Qhov tseem ceeb thrombocythemia

Qhov tseem ceeb thrombocythemia (ET) yog qhov mob uas cov hlwb pob txha tsim cov platelets ntau. Platelets yog ib feem ntawm cov ntshav uas pab ua ntshav txhaws.

ET tau los ntawm kev ua haujlwm ntau dhau ntawm cov platelets. Vim tias cov platelets no tsis ua haujlwm zoo, ntshav txhaws thiab los ntshav feem ntau yog cov teeb meem. Tsis tau txais kev sib tw, ET ntaug tshaj lub sijhawm.

ET yog ib feem ntawm ib pab pawg ntawm cov mob uas paub tias yog myeloproliferative ntshawv siab. Lwm tus suav nrog:

• Mob myelogenous mob ntshav (mob qog ntshav pib tawm rau tus hlwb pob txha)
• Polycythemia vera (mob hlwb pob txha uas ua rau muaj cov leeg ntshav nce ntxiv)
• Thawj myelofibrosis (kev tsis sib haum xeeb ntawm cov pob txha pob txha uas hloov hlwb pob txha los ntawm fibrous caws pliav nqaij)

Coob tus neeg uas nrog ET muaj kev hloov pauv ntawm cov gene (JAK2, CALR, lossis MPL).

ET yog feem ntau rau ntawm cov neeg nruab nrab. Nws kuj tseem tuaj yeem pom hauv cov hluas, tshwj xeeb tshaj yog cov poj niam hnub nyoog qis dua 40 xyoo.

Cov tsos mob ntawm cov ntshav txhaws yuav suav nrog ib qho hauv qab no:

• Mob taub hau (feem ntau)
• Qoj ib ce, mob khaub thuas, lossis daj xiav ntawm tes thiab taw
• Lub ntsej muag kiv taub hau lossis teeb pom kev zoo
• Cov teeb meem tsis pom kev
• Mini-strokes (hloov mus ischemic tawm tsam) lossis mob stroke

Yog tias los ntshav yog ib qho teeb meem, cov tsos mob tuaj yeem suav nrog ib qho hauv qab no:

• Nqaij tawv yooj yim thiab ntswg
• Los ntshav los ntawm lub plab hnyuv, ua pa, mob txeeb zig, lossis tawv nqaij
• Los ntshav los ntawm cov pos hniav
• Ntev ntshav los ntawm kev phais mob lossis tshem hniav

Feem ntau, ET yog pom los ntawm kev kuaj ntshav ua lwm yam teebmeem ua ntej muaj cov tsos mob tshwm sim.

Koj tus neeg saib xyuas kev noj qab haus huv yuav pom daim siab mob siab los yog nti ntawm kev kuaj lub cev. Koj kuj tseem yuav muaj cov ntshav khiav tsis zoo nyob hauv cov ntiv taw lossis taw uas ua rau tawv nqaij puas tsuaj rau cov chaw no.

Lwm yam kev ntsuam xyuas yuav suav nrog:

• Nqaij pob txha caj dab
• Ua kom tiav cov ntshav suav (CBC)
• Kev tshuaj ntsuam caj ces (saib seb puas muaj pauv rau hauv JAK2, CALR, lossis MPL caj ces)
• Uric acid qib

Yog tias koj muaj teeb meem phom sij txog lub neej, koj yuav muaj kev kho hu ua platelet pheresis. Nws sai txo cov platelets hauv cov ntshav.

Lub sijhawm ntev, cov tshuaj siv rau txo cov ntshav txhaws kom tsis txhob muaj teeb meem. Cov tshuaj siv feem ntau siv nrog hydroxyurea, interferon-alpha, lossis anagrelide. Hauv qee cov neeg muaj kev hloov JAK2, siv tshuaj tiv thaiv tshwj xeeb ntawm JAK2 protein yuav siv tau.

Hauv cov neeg uas muaj kev pheej hmoo txaus txhawm chim, tshuaj aspirin ntawm kev noj tshuaj tsawg (81 txog 100 mg rau ib hnub) yuav txo tau cov ntshav txhaws.

Coob tus neeg tsis xav tau kev kho mob, tab sis lawv yuav tsum tau ua raws li cov neeg muab kev pab kom zoo.

Qhov tshwm sim yuav txawv. Cov neeg feem coob tuaj yeem mus rau lub sijhawm ntev yam tsis muaj teeb meem thiab muaj lub neej zoo li qub. Ntawm qee leej neeg, muaj teeb meem los ntshav thiab ntshav khov tuaj yeem tsim teeb meem loj.

Tsawg tsawg zaus, tus kab mob tuaj yeem hloov mus rau cov neeg muaj ntshav lossis tus mob myelofibrosis.

Teeb meem yuav suav nrog:

• Mob caj dab mob ntshav lossis roj ntsha myelofibrosis
• Kev los ntshav heev (los ntshav)
• Mob stroke, mob plawv nres, lossis ntshav txhaws ntawm tes lossis taw

Hu rau koj tus kws khomob yog:

• Koj muaj cov kev qhia uas tsis tau qhia los ntshav uas txuas ntxiv ntev dua qhov nws yuav tsum.
• Koj pom tias mob hauv siab, mob ceg, tsis meej pem, qaug zog, loog lossis lwm yam tsos mob tshiab.

Thawj thrombocythemia; Qhov tseem ceeb thrombocytosis

• Cov qe ntshav

Mascarenhas J, Iancu-Rubin C, Kremyanskaya M, Najfeld V, Hoffman R. Qhov tseem ceeb thrombocythemia. Hauv: Hoffman R, Benz EJ, Silberstein LE, li al, eds. Hematology: Qhov Ntsiab Cai thiab Kev Coj UaCov. 7 tus ed. Philadelphia, PA: Elsevier; 2018: chap 69.

Tefferi A. Polycythemia vera, qhov tseem ceeb thrombocythemia, thiab thawj myelofibrosis. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 166.