I-Tubulointerstitial nephritis, ifom ekhuphayo kwaye engapheliyo: iimpawu, izizathu kunye nonyango

I-Tubulointerstitsialnye nephritis ibangelwa zizifo zeengtso kunye nezilonda zamachiza, ezikhokelela ekusebenzeni kakubi kwelilungu. Esi sifo sibonakaliswe utshintsho olukhulu kwisakhiwo seengxube zesifo seengqondo. Kukho iintlobo ezimbini zezifundo zesifo - esisigxina kunye esingapheliyo. Ekufundisweni kwamachiza amaninzi angena emzimbeni womntu, kuthethwa ukuba iyeza lidityaniswa ngeentso. Ukungenakucatshulwa nokungalawulwa kwamachiza kukhokelela ekuqalekeni kwesi sifo ngenxa yokunyuka kwamanye amayeza okanye imithi yonyango. Ukugula kwakhona kubangelwa ngenxa yesifo esitshintshiselweyo.

Ukufumanisa i-tubulointerstitial nephritis, iindlela zokuhlola izixhobo zomzimba zangoku, zisetyenziswa: i-ultrasound, umchamo kunye nokuhlaziywa kwegazi, ukuqokelela idatha ye-anamnesis, i-kidney biopsy. Isigqibo esiphathelene nokubuyiswa kwesi sifo senziwa ngesiseko somonakalo kunye nexesha lokufuna uncedo lwezonyango.

Izizathu zesifo

Ngamanye amaxesha ukulawulwa kwee-antibiotics okanye ezinye izidakamizwa ezichasayo zihlala zide ixesha elide. Kwaye kwonakalisa intlungu emva kokuba utyhefu oluninzi kunye neekhemikhali, isinyithi esinzima. Eyona nto inobungozi zimbini ze-ethanol. I-Tubulointerstitial nephritis inokuvela ngenxa yezizathu ezininzi:

• Emva kokutshatyalaliswa kwintsholongwane ye-virus - kwi-46% yamatyala;
• Ubunobuthi obubonakalayo obunobungozi buvusa isifo ngo-28.3%;
• Izifo zamathambo emzimbeni zenza igalelo ekukhuleni kwesi sifo ngo-13.9%;
• Ukuphazamiseka komsebenzi wokujikeleza we-ureters - 8.8%;
• I-Genetic kunye ne-immune causes - kwi-0.9% yezifo;
• Izizathu ezininzi ziqwalaselwa ngokukhawuleza kwi-2.5% yamatyala.

Iifomu ezingapheliyo zesifo zibangelwa ukuphazanyiswa okukhulu kwengqibelelo ye-cytoplasm, i-dysplasia yezicubu zeengso, utshintsho kwi-metabolism, i-congenital and anomalies of the ureters.

Ingxelo yokuxilongwa

Kuqhutyelwa uphando oluthile lwezifundo kunye nezifundo. Kwaye kuphela ukuxilongwa okuchanekileyo kwenziwa. I-Tubulointerstitial nephritis ithathwa njengesigulane ngokubonakala kweempawu ezibonakalisiweyo, ezifunyaniswa zizibonakaliso ezizimeleyo ezibonakalayo.

Isifo sesimo esingapheliyo sisiphumo sokungenelela kunye ne-atrophy yamanzi emzimbeni womntu ixesha elide. Umsebenzi wequmrhu uvinjelwe ngokuthe ngcembe - iminyaka emininzi. Isigulane sidlulisela ugqirha xa kubonakala iimpawu ezingathandekiyo, ezinjengentlungu yesifo, ukugqithisa kunye nabanye. Bayamkhathaza kakhulu. Esi sifo sichaphazela iinjongo ezimbini ngasinye okanye silimaza enye kuphela.

