Anisocytosis: wehewehe, hōʻailona a me nā hōʻailona

ʻO Anisocytosis kahi manawa i hoʻohana ʻia i hematology ke loaʻa ka nui o ke kino ma waena o nā hunaola o nā laina like e like me:

• nā pūpū kokoʻulaʻula, i kapa ʻia he ʻulaʻula a i ʻole nā ​​erythrocytes;
• pāpaʻa koko, i kapa ʻia hoʻi nā thrombosit.

Hiki ke hoʻokaʻawale i kekahi mau anisositosis ma muli o ka laina pūnaewele e pili ana.

• anisositosis erythrocyte ke pili ka abnormalities i nā erythrocytes (ʻulaʻula koko);
• platis anisositosis, i kekahi manawa i kapa ʻia he thrombosittic anisocytosis, ke pili ka mea maʻamau i nā thrombosit (nā pā koko).

Kaukaʻi ʻia i ke ʻano o ka hewa i loaʻa, wehewehe ʻia ka anisocytosis i kekahi manawa e like me:

• anisositosis, ʻoi aku ka manawa pōkole e like me microcytosis, ke liʻiliʻi ka liʻiliʻi o nā huna koko;
• aniso-macrocytosis, hoʻopōkole pinepine ʻia e like me ka macrocytosis, ke nui a hewa ʻole nā ​​aʻa koko.

ʻO Anisocytosis kahi maʻi maʻamau o ke koko i ʻike ʻia i ka wā a hemogram, i kapa ʻia ʻo Blood Count and Formula (NFS). Lawe ʻia e ka lawe ʻana i kahi laʻana o ke koko vena, hāʻawi kēia hōʻike i kahi nui o ka ʻikepili ma nā huna koko.

Ma waena o nā waiwai i loaʻa i ka wā o ka helu ʻana o ke koko, ʻo ka index index distribution cell cell (RDI) kahi i kapa ʻia ʻo ka helu anisositosis. Ke hiki nei ke loiloi i ka loli o ka nui o nā hunaola ʻulaʻula i ke kahe o ke koko, hiki i kēia papa kuhikuhi ke ʻike i ka anisositosis erythrocyte. Manaʻo ʻia he maʻa mau ia ma waena o 11 a 15%.

ʻO ka ʻōlelo maʻamau, ʻo ka anisocytosis kahi manawa i hoʻohana ʻia e nā kauka e kuhikuhi i ka erythrocyte anisositosis. E pili ana i nā hunaola ʻulaʻula, maʻamau kēia maʻamau o ke koko i anemia, kahi kulu kūpono ʻole o ka pae o nā hunaola ʻulaʻula a i ʻole hemoglobin i ke koko. Hiki i kēia hemahema ke kumu o nā pilikia no ka mea ʻo nā hunaola ʻulaʻula nā hunaola e pono ai no ka hāʻawi ʻana o ka oxygen ma loko o ke kino. Aia i loko o nā ʻulaʻula koko, he protein kahi hemoglobin i hiki ke hoʻopaʻa i kekahi mau mole o oxygen (O2) a hoʻokuʻu iā lākou i nā hunaola.

Hiki ke hoʻokaʻawale i kekahi ʻano o ke anemia e hana ana i ka anisositosis erythrocyte, me:

• kaanemia hemahema hao, i hoʻokumu ʻia e ka hemahema hao, i manaʻo ʻia he anemia microcytic no ka mea hiki ke alakaʻi i ka anisositosis me ke kūkulu ʻia ʻana o nā hunaola ʻulaʻula liʻiliʻi;
• anemia hemahema wikamina, ka mea maʻamau o nā anemias deficit wikamina B12 a me nā anemias deficiament B9, i manaʻo ʻia he anemias macrocytic no ka mea hiki iā lākou ke kumu i ka aniso-macrocytosis me ka hana ʻana o nā hunaola ʻulaʻula deformed.
• kaanemia hemolytic, ʻano e ka luku mua ʻia ʻana o nā hunaola ʻulaʻula, i hiki ke hopena ʻia e nā genetics abnormalities a i ʻole nā ​​maʻi.

