Hemosiderin yog cov xim uas sib sau hauv cov ntshav vim kev tawg ntawm cov qe ntshav liab, uas yog cov qe ntshav uas nqa oxygen mus rau cov ntaub so ntswg thiab cov kab mob hauv nruab nrog cev. Lawv lub neej ncua yog 120 hnub, tom qab ntawd lawv tawg. Yog li ntawd, kev puas tsuaj ntawm cov qe ntshav liab tshwm sim hauv lub xeev qub. Tab sis yog tias cov qe ntshav ntau dhau lawm, muaj ntau dhau ntawm cov xim hemosiderin hauv cov ntshav. Nyeem ntxiv txog qhov ua rau, cov tsos mob, cov yam ntxwv ntawm kev kuaj mob thiab kev kho mob ntawm cov kab mob no tom qab hauv kab lus.
ua rau ntawm pathology
Hemosiderin yog ib yam khoom uas, thaum ntau dhau hauv lub cev, ua rau kev loj hlob ntawm tus kab mob hu ua hemosiderosis. Muaj ob pawg ntawm cov ua rau ntawm no pathology: exogenous thiab endogenous. Hauv thawj kis, qhov cuam tshuam ntawm lwm yam hauv lub cev tau sau tseg. Qhov thib ob, tus kab mob no tshwm sim vim kev ua txhaum ntawm ib puag ncig ntawm lub cev.
rau endogenousyam uas ua rau kom nce hemosiderin deposition muaj xws li:
- mob inflammatory kab mob ntawm lub hauv paus chiv keeb - malaria, brucellosis;
- tshuaj lom lom;
- kev cuam tshuam ntawm qee yam tshuaj;
- noj ntau dhau ntawm cov hlau rau hauv lub cev nrog cov tshuaj uas muaj nws ("Sorbifer", "M altofer");
- ntshav ntshav nrog ib pawg tsis sib haum lossis Rh yam.
Ntawm cov xwm txheej exogenous, kev saib xyuas zoo tshaj plaws yog them rau kev xeeb tub. Muaj qee cov kab mob caj ces uas muaj ntau dhau ntawm hemosiderin hauv lub hlwb, daim siab thiab lwm yam kabmob hauv nruab nrog cev. Cov no yog, ua ntej ntawm tag nrho cov, xws li pathologies:
- thalassemia - impaired synthesis ntawm ib qho ntawm cov hemoglobin chains;
- mob ntshav qab zib hauv lub cev - ib qho kev tsis sib haum xeeb ntawm cov qe ntshav liab;
- enzymopathies - ib pab pawg ntawm cov kab mob uas tsis muaj cov enzyme txaus los tsim hemoglobin;
- membranopathy - kev tsis sib haum xeeb ntawm cov qauv ntawm cov qe ntshav liab.
Sib cais cais cov kab mob autoimmune raws li qhov ua rau kev loj hlob ntawm hemosiderosis.
kab mob daim ntawv
Hemosiderin yog ib yam khoom uas tuaj yeem tsim tau ob qho tib si hauv txhua qhov chaw hauv lub cev, hauv yuav luag txhua yam kabmob hauv nruab nrog cev, thiab kev sib cais, uas yog, nyob rau hauv ib qho chaw. Nyob rau hauv thawj rooj plaub, lawv hais txog ib tug generalized, los yog general daim ntawv ntawm tus kab mob. Hauv qhov thib ob, hauv zos, lossis hauv zos, hemosiderosis tshwm sim.
Qhov tshwm sim ntawm qhov sib xwshemosiderosis tshwm sim tawm tsam keeb kwm yav dhau ntawm txhua yam kab mob pathology. Tom qab ntawd hemosiderin accumulates hauv lub hlwb, daim siab thiab lwm yam kabmob. Nyob rau hauv daim ntawv hauv zos, cov xim yog sau nyob rau hauv cov cheeb tsam ntawm tib neeg lub cev. Piv txwv li, nyob rau hauv kab noj hniav ntawm ib tug tubular kab mob los yog nyob rau hauv ib tug hematoma.
