Matenda a hepatitis C (HCV) amapezeka ndi matenda a magazi. Mayeso a anti-antibody angadziwe ngati thupi lanu liyenera kulimbana ndi matenda a HCV. Kuyezetsa magazi komwe kumayambitsa kachilombo koyambitsa magazi kumatsimikizira kuti matendawa ndi otani, koma zotsatira zimatenga nthawi yaitali. Nthawi zina, kafukufuku wa chiwindi, maphunziro a zojambula kapena zojambula zingathandizire kapena kutsimikiziranso matendawa.
Kuyesedwa / Kuyesedwa Kwapanyumba
Ngati mukuganiza kuti mutha kukhala ndi HCV, pali zizindikiro zingapo zomwe mungayese nokha. Vuto, komabe, pakufufuza nokha kwa HCV, ndizomwe zizindikiro zambiri zomwe mungathe kuziwona ndizofala kwa matenda ambiri. Zina mwa zizindikiro zomwe mungayang'ane ndi zizindikiro za matenda a chiwindi, koma sizidziwika kwa HCV.
Khungu ndi Maso
Chizindikiro chomwe chimapezeka kwambiri ndi HCV ndi jaundice, mtundu wachikasu wa khungu ndi maso. Jaundice imakhudza thupi lonse ndi mbali yoyera ya maso. Mtunduwu ukhoza kuoneka ngati wachikasu, ngati ngati dzuwa, kapena ngati matendawa ali ndi mphamvu yaikulu ya chiwindi, maso ndi khungu lanu likhoza kukhala lowala kwambiri.
Jaundice imasonyeza chiwindi kulephera kapena chiwindi chosagwira ntchito, kotero sizowonekera kwa HCV.
Kusiyana kwa m'mimba
Kukula kwa m'mimba, kapena popanda kusokonezeka, kumakhala kofala kumapeto kwa HCV.
Anthu ambiri alibe zizindikiro za HCV kumayambiriro kwa matenda, ndipo kusamvana kwa m'mimba kungakhale chidziwitso choyamba chomwe muli ndi HCV.
Matenda-Monga Zizindikiro
Ngati muli ndi kachilombo koyambitsa matenda a HCV, mukhoza kukhala ndi fever yochepa, kutopa, kupweteka kwa minofu, kusowa kwa njala, kusowa kwachisokonezo komanso kusamva kwa m'mimba. Mungathe kuwona izi ndi pafupifupi matenda aliwonse a tizilombo, choncho si chidziwitso champhamvu chomwe muli ndi chiwindi cha chiwindi.
Zizindikiro za m'mimba
Ngati muli ndi kachilombo koyambitsa matenda a HCV, mwinamwake mungakhumudwitse mimba, mseru, kusanza kapena kutsekula m'mimba. Mofanana ndi zizindikiro za chimfine, ichi si chizindikiro chotsimikizika cha matenda a HCV, monga momwe angathere ndi matenda ena.
Zowopsa
Nthawi zambiri, simudziwa nthawi yomweyo ngati mwapezeka ndi HCV. Kuganizira mosamala ngati muli ndi chiopsezo chilichonse ndi njira yabwino yowunika ngati mungakhale ndi HCV.
Ngati muli ndi zifukwa zoopsa kapena zizindikiro zina za HCV, ndibwino kuti muyesedwe kachilombo ka HIV.
Mapulogalamu ndi Mayesero
Pali mayesero ambiri a magazi amene angathe kupeza matenda a HCV, kudziwa njira yabwino yoperekera chithandizo, ndi kuyang'anira chitukuko chanu. Mayeso a magazi amatha kuyang'ana anti-HCV antibody, kwa HCV yokha, komanso chifukwa cha kusintha kwa chiwindi.
