AmaLupus Anticoagulants

-Delile

• Ziyini izimpawu zama-lupus anticoagulants?
• Ukuhlukaniswa kwemishado
• Izimo ezihlanganisiwe
• Ngingawahlola kanjani ama-lupus anticoagulants?
• Ukuhlolwa kwe-PTT
• Okunye ukuhlolwa kwegazi
• Zelashwa kanjani i-lupus anticoagulants?
• Imithi yokuncipha kwegazi
• Ukuphuza ama-steroid
• Ukushintshaniswa kwe-Plasma
• Ukuyeka eminye imithi
• Izinguquko zendlela yokuphila
• Ukuvivinya umzimba njalo
• Yeka ukubhema futhi ulinganisele ukuphuza kwakho
• Ukuncipha emsimbeni
• Nciphisa ukudla kwakho ukudla okunothe ngo-vitamin K
• Uyini umbono?

Yini ama-lupus anticoagulants?

AmaLupus anticoagulants (LAs) awuhlobo lwe-antibody ekhiqizwa amasosha omzimba wakho.Ngenkathi amasosha omzimba amaningi ehlasela izifo emzimbeni, ama-LA ahlasela amaseli anempilo namaprotheni eseli.

Bahlasela i-phospholipids, okuyizinto ezibalulekile zezingqamuzana zeseli. Ama-LA ahlotshaniswa nesifo sokuzivikela komzimba esaziwa njenge-antiphospholipid syndrome.

Ziyini izimpawu zama-lupus anticoagulants?

Ama-LA angakhuphula ubungozi bamahlule egazi. Kodwa-ke, amasosha omzimba angaba khona futhi angaholeli ehluleni.

Uma uba negazi egazini kwesinye sezingalo noma emilenzeni yakho, izimpawu zingafaka:

• ukuvuvukala engalweni noma emlenzeni
• ububomvu noma ukushintsha kombala engalweni noma emlenzeni
• ubunzima bokuphefumula
• ubuhlungu noma ukuba ndikindiki engalweni noma emlenzeni

Ukuqina kwegazi endaweni yenhliziyo yakho noma amaphaphu kungadala:

• ubuhlungu besifuba
• ukujuluka okweqile
• ubunzima bokuphefumula
• ukukhathala, isiyezi, noma kokubili

Amahlule egazi esiswini sakho noma ezinso angaholela ku:

• ubuhlungu besisu
• ubuhlungu bethanga
• isicanucanu
• uhudo noma indle enegazi
• imfiva

Amahlule egazi angasongela impilo uma engelashwa ngokushesha.

Ukuhlukaniswa kwemishado

Amahlule amancane egazi abangelwa ama-LAs angaqinisa ukukhulelwa futhi abangele ukukhulelwa kwesisu. Ukuphuphuma kwesisu okuningi kungaba uphawu lwama-LAs, ikakhulukazi uma kwenzeka ngemuva kwe-trimester yokuqala.

Izimo ezihlanganisiwe

Cishe uhhafu wabantu abane-LA banesifo se-autoimmune lupus.

Ngingawahlola kanjani ama-lupus anticoagulants?

Udokotela wakho angalalela ukuhlolwa kwama-LA uma unamahlule egazi angachazeki noma uke waba nezisu eziningi.

Akukho sivivinyo esisodwa esisiza odokotela ukuxilonga ngokuphelele ama-LA. Ukuhlolwa kwegazi okuningi kuyadingeka ukuthola ukuthi ngabe ama-LA akhona yini egazini lakho. Ukuphinda ukuhlolwa kuyadingeka ngokuhamba kwesikhathi ukuqinisekisa ubukhona bazo. Lokhu kungenxa yokuthi la ma-antibody angavela ngokutheleleka, kepha ahambe uma isifo sesixazululekile.

Ukuhlolwa kungafaka:

Ukuhlolwa kwe-PTT

Isivivinyo se-thromboplastin esinqunyiwe (PTT) silinganisa isikhathi esithatha igazi lakho ukujiya. Ingabuye iveze ukuthi ngabe igazi lakho liqukethe ama-anticoagulant antibodies. Kodwa-ke, ngeke iveze ukuthi unawo yini ama-LA.

Uma imiphumela yakho yokuhlolwa ikhombisa ukuba khona kwama-anticoagulant antibodies, kuzodingeka uphinde uhlolwe. Ukuphinda uzame kaningi kwenzeka cishe emavikini ayi-12.

Okunye ukuhlolwa kwegazi

Uma ukuhlolwa kwakho kwe-PTT kukhombisa ukutholakala kwama-anticoagulant antibodies, udokotela wakho angalawula ezinye izinhlobo zokuhlolwa kwegazi ukubheka izimpawu zezinye izimo zezokwelapha. Ukuhlolwa okunjalo kungafaka:

• ukuhlolwa kwe-anticardiolipin antibody
• isikhathi sokuvala i-kaolin
• ukuhlolwa kwe-coagulation factor
• hlaziya uvivinyo lwesihlungu sezinyoka zikaRussell (DRVVT)
• I-LA-sensitive PTT
• i-beta-2 glycoprotein 1 ukuhlolwa kwamasosha omzimba

Lokhu konke ukuhlolwa kwegazi okunengozi encane. Ungase uzizwe ulunywa okwesikhashana lapho inaliti ihlaba isikhumba sakho. Kungazizwa kukubi ngemuva kwalokho. Kukhona nengozi encane yokutheleleka noma yokopha, njenganoma yikuphi ukuhlolwa kwegazi.