Nyob ntawm qhov ua rau ntawm kev loj hlob, ob pawg ntxiv ntawm tus kab mob sib txawv:
- primary - yog vim li cas rau daim foos no tseem tsis tau qhia meej;
- secondary - tsim tawm tsam keeb kwm ntawm lwm yam kab mob.
Qhov laj thawj tseem ceeb ntawm hemosiderosis thib ob tuaj yeem yog cov kab mob hauv qab no:
- leukemia - mob qog nqaij hlav ntawm pob txha;
- cirrhosis ntawm daim siab;
- kab mob sib kis;
- kab mob ntawm daim tawv nqaij: pyoderma, eczema, dermatitis;
- mob ntshav siab nrog kev kawm hnyav;
- ntaus ntshav;
- hemolytic anemia.
Qhov tseeb, muaj ntau ntau yam ntxiv rau kev txhim kho cov hemosiderosis thib ob, yog li tsuas yog cov ntsiab lus tseem ceeb tau nthuav tawm hauv ntu dhau los thiab saum toj no.
Risk Factors for Disease Development
Cais faib cov yam ntxwv uas tsis ncaj qha ua rau muaj kev nce ntxiv ntawm hemosiderin, tab sis ua rau muaj kev pheej hmoo ntawm cov kab mob no. Cov no suav nrog:
- permanent hypothermia ntawm lub cev;
- kev nyuaj siab;
- kev tawm dag zog ntau dhau;
- tswj tsis tau cov tshuaj diuretics, paracetamol, qee cov tshuaj tua kab mob.
Lub cev dab tsi cuam tshuam los ntawm hemosiderosis?
YHemosiderinyog ib qho pigment uas tuaj yeem tsim nyob rau hauv yuav luag txhua yam khoom nruab nrog cev. Tab sis feem ntau muaj qhov swb:
- siab;
- kidney;
- spleen;
- tawv;
- pob txha pob txha;
- qaub ncaug lossis hws qog;
- hlwb.
Hemosiderosis ntawm daim tawv nqaij: tshwm sim
Qhov tshwm sim zoo tshaj plaws yog kev sib sau ntawm hemosiderin hauv daim tawv nqaij. Hauv yuav luag txhua tus neeg mob, cov tsos mob tseem ceeb yog tsim cov xim av tsaus nti ntawm ob txhais ceg. Feem ntau cov cheeb tsam ntawm pigmentation muaj ib txoj kab uas hla loj, tab sis qee zaum muaj me me, yuav luag punctate pob. Qee cov neeg mob tsim cov pob liab liab, uas tshwm sim los ntawm kev puas tsuaj rau cov hlab ntsha ntawm daim tawv nqaij.
Cov xim ntawm cov pob liab liab tuaj yeem txawv ntawm cib liab mus rau xim av tsaus lossis daj. Ntxiv nrog rau cov pob, lwm cov pob khaus tshwm sim: nodules, papules, plaques. Tus neeg mob txhawj xeeb txog qhov khaus ntawm qhov chaw ntawm daim tawv nqaij.
Hemosiderosis ntawm daim siab: cov tsos mob
Kev tso tawm ntawm hemosiderin hauv daim siab cov ntaub so ntswg yog tshwm sim, ua ntej ntawm tag nrho cov, los ntawm kev nce hauv qhov loj ntawm lub cev. Qhov no ua rau stretching ntawm lub capsule nyob ib ncig ntawm lub siab. Tus neeg mob xav tias nws yog ib qho mob npub ntawm sab xis hauv qab tav. Nrog rau qhov nce ntxiv, muaj qhov asymmetry ntawm lub plab thiab nws bulging ntawm sab xis. Palpation ntawm lub plab nyob rau hauv cov cheeb tsam no kuj mob.
