Membranous nephropathy

Membranous nephropathy yog lub raum tsis zoo uas ua rau hloov pauv thiab ua paug ntawm cov qauv hauv sab raum uas pab lim dej thiab haus dej. Tus mob yuav ua teeb meem rau lub raum kev ua haujlwm.

Membranous nephropathy yog tshwm sim los ntawm thooj ntawm ib feem ntawm glomerular qab daus daim nyias nyias. Glomerular hauv qab daim nyias nyias yog ib feem ntawm lub raum uas pab lim cov dej khib nyiab thiab cov kua dej ntxiv los ntawm cov ntshav. Qhov tseeb yog vim li cas rau qhov kev ua tuab tuab no tseem tsis tau paub.

Lub thickened glomerular ua hauj lwm tsis tu ncua. Vim li ntawd, cov protein ntau tau ploj hauv cov zis.

Tus mob no yog ib qho ua rau muaj tus mob nephrotic syndrome. Qhov no yog cov pab pawg ntawm cov tsos mob tshwm sim xws li cov protein nyob hauv cov zis, cov ntshav protein tsawg, cov roj cholesterol siab, qib roj triglyceride thiab o tuaj Membranous nephropathy tuaj yeem yog thawj lub raum mob, lossis nws yuav cuam tshuam nrog lwm yam mob.

Cov hauv qab no ua rau koj qhov kev pheej hmoo rau tus mob no:

• Mob qog nqaij hlav, tshwj xeeb yog mob ntsws thiab mob hnyuv
• Raug rau cov co toxins, suav nrog kub thiab mercury
• Cov kab mob sib kis, nrog rau tus kab mob siab B, malaria, mob syphilis, thiab endocarditis
• Cov tshuaj noj, suav nrog penicillamine, trimethadione, thiab pleev xim rau tawv nqaij
• Systemic lupus erythematosus, mob caj dab, mob caj dab, Graves kab mob, thiab lwm yam mob autoimmune

Cov kev mob tshwm sim tsis hais lub hnub nyoog li cas, tab sis feem ntau tshwm sim tom qab hnub nyoog 40.

Cov tsos mob feem ntau pib maj mam dhau sijhawm, thiab suav nrog:

• Edema (o) rau txhua qhov chaw ntawm lub cev
• Nkees
• Ua npuas ncauj tsos ntawm cov zis (vim yog vim muaj protein ntau)
• Tsis qab los noj mov
• Tso zis, ntau dhau hmo
• Qhov hnyav nce

Kev kuaj mob lub cev yuav qhia tias o (o).

Qhov tso zis yuav qhia tawm cov protein ntau hauv cov zis. Kuj tseem yuav muaj qee cov ntshav hauv cov zis.Glomerular filtration rate (qhov "ceev" ntawm lub raum ntxuav cov ntshav) feem ntau yuav luag zoo li qub.

Yuav muaj lwm txoj kev kuaj kom pom seb ob lub raum ua haujlwm tau zoo li cas thiab lub cev hloov kho li cas rau teeb meem lub raum. Cov no suav nrog:

• Albumin - ntshav thiab zis
• Ntshav urea nitrogen (BUN)
• Creatinine - ntshav
• Creatinine kev tshem tawm
• Lipid vaj huam sib luag
• Protein - ntshav thiab zis

Lub raum tso tawm ua pov thawj hais txog kev kuaj mob.

Cov kev sim hauv qab no tuaj yeem pab txiav txim qhov ua rau mob rau lub ntsws nephropathy:

• Cov tshuaj tiv thaiv kev puas hlwb
• Anti-ob-xaib DNA, yog tias qhov tshuaj tiv thaiv cov tshuaj tua kabmob muaj qhov zoo
• Kev kuaj ntshav los ntsuas kab mob siab B, kab mob siab C, thiab syphilis
• Sib txuam sib luag
• Kev kuaj ntshav Cryoglobulin

Lub hom phiaj ntawm txoj kev kho yog txo qis tus tsos mob thiab ua rau qeeb tus mob ntawm tus mob.

