Qhov kev kuaj anti-CCP yog kev kuaj ntshav uas nrhiav pom cov tshuaj anti-cyclic citrullinated peptide, uas muaj feem cuam tshuam nrog mob rheumatoid arthritis. Yog tias muaj cov txiaj ntsig anti-CCP zoo ces yuav qhia tau tias koj muaj mob rheumatoid arthritis thiab qhia tau tias koj muaj feem yuav mob pob qij txha ntau dua. Yog tias muaj cov txiaj ntsig anti-CCP tsis zoo ces tsis suav nrog mob rheumatoid arthritis, vim tias feem ntau ntawm cov neeg mob muaj cov txiaj ntsig seronegative.
Tus yuam sij takeaways
- Qhov kev kuaj anti-CCP txhawb nqa kev kuaj mob rheumatoid arthritis; qhov kev kuaj anti-CCP tsis yog nws tus kheej ua qhov kev kuaj mob.
- Yog tias tsis muaj cov txiaj ntsig anti-CCP ces tsis yog hais tias koj muaj mob rheumatoid arthritis, ces feem ntau koj yuav muaj mob rheumatoid arthritis uas tsis muaj cov txiaj ntsig seronegative.
- Cov tshuaj tiv thaiv Anti-CCP tshwj xeeb dua rau mob pob qij txha rheumatoid dua li cov tshuaj rheumatoid factor, tab sis ob qho kev kuaj no tsis hloov kev kuaj mob hauv tsev kho mob.
- Cov qib Anti-CCP tsis yog siv los taug qab cov kab mob txhua hnub; cov cim qhia txog kev o thiab cov lej pob qij txha siv rau qhov ntawd.
- Cov chav ntsuas, cov txheej txheem ntsuas thiab cov kev txiav tawm sib txawv ntawm cov chaw kuaj mob, yog li cov txiaj ntsig yuav tsum tau muab piv rau qhov ntau thiab tsawg ntawm cov chaw kuaj mob uas tau tshaj tawm.
Ib nrais muag
| feature | Nthuav dav |
|---|---|
| qauv | Cov ntshav uas raug rho tawm ntawm cov leeg ntshav hauv caj npab |
| Kev yoo mov | Feem ntau tsis tas yuav tsum tau ua rau kev kuaj anti-CCP xwb; ua raws li cov lus qhia ntawm koj lub chaw kuaj mob yog tias muaj lwm yam kev kuaj mob ua ke. |
| Lub sijhawm rau kev kuaj ntshav | Feem ntau siv ob peb feeb; cia li 15-30 feeb nyob rau hauv thaj chaw sau npe suav nrog kev sau npe thiab so tom qab kos duab. |
| Lub ntsiab tseem ceeb | Txhawb kev kuaj mob thiab kev kwv yees rau cov neeg mob uas xav tias muaj mob rheumatoid arthritis |
| Feem ntau xaj nrog | Rheumatoid factor, CRP, ESR, suav cov ntshav tag nrho, thiab feem ntau yog duab tes/taw |
| Hom ntawv tshwm sim | Tus nqi lej nrog rau qhov txiav tawm tshwj xeeb hauv chaw kuaj mob, qhia tias tsis zoo, qis zoo lossis siab zoo |
| Rov sim dua | Tsis tshua xav tau thaum muaj ntaub ntawv pov thawj tseeb tias muaj qhov zoo; cov txiaj ntsig sib txawv nyob ntawm tus kheej qhov xwm txheej kho mob |
Kuj hu ua
- Kev kuaj tshuaj tiv thaiv kab mob peptide citrullinated antibody
- ACPA (anti-citrullinated protein antibody) kev kuaj
- Kev kuaj mob CCP antibody, anti-CCP2 lossis anti-CCP3 assay
- Feem ntau nug hauv Is Nrias teb li "CCP test", "RA antibody test" lossis "arthritis blood test", nco ntsoov tias "RA factor" yog lwm yam kev xeem (rheumatoid factor)
Qhov kev sim anti-CCP yog dab tsi
Citrullination yog ib qho kev hloov pauv tshuaj lom neeg ib txwm muaj rau cov protein. Hauv qee tus neeg, lub cev tiv thaiv kab mob pib kho cov protein citrullinated zoo li txawv teb chaws thiab tsim cov tshuaj tiv thaiv kab mob tawm tsam lawv. Cov tshuaj tiv thaiv kab mob no hu ua anti-citrullinated protein antibodies (ACPA). Qhov kev kuaj anti-CCP nrhiav tau lawv siv cov peptides cyclic citrullinated synthetic hauv chav kuaj mob.
Cov tshuaj tiv thaiv no tuaj yeem tshwm sim hauv cov ntshav ntau xyoo ua ntej cov tsos mob ntawm pob qij txha pib. Lawv muaj feem cuam tshuam nrog mob pob qij txha rheumatoid, tshwj xeeb tshaj yog hom uas ua rau pob txha lwj. Qhov kev xeem anti-CCP pab txhawb rau cov qauv kev faib tawm ACR/EULAR xyoo 2010 rau mob pob qij txha rheumatoid, nrog rau tus lej thiab hom pob qij txha uas koom nrog, cov cim qhia txog kev o thiab lub sijhawm ntawm cov tsos mob.
