Chidule cha Hepatitis B

by Chonchi; Yofotokozedwa ndi Richard N. Fogoros, MD

Amuna ali pangozi yaikulu ya matendawa

Hepatitis B ndi kutupa kwa chiwindi choyambitsa matenda. Padziko lonse, pali zonyamulira zoposa 400 miliyoni za matenda a hepatitis B. Pa anthu 200,000 omwe ali ndi chiwindi cha chiwindi B chaka chilichonse ku US, 10 mpaka 15,000 amapitiriza kukhala ndi matenda aakulu. Amuna amapezeka mobwerezabwereza kasanu ndi chimodzi kusiyana ndi akazi kuti akhale odwala matenda a hepatitis B (HBV), koma zifukwa izi sizidziwika bwino.

Mitundu ya Hepatitis B

Akuluakulu omwe amapeza kachilombo ka Hepatitis B, 95 peresenti amachiza kachilomboko ndipo sakhala ndi mtundu wodwala wa matendawa. Anthu ena ali ndi zizindikiro zochepa kapena palibe, kotero sangathe kuzindikira kuti ali ndi HBV kapena kuti ali nawo.

Ambiri achikulire adzathetsa kachilomboka mkati mwa miyezi isanu ndi umodzi. Nkhani yabwino ndi yakuti ma antibodies omwe amatetezedwa pamene akulimbana ndi matendawa amatanthauza kuti anthu omwe ali nawo sadzasowa kudandaula za HBV kachiwiri-adzakhala otetezeka.

Pali mitundu itatu ya matenda a hepatitis B:

Odwala ambiri omwe ali ndi matenda a hepatitis B sali opatsirana kwa ena ndipo, ngakhale kuti ali ndi chiopsezo chachikulu cha khansa ya chiwindi ndi chiwindi kuposa anthu ambiri, amakhala makamaka moyo wamba. Tizilombo toyambitsa matenda timatha kukonzanso ngati chitetezo cha mthupi chimatetezedwa, monga matenda aakulu, pakamwa ndi mankhwala osokoneza bongo omwe amawopsa ngati khansa kapena AIDS, kapena mankhwala osokoneza bongo monga steroids.

Matenda a chiwindi opatsirana opatsirana pogonana B ali opatsirana kwambiri. Munthu yemwe ali ndi vutoli akhoza kukhala ndi chiwindi choopsa komanso choonongeka ngakhale pamene munthuyo ali ndi zizindikiro zochepa kapena ayi. Anthu omwe ali ndi mtundu umenewu wa chiwindi cha mtundu wa B ndi omwe amakhala ndi matenda opititsa patsogolo . Ndi zisanu ndi zisanu zokha pa 100 peresenti zokhala ndi zowonjezereka, zimakhala zosafunikira kwa ena, ndipo sizikuthandizani kapena kuchepetsa chiwindi, ngakhale nthawi zina kachilombo ka HIV kamapezeka.

Matenda a chiwindi otchedwa hepatitis B omwe ali ndi matenda osokoneza bongo ndi omwe amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda. Anthu omwe ali nawo ali ndi mwayi wopatsirana ena ndipo akuganiza kuti ndi ovuta kwambiri kuposa mankhwala ena.

Kutumiza

Hepatitis B imapatsirana kudzera m'madzi amadzimadzi monga:

Magazi
Kutupa
Misozi
Saliva
Zima
Zisindikizo zamagetsi
Kusamba magazi
Mkaka wa m'mawere

Kutumiza kumatha kupezeka pamene mukugwiritsa ntchito sirinji yomweyi monga munthu wodwala, monga kulandira magazi isanayambe 1975 (zowonjezera magazi tsopano zikuwonetsedwa m'mayiko ambiri) ndikupeza zojambula kapena kupyoza thupi.

Hepatitis B ikhozanso kupatsirana pakubereka kuchokera kwa mayi kupita kwa mwana, panthawi yachipatala, kupyolera mu ntchito, komanso kugonana. Kukhala ndi Hepatitis B sikutanthauza kuti munthu ali ndi kachilombo kwa anthu ena, ndi anthu ena omwe ali ndi HBV omwe amawopsa.