Mayeso a Magazi a HCV
Pamene mavairasi a hepatitis C amachititsa kuti thupi lanu lisatengedwe, chitetezo chanu cha mthupi chimayankha pogwiritsira ntchito ma antibodies kuti adziwe mavairasi ngati owononga. Ma antibodies ndi enieni a HCV, kotero kukhalapo kwawo kumasonyeza kuti mwakhala ndi HCV nthawi ina m'moyo wanu. Mayesero a antibody sangathe kusiyanitsa pakati pa matenda oyamba kapena omwe alipo, kotero kuti zambiri zachipatala monga mbiri yachipatala, zizindikiro, zizindikiro kapena mayesero ena angathe kudziwa ngati muli ndi kachilombo koyambitsa matenda kapena kachilombo ka HIV.
Ndipotu, mayeso olimbitsa thupi angatanthauze kuti mwakhala ndi kachilombo koti mumagonjetsa, komanso kuti mulibe kachilombo koyambitsa matendawa.
- Mayeso a Magazi: Kuyeza kwa ImmunisomuSorbent Assay (ELISA) yowonongeka imatha kuzindikira ma antibodies m'magazi anu. Pali mitundu yosiyanasiyana ya ELISA. Mayeso a ELISA a HCV amafufuza mchere wa magazi kwa wodwalayo wa HCV. Ngati ma antibodies akupezeka, izi zikutanthauza kuti mukhoza kukhala ndi kachirombo ka HIV. Mayeso a ELISA ndi ofunika kwambiri, ndipo ali ndi mphamvu 95 peresenti ya nthawi ngati muli ndi ma antibodies a HCV. Izi zimatanthawuza kuti pamene mayeso a ELISA ali oipa, mukhoza kukhala otsimikiza kuti mulibe HCV. Komabe, zimakhala zovuta kwambiri kuti zizindikiritse ma antibodies a HCV molakwika, ndipo pali kuthekera kochepa kuti zotsatira zabwino zingakhale zolakwika. Chifukwa cha mwayi wabodza, kuyesa kwachiwiri kungafunike kutsimikizira zotsatira zoyambirira.
- Mayeso Ofulumira: Mayeso ofulumira angathe kuona HCV m'magazi kapena m'matumbo anu ndi 89% zokhudzidwa ndi 100% zenizeni. Izi zikutanthawuza kuti sizili zovuta ngati mayeso a ELISA, ndipo amatha kuphonya kukhalapo kwa HCV nthawi zina. Koma ngati mayesero ali abwino, ndiye mutha kutsimikiza kuti muli ndi HCV m'thupi lanu nthawi ina.
Hepatitis C RNA
Kuzindikira kwa HCV RNA, yomwe ili ndi mavitamini a kachilomboka, kumasonyeza kuti kachilombo kamene kalipo m'thupi lanu. Mayeso amphamvuwa amavomereza madokotala kuti awone bwino momwe mukuyankhira mankhwala chifukwa amatha kudziwa kuchuluka kwa kachilombo ka magazi, komwe nthawi zambiri imatchedwa kuti chiwerengero cha tizilombo . Zimateteza kachilombo pogwiritsa ntchito chipangizo cha PCR (polymerase chain chain), yomwe ndi njira yodziwira zamoyo.
Kugwiritsa ntchito mayeso a ELISA ndi HCV RNA pamodzi:
- Negative ELISA = Palibe mankhwala a hepatitis C omwe amapezeka m'magazi. Mwinamwake mulibe kachirombo ka HCV.
- Chokoma ELISA = Mukhoza kukhala ndi matenda a HCV. Komabe, n'zotheka izi ndi zabodza. Kuyesedwa kwina kumafunika.
- HVV yoipa HCV RNA = Palibe matenda a HCV.
- Zokongola HCV RNA = Ntchito yogwira ntchito ya HCV .
