Izintso zezinye zezona zitho zibalulekileyo emzimbeni wethu. Kodwa ngamanye amaxesha, utshintsho kwinkqubo yethu yokuzikhusela komzimba lunokonakalisa izintso. Enye yezi meko yi-primary immunoglobulin A nephropathy, okanye i-
IgA nephropathy. Kule meko, i-antibody ebizwa ngokuba yi-IgA iqokelelana kwizintso, nto leyo ebangela ukuba zidumbe kwaye zingasebenzi kakuhle. Namhlanje, siza kuthetha ngesi sifo kunye neyeza elikhethekileyo elibizwa ngokuba yiTarpeyo elinikwa sona.
Isebenza njani iyeza iTarpeyo?
Ngamafutshane, i-IgA Nephropathy iqala xa umzimba wethu uqala ukuvelisa ii-antibodies ezingaqhelekanga ze-IgA (IgA1). Ngokwesiqhelo, ii-antibodies zifana nabalindi benkqubo yethu yokuzikhusela. Zisikhusela kwizinto ezifana neebhaktheriya kunye neentsholongwane. Kodwa kwesi sifo, kukho isiphene esincinci kwi-antibodies ze-IgA eziveliswayo. Ezi antibodies zineempazamo zinamathelana kwaye zenze ii-clumps ezinkulu. Inkqubo yethu yokuzikhusela ijonga ezi clumps ngokungathi zilutshaba. Ngoko ke, inkqubo yokuzikhusela iqala ukulwa nezi clumps. Le mfazwe yenzeka ngaphakathi kwezintso. Oku kubangela
ukudumba kwiiyunithi zokucoca ezithambileyo ngaphakathi kwezintso, ezibizwa ngokuba yi-glomeruli. Ekuhambeni kwexesha, oku
kudumba kubangela amanxeba kwezo ndawo kwaye konakalisa izintso.
Lo monakalo ubangela ukuba izintso zingakwazi ukucoca igazi kunye nenkunkuma ngendlela efanelekileyo. Oku kubangela ukuba igazi kunye neproteni zidlule kumchamo okungafanele ukuba zikhutshwe rhoqo. Ukuba lo monakalo uyaqhubeka, izintso zisenokungasebenzi kakuhle kwaye zifune i-dialysis okanye ukufakelwa izintso.
Umntu onesi sifo usenokungaziva engonwabanga kangako ekuqaleni. Nangona kunjalo, ekuhambeni kwexesha, ezi mpawu zinokuvela ngenxa yomonakalo kwizintso.
| Uphawu | Inkcazo |
|---|
| Igazi kumchamo | Umchamo ungabonakala upinki okanye ubomvu. |
| Umchamo ophuma ugwebu | Oku kwenzeka kuba kukho iproteni eyongezelelweyo kumchamo. |
| Ukudumba komzimba | Izandla, iinyawo, amaqatha, nobuso zinokudumba, ingakumbi kusasa. |
| Igazi elonyukayo | Igazi elonyukayo. |
| Ukudinwa nokudinwa | Ndiziva ndidiniwe ngalo lonke ixesha. |
| Intlungu yesisu esisezantsi | Intlungu emqolo ongezantsi. |
Oogqirha badla ngokunyanga esi sifo ngokulawula iimpawu ezifana noxinzelelo lwegazi oluphezulu kunye nokunika amayeza alawula inkqubo yomzimba yokuzikhusela. Oku kuquka amayeza afana ne-immunosuppressants kunye ne-corticosteroids. Nangona kunjalo, la mayeza aqhelekileyo anokuba nemiphumo emibi emininzi engafunekiyo xa ethathwa ixesha elide. Kulapho ke iyeza
iTarpeyo lingena khona. I-Tarpeyo ikwayi-corticosteroid, kodwa ubuchule
bayo kukuba iya kwindawo apho kuveliswa khona ii-antibodies
ze-IgA ezinengxaki. Ii-antibodies ziveliswa kwinxalenye ethile yamathumbu ethu ebizwa ngokuba yi-ileum. I-Tarpeyo iya ngqo apho kwaye inciphisa ukuveliswa kwale IgA1 engalunganga. Ke ngoko, ukudumba kunye nomonakalo kwizintso kuyancitshiswa, kwaye iziphumo ebezingalindelekanga zexesha elide zamayeza aqhelekileyo e-steroid nazo ziyancitshiswa.
Ndingayisebenzisa njani le yeza?
I-Tarpeyo liyeza eliza likwimo ye-capsule. Lifanele lithathwe
qho kusasa, ubuncinane iyure ngaphambi kokutya .
- Musa ukuphula, ukuhlafuna, okanye ukutyumza iyeza. Lifanele liginywe lilonke.
- Musa ukutya i-grapefruit okanye usele ijusi ye-grapefruit ngelixa usebenzisa eli yeza. Siza kuthetha ngesizathu salo kamva.
