Inyumoniya Eosinophilic: incazelo izimpawu, izimbangela kanye nezici ukwelashwa

Sinzima wamaphaphu nesifo, ezifana nenyumoniya, kungukuthi njalo zibangelwa flora virus. Ukuphazamisa homeostasis we yasenhla nemithombo yasenzansi ipheshana zokuphefumula can izimuncagazi, isikhunta, izidakamizwa, immunodeficiency, nokungezwani komzimba nezinto. Futhi ezimweni ezinjalo, eosinophilic inyumoniya eba.

definition

inyumoniya Eosinophilic - inqubo sokugembula emaphashini, esibonakala by ekuqongeleleni ngokweqile eosinophils ku-alveoli. Kunezinhlobo eziningana noma ezahlukeneyo yalesi sifo, okungenza ukuthuthukisa ngasiphi yobudala.

Emtholampilo, cishe izakhamuzi zaseBosnia zifana ekuguleni ezibangelwa amagciwane, ngakho main Igxila zokuxilonga ukuhlolwa laboratory: ephelele kakhulu segazi, smear. Ezimweni eziningi, ngemva ekutholeni uhlobo isifo ziqala yokwelapha hormone steroid cortex adrenal. Lokhu kusiza ukunciphisa ukusabela ukuvuvukala kanye iwukudambisa izimpawu i-pneumonia. Onalesi sifo ngoba kulezi ziguli ngokuvamile evumayo.

indaba

Okungalapheki-pneumonia eosinophilic, izimbangela zezinkumbulo ngaleso sikhathi ayaziwa, labonakala okokuqala echazwe maphakathi nekhulu le-Athazeksesi, ngo-1969, i-Harrington udokotela. Akazange abe namahloni kakhulu, ngakho eyabiwe isifo igama layo, futhi emva kokushicilelwa emhlabeni yesayensi waqala ukubiza entsha zokugula syndrome Harrington.

Ngaphambi kwalokhu mlando sihloko eosinophilic inyumoniya besilokhu saziwa ngokuthi isifo ikhulela emaphashini emva kokutheleleka nezilokazane noma ukulaliswa esibhedlela engalawuliwe izidakamizwa. Iminyaka engamashumi amabili kamuva, ngo-1989, wabonakala imithi, igama elithi "acute nenyumoniya eosinophilic".

omsakazo

Thola ezicini eziningana, okuyinto ngaphansi kwethonya inyumoniya eosinophilic eba. Izimbangela, izimpawu kuhlobene. Ngokwesibonelo, izinhlobo acute pneumonia ugwayi (kokubili yekwentiwa), yokungezwani komzimba ukuze izidakamizwa noma wehlise umzimba ozivikela ne-HIV noma i-AIDS. Uma bengekho izizathu asifanele, kubhekwa ukuba inyumoniya idiopathic.

Okungalapheki-pneumonia eosinophilic kungenziwa cuphuluza igciwane fungal (aspergillosis pnevmomikoz) KWAMAGUNDANE helminthic (ascariasis, echinococcosis), ukusetshenziswa isikhathi eside izidakamizwa lapho sicindezeleke izivikeli mzimba (ama, cytostatics), ezingamahlalakhona sokuhlasela kwamasosha omzimba zezinzwa izifo izicubu (rheumatoid arthritis, ne-Kaposi sika).

Eosinophils babe imisebenzi okuvikela umzimba, kodwa njengoba ukuvuvukala - lokhu kuyinqubo ejwayelekile sokugembula, uma kukhona Yiqiniso ngokweqile futhi ngokushesha, owamenza wakwazi ukuba nomthelela omubi empilweni yomuntu.

pathogenesis

Isici Etiologic ngezindlela eziningi ichaza indlela ukuthuthukisa eosinophilic nenyumoniya. Izimbangela, izimpawu, zokwelapha - konke kuncike kule. Legumbi lolu hlobo inyumoniya ukunqwabelana inqwaba eosinophils emisipheni wamaphaphu. Izifo eziningi, kuhlanganise eczema, isifuba somoya, kubangelwa ukuphendula enobudlova kakhulu umzimba ukukhulula kwakwakhe esebenzayo.

