Kala-soocyada Hemoglobin

Ka-soo-baxayaasha Hemoglobin waa noocyada haemoglobin ee la beddelay. Hemoglobin waa borotiin ku jira unugyada dhiigga cas ee dhaqaajiya oksijiinka iyo kaarboon laba ogsaydhka inta u dhexeysa sambabaha iyo unugyada jirka.

Maqaalkani wuxuu ka hadlayaa baaritaanka loo isticmaalay in lagu ogaado laguna cabbiro xaddiga walxaha dhiiga ee dhiiga ku jira.

Baadhitaanka waxaa lagu sameeyaa iyadoo la isticmaalayo cirbad yar si looga soo qaado sambal dhiig ah xididka ama halbowlaha. Muunada waxaa laga soo qaadan karaa xididka ama halbawlaha gacanta, gumaarka, ama gacanta.

Kahor intaan dhiig laga qaadin, daryeel caafimaad bixiyaha ayaa laga yaabaa inuu ku baaro wareegga gacanta (haddii curcuraha ay tahay goobta). Ka dib marka dhiigga la soo qaado, cadaadis ayaa la mariyey goobta daloolinta daqiiqado yar oo dhiigbaxa ah ayaa joojiya.

Looma baahna diyaarin gaar ah.

Carruurta, way ku caawin kartaa in loo sharraxo sida baaritaanka u dareemi doono iyo sababta loo sameeyo. Tani waxay ilmaha ka dhigi kartaa inuu dareemo cabsi yar.

Waxaa laga yaabaa inaad dareento xanuun yar ama qaniinyo markii cirbadda la gelinayo. Waxa kale oo laga yaabaa inaad dareento xoogaa jug ah goobta ka dib markii dhiigga lagaa qaado.

Tijaabada karboxyhemoglobin waxaa loo isticmaalaa in lagu baaro sumowga kaarboon monoksaydh. Waxaa sidoo kale loo isticmaalaa in lagu ogaado isbeddelada haemoglobin ee ka dhalan kara daawooyinka qaarkood. Kiimikooyinka qaarkood ama daroogooyinka ayaa beddeli kara haemoglobin-ka sidaa darteed si sax ah uma sii shaqeeyo.

Noocyada aan caadiga ahayn ee haemoglobin waxaa ka mid ah:

• Carboxyhemoglobin: Waa qaab aan caadi ahayn oo haemoglobin ah oo ku lifaaqan kaarboon monoksaydh halkii uu ka heli lahaa oksijiin ama kaarboon laba ogsaydh. Qadar badan oo ah haemoglobin aan caadi ahayn ayaa ka hortageysa dhaqdhaqaaqa caadiga ah ee oksijiinka dhiigga.
• Sulfhemoglobin: Nooc dhif ah oo aan caadi ahayn oo haemoglobin ah oo aan qaadi karin oksijiinta. Waxay ka imaan kartaa daawooyinka qaarkood sida dapsone, metoclopramide, nitrates ama sulfonamides.
• Methemoglobin: Dhibaato dhacda marka birta qayb ka ah haemoglobin-ka la beddelo si aysan si fiican ugu qaadin oksijiinta. Daawooyinka qaarkood iyo xeryahooda kale sida nitrites ee lagu soo shubo dhiiga ayaa sababi kara dhibaatadan.

Qiimayaasha soo socdaa waxay matalayaan boqolkiiba hemoglobin-ka ku-saleysan wadarta guud ee haemoglobin:

• Carboxyhemoglobin - in ka yar 1.5% (laakiin waxay u badan tahay 9% dadka sigaarka caba)
• Methemoglobin - in ka yar 2%
• Sulfhemoglobin - lama ogaan karo

Heerarka qiimaha caadiga ahi way ku kala duwanaan karaan shaybaarada kala duwan. Kala hadal adeeg bixiyahaaga macnaha natiijooyinka baaritaankaaga gaarka ah.

Tusaalooyinka kor ku xusan waxay muujinayaan cabirka guud ee natiijooyinka imtixaanadan. Shaybaarada qaarkood waxay isticmaalaan cabbiro kala duwan ama waxay tijaabin karaan tijaabooyin kala duwan.

Heerarka sare ee ka-soo-baxa haemoglobin wuxuu horseedi karaa dhibaatooyin caafimaad oo waaweyn. Noocyada la beddelay ee haemoglobin ma oggola in oksijiinta si habboon loogu dhaqaaqo jirka. Tani waxay u horseedi kartaa dhimasho unugyada.

Qiimayaasha soo socda, marka laga reebo sulfhemoglobin, waxay metelaan boqolkiiba hemoglobin-ka ku-saleysan guud ahaan haemoglobin.

Carboxyhemoglobin:

• 10% ilaa 20% - calaamadaha sunta kaarboon moono oksaydh ayaa bilaabmaya inay muuqdaan
• 30% - sun daran oo kaarboon monoksaydh ayaa jirta
• 50% ilaa 80% - waxay keeneysaa sunta halista ah ee kaarboon monoksaydh

Methemoglobin:

• 10% ilaa 25% - natiijooyinka midabka maqaarka buluugga ah (cyanosis)
• 35% ilaa 40% - waxay keenaysaa neefta oo ku qabata iyo madax xanuun
• In kabadan 60% - natiijooyinka caajis iyo caajis
• In kabadan 70% - waxay sababi kartaa dhimasho

Sulfhemoglobin:

• Qiimayaasha 10 garaam halkii deciliter (g / dL) ama 6.2 millimoles halkii litir (mmol / L) waxay sababaan midab maqaarka oo buluug ah sababo la xiriira oksijiin la'aan (cyanosis), laakiin ma keento waxyeelo inta badan waqtiga.

Methemoglobin; Carboxyhemoglobin; Sulfhemoglobin

• Baaritaanka dhiigga

Benz EJ, Ebert BL. Noocyada Hemoglobin ee la xiriira hemolytic anemia, isbadalka kudhaca oksijiinta, iyo methemoglobinemias. Gudaha: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Mabaadi'da Aasaasiga ah iyo Tababarka. 7aad ed. Philadelphia, PA: Elsevier; 2018: cutubka 43.

Bunn HF. Kusoo dhowaanshaha dhiig-yaraan. Gudaha: Goldman L, Schafer AI, eds. Daawada Goldman-Cecil. 25aad. Philadelphia, PA: Elsevier Saunders; 2016: cutubka 158.

Christiani DC. Dhaawacyada jirka iyo kiimikada ee sambabka. Gudaha: Goldman L, Schafer AI, eds. Daawada Goldman-Cecil. 25aad. Philadelphia, PA: Elsevier Saunders; 2016: cutubka 94.

Nelson LS, Ford MD. Sunta daran. Gudaha: Goldman L, Schafer AI, eds. Daawada Goldman-Cecil. 25aad. Philadelphia, PA: Elsevier Saunders; 2016: cutubka 110.

Vajpayee N, Graham SS, Bem S. Baaritaanka aasaasiga ah ee dhiigga iyo dhuuxa lafta. Gudaha: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis iyo Maareynta Hababka Shaybaarka. 23aad ed. St Louis, MO: Elsevier; 2017: cutubka 30.