Zamkatimu
01Kodi MCAS ndi chiyani?02Kumvetsetsa Mast Maselo03Zomwe Zimachitika Panthawi Yoyambitsa Mast Cell04Zizindikiro za MCAS05Zomwe Zimayambitsa06Chifukwa chiyani MCAS Ndi Yovuta Kuzindikira07Zogwirizana08Kumvetsetsa Zomwe Zimayambitsa Panopa09Kukhala Ndi MCAS10Mafunso Ofunsidwa Kawirikawiri11Zowonjezera Zophunzirira12Zofunika Kwambiri13Kafotokozedwe ka mawu
Gawo 01
Ndi chiyani MCAS?
Mast Cell Activation Syndrome (MCAS) ndi mkhalidwe womwe ma mast cell - maselo oteteza thupi omwe amakhala pafupi ndi minofu iliyonse ya thupi - amagwira ntchito mosayenera komanso mobwerezabwereza, kutulutsa oyimira pakati pamankhwala mochulukira ndipo nthawi zina osagwira ntchito zodzitetezera. Chotsatira chake ndi chitsanzo cha zizindikiro zobwerezabwereza, zowonongeka zomwe zimakhudza machitidwe a ziwalo ziwiri kapena zingapo nthawi imodzi.
Kutanthauzira kuli kofunika chifukwa kumasiyanitsa MCAS ndi mikhalidwe yomwe imafanana kwambiri. Palibe ma cell ochuluka omwe amapezeka pa biopsy, palibe chotulukapo chimodzi chodziwikiratu poyezetsa khungu, ndipo nthawi zambiri palibe vuto lililonse pazantchito zanthawi zonse za labotale. Matendawa amakhala pamalo pomwe maselo owoneka bwino amasankha kuyankha.
Lingaliro Lofunika
Ku MCAS vuto siliri zingati mast cell omwe muli nawo. Zili choncho amawombera mosavuta. Zina zonse za chikhalidwecho - kusayembekezereka, kufalikira kwa machitidwe ambiri, kuyesa kovuta - kumatsatira mfundo imodzi.
Chifukwa chiyani ma cell cell alipo
Ma cell cell si vuto la kapangidwe kake. Ndizigawo zakale kwambiri za chitetezo chamthupi chobadwa nacho, zomwe zimapezeka mwanjira ina pakati pa zamoyo zambiri zamsana, ndipo zimagwira ntchito yomwe thupi limafunikira. Amathandizira kuyankha koyamba kwa tizilombo toyambitsa matenda, amathandizira kuletsa poizoni pambuyo polumidwa ndi kulumidwa, amatenga nawo mbali pakuchiritsa mabala ndi kukonzanso minofu, amathandizira kuwongolera kufalikira kwa mitsempha yamagazi, ndikuthandizira kusunga zotchinga zomwe zimalekanitsa thupi ndi dziko lakunja.
Amayikidwa molingana - amakhazikika pamalire, pakhungu, panjira ya mpweya, khoma lamatumbo, ndi minofu yozungulira mitsempha yamagazi ndi mitsempha. Ndipo amamangidwira liwiro: m'malo mopanga mayankho awo pazomwe akufuna, amazisunga kale m'ma granules osungira, okonzeka kumasula mkati mwa masekondi a chizindikiro. Zomangamangazi ndizomwe zimapangitsa kuti ziwengo zizikhala mwachangu, komanso ndizomwe zimapangitsa kuyambitsa kosayenera kukhala kovuta kukhala nako.
Momwe magwiridwe antchito a mast cell amawonekera
Poyankha bwino chitetezo chamthupi, cell ya mast imakumana ndi chiwopsezo chenicheni - antijeni ya parasite, poizoni, kapena kuwonongeka kwa minofu - ndikuwonongeka molingana ndi izo. Mitsempha ya magazi imatambasuka ndipo imakhala yowonjezereka, zomwe zimapangitsa kuti plasma ndi maselo a chitetezo azitha kulowa mu minofu. Mathero a mitsempha amalimbikitsidwa, kutulutsa kuyabwa kapena kupweteka komwe kumapangitsa chidwi pamalowo. Maselo ena oteteza thupi ku matenda amatengedwa. Chiwopsezocho chikachotsedwa, yankho limatha.
Chilichonse chosasangalatsa panjirayi chimagwira ntchito. Kutupa kumapereka zida zoteteza thupi kutsamba. Kuyabwa kumakupangitsani kuchotsa chilichonse chomwe chikuvulaza. Amachotsa misampha ndikuchotsa zokhumudwitsa. Poyankha molingana, kusapezako kumakhala kwakanthawi ndipo phindu lake ndi lenileni.
Mu MCAS, makina omwewo amagwira ntchito popanda chifukwa chofanana. Maselo a mast amawotcha moto zokha, kapena poyankha zolimbikitsa zomwe ziyenera kukhala zosadabwitsa - chipinda chofunda, fungo lonunkhira mukhonde, chakudya, kuyimirira, kuchita masewera olimbitsa thupi pang'ono, tsiku lotopetsa wamba. Oyimira pakati omwe amamasulidwa ndi omwewo omwe amagwiritsidwa ntchito pachitetezo chovomerezeka, koma amamasulidwa molakwika ndipo nthawi zambiri mobwerezabwereza.
Chifukwa ma cell cell amakhala mu minofu m'thupi lonse, komanso chifukwa omwe amawayimira amakhala pamitsempha yamagazi, minofu yosalala, minyewa, ndi ma cell ena oteteza chitetezo, gawo limodzi limatha kutulutsa kuthamanga kwamtima, kuthamanga kwamtima, kupweteka m'mimba, kupuma movutikira, komanso chifunga cha chidziwitso nthawi imodzi. Kwa dokotala yemwe sakuganiza za mast cell, kuphatikiza kumeneku kumatha kuwoneka ngati mavuto angapo osagwirizana omwe amabwera nthawi imodzi - chomwe ndi gawo lalikulu la chifukwa chomwe matendawa amaphonya.
Fanizo losavuta
| MCAS si mastocytosis | Uku ndiye kusiyana kofunikira kwambiri m'munda, ndipo kusokoneza ziwirizi kumabweretsa chisokonezo pa chilichonse chakumunsi. | |
|---|---|---|
| Mastocytosis poyerekeza ndi MCAS | Mastocytosis | MCAS |
| Kusakhazikika kwapakatikati | Ma cell ochuluka kwambiri amawunjikana mu minofu | Nambala yachibadwa ya mast cell, kuyambitsa mosayenera |
| Chiwerengero cha ma cell | Okwezeka - clonal kuchulukana | Wamba |
| Mtundu woyamba wa tryptase | Nthawi zambiri kumakwezedwa | Nthawi zambiri zimayambira |
| Kupeza kwachibadwa | KIT Kusintha kwa D816V m'milandu yambiri yamachitidwe akuluakulu | Palibe kusintha komwe kunakhazikitsidwa |
| Zotsatira za Biopsy | Kuphatikizika kwa mast cell kumawoneka bwino | Palibe khalidwe kudzikundikira |
| Chizindikiro cha khungu | Zilonda za maculopapular (urticaria pigmentosa) zofala m'njira zina | No enieni matenda khungu chotupa |
Momwe zimatsimikizidwira
Umboni wotsimikizika wa kuchuluka kwa ma cell
Chizindikiro cha zizindikiro + umboni wa mkhalapakati + kuyankha kwamankhwala
Zonsezi zimatha kubweretsa zizindikiro zodutsana, chifukwa nthawi zonse mast cell mediators amafika minofu mopitilira muyeso. Koma mastocytosis akhoza kuwonetsedwa mwa kupeza maselo; MCAS siyingathe, chifukwa chake kuzindikirika kwake kumakhazikika pazotsatira zingapo m'malo mwa mayeso amodzi otsimikizira.
MCAS si ziwengo wamba
Zochita za MCAS nthawi zambiri sizitero. Zambiri sizikhala za IgE konse, zomwe zimatuluka m'malo mwake kudzera pama receptor ena pamtunda wa cell kapena kukondoweza mwachindunji. Zoyambitsa nthawi zambiri zimakhala zakuthupi - kutentha, kuzizira, kupanikizika, kulimbitsa thupi - osati mapuloteni, ndipo palibe gulu lodziletsa lomwe limapangidwa kuti lizindikire izi. Zochita zimatha kuchedwetsedwa ndi maola ambiri, ndikuchotsa kulumikizana kwachilengedwe pakati pa kuwonekera ndi zotsatira zake, ndipo malire amatha kusintha ndi tulo, kupsinjika, momwe thupi limakhalira, kapena matenda aposachedwa, kotero kuwonetseredwa komwe kumaloledwa sabata imodzi kumadzetsa chidwi chotsatira.
Langizo lofunika la zachipatala
- Zowoneka bwino
- Zithunzi zofananitsa mbali ndi mbali: mapanelo atatu owonetsa kuchuluka kwa mast cell akuyankha molingana, gulu la mastocytosis lowonetsa ma cell ochulukirapo, ndi gulu la MCAS lowonetsa manambala a cell omwe ali ndi kutulutsidwa kwa mkhalapakati mokokomeza. Maselo omwewo amawerengera m'magulu amodzi ndi atatu, zotulutsa zosiyana kwambiri.
- Chidule cha gawo
- MCAS ndi vuto la mast cell osayenera kuyambitsa, osati nambala ya mast cell.
- Maselo a mast ndi maselo oteteza chitetezo omwe ali m'malo otchinga thupi ndipo amapangidwa kuti ayankhe mkati mwa masekondi.
Mastocytosis imaphatikizapo kuchuluka kwa maselo ndipo imatha kuwonetsedwa mwachindunji; MCAS sangathe, ndichifukwa chake matenda ali ndi gulu.
Kuyesedwa koyipa kwa ziwengo ndikofala mu MCAS ndipo sikumaletsa.
Gawo 02
Kumvetsetsa Maselo a Mast
Kutsatira chifukwa chomwe MCAS imachita monga momwe imachitira, zimathandiza kudziwa komwe ma cellwa amachokera, komwe amakhala, amakhala nthawi yayitali bwanji, komanso zomwe amamvera.
Chiyambi ndi chitukuko
Maselo a mast amayambira m'mafupa, kuchokera ku CD34-positive haematopoietic progenitor cells - chiwerengero chomwecho chomwe chimapangitsa maselo ena a magazi. Mosiyana ndi maselo oyera ambiri a magazi, iwo samalizitsa kukula kwawo kumeneko. Makolo osakhwima amalowa m'magazi, amazungulira pang'ono, ndiyeno amasamukira ku minofu, kumene kukhwima komaliza kumachitika.
