Thaum peb kawm tias peb muaj mob qog noj ntshav, thiab tom qab ntawd tham txog kev kho mob, peb feem ntau ntshai, puas yog? Tshwj xeeb tshaj yog txog cov kev mob tshwm sim. Tab sis txoj kev kho mob uas peb yuav tham txog hnub no, hu ua immunotherapy, txawv me ntsis ntawm cov txheej txheem ib txwm muaj xws li chemotherapy. Nws siv koj tus kheej cov tub rog, uas yog, lub cev tiv thaiv kab mob, los tawm tsam cov hlwb qog noj ntshav. Yog li cia peb saib qhov kev kho mob zoo kawg no thiab cov kev mob tshwm sim, yooj yim, kom koj nkag siab.
Kev kho mob tiv thaiv kab mob yog dab tsi?
Hais yooj yim xwb, kev kho mob tiv thaiv kab mob yog kev kho mob uas siv koj lub cev lub cev tiv thaiv kab mob, lub cev tiv thaiv kab mob, los nrhiav thiab rhuav tshem cov hlwb qog noj ntshav. Xav txog nws zoo li ib pab tub ceev xwm hauv peb lub cev. Lawv txoj haujlwm yog nrhiav thiab rhuav tshem cov khoom phem xws li cov kab mob, cov kab mob, thiab cov hlwb txawv txav uas loj hlob hauv peb lub cev, ua rau peb noj qab nyob zoo.
Tiamsis cov hlwb mob qog noj ntshav yog ib hom hlwb ntse heev. Lawv tuaj yeem nkaum ntawm lub cev tiv thaiv kab mob no yam tsis raug ntes. Ib yam li tus tub sab nkaum ntawm tub ceev xwm. Thaum zais li ntawd, lawv sai sai faib, kis mus, thiab ua rau muaj teeb meem loj.
Yog li ntawd, qhov kev kho mob tiv thaiv kab mob ua yog muab kev cob qhia tshwj xeeb rau koj lub cev tiv thaiv kab mob thiab txhawb nqa , ua rau nws muaj zog dua los tawm tsam cov hlwb qog noj ntshav. Qhov no tuaj yeem tshwm sim ua ob txoj hauv kev:
- Nws ua rau koj lub cev tiv thaiv kab mob ua haujlwm zoo thiab ua rau nws tsim cov qe ntshav dawb ntau dua uas tiv thaiv tau kab mob qog noj ntshav.
- Nws pab cov hlwb tiv thaiv kab mob uas twb muaj lawm kom paub tseeb thiab rhuav tshem cov hlwb mob qog nqaij hlav uas zais cia.
Vim nws ua rau koj lub cev tiv thaiv kab mob muaj zog, kev kho mob tiv thaiv kab mob tau dhau los ua kev kho mob zoo heev rau ntau hom mob qog noj ntshav.
Vim li cas kev kho mob tiv thaiv kab mob ua rau muaj kev phiv?
, . . , (supercharge ) . , , .
Xav txog nws xwb, nws zoo li tus neeg saib xyuas kev ruaj ntseg zoo siab heev uas ua yuam kev tawm tsam ib tus ntawm nws tus kheej, xav tias nws yog yeeb ncuab.
Qhov kev tawm tsam rau cov nqaij noj qab haus huv no hu ua 'kev cuam tshuam txog kev tiv thaiv kab mob (irAE).' Qhov no yog qhov ua rau mob o hauv cov nqaij noj qab haus huv, thiab koj pib hnov nws ua rau muaj ntau yam kev phiv.
Cov kev mob tshwm sim no feem ntau tshwm sim li cas?
Tsis txhob ntshai qhov no. Tsis yog txhua tus neeg yuav muaj cov kev mob tshwm sim. Tsuas yog li ntawm 20% ntawm cov neeg uas noj tshuaj immunotherapy thiaj li muaj hom 'irAE' no. Tsis tas li ntawd, feem ntau ntawm cov kev mob tshwm sim uas tshwm sim yog qhov tsis hnyav heev thiab yooj yim tswj.
Tiamsis qhov tseem ceeb tshaj plaws yog qhia rau koj tus kws kho mob tam sim ntawd txog txhua yam kev hloov pauv uas koj pom hauv koj lub cev, txawm tias thaum lub sijhawm lossis tom qab kev kho mob immunotherapy. Txawm tias nws me npaum li cas los xij, nws yog qhov zoo tshaj plaws kom paub txog qhov no.
