raum pathologies muaj ntau heev. Cov no suav nrog cov kab mob xws li pyelo- thiab glomerulonephritis. Ntxiv rau lawv, muaj lwm yam pathologies ntawm cov zis. Ib tug ntawm lawv yog Berger tus kab mob. Qhov no pathology kuj hais txog kev tsis sib xws. Nws raug kuaj pom hauv kwv yees li 20% ntawm cov neeg mob raum kab mob hauv cov txiv neej. Qhov kev ua txhaum cai no siv tsis tau rau cov teeb meem ntawm nephrology nkaus xwb, vim nws muaj kev tiv thaiv kab mob ntawm kev loj hlob. Cov kab mob no tuaj yeem xav tias yog cov tsos mob tseem ceeb - tag nrho hematuria.
Berger's disease - yog dab tsi?
Cov kab mob no yog ib hom mob glomerulonephritis. Piv nrog rau cov hypertensive thiab nephrotic variant ntawm chav kawm, Berger's tus kab mob muaj qhov pom zoo dua. Txawm hais tias nws tau kuaj pom thaum muaj hnub nyoog ntxov (15-30 xyoo), nws tsis tshua muaj mob raum tsis ua haujlwm. Lub ntsiab tshwm sim ntawm tus kab mob yog macrohematuria thiab tsis xis nyob nyob rau hauv lub lumbar cheeb tsam. Qhov no pathology tuaj yeem tshwm sim hauv menyuam yaus. Hauv cov txiv neej, nws tshwm sim 4 zaug ntau dua li cov poj niam. Raws li nrog tag nrho cov pathologies, kev kuaj mobtau nthuav tawm raws li International Classification of Diseases (ICD). Berger's nephropathy muaj tus lej N02, uas txhais tau tias "tsis tu ncua thiab rov tshwm sim hematuria".
Cas of disease development
Qhov laj thawj tseem ceeb ntawm tus kab mob yog tus txheej txheem sib kis. Feem ntau, lub raum pathology tshwm sim tom qab kis kab mob thiab kab mob. Cov kab mob fungal kuj tuaj yeem ua rau. Feem ntau, cov tsos mob tshwm sim ob peb hnub tom qab tus kab mob nyob rau hauv lub Upper pa ib ntsuj av tau txo qis (ARVI, tonsillitis, pharyngitis). Qhov ua rau tam sim no ntawm tus kab mob yog qhov txuam nrog kev tiv thaiv kab mob hauv cov phab ntsa ntawm lub raum cov hlab ntsha. Qee zaum, muaj kev sib txuas ntawm cov kab mob pathology thiab lub nra hnyav ntawm keeb kwm yav dhau los (tsev neeg IgA nephropathy). Tsis tas li ntawd, tus kab mob yog txuam nrog ib tug genetic predisposition. Cov nram qab no provoking yam yog txawv:
- Hypercooling.
- Kev tiv thaiv qis dua.
- Kab mob kis kab mob thiab kab mob hauv cov kab mob ua pa sab saud.
Mechanism of development of Berger's disease
Tus kab mob ntawm tus kab mob yog txuam nrog kev tso tawm ntawm lub cev tiv thaiv kab mob hauv cov phab ntsa ntawm cov hlab ntsha. Feem ntau, lub glomerular apparatus ntawm lub raum yog lub luag hauj lwm rau lim cov ntshav. Nws muaj ntau cov hlab ntsha nephrotic. Tom qab kis tus kab mob, cov ntsiab lus ntawm cov txheej txheem inflammatory - lub cev tsis muaj zog - nyob twj ywm hauv lub cev thiab nyob rau hauv lub glomerular apparatus. Yog li ntawd, glomerulonephritis tshwm sim. Cov hlab ntsha hauv lub raum tsis tuaj yeem ua haujlwm ib txwm vim muaj kev tiv thaiv kab mobcomplexes, thiab ntshav pom yog cuam tshuam. Tsis tas li ntawd, cov txheej txheem inflammatory ua rau cov kua tsub zuj zuj (parenchymal edema) thiab txo cov permeability ntawm lub hauv paus membrane. Raws li qhov tshwm sim, macro- thiab microhematuria tsim. Qhov ua rau ntawm cov txheej txheem no yog kev puas tsuaj rau lub glomeruli thiab nkag mus rau cov kua dej (ntshav) los ntawm lub hauv paus membrane.
Cov tsos mob ntawm tus kab mob Berger yog dab tsi?
Daim duab kho mob ntawm Berger tus kab mob zoo li mob glomerulonephritis. Txawm li cas los xij, nws yog ib qho tseem ceeb kom paub qhov txawv ntawm cov kab mob no. Feem ntau ua rau glomerulonephritis yog kab mob staphylococcal. Cov kev kho mob ntawm cov kab mob no kuj txawv. Cov tsos mob tseem ceeb ntawm Ig A nephropathy yog:
- Hematuria. Feem ntau, nws yog cov tsos mob no ua rau cov neeg mob mus nrhiav kev pab kho mob. Gross hematuria txhais tau hais tias cov ntshav tshwm sim thaum tso zis. Qhov no feem ntau nrog kev tsis xis nyob.
