Chiwindi chakumwa B: Chikhoza Kupangitsa Matenda a Impso?

Dziwani chifukwa chake matenda a Hepatitis B angakhudze impso, ndipo mungachite chiyani pa izo

Amagulu ambiri azachipatala amavomereza kuti chimodzi mwa matenda osocheretsa kwambiri omwe amachititsa kuti matendawa akhale a Hepatitis B komanso matenda a chiwindi a Hepatitis C. Mainawo sali okwanira kufotokoza matendawa kuyambira pamene "chiwindi" amatanthauza kutupa kwa chiwindi. Izi zimapereka chitsimikizo kuti thupi lokha limakhudzidwa ndi matenda a Hepatitis B kapena C ndi chiwindi, chomwe chimasocheretsa chifukwa matenda onse awiriwa amawona ziwalo zina zomwe zimakhala ndi chiwindi, ndipo ndizo zizindikiro zowonongeka.

Impso ndi mtundu umodzi womwe mavairasi a chiwindi amakhudza zonse mwachindunji ndi mwachindunji. Matenda a hepatitis siwo okha opatsirana omwe angakhudze impso. Komabe, udindo wawo mu matenda a impso ndi wofunika kuzindikira kuti kupatsirana kwakukulu kwa matendawa ndiwowonjezereka. Tiyeni tikambirane zina zokhudza matenda a impso a chiwindi a Hepatitis B.

Kodi Mgwirizano wa Matenda a Impso Ndi Wotani?

Matenda a impso chifukwa cha matenda a shuga a Hepatitis B amapezeka nthawi zambiri mwa anthu omwe ali ndi kachirombo ka HIV kuyambira ali wakhanda kapena ubwana. Odwalawa amakhala osowa kwambiri ndipo amakhala ndi chiopsezo chachikulu cha matenda a impso.

Chifukwa chiyani kachirombo ka chiwindi chikhoza kuwononga impso

Ngakhale kuti kawirikawiri amaganiza kuti, kuwonongeka kwa impso kuchokera ku matenda a Hepatitis B sizowonongeka chifukwa cha matenda opatsirana. Ndipotu, njira zosadziwika za chitetezo cha mthupi ku mbali zina za kachilombo ka HIV zingakhale ndi gawo lalikulu pa matenda omwe amabwera chifukwa cha matenda.

Zigawo izi zimapezeka kuti zimayambidwa ndi ma antibodies anu pofuna kulimbana ndi matendawa. Izi zikachitika, ma antibodies adzamanga ndi kachilomboka, ndipo zotsalira zomwe zimayambitsa zidzasungidwa mu impso. Icho chingathe kuchotsa kutentha komwe kungayambitse matenda a impso.

Choncho, osati momwe kachilombo ka HIV kamakhudzidwira mwachindunji, ndi momwe thupi lanu limayankhira kuti liwononge mtundu wa ubongo ndi impso.

Mitundu ya Matenda a Impso Amayambitsa matenda a Hepatitis B

Malingana ndi momwe impso zimayendera ndi kachilombo ndi kutupa kwa kutupa kotchulidwa pamwambapa, matenda osiyanasiyana a impso angayambitse. Nazi mwachidule mwachidule:

1. Polyarteritis Nodosa (PAN): Tiyeni tisiye dzina ili kukhala magawo ang'onoang'ono, osakanikirana. Mawu oti "poly" amatanthauza angapo, ndipo "arteritis" amatanthauza kutupa kwa mitsempha / mitsempha ya magazi. Zomwe zimatchulidwa kawirikawiri zimatchedwanso "vasculitis". Popeza chiwalo chilichonse m'thupi chimakhala ndi mitsempha ya magazi, (komanso impso ili ndi mafungo olemera), polyarteritis nodosa ndi kutupa kwakukulu kwa mitsempha ya magazi (pakali pano, impso 'mitsempha) yomwe imakhudza mitsempha yaing'ono ndi yaying'ono ya magazi wa limba.
   
   Kuwoneka kwa kutupa kwa PAN kukuwonekera kwambiri. Imodzi mwa matenda a impso oyambirira ndi omwe angayambitsidwe ndi matenda a Hepatitis B. Zimakhudza anthu akuluakulu komanso akuluakulu. Mmodzi wodwalayo adzadandaula za zizindikiro zosaoneka ngati zofooka, kutopa, ndi ululu wothandizira. Komabe, zotupa za khungu zina zimadziwikanso. Kuyesedwa kwa ntchito ya impso kudzawonetsa zosafunikira koma sizitsimikizira kuti matendawa ndi matenda a impso nthawi zambiri amafunika .