Tej zaum koj yuav muaj feem yuav muaj cov kev mob tshwm sim ntau dua yog tias koj noj ntau yam tshuaj kho mob tib lub sijhawm, lossis yog tias koj twb muaj tus kab mob autoimmune lawm. Tus kab mob autoimmune yog ib qho mob uas koj lub cev tiv thaiv kab mob ua yuam kev tawm tsam koj cov nqaij noj qab haus huv.
Cov kev mob tshwm sim feem ntau yog dab tsi?
Cov kev mob tshwm sim me me feem ntau yog:
- Qaug zog: Xav tias qaug zog heev mus txog rau qhov ua tsis tau dab tsi.
- Pob khaus: Pob liab, khaus ntawm daim tawv nqaij.
- Mob raws plab: kev txav ntawm lub plab.
- Xeev siab thiab ntuav: Mob thiab ntuav.
- Cov tshuaj hormones hauv cov thyroid qis dua: Kev ua haujlwm tsis zoo ntawm cov thyroid caj pas.
Kev kho mob tiv thaiv kab mob cuam tshuam li cas rau ntau yam kabmob sib txawv?
Vim tias peb lub cev tiv thaiv kab mob tiv thaiv tag nrho lub cev, lub cev no, uas muaj zog los ntawm kev kho mob tiv thaiv kab mob, tuaj yeem cuam tshuam rau txhua yam hauv lub cev. Txawm hais tias feem ntau ntawm cov tsos mob no yog me me, qee qhov tuaj yeem loj heev. Yog li ntawd, nws yog qhov tseem ceeb uas yuav tsum qhia rau koj tus kws kho mob txog txhua yam tsos mob .
Yuav kom yooj yim to taub, cia peb rhuav tshem cov teebmeem no los ntawm cov kab ke hauv lub cev uas lawv tuaj yeem tshwm sim.
| Lub cev/lub cev uas yuav raug kev cuam tshuam | Tej yam tshwm sim/cov tsos mob uas yuav tshwm sim |
|---|---|
| Tawv nqaij | Nws zoo li kev ua xua rau daim tawv nqaij. Nws tuaj yeem ua rau liab, khaus, ua pob liab, tawg, mob qhov txhab, thiab tsis haum rau lub hnub. |
| Lub siab thiab lub plab zom mov | Cov theem enzyme hauv siab yuav nce ntxiv. Qee zaum, kab mob siab yuav tshwm sim, ua rau lub qhov muag daj, zis dub, mob plab sab xis, ntuav, thiab muaj feem yuav los ntshav ntau ntxiv. Kab mob plab kuj tseem yuav tshwm sim, ua rau raws plab, quav ntshav, thiab mob plab. |
| Lub ntsws | Tsis tshua muaj mob ntsws (pneumonitis) . Cov tsos mob muaj xws li hnoos, mob hauv siab, thiab ua pa nyuaj. |
| Cov kab mob thyroid thiab endocrine | Cov qog tsim cov tshuaj hormones tuaj yeem raug cuam tshuam, tshwj xeeb tshaj yog cov qog thyroid. Tej zaum yuav muaj cov tshuaj hormones tsis txaus (hypothyroidism) lossis, tsis tshua muaj, ntau dhau (hyperthyroidism) . Cov tsos mob yuav suav nrog cov plaub hau poob, kiv taub hau, mob taub hau, hloov pauv qhov hnyav, hws ntau dhau, lub plawv dhia ceev, thiab kev tshaib plab/nqhis dej ntau ntxiv. |
| Lub Hlwb & Lub Paj Ntsws | Cov no kuj tsis tshua muaj. Kev o ntawm lub hlwb (encephalitis) tuaj yeem ua rau kub taub hau, coj tus cwj pwm tsis zoo, caj dab txhav, thiab qaug dab peg. Kev puas tsuaj rau cov hlab ntsha (neuropathy) tuaj yeem ua rau loog, tingling, lossis tsis muaj zog ntawm caj npab, ceg, lossis lub ntsej muag. |
| Lub Plawv & Lub Cev Ntshav | Kev ua haujlwm ntawm lub plawv yuav raug cuam tshuam. Lub plawv dhia tsis xwm yeem (Arrhythmia) , o ntawm cov leeg plawv (Myocarditis) , thiab o ntawm cov hlab ntsha (Vasculitis).Tej yam zoo li no yuav tshwm sim tsis tshua muaj. |
| Cov pob qij txha | Mob pob qij txha ua rau mob pob qij txha thiab o. |
Cov kev mob tshwm sim puas sib txawv nyob ntawm hom kev kho mob tiv thaiv kab mob?
Yog, tej kev mob tshwm sim uas koj yuav ntsib yuav txawv nyob ntawm hom kev kho mob tiv thaiv kab mob uas koj tau txais. Cia peb saib qee hom tseem ceeb.
