Antiphospholipid tshuaj tiv thaiv kab mob yog siv los paub txog qee cov proteins uas tsim los ntawm lub cev tawm tsam nws tus kheej vim yog cov tshuaj tiv thaiv autoimmune. Lawv cuam tshuam nrog thrombocytopenia (ib tug txo cov platelets hauv cov ntshav), nrog rau kev hem thawj ntawm nchuav menyuam, preeclampsia (qhov tsos ntawm toxicosis lig rau cov poj niam cev xeeb tub) thiab yug ntxov ntxov. Tawm tsam keeb kwm yav dhau los ntawm kev nce hauv cov ntsiab lus ntawm cov tshuaj tiv thaiv no, qhov kev pheej hmoo ntawm kev tsim cov ntshav txhaws nce, uas tuaj yeem ua rau muaj kev phom sij txaus ntshai xws li mob stroke thiab plawv nres.
Kev piav qhia ntawm lub tswvyim
Antiphospholipid cov tshuaj tiv thaiv muaj ntau yam cuam tshuam rau hemostasis nrog kev puas tsuaj rau tag nrho nws cov kev tiv thaiv kev sib txuas: endothelial barrier, kev ua haujlwm ntawm ntuj anticoagulants thiab endogenous fibrinolysis. Lawv qhib cov platelet txuas ntawm hemostasis nrog rau procoagulantfactor.
Kev sib xyaw ua ke ntawm cov teebmeem prothrombotic thiab non-thrombotic, suav nrog kev ua kom lub zog ntawm cov lus teb hauv zos, nrog rau cov nyhuv ntawm trophoblast thiab cov yam ntxwv ntawm lub embryo, ua rau kev txhim kho ntawm cov duab kho mob thiab tag nrho. ntau yam ntawm cov teeb meem thrombotic. Lawv tshwm sim nyob rau hauv venous thiab arterial hlab ntsha, raws li zoo raws li nyob rau hauv lub microcirculation system los ntawm qhov xwm ntawm angiopathy. Nws tuaj yeem ua rau kev loj hlob ntawm tus menyuam hauv daim ntawv ntawm preeclampsia thiab preeclampsia, nrog rau fetoplacental insufficiency thiab fetal loj hlob retardation.
Nyob ntawm cov tshuaj tiv thaiv no
Muab faib ua peb chav kawm, uas yog: cov tshuaj tiv thaiv phospholipid IgM, IgG thiab IgA. Lawv raug coj tawm tsam cov qauv phospholipid ntawm lub cev hlwb thiab cov ntshav plasma proteins. Nyob rau hauv lawv cov cawv, cov txheej txheem ntawm cov ntshav txhaws yog cuam tshuam, uas thaum kawg ua rau thrombosis. Kev tshawb fawb txog tus nqi ntawm cov tshuaj tiv thaiv antiphospholipid yog ua nyob rau hauv lub xub ntiag ntawm recurrent nchuav menyuam nyob rau hauv lub thib ob thiab thib peb trimester ntawm cev xeeb tub, nrog rau cov kev tshwm sim ntawm preeclampsia los yog tshwm sim ntawm yug ntxov ntxov. Tsuas muaj ob peb hom tshuaj tiv thaiv no:
- YLupus anticoagulants.
- Anticardiolipin tshuaj tiv thaiv.
- Yβ2-glycoproteins.
- Phosphatidylserine antibodies.
Lupus thiab anticardiolipin cov tshuaj tiv thaiv muaj ntau. Tag nrho tab sis lupus anticoagulants pom ncaj qha hauv cov qauv ntshav.
