Amazinga aphansi we-Neutrophils

Izinga eliphansi lama-neutrophils, aziwa nangokuthi i-neutropenia, angaba yisifo esibi esithinta ikhono lomzimba lokulwa nezifo. Lokhu kwenzeka lapho inani lama-neutrophils, uhlobo lwamangqamuzana amhlophe egazi, lehla libe ngaphansi kwamazinga avamile egazini.

Ukuqonda ukuthi amazinga aphansi ama-neutrophils asho ukuthini kubalulekile ekulawuleni impilo yomuntu ngempumelelo. Ama-neutrophils asezingeni eliphansi angenza umuntu angenwe kalula izifo kanye nezifo. Ake sihlole izimbangela eziphansi zama-neutrophils, izimpawu, nezindlela zokwelapha ngokufanayo. Kuzobuye kudingidwe ukuthi kumele umbone nini udokotela nokuthi ungasivikela kanjani lesi simo ukuthi senzeke noma sibe sibi kakhulu.

Yini amaNeutrophils?

Ama-neutrophils ayisici esibalulekile somzimba izivikeli mzimba, okuvikela umzimba ezifweni. Lawa mangqamuzana egazi amhlophe, aziwa ngokuthi ama-polymorphonuclear leukocytes (PMNs), awuhlobo olwanele kakhulu lwamangqamuzana omzimba omzimba egazini. Bakha u-50% kuya ku-75% wawo wonke amangqamuzana amhlophe egazi, okugqamisa ukubaluleka kwawo ekugcineni impilo yonke.

Umsebenzi oyinhloko wama-neutrophils ukusebenza njengomugqa wokuqala wokuzivikela kumagciwane ahlaselayo. Lapho amagciwane, isikhunta, noma amanye amagciwane ayingozi engena emzimbeni, ama-neutrophils aphakathi kwamangqamuzana amasosha omzimba okuqala ukuphendula. Ngokushesha baya lapho okutheleleke khona, lapho bebamba futhi bacekele phansi laba bahlaseli ngezindlela ezihlukahlukene.

Uma ama-neutrophils ephansi, isimo esaziwa ngokuthi i-neutropenia, ikhono lomzimba lokulwa nezifo liyancipha kakhulu. Lokhu kungenza abantu bangenwe kalula izifo nezinkinga ezihlukahlukene. 

Izimpawu zamazinga aphansi we-Neutrophils

Izimpawu zama-neutrophils zingahluka kumuntu nomuntu, futhi akubona bonke abantu abayoba nezimpawu ezifanayo. Ezinye izinkomba ezijwayelekile ze-neutropenia zifaka:

• Imfiva: Lokhu ngokuvamile kuwuphawu lokuqala lokutheleleka kubantu abane-neutrophils ephansi. Ngezinye izikhathi kuthiwa yi-febrile neutropenia.
• Ukukhathala Okudlulele (Ukukhathala): Abantu bangazizwa bekhathele ngokungavamile noma bebuthakathaka ngenxa yokutheleleka
• Ukutheleleka Okuphindaphindayo noma Okuqhubekayo: Amagciwane ahlala isikhathi eside noma alokhu ebuya kungaba uphawu lwamazinga aphansi we-neutrophils.
• Umphimbo Obuhlungu (Pharyngitis): Lokhu kungaba wuphawu olujwayelekile ngenxa yokwanda kokungenwa yizifo.
• Izilonda Zomlomo: Izilonda ezibuhlungu emlonyeni, ezaziwa nangokuthi i-mucositis, zingase zikhule.
• Ukulahlekelwa Ukudla: Abanye abantu bangase babe nesifiso esinciphile sokudla.
• Ukuvuvukala kwama-lymph nodes: Lokhu kungasho ukuthi umzimba ulwa nesifo.
• Uhudo: Izinkinga zesisu zingase zenzeke ngenxa yezifo.
• Izimpawu Zokuchama: Lokhu kungabandakanya ukuzwa okuvuthayo ngesikhathi sokuchama, ukuphuthuma, noma ukukhuphuka kwemvamisa.

