Koj tus me nyuam puas tsuas kub taub hau tas li? Puas yog nws zoo dua tom qab kub taub hau ob peb hnub, tsuas yog kub taub hau ntxiv ob peb hnub tom qab? Tej zaum koj yuav xav tsis thoob tias vim li cas qhov no tshwm sim yam tsis muaj kab mob lossis kab mob kis. Qhov no yuav yog vim muaj ib qho mob tsis tshua muaj hu ua SAIDs (Systemic Autoinflammatory Diseases) , uas ntau tus neeg tsis tau hnov txog. Tsis txhob txhawj, cia peb tham txog nws hauv cov lus yooj yim thiab nkag siab txhua yam.
SAIDs yog dab tsi? Cia peb nkag siab yooj yim.
Hais yooj yim xwb, cov kab mob SAIDs yog ib pawg kab mob uas ua rau kub taub hau ntau zaus thiab rov tshwm sim dua yam tsis muaj kev kis kab mob (xws li cov kab mob lossis cov kab mob me me). Qhov ua rau qhov no yog qhov tsis ua haujlwm ntawm peb tus menyuam lub cev tiv thaiv kab mob. Yav tas los hu ua 'Periodic Fever Syndromes'.
Tam sim no tej zaum koj yuav xav paub tias, qhov no puas yog kab mob 'autoimmune'? Peb feem ntau hnov txog cov kab mob autoimmune xws li Rheumatoid Arthritis lossis Lupus. Tsis yog, qhov no txawv.
Xav txog tias peb muaj ib pab tub rog tiv thaiv hauv peb lub cev, peb lub cev tiv thaiv kab mob. Pab tub rog no muaj ob feem tseem ceeb:
1. Lub cev tiv thaiv kab mob uas muaj txij thaum yug los: Qhov no yog pab tub rog uas peb yug los nrog, thiab yog thawj tus uas tawm tsam txhua yam kab mob.
2. Lub Cev Tiv Thaiv Kab Mob Uas Hloov Tau: Qhov no yog ib pab tub rog uas tau kawm tshwj xeeb los tawm tsam ntau yam kab mob thaum peb loj hlob tuaj.
Hauv cov kab mob SAIDs, qhov teeb meem yog nrog lub cev tiv thaiv kab mob uas muaj nyob hauv. Lub cev tiv thaiv kab mob ntawd pib ua kom lub cev tsis muaj yeeb ncuab thiab pib sib ntaus sib tua hauv lub cev. Qhov tshwm sim ntawm qhov kev sib ntaus sib tua no yog kev o ntawm lub cev thiab kub taub hau.
Tiamsis hauv cov kab mob autoimmune uas peb tau tham txog, qhov teeb meem yog nrog cov tub rog adaptive uas tau kawm tom qab. Cov tub rog ntawd tsis tuaj yeem paub cov cell zoo hauv nws lub cev thiab pib tawm tsam lawv.
Cov kab mob SAIDs tsis tshua muaj ntau dua li cov kab mob autoimmune. Lawv feem ntau yog los ntawm cov caj ces, uas txhais tau tias lawv yog los ntawm noob caj ces. Cov tsos mob no feem ntau pib thaum tus menyuam tseem hluas heev , xws li thaum nws tseem yog menyuam yaus lossis thaum nws tseem yog menyuam yaus. Tus menyuam tam sim ntawd muaj mob lossis mob hnyav nrog rau kub taub hau thiab lwm yam tsos mob, uas feem ntau yuav ploj mus hauv ob peb hnub. Tus menyuam yuav noj qab nyob zoo thaum tsis mob. Txawm hais tias tsis muaj kev kho mob, tab sis muaj cov kev kho mob zoo uas tuaj yeem tswj cov tsos mob.
Cov hom SAIDs tseem ceeb yog dab tsi?
