Igazi elixineneyo (Hypercoagulability)

Umxholo

• Zithini iimpawu zegazi elingqingqwa?
• Zintoni oonobangela begazi elixineneyo?
• Kufunyaniswa njani ukuba ligazi elingqingqwa?
• Luthini unyango lwegazi elixineneyo?
• IPolycythemia vera
• Unyango lweemeko ezichaphazela ukujiya kwegazi
• Zeziphi iingxaki kwigazi elingqingqwa?
• Iyintoni imbonakalo yale meko?

Yintoni igazi elingqingqwa?

Ngelixa igazi lomntu linokubonakala lifana, lenziwe ngokudityaniswa kweeseli ezahlukeneyo, iiproteni, kunye nezinto ezijiyisayo, okanye izinto ezinceda ekunqandeni.

Njengakwezinto ezininzi emzimbeni, igazi lixhomekeke kwimali eseleyo ukugcina ukungqinelana okuqhelekileyo. Ukuba ukungalingani kwiiproteni kunye neeseli ezijongene negazi kunye nokuqunjelwa kwegazi kuyakhula, igazi lakho linokuba lukhulu kakhulu. Oku kwaziwa njenge-hypercoagulability.

Zininzi izinto ezinokubangela igazi elingqingqwa, njenge:

• iiseli zegazi ezigqithileyo
• izifo ezichaphazela ukujiya kwegazi
• Iiproteni ezijija igazi egazini

Ngenxa yokuba zininzi izinto ezinokubangela igazi elityebileyo, oogqirha abanayo inkcazo esemgangathweni yegazi elixineneyo. Endaweni yoko bayichaza kwimeko nganye ekhokelela kwigazi elixineneyo.

Ukuphazamiseka kwegazi ekunqandeni okubangela ukuba igazi elingqingqwa kuthambekele ekubeni kunqabile. Ezinye zezona zixhaphakileyo zibandakanya i-V Leiden, eqikelelwa kwi-3 ukuya kwi-7 yeepesenti yabantu ngokubanzi. Le meko ayithethi ukuba igazi lomntu liya kuba lukhulu kakhulu, kodwa ukuba bachongelwe ukuba negazi elingqindilili.

Kubo bonke abantu abaye banegazi egazini kwimithambo yabo, bangaphantsi kweepesenti ezili-15 ngenxa yemeko ebangela igazi elingqindilili.

Zithini iimpawu zegazi elingqingqwa?

Uninzi alunazo iimpawu zegazi elingqingqwa de libe namava egazi. Ihlwili legazi lidla ngokwenzeka emthanjeni womntu, onokuthi ubangele iintlungu kwaye uchaphazele ukujikeleza ngaphakathi nakwindawo ejikeleze indawo apho ihlwili lenzeka khona.

Abanye bayazi ukuba banembali yosapho yokuphazamiseka kwegazi. Oku kunokubakhuthaza ukuba bavavanyelwe imiba yokujija igazi ngaphambi kokuvela.

Ukuba neeseli ezininzi zegazi kunokukhokelela kwiimpawu ezahlukeneyo. Imizekelo yoku ibandakanya:

• ukungaboni kakuhle
• isiyezi
• ukutyunyuzwa ngokulula
• ukuphuma kwegazi okugqithisileyo
• igawuthi
• intloko ebuhlungu
• igazi elonyukayo
• ukurhawuzelela ulusu
• ukunqongophala kwamandla
• ukuqhawukelwa ngumphefumlo

Ukuba unazo naziphi na kwezi mpawu, kuya kufuneka ubone ugqirha wakho ukuba avavanye igazi elinzima:

• enegazi elinemvelaphi engaziwayo
• ukuphindaphindeka kwamahlwili egazi ngaphandle kwesizathu esaziwayo
• ukufumana ukulahleka kokukhulelwa okuphindaphindiweyo (ilahleko yokukhulelwa ngaphezulu kwesithathu)

Ugqirha wakho unoku-odola iimvavanyo ezahlukeneyo zokuvavanywa kwegazi ukuba unezi mpawu ukongeza kwimbali yosapho enegazi elingqingqwa.

Zintoni oonobangela begazi elixineneyo?

