Agranulocytosis - Iyini? Agranulocytosis ezinganeni nakubantu abadala: Izimpawu, izimbangela kanye nokwelashwa

Laboratory ukuhlola igazi enze cishe zonke izifo. Lokhu ixhunyiwe okuqukethwe ilwazi we Assay. On izinguquko nemingcele ngazinye igazi kungabonwa etiology yesifo, ngobucayi inqubo sokugembula. Ulwazi on the ukwanda noma ukwehla plasma amaseli ezithize ivumela ukwephulwa othize okusolwayo. Ngokwesibonelo, wegazi, izinhlobo ezahlukene igazi. izimpawu Omunye laboratory kubhekwe agranulocytosis. Lesi sifo, okuyinto kungenzeka eyedwa noma inhlanganisela nezinye izinguquko egazini. Lesi sibonakaliso kubonisa khona ukutheleleka ezinzima.

Agranulocytosis - Iyini?

Izifo yegazi ababehileleke kwezesayensi Haematology. Ukwephulwa kwe-, okhombisa inqubo ezinzima sokugembula kuyinto agranulocytosis. Lesi sifo libhekene ukwehla okukhulu izinga wamangqamuzana egazi amhlophe - leukocyte. Ziyakwazi adingekayo ukuze ukulawula izinto ezithwala izifo ukungena emzimbeni ngesikhathi ukutheleleka.

Jwayelekile ezimhlophe cell segazi ilingana 4-9 x 10 ⁹ / l. Ukwanda kwenani kula maseli kubonisa ukuthuthukiswa focus ukuvuvukala. Ukuswelakala kokusebenza ngokuhlanganyela emangqamuzaneni egazi amhlophe kungakhishwa zenzeka lapho ukwehluleka kwesimiso somzimba sokuzivikela ezifweni, okusithiyayo of hematopoiesis, ukudakwa. Agranulocytosis - a syndrome laboratory libhekene ukwehla izinga amangqamuzana amhlophe egazi ukuze 1 x 10 ⁹ / l noma ngaphansi (neutrophil - 0.75 * 10 ^9). Ngenxa ukuntula evelele amaseli omzimba kukhona izinqubo ezihlukahlukene ezithathelwanayo omsakazo webhaktheriya noma ezibangelwa amagciwane. Ukuhlonza syndrome, ukuhlolwa kwegazi emitholampilo kuyadingeka.

Imvamisa okuvela agranulocytosis

Lesi sifo hematologic kwenzeka phakathi labantu kwabesifazane nabesilisa. agranulocytosis azalwa naso kuyaqabukela kulotshwe, uma ziqhathaniswa isifo kuluthola. Ngokufanayo, izinguquko ukwakheka kwamangqamuzana igazi bathambekele kakhudlwana kunabanye abesifazane asebeqinile noma (kusukela eminyakeni engu-40). Imvamisa lesi sici lab ihlukile emazweni ahlukahlukene. Ngokwesilinganiso, agranulocytosis ezitholakele 1 aphume 1200 abantu. • Ukunciphisa okuphawulekayo inani egazi amhlophe bathambekele kakhudlwana kunabanye kwabaMhlophe.

Izizathu sokuthuthukiswa agranulocytosis

Kungani ukuthuthukisa agranulocytosis? Izizathu zalokhu isimo sokugembula kuncike ezihlukahlukene sifo. agranulocytosis azalwa naso kubangelwa izici zofuzo eziyingozi. Lesi sifo libhekisela pathologies kunqunywa zofuzo. Ubungozi ukuthi ingane ezalwe kusuka umama ogulayo noma uyise, kuyokwenzeka yilesi sifo kakhulu. Izizathu okubangela agranulocytosis atholwe zihlanganisa:

