I-Hepatitis B: Ingaba Kungabangela Izifo Zengqondo?

Funda ukuba kungani i-Hepatitis B inokuchaphazela iinjongo, kwaye ungayenza ntoni ngako

Iingqungquthela zonyango ziyamkela ukuba esinye sezifo ezilahlekisa kakhulu iingu-nomenclatures ngaphandle kwe-Hepatitis B kunye nesifo sesibindi so-Hepatitis C. Ezi zihloko zingenakwaneleyo ukuchaza ezi zifo ekubeni igama elithi "hepatitis" lithetha ukuvuvukala kwesibindi. Oku kunika ingqiqo yokuba ilungu elilodwa elichaphazelekayo kwi-Hepatitis B okanye kwiC isifo, esilahlekisa ngenxa yokuba izi zifo zibona ukubandakanyeka kwamalungu angaphandle kwesibindi, kwaye ngoko ke izifo zengqondo ye-systemic (kunye nezingekho ndawo) zichaza.

Intso yinto enye enjalo ukuba iintsholongwane ze-hepatitis zichaphazela kokubili ngqo nangokungaqondile. Iintsholongwane ze-Hepatitis azikho kuphela ezichaphazelayo ezichaphazela iinjongo. Nangona kunjalo, indima yabo kwisifo seengtso kubalulekile ukuphawula ngokunikezwa ngokubanzi kwezifo zentsholongwane. Makhe sixoxe ngeenkcukacha malunga nesifo sengqondo se-Hepatitis B.

Ziyintoni na eziqhelekileyo kuMbutho weZifo Zengqondo Nge-Hepatitis B?

Izifo zengqondo ngenxa yokusuleleka kwintsholongwane ye-Hepatitis B ibonakala ngokugqithiseleyo kubantu abanentsholongwane kwintsholongwane okanye ebuntwaneni. Ezi zi gulane ziyakwazi ukuba "zithwala" kwaye zithwale ingozi ephezulu yezifo zengqondo.

Kutheni i-Virus Virus ingabangela iingozi kwiintso

Nangona oko kuthethwa rhoqo, ukuphazamiseka kweengtso ezivela kwintsholongwane ka-Hepatitis B akuqhelekanga ngenxa yesifo sobungozi ngqo. Enyanisweni, ukuphendula okungavumelekanga kwinqanaba le-immune kwiindawo ezithile zentsholongwane kunokuthatha inxaxheba enkulu kwiimeko zokugula.

Ezi zixhobo zentsholongwane ziza kuhlaselwa ziintlobo zamagciwane akho kumzamo wokulwa nesifo. Xa oko kwenzeka, i-antibodies iya kubopha intsholongwane, kwaye i-debris ephumayo iya kufakwa kwiintso. Iyakwazi ukumisa ukuphendula okuvuthayo okungabangela umonakalo wezintso.

Ngenxa yoko, kunokuba intsholongwane ichaphazele ngqo iimpilweni, impendulo yomzimba wakho yona ichaza uhlobo kunye nobukhulu besifo seentso.

Iintlobo zeZifo Zengqondo Ezibangelwa yi-Hepatitis B Yintsholongwane

Ngokuxhomekeka kwindlela iimpilane ezithatha ngayo intsholongwane kunye ne-inflammation cascade echazwe ngasentla, izifo zesifo seentlobo ezahlukeneyo zingabangela. Nanku ukujonga ngokukhawuleza:

1. I-Polyarteritis Nodosa (PAN): Masiqhekeze eli gama libe yincinci, iindawo ezinokutya. Igama elithi "ipolisi" lithetha ezininzi, kwaye "arteritis" ibhekisela ekuvukeleni kwemithambo / imithwalo yegazi. Esi sithuba siphezulu sibizwa ngokuba yi-vasculitis. Ekubeni zonke iziko emzimbeni zinemivenge yegazi, (kunye neengtso zinezityalo ezicebileyo), i-polyarteritis nodosa kukuvuvukala kakhulu kwemithambo yegazi (kule meko, iinjongo 'imithambo yegazi) echaphazela imifuno yegazi encinci naphakathi. lombutho.
   
   Ukubonakala kwe-PAN ukukrakra kubonakala kakhulu. Ingenye yesifo sesifo sesifuba esidala singabangela ukusuleleka kwe-Hepatitis B. Kuye kuthintela ukuchaphazela abadala abadala kunye nabadala. Isigulane esichaphazelekayo siya kukhononda ngezibonakaliso ezingafaniyo ezifana nobuthathaka, ukukhathala, kunye neentlungu ezihlangeneyo. Nangona kunjalo, izilonda ezithile zesikhumba zingabonwa kwakhona. Uvavanyo lomsebenzi weentso luza kubonisa ukungabikho komsebenzi kodwa ayiyi kuqinisekisa ukuba isifo kwaye i- kidney biopsy iya kuba yimfuneko .

