Kodi thupi lanu likamaukira chiwindi chanu, tiyeni tikambirane za matenda a chiwindi omwe amayambitsa matenda a autoimmune hepatitis?

Kodi munayamba mwaganizapo kuti chitetezo cha mthupi lanu, chitetezo cha mthupi, chingayambe kuukira chiwindi chanu? N'zosadabwitsa, sichoncho? Koma, matenda a chiwindi otchedwa autoimmune hepatitis ndi vuto lomweli. Ngakhale izi zingawoneke zovuta pang'ono, tiyeni tikambirane mwachidule, m'njira yomwe mungamvetse.

Kodi matenda a chiwindi otchedwa autoimmune hepatitis ndi chiyani?

Mwachidule, matenda a chiwindi otchedwa autoimmune hepatitis ndi matenda a nthawi yayitali omwe amakhudza chiwindi chanu. Amayamba ndi cholakwika chaching'ono mu chitetezo cha mthupi lanu, chitetezo cha mthupi . Taganizirani izi motere: chitetezo chathu cha mthupi chili ngati gulu lankhondo lomwe limateteza dziko lathu. Ntchito yake ndikulimbana ndi olowa m'dziko lachilendo monga majeremusi ndi mavairasi. Koma, mu matenda a chiwindi otchedwa autoimmune hepatitis, gulu lankhondoli, chitetezo cha mthupi, molakwika limaganiza kuti maselo ake a chiwindi abwino ndi mdani ndipo limayamba kuwaukira.

Chitetezo cha mthupi chikaukira minofu ya chiwindi mwanjira imeneyi, chimayambitsa kutupa kwa chiwindi, kapena matenda a chiwindi. Pamene kuukira kumeneku kukupitirira, kutupa kumeneku kumakhala kosatha. Pakapita nthawi, kutupa kosatha kumeneku kungayambitse kuwonongeka kwakukulu kwa chiwindi. Makamaka, minofu ya chiwindi imakhala ndi zipsera ndipo chiwindi chimatha kulephera pang'onopang'ono. Izi zimatchedwa cirrhosis .

Nkhani yabwino ndi yakuti chithandizo chamankhwala chingachepetse kutupa kwa chiwindi ndikuletsa mavuto omwe amabwera chifukwa cha matendawa. Komabe, nthawi zina simungakhale ndi zizindikiro zilizonse kumayambiriro kwa matendawa.

Kodi mitundu ikuluikulu ya matenda a chiwindi otchedwa autoimmune hepatitis ndi iti?

Pali mitundu iwiri ikuluikulu ya matenda a chiwindi otchedwa autoimmune hepatitis (AIH). Mitundu imeneyi imasiyanitsidwa ndi kukhalapo kwa ma autoantibodies osiyanasiyana, omwe asayansi athu amatha kuwazindikira pogwiritsa ntchito mayeso a ma antibodies . Ma antibodies osiyanasiyanawa amaukira mitundu yosiyanasiyana ya maselo m'chiwindi.

Mtundu 1

Uwu ndi mtundu wa "classic", ndipo ndi mtundu wofala kwambiri. Pafupifupi 80% ya odwala omwe apezeka ndi matendawa ali ndi mtundu uwu. Umatha kufalikira pa msinkhu uliwonse. Mu matenda a chiwindi a autoimmune a mtundu woyamba, ma antibodies otchedwa ASMA (anti-smooth muscle antibodies) amaukira maselo osalala a minofu m'chiwindi. Matenda a mtundu woyamba nthawi zina amatchedwa "lupoid hepatitis" chifukwa zizindikiro zake zimafanana ndi za Systemic Lupus Erythematosus . Komabe, kuyezetsa magazi kwa ASMA kungathandize kusiyanitsa pakati pa matenda awiriwa.

Mtundu Wachiwiri

Matenda a chiwindi a mtundu wa 2 autoimmune ndi matenda osowa komanso oopsa kwambiri a chiwindi. Nthawi zambiri amawonekera msanga, ali ana. Amathanso kukula mofulumira kuposa mtundu 1. Mtundu uwu umayambitsidwa ndi ma antibodies a anti-LKM-1 (anti-liver-kidney microsome type 1 antibodies) kapenaMa antibodies omwe akukhudzidwa amatchedwa anti-LC1 (anti-liver cytosol type 1 antibodies) . Ma antibodies a Anti-LKM-1 amalimbana ndi puloteni yotchedwa cytochrome P450-2D6 (CYP2D6) m'maselo a chiwindi. Anti-LC1 ndi antibodies ya chiwindi yomwe imayimira mtundu wa 2 AIH.

