Glomerulonephritis yog ib yam kab mob uas cuam tshuam rau cov hlab ntsha me ntawm lub raum hu ua glomeruli. Raws li etiology, kev tshwm sim, kab mob ntawm cov kab mob thiab nws cov txiaj ntsig, ob peb hom yog qhov txawv.
Lawv yog dab tsi? Dab tsi feem ntau provokes qhov tshwm sim ntawm tus kab mob no? Dab tsi yog qhov pathogenesis ntawm glomerulonephritis? Cov tsos mob dab tsi qhia tias nws muaj? Thiab yuav ua li cas nrog tus kab mob no? Qhov no tsim nyog tham txog ntau yam ntxiv.
Kev faib tawm
Ua ntej tshaj, koj yuav tsum xa mus rau ICD-10. Glomerulonephritis, raws li kev faib tawm thoob ntiaj teb ntawm cov kab mob, belongs rau nqe lus N03. Cov cai no sawv cev rau cov mob nephritic mob ntev.
Raws li cov ntaub ntawv no, ICD-10 glomerulonephritis yog raws li nram no:
- Diffuse membranous: N03.2.
- Mesangial proliferative: N03.3.
- Endocapillary proliferative: N03.4.
- Mesangiocapillary: N0З.5.
- Diffuse crescent: N0З.7.
Daim ntawv tus kab mob uas tus neeg tau kis tau tsuas yog tshwm sim hauv tus txheej txheem ntawm kev kuaj mob kom ntxaws. Vim hais tias sab nraud manifestations ntawm tus kab mob yog nonspecific. Cov tsos mob yuav zoo sib xws hauv ob qho tib si diffuse membranous thiab crescentic glomerulonephritis.
Mechanism of disease progression
Tam sim no peb yuav tsum tham txog cov kab mob ntawm glomerulonephritis. Txoj kev loj hlob ntawm tus kab mob no nyob rau hauv txhua rooj plaub yog txuam nrog ib tug mob hnyav los yog mob ntev, uas nyob rau hauv lub zos nyob rau hauv ntau yam kabmob thiab feem ntau muaj ib tug streptococcal keeb kwm.
Tsis tshua muaj, glomerulonephritis yog tshwm sim los ntawm kev lom tshuaj lom neeg, tshuaj tiv thaiv, lossis kev tsim txom ntawm cov khoom noj uas muaj cov tshuaj tua kab mob.
Kev loj hlob ntawm tus kab mob no pib nrog kev tsim cov tshuaj tiv thaiv kab mob hauv lub raum lossis cov ntshav - cov tshuaj tiv thaiv kab mob uas cuam tshuam nrog cov tshuaj tiv thaiv saum npoo ntawm cov kab mob ntawm tes. Lawv qib nce, thiab cov proteins complex (C3-complements) txo.
Yog tias kev kuaj ntshav biopsy tau ua nyob rau theem pib ntawm glomerulonephritis, ces glomerular puas ntawm 80 mus rau 100% yuav pom hauv cov khoom kuaj. Nws kuj tseem tuaj yeem pom cov pob zeb pob zeb nyob hauv qab daus ntawm cov hlab ntsha glomerular, uas muaj cov npe tsis zoo C3-ntxiv thiab immunoglobulin G..
Kawm kab mob
Muaj ob txoj kev xaiv tseem ceeb:
- Cyclic(ntev). Nws tshwm sim los ntawm qhov pib sai thiab qhov mob hnyav ntawm cov tsos mob.
- Acyclic (latent). Qhov no yog ib daim ntawv tshem tawm ntawm tus kab mob, uas yog tus cwj pwm los ntawm qhov pib maj mam thiab cov tsos mob me. Nws yog qhov txaus ntshai dua, tsis zoo li yav dhau los, vim nws feem ntau kuaj pom lig, thiab thaum kawg ua rau qhov tseeb tias tus kab mob no mus ntev.
Qhov no yog hais txog mob glomerulonephritis. Tab sis, raws li tau hais ua ntej, feem ntau nws dhau los ua mob ntev. Thiab nyob rau hauv cov ntaub ntawv no, cov nram qab no variants ntawm chav kawm ntawm tus kab mob yog ua tau:
- Hypertonic. Nrog rau daim ntawv no ntws, cov tsos mob ntawm cov zis yog me ntsis. Feem ntau, tus neeg mob raug kev txom nyem los ntawm cov ntshav siab tas li.
