Tsanangudzo
Glucose 6 Phosphate Dehydrogenase (G6PD) inoshaya ndiyo inonyanya kushaya enzyme inoshaya munyika. Vanenge mamiriyoni mazana mana vanhu vanobatwa pasi rose. Pane kuchinja kwakakura mukutsungirira kunobva pane kuchinjwa kunotora nhaka.
G6PD iine enzyme inowanikwa muchechi yeropa tsvuku inoda kupiwa simba kusero. Pasina simba iri, iro tsvuku tsvuku yeropa inoparadzwa nemuviri (hemolysis) inoita kuti anemia uye jaundice (kuchena kweganda).
Ndiani Ari panjodzi yekushayikwa kweG6PD?
Ijeni reG6PD rinowanika pa X chromosome kugadzira varume vanowanzosvikirwa neG6PD kushayikwa (chirwere chinonzi X-linked). G6PD kushayikwa kunodzivirira vanhu kubva kune hutachiwana hwemarariya saka inonyanya kuonekwa munzvimbo dzine hutachiona hwehutachiona hweAfrica, Mediterranean, uye Asia. MuUnited States, 10% yeAfrica -America varume vanokwana G6PD.
Ndezvipi Zviratidzo?
Zviratidzo zvinotenderera pane kuchinja kupi kwaunoita. Vamwe vanhu vangasazomboonekwa kuti hapana zviratidzo zviripo. Vamwe varwere vane G6PD kushayikwa vane zviratidzo chete kana vaiswa kune mamwe mishonga kana kudya (ona rondedzero iri pasi apa). Vamwe vanhu vanogona kuonekwa sevana vatsva mushure mekunge vaine jaundice yakaoma (inonziwo hyperbilirubinemia). Mune ivavo varwere uye avo vane maitiro akaoma eG6PD akashayikwa nekusingaperi hemolysis, zviratidzo zvinosanganisira:
- Pallor kana paravara ruvara rweganda
- Rapid moyo rate
- Kuneta kana kuneta
- Kunzwa kusina simba kana kuchena
- Kupenya kweganda (jaundice) kana maziso (scleral icterus)
- Mvura yakasviba
Kurasikirwa kweG6PD Kunowanikwa Sei?
Kuongorora kusakwana kweG6PD kunogona kunge kwakaoma. Kutanga, iwe chiremba anofanira kufungidzira kuti une hemolytic anemia (kuputsika kwemasero matsvuku eropa). Izvi zvinowanzosimbiswa nehuwandu hwekuverenga ropa uye reticulocyte count.
Reticulocytes masero masero matsvuku eropa akatumirwa kubva mumufupa wepafu mushure mekushaya chirwere chekushaya ropa. Anemia neyepamusoro reticulocyte count inowirirana ne hemolytic anemia. Mamwe mabhizimusi anogona kusanganisira bilirubin count iyo ichakwiridzirwa. Bilirubiin inosunungurwa kubva kune imwe tsvuku yeropa apo inoputsika uye inokonzera jaundice panguva yekutambudzika kwehemolytic.
Pakugadzirisa kusarudza kuongororwa, chiremba wako achada kutonga kunze autoimmune hemolytic anemia (AIHA). Iyo yakananga kupikisa globulin muedzo (inonziwo yakananga Coombs 'test) inoongorora kana kune ma antibodies kune masero matsvuku eropa achiita kuti varwise nemaitiro ezvirwere zvemuviri wenyu. Sezvakanyanya kuitika hemolytic anemia, chirwere cheropa chinonzi smear (microscope slide yeropa) chinobatsira zvikuru. Muchikamu cheG6PD, kukanganisa masero nemasero emabhanja zvinowanzoitika. Izvi zvinokonzerwa nekushanduka kunoitika kune imwe tsvuku yeropa sezvo iri kuparadzwa.
Kana kushayikwa kweG6PD kuchifungidzirwa, nhamba yeG6PD inogona kutumirwa. A low G6PD level inowirirana neG6PD inoshaya. Zvinosuruvarisa, pakati pehutachiona hwehemolytic dambudziko rejasi G6PD level haritauri kushaikwa. Iro reticulocytes yakawanda iripo munguva yehemolytic crisis ine maitiro akaenzana eG6PD zvichikonzera kuipa kwenhema.
Kana zvakanyanya kufungidzirwa, kuedza kunofanira kudzokororwa apo murwere ari pachigaro chekutanga.
G6PD Inotarirwa Sei?
Dzivisa mishonga kana zvikafu zvinokonzera hemolytic (red red cell breakdown) matambudziko. Mamwe aya aya akanyorwa pasi apa.
- Fava nyeredzi (inonziwo mahesheni makuru)
- Moth balls (kana zvimwe mishonga ine naphthalene)
- Sulfa antibiotics seBactrim / Septra, sulfadiazine
- Quinolone antibiotics yakafanana neciprofloxacin, levofloxacin
- Nitrofurantoin (antibiotic)
- Mishonga inorwisa marariya se primaquine
- Methylene blue
- Mishonga yeTBP semadhipa e-dapsone uye sulfoxone
- Kanzira kurapwa mishonga yakadai se doxorubicin kana rasburicase
- Phenazopyridine
Kuwedzerwa ropa kunoshandiswa apo inemia yakaoma uye murwere ane chiratidzo. Nenzira yakanaka, varwere vakawanda havadi kuwedzerwa ropa.