Kev Ntsuas ANC Profile (Absolute Neutrophil Count): Nws Ntsuas Dab Tsi, Leej Twg Xav Tau Nws thiab Yuav Nyeem Daim Ntawv Qhia Li Cas

Tus yuam sij takeaways

• Tus lej ANC yog tus lej uas tau suav ua ntej lawm, tsis yog ib qho qauv cais, nws los ntawm tag nrho cov qe ntshav dawb thiab feem pua ​​​​​​ntawm neutrophil ntawm CBC nrog qhov sib txawv.
• Lub ANC ntsuas qhov ntau, tsis yog qhov zoo. Ib qho ANC ib txwm tsis tau txhais hais tias neutrophils ua haujlwm ib txwm, thiab tsis suav nrog kev kis kab mob.
• Lub koom haum ANC tsis hais lub npe ntawm ib qho laj thawj. Nws tsis tuaj yeem paub qhov txawv ntawm kev kis tus kab mob los ntawm kev cuam tshuam ntawm steroid, kev ntxhov siab, mob ntshav dawb lossis mob hlwb tsis ua haujlwm ntawm nws tus kheej.
• ANC qis nrog kub taub hau yog xwm txheej ceev hauv kev kho mob rau txhua tus neeg uas tau txais kev kho mob chemotherapy, nws yuav tsum tau soj ntsuam tib lub sijhawm, tsis yog hnub tom qab.
• Kev txhais lus yog kev kho mob. Tsuas yog tus kws kho mob uas tau thov kom kuaj, nrog koj cov tsos mob, cov tshuaj thiab cov lej yav dhau los nyob rau pem hauv ntej, thiaj li hais tau tias koj tus lej txhais li cas.

Ib nrais muag

Kuj hu ua

• Kev suav cov neutrophil tag nrho (ANC)
• Tus lej neutrophil / tus lej neutrophil tag nrho
• Kev suav polymorph, "polys", kev siv hauv chaw kuaj mob qub tseem siv ntau hauv Is Nrias teb
• Ib feem ntawm CBC / haemogram / "kev kuaj ntshav suav"
• Tshaj tawm txog qhov suav cov leucocyte sib txawv (DLC) ua "Neutrophils %" nrog rau tus nqi tseeb nrog rau

Lus Cim Txog Kev Muab Lub Npe: "ANC" hauv kev kho mob yug me nyuam txhais tau tias kev saib xyuas ua ntej yug me nyuam. Ib daim "ANC profile" uas thov thaum cev xeeb tub feem ntau yog hais txog cov ntshav ua ntej yug me nyuam (haemoglobin, pawg ntshav, qab zib hauv ntshav, HIV, kab mob siab B, VDRL, kev kuaj zis), uas yog kev tshawb nrhiav sib txawv kiag li. Saib daim ntawv thov uas koj tus kws kho mob tau thov.

Kev Ntsuas Profile ANC yog dab tsi

Cov neutrophils yog cov qe ntshav dawb uas muaj ntau tshaj plaws hauv cov neeg laus thiab yog cov thawj cov neeg teb rau cov kab mob thiab cov pwm uas nkag mus rau hauv lub cev. Tus lej neutrophil qhia tias muaj pes tsawg lub qe ntshav no ncig, hauv cov qe ntshav ib microlitre (tseem sau /礚 lossis ua ?0?/L hauv SI units, piv txwv li 2.5 ?0?/L sib npaug rau 2,500 lub qe ntshav/礚).

Lub tshuab ntsuas ntshav hauv chav kuaj suav tag nrho cov qe ntshav dawb thiab txiav txim siab qhov feem pua ​​uas yog neutrophils. ANC yog qhov tshwm sim ntawm ob qho tib si. Vim tias nws yog kev xam, qhov yuam kev hauv ob qho kev nkag mus rau hauv ANC, uas yog ib qho laj thawj uas cov chaw kuaj ntshav yuav tshuaj xyuas cov zaj duab xis ntshav tes thaum cov lej tsawg heev, siab heev lossis tsis zoo li qub.

Vim li cas ANC Profile Test thiaj ua tiav

• Kev saib xyuas kev siv tshuaj kho mob thiab kev tswj hwm lub cev tiv thaiv kab mob: ANC coj kev txiav txim siab txog kev muab lub voj voog tom ntej, hloov kho qhov koob tshuaj, sau cov yam ntxwv kev loj hlob thiab kev soj ntsuam kev pheej hmoo ntawm kev kis kab mob.
• Kub taub hau ntawm ib tug neeg uas tab tom kho mob qog noj ntshav: txhawm rau txheeb xyuas qhov mob febrile neutropenia, uas hloov kev tswj hwm tam sim ntawd.
• Cov kab mob uas rov tshwm sim dua, tsis tshua muaj, lossis hnyav heev: mob qhov ncauj, mob pos hniav, mob tawv nqaij lossis mob ntsws rov qab los ntau zaus tuaj yeem ua rau muaj cov neutrophil suav.
• Kev soj ntsuam ntawm CBC tsis zoo pom los ntawm qhov xwm txheej.
• Kev saib xyuas kev nyab xeeb ntawm tshuaj: ntau yam tshuaj, suav nrog carbimazole, methimazole, clozapine, tshuaj antiretrovirals, qee cov tshuaj tua kab mob, tshuaj antiepileptics thiab tshuaj kho mob rheumatic, yuav tsum tau suav cov tshuaj raws li tus kws kho mob qhia.
• Kab mob pob txha uas xav tias muaj: ua ib feem ntawm kev kuaj mob thawj zaug ntawm leukaemia, aplastic anaemia lossis myelodysplastic syndrome, nrog rau lwm yam kev kuaj mob.
• Ua ntej thiab tom qab hloov pob txha lossis hloov hlwb pob txha, qhov twg neutrophil rov zoo yog ib qho tseem ceeb.