Matenda a Hepatitis C
Matenda a hepatitis C si ofanana. Ndithudi, onsewa amadziwika ngati mavairasi a hepatitis C ndipo onse amatha kuyambitsa matenda aakulu a chiwindi ndi matenda a chiwindi, koma sali osiyana kwenikweni. Iwo ali ndi kusiyana kosiyana kwa mafuko, ndipo amagawidwa m'magulu osiyanasiyana (ma genetic). Kudziwa dzina lanuli kungachepetse nthawi yambiri ya mankhwala chifukwa dokotala wanu angasankhe chithandizo chabwino cha mtundu wa HCV womwe muli nawo.
Zizindikirozi ndizofunikira chifukwa mavairasi a hepatitis C omwe ali ndi mitundu yosiyanasiyanasiyana imafuna njira zosiyanasiyana zochizira. Madokotala amadziwa mtundu wa HCV wanu pogwiritsa ntchito njira yomwe imatchulidwa kuti RT-PCR. Chiyesochi chimafufuza zomwe zimayambitsa kachilombo koyambitsa matendawa kuti zidziwe momwe zimakhalira, zomwe zimatchula maonekedwe a kachilomboka.
Ntchito ya Chiwindi Mayesero (LFTs)
Kuyezetsa magazi kumakhala kovuta ngati kachilombo ndi kutupa zimayambitsa chiwindi. Mayeserowa kawirikawiri samayembekezeredwa kukhala opanda zachilendo mpaka masitepe. Ndipo, mankhwala a HCV angasinthe maulendo a LFT.
Ma LFTs omwe amasinthidwa ngati muli ndi vuto la chiwindi ndi awa:
- Albumin
- Bilirubin
- Prothrombin Time (PT)
- Mayiko Odziwika Kwambiri (INR)
LFTs zomwe zingasinthe ngati muli ndi kutupa kwa chiwindi ndi:
- Alanine aminotransaminase (ALT)
- Aspartate aminotransferase (AST)
- Gamma-glutamyl transaminase (GGT)
Kujambula
Mayeso ojambula amatha kuzindikira kutupa kwa chiwindi, kukula kwa chiwindi, kuchepa kwa chiwindi kapena matumbo pachiwindi. Zotsatira zojambula sizikhoza kuwonetsa mwachindunji matenda a HCV. Zonse mwa zotsatirazi zikhoza kuchitika chifukwa cha matenda a HCV, ngakhale kuti angathe kuchitika ndi matenda aliwonse a chiwindi. Mwina mungafunike kuyesa zojambula ngati muli ndi msambo wamimba, zilonda zam'mimba kapena zizindikiro zomwe zimasonyeza kuti mukhoza kukhala ndi khansa. Mwinanso mungafunikire mayeso ojambula ngati dokotala akudera nkhawa zowonjezera zomwe zingathe kudziwika pamayesero a m'mimba, monga appendicitis kapena gallstones.
- Mimba ya m'mimba: Mayesowa angathe kuyesa zowonongeka m'chiwindi ndi mimba, ndipo amatha kuona kuti madzi akumwa m'mimba, omwe angathe kuchitika ndi chiwindi chosalimba.
- Katswiri wa kompyuta wotchedwa Axial Tomography (CT) amawunika: Katemera wa m'mimba amatha kuona kusintha kwa kukula ndi kuchulukitsa kwa chiwindi ndipo amatha kuona m'maganizo mwathu masoka kapena zizindikiro za khansa yoyambirira.
- Maginito Resonance Imaging (MRI): MRI ikhoza kuganizira zolakwika zomwe zimasonyeza kuti vuto la chiwindi silikugwira ntchito kapena khansara.
- Chiopsezo cha chiwindi: Chiwindi cha chiwindi ndi gawo la minofu yotengedwa pachiwindi ndi kuyesedwa pansi pa microscope pofuna kufufuza zizindikiro za matenda. ndondomekoyi nthawi zambiri imatsogoleredwa ndi zilonda zosadziwika zomwe zatchulidwa pa maphunziro a kujambula.
Kusanthula Kusiyanasiyana
Mavuto angapo osiyana ndi azachipatala angayambitse LFTs osadziwika ndipo amaonetsa zizindikiro zofanana ndi za matenda a HCV. Komabe, palibe mwazimenezi zingakupangitseni kuti mukhale ndi kachilombo koyambitsa magazi a HCV kapena mayeso abwino a HCV RNA.
