Ukuhlolwa Kuqhubeka Kusetshenziselwa Ukuphathwa Kwe-IBD Nokuhlanganiswa Ngezinkampani Zomshuwalense
Odokotela basebenzisa izivivinyo ezihlukahlukene ukuqapha ukuthi kwenzekani ngaphakathi kwendlela yokugaya abantu abanezifo zesifo sofuba (IBD) . Ukusebenzisa ukuhlolwa kwe - endoscopy ukubuka ngaphakathi emathunjini amancane noma amakhulu kuyindlela engcono kakhulu yokuthola, kodwa izilinganiso zingenziwa kuphela njalo futhi odokotela badinga ulwazi njalo kaningi kunalokho. Yilapho ukuhlola kwe-fecal calprotectin kungasiza ngoba, ngokungafani nenqubo yokuphela kwe-endoscopy, akuyona ingavamile kodwa inganikeza ulwazi olungasiza ekuthatheni izinqumo zokwelapha.
I-Calprotectin uhlobo lweprotheyini olutholakala ikakhulukazi ezinhlotsheni ezithile zamangqamuzana egazi ezimhlophe okuthiwa ama-neutrophil granulocyte nakwezinye izinhlobo zamangqamuzana egazi ezimhlophe ngezinga eliphansi. Inani le-calprotectin ezigodini lingalinganiswa, futhi litholakala ukuthi abantu abane-IBD bavame ukuba ne-calprotectin engaphezulu kwisitoreji sabo (indaba yamafecal) kunabantu abangenayo i-IBD.
Imininingwane Esheshayo Mayelana Nezilingo Ze-Fecal Calprotectin (Noma Ama-Assays)
- I-Calprotectin yiprotheni evame ukutholakala kumangqamuzana egazi amhlophe avame ukuba ngamanani aphezulu kubantu abane-IBD.
- Ukuhlolwa kwe-fecal calprotectin kwenziwa esikhwameni sesitokisi.
- Izinkampani eziningi zomshuwalense zizohlanganisa ukuhlola kwe-fecal calprotectin ukuze kulawulwe i-IBD.
- Kukhona ukuhlukahluka kumazinga "ejwayelekile" we-fecal calprotectin kusukela kumuntu kuya komuntu.
- Amazinga e-Fecal calprotectin angaba phezulu ngisho noma engekho izimpawu ze-IBD ezinzima.
Kungani Abantu Abano-IBD Beba ne-Calprotectin Eningi Esitokisini Sabo?
Izifundo zibonise ukuthi ukugcina ithrekhi yezinga le-calprotectin ye-fecal esitokisini kuyasiza ekuphathweni kwe-IBD.
Lokhu kungumphumela wesifo sikaCrohn noma i-ulcerative colitis esibangela ukuvuvukala endleleni yokugaya . Lapho ukuvuvukala kwenzeka emgqeni we-mucosal wamathumbu, kuyilapho amangqamuzana egazi ekhuphuka ngenombolo ukulwa nayo. Amangqamuzana amhlophe wegazi angase adibanise, okusho ukuthi akhulula okuqukethwe kwawo ukuze avikele amaseli omzimba ekuvuvukala.
Ngaphakathi kwamangqamuzana egazi amhlophe i-calprotectin (kanye namanye amakhemikhali amaningi) futhi uma kune-calprotectin engaphezulu esitokisini, ukubheja okulungile ukuthi kukhona ukuvuvukala okuningi emathunjini.
Ukuhlolwa kwe-Fecal Calprotectin kwenziwa kanjani?
