Koj puas tau pom tias koj ob txhais ceg thiab pob luj taws tsuas yog o xwb? Los yog koj puas tau pom tias thaum koj tso zis, nws ua npuas? Cov no tsis yog cov tsos mob uas yuav tsum tsis quav ntsej. Lawv tuaj yeem yog cov cim qhia tias muaj qee yam tsis raug nrog koj lub raum. Hnub no peb yuav tham txog ib qho mob tsis tshua muaj tab sis tseem ceeb uas cuam tshuam rau koj lub raum. Qhov ntawd hu ua Membranous Nephropathy (MN).
Kab mob Membranous Nephropathy (MN) yog dab tsi?
Hais yooj yim xwb, mob Membranous Nephropathy (MN) yog ib yam mob uas koj lub cev tiv thaiv kab mob, lub cev uas tiv thaiv koj ntawm kab mob, tawm tsam koj lub raum. Nws puas zoo kawg nkaus? Peb tus kheej txoj kev tiv thaiv tab tom tawm tsam peb.
Tam sim no saib, hauv peb lub raum, muaj ntau lab lub lim dej me me uas ntxuav cov ntshav. Peb hu cov no ua glomeruli . Zoo li lub lim tshuaj yej, cov glomeruli no lim cov khoom pov tseg tsis xav tau hauv cov ntshav thiab xa lawv tawm ntawm lub cev ua zis. Lwm lub luag haujlwm ntawm cov lim dej no yog khaws cov khoom tseem ceeb xws li cov protein uas lub cev xav tau hauv cov ntshav.
Qhov uas tshwm sim rau ib tug neeg uas muaj MN yog tias lub cev tiv thaiv kab mob, zoo li kuv tau hais lawm, tawm tsam thiab ua puas rau cov lim dej no hu ua glomeruli. Thaum qhov kev puas tsuaj no tshwm sim, cov qhov hauv cov lim dej yuav loj dua. Tom qab ntawd cov protein uas lub cev xav tau yuav pib lim los ntawm cov lim dej thiab tawm nrog cov zis. Qhov no yog qhov teeb meem tseem ceeb ntawm tus kab mob no.
Tus mob no tuaj yeem tshwm sim sai sai, lossis nws tuaj yeem loj hlob maj mam zuj zus. Qee zaum, tib neeg yuav tsis paub tias lawv muaj tus mob no tau ntau xyoo.
Muaj ob hom kab mob no tseem ceeb.
Peb faib qhov mob ntawm Membranous Nephropathy (MN) no ua ob pawg tseem ceeb. Kev faib tawm no yog ua raws li qhov ua rau.
| Hom kab mob | Kev piav qhia |
|---|---|
| Kab mob ntsws thawj zaug (Idiopathic) | Qhov no yog hom mob uas feem ntau tshwm sim (kwv yees li 75% ntawm cov neeg mob). Qhov uas tshwm sim ntawm no yog tias lub cev tiv thaiv kab mob ncaj qha tawm tsam lub raum, tsis muaj lwm yam kab mob. Qhov no suav tias yog tus mob autoimmune. |
| Kab mob qog nqaij hlav theem ob | Qhov no tshwm sim thaum lub raum raug puas tsuaj los ntawm lwm yam mob, kev kis kab mob, lossis tshuaj. Qhov no txhais tau tias lub raum raug puas tsuaj vim yog lwm yam kev phiv. Kwv yees li 25% ntawm cov neeg mob muaj hom no. |
Koj puas muaj cov tsos mob no thiab?
Cov tsos mob tseem ceeb ntawm tus kab mob MN yog tshwm sim los ntawm cov protein ntau ntau uas tawm hauv cov zis, raws li kuv tau hais ua ntej. Hauv kev kho mob, peb hu cov tsos mob uas tshwm sim los ntawm tus mob no ua Nephrotic Syndrome .
Cov tsos mob tseem ceeb yog cov no:
- Kev o: Kev o, tshwj xeeb tshaj yog nyob rau hauv ob txhais ceg, pob luj taws, taw, thiab qee zaum lub ntsej muag thiab tes. Qhov kev o no tshwm sim thaum muaj kev txo qis ntawm cov protein hauv cov ntshav, ua rau cov dej hauv cov hlab ntsha tawm mus rau hauv cov nqaij.
- Cov zis ua npuas ntau dhau (Proteinuria): Vim muaj cov protein ntau hauv cov zis, nws yuav zoo li ua npuas, zoo li dej xab npum.
- Qaug zog thiab qaug zog heev: Tej zaum koj yuav xav tias qaug zog txhua lub sijhawm vim tias koj lub cev poob lub zog thiab cov as-ham uas nws xav tau.
- Qhov hnyav nce sai sai: Qhov no tsis yog qhov loj dua, tab sis qhov hnyav nce vim yog dej khaws cia.
- Cov roj cholesterol ntau: Thaum cov protein hauv cov ntshav txo qis, peb lub siab tsim cov rog thiab cov roj cholesterol ntau dua los them rov qab.
