ʻAʻole hana ka lāʻau mua no PBC? E kamaʻilio kākou e pili ana i ka lua o ka hana (Primary Biliary Cholangitis)

Loaʻa iā ʻoe kahi maʻi akepaʻa i kapa ʻia ʻo PBC, a i ʻole Primary Biliary Cholangitis? Inā pēlā, ʻaʻole paha i holo pono ka lāʻau lapaʻau mua a kāu kauka i kuhikuhi ai e like me kou manaʻolana. Mai hopohopo no ia mea. Ua loaʻa i nā poʻe he nui nā ʻike like. ʻO ka mea nui, ʻo ia ke noho lana ka manaʻolana a me ka makaʻala i nā mea hiki iā ʻoe ke hana aʻe. I kēia lā, e kamaʻilio kākou e pili ana i nā mea hiki iā ʻoe ke hana i kahi manawa e like me kēia a me nā lāʻau lapaʻau hou e loaʻa ana.

ʻO ka mea mua, he aha ka PBC ma nā huaʻōlelo maʻalahi?

He kūlana paʻakikī a lōʻihi ka PBC kahi e hoʻouka ai ka ʻōnaehana pale o ko mākou kino i nā ʻauwai bile liʻiliʻi i loko o ko mākou ake. E noʻonoʻo i kēia mau ʻauwai bile e like me nā paipu liʻiliʻi i loko o ko mākou ake. ʻO kā lākou hana nui ka lawe ʻana i ka bile, kahi wai e kōkua ai i ka hoʻoheheʻe ʻana i ka meaʻai, mai loko mai o ke ake.

I kēia manawa, ma ke ʻano o PBC, hōʻino nā pūnaewele o kā mākou ʻōnaehana pale ponoʻī i kēia mau paipu. A laila ua ālai ʻia kēia mau paipu, a ʻaʻole kahe pono ka bile a paʻa i loko o ke ake. E like me nā kaʻa e paʻa ana i ke kaʻa. Ke hōʻiliʻili ka bile ma kēia ʻano, hoʻomaka ia e hōʻino i nā pūnaewele ake. I ka hala ʻana o ka manawa, hiki i kēia hōʻino ke hana i ka ʻeha o ke ake. Kāhea mākou i kēia he fibrosis . Ke lilo kēia ʻano i mea koʻikoʻi, hiki iā ia ke alakaʻi i ka pilikia o ka cirrhosis, kahi ʻano i kapa ʻia ʻo ka hāʻule ʻana o ke ake.

He ʻokoʻa iki kēia mai nā maʻi autoimmune ʻē aʻe. No ka mea, ʻaʻole pane maikaʻi ka PBC i nā lāʻau hoʻopau i ka ʻōnaehana pale i hoʻohana ʻia no nā maʻi autoimmune ʻē aʻe. ʻO kekahi kumu paha ua hōʻino mua ʻia ke akepaʻa i kekahi ʻano i ka manawa i ʻike ʻia ai ka maʻi. Akā, mai hopohopo, me ka holomua o ka ʻepekema, aia nā lāʻau lapaʻau maikaʻi no kēia.

ʻO ka hana mua i ka mālama ʻana: ka lāʻau lapaʻau UDCA

Aia kekahi mau pahuhopu nui i ka mālama ʻana i ka PBC: e hoʻolohi i ka holomua o ka maʻi, e kaohi ana i nā hōʻailona, ​​a me ka pale ʻana i nā pilikia mai ka hōʻino ʻana o ke ake.

Ke ʻike ʻia ʻoe me PBC, ʻo ka lāʻau lapaʻau mua a kāu kauka e hoʻomaka ai iā ʻoe ʻo ia ka Ursodeoxycholic acid , a i ʻole UDCA no ka pōkole. Ua ʻike paha ʻoe iā ia ma ka inoa inoa ʻo Ursodiol. Hana kēia lāʻau lapaʻau ma ke kōkua ʻana i ke akepaʻa e hoʻokuʻu i ka bile i paʻa i loko o ke akepaʻa a me ka hoʻēmi ʻana i ke kūkulu ʻia ʻana o ka scarring (fibrosis) i loko o ke akepaʻa. He mea nui kēia, no ka mea, ʻo ka scarring ka mea hiki ke alakaʻi i ka cirrhosis a me ka hāʻule ʻana o ke akepaʻa.

