Cov tshuaj tshawb nrhiav ntau yam teeb meem. Ib qho, piv txwv li, kawm cov duab kho mob, uas yog, qhov tshwm sim ntawm pathology. Lwm ceg ntawm cov tshuaj tshuaj xyuas qhov tshwm sim los yog kev cuam tshuam ntawm lub cev rau qee yam cuam tshuam. Pathological provoking yam tseem ceeb yog qhov tseem ceeb ob qho tib si hauv kev kuaj mob thiab hauv kev xaiv tom ntej ntawm kev kho. Etiology yog ib thaj chaw uas tsuas yog tshawb nrhiav qhov ua rau. Tom qab ntawv hauv tsab xov xwm peb yuav txheeb xyuas lo lus no kom ntxaws ntxiv.
cov ntaub ntawv dav dav
Etiology - cov no yog cov ua rau cov kab mob, qhov tshwm sim ntawm uas yuav tsum muaj kev sib xyaw ua ke ntawm kev cuam tshuam ntawm qhov tseem ceeb thiab tag nrho ntawm cov xwm txheej ntawm lub hauv paus thiab sab nraud ib puag ncig tsim nyog rau kev tshwm sim ntawm nws qhov kev ua. Cov tshuaj lom, cov kab mob pathogenic, hluav taws xob, kev raug mob, nrog rau ntau yam tshuaj lom neeg, lom neeg thiab lub cev muaj zog tuaj yeem ua rau muaj qhov tshwm sim provocative. Tus kab mob tuaj yeem tshwm sim nyob rau hauv cov xwm txheej ntawm hypothermia, qaug zog, tsis muaj zaub mov noj, tsis haum rau kev sib raug zoo thiab thaj chaw ib puag ncig. Lub luag haujlwm tseem ceeb yog ua los ntawm cov yam ntxwv ntawm lub cev. Cov no suav nrog, tshwj xeeb, poj niam txiv neej, hnub nyoog, genotype, thiab lwm yam.
Factors
Lub tswvyim ntawm etiology tsis yogtxwv rau cov laj thawj tshwj xeeb. Yeej, rau qhov tshwm sim ntawm tus kab mob, ntxiv rau qhov tshwm sim provoking, tej yam kev mob zoo yog tsim nyog rau nws. Piv txwv li, streptococcus, tam sim no nyob rau hauv lub qhov ncauj kab noj hniav nyob rau hauv daim ntawv ntawm ib tug saprophyte, vim hais tias ntawm lub sij hawm ntev ntawm qhov kub thiab txias, ua rau angina. Qhov no yog vim tsis muaj zog ntawm lub cev tiv thaiv mechanisms. Thiab cov kab mob typhoid kub taub hau thiab kab mob diphtheria yam tsis ua rau muaj teeb meem (kev qaug zog, kev tshaib kev nqhis) yuav tsis tshwm sim rau lawv tus kheej hauv txhua txoj kev. Feem ntau muaj cov xwm txheej thaum tib yam tuaj yeem ua hauv qee kis raws li etiological, thiab lwm yam raws li qhov xwm txheej. Ib qho piv txwv yog hypothermia. Ntawm qhov tod tes, nws ua rau frostbite, thiab ntawm qhov tod tes, nws muab kev pom zoo rau qhov tshwm sim ntawm ntau yam kab mob khaub thuas.
YKev faib tawm ntawm pathologies
Qee zaum, etiology ntawm tus kab mob yuav raug txwv rau ib qho. Hauv lwm qhov xwm txheej, txoj kev tshawb fawb yuav nthuav tawm ntau yam ua rau muaj kev cuam tshuam ib zaug. Nyob rau hauv thawj rooj plaub, tus kab mob hu ua mono-, thiab nyob rau hauv lub thib ob - polyetiological. Thawj hom suav nrog, piv txwv li, mob khaub thuas, tonsillitis. Tab sis kab mob plawv yog tsim los ntawm syphilis, rheumatism thiab ntau lwm yam. Lub etiology ntawm tus kab mob tso cai rau koj los txiav txim nws qhov tshwj xeeb thiab kev kho mob pathogenetic. Piv txwv li, cov chav kawm, qhov hnyav thiab qhov tshwm sim ntawm staphylococcal thiab anthrax carbuncles muaj qhov sib txawv loj. Tsis tas li, ntau hom kev kub siab, uas tuaj yeem tshwm sim los ntawmob qho tib si neurogenic thiab lub raum yam. Qhov ua rau mob plab hnyuv yog qhov compression sab nraud ntawm txoj hnyuv los yog nws sab hauv.
