Gavhuna uye Mazamu eAzivo Eropa anoshandiswa Kuongorora Arthritis
Ropa rekushandisa rinoshandiswa kubatsira kubata arthritis , kuongorora kubudirira kwehutano, uye kuongorora chirwere chekuita. Kunyange zvazvo mairareti eropa kuongororwa zviratidzo zvinokosha zvekuongorora, hazvirevi kana zvichionekwa sega. Kuumba zvakanyatsoongororwa, nhoroondo yezvechiremba yemurwere inofanira kuongororwa, pamwe chete nemigumisiro yekuongorora ye laboratory uye zvidzidzo zvekufungidzira.
Pano pane kuongororwa kweropa uye kuongororwa kwakaitwa ropa kunoshandiswa kuongorora arthritis.
Dambudziko reGumi Rese
Complete Blood Count (CBC)
Ropa rakazara nhamba ndiyo kuongorora ropa kunoyera nhamba yemasero matsvuku eropa , masero eropa , uye maplatelets . Izvo zvataurwa pamusoro pezvikamu zveropa zvinomiswa mu plasma (yakasviba, yakajeka yeropa, chikamu chechiropa cheropa). Automated machines mu laboratori yakakurumidza kuverenga majeri akasiyana-siyana.
White Cells
Iko tsvuku nyeredzi inowanzo inowanikwa pakati pe 5 000-10 000 pa microliter yeropa. Kuwedzera kwehutano kunoratidza kuputika kana utachiona. Zvinhu zvakadai sekurovedza muviri, kutonhora, uye kushungurudzika zvinogona kukwidziridza kwekanguva masero esero.
Maselo matsvuku
Maitiro anowanzoitwa red red cell kuenzaniswa nehutano.
- Varume vanowanzove vanokoshesa mamiriyoni mashanu kusvika ku5 kusvika masere emasero matsvuku pamamota.
- Madzimai ane huwandu hwakaderera huri pakati pe 3.6-5.6 mamiriyoni matsvuku matsvuku nema microliter.
Hemoglobin / Hematocrit
Hemoglobin, iyo yakagadzirwa nesimbi yakagadzirwa nemasero matsvuku anotakura oksijeni, inoyerwawo muhuwandu hwakazara weropa. Iko inowanikwa hemoglobin kukosha kwevarume ndeye 13-18 g / dl. Kazhinji hemoglobin yevakadzi ndeye 12-16 g / dl.
Iyo hematocrit inokwana huwandu hwemasero matsvuku sehuwandu hwehuwandu hweropa rose.
Kazhinji hematocrit yevarume inenge iri pakati pe40 kusvika ku55 uye inowanikwa hematocrit yevakadzi ndeye 36-48%. Kazhinji, hematocrit inenge katatu hemoglobin. Kurasika maitiro kunoratidza kushaya ropa .
Iyo MCV, MCH, MCHC iine red cell indices iyo inoratidza ukuru uye hemoglobin zvakagadzirwa nemamwe masero matsvuku. Nyeredzi dzinogona kupa zvinyorwa pamusoro pechikonzero chinokonzerwa nehutachiona hwehutachiwana hwehutachiwana.
Platelets
Platelets zvikamu izvo zvakakosha mukugadzira mazamu . Mishonga yakawanda inoshandiswa mukurapa arthritis inogona kuderedza platelet kuverengwa kana kuchinja platelet basa. Kazhinji mapepa epa platelet anobva kubva ku 150,000-400,000 pamusana we microliter.
Kusiyana
Iko yezana uye nhamba yakazara yega yega yega yeropa rega rega inonzi iyo yakasiyana.
- Neutrophils inowedzera muhutachiona hwehutachiona uye kuputika kukuru.
- Lymphocytes inowedzera muhutachiona hwehutachiona.
- Monocytes inowedzera muzvirwere zvisingaperi.
- Eosinophils inowedzera mumakemikari uye mamwe mamiriro. Nhamba yakakwirira ye eosinophils inozivikanwa se eosinophilia .
- Basophils , iyo inowanzova 1 kana 2 muzana yehutano hwemuchena, hushoma huwandu.
Kuvhiringidza
Nzira yekuvhiringidza inogona kukonzera kuchinja muhuwandu hweropa. Iko tsvuku tsvuku inogona kuwira pasi, iyo tsvuku yakawanda inogona kukwira, uye platelet kuverengwa inogona kukwidziridzwa.