Izimbangela Zamazinga Aphansi E-Neutrophils

Amazinga aphansi ama-neutrophils, aziwa nangokuthi i-neutropenia, angenzeka ngenxa yezizathu ezihlukahlukene. 

• Izimo Zofuzo: Abanye abantu bazalwa benezinkinga ezizuzwe njengefa ezithinta ukukhiqizwa noma ukusebenza kwama-neutrophils, njenge-benign ethnic neutropenia (BEN), i-cyclic neutropenia, ne-neutropenia enzima yokuzalwa.
• Amagciwane: Izifo ezibangelwa amagciwane, igciwane kanye ne-parasitic njenge-HIV, isifo sofuba, sofuba, futhi i-sepsis ingabangela ukwehla kwenani lama-neutrophil. 
• Umdlavuza kanye Nokwelashwa Okuhlobene: Umdlavuza wegazi njenge-leukemia ne-lymphoma kungaphazamisa ikhono lomnkantsha lokukhiqiza amangqamuzana egazi amhlophe anempilo, kuhlanganise nama-neutrophils. Ukwengeza, izindlela zokwelapha umdlavuza ezifana ne-chemotherapy kanye nokwelashwa ngemisebe kungalimaza noma kucekele phansi ama-neutrophils kanye nama-neutrophils umkantsha lokho kuyabakhiqiza.
• Imithi: Lokhu kufaka phakathi ama-antibiotics, imishanguzo ye-antipsychotic, nezidakamizwa ezisetshenziselwa ukwelapha indlala yegilo.
• Ukuntula Ukudla Okunomsoco: Ukungatholi ngokwanele amavithamini namaminerali abalulekile njengovithamini B12, i-folate, noma ithusi ekudleni kungaholela ekwehleni kokukhiqizwa kwe-neutrophil.
• Izimo ze-Autoimmune: I-Lupus, i-rheumatoid arthritis, nesifo sika-Crohn kungabangela amazinga aphansi we-neutrophils. Amasosha omzimba ahlasela ngokungazi futhi acekele phansi ama-neutrophils anempilo kulezi zimo.
• I-Chronic Idiopathic Neutropenia: Iwuhlobo oluthile lwe-neutrophil yezinga eliphansi elingenayo imbangela ebonakalayo. 

Sifo

Ukuqinisekisa i-neutropenia, odokotela bathembele ekuhlolweni nasekuhlolweni okuthile.

• Isibalo Segazi Esiphelele (CBC) noma Isibalo Segazi Esigcwele (FBC): Lokhu kuhlola kukala inani lohlobo ngalunye lwengqamuzana legazi, okuhlanganisa nama-neutrophils. 
• Ukuhlolwa Komnkantsha Wamathambo: Uma ukuhlolwa kwegazi kokuqala kubonisa amazinga aphansi e-neutrophils, isinyathelo esilandelayo sokuxilongwa ngokuvamile ukuhlolwa komnkantsha. Kunezindlela ezimbili zokuhlola umnkantsha. Eyokuqala i-bone marrow aspirate, lapho amangqamuzana omnkantsha akhishwa njengesampula yegazi. Eyesibili i-biopsy yomnkantsha, ehlanganisa ukuthatha ingxenye encane yomnkantsha eqinile ukuze kufundwe ukwakheka kwawo.
• Ukuhlolwa kwe-Neutrophil Antibody: Kungasiza ukukhipha i-autoimmune neutropenia. 
• Izifundo ze-Cytogenetic: Zenziwa ukuze kuhlolwe izici zofuzo zamaseli nama-chromosome, njengoba noma yikuphi ukungahambi kahle kwesakhiwo kumaseli omnkantsha kungase kwandulelwe izinguquko ze-cytogenetic.

