Nephrotic syndrome yog ib yam kab mob ntawm lub cev, nrog rau lub raum puas tsuaj thiab ua cim los ntawm qee yam kev kuaj mob thiab kev sim. Feem ntau cov mob ntawm cov kab mob no yog kuaj pom rau cov neeg laus uas tsis tau nto hnub nyoog 35 xyoo.
Ua rau nephrotic syndrome
Rau qhov nephrotic syndrome no yog qhov ua rau swb ntawm lub plab glomerular ntawm ob lub raum, uas yog koom ua ib pawg ntawm cov nephrons (cov khoom hauv lub cev ntawm lub raum) uas siv cov ntshav pom los ntawm kev tsim cov zis ntxiv. Muaj kev hloov hauv cov phab ntsa ntawm cov kab mob glomerular nrog kev nce hauv lawv cov kab mob, ua rau kev cuam tshuam cov protein thiab roj metabolism, uas yog nrog los ntawm:
- ua txhaum ntawm protein ntau thiab nws nkag mus rau hauv cov zis (proteinuria);
- ib qho tseem ceeb hauv cov protein ntau hauv cov ntshav ntshav (hypoproteinemia);
- tus thawj txo cov proteinin ntawm cov kua ntshav (hypoalbuminemia);
- nce hauv cov roj ntshav, triglycerides thiab phospholipids (hyperlipidemia), thiab lwm yam.
Yog tias qhov txawv txav tshwm sim sai sai thiab raug kaw thawj zaug, tus mob nephrotic syndrome tshwm sim, thiab nrog kev hloov ntawm kev sib zog thiab kev tshem tawm, txoj hau kev yog qhov ua rau mob ntev. Qhov tsis zoo ntawm lub meejmom tseem tsis tau tsim, tiamsis qhov tswvyim zoo tshaj plaws thiab tsim nyog ntawm nws cov kab mob pathogenesis yog ib qho kev tiv thaiv kabmob. Qhov kev tshawb xav no piav txog txoj kev hloov ntawm txoj kev hloov ntawm cov kab mob vim yog lub cev tsis muaj zog rau qhov kev txiav txim ntawm ntau yam kab mob hauv cov ntshav.
Los ntawm keeb kwm, tus mob nephrotic syndrome tau muab faib ua thawj (xws li tshwm sim ntawm ib qho kev mob raum sab nraud) thiab theem nrab (qhov tshwm sim ntawm cov kab mob uas muaj kab mob hauv nruab nrog ob yam kab mob ntawm ob lub raum). Ua ntej, nws tuaj yeem nyob rau hauv pathologies xws li:
- Lipoid nephrosis;
- nephropathy ntawm cov poj niam cev xeeb tub;
- amyloidosis ntawm ob lub raum;
- membranous nephropathy;
- pyelonephritis;
- glomerulonephritis;
- mob raum.
Cov leeg thij ob leeg tuaj yeem tsim tawm tsam rau tom qab ntawm cov nqaij mob nram no:
- kev mob lupus erythematosus;
- pre-eclampsia;
- hemorrhagic vasculitis;
- ntshav qab zib mellitus;
- amyloidosis;
- scleroderma;
- abscess ntawm lub ntsws;
- kab mob siab B;
- hepatitis C;
- myeloma;
- tuberculosis;
- syphilis;
- malaria;
- lom nrog hnyav hlau;
- snake tom, thiab lwm yam.
Nephrotic syndrome nrog glomerulonephritis
Feem ntau muaj cov kab mob glomerulonephritis nrog nephrotic syndrome, uas hauv lub plab glomeruli yog raug tus kab mob inflammation, feem ntau tshwm sim los ntawm cov kab mob hauv streptococci los yog lwm cov kab mob. Yog li ntawd, lub cev tiv thaiv kab mob ua rau cov tshuaj tiv thaiv, thaum khi rau antigens, khom ntawm glomerular membrane thiab cuam tshuam rau nws.
Nephrotic syndrome nrog amyloidosis
Thawj (idiopathic) nephrotic syndrome los ntawm amyloidosis yog vim qhov tseeb ntawm cov nqaij ntawm lub raum muaj cov khoom tso tawm ntawm cov protein-polysaccharide compounds ua rau lub cev tsis zoo ntawm lub cev. Muaj kev sib xyaw nrog kev sib txuam ntawm cov neeg laus hauv siab, qhov dej ntawm lub epithelium ntawm cov tubules, thiab lub raum nce qhov loj.
