Umboni Ukuthandizira Kugwiritsa Ntchito Steroid-Resistant Relapses
A. Kusinthanitsa kwa Plasma, komwe kumatchedwanso "plasmapheresis," akulimbikitsidwa ndi American Academy of Neurology (AAN) kuti athetse vuto lalikulu kwa anthu okhala ndi multiple sclerosis (rerpsing-reving multiple sclerosis) (rerpsing-reving multiple sclerosis).
Komabe, kusinthanitsa kwa plasma kumalimbikitsidwa ngati mankhwala a mzere wachiwiri wobwereranso omwe sanayankhepo pa Solu-Medrol - osati m'malo mwa Solu-Medrol.
Kuvomerezedwa kwa AAN kuti chithandizo cha kubwezeretsedwa mu RRMS kupangidwa mu January 2011 ndi kusintha kwa malangizo kuchokera mu 1996, pamene njirayi idatchulidwa "yokhazikika" komanso "yothandiza."
Tiyenera kukumbukira kuti kusinthanitsa kwa m'magazi sikunatchulidwe ndi AAN kuti apeze njira yachiwiri yopitilira miyendo yambiri yopitilirapo.
N'chifukwa Chiyani Ntchito Yophatikizira Plasma Ikubwereranso?
Kusinthanitsa kwa plasma kumachotsa zinthu zovulaza zomwe zikuyenda mu gawo la madzi (plasma) mwazi. Pankhani ya MS, izi ndizirombo zotsutsana ndi mapuloteni omwe amapangidwa ndi myelin , komanso ma maselo a T komanso mwina maselo ena omwe amateteza thupi langa.
Zimaganizidwa kuti kuchotsa maselowa panthawi yobwereza kungachepetse nthawi yomwe kubwezeretsedwa ndi kuwonongeka kwa kutupa. Komabe, pokhapokha ngati ma antibodieswa atayikidwa kapena atayikidwa m'matumbo, kusinthana kwa magazi sikungathe kuwachotsa ndipo mwina sangakhale ndi chithandizo chamankhwala.
Kodi Umboni wa Plasma Exchange wa RRMS umabwereranso?
Mu mayeso amodzi a crossover, anthu 22 omwe ali ndi RRMS kapena matenda ena opatsirana opweteka (transverse myelitis, neuromyelitis optica) omwe amachititsa kuti zizindikiro zovuta zikhalepo pofufuza za kusintha kwa plasma. Anthu onse anali atalephera kuchita nawo maphunziro a Solu-Medrol ndipo masewera ambiri pa EDSS anali 7.5 pamene anayamba mankhwala.
Odwala asanu anali "atazindikiritsa" kuti apite patsogolo "kusintha" pambuyo pa kusintha kwa plasma. Zisanu mwa izi zinapitilirabe kusintha kwa zaka zitatu.
Mgulu lina laling'ono, anthu anayi omwe ali ndi RRMS adabwereranso omwe sanayankhe Solu-Medrol. Aliyense anapatsidwa magawo asanu a kusintha kwa plasma. Munthu mmodzi "adayesa" kuchiritsa, anthu awiri anali ndi "zolimbitsa thupi" (ngakhale kuti mmodzi wa iwo ankafuna kuti mankhwala ozungulira 5 apite kawiri), ndipo munthu mmodzi anali ndi "chifatso" kuchira.
Pansi
Ngati muli ndi vuto lalikulu lomwe simunayankhe Solu-Medrol, dokotala wanu akhoza kunena bwino kusinthanitsa kwa plasma. Kusinthanitsa kwa plasma ndi njira yotetezeka yomwe si yachilendo ndipo siimabweretsa mavuto ambiri.ZOYENERA: Kusinthanitsa kwa plasma kumagwiritsidwanso ntchito kwa anthu omwe ali ndi multiple sclerosis omwe amapezeka kuti ali ndi Tysabri-yogwirizana kwambiri ndi leukoencephalopathy (PML). Nthawi zambiri amagwiritsidwa ntchito pogwiritsa ntchito mankhwala. (Kuti mudziwe zambiri: Q. Kodi chithandizo cha PML chogwirizana ndi PML ndi chiyani? )
Kuti mudziwe zambiri zokhudza kusintha kwa magazi, werengani: Plasma Exchange (Plasmapheresis) ya MS ndi Matenda Ena Okhudza Matenda a Edzi.
Zotsatira:
Cortese I, Chaudhry V, So YT, Cantor F, Cornblath DR, Rae-Grant A. Pulogalamu yotsogoleredwa ndi malangizo: Plasmapheresis mu matenda a ubongo: Report of Therapeutics and Technology Assessment Committee ya American Academy of Neurology. Neurology. 2011 Jan 18; 76 (3): 294-300.
Habek M, Barun B, Puretic Z, Brinar VV. Kuchiza kwa steroid kusabwerezabwereza kubwereza ndi plasma kusinthana mu ziwalo zoopsa zamatenda. The Apher Dial. 2010 Jun; 14 (3): 298-302.
Lehmann HC, Hartung HP, Hetzel GR, Stuve O, Kieseier BC. Kusintha kwa Plasma mu Matenda a Edzi, Gawo 1: Zomwe Zimagwiritsidwa Ntchito ndi Chithandizo cha Kutupa Kwambiri Padziko Lonse. Arch Neurol. 2006; 63: 930-935.
Kuchotsa BG, O'Brien PC, Petterson TM, et al. Chiyeso chosasintha cha kusinthanitsa kwa plasma m'magulu akuluakulu a mitsempha yotupa yotsekemera matenda. Ann Neurol. 1999; 46: 878-886.