1. Glomerulonephritis (MPGN): Memphane -of-a-disease-terme amatanthauza maselo ochulukirapo ndi maselo ena (chingwe chapansi) mu impso. Kachiwiri, izi ndi zotupa zomwe zimachitika m'malo mowopsa. Ngati muli ndi matenda a chiwindi cha Hepatitis B ndipo muyambe kuona magazi m'kodzo, izi ndizofunika kuziganizira. Mwachiwonekere, kupezeka kwa magazi mu mkodzo sikukwanira kutsimikizira matendawa ngakhale mutakhala ndi kachirombo ka Hep B. Choncho, kuyesedwa kwina kuphatikizapo matenda a impso kungakhale kofunikira.
2. Nthenda ya Nephropathy: Kusintha kwa mbali ya impso fyuluta (yotchedwa glomerular chapansi pansi) imatsogolera ku izi. Odwala omwe adakhudzidwawo ayamba kutulutsa kuchulukitsa kwa mapuloteni mu mkodzo. Monga wodwala, n'zovuta kufotokozera kukhalapo kwa mapuloteni mumtambo pokhapokha ngati uli wokwera kwambiri (ngati mungathe kuyembekezera kupyolera msuzi kapena mumtsinje). Magazi ndi ovuta kupeza mkodzo pakali pano koma amatha kuwonanso. Apanso, kuyesa magazi ndi mkodzo kwa ntchito ya impso kungasonyeze kuti sizowonongeka, koma kuti atsimikizire matendawa, ziwombankhanga za impso zidzafunikanso.

1. HepatoRenal Syndrome: Matenda a impso oopsa chifukwa cha matenda a chiwindi ndi omwe amatchedwa hepatorenal syndrome. Komabe, izi sizikutanthauza kuti matenda a chiwindi a Hepatitis B ndi ochizira ndipo amatha kuwoneka mu matenda aliwonse a chiwindi omwe amapezeka pamene impso zimakhudzidwa chifukwa cha njira zosiyanasiyana.

Kuzindikira Matenda a Chiwindi a Hepatitis B

Ngati muli ndi kachilombo koyambitsa matenda a hepatitis B ndipo mukuda nkhaŵa kuti impso zanu zikhoza kutenga, mukhoza kuyesedwa.

1. Mwachiwonekere, choyamba ndikutsimikiza kuti muli ndi matenda a chiwindi a hepatitis B, omwe ali ndi betri ya mayesero osiyana omwe safunikira kusowa kwa impso. Ngati mumabwera kuchokera kumadera omwe amadziwika kuti ali ndi kachilombo ka HIV (malo ovuta), kapena amakhala ndi chiopsezo cha matenda a chiwindi cha mtundu wa B (monga kugawaniza singano kuti azisokoneza bongo, azitenga zogonana mosagonana ndi anthu ambiri ogonana nawo, ndi zina zotero. .), mayesero ena a magazi omwe amayang'ana "mbali" zosiyana za kachilombo ka hepatitis B ayenera kutsimikizira matenda.
   
   Kuyezetsa kumachititsanso ma antibodies amene thupi limapanga motsutsana ndi kachilombo ka hepatitis B. Zitsanzo za mayesowa ndi HBsAg, anti-HBc, ndi anti-HBs. Komabe, mayeserowa sangathe kusiyanitsa pakati pa chiopsezo chotenga kachilombo ka HIV (komwe kachilombo kamatulutsa mofulumira), kapena malo otengera (pamene muli ndi kachilomboka, kachilombo kawirikawiri sikhalapo). Kuti atsimikizire, kuyesa matenda a chiwindi cha hepatitis B akulimbikitsidwa.
   
   Chifukwa chakuti mavairasi awiriwa amawawuza ena za ziopsezo, kuyesa kwapakati pa kachilombo ka HIV ka hepatitis C sikungakhale malingaliro oipa.
2. Chinthu chotsatira ndicho kutsimikizira kukhalapo kwa matenda a impso pogwiritsa ntchito mayesero omwe akufotokozedwa apa.
3. Pomalizira, dokotala wanu adzafunika kuika awiri ndi awiri palimodzi. Pambuyo pazigawo ziwirizi zapitazi, mukufunikira kutsimikizira kuti mukulephera. Choncho, matenda a impso adzafunika kutsimikizira kuti matenda a impso ndi chifukwa cha kachilombo ka hepatitis B komanso matenda ena a impso. Komanso chifukwa chakuti matenda a chiwindi a hepatitis B limodzi ndi matenda a impso sizikutsimikizira kuti matendawa akutsogolera kuwonongeka kwa impso. Wina akhoza kukhala ndi matenda a chiwindi cha hepatitis B ndipo ali ndi magazi / mapuloteni mu mkodzo chifukwa chosiyana (kuganiza, wodwala matenda a shuga ndi mwala wa impso).
4. Chidziwitso cha matenda otsiriza komanso chifukwa chake chimakhudza kwambiri njira ya chithandizo. Matendawa akunenedwa pamwambapa (PAN, MPGN, ndi zina zotero) amatha kuwoneka mwa anthu omwe alibe kachilombo ka HIV kameneka. Momwe timachitira matenda a impso amenewa muzochitika izi zidzakhala zosiyana kwambiri ndi momwe amachitira ndi matendawa chifukwa cha matenda a chiwindi.
   
