Hloov pauv hauv lub cev qhov cuam tshuam lossis cuam tshuam rau cov khoom txawv teb chaws hu ua kev tsis haum (los ntawm Greek. "kev tshwm sim rau lwm tus"). Lub npe "allergy" tau tsim los ntawm Austrian tus kws tshawb fawb Clemens Pirke hauv xyoo 1906. Nws kuj tau hais tias lo lus siv los piav qhia txog kev cuam tshuam rau lub cev ntawm ntau yam los ntawm ib puag ncig sab nraud, thiab cov tshuaj uas ua rau cov tshuaj tsis haum no yuav tsum hu ua allergens.
Tus neeg ua xua tus neeg Asmeskas R. A. Cook tau tsim thawj qhov kev ua xua hauv xyoo 1947. Los ntawm nws cov ntsiab lus, muaj tam sim hom hypersensitivity thiab ncua hom hypersensitivity. Hom tom kawg yuav tau tham kom ntxaws hauv kab lus no. Qhov tseem ceeb, tam sim ntawd thiab ncua sij hawm hom kev hnov mob siab heev yog qhov sib txawv ntawm ib leeg.
Qhov tseem ceeb sib txawv
HypersensitivityHom tam sim ntawd yog cov tshuaj tiv thaiv rau ib qho antigen uas tshwm sim 20-25 feeb tom qab qhov kev sib ntsib thib ob nrog ib qho tsis haum (antigen). Kev ncua sij hawm-hom hypersensitivity tshwm sim tsis pub dhau 7-8 teev lossis ob peb hnub. Xyoo 1968, P. G. Gell thiab R. A. Coombs tau sau ib daim ntawv tshawb fawb hu ua "A New Classification of Allergic Reactions." Raws li kev faib tawm no, 4 hom kev ua xua tseem ceeb yog qhov txawv.
Kev tsis haum tshuaj
- 1 hom - anaphylactic, atopic, reaginic. Qhov tshwm sim ntawm hom no suav nrog Quincke's edema, anaphylactic shock, atopic bronchial hawb pob, urticaria.
- 2 hom - cytotoxic lossis cytolytic, nws cov tsos mob suav nrog leukemia, hemolytic anemia, Rh incompatibility.
- 3 hom - immunocomplex, lossis Arthus hom. Nws yog kwv yees los ntawm cov tshuaj tiv thaiv dav dav thiab yog qhov tseem ceeb hauv etiology ntawm kev mob ntshav qab zib, rheumatoid mob caj dab, kab mob lupus erythematosus. Tag nrho peb hom no muaj feem cuam tshuam nrog hemagglutinin thiab koom rau hauv hom kev mob ntshav siab tam sim ntawd.
- 4 hom - qeeb hom hypersensitivity, lub counteraction mechanism yog tus cwj pwm los ntawm cellular kev txiav txim ntawm T-lymphocyte-heller antigen.
Sensitization
Ntev-hom hypersensitivity cov tshuaj tiv thaiv yog lub cev rhiab heev rau microbial antigens, kab mob, kab mob, fungi, helminths, mus rau dag thiab natural antigens (tshuaj, tshuaj), rau ib tug neeg cov proteins. feem ntau ci ntsa iabqeeb-hom hypersensitivity teb rau kev taw qhia ntawm cov immunogenic antigens tsawg. Ib koob me me ntawm antigens thaum txhaj tshuaj subcutaneously ua rau qeeb-hom hypersensitivity. Cov txheej txheem ntawm kev loj hlob ntawm hom kev tsis haum tshuaj no yog qhov tsis txaus ntseeg ntawm T-lymphocytes-hellers rau antigens. Hypersensitivity ntawm lymphocytes ua rau tso tawm cov tshuaj, piv txwv li, interleukin-2, uas ua kom cov macrophages, kev tuag ntawm cov antigen uas ua rau rhiab heev ntawm lymphocytes tshwm sim. T-lymphocytes kuj tig rau lub tshuab tiv thaiv uas tua cov kab mob, kab mob, lossis protozoa.