Ukulinganisa i-calprotectin ye-fecal ngokuvamile kuvivinywa okulula ukukwenza ngoba konke okudingayo kuyisampuli yesitoreji, into ejwayelekile ukuthi ilula ngaphandle kwemzamo omkhulu. Uma isiguli siceliwe ukuba sinike isampula esitokisini, kuyosho ukuthi ukubamba isikhala esitsheni esisinyumba bese siyiyisa ebhodini, kungaba esibhedlela, ehhovisi likadokotela noma esikhungweni esizimele. Izinga le-calprotectin le-fecal livame ukuphakama ngesikhatsi i-flare-up iphinde iyancipha ngesikhathi sokuxoxwa, kodwa ukuhlolwa akunakwenzeka. Kukhona ukuhlukahluka kwamanqanaba e-calprotectin omuntu othize futhi kukhona ukuhlukahluka okuvela kumuntu kuya komuntu. Kodwa-ke, elinye ithuluzi elingasetshenziswa yi- gastroenterologist ukusiza abantu abane-IBD bahlale ngaphambi kwezinguquko ezifweni zabo.
Kungani i-Fecal Calprotectin ewusizo ku-IBD?
I-Calprotectin iwusizo ngezizathu ezimbalwa: Okokuqala ukuthi uma itholakala esitokisini, kuzinzile isikhathi eside kakhulu. Ngoba kuze kube yizinsuku ezingu-7, izinga le-calprotectin esampula esitokisini lizohlala lifanayo, okwenza kube lula ukwenza ukuhlolwa.
Enye inzuzo kuloluhlolo ukuthi izinga le-calctectin le-fecal lingatholakala ngisho nasampula elincane lwesitokisi.
Ucwaningo oluthile lubonise ukuthi abantu abane-IBD banesilinganiso esiphezulu se-calprotectin esitokisini sabo uma kuqhathaniswa nabantu abangenayo IBD (abantu abanempilo kulezi zifundo babizwa ngokuthi izilawuli). Ukuze unqume ukuthi lolu hlelo luwusizo, kwenziwa izifundo ezazinganisa amazinga e-fecal calprotectin kubantu abane-IBD, elandelwa ukuhlolwa kwe-endoscopy ukubona ukuthi amazinga afanelana kanjani nalokho okwenzekayo endleleni yokugaya. Lokho abacwaningi abathola ukuthi abantu abane-IBD banamazinga aphezulu e-fecal calprotectin futhi kungenzeka ukuthi abe nokuvuvukala noma izilonda ezibangelwa i-IBD kwenye indawo endleleni yabo yokugaya.
Abantu abasesifundweni abazange babe nezimpawu ze-IBD ezinzima kakhulu, noma kunjalo, noma ngabe amazinga e-fecal calprotectin aphezulu. Lokhu kwakuyiqiniso ikakhulukazi kaningi ekulweni kwe-ulcerative kolitis kunesifo sikaCrohn. Lokhu kugcizelela enye inzuzo yokuhlola kwezinga le-fecal calprotectin, ngoba lingase linikeze isixwayiso sokuqala sokuthi ukuvuvukala okuthile okwenzekayo kumgudu wokugaya ngisho nangaphambi kokuba izimpawu ziqale ukukhula.
Ngokulinganisa i-calprotectin esitokisini, odokotela bangakwazi ukuqala indlela yokuthola i-IBD esigulini, noma ukuhlola umsebenzi wesifo esigulini esivele sitholiwe nge-IBD. Umqondo wukuthi ukuhlolwa okulula, okuyinto engeyona engavamile ngoba kwenziwa esitokisini, kungadlulisa isidingo sokuba i-endoscopy (njenge- sigmoidoscopy noma i- colonoscopy ) kwezinye izimo futhi igcizelele isidingo sokuhlolwa kwe-endoscopy kwabanye. Ukuhlola kwe-fecal calprotectin ngeke kuthathe isikhundla se-endoscopy, kodwa kungasiza odokotela njengethuluzi lokuhlola, ukucacisa kangcono uma futhi kudingeke yini ukuhlolwa okulandelayo kokulandela.
