Ukwakhiwa kwawo wonke amaseli omzimba kuhlanganisa ama-esters ama-acids aphakeme aphezulu kanye no-alcohols. Lezi zinhlanganisela zamakhemikhali zibizwa ngokuthi i-phospholipids, zinesibopho sokugcina isakhiwo esifanele samathishu, zibandakanye ezinkambisweni zemithambo kanye nasekuseni kwe-cholesterol. Isimo sezempilo jikelele sincike ekugxilweni kwalezi zinto.
I-AFS-syndrome - iyini?
Cishe eminyakeni engaba ngu-35 eyedlule, u-Graham Hughes we-rheumatistist wathola isifo lapho amasosha omzimba eqala ukukhiqiza ama-antibodies athile ngokumelene ne-phospholipids. Bambene namaplatelet kanye nezindonga ze-vascular, basebenzisane namaprotheni, bangene ekuphenduleni komzimba nokugubha. Zombili i-syndrome yesibili kanye eyinhloko yamagciwane omzimba we-antiphospholipid yisifo esizimele ngokuvela emvelaphi engacacisiwe. Le nkinga kungenzeka ukuthi ithinte abesifazane besifazane abaneminyaka yobudala bokuzala.
Antiphospholipid syndrome - izimbangela
Ku-rheumatologists kodwa kwakungenakwenzeka ukubeka, kungani kukhona ukugula okucatshangwa noma isifo. Kukhona ulwazi lokuthi i-antiphospholipid syndrome ivame ukutholakala ngezihlobo ezine-disorder efanayo. Ngaphandle kokufa, ochwepheshe batjengisa ezinye izinto eziningana ezivusa ukwelapha. Ezimweni ezinjalo, i-AFS yesibili iqala - izimbangela zokukhiqizwa kwama-antibody zihambisana nokuqhubeka kwezinye izifo ezithinta ukusebenza kwesistimu yomzimba. Isu lokwelapha lusekelwe ezindleleni zokuqala kwalesi sifo.
I-antiphospholipid syndrome eyinhloko
Loluhlobo lwe-pathology luqala ngokuzimela, hhayi ngokumelene nesimo sezinkinga ezithile emzimbeni. Le-syndrome yama-antiphospholipid antibodies kunzima ukuphatha ngenxa yokuntuleka kwezici ezicasulayo. Ngokuvamile uhlobo oluyinhloko lwesifo luyinto elula kakhulu futhi lufunyanwa kakade ezinyathelweni ezincane zokuqhubeka noma lapho kwenzeka khona izinkinga.
I-antiphospholipid syndrome yesibili
Lokhu okuhlukile kokuphendula okuzenzakalelayo kuvela ngenxa yobukhona bezinye izifo zesimiso noma ezinye izenzakalo zemitholampilo. Ukukhuthazwa kokuqala kokuthuthukiswa kwamathambo kwamagciwane kungase kube nomklamo. I-Antiphospholipid syndrome kwabesifazane abakhulelwe itholakele kumacala angu-5%. Uma lesi sifo esibucayi sitholwa ngaphambili, ukuthela kuyokwandisa inkambo yayo.
Izifo ezibhekwa ukuthi zenza i-antiphospholipid syndrome:
- ukutheleleka kwamagciwane nesibindi;
- i-neoplasms yezinto eziphilayo;
- i-nodular periarteritis;
- i-systemic lupus erythematosus.
Antiphospholipid syndrome - izimpawu kubesifazane
Isithombe somtholampilo se-pathology sihluke kakhulu futhi singenasici, esiyinkimbinkimbi yokuhlonza ukuhlukana. Ngezinye izikhathi ukukhubazeka kwenzeka ngaphandle kwezimpawu, kodwa ngokuvamile i-antiphospholipid syndrome ibonakala ngendlela ye-thrombosis ephindaphindiwe yemithwalo yegazi engapheli futhi ejulile (i-arteries noma i-veins):
- izitho ezincane;
- isibindi;
- i-retina;
- ubuchopho;
- inhliziyo;
- ukukhanya;
- izinso.
Izimpawu ezijwayelekile kwabesifazane:
- i-pattern ebizwa ngokuthi i-vascular pattern esikhumbeni (i-liveroid esicacisiwe);
- i-infarction ye-myocardial;
- i-migraines;
- ukuhlushwa;
- ubuhlungu esifubeni;
- i-varicose veins;
- i-thrombophlebitis;
- ukushaywa;
- ukucindezeleka komzimba;
- ukungakwazi ukusebenza kwama-renal;
- ascites;
- ukuhlaselwa kwe-ischemic ;
- ukukhwehlela okunzima;
- i-necrosis yamathambo nama-tissue alula;
- i-portal hypertension;
- ukuphuma kwamathumbu;
- ukulimala kwesibindi esikhulu;
- i-infringction ye-spleen;
- ukufa kwe-intrauterine fetal;
- ukukhulelwa okungahambi kahle.
