Txheej txheem lupus erythematosus

Systemic lupus erythematosus (SLE) yog ib tus kabmob autoimmune. Hauv cov kab mob no, lub cev tiv thaiv kab mob ntawm lub cev yuam kev tawm tsam cov ntaub so ntswg noj qab haus huv. Nws tuaj yeem cuam tshuam rau ntawm daim tawv nqaij, pob qij txha, ob lub raum, lub paj hlwb, thiab lwm yam.

Qhov ua rau SLE tsis tau paub meej. Nws tuaj yeem txuas nrog rau yam hauv qab no:

• Caj ces
• Ib puag ncig
• Hormonal
• Qee yam tshuaj

SLE muaj ntau rau cov poj niam ntau dua li cov txiv neej los ntawm ze li 10 txog 1. Nws yuav tshwm sim thaum muaj hnub nyoog. Txawm li cas los xij, nws tshwm sim feem ntau rau cov poj niam hluas hnub nyoog thaj tsam 15 txog 44 xyoo. Hauv Asmeskas, tus kab mob no muaj ntau rau cov neeg Asmeskas, Neeg Asmeskas Dub, Neeg Asmeskas Cov Neeg Qhab thiab Neeg Asmeskas.

Cov tsos mob txawv ntawm ib tug neeg mus rau lwm tus, thiab tej zaum tuaj thiab mus. Txhua tus neeg uas muaj SLE muaj mob pob qij txha thiab o nyob rau qee lub sijhawm. Qee tus pib mob caj dab. SLE feem ntau cuam tshuam cov pob qij txha ntawm tes, tes, dab teg, thiab hauv caug.

Lwm cov tsos mob tshwm sim suav nrog:

• Kev mob hauv siab thaum sib sib zog nqus pa.
• Nkees.
• Ua npaws uas tsis muaj lwm qhov teeb meem.
• Qhov tsis xis nyob, tsis xis nyob, los yog mob siab (mob siab).
• Cov plaub hau poob lawm.
• Lub cev yuag.
• Lub qhov ncauj mob.
• Hnov mus tshav ntuj.
• Cov tawv nqaij ua pob - A "npauj npaim" tawm pob los ntawm kwv yees li ib nrab ntawm cov neeg nrog SLE. Cov pob khaus ntsej muag feem ntau pom ntawm sab plhu thiab tus choj ntawm lub taub ntswg. Nws tuaj yeem ua kis thoob plaws. Nws mob heev ntxiv hauv tshav ntuj.
• O o cov qog ntshav.

Lwm cov tsos mob thiab cov cim yog nyob ntawm seb lub cev raug cuam tshuam li cas:

• Lub hlwb thiab lub paj hlwb - Cov mob taub hau, tsis muaj zog, loog, tingling, qaug dab peg, teeb meem tsis pom kev, nco thiab tus cwj pwm hloov
• Kev zom plab - mob plab, xeev siab, thiab ntuav
• Lub plawv - Cov teeb meem Valve, o mob plawv los yog mob hauv ob sab phlu (pericardium)
• Lub ntsws - Ua kua hauv qhov chaw pleural, ua pa nyuaj, hnoos tau ntshav
• Daim tawv nqaij - qhov ncauj tawm hauv lub qhov ncauj
• Raum - Nqaij hauv ob txhais ceg
• Kev ncig - cov hlab ntshav leeg lossis hlab ntsha, o ntawm cov hlab ntshav, tawm tsam ntawm cov hlab ntshav hauv kev teb rau qhov txias (Raynaud phenomenon)
• Ntshav tsis txaus rau suav nrog ntshav liab, ntshav dawb tsis muaj ntshav lossis ntshav txhaws

Qee tus neeg tsuas muaj cov tsos mob ntawm daim tawv xwb. Qhov no hu ua discoid lupus.

