Kumwe kamwe kamwe, kwakasimba kwemuviri mumuviri kune chirwere chinokonzera mishonga inonzi "anaphylaxis". Kunyange zvazvo kuora kwemazuva ose kunogona kukonzera kubvongodza, mhepo inoputika kana mhino yakakosha, kana kuputika, anaphylaxis inokonzera kusagadzikana kwe muviri wose.
Nhoroondo
Anaphylaxis yakatanga kuonekwa mumavambo ekutanga kwema1900 apo ichiita tsvakurudzo yekudzivirira imbwa kusvika kune gungwa anemone vhu.
Panzvimbo yekukudzivirira hutachiona hwegungwa reanemone nhamo, imbwa dzakanga dzichikurira nekushambadzira kwega kwega kwega.
Kunyange apo zvirwere zvaive zvichifanirwa kuva chirongwa cheprophylactic kubatsira mbwa, mhirizhonga yakatarwa yakaonekwa, saka vakataura mhinduro yakasiyana neprophylaxis, anaphylaxis.
Aina
Maitiro eAnaphylaxis anotevera matatu maitiro. Kunzwisisa kuti muenzaniso wako vanaphylaxis unogona kukubatsira kuti unzwisise (uye vabatsire vashandi vezvokurapa kunzwisisa) kuti zvakanakisisa sei kubata chirwere chako.
Uniphasic (1 gadziriro) zvinoshandiswa ndiyo inonyanyozivikanwa yevanaphylaxis kutevera. Inenge 70 kusvika ku90 muzana yematambudziko inotevera muenzaniso uyu. Uniphasic reaction ndiyo yakaipa mukati memaminitsi makumi matatu nemakumi matanhatu uye inowanzogadzirisa mukati meawa inotevera.
Biphasic (2 gadziriro) zvinowanikwa kaviri pane zvakajairika muvana pane vanhu vakuru uye nenyaya yezvishoma pane 23 kubva pamatambudziko makumi anaphylaxis. Maitiro eBiphasic anoratidzwa nekudzoka kweanaphylactic zviratidzo maawa akawanda mushure mekugadzirisa zviratidzo.
Kugadziriswa kwenguva refu ndiyo mafomu akaoma kwazvo uye ratire pattern ye anaphylaxis. Kugadzikana kwenguva refu kunopfuurira uye kunogona kugara kubva mumazuva mashoma kusvika kumavhiki mashoma.
Simba rako reMusununguko
Kuti ubatsire kunzwisisa chinokonzera vanaphylaxis , zvinobatsira kunzwisisa kuti muviri wako wekuzvidzivirira unofunga kuchengetedza muviri wako kubva kune zvinokuvadza zvakadai semavirusi kana mabhakitiriya.
Icho chiri chimwe chezvinhu zvakaoma kwazvo zvomuviri wako zvinoumbwa nhengo dzemuviri (bone marrow ne thymus), zvakasiyana siyana zvema cell, uye mapuroteni.
Kune mhando mbiri dzakasiyana dzehutachiona: innate (zvidziviriro zvaunoberekwa nazvo) uye adaptive (akadzidza kana akawana).
Systemate Immune System
Izvo zvirwere zvemuviri wako zvekuzvidzivirira ndezvokuchengetedza kwezvisikwa zvekuti iwe unoberekwa nezvo zvinokubatsira kudzivirira kuti urege kuwana utachiona kana kutaridzirwa kune zvinokuvadza. Ganda rako ndiro rinotanga kudzivirira muviri wako.
Mapuroteni anowanikwa mumapanga ako kana mamwe mashizha emumuviri anoita basa rinokosha mumuviri wako wesimba. Maseji ako ane protein inokosha inonzi lysozyme inobvumira mabhakitiriya masvingo kuti ave nyore kuparadzwa. Mune masero emuviri anokosha anonzi phagocytes (kusanganisira neutrophils, monocytes, kana macrophages) anokoshawo uye anoshandiswa nevakapoteredza uye vanopedza mabhakitiriya kana zvimwe zvinhu zvinogona kukuvadza.
Syndrome Immune System
Maitiro ako ekudzivirira anoshanda ndiwo chikamu chekudzivirira kwako kunodzidza muhupenyu hwako hwose.
Kana iwe wakaberekerwa, une ma T uye B masero ane ma-receptor pavari. Sezvo muviri wako unoratidzwa kune antigens dzakasiyana-siyana (chepfu), ma T cells ako neB B anozvibatanidza ivo pachavo kurwisana zvakananga nehutachiona antigen.
Ichi ndicho chikonzero kana uchingoratidzirwa kune dzimwe zvirwere, zvirwere zvinotevera zvinenge zviduku munguva yakareba, kana iwe unogona kunge usati wamboziva kuti wakaiswa pachena.
