Anisocytosis: ma'ana, alamu da jiyya

Anisocytosis kalma ce da ake amfani da ita hawan jini lokacin da akwai girman rashin daidaituwa tsakanin sel jini na layin sel guda ɗaya kamar:

• ƙwayoyin jini, wanda kuma ake kira jajayen ƙwayoyin jini ko erythrocytes;
• platelet na jini, wanda kuma ake kira thrombocytes.

Yana yiwuwa a rarrabe anisocytoses da yawa dangane da layin sel da abin ya shafa:

• erythrocyte anisocytosis lokacin da rashin daidaituwa ya shafi erythrocytes (jajayen ƙwayoyin jini);
• anisocytosis na platelet, wani lokacin ana kiranta thrombocytic anisocytosis, lokacin da rashin daidaituwa ya shafi thrombocytes (platelet na jini).

Dangane da nau'in rashin lafiyar da aka samo, anisocytosis wani lokaci ana bayyana shi azaman:

• anisocytosis, mafi sau da yawa ana taƙaita shi azaman microcytosis, lokacin da ƙwayoyin jini ba su da ƙima;
• aniso-macrocytosis, mafi sau da yawa ana taƙaita shi azaman macrocytosis, lokacin da ƙwayoyin jini ba su da girma.

Anisocytosis wani rashin lafiyar jini ne wanda aka gano a lokacin haemogram, wanda kuma ake kira Blood Count and Formula (NFS). Ana gudanar da shi ta hanyar ɗaukar samfurin jini na jini, wannan binciken yana ba da bayanai masu yawa akan ƙwayoyin jini.

Daga cikin ƙimar da aka samu yayin ƙidayar jini, ana kuma kiran alamar ragin sel jini (RDI) alamar anisocytosis. Da yake yin yuwu don tantance canjin da ke cikin girman jajayen ƙwayoyin jini a cikin jini, wannan alamar tana ba da damar gano erythrocyte anisocytosis. Ana la'akari da al'ada lokacin da yake tsakanin 11 zuwa 15%.

Gabaɗaya magana, anisocytosis kalma ce da likitoci ke amfani da ita don nufin erythrocyte anisocytosis. Dangane da jajayen ƙwayoyin jini, wannan rashin lafiyar jini yawanci saboda anemia, digo mara kyau a matakin jajayen ƙwayoyin jini ko haemoglobin cikin jini. Wannan rashi na iya haifar da rikitarwa saboda sel jini sune sel masu mahimmanci don rarraba iskar oxygen a cikin jiki. Wanda yake cikin jajayen ƙwayoyin jini, haemoglobin furotin ne wanda ke iya ɗaure da yawa na iskar oxygen (O2) da sakin su cikin sel.

Yana yiwuwa a rarrabe iri daban -daban na anemia da ke haifar da erythrocyte anisocytosis, gami da:

• dakarancin karancin baƙin ƙarfe, sanadiyyar rashi na baƙin ƙarfe, wanda ake ɗauka anemia microcytic saboda yana iya haifar da anisocytosis tare da samuwar ƙananan ƙwayoyin jini;
• karancin bitamin anemia, wanda aka fi sani da su shine karancin raunin bitamin B12 da raunin bitamin B9, wanda ake ɗauka macrocytic anemias saboda suna iya haifar da aniso-macrocytosis tare da samar da manyan gurɓatattun ƙwayoyin jini.
• dahemolytic anemia, wanda aka sani da lalacewar jajayen ƙwayoyin jinin da ba a daɗe ba, waɗanda za a iya haifar da cututtukan ƙwayoyin cuta ko cututtuka.

Platelet anisocytosis shima yana da asalin cuta. Platelet anisocytosis na iya zama musamman saboda myelodysplastic syndromes (MDS), wanda ya ƙunshi tarin cututtuka saboda lalacewar kasusuwan kasusuwa.

Musamman Dalilan Anisocytosis

Physiological

Ba koyaushe kasancewar anisocytosis yana nuna kowane nau'in cutar ba. Alal misali, a cikin jarirai, ana lura da macrocytosis physiological. Wannan ya faru ne saboda balaga a hankali na kasusuwa na kasusuwa da kuma tafiyar matakai na mitosis a cikin kwayoyin halitta na hematopoietic. A wata na 2 na rayuwa, anisocytosis sannu a hankali yana warware kansa.

baƙin ƙarfe

Mafi na kowa pathological sanadin anisocytosis ne baƙin ƙarfe rashi. Tare da rashin baƙin ƙarfe a cikin jiki, akwai cin zarafi na maturation na erythrocytes, samuwar membrane na cell, da samuwar haemoglobin. Sakamakon haka, girman ƙwayoyin jajayen jini yana raguwa (microcytosis). Tare da bayyana rashin ƙarfe, jimlar abun ciki na haemoglobin a cikin jini yana raguwa, kuma ƙarancin ƙarancin ƙarfe (IDA) yana tasowa.

