Sjogren's syndrome: tus kab mob no yog dab tsi, ua rau, tsos mob, kho thiab tiv thaiv

2024 Tus sau: Curtis Blomfield | [email protected]. Kawg hloov kho: 2023-12-16 21:10

Sjogren's syndrome - yog dab tsi? Qhov no yog lub npe ntawm cov kab mob txaus ntshai uas tshwm sim hauv cov poj niam hnub nyoog tshaj 40 xyoo. Cov duab kho mob ntawm cov kab mob pathology yog qhov dav heev, tus kab mob cuam tshuam rau ntau yam kabmob sib txawv thiab cov tshuab. Koj muaj peev xwm tshem tau tus kab mob thaum ntxov. Thaum kho, qee yam tshuaj tau siv.

Sjogren's syndrome tuaj yeem txo tus neeg lub neej zoo, yog li kev kho yuav tsum pib sai li sai tau. Tsis tas li ntawd, kev kuaj mob niaj hnub no tso cai rau koj kom yooj yim txiav txim siab qhov muaj tus kab mob thiab cov yam ntxwv ntawm nws cov chav kawm. Kev kho tus kab mob yuav tsum tau ua los ntawm kws kho mob rheumatologist.

Sjogren's Syndrome - hom kab mob dab tsi? Nyob rau hauv cov nqe lus ntawm nws qhov kev nthuav dav, qhov teeb meem no nyob rau qib thib ob ntawm cov kab mob rheumatic ntawm qhov xwm txheej autoimmune. Kwv yees li 4 lab tus tib neeg hauv Tebchaws Meskas raug mob los ntawm tus kabmob no. Feem ntau, cov poj niam laus raug mob pathology tom qab menopause.

Cia peb sim xyuas seb yog vim li cas, cov tsos mob, kev kho mob thiab kev tiv thaiv ntawm Sjögren's syndrome. Txog qhov no yuav tsumsawv daws yuav tsum paub, vim leej twg yuav ntsib tus kab mob no.

Sjogren's syndrome - nws yog dab tsi

Ib tug kab mob autoimmune loj, uas yog nrog los ntawm kev ua haujlwm tsis zoo ntawm cov qog ua kua qaub thiab qaub ncaug. Nrog rau qhov mob no, lawv cov dej num txo qis, uas maj mam ua rau kom qhuav ntawm daim tawv nqaij thiab cov mucous daim nyias nyias, nrog rau kev txo qis hauv kev tsim cov enzymes tseem ceeb.

Thawj qhov tshwm sim ntawm tus kab mob tau piav qhia hauv 1965 los ntawm Swedish ophthalmologist Sjögren, tom qab uas nws tau txais nws lub npe. Cov kab mob no tuaj yeem txhim kho nws tus kheej lossis tawm tsam keeb kwm ntawm lwm yam kab mob. Tsis tas li ntawd, nws tus kheej tuaj yeem ua rau lwm yam txawv txav hauv lub cev.

Raws li nws cov chav kawm, tus kab mob tau muab faib ua ob hom:

1. daim ntawv ntev. Nws yog characterized los ntawm kev puas tsuaj rau cov qog, tsim yuav luag imperceptibly rau tib neeg. Raws li tus kab mob loj tuaj, tus neeg mob pib hnov qhov qhov ncauj qhuav txawv txawv, thaum lub qog ua kua qaub tsis ua haujlwm tag nrho thiab loj tuaj.
2. chav kawm Subacute ntawm Sjögren's syndrome. Nws yog dab tsi? Ib daim ntawv txaus ntshai ntawm tus kab mob, nws daim duab kho mob yog qhov dav dua. Thaum ntxov, cov txheej txheem inflammatory tshwm sim, lub cev kub nce. Maj mam, tus kab mob ua rau kev puas tsuaj rau cov pob qij txha, thiab tom qab ntawd lwm cov txheej txheem tseem ceeb tau koom nrog cov txheej txheem pathological.

Sjögren's syndrome yog ib yam kab mob autoimmune. Hauv lwm lo lus, pathology tshwm sim vim kev sib txawv ntawm kev ua haujlwm ntawm kev tiv thaiv kab mob. Raws li qhov tshwm sim ntawm ntau yam kev ua tsis tiav, lub cev pib txais nws tus kheejhlwb rau txawv teb chaws sawv daws yuav, tiv thaiv keeb kwm yav dhau uas muaj ib tug active zus tau tej cov tshuaj tiv thaiv tshwj xeeb. Maj mam, qhov mob tshwm sim, uas ua rau txo qis hauv kev ua haujlwm ntawm cov qog lacrimal thiab qaub ncaug.

