Mankhwala atsopano omwe amachedwetsa matenda a shuga amtundu woyamba: Tiyeni tiphunzire za Tzield (Teplizumab)

Kodi pali aliyense m'banja mwanu amene ali ndi matenda a shuga amtundu woyamba? Kapena dokotala wakuuzani kuti muli pachiwopsezo chotenga matendawa? Ngati ndi choncho, lero tikulankhula za mankhwala atsopano omwe angachedwetse kuyamba kwa zizindikiro za matenda a shuga kwa zaka zingapo. Ichi ndi chinthu chomwe chabweretsa chiyembekezo chachikulu kwa anthu ambiri. Tiyeni tiwone kuti mankhwalawa ndi otani komanso momwe amagwirira ntchito.

Matenda a shuga amtundu woyamba ndi ntchito ya mankhwala a Tzield

Choyamba, tiyeni timvetse bwino kuti matenda a shuga amtundu woyamba ndi otani. Ndi matenda odziteteza okha . Mwachidule, chitetezo cha mthupi, chomwe chili ngati 'gulu lankhondo' lomwe limateteza thupi lathu ku matenda, molakwika limayamba kuukira maselo athu abwino. Mu matenda a shuga amtundu woyamba, 'kuukira' kumeneku kumachitika pa maselo a beta m'chifuwa chathu.

Ganizirani maselo a beta awa ngati mafakitale ang'onoang'ono omwe amapanga mahomoni otchedwa insulin, omwe ndi ofunikira m'thupi lathu. Insulin imathandiza maselo kusintha shuga (shuga) mu chakudya chomwe timadya kukhala mphamvu. Chifukwa chake, chitetezo cha mthupi chikawononga maselo a beta awa, kupanga insulin kumachepa pang'onopang'ono.

Chiwonongekochi sichidzachitika nthawi imodzi. Chidzachitika m'magawo atatu.

• Gawo 1: Chitetezo cha mthupi chimayamba kuukira maselo a beta, koma amapangabe insulin yokwanira.
• Gawo lachiwiri: Kuwonongeka kwa maselo a beta kumawonjezeka, shuga m'magazi amayamba kukhala wosazolowereka pang'ono, koma palibe zizindikiro zakunja zomwe zimawonekera.
• Gawo lachitatu: Maselo ambiri a beta amawonongeka, ndipo thupi silingathe kupanga insulin yokwanira. Shuga m'magazi amakwera kwambiri. Apa ndi pamene zizindikiro za matenda a shuga, monga ludzu lochuluka komanso kukodza pafupipafupi, zimawonekera.

Apa ndi pomwe mankhwala otchedwa Tzield (teplizumab-mzwv) amalowa. Tzield ndi mankhwala achilengedwe. Amatha kuchepetsa liwiro lomwe chitetezo cha mthupi chimaukira maselo a beta a anthu omwe ali ndi matenda a shuga amtundu woyamba a siteji yachiwiri . Izi zikutanthauza kuti amatha kuchedwetsa kupita patsogolo kwa matendawa kufika pa siteji yachitatu, pamene zizindikiro zimawonekera komanso pakufunika jakisoni wa insulin tsiku lililonse.

Mankhwalawa amaperekedwa kudzera mu mtsempha (kulowetsedwa m'mitsempha, kapena IV) . Mankhwalawa amaperekedwa kamodzi patsiku kwa masiku 14 otsatizana.

Kodi chithandizo cha Tzield ichi n'choyenera kwa ine?

Matenda a shuga amtundu woyamba angakhudze aliyense wa msinkhu uliwonse komanso moyo uliwonse. Chithandizo cha Tzield chingakhale choyenera kwa inu ngati mukwaniritsa izi:

• Ngati muli ndi matenda a shuga amtundu woyamba wa gawo lachiwiri .
• Kwa inuNgati mulibe matenda a shuga amtundu wachiwiri .
• Ngati muli ndi zaka 8 kapena kuposerapo .

Kuti atsimikizire ngati muli ndi matenda a shuga amtundu woyamba mu gawo lachiwiri, dokotala wanu adzachita mayeso apadera a magazi. Chofunika kwambiri mwa izi ndi mayeso oyesa ma antibodies motsutsana ndi maselo a beta komanso mayeso oletsa shuga m'kamwa . Adzayang'ananso kuchuluka kwa maselo m'magazi ndi ma enzymes a chiwindi kuti aone ngati mankhwalawa ndi otetezeka kwa inu.

Kodi zotsatira za mankhwala a Tzield zinaphunziridwa bwanji?

Kafukufuku wapadera wa zachipatala wotchedwa TN-10 unachitika kuti afufuze ubwino ndi zoopsa za mankhwalawa. Funso lalikulu lomwe adafunsa linali lakuti, "Kodi Tzield angaletse kapena kuchedwetsa kupita patsogolo kwa matenda a shuga amtundu woyamba kufika pa siteji yachitatu mwa anthu omwe ali pachiwopsezo chachikulu?"

Ophunzirawo anagawidwa m'magulu awiri. Gulu limodzi linapatsidwa mankhwala a Tzield. Gulu lina linapatsidwa placebo . Ndiko kuti, madzi amchere omwe amawoneka ngati mankhwalawo koma analibe mankhwala aliwonse. Odwalawo komanso madokotala sanadziwe amene anali kulandira chiyani.

