Myelodysplastic syndrome yog hais txog ib pawg hematological pathologies uas tshwm sim los ntawm kev ua haujlwm tsis zoo hauv kev tsim cov qe ntshav liab, xws li cov qe ntshav liab, platelets lossis cov qe ntshav dawb hauv cov pob txha. Cia peb xav txog tus kab mob no kom meej, tshawb xyuas nws cov laj thawj tseem ceeb, cov tsos mob thiab nrhiav seb qhov kev kho mob yog dab tsi.
Kev piav qhia tus kab mob
Myelodysplastic syndrome koom nrog ntau yam pathologies, sib sau ua ke ib qho kev sib txuas ntawm cov txheej txheem, uas muaj nyob rau hauv kev sib txuas ntawm dysplastic hloov hauv cytopenia thiab pob txha pob txha hauv cov ntshav ncig. Txhua yam ntawm pathologies nrog rau cov tsos mob ntawm tus mob no ua rau muaj kev pheej hmoo ntawm myeloid leukemia.
Tsis ntev los no, xws li tshwm sim xws li myelodysplastic syndrome (refractory anemia) tau txais ntau qhov kev tshawb fawb, txij li qhov tseeb zausQhov tshwm sim ntawm tus kab mob no tau nce ntau, thiab kev lees txais kev kho mob tseem tsis tau tsim. Tsis tas li ntawd, cov kws tshaj lij tau sau tseg tias qhov nce ntawm qhov tshwm sim ntawm thawj hom kab mob, uas tuaj yeem cuam tshuam rau tib neeg thaum muaj hnub nyoog yau, uas tuaj yeem piav qhia los ntawm kev puas tsuaj loj hauv ib puag ncig hauv ntiaj teb niaj hnub no.
Nws yuav tsum tau muab sau tseg tias pawg tseem ceeb ntawm kev pheej hmoo, nyob rau hauv uas txoj kev loj hlob ntawm myelodysplastic syndrome yog feem ntau, feem ntau yog cov neeg laus. Ntawm cov menyuam yaus, tej zaum nws yog qhov kev zam rau txoj cai, vim tias qhov kev tshawb pom ntxov ntawm tus mob no yog qhov nyuaj heev. Tom ntej no, xav txog cov laj thawj tseem ceeb rau kev loj hlob ntawm cov kab mob no.
Qhov laj thawj tseem ceeb
Feem ntau cov piv txwv ntawm tus mob tuaj yeem raug categorized raws li daim ntawv idiopathic etiopathogenetic, uas nws tsis tuaj yeem txiav txim siab qhov laj thawj ntawm nws txoj kev loj hlob. Daim ntawv thib ob ntawm myelodysplastic syndrome tshwm sim tshwj xeeb rau cov neeg mob uas muaj cov kab mob oncological, thiab qhov tshwm sim ntawm nws qhov kev tsim feem ntau tshwm sim nyob rau lub sijhawm tom qab siv tshuaj khomob. Nyob rau hauv pawg no ntawm cov neeg mob, lub syndrome mus heev aggressively, nyob rau hauv tas li ntawd, nws yog tshwj xeeb yog resistant rau tshuaj kho. Cov tshuaj siv rau hauv kev kho mob ntawm oncological pathologies, piv txwv li, Cyclophosphamide nrog Topotecan, muaj kev puas tsuaj rau cov genome, yog li provoking kev loj hlob ntawm myelodysplastic syndrome (reflex anemia).
muajib tug ncaj ntau yam ntawm lub ntsiab ua rau muaj kev pheej hmoo, tshem tawm uas, nws yuav ua tau kom tsis txhob tsim ntawm pathology. Cov no suav nrog kev haus luam yeeb nrog raug ionizing hluav taws xob, benzene vapor.
Feem ntau cov kws kho mob oncologists xav tias qhov mob no ua haujlwm tseem ceeb hauv keeb kwm yav dhau los rau kev txhim kho ntawm tus mob leukemia. Refractory anemia yog hom kab mob uas muaj ntau tshaj plaws thiab ntau tus kws tshaj lij hauv kev xyaum txheeb xyuas cov ntsiab lus no. Lub ntsiab sib txawv ntawm refractory anemia thiab tus qauv classical variant ntawm kev txo qis concentration ntawm hemoglobin nyob rau hauv cov ntshav yog hais tias tiv thaiv keeb kwm yav dhau ntawm ib tug syndrome nrog ib tug ntau ntawm blasts, ib tug loj tus naj npawb ntawm thiaj li hu ua blast hlwb tuaj yeem tsim nyob rau hauv tus neeg mob cov pob txha pob txha., uas ua rau peb caug feem pua ntawm tag nrho cov cellular muaj pes tsawg leeg.
