Javascript ndiyoyimitsidwa pa msakatuli wanu pano.Javascript ikayimitsidwa, zina zatsambali sizipezeka.
Lembetsani zambiri zanu ndi mankhwala omwe mukufuna, tidzafanana ndi zomwe mumapereka ndi zolemba patsamba lathu lalikulu, ndipo nthawi yomweyo titumizireni kopi ya PDF kwa inu.
Kuperewera kwa magazi m'thupi mwa akulu omwe ali ndi matenda ashuga omwe amapita kuchipatala chakum'mawa kwa Ethiopia: kafukufuku wam'mbali
Teshome Tujuba, 1 Behailu Hawulte Ayele, 2 Sagni Girma Fage, 3 Fitsum Weldegebreal41, Medical Laboratory, Guelmsau General Hospital, Guelmsau City, Ethiopia 2 School of Public Health, Faculty of Health and Medicine, Haramaya University, Harala State, Ethiopia; 3 School of Nursing and Midwifery, Faculty of Health and Medicine, Haramaya University, Ethiopia; 4 Faculty of Health and Medicine, Haramaya University, Harar City, Ethiopia News Agency: Sagni Girma Fage, Faculty of Health and Medical Sciences, Haral University, Ethiopia, Harar, Ethiopia POBox 235 Email giruu06@gmail.com Background: Although anemia is a common disease among diabetic patients, there is very little evidence of anemia in this part of the population in Ethiopia, especially in the research environment. Therefore, the purpose of this study was to evaluate the degree of anemia and related factors in adult diabetic patients treated in a general hospital in eastern Ethiopia. Methods: A cross-sectional study of health basics was conducted on 325 randomly selected adult diabetic patients. Follow-up clinic at the Gramsoe General Hospital in eastern Ethiopia. Use pre-tested structured questionnaires to collect data through interviews and then perform physical and laboratory measurements. Then enter the data into EpiData version 3.1, and use STATA version 16.0 for analysis. Fit a binary logistic regression model to identify factors related to anemia. When p-value<0.05, all statistical tests are declared significant. Results: The degree of anemia in adult diabetic patients was 30.2% (95% confidence interval (CI): 25.4%-35.4%). Men (36%) have higher anemia than women (20.5%). Male (adjusted odds ratio (AOR) = 2.1, 95% CI: 1.2, 3.8), DM ≥ 5 years (AOR = 1.9, 95% CI: 1.0, 3.7), comorbidities (AOR = 1.9, 95) %CI : 1.0, 3.7) and suffering from diabetic complications (AOR = 2.3, 95% CI: 1.3, 4.2) were significantly associated with anemia. Conclusion: Anemia is a moderate to moderate public health problem among adult DM patients in the study subjects. Male gender, the duration of DM, the presence of DM complications, and DM comorbidities are factors related to anemia. Therefore, routine screening and appropriate management should be designed for men, DM patients with long DM duration, and anemia patients with complications and comorbidities, so as to improve the quality of life of patients. Early diagnosis and regular monitoring of diabetes may also help minimize complications. Keywords: Anemia, Diabetes, General Hospital, Eastern Ethiopia
Kuchepa kwa magazi m'thupi kumatanthauza kuchepa kwa chiwerengero cha maselo ofiira a magazi (RBC) ndi / kapena kuchepa kwa mphamvu yonyamula mpweya chifukwa cha zotsatira zake, zomwe sizikwanira kukwaniritsa zosowa za thupi la munthu.1,2 Zimakhudza mayiko omwe akutukuka ndi otukuka, chifukwa cha thanzi la anthu, chitukuko cha anthu ndi zachuma.3 Pali anthu pafupifupi 1.62 biliyoni omwe ali ndi vuto la kuchepa kwa magazi padziko lonse lapansi, omwe ndi 24.8% ya anthu padziko lonse lapansi.4
Matenda a shuga mellitus (DM) ndi matenda a kagayidwe kachakudya, omwe amagawidwa kukhala mtundu wa I_wachichepere kapena wodalira insulin komanso mtundu II_wopanda insulini.5 Kwa odwala matenda a shuga, kuchepa kwa magazi m'thupi kumachitika makamaka chifukwa cha kutupa, mankhwala osokoneza bongo, kuperewera kwa zakudya, matenda a impso, matenda a autoimmune, 6,7 kuchepa kwa erythropoietin kupanga, kusowa kwathunthu kapena kugwira ntchito kwachitsulo, ndi kupulumuka kwa maselo ofiira a magazi kumafupikitsa.8,9 Choncho, kuchepa kwa magazi m'thupi kumakhala kofala kwa odwala matenda a shuga.10,11 Akuluakulu, kuchuluka kwa magazi m'thupi ndi 24% mwa amayi azaka zakubadwa (zaka 15-49) ndi 15% mwa amuna azaka 15-49.12
Odwala omwe ali ndi DM, makamaka omwe ali ndi matenda a impso odziwika bwino kapena kulephera kwaimpso, kuchuluka kwa kuchepa kwa magazi m'thupi kumakhala pafupifupi 2 mpaka 3 kuposa kwa odwala omwe alibe DM.13,14 Kuperewera kwa magazi m'thupi ndi matenda a shuga, monga nephropathy, retinopathy, neuropathy, machiritso osauka a mabala, ndi matenda a macrovascular [15,16], amakhudza kwambiri moyo wa odwala.17-19 Ngakhale zili choncho, malipoti a kafukufuku amasonyeza kuti pafupifupi 25% ya odwala matenda a shuga sangathe kuzindikira kuchepa kwa magazi m'thupi.20,21
Kuzindikira koyambirira ndi chithandizo cha kuchepa kwa magazi m'thupi mwa odwala DM kungathandize kuchepetsa kudwala komanso kufa, komanso kuwongolera moyo wawo.22 Komabe, ponseponse, kuwunika kwa kuchepa kwa magazi m'thupi mwa odwala matenda a shuga ku Ethiopia ndikotsika kwambiri, ndipo mpaka pano, palibe kafukufuku wofunikira.Izi ndi zoona makamaka m'dera lophunzirira.Choncho, phunziroli likufuna kuyerekezera kuchuluka kwa kuchepa kwa magazi m'thupi mwa odwala matenda a shuga ku Gramsoe General Hospital kum'mawa kwa Ethiopia ndikuwona zomwe zikugwirizana nazo.
Kafukufukuyu adachitika ku Glymso General Hospital (GGH) yomwe ili ku Glymso Town, Habro District, Oromiya State, Eastern Ethiopia.Chipatalachi chili pamtunda wa makilomita pafupifupi 390 kum’mawa kwa Addis Ababa, likulu la dziko la Ethiopia.23 Malinga ndi lipoti la Habro Woreda Health Office, GGH ndi malo otumizira anthu pafupifupi 1.4 miliyoni m'madera ozungulira.Amapereka chithandizo chamankhwala kwa odwala oposa 90,000 m'madipatimenti ake osiyanasiyana ndi zipatala chaka chilichonse.Chipatala cha Diabetes ndi amodzi mwa akatswiri omwe amapereka chithandizo kwa odwala pafupifupi 660 odwala matenda ashuga.Chigawo cha Habro chili pamtunda wa 1800-2000 mamita.
