Uma umzimba wakho uhlasela isibindi sakho? Ake sixoxe ngesifo sofuba esibangelwa ukuzivikela komzimba.

Wake wacabanga ukuthi uhlelo lokuzivikela lomzimba wakho, uhlelo lokuzivikela komzimba, luzoqala ukuhlasela isibindi sakho? Kuyamangaza, akunjalo? Kodwa, i-hepatitis yokuzivikela komzimba iyisimo esinjalo kanye. Nakuba lokhu kungase kubonakale kuyinkimbinkimbi kancane, ake sixoxe ngakho kalula, ngendlela ongayiqonda.

Kuyini i-hepatitis ye-autoimmune?

Kalula nje, i-hepatitis ye-autoimmune yisifo sesikhathi eside esithinta isibindi sakho. Siqala ngephutha elincane ohlelweni lokuzivikela lomzimba wakho, uhlelo lokuzivikela . Cabanga ngale ndlela: uhlelo lwethu lokuzivikela lufana nebutho elivikela izwe lethu. Umsebenzi walo ukulwa nabahlaseli bangaphandle njengamagciwane namagciwane. Kodwa, ku-hepatitis ye-autoimmune, leli butho, uhlelo lokuzivikela, licabanga ngephutha ukuthi amangqamuzana alo esibindi anempilo ayizitha bese liqala ukuwahlasela.

Uma amasosha omzimba ehlasela izicubu zesibindi ngale ndlela, kubangela ukuvuvukala kwesibindi, noma i-hepatitis. Njengoba lokhu kuhlasela kuqhubeka, lokhu kuvuvukala kuba okungapheli. Ngokuhamba kwesikhathi, lokhu kuvuvukala okungapheli kungabangela umonakalo omkhulu esibindini. Ngokukhethekile, izicubu zesibindi ziba nezibazi futhi isibindi singase sihluleke kancane kancane. Lokhu kubizwa ngokuthi i-cirrhosis .

Izindaba ezinhle ukuthi ukwelashwa kunganciphisa ukuvuvukala kwesibindi futhi kuvimbele izinkinga ezibangelwa yilesi sifo. Kodwa-ke, ngezinye izikhathi ungase ungabi nazimpawu ezigabeni zokuqala zalesi sifo.

Yiziphi izinhlobo eziyinhloko ze-hepatitis ye-autoimmune?

Kunezinhlobo ezimbili eziyinhloko ze-autoimmune hepatitis (AIH). Lezi zihlukaniswa ngokuba khona kwama -autoantibodies ahlukene, ososayensi bethu abangawathola ngokuhlolwa kwama-antibody . Lawa ma-antibodies ahlukene ahlasela izinhlobo ezahlukene zamaseli esibindini.

Uhlobo 1

Lolu uhlobo "olujwayelekile", futhi luwuhlobo oluvame kakhulu. Cishe ama-80% eziguli ezitholakale zinalolu hlobo. Lungakhula kunoma yimuphi ubudala. Ku-hepatitis yohlobo 1 yokuzivikela komzimba, ama-antibodies abizwa ngokuthi i-ASMA (ama-anti-smooth muscle antibodies) ahlasela amaseli emisipha ebushelelezi esibindini. Lesi simo sohlobo 1 ngezinye izikhathi sibizwa ngokuthi "i-lupoid hepatitis" ngoba izimpawu zaso zifana neze- Systemic Lupus Erythematosus . Kodwa-ke, ukuhlolwa kwegazi kwe-ASMA kungasiza ukuhlukanisa phakathi kwezifo ezimbili.

Uhlobo 2

I-hepatitis yohlobo lwesibili yokuzivikela komzimba iwuhlobo olungavamile nolunzima kakhulu lwe-hepatitis. Ivame ukuvela kusenesikhathi, ebuntwaneni. Ingaqhubeka ngokushesha kakhulu kunohlobo 1. Lolu hlobo lubangelwa ama-anti-LKM-1 (ama-anti-liver-kidney microsome type 1 antibodies) nomaAma-antibodies ahilelekile abizwa ngokuthi i-anti-LC1 (ama-anti-liver cytosol type 1 antibodies) . Ama-anti-LKM-1 antibodies ahlose iphrotheni ebizwa ngokuthi i-cytochrome P450-2D6 (CYP2D6) emaseli esibindi. I-Anti-LC1 iyi-antibody yesibindi eqondene ne-AIH yohlobo lwesibili.

