Ke'ng ea pancytopenia, ke matšoao afe, ke eng e bakang, hona e phekoloa joang? A re hlahlobeng lipotso tseo.
Pancytopenia e hlalosoa e le maemo a sa tloaelehang a tlaase mefuta eohle ea lisele tsa mali tse hlahisoang ke masapo. Sena se akarelletsa lisele tse khubelu tsa mali, lisele tse tšoeu tsa mali le liplatelete.
Lihlopha Tsa Mali li Amehang Pancytopenia
Ha e le hantle, pancytopenia e bolela ho haella ha:
- Lisele tse khubelu tsa mali (RBCs): RBC ke lisele tse tlama le ho tsamaisa oksijene likarolong tsa 'mele.
- Lisele tse tšoeu tsa mali (WBCs): Ho na le mefuta e 'maloa ea lisele tse tšoeu tsa mali (WBCs) tse ling tse fokotsehileng ka granulocyte (ho akarelletsa le neutrophils, eosinophils le basophils), le agranulocytes (ho akarelletsa lymphocytes le monocytes). Lisele tsena li na le boikarabelo ba ho loantša tšoaetso har'a mesebetsi e meng.
- Platelet: Li-platelet li na le boikarabelo ba ho pata mali.
Ho hlalosa mekhoa e tlaase ea lisele tsa mali
- Lebelo le tlase la lisele tse khubelu tsa mali le bitsoa anemia . Ho bohlokoa ho hlokomela hore ho na le mefuta e sa tšoaneng ea phokolo ea mali. Lebaka le leng ke tekanyo e tlase ea lisele tse khubelu tsa mali, empa e ka boela ea etsahala ka lebaka la tahlehelo ea mali, tekanyo e tlaase ea hemoglobin, ho haelloa ke vithamine B12, le lisosa tse ling.
- Lekala le tlase la lisele tsa mali tse tšoeu le bitsoa leukopenia (u ka 'na ua utloa ka neutropenia, e bolelang mofuta o tlaase oa mofuta o itseng oa lisele tse tšoeu tsa mali tse tsejoang e le neutrophils).
- Palo e tlaase ea li-platelet e bitsoa thrombocytopenia, e kang ea immune thrombocytopenia , le thothecytoenia e bakoang ke chemotherapy .
Ho theha Li-Cells tsa Mali Motleng oa Marrow kapa Hematopoiesis
Lisele tsa mali li tsoa ho sele e le 'ngoe e tloaelehileng ea mokoallo o tsejoang e le sekala sa hematopoietic stem (HSM) kapa lisele tsa pleuripotential stem (e bolelang hore e na le "monyetla" oa ho ba mefuta e fapaneng ea lisele.
Lisele tsena li arola 'me li tsoela pele ka ho khetheha haholoanyane ts'ebetsong e bitsoang hematopoiesis lisele tsohle tsa mali' meleng.
Liteko tsa Lab
Pancytopenia hangata e fumanoa ka ho sheba palo e feletseng ea mali (CBC). Liphello li tla bontša maemo a fokolang a mefuta eohle ea lisele tsa mali tse kenyeletsang:
- Sele e khubelu ea mali e ka tlaase ho limilione tse likete tse 4,2 ho basali kapa ka tlase ho limilione tse 4.7 li-cell (c) Le banna ba ka 'na ba hlalosoa ka lebelo le tlase la hemoglobin.
- Palo ea mali e tšoeu ho feta 4,000 lisele / cc (e tloaelehileng e pakeng tsa 4,000 le 10 000 lisele / cc).
- Palo ea platelet e ka tlaase ho 150,000 lisele / cc (e tloaelehileng e pakeng tsa 150,000 le 400,000 lisele / cc).
Lisosa
Pancytopenia e ka bakoa ke ntho leha e le efe e sitisang ho thehoa ha lisele tsa mali marong a masapo kapa ho fumaneha ha tsona maling (joalo ka ha li tšoaroa ka spleen).
