Ukuhlolwa kwe-ESR kuvame ukwenziwa njengengxenye ye ukuhlolwa kwegazi njalo. Lokhu kuhlola kukala isikhathi esisithathayo ukuze amangqamuzana egazi abomvu ahlale ngaphansi kweshubhu lokuhlola, ngezinga eliphezulu lokuzinza elibonisa ukuvuvukala okukhulayo. Ngokuvamile, amangqamuzana abomvu egazi athambekele ekuzinzeni kancane kancane. Uma imiphumela yokuhlolwa kwe-ESR ibonisa izinga eliphezulu lokuzinza (okungukuthi, amazinga aphakeme e-ESR), ingase iphakamise isimo sezempilo esicashile, esingase siveze njengezimpawu ze-ESR eziphakeme. Ngaphambi kokuhlolisisa izimbangela zamazinga e-ESR aphakanyisiwe, kubalulekile ukuqonda injongo yokuhlolwa kwe-ESR nokubaluleka kwayo okungokoqobo.

Kuyini ukuhlolwa kwe-ESR?

Ukuhlolwa kwe-ESR noma i-Erythrocyte Sedimentation Rate kulinganisa isivinini lapho ama-erythrocyte (amaseli abomvu egazi) ahlala khona ngaphansi kwesampula yegazi. Imiphumela yokuhlolwa kwe-ESR ayikwazi ukusetshenziselwa ukuxilonga isifo esithile, njengoba izimo zezempilo ezihlukahlukene zingaholela emazingeni aphezulu noma aphansi e-ESR. Odokotela babheka ukuhlolwa kwe-ESR njengethuluzi lokuxilonga elingaqondile, njengoba kukhombisa nje ukuba khona kwempendulo yokuvuvukala emzimbeni. Ukwenza ukuxilongwa okuphelele, ochwepheshe bezempilo ngokuvamile kuhlanganisa imiphumela yokuhlolwa kwe-ESR nokunye ukuhlola kwaselabhorethri, ukubhekwa komtholampilo, kanye nomlando wezokwelapha wesiguli.

Inhloso yokuhlolwa kwe-ESR

Umgomo oyinhloko wezinga le-ESR sedimentation ukukhomba amazinga aphezulu okuvuvukala ngaphakathi komzimba. I-ESR ingase inqunywe umhlinzeki wezempilo uma umuntu ebonisa izimpawu nezimpawu zesimo esihlobene nokuvuvukala. Lezi zimpawu zingahluka kuye ngesimo somuntu, kodwa zingabandakanya:

• Ubuhlungu bentamo noma ehlombe
• Ukuphathwa yikhanda
• Ukwehla kwesisindo
• Umkhuhlane ongachazeki
• Ukuqina okuhlangene
• Ukulahlekelwa kwesifiso
• I-anemia

Ukwengeza, ukuhlolwa kwe-ESR kungase kudingeke uma isiguli sitholakale sinesifo esingase sibe isizathu se-ESR ephezulu egazini.

Izinhlobo zokuhlolwa kwe-ESR

Kunezindlela ezimbili zokulinganisa izinga le-erythrocyte sedimentation:

• Indlela yase-Westergren: Indlela yase-Westergren iyindlela evame ukusetshenziswa kakhulu ye-ESR. Kulokhu kuhlolwa, igazi lidonswa eshubhuni le-Westergren-Katz lize lifinyelele ezingeni lamamilimitha angu-200 (mm). Ishubhu libe seligcinwa libheke phezulu ekamelweni lokushisa ihora. Isilinganiso sibandakanya ukunquma ibanga phakathi kwengaphezulu lengxube yegazi kanye nangaphezulu kokucwiliswa kwamaseli abomvu egazi (RBCs).
• Indlela ye-Wintrobe: Indlela ye-Wintrobe ifana kakhulu nendlela yase-Westergren, umehluko oyinhloko ukusetshenziswa kweshubhu elingu-100 mm ubude nelincane. Kodwa-ke, i-drawback yale ndlela ukuzwela kwayo okuphansi uma kuqhathaniswa nendlela yase-Westergren.

Yenziwa kanjani i-ESR?

Udokotela uzokhipha isampula yegazi emithanjeni yesiguli futhi alithumele elabhorethri. Ochwepheshe baselabhorethri bazodlulisela ngokucophelela isampula eshubhuni yokuhlola eqondile, evumela amangqamuzana egazi abomvu ukuthi ahlale phansi. Uketshezi olucacile, oluphuzi, olwaziwa ngokuthi i-plasma yegazi, luzonqwabelana engxenyeni engenhla yeshubhu. Umphumela wokuhlolwa uzonqunywa ngokulinganisa inani le-plasma eliqoqwe engxenyeni engenhla yeshubhu lokuhlola ngemva kwehora elilodwa. I-ESR ephezulu egazini iboniswa ngamamilimitha ngehora (mm/hr).

Abantu abanezimo zokuvuvukala bavame ukubonisa amazinga e-ESR aphakeme emibikweni yabo yegazi. Izimo ezivuthayo ziqala ukusabela emzimbeni, okuholela ekwandeni kokuhlushwa kwe amaprotheni ngaphakathi kwegazi. Ngenxa yalokho, amangqamuzana abomvu egazi ayahlangana futhi ahlale ngokushesha.

Asho ukuthini amazinga e-ESR aphezulu?

Imiphumela yokuhlolwa kwegazi ye-ESR ngokuvamile izoqhathaniswa neminye imiphumela yokuhlola ukuze kuqinisekiswe ukuxilongwa okungenzeka. Odokotela bazocubungula izimpawu nezimpawu isiguli esizibonisayo, kanye nomlando waso siqu nowomndeni wezokwelapha.

Ivelu ye-ESR ephezulu kakhulu engaphezu kuka-100 mm/h ingase ibonise enye yalezi zimo ezilandelayo:

• I-Myeloma eminingi: uhlobo lomdlavuza othinta amaseli e-plasma.
• Umdlavuza wamangqamuzana egazi amhlophe, eyaziwa nangokuthi i-macroglobulinemia ka-Waldenstrom.
• I-Hypersensitivity Vasculitis: isimo lapho ukungezwani komzimba kubangela ukuvuvukala kwemithambo yegazi.
• I-arteritis yesikhashana noma i-polymyalgia rheumatica.

Izinga le-erythrocyte sedimentation ephakeme kancane alibonisi inkinga yezempilo kumuntu ngamunye. Kodwa-ke, abantu abane-CRP ne-ESR ephakeme kancane bangase bahlotshaniswe nezinye zezimo ezilandelayo:

• rheumatoid arthritis
• Ukutheleleka ngesistimu
• Inani elincishisiwe lamaseli abomvu egazi noma i-anemia
• Izinkinga ze-thyroid
• Isifo sezinso
• Izinhlobo ezithile zomdlavuza, njenge-lymphoma
• Ukungajwayelekile kumaseli abomvu egazi
• Isifo sofuba
• Ukutheleleka kwamathambo
• Isifo senhliziyo

Udokotela ukuncoma nini ukuhlolwa kwe-ESR?

Ukuhlolwa kwegazi kwe-ESR kuthola futhi kulinganise ukuvuvukala emzimbeni ngokujwayelekile. Kodwa-ke, ukuhlolwa akutholi umthombo oqondile wokuvuvukala. Udokotela cishe uzosebenzisa ukuhlolwa ekuhlanganiseni nokunye ukuhlola ukuze abone imbangela eyinhloko yezimpawu. Uma umuntu esevele enesimo sokuvuvukala, udokotela angase asebenzise i-ESR ukuze aqinisekise ukusebenza kahle kohlelo lokwelapha lwamanje.

Ukuhlolwa kwe-ESR kungasetshenziswa ochwepheshe bezokwelapha ukukhomba izimo ezivuvukalayo ezifana nalezi:

• I-arteritis yesikhashana
•  Ezinye izinhlobo zomdlavuza
•  Izifo ezizenzakalelayo
•  Izifo

Ochwepheshe bezempilo bangasebenzisa ukuhlolwa kwe-ESR ukulandelela izifo ezivuvukalayo ze-autoimmune ezifana:

• I-rheumatoid arthritis (RA)
• I-Systemic lupus erythematosus (SLE)

Imiphumela ye-ESR

Imiphumela yokuhlolwa kwe-ESR itholakala ngokulinganisa inani elisele le-plasma kushubhu yokuhlola ngemva kwehora elilodwa. Njengoba ukuhlolwa akuhloselwe ukuxilonga isimo esithile, odokotela kufanele bahumushe imiphumela ngokuhambisana nenye idatha yomtholampilo ukuze baxilonge ngokunembile isiguli futhi banqume ukuba khona kwesifo. Ibanga elijwayelekile lereferensi lemiphumela ye-ESR kwabesilisa lingamamilimitha angu-1–13 ngehora (mm/hr), kanti kwabesifazane, lingamamilimitha angu-1–20 ngehora. Lawa manani angahluka kuye ngeminyaka yomuntu.

