Nyob rau hauv txoj kev tshawb fawb morphological ntawm cov qe ntshav liab, uas zoo li khaws tag nrho lawv cov yam ntxwv hauv lub neej, ntau yam sib txawv ntawm cov qauv raug kuaj pom zoo tshaj plaws.
Erythrocyte yam ntxwv
Hauv cov duab, erythrocytes zoo li biconcave discs nrog txoj kab uas hla ntawm 7-8 microns, lawv qhov ntim nruab nrab yog 80-100 femtoliters, lawv cov xim yog normochromic. Nyob rau hauv cov ntaub ntawv ntawm pathological hloov nyob rau hauv cov ntshav liab nrog microcytosis, macrocytosis, normocytosis, hypochromia thiab hyperchromia, anemic tej yam kev mob feem ntau yog kuaj. Lub tswv yim ntawm "microcytosis" yog tus cwj pwm los ntawm qhov muaj nyob hauv erythrocytes ntawm ntau cov hlwb me me. Qhov no qhia txog kev loj hlob ntawm microcytic anemia.
Kev tsis sib haum los ntawm tus qauv
cov qe ntshav liab ua haujlwm ntau thiab tseem ceeb hauv lub cev. Lawv kuj tuaj yeem qhia txog qhov sib txawv ntawm lawv qhov loj me piv rau cov txiaj ntsig ib txwm muaj (80-100 fl lossis microns 3):
- yog tias lawv tsawg dua li qub (MCV hauv cov tshuaj hematology <80 fl) - ces tus mob no hu ua microcytosis;
- ntau dua li qub(MCV>100 fl) – macrocytosis;
- thiab yog tias lawv muaj qhov ntau thiab tsawg, ces qhov no yog qhov normocytosis.
Xim
Lub luag haujlwm tseem ceeb hauv kev kuaj mob ntawm ntau yam anemias raug xa mus rau qhov ntsuas ntsuas raws li xim. Feem ntau muaj hypochromia, hyperchromia thiab normochromia. Raws li qhov tshwm sim ntawm kev ua txhaum ntawm kev sib txuas ntawm cov xim liab (nws tseem hu ua hemoglobin), vim tsis muaj hlau, microcytosis nrog hypochromia. Cov kab mob no hu ua microcytic anemia.
Hauv qhov no, qhov loj ntawm cov qe ntshav liab thiab lawv cov xim yog qhov cim ntawm tus kab mob. Vim li cas microcytosis tshwm sim, peb yuav txheeb xyuas hauv kab lus no.
YMicrocytosis - yog dab tsi?
Ntawm peb hom erythrocyte anisocytosis, microcytosis yog qhov ntau tshaj. Nws yog tus cwj pwm los ntawm qhov muaj nyob hauv tag nrho cov naj npawb ntawm erythrocytes ntawm ntau cov qe ntshav liab uas txo qis hauv qhov ntim.
Yog tias kuaj pom microcytosis hauv cov ntshav, tus kws kho mob yuav xav tias tus neeg mob tau tsim microcytic anemia. Ntawd yog, nws yog qhov laj thawj tseem ceeb rau kev nce hauv microcytes hauv tib neeg cov ntshav. Tus kws kho mob tshwj xeeb yuav tsum paub tseeb tias yog vim li cas rau qhov sib txawv, tshwj xeeb tshaj yog tias qhov tshwm sim no tsis tau kuaj pom ua ntej, tab sis tau pom thawj zaug. Ntau yam kab mob anemic muaj cov yam ntxwv no, yog li yuav tsum muaj kev kuaj mob sib txawv.
Qee hom ntshav ntshav tuaj yeem ua rau microcytosis. Dab tsi tuaj ua ntej - anemia lossis txo qhov loj ntawm cov qe ntshav liab? Qhov noib lo lus nug nquag nug.
Vim muaj cov tshuaj lom neeg biochemical nyuaj tshwm sim hauv lub cev, muaj kev sib raug zoo ntawm qhov ua rau mob ntshav qab zib thiab cov tsos mob ntawm microcytes hauv cov ntshav. Los yog hypochromic anemia tshwm sim meej vim qhov txo qis ntawm cov qe ntshav liab.
Iron deficiency anemia
Feem ntau ntawm tag nrho cov yog cov tsis muaj hlau tsis muaj microcytic anemia txuam nrog tsis muaj hlau hauv lub cev.
