Contents
Exogenous rashin lafiyar alveolitis kuma ana kiransa hypersensitivity pneumonitis. Rushewar cutar shine EAA. Wannan kalma tana nuna dukan ƙungiyar cututtuka waɗanda ke shafar interstitium na huhu, wato, haɗin haɗin gabobin. Kumburi yana mai da hankali a cikin parenchyma na huhu da ƙananan hanyoyin iska. Yana faruwa ne lokacin da nau'ikan antigens (fungi, ƙwayoyin cuta, sunadarai na dabba, sinadarai) suka shiga su daga waje.
A karo na farko, exogenous allergies alveolitis aka bayyana ta J.
A nan gaba, yana yiwuwa a tabbatar da cewa rashin lafiyar alveolitis na nau'in exogenous na iya haifar da wasu dalilai. Musamman, a cikin 1965, C. Reed da abokan aikinsa sun sami irin wannan alamun a cikin marasa lafiya uku waɗanda ke kiwon tantabara. Sun fara kiran irin wannan alveolitis "huhun masoya tsuntsaye."
Kididdigar da aka yi a cikin 'yan shekarun nan ya nuna cewa cutar ta yadu sosai a tsakanin mutanen da, saboda ayyukan sana'a, suna hulɗa da gashin tsuntsaye da tsuntsaye, da kuma abinci mai gina jiki. Daga cikin mutane 100, za a gano rashin lafiyar alveolitis a cikin mutane 000. A lokaci guda kuma, ba shi yiwuwa a faɗi daidai wane mutumin da ke da rashin lafiyar ƙasa ko gashin fuka-fukan zai ci gaba da alveolitis.
Kamar yadda aikin ya nuna, daga kashi 5 zuwa 15 cikin dari na mutanen da suka yi hulɗa tare da babban adadin allergens zasu ci gaba da ciwon huhu. Yaɗuwar alveolitis a tsakanin mutanen da ke aiki tare da ƙananan abubuwan da ke da hankali ba a san su ba har yau. Duk da haka, wannan matsala tana da girma sosai, yayin da masana'antu ke karuwa sosai a kowace shekara, wanda ke nufin cewa yawancin mutane suna shiga cikin irin waɗannan ayyuka.
etiology
Allergic alveolitis yana tasowa ne saboda shakar wani alerji, wanda ke shiga cikin huhu tare da iska. Abubuwa daban-daban na iya aiki azaman alerji. Mafi munin allergens a wannan batun sune fungal spores daga ruɓaɓɓen hay, maple haushi, sugar cane, da dai sauransu.
Har ila yau, kada mutum ya rubuta pollen shuka, mahadi masu gina jiki, ƙurar gida. Wasu magunguna, irin su maganin rigakafi ko abubuwan da ake amfani da su na nitrofuran, na iya haifar da rashin lafiyar alveolitis ko da ba tare da inhalation na baya ba, da kuma bayan shigar da jiki ta wasu hanyoyi.
Ba wai kawai gaskiyar cewa allergens shiga cikin numfashi na numfashi yana da mahimmanci, amma har ma da maida hankali da girman su. Idan barbashi ba su wuce 5 microns, to, ba zai yi wuya a gare su isa ga alveoli da kuma tsokani hypersensitivity a cikin su.
Tun da allergens da ke haifar da EAA galibi suna haɗuwa da ayyukan ƙwararrun mutum, ana kiran nau'ikan alveolitis don sana'o'i daban-daban:
Huhun Manoma. Ana samun antigens a cikin ciyawa mai laushi, daga cikinsu: Thermophilic Actinomycetes, Aspergillus spp, Mycropolyspora faeni, Thermoactinomycas vulgaris.
Huhun masoya tsuntsaye. Ana samun allergens a cikin najasa da dander na tsuntsaye. Sun zama sunadaran whey na tsuntsaye.
Bagassoz. Allergen shine sukari, wato Mycropolysporal faeni da Thermoactinomycas sacchari.
Huhu na mutane girma namomin kaza. Takin ya zama tushen allergens, kuma Mycropolysporal faeni da Thermoactinomycas vulgaris suna aiki azaman antigens.
Huhun mutane masu amfani da kwandishana. Masu humidifiers, dumama, da kwandishan sune tushen antigens. Hankali yana tsokani ta hanyar ƙwayoyin cuta kamar: Thermoactinomycas vulgaris, Thermoactinomycas viridis, Ameba, Fungi.
Suberose. Haushin bishiyar kwalaba ya zama tushen allergens, kuma yawan mutanen penicillum yana aiki azaman alerji kanta.
