Iyadoo la isticmaalayo buundooyinka Marsh si loo ogaado Cudurada Cudurka

by Nancy Lapid; Waxaa ku jawaabay Emmy Ludwig, MD

Dhibaatada mindhicirka ee Marsh ayaa saamiga ku yeeshay xiidmaha

Haddii lagaa baaro cudurada baruurta , dhakhtarkaagu wuxuu u suurtagelin doonaa inuu sameeyo endoscopy iyo biopsy si loo eego in xiidankaaga yar uu waxyeelo ka soo gaaray gluten , borotiin laga helay sarreen, ari, iyo galley. Dhakhtarkaagu wuxuu isticmaali doonaa qalab caafimaad, oo loo yaqaanno endoscope, oo leh kamarad yar oo si toos ah u eegta habka dheef-shiidka sare, oo aad qaadanayso qaybo aad u yar oo ka mid ah unugyada kaadida mindhicirkaaga yar.

Ka dib markaad dhakhtarkaaga joogtid, takhtaroole ayaa fiirin doona shaybaarada unugyada si loo arko haddii uu jiro waxyeellada gluten-la xiriira. Takhtarka cudur-sidaha ayaa qiimeyn doona xaalada shaybaaradan iyada oo ku saleysan habka qiimeynta lagu magacaabo Marsh Score. Dhibcahaaga Marsh wuxuu go'aamin doonaa in lagaa soo ogaado haddii lagaa helay cudurka baruurta, iyo sidoo kale sida aad u sarreeyso xaaladaada.

Cudurka jeermiska ma aha xaalad kaliya ee keeni karta isbeddelladan qaar, taas awgeed waa dheecaan laga soo qaaday oo kaliya mid ka mid ah baaritaanada cudurka lagu taliyey in lagu daaweeyo cudurada baruurta-inkastoo laga qaado dheecaan ka-qaadista loo yaqaan 'standard gold' oo loogu talagalay cudurka cagaac. Natiijooyinka baaritaanka dhiigga cudurada baruurta (celiac test test blood test) iyo jawaabta ugu dambeysa ee qofka kudeeqda cuntooyinka aan gluten-ka ahayn ayaa sidoo kale ka caawin kara helitaanka cudurka saxda ah.

1 -

Heerka 0

Sayniska Sawirada / Sawirada Sawirada

Tani waa sawir qaadatay inta lagu guda jiro endoscopy, oo muujinaysa mindhicir yar oo caadi ah oo lagu xardhay oo leh xayawaan caafimaad qaba. Maaddaama xuubka mindhicirka uu u muuqdo mid caadi ah, waxaa laga yaaba in qofku qabo cudurka baruurta.

Xaaladdan, shaybaarka baayobsiga waxaa loo qoondeeyn doonaa Marsh Stage 0, oo loo yaqaan 'marxalad horudhac ah. " waxaa loo yaqaan "pre-infiltrative" sababtoo ah lymphocytes weli ma bilaabin inay u guuraan, ama "ku dhejiyaan," maqaarka xiidmaha.

2 -

Marxaladaha 1 iyo 2

Marinka qulqulka - Marsh Dhibcaha 1. © Ludvigsson et al, 2009

Marxaladda 1aad ee dhibcaha Marsh micnaheedu waa unugyada dusha sare ee xuubka mindhicirka, oo loo yaqaanno unugyada epithelial, waxay leeyihiin lymphocytes, unugyada dhiigga cad, oo ka mid ah kuwa caadiga ah.

Xanuun yar oo caadi ah, waa in aysan jirin wax ka badan 30 lymphocytes per 100 unugyada epithelial, laakiin xaaladaha loo arko heerka 1, waxaa jira in ka badan. Haddii aad qabtid marxaladda 1, warbixintaada baranbaradu waxay u badan tahay inay akhriso "kororka lymphocytes intraepithelial."

Cudurka jeermiska ma aha xaalad keliya oo keeni karta kororka lymphocytes ee cudurka. Waxaa laga yaabaa in aad qabtid lymphocytes haddii aad qabtid cudurka mindhicirka bararka, Sjogren's syndrome, iyo cunno kale oo aan cunno lahayn. Infekshanka bakteeriyada loo yaqaan ' Helicobacter pylori' (oo ku xiran boogaha), iyo isticmaalka xanuunka miisaanka oo dilaacda sida aspirin iyo ibuprofen, ayaa sidoo kale sababi kara arrintan.

Dadka qaba cudur-sidaha 'celiac' oo raaca xayawaanka aan lahayn gluten la'aanta , xubnaha qoyska ee dadka qaba cudurka baruurta, iyo dadka qaba dermatitis herpetiformis , cuncun cuncun leh oo loo arko inay tahay muuqaalka maqaarka cudurada baruurta, ayaa sidoo kale laga yaabaa in marxaladda 1 Marsh dhibcaha.

Marxaladda 2aad, waxaad arkaysaa lymphocytes badan inta caadiga ah iyo sidoo kale dareenka ka weyn inta caadiga ah u dhexeeya villi mindhicirka. Niyadjabadaan waxaa lagu magacaabaa "crypts", ama "crypts" ka badan oo loo yaqaan "hyperplastic", sidaa daraadeed haddii cudurku uu soo sheego ka dib markii lagaa jaray baakteeriyadaada waxaad sheegeysaa in aad qabtid "crypts hyperplastic" ama "crypt hyperplasia", macnaheedu waa niyadjabka lagu arkay biopsiga way ka weyn yihiin inta ay ku jiri lahaayeen maqaarka caadiga ah ee mindhicirka.

