Pneumocystis nemabayo: zvinokonzera, zviratidzo, kurapwa. Pneumocystis nemabayo mu-neHIV

Health - chinokosha chinhu murume anogona. Munhu wose anotarisira kuti tirarame kwenguva yakareba uye havatamburi kubva imwe chirwere. The chirwere Kuchinja vanhu kupfuura kuzivikanwa - vanova mwoyo, chitarisiko chavo murombo, pane kusafarira zvose zviri kuitika kumativi, uye mune zvimwe zviitiko kamwe nomutsa uye kubatsira vamwe vanhu matambudziko vanhu dzikava akasuruvara uye kutsoropodza.

The chirwere Anorega hapana. Kunyange vana vacheche vanosanganawo kubva pedambudziko roku- chirwere chipi nechipi. Mukuwedzera, kutambura nazvo kwete varwere chete pachavo, asi nevadikanwi vavo. Zviri kunyanya kuoma kukurira manzwiro avo uye kunzwa vabereki vane vana kuti ichi kana kuti zvokurwara akanga dzakaonekwa. Kids nokuda kwavo muduku achiri havagoni kutsanangura zvavari yainetseka, nhengo dzomuviri chii nokurwadziwa, uye sei kuratidza pacharo.

Achinyengera chirwere PCP. Unogona kuva utachiona pose uye zvinoshamisa, kunyange zvipatara. Mamiriro rakaoma nokuti kuona chirwere achiri padanho ayo pakukura zvakaoma chaizvo. Kazhinji, vanhu vari kuziva kuti vanoda kurapwa kubatsirwa kana nguva inokosha kare akarasika. Ndokusaka rufu mwero kubva pneumocystosis kumusoro chaizvo. Vanachiremba havana nguva dzose vanokwanisa kuponesa upenyu hwomunhu.

Chirwere "pneumocystis"

Vanhu vasina chinhu chokuita nemishonga, vazhinji vavo vaiziva zvishoma zvokurapa mazwi. Naizvozvo, nechirwere kunzwa "pneumocystis" kana "PCP", vari kurasikirwa, uye kunyange kuwira vadhakwa. Kutaura zvazviri, musavhunduka. Kutanga, unofanira kudzikama, dhonzai iwe pamwe chete uye kumbira chiremba wako zvizere, nemashoko nyore kutsanangura chii.

Pneumocystis kazhinji kunzi PCP, inova protozoan chirwere kuti kunokanganisa mumapapu. Activators zvokurwara vaiona tupukanana tusingaoneki, rinozivikanwa Pneumocystis carinii. Kutozosvikira munguva ichangopfuura, masayendisiti vaitenda kuti vanopinda mhando zvakapfava. Zvisinei, panongova vachangobva pachishandiswa zveBhaibheri zvakawanda zvakanzi vakagumisa kuti zvigare izvi zvimwe zvinhu zvakananga kuna notumwe. Pneumocystis carinii chinhu chisvetasimba kuti hwacho chete vanhu. Kanenge kwemhuka kusvikira nhasi haana dzakaonekwa kunyange kamwe.

Chii chinoitika murwere PCP?

Kuchinja mumuviri yakafanira pneumocystosis kuvimba zviviri on: chii zvoutachiona ehupfumi vari utachiona nemabayo, uye mamiriro masoja dzevanhu gadziriro. Pneumocystis, kamwe mumuviri, kutanga pachine zvavo kuburikidza kufema turakiti, kuti poya navo uye tigopinda Formação de. Pano kunotanga zvakananga hwavo upenyu yatinofema. Ko kuwanda kwavo, ivo vapinda neVadzidzi surfactant uye kusunungura chepfu metabolites. Kunetseka Pneumocystis carinii T-lymphocytes, uyewo anonzi alveolar macrophages. Zvisinei, munhu simba rokuzvidzivirira, kwete chete havagoni kudzivirira hondo yaro kubva chirwere, asi zvikuru nekusiyana - une vanetsane: kunomutsa uye anowedzera uwandu Pneumocystis.