Kukhwima kumeneko kumadalira kwambiri kuwonetsa kwa stem cell factor (SCF) kudzera pa cholandirira cha KIT pa cell cell. Njira iyi ndiyofunikira pa biology ya mast cell, ndipo ndi njira yomweyi yomwe imasokonekera KIT D816V masinthidwe opezeka ambiri akuluakulu a systemic mastocytosis. Chilengedwe cham'deralo chimapanga phenotype yomaliza, ndichifukwa chake ma cell a m'matumbo amasiyana kwambiri ndi omwe ali pakhungu.
| Kugawa thupi lonse | Maselo a mast amagawidwa mwanzeru osati mofanana, kumangoyang'ana pomwe thupi limakumana ndi dziko lakunja komanso kuzungulira zida zomwe zimanyamula zizindikiro ndi magazi. Kugawa uku kumalongosola mawonekedwe a multisystem a MCAS mwachindunji kuposa china chilichonse. | Kumene ma mast cell amakhala, ndi zomwe zimapanga akawotcha |
|---|---|---|
| Malo | Udindo mu thanzi | Zizindikiro pamene kutsegula sikuli koyenera |
| Khungu ndi dermis | Kuteteza chitetezo; kuyankha kulumidwa, mbola, ndi kuvulala | Kutupa, kuyabwa, ming'oma, dermographism, kutupa |
| M'mimba thirakiti | Kusamalira zotchinga, kuwongolera motility, kuyankha ku ziwopsezo zomwe zalowetsedwa | Kutsekula m'mimba, nseru, reflux, kutsegula m'mimba, kudzimbidwa, kudzimbidwa |
| Airways ndi sinuses | Chitetezo cha m'mitsempha yamagazi | Kuchulukana, rhinitis, kutsekeka kwa mmero, kupuma, chifuwa |
| Kuzungulira mitsempha ya magazi | Kuwongolera kamvekedwe ka chotengera ndi permeability | Kuthamanga kwa magazi, tachycardia, kuthamanga kwa magazi, presyncope |
| Ubongo ndi meninges | kupezeka kwa perivascularly ndi meninges; chizindikiro cha neuroimmune | Chifunga chachidziwitso, mutu, chizungulire (njira zomwe zidakali zophunzira) |
| Connective minofu | Kukonzanso ndi kukonza minofu | Kupweteka kwapakati ndi minofu; zotheka kugwirizana ndi kulumikizana kwa minofu |
Mafupa a mafupa
Malo oyambira makolo
Kumene matenda a clonal amawunikidwa pamene mastocytosis akukayikira
Zindikirani momwe ubongo umalowera mosamala. Ma cell cell amapezekadi mu meninges ndi m'mitsempha yapakati mkati mwa minyewa yapakati, ndipo kulumikizana kwa mast cell-nerve ndi gawo lochita kafukufuku. Komabe, njira zolumikizira kuyambika kwa mast cell kuzizindikiro za minyewa ndi zidziwitso zikugwiridwabe, ndipo zonena zamakanika mderali zikuposa umboni womwe ulipo.
Kuzungulira kwa moyo
Mast cell amakhala ndi moyo wautali modabwitsa. Kumene neutrophil ikhoza kukhala ndi moyo kwa maola angapo mpaka masiku, maselo a minofu amatha kukhalapo kwa milungu kapena miyezi, ndipo umboni umasonyeza kuti ena amakhala ndi moyo nthawi yaitali. Amakhalanso okhoza kubwezeretsanso - pambuyo powonongeka, selo la mast likhoza kumanganso masitolo ake ndikuyankhanso, osati kufa panthawiyi.
- Izi ndizofunikira kuchipatala m'njira ziwiri. Zimatanthawuza kuti zizindikiro zoyendetsa ma cell ndizokhazikika m'malo motembenuka mwachangu, kotero palibe kusintha kwachilengedwe mwachangu kudikirira. Ndipo zikutanthauza kuti machiritso omwe amakhazikitsa mast cell amayenera kuchitidwa pafupipafupi pakapita nthawi - mukusintha machitidwe a anthu okhala mokhazikika, osachotsa osakhalitsa.
- Zolandilira pamwamba: zomwe mast cell amamvera
- Ma cell a mast amakhala ndi zolandilira zambiri zam'mwamba, ndipo kukula kwake ndichifukwa chake zinthu zambiri zimatha kukhala ngati zoyambitsa. Zina mwazodziwika bwino ndi izi:
- FcERI - cholandirira chachikulu cha IgE. Iyi ndiye njira yodziwika bwino: Ma antibodies a IgE amamanga cholandilira, ndikulumikizana ndi ma allergen omwe amayambitsa kuyambitsa.
- MRGPRX2 - receptor mediating IgE-yodziyimira pawokha kuyambitsa ndi mankhwala ena ndi ma peptides. Mawonekedwe ake adathandizira kufotokozera zomwe zimachitika popanda kukhudzidwa kwa IgE.
- KIT - cholandilira cha stem cell factor; pakati pa kupulumuka kwa mast cell, kusasitsa, ndi kukhalapo kwa minofu.
- Othandizira zolandilira (C3a, C5a) - kulola kutsegulidwa kudzera mu mkono wothandizira wa chitetezo chachibadwa.
CRH receptors - kuyankha ku corticotropin-release hormone, kupereka njira yolembedwa yomwe physiology yopanikizika imafika ku maselo akuluakulu.
Adenosine, opioid, estrogen ndi zolandilira ena - Kuthandizira pamitundu yosiyanasiyana komanso yoyambitsa ma profaili omwe amawonedwa pochita.
- Kodi Mumadziwa?
- Kukhalapo kwa mayendedwe angapo omwe si a IgE ndichifukwa chake kuyezetsa ziwengo nthawi zambiri kumabwereranso ku MCAS. Mayeserowa amapangidwa kuti azindikire kukhudzidwa kwa IgE-mediated - njira imodzi mwa zingapo zomwe zimatha kuyimitsa cell ya mast.
- Chithunzi chojambulidwa cha cell mast: cell membrane yodzaza ndi zolandilira zotchedwa (FcεRI, MRGPRX2, KIT, C3a/C5a, TLRs, CRH-R), mkati modzaza ndi ma granules, ndikudula komwe kumawonetsa zamkati mwa granule. Chipinda chothandizira chomwe chikuwonetsa selo lisanayambe komanso litatha degranulation.
- Ma cell cell amachokera ku CD34+ progenitors m'mafupa koma okhwima mu minofu, kotero kuchuluka kwa magazi sikumawawonetsa.
- Kuzindikiritsa kwa KIT/SCF ndikofunikira pakukula kwawo - njira yomwe imasokonekera mu mastocytosis ambiri akuluakulu.
Iwo amakhala ndi moyo wautali ndipo akhoza regranulate, kotero kasamalidwe kokhazikika m'malo mwa nthawi yochepa.
Mitundu yambiri yolandirira kupitilira IgE imatha kuwayambitsa, ndichifukwa chake mapanelo osagwirizana nawo nthawi zambiri amaphonya zoyambitsa za MCAS.
Kuyambitsa Mast Cell
Kutsegula ndikutsatizana, ndipo sitepe iliyonse ili ndi dzina. Kutsatira kumapangitsa kuti mitundu yodabwitsa ya MCAS ikhale yosavuta kutanthauzira.
Chokondoweza chimafika m'selo - allergen, mankhwala, kutentha, kupanikizika, mphamvu, mahomoni opanikizika, matenda, kapena palibe chochititsa chidwi.
Zolandilira zam'mwamba zimayamba kugwira ntchito ndipo ma intracellular signing cascades amayamba. Kuchuluka kwa calcium ndi gawo lofunikira poyambira.
Ma granules osungira amalumikizana ndi nembanemba ya cell ndikutulutsa zomwe zidapangidwa kale mu minofu yozungulira - mkati mwa masekondi.
Othandizira opangidwa kale amamasulidwa nthawi yomweyo; oyimira kumene opangidwa kumene monga ma prostaglandins ndi leukotrienes amatsatira mkati mwa mphindi zochepa, ndipo ma cytokines kwa maola ambiri.
5
Zizindikiro
Oyimira pakati amagwira ntchito pamitsempha yamagazi, minofu yosalala, minyewa, ndi ma cell ena oteteza chitetezo, kutulutsa zotsatira pazigawo zingapo zamagulu.
Mbali ziwiri za ndondomekoyi zikufotokozera zambiri zomwe odwala amakumana nazo. Choyamba, gawo laposachedwa limatengera malo ogulitsira omwe adapangidwa kale, ndichifukwa chake machitidwe amatha kuyamba mkati mwa masekondi. Chachiwiri, amkhalapakati am'magawo am'mbuyo amapangidwa pambuyo poyambitsa kuyambitsa, chifukwa chake zizindikiro zina zimafika bwino pambuyo poyambitsa komanso chifukwa chake zomwe zimachitika zimatha kuchedwa kutha kwa mafunde achiwiri pambuyo pake.
Mast cell amamasula oyimira pakati mafunde, osati zonse nthawi imodzi. Oyimira opangidwa kale amatuluka mumasekondi; oyimira lipid amamangidwa mumphindi; ma cytokines amawunjikana pakapita maola. Chochitika choyambitsa chimodzi chikhoza kubweretsa zizindikiro tsiku lonse.
| Mkhalapakati wamkulu ndi zomwe aliyense amachita | Ma cell cell amatha kutulutsa zinthu zambirimbiri. Zotsatirazi ndizo zomwe zimakambidwa kwambiri zachipatala, ndipo palimodzi zimawerengera zambiri za chizindikiro chodziwika bwino. | Oyimira ma mast cell |
|---|---|---|
| Mkhalapakati | Mtundu | Zotsatira zazikulu |
| Histamine | Mtundu | Zopangidwiratu |
| Mkhalapakati wodziwika kwambiri. Imakulitsa mitsempha yamagazi ndikuwonjezera kupenya kwawo, imathandizira malekezero a mitsempha, ndikuwonjezera kutulutsa kwa asidi m'mimba. Amatulutsa kutentha thupi, kuyabwa, ming'oma, kuthamanga kwa magazi, tachycardia, kupweteka mutu, ndi GI cramping. Zimagwira ntchito kudzera mumagulu angapo olandirira - H1 pakhungu ndi mpweya, H2 m'matumbo ndi pamtima - chifukwa chake kutsekereza magulu onse awiri kumagwira ntchito bwino kuposa kutsekereza. | Tryptase | Mapuloteni ochuluka kwambiri mu mast cell granules komanso cholembera chalabu chokhazikitsidwa. Zimathandizira kukonzanso minofu ndi kutupa, ndipo zimatha kukulitsa mayankho amtundu wa mast cell. Phindu lake lodziwikiratu limachokera ku kukhala mwachindunji kwa mast cell. |
| Prostaglandin D2 | Tryptase | Zatsopano apanga |
| Mkhalapakati wa lipid wopangidwa pambuyo poyambitsa. Zomwe zimayambitsa vasodilation ndi kuyanika, bronchoconstriction, ndi kutsegula m'mimba, ndipo zimatha kutsitsa kwambiri kuthamanga kwa magazi. Nthawi zambiri zimaphatikizidwa pomwe kutulutsa ndi chinthu chofunikira kwambiri. | Tryptase | Leukotrienes (LTC4, LTD4, LTE4) |
| Ma bronchoconstrictors amphamvu, ochulukirapo kuposa histamine polemera. Kuchulukitsa kufalikira kwa mitsempha ndi kupanga ntchofu, ndikuthandizira kuzizindikiro zam'mimba komanso zam'mimba. LTE4 imayezedwa mumkodzo. | Tryptase | Cytokines (IL-6, TNF-α, IL-1, IL-4 ndi ena) |
| Kuwonetsa ma protein omwe amayendetsa kutupa kwakukulu. Pang'onopang'ono pakuyamba ndi kuchitapo kanthu motalika kuposa omwe ali pamwambawa, ndipo amaganiziridwa kuti amathandizira kutopa, kufooka, komanso machitidwe amtundu wa 'chimfine' omwe amafotokozera panthawi komanso pambuyo poyaka moto. | Tryptase | Chemokines |
| Pezani ma cell owonjezera oteteza chitetezo pamalopo, ndikukulitsa ndikutalikitsa kuyankha kwa kutupa kupitilira momwe ma cell cell amayambira. | Mtundu | Platelet activating factor (PAF) |
| Mkhalapakati wamphamvu kwambiri wa lipid yemwe amawonjezera kufalikira kwa mitsempha ndipo angayambitse hypotension yayikulu. Kuphatikizidwa mu kuopsa kwa anaphylactic zimachitikira osati oletsedwa ndi antihistamines. | Mtundu | Heparin |
Anticoagulant yochitika mwachilengedwe. Zitha kupangitsa kuti odwala ena azikhala ndi mikwingwirima yachilendo kapena kukhetsa magazi, komanso kutenga nawo gawo pamalamulo oletsa kutupa.