Haske malt Brewers. Tushen antigens shine sha'ir moldy, kuma allergen kanta shine Aspergillus clavatus.
Cutar sankarau. Tushen antigens shine cuku da ƙwayoyin mold, kuma antigen kanta shine Penicilum cseii.
Sequoyz. Ana samun allergens a cikin kurar itacen redwood. Ana wakilta su ta Graphium spp., upularia spp., Alternaria spp.
Masu kera kayan wanka na huhu. Ana samun allergen a cikin enzymes da detergents. Bacillus subtitus ke wakilta.
Ma'aikatan dakin gwaje-gwaje na huhu. Tushen allergens shine dandruff da fitsarin rodent, kuma allergens da kansu suna wakiltar sunadaran fitsarinsu.
Huhu mai shakar pituitary foda. Antigen yana wakiltar porcine da sunadarai na bovine, waɗanda aka samo a cikin foda na glandan pituitary.
Huhu aiki a samar da robobi. Tushen da ke haifar da hankali shine diisocyanates. Allergens sune: Toluene diiosocianate, diphenylmethane diiosocianate.
Summer pneumonitis. Cutar tana tasowa ne saboda shakar ƙura daga wuraren zama masu damshi. Pathology ya yadu a Japan. Trichosporon cutaneum ya zama tushen allergens.
Daga cikin allergens da aka jera dangane da haɓakar rashin lafiyar exogenous alveolitis, actinomycetes thermophilic da antigens na tsuntsaye suna da mahimmanci musamman. A cikin yankunan da ke da babban ci gaban aikin noma, actinomycetes ne ke mamaye matsayi mai mahimmanci dangane da abin da ya faru na EAA. Ana wakilta su da ƙwayoyin cuta waɗanda ba su wuce girman micron 1 ba. Wani fasali na musamman na irin waɗannan ƙwayoyin cuta shine cewa suna da kaddarorin ba kawai ƙwayoyin cuta ba, har ma da fungi. Yawancin actinomycetes thermophilic suna cikin ƙasa, a cikin takin, cikin ruwa. Suna kuma zaune a cikin na'urorin sanyaya iska.
Irin waɗannan nau'ikan actinomycetes na thermophilic suna haifar da haɓakar rashin lafiyar alveolitis, kamar: Mycropolyspora faeni, Thermoactinomycas vulgaris, Thermoactinomycas viridis, Thermoactinomycas sacchari, Thermoactinomycas scandidum.
Duk wakilan da aka jera na flora pathogenic ga mutane sun fara girma sosai a zazzabi na 50-60 ° C. A karkashin irin waɗannan yanayi ne aka ƙaddamar da matakai na lalata kwayoyin halitta. Ana kiyaye irin wannan zafin jiki a cikin tsarin dumama. Actinomycetes na iya haifar da bagassosis (cututtukan huhu a cikin mutanen da ke aiki da sukari), suna haifar da cutar da ake kira "huhun manoma", "huhun masu tsinken naman kaza (masu noman naman kaza)", da dai sauransu. Dukan su an jera su a sama.
Antigens da ke shafar mutane suna hulɗa da tsuntsaye sune sunadaran jini. Waɗannan su ne albumin da gamma globulins. Suna samuwa a cikin zubar da tsuntsaye, a cikin ɓoye daga glandan fata na tattabarai, parrots, canaries, da dai sauransu.
Mutanen da ke kula da tsuntsaye suna fuskantar alveolitis tare da dogon lokaci da hulɗa da dabbobi. Sunadaran shanu, da aladu, suna iya haifar da cutar.
Mafi aiki na fungal antigen shine Aspergillus spp. Daban-daban nau'ikan wannan ƙananan ƙwayoyin cuta na iya haifar da suberosis, huhun malt brewer ko huhun mai yin cuku.
Ba kome ba ne a yi imani da cewa, rayuwa a cikin birni kuma ba aikin noma ba, mutum ba zai iya yin rashin lafiya tare da rashin lafiyar alveolitis ba. A gaskiya ma, Aspergillus fumigatus yana bunƙasa a cikin wuraren da ba a cika samun iska ba. Idan yawan zafin jiki a cikinsu yana da girma, to, ƙwayoyin cuta sun fara ninka da sauri.
Har ila yau, a cikin haɗari ga ci gaban rashin lafiyar alveolitis sune mutanen da ayyukan sana'a ke da alaƙa da mahadi sunadarai reactogenic, misali, filastik, resins, fenti, polyurethane. Phthalic anhydride da diisocyanate ana daukar su musamman haɗari.
