Kodi mukudziwa za vutoli lomwe limachitika munthu akalandira chithandizo cha khansa? (Cytokine Release Syndrome - CRS)

Tangoganizirani kuti munthu amene mumamudziwa, mwina wachibale wake, akulandira chithandizo cha khansa. Makamaka ndi imodzi mwa njira zamakono kwambiri zomwe zilipo masiku ano. Patatha masiku angapo atayamba kulandira chithandizo, mwadzidzidzi amayamba kutentha thupi kwambiri, kupweteka kwa thupi, ndipo amamva ngati ali ndi chimfine choipa. Nthawi zambiri timaganiza kuti izi ndi zotsatira zabwinobwino za chithandizocho. Komabe, izi zitha kukhala chizindikiro cha vuto lalikulu. Ili ndi vuto lachipatala lomwe timalitcha Cytokine Release Syndrome (CRS) .

Mwachidule, kodi CRS ndi chiyani?

Kuti timvetse izi, choyamba tiyeni tiganizire za chitetezo cha mthupi lathu. Chili ngati gulu lankhondo lomwe limateteza dziko lathu. Gulu lankhondo ili lili ndi amithenga omwe amatumiza mauthenga pakati pa asilikali ake (maselo a chitetezo cha mthupi). Mofananamo, pali mapuloteni apadera omwe amathandiza maselo athu a chitetezo cha mthupi kulankhulana ndikuwongolera ntchito zawo, otchedwa ma cytokines . Izi ndizofunikira kuti chitetezo cha mthupi chikhale chathanzi.

Koma nthawi zina, makamaka ndi mankhwala ena a khansa, monga chithandizo cha immunotherapy , chitetezo chathu cha mthupi chimatha kukhudzidwa kwambiri. Izi zimapangitsa kuti mwadzidzidzi ma cytokines awa atulutsidwe m'magazi. Zili ngati gulu lankhondo lomwe likuchita zachiwawa ndikutumiza mauthenga ambirimbiri nthawi imodzi. Izi nthawi zina zimatchedwa "cytokine storm." Pamene ma cytokines ambiri atulutsidwa nthawi imodzi, zimayambitsa kutupa m'thupi lonse. Ndicho chimene timachitcha CRS.

Kodi zifukwa zazikulu za CRS ndi ziti?

Chifukwa chachikulu komanso chofala kwambiri cha CRS ndi zina mwa njira zamakono zochiritsira khansa.

• Chithandizo cha Immunotherapy: Ichi ndiye chifukwa chofala kwambiri. Mankhwala monga chithandizo cha maselo a CAR-T ndi ma antibodies awiriawiri ali pachiwopsezo chachikulu cha CRS. Mankhwalawa amalimbikitsa chitetezo chathu chamthupi kuti chizilimbana ndi maselo a khansa. Panthawiyi, chitetezo chamthupi nthawi zina chimakhala chogwira ntchito mopitirira muyeso.
• Zina zomwe zimayambitsa: Anthu omwe ali ndi matenda enaake a majini kapena matenda odziteteza okha akhoza kukhala pachiwopsezo chachikulu. Mwachitsanzo, matenda a majini otchedwa Hemophagocytic lymphohistiocytosis (HLH) .

Kodi zizindikiro za CRS ndi ziti?

Zizindikiro za CRS zitha kufanana ndi za chimfine, kotero nthawi zina zimakhala zovuta kuzizindikira. Komabe, zizindikirozi zimathanso kukula mofulumira.

Kodi vutoli lingakhale lalikulu bwanji?

CRS ndi matenda omwe amatha kuyambira ofatsa mpaka oopsa. Kutupa kwambiri m'thupi lonse kumatha kuwononga ziwalo zazikulu monga impso, chiwindi, mapapo, ndi mtima.

Nazi zina mwa mavuto akuluakulu omwe angachitike:

• Zotsatira pa mtima: Matenda a mtima ndi kulephera kwa mtima zimatha kuchitika.
• Zotsatira zake pa mapapo: Kulephera kwa mapapo ndi mpweya wochepa m'magazi zimatha kuchitika.
• Kulephera kwa Impso ndi Chiwindi: Kuwonongeka kwa ziwalo izi kungayambitse kuti zisiye kugwira ntchito.
• Matenda a Capillary leak: Kutuluka kwa madzi m'mitsempha yaying'ono yamagazi kungayambitse kutsika kwa kuthamanga kwa magazi moopsa.

Kodi madokotala amapeza bwanji izi?

Gulu lachipatala lomwe likukuthandizani likudziwa bwino za CRS, kotero ngati mukulandira chithandizo monga chithandizo cha immunotherapy, adzayang'anira zizindikiro zanu mosamala.

Ngati zizindikiro zikuwonekera, dokotala adzalamula mayeso angapo kuti atsimikizire vutoli.

• Kuchuluka kwa Magazi Okwanira (CBC): Kumayang'anira kusintha kwa maselo a magazi.
• Milingo ya Cytokine: Yesani kuchuluka kwa ma cytokine m'magazi.
• Kuyesa kwa mapuloteni a C-reactive (CRP): Kuyesa kumeneku kumathandiza kuyeza kuchuluka kwa kutupa m'thupi.
• Kufufuza momwe impso ndi chiwindi zimagwirira ntchito: Dziwani ngati ziwalo izi zawonongeka.

Kutengera ndi kuopsa kwa vutoli, madokotala amaliika mu Giredi 1 mpaka 4. Chiwerengero chikakhala chachikulu, vutoli limakhala lalikulu kwambiri. Gawoli limatsimikiziridwa poganizira zinthu monga malungo, kuthamanga kwa magazi, kuchuluka kwa mpweya, ndi magwiridwe antchito a ziwalo.

Kodi mankhwala a CRS ndi otani?

Chithandizo chimadalira kuopsa kwa zizindikiro zanu. Pa milandu yofatsa, zinthu zosavuta monga mankhwala ochepetsa malungo zingakhale zokwanira. Koma ngati vutoli ndi lalikulu, chithandizo chapadera chingafunike.

Kodi ndiyenera kupeza upangiri wa dokotala liti?

Iyi ndi gawo lofunika kwambiri.

Ngati mukulandira chithandizo cha matenda a khansa, ndipo mukuyamba kutentha thupi kapena zizindikiro zina za CRS (monga kupweteka kwa mafupa, kusokonezeka) mutalandira chithandizo, si bwino kuchedwetsa ngakhale pang'ono.

Matendawa amatha kukhala aakulu kwambiri mwachangu kwambiri. Chifukwa chake, dziwitsani dokotala wanu kapena chipatala nthawi yomweyo. Mukayamba chithandizo mwachangu, chiopsezo cha mavuto aakulu chimachepetsa.

N'zomveka kumva mantha komanso kukhumudwa kumva za chinthu chonga ichi pamene mukulimbana ndi khansa. Koma kumbukirani, gulu lachipatala lomwe likukuthandizani limadziwa bwino za CRS. Akukuyang'anirani kwambiri. Musaope kuwauza za kusintha kulikonse m'thupi lanu, ngakhale pang'ono kwambiri. Ndi chithandizo chanu, vutoli lingathe kuthetsedwa lisanafike poipa kwambiri.