I-autoimmune hepatitis: iyini, izimpawu eziyinhloko, ukuxilongwa nokwelashwa

-Delile

• Izimpawu eziyinhloko
• I-autoimmune hepatitis ekukhulelweni
• Ungaqinisekisa kanjani
• Yelashwa kanjani

I-autoimmune hepatitis yisifo esidala ukuvuvukala okungapheli kwesibindi ngenxa yoshintsho kumasosha omzimba, aqala ukubona amaseli awo njengawangaphandle futhi awahlasele, abangele ukwehla kokusebenza kwesibindi nokuvela kwezimpawu ezifana ubuhlungu besisu, isikhumba esiphuzi kanye nesicanucanu esinamandla.

I-autoimmune hepatitis ezenzakalelayo ivame ukuvela ngaphambi kweminyaka yobudala engama-30 futhi ivame kakhulu kwabesifazane. Imbangela ngqo yokuqhamuka kwalesi sifo, okungenzeka ukuthi ihlobene nokushintshwa kwezakhi zofuzo, ayikaziwa, kodwa kufanele kukhunjulwe ukuthi akusona isifo esithathelwanayo ngakho-ke, asikwazi ukudluliselwa sisuke komunye umuntu siye komunye.

Ngaphezu kwalokho, i-hepatitis ezenzakalelayo ingahlukaniswa ngama-subtypes amathathu:

• Uhlobo lwe-hepatitis 1 oluzenzakalelayo: okuvame kakhulu phakathi kweminyaka engu-16 nengama-30 ubudala, okubonakala ngokuba khona kwama-antibodies e-FAN ne-AML esivivinyweni segazi, futhi kungahle kuhlotshaniswe nokuvela kwezinye izifo ezizimele, ezifana ne-thyroiditis, isifo se-celiac, i-synovitis ne-ulcerative colitis;
• Uhlobo lwe-hepatitis 2 oluzenzakalelayo: ivame ukuvela ezinganeni ezineminyaka engu-2 kuya kwengu-14, i-antibody ephawulekayo i-Anti-LKM1, futhi ingavela ngokuhlangana nohlobo 1 lwesifo sikashukela, i-vitiligo ne-autoimmune thyroiditis;

• Uhlobo lwe-hepatitis 3 oluzenzakalelayo: ifana nohlobo 1 lwe-hepatitis ezenzakalelayo, ene-anti-SLA / LP antibody enhle, kepha kungenzeka ibe nzima kakhulu kunohlobo 1.

  
  

Yize lungekho ikhambi, i-autoimmune hepatitis ingalawulwa kahle ngokwelashwa, okwenziwa ngemithi yokulawula ukuzivikela komzimba, njengePrednisone ne-Azathioprine, ngaphezu kokudla okunomsoco, okunothile ngezithelo, imifino nokusanhlamvu, okugwenywayo. - ukuphuza utshwala, amafutha, okweqile kwemithi yokubulala kanye ne-pesticides. Ukuhlinzwa noma ukufakelwa kwesibindi kuboniswa kuphela ezimweni ezinzima kakhulu.

Izimpawu eziyinhloko

Izimpawu zesifo sokusha kwesibindi esizimele imvamisa azicacisi futhi isithombe somtholampilo singahluka kusuka esigulini esingalindelekile kuye lapho kwenzeka ukwehluleka kwesibindi. Ngakho-ke, izimpawu nezimpawu eziyinhloko ezingakhombisa ukuthi i-hepatitis ezenzakalelayo yilezi:

• Ukukhathala ngokweqile;
• Ukuphelelwa isifiso sokudla;
• Ubuhlungu bemisipha;
• Ubuhlungu besisu obuhlala njalo;
• Isicanucanu nokuhlanza;
• Isikhumba esiphuzi namehlo, abizwa nangokuthi i-jaundice;
• Umzimba omncane olumayo;
• Ubuhlungu obuhlangene;
• Isisu esivuvukile.

Imvamisa lesi sifo siqala kancane kancane, sikhula kancane kusuka emavikini kuye ezinyangeni size siholele ku-fibrosis yesibindi nokulahlekelwa ngumsebenzi, uma lesi sifo singakhonjwa futhi singelashwa. Kodwa-ke, kwezinye izimo, lesi sifo singakhula ngokushesha, sibizwe ngokuthi yi-fulminant hepatitis, esibi kakhulu futhi esingaholela ekufeni. Yazi ukuthi kuyini nokuthi ziyini izingozi ze-hepatitis egcwele.

