I-Hepatitis B: Ingabe Ingabangela Ukugula Kwezinso?

Funda ukuthi kungani i-Hepatitis B ingathinta izinso, futhi ungenzani ngakho

Imibuthano yezokwelapha isamukela kabanzi ukuthi esinye sezifo ezilahlekisa kakhulu izifo ezibizwa nge-hepatitis B kanye nesifo sesibindi esibhekene nesifo se-Hepatitis C. Izihloko azifani ngokwanele ukuchaza lezi zifo kusukela igama elithi " ukushisa kwesibindi" lisho ukuvuvukala kwesibindi. Lokhu kunikeza umqondo wokuthi isitho esisodwa esithintekile ku-Hepatitis B noma C yisibindi, esidukisa ngoba lezi zifo zombili zibona ukubandakanyeka kwezitho ngaphandle kwesibindi, ngakho-ke isifo se-systic (hhayi esendaweni) esibhekene nayo siyasho.

Izinso yisinye isitho esinjalo ukuthi ama-virus we-hepatitis asithinta kokubili ngqo nangokungaqondile. Ama-virus we-hepatitis akuzona kuphela ama-agent aphethwe yizifo ezingathinta izinso. Kodwa-ke, indima yabo ezinsheni zezinso kubalulekile ukuphawula ukuthi kunikezwe ukusabalala okuphezulu kwezifo ezibangelwa amagciwane. Ake sixoxe ngeminye imininingwane mayelana nesifo sezinso ezihlobene ne-Hepatitis B.

Yekaphi Umhlangano Wezinkinga Zesifo Sezinso Nge-Hepatitis B?

Isifo sezinso ngenxa yokutheleleka kwegciwane le-Hepatitis B kubonakala ngokuphindaphindiwe kakhulu kubantu abanegciwane lesandulela ngculaza kusukela ebuntwaneni noma ebuntwaneni. Lezi ziguli cishe ziba "abathwali" futhi zithathe ingozi enkulu yezinso zezinso.

Okwenza i-Virus ye-Liver izolimaza izinso

Yize kunjalo, ukulimala kwezinso ezivela ku-virus ye-Hepatitis B ngokuvamile akubangelwa ukutheleleka okuqondile. Eqinisweni, ukusabela okungavamile kwesimiso sokuzivikela komzimba kwezinye izingxenye zegciwane kungaba nendima enkulu ekukhusheni izifo.

Lezi zinxenye ezibangelwa amagciwane zizovame ukuhlaselwa ama-antibodies akho ngomzamo wokulwa nokutheleleka. Uma lokhu kwenzeka, ama-antibodies azobopha igciwane, futhi imfucumfucu ephumelayo izotholakala ezinsoweni. Kungabeka isisombululo sokuvuvukala esingabangela ukulimala kwezinso.

Ngakho-ke, esikhundleni segciwane elichaphazela ngqo izinso, kuyimpendulo yomzimba wakho kulokho okucacisa isimo nesimo sokulimala kwezinso.

Izinhlobo zezifo zezinso ezibangelwa yi-Hepatitis B Virus Infections

Kuye ngokuthi izinso zithinta kanjani igciwane kanye nesifo sokuvuvukala okukhulunywe ngenhla, izifo ezihlukahlukene zesifo sezinso zingabangela. Nansi ukubuka okusheshayo:

1. I-Polyarteritis Nodosa (PAN): Ake siwaphule leli gama libe izingxenye ezincane, ezigayiwe. Igama elithi "poly" lisho eziningi, futhi "i-arteritis" ibhekisela ekuvukeni kwemithambo / izitsha zegazi. Lezi zinsuku zivame ukubhekwa njenge-vasculitis. Njengoba zonke izitho zomzimba zinezigaxa zegazi, (futhi izinso zinezinambuzane ezicebile), i-polyarteritis nodosa ukuvuvukala okukhulu kwemithambo yegazi (kulokhu, izinso zomzimba) ezithinta izitsha zegazi ezincane neziphakathi yesitho.
   
   Ukubonakala kokuvuvukala kwe-PAN kujwayelekile kakhulu. Kungenye yesifo sezinso sangaphambili esingahle sibangelwe ukutheleleka kwe-Hepatitis B. Kuvame ukuthinta abadala asebekhulile nabakudala. Isiguli esithintekile siyokhalaza ngokungazenzisi izimpawu ezingenakubalwa njengobuthakathaka, ukukhathala, nezinhlungu ezihlangene. Kodwa-ke, izilonda ezithile zesikhumba nazo zingaziwa. Ukuhlolwa komsebenzi wezinso kuzobonisa ukungavamile kodwa ngeke kuqinisekiswe ukuthi lesi sifo futhi isifo sezinso sezinso ngokuvamile sizodingeka .

