Xa umzimba wakho uhlasela isibindi sakho? Masithethe nge-hepatitis ebangelwa kukuzikhusela komzimba.

Ngaba wakha wacinga ukuba inkqubo yokuzikhusela yomzimba wakho, inkqubo yokuzikhusela, ingaqalisa ukuhlasela isibindi sakho? Kuyamangalisa, akunjalo? Kodwa, i-hepatitis ye-autoimmune yimeko enjalo kanye. Nangona oku kunokubonakala kunzima kancinci, masithethe ngayo ngokulula, ngendlela onokuyiqonda.

Yintoni i-hepatitis ye-autoimmune?

Ngamafutshane, i-autoimmune hepatitis sisifo esihlala ixesha elide esichaphazela isibindi sakho. Siqala ngempazamo encinci kwinkqubo yokuzikhusela yomzimba wakho, inkqubo yokuzikhusela . Cinga ngale ndlela: inkqubo yethu yokuzikhusela ifana nomkhosi okhusela ilizwe lethu. Umsebenzi wayo kukulwa nabahlaseli bamanye amazwe njengeentsholongwane kunye neentsholongwane. Kodwa, kwi-hepatitis yokuzikhusela, lo mkhosi, inkqubo yokuzikhusela, ngempazamo ucinga ukuba iiseli zesibindi ezisempilweni zilutshaba kwaye uqala ukuzihlasela.

Xa inkqubo yomzimba yokuzikhusela ihlasela izicwili zesibindi ngale ndlela, ibangela ukudumba kwesibindi, okanye i-hepatitis. Njengoko olu hlaselo luqhubeka, olu vuvuko luba yinto engapheliyo. Ekuhambeni kwexesha, olu vuvuko lungapheliyo lunokubangela umonakalo omkhulu kwisibindi. Ngokukodwa, izicwili zesibindi ziba namabala kwaye isibindi sinokungasebenzi kancinci kancinci. Oku kubizwa ngokuba yi -cirrhosis .

Iindaba ezimnandi zezokuba unyango lunokunciphisa ukudumba kwesibindi kwaye luthintele iingxaki ezibangelwa sisifo. Nangona kunjalo, ngamanye amaxesha usenokungabi nazimpawu kwisigaba sokuqala sesi sifo.

Ziziphi iintlobo eziphambili ze-hepatitis ye-autoimmune?

Kukho iintlobo ezimbini eziphambili ze-autoimmune hepatitis (AIH). Ezi zahlulwe ngokubakho kwee -autoantibodies ezahlukeneyo, ezinokufunyanwa ngovavanyo lwe-antibody . Ezi antibodies zahlukeneyo zihlasela iintlobo ezahlukeneyo zeeseli esibindini.

Uhlobo 1

Olu luhlobo "oluqhelekileyo", kwaye lolona hlobo luxhaphakileyo. Malunga nama-80% ezigulana ezifunyaniswe ukuba zinalo olu hlobo. Lunokukhula nangaliphi na ixesha. Kwi-hepatitis ye-autoimmune yohlobo 1, ii-antibodies ezibizwa ngokuba yi-ASMA (anti-smooth muscle antibodies) zihlasela iiseli zemisipha egudileyo esibindini. Olu hlobo 1 ngamanye amaxesha lubizwa ngokuba yi-"lupoid hepatitis" kuba iimpawu zalo zifana nezo zeSystemic Lupus Erythematosus . Nangona kunjalo, uvavanyo lwegazi lwe-ASMA lunokunceda ukwahlula phakathi kwezi zifo zimbini.

Uhlobo 2

I-Type 2 autoimmune hepatitis luhlobo olungaqhelekanga nolunzima lwe-hepatitis. Idla ngokubonakala kwangethuba, ebuntwaneni. Ingakhula ngokukhawuleza kunohlobo 1. Olu hlobo lubangelwa yi -anti-LKM-1 (i-anti-liver-kidney microsome type 1 antibodies) okanyeIi-antibodies ezibandakanyekayo zibizwa ngokuba yi-anti-LC1 (ii-anti-liver cytosol type 1 antibodies) . Ii-anti-LKM-1 antibodies zijolise kwiproteni ebizwa ngokuba yi-cytochrome P450-2D6 (CYP2D6) kwiiseli zesibindi. I-Anti-LC1 yi-antibody yesibindi ekhethekileyo kwi-type 2 AIH.