Iimeko ezikhokelela kwigazi elingqingqwa zinokuzuzwa njengelifa okanye zifunyanwe kamva, njengoko kuhlala kunjalo ngomhlaza. Ukulandela sisampulu encinci yeemeko ezininzi ezinokubangela igazi elingqingqwa:

• umhlaza
• I-lupus, ebangela ukuba umzimba wakho uvelise ii-antibacterolipid antibodies ezingaphezulu, ezinokubangela ukubola
• utshintsho kwi factor V
• i-polycythemia vera, ebangela ukuba umzimba wakho wenze iiseli ezibomvu ezininzi kakhulu, zikhokelela kwigazi elijiyileyo
• ukusilela kweprotein C
• Ukusilela kweprotein S
• prothrombin 20210 utshintsho
• ukutshaya, okunokubangela ukonakala kwethishu kunye nokunciphisa ukuveliswa kwezinto ezinciphisa amahlwili egazi

Kubalulekile ukuba uqonde ukuba iimeko ezibangela igazi elingqindilili, kwaye ngamanye amaxesha igazi lijiye, ayizizo zodwa izizathu ezibangela amahlwili egazi.

Umzekelo, umntu unokuhlaselwa sisifo sentliziyo kuba igazi lakhe lidibene ne-plaque kwimithambo yabo, ebangela ukuba ihlwili lenze. Abo banesasazo elibi nabo bathambekele ngakumbi kumahlwili egazi kuba igazi labo alihambi nasemizimbeni yabo. Oku akubangelwa kukuqina kwegazi. Endaweni yoko, imithambo kunye nemithambo yaba bantu yonakele, ngoko ke igazi alinako ukuhamba ngokukhawuleza njengesiqhelo.

Kufunyaniswa njani ukuba ligazi elingqingqwa?

Ugqirha wakho uza kuqala inkqubo yokuqonda isifo ngokuthatha imbali yakho yonyango. Baza kubuza imibuzo malunga naziphi na iimpawu onokuhlangabezana nazo kunye nembali yezempilo.

Ugqirha wakho uya kuthi aodole uvavanyo lwegazi, kodwa ngokwamanqanaba. Isizathu soku kukuba uninzi lweemvavanyo zegazi elingqingqwa zibiza kakhulu kwaye zichaze ngokuthe ngqo. Ke baya kuqala ngovavanyo oluqhelekileyo, emva koko baodole ngakumbi ukuba kukho imfuneko.

Umzekelo wolunye uvavanyo lwegazi olusetyenzisiweyo ukuba ugqirha wakho ucinga ukuba unokuba negazi elingqindilili kubandakanya:

• Gcwalisa ubalo lwegazi: Olu vavanyo lubonisa ubukho beeseli ezibomvu zegazi kunye neeplatelets egazini. Amanqanaba aphezulu e-hemoglobin kunye ne-hematocrit angabonisa ubukho bemeko efana ne-polycythemia vera.
• Ukusebenza kweprotein C esebenzayo: Olu vavanyo lobukho bento V Leiden.
• Prothrombin G20210A ukutshintsha kovavanyo: Oku kugqiba ubukho be-antithrombin, protein C, okanye protein S yokungaqhelekanga.
• I-Antithrombin, iprotein C, okanye amanqanaba okusebenza eprotein S Oku kunokuqinisekisa ubukho be-lupus anticoagulants.

Iklinikhi yaseCleveland icebisa ukuba ukuvavanywa kwegazi elingqindilili kwenzeka okungenani kwiiveki ezine ukuya kwezintandathu emva kokuba unegazi. Ukuvavanywa kwakamsinya kunokukhokelela kwiziphumo ezibubuxoki ngenxa yobukho bezinto ezitshisayo egazini kwihlwili.

Luthini unyango lwegazi elixineneyo?

Unyango lwegazi elixineneyo luxhomekeke kwisizathu esingunobangela.

IPolycythemia vera

Ngelixa oogqirha bengenako ukunyanga i-polycythemia vera, banokucebisa ngonyango ukuphucula ukuhamba kwegazi. Umsebenzi womzimba unokunceda ukukhuthaza ukuhamba kwegazi okufanelekileyo emzimbeni wakho. Amanye amanyathelo onokuwathatha aquka:

• ukuzolula rhoqo, ngakumbi imilenze kunye neenyawo ukukhuthaza ukuhamba kwegazi
• unxibe iimpahla zokuzikhusela, ngakumbi izandla neenyawo zakho, ebusika
• ukunqanda ukugqitha kobushushu
• ukuhlala u-hydrated kunye nokusela amanzi amaninzi
• ukuthatha isitya sokuhlambela ngokudibanisa ibhokisi yesiqingatha sesitatshi kumanzi ahlamba ashushu, anokuthi athobise ulusu oluhlala lurhawuzela olunxulunyaniswa ne-polycythemia vera

Ugqirha wakho unokucebisa ngendlela yonyango ebizwa ngokuba yi-phlebotomy, apho bafake khona umgca we-intravenous (IV) emthanjeni ukuze kususwe isixa esithile segazi.

