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Ịdị ụkọ ọbara

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Idi uko obara (British English) bu obara na adighi mma nke bu na ike obara gbature nke na onweghi ike ibu ndu n'ihi na odi ala karia onuogugu ndu obara ma obu mgbatu na onu hemoglobinsI'mn[1][2] The name is derived from Àtụ:Lang-grc Àtụ:Transliteration, meaning 'lack of blood', from ἀν-Àtụ:Transliteration, 'not' and αἷμα Àtụ:Transliteration, 'blood'.[3] When idi uko obara na eji nwayo abia, njirimara ya mgbe ufodu na abu vague,ihe dika ike ogwugwu, ume ngwu, anaghi eku ume nke oma, isi owuwa, ma wetue ike imeghari ahu. Mgbe idi uko obara di njo, njirimara ya na abu ogba ahara, odi ka I ga anwu, amaghi onwe, na oke apkiri ikpo nku. Idi uko obara ga aputariri ihe tupu mmadu ata ahu. Njirimara idi uko obara na abu otu osiso hemoglobin gbaturu..[2] Njirimara ya ozo nwere ike ibia na ihi ihe kpatara yaAdditional symptoms may occur depending on the underlying cause. Preoperative anemia can increase the risk of needing a blood transfusion following surgery.[4] Anemia can be temporary or long term and can range from mild to severe.[5]

Mgbaàmà nke ụkọ ọbara nwere ike ịbịa ngwa ngwa ma ọ bụ nwayọ.[6] Na mbido enwere ike inwe ihe mgbaàmà ole na ole ma ọ bụ enweghị ya.[6] Ọ bụrụ na ụkọ ọbara na-aga n'ihu nwayọ (na-adịghị ala ala), ahụ nwere ike ime mgbanwe ma kwụọ ụgwọ maka mgbanwe a. N'ọnọdụ a, ọ dịghị mgbaàmà nwere ike ịpụta ruo mgbe ụkọ ọbara siri ike.[7] Mgbaàmà nwere ike ịgụnye ike ọgwụgwụ, adịghị ike, isi ọwụwa, isi ọnya, enweghị ike ịnabata mgbalị anụ ahụ, ume dị mkpụmkpụ, ihe isi ike itinye uche, obi na-adịghị mma ma ọ bụ na-akụ ngwa ngwa, aka na ụkwụ oyi, enweghị ike ịnagide oyi, akpụkpọ ahụ na-acha odo odo, agụụ na-adịghị ike, mmerụ ahụ dị mfe na ọbara ọgbụ, na adịghị ike nke uru ahụ.[6] Ọrịa ụkọ ọbara nke na-amalite ngwa ngwa, mgbe mgbe, nwere mgbaàmà siri ike karị, gụnyere, mmetụta dị ala, obi mgbu, ọsụsọ, oke akpịrị ịkpọ nkụ, na mgbagwoju anya.[6] Enwere ike inwe mgbaàmà ndị ọzọ dabere na ihe kpatara ya.

N'ọrịa ụkọ ọbara siri ike karị, ahụ nwere ike ịkwụ ụgwọ maka enweghị ikike ibu oxygen nke ọbara site n'ịbawanye mmepụta obi. Onye ahụ nwere ike ịnwe mgbaàmà ndị metụtara nke a, dị ka obi ịkụ aka, angina (ma ọ bụrụ na ọrịa obi dịbu adị), nkwụsịtụ nke ụkwụ, na mgbaàmà nke nkụchi obi.[8]