Mutha kuona mosavuta zomwe zili zoyenera ndi zomwe sizikuyeneretsedwa kuti muchite nawo kafukufukuyu kuchokera patebulo lomwe lili pansipa.

Kodi zotsatira za kafukufukuyu ndi ziti?

Pambuyo pa masiku 14 a chithandizo, anthuwa anatsatiridwa kwa zaka pafupifupi 5. Zotsatira zake n’zolimbikitsa kwambiri.

Mwachidule, zinatenga pafupifupi zaka 4 kuti anthu omwe akumwa Tzield ayambe kudwala, pomwe omwe akumwa placebo anayamba kudwala patatha zaka ziwiri. Makamaka mkati mwa chaka choyamba cha chithandizo, ochepa okha ndi omwe adadwala matenda awo. Kumapeto kwa kafukufukuyu, 57% ya omwe adamwa Tzield anali athanzi komanso opanda zizindikiro zilizonse za matenda a shuga. Koma 28% yokha ya omwe adamwa placebo adadwala.

Kodi zotsatirapo zoyipa za Tzield ndi ziti?

Monga mankhwala ena aliwonse, Tzield akhoza kukhala ndi zotsatirapo zina. Koma musadandaule, zambiri mwa izi zitha kuthandizidwa.

Zotsatira zoyipa zofala:

• Matuza pakhungu: Izi nthawi zambiri zimakhala chizindikiro cha ziwengo. Nthawi zambiri, sizimakhala zoopsa ndipo zimatha zokha. Sungani khungu lonyowa ndipo pewani kukanda. Zinthu monga kusamba ndi madzi ozizira kapena kusamba mu oatmeal zingathandize. Lankhulani ndi dokotala wanu za izi. Iye adzakupatsani mankhwala ngati pakufunika kutero. Komabe , ngati matuzawo akugwirizana ndi kutupa kwa lilime kapena pakhosi, kapena ngati mukuvutika kupuma, pitani kuchipatala nthawi yomweyo.

• Maselo oyera ochepa m'magazi (Lymphopenia): Kuchuluka kwa maselo oyera m'magazi anu kungachepe kwakanthawi m'masiku oyamba a chithandizo. Izi sizingakukhudzeni, koma zingapangitse kuti mukhale ndi matenda ambiri. Izi zidzabwerera mwakale mkati mwa milungu ingapo. Dokotala wanu adzakuyang'anirani nthawi zonse kuti mudziwe izi.

• Mutu: Mutu wochepa ukhoza kuchitika. Nthawi zambiri umatha wokha. Ngati mutu ukupitirira kapena ukukulirakulira, dziwitsani dokotala wanu.

Zotsatirapo zoyipa zomwe muyenera kuzisamala nazo:

• Matenda Otulutsa Cytokine:Chifukwa mankhwala omwe amakhudza chitetezo chamthupi, monga Tzield, nthawi zina angayambitse kuti zinthu zambiri zoteteza thupi zotchedwa ma cytokines zitulutsidwe m'magazi nthawi yomweyo. Izi zitha kuchitika m'masiku oyamba a chithandizo. Zizindikiro monga kutentha thupi, nseru, kupweteka kwa thupi, komanso kutopa kwambiri zitha kuchitika. Dokotala wanu adzakupatsani mankhwala ena (monga paracetamol) musanalandire chithandizo kuti muchepetse izi. Ngati muli ndi zizindikiro izi, uzani dokotala wanu nthawi yomweyo.

• Kuchuluka kwa maselo oyera m'magazi kumachepa kwambiri: Ngati vutoli litakula kwambiri, lingayambitse matenda oopsa. Ngati muli ndi zizindikiro za matenda monga malungo, kuzizira, chifuwa, ndi kutopa kwambiri , uzani dokotala wanu nthawi yomweyo.

Izi si zotsatirapo zonse zomwe zingachitike chifukwa cha Tzield. Ngati muli ndi zizindikiro zilizonse zomwe zikukuvutitsani, onetsetsani kuti mwawonana ndi dokotala wanu kuti akupatseni upangiri.

Kodi mumadziwa bwanji ngati mankhwalawo akugwira ntchito?

Cholinga cha Tzield ndikuchedwetsa kuyambika kwa zizindikiro. Chifukwa chake, simungazindikire kusiyana kwakukulu mutatenga chithandizo. Ichi ndi chithandizo cha masiku 14 kamodzi kokha. Pambuyo pake, dokotala wanu adzayang'ana matenda anu a shuga nthawi zonse kuti awone momwe alili. Musasiye kumwa mankhwalawo kapena kusintha nthawi popanda upangiri wa dokotala wanu.

Kodi pali mavuto aliwonse ndi mankhwala ena?

Musanayambe chithandizo cha Tzield, ndikofunikira kwambiri kuuza dokotala wanu za mankhwala ena onse omwe mukumwa (kuphatikizapo mavitamini, zowonjezera, mankhwala a Ayurvedic kapena azitsamba).

Makamaka, muyenera kusamala kuti musalandire katemera mukamamwa Tzield. Katemera wina sangakhale wogwira ntchito bwino, ndipo wina sangakhale wotetezeka. Chifukwa chake , musanalandire katemera aliyense, uzani dokotala wanu kuti mukumwa Tzield.