Primary biliary cirrhosis

Iyo bile ducts ndiwo machubhu anofambisa bile kubva muchiropa kuenda mudumbu dumbu. Bira chinhu chinobatsira kugaya. Ese maburi ducts pamwechete anonzi biliary turakiti.

Kana iyo bile ducts yazvimba kana kuzvimba, izvi zvinodzivirira kuyerera kwe bile. Shanduko idzi dzinogona kutungamira mukukuvara kwechiropa chinonzi cirrhosis. Izvi zvinonzi biliary cirrhosis. Yepamberi cirrhosis inogona kutungamira kukundikana kwechiropa.

Chikonzero chekupisa bile ducts muchiropa hachizivikanwe. Nekudaro, yekutanga biliary cirrhosis chirwere che autoimmune. Izvi zvinoreva kuti immune system yako inokanganisa kurwisa zvinyama zvine hutano. Chirwere ichi chinogona kuve chakabatana ne autoimmune kusagadzikana senge:

• Chirwere cheCeliac
• Raynaud chiitiko
• Sicca syndrome (yakaoma maziso kana muromo)
• Utachiona chirwere

Chirwere chinowanzo bata vakadzi vepakati nepakati.

Vanopfuura hafu yehafu yevanhu havana zviratidzo panguva yekuongororwa. Zviratidzo zvinowanzotanga zvishoma nezvishoma. Zviratidzo zvekutanga zvinogona kusanganisira:

• Nausea uye kurwadziwa kwepamuviri
• Kuneta uye kurasikirwa kwesimba
• Mafuta anoisa pasi peganda
• Zvigaro zvine mafuta
• Itching
• Chido chisina kunaka uye kuonda

Sezvo chiropa chinoshanda chichiwedzera, zviratidzo zvinogona kusanganisira:

• Fluid buildup mumakumbo (edema) uye mudumbu (ascites)
• Yeruvara rweganda mune ganda, mucous membranes, kana maziso (jaundice)
• Kutsvuka pamaoko emaoko
• Mune varume, kushaya simba, kudzikira kwemachende, uye kuzvimba kwemazamu
• Kupwanya kuri nyore uye kubuda kweropa zvisina kujairika, kazhinji kazhinji kubva mutsinga dzekuzvimba munzira yekugaya
• Kuvhiringidzika kana matambudziko kufunga
• Pale kana chevhu-chitsvuku zvituru

Anopa hutano anoita bvunzo dzepanyama.

Iyi bvunzo inotevera inogona kutarisa kuti uone kana chiropa chako chiri kushanda nemazvo:

• Albumin kuongorora ropa
• Chiropa basa bvunzo (serum alkaline phosphatase inonyanya kukosha)
• Prothrombin nguva (PT)
• Cholesterol uye lipoprotein kuongororwa kweropa

Mimwe bvunzo inogona kubatsira kuyera kuti chirwere chakakomba chechiropa chingave chinosanganisira:

• Yakakwira immunoglobulin M mwero muropa
• Chiropa biopsy
• Anti-mitochondrial antibodies (mhedzisiro yakanaka mune angangoita 95% emakesi)
• Mhando dzakasarudzika dzeultransmia kana MRI inoyera huwandu hwevanga (unganzi elastography)
• Magnetic resonance cholangiopancreatography (MRCP)

Chinangwa chekurapa ndechekurerutsa zviratidzo uye kudzivirira kusagadzikana.

Cholestyramine (kana colestipol) inogona kudzikisa kutsemuka. Ursodeoxycholic acid inogona kusimudzira kubvisa kwe bile kubva muropa. Izvi zvinogona kuvandudza kupona mune vamwe vanhu. Mushonga mutsva unonzi obeticholic acid (Ocaliva) unowanikwa zvakare.

Vitamin kutsiva kurapa kunodzoreredza mavitamini A, K, E uye D, ayo akarasika mumafuta ezvituru. Kuwedzera calcium kana imwe mishonga yemapfupa inogona kuwedzerwa kudzivirira kana kurapa mapfupa asina kusimba kana akapfava.

Yenguva refu yekutarisa uye kurapwa kwechiropa kutadza kunodiwa.

Chiropa chekuisa chinogona kubudirira kana chikaitwa kusati kwaitika kutadza kwechiropa.

Mhedzisiro yacho inogona kusiyana. Kana mamiriro acho asina kurapwa, vanhu vazhinji vanofa vasina kuisirwa chiropa. Vanenge chikamu chimwe muzvina chevanhu vane chirwere ichi kwemakore gumi vachave nekukundikana kwechiropa. Vanachiremba vava kugona kushandisa nhamba yekuverengera kufanotaura nguva yakanakisa yekuisa. Zvimwe zvirwere, zvakaita sehypothyroidism uye kupererwa neropa, zvinogona zvakare kukura.

Kufambira mberi kwechirrhosis kunogona kutungamira mukundikana kwechiropa. Zvinetso zvinogona kusanganisira:

• Kubuda ropa
• Kukuvadza kune uropi (encephalopathy)
• Fluid uye electrolyte kusaenzana
• Itsvo kutadza
• Malabsorption
• Kushaya zvokudya zvinovaka muviri
• Mapfupa akapfava kana asina kusimba (osteomalacia kana osteoporosis)
• Ascites (inoyerera inovaka mudumbu)
• Kuwedzera njodzi yekenza yechiropa

Fonera mupiki wako kana iwe uine:

• Kuzvimba mudumbu
• Ropa muzvigaro
• Kuvhiringidzika
• Jaundice
• Kuchema kweganda risingapfuure uye risina hukama nezvimwe zvikonzero
• Kusvipa ropa

Primary biliary cholangitis; PBC

• Cirrhosis - kubuda

• Kugaya chirongwa
• Bile nzira

Eaton JE, Lindor KD. Chekutanga biliary cholangitis. Muna: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger uye Fordtran's Gastrointestinal uye Chirwere Chiropa. 11th ed. Philadelphia, PA: Elsevier; 2021: chits. 91.

Fogel EL, Sherman S. Zvirwere zveguruva uye bile ducts. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chap 146.

Mwenje LW. Chiropa: kwete-neoplastic zvirwere. Mune: Goldblum JR, Mwenje LW, McKenney JK, Myers JL, eds. Rosai naAckerman's Surgical Pathology. 11th ed. Philadelphia, PA: Elsevier; 2018: chitsiko 19.

Smith A, Baumgartner K, Bositis C. Cirrhosis: kuongororwa uye manejimendi. Ndiri Chiremba weNzara. 2019; 100 (12): 759-770. PMID: 31845776 pubed.ncbi.nlm.nih.gov/31845776/.