I-Immune Thrombocytopenia

I-Immune thrombocytopenia (ITP), eyaziwa nangokuthi i-idiopathic thrombocytopenic purpura, ibangela imihuzuko nokopha okungachazeki. Kokubili izingane kanye nabantu abadala bangathinteka yilokhu kuphazamiseka kwegazi. Abantu abadala abane-ITP ngokuvamile babhekana nohambo olude oluthatha izinyanga noma iminyaka, kodwa izimpawu zezingane zivame ukucaca phakathi kwamaviki noma izinyanga. Abesifazane abasebasha maningi amathuba okuba babe nalesi simo. Nakuba i-ITP ilawuleka, izinkinga zayo zingaba zimbi kakhulu ezimweni ezingavamile. 

Lesi sihloko sihlanganisa izici ezibalulekile zezimpawu ze-immune thrombocytopenic purpura, ukuxilongwa kwe-ITP kanye nezinketho zokwelashwa. Abafundi bazofunda ngezimpawu eziyisixwayiso ezidinga ukunakekelwa kwezokwelapha futhi bathole amathiphu asebenzayo okulawula lesi sifo ngokuphumelelayo.

Yini i-Immune Thrombocytopenia (ITP)?

Amasosha akho omzimba angahlasela ngephutha futhi abulale ama-platelet egazini lakho. Uma ama-platelet enganele, igazi lidonsa kanzima ukuze lihlule njengoba kufanele. Lokhu kungaholela ekulimazeni okulula, ukopha okuhlala isikhathi eside, noma amabala abomvu amancane esikhumbeni aziwa ngokuthi yi-petechiae. 

I-ITP ibonakala ngendlela ehlukile ezinganeni nakubantu abadala. Izingane ngokuvamile zibuyela emuva ngokwemvelo phakathi nezinyanga. Abantu abadala bavame ukuba nolwazi olude ngalesi simo. Lesi sifo singathinta noma ubani, nakuba abesifazane abasebasha nezingane eziphakathi kweminyaka engu-1-6 ubudala babhekana nezingozi ezinkulu. I-American Society of Hematology isitshela ukuthi i-ITP ikhombisa ukubala kweplatelet ngaphansi kuka-100,000/μL kanye nokuqubuka kwe-purpuric. Kunezinhlobo ezimbili ze-ITP:

• I-ITP eyinhloko ayinaso isizathu esicacile. 
• I-ITP yesibili yenzeka ngenxa yezibangeli zangaphandle njengemithi noma ezinye izimo ze-autoimmune.

Izimpawu ze-Immune Thrombocytopenia

Abantu abane-ITP bavamise ukuqaphela imihuzuko elula namachashaza abomvu amancanyana abizwa ngokuthi ama-petechiae esikhumbeni sabo. Okulandelayo yizimpawu ezijwayelekile kanye nezimpawu ze-ITP:

• Izinsini zokuphuza nokuphuma kwegazi ngamakhala
• Igazi emcimbini noma indle
• Izikhathi zokuya esikhathini ezinzima ngokungavamile
• Ukopha ebuchosheni kungase kubangele ubuhlungu bekhanda kanye nezinye izimpawu zesimiso sezinzwa 

Immune Thrombocytopenia Izimbangela 

Ama-antibodies akha futhi abhubhise ama-platelet omzimba ezimweni eziningi ze-ITP. Izifo ezibangelwa amagciwane zivame ukuqala lokhu kusabela komzimba ezinganeni. Eminye imithi efana i-heparin, kwemithi elwa namagciwane, nama-anticonvulsants nawo angaholela ku-ITP.

Izingozi Zezingozi

Iqembu elilandelayo libhekene nengozi ephezulu:

• Abafana abaphakathi kweminyaka engu-1-6 
• Abesifazane abaneminyaka ephakathi 
• Izici zofuzo
• Izifo ezithize (ikakhulukazi i-H. pylori kanye nezifo ezibangelwa amagciwane)
• Izimo ze-autoimmune njenge-lupus noma rheumatoid arthritis

Izinkinga ze-Immune Thrombocytopenia

• Ukopha kakhulu kugqama njengenkinga ebaluleke kakhulu, ikakhulukazi uma izibalo zeplatelet zehla zibe ngaphansi kuka-20,000/μL. 
• Ukopha ebuchosheni kuyenzeka - akuvamile kodwa kungase kubeke ukuphila engozini.

Ukuxilongwa kwe-Immune Thrombocytopenia

Odokotela baxilonga i-ITP ngokususa ezinye izimbangela zamaplatelet aphansi. 

Ukuhlola kwangempela kukadokotela wakho kubandakanya ukuhlaziywa kwegazi ngokuhlolwa okuphelele kwesibalo segazi kanye nama-peripheral blood smear. Lezi zivivinyo ngokuvamile zibonisa ukubalwa kweplatelet encishisiwe kuyilapho amazinga amangqamuzana egazi abomvu namhlophe ehlala evamile. Izimpawu zakho zingase ziholele odokotela ukuthi bancome ezinye izivivinyo eziningi ezifana nokusebenza kwegilo noma amapharamitha okuqina. Abantu abadala asebekhulile noma iziguli ezinezimpawu ezingavamile zidinga ukuhlolwa komnkantsha.

