Ko te Hemoglobin (Hb) he metalloprotein matatini kei roto he rino e noho ana i roto i ngā erythrocytes (ngā toto whero). Ko tana mahi matua ā-tinana—te herenga hāora whakahuri me te kawe mai i ngā alveoli pūkahukahu ki ngā kiko ā-taha, me te kawe hoki mai o te hauhā waro—nā reira he mea nui mō te manawa pūtau me te homeostasis pākia. Nō reira, ko te ine taiwhanga o te kukū hemoglobin tētahi o ngā whakamātautau tātaritanga tino tonohia me te tūāpapa haumanu. Ko tōna hiranga he nui atu i te tautuhi noa i te anemia; he taputapu tirotiro matua, he kāpehu tātaritanga rerekē, he tohu matapae mō ngā mate mau tonu, me te tawhā whakatau nui i roto i te tiaki perioperative me te oncological.

Ratonga Tirotiro me te Tātaritanga Matua

Ko te mea nui o te whakamātautau hemoglobin kei roto i tōna kaha ki te ine i te kaha o te toto ki te kawe hāora. Ko ngā rerekētanga mai i ngā awhe tohutoro kua whakatūria—ko te tikanga 130–175 g/L mō ngā tāne pakeke me te 115–150 g/L mō ngā wāhine kāore i te hapu—koia te tohu whero tuatahi mō ngā āhua mate e rua e rerekē ana. Ko te kukū i raro i te rohe o raro e tohu ana i te anemia, he āhua e tohuhia ana e te hypoxia kiko e puta ana i te taha haumanu hei ngenge, te kiri mā, te dyspnea, me te ngoikore o te hinengaro. I ngā take kino (Hb < 70 g/L), ka pāngia te pūnaha cardiovascular e tēnei āhua hypoxic, ka taea te whakaoho i te ngoikore o te ngakau. I tetahi atu taha, ko te kukū e nui ake ana i te rohe o runga e tohu ana i te erythrocytosis, e whakanui ana i te matotoru o te toto, ā, e whakanui ana i te mōrearea thromboembolic, e whakararu ana i ngā tūroro ki ngā aituā roro me te thrombosis uaua hohonu.

Te Tātaritanga Rerekē mā ngā Tātaitai Erythrocyte

Ahakoa te tohu o te uara hemoglobin tino tika mō te noho mai o tētahi mate pōrangi, ka tukuna tōna mana tātaritanga tūturu ina whakamāramahia ngātahi me ngā tohu toto whero—ina koa, te Mean Corpuscular Volume (MCV) me te Mean Corpuscular Hemoglobin (MCH). Ko tēnei whakarōpūtanga āhua te tūāpapa o te rangahau take. Ko te kōtaha hypochromic microcytic (MCV iti me te MCH) e tohu kaha ana i te korenga o te rino, e puta pinepine ana mai i te toto puku huna mau tonu, te menorrhagia rānei, i tētahi atu huarahi rānei, e tohu ana ki te āhuatanga thalassemia, te anemia rānei o te mate mau tonu. He mea nui tēnei rerekētanga ki te rongoā, nā te mea ka taea e te tāpiringa rino koretake i roto i ngā tūroro thalassemia te whakaoho i te nui rawa o te rino e mate ai. Ko te kōtaha macrocytic (MCV teitei) e tohu ana i te whakapae haumanu ki te cobalamin (huaora B12) me te korenga o te folate, e hono ana ki ngā putanga neurological, ki ngā mate myelodysplastic rānei. Ko te tauira normocytic te tikanga ka whakaoho i te mahi mō te toto toto nui, te hemolysis, te ngoikore rānei o te hinu wheua. Nō reira, ko te whakamātautau hemoglobin, me ngā tohu, ka whai hua ki te whakawhāiti i te rerekētanga whānui ki tētahi ara tātaritanga kua tohua.

He Tohu Kaitiaki mō ngā Mate Pūnaha Mau tonu

Haunga ngā mate toto tuatahi, ko te aroturukitanga o te hemoglobin raupapa he kaitiaki tairongo mō te haere whakamua o ngā mate pūnaha mau tonu. I roto i te mate tākihi mau tonu (CKD), ka kore e ranea te whakaputanga o te erythropoietin (EPO) e te ngoikore o te interstitium tākihi, ka hua ake he anemia normocytic haere tonu. Ko te tere o te hekenga o te hemoglobin e pā tika ana ki te hekenga o te mahi tākihi, ā, e whakahaere ana i te whakatau haumanu ki te tīmata i te rongoā whakakapinga EPO exogenous. I roto i te oncology, kāore i whakamāramatia, ko te hekenga o te hemoglobin haere tonu i roto i te tūroro kore-wera he tohu i te urunga mai o te hinu wheua mā te metastases, te tohu rānei i te pānga paraneoplastic o ngā cytokines mumura mau tonu. I tua atu, i roto i ngā tūroro e pangia ana e te chemotherapy myelosuppressive, te radiotherapy rānei, ko te hemoglobin nadir he tawhā nui e whakamahia ana e ngā tohunga tākihi hei whakatau i ngā whakarerekētanga horopeta, te hiahia mō te tautoko whakawhiti toto, te hiahia rānei kia mutu te maimoatanga.

Te Whakarōpūtanga Mōrearea me te Aroturukitanga Hauora

I te wā e tata ana ki te pokanga, kāore e taea te whakahē i te aromatawai i te hemoglobin i mua i te pokanga. He tohu pakari tēnei mō te mate o te pokanga; he nui ake ngā mate urutā i muri i te pokanga, te roa o te whakaora o te patunga, me te roa o te noho hōhipera i ngā tūroro he anemia i mua i te pokanga. Ko te tikanga, ka whakamahia e ngā tīma pokanga he whakaoho whakawhiti toto (ko te Hb < 70–80 g/L i ngā tūroro pumau) hei arotau i te tuku hāora i mua i ngā tikanga mōrearea nui. Heoi anō, ko te hemoglobin te ine paerewa koura mō te aromatawai i te whai huatanga o te rongoā. Hei tauira, i roto i te anemia ngoikore-rino, ko te pikinga ine o te 10–20 g/L o te kukū Hb i roto i ngā wiki e rua ki te whā o te rongoā rino ā-waha ka whakarato i te taunakitanga whai kiko, whakaū o te mimiti puku me te urupare a te hinu wheua. Ko tōna ngaro ka akiaki i te arotakenga anō tonu o te tautuhi, te tūhuratanga rānei o te kore piripono.

Hei whakamutunga, ehara i te mea he tawhā tatau toto noa iho te whakamātautau hemoglobin; he tohu koiora nui, maha-āhua e whakauru ana i te āhua o te hāora me te māramatanga pathophysiological. Mā te aromatawai auau ka taea te whakatūpato wawe, te whakarōpūtanga take tika, te aroturuki hihiri o te mate mau tonu, me te whakahaere haumanu haumaru, e ahu mai ana i ngā taunakitanga puta noa i ngā momo hauora katoa.