1. izifo sokuhlasela kwamasosha omzimba. pathologies ezinjalo omzimba izicubu erythematosus, scleroderma, i-rheumatoid arthritis. Kulezi izifo, ukuzivikela mzimba hhayi kuphela okuhloswe ngaso izinhlayiya zakwamanye amazwe, kodwa futhi ku amangqamuzana omzimba siqu.
2. Ukuchayeka ionizing emisebeni. Lokhu isici kuholela ukucindezelwa akuyona kuphela ezimhlophe, kodwa futhi abomvu lwegciwane hematopoietic.
3. Ukuthola imithi cytostatic. Lezi imithi akhonjiswa izifo rheumatism futhi umdlavuza. Ububi ukwelashwa nge cytostatics wukuthi imithi abulale amangqamuzana evamile.
4. kwesikhathi eside ngokwanele kwemithi elwa namagciwane (isb, isifo sofuba), ama-NSAID namanxusa antiparasitic.
5. ngamagciwane okunzima. Ukuncipha elibukhali inani neutrophil kungabonakala nasemkhakheni ukusha kwesibindi kohlobo viral, isimungumungwana ne-rubella, ingxibongo, umkhuhlane, nokunye. D.

Kuyaphawuleka ukuthi agranulocytosis akusona isifo ezimele. Lesi sifo asikwazi ukuthuthukisa ngaphandle ngenxa yesizathu esithile. Yena njalo namanye imiphumela sokugembula.

Mshini yentuthuko agranulocytosis

Neutrophil kukhona esivikelo egazi. Basuke kwakheka umnkantsha futhi zakhululwa inqwaba ngokuqhubekayo. akhawunti La mangqamuzana cishe u-70% ama-leukocyte Imininingwane. Ukungabikho ukuthuthukiswa igazi lazo izakhi ethuthuka neutropenia. Agranulocytosis kubhekwe amafomu eziseqophelweni isimo. ukuntula azalwa naso we neutrophil kanye Imininingwane amangqamuzana amhlophe count kwenzeka ngenxa yokubakhona isakhi sofuzo ongaphilile.

Ngenxa yalokho yezici exogenic, ukuthuthukiswa kwamangqamuzana amhlophe egazi kuyehla noma eyeka ngokuphelele. Esinye isimiso esikwazi yalesi sifo kubhekwa ukukhiqizwa kwamasosha omzimba kuya neutrophil. Ngakho, lapho agranulocytosis. Ukuhlolwa kwegazi ngesikhathi esifanayo zizoshintsha cishe ngokushesha. Phela, ngesikhathi impilo neutrophil kunalokho iDemo. Kuyinto kusuka 2 kuya 3 izinsuku.

Ukwahlukanisa izimo zokucabanga okubangelwa isifo

Kuye imbangela futhi indlela pathogenetic secrete ngeengaba eziningana agranulocytosis. Ngokusho lokhu, angawodwa azalwa naso futhi wathola nokuntuleka neutrophil. Esimweni sokuqala, lesi sifo hematological kwenzeka lapho pathologies elandelayo zofuzo:

1. isifo Granulomatous.
2. neutropenia kwamalungu omkhaya.
3. Shvahmana-Dayemonda syndrome.
4. Kostmann isifo.
5. Syndrome Shediac-Shtaynbrinka-Higashi.
6. aleukia azalwa naso.

ukuntula Kutholiwe amangqamuzana amhlophe egazi sehlukaniswe sokuhlasela kwamasosha omzimba, futhi hapten agranulocytosis myelotoxic. Ngayinye yalezi amafomu has indlela yayo yentuthuko. Ezansi inqubo sokugembula isehlane oyingozi futhi uthi ezingamahlalakhona agranulocytosis. Futhi kule ngezigaba kusekelwe kobukhulu syndrome.