Unyango oluninzi lukunceda ukususa enye yentsimbi yomzimba wakho, enokunciphisa ukuveliswa kwegazi.

Kwiimeko ezinqabileyo, xa imeko ibangela ukubanzima okukhulu, njengokulimala komzimba, ugqirha wakho unokucebisa amayeza e-chemotherapy. Imizekelo yoku ibandakanya ihydroxyurea (Droxia) kunye ne-interferon-alpha. Oku kunceda ukunqanda umongo wethambo lakho ekuveliseni iiseli zegazi ezigqithileyo. Ngenxa yoko, igazi lakho liya lisiba buthathaka.

Unyango lweemeko ezichaphazela ukujiya kwegazi

Ukuba unesifo esibangela ukuba igazi ligqume ngokulula (njenge-V factor), ugqirha wakho unokucebisa ezinye zonyango:

• Unyango lwe-antiplatelet: Oku kubandakanya ukuthatha amayeza athintela iiseli zegazi ezinoxanduva lokujiya, okubizwa ngokuba ziiplatelets, ekubeni zinamathelane ukuze zibe lihlwili. Imizekelo yezi inokubandakanya i-aspirin (iBufferin).
• Unyango lwe-Anticoagulation: Oku kubandakanya ukuthatha amayeza asetyenziselwa ukuthintela amahlwili egazi, anjenge-warfarin (Coumadin).

Nangona kunjalo, abantu abaninzi abaneemeko ezinokuthi zenze igazi labo lingqindane bangaze babe namahlwili egazi. Ngesi sizathu, ugqirha wakho unokufumanisa ukuba ligazi elingqingqwa, kodwa akanakumisela amayeza ukuba uwathathe rhoqo ngaphandle kokuba bakholelwa ukuba usengozini yokwambathiswa.

Ukuba uthambekele kumahlwili egazi, kuya kufuneka ubandakanyeke kwindlela yokuphila eyaziwa ukunciphisa amathuba abo. Oku kubandakanya:

• ukuyeka ukutshaya
• ukwenza umthambo rhoqo
• ukuthatha amathuba rhoqo ukolula nokuhamba xa uhamba umgama omde kwinqwelomoya okanye ngemoto
• ukuhlala ngamanzi

Zeziphi iingxaki kwigazi elingqingqwa?

Ukuba unegazi elingqindilili, usemngciphekweni omkhulu wamahlwili egazi, kokubini kwimithambo yakho nakwiimithambo. Ukugqabhuka kwegazi kwimithambo yakho kuya kuchaphazela ukuhamba kwegazi kwiindawo eziphambili zomzimba wakho. Ngaphandle kokuhamba kwegazi ngokwaneleyo, izicwili azinakuphila. Ukuba ucinga ukuba unokuba negazi, funa unyango kwangoko.

Esinye sezona ziphumo zibulalayo zegazi elingqindililiyo ngumgubo we-pulmonary emboli, angamahlwili egazi athintela enye okanye engaphezulu yemithambo yemiphunga emiphungeni. Ngenxa yoko, umphunga awunakufumana igazi elinomoya-mpilo. Iimpawu zale meko zibandakanya ukuphefumla kancinci, iintlungu esifubeni kunye nokukhohlela okunokuba negazi ngoku. Kuya kufuneka ufumane unyango olungxamisekileyo ukuba ucinga ukuba unokuba ne-pulmonary emboli.

Iyintoni imbonakalo yale meko?

Ngokwe-Cleveland Clinic, okwangoku akukho datha iphakamisa ukuba igazi elingqingqwa lichaphazela ixesha lokuphila. Nangona kunjalo, ukuba usapho lwakho lunembali yale meko, unokufuna ukudibana nogqirha wakho malunga neengozi ezinokubakho.