Eosinophilic chibayo: kufotokoza zizindikiro, amachititsa ndi makhalidwe a mankhwala

Aakulu m'mapapo matenda, monga chibayo, si nthawi zonse chifukwa cha zomera bakiteriya. Kusokoneza homeostasis wa chapamwamba ndipo m'munsi kupuma thirakiti ndingathere majeremusi, bowa, mankhwala, immunodeficiency, matupi awo sagwirizana zochita. Ndipo mu Zikatero, eosinophilic chibayo akufotokozera.

tanthauzo

Eosinophilic chibayo - njira pathological mu mapapo, amene amakhala ndi kudzikundikira kwambiri a eosinophils mu alveoli lapansi. Pali mitundu ingapo kapena mitundu ya matenda, umene kukhala pa msinkhu uliwonse.

Kukomoka, ndi pafupifupi osiyana matenda oyamba ndi bakiteriya, kotero chamene ndi pa matenda zasayansi mayesero: wathunthu magazi, kuipitsa mbiri. Nthawi zambiri, pambuyo kudziwa mtundu wa matenda ayamba mankhwala steroid mahomoni adrenal kotekisi. Izi zimathandiza kuchepetsa yotupa anachita ndi n'chongoletsa ndi zizindikiro za chibayo. Kuti madokotala ananena zawo odwala awa zambiri zabwino.

nkhani

Matenda eosinophilic chibayo, zimayambitsa umene panthawi imeneyo anali sanaidziwe, anafotokozedwa koyamba mu m'ma makumi awiri, mu 1969, dokotala Harrington. Iye sanali wamanyazi kwambiri, kotero n'kukagwiritsa matenda dzina lake, ndipo pambuyo buku la dziko sayansi anayamba kuitana latsopano kudwala matenda Harrington.

Isanafike mbiri chibayo Nkhaniyi eosinophilic wakhala ndi nthenda imene akufotokozera mu mapapo pambuyo matenda ndi tizilombo kapena kusalankhula kuvomera mankhwala. Patatha zaka makumi awiri, mu 1989, anaonekera mu mankhwala, mawu akuti "pachimake eosinophilic chibayo".

etiology

Kuzindikira mfundo zingapo, zimene mchikakamizo cha chibayo eosinophilic akufotokozera. Zoyambitsa, zizindikiro n'zogwirizana. Mwachitsanzo, mitundu pachimake a chibayo chifukwa chosuta fodya (onse udakali chabe), ziwengo mankhwala kapena kuchepa chitetezo cha thupi ndi HIV kapena AIDS. Ngati palibe zifukwa siyabwino, amaona kuti idiopathic chibayo.

Matenda eosinophilic chibayo akhoza chikwiyire ndi matenda a mafangasi (aspergillosis pnevmomikoz) helminthic infestation (ascariasis, echinococcosis), ntchito yaitali mankhwala omwe nkhawa chitetezo cha m'thupi (steroids cytostatics), aakulu autoimmune connective matenda minofu (nyamakazi, Kaposi a).

Eosinophils ndi ntchito zoteteza za thupi, koma monga kutupa kwa - izi ndi mmene pathological ndondomeko, pamene pali zimabwezera mofulumira ndithudi, iye akhoza kungasokoneze thanzi la munthu.

pathogenesis

Etiologic imayambitsa zambiri imalongosola bwanji kukhala eosinophilic chibayo. Zoyambitsa, zizindikiro, mankhwala - zonse zimadalira izi. Mwalawapangodya a mtundu umenewu chibayo ndi kudzikundikira ambiri eosinophils mu zimakhala m'mapapo. Matenda ambiri, kuphatikizapo chikanga, mphumu, chifukwa anachita kwambiri zachiwawa chamoyo ndi kumasula pawiri yogwira.

Mankhwala ndi zina poizoni kumasintha ndi reactivity wa eosinophils ndi kuwapanga iwo atengeke kwambiri. wothandizila Anti-yotupa, mankhwala mankhwala chifukwa chifuwa chopatsa chitukuko cha chibayo sekondale. Ndiponso, zinthu kuchititsa kuoneka ambiri eosinophils mu minofu, amatanthauza fodya kapena nthunzi mankhwala.

matenda parasitic

Madokotala njira zitatu za chibayo pa parasitosis. Choyamba - ndi parasitic infestation mu phapo, chachiwiri - gawo la mayendedwe amoyo mphutsi, ndi wachitatu - Zongotigwera mosamala m'magazi. Kuthana nawo thupi amatumiza eosinophils. Iwo ayenera imfayo kumasulidwa kwa cytokines, prostaglandins, leukotrienes ndi zinthu zina mphamvu kwa Kupha mphutsi. Koma m'malo chifukwa chibayo.

