Ua kom pom qhov tseeb thrombocytopenic purpura

Thrombotic thrombocytopenic purpura (TTP) yog cov ntshav tsis txaus uas ua rau cov ntshav txhaws ua rau cov leeg ntshav me. Qhov no ua rau cov neeg platelet tsawg tsawg (thrombocytopenia).

Tus kab mob no tuaj yeem tshwm sim los ntawm teeb meem nrog ib qho enzyme (hom protein) uas txuam nrog ntshav txhaws. Qhov enzyme no hu ua ADAMTS13. Qhov tsis txaus ntseeg no enzyme ua rau platelet clumping. Platelets yog ib feem ntawm cov ntshav uas pab ua ntshav txhaws.

Raws li cov ntshav platelets sib koom ua ke, tsawg dua platelets muaj nyob rau hauv cov ntshav hauv lwm qhov chaw ntawm lub cev los pab txhaws. Qhov no tuaj yeem ua rau los ntshav hauv qab daim tawv nqaij.

Hauv qee kis, qhov kev cuam tshuam no hla ntawm cov tsev neeg (tau txais los). Hauv cov xwm txheej no, tib neeg tau yug los nrog qhov qis ntawm qhov enzyme no.

Tus mob no kuj tseem tuaj yeem yog:

• Mob Cancer
• Kws khomob
• Hematopoietic qia cell hloov pauv
• HIV kis
• Txoj kev hloov kho tshuaj hormones thiab estrogens
• Tshuaj kho mob (suav nrog ticlopidine, clopidogrel, quinine, thiab cyclosporine A)

Cov tsos mob tuaj yeem suav nrog ib qho hauv qab no:

• Cov ntshav mus rau hauv daim tawv lossis hnoos qeev
• Tsis meej pem
• Qaug zog, qaug zog
• Ua npaws
• Mob taub hau
• Tawv tawv xim lossis tawv nqaij daj
• Ua tsis taus pa
• Lub plawv dhia ceev ceev (ntau tshaj 100 neeg ntaus ib feeb)

Kev ntsuam xyuas uas yuav raug txiav txim suav nrog:

• ADAMTS 13 kev ua theem
• Bilirubin
• Tshuaj tsw ntshav
• Ua kom tiav cov ntshav suav (CBC)
• Qib Creatinine qib
• Lactate dehydrogenase (LDH) qib
• Platelet suav
• Mob Lub Hlaus
• Haptoglobin
• Coombs kuaj

Tej zaum koj yuav muaj kev kho mob hu ua plasma exchange. Nws tshem tawm koj cov ntshav tsis txaus thiab hloov nws nrog cov ntshav ib txwm los ntawm cov neeg muaj txiaj ntsig zoo. Ntshav yog feem ntshav ua kua uas muaj cov qe ntshav thiab qe ntshav. Plasma pauv kuj hloov cov enzyme uas ploj lawm.

Cov txheej txheem yog ua raws li hauv qab no:

• Ua ntej, koj muaj koj cov ntshav kos raws li yog tias tso ntshav.
• Raws li cov ntshav tau dhau los ntawm lub tshuab uas cais cov ntshav mus rau nws qhov chaw sib txawv, cov ntshav tsis zoo yog raug tshem tawm thiab koj cov ntshav raug cawm.
• Koj cov ntshav tawm los ua ke nrog cov ntshav ntshav los ntawm tus pub, thiab mam li muab rov qab rau koj.

Qhov kev kho no yog rov ua txhua hnub kom txog thaum kuaj ntshav pom tias muaj kev txhim kho.

Cov neeg uas tsis teb rau txoj kev kho no lossis nws tus mob feem ntau yuav rov qab los:

• Tau phais tawm kom tshem lawv tus po
• Tau txais cov tshuaj uas ua kom lub cev tiv thaiv tsis muaj zog, xws li tshuaj steroids lossis rituximab

Feem ntau cov neeg uas yauv hloov pauv ntshav rov qab zoo li qub tas nrho. Tab sis qee cov neeg tuag los ntawm tus kab mob no, tshwj xeeb yog hais tias nws tsis raug kuaj tam sim ntawd. Hauv cov neeg uas tsis rov zoo, tus mob no tuaj yeem dhau los ua ntev (mob).

Teeb meem yuav suav nrog:

• Raum tsis ua haujlwm
• Platelet tsawg tsawg (thrombocytopenia)
• Cov qe ntshav liab qis tsawg (vim los ntawm lub sijhawm qog ua kom ntshav liab tsawg)
• Tej leeg muaj teeb meem hauv lub cev
• Kev los ntshav heev (los ntshav)
• Mob stroke

Hu koj tus kws kho mob yog tias koj tau los ntshav yam uas tsis pom tseeb.

Vim tias qhov tsis paub yog vim li cas, thiaj tsis muaj txoj hauv kev los tiv thaiv tus mob no.

TTP

• Cov qe ntshav

Abrams CS. Thrombocytopenia. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 172.

Teb chaws lub plawv, lub ntsws, thiab ntshav lub koom haum lub vev xaib. Ua kom pom qhov tseeb thrombocytopenic purpura. www.nhlbi.nih.gov/health-topics/thrombotic-thrombocytopenic-purpura. Nkag Mus Saib Lub Peb Hlis 1, 2019.

Schneidewend R, Epperla N, Friedman KD. Mob ntsws thrombocytopenic purpura thiab cov tsos mob hemolytic uremic. 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.