Multiple myeloma

Multiple myeloma ( chirwere chaRustitzky-Claire) hachisi chinhu kunze kwemuviri wemarara wemapfupa, iyo inosanganisira masero eplasma akasiyana nekukura. Kutsanangurwa kwechirwere ichi kwakange kuripo muzana remakore rechina reXIX. Nenzira yakawanda, chirwere ichi chinokanganisa chikamu chikuru chevanhu uye vakwegura.

Zvinotendwa kuti myeloma yakawanda ndiyo mhedziso yekuchinja kweB-lymphocytes. Pamwoyo wechirwere ndiko kupararira kwemaitiro e plasma, izvo zvinotungamirira pakuparara kwepafu uye kuparadzwa kwemapfupa. Somugumisiro wehupenyu huripo, kuputsika kwemapfupa uye kuchinja muhupenyu hwavo kunowanzoitika. Yakawanda muzvizhinji, plasma masero anogadzira paraprotein, zvichiita kuti kuwedzerwa kweproteine muropa. Hyperproteinemia, kazhinji inokonzera kuora kwepvo nekukudzidzira kwezvinhu zvinokonzerwa nekushaya simba. Kusarudzwa mu tubules, paraprotein, zvinokonzera nephrohydrosis uye amyloidosis.
Kubudirira kwechirwere kunokonzera kuchinja kwechirwere muropa, kukanganiswa kwehematopoiesis. Mumufananidzo weropa unogona kuona anemia, yakadzika yeaplatelet nemasero machena eropa.

Zviratidzo zvechirwere

Multiel myeloma kwenguva yakareba haina kuzviita, uye chirwere chemuviri chinogona kunge chinogutsa. Mumazuva okutanga echirwere pane malaise, kuneta, asthenia. Kazhinji, chiratidzo chekutanga chinokurudzira chiremba chinorwadza mumucheto wezasi, musana uye mapfupa, uye kurwadziwa kunowedzera kuwedzera. Zviratidzo zvine chokuita ne hematopoiesis (anemia, thrombocytopenia) inogona kukura, hemorrhagic syndrome, mukati mekudzivirira, zvirwere zvinokura. Pahupamhi hwechirwere ichi, zviratidzo zvinobatanidza nekuwedzera kukundikana kwechirwere uye hyperproteinemia.

Diagnostics

Mune nguva yekutanga muropa mune kuwedzera kwezinga re erythrocyte sedimentation sechikonzero che disproteinemia. Nekufambira mberi kwehutachiona, chirwere chepanyama, kuderera kweplatelets uye leukocytes kuonekwa. Mukuongorora urini, mapuroteni makuru ekurasika anoonekwa. Chidzidzo chehupenyu hwehupenyu hwekugadzirwa kweropa chinotarisa kuwedzera kweproteine yose. Pazvakaitika zvekusava nekushaya kukwana - kuwedzera kwe creatinine uye urea, kusaenzana kwe electrolytes.
Kuongororwa kwe "multiple myeloma" kunoitwa pamusana pemugumisiro wekuongororwa kwemasero emasero. Ichi ndicho chinonyanya kuongorora kuongorora. Nzira yemubatsiro ndeyekuona kwemafupa emapfupa kuti aone kusakwana uye kuora kwemapfupa, foci ye osteoporosis. Zvakakosha kutungamirira proteinogram.

Mushonga we multipleel myoma

Kana myeloma inowanikwa panguva yekuongorora, kurapwa kwechirwere ichi kwemazuva ano dambudziko risina kugadziriswa. Inofanira kuzivikanwa Tarisiro yehupenyu yevarwere vane kurapa kwakanaka uye yakatowanikwa kunyange chirwere chacho anenge makore mashanu. Mukurapa kwechirwere ichi, mishonga inobvisa kufambisa kwechirwere (cytotoxic zvinodhaka) inoshandiswa. Asi mishonga iyi inongowedzera hupenyu hwevarwere. Pakutanga kurapwa, vanorayirwa mumatokisi makuru, pamagumo edzidzo vanoshandura kuti vatsigire kurapa.

Mukubatana ne cytostatic drugs, Prednisolone inoshandiswa. Kushandiswa kwaro kunodzivisa kuparadzwa kwemapfupa emapfupa uye kunobatsira nekuwedzera calcium. Mishonga yekurapa yakagadzirwa iyo inosanganisira kusanganiswa kwakasiyana-siyana kwechirwere, maitiro akasiyana zvichienderana nekuoma uye mhando ye myeloma. Migumisiro yerapa inoongororwa mwedzi mitatu mushure mekutanga chemotherapy.

Apo kusungirirwa kukundikana kwechirwere kunosanganiswa, kurapwa ne hemodialysis kunogona kudiwa.

Zvinokwanisika kushandisa radiotherapy. Iyo inorayirwa kuti kurapwa kwemaitiro mashoma ane nhengo ari mumapfupa uye zvinyoro zvishoma.