Ubungqina Bunikela Ukusetyenziswa kweSteroid-Resistant Resistant Relapses
A. Ukutshintshisiswa kwePlasma, okubizwa nangokuthi "i-plasmapheresis," icetyiswa yi-American Academy of Neurology (AAN) ukunyanga ukuhlaziya abantu abaninzi ngokuphindaphindiweyo-ukubuyisela i-sclerosis ezininzi (RRMS), njengoko kubonwa "mhlawumbi isebenzayo."
Nangona kunjalo, utshintsho lwama -plasma lucetyiswa njengonyango lwamayeza okuphindaphinda aphendule kwi- Solu-Medrol - kungekhona eSolu-Medrol.
Ukuvuma okuvela kwi-AAN kwonyango lokubuyela kwakhona kwi-RRMS kwenziwa ngoJanuwari 2011 kwaye kukho utshintsho kwizikhokelo ezivela ngo-1996, apho inqubo ihanjiswe kuphela "njengethemba" kwaye "mhlawumbi luncedo."
Kufuneka kuqatshelwe ukuba utshintshiselwano lwe-plasma aluxhaswanga ngu-AAN ukunyanga ukuqhubela phambili kwesibalo esinyukayo okanye esilandelayo.
Kutheni i-Plasma Exchange Work ibuyela kwakhona?
Ukutshintshwa kwePlasma kususa izinto ezinobungozi ezijikelezayo kwicandelo lamanzi (plasma) yegazi. Kwimeko ye-MS, oku mhlawumbi i-antibodies malunga neprotheni eyenza i- myelin , kwakunye neeseli ze-T kwaye mhlawumbi namanye amaseli omzimba anokujolisa kwi-myelin.
Kucingelwa ukuba ukususa la maseli ngexesha lokuphindaphinda kunganciphisa ubude bokuphindaphinda kunye nomonakalo obangelwa ukuvuvukala. Nangona kunjalo, xa la maqhinga aphethwe ngumzimba okanye afakwe kwiisilonda , utshintsho lwe-plasma alusayi kubasusa kwaye mhlawumbi aluyi kuba nayiphi na inzuzo yonyango.
Ubuphi ubungqina bePlasma Exchange for RRMS Ukubuyela kwakhona?
Kwisilingo esincinane se-crossover, abantu abangama-22 abane-RRMS okanye ezinye izifo ezinokutshatyalaliswa kokutshabalalisa (i-myelitis, i-neuromyelitis optica) eyabangela ukuba impawu ezinzima zifakwe kwi-plasma exchange exchange. Bonke abantu behlulekile ukuphendula kwikhosi yeSolu-Medrol kunye namanqaku aphakathi kwi- EDSS yayingu-7.5 xa beqala unyango.
Izigulane ezithoba zaye za "phawula" ukuphucula "ukulinganiswa" emva kokutshintshwa kwe-plasma. Abahlanu balaba baqhubeka befumana ukuphucula iminyaka engama-3.
Kwinye iqela elincinci lamatyala, abantu abane abane-RRMS babuye baphinde baphendule kwiSolu-Medrol. Ngamnye wanikelwa amajikelezo ama-5 e-plasma exchange. Umntu oyedwa "wayemangele" ukuphulukana, abantu ababini "bahlaziye" ukubuyiswa (nangona omnye wabo efuna ukuba unyango lwe-5 luqhutywe kabini), kwaye omnye umntu "wayenomvuzo" wokubuyisela.
Okukwintsusa
Ukuba unobungozi obunzima obungaphenduliyo kwi-Solu-Medrol, ugqirha wakho unokubonisa ukuba utshintshiselwano lwe-plasma. Ukutshintshisiswa kwePlasma yinkqubo ekhuselekileyo engaqinisekanga kwaye ayibangeleli kakhulu.QAPHELA: Ukutshintshisiswa kwePlasma kusetyenziswa kubantu abane-sclerosis ezininzi abafumana ukuba ne-Tysabri-ehambelanayo ne-leukoencephalopathy (PML) ehamba phambili. Ngokuqhelekileyo kusetyenziswa ngokudibanisa namayeza. (Ukufunda okungakumbi: Q. Iyintoni unyango lwe-PML ehlobene neTysabri? )
Ukuze uphononongo lwenkqubo yokutshintshiselwa kwe-plasma, funda: I- Plasma Exchange (Plasmapheresis) ye-MS kunye nezinye izifo ze-Neurological Diseases
Imithombo:
Cortese I, Chaudhry V, So YT, Cantor F, Cornblath DR, Rae-Grant A. Uhlaziyo olususela kwizikhokelo: I-Plasmapheresis kwiintsholongwane ze-neurologic: I-Report of therapeutics kunye neComputer Committee ye-American Academy of Neurology. Neurology. 2011 Jan 18; 76 (3): 294-300.
Habek M, Barun B, i-Puretic Z, i-Brinar VV. Ukwelashwa kwe-steroid engaphenduliyo ngokuphindaphindiweyo nge-plasma exchange exchange in aggressive sclerosis. Ther Apher Dial. 2010 Juni; 14 (3): 298-302.
Lehmann HC, Hartung HP, Hetzel GR, Stuve O, Kieseier BC. Ukutshintshwa kwePlasma kwii-Neuroimmunological Disorders, Icandelo 1: Ukubaluleka kunye nokunyangwa kweengxaki zeNtshonalanga yeNervous Disorders. Arch Neurol. 2006: 63: 930-935.
I-BG, u-O'Brien PC, iPetterson TM, et al. Uvavanyo olungenangqondo lwe-plasma utshintsho kwinkqubo yesantya esichukumisayo yentsholongwane evuthayo yokutshatyalaliswa kwezifo. Ann Neurol. 1999; 46: 878-886.