Funsani Katswiri: Kusamalira Chithandizo Chanu cha Idiopathic Thrombocytopenic Purpura

Zamkati

• Kodi zina mwazachipatala zodziwika bwino za ITP ndi ziti?
• Ndingadziwe bwanji ngati chithandizo changa chikugwira ntchito? Kodi zidzafunika kuyesa?
• Kodi pali zovuta zoyipa zochizira ITP? Zowopsa?
• Kodi ndingatani kuti ndisamalire zovuta zamankhwala?
• Ndiyenera kupita kangati kukaonana ndi dokotala kukayezetsa? Kodi kuyesa kosalekeza ndikofunika bwanji?
• Kodi ITP ingakhale bwino payokha?
• Kodi chimachitika ndi chiyani ndikasiya kumwa mankhwala?
• Kodi chithandizo changa cha ITP chidzasintha pakapita nthawi? Kodi ndikhala ndikumwa mankhwala kwa moyo wanga wonse?

Kodi zina mwazachipatala zodziwika bwino za ITP ndi ziti?

Pali mitundu ingapo yamankhwala othandizira ITP kukweza kuwerengera kwa ma platelet ndikuchepetsa chiopsezo chotaya magazi kwambiri.

Steroids. Steroids nthawi zambiri amagwiritsidwa ntchito ngati chithandizo choyamba. Amalepheretsa chitetezo cha mthupi, chomwe chitha kusokoneza kuwonongeka kwa ma platelet.

Kutsegula m'mimba immunoglobulin (IVIG). IVIG imasokoneza ma platelet wokutidwa ndi antibody omwe amamangiriza kwa ma cell omwe amawawononga. IVIG itha kukhala yothandiza kwambiri, koma mayankho nthawi zambiri amakhala osakhalitsa.

Ma anti-CD20 monoclonal antibodies (mAbs). Izi zimawononga maselo a B, maselo amthupi omwe amapanga ma anti-maplatelet antibodies.

Ma Thrombopoietin receptor agonists (TPO-RA). Izi zimatsanzira zomwe kukula kwa chilengedwe kumayambitsa thrombopoietin ndikulimbikitsa mafuta m'mafupa kutulutsa ma platelet.

SYK yoletsa. Mankhwalawa amalepheretsa njira yayikulu yama macrophages, maselo omwe ndi malo oyambira kuwonongedwa kwa ma platelet.

Splenectomy. Kuchita opareshoni yochotsa ndulu kumachotsa tsamba loyambira la anatomical la chiwonongeko cha platelet. Zitha kubweretsa kukhululukidwa kwakanthawi kwa anthu ena.

Ndingadziwe bwanji ngati chithandizo changa chikugwira ntchito? Kodi zidzafunika kuyesa?

Cholinga cha chithandizo cha ITP ndikuchepetsa chiopsezo chotaya magazi kwambiri ndikupha powasunga ma platelet pamalo otetezeka. Kutsika kwa kuchuluka kwa ma platelet, kumawonjezera kutaya magazi. Komabe, zinthu zina zimatha kukopa magazi anu, monga msinkhu wanu, kuchuluka kwa zochita zanu, ndi mankhwala ena omwe mukumwa.

Kuyezetsa magazi kwathunthu (CBC) kumagwiritsidwa ntchito kuti muwone kuchuluka kwa ma platelet ndikupeza mayankho ake kuchipatala.

Kodi pali zovuta zoyipa zochizira ITP? Zowopsa?

Monga matenda amtundu uliwonse, pali zoopsa, zoyipa, ndi zabwino zochizira ITP. Mwachitsanzo, kupondereza chitetezo cha mthupi kumatha kugwira bwino ntchito pochiza matenda omwe amadzitchinjiriza. Izi zimawonjezeranso mwayi wanu wopeza matenda ena.

Popeza pali mankhwala ambiri othandiza a ITP omwe akupezeka, kambiranani ndi dokotala zosankha zanu zonse. Komanso, nthawi zonse mumakhala ndi mwayi wosinthira ku mtundu wina wa mankhwala ngati mukukumana ndi zovuta zomwe simungathe kuzipeza kuchokera kuchipatala.

Kodi ndingatani kuti ndisamalire zovuta zamankhwala?