Kafukufuku wokhudzana ndi chipatala adachitika kuyambira pa Juni 9, 2020 mpaka pa Ogasiti 10, 2020. Oyenerera ndi achikulire (≥18 zaka) odwala matenda ashuga omwe amatsatiridwa ku GGH.Akuluakulu odwala matenda a shuga omwe adalandira magazi m'miyezi itatu yapitayi, odwala omwe ali ndi pakati kapena obadwa kumene kapena akudwala matenda amisala, odwala omwe adachitidwa opaleshoni kapena kutuluka magazi pazifukwa zilizonse, komanso odwala omwe adalandira chithandizo chamankhwala am'mimba. .Phunzirani.
Kukula kwachitsanzo kunatsimikiziridwa pogwiritsa ntchito chiŵerengero chimodzi cha chiwerengero cha anthu komanso malinga ndi malingaliro otsatirawa: 95% nthawi yodalirika, 5% yolakwika, ndi kuchepa kwa magazi kwa odwala matenda a shuga kuchokera ku Dessie Referral Hospital ku Northeast Ethiopia (p = 26.7) %).24 Pambuyo powonjezera 10% kwa omwe sanayankhe, kukula kwachitsanzo komaliza ndi 331.
Odwala 660 odwala matenda ashuga adatsatiridwa mwachangu kuchipatala cha matenda ashuga ku GGH.Gawani chiwerengero chonse cha odwala matenda a shuga (660) ndi kukula kwachitsanzo komaliza (331) kuti mupeze magawo awiri otsatirira.Pogwiritsa ntchito kaundula wa odwala omwe ali ndi matenda a shuga omwe amalandila chithandizo chotsata matenda a shuga m'chipatala ngati sampuli, tidagwiritsa ntchito njira yotsatsira mwachisawawa kuti aphatikize odwala ena onse mu kafukufukuyu.Perekani aliyense wochita nawo kafukufuku nambala yake yapadera kuti apewe kubwereza, ngati wodwala yemweyo angabwerenso panthawi ya kafukufuku kuti akatsatirenso.
Sungani zambiri pamitundu yosiyanasiyana ya chikhalidwe cha anthu, kumwa mowa, kusuta, ndi zakudya zomwe mumadya pogwiritsa ntchito mafunso okonzedwa bwino omwe asinthidwa kuchokera ku ndondomeko ya ndondomeko ya WHO yowunikira matenda aakulu.25 Kumwa tiyi ndi khofi, kugwiritsa ntchito paipi yamadzi, mafunso otafuna a Carter, kugwiritsa ntchito njira zolerera, ndi mbiri ya kusamba zinapezedwa popenda mabuku osiyanasiyana.Mafunso a 26-30 adalembedwa m'Chingerezi ndikumasuliridwa m'chilankhulo cha komweko (Afaan Oromoo), kenako adamasuliridwanso ku Chingerezi ndi akatswiri azilankhulo zosiyanasiyana kuti awone kusasinthika.Pezani zambiri zachipatala monga nthawi ya matenda a shuga, mtundu wa shuga, zovuta za matenda a shuga, ndi kusala kudya kwa glycemia kuchokera m'mabuku achipatala a wodwalayo.Detayo inasonkhanitsidwa ndi anamwino awiri ogwira ntchito ndi katswiri wa labotale, ndipo amayang'aniridwa ndi katswiri wa maphunziro a zaumoyo.
Yezerani kuthamanga kwa magazi (BP) pogwiritsa ntchito mita ya kuthamanga kwa magazi (Heuer) yomwe imatsimikiziridwa pafupipafupi.Asanayeze kuthamanga kwa magazi, munthuyu anali asanamwe zakumwa zotentha, monga tiyi, khofi kapena fodya wosuta, Chenjera wotafuna, kapena kuchita masewera olimbitsa thupi amphamvu mphindi 30 zapitazi.Nkhaniyo itapumula kwa mphindi zosachepera zisanu ndikulemba kuchuluka kwa BP, miyeso itatu yodziyimira payokha idatengedwa kudzanja lamanzere.Miyezo yachiwiri ndi yachitatu idatengedwa mphindi zisanu ndi khumi pambuyo pa miyeso yoyamba ndi yachiwiri, motsatana.Kuthamanga kwa magazi kumatanthauzidwa ngati odwala omwe ali ndi BP yokwera (SBP≥140 kapena DBP≥90mmHg) kapena omwe adadziwika kale kuti akumwa mankhwala osokoneza bongo.31,32
Kuti tidziwe momwe zakudya zilili kudzera mu index mass index (BMI), tinayeza kutalika ndi kulemera kwa wodwalayo.Wophunzira aliyense akaima molunjika pakhoma, zidendene zawo zinkagwira khoma pamodzi, osavala nsapato, kukweza mitu yawo, ndikuyesa kutalika kwake ndi chowongolera ndikulemba pafupi masentimita 0.1.Gwiritsani ntchito sikelo ya digito yolembedwa 0-130 kg kuti muyese kulemera kwanu.Musanayambe muyeso uliwonse, yesani sikelo kukhala ziro.Yezerani kulemera kwa wophunzirayo atavala zovala zopepuka komanso opanda nsapato, ndipo lembani zapafupi kwambiri 0.1 kg.33,34 Body mass index (BMI) imawerengedwa pogawa kulemera kwa thupi (kg) ndi kutalika (m).Ndiye chikhalidwe cha zakudya chimatanthauzidwa ngati: ngati BMI <18.5, kuchepa;ngati BMI = 18.5-24.9, kuchepa;ngati BMI = 25-29.9, onenepa;ngati BMI ≥30.35,36, kunenepa kwambiri
Pafupi pakati pa m'mphepete mwa pansi pa nthiti zomveka ndi pamwamba pa mapeto, gwiritsani ntchito tepi wosasunthika kuti muyese kuzungulira kwa chiuno ndikulembera pafupi ndi 0.1 cm.Kunenepa kwapakati kumatanthawuza kuti chiuno chozungulira chiwongolero cha amuna ≥ 94 cm, ndi chiuno chozungulira cha akazi ≥ 80 cm.30,36 Panthawi yophunzitsidwa, odwala 10 achikulire omwe ali ndi matenda a shuga adakumana ndi zolakwika zaukadaulo (%TEM) kuti achepetse zolakwika zoyezera mwachisawawa za anthropometric.Zolakwika zozindikirika za muyeso waukadaulo mkati ndi pakati pa owonera ndizochepera 1.5% ndi zosakwana 2%, motsatana.