Mwachindunji anadzetsa pa zimakhala a m'munsi kupuma tapeworms thirakiti, Echinococcus ndi monga nkhumba njoka zam'mimba za matepi, komanso m'mapapo fluke. Kukhala mu mapapo ndi kupeza mpweya mumlengalenga wofunikila ascarids, matumbo ugritsy, zangowe ndi zangowe. Eosinophilic chibayo, amene amayamba ndi tizilombo toyambitsa matenda pamwamba, mwinamwake kudziwika matenda Loeffler a. Kudzera m'magazi m'mapapo mazira Trichinella ndi schistosomes.

chipatala

Monga ulamuliro, ndi madokotala, pulmonologist, kapena matenda opatsirana ngakhale pakuwonana koyamba wovuta kuyankha funso zimene chibayo mtima eosinophilic. Zizindikiro, ngakhale kutenga nkhani ya etiologies osiyana ndi zofanana kwambiri ndi mzake. Wodwala anadandaula za chifuwa, malungo, kufupika kwa mpweya ndi thukuta usiku. Patapita masabata pambuyo isanayambike chifuwa, ngati kanthu zachitika, muona zizindikiro za decompensated kupuma insufficiency. Mu nkhani yoteroyo wodwala ayenera kunditumiza ku mpweya yokumba.

Matenda eosinophilic chibayo pang'onopang'ono, kwa miyezi. Odwala kuonda, ali ndi kufupika kwa mpweya, wheezing ndi kukhosomola, kutentha thupi akutsikira m'munsimu subfebrile. Nthawi zina zizindikiro muoneke mphumu, zomwe zimachititsa matenda ndi kusankha zolakwika mankhwala.

mavuto ambiri kwa matenda a eosinophilic chibayo mankhwala amalenga. Zizindikiro, mankhwala ndi kupewa kufanana ake amphamvu ndi aspirin mphumu, kuti asakusocheretseni dokotala. Mu matenda parasitic ali enieni prodromal nthawi, amene angawauze ndi nkhondo helminthic.

diagnostics

Popeza kukomoka eosinophilic chibayo ndi pafupifupi munthu wosiyana chibayo ena, matenda zachokera zasayansi ndi zofufuza malangizo. Ambiri, kusanthula eosinophilia magazi kutchulidwa pansi fluoroscopic zowonera kwa m'mapapo mwanga kapena yopangidwa Tomography noticeable kusintha khalidwe pathological. Kutsimikiza mukhoza kutenga biopsy a minofu ya m'mapapo, komanso kuti chamadzi ndi padziko bronchus pa bronchoscopy.

Kuzindikira ubale kwa mankhwala, khalani mu malo ndi mankhwala zoipa, kapena khansa, muyenera bwinobwino mbiri mankhwala wodwala, komanso kusonkhanitsa mbiri mwatsatanetsatane za moyo ndi matenda. Ngati, pambuyo pa kafukufuku onse, chifukwa akadali si kudziwa, ndiye matenda ananena idiopathic chibayo eosinophilic.

Onetsetsani kuti ulitsa limasonyeza digiri kulephera kupuma. Mkati mwa sabata ya isanayambike matenda pali zizindikiro cha izi:
- zotupa angapo m'mapapo minofu;
- kudzikundikira madzimadzi mu M'mimbamo pleural;
- leukocytosis ndi okwera erythrocyte mlingo sedimentation mu kusanthula ambiri a magazi;
- amaika wa immunoglobulin E;
- kupuma spirometry limasonyeza kuchepa mu Volume m'mapapo.

chithandizo

Ngakhale pamaso pa matenda chomaliza kuika - chibayo eosinophilic, chithandizo imayamba ndi mankhwala a wodwalayo kwa dokotala.

Ngati chibayo ndi sekondale, m'pofunika kuchiza matenda chimapangitsa: chotupa kapena infestation nyongolotsi. Izi zingathandize kuchepetsa zizindikiro m'mapapo mwanga ndi kuchira othamanga.