Nephrotic syndrome nrog pyelonephritis
Infected thiab inflammatory lesions ntawm lub plab mog plaum, calyx thiab lub plab parenchyma, provoked feem ntau los ntawm E. coli, thaum tsis muaj kev kho tau sai sai ua rau ib tug ua txhaum ntawm excretory thiab filtering Function ntawm lub cev. Hauv qhov no, feem ntau ua rau tus mob nephrotic tsis ntev los no nrog kev ua kom qeeb ib ce.
Nephrotic Syndrome - cov tsos mob
Kev kuaj ntshav nyob rau hauv nephrotic syndrome yog qhov loj tshaj plaws tshwm sim. Ua ntej, puffiness yog pom nyob rau hauv cheeb tsam lub ntsej muag (feem ntau nyob rau hauv ob lub qhov muag), ntawm txhais tes thiab ob txhais taw, nyob rau hauv cheeb tsam lumbar. Tom qab, cov kua qaub nyob hauv cov ntaub so ntswg ntawm tag nrho lub cev. Lwm cov tsos mob muaj xws li:
- pallor thiab dryness ntawm daim tawv nqaij;
- nqhis dej;
- mob hauv taub hau;
- tsis qab los noj mov;
- tsam plab;
- quav mob;
- rub tsis xis nyob hauv cheeb tsam chaw lumbar;
- leeg mob;
- tsis tso zis;
- kev sib ceg;
- brittle plaub hau thiab tes;
- txog ua tsis taus pa, etc.
Lub chaw kuaj kabmob loj ntawm tus mob nephrotic syndrome tau tshwm sim hauv kev soj ntsuam ntawm cov zis thiab ntshav tom qab ntsuas:
- tus nqi ntawm cov protein nyob hauv cov zis - ntau dua 3 g / hnub;
- tus nqi ntawm cov hlav ntshav qab zib yog tsawg dua 27 g / l;
- theem ntawm cov protein nyob rau hauv cov kua ib feem ntawm cov ntshav - hauv qab 60-50 g / l;
- cov roj cholesterol hauv cov ntshav yog ntau tshaj 6.5 mmol / l.
Nephrotic Syndrome - sib txawv tshawb nrhiav
Los txiav txim siab txog kev puas tsuaj ntawm kev ua rau lub cev, txhawm rau taw qhia qhov kev tsim txom, ntxiv rau kev soj ntsuam ntawm tus kws kho mob nephrologist thiab anamnesis, qhov kev kuaj ntawm tus mob nephrotic syndrome muaj ntau yam kev kawm txog kev kawm thiab kev sim:
- kev ntsuam xyuas ntshav thiab zis;
- zis tsom rau Zimnitskiy;
- bacteriological tsom ntawm cov zis;
- biochemical ntsuam ntawm ntshav thiab zis;
- kuaj ntshav rau cov ntshav;
- electrocardiography;
- Ultrasonography ntawm ob lub raum nrog dopplerography;
- nephroscintigraphy;
- mob raum nrog lub qhov kuaj me me.
Nephrotic Syndrome - tso zis
Thaum twg muaj ib qho kev xav ntawm cov mob nephrotic Syndrome, cov kev kuaj mob muab kev pab tsis yog los xyuas qhov kev kuaj mob, tab sis kuj yuav txiav txim siab txog cov kev kho mob ntawm kev kho mob. Ib qho ntawm cov feem ntau pom yog tso zis, nyob rau hauv uas, ntxiv rau kom muaj protein ntau kom siab, cov txheej txheem hauv qab no tau qhia nyob rau hauv cov kab mob no:
- qhov muag plooj;
- nce ntom;
- alkaline fab;
- qhov muaj cov leukocytes thiab erythrocytes;
- muaj cov qhov cub thiab cov cylinders;
- muaj cov roj cholesterol;
- ib tug xov tooj ntawm cov microbial lub cev.