Cov kws tshawb nrhiav tau txheeb xyuas txog li 60 hom kab mob SAIDs txog tam sim no, thiab cov hom tshiab tau raug tshawb pom txhua lub sijhawm. Nov yog qee hom kab mob uas pom ntau tshaj plaws.
| Lub Npe Kab Mob (Hom Kab Mob SAID) | Ib qho kev taw qhia luv luv |
|---|---|
| Kab mob ua npaws hauv tsev neeg Mediterranean (FMF) | Qhov no yog hom kab mob SAID uas feem ntau pom muaj los ntawm caj ces, ua rau mob o hauv plab, hauv siab, thiab pob qij txha. |
| Mob Khaub Thuas Tsis Tu Ncua, Mob Aphthous-Stomatitis, Mob Pharyngitis, Mob Adenitis (PFAPA) | Nws pib tshwm sim rau cov menyuam yaus, tshwj xeeb tshaj yog ua ntej hnub nyoog 4 xyoos. Cov tsos mob xws li mob caj pas, mob qhov ncauj, thiab cov qog o hauv caj dab los nrog rau qhov kub taub hau. Feem ntau nws ploj mus tom qab hnub nyoog 10 xyoos. |
| Kab Mob Ntsws Pob Txha (Tumor Necrosis Factor Receptor-Associated Periodic Syndrome - TRAPS) | Qhov no tuaj yeem pib thaum yau lossis thaum hluas. |
| Kev Tsis Txaus Mevalonate Kinase (MKD) | Feem ntau qhov no pib ua ntej tus menyuam muaj ib xyoos. |
| Cov Kab Mob Autoinflammatory Txuas Nrog NLRP3 (CAPS) | Qhov no yog kev sib xyaw ua ke ntawm peb yam kab mob sib txawv. |
| Adult-onset Still's Disease (AOSD) | Raws li lub npe qhia, qhov no yog ib yam kab mob uas pib thaum laus. |
| Blau Syndrome | Qhov no feem ntau tshwm sim rau cov menyuam yaus hnub nyoog qis dua 4 xyoos. Nws feem ntau cuam tshuam rau daim tawv nqaij, qhov muag, thiab pob qij txha. |
Cov tsos mob ntawm cov kab mob no yog dab tsi?
Cov tsos mob tseem ceeb thiab feem ntau ntawm SAIDs yog kub taub hau rov qab los . Txawm li cas los xij, ntxiv rau kub taub hau, lwm cov tsos mob kuj tseem yuav tshwm sim nyob ntawm hom kab mob.
Qhov tseem ceeb yog tias cov tsos mob no tsuas yog tshwm sim thaum muaj mob xwb. Thaum lub sijhawm ntawd dhau mus, tus menyuam yuav noj qab nyob zoo yam tsis muaj tsos mob dab tsi li.
| Lub Npe Kab Mob (Hom Kab Mob SAID) | Cov tsos mob uas yuav tsum tau saib xyuas |
|---|---|
| FMF | Mob plab heev, mob hauv siab, thiab pob qij txha. Mob tawv nqaij ntawm ob txhais ceg qis lossis pob luj taws. |
| PFAPA | Mob caj pas, mob qhov ncauj, o cov qog ntshav hauv caj dab. |
| Cov NTAUB NTAWV | Lub cev txias thiab tshee hnyo. Muaj mob rau cov leeg nqaij ntawm lub cev, tshwj xeeb tshaj yog nyob rau hauv lub cev thiab caj npab. Tej zaum yuav muaj cov pob liab mob thoob plaws lub cev. |
| MKD | Lub cev txias thiab tshee hnyo, mob taub hau, mob plab, tsis xav noj mov, thiab cov tsos mob zoo ib yam li mob khaub thuas. |
| Cov Kab Mob NLRP3 | Mob pob khaus ntawm daim tawv nqaij, mob taub hau, qaug zog, mob pob qij txha, thiab mob qhov muag (conjunctivitis). |
| Blau Syndrome | Mob tawv nqaij ntawm tus menyuam txhais tes, ceg, lossis lub cev. Mob pob qij txha thiab mob qhov muag. |
Vim li cas cov kab mob no thiaj tshwm sim? Dab tsi yog cov ua rau muaj?