Nyob rau hauv txoj kev loj hlob ntawm pathogenesis ntawm myelodysplastic syndrome, kev ua tau zoo ntawm cell ntau lawm nyob rau hauv cov pob txha pob txha yog qhov tseem ceeb heev. Raws li qhov tshwm sim ntawm cov organic, morphological hloov pauv hauv cov pob txha pob txha, cov txheej txheem them nyiaj ntawm daim ntawv extramedullary ntawm hematopoiesis tuaj yeem txhim kho hauv lub cev ntawm cov neeg mob. Ib qho tshwm sim zoo sib xws yog nrog los ntawm hepatosplenomegaly.
Lub hauv paus pathogenetic ntawm cov mob myelodysplastic theem nrab muaj cov kev loj hlob tsis zoo, kev loj hlob ntawm cov qe ntshav nyob rau hauv cov pob txha pob txha, uas ua rau tsim muaj ntau lub cev tawg uas muaj tag nrho cov tsos mob ntawm malignancy.
Risk factors
KYam tseem ceeb ntawm kev pheej hmoo rau tus mob no suav nrog:
- Nyob rau txiv neej poj niam.
- Muaj daim tawv nqaij dawb.
- Tus neeg mob tshaj rau caum.
- Tshuaj kho mob ua ntej nrog rau hluav taws xob.
- Kev cuam tshuam ntawm qee yam tshuaj. Ib qho piv txwv yog haus luam yeeb nrog rau cov tshuaj tua kab, cov kuab tshuaj.
- raug rau lub cev ntawm ntau yam hlau hnyav, xws li mercury nrog txhuas.
Tom ntej no, peb yuav pom tias tus kab mob no tuaj yeem tshwm sim nws tus kheej li cas thiab nws cov tsos mob tseem ceeb yog dab tsi.
Dab tsi yog qhov tshwm sim tseem ceeb ntawm tus mob?
Tej yam tshwm sim ntawm myelodysplastic syndrome nrog ntau dhau ntawm blasts tej zaum yuav yog, ua ntej ntawm tag nrho cov, qhov tsos ntawm qaug zog thiab ua tsis taus pa. Nyob rau theem pib ntawm tus kab mob, tus mob no feem ntau tsis tshwm sim nws tus kheej hauv kev kho mob. Qee lub sij hawm nws tshwm sim tias nws raug kuaj pom los ntawm lub caij nyoog thaum lub sij hawm niaj hnub kuaj ntshav. Cov tsos mob zoo sib xws yuav yog vim muaj lwm yam kab mob. Yog tias ib tug neeg pom ib qho ntawm cov cim qhia hauv qab no, nws yuav tsum mus ntsib kws kho mob tam sim:
- ua tsis taus pa.
- Kev txhim kho qaug zog nrog rau kev nkees.
- Tshuaj tawv nqaij daj ntseg.
- Ntawm qhov tawv nqaij los ntawm qhov nqaij me me nrog rau cov ntshav nce ntxiv.
- Saib petechiae - tiaj tus, taw qhia qhov nqaij tawv hauv qab ntawm daim tawv nqaij qhov loj ntawm tus pinhead.
- Qhov tshwm sim ntawm kub taub hau lossis mob tsis tu ncuakab mob.
Myelodysplastic syndrome cov tsos mob
Qhov kev kho mob tshwm sim ntawm tus mob no ncaj qha nyob ntawm qib ntawm myelopoiesis kev koom tes. Hauv qhov no, nyob rau theem pib ntawm pathology, cov neeg mob saib lub sijhawm asymptomatic, uas tuaj yeem kav ntev heev. Nyob rau hauv cov xwm txheej uas myelodysplastic syndrome nyob rau hauv cov neeg mob tshwm sim vim yog ib tug tseem ceeb cov tsos mob complex ntawm ib tug anemic xwm, cov neeg mob muaj zog qaug zog nrog loj pallor ntawm daim tawv nqaij pom, thiab lawv kuj tsis qab los noj mov.
