Xav txog tias ib tug neeg uas koj paub, tej zaum yog ib tug neeg hauv tsev neeg, tab tom kho mob qog noj ntshav. Tshwj xeeb tshaj yog nrog ib qho kev kho mob zoo tshaj plaws niaj hnub no. Ob peb hnub tom qab pib kho mob, lawv cia li kub taub hau heev, mob lub cev, thiab xav tias lawv mob khaub thuas hnyav. Peb feem ntau xav tias qhov no tsuas yog ib qho kev phiv ntawm kev kho mob xwb. Txawm li cas los xij, qhov no yuav yog ib qho cim qhia txog qee yam loj dua. Qhov no yog ib qho mob uas peb hu ua Cytokine Release Syndrome (CRS) .
Hais yooj yim xwb, CRS yog dab tsi?
Yuav kom nkag siab qhov no, cia peb xub xav txog peb lub cev tiv thaiv kab mob. Nws zoo li ib pab tub rog uas tiv thaiv peb lub teb chaws. Pab tub rog no muaj cov neeg xa xov uas sib txuas lus ntawm nws cov tub rog (cov hlwb tiv thaiv kab mob). Ib yam li ntawd, muaj cov protein tshwj xeeb uas pab peb cov hlwb tiv thaiv kab mob sib txuas lus thiab tswj lawv cov haujlwm, hu ua cytokines . Cov no yog qhov tseem ceeb rau lub cev tiv thaiv kab mob noj qab haus huv.
Tiam sis qee zaum, tshwj xeeb tshaj yog nrog qee yam kev kho mob qog noj ntshav, xws li kev kho mob tiv thaiv kab mob , peb lub cev tiv thaiv kab mob tuaj yeem ua rau muaj kev txhawb zog ntau dhau. Qhov no ua rau muaj kev tso tawm cov tub txib no, hu ua cytokines, mus rau hauv cov ntshav. Nws zoo li ib pab tub rog mus rau kev sib ntaus sib tua thiab xa tawm ntau txhiab cov lus ib zaug. Qhov no qee zaum hu ua "cytokine storm." Thaum ntau cov cytokines raug tso tawm ib zaug, nws ua rau mob thoob plaws lub cev. Qhov ntawd yog qhov peb hu ua CRS.
Cov ua rau muaj CRS yog dab tsi?
Qhov ua rau CRS mob hnyav tshaj plaws yog qee yam kev kho mob niaj hnub no siv rau mob qog noj ntshav.
- Kev Kho Mob Tiv Thaiv Kab Mob: Qhov no yog qhov ua rau feem ntau. Kev kho mob xws li kev kho mob CAR-T cell thiab cov tshuaj tiv thaiv kab mob bispecific yog qhov muaj feem yuav mob CRS. Cov kev kho mob no ua rau peb lub cev tiv thaiv kab mob tiv thaiv kab mob kom tawm tsam cov hlwb qog noj ntshav. Thaum lub sijhawm no, lub cev tiv thaiv kab mob qee zaum ua haujlwm ntau dhau.
- Lwm yam ua rau: Cov neeg uas muaj tej yam mob caj ces lossis cov kab mob autoimmune kuj yuav muaj feem yuav muaj ntau dua. Piv txwv li, ib yam mob caj ces hu ua Hemophagocytic lymphohistiocytosis (HLH) .
Cov tsos mob ntawm CRS yog dab tsi?
Cov tsos mob ntawm CRS zoo ib yam li cov mob khaub thuas, yog li ntawd qee zaum nws yuav nyuaj rau paub. Txawm li cas los xij, cov tsos mob no kuj tuaj yeem hnyav sai sai.
| Cov tsos mob | Kev piav qhia |
|---|---|
| Kub taub hau thiab mob khaub thuas | Qhov no yog thawj cov tsos mob uas feem ntau pom. |
| Kev tsis meej pem thiab kiv taub hau | Cov teebmeem rau lub hlwb tuaj yeem ua rau tsis meej pem thiab tsis nco qab. |
| Xeev siab thiab ntuav | Cov tsos mob no tshwm sim vim muaj kev cuam tshuam rau lub cev zom zaub mov. |
| Mob plab/raws plab | Flatulence yog lwm yam tsos mob uas tshwm sim ntau. |
| Mob taub hau thiab mob lub cev | Tej zaum yuav mob pob qij txha thiab mob nqaij, zoo ib yam li mob dengue. |
| Mob pob khaus ntawm daim tawv nqaij | Ib txhia neeg yuav muaj cov pob liab ntawm lawv daim tawv nqaij. |
| Nyuaj nqos | Mob caj pas ua rau nws nyuaj rau nqos. |
| Ua haujlwm nyuaj | Xav tias nkees dhau ua tsis tau dab tsi. |
Qhov xwm txheej no yuav loj npaum li cas?
CRS yog ib yam mob uas muaj peev xwm ua rau tuag taus. Qhov mob o ntau dhau thoob plaws lub cev tuaj yeem ua rau puas tsuaj rau cov kab mob tseem ceeb xws li lub raum, siab, ntsws, thiab lub plawv.
Qhov tseem ceeb tshaj plaws yog kuaj mob no thaum ntxov thiab pib kho, txwv tsis pub muaj teeb meem loj tshwm sim.
Cov hauv qab no yog qee qhov teeb meem loj uas tuaj yeem tshwm sim:
- Cov teebmeem rau lub plawv: Cardiomyopathy thiab lub plawv tsis ua haujlwm tuaj yeem tshwm sim.
