Kev kho tus mob autoimmune no tuaj yeem ua rau cov tsos mob tshwm sim zoo li muaj siab
Kev mob ntsws (lipus erythematosus) (tseem hu ua lupus los yog SLE) yog ib qho mob tsis meej uas tshwm tuaj yeem ua rau muaj kab mob nyob hauv ntau seem ntawm lub cev. Thaum lub caij nyoog mechanisms rau lupus tsis paub hais tias, qhov mob kawg thaum nruab nrab yog lub cev tsis tau ploj mus awry, zuj qees hauv hlwb nws yuam kev pom li txaus ntshai.
Lub zog hauv lub paj hlwb yog ib qho ntawm lub hom phaj ntawm qhov kev kho mob kho mob no.
Thaum nws tshwm sim, nws tuaj yeem tshwm sim rau cov kev puas siab puas ntsws uas zoo li cov teeb meem ntawm kev puas siab puas ntsws bipolar .
Thaum cov tsos mob ntawm ob kab mob sib npaug (xws li cov tshuaj siv los kho lawv), SLE thiab bipolar tsis muaj kev sib raug zoo. Txawm tias muaj kev ntseeg zoo, SLE tsis ua rau muaj kev puas siab puas ntsws bipolar.
Ntawm qhov tod tes, SLE yog qee zaum yuam kev raws li kev puas siab puas ntsws bipolar. Thaum qhov no tshwm sim, ib tus neeg kuj tuaj yeem raug kev kho mob tsis tsim nyog thiab tsis tsim nyog.
Cov tsos mob ntawm Neuropsychiatric Lupus
Thaum lupus muaj feem xyuam rau lub hauv paus hauv lub cev, nws tuaj yeem ua rau ntau yam mob, ob qho tib si neurological thiab kev puas siab puas ntsws. Peb hais txog qhov teeb meem no raws li kev mob ntsws (neuropsychiatric) lupus erythematosus (NPSLE). Cov tsos mob yuav txawv me ntsis mus rau qhov hnyav thiab muaj xws li:
- Mob taub hau
- Cov mob puas siab ntsws, xws li kev nyuaj siab thiab kev puas siab ntsws bipolar
- Nco ploj
- Tsis nco qab txog kev ua haujlwm
- Ntshav, tics, thiab tsis thab plaub
- Kev txav los sis tsis sib luag
- Tsaus muag
- Qhov muag plooj tsis pom kev
- Teeb meem kev hnov lus
- Cov teeb meem hais lus
- Tsis meej pem thiab delirium
- Tingling, loog, hlawv, mob paj hlwb mob
- Stroke
NWS raug cuam tshuam txog li ntawm 40 feem pua ntawm cov neeg mob lupus, feem ntau tshwm sim li kev nyuab siab, nco kev nyuab siab, thiab kev paub dav dav. Nws yog suav tias yog ib qho teeb meem loj uas ua rau kom txo tau txoj sia thiab muaj kab mob ntxiv.
Cov kev tshawb xyuas tam sim no qhia NPSLE ua rau muaj kaum-fold ntxiv hauv kev tuag thaum piv rau cov neeg hauv cov pejxeem.
Ua rau NPSLE
Ntau dua li muaj ib qho laj thawj, TSIS yog vim muaj kev sib txuam nrog kev tiv thaiv kab mob, hormonal irregularities, vascular mob, thiab kev puas tsuaj rau cov nqaij ntshiv. Txawm tias cov tshuaj phiv tshuaj tuaj yeem ua rau cov tsos mob. Ntxiv mus, cov txheej txheem tiv thaiv uas nyob ib ncig ntawm lub hlwb, hu ua ntshav siab thaiv, muaj peev xwm raug cuam tshuam los ntawm lupus, tso cov co toxins mus rau hauv thiab ua kom puas ntsoog neural nqaij.