Factor action
Sib txawv ntawm qhov tam sim no (kev raug mob, kub hnyiab) thiab mus ntev (kev tshaib kev nqhis, kis kab mob) cuam tshuam ntawm qhov tshwm sim tshwm sim. Cov phenomena no kuj muaj xws li etiology. Qhov kev cuam tshuam no tuaj yeem ua rau kev loj hlob ntawm qhov mob hnyav lossis mob ntev ntawm pathology. Raws li qhov tshwm sim ntawm qhov tshwm sim ntawm qhov tshwm sim - ntev lossis luv - hauv tib neeg lub cev, qhov ua tsis tiav tshwm sim hauv ntau lub tshuab. Qhov no yog qhov ua rau tus kab mob no, uas feem ntau yog qhov tshwm sim ntawm cov kab mob no.
Kev kho thiab tiv thaiv
Etiology yog ib qho tseem ceeb ntawm kev txiav txim siab qhov no lossis txoj kev kho ntawd. Tom qab txheeb xyuas cov laj thawj thiab cov xwm txheej rau kev txhim kho pathology, koj tuaj yeem xaiv txoj hauv kev uas yuav tshem tawm cov teeb meem tshwm sim. Tsuas yog nyob rau hauv cov ntaub ntawv no nws yog tiag tiag ua tau kom tau ib tug zoo tshwm sim. Kev tiv thaiv kuj ua lub luag haujlwm tseem ceeb. Tus kab mob tuaj yeem tiv thaiv tau thaum lub sijhawm tshem tawm cov kab mob pathogenic thiab yam uas ua rau nws. Yog li, piv txwv li, kev tshawb nrhiav cov kab mob bacillus, tshem tawm cov yoov tshaj cum nyob rau hauv qhov chaw muaj kab mob malaria, thiab tiv thaiv kev raug mob. Txawm li cas los xij, nws tsis yog ib txwm muaj peev xwm txheeb xyuas cov laj thawj thiab cov xwm txheej rau kev txhim kho pathology. Hauv qhov no, lawv hais txog qhov tsis meej etiology. Hauv cov xwm txheej zoo li no, raws li txoj cai, tus neeg mob mus rau hauv kev saib xyuas ntawm tus kws kho mob. Nyob rau tib lub sijhawm, kev kuaj mob sib txawv thiab kev saib xyuas ntawm nws tus mob yog ua tiav. Feem ntau cov kev kho mob ntawm cov kws kho mob nyob rau hauv xws licov ntaub ntawv raug muab "dig muag"
YEtiology of diabetes
Hnub no, muaj pov thawj tsis txaus ntseeg tias qhov laj thawj tseem ceeb ntawm kev loj hlob ntawm DM yog cov caj ces. Tus kab mob no belongs rau hom polygenic. Nws yog raws li tsawg kawg yog ob hom kab mob ntshav qab zib mutant ntawm b-chromosome, uas cuam tshuam nrog HLA system. Qhov kawg, nyob rau hauv lem, txiav txim siab cov tshuaj tiv thaiv tshwj xeeb ntawm cov kab mob thiab nws cov hlwb rau kev ua ntawm antigens. Raws li txoj kev xav ntawm polygenic qub txeeg qub teg ntawm ntshav qab zib mellitus, nyob rau hauv tus kab mob muaj ob lub noob caj noob ces los yog ob pawg ntawm lawv, uas tau txais los ntawm txoj kev tsis zoo. Qee tus neeg muaj qhov ua rau puas tsuaj rau cov kab mob autoimmune lossis nce rhiab heev ntawm qee lub hlwb rau cov tshuaj tiv thaiv kab mob, txo qis tiv thaiv kab mob. Cov noob ntawm HLA system yog cov cim ntawm qhov kev xav no.
Xyoo 1987, D. Foster tau tshawb pom tias ib qho ntawm cov noob uas raug tus kab mob no nyob ntawm b-chromosome. Nyob rau tib lub sijhawm, muaj kev sib txuas ntawm cov ntshav qab zib mellitus thiab qee yam kab mob ntshav dawb hauv tib neeg lub cev. Lawv encoded los ntawm loj histocompatibility complex noob. Lawv, nyob rau hauv lem, nyob rau ntawm no chromosome.