Kodi matenda a chiwindi otchedwa autoimmune hepatitis ndi osowa bwanji?

Matenda a chiwindi otchedwa autoimmune immune si matenda ofala kwambiri. Sizikudziwika bwino kuti ndi anthu angati omwe ali ndi matendawa. Malinga ndi kafukufuku wa ku Europe, matendawa amakhudza pakati pa 0.010% ndi 0.025% ya anthu aku Europe. Ngakhale kuti angakhudze mtundu uliwonse kapena fuko lililonse, amapezeka kwambiri pakati pa anthu aku Alaska (pafupifupi 0.043% ya anthu amenewo). Amafalanso kwambiri mwa akazi kuposa amuna, pa chiŵerengero cha 4:1.

Kodi zizindikiro zake ndi ziti?

Si anthu onse omwe ali ndi matenda a chiwindi omwe amateteza thupi lawo ku matenda omwe amayamba chifukwa cha matenda a chiwindi. Nthawi zina zizindikiro zimaonekera pambuyo pake, matendawa atatha kukhudza ntchito ya chiwindi. Izi zingayambitse zotsatirapo zosiyanasiyana m'thupi.

Zizindikiro zina zoyambirira zodziwika bwino ndi izi:

• Kupweteka m'mimba kapena kusasangalala.
• Kutupa m'mimba chifukwa cha kukula kwa chiwindi.
• Kutopa .
• Kupweteka kwa mafupa.
• Ziphuphu pakhungu zimatanthauza kuyabwa.
• Ziphuphu.

Chiwindi chanu chikayamba kugwira ntchito molakwika, ndulu imatha kudziunjikira m'magazi. Izi zingayambitse zizindikiro monga:

• Jaundice ( kutuluka kwachikasu kwa khungu ndi maso).
• Mkodzo wakuda kapena ndowe zopepuka.
• Kuyabwa (Pruritus) .
• Kusanza kapena kusowa chilakolako cha chakudya.

Zotsatira zina zochedwa zingaphatikizepo:

• Spider angiomas (madontho ofiira pakhungu omwe amaoneka ngati ukonde wa akangaude) .
• Kukulira kwa mitsempha mu anus (varices) .
• Kutupa ndi kutuluka magazi mosavuta.
• Kutaya kwa msambo pamwezi kwa akazi.
• Kuchulukana kwa madzi m'mimba (ascites) kapena miyendo (edema) .
• Kusokonezeka, kugona tulo, kapena kugona (hepatic encephalopathy) .

Kodi matenda a chiwindi otchedwa autoimmune hepatitis ndi ati?

Matenda a autoimmune amachitika pamene chitetezo chanu cha mthupi chisokoneza maselo anu ena ngati chiwopsezo. Chitetezo cha mthupi chikazindikira "chiwopsezo" ichi, chimaukira maselo amenewo. Izi zimayambitsa kutupa kosatha m'mbali inayake ya thupi. Mu matenda a chiwindi a autoimmune, chitetezo cha mthupi chimatumiza ma antibodies enaake kuti akaukire mitundu ina ya maselo m'chiwindi. Imeneyi ndi njira yovuta kwambiri.

Kodi avareji ya zaka zomwe matendawa amayamba ndi iti?

Sizotheka nthawi zonse kudziwa nthawi yeniyeni yomwe matenda a chiwindi otchedwa autoimmune hepatitis adayamba. Izi zili choncho chifukwa nthawi zambiri palibe zizindikiro kumayambiriro. Mtundu woyamba wa AIH nthawi zambiri umapezeka pakati pa zaka zapakati pa 15 ndi 40. Komabe, ukhoza kuchitika pa msinkhu uliwonse. Mtundu wachiwiri wa AIH nthawi zambiri umawonekera msanga, paubwana, pakati pa zaka 4 ndi 14. Ngakhale zili choncho, zizindikiro zazikulu za matenda a chiwindi zitha kupezeka.