Dangane da ƙasar, ana iya gano nau'ikan rashin lafiyar alveolitis masu zuwa:
Huhun masoya budgerigar yawanci ana gano su a mazaunan Burtaniya.
Huhun mutanen da ke amfani da na'urorin sanyaya iska da na'urorin humidifier yana cikin Amurka.
Nau'in rani na alveolitis, wanda ya haifar da haifuwa na yanayi na fungi na nau'in Trichosporon cutaneun, an gano shi a cikin 75% na lokuta a cikin Jafananci.
A cikin Moscow da kuma a cikin biranen da ke da manyan masana'antun masana'antu, ana gano marasa lafiya tare da amsawar tsuntsaye da antigens na fungal.
Pathogenesis na exogenous alerji alveolitis
Tsarin numfashi na mutum a kai a kai yana ci karo da barbashi kura. Kuma wannan ya shafi duka kwayoyin halitta da gurɓataccen yanayi. An tabbatar da cewa antigens na nau'in iri ɗaya na iya haifar da ci gaban cututtuka daban-daban. Wasu mutane suna ci gaba da asma, wasu kuma suna ci gaba da rhinitis na kullum. Akwai kuma mutanen da ke nuna rashin lafiyar dermatosis, wato, raunuka na fata. Kada mu manta game da conjunctivitis na wani rashin lafiyan yanayi. A zahiri, exogenous alveolitis ba shine na ƙarshe a cikin jerin cututtukan da aka lissafa ba. Wace irin cuta ce wani mutum zai samu ya dogara da ƙarfin bayyanar, akan nau'in allergen, yanayin tsarin garkuwar jiki da sauran dalilai.
Domin majiyyaci ya bayyana exogenous rashin lafiyar alveolitis, hade da dama dalilai wajibi ne:
Isasshen kashi na allergens da suka shiga cikin fili na numfashi.
Tsawon lokaci ga tsarin numfashi.
Wani girman girman ƙwayoyin cuta, wanda shine 5 microns. Mafi yawanci, cutar tana tasowa lokacin da manyan antigens suka shiga tsarin numfashi. A wannan yanayin, ya kamata su zauna a cikin proximal bronchi.
Yawancin mutanen da ke fuskantar irin wannan allergens ba sa fama da EAA. Saboda haka, masana kimiyya sun yi imanin cewa ya kamata a shafi jikin mutum lokaci guda ta hanyar abubuwa da yawa a lokaci daya. Ba a yi nazarin su sosai ba, amma akwai zato cewa kwayoyin halitta da yanayin rigakafi suna da matsala.
Exogenous rashin lafiyan alveolitis daidai ake magana a kai a matsayin immunopathological cututtuka, wanda babu shakka dalilin da cewa su ne rashin lafiyan halayen na iri 3 da 4. Har ila yau, ba na rigakafi kumburi da ya kamata ba a yi watsi da.
Nau'in nau'in rigakafi na uku yana da mahimmanci musamman a cikin matakan farko na ci gaban cututtukan cututtuka. Samuwar hadaddun garkuwar jiki yana faruwa kai tsaye a cikin interstitium na huhu lokacin da antigen pathological yana hulɗa da ƙwayoyin rigakafi na aji na IgG. Samar da hadaddun na rigakafi yana haifar da gaskiyar cewa alveoli da interstitium sun lalace, haɓakar tasoshin da ke ciyar da su yana ƙaruwa.
Sakamakon rikice-rikice na rigakafi yana haifar da tsarin haɗin gwiwa da macrophages alveolar don kunna su. A sakamakon haka, an saki samfurori masu guba da anti-inflammatory, hydrolytic enzymes, cytokines (tumor necrosis factor - TNF-a da interleukin-1). Duk wannan yana haifar da kumburi mai kumburi a matakin gida.
Daga baya, sel da matrix sassan na interstitium sun fara mutuwa, kumburi ya zama mai tsanani. Ana ba da adadi mai yawa na monocytes da lymphocytes zuwa wurin raunin. Suna tabbatar da adana halayen jinkirin jinkiri-nau'i.
Bayanan da ke tabbatar da cewa halayen immunocomplex suna da mahimmanci a cikin rashin lafiyar alveolitis:
Bayan hulɗa tare da antigen, kumburi yana tasowa da sauri, a cikin sa'o'i 4-8.
A cikin wankewar exudate daga bronchi da alveoli, da kuma a cikin sashin jini na jini, ana samun yawan adadin ƙwayoyin rigakafi na aji na lgG.
