Ingabe I-Asthma Yakho Eyingozi Ngempela I-asthma Eosinophilic?
I-asthma ye-Eosinophilic, eyaziwa nangokuthi i-e-asthma, yi-subtype ejwayelekile kunazo zonke ye- asthma esivame ukutholakala ukuthi iyumuntu omdala. Ihlukaniswa njenge- atopic , okusho ukuthi kukhona ukuthambekela kwezakhi zofuzo ukuze kube yisisusa sesifo. Ngokungafani nezinye izinhlobo ze-asthma, i-asthma ye-eosinophilic ine-inflammation yomoya ovela emithini yakho ye-sinus kuze kube yindlela encane yokuhamba emoyeni yamaphaphu akho.
Ukuvuvukala kwesifo se-asthma eosinophilic kwenzeka njengengxenye yesimiso sokuzivocavoca noma isimiso somzimba sokuzivikela, esikhipha iseli elimhlophe legazi elibizwa nge- eosinophils . Uma une ukwanda kwamangqamuzana egazi amhlophe, ngokuvamile uzoba nesiphetho sokuvuvukala, okuholela ekuqiniseni kwe-airways yakho. Uketshezi kanye nomswakama okungaholela kungabangela ukuphazamiseka emiphakathini yakho ye-airways (i-bronchioles) futhi kubangele izimpawu zakho ze-asthma.
Ukuvama
I-asthma iyinkinga yokuvuvukala kwemimoya yakho engenza kube nzima ukuphefumula. Abantu abangaba ngu-1 kwabangu-13 banenkinga yalesi sifo esingapheli kanti cishe isigamu sabantu abathintekayo yi-asthma banokuhlaselwa yisifo se-asthma unyaka ngamunye. Yazi ukuthi iningi lalezi zikhukhula zingavinjelwa uma i-asthma ilawulwa kahle. Ngenkathi ekuqaleni kucatshangwa ukuthi iyisifo esisodwa, i-asthma inezinhlobo eziningi ezingashintsha ukuthi i-asthma yakho ingahle ilawulwe kanjani.
Abantu abangaba-1 kwabangu-10 abane-asthma bane-asthma enzima.
Nakuba ukusabalala kokuthola i-asthma ye-eosinophilic akungaziwa, kukhona ukucabanga ukuthi ama-50 kuya kwengu-60 kwamacala angu-100 e-asthma enzima kubantu abadala angase abe ne-asthma eosinophilic. Uma uneminyaka engaphezu kwengu-35 uma uthola ukuthi une-asthma enzima unengozi ephezulu yokuthola ukuthi une-asthma eosinophilic.
Ingozi yakho ifanayo kungakhathaliseki ubulili bakho, futhi unobungozi obuncane bokuthola ukuthi une-asthma ye-eosinophilic ebuntwaneni bakho naseminyakeni yobudala.
Izimpawu
Izimpawu eziningi ze-asthma ye-eosinophilic zifana nezinye izinhlobo ze-asthma kubandakanya:
- Ukuphelelwa umoya
- Ukushaya
- Ukushisa
- Ukuqina kwesifuba sakho
Kunezibonakaliso ezimbalwa ezingase zikhona futhi ezihlobene neze-asthma kubandakanya:
- Ukugeleza kwamanzi kanye nokuxubana ( i-rhinosinusitis engavamile )
- Ama-polyp nasal
- Ukwandisa izibilini zamasalonda emasalini
- Ukulahlekelwa iphunga (i-anosmia)
Nakuba i-asthma ye-eosinophilic ingumzimba wokuzivikela omzimba ohlobene nezifo, abantu abaningi abathintekayo abanakho abakuthola izifo ezinjenge-molds, mildew, noma ezinye izifo ezivamile.
Ukuxilongwa
I-asthma ye-Eosinophilic ivame ukuhlolwa. Akubhekwa njengento evamile noma ngabe ukusabalalisa kucatshangwa ukuthi kuphakeme kunekholwa ngaphambilini.
