Anisocytosis: nkọwa, mgbaàmà na ọgwụgwọ

Anisocytosis bụ okwu ejiri mee ya hematology mgbe enwere oke adịghị n'etiti sel ọbara nke otu ahịrị dị ka:

• mkpụrụ ndụ ọbara uhie, a na -akpọkwa ọbara ọbara uhie ma ọ bụ erythrocytes;
• platelet ọbara, nke a na -akpọkwa thrombocytes.

Ọ ga -ekwe omume ịmata ọdịiche dị iche iche anisocytoses dabere na ahịrị ekwentị metụtara:

• anisocytosis erythrocyte mgbe ihe na -adịghị mma gbasara erythrocytes (mkpụrụ ndụ ọbara uhie);
• platelet anisocytosis, mgbe ụfọdụ a na -akpọ thrombocytic anisocytosis, mgbe ihe na -adịghị mma metụtara thrombocytes (platelet ọbara).

Dabere n'ụdị adịghị ahụkebe achọpụtara, a na -akọwa anisocytosis mgbe ụfọdụ dị ka:

• anisocytosis, na -adịkarị mkpụmkpụ dị ka microcytosis, mgbe sel ọbara dị obere nke ukwuu;
• aniso-macrocytosis, a na -ebelatakarị ya dị ka macrocytosis, mgbe mkpụrụ ndụ ọbara buru oke ibu.

Anisocytosis bụ ọrịa na -adị n'ọbara nke achọpụtara n'oge a hemogram, nke a na -akpọkwa Blood Count and Formula (NFS). Emere ya site na ịlele nlele ọbara venous, nyocha a na -enye nnukwu data na sel ọbara.

N'ime ụkpụrụ enwetara n'oge ọnụọgụ ọbara, a na -akpọkwa ndepụta nkesa mkpụrụ ndụ ọbara uhie (RDI) anisocytosis index. Na -eme ka o kwe omume ịtụle mgbanwe nha nke mkpụrụ ndụ ọbara uhie n'ọbara, ndepụta a na -eme ka o kwe omume ịchọpụta erythrocyte anisocytosis. A na -ewere ya dị ka ihe nkịtị mgbe ọ dị n'agbata 11 na 15%.

N'ikwu okwu n'ozuzu, anisocytosis bụ okwu ndị dọkịta na -eji erythrocyte anisocytosis. N'ihe gbasara mkpụrụ ndụ ọbara uhie, ọrịa a na -abụkarị n'ihi anaemia, ọdịda na -adịghị ahụkebe n'ọkwa nke mkpụrụ ndụ ọbara uhie ma ọ bụ hemoglobin n'ime ọbara. Enweghi ike nke a nwere ike bute nsogbu n'ihi na mkpụrụ ndụ ọbara uhie bụ sel dị mkpa maka ikesa oxygen n'ime ahụ. N'ịbụ nke dị na mkpụrụ ndụ ọbara uhie, hemoglobin bụ protein nwere ike ijikọ ọtụtụ mkpụrụ ndụ oxygen (O2) wee tọhapụ ha na sel.

Enwere ike ịmata ọdịiche dị iche iche nke anaemia na -akpata erythrocyte anisocytosis, gụnyere:

• naanaemia nke iron, kpatara ụkọ iron, nke a na -ahụta dị ka anaemia microcytic n'ihi na ọ nwere ike ibute anisocytosis na obere sel ọbara ọbara;
• ụkọ vitamin anaemia, nke a na-ahụkarị bụ ụkọ vitamin B12 anaemia na ụkọ vitamin B9 anemias, nke a na-ewere dị ka macrocytic anemias n'ihi na ha nwere ike bute aniso-macrocytosis site na imepụta nnukwu mkpụrụ ndụ ọbara ọbara na-emebi emebi.
• nahemolytic anaemia, nke e ji mbibi nke mkpụrụ ndụ ọbara uhie mee n'oge, nke nwere ike bute ọrịa mkpụrụ ndụ ihe nketa ma ọ bụ ọrịa.

