Nehrotic syndrome chirwere chemuviri, chinokonzerwa nehupuka hwetsvo uye chakaonekwa nezvimwe zviratidzo zvekliniki uye laboratory. Kazhinji izvi zvakaoma zvinetso zvinowanikwa mune vanhu vakuru vasina kusvika makore makumi matatu.
Zvinokonzera nephrotic syndrome
Nokuti nephrotic syndrome inoratidzika nekukundwa kwe-glomerular zvishonga zveitsvo, iyo inobatanidzwa muzvikwata zveephrons (zvivako zvezvipi zveizinyo) umo kusvipa kweropa kunoitwa pamwe nekuwedzerwa urin. Pane kuchinja mumasvingo e-glomerular capillaries ane kuwedzerwa kwekusimudzira kwavo, zvichikonzera kukanganisa muprotheni nemafuta metabolism, ayo anotevera:
- kutyora kweprotheni kuwanikwa uye kupinda kwayo mumugine (proteinuria);
- kuderera kukuru kweprotheni yakakosha muropa plasma (hypoproteinemia);
- kunopera mu fractionin albumin yeprotein plasma (hypoalbuminemia);
- kuwedzera muropa cholesterol, triglycerides uye phospholipid (hyperlipidemia), nezvimwewo.
Kana kusaremara kuchiitika kamwe kamwe uye kwakanyorerwa kwekutanga, inonzi nephrotic syndrome inowanzoitika, uye nekugadzirisa kuwirirana kwekuwedzera uye kuregererwa, iyo inotorwa sekusingaperi. Zvimwe zvinokonzera svondo hazvisati zvasimbiswa, asi pfungwa yakajairika uye inonzwisisika yepathogenesis yayo ndiyo immunological imwe. Iyi nyanzvi inotsanangura kukura kwehutano hwehutano hunokonzerwa nehutachiona hwemumasimba kune zvakasiyana-siyana zvinopararira antigens muropa.
Kubvira pakutanga, nephrotic syndrome inogoverwa kuva nheyo (sekuratidzwa kwezvirwere zvakagadzirirwa zvepfungwa) uye yechipiri (zvinokonzera zvirwere zvekugadzirisa nekubatanidzwa kwechipiri neitsvo). Sezvakakosha, inogona kuvapo mumatambudziko akaita se:
- Lipoid nephrosis;
- nephropathy yevakadzi vane pamuviri;
- amyloidosis yeizinso;
- membranous nephropathy;
- pyelonephritis;
- glomerulonephritis;
- itsvo tumors.
Secondary syndrome inogona kukurwisana nechekuita kwezviitiko zvinotevera:
- systemic lupus erythematosus;
- pre-eclampsia;
- hemorrhagic vasculitis;
- chirwere cheshuga mellitus;
- amyloidosis;
- scleroderma;
- chikamu chemapapu;
- hepatitis B;
- hepatitis C;
- myeloma;
- tuberculosis;
- syphilis;
- malariya;
- inonyangadza nesimbi yakakura;
- nyoka inoruma, nezvimwewo.
Nehrotic syndrome ne glomerulonephritis
Kazhinji kune glomerulonephritis yakaoma nephrotic syndrome, iyo inonzi renal glomeruli inoratidzirwa kurwarisa kunotapukira, kazhinji inokonzerwa ne streptococci kana zvimwe zvirwere. Somugumisiro, maitiro ezvirwere zvemuviri anounza zvirwere zvinopesana, izvo zvakasungirwa kune antigens, zvigadzire pamagetsi ekudzivirira uye zvigadzirire.
Nehrotic syndrome ine amyloidosis
Primary (idiopathic) nephrotic syndrome inobatanidza neamyloidosis inokonzerwa nekuti mukati meimputi tishu pane kuiswa kweprotini-polysaccharide michina inokonzera kusashanda kwomuviri. Ikoko kunowedzera kuoma kweephrononi yepamunharaunda yakakomba, kupera kwe epithelium ye tubules, uye itsvo dzinowedzera muhukuru.
