FDA Oo La Ogaaday Sida Loo Ogolaaday Iyo Kalkaalisada Loogu Talagalay Cudurka Pulmonary Fibrois.
Bishii Oktoobar 2014, FDA waxay ogolaatay laba daroogo oo cusub, pirfenidone (Esbriet) iyo nintedanib (Ofev), si loogu daaweeyo ilmagaleenka sanbalka ee idiopathic. Fayruska sambabada ee iitoobiya waa cudur aad u xun oo dila dadka badankood lagu ogaado sanado kooban. Ka hor intaan la helin burcad-badeedeed iyo nintedanib, ma jirin dooro daaweyn oo gaar ah dadka qaba cudurkan halista ah.
Maxay Tahay Fudud-Joonis Sisiyeed (Pulmonary Fibrosis)?
Fayruska sambabada ee iitopathic waa cudur daba-dheer ama muddo-dheer kaas oo burburiya meelaha yaryar ee sanbabada (interstitia). In kasta oo xogta xadidan ay ka jirtahay jiritaanka dhabta ah ee cudurka, Ururka Sambabka Maraykanka wuxuu ku qiyaasayaa in uu ku dhaco 140,000 oo Maraykan ah. Inkasta oo uu kufududaynayo suugaanta, waxaan arkay qiyaaso hoose oo hoose marka cudurka loo qoondeeyey si xadidan (fadlan raali ahaada ciqaabta), iyadoo ay saameyneyso meel kasta 14 iyo 28 qof 100,000. Dadka qaba cudurkan caadi ahaan waa 50 jir ama ka weyn, cudurkuna wuxuu ku dhacaa ragga raga badan.
Qofna ma yaqaanno waxa keena fayruska maskaxda ee idiopathic (taas oo ah sababta loo yaqaan cudurka 'idiopathic' ). Waxa aan ognahay waa in cudurkan halista ah uu kordhiyo dib u celinta sambabada - sanbabadu waa unugyo dabacsan oo adkeynaya neefsiga. Xasuusta, fayruuska sambabada ee sanbalka waa cudur xanuunka sambabada ah oo hoos u dhigaya tirada sambabada.
Marka la ogaado, da'da dhexdhexaadka ah ee dadka cudurka qaba waa 4 sano oo kaliya.
Fayruuska sambabada ee Idiopathic wuxuu keenaa isbeddelo iyo isbeddelo fibrotic ah (nabarro) oo ku jira unugyada sambabada (parenchyma) kaas oo si farsamo ahaan ah loola xiriiro kilyaha sambabada ee alveoli. Xuubka sambabaha ee alveoli ayaa la burburiyaa; xididada sambabada ayaa ku lug leh isbeddelka oksijiinta iyo soo saarida dhiig badan oo oksijiin ah jirka.
Si kale haddii loo dhigo, dadka qaba fayruska sanbabada ee idiopathic, cirridka nudaha sambabada ayaa awood u leh inay yeeshaan kilyiyado sambabada ah si ay u daboolaan oksijiinka hawada naga neefsanaya.
Fayruska sambabada ee iitoobiya ayaa adkeynaya neefsashada ka dib. Waxa kale oo uu keenaa qufac iyo isbeddel ku dhaca dhawaaqa sanbabada imtixaanka. Calaamadaha badan ee cudurka waa nidaam ama jir ballaaran, sidoo kale waxaa ku jira daal, miisaan lumis iyo naadiyada faraha iyo suulasha. Baadhitaanka CT-ga oo sareeya (sawir raajo-faahfaahin dheeraad ah) ayaa muujiya boombalo ama dufan iyo muuqaal "malab" muuqaal ah oo isbeddel ku yimaada fibrotic. Baadhitaanka qaliinka ayaa bixiya cilad kufilan cudurka. Marka fayruska sambabada uu sii socdo, waxay u horseedaa xeelad ka mid ah cudurrada keena ama xaalado isku dhafan oo ay ka mid yihiin neefsashada neefsashada, wadnaha oo aan shaqeynin iyo dhiig-karka .
Inkasta oo aynaan hubin waxa dhabta ah ee keena fayruska sanbabada ee idiopathic, waxaan ognahay inay jiraan waxyaabo halis ah oo la xiriira cudurka:
- sigaar cabista
- infakshanka sanbabada fayraska
- neefsashada gaasta, qiiqa, boodhka iyo qaybo yaryar oo kale
- GERD (xanuunka qanjirka 'gastroesophageal reflux') ee xanuunka AKA ee joogtada ah)
- genetics
Fayruska suuxdinta ee fayruska ee 'idiopathic pulmonary fibrosis' waa mid aad u liidata sababtoo ah daaweyn wanaagsan oo wanaagsan.
Inkastoo dadka qaarkood ay ku sii jiri karaan mudo dheer ka dib baaritaanka, badankooda ayaa wax ka beddelaya ama sii xumeynaya xitaa daaweyn. Daaweynta xaadirka ah waxaa loogu talagalay calaamadaha cudurka ama isku dayidda in ay xaddidaan caabuqa iyo cirridka kale. Prednisone, steroid, ayaa inta badan loo isticmaalaa si looga caawiyo xakameynta bararka. Dad badan oo qaba fayruska maskaxda ee "idiopathic pulmonary fibroxis" ayaa sidoo kale hela oksijiin dheellitiran iyo dib u dhiska saafiga. Ugu dambeyntii, doorashada kaliya ee daaweynta dadka qaba fayruska sanbabada ee idiopathic waa sambab lagu beddelo sambabada.
