Kev txhaj tshuaj tiv thaiv kab mob hemolytic anemia

Kauj ntshav yog ib qho mob uas lub cev tsis muaj cov qe ntshav liab liab noj qab nyob zoo. Cov ntshav liab muab cov pa oxygen rau lub cev cov ntaub so ntswg.

Cov ntshav liab nyob ntev li 120 hnub ua ntej lub cev tau tshem tawm ntawm lawv. Hauv kev mob ntshav khov (hemolytic anemia), cov ntshav liab hauv cov ntshav tau ua kom ntxov tshaj li ib txwm.

Kev tiv thaiv kab mob ntshav qab zib ntshav siab (hemolytic anemia) tshwm sim thaum tsim cov tshuaj tiv thaiv lub cev cov ntshav liab thiab rhuav tshem lawv. Qhov no tshwm sim vim tias cov kab mob hauv lub nruab zog tsis lees paub cov ntshav no yog txawv teb chaws.

Cov teeb meem ua tau suav nrog:

• Qee yam tshuaj, siv yeeb siv tshuaj thiab co toxins
• Kab mob
• Hloov ntshav los ntawm tus neeg pub ntshav uas muaj hom ntshav tsis sib thooj
• Cov qog ntshav tshwj xeeb

Thaum cov tshuaj tiv thaiv tsim cov qe ntshav liab yam tsis muaj laj thawj, qhov mob hu ua idiopathic autoimmune hemolytic anemia.

Cov tshuaj tiv thaiv kuj tuaj yeem ua rau:

• Teeb meem ntawm lwm tus kab mob
• Yav tas los txhab ntshav
• Cev xeeb tub (yog hais tias tus menyuam cov ntshav hom sib txawv los ntawm leej niam)

Kev muaj feem cuam tshuam muaj feem xyuam rau cov laj thawj.

Koj yuav tsis muaj tsos mob dab tsi yog tias tus mob ntshav liab tsawg. Yog tias qhov teebmeem loj hlob qeeb, cov tsos mob uas yuav tshwm sim ua ntej yog:

• Lub cev tsis muaj zog lossis nkees feem ntau ntau dua li ib txwm muaj, lossis nrog kev tawm dag zog
• Mob taub Hau
• Cov teeb meem kev xav ua haujlwm lossis kev xav

Yog tias lub zog ntshav tsis zoo ntxiv, cov tsos mob yuav suav nrog:

• Lightheadedness thaum koj sawv
• Tawv nqaij tawv (pallor)
• Ua tsis taus pa
• Mob nplaig

Koj yuav tsum muaj cov kev ntsuas nram no:

• Tsis pom tseeb reticulocyte suav
• Coombs sim tau ncaj qha lossis tsis ncaj
• Hemoglobin hauv cov zis
• LDH (qib ntawm no enzyme nce raws li kev puas tsuaj ntawm cov nqaij mos)
• Cov qe ntshav liab suav (RBC), hemoglobin, thiab hematocrit
• Ntsig bilirubin qib
• Ntshav ntshav hemoglobin dawb
• Ntshiab haptoglobin
• Donath-Landsteiner kev sim
• Mob khaub thuas agglutinins
• Tsis pub hemoglobin dawb hauv cov ntshav dej lossis zis
• Hemosiderin hauv kev tso zis
• Platelet suav
• Protein electrophoresis - ntshav dej
• Pyruvate kinase
• Qib haptoglobin qib
• Zis thiab fecal urobilinogen

Thawj qhov kev kho tau sim feem ntau yog cov tshuaj steroid, xws li prednisone. Yog tias cov tshuaj steroid tsis txhim kho kev mob, kev kho mob nrog cov tshuaj tiv thaiv kab mob immunoglobulin (IVIG) lossis tshem tawm ntawm tus po (spleectomy) yuav raug txiav txim siab.

Koj tuaj yeem tau txais kev kho mob kom thiaj li muaj zog tiv thaiv koj lub cev yog tias koj tsis teb rau tshuaj yuam. Cov tshuaj xws li azathioprine (Imuran), cyclophosphamide (Cytoxan), thiab rituximab (Rituxan) tau siv.

Muab ntshav ntxiv rau kev ceev faj, vim hais tias cov ntshav yuav tsis sib haum thiab nws yuav ua rau muaj kev puas tsuaj ntau ntxiv hauv cov ntshav liab.

Tus mob yuav pib sai thiab mob hnyav, lossis nws tuaj yeem tsis hnyav thiab tsis xav tau kev kho mob tshwj xeeb.

Hauv cov tib neeg feem coob, cov tshuaj steroid los yog splenectomy tuaj yeem tswj tau tag nrho lossis ib nrab tswj kev ua kom ntshav khov.

Mob ntshav txaus ua rau tuag taus. Kev kis mob hnyav tuaj yeem tshwm sim los ntawm txoj kev kho mob nrog cov tshuaj steroids, lwm yam tshuaj uas txwv kev tiv thaiv kab mob hauv lub cev, lossis mob rau hauv lub cev. Cov kev kho no ua rau lub cev tsis muaj peev xwm los tua tus kab mob.

Hu rau koj tus kws kho mob yog tias koj tau nkees nkees heev lossis mob hauv siab, lossis cov cim ntawm kev kis mob.

Kev kuaj cov tshuaj tiv thaiv kab mob hauv cov ntshav uas tau pub dawb thiab hauv tus neeg tau txais yuav tiv thaiv tus kab mob ntshav siab tsis txaus ntsig txog ntshav ntxiv.

Anemia - tiv thaiv kab mob hemolytic; Tus kab mob hlab ntsha hemolytic anemia (AIHA)

• Tshuaj tua kabmob

Michel M. Autoimmune thiab intravascular hemolytic anemias. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 26th ed. Philadelphia, PA: Elsevier; 2020: chap 151.

Michel M, Jäger U. Autoimmune mob ntshav qab zib tsis txaus. 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 46.