Lupus pauku: tātaritanga, maimoatanga, kai

Lupus pauku Ko tetahi o nga pōauautanga tino auau o te erythematosus lupus pūnahanaha. SCR - Ko te mate autoimmune meinga e te ahua o paturopi i te tinana, e riro te "whenua" pūmua rite ke. Ka rite ki te hua, te whakawhanake mumura iroiti i roto i ngā wāhanga rerekē o te tinana. Tae atu i roto i nga whatukuhu.

whakamāramatanga

pauku Lupus, lupus pauku, ranei - he mate tākihi taimaha i roto i erythematosus lupus pūnahanaha. Ko te nuinga o tenei mate i roto i te taupori, i runga i toharite wha iwi ia rau mano taupori. mamae te nuinga i ngā māngai o te hawhe ataahua i waenganui i nga ake o rua tekau ki te wha tekau nga tau. Nuinga o ngā wā, ka kitea te māuiuitanga e i roto i ngā taupori Afro-Karipiana.

Ka taea te meinga te mate i te whānui o ngā āhuatanga momo, i te pakaru o te tanning, ki ngā ira mate, na ko reira te wa tino nui ki te whakarongo ki ngā tohu, me te kite i te tākuta. I muri i te katoa, kei te tīmata te maimoatanga maoro, te pai te waitohunga mo te ora o te manawanui, me te hauora.

etiology

Ka taea te rongo Lupus pauku i wā roa-ra te rongo tonu (arearea solarium noho i roto i nga wahi paki ranei), mate pāwera ki rongoā, ahotea tūturu me tae noa hapūtanga (mohio a te kukune te rite te tinana ke ka tīmata te pūnaha ārai mate ki te patu i te pūtau whaea).

I tua atu, i te whanaketanga o mate ira pā ma'unimā, te aroaro o nehe hormonal, mate huaketo auau (huaketo integrated ki te tinana pūtau, mahue i roto i a ratou antigens mata, me te whakapataritari ona kupu te whakautu ārai). Chance o te whakawhanake i te mate i roto i whanaunga tata e rave rahi taime teitei atu i te toharite mō te taupori.

pathogenesis

Lupus pauku he wahi o te tohumate e whanake i roto i te erythematosus lupus pūnahanaha. Autoantibodies whakawhanake i te wahi tuatahi ki te DNA taketake me ona hononga ki histones, ki pūmua o te pūnaha ngä me cardiolipin. Ko te take mo te taua fakaaoao - heke kātakí ki antigens whaiaro, mea kohakore i roto i te B, me te lymphocytes T.

Tika e pā ana ki te whanaketanga o te pauku i nga complexes e antigen-antibody Tropic ki nga kopa o te tubules tākihi. Kia piri te he taua muingota o te pūmua ki te mata pūtau, pāngia e te reira he Niniiraa o tauhohe matüora e hua i roto i te tuku i te matū kaha, rewa pūtau. Tenei, i roto i te tahuri, meinga he tauhohenga inflammatory, e kē atu anake te kino.

anatomy mehameha

Lupus pauku i roto i whakamatea ai i ngā faaiteraa morphological. Ki te whakatuwheratanga o nga tūroro i huringa i roto i te kiriuhi o te glomeruli tākihi, wehenga kaha o ngā pūtau, te roha o te mesangium, sclerosis iaia, koropiko me te ake. kia ēnei faaiteraa e rua i roto i te kotahi me te i roto i te maha glomeruli.

Ko te tino motuhake mō te lupus pauku he fibrinoid koropiko necrosis capillary o Henle, a histologically detectable karyopyknosis me karyorrhexis (wehenga me te lysis o te karihi pūtau). I roto i te tua, he huringa pathognomonic i roto i te membrane whawhe glomerular rite te "koropiko waea" me te aroaro o te puata thrombi i te lumen o te tōiti rite ki te hua o te waipara o complexes ārai.

whakarōpū

Hauora me morphologically e rave rahi ngā wāhanga e toro lupus pauku. Whakarōpū o te Health Organization World e whai ake:

1. Class Tuatahi: glomeruli i te hanganga noa.
2. piha haapiiraa Tuarua: i reira e tika e taui i roto i te mesangium.
3. piha haapiiraa tuatoru: glomerulonephritis ki lesion o tetahi tanga o te glomeruli.
4. kōeke A maha: E ruia ana glomerulonephritis.
5. kōeke A pae: glomerulonephritis membranous.
6. kōeke tuaono: sclerosing glomerulonephritis.

