Iimvavanyo zeGazethi jikelele kunye neziNzululwazi ezizodwa ziSebenzisiwe Ukuhlola iArthritis
Iimvavanyo zegazi zisetyenziselwa ukunceda ukuxilonga i- arthritis , ukubeka iliso ukusebenza kwonyango, nokulandelela umsebenzi wesifo. Ngelixa iimvavanyo zegazi zebhoratri zixhobo ezixhasayo zokuxilonga, azibonakali xa zicingwa zodwa. Ukwenza i-diagnostic echanekileyo, imbali yesigulane yesigulane kufuneka ihlolwe, kunye neziphumo zovavanyo lwebhoratri kunye nezifundo zokucinga.
Kukho ukuhlolwa kwegazi jikelele kunye neemvavanyo zegazi ezikhethekileyo ezisetyenziselwa ukuhlola i-arthritis.
Uvavanyo lweGazethi jikelele
Gcwalisa iAgazi yeGazi (iCBC)
Inani elipheleleyo legazi luvavanyo lwegazi olubala inani leeseli ezibomvu zegazi, iiseli zegazi ezimhlophe kunye neeplatelet . Iimpawu zegazi ezikhankanywe ngasentla zisiwe kwi-plasma (inxalenye ebomvu, ephuzi, isahluko segazi). Uomatshini ozenzekelayo kwi-laboratory ngokukhawuleza ubala iintlobo ezahlukeneyo zeeseli.
Iiseli ezimhlophe
Isibalo samaseli amhlophe ngokuqhelekileyo siphakathi kwama-5 000-10,000 nge-microliter yegazi. Iimpawu eziphakamileyo zibonisa ukuvuvukala okanye isifo. Izinto ezifana nokuzilolonga, ukubandayo kunye noxinzelelo kunokuphakamisa okwesikhashana inani leeseli ezimhlophe.
Iiseli ezibomvu
Iimpawu eziqhelekileyo zobalo obomvu bezibalo ziyahlukahluka ngokwesini.
- Amadoda ngokuqhelekileyo anokuxabisa ama-5-6 yezigidi ezibomvu iiseli nge-microliter.
- Amabhinqa anesiqhelo esiphantsi phakathi kwama-3.6-5.6 yezigidi ezibomvu iiseli nganye nge-microliter.
Hemoglobin / Hematocrit
I-Hemoglobin, inxalenye yesinyithi yeeseli ezibomvu ezithwala i-oksijeni, iphinda ilinganiswe ngokubala kwegazi elipheleleyo. Inani eliqhelekileyo le-hemoglobin yamadoda li-13-18 g / dl. I-hemoglobin eqhelekileyo yabesifazane i-12-16 g / dl.
Iimpawu ze-hematocrit inani lemaseli obomvu njengepesenti yenani legazi elipheleleyo.
I-hematocrit yesiqhelo yamadoda iphakathi kwama-40-55% kwaye i-hematocrit eqhelekileyo yabesifazane i-36-48%. Ngokuqhelekileyo, i-hematocrit iphindwe malunga ne-3 i-hemoglobin. Ixabiso elincinci libonisa ukukhulelwa kwegazi .
I-MCV, i-MCH, i-MCHC yinkcazo ebomvu yesalathisi ebonisa ubungakanani kunye nomxholo we-hemoglobin wamaseli obomvu ngabanye. Iingqungquthela zinokubonelela ngeenkcukacha malunga nokubangelwa kwe-anemia ekhoyo.
Platelets
Iiplatelet zizinto ezibalulekileyo ekubunjweni kwe-clot . Uninzi lwamachiza asetyenziswe kunyango lwe-arthritis lunokunciphisa inani leplatelet okanye lichaphazela umsebenzi weplatelet. Amanani aseplatelet aqhelekileyo avela kwi-150,000-400,000 nge-microliter nganye.
Ukwahlukana
Ipesenti kunye nenani elipheleleyo lalo hlobo ngalunye lweseli legazi elimhlophe libizwa ngokuba lucalulo.
- I-neutrophils yanda kwiintsholongwane zebhaktheriya kunye nokuvuvukala okukhulu.
- I-lymphocytes zonyuswa kwiintsholongwane zentsholongwane.
- Iimonocytes zinyuka kwiintsholongwane ezingapheliyo.
- I-Eosinophil yenyuka kwi-allergies nezinye iimeko. Inombolo ephakamileyo yama-eosinophil yaziwa ngokuba yi- eosinophilia .
- I-Basophil , eziqhelekileyo ezi-1 okanye ezi-2% zoluhlu lwabantu abamhlophe, abayincinci banda.
Ukuvutha
Inkqubo yokuvuvukala inokudala utshintsho kwibala legazi. Inani elibomvu leseli lingahla, inani leseli elimhlophe linyuke, kwaye inani leplatelet lingaphakanyiswa.