A cikin huhu nama da aka dauka don histology, a cikin marasa lafiya da wani nau'i mai nau'i na cutar, ana samun immunoglobulin, abubuwan da suka dace, da kuma antigens da kansu. Duk waɗannan abubuwa sune hadaddun rigakafi.
Lokacin yin gwaje-gwajen fata ta amfani da antigens masu tsafta waɗanda ke da cututtukan cututtuka ga wani majiyyaci, wani nau'in nau'in Arthus na al'ada yana tasowa.
Bayan yin gwaje-gwaje masu tayar da hankali tare da shakar ƙwayoyin cuta, adadin neutrophils a cikin marasa lafiya a cikin ruwan lavage na bronchoalveolar yana ƙaruwa.
Nau'in 4 na rigakafi sun haɗa da CD+ T-cell jinkiri-nau'in hypersensitivity da CD8+ T-cell cytotoxicity. Bayan antigens sun shiga cikin tsarin numfashi, jinkiri-nau'in halayen suna tasowa a cikin kwanaki 1-2. Lalacewa ga rukunin rigakafi yana haifar da sakin cytokines. Su, bi da bi, suna haifar da leukocytes da endothelium na nama na huhu don bayyana kwayoyin mannewa a saman. Monocytes da sauran lymphocytes suna mayar da martani ga su, wanda ya isa wurin da ake kira mai kumburi.
A lokaci guda, interferon gamma yana kunna macrophages wanda ke samar da CD4 + lymphocytes. Wannan alama ce ta jinkirin nau'in amsawa, wanda ke dadewa na dogon lokaci godiya ga macrophages. A sakamakon haka, granulomas suna samuwa a cikin mai haƙuri, collagen ya fara fitowa a cikin adadi mai yawa (fibroblasts ana kunna su ta hanyar ƙwayoyin girma), kuma fibrosis na interstitial yana tasowa.
Bayanan da ke tabbatar da cewa a cikin rashin lafiyar alveolitis, jinkirin nau'in 4 na rigakafi yana da mahimmanci:
Ana samun T-lymphocytes a cikin ƙwaƙwalwar jini. Suna kasancewa a cikin ƙwayar huhu na marasa lafiya.
A cikin marasa lafiya da m da subacute exogenous rashin lafiyar alveolitis, granulomas, infiltrates tare da tarin lymphocytes da monocytes, kazalika da interstitial fibrosis an gano.
Gwaje-gwaje akan dabbobin dakin gwaje-gwaje tare da EAA sun nuna cewa ana buƙatar CD4+ T-lymphocytes don shigar da cuta.
Hoton Histological na EAA
A mafi yawan lokuta, marasa lafiya da exogenous alerji alveolitis suna da granulomas, ba tare da curdled plaque. Ana gano su a cikin 79-90% na marasa lafiya.
Don kada ku dame granulomas waɗanda ke haɓaka tare da EAA da sarcoidosis, kuna buƙatar kula da bambance-bambance masu zuwa:
Tare da EAA, granulomas sun fi ƙanƙanta.
Granulomas ba su da fayyace iyakoki.
Granulomas sun ƙunshi ƙarin lymphocytes.
Ganuwar Alveolar a cikin EAA suna da kauri, suna da infiltrates na lymphocytic.
Bayan an cire hulɗa da antigen, granulomas sun ɓace da kansu a cikin watanni shida.
A cikin exogenous rashin lafiyar alveolitis, tsarin kumburi yana haifar da lymphocytes, monocytes, macrophages da ƙwayoyin plasma. Macrophages alveolar foamy suna taruwa a cikin alveoli da kansu, da lymphocytes a cikin interstitium. Lokacin da cutar ta fara tasowa, marasa lafiya suna da furotin da fibrinous effusion, wanda ke cikin alveoli. Har ila yau, an gano marasa lafiya tare da bronchiolitis, lymphatic follicles, peribronchial inflammatory infiltrates, wanda aka mayar da hankali a cikin kananan iska.
Don haka, cutar tana da nau'ikan canje-canje na morphological:
Alveolitis.
Granulomatosis.
Bronchiolitis.
Ko da yake wani lokacin daya daga cikin alamomin na iya faduwa. Da wuya, marasa lafiya tare da exogenous rashin lafiyar alveolitis suna tasowa vasculitis. An gano shi a cikin mara lafiya bayan mutuwarsa, kamar yadda aka nuna a cikin takardun da suka dace. A cikin marasa lafiya da hauhawar jini na huhu, hypertrophy na arteries da arterioles yana faruwa.
