Antinuclear tshuaj tiv thaiv yog ib pawg ntawm autoantibodies uas, thaum hnov mob nrog cov nuclei ntawm lub cev hlwb, pib rhuav tshem lawv. Yog li ntawd, txoj kev tshawb no ntawm ANA yog suav hais tias yog ib tug rhiab cim cim nyob rau hauv kev kuaj mob ntawm autoimmune kab mob, feem ntau yog nrog los ntawm cov kab mob ntawm cov ntaub so ntswg. Qee yam ntawm cov tshuaj tiv thaiv kab mob antinuclear kuj pom muaj nyob rau hauv cov kab mob ntawm cov kab mob uas tsis muaj kev tiv thaiv kab mob: inflammatory, kis kab mob, malignant, thiab lwm yam.
Cov kab mob dab tsi tshwj xeeb rau?
Qhov tshwj xeeb tshaj plaws antinuclear tshuaj tiv thaiv rau cov kab mob hauv qab no:
- Systemic lupus erythematosus yog ib yam kab mob sib txuas thiab kab mob ntawm daim tawv nqaij.
- Dermatomyositis - kev puas tsuaj rau cov leeg, daim tawv nqaij, cov ntaub so ntswg, thiab lwm yam.
- YScleroderma - thickeningcov ntaub so ntswg sib txuas.
- Periarteritis nodosa yog ib qho txheej txheem inflammatory uas cuam tshuam rau cov phab ntsa vascular.
- Rheumatoid mob caj dab - kev puas tsuaj rau cov ntaub so ntswg thiab pob qij txha.
- Sjögren's kab mob - cov ntaub so ntswg puas nrog qog nqaij hlav (txo qis hauv cov kua qaub thiab cov qog lacrimal).
Thaum twg yog tshuaj tiv thaiv kab mob tiv thaiv kab mob tiv thaiv kab mob zoo?
Autoimmune pathologies
Autoimmune pathologies, thaum lub cev tiv thaiv kab mob pib tawm tsam ntawm nws tus kheej cov ntaub so ntswg, suav tias yog qhov txaus ntshai tshaj plaws hauv cov tshuaj kho mob. Feem ntau cov kab mob autoimmune raug cais raws li kev mob ntev thiab tuaj yeem ua rau lub cev tsis ua haujlwm loj.
Ib qhov kev sim uas siv los kuaj xyuas ntau yam kab mob autoimmune yog qhov kev sim rau qib ntawm cov tshuaj tiv thaiv kab mob antinuclear (antinuclear), uas tau ua nyob rau hauv peb txoj kev:
- ELISA txoj kev, uas txiav txim siab tag nrho qib ntawm cov tshuaj tiv thaiv;
- kev tawm tsam ntawm indirect immunofluorescence RNIF, los ntawm qhov muaj txog 15 hom tshuaj tiv thaiv tuaj yeem kuaj pom;
- immunoblotting method.
Antinuclear antibody immunoblot
Nov yog qhov kuaj ntshav kuaj pom muaj cov tshuaj tiv thaiv kab mob HIV. Nws yog ib qho kev txheeb xyuas tseeb dua li ELISA thiab siv los txheeb xyuas qhov txiaj ntsig ELISA. Immunoblotting (western blot) yog siv rau hauv kev kuaj mob ntawm tus kab mob HIV, txiav txim siab qib ntawm cov tshuaj tiv thaiv kab mob hauv lub cev,raws li txoj kev pabcuam kws tshaj lij, uas yog tsim los kom paub meej tias qhov tshwm sim ntawm ELISA. Raws li txoj cai, cov txiaj ntsig zoo ELISA tau kuaj xyuas ob zaug nrog cov qauv no, vim nws suav tias yog qhov tshwj xeeb thiab rhiab heev.
Immune blotting ua ke ua ke enzyme immunoassay nrog electrophoretic gel cais cov kab mob cov protein thiab lawv hloov mus rau nitrocellulose daim nyias nyias. Immunoblot muaj ntau theem. Ua ntej, cov protein ua kom huv thiab rhuav tshem tau raug electrophoresis, uas cov antigens suav nrog hauv nws cov muaj pes tsawg leeg tau muab faib ua cov molecules. Tom qab ntawd, los ntawm blotting, cov antigens raug xa mus los ntawm cov gel mus rau ib lub nylon lim strip los yog nitrocellulose, uas muaj ib tug tshwj xeeb spectrum ntawm proteins.
