Isifo se-sideropenic enesisindo se-iron anemia: izimpawu, ukwelashwa

Iron - ingenye izakhi, ngaphandle okuyinto umzimba womuntu ayikwazi ukusebenza ngokugcwele. Noma kunjalo, kukhona ingozi ukwephulwa izimpahla zakhe kusukela umthelela izici ezihlukahlukene futhi izinqubo. Enye yezinkinga obujwayelekile yensimbi ukuntula anemiya (ida). Kungaba kukhule kokubili ngabantwana nangabantu abadala, ngisho nabesifazane abakhulelwe basengozini. Sikhishwe zonke Amandla okubhubhisa isifo, kusuke kukufanelekele ukuthola kabanzi.

Asho ukuthini i-anemiya yensimbi ukuntula?

Ngaphambi cwaningo syndrome sideropenic nensimbi ukuntula kwegazi, kufanele uthinte wenkinga ezihlobene nokuntula trace isici. Lolu hlobo lwe-anaemia yisimo sokugembula libhekene ukwehla ezingeni elithwala umoya-mpilo egazini ngenxa ukuntula lubonakale yensimbi emzimbeni. Ngqo kusilela livela ngenxa ukuhlukumeza irisidi yayo kanye nokwenziwa, noma ngenxa ukulahlekelwa sokugembula kwalesi sakhi.

Iron ukuntula anemiya (aka sideropenic) kuyehluka kuneminye anemias kakhulu uma lungenayo kukhona ukwehliswa kwamangqamuzana egazi abomvu. Ezimweni eziningi sitholakale abesifazane yokuzala, abesifazane abakhulelwe kanye nezingane.

Izimbangela zesifo

Ekuqaleni kufanele ukhombise engcupheni, okungase kwenzeke uma yensimbi ukuntula. ekusetshenzisweni kakhulu kwemithombo yensimbi, okuyinto kulandele anaemia kungadalwa sokukhulelwa okuphindaphindiwe kokuya esikhathini luningi sikhathi sokukhula ngokushesha kanye lactation ngesikhathi pubertantnogo isikhathi. Abantu asebebadala kungenzeka konakalise yensimbi ukusetshenziswa. Futhi isibalo izifo senile engibukhulumile ngaso isifo sokulahlekelwa igazi kakhulu anda (diverticulosis amathumbu, esingamahlalakhona kwezinso, oncopathology et al.).

Ukhathazeke inkinga ezifana yensimbi ukuntula, kubalulekile futhi ukuthi icala, uma kwaphazamisa ukumuncwa kwalesi sakhi kuleveli erythrokaryocytes (ngenxa engayitholi enganele insimbi ukudla). Njengoba izimbangela yensimbi ukuntula anaemia, kunengqondo ukulapha noma isiphi izifo eziholela ukopha. Lokhu kungase sasigcwala izilonda unesimila izinqubo pheshana emathunjini, i-endometriosis, hemorrhoids ezingamahlalakhona kanye nabanye. Ezimweni ezingavamile, kungase waphawula ukulahlekelwa igazi Meckel diverticulum emathunjini amancane, lapho isilonda peptic ngenxa ukwakheka hydrochloric acid peptin.

Izimbangela yensimbi ukuntula anaemia kungenzeka ukuthi umataniswe ngemihlume glomicheskimi emaphashini, pleura kanye diaphragm, kanye kule mesentery emathunjini nasesiswini. Lezi izimila, ezithinta ukuxhumana ngqo ukuvala imithambo, ungakwazi ulcerate futhi babe umthombo ukopha. ngezinye izikhathi ukopha esungulwe Eqinisweni esimweni ngofuzo noma bathenga siderosis yamaphaphu, okuyinto nzima ukopha. Ngenxa yalokho yale nqubo, yensimbi emzimbeni womuntu ikhishwe, kulandele ukususwa iphaphu lakhe kwifomu hemosiderin ngaphandle kokuba nokwenzeka kulahlwa okwalandela. Ukulahleka yensimbi umchamo kungenzeka kubangelwa inhlanganisela izifo ezifana glomerulonephritis ezingamahlalakhona futhi atholwe hemosiderosis ukukhanya, ukuba umsuka sokuhlasela kwamasosha omzimba.

Ngezinye izikhathi izimbangela yensimbi ukuntula anaemia elihlobene ne yensimbi ukulahlekelwa noma yini kanye negazi, zihlobene ngokuqondile umphumela helminth zazo engena phakathi odongeni emathunjini, owabangela umonakalo kuso futhi, ngenxa yalokho, mikrokrovopoteri engaholela ukuthuthukiswa ida. Ingozi lolu hlobo anaemia ungokoqobo kulabo abanikeli ngubani banikele ngegazi njalo. Futhi njengoba esinye isizathu ukopha, azinake, kungenzeka ukunquma hemangioma kwezitho zangaphakathi.

