Izakhi ze-hemoglobin

Izakhi ze-hemoglobin zishintshiwe izinhlobo ze-hemoglobin. IHemoglobin yiprotheni enamaseli abomvu egazi ahambisa umoya-mpilo kanye nesikhutha phakathi kwamaphaphu nezicubu zomzimba.

Lo mbhalo ukhuluma ngokuhlolwa okusetshenzisiwe ukuthola nokukala inani lezakhi ze-hemoglobin ezisegazini lakho.

Ukuhlolwa kwenziwa kusetshenziswa inaliti encane ukuqoqa isampula yegazi emthanjeni noma emthanjeni. Isampula lingaqoqwa emthanjeni noma emthanjeni esihlakaleni, emgodini, noma engalweni.

Ngaphambi kokudonswa kwegazi, umhlinzeki wezokunakekelwa kwempilo angahlola ukusakazwa kwesandla (uma isihlakala kuyisayithi). Ngemuva kokudonswa kwegazi, ingcindezi efakwa endaweni yokubhoboza okwemizuzu embalwa kumisa ukopha.

Akukho ukulungiselela okukhethekile okudingekayo.

Ezinganeni, kungasiza ukuchaza ukuthi isivivinyo sizozwakala kanjani nokuthi kungani senziwa. Lokhu kungenza ingane izizwe inovalo oluncane.

Ungase uzwe ubuhlungu obuncane noma isitinyela lapho kufakwa inaliti. Ungase futhi uzizwe ushaywa yisiza ngemuva kokukhishwa kwegazi.

Ukuhlolwa kwe-carboxyhemoglobin kusetshenziselwa ukuxilonga ubuthi be-carbon monoxide. Ibuye isetshenziselwe ukuthola izinguquko ku-hemoglobin engahle ibangelwe yimithi ethile. Amanye amakhemikhali noma izidakamizwa zingashintsha i-hemoglobin ngakho-ke ayisasebenzi kahle.

Izinhlobo ezingavamile ze-hemoglobin zifaka:

• I-Carboxyhemoglobin: Uhlobo olungajwayelekile lwe-hemoglobin enamathele ku-carbon monoxide esikhundleni se-oxygen noma i-carbon dioxide. Inani eliphakeme lalolu hlobo lwe-hemoglobin engavamile livimbela ukuhamba okuvamile komoya-mpilo ngegazi.
• I-Sulfhemoglobin: Uhlobo olungavamile lwe-hemoglobin olungakwazi ukuthwala umoya-mpilo. Kungabangelwa yimithi ethile efana ne-dapsone, metoclopramide, nitrate noma i-sulfonamides.
• I-Methemoglobin: Inkinga eyenzeka lapho i-iron eyingxenye ye-hemoglobin ishintshwa ukuze ingathwali i-oxygen kahle. Izidakamizwa ezithile kanye nezinye izinhlanganisela ezinjenge-nitrites ezifakwe emfudlaneni wegazi zingadala le nkinga.

Amanani alandelayo amelela iphesenti lama-hemoglobin derivatives asuselwa ku-hemoglobin ephelele:

• I-Carboxyhemoglobin - ingaphansi kuka-1.5% (kepha ingaba phezulu kwabangu-9% kwababhemayo)
• I-Methemoglobin - ngaphansi kuka-2%
• I-Sulfhemoglobin - ayibonakali

Ububanzi bamanani ajwayelekile bungahluka kancane phakathi kwamalabhorethri ahlukene. Khuluma nomhlinzeki wakho mayelana nencazelo yemiphumela yakho ethile yokuhlolwa.

Izibonelo ezingenhla zibonisa izilinganiso ezivamile zemiphumela yalezi zivivinyo. Amanye ama-laboratories asebenzisa izilinganiso ezahlukahlukene noma angahlola izinhlobo ezahlukene.

Izinga eliphakeme lama-hemoglobin derivatives angaholela ezinkingeni ezinkulu zempilo. Izinhlobo eziguquliwe ze-hemoglobin azivumeli ukuthi umoya-mpilo uhanjiswe kahle emzimbeni. Lokhu kungaholela ekufeni kwezicubu.

Amanani alandelayo, ngaphandle kwe-sulfhemoglobin, amele iphesenti lama-hemoglobin derivatives asuselwa ku-hemoglobin ephelele.

I-Carboxyhemoglobin:

• U-10% kuye ku-20% - izimpawu zobuhlungu be-carbon monoxide ziqala ukuvela
• I-30% - okunobuthi obukhulu be-carbon monoxide bukhona
• U-50% kuya ku-80% - imiphumela kubuthi obubulalayo be-carbon monoxide

I-Methemoglobin:

• 10% kuya ku-25% - imiphumela kumbala wesikhumba oluhlaza okwesibhakabhaka (i-cyanosis)
• U-35% kuye ku-40% - kubangela ukuphefumula okuncane nokuphathwa yikhanda
• Ngaphezulu kwama-60% - imiphumela yobudikadika nobuthongo
• Ngaphezulu kwama-70% - kungaholela ekufeni

I-Sulfhemoglobin:

• Amanani ka-10 amagremu nge-deciliter ngayinye (g / dL) noma ama-millimole ayi-6.2 ngelitha (mmol / L) adala umbala wesikhumba o-bluish ngenxa yokushoda komoya-mpilo (i-cyanosis), kepha awubangeli imiphumela eyingozi esikhathini esiningi.

I-Methemoglobin; I-Carboxyhemoglobin; I-Sulfhemoglobin

• Ukuhlolwa kwegazi

I-Benz EJ, i-Ebert BL. Ukwahluka kwe-hemoglobin okuhambisana ne-hemolytic anemia, ukushintsha kwe-oxygen, kanye ne-methemoglobinemias. Ku: Hoffman R, Benz EJ, Silberstein LE, et al, ama-eds. I-Hematology: Izimiso Eziyisisekelo Nokuzijwayeza. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2018: isahluko 43.

Bunn HF. Sondela kuma-anemias. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-25. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 158.

UChristiani DC. Ukulimala ngokomzimba nangokwemvelo kwamaphaphu. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-25. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 94.

UNelson LS, Ford MD. Ubuthi obunzima. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-25. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 110.

I-Vajpayee N, Graham SS, Bem S. Ukuhlolwa okuyisisekelo kwegazi nomnkantsha. Ku: McPherson RA, Pincus MR, abahleli. UHenry’s Clinical Diagnosis and Management by Laboratory Methods. Umhla ka-23. ISt Louis, MO: Elsevier; 2017: isahluko 30.