Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) yog kab mob autoimmune ntev. Yuav kom muaj qhov tshwj xeeb, CIDP yog qhov tsis muaj kev tiv thaiv kab mob ua rau tsis zoo ntawm lub paj hlwb. CIDP tuaj yeem tshwm sim sib txawv hauv tib neeg sib txawv, thiab zoo li no, ntau tus kws kho mob xav txog CIDP ntau dua ntawm cov xwm txheej ntawm ib puag ncig ntau dua li ib tus kab mob sib txawv. Kev kuaj mob CIDP yog ua raws cov tsos mob ntawm tus mob, kev tshawb fawb electrodiagnostic, thiab kev kuaj sim ntxiv. CIDP tsuas tuaj yeem kuaj pom los ntawm kws kho mob. Los ntawm kev lees paub cov tsos mob ntawm CIDP, nrhiav kev kuaj mob, thiab kawm paub txog tus mob, koj tuaj yeem koom tes zoo nrog koj tus kws kho mob txhawm rau txheeb xyuas CIDP.
Cov kauj ruam
Txoj Kev 1 ntawm 3: Paub Cov tsos mob ntawm CIDP
Kauj Ruam 1. Muaj thawj cov tsos mob ntawm lub cev
CIDP cuam tshuam nrog Guillain Barré syndrome (GBS), thiab ntau tus tsos mob zoo sib xws. Thawj cov cim qhia tias ib tus neeg yuav muaj CIDP suav nrog "lub cev tsis muaj zog," zoo li lub cev tsis muaj zog thiab mob. Cov tsos mob no feem ntau maj mam dhau mus li ob lub hlis. Nws yog ib qho tseem ceeb kom nco ntsoov tias cov tsos mob no tuaj yeem qhia txog ntau yam kev kho mob, thiab tsis yog ib leeg qhia CIDP. Qee yam ntawm cov tsos mob ntawm lub cev no tuaj yeem suav nrog:
- Tsis muaj zog
- Ua npaws
- Nyuaj taug kev (tshwj xeeb tshaj yog ntawm tus ntaiv)
- Tingling
- Mob
- Fainting spells (thaum sawv ntsug)
- Hlawv hauv qhov qis
- Rov qab pib sai sai thiab/lossis mob caj dab uas nthuav tawm los ntawm txhais ceg
Kauj Ruam 2. Paub txog kev ua haujlwm tsis zoo
Lwm cov cim ntawm CIDP poob rau hauv qeb ntawm "kev ua haujlwm tsis zoo." Cov tsos mob "hnov qab" no tuaj yeem tshwm sim tom qab pib ntawm thawj cov tsos mob ntawm lub cev. Lawv kuj tseem tuaj yeem nce qib tau ntau lub hlis. Ib zaug ntxiv, cov tsos mob no tuaj yeem qhia tus lej ntawm cov mob uas tuaj yeem kho tau, thiab tsis yog ib leeg taw tes rau CIDP. Cov tsos mob muaj xws li:
- Kiv taub hau
- Ua pa nyuaj
- Teeb meem plab thiab zais zis
- Xeev siab
- Twitching (xws li me me mus rau mob hnyav)
- Twitching los yog co hauv lwm qhov ntawm lub cev
Kauj Ruam 3. Txheeb xyuas koj cov tsos mob
Cov tsos mob ntawm CIDP feem ntau nce mus txog lub sijhawm 8-lub lim tiam, nce ntxiv. Qhov qeeb no (ib txwm nyob ruaj khov lossis ib qib-ntse) kev txhim kho cov tsos mob nyob rau lub sijhawm 8-lub lim tiam yog ib txoj hauv kev zoo tshaj plaws kom paub qhov txawv qhov teeb meem no los ntawm ntau qhov Guillain Barré syndrome (GBS). Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum muaj cov ntaub ntawv teev cia thaum cov tsos mob pib, thiab lawv tau nce mus li cas.
- Pib phau ntawv xov xwm noj qab haus huv.
- Sau ib tsab ntawv ceeb toom sai sai seb koj xav li cas txhua hnub.
- Suav nrog cov hnub rau thaum cov tsos mob pib.
