Kurapa kwe autoimmune hepatitis: nzira, zvinodhaka, migumisiro, zvirevo

Vazhinji vedu takanzwa pamusoro zvirwere zvakadai autoimmune chiropa. Chii zvokurwara ichi? Iri chirwere, inova insoluble kuzvimba kudaro chinokosha nhengo kuti kuvapo kwedu sezvo chiropa. Set zvakasikwa, zvokurwara ichi hachina.

Ko kana zvadai?

Kana nechirwere "autoimmune chiropa", izvozvo zvinorevei? Iyi haisi zvokurwara ari isingazivikanwi zvachose zvikonzero, zvishoma nezvishoma anoparadza chiropa masero. Zvino izvi kunobatsira chirwere pachake zvirwere. Mune Danho rokutanga chirwere kune kuzvimba parenchyma, kuti ndicho chikuru chikamu muviri. Izvi mberi nokukurumidza uye kunogona cirrhosis.

Izvi pamwe Sero rufu chakadaro muviri inokosha kwatiri - hepatocytes. nzvimbo yavo pakarepo anozadza dzemakwiringwindi uye inelastic connective tishu. Somugumisiro, chiropa hadzisi kukwanisa qualitatively vaite mabasa avo.

Unogona kuwana mazita akasiyana kuti chirwere ichi. Zvisinei, vakawanda zvokurwara mumabhuku yezvokurapa kuti nzira: active chirwere autoimmune chiropa. Zviri isingawanzowanikwi chirwere kuti chinonyanya nevakawanda nevasikana vakuru kupfuura makore 10 uye vakadzi vasina kuwana nemakore matatu.

zviratidzo

Clinical Kuratidza chirwere zvinosiyana. Somuenzaniso, chikamu chimwe muzvina varwere vose vasina zviratidzo autoimmune chiropa haisi. Uye rinovapo chero munhu asina chero matambudziko. Muzviitiko zvakadaro, chirwere pakarepo anobata pamwe vanhu kana kuti kuratidza zvose zviratidzo nemavhairasi chiropa, kana zvimwe zviratidzo anoratidza kukuvara chiropa. Mune musiyano wezvinyorwa zviitiko kwevanhu vokutanga rwunotanga kunokanganisa utera. muviri wake zvinwiwa kuva rima. Skin uye mucous membranes, yellowing, kurasikirwa kudya. Kana yechipiri, pane extrahepatic hunhu zviratidzo. Ndokusaka vanachiremba kakawanda zvinoratidza kuvapo mumuviri-siyana systemic zvirwere zvakadai dzinonzi rheumatoid arthritis, lupus, etc.

Asi vose, anokuzviratidza zvirwere akafanana kunyanya kuneta, kupisa, kuwedzera tembiricha muviri kuti madhigirii 39, lymphadenopathy, mburwa, abdominal kurwadziwa, kunyanya mune zvakanaka yokumusoro quadrant, kutyora mapfundo, uyewo yezviri kukura bvudzi riri kumativi ose muviri . Kana chirwere anotanga kutsamwisa kwetunhu adrenal mahormone, izvo anogadzirwa kwazvo, murwere anogona kuona vasanyanye chetsandanyama rinenge pamakumbo uye nemaoko, kukurumidza dhayira yokufutisa, chimiro tatamuka mucherechedzo pazvidya uye rakajeka tsuka meso pamatama.

Dzimwe nguva varwere hosha kunoitika nokukurumidza, zvinoita sokuti acutely uye anobuda zvakaoma chaizvo. Zvose izvi pamwe panowanikwa fulminant chiropa, izvo chinoita kukurumidza rufu akawanda hepatic masero. Izviwo, kunoita kuti nokukurumidza inotungamirwa muchetura, kukanganisa, wobva kutapura uropi. Zvakaoma chaizvo, kana kwete akatooneka autoimmune chiropa (zviratidzo), kurapwa. Fungidziro Pakadaro, vanachiremba vanopa chaizvo vanoshorwa murwere.