Cov Tshuaj Tiv Thaiv Kab Mob (ICI)
Qhov no yog hom tshuaj uas siv ntau tshaj plaws. Cov tshuaj no ua haujlwm los ntawm kev thaiv cov 'cim' uas cov hlwb qog noj ntshav siv los nkaum ntawm cov hlwb tiv thaiv kab mob (T-cells). Qhov no txhais tau tias cov hlwb qog noj ntshav tsis tuaj yeem nkaum ntxiv lawm. Cov kev mob tshwm sim feem ntau ntawm hom tshuaj no yog qaug zog, raws plab, thiab tawv nqaij ua pob.
Kev Kho Mob Cell Txais Yuav (Kev kho mob hloov T-cell)
Qhov no yog ib qho txheej txheem nyuaj me ntsis. Qhov koj ua ntawm no yog coj cov T-cell (cov hlwb tua kab mob qog noj ntshav) los ntawm koj lub cev, hloov kho lawv hauv chav kuaj, "qhia" lawv kom paub txog cov hlwb qog noj ntshav zoo dua, thiab tom qab ntawd muab lawv rov qab rau hauv koj lub cev.
- Hauv ib hom kev kho mob CAR T-cell , ib qho mob hu ua 'Cytokine Release Syndrome (CRS)' tuaj yeem tshwm sim. Hauv qhov no, lub cev tiv thaiv kab mob sai sai ua haujlwm ntau dhau, ua rau muaj cov tsos mob xws li kub taub hau, mob taub hau, thiab ua pa nyuaj. Tab sis koj cov kws kho mob paub yuav ua li cas tswj hwm qhov mob no.
Cov Tshuaj Monoclonal Antibodies
Cov no yog cov protein tshwj xeeb uas ua nyob rau hauv chav kuaj. Lawv tau tsim los tsom thiab tawm tsam qhov tsis muaj zog tshwj xeeb hauv cov hlwb qog noj ntshav. Lawv tuaj yeem ua rau muaj cov tsos mob zoo li mob khaub thuas xws li kub taub hau, mob lub cev, kev hloov pauv ntawm cov ntshav siab, thiab cov qhov txhab ntawm daim tawv nqaij.
Kev Kho Mob Tshuaj Tiv Thaiv Kab Mob
Cov no zoo li cov tshuaj tiv thaiv kab mob uas peb tau txhaj ua ntej peb mob. Tab sis cov no siv tom qab mob qog noj ntshav tau tsim. Cov tshuaj tiv thaiv kab mob no "qhia" lub cev tiv thaiv kab mob kom paub thiab rhuav tshem cov hlwb qog noj ntshav. Lawv tuaj yeem ua rau muaj tej yam xws li cov tsos mob zoo li mob khaub thuas thiab ntshav siab.
Cov Tshuaj Kho Mob Tiv Thaiv Kab Mob
Cov tshuaj no ua haujlwm los ntawm kev hloov pauv txoj kev uas lub cev tiv thaiv kab mob ua haujlwm, ua rau nws tawm tsam mob qog noj ntshav. Qee cov tshuaj tuaj yeem ua rau muaj kev phiv xws li qaug zog, hlab ntsha puas tsuaj (neuropathy), thiab cov ntshav txhaws.
Cov kev mob tshwm sim no pib thiab xaus thaum twg?
Tsis muaj hnub lossis lub sijhawm tseeb rau qhov no. Kev kho mob tiv thaiv kab mob siv sijhawm ua haujlwm. Yog li ntawd, nws tuaj yeem siv sijhawm ntau lub hlis, qee zaum ntau dua ib xyoos, rau cov kev mob tshwm sim. Tsis tas li ntawd, qee qhov kev mob tshwm sim ntau dua ib xyoos tom qab kev kho mob pib.
Feem ntau cov kev mob tshwm sim tsuas yog ib ntus xwb. Tab sis tsis tshua muaj, lawv tuaj yeem muaj cov kev mob tshwm sim mus sij hawm ntev. Qee zaum, koj yuav muaj cov kev mob tshwm sim ib ntus tom qab koj kho tiav. Qhov no yog vim tias kev kho mob tiv thaiv kab mob tsis yog tshuaj uas ua haujlwm tsuas yog thaum nws nyob hauv koj lub cev. Nws ua rau muaj kev hloov pauv mus sij hawm ntev rau koj lub cev tiv thaiv kab mob.
Yuav ua li cas thiaj tswj tau cov kev mob tshwm sim?