Ua rau kab mob

Hais kom meej yog vim li cas autoimmune pathologies tshwm sim, cov kws kho mob tseem tsis tuaj yeem. Yog li qhov twg Sjögren's syndrome los ntawm qhov tseem ceeb tsis yog rau cov neeg mob nkaus xwb, tab sis kuj rau cov kws kho mob.

Tsuas yog ib qho paub tseeb: kev tiv thaiv kab mob, caj ces, hormonal thiab txawm tias qee qhov xwm txheej sab nraud koom nrog cov txheej txheem ntawm keeb kwm ntawm pathology. Feem ntau, ntau yam kab mob, xws li herpes, Epstein-Barr, cytomegalovirus, los yog cov kab mob loj xws li mob caj dab, kab mob scleroderma, polymyositis, lupus erythematosus, ua provocateurs ntawm txoj kev loj hlob ntawm tus kab mob.

Yog tias koj pom tias qhov ntswg qhuav ntau dhau ntawm lub qhov ntswg thiab pob zeb ua rau tsis xis nyob, nqos cov khoom noj nyuaj, tsis muaj kua muag thaum tev dos, koj yuav tsum tau mus ntsib kws kho mob rheumatologist.

Muaj ntau yam kev pheej hmoo loj:

• poj niam tshaj 40;
• muaj kab mob nyob rau hauv lub cev;
• mob ntshav qab zib mellitus;
• metabolic deviations ntawm lub plab zom mov;
• raug kev nyuaj siab;
• smoking;
• siv cytostatics, tshuaj tiv thaiv kev ntxhov siab, tshuaj tiv thaiv kab mob thiab tshuaj tua kab mob;
• genetic predisposition.

Secondary and primary syndrome

Muaj ob hom kab mob. Tab sis nyob rau hauv ob qho tib si thawj thiab theem nrab Sjögren's syndrome, cov neeg mob yws ntawm cov teeb meem tib yam, thiab qhov ua rau ntawm pathology yog tib yam. Tom qab ntawd qhov txawv yog dab tsi? Hom thawj yog kab mob ywj pheej. Tab sis tus mob thib ob yeej ib txwm cuam tshuam nrog lwm yam pathologies, piv txwv li, lupus erythematosus, ntshav qab zib mellitus lossis mob caj dab rheumatoid.

Lub tshuab ntawm txoj kev loj hlob ntawm tus kab mob yog kev tawm tsam los ntawm leukocytes ntawm cov qog ua kua qaub thiab qaub ncaug, nrog rau lwm cov ntaub so ntswg. Nws yog qhov tsis txaus ntseeg no uas ua rau muaj qhov qhuav thiab tawv nqaij hauv qhov ntswg, qhov muag qhuav, nrog rau cov tawv nqaij qhuav heev thiab txawm tias qhov chaw mos.

Ob qho tib si theem nrab thiab thawj Sjögren's syndrome yog qhov nyuaj heev, mob hnyav heev. Kwv yees li 90% ntawm tag nrho cov neeg mob yog cov poj niam. Hais txog qhov tshwm sim tag nrho, Sjögren's syndrome tau kuaj pom nyob hauv kwv yees li 8% ntawm tag nrho cov pej xeem hauv ntiaj teb. Ntawm cov no, kwv yees li 20-25% yog ib hom kab mob thib ob. Uas yog yus muaj los ntawm ib tug autoimmune systemic lesion ntawm lub connective cov ntaub so ntswg. Tus lej no txaus ntshai heev.

Kev raug mob mucosal nws tus kheej ua rau cov neeg mob tsis xis nyob, tab sis ntxiv rau, nws tuaj yeem ua rau muaj ntau yam teeb meem uas nyuaj rau kho.

daim duab kho mob

Txhua cov tsos mob ntawm Sjögren's syndrome tau muab faib ua ob pawg:

• systemic (extra-glandular) - tshwm sim uas tsis yog yam ntxwv ntawm tus kab mob no;
• glandular - cov qog ua kom puas, vim tias lawv txoj haujlwm tsis zoo,uas ua rau cov tsos ntawm cov cim qhia.