Lub ntsiab lus ntawm kev tshuaj ntsuam
Antiphospholipid tshuaj tiv thaiv kab mob yuav tsum tau kuaj xyuas cov protein tshwj xeeb uasLub cev tsim tawm tsam nws tus kheej raws li qhov tshwm sim ntawm autoimmune cov tshuaj tiv thaiv. Nyob rau hauv lem, phospholipids yog ib feem ntawm lub hlwb ntawm lub cev. Cov ntsiab lus no nkag ncaj qha rau hauv cellular muaj pes tsawg leeg ntawm daim nyias nyias thiab platelets. Lawv yog, qhov tseeb, cov roj molecules uas ua lub luag haujlwm tseem ceeb hauv cov ntshav txhaws, txawm hais tias cov txheej txheem ntawm lawv qhov kev txiav txim tseem tsis meej txog hnub no. Antiphospholipids ua rau muaj kev pheej hmoo ntawm cov ntshav txhaws tsis zoo thiab tsim cov ntshav txhaws hauv cov hlab ntsha thiab cov hlab ntsha, uas tuaj yeem ua rau mob stroke thiab plawv nres.
Qhov muaj cov tshuaj tiv thaiv kab mob antiphospholipid kuj tseem cuam tshuam nrog qhov tshwm sim ntawm thrombocytopenia (cov platelets tsawg hauv cov ntshav), nrog rau kev pheej hmoo ntawm kev nchuav menyuam (tshwj xeeb tshaj yog nyob rau peb lub hlis kawg ntawm cev xeeb tub), nrog rau toxicosis nyob rau hauv lub xeem. theem ntawm cev xeeb tub thiab yug ntxov ntxov.
Qhov muaj cov tshuaj tiv thaiv no yog ib feem ntawm cov tsos mob hu ua antiphospholipid syndrome lossis Stovin's disease. Nws kuj muaj xws li thrombosis nrog rau obstetric pathologies (mis nchuav menyuam, rov qab nchuav menyuam) thiab thrombocytopenia. Cov kab mob no tuaj yeem cuam tshuam ncaj qha rau lwm yam kab mob autoimmune, tshwj xeeb tshaj yog kab mob lupus, lossis tsis muaj kab mob sib kis (ces hu ua thawj antiphospholipid syndrome).
Tseeb tiag, cov tshuaj tiv thaiv feem ntau tshwm sim hauv tib neeg lub cev thiab nrog cov kab mob autoimmune xws li lupus erythematosus, ntxiv rau, lawv tuaj yeem pom hauv tus neeg muaj tus kab mob HIV, qee hom mob qog noj ntshav, siv qee yam.tshuaj, piv txwv li, phenothiazine thiab novocainamide. Nyob rau hauv kev twb kev txuas nrog tag nrho cov no, kev txiav txim siab ntawm anticardiolipin tshuaj tiv thaiv yog ib qho kev soj ntsuam ntxiv thiab, nyob rau hauv nws tus kheej, lawv lub xub ntiag tsis tau suav hais tias yog ib qho kev ntsuam xyuas ncaj qha rau antiphospholipid syndrome. Nws yog ib qho tsim nyog sau cia tias qhov kev ntsuam xyuas, ib yam li kev kuaj mob ntawm tus mob no tag nrho, yuav tsum yog qhov nyuaj, suav nrog ntau qhov kev kuaj mob tshwj xeeb ib zaug.
Kev Tshawb Fawb Kev Ntsuam Xyuas: Qhov kev tshawb fawb no siv rau dab tsi thiab thaum twg nws raug muab
Antiphospholipid antibody test yog ua los txiav txim qhov ua rau thrombotic microangiopathy thiab hauv qee kis hauv qab no:
- Txhim kho qhov ua rau rov tshwm sim fetal poob.
- Kawm kom paub qhov ua rau thrombocytopenia.
- txhawm rau txiav txim siab lub sijhawm ntev ntawm kev tsim thromboplastin.
Thaum twg qhov kev kawm no raug txiav txim? Tus kws kho mob tuaj yeem pom zoo nws hauv ntau qhov xwm txheej hauv qab no:
- Yog tias ib tus neeg xav tias muaj cov kab mob antiphospholipid (qhov kev sim no tau ua ob peb zaug hauv rau lub lim tiam).
- Tom qab rov nchuav menyuam ua ib qho ntxiv rau lub sijhawm kuaj thromboplastin.
- Tom qab rov rov ua dua ntawm tus neeg mob thaum tseem hluas.
- Thaum ib tug neeg tsim thrombocytopenia.
