Kelyo xanuun lupus: cudurka, daaweynta, cunto

kelyo xanuun lupus waa mid ka mid ah dhibaatooyinka ugu badan ee lupus erythematosus oo nidaamsan. SCR - waa cudur uu keeno, shalalka muuqaalka kore ee unugyada jidhka ku, kaas oo soo helo borotiinada "hooyo" sidii shisheeye. Sidaas darteed, soo koraya caabuq aseptic in qaybaha kala duwan ee jidhka. Oo ay ku jiraan in kelyaha.

qeexid

kelyo xanuun lupus, kelyo xanuun lupus, ama - cudur kalyaha culus lupus erythematosus oo nidaamsan. baahsanaanta cudurka this ee dadweynaha, celcelis ahaan afartan qof boqol oo kun oo dadka. Inta badan xanuunsado tan iyo wakiillo ka qeybtii qurux badan da'doodu u labaatan ilaa afartan sano ee u dhexeeya. Inta badan, cudurada la helo in dadka Afro-Caribbean.

Cudurku wuxuu keeni karaa by kala duwan arrimood, ka istimaalka ee warshadaynta hargaha, si ay hiddo ahaan, sidaa darteed, waa wakhti aad u muhiim ah in fiiro gaar ah u calaamadaha iyo arko dhakhtar. Ka dib oo dhan, daaweynta si degdeg ah loo bilaabo, si fiican u saadaal ah ee nolosha iyo caafimaadka bukaan-socodka.

etiology

kelyo xanuun lupus waxa keeni kara qorax muddo dheer si joogto ah (solarium hiwaayad ama sii joogaan meelaha qoraxdu), xasaasiyad in daawooyinka, stress joogto ah iyo xataa uurka (uurjiifka waxaa loo arkaa jirka ajnabi ah iyo nidaamka difaaca jirka bilaabmaa si ay u weeraraan unugyada hooyada).

Intaa waxaa dheer, horumarinta cudurada hidde saamayn qabatinka, joogitaanka isu dheelitir la'aanta hormoon, cudurro soo noqnoqda virus (virus daro jirka gacanta, taasoo ka dhigeysa in cudur dusha iyo cadhaysiinina ay sidaas jawaab difaaca). Fursada cudurka ee qaraabada dhow dhowr jeer ka badan celceliska dadka.

pathogenesis

kelyo xanuun lupus waa qayb ka mid ah calaamad in uu yeesho in lupus erythematosus oo nidaamsan. Autoantibodies yeeshaan in meesha ugu horeysa in DNA hooyo iyo xidhiidhka ay la histones, borotiinka nidaamka complement iyo cardiolipin. Sababta gardarada sida - hoos u dulqaad in cudur-is, cilladaha ee B iyo limfosaytis T.

Si toos ah oo la xidhiidha horumarinta kelyo in kaxeynayo ku antigen antibody-tropic in unugyada ka mid ah tubules kelyaha. Marka sida Britain protein ah waxaa ku lifaaqan dusha sare gacanta, waxa ku kicin kara Cascade ah reactions lagmamaarmaanna u keeni in sii daayo walxaha firfircoon, dhalaalay cell. Tani, markeeda, sababa dareen bararka, taas oo kaliya yhay dhaawaca.

anatomy silica

kelyo xanuun lupus in uub laga yaabaa in daliilka morphological kala duwan. Iyada oo furitaanka bukaanka lahaa isbedel ku xuubka of glomeruli kelyaha, qeybinta firfircoon ee unugyada, ballaarinta mesangium ah, sclerosis vascular, siddo oo dheeraad ah. daliilka waxaa laga yaabaa in labadooda oo isku iyo dhowr glomeruli.

The ugu gaar ah kelyo lupus waa fibrinoid loop gaddoonka galleeyda of Henle, iyo karyopyknosis iyo karyorrhexis histologically dareemi (separation iyo lysis ah nuclei cell). Intaa waxaa dheer, isbedel pathognomonic in xuub hoostiisa glomerular sida a "siddo oo silig" iyo joogitaanka thrombi hyaline in Lumen ee qubaan oo sabab u ah dhigaalka laga kaxeynayo difaaca.

kala soocidda

Caafimaad iyo morphologically jira dhowr marxaladood oo kordhiyay kelyo lupus. Qoondaynta oo ah Ururka Caafimaadka Adduunka ayaa sida soo socota:

1. Class First: glomeruli leeyihiin qaab caadi ah.
2. fasalka labaad: waxaa jira badala kaliya ee mesangium ah.
3. fasalka saddexaad: glomerulonephritis la nabar ah nus ka mid ah glomeruli ah.
4. fasalka afaraad: waajihi glomerulonephritis.
5. fasalka shanaad: glomerulonephritis membranous.
6. fasalka lixaad: glomerulonephritis sclerosing.

