{"id":29561,"date":"2020-07-09T16:23:41","date_gmt":"2020-07-09T13:23:41","guid":{"rendered":"https:\/\/dev.synevo.md\/?p=29561"},"modified":"2022-06-20T16:27:51","modified_gmt":"2022-06-20T13:27:51","slug":"ce-este-si-ce-se-ascunde-in-spatele-unei-anemii","status":"publish","type":"post","link":"https:\/\/old.synevo.md\/ru\/ce-este-si-ce-se-ascunde-in-spatele-unei-anemii\/","title":{"rendered":"Ce este \u015fi ce se ascunde \u00een spatele unei anemii"},"content":{"rendered":"<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img decoding=\"async\" src=\"https:\/\/www.synevo.md\/wp-content\/uploads\/2007\/12\/simptome1.jpg\" alt=\"simptome\" class=\"wp-image-17352\"\/><\/figure><\/div><div class=\"wp-block-image\"><figure class=\"aligncenter\"><img decoding=\"async\" src=\"https:\/\/www.synevo.md\/wp-content\/uploads\/2009\/05\/bottom-shadow.png\" alt=\"bottom-shadow\" class=\"wp-image-15316\"\/><\/figure><\/div><p>Reducerea capacita\u0163ii de a asigura transportul oxigenului (ca urmare fie a reducerii concentra\u0163iei de hemoglobin\u0103 din eritrocite, fie a reducerii num\u0103rului de eritrocite din circula\u0163ie) se manifest\u0103 prin paloare, care se instaleaz\u0103 lent \u00een anemia cronica \u015fi rapid \u00een anemia consecutiv\u0103 unei hemoragii, r\u0103cirea extremit\u0103\u0163ilor din cauza reducerii metabolismului din \u0163esuturi, respira\u0163ie accelerat\u0103 care asigur\u0103 o cre\u015ftere a cantit\u0103\u0163ii de oxigen fixat\u0103 pe hemoglobin\u0103, tahicardie (adic\u0103 cre\u015fterea frecven\u0163ei b\u0103t\u0103ilor inimii) pentru a compensa reducerea cantit\u0103\u0163ii de s\u00e2nge care transport\u0103 oxigen.<\/p><p>Din cauza oxigen\u0103rii insuficiente a sistemului nervos, mai pot ap\u0103rea o serie de simptome cum ar fi: ame\u0163eli, cefalee (durerile de cap), astenie.<\/p><div class=\"wp-block-image\"><figure class=\"aligncenter\"><img decoding=\"async\" src=\"https:\/\/www.synevo.md\/wp-content\/uploads\/2007\/12\/cauze-2.jpg\" alt=\"cauze-2\" class=\"wp-image-17404\"\/><\/figure><\/div><p><strong>Anemiile posthemoragice<\/strong> se caracterizeaz\u0103 prin sc\u0103derea masiv\u0103 a num\u0103rului de hematii precum \u015fi a cantit\u0103\u0163ii de hemoglobin\u0103. O form\u0103 grav\u0103 a anemiei acute posthemoragice este \u00eenso\u0163it\u0103 de \u015foc sau colaps cardiovascular. Forma cronic\u0103 apare dup\u0103 pierderi mici, dar repetate, de s\u00e2nge, prelungite deseori timp de luni \u015fi ani, duc\u00e2nd la epuizarea m\u0103duvei osoase \u015fi a rezervelor de fier ale organismului. Aceasta situa\u0163ie apare \u00een caz de ulcer duodenal s\u00e2nger\u00e2nd, hemoroizi, colit\u0103 ulceroas\u0103, cancer gastric sau intestinal, pierderi de s\u00e2nge prin urin\u0103 \u015fi s\u00e2nger\u0103ri uterine abundente.<\/p><p><strong>Anemia feripriv\u0103<\/strong> se caracterizeaz\u0103 prin \u00eenc\u0103rcarea redus\u0103 cu hemoglobin\u0103 a hematiilor \u015fi apare la persoanele care primesc prin alimenta\u0163ie cantit\u0103\u0163i insuficiente de fier, la cele cu absorb\u0163ie defectuoas\u0103 de fier prin intestin, la cele la care consumul de fier este crescut (gravide, fete la pubertate etc.), precum \u015fi \u00een utilizarea defectuoas\u0103 a fierului (tumorile maligne \u015fi infec\u0163ii).<\/p><p><strong>Talasemiile<\/strong> sunt boli genetice (transmise ereditar) caracterizate prin afectarea sintezei globinei (proteina specific\u0103 hemoglobinei). Majoritatea sunt forme minore de boal\u0103 caracterizate prin persisten\u0163a de-a lungul vie\u0163ii a unei anemii u\u015foare, asimptomatice sau cu simptomatologie discret\u0103. Formele intermediar\u0103 \u015fi major\u0103 ale talasemiei sunt rare, dar foarte grave.