Inqabile kangakanani i-hepatitis ye-autoimmune?

I-Autoimmune hepatitis ayisosifo sixhaphakileyo. Akukacaci ukuba bangaphi abantu abanaso. Ngokwezifundo zaseYurophu, esi sifo sichaphazela phakathi kwe-0.010% kunye ne-0.025% yabemi baseYurophu. Nangona sinokuchaphazela naluphi na uhlanga okanye iqela lesizwe, sixhaphake kancinci phakathi kwabemi baseAlaska (malunga ne-0.043% yaloo bemi). Sixhaphake kakhulu kwabasetyhini kunamadoda, ngomlinganiselo we-4:1.

Zithini iimpawu?

Ayingabo bonke abantu abane-hepatitis ye-autoimmune abaya kuba neempawu. Ngamanye amaxesha iimpawu ziyavela kamva, emva kokuba isifo siqalile ukuchaphazela ukusebenza kwesibindi. Oku kunokubangela iziphumo ezahlukeneyo emzimbeni.

Ezinye zeempawu eziqhelekileyo zokuqala ziquka:

• Intlungu yesisu okanye ukungakhululeki.
• Ukudumba kwesisu ngenxa yokwanda kwesibindi.
• Ukudinwa .
• Intlungu yamalungu.
• Ukurhawuzelela kwesikhumba kuthetha ukurhawuzelelwa.
• I-acne.

Xa isibindi sakho siqala ukusebenza kakubi, inyongo ingaqokelelana egazini lakho. Oku kunokubangela iimpawu ezifana nezi:

• I-Jaundice ( ukutyheli kolusu namehlo).
• Umchamo onombala omnyama okanye indle enombala okhanyayo.
• Ukurhawuzelela (Pruritus) .
• Isicaphucaphu okanye ukungabi namdla wokutya.

Ezinye iziphumo ebezingalindelekanga zingabandakanya:

• I-spider angiomas (amabala abomvu eluswini afana neentambo zesigcawu) .
• Ukwanda kwemithambo ekwi-anus (varices) .
• Ukudumba okulula nokopha.
• Ukulahlekelwa yinyanga ukuya exesheni kwabasetyhini.
• Ukwanda kolwelo esiswini (ascites) okanye kwimilenze (edema) .
• Ukudideka, ukozela, okanye ukozela (i-hepatic encephalopathy) .

Zithini izizathu ze-autoimmune hepatitis?

Izifo ezibangelwa kukuzikhusela komzimba zenzeka xa inkqubo yakho yomzimba iphazama ezinye zeeseli zakho njengengozi. Nje ukuba inkqubo yomzimba yomzimba iqaphele olu "songelo," ihlasela ezo seli. Oku kubangela ukudumba okungapheliyo kwindawo ethile yomzimba. Kwi-hepatitis ye-autoimmune, inkqubo yomzimba yomzimba ithumela ii-antibodies ezithile ukuba zihlasele iintlobo ezithile zeeseli esibindini. Le yinkqubo enzima kakhulu.

Ingakanani iminyaka eqhelekileyo esi sifo siqala ngayo?

Akusoloko kusenzeka ukwazi ukuba i-hepatitis ye-autoimmune yaqala nini. Oku kungenxa yokuba akukho zimpawu zibonakalayo kwizigaba zokuqala. Uhlobo lwe-1 AIH ludla ngokufunyaniswa lukwiminyaka yokuqala ukuya kwephakathi, phakathi kweminyaka eli-15 nengama-40. Nangona kunjalo, lunokwenzeka nakweyiphi na iminyaka. Uhlobo lwe-2 AIH ludla ngokubonakala kwangethuba, ebuntwaneni, phakathi kweminyaka emi-4 neli-14. Nangona kunjalo, iimpawu ezinzima zesifo sesibindi zinokubakho.

I-hepatitis ye-autoimmune ikhula njani?

Kutheni abantu benesifo sokuzikhusela komzimba ngumbuzo onzima kakhulu. Akubonakali ngathi kukho unobangela omnye, kodwa kukho indibaniselwano yezinto.

