Lupus nephritis: ganewar asali, magani, rage cin abinci

Lupus nephritis ne daya daga cikin mafi m rikitarwa da tsari lupus erythematosus. SCR - shi ne wani autoimmune cuta lalacewa ta hanyar bayyanar antibodies a cikin jiki, wanda sama da " 'yan qasar" proteins kamar yadda waje. A sakamakon haka, masu tasowa, aseptic kumburi a sassa daban-daban na jiki. Ciki har da a kodan.

definition

Lupus nephritis, lupus nephritis, ko - wani nauyi koda cuta a cikin tsari lupus erythematosus. Yaduwar da wannan cuta a cikin yawan, a kan talakawan arba'in mutane da dubu ɗari yawan jama'a. Mafi wahala daga wakilan da kyau rabin dake da shekaru ashirin zuwa shekara arba'in. Mafi sau da yawa, da Pathology da aka samu a} ar fatar tsibiran Caribbean, wa jama'a.

A cutar za a iya lalacewa ta hanyar wani m iri-iri dalilai, daga overuse na tanning, to kwayoyin cuta, don haka yana da muhimmanci lokaci zuwa kula da cututtuka da kuma ganin likita. Bayan duk, da jima an fara Jiyya da, da mafi alheri da hangen nesa ga haƙuri da rai da kuma lafiya.

etiology

Lupus nephritis za a iya jawo da dadewa rana mai daukan hotuna m (sha'awa solarium ko zauna a rana wurare), allergies zuwa magunguna, m danniya da kuma ko da ciki (tayin ana riskarsa kamar kasashen waje jiki da kuma tsarin na rigakafi fara kai farmaki uwar Kwayoyin).

Bugu da kari, ci gaban kwayoyin cututtuka shafi buri, da gaban hormonal imbalances, m cutar cututtuka (virus hadedde cikin cell jiki, barin in su surface antigens da tsokane ta haka wani rigakafi martani). Chance bunkasa cutar a kusa da dangi sau da dama mafi girma fiye da talakawan ga yawan jama'a.

pathogenesis

Lupus nephritis ne wani ɓangare na wani alama cewa tasowa a tsari lupus erythematosus. Autoantibodies ci gaba da fari ga 'yan qasar DNA da ta dangane da histones, to sunadarai na dace da tsarin da kuma cardiolipin. Dalilin wannan ta'adi - rage haƙuri ga kai antigens, lahani a B da kuma T lymphocytes.

Tsaye hade da ci gaban nephritis a cewa antigen-antibody gidaje Tropic ga tsokoki na koda tubules. Da zarar wannan sunadarin ne a haɗe zuwa cell surface, shi triggers wani cascade na biochemical halayen da haifar da sakewa da aiki abubuwa, narke cell. Wannan, bi da bi, yana sa wani mai kumburi dauki, wanda kawai exacerbates da lalacewa.

mugun jin haltta

Lupus nephritis a SLE iya samun daban-daban morphological manifestations. Tare da bude daga cikin marasa lafiya da canje-canje a cikin membranes na koda glomeruli, aiki rabo na sel, fadada daga cikin mesangium, jijiyoyin bugun gini sclerosis, madaukai da kuma more. Wadannan manifestations iya zama duka biyu a daya kuma a dama glomeruli.

A mafi takamaiman for lupus nephritis ne fibrinoid necrosis capillary madauki na Henle, kuma histologically detectable karyopyknosis da karyorrhexis (rabuwa da kuma lysis na cell nuclei). Bugu da kari, a pathognomonic canji a glomerular ginshiki membrane a matsayin "waya madaukai" da kuma gaban hyaline thrombi a lumen na capillaries a sakamakon shaida na rigakafi da gidaje.

rarrabuwa

Asibiti da kuma morphologically ne dama, saukarwa da kara lupus nephritis. Nau'in na World Health Organization kamar haka:

1. Da farko Class: glomeruli da wata al'ada tsari.
2. Biyu aji: akwai kawai ya canjãwa a mesangium.
3. Uku aji: glomerulonephritis da rauni na rabin na glomeruli.
4. Fourth sa: yaxuwa glomerulonephritis.
5. Biyar sa: membranous glomerulonephritis.
6. Shida sa: sclerosing glomerulonephritis.