Zvachose utano munhu yokuwedzera Pneumocystis carinii haina pangozi. Asi mamiriro ezvinhu anochinja akanyatsosiyana kana dziviriro yezvirwere mumuviri murombo. Panyaya iyi, maperembudzi kusashanda semheni, uye mune pfupi nguva nhamba Pneumocystis, abatwa muchiedza rinosvika bhiriyoni imwe. Zvishoma nezvishoma alveolar nzvimbo izere zvakazara, achipa pave foamy exudate, nokuvhiringidzirwa Kamudzira kuvimbika Formação de leukocytes uye pakupedzisira kuti anokuvadza uye maererano, haizopereri kuparadzwa alveolocytes. Nokuda kuti Pneumocystis kukwanawo naka kusvika alveolocytes, kwakaderedza kufema pechiso mumapapu. Somugumisiro, kukuvara yemapapu rinenge rinotanga nedanho iri alveolar-rirambe richibvira blockade.

Kuvaka Sero pachako Kamudzira yenyu, Pneumocystis carinii vaida surfactant phospholipids munhu. Somugumisiro, pane kukanganisa pamusoro surfactant muviri uye yekudyidzana zvinowedzerwa zvemapapu tishu hypoxia.

Ndiani chinonyanya pangozi nezvimwe zvirwere?

Mhando nemabayo anozivikanwa kufambidzana Munokudzwa kubva mumwe, kusanganisira chokwadi chokuti pangozi yokuita pachena kuti akasiyana Mapato evanhu. Pneumocystis mupfungwa iyi haisi anosara. It anowanzodanwa ikabuda:

• rokusamhanyira vacheche;
• vacheche uye vana vari kutarisana chakasimba bronchopulmonary chirwere chakakomba, vakamanikidzwa kwenguva refu kuti ari muchipatara uye rakagara kurapa yakaoma uye refu;
• vanhu vachitambura oncological uye gemozabolevaniyami uye kubatwa cytostatics uye corticosteroids, uyewo kunetseka siyana renal pathologies uye connective munyama, yomuka somugumisiro transplantation imwe womukati nhego;
• TB varwere vakagamuchira refu nguva simba antibacterials;
• -NeHIV varwere.

Kazhinji, utachiona iri pachishandiswa kuenda neherikoputa mumate, uye kwarwakabva vanhu utano, zvikuru zvose - vashandi muzvipatara. On hwaro ichi, ruzhinji masayendisiti vanoti PCP - chete mira chirwere. Pasinei neizvi, zvakakodzera kujekesa kuti vamwe vanachiremba kutsigira maonero kuti kukura pneumocystosis ari neonatal nguva ndiwo mugumisiro chirwere ari mudumbu mudumbu.

Ndezvipi zviratidzo muri chiratidzo pamusoro kukura pneumocystis nemabayo muvana?

Moms uye vanotiza nguva chaizvo inonyatsoziva utano vana vavo. Hazvishamisi kuti vanoda kuziva mabayo nenguva. Chokwadi, chokupedzisira zvokuongorora kunogona chete kuva chiremba, asi kuziva zviratidzo chirwere wokutanga anofanira kukwanisa nomubereki chero vanoziva. akarasika zuva mumwe kungaita kuti chokwadi kuti mwana ave bilateral nemabayo, pneumocystis, uye mamwe matambudziko.

Pneumocystis nemabayo nevana kusimukira anowanzoita, kutanga pana mwedzi miviri zera. Most kazhinji chirwere inokanganisa vana avo rakazivikanwa kare cytomegalovirus chirwere. Hosha rinowanikwa dzavo dzekare muchimiro interstitsianalnoy nemabayo. Zvinosuruvarisa vanachiremba vanoziva kuti panguva kutanga kwekupwanyiwa kwakaoma zvisingaiti kuona chirwere chakadai, akadai Pneumocystis nemabayo. Zviratidzo kuonekwa akazotevera. Huru Zviratidzo achinongedzera kukurumidza kukura chirwere dzinosanganisira:

• simba chaizvo Whooping chikosoro kuti;
• Periodic panomuka ose breathlessness (kunyanya usiku);
• vamwe vana pane okuyerera rinoonekera, foamy, bvudzi uye viscous madzihwa.

The incubation Nguva hosha mazuva 28. Pasina zvakakwana uye nenguva kurapwa, mwero wokufa kwevanhu vana kutambura kubva pneumocystis, kunosvika 60%. Uyezve, vachangozvarwa vane Pneumocystis nemabayo kunoitika pasina zviratidzo zvinoonekwa, pane mukana mukuru kuti tichiratidza obstructive chirwere munguva yemberi iri pedyo. Izvi kunyanya nokuda mumatenhere mucous. Kana mwana wako haana kukurumidza vanokwanisa kubatsira yezvokurapa zvichagoverwa, obstructive chirwere chinogona kuva laryngitis, uye vana vakuru - ari asthmatic syndrome.