Tom ntej no, cov khoom siv kuaj tau siv rau cov kab xev, thiab yog tias muaj cov tshuaj tiv thaiv tshwj xeeb muaj nyob hauv cov qauv, lawv pib khi rau cov antigen strips sib haum rau lawv. Cov txiaj ntsig ntawm kev sib cuam tshuam zoo li no tau pom. Lub xub ntiag ntawm kab txaij nyob rau hauv qee qhov chaw ntawm cov kab txaij qhia pom tias muaj cov tshuaj tiv thaiv rau qee cov antigens hauv cov ntshav kuaj. Immunoblotting feem ntau yog siv los txheeb xyuas tus kab mob HIV. Ntshav sera raug suav hais tias yog qhov zoo yog tias cov tshuaj tiv thaiv rau ob lub hnab ntawv HIV tau kuaj pom los ntawm kev tiv thaiv kab mob. Yog tias qhov kev kuaj pom tau zoo, ces lub cev tab tom tsim cov kab mob autoimmune.
Kab mob tshwm sim
Antinuclear antinuclear tshuaj tiv thaiv tuaj yeem pom nyob hauv ntau dua 1/3 ntawm cov neeg mob uas muaj kab mob siab ntev. Tsis tas li ntawd, theem ntawm ANA yuav nce ntxiv nyob rau hauv rooj plaub ntawm kev loj hlob ntawm cov kab mob hauv qab no:
- kis kab mob mononucleosis (ib kab mob kis uas ua rau muaj kev puas tsuaj loj rau hauv nruab nrog cev);
- leukemia (mob ntshav siab) hauv cov ntawv mob hnyav thiab mob ntev;
- hemolytic anemia (anemia vim kev puas tsuaj ntawm cov qe ntshav liab);
- Waldenström tus kab mob (muaj feem cuam tshuam rau pob txha pob txha);
- cirrhosis ntawm daim siab (nrawm pathology cuam tshuam nrog kev hloov pauv hauv cov qauv ntawm daim siab);
- malaria;
- mob ruas (mob ntawm daim tawv nqaij);
- mob raum tsis ua haujlwm;
- thrombocytopenia (tsawg platelet ntau lawm);
- lymphoproliferative pathologies (cov qog hauv lymphatic system);
- myasthenia gravis (muscle fatigue);
- Ythymoma (cov qog ntawm thymus).
Immunoglobulin qib
Ib txhij nrog kev ntsuas ntawm qib ntawm cov tshuaj tiv thaiv antinuclear antinuclear antibodies thaum lub sijhawm tshuaj ntsuam, qib ntawm immunoglobulins raug soj ntsuam: IgM, IgA, IgG. Kev kuaj pom cov khoom hauv cov ntshav tuaj yeem qhia tau tias muaj kev pheej hmoo siab ntawm collagenosis thiab kab mob rheumatic.
Thaum pom muaj qhov sib txuas ntawm qib ntawm cov tshuaj tiv thaiv thiab cov tsos mob hauv tus neeg mob, qhov muaj cov tshuaj tiv thaiv kab mob hauv cov ntshav nws tus kheej yog qhov kev kuaj mob thiab tuaj yeem cuam tshuam rau kev xaiv cov txheej txheem kho mob rau ib qho kab mob. Kev khaws cia ntawm qhov siab ntawm cov tshuaj tiv thaiv antinuclear thaum lub sijhawm kawm ntevTxoj kev kho qhia tau hais tias qhov kev tshwm sim tsis zoo rau tus neeg mob. Qhov txo qis ntawm qhov tseem ceeb tawm tsam keeb kwm yav dhau los ntawm kev kho tsis tu ncua yuav qhia tau tias lub sijhawm ntawm kev zam txim lossis kev tuag yuav tshwm sim.
Ntxiv rau, cov tshuaj tiv thaiv kab mob tiv thaiv kab mob tuaj yeem kuaj pom hauv cov neeg noj qab haus huv hauv 3-5% ntawm cov neeg mob - txog 65 xyoo, thiab hauv 37% ntawm cov neeg mob - tom qab 65 xyoo.
