Agranulocytosis - ke eng see? Agranulocytosis ka bana ba le batho ba baholo: Matšoao, bakang le kalafo

Laboratori ea hlahloba mali ho phetha hoo e batlang e mong le e mong lefu. Ena e amana le dikahare lesedi la thlahlobo ena. Ka liphetoho tsa entsprechen motho mali ka bonoa ka etiology tsa lefu, ho tiea ea ho pathological. Tlhahisoleseding e mabapi le ho eketseha kapa fokotseha ka itseng lisele tse itseng lero la mali dumella itseng ditlolo belaeloa hore. Mohlala, kankere ea mali, mefuta e sa tšoaneng ea khaello ea mali. E mong le laboratori eo matšoao nkoa agranulocytosis. lefu lena, e ka etsahala le mong kapa hammoho le liphetoho tse ling tse maling. pontšo ena e bontša ho ba teng ha tshwaetso e matla.

Agranulocytosis - ke eng see?

Mafu a mali tse amehang tsa saense hematology. Itlhokomoloso ka eona e bontšang matla pathological thulaganyou e ke agranulocytosis. lefu lena e tšoauoa ka ea fokotseha ho phatlalatsoa ka boemo ba lisele tse tšoeu mali - leukocytes. Ba hlokahalang bakeng sa ho laola mahlahana a tšoaetsanoang ho kena 'meleng nakong tshwaetso.

Normal tšoeu count ya seleng ea mali o lekana le 4-9: x 10 ⁹ / k. Ho eketseha ha palo ea lisele tse tsena e bontša tsoelo-pele ea e bua haholo ka a hlabang. Ho haella ha lisele tse tšoeu mali a ka hlaha ha ho hlōleha ha boitshireletso ba mmele, thibelo ea hematopoiesis, botahoa. Agranulocytosis - le laboratori ea syndrome, tšoauoa ka ho fokotseha ha boemo ba lisele tse tšoeu mali ho 1: x 10 ⁹ / k kapa ka tlaase (neutrophil - 0.75 * 10 ^9). Ka lebaka la khaello phatlalletsoang ea lisele boitshireletso ho na le e hlophisitsweng, tse fapa-fapaneng a tšoaetsanoang baktheria kapa ea vaerase etiology. Ho khetholla syndrome, e, litleleniki tsa mali teko ke ke ho hlokahala.

The maqhubu a ya ketsahalo ea agranulocytosis

Ena lefu hematologic le hlaha har'a baahi e motšehali 'me e motona. Congenital agranulocytosis seoelo tlalehiloeng, ha ho bapisoa le lefu lena le se fumaneng. Ka ho tšoanang, liphetoho tse ka ea ho hlophisoa lisele tsa mali a le kotsing ea ho basali bohareng-hōlileng (ho tloha ho lilemo tse 40). The maqhubu a ya tšobotsi ena laboratori e fapaneng ka linaheng tse sa tšoaneng. Ka kakaretso, agranulocytosis lemoha ka batho ba 1 tsoa 1200. A phokotso bohlokoa ka palo ea lisele tse tšoeu mali ho feta le tsekamelo ea ho Caucasians.

Mabaka a ho ntshetsopele ya agranulocytosis

Hobaneng hlahisa agranulocytosis? Mabaka a boemo ena pathological itšetlehile ka mefuta e fapaneng ya lefu lena. Congenital agranulocytosis bakoang ke mabaka a lefa. syndrome, o bua ka pathologies liphatsa tsa lefutso e behilweng. Kotsi hore ngoana a tsoaloe ka 'mè e mong a kula kapa a ntate, e tla nka sebaka syndrome, ena ke phahameng haholo. Mabaka a etsang hore e fumanweng agranulocytosis kenyeletsa:

1. mafu Autoimmune. pathologies joalo ke systemic lupus erythematosus, scleroderma, ramatiki. Ka mafu tsena, tshireletso boitshireletso e sa feela ikemiseditse ho likaroloana tsoang linaheng tse ling, empa hape ka lisele tse 'mele ea bona.
2. Ke Kopana le ionizing mahlaseli. Ntho e 'Sena se etsa hore khatello e sa hematopoietic kokoana-hloko e tšoeu feela, empa hape e khubelu.
3. Kamohelo lithethefatsi cytostatic. medicaments tsena li bontša bakeng sa mafu a rheumatic le kankere. The bozangi litomba ya kalafo le cytostatics ke hore lithethefatsi timetsa lisele tse tloaelehileng.
4. tšebeliso ea nako e telele ea lithibela-mafu (mohlala, lefuba), NSAIDs le mahlahana antiparasitic.
5. tsoaetsanang matla. The fokotseha bohale palong ea neutrophils ka ho ketekoa ka lefu la sebete bongata ba kokwanahloko, maselese e bitsoang rubella, sekholopane, ntaramane, 'me joalo-joalo. D.

Ke habohlokoa ho hlokomela hore agranulocytosis hase lefu le ikemetseng. lefu lena ha hlahisa ntle ho lebaka itseng. O kamehla tse amanang le ba bang ba litla pathological.

The mochine oa ntshetsopeleng ya agranulocytosis

Neutrophils ke lisele sireletsang mali. Di thehoa e moko lesapo le ka lokolloa ka ngata tswelela pele. lisele tse tsena ikarabella ka ba ka bang 70% ea leukocytes palo yohle. Ka lebaka la ho hloka ntshetsopeleng ya mali a likarolo tsena e ho ntshetsa pele neutropenia. Agranulocytosis nkoa liforomo e tsoetseng pele ea boemo ba. Congenital khaello ea neutrophil le palo yohle tšoeu count ya seleng e le hlaha ka lebaka la ho ba teng ha phatsa ea lefutso e sa tloaelehang.

Ka lebaka la lintlha exogenic, ntshetsopele ya lisele tse tšoeu mali e fokotsehile kapa a kgaotsa ho feletseng. mochine o mong oa lefu la ho nkoa tlhahiso ea lithibela-mafu ho neutrophils ena. Kahoo, ho na le agranulocytosis. liteko mali ka nako e tšoanang o tla fetola hoo e ka bang hang-hang. Ka mor'a hore tsohle, ka nako ya bophelo ba neutrophils ena e khutšoanyane. Ho tswa ho matsatsing a 2 ho ea ho 3.

Classification tsa maemo pathological

Ho itšetlehile ka sesosa le mochine pathogenetic secrete classifications maloa agranulocytosis. Ho ea ka ena, tse ka thōko congenital le fumana khaello ea neutrophils. Tabeng ea pele, lefu hematological ho etsahala ha lintho tse latelang pathologies liphatsa tsa lefutso:

1. Granulomatous lefu.
2. La lelapa neutropenia.
3. Shvahmana-Dayemonda lefu.
4. Kostmann lefu.
5. Syndrome Shediac-Shtaynbrinka-Higashi.
6. Congenital aleukia.

Fumanweng khaello ea lisele tse tšoeu mali e arotsoe autoimmune, le hapten myelotoxic agranulocytosis. E mong le e ba mefuta ena e na le mochine tsa lona tsa ntlafatso. Tlaase ho linoka pathological thulaganyou e e ka thōko a hlobaetsang le ho re sa foleng agranulocytosis. Hape le ka tlhophiso e thehiloeng ho tiea la lefu la.

