Phospholipid Syndrome yog ib hom kab mob sib kis ntawm autoimmune keeb kwm. Tawm tsam keeb kwm ntawm tus kab mob, qhov txhab ntawm cov hlab ntsha, ob lub raum, pob txha thiab lwm yam kabmob feem ntau pom. Thaum tsis muaj kev kho mob, tus kab mob tuaj yeem ua rau muaj kev phom sij txog kev tuag ntawm tus neeg mob. Tsis tas li ntawd, feem ntau pom tus kab mob no hauv cov poj niam thaum cev xeeb tub, uas ua rau muaj kev phom sij rau niam thiab menyuam.
Tau kawg, ntau tus neeg nrhiav cov ntaub ntawv ntxiv los ntawm kev nug txog qhov ua rau muaj tus kabmob. Cov tsos mob dab tsi koj yuav tsum saib xyuas? Puas muaj kev tsom xam rau phospholipid syndrome? Cov tshuaj puas tuaj yeem muab kev kho mob zoo?
Phospholipid Syndrome: Nws yog dab tsi?
Thawj zaug tus kab mob no tau piav qhia tsis ntev dhau los. Cov ntaub ntawv tseem ceeb txog nws tau luam tawm xyoo 1980s. Txij li thaum Askiv tus kws kho mob rheumatologist Graham Hughes ua haujlwm ntawm txoj kev tshawb no, tus kab mob no feem ntau hu ua Hughes syndrome. Muaj lwm lub npe - antiphospholipid syndrome thiab antiphospholipid antibody syndrome.
Phospholipid Syndrome yog ib hom kab mob autoimmune uas lub cev tiv thaiv kab mob pib tsim cov tshuaj tiv thaiv uas tawm tsam lub cev ntawm tus kheej phospholipids. Txij li cov tshuaj no yog ib feem ntawm cov phab ntsa ntawm cov hlab ntsha ntawm ntau lub hlwb, cov kab mob hauv cov kab mob no tseem ceeb:
- Antibodies tua cov kab mob endothelial noj qab haus huv, txo cov synthesis ntawm kev loj hlob thiab prostacyclin, uas yog lub luag haujlwm rau kev nthuav dav ntawm phab ntsa ntawm cov hlab ntsha. Tawm tsam keeb kwm ntawm tus kab mob, muaj kev ua txhaum ntawm platelet aggregation.
- Phospholipids kuj pom nyob rau hauv cov phab ntsa ntawm cov platelets lawv tus kheej, uas ua rau muaj kev sib sau ntawm cov platelets, nrog rau kev puas tsuaj sai.
- Nyob rau hauv lub xub ntiag ntawm cov tshuaj tiv thaiv, muaj qhov nce hauv cov ntshav txhaws thiab txo qis hauv kev ua haujlwm heparin.
- Tus txheej txheem ntawm kev puas tsuaj tsis hla cov hlab ntsha ib leeg.
Cov ntshav pib coagulate hauv cov hlab ntsha, tsim cov ntshav txhaws uas cuam tshuam cov ntshav ntws thiab, yog li ntawd, kev ua haujlwm ntawm ntau yam kabmob - qhov no yog li cas phospholipid syndrome tsim. Qhov ua rau thiab cov tsos mob ntawm tus kab mob no yog txaus siab rau ntau tus neeg. Tom qab tag nrho, qhov pom tus kab mob sai dua, tus neeg mob yuav muaj teeb meem tsawg dua.
Qhov laj thawj tseem ceeb ntawm kev txhim kho tus kabmob
Vim li cas tib neeg thiaj tsim phospholipid syndrome? Cov laj thawj yuav txawv. Nws yog paub tias feem ntau cov neeg mob muaj ib tug genetic predisposition. Tus kab mob no tshwm sim nyob rau hauv cov ntaub ntawv ntawm kev ua hauj lwm tsis zoo ntawm lub cev tiv thaiv kab mob, uas yog vim li cas los yog lwm yam pib tsim cov tshuaj tiv thaiv rau lub hlwb.tus kheej lub cev. Nyob rau hauv txhua rooj plaub, tus kab mob yuav tsum tau provoked los ntawm ib yam dab tsi. Txog niaj hnub no, cov kws tshawb fawb tau txheeb xyuas ntau yam kev pheej hmoo:
- Phospholipid syndrome feem ntau tsim tawm tsam keeb kwm ntawm microangiopathies, tshwj xeeb trobocytopenia, hemolytic-uremic syndrome.