Leej twg yuav tsum tau txais qhov kev xeem no

• Txhua tus neeg uas tau txais kev kho mob chemotherapy, kev kho mob radiotherapy rau thaj chaw loj uas muaj cov pob txha, lossis kev kho mob tiv thaiv kab mob, raws li lub sijhawm teem tseg uas lawv tus kws kho mob oncologist teem tseg.
• Txhua tus neeg uas tab tom kho mob qog noj ntshav uas kub taub hau, mob khaub thuas lossis xav tias tsis xis nyob tam sim ntawd, ua sai sai, yam tsis tau tos lub sijhawm kuaj mob.
• Cov neeg pib noj tshuaj uas paub tias tswj tau cov neutrophils, thaum tus kws sau ntawv hais kom lawv saib xyuas.
• Cov menyuam yaus lossis cov neeg laus uas muaj cov kab mob bacterial rov qab kis dua, cov qhov txhab hauv qhov ncauj uas tsis kho lossis cov kab mob ntawm cov pos hniav uas tsis paub meej.
• Cov neeg uas muaj kub taub hau tsis tu ncua, poob phaus, mob pob txha, yooj yim raug mob lossis cov qog ntshav loj hlob, ua ib feem ntawm kev tawm dag zog dav dua.
• Cov neeg uas muaj cov teeb meem ntshav lossis pob txha uas paub tias muaj teeb meem nyob rau hauv kev saib xyuas ntshav.

Kev kuaj ANC tsis yog kev kuaj mob dav dav rau ib tus neeg noj qab haus huv uas tsis muaj tsos mob, thiab nws tsis yog kev kuaj "tshawb xyuas kuv lub cev tiv thaiv kab mob".

Qhov ANC Profile Test tsis tuaj yeem ntes tau lossis tsis suav nrog

• Nws tsis tuaj yeem qhia koj seb cov neutrophils puas ua haujlwm. Cov teeb meem kev ua haujlwm xws li mob granulomatous ntev lossis cov teeb meem ntawm cov leucocyte adhesion tuaj yeem tshwm sim nrog ANC uas zoo li qub. Cov no yuav tsum tau kuaj mob tshwj xeeb txog kev tiv thaiv kab mob.
• Kev siv ANC ib txwm tsis suav nrog kev kis kab mob. Muaj ntau yam kab mob los ntawm tus kab mob viral, tuberculosis thiab fungal, thiab txawm tias sepsis hnyav heev, tuaj yeem tshwm sim yam tsis muaj neutrophilia. Qee qhov kev kis kab mob hnyav ua rau tus lej tsawg dua.
• Qhov ANC siab tsis qhia tias muaj kab mob bacterial. Kev ntxhov siab, qhov mob, kev phais mob, qaug dab peg, haus luam yeeb, cev xeeb tub, corticosteroids, adrenaline thiab kev tawm dag zog hnyav txhua yam ua rau nws nce siab.
• Nws tsis qhia qhov chaw kis kab mob. Tsis muaj kev suav cov neutrophil qhia koj seb qhov chaw yog los ntawm lub ntsws, zis, tawv nqaij lossis ntshav; kev kuaj mob thiab kev thaij duab ua qhov ntawd.
• Nws tsis kuaj mob leukemia lossis lymphoma. Cov no yuav tsum tau kuaj xyuas cov ntshav, kev ntsuas cov ntshav ntws, kev kuaj pob txha thiab kev kuaj noob caj noob ces.
• Nws tsis hais dab tsi txog kev tiv thaiv kab mob lymphocyte, cov theem ntawm cov tshuaj tiv thaiv kab mob, tus kab mob HIV lossis kev tiv thaiv tshuaj tiv thaiv kab mob.
• Nws tsis ntsuas kev ua haujlwm ntawm cov kab mob autoimmune. Kev kuaj mob lupus lossis mob rheumatoid arthritis raug kuaj pom raws li cov qauv kho mob nrog cov kev kuaj mob tshwj xeeb thiab kev mob o; ANC tsuas yog qee zaum qhia tias muaj tus lej qis.
• Nws tsis tuaj yeem zam tsis tau qhov teeb meem ntawm cov pob txha. Cov myelodysplasia thaum ntxov thiab qee qhov kev nkag mus rau hauv cov hlwb pob txha tuaj yeem nthuav tawm nrog cov lej ze li qub.

Yog tias qhov tshwm sim zoo li qub tab sis cov tsos mob tseem muaj lossis hnyav zuj zus, rov qab mus ntsib koj tus kws kho mob. Tus lej ib txwm piav qhia txog tus qauv ntawd thaum lub sijhawm ntawd; nws tsis tau txiav txim siab tias yog kab mob.