Imithi kanye nezinye ezinobuthi okushintsha reactivity ka eosinophils futhi kubenza usengozini. ejenti eqeda ukuvuvukala, imithi elwa namagciwane, izidakamizwa kubangele komzimba ukuthi kungaholela ekwakhiweni pneumonia yesibili. Ngaphezu kwalokho, izici okubangela ukubukeka inqwaba eosinophils e nezicubu, libhekisela yogwayi noma evala zamakhemikhali.

izifo yisinanakazana

Odokotela izindlela ezintathu pneumonia ngesikhathi parasitosis. Okokuqala - a KWAMAGUNDANE yisinanakazana e iphaphu, owesibili - ingxenye ngibone umjikelezo wokuphila kwe-worms, kanti eyesithathu - Okungahleliwe Ukuhlolwa egazini. Ukubhekana nazo umzimba ithumela eosinophils. Kufanele liyochukuluza ukukhululwa kwe cytokines, prostaglandins, leukotrienes kanye nezinye izinto asebenzayo nokuqedwa worm. Kodwa esikhundleni kubangele i-pneumonia.

Ngokucacile busuka izicubu aphansi zokuphefumula ipheshana izikelemu, Echinococcus futhi ezifana yengulube tapeworm, kanye wamaphaphu yisikhohliso. Ukuhlala emaphashini kanye nokufinyelela-mpilo asemkhathini adingekayo ascarids, ugritsy emathunjini, hookworm futhi hookworm. inyumoniya Eosinophilic, okuyinto kubangelwa amagciwane ngaphezu, eyaziwa nangokuthi Loeffler Syndrome. Ngemithambo yegazi emaphashini uthole amaqanda Trichinella futhi schistosomes.

umtholampilo

Njengoba umthetho, owelapha, Pulmonologist, noma izifo ngisho ezithathelanayo lapho uqala nje ukubona kunzima ukuphendula umbuzo lokho ogulayo eosinophilic nenyumoniya. Izimpawu, ngisho ikhumbula etiologies ezahlukene zifana kakhulu nomunye. Isiguli ekhononda of ukukhwehlela, imfiva, iphika ngijuluka ebusuku. Ngemva kwamasonto ambalwa lapho kuqala ukukhwehlela, uma kungenziwa lutho, uzophawula izimpawu decompensated esingamahlalakhona zokuphefumula. Esimweni esinjalo isiguli kufanele idluliselwe ukupholisa yokufakelwa.

Okungalapheki-pneumonia eosinophilic sanda kancane kancane, izinyanga. Iziguli ulahlekelwe isisindo, banalo iphika, kwesifuba ukukhwehlela lokushisa lomzimba lehla ngezansi subfebrile. Ngezinye izikhathi izimpawu ukulingisa somoya, okwenza Ihlahlubo ekukhetheni okubi yokwelashwa.

nobunzima eziningi sitholakele eosinophilic inyumoniya izidakamizwa kudala. Izimpawu, ukwelashwa kanye nokuvimbela zifana yayo eqinile ukuze aspirin somoya, ukuthi udukisa udokotela. Ngo izifo yisinanakazana ine ezithile isikhathi prodromal, okungase ziphakamisa Ukuhlasela helminthic.

ukuhlola

Njengoba i-pneumonia emtholampilo eosinophilic cishe nsé ezinye inyumoniya, uphethwe kusekelwe laboratory kanye nophenyo wezinsimbi. Ngokuvamile, ukuhlaziya igazi eosinophilia liphinyiselwe ngaphansi ngeso fluoroscopic ngoba lubonakale izinguquko yamaphaphu noma ngekhompyutha tomography isici sokugembula. Ukuqinisekisa ungathatha biopsy ijwabu wamaphaphu, kanye ukwenza ezishaywayo ne kobuso bronchus ngesikhathi bronchoscopy.

Ukuhlonza ubuhlobo nemithi, uhlale esitha, izindawo okunobuthi amakhemikhali, noma umdlavuza, kudingeka uhlole ngokucophelela umlando wezempilo wesiguli, kanye ukuqoqa umlando eningiliziwe yokuphila nezifo. Uma, ngemva zonke zocwaningo, imbangela namanje abakwazi ukubona ke uphethwe liqoshwe njengombhali idiopathic inyumoniya eosinophilic.

Qiniseka kumephu kubonisa degree of nokuvaleka kwemigudu yokuphefumula. Lingakapheli isonto ka ukuqala isifo zikhona izimpawu zokuqala ke:
- izilonda amaningi wamaphaphu izicubu;
- ekuqongeleleni oketshezini ingaphakathi pleural;
- leukocytosis futhi kuphakeme erythrocyte sedimentation izinga ekucubunguleni jikelele igazi;
- bandise izindlela immunoglobulin E;
- spirometry zokuphefumula sikhombisa ukwehla wamaphaphu ivolumu.

ukwelashwa

Ngisho yangaphambi kokuvela kwaleso sifo yokugcina bazothola - pneumonia eosinophilic, impatho iqala nge ekwelapheni isiguli udokotela.

Uma i-pneumonia kuyinto yesibili, kubalulekile ukuba aphathe lesi sifo ecashile: isimila noma KWAMAGUNDANE worm. Lokhu kuzosiza ukunciphisa imiphumela yezimpawu yamaphaphu futhi ukululama okusheshayo.