- Cov xwm txheej pheej hmoo suav nrog lwm yam kab mob autoimmune xws li lupus erythematosus, vasculitis, scleroderma.
- Tus kab mob feem ntau tshwm sim thaum muaj cov qog nqaij hlav hauv tus neeg mob lub cev.
- Cov kev pheej hmoo muaj xws li kab mob sib kis. Ntawm qhov xwm txheej tshwj xeeb yog kis kab mob mononucleosis thiab AIDS.
- Antibodies yuav tshwm sim hauv DIC.
- Nws paub tias tus kab mob tuaj yeem tshwm sim thaum noj qee yam tshuaj, suav nrog cov tshuaj tiv thaiv kab mob hormonal, tshuaj psychotropic, Novocainamide, thiab lwm yam.
Ib txwm, nws yog ib qho tseem ceeb kom paub seb vim li cas tus neeg mob tsim phospholipid syndrome. Kev kuaj mob thiab kev kho mob yuav tsum txheeb xyuas thiab, yog tias ua tau, tshem tawm lub hauv paus ua rau tus kab mob.
Kev poob ntawm cov hlab plawv hauv phospholipid syndrome
Ntshav thiab cov hlab ntsha yog thawj "cov phiaj xwm" uas cuam tshuam rau phospholipid syndrome. Nws cov tsos mob nyob ntawm theem ntawm kev loj hlob ntawm tus kab mob. Thrombi feem ntau tsim thawj zaug hauv cov hlab ntsha me ntawm cov extremities. Lawv cuam tshuam cov ntshav khiav, uas yog nrog cov ntaub so ntswg ischemia. Cov ceg uas cuam tshuam yog ib txwm txias rau qhov kov, daim tawv nqaij tig daj ntseg, thiab cov leeg maj mam atrophy. Cov ntaub so ntswg ntev ntev ua rau necrosis thiab tom qab gangrene.
Muaj peev xwm thiab sib sib zog nqus hlab ntsha ntawm cov extremities, uas yog nrog los ntawm cov tsos mob ntawm edema, mob, tsis muaj zog. Phospholipid Syndrome tuaj yeem cuam tshuam los ntawm thrombophlebitis (mob ntawm cov phab ntsa vascular), uas yog nrog kub taub hau, ua daus no, reddening ntawm daim tawv nqaij nyob rau hauv cov cheeb tsam cuam tshuam thiab ntse, ntse mob.
Kev tsim cov ntshav txhaws hauv cov hlab ntsha loj tuaj yeem ua rau kev txhim kho ntawm cov kab mob hauv qab no:
- aortic syndrome (nrog los ntawm kev nce siab hauv cov hlab ntsha ntawm lub cev sab sauv);
- kab mob ntawm lub superior vena cava (tus mob no yog tus yam ntxwv ntawm o, cyanosis ntawm daim tawv nqaij, los ntshav los ntawm lub qhov ntswg, trachea thiab esophagus);
- inferior vena cava syndrome (nrog rau cov hlab ntsha hauv lub cev qis, o ntawm cov ceg, mob ob txhais ceg, pob tw, plab thiab puab tais).
Thrombosis kuj cuam tshuam rau kev ua haujlwm ntawm lub plawv. Feem ntau tus kab mob no nrog rau kev loj hlob ntawm angina pectoris, persistent arterial hypertension, myocardial infarction.
raum puas thiab cov tsos mob tseem ceeb
Kev tsim cov ntshav txhaws ua rau cov hlab ntsha tsis zoo tsis yog hauv cov ceg ceg - cov kabmob sab hauv, tshwj xeeb hauv lub raum, kuj raug kev txom nyem. Nrog rau kev loj hlob ntev ntawm phospholipid syndrome, qhov hu ua raum infarction yog ua tau. Tus mob no yog nrog los ntawm qhov mob ntawm lub nraub qaum, txo qis ntawm cov zis thiab muaj cov ntshav impurities hauv nws.
