ʻO Fibrosis ke ake

Anter

• He aha nā pae o ka fibrosis ate?
• He aha nā hōʻailona o ka fibrosis ate?
• He aha nā kumu o ka fibrosis ate?
• Nā koho lapaʻau
• Kānāwai
• ʻO ka biopsy ate
• ʻO ka elastography kuewa
• Nā hoʻāʻo Nonsurgical
• Nā pilikia
• Outlook

Hōʻike Overview

Hana ʻia ka fibrosis o ke ake ke lilo ka maka o ke ake olakino o kou ake a no laila ʻaʻole hiki ke hana pū kekahi. ʻO Fibrosis ka pae mua o ka scarring ate. Ma hope, inā lilo ka nui o ke akepaʻa i makaʻu, ʻike ʻia ʻo cirrhosis ate.

ʻOiai ua hōʻike ʻia kekahi mau noiʻi holoholona i ka hiki i ke ake ke hoʻōla hou a hoʻōla iā ia iho, ke hana ʻia ka pōʻino o ke akepaʻa i ke kanaka, ʻaʻole ola ka ate. Eia nō naʻe, hiki i nā lāʻau a me nā loli nohona ke kōkua i ka mālama ʻana i ka fibrosis mai ka ʻino ʻana.

He aha nā pae o ka fibrosis ate?

Aia kekahi mau unahi like ʻole o ke ake fibrosis e hana ana, kahi a ke kauka e hoʻoholo ai i ke kiʻekiʻe o ka hōʻino o ke ake. Ma muli o ke kau ʻana hiki ke lilo i kumuhana, he pālena kā ko kēlā me kēia unahi. Manaʻo paha kekahi kauka he ʻāpī iki ka akepaʻa o ke ake ma mua o kekahi. Eia naʻe, hāʻawi mau nā kauka i kahi pae i ka fibrosis o ke akepaʻa no ka mea kōkua ia i ka mea maʻi a me nā kauka ʻē aʻe e hoʻomaopopo i ke ʻano o ka ate o ke kanaka.

ʻO kekahi o nā ʻōnaehana helu ʻoi aku ka makemake ʻia ʻo ka ʻōnaehana helu METAVIR. Hāʻawi kēia ʻōnaehana i kahi helu no "ka hana" a i ʻole ka wanana o ka holomua o ka fibrosis, a no ka pae fibrosis ponoʻī. Hiki i nā kauka ke hoʻokau i kēia helu wale nō ma hope o ka lawe ʻana i kahi biopsy a i ʻole mea kikoʻī o kahi ʻāpana o ke ake. Aia nā papa hana mai A0 a i A3:

• A0: ʻaʻohe hana
• A1: ka hana akahai
• A2: ka hana kūpono
• A3: hana koʻikoʻi

Aia nā pae fibrosis mai F0 a i F4:

• F0: ʻaʻohe fibrosis
• F1: portal fibrosis me ka ʻole septa
• F2: portal fibrosis me kekahi septa
• F3: septa lehulehu me ka ʻole cirrhosis
• F4: cirrhosis

No laila, ʻo kahi kanaka me ka maʻi maʻi ʻoi loa e loaʻa iā ia kahi helu A3, F4 METAVIR.

ʻO kekahi ʻōnaehana helu ʻo Batts a me Ludwig, nā mākia fibrosis ma ka pālākiō o ka papa 1 a hiki i ka papa 4, me ka papa 4 ka mea ʻoi loa. Loaʻa i ka International Association of the Study of the Liver (IASL) kahi ʻōnaehana helu me ʻehā mau ʻāpana e kū ana mai ka hepatitis maʻi mau a hiki i ka maʻi hepita koʻikoʻi.

He aha nā hōʻailona o ka fibrosis ate?

ʻAʻoleʻike pinepine nā kauka i nā fibrosis o ke ake i kona ʻano akahai a me ke akahai. ʻO kēia no ka mea ʻaʻole maʻamau ka fibrosis ate i nā ʻōuli a hiki i ka hōʻeha ʻana o ka ake hou.

Ke holomua ke kanaka i ko lākou maʻi ate, ʻike paha lākou i nā ʻōuli e pili pū me:

• poho ʻai
• paʻakikī e noʻonoʻo pono
• ka hoʻoulu wai i nā wāwae a i ʻole ka ʻōpū
• jaundice (kahi e melemele ai ka ʻili a me nā maka)
• nausea
• lilo kaumaha maopopo ʻole
• nāwaliwali

Wahi a a, kuhi ʻia he 6 a he 7 pākēneka o ko ka honua heluna kanaka he fibrosis ate a ʻike ʻole iā ia no ka mea ʻaʻohe o lākou mau ʻōuli.

