Pemphigus vulgaris: zvinokonzera, zviratidzo, kurapwa, kurapwa. autoimmune zvirwere

chirwere chakadai sei, zvakadai pemphigus? Treatment uye zviratidzo chirwere ichi vari inokurukurwa pazasi. Uchadzidzawo pamusoro zvinokonzera ichi chirwere kwacho uye sei kuongorora chirwere chake.

chikuru mashoko

Pemphigus, pikicha iri munyaya ino, - boka chisingawanzowaniki asi zvikuru kwazvo, vanotsungirira uye zvinogona dzinouraya vesiculobullous autoimmune nezvirwere chokuita ganda uye mucous membranes.

Nyanzvi ziva zvinotevera mhando chirwere:

• pemphigus vulgaris;
• vegetans chimiro;
• mashizha;
• seborrhoeic (vangava mazita akadai Shenir-Usher urwere, kana erythematous).

General zvechadenga chirwere

Pemphigus vulgaris anomirira chikamu zvirwere ganda uye subcutaneous rinenge inoyerera muna chirwere chimiro, pamwe kakawanda zvazvo.

chirwere ichi ndicho kemikari zvaanoda. It kunoratidzwa mberi Chokwadi, uyewo paumbwe intraepidermal Maronda akasiyana.

Kakawanda, pemphigus vulgaris inobata vanhu vakwegura kwemakore 50 kana kupfuura.

Nei chirwere ichi chinoitika? Zvikonzero kukura chirwere ichi, pane chete hypotheses.

Pemphigus: asi ungangotarisa zvikonzero

Asati kurapwa, chirwere mu mubvunzo unokosha chaizvo kuziva nei chiri chirwere autoimmune akasimuka imwe murwere. Zvinosuruvarisa, kuwana mhosva pemphigus kwakaoma. Nyanzvi dziri kutambura dambudziko iri kwemakumi akawanda emakore. Panguva ino vakaisa mberi pfungwa:

• Exogenous zvinhu, kureva vachitora mishonga, kusanganisira kuti penicillin nezvinogadzirwa nomukaka, uye mainterferon siyana uye zvimwe zvinhu.
• Endogenous zvinhu, kusanganisira zvirwere uye magene.
• Physical zvinhu (anogona kungowira vakagamuchira akakura kutsva uye nemwaranzi).
• Kwemakemikari anobudiswa (semuenzaniso hormone kukundikana muvanhu).
• Nemavhairasi (Herpesviruses).
• Kutora zvimwe zvokudya.

Kubva pane izvi, nokutsanangura fungidzira panowanikwa chirwere, tingati: pemphigus vulgaris kunogona immunological, kwemakemikari anobudiswa, chirwere, neurogenic, chepfu, etc. Zvisinei, zvinofanira kucherechedzwa kuti pachine zvisingazivikanwi kana kuchinja kwakadaro chikuru kana twavanopfeka .. yechipiri hunhu, mukupindura zvinokonzera.

Saka, nekusagona kuziva chaiyo mhaka vaiona autoimmune chirwere yekudyidzana kunokanganisa yayo yakakodzera nechirwere, saka kakawanda vanhu vakawanda kuva zvakakomba matambudziko.

nucleation mashandiro

Sei kukura zvirwere zvakadai, zvakadai pemphigus? Photo kutanga pavaipfuura chirwere, unogona kuona munyaya ino. Nyanzvi dzinoti mhaka dzakadaro pathologic autoaggressive zvinoitawo paumbwe antibodies kuti mapuroteni vechigaro mhuri desmoglein. Ekupedzisira vanomiririra vorudzii "guruu" vari kubatana pedyo epidermal masero Via unobatanidza anokosha okunze, makatumidzwa desmosomes.