Tare da anisocytosis, hypochromia sau da yawa yana faruwa, watau rage haemoglobin jikewa na erythrocytes. Anisocytosis, tare da wasu canje-canje a cikin alamun erythrocyte (MCV, MCH, MCHC), na iya gaba da ci gaban IDA, a cikin abin da ake kira rashi na baƙin ƙarfe.

Har ila yau, anisocytosis na iya ci gaba a farkon karin ƙarfe don maganin ƙarancin ƙarfe na anemia. Haka kuma, yana da wani wajen takamaiman hali - akwai babban adadin duka biyu microcytes da macrocyte a cikin jini, wanda shine dalilin da ya sa histogram na rarraba erythrocytes yana da halayyar biyu-kololuwar bayyanar.

Abubuwan da ke haifar da karancin ƙarfe:

• Abun abinci.
• Yaro, samartaka, ciki (lokacin ƙara buƙatar ƙarfe).
• Profuse tsawan lokaci haila.
• Raunin jini na yau da kullun: cututtukan peptic na ciki ko duodenum, basur, diathesis hemorrhagic.
• Yanayin bayan resection na ciki ko hanji.
• Cututtukan kwayoyin halitta na metabolism na ƙarfe: atransferrinemia na gado.

Samfuran jini don bincike

Vitamin B12 da kuma folic acid rashi

Wani dalili na anisocytosis, wato macrocytosis, shine rashi na B12 tare da folic acid, kuma ana lura da raunin bitamin na haɗin gwiwa sau da yawa. Wannan shi ne saboda abubuwan da ke faruwa a hankali na rayuwa. Rashin B12 yana hana canjin folic acid zuwa wani aiki, nau'in coenzyme. Wannan al'amari na sinadarai ana kiransa tarkon folate.

Rashin waɗannan bitamin yana haifar da cin zarafi na purine da sansanonin pyrimidine (babban abubuwan da ke cikin DNA), wanda da farko yana rinjayar aikin ƙwayar kasusuwa, a matsayin sashin jiki tare da mafi girman aiki na yaduwar kwayar halitta. Wani nau'in hematopoiesis na megaloblastic ya taso - sel ba su cika balagagge tare da abubuwa na tsakiya na tantanin halitta, haɓaka jikewa na haemoglobin da haɓakar girma sun shiga cikin jini na gefe, watau anemia shine macrocytic da hyperchromic a yanayi.

Babban dalilan rashin B12:

• Ƙuntataccen abinci da keɓance kayan dabba.
• atrophic gastritis.
• Autoimmune gastritis.
• Resection na ciki.
• Rashin gada na intrinsic factor Castle.
• Malabsorption : cutar celiac, cututtukan hanji mai kumburi.
• Cutar cututtuka: diphyllobotriasis.
• Lalacewar kwayoyin halitta na transcobalamin.

Koyaya, rashi folate na iya faruwa. A irin waɗannan lokuta, kawai canjin pathological a cikin jini na iya zama anisocytosis (macrocytosis). Ana samun wannan galibi a cikin shaye-shaye, yayin da barasa na ethyl yana raguwa da ɗaukar folate a cikin sashin gastrointestinal. Har ila yau, rashin folic acid da macrocytosis na gaba yana faruwa a cikin marasa lafiya da ke shan maganin hana haihuwa na dogon lokaci, a cikin mata masu ciki.

Harshen Thalassemia

A wasu lokuta, anisocytosis (microcytosis), tare da hypochromia, na iya zama alamun thalassaemia, rukuni na cututtuka da ke nuna rashin daidaituwa na kwayoyin halitta a cikin kira na sarkar globin. Dangane da maye gurbin wani nau'in kwayar halitta, akwai karancin wasu sarƙoƙi na globin da ƙari na wasu (alpha, beta ko gamma sarƙoƙi). Saboda kasancewar ƙwayoyin haemoglobin marasa lahani, ƙwayoyin jajayen jini suna raguwa a girma (microcytosis), kuma membrane nasu ya fi saurin lalacewa (hemolysis).