- Cov teebmeem rau lub ntsws: Lub ntsws ua haujlwm tsis zoo thiab cov pa oxygen hauv cov ntshav qis heev tuaj yeem tshwm sim.
- Kev Ua Tsis Tau Zoo ntawm Lub Raum thiab Siab: Kev puas tsuaj rau cov kabmob no tuaj yeem ua rau lawv tsis ua haujlwm.
- Kab mob Capillary leak syndrome: Cov kua dej tawm ntawm cov hlab ntsha me me tuaj yeem ua rau cov ntshav siab poob qis txaus ntshai.
Cov kws kho mob nrhiav tau qhov no li cas?
Cov neeg kho mob uas kho koj paub zoo txog CRS, yog li ntawd yog tias koj tau txais kev kho mob zoo li kev kho mob tiv thaiv kab mob, lawv yuav saib xyuas koj cov tsos mob kom zoo.
Yog tias muaj cov tsos mob tshwm sim, tus kws kho mob yuav xaj ntau qhov kev kuaj mob kom paub meej tias muaj mob.
- Kev suav cov ntshav tag nrho (CBC): Saib xyuas kev hloov pauv ntawm cov qe ntshav.
- Cov Qib Cytokine: Ntsuas cov cytokines hauv cov ntshav.
- Kev kuaj C-reactive protein (CRP): Qhov kev kuaj no pab ntsuas qib kev o ntawm lub cev.
- Tshawb xyuas kev ua haujlwm ntawm lub raum thiab daim siab: Nrhiav seb cov kabmob no puas tau puas lawm.
Nyob ntawm seb tus mob hnyav npaum li cas, cov kws kho mob faib nws ua Qib 1 txog 4. Tus lej siab dua, tus mob hnyav dua. Theem no yog txiav txim siab los ntawm kev xav txog cov yam xws li kub taub hau, ntshav siab, cov pa oxygen, thiab kev ua haujlwm ntawm lub cev.
Cov kev kho mob rau CRS yog dab tsi?
Kev kho mob nyob ntawm seb koj cov tsos mob hnyav npaum li cas. Rau cov mob me me, tej yam yooj yim xws li tshuaj txo qhov kub taub hau tej zaum yuav txaus. Tab sis yog tias qhov mob hnyav heev, tej zaum yuav xav tau kev kho mob tshwj xeeb ntxiv.
| Txoj kev kho mob | Muaj dab tsi tshwm sim? |
|---|---|
| Cov tshuaj Corticosteroids | Tswj kev o ntawm lub cev thiab kev ua haujlwm ntawm lub cev tiv thaiv kab mob. |
| Cov tshuaj uas tsom mus rau cov cytokines tshwj xeeb | Tua thiab thaiv cov cytokines uas tsim ntau dhau. Piv txwv li: tocilizumab, siltuximab, anakinra. |
| Kev Saib Xyuas Txhawb Nqa | Muab tshuaj rau cov ntshav siab qis, muab oxygen, thiab siv tshuab ua pa yog tias tsim nyog. |
Thaum twg kuv yuav tsum nrhiav kev pab kho mob?
Qhov no yog qhov tseem ceeb tshaj plaws.
Yog tias koj tau txais kev kho mob qog noj ntshav, thiab koj kub taub hau lossis lwm yam tsos mob CRS (xws li mob pob qij txha, tsis meej pem) tom qab kho mob, nws tsis yog lub tswv yim zoo los ncua nws txawm tias me ntsis.
Qhov mob no tuaj yeem loj hlob sai heev. Yog li ntawd, qhia rau koj tus kws kho mob lossis tsev kho mob tam sim ntawd. Thaum koj pib kho mob sai npaum li cas, qhov kev pheej hmoo ntawm cov teeb meem loj yuav tsawg dua.
Nws yog ib qho kev nkag siab uas yuav ntshai thiab ntxhov siab thaum hnov txog ib yam dab tsi zoo li no thaum koj tab tom tawm tsam mob qog noj ntshav. Tab sis nco ntsoov, pab pawg kws kho mob uas kho koj paub zoo txog CRS. Lawv tab tom saib xyuas koj ze heev. Tsis txhob ntshai qhia rau lawv txog txhua yam kev hloov pauv hauv koj lub cev, txawm tias yog qhov me tshaj plaws. Nrog koj txoj kev txhawb nqa, qhov mob no tuaj yeem tswj tau ua ntej nws loj hlob tuaj.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- CRS yog ib qho mob hnyav uas tshwm sim los ntawm lub cev tiv thaiv kab mob ua haujlwm ntau dhau. Nws tuaj yeem tshwm sim, tshwj xeeb tshaj yog tom qab kev kho mob qog noj ntshav.
- Cov tsos mob yuav pib zoo li mob khaub thuas, tab sis tuaj yeem ua rau hnyav sai sai. Cov tsos mob tseem ceeb yog kub taub hau heev, txias, thiab tsis meej pem.
- Yog tias koj tab tom txais kev kho mob tiv thaiv kab mob, qhia rau koj tus kws kho mob tam sim ntawd yog tias koj kub taub hau lossis lwm yam tsos mob txawv txawv.
- Muaj cov kev kho mob zoo rau CRS. Kev kho mob thaum ntxov tuaj yeem tiv thaiv cov teeb meem loj.
- Qhia rau koj pab neeg kho mob paub txog qhov no. Tham nrog lawv txog koj tej kev txhawj xeeb thiab cov tsos mob.
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