Antiphospholipid syndrome - APS

Antiphospholipid syndrome (APS) yog ib qho kev tiv thaiv kabmob autoimmune uas feem ntau muaj ntshav txhaws (thromboses).Thaum koj muaj tus mob no, koj lub cev tiv thaiv kab mob ua rau cov protein tsis txaus uas ua rau cov leeg ntshav thiab cov hlab ntsha tawg. Qhov nyob ntawm cov tshuaj no tuaj yeem ua teeb meem nrog ntshav khiav thiab ua rau muaj kev cov ntshav txhaws hauv cov hlab ntshav thoob plaws lub cev.

Vim li cas tiag ntawm APS tseem tsis tau paub. Ob qhov kev hloov pauv ntawm qee yam gene thiab lwm yam (xws li kis tus kabmob) tuaj yeem tsim qhov teebmeem no.

Nws feem ntau pom muaj hauv cov neeg muaj lwm cov kab mob autoimmune, xws li cov kab mob lupus erythematosus (SLE). Tus mob feem ntau cov poj niam ntau dua li cov txiv neej, Nws feem ntau pom muaj nyob hauv cov poj niam uas muaj keeb kwm ntawm rov muaj dua nchuav me nyuam.

Qee tus neeg nqa cov tshuaj tiv thaiv tau hais los saum toj no, tab sis tsis muaj APS. Qee yam chiv keeb tuaj yeem ua rau cov neeg no tau ua txhaws ntshav, suav nrog:

• Haus Yeeb
• Lub caij nyoog pw
• Cev xeeb tub
• Kev kho tus pojniam lossis tshuaj noj tswj menyuam
• Mob Cancer
• Mob raum

Koj yuav tsis muaj tsos mob dab tsi, txawm tias koj muaj cov tshuaj tiv thaiv. Cov tsos mob uas yuav tshwm sim suav nrog:

• Cov ntshav txhaws nyob hauv ob txhais ceg, caj npab lossis lub ntsws. Cov ntshav tawm tuaj yeem yog hauv cov leeg lossis hauv cov hlab ntsha.
• Rov yug me nyuam los tseem yug.
• Pob xoo, hauv qee tus neeg.

Muaj qee zaus, cov ntshav txhaws sai heev hauv cov hlab ntshav ntau dhau ib hnub. Qhov no yog hu ua catastrophic anti-phospholipid syndrome (CAPS). Nws tuaj yeem ua rau mob stroke raws li cov txhaws hauv lub raum, nplooj siab, thiab lwm qhov hauv lub cev, thiab mob caj dab hauv cov ceg.

Kev ntsuam xyuas rau cov ntshav tiv thaiv lupus anticoagulant thiab antiphospholipid tuaj yeem ua thaum:

• Qhov tshwm sim txhaws ntshav ntuag tsis xws li, xws li cov hluas lossis cov tsis muaj lwm yam kev pheej hmoo hauv ntshav txhaws.
• Tus poj niam muaj keeb kwm ua txhaum kev xeeb tub tas li.

Qhov kev sim ntshav lupus anticoagulant yog kev kuaj ntshav txhaws. Cov tshuaj tiv thaiv kab mob ntshav (aPL) ua rau qhov kev ntsuas tsis meej nyob hauv chav sim.

Hom kev kuaj mob txhaws no yuav suav nrog:

• Siv ib nrab thromboplastin sij hawm (aPTT)
• Russell viper lub sijhawm
• Thromboplastin inhibition kuaj

Kev kuaj rau tshuaj tua kab mob tiv thaiv kab mob (aPL) tseem yuav ua. Lawv suav nrog:

• Anticardiolipin kev sim tshuaj
• Tshuaj tua kab mob rau beta-2-glypoprotein I (Beta2-GPI)

Koj tus neeg saib xyuas kev noj qab haus huv yuav kuaj pom tus mob antiphospholipid antibody syndrome (APS) yog tias koj muaj kev kuaj zoo rau aPL lossis lupus anticoagulant, thiab ib lossis ntau yam ntawm cov xwm txheej hauv qab no:

• Ib qho ntshav txhaws
• Rov qab deev me me

Cov kev kuaj pom zoo yuav tsum tau lees paus tom qab 12 lub lis piam. Yog tias koj muaj kev kuaj pom tsis muaj lwm yam kab mob ntawm tus kab mob, koj yuav tsis muaj qhov kuaj pom ntawm APS.

Txoj kev kho mob rau APS yog hais txog kev tiv thaiv cov teeb meem los ntawm cov ntshav txhaws tshiab los yog cov ntshav uas twb muaj lawm zuj zus. Koj yuav tsum tau coj qee yam ntawm cov ntshav-thinning tshuaj. Yog tias koj muaj kab mob autoimmune, xws li mob lupus, koj yuav tsum tau tswj hwm tus mob no kom zoo.

