Ingabe ukhona emndenini wakho onesifo sikashukela sohlobo 1? Noma ingabe udokotela ukutshelile ukuthi usengozini yokuthola lesi sifo? Uma kunjalo, namuhla sikhuluma ngomuthi omusha ongase ubambezele ukuqala kwezimpawu zesifo sikashukela ngeminyaka eminingana. Lokhu kuyinto eyilethele ithemba elikhulu abantu abaningi. Ake sibone ukuthi lo muthi uyini nokuthi usebenza kanjani.
Isifo sikashukela sohlobo 1 kanye nendima yomuthi kaTzield
Okokuqala, ake siqonde ukuthi siyini isifo sikashukela sohlobo 1. Empeleni yisifo esihlasela amasosha omzimba . Kalula nje, isimiso somzimba sokuzivikela, esifana 'nebutho' elivikela imizimba yethu ezifweni, siqala ngephutha ukuhlasela amangqamuzana ethu amahle. Kusifo sikashukela sohlobo 1, lokhu 'kuhlasela' kwenzeka kumaseli e-beta kuma-pancreas ethu.
Cabanga ngala maseli e-beta njengezimboni ezincane ezikhiqiza i-hormone ebizwa ngokuthi i-insulin, ebalulekile emizimbeni yethu. I-insulin isiza amangqamuzana ukuguqula ushukela (i-glucose) ekudleni esikudlayo ube amandla. Ngakho-ke, lapho amasosha omzimba ebhubhisa la maseli e-beta, ukukhiqizwa kwe-insulin kwehla kancane kancane.
Lokhu kubhujiswa ngeke kwenzeke konke ngesikhathi esisodwa. Kuzokwenzeka ngezigaba ezintathu.
- Isigaba 1: Amasosha omzimba aqala ukuhlasela amaseli e-beta, kodwa asakhiqiza i-insulin eyanele.
- Isigaba sesi-2: Ukulimala kwamaseli e-beta kuyanda, amazinga kashukela egazini aqala ukungajwayelekile kancane, kodwa azikho izimpawu zangaphandle.
- Isigaba 3: Iningi lamaseli e-beta liyabhujiswa, futhi umzimba awukwazi ukukhiqiza i-insulin eyanele. Amazinga kashukela egazini akhuphuka kakhulu. Yilapho kuvela khona izimpawu zesifo sikashukela, njengokoma kakhulu kanye nokuchama njalo.
Yilapho umuthi obizwa ngokuthi i-Tzield (teplizumab-mzwv) ungena khona. I-Tzield umuthi webhayoloji. Inganciphisa umonakalo wesistimu yomzimba kumaseli e-beta kubantu abanesifo sikashukela sohlobo 1 sesigaba sesi-2 . Lokhu kusho ukuthi ingalibazisa ukuqhubekela phambili kwesifo kuya esigabeni sesi-3, lapho kuvela izimpawu futhi kudingeka imijovo ye-insulin yansuku zonke.
Lona umuthi onikezwa ngemithambo yegazi (i-intravenous infusion, noma i-IV) . Le nkambo yokwelashwa inikezwa kanye ngosuku izinsuku ezingu-14 zilandelana.
Ingabe lokhu kwelashwa kwe-Tzield kufanelekile kimi?
Isifo sikashukela sohlobo 1 singathinta noma ubani kunoma yimuphi ubudala nanoma iyiphi indlela yokuphila. Ukwelashwa kwe-Tzield kungase kukufanele uma uhlangabezana nalezi zidingo:
- Uma unesifo sikashukela sohlobo 1 sesigaba sesi-2 .
- KuweUma ungenaso isifo sikashukela sohlobo lwesibili .
- Uma uneminyaka engu-8 noma ngaphezulu .
Ukuqinisekisa ukuthi unesifo sikashukela sohlobo 1 esigabeni sesibili, udokotela wakho uzokwenza ukuhlolwa kwegazi okukhethekile. Okubaluleke kakhulu kulokhu ukuhlolwa kokuhlola ama-autoantibodies ngokumelene namaseli e-beta kanye nokuhlolwa kokubekezelela ushukela ngomlomo . Bazohlola nenani lamaseli akho egazi kanye nama-enzyme esibindi ukuze babone ukuthi lo muthi uphephile yini kuwe.