Waxa kale oo jira kala soocidda a Serova, kuwaas oo waxaa lagu qoondeeyay focal, waajihi, membranous, mesangioproliferative, glomerulonephritis mesangiocapillary iyo fibroplastic.

calaamadaha

kelyo xanuun lupus Membranous ayaa labada calaamadaha waajibiyo iyo facultative. Mid ka mid ah daliilka ay waa proteinuria khasab ah, in uu yahay, joogitaanka borotiin laga helo kaadida. Sidoo kale, aad inta badan ka heli kartaa hematuria, leuco - iyo limfotsituriyu. Calaamadahan waxay muujinayaan jiritaanka caabuq kelyaha iyo waxay noqon kartaa ma aha oo kaliya in uub.

Iyada oo horumar ah ee hanaanka, shalalka sii kordhaya calaamadaha kelyaha la muujiyey by heer kariyaatiniin kordhay dhiigga iyo kaadida, daciifnimo, feejignaan xumo bukaanka dalalka soporous.

Waa si tartiib tartiib iyo si degdeg ah kelyo horusocod ah. Haddii cudurka si tartiib tartiib ah uu yeesho, ka adkaan kaadida iyo nephrotic syndrome. Waxaa intaa dheer, kelyo xanuun lupus la qaban karaa foomka firfircoonayn ama qarsoon, marka dhammaan calaamadaha joogo proteinuria kaliya yar.

Si degdeg ah kelyo lupus horusocod ah aad uula mid tahay glomerulonephritis ah classic. kelyaha si degdeg ah u koraya, waxaa jira hematuria guud, kordhay cadaadiska dhiigga, iyo nephrotic syndrome. Xaaladaha daran horumarin karaan xinjirowga intravascular faafiyay (Indvandrerrådgivningen).

kelyo xanuun lupus carruurta

In 1/5 bukaannada qaba lupus erythematosus oo nidaamsan calaamadaha u horeeyay ee carruurnimada. In carruurta ka yar 10 sano, waxay ku dhow ma dhici karto, laakiin waxaa jira sharaxaad ka mid ah xaaladaha of uub in ilmaha bilood iyo badh jir ah.

Horumarinta cudurka ee carruurta ma aha in dadka waaweyn oo kala duwan. Sawirka caafimaad oo la kala duwanaayeen kara: ka astaamo ay si degdeg ah horumar. Xiisad renal failure waa dhif.

Dhowr aayaad Cad iyagoo ah uub ee ilmaha:

• erythema wajiga,
• finan saxan on jidhka,
• dareemo iftiinka cadceedda,
• ulceration xuubka;
• hurgunta kalagoysyada,
• cudurka kalyaha;
• xadgudub ku ah nidaamka dareenka dhexe;
• dhiigbax ugu kordheen;
• cudurada difaaca;
• jiritaanka unugyada antinuclear.

Haddii rugta caafimaadka ay leedahay ugu yaraan afar muuqaalada liiskan, waxaan si kalsooni leh u odhan kartaa in ilmuhu leeyahay lupus erythematosus oo nidaamsan. kelida oo dhaawac gaaro carruurta dhif ah bannaanka u soo baxday. Sida caadiga ah, calaamado u dhaxayn karo glomerulonephritis in daliilka ee antiphospholipid syndrome.

Saadaasha horumarinta cudurka in carruurta wanaagsan more. Toban sano ka dib markii Soon ee cudurka dialysis u baahan tahay boqolkiiba bukaannada 10 oo keliya.

Baadhista xanuunada

Oo waxa dhakhtarku ku siinayaa sabab tuhun kelyo lupus? Cilad waxaa inta badan ku salaysan xogta caafimaad ee hadda jira iyo shaybaar-xaqiijiyay uub:

• Xanuun iyo barar ku jira laabatooyinka ee;
• dildilaaca maqaarka wejiga oo ah qaab balanbaalis oo kale;
• iyadoo ay wada joogaan ee taariikhda effusion in saabka (pleurisy, pericarditis);
• miisaan dhakhso khasaaro, qandho.

Falanqaynta guud ee dhiigga arkay dhiig, hoos u platelets, heerka Kimikada erythrocyte kordhay, hoos u dhameystiraan borotiinada. Si xanuunkan waxaa muhiim ah in la ogaado unugyada DNA hooyo.

Sida caadiga ah, tani waa ku filan si ay u sameeyaan ogaanshaha lupus erythematosus oo nidaamsan iyo, sida natiijo ah oo kelyo lupus. Si kastaba ha ahaatee, muuqaalka kore ee borotiin laga helo kaadida ayaa loo dhigi karaa hal ama laba sannadood laga bilawga cudurka. In kiiska noocan oo kale ah, dhakhtarka ku tiirsan immunoassay enzyme iyo ogaanshaha antibodies. Haddii aadan xaqiijiyay xogta shaybaarka, waxaa lagama maarmaan ah in ay sii wadaan raadinta ogaanshaha, gaar ahaan bukaanka lab, ay nosology, tani waa dhif.

