Ina whakaekea tō ate e tō tinana ake? Me kōrero tātou mō te mate hepatitis aunoa.

Kua whakaaro koe i mua ka tīmata te pūnaha ārai mate o tō tinana, arā, te pūnaha ārai mate, ki te whakaeke i tō ake ate? He mea miharo, kāore? Engari, ko te mate hepatitis aunoa koia tonu te momo mate. Ahakoa he ahua uaua tēnei, me kōrero noa iho, kia mārama ai koe.

He aha te mate hepatitis ā-aunoa?

Ki te kī ngāwari, he mate roa te mate hepatitis ā-tinana e pā ana ki tō ate. Ka tīmata mai i tētahi hapa iti i roto i te pūnaha parepare o tō tinana, arā, te pūnaha ārai mate . Whakaarohia pēnei: ​​he rite tō tātou pūnaha ārai mate ki tētahi ope taua e tiaki ana i tō tātou whenua. Ko tāna mahi he whawhai ki ngā whakaekenga mai i tāwāhi pērā i ngā iroriki me ngā huaketo. Engari, i roto i te mate hepatitis ā-tinana, ka whakaaro hē tēnei ope taua, te pūnaha ārai mate, ko ōna ake pūtau ate hauora te hoariri, ā, ka tīmata ki te whakaeke i a rātou.

Ina whakaekea e te pūnaha ārai mate te kiko o te ate i tēnei ara, ka puta te mumura o te ate, te mate hepatitis rānei. I te haere tonu o tēnei whakaeke, ka roa te mumura. I roto i te wā, ka taea e tēnei mumura roa te whakararu nui i te ate. Ina koa, ka pakaru te kiko o te ate, ā, ka ngoikore haere te ate. Ka kiia tēnei ko te cirrhosis .

Ko te rongo pai, ka taea e te maimoatanga hauora te whakaiti i te pupuhi o te ate, me te ārai i ngā raruraru o te mate. Heoi, i ētahi wā, kāore pea koe e kite i ngā tohu i ngā wāhanga tōmua o tēnei mate.

He aha ngā momo matua o te mate hepatitis ā-aunoa?

E rua ngā momo matua o te mate hepatitis ā-aunoa (AIH). Ka wehewehea ēnei e te aroaro o ngā momo paturopi rerekē, ka taea e ā mātou kaipūtaiao te kite mā te whakamātautau paturopi . Ka whakaekea e ēnei momo paturopi rerekē ngā momo pūtau rerekē i roto i te ate.

Momo 1

Koinei te momo "tūturu", ā, koinei hoki te momo tino noa. Tata ki te 80% o ngā tūroro kua tātaritatia he momo tēnei. Ka taea te whanake i ngā tau katoa. I roto i te mate hepatitis ā-tinana momo 1, ka whakaekea e ngā paturopi e kiia nei ko te ASMA (anti-smooth muscle antibodies) ngā pūtau uaua maeneene o te ate. I ētahi wā ka kiia tēnei mate momo 1 ko te "lupoid hepatitis" nā te mea he rite ōna tohu ki ērā o te Systemic Lupus Erythematosus . Heoi, ka taea e te whakamātautau toto ASMA te āwhina i te wehewehe i waenga i ngā mate e rua.

Momo 2

Ko te momo hepatitis ā-aunoa momo 2 he momo hepatitis onge ake, he kino ake hoki. I te nuinga o te wā ka puta wawe mai, i te tamarikitanga. Ka tere ake hoki te whanake i te momo 1. Ka puta tēnei momo i te anti-LKM-1 (anti-ate-kidney microsome momo 1 antibodies) me teKo ngā paturopi e whai wāhi ana ko te anti-LC1 (anti-ate cytosol type 1 antibodies) . Ka aro atu ngā paturopi anti-LKM-1 ki tētahi pūmua e kiia nei ko te cytochrome P450-2D6 (CYP2D6) i roto i ngā pūtau ate. Ko te Anti-LC1 he paturopi ate motuhake mō te momo 2 AIH.

