Zviratidzo, Kuongororwa uye Kurapwa kwePCC, Chirwere Chiropa Chinosangana neBD
Primary sclerosing cholangitis (PSC) chirwere chechiropa chinokonzera kuvhiringidza uye kuderedza ducts mukati uye kunze kwechiropa. Hazvizivi kuti chii chinokonzera PSC, kunyange zvazvo inofungidzirwa kuti inomira mamiriro ezvinhu. PSC haina kufungidzirwa kuti inotora nhaka yakananga, asi inofungidzirwa kuti ine genetic component.
Bhiri inofanirwa kugadzirwa kwemafuta uye kubvisa chiropa kubva pachiropa.
PSC inokonzera kuti ducts inopedzisira ishoma kubva pakusuruvara nekuputika, uye bile inotanga kuwedzera muropa, iyo inokuvadza. Izvi zvinokonzera kupedzisira kuora ruzivo uye chirwere chepirhosis , chinoita kuti chiropa chirege kuita mabasa ayo anokosha. Makore anoverengeka ePCC anogona kutungamirira kumarara ekurwara e-bile ducts anonzi cholangiocarcinoma, inowanikwa mu10 kusvika ku15% yevarwere.
PSC inofambira mberi zvishoma nezvishoma mumatambudziko akawanda, asi inogonawo kunge isingazivikanwi uye upenyu hunopisa. Vanhu vane PSC vanogona kugamuchira kurapwa kusunungura zviratidzo uye kuvabatsira kuti vatungamirire hupenyu hunoshingaira.
At-Risk Demographic
Kazhinji kazhinji, vanhu vanobatwa nePCC vari pakati pemakore makumi matatu nemakumi matanhatu, uye mavhareji emakore ekuongororwa ari 40. PSC inowanzova yakajairika kune varume; 60 kusvika ku75% yevanhu vanoongororwa ndivo varume. Pamusoro pezvose, PSC chirwere chisingawanzoitiki.
Zviratidzo
Vamwe vanhu havana zviratidzo zvekuongorora kana kunyange kwemakore akawanda apfuura.
Zviratidzo zvinosanganisira:
- Dhairrhea (inokonzerwa ne malabsorption ye mafuta)
- Kuneta
- Fever / chills (kubva kune utachiona mu bile ducts)
- Itching iyo inowanzobata muviri wose
- Jaundice (kuchena kweganda nemeso)
Associated Diseases
Vanhu vane PSC vanowanzove vane chirwere chinokonzera chirwere (IBD) kana osteoporosis.
PSC yakanyatsobatanidzwa ne ulcerative colitis muna 70 muzana yevarwere, asi inogonawo kubatanidzwa neCrohn's disease yemukumbo mukuru, dzimwe nguva inonzi Crohn's colitis . Chikonzero chekushamwaridzana neBD hachizivikanwi, asi chinofungidzirwa kuti ndicho chigumisiro chekuzvidzivirira kwemuviri.
Kuziva
PSC inowanzoongororwa nenzira inonzi ERCP (endoscopic retrograde cholangiopancreatography) . Munguva yeE ERCP, chiremba anoisa endoscope mumuromo uye aifambe ichidzika pasi kuburikidza nehuputi uye mudumbu kusvika kune ducts yemuoriyari. Dye inowanikwa mumidha kuitira kuti izviratidze apo x-ray dzinotorwa. I-ray-ray inozoongororwa kuti ione kana kune matambudziko aine bile ducts.
Kuonekwa kwePCC kunogonawo kusimbiswa nechirwere cheropa chinonzi "ALK (alkaline phosphatase)", kunyange zvazvo chiitiko chakanaka chinogona kureva kune mamwe mamiriro ezvinhu akawanda kupfuura PSC chete.
Chiropa chinoputika chinobatsirawo kusimbisa kuongororwa kwePCC, pamwe nekucherechedza kufambira mberi kwechirwere mushure mekuongororwa. Chiropa chinonyanya kuitika chinowanikwa munzvimbo yezvipatara pamusana pechirwere chepakati pekushaya maitiro . Chiremba anoita chiyero achishandisa nenyuchi kuti atore chiduku chiduku chechiropa chechiropa chekuongororwa nechiremba.
Mishonga
Hapana hutano hwakaratidzwa kuva hunobudirira mukurapa PSC. Kutsvakurudza kutsvaga kurapwa kunobudirira kwave kuitika. Zvirongwa zvekurapa zvinotarisa kuderedza zviratidzo, kupomesa kufambira mberi kwechirwere, uye kuongorora zvinogona kuitika.
Zviratidzo zvePCC zvinogona kurapwa kuitira kuti varwere vanyatsogadzikana. Itching inogona kubatwa neQuestran (cholestyramine) kana Benadryl (diphenhydramine). Kune zvirwere zvinowanzoitika zvinogona kuitika ne PSC, ma antibiotics angave akadikanwa. Nemhaka yokuti PSC inopindira nekudyiwa kwemafuta, zvigadzirwa zvinowedzera zvinogona kudiwa kurapa kukanganisa kwevhithamini yakasviba mafuta A, D, E uye K.
Kana zvivharoka zvikaitika mu bile ducts, chirongwa chokuvhiya chinogona kudikanwa kutambanudza kana kuvhura. Nhengo, dzinochengetedza mazhenje akazaruka, dzinogona kuiswa mumatavi panguva iyi.
Kana kuenderera mberi kwePCC kuchiita kuti chiropa chisakundikana kana kuti zvirwere zvinoramba zvichiripo, kuwedzerwa kweropa kunogona kudiwa. Chiropa chinoputika chinopa hutano hwakanaka hwehupenyu kune vanogamuchira, pamwe nekusara kwemazana anenge 75 muzana.
Nguva Yokudaidza Chiremba
Kana imwe yezviratidzo zvinotevera zvichiitika ne PSC, danai chiremba wako:
- Marwadzo emudumbu
- Dema kana kuti masikati machena
- Jaundice
- Kutya kupfuura 100.4
- Kurova neropa
Sources :
Johns Hopkins Mushonga. "Primary Sclerosing Cholangitis." Johns Hopkins University 2013.
Karlsen TH, Hampe J, Wiencke K, Schrumpf E, Thorsby E, Lie BA, Broomé U, Schreiber S, Boberg KM. "Genetic Polymorphisms Inobatanidza Nezvirwere Zvirwere Zvirwere Hazvirevi Ngozi yeChitamende Sclerosing Cholangitis." A m J Gastroenterol Jan 2007.
The Merck Manual. "Primary Sclerosing Cholangitis (PSC)" Merck & Co, Inc Sept 2007.
Van Steenbergen W, De Goede E, MP Emmond, Reinders J, Tilanus M, Fevery J. "Primary Sclerosing Cholangitis Munun'una Aviri: Mushumo weMhuri Inonyanya kusimbiswa neHLA yeMatomu uye MICA Genotyping." Eur J Gastroenterol Hepatol Jul 2005.