Kev ntsuam xyuas sib txuas tab sis sib txawv

Qhov kev kuaj twg yuav ua ntej nyob ntawm seb qhov teeb meem hauv kev kho mob yog dab tsi, tsis yog nyob ntawm seb qhov kev kuaj twg zoo dua. Rau qhov kub taub hau thaum lub sijhawm kho mob chemotherapy, kev kuaj ANC thiab cov kab mob ntshav yuav raug noj ua ke thiab cov tshuaj tua kab mob feem ntau pib ua ntej cov txiaj ntsig tuaj txog. Rau cov o ntawm cov qog uas rov tshwm sim hauv tus menyuam uas muaj ANC ib txwm muaj, kev kuaj kev ua haujlwm tseem ceeb dua. Rau qhov mob pancytopenia uas tsis paub meej, cov ntshav thiab cov pob txha kuaj ua rau muaj kev kuaj mob.

Yuav npaj li cas

Kev npaj yog tsawg heev, tab sis cov kev cai yog teem los ntawm lub chaw kuaj mob thiab pab neeg kho mob, thiab lawv cov lus qhia yuav tseem ceeb dua txhua yam uas sau ntawm no.

• Kev yoo mov: tsis tas yuav siv rau ANC. Yog tias qhov kev kuaj ntawd muaj xws li glucose, lipids lossis insulin, ua raws li cov lus qhia thaum yoo mov rau cov kev kuaj ntawd.
• Cov tshuaj kho mob: Nqa ib daim ntawv teev cov tshuaj uas siv tam sim no, xws li cov tshuaj steroids, lithium, cov tshuaj antithyroid, clozapine, cov tshuaj antiretrovirals thiab cov tshuaj uas siv txhaj rau hauv lub cev tshiab xws li G-CSF. Tsis txhob tsum lossis hloov cov tshuaj uas tau muab rau koj kom "tau txais txiaj ntsig zoo dua," nrog tus kws kho mob tham ua ntej.
• sij hawm: Cov lej neutrophil sib txawv thoob plaws hnub thiab tom qab txhaj tshuaj growth factor. Yog tias koj pab neeg tau thov kom muaj ib hnub lossis lub sijhawm tshwj xeeb hauv lub voj voog chemotherapy, ua raws li nws, vim tias tib tus lej txhais tau tias txawv ntawm cov hnub sib txawv.
• Ua ntej qhov kev kos duab: tsis txhob ua kev tawm dag zog hnyav ua ntej, zaum ntsiag to ob peb feeb, thiab haus dej li qub tshwj tsis yog tias koj tau muab kev txwv dej rau koj.
• Cawv thiab haus luam yeeb: ob qho tib si tuaj yeem hloov pauv cov lej ntawm cov qe ntshav dawb; hais txog kev noj ntau dhau tsis ntev los no kom daim ntawv qhia tuaj yeem nyeem tau kom raug.
• Qhia rau tus kws kho mob phlebotomist txog kev mob ntshav, tshuaj ua kom ntshav nyias, caj npab lymphoedematous lossis fistula, lossis keeb kwm tsaus muag thaum kuaj ntshav.

Cev xeeb tub

Cov lej neutrophil nce ntxiv thaum cev xeeb tub thiab thaum lub sijhawm yug menyuam. Cov poj niam cev xeeb tub uas muaj mob zoo feem ntau yog qhov ib txwm muaj thiab tsis tas yuav suav tias yog kev kis kab mob ntawm nws tus kheej.

Cov menyuam yaus thiab cov menyuam mos

Cov nqi siv los ua piv txwv txawv ntawm lub hnub nyoog, thiab cov menyuam mos yug tshiab yuav hloov pauv sai heev thaum lawv tseem muaj hnub nyoog. Cov txiaj ntsig ntawm kev kuaj mob menyuam yaus yuav tsum tau muab piv rau cov nqi uas haum rau hnub nyoog los ntawm tus kws kho mob menyuam yaus. Rau cov menyuam mos me me, yuav tsum tau siv lub pob taws chob, thiab kev quaj lossis kev kuaj mob nyuaj yuav cuam tshuam rau kev suav.

Cov neeg uas muaj kev txwv tsis pub haus dej, lub plawv tsis ua haujlwm lossis kab mob raum

Tsis tas yuav ntxiv dej tshwj xeeb rau qhov kev kuaj no. Tsis txhob haus dej ntau dhau qhov koj tau teev tseg kom yooj yim dua rau kev nqus ntshav.

Cov neeg mob ntshav qab zib uas tab tom kho mob kom txo cov piam thaj

Txoj kev kuaj mob ANC tsis tas yuav tsum yoo mov. Yog tias muaj lwm yam kev kuaj mob yoo mov ua ke, nug koj pab neeg mob ntshav qab zib seb yuav siv sijhawm insulin lossis tshuaj ntsiav li cas, yog li koj thiaj li tsis tas yuav yoo mov kom tau txais tshuaj ntau npaum li cas.

Cov neeg laus thiab cov neeg uas noj tshuaj steroids ntev

Cov tshuaj steroids feem ntau ua rau cov neutrophils ntau ntxiv. Cov neeg laus kuj tseem yuav muaj cov qe ntshav dawb me dua thaum muaj kev kis kab mob hnyav, yog li ANC ib txwm tsis txhim khu kev qha ua rau muaj kev ntseeg siab hauv pawg no.