Txhawm rau kuaj xyuas tus mob lupus, koj yuav tsum muaj 4 ntawm 11 yam pom ntawm tus kabmob. Yuav luag txhua tus neeg uas mob lupus muaj qhov tshuaj tiv thaiv zoo rau kev tiv thaiv kabmob ua kom tsis haum (ANA). Txawm li cas los xij, muaj ANA zoo ib leeg tsis txhais tau tias koj mob lupus.

Tus kws kho mob yuav kuaj ib ce kom tiav. Tej zaum koj yuav muaj pob liab vog, mob caj dab, lossis txhaws ntawm pob taws. Tej zaum yuav muaj lub suab tsis xws li hu ua lub plawv txhuam qhov muag lossis pleural txhuam txhuam. Koj tus kws khomob tseem yuav kuaj mob hlwb.

Kev ntsuam xyuas siv los kuaj xyuas SLE yuav suav nrog:

• Cov tshuaj tiv thaiv kev ua kom yuag (ANA)
• CBC nrog qhov sib txawv
• Kev ntsuas hluav taws xob xoo
• Ntshav dej creatinine
• Mob Lub Hlaus

Koj kuj tseem yuav muaj lwm qhov kev kuaj kom paub ntxiv txog koj tus mob. Ib txhia ntawm cov no yog:

• Lub vaj huam sib luag Antinuclear antibody (ANA)
• Nkij los txuam rau cov khoom (C3 thiab C4)
• Tshuaj tua kab mob kom muaj ob-xaim DNA
• Coombs kuaj - ncaj qha
• Cryoglobulins
• ESR thiab CRP
• Kev kuaj ntshav raum ua haujlwm
• Kev kuaj ntshav ua haujlwm zoo
• Qhov zoo tshaj yuav Rheumatoid
• Cov tshuaj tiv thaiv Antiphospholipid thiab kev sim tshuaj lupus anticoagulant
• Raum raum
• Kev ntsuam xyuas lub plawv, lub hlwb, lub ntsws, lub pob qij txha, cov leeg lossis cov hnyuv

Tsis muaj txoj hau kev los kho tus mob SLE. Lub hom phiaj ntawm kev kho mob yog tswj hwm tus mob. Cov tsos mob hnyav uas cuam tshuam nrog lub siab, lub ntsws, lub raum, thiab lwm yam hauv lub cev feem ntau xav tau kev kho mob los ntawm cov kws tshwj xeeb. Txhua tus neeg uas muaj SLE xav tau kev soj ntsuam txog:

• Tus kab mob nquag siv npaum li cas
• Dab tsi hauv lub cev raug cuam tshuam
• Yuav tsum muaj hom kev kho twg li cas

Hom mob me yuav tau muab kho nrog:

• NSAIDs rau cov tsos mob ua ke thiab pleurisy. Tham nrog koj tus kws kho mob ua ntej noj cov tshuaj no.
• Kev txhaj tshuaj corticosteroids tsawg, xws li prednisone, rau cov tsos mob ntawm daim tawv nqaij thiab mob caj dab.
• Corticosteroid cream rau pob khaus tawv nqaij.
• Hydroxychloroquine, ib yam tshuaj kuj siv los kho mob npaws.
• Methotrexate tuaj yeem siv los txo cov koob tshuaj corticosteroids
  
• Belimumab, ib qho tshuaj lom biologic, tej zaum yuav pab tau hauv qee tus neeg.

Cov kev kho rau SLE loj dua yuav suav nrog:

• Kev noj tshuaj ntau dua corticosteroids.
• Immunosuppressive tshuaj (cov tshuaj no ua rau lub cev tiv thaiv tsis tau). Cov tshuaj no yog siv yog tias koj muaj lupus hnyav uas cuam tshuam rau cov leeg hlwb, lub raum lossis lwm yam hauv lub cev. Lawv kuj tseem siv tau yog tias koj tsis zoo dua nrog corticosteroids, lossis yog tias koj cov tsos mob hnyav dua thaum koj tsum tsis noj cov tshuaj corticosteroids.
• Cov tshuaj siv feem ntau siv nrog mycophenolate, azathioprine thiab cyclophosphamide. Vim tias nws cov tshuaj lom, cyclophosphamide tsuas yog kawm luv luv ntawm 3 txog 6 lub hlis. Rituximab (Rituxan) yog siv hauv qee kis zoo ib yam.
• Cov ntshav txhaws, xws li warfarin (Coumadin), txhawm rau txhaws kev ua kom tsis haum xws li antiphospholipid syndrome.