Nangona i-anemia ingahamba ne- arthritis evuthayo ingabangelwa ezinye izinto, ezifana nokulahleka kwegazi okanye ukusilela kwintsimbi. Kuphela xa ezinye izizathu ziye zagqitywa ngaphandle ugqirha ugqithisa ukungabikho kwegazi njengophawu lokuvuvukala.
ZeKhemistry Panels
Iphaneli yamakhemikhali yinkalo yeemvavanyo ezisetyenziselwa ukuphonononga imisebenzi eyimfuneko. Iqela leemvavanyo lenziwa kwi-serum (isabelo segazi ngaphandle kweeseli). I-electrolytes, i-saluted ionisedised in blood or tissue fluids (umzekelo, i-sodium, i-potassium, i-chloride), inxalenye yepaneli yechemistry. Kukho iimvavanyo ezisebenzela njengezibonakaliso zengozi yengqondo , isifo sikashukela, umsebenzi wezintso kunye nesibindi somsebenzi .
Ngokomzekelo, isigulane esinomgangatho ophezulu we-creinine sinokuba neentso ezingavamile. I-Creatinine yintengiso efumaneka kwigazi. Ezinye iintlobo zesifo se-arthritis esivuthayo sinokuchaphazela umsebenzi wezintso. Ezinye iziyobisi ze-arthritis zinokuchaphazela umsebenzi wezintso, nazo. Uric acid enye uvavanyo olufakwe kwipaneli yechemistry yegazi. Ukuba iphakamileyo, i-uric acid ingabonakalisa isifo. Le nto imbalwa nje imizekelo. Enyanisweni, iphaneli yamakhempiki inikeza ulwazi oluninzi malunga nendlela umzimba usebenza ngayo.
Uvavanyo lwegazi
I-Erythrocyte yeSetymentation Rate (ESR)
Isilinganiselo se- erythrocyte sediment is uvavanyo olubandakanya ukubeka isampuli yegazi kwiphubhu ekhethekileyo kwaye uqikelele ukuba ngokukhawuleza iiseli ezibomvu zegazi zihlala ngaphantsi ngelixa elinye. Xa ukuvuvukala kubakho, umzimba uvelisa amaprotheni egazini eyenza iiseli ezibomvu zihlangane kunye. Izithako ezilukhuni zeeseli ziwela ngokukhawuleza kuneeseli ezibomvu eziqhelekileyo. Kubantu abaphilileyo, izinga eliqhelekileyo lingama-millimitha angama-20 ngeyure enye (0-15 mm / hr amadoda kunye no-0-20 mm / hr yabasetyhini). Ukuvuvukala kwandisa izinga kakhulu. Ekubeni ukuvuvukala kunokunxulumana neemeko ngaphandle kwe-arthritis, ukuhlolwa kwezinga lokutshatyalaliswa kwedwa kuphela kuthathwa njengento engeyiyo.
Factor Rheumatoid (RF)
I-rheumatoid factor is antibody efumaneka kwizigulane ezininzi ezine- rheumatoid arthritis . Isixhobo se-Rheumatoid safunyanwa ngawo-1940 kwaye saba yinto ephawulekayo yokuxilongwa kwimiba ye-rheumatology. Phantse i-80% yezigulane ze-rheumatoid arthritis zinezifo zethumama kwigazi labo. Iziphumo eziphezulu ze-rheumatoid factor zihambelana nezifo ezinzima.
Isici se-Rheumatoid singathatha inyanga ezininzi ukuba zibonise egazini. Ukuba ukuvavanywa kakhulu kwangoko kwesi sifo, umphumo unokuba nombi kwaye ukuhlolwa kwakhona kufuneka kuqwalaselwe ngomhla ozayo. Kwiimeko apho izigulane zikhona ngeempawu kunye neempawu ze-rheumatoid arthritis kodwa ziyi-seronegative kwi-rheumatoid factor, oogqirha banokukrokra ukuba esinye isifo sifana nesifo se-rheumatoid arthritis. I-Rheumatoid factor ingenzeka nakwezinye izimo ezivuthayo okanye izifo ezithathelwanayo, nangona ngokuqhelekileyo kwiimeko ezinjalo, ingcamango ingaphantsi kune-arthritis ye-rheumatoid.
HLA Typing
Iiseli zegazi ezimhlophe zingabonakaliswa ukuvela kwe- HLA-B27. Uvavanyo luqhelekileyo kumaziko ogqirha apho kwenziwa khona ukutshintshwa. I-HLA-B27 nayo ibonakalisa imfuyo ehambelana neentlobo ezithile ze-arthritis, ikakhulukazi i- spondylitis ene-ankylosing kunye ne- Reiter's syndrome / iArthritis esebenzayo .
