Uchapupu Hunotsigira Shandisai Steroid-Resistant Relapses
A. Kushandurwa kwePlasma, iyo inonziwo "plasmapheresis," inokurudzirwa neAmerican Academy of Neurology (AAN) kuti inorapwa zvakare zvakanyanya kune vanhu vanezvezve-remitting multiple sclerosis (RRMS), sezvo inonzi "zvichida inoshanda."
Zvisinei, kuchinjana kweplasma kunokurudzirwa semutsara wechipiri mushonga wekudzoka zvakare usina kumbobvuma pane imwe solu Solu-Medrol - kwete panzvimbo yeSolu-Medrol.
Kubvumidzwa kubva kuAAN kuti kurapwa kwekudzoka zvakare muRRMS kwakaitwa munaJanuary 2011 uye kuchinja kune mirayiridzo kubva muna 1996, apo nzira yacho yakanzi "inovimbisa" uye "inogona kubatsira."
Zvinofanira kuonekwa kuti kushandiswa kwemaplasma hakurudzirwi neAAN kubata chirwere chechipiri chinopfuurira kana chekutanga chinopfurikidza nekuwanda kwezvirwere.
Sei Plasma Exchange Exchange Inobatsira Kudzoka?
Pashma inoshandiswa inobvisa zvinhu zvinokuvadza zvinopararira mumvura inowanikwa (plasma) yeropa. Munyaya ye MS, izvi zvinogona kunge zvinorwisana neproteine inoita myelin , uyewo masero eT uye zvichida mamwe masero ezvirwere angangotarisa myelin.
Inofungidzirwa kuti kubvisa masero aya panguva yekudzoka kunogona kukonzera nguva yekudzoka zvakare uye kukanganisa kunokonzerwa nokuputika. Zvisinei, kana izvi zvinopesana nemasikirini akaiswa muzvipembenene , kushandiswa kwemaplasma hakugoni kuabvisa uye pamwe zvichida kusina mushonga unobatsira.
Chii Chiratidzo chePlasma Exchange yeRRMS Inodzokerazve?
Mune imwe mutsara wechidiki wekaseka, vanhu 22 vane RRMS kana zvimwe zvirwere zvinokonzera kukuvadza (transversal myelitis, neuromyelitis optica) iyo inokonzera zviratidzo zvakaoma zvakabatanidzwa mukudzidza kwekuparadzanisa plasma. Vanhu vose vakange vakundikana kupindura musangano weSolu-Medrol uye mavhareji mapurogiramu EDSS aiva 7.5 pavakatanga kurapwa.
Vapfumbamwe varwere vakanga "vakaisa" "kuenzanisa" pakuvandudza mushure mekushandura plasma. Vashanu veizvi vakaramba vachiwana huri nani kusvika kumakore matatu.
Mune rimwe boka duku rezviitiko, vanhu vana vane RRMS vakanga vadzoka zvakare vasina kupindura Solu-Medrol. Rimwe nerimwe rakapiwa mabhiriyoni mashanu ekushandura plasma. Mumwe munhu "akacherechedza" kupora, vanhu 2 vakanga va "chengetedza" kupora (kunyange zvazvo mumwe wavo aida kuti mushonga we-5-cycle uitwe kaviri), uye munhu mumwechete akanga ane "unyoro" kupora.
Pasi Pasi
Kana iwe uine kuora kwakanyanya kusingabvunzi kuna Solu-Medrol, chiremba wako anogona kunyatsoratidza kuparadzanisa plasma. Plasma kuchinjana inzira yakachengeteka iyo isiri isina kuvhiringidza uye haina kukonzera kunetseka kukuru.Cherechedzai: Pashma inoshandiswa inoshandiswawo kune vanhu vane multiple sclerosis vanoonekwa kuti vane Tysabri-inoshandiswa mberi inowedzera multifocal leukoencephalopathy (PML). Inowanzoshandiswa pamwe chete nemishonga. (Kuti udzidze zvimwe: Q. Ndeupi mushonga weTysabri-yakabatana na PML? )
Nokuda kwechidimbu chekushandura kwema plasma, verenga: Plasma Exchange (Plasmapheresis) yeMS uye Other Neurological Diseases
Sources:
Cortese I, Chaudhry V, So YT, Cantor F, Cornblath DR, Rae-Grant A. Zviratidzo-based based guideline update: Plasmapheresis muhutano hwehutano: Report of Therapeutics and Technology Test Subcommittee yeAmerican Academy of Neurology. Neurology. 2011 Jan 18; 76 (3): 294-300.
Habek M, Barun B, Puretic Z, Brinar VV. Kurapa kweSteroid kusingatauri kudzokazve ne plasma kuchinjana mune zvinotyisa multiple sclerosis. Ther Apher Dial. 2010 Jun; 14 (3): 298-302.
Lehmann HC, Hartung HP, Hetzel GR, Stuve O, Kieseier BC. Plasma Exchange muNeuroimmunological Disorders, Chikamu 1: Maonero uye Kurapwa Kwechiremera Chinonzi Nervous System Disorders. Arch Neurol. 2006; 63: 930-935.
Weinshenker BG, O'Brien PC, Petterson TM, et al. Muedzo unoshandiswa nemaitiro weplasma kuchinjana mukati mechirwere chetachiona chirwere chinoputira chirwere chinoparadza. Ann Neurol. 1999; 46: 878-886.