- Tawm tsam keeb kwm yav dhau los ntawm cov tsos mob ntawm thrombotic microangiopathy (nrog o ntawm ceg ceg, ua tsis taus pa thiab mob taub hau tas li).
Tus qauv rau cov tshuaj tiv thaiv phospholipid yog dab tsi?
Transcript: cov txiaj ntsig txhais li cas
Raws li ib feem ntawm kev txiav txim siab, siv qhov tseem ceeb ntawm 0 txog 10 units ib milliliter. Qhov tshwm sim tsis zoo yog qhov tsis muaj cov tshuaj tiv thaiv tshwj xeeb rau IgM phospholipids. Nyob rau hauv cov xwm txheej uas thaum lub sij hawm txoj kev tshawb no muaj ib tug tsawg los yog nruab nrab cov ntsiab lus ntawm cov tshuaj tiv thaiv kab mob, ces qhov no qhia cov nram qab no:
- Kev muaj kab mob hauv lub cev.
- Tus neeg mob siv qee yam tshuaj.
Thaum muaj qhov nruab nrab qhov nruab nrab antiphospholipid cov tshuaj tiv thaiv kab mob uas tseem muaj ntxiv txawm tias yog ib feem ntawm kev rov sim dua tom qab yim lub lis piam, qhov no qhia txog cov hauv qab no:
- Ib tug neeg muaj kev pheej hmoo siab rau thrombosis.
- Thaum cev xeeb tub, qhov xwm txheej no qhia tau tias muaj kev pheej hmoo siab ntawm kev xeeb tub (qhov no, yuav tsum tau saib xyuas cov ntsuas ntawm cov kab mob hemostasis).
- Nyob rau hauv muaj qee cov tsos mob, peb tuaj yeem tham txog cov kab mob antiphospholipid.
Thaum kuaj rau cov tshuaj tiv thaiv no thiab kuaj pom, muaj kev pheej hmoo ntawm thrombotic recurrent angiopathy, recurrent miscarriages thiab thrombocytopenia. Muaj tseeb tiag, qhov ntsuas ntawm cov kev ntsuas no tsis tuaj yeem kwv yees qhov yuav tshwm sim ntawm qhov teeb meem thiab hom kev mob hnyav ntawm tus neeg mob.
Nws tsim nyog sau cia tias qee tus neeg mob tuaj yeem raug ntau hom kev rov tshwm sim ntawm tus kab mob, thaum lwm tus tsis tau ntsibtej teeb meem. Ib qho piv txwv ntawm qhov no yog nyob rau hauv cov neeg mob asymptomatic uas tau kuaj pom tias muaj cov tshuaj tiv thaiv kab mob antiphospholipid tom qab ncua sij hawm ntawm kev tsim thromboplastin los ntawm lwm qhov laj thawj, xws li thaum kuaj mob ua ntej kev phais. Cov neeg laus asymptomatic yuav tsum tau hais ua piv txwv.
Lupus type - txhais li cas?
Nov yog kev kawm txog cov tshuaj tiv thaiv kab mob uas tsim los ntawm lub cev tiv thaiv kab mob tiv thaiv nws cov phospholipids, uas ua lub luag haujlwm loj hauv kev tsim cov ntshav txhaws.
Yuav ua li cas npaj kom zoo rau kev pub ntshav rau lupus antiphospholipid tshuaj tiv thaiv? Ua ntej tshaj plaws, koj tsis tuaj yeem noj tau peb teev ua ntej tus txheej txheem, tab sis koj tuaj yeem haus cov dej ntshiab uas tsis yog carbonated. Kuj tsis txhob noj "Heparin", nrog rau nws cov analogues tsib hnub ua ntej kev kawm. Tshem tawm tib qho kev xav thiab lub cev overstrain. Ntawm lwm yam, koj tsis tuaj yeem haus luam yeeb peb caug feeb ua ntej kev soj ntsuam. Dab tsi yog lupus antiphospholipid antibody test siv rau? Nws yog siv rau hauv cov xwm txheej hauv qab no:
- Kawm kom paub qhov ua rau thrombosis.