Insimbi zomzimba womuntu zingase kabi ugxile ngenxa izifo ezincane wamathumbu, okuyinto zenzeka ngokuhlanganyela malabsorption syndrome dysbacteriosis amathumbu nabancane amathumbu resection. Ngaphambili, ungase kaningi ukuhlangabezana umbono wokuthi kolwelwesi atrophic, kokuba encishisiwe umsebenzi secretory, kwakudingekile ukuba siyicabangele njengoba le lowo oyimbangela yangempela yensimbi ukuntula igazi. Eqinisweni, leso sifo iyakwazi ukunikeza kuphela nethonya asizayo.

I esicashile yensimbi ukuntula (kufihlwe, ngaphandle izimpawu zokwelashwa) kungatholakala ezingeni kwamakhemikhali. Elinesimo ukuntula noma ukungabi khona ukwehla elibukhali idiphozithi yanoma microelement umnkantsha macrophage, okuyinto bungabonakala umbala ekhethekile. Kubalulekile ukuziphinda ukuthi ngalesi sigaba, ukulahlekelwa yensimbi kungatholakala kuphela ezimweni zaselebhu.

Esinye isici, okuvumela ukuba abone kusilela - nokuncipha serum ferritin.

Izimpawu sici yensimbi-ukuntula anaemia

Ukuze izimpawu abangu kangcono, kunengqondo ukuba kwahlukaniswe inqubo kumiswa yensimbi ukuntula ku izigaba 3.

Ekhuluma esigabeni sokuqala, kuyafaneleka ukuthi akukhona ephelezelwa izimpawu emtholampilo. Kungaba kuphela ukuhlonza nangokunquma nenani enemisebe yensimbi ukumuncwa e pheshana emathunjini kanye nenani hemosiderin, okuyinto kuqukethwe umnkantsha macrophage.

Isigaba sesibili lingachazwa ngokuthi i esicashile yensimbi ukuntula. It livezwa ukwehla umsebenzi ukubekezelelana ukukhathala abalulekile. Zonke lezi zimpawu zibonisa ngokucacile ukuntuleka yensimbi emisipheni ngenxa ukwehla lokuhlushwa enzyme yensimbi-aqukethe. Kuleli zinga, izinqubo ezimbili kungenzeki kanyekanye: ekunciphiseni ferritin amazinga e erythrocyte futhi serum, kanye ukuntuleka transferrin yensimbi ukugcwaliswa.

Ngaphansi esigabeni sesithathu kubalulekile ukuqonda ukubonakaliswa basemtholampilo yensimbi ukuntula igazi. Izimpawu eyinhloko kulesi sikhathi akunakubangelwa iziyaluyalu trophic we isikhumba, izinzipho, nezinwele, izimpawu sideropenic (ukukhathala noma ukuba buthakathaka), ukukhula ukuba buthakathaka kwezicubu, iphika izimpawu ukwehluleka palsy futhi inhliziyo (enkeneneza ezindlebeni, isiyezi, ubuhlungu besifuba, yokufikelwa ).

Ngu izimpawu sideropenic ngesikhathi Isinyathelo sesithathu osebenza isifiso ukudla wokulinganisa -. Geophagy, dysuria, incontinence urinary, akhuthaza ukuba uphethiloli iphunga, acetone, njll Ngokuphathelene geophagic, kuba ngaphezu yensimbi ukuntula zingase zibe Indlela ukuntula emzimbeni magnesium ne-zinc.

Lapho lichaza izimpawu ezivamile yensimbi ukuntula, kubalulekile ukuba banake izimpawu ezifana ubuthakathaka, isifiso ukulahlekelwa, nakwisyncope, palpitations, ubuhlungu bekhanda, ukucasuka, umfutho ophansi wegazi agqoke "izimpukane" phambi kwamehlo, ubuthongo ompofu ebusuku futhi ukozela emini, ukwenyuka kancane lokushisa, ehle ukunakwa inkumbulo, kanye tearfulness bese ukwethuka.

