Kodi mulinso ndi magazi oundana m'thupi lanu popanda chifukwa? Tiyeni tiphunzire za TTP yoopsa iyi (Thrombotic Thrombocytopenic Purpura)!

Kodi mudamvapo za Thrombotic Thrombocytopenic Purpura, kapena mwachidule TTP? Iyi ndi matenda osowa koma oopsa kwambiri a magazi. Ndi vuto lomwe magazi amaundana (thrombi) m'mitsempha yaying'ono yamagazi m'thupi lanu. Zili ngati kutsekeka kwa chitoliro cha madzi. Izi zitha kuletsa kuyenda kwa magazi kupita ku ziwalo zofunika kwambiri m'thupi lanu, monga ubongo, impso, ndi mtima. Izi zingayambitse mavuto akulu. Ichi ndichifukwa chake ndikofunikira kudziwa za TTP.

Kodi TTP ndi chiyani? Tiyeni timvetse tanthauzo la dzinalo.

Dzina la matendawa lingaoneke ngati lalitali pang'ono. Koma magawo atatu a dzinali atipatsa lingaliro labwino la mtundu wa matendawa. Tiyeni tiwone momwe zilili?

1. Matenda a Thrombotic: Izi zikutanthauza magazi kuundana (thrombi) omwe amapangika mkati mwa mitsempha yamagazi, monga ndanenera kale. Magazi kuundana awa ndiye maziko a vuto lalikulu.

2. Thrombocytopenic: Izi zikutanthauza kuti m'magazi mwanu muli ma platelet ochepa. Ma platelet ali ngati asilikali ang'onoang'ono omwe amathandiza kuletsa kutuluka magazi tikavulala. Koma TTP ikachitika, ma platelet amenewa amagwiritsidwa ntchito mosafunikira kuti magazi aziundana. Kenako sipamakhala ma platelet okwanira komwe kutuluka magazi kumafunika kutha.

3. Purpura: Izi zikutanthauza kuti khungu lanu limakhala ndi madontho ang'onoang'ono, ofiirira kapena mabala. Lingawoneke ngati ziphuphu. Izi ndi zizindikiro za kutuluka magazi pang'ono pansi pa khungu. Izi ndizofala pakati pa anthu omwe ali ndi TTP.

Mwachidule, TTP ndi matenda oopsa omwe magazi amaundana m'mitsempha yaying'ono yamagazi m'thupi lathu, zomwe zimapangitsa kuti magazi azituluka pang'ono komanso zizindikiro za kutuluka magazi pakhungu. Izi zimachitika mwadzidzidzi, kotero chithandizo chadzidzidzi n'chofunikira . Anthu ena amatha kukhalanso ndi vutoli ngakhale atalandira chithandizo. Komabe, zizindikiro nthawi zambiri zimaonekera bwino matendawa akayamba. Nthawi zina zimatha kuyambitsidwa ndi zinthu monga matenda a kachilombo, opaleshoni, kapena mimba. Ngati sichinalandire chithandizo, TTP ikhoza kukhala pachiwopsezo chachikulu.

Kodi zizindikiro za TTP ndi ziti?

TTP nthawi zambiri imabwera mwachangu kwambiri. Anthu ena amachira kenako n’kubwereranso, koma zizindikiro sizimabwera ndi kutha. Zimakhala zokhazikika komanso zodziwikiratu. Sizitha zokha, ndipo zimafunika chithandizo.

TTP imayambitsa magazi kuundana m'mitsempha yaying'ono yamagazi m'thupi lonse. Magazi amenewa amatha kukhudza chiwalo chilichonse, koma nthawi zambiri zizindikiro zimayamba kuwonekera muubongo.

Tangoganizirani, ngati magazi oundana amenewa apangika mumtima, amatha kusokoneza kwambiri momwe mtima umagwirira ntchito, mwina kubweretsa imfa. TTP imayambitsa kuchepa kwa magazi m'thupi (kuchepa kwa magazi) ndi kuchepa kwa ma platelet m'magazi (thrombocytopenia). Anthu ena amathanso kutuluka magazi, koma izi sizichitika kawirikawiri.

