Hemolytic-uremic syndrome

Shiga-li toxin ua E coli hemolytic-uremic syndrome (STEC-HUS) yog ib qho kev tsis sib haum xeeb uas feem ntau tshwm sim thaum kis mob hauv cov zom zaub mov ua rau cov tshuaj lom.Cov tshuaj no ua rau cov ntshav liab thiab ua rau lub raum mob.

Hemolytic-uremic syndrome (HUS) feem ntau tshwm sim tom qab mob rau txoj hnyuv E coli cov kab mob (Escherichia coli O157: H7). Txawm li cas los xij, qhov xwm txheej tseem tau txuas rau lwm qhov mob plab hnyuv, suav nrog shigella thiab salmonella. Nws kuj tau txuas rau kab mob nongastrointestinal.

Tus HUS no yog cov menyuam yaus nyiam tshaj plaws. Nws yog qhov ua kom mob raum tsis ua haujlwm rau menyuam yaus. Muaj ntau qhov kev sib kis loj tau sib txuas nrog undercooked hamburger nqaij kis nrog E coli.

E coli yuav kis tau los ntawm:

• Sib cuag ntawm ib tug neeg mus rau lwm tus
• Noj cov zaub mov uas tsis txawv, xws li cov mis nyuj lossis nqaij nyuj

STEC-HUS tsis yog yuav tsum muab zais nrog atypical HUS (aHUS) uas tsis cuam tshuam txog kev sib kis. Nws yog qhov zoo sib xws rau lwm tus kabmob hu ua thrombotic thrombocytopenic purpura (TTP).

STEC-HUS feem ntau pib ntuav thiab zawv plab, uas yuav los ntshav. Hauv ib asthiv, tus neeg ntawd yuav tsis muaj zog thiab tsis haum siab. Cov neeg muaj tus mob no yuav tso zis tsawg dua li ib txwm. Cov zis muaj peev xwm yuav luag nres.

Cov kab mob ntshav liab hauv lub cev ua rau cov tsos mob ntawm tus ntshav tsis txaus.

Cov tsos mob thaum ntxov:

• Cov ntshav hauv cov quav
• Vauv
• Ua npaws
• Qaug zog
• Ntuav thiab raws plab
• Neeg tsis muaj zog

Cov tsos mob tom qab:

• Nqaij ntuag
• Tsis nco qab qis
• Cov zis muaj tsawg
• Tsis muaj zis tawm los
• Pallor
• Mob chua leeg - muaj tsawg
• Cov tawv nqaij ua xua uas zoo li ua pob liab liab me me (petechiae)

Tus kws kho mob yuav kuaj xyuas lub cev. Qhov no yuav qhia:

• Mob siab lossis hnoos ntshav o
• Tej leeg hauv nruab siab hloov

Cov kev sim hauv tsev sim yuav pom cov tsos mob ntawm hemolytic anemia thiab mob raum tsis zoo. Kev ntsuam xyuas yuav muaj xws li:

• Kev kuaj ntshav txhaws (PT thiab PTT)
• Cov vaj huam sib xyaw metabolic vaj huam sib luag yuav qhia tau nce qib ntawm BUN thiab creatinine
• Ua kom tiav cov ntshav suav (CBC) tej zaum yuav qhia cov ntshav muaj ntshav nce ntxiv thiab muaj cov qe ntshav liab tsawg
• Platelet suav feem ntau txo
• Urinalysis yuav qhia pom cov ntshav thiab cov protein nyob hauv cov zis
• Kev ntsuam xyuas cov ntshav ntawm cov zis yuav qhia tias muaj protein ntau npaum li cas nyob hauv cov zis

Lwm yam kev ntsuam xyuas:

• Tso quav kab lis kev cai tej zaum yuav zoo rau ib hom E coli cov kab mob lossis lwm yam kab mob
• Kev kuaj mob hnyuv
• Ob lub raum (ib qho tsis tshua mob)

Kev kho mob yuav suav nrog:

• Kev lim ntshav
• Tshuaj noj tshuaj, xws li corticosteroids
• Kev tswj cov kua thiab electrolytes
• Hloov ntshav ntawm cov ntshav liab thiab ntshav khov

Nov yog ib qho mob hnyav heev rau menyuam yaus thiab neeg laus, thiab nws tuaj yeem ua rau tuag taus. Nrog kev kho kom zoo, ntau dua ib nrab ntawm tib neeg yuav rov qab los. Qhov tshwm sim tau zoo dua hauv cov menyuam yaus dua li cov laus.

Teeb meem yuav suav nrog:

• Teeb meem ntshav txhaws
• Hemolytic anemia
• Raum tsis ua haujlwm
• Kev siab siab ua rau qaug dab peg, txob taus, thiab lwm yam teeb meem ntawm cov leeg poob siab
• Platelets dhau lawm (thrombocytopenia)
• Uremia

Hu rau koj tus kws kho mob yog tias koj muaj tus mob HUS. Cov tsos mob ceev xws li:

• Cov ntshav hauv cov quav
• Tsis tso zis
• Txo kev ceev faj (nco qab)

Hu rau koj tus kws kho mob yog tias koj muaj mob HUS thiab koj cov zis tso zis tsawg, lossis koj muaj lwm cov tsos mob tshiab.

Koj tuaj yeem tiv thaiv tus paub vim li cas, E coli, los ntawm kev ua noj hamburger thiab lwm yam nqaij zoo dua. Koj yuav tsum tsis txhob kov cov dej tsis huv thiab ua tib zoo ntxuav tes.

HUS; STEC-HUS; Hemolytic-uremic syndrome

• Txiv neej urinary system

Alexander T, Licht C, Smoyer PEB, Rosenblum ND. Kab mob ntawm lub raum thiab mob tso zis rau hauv cov menyuam yaus. 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: 72.

Mele C, Noris M, Remuzzi G. Hemolytic uremic syndrome. Hauv: Ronco C, Bellomo R, Kellum JA, Ricci Z, eds. Kev Tu Neeg Mob HlavCov. 3lawm ed. Philadelphia, PA: Elsevier; 2019: chap 50.

Schneidewend R, Epperla N, Friedman KD. Cov tshuaj ua kom zoo nkauj thrombocytopenic purpura thiab cov thev naus laus zis syndrome. Hauv: Hoffman R, Benz EJ, Silberstein LE, li al, eds. Hematology: Qhov Ntsiab Cai thiab Kev Coj UaCov. 7 tus ed. Philadelphia, PA: Elsevier; 2018: chap 134.