Yintoni i-pancytopenia, zeziphi iimpawu, yintoni ebangela ukuba, kwaye uphathwa njani? Makhe sijonge kule mibuzo.
I-Pancytopenia ichazwa njengamazinga aphantsi aphantsi zonke iintlobo zeeseli zegazi eziveliswa ngumnatha wethambo. Oku kufaka iiseli ezibomvu zegazi, iiseli zegazi ezimhlophe kunye neeplatelet.
Iifom zegazi ezichaphazelekayo ePancytopenia
Ngokukodwa, i-pancytopenia ibhekisela ekusileni kwe:
- Iiseli zegazi ezibomvu (i-RBCs): IiRBC ziiseli ezibopha kwaye zithwala i-oksijini kwizicubu zomzimba.
- Amaseli egazi ezimhlophe (ii-WBCs): Zininzi iintlobo zeeseli zegazi ezimhlophe (i-WBCs) ezigqitywa ngakumbi zibe yi-granulocyte (kuquka neutrophils, i-eosinophil, kunye ne-basophil), kunye ne-agranulocytes (kuquka i-lymphocytes kunye ne-monocytes). Ezi iiseli zinoxanduva lokulwa nezifo phakathi kweminye imisebenzi.
- Iiplatelets: Iiplatelet zinoxanduva lokucima igazi.
Ukuchaza amaNqanaba aPhantsi eGazi
- Iqondo eliphantsi lamaseli obomvu libhekiswa njenge- anemia . Kubalulekile ukuba uqaphele ukuba kukho iindlela ezahlukeneyo ze-anemia. Esinye isizathu sinqanaba elingaphantsi kweeseli ezibomvu zegazi, kodwa kungenzeka ngenxa yokulahleka kwegazi, izinga eliphantsi le-hemoglobin, ukungabikho kwe-vitamin B12 kunye nezinye izizathu.
- Iqondo eliphantsi lamaseli egazi ezimhlophe libhekiswa njenge-leukopenia (unokuva nge-neutropenia, ebhekisela kumgangatho ophantsi woluhlobo oluthile lweeseli zegazi ezimhlophe ezibizwa ngokuba yi-neutrophils).
- Iqondo eliphantsi leeplatelet libhekiswa njenge-thrombocytopenia, njenge- thrombocytopenia ye-immune , ne- chemotherapy-induced thrombocytopenia .
Ukuqulunqwa kweeSele zeGazi kwiMarrow Bone okanye kwiHematopoiesis
Iiseli zegazi zonke zivela kwiselinye esisodwa esesiswini somnxeba esaziwa njenge-hematopoietic stem cell (HSM) okanye i-pleuripotential cell stem (oku kuthetha ukuba "unako" ukufumana iintlobo ezahlukeneyo zeeseli.
Ezi iiseli zahlula kwaye ziyaqhubeka zizodwa ngokukhethekileyo kwinkqubo ebizwa ngokuthi i-hematopoiesis kuwo onke amaseli egazi emzimbeni.
Uvavanyo lweBeb
I-Pancytopenia ivame ukufunyanwa ngokujonga i-blood full count (CBC). Iziphumo ziza kubonisa amanqanaba ahlulekiyo zonke iintlobo zeeseli zegazi kuquka:
- Isalathisi segazi elibomvu liba ngaphantsi kwezigidi ezi-4.2 zeeseli / cc kubasetyhini okanye ngaphantsi kwama-4.7 yezigidi zeeseli / cc kumadoda (Oku kungachazwa ngezinga eliphantsi le-hemoglobin).
- Inani legazi elimhlophe lingaphantsi kwee-4,000 iiseli / cc (eziqhelekileyo ziphakathi kwama-4,000 no-10,000 amaseli / cc).
- Inani leplatelet lingaphantsi kwe-150,000 iiseli / cc (eziqhelekileyo ziphakathi kwama-150,000 no-400,000 amaseli / cc).
Izizathu
I-Pancytopenia ibangelwa yiyiphi into ephazamisa ukubunjwa kweeseli zegazi kwi-bone lomnatha okanye ukufumaneka kwazo kwigazi (njengokuba zigcinwe ngepeni).