   Ndipotu, mankhwala ambiri (monga cyclophosphamide kapena steroids) omwe amagwiritsidwa ntchito popanga mankhwala osagwidwa ndi matenda a hepatitis B kapena MPHN, amatha kupweteka kwambiri kusiyana ndi zabwino zomwe amapatsidwa kwa wodwalayo ndi kachilombo ka hepatitis B. Chifukwa chakuti mankhwalawa apangidwa kuti athetse chitetezo cha mthupi, chomwe ndi thupi lomwe limafunikira kulimbana ndi matenda a Hepatitis B. Kuchiza ndi ma immunosuppressants mu mkhalidwe uno ukhoza kubwezeretsa ndi kuchititsa kuwonjezeka kwa kubwereza kwa tizilombo. Choncho, kutsimikizira chifukwa chake ndikofunikira.

Kodi Matenda a Impso Amene Amayambitsa Matenda a Hepatitis B Amachitikira Bwanji?

Tenga chifukwa. Izi ndizovuta kwambiri pa mankhwalawa. Mwamwayi, palibe mayesero aakulu omwe alipo kuti athe kutsogolera chithandizo cha matenda a impso zomwe zimachitika chifukwa cha matenda a chiwindi cha hepatitis B. Zilizonse zomwe timapeza kuchokera kumaphunziro ang'onoang'ono omwe timaphunzira mwachidule timagwiritsa ntchito mankhwala oletsa tizilombo toyambitsa matenda omwe amachititsa kuti matenda a chiwindi a mtundu wa B asapitirire.

1. Mankhwala othandizira antiviral: Izi zimaphatikizapo mankhwala monga interferon alpha (omwe amalepheretsa kufalikira kwa kachilombo ka hepatitis B ndi "kusamalitsa" chitetezo cha mthupi ku matenda), ndi othandizira monga lamivudine, entecavir, etc. (mankhwalawa amaletsa kuchulukitsa kachilomboka ). Ndizosiyana kwambiri ndi chithandizo cha wothandizira (makamaka kudalira pa zinthu zina monga zaka, kaya wodwalayo ali ndi matenda a chiwindi kapena ayi, kukula kwa impso, etc.). Mankhwala omwe amasankhidwa amathandizanso kuti chithandizo cha mankhwala chikhoza kupitilira kwa nthawi yayitali bwanji. Zokambiranazi sizingatheke pa nkhaniyi ndipo ziyenera kukhala zina zomwe dokotala wanu adzakambirane ndi inu musanayambe chithandizo.
2. Mankhwala osokoneza bongo: Awa ndi mankhwala monga steroids kapena mankhwala ena a cytotoxic monga cyclophosphamide . Ngakhale izi zingagwiritsidwe ntchito pa matenda a impso a "garden" osiyanasiyana a MPGN kapena nthenda yosagwirizana ndi matenda, amatha kugwiritsa ntchito nthawi zambiri pamene matendawa amayamba chifukwa cha matenda a hepatitis B (omwe ali ndi chiopsezo chotentha matendawa). Komabe, izi sizotsutsana ndi "bulangete". Pali zizindikiro zenizeni pamene othandizirawa angafunike kuganiziridwa ngakhale pakadali kachilombo ka hepatitis B. Mtundu umodzi woterewu ndi mtundu waukulu wa kutupa kumene kumakhudza impso 'fyuluta (yomwe imatchedwa progressive glomerulonephritis). Zikatero, mankhwala osokoneza bongo amatha kukhala ndi chinthu china chotchedwa plasmapheresis.

> Zotsatira:

> Hepatitis B ndi Matenda a Renal. Tak Mao Chan. Curr Hepat Rep. 2010 May; 9 (2): 99-105. Lofalitsidwa pa intaneti 2010 Apr 14 14. Chitani: 10.1007 / s11901-010-0042-6

> Matenda a hepatitis B omwe amagwiritsidwa ntchito polyarteritis nodosa: zizindikiro zamankhwala, zotsatira, komanso zotsatira za odwala 115. Guillevin L. Medicine (Baltimore). 2005 Sep; 84 (5): 313-22.