Ke manaʻo pinepine nei ʻoe i ka palaualelo, loaʻa iā ʻoe ke kuni i wehewehe ʻole ʻia, a emi ke kaumaha me ka ʻeha o nā hono? ʻOiai ke ʻano o kēia mau mea he mau mea maʻamau, i kekahi manawa ʻo ka mea i hūnā ʻia ma hope o kēia mau hōʻailona he maʻi paha a mākou i lohe ʻole ai a pono mākou e hopohopo iki. I kēia lā ke kamaʻilio nei mākou e pili ana i kahi maʻi kakaikahi akā koʻikoʻi e pono ai mākou e makaʻala. Ua kapa ʻia kēia he microscopic polyangiitis, a i ʻole MPA e like me ka kapa ʻana o nā kauka.
I ka ʻōlelo maʻalahi, he aha ka Microscopic Polyangiitis (MPA)?
I ka ʻōlelo maʻalahi, ʻo MPA kahi kūlana kahi e pehu ai nā kīʻaha koko liʻiliʻi a me waena (nā kīʻaha koko) i loko o ko mākou kino, ʻo ia hoʻi, pehu. I ka lāʻau lapaʻau, kapa pinepine mākou i kēia pehu o nā kīʻaha koko ʻo 'vasculitis'. He maʻi laha ʻole kēia.
Ke pehu nā kīʻaha koko ma kēia ʻano, hoʻomaka lākou e hōʻino i nā ʻōpū a lākou e hoʻolako ai i ke koko. ʻO nā ʻōpū nui e hiki ke hoʻopilikia ʻia i ka MPA:
- nā puʻupaʻa
- Nā māmā
- Nā aʻalolo
- ʻIli
- Nā hono (nā hono)
He aha ka 'Vasculitis'? He aha ke kumu?
E noʻonoʻo i ka ʻōnaehana aʻa koko ma loko o ko kākou kino e like me kahi ʻōnaehana o nā paipu e lawe ana i ka wai. Ke pehu a pehu paha kēia mau paipu, hiki ke loaʻa kekahi mau pilikia.
1. Ka nāwaliwali o ke kīʻaha koko: Ma muli o ka pehu ʻana, lilo ka paia o ke kīʻaha koko i nāwaliwali a hiki ke puʻupuʻu e like me ka pōpō. Kāhea mākou i kēia "(Aneurysm)". I kekahi manawa hiki i kēia wahi nāwaliwali ke pahū a kahe ke koko i loko o nā ʻiʻo a puni.
2. Ka hāiki ʻana o nā kīʻaha koko: ʻO kekahi mea ʻē aʻe, hiki i nā kīʻaha koko ke hāiki ma muli o ka pehu ʻana i loko o lākou, a i kekahi manawa ua ālai loa ʻia. A laila hoʻomaka nā ʻōkana e loaʻa ke koko a me ka oxygen mai kēlā mau kīʻaha koko e hōʻino ʻia. E like me ka make ʻana o ka lāʻau ke nele i ka wai.
ʻO ia ka mea e hana ʻia ma MPA. Ma muli o ka hoʻopilikia ʻia ʻana o nā kīʻaha koko liʻiliʻi, hōʻino lākou i nā ʻōpū koʻikoʻi e hoʻolako ana i ke koko, e like me nā puʻupaʻa a me nā māmā.
ʻO wai ka mea i loaʻa i kēia maʻi? He aha ke kumu?
He maʻi laha ʻole kēia. Wahi a nā helu helu, hoʻopilikia kēia ma waena o 13 a me 19 o kēlā me kēia miliona kānaka ma ka honua. Hiki iā ia ke ulu i kēlā me kēia makahiki a me he mea lā e hoʻopilikia like i nā kāne a me nā wahine.
ʻAʻole i ʻike ʻia ke kumu maoli o kēia maʻi, akā ua maopopo kēia:
- ʻAʻole kēia he maʻi ʻaʻai.
- ʻAʻole ia he maʻi lele.
- ʻAʻole ia he maʻi hoʻoilina maʻamau.
Ua hōʻike nui ʻia e ka noiʻi he ʻano maʻi kēia i hoʻokumu ʻia e kahi hana hewa i loko o ka ʻōnaehana pale ponoʻī o ko mākou kino. I ka ʻōlelo maʻalahi, ʻo ka ʻōnaehana pale, ka mea i manaʻo ʻia e pale i ko mākou kino, hoʻomaka hewa i ka hoʻouka ʻana i ko mākou mau kīʻaha koko ponoʻī. ʻO ia ke kumu o kēia mumū.
He aha nā hōʻailona o ka maʻi MPA?