Chymase & carboxypeptidase A3
- Mapuloteni a granule omwe amakhudzidwa ndi kukonzanso minyewa, njira zowongolera kuthamanga kwa magazi, komanso kuwonongeka kwa ma venom ndi ma peptide ena.
- Chifukwa ma antihistamines amaletsa histamine yokha, kuyankha pang'ono kwa antihistamines kumagwirizana kwathunthu ndi MCAS osati umboni wotsutsa. Prostaglandins, leukotrienes, PAF, ndi ma cytokines sanakhudzidwe ndi othandizira amenewo - chomwe ndi chifukwa chakuwonjezera pang'onopang'ono kwa magulu ena amankhwala.
- Tchati chotuluka kuchokera kumanzere kupita kumanja: Yambitsani → Kuyambitsa → Kuchepetsa → Kutulutsa kwa mkhalapakati → Zizindikiro, zokhala ndi nthawi yoyambira yomwe ili pansi pakuwonetsa oyimira omwe adapangidwa kale pamasekondi, oyimira lipid pamphindi, ndi ma cytokines pa maola, nthambi iliyonse imadziwika ndi zizindikiro zomwe imayendetsa.
- Kutsegula kumatsatira motsatana: choyambitsa, kuyambitsa, degranulation, kumasulidwa kwa mkhalapakati, zizindikiro.
- Othandizira opangidwa kale amamasulidwa mumasekondi; lipid mkhalapakati mu mphindi; cytokines kwa maola angapo.
Histamine ndi imodzi mwa oyimira pakati ambiri, chifukwa chake antihistamine okha nthawi zambiri amapereka mpumulo pang'ono.
PAF ndi prostaglandins zimatha kuyambitsa zovuta zamtima zomwe ma antihistamines sathana nazo.
Gawo 04
| MCAS imatanthauzidwa pang'ono ndi kukula kwake. Chifukwa maselo a mast amakhala pafupifupi minofu iliyonse, zizindikiro zimatha kuwoneka paliponse - ndipo kufunikira kwa ziwalo ziwiri kapena zingapo ndizofunikira pakuzindikira. | Matebulo ali m'munsiwa amafotokoza za zizindikiro zomwe zimafotokozedwa motsatira dongosolo la thupi. Machenjezo awiri asanawawerenge. Choyamba, palibe wodwala amene ali ndi zonsezi, ndipo mndandanda wautali suyenera kuwerengedwa ngati mndandanda wogwirizana nawo. Chachiwiri, chizindikiro chilichonse pano chimapezeka muzinthu zina zambiri; zomwe zikusonyeza kuti MCAS ndi chitsanzo - episodic, recurrent, multisystem, nthawi zambiri ndi zoyambitsa zozindikirika - m'malo molowa munthu aliyense. |
|---|---|
| Khungu ndi mucous membrane | Chizindikiro |
| Zolemba | Kupukuta |
| Nthawi zambiri mwadzidzidzi, zimakhudza nkhope, khosi, ndi chifuwa; chinthu chomwe chimanenedwa pafupipafupi | Kuyabwa (pruritus) |
| Zitha kuchitika kapena popanda zidzolo zowoneka | Matenda a urticaria (urticaria) |
| Zokwera, zotsekemera zoyabwa; akhoza kukhala osakhalitsa komanso osamukasamuka | Dermographism |
| Ma welts adakwezedwa ndi kusisita kolimba pakhungu - chizindikiro chodziwika bwino | Angioedema |
| MCAS imatanthauzidwa pang'ono ndi kukula kwake. Chifukwa maselo a mast amakhala pafupifupi minofu iliyonse, zizindikiro zimatha kuwoneka paliponse - ndipo kufunikira kwa ziwalo ziwiri kapena zingapo ndizofunikira pakuzindikira. | Matebulo ali m'munsiwa amafotokoza za zizindikiro zomwe zimafotokozedwa motsatira dongosolo la thupi. Machenjezo awiri asanawawerenge. Choyamba, palibe wodwala amene ali ndi zonsezi, ndipo mndandanda wautali suyenera kuwerengedwa ngati mndandanda wogwirizana nawo. Chachiwiri, chizindikiro chilichonse pano chimapezeka muzinthu zina zambiri; zomwe zikusonyeza kuti MCAS ndi chitsanzo - episodic, recurrent, multisystem, nthawi zambiri ndi zoyambitsa zozindikirika - m'malo molowa munthu aliyense. |
|---|---|
| Kuchedwa kuchira kwa chilonda | Adanenedwa ndi odwala ena; njira zomwe sizinakhazikitsidwe kwathunthu |
| Wopuma | Kuchulukana kwa mphuno ndi rhinitis |
| Nthawi zambiri matenda ndi sanali nyengo | Kuthina kwapakhosi |
| Imafunika kuunika mwachangu ngati ikupita patsogolo - ikhoza kuwonetsa anaphylaxis | Kupuma ndi kupuma movutikira |
| Leukotriene-driven bronchoconstriction ndi njira yodziwika | chifuwa chosatha |
| MCAS imatanthauzidwa pang'ono ndi kukula kwake. Chifukwa maselo a mast amakhala pafupifupi minofu iliyonse, zizindikiro zimatha kuwoneka paliponse - ndipo kufunikira kwa ziwalo ziwiri kapena zingapo ndizofunikira pakuzindikira. | Matebulo ali m'munsiwa amafotokoza za zizindikiro zomwe zimafotokozedwa motsatira dongosolo la thupi. Machenjezo awiri asanawawerenge. Choyamba, palibe wodwala amene ali ndi zonsezi, ndipo mndandanda wautali suyenera kuwerengedwa ngati mndandanda wogwirizana nawo. Chachiwiri, chizindikiro chilichonse pano chimapezeka muzinthu zina zambiri; zomwe zikusonyeza kuti MCAS ndi chitsanzo - episodic, recurrent, multisystem, nthawi zambiri ndi zoyambitsa zozindikirika - m'malo molowa munthu aliyense. |
|---|---|
| Kumva kununkhira ndi mankhwala opangidwa ndi mpweya | Kuphatikizika kofala kwambiri kwa zizindikiro zoyambitsa |
| Zamtima | Tachycardia |
| Kuthamanga mtima, nthawi zambiri popanda khama | Kusakhazikika kwa magazi |
| Itha kusuntha mbali iliyonse panthawi yagawo | Presyncope ndi syncope |
| Mutu wopepuka kapena kukomoka, nthawi zambiri utayima | Kusapeza bwino pachifuwa |
| MCAS imatanthauzidwa pang'ono ndi kukula kwake. Chifukwa maselo a mast amakhala pafupifupi minofu iliyonse, zizindikiro zimatha kuwoneka paliponse - ndipo kufunikira kwa ziwalo ziwiri kapena zingapo ndizofunikira pakuzindikira. | Matebulo ali m'munsiwa amafotokoza za zizindikiro zomwe zimafotokozedwa motsatira dongosolo la thupi. Machenjezo awiri asanawawerenge. Choyamba, palibe wodwala amene ali ndi zonsezi, ndipo mndandanda wautali suyenera kuwerengedwa ngati mndandanda wogwirizana nawo. Chachiwiri, chizindikiro chilichonse pano chimapezeka muzinthu zina zambiri; zomwe zikusonyeza kuti MCAS ndi chitsanzo - episodic, recurrent, multisystem, nthawi zambiri ndi zoyambitsa zozindikirika - m'malo molowa munthu aliyense. |
|---|---|
| Anaphylaxis | Zowopsa, zachangu, zowopseza moyo - onani gawo lazadzidzidzi |
| M'mimba | Kupweteka kwa m'mimba ndi kupweteka |
| Zina mwa zizindikiro zomwe zimanenedwa kawirikawiri | Mseru ndi kusanza |
| Itha kutsatira chakudya kapena kuchitika palokha | Kutsekula m'mimba ndi/kapena kudzimbidwa |
| Motility imatha kusiyanasiyana pakati pa magawo ndi pakapita nthawi | Reflux |
| MCAS imatanthauzidwa pang'ono ndi kukula kwake. Chifukwa maselo a mast amakhala pafupifupi minofu iliyonse, zizindikiro zimatha kuwoneka paliponse - ndipo kufunikira kwa ziwalo ziwiri kapena zingapo ndizofunikira pakuzindikira. | Matebulo ali m'munsiwa amafotokoza za zizindikiro zomwe zimafotokozedwa motsatira dongosolo la thupi. Machenjezo awiri asanawawerenge. Choyamba, palibe wodwala amene ali ndi zonsezi, ndipo mndandanda wautali suyenera kuwerengedwa ngati mndandanda wogwirizana nawo. Chachiwiri, chizindikiro chilichonse pano chimapezeka muzinthu zina zambiri; zomwe zikusonyeza kuti MCAS ndi chitsanzo - episodic, recurrent, multisystem, nthawi zambiri ndi zoyambitsa zozindikirika - m'malo molowa munthu aliyense. |
|---|---|
| Kutupa ndi reactivity chakudya | Nthawi zambiri amayendetsa zoletsa zakudya - onani machenjezo mu gawo 9 |
| Neurological ndi chidziwitso | Chifunga chanzeru |
| Kuvuta kukhazikika, kukumbukira, ndi kupeza mawu | Mutu ndi migraine |
| Migraine imanenedwa kuti ndi yokwera kwambiri pakati pa anthuwa | Chizungulire |
| Nthawi zambiri amadutsana ndi mtima ndi autonomic mbali | Kutopa |
| Zowopsa kwambiri komanso mwazinthu zolemala zomwe zimanenedwa | Sensor sensitivity |
| MCAS imatanthauzidwa pang'ono ndi kukula kwake. Chifukwa maselo a mast amakhala pafupifupi minofu iliyonse, zizindikiro zimatha kuwoneka paliponse - ndipo kufunikira kwa ziwalo ziwiri kapena zingapo ndizofunikira pakuzindikira. | Matebulo ali m'munsiwa amafotokoza za zizindikiro zomwe zimafotokozedwa motsatira dongosolo la thupi. Machenjezo awiri asanawawerenge. Choyamba, palibe wodwala amene ali ndi zonsezi, ndipo mndandanda wautali suyenera kuwerengedwa ngati mndandanda wogwirizana nawo. Chachiwiri, chizindikiro chilichonse pano chimapezeka muzinthu zina zambiri; zomwe zikusonyeza kuti MCAS ndi chitsanzo - episodic, recurrent, multisystem, nthawi zambiri ndi zoyambitsa zozindikirika - m'malo molowa munthu aliyense. |
|---|---|
| Zomverera za mitsempha yosagwira bwino | Kupweteka, kuyaka, kapena dzanzi zomwe zimanenedwa ndi odwala ena |
| Minofu ndi mafupa, genitourinary, ndi maganizo | Kupweteka kwamagulu ndi minofu |
| Zitha kuphatikizika ndi mikhalidwe yolumikizirana yomwe takambirana mu gawo 7 | Kupweteka kwa mafupa |
| Kuwunika kovomerezeka, makamaka komwe mastocytosis ndiyolingaliridwa | Kufulumira kwa chikhodzodzo komanso pafupipafupi |
| Zizindikiro za interstitial-cystitis zimafotokozedwa | Zizindikiro zimasiyana malinga ndi msambo |
| Mphamvu ya mahomoni pama cell a mast imalembedwa | Nkhani ngati nkhawa |
Kutulutsa kwa mkhalapakati kumatha kubweretsa kugunda kwamtima, kupuma movutikira, komanso kumva kuti ali pachiwopsezo
Kusintha kwamalingaliro ndi kukwiya
Zonse kuchokera ku zotsatira za mkhalapakati komanso kukhala ndi matenda aakulu, osadziwika bwino
- Kulowa 'ngati nkhawa' kumayenera kusamalidwa mbali zonse ziwiri. Kutulutsidwa kwa mkhalapakati kungapangitse thupi lenileni la mantha, ndipo odwala nthawi zambiri amawadziwa molakwika chifukwa chake. Panthawi imodzimodziyo, nkhawa ndi kuvutika maganizo zimachitikadi limodzi ndi matenda aakulu ndipo amayenera kulandira chithandizo paokha. Kuzindikira chimodzi sikutanthauza kuthamangitsa wina.