Antiinuclear Antibody (ANA)
Uvavanyo lwe- ANA (i-anti-nuclear antibody) luyenziwa ukuze luncede ukufumanisa izifo ezithile ze- rheumatic . Izigulane ezinezifo ezithile, ngokukodwa i- lupus , zenza i-antibodies kwi-nucleus yamaseli omzimba. Ama-antibodies abizwa ngokuba ngama-anti-nuclear antibodies kwaye ayafunyanwa ngokubeka isigulane sesigulane kwi-slide ekhethekileyo ye-microscope equle iiseli ezinama-nuclei ebonakalayo. Into equkethe idayi ye-fluorescent yongezwa. Idayi ibophelela kwi-antibodies kwi-slide, eyenza ibonakale phantsi kwe-microscope ye-fluorescent.
- I-95% yezigulane ezine-lupus zinokuhlolwa kwe-ANA.
- I-50% yezigulane ze-rheumatoid arthritis zenza i-ANA.
Izigulane ezinezinye izifo nazo zi novavanyo lwe-ANA ezintle. Ukufumana ukuxilongwa ngokucacileyo, ezinye iikhrayitheriya maziqwalaselwe kwakhona.
Iprotheni esebenzayo C (CRP)
Iprotheni esebenzayo yeC-inomlinganiselo wokuxinwa kweprotheyini ekhethekileyo eveliswa sisibindi. Iprotheni ifumaneka kwi-serum yegazi ngexesha leengqungquthela zesibindi okanye ukusuleleka.
Njengophando lwegazi, i-CRP ithathwa njengeyodwa. Isiphumo esiphezulu sibonisa ukuvuvukala okukhulu. Kwiimeko zezifo zesifo se-rheumatic, njenge-rheumatoid arthritis kunye ne-lupus, oogqirha bangasebenzisa uvavanyo lwe-CRP ukujonga ukusebenza kwonyango kunye nomsebenzi wesifo.
I-Lupus Erythematosus (LE)
Uvavanyo lwe-LE lwesilwanyana alusetyenziswanga. Ukufunyanwa kwayo kokuqala kwavulela yonke indawo yesifo se-nuclear, kodwa. Ingxaki - kuphela i-50% yezigulane ze-lupus zifunyenwe ukuba zinemivavanyo emihle ye-LE.
Anti-CCP
I-anti-CCP (anti-cyclic citrullinated peptide antibody) enye yeemvavanyo zegazi ezitsha ezisetyenzisiweyo ukuqinisekisa ukuxilongwa kwe-rheumatoid arthritis. Ukuba i-antibody ikhona kwizinga eliphezulu, ingakhombisa ukuba kukho umngcipheko ophezulu womonakalo odibeneyo.
I-Anti-DNA kunye no-Anti-Sm
Izigulane zeLupus zenza i-anti-DNA (deoxyribonucleic acid). Uvavanyo olukhoyo luhlola ukuba ubukho be-anti-DNA. Isixhobo esinokuxilonga, kubaluleke ngakumbi ekubeni ukususela kwi-anti-DNA ayifumaneki kubantu abangenawo i-lupus. Uvavanyo luyeyona sixhobo esihle sokujonga kuba amanqanaba okulwa ne-DNA aphakama kwaye awa nemisebenzi yesifo.
Izigulane zeLupus zineengqungquthela ze-Sm (ezichasene neSmith), enye into ekhoyo kwinucleus yeli cell. I-antibodies ye-Sm nayo ifunyenwe kuphela kwizigulane ze-lupus. Uvavanyo aluncedo ngakumbi ekujongeni umsebenzi wesifo, nangona kunjalo.
Gcwalisa
Inkqubo yenkxaso yinkqubo eyinkimbinkimbi yeeprotheni zegazi eziyinxalenye yenkqubo yokukhusela umzimba. Iiprotheni zisebenzekile kude kube i-antibody ibophe kwi-antigen kwaye isebenzise inkqubo yokuxhasa. Inkqubo ivelisa izinto ezinokubangela ukutshabalalisa ibhaktheriya kunye nokulwa nabahlaseli. Ezi mpendulo zidla ukuxhasa kunye nokushiya amanqanaba ecindezelekileyo abonakalisa ukubunjwa kwe-immune complex. Izigulane zeLupus zivame ukubonisa amanqanaba ehla Ukuxhaswa kovavanyo kunokuba luncedo ekulandeleni umsebenzi wesifo somguli we-lupus.
Imithombo:
I-Kelley's Bookbook yeRheumatology. Elsevier. I-ninth edition.
I-Duke University Medical Centre yeArthritis, uDavid S. Pisetsky, MD, Ph.D.