Kungavamile kangakanani ukuba nesifo sofuba esibangelwa ukuzivikela komzimba?

I-hepatitis ye-autoimmune ayisona isifo esivame kakhulu. Akukacaci ukuthi bangaki abantu abanaso. Ngokusho kwezifundo zaseYurophu, lesi sifo sithinta phakathi kuka-0.010% no-0.025% wabantu baseYurophu. Nakuba singathinta noma yiluphi uhlanga noma iqembu lobuzwe, sivame kakhulu phakathi kwabantu base-Alaska (cishe u-0.043% walabo bantu). Sivame kakhulu kwabesifazane kunakwabesilisa, ngesilinganiso esingu-4:1.

Ziyini izimpawu?

Akuwona wonke umuntu one-hepatitis yokuzivikela komzimba ozoba nezimpawu. Ngezinye izikhathi izimpawu zivela kamuva, ngemva kokuba lesi sifo sesiqalile ukuthinta ukusebenza kwesibindi. Lokhu kungabangela imiphumela emibi ehlukahlukene emzimbeni.

Ezinye izimpawu zokuqala ezivamile zifaka:

• Ubuhlungu besisu noma ukungakhululeki.
• Ukuvuvukala kwesisu ngenxa yokukhula kwesibindi.
• Ukukhathala .
• Ubuhlungu bamalunga.
• Ukuqubuka kwesikhumba kusho ukucasuka.
• Induna.

Uma isibindi sakho siqala ukusebenza kabi, inyongo inganqwabelana egazini lakho. Lokhu kungabangela izimpawu ezifana nalezi:

• I-jaundice ( ukuphuzi kwesikhumba namehlo).
• Umchamo omnyama noma indle enombala okhanyayo.
• Ukuluma (Pruritus) .
• Ukucanuzela noma ukuphelelwa yisifiso sokudla.

Eminye imiphumela emibi ebambezelekile ingafaka:

• Ama-spider angioma (amabala abomvu esikhumbeni afana ne-spider webs) .
• Ukwanda kwemithambo e-anus (varices) .
• Ukuphuka kalula nokopha.
• Ukulahlekelwa ukuya esikhathini kwanyanga zonke kwabesifazane.
• Ukwakheka koketshezi esiswini (ama-ascites) noma emalungeni (i-edema) .
• Ukudideka, ukozela, noma ukozela (i-hepatic encephalopathy) .

Yiziphi izimbangela ze-hepatitis ye-autoimmune?

Izifo zokuzivikela komzimba zenzeka lapho isimiso sakho somzimba sokuzivikela siphatha kabi amanye amangqamuzana akho njengosongo. Uma isimiso somzimba sokuzivikela somzimba sesiqaphela lolu "songo," sihlasela lawo maseli. Lokhu kubangela ukuvuvukala okungapheli engxenyeni ethile yomzimba. Ku-hepatitis yokuzivikela komzimba, isimiso somzimba sokuzivikela komzimba sithumela ama-antibodies athile ukuhlasela izinhlobo ezithile zamangqamuzana esibindini. Empeleni lena inqubo eyinkimbinkimbi kakhulu.

Ingakanani iminyaka evamile lapho lesi sifo siqala khona?

Akunakwenzeka njalo ukwazi ukuthi i-hepatitis ye-autoimmune yaqala nini. Lokhu kungenxa yokuthi ngokuvamile azikho izimpawu ezigabeni zokuqala. Uhlobo 1 lwe-AIH luvame ukutholakala kakhulu ekuqaleni kuya eminyakeni ephakathi, phakathi kweminyaka eyi-15 neyi-40. Kodwa-ke, lungenzeka kunoma yimuphi ubudala. Uhlobo 2 lwe-AIH luvame ukuvela ngisho nangaphambi kwesikhathi, ebuntwaneni, phakathi kweminyaka eyi-4 neyi-14. Ngisho nalapho, izimpawu ezinzima zesifo sesibindi zingase zibe khona.

