Koj puas paub qhov twg Rh yam muaj yeej hauv cov neeg European haiv neeg? Nws tseem ceeb npaum li cas thaum npaj tus menyuam? Thiab lub tswvyim no txhais li cas tiag? Koj yuav pom cov lus teb rau cov lus nug no thiab lwm cov lus nug hauv peb tsab xov xwm.
Cov ntshav
Ntawm cov kua dej uas tsim nyob rau hauv ib puag ncig ntawm lub cev, nws yog cov ntshav uas muab roj pauv, khoom noj khoom haus ntawm tes, kev tiv thaiv kab mob thiab thermoregulation. Muab cov haujlwm tseem ceeb no tuaj yeem ua tau vim nws muaj pes tsawg leeg. Ntshav muaj cov tshuaj intercellular - plasma - thiab tsim cov ntsiab lus. Cov no suav nrog erythrocytes, leukocytes thiab platelets. Yog li ntawd, ib hom "kev thauj mus los" yog tsim. Txhua yam hauv nws ua nws txoj haujlwm. Yog li, plasma plays lub luag haujlwm ntawm cov tshuaj intercellular, leukocytes muab kev tiv thaiv, thiab platelets - coagulation.
qe ntshav liab
Erythrocytes nqa oxygen los ntawm lub ntsws mus rau lub hlwb, thiab carbon dioxide nyob rau hauv qhov sib txawv. Lawv cov xim liab yog vim hemoglobin. Cov khoom no muaj cov protein globin thiab cov khoom muaj hlau - heme. Cov tom kawg muaj hlau. Nws yog nws cov atoms uas tsis tsuas yog muab cov qe ntshav liab liab,tab sis lawv kuj thauj cov roj molecules.
Rh factor yog dab tsi
Tej zaum yuav muaj cov protein tshwj xeeb ntawm cov erythrocyte daim nyias nyias. Qhov no yog Rh factor. Nws yog tam sim no nyob rau hauv 86% ntawm lub ntiaj teb no cov pej xeem. Cov neeg zoo li no hu ua Rh-positive. Thiab 14% tsis muaj nws. Lawv hu ua Rh-negative.
Daim paib no qhia txog ib qho ntawm 36 pawg ntshav. Feem ntau ntawm cov no yog ABO. Cov no yog plaub pawg ntshav loj. Lawv tau tshawb pom rov qab rau xyoo 1901 los ntawm tus kws tshawb fawb Austrian Karl Landsteinr, uas nws tau txais txiaj ntsig Nobel nqi zog. Tab sis cov kws kho mob transfusiologists - cov kws tshawb fawb uas hloov ntshav - xav txog Rh system yog qhov tseem ceeb hauv kev kho mob. Nws muaj 54 antigens. Lo lus "Rh factor" tsuas yog hais txog ib leeg xwb. Qhov no yog antigen D.
Statistics
Cov kws tshawb fawb hais tias Rh yog ib qho cim uas nyob ntawm haiv neeg thiab thaj chaw nyob. Piv txwv li, 85% ntawm Caucasians, 93% ntawm Negroids, thiab 99% ntawm Asians thiab Indians muaj nws. Qhov xwm txheej ntawm qhov kev coj cwj pwm no ntawm haiv neeg tseem tsis tau tsim. Txawm li cas los xij, lub xub ntiag ntawm Rh tau txais los ntawm cov noob, tsis yog nyob ntawm hom ntshav thiab tsis hloov mus thoob lub neej.
keeb kwm me ntsis
Rhesus yog ib qho cim uas tau pom los ntawm Karl Landsteinr. Tab sis qhov no tshwm sim ntau tom qab thawj qhov kev xav - hauv xyoo 1940. Ua ke nrog American immunohematologist Alexander Wiener, tus kws tshawb fawb thawj zaugpom cov protein no hauv cov ntshav ntawm macaques, ib hom hu ua Rhesus. Nws yog yav tas los tsis paub agglutinogen - antigen D. Nws tsis suav nrog hauv ABO cov ntshav pawg system.
