Kuwedzerwa ropa kakawanda ichokwadi chehupenyu kune vamwe varwere vane leukemia, lymphoma uye myeloma. Kushandiswa kunoshandiswa kuvandudza ropa masero ekuverenga uye kurapa zviratidzo uye zviratidzo zvekushaya ropa - zvakadai sokuneta, kufungidzira, kupera kwekufema uye kushaya simba . Zvisinei, kuwedzerwa kuwedzerwa ropa kwenguva yakawanda kunogona kukonzera simbi kuwedzerwa - mamiriro ezvinhu, kana asingateereri, anogona kukuvadza mwoyo uye chiropa.
Zvinoitika Sei
Iron ine basa rinokosha zvikuru mumitumbi yedu. Inotora chikamu mumagariro akawanda ehupenyu, kusanganisira kubudiswa kweDNA apo masero akaparadzanisa, uye kutakura okisijeni kubva kumapapu kuenda kumasero edu nematumbu. Iron iyo yatinopinda nayo kuburikidza nezvokudya zvedu kazhinji inosungira puroteni inonzi transferrin uye inotenderera mukati meropa redu plasma.
Nokuda kwechikamu chikuru, iyi simbi inoshandiswa kugadzira hemoglobin, iyo iri mumasero matsvuku eropa anotakura okisijeni yatinofema mumatumbu edu . Leftover iron inenge yakachengetwa muropa, kuitira kushandiswa munguva yemberi.
Muviri womunhu hauna simba rekubvisa nemaune kana kuvhara simbi yakawanda, kunyange zvazvo imwe simbi inorasika mumagariro akadai sekudururwa kwemasero eganda. Kana imwechete iyo muviri yakakura yekusachengetedza yakawanda yesimbi yakawanikwa, iron inotanga kuvaka mune dzimwe nhengo dzomuviri, zvichiita kuti iron iwedzere.
Ropa tsvuku rekuisira ropa rinopa huwandu hwakawanda hwesimbi.
Muvanhu vane utano, chete anenge 1-2 mg yesimbi inoshandiswa mukati mezuva rakapiwa - kureva, simbi inotorwa kubva pakudya uye yakarasika kuburikidza nekudururirwa kwemasero eganda uye masero emuviri, somuenzaniso. Chimwe chechimwechete chemasero matsvuku eropa (PRBCs), zvisinei, ine makore anenge 200-250mg . Kazhinji kacho, varwere vanowana maundi maviri nguva dzose pavanoiswa ropa, saka ndiyo imwe 500 mg muzuva rimwe chete.
Migumisiro
Apo dare rakapedza simba remuviri kuti richengetedze zvakachengeteka, rinogona kukonzera kukuvadza nenzira dzakawanda. Kutanga pane zvose, kana pane dare rakawanda mumuviri kudarika transferrin kuti rizvisungirire, rinopararira roga roga sesimbi isiri-transferrin-iron (NTBI). Iyi iyo yesimbi ine uturu kune miviri yedu, uye inokonzera kukanganisa kwemasumbu edu nhengo nhengo dzemafoni.
Mukuwedzera, iron yakawandisa inowedzera mumoyo, mapapu, uropi, zvirwere zve endocrine, chiropa uye kunyange pfupa remafupa.
Usingafungi, kuunganidza uku kunogona kutungamirira kune:
• Mwoyo kukanganisa
• Kusakosha
• Chirwere cheshuga
• Cirrhosis yechiropa
• Arthritis
• Hypothyroidism (utachiona husingaoneki)
• Kukurira kusina simba
• Erectile dysfunction
• Kanzera
• Kuora mwoyo
Humwe humwe uchapupu hunotiwo hutachiona hwehutachiona hunogona kuva imwe yemigumisiro yesimbi inowedzera.
Ndiani ari pangozi?
Vanhu vari pangozi yekuwedzerwa ropa kuwedzerwa ndevaya vakagamuchira kuwedzerwa kwemasero matsvuku eropa. Vakuru vanogara vachiwana kuwedzerwa vari panjodzi mushure mekunge zvikamu makumi maviri zveupenyu hwe PRBCs, kana kuti kuwedzerwa 10 kana ukawana mairi maviri panguva.