Akatswiri a mu Laboratory anatenga pafupifupi mamililita awiri (2 mL) a magazi kuchokera kwa onse omwe anali nawo ndikuwayika mu chubu choyesera chomwe chili ndi tripotassium ethylenediaminetetraacetic acid (EDTA K3) anticoagulant kuti adziwe hemoglobini.Sakanizani bwino magazi athunthu ndikugwiritsa ntchito Sysmex XN-550 hematology analyzer kuti muwunike.Kuyeza kwa hemoglobini kunasinthidwa mwa kuchepetsa kutalika kwa otenga nawo mbali onse mwa kuchotsa 0.8 g/dl ndi kusuta fodya pochotsa 0.03 g/dl.Kenako fotokozani kuchepa kwa magazi m'thupi ngati mulingo wa hemoglobin yachikazi <12g/dl ndi wamwamuna <13g/dl.Kuopsa kwa kuchepa kwa magazi m'thupi kumagawidwa motere: hemoglobini ya amuna ndi akazi ndi 11-12.9 g/dl ndi 11-11.9 g/dl, motero, omwe ndi ochepa magazi m'thupi, pamene hemoglobini ya hemoglobin yochepetsetsa ndi yoopsa kwambiri ndi 8-10.9 g/dl, motsatira dl ndi <8 mg/dl.Mwamuna ndi mkazi
Sungani mamililita asanu (5 mL) a magazi a venous mu chubu choyesera popanda anticoagulant kuti mudziwe creatinine ndi urea.Magazi onse opanda anticoagulant amaundana kwa mphindi 20-30 ndikukhazikika pa 3000 rpm kwa mphindi zisanu kuti alekanitse seramu.Kenako, Mindray BS-200E (China Mindray Biomedical Electronics Co., Ltd.) chemistry analyzer idagwiritsidwa ntchito kudziwa seramu creatinine ndi urea zili ndi asidi picrine ndi njira enzymatic.37 Gwiritsani ntchito creatinine clearance rate kuti muyerekeze kusefera kwa glomerular.Gwiritsani ntchito Chronic Kidney Disease (CKD) Ratio (GFR), yofotokozedwa ngati CKD-EPI Cockroft-Gault formula yosonyezedwa pa 1.73 square metres.
Kusala kudya kwa shuga m'magazi (osachepera maola 8) amayezedwa ndi zolozera zala pogwiritsa ntchito glucometer yoyesedwa magazi.38 Ngati mulingo wa shuga m'magazi osala kudya ndi wochepera 80 kapena> 130 mg/dl, ndiye kuti chizindikirocho ndi chowongolera mosasamala.Kuwongolera ngati kuchuluka kwa shuga m'magazi kusala pakati pa 80-130mg/dl 39
Ophunzirawo anapatsidwa ndodo yathabwa yaukhondo ndi kapu yapulasitiki yoyera, youma, yosaduka yokhala ndi nambala ya serial ya munthu amene wafunsidwayo kuti aonere tizirombo ta ndowe.Auzeni kuti abweretse chopondapo chatsopano cha magalamu awiri (pafupifupi kukula kwa chala chachikulu).Pambuyo pozindikira nyongolotsi (mazira ndi/kapena mphutsi) pogwiritsa ntchito njira zowotchera monyowa, zitsanzozo zidawunikidwa mkati mwa mphindi 30 za kusonkhanitsa zitsanzo.Zitsanzo zotsalazo zinasungidwa mu chubu choyesera chomwe chili ndi 10 mL ya 10% formalin kuti apititse patsogolo kuchuluka kwa tizilombo toyambitsa matenda, ndipo pambuyo pa chithandizo ndi teknoloji ya ndende ya formalin-ether precipitation, Olympus Microscope inagwiritsidwa ntchito poyang'ana.
Gwiritsani ntchito lanceti wosabala kuti mutenge magazi a capillary kuchokera ku zala kuti muzindikire malungo.Konzani filimu yopyapyala yamagazi pagalasi loyera lopanda mafuta, kenako ndi mpweya wouma.Zithunzizo zidadetsedwa ndi 10% Giemsa kwa mphindi pafupifupi 10, ndipo mitundu ya tizilombo ta malungo idawunikidwa.Pamene madera 100 amphamvu kwambiri adawunikiridwa ndi cholinga chomiza mafuta, slideyo idawonedwa kuti ndi yoipa.40
Maphunziro a masiku awiri okhudza zida ndi njira zosonkhanitsira deta adaperekedwa kwa osonkhanitsa ndi oyang'anira.Chipatala chachikulu cha Chiro chisanayambe kusonkhanitsa deta yeniyeni ya odwala matenda a shuga a 30, mafunsowa adayesedwa kale ndipo zofunikira zinasinthidwa moyenerera.Muyezo wakuthupi umakhazikitsidwa ndi cholakwika chaukadaulo cha muyeso (%TEM).Kuphatikiza apo, njira zoyendetsera ntchito zimatsatiridwa m'mabungwe onse osonkhanitsa zitsanzo za labotale, kusungirako, kusanthula ndi kujambula.
Chilolezo cha zamakhalidwe abwino chapezedwa kuchokera ku Institutional Health Research Ethics Review Committee (IHRERC) ya sukulu yakale ya Health and Medicine ya Am Valley University (IHRERC 115/2020).Koleji yapereka kalata yothandizira GGH ndikupeza chilolezo kuchokera kwa mkulu wa chipatala.Musanasonkhanitse deta, pezani chilolezo chodziwitsidwa, mwakufuna kwanu, cholembedwa ndi kusaina kuchokera kwa aliyense wochita nawo kafukufuku.Ophunzirawo adauzidwa kuti zonse zomwe zasonkhanitsidwa kuchokera kwa iwo zidzasungidwa mwachinsinsi pogwiritsa ntchito zizindikiro, ndipo palibe zidziwitso zaumwini zomwe zidzagwiritsidwe ntchito, ndipo zidzagwiritsidwa ntchito pazofufuza zokha.Kafukufukuyu adachitika mogwirizana ndi "Declaration of Helsinki".
Onani kukhulupirika kwa zomwe zasonkhanitsidwa, sungani ndikulowetsa EpiData mtundu 3.1, ndiyeno tumizani ku STATA mtundu 16.0 kuti muzitha kuyang'anira ndi kusanthula deta.Gwiritsani ntchito maperesenti, kuchuluka, ma avareji, ndi masinthidwe okhazikika pofotokoza za data.Pambuyo pokonza mlingo wa hemoglobini molingana ndi momwe anthu amasuta fodya komanso kutalika kwa derali, kuchepa kwa magazi m'thupi kunatsimikiziridwa motsatira ndondomeko yatsopano ya WHO.Gwiritsirani ntchito mitundu iwiri yosinthira mayendedwe kuti muzindikire zosinthika pakuwunika komaliza kwa multivariate logistic regression.Mu bivariate logistic regression, zosinthika zokhala ndi p-value ≤ 0.25 zimawonedwa ngati ofuna kuwongolera zinthu zambiri.Khazikitsani ma multivariate logistic regression model kuti mudziwe zinthu zomwe sizikugwirizana ndi kuchepa kwa magazi m'thupi.Gwiritsani ntchito chiŵerengero cha odds ndi 95% nthawi yodalirika kuti muyese mphamvu ya mayanjano.Mulingo wofunikira wa ziwerengero adalengezedwa ngati p-value <0.05.
Mu kafukufukuyu, odwala 325 achikulire a DM adatenga nawo gawo pamsonkhano, ndipo omwe adayankha anali 98.2%.Ambiri mwa omwe akutenga nawo mbali;amuna ochokera kumidzi ndi 203 (62.5%), 247 (76%), 204 (62.8%) ndi 279 (85.5%) ndi amuna okwatira, ndipo mtundu wawo ndi Oromo.Zaka zapakati za omwe adatenga nawo gawo zinali zaka 40, ndipo interquartile range (IQR) inali zaka 20.Pafupifupi 62% ya omwe adatenga nawo gawo sanaphunzirepo, ndipo 52.6% mwa omwe adatenga nawo gawo ndi alimi odziwa ntchito (Table 1).