Qhov tseem ceeb tshaj plaws yog qhia rau koj tus kws kho mob txog txhua yam tsos mob uas koj muaj, txawm tias me me li cas los xij . Qee zaum, txawm tias lawv zoo li ib txwm rau koj los xij, lawv tuaj yeem yog ib qho cim qhia ntxov ntawm tus mob hnyav.
Koj tus kws kho mob yuav hloov koj txoj kev kho mob lossis muab lwm yam tshuaj rau koj kom tswj tau cov kev mob tshwm sim. Qhov no feem ntau ua los ntawm:
- Kev kho mob raug tso tseg ib ntus thiab lub cev tiv thaiv kab mob tau muab sijhawm rau "so kom txaus" me ntsis.
- Cov tshuaj kho mob raug sau tseg kom txo qhov kev ua haujlwm ntawm lub cev tiv thaiv kab mob. Piv txwv li, cov tshuaj xws li steroids lossis cov tshuaj tiv thaiv kab mob .
Qhov tshwm sim ntawm cov kev mob tshwm sim puas txhais tau tias kev kho mob ua tiav?
Qhov no yog ib lo lus nug uas ntau tus neeg nug. Qee qhov kev tshawb fawb tau qhia tias qhov tshwm sim ntawm cov kev mob tshwm sim tuaj yeem yog ib qho cim qhia tias kev kho mob tau ua tiav hauv kev rhuav tshem cov qog nqaij hlav.
Tiamsis qhov no tsis yog ib txoj cai. Qhov tseem ceeb yog tias tsuas yog vim koj tsis muaj kev phiv tsis tau txhais hais tias kev kho mob tsis ua haujlwm .
Yog li ntawd, tsis txhob txhawj txog qhov tsis muaj cov kev mob tshwm sim. Tib txoj kev kom paub tseeb yog los ntawm kev kuaj mob uas koj tus kws kho mob ua.
Yog li ntawd, cov txiaj ntsig ntawm kev kho mob immunotherapy yog dab tsi?
Thaum tham txog cov kev mob tshwm sim, tej zaum koj yuav xav tias, "Puas tsim nyog kho qhov kev kho mob no?" Tab sis peb kuj yuav tsum nkag siab txog cov txiaj ntsig ntawm kev kho mob tiv thaiv kab mob.
- Nws ua rau muaj feem ntau ntawm kev ciaj sia nyob mus sij hawm ntev hauv ntau hom mob qog noj ntshav.
- Nws pab rhuav tshem cov qog nqaij hlav thiab tiv thaiv kom tsis txhob rov qab los .
- Nws tuaj yeem tiv thaiv kab mob qog noj ntshav kom tsis txhob kis mus rau lwm qhov ntawm lub cev.
- Txawm tias tom qab koj tsum tsis kho mob lawm los, koj lub cev tiv thaiv kab mob tseem muaj zog tiv thaiv kab mob cancer .
- Piv rau cov kev kho mob ib txwm muaj xws li chemotherapy, cov kev mob tshwm sim ntawm immunotherapy feem ntau tsis hnyav heev .
Thaum kawg, kev kho mob tiv thaiv kab mob tsis yog ib txoj kev kho mob uas haum rau txhua tus. Nws nyob ntawm ntau yam, suav nrog hom mob qog noj ntshav uas koj muaj thiab koj txoj kev noj qab haus huv tag nrho. Yog li, nrog koj tus kws kho mob tham txog qhov zoo thiab qhov tsis zoo ntawm txoj kev kho mob no thiab txiav txim siab qhov zoo tshaj plaws rau koj.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Kev kho mob tiv thaiv kab mob yog kev kho mob niaj hnub uas siv koj lub cev tiv thaiv kab mob los tawm tsam mob qog noj ntshav.
- Cov kev mob tshwm sim vim tias lub cev tiv thaiv kab mob ua haujlwm ntau dhau ua yuam kev tawm tsam cov hlwb noj qab haus huv.
- Qhov tseem ceeb tshaj plaws: Qhia txog cov tsos mob tshiab uas koj ntsib thaum lub sijhawm lossis tom qab kev kho mob, txawm tias me me li cas los xij, rau koj tus kws kho mob tam sim ntawd.
- Tsis yog txhua tus neeg yuav muaj cov kev mob tshwm sim. Qhov uas tsis muaj cov kev mob tshwm sim tsis tau txhais hais tias kev kho mob tsis ua tiav.
- Feem ntau cov kev mob tshwm sim tsis hnyav heev thiab koj tus kws kho mob tuaj yeem tswj tau zoo heev, yog li tsis txhob txhawj.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus