Hemoglobin (Hb) iprotein ine iron yakawanda inogara mukati memasero matsvuku eropa. Basa rayo guru remuviri - kusunganidza okisijeni inodzoserwa uye kutakurwa kubva kumapapu alveoli kuenda kunhengo dzemuviri, pamwe chete nekutakurwa kwecarbon dioxide zvakare - zvinoita kuti ive yakakosha pakufema kwemasero uye metabolic homeostasis. Nekuda kweizvozvo, kuyerwa kwehuwandu hwehemoglobin murabhoritari ndeimwe yemiedzo inowanzo rongwa uye yekutanga yekuongorora. Kukosha kwayo kunopfuura kungoziva chete anemia; inoshanda sechishandiso chakakosha chekuongorora, compass yekuongorora yakasiyana, chiratidzo chekufanotaura zvirwere zvisingaperi, uye chiyero chakakosha chekuita sarudzo mukurapa kweperioperative nekenza.

Kuongororwa Kwekutanga uye Kushandiswa Kwekuongorora

Kukosha kukuru kwekuongororwa kwehemoglobin kuri mukukwanisa kwayo kuyera kugona kweropa kutakura okisijeni. Kusiyana kubva pamatanho akatarwa ekutarisa - kazhinji 130-175 g/L kuvarume vakuru uye 115-150 g/L kuvakadzi vasina pamuviri - kunoshanda sechiratidzo chekutanga chezvirwere zviviri zvakasiyana zvachose. Kuwanda kuri pasi pemuganhu wakaderera kunoratidza anemia, chirwere chinoratidzwa nekushaya hope mumuviri chinoratidzwa nekurapwa sekuneta, kusviba, kushaya simba, uye kukanganisa kugona. Muzviitiko zvakakomba (Hb <70 g/L), mamiriro aya ekushaya hope anoisa mutoro we hyperdynamic pahurongwa hwemwoyo, zvichikonzera kutadza kwemoyo kwakanyanya. Kusiyana neizvi, kuwanda kuri pamusoro kunoratidza erythrocytosis, iyo inokwidza viscosity yeropa uye inowedzera zvakanyanya njodzi ye thromboembolic, zvichiita kuti varwere varasikirwe netsaona dze cerebrovascular uye deep vein thrombosis.

Kuongororwa Kwekusiyana NeErythrocyte Indices

Kunyange zvazvo kukosha kwehemoglobin kwakakwana kuchiratidza kuvapo kwekusagadzikana, simba rayo rechokwadi rekuongorora rinoburitswa kana richitsanangurwa pamwe chete nezviratidzo zvemasero matsvuku eropa—kunyanya, Mean Corpuscular Volume (MCV) uye Mean Corpuscular Hemoglobin (MCH). Kupatsanurwa uku kwechimiro ndicho chinhu chikuru chekuongorora kwe etiological. Microcytic hypochromic profile (low MCV neMCH) inoratidza zvakasimba kushomeka kwesimbi, kazhinji kunobva mukubuda ropa kwe occult gastrointestinal bleeding kana menorrhagia, kana neimwe nzira, zvinoratidza hunhu hwethalassemia kana anemia yechirwere chisingaperi. Musiyano uyu wakakosha pakurapa, sezvo kuwedzerwa kwesimbi zvisina musoro muvarwere vethalassemia kunogona kukonzera kuuraya kwesimbi. Macrocytic profile (elevated MCV) inotungamira fungidziro yekiriniki kune cobalamin (vitamin B12) kana folate deficiencies, izvo zvine chekuita ne neurological sequelae, kana kune myelodysplastic syndromes. Maitiro e normocytic anowanzo kukonzera ongororo ye acute hemorrhage, hemolysis, kana bone marrow failure. Saka, kuongororwa kwehemoglobin, pamwe chete nezviratidzo, zvinonyatsoita kuti musiyano mukuru uve nzira yekuongorora yakanangwa.

Chiratidzo cheMuchengeti weZvirwere Zvisingaperi zveMutumbi

Kunze kwezvirwere zveropa zvepakutanga, kuongorora hemoglobin muropa kunoshanda semuchengeti anonzwisisa kufambira mberi kwezvirwere zvakasiyana-siyana zvemuviri. Muchirwere cheitsvo chisingaperi (CKD), renal interstitium inokundikana inokonzera erythropoietin (EPO) isina kukwana, zvichikonzera anemia inofambira mberi, inofambira mberi. Mwero wekuderera kwe hemoglobin unoenderana zvakananga nekushata kwebasa reitsvo uye unotungamira sarudzo yekiriniki yekutanga kurapwa kwekutsiva EPO. Mukenza, hemoglobin isingatsanangurike, inoderera mumurwere ane hosha inowanzo ratidza kupinda kwemongo wemapfupa ne metastases kana inomiririra mhedzisiro ye paraneoplastic ye cytokines isingaperi inoputika. Uyezve, muvarwere vari kurapwa ne myelosuppressive chemotherapy kana radiotherapy, hemoglobin nadir chinhu chakakosha chinoshandiswa nevanorapa oncologists kuona kugadziriswa kwedosi, kudiwa kwekutsigira kuwedzerwa ropa, kana kudiwa kwekukanganiswa kwekurapwa.

Kurongeka kweNjodzi uye Kutarisa Kurapa

Munguva yekuvhiyiwa, kuongororwa kwe hemoglobin isati yavhiyiwa hakugone kukurukurwa. Inoshanda sechiratidzo chakasimba chezvirwere zvekuvhiyiwa; varwere vane anemia vasati vavhiyiwa vanoratidza huwandu hwakanyanya hwehutachiona mushure mekuvhiyiwa, kunonoka kupora kweronda, uye kugara muchipatara kwenguva refu. Mapoka ekuvhiya anowanzo shandisa chinhu chinotanga kuwedzerwa ropa (kazhinji Hb < 70–80 g/L muvarwere vakagadzikana) kuti vawedzere oxygen kuendesa mushonga usati wasvika kune njodzi huru. Uyezve, hemoglobin ndiyo chiyero chegoridhe chekuongorora kushanda kwekurapa. Semuenzaniso, mu anemia yekushaikwa kwesimbi, kuwedzera kunoyerwa kweinenge 10–20 g/L muhuwandu hweHb mukati memavhiki maviri kusvika mana ekurapwa nesimbi nemuromo kunopa humbowo hwakajeka, hunosimbisa kunyudzwa kwemudumbu uye kupindura kwemubofu. Kusavapo kwayo kunoita kuti kuongororwazve kwechirwere kana kuongororwa kwekusatevedzera.

Mukupedzisa, kuongororwa kwehemoglobin hakusi kungoongorora huwandu hweropa chete; i biomarker inokosha, ine mativi akawanda inobatanidza physiology yeokisijeni neruzivo rwezvirwere. Kuongororwa kwayo nguva dzose kunogonesa yambiro yekutanga, kupatsanurwa kwakarurama kwe etiological, kuteverwa kwakasimba kwezvirwere zvisingaperi, uye kutarisirwa kwakachengeteka kwekiriniki muzvipenyu zvese zvekurapa.