I-ESR yisilinganiso se-erythrocyte sedimentation. Phambilini, le nkomba ibizwa nge-ROE. Isikhombi sisetshenziswe kwezokwelapha kusuka ngo-1918. Izindlela zokulinganisa i-ESR zaqala ukwenziwa ngo-1926 futhi zisasetshenziswa.
Ucwaningo luvame ukunikezwa udokotela ngemuva kokubonisana kokuqala. Lokhu kungenxa yobulula bokuziphatha kanye nezindleko eziphansi zezezimali.
I-ESR iyinkomba ebucayi engacacisanga engathola ubuthi emzimbeni ngaphandle kwezimpawu. Ukwanda kwe-ESR kungaba kwizifo ezinesifo sikashukela, kanye nezifo ze-oncological, ezithathelwanayo neze-rheumatological.
Kusho ukuthini u-ESR?
Ngo-1918, usosayensi waseSweden, uRobin Farus, wembula ukuthi ngeminyaka ehlukahlukene nangezifo ezithile, amangqamuzana abomvu egazi aziphatha ngendlela ehlukile. Ngemuva kwesikhashana, abanye ososayensi baqala ukusebenza ngenkuthalo ngezindlela zokuthola inkomba le.
Inani le-erythrocyte sedimentation izinga lokuhamba kwamangqamuzana egazi abomvu ezimeni ezithile. Inkomba ivezwa ngamamilimitha ngehora eli-1. Ukuhlaziywa kudinga inani elincane legazi lomuntu.
Lesi sibalo sifakwa ekubalweni kwegazi okujwayelekile. I-ESR ilinganiselwa ngosayizi we-plasma layer (isakhi esiyinhloko segazi), esasala ngaphezulu komkhumbi wokulinganisa.
Ukushintsha isilinganiso se-erythrocyte sedimentation kukuvumela ukuthi usungule i-pathology ekuqaleni kokukhula kwayo. Ngakho-ke, kungenzeka ukuthatha izinyathelo eziphuthumayo zokuthuthukisa lesi simo, ngaphambi kokuthi lesi sifo sidlulele esigabeni esiyingozi.
Ukuze imiphumela ithembeke ngangokunokwenzeka, izimo kufanele zakhiwe ngaphansi kokuthi amandla adonsela phansi kuphela azothonya amaseli abomvu egazi. Ngaphezu kwalokho, kubalulekile ukuvimbela ukwanda kwegazi. Ezimweni zaselebhu, lokhu kutholakala ngosizo lwama-anticoagulants.
I-erythrocyte sedimentation ihlukaniswe izigaba eziningana:
- ukulungisa kancane
- ukushesha kokudungeka ngenxa yokwakheka kwamangqamuzana abomvu egazi, adalwe ngokufaka amangqamuzana ngamanye amaseli abomvu egazi,
- ukubambezela ukuncipha nokuvimba inqubo.
Isigaba sokuqala sibalulekile, kepha kwezinye izimo, kuhlolwa umphumela bese kuthi ngosuku olulandelayo kususwe isampula legazi.
Isikhathi sokwanda kwe-ESR sinqunywa ukuthi lingakanani iseli elibomvu legazi elihlala kulo, ngoba inkomba ingahlala emazingeni aphezulu ezinsukwini eziyi-100-120 ngemuva kokuba lesi sifo selaphekile ngokuphelele.
Izinga le-ESR
Amanani e-ESR ahlukahluka ngokuya ngezici ezilandelayo:
- ubulili
- iminyaka
- izici ngazinye.
I-ESR ejwayelekile yabesilisa isebangeni le-2-12 mm / h, kwabesifazane, izibalo zi-3-20 mm / h. Ngokuhamba kwesikhathi, i-ESR kubantu iyanda, ngakho-ke kubantu abaneminyaka le nkomba inamanani ukusuka ku-40 kuye ku-50 mm / h.
Izinga elikhulayo le-ESR ezinganeni ezisanda kuzalwa lingama-0-2 mm / h, eneminyaka engu-2-12 izinyanga -10 mm / h. Inkomba eneminyaka engu-1-5 ifana ne-5-11 mm / h. Ezinganeni esezikhulile, lesi sibalo sisebangeni le-4-12 mm / h.
Esikhathini esiningi, ukuphambuka kusuka kokujwayelekile kubhalwe endaweni yokunyuka kunokuncipha. Kepha inkomba ingehla nge:
- i-neurosis
- ukukhuphuka kwe-bilirubin,
- isithuthwane
- ukwethuka kwe-anaphylactic,
- i-acidosis.
Kwezinye izimo, ucwaningo lunikeza umphumela ongathembekile, ngoba imithetho emisiwe yokwephulwa yephulwa. Igazi kufanele linikezwe kusukela ekuseni kuze kube kusihlwa. Awungeke uyidle inyama noma, ngakolunye uhlangothi, ulambile. Uma imithetho ingalandelwa, udinga ukuhlehlisa isifundo isikhathi esithile.
Kwabesifazane, i-ESR ivame ukwanda ngesikhathi sokukhulelwa. Kwabesifazane, lezi zindinganiso ezilandelayo zincike eminyakeni yobudala:
- Iminyaka eyi-14 - eyi-18: 3 - 17 mm / h,
- Iminyaka engu-18 - 30: 3 - 20 mm / h,
- Iminyaka engama-30 - 60 ubudala: 9 - 26 mm / h,
- 60 nokuningi 11 - 55 mm / h,
- Ngesikhathi sokukhulelwa: 19 - 56 mm / h.
Kumadoda, iseli elibomvu legazi lihlala kancane. Ekuhlolweni kwegazi lesilisa, i-ESR isebangeni le-8-10 mm / h. Kepha emadodeni emva kweminyaka engama-60, okujwayelekile nakho kuyakhuphuka. Kulesi sikhathi, i-ESR evamile ingama-20 mm / h.
Ngemuva kweminyaka engama-60, isithombe esingu-30 mm / h sibhekwa njengokuphambuka emadodeni. Ngokuphathelene nabesifazane, le nkomba, yize iphakama futhi, ayidingi ukunakwa okukhethekile futhi akuyona uphawu lwe-pathology.
Ukwanda kwe-ESR kungenzeka kubangelwa uhlobo 1 lwesifo sikashukela, kanye:
- ama-pathologies athelelekayo, imvamisa evela emvelaphi yamagciwane. Ukwanda kwe-ESR kuvame ukukhombisa inqubo ebuhlungu noma inkambo yesifo engapheli,
- izinqubo zokuvuvukala, kufaka phakathi izilonda ze-septic ne-purulent. Noma yikuphi ukwenziwa kwasendaweni kwe-pathologies, ukuhlolwa kwegazi kwembula ukwanda kwe-ESR,
- izifo ezithinta izicubu. I-ESR inyuka nge-vasculitis, i-lupus erythematosus, isifo samathambo, i-systemic scleroderma nezinye izifo.
- ukuvuvukala okwenziwe ngaphakathi emathunjini ngesifo sikaCrohn kanye ne-ulcerative colitis,
- amathumba amabi. I-ESR inyuka kakhulu nge-leukemia, i-myeloma, i-lymphoma nomdlavuza esigabeni sokugcina,
- Izifo ezihambisana ne-izic necrotization, sikhuluma ngokuhlaselwa yisifo sohlangothi, isifo sofuba kanye nokuqanjwa kwe-myocardial. Inkomba ikhuphuka ngangokunokwenzeka ngomonakalo wezicubu,
- izifo zegazi: anemia, anisocytosis, hemoglobinopathy,
- ama-pathologies ahambisana nokwanda kokubonakala kwegazi, ngokwesibonelo, ukuphazamiseka kwamathumbu, isisu, ukugabha isikhathi eside, ukululama ngemuva kokusebenza,
- ukulimala, ukushiswa, ukulimala kanzima kwesikhumba,
- ubuthi ngokudla, amakhemikhali.
Kunqunywa kanjani i-ESR
Uma uthatha igazi kanye ne-anticoagulant futhi uwayeke ame, khona-ke emva kwesikhathi esithile ungabona ukuthi amangqamuzana abomvu ehlile, futhi uketshezi ophuzi, okungukuthi, iplasma, uhlala phezulu. Ibanga lelo amaseli egazi abomvu azohamba ngalo ngehora isilinganiso se-erythrocyte sedimentation - ESR.
Umsizi weLabhoratri uthatha igazi elivela emunweni womuntu alifaka kwishubhu yengilazi - i-capillary. Ngokulandelayo, igazi libekwa kwisilayidi sengilazi, bese liphinda liqoqwe ku-capillary bese lifakwa kwi-patod ye-Panchenkov ukulungisa umphumela ngehora.
Le ndlela yendabuko ibizwa nge- ESR ngokusho kukaPanchenkov. Kuze kube manje, le ndlela isetshenziswa ezindaweni eziningi zokucwaninga ezikhaleni zangemva kweSoviet.
Kwamanye amazwe, incazelo ye-ESR ngokuya nge-Westergren isetshenziswa kabanzi. Le ndlela ayihlukile kakhulu kunendlela yePanchenkov. Kodwa-ke, ukulungiswa kwesimanje kokuhlaziywa kunembe kakhudlwana futhi kwenza kube lula ukuthola umphumela ophela ngaphakathi kwemizuzu engama-30.
Kukhona enye indlela yokuthola i-ESR - ngeVintrob. Kulokhu, igazi ne-anticoagulant kuxutshwe futhi kubekwe ishubhu enokwehlukana.
Ngokwesilinganiso esiphakeme samangqamuzana egazi abomvu (ngaphezulu kuka-60 mm / h), ishubhu le-tube ligxothwa ngokushesha, okugcwele imiphumela yokuhlanekezela.
I-ESR nesifo sikashukela
Ngezifo ze-endocrine, isifo sikashukela kwesinye isikhathi sitholakala, esibonakala ngeqiniso lokuthi kukhona ukwanda okubukhali njalo koshukela wegazi. Uma ngabe le nkomba ingaphezu kwe-7-10 mmol / l, khona-ke ushukela uqala ukunqunywa futhi kumchamo womuntu.
Kufanele kukhunjulwe ukuthi ukwanda kwe-ESR kwisifo sikashukela kungenzeka ngenxa yokungaphazamiseki kwe-metabolic kuphela, kepha futhi nezinqubo ezahlukahlukene zokulimala ezivame ukubonwa kubantu abanesifo sikashukela, esichazwa wukuwohloka kwamasosha omzimba.
I-ESR yohlobo 1 nesifo sikashukela sohlobo 2 ihlala ikhuphuka. Lokhu kungenxa yokuthi njengoba kukhuphuka ushukela, ukunyuka kwegazi kuyabonakala, okukhombisa ukushesha kwenqubo ye-erythrocyte sedimentation. Njengoba wazi, ngesifo sikashukela sohlobo 2, ukukhuluphala kuvame ukubonwa, okuthi ngokwako kuthuthukise amanani aphezulu okuwohloka kwe-erythrocyte.
Naphezu kweqiniso lokuthi lokhu kucubungula kuzwela kakhulu, inani elikhulu lezinto eziseceleni linethonya ushintsho ku-ESR, ngakho-ke akunakwenzeka njalo ukusho ngokuqiniseka ukuthi yini ngempela ebangele izinkomba ezitholakele.
Ukulimala kwezinso kusifo sikashukela kubhekwa njengenye yezinkinga. Inqubo yokuvuvukala ingathinta i-renal parenchyma, ngakho-ke i-ESR izokwanda. Kepha ezimweni eziningi, lokhu kwenzeka lapho izinga leproteyini egazini lehla. Ngenxa yokugxilisa okukhulu kakhulu, idlulela emchameni, ngoba imithambo ye-renal iyathinteka.
Njengoba sekwephuze kakhulu isifo sikashukela i-mellitus, i-necrosis (necrosis) yezicubu zomzimba nezinye izinto ezithinta imikhiqizo yamaphrotheni anobuthi egazini. Isifo sikashukela sivame ukuhlupheka:
- i-purulent pathologies,
- i-myocardial infarction namathumbu,
- imivimbo
- amathumba amabi.
Zonke lezi zifo zingakhuphula izinga le-erythrocyte sedimentation rate. Kwezinye izimo, i-ESR eyandayo ivela ngenxa yenzalo yefa.
Uma ukuhlolwa kwegazi kukhombisa ukukhuphuka kwezinga le-erythrocyte sedimentation rate, ungazwakali umsindo. Udinga ukwazi ukuthi umphumela uvame ukuhlolwa ku-dynamics, okungukuthi, kufanele uqhathaniswe nokuhlolwa kwegazi kwangaphambilini. Okushiwo yi-ESR - kuvidiyo ekulesi sihloko.