Ib qho ntawm cov tsos mob tseem ceeb ntawm tus kab mob yog ntau dhau qhuav ntawm cov mucous daim nyias nyias nrog cov paj hlwb thiab kev xav ntau dhau. Kev loj hlob ntawm cov kab mob pathology yog tshwm sim los ntawm kev nce hauv cov tsos mob. Dryness tsis ploj mus, ib tug neeg yuav tsum tau haus cov khoom noj tas li, nws xav tias yuav tsum tau moisturize lub qhov ncauj kab noj hniav thiab siv tshwj xeeb moisturizing npaj rau ob lub qhov muag.

Cov tsos mob ntawm tus kab mob Glandular

Keroconjunctivitis yog ib qho ntawm cov tsos mob tseem ceeb ntawm Sjögren's syndrome. Nws yog nrog los ntawm khaus thiab liab ntawm daim tawv muag, tsub zuj zuj ntawm cov kua nyob rau hauv lub ces kaum ntawm lub qhov muag. Tus neeg mob lub qhov muag pom kev maj mam txo qis, nws ntsib kev tsis xis nyob hauv lub teeb ci. Tsis tas li ntawd, muaj ntau lub lacrimation, clouding ntawm lub cornea, thiab trophic ulcers nyob rau hauv tej qhov chaw. Qhov no yog vim li cas rau qhov muag qhuav. Perforation thiab purulent conjunctivitis tshwm sim vim kev nkag mus ntawm lub plhaub ntawm staphylococcus aureus.

Tus kab mob parotitis yog qhov tshwm sim thib ob ntawm Sjögren's syndrome. Nws yog tus cwj pwm los ntawm kev puas tsuaj rau cov qog ua kua qaub, nce qhov loj ntawm cov qog nqaij hlav, qhov tshwm sim ntawm stomatitis thiab caries. Nyob rau theem tom ntej, dryness nyob rau hauv caj pas thiab qhov ntswg tshwm, ib qho kev nce nyob rau hauv cov qog ua kua qaub. Tus neeg mob yuav tsum tau saib xyuas qhov moistening ntawm lub qhov ncauj tas li. Cov tsos mob tshwm sim ntau zaus thaum siv cov khoom qab zib.

Hais txog ib nrab ntawm cov neeg mob, tus kab mob no nrog rau kev ua kom tsis tu ncua. Raws li nws nce, qhov nce hauv cov qog ua kua qaub yog pom, vim yoguas tej zaum yuav txawm hloov lub ntsej muag nta. Tus nplaig qhuav thiab lub qhov ncauj mucosa tig liab dhau lub sijhawm, qee qhov kev puas tsuaj tau sau tseg, qhov sib xws ntawm cov qaub ncaug hloov pauv - nws dhau los ua kua thiab tuab, ua rau ntau qhov tsawg.

Nrog rau lwm yam, cov kab mob muaj nrog ntau yam tsos mob:

1. Lub suab nrov, o ntawm cov mucous ntawm lub larynx, hnov lus tsis hnov tsw ntawm keeb kwm ntawm otitis media. Cov poj niam tsim o, atrophy thiab dryness ntawm qhov chaw mos. Sij hawm dhau mus, vim qhov no, colpitis tshwm sim, uas yog tus cwj pwm los ntawm kev txo qis hauv libido, mob, khaus thiab kub hnyiab hauv cov plab hnyuv siab raum.
2. Ib yam mob tshwm sim ntawm tus kab mob yog qhov txo qis hauv hws, ntau dhau ntawm daim tawv nqaij qhuav. Hauv kwv yees li 30% ntawm cov neeg mob, muaj qhov txhab ntawm cov qog hws nyob rau hauv armpits, vulva, pubis.
3. Kwv yees li 80% ntawm cov neeg mob cuam tshuam nrog txoj hnyuv. Vim qhov txo qis ntawm cov enzymes tsim nyog, rhiab heev rau cov khoom noj siv mis thiab cov rog rog nce ntau zaus, kev sib txawv hauv kev ua haujlwm ntawm lub plab thiab cov hnyuv tau sau tseg.