- Chifukwa chiyani zizindikiro zimasiyana kwambiri pakati pa odwala
- Anthu awiri omwe ali ndi matenda ofanana amatha kuwonetsa mosiyanasiyana mosiyanasiyana. Zinthu zingapo zimathandizira, ndipo zambiri sizimamveka bwino:
- Kugawa kwachigawo. Kachulukidwe ka maselo a mast ndi phenotype amasiyana pakati pa minyewa komanso pakati pa anthu, kotero kuti ziwalo zomwe zimakhudzidwa kwambiri zimasiyana.
- Kutulutsidwa kwa mkhalapakati kosiyana. Maselo a mast amatha kumasula oyimira osankhidwa m'malo mwa zonse zomwe zili mkati mwake, ndipo mitundu yosiyanasiyana ya mkhalapakati imatulutsa zizindikiro zosiyanasiyana.
- Mbiri ya cholandilira. Ma receptor omwe amawonetsedwa pama cell amunthu amapangidwa ndi zinthu zomwe zimawayambitsa.
Zikhalidwe zomwe zilipo. Matenda ophatikizika monga POTS kapena hypermobility amasintha chithunzi chonse chachipatala.
- Poyambira ndi kuchulukana katundu. Kugona, kupsinjika, kuchuluka kwa mahomoni, komanso matenda aposachedwa, zonse zimasintha momwe zimakhalira, motero munthu yemweyo amasinthasintha pakapita nthawi.
- Zinthu zachibadwa. Hereditary alpha tryptasemia ndi mitundu ina ya majini imatha kusintha mawonekedwe - gawo la kafukufuku wokhazikika m'malo mokhazikika chidziwitso.
- Mapu a thupi lachizindikiro: chidule cha ma anatomical okhala ndi zilembo zolembedwa kudera lililonse lomwe lakhudzidwa - khungu, mpweya, mtima, matumbo, ubongo, mafupa, chikhodzodzo - chilichonse chimakulitsidwa kuti chiwonetsere zomwe zikugwirizana ndi dongosololo. Kusintha kumatha kuwonetsa machitidwe omwe wodwala wapatsidwa akukumana nawo.
- Zizindikiro zimayambira pakhungu, kupuma, mtima, GI, minyewa, minofu ndi mafupa, madera a genitourinary, ndi malingaliro.
- Kuphatikizidwa kwa machitidwe a ziwalo ziwiri kapena kuposerapo ndi gawo lachidziwitso cha matenda.
Kuwonetsera kumasiyana kwambiri pakati pa odwala komanso pakapita nthawi mkati mwa wodwala yemweyo.
Zochitika zokhala ndi nkhawa zimatha kukhala zoyendetsedwa ndi mkhalapakati; izi siziyenera kugwiritsidwa ntchito kuchotseratu vutoli, kapena kunyalanyaza zosowa zenizeni za thanzi la maganizo.
Gawo 05
Wamba Zoyambitsa
Zoyambitsa sizichitika zokha. Maselo a mast amayankha pakachulukidwe kachulukidwe, ndichifukwa chake chakudya, chipinda, kapena zochitika zomwezo zitha kukhala zopanda vuto tsiku lina ndikusapiririka tsiku lotsatira.
Kutsegula ndi kuchuluka. Kuwonetseredwa kovomerezeka kwapang'onopang'ono kukafika pamodzi kumatha kudutsa malire omwe palibe amene angadutse yekha. Ili ndiye lingaliro limodzi lothandiza kwambiri pakumvetsetsa zomwe zimangochitika mwachisawawa.
Zakudya
Zoyambitsa zakudya mu MCAS nthawi zambiri zimagwirizana ndi zomwe zili ndi histamine kapena kuwongolera kukwiya kwa mast cell m'malo mongodya zakudya zakale. Histamine imadziunjikira m'zakudya zikamakalamba, kupesa, kapena kusungidwa, chifukwa chake kutsitsi nthawi zambiri kumakhala kofunikira kwambiri kuposa zomwe zili - nsomba zomwezo zimatha kuloledwa patsiku logula osati masiku atatu pambuyo pake. Tchizi zachikale, nyama zochiritsidwa ndi zowonongeka, zakudya zofufumitsa, ndi zotsalira zimakhudzidwa kwambiri. Gulu lachiwiri likuwoneka kuti likupangitsa ma mast cell kutulutsa histamine yawo. Kusiyanasiyana kwapaokha ndikwambiri, ndipo mindandanda yosindikizidwa imatengedwa bwino ngati malingaliro oti ayesedwe osati malamulo.
Kutentha
Zina mwazomwe zimanenedwa kawirikawiri zoyambitsa thupi. Mashawa otentha ndi mabafa, saunas, nyengo yotentha, zipinda zofunda, ndi zakumwa zotentha zonse zimatchulidwa mofala. Kutentha sikufuna kuti zinthu zilowe m'thupi, zomwe ndi gawo la chifukwa chake kuyezetsa kwazomwe sikungathe kuzizindikira.
Kuzizira
Mpweya wozizira, madzi ozizira, zakumwa zoziziritsa kukhosi, ndi malo okhala m'firiji zimanenedwa kuti zimayambitsa odwala ena. Makamaka, mofulumira kusintha Kutentha kwapakati nthawi zambiri kumafotokozedwa kuti ndi koipa kwambiri kuposa kusakhazikika.
Masewera olimbitsa thupi
Kuchita masewera olimbitsa thupi ndikoyambitsa kwenikweni kwa odwala ambiri, komanso komwe kumakhala ndi mtengo weniweni, popeza kuchita zinthu kumakhala kopindulitsa pa thanzi ndi malingaliro. Kuchuluka ndi kuchuluka kwa chiwonjezeko ndizofunikira kwambiri kuposa nthawi yonse, ndichifukwa chake njira zapang'onopang'ono, zotsika kwambiri - ndi zochitika zongowonjezera kapena zamadzi pomwe kuyimirira sikuloledwa bwino - nthawi zambiri zimayendetsedwa bwino.
Kupsinjika maganizo
Kupsinjika maganizo ndiko kuyambitsa thupi, osati fanizo. Maselo a mast amanyamula ma receptor a corticotropin-release hormone ndipo amakhala pafupi ndi mathero a mitsempha, ndikupereka njira yolembedwa yomwe dongosolo lamanjenje limakhudza kuyambitsa kwawo. Mfundoyi ikuyenera kutsindika chifukwa odwala omwe zizindikiro zawo zimawonjezereka ndi kupsinjika maganizo kawirikawiri amauzidwa kuti matenda awo ndi amaganizo. Njira yowonetsera neuroimmune si chinthu chofanana ndi chizindikiro chomwe chimaganiziridwa.
Mahomoni
Odwala ambiri amafotokoza zizindikiro za cyclical, zomwe nthawi zambiri zimakhala zovuta kuzungulira msambo. Estrogen imakhudza machitidwe a mast cell, omwe ndi amodzi omwe amathandizira pakukula kwa matendawa mwa amayi. Zosintha pa nthawi ya mimba, pambuyo pobereka, ndi perimenopause zimafotokozedwanso, ndipo zimasiyana kwambiri pakati pa anthu.
Matenda
Infection modalirika imabweretsa reactivity yoyambira kwa odwala ambiri. Matenda obwera chifukwa cha ma virus nthawi zambiri amakulitsa chiwopsezo chomwe chimayambika kwa milungu ingapo pambuyo pake, motero mawonekedwe omwe adaloledwa kale amakhala oyambitsa kuchira. Odwala ena amakumana ndi zizindikiro zawo ku matenda opatsirana, ngakhale kukhazikitsa chifukwa chazochitika payekha kumakhala kovuta.
Zowonetsa zachilengedwe
Mankhwala
Magulu ena amankhwala amadziwika m'mabuku a mast cell monga oyambitsa, kuphatikiza opioid, mankhwala ena osagwiritsa ntchito steroidal anti-inflammatory, radiocontrast media, neuromuscular blocking agents omwe amagwiritsidwa ntchito mu anesthesia, ndi vancomycin. Zosakaniza zosagwira ntchito - utoto, zosungira, zodzaza - zingakhalenso chigawo choyambitsa matenda, chifukwa chake wodwala akhoza kulekerera mapangidwe a wopanga wina ndikuchitapo kanthu kwa wina.
Zofunika
Musayime, kupewa, kapena kusintha mankhwala omwe mwapatsidwa chifukwa cha mndandanda wa mankhwala. Bweretsani mndandandawo kwa sing'anga yemwe amadziwa mbiri yanu. Kuopsa kosiya chithandizo chofunikira kungathe kupitirira chiopsezo chomwe chikupeŵedwa, ndipo chisankhochi chimafuna kuwunika payekha.
Zonunkhira ndi zonunkhira
Mafuta onunkhiritsa, zotsitsimutsa mpweya, zoyeretsera, zochapira, zosungunulira, utoto watsopano, ndi ziwiya zatsopano ndi zina mwa zinthu zomwe zimanenedwa mosalekeza, ndipo pakati pazovuta kwambiri kuzipewa m'malo ogawana. Malo opanda mafuta onunkhira ndi pempho lokhazikika m'masukulu ndi m'malo antchito pazifukwa izi.