Nephrotic syndrome ne pyelonephritis
Zvirwere zvinotapukira uye zvinovhiringidza zvezinonzi renal pelvis, calyx uye renal parenchyma, zvinokonzerwa kakawanda neE E. coli, pakusabatwa kwekodzero yakakwana kunogona kutungamirira nokukurumidza kukanganisa kwekunyanya kushandiswa nekushambadzira kwechirongwa. Muchiitiko ichi, kazhinji kacho kunotanga chirwere chisingaperi chinephrotic syndrome ine nguva yakaoma.
Nehrotic syndrome - zviratidzo
Edema muNephrotic syndrome ndiyo kliniki huru yekuratidzwa. Chokutanga, kuzvikudza kunoonekwa munzvimbo yechiso (kazhinji pasi pemaziso), pamaoko netsoka, munharaunda yechipararira. Pakupedzisira, mvura yacho inounganidza mumuviri unobuda mumutumbi wose. Dzimwe zviratidzo zvinogona kusanganisira:
- kupisa uye kuoma kweganda;
- nyota;
- kurwadziwa mumusoro;
- kusada kudya;
- bloating;
- stool disorders;
- kuvhiringidza kusagadzikana munharaunda ye lumbar;
- muscle pain;
- kuderedza urine yakabuda;
- kunetseka;
- bvindtle bvudzi nemisungo;
- kupfupika kwemhepo, nezvimwewo.
Iyo huru ma laboratori zviratidzo zveNephrotic syndrome zvinoratidzwa mukuongorora urine uye neropa kutevera zviratidzo:
- chiyero cheprotheni mumuguta - kupfuura 3 g / zuva;
- huwandu hweSerum albumin inopfuura 27 g / l;
- huwandu hweprotheni muhutu hwechikamu cheropa - pasi pe 60-50 g / l;
- cholesterol inopa muropa inopfuura 6.5 mmol / l.
Nehrotic syndrome - kusiyana kwekuongorora
Kuti aone kuoma kwechimiro chemuviri, kujekesa zvinokonzera zvinokonzera, kuwedzera pakuongororwa kwakawanda kwesafrologist uye anamnesis, kuongororwa kweNephrotic syndrome kunosanganisira zvidzidzo zvakasiyana-siyana uye laboratory:
- kazhinji kuongorora ropa neropa;
- urin analysis in Zimnitskiy;
- Bacteriological analysis of urine;
- biochemical analysis of blood and urine;
- kuongorora ropa nekuda kwekuvhara;
- electrocardiography;
- Ultrasonography yeitsvo ne dopplerography;
- nephroscintigraphy;
- inso biopsy nekuongorora kukuru.
Nehrotic syndrome - urinalysis
Kana pane kusafungirwa kweephrotic syndrome, kuongororwa kunopa mukana kwete kwete chete kugadzirisa kuongororwa, asiwo kugadzirisa maitiro ekurapwa. Chimwe chezvinyanya kuzivisa ndezvekuregera, umo, kunze kwekuva neproteiniti yakakwirira, zvinotevera zvinoratidzirwa muhutano huno:
- kusava nemuviri;
- kuwedzera kwehukuru;
- alkaline reaction;
- kuvapo kwe-leukocytes uye erythrocytes;
- kuvapo kwefufu uye makisi machena;
- kuvapo kwekristarori yekristasi;
- nhamba yakawanda yemashiripiti miviri.
Kurapa kweyephrotic syndrome
Kana chirwere chinonzi nephrotic chinoratidzwa, chirwere chinofanira kuitwa muchipatara kuitira kuti chiremba anokwanisa kutarisa mamiriro ekurapa uye chirongwa cherapa, kana zvichifanira kuchinja. Chinonyanya kukosha ndiko kurapwa kwehutachiona hwepamusoro uye zvimwe zvirwere zvepakutanga, izvo zvinogona kukonzera nephrotic syndrome. Varwere vanokurudzirwa kuti vashandise muviri miviri kuitira kuti vasave nekugadzirwa kweprombosi.