Nrog cov txheej txheem mus sij hawm ntev, lub siab ua haujlwm ntawm lub siab yog maj mam poob qis. Qhov no yog tshwm sim los ntawm kev nce hauv plab vim yog cov kua dej ntau hauv nws,varicose leeg ntawm lub plab thiab txoj hlab pas, hemorrhoidal veins, yellowing ntawm daim tawv nqaij thiab sclera, hemorrhagic pob.
Hemosiderosis ntawm lub raum: cov tsos mob
Cov tsub zuj zuj ntawm cov xim hauv lub raum tsis yog tsuas yog ua rau muaj kev hloov pauv hauv cov zis, tab sis kuj rau qee qhov kev kho mob tshwm sim. Hemosiderin cuam tshuam rau lub raum tubules thiab glomeruli, uas ua rau cov ntshav tsis pom zoo thiab tso cov protein thiab carbohydrates los ntawm nws. Raws li qhov tshwm sim, hypoproteinemia tshwm sim - qhov txo qis ntawm cov protein hauv cov ntshav.
Tus neeg mob yws ntawm edema. Ua ntej lawv tshwm sim ntawm lub ntsej muag, thiab nyob rau hauv cov neeg mob siab heev npog tag nrho lub cev. Tus neeg mob txhawj xeeb txog kev qaug zog thiab qaug zog.
Kev puas tsuaj rau lub raum ua haujlwm ntev ua rau lub cev tsis ua haujlwm ntawm lwm yam kabmob thiab lub cev.
pob txha puas
Kev tso tawm ntawm hemosiderin hauv lub hlwb muaj qhov sib txawv ntawm qhov chaw kho mob. Nws tag nrho yog nyob ntawm seb qhov chaw tshwj xeeb qhov chaw raug mob.
Kev sib sau ntawm hemosiderin ua rau kev tuag ntawm cov paj hlwb, kev puas tsuaj ntawm myelin sheath ntawm paj hlwb. Feem ntau, cov neeg mob uas muaj hemosiderosis ntawm lub paj hlwb muaj ib tug yav dhau los hemorrhage nyob rau hauv lub parenchyma, tshem tawm cov qog, hemorrhagic strokes.
Cov tshuaj kho mob tshwm sim ntawm hemosiderin tsub zuj zuj hauv lub hlwb yog:
- kev tsis sib haum xeeb - ataxia;
- tsis hnov lus los ntawm hom kev hnov lus tsis hnov lus;
- kev puas hlwb;
- dysarthria - hais lus tsis zoo;
- kev tsis sib haum xeeb.
Diagnosis
Kev kuaj mob hemosiderosis yuav tsum yog qhov nyuaj. Feem ntau, kev sib koom ua haujlwm ntawm cov kws kho mob ntawm ntau yam tshwj xeeb yog tsim nyog: tus kws kho mob dermatologist, kws kho mob hlwb, kws kho mob ntsws, kws kho mob kis mob, thiab lwm yam. Txhua yam nyob ntawm seb lub cev twg muaj feem cuam tshuam.
Kev tshawb nrhiav kev kuaj mob pib nrog cov lus nug ntxaws ntxaws ntawm tus neeg mob txog nws qhov kev tsis txaus siab, lawv txoj kev loj hlob hauv kev muaj zog, muaj cov kab mob yav dhau los. Tsuas yog tom qab ntawd, cov txheej txheem kuaj ntxiv raug sau tseg.
Txawm hais tias tus kab mob no zoo li cas, cov txheej txheem kuaj mob hauv qab no tau sau tseg:
- Txuag ntshav suav - txo cov qe ntshav liab thiab hemoglobin raug txiav txim.
- Kev txiav txim siab muaj hemosiderin hauv cov zis.
- Qhia cov qib hlau hauv cov ntshav ntshav.
- Tshaj tawm ntawm kev khi lub peev xwm ntawm cov hlau hauv lub cev.
