Polycythemia - polycythemia ndiko ...: Zviratidzo neMarapirwo

Polycythemia - chirwere chirwere umo kugutsikana kunowedzera masero matsvuku eropa (matsvuku masero) muropa. Uyewo, kana zvakadaro zvokurwara muna 70% wevarwere siyana uwandu maplatelet uye leukocytes hombe nzira.

The chirwere haana yakakwirira hwakapararira - pagore paminiti miriyoni kwevanhu kunyora hapana kupfuura pazviitiko zvishanu. Most kazhinji chirwere hwapedyo polycythemia repakati uye vanhu vakwegura. Maererano nenhamba, muri varume kutambura nyonganyonga ichi vari kashanu kakawanda kupfuura vakadzi. Nhasi, tikanyatsoongorora mamiriro ichi sezvo polycythemia, zviratidzo uye kurapwa zvirwere zvinotsanangurwa pazasi.

Zvinokonzera chirwere

Polycythemia - asiri rakaipa chirwere. Pari, chikonzero chaiwo chirwere harizivikanwi. Zvinofungidzirwa kuti hosha iri kukonzerwa kunotouraya kuva anokosha mwongo enzayemu. Genetic kuchinja kukonzera kunyanya weboka uye kukura masero eropa, kunyanya matsvuku masero.

kupatsanura zvirwere

mapoka maviri chirwere:

• Polycythemia Vera kana Vakeza chirwere, icho zvinozoita akakamurwa chikuru (i.e., anoita somunhu akazvimirira chirwere) uye yechipiri (polycythemia yechipiri anova nokuda chisingaperi zvirwere zvemapapu, namamota, hydronephrosis, musi vachisimudza nokukwirira).

• Hama polycythemia (kushushikana kana nhema) - kana mamiriro iri padanho masero matsvuku eropa ari chakaipa siyana.

Polycythemia: Zviratidzo chirwere

Kakawanda, chirwere chacho asymptomatic. Dzimwe nguva, somugumisiro kuongorora nezvikonzero zvakasiyana chaizvo zvingava netsaona kwakaratidza polycythemia. Zviratidzo, izvo zvinofanira kuteerera, tarisai rinotevera.

Kuwedzera subcutaneous mutsinga

Kana polycythemia paganda, kazhinji zviri pamutsipa, dilated subcutaneous mutsinga anoratidza kuburikidza. With chirwere ichi ganda kunova yakatsvukuruka Cherry ruvara, kunyanya kuoneka mune rakazaruka nzvimbo muviri - mutsipa, maoko, chiso. The mucous Kamudzira nemiromo uye rurimi rinokwanisa kucheneruka-yakatsvuka, nevachena kwemaziso zvaiita akatsvuka.

Chinokonzera kuchinja ropa nokupararira yakapfuma erythrocytes, zvose pemvura midziyo uye tava kuderera rheological zvivako ayo (kumhanya rwokufamba), dzakatsigira chikuru chikamu Chizenga (dzvuku ruvara) inova shoma chimiro (i.e., kaviri makemikari kuchinja) uye kuchinja ruvara.

kuvaviwa

Chinenge hafu varwere vanenge polycythemia, pane kuvaviwa simba, kunyanya pachena pashure pokutora kugeza nemvura inodziya. Fani iyi anoshumira dzakananga chinoratidza polycythemia Vera. Kuvava kunoitika yakafanira kusunungura kuti basa zvinhu muropa, zvikurukuru histamine, rinogona kuwedzera ganda capillaries, zvichitungamirira ropa riyerere yakawedzera mavari uye chitarisiko dzakananga nezvekufadza.

Eritromelalagiya

Fani iyi kunoratidzwa yakasimba marwadzo pfupi-izwi iri nyore. Chinokurwadzai yavo kuwedzera platelet yomuropa mumidziyo diki mumakwenzi, zvichiguma nokuumbwa dzakawanda microthrombuses, arterioles Kukunda uye ichivharira ropa riyerere kuti munyama ari minwe. External zvinhu ezvinhu akadaro akatsvuka uye chitarisiko pamusoro ganda rinokwanisa kucheneruka mavara. Nechinangwa yokudzivirirwa thrombosis inokurudzirwa asipurini.

Splenomegaly (akawedzera chirwatata)

Kunze chirwatata, chiropa, uye rinogona kushandurwa, kana pane saizi yayo. mitumbi izvi dzinoshanda paumbwe uye kuparadzwa masero eropa. Kuwedzera wevasungwa neyokupedzisira zvinoisa nokuwedzera chiropa uye chirwatata.