He pēhea te onge o te mate hepatitis ā-aunoa?

Ehara te mate pūkahukahu ā-tinana i te mate tino noa. Kāore anō kia mārama te tokomaha o te tangata e pāngia ana e tēnei mate. E ai ki ngā rangahau a te Pākehā, e pāngia ana te 0.010% me te 0.025% o te taupori Pākehā e tēnei mate. Ahakoa ka pāngia tetahi iwi, tetahi rōpū iwi rānei, he paku noa ake i waenga i ngā Māori o Alaska (tata ki te 0.043% o taua taupori). He nui ake hoki te kitea i roto i ngā wāhine i ngā tāne, i te ōwehenga o te 4:1.

He aha ngā tohu?

Ehara i te mea ka puta ngā tohumate ki te katoa e pāngia ana e te mate hepatitis ā-tinana. I ētahi wā ka puta mai ngā tohumate i muri mai, i muri i te tīmatanga o te pā o te mate ki te mahi a te ate. Ka pā mai pea tēnei i ngā pānga taha maha ki te tinana.

Ko ētahi o ngā tohu tōmua noa ko:

• Te mamae o te puku, te koretake rānei.
• Te pupuhi o te puku nā te nui o te ate.
• Te ngenge .
• Mamae hononga.
• Ko te tikanga o te mākūkū o te kiri he riri.
• Pūngāwerewere.

Ina tīmata te ngoikore o te mahi a tō ate, ka nui haere te wai au i roto i tō toto. Ka puta pea ngā tohu pēnei i:

• Te kōwhai o te kiri me ngā kanohi ( te whero o te kiri me ngā kanohi).
• He mimi pouri, he tūtae mārama rānei.
• Mākūkū (Pruritus) .
• Te whakapairuaki, te ngaro rānei o te hiahia kai.

Ko ētahi atu pānga taha whakaroa ko:

• Ngā angiomas pungawerewere (ngā ira whero i runga i te kiri e rite ana ki te tukutuku pungawerewere) .
• Te whakanui ake i ngā uaua i roto i te nono (varices) .
• Ngāwari te pakaru me te toto.
• Te ngaronga o te paheketanga o ia marama i roto i ngā wāhine.
• Te pupūnga wai i roto i te puku (ascites) me ngā peka (edema) .
• Te pōhēhē, te hiamoe, te hiamoe rānei (te mate hinengaro o te ate) .

He aha ngā take o te mate hepatitis aunoa?

Ka puta ngā mate pūnaha ārai mate ina pohehe tō pūnaha ārai mate i ētahi o ō ake pūtau hei tūmomo mōrearea. Kia mōhio te pūnaha ārai mate ki tēnei "momo mōrearea," ka whakaekea aua pūtau. Ka puta te mumura mau tonu i tētahi wāhanga motuhake o te tinana. I roto i te mate hepatitis pūnaha ārai mate, ka tukuna e te pūnaha ārai mate he paturopi motuhake hei whakaeke i ngā momo pūtau motuhake o te ate. He tukanga tino uaua tēnei.

He aha te tau toharite ka tīmata ai tēnei mate?

Kāore e taea te mōhio tonu i te wā i tīmata ai te mate hepatitis ā-pūnaha. Nā te mea he maha ngā wā kāore he tohu i ngā wāhanga tōmua. Ko te momo AIH 1 ka kitea i te tīmatanga ki te waenga o te pakeketanga, i waenga i te 15 me te 40 tau. Heoi, ka taea te puta i ngā tau katoa. Ko te momo AIH 2 ka puta wawe ake, i te tamarikitanga, i waenga i te 4 me te 14 tau. Ahakoa i taua wā, tera pea ka kitea ngā tohu kino o te mate ate.

Me pēhea te whanaketanga o te mate hepatitis aunoa?