Kwiimviwo zebhubhoratri ye-urine, i-sediment sediment kunye nomxholo omkhulu we-erythrocyte kunye ne-leukocytes ibonakala ngokucacileyo. Kule meko, kukho ukungabikho okupheleleyo kwe-erythrocytes yoluhlobo lwe-dysmorphic kunye nomboniso omncinane we-hematuria. Ubukho be-eosinophil e-urine abubonakalisi ubukho besifo, kuba kuphela kwi-50% yeziganeko ezibangelwa yimpilo. Ukuba azinjalo, oko kubonisa ukuba isifo asikho. Iproteinuria ibonakaliswa zizibonakaliso ezincinci, kodwa ukuba isilwanyana sele seye savelisa i-glomerular pathology ebangelwa ukusetyenziswa kweziza-antibiotics, ngoko le nqondiso ifinyelela kwi-nephrotic level.

Kuvavanyo lwegazi, i-tubulainterstitial nephritis ebonakalayo ibonakalisa njengengxube ye-hypercalcemia. Ukuphululwa komsebenzi weziteshi kuholele kwi- acidosis ye-metabolic. Nge-ultrasound, isalathisi se-echogenicity siphezulu kakhulu ngenxa yokuphuhliswa komzimba kunye nokungena kwenkqubo. I-ultrasound ibonisa ukunyuka kobukhulu bezintso, ukwanda kwesohlwayo se-gallium ne-leukocytes, echazwe kwinkqubo ye-radionuclides. I-scan enhle ibonisa i-tubulainterstitial nephritis. Ukuxilongwa, okubhengeze umphumo ombi, kufuneka kuqinisekiswe ezinye iindlela.

I-Symptomatology yesifo

Kwizigaba zokuqala zesifo, iimpawu azibonakali. Ezinye izigulane azizi malunga nokuphuhliswa kwezilwanyana. Imva kamva yesifundo sesi sifo yenza ukuba bazive ngeempawu ezicacileyo:

• Kukho ukuqhuma kwinqanaba okanye kummandla wonke womzimba, onobunzima obunzima;
• Ukwandiswa kwinqanaba elincinci lokushisa, amacala amaninzi ayaziwa imeko yesifo;
• Ubuhlungu kwiintliziyo zivakalelwa rhoqo okanye zihamba rhoqo;
• Ukunyameka kunyuke, isigulane sivakalelwa;
• Ukunyuka kwengcinezelo kwenzeka ngenxa yesizathu esicacileyo;
• Kukho i polyuria.

Ukubonakalisa ezininzi ezahlukeneyo ze-tubulointerstitial nephritis. Iimpawu zibonwa ngohlobo lomkhuhlane kunye nokugqithisa, kodwa olu tshintsho emzimbeni alwanele ukuba lunokuxilongwa. I-Rash iyenzeka ngenyanga emva kwesenzo se-toxin okanye iintsuku ezi-3-6. Kuxhomekeke kwimeko yomzimba kunye nokuphendula kwayo kwi-allergen. Kukho ukulahleka kwesisindo, intlungu kwisisu nangasemuva ngasentla.

Isifo, esadlulile kwisigaba esingapheliyo, sichaphazeleka ngexesha elithile ngeempawu ezincinci ezanda ngexesha. Abanye abantu bahlakulela i-nocturia kunye ne-polyuria. Ukunyuka kwengcinezelo yegazi kunye nokuvuvukala kweengalo akugcinwa kwaze kwaba yintsholongwane yezintso. Izibonakaliso ezichazwe kwoluhlu zifana nesigaba esiluncedo sesi sifo.

Nephritis engapheliyo

Isifo sidlulela kwifomu engapheliyo emva kwekhosi elula. Kodwa loo matyala awanqabile. Ngokuqhelekileyo, i-nephritis engapheliyo ikhula emva kokusuleleka, ukuphazamiseka okuqhubekayo emzimbeni, ukuxiliswa kweziyobisi ngokusisigxina. I-tubulointerstitial nephritis yokuhlolwa kwe-ultrasound ibonisa i-glomerulus kwiimeko eziqhelekileyo okanye zichithwe. Iibhulebhu azikho ngokupheleleyo okanye ziphosakele. Kukho iimpawu zecala ezahlukileyo - ukusuka kumncinci ukuya kwiindawo ezinobunqamana.

