Uvavanyo luyasetyenziswa ngokubanzi kwi-IBD Management kunye ne-Covered By Companies
Oogqirha basebenzisa iintlobo ezahlukeneyo zokuvavanya okwenzekayo ngaphakathi kwendlela yokugaya abantu abanezifo zesibindi sokuvuvukala (IBD) . Ukusebenzisa uvavanyo lwe- endoscopy ukujonga ngaphakathi emathunjini amancinci okanye amaninzi yindlela efanelekileyo yokufumana, kodwa iziganeko zenziwa kuphela rhoqo rhoqo kwaye amayeza adinga ulwazi rhoqo rhoqo. Yilapho ukuhlolwa kwe-fecal calprotectin kunokuba luncedo ngenxa yokuba, ngokungafani nenkqubo yokugcina i-endoscopy, akusiyo intsha kodwa inganika ulwazi olunokukunceda ekwenzeni izigqibo zonyango.
I-Calprotectin luhlobo lweprotheni olutholakala kakhulu kwiintlobo ezithile zeeseli ezimhlophe zegazi ezibizwa ngokuthi i-neutrophil granulocyte kunye nezinye iintlobo zeeseli ezimhlophe zegazi ukuya kumlinganiselo omncinci. Isixa se calprotectin kwiisitori sinokulinganiswa, kwaye kufunyaniswe ukuba abantu abane-IBD banamathuba amaninzi okuba ne-calprotectin kwi- stool yabo (into yefecal) kunabantu abangenawo IBD.
Iimvavanyo Eziqinileyo Ngezilingo ze-Fecal Calprotectin (okanye i-Assays)
- I-Calprotectin yiprotheni ngokuqhelekileyo ifunyenwe kwiiseli ezimhlophe zegazi ezivame ukuba ziphezulu kumanani abantu abane-IBD.
- Uvavanyo lwe-fecal calprotectin lwenziwe kwisampuli yesitolishi.
- Uninzi lweenkampani zomshuwalense ziza kuhlaziya uvavanyo lwe-fecal calprotectin ukwenzela ukulawula i-IBD.
- Kukho ukuhluka kwiindawo "eziqhelekileyo" ze-fecal calprotectin ukusuka kumntu ukuya kumntu.
- Amanqanaba eFecal calprotectin angaba phezulu nangona kungekho naziphi iimpawu ze-IBD ezinzima.
Kutheni Abantu Bokuba ne-IBD banama-Calprotectin angaphezulu kwi-Stool yabo?
Izifundo zibonise ukuba ukugcina umkhondo wezinga le-calectectin ye-fecal kwisitulo kunceda ekulawuleni i-IBD.
Esi sisiphumo sesifo sikaCrohn okanye i-ulcerative colitis ebangela ukuvuvukala kwindlela yokugaya . Xa ukuvuvukala kwenzeka kwi-mucosal layout yamathumbu, ngelixa iiseli zegazi zanda kwinani ukulwa nalo. Amaseli amhlophe egazi angagqithisa i-degranulate, oku kuthetha ukuba bakhululwa okuqukethwe kwabo ukwenzela ukukhusela iiseli zomzimba ekugqibeleni.
Ngaphakathi kweeseli zegazi ezimhlophe i-calprotectin (kunye nezinye iikhemikhali ezininzi) kwaye xa kukho i-calprotectin eninzi kwi-stool, kubhetele ngokufanelekileyo ukuba kukho ukuvutha kwamathumbu.
Uvavanyo lweFecal Calprotectin lwenziwa njani?
Ukulinganisa i-fecal calprotectin ngokuqhelekileyo kuyilingo olulula ukuyenza ngoba konke okufunayo kuyisampula ye-stool, into elula ngokuza ngaphandle kokuzama. Xa isigulane siceliwe ukuba sinike isampula se-stool, kuya kuthetha ukuthatha isitoli kwisitya esingasinyanisi kwaye siyibuyisele ebhodini, mhlawumbi kwisibhedlele, kwi-ofisi yogqirha, okanye kwisiko elizimeleyo. I-fecal calprotectin nqanaba ivame ukuphakama ngexesha lokuhlaselwa kunye nezantsi ngexesha lokuxolelwa, kodwa uvavanyo alupheli. Kukho ukuhlukahluka kumanqanaba e-calprotectin kumntu othile kwaye, ngokuqinisekileyo, ukuhlukahluka komntu kumntu. Kodwa ke, esinye isixhobo esinokusebenzisa ngayo i- gastroenterologist ukunceda abantu abane-IBD bahlale phambili kwiinguqu zabo.