- Biopsy ntawm cov ntaub so ntswg cuam tshuam nrog kev kuaj histological txhawm rau kuaj pom hemosiderin deposits.
Tsuas yog kuaj histological ntawm biopsy tuaj yeem kuaj xyuas hemosiderosis nrog qhov tseeb tseeb. Thaum kuaj ib daim ntawm cov ntaub so ntswg nyob rau hauv lub microscope, macrophages nrog hemosiderin tau pom, vim nws yog cov hlwb uas yog thawj zaug "noj" cov xim ntxiv.
Kuj, nyob ntawm qhov mob ntawm lub cev uas tus kws kho mob xav tias, nws tau sau cov txheej txheem kuaj hauv qab no:
- magnetic resonance duab ntawm lub hlwb;
- CT scan;
- ultrasound;
- radioography;
- bronchoscopy.
Ib yam ntxivib txoj hauv kev kuaj pom muaj txiaj ntsig zoo yog qhov kev sim desferal. Rau nws txoj kev siv, tus neeg mob tau noj 500 mg ntawm Desferal. Yam tsawg kawg ntawm 6 teev thiab qhov siab tshaj plaws ntawm 24 teev tom qab txhaj tshuaj, tus neeg mob cov zis tau sau thiab kuaj cov hlau hauv nws.
Kev kho mob
Txij li thaum lub sijhawm tam sim no qhov kev saib xyuas feem ntau yog them rau cov kab mob autoimmune ntawm hemosiderosis, cov tshuaj los ntawm pawg corticosteroids yog suav tias yog cov tshuaj tseem ceeb. Lawv ua rau lub cev tsis muaj zog, yog li txo qis cov tshuaj tiv thaiv kab mob tiv thaiv lawv tus kheej cov qe ntshav liab. Cov tshuaj no suav nrog "Dexamethasone", "Prednisolone". Tab sis glucocorticoids pab tsuas yog hauv 40-50% ntawm cov neeg mob. Thaum tsis muaj kev ua tau zoo, tus neeg mob tau muab tshuaj cytostatics ("Methotrexate", "Azathioprine")
Tseem tau sau cov tshuaj uas txhim kho cov ntaub so ntswg trophism, cell metabolism, nce cov pa oxygen rau lawv. Cov tshuaj no suav nrog:
- Venotonics. Lawv ua kom cov elasticity ntawm cov phab ntsa vascular, txhim kho cov ntshav khiav hauv lub hlwb cov ntaub so ntswg - "Detralex", "Doppelhertz"
- Vitamins ntawm pab pawg B. Txhim kho cov conductivity ntawm cov hlab ntsha impulse, qhov mob ntawm qaum cov ntaub so ntswg.
- Vitamin C. Ua kom lub zog ntawm cov hlab ntsha.
- Angioprotectors. Lawv muaj cov nyhuv zoo sib xws rau vitamin C - "Etamzilat", "Vincamine"
- Nootropics. Txhim kho cov ntshav khiav hauv lub hlwb thiab ua kom cov cell metabolism - Cerebrolysin, Phenibut.
- Neuroleptics. Lawv raug muab tshuaj tsuas yog tias tus neeg mob muaj kev puas siab puas ntsws - "Aminazine".
Thaum muaj hemosiderosis ntawm ob lub raum thiab muaj qhov cuam tshuam loj ntawm lawv txoj haujlwm, plasmapheresis lossis hemodialysis raug tshuaj.
Yog li, ntau dhau ntawm hemosiderin yog ib qho mob hnyav heev. Nws yuav tsum tau kuaj pom ntxov tshaj plaws thiab kev kho mob raws sij hawm, txij li thaum muaj mob hnyav, hemosiderosis ua rau muaj kev ua haujlwm tsis zoo ntawm cov kabmob hauv nruab nrog cev. Feem ntau cov kev puas tsuaj no rov qab tsis tau.