Mhando zvirwere

Mabatirwo autoimmune chiropa iri zvakananga ndezvokungotevedzera mhuka dzaro. A kunyanya Chirwere kunotemwa nokuvapo muropa serum ine antibody imwe mhando. Muchiitiko chino, pane mhando nhatu autoimmune chisingaperi nehepatitis B:

1. wokutanga mhando kuzivisa chirwere-actin antibodies kuti mapuroteni, mapuroteni, wakatsetseka tsandanyama masero, antinuclear antibodies.

2. Nokuti chechipiri Chirwere inozivikanwa pamberi antibodies kuti microsomes, kuti masero itsvo uye chiropa.

3. Chechitatu mhando zvokurwara kunokwanisa kuonekwa vanenge kuziva miedzo antibodies kuti nenhumbi kuti ndiye anokonzera mapuroteni usage, i.e. kune hepatic soluble antigen.

zvokurwara Zvinokonzera

Autoimmune chiropa - chirwere umo munhu zvirwere kunotanga kushingaira Zvinotambudza munyama yavo zvachose utano uye masero. Chii midzi zvinokonzera chiitiko ichi? On mubvunzo uyu, mushonga ano haagoni kupindura asi. Zvisinei, masayendisiti pfungwa kuti kwakadaro kukundikana muviri dzokuzvidzivirira kupa akasiyana kare kutakurwa nemavhairasi zvirwere, zvakadai chiropa A uye B uye C, herpes, Epstein-Barr utachiwana.

Vamwe vanotsvakurudza akataura maonero, uye kuti kukura siyana autoimmune zvirwere, chikuru basa iri kuridzwa ne chaicho Gene. Zvisinei, zvinokosha kuziva kuti hosha iri vana pasi pemakore 10 vari anenge kumbobvira dzakaonekwa.

Diagnostics

Mabatirwo autoimmune chiropa zvichava zvikuru vanobudirira kana maperembudzi dzakaonekwa vachiri yakatanga kukura kwayo. Zvisinei, zvokurwara chirwere zvakaoma zvikuru. Kazhinji, zvakadai chirwere vanachiremba akaisa chete apo zvishoma nezvishoma haabatanidzi kuvapo zvimwe zvirwere. Kuti aite izvi, chiremba inoongorora murwere zviratidzo uye nhoroondo ezvokurapa hwake. Izvi zvose zvinoitika muupenyu kurukurirano. Panyaya iyi, nyanzvi anowana zvinenge kukunetsa munhu, uye sei kwazvinogumira refu.

Next, muviri kuongororwa achiita, panguva iyo chiremba anoongorora ganda uye mucous membranes, anoyera murwere muviri tembiricha, uye rinorira anobata chiropa yokuzvifungidzira marwadzo wake uye nokuwedzera kukura. Kana iripo vaifungidzirwa kuva zvokurwara rabhoritari vari kudzidziswa. Vari zvakagadzirirwa kuona pachiyero nokusungwa globulin, uye basa enzayemu AST. Inopa mirayiridzo uye immunological kuongorora ropa. Ongorora uye kuti nehepatitis A uye B uye C. The chiremba rinopa nhungamiro coprogram. Kudzidza ndiyo chitsiko cheki kuvapo undigested zvokudya zvacho.

Diagnostics rinoitwa kana zvakakodzera. Rinosanganisira Ultrasound pakuongorora mudumbu, yegurokuro uye duodenum 12 nokushandiswa endoscopic michina. kudzidza izvi zvichiitirwa haabatanidzi kuvapo namamota dzakasiyana etiology. The murwere akatumira kuti chiropa biopsy, umo duku zvinyama yokuenzanisira chinobviswa muviri wayo histology.

Kamwe kuzivikanwa autoimmune chiropa chirwere, uye kurapwa ushandiswe nachiremba, zvose akagamuchira zvinofanira kuitwa pasina kukundikana. Chete muchiitiko ichi tinogona kutaura pamusoro akanaka Zvaifungidzirwa okukura chirwere chacho.

mushonga zvokurwara

Kamwe autoimmune chiropa (Zviratidzo) vanozivikanwa, uye kurapwa chirwere ichi rava rinokosha, chiremba anogona kushandisa nzira dzakawanda. Ivo ndeinotevera:

- tatevedzera vaitofanira kudya;

- mune zvokurapa kurapa;

- kuita kuvhiyiwa.