- Ntshav Siab: Ntshav siab tuaj yeem nce ntxiv thaum lub raum tsis ua haujlwm.
- Ua pa nyuaj: Qhov mob no tuaj yeem tshwm sim yog tias cov kua dej sib sau ua ke nyob ib puag ncig lub ntsws.
Vim li cas qhov no thiaj tshwm sim? Yog vim li cas?
Cov laj thawj kuj sib txawv nyob ntawm ob hom uas peb tau tham ua ntej.
Qhov ua rau muaj tus kab mob MN thawj zaug
Kuv hais tias tus kab mob MN thawj zaug yog ib yam mob uas tiv thaiv kab mob tsis tau. Qhov uas tshwm sim ntawm no yog tias peb lub cev tiv thaiv kab mob yuam kev txheeb xyuas ib qho protein tshwj xeeb hu ua phospholipase A2 receptor (PLA2R) hauv cov lim dej raum (glomeruli) ua "yeeb ncuab." Tom qab ntawd, nws tsim cov tshuaj tua kab mob los rhuav tshem cov protein PLA2R no thiab tawm tsam nws. Qhov kev sib ntaus sib tua no yog qhov ua rau cov lim dej ntawd puas tsuaj thiab cov protein tawm mus.
Tej yam uas ua rau muaj MN theem ob
MN theem ob yog qhov tshwm sim ntawm lwm yam. Nov yog qee yam uas tuaj yeem cuam tshuam rau nws:
- Lwm cov kab mob autoimmune: Cov kab mob zoo li Lupus thiab Rheumatoid Arthritis.
- Cov kab mob: Cov kab mob xws li Hepatitis B, Hepatitis C, Malaria, thiab Syphilis.
- Mob qog noj ntshav: Tshwj xeeb yog mob qog noj ntshav ntsws thiab mob qog noj ntshav plab hnyuv.
- Cov tshuaj kho mob:Siv cov tshuaj ntev xws li qee cov tshuaj tua kab mob (NSAIDs) thiab penicillamine.
- Cov tshuaj lom: Kev raug cov hlau hnyav xws li mercury.
Nco ntsoov, yog tias koj muaj cov tsos mob no, qhov tseem ceeb tshaj plaws yog mus ntsib koj tus kws kho mob sai li sai tau thiab nrhiav kev pab tswv yim, es tsis txhob kwv yees qhov ua rau.
Qhov no ua rau muaj teeb meem dab tsi?
Yog tias MN tsis kho kom zoo, cov teeb meem loj tuaj yeem tshwm sim raws sijhawm.
- Kev muaj roj cholesterol ntau thiab kab mob plawv: Cov rog ntau hauv cov ntshav ua rau muaj kev pheej hmoo ntawm cov mob xws li kab mob plawv thiab mob hlwb.
- Ntshav txhaws: Thaum cov protein raug tso tawm hauv cov zis, cov protein uas tiv thaiv cov ntshav txhaws kuj raug tso tawm ntawm lub cev. Qhov no tuaj yeem ua rau cov ntshav txhaws tsim nyob rau hauv cov leeg ntawm ob txhais ceg. Peb hu qhov no tias Deep Vein Thrombosis (DVT) . Yog tias cov ntshav txhaws no tawg xoob thiab daig hauv cov leeg hauv lub ntsws, nws yog ib qho mob hnyav thiab txaus ntshai rau lub neej hu ua Pulmonary Embolism (PE) .
- Kev Ua Tsis Taus Mob Raum: Yog tias tus kab mob tsis raug tswj, kev puas tsuaj rau lub raum yuav maj mam nce ntxiv, thiab thaum kawg lub raum yuav ua tsis tau haujlwm tag nrho.
Tus kws kho mob nrhiav tau qhov no li cas?
Yog koj muaj cov tsos mob saum toj no, koj tus kws kho mob yuav xa koj mus rau tus kws kho mob tshwj xeeb raum (Nephrologist). Nws yuav ua ntau qhov kev kuaj mob kom paub tseeb tias yog tus kab mob.
| Kev Ntsuas | Koj tab tom kuaj xyuas dab tsi? |
|---|---|
| Kev Kuaj Zis | Lawv xyuas seb muaj protein thiab ntshav ntau npaum li cas nyob rau hauv cov zis. |
| Kev Kuaj Ntshav | Tej yam xws li creatinine, cov ntshav urea nitrogen (BUN) , uas ntsuas kev ua haujlwm ntawm lub raum, thiab cov protein hauv cov ntshav (albumin) raug kuaj xyuas. |
| Tus Nqi Pom Glomerular (GFR) | Qhov no kuj ua tiav los ntawm kev kuaj ntshav. Nws ntsuas seb koj lub raum lim cov khoom pov tseg sai npaum li cas. |
| Kev kuaj mob raum | Qhov no yog txoj kev zoo tshaj plaws los paub tseeb tias muaj tus kab mob 100%. Siv ib rab koob me me, muab ib daim nqaij me me ntawm lub raum coj mus kuaj hauv lub tshuab kuaj mob me me. Qhov no tuaj yeem txiav txim siab tau meej tias puas muaj kev hloov pauv thiab cov tshuaj tiv thaiv kab mob uas cuam tshuam nrog tus kab mob MN. |
Cov kev kho mob rau qhov no yog dab tsi?