He pātai uaua rawa te take e pāngia ai te tangata e ngā mate pūnaha ārai mate. Te āhua nei kāore he take kotahi, engari he huinga o ngā āhuatanga.

• Te awe ira: I ētahi wā, ka nui ake te tūponotanga o te whakawhanake i ētahi mate pūnaha ārai mate nā ō ira. Heoi, ehara i te mea ko te hunga katoa kei a rātou aua ira ka pāngia e te mate, ā, ehara i te mea ko te hunga katoa e pāngia ana e te mate ka pāngia e aua ira.
• Ngā āhuatanga taiao: Ka whai wāhi atu pea ētahi atu āhuatanga ehara i te ira, e kiia ana ko ngā "āhua taiao" ki tēnei. He paitini, he āhuatanga rānei ēnei e whakararuraru ana i tō pūnaha ārai mate. Mō ētahi tāngata ngoikore, ka taea e ēnei āhuatanga te whakararuraru i te pūnaha ārai mate, ka hua ake he mate pūnaha ārai mate mau tonu.

Kua tautuhia ētahi rongoā me ngā mate huaketo hei take mō te mate hepatitis ā-pūnaha. Waihoki, ki te mea kua pāngia koe e tētahi atu mate ārai mate, ka nui ake te tūponotanga ka pāngia koe e te mate hepatitis ā-pūnaha.

He aha ngā huaketo ka taea te whakaoho i te mate hepatitis autoimmune?

He nui ake te tūponotanga ka pāngia koe e te mate hepatitis ā-aunoa mēnā he hītori tōu mō ēnei mate huaketo:

• Te mate ate wheori (A, B, C, D, E rānei).
• Mononucleosis (Mononucleosis - huaketo Epstein-Barr) .
• Te rewharewha .
• Herpes .

He aha ngā rongoā ka taea te whakaoho i te mate hepatitis autoimmune?

Kua honoa te mate hepatitis ā-pūnaha i puta mai i te rongoā ki ēnei rongoā:

• Nitrofurantoin ( mō ngā mate pukupuku mimi).
• Minocycline ( mō te hakihaki).
• Atorvastatin ( mō te cholesterol tiketike).
• Isoniazid ( he rongoā paturopi).

He aha ētahi atu mate pūnaha ārai mate e pā ana ki te mate hepatitis pūnaha ārai mate?

Ka pāngia ētahi tāngata e te mate hepatitis ā-tinana me tētahi atu mate ā-tinana e pā ana ki ō rātou awa waikura. Hei tauira:

• Te mate pūkahukahu biliary tuatahi (PBC) .
• Te mate korokoro sclerosing tuatahi (PSC) .

E kiia ana tēnei he "momo rerekē" o te mate hepatitis aunoa.

Engari i te nuinga o te wā, ki te mea kua pāngia koe e te mate pūnaha ārai mate, he nui ake te tūponotanga ka pāngia koe e tētahi atu. Te āhua nei ka taea e te mumura mau tonu i tētahi wāhi te whakaoho i te mumura i tētahi atu wāhi. Ko te tūponotanga ka pāngia koe e te mate pūnaha ārai mate tuarua he tata ki te 25%-50%. Mena ko te mate pūnaha ārai mate hepatitis tō mate pūnaha ārai mate tuatahi, he rite tonu te tūponotanga ka pāngia koe e te mate tuarua.

Ko ētahi atu āhuatanga e kitea whānuitia ana me te AIH ko:

• Te mate a Graves .
• Mate Celiac .
• Te mate puku mumura .
• Te mate rumatiki .
• Mate huka momo 1.
• Vitiligo ( ngā ira mā i runga i te kiri).

He mate hopuhopu te mate hepatitis ā-pūnaha?

Kāo. Ka taea te whakaputa i te mate ate ate huaketo (pērā i te ate ate ate A, B, me te C) e ngā huaketo pangia. Ka taea te horapa atu i ēnei mate ki ētahi atu. Heoi, ehara te ate ate ate ā-tinana i te mate, nō reira kāore e horapa atu ki ētahi atu.