Hanya na yau da kullun na EAA yana haifar da canje-canjen fibrinous, wanda zai iya samun ƙarfi daban-daban. Duk da haka, suna da halayyar ba kawai ga exogenous rashin lafiyar alveolitis ba, har ma ga sauran cututtuka na huhu na kullum. Saboda haka, ba za a iya kiran shi alamar cututtuka ba. Tare da alveolitis na dogon lokaci a cikin marasa lafiya, parenchyma na huhu yana fuskantar canje-canje na pathological a cikin nau'in huhu na saƙar zuma.
Alamomin rashin lafiyar exogenous alveolitis
Cutar tana tasowa mafi sau da yawa a cikin mutanen da ba su da haɗari ga rashin lafiyan halayen. Pathology bayyana kanta bayan dogon hulda da kafofin, yada antigens.
Exogenous rashin lafiyar alveolitis na iya faruwa a cikin nau'ikan 3:
M bayyanar cututtuka
Babban nau'in cutar yana faruwa bayan babban adadin antigen ya shiga cikin sassan numfashi. Wannan na iya faruwa duka a gida da wurin aiki ko ma a kan titi.
Bayan sa'o'i 4-12, zafin jiki na jikin mutum yana tashi zuwa matakan da yawa, sanyi yana tasowa, rauni yana ƙaruwa. Akwai nauyi a cikin kirji, mai haƙuri ya fara tari, yana fama da ƙarancin numfashi. Ciwon ciki yana bayyana a cikin haɗin gwiwa da tsokoki. Sputum a lokacin tari baya bayyana sau da yawa. Idan kuma ya fita, to yana da kankanta kuma ya kunshi gamsai.
Wani alamar halayyar EAA mai tsanani shine ciwon kai wanda ke mayar da hankali ga goshi.
A lokacin binciken, likita ya lura cyanosis na fata. Lokacin sauraron huhu, ana jin kururuwa da hayaniya.
Bayan kwanaki 1-3, alamun cutar sun ɓace, amma bayan wani hulɗa tare da allergen, sun sake karuwa. Babban rauni da rashin jin daɗi, haɗe tare da ƙarancin numfashi, na iya damun mutum har tsawon makonni da yawa bayan ƙudurin babban matakin cutar.
Babban nau'in cutar ba sau da yawa ana gano shi. Saboda haka, likitoci sun rikita shi da SARS, tsokanar ƙwayoyin cuta ko mycoplasmas. Ya kamata masana su kasance faɗakarwa ga manoma, kuma su bambanta tsakanin alamun EAA da alamun mycotoxicosis na huhu, wanda ke tasowa lokacin da ƙwayoyin fungal suka shiga cikin ƙwayar huhu. A cikin marasa lafiya da myotoxicosis, huhu radiyo ba ya nuna wani pathological canje-canje, kuma babu wani precipitating antibodies a cikin serum sashe na jini.
subacute bayyanar cututtuka
Alamomin cutar subacute nau'in cutar ba a bayyana kamar yadda a cikin m nau'i na alveolitis. Irin wannan alveolitis yana tasowa ne saboda tsawaita shakar antigens. Mafi sau da yawa wannan yana faruwa a gida. Don haka, kumburi subacute a mafi yawan lokuta ana tsokanar da kula da kaji.
Babban bayyanar cututtuka na subacute exogenous allergic alveolitis sun hada da:
Karancin numfashi da ke kara tsananta bayan aikin jiki na mutum.
Ƙara gajiya.
Tari wanda ke haifar da sputum.
A mataki na farko a cikin ci gaban ilimin cututtuka, zafin jiki na iya karuwa.
Crepitus lokacin sauraron huhu zai zama mai laushi.
Yana da mahimmanci don rarrabe EAA subacute daga sarcoidosis da sauran cututtukan interstitium.
Alamun nau'in na kullum
Tsarin cutar na kullum yana tasowa a cikin mutanen da ke hulɗa da ƙananan ƙwayoyin antigens na dogon lokaci. Bugu da ƙari, subacute alveolitis na iya zama na kullum idan ba a kula da shi ba.
Tsarin cutar na yau da kullun yana nuna alamun cututtuka kamar:
Ƙara yawan lokaci, ƙarancin numfashi, wanda ya bayyana tare da motsa jiki na jiki.
Ma'anar asarar nauyi, wanda zai iya kaiwa anorexia.