Mgbe a na-enyocha ya, ihe ịrịba ama ndị a na-egosipụta nwere ike ịgụnye ntụpọ (akpụkpọ ahụ na-acha odo odo, mucosa, conjunctiva na mbọ), mana nke a abụghị ihe ịrịbaanya a pụrụ ịdabere na ya. Enwere ike ịhụ ụcha na-acha anụnụ anụnụ nke sclera n'ọnọdụ ụfọdụ nke iron-deficiency anemia.[9] Enwere ike inwe ihe ịrịba ama nke ihe kpatara ụkọ ọbara, dịka koilonychia (n'oge ụkọ iron), jaundice (mgbe ụkọ ọbara na-esite na mmebi nke mkpụrụ ndụ ọbara uhie - na ụkọ ọbara ọbara), mmebi nke ụbụrụ (n'ụzọ dị ụkọ vitamin B12), nkwarụ ọkpụkpụ (nke a hụrụ na thalassemia major) ma ọ bụ ọnyá ụkwụ (nke a na-ahụ na ọrịa sickle-cell). Na oke ụkọ ọbara, enwere ike inwe ihe ịrịba ama nke hyperdynamic circulation: tachycardia (obi na-agba ọsọ), ịkụ aka, ntamu na-agafe, na hypertrophy ventricular nke obi (ịbawanye). Enwere ike inwe ihe ịrịba ama nke nkụchi obi. Pica, iri ihe ndị na-abụghị nri dịka ice, akwụkwọ, wax, ahịhịa, ntutu ma ọ bụ unyi, nwere ike ịbụ ihe mgbaàmà nke ụkọ iron; ọ bụ ezie na ọ na-emekarị na ndị nwere ọkwa hemoglobin dị mma.[10] Anemia na-adịghị ala ala nwere ike ịkpata nsogbu omume n'ime ụmụaka dịka nsonaazụ kpọmkwem nke mmepe akwara na-adịghị mma n'ime ụmụ ọhụrụ, yana mbelata arụmọrụ agụmakwụkwọ n'ime vana nọ n'afọ akwụkwọ. Ọrịa ụkwụ na-enweghị ntụsara ahụ bụ ihe a na-ahụkarị n'etiti ndị nwere ụkọ iron karịa n'etiti mmadụ n'ozuzu.[11]

Enwere ike ịkọwa ihe na-akpata ụkọ ọbara dị ka mmepụta ọbara uhie (RBC), mmụba mbibi RBC (hemolytic anemia), ọbara na-efu na mmiri karịrị akarị (hypervolemia). Ọtụtụ n'ime ndị a nwere ike imekọ ihe ọnụ iji kpatara ụkọ ọbara. Ihe kachasị akpata ụkọ ọbara bụ ọbara, mana nke a anaghị akpata mgbaàmà ọ bụla na-adịgide adịgide ọ gwụla ma mmepụta RBC na-adịghị mma, n'aka nke ya, nke kachasị n'ihi ụkọ iron.[2]

Mmepụta na-adịghị mma[dezie | dezie ebe o si]

  • Nsogbu nke mmụba na ọdịiche nke mkpụrụ ndụ stem
    • Aplasia nke mkpụrụ ndụ uhie[12]
    • Aplastic anemia na-emetụta ụdị mkpụrụ ndụ ọbara niile.[12] Anemia Fanconi bụ nsogbu nketa ma ọ bụ nkwarụ na-egosi anemia aplastic na ihe ndị ọzọ na-adịghị mma.
    • Anemia nke nkụchi akụrụ n'ihi mmepụta na-ezughị ezu nke hormone erythropoietin[12]
    • Anemia nke ọrịa endocrine[13]
  • Nsogbu nke ịmụba na ntozu nke erythroblasts
    • Anemia na-emerụ ahụ bụ ụdị anemia megaloblastic n'ihi ụkọ vitamin B12 dabere na mbelata nke vitamin B12.[12] Enweghị nri B12 na-akpata ọrịa megaloblastic na-adịghị emerụ ahụ.
    • Anemia nke ụkọ folate, dị ka vitamin B12, na-akpata anemia megaloblastic[12]
    • Anemia nke ịmụ nwa n'oge, site na mmeghachi omume erythropoietin na mbelata nke ọkwa hematocrit, jikọtara ya na ọbara na-efu site na nyocha ụlọ nyocha, na-emekarị na ụmụ ọhụrụ a mụkwuru n'oge izu abụọ ruo isii.
    • Enweghị iron ụkọ ọbara, na-akpata mmepụta heme ụkọ[12]
    • Thalassemias, na-akpata mmepụta globin na-adịghị mma[12]
    • Anemia dyserythropoietic amụrụ amụrụ amụọ, na-akpata erythropoiesis na-adịghị arụ ọrụ
    • Anemia nke nkụchi akụrụ (nke na-akpatakwa dysfunction stem cell)[12]
  • Usoro ndị ọzọ nke mmepụta RBC na-adịghị mma
    • Myelophthisic anemia ma ọ bụ myelophthisis bụ ụdị ọrịa ụkọ ọbara[12] siri ike nke na-esite na iji ihe ndị ọzọ dochie ụmị ọkpụkpụ, dị ka akpụ ọjọọ, fibrosis, ma ọ bụ granulomas.
    • Ọrịa myelodysplastic[12]
    • ụkọ ọbara nke ọzịza na-adịghị ala ala[12]
    • Leukoerythroblastic anemia na-esite na mmerụ ahụ na-ewepụta ohere na ụmị ọkpụkpụ nke na-egbochi mmepụta nke mkpụrụ ndụ ọbara.[14]

