Ko te hanganga o nga pūhui, me nga momo matua o te pūtoto

mahi te pūnaha circulatory te mahi waka i roto i te tinana o te kararehe mahana te toto, tukua ki te kopa ki ngā matūkai me te hāora. whakamana Transport o te hāora, me te hauhā e i roto i te kuao kau toto whero, e ngā te taonga nui - pūtoto. I roto i tēnei tuhinga ka titiro tatou ki nga momo me te pūtoto pūhui.

He aha te pūtoto

Pūtoto - he wāhanga ngeniwhero, no ki te rōpū o te pūmua. Kei a ia ko 96% mea proteinaceous globin me 4% o te rauemi ki te ngota o 2-valent rino - heme. I roto i tetahi o ona pūtau ngeniwhero kei pā ana ki 280 miriona rāpoi e hanga he tae whero toto.

Ko te taonga matua o te pūtoto - rino ko te kaha ki te tāpiri gasses ka piri, hanga he hāora neke i te pūkahukahu ki te kopa, me te hauhā i te kopa ki te pūkahukahu. Ko te kupu, tona tūranga i roto i te tukanga o te utu hau i roto i te tinana he mahuinga ia.

Hanganga me ngā momo o te pūtoto tangata

I ngā wāhanga rerekē o te whanaketanga o te hanganga tinana tangata o te pūtoto he rerekē i roto i te hanganga o nga mekameka polypeptide. I runga anō i te aha te huru o mekameka polypeptide kei roto ngā momo hanganga pūtoto o pūtoto tangata e whai ake:

1. kitea pūtoto Pakeke (HbA) i roto i te nui tino (e pā ana ki 98-99% o te tapeke i roto i te toto) i roto i ngā pakeke. HbA 2 me ngā o mekameka polypeptide rua. I roto i ia o te waikawa amino kei te helices wāhanga heme ki te ngota kawenga mo te marena ki te rāpoi ngota hāora. HbA kua he kaha raro mo te hāora atu te hunaonga ki a ētahi atu momo o te pūtoto, engari i te wa ano ko reira atu ātete ki rerekē pH me te t.
2. Fetal (HbF) synthesized te i roto i te kukune tonu i roto i te kopu, tīmata ki 6-7 wiki o te hapūtanga , aru e tona whakauru i runga i HbA. Kua pōturi 1 marama o te ora iho te kōtuitui o HbF, te tapeke rōrahi o piki toto, me te intensifies te kōtuitui o HbA, e hoki e toru tau i roto i te ora o te tamaiti mai ki te ōrau o te hanganga o te toto o te pakeke. pūtoto fetal i mekameka globin pakeke o hanganga rerekē, he hakari hei utu o te momo mekameka tōrino. HbF, he mea whakarite ki HbA, kua he tohu raro o te ātete ki huringa i roto i te toto pH me ngā rerekētanga i te pāmahana te tinana.
3. Embryonic (HbE). hua te Paraimere ahua romahā o te pūmua kei roto i te ira i mua i te hanganga o te ewe (kua i roto i te wiki tuatahi o te hapūtanga) me pumau 6-7 wiki. huru no te hanganga e te mekameka, me te z-momo.

momo pathological o pūtoto

I roto i ētahi wā awe e hē ira puta rerekē pūtau pūtoto kōtuitanga. He rerekē i te hanganga whaiaroaro o here polypeptide, ranei, kaua, ratou irakētanga momo pathological o pūtoto.

Ka rite ki te hua, ngā irakētanga DNA kete kore e wāhanga ngeniwhero waikawa amino glutamic me valine. arata'i tenei "HR" whakauru ki te hanganga o te hanganga pūmua-rite 2 ki te "tāpiapia" wahi mata ahei o te tautapa enei hanganga ratou. Ko te kupu, puta te polymerization HbS-rāpoi, me te, rite ki te hua, waipara o erythrocytes taimaha, me te painga kawea i roto i te oko toto. huaina ana tēnei ine ko "anemia pūtau toronaihi".

Tikanga o te tiaki o te pūtoto i roto i te tangata

Ko te ihirangi o te pūmua o ngā hanganga romahā i te toto o te iwi kia rerekē rite ki te ira tangata, rōpū pakeke, āhua noho, me etahi atu āhuatanga, pērā i te hapūtanga.

uara Normal o pūtoto toto, e kore e whakaaro ine pathological:

• Ko te tangata - 130-150 g / l.
• Women - 120-140 g / l.
• Tamariki i raro i tetahi tau o 100-140 g / l, me i te marama tuatahi, ka taea e enei uara tae ake ki te 220 g / l tika ki te nui haere kukū o te pūtoto fetal. Hoki ngā tamariki i te tau kotahi ki te ono tau - 110-145 g / l, me ki 6 tau o te ora - 115-150 g / l, ahakoa o te sex o te tamaiti.
• I roto i te hapūtanga, te hekenga i roto i HbA kukū ki te 110 g / l, e kore Heoi e whakaaro anemic.
• iwi pakeke Ko te täkupu au whakararo o 5 wae i te paerewa kī, i runga i te takoto o te manawanui rānei.