Duodenal maronda uye dumbu

zvinorwadza kuvhiya zvokurwara kwakadaro anova nokuda duku mudziyo thrombosis zvomudumbu turakiti mucous membrane. Mugumisiro chakasimba kweropa zvirwere ndiyo necrosis (necrosis) muviri rusvingo mugove nokuita panguva yayo Nzvimbo urikanwi. Uyezve, akaderedza kuramba gastric helicobacter (a microorganism anokonzera urikanwi uye gastritis).

Ropa clots mumidziyo guru

Ko tichikurumidza chirwere ichi repasi richiripo mutsinga. Thrombi, kutiza kubva mudziyo parusvingo anogona, pavaigona kutora chikepe chaienda mwoyo, kuti kupinda munzvimbo pulmonary riparadzirwe (mapapu) uye kukonzera pulmonary embolism (pulmonary embolism) - mamiriro haawirirani upenyu.

ropa matadza

Kunyange zvazvo nhamba maplatelet mu peripheral ropa dzinosiyana uye kunowedzera coagulation kwayo, gingival ropa kunogona kuitika kana polycythemia.

gout

At dzakakwirira kwevari uric asidhi munyu aro iiswe majoini siyana uye kumutsa munhu unopinza marwadzo.

• Kurwadziwa maoko nemakumbo. chiratidzo ichi chinoita kukuvara gumbo arteries, kuderedza navo uye, sezvo zvakaguma murombo kutenderera. zvokurwara uyu anonzi "chirwere occlusive"
• Kurwadziwa flat mapfupa. Inosimudzira mwongo webasa (kukura nzvimbo masero eropa) zvinoita aikanganiswa mapfupa sandara kuti zvokuimba kushushikana.

Kushatiswa mukuru ezvinhu nhengo

Zvakadaro chirwere sezvo polycythemia, zvingaratidza kuva akafanana zviratidzo zvimwe zvirwere (semuenzaniso, kupererwa neropa): nomusoro, kugara kuneta, tinnitus, vertigo, kuvheneka "tingling" pamberi pemaziso, kupfupika mweya, ropa kusvikira musoro. Inosimudzira ropa viscosity ehupfumi zvaanopa simba compensatory maitiro midziyo, somugumisiro, pane kuwedzera BP. Apo chirwere ichi vanowanzova yematambudziko zvakadai mwoyo nokukundikana uye mikrokardioskleroza (kuzvitsinhanisa pakati connective zvinyama kwomwoyo tsandanyama, anozadza kuremara, asi asingadi kuita zvakafanira mabasa).

Diagnostics

Polycythemia zvinoratidza migumisiro vakawanda pachisara ropa, iro akawana:

• vazhinji masero matsvuku kubva 6,5 kusvika 7,5 • 10 ^ 12 / L;

• yakakwirira kwevari Chizenga - 240 g / L;

• zvachose erythrocyte (OOE) kukasapfuura 52%.

Sezvo nhamba masero matsvuku eropa hazvigoni dzaona maererano pamusoro dzakaenzana tsika, kushandiswa kuyera radionuclide kuongorora chirwere. Kana vakawanda masero matsvuku eropa mukuru 36 Rine mamiririta / makirogiramu nevanhu uye 32 Rine mamiririta / makirogiramu vakadzi, yakavimbika inoratidza pamberi Vakeza chirwere.

Kana polycythemia rakaramba Morphology masero matsvuku eropa, kureva ivo handishanduki wavo wenguva chimiro uye kukura. Zvisinei, pamwe kukura kupererwa neropa nokuda kwazvo ropa kana kakawanda bleedings vakachengeta microcytosis (kwakaderedza masero matsvuku).

Polycythemia: kurapwa

Good kuchirapa Basa ropa riyerere. Varumbidzwa pavhiki 200-300 ml ropa akabviswa kusvikira OOE kusvikira pamwero anodonhedza kuti aida ukoshi. Kana pane contraindications kuti ropa riyerere, umutse chikamu masero matsvuku eropa zvinogoneka pachishandiswa ropa dilution nokuwedzera mugove emura (macromolecular mhinduro dziri kupiwa nomutsinga).

Zvinofanira kurangarirwa kuti kazhinji ropa zvinoisa kukura simbi kushaikwa kupererwa neropa umo mune tsamba zviratidzo uye kuwedzera platelet count.