Zviratidzo kuti anowanika nedzevakuru

Nemabayo vakwegura uye vechidiki kuchiitika mune zvakawanda kunzwisisa nzira kupfuura vacheche nevana vaduku. The chirwere kurwiswa kunyanya vanhu vaine immunodeficiency, kana avo kwakasimbiswa uyo kwoupenyu hwose. Zvisinei, ichi hachisi mutemo kuti brooked kwete kuchangotanga kutsauka. Mune zvimwe zviitiko, Pneumocystis mabayo rinowanikwa mune varwere vane zvachose utano zvirwere.

The incubation Nguva chirwere zvichisiyana 2 kusvika 5 mazuva. Murwere ane zvinotevera zviratidzo:

• fivhiri,
• migraine,
• kusimba muviri wose,
• kunyanya vangadikitira,
• kurwadziwa muchipfuva,
• zvakakomba kufema kutambudzika pamwe yakaoma kana nyoro chikosoro uye tachypnea.

Kunze pamusoro zvinokosha zviratidzo, zviratidzo zvakadai dzimwe nguva yakati sezvo acrocyanosis, yokururamisa pakati nemaburi mbabvu, cyanosis (rinokwanisa kucheneruka) nasolabial Triangle.

Kunyange pashure zvakazara yawapiwa mune vamwe varwere pane nhamba chaicho Pneumocystis mabayo matambudziko. Vamwe varwere tiine dzokororo. Vanachiremba vanoti kana pane kuitazve mukati 6 mwedzi kubva nyaya chirwere rokutanga, izvozvo kunoratidza kuti ane chirwere mumuviri huvandudzwe. Uye kana zvikaitika zvinopfuura 6 mwedzi, ipapo tiri kutaura pamusoro idzva chirwere kana reinfection.

Pasina kurapwa hwenyama pavarwere akura pamwe pneumocystis neeSultan kubva 90 uye kusvikira 100%.

Zviratidzo zviri zvirwere HIV-utachiona

Pneumocystis nemabayo muna HIV-utachiona, kusiyana nevanhu vasina utachiona hwapedyo zvishoma nezvishoma. Kubva nguva inotanga prodromal mananara, uye vasati kurwisa akasiyana pulmonary zviratidzo, zvingatora kubva 4 kusvika 8-12 mavhiki. Naizvozvo, vanachiremba kuchangotanga nokufungirana kuvapo chirwere pamuviri, kuwedzera mamwe miedzo, Zvinokurudzirwa Varwere dzakadaro kuita bhokisi X-ray.

The chikuru zviratidzo pneumocystosis pavarwere AIDS anosanganisira:

• High tembiricha (38 kusvika 40 ° C), chisingazivi kuwira mukati 2-3 mwedzi;
• kungoerekana uremu;
• chikosoro yakaoma;
• kupfupika mweya;
• kuwedzera kufema insufficiency.

Vazhinji Nyanzvi ndiko maonero kuti kumwe nemabayo pavarwere neHIV vane zviratidzo zvimwechete pneumocystosis. Saka, pakutanga nzendo chirwere kuona chii mhando nemabayo mune murwere anotora nzvimbo kutonetsa. Zvinosuruvarisa kana Pneumocystis mabayo pavarwere neHIV kwakaratidza, atova akarasika nguva yakawandisa, uye aneta muviri zvakaoma chaizvo kurwisa chirwere.

Sei nechirwere pneumocystis?

Zvirokwazvo munhu wose anoziva Zvinoonekwa mumapapu emunhu. Photos of muviri iri wakazvidzosa neimwe kana mune bhuku iri yakaitwa kana rinomirira pakiriniki kana kumwewo. The mashoko zvevakomana, hapana kuperevedza. Uyezve, vanachiremba kuyeuchidza dzangu varwere vose kuti vanofanira kuita bhokisi gore negore maekisirei. Kusiyana maonero akawanda, ichi hachisi kwechokwadi, vanachiremba "picky", uye yaida. Izvi zvinoita kuti tikwanise kuziva chiedza dimming nguva-kuna maekisirei, uye havana kupambadza nguva kutanga kurapwa. Nokukurumidza tichaziva pamusoro chirwere, zvikuru mukana uchava kupora.