Cutar tana barazanar ci gaban cor pulmonale, interstitial fibrosis, zuciya da gazawar numfashi. Tunda rashin lafiyan exogenous alveolitis na yau da kullun ya fara haɓakawa a hankali kuma baya ba da alamu mai tsanani, ganewar asali yana da wahala.
Ganewar rashin lafiyar exogenous alveolitis
Don gano cutar, ya zama dole a dogara da gwajin X-ray na huhu. Dangane da matakin ci gaban alveolitis da nau'in sa, alamun rediyo zasu bambanta.
M da subacute nau'i na cutar yana haifar da raguwa a cikin gaskiyar filayen kamar gilashin ƙasa da kuma yaduwar nodular-mesh opacities. Girman nodules bai wuce 3 mm ba. Ana iya samun su a duk faɗin saman huhu.
Na sama na huhu da sassansu basal ba a rufe su da nodules. Idan mutum ya daina hulɗa da antigens, to, bayan watanni 1-1,5, alamun bayyanar cututtuka na cutar sun ɓace.
Idan cutar tana da tsari na yau da kullun, to, inuwa madaidaiciya tare da fayyace bayyananne, wuraren duhu waɗanda ke wakiltar nodules, canje-canje a cikin interstitium, da raguwar girman filayen huhu suna bayyane akan hoton x-ray. Lokacin da ilimin cututtuka yana da hanyar gudu, ana ganin huhun saƙar zuma.
CT wata hanya ce da ke da daidaito mafi girma idan aka kwatanta da radiyo. Nazarin ya nuna alamun EAA, waɗanda ba a iya gani tare da daidaitattun rediyo.
Gwajin jini a cikin marasa lafiya tare da EAA yana da alamun canje-canje masu zuwa:
Leukocytosis har zuwa 12-15 × 103/ml Kadan yawanci, matakin leukocytes ya kai matakin 20-30 × 103/ ml.
Tsarin leukocyte yana canzawa zuwa hagu.
Haɓaka matakin eosinophils baya faruwa, ko yana iya ƙaruwa kaɗan.
ESR a cikin 31% na marasa lafiya sun tashi zuwa 20 mm / h, kuma a cikin 8% na marasa lafiya har zuwa 40 mm / h. A wasu marasa lafiya, ESR ya kasance cikin kewayon al'ada.
Matsayin lgM da lgG yana ƙaruwa. Wani lokaci ana yin tsalle a cikin aji na immunoglobulins.
A wasu marasa lafiya, rheumatoid factor yana kunna.
Yana haɓaka matakin jimillar LDH. Idan wannan ya faru, to ana iya zargin kumburi mai tsanani a cikin parenchyma na huhu.
Don tabbatar da ganewar asali, ana amfani da hanyoyin Ouchterlony sau biyu, micro-Ouchterlony, counter immunoelectrophoresis da hanyoyin ELISA (ELISA, ELIEDA). Suna ba ka damar gano takamaiman ƙwayoyin rigakafi masu tasowa zuwa antigens waɗanda suka haifar da rashin lafiyar.
A cikin matsanancin lokaci na cutar, ƙwayoyin rigakafin ƙwayoyin cuta za su yawo a cikin jinin kusan kowane majiyyaci. Lokacin da allergen ya daina hulɗa da ƙwayar huhu na marasa lafiya, matakin ƙwayoyin rigakafi ya ragu. Duk da haka, suna iya kasancewa a cikin sashin jini na dogon lokaci (har zuwa shekaru 3).
Lokacin da cutar ta daɗe, ba a gano ƙwayoyin rigakafi. Hakanan akwai yuwuwar samun sakamako mai kyau na ƙarya. A cikin manoma ba tare da alamun alveolitis ba, ana gano su a cikin 9-22% na lokuta, kuma a cikin masoya tsuntsaye a cikin 51% na lokuta.
A cikin marasa lafiya tare da EAA, ƙimar haɓakar ƙwayoyin cuta ba ta da alaƙa da aikin tsarin cututtukan cututtukan fata. Matsayin su na iya shafar abubuwa daban-daban. Don haka, a cikin masu shan taba, za a yi la'akari da shi. Saboda haka, gano takamaiman ƙwayoyin rigakafi ba za a iya la'akari da shaidar EAA ba. Hakanan, rashin su a cikin jini baya nuna cewa babu cuta. Duk da haka, bai kamata a rubuta maganin rigakafi ba, kamar yadda a gaban alamun asibiti masu dacewa, za su iya ƙarfafa tunanin da ake ciki.