- Nephrotic. Glomerulonephritis nyob rau hauv cov ntaub ntawv no yog nrog los ntawm qhov tshwm sim ntawm pronounced urinary tsos mob.
- Nco. Nws yog tus cwj pwm los ntawm kev sib xyaw ua ke ntawm ob qho tib si ntawm cov kab mob saum toj no.
- Lam. Ib hom kab mob sib kis ntawm cov kab mob ntev. Nws yog tus cwj pwm los ntawm qhov tsis muaj arterial hypertension thiab edema. Tus mob nephrotic mob me heev.
- Hematuric. Ib qho teeb meem nyuaj, txij li cov tsos mob tsuas yog muaj cov erythrocytes hauv cov zis, thiab qhov no tsuas yog kuaj tau los ntawm kev xa cov khoom siv biomaterial no rau kev tshuaj xyuas.
Tham txog cov ntaub ntawv ntawm chav kawm thiab cov kab mob ntawm cov kab mob glomerulonephritis, nws yuav tsum raug sau tseg tias txhua qhov sib txawv yog tus cwj pwm los ntawm kev rov ua dua tshiab. Thaum ib qho exacerbation tshwm sim, ces tag nrho cov tsos mob ntawm kev kho mob kiag li rov ua thawj zaug.kab mob, los yog tsawg kawg zoo li nws.
Qhov zoo li yuav rov qab los, los ntawm txoj kev, nce hauv caij nplooj ntoos hlav thiab caij nplooj zeeg. Nws yog lub sijhawm no uas kis tau tus kab mob streptococcal tshwj xeeb yog nquag. Thiab yog hais tias ib tug neeg twb raug kev txom nyem ib yam ntawm cov kab mob glomerulonephritis ib zaug, ces ib tug relapse yuav tshwm sim 1-2 hnub tom qab raug rau ib tug irritant.
Symptoms
Vim peb tab tom tham txog qhov ua rau thiab qhov tshwm sim ntawm glomerulonephritis, nws yog ib qho tsim nyog yuav tsum tau sau cov cim qhia uas muaj tus kab mob no tuaj yeem lees paub.
Thawj cov tsos mob tshwm sim 1-3 lub lis piam tom qab tus kab mob streptococcal. Feem ntau nws yog tonsillitis, pyoderma thiab tonsillitis.
Yog li, qhov muaj tus kab mob no feem ntau qhia los ntawm cov tsos mob hauv qab no:
- Hloov cov zis. Nws qhov ntau ntxiv, tab sis qhov ceev txo.
- Fever.
- mob hauv cheeb tsam lumbar.
- Tsib txias txias zuj zus zuj zus mus.
- Kev qaug zog.
- Tsis qab los noj.
- Nausea.
- Headache.
Nws tseem yuav tsum tau sau tseg tias cov zis nrog glomerulonephritis ua liab lossis liab dhau sijhawm. Qhov no yog vim hematuria - muaj ntshav nyob hauv nws.
Cov tsos mob no tuaj yeem muaj qhov sib txawv. Kwv yees li ntawm 85% ntawm cov neeg mob tsim microhematuria - nyob rau hauv cov ntaub ntawv no, lub xub ntiag ntawm cov qe ntshav liab nyob rau hauv cov zis tsuas yog kuaj tau los ntawm kev soj ntsuam cov biomaterial nyob rau hauv ib lub microscope. Tab sis 15% ntawm cov neeg mob muaj tag nrho hematuria. Hauv qhov no, tso zistej zaum yuav tig dub los yog xim av tsaus.
Hypertension (nce ntshav siab) kuj yog ib qho mob tshwm sim. Nrog rau tus kab mob hnyav, nws kav ntev li ob peb lub lis piam.
Thiab nws yuav tsum tau muab sau tseg tias glomerulonephritis, qhov ua rau thiab cov tsos mob ntawm tam sim no tau tham, feem ntau ua rau kev puas tsuaj rau cov hlab plawv, nrog rau cov teeb meem nrog lub hauv nruab nrab lub paj hlwb thiab daim siab o.
