Syndrome Sideropenic e ayoni anemia: iimpawu, unyango

Iron - yenye yezinto, ngaphandle apho umzimba womntu azikwazi ukusebenza ngokupheleleyo. Noko ke, kukho ingozi yokuba iphula izinto zakhe nemiphumela yeemeko ezahlukeneyo kunye neenkqubo. Enye yezona ngxaki iqhelekileyo ayoni anemia (Ida). Kunokuba ukuphuhlisa abantwana kunye nabantu abadala, kwaye nkqu abasetyhini abakhulelweyo basengozini. Banikwa bonke amandla etshabalalisayo izifo, kuluncedo ukufumana iinkcukacha ngakumbi.

Kuthetha ukuthini i-anaemia ayoni?

Phambi ukufunda syndrome sideropenic kunye ayoni anemia, kufuneka bachukumise Ingcambu ingxaki ezinxulumene ne yokunqongophala umkhondo element. Olu hlobo kwegazi yimeko zophendlo lwezifo iphawulwa ukuhla kwinqanaba mpilo egazini ngenxa ukuswela olubonakalayo yesinyithi emzimbeni. Ngqo kusilela kubonakala ngenxa nokuhluthwa irisithi yayo kunye nokwenziwa, okanye ngenxa ukulahleka zophendlo lwezifo lwesi sakhi.

Ayoni anemia (aka sideropenic) kwahlukile ezininzi kwezinye anemias ukuba ukuba ngaba kukho ukwehla iiseli ezibomvu zegazi. Kwiimeko ezininzi banesifo kwabasetyhini yokuzala, abasetyhini abakhulelweyo kunye nabantwana.

Ezibangela isifo

Kuqala kufuneka ubonise ubungozi, ezinokuthi zenzeke xa deficiency yentsimbi. ukusetyenziswa Ukwanda yesinyithi, nto leyo kulandele igazi ezinokubangelwa lokukhulelwa ngokuphindaphindiweyo ixesha sexesheni intabalala ukukhula ngokukhawuleza lokwaphusa ngexesha pubertantnogo xesha. Abantu abadala kuthi kuphazamisane ukusetyenziswa yentsimbi. Kwakhona inani kwezifo saka apho anemia yandiswa ngokubonakalayo (diverticulosis emathunjini, insufficiency sezintso, oncopathology et al.).

Ungakhathazeki ngengxaki efana imibala intsimbi, oko kuyimfuneko enkulu kwaye mzekelo, xa eyayiphazamisa ukufunxeka lwesi sakhi kumgangatho erythrokaryocytes (ngenxa inani elingonelanga intsimbi ekutyeni). Njengoko ezibangela ayoni anemia, iyavakala ukuzinyanga zonke izifo ezikhokelela ukopha. Oku izilonda thumba kunye neenkqubo kwisiqwenga zesisu, endometriosis, hemorrhoids ezingapheliyo kunye nabanye. Kwiimeko ezinqabe kakhulu, ukuze babonwe ukulahleka igazi Meckel diverticulum ye emathunjini amancinci, apho isilonda Peptic ngenxa nokusekwa zehydrochloric acid kunye peptin.

Izinto ezibangela ayoni anemia esinxulunyaniswa nangezilonda glomicheskimi emiphungeni, pleura kunye uvalo, ngokunjalo kwi mesentery yethumbu kunye nesisu. Ezi nangezilonda, leyo unodibaniso ngqo yokuvala kwemithambo, unako ulcerate waba umthombo ukopha. maxa wambi yokopha elisekwe Enyanisweni kwimeko njengelifa okanye ezifunyenwe siderosis yemiphunga, nto leyo nzima legazi. Ngenxa yale nkqubo, intsimbi emzimbeni womntu kwiwebhsayithi, kulandele ngako ukuhluba umphunga lwakhe ngohlobo hemosiderin ngaphandle ithuba zokulahla olulandelayo. Ilahleko yesinyithi umchamo ibe ngenxa kwindibaniselwano kwezifo ezifana glomerulonephritis ezingapheliyo kwaye ziyafikelelwa ukukhanya hemosiderosis, ukuba imvelaphi sokuhlasela.

Ngamanye amaxesha izinto ezibangela kwegazi ayoni ezinxulumene ilahleko intsimbi kunye negazi, ezinxulumene ngqo isiphumo helminth athe zingene eludongeni isisu, ebangela umonakalo kulo kwaye, ngenxa yoko, mikrokrovopoteri nga ezikhokelela kuphuhliso Ida. Umngcipheko olu hlobo kwegazi ukho kwabo kubaxhasi abo banikela ngegazi rhoqo. Kwaye njengokuba esinye legazi isizathu, ufanelwe ingqalelo, kunokwenzeka ukuba ukumisela hemangioma amalungu zangaphakathi.

