Thrombocytopenic purpura nedzevakuru: chirwere, zvinokonzera uye kurapwa

Thrombocytopenic purpura nedzevakuru - ari chirwere chinogona kukonzera nokukurumidza kwaita makuru mavanga uye ropa. Kazhinji, kurasikirwa ropa riri nokuda kunoshamisa kuwa muna platelet count - masero kuti dzinobatsira ayo pakugwamba.

Zvimwe zvinokonzera zvokurwara ichi chinonziwo masoja thrombocytopenia. Kunochinja vakuru nevana, asi muvarwere vaduku akaita ezvinhu kazhinji ikabuda pakanyorwa akabatwa chirwere uye mumwoyo pamusoro yayo pasina kudikanwa vavashandire. In vakuru, chirwere chiri kakawanda refu mumwe.

Kana hamuna zviratidzo ropa uye platelet kuverenga, kunyange pasi, asi, pfungwa, dzinogutsa, chiremba ingangova haangaregi taurira kurapwa. Zvisinei, Mune zvisingawanzoitiki zviitiko, nhamba maplatelet inowira yakaoma zvishoma, zvichikonzera zvinouraya zvemukati kubuda ropa. Nokuti kurapa yematambudziko izvi zvinoda nokukurumidza zvokurapa kupindira.

zviratidzo

Thrombocytopenic purpura nedzevakuru (yaifananidzira pamusoro) nguva dzose pamwe zvokunze kuratidzirwa chirwere. Kana kwese zviratidzo ndeizvi zviratidzo chirwere:

• wo nokukurumidza nezvekugadzirwa kupwanywa guru (hematoma);
• zvachero ropa paganda kuti anotarisa akafanana mapundu duku, tsvuku-tsvuku makwapa (petechiae) uye ari vemunyika kunyanya pamusoro makumbo;
• ropa kubva matadza kana mhuno;
• kuvapo ropa weti kana chetsoka;
• outsinye rinorema kumwedzi ropa.

Kana kuona chiremba

Thrombocytopenic purpura vari vakuru vanogona kuva zvokuva nehanya, uye iyi zviri nani taronga pachine munhu anokwanisa nyanzvi.

Kana akatanga ropa, dana "amburenzi." Typical nokuti ropa ichi chirwere hazvigoni ichitongwa kwakajairika nzira kubva pamba zvi- kana mifananidzo nzira ropa riyerere kwamira. Somuenzaniso, musingadi kubatsira kumanikidza rinoda yakakodzera nzvimbo muviri. Nyanzvi vanokurudzira kutendeukira kuzobatsira vanachiremba nokukurumidza sezvinobvira.

zvikonzero

Idiopathic thrombocytopenic purpura nedzevakuru dzimwe nguva vanova nokuti muviri zvirwere chikanganiso nokurwiswa uye anoparadza maplatelet. Shoko rokuti "idiopathic" rinoreva "rakavapo isingazivikanwi chikonzero"; thrombocytopenia saka maitiro muzviitiko apo vanachiremba vasingakwanisi kuziva chii akaparirwa rwakakwana maitiro zvirwere.

Vana akaisa nechekumashure zvokurwara Zvinowanzova nyore, sezvo chirwere kuti kunyanya ane zvirwere (mumps kana besa). Zvinofungirwa kuti utachiona kuchambokanganisa kunowanzoitika kushanda zvirwere.

Kuwedzera platelet disintegration

Kana kwokutanga zvokuongorora anova thrombocytopenic purpura vari vakuru, kukiriniki (zvekuchipatara kuratidzwa) kwakabatana, kazhinji vane zvirwere nyonganyonga. The antibodies vachikoshesa kuna maplatelet, chokuguma kwavari masero kuti kuparadzwa. Chirwatata zvakagadzirirwa kubata kwokunze zvirwere, kuti antibody anoziva uye anobvisa maplatelet kubva mumuviri. Somugumisiro ichi yakakanganiswa Kuzivikanwa muropa circulates nhamba duku zvikuru kuti maplatelet tichienzanisa vasingambooni chakaipa nazvo.

Normal platelet Counts siyana 150 kusvika 450 zviuru masero por microliter kuti achiparadzira ropa. Vanhu nechirwere "thrombocytopenic purpura" (vakuru) ongororo inoratidza masero 20,000 chete kunodiwa. Sezvo maplatelet pave kweropa, nokuderedza nhamba yavo kunowedzera njodzi ropa uye munyika kubuda ropa. The pamwero zviuru 10 muchitokisi kubaya. With yakadaro inokosha kuderera kwenhamba maplatelet womukati ropa anokwanisa kutanga kunyange pasina chinhu kunotevera.

zvinokonzera njodzi

Zvisinei, Thrombocytopenic purpura nedzevakuru (Photo zvaishandiswa pakutanga kwenyaya ino, inoratidza kwokunze kuratidzwa chirwere) rinowanikwa chero zera, masayendisiti vanozivikanwa zviviri ngozi zvinhu kuti zvinowedzera mukana wokuti dzichiri chirwere zviratidzo. Ivo:

• Sexual ani. Vakadzi, chirwere ichi chirwere Paavhareji maviri katatu kakawanda kupfuura vanhu.
• Munguva ichangopfuura, imwe nemavhairasi zvirwere zvinotapukira. Mumps, gwirikwiti uye zvirwere kufema kungatowedzera pakuonekwa maitiro zviratidzo thrombocytopenia, asi ukama nemavhairasi kuwanikwa kazhinji vana.