- Yuav txiav txim siab vim li cas thiaj rho menyuam.
- Yuav kom paub seb qhov nce ntawm cov tshuaj tiv thaiv kab mob no yog vim lupus anticoagulant lossis lwm tus inhibitor tshwj xeeb.
- Rau lub hom phiaj ntawm kev kuaj mob antiphospholipid syndrome (ua ke nrog kev kuaj mob anticardiolipin antibody).
- Kom paub meej tias muaj lupus anticoagulant.
- Bthrombosis.
- Vim muaj cov tshuaj lupus anticoagulant mus sij hawm ntev (nyob rau hauv cov ntaub ntawv tau txais txiaj ntsig zoo, kev ntsuam xyuas feem ntau rov ua dua tom qab ob peb lub lis piam kom paub meej tias muaj lupus anticoagulant).
- Thaum kuaj pom cov tshuaj tiv thaiv cardiolipin hauv cov neeg mob.
Antiphospholipid Antibody Syndrome
Tus kab mob no yog kab mob autoimmune uas suav nrog thrombosis, thiab thaum cev xeeb tub ua rau tus menyuam tuag. Cov tsos mob no tuaj yeem tshwm sim los ntawm cov tshuaj tiv thaiv sib txawv, qhov kev txiav txim ntawm cov tshuaj tiv thaiv ntau yam phospholipid binding proteins. Lawv zoo li khi rau phospholipid tivthaiv ntawm daim nyias nyias, tiv thaiv nws los ntawm kev ua kom coagulation ntau dhau.
Autoimmune antibodies tshem tawm cov protein tiv thaiv, thiab yog li procoagulant nto ntawm endothelial hlwb raug tsim, uas ua rau venous lossis arterial thrombosis. Kev kuaj ntshav coagulation tuaj yeem ntev vim qhov tseeb tias phospholipid cov tshuaj tiv thaiv tsuas yog cuam tshuam nrog kev sib sau ntawm coagulation yam thiab cov txheej txheem ua kom cov ntsiab lus ntxiv rau cov ntshav.
Lupus anticoagulant yog ib qho tshuaj tiv thaiv kab mob antiphospholipid uas khi rau cov protein ntau. Thaum xub thawj, tus mob no tau lees paub hauv cov neeg mob lupus erythematosus. Tab sis cov neeg mob tam sim no sawv cev rau qhov tsawg tshaj plaws ntawm cov neeg mob uas muaj autoimmune antibodies.
Kev kuaj mob ntawm tus mob txaus ntshai no
Kev kuaj mob muaj ntau yam kev tshawb fawb hauv chav kuaj, pib nrog kev tsim lub sijhawm thromboplastin ib nrab (uas yog, kev tshuaj xyuas rau PTT). Qhov kev kuaj ntshav no rau cov tshuaj tiv thaiv kab mob antiphospholipid yog ua nyob rau hauv cov neeg mob uas xav tias yuav tau txais cov txheej txheem invasive. Nws kuj raug muab tso rau hauv cov xwm txheej hauv qab no:
- Cov neeg mob uas tsis tau piav qhia los ntshav lossis los ntshav.
- Cov neeg mob noj cov tshuaj ua kom ntshav hnyav.
Lupus anticoagulant xav tias yog PTT ntev thiab tsis kho tam sim tom qab sib xyaw nrog cov ntshav ntawm qhov sib piv ib-rau-ib, tab sis rov qab mus rau qhov qub yog tias cov phospholipids tau ntxiv lawm (kev soj ntsuam tau ua nyob rau hauv cov chaw soj ntsuam tshawb fawb). Tom ntej no, tus naj npawb ntawm cov tshuaj tiv thaiv hauv tus neeg mob cov ntshav ntshav yog ntsuas ncaj qha los ntawm kev kuaj cov tshuaj tiv thaiv rau IgM phospholipids, nrog rau IgG, uas khi rau glycoprotein ntawm microtiter phaj.