He he ano hoki te whakarōpūtanga Serova, i roto i nei tukuna reira rahi, E ruia ana, membranous, mesangioproliferative, glomerulonephritis mesangiocapillary me fibroplastic.

tohu

He rua tohu faahepo nei, me te facultative pauku lupus Membranous. Ko tētahi o ona faaiteraa he proteinuria whakahauanga, e ko, te aroaro o te pūmua i roto i te mimi. Hoki, ka taea e maha e kitea e koe hematuria, leuco - me te limfotsituriyu. tohu enei tohu i te aroaro o te mumura i roto i nga whatukuhu, me te taea e kore anake i roto i whakamatea.

Ki te whakanui ake i te ahunga whakamua o te tukanga autoimmune tohu o täkihi e whakakitea e nui haere ngā taumata creatinine i roto i te toto me te mimi, ngoikore, lethargy manawanui āhua soporous.

He āta ahu whakamua, me te tere e pauku ana ahu whakamua. Ki te āta whanake i te mate, taea mimi me te syndrome nephrotic. Ano, e taea te pupuri lupus pauku i roto i te puka tautauā moe ranei, ina he reira proteinuria iti anake katoa o te tohu.

Tere, ko te tino rite ki te glomerulonephritis matarohia e pauku ana lupus ahu whakamua. Kei te tipu haere tere täkihi, i reira he hematuria matotoru, te pēhanga toto nui haere, me te syndrome nephrotic. I roto i ngā take kino taea te whakawhanake coagulation intravascular tohatohaina (ano).

pauku Lupus i roto i ngā tamariki

I roto i te 1/5 o te tūroro ki pūnahanaha lupus erythematosus tohu tuatahi puta i roto i te tamarikitanga. I roto i ngā tamariki teina atu i te 10 nga tau, i te reira e kore e tata puta, engari i reira ko te whakamārama o te wā o whakamatea i roto i te tamaiti me te marama tawhito te hawhe.

e kore he rerekē i taua o ngā pakeke te whanaketanga o te mate i roto i ngā tamariki. kia rerekē ai te pikitia haumanu: i asymptomatic ki tere ahu whakamua. He onge whakapeka täkihi.

He maha ngā tohu motuhake o whakamatea i roto i te tamaiti:

• erythema i runga i te mata;
• ponana discoid i runga i te tinana;
• tūtohutanga ki te rā;
• ulceration mucosal;
• mumura o nga hononga;
• mate tākihi;
• he takahi o te pūnaha io pokapū;
• nui haere toto;
• disorders immunological;
• te aroaro o paturopi antinuclear.

Ki te i te iti rawa e wha āhuatanga i tenei rārangi te whare hauora, He pakari tatou e nehenehe e te mea e te tamaiti he erythematosus lupus pūnahanaha. kino tākihi i roto i ngā tamariki uaua mai ki te mua. Ko te tikanga, ka taea e tohu ngā i glomerulonephritis ki faaiteraa o syndrome antiphospholipid.

Matapae o te whanaketanga o te mate i roto i ngā tamariki atu pai. Kotahi tekau nga tau i muri i te waihanga o te tātari tātaritanga titau 10 anake ōrau o tūroro.

tātaringa

He aha homai te tākuta he take ki te whakapae lupus pauku? Kei te nuinga o te wā e hāngai ana tātaritanga runga ngā raraunga haumanu me te taiwhanga-whakapumautia i runga i whakamatea:

• Mamae me te mumura i roto i te hononga;
• rashes i runga i te kiri o te mata i roto i te puka o te pūrerehua;
• i roto i te aroaro o te hītori effusion i roto i te kōhao (kiripūkahu, pericarditis);
• mate taimaha nohopuku, kirika.

Ko te tātari whānui o te toto kitea anemia, heke platelets, nui haere auau ngeniwhero parataiao, heke ngā pūmua. He nui hoki tātaritanga ki te tautuhi i paturopi ki DNA taketake.

Ko te tikanga, he nui ki te hanga i te tātaritanga o te erythematosus lupus pūnahanaha tenei a, kia rite ki te putanga o te lupus pauku. Heoi, kia roa ai te ahua o te pūmua i roto i te mimi mo tetahi e rua ranei tau i te tīmatanga o te mate. I roto i te take i taua, whakawhirinaki te rata i runga i whākōkī immunoassay me te rapunga paturopi. Ki te kore whakapumautia e raraunga taiwhanga, he mea e tika ana ki te haere tonu i te rapu tātaritanga, tūroro toa rawa, mo to ratou nosology, he onge tenei.

