Phokolo ea mali e tšabehang

Phokolo ea mali ke boemo boo 'mele o se nang lisele tse khubelu tsa mali tse phetseng hantle. Lisele tse khubelu tsa mali li fana ka oksijene lithong tsa 'mele. Hona le mefuta e mengata ea phokolo ea mali.

Phokolo ea mali e matla ke ho fokotseha ha lisele tse khubelu tsa mali tse etsahalang ha mala a sa khone ho monya vithamine B12 hantle.

Phokolo ea mali e matla ke mofuta oa khaello ea mali ea vithamine B12. 'Mele o hloka vithamine B12 ho etsa lisele tse khubelu tsa mali. U fumana vithamine ena ka ho ja lijo tse kang nama, likhoho, khofu, mahe le lihlahisoa tsa lebese.

Protheine e khethehileng, e bitsoang intrinsic factor (IF), e tlama vithamine B12 e le hore e ka kenella ka maleng. Protheine ena e hlahisoa ke lisele tse ka mpeng. Ha mpa e sa etse letho le lekaneng, mala a ke ke a amohela vithamine B12 hantle.

Lisosa tse tloaelehileng tsa khaello ea mali e kotsi li kenyelletsa:

• Lera le fokolang la mpa (atrophic gastritis)
• Boemo bo ikemetseng ba mmele moo sesole sa 'mele se hlaselang protheine ea' mele ea 'mele kapa lisele tse ka mpeng ea mpa ea hao tse e etsang.

Maemong a sa tloaelehang, phokolo ea mali e kotsi e fetisoa ke malapa. Sena se bitsoa congenital anemia e kotsi. Bana ba nang le mofuta ona oa phokolo ea mali ha ba etse letho le lekaneng. Kapa ba sitoa ho monya vithamine B12 hantle ka maleng.

Ho batho ba baholo, matšoao a phokolo ea mali a kotsi hangata ha a bonahale ho fihlela kamora lilemo tse 30. Karolelano ea lilemo tsa tlhahlobo ke lilemo tse 60.

U na le monyetla oa ho ba le lefu lena haeba u:

• Ke Scandinavia kapa Europe Leboea
• Eba le nalane ea lelapa ka boemo bona

Maloetse a mang a ka baka kotsi. Li kenyeletsa:

• Lefu la Addison
• Lefu la mabitla
• Hypoparathyroidism
• Hypothyroidism
• Myasthenia gravis
• Ho lahleheloa ke ts'ebetso e tloaelehileng ea mae a bomme pele a le lilemo li 40 (ho hloleha ha mantlha ea mahe a bomme)
• Mofuta oa 1 oa lefu la tsoekere
• Ho se sebetse ha testicular
• Vitiligo
• Sjögren lefu
• Lefu la Hashimoto
• Lefu la Celiac

Phokolo ea mali e matla e ka hlaha hape kamora ho buuoa ka mpeng.

Batho ba bang ha ba na matšoao. Matšoao a ka ba bonolo.

Li ka kenyelletsa:

• Letšollo kapa ho patoa
• Ho nyekeloa
• Ho hlatsa
• Mokhathala, ho hloka matla, kapa ho ba hlooho e bobebe ha u eme kapa ka boiteko
• Ho felloa ke takatso ea lijo
• Letlalo le bosootho (jaundice e bonolo)
• Phefumoloho e khutšoanyane, haholo nakong ea boikoetliso
• Ho heletsa
• Ho ruruha, leleme le lefubedu kapa marenene a tsoang mali

Haeba o na le vithamine B12 e tlase nako e telele, o ka senyeha tsamaiso ea methapo. Matšoao a ka kenyelletsa:

• Pherekano
• Ho lahleheloa ke mohopolo ha nakoana
• Ho tepella maikutlo
• Ho lahleheloa ke botsitso
• Ho ba lerootho le ho hlohlona matsohong le maotong
• Mathata a tsepamisa maikutlo
• Ho teneha
• Litlelase
• Litšitiso
• Optic methapo ea kutlo

