Eosinophilic nemabayo: rondedzero zviratidzo, hunokonzera uye unhu kurapwa

Zvakakomba zvemapapu chirwere, zvakadai nemabayo, hakusi kunokonzerwa kwemabhakitiriya kasvisto. Kuvhiringidza homeostasis pakati okumusoro kufema turakiti anogona tupukanana, notumwe tupukanana zvinodhaka, immunodeficiency, neutachiona. Uye nyaya dzakadaro, eosinophilic mabayo hwapedyo.

tsananguro

Eosinophilic nemabayo - a pathological kwacho mumapapu, iyo inozivikanwa nokutaurisa kuunganidza eosinophils vari Formação de. Kune mhando dzakawanda kana dzakasiyana chirwere ichi, izvo zvinogona kuva chero zera.

Akaora, zviri zvachose indistinguishable paurwere kunokonzerwa nemabhakitiriya, saka huru ndeye chirwere rabhoritari nemiedzo: zvakakwana ropa count, zodzera. Kazhinji, pashure Pakusarudza Chirwere kutanga kurapa steroid mahormone adrenal cortex. Izvi zvinobatsira kuderedza anogumbura maitiro uye neutralize kuti zviratidzo nemabayo. The fungidziro varwere idzi kazhinji zvakanaka.

nyaya

Chirwere eosinophilic nemabayo, zvinokonzera iyo panguva iyoyo vakanga vasina kuziva, yakatanga inorondedzerwa pezana-ramakumi remakore, muna 1969, mumwe chiremba Harrington. Akanga asiri kunyara chaizvo, saka kutorwa chirwere zita raro, uye pashure racho nyika masayendisiti akatanga kudana mutsva zvokurwara chirwere Harrington.

Asati ichi rinokosha nyaya eosinophilic nemabayo yave kuzivikanwa somunhu chirwere kuti anova mumapapu pashure chirwere pamwe tupukanana kana kusingadzoreki kubvuma zvinodhaka. Makore makumi maviri gare gare, muna 1989, iye akaonekwa zvokurapa, okuti "chakasimba eosinophilic mabayo".

etiology

Ziva zvinoverengeka, izvo pasi pokudzora eosinophilic nemabayo hwapedyo. Zvinokonzera, zviratidzo zviri pedyo nepedyo. Somuenzaniso, chenjera siyana nemabayo kunokonzerwa fodya (zvose rinoita uye pusa), chisimbwa nezvinodhaka kana kuderera muviri okuchengetedza vane HIV kana AIDS. Kana hapana zvikonzero haisi akakodzera, zviri kuonekwa idiopathic nemabayo.

Chirwere eosinophilic nemabayo anogona kushatiriswa munhu fungal chirwere (aspergillosis pnevmomikoz) helminthic infestation (ascariasis, echinococcosis), kushandisa yakareba zvinodhaka izvo inoodza mwoyo masoja emuviri (steroids, cytostatics), chirwere autoimmune connective zvinyama zvirwere (dzinonzi rheumatoid arthritis, Kaposi raMwari).

Eosinophils vane runodzivirira mashandiro anoita muviri, asi sezvo kuzvimba - iri nezvekumwe pathological muitiro, kana paine kunyanyisa uye nokukurumidza Ichokwadi aigona inokanganisa utano hwevanhu.

pathogenesis

Etiologic chinhu muzvinhu zvakawanda rinotsanangura sei kutanga eosinophilic nemabayo. Zvinokonzera, zviratidzo, kurapwa - zvose kunobva ichi. Repakona iyi mhando nemabayo ndiko kuunganidza vakawanda eosinophils vari zvemapapu munyama. zvirwere zvakawanda, kusanganisira eczema, asima, zvinokonzerwa wo chisimba maitiro nhengo kusunungura zvinoshingaira akakura.

Mishonga nezvimwe zvine chepfu alters ari reactivity pamusoro eosinophils uye inoita vade. Anti-anogumbura vamiririri, nemishonga, zvinodhaka vanokonzera Kurwara kuti kutungamirira kukudziri- nemabayo yechipiri. Uyezve, zvinoita kukonzera nechitarisiko vakawanda eosinophils iri rinenge rinoreva mudzanga utsi kana makemikari vapor.

parasitic noutachiona

Doctors zvitatu zvigadziriswe nemabayo panguva parasitosis. First - a parasitic infestation iri zvemapapu, yechipiri - chikamu upenyu kutenderera makonye, uye wechitatu - Random kuongorora dzeropa. Kubata navo muviri anotumira eosinophils. Vanofanira kutsamwisa mumwe kusunungurwa cytokines, prostaglandins, leukotrienes nezvimwe vanoshingaira zvinhu kuti kubviswa nehonye. Asi pachinzvimbo kukonzera nemabayo.