Ma muli o ka hoʻopilikia ʻana o ka MPA i nā ʻōkana he nui, hiki ke loli ākea nā hōʻailona, a hiki ke ʻokoʻa mai kēlā kanaka a kēia kanaka.
| ʻĀpana i hoʻopilikia ʻia | Nā hōʻailona hiki ke loaʻa |
|---|---|
| Nā hiʻohiʻona maʻamau | Luhi, kuni, nalowale o ka makemake e ʻai, pohō kaumaha, ʻeha ʻiʻo a me nā hono. |
| Nā māmā | Paʻakikī ka hanu ʻana, ke ʻū ʻana i ke koko. |
| Nā aʻalolo | Nā manaʻo ʻē (e like me nā haʻalulu uila, nā ʻanuʻu e holo ana a puni), ukali ʻia e ka mae ʻana o ka hanu, ka nalowale ʻana o ka ikaika. |
| ʻIli | Nā kiko ʻulaʻula a poni paha ma ka ʻili (nā ʻōhūhū). |
| nā puʻupaʻa | ʻO kēia kahi e waiho ai ka pōʻino. Ke hoʻopilikia ʻia nā puʻupaʻa , ʻaʻohe pinepine nā hōʻailona i nā pae mua. ʻAʻole paha ʻoe e ʻike a hiki i ka hoʻomaka ʻana o kou mau puʻupaʻa e oki i ka hana. |
Ma muli o ka hiki ʻana mai o ka maʻi puʻupaʻa me ka ʻole o nā hōʻailona, he mea nui loa ka hoʻāʻo ʻana i ka mimi o kekahi mea i manaʻo ʻia he vasculitis.
Pehea e ʻike ai ke kauka i kēia maʻi?
ʻAʻole hana hoʻokahi kaʻina hana no ka ʻike ʻana i ka MPA. Pono ke kauka e hoʻohui i kekahi mau kumu e hiki ai i kahi hopena.
- E nīnau ʻia ʻoe no nā kikoʻī: E hoʻolohe pono ke kauka i kāu mau hōʻailona, pehea lākou i hoʻomaka ai, a me kāu mōʻaukala olakino.
- He hoʻokolokolo kino: E nānā kāu kauka i kou kino e ho'āʻo e ʻike i nā ʻōpū i hoʻopilikia ʻia.
- Nā hoʻāʻo koko a me ka mimi: Ke nānā pono nei nā hoʻāʻo koko i kahi antibody i kapa ʻia ʻo "(ANCA - Antineutrophil Cytoplasmic Antibodies)". Hiki i kēia ke maikaʻi i nā maʻi e like me MPA. Eia kekahi, he mea nui ka nānā ʻana i ka mimi no ka protein a me nā hunaola koko ʻulaʻula e ʻike i ke kūlana o nā puʻupaʻa.
- Nā scan: Hoʻohana ʻia nā kiʻi X-ray, CT scans, a i ʻole MRI scans e nānā i nā mea ʻino i loko o nā ʻōpū e like me nā māmā.
- Biopsy: Inā kānalua ʻia ka maʻi, lawe ʻia kahi ʻāpana liʻiliʻi o ka ʻiʻo mai ka wahi i hoʻopilikia ʻia (e.g., puʻupaʻa, ʻili) a nānā ʻia ma lalo o kahi microscope. ʻO kēia ke ala maikaʻi loa e hōʻoia ai inā he vasculitis kou.
ʻOiai ua maikaʻi ka hoʻāʻo koko ANCA, ʻaʻole ia he manaʻo ua loaʻa iā ʻoe ka maʻi. He mea kōkua wale nō ia i ka ʻike ʻana. I mea e maopopo ai, pono pinepine ʻia kahi biopsy.
He aha nā lāʻau lapaʻau no ka MPA?
ʻO ka pahuhopu nui o ka mālama ʻana iā MPA, ʻo ia ke kāohi i ka hana nui o kā mākou ʻōnaehana pale a hoʻōki i ka hōʻino ʻana i nā kīʻaha koko. Hoʻohana ʻia nā lāʻau lapaʻau immunosuppressive no kēia.
Ke koʻikoʻi ka maʻi
Inā pilikia nui nā ʻōpū nui e like me nā puʻupaʻa a me nā māmā, hāʻawi pinepine ʻia nā corticosteroids me kahi lāʻau lapaʻau immunosuppressive ikaika ʻē aʻe e like me Cyclophosphamide (Cytoxan®) a i ʻole Rituximab (Rituxan®).
Inā ʻaʻole koʻikoʻi loa ka maʻi
I nā hihia ʻoi aku ka koʻikoʻi, hiki ke hoʻohana mua ʻia nā corticosteroids a me methotrexate.
ʻO ka pahuhopu o ka mālama ʻana, ʻo ia ke kāohi piha i ka maʻi a lawe mai iā ia i kahi kūlana hana ʻole. Ua kapa ʻia kēia ke komo ʻana i ke 'remission'. Ke kāohi ʻia ka maʻi, e hoʻemi mālie ke kauka i ka nui o nā steroids.