Kamwe kusashanda lymphocytes uye autoantibodies akarwisa desmogleins, masero epidermal vanoparadzaniswa mumwe, uye Epiderme e anova porous uye "pasted", nokudaro nyore akasvuura kure uye pasi kupinda pakati notumwe siyana uye utachiona. In kurapwa tsika, chiitiko ichi anonzi acantholysis.

Somugumisiro pamusoro muitiro murwere ane Maronda akasiyana paganda, uyewo Ukobvu. Panguva iyoyo vari vakazadzwa exudate uye kuramba akaora. Nokufamba kwenguva, mashoko matema vari akasvuura akabviswa machira, achifumura zvinyama nokuita pus uye kutapukirwa maronda. In yepamusoro nguva inotungamirwa kwakadaro rifukidze substantially pepasi muviri.

nhoroondo mashoko

Aimbova dermatological chirwere nyanzvi havazivi zvinenge chinhu. Shoko rokuti "pemphigus" kushandisirwa maronda ose mucous uye ganda, achiperekedzwa acantholysis, inotungamirwa matema uye yokuzviparadzanisa pakati machira kuti chitange suppurating maronda. Zvisinei, muna 1964 imwe nyaya yakabudiswa mumagazini yokurapa, rakachinja kunzwisisa vanachiremba pamusoro zvirwere mubvunzo, uyewo ayo nzira chirwere uye kurapwa. Kubvira panguva iyoyo, kuvapo antibodies vari plasma wevarwere kuti desmogleina kuva chokuratidza chikuru nokuda kuziva pemphigus.

Panzira, muna 1971 akabudisa rimwe nyaya umo autoimmune zvakaita kuongororwa zvakadzama uye mashandiro okukura chirwere ichi.

Huru Zviratidzo

Maronda akasiyana paganda, kunobva pave anonyadzisira kana nevakawanda bladderwort, inomirira chiratidzo chirwere rokutanga. Zvinofanira kucherechedzwa kuti ichi Chirwere kunoitika kakawanda. Maererano nenyanzvi, nezvokuvandudzika 77% vose dzakaonekwa siyana pemphigus.

Maronda muchimiro matema kukanganisa ganda murwere, asiwo mucosa mumuromo uye pahuro wayo. Gare gare vakawaridza pamusoro muzvidimbu zvokunze sikarudzi, chiso uye zvichingodaro.

Zvaunofanira kuziva pamusoro zvirwere izvi ganda? Kazhinji, pemphigus hwapedyo pakarepo. Nokudaro musi ganda utano kunze kuumbwa zviduku matema kusawirirana kuti ane kuti munhu nokukurumidza fuma flaccid chitarisiko. Zviri yavo segirazi serous mvura (zvishoma turbid).

Mushure nokuvhura papules kuumbwa kwakakanganisa pamusoro, vakazochinja kuporesa, asi kusiya tichingoda pigmentation dzebhurauni.

Nokuti akadaro autoimmune chirwere dzinoratidzwa kwazvo chisingaperi chokubuda chimiro. Zvinofanira kucherechedzwa kuti vamwe vanhu pasina kurapwa yaiitwa vaingoerekana kuvandudzika, iyo yakatsiviwa kusembura.

Kakawanda akaperekedza pemphigus vulgaris yechipiri zvirwere (candidiasis).

Nokuda puroteni kurasikirwa, zvinwiwa uye zvirwere zvinokonzerwa fungidziro chirwere ichi zvakaoma. siyana zvisingafadzi..

Kuziva chirwere

Rinotaurwa pemphigus vulgaris? Chirwere chirwere rinoitwa muchipatara. Kuvapo maperembudzi dzakaonekwa yakavakirwa kurapwa zviratidzo uye migumisiro Analyses.