1. I-Membranoproliferative Glomerulonephritis (MPGN): Leli gama elisengumlomo libhekiselele kwiiyunithi ezivuthayo kunye neentlobo ezithile zezicubu (i-membrane esezantsi kwimeko) kwiintso. Kwakhona, oku kuyindlela yokuvuvukala kunokuthethelela kwintsholongwane yentsholongwane. Ukuba unentsholongwane kaGawulayo ye-Hepatitis B kwaye uqala ukubona igazi emcinini, oku kuyinto efuna ukuqwalaselwa. Kucacile ukuba ubukho begazi emcimbini abuyi kubakho ukuqinisekisa ukuxilongwa nangona unentsholongwane ye-Hep B. Ngenxa yoko, iimvavanyo ezongezelelweyo kuquka ne-kidney biopsy kuya kufuneka.
2. I-Membranous Nephropathy: Utshintsho kwinxalenye yesilathisi sezintso (ebizwa ngokuba yi-glomerular basement membrane) ikhokelela kule nto. Izigulane ezichaphazelekayo ziya kuqalisa ukukhupha inani elingaqhelekanga leprotheni kumchamo. Njengogulane, kunzima ukuphawula malunga nobukho beeprotheni kumchamo ngaphandle kokuba luphezulu kakhulu (apho ungalindela ukubona i-foam okanye i-sud kumchamo). Igazi lifunyanwa ngokukhawuleza kumchamo kweli phepha kodwa linokubonakala. Kwakhona, ukuhlolwa kwegazi kunye nomchamo kwintsebenzo yezintso kuya kubonisa ukungaqhelekanga, kodwa ukuqinisekisa isi sifo, i-kidney biopsy iya kusadingeka.

1. I-HepatoRenal Syndrome: Uhlobo olubi kakhulu lweesifo ngenxa yesifo sesibindi sisifo esibizwa ngokuba yi-hepatorenal syndrome. Nangona kunjalo, oko akunjalo ngokuthe ngqo kwi-Hepatitis B ehlobene nesifo sesibindi kwaye sinokubonwa nayiphi na isifo sesibindi esiphezulu esichaza apho izintso zichaphazelekayo ngenxa yeendlela ezininzi.

Ukuchonga i-Hepatitis B yeVirus Associated Disease

Ukuba unentsholongwane yesifo se-hepatitis B kwaye unxhala lokuba izintso zakho zingenakuchaphazeleka, unokuvavanywa.

1. Ngokucacileyo, isinyathelo sokuqala kukuqinisekisa ukuba unentsholongwane ye-hepatitis B yokutheleleka, apho kukho ibhetri eyahlukeneyo yeemvavanyo ezingabalulekanga ukuba i-kidney biopsy. Ukuba uvela kummandla owaziwayo ukuba unamazinga aphezulu okusuleleka kwintsholongwane ye-hepatitis B (ukusuleleka kwendawo), okanye unobungozi bokusuleleka kwintsholongwane ye-hepatitis B (ukufana nokwabelana ngezilonda ze-IV ukusetyenziswa kakubi kweziyobisi, ungaba nesondo esingakhuselekanga kunye namaqabane amaninzi ezesondo, njl. .), iimvavanyo ezithile zegazi ezibhekiselele kwiindawo "ezahlukeneyo" zengcinezelo ye-hepatitis B kufuneka zikwazi ukuqinisekisa ukusuleleka.
   
   Ukuvavanya kwenzelwa i-antibodies eyenziwa ngumzimba ngokubhekiselele kwintsholongwane ye-hepatitis B. Imizekelo yale mvavanyo iquka i-HBsAg, i-anti-HBc kunye ne-HBs. Nangona kunjalo, ezi mvavanyo zisoloko zingakwazi ukwahlula phakathi kokusuleleka kwintsholongwane (apho intsholongwane iphinda iphendule ngokukhawuleza), okanye i-state carrier (apho usufumana intsholongwane, intsholongwane ihlala ilele). Ukuqinisekisa ukuba, ukuvavanya i-DNA ye-hepatitis B yintsholongwane.
   
   Ngenxa yokuba iintsholongwane ezimbini zenzeke ukwabelana ngeziganeko ezithile zengozi, ukuvavanya ngokufanayo ukusuleleka kwintsholongwane ka-hepatitis C kungabi yinto engalunganga.
2. Isinyathelo esilandelayo kukuqinisekisa ubungqina beesifo sezintso, usebenzisa iimvavanyo ezichazwe apha.
3. Ekugqibeleni, ugqirha wakho uya kufuneka afake ezimbini kunye ezimbini. Emva kwamanyathelo amabini angentla ayenziwe, usadinga ukubonisa ubungqina bendawo. Ngenxa yoko, i-kidney biopsy iya kuba yimfuneko ukuqinisekisa ukuba isifo sesifo sisiphumo sentsholongwane ye-hepatitis B, kwakunye nesifo esithile sesifo. Kwakhona kuba nje ukusuleleka kwintsholongwane ye-hepatitis B kunye nesifo seengtso akubonakali ukuba ukusuleleka kukukhokelela ekubanjweni kweentliziyo. Omnye unokufumana ukusuleleka kwintsholongwane ye-hepatitis B kwaye abe negazi / iprotheni emcanjeni ngenxa yezizathu ezahlukeneyo (cinga, isigulane sesifo sikashukela sinamatye eentso).
4. Ukuqinisekiswa kokuxilongwa kokugqibela kunye nesibangela sayo kunempembelelo enkulu kwiplani yokonyango ngokunjalo. Isifo esichazwe ngentla (PAN, MPGN, njl.) Sinokubonakala kubantu abangenayo intsholongwane ye-hepatitis B. Indlela esiphatha ngayo le zifo zengqondo ziloo meko ziya kuba zihluke ngokupheleleyo kwindlela abaphathwa ngayo xa kubangelwa yi-virus ye-hepatitis B.
   