Nazi zina mwa zizindikiro zofala kwambiri za TTP:

• Kusintha kwa maganizo: Kusokonezeka mwadzidzidzi, chisokonezo, kapena kutaya chidziwitso.
• Kusokonezeka: Kusadziwa zomwe zikuchitika kapena komwe uli.
• Kutopa kwambiri: Kumva kutopa kwambiri moti sungathe kuchita chilichonse.
• Mutu: Mutu wopweteka kwambiri kuposa mutu wamba.
• Kusanza ndi kusanza: Kusanza m'mimba, kusanza.
• Khungu lotumbululuka kapena lachikasu (Jaundice): Khungu likhoza kuyera chifukwa cha kusowa kwa magazi m'thupi, komanso likhoza kukhala lachikasu chifukwa cha zotsatirapo zake pa chiwindi.
• Kuvuta kupuma (Dyspnea): Kumva ngati n'kovuta kupuma.
• Madontho ang'onoang'ono ofiira kapena ofiirira pansi pa khungu (Petechiae): Madontho ang'onoang'ono a magazi amaonekera pakhungu, ngati kuti abayidwa ndi pini.
• Kutaya magazi m'thupi: Magazi m'mkodzo .
• Kusintha kwa masomphenya: Kuona zinthu molakwika, nthawi zina kuona zinthu ziwiri nthawi imodzi (diplopia).

Ngati mwadzidzidzi mukumana ndi chimodzi kapena zingapo mwa zizindikirozi, muyenera kuonana ndi dokotala popanda kutaya nthawi.

N’chifukwa chiyani TTP imeneyi imachitika? Kodi zimayambitsa chiyani?

Magazi oundana omwe amayambitsa mavuto mu TTP amapangidwa pamene thupi likusowa enzyme yokwanira yotchedwa ADAMTS13. Chomwe enzyme iyi ya ADAMTS13 imachita ndikuletsa ma platelet kuti asagwirizane ndikupanga magazi oundana pamene sitikuwafuna. Taganizirani izi ngati apolisi apamsewu, kupewa kuchulukana kosafunikira kwa magalimoto. Chifukwa chake, ADAMTS13 iyi ikachepa, magazi oundana amayamba kupangika m'mitsempha yaying'ono yamagazi m'thupi lonse. Magazi oundana awa akagundana, ngakhale maselo ofiira amagazi amatha kusweka ndikusweka.

Popeza ma platelet ambiri amagwiritsidwa ntchito kupanga magazi oundana osafunikira, pamene tikufunikadi kuletsa kutuluka magazi chifukwa cha kuvulala, pali ma platelet ochepa kwambiri otsala kuti tigwiritse ntchito. Ngati kuchuluka kwa ma platelet anu kumatsika kwambiri, mutha kuvulala mosavuta ndikutuluka magazi ambiri kuposa masiku onse.

TTP ikhoza kuchitika m'njira ziwiri zazikulu:

1. Kupeza TTP (imeneyi ndi yofala kwambiri): Apa ndi pamene chitetezo cha mthupi lanu chimapanga molakwika ma antibodies omwe amaletsa enzyme ya ADAMTS13 kugwira ntchito bwino. Zili ngati asilikali anu akudziukira okha.

2. TTP yobadwa nayo (yosowa): Izi zimachitika mwana akalandira cholakwika mu jini yomwe imapanga ADAMTS13 enzyme kuchokera kwa makolo onse awiri. Zizindikiro nthawi zambiri zimayamba panthawi ya mimba kapena nthawi yamavuto aakulu.

Kodi pali zinthu zinazake zomwe zingayambitse TTP?

Akatswiri sakudziwabe chomwe chimayambitsa zizindikiro za thrombotic thrombocytopenic purpura. Komabe, anthu ena amakhala ndi vutoli ngati:

• Matenda a HIV
• Matenda a autoimmune monga lupus
• Mimba
• Mankhwala ena, mwachitsanzo mankhwala a chemotherapy , cyclosporine A , ndi quinine .

Kodi ndi mavuto ati omwe angakhalepo chifukwa cha TTP?

Matenda a Thrombotic thrombocytopenic purpura ndi matenda oopsa kwambiri ngati sachiritsidwa. Magazi oundana amatha kutseka kuyenda kwa magazi ndikuyambitsa mavuto aakulu, monga:

• Kuwonongeka kwa ubongo
• Matenda amtima
• Kulephera kwa impso
• Kutaya mimba (kutaya mimba)
• Kugwidwa ndi khunyu
• Stroke

Ndicho chifukwa chake timati ndikofunikira kwambiri kupeza chithandizo mwamsanga ngati muli ndi zizindikiro za TTP.

Kodi madokotala amazindikira bwanji TTP?

