Ukuphononongwa kweNsimbi yokuLawulwa kweMpahla esuka kwiiNguqulelo ezininzi
I-Iron overload yimeko apho kukho enye insimbi emzimbeni kunokuba isuswe ngumzimba. Ixesha lobugcisa ngensimbi ye-hemochromatosis. Kukho izizathu ezibini zokwenza utywala obuninzi: 1) i- hemochromatosis yelifa okanye 2) i-hemochromatosis ye-transfusion. I-hemochromatosis ye-Hereditary yimeko echaphazelekayo kwiintsapho. Ukutshatyalaliswa kwe-hemochromatosis kwenzeka xa umntu efuna i-red blood cell (RBC).
Intsimbi ifunyenwe ngaphakathi kwe- hemoglobin , iprotheni ngaphakathi kwiRBC. Umsebenzi wensimbi ukunceda ukuthutha i-oksijini kuzo zonke iifom. Ngokuqhelekileyo umzimba uthatha isinyithi esaneleyo kwisondlo sakho ukuze uqhubeke noveliso lweRBC. Ukuba awudli ukutya okwaneleyo ngensimbi, amazinga ensimbi yakho aphantsi aphethwe yintsilelo ye-anemia . Xa iiRBC zifikelela ekupheleni kobomi babo, isinyithi ngaphakathi kwazo sisetyenziselwa ukusetyenziswa kwiiRBC ezintsha.
Kutheni i-RBC Transfusions ezininzi iComputer Overload?
Intsimbi ifunyenwe ngaphakathi kuyo yonke i-RBC kwiyunithi yegazi. Ngoko yonke i-RBC ukudluliselwa komntu umntu ofumanayo ngokukodwa i-intravenous (IV) ukunyuka kwentsimbi. Ingxaki kukuba umzimba ulinganiselwe ekukhutsheni le ntsimbi egqithiseleyo. Ukongezelela, abantu abane-thalassemia bathabatha insimbi engaphezulu kunokuba bayidinga ekudleni kwabo kwandisa ingxaki.
Ngubani Osemngciphekweni weTransfusional Iron Overload?
Nabani na ofumana ukutyilwa kwe-RBC amaninzi usemngciphekweni, kodwa abantu abaxhomekeke ekumpontsheni basengozini enkulu.
Oku kuya kubandakanya abantu abanesifo sengqungquthela sesigulo esine-stroke (okanye basengozini enkulu yokushaya isifo ), i- beta thalassemia enkulu , i- Diamond Blackfan i-Anemia , i-anemia ye-anemia kunye ne- myelodysplastic syndrome phakathi kwabanye. Abantu abanomhlaza abadinga ukuxilongwa ngamanyathelo ngexesha lotyando kunye ne-chemotherapy okanye ithambo lomtshini wokutshintshwa komnyoba nalo mngcipheko wokutsalwa kwe-iron.
Ingaba Ugqirha Wami Ugxininisa njani I-Iron Overload?
Abantu abaya kufuna ukupheliswa kwexesha elizeleyo bajongwa ngokukhawuleza kwintsimbi engaphezulu. Kulezi zigulane, ukugqithiswa kwensimbi kubonakala emva kwe-12 ukuya kwe-15 kwi-RBC. Ukugqithiswa kweentsimbi kuhlolwe ngokuhlolwa kwegazi okubizwa ngokuba yi-ferritin ekuqaleni. UFerritin umele inani elipheleleyo lentsimbi egcinwe emzimbeni wakho. UFerritin udlalwa kwishedyuli, nganye ukuya kwiinyanga ezintathu, ukuze ugqirha wakho abone indlela ehamba ngayo (oko kukuthi, ukunyuka kwexabiso?). I-Chelation, ixesha lemithi elisebenzisayo ukususa isinyithi, ngokuqhelekileyo iqalwa emva kokuba i-ferritin ikhulu kune-1000 ng / mL. Ngelishwa, amazinga e-ferritin achaphazelekayo ngezinto ngaphandle kweyinyithi engaphezulu. Amanqanaba e-ferritin aphakanyisiwe angabonwa ngexesha lokugula nokuvutha.
Ngenxa yokunciphisa i-ferritin, ezinye iindlela zokuvavanya i-iron over load zenziwe. Ngaphambili, inkunkuma yensimbi yayibekwe iliso nge-biopsies apho isibindi esincinci sisuswe kwaye savavanywa ngentsimbi. Okwangoku, uninzi lwabantu lunokubekwa iliso nge-imagination magontic resonance (MRI) yesibindi kunye / okanye intliziyo. I-MRI inokubala isiqulatho sesinyithi sesibindi (i-LIC) esifana neziphumo zesibindi se-foopsy.
I-Chelation iqalwe xa i-LIC iphezulu kune-3 mg ngesigragram esomeleleyo sesibindi. Ngokufanayo, i-MRI yentliziyo inokulinganisa isixa sesinyithi esisezintliziyweni.
Ziziphi iingxaki ezinokuthi zenzeke ngeTranger Overload?
Xa zonke iindawo eziqhelekileyo ukugcina isinyithi ayisekho, isinyithi sinokugcinwa kwisibindi, intliziyo, i-pancreas, kunye nezitho ze-endocrine (ngokuqhelekileyo zibizwa ngeengqungquthela). Xa isinyithi igcinwe kule ndawo, lilimaza ilungu. Oku kunokubangela i-fibrosis okanye ukusila kwesibindi, i-cardiomyopathy (isifo se-muscle ye-heart), isifo sikashukela (ngenxa yesinyithi kwi-pancreas), i- hypothyroidism (iqondo eliphantsi le-hormone ye-thyroid) kunye ne-hypogonadism (kubangela ukunciphisa i-libido nokungabi namandla kubantu kunye nokungabi yokuhamba kwimizi kubafazi).
Ukuthintela le nkxalabo enzulu kunye neyiyo ingozi yokuphila, inkunkuma yensimbi iphathwa kakubi.
I-Transfusional Iron Overload isingathwa njani?
I-Iron overload of transfusion iphathwa ngonyango lwe-chelation, amayeza anikwe ukususa insimbi emzimbeni. Kukho amayeza amathathu atholakalayo.
- Deferoxamine (Desferal)
- Deferasirox (Jadenu okanye Exjade)
- Deferiprone (Ferriprox)
I-phlebotomy yonyango : Ukuba ngezinye iinkalo unako ukuyeka ukunyelwa igazi, ukugqithiswa kwensimbi kunokuphathwa nge-serial phlebotomy. I-Phlebotomy ifana nomnikelo wegazi apho inani elikhulu legazi lisuswa emzimbeni. Kwi-RBCs isuswe yinyithi kwaye xa ezi zitshintshwa ngethambo lomnyoba ziya kusebenzisa i-iron eyimfuneko egcinwe emzimbeni wakho.
> Imithombo:
> Schrier SL kunye neBacon BR. I-Chelation Therapy yeThalassemia kunye nezinye i-Iron Overload I-States kunye ne-Iron Overload Syndromes Ezinye i-Hemochromatosis. Ku: U-UpToDate, i-Post TW (Ed), UpToDate, i-Waltham, MA.