Yog tias koj muaj SLE, nws tseem ceeb heev rau:

• Hnav cov khaub ncaws tiv thaiv, tsom iav, thiab tshuaj pleev thaiv hnub thaum tshav ntuj.
• Tau txais kev tiv thaiv lub siab.
• Nyob nrog kev txhaj tshuaj tiv thaiv kab mob.
• Muaj kev ntsuam xyuas los soj ntsuam cov pob txha ua kom tsis muaj pob txha (txha pob txha).
• Zam kev haus luam yeeb thiab haus cawv kom tsawg.

Cov neeg tawm tswv yim thiab pabcuam yuav pabcuam nrog cov teebmeem kev ntxhov siab nrog tus kabmob.

Qhov tshwm sim rau cov neeg muaj SLE tau zoo dua nyob rau xyoo tas los no. Coob tus neeg uas muaj SLE yeej pom mob mentsis. Koj zoo npaum li cas yog nyob ntawm seb mob hnyav npaum li cas. Cov neeg feem coob uas muaj SLE yuav xav tau tshuaj kom ntev. Yuav luag txhua tus yuav xav tau hydroxychloroquine tsis muaj qhov kawg li. Txawm li cas los xij, hauv Asmeskas, SLE yog ib qho ntawm 20 tus thawj coj ua rau muaj kev tuag rau poj niam cov hnub nyoog ntawm 5 thiab 64. Ntau cov tshuaj tshiab tau kawm los txhim kho qhov tshwm sim ntawm cov poj niam nrog SLE.

Tus mob yuav nyhav tshaj:

• Hauv thawj lub xyoos tom qab kuaj pom
• Hauv cov neeg muaj hnub nyoog qis dua 40 xyoo

Coob tus pojniam nrog SLE tuaj yeem cev xeeb tub thiab yug menyuam tau zoo. Qhov ua tau zoo yog feem ntau rau cov poj niam uas tau txais kev kho mob zoo thiab tsis muaj teeb meem mob plawv lossis raum. Txawm li cas los xij, muaj qee yam ntawm cov tshuaj tiv thaiv SLE lossis cov tshuaj tiv thaiv antiphospholipid ua rau muaj kev pheej hmoo me nyuam.

LUPUS NEPHRITIS

Qee cov neeg muaj SLE muaj qhov tsis txaus hauv lub raum. Qhov no ua rau muaj kev mob hu ua lupus nephritis. Cov neeg muaj tus mob no yuav tuaj yeem ua lub raum tsis ua haujlwm. Tej zaum lawv yuav tau lim ntshav lossis hloov raum.

Lub raum ua tiav kom paub txog qhov puas tsuaj ntawm lub raum thiab pab qhia kho. Yog tias muaj tus mob nephritis tam sim no, kho cov tshuaj tiv thaiv kab mob nrog rau cov tshuaj corticosteroids ntau dua nrog rau cyclophosphamide lossis mycophenolate xav tau.

