Tusitala: Janice Evans
Aso O Foafoaga: 2 Iuli 2021
Faafouga Aso: 9 Fepuari 2025
Anonim
Cystic Fibrosis Mechanism and Treatment | HHMI BioInteractive Video
Ata: Cystic Fibrosis Mechanism and Treatment | HHMI BioInteractive Video

O le cystic fibrosis o se faʻamaʻi e mafua ai le mafuʻe o le puputa, i luga o le mama, ala o manava, ma isi vaega o le tino. O se tasi o faʻamaʻi masani lava o mama mama i tamaiti ma talavou matutua. O se faʻamaʻi e lamatia ai le ola.

Cystic fibrosis (CF) o se faʻamaʻi e pasi atu i totonu o aiga. E mafua mai i se kenera gaʻo e mafua ai ona gaosia e le tino le mafiafia ma faʻapipiʻi vai, e taʻua o le mucus. O lenei mucus e faʻaputuputu i mea manava o manava ma i le papala.

O le faʻaputuputuina o le suauʻu e mafua ai le pipisi o le ola i siama mama ma faʻafitauli ogaoga o le faʻasoesa. O le faʻamaʻi ono afaina ai foi le afu o le afu ma le tino o le tane.

Tele o tagata o loʻo aveina se kenera CF, ae leai ni faʻailoga. E mafua ona o le tagata ma CF e tatau ona mautofi i le le atoatoa genes, 1 mai matua taʻitasi. O nisi tagata Amerika o loʻo iai le gafa ole CF. E taatele i latou na tupuga mai i matu poʻo Europa tutotonu.


Ole tele o tamaiti e maua ile CF e faʻamaonia ile tausaga 2, ae maise ole faʻataʻitaʻiga ole pepe faatoa fananau mai, e faʻatautaia ile lautele o Amerika. Mo se numera laititi, o le faʻamaʻi e le o vaʻaia seʻia oʻo i le 18 tausaga pe sili atu. O nei tamaiti e masani ona i ai le mama o ituaiga faʻamaʻi.

Faʻailoga i pepe fou mafai ona aofia ai:

  • Tuai tuputupu ae
  • Le mafai ona maua le mamafa masani i taimi o tamaititi
  • Leai ni manaʻoga i le muamua 24 i le 48 itula o le olaga
  • Paʻu suamalie masima

Faʻailoga e fesoʻotaʻi ma le manava manava ono aofia ai:

  • Manava manava mai faigata papala
  • Faʻateleina kesi, fulafula, poʻo se manava e foliga mai ua fulafula (faʻafuaseʻi)
  • Faanoanoaga ma le leai o se fiaai
  • O nofoa e paʻeʻe poʻo le omea, e manogi leaga, e i ai ni puputa poʻo se opeopea
  • Paʻu pauna

Faʻailoga e fesoʻotaʻi ma le mama ma sinuses ono aofia ai:

  • O le tale poʻo le faʻateleina o le mucus i totonu o sinus poʻo mama
  • Le lavava
  • Faʻasolosolo isu e mafua mai i nasal polyps
  • Faʻaauau vaega o le niumonia (faʻailoga o le niumonia i se tasi e maua i le cystic fibrosis e aofia ai le fiva, faateleina le tale ma le manava puʻupuʻu, faateleina mucus, ma le leai o se fiaai)
  • Sinus tiga poʻo le mamafa e mafua mai i siama poʻo polyps

Faʻailoga e ono maitauina mulimuli ane i le olaga:


  • Le fanau (i alii)
  • Fula faʻafuaseʻi o le pancreas (pancreatitis)
  • Faailoga manava
  • O tamatamai lima kalapu

Ua faia se suʻega ile toto e fesoasoani ai ia iloa le CF. O le suʻega e suʻesuʻeina mo suiga i le vaega o le CF. O isi suʻega na suʻesuʻe ai CF e aofia ai:

  • Ole suʻega ole Immunoreactive trypsinogen (IRT) ose suʻega masani mo le suʻesuʻeina ole pepe. Ole maualuga ole IRT e fautuaina ai le CF ma manaʻomia nisi faʻataʻitaʻiga.
  • O le suʻega ole afu ole chloride ole suʻega masani lea mo le CF. Ole maualuga ole masima ile afu o le tagata ole faʻailoga lea ole faʻamaʻi.

