Ukubuyekezwa kwe-Iron Overload Kusukela ekuthunjweni okuNingi
I-Iron overload yisimo lapho kukhona khona insimbi eningi emzimbeni kunokuba isuswe ngumzimba. Ithimba lobuchwepheshe lensimbi ngokweqile i-hemochromatosis. Kunezizathu ezimbili eziyinhloko zokweqiza insimbi: 1) i-hemochromatosis ye-heredit noma 2) i-hemochromatosis yokumpontshelwa igazi. Hereditary hemochromatosis yisimo esidluliselwe emindenini. I-hemochromatosis ye-Transfusional iyenzeka uma umuntu edinga ukumpontshelwa okuningi kwegazi elibomvu (RBC).
I-iron itholakala ngaphakathi kwe- hemoglobin , iphrotheni ngaphakathi kwe-RBC. Umsebenzi wensimbi ukusiza ukuthutha i-oxygen kuzo zonke izicubu. Ngokujwayelekile umzimba uthatha insimbi nje ngokwanele ekudleni kwakho ukuze uqhubeke nokukhiqizwa kwe-RBC. Uma ungadli ukudla okwanele nge-iron, amazinga akho ensimbi abe phansi ngenxa yokuntuleka kwe-iron anemia . Lapho ama-RBC efika ekupheleni kokuphila kwawo, insimbi ngaphakathi kubo iphinda isetshenziswe ukuze isetshenziswe kumaRBC amasha akhiqizwa.
Kungani I-RBC Transfusions Yaningana Yenza I-Iron Overload?
I-Iron itholakala ngaphakathi kwe-RBCs ngayinye egazini lokumpompela igazi. Ngakho wonke ukumpontshelwa kwe-RBC umuntu owamukelayo ngokuyinhloko ukungenwa kwe-intravenous (IV) yensimbi. Inkinga yukuthi umzimba ulinganiselwe amandla ayo okuqeda le nsimbi eningi kakhulu. Ukwengeza, abantu abane-thalassemia bathatha insimbi engaphezu kwalokho abayidingayo ekudleni kwabo kwandisa inkinga.
Ubani Osemngciphekweni We-Transfusional Iron Overload?
Noma ubani othola ukumpontshelwa kwe-RBC amaningi engcupheni, kodwa abantu abaxhomeke ekumpomeni basengozini enkulu.
Lokhu kuzobandakanya abantu abanesifo se-sickle cell abaye bahlaselwa isifo (noma basengozini enkulu yokushaywa yisifo ), i- beta thalassemia enkulu , i- Diamond Blackfan Anemia , i-anemia ye-anemia , ne- myelodysplastic syndrome phakathi kwabanye. Abantu abanomdlavuza abadinga ukumpontshelwa ngamakhemikhali amaningi ngenkathi belashwa nge-chemotherapy noma ukufakelwa komnyoba wamathambo nabo bangengozi yokuxiliswa kwe-iron.
Ngabe Udokotela Wami Uqapha Kangakanani I-Iron?
Abantu abazodinga ukumpontshelwa impilo yonke bavame ukubhekwa ngokucophelela ngenqwaba yensimbi. Kulezi ziguli, ukugqithiswa kwensimbi kungabonakala ngemuva kokumpontshelwa kwe-RBC 12 kuya ku-15. I-Iron overload ihlolwe ngokuhlolwa kwegazi okuthiwa ferritin ekuqaleni. UFerritin ubele inani lensimbi eligcinwe emzimbeni wakho. UFerritin uvame ukuhlelwa ohlelweni, njalo kuya ezinyangeni ezintathu, ukuze udokotela wakho abone ukuthi kuhamba kanjani (okungukuthi, inani liyanda?). I-Chelation, igama lemithi esetshenziselwa ukususa insimbi, ngokuvamile iqalwa ngemva kokuba i-ferritin inkulu kune-1000 ng / mL. Ngeshwa, amazinga e-ferritin ayathinteka yizinto ngaphandle kwe-iron overload. Amazinga aphezulu e-ferritin angabonakala ngesikhathi sokugula nokuvuvukala.
Ngenxa yemikhawulo ka-ferritin, ezinye izindlela zokuhlola ukunqwabelana kwensimbi zenziwa. Esikhathini esidlule, ukunqwabelana kwensimbi kwakuqashwe nge-biopsies yesibindi lapho isiqephu esincane sesibindi sasuswa futhi sihlolwa ngensimbi. Njengamanje, iningi labantu lingabhekwa nge-imagination yamagnetic resonance (MRI) yesibindi kanye / noma inhliziyo. I-MRI ingabala okuqukethwe kwensimbi yesibindi (i-LIC) efana nemiphumela ye-biopsy yesibindi.
I-Chelation iqala lapho i-LIC ingaphezu kuka-3 mg ngesigamu ngesisindo esilwe nesisindo. Ngokufanayo, i-MRI yenhliziyo ingakwazi ukulinganisa inani lensimbi elisezinhlungwini zenhliziyo.
Iziphi Izinkinga Ezingenzeka Ngenqwaba Ye-Iron?
Uma zonke izindawo ezijwayelekile zokugcina insimbi zingasatholakali, insimbi ingagcinwa esibindi, inhliziyo, ama-pancreas, kanye nezitho ze-endocrine (ngokuvamile ezibizwa ngokuthi izigulane). Uma insimbi igcinwa kulezi zindawo, ilimaza isitho. Lokhu kungabangela i-fibrosis noma ukuhluleka kwesibindi, isifo senhliziyo (isifo senhliziyo), isifo sikashukela (ngenxa yensimbi emaqanda), i- hypothyroidism (izinga eliphansi le-hormone ye-thyroid) kanye ne-hypogonadism (okubangela ukuncipha kwe-libido nokungabi namandla emadodeni nokuntuleka yokujikeleza kokuya esikhathini kwabesifazane).
Ukuvimbela lezi zinkinga ezinzima ezisengcupheni zokuphila, inqwaba yensimbi iphathwa kabi.
Kuthathwa Kanjani Ukuguqulwa Kwensimbi Ye-Transfusional?
Ukwehla kwe-iron kusuka ekugonyweni kuphathwa nge-chelation therapy, imithi enikezwe ukususa insimbi emzimbeni. Kunemithi emithathu etholakalayo.
- I-Deferoxamine (Desferal)
- I-Deferasirox (iJadenu noma i-Exjade)
- I-Deferiprone (Ferriprox)
I-phlebotomy yokwelashwa : Uma ngezinye izikhathi ukwazi ukuyeka ukumpontshelwa igazi, ukunqwabelana kwensimbi kungaphathwa nge-phlebotomy ye-serial. I-Phlebotomy ifana ne-blood donation lapho inani elikhulu legazi lisuswa emzimbeni. Phakathi kwama-RBC asuswe yinsimbi futhi uma lokhu kufakwa esikhundleni somnyosi wethambo uzosebenzisa insimbi engaphezu kwemali egcinwe emzimbeni wakho.
> Imithombo:
> Schrier SL kanye neBacon BR. I-Chelation Therapy ye-Thalassemia nezinye Izinsimbi Zenqwaba Ye-Iron Nokunakekelwa Kwe-Iron Okunye kune-Hemochromatosis. Ku: Phezulu, I-post TW (Ed), UpToDate, Waltham, MA.