Rerekëtanga pauku lupus i roto i ngā tūroro whakamatea ki endocarditis kitakita, exacerbations tāhapa o te kaikōiwi, myeloma maha, kakā B, me amyloidosis syndrome, Enoka-Schonlein te purapura.

Ko te wāhanga tuatahi o te maimoatanga

Maimoatanga o te lupus pauku - he tukanga roa, me te whakaware e maha pumau te ora. E te reira i wahi i roto i te rua ngā wāhanga. I roto i te wā tuatahi tapaeraa'tu exacerbation. Ko te whāinga o te maimoatanga - ki te whakatutuki i murunga pūmau, i te iti rawa whakaiti i te mau faaiteraa haumanu ranei.

kia timata rite wawe tonu rongoā i te kau o te tātaritanga. Mea katoa tupu hohoro kia e taea noa i roto i te rima ki te whitu nga ra o te whakaroa hei te hape mate. Ki te he iti te mahi tukanga (ka whakaatu i te reira i te titers antibody), kia iti te tākuta ki te whakamahi o corticosteroids i roto i pota tiketike mo te wā o nga marama e rua, aru e te hekenga puhoi i roto i te inenga (koimutu whakakore i te tarukino kore e taea e, ka taea e whakakahore nga repe adrenal).

Ki te he akoranga ake tere o te mate, i roto i te tua ki steroids, e pâmuhia whakahaere pota tiketike o cytostatics. kawea ana tēnei therapy pini i roto i roto i te ono marama. muri anake i tenei wā e taea timata ki te whakaiti i te horopeta o raau taero, ka whakawhiti i te manawanui ki te rongoā ā-waha.

Kaua e wareware ki i roto i te tūroro ki te patua coagulation intravascular maha whakawhanake tohatohaina, na e tūtohu ana ki te tango i āraihia, ara:

• huhu o te toto, me ona wāhanga;
• rō-uaua "Trental";
• whakahaere subcutaneous o 2.5 wae o nga mano o "heparin".

atamira Tuarua o te maimoatanga

Kei te tukinotia ano e pauku ana Lupus i whakamatea i roto i te wāhanga tuarua ki te steroids me taero cytotoxic. te horopeta anake e ratou nui iti. Tino pōturi, i runga i wha ki te ono marama, i te horopeta "Prednisolone" titrated ki te 10 milligrams ia manokaramu o taimaha tinana. whakaritea āpiha cytotoxic hoki pota bolus kotahi toru nga marama, a ka ki te nga akiaki pai o te mate, ka neke i runga i ki i te werohanga kotahi nga marama e ono.

kia muri therapy tiaki taua mō ngā tau. Neke atu i te wa, kua tapiritia reira (ki te tika) ārai o ngā pānga taha o raau taero, me te maimoatanga symptomatic.

Otiia ara ki wā timata maimoatanga i rima ōrau o tūroro whakawhanake tonu hēnga o ōna whatukuhu. I roto i tenei take, ka taea e te āwhina anake tātari toto tākihi transplantation ranei. Kia aroha mai, e kore e wātea ana ki te iwi whānui enei maimoatanga.

Kai mō te lupus pauku

I roto i te tikanga ki te mau tonu te mahi tākihi ki tūroro lupus pauku kia piri ki etahi ture:

1. Inu nui o fluids ki te tātari pai te toto, me te mau tonu i te taumata o te pākia e.
2. kia roto i te kai moni iti o pāhare pāporo, ūkuikui me te pūmua, mai i enei āhuatanga i te pānga kino i runga i whatukuhu pakaru.
3. Homai ake mau peu kino.
4. Whai wāhi i roto i te mahi marama.
5. Rite tonu te tirohia koutou pēhanga toto.
6. Whakawhāiti i te rōpū o ngā kai fatty.
7. Kaua e tango i NSAIDs no te mea e ratou i te pānga kino i runga i te whatukuhu.

Ki te whai te manawanui enei tūtohutanga, kei te tino pai ake te kounga o te ora, a ka he atu te fafau mai te waitohunga oranga.

outlook

Whakaaroa penei lupus pauku membranous tei runga i te āhua o te pānga rawatia nga whatukuhu, me te tīmatanga o te therapy. haere te mua te manawanui ki te tākuta, te nui te tūponotanga o te putanga pai.

E wha tekau nga tau ki muri, kua noho atu atu i te tau i te tātaritanga kutanga anake he o tūroro ki lupus pauku. Ngā mihi ki ngā tikanga hou o te maimoatanga me te tātaritanga, ka taea e tūroro e titau i te roa atu i te rima-tau.