Ukwelashwa kwe-Immune Thrombocytopenia

Isiguli ngasinye sidinga indlela yokwelashwa eyingqayizivele esekelwe engozini yokopha. Izingane eziningi zisabela kahle ekulindeni ziqaphile - cishe u-80% uyalulama ungakapheli unyaka ngokwemvelo. Iziguli zabantu abadala ngokuvamile zidinga ukungenelela njengoba zonke ngaphandle kwesisodwa salezi zimo ziba ne-ITP engapheli. Ukwelashwa kuhlanganisa:

• I-Corticosteroids ihlala iyindlela yokwelashwa eyinhloko enezinga eliphezulu lempumelelo. 
• Ama-agonists e-Thrombopoietin receptor akhuphula ukukhiqizwa kweplatelet ngempumelelo. 
• Ukususwa kobende kusiza ezinye iziguli ngokumisa ukubhujiswa kweplatelet.

Kufanele Ngimbone Nini Udokotela

Thola usizo lwezokwelapha ngokushesha uma usizo lokuqala oluyisisekelo lungasebenzi ukumisa ukopha. Futhi thintana nodokotela wakho uma imihuzuko engachazeki noma amabala abomvu avela esikhunjeni sakho - lokhu kungabonisa ukuwohloka kwesimo sakho.

Isiphetho

Iningi labantu lingakwazi ukuphatha i-immune thrombocytopenia ngokuphumelelayo ngokunakekelwa okufanele, naphezu kwezinselele zayo. Ukuqaphela izimpawu zokuqala kubalulekile. Lokhu kuhlanganisa imihuzuko engavamile, amachashazi amancane abomvu esikhumbeni kanye nokopha okungaqondakali. Udokotela wakho uxilonga i-ITP ngokuhlolwa kwegazi nokuhlolwa ukuze abone ukuthi kungani izibalo zeplatelet ziphansi.

Umuntu ngamunye udinga indlela yokwelashwa eyingqayizivele. Izingane eziningi zenza kahle ngokulinda ziqaphile. Abantu abadala bangase badinge imithi efana ne-corticosteroids noma ukuhlinzwa kokukhipha ubende kwezinye izimo. Ukuthola ukwelashwa okufanele kuthatha isikhathi nesineke. Ukwengeza, ukuxhumana njalo nodokotela kusiza ukulawula izimpawu nokugcina izinga lokuphila.

Ulwazi lwenza iziguli zikwazi ukuphatha i-ITP kangcono. Ukuqonda kahle isimo sakho, ukwelashwa okungaguquki kanye nokuqwashisa ngezinguquko zezimpawu kukusiza ukuthi uzulazule empilweni ngalesi sifo segazi. Abantu abane-ITP bangaphila ukuphila okugcwele, okusebenzayo ngokusekelwa okufanele kwezokwelapha, ngisho nezinselele zakhona.

Imibuzo Evame Ukubuzwa

1. Ingabe i-immune thrombocytopenia ibucayi?

I-ITP akusona isimo esibucayi ezinganeni eziningi nakubantu abadala. Abantu abane-ITP engapheli ngokuvamile baphila amashumi eminyaka ngemva kokuxilongwa kwabo. Kodwa-ke, i-ITP eqinile ingaholela ekopheni kwangaphakathi okuyingozi ezimweni ezingavamile. Okopha ebuchosheni obusongela ukuphila kwenzeka cishe ku-0.5-1% wezingane ezinezibalo eziphansi kakhulu zeplatelet.

2. Ingabe i-immune thrombocytopenia ingelapheka?

Alikho ikhambi eliqinisekile elikhona le-ITP okwamanje. Lesi simo singadlulela isikhathi eside—ngezinye izikhathi sithathe ukuphila komuntu konke. Izingane eziningi (cishe ama-80%) ziyalulama zingakapheli izinyanga eziyi-12 ngaphandle kokwelashwa. Iziguli ezikhulile ngokuvamile zidinga ukwelashwa njengoba ngaphezu kuka-50% ziba ne-ITP engapheli. Ukwelashwa kusiza isibalo samaplatelet eziguli sibe ngcono.

3. Ubani osengozini enkulu ye-ITP?

Izingane ezineminyaka engu-1-6 zisengozini enkulu, ikakhulukazi abafana. Abesifazane abaneminyaka ephakathi bathola i-ITP izikhathi ezingu-2-3 kaningi kunamadoda. Abantu abanezimo ze-autoimmune njenge-lupus noma i-rheumatoid arthritis babhekana nezingozi ezinkulu. Ubungozi buyanda futhi kubantu abanezifo ezithile ezifana ne-H. pylori, isibindi C, Futhi HIV.

4. Isiphi isizathu esivame kakhulu se-thrombocytopenia?

Amasosha omzimba ahlasela amaplatelet ngephutha adala izimo eziningi. Lokhu kusabela kokuzivikela komzimba kuvame ukwenzeka ngemva kokutheleleka ngegciwane ezinganeni. Imithi eminingi ingase futhi ibangele ukubhujiswa kweplatelet.

5. Yikuphi ukudla okufanele ngikugweme nge-ITP?

• Kufanele uphuze utshwala obuncane ngoba buthinta umnkantsha kanye nokusebenza kweplatelet. 
• Gwema ukudla okugaywe kakhulu, izinto ezinoshukela omningi, nokudla okuthosiwe. 
• Ezinye iziguli kungase kudingeke zigweme ukudla okune-quercetin (etholakala kumajikijolo aluhlaza, ugaliki, notamatisi) ngoba ingaphazamisa ukujiya kwegazi.

CARE Medical Team