O isi suʻega e iloa ai faʻafitauli e mafai ona fesoʻotaʻi ma le CF aofia ai:

  • Fatafata x-ray poʻo le CT scan
  • Suʻesuʻega gaʻo ole gaʻo
  • Luga gaioiga suʻega
  • Fuataga o gaioiga pancreatic (nofoa pancreatic elastase)
  • Suʻega faʻaosofia o le Secretin
  • Toso i fafo ma chymotrypsin i le nofoa
  • Maualuga GI ma tamaʻi manava faʻasologa
  • Lung culture (maua e le sputum, bronchoscopy poʻo le faʻaʻafu faai)

Ole vave suʻesuʻe ole CF ma togafitiga togafitiga e mafai ona faʻaleleia atili ai le ola ma le ola lelei. Tulitatao ma mataituina e taua tele. A talafeagai, e tatau ona maua le tausiga i le cystic fibrosis faʻapitoa falemaʻi. A oʻo ina matutua tamaiti, e tatau ona latou fesiitaʻi i le cystic fibrosis faʻapitoa nofoaga mo tagata matutua.


Togafitiga mo mama faafitauli aofia ai:

  • Antibiotics e puipuia ma togafitia mama ma sinus siama. E mafai ona ave i le gutu, pe avatu i alatoto poʻo manava togafitiga. Tagata e iai CF e naʻo vailaʻau faʻafofuina e inu ai pe a manaʻomia, pe i taimi uma. E masani ona sili atu le maualuga o dosis nai lo le mea masani.
  • Fofoina vailaʻau e fesoasoani tatalaina auala alatele.
  • O isi vailaʻau o loʻo tuʻuina atu e ala ile manavaina o le manava ma faʻafaigofie ai le tale o le DNAse enzyme therapy ma faʻamalosia masima masima (saline hypertonic).
  • Tui puipuia o le Flu ma le tui o le pneumococcal polysaccharide (PPV) i tausaga taʻitasi (fesili i lau fomaʻi).
  • Lung transplant o se filifiliga i nisi tulaga.
  • O le okesene togafitiga e ono manaʻomia pe a faʻateleina le faʻamaʻi o le mama.

O faʻafitauli o le mama e togafitia foʻi ma togafitiga e faʻa manifinifi ai le puta. E faʻafaigofie ai ona tale le papala mai māmā.

O nei metotia aofia ai:

  • Gaioiga poʻo faʻamalositino e mafua ai ona e manava tele
  • Masini e faʻaaogaina ile ao e fesoasoani e kilia ala o le ea i le tele o le suka
  • Pusa o le fatafita (poʻo le fatafata fatafata), o se tagata o le aiga poʻo se fomaʻi e pati faʻafuaseʻi le fatafata o le tagata, tua, ma le vaega i lalo o lima.

Togafitiga mo le manava o le manava ma faafitauli ono aofia ai:

  • O se meaʻai faʻapitoa e maualuga ai le polotini ma kalori mo tamaiti matutua ma tagata matutua
  • Pancreatic enzymes e fesoasoani e mitiia gaʻo ma polotini, e ave i taumafataga uma
  • Vitamini faʻaopopo, aemaise vaitamini A, D, E, ma le K.
  • E mafai e lau tautua ona fautuaina isi togafitiga pe a fai e faigata tele ou nofoa

Ivacaftor, lumacaftor, tezacaftor, ma elexacaftor o vailaʻau ia e togafitia ai nisi ituaiga o CF.