Zvisinei, kashoma kuti mumwe munhu wedu anoziva sei kuratidza pamusoro radiographs PCP. Photos orudzi urwu kuchikoro mabhuku havana kuwana wezvokurapa mabhuku uye maenisaikoropidhiya vakawanda vanhuwo regai kukonzera kufarira. Uyezve, isu kunyange tisina kumiririrwa sezvo chirwere kunokwanisa kuonekwa, kunyange uzivewo haana kukuvara.

Chokutanga, munhu rokutanga chirwere chinoitwa. Chiremba anobvunza murwere pamusoro vokukurukura ake nevanhu kuva mapoka njodzi (-neHIV uye varwere AIDS).

Pashure pomuedzo zvawanikwa. Zvinotevera rabhoritari uye richishanda zveBhaibheri:

1. Chiremba prescribes kutungamirirwa murwere vanhuwo ropa kuongorora kuchinja. Cherechedzai wavhomorwa kuti rakakwirira kwevari eosinophils, lymphocytes, leukocytes uye monocytes. In varwere pneumocystis angava munyoro kupererwa neropa uye zvishoma kutura hemoglobin.
2. Akagadzwa paku ongororo. Zviri pamusoro rengenografii nako vakatsunga pavaipfuura chirwere. Ari X-ray, riri pachena kuonekwa munhu mumapapu. The mufananidzo wanamatira murwere kadhi. In wokutanga Danho nayo zvikuru nyore pfuma muenzaniso. Kana pneumocystis ndanogara yechipiri pachikuva, zviri pachena zvinoonekwa pamusoro X-ray chiedza dimming. Utachiona inogona kana chete kuruboshwe kana chete yakarurama yemapapu, asi zvinogona vouta uye mumwe uye imwe.
3. Kuti tione pamberi pneumocystosis, chiremba kazhinji anosarudza kuchengeta parasitological kudzidza. Chii? Murwere wokutanga anoendeswa kuongorora nzwisa madzihwa. Nokuti dzisina iri nzira dzakadai bronchoscopy, bronchoscopy uye biopsy. Mukuwedzera, mharidzo kunogona kuwanikwa vachishandisa Yaunoti nzira induction kuti chikosoro.
4. Kuti uzive antibodies kuti Pneumocystis vakaperekedza serological kudzidza kunoratidzwa ndechokuti musiyano muna 2 weeks murwere anoendeswa kuongorora serum 2. Kana mumwe wavo kuona kupfuura dzose ukoshi titer vanenge raishandiswa 2, zvinoreva kuti munhu anorwara. Kudzidza uku chaiitirwa kuti kubvisa zvatinosiita nhau, sezvo antibodies zvinowanikwa munenge 70% yevanhu.
5. Kuziva chisvetasimba maantigen mu sputum, uye biopsy chiratidzazvizhinji uye broncho-alveolar lavage akaita PCR Diagnostics.

Danho pneumocystosis

Kune anotevedzana zvitatu zvokukura PCP:

• oedematous (1-7 masvondo);
• atelektaticheskuyu (avhareji 4 mavhiki);
• emphysematous (pamusoro durations yakasiyana).

Edematous Danho pneumocystosis inozivikanwa kuonekwa utera panyika muviri, lethargy, chikosoro uye zvadaro isingawanzowanikwi, zvishoma kuwedzera, uye chete pakupera kwenguva - yakasimba yakaoma chikosoro, uye kupfupika mweya panguva yechiitwa. Vacheche breastfeed zvakaipa, regai kuisa pamusoro uremu uye dzimwe nguva kuramba mukaka waamai. No kuchinja mune X-ray chiedza haisi dzakaonekwa.

Munguva atelektaticheskoy Danho febrile nefivha ari kuchengetwa. Chikosoro kunowedzerwa zvikuru uye rinowanika foamy sputum. Kupfupika mweya rinowanika kunyange panguva zviduku muviri. On imwe X-ray anooneka atelektaticheskie kuchinja.