• Impembelelo yemfuza: Kwezinye iimeko, iimfuza zakho zinokukwenza ube namathuba amaninzi okufumana izifo ezithile zokuzikhusela komzimba. Nangona kunjalo, ayinguye wonke umntu onezo mfuza oza kuphuhlisa esi sifo, kwaye ayinguye wonke umntu ofumana esi sifo oza kuba nazo ezo mfuza.
• Izinto ezisingqongileyo: Ezinye izinto ezingezizo ezemfuza, ezikwabizwa ngokuba "zizinto ezisingqongileyo," zinokuba negalelo koku. Ezi zinokuba yityhefu okanye iziganeko ezibeka uxinzelelo kwinkqubo yakho yokuzikhusela komzimba. Kwabanye abantu abasengozini, ezi zinto zinokubangela ukuba inkqubo yokuzikhusela yomzimba isabele ngokugqithisileyo, nto leyo ekhokelela kwisifo esingapheliyo sokuzikhusela komzimba.

Amayeza athile kunye nosulelo lweentsholongwane luchongiwe njengezinto ezibangela i-hepatitis ye-autoimmune. Kwakhona, ukuba sele unesinye isifo se-autoimmune, unamathuba amaninzi okuba ne-hepatitis ye-autoimmune.

Ziziphi iintsholongwane ezinokubangela i-hepatitis ye-autoimmune?

Usethubeni elikhulu lokufumana isifo sesibindi esizikhuselayo ukuba unembali yosulelo lwentsholongwane:

• I-hepatitis ebangelwa yintsholongwane (A, B, C, D okanye E).
• I-Mononucleosis (i-Mononucleosis - i-Epstein-Barr virus) .
• I-Maasles .
• I-Herpes .

Ngawaphi amayeza anokubangela i-hepatitis ye-autoimmune?

I-hepatitis ye-autoimmune ebangelwa ngamayeza iye yanxulunyaniswa nala mayeza:

• I-Nitrofurantoin ( yosulelo lomchamo).
• I-Minocycline ( yokuthintela i-acne).
• I-Atorvastatin ( kwi-cholesterol ephezulu).
• Isoniazid ( i-antibiotic).

Ziziphi ezinye izifo ezibangelwa kukungasebenzi komzimba ezinxulunyaniswa ne-hepatitis ye-autoimmune?

Abanye abantu baba ne-autoimmune hepatitis kunye nesinye isifo se-autoimmune esichaphazela imibhobho ye-bile. Umzekelo:

• I-Primary biliary cholangitis (PBC) .
• I-Primary sclerosing cholangitis (PSC) .

Oku kuthathwa njengohlobo "oluhlukeneyo" lwe-hepatitis ye-autoimmune.

Kodwa ngokubanzi, ukuba sele unesifo sokuzikhusela komzimba, unamathuba amaninzi okufumana esinye. Kubonakala ngathi ukudumba okungapheliyo kwindawo enye kunokubangela ukudumba kwenye indawo. Amathuba okufumana isifo sesibini sokuzikhusela komzimba amalunga nama-25%-50%. Ukuba i-hepatitis yokuzikhusela komzimba sisifo sakho sokuqala sokuzikhusela komzimba, unethuba elifanayo lokufumana esesibini.

Ezinye iimeko eziqhele ukubonwa nge-AIH ziquka:

• Isifo samangcwaba .
• Isifo seCeliac .
• Isifo samathumbu esibangela ukudumba .
• Irheumatoid arthritis.
• Uhlobo loku -1 lweswekile.
• I-Vitiligo ( amabala amhlophe eluswini).

Ngaba i-hepatitis ye-autoimmune iyasuleleka?

Hayi. I-hepatitis ebangelwa ziintsholongwane (ezifana ne-hepatitis A, B, kunye ne-C) inokubangelwa ziintsholongwane ezosulelayo. Ezi ntsholongwane zinokudluliselwa kwabanye. Nangona kunjalo, i-hepatitis ye-autoimmune ayilosulelo, ngoko ke ayosuleli kwabanye.

Ifunyanwa njani i-hepatitis ye-autoimmune?