ʻO nā lāʻau ikaika e like me ka 'Cyclophosphamide' e hāʻawi wale ʻia a hiki i ka wā e kaohi ʻia ai ka maʻi (ma kahi o 3-6 mau mahina). Ma hope o kēlā, e hoʻololi ʻia ʻoe i ka 'Lapaʻau Mālama', e like me ka 'Azathioprine (Imuran®)' a i ʻole 'Mycophenolate Mofetil (Cellcept®)', e mālama i ka maʻi a pale i kona hoʻi hou ʻana mai. Pono paha e lawe ʻia kēia lāʻau mālama no hoʻokahi a ʻelua paha makahiki.
Loaʻa iā ʻoe ka makaʻu o ka ʻōlelo ʻana, "He mau lāʻau lapaʻau maʻi kanesa kēia, ʻeā?"
He nui ka poʻe i nīnau ma ʻaneʻi. Hāʻawi ʻia nā lāʻau lapaʻau i kapa ʻia ʻo 'Cyclophosphamide' a me 'Methotrexate' no ke kanesa, no laila ke ʻōlelo nei lākou he mau lāʻau lapaʻau 'Chemotherapy' kēia. ʻAe, hāʻawi ʻia kēia no ke kanesa. Akā, ʻo ka nui i hāʻawi ʻia no 'Vasculitis' he 10-100 mau manawa haʻahaʻa ma mua o ka nui i hāʻawi ʻia no ke kanesa. Maanei, ʻaʻole ka hana a kēia mau lāʻau lapaʻau e pepehi i nā hunaola kanesa, akā, e kāohi i ka hana o ka ʻōnaehana pale.
Ma muli o ke kāohi ʻana o kēia mau lāʻau lapaʻau i ka ʻōnaehana pale, aia kahi pilikia o ka loaʻa ʻana o nā maʻi koʻikoʻi. Eia kekahi, hiki i kēlā me kēia lāʻau lapaʻau ke loaʻa kekahi mau hopena ʻaoʻao. No laila, he mea nui loa ka hoʻāʻo ʻia ʻana i ka manawa kūpono a e noho ma lalo o ka nānā mau ʻana o ke kauka, e like me ke kauoha a ke kauka.
Pehea lā ke ʻano o ke ola me kēia maʻi?
ʻOiai he maʻi koʻikoʻi ka MPA, me ka mālama kūpono, hiki i ka hapa nui o ka poʻe ke kāohi pono i ke kūlana. ʻOkoʻa nā hopena ma muli o ke koʻikoʻi o ka maʻi. Eia nō naʻe, ma ke ʻano laulā, ʻoi aku ma mua o 80% o ka poʻe e ola ana a olakino ma hope o 5 mau makahiki o ka ʻike ʻia ʻana o ka maʻi.
Hiki i ka ʻike mua ʻana a me ka mālama mua ʻana ke kōkua i ka hōʻemi ʻana i ka hōʻino ʻana o nā kino. He mea nui hoʻi e mālama i ka launa mau me kāu kauka.
Ma hope o ka hoʻomalu ʻia ʻana o ka maʻi, ʻo ia hoʻi, ma hope o ke komo ʻana i ka "Remission", hiki ke hoʻi hou mai i kekahi manawa. Kāhea mākou i kēia he "Relapse". Ma kahi o 50% o nā maʻi e ʻike i kēia ʻano relapse maʻi. No laila, pono ʻoe e hoʻomaopopo koke i kāu kauka e pili ana i nā hōʻailona hou āu e ulu ai.
Leka Lawe-Home
- He maʻi laha ʻole ka MPA kahi e hoʻouka ai ko kākou ʻōnaehana pale ponoʻī i nā kīʻaha koko.
- Hiki i kēia ke hōʻino i nā ʻōpū koʻikoʻi e like me nā puʻupaʻa, nā māmā, a me nā aʻalolo. ʻOiai inā pili nā puʻupaʻa, ʻaʻohe paha he mau hōʻailona i nā pae mua.
- Hiki i ka ʻike mua a me ka mālama ʻana ke pale i ka pōʻino lōʻihi.
- Ma muli o ka hoʻohana ʻia ʻana o nā lāʻau immunosuppressive no ka mālama ʻana, he mea nui loa ia e noho ma lalo o ka mākaʻikaʻi lapaʻau a pale iā ʻoe iho mai nā maʻi.
- ʻOiai inā ua kāohi ʻia ka maʻi, aia kahi hiki ke hoʻi hou. No laila, inā ʻike ʻoe i kekahi mau hōʻailona hou, ʻoiai nā mea liʻiliʻi, e haʻi koke i kāu kauka.
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