Zvinokonzerwa nehutachiona, zvakatipoteredza, uye mageneti vese vanogona kutora chikamu
Angioedemia, kuvhara kwemuviri wehutundu pakarepo pasi peganda, kunogona kukonzerwa nehutano, zvinodhaka, nzvimbo yako, kana kunyanya kushungurudzika. Inogonawo kuva nhaka, nehutano hwakasiyana-siyana huri kuendeswa mumhuri. Izvo zvinogadziriswa mumatambudziko ose ndezvisina kushanda kwemuviri wezvirwere mumuviri umo makemikari anonzi histamine kana bradykinins anosunungurwa zvakasununguka muropa remvura.
Nzvimbo yemuviri inobata-chiso, rurimi, huro, maoko, kana makumbo-zvinogona kupa chikonzero chechikonzero, asi kwete nguva dzose.
Zvinowanzokonzera
Kuwana angioedema (AAE) kunogona kunge iri immunologic (yakabatana nezvirwere), kwete-immunologic (inokonzerwa neicho chisingaoneki chinokonzera), kana idiopathic (isina kuzivikanwa yakabva). Kusiyana ne angioedema ine maitiro chaiwo (ona pasi apa), zvimwe zvezvinhu zvakabatanidzwa mumhando idzi zvinogona kuchinja.
Immunologic
Zvinokonzerwa nezveruzhinji ndizvo zvinowanzokonzera angioedema, zvinokonzerwa nekuita mishonga , zvokudya , zvipembenene zvezvipembenene , kana zvimwe zvinhu zvakadai se latex . Chikonzero chacho chinofungidzirwa kuti hachizivikanwi nemasikironi nokuti inosanganisira kugadzirisa kwemaitiro ezvirwere zvemuviri.
Nokuda kwezvikonzero zvisingazivikanwi, muviri unozokanganisa chimwe chinhu chisina chakaipa kune chinotyisa uye kuparadzira yakawanda ye histamine muropa senzira yekuzvidzivirira.
Kunyange zvazvo histamines inotarisirwa kuderedza midziyo yeropa kuitira kuti masero machena eropa aswedere pedyo nenzvimbo yekukuvadzwa, paanosunungurwa pasina kusakuvara, anogona kukonzera zviratidzo zvakashata, kusanganisira hay fever ( allergenic rhinitis ), mikoko ( urticaria ), uye allergic asthma .
Zvisinei, kusiyana nekumwe kwezvakaita izvi, angioedema inowanikwa mumagunha mashoma pasi pepamusoro peganda kana mucous membrane. Kuzvikudza hakuzove kwakachena kana kutsvuka uye kunogona kugara kwamaawa akawanda kana mazuva. Apo kuvhara kwekupedzisira kunomira, ganda rinowanzoonekwa sechinhu chisina kujeka risina kutyisa, kutengesa, kana kupwanya.
Non-Immunologic
Ne immunologic angioedema, masero anokonzerwa nekukurudzira kurwisana anozivikanwa semasiti masero . Mast masero ane granules akazara mu histamine uye, kana akarayirwa nehurumende yezvirwere kuti aite kudaro, achaita chirongwa chinonzi degranulation kuti asunungure histamine muitiro.
Nekusava immunologic angioedema, maitiro ezvirwere zvemusununguko haana maitiro nekusunungurwa. Pane kudaro, mamwe makemikari kana zvirongwa zvepanyama zvinogona kuita kuti mast cells awedzere. Kugadzirisa kunowanzoitika kune vanhu vane mast cell disorder disorder, zvakadai semastocytosis .
Mishonga inowanzobatanidzwa neiyi inosanganisira:
- Opiates, kunyanya codeine uye morphine
- Nonsteroidal anti-inflammatory drugs (NSAIDs), kunyanya aspirin
- Intravenous vancomycin , mishonga inorwisa mabhakitiriya
- Non-ionic radiocontrast dyes inoshandiswa kusimbisa mifananidzo ye-X-ray
Zvimwe zvisati zvisiri-immunologic zvinokonzera kuwedzerwa ropa, kanzira dzakadai se lymphoma , zvirwere zvega autommune zvakadai se lupus , uye zvimwe zvirwere zvakadai sehepatitis, HIV, cytomegalovirus , uye Epstein-Barr.
Zvimwe zvinokonzera muviri zvakadai sekupisa, kutonhora, kuwedzerwa muviri, kutinhira , kubuda kwezuva, uye kunyange kushushikana mupfungwa zvakange zvichizivikanwa zvichiita kuti angioedema.
Idiopathic
Ne idiopathic angioedema, hapachazovi nechikonzero chakazivikanwa kana tsananguro yekurumidza kukurumidza kuzvimba.
Chinokonzera kuti mamiriro acho ezvinhu anetseke ndeyekuti avo vanobatwa vanowanzotanga kudzoka, dzimwe nguva zvakaoma.