Kodi matenda a chiwindi otchedwa autoimmune hepatitis amakula bwanji?

Chifukwa chomwe anthu amakhalira ndi matenda odziteteza ku matenda a autoimmune ndi funso lovuta kwambiri. Zikuoneka kuti palibe chifukwa chimodzi chokha, koma pali zinthu zosiyanasiyana.

• Mphamvu ya majini: Nthawi zina, majini anu angakupangitseni kukhala ndi matenda enaake odziteteza ku matenda enaake. Komabe, si aliyense amene ali ndi majini amenewo amene adzadwala matendawa, ndipo si aliyense amene adzadwala matendawa amene adzakhala ndi majini amenewo.
• Zinthu Zachilengedwe: Zinthu zina zomwe sizili za majini, zomwe zimatchedwanso "zinthu zachilengedwe," zingayambitse izi. Izi zitha kukhala poizoni kapena zochitika zomwe zimaika mphamvu pa chitetezo chanu chamthupi. Mwa anthu ena omwe ali pachiwopsezo, zinthuzi zingayambitse chitetezo chamthupi kuchita zinthu mopitirira muyeso, zomwe zimapangitsa kuti pakhale matenda osatha a autoimmune.

Mankhwala ena ndi matenda opatsirana ndi mavairasi apezeka kuti ndi omwe amayambitsa matenda a chiwindi otchedwa autoimmune hepatitis. Komanso, ngati muli kale ndi matenda ena a autoimmune hepatitis, muli ndi mwayi waukulu woti mudwale matenda a chiwindi otchedwa autoimmune hepatitis.

Ndi mavairasi ati omwe angayambitse matenda a chiwindi a autoimmune?

Muli ndi mwayi waukulu wodwala matenda a chiwindi otchedwa autoimmune hepatitis ngati muli ndi mbiri ya matenda awa:

• Matenda a chiwindi (A, B, C, D kapena E).
• Mononucleosis (kachilombo ka Mononucleosis - Epstein-Barr) .
• Chikuku .
• Herpes .

Ndi mankhwala ati omwe angayambitse matenda a chiwindi a autoimmune?

Matenda a chiwindi odziteteza okha omwe amayambitsidwa ndi mankhwala agwirizanitsidwa ndi mankhwalawa:

• Nitrofurantoin ( yothandiza pochiza matenda a mkodzo).
• Minocycline ( yothandiza pa ziphuphu).
• Atorvastatin ( kwa cholesterol yambiri).
• Isoniazid ( mankhwala opha tizilombo).

Ndi matenda ena ati a autoimmune omwe amagwirizana ndi matenda a chiwindi a autoimmune?

Anthu ena amadwala matenda a chiwindi otchedwa autoimmune hepatitis pamodzi ndi matenda ena omwe amakhudza njira zawo zotulutsira ndulu. Mwachitsanzo:

• Cholangitis yoyamba ya biliary (PBC) .
• Matenda oyamba a sclerosing cholangitis (PSC) .

Izi zimaonedwa ngati "mtundu wosiyanasiyana" wa matenda a chiwindi omwe amadziteteza okha.

Koma kawirikawiri, ngati muli kale ndi matenda a autoimmune, muli ndi mwayi waukulu wopeza matenda ena. Zikuoneka kuti kutupa kosatha m'dera lina kungayambitse kutupa m'dera lina. Mwayi wopeza matenda ena a autoimmune ndi pafupifupi 25%-50%. Ngati matenda a chiwindi a autoimmune ndi matenda anu oyamba a autoimmune, muli ndi mwayi wofanana wopeza matenda ena.

Matenda ena omwe amapezeka nthawi zambiri ndi AIH ndi awa:

• Matenda a Manda .
• Matenda a Celiac .
• Matenda otupa m'matumbo .
• Matenda a nyamakazi .
• Matenda a shuga amtundu woyamba.
• Vitiligo ( mabala oyera pakhungu).

Kodi matenda a chiwindi otchedwa autoimmune hepatitis amapatsirana?

Ayi. Matenda a chiwindi (monga hepatitis A, B, ndi C) amatha kuyambitsidwa ndi mavairasi opatsirana. Matendawa amatha kufalikira kwa ena. Komabe, matenda a chiwindi a autoimmune si matenda, kotero safalikira kwa ena.