Intsimbi emzimbeni womntu nokuba kakubi wendele ngenxa izifo ezincinane kwamathumbu, ezifumaneka kunye malabsorption syndrome dysbacteriosis emathunjini kunye resection emathunjini amancinci. Ngaphambili, unga kaninzi kukhawulela imbono yokuba gastritis atrophic, akuba kunciphise umsebenzi secretory, kwafuneka ukuba siqwalasele njengoko oyena nobangela ayoni anemia. Enyanisweni, isifo esinjalo iyakwazi ukunikezela nempembelelo abangabancedani kuphela.

Ukuswela yentsimbi efukamileyo (ifihliwe, ngaphandle iimpawu zonyango) kungabonwa kwinqanaba ezinto eziphilayo. Lubonakala ngokuba ukuswela okanye ukungabikho ukuncipha elibukhali efakwa ngethambo microelement macrophage ezinomongo, leyo kuchongwa umbala okhethekileyo. Iyafuna ephindaphinda ukuba kwesi sigaba, ilahleko intsimbi kungabonwa kuphela kwiimeko elebhu.

Enye inkalo, leyo evumela ukuba ukuchonga intsilelo - ukwehliswa serum ferritin.

Iimpawu uphawu yentsimbi kaGawulayo anemia

Beneempawu aqondwe ngcono, iyavakala ukwahlula inkqubo ukuyilwa deficiency yesinyithi nezigaba-3.

Ethetha kwinqanaba lokuqala, kubalulekile ukuqaphela ukuba akukho lukhatshwa iimpawu zonyango. Oku uyakwazi ukubona kuphela ngokumisela ubuninzi ukufakwa intsimbi radioactive kwisiqwenga zesisu kunye nenani hemosiderin, nto leyo iqulethwe macrophage lomongo wethambo.

Inqanaba lesibini linokuchazwa njenge intswelo intsimbi afihlakeleyo. Ubonakala ukuncipha umthambo ukunyamezelana kuzipha ebalulekileyo. Zonke ezi iimpawu zibonisa ngokucacileyo ukungabi yesinyithi ancedisana ngenxa ukuhla xi enqanda yentsimbi-equlethe. Kule meko, iinkqubo ezimbini zenzeka ngexesha elinye: ekunciphiseni amanqanaba ferritin kwi erythrocytes kunye serum, kwakunye nokungabikho Ukwanda transferrin yentsimbi.

Ngaphantsi kweqonga wesithathu kuyimfuneko ukuqonda imbonakaliso bezonyango belo ayoni anemia. Iimpawu eziphambili eli thuba ekunokuthiwa ukuphazamiseka trophic ulusu, izikhonkwane, iinwele, iimpawu sideropenic (ekhathala kwaye ubuthathaka), ukukhula ukuba buthathaka kwezihlunu, ukuphelelwa umoya kunye iimpawu ukusilela yobuchopho kunye kwentliziyo (unkenteza ezindlebeni, isiyezi, iintlungu esifubeni, niphele ).

Ziimpawu sideropenic ngexesha inyathelo wesithathu isebenza umnqweno ukuba adle ngetshokhwe -. Geophagy, dysuria, ngumchamo wokuchama, nenkani ipetroli ivumba, acetone, njl Ngokuphathelele geophagic, oko ukongezelela deficiency intsimbi kusenokuba kubonisa ukungabi kumzimba magnesium zinc.

Ichaza iimpawu oqhelekileyo imibala intsimbi, kubalulekile ukuba sinikele ingqalelo iimpawu ezifana buthathaka, ukulahleka wokutya, syncope, iyangongoza, intloko ebuhlungu, ukuba nochuku, libya uxinzelelo lwegazi obumbeneyo njengembumbulu "iimpukane" phambi kwamehlo, ukulala kakuhle ebusuku kunye nobuthongo emini, ukunyuka kancinane lobushushu, ukuncipha ingqalelo kwaye nenkumbulo, kwakunye tearfulness kunye luvalo.

