Lihlahisoa tsa hemoglobin

Lihlahisoa tsa hemoglobin ke mefuta e meng ea hemoglobin. Hemoglobin ke protheine e lisele tse khubelu tsa mali tse tsamaisang oksijene le carbon dioxide lipakeng tsa matšoafo le lisele tsa 'mele.

Sengoloa sena se bua ka tlhahlobo e sebelisitsoeng ho fumana le ho lekanya bongata ba metsoako ea hemoglobin e maling a hau.

Teko e etsoa ka nale e nyane ho bokella sampole ea mali mothapong kapa mothapong. Sampole e kanna ea bokelloa ho tsoa mothapong kapa mothapong o letsohong, botennyeng kapa letsohong.

Pele mali a huloa, mofani oa tlhokomelo ea bophelo a ka etsa liteko tsa ho potoloha ha letsoho (haeba letsoho ke sebaka). Kamora hore mali a huloe, khatello e sebelisitsoeng sebakeng sa ho phunya metsotso e 'maloa e emisa ho tsoa ha mali.

Ha ho litokisetso tse khethehileng tse hlokahalang.

Bakeng sa bana, ho ka thusa ho hlalosa hore na tlhahlobo e tla ikutloa joang le hore na hobaneng e etsoa. Sena se ka etsa hore ngoana a se ke a tšoha haholo.

U ka utloa bohloko bo bonyenyane kapa motsu ha nale e kentsoe. U kanna oa utloa ho phatloha hampe setšeng kamora hore mali a huloe.

Teko ea carboxyhemoglobin e sebelisetsoa ho fumana chefo ea carbon monoxide. E boetse e sebelisetsoa ho fumana liphetoho ho hemoglobin e ka bakoang ke lithethefatsi tse ling. Lik'hemik'hale tse ling kapa lithethefatsi li ka fetola hemoglobin ka hona ha e sa sebetsa hantle.

Mefuta e sa tloaelehang ea hemoglobin e kenyelletsa:

• Carboxyhemoglobin: Mofuta o sa tloaelehang oa hemoglobin e hoketsoeng ho carbon monoxide sebakeng sa oksijene kapa carbon dioxide. Boholo ba mofuta ona oa hemoglobin e sa tloaelehang bo thibela motsamao o tloaelehileng oa oksijene ka mali.
• Sulfhemoglobin: Mofuta o sa tloaelehang oa hemoglobin o sa khone ho tsamaisa oksijene. E ka bakoa ke meriana e meng e kang dapsone, metoclopramide, nitrate kapa sulfonamides.
• Methemoglobin: Bothata bo hlahang ha tšepe eo e leng karolo ea hemoglobin e fetoloa hore e se ke ea tsamaisa oksijene hantle. Lithethefatsi tse ling le metsoako e meng e kang li-nitrite tse hlahisitsoeng ka har'a phallo ea mali li ka baka bothata bona.

Litekanyetso tse latelang li emela liperesente tsa lihlahisoa tsa hemoglobin tse ipapisitseng le hemoglobin e felletseng:

• Carboxyhemoglobin - ka tlase ho 1.5% (empa e kanna ea ba holimo ho 9% ho batho ba tsubang)
• Methemoglobin - ka tlase ho 2%
• Sulfhemoglobin - ha e bonahale

Mekhahlelo e tloaelehileng ea boleng e ka fapana hanyane hara lilaboratori tse fapaneng. Bua le mofani oa hau ka moelelo oa sephetho sa hau sa liteko.

Mehlala e kaholimo e bonts'a litekanyo tse tloaelehileng bakeng sa liphetho bakeng sa liteko tsena. Li laboratori tse ling li sebelisa litekanyo tse fapaneng kapa li ka leka mefuta e fapaneng.

Mefuta e phahameng ea lihlahisoa tsa hemoglobin li ka baka mathata a maholo a bophelo bo botle. Mefuta e fetotsoeng ea hemoglobin ha e lumelle oksijene ho tsamaisoa hantle ka 'mele. Sena se ka lebisa lefung la lisele.

Litekanyetso tse latelang, ntle le sulfhemoglobin, li emela liperesente tsa lihlahisoa tsa hemoglobin tse ipapisitseng le hemoglobin e felletseng.

Carboxyhemoglobin:

• 10% ho isa ho 20% - matšoao a chefo ea carbon monoxide a qala ho hlaha
• 30% - chefo e matla ea carbon monoxide e teng hona joale
• 50% ho ea ho 80% - e hlahisa chefo ea carbon monoxide e ka bang kotsi

Methemoglobin:

• 10% ho isa ho 25% - liphetho tsa 'mala o moputsoa oa letlalo (cyanosis)
• 35% ho 40% - e fella ka phefumoloho e khuts'oane le hlooho e opang
• Ho feta 60% - ho fella ka ho tepella le boroko
• Ho feta 70% - ho ka baka lefu

Sulfhemoglobin:

• Boleng ba ligrama tse 10 ka desilitara e ngoe (g / dL) kapa limilimithara tse 6.2 ka litha e le nngwe (mmol / L) bo baka mmala oa letlalo le boputsoa ka lebaka la khaello ea oksijene (cyanosis), empa ha e bake litlamorao tse mpe nako e ngata.

Methemoglobin; Carboxyhemoglobin; Sulfhemoglobin

• Teko ea mali

Benz EJ, Ebert BL. Mefuta e fapaneng ea hemoglobin e amanang le phokolo ea mali ea hemolytic, kamano e fetotsoeng ea oksijene le methemoglobinemias. 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 43.

Mohloli HF. Atamela li-anemias. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 158.

Christiani DC. Likotsi tsa 'mele le tsa lik'hemik'hale tsa matšoafo. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 94.

Nelson LS, Ford MD. Chefo e bohloko. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 110.

Vajpayee N, Graham SS, Bem S. Tlhahlobo ea mantlha ea mali le moko oa masapo. 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 30.