Uma i-asthma ye-eosinophilic iyimbangela ye-asthma yakho futhi ingatholakali, ungase uhlakulele ukuthola i-asthma yakho enamandla ngaphansi kokulawula. Ngokuvamile ufuna ukubonwa yi-pulmonologist uma ukhathazekile. Kodwa-ke, i-allergen ne-immunologists ingase ibe usizo ekuhloleni kwakho okuphelele.
I-Eosinophil Count Cell
Ukwenza isibalo se-cell eosinophil kusuka kwisampuli esitshenzisiwe esithwetshiwe kubhekwa njengesilinganiso segolide esilinganiselwe sokubalwa kweseli, kodwa kunzima ukuthola, ukuchitha isikhathi, nokubukela.
Ngokuvamile kudinga ukusetshenziswa kwebhu lab ethize abasebenzisa ochwepheshe.
Uma uqoqa umcwaningi, ufuna ukuqinisekisa ukuthi awunamathe, kepha ukhwehlela uphuthi ovela emoyeni wakho. Ukuze usize ukhiqiza isipulum, udokotela wakho angase abe nesifo sokuphefumula akunike umthamo we-albuterol noma enye i-bronchodilator esheshayo. Lokhu ukwelashwa kulandelwa ngokukunika u-saline hypertonic nebulazed. I-saline ephakeme ephakeme lapho ixiliswa icasula imimoya yomoya futhi iyasiza ekwenzeni ukukhwehlela. I-specimen ekhukhumezayo ingabuye ihlaziywe ebhokisini ukuze ibone ukuthi kukhona yini okungaphezu kwezingu-1 kuya kwezingu-3 kwezingu-100 ze-eosinophil.
I-Airway Biopsy
Enye indlela yokuthola i-asthma ukuthatha i-biopsy ye-air ngesikhathi ku-bronchoscopy. Le nqubo ingenziwa ukuze kugcwaliswe ukuxilongwa okumbalwa. Kodwa-ke, le ndlela ayikhuthazwa kuphela ukuthola i-asthma ye-eosinophilic ngoba yinkambiso evumayo edinga ukuhlala ngaphandle uma isampuli esaneleyo se-sputum engatholakali.
Ezinye Izindlela
Ezinye izindlela zenzelwe ukusiza ukuhlonza i-asthma. Udokotela wakho angabheka i-CBC (inani eliphelele legazi) ukuhlola i-eosinophilia (inani lokunyuka kwama-eosinophil). Kodwa-ke, ukuhumusha ama-eosinophil ephakeme egazini kufanele kwenziwe kuphela ngudokotela kusukela ekuphakameni okuphakeme egazini lakho akuqinisekisi ukuthi une-asthma eosinophilic. Nokho, kungase kusize udokotela wakho ukuba aphinde ahlukanise noma yiziphi ezinye izimpawu onayo.
Okunye ukuxilonga okungase kuthathwe ngokuthi unesibalo esiphezulu se-eosinophil egazini lakho kuhlanganisa i-hypereosinophilic syndrome, ukuphazamiseka okuzenzekelayo, ukungaqiniseki ngokweqile, kanye nokuphendula kwemithi.
Izivivinyo ezimbili ezengeziwe zingase zibhekwe njengesizibopho se-sputum noma i-blood eosinophil count: ukuhlolwa kokuphefumula kwe-nitric oxide (FeNO) eyinkimbinkimbi kanye nokuhlolwa kwegazi nge-periostin. Uma une-asthma ye-eosinophilic, uzovame ukukhombisa ama-eosinophil akhule egazini lakho ne-sputum, i-immunoglobulin E, i-FeNO, ne-periostin.
I-FeNO ingaba usizo ekusizeni ukubikezela ukuthi uzophendula yini ku-corticosteroids engatholakali. Ukuhlolwa kungenziwa ngokusebenzisa idivayisi ebizwa nge-NIOX. Kodwa-ke, izici eziningi zingathinta amazinga akho we-FeNO kuhlanganise nokusetshenziswa kwe-steroids, ubudala, ubulili, i-atopy (ukuthambekela kokuthuthukisa imvelo), nesimo sokubhema.