Kutheni iFecal Calprotectin iSebenzayo kwi-IBD?
I-Calprotectin iyanceda ngezizathu ezimbalwa: Okokuqala kukuba xa itholakala kwi-stool, izinzile ixesha elide. Ukufikelela kude kube ziintsuku ezi-7, izinga le calprotectin kwisampuli se-stool liya kuhlala lifanayo, okwenza uvavanyo lube lula ukwenza.
Enye inzuzo kulo mvavanyo kukuba i-fecal calprotectin inqanaba linokufunyanwa kwisesampula encinane.
Ucwaningo oluninzi luye lwabonisa ukuba abantu abane-IBD banomlinganiselo ophakamileyo we-calprotectin kwisitulo sabo xa kuthelekiswa nabantu abangenayo i-IBD (abantu abaphilileyo kulezi zifundo babizwa ngokuba ngabalawuli). Ukufumanisa ukuba lo vavanyo luncedo, kwenziwe uphando olulinganisa amazinga e-fecal calprotectin kubantu abane-IBD, elandelwayo kunye nokuhlolwa kwe-endoscopy ukubona indlela amazinga afana ngayo nento eyenzekayo kwindlela yokugaya. Yintoni abaphandi abafumene ngayo kukuba abantu abane-IBD banamazinga aphezulu e-fecal calprotectin ayenokwenzeka ukuba abe nokuvuvukala okanye izilonda ezibangelwa yi-IBD kwenye indawo kwindawo yabo yokugaya.
Abantu abahlala kwizifundo abazange babe neempawu ze-IBD ezigqithiseleyo, nangona kunjalo, nokuba amazinga e-fecal calprotectin aphezulu. Oku kwakuyinyani ngokunyanisekileyo ngokuphindaphindiweyo kwi-ulcerative colitis kunokuba isifo sesifo sikaCrohn. Oku kugxininisa enye inzuzo yolu vavanyo lwezinga le-calctectin ye-fecal, kuba liyakwazi ukunika isilumkiso esasisandul 'ukukhwabanisa okwenzekayo kwindlela yokutya ngaphambi kokuba iimpawu ziqale ukukhula.
Ngokulinganisa i-calprotectin kwisigxina, oogqirha banokukwazi ukuqala indlela yokuxilonga i-IBD kwisigulane, okanye ukuvavanya umsebenzi wesifo kwisigulane esele sifumanwe ne-IBD. Iingcamango kukuba ukuhlolwa okulula, okungekho kungenavangeli kuba kwenziwa kwi-stool, kunokuncedisa isidingo sokugcina i-endoscopy (njenge- sigmoidoscopy okanye i- colonoscopy ) kwezinye iimeko kwaye igxininise imfuneko yokuhlolwa kwe-endoscopy kwabanye. Uvavanyo lwe-fecal calprotectin aluyi kuthatha indawo ye-endoscopy, kodwa lunokunceda oogqirha njengethuluzi lokuhlola, ukugqiba ngakumbi ukuba ngaba kufuneka naziphi iimvavanyo zokulandelela.
Kubantwana abane-IBD i-calprotectin ye-fec inokuba luncedo ngakumbi. Ngokusebenzisa olu vavanyo, kunokwenzeka ukuba ugqirha ukwazi ukukhawuleza ukuba ngaba iimpawu zivela kwi-IBD okanye cha, ngaphandle kokuhlola uvavanyo olufana ne-endoscopy okanye uvavanyo olubandakanya i-radiology njenge-CT scan ngaphandle kwe-bat.