Qhov kev kho mob twg yog nyob ntawm seb koj tus mob muaj hnyav npaum li cas thiab nws ua rau nws mob hnyav npaum li cas.

COV TXHEEJ TXHEEM LOSSIS LUB CEV (APS)

Feem ntau, koj yuav tsum tau kho nrog cov ntshav ua pa kom ntev ntev yog tias koj muaj APS. Kev pib kho tus mob yuav yog heparin. Cov tshuaj no tau muab los ntawm kev txhaj tshuaj.

Feem ntau, warfarin (Coumadin), uas tau muab los ntawm qhov ncauj, yog li pib. Nws yog ib qho tsim nyog yuav tsum tau saib xyuas feem ntau ntawm theem ntawm cov tshuaj tiv thaiv. Qhov no feem ntau tau ua tiav siv ntsuas INR.

Yog tias koj muaj APS thiab cev xeeb tub, koj yuav tsum tau ua raws li cov kws kho mob uas yog tus paub zoo txog tus mob no. Koj yuav tsis noj tshuaj warfarin thaum cev xeeb tub, tab sis yuav raug txhaj tshuaj rau heparin.

Yog tias koj muaj SLE thiab APS, koj tus kws kho mob tseem yuav kom koj noj hydroxychloroquine.

Tam sim no, lwm hom tshuaj ntshav ntshav tsis pom zoo.

CATASTROPHIC ANTIPHOSPHOLIPID SYNDROME (CAPS)

Kev kho mob rau CAPS uas muaj kev sib txuas ntawm cov tshuaj tiv thaiv kev tiv thaiv, kev txhaj tshuaj ntau ntau ntawm corticosteroids, thiab ntshav pauv tau ua haujlwm tau zoo hauv tib neeg feem coob. Qee zaum IVIG, rituximab lossis eculizumab kuj tseem siv rau rooj plaub loj.

KUAJ COV KEV TXHEEJ TXHEEM RAU TUS TSWV LOS LOS APL

Koj yuav tsis xav tau kev kho mob yog tias koj tsis muaj tsos mob, cev tsis tab seeb, lossis yog tias koj tsis tau ua dua los ntshav li.

Ua raws li cov kauj ruam hauv qab no los pab tiv thaiv kom ntshav txhaws ntawm kev tsim:

• Zam kev kho mob tshuaj tiv thaiv kev xeeb tub feem ntau lossis kev kho tus kabmob rau lub sijhawm (pojniam).
• TSIS TXHOB haus luam yeeb lossis siv lwm yam khoom luam yeeb.
• Sawv thiab txav mus los thaum lub dav hlau ya ntev ntev lossis lwm lub sijhawm thaum koj yuav tsum zaum lossis pw hauv ncua ntev.
• Txav koj cov qij taws thiab txav qis thaum koj tsis tuaj yeem txav mus los.

Koj yauv raug tshuaj kom tua cov ntshav ua ntshav (xws li heparin thiab warfarin) txhawm rau pab tiv thaiv cov ntshav txhaws:

• Tom qab phais
• Tom qab pob txha txhawm rau
• Nrog rau mob qog noj ntshav
• Thaum koj yuav tsum tau zaum lossis pw ib ntus ntev ntev, xws li thaum nyob hauv tsev khomob lossis rov qab los tsev

Tej zaum koj yuav tsum tau noj tshuaj ntshav nyias ntev txog 3 rau 4 lub lis piam tom qab phais koj tus mob cov ntshav txhaws.

Yog tias tsis muaj kev kho mob, cov neeg mob APS yuav rov qab txhaws. Feem ntau ntawm lub sijhawm, qhov tshwm sim tau zoo nrog kev kho mob kom raug, uas suav nrog kev kho mob ntev ntev. Qee tus neeg yuav muaj ntshav txhaws uas nyuaj los tswj txawm hais tias kev kho mob los xij. Qhov no tuaj yeem ua rau CAPS, uas tuaj yeem tsim kev puas tsuaj rau txoj sia.

Hu rau koj tus kws kho mob yog tias koj pom muaj cov ntshav txhaws, xws li:

• O o los yog liab rau ntawm ob txhais ceg
• Ua tsis taus pa
• Mob, loog, thiab xim tawv nqaij daj ntawm sab caj npab lossis txhais ceg

Kuj nrog koj tus kws kho mob tham yog tias koj rov qab ua tsis taus cev xeeb tub (nchuav menyuam).

Cov tshuaj tiv thaiv Anticardiolipin; Hughes mob

• Systemic lupus erythematosus pob rau ntawm lub ntsej muag
• Cov ntshav txhaws

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Teb chaws lub plawv, lub ntsws, thiab ntshav lub koom haum lub vev xaib. Antiphospholipid tshuaj tiv thaiv mob. www.nhlbi.nih.gov/health-topics/antiphospholipid-antibody-syndrome. Nkag mus rau Lub Rau Hli 5, 2019.