Daim ntawv no tau pom muaj ntau yam kab mob sib kis, xws li tuberculosis, syphilis, brucellosis, diphtheria, kab mob fungal, helminthiases thiab lwm yam, nrog rau kev tsis lees txais kev hloov pauv.
Example
Qhov piv txwv pom tseeb tshaj plaws ntawm cov kev tshwm sim no yog kev sim Mantoux tuberculin. Yog hais tias tuberculin yog muab intradermally rau ib tug neeg nyob rau hauv nws lub cev lub tubercle bacillus nyob, ces tom qab 24-48 teev ib tug induration ntawm 10-15 hli nrog ib tug abscess nyob rau hauv qhov chaw yuav tsim nyob rau hauv qhov chaw txhaj tshuaj.
Histological kuaj pom tau tias cov infiltrate feem ntau yog cov lymphocytes thiab cov hlwb ntawm monocyte-macrophage series.
Aneriya
Nyob rau hauv tsawg zaus, tsis muaj tshuaj tiv thaiv. Qhov no yog hu ua anergy, uas yog, tsis muaj cov tshuaj tiv thaiv ntawm lub cev rau stimuli.
Lub zog zoo tshwm sim thaumallergen, nkag mus rau hauv lub cev, tuag. Qhov no tsis ua rau mob.
Neegative anergy tshwm sim thaum lub cev tsis tuaj yeem tiv thaiv nws tus kheej, qhia tias tsis muaj zog ntawm tus kheej. Yog vim li cas rau qhov tsis muaj cov tshuaj tiv thaiv lossis nws qhov tsis muaj zog yuav yog qhov txo qis ntawm T-lymphocytes lossis ua txhaum ntawm lawv lub luag haujlwm, thiab qhov no kuj tuaj yeem tshwm sim los ntawm kev ua haujlwm ntawm T-suppressors.
Para-allergy thiab pseudo-allergy
Muaj cov ntsiab lus ntawm "paraallergy" thiab "pseudoallergy". Lawv tshwm sim thaum kuaj pom cov kab mob kis tau los ntawm kev tsis haum tshuaj.
Paraallergy yog thaum cov kab mob kis tau tshwm sim rau cov kab mob zoo sib xws, piv txwv li, tus neeg mob tuberculosis reacts rau atypical mycobacteria.
A pseudo-allergy yog kev ua xua, piv txwv li, rau tuberculin hauv tus neeg mob leukemia.
Kev tsis haum tshuaj
Nyob rau lub sijhawm ua xua, 3 theem tau piav qhia:
- Immunological theem. Nyob rau theem no, tag nrho cov kev hloov kho ntawm lub cev tiv thaiv kab mob tshwm sim. Cov tshuaj tsis haum uas nkag mus rau hauv lub cev ua ke nrog cov tshuaj tiv thaiv kab mob thiab cov lymphocytes hypersensitive.
- Patochemical theem. Nyob rau theem no, cov hlwb tsim cov neeg nruab nrab (cov tshuaj lom neeg lom neeg), monokines, lymphokines, uas yog tsim los ntawm kev ua xua tau txuas nrog cov tshuaj tiv thaiv kab mob thiab cov lymphocytes hypersensitive.
- Pathophysiological theem. Nyob rau theem nosoj ntsuam manifestations ntawm tus kab mob. Qhov no tshwm sim vim hais tias cov neeg nruab nrab uas tau tshwm sim muaj kev cuam tshuam rau cov ntaub so ntswg ntawm lub cev. Nyob rau theem no, o, khaus, spasms ntawm cov leeg nqaij du, circulatory ntshawv siab, thiab lwm yam.
Cov theem no txhais tau tias qeeb-hom hypersensitivity.
Kev kho mob
Nov yog ib lo lus nug nyuaj tshaj plaws. Kev kho mob yuav tsum sib txawv ntawm kev kho mob tam sim ntawd, raws li kev ncua ntev-hom hypersensitivity yog kev tiv thaiv kab mob.