Uma imbangela isifo engakaze ezikhonjwe, kunikezelwe yokwelapha glucocorticosteroid. Basuke isuswe kahle impendulo ukuvuvukala, usimamise cell ulwelwesi, ukunciphisa izinga lokushisa. Ukuthethelelwa abayifunayo ngokushesha - ngosuku lesithathu noma lesine. Kodwa lokhu imithi akugcini lapho. Ukunyamalala izimpawu akusho ukuthi lesi sifo esesindile. Ngakho-ke, corticosteroids, isiguli kuthatha ngenyanga, nge ukunciphisa kancane kancane umthamo ukuze afinyelele eqophelweni lapho izindlela wezinsimbi zokuxilonga musa ukuqinisekisa yokutakula.

Ifomu ezingamahlalakhona zesifo zidinga ukwelashwa izinyanga ezintathu noma ngaphezulu, ngisho emva ukunyamalala izimpawu zokwelashwa. Uyahluleka uma elwa nokuphuza kukhona inyumoniya kungenzeka on isizinda lokuhoxa ngokushesha corticosteroids. Kwezinye izimo, isiguli kungase kudingeke ukushintshela ukupholisa lokukhanda.

ukuba nombono ongafani ngeke

Uma i-pneumonia eosinophilic iyisifo yesibili yokulwa nomdlavuza noma parasitosis ke umphumela incike ukugeleza zokugula ecashile. Ephukile, inqobo ukwelashwa okufanele futhi ifike ngesikhathi akunakwenzeka.

Okungalapheki-pneumonia eosinophilic uthambekela ziyabuya ebusweni we glucocorticosteroids. Ngakho-ke, ezinye iziguli ukuthatha le mithi ukuphila. Kodwa kulesi simo, kukhona embi ngalo. imiphumela emibi yokwelashwa, ezifana prednisone, kunganciphisa kakhulu izinga lokuphila komuntu. Lezi zihlanganisa: isilonda peptic, ukukhumuzeka kwamathambo, kushingoid, kwehle amasosha omzimba.

lwezifo

Njengomthetho, inyumoniya esibangelwa amagciwane ukuthi kuvamile ezifundeni sendawo lezi Amagciwane. Lokhu kungaba ezishisayo, ehlathini laseSiberia, saseMedithera noma yimuphi umfula ethile.

Acute eosinophilic inyumoniya ingaqala ngasiphi yobudala, ngisho nezingane ezincane kakhulu, kodwa iningi labo uhlushwa abantu oseqinile kusukela kwabaneminyaka engamashumi amabili kuya amane. Ngo ukugula kukhona ezinye ukucwasa ngokobulili - amadoda sigule kakhulu ukudlula abantu besifazane, ngoba sifo sibangelwa ukubhema ugwayi. Ngo izincwadi zezokwelapha ezisekelwe ekwazisweni zamanje kukhona izincazelo pneumonia eosinophilic emva ukwelashwa ngemisebe yomdlavuza webele.

inyumoniya Eosinophilic e izinja

Izilwane lungatholwa inyumoniya eosinophilic. Izimbangela, izimpawu, zokuvimbela yalesi sifo kakhulu efana wobuntu. Ngokufanayo, izimbangela zesifo: izimuncagazi emaphashini, isikhunta, komzimba impova, izinambuzane, amakhemikhali kanye nemithi.

Inja waphawula impendulo engalawuliwe mzimba ukuthi kubangela wamaphaphu izicubu kokuziphatha by eosinophils. Lightness ukwahlukana aphansi incipha, lapho eba isikhunta pathogenic ezibangela i-pneumonia. Isilwane ubulawa lactic futhi hypoxia. Umtholampilo iyafana ukukhwehlela womuntu, iphika, ubuthakathaka, imfiva, ukungabi esesuthi, kwesisindo.

Ukuze kuhlonzwe usebenzisa ukuhlolwa igazi, X-ray kwamaphaphu, bronchoalveolar lavage Cytology, serology. On the-X-ray ebonakalayo wamaphaphu izicubu edema, khona cell granuloma, izindlala zamanzi node mediastinal ukukhulisa futhi hilar ukunwetshwa umthunzi inhliziyo. Ngemva ukucaciseleka we-pneumonia omsakazo eosinophilic, wezilwane esabela oluthile lokwelapha okuhloswe ngalo ukuqeda lesi sifo eyinhloko. Indlela ephumelela kakhulu - corticosteroids, lihambisana antibiotic bronchodilators. Ngokuvamile, izilwane ukuhlala yokwelapha impilo yonke.