Sjögren's syndrome yog ib hom kab mob autoimmune, tseem hu ua "dry syndrome". Tus kab mob no muaj npe tom qab Swedish ophthalmologist uas nyob rau hauv 1929 kho tus neeg mob nrog lub qhov ncauj qhuav, qhov muag thiab mob pob qij txha. Peb yuav tham txog yam kab mob dab tsi, nws yog dab tsi thiab nws cov tsos mob, nrog rau kev kho mob.
Syndrome Information
Sjögren's syndrome muaj ntau dua rau cov poj niam dua li cov txiv neej, tshwm sim cuaj zaug ntawm kaum. Raws li txoj cai, xws li tus mob no cuam tshuam rau cov poj niam tam sim ntawd tom qab menopause. Tab sis feem ntau, tus kab mob tuaj yeem cuam tshuam rau tib neeg ntawm txhua tus poj niam txiv neej, tsis hais hnub nyoog li cas. Tsis muaj kev txheeb cais thoob ntiaj teb rau cov kab mob no, tab sis hauv cov tebchaws tsim kho, suav nrog Russia, qhov xwm txheej tau kwv yees ntau lab. Yog li, tus kab mob yog ib qho ntawm cov kab mob rheumatic feem ntau.
Nrog Sjögren's syndrome, tus neeg tiv thaiv pib pomlub cev hlwb raws li txawv teb chaws txaus ntshai ntsiab, pib maj mam, thiab nyob rau tib lub sij hawm systematically rhuav tshem lawv. Lub cev tiv thaiv kab mob nkag mus rau hauv cov ntaub so ntswg ntawm cov qog qog nqaij hlav sab nraud, cuam tshuam rau lawv, yog li lawv, dhau los, tso tawm tsawg dua ntawm qhov xav tau zais cia (qaib, kua muag, thiab lwm yam).
Tsis tas li ntawd, tus kab mob feem ntau cuam tshuam rau lwm yam kabmob, ua rau mob caj dab nrog rau qhov mob ntawm cov pob qij txha thiab cov leeg, ua rau tib neeg ua tsis taus pa. Kuj tseem muaj ib qho mob uas nrog rheumatoid mob caj dab, diffuse connective cov ntaub so ntswg kab mob, kab mob ntawm biliary system thiab lwm yam autoimmune pathologies.
Nws yog ib qho tseem ceeb heev uas yuav tau sab laj nrog kws kho mob uas twb muaj cov tsos mob thawj zaug, txwv tsis pub khiav Sjögren's syndrome tuaj yeem tau txais kev kawm tsis zoo, cuam tshuam rau lub cev tseem ceeb, uas feem ntau ua rau txhua yam teeb meem, thiab qee zaus txawm tias tuag.
Vim txoj kev loj hlob
Dab tsi yog qhov ua rau Sjögren's syndrome?
Ib yam tseem ceeb uas ua rau muaj tus kab mob no yog qhov tsis ua haujlwm autoimmune. Nrog xws li kev ua txhaum cai, lub cev tiv thaiv kab mob pib rhuav tshem cov hlwb ntawm cov qog ua kua. Yog vim li cas raws nraim qhov no tshwm sim yog nyuaj hais, qhov no mechanism yuav tsum tau kom meej meej. Qhov ua rau thiab cov tsos mob ntawm Sjögren's Syndrome yog ze ze.
Lwm yam ntawm qhov tshwm sim ntawm tus kab mob yog ib qho genetic predisposition. Qee lub sij hawm thaum muaj tus kab mob no tshwm sim hauv leej niam, ces nws kuj tuaj yeem kuaj pom hauv tus ntxhais. Ib qho kev hloov pauv ntawm poj niam hormonal keeb kwm yav dhau tuaj yeem ua rau muaj tus mob no. Raws li txoj cai, Sjögren's syndrome (daim duab) tshwm simtiv thaiv keeb kwm yav dhau los ntawm lwm cov kab mob hauv lub cev, piv txwv li, ua ib feem ntawm kev mob caj dab rheumatoid, nrog rau cov kab mob lupus erythematosus, thiab lwm yam.
Kev mob nkeeg
Muaj ob txoj hauv kev rau kev txhim kho tus kab mob no. Cov kev kho mob tshwm sim ntawm cov ntau yam no zoo ib yam nkaus, tab sis muaj qee qhov sib txawv ntawm qhov ua rau tshwm sim:
- Hauv thawj kis, tus mob no yuav tshwm sim tawm tsam keeb kwm ntawm lwm yam kab mob autoimmune. Feem ntau nws tsim tshwm sim hauv rheumatoid mob caj dab.
- Nyob rau hauv rooj plaub thib ob, Sjögren's syndrome yog tsim los ua tus kab mob ywj pheej.
Ncaj nraim los ntawm qhov pib thiab cov chav kawm tom ntej, tus mob tuaj yeem muaj cov ntaub ntawv hauv qab no:
- daim ntawv ntev. Nyob rau hauv cov ntaub ntawv no, lub chav kawm ntawm tus kab mob yog characterized tsuas yog los ntawm defeat lub qog. Cov tsos mob pib, raws li txoj cai, maj mam, tsis muaj kev kho mob tshwm sim. Tab sis maj mam nws tsim, ib tug neeg tsim lub qhov ncauj qhuav, glands loj, lawv cov hauj lwm yog cuam tshuam. Kev koom tes ntawm lwm yam kabmob hauv cov txheej txheem pathological yog qhov tsawg kawg nkaus hauv kev xyaum.
- Subacute daim ntawv ntawm tus kab mob. Tawm tsam keeb kwm yav dhau los ntawm hom mob no, nws cov chav kawm pib nrog cov txheej txheem ntawm o. Hauv qhov no, tus neeg mob tuaj yeem ua rau lub cev kub siab nrog rau kev mob ntawm cov qog qaub ncaug. Cov pob qij txha kuj tuaj yeem ua rau mob. Tawm tsam keeb kwm ntawm tag nrho cov txheej txheem no, cov neeg mob yuav muaj kev hloov pauv hauv kev kuaj ntshav. Daim ntawv no ntawm tus kab mob no feem ntau yog tus cwj pwm los ntawm cov kab mob hauv lub cev, uas yog, tawm tsam nws keeb kwm ntawm cov txheej txheem pathological. Muaj ntau lub cev thiab lub cev ntawm lub cev koom nrog.
Xav txog cov tsos mob ntawm Sjögren's syndrome.
Symptomatics
Txhua cov tsos mob ntawm tus kab mob no tuaj yeem muab faib ua cov qog ua qog thiab qog qog. Glandular cov cim qhia ntawm pathology tau tshwm sim hauv qhov txo qis hauv kev tsim cov zais cia.
Ib qho ntawm cov tsos mob tseem ceeb ntawm Sjögren's syndrome yog qhov mob ntawm lub qhov muag, uas cuam tshuam nrog qhov txo qis ntawm cov kua dej hauv qhov muag. Nyob rau tib lub sijhawm, cov neeg mob pib cuam tshuam los ntawm kev tsis xis nyob hauv daim ntawv ntawm kev kub hnyiab, khawb thiab xuab zeb hauv qhov muag. Nrog rau qhov no, cov neeg mob feem ntau hnov o ntawm daim tawv muag nrog rau qhov liab, tsub zuj zuj ntawm cov ces kaum ntawm lub qhov muag ntawm cov kua nplaum uas muaj xim dawb. Nyob rau theem tom ntej ntawm tus kab mob, cov neeg mob yuav pib yws ntawm photophobia, thiab vim li ntawd, lawv qhov muag pom kev tsis zoo.
Qhov thib ob qhov tsos mob ntawm Sjögren's syndrome yog qhov mob ntawm cov qog qaub ncaug, uas ntws mus rau hauv daim ntawv ntev. Nyob rau tib lub sijhawm, cov neeg mob yws ntawm qhov ncauj qhuav, ntxiv rau, nce hauv cov qog ua kua qaub. Thaum pib ntawm tus kab mob, tej zaum tsuas yog me ntsis los yog tsis sib haum xeeb ntawm qhov ncauj qhuav, uas tshwm sim los ntawm kev zoo siab lossis kev tawm dag zog lub cev. Tom qab ntawd lub dryness yuav mus tas li. Tawm tsam keeb kwm ntawm cov txheej txheem zoo li no, cov mucous daim nyias nyias thiab tus nplaig qhuav heev, tau txais cov xim liab liab thiab feem ntau ua rau mob. Tsis tas li ntawd, nrog rau cov tsos mob no, cov hniav caries pib sai sai rau cov neeg mob. Qee zaum, ua ntej cov cim qhia no tshwm sim, cov neeg mob muaj kev nce tsis tsim nyoglymph nodes.
Kab mob lig dhau los yog qhov ncauj qhuav heev, nws tuaj yeem nyuaj rau tus neeg tham thiab nqos cov khoom noj. Txhawm rau ua qhov no, koj yuav tsum haus dej nrog zaub mov. Cov kab nrib pleb tshwm rau ntawm daim di ncauj. Mob plab gastritis nrog tsis txaus secretion kuj tuaj yeem tshwm sim, uas yuav ua nrog belching thiab txo qis hauv qab los noj mov, thiab cov tsos mob ntawm xeev siab tsis suav nrog. Nyob rau hauv txhua txhua tus neeg mob thib peb nyob rau theem lig, raws li txoj cai, cov kws kho mob nco ntsoov qhov loj ntawm cov qog parotid.
Ntawm lwm yam, tej zaum yuav muaj kev puas tsuaj rau cov kab mob biliary nrog rau kab mob siab thiab mob pancreatitis. Nyob rau hauv lub lig theem ntawm lub syndrome, nasopharynx yuav qhuav heev, thiab qhuav crusts nyob rau hauv lub qhov ntswg. Nyob rau theem no, tus neeg mob yuav hnov tsis hnov lus thiab otitis media. Vim muaj dryness nyob rau hauv lub larynx, hoarseness tshwm sim. Cov kab mob thib ob kuj tshwm sim rau lawv tus kheej nyob rau theem no nyob rau hauv daim ntawv ntawm feem ntau recurrent sinusitis, tracheobronchitis thiab mob ntsws. Txhua tus neeg mob thib peb muaj cov txheej txheem inflammatory hauv qhov chaw mos.
Ntau tus neeg xav paub seb Sjögren's syndrome puas tuaj yeem kho tau? Xav paub ntau ntxiv tom qab.
Cov tsos mob ntawm glandular ntxiv
Cov tsos mob ntawm cov qog nqaij hlav ntawm tus mob muaj ntau haiv neeg thiab muaj lub cev ua haujlwm. Ua ntej ntawm tag nrho cov, cov neeg mob muaj mob nyob rau hauv cov pob qij txha nrog rau nruj thaum sawv ntxov, cov leeg tsis xis nyob thiab cov leeg tsis muaj zog. Feem ntau cov neeg mob feem ntau nco txog qhov nce hauv cov qog ntshav hauv thaj tsam submandibular, occipital, cervical thiab supraclavicular cheeb tsam.
Nyob rau hauv ib nrab ntawm cov neeg mob, cov kws kho mob saib o ntawm lub pa system nyob rau hauvdaim ntawv ntawm dryness hauv caj pas, hws, khawb, hnoos qhuav thiab ua tsis taus pa. Sjögren tus kab mob tuaj yeem tshwm sim raws li cov kab mob vasculitis, thiab cov pob khaus ntawm daim tawv nqaij kuj zoo li, uas pib tshwm sim ntawm ob txhais ceg, thiab tom qab ntawd txav mus rau hauv plab, ncej puab thiab pob tw. Tsis tas li ntawd, cov pob khaus tuaj nrog cov tawv nqaij khaus, kub hnyiab thiab kub taub hau.
Ib tug ntawm peb tus neeg mob muaj kev tsis haum tshuaj rau qee yam tshuaj tua kab mob, ntxiv rau cov vitamins B, zaub mov thiab tshuaj ntxhua khaub ncaws. Nrog Sjögren's syndrome, cov tsos mob ntawm lymphomas yog ua tau. Qhov xwm txheej dav dav yog qhov hnyav dua los ntawm qhov tseeb tias qhov no pathology feem ntau tshwm sim tawm tsam keeb kwm ntawm lwm yam kab mob. Feem ntau, nws yog tsim nyob rau hauv lub xub ntiag ntawm tej yam kab mob rheumatic.
Diagnostics
Thaum kuaj pom tus kab mob no, nws yog ib qho tsim nyog yuav tsum coj mus rau hauv tus account tsis yog txhua yam ntawm nws cov cim qhia nyias, tab sis tag nrho cov tsos mob ntawm ib zaug. Nyob rau hauv cov xwm txheej uas muaj tsawg kawg yog plaub yam, ces nws muaj peev xwm hais nrog ib tug high degree ntawm qhov tshwm sim hais tias ib tug neeg yeej muaj Sjogren's syndrome. Yog li, cov kws kho mob saib xyuas cov tsos mob hauv qab no:
- Kev nthuav tawm ntawm cov qog qog nqaij hlav parotid.
- Kev txhim kho ntawm Raynaud's syndrome, uas muaj kev ua txhaum ntawm cov ntshav ncig hauv ob txhais ceg lossis tes.
- Zoo qhov ncauj qhuav.
- Ntau erythrocyte sedimentation tus nqi.
- Kev tshwm sim ntawm kev sib koom ua ke.
- Qhov tshwm sim ntawm qhov tshwm sim tsis tu ncua ntawm cov kab mob sib kis.
Txhawm rau kom paub meej tias muaj tus kab mob no, siv ntau txoj hauv kev kuaj mob. Ua ntej tshaj plaws, cov ntshav pub dawb rau kev tsom xam ntawm Sjögren's syndrome. Feem ntau, tus neeg mob tau kuaj pom tias muaj ntshav liab nrog rau leukopenia me me thiab nce ESR. Raws li kev txheeb xyuas biochemical, nws yuav qhia txog qib ntawm globulins thiab tag nrho cov protein. Fibrin kuj tseem yuav muaj nyob rau hauv qhov ntau ntxiv. Immunological teb yuav cuam tshuam txog qib ntawm immunoglobulins thiab autoantibodies txawv txav.
Lwm yam kev kuaj mob ntawm Sjögren's syndrome tau ua li cas?
Raws li ib feem ntawm Schirmer qhov kev sim, kev tsim cov kua muag qis feem ntau yog kuaj pom hauv cov lus teb rau kev txhawb nqa nrog ammonia. Ua tsaug rau staining ntawm sclera nrog cov dyes tshwj xeeb, nws muaj peev xwm txheeb xyuas qhov yaig ntawm lub epithelium. Cov txheej txheem kuaj mob kuj suav nrog qhov sib txawv ntawm cov duab hluav taws xob thiab ntau qhov kev sim hauv qab no, piv txwv li:
- Kev kuaj ntshav ntawm cov qog qaub ncaug.
- Ua lub qog qog noj ntshav ultrasound.
- Hloov lub ntsws x-ray.
- Ua tus txheej txheem gastroscopy.
Ntawm lwm yam, echocardiography kuj tau ua, uas pab txheeb xyuas cov teeb meem uas cuam tshuam rau lwm yam kabmob nrog lub cev.
Kev kho mob ntawm Sjögren's syndrome yuav tsum muaj kev dav.
YSyndrome Treatment
Tus kws tshaj lij tshwj xeeb uas kuaj thiab kho tus kab mob no yog tus kws kho mob rheumatologist. Tab sis nyob rau hauv cov chav kawm ntawm kev kho mob, feem ntaukev pab los ntawm lwm tus kws kho mob yuav tsum tau, piv txwv li, kws kho hniav, kws kho mob ophthalmologist, gynecologist, nephrologist, pulmonologist, thiab hais txog. Hauv kev kho mob ntawm tus mob no, qhov chaw tseem ceeb yog nyob ntawm kev kho cov tshuaj hormonal thiab cytostatic nrog cov tshuaj tiv thaiv kab mob.
Nyob rau hauv lub xub ntiag ntawm ulcerative necrotic vasculitis, glomerulonephritis, polyneuritis thiab lwm yam kab mob ntawm lub cev nyob rau hauv kev kho mob ntawm Sjögren's syndrome, plasmapheresis yog suav hais tias yog qhov zoo tshaj plaws. Tsis tas li ntawd, cov neeg mob raug qhia kom tiv thaiv kev kis kab mob thib ob. Txhawm rau tshem tawm qhov qhuav ntawm lub qhov muag, cov kua muag dag siv, thiab cov kev daws teeb meem nrog cov tshuaj tua kab mob kuj siv rau kev ntxuav. Tsis tas li ntawd, cov ntawv thov tshuaj hauv zos tau raug sau tseg kom tshem tawm qhov mob ntawm cov qog parotid.
Txhim kho qhov ncauj qhuav, cov qaub ncaug yog siv. Daim ntawv thov nrog kev siv hiav txwv buckthorn, rosehip roj kuj pab zoo kawg nkaus. Cov roj zoo li no pab txhawb kev tsim kho sai ntawm qhov ncauj mucosa. Ncaj nraim rau kev tiv thaiv kab mob caries, cov neeg mob yuav tsum tau saib xyuas los ntawm kws kho hniav.
Tsis tas li ntawd, cov neeg mob uas muaj tus mob no yuav tsum tau mus ntsib kws kho mob tshwj xeeb. Cov neeg mob uas muaj kev tsis txaus siab ntawm lub plab tsis muaj peev xwm tau txais kev kho mob mus sij hawm ntev nrog hydrochloric acid. Thiab cov neeg mob uas tsis muaj kab mob pancreatic noj qab haus huv yog cov kws kho mob enzyme. Yog tias tsis kho, tus mob no tuaj yeem txo tus neeg lub neej zoo. Sab laug tsis saib xyuas, cov txheej txheem pathological tuaj yeem ua rau qee yamCov teeb meem uas feem ntau ua rau kev tsis taus.