Impembelelo sideropenic syndrome

Kubalulekile ukuqonda ukuba nentsimbi licandelo enqanda ezininzi. Ngenxa yesi sizathu, xa kukho ngxaki, umsebenzi enzyme lifinyele yaye ngexesha iinkqubo eziqhelekileyo pathways emzimbeni egxobhekile. Ngenxa yoko, sideropenic syndrome na unobangela iimpawu ezininzi:

1. utshintsho Skin. Xa kukho ukuswela yentsimbi, kunokuthi kubonwe ukuxobuka kwaye kome kakhulu eluswini, leyo ekugqibeleni iintanda. Kukuvela iintanda ukuze amasundu, iimbombo emlonyeni, kwaye nkqu iinyawo ingquza. Hair nale syndrome ekuqaleni Wajika ndiyingwevu, zaqina uze uwe ngenkuthalo. Malunga nekota izigulane abajongene striations nkum hedge kunye ezinqamlezayo nakwiinzipho. Ijwabu ayoni Oku ngenene ngenxa yokunqongophala enqanda zeethishu.
2. Utshintsha inkqubo dystrophy. Iron Iziphumo ukunqongophala kukuswela enzyme myoglobin kwi esihlunwini. Oku kukhokelela lidiniwe buthathaka. Xa abakwishumi elivisayo, kwakunye ebantwaneni, ukunqongophala yesinyithi enqanda evusa ulibaziseko yophuhliso ngokwasemzimbeni kunye nokukhula. Ngenxa yokuba inkqubo dystrophy ukuba buthathaka, isigulana uvakalelwa ezimisele nezinyanzelisayo ukuchama, ubunzima ngokubamba umchamo xa ehleka kunye ekhohlela. Amantombazana kunye deficiency yentsimbi kaninzi kuye kufuneke ukuba bajongane bedwetting.

sideropenic syndrome kuyayitshintsha kwiinwebu iphecana wamathumbu (neentanda iimbombo emlonyeni, stomatitis emboxo, ukwanda susceptibility ukuya yidityaniso kunye nezifo periodontal). Kwakhona, kukho utshintsho kwimbono ziziqhumiso. Ekubeni onjalo syndrome izigulane baqale ungathanda ivumba yezihlangu, ioli amafutha, ipetroli, irhasi, naphthalene, acetone, emhlabeni emanzi emva kwemvula, ivanishi.

Utshintsho kuchaphazele incasa. Kungumnqweno kakhulu angcamle iimveliso nonfood ezifana izinyo powder, intlama ekrwada, umkhenkce, isanti, udongwe, inyama okuthambile, okuziinkozo.

Xa isifo ezifana sideropenic syndrome, imazi ibonakalisa abafani inwebu iphecana yokuphefumla eliphezulu nengasezantsi. Olo tshintsho kukhokelela kuphuhliso nokuthimliswa atrophic kunye pharyngitis. Uninzi lwabantu abane-ayoni syndrome kubonakala sclera oluhlaza. Ngenxa yokuhlukunyezwa gidroskolirovaniya lysine ukungasebenzi kwenzeka kule nkqubo collagen yokuqaphela.

Ukuba deficiency intsimbi umngcipheko yeenguqu yamajoni omzimba. Sithetha ukuthoba izinga immunoglobulins ezithile, B-lysine, kunye lysozyme. Kwakhona, kukho ulwaphulo-mthetho umsebenzi phagocytic of neutrophils kunye nezifo zeselula.

Xa ingxaki ezifana sideropenic syndrome, hayi ngaphandle ukuvela utshintsho dystrophic ngamalungu angaphakathi. Ezi ziquka zasesekondari sideropenic engabalulekanga igazi. Oku kubonakala ngokomeleza pitch yokuqala njengezona intliziyo kunye nokwandiswa imida zibuphekhashini anozizi.

Ayoni kwakhona ukutshintsha kunye nemeko lokugaya. Sithetha malunga neempawu ezifana dysphagia sideropenic, inwebu eyomileyo kwiinwebu emphinjeni kwaye mhlawumbi intshabalalo yayo. Izigulane baqala ukuva ubunzima yokuginya ebusuku okanye kwimo komzimba. Kuthi kuphazamisane lolwabo yokuphefumla, okukhokelela yoma ngcembe le isifo esiswini, ukuphuhlisa apho gastritis atrophic. syndrome Sideropenic kwaye kungakhokelela ekuncitshisweni secretion esiswini, nto leyo kungabangela ahilii.

Kutheni ayoni anemia amabhinqa akhulelweyo?