Zvinofanira kungwarira ngozi yematambudziko. The zvakakura vavo - uyu uropi ropa, izvo zvinogona kuuraya.

pamuviri

Kunyange thrombocytopenic purpura nedzevakuru chirwere kunyange vakadzi pamuviri, mamiriro achangoberekwa utano zvokurwara kwakadaro mai kakawanda haina kukanganiswa. Zvisinei, nyanzvi, Zvinokurudzirwa kuti aone pachiyero maplatelet muropa mwana pakarepo pashure pokuberekwa.

Kana uine pamuviri, asi pakuongororwa vanoratidza vasanyanye platelet kuverenga, uri pangozi sezvakaita ndingangokuvara yakasimba hwomukova postpartum ropa chaizvo. Muzviitiko zvakadaro, pane gayinakorojisiti kana muchipatara, vanachiremba vanofanira kukurukura newe iripo dzokurapa vakachengeteka vana.

Diagnostics

The chiremba akakwanisa kuita kuongororwa zvakarurama "purpura thrombocytopenic" (vakuru), Dambudziko kuitwa pamusoro differential zano. Zvinofanira kuva pakarepo ushe vamwe zvichibvira zvinokonzera ropa uye kuderedza uwandu maplatelet - semuenzaniso, chirwere zvirwere kana divi zvinokonzerwa zvinodhaka akatorwa nemi.

Mazvikokota vachakubvisisayi mibvunzo enhoroondo wako zvokurapa, ichabereka wezvokurapa kuongororwa pakutanga uye anofanira kunan'anura mumwe kana kupfuura mwero chirwere nemiedzo. Ekupedzisira dzinosanganisira:

• Complete count ropa. Zvichienderana wezvaizogona wakatorwa kubva ropa zvomurwere akatsunga tikwanise reshiyo masero eropa, uye imwe nhamba maplatelet. Kana thrombocytopenia rokupedzisira parameter iri zvisinganzwisisiki pasi, pasinei nokuti kwevari chena uye matsvuku masero vacharamba kuti avhareji.
• Clinical Kuongororwa kweropa. Kudzidza uku kakawanda anoitwa kuzosimbisa pachiyero maplatelet yaunganidzwa zvachose ropa kuongorora. A murwere chiratidzazvizhinji anoiswa pamusoro rinokosha regirazi nemasiraidhi uye aongororwe maikorosikopu.
• Analysis kuti mwongo. Izvi tsvakurudzo nzira iri chete pachii varwere vakura vane dzakamboitika chirwere kuti "thrombocytopenic purpura" (vakuru pavakanzwa izvozvo chiitiko zvakawanda zvakakwana, vari nyore kushivirira muitiro).

Maplatelet anobudiswa mu mumwongo - the nyoro, chirambe chakapfava zvinyama pakati mapfupa makuru. Mune zvimwe zviitiko, chiremba anogona kubvisa nzwisa pfupa rinenge riri mukati mumwongo biopsy nzira. Vamwe vanachiremba vanosarudza kutora ivhu kuti ongororo ne nzira inonzi "chido," uye zvadaro kubviswa mumwongo chete chikamu emura zvinoriumba. Kakawanda, nzira mbiri anoteererwa panguva uye vari pamwe kunzi "mwongo kuongorora."

Idiopathic thrombocytopenic purpura mwongo akasununguka kubva pathologies, sezvo zvinoderedza platelet Count kunokonzerwa kuparadzwa masero muropa uye dysfunction pamusoro chirwatata uye hapana nezvinetso pagadzirwe maplatelet.

mabatiro

Easy thrombocytopenic purpura nedzevakuru, zvinokonzera izvo zvisina yakavimbika yakasimbiswa, kazhinji haatarisiri marapiro - zvikuru kugara kuonekwa chiremba, uye panguva nenguva kuongorora pachiyero maplatelet. Vana vanenge usambofa zvinoda kurapwa, uye kushushikana anomhanya pacharo. Zvisinei, vakuru, zvingada zvinobudirira kurapwa kana mamiriro yaita zvakakomba kana mazhinji (chirwere) hunhu.