Me pēhea te tautuhi i te mate hepatitis ā-aunoa?

Tērā pea ka kitea, ka kitea rānei ngā tohu o te AIH. Ka tirohia tō tinana e te tākuta, ā, ka mahia ētahi whakamātautau taketake, pērā i ngā whakamātautau whakaahua me ngā whakamātautau toto. Ka taea e te whakamātautau toto e kiia nei ko te comprehensive metabolic panel te rapu taunakitanga mō te mate ate. Kei roto i tēnei panel ētahi whakamātautau mahi ate e ine ana i ngā mea pēnei i ngā taumata whākōkī ate me te mumura.

Engari kāore ēnei tohu e motuhake ki te mate hepatitis ā-pūnaha. Ka whakahaerehia e tō tākuta ētahi atu whakamātautau toto hei rapu i ngā huaketo motuhake me ētahi atu take o te mate hepatitis. Ka rapua hoki e rātou ngā paturopi ā-pūnaha . Kia whakakorea e rātou ētahi atu take me te tautuhi i ngā paturopi e pā ana ki te mate hepatitis ā-pūnaha, ka rite rātou ki te whakaū i te mate. Ko te huarahi pai ki te whakaū i tēnei ko te mahi i te koiora ate . Ko te tikanga ko te tango i tētahi wahi iti o te kiko mai i te ate ka tirotirohia i raro i te karu hiko.

He aha ngā maimoatanga mō te mate hepatitis autoimmune?

Ko te maimoatanga paerewa ko te tīmata me ngā horopeta nui o te corticosteroids hei whakahaere i te mumura me te urupare ārai mate, kātahi ka whakaiti haere i te horopeta. Ko te Prednisone te rongoā e tino tohua ana, e tino rangahauhia ana hoki mō te hepatitis ārai mate. He pai te mahi mō te tini o te tangata, engari ka pāngia e ngā pānga taha. Ko ngā rongoā rerekē, pērā i te budesonide, te āhua nei he iti ake ngā pānga taha.

Ka tohua pea e tō tākuta he rongoā ārai mate e kiia nei ko te azathioprine me ngā steroids.Tērā pea ka tohua te rongoā. Tērā pea ka tohua i muri i tō otinga i tō maimoatanga steroid. Nā te mea he iti ake ngā pānga taha o te azathioprine i ngā steroids, he pai ake te mahi hei maimoatanga pupuri mō te wā roa, arā, ka ārai i tō pūnaha ārai mate kia kore e kaha rawa anō. Me tango pea e koe i ia wā, i ia wā, puta noa i tō oranga.

He aha ngā pānga taha o te rongoā?

Tērā pea ka pāngia koe e ētahi pānga taha o ēnei maimoatanga. Koia te take ka aroturukihia koe e te tākuta i ia wā.

Ngā pānga taha o te whakamahinga roa o ngā steroids (Corticosteroids):

• Te pikinga o te hiahia kai me te taumaha.
• Ngā mate kare ā-roto pērā i te manukanuka me te pouri.
• Glaucoma ( kite pōuri).
• Te ngoikore o ngā wheua (osteopenia), te ngoikore rānei o ngā wheua (osteoporosis).
• Mate huka .
• Te toto toto tiketike .

Ngā pānga taha o te tango i ngā rongoā ārai mate:

• Ngā mate pāwera auau (nā te ngoikore o te pūnaha ārai mate).
• Whakapairuaki me te ruaki.
• Te mākūkū o te kiri (te mākūkū).
• Ngāwari te pakaru me te toto.
• Te ngoikore o te mahi a te whatukuhu.
• Te mate pāwera .