Qhov muaj qhov nce ntxiv rau cov kab mob ntawm cov kab mob sib kis qhia tau hais tias kev loj hlob ntawm neutropenia. Tsis tas li ntawd, pawg neeg mob no muaj kev pheej hmoo ntawm kev tsim cov teeb meem inflammatory. Muaj tseeb, thrombocytopenic tivthaiv ntawm tus mob syndrome, uas tuaj yeem pom nws tus kheej hauv cov tsos mob hemorrhagic complex nyob rau hauv daim ntawv ntawm los ntshav, yog qhov tseem ceeb tshaj plaws uas cuam tshuam rau kev noj qab haus huv ntawm cov neeg mob. Tej zaum kuj yuav muaj ntu ntu ntawm epistaxis nrog kev txhim kho ntawm petechial cov pob liab liab ntawm daim tawv nqaij.
Kev kuaj pom zoo ntawm myelodysplastic syndrome (refractory anemia) nrog ntau dhau ntawm cov blasts yuav tsum suav nrog kev ntsuam xyuas ntawm kev siv tshuaj kho mob, nrog rau cov kev hloov pauv hauv cov ntsuas hauv cellular muaj pes tsawg leeg tsis yog cov ntshav peripheral nkaus xwb, tab sis kuj cov pob txha pob txha. nqus tau. Nyob rau hauv cov ntaub ntawv ntawm kev kuaj pom cov tsos mob xws li refractory anemia, leukocytopenia lossis thrombocytopenia, nrog rau kev sib xyaw ua ke ntawm tag nrho cov teeb meem no hauvCov neeg laus yuav tsum tau xav tias muaj tus mob.
Refractory anemia yog tus cwj pwm los ntawm kev sib xyaw nrog anisocytosis, ntxiv rau, nrog rau macrocytosis, uas tuaj yeem tshwm sim nws tus kheej hauv qhov nce hauv nruab nrab ntawm tes ntim ntawm erythrocyte series. Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias thrombocytopenia tiv thaiv keeb kwm yav dhau ntawm myelodysplastic syndrome feem ntau tsis ncav cuag tus nqi tseem ceeb, txawm li cas los xij, nws tuaj yeem nrog kev hloov pauv ntawm qhov loj ntawm platelet hlwb. Cov yav tas yuav tshwm sim nyob rau hauv daim ntawv ntawm ib tug txo nyob rau hauv lawv granularity. Nws tsis yog qhov tsim nyog los saib xyuas qhov txo qis ntawm leukocyte suav. Cov txheej txheem tshwj xeeb tshaj plaws yog kev hloov pauv hauv leukocyte plasma granularity nrog lub xub ntiag ntawm pseudo-Pelger hlwb. Lub xub ntiag ntawm qhov nce hauv cov concentration ntawm cov qe ntshav monocytic yuav ua pov thawj pom zoo ntawm kev tsim cov kab mob leukemia ntev ntawm hom myelomonocytic.
Ib txoj kev kuaj xyuas qhov tseeb, uas muaj yuav luag ib puas feem pua kev ntseeg tau, yog immunophenotyping nrog rau cytochemical tsom xam ntawm pob txha pob txha aspirate, uas tso cai rau koj los txiav txim cov enzymes tshwj xeeb. Nws yuav tsum raug sau tseg tias cov enzymes no tsuas yog cov yam ntxwv ntawm cov hlwb tawg xwb.
Cia peb xav txog kev faib tawm ntawm myelodysplastic syndrome.
Kev faib kab mob
Hauv cov tshuaj niaj hnub no, hom kab mob hauv qab no yog qhov txawv:
- Kev txhim kho ntawm refractory anemia. Tus kab mob no tuaj yeem nyob ntev dua rau lub hlis. Nyob rau hauv cov ntaub ntawv no, nyob rau hauv kev tsom xam ntawm tus neeg mob cov ntshav, blasts yuavtsis tuaj los yog tshwm sim hauv ib qho kev txiav txim. Hauv cov pob txha, raws li txoj cai, erythroid dysplasia tau pom.
- Kev txhim kho ntawm refractory anemia nrog sideroblasts. Cov kab mob pathology no tseem tuaj yeem nyob ntev dua rau lub hlis. Yuav tsis muaj blasts nyob rau hauv tus neeg mob qhov kev kuaj ntshav. Kuj tseem muaj erythroid dysplasia hauv cov pob txha.