Xa abafazi wozeleyo inkwenkwe, deficiency yentsimbi inokuba ngenxa inkangeleko kwezifo extragenital kunye yamanina phambi lokukhulelwa, kwakunye imfuno ophezulu nentsimbi Palsy.

izinto ezininzi nefuthe kukuvela izifo ezifana kwegazi. Iron ukuhluleka abasetyhini abakhulelweyo, njengoko umthetho, ephuhliswe ngenxa yezi zizathu zilandelayo:

• ikhankanywe ngentla ekstragenital'nye izifo ezingapheliyo (isifo sentliziyo, isilonda duodenal nesisu, gastritis atrophic, ukusilela kwezintso, zintwala helminthic, izifo zesibindi, izifo ukuba zihamba kunye epistaxis, kunye hemorrhoids);
• ifuthe iikhemikhali umfazi wakhe umzimba ezahlukeneyo kunye zinambuzane, ezinako ukukulumkisela zinqanda ukufunxeka yesinyithi;
• intswelo naso;
• ukuphazamiseka kwenkqubo yentsimbi yokufunxa (pancreatitis ezingapheliyo, enteritis, resection of namathumbu amancinci, dysbiosis emathunjini);
• ukutya engafanelekanga, nto leyo nako ukunika unikezelo kwi isiqalelo mkhondo emzimbeni kwi mali efunekayo.

Iron ukuhluleka abantwana

Ngalo lonke ixesha ukukhulelwa xa umzimba umntwana ukuyilwa ubume olusisiseko element mkhondo ngegazi. Noko ke, ukuziswa intsimbi kakhulu njengesebenzayo izitya placental ibonakala leenyanga ezintathu lesithathu. Xa umntwana ngokupheleleyo elide amanqanaba eziqhelekileyo ngawo umzimba kufuneka ilingane 400 mg. Kulo mzekelo, abo abantwana abazalwa ngaphambi elide, esi salathisi lingaphumi ngentla 100 mg.

Kubalulekile ukuqwalasela into yokuba ubisi lwebele iqulethe ngokwaneleyo lwesi sakhi mkhondo umzimba umntwana wemvula phambi kweenyanga-4 ubudala. Ngoko ke, ukuba kusekutsha kakhulu ukuba uyeke ukuluncancisa, umntwana aphuhlise deficiency yentsimbi. Izinto ezibangela ayoni anemia ebantwaneni esinxulunyaniswa nalo ixesha siswini. Sithetha zizifo ezahlukahlukeneyo ezosulelayo kukamama ngexesha lokukhulelwa, ekuqaleni kunye toxicosis kade kunye hypoxia syndrome. Kuchaphazela kwamanani intsimbi ukuze izinto ezifana nokukhulelwa ezininzi xa ukutofelwa foetal alcohol syndrome, ezingapheliyo anaemia ayoni ngexesha lokukhulelwa, kunye zesibeleko-placental ukopha.

Ingozi intrapartum ixesha ukopha esikhulu ngexesha unikezelo nokushwabana wokubopha nentambo. Ngokumalunga kwixesha post-Natal, ngeli nqanaba deficiency yentsimbi kunokuba iziphumo izinga olukhawulezisiweyo ekukhuleni komntwana, ekuqaleni zilunyulwe ubisi lwenkomo yonke kunye nezifo, ezo zikhatshwa ukufunxeka emathunjini.

Uvavanyo igazi ukufumanisa shandi

Le ndlela loxilongo siyafuneka ukuze ukujonga amanqanaba kuncitshiswa mpilo kunye neeseli ezibomvu zegazi. Ingasetyenziswa ukuchonga hemolytic anemia kunye imibala intsimbi, imibhobho iimpawu morphological iiseli abomvu zipakishwe iiseli ezibomvu.

Kwimeko ka-Ida igazi chemistry ngokuyimfuneko kuya kuncipha kwi uyondelelwano lwee- serum ferritin, ukwanda TIBC, bewuhlisele ndzo yesinyithi serum kunye ngaphantsi kakhulu kunesiqhelo transferrin Ukwanda data umkhondo element.

Kubalulekile ukwazi ukuba imini phambi kokuba unikezelo yokuhlaziya akakwazi ukusela utywala. Akukho mfuneko yokuba badle iiyure 8 phambi kokuxilongwa kuvumelekile amanzi acocekileyo kuphela ngaphandle gas.

diagnosis umehluko

Kulo mzekelo, kunceda kakhulu lokufunyaniswa sifo unako imbali. Ayoni anemia rhoqo ukuvela imvelaphi nezinye izifo, ukuze lwazi kuya kuba luncedo kakhulu. Ke ukuba kusondelwe umahluko ukuba lokufunyaniswa ayoni anemia, ukuba lwenziwa ezo zifo ezinokubangela deficiency yentsimbi. Ngaloo thalassemia luphawulwa erythrocytes zonyango kunye zaselebhu imiqondiso shemoliza (ubukhulu udakada banzi, ukwanda amanqanaba yibilirubin ngqo, igazi hypochromic, reticulocytosis kunye nesiqulatho nentsimbi eziphakamileyo yokugcina kunye serum igazi).