Iimpawu ze-Renal zithinteka kwi-fibrosis kunye neenkqubo zokuvuvukala. Ukuba kukho i-fibrosis eninzi, i-parenchyma ibonakala iphilile. Izintso ezinama-atrophie zinobuncinane obukhulu kunye nemiqondiso ye-asymmetry. Iimpawu ze- nephritis ezingapheli zifana nalabo abakhona kwisigaba esicacileyo, kodwa banokubonakaliswa okungaphantsi. I-leukocytosis kunye nokwanda kwinqanaba legazi elibomvu aliqabile. Inkqubo engapheliyo yesifo iyingozi kakhulu, ngoko kufuneka uphulaphule ngokucophelela iimpawu kwiimpawu zokuqala zesifo. Ukunyanga okungahambi kakuhle kubangela ukungaphumeleli kwezintso, okuphethwe yingxaki enkulu.

Inkqubo efanelekileyo yesifo

Ngokuqhelekileyo kwenzeka ngenxa yokuzithobela kakubi ngaphandle kokubonisana nodokotela. Ukungakwazi kweentso ukwenza imisebenzi yabo, ukuvela kweenkqubo ezivuthayo ezibonakalayo emva kwexesha elide lokusetyenziswa kunyango lwe-beta-lactamide antibiotics.

I-nephropathy ecacileyo ibonakaliswa nobukho be-edema kunye ne-infiltration infiltration. Zisasazeka kwiifom zeentso. Ngaphambi kokuqala kweempawu ezinzima, ngamanye amaxesha kuthatha iiveki ezimbalwa. Emva koko ukungaphumeleli komnxeba oqaqambileyo , kuqhutywe ngukuqala kokunyangwa kwonyango kunye nefuthe eliqhubekayo lezinto ezinomsindo.

Baby jade

Ithuba lokukhusela ukuphuhliswa kwesi sifo ebuntwaneni luba unyango olufanelekileyo ngexesha elifanelekileyo xa ugqirha ukugula. Musa ukuzigulisa, unomntwana oyedwa kuphela oza kuthatha amayeza angalimazi isimiso somzimba somzimba esingazange senziwe.

I-Tubulointerstitial nephritis kubantwana iphathwa phantsi kolawulo lweengcali. Ngendlela efanayo, ukutya okunomdla kuyimfuneko, ngaphandle kweziphi iziphumo ezintle kunzima ukuphumeza. Xa umhlathi ulahliwe, intso enesifo ayikwazi ukuphiliswa, kwaye ilungu litshintshwa. Kubantwana, inkambo ye-wavy yesi sifo kunye nexesha elide eliqhelekileyo liyimpawu.

Ukugxekwa kwesi sifo

Ukuba umsebenzi wezintso unzima ngenxa yokusetyenziswa kwamachiza, i-tubulointerstitial nephritis ivela. Unyango kumaxesha amancinci awunyanzelwanga. Yeka ukuthatha imithi, kwaye iintso ziqale umsebenzi oqhelekileyo emva kweenyanga ezi-2 ukuya ku-2.5. Ngamanye amaxesha isalathiso sokuhlala sisona sikhoba. Xa isifo sesinye i-etiology siphelisa isizathu, kodwa eso sifo siphendulwa. Kwiimeko ezinzima, ukuhluleka kwezintso kunye ne-fibrosis zihlala.

Ukugxekwa kwesimo esingapheliyo se-nephritis kuxhomekeke kwisantya sokufumanisa nokunciphisa ukukhubazeka ngaphambi kokuba ifom Ukuba akunakwenzeka ukulungisa i-genetic, i-toxic and modification changes, isifo siba yintsholongwane ye-renal failure.

