Tubulointerstitial nephritis, chenjera uye chisingaperi nezvimiro: Zviratidzo, Zvinokonzera neMarapirwo

Tubulointerstitial nephritis ndezvaJehovha zvakajairika cheitsvo uye maronda migero kunotungamirira Kuipa nhego chaitika. The chirwere kunoratidzwa zvakawanda zvachinja sechivako interstitial itsvo tishu. Pane akasiyana mbiri chirwere - chakasimba uye refu. In kuraira mishonga zhinji vachiuya muviri, rinotaurwa kuti zvinodhaka yakapedza vachishandisa neitsvo. Uye kufunga kusingadzoreki kugamuchira mishonga kukonzera chirwere nokuda imwe chisimbwa dzimwe mishonga kana mishonga kurapa. The chirwere zvakare kunoitika Somugumisiro vakatamira hutachiona.

Kuziva tubulointerstitial nephritis, kushandiswa ano tsvakurudzo unyanzvi muviri, kureva, Ultrasound, weti uye kuongorora ropa, zvokurapa nhoroondo Data muThe itsvo biopsy. Mhedziso pamusoro reversibility chirwere anobva kwokuomerwa akatyoka uye nguva ichaitika kutsvaka rubatsiro.

The zvinokonzera chirwere

Dzimwe nguva womuchato inorwisa mabhakitiriya kana zvimwe Anti-anogumbura zvinodhaka rwakaramba kwenguva refu. Uye kukuvara itsvo kunoitika pashure simba namakemikari chepfu, inorema simbi. Kunyanya kurwadza vari panyaya iyi mhute. Tubulointerstitial nephritis anogona kuitika nokuda zvakawanda:

• pashure kuwana akabatwa chirwere - muna 46% nyaya;
• chepfu kuratidzwa vanotsamwisa sema chirwere muna 28.3%;
• metabolic zvirwere mumuviri pave panowanikwa chirwere muna 13.9%;
• kusagadzikana kweropa mashandiro ureters - 8.8%;
• majini anokonzera uye masoja - 0,9% of chirwere;
• zvikonzero zvinoverengeka panguva akambotaura muna 2,5% nyaya.

Chirwere marudzi chirwere zvinokonzerwa zvakakomba kutyorwa kuvimbika cytomembranes, renal dysplasia rinenge metabolic kuchinja, vachiberekwa anomalies uye vawana ureters.

kuongorora chirwere

It aidzidza nhamba yezvidzidzo mumuviri uye mumarabhoritari hunhu. Uye chete ipapo nechirwere yakarurama. Tubulointerstitial nephritis inotarisirwa mune murwere chete kwaita upenyu zviratidzo vari panoonekwa vakaparadzana kuratidzwa chaiko.

vanhu chirwere yezvakaita chirwere ndiwo mugumisiro infiltration uye atrophy pakati migero mumuviri womunhu kwenguva refu. Nhengo basa hwakaipa zvishoma nezvishoma - pamusoro akawanda. Murwere anoenda chiremba kana paine vatarisane zviratidzo, zvakadai kurwadziwa itsvo, ganda rashes, uye vamwe. Ivo Akamusunungura chinokosha kusanzwa. Chirwere inobata chete maviri kana itsvo kukuvara oga.

Murabhoritari kudzidza, weti uric zvakajeka zvinoonekwa precipitate rurefu zviri erythrocytes uye leukocytes. Panguva iyo pane asipo rakakwana erythrocytes dismorfnogo mhando uye chete kuratidzwa duku hematuria. Kuvapo eosinophils iri weti haina dzinoratidzwa pamberi chirwere, sezvo chete 50% nyaya ndivo mugumisiro chirwere. Kana havapo pane zvose, zvino iyi kunoratidza kuti chirwere vasipo. Proteinuria padzakacherechedza Minimum chaitwa, asi kana muviri akatotanga dzakabudirira glomerular zvokurwara kunokonzerwa nokushandisa nemishonga, nepo nhamba iyi inosvika nephrotic chechetere.