Varwere vane ropa uye marori kanzira, zvakadai seukemikemia uye lymphoma, kazhinji vanoda kuwanda kwekuwedzerwa kwemashure mushure mechemotherapy, mushure mokunge radiotherapy kuenda kunharaunda yavo, kana kuti kutevera sero cell transplantation .
Varwere vane myelodysplastic syndromes (MDS) vanowanzoramba vaine hemoglobin yakasimba uye vazhinji vari kuwedzerwa ropa, vachivaisa pangozi yakawanda yesimbi yakawanda. MDS ne-sideroblastic anemia inogonawo kuita kuti varwere vawane yakawandisa yesimbi kubva pakudya kwavo, zvichiita kuti dambudziko riwedzere.
Kuziva
Iron inowedzera inowanikwa munguva, uye kazhinji varwere havazoratidza zviratidzo. Zvinowanzoita kuti simbi inowedzera ionekwe nemigumisiro ye laboratory musati munhu ane zviratidzo.
Chiyero chinowanzoonekwa pakuongorora masimbi esimbi chinonzi serum ferritin mazinga. Uku ndiko kuongororwa kweropa kunogona kuitwa nguva dzose kune vanhu vane ngozi.
Serum ferritin mazinga anowedzera sezvakawanda zveTBBI inowedzera muropa. Ropa ferritin mazinga anopfuura 1 000 mcg / L anoratidza iron inowedzera. Varume vane utano vanowanzova neserum ferritin ya 24-336 mcg / L uye vakadzi vane utano 12-307 mcg / L. Zvimwe zvirwere nemamiriro ezvinhu zvinogona kuitawo kuti yakawanda ye ferritin isunungurwe mukuparadzirwa, zvisinei, izvo zvinogona kuita kuti kuverenga kwakakwirira kusatendeseka, saka kuedzwa nguva dzose ndiko kunowanzoitika.
Vanachiremba vanogonawo kusarudza kuita chiropa chepikisi kuti vaone hutano hwesimbi. Kunyange zvazvo chiyero ichi chichipa mitsara yakajeka kupfuura serum ferritin mazinga, zvinoda nzira isina kukanganisa iyo inogona kutungamirira kune zvinetso, zvakadai sehutachiona uye kubuda ropa. Bhiopsy inobata kupfuura 7 mg yesimbi pa gramu yechiropa inoratidza iron inowedzera.
Kufungidzira zvidzidzo kunogonawo kuratidza kuwanikwa kunofadza kwesimbi kunowedzera. Magnetic resonance imaging (MRI) inogona kushandiswa kuona huni inounganidza muchiropa uye nemwoyo. MRI inogona kushandiswa pamwe nechiropa cheopsy kuti iongorore iron inowedzera kana kuti yakazvimirira. Zvisinei, kusungirwa kwesimbi hakusi kutarisirwa kutarisirwa neMRI mune dzimwe nguva, zvakadai sokunge dhidziro yesimbi inowanikwa mukancreas.
Kurapa
Kune nzira mbiri huru iyo iron yakawandisa inotarisirwa: therapeutic phlebotomy uye iron chelation therapy.
Kurapa phlebotomy ndiyo nzira inokurumidza uye inonyatsobudirira yekuwana simbi mairi pasi murwere. Zvinosuruvarisa, hazvigone kushandiswa kune varwere vanoramba vari nenyuchi. Nokudaro, inowanzochengeterwa varwere vane chirwere cheukwepa kana lymphoma chiri mukuregererwa.
Munguva yekurapwa kwephlebotomy, mukoti kana chiremba achaisa nhovo huru mumhino dzako , kazhinji mumaoko ako. Vachazobvisa anenge 500 ml yeropa kubva mumuviri wako kunenge maminitsi gumi nemashanu. Kana iwe wakambopa ropa, unowana pfungwa. Ichi chiyero cheropa chinoda kusvika 250 mg yesimbi. Sezvo iyi iron ichibviswa muropa rako, chiropa chako chinosunungura zvimwe zvezvitoro zvayo uye pakupedzisira kuwanda kwesimbi kunogona kudzorerwa kumativi akaenzana. Phlebotomy inogona kuitwa kamwe kana kaviri pavhiki kana zvichidikanwa kusvika kune chinangwa chema serum ferritin mazinga 50-100mcg / L.