Table 1 Makhalidwe a chikhalidwe cha anthu achikulire a DM odwala omwe amathandizidwa kuchipatala chakum'mawa kwa Ethiopia mu 2020 (N = 325)
Mwa omwe adachita nawo kafukufukuyu, 74 (22.8%) adanenanso kuti adasuta kamodzi m'miyoyo yawo, poyerekeza ndi 13 omwe amasuta pano (4%).Kuphatikiza apo, anthu 12 (3.7%) ndi omwe amamwa panopa, ndipo 64.3% mwa omwe adachita nawo kafukufukuyu ndi tiyi wakuda.Oposa gawo limodzi mwa magawo atatu (68.3%) omwe adachita nawo kafukufuku adanenanso kuti amamwa khofi nthawi zonse akatha kudya.Otsatira zana limodzi ndi makumi atatu ndi atatu (96.3%) ndi 310 (95.4%) adadya zipatso ndi ndiwo zamasamba zosakwana kasanu pa sabata.Ponena za zakudya zawo, 92 (28.3%) ndi 164 (50.5%) omwe anali nawo anali olemera kwambiri komanso olemera kwambiri (Table 2).
Table 2 Makhalidwe ndi kadyedwe ka odwala achikulire a DM omwe amathandizidwa ku Eastern Ethiopia General Hospital mu 2020 (N = 325)
Odwala oposa 170 (52.3%) omwe ali ndi mtundu wa II DM anali ndi nthawi ya DM ya zaka 4.5 (SD ± 4.0).Pafupifupi 50% ya odwala omwe ali ndi DM akumwa mankhwala a hypoglycemic (glibenclamide ndi/kapena metformin), ndipo pafupifupi magawo atatu mwa atatu mwa omwe adachita nawo kafukufukuyu amakhala ndi shuga wosalamulirika wamagazi (Table 3).Ponena za comorbidities, 2% ya omwe anali nawo anali ndi comorbidities.Odwala 80 (24.6%) ndi 173 (53.2%) omwe ali ndi DM opanda matenda oopsa anali kuchepa kwa magazi m'thupi komanso opanda magazi m'thupi motsatira.Komano, pakati pa odwala DM omwe adapezeka ndi matenda oopsa, 189 (5.5%) ndi 54 (16.6%) anali kuchepa kwa magazi m'thupi.
Table 3 Makhalidwe azachipatala a odwala akuluakulu a DM omwe amathandizidwa kuchipatala chakum'mawa kwa Ethiopia mu 2020 (N = 325)
Mlingo wa kuchepa kwa magazi m'thupi mwa odwala matenda a shuga ndi 30.2% (95% CI: 25.4-35.4%), ndipo mlingo wa hemoglobini ndi 13.2±2.3g/dl (amuna: 13.4±2.3g/dl, akazi: 12.9±1.7g/ dl).Ponena za kuopsa kwa kuchepa kwa magazi m'thupi mwa odwala DM omwe ali ndi magazi m'thupi, panali milandu 64 ya kuchepa kwa magazi m'thupi (65.3%), milandu 26 ya kuchepa kwa magazi m'thupi (26.5%), ndi 8 milandu ya kuchepa kwa magazi (8.2%).Kuperewera kwa magazi m'thupi mwa amuna (36.0%) kunali kwakukulu kwambiri kuposa akazi (20.5%) (p = 0.003) (Chithunzi 1).Tidapeza kulumikizana kwakukulu pakati pa kuopsa kwa kuchepa kwa magazi m'thupi ndi nthawi ya matenda ashuga (r = 0.1556, p = 0.0049).Izi zikutanthauza kuti pamene nthawi ya DM ikuwonjezeka, kuopsa kwa magazi m'thupi kumawonjezeka.
Chithunzi 1 Mlingo wa kuchepa kwa magazi m'thupi mwa amuna ndi akazi mwa odwala akuluakulu a DM omwe amathandizidwa kuchipatala chakum'mawa kwa Ethiopia mu 2020 (N = 325)
Pakati pa odwala DM, 64% ya amuna ndi 79.5% ya amayi alibe magazi m'thupi, pomwe 28.7% ndi 71.3% ya omwe amatafuna Khat pano ali ndi magazi.67% ya odwala DM akuluakulu omwe adagwiritsa ntchito khofi atatha kudya anali opanda magazi m'thupi, ndipo 32.9% ya iwo adapezeka kuti ali ndi magazi m'thupi.Ponena za kukhalapo kwa comorbidities, 72.2% ya odwala DM opanda comorbidities anali magazi m'thupi, ndipo 36.3% odwala DM comorbidities anali magazi m'thupi.Odwala matenda a shuga omwe ali ndi zovuta za DM anali ndi kuchepa kwa magazi m'thupi (47.4%) kuposa omwe alibe zovuta za DM (24.9%) (Table 4).
Table 4 Zinthu zokhudzana ndi kuchepa kwa magazi m'thupi mwa odwala akuluakulu a DM omwe amathandizidwa kuchipatala chakum'mawa kwa Ethiopia mu 2020 (N = 325)
Gwirizanitsani ma bivariate ndi ma multivariate logistic regression model kuti muwone mgwirizano pakati pa kuchepa kwa magazi m'thupi ndi mafotokozedwe osiyanasiyana.Mu kusanthula bivariate;zaka, jenda, m'banja, kutafuna Khat, khofi mutatha kudya, comorbidities, matenda a shuga, nthawi ya DM ndi chikhalidwe cha zakudya (BMI) zimagwirizana kwambiri ndi kuchepa kwa magazi m'thupi ndi p value <0.25, ndipo ndi Multivariate candidate logistic regression.
Pakuwunika kosinthika kwazinthu zambiri, amuna omwe ali ndi DM ≥ zaka 5 zautali, kupezeka kwa comorbidities ndi zovuta za DM zidalumikizidwa kwambiri ndi kuchepa kwa magazi.Amuna akuluakulu a DM odwala ali ndi mwayi wokwana 2.1 kudwala magazi m'thupi kusiyana ndi akazi (AOR = 2.1, 95% CI: 1.2, 3.8).Poyerekeza ndi odwala DM opanda comorbidities, odwala DM ndi comorbidities ndi 1.9 nthawi zambiri kukhala ndi magazi m'thupi (AOR = 1.9, 95% CI: 1.0, 3.7).Poyerekeza ndi odwala omwe ali ndi DM yazaka 1-5, odwala DM omwe ali ndi DM ≥ zaka 5 amakhala ndi mwayi wokhala ndi kuchepa kwa magazi m'thupi ka 1.8 (AOR = 1.8, 95% CI: 1.1, 3.3).Kuopsa kwa kuchepa kwa magazi m'thupi kwa odwala omwe ali ndi vuto la DM ndi 2.3 nthawi ya anzawo (AOR = 2.3, 95% CI: 1.3, 4.2) (Table 4).