Nakuba kuyisici esiyingozi ukuba nomuntu emndenini wakho onesifo sikashukela sohlobo 1, khumbula ukuthi iningi labantu abanalesi sifo abanawo umlando womndeni.
Yafundwa kanjani imiphumela yesidakamizwa i-Tzield?
Ucwaningo olukhethekile lwezokwelapha olubizwa nge-TN-10 lwenziwa ukuze kuhlolwe izinzuzo nezingozi zalo muthi. Umbuzo oyinhloko owawubuzwa wawuthi, "Ingabe i-Tzield ingamisa noma ilibazise ukuqhubeka kwesifo sikashukela sohlobo 1 kuya esigabeni sesi-3 kubantu abasengozini enkulu?"
Abahlanganyeli bahlukaniswe ngamaqembu amabili. Elinye iqembu lanikezwa umuthi we-Tzield. Elinye iqembu lanikwa i- placebo . Okusho ukuthi, isisombululo se-saline esasifana nomuthi kodwa singenawo umuthi. Iziguli noma odokotela babengazi ukuthi ubani othola ini.
Ungabona kalula ukuthi yikuphi ukufaneleka kanye nokungafaneleki kokuhlanganyela ocwaningweni kusukela kuthebula elingezansi.
| Izindlela Zokufaka | Izindlela Zokungabandakanyi |
|---|---|
| Ukuba phakathi kweminyaka engu-8 no-45 ubudala. | Ukuba nesifo sikashukela sesigaba sesi-3. |
| Ukuba nelungu lomndeni eliseduze elinesifo sikashukela sohlobo 1. | Amazinga angavamile amaseli egazi noma ama-enzyme esibindi. |
| Ukuba khona okungenani kwezinhlobo ezimbili ezithile zama-autoantibodies. | Ukuba nomlando wezifo ezifana ne-HIV, i-hepatitis B noma i-C. |
| Imiphumela engavamile evela ekuhlolweni kokubekezelela ushukela. | Ukuba ngumama okhulelwe noma oncelisayo. |
Iyini imiphumela yocwaningo?
Ngemva kwezinsuku ezingu-14 zokwelashwa, laba bantu balandelwa iminyaka engaba ngu-5. Imiphumela iyakhuthaza ngempela.
Inzuzo eyinhloko kwakuwukuthi labo abathatha umuthi we-Tzield bathuthukela esigabeni sesi-3 sikashukela ngesilinganiso seminyaka emibili kamuva kunalabo abangazange bawuthathe umuthi (i-placebo).
Kalula nje, kwathatha iminyaka engaba ngu-4 ukuthi labo abathatha i-Tzield babe nezimpawu, kuyilapho labo abathatha i-placebo baba nezimpawu eminyakeni engaba ngu-2. Ikakhulukazi phakathi nonyaka wokuqala wokwelashwa, inani elincane kakhulu lalabo abathatha i-Tzield laba nesifo esibi kakhulu. Ekupheleni kocwaningo, ama-57% alabo abathatha i-Tzield babesaphilile futhi bengenazo izimpawu zesifo sikashukela. Kodwa ama-28% kuphela alabo abathatha i-placebo abenza kanjalo.
Yimiphi imiphumela emibi ye-Tzield?
Njenganoma yimuphi umuthi, i-Tzield ingaba nemiphumela emibi. Kodwa ungakhathazeki, eminingi yale miphumela ingalawulwa.
Imiphumela emibi evamile:
- Ukuqubuka kwesikhumba: Lokhu kungaba uphawu lokungezwani komzimba. Esikhathini esiningi, akukubi kakhulu futhi kuzophela ngokwako. Gcina isikhumba simanzi futhi ugweme ukuklwebheka. Izinto ezifana nokugeza ngamanzi abandayo noma ukugeza nge-oatmeal zingasiza. Khuluma nodokotela wakho ngalokhu. Uzokunikeza imithi uma kudingeka. Kodwa-ke , uma ukuqubuka kuhambisana nokuvuvukala kolimi noma umphimbo, noma uma unenkinga yokuphefumula, iya ekamelweni lezimo eziphuthumayo (ETU) esibhedlela ngokushesha.
- Amangqamuzana amhlophe egazi aphansi (i-Lymphopenia): Inani lamangqamuzana akho amhlophe egazi lingase lehle okwesikhashana phakathi nezinsuku ezimbalwa zokuqala zokwelashwa. Lokhu kungase kungakuthinti, kodwa kungakwenza ube namathuba amaningi okuthola izifo. Lokhu kuzobuyela esimweni esijwayelekile phakathi namasonto ambalwa. Udokotela wakho uzokuqapha njalo ngalokhu.