ʻO ka platis anisositosis kekahi kumu pilikino. Hiki ke pili pono i ka anelositosis platelet ma muli o ka myelodysplastic syndromes (MDS), kahi o nā maʻi ma muli o ka hana ʻole o ka iwi iwi.

Nā kumu kūikawā o ka anisocytosis

ʻO ke kino

ʻAʻole i nā manawa a pau ka hele ʻana o ka anisocytosis e hōʻike i kahi pathology. No ka laʻana, i nā keiki hānau hou, ʻike ʻia ka macrocytosis physiological. ʻO kēia ma muli o ka ulu mālie ʻana o ka iwi iwi a me nā kaʻina o ka mitosis i loko o nā cell stem hematopoietic. Ma ka mahina ʻelua o ke ola, hoʻoholo mālie ka anisocytosis iā ia iho.

pauʻa hao

ʻO ke kumu maʻamau maʻamau o ka anisocytosis ka nele o ka hao. Me ka nele o ka hao i loko o ke kino, aia ka hewa o ka maturation o nā erythrocytes, ka hoʻokumu ʻana o kā lākou membrane cell, a me ka hoʻokumu ʻana o ka hemoglobin. ʻO ka hopena, ua emi ka nui o ke koko ʻulaʻula (microcytosis). Me ka haʻi ʻole o ka hao, e emi iho ka nui o ka hemoglobin i loko o ke koko, a ulu ka iron deficiency anemia (IDA).

Me ka anisocytosis, ʻike pinepine ʻia ka hypochromia, ʻo ia hoʻi, hoʻemi ʻia ka saturation hemoglobin o nā erythrocytes. ʻO Anisocytosis, a me nā hoʻololi ʻē aʻe i nā helu erythrocyte (MCV, MCH, MCHC), hiki ke ma mua o ka hoʻomohala ʻana o IDA, i ka mea i kapa ʻia ʻo latent iron deficiency.

Eia kekahi, hiki i ka anisocytosis ke hoʻomau i ka hoʻomaka ʻana o ka hoʻohui hao no ka mālama ʻana i ka anemia deficiency hao. Eia kekahi, he ʻano kikoʻī kona - aia ka nui o nā microcytes a me nā macrocytes i loko o ke koko, ʻo ia ke kumu o ka histogram o ka hāʻawi ʻana i nā erythrocytes he hiʻohiʻona ʻelua-peak hiʻohiʻona.

Nā kumu o ka nele o ka hao:

• Mea ʻai meaʻai.
• ʻO ka wā kamaliʻi, ka wā ʻōpio, ka hāpai ʻana (nā manawa o ka piʻi ʻana o ka pono no ka hao).
• ʻO ka hoʻopaneʻe lōʻihi lōʻihi.
• ʻO ke kahe o ke koko maʻamau: ʻeha peptic o ka ʻōpū a i ʻole duodenum, hemorrhoids, hemorrhagic diathesis.
• Ke kūlana ma hope o ka wehe ʻana o ka ʻōpū a i ʻole ka ʻōpū.
• ʻO nā maʻi genetic o ka metabolism hao: hereditary atransferrinemia.

Ka laʻana koko no ka noiʻi

ʻO ka nele o ka Vitamin B12 a me ka folic acid

ʻO ke kumu ʻē aʻe o ka anisocytosis, ʻo ia hoʻi ka macrocytosis, ʻo ia ka nele o ka B12 me ka waikawa folic, a ʻike pinepine ʻia kahi hemahema vitamina hui. ʻO kēia ma muli o kā lākou mau hopena metabolic kokoke. ʻO ka nele o B12 ka mea e pale ai i ka hoʻololi ʻana o ka folic acid i loko o kahi ʻano coenzyme ikaika. Ua kapa ʻia kēia hanana biochemical he folate trap.

ʻO ka nele o kēia mau huaora e alakaʻi ai i ka hōʻino ʻana i nā kumu purine a me nā pyrimidine (nā ʻāpana nui o ka DNA), ka mea e hoʻopilikia nui i ka hana o ka iwi iwi, ma ke ʻano he okana me ka hana kiʻekiʻe loa o ka hoʻonui ʻana o ka cell. Hiki mai kekahi ʻano megaloblastic o ka hematopoiesis - ʻaʻole i oʻo piha ʻia nā cell me nā mea o ka cell nucleus, hoʻonui ʻia ka saturation o ka hemoglobin a hoʻonui i ka nui e komo i ke koko peripheral, ʻo ia hoʻi, ʻo ka anemia he macrocytic a hyperchromic ma ke ʻano.