Platelet anisocytosis nwekwara mmalite ọrịa. Platelet anisocytosis nwere ike bụrụ ọkachasị n'ihi ọrịa myelodysplastic (MDS), nke mejupụtara ọtụtụ ọrịa n'ihi adịghị ike nke ụmị ọkpụkpụ.

Ihe kpatara anisocytosis kpọmkwem

Nkịtị

Ọ bụghị mgbe niile ọnụnọ anisocytosis na-egosi pathology ọ bụla. Dịka ọmụmaatụ, na ụmụ amụrụ ọhụrụ, a na-ahụ macrocytosis physiological. Nke a bụ n'ihi mmụba nwayọọ nwayọọ nke ụmị ọkpụkpụ na usoro nke mitosis na mkpụrụ ndụ hematopoietic. Site na ọnwa nke abụọ nke ndụ, anisocytosis ji nwayọọ nwayọọ na-edozi onwe ya.

ụkọ ígwè

Ihe na-akpatakarị ọrịa anisocytosis bụ ụkọ ígwè. N'ihi enweghị ígwè n'ime ahụ, a na-emebi maturation nke erythrocytes, nhazi nke akpụkpọ ahụ ha, na nhazi nke hemoglobin. N'ihi ya, ọnụ ọgụgụ nke mkpụrụ ndụ ọbara uhie na-ebelata (microcytosis). Site na enweghị ígwè akpọpụtara, mkpokọta hemoglobin dị n'ọbara na-ebelata, ụkọ iron erughi anaemia (IDA) na-amalite.

Ya na anisocytosis, hypochromia na-emekarị, ya bụ, mbelata haemoglobin saturation nke erythrocytes. Anisocytosis, yana mgbanwe ndị ọzọ na erythrocyte indices (MCV, MCH, MCHC), nwere ike bute mmepe nke IDA, na nke a na-akpọ ụkọ ígwè latent.

Ọzọkwa, anisocytosis nwere ike ịdịgide na mmalite nke mgbakwunye ígwè maka ọgwụgwọ anaemia ụkọ ígwè. Ọzọkwa, ọ nwere a kpọmkwem agwa - e nwere ọnụ ọgụgụ buru ibu nke ma microcytes na macrocytes n'ime ọbara, nke mere na histogram nke nkesa nke erythrocytes nwere àgwà abụọ-elu elu ọdịdị.

Ihe na-akpata ụkọ ígwè:

• Ihe nri nri.
• Nwatakịrị, oge uto, afọ ime (oge mkpawanye ígwè).
• Profuse ogologo oge ịhụ nsọ.
• Ọbara na-adịghị ala ala: ọnyá afọ peptic nke afọ ma ọ bụ duodenum, hemorrhoid, hemorrhagic diathesis.
• Ọnọdụ mgbe resection nke afọ ma ọ bụ eriri afọ.
• Ọrịa mkpụrụ ndụ ihe nketa nke iron metabolism: eketa atransferrinemia.

Nlele ọbara maka nyocha

Vitamin B12 na ụkọ folic acid

Ihe ọzọ kpatara anisocytosis, ya bụ macrocytosis, bụ ụkọ B12 na folic acid, a na-ahụkarị ụkọ vitamin nkwonkwo. Nke a bụ n'ihi mmeghachi omume metabolic ha na-apụta. Enweghị B12 na-egbochi mgbanwe nke folic acid n'ime ụdị coenzyme na-arụ ọrụ. A na-akpọ ihe omume biochemical a ọnyà folate.

Enweghị vitamin ndị a na-eduga na mmebi nke purine na pyrimidine bases (isi akụkụ nke DNA), nke na-emetụta ọrụ nke ụmị ọkpụkpụ, dịka akụkụ nke nwere ọrụ kachasị elu nke mgbasa cell. Ụdị hematopoiesis nke megaloblastic na-ebilite - mkpụrụ ndụ etoliteghị nke ọma na ihe ndị dị na cell cell, saturation nke hemoglobin na ụbara nha na-abanye n'ọbara dị n'akụkụ, ya bụ anaemia bụ macrocytic na hyperchromic na ọdịdị.