Kafukufukuyu adawunikira kuopsa kwa kuchepa kwa magazi m'thupi komanso zinthu zina zokhudzana ndi odwala a DM omwe adatsatiridwa ndi matenda a shuga ku Gelemso General Hospital.Mlingo wa kuchepa kwa magazi m'maphunziro apano ndi 30.2%.Malinga ndi gulu la WHO la kufunikira kwaumoyo wa anthu, m'malo ochita kafukufuku, kuchepa kwa magazi m'thupi ndi vuto la thanzi la anthu achikulire omwe ali ndi DM.Jenda, nthawi ya DM, kukhalapo kwa zovuta za DM, ndi amuna omwe ali ndi DM comorbidities adadziwika ngati zinthu zokhudzana ndi kuchepa kwa magazi m'thupi.
Mlingo wa kuchepa kwa magazi m'thupi mu phunziroli ndi wofanana ndi wa chipatala cha Ethiopian Dessie Referral Hospital [24], koma chapamwamba kuposa cha Chipatala cha Fenote Selam cha Ethiopia [41] mu kafukufuku wamba wochitidwa ku China, 42 Australia, 43 ndi India [44] ]., Zomwe zili zochepa kuposa maphunziro omwe anachitika ku Thailand [45], Saudi Arabia [46] ndi Cameroon [47].Kusiyanaku kungakhale chifukwa cha kusiyana kwa zaka za anthu omwe amaphunzira.Mwachitsanzo, mosiyana ndi kafukufuku waposachedwa yemwe sanaphatikizepo achikulire azaka zopitilira 18, kafukufuku yemwe adachitika ku Thailand adaphatikiza akuluakulu azaka zopitilira 60, pomwe kafukufuku ku Cameroon adaphatikiza akuluakulu azaka zopitilira 50.Kusiyanaku kungakhalenso chifukwa cha kuchepa kwa ntchito ya impso, kutupa, kuponderezedwa kwa mafupa, ndi kusowa kwa zakudya m'thupi (kuwonjezeka ndi zaka)17.
Tikudabwa kuti mu phunziro lathu, kuchepa kwa magazi kwa amuna kumakhala kofala kwambiri kuposa akazi.Kupeza kumeneku kumatsutsana ndi malipoti ena ofufuza [42,48], momwe amayi amakhala ndi vuto la kuchepa kwa magazi m'thupi kusiyana ndi amuna omwe ali ndi matenda a shuga.Chifukwa chotheka cha kusiyana kumeneku kungakhale kuti amuna mu phunziro lathu anali ndi zizolowezi zapamwamba za Khat kutafuna, zomwe zingayambitse kusowa chilakolako49, ndipo Khat ili ndi tannins-chinthu chomwe chimachepetsa bioavailability wa non-heme iron mu zakudya.50 Chifukwa china n'chakuti amuna ambiri amamwa khofi ndi tiyi mu kafukufukuyu analepheretsa kuyamwa kwachitsulo m'matumbo.51-54
Tidapeza kuti odwala omwe ali ndi DM ≥ zaka 5 amakhala ndi mwayi wokhala ndi vuto la kuchepa kwa magazi m'thupi kuposa odwala omwe ali ndi zaka 1-5.Izi zikugwirizana ndi maphunziro omwe anachitika ku Fenote Selam Hospital ku Ethiopia, 41 Iraq 55 ndi United Kingdom.17 Izi zitha kukhala chifukwa chokumana ndi hyperglycemia kwa nthawi yayitali, zomwe zimapangitsa kuchuluka kwa ma cytokines otupa okhala ndi anti-erythropoietin zotsatira, zomwe zimapangitsa kuchepa kwa chiwerengerocho.Kuchepa kwa maselo ofiira a magazi kumabweretsa kuchepa kwa hemoglobin.35
Mogwirizana ndi maphunziro omwe anachitika ku China, 13 kuchepa kwa magazi m'thupi mu phunziroli kunali kofala kwambiri kwa odwala DM omwe ali ndi zovuta.Mwachilengedwe, zovuta za matenda a shuga zimatha kuwononga kwambiri maselo ndi mitsempha ya impso, kutupa kwadongosolo, komanso kulowetsedwa kwa erythropoietin release inhibitors kungayambitse matenda a shuga.56 Hypoxia ingakhudze kufotokozera kwa majini, kagayidwe kake, capillary permeability ndi moyo wa maselo 57. Kuchepetsa maselo ofiira a magazi ndi antioxidant katundu wokhudzana ndi kuchepa kwa magazi m'thupi kungayambitsenso mavuto ena kwa odwala matenda a shuga58.
Kuonjezera apo, odwala DM omwe ali ndi comorbidities amakhala osowa magazi m'thupi kusiyana ndi odwala DM opanda comorbidities.Izi zikufanana ndi maphunziro apitalo ofanana [35,59], omwe angakhale chifukwa cha zotsatira za comorbidities (monga kuthamanga kwa magazi) zomwe zimayambitsa matenda a mtima, motero kumawonjezera chiopsezo cha kuchepa kwa magazi m'thupi.60
Monga imodzi mwazofukufuku ochepa kwambiri opangidwa ndi labotale ku Ethiopia, matenda osachiritsika monga DM achulukirachulukira, zomwe ndi mphamvu ya kafukufukuyu.Kumbali ina, phunziroli ndi phunziro limodzi lochokera ku chipatala ndipo silingaimirire odwala onse omwe ali ndi DM kapena odwala omwe amatsatiridwa m'mabungwe ena azachipatala.Kuphatikizika kwa magawo a maphunziro omwe tidagwiritsa ntchito sikulola kukhazikitsidwa kwa ubale wanthawi yayitali pakati pa kuchepa kwa magazi ndi zinthu.Kafukufuku wamtsogolo angafunikire kugwiritsa ntchito zowongolera zochitika, maphunziro amagulu kapena mapangidwe ena ofufuza kuti aganizire zizindikiro za kuchepa kwa magazi m'thupi, mawonekedwe a RBC, iron iron, vitamini B12, ndi milingo ya folic acid.
M'malo ochita kafukufuku, kuchepa kwa magazi m'thupi ndi vuto la thanzi la anthu akuluakulu pakati pa odwala DM akuluakulu.Jenda, nthawi ya DM, kukhalapo kwa zovuta za DM, ndi matenda obwera chifukwa cha matenda anali amuna ndipo adadziwika ngati zinthu zokhudzana ndi kuchepa kwa magazi.Chifukwa chake, kuwunika kwanthawi zonse kwa kuchepa kwa magazi m'thupi komanso kasamalidwe koyenera kwa odwala a DM omwe ali ndi nthawi yayitali ya DM, zovuta komanso zovuta ziyenera kupangidwa kuti zipititse patsogolo moyo wa odwala.Kuzindikira msanga ndi kuwunika pafupipafupi kwa DM kungathandizenso kuchepetsa zovuta.
Deta yochirikiza zotsatira zomwe zafotokozedwa m'mipukutuyi zitha kupezeka kwa wolemba yemwe amagwirizana nazo malinga ndi zofunikira.
Tikufuna kuthokoza mkulu wa chipatala cha Gelemso General Hospital, ogwira ntchito ku chipatala cha Diabetes, ochita nawo maphunziro, osonkhanitsa deta ndi othandizira kafukufuku.