ʻO nā kumu nui o ka nele B12:

• ʻO ka ʻai koʻikoʻi a me ka haʻalele ʻana i nā huahana holoholona.
• atrophic gastritis.
• ʻO ka gastritis autoimmune.
• Ka wehe ʻana o ka ʻōpū.
• Ka hemahema hoʻoilina o ka intrinsic factor Castle.
• Malabsorption : ka maʻi celiac, ka maʻi ʻōpū.
• ʻO nā ilo: diphyllobothriasis.
• ʻO ka hemahema genetic o ka transcobalamin.

Eia naʻe, hiki mai ka nele o ka folate kaʻawale. I kēlā mau hihia, ʻo ka hoʻololi pathological wale nō i ke koko he anisocytosis (macrocytosis). Loaʻa kēia ma ka waiʻona, no ka mea, hoʻolohi ka ethyl alcohol i ka komo ʻana o ka folate i loko o ka ʻōpū o ka ʻōpū. Eia kekahi, ʻo ka nele o ka folic acid a me ka macrocytosis e hiki mai ana i nā maʻi e lawe i nā contraceptive waha no ka manawa lōʻihi, i nā wahine hāpai.

Kahalaima

I kekahi mau hihia, ʻo ka anisocytosis (microcytosis), me ka hypochromia, he mau hōʻailona paha ia o ka thalassemia, kahi hui o nā maʻi i hōʻike ʻia e kahi genetic abnormality i ka synthesis o nā kaulahao globin. Ma muli o ka hoʻololi ʻana o kekahi gene, aia ka nele o kekahi mau kaulahao globin a me nā kaulahao ʻē aʻe (alpha, beta a i ʻole nā ​​kaula gamma). Ma muli o ka loaʻa ʻana o nā molekole hemoglobin hemahema, ua emi ka nui o nā ʻulaʻula koko (microcytosis), a ʻoi aku ka maʻalahi o kā lākou membrane i ka luku ʻia (hemolysis).

Microspherocytosis hoʻoilina

I ka maʻi Minkowski-Choffard, ma muli o ka mutation o ka gene encoding i ka hoʻokumu ʻia ʻana o nā proteins structural o ka membrane erythrocyte, ka permeability o ko lākou paʻa paʻa e piʻi aʻe i loko o ke koko ʻulaʻula, a hoʻonui ka wai i loko o lākou. Hoʻemi ka nui o nā Erythrocytes a lilo i spherical (microspherocytes). Hoʻohui pinepine ʻia ka anisocytosis i kēia maʻi me ka poikilocytosis.

ʻO ka anemia sideroblastic

ʻAʻole hiki ke loaʻa ka anisocytosis ma muli o ke ʻano o ka anemia sideroblastic, kahi maʻi pathological kahi i hōʻino ʻia ai ka hoʻohana ʻana i ka hao, ʻoiai ʻo ka mea hao i loko o ke kino he mea maʻamau a piʻi paha. ʻO nā kumu o ka anemia sideroblastic:

• ʻO ka maʻi Myelodysplastic (ke kumu maʻamau).
• ʻO ka lawe ʻana i nā lāʻau e hoʻopau i ka metabolism o ka huaora B6.
• ʻO ka ʻona kepau mau.
• Ka hoʻololi ʻana o ka gene ALAS2.

lapaʻau '

ʻO kaʻikeʻana i ka hopena "anisocytosis" ma keʻano o ka ho'āʻo koko e koi i ka hoʻopiʻi he kauka lapaau e hoʻoholo i ke kumu o kēia kūlana. I ke koho ʻana, hōʻiliʻili ke kauka i ka mōʻaukala kikoʻī, hōʻike i ka hele ʻana o nā hoʻopiʻi ʻano o ka anemia (nāwaliwali maʻamau, dizziness, deterioration in concentration, etc.). Hoʻomaʻamaʻa inā e lawe mau ana ka mea maʻi i nā lāʻau lapaʻau.