   Enyanisweni, unyango oluninzi (olufana ne-cyclophosphamide okanye i-steroids) olusetyenziselwa unyango lwe-MPGN olungenayo i-hepatitis B kunye ne-membranous nephropathy inokulimaza ngaphezu kokulungileyo xa unikezelwa isigulane ngegciwane lesifo se-hepatitis B. Kungenxa yokuba ezi zonyango zenzelwe ukukhusela isistim somzimba, nto leyo into edinga umzimba ukulwa nokusuleleka kwe-Hepatitis B. Unyango kunye ne-immunosuppressants kule meko inokubuya kwaye ibangele ukwanda kwe-viral replication. Ngoko ke, ukubonisa isizathu kubalulekile.

Isifo se-Hepatitis B esifana ne-Virus-Related Related to the disease

Phatha eso sizathu. Oko kukuthi i-crux yonyango. Ngelishwa, akukho zilingo ezinkulu ezinokuthi zifumaneke ukukhokela unyango lwezifo zengqondo ezenzeka ngenxa yokusuleleka kwintsholongwane ye-hepatitis B. Naluphi na ulwazi esinalo kwiinkalo ezincinci zophando luxhasa ukusetyenziswa kweyeza-antiviral ezichasene nokusuleleka kwe-hepatitis B njenge-linchpin yonyango.

1. Ulwaphulo lwe-antiviral: Olu luquka imishanguzo efana ne-interferon alpha (ephazamisa ukuphindaphinda kwintsholongwane ye-hepatitis B kwaye "imodareyitha" ukumelana nomzimba wokusuleleka kwintsholongwane), kunye nezinye iizithunywa ezifana ne-lamivudine, entecavir, njl. (Le mithi inqanda ukuphindaphinda intsholongwane kunye ). Ziyimpawu ezigqithiseleyo kunonyango ekude kukhethwe i-ejenti esetyenzisiweyo (ngokuxhomekeka ngakumbi kwezinye izinto ezifana nobudala, nokuba isiguli sinesifo se-cirrhosis okanye cha, ubukhulu bomonakalo wento, njl.). Yiyiphi imithi ekhethiweyo iya kugqiba nokuba unyango luya kuqhubeka kangakanani. Ezi ngxoxo zigqithisileyo kweli nqaku kwaye kufuneka zibe yinto into yokuba ugqirha wakho uza kuxoxa nawe ngaphambi kokuqalisa unyango.
2. Ama-immunosuppressive agents: Ezi ziquka imishanguzo efana ne-steroids okanye amanye amayeza e-cytotoxic njenge-cyclophosphamide . Ngoxa ezi zinto zingasetyenziselwa "izilwanyana zasendle" izifo zesifo seentsho ze-MPGN okanye i-nephropathy membranous, kukho ukusetyenziswa ngokuqhelekileyo akukhuthazwayo xa ezi zifo zibangelwa yi-virus ye-hepatitis B (inikwe ingozi yokutshatyalaliswa intsholongwane). Nangona kunjalo, oku akunjalo "ukuvinjelwa kwengubo." Kukho izibonakaliso ezicacileyo xa ezi zithunywa zingasadingeka ziqwalaselwe kwimeko yesifo se-hepatitis B. Enye into enjalo yinto enzima kakhulu yokuvuvukala echaphazela izintso 'ezicoca (ezibizwa ngokuthi i-glomerulonephritis ehamba phambili ngokukhawuleza). Ngaloo meko, imithi yokugonywa kwe-immunosuppressive idla ngokudibene nento ebizwa nge-plasmapheresis.

> Imithombo:

> I-Hepatitis B kunye ne-Renal Disease. Tak Mao Chan. I-Curr Hepat Rep u-2010 ngoMeyi; 9 (2): 99-105. Ishicilelwe nge-intanethi ngo-2010 ngoMatshi 14. ityala: 10.1007 / s11901-010-0042-6

> I-virus ye-Hepatitis B echaphazelekayo: i-polyarteritis nodosa: iimpawu zekliniki, isiphumo, kunye nempembelelo yonyango kwizigulana eziyi-115. Guillevin L. Iyeza (iBaltimore). 2005 Sep; 84 (5): 313-22.