Rhesus liab erythrocytes tau ntxiv rau cov ntshav ntawm luav thaum tshawb fawb. Qhov tshwm sim yog ib hom tshuaj tshwj xeeb. Thaum sib xyaw nrog tib neeg cov ntshav ntawm ntau pawg, hauv 85% ntawm cov neeg mob, erythrocytes lo ua ke. Cov tshuaj no hu ua Rh-positive.
Factor definition
Kev paub txog tus kheej Rh yog qhov tsim nyog hauv ob kis. Qhov no yog kev hloov ntshav thiab kev npaj tsev neeg. Txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau nws, koj yuav tsum kuaj xyuas cov ntshav ntawm cov ntshav capillary lossis venous. Qhov no yuav tsum tau ua thaum sawv ntxov, ntawm lub plab khoob. Hnub ua ntej, yuav tsum tsis suav cov zaub mov muaj roj, tshuaj thiab cawv los ntawm kev noj haus.
Txoj hauv kev tshaj plaws los txiav txim siab Rhesus yog los ntawm gluing cov qe ntshav liab hauv Petri tais. Rau qhov no, ob tee ntshav thiab ntshav tau muab tso rau hauv nws. Tom ntej no, lawv txuas nrog lub iav pas nrig thiab qhov sib xyaw ua ke yog rhuab rau ntawm chav da dej rau 10 feeb. Yog tias cov flakes liab tshwm nyob rau tib lub sijhawm, nws txhais tau tias cov erythrocytes tau daig ua ke. Qhov no qhia txog qhov zoo Rh yam.
Txoj cai hloov ntshav
Los ntawm 1873, muaj 247 qhov kev hloov pauv, ntawm 176 tus neeg tuag. Tsuas yog qhov kev tshawb pom ntawm pawg ntshav ua rau nws muaj peev xwm txiav txim siab seb yuav tsum xav txog dab tsi thaum lub sijhawm txheej txheem no. Tsis yog txhua tus ntawm lawv yog sib xws. Thaum transfused, yuav tsum tsis txhob lo los yog agglutination,erythrocytes.
Nyob rau hauv ABO system, thawj pab pawg yog universal. Nws cov tswv yog suav tias yog cov neeg pub nyiaj thoob ntiaj teb. Nws tsis muaj cov nplaum nplaum hu ua "agglutinogens". Cov neeg uas muaj ntshav thib plaub yog cov neeg tau txais txiaj ntsig thoob ntiaj teb. Raws li kev xav, lawv tuaj yeem hloov pauv nrog cov ntshav ntawm txhua pawg.
Thiab Rhesus yuav tsum ua li cas thiaj li ua rau kev hloov ntshav ua tiav? Nws tag nrho yog nyob ntawm "tus neeg txais nyiaj pub dawb" system. Tus neeg Rh-positive tuaj yeem muab ntshav yam tsis muaj cov protein no. Txwv tsis pub, agglutination yuav tshwm sim. Qhov tseeb yog hais tias ib tug neeg tsis muaj Rhesus rau cov ntshav, nws ntaus yog perceived los ntawm lub cev raws li ib tug txawv teb chaws nres thiab ib tug tiv thaiv tshwm sim pib - aggregation ntawm erythrocytes.
Rhesus compatibility
Cia peb saib seb nws yog dab tsi. Qhov tseem ceeb tshwj xeeb yog Rh ntshav ntawm niam txiv. Muaj kev xav tias nws cuam tshuam qhov muaj peev xwm ntawm kev xeeb tub, kev xeeb tub thiab kev noj qab haus huv ntawm tus menyuam hauv plab. Tsis yog txhua yam no muaj tseeb. Ua ntej tshaj plaws, koj yuav tsum paub tias tsis yog hom ntshav lossis Rh yam cuam tshuam rau cov txheej txheem fertilization. Lwm yam ua rau infertility yuav tsum tau saib rau. Nws tau raug pov thawj tias cov niam txiv uas muaj Rh yam sib txawv tuaj yeem muaj menyuam noj qab nyob zoo.