Ezinganeni ezine-IBD i-calprotectin ye-fecal ingaba usizo ikakhulukazi. Ngokusebenzisa lokhu kuhlolwa, kunesidingo sokuba udokotela akwazi ukubona ukuthi izimpawu zingase zivele ku-IBD noma cha, ngaphandle kokuhlola ukuhlasela okufana nokuphela kwe-endoscopy noma ukuhlolwa okubandakanya i-radiology njenge-CT scan ngaphandle kwe-bat.
Amazinga e-Fecal calprotectin angasiza futhi kubantu abafuna ukuxilongwa futhi i-IBD iyingxube. I-calprotectin ye-fecal ingalawulwa udokotela oyinhloko noma ukunakekelwa kwe-internist futhi uma iphakamisa ukuthi ingaphezulu, lokho kungaholela ekudluliselwe ku-gastroenterologist ukuze kuhlolwe okuqhubekayo.
Ingabe Kukhona Ukubuyisela ku-Fecal Calprotectin Assay?
Enye yezingqinamba zokuhlola i-calprotectin ye-fecal yiyona mphumela ongamanga noma umphumela omubi, nakuba lezi miphumela azivamile. Isiguli singase sibe ne-IBD noma singase sibe nokuvuvukala ku-IBD, kodwa izinga le-fecal calprotectin angeke liphakeme kakhulu. Lokhu kungasho ukuthi kukhona ngempela ukuvuvukala okwenzekayo emgqeni wokugaya kodwa imiphumela yokuhlola ibuyele namazinga aphansi we-calprotectin (nakuba lokhu kungavamile). I-negative-negative ingaba yinkinga ikakhulu kubantwana nasebasha, abakha ingxenye ebalulekile yeziguli ezixilongwa nge-IBD.
Ingabe Ukuhlolwa Kwe-Fecal Calprotectin Kuhlanganiswe Ngomshwalense?
Amanye ama-insurances angase afake ukuhlola kwe-fecal calprotectin yesifo sika-Crohn nesifo sofuba ngenxa yokuthi kuboniswe ukuthi kuyindleko ephumelelayo. Izindleko zalesi sivivinyo zizobe ziphansi kakhulu kune-endoscopy noma i-CT scan. Kungenzeka kube nezinkampani zomshuwalense ezingabheki lokhu kuhlolwa okwamanje ngoba kungenalo umlando omude wezinye izivivinyo, kanti izinkampani zomshuwalense zivame ukuphuza ukuzishintsha. Kodwa-ke, kukhona njalo inqubo yokudlulisa isikhalazo, futhi iCrohn's and Colitis Foundation inomqulu otholakala ukuthi udokotela angasebenzisa ukucela ukuhlolwa kokuhlolwa kumhlinzeki womshuwalense.
Inothi Kusuka
Isivivinyo sezinga le-fecal calprotectin asiqapheli kangako ezweni le-IBD kunalokho, kusho, ikholonoscopy. Kodwa-ke, kuyisivivinyo esiwusizo, ikakhulukazi ngoba asidingi lutho olukhethekile, njenge-prep noma usuku lokuyeka emsebenzini, ukuze lufeze. Akuzona zonke izidakamizwa ezingase zenze lokhu kuhlolwa, ngakho-ke kufanelekile ukubuza uma kufanelekile ngaphansi kwezimo ezithile. Izinkampani zomshuwalense zivame ukukumboza, ikakhulukazi uma kungenxa yesiguli ne-IBD (bayazi ukuthi ishibhile kunabanye ukuhlolwa). Kunezinye izimo lapho i-calprotectin ye-fecal ingase ingabuyi khona namazinga kulindeleke, kodwa lokhu akuyona into evamile.
> Imithombo:
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> Van Rheenen PF, Van de Vijver E, Fidler V. "I-calprotectin ye-faecal yokuhlola iziguli ezinezifo zesifo sofuba esicasulayo: ukuhlolwa kwe-meta-analysis." BMJ . 2010 Jul 15; 341: c3369.
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