Kev kho mob ntawm tus mob no yog dab tsi
Kev kho mob feem ntau yog nrog kev kho mob anticoagulant. Rau kev tiv thaiv thiab kev kho mob, tshuaj xws li Heparin yog siv nrog rau Warfarin thiab Aspirin. Nws tsis paub tias cov tshuaj anticoagulants tshiab uas inhibit thrombin tuaj yeem siv los kho tus kab mob no.
Qhov kev cia siab rau qhov txaus ntshai pathology no tsis meej. Kev ua tiav ntawm kev kho mob yog nyob ntawm ntau yam. Ua ntej tshaj plaws, nws tseem ceeb heevraws sijhawm pub ntshav rau kev tshawb fawb txhawm rau txiav txim siab qib ntawm cov tshuaj tiv thaiv. Tsuas yog raws li cov txiaj ntsig thiab kev kho mob tshwm sim tuaj yeem kho kom raug los ntawm kws kho mob rheumatologist. Tab sis tib lub sijhawm, nws yuav tsum nco ntsoov tias kev sab laj ntawm ntau tus kws tshaj lij yuav xav tau tiag tiag vim tias tus kab mob no cuam tshuam rau ntau lub cev.
Tsis muaj qhov twg koj yuav tsum tau noj tshuaj rau tus kheej, vim qhov no yog fraught nrog mob hnyav.
Anti-sperm antiphospholipid antibodies thiab lawv cov qauv
Anti-sperm antibodies yog cov khoom rau antigens ntawm spermatozoa daim nyias nyias. Lawv tau piav qhia thawj zaug hauv cov ntshav ntawm cov txiv neej uas tsis muaj menyuam, Wilson xyoo 1954. Cov tshuaj feem ntau pom muaj nyob rau hauv cov ntshav, cov qog ntshav ntshav, cov qog nqaij hlav hauv tsev menyuam, thiab, ntxiv rau, ntawm qhov chaw ntawm cov spermatozoa. Feem ntau, cov no yog cov tshuaj tiv thaiv phospholipid IgG lossis IgM.
Nquag, cov tshuaj tiv thaiv kab mob hauv cov txiv neej noj qab haus huv pom muaj nyob rau hauv cov nyiaj ntawm ib mus rau kaum feem pua. Hauv cov neeg sawv cev tsis muaj zog ntawm kev sib deev muaj zog, lawv muaj nyob rau hauv tus nqi nees nkaum feem pua.
Antibodies hauv txiv neej
Cov tshuaj tiv thaiv kab mob phev tuaj yeem tshwm sim ntawm thawj theem ntawm cov kab mob spermatocyte, thiab lawv cov theem ntawm kev nthuav tawm nce ntxiv raws li kev loj hlob zuj zus. Cov tshuaj tiv thaiv no txawv los ntawm cov cuab yeej ntawm tus kheej-antigenicity, uas yog, lawv yog cov tshuaj tiv thaiv kab mob txawv teb chaws hauv lawv lub cev. Ntawm cov txiv neej noj qab nyob zoo, spermatozoa uas nyob rau hauv lub epididymis tuaj yeem raug phagocytosis yog tias ejaculation tsis tshwm sim. Muaj tseeb, qhov no tsis cuam tshuam nrog kev tsim cov tshuaj tiv thaiv kab mob phev, uas yog vim li no:
- Lub xub ntiag ntawm kev tiv thaiv kab mob los ntawm cov txheej txheem ntawm resorption ntawm spermatozoa.
- Thaiv kev tsim cov tshuaj tiv thaiv kab mob los ntawm lwm cov tshuaj tiv thaiv.
- Ib tus yam ntxwv ntawm kev tsim tshuaj tiv thaiv kab mob.
Kev tsim cov tshuaj tua kab mob tua kab mob hauv ntau qhov chaw ntawm cov txiv neej kev ua me nyuam yog cuam tshuam los ntawm qee cov txheej txheem. Yog li, nyob rau hauv cov noob qes, kev tiv thaiv yog muab los ntawm lub hematotesticular barrier, uas cais cov hlwb ntawm spermatogenesis los ntawm immunocompetent ntsiab ntawm lub cev. Qhov teeb meem no yog ua raws li cov Sertoli tshwj xeeb nrog lawv cov txheej txheem.