I a koe e tango ana i ēnei rongoā, ka tirotirohia koe e tō tākuta mō ngā pānga taha. Mena he kino rawa ngā pānga taha o ō rongoā, kāore rānei e tino āwhina ana i a koe, ka tūtohu rātou i tētahi atu rongoā. Kaua e wehi ki te kōrero mō ēnei mea katoa ki tō tākuta.

Kia pēhea te roa ka whai hua te maimoatanga?

Ko te whāinga o te rongoā he whakaora i te mate. Me tango pea koe i te rongoā mō ētahi marama ki ētahi tau kia tutuki ai tēnei. I tēnei wā, ka tirotirohia tō ate e tō tākuta i ia wā, kia mōhio ai kei te whai hua te maimoatanga. Mā ngā whakamātautau mahi ate ka whakaatu kei te hoki mārire ngā taumata whākōkī ate ki te āhua noa. Ko te tikanga o te whakaora kua ngaro katoa ngā tohu me ngā āhuatanga o te mate.

E taunaki ana te American Association for the Study of Liver Diseases (AASLD) kia tangohia e koe ngā steroids mō te toru tau pea i mua i te whakamutu i te rongoā. Kia rua tau pea te roa o tō noho mārire, ka whakaarohia e rātou te whakamutu i ngā rongoā ārai mate. Kia mutu te rongoā, tata ki te 50% o te tangata ka hoki anō ki te mate i roto i ngā marama e toru. Mō ētahi atu, ka roa pea ngā tau, kāore rānei e hoki anō ki te mate.

Ka pai ake te āhua o ētahi tāngata i muri i te maimoatanga, engari kāore i te nui hei whakaora i te mate. Mēnā ka pērā, ka whakamātau tō tākuta i ētahi atu rongoā. Kāore ētahi e aro ki te maimoatanga. Mēnā ka pērā, ka kino haere tonu te haere o te mate. Tērā pea ka pāngia ēnei tāngata e ngā raruraru e hiahia ana kia tāpirihia te maimoatanga. Tērā pea ka pāngia rātou i te mutunga.Tērā pea e hiahiatia ana he whakawhitinga ate.

Ka taea te whakaora katoa i te mate hepatitis ā-aunoa?

Kāo. Kāore e taea te whakaora katoa. Engari ka taea te whakamama i te mate. Ko te tikanga ka ngaro te mumura mō tētahi wā, i ētahi wā mō te wā roa. Engari i muri i te whakamutu i te maimoatanga, ka hoki mai anō. Ka kiia tēnei he hokinga mai anō . Ko te nuinga o te hunga ka mutu te tango i te rongoā (tata ki te 80%) ka hoki mai anō te mate, ā, me tīmata anō te tango i te rongoā. I te nuinga o te wā ka taea e ngā rongoā te whakahaere pai i te mate, engari me tango pea e koe i ia wā puta noa i tō oranga.

He aha te roanga o te oranga toharite mō te mate hepatitis ā-pūnaha?

Ki te kore he maimoatanga, ko te reiti oranga mō ngā tau e rima he 50%. Engari ki te maimoatanga, ko te reiti oranga mō ngā tau 10 he 90%, ā, ko te reiti oranga mō ngā tau 20 he 70%. Ahakoa te maimoatanga, tata ki te 15% o ngā tāngata ka pāngia e te mate ate, i muri i te 10 ki te 20 tau. Ka taea tēnei te tupu mēnā ka kore e angitu te maimoatanga, mēnā kāore i tino pai te urupare ki te maimoatanga, mēnā rānei ka hoki anō te mate i ngā wā maha. Ina hoki anō te mate, ka tere ake te hoki mai.

Me pēhea taku tiaki i a au anō i a au e noho tahi ana me te mate hepatitis aunoa?

He take tino nui tēnei. Tērā ētahi mea ka taea e koe te mahi hei whakahaere i te mate, hei oranga hauora hoki.