Peb tau saib cov tsos mob thiab kev kho mob ntawm Sjögren's syndrome.
Cov Teeb Meem thiab qhov tshwm sim
Yog li, raws li twb tau sau tseg lawm, thaum tsis muaj kev kho raws sijhawm thiab tsim nyog, tus kab mob no tuaj yeem txhim kho tsis tu ncua thiab, vim li ntawd, coj tus neeg mob mus rau qhov teeb meem tseem ceeb cuam tshuam nrog kev puas tsuaj ntawm lub cev. Cov teeb meem tseem ceeb, thiab tib lub sijhawm ua rau tuag, tej zaum yuav yog:
- Kev txhim kho vasculitis (mob ntawm cov hlab ntsha), uas tuaj yeem koom nrog ntau lub cev.
- Cov tsos mob ntawm lymphoma - kab mob malignant uas cuam tshuam rau cov qog ntshav qog ntshav.
- tshwm sim ntawm lwm yam malignant neoplasms. Hauv qhov no, lub plab feem ntau raug kev txom nyem.
- Kev txhim kho autoimmune kev tsim txom ntawm hematopoiesis nrog qhov txo qis hauv cov ntsiab lus ntawm qee cov cellular hauv cov ntshav, piv txwv li, leukocytes, erythrocytes, platelets, thiab lwm yam.
- Kev nkag mus ntawm tus kab mob thib ob.
prophylaxis
Kev tiv thaiv ntawm tus mob no los, ua ntej ntawm tag nrho cov, rau kev tiv thaiv ntawm exacerbations thiab ntxiv kev loj hlob ntawm pathology. Yog li, ua ib feem ntawm kev tiv thaiv, cov lus pom zoo hauv qab no yuav tsum tau:
- Nws tseem ceeb heev uas yuav tau noj koj tus kws kho mob cov tshuaj tsis tu ncua.
- Cov neeg mob yuav tsum txwv lub nra ntawm lub cev ntawm lub zeem muag, ntxiv rau, ntawm lub suab.
- Txhua yam kab mob yuav tsum tiv thaiv.
- tseem ceeb heevzam txhua yam xwm txheej ntxhov siab.
- Nws yuav tsum tsis suav nrog kev siv tshuaj tiv thaiv thiab kho hluav taws xob, suav nrog.
- Kev kho lub cev yuav tsum tau kho nrog ceev faj. Kev siv cov tshuaj no tsuas yog ua tau tom qab kev sab laj nrog kws kho mob lub cev.
- Yog tias tus mob tshwm sim tawm tsam keeb kwm ntawm lwm yam pathology, tus neeg mob, ua ntej ntawm tag nrho cov, xav tau kev kho mob rau tus kab mob.
Kev tshuaj xyuas ntawm Sjögren's syndrome
Kev tshuaj xyuas txog tus kab mob no muaj ntau. Pathology yog qhov tsis kaj siab, thiab yog tias tsis kho, nws yog qhov txaus ntshai. Cov neeg sau tias qhov tshwm sim yuav pom tsuas yog tias koj ua raws li txhua tus kws kho mob cov lus pom zoo thiab zam kev ntxhov siab.
Sjögren's disease yog ib hom kab mob inflammatory uas tshwm sim los ntawm kev puas tsuaj rau cov qog nqaij hlav. Nyob rau hauv cov ntaub ntawv no, ua ntej ntawm tag nrho cov, nws yog cov salivary thiab lacrimal qog uas raug kev txom nyem nyob rau hauv tib neeg. Qhov no pathology belongs rau cov pab pawg neeg ntawm autoimmune kab mob, yam ntxwv los ntawm tej yam tsis ua hauj lwm nyob rau hauv lub cev tiv thaiv kab mob. Tawm tsam keeb kwm yav dhau los ntawm cov kev ua tsis tiav no, vim tsis paub txog niaj hnub no, lub cev pom cov hlwb uas txawv teb chaws thiab tsim cov tshuaj tiv thaiv rau lawv. Xws li kev ua tsis tiav, thaum tsis muaj kev kho kom raug, ua rau muaj kev txhim kho ntawm cov txheej txheem inflammatory uas tuaj yeem kis mus rau ntau yam kabmob thiab cov kab ke ntawm tib neeg lub cev, uas thaum kawg tuaj yeem ua rau tus neeg mob tsis taus. Hauv qhov no, thaum tus mob no tshwm sim, nws tseem ceeb heev kom mus ntsib kws kho mob.
Cov kab lus nthuav tawm cov laj thawj, cov tsos mob, kev kho mob thiabKev tiv thaiv ntawm Sjögren's Syndrome.