Gwajin don raguwa a cikin ƙarfin watsawa na huhu yana nuna alama, tun da sauran canje-canje na aiki a cikin EAA suna halayyar wasu nau'in cututtuka tare da lalacewa ga interstitium na huhu. Hypoxemia a cikin marasa lafiya da rashin lafiyar alveolitis ana lura da su a cikin kwanciyar hankali, kuma yana ƙaruwa yayin motsa jiki. Keɓancewar iska na huhu yana faruwa ta nau'in ƙuntatawa. Ana gano alamun hyperreactivity na iska a cikin 10-25% na marasa lafiya.
An fara amfani da gwaje-gwajen numfashi don gano rashin lafiyar alveolitis tun a farkon 1963. An yi amfani da iska daga ƙurar da aka ɗauko daga ciyawa. Sun haifar da haɓakar alamun cutar a cikin marasa lafiya. A lokaci guda kuma, abubuwan da aka samo daga "tsarki mai tsabta" bai haifar da irin wannan amsa ga marasa lafiya ba. A cikin mutane masu lafiya, ko da aerosols tare da mold bai haifar da alamun cututtuka ba.
Gwaje-gwaje masu tayar da hankali a cikin marasa lafiya masu fama da asma ba su haifar da bayyanar saurin rigakafi ba, ba su haifar da damuwa a cikin aikin huhu ba. Duk da yake a cikin mutanen da ke da kyakkyawar amsawar rigakafi, suna haifar da canje-canje a cikin aikin tsarin numfashi, zuwa karuwa a cikin zafin jiki, sanyi, rauni da dyspnea. Bayan sa'o'i 10-12, waɗannan bayyanar cututtuka sun ɓace da kansu.
Yana yiwuwa a tabbatar da ganewar asali na EAA ba tare da yin gwaje-gwaje masu tayar da hankali ba, don haka ba a amfani da su a cikin aikin likita na zamani. Ana amfani da su ne kawai ta hanyar kwararru waɗanda ke buƙatar tabbatar da dalilin cutar. A madadin, ya isa ya lura da mai haƙuri a cikin yanayin da ya saba, misali, a wurin aiki ko a gida, inda akwai lamba tare da allergen.
Bronchoalveolar lavage (BAL) yana ba ku damar tantance abubuwan da ke cikin alveoli da sassa masu nisa na huhu. Ana iya tabbatar da ganewar asali ta hanyar gano haɓakar abubuwan salula a cikinta sau biyar, kuma kashi 80% daga cikinsu za a wakilta su da lymphocytes (yafi T-cell, wato CD8 + lymphocytes).
An rage ma'aunin rigakafi a cikin marasa lafiya zuwa ƙasa da ɗaya. Tare da sarcoidosis, wannan adadi shine raka'a 4-5. Duk da haka, idan an yi lavage a cikin kwanaki 3 na farko bayan m ci gaban alveolitis, za a kara yawan neutrophils, kuma lymphocytosis ba a lura.
Bugu da kari, lavage yana ba da damar gano haɓakar adadin ƙwayoyin mast ɗin ninki goma. Wannan taro na sel mast na iya dawwama har zuwa watanni 3 ko fiye bayan haɗuwa da allergen. Wannan alamar tana nuna aikin tsarin samar da fibrin. Idan cutar tana da tsarin subacute, to za a sami ƙwayoyin plasma a cikin lavage.
Yin ganewar asali daban
Cututtuka daga abin da exogenous rashin lafiyar alveolitis dole ne a bambanta:
Ciwon daji na Alveolar ko metastases na huhu. Tare da ciwace-ciwacen daji, babu wata alaƙa tsakanin alamun cutar da suka bayyana da haɗuwa da allergens. Pathology yana ci gaba da ci gaba, yana da alamun bayyanar cututtuka. A cikin sashin jini na jini, ba a saki ƙwayoyin rigakafin da ke haifar da allergens. Hakanan, ana iya fayyace bayanai ta amfani da x-ray na huhu.
miliya tarin fuka. Tare da wannan cuta, kuma babu dangantaka da allergens. Cutar kanta tana da hanya mai tsanani da kuma ci gaba mai tsawo. Dabarun serological suna ba da damar gano ƙwayoyin rigakafi ga antigen tarin fuka, yayin da ba su bayyana ga exoallergens ba. Kar a manta game da gwajin x-ray.
Sarcoidosis. Wannan cuta ba ta da alaƙa da aikin ƙwararrun mutum. Tare da shi, ba kawai gabobin numfashi ba ne ke shafar, har ma da sauran tsarin jiki. Ƙirar ƙwayoyin lymph na hilar a cikin ƙirjin suna ƙonewa a bangarorin biyu, akwai raƙuman raɗaɗi ko rashin ƙarfi ga tuberculin. Halin Kveim, akasin haka, zai zama tabbatacce. Sarcoidosis za a iya tabbatar da shi ta hanyar nazarin tarihi.