Kodi matenda a chiwindi otchedwa autoimmune hepatitis amawapeza bwanji?

Mwina muli ndi zizindikiro zoonekeratu za AIH kapena ayi. Dokotala adzakuyesani kaye mwakuthupi ndikuchita mayeso oyambira, monga kuyezetsa zithunzi ndi kuyezetsa magazi. Kuyezetsa magazi kotchedwa comprehensive metabolic panel kungayang'ane umboni wa matenda a chiwindi. Gululi limaphatikizapo mayeso angapo a ntchito ya chiwindi omwe amayesa zinthu monga kuchuluka kwa ma enzyme a chiwindi ndi kutupa.

Koma zizindikiro izi sizikutanthauza matenda a chiwindi omwe amayambitsa matenda a autoimmune. Dokotala wanu adzachita mayeso ena a magazi kuti aone mavairasi ndi zina zomwe zimayambitsa matenda a chiwindi. Adzafufuzanso ma autoantibodies . Akangochotsa zifukwa zina ndikupeza ma antibodies omwe amagwirizana ndi matenda a chiwindi omwe amayambitsa matenda a autoimmune, adzakhala okonzeka kutsimikizira matendawa. Njira yabwino yotsimikizira izi ndikuchita biopsy ya chiwindi . Izi zimaphatikizapo kutenga chidutswa chaching'ono cha minofu kuchokera pachiwindi ndikuchiyang'ana pansi pa maikulosikopu.

Kodi mankhwala a chiwindi cha autoimmune ndi ati?

Chithandizo chokhazikika ndi kuyamba ndi mankhwala ambiri a corticosteroids kuti muchepetse kutupa ndi chitetezo chamthupi, kenako pang'onopang'ono muchepetse mlingo. Prednisone ndi mankhwala omwe amaperekedwa komanso ophunziridwa bwino kwambiri a chiwindi cha autoimmune. Imagwira ntchito bwino kwa anthu ambiri, koma ingayambitse zotsatirapo zake. Mankhwala ena, monga budesonide, akuwoneka kuti alibe zotsatirapo zoyipa zambiri.

Dokotala wanu angakulembereni mankhwala oletsa chitetezo chamthupi otchedwa azathioprine pamodzi ndi ma steroids.Mankhwalawa angakupatseni. Kapena angakupatseni mukamaliza kumwa mankhwala a steroid. Popeza azathioprine ili ndi zotsatirapo zochepa poyerekeza ndi ma steroid, amagwira ntchito bwino ngati chithandizo chosamalira kwa nthawi yayitali, zomwe zikutanthauza kuti amateteza chitetezo chanu cha mthupi kuti chisabwererenso kuchita zinthu mopitirira muyeso. Mungafunike kumwa nthawi ndi nthawi pa moyo wanu wonse.

Kodi zotsatirapo zake za mankhwalawa ndi ziti?

Mankhwalawa angakhalenso ndi zotsatirapo zina. Ndicho chifukwa chake dokotala adzakuyang'anirani nthawi zonse.

Zotsatira zoyipa za kugwiritsa ntchito mankhwala a steroid kwa nthawi yayitali (Corticosteroids):

• Kuwonjezeka kwa chilakolako cha chakudya ndi kunenepa.
• Matenda a maganizo monga nkhawa ndi kuvutika maganizo.
• Glaucoma ( kulephera kuona bwino).
• Kufooka kwa mafupa kapena kufooka kwa mafupa (osteopenia).
• Matenda a shuga .
• Kuthamanga kwa magazi kwambiri .

Zotsatira zoyipa za kumwa mankhwala oletsa kupanikizika kwa thupi:

• Matenda obwera pafupipafupi (chifukwa cha kuchepa kwa chitetezo chamthupi).
• Kusanza ndi kusanza.
• Kutupa pakhungu (kuyabwa).
• Kutupa ndi kutuluka magazi mosavuta.
• Kulephera kugwira ntchito kwa impso.
• Pancreatitis .

Pamene mukumwa mankhwala awa, dokotala wanu adzakuyang'anirani kuti awone ngati pali zotsatirapo zake. Ngati zotsatirapo zake zili zoopsa kwambiri, kapena ngati sizikukuthandizani mokwanira, adzakupatsani njira ina. Musachite mantha, lankhulani ndi dokotala wanu za zonsezi.