Mowa
Mowa nthawi zambiri umanenedwa ngati woyambitsa kudzera munjira zingapo: zakumwa zambiri zoledzeretsa zimakhala ndi histamine mwachindunji, makamaka vinyo ndi mowa; mowa ukhoza kusokoneza ma enzyme omwe amaphwanya histamine; ndipo imayambitsa vasodilation palokha. Zomwe zimachitika pazigawo zing'onozing'ono zimafotokozedwa kawirikawiri.
Kusowa tulo
Kusagona mokwanira kapena kusagona mokwanira kumachepetsa kulolerana komanso kumalumikizana ndi chilichonse chomwe chili pamndandandawu. Sikuti nthawi zambiri imayambitsa moto, koma ndi imodzi mwazinthu zomwe zimathandizira kwambiri, ndipo odwala nthawi zambiri amafotokoza kuti kuteteza kugona kumakweza malire awo pa china chilichonse.
- Chifukwa chiyani zoyambitsa zimasiyana kwambiri
- Ma trigger seti amasiyana pakati pa anthu chifukwa mbiri yolandirira, kugawa minofu, mikhalidwe yomwe ilipo, komanso kuyambiranso koyambira zonse zimasiyana. Amasinthanso mkati munthu pakapita nthawi - kuchulukirachulukira panthawi yomwe simukuwongolera bwino ndikucheperanso kamodzi chithandizo chikachepetsa kuyambiranso koyambira. Zochita zimatha kuchedwa ndi maola, zomwe zimalepheretsa kulumikizana pakati pa zomwe zimayambitsa ndi zotsatira zake. Pazifukwa zonsezi, kuzindikira zoyambitsa kumafuna kusungidwa mwadongosolo kwa milungu ingapo m'malo motengera zomwe zachitika m'modzi.
- Threshold infographic: bala yopingasa yomwe imayimira momwe mungayankhire, yokhala ndi midadada yowunjikana pansi pa kutentha, kusowa tulo, kupsinjika, chakudya chachikulire, komanso kulimbikira. Onetsani chochitika choyamba pomwe midadada itatu imakhala pansi pa mzere, ndipo yachiwiri pomwe chipika chachinayi chikukankhira stack pamwamba pake - zigawo zomwezo, zotsatira zosiyana.
- Zoyambitsa stack - kuchuluka kwa katundu kumafunika kwambiri kuposa kuwonekera kulikonse.
- Zoyambitsa thupi (kutentha, kuzizira, kupanikizika, kuchita khama) sizifuna kuti zilowe m'thupi ndipo siziwoneka poyesa ziwengo.
Zoyambitsa mankhwala ziyenera kukambidwa ndi dokotala, osadzilamulira nokha pamndandanda.
Ma trigger seti amasiyana pakati pa anthu ndikusintha pakapita nthawi, kotero kusunga mbiri ndikofunikira.
Gawo 06
Chifukwa chiyani MCAS ili
Zovuta ku Dziwani
Kuchedwa kwa matenda mu MCAS sikuti kulephera kwa asing'anga payekha. Zimachokera kuzinthu zenizeni, zozindikirika za chikhalidwecho ndi mayesero omwe amagwiritsidwa ntchito pofufuza.
Zizindikiro zosinthika
MCAS imapanga mitundu yosiyanasiyana yazizindikiro mwa odwala osiyanasiyana, komanso kuphatikiza kosiyanasiyana kwa wodwala yemweyo pakapita nthawi. Palibe chiwonetsero chimodzi chotsutsana ndi mapeto. Chifukwa chakuti zizindikirozo sizikhala zachindunji, chilichonse chikhoza kunenedwa kuti chimachitika chifukwa chofala kwambiri akamaganiziridwa payekha.
Kuyesedwa kwa labotale kwachizolowezi
Kugwira ntchito pafupipafupi kwa magazi nthawi zambiri kumakhala kosadabwitsa mu MCAS. Magazi athunthu, zolembera zotupa, ndi biochemistry wamba nthawi zambiri zimakhala zachilendo, monganso mapanelo osagwirizana nawo. Kuyesa kwapadera kwa mkhalapakati kumafunika, ndipo ngakhale zomwe nthawi zambiri zimabweretsa zotsatira zabwinobwino pazifukwa zaukadaulo zomwe zili pansipa. Choncho wodwala akhoza kudziunjikira zambiri za kafukufuku wamba pomwe akukhalabe bwino - njira yomwe mwatsoka imawonjezera mwayi woti auzidwe kuti palibe cholakwika.
Kutulutsidwa kwa mkhalapakati wapakati
Ili ndiye vuto lalikulu laukadaulo. Oyimira pakati omwe amayezedwa amakhala ndi moyo waufupi. Seramu tryptase ifika pachimake pakangopita maola ochepa atachitapo kanthu kenako ndikugwa; ma metabolites a mkodzo amakhalabe nthawi yayitali koma amawonetsabe zenera lochepa. Zitsanzo pakati pa zigawo sizingapeze chilichonse chokwezeka - osati chifukwa kuyambitsa sikunachitike, koma chifukwa sikungathenso kuyezedwa.
Zofunikira pakusamalira zimaphatikiza izi. Oyimira pakati angapo amakhala osakhazikika kutentha kwa chipinda, ndipo zitsanzo za prostaglandin ndizosalimba kwambiri. Zitsanzo zimafunika kuzizira nthawi yomweyo, kuziziritsa nthawi yonse yosonkhanitsa, komanso kukonza mwachangu. Chitsanzo chosiyidwa pa kutentha kwa chipinda kapena chochedwetsedwa paulendo chikhoza kutulutsa zotsatira zabwinobwino kuchokera kwa wodwala yemwe anali kuchitapo kanthu.
Kuchuluka kwa zotsatira zoyipa za mkhalapakati zikuwonetsa nthawi ndi kusamalira m'malo mopanda matenda. Kutsimikizira ndondomeko ya kusonkhanitsa ndi dokotala wolamula ndi labotale musanatenge sampuli ndi kofunika kwambiri kuposa kubwereza kuyesa kosayendetsedwa bwino.
Kuthana ndi matenda ena
Zizindikiro za MCAS zimaphatikizana kwambiri ndi matumbo okwiya, urticaria osatha, mphumu, fibromyalgia, matenda otopa kwambiri, nkhawa, dysautonomia, ndi ena angapo. Iliyonse mwa izi ndi yodziwika bwino kwa asing'anga ambiri ndipo imapezeka kawirikawiri. Wodwala akasonyeza kuti ali ndi zizindikiro zoyenerera zingapo mwa izi pang'ono, zotsatira zake nthawi zonse zimakhala zongopeka pang'ono m'malo mongogwirizanitsa.
Kupanda kuzindikira kwa dokotala
MCAS idadziwika bwino mu 2007, ndi mfundo zovomerezeka zomwe zidatsatiridwa mu 2010 ndi 2012. Madokotala ambiri omwe adamaliza maphunziro awo asanalowe m'maphunziro apamwamba. Kudziwika kumasiyana mosiyanasiyana ngakhale pakati pa allergists ndi immunologists, ndipo mwayi wopeza akatswiri omwe ali ndi chidziwitso cha mast cell ndi wosagwirizana ndi malo.
Kusamvana kwa matenda
Ndikoyenera kunena momveka bwino kuti njira zodziwira matenda a MCAS zimakhalabe nkhani yotsutsana kwenikweni m'mabuku azachipatala. Mwachidule, mbali imodzi imakhala ndi mfundo zokhwima zomwe zimafuna umboni wa mkhalapakati, chifukwa popanda izi, matendawa amatha kugwiritsidwa ntchito mozama kwambiri. Udindo wina ukunena kuti njira zokhwima zimaphonya odwala omwe ali ndi vutoli koma omwe kuyesa kwawo kwa mkhalapakati kumalephera mobwerezabwereza pazifukwa zaukadaulo zomwe tafotokozazi.
Izi si kusagwirizana odwala analenga, ndipo si kuthetsedwa. Zotsatira zake ndikuti akatswiri awiri odziwa bwino amatha kufika paziganizo zosiyanasiyana za wodwala yemweyo. Kumvetsetsa kuti mkangano ulipo kumathandizira kufotokoza malingaliro otsutsana popanda kuganiza kuti dokotala wina adangolakwitsa.
- Kuchedwa kwa matenda
- Kuphatikiza pamwambapa kumatulutsa kuchedwa kwanthawi yayitali. Odwala nthawi zambiri amadutsa muzapadera zingapo - gastroenterology, dermatology, cardiology, ziwengo, zamitsempha, zamisala - chilichonse chikuwunika gawo limodzi lavuto ladongosolo. Ziwerengero zofalitsidwa ndi zofufuza za odwala nthawi zambiri zimalongosola kuchedwa komwe kumayesedwa m'zaka, ndipo kuyerekezera kwazaka khumi kumatchulidwa kawirikawiri, ngakhale kuti ziwerengerozi zimabwera ndi malire enieni a njira ndipo ziyenera kuwerengedwa monga zowonetsera osati zenizeni.
- Chithunzi cha nthawi yaulendo wodziwitsa woyimilira: Zizindikiro zoyambira pazaka ziro; ulendo woyamba wa GP; kutumiza kwa gastroenterology ndi endoscopy yachibadwa; dermatology yokhala ndi zotsatira za chithandizo chamankhwala; cardiology ndi kuyang'anitsitsa kwabwino kwa Holter; kutumizidwa kwa misala; ndiye ziwengo / immunology ndikuwunika komaliza kwa mast cell. Nodi iliyonse yodziwika ndi nthawi yodutsa ndi zolembera za 'zotsatira zodziwika bwino', zomwe zimapangitsa kuti mayeso olakwika awoneke ngati mawonekedwe m'malo motengera zochitika zapadera.
- Kuyesa kwa labotale kwanthawi zonse kumakhala kwabwinobwino mu MCAS; kuyezetsa kwapadera kwa mkhalapakati kumafunika.
- Oyimira pakati amakhala akanthawi kochepa komanso osakhazikika, chifukwa chake nthawi ndi kasamalidwe ka zitsanzo zimayendetsa zolakwika zambiri zabodza.
Kudziwa kwachipatala kumasiyanasiyana; chikhalidwecho chinalowa mu maphunziro posachedwapa.
Njira zodziwira matenda zimakhalabe zotsutsana, kotero malingaliro a akatswiri akhoza kusiyana movomerezeka.
Zogwirizana Zoyenera
MCAS imanenedwa pafupipafupi limodzi ndi zina zingapo. Mphamvu zaumboni zimasiyana kwambiri pakati pa mayanjano awa, ndi kusiyana kwa zinthu.
Werengani izi poyamba
Kugwirizana si chifukwa. Zinthu zingapo zomwe zili pansipa zimachitika limodzi ndi MCAS nthawi zambiri kuposa momwe mwadzidzi ungadziwire, koma kaya amagawana njira, kaya imayambitsa ina, kapena njira zotumizirana zogawana zimakulitsa kuphatikizika komwe kukuwoneka. sanakhazikitsidwe kwa ambiri mwa ma pairings awa.