Kev nyuaj siab
Yog ib tug neeg tsis xyuam xim rau cov tsos mob raws sij hawm thiab tsis mus ntsib kws kho mob, ces nws yuav tau ntsib qhov tshwm sim. Raws li txoj cai, cov teeb meem hauv qab no ntawm glomerulonephritis tshwm sim:
- Pulmonary edema. Nws muaj feem yuav tshwm sim rau cov neeg mob plawv thiab ntshav siab.
- Eclampsia. Nws yog tus cwj pwm los ntawm kev nce siab hauv siab, qaug dab peg, qaug dab peg thiab muaj kev kub ntxhov siab.
- Toxification ntawm tag nrho lub cev (uremia).
- mob plawv tsis ua hauj lwm. tshwm sim hauv 1% ntawm cov neeg mob.
- mob raum tsis ua haujlwm. tshwm sim hauv 3% ntawm cov neeg mob.
- Intracerebral los ntshav.
- Hypertensive encephalopathy.
- Impaired vision.
- YDiffuse chronic glomerulonephritis.
Yuav kom zam qhov tshwm sim, koj yuav tsum muaj lub luag haujlwm rau koj txoj kev noj qab haus huv. Thaum ntxov, glomerulonephritis yog kho tau tag nrho. Koj tuaj yeem tshem tau nws hauv ob peb lub lis piam, thiab tseem zam dhau qhov teeb meem.
Diagnosis
Ua ntej tshaj, tus kws kho mob xam phaj tus neeg mob. Nws yog ib qho tseem ceeb kom paub seb tus kab mob twg nws nyuam qhuav raug txom nyem, vim glomerulonephritis muaj qhov tshwm sim kis tau.
Tom qab ntawd kev tshuaj xyuas qhov muag tau ua tiav, thiab tsuas yog tom qab ntawd tus neeg raug xa mus rau kev tshuaj xyuas. Raws li kev tshawb fawb, nws tuaj yeem txheeb xyuas cov kev hloov pauv hauv qab no:
- Cov ntsiab lus ntawm erythrocytes hauv cov zis. Thaum thawj theem lawv tshiab. Tom qab ib tug - leach.
- Albuminuria (nruab nrab, 3-6%).
- Hyaline los yog granular casts nyob rau hauv cov urinary sediment.
- Kev tsis pom kev ua haujlwm ntawm lub raum. Kev txiav txim los ntawm kev kawm endogenous creatinine clearance.
- Txo diuresis thiab nocturia. Pom tau los ntawm Zimnitsky test.
Tsis tas li, cov neeg mob muaj leukocytosis thiab nce erythrocyte sedimentation tus nqi. Qhov no tau tshwm sim los ntawm kev tshawb fawb ntawm cov ntshav coj mus rau kev tshuaj ntsuam dav dav. Txoj kev tshawb fawb biochemical tau lees paub tias muaj creatinine, cov roj cholesterol thiab cov nitrogen seem hauv nws.
Los ntawm txoj kev, cov neeg mob kuj tau raug xa mus rau ultrasound ntawm lub raum hlab ntsha thiab ultrasound. Kev kuaj ntshav biopsy tsuas yog qhia tshwj xeeb rau cov mob hnyav, thaum cov txheej txheem kuaj mob tsis muab cov txiaj ntsig raug.
Drug therapy
Tam sim no koj tuaj yeem tham txog yam tshuaj twg koj yuav tsum noj txhawm rau tshem tawm cov tsos mob thiab kho glomerulonephritis hauv cov laus.
Feem ntau, cov kws kho mob sau cov tshuaj hauv qab no:
- Wobenzym. Immunomodulatory thiab anti-inflammatory tus neeg sawv cev, uas yog raws li enzymes (protein molecules) ntawm tsiaj thiab zaub keeb kwm. Noj cov tshuaj noyog tsom rau txo tus naj npawb ntawm kev tiv thaiv kab mob hauv lub cev, normalizing permeability ntawm cov phab ntsa vascular thiab tswj cov adhesion ntawm cov ntshav.
- "Canephron N". Qhov no yog phytopreparation, diuretic ntawm cov nroj tsuag keeb kwm. Nws muaj ntau yam kev ua ib zaug - tshuaj tua kab mob, tshuaj tua kab mob, tshuaj tua kab mob thiab tshuaj tua kab mob.