Isi ihe kpatara ụkọ B12:

• Nri siri ike na mwepu nke ngwaahịa anụmanụ.
• atrophic gastritis.
• Ọrịa gastritis autoimmune.
• Resection nke afo.
• Enweghi ike nketa nke Castle intrinsic factor.
• Malabsorption : ọrịa celiac, ọrịa afọ ọzịza.
• Ọrịa irighiri: diphyllobothriasis.
• Mkpụrụ ndụ ihe nketa nke transcobalamin.

Agbanyeghị, ụkọ folate dịpụrụ adịpụ nwere ike ime. N'ọnọdụ ndị dị otú ahụ, nanị pathological mgbanwe n'ime ọbara nwere ike ịbụ anisocytosis (macrocytosis). A na-ahụkarị nke a na mmanya na-egbu egbu, ebe ọ bụ na mmanya ethyl na-ebelata nnabata nke folate na eriri afọ. Ọzọkwa, enweghi folic acid na macrocytosis na-esote na-eme na ndị ọrịa na-aṅụ ọgwụ mgbochi ọnụ ruo ogologo oge, na ụmụ nwanyị dị ime.

Thalassaemia

N'ọnọdụ ụfọdụ, anisocytosis (microcytosis), yana hypochromia, nwere ike ịbụ ihe ịrịba ama nke thalassemia, otu ọrịa nke mkpụrụ ndụ ihe nketa na-adịghị mma na njikọ nke agbụ globin. Dabere na ngbanwe nke otu mkpụrụ ndụ ihe nketa, enwere ụkọ ụfọdụ agbụ globin yana ngafe nke ndị ọzọ (alfa, beta ma ọ bụ gamma chains). N'ihi ọnụnọ nke mkpụrụ ndụ hemoglobin nwere nkwarụ, mkpụrụ ndụ ọbara uhie na-ebelata nha (microcytosis), akpụkpọ ahụ ha na-enwekwa ike ibibi (hemolysis).

Microspherocytosis eketa

Na ọrịa Minkowski-Choffard, n'ihi ngbanwe nke mkpụrụ ndụ ihe nketa na-edobe nguzobe nke protein structural nke akpụkpọ ahụ erythrocyte, ikike nke mgbidi sel ha na-abawanye na mkpụrụ ndụ ọbara uhie, na mmiri na-agbakọta n'ime ha. Erythrocytes na-ebelata nha ma ghọọ okirikiri (microspherocytes). Anisocytosis na ọrịa a na-ejikọta ya na poikilocytosis.

Sideroblastic anaemia

Ọ na-adịkarị obere, anisocytosis nwere ike ịbụ n'ihi ọnụnọ nke anaemia sideroblastic, ọnọdụ pathological nke iji ígwè eme ihe na-adịghị mma, ebe ígwè dị n'ime ahụ nwere ike ịdị mma ma ọ bụ ọbụna dị elu. Ihe na-akpata anaemia sideroblastic:

• Myelodysplastic syndrome (ihe na-akpatakarị).
• Ịṅụ ọgwụ ndị na-akpaghasị metabolism nke vitamin B6.
• Ịṅụbiga mmanya ókè ndu.
• Mgbanwe nke mkpụrụ ndụ ALAS2.

nchọpụta nsogbu

Nchọpụta nke nkwubi okwu "anisocytosis" n'ụdị nyocha ọbara chọrọ ịrịọ arịrịọ onye dibia bekee iji chọpụta ihe kpatara ọnọdụ a. N'oge nhọpụta, dọkịta ahụ na-anakọta akụkọ ihe mere eme zuru ezu, na-ekpughe ọnụnọ mkpesa nke njirimara anaemia (adịghị ike zuru oke, dizziness, mmebi na ntinye uche, wdg). Na-akọwapụta ma onye ọrịa na-aṅụ ọgwụ ọ bụla na-aga n'ihu.

