Autoimmune hepatitis. Clinical picture

Autoimmune hepatitis inowanzoitika nokukurumidza, uye zvirwere zvaro zvinoratidzika hazvipi zvakasiyana neaya ane hepatitis yakaoma. Pachikamu chekutanga chechirwere munhu anonzwa kushaya simba. Kusviba kwemuti, kunyanya jaundice zviratidzo zvinosanganisira autoimmune hepatitis. Zviratidzo zvinonyatsojeka kunyange pakutanga. Kwemwedzi inoverengeka, imwe kliniki yakakwana yakazara iri kuitika.

Muzviitiko zvisingawanzoitiki, autoimmune hepatitis inoratidzirwa nekufamba zvishoma. Zvisinei, munyaya iyi, kurwadziwa nekuremara zvinowanikwa mune zvakanaka hypochondrium, munhu anonzwa malaise, jaundice inozviratidza zvishoma. Mune varwere vanoverengeka, autoimmune hepatitis inotanga kukura nefivha, pamwe nekuratidzwa kwehemberesi.

Chirwere chechipatara chinowanikwa chinoratidzirwa neutera hwakasimba, ganda rinogunzva, rinononoka, uye lymphadenopathy. Nokuda kwehutachiona, jaundice inowanikwawo (kwete nguva dzose, asi kuwedzera panguva yekuwedzera), kuwedzera kwehukuru hwepleen nechiropa. Muchikamu chechitatu chevakadzi, autoimmune hepatitis inofambidzana ne amenorrhea (kusakwana kwekuenda kumwedzi) uye hirsutism (kukura kwebvudzi, sekuvanhu). Muvanhu, chirwere chinogona kuendeswa ne gynecomastia (kukura kwezvinyorwa zvemammary, sekuvakadzi). Pakati peganda guru rekuita maitiro, masikati, capillaritis, lupus-like uye palmarma erythema nezvimwe zvipembenene.

Autoimmune hepatitis inoramba ichinge isingagoneki uye ichipo nekuvapo kwehepatic-inobatanidza, serum autoantibodies. Pane imwe nzira ine kuvhiringidza zvakakwana, hypergammaglobulinemia.

Autoimmune hepatitis. Kurapa

Pathogenetic therapy yechirwere chirwere che glucocorticosteroids. Immunosuppressive therapy inobvumira kuderedza basa rehutachiona hunoitwa muropa, sechikonzero chekuti basa revanodzvinyirira rinowedzera, kuwedzera kwekuita zvinokonzera kuparadzwa kwe hepatocytes kunoderedza.

Semitemo, panguva yekurapa, mishonga yakadai se "Methylprednisolone" kana "Prednisolone" inoshandiswa. Nhamba yekutanga yezuva rimwe nerimwe makirogiramu makumi matanhatu - muvhiki yekutanga, makumi mana - mugore rechipiri, makumi matatu - mugore rechitatu-rechina. Pakupedzisira, kuyerwa kwacho kwakaderedzwa kusvika pamamiriyoni makumi maviri, iyo inonzi chirongwa chekuchengetedza. Chirongwa chinotsigira chinoitwa kusvikira kliniki-laboratory uye histological parameters inowanikwa.

Kuderedza muwandu wemishonga inotorwa inoitwa zvishoma nezvishoma. Izvi zvinofunga nezvekuwedzera kwekliniki yekliniki uye nehutachiona hweva serum markers.

Autoimmune hepatitis inogona kubviswa mumwedzi mitanhatu. Zvisinei, pane dzakawanda, chirwere chinotora nguva refu, uye dzimwe nguva muupenyu hwose. Mukana wekusava nekugadzirisa kwema-monotherapy, zvinotarisirwa kusanganisira "Delagil", "Azathioprine", "Cyclosporine" muhurumende.

Kana kugadziriswa kweumunosuppressive kusakwanisa kuunza mhinduro inotarisirwa mukati memakore mana, pamwe nekudzoka kakawanda, nemigumisiro kubva kuchipatara, mubvunzo wekushandura chiropa unogona kusimudzwa .