Muaj dab tsi tshwm sim thaum lub sijhawm xeem

• Kev kos npe thiab kev txheeb xyuas tus kheej: koj cov ntaub ntawv thiab daim ntawv thov tau raug txheeb xyuas lawm.
• Kev npaj qhov chaw: ib daim ntaub qhwv caj npab raug siv rau sab caj npab sab saud thiab ntxuav daim tawv nqaij nrog tshuaj tua kab mob.
• Cov qauv sau: Cov ntshav raug rho tawm ntawm cov leeg ntshav, feem ntau ntawm sab hauv lub luj tshib, mus rau hauv lub raj EDTA. Cov neeg uas muaj txoj hlua nruab nrab yuav tau coj cov qauv los ntawm txoj hlua ib chav.
• Tom qab kos duab: nias thiab npog qhov chaw ntawd. Lub sijhawm siv koob feem ntau yog qis dua ib feeb.
• Ntsuas: ib lub tshuab ntsuas ntshav suav cov cell; tus kws kho mob lossis tus kws kho mob tej zaum yuav tshuaj xyuas daim zaj duab xis uas muaj xim yog tias tus qauv tsis zoo.

Cov txheej txheem siv sijhawm ntev npaum li cas

• Ntawm lub txee sau nyiaj: li ntawm 5-10 feeb, suav nrog cov ntaub ntawv thiab kev nias tom qab kos duab.
• Tag nrho cov kev mus ntsib: feem ntau yog 15-30 feeb nyob ntawm seb kab ntev npaum li cas.
• Lub sijhawm khiav ntawm lub tshuab tshuaj ntsuam xyuas: ob peb feeb rau ib qho qauv thaum nws mus txog lub rooj ntev zaum.
• Qhia txog: Kev kuaj mob raws li CBC yog cov kev tshaj tawm hauv chaw kuaj mob sai dua, thiab ntau lub chaw muab kev tshaj tawm tib hnub, nrog rau cov qauv kuaj mob ceev lossis cov qauv kuaj mob hauv tsev kho mob ua tiav sai dua. Kev tshuaj xyuas zaj duab xis tes ntxiv sijhawm. Paub meej tias lub sijhawm tshaj tawm xav tau nrog lub chaw kuaj mob uas tuav koj cov qauv, vim qhov no tau teeb tsa hauv zos.

Kev nkag siab txog koj daim ntawv qhia

Daim ntawv tshaj tawm feem ntau qhia txog feem pua ​​​​​​ntawm neutrophil los ntawm qhov suav sib txawv thiab tus nqi neutrophil kiag li hauv cov hlwb /礚 lossis ?0?/L, luam tawm ib sab ntawm lub chaw kuaj mob ntawd lub sijhawm siv.

Siv koj tus kheej lub chaw kuaj mob qhov ntau thiab tsawg. Lub sijhawm sib txawv ntawm cov khoom siv tshuaj ntsuam, cov txheej txheem thiab cov pej xeem, thiab txawv raws li hnub nyoog, tshwj xeeb tshaj yog rau cov menyuam yaus, qhov twg tus nqi uas yog ib txwm muaj thaum ob xyoos yuav txawv txawv thaum ob lub lis piam. Vim li no tsis muaj daim ntawv teev lej thoob ntiaj teb rov ua dua ntawm no; nyeem koj tus nqi piv rau qhov ntau thiab tsawg uas luam tawm ntawm koj daim ntawv qhia thiab tham nrog tus kws kho mob uas tau xaj qhov kev kuaj.

Thaum ANC qis dua qhov ntsuas siv (neutropenia)

Tej yam ua rau muaj xws li: mob hnyav, mob tsis muaj mob, mob ntev, mob hnyav, mob ntsws, mob ntshav, mob ntshav tsis zoo, mob hlwb pob txha, thiab mob ntshav tsis muaj zog, uas cov neeg mob uas tsis muaj mob ntshav ntau dhau feem ntau yuav muaj cov ntshav tsawg heev. Qhov mob hnyav tseem ceeb dua li daim ntawv lo: cov ntshav tsawg dua thiab ntev dua, qhov muaj feem kis tau kab mob ntau dua. Koj tus kws kho mob qog nqaij hlav lossis kws kho mob ntshav yuav muab qhov no piv rau koj txoj kev npaj kho mob.

Thaum ANC siab dua qhov ntsuas siv (neutrophilia)

Cov lus piav qhia feem ntau suav nrog kev kis tus kab mob, kev raug mob ntawm cov nqaij, kev phais, kev kub hnyiab, kev o, corticosteroids, kev txhaj tshuaj G-CSF, kev haus luam yeeb, kev xeeb tub, kev ntxhov siab ntawm lub cev lossis kev xav, thiab tsis tshua muaj myeloproliferative disorders lossis chronic myeloid leukaemia. Yog tias muaj cov hlwb tsis loj hlob zoo, lossis muaj cov hlwb tsis tau loj hlob zoo hauv daim zaj duab xis, yuav tsum tau kuaj xyuas cov ntshav sai sai.

Ib qho nqi tsis tshua muaj txiaj ntsig zoo li qhov sib txawv. Khaws cov ntawv qhia ua ntej kom cov kev hloov pauv tuaj yeem sib piv.

Thaum cov txiaj ntsig tuaj yeem ua rau neeg nkag siab yuam kev

Tsa siab dhau los yog siab dhau lawm

• Tsis ntev los no, kev txhaj tshuaj G-CSF lossis GM-CSF, uas ua rau cov neutrophils nyob hauv cov ntshav nce ntxiv ntau hnub.
• Corticosteroids, adrenaline thiab lwm yam tshuaj zoo li catecholamine.
• Kev ntxhov siab sai sai, mob, qaug dab peg, ntuav, tawm dag zog ntau dhau lossis tus menyuam mos quaj ua ntej qhov kev rub tawm, qhov cuam tshuam luv luv rau kev faib ciam teb.
• Haus luam yeeb, uas tuaj yeem ua rau tus lej nyob twj ywm rau ntawm qhov kawg siab tshaj plaws.
• Tus neeg tshuaj xyuas suav cov platelets uas sib sau ua ke lossis cov qe ntshav liab uas muaj nucleus ua cov qe ntshav dawb hauv qee cov qauv tsis zoo.

Qis qis los yog qis tsis tseeb

• Ib lub raj mis EDTA uas txhaws los yog puv tsis txaus, lossis ncua sijhawm ua ntej kev tshuaj xyuas, uas ua rau cov cell puas tsuaj.
• Kev txo cov qauv yog tias rho tawm ntawm ib ceg uas muaj cov tshuaj txhaj rau hauv cov hlab ntsha lossis los ntawm txoj kab liab.
• Neutrophil clumping lossis EDTA-related artefact, qee zaum yuav tsum tau rov ua qauv dua hauv lwm yam tshuaj anticoagulant.
• Kab mob sepsis thaum ntxov heev, qhov twg cov neutrophils marginalized rau hauv cov nqaij ua ntej cov suav rov qab zoo.

Ntsuas kom raug tab sis nyeem tsis raug yooj yim

• Ib qho WBC tag nrho nrog ANC qis: Cov lymphocytes tuaj yeem npog cov neutropenia, yog li ntawd qhov tseem ceeb ntawm qhov tseem ceeb, tsis yog tag nrho.
• Cov qe ntshav dawb tsis muaj zog (benign ethnic or constitutional neutropenia): tus lej qis me ntsis ruaj khov hauv ib tus neeg noj qab nyob zoo, uas raug tshuaj xyuas tsis raug raws li kab mob pob txha.
• Lub sijhawm voj voog hauv kev kho mob chemotherapy: yuav muaj qhov qis tshaj plaws hauv ib lub lim tiam tom qab ib lub voj voog; tus nqi qub ntawm lwm lub sijhawm yuav tsis yog.

Txhua qhov tshwm sim tsis tau xav txog lossis hnyav heev yuav tsum tau lees paub ntawm cov qauv rov ua dua ua ntej kos cov lus xaus.

Kev Pheej Hmoo thiab Kev Nyab Xeeb

Kev ntsuas ntshav venous txheem

Qhov teeb meem feem ntau yog qhov tsis xis nyob ntawm qhov koob, qhov mob me me thiab lub taub hau luv luv. Feem ntau yuav muaj cov ntshav loj dua, tshwj xeeb tshaj yog rau cov tshuaj thinning ntshav, lossis qhov tingling ib ntus yog tias cov ceg hlab ntsha me me raug khaus. Kev kis kab mob ntawm qhov chaw txhaj tshuaj tsis tshua muaj nrog cov txheej txheem aseptic ib txwm muaj.

Mob pob taws los yog ntiv tes rau cov menyuam mos thiab cov menyuam yaus me

Mob me ntsis, mob me ntsis thiab qee zaum kuaj tsis txaus uas yuav tsum tau txhaj dua. Kev kho mob hauv zos qhia txog kev xaiv qhov chaw rau cov menyuam mos.

Kev kuaj los ntawm txoj hlab ntsha hauv nruab nrab lossis qhov chaw nres nkoj

Tsis txhob raug rab koob nias, tab sis muaj kev pheej hmoo me ntsis ntawm kev kis kab mob lossis kev thaiv kab thiab yuav tsum ua raws li cov txheej txheem ntawm chav tsev. Cov qauv kuaj uas tsis muaj pov tseg txaus tuaj yeem raug diluted.

Kev pheej hmoo ntawm kev ua raws li qhov tshwm sim

Cov kev pheej hmoo tseem ceeb dua yog kev txhais lus: kho cov neutrophilia uas cuam tshuam nrog kev ntxhov siab ntau dhau nrog cov tshuaj tua kab mob tsis tsim nyog, lossis tsis teb zoo rau cov lej qis tiag tiag. Cov txiaj ntsig sib txawv nyob ntawm tus kheej qhov xwm txheej thiab yuav tsum tau txhais los ntawm tus kws kho mob thov.

Cov xwm txheej tshwj xeeb

Cev xeeb tub

Neutrophilia yog ib qho mob uas tshwm sim thaum cev xeeb tub thiab feem ntau tshwm sim thaum yug menyuam. Yog tias tus lej qes qis thaum cev xeeb tub xav tau kev soj ntsuam, vim tias yuav tsum xav txog daim ntawv teev cov tshuaj uas yuav tsum tau noj. Txhua qhov kev txiav txim siab txog kev kho mob, suav nrog cov yam tseem ceeb uas ua rau kev loj hlob, tus kws kho mob yug menyuam thiab kws kho mob ntshav yuav tsum ua ke.

Cov me nyuam

Cov nqi siv rau txhua hnub nyoog yog qhov tseem ceeb. Cov menyuam yaus uas muaj cov kab mob neutropenia tas li, mob qhov ncauj lossis tsis loj hlob zoo yuav tsum tau kev pab los ntawm kws kho mob ntshav lossis kws kho mob tiv thaiv kab mob, suav nrog kev xav txog cov kab mob neutropenia uas muaj los ntawm lub cev thiab los ntawm lub cev. Kev suav ntau zaus ntau lub lis piam yuav tsum tau ua kom pom cov qauv uas muaj los ntawm lub cev.