Tom qab tso cov spermatozoa los ntawm cov noob qes, lwm txoj kev tiv thaiv ua haujlwm, uas muaj lawv lub peev xwm hloov mus rau ib puag ncig. Qhov peev xwm no muaj zog ntau dua hauv cov phev siv tau. Tsis tas li ntawd, cov phev plasma muaj cov kev tswj hwm hauv zos uas tiv thaiv kev tsim cov tshuaj tiv thaiv kab mob phev thiab tsim cov cellular anti-sperm sensitizations (piv txwv li, cov tshuaj tiv thaiv kab mob ntawm cov phev plasma). Cov yam ntxwv zoo li no tau muab zais rau hauv lub caj pas adnexal ntawm tus txiv neej txoj kev loj hlob.
As manifested in poj niam
Cov kab mob ntawm qhov chaw mos ntawm tus poj niam muaj ntau ntau cov kab mob tiv thaiv kab mob. Lub ntuj nkag ntawm cov phev mus rau hauv qhov chaw mos tuaj yeem ua rau lub cev tiv thaiv kab mob. Muaj tseeb, cov txheej txheem immunological uas tshwm sim hauv poj niam lub cevtam sim ntawd tom qab phev noj tseem tsis tau to taub zoo. Kev tsim cov tshuaj tiv thaiv hauv lub cev poj niam, raws li txoj cai, yog tiv thaiv los ntawm ntau yam txheej txheem uas txo cov tshuaj tiv thaiv kab mob.
Thaum ovulation hloov qhov nyiaj tshuav ntawm T-lymphocytes. Piv txwv li, theem ntawm T-tus pab txo qis, thiab T-suppressors nce. Ntawm lwm yam, tag nrho cov ntsiab lus ntawm immunoglobulins thiab C3 lub ntsiab lus ntawm cov kab ke ntxiv txo qis. Lub luag haujlwm tseem ceeb hauv kev txo qis kev tiv thaiv kab mob rau spermatozoa, raws li txoj cai, yog ua los ntawm cov txiv neej tiv thaiv mechanism nyob rau hauv daim ntawv ntawm sorption thiab desorption ntawm nto antigens thaum hloov ib puag ncig, thiab, ntxiv rau, spermoplasma immunosuppressive yam tseem ceeb.
Ntxiv rau, nws tau xav tias tsuas yog qee tus lej ntawm cov genetic spermatozoa xaiv nkag mus rau hauv cov hlab ntsha, uas yog cov tshuaj tiv thaiv kab mob sib txawv ntawm feem ntau, thiab lwm tus, dhau los, tuag thiab thaiv kev tiv thaiv hauv zos.
Yog li, cov tshuaj tiv thaiv kab mob antiphospholipid muaj ntau yam cuam tshuam rau cov kab mob hemostasis, ib qho ntawm nws cov kev tiv thaiv kev sib txuas hauv daim ntawv ntawm endothelial barrier, kev ua haujlwm ntawm natural anticoagulants, thiab endogenous fibrinolysis puas lawm. Ntawm lwm yam, platelet txuas ntawm hemostasis nrog cov yam ntxwv procoagulant tau qhib.
Qhov kev tshawb fawb no tau ua tiav
Tshawb nrhiav cov tshuaj tiv thaiv phospholipid hauv "Hemotest" yog qhov ua tau dhau mus.
Lub chaw kuaj mob no yog qhov chaw ua haujlwm siab niaj hnub uas ua ntau txhiab txhiab qhov kev kuaj mob txhua hnub rau txhua tus neeg mob Lavxias.
Antiphospholipid testCov tshuaj tiv thaiv hauv "Hemotest" raug nqi 3,000-3,500 rubles.
Koj tuaj yeem mus rau txhua qhov chaw kuaj mob uas muaj qhov tshuaj ntsuam no. Tsis tas li, kev tshuaj ntsuam xyuas qhov muaj cov tshuaj tiv thaiv kab mob antiphospholipid yog ua nyob rau hauv cov chaw kuaj mob thiab qee lub tsev kho mob ntiag tug.