Cov cim qhia ntawm pathology

Ntawm lwm yam, Sjögren's syndrome ua rau muaj cov tsos mob ntxiv:

1. mob pob txha. Tib txoj hauv kev los txiav txim qhov ua rau yog nrog x-rays. Hauv kwv yees li 60% ntawm cov neeg mob, tus kab mob yog nrog los ntawm qhov mob, nruj ntawm kev txav, uas tshwm sim nws tus kheej kom meej meej thaum sawv ntxov. Feem ntau, nyob rau hauv cov txheej txheem pathologicalcov pob txha me me tau koom nrog, tab sis cov pob qij txha loj tseem nyob tsis tau. Hauv 10% ntawm cov neeg mob, muaj mob hnyav thiab cov leeg nqaij tsis muaj zog, qee zaum polymyositis tshwm sim.
2. YTracheobronchitis. Pom nyob rau hauv ib nrab ntawm cov rooj plaub. Tawm tsam keeb kwm ntawm tus kab mob no, tus neeg mob muaj hnoos me ntsis, ua tsis taus pa ua ntau zaus. Pulmonary fibrosis, vasculitis, lossis pleurisy tuaj yeem tsim. Cov pob me me tshwm sim ntawm daim tawv nqaij, muaj cov pob thiab cov dots, ulcers, me ntsis necrosis yog tsim. Tus neeg mob hnov khaus, kub hnyiab, lub cev kub nce.
3. Y Polyneuropathy. Cov mob no yog tus cwj pwm los ntawm kev ua tiav lossis txo qis ntawm cov tawv nqaij ntawm ob txhais ceg thiab caj npab, qee zaum cov kab mob hlwb tshwm sim. Thaum kuaj mob, tus neeg mob tuaj yeem kuaj pom qhov txawv txav hauv kev ua haujlwm ntawm cov thyroid caj pas, muaj kev nyiam ua xua rau qee yam zaub mov, tshuaj thiab tshuaj.

Diagnosis

Qhov tseeb, Sjögren's syndrome tsis yog qhov txaus ntshai rau tib neeg lub neej, tab sis nws tuaj yeem txo nws qhov tsis zoo, ua rau muaj kev tsis taus. Koj tuaj yeem kuaj pom tus kab mob ntawm tus kheej los ntawm tus nplaig qhuav thiab tsis muaj kua muag thaum txiav dos. Yog tias muaj cov tsos mob tshwm sim, nws yuav tsum tau hu rau tus kws kho mob rheumatologist kom kuaj tag nrho, uas oculists thiab kws kho hniav yuav koom nrog. Tsis tas li ntawd, tus neeg mob yuav tau mus ntsib kws kho mob neurologist, kws kho mob gastroenterologist thiab orthopedist.

Vim qhov zoo sib xws ntawm cov tsos mob ntawm Sjögren's syndrome nrog kev tshwm sim ntawm lwm yam kab mob kom paub meej tias qhov kev kuaj mob xav tauxav tau ntau yam kev tshawb fawb. Tus kws kho mob yuav xav tias muaj tus kab mob no tshwm sim thaum cov tsos mob tshwm sim:

• yog ib tug neeg raug yuam siv qhov muag txhua lub sijhawm;
• nrog cov qog ua kua qaub o;
• yog tias koj mob qhov muag tsis tu ncua;
• haus zaub mov yog tsim nyog;
• dryness tsis ploj hauv peb lub hlis.

Txhawm rau txiav txim siab txog kab mob thiab ntsuas nws qhov hnyav, tus kws tshaj lij tuaj yeem sau ntau qhov kev kuaj:

• ntshav kuaj kom muaj lub cev tiv thaiv kab mob, uas yog cov cim ntawm cov txheej txheem inflammatory;
• Schirmer strip test - suav nrog qhov nqaim ntawm daim ntawv tshwj xeeb hauv qab daim tawv muag, uas yuav tsum tau ntub hauv 5 feeb xwb;



• salivary gland biopsy;
• MRI thiab ultrasound kom pom qhov chaw mob;
• suav ntshav tag;
• kev tshuaj xyuas ntawm fundus nrog lub teeb tshwj xeeb;
• staining the cornea with a pink solution;
• sialometry - tsim nyog los ntsuas kev ua haujlwm ntawm cov qog qaub ncaug.

Tsuas yog tom qab kuaj tau tiav lawm, tus kws kho mob yuav muaj peev xwm sau tau cov kev kho mob uas tsim nyog.