Kev taw qhia
Kev kho mob yuav tsum tau coj mus rau lub sijhawm tiv thaiv kab mob, tiv thaiv kev kho mob thiab kev ua kom tsis zoo ntawm cov kab mob. Txawm li cas los xij, kev kho mob yuav tsum pib nrog cov kev cai dav dav rau kev kho cov kab mob ua xua. Nco ntsoov ua raws li kev noj zaub mov hypoallergenic. Hauv kev kho mob ntawm hom hypersensitivity no, ib qho chaw tshwj xeeb yog nyob ntawm kev kho mob etiological, uas yog, qhia rau tus kab mob.
hom qeeb-hom hypersensitivity. Lawv kho mob
hom kev kub siab no tau muab faib ua kev sib cuag, tuberculin thiab granulomatous, yog li kev kho mob yuav tsum raug coj mus rau qee yam.
- Kev mob siab tshwm sim thaum cuam tshuam nrog cov tshuaj (cob alt, npib tsib xee, ntoo resins, mercury, thiab lwm yam), tshuaj, tshuaj lom nroj tsuag. Ntxiv nrog rau kev kho mob tseem ceeb ntawm kev ua xua, ntxiv rau kev kho mob ntawm kev sib cuag hypersensitivity, kev txiav tawm ntawm kev cuam tshuam nrogua rau kev ua xua, kev kho mob txhawm rau txo qhov mob, UV irradiation.
- Tuberculin hypersensitivity yog kuaj tau thiab tshwm sim los ntawm tuberculin lossis antigens zoo sib xws thiab yog li tsis tas yuav kho.
- Ntev-hom kab mob hypersensitivity tshwm sim thaum rhiab rau cov kab mob uas ua rau kis kab mob, xws li: tuberculosis, syphilis, brucellosis, anthrax, gonorrhea, parasitic infestations. Kev kho mob ntawm cov kab mob sib kis yog tsom mus rau kev puas tsuaj ntawm cov kab mob ua rau tus kab mob.
- Kev ua xua rau cov proteins uas tsis muaj kuab lom tshwm sim thaum lub cev tsis muaj zog, uas lub cev tsis lees txais cov protein sib txuas xws li: mis nyuj, ntses, qe, txiv ntseej, legumes thiab qee cov proteins pom hauv cov nplej. Txhawm rau kho kom zoo, txhua yam khoom noj uas ua rau muaj kev fab tshuaj tsis suav nrog kev noj haus.
- Autoallergic hypersensitivity yog thaum cov lymphocytes rhiab heev thiab tus kheej cov tshuaj tiv thaiv raug tsim tawm ntawm lub cev cov ntaub so ntswg, uas ua rau muaj kev fab tshuaj. Muaj ob hom kev tsis haum autoallergic.
Thawj yog thaum lub luag haujlwm ntawm lub cev tiv thaiv kab mob tsis raug puas tsuaj, tab sis ib qho autoallergen tshwm sim, uas ua rau muaj kev ua txhaum ntawm kev tiv thaiv kab mob. Qhov thib ob yog thaum lub cev tsis muaj zog, tsis nkag siab tias nws cov protein nyob qhov twg thiab lawv nyob qhov twg yog neeg txawv, yog li nws ntseeg tias qhov no yog qhov ua xua. Kev kho mob yog cov tsos mob thiab pathogenetic, uas muaj nyob rau hauv kev siv cov tshuaj tiv thaiv kab mob. Feem ntau yog corticosteroids.
Hypersensitivity thaum hloov pauv yog qhov kev puas tsuaj ntawm lub cev txawv teb chaws nkag rau hauv lub cev. Xws li kev ua xua tuaj yeem tiv thaiv tau los ntawm kev xaiv tus neeg pub dawb, nrog rau los ntawm kev sau ntau yam tshuaj tiv thaiv kab mob txhawm rau txhawm rau tiv thaiv kab mob.
Yog li, ncua sij hawm-hom tshuaj tiv thaiv hypersensitivity yog qhov tseem ceeb. Cov tshuaj tiv thaiv kab mob siab yog ua raws li qhov mob, uas pab tiv thaiv kev kis kab mob hauv thaj chaw cuam tshuam thiab tsim kom muaj kev tiv thaiv kab mob noj qab haus huv.
