Chiropa Fibrosis

Zvemukati

• Ndeapi matanho echiropa fibrosis?
• Ndezvipi zviratidzo zvechiropa fibrosis?
• Ndezvipi zvikonzero zvechiropa fibrosis?
• Kurapa nzira
• Kuongorora
• Chiropa biopsy
• Yechinguva elastography
• Miedzo yekuvhiya
• Matambudziko
• Outlook

Mhedziso

Chiropa fibrosis inoitika kana hutano hwechiropa chako hwave neronda uye nekudaro haugone kushanda futi. Fibrosis ndiyo yekutanga nhanho yekushaiwa kwechiropa. Gare gare, kana yakawanda chiropa ikava nemavanga, inozivikanwa sechiropa cirrhosis.

Nepo zvimwe zvidzidzo zvemhuka zvakaratidza kugona kwechiropa kuti zvimutsiridze kana kuzvirapa, kana kukuvara kwechiropa kwaitwa muvanhu, chiropa hachiwanzo kupora. Zvisinei, mishonga uye mararamiro ehupenyu anogona kubatsira kuchengetedza fibrosis kubva pakuwedzera.

Ndeapi matanho echiropa fibrosis?

Pane zviyero zvakasiyana zvechiropa fibrosis staging, uko chiremba anoona mwero wekukuvara kwechiropa. Sezvo danho rinogona kuve rekuzviisa pasi, chiyero chimwe nechimwe chine zvadzinogumira. Mumwe chiremba anogona kufunga kuti chiropa chakati pfuurei zvishoma mavanga pane mumwe. Zvisinei, vanachiremba vanowanzo kupa danho kune chiropa fibrosis nekuti inobatsira murwere nevamwe vanachiremba kuti vanzwisise danho iro iro chiropa chemunhu chinokanganiswa.

Imwe yeanonyanya kuzivikanwa masystem masisitimu ndiyo METAVIR yekugaya system. Iyi sisitimu inopa mamaki e "chiitiko" kana fungidziro yekuti fibrosis iri kufambira mberi sei, uye nezinga reiyo fibrosis pachayo. Vanachiremba vanowanzo gadza uyu mamakisi mushure mekutora biopsy kana tishu sampu yechimedu chechiropa. Iwo mamakisi emabasa anotangira kubva kuA0 kusvika kuA3:

• A0: hapana chiitiko
• A1: zvinyoro basa
• A2: zvine mwero chiitiko
• A3: kuita kwakakomba

Iwo mafirosi echikamu anotangira paF0 kusvika F4:

• F0: hapana fibrosis
• F1: portal fibrosis isina septa
• F2: portal fibrosis ine mashoma septa
• F3: yakawanda septa isina cirrhosis
• F4: cirrhosis

Naizvozvo, munhu ane chirwere chakakomba fomu angave aine A3, F4 METAVIR mamaki.

Imwe yekumisikidza masisitimu maBatts naLudwig, ayo anopasa fibrosis pachiyero chegiredhi 1 kusvika giredhi 4, negiredhi rechina riri iro rakanyanya. Sangano reInternational Association reChidzidzo cheRopa (IASL) zvakare rine zviyero zvine zvikamu zvina zvinotangira kubva kushoma hepatitis kusingaperi kusvika kune yakakomba hepatitis.

Ndezvipi zviratidzo zvechiropa fibrosis?

Vanachiremba havawanzo kuongorora chiropa fibrosis mumatanho ayo akapfava kusvika pakati nepakati. Izvi zvinodaro nekuti chiropa fibrosis haiwanzo kukonzera zviratidzo kudzamara chiropa chakakuvara.

Kana munhu achifambira mberi muchirwere chechiropa, vanogona kuona zviratidzo zvinosanganisira:

• kuda kudya
• kunetseka kufunga zvakajeka
• mvura inovaka mumakumbo kana mudumbu
• jaundice (uko ganda nemeso zvinoita kunge yero)
• kusvotwa
• kusanzwisisika kuonda
• kushaya simba

Zvinoenderana nea, inofungidzirwa kuti 6 kusvika ku7 muzana yevagari vepasi rose vane chiropa fibrosis uye havazvizive nekuti havana zviratidzo.