Kala kelyo lupus in bukaanka uub la endocarditis bakteeriyada, exacerbations ba'an ee rheumatoid arthritis, myeloma, hepatitis B ee joogtada ah, iyo amyloidosis syndrome, Xanoog-Schonlein purpura.

Wejiga kowaad ee daaweynta

Daaweynta kelyo lupus - geedi socod dheer oo daalin in badanaa ku dhammaataa ee Meyeydaan. Waxay qaadataa meel laba marxaladood. Marxalada koowaad xirtay sii daridda. Natiijada daaweynta - si ay u gaaraan dembidhaafka deggan, ama ugu yaraan loo yareeyo daliilka kiliinikada.

Daawada waa in ay bilaabaan sida ugu dhaqsaha badan ka xaadirka ah ee cudurka. Wax kasta oo si deg deg ah ay dhacdo in xitaa shan ilaa toddoba maalmood ah dib u dhac uu noqon karaa mid qalad dilaa. Haddii hawlaha geedi socodka gaaban tahay (tus doonaa titers antibody) waxay, dhakhtarkaaga ayaa laga yaabaa in la xadidin isticmaalka corticosteroids in qaadasho sare muddo laba bilood ah, raaceen by hoos u gaabis ah in qiyaasta (jir- baajiso daroogada ma noqon karo, diidi karaa qanjidhada adrenal).

Haddii koorso dheeraad ah oo deg deg ah ee cudurka, marka lagu daro steroids, intravenously maamula qaadasho sare ee nudaha. therapy garaaca wadnaha Tani waa la fuliyay lix bilood gudahood. Keliya muddo ka dib bilaabi karaan in la dhimo cadadka ee daroogada, iyo wareejiyo bukaanka dawada afka.

Ha illoobin in bukaanka qaba uub inta badan sameeyo faafiyay xinjirowga intravascular, sidaas waxaa lagu talinayaa in ay qaataan tallaabooyin ka hortag ah, kuwaas oo:

• shubo dhiig iyo qaybaha;
• xididka "Trental";
• Maamulka subcutaneous of 2.5 halbeeg kun oo "heparin".

marxaladdan labaad ee daaweynta

kelyo xanuun lupus in uub in marxaladda labaad waxaa sidoo kale lagu daweeyaa steroids iyo daroogada cytotoxic. dose oo kaliya ay uga yar yihiin. Aad u tartiib ah, in ka badan afar ilaa lix bilood, dose "prednisolone" ayuu titrated 10 milligram per kiilo ee miisaanka jidhka. wakiilada cytotoxic kaloo amray qaadasho bolusdose mar saddexdii biloodba mar, oo haddii dhaqdhaqaaqa wanaagsan ee cudurka, ka dibna u guurto on in hal cirbid oo lixdii biloodba mar.

therapy dayactirka noocan oo kale ah waxay socon kartaa muddo sanado ah. Waqti ka, waxaa lagu daray (haddii loo baahdo) hortagga waxyeellooyinka dawooyinka iyo daaweynta calaamadaha.

Laakiin xitaa iyada oo waqtiga daaweynta bilaabay at shan iyo toban boqolkiiba bukaannada ku samaysi kelyaha. Xaaladdan oo kale, kaa caawin karaan oo keliya kelyaha ama kelyaha badalida. Nasiib darro, daaweynta, kuwaas oo aan diyaar u yihiin inay bulshada guud.

Cuntada loogu talagalay kelyo lupus

Si ay u joogteeyaan function kelyaha bukaanka kelyo lupus waa u hoggaansamaan xeerarka qaarkood:

1. Cab cabitaano badan si ay si fiican shaandhayso dhiigga iyo joogteeyo heerka shiid.
2. cunto waa ku jira xaddi yar oo ka mid ah potassium, fosfooraska, iyo protein, tan iyo xubno waxay leeyihiin saamayn xun ku kelyaha ay waxyeello.
3. Sii kor caadooyinka xun.
4. Wadahadal in jimicsiga iftiinka.
5. Si joogto ah u hubi cadaadiska dhiiggaaga.
6. Xaddid qaadashada cuntooyinka dufanka leh.
7. Ha qaadan NSAIDs maxaa yeelay, waxay leeyihiin saamayn taban ku kelyaha.

Haddii bukaanka socota talooyinka, tayada nolosha waxaa si weyn u soo hagaagtay, iyo saadaasha badbaadada waa ka rajo.

Odoroska

Saadaasha daweynta kelyo lupus membranous ku xiran tahay sida xun u saameeyey kelyaha iyo bilowgii therapy. The hore bukaanku uu aado dhakhtarka, ugu weyn suurtagalnimada of natiijo wanaagsan.

Afartan sano ka hor, hadana in yar oo bukaanka qaba kelyo lupus ku noolaa in ka badan sanad ka ogaanshaha. Thanks to hababka casriga ah ee daaweynta iyo ogaanshaha, bukaanka ka filan karto in ka badan shan sano dari ah.