Oku kungabandakanya ukutshatyalaliswa komongo we-bone ngomnxeba, ukunyanzelwa komongo we-bone, njengokwakhe ngexesha le-chemotherapy, okanye ukutshintshwa kwethambo lomongo ngamanye amaseli okubangelwa ukuphazamiseka kwemveliso yeselingo yegazi njengoko kunokuthi kwenzeke kunye namanye amachiza. Ukutshatyalaliswa okanye ukuxinwa kunokuvela kwi- inflammation , izifo okanye izimo ezizimeleyo .
Uninzi lwezi meko luzuzwa kamva ebomini, kodwa ke bambalwa bazuze ilifa baze bavela ekuzalweni.
Ubuncinane i-50 ekhulwini yexesha alikho imbangela ecacileyo-into ethile oogqirha abhekisela kuyo ngokuthi "idiopathic ." Ezinye zezizathu ezinokwenzeka zePancytopenia zingaquka:
- Ukunciphisa umongo we-okotherapy
- Ukusetyenziswa kweziyobisi: Izidakamizwa ngaphandle kweziyobisi ze-chemotherapy, ukusuka kumayeza okulwa namachiza asetyenziswa kwisifo senhliziyo, zikhankanywe njengezizathu.
- Izifo ezifana ne-infectous mononucleosis kunye ne-HIV, kunye nezifo eziphazamisayo (sepsis).
- I-anemia ye-aplastiki
- Ukulandelwa kwe-Splenic (ukugcinwa kweeseli zegazi kwipeni ukuze bakwazi ukufikelela kuwo wonke umzimba).
- Iifomsi kunye nokukhutshwa kwamakhemikhali afana ne-exposed arsenic okanye i-benzene.
- Amagciwane egazi emnzini wethambo ezifana ne-leukemia, i-lymphoma, i-myeloma, okanye umdlavuza we-metastatic ukuthambo lomongo.
- Ukusabalalisa ezinye izicubu ezinamandla emathambo esifuba, ingakumbi umdlavuza webele, umhlaza wesibeletho, umhlaza wesibeletho, umhlaza wesisu, kunye ne-melanoma. Ngomnatha weethambo i-metastase i-symptom eqhelekileyo yintsholongwane elandelwa yi-thrombocytopenia.
- I-Myelodysplastic syndrome ("imeko engaphambi komdlavuza" yomnatha wethambo)
- Izifo ezizenzekelayo ngokuzenzekelayo ezifana ne-lupus
- Ukugula kwezifo
- Ama-syndromes anemveli, njenge-Fanconi anemia, i-anemia ye- Diamond Blackfan .
Eyona nto ibangeleyo
Uphononongo luka-2014 olubekwe ukucacisa izizathu eziqhelekileyo zepancytopenia kubantu abangenakufumanisa ukuba banesimo. Ngokomzekelo, akukho namnye kulaba bantu abadala abafumana i-chemotherapy okanye babenezizathu ezicacileyo ze-pancytopenia yabo. Kula bantu:
- Amaphesenti angaphezu kwama-60 anomdla othile ochaphazeleka ngegazi. Eyona nto iqhelekileyo yayiyi -leukemia enamandla , i-myelodysplasia, i-non-Hodgkin's lymphoma, i-leukemia yengqumbo, kunye ne-acute lemonemic leukemia.
- Kwalabo abangenayo umdlavuza ochaphazeleka ngegazi njengesizathu se-pancytopenia yabo, ukuxilongwa kwakuquka i-aplastic anemia, i-megaloblastic anemia kunye ne-HIV. i-anemia, ne-HIV.
Iimpawu
Izimpawu ze-pancytopenia zingabandakanya ubuthathaka, ukuxhatshazwa okanye ipenti ephakamileyo ngaphezu kweempawu ezinxulumene nokungabikho kweeseli ezithile zegazi. Ezinye zeempawu ziquka:
- Iimpawu ezinxulumene ne-anemia (inani elibomvu lentsholongwane yegazi) kubandakanya i-pallor, ukukhathala, isantya senhliziyo ngokukhawuleza, kunye nokuphefumula okufutshane.