Kev taw qhia rau kev txiav txim siab qib ANA
Kev ntsuas tshuaj tiv thaiv kab mob qog noj ntshav yog qhov tsim nyog hauv cov xwm txheej hauv qab no:
- hauv kev kuaj mob autoimmune thiab lwm yam kab mob uas tsis muaj tsos mob hnyav;
- hauv kev kuaj mob ntawm cov kab mob lupus erythematosus, nws theem thiab daim ntawv, nrog rau hauv kev xaiv ntawm kev kho mob tactics thiab prognosis;
- nyob rau hauv kev kuaj mob ntawm cov tshuaj tiv thaiv kab mob lupus;
- thaum tiv thaiv kev kuaj mob ntawm cov neeg mob lupus erythematosus;
- nyob rau hauv muaj cov tsos mob tshwj xeeb: kub taub hau ntev yam tsis muaj qhov ua rau, mob thiab mob hauv cov leeg, pob qij txha, tawv nqaij pob, qaug zog, thiab lwm yam.;
- yog tias muaj cov tsos mob ntawm cov kab mob hauv lub cev: kev puas tsuaj rau cov kab mob hauv nruab nrog cev lossis tawv nqaij, mob caj dab, convulsions, qaug dab peg, ua npaws, ua npaws;
- thaum sau tshuaj kho mob nrog hydralazine, disopyramide, propafenone, ACE inhibitors, procainamide beta-blockers, propylthiouracil, lithium, chlorpromazine, carbamazepine, isoniazid, phenytoin, hydrochlorothiazide, minocyins muaj xws li astaticins. induced lupus erythematosus.
Tus kws kho mob tham
Ntxiv rau tus kws kho mob dav dav, nws tuaj yeem sab laj thiab tau txais kev xa mus rau kev tshawb fawb los ntawm cov kws tshwj xeeb nqaim:
- dermatovenereologist;
- kws kho mob rheumatologist;
- nephrologist.
Tus qauv rau kev tiv thaiv nuclear yog dab tsi?
Deciphering cov qhabnias, pathological thiab ib txwm ntsuas
Nquag, cov tshuaj tiv thaiv kab mob hauv plasma feem ntau tsis tuaj lossis kuaj pom me me. Qhov tshwm sim nyob ntawm txoj kev sim ua tiav:
1. ELISA:
- tsawg dua 0.9 ntsiab lus - ib txwm (tsis zoo);
- 0, 9-1, 1 cov ntsiab lus - tsis ntseeg qhov tshwm sim (pom kom rov kuaj dua tom qab 14 hnub);
- ntau tshaj 1, 1 taw tes - qhov txiaj ntsig zoo.
2. Rau kev tsom xam ntawm RNIF, ib qho titer tsawg dua 1: 160 yog suav tias yog qhov tshwm sim ib txwm muaj.
3. Ntawm immunoblotting, tus qauv yog "tsis pom."
Hauv qhov xwm txheej twg tuaj yeem kuaj tshuaj tiv thaiv kab mob tiv thaiv kab mob zoo?
Yam dab tsi tuaj yeem cuam tshuam qhov tshwm sim?
Cov npe ntawm yam uas ua rau muaj kev cuam tshuam ntawm kev kuaj pom muaj xws li:
- ua txhaum txoj cai ntawm kev npaj rau kev tsom xam lossis venipuncture algorithm;
- noj tshuaj tshuaj (Methyldopa, Carbamazepine, Penicillamine, Nifedipine, Tocainide, thiab lwm yam);
- Qhov muaj uremia hauv tus neeg mob feem ntau ua rau qhov tsis zoo tshwm sim.
Kev txhais lus ntawm cov txiaj ntsig tau ua tiav hauv qhov nyuaj. Txiav txim siab qhov tseebRaws li kev kuaj mob ib leeg tsis tuaj yeem ua tau.
Kev npaj
Venipuncture yog ua rau ntawm lub plab khoob thaum sawv ntxov (8 teev dhau los ntawm lub sijhawm noj mov). Koj tsuas haus dej xwb. Nws tsis pom zoo kom siv nicotine hloov pauv thiab haus luam yeeb ua ntej kuaj ntshav. Hnub ua ntej thiab hnub ntawm kev kawm, koj tsis tuaj yeem haus lub zog thiab haus dej cawv, ua haujlwm ntawm lub cev thiab txhawj xeeb. 15 hnub ua ntej kev sim, hauv kev pom zoo nrog tus kws kho mob, kev siv tshuaj (cov tshuaj tiv thaiv kab mob thiab tshuaj hormonal, tshuaj tua kab mob, thiab lwm yam) raug tso tseg. Txhawm rau kom tau txais cov txiaj ntsig raug, kev tshuaj xyuas raug pom zoo kom rov ua dua tom qab 2 lub lis piam.
Peb tau txiav txim siab tias qhov no yog kev tshuaj ntsuam xyuas cov tshuaj tiv thaiv nuclear.