Wasu fibrosing alveolitis. Tare da su, mafi sau da yawa, marasa lafiya suna haɓaka vasculitis, da kuma lalacewar tsarin tsarin da ke tattare da haɗin kai ba kawai huhu ba, har ma da jiki gaba ɗaya. Tare da shakku game da ganewar asali, ana yin biopsy na huhu tare da ƙarin binciken tarihi na kayan da aka samu.
Namoniya. Wannan cuta tana tasowa bayan mura. A kan x-ray, ana iya ganin baƙar fata, wanda ke bayyana saboda kutsawar nama.
ICD-10 yana nufin exogenous rashin lafiyar alveolitis zuwa aji X "cututtukan numfashi".
Sanarwa:
J 55 Cututtukan numfashi da ke haifar da takamaiman kura.
J 66.0 Byssino.
J 66.1 Cutar flax.
J 66.2 Cannabiosis.
J 66.8 Cutar numfashi saboda wasu ƙayyadaddun kurakuran kwayoyin halitta.
J 67 Ƙaunar ciwon huhu.
J 67.0 Huhu na manomi (ma'aikacin noma).
J 67.1 Bagassose (don ƙurar rake)
J 67.2 Huhun mai kiwon kaji.
J 67.3 Suberoz
J 67.4 Huhun ma'aikacin Malt.
J 67.5 Huhun ma'aikacin naman kaza.
J 67.6 Maple haushi huhu.
J 67.8 Ƙunƙashin ciwon huhu saboda wasu kurakuran kwayoyin halitta.
J 67.9 Hypersensitivity pneumonitis saboda wasu ƙurar kwayoyin da ba a bayyana ba.
Za a iya tsara cutar ta kamar haka:
Exogenous rashin lafiyar alveolitis (huhun manomi), m nau'i.
Rashin lafiyar alveolitis da ke haifar da miyagun ƙwayoyi ta hanyar furazolidone, nau'i mai zurfi, tare da gazawar numfashi.
Exogenous rashin lafiyan alveolitis (kaji kiwo ta huhu), na kullum nau'i. Zuciyar huhu na yau da kullun, mashako na kullum.
Jiyya na exogenous alerji alveolitis
Don jimre wa cutar, ya zama dole a cire gaba ɗaya hulɗar mai haƙuri da allergen. Dole ne mutum a lokacin aiki ya yi amfani da abin rufe fuska, masu tacewa na musamman. Yana da matuƙar kyawawa don canza ayyuka da halayen ku. Don hana ci gaban cututtukan cututtuka, yana da mahimmanci a gano shi a farkon matakan ci gaba. Idan lamba tare da alerji ya ci gaba, canje-canje a cikin huhu zai zama maras tabbas.
Babban yanayin alveolitis yana buƙatar alƙawari na glucocorticosteroids. Likita ne kawai zai iya rubuta su, ta alƙawari.
Marasa lafiya tare da hyperresponsiveness na huhu an wajabta inhaled bronchodilator. Idan cutar ta haifar da ci gaba da rikitarwa, to ana amfani da maganin rigakafi, diuretics, oxygen, da dai sauransu.
Hasashen da rigakafin
Don hana ci gaban cutar, ya zama dole don rage duk yiwuwar hulɗa tare da allergens. Don haka, ciyawa ya kamata a bushe sosai, a buɗe ramukan silo. Wuraren da ke samarwa ya kamata a sami iska sosai, kuma idan dabbobi da tsuntsaye suna cikin su, ya kamata a kiyaye ƙa'idodin tsabta da tsabta. Dole ne a sarrafa na'urorin kwantar da iska da tsarin samun iska tare da inganci mai kyau kuma akan lokaci, da dai sauransu.
Idan alveolitis ya riga ya ci gaba, to, mai haƙuri ya kamata ya ware lamba tare da allergens. Lokacin da aikin ƙwararru ya zama laifi, aikin yana canzawa.
Hasashen ya bambanta. Idan cutar da aka gano a farkon matakai, da Pathology iya warware kanta. Komawar alveolitis yana haifar da gaskiyar cewa ƙwayar huhu yana fuskantar canje-canje maras canzawa. Wannan yana daɗaɗa hasashe, da kuma rikice-rikice na alveolitis ko kuma yanayinsa na yau da kullun.