I ka wā o ka hoʻokolokolo hoʻokolokolo, ua huki ʻia ka manaʻo i ke alo o nā hōʻailona o ka anemic syndrome: pallor o ka ʻili a me nā mucous membranes, ke koko haʻahaʻa, hoʻonui ʻia ka puʻuwai puʻuwai, a me nā mea ʻē aʻe. iwi iwi ke ano.

Hoʻonohonoho ʻia nā haʻawina hou:

• Nānā koko nui. I loko o ka KLA, ʻo ka hōʻailona o ka mea nānā hematological, e hōʻike ana i ka hele ʻana o ka anisocytosis, ʻo ia ka RDW. Eia nō naʻe, he kiʻekiʻe hewa paha ia ma muli o ka loaʻa ʻana o nā aglutinins anu. No laila, koi ʻia ka nānā ʻana i ka microscopic o kahi hamo koko. Eia kekahi, hiki i ka microscopy ke ʻike i nā hōʻailona o ka hemahema B12 (Jolly body, Kebot rings, hypersegmentation of neutrophils) a me nā hoʻopili pathological ʻē aʻe (basophilic granularity, nā kino Pappenheimer).
• Ke kemika koko. Ma kahi ho'āʻo koko biochemical, nānā ʻia ke kiʻekiʻe o ka serum iron, ferritin, a me transferrin. Hiki ke ʻike ʻia nā hōʻailona o ka hemolysis - ka piʻi ʻana o ka lactate dehydrogenase a me ka bilirubin indirect.
• Ka noiʻi immunological. Inā manaʻo ʻia kahi maʻi autoimmune o ka ʻōpū o ka ʻōpū, hana ʻia nā hoʻāʻo no nā antibodies i nā cell parietal o ka ʻōpū, nā antibodies i transglutaminase, a me gliadin.
• Ka ʻike ʻana i ka hemoglobin abnormal. I ka hōʻoia ʻana o ka thalassemia, hana ʻia ka hemoglobin electrophoresis ma ke kiʻi cellulose acetate a i ʻole ka chromatography wai hana kiʻekiʻe.
• ʻO ka hōʻailona o ka microspherocytosis. No ka hōʻoia ʻana a i ʻole ka haʻalele ʻana i ka microspherocytosis hoʻoilina, ua hoʻokō ʻia ke kūʻē osmotic o nā erythrocytes a me ka hōʻike EMA me ka hoʻohana ʻana i ka fluorescent dye eosin-5-maleimide.
• noiʻi parasitological. I ka hihia o ka diphyllobothriasis, ua kuhikuhi ʻia ka microscopy o kahi hoʻomākaukau fecal maoli e ʻimi i nā hua o kahi tapeworm ākea.

I kekahi manawa pono ia e hana i kahi hōʻailona ʻokoʻa ma waena o IDA a me thalassemia minor. Hiki ke hana ʻia kēia ma o ka hoʻāʻo koko maʻamau. No kēia, ua helu ʻia ka helu Mentzer. ʻO ka lakio o ka MCV i ka helu o nā keʻena koko ʻulaʻula ma mua o 13 he mea maʻamau no ka IDA, emi iho ma lalo o 13 - no ka thalassemia.

Ke nānā ʻana i kahi paʻi koko

ʻO nā ʻōuli o anisositosis nā anemia. ʻOiai aia nā ʻano like ʻole a me nā kumu o ka anemia, ʻike pinepine ʻia kekahi mau hōʻailona ʻano like ʻole:

• he manaʻo luhi nui;
• pokole o ka hanu
• palpitations;
• nāwaliwali a me ka luʻuluʻu;
• ʻeleʻele;
• ʻeha poʻo.

ʻO ka mālama ʻana no anisocytosis kaukaʻi ʻia i ke kumu o ka abnormalities. I ka hanana o ka hao hemahema anemia a i ʻole wikamina deficience anemia, hiki ke ʻōlelo ʻia i ka supplementation nutritional e mālama i ka anisositosis.