- Suav nrog sau ntawv hais txog qhov mob hnyav.
Kauj Ruam 4. Xav txog koj lub hnub nyoog
CIDP tau kuaj pom hauv tib neeg txhua lub hnub nyoog (suav nrog menyuam yaus). Txawm li cas los xij, cov neeg muaj hnub nyoog 50 txog 60 xyoos muaj feem ntau yuav raug kuaj mob. Coj koj lub hnub nyoog los txiav txim siab thaum sim tshuaj CIDP.
Txoj Kev 2 ntawm 3: Tau Txais Kev Kho Mob
Kauj Ruam 1. Tham nrog koj tus kws kho mob
Yog tias koj tab tom muaj ib yam ntawm cov tsos mob saum toj no, teem caij tham nrog koj tus kws kho mob. Koj tus kws kho mob yuav xav xa koj mus rau kws kho paj hlwb lossis lwm tus kws tshwj xeeb. Thaum koj teem sijhawm, npaj kom piav qhia:
- Cov tsos mob. Nco ntsoov tias cov tsos mob yuav ua raws ib qho ntawm peb tus qauv suav nrog kev nce qib (cov tsos mob hnyav zuj zus dhau sijhawm), rov tshwm sim (cov tsos mob tshwm sim thiab mus raws ntu), thiab monophasic (cov tsos mob nyob ntev li ib rau peb xyoos thiab tsis rov tshwm sim dua).
- Thaum koj cov tsos mob pib
- Koj keeb kwm kho mob
- Lwm yam xwm txheej uas koj muaj
- Txhua yam tshuaj uas koj tab tom noj
Kauj Ruam 2. Soj ntsuam lub cev
Thaum koj tus kws kho mob tshuaj xyuas koj rau CIDP, lawv yuav pib los ntawm kev kuaj lub cev. Lawv yuav taug qab koj qhov hnyav, ntsuas kub, thiab ntshav siab. Lawv yuav ntsuas lub zog ntawm koj cov leeg thiab cov leeg, nrog rau koj qhov sib npaug.
Kauj Ruam 3. Npaj rau "kev kuaj mob electrodiagnostics"
Tom ntej no, koj tus kws kho mob yuav saib xyuas puas myelin hauv qab haus huv. Qhov no tuaj yeem ua tiav los ntawm txoj kev kuaj electromyography (EMG) thiab/lossis kev tshawb fawb paj hlwb (NCS). Cov kev xeem no tsis yog kev cuam tshuam, tab sis lawv tuaj yeem tsis xis nyob. Lawv koom nrog siv cov hluav taws xob maj mam ntsuas cov hlab ntsha ua haujlwm thiab teb. Cov kev ntsuam xyuas no yuav tab tom nrhiav kev puas tsuaj rau cov hlab ntsha, lossis "demyelination." Qhov no tuaj yeem qhia los ntawm:
- Kev txo qis ntawm cov hlab ntsha
- Ib qho kev coj ua hauv ib lossis ntau lub qab haus huv
- Lub xub ntiag ntawm kev txawv txav ntawm lub cev nqaij daim tawv hauv ib lossis ntau lub paj hlwb
- Ntev distal latencies nyob rau hauv ob lossis ntau lub paj hlwb
Kauj Ruam 4. Khiav cov ntshav thiab tso zis
Txhawm rau txiav txim tawm lwm yam mob-xws li ntshav qab zib, kis kab mob, kis cov tshuaj lom, tsis muaj zaub mov tsis zoo, mob kab mob ntawm cov hlab ntshav, thiab/lossis lwm yam kab mob autoimmune-koj tus kws kho mob yuav kuaj ob qho tib si koj cov ntshav thiab zis.
Kauj Ruam 5. Paub “lumbar puncture
Lub lumbar puncture yuav nrhiav tshuaj tiv thaiv ganglioside. Txawm hais tias cov tshuaj tiv thaiv kab mob no yuav tsis muaj nyob hauv txhua kis ntawm CIDP, muaj ib ceg ntawm cov kab mob CIDP muaj tus yam ntxwv los tiv thaiv GM1, tiv thaiv GD1a, thiab tiv thaiv GQ1b. Lub lumbar puncture cuam tshuam nrog kev txhaj ib rab koob me me rau sab nraub qaum uas ua rau lub cev puas hlwb (CSF). Tom qab ntawv cov kua dej no tau kuaj pom tias muaj cov tshuaj tiv thaiv no.