E ai ki te tohu tau he rerekē me te toto kei roto wā kotahi rerekē momo o pūtoto. Hei tauira, i roto i te pakeke ōwehenga tūturu tangata ko 99% HbA me ki runga ki te 1% HbF. Tamariki ki runga ki te ōrau o HbF he nui ki runga ake i roto i ngā pakeke, e tika ana ki te mimiti āta o te puka te tīmatanga wātea o te pūtoto fetal.

puka whaiaroaro

Mai tonu wāhi te ngarahu romahā whero i roto i ngā tukanga utu hau i roto i te tinana, tona āhuatanga matua ko te kaha ki te hanga i pūhui ki ngā rāpoi ngota o ngā hau. Ka rite ki te hua o taua tauhohe he momo whaiaroaro o te pūtoto, whakaaro nei te noa.

• Oxyhemoglobin (Hb) - pūhui ki te rāpoi ngota hāora. Puta ana te tukanga i roto i te wahi romahā, i roto i nga alveoli o te pūkahukahu. E poke oxygenated corpuscles toto whero i roto i te tae whero, e kiia nei ko te matua me te neke i te pūkahukahu ki te kopa, haamaitai ratou ki te hāora e tika ana mō te tukanga pitihāoratanga.
• Deoxyhemoglobin (HbH) - heke pūtoto i hanga te ina hoatu e nga corpuscles whero te kopa hāora, engari tonu kihai i whakahaere ki te tango atu i a ratou te hauhā.
• Carboxyhemoglobin (Hb) i hanga i roto i werohia o te hauhā i te kopa, me te tango i reira ki te marama, whakaoti i te tukanga o te respiration tangata. Carboxyhemoglobin homai toto venous tae pouri - MAORI.

hononga rerekē

Ka taea te hono ngā pūtau toto whero e kore anake ki te haurehu whai wāhi i roto i te tukanga manawa, engari ano hoki i ētahi atu momo o te ahua rerekē o te pūtoto e e mōrearea ana ki te hauora o te tangata, me te ara ki te ora. Ēnei pūhui i te iti o te tiango, Heoi arahi ki kiko hypoxia, me maumaui nui o te tukanga romahā.

• Karbgemoglobin (HbCO) - pūhui tino mōrearea i roto i te toto tangata i muri i ngongoa te waro haukura. Poraka te kaha o ngā pūtau toto whero ki te kawe hāora ki te kopa. Ahakoa he kukū iti o te haukino i te rangi o te 0,07% e taea arahi ki te mate.
• Methemoglobin (HbMet) i hanga e pau pūhui nitrobenzene, tauira o nei he resins memeka, whakarewa, ethers, cellulose, whānui e hāngai ana i roto i te ahumahi pueru. Pūhau i roto i te pāhekoheko ki pūtoto roto i roto i te heme tahuri te 2-valent rino i roto i te-valent 3, e arata'i hoki ki hypoxia.

tātaritanga o te pūtoto

I roto i te tikanga ki te tautuhi i te kukū o globin hanganga romahā i roto i te toto tangata e kawea atu e rua momo kounga, me te ine o assays. Kei te uiui e hoki pūtoto mo te nui o te ihirangi roto reira o katote rino.

Ko te tikanga ine matua mō te whakatau i te kukū o te pūtoto he i tenei ra i te anga matou colorimetric. Ko reira he ako o te waiwai tae o te rauemi koiora mā te tāpiri taua te kaiwhakahohe motuhake.

tikanga kounga ngā tātari i runga i te ihirangi nga momo pā ana HbA a HbF roto reira toto. He he ano hoki te tātaritanga kounga pā ana ine rahinga o te toto glycated rāpoi pūtoto (pūhui ki waro) - he tikanga e whakamahia ana ki te tātari mate huka.

Ine i te kukū pūtoto noa

kia rerekē Balance HbA e rua i raro me runga ake te täkupu. I roto i tetahi take, arata'i tenei ki hopearaa kino. A, no te reira he he heke i roto i HbA syndrome pathological i raro te täkupu, i huaina nei ko "anemia hē rino". Ua faaite te reira i lethargy, kore o te pūngao, te kore o te aro. Pēhia pā te pūnaha io, ko ngā mōrearea i roto i ngā tamariki, he maha rite te take o takaroa i roto i te whanaketanga psycho-nekeneke.

e kore te mea he mate motuhake pūtoto nui haere, kaua, he mea he syndrome tohu o pathologies ngā pērā i te mate huka, kore pūkahukahu, mate ngakau, mate tākihi, waikawa folic ranei te maha atu o B huaora, mate pukupuku me etahi atu.