<\/p><p><strong>Anemia pernicioas\u0103<\/strong> (megaloblastic\u0103, Biermer) se caracterizeaz\u0103 prin lipsa de matura\u0163ie a globulelor ro\u015fii din cauza fie a unui aport insuficient de vitamina B12 \u015fi\/sau acid folic, fie a unei absorb\u0163ii necorespunz\u0103toare (orice afec\u0163iune gastric\u0103 care scade sinteza factorului intrinsec, factor care asigur\u0103 absorb\u0163ia vitaminei B12).<\/p><p><strong>Anemiile hemolitice<\/strong> apar \u00een urma unei distrugeri exagerate a globulelor ro\u015fii, distrugeri datorate fie calit\u0103\u0163ii defectuoase a hematiei, fie anticorpilor din plasma sangvin\u0103, fie distrugerii \u00eentr-un ritm prea accelerat a hematiilor de c\u0103tre splin\u0103. Factorii chimici care pot declan\u015fa anemiile hemolitice sunt: cloratul de potasiu, benzenul, plumbul, fosforul, sulfamidele, fenacetina, toxinele unor microbi (streptococi, stafilococi), toxinele unor parazi\u0163i (exemplu: malaria) precum \u015fi unele toxine provenite din ciuperci sau veninuri de \u015farpe \u015fi p\u0103ianjen. O anemie hemolitic\u0103 foarte grav\u0103 se produce \u00een cursul transfuziilor cu s\u00e2nge incompatibil.<\/p><p><strong>Anemiile<\/strong> prin defect de generare a hematiilor se mai numesc <strong>hipoplastice<\/strong> sau aplastice \u015fi sunt consecin\u0163a incapacit\u0103\u0163ii m\u0103duvei osoase de a produce hematii. Aceste anemii care apar \u00een special \u00een bolile maligne ale s\u00e2ngelui (leucemii acute \u015fi cronice) sunt asociate cu o sc\u0103dere a num\u0103rului de trombocite, din a c\u0103ror cauz\u0103, al\u0103turi de anemie, apar \u015fi hemoragii care vor accentua anemia.<\/p><div class=\"wp-block-image\"><figure class=\"aligncenter\"><img decoding=\"async\" src=\"https:\/\/www.synevo.md\/wp-content\/uploads\/2007\/12\/rolul.jpg\" alt=\"rolul\" class=\"wp-image-17393\"\/><\/figure><\/div><div class=\"wp-block-image\"><figure class=\"aligncenter\"><img decoding=\"async\" src=\"https:\/\/www.synevo.md\/wp-content\/uploads\/2009\/05\/bottom-shadow.png\" alt=\"bottom-shadow\" class=\"wp-image-15316\"\/><\/figure><\/div><p>Efectuarea unei <strong>hemograme complete reprezint\u0103 investiga\u0163ia primar\u0103 obligatorie<\/strong> la care se adaug\u0103, \u00een anumite cazuri (stabilite de c\u0103tre medicul de laborator \u00een func\u0163ie de aspectul hemogramei), examinarea frotiului de s\u00e2nge. O hemogram\u0103 complet\u0103 (care \u00een laboratoarele moderne se face \u00een 1-5 minute datorit\u0103 aparaturii ultraperformante) cuprinde:<\/p><ul class=\"wp-block-list\"><li>num\u0103rul de hematii \u2013 care \u00een anemie poate fi sc\u0103zut, normal sau crescut \u00een func\u0163ie de vechimea anemiei \u015fi de capacitatea m\u0103duvei osoase de a compensa anemia<\/li><li>hematocritul \u2013 care \u00een anemii este sc\u0103zut<\/li><li>hemoglobina \u2013 care de asemenea este sc\u0103zut\u0103<\/li><li>volumul eritrocitar mediu (VEM) ne d\u0103 informa\u0163ii asupra m\u0103rimii hematiei \u2013 este sc\u0103zut \u00een anemiile feriprive \u015fi talasemii, normal \u00een anemii posthemoragice, crescut \u00een anemia pernicioas\u0103<\/li><li>hemoglobina eritrocitara medie (HEM) \u2013 este sc\u0103zut\u0103 \u00een anemiile feriprive \u015fi alte anemii care merg cu sc\u0103derea sintezei de hemoglobin\u0103 (talasemii), normal\u0103 \u00een anemiile posthemoragice recente, crescut\u0103 \u00een anemia