Ngati chifukwa cha matenda ayi ya anthu, anatumizidwa mankhwala glucocorticosteroid. Iwo bwino kuchotsedwa yotupa Poyankha, ziziyenda selo nembanemba, kuchepetsa kutentha. Chikhululukiro zimatheka msanga - mu tsiku lachitatu kapena wachinayi. Koma mankhwala sikuthetsa kumeneko. Mofulumira zizindikiro sizikutanthauza kuti nthendayo anachiritsa. Choncho, corticosteroids, wodwalayo amatenga mwezi, ndi kuchepetsa mwapang'onopang'ono mlingo poti njira malangizo matenda musati atsimikizire kuchira.

Mawonekedwe a matenda aakulu amafuna chithandizo kwa miyezi itatu kapena zambiri, ngakhale pambuyo mofulumira zizindikiro matenda. Musabise zitheka chibayo pa maziko a achire mwadzidzidzi wa corticosteroids. Nthawi zina, wodwalayo angafunike kusinthana kwa mpweya wabwino makina.

kaonedwe

Ngati eosinophilic chibayo ndi matenda sekondale ndi khansa kapena parasitosis, ndiye zotsatira zimadalira otaya wa kudwala chimapangitsa. Oopsa, anapereka chithandizo chokwanira yake chodziwikiratu.

Matenda eosinophilic chibayo sachedwa anawathetsa akuyambiranso pa nkhope ya glucocorticosteroids lapansi. Choncho ena odwala kumwa mankhwala amenewa kwa moyo. Koma imeneyi, pali downside. Zotsatira zake zoyipa za mankhwalawa, monga prednisone, akhoza kwambiri kuchepetsa khalidwe la moyo. Zikuphatikizapo: chironda chachikulu, kufooka kwa mafupa, kushingoid, utachepa chitetezo chokwanira.

EPIDEMIOLOGY

Monga ulamuliro, chibayo chifukwa cha majeremusi amene ambiri m'madera kuderako kuti tizilombo toyambitsa matenda amenewa. Izi zikhoza kukhala kotentha, ndi Siberia nayonso, Mediterranean kapena mtsinje iliyonse.

Pachimake eosinophilic chibayo angathe pa msinkhu wina uliwonse, ngakhale ana aang'ono kwambiri, koma ambiri a iwo akudwala anthu wazaka zapakati kwa zaka makumi awiri ndi anai. Mu matenda pali kusankhana jenda - amuna amadwala zambiri kuposa akazi, chifukwa matendawa amayambitsidwa ndi fodya kusuta. Mu mabuku panopa zachipatala pali kufotokozera za chibayo eosinophilic pambuyo cheza mankhwala a khansa ya m'mawere.

Eosinophilic chibayo agalu

nyama akhoza kupezeka chibayo eosinophilic. Zoyambitsa, zizindikiro, kupewa matenda ndi ofanana kwambiri ndi anthu. Mofananamo, zimayambitsa matenda: tizilombo mu mapapo, bowa, chifuwa ndi mungu, tizilombo, mankhwala ndi mankhwala.

Galuyo anaona ndi kusalankhula m'thupi ayankhe imene imapangitsa m'mapapo minofu kusalola ndi eosinophils. Lightness m'munsi magulu amachepetsa, pali akufotokozera bowa tizilombo timene timayambitsa chibayo. nyama waphedwa ndi acidosis ndi hypoxia. chipatala ndi ofanana ndi chifuwa anthu, kufupika kwa mpweya, kufooka, malungo, kusafuna kudya, kuwonda.

Pakuti matenda ntchito atayezetsa, X-ray a m'mapapo, bronchoalveolar lavage cytology, serology. Pa X-ray kuonekera m'mapapo minofu edema, pamaso pa foni granuloma, lymph mfundo kukulitsa mediastinal ndi hilar kuwonjezeka mthunzi mtima. Pambuyo mafotokozedwe a chibayo etiology eosinophilic, vetenale anapereka chithandizo yeniyeni umalimbana ndi kuthetsa matenda choyambirira. The mtima kwambiri - corticosteroids, osakaniza ndi mankhwala ndi bronchodilators. Kawirikawiri, nyama kukhala moyo wonse mankhwala.