Tswj ntshav siab yog qhov tseem ceeb tshaj plaws rau kev ncua sij hawm lub raum. Lub hom phiaj yog txhawm rau ua kom cov ntshav siab lossis qis dua 130/80 hli Hg.

Mob ntshav siab thiab qib roj triglyceride yuav tsum tau kho mob kom txo qis kev pheej hmoo ntawm atherosclerosis. Txawm li cas los xij, kev noj zaub mov kom tsis txhob rog thiab muaj roj cholesterol feem ntau tsis muaj txiaj ntsig zoo rau cov neeg muaj nqaij mos nephropathy.

Cov tshuaj siv los kho kev mob ntsws thiav nrog:

• Angiotensin-converting enzyme (ACE) inhibitors thiab angiotensin receptor blockers (ARBs) kom txo qis ntshav siab
• Corticosteroids thiab lwm yam tshuaj uas ua kom lub cev tsis muaj zog
• Tshuaj noj tshuaj (feem ntau ntau npaum li cas statins) los txo cov roj (cholesterol) thiab triglyceride
• Dej tshuaj noj (diuretics) kom txo qhov o
• Txhaws ntshav txhawm rau txhawm rau txo kev pheej hmoo ntawm cov ntshav txhaws hauv lub ntsws thiab ceg

Kev noj zaub mov muaj protein tsawg yuav pab tau. Cov kev xav txog cov khoom noj muaj protein tsawg (1 gram [gm] ntawm cov protein ib phaus [kg] ntawm lub cev hnyav hauv ib hnub) yuav tau qhia.

Vitamin D yuav tau hloov pauv yog tias cov tsos mob nephrotic yog mob ntev (mob ntev) thiab tsis teb rau kev kho.

Tus kab mob no ua rau muaj kev pheej hmoo ntawm cov ntshav txhaws hauv cov ntsws thiab ceg. Ntshav cov ntshav tuaj yeem tsim tshuaj kom tiv thaiv cov mob no.

Qhov tshwm sim nws txawv, nyob ntawm seb muaj protein ntau npaum li cas. Tej zaum yuav muaj tsos mob pub dawb thiab qee zaus ntwm tawm. Qee zaum, tus mob mus, nrog lossis tsis muaj kev kho.

Cov neeg feem ntau uas muaj tus kab mob no yuav muaj lub raum puas tsuaj thiab qee tus neeg yuav mob raum thaum kawg lub raum.

Lwm yam mob uas yuav yog los ntawm tus kab mob no suav nrog:

• Mob raum tsis ua hauj lwm
• Mob tuag tes tuag taw (venous thrombosis)
• Mob raum ntu kawg
• Tus mob Nifaisrotic
• Pulmonary embolism
• Hlab ntsha leeg ntshav hlab ntsha

Hu teem sijhawm nrog koj tus kws khomob yog:

• Koj muaj cov tsos mob ntawm mob ntsws nephropathy
• Koj cov tsos mob mob heev dua los yog tsis ploj mus
• Koj tsim cov tsos mob tshiab
• Koj tau tso zis tsawg dua cov zis

Kev kho mob sai sai thiab zam cov tshuaj uas tuaj yeem ua rau mob rau lub ntsws nephropathy tuaj yeem txo koj txoj kev pheej hmoo.

Membranous glomerulonephritis; Tsam GN; Cov tshuaj tiv thaiv glomerulonephritis Qhuas; Glomerulonephritis - membranous; MGN

• Raum anatomy

Radhakrishnan J, Appel GB. Glomerular mob thiab nephrotic syndromes. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 26th ed. Philadelphia, PA: Elsevier; 2020: cha 113.

Saha MK, Pendergraft WF, Jennette JC, Falk RJ. Thawj tus kab mob glomerular. Hauv: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner thiab Rector's RaumCov. 11th ed. Philadelphia, PA: Elsevier; 2020: chap 31.

Salant DJ, Cattran DC. Membranous nephropathy. Hauv: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Cov Chaw Kho Mob Tshaj LojCov. 6 tus ed. Philadelphia, PA: Elsevier; 2019: chap 20.