Marxaladda 2aad waa mid aad u yar- waxaa badanaa lagu arkaa dadka qaba dermatitis herpetiformis.

_{Sawir-qaadashada sawirkani wuxuu ka yimid Jaantus 1b ee Ludvigsson et al.} _{BMC Gastroenterology 2009 9:19.} _{doi: 10.1186 / 1471-230X-9-19.} _{Sawirka sawirrada ayaa laga helay Prof. Åke Öst, oo ah guddoomiye hore ee kooxda hoggaanka qaranka ee loogu talagalay cudurada yar yar ee mindhicirka.}

3 -

Heerka 3aad

Tani waxay muujineysaa xoqidda mindhicirka Marsh Score 3. © Ludvigsson et al, 2009

Dhakhaatiirta intooda badan ma ogaanayaan cudurada baruurta ilaa ilaa inta xuddunta mindhicirku ay gaaraan marxaladda 3aad. Marxaladdan, isbeddelka marxaladda 2aad ayaa jira - badanaa lymphocytes ka badan diiqadaha caadi ah iyo kuwa aan caadiga ahayn - iyo sidoo kale yareynta iyo xoqitaanka xiidmaha , waxa loo yaqaano niyad jab.

Heerka 3aad wuxuu leeyahay saddex qaybood:

Qayb ka mid ah qashin-celinta qashinka ah (Marxaladda 3a): Xididada mindhicirku weli way jirtaa, laakiin waa yar tahay
Qaybta 3-aad ee qashin-qubka ah (Marxaladda 3b): Cunuggaaga mindhicirku aad ayuu u yaraaday
Wadarta guud ee qulqulka leh (Marxaladda 3c): Xididada mindhicirku waxay ku saleysan tahay iyadoo aan lahayn xayawaan mindhicir ah

Dadka badankood laga hela cudurka cagaarshowga badankoodu waxay leeyihiin marxaladda 3 dhibcood Marsh.

_{Sawir-qaadashada sawirkani wuxuu ka yimid Jaantus 1c ee Ludvigsson et al.} _{BMC Gastroenterology 2009 9:19.} _{doi: 10.1186 / 1471-230X-9-19.} _{Sawirka sawirrada ayaa laga helay Prof. Åke Öst, oo horay u ahaan jiray guddiga hoggaanka qaranka ee loogu talagalay cudurada yar yar ee mindhicirka.}

4 -

Marxaladda 4aad

Heerka 4aad waa marxaladda ugu sarreysa oo nasiib wanaagna lama arki karo inta badan. Marxaladda 4aad, xayndaabkaaga ayaa gebi ahaanba la siman yahay (boodhka) murugada u dhaxaysa iyaga (qaylo-dhaanta) ayaa sidoo kale hoos u dhacaya.

Marxaladda 4-aad waxay ku badan tahay dadka waayeelka ah ee qaba cudurka baruurta. Haddii dhibcahaaga Marshu yahay marxaladda 4, waxaa laga yaabaa inaad halis dheeraad ah u tahay dhibaatooyinka cudurka barojada, oo ay ku jiraan lymphoma.

Qirashada:

_{Sawir-qaadashada sawirkani wuxuu ka soo baxaa Jaantus 1d ee Ludvigsson et al.} _{BMC Gastroenterology 2009 9:19.} _{doi: 10.1186 / 1471-230X-9-19.} _{Sawirka sawirrada ayaa laga helay Prof. Åke Öst, oo horay u ahaan jiray guddiga hoggaanka qaranka ee loogu talagalay cudurada yar yar ee mindhicirka.}

5 -

Ereyga ka

Dhakhaatiirta Gastroenterists waxay isticmaalaan dhibcaha Marsh si ay u qiyaasaan dhaawaca xuubka yar ee mindhicirrada mindhicirkaaga. Dhibcahaaga Marsh ayaa go'aamin doona haddii aad qabtid cudurka baruurta, iyo inta ay waxyeelo gaarsiisay xiidmaha mindhicirkaaga.

Tilmaamahan heerarka dhibcaha Marsh wuxuu kaa caawin karaa inaad u fasirto warbixinta ka soo qaadista mindhicirkaaga. Si kastaba ha noqotee, haddii aad dhibaato kala kulanto fahamka, ha ka baqin inaad kala hadasho dhakhtarkaaga wixii macnahiisu yahay. Xasuusnow: marka aad bilowdo cunto-ku-rididda-gluten-free, xitaa xitaa waxyeelada xun ee mindhicirka waa inay bilaabaan inay bogsadaan.

> Ilo:

> Ludvigsson JF et al. Daraasad ku-ool ah oo ku saabsan xanuunka qallafsan iyo bararka yar ee mindhicirrada ee xayiraadda qashinka Swedishka. BMC Gastroenterology . 2009; 9: 19.

> Snyder CL, Young DO, Green PHR, Taylor AK. GeneReviews: Cudurka Cagaac. 2009.

> Hill ID et al. Cilmi-baaris loogu talagalay ogaanshaha iyo daaweynta cudurrada 'celiac' ee carruurta: talooyin ka soo jeeda bulshada waqooyiga Ameerika ee fayadhowrka carruurta, Cagaarshowga iyo nafaqada. Wargeyska Gastroenterology ee carruurta iyo nafaqada. 2005; 40: 1-19.

> Isticmaalka Cudurka Qaliinka ee Stanford Daawada: Cudurka Cagaac.

Related Content

Fresh articles

Intresting articles