Kev faib tawm ntawm cov noob loj histocompatibility complex genes
Muaj peb hom. Cov noob sib txawv ntawm hom encoded proteins thiab lawv txoj kev koom tes hauv kev tsim cov txheej txheem tiv thaiv kab mob. Chav kawm 1 suav nrog loci A, B, C. Lawv muaj peev xwm encode antigens uas muaj nyob rau txhua qhovcov cell uas muaj cov nucleus. Cov ntsiab lus no ua haujlwm ntawm kev tiv thaiv kab mob (feem ntau yog viral). Class 2 noob, nyob rau hauv cheeb tsam D, muaj cov DP, DQ, thiab DR loci. Lawv encode antigens uas tuaj yeem qhia tshwj xeeb rau ntawm cov hlwb immunocompetent. Cov no suav nrog monocytes, T-lymphocytes thiab lwm yam. Chav kawm 3 noob encode cov khoom ntawm cov khoom ntxiv, cov qog necrosis, thiab cov khoom thauj uas cuam tshuam nrog kev ua cov tshuaj tiv thaiv kab mob.
Tsis ntev los no, tau muaj kev xav tias tsis yog tsuas yog cov ntsiab lus ntawm HLA system, tab sis kuj yog cov noob encoding cov synthesis ntawm insulin, cov saw hnyav ntawm immunoglobulins, T-cell receptor bonds, thiab lwm yam cuam tshuam nrog cov qub txeeg qub teg. ntawm insulin-dependant mob ntshav qab zib mellitus. Cov neeg uas muaj qhov tsis txaus ntseeg rau IDDM muaj kev hloov pauv ib puag ncig. Lawv cov tshuaj tiv thaiv kab mob tsis muaj zog, cov hlwb tuaj yeem raug cytotoxic kev puas tsuaj raws li kev cuam tshuam ntawm cov kab mob kab mob thiab cov tshuaj lom neeg.
Lwm yam yog vim li cas
IDDM kuj tuaj yeem muaj tus kab mob etiology. Feem ntau, cov kab mob tau txhawb nqa los ntawm rubella (cov kab mob nkag mus rau hauv cov kab mob pancreatic, tom qab ntawd sau thiab rov ua dua hauv lawv), kab mob qog nqaij hlav (tus kab mob feem ntau tshwm sim hauv cov menyuam yaus tom qab kis mob, tom qab 1-2 xyoos), kab mob siab B thiab Coxsackie. Tus kab mob B (replicates hauv insular apparatus), kab mob mononucleosis, mob khaub thuas thiab lwm yam. Qhov tseeb tias qhov tseem ceeb hauv kev saib xyuas yog cuam tshuam nrog kev txhim kho ntawm cov ntshav qab zib mellitus tau lees paub los ntawm lub caij nyoog.kab mob. Feem ntau, IDDM raug kuaj pom hauv cov menyuam yaus thaum lub caij nplooj zeeg thiab lub caij ntuj no, mus txog qhov siab tshaj plaws thaum Lub Kaum Hli thiab Lub Ib Hlis. Tsis tas li nyob rau hauv cov ntshav ntawm cov neeg mob, titers siab ntawm cov tshuaj tiv thaiv kab mob tuaj yeem kuaj pom. Hauv cov neeg uas tuag los ntawm ntshav qab zib mellitus, raws li kev tshawb fawb ntawm immunofluorescence, cov kab mob kis tau pom hauv islets ntawm Langerhans.
Lub hauv paus ntsiab lus ntawm exciter
Cov kev tshawb fawb sim ua los ntawm M. Balabolkin lees paub qhov kev koom tes ntawm tus kab mob no hauv kev txhim kho tus kab mob. Raws li nws cov kev soj ntsuam, tus kab mob no nyob rau hauv cov neeg uas muaj ib tug nyiam mob ntshav qab zib ua raws li no:
- mob cell puas raug sau tseg (piv txwv li, Coxsackievirus);
- persistence (ntev ciaj sia) ntawm tus kab mob (rubella) tshwm sim nrog tsim cov txheej txheem autoimmune nyob rau hauv cov ntaub so ntswg.
Etiology ntawm daim siab cirrhosis
Zoo ntawm qhov ua rau tshwm sim, cov kab mob no tau muab faib ua peb pawg. Cov no suav nrog, tshwj xeeb:
- Nrog qee qhov laj thawj etiological.
- Nrog kev tsis sib haum xeeb.
- Unclear etiology.