Txoj Kev Kho Mob

Qhov tseeb, Sjögren's syndrome yog ib qho teeb meem loj heev tab sis tsis muaj teeb meem tuag. Yog tias cov tsos mob ntawm tus kab mob tau kuaj pom nyob rau lub sijhawm thiab kho, qhov kev pheej hmoo ntawm cov teeb meem yuav tsawg. Rau cov neeg mob, tsuas yog ib qho tseem ceeb - nco ntsoov qhov tseem ceeb ntawm txoj kev noj qab haus huv. Qhov ntawd yog tib txoj kevntxiv dag zog rau kev tiv thaiv, uas yuav tiv thaiv cov txheej txheem pathological los ntawm kev txhim kho ntxiv.

Hnub no, Sjögren's syndrome tau kho tau zoo, tab sis nws tsis tuaj yeem tshem tawm tus kab mob tag nrho. Yog li tom qab kuaj pom, tus neeg mob yuav tsum tau txais kev kho mob nkaus xwb.

Kev kho mob nyuaj ua rau nws tuaj yeem txo qhov tshwm sim ntawm tus kab mob thiab tiv thaiv qhov tshwm sim ntawm ntau yam teeb meem. Kev noj tshuaj rau tus kheej hauv qhov no yog txwv nruj heev, vim tias qhov kev txiav txim siab no yuav ua rau muaj qhov hnyav ntawm daim duab kho mob.

Nyob rau theem pib, cov kws kho mob pom zoo kom noj cov tshuaj tiv thaiv kab mob thiab cov tshuaj hormones. Txhawm rau tiv thaiv kev mob, siv cov tshuaj tiv thaiv kab mob thiab glucocorticosteroids. Cov tshuaj no ua rau lub cev tsis muaj zog thiab txo nws cov kev tawm tsam ntawm nws lub cev. Yog tias tus neeg mob lub cev tiv thaiv kab mob tsis muaj zog heev, tus kws kho mob yuav sau tshuaj tua kab mob los tiv thaiv kab mob thib ob.

Cov lus qhia kho mob rau Sjögren's syndrome

Kev kho tus kab mob no muab kev pab ntau tshaj plaws ntawm tus neeg mob tus mob thiab kev tawm tsam autoimmune tsis ua haujlwm:

1. Nrog txo qis qaub ncaug, "Pilocarpine" thiab nws cov analogues tau siv. Tsis tas li ntawd, cov neeg mob raug txhawb kom haus dej ntau npaum li qhov ua tau.
2. Thaum qhov muag qhuav, "Artificial tear" tee yog siv. Tus nqi ntawm cov tshuaj no yog suav tias yog pheej yig. Kev npaj raws li hypromellose suav hais tias tsis muaj txiaj ntsig zoo, thiab thaum yav tsaus ntuj nws raug nquahu kom nteg cov tshuaj pleev rau hauv daim tawv muag. Raws li kev txheeb xyuas, cov txiaj ntsig zoo tshaj plawsmuaj tee "Artificial kua muag". Tus nqi ntawm cov tshuaj yog los ntawm 120-210 rubles. Lawv muab kev pab sai rau qhov muag qhuav thiab muab cov txiaj ntsig tau ntev.



3. Thaum exacerbations, noj tshuaj tua kab mob.
4. Yog tus neeg mob raug mob los ntawm qhov mob txuam nrog pathologies ntawm musculoskeletal system lossis myalgia, siv cov tshuaj uas tsis yog-steroidal anti-inflammatory siv.
5. Daim ntawv thov raws li "Heparin", "Hydrocortisone" thiab "Dimexide" zoo tiv thaiv qog nqaij hlav.
6. Rau qhov qhuav ntawm bronchi thiab trachea, nws raug nquahu kom siv Bromhexine.
7. Rinses yog siv los tshem tawm qhov ncauj qhuav.
8. Qhov muag qhuav yog tshem tawm nrog saline thiab "Hemodez". Tab sis ua ntej siv, nws yog qhov zoo dua mus ntsib kws kho mob.
9. Yuav ua li cas rau qhov chaw mos qhuav? Cov kws kho mob pom zoo kom siv cov roj nplua nyeem tshwj xeeb thiab noj tshuaj tiv thaiv kab mob.
10. Ntau zaus, qhov ncauj qhuav ua rau caries. Txhawm rau tiv thaiv qhov teeb meem, cov kws kho mob qhia kom saib xyuas kev tu cev tas li, mus ntsib kws kho hniav tsis tu ncua thiab siv cov tshuaj fluoride.
11. Qee zaum cov kws kho mob kuj pom zoo kom txo qis kev ua lub cev thiab hloov koj cov zaub mov. Yog tias muaj kev zam txim ruaj khov, lwm txoj kev raug tso cai.