Olemba onse athandizira kwambiri ntchito ya lipotilo, kaya ndi lingaliro, kamangidwe ka kafukufuku, kachitidwe, kupeza deta, kufufuza ndi kutanthauzira, kapena m'zinthu zonsezi;adatenga nawo gawo pakukonza, kukonzanso kapena kuunikanso mozama kwa ndimeyi;potsiriza Anavomereza Baibulo kuti lifalitsidwe;adachita mgwirizano pamagazini yomwe nkhaniyo idatumizidwa;ndipo adagwirizana kuti aziyang'anira mbali zonse za ntchitoyo.
1. WHO.Mlingo wa hemoglobin umagwiritsidwa ntchito pozindikira komanso kuwunika kuopsa kwa kuchepa kwa magazi.Mavitamini ndi mineral information information system.Geneva, Switzerland.2011. NMH / NHD / MNM / 11.1.Ipezeka patsamba lotsatirali: http://www.who.int/entity/vmnis/indicators/haemoglobin.Adachezeredwa pa Januware 22, 2021.
2. Viteri F. Lingaliro latsopano la kuwongolera chitsulo: kudya kwa mlungu ndi mlungu kwa zitsulo zowonjezera, zowonjezera zodzitetezera kumudzi kwa magulu omwe ali pachiopsezo chachikulu.Biomedical Environmental Science.1998;11(1): 46-60.
3. Mehdi U, Toto RD.Kuperewera kwa magazi m'thupi, shuga komanso matenda a impso.Kusamalira matenda a shuga.2009;32(7):1320-1326.doi: 10.2337/dc08-0779
5. Johnson LJ, Gregory LC, Christenson RH, Harmening DM.Appleton ndi Lange mndandanda amawunikiranso zachipatala.New York: McGraw-Hill;2001.
6. Gulati M, AgrawalN.Kafukufuku wokhudza kuchuluka kwa kuchepa kwa magazi m'thupi mwa odwala omwe ali ndi matenda amtundu wa 2.Sch J App Med Science.2016;4 (5F): 1826-1829.
7. Cawood TJ, Buckley U, Murray A, etc. Kuchuluka kwa magazi m'thupi mwa odwala matenda a shuga.Ir J Med Sayansi.2006;175(2):25.doi: 10.1007 / BF03167944
8. Kuo IC, Lin-HY-H, Nu SW, etc. Glycated hemoglobin ndi matenda a odwala omwe ali ndi matenda aakulu a shuga a shuga.Woimira Sayansi.2016;6:20028.doi: 10.1038 / srep20028
9. Loutradis C, Skodra A, Georgianos P, etc. Matenda a shuga amachulukitsa kuchuluka kwa kuchepa kwa magazi m'thupi mwa odwala omwe ali ndi matenda aakulu a impso: phunziro loyang'anira zisa.Dziko J Nephrol.2016;5(4):358.doi: 10.5527 / wjn.v5.i4.358
10. Rajagopal L, Ganesan V, Abdullah S, Arunachalam S, Kathamuthu K, RamrajB.Kufufuza ubale womwe ulipo pakati pa ma electrolyte, kuchepa kwa magazi m'thupi, ndi milingo ya glycosylated hemoglobin (Hba1c) mwa odwala omwe ali ndi matenda amtundu wa 2.Kafukufuku wazachipatala waku Asia J.2018;11(1): 251–256.doi: 10.22159 / ajpcr.2018.v11i1.22533
11. Angelousi A, Major E. Anemia, chiopsezo chodziwika koma kawirikawiri chosadziwika kwa odwala matenda a shuga: kubwereza.Matenda a shuga a Metabolism 2015;41(1): 18-27.doi: 10.1016 / j.diabet.2014.06.001
12. Ethiopia CSA, ICF International Organization.Zomwe zapeza mu 2016 Ethiopian Demographic and Health Survey.Ethiopian Central Bureau of Statistics ndi ICF International.Addis Ababa, Ethiopia ndi Rockville, Maryland, USA;2017.
13. Iye BB, Xu M, Wei L, etc. Ubale pakati pa kuchepa kwa magazi m'thupi ndi mavuto aakulu kwa odwala achi China omwe ali ndi matenda a shuga a mtundu wa 2.The Great Arch of Iranian Medicine.2015;18(5): 277-283.
14. Wright J, Oddy M, RichardsT.Kukhalapo ndi zizindikiro za kuchepa kwa magazi m'magazi a zilonda zam'mimba.kuchepa kwa magazi m'thupi.2014;2014: 1-8.doi: 10.1155/2014/104214
15. Thambiah SC, Samsudin IN, George E, etc. Anemia ya mtundu wa 2 shuga (T2DM) mu chipatala cha Putrajaya.J Med Health Science, Malaysia.2015;11(1): 49-61.
16. Roman RM, Lobo PI, Taylor RP, etc. Kafukufuku woyembekezeredwa wa chitetezo chamthupi cha normalizing hemoglobin ndende mu hemodialysis odwala kulandira recombinant human erythropoietin.J Am Soc Nephrol.2004;15(5): 1339-1346.doi: 10.1097 / 01.ASN.0000125618.27422.C7
17. Trevest K, Treadway H, Hawkins-van DCG, Bailey C, Abdelhafiz AH.Kuchuluka ndi zomwe zimayambitsa kuchepa kwa magazi m'thupi mwa odwala okalamba omwe ali ndi matenda ashuga omwe amapita ku chipatala chakunja: kuwunika kwapakati.Matenda a shuga.2014;32 (4):158.doi: 10.2337 / diaclin.32.4.158
18. Thomas MC, Cooper ME, Rossing K, Parving HH.Diabetic Anemia: Kodi chithandizocho ndi choyenera?matenda a shuga.2006;49(6):1151.doi: 10.1007 / s00125-006-0215-6
19. New JP, Aung T, Baker PG, etc. Kuchuluka kwa kuchepa kwa magazi m'thupi mwa odwala omwe ali ndi matenda a shuga ndi matenda aakulu a impso ndipamwamba: kafukufuku wa anthu.Mankhwala a shuga.2008;25(5): 564-569.doi: 10.1111 / j.1464-5491.2008.02424.x
20. Bosman DR, Winkler AS, Marsden JT, Macdougall IC, Watkins PJ.Kuperewera kwa magazi m'thupi ndi erythropoietin kumatha kuchitika kumayambiriro kwa matenda ashuga nephropathy.Kusamalira matenda a shuga.2001;24(3): 495-499.doi: 10.2337 / diacare.24.3.495
21. McGill JB, Bell DS.Udindo wa kuchepa kwa magazi m'thupi ndi erythropoietin mu shuga.J Matenda a shuga.2006;20(4):262-272.doi: 10.1016 / j.jdiacomp.2005.08.001
22. Baisakhiya S, Garg P, Singh S. Anemia mu mtundu wa 2 odwala matenda a shuga omwe ali ndi matenda a shuga komanso opanda matenda a shuga.International Medical Science Public Health.2017;6(2): 303-306.doi: 10.5455/ijmsph.2017.03082016604
23. Wikipidia.Gelemso ili m'chigawo cha Oromia pa Juni 11, 2020. 2020 [tsiku lolozera ndi Okutobala 20, 2020].Ikupezeka pa ulalo wotsatirawu: https://en.wikipedia.org/wiki/Gelemso.Adachezeredwa pa Januware 22, 2021.