Kodi zimatenga nthawi yayitali bwanji kuti chithandizo chigwire ntchito?

Cholinga cha mankhwalawa ndikuchepetsa matendawa. Mungafunike kumwa mankhwalawa kwa miyezi ingapo mpaka zaka zingapo kuti muchite izi. Panthawiyi, dokotala wanu adzayang'ana chiwindi chanu nthawi zonse kuti atsimikizire kuti chithandizocho chikugwira ntchito. Kuyezetsa kwa chiwindi kudzawonetsa kuti kuchuluka kwa ma enzyme a chiwindi chanu kukubwerera pang'onopang'ono kukhala kwabwinobwino. Kuchepetsa kumatanthauza kuti zizindikiro zonse za matendawa zatha.

Bungwe la American Association for the Study of Liver Diseases (AASLD) limalimbikitsa kuti mutenge mankhwala a steroid kwa zaka zosachepera zitatu musanasiye kumwa mankhwalawa. Mukatha kuchira kwa zaka zosachepera ziwiri, adzaganiza zosiya kugwiritsa ntchito mankhwala oletsa chitetezo chamthupi. Mukasiya kumwa mankhwalawa, pafupifupi 50% ya anthu akhoza kubwereranso mkati mwa miyezi itatu. Kwa ena, zingatenge zaka zambiri, kapena sangabwererenso konse.

Anthu ena amapeza bwino akalandira chithandizo, koma osakwanira kuti achire. Zikatero, dokotala wanu adzayesa mankhwala ena. Anthu ena sayankha konse akalandira chithandizo. Zikatero, matendawa amapitirirabe kukulirakulira. Anthuwa akhoza kukhala ndi mavuto omwe amafunikira chithandizo china. Pomaliza pake akhoza kukhala ndi vuto.Kuikidwa chiwindi kungafunikenso.

Kodi matenda a chiwindi omwe amadziteteza okha angachiritsidwe kwathunthu?

Ayi. Sichingathe kuchiritsidwa kwathunthu. Koma matendawa amatha kuchira. Izi zikutanthauza kuti kutupa kumatha kwakanthawi, nthawi zina kwa nthawi yayitali. Koma mukasiya kulandira chithandizo, kumatha kubwereranso. Izi zimatchedwa kubwereranso . Anthu ambiri omwe amasiya kumwa mankhwala (pafupifupi 80%) pamapeto pake matendawa amabwereranso ndipo amafunika kuyambanso kumwa mankhwalawo. Mankhwala nthawi zambiri amatha kulamulira matendawa bwino, koma mungafunike kuwamwa nthawi ndi nthawi pa moyo wanu wonse.

Kodi nthawi ya moyo wapakati yokhala ndi matenda a chiwindi otchedwa autoimmune hepatitis ndi yotani?

Popanda chithandizo, chiwerengero cha anthu opulumuka zaka zisanu ndi 50%. Koma ndi chithandizo, chiwerengero cha anthu opulumuka zaka 10 ndi 90% ndipo chiwerengero cha anthu opulumuka zaka 20 ndi 70%. Ngakhale atalandira chithandizo, pafupifupi 15% ya anthu pamapeto pake amakhala ndi matenda a chiwindi, nthawi zambiri patatha zaka 10 mpaka 20. Izi zitha kuchitika ngati chithandizo chalephera, ngati palibe yankho lokwanira ku chithandizo, kapena ngati matendawa abwereranso kangapo. Matendawa akabwereranso, amatha kubwerera mwachangu.

Kodi ndiyenera kudzisamalira bwanji ndikakhala ndi matenda a chiwindi otchedwa autoimmune hepatitis?

Nkhaniyi ndi yofunika kwambiri. Pali zinthu zomwe mungachite kuti muchepetse matendawa ndikukhala ndi moyo wathanzi.