1. I-Membranulonephritis ye-Membranoproliferative (MPGN): Leli gama elikhuluma ngomlomo libhekisela emangqamuzaneni angaphezu kokuvuthayo kanye nezinhlobo ezithile zezicubu (isikhumba esingaphansi kwalesisimo) ezinso. Nakulokhu, lokhu kuyisenzo sokuvuvukala kunokuba kutholakale ukutheleleka kwegciwane. Uma unegciwane lesandulela ngculaza le-Hepatitis B bese uqala ukubona igazi emcimbini, lokhu kuyinto okufanele idatshulwe. Ngokusobala, ukuba khona kwegazi emcimbini ngeke kube okwanele ukuqinisekisa ukuxilongwa ngisho noma une-HIV ye-virus yokutheleleka. Ngakho-ke, ukuvivinya okuqhubekayo kuhlanganise ne-biopsy yezinso kuyodingeka.
2. I-Nephropathy enemfihlakalo: Ukuguquka kwengxenye yehlungi yezinso (ebizwa ngokuthi i-glomerular basement membrane) iholela kulokhu. Iziguli ezithintekile zizoqala ukuchitha umthamo ongejwayelekile ngokweqile wamaprotheni emcinini. Njengesiguli, kunzima ukuphawula ngobuso bama-protini emcimbini ngaphandle uma kuphakama kakhulu (uma kwenzeka ungalindela ukubona isikhumba sezinyosi noma amasondo emcintini). Igazi liyingxenye yokuthola umchamo kuleli cala kodwa liyabonakala futhi. Okunye futhi, ukuhlolwa kwegazi kanye nomchamo wezinso zezinso kuzokubonisa okungavamile, kodwa ukuqinisekisa lesi sifo, i-biopsy yezinso izobe isadingeka.

1. I-HepatoRenal Syndrome: Uhlobo olubi kakhulu lwezinso ngenxa ye-preexisting isifo sesibindi into okuthiwa i-hepatorenal syndrome. Kodwa-ke, lokho akuyona into eqondene nesifo sobindi esihlobene nesifo se-Hepatitis B futhi singabonwa kunoma yiluphi uhlobo lwesifo sesibindi esiphezulu lapho izinso zithola khona ngenxa yezinqubo eziningi.

Ukubona i-Hepatitis B Virus Associated Disease Virus

Uma unegciwane lesandulela ngculaza ye-hepatitis B futhi unenkathazo yokuthi izinso zakho zingase zithole ukutheleleka, ungahlolwa.

1. Ngokusobala, isinyathelo sokuqala ukuqinisekisa ukuthi unesifo sokungenwa kwesifo se-hepatitis B, okukhona ibhethri ehlukile yokuhlolwa okungadingeki ukuthi i-biopsy yezinso. Uma uvela endaweni eyaziwa ukuthi unezinga eliphakeme lokutheleleka kwegciwane le-hepatitis B (ukuphela kwesifo), noma unobungozi bokutheleleka kwe-virus ye-hepatitis B (njengokufana nokwabelana ngezilonda ze-IV ukusetshenziswa kabi kwezidakamizwa, ube nobulili obuvikelekile nabalingani abaningi bezocansi, njll. .), ukuhlolwa kwegazi okuthiwa yi-telltale igazi okubukeka "izingxenye" ​​ezahlukene zegciwane lesifo sofuba kufanele likwazi ukuqinisekisa ukutheleleka.
   
   Ukuhlolwa kuyenziwa futhi ngama-antibodies umzimba owenzayo ngokumelene negciwane lesifo sofuba. Izibonelo zalezi zivivinyo zihlanganisa ama-HBsAg, anti-HBc, nama-HBs. Noma kunjalo, lezi zivivinyo kungenzeka ukuthi azikwazi ngaso sonke isikhathi ukuhlukanisa phakathi kokutheleleka okusebenzayo (lapho igciwane liphindaphinda khona), noma isimo senkampani (lapho ukhona khona ukutheleleka, i-virus iselahle kakhulu). Ukuze kuqinisekiswe lokho, ukuhlolwa kwe-DNA yesifo se-hepatitis B kunconywa.
   
   Ngenxa yokuthi ama-virus amabili ayenzeka ukwabelana ngezici ezithile ezingozi, ukuhlolwa okufanayo kokutheleleka kwegciwane lesifo sofuba kungase kungabi umqondo omubi.
2. Isinyathelo esilandelayo ukuqinisekisa ukutholakala kwesifo sezinso, ukusebenzisa izivivinyo ezichazwe lapha.
3. Okokugcina, udokotela wakho kuzodingeka abeke ababili nambili ndawonye. Ngemuva kwezinyathelo ezimbili ezingenhla zenziwe, usadinga ukufakazela ukuthi kwenzekani. Ngakho-ke, kuyodingeka ukuthi i-biopsy yezinso kuqinisekiswe ukuthi isifo sezinso empeleni sibangelwa yi-virus ye-hepatitis B, kanye nohlobo oluqondile lwesifo sezinso. Kungenxa yokuthi nje ukuba nesifo sengculaza ye-hepatitis B kanye nesifo sezinso akusho ukuthi ukutheleleka kuholela ekulimaleni kwezinso. Omunye angaba nesifo sengculaza ye-hepatitis B futhi abe negazi / amaprotheni emcimbini ngezizathu ezihluke ngokuphelele (cabanga, isifo sikashukela esinamatshe enso).
4. Ukuqinisekiswa kokuxilongwa kokugcina kanye nombangela walo kunomthelela omkhulu ohlelweni lwezokwelapha. Isifo esichazwe ngenhla (PAN, MPGN, njll) singabonakala kubantu abangenayo ukutheleleka kwegciwane lesandulela ngculaza. Indlela esiphatha ngayo lezi zifo zezinso kulezi zimo zizohluka ngokuphelele ukuthi ziphathwa kanjani uma zibangelwa yi-virus ye-hepatitis B.
   