24. Fiseha T, Adamo A, Tesfaye M, Gebreweld A, Hirst JA.Kuchuluka kwa kuchepa kwa magazi m'zipatala za odwala matenda ashuga achikulire kumpoto chakum'mawa kwa Ethiopia.PLoS imodzi.2019;14(9): e0222111.doi: 10.1371/journal.pone.0222111
25. WHO.Njira yapang'onopang'ono ya WHO pakuwunika kowopsa kwa matenda osapatsirana ku Geneva, Switzerland: WHO;2017.
26. Aynalem SB, Zeleke AJ.Kuchuluka kwa matenda a shuga ndi zowopsa zake mwa anthu azaka zapakati pa 15 ndi kupitilira mu Mizan-Aman Township, Southwest Ethiopia, 2016: kafukufuku wam'mbali.Ndi endocrine.2018;2018: 2018. doi: 10.1155 / 2018/9317987
27. Seifu W. Gilgil Gibe Field Research Center, Southwestern Ethiopia, 2013. Kufalikira ndi zoopsa za matenda a shuga ndi kusokonezeka kwa kusala kudya kwa shuga kwa akuluakulu a zaka zapakati pa 15-64: njira yotsatizana.MOJ Public Health.2015;2 (5): 00035. doi: 10.15406 / mojph.2015.02.00035
28. Roba HS, Beyene AS, Mengesha MM, Ayele BH.Kuchuluka kwa matenda oopsa komanso zinthu zina zofananira ku Dire Dawa City, Eastern Ethiopia: kafukufuku wapagulu.Int J hypertension.2019;2019: 1-9.doi: 10.1155 / 2019/9878437
29. Tesfaye T, Shikur B, Shimels T, Firdu N. Pakati pa mamembala a Federal Police Commission omwe amakhala ku Addis Ababa, Ethiopia, kufalikira ndi zinthu zokhudzana ndi matenda a shuga komanso kuchepetsa kusala kudya kwa shuga m'magazi.BMC Endocr yasokonezeka.2016;16 (1): 68. doi: 10.1186 / s12902-016-0150-6
30. Abebe SM, Berhane Y, Worku A, Getachew A, LiY.Kuchuluka kwa matenda oopsa komanso zinthu zina zofananira: kafukufuku wokhudza mbiri ya anthu kumpoto chakumadzulo kwa Ethiopia.PLoS imodzi.2015;10(4): e0125210.doi: 10.1371/journal.pone.0125210
31. Kearney PM, Whelton M, Reynold K, Muntner P, Whelton PK, HeJ.The Global Burden of Hypertension: Global Data Analysis.The Lancet 2005;365(9455):217-223.doi: 10.1016 / S0140-6736 (05) 17741-1
32. Singh S, Shankar R, Singh GP.Kuchuluka kwa matenda oopsa komanso zovuta zake zofananira: kafukufuku wapakatikati pa mzinda wa Varanasi.Int J hypertension.2017;2017: 2017. doi: 10.1155 / 2017/5491838
33. De Onis M, Habicht JP.Deta ya Anthropometric yogwiritsidwa ntchito padziko lonse lapansi: malingaliro a Komiti Yazidziwitso ya World Health Organisation.Ichi ndi J Clinical Food.1996;64(4):650-658.doi: 10.1093 / ajcn / 64.4.650
34. WHO.Mkhalidwe wathupi: kugwiritsa ntchito ndi kutanthauzira kwa anthropometry.WHO technical report series.1995;854 (9).
35. Barbieri J, Fontela PC, Winkelmann ER, etc. Anemia mu mtundu wa 2 odwala matenda a shuga.kuchepa kwa magazi m'thupi.2015;2015: 2015. doi: 10.1155/2015/354737
36. Owolabi EO, Ter GD, Adeni OV.Kunenepa kwapakatikati komanso kunenepa kwambiri kwapakatikati pakati pa akulu akulu mu metropolitan Medical Institute ku Buffalo, South Africa: kafukufuku wam'mbali.J chakudya chamagulu abwino.2017;36(1): 54. doi: 10.1186 / s41043-017-0133-x
37. Adera H, Hailu W, Adane A, Tadesse A. Chiwopsezo cha kuchepa kwa magazi m'thupi ndi zifukwa zake zokhudzana ndi odwala matenda a impso ku Gondar University Hospital kumpoto chakumadzulo kwa Ethiopia: kafukufuku wokhudzana ndi chipatala.Int J Nephrol Renovasc Dis.2019;12: 219. doi: 10.2147 / IJNRD.S216010
38. Chiwanga FS, Njelekela, Massachusetts, Diamond MB, etc. Kuchuluka kwa matenda a shuga ndi matenda a shuga komanso zoopsa zokhudzana ndi matenda a shuga m'matauni ndi kumidzi ku Tanzania ndi Uganda.Zochita padziko lonse lapansi zaumoyo.2016;9(1): 31440. doi: 10.3402/gha.v9.31440
39. Kassahun T, Eshetie T, Gesesew H. Zinthu zokhudzana ndi kulamulira kwa shuga m'magazi mwa akuluakulu omwe ali ndi matenda a shuga a mtundu wa 2: kafukufuku wopita ku Ethiopia.Zolemba za BMC Res.2016;9 (1): 78. doi: 10.1186 / s13104-016-1896-7
40. Fana SA, Bunza MDA, Anka SA, Imam AU, Nataala SU.Kufalikira ndi zoopsa zomwe zimagwirizanitsidwa ndi matenda a malungo pakati pa amayi apakati m'madera omwe ali m'matauni kumpoto chakumadzulo kwa Nigeria.Kuwononga umphawi.2015;4(1): 1-5.doi: 10.1186 / s40249-015-0054-0
41. Abate A, Birhan W, Alemu A. Association of kuperewera kwa magazi m'thupi ndi mayesero a impso kwa odwala matenda a shuga omwe amapita ku chipatala cha Fenote Selam ku Sigoyam, kumpoto chakumadzulo kwa Ethiopia: kafukufuku wodutsa.BMC Hematol.2013;13 (1): 6. doi: 10.1186 / 2052-1839-13-6
42. Chen CX, Li YC, Chan SL, Chan KH.Anemia ndi Type 2 Diabetes: Kafukufuku Wobwerezabwereza wa Impact of Primary Care Case Series.Hong Kong Med J. 2013;19(3): 214–221.doi: 10.12809 / hkmj133814
43. Wee YH, Anpalahan M. Udindo wa ukalamba m'magazi abwinobwino a magazi amtundu wa 2 shuga.Curr Sayansi Yakukalamba.2019;12 (2): 76-83.doi: 10.2174 / 1874609812666190627154316
44. Panda AK, Ambad County.Kuchuluka kwa kuchepa kwa magazi m'thupi mwa odwala omwe ali ndi matenda amtundu wa 2 komanso kulumikizana kwake ndi HBA1c: kafukufuku woyambirira.Natl J Physiol Pharm Pharmacol.2018;8(10): 1409-1413.doi: 10.5455 / njppp.2018.8.0621511072018
45. Sudchada P, Kunmaturos P, Deoisares R. Kuchuluka kwa magazi m'thupi mwa odwala matenda a shuga a mtundu wa 2 ku Thailand, koma palibe matenda okhudzana ndi matenda a mtima kapena matenda a impso.Singapore Medical Journal, 2013;28(2): 190-198.