Cov laus

Cov qe ntshav dawb teb rau kev kis kab mob yuav tsis muaj zog, yog li kev kis kab mob loj tuaj yeem tshwm sim nrog ANC uas tsis muaj qhov txawv txav. Kev tsis muaj zog, kev noj tshuaj ntau dhau thiab kev tsis txaus noj haus txhua yam ua rau muaj cov lej tsis zoo.

Cov neeg uas tau txais chemotherapy lossis tom qab hloov pauv

Kev saib xyuas yuav teem sijhawm nyob ib puag ncig qhov qis tshaj plaws uas xav tau. Kev rov zoo ntawm cov neutrophil yog ib qho tseem ceeb tom qab hloov cov noob hlwb. Ua raws li koj pab neeg cov lus qhia ua npaws thiab khaws lawv tus xov tooj hu rau thaum muaj xwm txheej ceev kom lawv nkag tau yooj yim.

Kab mob ntshav qab zib, kab mob raum ntev thiab kab mob plawv tsis ua haujlwm

Cov mob no tsis hloov txoj kev uas cov qauv kuaj raug coj mus, tab sis lawv ua rau muaj kev pheej hmoo ntawm kev kis kab mob thiab tuaj yeem ua rau kev kho mob ntawm neutropenia nyuaj. Qee cov tshuaj siv rau hauv cov mob no cuam tshuam rau cov lej, yog li khaws cov npe tshuaj kho mob kom hloov kho tshiab txhua zaus mus ntsib kws kho mob.

Cov neeg uas muaj tus kab mob HIV los yog cov neeg uas tau tiv thaiv kab mob mus sij hawm ntev

Cov qe ntshav dawb tsis muaj zog (neutropenia) tej zaum yuav qhia txog tus kab mob, cov tshuaj, lossis kev kis kab mob uas tshwm sim los ntawm kev sib kis. Tus lej ANC nyeem ua ke nrog tus lej CD4 thiab tus lej viral load; nws tsis hloov lawv.

Kev Xeem ANC Profile hauv Is Nrias teb

• Terminology: ntau lub chaw soj nstuam hauv Is Nrias teb tseem tshaj tawm cov neutrophils ua "polymorphs" lossis "polys" ntawm DLC, nrog rau feem pua ​​ua ntej thiab qhov suav tag nrho nyob ib sab ntawm nws. Nug txog tus nqi tag nrho yog tias tsuas yog luam tawm feem pua, qhov feem pua ​​ib leeg tuaj yeem ua rau yuam kev.
• Kev sib sau ua ke ntawm lub npe: vim tias "ANC" siv dav rau kev saib xyuas ua ntej yug menyuam hauv kev xyaum ua poj niam hauv Is Nrias teb, xyuas kom meej seb koj daim ntawv qhia tshuaj puas txhais tau tias suav cov neutrophil tag nrho lossis pawg neeg ua ntej yug menyuam. Cov no tsis muaj feem cuam tshuam.
• Tus qauv kab mob: Kab mob ntsws (tuberculosis), kab mob ua npaws plab (enteric fever), kab mob dengue, kab mob malaria, kab mob scrub typhus thiab kab mob siab E yog cov kab mob ua rau mob kub taub hau hauv Is Nrias teb, thiab qee cov kab mob no qis dua li ua rau cov neutrophil nce. Yog li ntawd, cov lej qis lossis ib txwm thaum mob kub taub hau tsis yog qhov sib kis kab mob hnyav, thiab kev kuaj mob hauv zos yog qhov tsim nyog.
• Kab mob ntshav tsis txaus thiab kev noj haus: Kab mob ntshav tsis txaus hlau, thiab tsis txaus vitamin B12 thiab folate, feem ntau yog cov kab mob no. Kev tsis txaus B12 thiab folate tuaj yeem txo cov lej neutrophil thiab tsim cov ntshav zoo li cov ntshav, yog li ntawd CBC feem ntau raug tshuaj xyuas tag nrho es tsis yog ANC ib leeg xwb.
• Cov yam ntxwv ntawm Thalassemia thiab cov kab mob haemoglobinopathy feem ntau nyob rau hauv qee qhov ntawm Is Nrias teb. Cov no feem ntau cuam tshuam rau cov ntsuas ntshav liab es tsis yog ANC, tab sis lawv yog ib qho laj thawj uas tag nrho cov ntshav haemogram raug txhais ua ke.
• Kev raug tshuaj: Cov tshuaj tua kab mob uas yuav tsis tas yuav muaj daim ntawv yuav tshuaj, cov tshuaj tiv thaiv thyroid, cov tshuaj tiv thaiv qaug dab peg thiab kev siv tshuaj rau tus kheej yog cov uas muaj ntau heev. Yuav tsum qhia txog kev siv tshuaj ntsuab, AYUSH thiab cov tshuaj ntxiv rau hauv chaw dhia ua si, vim tias tau muaj kev tshaj tawm tias cov pob txha tsis ua haujlwm zoo thiab raug mob siab nrog cov khoom tsis raug tswj.
• Kev Nkag: Kev siv tshuab CBC nrog kev sib txawv muaj nyob rau hauv feem ntau ntawm cov chaw kuaj mob hauv cheeb tsam, thaum kev kuaj neutrophil function, flow cytometry thiab marrow genetics muaj nyob rau hauv cov nroog loj dua thiab cov chaw xa mus.
• Cov lus qhia txog kev cai lij choj: raws li Txoj Cai Tshuaj thiab Kev Kho Mob Khawv Koob (Kev Tshaj Tawm Tsis Zoo) Xyoo 1954, tsis pub muaj khoom lag luam raug tshaj tawm tias yog kev txhawb nqa neutrophils lossis kho neutropenia. Yog tias koj qhia koj cov ntawv ceeb toom los ntawm lub portal online, koj cov ntaub ntawv kev noj qab haus huv tus kheej raug tswj hwm raws li Txoj Cai Tiv Thaiv Cov Ntaub Ntawv Tus Kheej Digital Xyoo 2023.