Ithonya syndrome sideropenic

Kubalulekile ukuqonda ukuthi insimbi ingxenye enzyme eziningi. Ngenxa yalesi sizathu, uma kukhona ukuntula, umsebenzi enzyme sinciphile phakathi izinqubo evamile umzimba emzimbeni kuyaphazamiseka. Ngakho, sideropenic syndrome imbangela yezimpawu zesifo eziningi:

1. izinguquko Skin. Lapho kukhona ukuntuleka yensimbi, kungabonwa uyaxebuka bese we isikhumba, eyagcina imifantu. Livela ukuqhekeka kungase izintende, amakhona emlonyeni, ngisho izinyawo ingquza. Izinwele nale syndrome ekuseni turning grey, babe ziyaqothuka futhi ewa ngenkuthalo. Cishe ingxenye yesine ka iziguli sibhekene ziyaqothuka, thinning futhi transverse striations izinzipho. Izicubu yensimbi ukuntula Empeleni is phetho ukuntuleka izicubu enzyme.
2. Ishintsha uhlelo kwemisipha. Iron imiphumela ukuntula ngokuntula enzyme myoglobin e imisipha. Lokhu kuholela ukukhathala noma ukuba buthakathaka. Ngo intsha, kanye nezingane, ukuntuleka yensimbi e enzyme kuphakamisa ukubambezeleka ngokomzimba nokukhula. Ngenxa yokuthi uhlelo kwemisipha zibuthaka, isiguli uzizwa esezizwa okucindezelayo ukuchamela, nobunzima ephethe umchamo lapho elihlekayo ukukhwehlela. Girls nensimbi ukuntula ngokuvamile kufanele ubhekane bedwetting.

sideropenic syndrome lushintsha nolwelwesi lwamafinyila yaleli pheshana emathunjini (imifantu ezisemagumbini emlonyeni, stomatitis emincane, kukhuphuke ezifweni ukuba caries kwamazinyo nezifo periodontal). Futhi, kukhona ushintsho bezibona iphunga. Nge a syndrome enjalo iziguli ziqala ukuba uthanda iphunga upholishi wezicathulo, uwoyela fuel, uphethiloli, igesi, i-naphthalene, acetone, mhlabathi omanzi emva kwemvula, varnishes.

Izinguquko futhi kungathinta ukunambitheka. Kuyinto nesifiso esinamandla ukunambitha imikhiqizo nonfood ezifana izinyo powder, inhlama eluhlaza, iqhwa, isihlabathi, ubumba, inyama nengulube, okusanhlamvu.

Ngo isifo esinjengo sideropenic syndrome, lwamafinyila zihluka yasenhla nemithombo yasenzansi zokuphefumula ipheshana ulwelwesi. Izinguquko ezinjalo, ngakho kungaholela ekwakhiweni rhinitis atrophic kanye pharyngitis. Iningi labantu nensimbi ukuntula syndrome livela sclera okwesibhakabhaka. Ngenxa yalokho ukwephula gidroskolirovaniya lysine ukungasebenzi kwenzeka enqubeni ye-collagen zamagama.

Uma insimbi ukuntula ingozi izinguquko izivikeli mzimba. Sikhuluma ukwehlisa amazinga immunoglobulin, ayisiza ezithile, B-lysine, futhi lysozyme. Futhi, kukhona ukwephula umsebenzi phagocytic ka neutrophil nokuvikeleka yeselula.

Lapho inkinga ezifana sideropenic syndrome, hhayi ngaphandle ukubukeka izinguquko dystrophic yezitho zangaphakathi. Lezi zihlanganisa yesibili sideropenic esivimba amanzi anemiya. It kubonakala ngokuqinisa first pitch ngesikhathi sokudlondlobala inhliziyo kanye ukunwetshwa imingcele eshaywayo onokuqundeka.

Iron ukuntula kungase futhi ushintshe futhi isimo ipheshana wokugaya ukudla. Sikhuluma izimpawu ezifana dysphagia sideropenic, ezomile nolwelwesi lwamafinyila we kuqhoqhoqho futhi mhlawumbe ukubhujiswa kwalo. Iziguli uqale ukuzizwa nenkinga yokugwinya ebusuku noma esimweni yokukhathala. Kwangathi konakalise izicubu emishinini yokuphefumula, okuholela yoma kancane kancane le mucosa esiswini, lapho asathuthuka kolwelwesi atrophic. Sideropenic syndrome ne kungaholela ukwehla kwe-uketshezi esiswini, okungaveza ahilii.

Kungani yensimbi ukuntula anaemia kwabesifazane abakhulelwe?

Ngo abesifazane walowo obeletha, yensimbi ukuntula kungenzeka kubangelwa ukubukeka izifo extragenital futhi izifo zabesifazane ngaphambi kokukhulelwa, kanye ukufuneka kakhulu yensimbi phakathi kwengane esiswini.