Mofani oa tlhokomelo ea bophelo o tla etsa tlhahlobo ea 'mele. Liteko tse ka etsoang li kenyelletsa:

• Ho hlahlojoa ha moko oa masapo (ho hlokahala feela haeba ho tsebahala ho sa hlaka)
• Palo e felletseng ea mali (CBC)
• Palo ea Reticulocyte
• Boemo ba LDH
• Serum bilirubin
• Boemo ba Methylmalonic acid (MMA)
• Tekano ea homocysteine ​​(amino acid e fumanoang maling)
• Boemo ba vithamine B12
• Methati ea lithibela-mafu khahlanong le IF kapa lisele tse etsang IF

Morero oa kalafo ke ho eketsa boemo ba hau ba vithamine B12:

• Kalafo e kenyelletsa thunya ea vithamine B12 hang ka khoeli. Batho ba nang le maemo a tlase haholo a B12 ba ka hloka lithunya tse ngata qalong.
• Batho ba bang ba ka phekoloa ka mokhoa o lekaneng ka ho noa lipilisi tse ngata tsa vithamine B12 ka molomo.
• Mofuta o itseng oa vithamine B12 o ka fanoa ka nko.

Hangata batho ba bangata ba sebetsa hantle ka kalafo.

Ho bohlokoa ho qala kalafo kapele. Tšenyo ea methapo e ka ba ea ka mehla haeba kalafo e sa qale nakong ea likhoeli tse 6 tsa matšoao.

Batho ba nang le phokolo ea mali e kotsi ba ka ba le li-polyps tsa ka mpeng. Ba na le monyetla oa ho ba le mofetše oa ka mpeng le lihlahala tsa ka mpeng tsa carcinoid.

Batho ba nang le phokolo ea mali e kotsi ba na le menyetla ea ho robeha mokokotlo, leoto le holimo le sephakeng se holimo.

Mathata a boko le tsamaiso ea methapo a ka tsoelapele kapa a ba teng ka ho sa feleng haeba kalafo e lieha.

Mosali ea nang le boemo bo tlase ba B12 a ka ba le Pap smear e fosahetseng. Lebaka ke hore khaello ea vithamine B12 e ama tsela eo lisele tse ling (lisele tsa epithelial) tse molomong oa molomo li shebahalang ka eona.

Bitsa mofani oa hau haeba u na le matšoao a khaello ea vithamine B12.

Ha ho na mokhoa o tsebahalang oa ho thibela mofuta ona oa phokolo ea mali ea vithamine B12. Leha ho le joalo, ho fumanoa kapele le kalafo ho ka thusa ho fokotsa mathata.

Macrocytic achylic khaello ea mali; Congenital kotsi kotsi khaello ea mali; Bacha ba khaello ea mali e kotsi; Ho haella ha vithamine B12 (malabsorption); Khaello ea mali - ntho ea tlhaho; Khaello ea mali - IF; Khaello ea mali - atrophic gastritis; Phokolo ea mali ea Biermer; Addison khaello ea mali

• Phokolo ea mali ea Megaloblastic - pono ea lisele tse khubelu tsa mali

Antony AC. Li-anemias tsa Megaloblastic. Ka: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Melao-motheo le Tloaelo ea Motheo. La 7th. Philadelphia, PA: Elsevier; 2018: khaolo ea 39.

Anusha V. Phokolo ea mali e kotsi / phokolo ea mali e megaloblastic. Ka: Kellerman RD, Rakel DP, eds. Phekolo ea Hajoale ea Conn ea 2020. Philadelphia, PA: Elsevier; Ka selemo sa 2020: 446-448.

Elghetany MT, Schexneider KI, mathata a Banki K. Erythrocytic. Ka: McPherson RA, Pincus MR, bahlophisi. Henry's Clinical Diagnosis le Tsamaiso ka Mekhoa ea Laboraro. La bo23 la ed. St Louis, MO: Elsevier; 2017: khaolo ea 32.

E bolela RT. Atamela li-anemias. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 149.