Ukwelashwa

Ukwelashwa kwamazinga aphansi ama-neutrophils kuncike endabeni ewumsuka nobukhulu besimo. Kuhlanganisa:

• Nemithi Elwa Namagciwane: Lapho umuntu onamazinga aphansi e-neutrophils eba nomkhuhlane, odokotela bavame ukunikeza ama-antibiotic njengesinyathelo sokuzivikela. 
• I-Granulocyte Colony-stimulating Factor (G-CSF): Lokhu kwelashwa kukhuthaza umnkantsha ukuthi ukhiqize ama-WBC amaningi, okuhlanganisa nama-neutrophils. I-G-CSF izuzisa izinhlobo ezahlukene ze-neutropenia, okuhlanganisa nalezo ezibangelwa ukwelapha ngamakhemikhali. 
• I-Chemotherapy: Kuyasiza uma i-neutropenia ibangelwa ukonakala komnkantsha.
• Ukushintsha Imithi: Uma imithi ethile idala amazinga aphansi e-neutrophils, ukubuyekeza uhlobo lwemithi kungasiza ekuxazululeni inkinga. 
• I-Corticosteroids: Odokotela bangase banikeze i-corticosteroids kubantu abanezimo ze-autoimmune ukuze banciphise ukusabela komzimba komzimba futhi bakuvimbele ekuhlaseleni ama-neutrophils.
• Ukufakelwa kwe-Stem Cell: Odokotela bangase bacabangele ukufakelwa kwe-stem cell inketho yokwelapha kwezinye izinhlobo ze-neutropenia enzima, ikakhulukazi lezo ezibangelwa izinkinga zomnkantsha.

Uzoyibona Nini Udokotela

Uma unamazinga aphansi ama-neutrophils, kubalulekile ukuthi uqaphe ngempilo yakho futhi ufune usizo lwezokwelapha ngokushesha lapho kudingeka. Vakashela udokotela uma:

• Izinga lokushisa lakho likhuphukela ku-100.4 degrees Fahrenheit (38 degrees Celsius) noma ngaphezulu isikhathi esingaphezu kwehora
• Unezinga lokushisa elingaphansi kuka-98.6 degrees Fahrenheit 
• Unokugodola, ubuhlungu bomzimba, ukukhathala okukhulu, umphimbo obuhlungu, izilonda emlonyeni, noma ukukhwehlela okusha noma okubi kakhulu
• Uba nezimpawu zesisu esifana nesifo sohudo, ukuhlanza, ubuhlungu besisu noma izimpawu zokuchama, okuhlanganisa ukushiswa noma ubuhlungu lapho uchama, ukwanda kwemvamisa, noma umchamo omnyama.
• Unokukhishwa okungavamile kwesitho sangasese sowesifazane noma ukucasuka. 
• Uhlangabezana nezinguquko esimweni sengqondo, njengokudideka noma ukukhohlwa kungazelelwe, isikhumba esiphaphathekile, ubuhlungu besifuba, ukushaya kwenhliziyo okusheshayo, noma ukuphelelwa umoya. 

Prevention

Nakuba ezinye izinhlobo ze-neutropenia zingenakuvinjelwa, kunamasu amaningana okunciphisa ubungozi nokuphatha isimo ngempumelelo.