- Metipred. Glucocorticosteroid ntawm cov khoom siv hluavtaws, uas muaj cov tshuaj tiv thaiv kab mob, tiv thaiv kev ua xua thiab tiv thaiv kab mob. Tsis tas li ntawd, cov tshuaj txo cov nqi ntawm globulins hauv plasma, nce cov synthesis ntawm albumin nyob rau hauv ob lub raum thiab daim siab, normalizes carbohydrate metabolism, tsub kom lub zog ntawm lub cell membrane mus rau qhov kev txiav txim ntawm ntau yam kev puas tsuaj.
Tau kawg, qhov no tsis yog tag nrho cov npe tshuaj uas tau qhia rau kev siv. Txawm li cas los xij, nws yuav tsum raug sau tseg tias tsuas yog ib tus kws kho mob nephrologist, uas kho glomerulonephritis, tuaj yeem sau tshuaj kho.
Tus kws kho mob cov lus pom zoo yog ua raws li cov txiaj ntsig ntawm kev kuaj mob, thiab yog li tsis txhob ua rau tsis ntseeg. Tab sis kev noj tshuaj rau tus kheej thiab kev txiav txim siab rau nws tus kheej sau tshuaj rau tus kheej tuaj yeem ua rau muaj teeb meem thiab lwm yam teeb meem kev noj qab haus huv.
Txoj cai ntawm kev noj haus thiab txwv tsis pub
Hais txog cov tsos mob ntawm glomerulonephritis hauv cov neeg laus thiab kev kho mob ntawm tus kab mob no, yuav tsum tau tham txog kev noj zaub mov zoo li cas tus neeg uas ntsib tus kab mob no yuav tsum ua raws.
Nyob rau hauv daim ntawv mob, khoom noj khoom haus yuav tsum xyuas kom meej lub unloading ntawm protein metabolism. Yuav tsum tau noj zaub movkom cov dej ntws tawm ntawm cov zis ntau kawg, thiab cov ntshav ncig thiab lwm cov txheej txheem metabolic tau nrawm.
Nws yuav tsim nyog los txo cov nqi zog ntawm cov ntawv qhia txhua hnub rau 2200 kilocalories thiab txo cov khoom noj uas muaj carbohydrates thiab rog. Cov zaub mov yuav tsum muaj ntau cov zaub mov thiab cov vitamins ntau li ntau tau. Tab sis cov kua dej haus ib hnub yuav tsum tau txo qis.
Tsis tas li, thaum ua raws li kev noj haus rau glomerulonephritis, koj yuav tsum tso cov khoom nram qab no:
- Ntsev thiab txhua yam zaub mov uas muaj. Xws li khob cij, cheeses, confectionery thiab hmoov khoom, thiab lwm yam.
- khoom nrog cov khoom xyaw.
- zaub tawm-ntawm-lub caij nyoog (lawv muaj nitrates).
- Decoctions of legumes.
- khoom noj kaus poom, nqaij haus luam yeeb.
- Nqaij.
- ci thiab steps uas tsis tau ua ntej.
- qaub cream, lard, tsiaj rog thiab qab zib.
- Ntses thiab haus ntses.
- ntses kaus poom.
- Marinated, s alted and pickled zaub.
- Nyiaj yuav cov kua ntses thiab cov khoom xyaw.
- Txhua yam ntsim.
- -radish, dos, legumes, qej, radish, sorrel, spinach, nceb.
- Cov dej ntxhia nrog sodium bicarbonate muaj pes tsawg leeg.
- Cocoa, tshuaj yej thiab kas fes.
Ntxiv rau qhov saum toj no, koj tseem yuav tau tso cov tshuaj tsis haum, uas suav nrog ntau cov txiv hmab txiv ntoo thiab txiv kab ntxwv.
Allowed Foods
Txuas ntxiv los tham txog cov hauv paus ntsiab lus ntawm kev noj zaub mov qhia rau glomerulonephritis, nws tsim nyog xav txog cov npe ntawm cov khoom uas tuaj yeem suav nrog hauv kev noj haus.
Yog li, cov ntawv qhia zaub mov yuav tsum ua raws li cov khoom lag luam hauv qab no:
- Cov ncuav qab zib thiab qhob cij tsis muaj ntsev.