- Kev txhim kho ntawm refractory cytopenia nrog multilinear dysplasia. Hauv kev kuaj ntshav ntawm tus neeg mob, Auer lub cev feem ntau tsis tuaj. Raws li rau blasts, lawv kuj tsis tuaj los yog tshwm sim nyob rau hauv cov xwm txheej cais. Pancytopenia tuaj yeem pom nrog nce ntawm cov monocytes. Hauv cov pob txha pob txha, dysplastic hloov yuav tsawg dua kaum feem pua, Auer lub cev tsis tuaj.
- Kev txhim kho ntawm refractory anemia nrog qhov tseem ceeb tshaj ntawm blasts-1. Tsis muaj Auer lub cev nyob rau hauv tus neeg mob cov ntshav, thiab blasts muaj ntau tshaj li tsib feem pua. Nyob rau tib lub sijhawm, cytopenia tau pom nrog kev nce ntawm cov monocytes. Hauv qhov no, dysplasia ntawm ib lossis ob peb kab ntawm tes yuav raug pom nyob rau hauv cov pob txha pob txha, Auer lub cev tsis tuaj.
- Kev txhim kho ntawm refractory anemia nrog ntau tshaj ntawm blasts-2. Hauv cov neeg mob cov ntshav, qhov nce ntawm tag nrho cov monocytes tau pom, thiab cytopenia kuj tseem muaj. Kev tawg ua kom txog li kaum cuaj feem pua; Auer lub cev tuaj yeem kuaj pom. Hauv cov pob txha, raws li txoj cai, muaj dysplasia ntawm ib lossis ob peb kab ntawm tes ib zaug.
- Tsim kom muaj qhov tsis tuaj yeem cais tawm myelodysplastic syndrome. Cytopenia pom nyob rau hauv tus neeg mob cov ntshav, thiab blasts nyob rau hauv lawvtsis muaj queues lossis lawv tshwm sim hauv ib qho kev txiav txim. Auer lub cev tsis tuaj. Nyob rau hauv cov pob txha pob txha, dysplasia ntawm ib kab megakaryocytic tej zaum yuav pom.
- Kev txhim kho ntawm myelodysplastic syndrome cuam tshuam nrog kev rho tawm cais. Anemia yuav raug soj ntsuam nyob rau hauv kev kuaj ntshav, thiab blasts yuav ua tau ntau tshaj li tsib feem pua, thrombocytosis tsis cais.
Diagnosis
Kev kuaj mob ntawm tus kab mob yog tsim los ntawm cov ntaub ntawv kuaj. Raws li ib feem ntawm txoj kev tshawb no, cov txheej txheem hauv qab no tau muab rau tus neeg mob:
- Peripheral ntshav kuaj.
- Bone marrow biopsy ua raws li cytology.
- Kev xeem cytochemical, cytogenetic test.
Raws li ib feem ntawm kev tshuaj xyuas ntawm cov ntshav peripheral hauv cov neeg uas raug kev txom nyem los ntawm pathology, raws li txoj cai, pancytopenia raug kuaj pom, tsawg dua ib kab cytopenia tuaj yeem kuaj pom. Ntawm cuaj caum feem pua ntawm cov neeg mob, cov kws kho mob saib normocytic lossis macrocytic anemia. Rau caum feem pua ntawm cov neeg mob muaj neutropenia nrog leukopenia. Ntawm lwm yam, nyob rau hauv feem ntau cov neeg mob, kws kho mob nco ntsoov lub xub ntiag ntawm thrombocytopenia. Dab tsi ntxiv yog qhov kev kuaj mob ntawm myelodysplastic syndrome?
Raws li ib feem ntawm kev kuaj mob pob txha, tag nrho cov hlwb feem ntau yog qhov qub lossis nce siab. Twb tau nyob rau theem pib, cov kws kho mob tuaj yeem kuaj pom cov tsos mob ntawm dyserythropoiesis. Cov ntsiab lus ntawm blasts ncaj qha nyob ntawm hom mob, yog li lawv tus lej tuaj yeem ua tau zoo lossis nce ntxiv. Yav tom ntej, kws kho mob saibdysgranulocytopoiesis nrog dysmegakaryocytopoiesis. Hauv qee cov neeg mob, cov tsos mob ntawm dysplasia nyob rau hauv cov pob txha pob txha yog me me heev. Raws li ib feem ntawm txoj kev tshawb fawb cytogenetic, yuav luag txhua tus neeg mob tau kuaj pom muaj tus kab mob chromosomal. Cia peb tam sim no xav txog yuav kho tus mob no li cas.