A na-ahazi ụkọ ọbara nke na-abawanye na mbibi nke mkpụrụ ndụ ọbara uhie dị ka ụkọ ọbara ọbara ọbara. Ụdị ndị a na-egosipụtakarị jaundice, na ọkwa dị elu nke lactate dehydrogenase.[15][16]

  • Ihe ndị na-adịghị mma n'ime (intracorpuscular) na-akpata mbibi ngwa ngwa.[12] Ihe ndị a niile, ma e wezụga paroxysmal nocturnal hemoglobinuria, bụ nsogbu mkpụrụ ndụ ihe nketa.[17]
    • Hereditary spherocytosis[12] bụ nkwarụ nketa nke na-akpata nkwarụ na membrane nke mkpụrụ ndụ RBC, na-eme ka ọkpụkpụ na-ejide ma na-ebibi erythrocytes.
    • Elliptocytosis[12] nketa bụ nkwarụ ọzọ na protein ọkpụkpụ membrane.
    • Abetalipoproteinemia, na-akpata nkwarụ na membrane lipids[12]
    • Enzyme na-adịghị mma
      • Enweghị pyruvate kinase na hexokinase, na-akpata glycolysis nwere nkwarụ[12]
      • Glucose-6-phosphate dehydrogenase deficiency na glutathione synthetase deficiency, na-akpata mmụba nke nrụgide oxidative[12]
    • Ọrịa Hemoglobin
      • Ọrịa ụkọ ọbara[12]
      • Ọrịa ọbara na-akpata hemoglobin na-adịghị akwụsi ike[12]
    • Hemoglobinuria abalị paroxysmal[12]
  • Ihe ndị na-adịghị mma n'èzí
    • Ihe na-egbochi ahụ
      • Anemia hemolytic na-ekpo ọkụ nke autoimmune na-akpata site na mwakpo autoimmune megide mkpụrụ ndụ ọbara uhie, karịsịa site na IgG. Ọ bụ ọrịa a na-ahụkarị n'ime ọrịa hemolytic autoimmune.[18] Ọ nwere ike ịbụ idiopathic, ya bụ, na-enweghị ihe ọ bụla a maara ihe kpatara ya, ọgwụ na-ejikọta ma ọ bụ nke abụọ na ọrịa ọzọ dị ka systemic lupus erythematosus, ma ọ bụ malignancy, dị ka chronic lymphocytic leukemia.[19]
      • IgM na-ebute ọrịa aglutinin hemolytic anemia oyi. Ọ nwere ike ịbụ idiopathic ma ọ bụ sitere na ọnọdụ dị n'okpuru.[20]
      • Ọrịa Rh, otu n'ime ihe na-akpata ọrịa hemolytic nke nwa ọhụrụ[12]
      • Mmeghachi omume mmịnye ọbara[12] na mmịnye ya
    • Mmetụta na-akpata mkpụrụ ndụ ọbara uhie
      • Microangiopathic hemolytic anemia, gụnyere thrombocytopenic purpura na disseminated intravascular coagulation[12]
      • Nje ndị na-efe efe, gụnyere ịba[12]
      • Ịwa ahụ n'obi [ihe odide ahụike dị mkpa]
      • Haemodialysis [ihe odide ahụike dị mkpa]
    • Ihe na-egbu egbu
      • Trypanosoma congolense na-agbanwe elu nke RBCs nke onye na-elekọta ya na nke a nwere ike ịkọwa T. c. induced anemia[21]
  • Anemia nke ịmụ nwa n'oge, site na nnwale ọbara ugboro ugboro maka nyocha ụlọ nyocha, jikọtara ya na mmepụta RBC ezughi oke
  • Mmetụta[12] ma ọ bụ ịwa ahụ, na-akpata ọbara ọgbụgba
  • Mmerụ ahụ nke eriri afọ, na-akpata ma ọ bụ ọbara mgbali elu (dịka mmerụ ahụ variceal, ọnyá peptic) ma ọ bụ ọnwụ ọbara na-adịghị ala ala (dịka angiodysplasia)[12]
  • Nsogbu ụmụ nwanyị, nke na-akpatakarị ọbara na-adịghị ala ala[12]
  • Site na ịhụ nsọ, karịsịa n'etiti ụmụ agbọghọ ma ọ bụ ụmụ nwanyị toro eto nwere fibroids
  • Ọtụtụ ụdị ọrịa kansa, gụnyere ọrịa kansa colorectal na ọrịa kansa nke nsị, nwere ike ịkpata ọbara ọgbụgba siri ike ma ọ bụ na-adịghị ala ala, ọkachasị n'oge ọ dị elu.
  • Mmetụta sitere na eriri afọ nematodes na-eri ọbara, dị ka hookworms na whipworm Trichuris trichiura[22][23]
  • Iatrogenic anemia, ọbara na-efu site na ọbara na-adọta ugboro ugboro na usoro ọgwụgwọ.[24][25]