Zizindikiro ndi Zizindikiro

Pali njira zambiri zomwe anthu angadziwire kuti ali ndi chiwindi. Chifukwa nthawi zina zimakhala zochepa zozizwitsa zowonjezereka, mwachitsanzo, kuti zikhoza kupezeka pamene mayesero amagazi akuchitidwa-nthawi zina chifukwa cha zifukwa zosagwirizana, monga asanapereke zopereka za magazi, chifukwa cha inshuwalansi, kuti aziwunika bwino, kapena zotsatira zovulala zokhudzana ndi ntchito.

Chiwindi cha Hepatitis B

M'mawonekedwe ake oopsa, zizindikiro za matenda a chiwindi amachititsa munthuyo kumva kuti akudwala kwambiri. Ena angakhulupirire kuti ali ndi chimfine pomwe ena sangakhale ndi zizindikiro.

Zizindikiro zikuphatikizapo jaundice, malungo, kupweteka kwa m'mimba, kusala kudya, kunyoza, kusanza, kutopa, mkodzo wamdima, zojambula zamitundu yosiyanasiyana, kupweteka kwa minofu ndi kuphwanya , ndi kupweteka. Chiwindi chikhoza kukulitsidwa komanso kutentha.

Fulminant hepatitis ndi mtundu wovuta koma wosawoneka wa chiwindi cha hepatitis . Zingayambe ndi kutopa ndi kunjenjemera, koma, mkati mwa masabata angapo, zizindikiro zimatchulidwa. Pafupifupi masabata awiri chitatha chifuwa, matenda otupa amayamba.

Encephalopathy ndi mkhalidwe wosokonekera kapena wosinthika. Mwa kufatsa kwake, pangakhale kukumbukira kwa kanthaŵi kochepa, kukumbukira, kusalankhula momasuka, kusintha khalidwe laling'ono kapena kusintha kwa khalidwe, kapena kusintha kwa kugona.

Mwachizolowezi chake, munthu akhoza kukhumudwa kwambiri (osadziŵa tsiku, chaka, dzina lawo kapena adiresi), chisokonezo, kusonyeza khalidwe lolakwika, kugwirizanitsa bwino, asterixis (manja osatetezeka a manja), fetor hepaticus ( mpweya woipa), ndi coma. Mpaka 85 peresenti ya anthu omwe ali ndi matendawa omwe amapezeka kuti alibe chiwindi, amafa opanda chiwindi .

Matenda a Hepatitis B

Apanso, zizindikiro ndi zizindikiro zimasiyana ndipo anthu ambiri sakudziwa kuti chirichonse cholakwika ndi cholakwika kapena chidziwitso chodziwika bwino. Izi zimaphatikizapo kutopa kapena kuchepa mopanda phokoso, jaundice, ndi chiwindi chofutukuka. Mwamwayi, ngati matenda a chiwindi sangathe kuchotsedwa ndi thupi kapena sichichiritsidwe ndi kuchiritsidwa, matenda a chiwindi kapena chiwindi amatha.

Mayesero a Magazi Odziŵa

Mayeso a magazi amasonyeza kuti pali matendawa komanso zomwe zimakhudza. Kachilombo ka magazi ka hepatitis B kamene kamapereka kachidziwitso ka magazi kamene kamatulutsa kachilomboka kamene kamakhala ndi matenda osiyanasiyana.

Ntchito ya Chiwindi
Mayeso a magaziwa amasonyeza mmene chiwindi chimagwirira ntchito koma sichiyesa molondola ntchito zosiyanasiyana zomwe chiwindi chimayang'anira mthupi lathu. Amayang'ana kuchuluka kwa mavitamini a chiwindi, transaminases ndi cholestatic michere, bilirubin, ndi mapuloteni a chiwindi, zomwe zonsezi zingakhudzidwe ndi kachilombo ka chiwindi.

Maseŵera apamwamba a transaminase m'magazi samasonyeza kuti chiwindi chimatentha kapena kuwonongeka. Zambiri mwa izi zingatheke chifukwa cha matenda a chiwindi, chiwindi cha chiwindi, ndi mtima wosalimba. Mipiringi yowonongeka ya AST ndi ALT transaminase ili pafupi 0 mpaka 40 IU / L ndi 0 mpaka 45 IU / L motsatira. Mu chifuwa chachikulu cha matenda a chiwindi B, maguluwo amakhala kawiri kapena katatu pamwamba payomweyo.