He aha nā kumu o ka fibrosis ate?

Hana ka fibrosis o ke ake ma hope o ka ʻike ʻana o ke kanaka i ka ʻeha a i ʻole ka mumū i ke ake. Hoʻoulu nā hunaola o ke ake i ka hōʻeha ʻana i ka ʻeha. I loko o kēia hōʻeha ʻana o ka ʻeha, kūkulu nā protein āpau e like me collagen a me glycoproteins i ke ake. ʻO ka hopena, ma hope o nā manawa he nui o ka hoʻoponopono ʻana, ʻaʻole hiki i nā hunaola ate (ʻike ʻia he hepatosit) ke hoʻoponopono hou iā lākou iho. Hoʻokumu nā protein āpau i nāʻiʻo makaʻu a fibrosis paha.

Aia kekahi mau ʻano o nā maʻi akepaʻa i hiki ke kumu i ka fibrosis. Pākuʻi ʻia kēia mau mea:

• hepatitis autoimmune
• keʻakeʻa biliary
• hoʻoulu hao
• maʻi maʻi ʻalekiko ʻaʻaleka ʻole, i komo pū me nā akepaʻa momona ʻole (NAFL) a me steatohepatitis nonalcoholic (NASH)
• ʻO ka maʻi hepatitis B a me C
• maʻi maʻi ʻalekohola

Wahi a, ʻo ke kumu maʻamau o ka ake fibrosis he maʻi maʻi ʻona nonalcoholic fatty (NAFLD), ʻo ka lua ka maʻi ʻona ʻalekohola ma muli o ka lōʻihi o ka inu rama.

Nā koho lapaʻau

ʻO nā koho lapaʻau no ka fibrosis o ke ake e kaukaʻi ʻia ma ke kumu o ka fibrosis. E mālama ke kauka i ka maʻi maʻi, inā hiki, e hōʻemi i nā hopena o ka maʻi ate. ʻO kahi laʻana, inā inu nui kekahi kanaka i ka waiʻona, hiki i ke kauka ke koi i kahi papa hana e kōkua iā lākou e hōʻoki i ka inu ʻana. Inā loaʻa ka NAFLD i kekahi kanaka, hiki i ke kauka ke koi aku i ka hoʻololi ʻana i nā papaʻai e hoʻoliʻiliʻi i ke kaupaona a me ka lawe ʻana i nā lāʻau e hoʻolaulaha i ka kaohi kō kō aʻe. ʻO ka hoʻoikaika kino a me ka lilo ʻana o ka paona ke kōkua pū paha e hōʻemi i ka holomua o ka maʻi.

E kuhikuhi paha ke kauka i nā lāʻau i ʻike ʻia me nā antifibrotics, i hōʻike ʻia e hōʻemi i ka likelike o ke kū ʻana o ka ate. Kau ka antifibrotic i ka maʻamau ma muli o ke ʻano o ka lāʻau olakino. ʻO nā laʻana o kēia mau mālama ʻana:

• maʻi maʻi akepaʻa: Nā mea kāohi ACE, e like me benazepril, Lisinopril, a me ramipril
• maʻi virus hepatitis C: a-Tocopherol a i ʻole interferon-alpha
• nonalcoholic steatohepatitis: ʻO PPAR-alpha agonist

ʻOiai ke hana nei nā mea noiʻi i nā hoʻokolohua he nui e hoʻāʻo e loaʻa nā lāʻau i hiki ke hoʻohuli i nā hopena o ka fibrosis ate, ʻaʻohe lāʻau e hiki ke hoʻokō i kēia manawa.

Inā piʻi ka fibrosis akepaʻa o ke kanaka i kahi i wīwī loa ai ko lākou akepaʻa a ʻaʻole holo, hana pinepine wale ʻia kahi kanaka e loaʻa kahi transplant ake. Eia nō naʻe, lōʻihi ka papa inoa kali no kēia mau ʻano transplan ʻaʻole kēlā me kēia kanaka he moho ʻoki.

Kānāwai

ʻO ka biopsy ate

ʻO ka mea maʻamau, ua manaʻo nā kauka e lawe i kahi biopsy ate ke "kūlana gula" o ka hoʻāʻo ʻana no ka fibrosis ate. ʻO kēia kahi kaʻina hana ʻokiʻoki kahi e lawe ai kahi kauka i kahi laʻana kikoʻī. ʻO kahi loea i ʻike ʻia ma ke ʻano he pathologist e nānā i ka nāʻaʻa no ke kū ʻana o ka scarring a i ʻole fibrosis.