Kusiyana nehutachiona husingawaniki, immune system inogadzirisa haikwanise kupfuudzwa kuvana vako.
Zvinokonzera
Kana muviri wako uchitanga kuzarura muviri wako, muviri wako unogona kukura masero ezvirwere izvo zvakananga kumhepo. Kana muviri wako unokura masero ezvirwere mumuviri, ipapo iwe uchava nemararamiro emakemikari uye kusvibiswa kwakatevera.
Hazvanzwisisi kuti nei vamwe vanhu vachikurira mitezo uye vamwe havaiti. Kana iwe uchinge uchinge uchinge uine zvirwere zvekuti muviri wako unenge uine ma antibodies anozivikanwa se immunoglobulin E (IgE), iyo ichapindura nguva dzose apo muviri wako unoratidzika kune allergen.
Immunoglobulin E inogadziriswa kusvika pakujekesa kuburikidza nekushandura basophils nemasero matsvuku , ayo ari chikamu chemasero eropa remuviri wako.
Basophils uye mast cells dzinosunungura vamiririri izvo zvinokonzera kuchinja mukati memuviri unobatanidza zvakananga nezviratidzo zvinosangana neanoratidzika. Vagadziri vanobatanidzwa muvanaphylaxis vanosanganisira:
- histamine : inokonzera kuchenesa, kuputika, kuderera kwemuviri weropa, kuora musoro, runny nose, uye bronchospasm
- tryptase: mazinga akakwirira ane mamwe maitiro akaoma anphyphyis, kunze kwekudya kwekudya
- platelet-activating factor: yakakwirira mazinga ane maitiro akaoma anphyphyis
- nitric oxide: inokonzera hypotension yakabatana nekuderedza mitsipa yeropa
- arachadonic acid metabolites: zvinokonzera bronchospasm, hypotension, uye erythema
Haasi zvose zvinokonzera mishonga zvinokonzera vanaphylaxis . Kana iwe uine zvirwere zvinowedzera nekudzokorora zvakare kune zvokudya, mishonga, kana zvipembenene zvinokonzera, iwe unofanirwa kuva nehanya nekukura vanaphylaxis uye iwe unofanirwa kuchengetedza chirwere.
Imwe nzira inogona kukonzera vanaphylaxis inosanganisira kusateerera kwe-non-IgE kunobatanidza masimba ako ezvirwere T-seli. Nhengo dzakawanda dzinogona kukonzera kwete-IgE anaphylaxis dzinosanganisira:
- aspirin
- NSAIDs: zvakadai saIbuprofen, Aleve, kana Celebrex
- Kusiyanisa kwemasvikiro emifananidzo (x-ray, CT scans, MRI, kana ultrasound)
- IV immunoglobulin therapy
- Heparin
- kunyoresa ku dialysis membrane
Kushanda kweT-seli kunokonzera rudzi rumwechete rwekushandiswa kwebasophils nemasero emasero anotsanangurwa pamusoro apa.
Zviratidzo
Anaphylaxis inogona kukanganisa zvikamu zvakawanda zvemuviri uye nzira, kusanganisira:
- ganda: rashes , itching, kana kuzvimba
- Kufema: kukwezva, kuruka, kana kuoma kufema
- moyo: kusagadzikana kwepfungwa, kupera kweropa, kana kurwadziwa kwepfupa
- Mimba: kushungurudza, kusuruvara, kana kupwanya
- Utano hwepfungwa: misoro, kupesana, kana chizuru
Zviratidzo zvinowanzovhiringidza (kunyanya chiso kana angioedema ), zvinetso zvokufema, uye kuderera kweropa.
Kana uri kuona zviratidzo zvevanaphylaxis , kuchengetedzwa kwekukurumidza, kusanganisira epinephrine shot, inodiwa nokukurumidza. Kuziva kuti chii chakakonzera kupindura kunogona kubatsira kudzivirira munguva yemberi, pakati peimwe nzira .
Shoko Rinobva
Kuwana vanaphylaxis inotyisa zvikuru. Kudzidza chinokonzera vanaphylaxis, pamwe chete nemishonga uye nzira dzekudzivirira zvikamu , zvichava chikamu chinokosha chekutarisana nehutano hwemagetsi. Kana iwe usina chokwadi kana iwe uri kutarisana nehutachiona hwemagetsi, iwe unofanira kugara uchitsvaka rubatsiro rwekukurumidza.
> Sources:
> Loverde, D, Iweala, O, Eginli, A & Krishnaswamy, G. (2018). Anaphylaxis. CHEST, 153 (2): 528-543. DOI: 10.1016 / j.chest.2017.07.033
> Mhedziso yehutachiona hwemunondo. UpToDate website. 2017.
> Pathophysiology of anaphylaxis. UpToDate website. 2018.