Kev kho mob myelodysplastic syndrome yog dab tsi?
Kev kho mob
Txog tsis ntev los no, kev kho mob ntawm myelodysplastic syndrome tsuas yog cov tsos mob xwb. Niaj hnub no, cov kws kho mob tshwj xeeb tab tom tsim cov txheej txheem tshiab ntawm kev kho mob, txawm li cas los xij, kev kho mob zoo ntawm pab pawg kab mob no tseem yog ib qho teeb meem nyuaj tshaj plaws ntawm niaj hnub hematology. Txog tam sim no, kev kwv yees rau tus mob myelodysplastic feem ntau yog nyob ntawm tus yam ntxwv ntawm cov kab mob, muaj lossis tsis muaj teeb meem. Kev kho mob yog ua los ntawm cov kws tshwj xeeb hauv thaj chaw ntawm oncology thiab hematology.
Kev txiav txim siab txog kev xaiv ntawm cov tswv yim tseem ceeb ntawm kev tswj cov neeg mob nrog cov kab mob no ncaj qha nyob ntawm qhov hnyav ntawm kev kuaj pom. Qhov tsis muaj cov tsos mob ntawm hemorrhagic syndrome, anemia, muaj kev pheej hmoo siab ntawm kev tsim cov kab mob sib kis yog lub hauv paus rau kev xaiv cov kev cia siab rau kev sib raug zoo nrog tus neeg mob. Nyob rau hauv cov xwm txheej zoo li no, tsuas yog kev soj ntsuam zoo ntawm lub chaw soj nstuam ntawm myelopoiesis yog qhia.
Kev siv cov txheej txheem kho mob los kho tus mob no tsuas yog ua tau raws li qhov tshwm sim ntawm kev kho mob hnyav, nrog rau kev pheej hmoo ntawm kev hloov pauv mus rau leukemia. ATRaws li ib feem ntawm kev kho mob rau myelodysplastic syndrome, raws li txoj cai, kev saib xyuas thiab kev phais yog siv.
Qhov kev nthuav dav tshaj plaws yog nrog kev hloov pauv kev kho mob, uas suav nrog kev qhia cov ntshav cov khoom hauv daim ntawv ntawm erythrocyte masses lossis thromboconcentrate intravenously. Nws yuav tsum raug coj mus rau hauv tus account tias kev kho mob ntev nrog kev siv cov hemocomponent yuav ua rau muaj kev cuam tshuam ntau dhau ntawm tus neeg mob lub cev nrog hlau, uas nyob rau hauv siab concentrations tsuas yog muaj kev cuam tshuam rau lub cev thiab cov qauv, uas, ntawm chav kawm, ua txhaum cai. ntawm lawv cov haujlwm. Muab qhov tshwj xeeb no, kev tso ntshav yuav tsum tau ua ke nrog kev siv tshuaj uas khi hlau thiab pab txhawb rau nws tshem tawm. Piv txwv li, cov tshuaj "Desferal" yog siv parenterally ntawm 20 milligrams ib kilogram ntawm tus neeg mob qhov hnyav raws li ib feem ntawm kev kho mob rau myelodysplastic syndrome.
Parenteral kev tswj hwm ntawm cov tshuaj xws li erythropoietin thiab thrombopoietin yog siv rau kev kho mob ntxiv, uas tsis muaj kev cuam tshuam rau tag nrho lub neej expectancy ntawm tus neeg mob. Qhov no, nyob rau hauv lem, ua hauj lwm raws li ib tug tseem ceeb qhia txog kev ua tau zoo ntawm kev kho mob ntawm no syndrome. Lub xub ntiag nyob rau hauv cov neeg mob ntawm xws li ib tug tshwm sim raws li refractory anemia, raws li ib tug ntawm cov cim qhia ntawm pathology, yog lub laj thawj rau kev siv ntawm immunosuppressive kev kho mob. Txhawm rau ua qhov no, sau ntawv "Lenalipomide" hauv ib hnub ntawm 25 milligrams. Cov txheej txheem kho mob rau myelodysplastic syndrome tsis xaus rau ntawd.