Kubaluleke kakhulu: Musa ukuyeka ukuthatha eli yeza ngaphandle kokuthetha nogqirha wakho. Xa uqhubeka nokuthatha ii-corticosteroids ezifana neTarpeyo, umzimba wakho uyayeka ukuvelisa ii-hormone ze-steroid eziveliswa ngokwemvelo. Ukuba uyeka ukuthatha eli yeza ngequbuliso, umzimba wakho uya kulahlekelwa yi-steroids oyidingayo kwaye unokufumana iimpawu zokurhoxa. Umzekelo, unokufumana ukudinwa okukhulu, iintlungu zomzimba, isicaphucaphu, uxinzelelo lwegazi oluphantsi, kunye nentloko ebuhlungu. Ke ngoko, ukuba uyeka ukusebenzisa eli yeza, kufuneka wenze njalo
kancinci kancinci ngokunciphisa idosi (ukunciphisa umthamo) . Ugqirha wakho uya kukuxelela indlela echanekileyo yokwenza oku.
Ziye zafundwa njani iingenelo zale mithi?
Kwisifundo esikhulu sokubona ukhuseleko nokusebenza kakuhle kweTarpeyo, ithelekiswe ne-placebo. I-placebo yipilisi yobuxoki engenalo iyeza. Oku kukubona ukuba yintoni umahluko phakathi kwabantu abathathe iyeza lokwenyani kunye nabo bathathe ipilisi yobuxoki. Bonke abathathi-nxaxheba kolu phononongo babene-IgA nephropathy kwaye babeneproteni eyongezelelweyo kumchamo wabo. Bonke babethatha amayeza oxinzelelo lwegazi, anjenge-ACE inhibitors okanye ii-ARB, ezinciphisa uxinzelelo kwizintso. Abathathi-nxaxheba bakhethwa ngokusekelwe kwiindlela ezimbini:
- Umlinganiselo weproteni yomchamo ukuya kwi-creatinine (UPCR): Oku kulinganisa ukuba ingakanani iproteni ekhutshwayo kumchamo kwiiyure ezingama-24.
- Izinga lokuhluza eliqikelelweyo le-glomerular (eGFR): Oku kulinganisa indlela ezisebenza kakuhle ngayo izintso zakho kunye nendlela ezihluza ngayo inkunkuma. Abantu abakolu phando babeneengxaki zokusebenza kwezintso ezincinci ukuya kweziphakathi.
Kolu phononongo, elinye iqela lanikwa iTarpeyo iinyanga ezili-9, kwaye elinye iqela lanikwa i-placebo. Emva kweenyanga ezili-9, unyango lwayekiswa baza bajongwa ezinye iinyanga ezili-15.
Ziziphi iingenelo ezibonisiweyo kwizifundo?
Olu phononongo lubonise ukuba abantu abathathe iTarpeyo babenomonakalo omncinci kakhulu kwizintso kunabo bathathe i-placebo. Le nzuzo yaqhubeka emva kweenyanga ezili-9 bethatha eli yeza.
Ukwehla kwamanqanaba eeprotheyini kumchamo
Ekupheleni kweenyanga ezili-9, amanqanaba eeprotheyini kumchamo wabo bathatha iTarpeyo ehle ngama-35%, xa kuthelekiswa nama-5% kuphela kwabo bathatha i-placebo. Olu nciphiso lugcinwe iinyanga ezingama-24.
| Ixesha | I-Tarpeyo (ukwehla kwe-% kwi-UPCR) | I-Placebo (ukwehla kwe-% kwi-UPCR) |
|---|
| Iinyanga ezi-3 | 5% | 4% |
| Iinyanga ezi-6 | 24% | 8% |
| Iinyanga ezi-9 | 35% | 5% |
| Iinyanga ezingama-24 | 34% | 4% |
Umsebenzi wezintso (eGFR)
Ekupheleni kweenyanga ezingama-24, abo bathathe iTarpeyo babenokwehla okuncinci kakhulu ekusebenzeni kwezintso kunabo bathathe i-placebo. Ixabiso elihle (+) lithetha ukuba ukusebenza kwezintso kuphucukile, kwaye ixabiso elibi (-) lithetha ukuba kuphucukile.
| Ixesha | I-Tarpeyo (umahluko we-eGFR) | I-Placebo (umahluko we-eGFR) |
|---|
| Iinyanga ezi-9 | + 1.5 mL/min/1.73 m2 | - 4.0 mL/umzuzu/1.73 m2 |
| Iinyanga ezingama-24 | - 5.3 mL/ngomzuzu/1.73 m2 | - 11.2 mL/ngomzuzu/1.73 m2 |
Olu phononongo lubonise ukuba ukuthatha iTarpeyo kangangeenyanga ezili-9 kunokucothisa umonakalo kwizintso. Oku kunokunceda ukulawula iimpawu kunye nokulibazisa ukungasebenzi kakuhle kwezintso. Kodwa khumbula ukuba ezi ziphumo zinokuhluka kumntu nomntu.
Ungayithintela kwaye uyilawule njani imiphumo emibi?