Raws li peb tau hais ua ntej lawm, ntau yam kab mob SAIDs yog cov kab mob caj ces . Qhov no txhais tau hais tias cov kab mob no yog tshwm sim los ntawm kev hloov pauv (variant) hauv ib lub noob caj ces tshwj xeeb.
| Lub Npe Kab Mob (Hom Kab Mob SAID) | Cov noob caj noob ces cuam tshuam |
|---|---|
| FMF | MEFV gene |
| PFAPA | Qhov laj thawj tseeb tseem tsis tau pom. |
| Cov NTAUB NTAWV | TNFRSF1A gene |
| MKD | MVK gene |
| Cov Kab Mob NLRP3 | NLRP3 gene |
| AOSD | Qhov laj thawj tseeb tseem tsis tau pom. |
| Blau Syndrome | NOD2 gene |
Yog tsis tau txais kev kho mob zoo ces yuav muaj dab tsi tshwm sim?
Qhov no yog ib qho teeb meem tseem ceeb heev. Nws yog ib qho tseem ceeb heev uas yuav tsum tswj tus mob no los ntawm kev kho mob kom zoo. Vim tias, yog tias muaj kev o ntawm lub cev zoo li no, nws tuaj yeem ua rau muaj tus mob hu ua Amyloidosis . Hais yooj yim, ib hom protein tuaj yeem tso rau hauv peb lub raum, ua rau lub raum puas tsuaj mus tas li. Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum kuaj mob thiab kho nws sai sai.
Tus kws kho mob kuaj mob li cas?
Yuav kom ncaj ncees, kev kuaj mob SAIDs tuaj yeem nyuaj me ntsis vim tias cov tsos mob yuav zoo ib yam li cov kab mob loj xws li lupus.
Yog li ntawd, qhov tseem ceeb tshaj plaws yog mus ntsib kws kho mob uas tshwj xeeb hauv cov kab mob no. Tus kws kho mob uas tshwj xeeb hauv cov kab mob ntsig txog cov pob qij txha thiab lub cev tiv thaiv kab mob hu ua Rheumatologist .
Koj tus kws kho mob yuav xav txog ntau yam los kuaj mob. Nws yuav nug txog koj tus menyuam cov tsos mob thiab seb puas muaj keeb kwm tsev neeg ntawm tus mob no. Koj tus kws kho mob yuav xav tias muaj SAIDs, tshwj xeeb yog tias:
- Yog tias tus menyuam muaj mob kub taub hau ntau zaus.
- Yog tias muaj leej twg hauv tsev neeg tau muaj mob khaub thuas zoo li no rov tshwm sim dua.
- Vim tias cov kab mob no feem ntau tshwm sim ntawm qee haiv neeg, qhov ntawd kuj raug txiav txim siab.
Yuav ua cov kev ntsuam xyuas twg?
Tus kws kho mob yuav pom zoo kom kuaj ntau zaus kom paub meej tias muaj tus kab mob.
- Kev kuaj ntshav (Kev kuaj hauv chaw kuaj mob): Kev kuaj xws li C-reactive protein (CRP) thiab CBC (Full Blood Count) tuaj yeem kuaj xyuas seb puas muaj kev o ntawm lub cev. Cov theem no nce ntxiv thaum muaj mob thiab rov qab mus rau qib ib txwm thaum lub cev zoo.
- Kuaj zis: Xyuas seb puas muaj cov protein ntau hauv cov zis. Hauv qee yam kab mob, xws li MKD, kev kuaj zis tuaj yeem nrhiav tau cov kua qaub tshwj xeeb.