N'oge nyocha ebumnuche, a na-adọrọ uche gaa na ọnụnọ nke mgbaàmà ụlọ ọgwụ nke ọrịa anamic syndrome: pallor nke anụ ahụ na akpụkpọ anụ mucous, ọbara mgbali elu, ụbara obi, wdg. ọkpụkpụ bụ njirimara.

A na-ahazi ọmụmụ ihe ndị ọzọ:

• Nnyocha ọbara n'ozuzu. Na KLA, ihe na-egosi onye nyocha hematological, na-egosipụta ọnụnọ nke anisocytosis, bụ RDW. Agbanyeghị, ọ nwere ike ịdị elu na-ezighi ezi n'ihi ọnụnọ agglutinin oyi. Ya mere, nyocha nke microscopic nke nyocha ọbara dị mkpa. Ọzọkwa, microscopy nwere ike ịchọpụta ihe ịrịba ama nke erughi B12 (Jolly ozu, Kebot mgbanaka, hypersegmentation nke neutrophils) na ndị ọzọ pathological inclusions (basophilic granularity, Pappenheimer ozu).
• Ọbara ọbara. N'ime nyocha ọbara nke biochemical, a na-enyocha ọkwa nke iron serum iron, ferritin na transferrin. A pụkwara ịhụ ihe nrịbama nke hemolysis - mmụba nke mkpokọta lactate dehydrogenase na bilirubin na-apụtaghị ìhè.
• Immunological nnyocha. Ọ bụrụ na a na-enyo enyo na ọnya autoimmune nke eriri afọ eriri afọ, a na-eme nyocha maka ọgwụ mgbochi nke mkpụrụ ndụ parietal nke afọ, ọgwụ mgbochi transglutaminase, na gliadin.
• Nchọpụta hemoglobin na-adịghị mma. Na nchoputa nke thalassemia, a na-eme hemoglobin electrophoresis na fim cellulose acetate ma ọ bụ chromatography mmiri na-arụ ọrụ dị elu.
• Nchọpụta nke microspherocytosis. Iji gosi ma ọ bụ wepu microspherocytosis eketa, a na-eme nguzogide osmotic nke erythrocytes na ule EMA site na iji eosin-5-maleimide fluorescent.
• nchọpụta parasitological. Ọ bụrụ na a na-enyo enyo nke diphyllobothriasis, a na-enye microscopy nke nkwadebe fecal nwa afọ ka ọ chọọ akwa nke nnukwu tapeworm.

Mgbe ụfọdụ ọ na-achọrọ ịme nchọpụta dị iche n'etiti IDA na obere thalassemia. Enwere ike ime nke a ugbua site na nyocha ọbara n'ozuzu. Maka nke a, a na-agbakọ ndeksi Mentzer. Oke MCV na ọnụ ọgụgụ nke mkpụrụ ndụ ọbara uhie karịa 13 bụ ụdị IDA, ihe na-erughị 13 - maka thalassemia.

Na-enyocha nyocha ọbara

Ihe mgbaàmà nke anisocytosis bụ nke anaemia. Agbanyeghị na enwere ụdị na mmalite nke anaemia, a na -ahụkarị ọtụtụ akara njirimara:

• mmetụta nke ike ọgwụgwụ n'ozuzu ya;
• obere ume
• mgbali elu;
• adịghị ike na dizziness;
• ihu ala;
• isi ọwụwa.

Ọgwụgwọ maka anisocytosis dabere n'ihe kpatara ọrịa ahụ. N'ọnọdụ ụkọ anaemia ma ọ bụ ụkọ vitamin, ana -atụ aro ka inye nri maka ịgwọ anisocytosis.