I-hepatitis ye-autoimmune ikhula kanjani?

Kungani abantu beba nezifo zokuzivikela komzimba kungumbuzo oyinkimbinkimbi ngempela. Kubonakala sengathi akukho imbangela eyodwa, kodwa kunenhlanganisela yezici.

• Ithonya lezakhi zofuzo: Kwezinye izimo, izakhi zofuzo zakho zingakwenza ube namathuba amaningi okuthola izifo ezithile zokuzivikela komzimba. Kodwa-ke, akuwona wonke umuntu onalezo zakhi zofuzo ozokuthola lesi sifo, futhi akuwona wonke umuntu othola lesi sifo ozoba nalezo zakhi zofuzo.
• Izici Zemvelo: Ezinye izici ezingezona ezezakhi zofuzo, ezibizwa nangokuthi "izici zemvelo," zingaba nomthelela kulokhu. Lokhu kungaba ubuthi noma izehlakalo ezibeka ingcindezi ohlelweni lwakho lokuzivikela komzimba. Kwabanye abantu abasengozini, lezi zici zingabangela ukuthi uhlelo lokuzivikela komzimba lusabele ngokweqile, okuholela esifweni esingamahlalakhona sokuzivikela komzimba.

Imithi ethile kanye nokutheleleka ngamagciwane kuye kwabonakala njengezimbangela ze-hepatitis ye-autoimmune. Futhi, uma usuvele unesinye isifo se-autoimmune, kungenzeka kakhulu ukuthi ube ne-hepatitis ye-autoimmune.

Yimaphi amagciwane angabangela i-hepatitis ye-autoimmune?

Kungenzeka kakhulu ukuthi ube nesifo sofuba esihlasela amasosha omzimba uma unomlando walezi zifo ezibangelwa amagciwane:

• I-hepatitis ebangelwa yigciwane (A, B, C, D noma E).
• I-Mononucleosis (i-Mononucleosis - igciwane le-Epstein-Barr) .
• Isimungumungwane .
• I-Herpes .

Yimiphi imithi engabangela i-hepatitis ye-autoimmune?

I-hepatitis yokuzivikela komzimba ebangelwa izidakamizwa iye yahlotshaniswa nale mithi:

• I-Nitrofurantoin ( yezifo zomgudu womchamo).
• I-Minocycline ( ye-acne).
• I-Atorvastatin ( ye-cholesterol ephezulu).
• I-Isoniazid ( i-antibiotic).

Yiziphi ezinye izifo ezibangelwa ukuzivikela komzimba ezihlotshaniswa ne-hepatitis ebangelwa ukuzivikela komzimba?

Abanye abantu bahlushwa yi-hepatitis yokuzivikela komzimba kanye nesinye isifo sokuzivikela komzimba esithinta imigudu yabo ye-bile. Isibonelo:

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

Lokhu kubhekwa "njengohlobo oluhlukile" lwe-hepatitis yokuzivikela komzimba.

Kodwa ngokuvamile, uma usuvele unesifo sokuzivikela komzimba, kungenzeka kakhulu ukuthi uthole esinye. Kubonakala sengathi ukuvuvukala okungapheli endaweni eyodwa kungabangela ukuvuvukala kwenye indawo. Amathuba okuthola isifo sesibili sokuzivikela komzimba cishe angama-25%-50%. Uma i-hepatitis yokuzivikela komzimba iyisifo sakho sokuqala sokuzivikela komzimba, unethuba elifanayo lokuthola esesibili.

Ezinye izimo ezivame ukubonakala nge-AIH zifaka:

• Isifo samathuna .
• Isifo se-Celiac .
• Isifo samathumbu esivuvukalayo .
• Isifo samathambo esibizwa nge-rheumatoid arthritis.
• Isifo sikashukela sohlobo 1.
• I-Vitiligo ( amabala amhlophe esikhumbeni).

Ingabe i-hepatitis ye-autoimmune iyathelelana?