Mgbọrọgwụ nke okwu anemia na ischemia na-ezo aka n'echiche bụ isi nke "enweghị ọbara", mana anemia na ischemia abụghị otu ihe na okwu ahụike nke oge a. Okwu anemia eji naanị ya na-egosi mmetụta zuru oke site na ọbara nke dị oke ụkọ (dịka, ọbara na-efu) ma ọ bụ na-adịghị arụ ọrụ na ikike inye ikuku oxygen (n'ihi ụdị hemoglobin ma ọ bụ nsogbu erythrocyte ọ bụla). N'ụzọ dị iche, okwu ischemia na-ezo aka naanị na enweghị ọbara (mmiri na-adịghị mma). Ya mere, ischemia n'akụkụ ahụ nwere ike ịkpata mmetụta anemic dị n'ime anụ ahụ ndị ahụ.[26]

Mmiri karịrị akarị[dezie | dezie ebe o si]

Mmiri karịrị akarị (hypervolemia) na-akpata mbelata nke hemoglobin na ụkọ ọbara:[27]

  • Ihe na-akpata hypervolemia na-agụnye sodium ma ọ bụ mmiri na-eribiga ihe ókè, sodium maọbụ njigide mmiri na mgbanwe mmiri n'ime oghere intravascular.[28]
  • Site na izu nke isii nke ime ime, mgbanwe homonụ na-akpata mmụba nke ọbara nne n'ihi mmụba na plasma.[29]
  1. Anemia: Practice Essentials, Pathophysiology, Etiology (9 November 2021). Retrieved on 8 February 2022.
  2. 2.0 2.1 2.2 Anemia | NHLBI, NIH. www.nhlbi.nih.gov. Retrieved on 8 February 2022.
  3. anaemia. Dictionary.com. Archived from the original on 14 July 2014. Retrieved on 7 July 2014.
  4. Ng (7 December 2019). "Iron therapy for preoperative anaemia". Cochrane Database of Systematic Reviews 2019 (12): CD011588. DOI:10.1002/14651858.CD011588.pub3. PMID 31811820. 
  5. Anemia - Symptoms and causes (en). Mayo Clinic. Retrieved on 2022-04-01.
  6. 6.0 6.1 6.2 6.3 What Are Symptoms of Anemia?. National Heart, Lung, and Blood Institute. (2022-03-24). Retrieved on 2022-06-26.
  7. Anemia (en). www.hematology.org. Retrieved on 2022-01-08.
  8. Franceschi (2017-07-01). "Clinical management of iron deficiency anemia in adults: Systemic review on advances in diagnosis and treatment" (in English). European Journal of Internal Medicine 42: 16–23. DOI:10.1016/j.ejim.2017.04.018. ISSN 0953-6205. PMID 28528999. 
  9. Weksler (2017). Wintrobe's Atlas of Clinical Hematology (in en). Lippincott Williams & Wilkins. ISBN 9781451154542. 
  10. Mental Health and Pica (en). WebMD. Retrieved on 2022-04-26.
  11. Allen (April 2013). "The prevalence and impact of restless legs syndrome on patients with iron deficiency anemia". American Journal of Hematology 88 (4): 261–264. DOI:10.1002/ajh.23397. PMID 23494945. 
  12. 12.00 12.01 12.02 12.03 12.04 12.05 12.06 12.07 12.08 12.09 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21 12.22 12.23 12.24 12.25 12.26 Table 12-1 in: Mitchell (2007). Robbins Basic Pathology, 8th, Philadelphia: Saunders. ISBN 978-1-4160-2973-1. 