Kev kho mob nyob ntawm seb koj muaj hom mob MN twg thiab koj cov tsos mob hnyav npaum li cas. Lub hom phiaj tseem ceeb ntawm kev kho mob yog kom txo cov tsos mob thiab tiv thaiv kom tus kab mob tsis txhob loj zuj zus.
Ib lossis ntau yam hauv qab no yuav siv tau los kho:
- Cov tshuaj kho ntshav siab: Cov tshuaj xws li ACE inhibitors thiab ARBs tswj ntshav siab thiab txo qhov kev tso cov protein tawm hauv cov zis.
- Cov tshuaj diuretics: Cov no kuj hu ua "tshuaj ntsiav dej." Lawv pab txo qhov o los ntawm kev tshem tawm cov kua dej ntau dhau ntawm lub cev ua zis.
- Cov tshuaj txo cov roj cholesterol (Statins): Cov no yog muab los tswj cov roj cholesterol hauv cov ntshav.
- Cov tshuaj ua kom cov ntshav nyias: Cov no yog siv los txo qhov kev pheej hmoo ntawm cov teeb meem xws li DVT.
- Cov tshuaj tiv thaiv kab mob: Cov tshuaj xws li corticosteroids raug muab los tswj kev ua haujlwm ntawm lub cev tiv thaiv kab mob thiab sim tiv thaiv nws kom tsis txhob tawm tsam lub raum.
- Kev hloov pauv zaub mov: Nws yog ib qho tseem ceeb heev uas yuav tsum txo koj cov zaub mov uas muaj ntsev thiab rog ntau . Koj tus kws kho mob yuav qhia koj txog kev noj zaub mov kom haum.
Yog tias cov kev kho mob ib txwm muaj no tsis txaus los tswj tus kab mob, tus kws kho mob yuav hloov mus rau kev kho mob muaj zog dua hu ua immunotherapy . Cov tshuaj xws li Rituximab thiab Cyclophosphamide yog siv los rhuav tshem cov hlwb uas tsim cov tshuaj tua kab mob uas tawm tsam lub raum.
Rau ib tug neeg uas muaj MN theem ob, kev kho qhov ua rau mob (piv txwv li, kab mob siab, lupus) tuaj yeem tiv thaiv lossis txo qhov kev puas tsuaj rau lub raum.
Yog tias tus kab mob loj zuj zus mus txog theem hnyav tshaj plaws thiab ua rau lub raum tsis ua haujlwm, tej zaum yuav tsum tau ntxuav dialysis lossis hloov lub raum.
Lub neej nrog tus kab mob no zoo li cas?
Tus kab mob no kis mus rau lwm tus neeg txawv. Rau qee tus neeg, tus kab mob no yuav ploj mus tag nrog kev kho mob me ntsis lossis tsis kho dab tsi li. Rau lwm tus, tus kab mob no yuav kav ntev ntau xyoo.
Qhov zoo tshaj plaws yog tias muaj tsawg dua 15% ntawm cov neeg uas muaj MN mus rau qhov ua rau lub raum tsis ua haujlwm, uas txhais tau tias feem ntau ntawm cov neeg no tuaj yeem ua neej nyob li qub yog tias tau txais kev kho mob.
Tiamsis qhov tseem ceeb tshaj plaws uas yuav tsum nco ntsoov yog tias tus kab mob no tuaj yeem rov tshwm sim dua txawm tias tom qab kho mob lawm los xij. Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum mus ntsib cov chaw kho mob thiab mus kuaj mob raws sijhawm uas koj tus kws kho mob nephrologist tau teev tseg. Tom qab ntawd, yog tias muaj cov cim qhia tias tus kab mob rov tshwm sim dua, kev kho mob tuaj yeem pib tam sim ntawd.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Yog koj ob txhais ceg, ko taw, lossis lub ntsej muag o tuaj yam tsis paub meej, lossis pom tias koj cov zis ua npuas ntau dhau, tsis txhob tsis quav ntsej. Mus ntsib koj tus kws kho mob tam sim ntawd.
- Mob raum tsis ua haujlwm (Membranous Nephropathy - MN) yog ib yam mob uas koj lub cev tiv thaiv kab mob tawm tsam koj lub raum.
- Kev kuaj mob raum yog ib qho tseem ceeb heev rau kev kuaj mob no kom meej.
- Txawm hais tias tus kab mob no kho tsis tau tag nrho los xij, muaj cov kev kho mob zoo heev los tswj cov tsos mob, txo qhov kev puas tsuaj rau lub raum, thiab tiv thaiv cov teeb meem.
- Ua raws li koj tus kws kho mob cov lus qhia kom meej thiab mus rau cov chaw kho mob raws sijhawm yog qhov tseem ceeb rau kev tswj hwm kev noj qab haus huv ntawm koj lub raum.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
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