ESR ndi erythrocyte sedimentation rate. M'mbuyomu, chizindikirochi chimatchedwa ROE. Chizindikiro chakhala chikugwiritsidwa ntchito ngati mankhwala kuyambira 1918. Njira zoyezera ESR zinayamba kupangidwa mu 1926 ndipo zikugwiritsidwabe ntchito.
Phunziroli nthawi zambiri limayikidwa ndi dokotala atakambirana kale. Izi zimachitika chifukwa chophweka kwa mayendedwe komanso mtengo wotsika wa ndalama.
ESR ndichizindikiro chosazindikira chosadziwika chomwe chimatha kuzindikira zonyansa m'thupi pakalibe zizindikiro. Kuwonjezeka kwa ESR kungakhale mu matenda a shuga, komanso oncological, matenda opatsirana komanso matenda amitsempha.
Kodi ESR amatanthauza chiyani?
Mu 1918, wasayansi wina waku Sweden a Robin Farus adavumbulutsa kuti pazaka zosiyanasiyana komanso matenda ena, maselo ofiira a magazi amakhala mosiyanasiyana. Pambuyo pakupita nthawi, asayansi ena adayamba kugwira ntchito molimbika pazinthu zothandizira kudziwa chizindikiro ichi.
Mlingo wa erythrocyte sedimentation ndi gawo la kayendedwe ka maselo ofiira amwazi m'magawo ena. Chizindikiro chimafotokozedwa mamilimita pa ola limodzi. Kusanthula kumafunikira magazi ochepa a munthu.
Kuwerengera kumeneku kumaphatikizidwa ndi kuchuluka kwa magazi. ESR akuyerekezedwa ndi kukula kwa plasma wosanjikiza (gawo lalikulu la magazi), lomwe linatsalira pamwamba pa chotengera choyeza.
Kusintha kwa gawo la erythrocyte sedimentation limalola kuti matenda azitha kukhazikitsidwa kumayambiriro kwa chitukuko chake. Chifukwa chake, zimatha kuchitapo kanthu mwachangu kuti vutolo lithe, matendawa asanadutse pachiwopsezo.
Kuti zotsatira zake zikhale zodalirika momwe zingathekere, zinthu ziyenera kupangidwa momwe mphamvu yokoka yokha imakhudzira maselo ofiira amwazi. Kuphatikiza apo, ndikofunikira kuti muchepetse magazi. M'malo a labotale, izi zimatheka mothandizidwa ndi anticoagulants.
Erythrocyte sedimentation imagawidwa m'magawo angapo:
- wodekha pang'onopang'ono
- mathamangitsidwe osokoneza bongo chifukwa cha kupangika kwa maselo ofiira a m'magazi, omwe amapangidwa ndi gluing maselo am'magazi ofiira,
- Kuchepetsa subsidence ndikuyimitsa njirayi.
Gawo loyamba ndilofunikira, koma nthawi zina, kuwunika kwa zotsatira kumafunika ndipo patatha tsiku limodzi pambuyo pakupereka magazi.
Kutalika kwa kuchuluka kwa ESR kumatsimikiziridwa ndi kuchuluka kwa maselo ofiira a m'magazi, chifukwa chizindikirocho chimatha kukhalabe pamasiku 100-120 pambuyo poti matendawa atachiritsidwa.
Mulingo wa ESR
Mitengo ya ESR imasiyana malinga ndi izi:
- jenda
- zaka
- mawonekedwe ake.
ESR yabwinobwino kwa amuna ili pamtunda wa 2-12 mm / h, kwa akazi, ziwerengerozi ndi 3-20 mm / h. Popita nthawi, ESR mwa anthu imachuluka, kotero mwa anthu azaka chizindikiro ichi chimakhala ndi mfundo kuchokera pa 40 mpaka 50 mm / h.
Kuchuluka kwa ESR mu akhanda kumene ndi 0-2 mm / h, ali ndi zaka 2-12 miyezi -10 mm / h. Choyimira pazaka 1-5 zaka chimafanana ndi 5-11 mm / h. Mwa ana achikulire, chiwerengerochi chili pamtunda wa 4-12 mm / h.
Nthawi zambiri, kupatuka kuzinthu zomwe zimachitika nthawi zambiri kumalembedwa kuti kukule m'malo mochepera. Koma chizindikiro chikhoza kuchepa ndi:
- neurosis
- kuchuluka bilirubin,
- khunyu
- anaphylactic shock,
- acidosis.
Nthawi zina, kafukufukuyu amapereka zotsatira zosadalirika, popeza malamulo okhazikitsidwa anaphwanyidwa. Magazi ayenera kuperekedwa kuyambira m'mawa mpaka m'mawa. Simungadye nyama kapena, mutakhala ndi njala. Ngati malamulowo sangathe kutsatiridwa, muyenera kuchedwanso phunziroli kwakanthawi.
Mwa akazi, ESR imakonda kuwonjezeka panthawi yapakati. Kwa akazi, miyezo yotsatirayi imakhazikitsidwa ndi zaka:
- Zaka 14 - 18: 3 - 17 mm / h,
- Zaka 18 - 30: 3 - 20 mm / h,
- Zaka 30 - 60: 9 - 26 mm / h,
- 60 ndi zina 11 - 55 mm / h,
- Pa nthawi yapakati: 19 - 56 mm / h.
Mwa amuna, maselo ofiira amakhala pang'ono pang'ono. Poyesedwa wamagazi aamuna, ESR ili pamtunda wa 8-10 mm / h. Koma mwa amuna pambuyo pa zaka 60, chizolowezicho chimakwera. Pazaka izi, ESR wamba ndi 20 mm / h.
Pambuyo pa zaka 60, chithunzi cha 30 mm / h chimawerengedwa kuti ndichopatuka mwa amuna. Pokhudzana ndi azimayi, chizindikiro ichi, ngakhale chimawukanso, sichifunikira chisamaliro chapadera komanso sichizindikiro cha matenda.
Kuwonjezeka kwa ESR kungakhale chifukwa cha matenda amtundu wa 1 komanso mtundu wa 2, komanso:
- matenda opatsirana, nthawi zambiri amachokera ku bakiteriya. Kuwonjezeka kwa ESR nthawi zambiri kumawonetsa njira yodwala kapena matenda
- njira zotupa, kuphatikiza zotupa za m'mimba ndi zotupa. Ndi kutanthauzira kulikonse kwa pathologies, kuyezetsa magazi kukuwonetsa kuwonjezeka kwa ESR,
- matenda a minyewa. ESR imawonjezeka ndi vasculitis, lupus erythematosus, nyamakazi yamatenda, systemic scleroderma ndi matenda ena,
- kutupa kwodziwika bwino m'matumbo ndi matenda a Crohn ndi colitis yam'mimba,
- zotupa zoyipa. ESR imachuluka kwambiri ndi leukemia, myeloma, lymphoma ndi khansa kumapeto komaliza.
- matenda omwe amatsatana ndi minofu necrotization, tikukamba za stroke, chifuwa chachikulu komanso kuphwanya myocardial. Chizindikirochi chikuwonjezeka momwe chingathere ndi kuwonongeka kwa minofu,
- magazi m'magazi: anemia, anisocytosis, hemoglobinopathy,
- Matenda omwe amaphatikizidwa ndi kuwonjezeka kwamitsekedwe yamagazi, mwachitsanzo, kutsekeka kwamatumbo, kutsekula m'mimba, kusanza kwakutali, kuchira pambuyo pake
- kuvulala, kuwotcha, kuwononga khungu,
- poyizoni ndi chakudya, mankhwala.
Kodi ESR yatsimikizika bwanji?
Ngati mutenga magazi ndi mankhwala opatsirana ndikuwasiya, ndiye kuti patapita nthawi mutha kuzindikira kuti maselo ofiira atsika, ndipo madzi amaso achikasu, ndiye kuti plasma, amakhalabe pamwamba. Mtunda womwe maselo ofiira a m'magazi amayenda mu ola limodzi ndi muyezo wa erythrocyte sedimentation - ESR.
Wothandizira labotale amatenga magazi kuchokera pachala kuchokera kwa munthu kupita mu chubu chagalasi - capillary. Kenako, magazi amayikidwa pa slide yagalasi, kenako ndikuwunjikanso mu capillary ndikuyika mu Panchenkov tripod kuti akonze zotsatira mu ola limodzi.
Njira yachikhalidweyi imatchedwa ESR malinga ndi Panchenkov. Mpaka pano, njirayi imagwiritsidwa ntchito m'ma laboratori ambiri mu post-Soviet space.
M'mayiko ena, tanthauzo la ESR malinga ndi Westergren limagwiritsidwa ntchito kwambiri. Njira iyi siyosiyana kwambiri ndi njira ya Panchenkov. Komabe, zosintha zamakono za kusanthulaku ndizolondola kwambiri ndikupangitsa kuti zitheke kupeza chofunikira mu mphindi 30.
Pali njira inanso yodziwira ESR - yolemba Vintrob. Mwanjira iyi, magazi ndi anticoagulant amasakanikirana ndikuyikidwa mu chubu chokhala ndi magawano.
Akuluakulu ngati maselo ofiira okwera kwambiri (oposa 60 mm / h), tinthu tating'onoting'ono timatsekedwa mwachangu, komwe limakhala lodzaza ndi zosokoneza.
ESR ndi matenda ashuga
Mwa matenda a endocrine, matenda a shuga amapezeka nthawi zambiri, omwe amadziwika kuti pali kuwonjezeka kowopsa kwa shuga m'magazi. Ngati chizindikirochi ndichoposa 7-10 mmol / l, ndiye kuti shuga amayamba kutsimikizidwanso mumkodzo wa anthu.
Tiyenera kukumbukira kuti kuwonjezeka kwa ESR mu matenda ashuga kumatha kuchitika osati chifukwa cha vuto la metabolic, komanso njira zingapo za kutupa zomwe zimawonedwa nthawi zambiri mwa anthu omwe ali ndi matenda a shuga, omwe amafotokozedwa ndikuchepa kwa chitetezo cha mthupi.
ESR mu mtundu woyamba wa 2 ndi matenda ashuga 2 amawonjezeka nthawi zonse. Izi zili choncho chifukwa cha kuwonjezeka kwa shuga, kukhuthala kwa magazi kumawonjezera, zomwe zimapangitsa kuti njira yolimbira ya erythrocyte ikhale. Monga mukudziwa, ndi matenda amtundu wa 2 shuga, kunenepa kwambiri kumawonedwa nthawi zambiri, komwe kumapangitsa mkwiyo wa erythrocyte.
Ngakhale kuti kusanthula uku ndikumvekera kwambiri, kuchuluka kwakukulu pazinthu kumakhudza kusintha kwa ESR, chifukwa chake sizotheka nthawi zonse kunena motsimikiza zomwe zimayambitsa zizindikirazi.
Kuwonongeka kwa impso mu shuga kumawerengedwa kuti ndi imodzi mwazovuta. Njira yotupa imatha kukhudza a impso parenchyma, motero ESR ichulukira. Koma nthawi zambiri, izi zimachitika pamene kuchuluka kwa mapuloteni m'magazi kumachepera. Chifukwa cha kuchuluka kwake, imadutsa mkodzo, chifukwa zotupa za impso zimakhudzidwa.
Ndi matenda apamwamba a shuga, necrosis (necrosis) yamatupi amthupi ndi zinthu zina ndi mayamwidwe azinthu zophatikiza mapuloteni m'magazi ndizodziwika. Anthu odwala matenda ashuga nthawi zambiri amavutika:
- purulent pathologies,
- myocardial infarction ndi matumbo,
- mikwingwirima
- zotupa zoyipa.
Matenda onsewa amatha kuchulukitsa erythrocyte sedimentation rate. Nthawi zina, ESR yowonjezereka imachitika chifukwa cha cholowa.
Ngati kuyezetsa magazi kukuwoneka kuti kuchuluka kwa erythrocyte sedimentation, musamveke. Muyenera kudziwa kuti zotsatirazi zimayesedwa nthawi zonse mumphamvu, ndiye kuti, ziyenera kufananizidwa ndi kuyesedwa koyambirira kwa magazi. Zomwe ESR akunena - mu kanema munkhaniyi.