Nws suav nrog tag nrho pab pawg ntawm cov tsis muaj hlau tsis muaj zog uas tau tsim los rau ntau yam laj thawj:
- mob ntshav qab zib los ntawm hemoglobinuria (nyob rau hauv uas cov qe ntshav liab raug puas tsuaj thiab hemoglobin tawm mus rau hauv cov ntshav, qhov mob no hu ua hemolysis, uas feem ntau tshwm sim hauv cov zis) thiab hemosiderinuria (hemoglobin accumulates hauv lub raum thiab cov khoom lag luam. ntawm nws cov oxidation, hemosiderin, raug tshem tawm hauv cov zis)
- Mob ntshav qab zib hemorrhagic iron deficiency anemia - tus mob tshwm sim vim muaj ntau yam kab mob uas nrog los ntshav (uterine, qhov ntswg, raum, ntshav poob los ntawm txoj hnyuv).
- Anemias txuam nrog:
- Qhov tseeb tias kev noj zaub mov tsawg tsawg (nrog rau cov neeg tsis noj nqaij lossis lwm yam zaub mov, yuam los yog tsom, txwv tsis pub lub cev muaj hlau thiab protein ntau).
- Los ntawm kev ua kom lub cev xav tau cov tshuaj irreplaceable no (thaum cev xeeb tub, pub niam mis, nquag yug menyuam, pub dawb).
- Qhov tseeb tias kev nqus thiab thauj cov hlau cuam tshuam (nrog rau kev mob ntevinflammatory los yog malignant txheej txheem nyob rau hauv lub cheeb tsam ntawm lub digestive ib ntsuj av los yog nyob rau hauv lub pancreas, thaum nws secretory muaj nuj nqi cuam tshuam, nrog nws kim heev resection ntawm txoj hnyuv).
Dab tsi muaj lwm yam anemias?
Muaj, ntxiv rau qhov tsis muaj hlau tsis txaus ntshav ntshav, nyob ntawm qhov loj ntawm erythrocyte thiab xim, thiab lwm yam hematological pathologies:
- Hemoglobinopathy (thalassemia, Minkowski-Choffard kab mob, kab mob microspherocytosis, H hemoglobinopathy).
- Sideroblastic microcytic anemia yog ib qho mob pathological uas cuam tshuam cov metabolism hauv hlau. Nrog xws li ntshav tsis txaus, muaj qhov tshwm sim tsis tu ncua ntawm microcytosis, hypochromia, txo qis ntawm cov hlau hauv erythrocytes, nce qib hauv cov ntshav (vim tias lub ntsiab lus no tsis raug coj los ntawm cov pob txha pob txha los tsim hemoglobin). Pathology tuaj yeem kis tau, uas feem ntau tshwm sim hauv cov neeg laus thiab nrog rau lwm yam kab mob (nrog rau cov txheej txheem inflammatory, qog nqaij hlav, mob cawv), thiab keeb kwm (cov noob tsis zoo nyob ntawm X chromosome).
- Anemia cuam tshuam nrog kis tus kab mob mus ntev.
- mob ntshav qab zib vim muaj tshuaj lom nrog ntsev ntawm cov hlau hnyav, tshwj xeeb yog cov hlau lead, uas cuam tshuam tsis zoo rau kev siv hlau thiab tsim cov hemoglobin. Cov yam ntxwv ntawm cov kab mob no yuav yog - microcytes, hypochromia, coarse intracellular inclusions (Jolly lub cev, basophilic granularity, Cabot rings) yuav pom nyob rau hauv cov ntshav.
- Nrhiav homhypochromic microcytic anemia - qhov ua rau ntawm lawv tshwm sim yog vim congenital anomalies nyob rau hauv cov hlau metabolism, ua txhaum ntawm cov txheej txheem ntawm thauj thiab reutilization ntawm no tseem ceeb lub ntsiab, thiab tsis muaj ib tug hlau-binding protein.
Yuav ua li cas hypochromic microcytic anemia tshwm sim hauv cov menyuam yaus?
Hemogram tsis yuav tsum tau tswj hwm, nws tau qhia yam tsis muaj kev cuam tshuam rau lub cev loj hlob.
Hypochromia thiab microcytosis thaum kuaj ntshav dav dav, nrog rau lwm cov tsos mob ntawm kev noj qab haus huv (qhov hnyav dhau los lossis poob, tsis yog qhov xav tau los saj thiab txawm tias noj zaub mov tsis zoo, kev hloov pauv tus cwj pwm, txo qis) qhia tias muaj qhov tshwm sim. tus me nyuam muaj ntshav tsis txaus vim muaj cov hlau tsis txaus. Tom qab tag nrho, kev sib txuas ntawm hemoglobin (cov ntshav liab xim) tsuas yog nyob ntawm cov tshuaj no xwb.
Nws kuj yog tus nqa cov pa oxygen los ntawm cov ntaub so ntswg thiab hauv nruab nrog cev, thiab thaum nws txo qis, cov tsos mob tsis zoo tshwm sim tshwm sim.
Yuav ua li cas tiv thaiv qhov no?