Tus nqi thiab kev pov hwm, thiab dab tsi cuam tshuam rau tus nqi hauv Is Nrias teb

Ib qho CBC uas muaj qhov sib txawv, uas yog ANC tau los ntawm, yog ib qho ntawm cov kev kuaj mob pheej yig tshaj plaws hauv Is Nrias teb, thiab kev suav cov neutrophil uas sawv cev tsis tshua muaj nqi sib cais ntawm cov ntshav. Cov nqi tiag tiag sib txawv ntawm cov chaw haujlwm tsoomfwv, cov chaw kuaj mob uas sawv cev, cov tuam txhab lag luam thiab cov nqi kho mob hauv tsev kho mob. Nug tus nqi tam sim no ntawm qhov chaw sau ua ntej coj cov qauv.

Cov yam uas cuam tshuam rau qhov koj them

• Txawm tias ANC los nyob hauv CBC, pob khoom kho mob lossis pawg neeg mob qog nqaij hlav loj dua.
• Tsoom fwv piv rau cov chaw ntiag tug, thiab lub nroog piv rau lub nroog me.
• Kev them nqi rau cov neeg mob hauv tsev kho mob piv rau cov neeg mob sab nraud, thiab kev ua tiav sai lossis tom qab sijhawm ua haujlwm.
• Txawm yog ntxiv kev tshuaj xyuas cov yeeb yaj kiab ntshav, kev suav cov reticulocyte lossis kev xav ntawm tus kws kho mob.
• Cov nqi sau nyiaj hauv tsev thiab kev rov saib xyuas ntau zaus thaum lub sijhawm kho mob chemotherapy.
• Cov kev kuaj ntxiv uas tau xaj tib lub sijhawm, xws li kev kuaj kab mob, CRP lossis vitamin B12.

Insurance

Cov kev kuaj mob uas tau ua thaum lub sijhawm nkag mus rau hauv tsev kho mob lossis kev kho mob chemotherapy uas tau pom zoo hauv tsev kho mob feem ntau yuav tau txais nyiaj rov qab ua ib feem ntawm qhov kev thov ntawd, raws li cov nqe lus ntawm txoj cai. Cov kev kuaj mob hauv chaw kuaj mob sab nraud feem ntau tsis raug them tshwj tsis yog tias txoj cai suav nrog OPD lossis kev pab kuaj mob. Qee cov phiaj xwm tsoomfwv them rau kev tshawb nrhiav hauv kev kho mob qog noj ntshav uas tau ntim khoom. Paub meej tias kev them nqi nrog koj tus neeg pov hwm lossis lub rooj pov hwm ntawm tsev kho mob ua ntej kev kuaj mob, thiab khaws daim ntawv qhia ntawm tus kws kho mob, vim tias cov ntaub ntawv tsim nyog kho mob feem ntau yuav tsum tau ua.

Cov lus dab neeg thiab qhov tseeb

Lus nug cov lus nug

Puas yog ANC Profile Test zoo ib yam li CBC?

Tsis yog kiag li. Tus lej neutrophil tag nrho yog ib tus lej suav los ntawm kev suav cov ntshav tag nrho nrog qhov sib txawv. Kev txiav txim siab ANC feem ntau txhais tau tias yuav tsum tau kuaj CBC. CBC kuj tseem qhia txog haemoglobin, platelets thiab lwm hom qe ntshav dawb, uas feem ntau xav tau los piav qhia txog tus lej neutrophil tsis zoo.

Kuv puas yuav tsum tau yoo mov ua ntej qhov kev kuaj ANC Profile?

Tsis tas yuav tsum yoo mov rau qhov suav neutrophil nws tus kheej. Yog tias koj tus kws kho mob tau ua ke nrog kev kuaj ntshav qabzib, roj lossis insulin, ua raws li cov lus qhia yoo mov rau cov kev kuaj ntawd. Cov kev cai yog teem los ntawm lub chaw kuaj mob thiab pab pawg kho mob, yog li lawv cov lus qhia sau ntawv yuav tsum muaj qhov tseem ceeb dua.

Vim li cas kuv tus kws kho mob thiaj xav kom kuaj rau hnub tshwj xeeb ntawm kuv lub voj voog chemotherapy?

Feem ntau cov lej neutrophil poob qis rau lawv qhov qis tshaj plaws ob peb hnub tom qab tshuaj chemotherapy thiab tom qab ntawd rov zoo. Tus lej tib yam muaj lub ntsiab lus txawv ntawm qhov qis tshaj plaws dua li ua ntej lub voj voog tom ntej. Kev kuaj mob rau hnub teem tseg tso cai rau koj tus kws kho mob qog nqaij hlav piv rau lwm yam.