Iron chelation therapy inoshandisa mishonga inosunga, kana chelate, simbi uye inoita kuti ibudiswe kubva mumuviri. Chinangwa chemhando iyi yekurapa ndechokubvisa zvakadzama simbi kubva muropa uye nhengo dzomuviri. Kunyange zvazvo kurapwa uku kunoshanda zvakanaka pasesimbi yeplasma uye chiropa ichiisa, hazvisi zvakakosha mukubvisa simbi inobva pamwoyo.
Deferoxamine (Desferal), deferasirox (Exjade), uye deferiprone (Ferriprox) mitatu yakadai yemishonga.
Iron chelator mishonga inobatsira pakuderedza matanho eTBBI, asi mazinga aya anokurumidza kukurumidza kana chirwere chacho chichigadziriswa. Nokudaro, mishonga iyi inofanira kutorwa sezvakanyorerwa kuti vashande zvakanaka. Izvi zvinogona kuva kuzvipira kukuru kune vamwe varwere. Iron chelators haisiwo kunze kwemigumisiro, uye njodzi nemigumisiro yesimbi chelation inoda kuyerwa zvakanyatsonaka.
Mukuwedzera kune idzirapa, mushandi wako wehutano anogona kupa mazano ekuderedza huwandu hwesimbi yaunotora kuburikidza nekudya kwako zvakare. Kunyange zvazvo ichi chiri chiyero chinonzwisisika muhutano, pamwe nemamwe mashoma, zvikomborero zvekudzivirira simbi muzvokudya hazvina mubvunzo sezvo nzira iyi inotambura ne "kudonha mubhakete" chiitiko, uye sezvo kurapwa kwesimbi kuwedzerwa zvakadai sephlebotomy iri kure kunyanya kubudirira pakuderedza simbi.
Mazano ekuzviriritira
Kuwedzerwa ropa kunowanzotarisirwa uye kunoshanda kwechiremia uye lymphoma. Anemia inogona kuva yakakuvadza, kunyange inouraya, zvinokonzera mumuviri wako uye kuwedzerwa ropa kunogona kudziviswa.
Zvisinei, pane zvinhu zvaunokwanisa kuita kuti uone kuti iron yako inotariswa inotariswa zvakanaka. Iva nechokwadi chekuti nhengo yako yehutano yezvino yehutano inoziva zvose nezvehupenyu hwako hwekuwedzerwa ropa. Iwe ungangodaro wakagamuchira PRBCs makore akapfuura kuti usagadzikana zvachose, asi chiremba wako anofanira kuziva pamusoro pazvo ikozvino. Yeuka kuti dare haina nzira yekuderedzwa kubva mumuviri wako, naizvozvo kuwedzerwa kwega kwega iwe unogamuchira muhupenyu hwako hune simba rokubatsira kuwedzerwa dare nhasi.
Iwe unofanirwawo kuedza kuchengetedza ruzivo rwekuwedzerwa kwega kwega iwe unogamuchira. Izvi zvingasava nyore, uye pangave pane dzimwe nguva mukurapa kwako apo zvinoratidzika sezvose zvaunoita zvinotengeswa, asi zvichave zvichikosha gare gare.
Bato rako rezveutano rinofanira kutanga kutarisa serum ferritin mazinga ako kana iwe wakagamuchira makore makumi maviri ehupenyu hweropa. Kana iwe kazhinji uine maviri maviri pane imwe nguva, izvi zvingangodaro kuwedzerwa ropa. Kana vasingatori zvigadziriswa, unofanira kuzvikumbira.
Pasi Pasi
Varwere vanogamuchira kuwedzerwa ropa muhupenyu hwavo vari pangozi yekuwedzera simbi. Nokuda kwehutano hwezvirwere zvavo, uye kurapwa kwakashandiswa kuvabata, ropa uye maronda emuroora varwere vanowanzowedzerwa-kuwedzerwa-vanovimba kwenguva. Kana isingateereri, simbi inorema inogona kutungamirira kuchiremera chemuviri chakanyanya uye kunyange rufu, asi kurapa kunobudirira kuripo.
Kunyange zvazvo zvisingakwanisi kudzivisa kuwedzerwa ropa, varwere vanogona kubatsira kuzvidzivirira pachavo nekurangarira huwandu hwezvikamu zvavari kugamuchira uye kukumbira simbi kuwedzerwa kuongororwa kana zvichidiwa.
Yakarongwa muna March 2016, TI.
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