pernicioas\u0103<\/li><li>concentra\u0163ia hemoglobinei eritrocitare medii (CHEM) este sc\u0103zut\u0103 \u00een anemiile feriprive \u015fi alte anemii care merg cu sc\u0103derea sintezei de hemoglobin\u0103 \u015fi normal\u0103 \u00een restul anemiilor<\/li><\/ul><p>Restul parametrilor unei hemograme (num\u0103r de trombocite, volumul trombocitar mediu, trombocitocritul, num\u0103rul de leucocite \u015fi formula leucocitar\u0103) constituie, \u00een multe cazuri, informa\u0163ii utile care ne pot avertiza asupra unei cauze a anemiei (leucemii, trombocitopenii, etc.).<\/p><p>Examinarea microscopic\u0103 a frotiului se s\u00e2nge\u00a0(preparat ob\u0163inut prin \u00eentinderea \u00een strat sub\u0163ire pe o lam\u0103 de sticl\u0103 a unei pic\u0103turi de s\u00e2nge urmat\u0103 de colorarea acestuia) reprezint\u0103 modalitatea de studiere a morfologiei celulelor sangvine, de apreciere a cantit\u0103\u0163ii de hemoglobin\u0103 din hematii, a num\u0103rului de leucocite \u015fi trombocite din s\u00e2nge, informa\u0163ii suplimentare care vor ajuta la stabilirea tipului de anemie.<\/p><p>Pentru confirmarea diagnosticului provizoriu stabilit dup\u0103 examenul clinic \u015fi investiga\u0163iile primare, sunt necesare \u015fi alte investiga\u0163ii cum ar fi: dozarea <a class=\"rank-math-link\" href=\"https:\/\/www.synevo.md\/shop\/sideremie\/\" rel=\"nofollow noopener\" target=\"_blank\">sideremiei <\/a>(determinarea fierului din s\u00e2nge), <a class=\"rank-math-link\" href=\"\/ru\/shop\/capacitatea-totala-de-legare-a-fierului-ctlf\/\">capacitatea total\u0103 de legare a fierului<\/a> (CTLF), <a class=\"rank-math-link\" href=\"\/ru\/shop\/feritina\/\">feritina<\/a>, <a class=\"rank-math-link\" href=\"\/ru\/shop\/haptoglobina\/\">haptoglobina<\/a>, <a class=\"rank-math-link\" href=\"\/ru\/shop\/transferina\/\">transferina<\/a>, <a class=\"rank-math-link\" href=\"https:\/\/www.synevo.md\/shop\/bilirubina-totala\/\" rel=\"nofollow noopener\" target=\"_blank\">bilirubina<\/a>, <a href=\"https:\/\/www.synevo.md\/shop\/lactat-dehidrogenaza-ldh\/\" class=\"rank-math-link\" rel=\"nofollow noopener\" target=\"_blank\">lactat dehidrogenaza (LDH)<\/a>, <a class=\"rank-math-link\" href=\"\/ru\/shop\/test-coombs-direct\/\">testul Coombs<\/a>, electroforeza de hemoglobin\u0103, etc. Se poate ajunge \u00een unele situa\u0163ii p\u00e2n\u0103 la punc\u0163ie medular\u0103 pentru examinarea m\u0103duvei osoase.<\/p><p>\u00cen cursul tratamentului unei anemii este foarte important s\u0103 se urm\u0103reasc\u0103, pe l\u00e2ng\u0103 hemograma complet\u0103, \u015fi num\u0103rul de reticulocite (ele sunt precursori ai hematiilor) care ne vor da informa\u0163ii asupra eficien\u0163ei tratamentului.<\/p><div class=\"wp-block-image\"><figure class=\"aligncenter\"><img decoding=\"async\" src=\"https:\/\/www.synevo.md\/wp-content\/uploads\/2007\/12\/Principii2.jpg\" alt=\"Principii\" class=\"wp-image-17402\"\/><\/figure><\/div><div class=\"wp-block-image\"><figure class=\"aligncenter\"><img decoding=\"async\" src=\"https:\/\/www.synevo.md\/wp-content\/uploads\/2009\/05\/bottom-shadow.png\" alt=\"bottom-shadow\" class=\"wp-image-15316\"\/><\/figure><\/div><p>\u0414\u043b\u044f <strong>anemiile cu caracter acut<\/strong>, provocate de hemoragii importante, cel mai bun tratament este \u00eenlocuirea rapid\u0103 a s\u00e2ngelui pierdut (dup\u0103 ce s-a oprit hemoragia) prin efectuarea de transfuzii.<\/p><p>\u041f\u0440\u0438 <strong>anemiile provocate de lipsa diferitelor elemente necesare produc\u0163iei de hematii \u015fi de hemoglobin\u0103<\/strong> (anemie prin lipsa de fier, prin lipsa de vitamine) se administreaz\u0103, dup\u0103 caz \u015fi \u00een cantit\u0103\u0163ile necesare, fierul sau vitaminele care lipsesc.