Tlhaloso boitshireletso agranulocytosis

Boitshireletso agranulocytosis amanang le liphello pathological tsa lisireletsi ka lisele tse khubelu tsa mali. E ka bakoang ke ka bobeli mochine e se nang sesosa le exogenous. Tabeng ea pele, lefu lena le hlaha ka lebaka la ho tlhaselo autoimmune. Joalo boemong ba ho e isa ho lefu la systemic connective dinama tse nyenyane tse. Ya boitshireletso ba mmele tsamaiso ea oona lisele tse ba e-s'o fetohe ka sebopeho, empa ba ile ba ba e le hore li ne li "reprogrammed." Ka lebaka leo, ba qala ho hanyetsa phelang e lisele mong. Granulocytes potlako ba hōlileng tsebong le ba ikhopolang ho timetsoa. lintlha Exogenous tabeng ena ke irrelevant. boitshireletso agranulocytosis lefu o hlahellang teng pathologies joalo joaloka systemic lupus erythematosus le ramatiki. Nako e le nngwe sekgeo ea neutrophils kopantswe ka ho hloka liseleng tse ling mali.

E mong fapaneng ya lefu lena le, e leng le hlaha ka semelo sa dithulaganyo boitshireletso, e hapten agranulocytosis. Foromo ena ea ho pathological boela tsa etsa e antibody ho neutrophils. Phapang ke hore tse di hlahiswa hase uena feela, 'me ka mor'a ho nka meriana itseng - hapten. Pheta ja ya dintho tsena e etsa hore e ka karabelo boitshireletso, bontšitsoeng ka granulocytes timetso. The haptens ka sebetsa jwalo ka ba bang ba lithibela-mafu, antiinflammatory le hypoglycemic mahlahana, barbiturates.

Tlhaloso myelotoxic agranulocytosis

Myelotoxic agranulocytosis develops ka lebaka la litšusumetso exogenous. Kamehla o ne a ho kopantswe le erythromycin le thrombocytopenia. Maemong a mangata, myelotoxic fapaneng ya lefu lena le amahanngoa le ho pepesehela mahlahana chemotherapeutic le mahlaseli ionizing. lintlha tsena lebisa thibelo tsa hematopoiesis ka maemo e ka tlaase ea ho hōla eona. Ho lithethefatsi cytostatic tse bakang itsoara joang ka tsela e tšoanang le bolela cyclophosphamide, fluorouracil, mercaptopurine, joalo-joalo D. thibelo ea lisele hematopoietic moholo-holo ho etsa hore e le ho fokotseha ha palo ea granulocytes ka moko oa masapo. Sena ke ka lebaka la ho le nonofo ya mmele ea mafu a mali likokoana-hloko.

Ho phaella ho litšusumetso exogenous, ho hloka ea lisele hematopoietic develops ka mefuta e meng ea khaello ea mali le kankere ea mali. Mabaka ana, hangata e bakileng agranulocytosis ka bana. Hangata liphetoho hematologic di lefa. Mehlala nkoa haemolytic le aplastic khaello ea mali, lefu Fanconi e. A hlobaetsang le a sa foleng myelogenous kankere ea mali develops bongoaneng le ka baahi ba batho ba baholo.

Agranulocytosis: matšoao a

granulocytes lekaneng tsamaea le haholo liponahatso tsa tleleniki. Ba ka 'na ba e fapaneng, ho itšetlehile ka lefu boo, e leng se ileng ho ketsahalo e sa khaello neutrophil. Joang agranulocytosis? Matšoao a lefu:

1. Haholo bofokoli.
2. Phahameng feberu.
3. Lymphadenopathy.
4. Hepatosplenomegaly.
5. diso Necrotic tsa lera la ka mucous.
6. Hemorrhagic lefu.

Hapten agranulocytosis, ho fapana le mefuta e meng, e tšoauoa ka tsela e hlobaetsang. Bakuli ba ikutloa hobe le ho feta ka potlako develops feberu, ho na le liso ka hanong la ka. Tshenyo marenene, tonsils, uvula, bonolo mahalapa a tsoela pele, ea isang ho dinama tse nyenyane tse necrosis. E tsamaea le ho utloisa bohloko, ho hloleha ba metsa, ka tsela e feteletseng salivation.