Funga zvose nzira izvi zvizere.

dhayeti

Treatment echirwere autoimmune chiropa, vari rikwanise danho, kuitwa pasi pemubhedha kuzviomesera zororo. Pamusoro panowanikwa danho kuregererwa murwere zvakakwana kuronga basa rako uye zororo, tichidzivisa ose mhando (mupfungwa uye mumuviri) kuneta. Uyezve, zvinokosha kubvisa sei chiropa-siyana zvine chepfu, kusanganisira doro uye somushonga zvinodhaka, akaenda naro parutivi simba iroro. Munguva kuregererwa haumanikidzwi wo kuitisa uye physiotherapy kurapa chokuita chiropa nzvimbo. Hazvitenderwi uye balneotherapy.

Kuti normalize mamiriro murwere kunokosha kudya zvinovaka muviri. Kuburikidza pakurapa chirwere autoimmune chiropa, gastroenterologists kutokurudzira kushandiswa zvokudya (tafura № 5). Hunosanganisira miriwo soups uye dzakaonda nyama (yehuku, nyama). Zvokudya varwere hove zvokudya zvinogona kushandiswa zvakabikwa kana yakabikwa. Diet, iyo inokurudzirwa muzviitiko apo runodiwa kurapwa echirwere autoimmune chiropa, rinosanganisira zvinhu zvakadai yoghurt yakaderera-mafuta uye chizi, uye kana asina kusashivirira, ipapo mukaka uye mukaka zvigadzirwa. Kana kubika nokuti vanhu vanotambura autoimmune chiropa, zvakakosha kushandisa ruomba mafuta muriwo bedzi diki zvakawanda. Zvinofanira kuva mashoma uye kushandisa mazai. Vanogona ubatanidzwe zvokudya chete 2 kana 3 nguva muvhiki 1-2 mazai pazuva.

Pasina kumanikana Kudya hakunganzi pachinhu vasiri acidic miriwo nemichero. Zvisinei, kushandisa kwavo, uyewo zvose zvimwe akabvumidza zvokudya, anofanira hazvo kuva munhu anonzwisisa-siyana.

Diet, ndakarumbidzwa munhu uyo ari pakurapa autoimmune chiropa, haabatanidzi kubva zvokudya zvakakanyiwa namafuta zvokudya, mafuta nyama, wakawanda uye Spicy nezvikafu zvishoma, zvakarungwa uye sipinachi, but uye simba kofi, doro, uye zvomumagaba zvinhu. Power Saka tinofanira kugara fractional. Zvakakosha kuti kudya kanenge mana nguva rimwe zuva, uye zviri nani kana kuti kudya rinofanira kubudiswa katanhatu. Zvinokoshawo kuti kuremekedza zvinovaka muviri zvokuti muviri anogamuchira zvose zvakakodzera zvinhu nokuda kwayo.

Kushandisa zvinodhaka

Kana mabatiro autoimmune chiropa, chiremba kutevedzana kwezviitiko zviito kuchaenderana pachikuva uye mukurwara. Asi chero zvakadaro, kuwedzera kushandiswa zvataidya, varwere vakanga dzakabatwa mishonga inodiwa. Zvichienderana nezvakanyorwa kuchengetwa murwere ane chirwere che "autoimmune chiropa" kiriniki, kurapwa nyanzvi inogona kupiwa zvinodhaka zvakasiyana-siyana.

Akapiwa chokwadi kuti huru chinokonzera chirwere ichi ndicho hyper-activation uye atadze kushanda zvakanaka kwomuviri dzokuzvidzivirira, kutanga kuzviita kuparadza utano masero chiropa, vari kurapa chiremba anofanira zvinosanganisira inogadzirirwa masoja kudzvinyirira. It imunosupressivnye zvinodhaka zviri hormone uye Anti-anogumbura. Izvi achinyanya zvinosanganisira mishonga yakadai se "Prednisolone" uye "Azathioprine". zvinodhaka maviri aya anoshandiswa avo ezvinhu apo mishonga autoimmune chiropa. Nokufamba kurapwa yavangatarisana kunan'anura kana yoga kana pamwe chete.