Sena se ka 'na sa akarelletsa tšenyo ea moko oa masapo ka chefo, khatello ea mongobo, joaloka nakong ea chemotherapy, kapa ho nkeloa sebaka ke masapo a mang ka lisele tse ling tse bakang ho senyeha ha lisele tsa mali joalokaha ho ka khoneha ka kankere. Ho timetsoa kapa ho tlosoa ho ka bakoa ke ho ruruha , tšoaetso, kapa maemo a ikemetseng .
Boholo ba maemo ana bo fumanoa hamorao bophelong, empa ba 'maloa ba futsitse' me ba hlahile ho tloha ha ba hlaha.
Bonyane karolo ea 50 lekholong ea nako eo ha e na lebaka le totobetseng-ho na le ntho eo lingaka li e bitsang "idiopathic ." Tse ling tsa lisosa tsa pancytopenia li ka kenyeletsa:
- Phekolo e bakoang ke phekolo ea bone ea mongobo ea chemotherapy
- Meriana e bakoang ke lithethefatsi: Lithethefatsi tse ling ntle le lithethefatsi tsa chemotherapy, ho tloha likokoana-mafu ho ea meriana e sebelisetsoang lefu la pelo, li 'nile tsa boleloa e le lisosa.
- Matšoao a kang tšoaetso ea mononucleosis le HIV, hammoho le tšoaetso e matla haholo (sepsis).
- Anemia ea mali
- Ho tlosoa ha li-splenic (ho tšoara lisele tsa mali ka spleen e le hore li se ke tsa fihla 'meleng o mong kaofela).
- Chefo le lik'hemik'hale tse kang ho pepesehela arsenic kapa benzene.
- Mali a kankere mongobo o kang lefu la kankere, lymphoma, myeloma kapa kankere ea metastatic ho senya moko.
- Ho hasana ha lisele tse tiileng mokokotlong, haholo-holo kankere ea matsoele, kankere ea tšoelesa ea senya, kankere ea colon, kankere ea gastric le melanoma. Ho na le mongobo oa metastases, letšoao le tloaelehileng ke lefu la phokolo ea mali le lateloang ke thrombocytopenia.
- Myelodysplastic syndrome (boemo ba "pele ho kankere" boemo ba mokopa oa masapo)
- Itšitiso ea ho iketsa likotsi tse kang lupus
- Ho kula ha mahlaseli
- Syndromes e futsitsoeng, e kang Fanconi anemia, Diamond Blackfan anemia .
Lisosa Tse Tloaelehileng
Thuto ea 2014 e behiloe ho fumana lisosa tse tloaelehileng tsa pancytopenia ho batho ba neng ba e-s'o fumanoe ba e-na le boemo. Ka mohlala, ha ho le ea mong oa batho bana ba baholo ea neng a fumane chemotherapy kapa a na le mabaka a totobetseng ea pancytopenia ea bona. Ho batho bana:
- Ba fetang 60 lekholong ba na le mofuta o itseng oa kankere e amanang le mali. Ntho e tloaelehileng ka ho fetisisa e ne e le kankere ea myelogenous leukemia , myelodysplasia, ea ha-Hodgkin's lymphoma, ea lisele tse nang le lisele tse nang le moriri o mosoeu le oa lekoemia e matla ea lymphocytic.
- Har'a ba neng ba se na kankere e amanang le mali e le sesosa sa pancytopenia ea bona, mafu a ne a kenyelletsa aplastic anemia, megaloblastic anemia le HIV. tšoaetso ea mali le HIV.
Matšoao
Matšoao a pancytopenia a ka 'na a kenyelletsa bofokoli, ho tšoaroa ke matla, kapa spleen e atolositsoeng ho phaella matšoao a amanang le ho haella ha lisele tse itseng tsa mali. Tse ling tsa matšoao ana li kenyelletsa:
- Matšoao a amanang le phokolo ea mali (tekanyo e fokolang ea lisele tsa mali) ho kenyeletsa pallor, mokhathala, lebelo la pelo le potlakileng.