Cov tshuaj, uas nws cov txiaj ntsig zoo hauv kev tiv thaiv kev txhim kho ntawm leukemia tiv thaiv keeb kwm yav dhau los ntawm tus kab mob, tau raug pov thawj ntau dua ib zaug, yog Azacitidine, nws siv tau ua raws li qee lub tswv yim. Thawj chav kawm ntawm kev kho mob yog xya hnub, thaum lub sij hawm uas Azacitidine tau txhaj tshuaj rau cov neeg mob ntawm ib hnub koob tshuaj 75 milligrams. Thaum lub sij hawm tom ntej ntawm kev kho mob, koob tshuaj txhua hnub yog 100 milligrams. Kev kho ntau yam ntawm chav kawm yog ib lub lis piam txhua lub hlis. Nws yuav tsum raug sau tseg tias cov nyhuv ntawm kev siv "Azacitidine" tuaj yeem khaus heev. Hauv qhov no, txhua qhov kev siv tshuaj yuav tsum ua ntej los ntawm kev tshawb fawb soj ntsuam ntawm kev kuaj ntshav.
Kev ntsuas ntawm hematological hloov pauv yuav tsum tau ua tom qab tswj hwm cov tshuaj. Ib tug categorical contraindication rau kev siv ntawm "Azacitidine" yog lub xub ntiag ntawm hnyav organic pathologies ntawm lub siab thiab ob lub raum nyob rau hauv cov neeg mob, vim hais tias cov tshuaj ntawm no pharmacological pab pawg neeg yog xam tau tias yog heev hepatotoxic. Muab hais tias cov khoom metabolic nyob rau hauv lub moj khaum ntawm kev puas tsuaj ntawm "Azacitidine" raug tshem tawm los ntawm kev ua haujlwm ntawm lub raum, cov xwm txheej raug tsim rau kev puas tsuaj rau cov qauv no. Hauv qhov no, kev siv tshuaj yuav tsum tau ua nruj me ntsis raws li kev tswj hwm ntawm creatinine thiab urea qhov tseem ceeb, cov ntsuas no yog cov cim tseem ceeb ntawm lub raum tsis ua haujlwm.
Cov lus pom zoo rau myelodysplastic syndrome yuav tsum tau ua raws nruj me ntsis.
Txawm tias muaj txiaj ntsig zoo ntawm kev siv kho mob kho, tsuas yog kev kho kom tsim nyog xwbtso cai rau cuaj caum-tsib feem pua ntawm cov neeg mob kom ua tiav kev zam txim, allogeneic hloov pauv ntawm qia hematopoietic cell substrates tau tawm tswv yim, txawm li cas los xij, kev siv txoj kev no yog siv rau hauv ib pawg ntawm cov neeg mob uas tsis muaj hnub nyoog tshaj tsib caug-tsib xyoo. Qhov no, hmoov tsis, txwv kev siv cov txheej txheem no.
Cov kev txwv no yog vim qhov tseeb tias cov neeg laus muaj hnub nyoog nyuaj heev rau kev zam cov tshuaj kho mob, uas yuav tsum tau ua raws li ib feem ntawm kev npaj cov neeg mob rau kev hloov pauv. Tsis tas li ntawd, nws yuav tsum raug coj mus rau hauv tus account tias hauv kaum feem pua ntawm cov neeg mob tom qab hloov pauv, kev hloov pauv tsis tuaj yeem tshwm sim, uas yuav ua rau muaj kev phom sij rau tus neeg mob. Tsis ntev los no, qia cell hloov tau siv tau zoo heev, uas tsis yog los ntawm cov pob txha pob txha, tab sis ncaj qha los ntawm cov ntshav ncig peripheral.
Kev noj haus rau myelodysplastic syndrome
Nyob rau hauv rooj plaub no, nws yuav tsum tau ua raws li cov lus 15. Cov neeg mob Neutropenic tsis pom zoo kom ua raws li kev noj haus tshwj xeeb.
Kev noj zaub mov ntawm lub rooj naj npawb 15 muaj qhov sib npaug ntawm lub cev thiab lub zog muaj pes tsawg leeg. Kev noj zaub mov txhua hnub ntawm 2,600-3,100 kcal yog qhov noj ntawm tus neeg uas tsis koom nrog lub cev ua haujlwm. Noj zaub mov nrog qhov hnyav tag nrho tsis pub ntau tshaj peb kg ib hnub twg, kua - 1.5-2.0 litres ib hnub twg. Tawm tsam keeb kwm ntawm cov khoom noj no, koj yuav tsum noj cov vitamins complexes, noj zaub thiab txiv hmab txiv ntoo ntau.