• Kaua e mahue ngā wā whakarite a tō tākuta. Me aroturuki tō ate e tō tākuta mō te toenga o tō oranga. Ahakoa kua roa koe e noho mārire ana, ka hoki mai anō te mate me te kore whakatūpato, me ngā tohu e kitea ana. Ka taea e tō tākuta te aroturuki i te nui o te fibrosis (te kino i mua i te kiriuhi) i roto i tō ate mā te whakamahi i ngā tikanga kore-whakaeke pērā i te elastography . Ki te tīmata anō koe ki te pāngia e ngā tohu, whakapā atu ki tō tākuta tonu.
• Kia tiakina tō kai. He mea nui te kai hauora mō te hunga e pāngia ana e te mate ate. Ina koa mō te AIH, kua whakaatuhia e ngā rangahau tata ki te 30% o te hunga he tohu o te mate ate momona kore-waipiro . Ko te tikanga o tēnei he āhua tō te tinana ki te penapena ngako tāpiri ki roto i te ate, he take anō tēnei o te mumura. Ka taea e koe te ārai i tēnei mā te pupuri i te taumaha hauora me te whakaiti i te huka me ngā ngako kukū mai i tō kai. Ka taea hoki e tēnei te āwhina ki te whakapai ake i ngā putanga o tō maimoatanga.
• Tiakina tō pūnaha ārai mate. Ka ngoikore tō pūnaha ārai mate i ngā mate ate me ngā rongoā ārai mate. Ko te tikanga me tiaki pai koe i a koe anō kia kore ai koe e pāngia e te mate. Ka tūtohu pea tō tākuta i ētahi tāpiringa huaora me ngā kano ārai mate hei tiaki i a koe mai i ngā mate. Kaua e tango i ngā tāpiringa kāore i whakaaetia e tō tākuta.
• Kaua e inu waipiro. Ka ngoikore te pūnaha ārai mate o te tinana, ka kino hoki te ate ki te inu waipiro.

He mate kino te mate ate pūkahukahu ā-tinana, engari he maha ngā tāngata e pai ana te urupare ki te maimoatanga. Ka taea e te mate te memeha haere, tata ngaro katoa mō te wā roa. Ki te hoki mai anō, ka whakamahia anō pea te maimoatanga kotahi. Ka pāngia pea koe e ngā pānga taha o te maimoatanga, engari mā te tiaki i tō kai me tō pūnaha ārai mate, ka taea e koe te noho i tētahi oranga noa. Ki te kore e angitu te maimoatanga, he kōwhiringa te whakawhitinga ate.

Ngā mea hei maumahara māu i tēnei tuhinga (Karere hei tango māu i te kāinga)

Āe, nā, mai i ngā mea kua kōrerotia e tātou, koinei ngā mea tino nui hei maumahara māu:

• Ko te mate pūkahukahu aunoa-pūnaha he mate mau tonu e whakaekea ai tō ate e tō ake pūnaha ārai mate.
• Ehara tēnei i te mate hopuhopu.
• Kāore pea he tohu i ngā wāhanga tōmua, engari ka puta pea ngā tohu pēnei i te ngenge, te mamae o te puku, me te waikura.
• Tērā pea e hiahiatia ana ngā whakamātautau toto me te koiora ate hei tāutu i te mate tika.
• Mā te rongoā (steroids, immunosuppressants) ka taea te whakaiti i te mate. Heoi, kāore he rongoā katoa, ā, tera pea ka hoki anō te mate.
• Tērā pea ka pā mai ngā pānga taha o ngā maimoatanga, nō reira he mea nui te tirotiro hauora.
• He mea tino nui te noho hauora (te kai pai, te karo i te waipiro, te whai i ngā tohutohu a te taote) hei whakahaere i te mate.
• Kaua e wehi. Ahakoa tēnei mate, ka taea e koe te ora pai. Kōrerohia ngā mea katoa ki tō tākuta, ā, whai i ana tohutohu.

Mena he pātai anō āu mō tēnei, me pātai atu ki tō tākuta. Kia tere tō ora!

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