Zvakananga chakaunzwa munyama repasi kufema turakiti tapeworms, Echinococcus uye zvakadai nyama yenguruve tapeworm, uyewo zvemapapu fluke. Kuramba mumapapu uye kuwana mumhepo okisijeni inodiwa ascarids, intestinal ugritsy, hookworm uye hookworm. Eosinophilic nemabayo, izvo anokonzerwa pamusoro utachiona, zvimwe kuzivikanwa Loeffler kuti syndrome. Kuburikidza muropa kuti mapapu kuwana mazai Trichinella uye schistosomes.

kiriniki

Sezvo kutonga, chiremba, pulmonologist, kana kunyange zvirwere pakutanga kuona zvakaoma kupindura mubvunzo chii murwere eosinophilic nemabayo. Zviratidzo, kunyange kufungisisa etiologies vakasiyana chaizvo rakafanana mumwe. Murwere anonyunyuta kuti chikosoro, nefivhiri, kupfupika mweya uye iratidzike seiri kubuda usiku. Pashure vaviri vhiki pashure kutanga chikosoro, kana hapana zvaitwa, uchaona zviratidzo decompensated kufema insufficiency. Kana zvakadaro murwere anofanira kune chakagadzirwa kufefetedza.

Chirwere eosinophilic nemabayo mberi zvishoma nezvishoma, mwedzi. Varwere, uremu, vane kupfupika mweya, wheezing uye vangakosora, tembiricha muviri anodonhedza pazasi subfebrile. Dzimwe zviratidzo sezvimwe asima, izvo zvinoita kuti chirwere uye nezvakaipa kusarudza kurapwa.

matambudziko mazhinji nokuti chirwere ose eosinophilic nemabayo zvinodhaka pave. Zviratidzo, kurapwa uye kudzivirira ayo akasimba kufanana asipurini asima, kuti anotsausa chiremba. In parasitic Zvirwere ane chaiwo prodromal nguva, izvo angataura munhu helminthic yaingopambwa.

Diagnostics

Sezvo akaora eosinophilic nemabayo rinenge hapana kusiyana nemamwe nemabayo, nechirwere hwakavakirwa kwomurabhoritari uye richishanda kuferefeta. Kazhinji, kuongorora ropa eosinophilia iziviswe pasi fluoroscopic Visualization nokuda pulmonary kana computed Tomography Kumwe kuchinja kunotanga oneka noruzhinji. Kuti asimbise unogona kutora biopsy pakati zvemapapu rinenge uyewo kuti chomumba pamwe pemvura bronchus panguva bronchoscopy.

Kuziva ukama mishonga, kugara munzvimbo mishonga utachiona, kana kenza, unofanira ukanyatsoongorora nhoroondo murwere zvokurapa, uyewo kuunganidza mashoko akakwana nhoroondo upenyu uye chirwere. Kana, pashure ose tsvakurudzo, chikonzero achiri asingakwanisi kuziva, ipapo chirwere Zvinonzi idiopathic eosinophilic nemabayo.

Iva nechokwadi kunonyora inoratidza mwero kufema kukundikana. Mukati vhiki pakatanga chirwere pane zviratidzo kutanga:
- akawanda maronda bapu tishu;
- kuunganidza mvura iri pleural mhango;
- leukocytosis uye yakakwirira erythrocyte sedimentation mwero mukuru kuongorora ropa;
- kuwedzera kwevari immunoglobulin E;
- kufema spirometry inoratidza vasanyanye zvemapapu vhoriyamu.

mabatiro

Kunyange asati kwokupedzisira zvokuongorora achaurawa - eosinophilic nemabayo, kurapwa rinotanga pakurapa murwere kwachiremba.

Kana nemabayo hakukoshi, zvinokosha kurapa runotikurudzira chirwere: bundu kana gonye infestation. Izvi zvichakubatsira kuderedza pulmonary zviratidzo uye kunokurumidza kupora.