Usenokuba uneempawu ezicacileyo ze-AIH okanye ungabi nazo. Ugqirha uza kuqala akuhlole ngokwasemzimbeni aze enze uvavanyo olusisiseko, olufana novavanyo lwemifanekiso kunye novavanyo lwegazi. Uvavanyo lwegazi olubizwa ngokuba yi-comprehensive metabolic panel lunokukhangela ubungqina besifo sesibindi. Olu vavanyo luquka uvavanyo oluninzi lomsebenzi wesibindi olulinganisa izinto ezifana namanqanaba e-enzyme yesibindi kunye nokuvuvukala.

Kodwa ezi mpawu azichanekanga kwi-hepatitis ye-autoimmune. Ugqirha wakho uza kwenza ezinye iimvavanyo zegazi ukukhangela iintsholongwane ezithile kunye nezinye izizathu ze-hepatitis. Baza kukhangela nee -autoantibodies . Nje ukuba bakhuphe ezinye izizathu kwaye bachonge ii-antibodies ezinxulumene ne-hepatitis ye-autoimmune, baya kuba bekulungele ukuqinisekisa ukuxilongwa. Eyona ndlela ilungileyo yokuqinisekisa oku kukwenza i-biopsy yesibindi . Oku kubandakanya ukuthatha iqhekeza elincinci lesicwili esibindini kwaye ulihlolisise phantsi kwe-microscope.

Ziziphi iindlela zonyango lwe-hepatitis ye-autoimmune?

Unyango oluqhelekileyo kukuqala ngeedosi eziphezulu ze-corticosteroids ukulawula ukudumba kunye nempendulo ye-autoimmune, uze unciphise kancinci idosi. I-Prednisone yeyona mayeza aqhelekileyo achazwe kwaye afundwe kakuhle kwi-hepatitis ye-autoimmune. Isebenza kakuhle kubantu abaninzi, kodwa inokubangela iziphumo ebezingalindelekanga. Amanye amayeza, anjenge -budesonide, abonakala engenazo iziphumo ebezingalindelekanga ezininzi.

Ugqirha wakho angakunika iyeza lokuthintela ukuvuvukala elibizwa ngokuba yi-azathioprine kunye nee-steroids.Iyeza linokumiselwa. Okanye linokumiselwa emva kokuba ugqibile unyango lwakho lwe-steroid. Ngenxa yokuba i-azathioprine ineziphumo ebezingalindelekanga ezimbalwa kune-steroids, isebenza kakuhle njengonyango lokugcina ixesha elide, oko kuthetha ukuba igcina amasosha omzimba wakho ukuba angasebenzi kakhulu kwakhona. Kusenokufuneka ulithathe rhoqo ebomini bakho.

Zithini iziphumo ebezingalindelekanga zale mithi?

Olu nyango lunokuba nemiphumo emibi. Yiyo loo nto ugqirha eza kukujonga rhoqo.

Iziphumo ebezingalindelekanga zokusetyenziswa ixesha elide kwee-steroids (ii-Corticosteroids):

• Ukwanda komnqweno wokutya kunye nokutyeba.
• Iingxaki zeemvakalelo ezifana nokuxhalaba kunye nokudakumba.
• I-Glaucoma ( ukubona okufipheleyo).
• I-Osteopenia okanye i-osteoporosis (ukuba buthathaka kwamathambo).
• Isifo seswekile .
• Igazi elonyukayo .

Iziphumo ebezingalindelekanga zokuthatha amayeza okunciphisa uxinzelelo lwegazi:

• Usulelo oluqhelekileyo (ngenxa yokuncipha kwenkqubo yomzimba yokuzikhusela).
• Isicaphucaphu nokuhlanza.
• Ukurhawuzelela kwesikhumba (ukurhawuzelela).
• Ukudumba okulula nokopha.
• Ukungasebenzi kakuhle kwezintso.
• I-Pancreatitis .

Ngelixa usebenzisa la mayeza, ugqirha wakho uza kukujonga ukuba awunazo iziphumo ebezingalindelekanga. Ukuba iziphumo ebezingalindelekanga zamayeza akho zinzima kakhulu, okanye ukuba akakuncedi ngokwaneleyo, uza kucebisa enye indlela. Ungoyiki ukuthetha ngayo yonke le nto nogqirha wakho.