- Ikhanda elibuhlungu: Ikhanda elibuhlungu elincane lingase livele. Livame ukuphela lodwa. Uma ikhanda liqhubeka noma liba libi kakhulu, yazisa udokotela wakho.
Imiphumela emibi kakhulu okufanele uyiqaphele:
- I-Cytokine Release Syndrome: Isifo Sokukhululwa Kwe-Cytokine:Ngoba imithi ethinta amasosha omzimba, njenge-Tzield, ngezinye izikhathi ingabangela ukuthi inani elikhulu lezinto zokuzivikela ezibizwa ngokuthi ama-cytokine likhishwe egazini ngesikhathi esisodwa. Lokhu kungenzeka ezinsukwini zokuqala zokwelashwa. Izimpawu ezifana nomkhuhlane, isicanucanu, ubuhlungu bomzimba, kanye nokukhathala okukhulu zingase zivele. Udokotela wakho uzokunikeza eminye imithi (isib. i-paracetamol) ngaphambi kokwelashwa ukuze anciphise lezi zimpawu. Uma unezinye zalezi zimpawu, tshela udokotela wakho ngokushesha.
- Inani elikhulu lamaseli amhlophe egazi liyehla: Uma lesi simo siba sibi kakhulu, singaholela ezifweni ezinkulu. Uma unezimpawu zokutheleleka njengomkhuhlane, ukubanda, ukukhwehlela, kanye nokukhathala okukhulu , tshela udokotela wakho ngokushesha.
Lezi akuzona zonke imiphumela emibi engaba khona ye-Tzield. Uma unezimpawu ezikukhathazayo, qiniseka ukuthi ubona udokotela wakho ukuze uthole iseluleko sezokwelapha.
Wazi kanjani ukuthi umuthi uyasebenza?
Inhloso ye-Tzield ukubambezela ukuqala kwezimpawu. Ngakho-ke, ungase ungaboni umehluko omkhulu ngemva kokuthatha ukwelashwa. Lokhu ukwelashwa kwezinsuku eziyi-14 kanye kuphela. Ngemva kwalokho, udokotela wakho uzohlola isifo sakho sikashukela njalo ukuze abone ukuthi sinjani. Ungalokothi uyeke ukuthatha ukwelashwa noma ushintshe ishejuli ngaphandle kweseluleko sikadokotela wakho.
Ingabe zikhona izinkinga ngeminye imithi?
Ngaphambi kokuthi uqale ukwelashwa kwe-Tzield, kubaluleke kakhulu ukutshela udokotela wakho ngayo yonke eminye imithi oyithathayo (kufaka phakathi amavithamini, izithasiselo, imithi ye-Ayurvedic noma imithi yamakhambi).
Ikakhulukazi, kufanele uqaphele ngokuthola imijovo yokugoma ngenkathi uthatha i-Tzield. Eminye imijovo yokugoma ingase ingasebenzi kahle, kanti eminye ingase ingaphephile. Ngakho-ke , ngaphambi kokuthola noma yimuphi umuthi wokugoma, tshela udokotela wakho ukuthi uthatha i-Tzield.
Umlayezo Wokuya Nawe Ekhaya
- I-Tzield (i-Teplizumab) umuthi omusha ongalibazisa ukuqala kwezimpawu kanye nesidingo se-insulin iminyaka eminingana kubantu abanesifo sikashukela sohlobo 1 sesigaba sesi-2.
- Lokhu kusebenza ngokunciphisa izinga lapho amasosha omzimba ebhubhisa khona amaseli e-beta akhiqiza i-insulin kuma-pancreas.
- Udokotela wakho uzonquma ukuthi lokhu kwelashwa kulungile yini kuwe ngemuva kokuhlolwa kwegazi okukhethekile.
- Imiphumela emibi emincane efana nokuqubuka kwesikhumba kanye nekhanda elibuhlungu ingase ivele futhi ingalawulwa. Kodwa-ke, uma kuvela izimpawu ezinzima njengobunzima bokuphefumula noma umkhuhlane, funa iseluleko sezokwelapha ngokushesha.
- Qiniseka ukuthi ukhuluma nodokotela wakho ngayo yonke eminye imithi kanye nemijovo oyithathayo.
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