  • Latou te faʻaleleia le gaioiga o se tasi o le le atoatoa genes e mafua ai CF.
  • E oʻo atu i le 90% o tagata mamaʻi ma le CF ma agavaʻa mo se tasi pe sili atu o nei vailaʻau na o oe pe tuʻufaʻatasi.
  • O lona iʻuga, e tau leai se faʻaputuputu o pupuga mafiafia i māmā. O isi CF faʻailoga ua faʻaleleia foi.

Tausiga ma mataʻituina i le fale tatau ona aofia ai:

  • Aloese mai le asu, pefu, palapala, ausa, vailaʻau a le aiga, asu afu, ma suia pe faʻaputuga.
  • Mauaina o tele o vai, aemaise lava i pepe ma tamaiti i le vevela o le tau, pe a i ai le manava manava pe malepe nofoa, pe i le taimi o faʻamalositino tele gaioiga.
  • Faʻamalositino faʻalua pe 3 taimi ile vaiaso. Aʻau, tamoʻe, ma uila vilivae o ni filifiliga lelei.
  • Faamamaina po o le aumaia luga mucus po o secretions mai ala vaalele. Lenei tatau ona faia 1 i le 4 taimi i aso uma. O tagata mamaʻi, aiga, ma tagata e vaʻaia tagata e tatau ona aʻoaʻoina e uiga i le faia o le fatafata o le fatafata ma le faʻavaivai o alavai e fesoasoani e faʻamama auala o alatele
  • Leai se fesoʻotaʻiga ma isi tagata ma CF e fautuaina aua e mafai ona latou fesuiaʻia faʻamaʻi (e le faʻaoga i tagata o le aiga).

Oe mafai ona faʻafaigofieina le popolevale o maʻi e ala i le auai i le cystic fibrosis lagolago kulupu. O le fefaʻasoaaʻi ma isi e masani ona maua i latou faʻafitauli ma faʻafitauli e mafai ona fesoasoani i lou aiga e aua ai neʻi lagona le tuua toʻatasi.

Ole toʻatele o tamaiti e maua le CF tumau i le soifua maloloina lelei seʻia oʻo ina matutua. E mafai ona latou auai i le tele o gaioiga ma auai i le aʻoga. Tele talavou matutua ma CF maeʻa kolisi pe maua galuega.

O le maʻi mama e iʻu lava ina leaga i le tulaga ua le atoatoa le tagata. I aso nei, o le averesi olaga vaʻaia mo tagata ma CF oe ola i le matua e tusa ma le 44 tausaga.

O le oti e masani ona mafua mai i faʻalavelave o le mama.

Ole faʻalavelave la e masani ai ole faʻamaʻi pipisi ole manava.

Isi faʻafitauli aofia ai:

  • Faʻafitauli o le manava, e pei o maʻamaʻa, poloka poloka, ma le toe faʻatupuina o le ponaivi
  • Mauaina le toto
  • Paʻu manava faaumiumi
  • Maʻi suka
  • Le fanau
  • Faʻamaʻi ole ate poʻo le paʻu ole ate, pancreatitis, biliary cirrhosis
  • Paleni meaai
  • Nasal polyps ma sinusitis
  • Osteoporosis ma le gugu
  • Pamu e toe foi mai i tua
  • Pamuʻu
  • Lelei itu fatu taumatau (cor pulmonale)
  • Kanesa o le Colorectal

Valaʻau lau tautua pe a fai o se pepe poʻo se tamaititi ua i ai faʻailoga o le CF, ma poto masani:

  • Fiva, faateleina le tale, suia i le sputum poʻo le toto i le mimiti, leai se fia 'ai, poʻo isi faʻailoga o le niumonia
  • Faateleina le paʻu pauna
  • Faʻasolosolo gofie le manava poʻo nofoa e leaga ai le manogi pe sili atu foi le lololo
  • Fula fulafula poʻo faateleina bloating

Valaʻau lau tautua pe a fai e maua e se tagata ma le CF ni faʻailoga fou pe a faʻapea e atili ai ona leaga faʻailoga, aemaise lava le faigata o le manava poʻo le tale o le toto.