- Matšoao a amanang le leukopenia kapa neutropenia (e leng tlaase e tšoeu) ho kenyeletsa feberu le matšoao a tšoaetso e kang ho khohlela kapa bohloko ka ho ntša metsi
- Matšoao a amanang le thrombocytopenia (liplatelete tse tlase) tse kenyelletsang ho lla habonolo, le ho tsoa mali a mangata.
Tlhahlobo le Tlhahlobo
Ka mor'a hore u pheta mosebetsi oa hao oa laboraka ho netefatsa hore u na le pancytopenia, mohato oa pele hangata o tšoana le 'mele oa masapo.
Tlaleho ea lesela la mokokotlo oa lefutso le ka fa ngaka boitsebiso bo bongata.
Phekolo
Sepheo sa ho phekola pancytopenia ke ho fumana le ho sebetsana le sesosa sa motheo. Haeba sesosa se sa tsejoe, kapa haeba se lebeletsoe, joalo ka chemotherapy, kalafo e ikemiselitse ho fokotsa matšoao a amanang le ho haella ha lisele tsa mali. Liphekolo tse ling tse ka sebelisoang li kenyelletsa:
- Lithethefatsi tse hlasimollang masapo. Bakeng sa neutropenia e bakoang ke chemotherapy le lisosa tse ling, lisosa tsa Leukine, Neupogen, kapa Neulasta li ka sebelisoa ho susumelletsa ho thehoa ha lisele tse tšoeu tsa mali. Bakeng sa phokolo ea mali ea chemotherapy , ho boetse ho e-na le meriana e ka 'nang ea nkoa.
- Ho tšeloa mali
- Lithethefatsi tsa immunosuppressive haeba ke ka lebaka la boemo bo ikemetseng.
- Ho fetisetsa 'mele oa' mele oa masapo kapa ho kenyelletsa seleng ea stem .
Ho phatloha
Tlhaselo ea pancytopenia e itšetlehile haholo ka sesosa sa eona. Ka lehlohonolo joale re na le mekhoa ea phekolo e kang ho tšeloa mali le lisosa tse matlafatsang ho thusa ka ho hloleha ha sele ea mali ha boemo bo tlaase bo hlahlojoa le ho phekoloa.
Ntho e ka tlaase
Ho na le lintho tse ngata tse ka hlahisang pancytopenia, empa bohle ba na le likotsi. Le pancytopenia mefuta eohle ea lisele tsa mali e fokotsehile, le hoja ho fokotseha ho ba bang ho ka ba le ho ameha ho feta tse ling.
Mohlala: Dan o ile a hlahisa pancytopenia-tekanyo e tlase ea lisele tse khubelu tsa mali, lisele tse tšoeu tsa mali le liplatelete-ka mor'a phekolo ea hae ea ho qetela ea chemotherapy.
> Mehloli:
> Devitt, K., Lunde, J., le M. Lewis. Newset Pancytopenia ho Batho ba baholo: Tlhahlobo ea Lipatlisiso tsa Pathologies le Liphihlelo tsa Ts'ebetso ea Ts'ebeliso ea Meriana le Litho tsa Lekala. Lefuemia le Lymphoma . 2014. 55 (5): 1099-105.
> Miano, M., le C. Dufour. Tlhahlobo le Phekolo ea Maemo a Mahlaseli a Maiketsetso: Tlhahlobo. International Journal of Hematology . 2015. 101 (6): 527-35.
> Sharma, R., le G. Nalepa. Tlhahlobo le Tsamaiso ea Panycytopenia e sa Feleng. Litlhahlobo tsa Tlhahlobo . 2016. 37 (3): 101-113.
> Weinzierl, E., le D. Arber. Bone Marrow Tlhaloso ho Ncha-ho qala Pancytopenia. Human Pathology . 2013. 44 (6): 1154-64.
> Weinzierl, E., le D. Arber. Tlhaloso ea ho Fapana le Matsoalo a Mongobo Tlhaloso ea Ntho e ncha-pele ea Pancytopenia. American Journal of Clinical Pathology . 2013. 139 (1): 9-29.