ʻO ka elastography kuewa

ʻO kahi koho ʻē aʻe kahi hōʻike kiʻi i ʻike ʻia ma ke ʻano he elastography transient. He hoʻāʻo kēia e ana ana i ka ʻoʻoleʻa o ke ake. Ke loaʻa ka fibrosis ate i ke kanaka, hana nā hunaola ʻino i ke ake ake. Hoʻohana kēia hoʻokolohua i nā nalu kani haʻahaʻa e ana i ka ʻāʻī o ke ake o ke ake. Eia nō naʻe, hiki ke loaʻa nā mea maikaʻi ʻole hewahewa ma kahi o ke ake o ke akepaʻa ke ʻoʻoleʻa, akā ʻaʻole hōʻike kahi biopsy i ka scarring o ke ake.

Nā hoʻāʻo Nonsurgical

Eia naʻe, ua hiki i nā kauka ke hoʻohana i nā hoʻokolohua ʻē aʻe ʻaʻole koi i ke ʻoki e hoʻoholo ai i ka likelike o ke kanaka i ka fibrosis o ke ake. Hoʻomaʻamaʻa mau ʻia kēia mau ho'āʻo koko no ka poʻe me nā maʻi hepatitis C ʻike pinepine ʻia e loaʻa ka fibrosis ate ma muli o ko lākou maʻi. ʻO nā laʻana me ka serum hyaluronate, ka matrix metalloproteinase-1 (MMP), a me ka mea hoʻopaʻa i nā meaola o ka matrix metalloproteinase-1 (TIMP-1).

Hiki paha i nā kauka ke hoʻohana i nā hoʻokolohua e koi ai i nā helu, e like me ka aminotransferase-to-platelet ratio (APRI) a i ʻole kahi hoʻokolohua koko i kapa ʻia ʻo FibroSURE e ana ana i ʻeono mau māka ʻokoʻa o ka hana ate a hoʻokomo iā lākou i kahi algorithm ma mua o ka hāʻawi ʻana i kahi helu. Eia naʻe, ʻaʻole hiki i ke kauka ke hoʻoholo maʻamau i ke kahua o ka fibrosis ate e pili ana i kēia mau hoʻāʻo.

Ma ke kūpono, e hōʻoia ke kauka i kahi kanaka me ka fibrosis ate i kahi pae ma mua ke hiki ke mālama ʻia ke ʻano. Eia naʻe, no ka mea ʻaʻole maʻamau ke ʻano o ke ʻano i nā ʻōuli ma nā pae mua, ʻaʻole ʻike pinepine nā kauka i ka maʻi ma mua.

Nā pilikia

ʻO ke komikina nui loa o ka fibrosis o ke akekea hiki ke lilo i ka cirrhosis o ke ake, a i ʻole ka ʻeha koʻikoʻi e hōʻino ai ke akepaʻa a lilo ke kanaka i maʻi. ʻO ka maʻamau, lōʻihi kēia e hana ai, e like me ke ʻano o hoʻokahi a ʻelua mau makahiki paha.

Pono ke kanaka i ko lākou ake e ola no ka mea ke kuleana o ke akepaʻa no ka kānana ʻana i nā mea ʻino i loko o ke koko a hana i nā hana ʻē aʻe he mea nui i ke kino. ʻO ka mea hope loa, inā holomua ka fibrosis o ke kanaka i ka cirrhosis a me ka holo pono ʻole o ke ake, hiki iā lākou ke loaʻa nā pilikia e like me:

• ascites (hana nui i ka wai i loko o ka ʻōpū)
• hepatic encephalopathy (kūkulu ʻia ʻana o nā huahana neoneo e hoʻohoka ai)
• maʻi maʻi hepatorenal
• portal hypertension
• kahe variceal

Hiki i kēlā me kēia ʻano ke lilo i mea make i ke kanaka me ka maʻi ate.

Outlook

Wahi a, ʻo ka cirrhosis ate kekahi kumu nui o ka make ma ka honua holoʻokoʻa. No laila, he mea nui e ʻike ʻia kekahi kanaka a mālama ʻia no ka fibrosis o ke ake i ka wā hiki ma mua o ka holo ʻana i ka cirrhosis ate. Ma muli o ke kumu o ke ake fibrosis e hana ʻole ai i nā ʻōuli, paʻakikī kēia e hana. I kekahi manawa pono ka poʻe kauka e noʻonoʻo i nā pilikia o ke kanaka, e like me ka momona a i ʻole ka mea inu nui, i ke kuhi ʻana i ka fibrosis a me ka paipai ʻana i nā lāʻau lapaʻau.