Akwai kuma rarrabuwa Serova, a cikin abin da shi allocates mai da hankali, yaxuwa, membranous, mesangioproliferative, mesangiocapillary glomerulonephritis da fibroplastic.

cututtuka

Membranous lupus nephritis yana da biyu obligate da facultative bayyanar cututtuka. Daya daga cikin manifestations ne m proteinuria, cewa shi ne, gaban gina jiki a cikin fitsari. Har ila yau, za ka iya sau da yawa sami hematuria, leuco - da kuma limfotsituriyu. Wadannan alamu sun nuna gaban kumburi a kodan kuma zai iya zama ba kawai a SLE.

Tare da ci gaban da autoimmune tsari na karuwa bayyanar cututtuka na koda gazawar da aka bayyana ta ƙãra creatinine matakai a jini da fitsari, wani rauni, lethargy haƙuri soporous jihohi.

Shin sannu a hankali m da hanzari m nephritis. Idan cutar tasowa sannu a hankali, fi fitsari da kuma nephrotic ciwo. Bugu da ƙari, lupus nephritis za a iya gudanar a wani m ko latent tsari, lokacin da dukan cututtuka ne ba kawai qananan proteinuria.

Hanzari m lupus nephritis ne sosai kama da classic glomerulonephritis. Koda gazawar da aka girma cikin sauri, akwai babban hematuria, ta ƙara jini, da kuma nephrotic ciwo. A tsanani lokuta zai iya ci gaba watsa intravascular coagulation (DIC).

Lupus nephritis a yara

A 1/5 na marasa lafiya da na tsari lupus erythematosus farko bayyanar cututtuka bayyana a cikin shimfiɗar jariri. A yara, matasa, fiye da shekaru 10, shi kusan ba ya faruwa, amma akwai wani bayanin lokuta da SLE a wani yaro da rabi watanni da haihuwa.

A ci gaba da cuta a cikin 'ya'yanku ba daban-daban daga abin da na manya. The asibiti hoto iya bambanta: daga asymptomatic zuwa hanzari m. M na koda gazawar ne rare.

Da dama; ãyõyi na SLE a cikin yaro:

• erythema a kan fuskarsa.
• discoid rash a jiki;
• ýan zuwa ga hasken rana.
• mucosal ulceration.
• kumburi daga cikin gidajen abinci.
• koda cuta.
• wani take hakkin tsakiya m tsarin.
• ya karu zub da jini;
• immunological cuta.
• gaban antinuclear antibodies.

Idan asibitin yana da akalla hudu siffofin daga wannan jerin, za mu iya amincewa ce da cewa yaro yana da tsari lupus erythematosus. koda lalacewa a yara wuya zo da fore. Yawancin lokaci, bayyanar cututtuka zai iya Range daga glomerulonephritis zuwa manifestations na antiphospholipid ciwo.

Forecast na ci gaba cuta a cikin yara fiye da m. Shekaru goma bayan da halitta na dialysis ganewar asali na bukatar kawai 10 bisa dari na marasa lafiya.

bincikowa da

Abin da ya bada likita a dalilin zargin lupus nephritis? Ganewar asali ne yawanci dogara ne a kan data kasance asibiti da kuma awon-tabbatar da bayanai a kan SLE:

• Zafi da kumburi a gidajen abinci.
• rashes a kan fata na fuska a cikin nau'i na malam;
• a gaban effusion tarihi a cikin kogo (pleurisy, pericarditis).
• sauri nauyi asara, zazzabi.

A general bincike na jini lura anemia, rage platelets, ta ƙara erythrocyte sedimentation kudi, rage gaba da sunadarai. Domin ganewar asali da muhimmanci a gane antibodies 'yan kasa DNA.

Yawancin lokaci, wannan shi ne isa ya yi ganewar asali da na tsari lupus erythematosus kuma, kamar yadda wani sakamako na lupus nephritis. Duk da haka, bayyanar gina jiki a cikin fitsari iya yi jinkiri ga daya ko shekaru biyu daga farko na cutar. A irin wannan yanayin, da likita ya dogara akan enzyme immunoassay da kuma ganewa antibodies. Idan ba a tabbatar da dakin gwaje-gwaje data, shi wajibi ne su ci gaba da bincike search, musamman namiji marasa lafiya, domin su nosology, wannan shi ne rare.