Kana "prednisolone", mushonga uyu ane chakarondedzera basa. It ane tambira mhando dzose metabolic kwacho, uye inopa hahwo Anti-anogumbura mugumisiro. Pasi pokudzora kwomudzimu zvinodhaka kunoderedza basa pathological muitiro. Izvi zvakafanira zvose kuti zvakananga simba immunosuppressive vamiririri iri K-masero uye kufurira simba rayo pamusoro suppressor mashandiro T-lymphocytes.

Chete mishonga Akakwirira zvinodhaka vanokwanisa kupa kubudirire, kana akaonekwa autoimmune chiropa (zviratidzo) kurapwa. Fungidziro chirwere muzviitiko izvi, zviri zvakanaka. Saka, muna kurapwa miedzo panguva kosi rwendo using pharmacological rinoreva "Prednisolone" vakachengeta zvinoderedza kusimba uye kakawanda immunopathological siyana kuchengetwa chiropa tishu.

Chimwe kurapika kubva autoimmune chiropa - "Azathioprine". Masoja Mhinduro zvinokanganisawo Nokudzvinyirira mashandiro vachishingaira dzichiri miitiro inoburitsa zvinhu zvakanyatsofanana masero masoja, uyewo kubviswa kuchaitwa masero anogumbura.

Drug "Azathioprine" inokanganisa zvose zvikuru uye yechipiri masoja mhinduro. Zvisinei, mishonga mishonga iri nyanzvi dzakawanda vanoti kukwana kushanda. Izvi imhaka kutyora mutemo simba zvinodhaka, uyewo kumhanyisa acho yokuparadza kwayo vanenge chiropa chirwere. Kugadzirisa nyaya iyi mukufamba ARV Panguva atumirwa kune imwe hormone zvinodhaka - "Prednisolone". Anokwanisa kuita Activate migumisiro "azathioprine". Uyezve, marwadzo pashure Mabatirwo autoimmune chiropa vari kunzwisisa kushandisa zvinodhaka mbiri munguva mana maduku achienzaniswa avo vakacherekedza apo chete "prednisolone". Izvi zvakajeka zvinoratidza kudiwa kudaro ainoita kurapwa.

Kushandisa zvinodhaka maviri panguva imwe chete kuchititadzisa kukura kuzvimba uye anobvumira mauto kukudzivirira nhengo vakazvimiririra kubvisa huripo glitches. Zvinosuruvarisa kushandisa zvinodhaka izvi, varwere vanomanikidzwa kubva mwedzi mitanhatu kusvika 4 makore. Zvisinei, vanachiremba regai kupa chero zvinovimbisa kuti kosi iyi ichava chete. Varwere vakawanda kudzokorora kupfuura kamwe muupenyu hwavo.

algorithm ichi rinoshandisirwa kurapa uye avo zviitiko apo pane mishonga autoimmune chiropa muvana.

Kubvisa kofermentativnye zvokurwara uye zvinodhaka metabolic anogona kushandiswa. Ivo vhitamini yakadaro uye multivitamin zvivako, se "kokarboksilazu", "Riboksin" uye vamwe vakawanda. In marapirwo anoshandiswa uye gepatoprotektory kuti ane kwavo Zvinoumba phospholipids. Ava zvinodhaka akafanana "Livolin", "Esentsiale", "Geptral" uye vamwe vakawanda. Maererano nenyanzvi, chinangwa mari izvi zvinofanira kuitwa chete panguva padariro ruregerero, kana pasina raidudzwa kuzvimba.

Kuti excrete kuti chepfu metabolic zvigadzirwa vaya izvo chiropa hauchadi, vanachiremba akarayira intravenous aizomupa mishonga. Kazhinji, mune zviitiko zvakadaro, mumwe mushonga "Reosorbilakt" kana sesaline. The nzira rinoitwa pasi dzose kudzora BP uye weti goho.