- Mankhwala Osokoneza Bongo: Kutha kwauchidakwa kungayambitse mavuto ambiri m'chiwindi, kuphatikizapo mafuta, chiwindi ndi khansa. Kukula kwa chiwerewere cha chiwindi kumawonekera pang'onopang'ono pa nthawi, ndipo zofukufuku zikhoza kusonyeza njira zosiyana ndi zomwe zingayembekezeredwa ndi HCV.
- Hepatitis B (HBV): Chitsanzo cha matenda ndi HBV ndi choopsa kwambiri kuposa cha HCV, ngakhale kuti zikhoza kukhala zofanana chifukwa zonse zimayambitsa chiwindi.
- Hepatitis A (HAV, chiwindi A) : Vuto lina limene limayambitsa matenda a hepatitis, monga HCV, chiwindi A, amatha kupweteka ngati zizindikiro. Tizilombo toyambitsa matenda timafalitsa kudzera mu zakudya zowonongeka. Chimafalikira chifukwa kachilombo kamene kalipo mthunzi (poop) ndipo imatha kufalikira kwa munthu aliyense chifukwa cha kusamba m'manja.
- Cholecystitis (kutupa kwa ndulu) kapena Coledocholithiasis (miyala yamwala): Mwala wamwala kapena kutupa kwa ndulu kungayambitse jaundice, kunyoza, kusanza ndi malungo. Cholecystitis ndi choledocholithiasis zingakhalenso zopweteka.
- Appendicitis: Kutupa kapena matenda a zowonjezereka zimayambitsa ululu waukulu m'mimba ndi fever, ndipo imakula mofulumira. Nthawi zina, kugwiritsira ntchito zizindikiro zingathe kulakwa chifukwa cha matenda a HCV ngati ululu wa appendicitis ndi wofatsa. Matenda a HCV akhoza kulakwitsa chifukwa cha kupweteka kwa m'mimba ngati kupweteka ndi kupweteka kwa m'mimba kuli koipa kuposa momwe zimakhalira ndi HCV.
- Hepatocellular Carcinoma: Khansa ya chiwindi ingayambitse m'mimba kutalika, jaundice ndi LFTs zosadziwika. Khansara ya chiwindi ingakhalenso chifukwa cha mapeto a HCV. Ndikofunika kudziwa ngati HCV ndi amene amachititsa khansa chifukwa kachilombo ndi khansayo zonse ziyenera kuchitidwa.
> Zotsatira:
> Deterding K, Höner Zu Siederdissen C, Port K, ndi al. Kupititsa patsogolo chiwindi cha ntchito za chiwindi muzomwe zimapangidwira kwambiri za HCV-zogwirizana ndi chiwindi cha anti-antiretroviral (IFT). Kudyetsa Pharmacol Ther. 2015 Oct; 42 (7): 889-901. lembani: 10.1111 / apt.13343. Epub 2015 Aug 6.
> Lee SJ, Cho YK, Na SY, ndi al. Kugonjetsedwa kwa matenda osokoneza bongo ndi splenomegaly mwa odwala awiri omwe ali ndi chiwindi cha chiwindi cha hepatitis-C pambuyo pa interferon ndi ribavirin mankhwala othandizira. Clin Mol Hepatol. 2016 Sep; 22 (3): 390-395. Epub 2016 Aug 30
> Pallarés C, Carvalho-Gomes Â, Hontangas V, et al. Kuchita kwa oraQuick Hepatitis C kachilombo ka HIV kumayesera mu mkamwa zamadzimadzi ndi zozizira magazi pamaso ndi pambuyo mankhwala opatsirana kachilombo. J Clin Virol. 2018 May; 102: 77-83. do: 10.1016 / j.jcv.2018.02.016. Epub 2018 Feb 24.