Ziningi izinto ezingasenza ukuthonya nesenzakalo kwezifo ezifana nesifo sokuntuleka kwegazi. Iron ukuntula kwabesifazane abakhulelwe, njengoba umthetho, ithuthukiswe ngenxa yezizathu ezilandelayo:

• eshiwo ngenhla ekstragenital'nye izifo (isifo senhliziyo, isilonda duodenal nasesiswini, kolwelwesi atrophic, ukwehluleka kwezinso, kucabanga helminthic, izifo zesibindi, izifo ukuthi ahambisana epistaxis, futhi hemorrhoids);
• umthelela umzimba amakhemikhali sowesifazane ezahlukene futhi kwenze izibulala-zinambuzane, ekwazi zivimbela ukumuncwa yensimbi;
• ukuntula azalwa naso;
• iziyaluyalu inqubo yensimbi ukumuncwa (pancreatitis okungamahlalakhona, enteritis, resection of wamathumbu encane, dysbiosis emathunjini);
• Ukudla okungalungile, okuyinto abakwazi ukunikeza ukulethwa element trace emzimbeni ibe yisikali edingekayo.

Iron ukuntula in izingane

Ngesikhathi sokukhulelwa emzimbeni wengane Ukwakheka kwezitho ukwakheka eziyisisekelo element mkhondo igazi. Nokho, iningi asebenzayo yensimbi kwezidingo izitsha esinomhlapho kungabonakala nasemkhakheni yokuthathu yesithathu. Ngo ingane egcwele eside amazinga evamile ngakho emzimbeni kufanele alingane mg 400. Kulokhu, labo abantwana abazalwa phambi elithi oyifunayo, le nkomba aliphumi ngenhla 100 mg.

Kubalulekile ukucabangela iqiniso lokuthi ubisi lwebele luqukethe ngokwanele kwalesi sakhi trace ngoba umzimba wengane replenishment ngaphambi 4 izinyanga ubudala. Ngakho-ke, uma isencane kakhulu ukuyeka ibele, ingane ingase ukuthuthukisa yensimbi ukuntula. Izimbangela yensimbi ukuntula anaemia ezinganeni kungenzeka ukuthi umataniswe kanye nongqi kokubeletha. Sikhuluma yizifo ezihlukahlukene ezithathelwanayo kukamama ngesikhathi sokukhulelwa, ekuseni khulu, hypoxia syndrome toxicosis sekwephuzile futhi. Ezisithinta Ukuwohloka yensimbi may izinto ezifana kaningana lapho ukumpontshelwa fetus syndrome, ezingamahlalakhona yensimbi ukuntula anaemia ngesikhathi sokukhulelwa, futhi ukopha lesizalo-esinomhlapho.

Ingozi iba intrapartum isikhathi ukopha okukhulu ngesikhathi sokubeletha bese nisebancane wokubopha intambo. Ngokuphathelene nesikhathi emva kokubeletha, kulesigaba yensimbi ukuntula kungaba umphumela we ngesivinini ukukhula kwengane, ekuqaleni kokulunyulwa ubisi lonke inkomo kanye izifo, okuyinto ahambisana ukumuncwa emathunjini.

Ukuhlolwa kwegazi ukuthola ida

Le ndlela ukuxilongwa liyadingeka ukuze sithole yehlise amazinga e-hemoglobin kanye amangqamuzana abomvu egazi. Ingasetshenziselwa ukuhlonza hemolytic sokuntuleka kwegazi kanye yensimbi ukuntuleka kwamavithamini, ukungezwani by ukulungisa izici morphological abomvu egazi ashaye kanye amangqamuzana abomvu phama.

Endabeni ida igazi yokuthakwa kwamakhemikhali lu- ehle lokuhlushwa serum ferritin, kukhuphuke TIBC, wehlise lokuhlushwa yensimbi serum futhi ngokuphawulekayo esingaphansi evamile transferrin ukugcwaliswa idatha trace isici.

Kubalulekile ukwazi ukuthi ngayizolo ukulethwa yokuhlaziya abakwazi baphuze utshwala. Akubalulekile ukuba sidle, ngokuba 8 amahora ngaphambi uphethwe kuvunyelwe amanzi ahlanzekile kuphela ngaphandle igesi.

ukuxilongwa umehluko

Kulokhu, ukusiza kakhulu sitholakele isifo uyakwazi umlando. Iron ukuntula anaemia ngokuvamile eba phezu zasemuva zezinye izifo, ukuze uthole ukwaziswa kungaba usizo kakhulu. Kepha indlela umehluko ku sitholakele yensimbi ukuntula kwegazi, iqhutshwa nalabo izifo ukuthi kungabangela yensimbi ukuntula. Ngakho thalassemia libhekene emitholampilo laboratory izimpawu shemoliza erythrocyte (lakhulisiwe usayizi ubende, amazinga anda bilirubin ngokungaqondile, anaemia hypochromic, reticulocytosis futhi okusezingeni eliphezulu okuqukethwe yensimbi edepho negazi serum).