Kauj Ruam 6. Ua ib qho kev kuaj lub paj hlwb
Hauv qee qhov xwm txheej uas qhov kev kuaj mob tsis meej, lossis qhov twg lwm qhov ua rau mob ntshav qab zib tsis tuaj yeem raug cais tawm, koj tus kws kho mob tuaj yeem thov kuaj ntshav. Cov txheej txheem kho mob sab nrauv no suav nrog 4-5 cm (1.6-2.0 in) kev phais hauv txhais ceg (nrog kev pab ntawm tshuaj loog hauv zos). Los ntawm kev phais, 1–2 cm (0.39–0.79 in) daim ntawm lub paj hlwb tau raug txiav tawm, thiab tom qab ntawd kawm. Cov txheej txheem no yog ua tiav thaum koj nyob hauv tshuaj loog.
Txoj Kev 3 ntawm 3: Kawm Txog CIDP
Kauj Ruam 1. Pib nrog CIDP raug
CIDP tsis tshua muaj kab mob autoimmune uas ua rau lub cev tawm tsam nws cov ntaub so ntswg. CIDP ua rau lub cev tawm tsam myelin sheaths uas tiv thaiv cov hlab ntsha, thaum kawg ua rau lub paj hlwb puas. CIDP feem ntau tshwm sim raws li lub cev muaj zog thiab lub cev tsis ua haujlwm.
- Lub cev tsis muaj zog (xws li tsis muaj zog, taug kev nyuaj) tau tshaj tawm hauv 94% ntawm CIDP cov neeg mob.
- Kev hnov qab tsis txaus (xws li loog, tsis zoo) tau tshaj tawm hauv 89% ntawm cov neeg mob CIDP.
Kauj Ruam 2. Kawm paub txog kev nkag siab/lub cev muaj zog CIDP
Hauv 5-35% ntawm cov neeg mob CIDP, cov tsos mob hauv lub cev yuav tshwm sim feem ntau, nrog rau me me kom tsis muaj lub cev tsis muaj zog. Ntawm qhov tsis sib xws, 7-10% ntawm cov neeg mob CIDP (feem ntau cov neeg mob hnub nyoog qis dua 20 xyoo) muaj cov tsos mob cuam tshuam nrog lub cev, nrog rau me me kom tsis muaj qhov hnov tsis zoo.
Kauj Ruam 3. Tshawb Lewis-Sumner syndrome (LSS)
Lewis-Sumner syndrome (LSS)-tseem hu ua multifocal tau txais kev ua kom lub cev tsis muaj zog thiab lub cev tsis muaj zog (MADSAM)-sawv cev hauv 6-15% ntawm CIDP cov neeg mob. Daim ntawv CIDP no yog tus yam ntxwv asymmetry, qhov tsos mob cuam tshuam rau ib feem ntawm lub cev (feem ntau yog lub cev sab saud/sab ceg) ntau dua li lwm tus.
Kauj Ruam 4. Tshawb nrhiav CIDP kev kho mob
Txawm hais tias qhov tseeb ua rau CIDP tseem tsis tau paub, tus mob no tuaj yeem kho tau. Tshwj xeeb tshaj yog thaum tus mob tau kuaj pom ntxov, ntau tus neeg mob tau txais kev tshem tawm thiab rov zoo los ntawm cov tsos mob yam tsis muaj kev puas tsuaj rau lub paj hlwb ntev. Koj txoj kev npaj kho mob yuav ua raws lub hom phiaj tshwj xeeb ntawm CIDP uas koj tab tom ntsib, koj cov tsos mob, thiab lwm yam mob uas koj muaj. Qee hom kev kho CIDP suav nrog:
- Corticosteroids, xws li prednisone
- Immunosuppressant tshuaj
- Plasmapheresis (ntshav pauv)
- Kev txhaj tshuaj tiv thaiv kab mob immunoglobulin (IVIg)
- Kev kho lub cev