- Lean nqaij (qaib ntxhw, qaib) ua ntej ua ntej ua zaub mov kawg. Koj tseem tuaj yeem ua cov khoom. Tab sis nws kuj yuav tsum tau boiled. Tom qab ntawd koj tuaj yeem ntim zaub nrog nws, ua zaub qhwv, casseroles lossis pancakes nrog nws.
- ntses tsis rog.
- Zaub kua zaub, qaub cream, txiv lws suav, mis nyuj los yog dos.
- Zaub mov nrog zaub kua zaub los yog dej. Koj tuaj yeem ntxiv cereals, pasta, dos (tab sis tom qab boiling). Borscht, beetroot kua zaub thiab zaub qhwv kua zaub tau tso cai.
- pasta thiab cereals. Koj tuaj yeem ua puddings, cutlets, pilaf, casseroles los ntawm lawv.
- yogurt, curdled mis nyuj, mis nyuj muaj roj tsawg (txog 400 ml ib hnub).
- Qe, 2 siab tshaj. Koj muaj peev xwm boil lawv soft-boiled los yog ua omelettes.
- Apricots, apples, watermelon, txiv duaj, bananas, nectarine, melon, figs, strawberries.
- Kissels, txiv hmab txiv ntoo thiab txiv hmab txiv ntoo purees, compotes, jelly, jams.
- Rosehip infusion, freshly squeezed kua txiv, tshuaj yej nrog qab zib thiab txiv qaub.
- marshmallow, popsicles, zib ntab, marshmallow, caramel.
Raws li cov khoom tso cai, koj tuaj yeem tsim cov ntawv qhia zaub mov txawv. Yog li tus neeg mob glomerulonephritis yuav tsum tsis txhob txhawj txog seb nws cov khoom noj puas yuav ua tiav.
kev kho neeg zoo
Nrog glomerulonephritis, cov lus pom zoo hauv chaw kho mob tau teev tseg saum toj no yuav tsum ua raws. Thiab kev kho tshuaj nrog kev noj zaub mov zoo feem ntau yog txaus los kho kev noj qab haus huv, tab sis ntau tus txiav txim siab mus rau kev kho mob pej xeem. Thiab yog li ntawd nws tsim nyog qhia txog lawv thaum kawg.
Nov yog qee cov zaub mov yooj yim:
- Parsley noob (25 g), hop cones (10 g), hawthorn thiab motherwort (20 g txhua) sib tov thiab ncuav boiling dej (300 ml). Rau ib nrab ib teev xa mus rau da dej. Ces lim. Haus peb zaug ib hnub twg rau 1 tbsp. l.
- Ntxuav thiab ntxuav oats (5 tablespoons) ncuav 1 liter ntawm mis nyuj. Boil nws kom txog thaum kev sib tw dhau qhov kub thiab noj 100 g peb zaug ib hnub.
- Catchment (2 tablespoons) ncuav boiling dej (250 ml) thiab ua noj rau 5 feeb tshaj kub. Lim. Haus qhov tshwm sim hauv ib hnub hauv peb koob tshuaj.
- Crushed burdock hauv paus (4 tablespoons) ncuav 1 liter ntawm boiling dej thiab xa mus rau ib tug me me hluav taws. Tuav kom txog thaum ib nrab ntawm cov dej tau evaporated. Tom qab ntawd tshem tawm cov decoction, lim, thiab ces ntxiv zib mu (2 tablespoons). Haus peb zaug ib hnub rau 0.5 khob, thiab ua ntej yuav mus pw - ib tag nrho.
Feem ntau, txhua yam tshuaj uas muaj tshuaj tua kab mob thiab tshuaj tiv thaiv kab mob yog tsim nyog rau kev kho mob ntawm glomerulonephritis. Ntawm lawv yog cov chaw muag tshuaj chamomile, plantain, calendula, qus sawv, ntoo qhib tawv, St. John's wort, yarrow, sage, birch buds, hiav txwv buckthorn ceg.
Qhov tseem ceeb tshaj plaws yog tsis tau nqa mus nrog infusions thiab decoctions. Lawv qhov kev noj zaub mov tsis zoo tuaj yeem cuam tshuam kev noj qab haus huv, thiabquav yeeb quav tshuaj.