Unyango lwesifo

Kwiimpawu zokuqala zesifo omele usibone ugqirha. Nguye kuphela oya kukhetha unyango olufanelekileyo kunye nolululo. Unyango ngamnye kumguli ngamnye. Kodwa, umzekelo, ukukhawulezisa ukubuyisela kwisigaba esicacileyo sesifo, kwaye ngamanye amaxesha angaphili, sebenzisa i-glucocorticoids. Iibrakes inkqubo yokwenza i-angiotensin blockers, inhibitors.

Iinjongo ze-biopsy

Inkqubo ibhekisela kumanyathelo okuxilonga ekufumaneni izifo zesifo. Ingqungquthela yezicubu zeemviwo ezincinci. Isixa esincinci sezinto zezintso siqokelelwa ngedaliti encinci yesirinji. Uphononongo olunjalo lunceda ekuqinisekiseni ngempumelelo imveliso yeekhemikhali zenyama kunye nokukhetha indlela efanelekileyo yokonyango.

Iimpawu zenkqubo ye-biopsy

Indlela ye-biopsy isetyenziswe kwezi zilandelayo:

• Kuze kube sekupheleni ukuba akunakwenzeka ukufumanisa isizathu sesifo esingasigxina okanye esibi.
• Kukho ukukrokra kweJade.
• Ukungaphumeleli kwe-Renal kuqhubela phambili ngokukhawuleza.
• Kukho i-etiology echaphazelayo.
• Kwiimvavanyo zebhubhoratri zomlambo, ukuxutywa kwegazi kunye neprotheni kwafunyanwa.
• Uvavanyo lwegazi lubonisa inani elikhulu le-uric acid, i-creinine, urea.
• Ukuxhaswa nge-oncology.
• Imisebenzi yeentso ezifakelwayo kunye neengxaki.
• Kukho imfuno yokumisela umlinganiselo womonakalo.
• Ukubeka iliso kwinkqubo yokonyango.

Iimpawu ze-Biopsy

Inkqubo yenziwa ngesikhumba. Iqhutywe ngephonkco ngaphezu kweentso kwaye ihlolwe ngu-x-ray okanye i-ultrasound. Ukuququzelela ukufunyanwa kwelungu kwiimvini, umbala ongathandabuzekiyo ohlukileyo kumbala uyaziswa. Inkqubo ye-biopsy evulekileyo ibonakala ngokuthatha inani elincinane leethambo ngqo ngexesha lotyando. Umzekelo, xa kususwa i-oncologic neoplasm. Inkqubo iboniswe kulabo abaye baphala okanye kukho intliziyo enye kuphela kwiimeko zokusebenza. Oku kwenziwa ukwenzela ukunciphisa umngcipheko wokungcola kuwo.

I-biopsy ehlangeneyo kunye ne-urethroscopy yenziwa phambi kwamatye kwi-ureter okanye i-renal pelvis. Yenziwa ekamelweni lokusebenza kwaye ibonisa ukufakwa kwetyhubhu eguquguqukayo yokuhlolwa kwangaphakathi kwe-ureter. Uhlobo lokutshintshwa kwe-biopsy ukufakwa kwekathetha kwi-veal ye-renal ekhethiweyo. Isetyenziswe kwizigulane ezinobungcipheko, ukungapheli okungapheliyo kokuphefumula kunye negazi elimnyama, xa kungekho nanye yezi ndlela zingentla ziyenziwa ngenxa yengozi ebomini kwaye engabonakali i-tubulointerstitial nephritis.

Ekugqibeleni, kufuneka kuthathelwe ukuba isifo esibonakalayo kuqala sihamba ngaphandle kweempawu ezingaphazamisi isigulane, eqinisweni, kufuneka zichongwe ngexesha. I-nephritis enzima kwaye ingathatyathwa iyanciphisa umsebenzi wezintso kwaye ikhokelela kwimiphumo engapheliyo.