Dokotala wanu adzayamba wakuyang'anani ndikufunsani za zizindikiro zanu komanso mbiri yanu ya thanzi. Ngati akukayikira kuti muli ndi TTP, angafune mayeso angapo, monga:

• Kuyesa kwa ADAMTS13: Kuyesa kumeneku kumayesa ntchito ya enzyme ya ADAMTS13. Ngati mulingo wake ndi wotsika, kungatsimikizire kukhalapo kwa TTP.
• Kuchuluka kwa magazi (CBC): CBC imawerengera mitundu ya maselo m'magazi mwanu. Anthu omwe ali ndi TTP ali ndi kuchuluka kochepa kwa maselo ofiira a m'magazi ndi ma platelet.
• Kuyeza magazi m'magazi (PBS): Izi zimaphatikizapo kutenga chitsanzo cha magazi anu ndikuwunika pogwiritsa ntchito maikulosikopu. Ngati muli ndi TTP, maselo ofiira a magazi anu akhoza kusweka ndi kung'ambika (omwe amatchedwanso schistocytes ).
• Kuyesa kwa Bilirubin: Bilirubin ndi zinthu zotayidwa zomwe zimapangidwa ndi maselo ofiira amagazi owonongeka. Kuchuluka kwa bilirubin ndi chizindikiro chimodzi chosonyeza kuti muli ndi TTP.
• Mayeso a ntchito ya impso: Mayeso awa angathandize dokotala wanu kuona ngati impso zanu zikugwira ntchito bwino. Ngati muli ndi TTP, mwina muli ndi maselo a magazi kapena mapuloteni mumkodzo wanu.
• Kuyesa kwa Lactate dehydrogenase (LDH): Lactate dehydrogenase (LDH) ndi enzyme yomwe imatulutsidwa minofu ya thupi lanu ikawonongeka. TTP imayambitsa kuchuluka kwa LDH m'magazi.

Kodi mankhwala a TTP ndi ati?

Nthawi zambiri, madokotala amagwiritsa ntchito plasma therapy pochiza TTP. Kuphatikiza apo, palinso mankhwala.

Mankhwala a plasma

Mankhwala odziwika kwambiri ndi awa:

• Kusinthana kwa plasma: Izi zimaphatikizapo kuchotsa plasma yanu yosazolowereka (gawo lamadzimadzi m'magazi anu) ndikuyiyika m'malo mwake ndi plasma yochokera kwa wopereka wathanzi. Iyi ndi njira yopulumutsa moyo kwa anthu omwe ali ndi TTP.
• Corticosteroids: Mankhwalawa amathandiza kuchepetsa TTP yoopsa, kuchepetsa zizindikiro, komanso kuchepetsa kutupa.

Chithandizo cha plasma chimaperekedwa kuchipatala ndipo chingapitirire kwa masiku kapena milungu ingapo mpaka zizindikiro zanu zitatha.

Mankhwala

Pali mankhwala ena omwe angachepetse kapena kuletsa kupanga ma antibodies motsutsana ndi enzyme ya ADAMTS13 (ma antibodies a anti-ADAMTS13). Mankhwala ena omwe madokotala amagwiritsa ntchito pochiza TTP ndi awa:

• Glucocorticoids: Mankhwalawa amaletsa chitetezo chamthupi chanu. Izi zitha kukhala zothandiza pa TTP.
• Caplacizumab: Mankhwalawa amachiritsa TTP yoopsa. Amawonjezera kuchuluka kwa ma platelet mwachangu kuposa kusinthana kwa plasma kokha, zomwe zimathandiza kuthetsa matendawa mwachangu.
• Rituximab: Mankhwalawa amathandiza kupewa matendawa kuti asabwererenso pambuyo pa mankhwala a corticosteroids ndi plasma exchange.
• ADAMTS13 Yophatikizana: Mankhwalawa amabwezeretsa enzyme ya ADAMTS13. Amavomerezedwa ndi U.S. Food and Drug Administration (FDA) kuti agwiritsidwe ntchito mwadzidzidzi kwa anthu omwe ali ndi TTP yobadwa nayo. Nthawi zina, madokotala amagwiritsanso ntchito kuti apewe kutuluka magazi kwambiri. Kafukufuku akupitilira kuti awone momwe imathandizira TTP yothandizidwa ndi chitetezo chamthupi.

Opaleshoni

Kawirikawiri, dokotala wanu angakulangizeni kuti muchotse ndulu yanu (splenectomy). Izi zimachitika pokhapokha ngati muli ndi TTP yoopsa yomwe sikugwira bwino chithandizo kapena ngati ikubwerezabwereza.

Kodi zimatenga nthawi yayitali bwanji kuti munthu achire pambuyo pa chithandizo cha TTP?

Nthawi yochira imadalira zinthu zingapo. Kuopsa kwa vuto lanu komanso mtundu wa chithandizo chomwe mumalandira zingakhudze izi. Anthu ambiri omwe amalandira chithandizo cha plasma cha TTP amatenga masiku angapo mpaka milungu ingapo kuti achire. Anthu omwe amachotsedwa splenectomy nthawi zambiri amatenga milungu inayi kapena isanu ndi umodzi kuti achire.