- Kev kuaj mob caj ces: Qhov kev kuaj no tuaj yeem nrhiav tau kev hloov pauv caj ces. Txawm li cas los xij, qee zaum, tus menyuam yuav muaj SAID tab sis kev kuaj mob caj ces yuav tsis pom nws. Yog li ntawd, txawm tias qhov tshwm sim ntawm kev kuaj tsis zoo los xij, nws tsis tuaj yeem hais tau 100% tias tus kab mob tsis muaj.
Cov kev kho mob rau qhov no yog dab tsi?
Kev kho mob rau SAIDs nyob ntawm seb hom kab mob thiab qhov hnyav ntawm tus kab mob. Txawm hais tias cov kab mob no tsis tuaj yeem kho tau tag nrho, cov tshuaj tuaj yeem tswj tau cov tsos mob zoo heev.
- FMF: Siv tshuaj hu ua Colchicine rau qhov no. Nws txo qhov o ntawm lub cev. Yog tias tshuaj ntawd tsis ua haujlwm rau tus menyuam, lawv tuaj yeem tig mus rau cov tshuaj xws li Canakinumab .
- PFAPA: Cov tshuaj steroids xws li Prednisone tuaj yeem muab rau lub sijhawm luv luv kom txo qhov mob ntev sai.
- TRAPS: CanakinumabCov tshuaj no zoo heev. Tsis tas li ntawd, cov tshuaj tiv thaiv kev o xws li glucocorticoids kuj raug siv.
- MKD: Cov tshuaj Canakinumab kuj zoo rau qhov no thiab. Cov tshuaj NSAIDs (tshuaj tua mob) lossis cov tshuaj steroids tuaj yeem pab tau thaum muaj mob.
- Cov Kab Mob NLRP3: Cov tshuaj hloov kho lub cev xws li Canakinumab , Rilonacept , thiab Anakinra raug siv tau zoo rau qhov no.
- Blau Syndrome: Nyob ntawm cov tsos mob, cov tshuaj immunosuppressants, TNF inhibitors, thiab cov tshuaj qhov muag yuav siv tau.
Tus mob no puas yuav kho tau tag nrho?
Qee cov kab mob SAIDs yuav nyob mus ib txhis. Txawm li cas los xij, qee qhov, zoo li PFAPA, yuav ploj mus thaum tus menyuam loj hlob tuaj. Txawm hais tias lawv yog cov mob uas nyob mus ib txhis, qhov zaus ntawm kev mob thiab qhov hnyav ntawm cov tsos mob yuav txo qis raws sijhawm. Koj tus kws kho mob yuav muab cov ntsiab lus tshwj xeeb rau koj txog koj tus menyuam tus mob.
Kev saib xyuas ib tug me nyuam uas muaj tus mob no yuav nyuaj heev. Tab sis nrog kev pab los ntawm cov kws tshwj xeeb, koj tuaj yeem tswj hwm koj tus me nyuam cov tsos mob thiab muab rau lawv lub neej thaum yau zoo tshaj plaws.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Yog koj tus menyuam kub taub hau ntau zaus yam tsis muaj laj thawj pom tseeb, tsis txhob tsuas yog tsis quav ntsej lawv thiab mus ntsib kws kho mob tam sim ntawd.
- SAIDs yog ib pawg kab mob tsis tshua muaj uas tshwm sim los ntawm teeb meem hauv lub cev tiv thaiv kab mob.
- Cov no tsis yog cov kab mob sib kis tau; lawv feem ntau yog los ntawm cov yam ntxwv caj ces.
- Nws yog ib qho tseem ceeb heev uas yuav tsum mus ntsib kws kho mob rheumatologist (tus kws kho mob uas tshwj xeeb hauv cov pob qij txha thiab lub cev tiv thaiv kab mob) kom paub tseeb tias tus kab mob yog dab tsi.
- Txawm hais tias cov no tsis tuaj yeem kho tau tag nrho los xij, cov tshuaj tuaj yeem pab tswj cov tsos mob thiab cia koj ua neej nyob li qub.
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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