Liyini ibanga elijwayelekile lamazinga e-ESR?

Amazinga e-ESR ahambisana namazinga aphakeme amaprotheni egazini, okuholela ekwenyukeni kwezinga lapho amangqamuzana egazi abomvu (RBCs) ahlangana khona. Ukuhlolwa kwe-ESR kusebenza ngokulinganisa ibanga ngamamilimitha (mm) ukusuka oketshezini olucacile ekugcineni kweshubhu kuya kumaseli abomvu egazi (RBCs) ngemva kwehora elilodwa. Amanani ajwayelekile ezilinganiso ze-ESR ami kanje:

• 0 kuya ku-15 mm/ihora emadodeni angaphansi kweminyaka engama-50 ubudala
• 0 kuya ku-20 mm/ihora kwabesilisa abaneminyaka engu-50 nangaphezulu
• 0 kuya ku-20 mm/ihora kwabesifazane abangaphansi kweminyaka engama-50 ubudala
• 0 kuya ku-30 ​​mm/ihora kwabesifazane abaneminyaka engu-50 nangaphezulu

Yiziphi izimpawu ezibonisa ukuthi ungadinga ukuhlolwa kwe-ESR? 

Ukuhlolwa kwe-ESR kungase kudingeke uma uhlangabezana nezimpawu zezimo ezivuvukalayo njenge-arthritis noma isifo samathumbu esivuvukalayo (IBD). Lezi zimpawu zingabandakanya:

• ubuhlungu obuqhubekayo bamalunga noma ukuqina okuhlala ngaphezu kwemizuzu engama-30 ekuseni,
• ikhanda, ikakhulukazi lezo ezihambisana nobuhlungu bethempeli kanye noshintsho lombono,
• ukunciphisa umzimba okungahlosiwe,
• ukungakhululeki emahlombe, intamo, noma i-pelvis,
• izimpawu ze-gastrointestinal, njenge:
  • isifo sohudo
  • imfiva
  • ukuba khona kwegazi esithweni
  • ubuhlungu besisu obungavamile

Yini engabangela amazinga aphezulu e-ESR?

Kungase kube nezizathu ezihlukahlukene zamazinga aphezulu e-ESR, okuvame kakhulu izifo ezivuthayo. Eminye yale mibandela ihlanganisa:

• Izifo ezivuvukalayo zesistimu: Izifo ezivuvukalayo eziye zasakazekela egazini.
• Ukwanda kwe-ESR ngenxa yezifo ezincane ezinjengomkhuhlane, amanxeba, nezinye izenzakalo.
• Ukulimala kwezicubu noma ukulimala kwezicubu ze-ischemic (izicubu ezingenalo ukunikezwa kwegazi okwanele).
• Ngokuvamile, i-ESR ivame ukukhula ngokuya ngeminyaka.
• Izehlakalo ezibuhlungu noma izingozi

Yini okufanele ngiyenze uma nginezinga eliphezulu le-ESR?

Ngemva kokuthola umbiko wezokwelapha we-ESR obonisa amazinga e-ESR aphakeme, inkambo engcono kakhulu yesenzo iwukulinda udokotela ukuthi enze ukuxilongwa okufanele ngokusekelwe kwezinye izici ezifana nobulili, ubudala, kanye. impilo ejwayelekile. Abantu abanamazinga e-ESR aphakeme bangase bangabi nazo zonke izimo zezokwelapha ezidinga ukwelashwa. 

Amazinga e-ESR aphakeme angase ahlotshaniswe nokukhulelwa, ukuya esikhathini, noma ukuguga. Uma udokotela enquma ukuthi umuntu uhlushwa yisimo sezempilo, cishe angase anikeze ukwelashwa okufanelana nesimo esithile somuntu. 

Izikhombo:
https://www.medicalnewstoday.com/articles/323057#results
https://www.healthline.com/health/esr#uses
https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=erythrocyte_sedimentation_rate