Qee cov tsos mob ntawm cov NPLSE tej zaum kuj yuav muaj feem rau qhov mob hu ua demyelinating syndrome uas qhov kev kho mob ntawm cev nqaij daim tawv pib maj mam tawm cov paj hlwb (xav txog nws li lub hau khwb) ntawm cov hlab ntsha. Nyob ntawm seb qhov no tshwm sim, nws tuaj yeem ua rau ntau yam kev xav, kev paub, thiab kev pom teeb meem.
Kev kuaj ntawm NPSLE
Vim hais tias nws tsis yooj yim los qhia qhov txawv ntawm cov NPSLE ntau yam (xws li muaj kev puas siab puas ntsws mob hlwb), tsis muaj cov qauv kub rau kev kuaj mob. Raws li xws li, kev ntsuam xyuas yog feem ntau ua los ntawm kev cais, tshawb tag nrho lwm yam ua tau xws li kis tau tus kab mob, kab mob sib kis, thiab txawm tias muaj kev phom sij tshuaj.
Qhov no yog tsim los ntawm ib rooj plaub-raws li nyob hauv kev coj ntawm tus kws kho mob tshwj xeeb hauv NPSLE.
Yog tias cov kev mob plab hnyuv txhom, kev kuaj yuav tsum tau ua kom pom tseeb tias muaj cov kab mob autoimmune (autoantibodies) nrog kev puas hlwb.
Kev kho mob ntawm tus tsiaj
Feem ntau hais lus, cov tshuaj siv los kho cov kev puas siab puas ntsws thiab kev puas siab ntsws kuj yuav raug siv los kho cov kev mob ntawm kev mob hlwb ntawm lupus.
Yog tias muaj NPSLE hnyav heev, kev kho yuav tsom rau kev siv cov tshuaj uas cuam tshuam thiab txhawm rau qhov kev kho mob kho mob. Cov kev xaiv muaj xws li high-dose corticosteroids (xws li prednisone los yog dexamethasone nrog intravenous cyclophosphamide).
Lwm cov kev kho mob muaj xws li rituximab, tshuaj tua kab mob hauv lub cev (antibody), lossis plasmapheresis (plasma lim ntshav). Cov tsos mob me me mus rau qib qis yuav tau kho nrog rau lub qhov ncauj tsawg mintshioprine lossis mycophenolate.
Nws tseem ceeb heev uas yuav tsum nco ntsoov, txawm li cas los xij, cov kab mob siab corticosteroids siab tuaj yeem ua rau lub siab tsis zoo thiab muaj qee zaum, ua rau muaj kev puas hlwb.
> Qhov chaw:
> Govoni, M .; Bortoluzzi, A .; Padovan, M .; li al. "Lub Diagnosis thiab Clinical Management ntawm lub Neuropsychiatric Manifestations of Lupus." Phau ntawv ntawm Autoimmunity . 2016; 74: 41-72.
> Ho, R .; Thamhu, C .; Ong, H .; li al. "Tus Meta-Analysis of Serum thiab Cerebrospinal Fluid Autoantibodies hauv Neuropsychiatry Systemic Lupus Erythematosus." Autoimmunity xyuas . 15 (2): 124-38.
> Magro-Checa, C .; Zirkzee, E .; Huizinga, T .; thiab Steup-Beekman, G. "Kev Tswj Luam Txog Kev Kuaj Ntshav Qab Zib Lupus Erythematosus: Gog thiab Zej Zog". Tshuaj . 2016; 76 (4): 459-83.
> Shimizu, Y .; Yasuda, S .; Kako, Y .; li al. "Post-Steroid Neuropsychiatric Indications muaj ntau heev nyob rau hauv SLE sib piv nrog rau lwm cov kab mob hauv lub cev thiab kho kom zoo dua qub nrog piv nrog Novo Neuropsychiatric SLE." Autoimmunity xyuas . 2016. 15 (8): 786-94.
> Tay, S. thiab Mak, A. "Diagnosing thiab Attributing Neuropsychiatric Txheej Txheem rau Kev Xeeb Txawm Lupus Erythematosus: Lub sij hawm mus daws cov Gordian Knot?" Rheumatology (Oxford) . Lub Kaum Hlis 15, 2016 (Epub ua ntej sau).