46 Al-Salman M. Kuperewera kwa magazi m'thupi mwa odwala matenda a shuga: kufalikira ndi kufalikira kwa matenda.Gen Med.2015;1-4.
47. Feteh VF, Choukem SP, Kengne AP, Nebongo DN, Ngowe-Ngowe M. Anemia kwa odwala omwe ali ndi matenda a shuga a 2 komanso mgwirizano wake ndi aimpso m'zipatala zapamwamba ku sub-Saharan Africa: phunziro lachigawo.BMC adrenaline.2016;17(1): 29. doi: 10.1186 / s12882-016-0247-1
48. Idris I, Tohid H, Muhammad NA, etc. Kuperewera kwa magazi m'thupi mwa odwala omwe ali ndi matenda a shuga a mtundu wa 2 (T2DM) ndi matenda aakulu a impso (CKD): kafukufuku wambiri.BMJ yatsegulidwa.2018;8(12): 12. doi: 10.1136 / bmjopen-2018-025125
49. Wabe NT, Mohamed, Massachusetts.Kodi asayansi akuganiza chiyani za catha edulis forsk?Chidule cha chemistry, toxicology ndi pharmacology.J Exp Integr Med.2012;2(1): 29. doi: 10.5455 / jeim.221211.rw.005
50. Al-Motarreb A, Al-Habori M, Broadley KJ.Kutafuna kwa Khaki, matenda amtima ndi zovuta zina zachipatala zamkati: momwe alili pano komanso malangizo amtsogolo ofufuza.J Journal ya National Pharmacology.2010;132(3):540-548.doi: 10.1016 / j.jep.2010.07.001
51. Disler P, Lynch SR, Charlton RW, etc. Zotsatira za tiyi pa kuyamwa kwachitsulo.Matumbo.1975;16(3): 193-200.doi: 10.1136 / gut.16.3.193
52. Wokonda FS.Kudya kwambiri tiyi wobiriwira kungayambitse kuchepa kwachitsulo m'magazi.Woyimira milandu kuchipatala.2016;4(11): 1053. doi: 10.1002 / ccr3.707
53. Kumera G, Haile K, Abebe N, Marie T, Eshete T, Ciccozzi M. Anemia ndi mgwirizano wake ndi kumwa khofi ndi matenda a hookworm pakati pa amayi apakati omwe akuyang'aniridwa kuchipatala ku Debre Markos Referral Hospital ku Northwestern Ethiopia.PLoS imodzi.2018;13(11): e0206880.doi: 10.1371/journal.pone.0206880
54. Nelson M, Poulter J. Zotsatira za kumwa tiyi pa chikhalidwe chachitsulo ku UK: ndemanga.J Hum zakudya zopatsa thanzi.2004;17(1):43-54.doi: 10.1046 / j.1365-277X.2003.00497.x
55. Abdul Kadir AH.Kuchuluka kwa matenda osatha komanso kuchepa kwa iron anemia pakati pa akulu omwe ali ndi matenda ashuga mumzinda wa Erbil.Zanco J Med Sci.2014;18(1): 674-679.doi: 10.15218 / zjms.2014.0013
56. Thomas MC, MacIsaac RJ, Tsalamandris C, etc. Anemia kwa odwala omwe ali ndi matenda a shuga 1.J Clinical endocrine metabolism.2004;89(9):4359-4363.doi: 10.1210 / jc.2004-0678
57. Deicher R, HörlWH.Kuperewera kwa magazi m'thupi ndi chiopsezo cha chitukuko cha matenda aakulu a impso.Curr Opin Nephrol matenda oopsa.2003;12 (2): 139-143.doi: 10.1097 / 00041552-200303000-00003
58. Klemm A, Voigt C, Friedrich M, etc. Electron paramagnetic resonance imayesa maselo ofiira a magazi a antioxidant mphamvu ya odwala hemodialysis.Nephrol dial transplantation.2001;16(11): 2166–2171.doi: 10.1093 / ndt / 16.11.2166
59. Ximenes RMO, Barretto ACP, Silva E. Anemia kwa odwala omwe ali ndi vuto la mtima: zifukwa zachitukuko.Rev Bras Cardiol.2014;27(3): 189–194.
60. Francisco PMSB, Belon AP, Barros MBDA, etc. Matenda a shuga odziwonetsa okha mwa okalamba: kufalikira, zinthu zokhudzana ndi zochitika ndi njira zowongolera.Cad Saude Publica.2010;26(1): 175-184.doi: 10.1590 / S0102-311X2010000100018
Ntchitoyi idasindikizidwa ndikupatsidwa chilolezo ndi Dove Medical Publishing Co., Ltd. Zolemba zonse za chilolezochi zitha kupezeka pa https://www.dovepress.com/terms.php, kuphatikiza ndi Creative Commons Attribution-Non-commercial ( unported, v3.0) chilolezo.Kupeza ntchito kumatanthauza kuti mumavomereza izi.Ngati ntchitoyo yasankhidwa moyenera, singagwiritsidwe ntchito pazinthu zina popanda chilolezo chochokera ku Dove Medical Press Limited.Kuti mulole kugwiritsa ntchito ntchitoyi pazinthu zamalonda, chonde onani ndime 4.2 ndi 5 ya mawu athu.
Lumikizanani Nafe•Mfundo Zazinsinsi•Mabungwe ndi Othandizana Nawo•Zomwe Mungapangire•Migwirizano ndi Zokwaniritsa
©Copyright 2021•Dove Press Ltd•maffey.com pakupanga mapulogalamu•Kumamatira pamapangidwe awebusayiti
Malingaliro omwe afotokozedwa m'nkhani zonse zomwe zasindikizidwa pano ndi a olemba enieni ndipo samasonyeza maganizo a Dove Medical Press Ltd kapena aliyense wa antchito ake.
Dove Medical Press ndi ya Taylor & Francis Group, yomwe ndi dipatimenti yosindikiza mabuku ya Informa PLC, copyright 2017 Informa PLC.maumwini onse ndi otetezedwa.Tsambali ndi la Informa PLC (lomwe limadziwika kuti "Informa"), ndipo ofesi yake yolembetsedwa ndi 5 Howick Place, London SW1P 1WG.Adalembetsedwa ku England ndi Wales.Nambala 3099067. Gulu la VAT la UK: GB 365 4626 36
Kuti tipereke chithandizo chopangidwa mwaluso kwa omwe abwera patsamba lathu komanso ogwiritsa ntchito omwe adalembetsa, timagwiritsa ntchito makeke kusanthula kuchuluka kwa alendo ndikusintha zomwe zili patsamba lathu.Mutha kuwerenga zachinsinsi chathu kuti mumvetsetse momwe timagwiritsira ntchito makeke.Timasunganso zambiri za alendo ndi ogwiritsa ntchito olembetsa kuti azigwiritsa ntchito mkati ndikugawana zambiri ndi mabizinesi.Mukhoza kuwerenga mfundo zathu zachinsinsi kuti mumvetse deta yomwe timasunga, momwe timachitira, omwe timagawana nawo komanso ufulu wanu wochotsa deta.
Nthawi yotumiza: Feb-19-2021