Cov menyuam yaus muaj feem yuav ntsib cov teeb meem no. Qhov no yog vim peculiarities ntawm hlau metabolism thiab khoom noj khoom haus. Kev noj zaub mov yuav tsum tau ua kom tus menyuam muaj hlau txaus. Tab sis nws tsis yog ib txwm ua haujlwm.
Los ntawm niam cov kua mis, uas nqus tau cov hlau zoo dua li nyuj los yog tshis mis nyuj, muaj kev pheej hmoo me ntsis ntawm cov ntshav liab.
Tom qab ib xyoos ntawm lub neej, khoom noj uas muaj cov ntsiab lus siablub caij no rau kev loj hlob ntawm lub cev.
Yog tias muaj cov tsos mob ntawm microcytic anemia (peb tshuaj xyuas qhov laj thawj), nws yooj yim los txiav txim siab los ntawm cov duab ntshav, vim tias qib hemoglobin yuav raug txo.
Yuav ua li cas thiaj tsis muaj hlau?
Thaum theem ntawm cov hlau hauv lub cev txo qis, cov tshuaj biochemical hauv qab no yuav ua raws li:
- txo qis hauv cov khoom ntawm heme-forming Cheebtsam hauv cov pob txha pob txha thiab daim siab nqaij;
- txo qis hauv kev zais cia thiab ferritin qib (lub ntsiab ntawm cov hlau cia protein);
- nce hauv cov ntshav tag nrho cov hlau-txhim kho cov ntshav;
- nce qib ntawm cov dawb erythrocyte protoporphyrins, uas tsis muaj dab tsi los txuas rau hauv daim ntawv heme;
-
txo qis hauv kev ua haujlwm ntawm cov enzymes uas muaj hlau hauv cov hlwb.
microcytic hypochromic anemia
Raws li kev txo qis hauv cov hlau hauv cov ntshav nce ntxiv thiab, raws li, theem ntawm hemoglobin poob, ntau thiab ntau erythrocytes yuav hloov xim, lawv qhov loj me thiab sab nrauv yuav txo qis. Thaum kawg, qhov no yuav ua rau deformation ntawm erythrocytes, lawv hloov mus rau microcytes. Thiab nrog rau microcytosis, hypochromia thiab poikilocytosis yuav raug sau tseg hauv cov qe ntshav liab.
Qhov no yuav tshwm sim hauv hemogram thiab kuaj ntshav biochemical. Txo cov qib hemoglobin, hloov pauv cov ntshav cov ntshav, cov ntsuas erythrocyte yuav hloov, hypochromia thiab microcytosis yuav tshwm sim hauv kev kuaj ntshav dav dav - tag nrho cov no yuav paub meej tias kev txhim kho hypochromic microcytic anemia.
PabMuaj tseeb tiag, tsis muaj qhov tseeb tias tsis muaj hlau tsis muaj ntshav liab tau tshwm sim hauv tus menyuam mos lossis tus neeg laus.
Yog li ntawd, tus mob pathological yuav tsum sib txawv ntawm lwm hom ntshav qab zib. Piv txwv li, nws tuaj yeem tshwm sim los ntawm kev lom tshuaj lom neeg txhuas (nrog basophilic inclusions hauv erythrocytes, nce qib ntawm cov hlau lead hauv cov ntshav, cov tsos ntawm cov dawb erythrocyte protoporphyrins thiab captoporphyrins hauv cov zis). Nws tuaj yeem yog thalassemia (nws tuaj yeem xav tias muaj qhov nce hauv cov ntshav HbA2, HbF). Thaum kuaj pom tias muaj microcytic anemia, kev kho mob yuav tsum tau raws sijhawm.
Yuav ua li cas thiaj tshem tau ntshav ntshav?
Cov qib hlau qub yuav tsum tau hloov. Cov ntawv qhia tus neeg mob tau raug kho dua.
Yog tias ntshav ntshav muaj feem cuam tshuam nrog kev poob ntshav tas li, lawv qhov ua rau raug tshem tawm. Thaum cev xeeb tub hnyav, kev kho mob los ntawm gynecologist yuav tsum tau ua. Qhov mob hnyav lossis raug mob los ntshav yog tshem tawm los ntawm kev phais mob. Ulcerative los ntshav cuam tshuam nrog kev kho mob ntawm cov kab mob hauv plab.
Thaum qhov tsis txaus microelement provokes lub cev nws tus kheej, cov kev npaj npaj tau raug tswj hwm hauv cov ntsiav tshuaj lossis txhaj tshuaj. Lawv muaj contraindications thiab phiv. Iron overdose yog txaus ntshai npaum li hlau deficiency.
Peb tau tshuaj xyuas cov hlau tsis txaus hypochromic microcytic anemia kom meej.