Incazelo mzimba agranulocytosis

agranulocytosis Immune ezihambisana nemiphumela sokugembula omzimba phezu abomvu egazi. It kungadalwa kokubili indlela endogenous futhi exogenous. Esimweni sokuqala, lesi sifo kwenzeka ngenxa kuhlasela sokuhlasela kwamasosha omzimba. isimo okunjalo kuholela ekuphikeni letindzala zezinzwa izicubu iziyaluyalu. Omzimba amaseli azishintshiwe ukubunjwa, kodwa kungathi "reprogrammed." Ngenxa yalokho, baqala melanani kwezicubu umzimba uqobo. Granulocytes ngokushesha ovuthiwe futhi self-izobhujiswa. izici Exogenous kulokhu kukhona isidingo. mzimba agranulocytosis syndrome kwenzeka pathologies onjalo afana ngazo omzimba izicubu erythematosus ne-rheumatoid arthritis. Ngesikhathi esifanayo kusilela of neutrophil kuhlangene ukuntula nezinye egazi.

Enye okufana lesi sifo, okuyinto eyenzeka ngo-isizinda izinqubo mzimba, a agranulocytosis hapten. Kuleli fomu yenqubo sokugembula bakhiqiza i omzimba ukuba neutrophil. Umehluko wukuthi lapho kukhiqizwa awuwedwa, futhi ngemva kokuthatha kunemithi noma amaphilisi owaphuzayo - hapten. engayitholi okuphindiwe lezi izinto kubangela amasosha omzimba obonakaliswe granulocytes ekubhujisweni. I haptens ingaba njengesihluthulelo ezinye imithi elwa namagciwane, ama-ejenti antiinflammatory futhi hypoglycemic, barbiturates.

Incazelo myelotoxic agranulocytosis

agranulocytosis Myelotoxic eba ngenxa amathonya exogenous. Ngaso sonke isikhathi kuhlanganiswe erythromycin futhi thrombocytopenia. Ezimweni eziningi, okufana myelotoxic lesi sifo lihlotshaniswa ukuchayeka ezintweni chemotherapeutic futhi ionizing emisebeni. Lezi zici eziholela okusithiyayo of hematopoiesis emazingeni aphansi ngendlela. Ukuze izidakamizwa cytostatic ezibangela ukusabela okufanayo libhekisela cyclophosphamide, fluorouracil, mercaptopurine, njll D. okusithiyayo of hematopoietic sikakhokho amaseli kuholela ekuncipheni kwenani granulocytes umnkantsha. Lokhu kungenxa nokuvuthwa kuphazamiseka igazi amagciwane.

Ngaphezu amathonya exogenous, ukungabi amaseli hematopoietic kwezinye zezintaka sokuntuleka kwegazi kanye wegazi. Lezi zizathu okuvame ukubangelwa agranulocytosis ezinganeni. Ngokuvamile, izinguquko hematologic kukhona sitholwa njengefa. Izibonelo kubhekwe hemolytic futhi anaemia aplastic, Fanconi Syndrome. Oyingozi futhi ezingalapheki wegazi myelogenous eba ebuntwaneni futhi abantu abadala.

Agranulocytosis: izimpawu

granulocytes ezinganele ephelezelwa ukubonakaliswa emitholampilo ezinzima. Zingase zihluke, kuye ngokuthi isifo eziyimbangela, okwaholela okuvela neutrophil ukuntula. Kanjani agranulocytosis? Ngezimpawu zesifo:

1. ubuthakathaka Sinzima.
2. Imfiva ephezulu.
3. Lymphadenopathy.
4. Hepatosplenomegaly.
5. izilonda Necrotic ka nolwelwesi lwamafinyila.
6. Oluhambisana syndrome.

agranulocytosis Hapten, ngokungafani nezinye izinhlobo, libhekene inkambo oyingozi. Iziguli azizwe kabi kakhulu ngokushesha eba imfiva, kukhona izilonda emlonyeni. Umonakalo izinsini, amalaka, uvula, ulwanga ezithambile iqhubeka, okuholela izicubu necrosis. It kuhambisana ubuhlungu, ukungakwazi ukugwinya, amathe ngokweqile.

Lapho myelotoxic agranulocytosis okufana ngokuvamile ukuthuthukisa ukopha. Basuke exhunywe hhayi kuphela ulceration ka nolwelwesi lwamafinyila, kodwa futhi nge platelet ukuntula. acinene emakiwe, gingival, lesizalo, ukopha emathunjini. On the isikhumba avele hematoma. Ngenxa izinqubo isilonda-necrotic emathunjini waphawula uhudo, ubuhlungu besisu. Ngenxa nenshisekelo wegazi eba oluhambisana nenyumoniya.