Tab sis cov tsos mob no tuaj yeem cuam tshuam rau lub sijhawm cev xeeb tub. Qhov twg Rhesus ua ke tuaj yeem ua rau muaj kev hem thawj? Xav txog tias tus poj niam Rh-negative nqa tus menyuam Rh-zoo. Thaum cov ntshav ntawm tus menyuam hauv plab nkag mus rau hauv niam lub cev, tom kawg pib tiv thaiv nws tus kheej - los tsim cov tshuaj tiv thaiv. Cov no yog cov proteins tshwj xeeb uas tau tsim los teb rautxawv teb chaws - antigens. Tiv thaiv nws tus kheej li no, niam lub cev ua rau muaj kev phom sij rau lub neej ntawm tus menyuam hauv plab: kev tuag hauv plab lossis nchuav menyuam tuaj yeem tshwm sim ntawm txhua theem ntawm cev xeeb tub.
Thaum Rh teeb meem tshwm sim
Thaum npaj ib tsev neeg, koj yuav tsum tau xyuam xim rau ob peb lub ntsiab lus yooj yim. Ua ntej tshaj plaws, cov niam txiv yav tom ntej yuav tsum tau kuaj Rh. Yog tias nws yog qhov zoo lossis tsis zoo hauv ob qho xwm txheej, tsis muaj laj thawj txhawj xeeb. Kev tsis sib haum xeeb tsuas yog tshwm sim yog tias tsis pom antigen D hauv niam cov ntshav, tab sis leej txiv muaj nws.
Ntawm no, leej niam lub cev tiv thaiv kab mob yog qhov kev zam. Txawm tias nyob rau hauv ib txwm cev xeeb tub, Rh yam ntawm tus me nyuam hauv plab overcomes lub placental barrier. Hauv kev teb, cov tshuaj tiv thaiv kab mob hauv niam cov ntshav. Los ntawm cov placenta, lawv nkag mus rau hauv fetus, rhuav tshem nws cov qe ntshav liab. Anemia tshwm sim dhau sijhawm.
Bilirubin tsim nyob rau hauv tus menyuam cov ntshav, uas ua rau kev loj hlob ntawm jaundice. Nws yog cov khoom no uas ua rau tus menyuam cov tawv nqaij daj daj. Qhov tshwm sim ntawm Rh tsis sib haum xeeb kuj tuaj yeem ua rau puas tsuaj rau lub paj hlwb, o thiab txawm tias tuag ntawm tus menyuam hauv plab.
Kev sib xyaw cov ntshav ntawm leej niam thiab tus menyuam hauv plab tuaj yeem tshwm sim thaum muaj xwm txheej tsis tau pom dua. Nws tuaj yeem yog cev xeeb tub ectopic, los ntshav ntawm qhov chaw mos, lossis kev raug mob rau lub plab.
Kev nce qib hauv cov tshuaj niaj hnub
Tab sis txhob ntshai. Tam sim no, tag nrho cov txheej txheem ntawm kev tiv thaiv tau raug tsim los uas tuaj yeem zam qhov tsis sib haum Rhesus. Nrogthawj hnub ntawm cev xeeb tub, qhov xwm txheej yuav tsum tau tswj hwm nruj.
Tus niam uas muaj kev cia siab yuav tsum tsis tu ncua pub ntshav rau kev tshuaj xyuas. Txog rau lub lim tiam 32, nws yuav txaus ua qhov no ib hlis ib zaug. Tsis tas li ntawd, qhov tshwm sim ntawm kev tsim cov tshuaj tiv thaiv kab mob nce ntxiv. Yog li ntawd, txij hnub tim 32 mus rau 35 lub lis piam, cov ntshav tau kuaj 2 zaug hauv ib hlis, thiab tom qab ntawd txhua lub lim tiam. Yog tias tsis kuaj pom cov tshuaj tiv thaiv kab mob, tshuaj tiv thaiv Rhesus gamma globulin yog muab rau niam leej txiv. Cov tshuaj tiv thaiv no tiv thaiv lawv qhov tsim. Cov tshuaj tiv thaiv no siv tau rau lub sijhawm 18 txog 20 lub lis piam. Nyob rau tib lub sijhawm, thawj zaug ultrasound tau ua. Raws li nws cov txiaj ntsig, nws twb muaj peev xwm txiav txim siab seb tus menyuam hauv plab puas tsim kab mob hemolytic. Nws cov cim qhia yuav ua rau lub cev hnyav, nrog rau qhov loj ntawm tus po thiab daim siab.