Ndezvipi zvikonzero zvechiropa fibrosis?

Chiropa fibrosis inoitika mushure mekunge munhu aona kukuvara kana kuzvimba muchiropa. Masero echiropa anoita kuti ronda ripore. Munguva yekurapa uku kwekukuvara, mapuroteni akawandisa akadai seclagen uye glycoprotein anovaka muropa. Pakupedzisira, mushure mezviitiko zvakawanda zvekugadzirisa, masero echiropa (anozivikanwa se hepatocytes) haachakwanise kuzvigadzirisa. Mapuroteni akawandisa anoumba vanga kana kuti fibrosis.

Mhando dzinoverengeka dzechiropa hosha dziripo dzinogona kukonzera fibrosis. Izvi zvinosanganisira:

• autoimmune hepatitis
• biliary mhingaidzo
• iron kuwandisa
• nonalcoholic fatty chiropa chirwere, izvo zvinosanganisira nonalcoholic mafuta chiropa (NAFL) uye nonalcoholic steatohepatitis (NASH)
• hutachiona hepatitis B uye C
• chinodhakwa chiropa chirwere

Zvinoenderana nechikonzero chinonyanya kukosha chechiropa fibrosis chisiri chakakora mafuta chirwere chechiropa (NAFLD), nepo chechipiri chiri chirwere chechiropa chinodhakwa nekuda kwekuwedzeredza kwenguva refu kwekunwa doro.

Kurapa nzira

Kurapa sarudzo yechiropa fibrosis kazhinji kunoenderana nechikonzero chinokonzera iyo fibrosis. Chiremba acharapa chirwere chiri pasi, kana zvichibvira, kudzikisa zvinokonzereswa nechiropa chirwere. Semuenzaniso, kana munhu achinwa doro zvakanyanyisa, chiremba anogona kukurudzira chirongwa chekurapa kuti chimubatsire kurega kunwa. Kana munhu aine NAFLD, chiremba anogona kukurudzira kuita dhayeti shanduko kuti uderedze huremu uye kutora mishonga yekusimudzira nani kudzora shuga muropa. Kuita maekisesaizi uye kudzikira huremu kunogona kubatsirawo kuderedza kufambira mberi kwechirwere.

Chiremba anogona zvakare kupa mishonga inozivikanwa seantifibrotics, iyo yakaratidzirwa kudzikisa mukana wekuti chironda chechiropa chichaitika. Iyo antifibrotic yakatemwa kazhinji inoenderana neari pasi pehutano mamiriro. Mienzaniso yekurapa uku inosanganisira:

• chisingaperi chirwere chechiropa: ACE inhibitors, senge benazepril, Lisinopril, uye ramipril
• Hepatitis C hutachiona: a-Tocopherol kana interferon-alpha
• nonalcoholic steatohepatitis: PPAR-alpha agonist

Nepo vatsvagiri vari kuitisa bvunzo dzakawanda kuyedza kutsvaga mishonga inogona kudzosera kumashure maitiro echiropa fibrosis, hapana mimwe mishonga inogona kuita izvi parizvino.

Kana chiropa chemunhu chiropa chichifambira kune uko chiropa chavo chine mavanga uye chisingashande, kurapwa chete kwemunhu kunowanzo gashira chiropa. Nekudaro, iyo yekumirira rondedzero yakareba kune aya ekuisa mhando uye kwete munhu wese munhu ari wekuvhiya mumiriri.

Kuongorora

Chiropa biopsy

Pachivanhu, vanachiremba vakafunga kutora chiropa biopsy iyo "goridhe standard" yekuyedza chiropa fibrosis. Iyi ndiyo nzira yekuvhiya uko chiremba aigona kutora sampu yeshuga. Nyanzvi inozivikanwa sehutachiona ichaongorora zvinyama zvekuvapo kwekushaiwa kana fibrosis.