Postural Orthostatic Tachycardia Syndrome (POTS)
POTS ndi mtundu wa dysautonomia womwe umadziwika ndi kugunda kwa mtima kwambiri pakuyima, nthawi zambiri ndi mutu wopepuka komanso kutopa. Kuyanjana ndi MCAS kumafotokozedwa bwino m'mabuku. Mafotokozedwe omwe akufunsidwa akuphatikizapo mast cell mediators omwe amakhudza kamvekedwe ka mitsempha ndi kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe kake sikunakhazikitsidwe. Zinthu zonsezi zimatha kuyambitsa tachycardia, chizungulire, komanso kutopa, zomwe zimasokoneza kuwonetsa zizindikiro za chimodzi kapena chimzake.
Hypermobile Ehlers-Danlos Syndrome (hEDS) ndi hypermobility spectrum disorders
Kugwirizana kwa hEDS, POTS, ndi MCAS kumakambidwa pafupipafupi mokwanira kuti afotokozeredwe mwamwayi ngati atatu. Chiyanjanochi chimanenedwa nthawi zonse, koma njira yoyambira imakhalabe yongopeka. Maselo a mast amakhala mu minofu yolumikizana ndi kutenga nawo mbali pakukonzanso minofu, yomwe imapereka njira yomveka yofufuzira, koma kumveka si umboni. Njira zotumizira ndi zowunikira zingathandizenso kuti kuphatikizikako kuwonekere kwamphamvu.
Hereditary alpha tryptasemia (HaT)
HaT ndi chibadwa chomwe chimaphatikizapo makope owonjezera a jini ya alpha-tryptase TPSAB1, chotengera chotengera chachikulu cha autosomal, ndipo chimapanga seramu tryptase yokwera mosalekeza. Ndilofala poyerekezera ndi anthu wamba. Chiyanjano chake ndi zizindikiro chikufotokozedwabe: chimalumikizidwa ndi zovuta kwambiri m'mikhalidwe ina, koma anthu ambiri omwe ali ndimtunduwu amakhala opanda zizindikiro.
HaT imafunika kutanthauzira. Chifukwa imakweza tryptase yoyambira, mtengo umodzi wokwera wa tryptase mwa munthu yemwe ali ndi HaT sumangowonetsa kuyambika kwa ma cell cell - zomwe zimatsimikizira chifukwa chake gawo lozindikira limatanthauzidwa ngati kukwera pamwamba pa maziko a munthu osati nambala yeniyeni.
Irritable bowel syndrome (IBS)
Zizindikiro za m'mimba mu MCAS zimayenderana pafupifupi ndi njira za IBS, ndipo odwala ena amakhala ndi zilembo zonse ziwiri. Kafukufuku wawunika kachulukidwe ka mast cell komanso kuyambitsa kwamatumbo am'matumbo a odwala a IBS omwe ali ndi zopeza zosiyanasiyana. Kaya kagawo kakang'ono ka IBS kakuyimira kukhudzidwa kwa mast cell ndi funso lotseguka osati zotsimikizika.
Migraine
Migraine imanenedwa kuti ndi yokwera kwambiri pakati pa odwala MCAS. Histamine ndi chinthu chokhazikika cha vasoactive chomwe chimadziwika kuti chimagwirizana ndi mutu, ndipo ma mast cell amapezeka mu meninges. Ulalo wamakina ndi wovomerezeka mwachilengedwe ndipo ukufufuzidwa, koma osakhazikika.
mphumu ndi urticaria yosatha
Awa ali ndi ubale womveka bwino wamakina ndi ma cell amtundu uliwonse mugawoli. Maselo a mast ali pakatikati pa pathophysiology ya onse awiri - leukotrienes ndi histamine drive bronchoconstriction ndi mapangidwe a wheal motsatana. Urticaria yosachiritsika makamaka imakhudza mast cell activation mwachindunji. Awa si mayanjano ongoyerekeza; ndi mikhalidwe yomwe kukhudzidwa kwa mast cell kumakhazikitsidwa, ngakhale amakhalabe ndi matenda osiyana ndi MCAS.
COVID yayitali
| Matenda a Autoimmune | Mitundu yosiyanasiyana ya autoimmune imanenedwa pamodzi ndi MCAS, kuphatikiza chithokomiro cha autoimmune. Ma cell a mast amatenga nawo gawo pakuwongolera chitetezo chamthupi ndikulumikizana ndi mayankho osinthika a chitetezo chamthupi, ndikupereka maziko omveka a kusagwirizana, koma njira zenizeni zolumikizira MCAS ku matenda ena a autoimmune sizinakhazikitsidwe. | Mphamvu ya umboni pang'onopang'ono |
|---|---|---|
| Mkhalidwe | Chikhalidwe cha ubale | Udindo wa umboni |
| Matenda a urticaria | Mast cell activation ndiyofunika kwambiri pa matendawo | Udindo wa umboni |
| Njira yokhazikitsidwa | mphumu | Mast cell mediators amayendetsa bronchoconstriction |
| Cholowa cha alpha tryptasemia | Makhalidwe a chibadwa okweza tryptase yoyambira; zimakhudza kutanthauzira kwa mayeso | Khalidwe lokhazikika; Chiyanjano cha zizindikiro chikufotokozedwabe |
| Mpoto | Zochitika nthawi zambiri; mkhalapakati zotsatira pa mtima kamvekedwe akufuna | Association inanena; makina osathetsedwa |
| HaT imafunika kutanthauzira. Chifukwa imakweza tryptase yoyambira, mtengo umodzi wokwera wa tryptase mwa munthu yemwe ali ndi HaT sumangowonetsa kuyambika kwa ma cell cell - zomwe zimatsimikizira chifukwa chake gawo lozindikira limatanthauzidwa ngati kukwera pamwamba pa maziko a munthu osati nambala yeniyeni. | hEDS / hypermobility | Zochitika nthawi zambiri; kukhudzidwa kwa minofu yolumikizana |
| Association inanena; makina ongoyerekeza | Mitengo yokwezeka yomwe idanenedwa; oyimira vasoactive omveka | Association inanena; makina akuphunziridwa |
| IBS | Chizindikiro chikuphatikizana; Zotsatira za ma cell a m'matumbo zimasiyanasiyana | Kuphatikizika bwino; ubale wosathetsedwa |
| Migraine imanenedwa kuti ndi yokwera kwambiri pakati pa odwala MCAS. Histamine ndi chinthu chokhazikika cha vasoactive chomwe chimadziwika kuti chimagwirizana ndi mutu, ndipo ma mast cell amapezeka mu meninges. Ulalo wamakina ndi wovomerezeka mwachilengedwe ndipo ukufufuzidwa, koma osakhazikika. | Matenda a Autoimmune | Co-occurrence lipoti; adagawana chitetezo chamthupi chomwe chimaperekedwa |
- Association inanena; makina sanakhazikitsidwe
- Chizindikiro chikuphatikizana; kukhudzidwa kwa mast cell
- Choyambirira - pofufuza mwachangu
- Kukhudzidwa kwa mast cell kumakhazikitsidwa mu urticaria osatha ndi mphumu - izi sizolumikizana zongopeka.
- HaT ndi chibadwa chenicheni chomwe chimadzutsa tryptase yoyambira ndikusintha momwe zotsatira zoyezetsa ziyenera kuwerengedwa.
Kulumikizana kwa Long COVID ndi koyambirira ndipo sikuyenera kuwonetsedwa monga kukhazikitsidwa.
M'dera lonseli, mayanjano akhala akulakwitsa mobwerezabwereza kuti ndi chifukwa - werengani zonena mosamala.
Gawo 08
Kumvetsetsa Kwamakono
za Zoyambitsa
Chidule chabodza ndichakuti chomwe chimayambitsa MCAS sichidziwika. Zomwe zikutsatira zimasiyanitsa zomwe zakhazikitsidwa ndi zomwe zatsalirabe.
Palibe chifukwa chimodzi cha MCAS chomwe chakhazikitsidwa. Zomwe zili m'munsizi ndi madera ofufuzira omwe ali ndi chithandizo chosiyana. Chilichonse chomwe chikuwonetsa chidaliro, akaunti yogwirizana ya MCAS ikupitilira umboni.
Genetics
Zomwe zimakhazikitsidwa: Hereditary alpha tryptasemia ndi mtundu weniweni, wodziwika bwino womwe umaphatikizapo zolemba zina zowonjezera. TPSAB1, ndipo imakweza tryptase yoyambira. Payokha, a KIT Kusintha kwa D816V kumakhazikitsidwa ngati dalaivala mu mastocytosis akuluakulu ambiri - chikhalidwe chosiyana, koma chomwe chikuwonetsa momwe kusintha kumodzi kungawonongere biology ya mast cell.
Kupsinjika maganizo ndiko kuyambitsa thupi, osati fanizo. Maselo a mast amanyamula ma receptor a corticotropin-release hormone ndipo amakhala pafupi ndi mathero a mitsempha, ndikupereka njira yolembedwa yomwe dongosolo lamanjenje limakhudza kuyambitsa kwawo. Mfundoyi ikuyenera kutsindika chifukwa odwala omwe zizindikiro zawo zimawonjezereka ndi kupsinjika maganizo kawirikawiri amauzidwa kuti matenda awo ndi amaganizo. Njira yowonetsera neuroimmune si chinthu chofanana ndi chizindikiro chomwe chimaganiziridwa.
Zomwe siziri: Palibe kusintha kofanana komwe kwadziwika kwa MCAS. Kuphatikizika kwapabanja kumanenedwa, ndipo odwala ena amafotokozera achibale angapo omwe akhudzidwa, koma njira yodziwika ya cholowa cha MCAS yokha sinakhazikitsidwe. Kaya MCAS ikuyimira vuto limodzi lomwe lili ndi chibadwa chomwe sichinapezeke, kapena mikhalidwe yosiyanasiyana yomwe ili pansi pa chizindikiro chimodzi chachipatala, sichinathetsedwa.
Kuwonongeka kwa chitetezo chamthupi
Broad immune dysregulation ndi gawo lotsogola pakufufuza. Njira zomwe akuyembekezeredwa zimaphatikizapo kusinthika kwa ma receptor kapena kukhudzidwa kwa mast cell, kusokoneza mayendedwe omwe nthawi zambiri amatha kuletsa kuyambitsa, komanso kuyanjana kwachilendo pakati pa ma mast cell ndi magulu ena oteteza chitetezo. Izi ndi zomveka komanso zophunziridwa mwakhama, koma zimalongosola gulu la kufotokozera m'malo mwa njira yowonetsera.
Odwala ambiri amakhala ndi zizindikiro za matenda opatsirana. Matendawa amadziwika kuti amatsegula ma mast cell kudzera pa ma Toll-like receptors, kupereka njira yomveka, ndipo kuyambika kwa matenda pambuyo pake ndi njira yodziwika bwino m'mikhalidwe ingapo. Komabe, kukhazikitsa kuti matenda zidayambitsa MCAS muzochitika payekha ndizovuta kwambiri, ndipo kukumbukira kukondera kumakhudza maakaunti obwereza. Izi zikadali mgwirizano womwe ukuphunziridwa.