With chirwere ichi sezvo polycythemia, kurapwa kunoda zvaidiwa zvimwe zvokudya. Zvinokurudzirwa kuderedza kudya nyama uye hove zvigadzirwa, sezvo ane refu mari mapuroteni, kunomutsa basa ropa. Unofanirawo kurega zvakakora zvokudya. Remafuta akawandisa chinowedzera kukura atherosclerosis, kukonzera thrombi, izvo akawanda uye saka vari achiumbwa vanhu vachitambura kubva polycythemia.

With chirwere ichi, Zvinokurudzirwa kupa kupfuura dheri uye chirimwa zvigadzirwa, uye kuti dzisanyanya kurovedza muviri.

Uyewo, kana chirwere se "polycythemia", kurapwa zvingasanganisira mishonga. Kuzvishandisa panguva yakakwirira thrombocytosis uye zvikuru kuvaviwa. Kazhinji, izvi "cytoreductive mumiririri" ( "Hydroxycarbamide" gadziriro).

Kutozosvikira munguva ichangopfuura, kuti kudzvinyirira mwongo jekiseni radioactive isotopes inoshandiswa (yemanyorero, phosphorus-32). Nhasi, kuwedzera kuramba kurapa kwakadaro nemhaka mukuru mwero leukemic kushanduka.

Zvipatara rinewo majekiseni interferon kuti kurapa thrombocytosis yechipiri vaishandisa zvinodhaka "Anagrelide".

In chirwere ichi haawanzopiwi akaita mwongo transplantation, sezvo polycythemia - chirwere kuti haasi zvinouraya, chero bedzi, zvakakwana kurapwa uye kuramba zvichiongororwa.

Polycythemia vachangoberekwa

Polycythemia - mumwe zvokurwara, zviratidzo izvo zvinogona kuwanikwa vachangoberekwa. The chirwere ndiwo muviri achipindura Kutamiswa hypoxia mafufu, izvo zvinogona kunetsa placental insufficiency. mwana muviri kugadzirisa hypoxia anotanga synthesize vakawanda masero matsvuku eropa.

Nepakati kufema vakaumbwa, achangoberekwa anogona kuumba polycythemia Vera. njodzi yakadaro kunyanya zvikuru pachena pemapatya.

Polycythemia ari achangoberekwa anova pakutanga shoma vhiki upenyu, ndicho kuratidzwa kuwedzera hematocrit (60%) uye kuwedzera Chizenga nhanho yokutanga.

Neonatal polycythemia kuyerera ane dzakawanda matanho: kwokutanga, danho poliferatsii uye kuneta. tsanangura muchidimbu navo.

The kutanga kwekupwanyiwa hosha haina zvokuti hapana chero zvekuchipatara kuratidzwa. Polycythemia dzinoratidza mwana Panguva iyi zvinokwanisika chete nezvidzidzo zviri peripheral ropa: hematocrit, Chizenga pamwero uye masero matsvuku eropa.

At danho poliferatsii hwapedyo yakawedzerwa chiropa uye chirwatata. Pletoricheskie vakacherechedza zviitiko: ganda wana anozivikanwa "pletoricheski tsvuku" Hue, mwana rinoratidza mwoyo kana mwoyo ganda. Pletorichesky chirwere kuzadzikiswa thrombosis. The Kuongorora vakachengeta shanduko iri nhamba masero matsvuku eropa, maplatelet uye leukocyte kuchinja. Zviratidzi masero eropa anogona ngazviwedzerwe, zvakadai kutanga anonzi "panmieloza".

Step kuparadzwa kunoratidzwa yakawanda uremu, asthenia uye kuneta.

For achangoberekwa zvekuchipatara kuchinja kwakadaro zvikuru inorema uye kungakonzera kusingarapiki kuchinja uye rufu yaizotevera. Polycythemia anogona kuva kukanganisa kuva imwe mhando chena ropa masero kuti vari kukonzera mutumbi zvirwere. Somugumisiro, mucheche yakatanga zvirwere zvakakomba kwemabhakitiriya hunhu, zvichitungamirira pakupedzisira rufu.

Pashure kuverenga nyaya ino, uchadzidza zvakawanda nezvechirwere ichi sezvo polycythemia. Zviratidzo uye kurapwa vaionekwa nesu zvikuru zvakadzama sezvinobvira. Tinovimba mashoko akapiwa achava richishanda kwauri. Zvichengetedze uye vaine utano!