<\/p><p>\u041f\u0440\u0438 <strong>anemiile produse de o hemoliz\u0103 crescut\u0103<\/strong> se administreaz\u0103 hormoni corticoizi sau se \u00eendep\u0103rteaz\u0103 operator splina.<\/p><p>\u041f\u0440\u0438 <strong>anemiile provocate de infec\u0163ii<\/strong> se face tratament antiinfec\u0163ios corespunz\u0103tor (cu antibiotice sau alte preparate), iar \u00een cele provocate de cancer se face tratamentul bolii de baz\u0103.<\/p><p><strong>Cel mai bun tratament este \u00eens\u0103 preven\u0163ia.<\/strong> O aten\u0163ie deosebit\u0103 trebuie acordat\u0103 regimului alimentar la care ne supunem cu sau f\u0103r\u0103 voie zilnic \u015fi care trebuie s\u0103 con\u0163in\u0103 cantit\u0103\u0163i adecvate de minerale \u015fi vitamine.<\/p><p>De asemenea, \u00een cazul talasemiilor minore, medicul trebuie s\u0103-i explice pacientului natura bolii, precum \u015fi riscul de a avea descenden\u0163i afecta\u0163i (\u00een cazul unui cuplu \u00een care unul sau ambii parteneri prezint\u0103 aceast\u0103 afec\u0163iune). \u00cen cazul \u00een care ambii parteneri sufer\u0103 de aceast\u0103 afec\u0163iune, exist\u0103 riscul ca descenden\u0163ii s\u0103 prezinte forma grav\u0103 a bolii \u015fi, de aici, importan\u0163a sfatului genetic. Tratamentul aplicat \u00een aceast\u0103 situa\u0163ie nu poate trata cauza, ci doar simptomele \u015fi complica\u0163iile induse de leziunile genetice.<\/p><p><em><strong>Dr. Liliana Lup<\/strong><br>Laboratorul Synevo Satu Mare<br><strong>Dr. Ileana Apostolescu<\/strong><br>Laboratorul Synevo Bucure\u015fti<\/em><\/p><figure class=\"wp-block-table\"><table><tbody><tr><th><a class=\"rank-math-link\" href=\"\/ru\/shop\/hemograma-cu-formula-leucocitara-cu-hb-ht-si-indici\/\">Hemogram\u0103 cu formul\u0103 leucocitar\u0103 cu Hb, Ht \u015fi indici<\/a><\/th><th>Pre\u0163: 100 MDL<\/th><\/tr><\/tbody><\/table><\/figure>","protected":false},"excerpt":{"rendered":"<p>Reducerea capacita\u0163ii de a asigura transportul oxigenului (ca urmare fie a reducerii concentra\u0163iei de hemoglobin\u0103 din eritrocite, fie a reducerii num\u0103rului de eritrocite din circula\u0163ie) se manifest\u0103 prin paloare, care se instaleaz\u0103 lent \u00een anemia cronica \u015fi rapid \u00een anemia consecutiv\u0103 unei hemoragii, r\u0103cirea extremit\u0103\u0163ilor din cauza reducerii metabolismului din \u0163esuturi, respira\u0163ie accelerat\u0103 care asigur\u0103 &hellip; <a href=\"https:\/\/old.synevo.md\/ru\/ce-este-si-ce-se-ascunde-in-spatele-unei-anemii\/\">Continued<\/a><\/p>","protected":false},"author":1,"featured_media":29562,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[458],"tags":[],"class_list":["post-29561","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sanatate-si-nutritie"],"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/posts\/29561","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/comments?post=29561"}],"version-history":[{"count":7,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/posts\/29561\/revisions"}],"predecessor-version":[{"id":46129,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/posts\/29561\/revisions\/46129"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media\/29562"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=29561"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/categories?post=29561"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/tags?post=29561"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}