Tshawb nrhiav qhov ua rau kev puas tsuaj
Kev tshawb fawb soj ntsuam, kis kab mob thiab chaw kuaj mob tau ua los txheeb xyuas cov xwm txheej uas ua rau mob ntshav siab. Nyob rau tib lub sijhawm, kev sib txuas nrog kev haus cawv ntau dhau raug tsim. Tau ntev nws tau ntseeg tias cirrhosis ntawm daim siab tshwm sim nyob rau hauv tej yam kev mob ntawm malnutrition ntawm ib tug cawv. Nyob rau hauv tas li ntawd, qhov no pathology yog hu ua alimentary los yog khoom noj khoom haus. Xyoo 1961 Beckett tsimua hauj lwm nyob rau hauv uas nws piav qhia txog cawv kab mob siab ntawm tus mob theem. Nyob rau tib lub sijhawm, nws tau hais tias nws yog tus kab mob no uas ua rau muaj kev pheej hmoo ntawm cirrhosis ntawm daim siab nrog rau kev haus cawv. Tom qab ntawd, cov nyhuv ntawm ethanol rau kev txhim kho cov kab mob siab mob siab, uas tuaj yeem hloov mus rau kev puas tsuaj rau cov ntaub so ntswg ntawm lub cev hematopoietic, tau tsim. Qhov no yog qhov tseeb tshwj xeeb rau kev kis tus kabmob.
Kev phom sij ntawm ethanol
Kab mob siab ntsws tshwm sim los ntawm cawv tsis tas yuav tshwm sim nrog rau theem mob siab lossis mob ntev. Tus kab mob tuaj yeem hloov pauv mus rau qhov sib txawv. Nyob rau hauv tag nrho, muaj peb theem tseem ceeb:
- fatty degeneration ntawm lub cev;
- fibrosis nrog cov tshuaj tiv thaiv mesenchymal;
- cirrhosis.
Qhov kev pheej hmoo ntawm kev tsim kab mob los ntawm 15 xyoo ntawm kev haus cawv ntau dhau yog 8 npaug ntawm kev haus cawv tsib xyoos. Pequigno tau txheeb xyuas qhov txaus ntshai npaum li cas ntawm ethanol rau kev txhim kho ntawm daim siab cirrhosis. Nws yog 80 g ib hnub twg (200 g ntawm vodka). Ib koob tshuaj txaus ntshai heev txhua hnub yog kev siv 160 g cawv lossis ntau dua. Yav tom ntej, "Pequigno mis" tau hloov me ntsis. Cov poj niam muaj ob npaug ntawm cawv rhiab heev dua li txiv neej. Hauv qee tus neeg sawv cev ntawm kev sib deev muaj zog, qhov kev txwv ntawm cirrhosis raug txo rau 40 g ntawm ethanol ib hnub twg, lwm tus kab mob tshwm sim thaum noj 60 ml ntawm cawv. Rau cov poj niam, 20 ml ntawm cawv ib hnub yog txaus. Hauv kev loj hlob ntawm cov dej cawv daim siab cirrhosis, lub luag haujlwm tseem ceeb yog ua los ntawm cov lipopolysaccharide tshwj xeeb ntawm cov hnyuv hauv plab - endotoxin.
Lwm yam yog vim li cas
Cirrhosis tuaj yeem tshwm sim vim yog kev txiav txim siab ntawm caj ces metabolic. Ob leeg hauv cov menyuam yaus thiab cov neeg laus, kev sib raug zoo tau pom ntawm kev loj hlob ntawm pathology thiab a1-antitrypsin deficiency. A1-antitrypsin yog glycoprotein uas yog synthesized nyob rau hauv lub hepatocyte thiab yog ib tug inhibitor ntawm tam sim no cov teebmeem ntawm serine proteinases (elastase, trypsin, plasmin, chymotrypsin). Tawm tsam keeb kwm yav dhau los ntawm qhov tsis txaus, cholestasis tshwm sim hauv 5-30% ntawm cov menyuam yaus, thiab 10-15% ua rau mob siab rau lub siab thaum tseem hluas. Ntxiv mus, txawm tias nyob rau hauv cov xwm txheej ntawm biochemical tsis zoo, qhov kev tshwm sim feem ntau yog qhov zoo. Thaum muaj hnub nyoog laus, qhov tshwm sim ntawm kev tsim cirrhosis thiab mob qog noj ntshav siab nce ntxiv. Qhov no yog tshwj xeeb tshaj yog muaj tseeb rau cov neeg uas muaj emphysema. Kev ua haujlwm ntawm daim siab kuj tuaj yeem ua rau tsis zoo thaum cov tshuaj thiab cov tshuaj pharmacological npaj nkag mus rau hauv lub cev. Yog li ntawd, muaj cov theem mob ntawm kev puas tsuaj rau lub cev thiab kab mob siab ntev. Muaj tsawg zaus, cirrhosis ntawm daim siab tsim. Piv txwv li, carbon tetrachloride tuaj yeem ua rau mob hnyav thiab qee zaum mob siab mob siab. Cov kab mob no yuav nyob rau qee kis tau nrog cov necrosis loj heev thiab kev loj hlob ntawm cirrhosis.