Mune Kuongororwa kweropa chakasimba tubulointerstitial nephritis hworatidza pacharo hypercalcemia. Zvaipesana mugero basa kutungamirira metabolic acidosis. Kana Ultrasound ichiwedzerwa zvazvingava echogenicity zvikuru pamusana muviri kuzvimba uye infiltration rikurumidze. US inoratidza kuwedzera itsvo kukura kuwedzera indekisi radioactive gallium uye leukocytes vakanyorwa panguva radionuclides. A yakanaka Ongororo mugumisiro anoratidza tubulointerstitial nephritis. Diagnostics, akaratidza akaipa mugumisiro, dzimwe nzira inofanira inopiwa.

symptomatology chirwere

Mukutanga nzendo chirwere vasina zviratidzo. Vamwe varwere havazivi kukura zvokurwara. The akazotevera zvokukura kosi chirwere ane nomugumisiro kuratidza zvinhu:

• rashes kuoneka zvisina kukwana kana pamusoro pepasi muviri vakatakura unhu kuvaviwa;
• kuwedzera duku tembiricha chikuva, zvikuru nyaya anozivikanwa fivha;
• kurwadziwa itsvo Runonzwika kuramba kana kakawanda kupfuura kurwisa;
• yakawedzera kuneta, murwere anonzwa hope mabhanzi;
• kumanikidzwa RINOFAMBIRA kuitika pasina chikonzero;
• pane polyuria.

kuratidzwa dzakawanda dzakasiyana akacherekedza tubulointerstitial nephritis. Zviratidzo vakachengeta muchimiro nefivha uye mapundu, asi vamwe ndachinja muviri hadzikwani nokuda kuongorora chirwere. The mapundu kunoitika mwedzi mumwe pashure Zvakaitwa toxin kana mazuva 3-6. Izvi zvinoenderana mamiriro nhengo wayo pakupindurwa allergen. Nemuumbi uremu, marwadzo mudumbu uye shure pamusoro magaro.

The chirwere, ndokupfuura mune chirwere danho, zvakasiyana pane nguva nyoro zviratidzo, kunosimbisa pamwe nguva. Vamwe vanhu kuva polyuria uye nocturia. BP uye mumatenhere makumbo zvinochengetwa chero kusvikira yava renal kukundikana. Zviratidzo inorondedzerwa pamazita, muri chakanangana rikwanise pavaipfuura chirwere.

brightism

The chirwere inova chisingaperi mushure rikwanise kosi. Asi zviitiko zvakadaro hadziwanzowaniki. Kakawanda, chisingaperi nephritis kuva pashure achirapwa utachiona, kuramba metabolic zvirwere mumuviri, nguva nemishonga kudhaka. Tubuloinsterstitsialnye chirwere nephritis pamusoro Ultrasound akaratidza glomeruli chaiye ezvinhu kana kuparadzwa. Tubules hatisi zvachose kana akaremara. Notes akasiyana Makwanza ose channel - kubva kujekesa kuti rakafara homogeneous membranes.

Renal zvinyama zviri kubatwa fibrosis uye kuzvimba. Kana dzakawanda fibrosis vasipo, ari parenchyma anotarisa anenge utano. Atrophied itsvo duku ukuru uye nezviratidzo asymmetry. Zviratidzo echirwere nephritis yakafanana neiya anowanika mune rikwanise danho, asi vane kuratidzwa zvishoma yakajeka. Leukocytosis ikawanda erythrocytes hadziwanzowaniki. Chirwere nzira hosha iri ngozi zvikuru, saka unofanira kuteerera zviratidzo mukutanga nzendo chirwere. Pokumbononotswa mabatiro kukonzera itsvo kukundikana, izvo hwakazara taisireva.

The chenjera weboka chirwere

Kazhinji kunoitika nokuda kukodzera dzokuzvirapa pasina kubvunza chiremba wako. Nekusagona etsvo ichishanda, pakuonekwa chakasimba anogumbura pezvakaitwa kuoneka pashure imwe nguva kushandisa refu pakurapa Beta-laktamidnyh inorwisa mabhakitiriya.

Chenjera nephropathy kunoratidzwa pamberi peripheral edema uye anogumbura infiltration. Vanoedza kusvika renal tishu. dzimwe nguva zvinotora mavhiki mashoma isati chitarisiko kamwe zviratidzo. Zvadaro kutanga chenjera renal kukundikana, izvo kukonzerwa kukurumidza mharuro kurapwa uye mberi kuona imwe irritant.

Children jades

Kugona kudzivisa kukura chirwere pauduku anova nenguva kushanyira chiremba kana chero zvirwere, kubvira chikosoro. Kuzvinzwira hazviiti, chete vachiita wevana achasarudza mishonga kuti usakanganisa mwana haana kuumbwa kwesimba romuviri rinodzivirira zvirwere.