CF le mafai ona taofia. O le suʻesuʻeina o i latou e iai talaʻaga a le aiga ole faʻamaʻi atonu e iloa ai le genes CF ile tele o feaveaʻiga.

CF

  • Enteral taumafa - tamaititi - faʻafoeina faʻafitauli
  • Fagu fafagaina Gastrostomy - bolus
  • Faʻafefea ona manava pe a fai e te le manava
  • Jejunostomy fafagaina paipa
  • Alavai i tua
  • Kalapu
  • Alavai i tua
  • O tamatamai lima kalapu
  • Fibrosis o le cystic

Donaldson SH, Pilewski JM, Griese M, et al. Tezacaftor / ivacaftor i mataupu ma cystic fibrosis ma F508del / F508del-CFTR poʻo F508del / G551D-CFTR. Am J Respir Crit Care Med. 2018; 197 (2): 214-224. PMID: 28930490 pubmed.ncbi.nlm.nih.gov/28930490/.

Eagan ME, Schechter MS, Voynow JA. Fibrosis o le cystic I le: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Tusitusiga o Pediatrics. 21 ed. Filatelefia, PA: Elsevier; 2020: mata 432

Farrell PM, White TB, Ren CL, et al. Suʻesuʻega o cystic fibrosis: maliega autasi mai le Cystic Fibrosis Foundation. J Pediatr. 2017; 181S: S4-S15.e1. PMID: 28129811 pubmed.ncbi.nlm.nih.gov/28129811/.

Graeber SY, Dopfer C, Naehrlich L, et al. Aʻafiaga o lumacaftor / ivacaftor togafitiga i luga o le CFTR gaioiga i Phe508del homozygous tagata mamaʻi ma cystic fibrosis. Am J Respir Crit Care Med. 2018; 197 (11): 1433-1442. PMID: 29327948 pubmed.ncbi.nlm.nih.gov/29327948/.

Grasemann H. Cystic fibrosis. I totonu: Goldman L, Schafer AI, eds. Faʻafomaʻi Goldman-Cecil. 26th lomiga. Filatelefia, PA: Elsevier; 2020: chap 83.

Rowe SM, Hoover W, Solomon GM, Sorscher EJ. Fibrosis o le cystic I: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray ma Nadel's Textbook of Respiratory Medicine. 6th ed. Filatelefaia, PA: Elsevier Saunders; 2016: mata 47.

Taylor-Cousar JL, Munck A, McKone EF, et al. Tezacaftor-ivacaftor i tagata mamaʻi ma cystic fibrosis homozygous mo phe508del. N Engl J Med. 2017; 377 (21): 2013-2023. PMID: 29099344 pubmed.ncbi.nlm.nih.gov/29099344/.

Mo Oe

Lauti lauti mo toto maualuga

Lauti lauti mo toto maualuga

Ole inuina ole ti lea e mafai ona faʻailoa mai e faʻatonutonu ai le toto maualuga, pe a oʻo atu i luga ole 140 x 90 mmHg, ae le faʻaalia mai i i faʻailoga, pei ole tiga o le ulu, niniva, faʻanenefu va...
Virosis: o le a lea, faʻailoga autu ma togafitiga

Virosis: o le a lea, faʻailoga autu ma togafitiga

Viro i o oʻo e faʻamaʻi e mafua mai iama ma e i ai e puʻupuʻu umi, lea e ma ani ona le ilia le 10 a o. O ona faʻailoga iloga e aofia ai:Manava, fiva ma puaʻi;Lagona le maʻi ma le leai o e fiaai;Tiga o...