Kodi ndiyenera kupita liti kwa dokotala ngati ndikukayikira kuti ndili ndi TTP?

Zizindikiro za TTP nthawi zambiri zimakhala zoopsa kwambiri moti zimafunika kupita kuchipatala chadzidzidzi. Ngati mukuganiza kuti muli ndi TTP, musayembekezere kuti mukawone dokotala wamba - chithandizo chadzidzidzi n'chofunikira!Ukadaulo wa akatswiri a zamagazi ndi akatswiri osamalira odwala kwambiri ndi wofunikira kwambiri pochiza matenda a TTP.

Kodi mungayembekezere chiyani mukakhala ndi TTP? Kodi chiyembekezo cha kuchira n'chiyani?

TTP kale inali matenda oopsa. Koma ndi chithandizo choyambirira, chiwerengero cha imfa tsopano chatsika kufika pa 10%. Popeza matendawa amatha kubwereranso, ndikofunikira kukhala pafupi ndi dokotala wanu wa matenda a magazi ngakhale mutalandira chithandizo. Kuyang'ana pafupipafupi kuchuluka kwa ADAMTS13 yanu kungathandize kuzindikira kusintha kulikonse msanga. Ngati kuchuluka kwa ADAMTS13 kuli kochepa zizindikiro zisanabwerere, mankhwala oletsa monga Rituximab angathandize kuletsa matendawa kubwereranso asanayambe.

Kodi chiŵerengero cha kupulumuka kwa TTP ndi chotani?

Popanda chithandizo, munthu m'modzi yekha mwa anthu khumi omwe ali ndi TTP ndi amene amapulumuka. Koma akalandira chithandizo choyenera, anthu asanu ndi atatu mpaka asanu ndi anayi mwa khumi akhoza kupulumuka.

Ndicho chifukwa chake ndikofunikira kufunafuna chithandizo ngati muli ndi zizindikiro. Ndikofunikanso kutsatira malangizo a dokotala anu a momwe mungadzisamalire nokha mutapezeka ndi matendawa.

Ndi chithandizo choyenera, anthu ambiri omwe ali ndi Thrombotic Thrombocytopenic Purpura (TTP) amakhala ndi moyo wabwinobwino. Dokotala wanu adzakufotokozerani kangati komwe muyenera kuyesedwa kuti muwone momwe mulili. Iye adzakuuzaninso ngati mukufuna chithandizo chamankhwala nthawi zonse kuti muchepetse chiopsezo chanu chotuluka magazi ndi magazi kuundana.

Pakadali pano, ngati muli ndi zizindikiro za TTP, funani chithandizo mwamsanga. TTP ndi vuto lachipatala. Koma chithandizo choyambirira chingakupulumutseni.

Ndiye, kodi chofunika kwambiri kukumbukira kuchokera pa zomwe takambiranazi ndi chiyani?

Chabwino, takambirana zambiri za TTP (Thrombotic Thrombocytopenic Purpura). Zinthu zofunika kwambiri kuzikumbukira ndi izi:

• TTP ndi matenda osowa koma oopsa kwambiri a magazi omwe amaundana m'mitsempha yaying'ono yamagazi ya thupi.
• Ngati mukumva zizindikiro monga kusokonezeka mwadzidzidzi, mutu waukulu, mawanga ofiirira pakhungu lanu, kapena kuyera, mwina ndi TTP. Choncho musataye nthawi ndikuonana ndi dokotala nthawi yomweyo.
• Izi sizingachiritse zokha. Chithandizo chadzidzidzi chikufunikadi.
• TTP imatha kuchiritsidwa ngati yapezeka msanga ndikuchiritsidwa bwino. Ndi mankhwala apamwamba omwe alipo masiku ano, mwayi wopulumutsa miyoyo ndi wokwera kwambiri.
• Ngakhale mutalandira chithandizo, tsatirani malangizo a dokotala ndipo kayezetseni. Izi zithandiza kupewa kuti matendawa asabwererenso.

Ngati inuyo kapena munthu amene mumamudziwa akukayikira zinthu ngati izi, musachite mantha. Koma chitanipo kanthu mwachangu. Kufunafuna upangiri wa dokotala ndiye chinthu chabwino kwambiri kuchita. Khalani ndi thanzi labwino!

Thrombotic Thrombocytopenic Purpura, TTP, matenda a magazi, magazi kuundana, ma platelet, zizindikiro, chithandizo