Maererano nekutsvakurudza kubva kuYunivhesiti yeWisconsin School of Medicine, vanopfuura hafu yevanhu 99 vanorwara neIdiopathic angioedema vakaona zviitiko zvekare zvinopfuura zvegore. Chiso, muromo, nerurimi ndiwo nzvimbo dzinowanzobatwa. Kakawanda, 55 kubva muzana vavo vakataura kuti vakagamuchira chikamu chimwe chete che-high corticosteroids kuderedza kuzvimba. Kunyanya pamusoro paive zvakadaro asi iyo yekuti 52 muzana inoda kushanya imwe chete muimba yepamhanho.
Genetics
Hereditary angioedema (HAE) inofungidzirwa kuti ndiyo inodhaka yakaremara , zvichireva kuti iwe unogona kugara nhaka yechinetso chinotambudza kubva kumubereki mumwe chete.
Kune marudzi maviri eAE ane chokuita nekuchinja mutsva muSERPING1 geni uye chechitatu chinokonzerwa nekuchinja kweF1 gene.
Zvose zvitatu zvinokonzera kusagadzikana kwemaitiro ezvirwere zvemuviri uye zvinogona kukonzera kuzvimba mumativi ose emuviri. Apo HAE yakasiyana neAAE ndeyokuti mhosva huru haisi histamine. Pane kudaro, kurwisa kuchave kwakagadzirwa nechimwe chikamu chinowanzoitika chinonzi bradykinin.
Bradykinin, kufanana ne histamine, inokonzera kuputika kwemidziyo yeropa asi inoita senzira yekugadzirisa mabasa emuviri. Semuenzaniso, muviri unosunungura bradykinins kuderedza kushanda kweropa kana kuti kuronga kuporesa kana zvepfungwa basa.
Kubudiswa kusingawanzo kwebrasdykinins kunogona kukonzera angioedema, kazhinji kemakumbo, maoko, mazamu, maziso, miromo, larynx, kana gastrointestinal (GI) turakiti. Kukuvadzwa kwechidiki kana chiitiko chekushungurudzika mupfungwa kunogona kukonzera kurwisa, asi kunowanzoitika pasina chero chikonzero chakazivikanwa.
Angioedema yeGI turakiti inogona kuva yakaoma, ichiita kusuruvara kunorwadza, kurwadziwa kwakanyanya, uye kupera simba kubva pakusakwanisa kuchengetedza mvura. Kana kutuka kuchiitika muhuro, kunogona kutyisidzira upenyu.
Nemhaka yokuti ACE inhibitors (anoshandiswa kuporesa ropa rakanyanya) kushanda nekusimbisa mazinga e bradykinin, ndevamwe vanowanzokonzera mishonga inokonzerwa nemishonga-induced angioedema (asi ine chirwere chakasiyana-siyana pane opiates kana aspirin).
HERE inofungidzirwa isingawanzoitiki, inowanikwa mune imwe yevamwe vanhu 50 000, uye inowanzofungidzirwa kana munhu ane angioedema asingatendi kune antihistamine. HERE inogona kugadziriswa nevechitatu kuongororwa kweropa kunongedza maitiro ekudzivirira zvirwere.
Risk Factors
Iko pasina nzira chaiyo yekutsanangura chikonzero nei vamwe vanhu vachiwana angioedema nevamwe vane hutano hwakadaro kana mararamiro. Nezvo zvataurwa, iwe unogona kunge uri pangozi yakanyanya kana iwe uine kana wakamboona chimwe cheizvi:
- Kushandisa zvinodhaka zvinosanganisira kuputika kana mikoko
- Mishonga inosanganisira mikoko
- Nhoroondo ye angioedema
- Nhoroondo yemhuri yemukoko kana angioedema
- Kuita zvirwere zvakadai se lupus kana Hashimoto's thyroiditis , iyo angioedema chiratidzo chinogona kuitika
Kana iwe kana munhu waunoda wakatambudzwa kakawanda ye angioedema, unogona kubatsirwa nemishonga inogona kubatsira kudzivirira kurwiswa munguva yemberi. Zvimwe zvinosanganisira nhamba yeusiku ye antihistamine Zyrtec (cetirizine) , kana chinokonzera chirwere, kana mishonga inogadzirisa zvirwere yakadai seKalbitor (inowanikwa) kana Firazyr (icatibant).
> Kwakabva:
> Bernstein, J .; Lang, D ;; Khan, D. et al. "Kuongororwa uye kutungamirirwa kwehutachiona uye husingaperi urticaria: 2014." J Allergy Clin Immunol. 2014; 133 (5): 1270-7.
> Inomata, M. "Kufambira Mberi Kwakaitika Mukurapa-Kwakaita Angioedema." Allerg Int. 2012; 61 (4): 545-57. DOI: 10.2332 / alergolint.12-RAI-0493.
> Rosenberg, D .; Mathur, S ;; uye Viswanathan, R. "Zvinyorwa Zvitsva zveIdiopathic Angioedema." J Allergy Clin Immunol. 2017; 139 (2): AB235. DOI: 10.1016 / j.jaci.2016.12.757.