I-Periostin iyi-biomarker kumaseli akho e-epithelial airway. Amazinga e-Periostin athambekele ekuphakanyweni kwe-asthma eyenza amaseli athile omzimba (TH2) futhi kwezinye izifundo aboniswe ukuthi yi-subrogate ehle kakhulu yokuhlola i-sputum. Noma kunjalo, imiphumela iyahluka kwezinye izifundo futhi ukuhlolwa akutholakali kalula. Izibalo ze-sputum kanye ne-blood eosinophil izibalo zisengcono ku-FeNO naku-periostin ngokwemitholampilo eminingi nemikhombandlela.
Ukwelapha
Ukwelashwa kokuqala kwe-asthma ye-eosinophilic kufanele kuhlanganise nomgomo wakho wokwelashwa ojwayelekile wesifo se-asthma. Ngokuvamile uzothola imiphumela emihle ngenxa ye-corticosteroids etholakalayo (i-ICS) esetshenziselwa njengengxenye yemihlahlandlela yokwelashwa ejwayelekile yesifo se-asthma. Kodwa-ke, uma udokotela wakho ekutholile ukuthi une-asthma ye-eosinophilic, angashintsha indlela evamile esebenzisa ama-corticosteroids. Imithi ye-Corticosteroid ihlanganisa:
- I-QVAR (beclomethasone i-HFA efanele)
- I-Pulmicort (i-budesonide)
- I-Flovent (i-fluticasone proprionate)
- I-Asmanex (i-mometasone)
- I-Azmacort (i-triamcinolone acetonide)
Nakuba i-corticosteroids ephazamisekile kaningi inemiphumela emihle, abanye abantu bane-asthma e-sosid-refractory eosinophilic, okusho nje ukuthi i-asthma yakho ayinayo inzuzo ephawulekayo noma emtholampilo ngokuthatha i-corticosteroids etholakalayo. Uma uye wahlunga i-corticosteroids eyodwa noma ngaphezulu ekhonjiwe ngenhla ngaphandle kokukhululeka kwesifo, khona-ke uzofuna ukuxoxa nodokotela wakho eminye imithi esanda kutholakala yokuphatha i-asthma ye-eosinophilic.
Kunezinhlobo ezintathu zokwelashwa ezihlosiwe eziye zamukelwa imvume ye-FDA ye-asthma yokugula:
- I-Xolair (i-omalizumab) iyimithi yokwelapha ye-anti-immunogobulin E (IgE)
- I-Nucala (mepolizumab), eyayibizwa ngokuthi i-Bosatria, iyi-anti-interleukin-5 (IL5) yeklasi imithi
- I-Cinqair (reslizumab) enye imithi yokwelapha ye-IL5
- I-Fasenra (benralizumab) imithi entsha ye-FDA eyamelana ne-IL5 ekilasini
Imithi emithathu ekhonjisiwe ngenhla ibonise imiphumela emihle uma usalokhu uveza izimpawu naphezu kokunamathela kahle emgomweni wakho we-corticosteroid enqunyiwe. Eminye imithi emithathu, i-omalizumab ijwayele ukuphumelela kangako, njengoba ithinta imithwalo yemvelo ngokuqondile kune-mepolizumab ne-reslizumab. Le mithi iphinde ibekezeleleke kahle ngemiphumela emibi yecala kanye nokuthi kungenzeka ukuthi uzokwazi ukunciphisa ukusetshenziswa kwakho kwe-corticosteroids. Ukunciphisa ukusetshenziswa kwe-steroids kubuye kunciphise imiphumela emibi engayandisa izinga lakho lokuphila.