Cha. I-hepatitis ebangelwa yigciwane (njenge-hepatitis A, B, kanye ne-C) ingabangelwa amagciwane athelelekayo. Lokhu kutheleleka kungadluliselwa kwabanye. Kodwa-ke, i-hepatitis ebangelwa yi-autoimmune akuyona igciwane, ngakho ayitheleleki kwabanye.

I-hepatitis ye-autoimmune ihlolwa kanjani?

Ungase ube nezimpawu ezicacile ze-AIH noma ungabi nazo. Udokotela uzokuhlola ngokomzimba kuqala bese enza izivivinyo eziyisisekelo, njengokuhlolwa kwezithombe nokuhlolwa kwegazi. Ukuhlolwa kwegazi okubizwa ngokuthi iphaneli ephelele ye-metabolic kungabheka ubufakazi besifo sesibindi. Leli phaneli lihlanganisa izivivinyo eziningana zokusebenza kwesibindi ezilinganisa izinto ezifana namazinga e-enzyme yesibindi nokuvuvukala.

Kodwa lezi zinkomba aziqondile ku-hepatitis ye-autoimmune. Udokotela wakho uzokwenza ezinye izivivinyo zegazi ukuze abheke amagciwane athile kanye nezinye izimbangela ze-hepatitis. Bazobheka nama -autoantibodies . Uma sebezisusile ezinye izimbangela futhi bathole ama-antibodies ahlobene ne-hepatitis ye-autoimmune, bazobe sebekulungele ukuqinisekisa ukuxilongwa. Indlela engcono kakhulu yokuqinisekisa lokhu ukwenza i-biopsy yesibindi . Lokhu kuhilela ukuthatha ingxenye encane yezicubu esibindini bese uyihlola ngaphansi kwe-microscope.

Yiziphi izindlela zokwelapha i-hepatitis ye-autoimmune?

Ukwelashwa okujwayelekile ukuqala ngemithamo ephezulu ye-corticosteroids ukulawula ukuvuvukala kanye nokusabela kwe-autoimmune, bese unciphisa kancane kancane umthamo. I -Prednisone umuthi ovame ukunqunywa futhi ocwaningwa kakhulu we-hepatitis ye-autoimmune. Isebenza kahle kubantu abaningi, kodwa ingabangela imiphumela emibi. Imithi ehlukile, njenge -budesonide, ibonakala inemiphumela emibi embalwa.

Udokotela wakho angase akunike umuthi wokucindezela amasosha omzimba obizwa ngokuthi i-azathioprine kanye nama-steroids.Umuthi ungase unikezwe. Noma ungase unikezwe ngemva kokuqeda ukwelashwa kwakho ngama-steroid. Ngenxa yokuthi i-azathioprine inemiphumela emibi embalwa kune-steroids, isebenza kahle njengokwelashwa kokugcina isikhathi eside, okusho ukuthi ivikela amasosha omzimba wakho ekubeni asebenze ngokweqile futhi. Kungadingeka ukuthi uwuthathe njalo empilweni yakho yonke.

Iyini imiphumela emibi yomuthi?

Lokhu kwelashwa kungaba nemiphumela emibi. Yingakho udokotela ezokugada njalo.

Imiphumela emibi yokusetshenziswa isikhathi eside kwama-steroid (ama-Corticosteroids):

• Ukwanda kwesifiso sokudla kanye nokukhuluphala.
• Izinkinga zemizwa ezifana nokukhathazeka nokucindezeleka.
• I-Glaucoma ( ukubona okufiphele).
• I-Osteopenia noma i-osteoporosis (ubuthakathaka bamathambo).
• Isifo sikashukela .
• Umfutho wegazi ophakeme .

Imiphumela emibi yokuthatha ama-immunosuppressants:

• Ukutheleleka okuvamile (ngenxa yokuncipha kwesimiso somzimba sokuzivikela).
• Isicanucanu nokuhlanza.
• Ukuqubuka kwesikhumba (ukuluma).
• Ukuphuka kalula nokopha.
• Ukungasebenzi kahle kwezinso.
• I-Pancreatitis .

Ngesikhathi uthatha le mithi, udokotela wakho uzokuqapha ukuze athole imiphumela emibi. Uma imiphumela emibi yemithi yakho inzima kakhulu, noma uma ingakusizi ngokwanele, uzosikisela okunye. Ungesabi ukukhuluma ngakho konke lokhu nodokotela wakho.