Aimbova dzinosanganisira:

• A chiratidzo asbestos-Hansen. Nyaya iyi iri dzakaonekwa nokutsikirira munhu munwe kana ari pabutiro girazi (i.e., dzisati dzasvika) sefuro. nzira kwakadaro hwezvekukurukurirana yokuzviparadzanisa zviri Epiderme e munharaunda iri yakabatana papules, uyewo kuwedzera munzvimbo yayo nokuda mvura kumanikidzwa mukati chikwata.
• Chiratidzo Nikolsky. Nyaya iyi iri dzakaonekwa mu rouchenjeri entrainment zvidimbu navo forceps uye vachidzipukuta munhu munwe mugove kunze sanganisika ganda pedyo lesion nzvimbo. Saka pane yokuzviparadzanisa pakati Epiderme e.

Zvinofanira kucherechedzwa kuti anonyadzisira pemphigus zviratidzo izvi hazvisi zvakananga, uye Diagnostics. Zvinofanira kurangarirwa kuti kuratidzwa kwakadaro kunogona kuitika mune dzimwe zvirwere.

rabhoritari miedzo

Sei chirwere pemphigus vulgaris? Mabatirwo autoimmune chirwere yaifanira chete mushure kuongorora zvokurapa. Kuziva akadaro chirwere rinoshandiswa:

• Histological pachisara inosanganisira kuongorora smears, kana anonzi fingapurindi kuziva matema masero acantholytic (kureva, masero epidermal kuti inini morphological kuchinja).

Zvinofanira kucherechedzwa kuti nemhaka histological kuongorora mashoko kugumisa kuti kukura autoimmune chirwere hazvibviri. Izvi imhaka yokuti pane zvimwe zvirwere ane zvakafanana mufananidzo.

• Immunofluorescence nzira kuziva intracellular deposits ose immunoglobulin G uye A, uyewo kuziva Pamwero maantigen - desmoglein 3 uye desmoglein-1. Nzira iyi ndiyo yakarurama zvikuru zvawanikwa.

Saka, nechirwere "pemphigus anonyadzisira 'anoiswa kwakavakirwa tinofanira kugara Data kunotoda kurapwa zviratidzo uye kurapwa mufananidzo chirwere uye migumisiro immunofluorescence unyanzvi uye histologic kuzviongorora.

mabatiro

Pakutanga kukura pemphigus vulgaris varwere ushandiswe glucocorticoids. Zvinodhaka mune boka iri wakagamuchira nehana mishonga. Kugadzwa mushonga akawanda dzinokosha uchapupu. Panyaya contraindications uye marwadzo, vane yechipiri.

Zvakadini kana hosha iri mubvunzo varayire glucocorticoids? Kugadzirira pakurapa anonyadzisira puzyrchaki angava sezvinotevera: "Prednisolone" "Dexamethasone" uye "Triamptsinolon".

Kamwe uvandudze murwere, i.e. pasina matema idzva, dose mishonga ipfupi zvishoma nezvishoma uye anozunungusa kutsigira kuitira kudzivirira dzokororo. kurapwa kwakadaro wevarwere refu zvakakwana.

Kunze glucocorticoids, varwere vanogona kunan'anura cytotoxic vamiririri, immunosuppressants, kusanganisira "Methotrexate", "Azathioprine" kana "Prospidin". Ndivo zvakakodzera kubvisa matambudziko nenjodzi pashure ingestion mishonga inokosha.

Other kurapwa nzira

Kana zvichiratidza kuti autoimmune chirwere varwere vanogona kubatwa nemishonga, uye zvinodhaka kuti dzinotsigira kumwoyo, yokudzora BP uye normalize kushanda chiropa uye neitsvo.

Also zvaida kudya kuti potassium tubhokisi nevasori, calcium mavhitaminzi. Nokuti kukamura uchishandisa dambudziko pemphigus Anti-anogumbura zvinodhaka, infusions uye decoctions wemiriwo zvinogona kushandiswa.

Zvinofanira kucherechedzwa kuti, zvichienderana ezvinhu omurwere zvinogona kupiwa nzira dzakadai gemabsorbtsiya, kuisira ropa uye plasmapheresis.