Izindlela yokwelashwa

Ukuze unqobe inkinga efana yokuntuleka zensimbi egazini, kubalulekile ukuba ngokuphumelelayo asondele isu lokutakula. Isiguli ngasinye kumele kubonakaliswe indlela ngamunye, ngaphandle kwalokho ezingeni oyifunayo nekusebenta ezelaphayo ukufinyelela nzima.

Lapho inkinga ezifana yensimbi ukuntula emzimbeni, impatho ngokuyinhloko kuhilela ukuchayeka ngumuntu isici ukuthi kuphakamisa igazi. Ukulungisa lesi simo ngokuthi bathathe imithi yabo futhi kunendima isenzo.

Ukunakwa kufanele ikhokhwe kanye nokudla. I isabelo ida iziguli kufanele nemikhiqizo equkethe i-heme yensimbi kuhlanganisiwe. Lokhu unogwaja inyama, inyama yenkonyana, yenkomo. Ungakhohlwa succinic, citric futhi ascorbic acid. Gcwalisa yensimbi ukuntula kuzosiza ukusetshenziswa wezokudla fibre, i-calcium oxalate, futhi polyphenol (soy amaprotheni, itiye, ikhofi, ushokoledi, ubisi).

Ebhekisela emithini yokuselapha izihloko kabanzi, kuyafaneleka ukuthi yensimbi izidakamizwa kuyabekwa izinga kusuka 1.5 2 izinyanga. Ngemva ezingeni Hb sibuyela kwesejwayelekile, kuboniswa yokwelapha yesondlo usebenzisa isigamu-ngemithamo amasonto 4-6.

Iron onikwa anaemia wamukele based 100-200 mg / usuku. Ngemva umthamo kuyehla kube 30-60 g (izinyanga 2-4). Ethandwa kakhulu zihlanganisa izidakamizwa ezilandelayo: "Tardiferon", "Maltofer", "Totem", "Ferropleks", "Sorbifer", "Ferrum Lek". Ngokuvamile, imithi wenziwa ngaphambi kokudla. Okukhishiwe ezigulini uxilongwe kolwelwesi kanye nezilonda. Imithi oshiwo ngenhla angeke baphuze imikhiqizo, kuyakwazi ukubopha yensimbi (ubisi, itiye, ikhofi). Kungenjalo, ithonya lazo okuyoqedwa. Kufanele ekuqaleni ukuqaphela engenangozi side effect, okuyinto akwazi Izithako nensimbi yokwensimbi anemiya (ie mnyama umbala wamazinyo). Wesabe ukusabela ngaleyo ndlela akudingekile. Ngokuqondene nemiphumela ebuhlungu zokwelapha, kungase kubangele iziyaluyalu gastro-emathunjini (ukuqunjelwa, ubuhlungu besisu), kanye nesicanucanu.

Indlela eyisisekelo yokuphuza imithi nensimbi ukuntula - ngaphakathi. Kodwa endabeni izifo emathunjini, lapho iphazamiseke ukuncela inqubo eboniswe abaphathi parenteral.

zokuvimbela

Ezimweni eziningi, besebenzisa indlela yokwelashwa odokotela ukuphatha ukulungisa yensimbi ukuntula. Noma kunjalo, lesi sifo singumbulali ukwazi ziyabuya futhi nokuthuthukisa (akuvamile). Ukuze ugweme sokuchuma okunjalo, isidingo nokuvinjelwa yensimbi ukuntula igazi. Lokhu kusho ukuthi control yaminyaka yonke kwemigomo emitholampilo igazi ukuhlaziywa, ukuqedwa okusheshayo zonke izimbangela ukopha kanye nokudla. Labo abasengozini, udokotela wakho angase akunikeze ethola amalungiselelo adingekayo ngenhloso yokuvimbela.

Kusobala ukuthi ukuntuleka zensimbi egazini - lokhu kuyinkinga enkulu kakhulu. Lokhu kungase ukuqinisekisa noma yimuphi umlando wezokwelapha. Iron ukuntula kwegazi, kungakhathaliseki ukuthi hlobo luni nesineke embuzweni, iyisibonelo esivelele i isifo elimazayo kakhulu. Ngakho-ke, lapho izimpawu zokuqala yokuntuleka lesi sici trace kuyadingeka ukubonana nodokotela asikisele futhi uthole ukwelashwa ngendlela esifike ngesikhathi.