Alternative kurapwa vanoronga

Treatment kushandisa mubatanidzwa zvinodhaka akadai "prednisolone" uye "Azathioprine" iri zvinobudirira kushandiswa okurapa rinenge shanu emakore. kurapa kwakadaro kuchaita yekudyidzana kuwedzera upenyu hunotarisira varwere autoimmune chiropa.

Zvisinei, pari, zvose zvikuru rirwadze gakava pamusoro pakushandisa zvimwe zvirongwa kuti vave shoma nguva varwere uye kungakonzera vashoma nemishonga. Somuenzaniso, nyanzvi funga mukana kuti mishonga inogona pave autoimmune chiropa "Budenofalk". Zviri mushonga weboka 2nd chizvarwa boka glucocorticosteroids. Uyezve, ane zvishoma nemishonga uye mapfumbamwe muzana iri metabolised nokuda chiropa kare pakutanga ndima therethrough. Izvi zvinobatsira kuti kudzorera utano varwere vanenge autoimmune chiropa.

Migumisiro zvekuchipatara ongororo yakaratidza pachena kuti chinodhaka "Budenofalk" kuitwa ikashandiswa pamwe "azathioprine" kunyengedza uye kuramba kuregererwa vanhu ivavo vane autoimmune chiropa vasati aiva zviratidzo chiropa cirrhosis. In mushonga uyu pamusoro chidzoke zviduku, pane pashure kushanda "Prednisolone" nemishonga.

Maererano nevaongorori, mushonga anokwanisa kuva itsva kunotoda mwero hanya zvaishandiswa kurasa autoimmune chiropa.

kuvhiya kurapwa

Muzviitiko apo kushandiswa kwezvinodhaka mishonga kwemakore mana havana kuvandudza mamiriro murwere uye asingauyi normalize nokukanganisika pokazatelt ropa rayo, murwere rinoitwa kuvhiyiwa.

Zviri kuvhiyiwa ndinobvisa nomupi wacho nenyere. Kazhinji, izvi zvinotora chikamu chizvarwa chiropa ropa revanhu.

zvavo mishonga

Kushandisa mari, izvo yokubika akasikwa quacks kwakavakirwa dzinongoitika zvinhu, kubvumira kubvisa zviri bile, kubvisa kuda kurutsa, uye zviratidzo kudhaka, uyewo kubvisa marwadzo.

Zvinofanira kurangarirwa kuti kana munhu dzakaonekwa autoimmune chiropa, Mabatirwo chevarwere mishonga chete zvinozorodza zviratidzo chirwere, asi kuchiparadza haina zvakazara kubvumira. Nzira yakadaro inobudirira chete kana pathologies kuti anogona kubatwa nyore. Izvi zvinoshandawo nehepatitis A kana kuti muchetura mhando.

Well yakasimbiswa pakurwisa kuzvimba chiropa kwemiti siyana vane choleretic kushanda. Kwavari kugadzirira infusions uye decoctions. nemiriwo akadaro:

- yorukato midzi uye mashizha;
- chemindi anise;
- Yarrow;
- Horticultural mbeu fennel;
- St. Johani sana;
- Birch mashizha.

Kubva yemakwenzi wakavhomorwa mhosva kuti kutora pamberi kudya. An aizomupa ruva muhudyu tii anotsiviwa. Kuinwa kuburikidza uswa nokuti mumiririri uyu ane kunambwa zino enamel.

Kunobatsirawo chiropa uye muto siyana miriwo, nokuti rine yakawanda mavhitaminzi uye chicherwa zvinhu. Muto anogona kushandiswa pakurapa nehepatitis B mumba:

- Jerusarema artichoke;
- mbishi matapiri;
- kerotsi, rakasanganiswa nemvura;
- celery uye voikukka mashizha;
- mbishi beets, sanganisa nemvura.

mataridzikiro

Survival wevarwere kutambura kubva autoimmune chiropa, zvachose yakazvimirira kusimba kushoma kuitika chiropa. In munyoro Muzviitiko, 80% vanhu zviri makore anopfuura 15. Zvisinei, pasina munhu kurapa kwakakwana uye chirwere huru chete mishoma vanokwanisa kurarama makore anodarika mashanu.