Kana mhaka chirwere haina kuzivikanwa, basa glucocorticosteroid kurapa. Vari zvakanaka akabvisa anogumbura mhinduro, dzikamisa sero Kamudzira, kuderedza tembiricha. Kanganwiro kunokwanisika nokukurumidza - rechitatu kana kuti rechina zuva. Asi mishonga iyi hazvirevi kuguma ikoko. Kunyangarika zviratidzo hazvirevi kuti hosha iri vakarapwa. Naizvozvo, corticosteroids, murwere anotora mwedzi, ane zvishoma nezvishoma rutapudzo of dose kusvikira apo paku chirwere nzira regai richasimbiswa pakupora.

The chirwere chimiro chirwere zvinoda kurapwa kwemwedzi mitatu kana kupfuura, kunyange pashure kunyangarika yokuora zviratidzo. Zvazvo zvinogoneka nemabayo pamusoro yaitwa chimbichimbi kurega kuti corticosteroids. Mune zvimwe zviitiko, murwere angafanira chinja kune zvokuimba kufefetedza.

mataridzikiro

Kana eosinophilic nemabayo chirwere yechipiri pamusoro kenza kana parasitosis, ipapo Magumisiro pamusoro aibuda runotikurudzira zvokurwara. Zvinouraya, akapa zvakakwana uye nenguva kurapwa sezvisingaiti.

Chirwere eosinophilic nemabayo asingatani recur pamusoro pechiso glucocorticosteroids. Naizvozvo, vamwe varwere kushandisa zvinodhaka izvi upenyu. Asi ichi mamiriro ezvinhu, pane marapirwo. Side migumisiro yokurapa, akadai prednisone, anogona kuderedza zvikuru mararamiro evanhu. Idzi dzinosanganisira: peptic urikanwi, osteoporosis, kushingoid, ungaderedza kutapata.

epidemiology

Kazhinji, mabayo kunokonzerwa tupukanana kuti vari kupfuura mune endemic kumatunhu kuti utachiona izvi. Izvi zvingava dzinopisa, eSiberia, reMediterranean kana kunyanya rwizi.

Chenjera eosinophilic nemabayo anogona kuva chero zera, kunyange vana vaduku chaizvo, asi vakawanda vavo chirwere repakati vanhu makumi maviri kusvika makumi mana namaviri. In chirwere pane chechikadzi kusarurwa - varume vanorwara kakawanda kupfuura vakadzi, nokuti chirwere kunokonzerwa fodya. In mabhuku ano dzokurapa pane kurondedzerwa eosinophilic nemabayo pashure nemwaranzi kurapa nokuda kenza yemazamu.

Eosinophilic nemabayo mune imbwa

Mhuka inogona kuwanikwa eosinophilic nemabayo. Zvinokonzera, zviratidzo, kudzivirira chirwere ichi zvikuru zvakafanana munhu. Saizvozvowo, zvinokonzera hosha; tupukanana mumapapu, notumwe tupukanana Kurwara kuti mukume, tumbuyu, makemikari uye mishonga.

Imbwa vakacherechedza ane inondimukira zvirwere mhinduro unounza zvemapapu rinenge infiltration kubudikidza eosinophils. Nenyama ezasi mapoka zvinoderedza, pane anovandudza pathogenic notumwe anokonzera nemabayo. The mhuka iri vakaurayiwa acidosis uye hypoxia. The kiriniki akafanana chikosoro dzevanhu, kupfupika mweya, simba, fivha, kushaya kudya, uremu.

Nokuti nechirwere uchishandisa bvunzo ropa, maekisirei pakati mumapapu, bronchoalveolar lavage cytology, serology. On the X-ray inooneka zvemapapu rinenge edema, kuvapo muchitokisi granuloma, node raiva pedyo nebundu akawedzera mediastinal uye hilar kuwedzera nomumvuri mwoyo. Pashure kujekeswa kuti etiology eosinophilic nemabayo, murapi wemhuka ibasa marapiro zvainanga kubvisa chikuru chirwere. The inobudirira zvikuru - corticosteroids, akabatana nemishonga inorwisa mabhakitiriya uye bronchodilators. Kazhinji, mhuka kuramba hwose kurapa.