Zelashwa kanjani i-lupus anticoagulants?

Akuwona wonke umuntu othola ukuxilongwa kwama-LA adinga ukwelashwa. Uma ungenazo izimpawu futhi ungakaze ube namahlule egazi phambilini, udokotela wakho kungenzeka anikeze ukuthi akukho ukwelashwa okwamanje, inqobo nje uma uzizwa uphilile.

Izinhlelo zokwelashwa zizohluka kuye ngomuntu ngamunye.

Imithi yokwelashwa yama-LA ifaka:

Imithi yokuncipha kwegazi

Le mithi isiza ukuvimbela amahlule egazi ngokucindezela ukukhiqizwa kwesibindi sakho sikavithamini K, okusiza ukujiya kwegazi. Abanciphisa igazi abajwayelekile bahlanganisa i-heparin ne-warfarin. Udokotela wakho futhi angakunikeza i-aspirin. Lesi sidakamizwa sivimbela ukusebenza kweplatelet esikhundleni sokucindezela ukukhiqizwa kukavithamini K.

Uma udokotela wakho ekuyalela ukuthi kube nabanciphisi begazi, igazi lakho lizohlolwa ngezikhathi ezithile ukutholakala kwama-antibody e-cardiolipin ne-beta-2 glycoprotein 1. Uma imiphumela yakho yokuhlolwa ikhombisa ukuthi amasosha omzimba ahambile, ungakwazi ukuyeka imithi yakho. Kodwa-ke, lokhu kufanele kwenziwe kuphela ngokubonisana nodokotela wakho.

Abanye abantu abanama-LA badinga kuphela ukuthatha izinciphisi zegazi izinyanga ezimbalwa. Abanye abantu badinga ukuhlala emithini yabo isikhathi eside.

Ukuphuza ama-steroid

Ama-steroid, afana ne-prednisone ne-cortisone, angavimbela ukukhiqizwa kwamasosha akho omzimba ama-antibodies e-LA.

Ukushintshaniswa kwe-Plasma

Ukushintshaniswa kweplasma kuyinqubo lapho umshini uhlukanisa khona i-plasma yakho yegazi - equkethe ama-LA - kwamanye amaseli akho egazi. I-plasma equkethe ama-LA ithathelwa indawo yi-plasma, noma into engena esikhundleni se-plasma, engenawo amasosha omzimba. Le nqubo ibizwa nangokuthi i-plasmapheresis.

Ukuyeka eminye imithi

Eminye imithi ejwayelekile ingadala i-LA. Le mithi ihlanganisa:

• amaphilisi okuvimbela inzalo
• Ama-ACE inhibitors
• i-quinine

Khuluma nodokotela wakho nganoma imuphi umuthi owuthathayo ukunquma ukuthi ungadala i-LAs. Uma kunjalo, wena nodokotela wakho ningaxoxa ngokuthi ngabe kuphephile yini kuwe ukuyeka ukusetshenziswa.

Izinguquko zendlela yokuphila

Kunezinguquko ezilula zempilo ongazenza ezingakusiza futhi ukuphatha ama-LA, noma ngabe uthatha imithi yesimo sakho noma cha. Lokhu kufaka phakathi:

Ukuvivinya umzimba njalo

Ukuzivocavoca nokunyakaza kwandisa ukugeleza kwegazi. Lokhu kusho ukuthi kusiza nokuvikela ukuvimba kwegazi. Thola indlela oyithandayo yokuvivinya umzimba futhi ukwenze njalo. Akudingeki ukuba kube nzima. Ukumane uhambe kahle nsuku zonke kungashukumisela ukugeleza kwegazi.

Yeka ukubhema futhi ulinganisele ukuphuza kwakho

Ukuyeka ukubhema kubaluleke kakhulu uma unama-LA. I-nicotine ibangela ukuthi imithambo yegazi yakho iqhume, okuholela ekunqandeni.

Ukuhlolwa kwemitholampilo kukhombisile ukuthi ukuphuza ngokweqile utshwala kuhlotshaniswa nokwakheka kwegazi.

Ukuncipha emsimbeni

Amaseli amafutha akhiqiza izinto ezingavimbela amahlule egazi ancibilike njengoba kufanele. Uma ukhuluphele ngokweqile, ukugeleza kwegazi lakho kungathwala eziningi kakhulu zalezi zinto.

Nciphisa ukudla kwakho ukudla okunothe ngo-vitamin K

Ukudla okuningi okuqukethe uvithamini K omningi kukusiza ngenye indlela, kepha kuyasiza ukudala amahlule egazi.

Uma usebenzisa izinciphisi zegazi, ukudla ukudla okunovithamini K omningi akulutho ekwelashweni kwakho. Ukudla okunothe ku-vitamin K kufaka:

• i-broccoli
• ulethisi
• isipinashi
• i-asparagus
• umlimi
• iparsley
• iklabishi

Uyini umbono?

Ezimweni eziningi, kokubili ukuvimba kwegazi nezimpawu zama-LA kungalawulwa ngokwelashwa.

Ngokusho kokubuyekezwa kuka-2002, abesifazane abelashwa i-antiphospholipid syndrome - imvamisa abane-aspirin enomthamo ophansi kanye ne-heparin - banamathuba angaba ngamaphesenti angama-70 okuphatha ukukhulelwa okuphumelelayo kuze kube sekupheleni.