  13. Gregg (2007). "Anemia of Endocrine Disorders", Williams Hermatology. McGraw-Hill. 
  14. the definition of leukoerythroblastosis (en). www.dictionary.com. Archived from the original on 2018-12-02. Retrieved on 2018-12-02.
  15. Despotovic (2021). Overview of hemolytic anemias in children. The Lecturio Medical Concept Library. UpToDate. Retrieved on 28 June 2021.
  16. Capriotti, Theresa (2016). Pathophysiology : introductory concepts and clinical perspectives, Frizzell, Joan Parker. ISBN 978-0-8036-1571-7. OCLC 900626405. 
  17. Mitchell (2007). Robbins Basic Pathology, 8th, Philadelphia: Saunders. ISBN 978-1-4160-2973-1. 
  18. Cotran (2005). Robbins and Cotran pathologic basis of disease. St. Louis, Mo: Elsevier Saunders. ISBN 978-0-7216-0187-8. 
  19. "Autoimmune Hemolytic Anemia (AIHA)" By J.L. Jenkins.
  20. (October 2007) "Primary chronic cold agglutinin disease: an update on pathogenesis, clinical features and therapy". Hematology 12 (5): 361–370. DOI:10.1080/10245330701445392. PMID 17891600. 
  21. Stijlemans (2007). "African trypanosomosis: From immune escape and immunopathology to immune intervention". Veterinary Parasitology 148 (1): 3–13. DOI:10.1016/j.vetpar.2007.05.005. ISSN 0304-4017. PMID 17560035. 
  22. (September 2008) "Hookworm-related anaemia among pregnant women: a systematic review". PLOS Neglected Tropical Diseases 2 (9): e291. DOI:10.1371/journal.pntd.0000291. PMID 18820740. 
  23. (April 2011) "Trichuris and hookworm infections associated with anaemia during pregnancy". Tropical Medicine & International Health 16 (4): 531–537. DOI:10.1111/j.1365-3156.2011.02727.x. PMID 21281406. 
  24. Whitehead (December 2019). "Interventions to prevent iatrogenic anemia: a Laboratory Medicine Best Practices systematic review". Critical Care 23 (1): 278. DOI:10.1186/s13054-019-2511-9. PMID 31399052. 
  25. Martin (September 2015). "Hospital-Acquired Anemia: A Contemporary Review of Etiologies and Prevention Strategies". Journal of Infusion Nursing 38 (5): 330–338. DOI:10.1097/NAN.0000000000000121. PMID 26339939. 
  26. Bellotto (March 2006). "[Anemia and myocardial ischemia: relationships and interferences]". Recenti Progressi in Medicina 97 (3): 153–164. ISSN 0034-1193. PMID 16700423. 
  27. Hung (2015). "Association of Fluid Retention With Anemia and Clinical Outcomes Among Patients With Chronic Kidney Disease". Journal of the American Heart Association 4 (1): e001480. DOI:10.1161/JAHA.114.001480. PMID 25559015. 
  28. (2007) "Fluid imbalances", Portable Fluids and Electrolytes (Portable Series). Hagerstwon, MD: Lippincott Williams & Wilkins. ISBN 978-1-58255-678-9. 
  29. ISBT: 8. Obstetric anaemia (en). www.isbtweb.org. Retrieved on 2018-05-22.