Kunyange zvazvo chirwere chekushaya ropa chinogona kuenderana nekuputika arthritis kunogona kukonzerwa nezvimwe zvinhu, zvakadai sekurasikirwa neropa kana kushayikwa kwesimbi. Chero kana zvimwe zvikonzero zvichitongwa kunze zvinogona chiremba kududzira ropa risina kunaka sechiratidzo chokuputika.
Chemistry Panels
Iko chemistry pane imwe nhungamiro yezvidzidzo zvinoshandiswa kuongororodza mabasa anokosha emagetsi. Iboka rekuongororwa rinoitwa pane serum (chikamu cheropa pasina masero). Electrolytes, saloni ionized muropa kana mishonga yemvura (semuenzaniso, sodium, potassium, chloride), inhengo yekemiti yemakiti. Panewo mimwe miedzo inoshanda sezviratidzo zvehupenyu hwehutano, chirwere cheshuga, hwepfungwa , uye chiropa chinoshanda .
Semuenzaniso, murwere ane chiremera chakakura chekusika angave asina kufanana kwetsvo. Creatinine isvina yakagadzirwa muropa. Mamwe maitiro ezvokuputika arthritis anogona kukanganisa basa repvo. Zvichida mamwe arthritis zvinodhaka zvinogona kukanganisa basa repvo, zvakare. Uric acid chimwe chiedzo chinowanikwa muropa chemistry panel. Kana yakasimudzwa, uric acid inogona kuratidza gout. Icho chaingova mishoma mienzaniso. Ichokwadi, iyo chemistry panel inopa ruzivo rwakanyanya pamusoro pokuti muviri unoshanda sei.
Special Species Blood Test
Erythrocyte Sedimentation Rate (ESR)
I- erythrocyte sedimentation rate ndiwo muedzo unosanganisira kuisa muropa wepamu inokosha uye kugadzirisa kuti masero matsvuku eropa anotarisa kusvika pasi sei muawa imwe chete. Kana kutuka kuripo, muviri unobereka mapuroteni muropa iro anoita kuti masero matsvuku awirirane. Inorema sejeri aggregates inowira nokukurumidza kudarika masero masero ose matsvuku. Kune vanhu vane hutano, huwandu hunowanikwa kusvika mamita 20 muawa imwe (0-15 mm / hr varume uye 0-20 mm / hr yevakadzi). Kuvhiringidza kunowedzera muzinga zvakanyanya. Sezvo kuvhiringidzika kunogona kusanganiswa nemamiriro ezvinhu kunze kweArthritis, sedimentation rate test test chete inofungidzirwa isiri yakananga.
Rheumatoid Factor (RF)
Rheumatoid factor is antibody in found in many patients with rheumatoid arthritis . Rheumatoid factor yakawanikwa muma1940 uye yakazova chinhu chikuru chekuongorora chinoshandiswa mumunda we rheumatology. Inenge 80% ye rheumatoid arthritis varwere vane rheumatoid iyo muropa ravo. Kukurukurira kwakanyanya kwerheumatoid chinhu inowanzobatanidzwa nechirwere chakakomba.
Rheumatoid chinhu inogona kutora mwedzi yakawanda kuratidzira muropa. Kana akaedzwa kare kare munguva yechirwere chacho, chigumisiro chacho chingave chakaipa uye kuongorora zvakare kunofanira kuonekwa pane imwe nguva yakatevera. Mumamiriro ezvinhu apo varwere varipo nezviratidzo uye zviratidzo zve rheumatoid arthritis asi ivo vane seronegative nokuda kwerumatoid factor, vanachiremba vangafungidzira kuti chimwe chirwere chinomirira rheumatoid arthritis. Rheumatoid chinhu inogonawo kuitika kune mamwe mamiriro ekuvhiringidza kana zvirwere zvinotapukira, kunyange zvazvo kazhinji mumamiriro ezvinhu akadaro, maitiro acho akaderera pane rheumatoid arthritis.
HLA Typing
Maseji akachena eropa anogona kuenzaniswa nehupo hweHLA-B27. Chiyero chinowanzoonekwa mune zvezvipatara uko kuchinja kunoitwa. HLA-B27 iinewo maitiro ehutano anobatanidzwa nemamwe marudzi eArthritis, kunyanya ankylosing spondylitis uye Reiter's syndrome / Reactive Arthritis .