LWM YAM NTAWM LUB CEV

SLE tuaj yeem tsim kev puas tsuaj hauv ntau ntau qhov ntawm lub cev, suav nrog:

• Cov ntshav txhaws hauv cov hlab ntsha ntawm cov leeg ntawm txhais ceg, lub ntsws, lub hlwb, lossis cov hnyuv
• Kev puas tsuaj cov qe ntshav liab lossis ua kom ntshav liab lub cev ntev (mob)
• Mob ntshav ncig lub plawv (mob pericarditis), lossis mob rau hauv lub plawv (mob myocarditis lossis endocarditis)
• Ua kua ncig lub ntsws thiab kev puas tsuaj rau cov ntaub so ntswg
• Teeb meem xeeb tub, nrog rau nchuav menyuam
• Mob stroke
• Kev mob plob tsis so tswj nrog mob plab thiab txhaws
• O hauv cov hnyuv
• Cov ntshav platelet tsawg heev (ntshav yuav tsum ua kom ntshav txhaws)
• Kev o ntawm cov hlab ntshav

TIV THAIV THIAB HAIV NEEG

Ob SLE thiab qee cov tshuaj siv rau SLE tuaj yeem tsim kev puas tsuaj rau tus menyuam hauv plab. Tham nrog koj tus kws kho mob ua ntej koj xeeb tub. Yog tias koj xeeb tub, nrhiav ib tus kws kho mob uas tau mob hnoos thiab cev xeeb tub.

Hu rau koj tus kws kho mob yog tias koj muaj cov tsos mob ntawm SLE. Hu rau yog tias koj muaj tus kab mob no thiab koj cov tsos mob mob heev dua lossis cov tsos mob tshiab tshwm sim.

Raug txim tawm lupus erythematosus; XIB; Lupus; Lupus erythematosus; Kab npauj npaim - SLE; Discoid lupus

• Txheej txheem lupus erythematosus
• Lupus, discoid - pom ntawm qhov mob txhab ntawm lub hauv siab
• Lupus - discoid ntawm tus menyuam lub ntsej muag
• Systemic lupus erythematosus pob rau ntawm lub ntsej muag
• Tshuaj tua kabmob

Arntfield RT, Hicks CM. Cov kab ke lupus erythematosus thiab vasculitides. Hauv: Phab Ntsa RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Cov Tshuaj Siv Thaum Muaj Xwm Ceev: Cov Ntsiab Lus thiab Kev Siv Tshuaj. 9le ed. Philadelphia, PA: Elsevier; 2018: chap 108.

Phaib MK. Etiology thiab pathogenesis ntawm kab ke lupus erythematosus. Hauv: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, eds. Kelley thiab Firestein Cov Ntawv Phau Ntawv Rheumatology. 10 tus ed. Philadelphia, PA: Elsevier; 2017: tshooj 79.

Fanouriakis A, Kostopoulou M, Alunno A, li al. 2019 hloov kho ntawm EULAR cov lus pom zoo rau kev tswj hwm ntawm licus erythematosus. Ann Rheum Dis. 2019; 78 (6): 736-745. PMID: 30926722 pubmed.ncbi.nlm.nih.gov/30926722/.

Hahn BH, McMahon MA, Wilkinson A, li al. American College of Rheumatology cov lus qhia rau kev kuaj mob, kho mob, thiab kev tswj hwm tus mob lupus nephritis. Mob caj dab los tu Res (Hoboken). 2012; 64 (6): 797-808. PMID: 22556106 pubmed.ncbi.nlm.nih.gov/22556106/.

van Vollenhoven RF, Mosca M, Bertsias G, li al. Kho-rau-phiaj nyob rau hauv cov kab ke lupus erythematosus: cov lus pom zoo los ntawm tus neeg ua haujlwm thoob ntiaj teb. Ann Rheum Dis. Xyoo 2014; 73 (6): 958-967. PMID: 24739325 pubmed.ncbi.nlm.nih.gov/24739325/.

Yen EY, Singh RR. Daim ntawv qhia luv luv: lupus - qhov tsis lees paub ua rau kev tuag ntawm cov pojniam hluas: qhov kev tshawb nrhiav pejxeem siv cov ntawv pov thawj tuag thoob tebchaws, 2000-2015. Mob Pob Txha Rheumatol. 2018; 70 (8): 1251-1255. PMID: 29671279 pubmed.ncbi.nlm.nih.gov/29671279/.