- Microhematuria yog ib qho tsos mob uas tseem pom tsis tau rau tib neeg thiab tsuas yog kuaj pom hauv cov qauv tshwj xeeb.
- Mob hauv cheeb tsam lumbar. Feem ntau lawv ua npub mob hauv qhov xwm txheej. Tsis zoo li lwm cov txheej txheem inflammatory hauv ob lub raum (pyelonephritis), kev tsis xis nyob ntawm ob sab.
- Muaj tus kab mob ua pa sab sauv dhau los.
- nce lub cev kub.
- Kev qaug zog.
- Proteinuria - pom cov protein nyob hauv cov zis. Nws raug sau tseg hauv cov xwm txheej tsis tshua muaj, nrog rau cov kab mob atypical.
Ig diagnosticsA-nephropathy NWS
Qhov kev kuaj mob tseem ceeb rau Berger tus kab mob yog ib qho kev kawm ntev. Feem ntau, cov tsos mob thab tus neeg mob 2-3 zaug hauv ib xyoos, tom qab kis tus kab mob. Nws tseem ceeb heev uas yuav tsum nco ntsoov tias tus kab mob no yog benign. Txawm hais tias tsis sib xws hematuria, cov mob ntawm lub raum tseem zoo li qub. Tsis zoo li lwm cov txheej txheem inflammatory (pyelo-, glomerulonephritis), CRF tsis tshua muaj tshwm sim nrog Berger's disease.
Kev kuaj mob hauv chaw kuaj mob suav nrog KLA, OAM thiab kuaj zis tshwj xeeb (Nechiporenko, Zimnitsky). Lawv yuav tsum tau kuaj xyuas erythrocytes thiab leukocytes. Nyob ntawm qhov no, micro- thiab macrohematuria txawv. Hauv kev tsom xam dav dav ntawm cov zis, cov protein tuaj yeem muaj. Txhawm rau xyuas seb puas muaj kev ua txhaum ntawm lub raum ua haujlwm, tus neeg mob yuav tsum pub ntshav los ntawm cov hlab ntsha rau biochemistry. Hauv qhov kev tshuaj ntsuam no, nws yog ib qho tseem ceeb kom paub txog qib ntawm creatinine, uas tseem zoo li qub hauv Berger tus kab mob. Txhawm rau txiav txim siab zaum kawg, ib qho kev sim ua kom pom muaj Ig A hauv cov ntshav. Nyob rau hauv tsawg zaus, lub raum biopsy yog ua, nyob rau hauv uas lub cev tiv thaiv complexes muaj nyob rau hauv lub vascular apparatus. Ultrasound kuj ua rau kev kuaj mob sib txawv.
Immunological mob ntawm lub raum: kho
Txawm hais tias muaj tus kab mob zoo li cas, kev kho mob yog qhov tsim nyog thaum rov ua dua. Nws yog tsim nyog tsis tsuas yog txo cov tsos mob ntawm pathology, tab sis kuj los tiv thaiv cov teeb meem thiab khaws cia lub raum ua haujlwm. Kev kho mob pib nrog kev huv ntawm foci ntawm tus kab mob. Feem ntau, cov tshuaj tua kab mob tau muab rau qhov no (cov tshuaj "Amoxicillin","Cefazolin") thiab cov tshuaj tiv thaiv kab mob (cov tshuaj "Viferon", "Genferon"). Tsis tas li ntawd, cov NSAIDs yog xav tau los txo qhov mob ntawm lub glomerular apparatus ntawm ob lub raum. Cov tshuaj feem ntau siv yog Canephron, Ibuprofen. Hauv cov kab mob raum, tshuaj ntsuab muaj txiaj ntsig zoo. Tshwj xeeb decoctions thiab infusions kuj tau sau tseg (knotweed, birch cones, bearberry).
Yog tias tus kab mob nyuaj kho, muaj kev rov qab los tsis tu ncua lossis muaj teeb meem, ces kev kho hormonal yog ua. Feem ntau sau cov tshuaj "Prednisolone", nrog rau cov tshuaj cytostatic. Qee zaum, kev kho antiplatelet yog xav tau, txhais tau tias txhawm rau txhim kho cov ntshav khiav (cov tshuaj "Kurantil").
Kev Tiv Thaiv Kab Mob Berger
Nws yuav tsum nco ntsoov tias Berger tus kab mob hais txog cov kab mob ntev. Yog li ntawd, txhawm rau kom tsis txhob exacerbations, nws yog ib qho tsim nyog yuav tsum tau ua kev tiv thaiv. Nws yog ib qho tseem ceeb kom ntxuav lub foci ntawm tus kab mob (tonsillitis, sinusitis) nyob rau hauv lub sij hawm, tsis txhob raug mus rau hypothermia. Tsis tas li, cov neeg mob yuav tsum tau kawm cov tshuaj ntsuab ib ntus, txhawb kev tiv thaiv kab mob.