Nzira yokurapa zvakasiyana uye dzinosiyana mishonga kukura kusimudzira platelet count asati kuvhiyiwa kubvisa chirwatata (splenectomy). Zvinokurudzirwa kukurukura nachiremba wako pachine marapirwo pamwe zvakanakira nekuipira kuvhiyiwa. Vamwe varwere vanoona kuti divi migumisiro kutora mishonga avanunure zvakawanda kuzvuzvungudza uye kusagadzikana pane chaiko zvakazokonzerwa chirwere.

mishonga

Chiremba ichakurukura newe kurutivi migumisiro uye chipimo chemushonga pamusoro mishonga uye Mishonga zvokuwedzera kuti uri kutora panguva. Zvichida vamwe vanobatsira kuderedza kwevari maplatelet iri achiparadzira ropa. Izvi marwadzo vane aspirin, "Ibuprofen", "Ginkgo biloba" uye "Warfarin".

The huru Pamazita

Kana chirwere kunosimbiswa "thrombocytopenic purpura" vanhu vakuru, kurapwa kunogona kuva kutora zvinotevera mishonga:

1. Mishonga kuti vasaziva zvirwere. Varwere vakawanda mukutanga kurapa pauri dzinogamuchidzanwa corticosteroids akadai "Prednisone". Kuderedza rokuzvidzivirira basa, mushonga uyu unokurudzira platelet count. Kamwe zvinonyatsorehwa pamwero kwasvika kunogamuchirika pamwero, vachava pasi pokudzora chiremba zvishoma nezvishoma kunwa mishonga. Yawapiwa zvinotora kubva maviri mavhiki matanhatu.

Chinetso ndechokuti thrombocytopenic purpura nedzevakuru, zviratidzo izvo zvikava pasina pashure pakugamuchira "Prednisone" anogona kudzoka pakupera mishonga. Doctors kazhinji mishonga mutsva nenzira corticosteroids, zvisinei, kurapwa ichi hazvigoni akaramba nokusingaperi nokuti zvakakomba divi migumisiro ichi nemishonga mhando. Kana zvichiita ovhadhozi cataract, vakawedzera ropa shuga yomuropa, vakawedzera mukana zvirwere uye osteoporosis (kwakaderera mapfupa).

2. jekiseni kuwedzera uwandu masero eropa. Kana corticosteroids regai kubatsira, vanachiremba vanonyorera jekiseni masoja globulin,. mushonga uyu rinoshandiswawo zviitiko apo murwere kwakaratidza zvikuru ropa kuti kunoda pakarepo kuvhiya kupindira. Kuvhiringidzwa kunotora vaviri kwemavhiki. Pakati zvingakonzerwa nemishonga - nomusoro, kurutsa, uye vakaderera BP.

3. Formulations mhanyisa platelet kugadzirwa. Zvinodhaka akadai "Romiplostim" uye "Eltrombopag" ( "PROMAKTIV"), zvinobatsira mumwongo kubereka zvakawanda maplatelet. Muchimiro nemishonga angava nemusoro, dzungu, kuda kurutsa uye kurutsa.

4. Other immunosuppressants. "Rituximab" ( "Rituxan ') kunoderedza kusimba ari zvemamiriro kwaiita zvirwere chinoguma zvisingatomboiti maplatelet vaparadzwa. Anotarisirwa nemishonga zvinosanganisira ganda mapundu, pasi BP, nefivhiri, uye kwazvo huro.

Kana zvinodhaka simba

Kana (uye dzimwe nguva havaiti kubatsira vakuru kunovaka muviri maererano nenheyo mararamiro utano, tichidzivisa doro uye kunwa mushonga kubvisa dambudziko) iwe mberi thrombocytopenic purpura, chiremba ringavakurudzira kuvhiyiwa. Nokubviswa chirwatata (splenectomy) nokukurumidza hakubvisi zvokurwara, sezvo chiremba anocheka chikuru muparadzi maplatelet. Yeuka Zvisinei, kuti iwe uchava pangozi postoperative yematambudziko. Uyezve, vanhu vasina chirwatata nguva yakawedzerwa pedambudziko roku- zvirwere zvinotapuriranwa.

dzimwe nzira

Kana, nokuti utano kana zvimwe zvikonzero, haugoni kutenga kuvhiyiwa, chiremba wacho anogona mishonga yacho kubvuma mishonga mitsva - semuenzaniso, "azathioprine" ( "Azathioprine", "Azasan"). Zvisinei zvinodhaka zvakawanda simba inosanganisira zvakawanda zvikuru nemishonga. "Azathioprine", zvikurukuru, rinoita kuwedzera muviri tembiricha, nomusoro, kuda kurutsa, kurutsa, uye tsandanyama kurwadziwa.

With chisingaperi kushungurudzwa

Iwe nechirwere "thrombocytopenic purpura"? In vakuru, panowanikwa chirwere ichi zvinoda kuchinja mararamiro. Sezvo chirwere achabatsirwa mikana yakawanda ropa, kudzivisa nengozi kuonana mitambo (tsiva, zvombo, nhabvu) uye sei unogona kutarisira pachavo muviri.