Ha myelotoxic agranulocytosis fapaneng ba atisa ho ba tsoa mali. Di amanang ha feela le ulceration tsa lera la ka mucous, empa hape le ka khaello platelet. Tshwaileng e nasal, gingival, uterine, gastrointestinal mali. Ka letlalo hlaha hematoma. Ka lebaka la ho le thulaganyo seso-necrotic ka intestine ba ile ba hlokomela letšollo, bohloko mpeng. Ka lebaka la aspiration mali develops serame sa matšoafo hemorrhagic.

Liphetoho ka metsoako e ka agranulocytosis e

Hangata e agranulocytosis ntshetsopeleng le hlaha ka bakuli ba kankere, systemic le mafu a tsoaetsanoang le kotsi. lefu lena le ka ka belaela ba le litšobotsi tse kang feberu e phahameng, mokhathala le ponahalo ea liso ka molomo. Ho thata le ho feta ho fumana congenital agranulocytosis. A hlahloba mali ke ho hlokahala hore ho phetha ka pallor haholo tsa letlalo la ngoana, hemorrhagic liponahatso. Ka lipatlisiso ho na le ea fokotseha ea leukocytes (ka tlase ho 1 * 10 ⁹ / l). e hangata bo amahanngoa le khaello ea mali 'me thrombocytopenia.

Ho fumana hore, ka lebaka leha e le efe, pele ho lefu hematological, phetha immunogram puncture le masapo moko. Ho hlahloba mathata a bakiloeng ke ho khaello ea granulocytes atlehe ho etsa lipatlisiso karaoke. Har'a bona - le sefubeng X-ray, colonoscopy. E boetse e hloka setsebi keletso - otolaryngologist, oncologist, ngaka ea meno, rheumatologist le gastroenterologist.

Mekhoa bolwetse tsa kalafo

Hloka bookelong mamello, haeba fumanoa agranulocytosis. Phekolo e na le ho phekola ulcerous le necrotic bokaholimo mahlahana sebolaya dikokwana-hloko, litokisetso mafura. Ho ba le mamello e sa tlas'a tshwaetso le se mahareng, e kenngoa ka kamoreng ea isolator ena. Ha senyehile mala mucosa e tsamaisoa ke tsela parenteral.

Meriana bakeng sa kalafo ya agranulocytosis

Ho thibela ntshetsopele ya tshwaetso (serame sa matšoafo, sepsis), Lithibela-mafu le meriana e antifungal. Entoe laolwa lihlahisoa mali, haholo-holo leukocyte boima. Ha agranulocytosis boitshireletso bontša meriana hormonal. Tsena li akarelletsa "Hydrocortisone" lithethefatsi "Prednisolone". Haeba lefu la ho bakoa ke ho thibelo ya hematopoiesis, moemeli stimulatory e tsamaisoa. Har'a bona ke tharollo "Granocyte", "leucogen", "Virudan". Kalafo o etsoang tsoa ka lefapha hematology.

Thibelo ea agranulocytosis ka bana ba le batho ba baholo

Thibelo ea agranulocytosis congenital akarelletsa ho ba bonoa pele tsa lefu. Ho finyella sena, bana ba ka phetha CBC selemo le selemo. Ke ho thibela mehato e kenyeletsa go baya leitlho ea bakuli fumana lithethefatsi cytotoxic,-ba khahlanong le lefu la tsoekere meriana. Ha mokuli e neng e ketekoa e le karabelo hematological ho taolo ya lithethefatsi tse ling, lithethefatsi tsena li ka ke ke khethoa hape hore.

Forecast bakeng sa bophelo bo nang le agranulocytosis

The itse'ng itšetlehile ka sesosa sa lefu la. Foromo kotsi ka ho fetisisa tsa agranulocytosis hapten, kaha e ka potlako ho ntshetsa pele dinama tse nyenyane tse necrosis. Autoimmune le myelotoxic tshenyo phekoleha leboha ho tloswa phekolo. Empa mafutsana itse'ng hlokometse ka ntshetsopele ya mathata a ya bolwetse se ipatileng. Har'a bona - mali a maholohali, perforation ea mantle a lerako, hemorrhagic serame sa matšoafo, sepsis.