Ukuqapha Ukwelashwa
Ukulandelwa kunconywa njengendlela yokwelashwa okuhlosiwe akuyona ikhambi, kodwa ukwelashwa. Yilungiselele ukuhlola ngezikhathi ezithile futhi uxoxe ngalokhu okulandelayo nodokotela wakho ekuqokeni okulandelwayo:
- Ukuhlolwa kokusebenza kwamapulmonary
- Izimpawu ezenzeka kusukela ekuvakasheni kokugcina (ngcono noma ezimbi kakhulu)
- Ukuvama kokwanda kwe-asthma
- Ukuxazulula izinkinga ezifana nokulahlekelwa iphunga
- Isimo sezempilo jikelele
- Ukulandelela Ukuhlolwa Kwezinga Lokuphila
- Ukuhlaziywa kwelabhu
Ukuqokwa okujwayelekile okulandelwayo sekuyizinyanga ezingu-4 ngemuva kokuqala ukwelashwa okuhlosiwe. Uma uhlangabezane nemiphumela emihle, uzogcinwa kwimithi enqunyiwe. Uma imiphumela enganciphisi ukulinganisa, cishe uzoqhubeka ulandelwa imithi kuze kube unyaka ngaphambi kokuhlola ukushintsha noma ukwengeza imithi eyengeziwe. Uma ungenayo impendulo emva kwezinyanga ezine, udokotela wakho cishe uzoyeka imithi bese akushintshele kwelinye ukwelashwa okuhlosiwe.
Udokotela wakho angase futhi alandele amazinga wegazi we-IgE uma ethatha i-omalizumab. Ngenkathi amazinga e-IgE engahlolisisi i-asthma ye-eosinophilic, indlela yokwelashwa ejwayelekile ku-omalizumab kuyoba ukubona ukunciphisa amazinga wakho wegazi we-IgE.
Izwi elivela
Nakuba i-asthma ye-eosinophilic ihlotshaniswa ne-asthma enzima, ukwelashwa kungenzeka uma kutholakala kahle. I-asthma engeyona i-eosinophilic engenakwenzeka ingase ibangele kunzima ukulawula ukukhushulwa kwe-asthma okungagcini kakhulu izinga lakho lokuphila kodwa kungasongela ukuphila. Ukusebenza ne-pulmonologist yakho ngezokwelapha okuhlosiwe kungakusiza ukuthi ubuyisele izinga lempilo oyifanele futhi linganciphisa imvamisa yokukhushulwa kwe-asthma yakho.
> Imithombo:
> I-Clinical Utility ye-Fractional Exhaled Nitric Oxide (i-FeNO) ekuPhathwa kwe-Asthma. I-Agency for Research and Health Quality website. Kubuyekezwe ngomhlaka 20, 2017. https://effectivehealthcare.ahrq.gov/topics/asthma-nitric-oxide/research/.
> Buhl, R, Humbert, M, Bjermer, L, Chanez, P, Heaney, LG ,. Holgate, S. (2017). I-asthma eosinophilic ekhululekile: indlela yokubambisana. Journal European Respiratory Journal. 49: 1700634, DOI: 10.1183 / 13993003.00634-2017.
> I-asthma ye-Eosinophilic. Ukusebenzisana kwamaMelika kwewebhusayithi ye-Eosinophilic Disorders. http://apfed.org/about-ead/eosinophilic-asthma. Kubuyekezwe ngo-12/19/2017.
> Iningi le-Asthma Dat Recent. Amasevisi Okulawula Nokuvimbela Izifo. http://www.cdc.gov/asthma/most_recent_data.htm. Kubuyekezwe 6/2017.
> Wagener AH, de Nijs SB, uLutter R, et al. Ukuqinisekiswa kwangaphandle kwe-eosinophils yegazi, i-FE (CHA) ne-serum periostin njengama-surrogates e-sputum eosinophils e-asthma. Thorax 2015; 70: 115
> Walford, HH & Doherty, TA. (2014). Ukuxilongwa nokuphathwa kwe-asthma ye-eosinophilic: umbono we-US. I-J Asthma Ukuzivocavoca. 7: 53-65, i-doi: 10.2147 / JAAS39119.