A thrombus tuaj yeem thaiv lub raum cov hlab ntsha, uas yog nrog los ntawm qhov mob hnyav, xeev siab thiab ntuav. Qhov no yog ib qho xwm txheej txaus ntshai - yog tias tsis kho, nws tuaj yeem txhim khotxheej txheem necrotic. Cov txiaj ntsig txaus ntshai ntawm phospholipid syndrome suav nrog rau lub raum microangiopathy, uas cov ntshav me me tsim ncaj qha rau hauv lub raum glomeruli. Tus mob no feem ntau ua rau kev txhim kho lub raum tsis ua haujlwm.
Qee zaum muaj kev ua txhaum ntawm cov ntshav ncig hauv cov qog adrenal, uas ua rau muaj kev ua txhaum ntawm hormonal keeb kwm yav dhau.
Yuav ua li cas lwm lub cev tuaj yeem cuam tshuam?
Phospholipid syndrome yog ib yam kab mob uas cuam tshuam rau ntau lub cev. Raws li twb tau hais lawm, cov tshuaj tiv thaiv kab mob cuam tshuam rau daim nyias nyias ntawm cov paj hlwb, uas tsis tuaj yeem ua yam tsis muaj qhov tshwm sim. Ntau tus neeg mob yws ntawm qhov mob taub hau tas li, uas feem ntau nrog kiv taub hau, xeev siab thiab ntuav. Muaj peev xwm tsim muaj ntau yam kev puas siab puas ntsws.
Nyob rau hauv qee cov neeg mob, cov ntshav txhaws tau pom nyob rau hauv cov hlab ntsha uas muab cov ntshav ntsuas ntshav. Lub sij hawm tsis muaj oxygen thiab cov as-ham ua rau atrophy ntawm lub paj hlwb. Qhov ua tau thrombosis ntawm cov hlab ntsha retinal nrog cov ntshav tom qab. Qee qhov ntawm qhov muag pathologies, hmoov tsis zoo, yog qhov rov qab tsis tau: qhov muag tsis pom kev nyob nrog tus neeg mob mus tas li.
Cov pob txha kuj tuaj yeem koom nrog cov txheej txheem pathological. Cov tib neeg feem ntau raug kuaj pom tias muaj kev rov qab osteoporosis, uas yog nrog rau cov pob txha deformity thiab cov pob txha nquag. Qhov txaus ntshai tshaj yog aseptic pob txha necrosis.
daim tawv nqaij qhov mob kuj yog tus yam ntxwv ntawm tus kab mob. Feem ntau, kab laug sab leeg tsim ntawm daim tawv nqaij ntawm sab sauv thiab sab qis. Qee lub sij hawm koj tuaj yeem pom cov pob liab liab uas zoo li me me, pom cov hemorrhages. Qee tus neeg mob tsim erythema ntawm ob txhais taw thiab xib teg. Feem ntau tshwm sim ntawm subcutaneous hematomas (tsis muaj laj thawj) thiab hemorrhages nyob rau hauv cov ntsia thawv phaj. Kev ua txhaum mus sij hawm ntev ntawm cov ntaub so ntswg trophism ua rau pom cov kab mob uas siv sij hawm ntev los kho thiab nyuaj kho.
Peb paub seb qhov phospholipid syndrome yog dab tsi. Qhov ua rau thiab cov tsos mob ntawm tus kab mob yog cov lus nug tseem ceeb heev. Tom qab tag nrho, txoj kev kho mob xaiv los ntawm tus kws kho mob yuav nyob ntawm cov yam ntxwv no.
YPhospholipid Syndrome: Kev kuaj mob
Tau kawg, qhov no nws yog ib qho tseem ceeb heev uas yuav tsum tau kuaj pom tus kab mob nyob rau lub sijhawm. Tus kws kho mob tuaj yeem xav tias phospholipid syndrome txawm tias thaum sau cov anamnesis. Lub xub ntiag ntawm thrombosis thiab trophic ulcers nyob rau hauv tus neeg mob, nquag nchuav menyuam, cov tsos mob ntawm anemia tuaj yeem ua rau qhov kev xav no. Tau kawg, kev tshuaj xyuas ntxiv tau ua rau yav tom ntej.