Yog tias leej niam qhov kev kuaj ntshav qhia pom tias muaj cov tshuaj tiv thaiv me ntsis, ces nws raug muab tshuaj kho mob sab nraud. Nws yog tsom rau txo lub cev cov lus teb rau antigens. Cov tshuaj desensitizing no yog cov tshuaj qabzib, cov vitamins lossis ascorbic acid.
Thaum cov tshuaj tiv thaiv kab mob nce mus txog qhov tseem ceeb, kev mus pw hauv tsev kho mob sai thiab kev saib xyuas tas li ntawm tus niam thiab tus menyuam uas muaj kev cia siab yog qhov tsim nyog. Nyob rau hauv cov ntaub ntawv no, ib tug txaus ntshai teeb liab yog cov tsos ntawm cov kua nyob rau hauv lub fetus nyob rau hauv lub pericardial sac thiab plab kab noj hniav.
Kom paub meej daim duab, cov kua dej amniotic raug tshuaj xyuas rau cov ntsiab lus bilirubin. Yog tias nws nce siab, muaj ntau txoj hauv kev tawm ntawm qhov xwm txheej. Qhov yooj yim tshaj plaws yog kev ua kom huv ntawm leej niam lub plasma los ntawm cov tshuaj tiv thaiv - plasmapheresis. Kev muab ntshav rau tus menyuam hauv plab yuav ua tau zoo. Cov txheej txheem no yuav tsum tau ua raws li kev taw qhia ultrasound. fetusRh-negative ntshav yog txhaj los ntawm txoj hlab ntaws, uas hloov nws tus kheej ib ntus. Cov txheej txheem no rov ua dua txhua ob lub lis piam.
Thaum cev xeeb tub nrog Rh tsis sib haum, qhov tseem ceeb tshaj plaws yog coj mus rau 34 lub lis piam. Lub sijhawm no, cov kab mob hauv nruab nrog cev tau tsim txaus thiab peb tuaj yeem tham txog kev yug ntxov.
thib ob cev xeeb tub
Tom qab yug thawj zaug, cov tshuaj tiv thaiv tseem nyob hauv cov ntshav ntawm leej niam Rh-negative. Qhov no tuaj yeem ua rau kev xeeb tub yav tom ntej nyuaj dua. Lub xub ntiag ntawm cov tshuaj tiv thaiv ua rau muaj qhov ua rau Rh tsis sib haum.
Kom zam tau qhov no, tsis pub dhau ib hnub tom qab yug thawj zaug, tshuaj txhaj rau hauv niam cov ntshav. Nws hu ua anti-Rhesus immunoglobulin. Cov tshuaj tiv thaiv kev tsim cov tshuaj tiv thaiv kab mob, txo qhov kev pheej hmoo ntawm cov teeb meem ntxiv.
Yog li, Rh-kev koom tes yog txiav txim siab los ntawm qhov muaj cov protein tshwj xeeb ntawm erythrocyte daim nyias nyias. Nws muaj nyob rau hauv cov ntshav ntawm cov neeg feem coob. Lawv hu ua Rh-positive. Cov tsos mob no yuav tsum tau txiav txim siab thaum muab ntshav thiab cev xeeb tub. Yog tias Rh nkag mus rau hauv cov ntshav, uas tsis muaj cov protein no, kev puas tsuaj ntawm cov qe ntshav liab tshwm sim. Cov kev ntsuas kho mob uas twb muaj lawm tso cai rau feem ntau kom tsis txhob muaj teeb meem Rh.
