Thrombocythemia yofunikira

Chofunika kwambiri cha thrombocythemia (ET) ndi momwe mafupa amapangira ma platelet ochulukirapo. Ma Platelet ndi gawo la magazi omwe amathandiza pakumanga magazi.

ET amachokera pakupanga kwa ma platelet. Popeza ma platelet amenewa sagwira ntchito mwachizolowezi, kuundana kwamagazi ndi magazi ndimavuto ofala. Popanda kuchitapo kanthu, ET imakulirakulira pakapita nthawi.

ET ndi gawo limodzi lazikhalidwe zotchedwa myeloproliferative matenda. Zina ndizo:

• Matenda osachiritsika a khansa ya m'magazi (khansa yomwe imayamba m'mafupa)
• Polycythemia vera (matenda am'mafupa omwe amatsogolera kuwonjezeka kosazolowereka kwama cell amwazi)
• Pulayimale ya myelofibrosis (kusokonekera kwa mafupa m'mene mafutawo amalowetsedwera ndi minofu yolimba)

Anthu ambiri omwe ali ndi ET amasintha majini (JAK2, CALR, kapena MPL).

ET ndizofala kwambiri pakati pa anthu okalamba. Zitha kuwonekeranso kwa achinyamata, makamaka azimayi ochepera zaka 40.

Zizindikiro zamagulu amwazi zimatha kuphatikizira izi:

• Mutu (wofala kwambiri)
• Kujambula, kuzizira, kapena kubiriwira m'manja ndi m'mapazi
• Kumva chizungulire kapena wamutu wopepuka
• Mavuto masomphenya
• Zilonda zazing'ono (kupwetekedwa kwakanthawi kochepa) kapena sitiroko

Ngati kutuluka magazi kuli vuto, zizindikiro zimatha kuphatikizira izi:

• Kuvulaza kosavuta ndi kutulutsa magazi m'mphuno
• Kutuluka magazi m'matumbo, njira yopumira, kwamikodzo, kapena khungu
• Kutuluka magazi kuchokera m'kamwa
• Kutuluka magazi kwa nthawi yayitali pochita opaleshoni kapena kuchotsa mano

Nthawi zambiri, ET imapezeka kudzera pakuyesa magazi komwe kumachitika pamavuto ena asanakwane.

Wothandizira zaumoyo wanu amatha kuwona chiwindi chokulitsa kapena nthenda pakuwunika. Muthanso kukhala ndi magazi osazolowereka m'miyendo kapena m'mapazi omwe amawononga khungu m'malo amenewa.

Mayesero ena atha kuphatikizira:

• Kutupa kwa mafupa
• Kuwerengera kwathunthu kwa magazi (CBC)
• Mayeso amtundu (kuyang'ana kusintha kwa jak2, CALR, kapena MPL jini)
• Mulingo wa asidi a Uric

Ngati muli ndi zovuta zowopsa pamoyo wanu, mutha kukhala ndi chithandizo chotchedwa platelet pheresis. Imachepetsa mwachangu maplatelet m'magazi.

Kwa nthawi yayitali, mankhwala amagwiritsidwa ntchito pochepetsa kuchuluka kwa ma platelet kuti mupewe zovuta. Mankhwala omwe amagwiritsidwa ntchito kwambiri ndi monga hydroxyurea, interferon-alpha, kapena anagrelide. Mwa anthu ena omwe ali ndi kusintha kwa JAK2, ma inhibitors apadera a JAK2 protein atha kugwiritsidwa ntchito.

Kwa anthu omwe ali pachiwopsezo chachikulu chotseka magazi, aspirin pamlingo wochepa (81 mpaka 100 mg patsiku) imatha kuchepa magawo omwe amaundana.

Anthu ambiri safuna chithandizo chilichonse, koma ayenera kuwatsatira mosamala ndi omwe amawapatsa chithandizo.

Zotsatira zimatha kusiyanasiyana. Anthu ambiri amatha nthawi yayitali popanda zovuta ndipo amakhala ndi moyo wathanzi. Mwa anthu ochepa, zovuta zakutuluka m'magazi komanso kuundana kwamagazi kumatha kubweretsa zovuta zazikulu.

Nthawi zina, matendawa amatha kusintha khansa ya m'magazi kapena myelofibrosis.

Zovuta zingaphatikizepo:

• Khansa ya m'magazi kapena myelofibrosis
• Kutaya magazi kwambiri (kukha magazi)
• Sitiroko, vuto la mtima, kapena kuundana kwamagazi m'manja kapena m'mapazi

Itanani omwe akukuthandizani ngati:

• Muli ndi magazi osadziwika omwe akupitilira nthawi yayitali kuposa momwe ayenera.
• Mukuwona kupweteka pachifuwa, kupweteka kwa mwendo, kusokonezeka, kufooka, kuchita dzanzi, kapena zizindikiro zina zatsopano.

Pulayimale thrombocythemia; Thrombocytosis yofunikira

• Maselo amwazi

Mascarenhas J, Iancu-Rubin C, Kremyanskaya M, Najfeld V, Hoffman R. Wofunikira thrombocythemia. Mu: Hoffman R, Benz EJ, Silberstein LE, et al, olemba. Hematology: Mfundo Zoyambira ndi Zochita. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2018: mutu 69.

Tefferi A. Polycythemia vera, thrombocythemia yofunikira, ndi myelofibrosis yoyamba. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. Wolemba 25. Philadelphia, PA: Elsevier Saunders; 2016: chap 166.