• Musaphonye nthawi yokumana ndi dokotala. Dokotala wanu adzafunika kuyang'anira chiwindi chanu kwa moyo wanu wonse. Ngakhale mutakhala kuti mwachira kwakanthawi, matendawa amatha kubwerera popanda chenjezo kapena zizindikiro zoonekeratu. Dokotala wanu akhoza kuyang'anira kuchuluka kwa fibrosis (kuwonongeka musanachite zipsera) m'chiwindi chanu pogwiritsa ntchito njira zosavulaza monga elastography . Ngati muyambanso kukumana ndi zizindikiro, funsani dokotala wanu nthawi yomweyo.
• Samalani zakudya zanu. Zakudya zabwino ndizofunikira kwa aliyense amene ali ndi matenda a chiwindi. Makamaka ndi AIH, kafukufuku wasonyeza kuti pafupifupi 30% ya anthu ali ndi zizindikiro za matenda a chiwindi omwe alibe mowa . Izi zikutanthauza kuti thupi lanu limakonda kusunga mafuta ochulukirapo m'chiwindi, chomwe ndi chifukwa china chotupa. Mutha kuthana ndi izi mwa kusunga kulemera kwabwino ndikuchepetsa shuga ndi mafuta okhuta kuchokera muzakudya zanu. Izi zingathandizenso kukonza zotsatira za chithandizo chanu.
• Tetezani chitetezo chanu chamthupi. Matenda a chiwindi ndi mankhwala oletsa chitetezo chamthupi amafooketsa chitetezo chanu chamthupi. Izi zikutanthauza kuti muyenera kudzisamalira bwino kuti musadwale. Dokotala wanu angakulangizeni mavitamini ndi katemera kuti akutetezeni ku matenda. Musamwe mankhwala ena aliwonse omwe dokotala wanu sanavomereze.
• Pewani kumwa mowa. Kumwa mowa kumafooketsa chitetezo cha mthupi lanu komanso kumawononga chiwindi chanu.

Matenda a chiwindi otchedwa Autoimmune hepatitis ndi matenda oopsa, koma anthu ambiri amalandira bwino chithandizo. Matendawa amatha kuchira, pafupifupi kutha kwathunthu kwa nthawi yayitali. Ngati abwereranso, chithandizo chomwecho chingagwiritsidwenso ntchito. Chithandizo chingakhale ndi zotsatirapo zoyipa, koma posamalira zakudya zanu komanso chitetezo chanu cha mthupi, mutha kukhala ndi moyo wabwinobwino. Ngati chithandizo sichikugwira ntchito, kuyika chiwindi ndi njira ina.

Zinthu zoti muzikumbukire kuchokera munkhaniyi (Uthenga Wopita Nawo Kunyumba)

Chabwino, kuchokera pa zomwe takambirana, izi ndi zinthu zofunika kwambiri zomwe muyenera kukumbukira:

• Matenda a chiwindi otchedwa Autoimmune hepatitis ndi matenda osatha omwe chitetezo cha mthupi lanu chimaukira chiwindi chanu.
• Iyi si matenda opatsirana.
• Pakhoza kukhala palibe zizindikiro kumayambiriro, koma zizindikiro monga kutopa, kusamva bwino m'mimba, ndi jaundice zingawonekere.
• Kuyezetsa magazi ndi kufufuzidwa kwa chiwindi kungakhale kofunikira kuti munthu adziwe matenda molondola.
• Chithandizo (mankhwala oletsa kutupa, ma steroids, ndi ma immunosuppressants) chingathandize kuti matendawa abwerere mwakale. Komabe, palibe mankhwala okwanira, ndipo kubwereranso n'kotheka.
• Mankhwala amatha kukhala ndi zotsatirapo zoyipa, kotero kuyang'aniridwa ndi dokotala ndikofunikira.
• Moyo wathanzi (kudya bwino, kupewa kumwa mowa, kutsatira malangizo a dokotala) ndikofunikira kwambiri pothana ndi matendawa.
• Musachite mantha. Mungakhale ndi moyo wabwino ngakhale muli ndi vutoli. Kambiranani zonse ndi dokotala wanu ndipo tsatirani malangizo ake.

Ngati muli ndi mafunso ena okhudza izi, onetsetsani kuti mwafunsa dokotala wanu. Ndikukufunirani kuti muchire mwachangu!

Matenda a chiwindi , matenda a chiwindi a autoimmune, chitetezo chamthupi, kutupa kwa chiwindi, cirrhosis, matenda a autoimmune, chithandizo cha chiwindi