Kev ntxhov siab lossis kev tawm dag zog puas tuaj yeem hloov kuv cov neutrophil suav?

Yog. Kev ntxhov siab ntawm lub cev lossis lub siab, mob, kev tawm dag zog hnyav, qaug dab peg thiab txawm tias quaj ntev rau ib tug menyuam tuaj yeem ua rau cov neutrophils nce siab ib ntus. Qhov cuam tshuam no tsuas yog ib ntus xwb. Zaum ntsiag to ob peb feeb ua ntej kuaj thiab hais txog kev tawm dag zog tsis ntev los no yuav pab nyeem daim ntawv qhia kom raug.

Kuv cov neutrophil feem pua ​​siab tab sis tus lej tag nrho yog ib txwm muaj. Qhov twg tseem ceeb?

Qhov suav tag nrho tseem ceeb dua. Ib feem pua ​​tsuas yog piav qhia txog feem pua ​​ntawm cov qe ntshav dawb uas yog neutrophils, yog li nws tuaj yeem zoo li siab vim tias lymphocytes qis. Nug tus nqi tag nrho yog tias koj daim ntawv qhia tsuas yog qhia feem pua, thiab tham txog ob tus lej nrog koj tus kws kho mob.

Kuv puas noj tau kuv cov tshuaj ib txwm ua ntej qhov kev kuaj mob?

Noj cov tshuaj uas tau muab rau koj li niaj zaus tsuas yog tus kws kho mob tau hais lwm yam rau koj xwb, thiab nqa daim ntawv teev tshuaj nrog koj mus. Tsis txhob tsum, ncua sijhawm lossis hloov cov tshuaj kom hloov qhov tshwm sim. Yog tias koj xav tias cov tshuaj cuam tshuam rau koj cov lej tshuaj, nug tus kws kho mob kom muab tshuaj rau koj es tsis txhob hloov koj tus kheej.

ANC yuav tsum tau ua dua ntau zaus npaum li cas?

Qhov ntawd nyob ntawm seb yog vim li cas. Thaum lub sijhawm kho mob chemotherapy nws yuav yog txhua lub lim tiam lossis ntau zaus dua. Rau kev saib xyuas kev nyab xeeb ntawm cov tshuaj, tus kws sau ntawv teem sijhawm uas yuav yog txhua ob lub lim tiam thaum xub thawj thiab tom qab ntawd tsawg dua. Rau qhov tshwm sim tsis zoo me ntsis, rov ua dua ib zaug tom qab ob peb lub lis piam feem ntau txaus.

Puas yog qhov tshwm sim ib txwm txhais tau tias kuv tsis muaj kab mob?

Tsis yog. Muaj ntau yam kab mob uas tshwm sim hauv Is Nrias teb, suav nrog tuberculosis, dengue, enteric fever thiab kab mob viral, tuaj yeem tshwm sim nrog cov lej neutrophil ib txwm lossis tsawg. ANC ib txwm piav qhia txog cov cell hauv cov qauv ntawd, tsis yog tsis muaj kab mob. Yog tias cov tsos mob tseem muaj lossis hnyav zuj zus, rov qab mus rau koj tus kws kho mob kom rov ntsuam xyuas dua.

Puas yog tus lej neutrophil qis txaus ntshai?

Kev pheej hmoo nyob ntawm seb tus lej ntawd qis npaum li cas, nws kav ntev npaum li cas thiab qhov ua rau muaj teeb meem. Cov neeg mob uas muaj mob zoo feem ntau tsis ua rau muaj teeb meem. Cov neeg mob uas muaj mob hnyav lossis ntev heev, tshwj xeeb tshaj yog tom qab siv tshuaj kho mob chemotherapy, ua rau muaj kev pheej hmoo ntawm kev kis kab mob ntau ntxiv thiab xav tau cov lus qhia meej los ntawm koj pab neeg kho mob txog thaum twg yuav tsum nrhiav kev pab.

Qhov chaw

• World Health Organization. WHO Kev Faib Tawm Cov Qog: Cov Qog Haematolymphoid, 5th ib.
• Lub Koom Haum Kab Mob Cancer Thoob Plaws Tebchaws. Cov Lus Qhia Txog Kev Kho Mob Oncology: Kev Tiv Thaiv thiab Kev Kho Mob Cov Kab Mob Uas Cuam Tshuam Nrog Kab Mob Cancer; Cov Yam Ntxim Saib Xyuas Kev Loj Hlob ntawm Hematopoietic.
• Lub Koom Haum Kab Mob Sib Kis ntawm Asmeskas. Cov lus qhia txog kev siv tshuaj tua kab mob rau cov neeg mob uas muaj mob qog noj ntshav uas muaj mob qog noj ntshav.
• British Society for Hematology. Cov lus qhia txog kev tshawb nrhiav thiab kev tswj hwm ntawm neutropenia.
• Tsoom Fwv Tebchaws Is Nrias teb, Ministry of Law and Justice. Txoj Cai Tshuaj thiab Kev Kho Mob Khawv Koob (Kev Tshaj Tawm Tsis Zoo), 1954; Txoj Cai Tiv Thaiv Cov Ntaub Ntawv Tus Kheej Digital, 2023.
• Lub Koom Haum Txheej Txheem Kev Kho Mob thiab Chaw Kuaj Mob. Cov lus qhia txog kev txhais, kev tsim thiab kev txheeb xyuas cov sijhawm siv hauv chaw kuaj mob.