Chida chofunikira kwambiri pothana ndi zovuta zamankhwala ndikulankhulana ndi dokotala. Mwachitsanzo, ngati ndikudziwa kuti m'modzi mwa odwala anga ali ndi mutu wopunduka wokhala ndi IVIG kapena wonenepa kwambiri komanso kusinthasintha kwamaganizidwe a steroids, malingaliro anga azithandizo asintha. Ndifunafuna njira zina zololera zomwe ndingalandire.

Zotsatira zoyipa zamankhwala ena nthawi zambiri zimayankhidwa ndi mankhwala othandizira. Komanso, mankhwala amatha kusintha malinga ndi zovuta zina.

Ndiyenera kupita kangati kukaonana ndi dokotala kukayezetsa? Kodi kuyesa kosalekeza ndikofunika bwanji?

Ubale wopitilira ndi hematologist wodziwa bwino ndikofunikira kwa aliyense amene ali ndi ITP. Pafupipafupi kuyezetsa kumasiyana kutengera ngati mukuwukha mwazi kapena ma platelet anu ndi otsika kwambiri.

Mankhwala atsopano akangoyamba, kuyesa kumachitika tsiku ndi tsiku kapena sabata iliyonse. Ngati ma platelet ali pamalo otetezeka chifukwa cha chikhululukiro (mwachitsanzo, pambuyo pa steroids kapena splenectomy) kapena chifukwa chothandizidwa mwakhama (mwachitsanzo, TPO-RAs kapena SYK inhibitors), kuyesa kumatha kuchitika mwezi uliwonse kapena miyezi ingapo iliyonse.

Kodi ITP ingakhale bwino payokha?

Kwa akulu omwe ali ndi ITP, kukhala ndi chikhululukiro chodzidzimutsa popanda chithandizo ndikosowa (pafupifupi 9% malinga ndi). Ndizofala kwambiri kuti mukwaniritse chikhululukiro chokhazikika mutatha kulandira chithandizo.

Mankhwala ena amaperekedwa kwakanthawi kochepa poyembekeza kuti atha kulandira chithandizo chamankhwala kwa nthawi yayitali, iliyonse ndi mayankho osiyanasiyana. Izi zikuphatikiza ma steroids, IVIG, mAbs, ndi splenectomy. Mankhwala ena amaperekedwa mosalekeza kuti azisunga mapulateleti m'njira yotetezeka. Izi zikuphatikiza TPO-RAs, SYK inhibitors, ndi ma immunosuppressants osachiritsika.

Kodi chimachitika ndi chiyani ndikasiya kumwa mankhwala?

Kuyimitsa chithandizo kumatha kuyambitsa kugwa mwadzidzidzi kwamagulu anu. Zitha kuchititsanso kuti pakhale chiwopsezo chachikulu chotaya magazi kapena kupha. Kuthamanga komanso kuchepa kwa ma platelet omwe amatha kutsika atasiya chithandizo kumasiyanasiyana pakati pa anthu omwe ali ndi ITP.

Palibe chiopsezo chosiya mankhwala ngati kuchuluka kwanu kwa ma platelet kuli bwino. Ma steroids ambiri othira mankhwala amafunika kuti azijambulidwa pang'onopang'ono pakapita nthawi kuti apewe zovuta za adrenal ndikulola thupi kusintha.

Zachidziwikire, ndikofunikira kulumikizana pafupipafupi ndi dokotala wanu zakukhosi kwanu komanso zosowa zanu.

Kodi chithandizo changa cha ITP chidzasintha pakapita nthawi? Kodi ndikhala ndikumwa mankhwala kwa moyo wanga wonse?

Popeza akuluakulu a ITP nthawi zambiri amakhala matenda osachiritsika, anthu omwe ali ndi vutoli nthawi zambiri amayenda m'njira zosiyanasiyana zamankhwala nthawi yonse ya moyo wawo.

Dr. Ivy Altomare ndi pulofesa wothandizira wa zamankhwala ku Duke University Medical Center. Ali ndi ukadaulo wazachipatala pamatenda osiyanasiyana am'magazi komanso matenda am'magazi ndipo akhala akuchita kafukufuku wazachipatala ndi zamankhwala m'munda wa ITP kwazaka zopitilira khumi. Ndiye wolandila mphotho ya Junior Faculty and Senior Faculty Teaching ku Duke University ndipo ali ndi chidwi ndi maphunziro azachipatala kwa onse odwala ndi asing'anga.