Microspherocytosis na gado

A cikin cutar Minkowski-Choffard, saboda maye gurbi na kwayoyin halitta wanda ke sanya tsarin sunadaran tsarin membrane erythrocyte, dacewar bangon tantanin su yana ƙaruwa a cikin jajayen ƙwayoyin jini, kuma ruwa yana taruwa a cikinsu. Erythrocytes suna raguwa a girma kuma su zama masu siffar zobe (microspherocytes). Anisocytosis a cikin wannan cuta sau da yawa ana haɗuwa tare da poikilocytosis.

Sideroblastic anemia

Da wuya, anisocytosis na iya kasancewa saboda kasancewar anemia na sideroblastic, yanayin cututtukan da ke tattare da amfani da baƙin ƙarfe, yayin da baƙin ƙarfe a cikin jiki na iya zama al'ada ko ma haɓaka. Abubuwan da ke haifar da anemia na sideroblastic:

• Myelodysplastic ciwo (mafi yawan sanadi).
• Shan magungunan da ke rushe metabolism na bitamin B6.
• Maganin gubar na yau da kullun.
• Maye gurbin kwayar halittar ALAS2.

kanikancin

Gano ƙarshen "anisocytosis" a cikin hanyar gwajin jini yana buƙatar roko zuwa babban likita domin sanin musabbabin wannan yanayin. A alƙawari, likita ya tattara tarihin daki-daki, ya nuna kasancewar gunaguni halayen anemia (rauni na gaba ɗaya, dizziness, tabarbarewar maida hankali, da dai sauransu). Yana fayyace ko majiyyaci yana shan wasu magunguna akai-akai.

A lokacin haƙiƙa jarrabawa, da hankali ne kõma zuwa gaban asibiti bayyanar cututtuka na anemic ciwo: pallor na fata da kuma mucous membranes, low jini karfin jini, ƙara zuciya rate, da dai sauransu Ga hereditary hemolytic anemia, gaban ãyõyin nakasu daga cikin kashi. kwarangwal hali ne.

An tsara ƙarin karatu:

• Binciken jini na gaba ɗaya. A cikin KLA, mai nuna alamar mai nazarin hematological, yana nuna kasancewar anisocytosis, shine RDW. Koyaya, yana iya yin kuskure babba saboda kasancewar agglutinin sanyi. Sabili da haka, gwajin ƙananan ƙwayoyin cuta na smear jini ya zama dole. Hakanan, microscopy na iya gano alamun raunin B12 (jikin Jolly, zoben Kebot, hypersegmentation na neutrophils) da sauran abubuwan da ke tattare da cututtukan cututtukan fata (basophilic granularity, jikin Pappenheimer).
• Kimiyyar jini. A cikin gwajin jini na biochemical, ana duba matakin baƙin ƙarfe, ferritin, da transferrin. Hakanan za'a iya lura da alamun hemolysis - karuwa a cikin taro na lactate dehydrogenase da bilirubin kai tsaye.
• Binciken rigakafi. Idan ana zargin raunin da ya faru na autoimmune na gastrointestinal tract, ana yin gwaje-gwaje don maganin rigakafi ga ƙwayoyin parietal na ciki, ƙwayoyin rigakafi zuwa transglutaminase, da gliadin.
• Gano haemoglobin mara kyau. A cikin ganewar asali na thalassaemia, ana yin haemoglobin electrophoresis akan fim din cellulose acetate ko babban aikin ruwa chromatography.
• Binciken microspherocytosis. Don tabbatarwa ko ware microspherocytosis na gado, ana yin juriya na osmotic na erythrocytes da gwajin EMA ta amfani da fenti eosin-5-maleimide.
• parasitological bincike. Idan akwai tuhuma na diphyllobotriasis, an wajabta microscopy na shirye-shiryen fecal na asali don bincika ƙwai na tsutsotsi mai faɗi.

Wani lokaci ana buƙatar gudanar da ganewar asali tsakanin IDA da ƙananan thalassaemia. Ana iya yin wannan ta hanyar gwajin jini na gabaɗaya. Don wannan, ana ƙididdige ma'anar Mentzer. Matsakaicin MCV zuwa adadin jajayen ƙwayoyin jini fiye da 13 shine na hali don IDA, ƙasa da 13 - don thalassaemia.

Yin nazarin smear jini

Alamomin anisocytosis sune na rashin jini. Kodayake akwai sifofi daban -daban da asalin anemia, ana lura da alamomin halaye da yawa:

• jin gajiya gaba ɗaya;
• rashin ƙarfi na numfashi
• bugun zuciya;
• rauni da dizziness;
• pallor;
• ciwon kai.

Jiyya don anisocytosis ya dogara da sanadin rashin lafiya. Idan an sami karancin raunin ƙarfe ko karancin raunin bitamin, ana iya ba da shawarar ƙarin abinci don magance anisocytosis.