Zinthu zachilengedwe
Zomwe angafunike kuti athandizire zachilengedwe ndi monga kuwonetseredwa kwa mankhwala, nkhungu, kuwononga mpweya, ndi kusintha kwa zakudya pamlingo wa anthu. Umboni pano ndi wochepa kwambiri poyerekeza ndi madera omwe ali pamwambawa, ndipo zambiri siziri zachindunji. Ili ndi gawo lovomerezeka la kafukufuku m'malo mopereka chithandizo chokhazikika, komanso ndi malo omwe zonena zamalonda zodalirika ndizofala komanso zosachirikizidwa bwino.
Kutupa kosatha
Maselo a mast onse amayankha ndikuthandizira kutupa, zomwe zimabweretsa mwayi wodzilimbitsa nokha pomwe kuyambitsa kumabweretsa malo otupa omwe amachepetsa mwayi wowonjezera. Izi ndizogwirizana mwamakina ndipo zimagwirizana ndi kuwunika kwachipatala kuti kuchitapo kanthu kumakulirakulira pakuwongolera koyipa. Imakhalabe chitsanzo osati chifukwa chowonetseredwa.
Epigenetics
Kusintha kwa epigenetic - kusintha kwa mawonekedwe a jini popanda kusintha kwazomwe zimayendera - kwaperekedwa ngati njira yomwe kuwonetseredwa kwa chilengedwe kungapangitse kusintha kosatha mu khalidwe la mast cell. Ichi ndi lingaliro loyambirira. Ndizomveka komanso zoyenera kuzifufuza, ndipo pakadali pano pali umboni wochepa wachindunji wa MCAS.
- Kumene izi zimasiya zinthu
- Ndizotheka kuti MCAS monga momwe ikufotokozedwera pano ikuphatikiza njira zingapo zoyambira, komanso kuti magulu azachipatala amaphatikiza odwala omwe pamapeto pake adzalekanitsidwa ndi makina. Kafukufuku akupitilira m'mbali zonse pamwambapa. Kwa odwala, tanthauzo lothandiza ndiloti kasamalidwe kamene kamayang'ana oyimira pakati ndi zoyambitsa m'malo mokhala ndi chifukwa chachikulu - komanso kuti kukayikira kuli koyenera ku chinthu chilichonse kapena ndondomeko yomwe imanena kuti imayambitsa chifukwa chomwe gulu la kafukufuku silinazindikire.
- Chithunzi chaumboni: magulu okhazikika akusunthira kunja kuchokera ku 'Kukhazikitsidwa' (makhalidwe a HaT; KIT D816V mu mastocytosis) kudzera mu 'Kufufuzidwa mwachangu ndi umboni wochirikiza' (kuwonongeka kwa chitetezo chamthupi, kuyambika kwa matenda) kupita ku 'Hypothesised, umboni wocheperako wachindunji' (epigenetics, kuwonetseredwa kwachilengedwe).
- Palibe chifukwa cha MCAS chomwe chakhazikitsidwa.
- HaT ndi kusintha kwa KIT D816V mu mastocytosis kumakhazikitsidwa chibadwa - komanso sichomwe chimayambitsa MCAS.
Zopereka zachilengedwe ndi epigenetic ndizongopeka zokhala ndi umboni wochepa wachindunji.
Khalani okayikira zonena za 'zoyambitsa' mokayikira - gulu lofufuza silinazindikire chimodzi.
Gawo 09
Kukhala Ndi MCAS
Utsogoleri umapangidwa makamaka kuchokera ku zochitika za tsiku ndi tsiku osati kuchokera pakuchitapo kanthu kamodzi. Zomwe zikutsatira ndizoyang'ana ntchito - cholinga chake ndi moyo waukulu kwambiri womwe thupi lanu lingathandizire.
Kasamalidwe ka tsiku ndi tsiku ndi machitidwe
Odwala ambiri amapeza kuti kusasinthasintha kumakweza malire awo modalirika kuposa momwe aliyense payekhapayekha. Kugona nthawi zonse ndi kudzuka, nthawi yodziwikiratu ya chakudya, kutentha kokhazikika komwe kungatheke, komanso kusasinthasintha kwanthawi yamankhwala kumachepetsa kusinthasintha. Mayendedwe amathandizanso kuti chizindikiritso choyambitsa chikhale chotheka: zosintha zambiri zikakhazikika, zomwe zidasintha zimawonekera.
Pacing ndi mutu womwe umabwerezedwa m'maakaunti a odwala - kugawa zochitika tsiku limodzi kapena sabata m'malo momangoyang'ana, ndikumanga nthawi yochira pambuyo pa zomwe zimadziwika. Izi sizofanana ndi kusagwira ntchito, ndipo kusagwira ntchito kwanthawi yayitali kumatengera ndalama zake zolembedwa bwino.
Kutsata zizindikiro ndikupeza zoyambitsa
Mbiri yokhazikika ndiyo njira yodalirika kwambiri yodziwira zoyambitsa zamunthu. Zolemba zothandiza zimapitilira chakudya: nthawi yamasana, kutentha kozungulira, zomwe zidadyedwa komanso momwe zidali zatsopano, kuchita masewera olimbitsa thupi, kupsinjika ndi kugona, fungo lonunkhira, mankhwala omwe amamwedwa, komanso - kwa odwala omwe ali msambo - kuzungulira. Zizindikiro ziyenera kulembedwa ndi nthawi yake komanso mozama.
Masabata awiri ndi ocheperako pang'ono kuti mapangidwe awonekere, ndipo nthawi yayitali ndi yabwino. Chifukwa chakuti zochitazo zingachedwe ndi maola ambiri, kuonekera kwa nkhaniyo kungaonekere bwino kwambiri zizindikirozo zisanachitike. Yang'anani kubwereza zochitika m'malo mofotokozera zochitika zamtundu umodzi - cholinga chake ndikungoyesa kuyesa, osati chigamulo.
Diary yazizindikiro ndi imodzi mwazinthu zothandiza kwambiri zomwe wodwala angabweretse ku nthawi yokumana: konkire, nthawi yayitali, komanso yeniyeni kwa iwo mwanjira yomwe palibe mndandanda wazomwe zingayambitse. Zimathandizanso kusiyanitsa zoyambitsa zenizeni ndi zomwe zinangochitika mwangozi, zomwe kukumbukira kokha sikumachita bwino.
Kugwira ntchito ndi madokotala
Kuwonetsa zizindikiro zokonzedwa ndi organ system m'malo motengera nthawi yomwe imapangitsa kuti mawonekedwe amitundu yambiri awonekere nthawi yomweyo, pomwe nkhani yofotokozera imakonda kuyibisa. Kubweretsa zotsatira - kuphatikizapo zachilendo - ndizothandiza kwambiri ndipo zimapewa kubwereza kufufuza komaliza.
Kufunsa mwachindunji za nthawi yoyezetsa mkhalapakati ndi kasamalidwe ka zitsanzo ndikoyenera ndipo kumapangitsa mwayi wopeza zotsatira zomwe zingagwiritsidwe ntchito. Ngati simukumvedwa, kufunafuna lingaliro lachiwiri ndikovomerezeka; Matenda a mast cell ndi malo omwe amadziwika bwino kwambiri. Kuchotsedwa ntchito kamodzi ndi kofala ndipo si chigamulo.
Sukulu
Malo ogona ambiri amaphatikizapo malamulo a m'kalasi opanda mafuta onunkhira, chilolezo chonyamula ndi kudzipangira yekha mankhwala, kupeza madzi ndi nthawi yopuma, kuganizira za kutentha pakukhala, kusinthasintha kwa kupezeka pa nthawi yamoto, ndi kusintha kwa maphunziro a thupi. Kumene ndondomeko za malo ogona zimakhalapo m'maphunziro anu, kukhala ndi matenda olembedwa molembedwa kumapangitsa kuti kuwapeza kukhala kosavuta.
Ntchito
Zolinga zapantchito zimafanana ndi za kusukulu: malamulo onunkhiritsa, kuwongolera kutentha, kusinthasintha kapena kukhazikika patali pakayaka moto, ndikusintha ndandanda komwe kutopa kumatsata njira yodziwikiratu. Kaya ndi kuwulutsa zochuluka bwanji ndi chisankho chaumwini chokhala ndi malonda enieni, ndipo chimagwirizana ndi chitetezo cha ntchito chomwe chimasiyana kwambiri pakati pa madera.
Maulendo
Njira zothandiza zomwe odwala amatchula nthawi zambiri ndi monga kunyamula mankhwala m'chikwama cha m'manja chokhala ndi zolemba, kupeza kalata ya dokotala ya mankhwala obaya jekeseni, kufufuza zipatala zachipatala komwe mukupita, kukonzekera chakudya pasadakhale komwe kudzakhala kofunikira, komanso kulola nthawi yochira pofika. Kusintha kwa kutentha ndi kukwera ndikofunika kuyembekezera.
Thanzi la maganizo
Kukhala ndi matenda osinthasintha, osadziwika bwino, komanso omwe nthawi zambiri amachotsedwa nthawi zambiri kumakhala ndi mtengo weniweni wamaganizo, ndipo mtengo umenewo si kufooka kwa khalidwe. Odwala ambiri amafotokoza nthawi yayitali ya kusakhulupirira asanazindikire, zomwe zimasiya chizindikiro chake. Thandizo - kaya akatswiri, anzako, kapena onse awiri - ndi gawo loyenera la kasamalidwe osati kuvomereza kuti zizindikiro ndi zamalingaliro.
- Kusiyanitsa komwe kuli koyenera kugwiridwa ndi ichi: kumasulidwa kwa mkhalapakati kumatha kubweretsa nkhawa ngati physiology, ndipo izi zimayenera kuzindikirika m'malo molembanso za chikhalidwe chonsecho. Panthawi imodzimodziyo, nkhawa ndi kupsinjika maganizo ndizofala, zochiritsika, ndipo ziyenera kuthetsedwa pazokha pamene zilipo.
- Kukonzekera mwadzidzidzi
- Odwala ena omwe ali ndi matenda a mast cell ali pachiwopsezo cha anaphylaxis - kufulumira, koopsa, komwe kumatha kuyika moyo pachiwopsezo. Kumene ngoziyo ingagwire ntchito, kukonzekera sikosankha, ndipo ndi kukambirana ndi dokotala musanafunikire.
- Odwala omwe amayesedwa kuti ali pachiwopsezo amapatsidwa epinephrine auto-injection ndipo amalangizidwa kuti azinyamula nthawi zonse.
- Epinephrine ndiye njira yoyamba yothandizira anaphylaxis. Ma antihistamines siwolowa m'malo ndipo sayenera kudaliridwa pazovuta kwambiri.
- Dongosolo lolembedwa lachidziwitso chadzidzidzi lomwe mwagwirizana ndi dokotala wanu liyenera kukuwonetsani zizindikiro, zomwe muyenera kupereka, komanso nthawi yoti muyimbire chithandizo chadzidzidzi.
Odwala omwe amayesedwa kuti ali pachiwopsezo amapatsidwa epinephrine auto-injection ndikulangizidwa kuti azinyamula nthawi zonse. Epinephrine ndi mankhwala oyamba a anaphylaxis; antihistamines siilowa m'malo mwake ndipo sayenera kudaliridwa muzochitika zoopsa kwambiri.