Yechinguva elastography

Imwe sarudzo muyedzo wekufungidzira unozivikanwa seinononoka elastography. Uyu ndiwo muyedzo unoyera kuti chiropa chakaomarara sei. Kana munhu aine chiropa fibrosis, maseru ane mavanga anoita kuti chiropa chiome. Bvunzo iyi inoshandisa yakaderera-frequency ruzha mafungu kuyera kuti yakaoma sei chiropa tishu iri. Zvisinei, zvinokwanisika kuva nezvakanaka zvenhema apo chiropa chechiropa chinogona kuoneka chakaomarara, asi biopsy hairatidze chironda chekutsva.

Miedzo yekuvhiya

Zvisinei, vanachiremba vakakwanisa kushandisa mimwe bvunzo isingade kuvhiyiwa kuti vaone mukana wekuti munhu angave ane chiropa fibrosis. Aya maedzo eropa anowanzo chengeterwa avo vane inozivikanwa isingaperi hepatitis C hutachiona avo vanowanzo kuve nechiropa fibrosis nekuda kwechirwere chavo. Mienzaniso inosanganisira serum hyaluronate, matrix metalloproteinase-1 (MMP), uye tishu inhibitor yematrix metalloproteinase-1 (TIMP-1).

Vanachiremba vanogona zvakare kushandisa bvunzo dzinoda kuverenga, senge aminotransferase-to-platelet ratio (APRI) kana kuongororwa kweropa kunonzi FibroSURE iyo inoyera zviyero zvitanhatu zvakasiyana zvechiropa uye inozviisa mune algorithm isati yapa mamaki. Nekudaro, chiremba haagone kusarudza danho rechiropa fibrosis zvichibva pane bvunzo idzi.

Sezvineiwo, chiremba anozoongorora munhu ane chiropa fibrosis panguva yekutanga apo mamiriro acho ari kurapwa. Zvisinei, nekuti mamiriro acho haawanzo kukonzera zviratidzo mumatanho ekutanga, vanachiremba havawanzo kuongorora mamiriro acho pakutanga.

Matambudziko

Chinhu chinonyanya kukosha chechiropa fibrosis chinogona kunge chiri chiropa cirrhosis, kana kukuvara kwakakomba kunoita kuti chiropa chikanganisike munhu achazorwara. Kazhinji, izvi zvinotora nguva yakareba kuti zviitike, senge pamusoro peyaka rimwe chete kana makumi maviri emakore.

Munhu anoda chiropa chake kuti chirarame nekuti chiropa chine basa rekusefa zvinhu zvinokuvadza muropa uye kuita mamwe mabasa mazhinji akakosha mumuviri. Pakupedzisira, kana munhu fibrosis ikafambira mberi ichiita cirrhosis uye kutadza kwechiropa, vanogona kuve nematambudziko akadai se:

• ascites (yakasimba buildup yemvura mudumbu)
• hepatic encephalopathy (kuwanda kwemarara zvigadzirwa zvinokanganisa kuvhiringidzika)
• hepatorenal chirwere
• portal hypertension
• variceal kubuda ropa

Imwe yeaya mamiriro anogona kuuraya munhu ane chirwere chechiropa.

Outlook

Sekureva kwa, chiropa cirrhosis ndechimwe chezvikonzero zvinouraya pasi rese. Naizvozvo, zvakakosha kuti munhu aonekwe uye arapwe chiropa fibrosis nekukurumidza sezvinobvira isati yafambira mberi kuchiropa cirrhosis. Nekuti chiropa fibrosis hachiwanzo kukonzera zviratidzo, izvi zvakaoma kuita. Dzimwe nguva vanachiremba vanofanirwa kufunga nezve njodzi dzemunhu, dzakadai sekurema zvakanyanya kana chidhakwa, pakuongorora fibrosis uye kukurudzira kurapwa.