• Kubantu abathola ukwelashwa ngamakhemikhali, odokotela bangase balungise izinhlelo zokwelashwa ukuze bavimbele amazinga aphansi ama-neutrophils. Lokhu kungase kuhlanganise ukubambezeleka komjikelezo olandelayo we-chemotherapy noma ukunciphisa umthamo. Odokotela ngezinye izikhathi bangase baphakamise imijovo ye-granulocyte colony-stimulating factor (G-CSF) ukuze kukhuliswe ukukhiqizwa kwamangqamuzana amhlophe egazi, okwandisa ama-neutrophils.
• Imikhuba emihle yenhlanzeko ibalulekile ekuvimbeleni izifo lapho amazinga e-neutrophil ephansi. Ukugeza izandla njalo ngensipho namanzi noma ukusebenzisa isibulali magciwane esisekelwe etshwaleni kubalulekile. 
• Gwema ukuthintana nabantu abagulayo nezindawo eziminyene kungasiza ekunciphiseni ubungozi bokuchayeka kumagciwane ayingozi. 
• Ukuphatha nokudla ngendlela efanele kubalulekile. Lokhu kuhlanganisa ukugeza izithelo nemifino kahle, ukugcina inyama eluhlaza ihlukene nokunye ukudla, nokupheka ukudla ezingeni lokushisa elifanele. Kuyafaneleka ukugwema imikhiqizo yobisi engagcotshiwe kanye nenyama engaphekiwe.
• Ukuvimbela ukulimala kanye nokwelapha ngokushesha noma yikuphi ukusikeka noma imihuzuko nakho kubalulekile.
• Ngokulandela lezi zinyathelo zokuvimbela, abantu abanamazinga aphansi we-neutrophils banganciphisa kakhulu ingozi yokutheleleka futhi bagcine impilo engcono kakhulu.

Imibuzo Evame Ukubuzwa

1. Ayini amazinga e-neutrophil avamile?

Amazinga e-neutrophil avamile ngokuvamile aqala phakathi kwama-neutrophil angu-2,500 kanye nezi-7,000 nge-microlitre ngayinye yegazi. 

2. Ubani othintekayo ngenxa ye-neutropenia?

I-Neutropenia ingathinta abantu bayo yonke iminyaka. Kujwayelekile ezigulini ezinomdlavuza ezilashwa ngamakhemikhali, cishe amaphesenti angama-50 azo athola amazinga aphansi e-neutrophils. Izingane ezingaphansi kweminyaka emibili ubudala zingase zibe ne-primary autoimmune neutropenia. Ezinye izizwe, njengalezo ezidabuka e-Afrika, eMpumalanga Ephakathi, naseNtshonalanga YamaNdiya, zingase zibe nesimo esibizwa ngokuthi i-benign ethnic neutropenia.

3. Ngabe i-neutropenia iwuthinta kanjani umzimba wami?

Uma amazinga aphansi e-neutrophils esho ukuthi amasosha akho omzimba abuthakathaka, umzimba wakho ukuthola kuyinselele kakhulu ukulwa nezifo. Lokhu kukwenza ube sengozini enkulu yokutheleleka nge-bacterial and fungal. 

4. Kusho ukuthini uma ama-neutrophils akho ephansi?

Amazinga aphansi e-neutrophil akhombisa ukuthi amandla omzimba wakho okulwa nezifo ehlile. Lapho isibalo sakho se-neutrophil sincipha, ayanda amathuba okuba ungenwe ukutheleleka.

5. Ingabe ama-neutrophils aphansi ayelapheka?

Ukwelashwa kwamazinga aphansi ama-neutrophils kuncike kumbangela. Ezinye izinhlobo zingase zingadingi ukwelashwa, kanti ezinye zingaphathwa ngama-antibiotics, i-corticosteroids, noma izidakamizwa ezikhuthaza ukukhiqizwa kwamangqamuzana amhlophe egazi. Ngezinye izikhathi, ukubhekana nesimo esiyisisekelo noma ukulungisa imithi kungasiza ukubuyisela amazinga avamile e-neutrophil.

6. Yini okufanele ngidle uma ngine-neutrophils ephansi?

Gxila ekudleni ukudla okuhlukahlukene okunezinqubo ezifanele zokuphepha kokudla. Gwema imikhiqizo yobisi engagcotshiwe, inyama eluhlaza noma engaphekiwe kahle, nezithelo nemifino engageziwe. 

7. Ngingawandisa kanjani ama-neutrophils ami ngokwemvelo?

Ukuze usekele ukukhiqizwa kwe-neutrophil yomzimba wakho, qiniseka ukuthi uthola imisoco eyanele, ikakhulukazi uvithamini B12 kanye ne-folate. Nokho, imbangela eyisisekelo idinga ukubhekwa. 

UDkt. Kunal Chhattani

CARE Medical Team

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