Ushintsho E-assays i-agranulocytosis

Ngokuvamile ukuthuthukiswa agranulocytosis kwenzeka abanomdlavuza, eluhlelweni kanye nezifo ezimbi ezithathelwanayo. Lesi sifo kungaba esolwa izici ezifana imfiva, ukukhathala kanye ukubukeka ulcer emlonyeni. Kunzima kakhulu ukuxilonga agranulocytosis azalwa nako. Ukuhlolwa kwegazi kuyadingeka ukwenza e pallor okunzima isikhumba ingane, ukubonakaliswa oluhambisana. Kucwaningo kukhona ukwehla leukocyte (ngaphansi kuka-1 * 10 ⁹ / l). ivame ukuhlanganiswa igazi futhi thrombocytopenia.

Ukuze sithole izimpendulo, nganoma isiphi isizathu, bahlakulele syndrome hematological, enze immunogram wokubhoboza futhi umnkantsha. Ukuxilonga yobunzima obabangelwa nokuntuleka granulocytes kwenziwe ucwaningo wezinsimbi. Phakathi kwabo - esifubeni-X-ray, colonoscopy. Lo mbono uphinde udinge iseluleko kuchwepheshe - Otolaryngologist, oncologist, udokotela wamazinyo, wamathambo futhi gastroenterologist.

Pathology Izindlela yokwelashwa

Dinga esibhedlela nesineke, uma kutholakala agranulocytosis. Ukwelashwa siqukethe ekwelapheni evele ulcerous futhi necrotic ejenti isinqandakuvunda, amalungiselelo wamafutha. Ukuze isiguli hhayi ngaphansi igciwane yesibili, ibekwe ekamelweni we isolator. Uma ezilimele mucosa emathunjini lusekelwa ngamandla umzila parenteral.

Imithi yokwelapha agranulocytosis

Ukuvimbela ukuthuthukiswa ukutheleleka (pneumonia, sepsis), ama-antibiotic kanye nemithi antifungal. Ngemithambo yegazi iqondiswa imikhiqizo yegazi, mass ikakhulukazi leukocyte. Lapho agranulocytosis mzimba kuboniswe nemithi hormone. Lezi zihlanganisa "Hydrocortisone" izidakamizwa "Prednisolone". Uma lesi sifo sibangelwa okusithiyayo of hematopoiesis, ejenti ukuvuselela iqondiswa. Phakathi kwabo kukhona ikhambi "Granocyte", "leucogen", "Virudan". Ukwelashwa Kwenziwa emnyangweni Haematology.

Ukuvimbela agranulocytosis ezinganeni nakubantu abadala

Ukuvimbela agranulocytosis azalwa naso kuhlanganisa ukuthola zesifo. Kuze kube yimanje, izingane enze CBC ngonyaka. Ngu ekuvimbeleni izinyathelo zihlanganisa ukuqapha seziguli ezithola imithi cytotoxic, anti-sikashukela imithi. Uma isiguli kwake eqaphela indlela abasabela hematological nokuphathwa kwezidakamizwa ezithile, le mithi ayikwazi liqokwe.

Isibikezelo ziphile agranulocytosis

Onalesi sifo incike imbangela yalesi sifo. I uhlobo oluvame kakhulu i-agranulocytosis hapten, njengoba ngokushesha ukuthuthukisa izicubu necrosis. Sokuhlasela kwamasosha omzimba futhi myelotoxic umonakalo sibonga esilaphekayo yokwelapha esikhundleni. Izibikezelo Kubi ebonwe ukuthuthukiswa yezinkinga we zokugula ecashile. Phakathi kwabo - ukopha okukhulu, perforation odongeni wamathumbu, inyumoniya oluhambisana, sepsis.