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Lupus ban do

Toi co mot nguoi em gai, hien nay 23 tuoi. Em toi bi benh he thong va hoi chung Raynaud. Xin bac si cho biet ro hon ve can benh nay cua em toi. Benh cua em toi co nang lam khong? Co dieu tri het duoc khong?(Hop)

Tra loi cua phong mach online:

Lupus la mot tu latin co nghia la cho soi, xuat phat tu viec nguoi benh thuong co ban do dac trung o mat giong nhu hinh vet can cua cho soi. Benh khong khoi hoan toan nhung co the kiem soat neu duoc dieu tri dung. la mot loai benh to chuc lien ket man tinh thuong gap. Nu mac benh nhieu hon nam tu 8-10 lan va tuoi tu 20 - 40. Thuong chia lam 2 loai: dang dia va he thong. Nhu em gai chi la bi lupus ban do he thong.

Nguyen nhan:  Y hoc hien dai cho rang co so cua benh la mot phan ung tu mien do hinh thanh cac tu khang nguyen tai cac to chuc da bi bien doi do nhieu nguyen nhan nhu co hoc (chan thuong), hoa hoc (thuoc, hoa chat), ly hoc (tia xa, nong, lanh), vi khuan, vi rut. Cung nhu trong qua trinh tu mien dich noi chung, trong LE co vai tro cua cac he thong te bao mien dich T va B (mat can bang giua Lympho T va Lympho B).

he thong:  la the nang nhat, co the tien phat hoac thu phat tu cac the khac chuyen thanh, ngay cang gap nhieu hon. Ton thuong da dang o da, noi tang va nhieu co quan khac, co khi cap dien co khi tu tu, nhieu truong hop tu vong sau thoi gian ngan, co khi tien trien man tinh, luc tang luc giam that thuong. Ton thuong da va niem mac nhu the tren nhung da dang hon, rong khap hon, kem theo cac ton thuong toan than nhu sot, dau co, ton thuong khop, noi tang. Sot nhe, co luc cao den 40-41oC (luc benh cap dien).

Bieu hien cua benh gom:

- Ban hinh canh buom o mat (hai ma va song mui).

- Sam da, da nhay cam voi anh nang.

- Sot keo dai.

- Rung toc.

- Loet mieng, loet hong.

- Dau nhuc cac khop nhung rat hiem khi bi bien dang khop. Khoang co 90% dau cac khop to nho chan tay, bien hien viem khop phong thap, co khi dan den teo co bien dang, dau khop co dinh hoac di chuyen 

- Viem cac mach mau nho, viem hach, viem cau than va co.

- Viem va tran dich cac mang (mang phoi, mang bung, mang tim).

- Benh ly than kinh trung uong va ngoai vi.

Ton thuong noi tang: 30-50% ton thuong tim mach (viem noi hoac ngoai tam mac, viem co tim), 45-75% ton thuong than (viem cau than, suy than cap), 25% bieu hien bien chung tam than kinh (co giat, liet nua nguoi, roi loan tam than, viem day than kinh ngoai bien), 20-60% ton thuong phoi (viem phoi, viem mang phoi), ngoai ra co the kem theo roi loan tieu hoa; viem gan viem lach, sung hach rai rac.

he thong la mot benh co trieu chung lam sang rat da dang, nhieu khi rat kho chan doan, nhat la the lupus khong co ton thuong ngoai da. Nhu em gai chi da bat dau co ton thuong mach mau nho voi bieu hien co mach o cac dau chi dan den hoi chung  Raynaud. Nhung luc nhu the nen ngam tay vao nuoc am de mach gian ra se do dau.

Chi hoi rang trien vong cua em gai chi se ra sao? Binh thuong, he mien dich giup co the chong lai su xam nhap cua cac tac nhan la (vi khuan, virus...) nhung trong lupus ban do he thong va cac benh tu mien khac, he mien dich mat kha nang phan biet la-quen. No quay ra chong lai chinh minh bang cach sinh ra cac khang the chong lai te bao cua hau het cac co quan. Trong ten cua benh, Lupus co nghia la cho soi, vi nguoi benh thuong co ban do o mat giong hinh vet can cua cho soi. Tu "ban do" de chi mot dau hieu pho bien o hau het cac benh nhan. Tu "he thong" duoc su dung do benh gay anh huong den hau het cac co quan trong co the.

he thong khong the dieu tri khoi hoan toan nhung co the kiem soat duoc neu dieu tri dung. Trong giai doan nang cua benh dang cap, nguoi benh can duoc nghi ngoi, nhung van can mot che do van dong hop ly de tranh teo co va cung khop. Cac thuoc chong viem giam dau khong steroid nhu aspirin, ibuprofen, naproxen, nimesulide co hieu qua tot voi cac trieu chung o co va khop. Thuoc de gay viem loet da day ta trang nen phai dung khi no.

Cac loai corticosteroid chong viem manh hon nhom thuoc tren nhung cung nhieu tac dung phu hon, chi dung trong truong hop benh nang co ton thuong noi tang. Cac tac dung phu thuong gap la viem loet da day ta trang, tang duong mau, loang xuong, ran da, tang nguy co nhiem trung, uc che tuyen thuong than. Do vay, nen uong thuoc mot lan sau bua an sang.

Cac thuoc chong sot ret nhu hydroxychlloroquine, chloroquine co hieu qua kha tot voi ton thuong o da va khop. Thuoc uc che mien dich nhu azathioprin (Imuran), cyclopphosphamide (Endoxan), cycloporin (Sandimum) co rat nhieu tac dung phu nguy hiem nen chi dung trong nhung truong hop nang khong dap ung voi corticosteroid don thuan.

Nguoi bi mac benh lupus ban do he thong can co mot cuoc song lanh manh, nang van dong, tranh bi sang chan tam ly. Da benh nhan lupus he thong rat man cam voi tia mat troi; vi vay, can chu y khong de anh nang va tia tu ngoai chieu len da. Khi ra nang, phai mac ao quan dai, che o hoac doi mu. Tranh bi lanh, nhat la lanh dot ngot. Nen an cac thuc pham giau canxi nhu sua, cac che pham tu sua, dau nanh; khong an cac gia vi cay, nam huong, rau thom; an it dau mo. Nen uong nuoc tra hoa cuc thuong xuyen vi hoa cuc tinh mat, co tac dung giai doc.

BS LE THUY TUOI

Ban co nhung thac mac ve suc khoe cua minh ma khong biet hoi ai. Ban can duoc tu van cho nhung thac mac ve suc khoe cua minh, cua nguoi than... Phong mach online cua Tuoi Tre Online se giup ban giai dap 1.001 thac mac ve suc khoe. Moi thac mac ve suc khoe xin gui ve dia chi email: tto@tuoitre.com.vn

De chinh xac ve noi dung, van de can hoi, xin ban doc vui long go co dau (font chu unicode). Xin chan thanh cam on!

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