I-Tarpeyo liyeza elithintela amajoni omzimba, ngoko ke
unamathuba amaninzi okufumana usulelo. Unokufumana umkhuhlane, umkhuhlane, kunye nosulelo lomchamo rhoqo. Hlala kude nabantu abanezifo ezisulelayo ezifana ne-chickenpox kunye ne-masisi. Eyona ndlela ilungileyo yokuthintela usulelo kukuhlamba izandla zakho rhoqo kwaye uhlale kude nabantu abagulayo. Thetha nogqirha wakho malunga nokufumana ugonyo. Fowunela ugqirha wakho ngoko nangoko ukuba unezinye zezi mpawu zosulelo:
- Umkhuhlane okanye ukubanda
- Intlungu yomzimba
- Ukukhwehlela
- Ukudinwa kakhulu
- Intloko ebuhlungu engapheliyo
- Utshintsho lombono okanye ukulahleka kwenkumbulo
- Isibetho esibuhlungu
I-Tarpeyo inokubangela
ukudumba okanye uxinzelelo lwegazi oluphezulu . Thetha nogqirha wakho ngendlela yokuphila enempilo, kuquka ukutya kunye nokuzilolonga. Ukunciphisa ityuwa ekutyeni kwakho, ukusela amanzi amaninzi, kunye nokwenza umthambo olula njengokuhamba kunokunceda ukunciphisa ukudumba kunye nokulawula uxinzelelo lwegazi. Ezinye iziphumo eziqhelekileyo ziquka
isicaphucaphu, ukudumba kwesisu, ukuqaqamba kwemisipha, amaqhakuva, kunye nentloko ebuhlungu . Ukuba une-acne, landela inkqubo elungileyo yokhathalelo lolusu, njengezicoci ezithambileyo kunye nezithambisa ezingenamafutha. Ezi azizo zonke iziphumo ebezingalindelekanga. Ukuba uneempawu ezikukhathazayo, thetha nogqirha wakho ngazo.
Zeziphi iimvavanyo ekufuneka zenziwe ngelixa usela amayeza?
Ugqirha wakho uza kuyalela iimvavanyo ezahlukeneyo ukuze abone ukuba umzimba wakho usabela njani kumayeza. Nazi ezona ziphambili:
- Uvavanyo loxinzelelo lwegazi
- Uvavanyo lomchamo ukujonga ubungakanani beproteni kumchamo
- Uvavanyo lwegazi ukujonga ukusebenza kwezintso
- Uvavanyo lwegazi lwentsholongwane ye-hepatitis B
Ziziphi ezinye izinto ezinokusebenzisana nale mithi?
Amanye amayeza nokutya kunokuchaphazela indlela esebenza ngayo iTarpeyo. Ngoko ke, kubaluleke kakhulu ukuxelela ugqirha wakho
ngawo onke amayeza owasebenzisayo (kuquka iivithamini kunye neemveliso zezityalo) . Lumka ngakumbi ngezi zinto zilandelayo:
- Amanye amayeza okulwa nentsholongwane kunye namayeza okubulala iintsholongwane (umz., i-clarithromycin (Biaxin), i-itraconazole (Sporanox), i-ketoconazole (Nizoral))
- Amanye amayeza asetyenziselwa i-HIV
- Ijusi yegrapefruit okanye igrapefruit
Olu luhlu aluphelelanga, ngoko qiniseka ukuba uxelela ugqirha wakho ngayo yonke into oyithathayo.
Fumana indlela onokulifumana ngayo eli yeza.
ITarpeyo liyeza elikhethekileyo. Oku kuthetha ukuba libiza kakhulu kwaye lisetyenziselwa iimeko ezithile zonyango. Ngenxa yoko, lisenokungafumaneki kuzo zonke iikhemesti. Ngokwesiqhelo, olu hlobo lwamayeza lufumaneka kwiikhemesti zesibhedlele okanye kwiikhemesti ezikhethekileyo. Ugqirha wakho uya kukhokela kwinkqubo yokufumana eli yeza kunye nendawo yokulifumana.
Umyalezo Wokuya Ekhaya
- I-IgA Nephropathy sisifo apho inkqubo yakho yomzimba yokuzikhusela yonakalisa izintso zakho.
- I-Tarpeyo lunyango olujoliswe kulo olunciphisa ukuveliswa kwee-antibodies ze-IgA ezingalunganga ezibangela esi sifo.
- Sela eli yeza kanye njengoko ugqirha wakho ekuyalele. Ungaze uyeke ukulisela okanye utshintshe umthamo ngaphandle kokubonisana nogqirha wakho.
- Lumka ngomngcipheko wokosuleleka. Ukuba ubonakalisa iimpawu ezifana nomkhuhlane nokukhwehlela, funa ingcebiso kagqirha ngoko nangoko.
- Hlala unxibelelana rhoqo nogqirha wakho kwaye wenze uvavanyo olufunekayo ngexesha.
- Kubalulekile ukwazisa ugqirha wakho malunga neminye imithi, iivithamini, okanye iimveliso ze-Ayurvedic/herbal ozisebenzisayo.
I-IgA nephropathy, iTarpeyo, isifo sezintso, iiproteni kumchamo, i-eGFR, i-corticosteroid, inkqubo yomzimba yokuzikhusela
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