No ke aha i lawa ʻole ai ka UDCA wale nō?

Ua ʻike ʻia ma ka noiʻi ʻana ma waena o 25% a me 50% o nā maʻi e lawe ana i ka UDCA ʻaʻole i loaʻa nā hopena i manaʻo ʻia mai ka lāʻau. ʻO ke ʻano kēia, ʻaʻole hōʻike koʻikoʻi kā lākou mau hoʻokolohua hana ate.

Ma kēia ʻano, ʻo ke kanaka i pane maikaʻi ʻole i ka UDCA he ʻelima manawa ka nui o ka pilikia o ka loaʻa ʻana o ka cirrhosis. A ʻekolu manawa ka nui o ka pilikia o ka make ʻana mai ka maʻi. No laila, inā ʻaʻole e hana ana ka UDCA, he mea nui e kamaʻilio me kāu kauka e pili ana i nā hana aʻe, ma mua o ka hoʻomau wale ʻana i ka hoʻohana ʻana.

Ke noʻonoʻo nei ʻoe no ke aha e hana pono ʻole ai ʻo UDCA? Aia paha kekahi mau kumu no kēlā.

Inā loaʻa iā ʻoe kekahi a ʻoi aku paha o kēia mau kumu, ua hiki i ka manawa e noʻonoʻo ai i kahi lāʻau lapaʻau laina lua . ʻO ka pahuhopu ma ʻaneʻi ʻaʻole wale ka hoʻomaikaʻi ʻana i kāu mau hopena hoʻāʻo koko. He mea nui hoʻi e kāohi i nā hōʻailona e hoʻopilikia nei i kou ʻano ola, e like me ka maneʻo hiki ʻole ke hoʻomanawanui, ka luhi nui, a me ka hiamoe ʻole . No ka mea, ʻaʻole hāʻawi nui ka UDCA i ka hōʻoluʻolu no kēia mau hōʻailona.

Nā lāʻau lapaʻau laina lua: He aha kēia mau koho hou?

Ke loli koke nei nā koho lapaʻau no PBC. Aia kekahi mau lāʻau lapaʻau hou i nā pae hope loa o ka ʻāpono ʻia. E nānā kākou i nā lāʻau lapaʻau o kēia manawa a me nā lāʻau lapaʻau e hiki mai ana.

ʻO ka waikawa Obeticholic (OCA)

Inā ʻaʻole hana maikaʻi ka UDCA, a inā ʻaʻole hiki iā ʻoe ke ʻae i ka UDCA, ʻo ka lāʻau lapaʻau nui aʻe a kāu kauka e noʻonoʻo ai ʻo ia ka obeticholic acid , a i ʻole OCA . Loaʻa pinepine ia ma lalo o ka inoa inoa ʻo Ocaliva.

I kekahi manawa hiki ke hāʻawi ʻia ʻo OCA me UDCA. ʻO ia hoʻi, hoʻohana pū ʻia nā lāʻau ʻelua. No OCA kahi hui o nā lāʻau i kapa ʻia ʻo farnesoid X receptor agonists . I nā huaʻōlelo maʻalahi, ʻo kāna hana,

1. Hoʻemi i ka nui o ka bile i hana ʻia e ke akepaʻa.

2. Kōkua i ka hoʻokuke ʻana i ka bile i waho o ke akepaʻa.

Ma kēia ʻano, ke hoʻohana wale ʻia ʻo OCA a i ʻole me UDCA, hoʻomaikaʻi ka hana o ke akepaʻa a emi iho ka nui o ka ʻeha o ke akepaʻa.

Ke loli mau nei ke kahua o ka mālama ʻana iā PBC, no laila he mea nui i kou olakino e noho mau me kāu kauka a kūkākūkā i nā lāʻau hou.