Amanqanaba eFecal calprotectin angabancedisa abantu abafuna ukuxilongwa kunye ne-IBD ixutywe. I-calprotectin ye-fecal ingayalawulwa ngumgqirha wokunakekela oyintloko okanye umqeqeshi we-internist kwaye ukuba iphakamileyo ibe yinto ephakamileyo, enokubangela ukuba kuhanjiswe kwi-gastroenterologist ukuphonononga kwakhona.
Ngaba kukho i-Drawback kwi-Fecal Calprotectin Assay?
Enye yeengxaki zokuvavanya i-calectectin ye-fecal yiphumo elibi-okanye umphumo okhohlakeleyo, nangona ezi ziphumo aziqhelekanga. Isigulane sinokwenene sibe ne-IBD okanye sinokuba nokuvuvukala kwi-IBD, kodwa inqanaba le-fecal calprotectin lingafi liphezulu kakhulu. Oko kuthetha ukuba kukho ukutshaya okwenzeka kwindlela yokutya kodwa iziphumo zokuvavanya ziya kubuya ngezinga elincinci le-calprotectin (nangona oku akunjalo). I-negative-negative ingabangela ingxaki ngakumbi kubantwana nakwishumi elivisayo, abenza inxalenye ebalulekileyo yezigulane ezifunyaniswe ne-IBD.
Ngaba uVavanyo lweFecal Calprotectin lugqitywe nge-inshurensi?
Amanye ama-inshurensi angabavavanya i-fecal calprotectin yokuvavanya isifo sikaCrohn kunye nesifo sokulonda kwezilonda ngenxa yokuba uye waboniswa njengexabiso elifanelekileyo. Iindleko zolu vavanyo ziya kuba ziphantsi kakhulu kune-endoscopy okanye i-CT scan. Kukho iinkampani ze-inshorensi ezingagqithisi lo vavanyo kodwa ngokuqhelekileyo ngenxa yokuba ingenayo imbali emide yezinye iimvavanyo, kwaye iinkampani zomshuwalense zihlala ziphuza ukufumana utshintsho. Nangona kunjalo, kukho rhoqo inkqubo yokubhena, kunye neCrohn's and Colitis Foundation ibe nexwebhu efumanekayo ukuba ugqirha angasebenzisa ukucela ukuvavanywa kovavanyo kwi-inshurensi.
Inqaku esuka
Uvavanyo lwezinga le-fecal calprotectin lugxininisa kakhulu kwihlabathi le-IBD kunoko, yithi, i-colonoscopy yenzayo. Nangona kunjalo, luvavanyo oluncedo, ingakumbi kuba alufunanga nantoni na ekhethekileyo, njengengqungquthela okanye usuku lokuyeka emsebenzini, ukuba luyenze. Akunjalo wonke ugqirha angalawula lo vavanyo, ngoko kuyafaneleka ukuba abuze ukuba kulungile phantsi kweemeko ezithile. Iinkampani zomshuwalense ziya kubakhokelela, ngokukodwa ukuba kukho isigulane nge-IBD (bayazi ukuba ixabiso elincinci kunezinye iimvavanyo). Kukho ezinye iimeko apho i-calectectin ye-fecal ingenakubuya kwakhona ngamanqanaba alindelekileyo, kodwa oku akunjalo.
> Imithombo:
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Van de Vijver E, Schreuder AB, et al. Umntla eNtshona Netherlands I-IBD Consortium. "Ukukhusela ngokukhuselekileyo isifo sesisu sesibindi kubantwana nakwishumi elivisayo ngaphandle kokudluliselwa kwe-endoscopy." I-Arch Dis Child . 2012 Dec; 97: 1014-1018.
> Waugh N, Cummins E, Royle P, et al. Uvavanyo lwe-Faecal calprotectin olwehlukileyo phakathi kwezifo ezikhulayo kunye nokungabhubhi kwezifo zesilonda: ukuhlolwa kweenkqubo kunye novavanyo lwezoqoqosho. " Uvavanyo lwezeNzululwazi lwezeMpilo, uNombolo 17.55. I-Southampton (UK): IiNcwadi zeeNcwadi zeeNcwadi ze-NIHR; 2013 NgoNovemba