Makope operekedwa kwa achibale, ogwira nawo ntchito, kapena ogwira ntchito kusukulu amatanthauza kuti ena akhoza kuchita ngati simungathe.
Chidziwitso chachipatala chozindikira matenda ndi zomwe zimadziwika kuti zimayambitsa mankhwala zimathandiza ogwira ntchito mwadzidzidzi omwe mwina sakudziwa bwino za matendawa.
Opaleshoni ndi opaleshoni imalola kukambirana pasadakhale kotero kuti othandizira amatha kusankhidwa poganizira momwe alili.
- Ndemanga yoletsa zakudya
- Zakudya zochepetsera histamine ndi kuchotseratu zimayesedwa kwambiri, ndipo umboni wochirikiza ndi wochepa komanso wabwino kwambiri. Kuletsa kwachulukidwe kosayang'aniridwa kumakhala ndi chiopsezo chenicheni cha kuperewera kwa zakudya m'thupi komanso kudya molongosoka, ndipo chiwopsezochi chimakhala chachikulu mwa achinyamata. Kuyesa kokhazikika, kwanthawi yochepa ndi kubweretsanso mwadongosolo - mothandizidwa ndi okonda kudya - ndiyo njira yotetezeka.
- Ndikoyenera kutchula msampha mwachindunji: ndizotheka kuchepetsa zoyambitsa mwamphamvu kwambiri kotero kuti moyo umagwirizanitsa pafupifupi chilichonse. Dongosolo lomwe limathetsa kusamvana mwa kuthetsa ntchito, sukulu, zakudya zosiyanasiyana, ndi kucheza ndi anthu lasintha mtundu wina wovulaza ndi wina.
- Zochita zokhazikika zimakulitsa malire ndikupangitsa kuti chizindikiritso choyambitsa chitheke.
- Diary yokhazikika yazizindikiro pakatha milungu ingapo ndiyo njira yodalirika yodziwira zomwe zimayambitsa.
- Kuwonetsa zizindikiro ndi dongosolo la ziwalo kumapangitsa kuti mawonekedwe a multisystem awonekere kwa asing'anga.
Kumene chiwopsezo cha anaphylaxis chikugwira ntchito, epinephrine ndi ndondomeko yolembedwa ndizofunikira - antihistamines siilowa m'malo.
Kuletsa zakudya zolimbitsa thupi kumakhala ndi zoopsa zenizeni ndipo kuyenera kusanjidwa, kukhala ndi nthawi yochepa, komanso kuyang'aniridwa.
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Kodi MCAS ndi cholowa?
Kodi ana angakhale ndi MCAS?
Kodi MCAS ingathe kuzimiririka yokha?
Chifukwa chiyani zizindikiro zanga zimasintha?
Chifukwa chiyani zotsatira za mayeso anga zimakhala zabwinobwino nthawi zonse?
Kodi kupsinjika kungayambitse moto?
Kodi zakudya zingathandize MCAS?
Kodi pali kusiyana kotani pakati pa MCAS ndi mastocytosis?
Kodi MCAS ndi yofanana ndi kusalolera kwa histamine?
Kodi ndikufunika kuyezetsa kuti ndipezeke?
Ndi dokotala wamtundu wanji yemwe amathandizira MCAS?
Kodi antihistamines adzakonza zonse?
Kodi ndichifukwa chiyani ndimatani ndi mankhwala omwe amayenera kundithandiza?
Kodi MCAS ndi olumala?
Kodi MCAS ingayambitse anaphylaxis?
Kodi mimba imakhudza MCAS?
Chifukwa chiyani kutentha kumandipangitsa kuchitapo kanthu pomwe sindine matupi aliwonse?
Zimatenga nthawi yayitali bwanji kuti mankhwala agwire ntchito?
Kodi ndisinthe mankhwala angapo nthawi imodzi kuti ndichire mwachangu?
Kodi COVID-19 kapena matenda ena angayambitse MCAS?
Kodi MCAS imapezeka kwambiri mwa amayi?
Kodi MCAS ndi yofala bwanji?
Kodi ndiyenera kupewa zakudya zilizonse zomwe zili pamindandanda yambiri ya histamine?
Kodi ndiyenera kubweretsa chiyani ku msonkhano wanga woyamba wa akatswiri?
Mbiri ya zizindikiro zokonzedwa ndi ziwalo m'malo motsatira nthawi, zomwe zimapangitsa kuti ma multisystem awonekere nthawi yomweyo. Diary yokhala ndi zizindikiro zosachepera milungu iwiri. Zotsatira zonse zoyesedwa m'mbuyomu, kuphatikiza zodziwika bwino, chifukwa izi ndi gawo la njira yochotsera. Mndandanda wamakono wamankhwala ndi zowonjezera. Ndipo mndandanda wachidule wamafunso anu - nthawi yoikidwiratu ndi yachidule ndipo ndikosavuta kuchoka osafunsa zomwe zinali zofunika kwambiri.
Gawo 11
Maphunziro Owonjezera Zida
- Zoyambira zosankhidwa kuti muwerenge mozama. Maulalo enaake akupangidwa ndipo awonjezedwa apa.
- Otsogolera Odwala
- Maupangiri opezeka olembera odwala ndi mabanja, oyenera kugawana ndi anthu omwe ali ndi vutoli.
- Wotsogolera wodwala - ulalo kuti uwonjezedwe
Paketi yodziwika kumene - ulalo kuti uwonjezedwe
Chizindikiro chosindikizidwa ndikuyambitsa diary template - ulalo kuti uwonjezedwe
- Malangizo kwa achibale ndi osamalira - ulalo woti muwonjezedwe
- Malangizo a Zamankhwala
- Mawu ogwirizana ndi malangizo azachipatala opangira akatswiri azachipatala. Zothandiza kubweretsa mapointi.
- Consensus diagnostic criteria - mawu ndi ulalo wowonjezera
Specialist Society Clinical Guide - ulalo kuti uwonjezedwe
Kuyesa kwa mkhalapakati ndi protocol yosamalira zitsanzo - ulalo kuti uwonjezedwe
- Malingaliro a Perioperative ndi anesthesia - ulalo kuti uwonjezedwe
- Mapepala Ofufuza
- Zolemba zoyambirira. Ngati n'kotheka, sankhani malo owunikiridwa ndi anzanu ndi masiku osindikiza, pamene gawoli likuyenda.
- Mapepala odziwika bwino (2007 mtsogolo) - mawu oti awonjezedwe
Mapepala ovomerezeka a Consensus (2010, 2012) - mawu oti awonjezedwe
Kafukufuku wa hereditary alpha tryptasemia - mawu oti awonjezedwe
- Ndemanga zamakhalidwe ogwirizana - mawu oti awonjezedwe
- Mabungwe Aukadaulo
- Magulu apadera ndi mabungwe ophunzira omwe amagwira ntchito pa matenda a mast cell.
Mabungwe a National and International Allergy/immunology - maulalo kuwonjezeredwa
Maukonde ofufuza matenda a Mast cell - maulalo kuwonjezeredwa
- Mabungwe osowa matenda - maulalo kuwonjezeredwa
- Mabuku
Kuwerenga kwanthawi yayitali kwa odwala ndi asing'anga.
Mayina okhudzana ndi odwala - kuti iwonjezedwe
- Zolemba zachipatala - kuti iwonjezedwe
- Mavidiyo a Maphunziro
- Nkhani zojambulidwa, zofotokozera, ndi nkhani za msonkhano.
Mavidiyo ofotokozera oyambira - maulalo kuwonjezeredwa
Maphunziro apadera amsonkhano - maulalo kuwonjezeredwa
- Tsatanetsatane wamaphunziro a MCAS - maulalo kuwonjezeredwa
- Mabungwe Othandizira
- Thandizo la anzawo, kulengeza, ndi anthu ammudzi.
Mabungwe olimbikitsa odwala - maulalo kuwonjezeredwa
Magulu othandizira anzawo - maulalo kuwonjezeredwa
- Magulu othandizira a zigawo ndi dziko lonse - maulalo kuwonjezeredwa
- Mayesero Achipatala
- Maphunziro omwe akulembedwa pano. Kupezeka kwa mayesero kumasintha kawirikawiri, choncho yang'anani mndandanda wa registry mwachindunji.
Panopa akulembera maphunziro a mast cell - maulalo kuwonjezeredwa
Malangizo pa zomwe kutenga nawo gawo pamayesero kumakhudzanso - ulalo kuti uwonjezedwe
- Chinsinsi Zotengera
- Mfundo zofunika kwambiri za bukhuli, zofupikitsidwa.
- Mwachidule
- MCAS ndi vuto la mast cell osayenera kuyambitsa, osati nambala ya mast cell - maselo ndi abwino, malire awo sali.
- Maselo a mast ndi maselo othandiza chitetezo m'thupi omwe ali pafupi ndi zotchinga za thupi, akugwira oyimira omwe adapangidwa kale okonzeka kumasulidwa mkati mwa masekondi.
- Zizindikiro ndi episodic, zobwerezabwereza, ndipo zimaphatikizapo ziwalo ziwiri kapena zingapo - chitsanzocho, osati chizindikiro chilichonse, ndi chomwe chimasonyeza matenda.
- Oyimira pakati amamasulidwa m'mafunde: opangidwa kale mumasekondi, oyimira lipid mumphindi, ma cytokines opitilira maola. Chochitika chimodzi chotsegula chikhoza kutenga tsiku.
- Histamine ndi mkhalapakati m'modzi mwa ambiri, ndichifukwa chake antihistamines nthawi zambiri amapereka pang'onopang'ono m'malo mopumula kwathunthu.
- Zoyambitsa stack. Cumulative load imafotokoza zochitika zomwe zimawoneka mwachisawawa, ndipo ndi lingaliro limodzi lothandiza kwambiri pakuwongolera tsiku ndi tsiku.
- Zoyambitsa thupi - kutentha, kuzizira, kupanikizika, kulimbitsa thupi - sizifuna kulowetsedwa ndipo siziwoneka ndi kuyezetsa koyenera kwa ziwengo.
- Mapanelo osagwirizana ndi ziwengo ndi ntchito yanthawi zonse yamagazi zimayembekezeredwa mu MCAS ndipo sizikuletsa.
- Mayeso ambiri oyipa amkhalapakati amawonetsa zovuta zanthawi ndi kasamalidwe ka zitsanzo m'malo mopanda matenda.
- Njira zodziwira matenda zimakhalabe zotsutsana, kotero akatswiri odziwa bwino amatha kufika paziganizo zosiyanasiyana za wodwala yemweyo.
- Kukhudzidwa kwa mast cell ndi kukhazikitsidwa matenda urticaria ndi mphumu; mayanjano ndi POTS, hEDS, IBS ndi Long COVID amanenedwa koma osathetsedwa.
- Palibe chifukwa cha MCAS chomwe chakhazikitsidwa - perekani 'zoyambitsa' zodzidalira mokayikira.
Kumene chiwopsezo cha anaphylaxis chikugwira ntchito, epinephrine ndi ndondomeko yolembedwa ndizofunikira; antihistamines si cholowa m'malo.
Cholinga chake ndi moyo waukulu kwambiri momwe thupi lanu lingathandizire - osati moyo wawung'ono kwambiri womwe umapewa zizindikiro zonse.
Kuyambitsa Mast Cell