Kev tshuaj ntsuam rau phospholipid syndrome yog txhawm rau txiav txim siab qib ntawm cov tshuaj tiv thaiv rau phospholipids hauv cov ntshav ntawm cov neeg mob. Hauv kev kuaj ntshav dav dav, koj tuaj yeem pom qhov txo qis hauv qib platelets, nce ESR, nce ntawm cov leukocytes. Feem ntau, tus mob no yog nrog los ntawm hemolytic anemia, uas tuaj yeem pom thaum lub sij hawm soj ntsuam.
Tsis tas li ntawd, kuaj ntshav biochemical tau ua. Cov neeg mob muaj qhov nce ntawm gamma globulins. Yog hais tias daim siab tau puas tawm tsam keeb kwm ntawm pathology, ces tus nqi ntawmbilirubin thiab alkaline phosphatase. Thaum muaj kab mob raum, kev nce qib ntawm creatinine thiab urea tuaj yeem pom.
Qee tus neeg mob kuj tau pom zoo kuaj ntshav tiv thaiv kab mob. Piv txwv li, kev sim kuaj yuav ua tau los txiav txim siab rheumatoid factor thiab lupus coagulant. Nrog phospholipid syndrome nyob rau hauv cov ntshav, muaj cov tshuaj tiv thaiv rau erythrocytes, nce qib ntawm lymphocytes tuaj yeem kuaj pom. Yog tias muaj kev xav tias muaj kev puas tsuaj loj rau daim siab, ob lub raum, cov pob txha, tom qab ntawd kev tshuaj ntsuam xyuas, suav nrog X-ray, ultrasound, tomography.
Tus kab mob yog dab tsi?
Yog tias tsis kho, phospholipid syndrome tuaj yeem ua rau muaj teeb meem txaus ntshai heev. Tawm tsam keeb kwm ntawm tus kab mob, cov ntshav txhaws tsim nyob rau hauv cov hlab ntsha, uas nyob rau hauv nws tus kheej yog txaus ntshai. Cov ntshav txhaws txhaws cov hlab ntsha, cuam tshuam cov ntshav ncig - cov ntaub so ntswg thiab lub cev tsis tau txais cov as-ham txaus thiab oxygen.
Ntau zaus, tawm tsam keeb kwm ntawm tus mob, cov neeg mob tsim mob stroke thiab myocardial infarction. Kev thaiv ntawm cov hlab ntsha ntawm cov extremities tuaj yeem ua rau kev loj hlob ntawm gangrene. Raws li tau hais los saum no, cov neeg mob tau ua haujlwm tsis zoo ntawm lub raum thiab cov qog adrenal. Qhov tshwm sim txaus ntshai tshaj plaws yog pulmonary embolism - qhov pathology no loj hlob zuj zus, thiab tsis yog txhua tus neeg mob tuaj yeem xa mus rau tsev kho mob raws sijhawm.
Kev cev xeeb tub hauv cov neeg mob uas muaj phospholipid syndrome
Raws li twb tau hais lawm, phospholipid syndrome tau kuaj pom thaum cev xeeb tub. Dab tsi yog qhov txaus ntshai ntawm tus kab mob thiab yuav ua li cas rau qhov xwm txheej zoo li no?
Vim yog phospholipid syndrome, cov ntshav txhaws tsim nyob rau hauv cov hlab ntsha, uas txhaws cov hlab ntsha uas nqa ntshav mus rau lub placenta. Lub embryo tsis tau txais oxygen txaus thiab cov as-ham, nyob rau hauv 95% ntawm cov mob no ua rau nchuav menyuam. Txawm hais tias cev xeeb tub tsis cuam tshuam, muaj kev pheej hmoo ntawm cov placental abruption thaum ntxov thiab kev loj hlob ntawm preeclampsia lig, uas yog heev txaus ntshai rau leej niam thiab tus me nyuam.
Qhov zoo tshaj plaws, tus poj niam yuav tsum tau sim ntawm theem npaj. Txawm li cas los xij, phospholipid syndrome feem ntau kuaj pom thaum cev xeeb tub. Nyob rau hauv cov ntaub ntawv no, nws yog ib qho tseem ceeb heev uas yuav tsum tau pom muaj tus kab mob nyob rau hauv lub sij hawm thiab ua raws li qhov tsim nyog ntsuas. Txhawm rau tiv thaiv thrombosis ntawm leej niam expectant, anticoagulants yuav raug sau rau hauv koob me me. Tsis tas li ntawd, tus poj niam yuav tsum tsis tu ncua mus kuaj kom tus kws kho mob tuaj yeem pom qhov pib ntawm placental abruption nyob rau lub sij hawm. Txhua ob peb lub hlis, cov niam uas muaj kev cia siab tau txais kev kho mob dav dav, noj cov tshuaj uas muaj cov vitamins, minerals thiab antioxidants. Nrog txoj hauv kev zoo, kev xeeb tub feem ntau xaus zoo siab.
kev kho mob zoo li cas?
