Fibrosis o le cystic
![Cystic Fibrosis Mechanism and Treatment | HHMI BioInteractive Video](https://i.ytimg.com/vi/6IbP1ASGv9w/hqdefault.jpg)
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.
![](https://a.svetzdravlja.org/medical/cystic-fibrosis.webp)
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
![](https://a.svetzdravlja.org/medical/cystic-fibrosis-1.webp)
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).
![](https://a.svetzdravlja.org/medical/cystic-fibrosis-2.webp)
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
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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/.