Antiphospholipid syndrome - ukuxilongwa
Kunzima ukufakazela ukuba khona kwe-pathology echazwe, ngoba ibamba ezinye izifo, kunezibonakaliso ezingekho emthethweni. Ukuze kutholakale lesi sifo, odokotela basebenzisa amaqembu amabili okuhlukaniswa. Ukuhlolwa kwe-antiphospholipid syndrome kuqala kuhilela ukuqoqwa kwe-anamnesis. Uhlobo lokuqala lwezinkomba zokuhlola lufaka phakathi izimo zomtholampilo:
- I-thrombosis ye-Vascular. Umlando wezokwelapha kufanele uqukethe amacala owodwa noma ngaphezulu emonakalweni emithanjeni noma emithanjeni eyenziwe nge-instrumentally kanye ne-laboratory.
- I-pathology engavamile. Umgogodla uhlolwe uma ukufa kwe-intrauterine kokuzalwa kwentombazane kwenzeka ngemuva kweviki leshumi lokubeletha noma ukubeletha ngaphambi kwesikhathi ngaphambi kokuzalwa kwamaviki angama-34 ngokungabikho kwe-chromosomal, i-hormonal kanye ne-imperomical defects evela kubazali.
Ngemuva kokuba umlando wezokwelapha uqoqwe, udokotela ukhetha izifundo ezengeziwe. I-Antiphospholipid syndrome iqinisekiswa uma kunenhlanganisela yesifo esisodwa semitholampilo kanye nesilinganiso se-laboratory (ubuncane). Ngokufanayo, izinyathelo eziningi zokuhlonza ukuhlukana zenziwa. Ngenxa yalokhu, lochwepheshe ukhuthaza ukuthi uhlole iziqu ezingafaki izifo ezifanayo.
I-Antiphospholipid syndrome - ukuhlaziywa
Ukutholakala kwemibonakaliso ye-laboratory ye-disorder yamanje kuhlinzekwa ukutadisha kwezidakamizwa eziphilayo. Udokotela wakhetha ukunikela igazi nge-antiphospholipid syndrome ukucacisa ukuba khona kwama-plasma nama-serum antibodies kuma-cardiolipins ne-lupus anticoagulant. Ukwengeza, okulandelayo kungatholakala:
- i-cryoglobulins;
- ama-antibodies ama-erythrocyte;
- I-T- kanye ne-B-lymphocytes ekukhuleni okukhulayo;
- i-antinuclear ne-rheumatoid factor.
Ngezinye izikhathi kuphakanyiswa isifundo sezakhi zofuzo esivumela ukuthi bathole izimpawu ze-antiphospholipid syndrome:
- I-HLA-DR7;
- I-HLA-B8;
- I-HLA-DR2;
- I-DR3-HLA.
I-antiphospholipid syndrome iphathwa kanjani?
Ukwelashwa kwalesi sifo esizimele ngokuzenzakalelayo kuncike efomini yayo (eyinhloko, eyesibili) nokuqina kwempawu zomtholampilo. Izinkinga zivela uma owesifazane okhulelwe ene-antiphospholipid syndrome - ukwelashwa kufanele kumise kahle izimpawu zesifo, kuvimbele ukucindezeleka, futhi ngokufanayo akuyona ingozi emntwaneni. Ukuze kuzuzwe ukuthuthukiswa okuhlala njalo, ama-rheumatologists asebenzisa indlela ehlangene yokwelapha.
Kungenzeka yini ukwelapha i-antiphospholipid syndrome?
Ukuqeda ngokuphelele inkinga echazwe akunakwenzeka, kuze kube yilapho izimbangela zenzeka khona. I-Antiphospholipid syndrome idinga ukwelashwa okuyinkimbinkimbi ehlose ukunciphisa inani lama-antibodies afanele egazini nokuvimbela izinkinga ze-thromboembolic. Ezikhathini ezimbi zesifo, ukwelashwa okulwa nokuvuvukala kuyadingeka.
Ukwelashwa kwe-antiphospholipid syndrome - izincomo zamanje
Indlela eyinhloko yokuqeda izibonakaliso zalesi sifo ukusetshenziswa kwamagciwane kanye nama-anticoagulants wezenzo ezingaqondile:
- I-Acetylsalicylic acid (i-Aspirin ne-analogues);
- I-Warfarin ;
- I-Acenocoumarol;
- I-Phenylin;
- I-Dipyridamole.
Indlela yokuphatha i-antiphospholipid syndrome - izincomo zomtholampilo:
- Ukwenqaba ukubhema, ukuphuza utshwala nezidakamizwa, ukukhulelwa komlomo.
- Lungisa ukudla ngokudla okunevithamini K - itiye eluhlaza, isibindi, imifino eluhlaza.
- Ukuphumula okuphelele, ubheke umbuso wosuku.
Uma ukwelapha okuvamile kungasebenzi, umkhuba wokumisela imithi eyengeziwe yilezi:
- Aminoquinolines - Plakvenil, Delagil;
- i-anticoagulants eqondile - iClexan , i-Fraksiparin;
- i-glucocorticoids - i-Prednisolone, i-Methylprednisolone;
- inhibitors of receptors platelet - iTagren, Clopidogrel;
- i-heparinoids - i-Emeran, i-Sulodexide;
- i-cytostatics - i-Endoxane, isi-Cytoxan;
- ama-immunoglobulins (ukuphathwa kwangaphakathi).
Imithi yendabuko ne-antiphospholipid syndrome
Azikho izindlela ezisebenzayo zokwelapha, okuwukuphela kwendlela yokukhetha i-acetylsalicylic acid ngezinto ezibonakalayo zemvelo. I-Antiphospholipid syndrome ayikwazi ukumiswa ngosizo lwabantu bokupheka, ngoba ama-anticoagulants wemvelo anomphumela omnene kakhulu. Ngaphambi kokusebenzisa noma iyiphi enye indlela kubalulekile ukubonisana nesifo se-rheumatologist. Uchwepheshe kuphela ozosiza ekunciphiseni i-antiphospholipid syndrome - izincomo zodokotela kufanele zigcinwe ngokucophelela.
I-tea enezindawo ze-aspirin
Izithako:- amagxolo owomile we-willow emhlophe - 1-2 tsp.
- amanzi abilayo - 180-220 ml.
Ukulungiselela, sebenzisa :
- Izinto eziluhlaza zemifino zihlanza kahle futhi zigaye.
- I-Willow willow igxume ngamanzi abilayo, imise imizuzu engu-20-25.
- Phuza isixazululo njengetiyi 3-4 izikhathi ngosuku, ungakwazi ukunambitha ukunambitha.
Antiphospholipid syndrome - ukubikezela
Zonke iziguli ze-rheumatologist ezinezifo ezihlongozwayo kufanele zigcinwe isikhathi eside futhi zihlale zihlolwa ukuvimbela. Ngingahlala isikhathi esingakanani nge-antiphospholipid syndrome, kuncike ekutheni ifomu, ubunzima nobukhona bezinkinga zokuzivivinya kwe-immunological. Uma i-APS eyinhloko enezimpawu ezilinganisiwe itholakele, ukwelashwa okufika ngesikhathi kanye nokwelashwa okuvimbelayo kusiza ukugwema izinkinga, ukubikezela ezimweni ezinjalo kungcono kakhulu.
Izifo ezikhulayo zihlanganisa ukugula okukhulunywa ngakho nge-lupus erythematosus, thrombocytopenia, ukucindezela okuqhubekayo kokugonywa komzimba kanye nezinye izifo. Kulezi zimo, kuvame ukuthuthukisa i-antiphospholipid complex syndrome (inhlekelele), ebonakala ngokunyuka kwezibonakaliso zemitholampilo kanye ne-thrombosis ephindaphindiwe. Iminye imiphumela ingaqeda ukubulala.
Antiphospholipid syndrome nokukhulelwa
Isifo esichazwe yisifo esivamile sokukhulelwa kwesisu, ngakho bonke omama abazayo kufanele bahlole ukuhlolwa kwe-prophylactic futhi banikele ngegazi ku-coagulogram. I-Antiphospholipid syndrome e-obstetrics ibhekwa njengesifo esiyingozi esibangela ukufa kwe-fetus nokukhulelwa komzimba, kodwa ukutholakala kwayo akuyona isinqumo. Owesifazane onokuxilongwa okunjalo uyakwazi ukuthwala futhi abelethe ingane enempilo uma ngesikhathi sokukhulelwa uzolandela zonke izincomo zesidakamizwa futhi athathe ama-antigregregants.
Uhlelo olufanayo lusetshenziselwa lapho kuhlongozwa ukufakelwa okufakelwayo. I-Antiphospholipid syndrome ne-IVF iyahambisana ngokugcwele, kuphela okuzodingeka ukuthi bafunde izidakamizwa ezithintekayo. Ukusetshenziswa kwama-anticoagulants kanye nama-antiaggregants kuzoqhubeka phakathi nesikhathi sonke sokubeletha. Ukuphumelela kokwelapha okunjalo kufinyelele ku-100%.