Yuav ua li cas yog tias ib tug neeg muaj phospholipid syndrome? Kev kho mob hauv qhov no yog qhov nyuaj, thiab nws nyob ntawm seb muaj qee yam teeb meem hauv tus neeg mob. Txij li thaum cov ntshav txhaws tsim tawm tsam keeb kwm ntawm tus kab mob, txoj kev kho mob feem ntau yog tsom rau cov ntshav thinning. Tswv yimKev kho mob feem ntau suav nrog kev siv ntau pawg tshuaj:
- Ua ntej ntawm tag nrho, cov tshuaj tiv thaiv tsis ncaj ncees thiab cov tshuaj tiv thaiv kab mob ("Aspirin", "Warfarin") tau sau tseg.
- Kev kho mob feem ntau suav nrog cov tshuaj uas tsis yog tshuaj steroidal los tiv thaiv kab mob xws li Nimesulide lossis Celecoxib.
- Yog tias tus kab mob cuam tshuam nrog cov kab mob lupus erythematosus thiab qee yam kab mob autoimmune, tus kws kho mob tuaj yeem sau tshuaj glucocorticoids (hormonal anti-inflammatory tshuaj). Nrog rau qhov no, cov tshuaj tiv thaiv kab mob tuaj yeem siv los txhawm rau ua haujlwm ntawm lub cev tiv thaiv kab mob thiab txo qis kev tsim cov tshuaj tiv thaiv kab mob txaus ntshai.
- Immune globulin qee zaum muab rau cov poj niam cev xeeb tub.
- Cov neeg mob tsis tu ncua noj tshuaj muaj cov vitamins B.
- Rau kev kho dav dav, kev tiv thaiv cov hlab ntsha thiab cov cell membranes, siv tshuaj antioxidant, nrog rau cov tshuaj uas muaj cov complex ntawm polyunsaturated fatty acids (Omacor, Mexicor).
cov txheej txheem electrophoresis yog qhov muaj txiaj ntsig zoo rau tus neeg mob tus mob. Thaum nws los txog rau theem nrab phospholipid syndrome, nws yog ib qho tseem ceeb los tswj tus kab mob thawj. Piv txwv li, cov neeg mob vasculitis thiab lupus yuav tsum tau txais kev kho mob txaus rau cov kab mob no. Nws tseem yog ib qho tseem ceeb kom kuaj tau cov kab mob sib kis raws sij hawm thiab ua raws li cov kev kho kom tsim nyog kom txog thaum rov ua tiav (yog tias ua tau).
Kev ntsuas rau cov neeg mob
Yog phospholipid syndrome tau kuaj pomraws sij hawm thiab tus neeg mob tau txais kev pab tsim nyog, qhov kev kwv yees tau zoo heev. Hmoov tsis zoo, nws tsis tuaj yeem tshem tawm tus kab mob mus ib txhis, tab sis nrog kev pab ntawm cov tshuaj, nws muaj peev xwm tswj tau nws cov exacerbations thiab nqa tawm kev tiv thaiv ntawm thrombosis. Kev phom sij yog cov xwm txheej uas tus kab mob cuam tshuam nrog thrombocytopenia thiab ntshav siab.
Txawm li cas los xij, txhua tus neeg mob uas kuaj mob "phospholipid syndrome" yuav tsum nyob rau hauv kev tswj hwm ntawm tus kws kho mob rheumatologist. Kev tshuaj xyuas ntau npaum li cas, koj yuav tsum tau mus kuaj ntau npaum li cas nrog lwm tus kws kho mob, tshuaj dab tsi koj yuav tsum tau noj, saib xyuas lub xeev ntawm koj tus kheej li cas - tus kws kho mob tuaj koom yuav qhia txog txhua yam no.