Mapuloteni a Chiwindi
Albumin, prothrombin ndi immunoglobulins-mapuloteni omwe amapangidwa ndi chiwindi-amayang'anitsitsa ndi maonekedwe osalimba amasonyeza matenda aakulu a chiwindi. Nthawi zowonjezereka zimayenera kutsimikiziranso, chifukwa chiwindi chimapanga zinthu zambiri zotsekemera zomwe zimafunika kuti asiye kutuluka magazi.

Chiopsezo cha Chiwindi
Chiwindi cha chiwindi ndi chimodzi mwa njira zazikulu komanso zowona bwino zomwe zingathe kudziwa zomwe zili zolakwika ndi chiwindi komanso momwe zawonongeka. Monga momwe matenda ambiri a chiwindi amakhudzira thupi lonse lofanana, kachilombo kakang'ono kamene kamapezeka ndi chiwopsezo, chomwe chimagwiritsidwa ntchito pansi pano, chimasonyeza kuti palibe vuto lililonse. Kwa ambiri, chiwopsezo cha chiwindi chowongolera ndi chida chodziwika bwino komanso choyenera.

Chithandizo

A FDA (Food and Drug Administration) avomereza mitundu iwiri ya mankhwala, alpha interferon ndi lamivudine. Alpha interferon, yoperekedwa ndi jekeseni, imachititsa chitetezo cha thupi kuti chiteteze thupi lake ndipo chimaperekedwa kwa masabata 16. Ndi okwera mtengo kwambiri ndipo ali ndi zotsatira zingapo, zina mwazovuta. Lamivudine, yotengedwa pamlomo kwa milungu 52, ngakhale kuti ili ndi zotsatira zochepa, sizikhala ngati interferon. Kubwereranso ndi chinthu chofala ndipo kugwiritsa ntchito kwake kungayambitse kusakaniza tizilombo toyambitsa matenda.

Malangizo a mankhwalawa mu mapulogalamu ochiritsira amatha kusintha. Mu 2002, a FDA adanena kuti "pamwamba pa 50 peresenti kwa odwala okhala ndi magulu a ALT akuluakulu oposa asanu nthawi zonse, koma otsika (20 peresenti mpaka 35 peresenti) odwala omwe ali ndi magulu a ALT osachepera kawiri zachilendo. Odwala omwe ali ndi magulu a ALT osachepera kawiri kuposa kumapeto kwa chizoloŵezi chokhazikika, mayendedwe ake ndi osauka ndipo chithandizochi chiyenera kuchepetsedwa. "

Mtundu watsopano wa mankhwalawa-nucleotide analogue adefovir dipivoxil (Hepsera) -wapeza mwayi wotsatira wachitatu ndipo unavomerezedwa ndi FDA kuti amwe mankhwala a hepatitis B mu September 2002.

Chiwindi cha Hepatitis B
Kuchuluka kwa chiwindi cha mtundu wa B kumachiritsidwa moyenera ndi kupumula ndi madzi ambiri. Simungasowe mpumulo wa bedi; Zimadalira momwe mukuvutikira.

Ngati mulipo, ndiye kuti palibe chifukwa chomwe simuyenera kupita kuntchito. Ndikofunika kuti ukhale ndi thanzi labwino, choncho suta kusuta (yesani!) Ndi kudya zakudya zabwino. Muyenera kusiya kumwa mowa kwa miyezi ingapo chiwindi chimafuna nthawi kuti mupeze.

Matenda a Hepatitis B
Kwa anthu omwe matupi awo satha kuthetsa kachilomboka, HBV idzapitirirabe kukhala matenda aakulu. Pasanapite nthawi panalibe chithandizo cha hepatitis B; Komabe, palinso mankhwala angapo omwe akuwoneka ogwira mtima kwambiri.

Tsogolo labwino likuyang'ana kwambiri ndipo asayansi ndi makampani osokoneza bongo akuyembekezera kuti, m'zaka zingapo zotsatira, chithandizochi chidzapezedwa chomwe chidzapereka chithandizo kwa aliyense amene ali ndi matenda a chiwindi.

Chithandizo ndi mankhwala oletsa tizilombo toyambitsa matenda amapezeka kwa anthu omwe ali ndi matenda a chiwindi a B osapitirirabe ngakhale kuti palibe chovomerezeka kwa anthu onse omwe ali ndi kachilomboka. Chithandizochi chimayambitsa kuthetsa matenda a hepatitis B ndikuletsa matenda a chiwindi.