Bambance lupus nephritis a SLE marasa lafiya da kwayan endocarditis, m exacerbations na rheumatoid amosanin gabbai, mahara myeloma, kullum hepatitis B, kuma amyloidosis ciwo, da Hanok-Schonlein purpura.

A mataki na farko na magani

Jiyya na lupus nephritis - mai tsawo da kuma muhimmin tsari cewa sau da yawa yana a rayuwa. Yana faruwa a matakai biyu. A mataki na farko docked exacerbation. Manufar magani - cimma barga gafarta musu, ko a kalla rage asibiti manifestations.

Magani ya kamata a fara maza maza daga lokacin da ganewar asali. Duk abin da ya faru don haka da sauri da cewa ko da a biyar zuwa bakwai kwanaki na bata lokaci zai iya zama mai m kuskure. Idan aiwatar aiki ne low (shi zai nuna antibody titers), likita iya iyakance ga yin amfani da corticosteroids a high allurai na tsawon watanni biyu, bi da wani jinkirin karu a sashi (abruptly soke miyagun ƙwayoyi ba zai iya zama, zai iya musun da adrenal gland).

Idan wani mafi m hanya da cutar, ban da steroids, intravenously gudanar high allurai cytostatics. Wannan bugun jini far ne da za'ayi a cikin watanni shida. Kawai bayan wannan lokaci za su iya fara don rage kashi na kwayoyi, da kuma canja wurin haƙuri zuwa wani baka magani.

Kada ka manta da cewa a cikin marasa lafiya da SLE sau da yawa ci gaba watsa intravascular coagulation, don haka ne shawarar ya dauki m matakan, wato:

• transfussion na jini da kuma da aka gyara.
• igiyar jini "Trental".
• subcutaneous gwamnatin 2.5 raka'a dubban "heparin".

Mataki na biyu na magani

Lupus nephritis a SLE a mataki na biyu kuma an bi da tare da steroids da cytotoxic kwayoyi. Kawai da kashi suna da yawa karami. Very sannu a hankali, a kan hudu zuwa watanni shida, da kashi "Prednisolone" titrated zuwa 10 milligrams da kilogram na jiki nauyi. Cytotoxic jamiái kuma nada bolus allurai da zarar kowane watanni uku, kuma idan m muhimmancin da cutar, sa'an nan, matsa zuwa wani guda allura kowane watanni shida.

Irin wannan goyon baya far iya šauki shekaru. A tsawon lokaci, shi ne kara (idan ya cancanta) rigakafin illa da kwayoyi da kuma symptomatic magani.

Amma ko da tare da dace fara jiyya a goma sha biyar bisa dari na marasa lafiya har yanzu ci gaba koda gazawar. A wannan yanayin, za a iya kawai taimaka hemodialysis ko koda dasawa. Abin baƙin ciki, wadannan jiyya ba su da samuwa ga jama'a.

Rage cin abinci domin lupus nephritis

Domin ya kula da na koda aiki tare da lupus nephritis marasa lafiya ya kamata bi wasu sharudda:

1. Sha yalwa da ruwaye zuwa da tace da jini da kuma kula da matakin na metabolism.
2. The abinci ya kamata dauke da qananan yawa na potassium, phosphorus da kuma gina jiki, tun da wadannan abubuwa da wani mummunan sakamako a kan lalace kodan.
3. Daina miyagun halaye.
4. Tafiyar da haske motsa jiki.
5. A kai a kai duba your jini.
6. Iyakance ci daga m abinci.
7. Kada ku riƙi NSAIDs domin suna da wani mummunan tasiri a kan kodan.

Idan haƙuri haka wadannan shawarwari, da ingancin rayuwa da aka muhimmanci inganta, da kuma rayuwa hangen nesa ne mafi alamar rahama.

Outlook

Forecast zalunta lupus nephritis membranous dogara a kan yadda mai tsanani shafi kodan da kuma farkon far. A baya cikin haƙuri ke da likita, da girma da alama na m sakamako.

Shekara arba'in da suka wuce, kawai dintsi na marasa lafiya da lupus nephritis sun rayu fiye da shekara daga ganewar asali. Godiya ga hanyoyin zamani na jiyya da kuma ganewar asali, marasa lafiya za su iya sa ran wani fiye da shekara biyar lifespan.