Tubulointerstitial nephritis muvana kubatwa pasi pokudzora nyanzvi. Panguva basa kuchirapa zvokudya, pasina iyo yakanaka kubatsirwa zvikuru. Kana uchimhanya nephritis itsvo chirwere mushonga hazvibviri, ipapo akarwawo nhego transplantation. For chiremba mamirire undulating weboka chirwere ane refu latency nguva.

fungidziro

Kana itsvo basa iri vasingadzoreki nokuda kushandiswa kwezvinodhaka, tubulointerstitial nephritis kunoitika. Kunorapwa nounyoro kacho inodiwa. Regai kutora mushonga, uye nhungirwa vanotanga chakaipa kuvhiyiwa muna 2-2.5 mwedzi. Dzimwe nguva residual chinoshamisa pamberi scarring. Apo chirwere chimwe etiology kubvisa mhaka, asi chirwere ndicho reversible. In Muzviitiko zvakaipisisa vari renal kukundikana uye fibrosis.

Kufembera chisingaperi siyana nephritis kunoenderana kumhanya kuonekwa uye kuderedza zvokurwara asati kuumba kusingarapiki fibrosis. Kana iwe usingagoni kugadzirisa majini, chepfu uye metabolic kuchinja, chirwere achipinda chafariz renal kukundikana.

kurapwa chirwere

Kana zviratidzo chirwere rokutanga vanofanira kuona chiremba. Chete Achasarudza kumusoro yakarurama uye anokwanisa kurapwa. Zvipatara rimwe murwere munhu. Asi Somuenzaniso, kuwedzera apore kubva rikwanise chokutambudzika kurwara, uye dzimwe nguva chisingapere glucocorticoid kushandiswa. Kugamuchirwa muitiro kuchititadzisa angiotensin FIs.

A itsvo biopsy

The nzira chokuita chirwere kupindira kuziva chirwere cheitsvo. Ndicho kubviswa zvinyama toaisa pamusoro nemaziso kuzviongorora. Kuburikidza tsono sirinji nhete kuenda shoma renal zvinhu. Kudzidza uku kunobatsira kuti zvinobudirira kuona makemikari anoumba zvinyama uye kusarudza Zvakanyanya Kunaka Panguva Yepamuviri kurapwa.

Zvairatidza kuti biopsy nzira

The yokudzidza biopsy nzira iri tanzi zvinotevera nyaya:

• Kusvikira pakuguma vanokundikana kuziva chikonzero echirwere kana chakasimba zvirwere.
• Ko vanofungidzirwa nephritis.
• Nokukurumidza mberi renal kukundikana.
• Pane kunzwisisa rwarisa aetiology.
• Murabhoritari kuongorora kuti weti padzakacherechedza ane admixture ropa uye mapuroteni.
• Blood bvunzo anoratidza mari guru uric acid, creatinine, urea.
• Vanofungidzirwa oncology.
• Wakasimwa itsvo basa matambudziko.
• Pane chikonzero kuona kukura kwakaita kukuvara.
• Kuongorora mberi kurapwa.

mhando biopsy

The nzira kunoitwa kuburikidza ganda. Zvinonzi kuitwa jekiseni etsvo uye inotongwa X-ray kana Ultrasound. Kuti zviite kuti nzvimbo muviri akaiswa muruoko tsinga munhu musiyano iri ruvara kwazvakarerekera fuma. Open biopsy nzira iri dzinoratidzwa fence shoma zvinyama zvakananga pakuvhiya. Somuenzaniso, apo achibvisa pemipata neoplasms Cancer. Zvinoratidza kuti vaya ropa kana pane chimwe chete itsvo ari kushanda. Izvi zvinoitwa yekuzvidzivirira yokuwana nayo.

Joint cystoscopy pamwe biopsy rinoitwa pakuparwa pamberi matombo ari ureter kana renal chiuno. It akaita iri uchishandisa mukamuri uye inopa sumo imwe anonzwisisa chubhu nokuda womukati rokuongorora yacho ureter. Transjugular maonero biopsy ndiyo sumo iri anobudisa mushonga zvishoma nezvishoma vachipinda vakasarudzwa renal tsinga. It rinoshandiswa varwere kufutisa, chirwere kufema insufficiency uye murombo kweropa kana hapana apa nzira isina kuitwa nokuda ngozi kuupenyu uye asingauyi wanikidza tubulointerstitial nephritis.

In mhedziso, zvinofanira akati, kuti hosha yaiita sokuti asymptomatic, kwete kukanganisa murwere chaizvoizvo inoda nguva kuziva. Uye kuoma pamwe untreated nephritis kunokanganisa itsvo nerevane kukonzera kusingarapiki nemigumisiro.