Kuthatha ixesha elingakanani ukuba unyango lusebenze?

Injongo yamayeza kukubuyisela isifo esiqhelekileyo . Kusenokufuneka uthathe amayeza kangangeenyanga eziliqela ukuya kwiminyaka eliqela ukuze ufezekise oku. Ngeli xesha, ugqirha wakho uza kujonga isibindi sakho rhoqo ukuqinisekisa ukuba unyango luyasebenza. Uvavanyo lokusebenza kwesibindi luya kubonisa ukuba amanqanaba eeenzyme zesibindi sakho abuyela kancinci kancinci kwisiqhelo. Ukuxolelwa kuthetha ukuba zonke iimpawu zesifo ziphelile.

I-American Association for the Study of Liver Diseases (AASLD) icebisa ukuba uthathe ii-steroids ubuncinane iminyaka emithathu ngaphambi kokuba uyeke amayeza. Emva kokuba ubusele uphilile ubuncinane iminyaka emibini, baya kuqwalasela ukuyeka amayeza okunciphisa amasosha omzimba. Emva kokuyeka amayeza, malunga nama-50% abantu banokubuyela umva kwisithuba seenyanga ezintathu. Kwabanye, kungathatha iminyaka, okanye basenokungaphindi babuyele umva kwaphela.

Abanye abantu bafumana uphuculo oluthile ngonyango, kodwa akwanelanga ukuba babuyele esiqhelweni. Kwimeko enjalo, ugqirha wakho uza kuzama amanye amayeza. Abanye abantu abasabeli kunyango konke konke. Kwimeko enjalo, indlela esi sifo siqhubeka ngayo. Aba bantu banokuba neengxaki ezifuna unyango olongezelelweyo. Ekugqibeleni basenokugula.Kusenokufuneka ukuba kufakwe isibindi.

Ngaba i-hepatitis ye-autoimmune inokunyangwa ngokupheleleyo?

Hayi. Ayinakuphiliswa ngokupheleleyo. Kodwa isifo sinokubuyiselwa kwimeko yesiqhelo. Oku kuthetha ukuba inkqubo yokudumba iyaphela okwethutyana, ngamanye amaxesha ixesha elide. Kodwa emva kokuba uyekile unyango, ingabuya. Oku kubizwa ngokuba kukubuyela umva . Uninzi lwabantu abayeka ukuthatha amayeza (malunga nama-80%) ekugqibeleni babuya isifo kwaye kufuneka baqale ukuthatha amayeza kwakhona. Amayeza adla ngokulawula isifo kakuhle, kodwa kunokufuneka uwathathe amaxesha ngamaxesha ubomi bakho bonke.

Ingakanani imilinganiselo yobomi obuqhelekileyo xa umntu ene-hepatitis ye-autoimmune?

Ngaphandle konyango, izinga lokusinda leminyaka emihlanu liyi-50%. Kodwa ngonyango, izinga lokusinda kweminyaka eli-10 liyi-90% kwaye izinga lokusinda kweminyaka engama-20 liyi-70%. Nokuba unyango luqhubeka, malunga ne-15% yabantu ekugqibeleni baba ne-cirrhosis, ngesiqhelo emva kweminyaka eli-10 ukuya kwengama-20. Oku kunokwenzeka ukuba unyango aluphumeleli, ukuba akukho mpendulo ingaphelelanga kunyango, okanye ukuba isifo siphinda sibuye amaxesha amaninzi. Xa isifo siphinda sibuye, sinokubuya ngokukhawuleza.

Ndingazinyamekela njani xa ndiphila ne-autoimmune hepatitis?

Le yingxaki ebaluleke kakhulu. Kukho izinto onokuzenza ukuze ulawule esi sifo kwaye uphile ubomi obusempilweni.