Kuthamangitsani

Pafupifupi awiri peresenti ya anthu omwe ali ndi matenda a chiwindi (B) omwe amatha kudwala matenda a chiwindi (B) omwe akudwala matenda a chiwindi amatha kukhala ndi chiwindi chaka chilichonse.
Kwa zaka zoposa zisanu, mwayi wokhala ndi chiwindikiro ndi 15 mpaka 20 peresenti.
Pakati pa zaka zisanu ndi makumi asanu ndi zitatu (80) peresenti yachisanu ndi chitatu yowonjezereka ikupulumuka.
Ngati matenda opatsirana odwala matenda a chibwibwi (odwala matenda a chibwibwi pamodzi ndi mavuto monga kupha magazi ndi kuperewera kwa magazi) amakula, chiwerengero cha moyo chimachepa kufika pakati pa 14 ndi 32 peresenti.
Chifukwa cha chiopsezo chachikulu cha khansa ya chiwindi , anthu pafupifupi 1 miliyoni padziko lonse amamwalira chaka chilichonse chifukwa cha matenda a chiwindi.

Kugonjera sikoyenera kwa iwo omwe ali ndi izi:

Zovuta zaumoyo wathanzi
Kupeza machitidwe okhudzana ndi thanzi, kusowa ndalama, ukhondo wabwino, ndi zina zotero.
Ukalamba
Matenda a hepatitis D ndi hepatitis B pamodzi
Matenda a hepatitis C ndi hepatitis B pamodzi
Chiwindi chapamwamba cha chiwindi
Anapitiriza kumwa mowa pambuyo poti akudwala matenda a chiwindi

Zindikirani: Chiwindi cha matenda a Hepatitis D (HDV) chingakhalepo ndi kachilombo ka hepatitis B. Hepatitis D imafalitsidwa mofanana ndi matenda a hepatitis B ndipo ingagwidwe nthawi imodzimodzimodzi ndi HBV (kachilombo ka HIV) kapena matenda a HBV. Kachilombo ka HIV kamadziwika bwino poyeretsa thupi (90 mpaka 95 peresenti). Pankhani ya superinfection, 70 mpaka 95 peresenti amatha kukhala ndi mawonekedwe aakulu a HDV.

Kupewa

Katemera alipo ndipo akulangizidwa kwa omwe ali pangozi kapena okhudzana ndi matendawa. Katemerayu ndi 90 mpaka 95 peresenti yotetezera chiwindi cha B ndi matenda osatha.

Mamembala makumi asanu ndi anayi mphambu asanu ndi anayi a anthu asanu ndi atatu a mamembala a World Health Organisation adziko lonse lapansi ali ndi kachilombo ka HIV. Mwamwayi, mtengo wa katemera ndi njira zophweka zofalitsira kachilomboka zimatanthauza kuti chiwerengero cha matenda a hepatitis B chikupitirirabe kukula.

Anthu omwe amadziwa kuti ali ndi kachilombo ka HIV ndi matenda a hepatitis B akhoza kuteteza kuti asapatsire ena. Izi zimaphatikizapo kutaya zowonongeka koyenera, pogwiritsa ntchito mabotolo ndi mano, osagwiritsa ntchito singano ndi siringi ndi ena, kugwiritsa ntchito makondomu nthawi zonse, komanso kupewa kugonana .

Ngati ntchito yanu ikuphatikizapo kugwira ntchito pamalo oopsa, muyenera kufunsa dokotala wanu kuti mudziwe njira zothetsera vutoli komanso zotsatira zake zomwe zingakhale ndi thanzi lanu m'tsogolo. Anthu onse odwala matenda a hepatitis B ayenera kupeza katemera wa hepatitis A kuti athe kupewa matenda.

Kulimbana

Ngati mupeza kuti muli ndi chiwindi cha B, musataye mtima. Pezani dokotala wapadera mu hepatology kuti akukulangizeni za mankhwala abwino ndi momwe mungapititsire umoyo wanu kuti muthane ndi kachilomboka.

Kumbukirani, simuli nokha. Pali mamiliyoni ambiri a anthu omwe ali ndi chiwindi cha bulu B. Pezani gulu lothandizira kuderalo kudzera pa intaneti kapena funsani gulu lanu lachipatala lomwe likukupatsani chisamaliro chomwe muli ndi thandizo lanu.