Kuthatha isikhathi esingakanani ukuthi ukwelashwa kusebenze?

Umgomo wemithi uwukupholisa lesi sifo. Kungase kudingeke ukuthi uphuze imithi izinyanga eziningana kuya eminyakeni eminingana ukuze ufeze lokhu. Phakathi nalesi sikhathi, udokotela wakho uzohlola isibindi sakho njalo ukuqinisekisa ukuthi ukwelashwa kuyasebenza. Ukuhlolwa kokusebenza kwesibindi kuzobonisa ukuthi amazinga e-enzyme yesibindi sakho abuyela kancane kancane esimweni esijwayelekile. Ukuphola kusho ukuthi zonke izimpawu zesifo seziphelile.

I-American Association for the Study of Liver Diseases (AASLD) itusa ukuthi uthathe ama-steroid okungenani iminyaka emithathu ngaphambi kokuyeka umuthi. Ngemva kokuba usuphumule okungenani iminyaka emibili, bazocabangela ukuyeka imithi yokucindezela amasosha omzimba. Ngemva kokuyeka umuthi, cishe abantu abangu-50% bangase baphinde babuye zingakapheli izinyanga ezintathu. Kwabanye, kungathatha iminyaka, noma bangase bangaphinde babuye nhlobo.

Abanye abantu bathola ukuthuthuka okuthile ngokwelashwa, kodwa akwanele ukuba baphumule. Uma kunjalo, udokotela wakho uzozama eminye imithi. Abanye abantu abasabeli nhlobo ekwelashweni. Uma kunjalo, ukuqhubeka kwesifo kuyaqhubeka nokuba kubi. Laba bantu bangase babe nezinkinga ezidinga ukwelashwa okwengeziwe. Bangase bagcineKungadingeka nokufakelwa isibindi.

Ingabe i-hepatitis yokuzivikela komzimba ingelapheka ngokuphelele?

Cha. Ngeke kwelapheke ngokuphelele. Kodwa lesi sifo singasuswa. Lokhu kusho ukuthi inqubo yokuvuvukala iyaphela isikhashana, ngezinye izikhathi isikhathi eside. Kodwa ngemva kokuyeka ukwelashwa, ingabuya. Lokhu kubizwa ngokuthi ukubuyela emuva . Iningi labantu abayeka ukuthatha imithi (cishe ama-80%) ekugcineni lesi sifo siyabuya futhi kufanele baqale ukuthatha imithi futhi. Imithi ngokuvamile ingalawula lesi sifo kahle, kodwa kungadingeka ukuthi uyithathe njalo impilo yakho yonke.

Iyini isilinganiso sobude bokuphila nge-hepatitis ye-autoimmune?

Ngaphandle kokwelashwa, izinga lokusinda leminyaka emihlanu lingu-50%. Kodwa ngokwelashwa, izinga lokusinda kweminyaka eyi-10 lingu-90% kanti izinga lokusinda kweminyaka engama-20 lingu-70%. Ngisho noma belashwa, cishe abantu abayi-15% bagcina benesifo sokuqina kwesibindi, ngokuvamile ngemva kweminyaka eyi-10 kuya kwengama-20. Lokhu kungenzeka uma ukwelashwa kwehluleka, uma kungekho impendulo ephelele ekwelashweni, noma uma lesi sifo siphinda izikhathi eziningana. Lapho lesi sifo siphinda, singabuya ngokushesha.

Kufanele ngizinakekele kanjani ngenkathi ngiphila ne-hepatitis ye-autoimmune?

Lolu udaba olubaluleke kakhulu. Kunezinto ongazenza wena ukulawula lesi sifo nokuphila impilo enempilo.