• Ungaphoswa kukubonana nogqirha wakho. Ugqirha wakho kuya kufuneka ajonge isibindi sakho ubomi bakho bonke. Nokuba sele uphilile ixesha elide, isifo sinokubuya ngaphandle kwesilumkiso okanye iimpawu ezibonakalayo. Ugqirha wakho unokujonga ubungakanani be- fibrosis (umonakalo ngaphambi kokuba ube namanxeba) kwisibindi sakho esebenzisa iindlela ezingangenisi gazi ezifana ne -elastography . Ukuba uqala ukufumana iimpawu kwakhona, nxibelelana nogqirha wakho ngoko nangoko.
• Lumka ukutya kwakho. Ukutya okunempilo kubalulekile kuye nabani na onesifo sesibindi. Ingakumbi kwi-AIH, uphando lubonise ukuba malunga nama-30% abantu baneempawu zesifo sesibindi esinamafutha angenatywala . Oku kuthetha ukuba umzimba wakho unomdla wokugcina amafutha angaphezulu esibindini, nto leyo enye imbangela yokudumba. Ungayilwa le nto ngokugcina ubunzima obusempilweni kunye nokunciphisa iswekile kunye namafutha agcweleyo ekutyeni kwakho. Oku kunokunceda ukuphucula iziphumo zonyango lwakho.
• Khusela amasosha omzimba wakho. Amayeza esifo sesibindi kunye namayeza okunciphisa amasosha omzimba awenza buthathaka amasosha omzimba wakho. Oko kuthetha ukuba kufuneka uzinyamekele kakuhle ukuze ungaguli. Ugqirha wakho unokucebisa izongezo ezithile zeevithamini kunye neegonyo zokukhusela kwiintsholongwane. Musa ukuthatha naziphi na izongezo ezingavunywanga ngugqirha wakho.
• Kuphephe utywala. Ukusela utywala kuyenza buthathaka inkqubo yakho yokuzikhusela komzimba kwaye konakalisa isibindi sakho.

I-Autoimmune hepatitis sisifo esibi kakhulu, kodwa abantu abaninzi basabela kakuhle kunyango. Esi sifo sinokuphela, siphele phantse siphele ixesha elide. Ukuba sibuya, unyango olufanayo lungasetyenziswa kwakhona. Unyango lunokuba nemiphumo emibi, kodwa ngokunyamekela ukutya kwakho kunye nenkqubo yomzimba yokuzikhusela, ungaphila ubomi obuqhelekileyo. Ukuba unyango alusebenzi, ukufakelwa isibindi lukhetho.

Izinto ekufuneka uzikhumbule kweli nqaku (Umyalezo Wokuya Ekhaya)

Kulungile, ngoko ke, ngokwezinto esithethe ngazo, ezi zezona zinto zibalulekileyo ekufuneka uzikhumbule:

• I-Autoimmune hepatitis sisifo esingapheliyo apho inkqubo yakho yomzimba yokuzikhusela ihlasela isibindi sakho.
• Esi asisosifo esosulelayo.
• Kusenokungabikho zimpawu kwizigaba zokuqala, kodwa iimpawu ezifana nokudinwa, ukungonwabi esiswini, kunye ne-jaundice zinokubonakala.
• Uvavanyo lwegazi kunye ne-biopsy yesibindi kunokufuneka ukuze kufunyanwe isifo esichanekileyo.
• Unyango (ii-steroids, ii-immunosuppressants) lunokubangela ukuba isifo siphinde siphele. Nangona kunjalo, akukho nyango lupheleleyo, kwaye ukuphinda ubuye kusenokwenzeka.
• Unyango lunokuba nemiphumo emibi, ngoko ke ulwalathiso lwezonyango lubalulekile.
• Indlela yokuphila esempilweni (ukutya okunempilo, ukuphepha utywala, ukulandela iingcebiso zonyango) kubaluleke kakhulu ekulawuleni esi sifo.
• Musa ukoyika. Ungaphila ubomi obumnandi nangona unesi sifo. Xoxa ngayo yonke into nogqirha wakho kwaye ulandele icebiso lakhe.

Ukuba uneminye imibuzo malunga noku, qiniseka ukuba ubuza ugqirha wakho. Ndikunqwenelela impilo ekhawulezileyo!

Isifo sesibindi , i-hepatitis ye-autoimmune, inkqubo yomzimba yokuzikhusela, ukudumba kwesibindi, isifo sesibindi, izifo ze-autoimmune, unyango lwesibindi