Antiphospholipid chirwere - APS

Antiphospholipid syndrome (APS) chirwere che autoimmune chinosanganisira kuwanda kweropa (thromboses)Paunenge uine mamiriro aya, immune system yako inogadzira zvisina kujairika mapuroteni anorwisa masero eropa uye mutsetse wetsinga dzeropa. Kuvapo kwema antibodies aya kunogona kukonzera matambudziko nekuyerera kweropa uye kunotungamira kune ane ngozi clots mumidzi yeropa mumuviri wese.

Icho chaicho chikonzero cheAPS hachizivikanwe. Ose maviri mamwe majini shanduko uye zvimwe zvinhu (senge hutachiona) zvinogona kukonzera dambudziko kukura.

Iyo inowanzo kuwanikwa muvanhu vane zvimwe autoimmune hosha, senge systemic lupus erythematosus (SLE). Mamiriro acho akajairika vakadzi kupfuura varume, Inowanzo kuwanikwa mumadzimai ane nhoroondo yekudzokororwa miscarriage.

Vamwe vanhu vanotakura masoja ekudzivirira chirwere ataurwa pamusoro, asi havana APS. Zvimwe zvinokonzeresa zvinogona kukonzera kuti vanhu ava vave neropa, kusanganisira:

• Kusvuta
• Kurara kwenguva refu kwemubhedha
• Kubata pamuviri
• Hormone therapy kana mapiritsi ekudzivirira kubereka
• Gomarara
• Chirwere cheitsvo

Iwe unogona kunge usina chero zviratidzo, kunyangwe uine ma antibodies. Zviratidzo zvinogona kuitika zvinosanganisira:

• Ropa rinovhara mumakumbo, maoko kana mapapu. Mavhinga anogona kunge ari mutsinga kana mutsinga.
• Kudzokororazve kusabatika kana achiri kuzvara.
• Rash, mune vamwe vanhu.

Muzviitiko zvisingawanzoitika, kugwinha kunoerekana kwakura mune tsinga zhinji mukati memazuva. Izvi zvinonzi zvine njodzi anti-phospholipid syndrome (CAPS). Zvinogona kutungamira mukurohwa pamwe nekugwamba kweitsvo, chiropa, nedzimwe nhengo mumuviri wese, uye nekukuvara mumakumbo.

Kuyedzwa kweiyo lupus anticoagulant uye antiphospholipid antibodies inogona kuitwa kana:

• Ropa risingatarisirike rinoitika, senge mune vechidiki kana avo vasina zvimwe zvinenjodzi zvekuvhara ropa.
• Mukadzi ane nhoroondo yekudzokorora kubata pamuviri kurasikirwa.

Iyo lupus anticoagulant bvunzo ndeyekuvhara kweropa bvunzo. Iyo antiphospholipid antibodies (aPL) inokonzeresa kuti muyedzo uve usina kujairika murabhoritari.

Mhando dzekuvhara miedzo dzinogona kusanganisira:

• Yakagadziriswa chikamu chetromboplastin nguva (aPTT)
• Russell viper uturu nguva
• Thromboplastin inhibition bvunzo

Kuedzwa kweantiphospholipid antibodies (aPL) kuchaitwa zvakare. Zvinosanganisira:

• Anticardiolipin antibody bvunzo
• Antibodies kune beta-2-glypoprotein I (Beta2-GPI)

Anokuchengetedza hutano anozoongorora antiphospholipid antibody syndrome (APS) kana uine bvunzo yakanaka yePL kana lupus anticoagulant, uye chimwe kana zvimwe zvezviitiko zvinotevera.

• Ropa rakavhara
• Kudzokororwa kwepamuviri

Iyo miedzo yakanaka inoda kusimbiswa mushure memasvondo gumi nemaviri. Kana iwe uine bvunzo yakanaka pasina zvimwe zvechirwere, hauzove nekuongororwa kweAPS.

Kurapa kweAPS kunoitirwa kudzivirira kusagadzikana kubva kune matsva eropa kuumbana kana kuvapo kwamagodo kuriko kukura. Iwe unozofanirwa kutora imwe nzira yekurapa-kutapudza mushonga. Kana iwe zvakare uine autoimmune chirwere, senge lupus, iwe uchafanirwa kuchengetedza iwo mamiriro ari pasi pekutonga futi.

Kurapa chaiko kunoenderana nekuti mamiriro ako akaoma sei uye matambudziko airi kukonzera.

ANTIPHOSPHOLIPID ANTIBODY SYNDROME (APS)

Kazhinji, iwe uchazoda kurapwa neropa rakatetepa kwenguva yakareba kana uine APS. Pakutanga kurapwa kunogona kuva heparin. Iyi mishonga inopihwa jekiseni.