• Ungaphuthelwa ukubonana nodokotela wakho. Udokotela wakho kuzodingeka aqaphe isibindi sakho impilo yakho yonke. Ngisho noma usuphumule isikhathi eside, lesi sifo singabuya ngaphandle kwesixwayiso noma izimpawu ezisobala. Udokotela wakho angaqapha inani le- fibrosis (umonakalo ngaphambi kokuba kube nezibazi) esibindini sakho esebenzisa izindlela ezingangenisi uhlaselo njenge- elastography . Uma uqala ukuzwa izimpawu futhi, xhumana nodokotela wakho ngokushesha.
• Nakekela ukudla kwakho. Ukudla okunempilo kubalulekile kunoma ubani onesifo sesibindi. Ikakhulukazi nge-AIH, ucwaningo lubonise ukuthi cishe abantu abangu-30% banezimpawu zesifo sesibindi esinamafutha angenalo utshwala . Lokhu kusho ukuthi umzimba wakho uthambekele ekugcineni amafutha engeziwe esibindini, okungenye imbangela yokuvuvukala. Ungalwa nalokhu ngokugcina isisindo esinempilo nokunciphisa ushukela namafutha agcwele ekudleni kwakho. Lokhu kungasiza futhi ekuthuthukiseni imiphumela yakho yokwelashwa.
• Vikela amasosha omzimba wakho. Izifo zesibindi kanye nemithi yokucindezela amasosha omzimba kwenza amasosha omzimba wakho abe buthaka. Lokho kusho ukuthi udinga ukuzinakekela kahle ukuze uzivikele ekuguleni. Udokotela wakho angase ancome izithasiselo ezithile zamavithamini kanye nemijovo yokukuvikela ezifweni. Ungathathi noma yiziphi izithasiselo udokotela wakho angazivumanga.
• Gwema utshwala. Ukuphuza utshwala kunciphisa amandla omzimba wakho futhi kulimaze isibindi sakho.

I-Autoimmune hepatitis yisifo esibi kakhulu, kodwa abantu abaningi basabela kahle ekwelashweni. Lesi sifo singaphela, sicishe sinyamalale ngokuphelele isikhathi eside. Uma sibuya, ukwelashwa okufanayo kungasetshenziswa futhi. Ukwelashwa kungaba nemiphumela emibi, kodwa ngokunakekela ukudla kwakho kanye nesimiso sakho somzimba sokuzivikela, ungaphila impilo evamile. Uma ukwelashwa kungasebenzi, ukufakelwa kwesibindi kuyindlela engcono.

Izinto okufanele uzikhumbule kulesi sihloko (Umyalezo Wokuya Ekhaya)

Kulungile, ngakho-ke, kusukela kulokho esikhulume ngakho, lezi yizinto ezibaluleke kakhulu okudingeka uzikhumbule:

• I-hepatitis ye-autoimmune iyisifo esingapheli lapho amasosha omzimba wakho ehlasela khona isibindi sakho.
• Lesi akusona isifo esithathelwanayo.
• Kungase kungabi khona zimpawu ezigabeni zokuqala, kodwa izimpawu ezifana nokukhathala, ukungakhululeki esiswini, kanye ne-jaundice zingase zivele.
• Ukuhlolwa kwegazi kanye ne-biopsy yesibindi kungadingeka ukuze kutholakale ukuxilongwa okunembile.
• Ukwelashwa (ama-steroid, ama-immunosuppressants) kungenza lesi sifo siphumule. Kodwa-ke, akukho ukwelashwa okuphelele, futhi kungenzeka ukuthi kuphinde kubuyele esimweni saso.
• Ukwelashwa kungaba nemiphumela emibi, ngakho-ke ukubhekwa kwezokwelapha kubalulekile.
• Indlela yokuphila enempilo (ukudla okuhle, ukugwema utshwala, ukulandela iseluleko sezokwelapha) kubaluleke kakhulu ekulawuleni lesi sifo.
• Ungesabi. Ungaphila impilo enhle ngisho noma unalesi simo. Xoxa ngakho konke nodokotela wakho bese ulandela iseluleko sakhe.

Uma uneminye imibuzo mayelana nalokhu, qiniseka ukuthi ubuza udokotela wakho. Ngikufisela ukululama okusheshayo!

Isifo sesibindi , i-hepatitis ye-autoimmune, amasosha omzimba, ukuvuvukala kwesibindi, i-cirrhosis, izifo ze-autoimmune, ukwelashwa kwesibindi