   Eqinisweni, ukwelashwa okuningi (njenge-cyclophosphamide noma i-steroids) okusetshenziselwa ukwelashwa kwe-MPGN engeyona isifo sohlobo lwe-hepatitis B noma i-nephropathy ye-membranous kungenza okubi kakhulu kunokuhle uma kunikezwe isiguli ngesifo se-hepatitis B. Kungenxa yokuthi lezi zokwelapha zenzelwe ukuvimbela isimiso somzimba sokuzivikela, okuyinto into edinga umzimba ukulwa nokutheleleka kwe-Hepatitis B. Ukwelapha nge-immunosuppressants kuleso simo kungahle kuvuselele futhi kubangele ukwanda kokuphindaphindiwe kwegciwane. Ngakho-ke, ukufakazela imbangela kubalulekile.

Isifo Se-Hepatitis B Esihlobene Nesifo Sezinso Esithinta Virus Sithathwa kanjani

Phatha imbangela. Yilokho ngempela i-crux yokwelapha. Ngeshwa, akukho ukuhlolwa okukhulu okungahleliwe okutholakala ukuhola ukwelashwa kwezinso zezinso ezenzeka ngenxa yokutheleleka kwe-hepatitis B. Kungakhathaliseki ukuthi yini esinazo kusuka ezinfundweni ezincane zokubheka ukusekela ukusekela ukusetshenziswa kwe-antiviral therapy eqondiswa ukutheleleka kwesibindi se-hepatitis B njengokwelashwa.

1. Ukwelashwa kwe-antiviral: Lokhu kuhlanganisa imithi efana ne-interferon alpha (okuvimbela ukuphindaphinda kwesifo se-hepatitis B futhi "ihlunga" indlela yokuzivikela ngomzimba ngokutheleleka), namanye ama-agent njenge lamivudine, entecavir, njll (le mithi igwema ukuphindaphinda igciwane kanye ). Ziyizigqila ezimnandi zokwelapha kude nokukhethwa kwe-agent esebenzayo (ngokuxhomeke kakhulu kwezinye izici ezifana nobudala, ukuthi isiguli sinesifo se-cirrhosis noma cha, ubukhulu bomonakalo wezinso, njll). Imiphi imithi ekhethiwe iyophinde ikhiphe ukuthi ukwelashwa kungadluliselwa isikhathi eside kangakanani. Lezi zingxoxo zingaphezu kwalesi sihloko futhi kumele kube into edokotela wakho ezoxoxa nawe ngaphambi kokuqala ukwelashwa.
2. Ama-immunosuppressive agents: Lokhu kuhlanganisa imithi efana ne-steroids noma imithi e-cytotoxic efana ne-cyclophosphamide . Nakuba lezi zingase zisetshenziswe "izifo zezinsizwa ezihlukahlukene" ezibizwa ngokuthi i-MPGN noma i-nephropathy ye-membranous, kusetshenziselwa ukusetshenziswa ngokuvamile akukhuthazwa lapho lezi zinhlangano zezifo zibangelwa yi-virus ye-hepatitis B (inikezwe ingozi yokufisa isifo). Noma kunjalo, lokhu akuyona "ukuvinjelwa ngengubo." Kukhona izinkomba ezithile uma lezi zithunywa zingadingeka zicatshangelwe ngisho nasesimweni segciwane lesifo sofuba. Enye yezobuhlobo obunjalo yihlobo olubi kakhulu lokuvuvukala oluthinta izinso 'ezihlungiwe (okuthiwa i-glomerulonephritis esheshayo eqhubekayo). Kuleso simo, imishanguzo ye-immunosuppressive ivame ukuhlanganiswa nento okuthiwa i-plasmapheresis.

> Imithombo:

> I-Hepatitis B ne-Renal Disease. Tak Mao Chan. I-Curr Hepat Rep 2010 ngo-May; 9 (2): 99-105. Ishicilelwe ku-intanethi ngo-2010, Apr 14. Ukuthi: 10.1007 / s11901-010-0042-6

> I-virus ye-hepatitis B ehlobene ne-polyarteritis nodosa: izici zokwelapha, umphumela, kanye nomthelela wokwelashwa ngeziguli ezingu-115. UGuillevin L. Medicine (Baltimore). 2005 Sep; 84 (5): 313-22.