Maxay yihiin Pirfenidone (Esbriet) iyo Nintedanib (Ofev)?
Baadhitaanada kiliinikada, pirfenidone (Esbriet) iyo nintedanib (Ofev) ayaa lagu muujiyay in la yareeyo fibrosis ama nabaro, sidaas awgeedna u socodka cudurkan.
Pirfenidone wuxuu leeyahay qaabab badan oo ficil ah oo ficil ah waana daaweyn afka ah. Marxaladda 3aad ee kiliinikada qaliinka, ku dhawaad kala badh ka mid ah ka qaybgalayaasha oo leh fayruska sanbabada ah ee dhexdhexaad ah oo lagu helo pirfenidone ayaa arkay hoos u dhac ku yimid awoodda muhiimka ah ee qasabka ah. Qiyaastani waxay muujinaysaa dib u dhac ku yimaada cudurka. Ka-qaybgalayaashu waxay la kulmeen faa'iidooyin kale oo wanaagsan oo ay ku jiraan hagaajinta socodka socodka 6-daqiiqo iyo hoos u dhaca dhimashada (tirada dhimashada) intii lagu jiray muddada 52-usbuuc. Dhibaatooyinka laga yaabo inay waxyeello u geystaan daaweynta waa la maamuli karaa oo xaddidnaayo sawirnimada, calool xanuun, lallabo iyo matag.
Nintenanib waa tyrosin-kinase inhibitor iyo sida pirfenidone waa dawo afka ah. Waxaa ka mid ah hababka kale ee bayoolojiga ah, kinase tyrosine waxay ku lug leedahay isbeddelka iyo isbeddelka fibrotic. Marxaladda 3aad ee kiliinikada caafimaadka, sida pirfenidone, nintenanib ayaa sidoo kale hoos u dhigtay horumarka maskaxda sanbabada ee idiopathic ee loo yaqaan 'measured pulmonary pulmonis' sida lagu qiyaaso hoos u dhaca heerka hoos u dhaca awoodda muhiimka ah. Dhibaatooyinka iman kara waxaa ka mid ah shuban, yalaalugo, matag, madax xanuun, cadaadiska dhiigga oo kor u kaca, iyo xajmiga enzymes ee kor u kaca (tilmaamaya beerka cillad la'aanta). Ugu dambeyntii, Ofev waa teratogen ah oo aan la qaadin muddada uurka si looga baqdo jiritaanka uur-ku-jirka ama dhimashada.
Maxay Tahay Pirfenidone (Esbriet) iyo Nintedanib (Ofev)?
Haddii adiga ama qof aad taqaanid uu leeyahay fayruska maskaxda ee idiopathic, ogolaansho pirfenidone (Esbriet) iyo nintedanib (Ofev) Waa daaweyn dhab ah oo ay tahay in lagu soo dhaweeyo woxoogaa wanaagsan. Si kastaba ha noqotee, arrimaha qaarkood ayaa loo baahan yahay in la caddeeyo ka hor intaan daawooyinkan si dhab ah u helin booskooda daawada kiliinikada. Marka hore, ma caddayn in pirfenidone iyo nintendanib loo isticmaali karo si gooni gooni ah ama isku mar ah marka la daaweynayo fayruska sanbabada ee idiopathic. Haddii wadajir loo isticmaalo, ma hubno waa in daroogada la isticmaalo marka hore. Haddii si gooni ah loo isticmaalo, ma hubno haddii daawooyinka ay muujinayaan saameyn isku mid ah ama saameyn weyn leh. Marka labaad, ma hubno in dadka qaarkood ay si gaar ah u jawaabaan ("jawaabeyaasha") midkood ama labadaba daawooyinkaas. Saddexda, ma naqaanno haddii daroogadu sii wadi doonto yareynta yareynta horumarka maskaxda sanbabada ee sanbabada sanadka soo socda.
Qoraalka kama dambaysta ah, haddii adiga ama qof aad jeceshahay uu leeyahay fayruska sanbabada ee idiopathic, waxaad tixgelisaa inaad baratid wax dheeraad ah oo ku saabsan kooxaha taageerada ee cudurka kudhaca Ururka Sambabka Maraykanka ama Wadnaha Qaranka, Sambabka, iyo Dhiigbaxa.
Ilaha la Xushay
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Naureckas ET, Solway J. Cutubka 252. Dhibaatooyinka Hawlaha Neefsashada. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds. Mabaadii'da Harrison ee Daawooyinka gudaha, 18e. New York, NY: McGraw-Hill; 2012. Lasoo gooyey November 04, 2014.
Kemp WL, Burns DK, Brown TG. Cutubka 13-aad ee cudur-wadareedka. In: Kemp WL, Burns DK, Brown TG. eds. Pathology: Sawirka Big . New York, NY: McGraw-Hill; 2008 Soo gashay November 04, 2014.
King TE, Jr .. Cutubka 261. Cudurrada Sambabka Sambabka. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds. Mabaadii'da Harrison ee Daawooyinka gudaha, 18e. New York, NY: McGraw-Hill; 2012. Lasoo gooyey November 04, 2014.
"Neefsaar kulul: talaabo weyn oo loogu talagalay fayruska sanbabada ee idiopathic" by CJ Ryerson iyo HR Collard ka soo BMJ la daabacay Sebtembar 2014. Laga soo bilaabo PubMed 11/4/2014.