Iindlela zonyango

Ukuze soyise ngxaki efana nokungabikho yentsimbi egazini, kuyimfuneko ukuya ngobuchule isicwangciso ekuphulukenwe nalo. Isigulana ngasinye kufuneka ibonakalaliswe indlela ngamnye, kungenjalo inqanaba efunekayo ucikizeko lwezi zongenelelo isiqabu ukufikelela nzima.

Xa loo ngxaki ukunqongophala intsimbi emzimbeni, unyango kakhulu ibandakanya ukuvezwa ngu into omnye afune anemia. Ukulungiswa kwale meko ngamayeza kudlala indima kwinkqubo ekuphulukenwe nalo.

Ingqalelo kufuneka ihlawulwe kunye nesondlo. Le imbijana izigulane Ida kufuneka zibandakanywe iimveliso eziqulathe heme yentsimbi. Le inyama umvundla, yemvu, yenkomo. Musa ukulibala succinic, citric kunye ascorbic acid. Gcwalisa deficiency intsimbi kuya kunceda ukusetyenziswa fibre, calcium, oxalate, kunye polyphenols (kwiproteni ye-soy, iti, ikofu, itshokolethi, ubisi).

Ngokumalunga nesihloko sonyango lwezonyango ngokubhekiselele, kubalulekile ukuba uqwalasele ukuba amalungiselelo ensimbi anqunywe yikhosi ukusuka kwi-1.5 ukuya kwiinyanga ezimbini. Emva kokuba izinga le-Hb liqheleke, unyango lokulondolozwa luboniswa ngesilinganiso sehafu yesilwanyana kwiiveki ezi-4-6.

Izidakamizwa eziphathekayo zentsimbi ye-anemia zithathwa ngesantya se-100-200 mg / ngosuku. Emva kokuba i-dosage iyancishiswa ibe yi-30-60 g (iinyanga ezi-2-4). Phakathi kwezona zidumileyo zilandelayo iziyobisi: Tardiferon, Maltofer, Totema, Ferroplex, Sorbifer, kunye neFerrum Lek. Ngokuqhelekileyo, amayeza athathwa ngaphambi kokutya. Ngaphandle kwezigulane ezinegastritis kunye nezilonda. Amayeza angentla angenakuhlamba kunye nemveliso enokubambisa isinyithi (ubisi, itiye, ikhofi). Ngaphandle koko, isiphumo sabo siya kuncitshiswa. Okokuqala kufuneka ukuba uqaphele umphumo ongenalingozi onokuthi uvelise izidakamizwa ezinesinyithi kwi-anemia (echaza umbala omnyama wamazinyo). Musa ukwesaba ukuphendula okunjalo. Ngokumalunga nemiphumo engathandekiyo yokunyango lweziyobisi, kunokubakho ukuphazamiseka kwamathumbu (ukumbomboza, iintlungu zesisu) kunye neentlanzi.

Indlela eyona ndlela yokulawula iziyobisi ngokungenasitye ngaphakathi. Kodwa xa kwenzeka uphuhliso lwezilwanyana zamathumbu emathunjini, apho inkqubo yokumangalisa iphazamiseka, ulawulo lwe-parenteral luboniswe.

Thintelo

Kwinkoliso yamatyala, ngoncedo lwezobisi zonyango, oogqirha bakwazi ukulungisa ukusilela kwesinyithi. Nangona kunjalo, esi sifo sinako ukuphindaphinda nokuphuhliswa kwakhona (kakhulu kuncinci). Ukuze ugweme ukuphuhliswa kweziganeko, kuyimfuneko ukukhusela i-anemia yokunqongophala kwesinyithi. Oku kuthetha ukubeka iliso rhoqo kwimiqathango ye-klinikhi yokuhlolwa kwegazi, ukupheliswa kokukhawuleza kwanoma ziphi na izizathu zokulahleka kwegazi kunye nokondla okwaneleyo. Abo basemngciphekweni, ugqirha unokumisela ukusetyenziswa kwezidakamizwa eziyimfuneko ukwenzela ukukhusela.

Kucacile ukuba ukungabi ncitshe egazini yinkinga enkulu. Oku kungaqinisekiswa yiphina imbali yezonyango. Ukunqongophala kwe-Iron anemia, kungakhathaliseki ukuba yisiphi isigulane esicatshangelwayo, ngumzekelo ocacileyo wesifo esibuhlungu kakhulu. Ngoko ke, ngeempawu zokuqala zokungabikho kwalolu hlobo, kufuneka udane ugqirha uze uthathe inkqubo yokonyango ngexesha.