Antinuclear Antibody (ANA)
Chirwere cheAnA (antinuclear antibody) chinoitwa kuti chibatsire kuongorora dzimwe zvirwere zverheumatic . Varwere vane dzimwe zvirwere, kunyanya lupus , vanoumba zvirwere kumusana wemasero emuviri. Mishonga inonzi anti-nuclear antibodies uye inoonekwa nokuisa serum murwere pane imwe microscope slide inosanganisira masero ane nuclei inoratidzika. Chimwe chinhu chine dhayi re fluorescent chinowedzerwa. Dhayi yacho inosungira kumasikirwo epasiki, zvichiita kuti zvioneke pasi pechircroscope fluorescent.
- Vanopfuura 95% varwere vane lupus vane chirongwa chakanaka cheAA.
- 50% ye rheumatoid arthritis varwere vane chivimbo kune ANA.
Varwere vane dzimwe zvirwere vanogonawo kuva neAA positive zvakanaka. Nokuda kwechikonzero chekuongorora, mamwe maitiro anofanirwawo kutaridzirwa.
C-Reactive Protein (CRP)
C-Reactive Protein inotarisa kuiswa kwepurogiramu chaiyo yeprotini inobudiswa nechiropa. Puroteni iripo muropa serum munguva dzezvikamu zvekuvhiringidza kwakanyanya kana utachiona.
Sezvo kuongororwa ropa, CRP inofungidzirwa isiri yechokwadi. Chigumisiro chepamusoro chinoratidza kurwisa kukuru. Muzviitiko zvezvirwere zvinoputika rheumatic, zvakadai se rheumatoid arthritis uye lupus, vanachiremba vanogona kushandisa chirongwa cheRPP kuti vaone kubudirira kwehutano uye chirwere chekuita.
Lupus Erythematosus (LE)
Iko yesero seE cell haisati yashandiswa zvakare. Kuwanikwa kwaro kwokutanga kwakazarura munda wose wezvigadziriswe zvisikliya, kunyange zvakadaro. Dambudziko - 50% chete yevanhu vane lupus vanowanikwa kuva neE positive test.
Anti-CCP
Anti-CCP (anti-cyclic citrullinated peptide antibody) ndechimwe chekuongorora kweropa kutsva kunoshandiswa kusimbisa kuongororwa kwerheumatoid arthritis. Kana munhu anopesana aripo pakakwirira, zvinogonawo kuratidza kuti kune ngozi yakanyanya yekuvhiringidza kwakanyanya.
Anti-DNA uye Anti-Sm
Lupus varwere vanoumba zvirwere kuDNA (deoxyribonucleic acid). Chiyero chinowanika chinoongorora kuvepo kweAn anti-DNA. Icho chinhu chakakosha chokuongorora, kunyanya sezvo anti-DNA isingawanzowaniki kune vanhu vasina lupus. Chiyero ichiwo chakanaka chekucherechedza chikonzero nokuti maitiro e-anti-DNA anosimudza uye anowa nehutano hwekuita.
Vachirwere veLupus vanewo zvirwere zveSm (anti-Smith), chimwe chinhu chiri mumusero wechikamu. Zvirwere zveAn Sm zvinowanikwa chete mu lupus. Chiyero hachibatsiri pakuongorora chirwere chekuita, kunyange zvakadaro.
Complement
Iko kuwedzera komutambo iyi yakaoma yakawanda yemapuroteni eropa ayo ari chikamu chekudzivirirwa kwemuviri wemuviri. Izvo mapuroteni haana kushanda kusvikira an antibody anonamatira kune an antigen uye anoita kuti kuve nekugadzirisa hurongwa. Izvo zvinokonzera zvinhu zvinobatsira kuparadza mabhakitiriya uye kurwisa vapambi. Izvi zvinoshandisa kubatsiridza uye kusiya mafungiro akaora mwoyo anoratidza maitiro ekudzivirira zvirwere. Varwere vaLupus vanowanzoratidza kurara kwehuwandu hwekubatsira . Muongorori wokuenzanisa unogonawo kubatsira mukutsvaga chirwere chechirwere chepirus patient.
Sources:
Kelley's Textbook yeRheumatology. Elsevier. Ninth edition.
Duke University Medical Center Bhuku reArthritis, David S. Pisetsky, MD, Ph.D.