Dau hieu nhan biet viem cau than

Tags: Viem Cau Than, tieu cau than, giai doan cuoi, duoc su dung, tien trien, xuat hien, co the, ton thuong, hoi chung, than hu, benh, den, phat, sinh, tang


Dau hieu nhan biet viem cau than
Benh VCT co the xuat hien doc lap hoac ket hop voi hoi chung than hu. Viem cau than (VCT) la mot benh dac trung boi tinh trang viem cua cac tieu cau than va cac mach mau nho trong than. Benh co the xuat hien doc lap hoac ket hop voi hoi chung than hu. Benh duoc phan loai thanh nhieu the khac nhau, duoc chia thanh cac nhom theo muc do tien trien.

Chan doan the benh VCT rat quan trong vi ket qua va dieu tri khac nhau trong cac loai hinh khac nhau. VCT tien phat do ton thuong noi tai cua than, trong khi VCT thu phat co lien quan den mot so benh nhiem khuan (vi khuan, virut hay ky sinh trung gay benh), thuoc, benh he thong (lupus ban do, viem mach) hoac benh tieu duong.

Trieu chung dien hinh la gi? Trieu chung VCT phu thuoc vao tung the benh va su tien trien cap hay man tinh. Cac trieu chung chung co the bao gom: nuoc tieu sam mau, co bot (do du thua protein); tang huyet ap; phu; met moi, thieu mau; di tieu it hon binh thuong.

Phan loai the benh: Co nhieu cach phan loai, nhung phan loai theo cach tien trien cua benh la cach duoc su dung rong rai. Bao gom:

Benh mong mang day cau than: La benh di truyen gen troi voi bieu hien lam sang la tinh trang dai mau dai the dai dang. Ton thuong duoc xac dinh bang sinh thiet than va soi tren kinh hien vi dien tu thay mang day cau than mong hon binh thuong.

Benh cau than tien trien cham: Viem cau than ton thuong toi thieu: loai benh nay chiem toi 80% hoi chung than hu o tre em, nhung lai chi chiem 20% HCTH o nguoi lon. Dieu may man la the benh nay dap ung dieu tri tuong doi tot. Hon 90% tre em khoi benh sau 3 thang dieu tri, ti le khoi benh o nguoi lon la 80%. Thuoc thuong duoc dung la corticoid. Thuoc giam mien dich duoc chi dinh khi co hien tuong khang corticoid.

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Xo cung cau than tung o, tung doan, con goi la viem cau than o: co the nguyen phat hay thu phat trong cac benh ly nhu viem than nguoc dong (do nhiem khuan o duong tiet nieu), hoi chung Alport (viem cau than, ton thuong thinh giac, thi giac), lam dung heroin, HIV. Bieu hien cua benh nhu mot hoi chung than hu voi suy than o nhieu muc do, tinh trang xo cung chi xay ra o mot so vi tri nhat dinh. Ton thuong tien trien cham dan den suy than va dap ung kem voi dieu tri corticoid.

Viem cau than mang: La the benh hay gap o nguoi lon. Bieu hien lam sang la su ket hop trieu chung cua ca viem cau than va hoi chung than hu. Thuong vo can nhung cung co the ket hop voi mot so benh nhu viem gan, sot ret, ung thu phoi va ruot, lupus ban do. 1/3 so benh nhan tien trien den suy than giai doan cuoi. Dieu tri corticoid cung duoc su dung nhu mot no luc de han che su tien trien cua benh.

Mot so benh ly khac gay ton thuong than: Tang huyet ap, benh than do tieu duong. Bieu hien som la microalbumin nieu. Vi vay viec xet nghiem nuoc tieu de phat hien benh som la rat quan trong. Tien trien thuong cham va phu thuoc vao viec dieu tri nguyen nhan gay benh.

Benh cau than tien trien nhanh: Ve mat mo benh hoc, nhom benh nay duoc dac trung boi su gia tang nhanh chong ve so luong te bao trong tieu cau than. Qua trinh suy than dan den giai doan cuoi cung dien ra nhanh chong trong thoi gian tu vai tuan den vai thang tuy theo tung loai.

Benh than IgA: Day la nguyen nhan gay viem cau than hang dau o nguoi lon, nam mac nhieu hon nu. Dac thu cua benh nay la su xuat hien thuong xuyen hong cau trong nuoc tieu. Trieu chung thuong xuat hien trong vong 24 48 gio sau mot nhiem khuan duong ho hap hoac tieu hoa. Ton thuong truc tiep cau than do su lang dong IgA tren mang day. Tien luong benh rat khac nhau, khoang 20% benh nhan se tien trien den suy than giai doan cuoi.

Viem cau than sau nhiem khuan: Co the xay ra voi nhieu loai nhiem khuan, nhung nguyen nhan hay gap nhat la sau nhiem lien cau nhom D, dac biet la Streptoccocus pyogenes. Benh xuat hien sau cac nhiem khuan ho hap, nhiem khuan da khoang 10 - 14 ngay. Chan doan dua vao viec khai thac tien su nhiem lien cau truoc do. Cac test huyet thanh chan doan lien cau rat huu ich de cung cap them bang chung. Sinh thiet than hiem khi duoc dat ra. Duoc dieu tri dung cach, benh thuong tien trien tot va khoi benh trong 2 - 4 tuan.

Viem cau than tang sinh mang/viem cau than tang sinh gian mach: Benh co the tien phat hoac thu phat sau lupus ban do, viem gan virut. Nguoi ta nhan thay cac tieu cau than co hien tuong tang sinh te bao bat thuong ca o mang day, mao mach va khoang gian mach. Bieu hien bang tinh trang than hu - viem than va tien trien den suy than giai doan cuoi la dieu khong tranh khoi.

Viem cau than tien trien nhanh: The benh nay co tien luong xau. Benh tien trien nhanh chong den suy than giai doan cuoi trong vong vai tuan. Corticoid co the duoc su dung nhung hieu qua khong thuc su ro rang. Bao gom cac nguyen nhan sau: Viem cau than te bao hinh liem (Ton thuong cau than ket hop voi viem than ke. Benh xuat hien sau viem noi tam mac nhiem khuan. Chup Immunofluorescen cho thay hinh anh nhung te bao hinh liem xuat hien ca o tieu cau va khoang gian mach; Hoi chung goodpasture (la mot loai benh tu mien dich. Nguoi ta phat hien khang the khang mang day o than va phoi. Vi the bieu hien lam sang cua benh ngoai trieu chung cua VCT con co trieu chung cua ton thuong phoi nhu ho ra mau); Cac benh ly ton thuong mach mau (dien hinh la viem nhieu dong mach (polyartritis) va U hat Wegener. Chan doan dua vao su xuat hien khang the khang te bao chat cua bach cau trong mau).

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