Table No. Nyob rau hauv tej yam kev mobtsev kho mob lossis sanatorium yog siv rau lub sijhawm rov qab los tom qab muaj mob, lossis txhawm rau hloov pauv ntawm lwm yam khoom noj mus rau ib txwm noj.
Kev kho mob myelodysplastic syndrome nrog cov tshuaj pej xeem yuav tsis ua haujlwm. Yuav siv tau los pab.
Kev kho mob qis qis
Kev txhawb nqa yog ib feem tseem ceeb ntawm kev kho mob rau tus kab mob no thiab coj mus rau hauv tus account lub hnub nyoog ntawm cov neeg mob. Xws li kev kho mob suav nrog cov tsos mob kho, uas yog tsom rau kev tswj hwm qib ntawm cov platelets, leukocytes thiab erythrocytes. Txoj kev kho no yog tsim los txhim kho lub neej zoo ntawm cov neeg mob thiab ua kom nws ntev.
- RBC Hloov yog nqa tawm hauv kev txiav txim kom tsis txhob muaj qhov mob me me. Yog tias yuav tsum tau txhaj tshuaj ntau, yuav muaj kev pheej hmoo ntawm cov hlau ntau dhau, yuav tsum tau kho chelation.
- Ib txoj kev tso ntshav platelet rau myelodysplastic syndrome nrog cov blasts ntau dhau yuav tsum tau tiv thaiv los ntshav. Feem ntau cov txheej txheem no tsis ua rau muaj teeb meem.
- Nws muaj qhov hu ua hematopoietic kev loj hlob, uas cuam tshuam nrog cov proteins uas txhawb kev loj hlob ntawm cov qe ntshav, lawv siv ua kom txo tau qhov kev xav tau hloov pauv. Muaj tseeb tiag, ntau tus neeg mob uas muaj tus mob no tsis teb rau qhov kev loj hlob.
Dab tsi yog pab pawg neeg xiam oob qhab rau myelodysplastic syndrome? Nws tau nto mootom qab kev kuaj mob thiab kev sib raug zoo.
Yuav ua li cas rau cov neeg mob
Yeej, qhov kev cia siab rau qee yam ntawm pathology ncaj qha nyob ntawm cov kab mob sib txawv ntawm cov kab mob no, nrog rau qhov muaj lossis tsis muaj teeb meem hnyav.
Kev tshawb fawb tsis ntev los no hauv thaj chaw ntawm hematology cuam tshuam txog kev txhim kho ntawm qhov ntsuas kev ntsuas tus mob hauv myelodysplastic syndrome. Hauv lawv cov kev xyaum txhua hnub, hematologists siv thoob ntiaj teb kev faib tawm IPSS. Raws li yav tas los, muaj peb yam tseem ceeb ntawm kev pheej hmoo: qis, nruab nrab thiab siab.
Qhov tseem ceeb ntawm kev ntsuas qhov ntsuas pom hauv myelodysplastic syndrome yog qhov feem pua ntawm cov hlwb tawg hauv cov pob txha. Qhov profile ntawm chromosomal abnormality nrog qhov tseeb qhov hnyav ntawm cytopenia kuj raug soj ntsuam. Qhov kev pom zoo tshaj plaws ntawm tus kab mob yog pom nyob rau hauv cov neeg mob uas muaj pes tsawg lub ntsiab lus raws li kev faib tawm IPSS. Raws li qhov nruab nrab lub neej expectancy nyob rau hauv uas muaj kev pheej hmoo siab raws li qhov kev faib tawm no, nws tsis ntau tshaj rau lub hlis.
Thaum kuaj pom tus mob myelodysplastic, cov lus nug tam sim ntawd tshwm sim ntawm tus kws kho mob yuav pab. Nyob rau hauv cov kev tshwm sim ntawm lub xub ntiag los yog xav tsis thoob ntawm lub tsim ntawm ib tug pathology, nws yog ib qho tseem ceeb heev kom tam sim ntawd nrhiav tswv yim los ntawm cov kws tshwj xeeb xws li hematologist thiab ib tug ntshav transfusiologist. Kev sab laj kuj tseem yuav muab los ntawm tus kws tshuaj tiv thaiv kab mob nrog tus kws kho mob oncologist.