In varwere vakapona wokutanga 2 nguva, kuva emphysematous pneumocystosis rwakazara, panguva iyo kwakaderedza dzichipfekeka chokupika kufema uye kuratidza emphysema.

dhigirii nemabayo

Mukurapa, kusiyanisa zvinotevera inosiyana kwokuomerwa chirwere:

• chiedza, izvo dzinoratidzwa simba toxicity (tembiricha isingadariki 38 ° C, uye nezatumanennoe kuziva) pa zororo haina segwapa dyspnoea, rose richiora chiedza kuona iri diki X-ray;
• Paavhareji, inozivikanwa mwero kudhaka (tembiricha kwazvo 38 ° C, rinosvika 100 mwoyo anorova paminiti, murwere anonyunyuta kuti vawedzere vangadikitira , etc ...), panguva yokuzorora dyspnea iri musi X-ray firimu zvakajeka kuonekwa infiltration of mumapapu;
• varemerwa zvakakomba kudhaka ichiyerera (chidhindo tembiricha kwazvo 39 ° C, palpitations kukasapfuura anorova 100 paminiti, pane delirium), mberi kufema insufficiency, uye kunoonekwa pamusoro X-ray zvakawanda infiltration pakati mumapapu, zvichida kutanga matambudziko akasiyana-siyana.

Chii kunwa mushonga varwere PCP?

Hapana mubvunzo kuti ruzivo sei kuziva zvemapapu kuzvimba, ndiko kuwedzera kukuru neimwe munhu. Zvisinei, izvi hazvina kukwana. Hatisi vanachiremba uye kuongororwa zvakarurama vanogona kuisa. Hakuna mhando nemabayo uye kuona yaitsigira divi kana bilateral nemabayo, pneumocystis, uye dzimwe mhando chirwere munhuwo zvake anogona havazvikwanisi. Naizvozvo, munhu anozvipira kurapwa haigoni kufamba uye nehurukuro. Chinhu chikuru - kwete kunonoka uye kuvimba vanachiremba. Tapedza kudzidza zvose zvakafanira tsvakurudzo chiremba anogona zvakarurama tigumise pamusoro kana mhaka chirwere murwere ari Pneumocystis nemabayo. Treatment anopiwa chete pashure kusimbisa nechirwere iri mufambiro nesangano kuchengeteka matanho uye zvinodhaka mishonga.

KweSangano-hurumende mabasa zvinosanganisira inokosha muchipatara. Muchipatara murwere anogamuchira mishonga uye zvokudya ndakarumbidzwa chiremba.

Drug kurapa chinosanganisira etiotrop, pathogenetic uye symptomatic kurapwa. Varwere kazhinji prescribers "Pentamidine" "furazolidone" "Trichopolum" "Biseptolum", uye siyana Anti-anogumbura zvinodhaka, zvinodhaka kuti pave uye aivabatsira kuti expectoration pamusoro sputum expectoration, mucolytics.

"Biseptol" chinotarisirwa nomuromo kana nomutsinga. The mushonga zvakanaka akashivirira uye zvinodiwa "Pentamidine" kugadzwa varwere kwete kutambura neAIDS. "Pentamidine" raitongwa intramuscularly kana nomutsinga.

-NeHIV varwere, pakati pezvimwe zvinhu, kugamuchira yemaARV kurapa nokuti Pneumocystis nemabayo kunoitika pamusana kuderera zvirwere. Pneumocystosis kurapa varwere AIDS mumakore achangopfuura awedzera akashandisa Arifa difluoromethylornithine (DFMO).

dziviriro

Kudzivirira pneumocystosis zvinosanganisira dzinoverengeka mabasa, ramakagadzwa zvinotevera zvinofanira kucherechedzwa:

1. Kubvisa chirwere muna outano zvevana muzvipatara, izvo kubatwa varwere oncological uye hematological, zvose tsvimbo, pasina chaakasiya inofanira nguva nenguva kuongororwa kuti kuvapo chirwere.
2. Drug prophylaxis vanhu pangozi. kudzivirira Izvi pakubhadhara zviviri: chikuru (vasati vatanga kukudziridza chirwere) uye yechipiri (chokudzivirira pashure pakupora zvakakwana kudzivirira dzokororo).
3. Early kuziva miedzo pneumocystis nemabayo uye pakarepo voga murwere.
4. Kugara disinfection munzvimbo panomuka kunge akanyorwa pneumocystosis. Kuti aite izvi, itai kuchenesa nyoro, achishandisa 5% mhinduro kubva kuiisa chlorine chibi.