Ngaphezu kwalokho, ezimeni ezimbalwa, lesi sifo kungenzeka singazibangeli izimpawu, sitholakale ekuhlolweni okujwayelekile, okukhombisa ukwanda kwama-enzyme wesibindi. Kubalulekile ukuthi ukuxilongwa kwenziwe kusenesikhathi ukuze ukwelashwa kusheshe kusungulwe ngudokotela, ukwazi ukugwema izinkinga, ezifana ne-cirrhosis, ascites ne-hepatic encephalopathy.

I-autoimmune hepatitis ekukhulelweni

Izimpawu zesifo sokusha kwesibindi sokuzimela lapho ukhulelwe ziyefana nalezo zesifo ngaphandle kwalesi sikhathi futhi kubalulekile ukuthi owesifazane ahambisane nodokotela wokubelethisa ukuyobheka ukuthi azikho yini izingcuphe yena nengane, nokuyinto engajwayelekile lapho isifo isathola kusenesikhathi.

Kwabesifazane abakhulelwe abanesifo esithuthuke kakhulu futhi abane-cirrhosis njengenkinga, ukuqapha kubaluleke kakhulu, ngoba kunengozi enkulu yokuzalwa ngaphambi kwesikhathi, isisindo sokuzalwa esiphansi kanye nesidingo sengxenye yokuhlinzwa. Ngakho-ke, kubalulekile ukuthi udokotela obelethisayo akhombise ukwelashwa okungcono kakhulu, okuvame ukwenziwa nge-corticosteroid, njengePrednisone.

Ungaqinisekisa kanjani

Ukuxilongwa kwe-hepatitis ezenzakalelayo yenziwa ngokuhlola izimpawu nezimpawu ezilethwa ngumuntu nomphumela wokuhlolwa kwelabhorethri okufanele kucelwe ngudokotela. Olunye lwezivivinyo oluqinisekisa ukutholakala kwesifo sokusha kwesibindi okuzenzakalelayo yi-biopsy yesibindi, lapho kuqoqwa khona ucezu lwalesi sitho bese luthunyelwa elabhorethri ukuze lubone izinguquko ezicutshini ezibonisa i-hepatitis ezenzakalelayo.

Ngaphezu kwalokho, udokotela anga-oda ukukalwa kwama-enzyme wesibindi, njenge-TGO, TGP kanye ne-alkaline phosphatase, ngaphezu kwesilinganiso sama-immunoglobulin, amasosha omzimba kanye ne-serology yamagciwane e-hepatitis A, B no-C.

Imikhuba yakhe yokuphila iyabhekwa nangesikhathi sokuxilongwa, njengokuphuza ngokweqile nokusetshenziswa kwemithi enobuthi esibindini, okwenza kukhishwe ezinye izimbangela zezinkinga zesibindi.

Yelashwa kanjani

Ukwelashwa kwe-autoimmune hepatitis kukhonjiswa yi-hepatologist noma i-gastroenterologist, futhi kuqalwa ngokusetshenziswa kwezidakamizwa ze-corticosteroid, njenge-Prednisone, noma ama-immunosuppressants, njenge-Azathioprine, anciphisa ukuvuvukala kwesibindi okunamandla ngokukugcina kulawula eminyakeni edlule, futhi kungaba kwenziwe ekhaya. Kwezinye izimo, ikakhulukazi ezigulini ezisencane, kunganconywa ukusetshenziswa kwenhlanganisela yePrednisone ne-Azathioprine ukunciphisa imiphumela emibi.

Ngaphezu kwalokho, kunconywa ukuthi iziguli ezine-hepatitis ezenzakalelayo zizidle ngokudla okuhlukahlukene futhi okulinganiselayo, okugwema ukuphuza utshwala noma ukudla ukudla okunamafutha kakhulu, njengamasoseji nokudla okulula.

Ezimweni ezinzima kakhulu, lapho kungenakwenzeka ukulawula ukuvuvukala ngokusetshenziswa kwezidakamizwa, ukuhlinzekwa kokufakelwa kwesibindi, okubandakanya ukufaka isibindi esigulayo ngesinempilo, kungasetshenziswa. Kodwa-ke, njengoba i-autoimmune hepatitis ihlobene namasosha omzimba hhayi nesibindi, ngemuva kokufakelwa kungenzeka ukuthi lesi sifo sizokhula kabusha.