- Iimpawu ezinxulumene ne-leukopenia okanye i-neutropenia (inani eliphantsi elimhlophe) kubandakanya umkhuhlane kunye nempawu zentsholongwane efana nokukhwehlela okanye intlungu nge-urination
- Iimpawu ezinxulumene ne-thrombocytopenia (iiplatelet ezisezantsi) kuquka ukubetha okulula, kunye nokuphuma kwegazi.
Ukuxilongwa nokuHlola
Emva kokuphinda umsebenzi wakho webholo ukuqinisekisa ukuba unayo i-pancytopenia, isinyathelo sokuqala sisoloko siba ngumongo we-bone.
Ingxelo yomongo we-biopsy ingxelo inganika udokotela ulwazi oluninzi.
Unyango
Injongo ekuphatheni i-pancytopenia kukufumana nokuphatha isisiseko esiyintloko. Ukuba isizathu asiyazi, okanye ukuba kulindeleke, njenge-chemotherapy, unyango lujoliswe ekunciphiseni iimpawu ezinxulumene nokusilela kweeseli zegazi. Ezinye zonyango ezingasetyenziswa ziquka:
- Iziyobisi ezikhuthaza umongo wethambo. I -neutropenia eyenziwa yi-chemotherapy kunye nezinye izizathu, ukukhula kweengxaki zeLeukine, Neupogen, okanye i-Neulasta zingasetyenziselwa ukukhuthaza ukubunjwa kweeseli ezimhlophe zegazi. Ukukhulelwa kwe-anemia yokukhupha i-chemotherapy , kukho na amanye amayeza anokuqwalaselwa.
- Ukunyelwa igazi
- Iziyobisi ezingenasifo sokungena kwempilo xa zibangelwa yimeko engenziwayo.
- Ukutsaliswa komnxeba we-Bone okanye ukutshintshwa kwe-cell stem .
Prognosis
Ukugxekwa kwe-pancytopenia kuxhomekeke kakhulu kwizathu. Siyabonga ngoku ngoku unyango olunjenge-transfusion kunye neemeko ezikhuthazayo zokuncedisa ukulahleka kwetyala legazi ngelixa imeko ephantsi ihlolwa kwaye iphathwa.
Okukwintsusa
Kukho ezininzi ezinokubangela i-pancytopenia, kodwa zonke ziphethe ingozi. I-pancytopenia zonke iintlobo zeeseli zegazi ziyancitshiswa, nangona ukunciphisa kwezinye izinto kunokukhathazeka ngakumbi kunabanye.
Umzekelo: UDan wavelisa i-pancytopenia-inqanaba elincinane leeseli ezibomvu zegazi, iiseli zegazi ezimhlophe kunye neeplatelet-emva kokunyanga kwakhe kokugqibela kweyeza.
> Imithombo:
> Devitt, K., Lunde, J., noM. Lewis. I-Pancytopenia entsha kwi-Pancytopenia kuBantu abadala: Ukuhlaziywa kweePathologies ezisisiseko kunye neZikolo eziManyeneyo kunye neeLebhu. I-Leukemia kunye neLymphoma . 2014. 55 (5): 1099-105.
> Miano, M., kunye neC. Dufour. Ukuxilongwa nokuPhathwa kwe-Anemia ye-Alastiki: Ukuphononongwa. I-International Journal yeHematology . 2015. 101 (6): 527-35.
> Sharma, R., noG. Nalepa. Ukuvavanya noLawulo lwePanycytopenia engapheliyo. Iingcali ekuhlaziyweni . 2016. 37 (3): 101-113.
> Weinzierl, E., noD. I-Bone Marrow Ukuphononongwa kwi-New-rise Pancytopenia. Ulwaphulo lwabantu . 2013. 44 (6): 1154-64.
> Weinzierl, E., noD. Ukuxilongwa okuhlukileyo kunye neM Bone Marrow Ukuhlaziywa kwe-New-rise Pancytopenia. I-American Journal ye-Clinical Pathology . 2013. 139 (1): 9-29.