Feem ntau, cov kws kho mob tau sau ntau yam tshuaj zoo:

• "Prednisolone" - glucocorticoid;
• "Solcoseryl" thiab "Parmidin" - angioprotectors;
• "Splenin" - immunomodulator;
• "Heparin" - anticoagulant;
• "Cyclophosphamide", "Azathioprine", "Chlorbutin" - cytostatics;
• "Trasilol", "Kontrykal" - nres kev tsim cov enzymes.

Cov ntsiab lus ntawm kev noj haus

Tsis muaj kev noj zaub mov tshwj xeeb rau Sjögren's syndrome, tab sis muaj qee yam kev noj haus uas pab txo qis cov tsos mob tsis zoo. Tsis tas li ntawd, yog tias koj coj mus rau hauv tus account qhov kev noj qab haus huv ntawm qhov ncauj kab noj hniav, ces tsuas yog kev noj zaub mov zoo tso cai rau koj los tiv thaiv koj cov hniav los ntawm kev txhoj puab heev.

Cov kws kho mob qhia ua ntej kom tso cawv. Tsis tas li ntawd, cov khoom noj uas muaj cov txiv hmab txiv ntoo acids ntau yuav tsum raug cais tawm ntawm cov ntawv qhia txhua hnub.

Cov zaub mov tseem ceeb ntawm tus neeg mob Sjögren's syndrome yuav tsum muaj cov zaub mov ua kua. Cov kws kho mob qhia kom ntxiv kev kho mob nrog ntau yam kua ntses, kua txiv hmab txiv ntoo thiab zaub, xws li txiv lws suav thiab dib.

Kev xaiv zaub mov zoo tshaj plaws yog cov ntawv qhia zaub mov nrog ntau cov khoom tshiab thiab tsawg kawg ntawm cov khoom qab zib thiab cov roj saturated.

Yam yuav tshwm sim

Cov neeg mob uas tsis kho tus kab mob no yuav ntsib ntau yam teeb meem tsis zoo:

• ntxhij tus nplaig, nqos nyuaj;
• ua kom tiav cov qaub ncaug;
• keratinization ntawm daim tawv nqaij ntawm sab hauv ntawm lub puab tsaig;
• kis kab mob thib ob;
• -cracking thiab poob ntawm cov hniav, caries;
• ntau yam ua rau qhov muag qhuav tuaj yeem ua rau pom kev tsis zoo;
• kab mob fungal - stomatitis, candidiasis;
• pathology ntawm lub hauv siab - pleurisy, bronchitis, mob ntsws, ua pa tsis ua haujlwm;
• raum tsis ua haujlwm thiab lwm yam raum tsis zoo;
• loog lossis poob ntawm caj npab thiab txhais ceg;
• lymphoma.

Cov neeg kuaj mob Sjögren's syndrome feem ntau tsim cov qog nqaij hlav malignant. Feem ntau, cov neeg mob no ntsib lymphosarcoma ntawm cov qog qaub ncaug.

Kev Tiv Thaiv Rov Qab

Txhawm rau tiv thaiv kev txhim kho ntxiv thiab ua rau muaj qhov tshwm sim ntawm daim duab kho mob hauv Sjögren's syndrome, nws raug pom zoo:

• txo kev ntxhov siab ntawm lub suab thiab ob lub qhov muag;
• zam qhov xwm txheej ntxhov siab;
• noj cov tshuaj tsis tu ncua;
• zam lub hnub raug ntev;
• tsis kam txhaj tshuaj tiv thaiv;
• kho comorbidities;
• Nyob zoo ib tsoom phooj ywg.

Kev kho tsis raws sijhawm thiab tsis saib xyuas tus kws kho mob cov lus qhia yog qhov ua rau poob ntawm kev ua haujlwm, kev tsis taus thiab kev puas tsuaj rau ntau yam kabmob.

Tam sim no koj paub txhua yam txog dab tsi yog qhov ua rau, tsos mob, kho thiab tiv thaiv Sjögren's syndrome. Raws li koj tau pom, nws yog qhov hnyav heev.kab mob, tab sis tsis ua rau lub neej. Thiab yog tias koj ua raws li txhua tus kws kho mob cov lus pom zoo, koj tuaj yeem hnov qab tag nrho cov kev tsis xis nyob uas cov tsos mob ntawm pathology provoke.