Muzviitiko zvakawanda, warfarin (Coumadin), iyo inopihwa nemuromo, inotangwa. Izvo zvinodikanwa kuti ugare uchitarisa padanho reanticoagulation. Izvi zvinowanzoitwa uchishandisa iyo INR bvunzo.

Kana iwe uine APS uye ukava nepamuviri, iwe unozofanirwa kuteedzerwa padyo nemupi mupi ari nyanzvi mune ino mamiriro. Iwe hautore warfarin panguva yekuzvitakura, asi uchapihwa heparin shots pachinzvimbo.

Kana uine SLE uye APS, mupi wako anokurudzirawo kuti utore hydroxychloroquine.

Parizvino, mamwe marudzi emishonga yekuonda ropa haakurudzirwe.

CATASTROPHIC ANTIPHOSPHOLIPID SYNDROME (CAPS)

Kurapa kweCAPS kunosanganisira mubatanidzwa weanticoagulation therapy, yakakwira doses yecorticosteroids, uye kuchinjana kweplasma kwave kushanda muvanhu vazhinji. Dzimwe nguva IVIG, rituximab kana eculizumab inoshandiswawo kumatambudziko akakomba.

POSITIVE TEST YEKUPUSA ANTICOAGULANT KANA APL

Hauzodi kurapwa kana usina zviratidzo, kurasikirwa nepamuviri, kana kana usati wambove neropa.

Tora matanho anotevera ekubatsira kudzivirira kugwamba kweropa kubva pakuumba:

• Dzivisa mazhinji mapiritsi ekudzivirira kubereka kana ekurapa mahormone ekuguma kuenda kumwedzi (vakadzi).
• Usasvuta kana kushandisa zvimwe zvigadzirwa zvefodya.
• Simuka ufambe-fambe panguva dzendege refu kana dzimwe nguva kana uchifanira kugara kana kurara pasi kwenguva yakareba.
• Fambisa makumbo ako kumusoro uye pasi apo iwe usingakwanise kufamba-famba.

Iwe unozonyorerwa mishonga-yekuchekerera ropa (senge heparin uye warfarin) kubatsira kudzivirira kugwamba kweropa:

• Mushure mekuvhiyiwa
• Mushure mekupunzika kwepfupa
• Nekenza inoshanda
• Paunenge uchida kugara kana kurara pasi kwenguva yakareba, senge panguva yekugara muchipatara kana kupora uri kumba

Iwe unogona zvakare kutora ropa rakaonda kwemavhiki matatu kusvika mana mushure mekuvhiyiwa kudzikisa njodzi yako yekugwamba kweropa.

Pasina kurapwa, vanhu vane APS vanozove nekudzokorora kugwamba. Kazhinji yenguva, mhedzisiro yakanaka nekurapwa kwakakodzera, uko kunosanganisira kwenguva refu kurapwa kweanticoagulation. Vamwe vanhu vanogona kunge vakagwamba ropa iro rakaoma kudzora kunyangwe marapirwo. Izvi zvinogona kutungamira kuCAPS, inogona kutyisidzira hupenyu.

Fonera waunopa kana iwe ukaona zviratidzo zveropa, zvakadai se:

• Kuzvimba kana kutsvuka mugumbo
• Kufema kwekufema
• Marwadzo, chiveve, uye rakachenuruka ganda ruvara muruoko kana gumbo

Uyezve taura nemupi wako kana iwe wakadzokororazve kurasikirwa nepamuviri (kusununguka).

Anticardiolipin antibodies; Hughes chirwere

• Systemic lupus erythematosus kuputika kumeso
• Ropa rinovhara

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Dufrost V, Risse J, Wahl D, Zuily S. Direct anticoagulants anoshandiswa muantiphospholipid syndrome: mishonga iyi inzira inoshanda uye yakachengeteka kune warfarin? Kuongorora kwakarongeka kwemabhuku: mhinduro yekutaura. Curr Rheumatol Mumiriri. 2017; 19 (8): 52. PMID: 28741234 www.ncbi.nlm.nih.gov/pubmed/28741234.

Erkan D, Salmon JE, Lockshin MD. Anti-phospholipid chirwere. Mune: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, eds. Kelley uye Firestein's Bhuku reRheumatology. 10th ed. Philadelphia, PA: Elsevier; 2017: chits. 82.

National Moyo, Lung, uye Ropa Institute webhusaiti. Antiphospholipid antibody chirwere. www.nhlbi.nih.gov/health-topics/antiphospholipid-antibody-syndrome. Yakasvika munaJune 5, 2019.