Kev kho nephrotic syndrome
Yog tias muaj tus mob nephrotic Syndrome, kev kho yuav tsum tau ua hauv tsev kho mob kom tus kws kho mob tuaj yeem soj ntsuam tus neeg mob tus mob thiab qhov kev kho mob, yog tias tsim nyog kho nws. Qhov tseem ceeb yog qhov kev kho mob ntawm thawj tus kab mob thiab lwm yam kab mob, uas yuav ua rau tus mob nephrotic syndrome. Cov neeg mob raug nquahu kom mob lub cev qoj ib ce kom tsis txhob muaj kev tsim kom muaj thrombosis.
Nyob rau hauv lub moj khaum ntawm kev kho mob tshuaj, intravenous txhaj ntawm protein daws yog tau, raws li tau zoo raws li cov nram qab no pawg ntawm cov yeeb tshuaj:
- glucocorticoids (Prednisone, Dexazon, Urbazon) - nrog atopic, lupus, membranous thiab lwm hom nephropathy;
- cytostatics (Azathioprine, Cyclophosphamide, Leukeran) - nrog lymphogranulomatosis , sarcoidosis, Wegener's syndrome, etc .;
- anticoagulants (Heparin) - nrog glomerulonephritis hypertensive, malignant, mob hnyav, nrog rau kev hnyuv raum, pre-eclampsia, etc .;
- Diuretics (Furosemide, Etakrinaic acid, Veroshpiron) - nrog qhia tau o;
- immunosuppressants (Azathioprine, Cyclosporine) - nyob rau hauv qhov kev paub ntawm cov kab mob autoimmune;
- tshuaj tua kab mob (Ampicillin, Doxycycline, Cefazolin) - thaum muaj kev sib kis kab mob.
Cytostatics hauv nephrotic syndrome
Txoj kev kho tus mob nephrotic syndrome nrog cov tshuaj cytostatic feem ntau yuav tsum yog thaum muaj kev tu mob ntawm kev kho glucocorticosteroid los yog qhov tsis zoo ntawm nws cov nyhuv. Qee lub sij hawm lawv siv tib yam li cov tshuaj hormonal, uas tso cai rau koj kom txo cov tshuaj noj thiab qhov hnyav ntawm kev phiv. Cov tshuaj no ua rau lub hlwb faib, tiv thaiv lawv ntawm kev faib. Koj tsis tuaj yeem noj cytostatics thaum cev xeeb tub, cytopenia, nephropathy tsis muaj cov cim qhia ntawm kev ua si, muaj cov kab mob focal.
Kev noj zaub mov nrog nephrotic syndrome
Tus mob ntawm "nephrotic syndrome" - qhia txog lub sij hawm ntawm kev noj haus naj npawb xya, tsom rau normalizing metabolic processes thiab zis tawm, txo kev kawm. Cov tswv yim tseem ceeb rau cov pluas noj yog raws li nram no:
- 5-6 noj ib hnub;
- Tshaj tawm ntawm ntsev noj los yog txwv kom txog 2-4 g ib hnub;
- kev siv cov zaub mov ua si rau ntawm steamed, khib nyiab, stewed;
- protein khoom noj yog siv nyob rau hauv tus nqi ntawm 1-2 g ib kilogram ntawm qhov ceeb thawj;
- nce intake ntawm cov khoom noj khoom haus nplua nuj nyob rau hauv poov tshuaj (almonds, qhuav apricots, soya);
- txo cov khoom siv uas muaj cov kab yooj yim carbohydrates (cov qhob cij dawb, qos yaj ywm, dawb txhuv);
- txo qis hauv cov tsiaj noj nqaij (nqaij, ntses rog, qe);
- txwv ntawm kev siv cov kua dej (noj rau hauv cov account txhua txhua hnub ntawm cov zis).
Cov teeb meem ntawm nephrotic syndrome
Tej teeb meem ntawm cov mob nephrotic syndrome no tsuas yog vim qhov tsis xyuas ntawm txoj kev mob ntsws, kev kho tsis zoo, tab sis vim yog siv cov tshuaj. Cov teeb meem feem ntau ntawm cov mob nephrotic syndrome yog:
- phlebothrombosis;
- pneumococcal peritonitis;
- mob ntsws o;
- pleurisy ;
- tromboembolism ntawm cov hlab ntsig;
- infarct ntawm lub raum;
- stroke ntawm lub hlwb;
- nephrotic teebmeem;
- peptic ulcer;
- ua xua tshwm sim;
- ntshav qab zib mellitus thiab lwm tus.