Mukugadzirwa kwezvinodhaka remishonga, injected injection yeproteine ​​solutions inogoneka, pamwe chete nemapoka anotevera emishonga:
- glucocorticoids (Prednisone, Dexazon, Urbazon) - ne-atopic, lupus, membranous uye mamwe mhando dzesipropathy;
- cytostatics (Azathioprine, Cyclophosphamide, Leukeran) - ine lymphogranulomatosis , sarcoidosis, Wegener's syndrome, nezvimwewo;
- anticoagulants (Heparin) - ine glomerulonephritis hypertensive, inokuvadza, yakaoma, neinetseka, itsva-eclampsia, etc ;;
- diuretics (Furosemide, Etakrinaic acid, Veroshpiron) - nekutaura kuzvimba;
- immunosuppressants (Azathioprine, Cyclosporine) - pakuonekwa kwezvirwere zvemoto;
- maantibayoti (Ampicillin, Doxycycline, Cefazolin) - apo zvirwere zvinotapukira zvinowanikwa.
Cytostatics muNephrotic syndrome
Therapy ye nephrotic syndrome ine cytostatic madzimai inowanzodiwa mumamiriro ekushaya kwe glucocorticosteroid therapy kana kusavapo kwaro. Dzimwe nguva dzinoshandiswa zvakaenzana nemishonga yehomoni, iyo inokubvumira kuderedza kuwedzerwa uye kuoma kwemigumisiro. Iyi mishonga inoita masero ekuparadzanisa, ichidzivirira kuti irege kugovana. Iwe haugoni kutora cytostatics mukuzvitakura, cytopenia, nephropathy pasina zviratidzo zvebasa, kuvapo kwehutachiona hwehutachiona.
Kudya nephrotic syndrome
Kuongororwa kwe "nephrotic syndrome" - chiratidzo chekugadzwa kwe nhamba yezvokudya zvinomwe, inotarisirwa kuenzanisa zvirongwa zvemigodhi uye urin output, kuderedza dema. Iyo huru yekukurudzira kwekudya ndeyotevera:
- 5-6 kudya kwezuva;
- Kusabvisa munyu kuvhara kana kuvharirwa 2-4 g pazuva;
- kushandiswa kwezvokudya zvakabikwa pamhepo, zvakabikwa, zvakabikwa;
- mapurotini zvokudya anoshandiswa muhuwandu hwe 1-2 g kilogram yehuremu;
- kuwedzera kuwedzerwa kwezvokudya zvakapfuma mu potassium (amamondi, apricots akaomeswa, soya);
- kuderedza kushandiswa kwezvinhu zvinosanganisira makorobhohydrates ari nyore (chingwa chakachena, mbatatisi, jisi jena);
- kuderedza kudyiwa kwemafuta emhuka (nyama, hove dzakakora, mazai);
- kugadziriswa kwekushandiswa kwemvura (kunyanya kubvunzurudza zuva rega rega).
Matambudziko aNephrotic syndrome
Zvinetso zveNephrotic syndrome zvinogona kunge zvakaoma kwete nekuda kwekuregererwa kwehutano hwehutano, kusakwanira kurapwa, asiwo nekuda kwekushandiswa kwemimwe mishonga. Matambudziko anowanzoitwa nephrotic syndrome ndeaya:
- phlebothrombosis;
- pneumococcal peritonitis;
- pneumonia;
- pleurisy ;
- thromboembolism ye pulmonary artery;
- isina hanya;
- kurohwa kweuropi;
- nephrotic crisis;
- peptic ulcer;
- allergic manifestations;
- chirwere cheshuga mellitus nevamwe.