayelekile lifinyelela kumamitha angu-20 ngehora elilodwa (0-15 mm / hr lamadoda no-0-20 mm / hr abesifazane). Ukuvuvukala kwandisa izinga ngokuphawulekayo. Njengoba ukuvuvukala kungahlotshaniswa nezimo ngaphandle kwe-arthritis, ukuhlolwa kwesilinganiso se-sedimentation kuphela kubhekwa njengokungaqondile.
Factor ye-Rheumatoid (RF)
Isisindo somzimba esibonakalayo sitholakala kumagciwane amaningi ane- arthritis ye-rheumatoid . Isici se-rheumatoid satholwa ngawo-1940 futhi saba yithuluzi elikhulu lokuxilonga emkhakheni we-rheumatology. Cishe iziguli ezingama-80% ze-rheumatoid arthritis zinesisindo se-rheumatoid egazini labo. Ukugxila okuphezulu kwe-rheumatoid factor ngokuvamile kuhlotshaniswa nezifo ezinzima.
Isici se-rheumatoid singathatha izinyanga eziningi ukubonisa egazini. Uma ihlolwe kakhulu ekuqaleni kwesi sifo, umphumela ungaba nombi futhi ukuhlolwa kabusha kumele kucatshangelwe ngesikhathi esilandelayo. Ezimweni lapho iziguli zikhona ngezibonakaliso nezimpawu zesifo samathambo kodwa ziyi-seronegative ye-rheumatoid factor, odokotela bangase basho ukuthi esinye isifo sifana nesifo se-rheumatoid arthritis. Isifo se-rheumatoid singase senzeke nakweminye imibandela yokuvuvukala noma izifo ezithathelwanayo, nakuba ngokuvamile ezimweni ezinjalo, ukuhlushwa kuncane kune-arthritis ye-rheumatoid.
I-HLA Typing
Amaseli amhlophe wegazi angase afakwe kuhlu lwe- HLA-B27. Uhlolo luvame ezikhungweni zezokwelapha lapho kwenziwa khona ukuguqulwa. I-HLA-B27 iphinde ibe nesibonakaliso sezakhi zofuzo ezihlobene nezinhlobo ezithile ze-arthritis, ikakhulukazi i- ankylosing spondylitis ne- Reiter's syndrome / Arthritis esebenzayo .
I-Antinuclear Antibody (ANA)
Isivivinyo se- ANA (antinuclear antibody) senziwa ukusiza ukuxilonga izifo ezithile ze- rheumatic . Iziguli ezinezifo ezithile, ikakhulukazi i- lupus , zakha ama-antibodies ku-nucleus yamaseli omzimba. Ama-antibodies abizwa ngokuthi ama-anti-nuclear antibodies futhi abonakala ngokubeka isiguli sesiguli ku-slide ekhethekile ye-microscope equkethe amaseli ane-nuclei ebonakalayo. Into equkethe idayi ye-fluorescent yengezwe. Idayi ibophezela kuma-antibodies ku-slide, okwenza kubonakale ngaphansi kwe-microscope ye-fluorescent.
- Iziguli ezingama-95% ezine-lupus zinesimo esihle se-ANA.
- Iziguli ezingama-50% ze-rheumatoid arthritis zenza i-ANA.
Iziguli ezinezinye izifo nazo zingaba nokuhlolwa okuhle kwe-ANA. Ukuze uthole ukuxilongwa okucacile, ezinye izindlela kufanele nazo zicatshangelwe.
Iphrotheni ye-C-Reactive (CRP)
Iprotheyini e-C-Acactive ihlose ukuhlunga uhlobo oluthile lweprotheyini olukhiqizwa yisibindi. Iprotheyini ikhona kwi-serum yegazi phakathi neziqephu zokuvuvukala okukhulu noma ukutheleleka.
Njengesivivinyo segazi, i-CRP ibhekwa njengewona oqondile. Umphumela ophezulu ubonisa ukuvuvukala okukhulu. Ezimweni zezifo zengqondo ezivuvukalayo, njenge-arthritis ye-rheumatoid ne-lupus, odokotela bangasebenzisa ukuhlolwa kwe-CRP ukuqapha ukusebenza kokwelashwa nokusebenza kwesifo.
I-Lupus Erythematosus (LE)
Ukuhlolwa kwesilwane se-LE akusasetshenziswa kakhulu. Ukutholakala kwalo kokuqala kwavula yonke insimu yezikhali zokulwa nezikhali ze-anti-nyukliya. Inkinga - kutholakala kuphela iziguli ezingu-50% ze-lupus ukuthi zinemibuzo emihle ye-LE.
Anti-CCP
I-anti-CCP (anti-cyclic citrullinated antibody peptide) ingenye yokuhlolwa kwegazi okusha esetshenziswa ukuqinisekisa ukutholakala kwe-arthritis ye-rheumatoid. Uma i-antibody ikhona ezingeni eliphezulu, ingase ikhombise nokuthi kunengozi ephezulu yokulimala okuhlangene.
I-Anti-DNA ne-Anti-Sm
Iziguli ze-Lupus zakha ama-antibodies ku-DNA (deoxyribonucleic acid). Uhlolo luyatholakala oluhlola ukutholakala kwe-anti-DNA. Kuyinto ithuluzi lokuhlonza eliwusizo, ikakhulukazi njengoba i-anti-DNA ingatholakali kubantu abangenakho i-lupus. Ukuhlolwa futhi kuyithuluzi lokuqapha elihle ngoba amazinga e-anti-DNA aphakama futhi awela ngemisebenzi yesifo.
Iziguli ze-Lupus nazo zinama-antibodies ku-Sm (aphikisana no-Smith), enye into esebenzisa i-nucleus yeseli. Ama-antibodies ase-Sm nawo atholakala kuphela kuziguli ze-lupus. Ukuhlolwa akusizi ngokukhethekile ekuqapheleni umsebenzi wesifo, noma kunjalo.
Qedelela
Uhlelo lwe-complement uhlelo oluyinkimbinkimbi lwamaprotheni egazi ayingxenye yesistimu yokuvikela umzimba. Amaprotheni ayasebenza kuze kube yilapho i-antibody ibopha ku-antigen futhi ivuselela uhlelo lokuqedela. Uhlelo luveza izinto ezisiza ukubhubhisa amabhaktheriya nokulwa nabahlaseli. Lezi zindlela zokudla ziqeda ukondla futhi zishiye amazinga acindezelekile abonisa ukubunjwa kwe-immune complex. Iziguli ze-Lupus zivame ukukhombisa amazinga wokunciphisa amazinga. Ukuhlolwa okuhambisanayo kungasiza futhi ekulandeleni umsebenzi wesifo wesiguli se-lupus.
Imithombo:
I-Kelley's Bookbook of Rheumatology. Elsevier. Umagazini wesishiyagalolunye.
I-Duke University Medical Center Book of Arthritis, uDavid S. Pisetsky, MD, Ph.D.