Vim li cas thiaj ua qhov kev sim anti-CCP
- Txhawm rau txhawb kev kuaj mob ntawm mob pob qij txha rheumatoid hauv ib tus neeg uas mob pob qij txha, o thiab mob nqaij tawv thaum sawv ntxov.
- Yuav pab kom paub qhov txawv mob pob qij txha rheumatoid los ntawm lwm yam ua rau mob polyarthritis, xws li mob pob qij txha psoriatic, mob pob qij txha viral (suav nrog mob pob qij txha uas cuam tshuam nrog chikungunya) lossis mob cov nqaij sib txuas.
- Pab nrog kev kwv yees: qhov muaj anti-CCP zoo feem ntau cuam tshuam nrog cov kab mob uas lwj ntau dua, uas yuav cuam tshuam rau qhov pib kho mob thaum ntxov thiab kev kho mob hnyav npaum li cas.
- Txhawm rau kom meej meej txog mob pob qij txha uas tsis sib txawv, qhov twg tseem tsis tau meej meej seb tus kab mob pob qij txha thaum ntxov puas yuav hloov mus ua mob pob qij txha rheumatoid.
Leej twg yuav tsum xav txog qhov kev xeem anti-CCP
Kev kuaj anti-CCP yog kev kuaj uas kws kho mob xaj, tsis yog kev kuaj mob dav dav. Feem ntau nws yog rau:
- Cov neeg laus uas muaj mob thiab o ntawm ntau lub pob qij txha, tshwj xeeb tshaj yog cov pob qij txha me me ntawm tes, dab teg lossis taw, kav ntev tshaj rau lub lis piam.
- Cov neeg uas muaj mob pob qij txha thaum sawv ntxov uas kav ntev tshaj 30-60 feeb.
- Cov neeg uas muaj kev koom tes ntawm cov pob qij txha sib npaug, lossis cov kab mob synovitis uas tsis paub meej pom ntawm kev kuaj mob lossis ultrasound.
- Cov neeg twb pom tias muaj tus kab mob rheumatoid factor zoo los yog tsis zoo lawm, qhov twg tseem tsis paub meej tias muaj mob dab tsi.
- Cov menyuam yaus thiab cov hluas tsuas yog thaum tus kws kho mob tshwj xeeb xav tias muaj tus kab mob rheumatoid-factor-positive ntawm cov menyuam yaus idiopathic arthritis xwb, kev siv niaj hnub rau cov menyuam yaus raug txwv.
Qhov kev kuaj anti-CCP tsis muaj txiaj ntsig rau cov neeg uas tsis muaj cov tsos mob ntawm pob qij txha, thiab qhov tshwm sim zoo hauv tus neeg uas tsis muaj tsos mob tsis tau txhais hais tias mob pob qij txha rheumatoid arthritis muaj lossis yuav tshwm sim.
Yam uas qhov kev kuaj anti-CCP tsis tuaj yeem ntes tau lossis tsis suav nrog
- Qhov kev kuaj anti-CCP tsis tuaj yeem tshem tawm cov mob rheumatoid arthritis. Feem ntau ntawm cov neeg uas muaj mob rheumatoid arthritis tsis muaj anti-CCP. Lawv tus kab mob tseem tuaj yeem ua rau mob thiab ua rau tsis taus. Yog tias cov tsos mob tseem muaj txawm tias tsis muaj qhov tshwm sim, rov qab mus rau koj tus kws kho mob.
- Qhov kev kuaj anti-CCP tsis tuaj yeem qhia txog kev puas tsuaj ntawm cov pob qij txha. Kev puas tsuaj, qhov chaw sib koom ua ke nqaim thiab synovitis raug soj ntsuam los ntawm X-rays, ultrasound lossis MRI, tsis yog los ntawm cov qib antibody.
- Qhov kev kuaj anti-CCP tsis tuaj yeem ntsuas qhov kev ua haujlwm ntawm tus kab mob tam sim no. Qib siab tsis tau txhais hais tias tus kab mob tab tom loj hlob sai rau lub sijhawm ntawd.
- Qhov kev kuaj anti-CCP tsis tuaj yeem kuaj mob osteoarthritis, gout, fibromyalgia, ankylosing spondylitis lossis lupus, thiab nws tsis tuaj yeem txiav txim siab tias muaj ob yam no thiab. Kev kuaj mob pob qij txha thiab mob gout yog ua los ntawm kev siv tshuab thaij duab thiab, rau kev kuaj mob gout, yuav tsum kuaj cov kua qaub uric thiab cov kua dej hauv pob qij txha.
- Qhov kev kuaj anti-CCP tsis qhia txog qhov ua rau muaj kev tiv thaiv kab mob, nws kuj tsis qhia tias cov tshuaj tshwj xeeb yuav ua haujlwm zoo li cas rau ib tus neeg.
- Tsuas yog qhov tshwm sim zoo xwb tsis yog kev kuaj mob. Cov tshuaj tiv thaiv kab mob uas tsis muaj mob pob qij txha thaum kuaj pom yog qhov muaj kev pheej hmoo, tsis yog kab mob.
Kev ntsuam xyuas sib txuas tab sis sib txawv
| xeem | Lo lus nug nws teb | Qhov sib txawv tseem ceeb ntawm anti-CCP |
|---|---|---|
| Tus kab mob Rheumatoid (RA factor, RF) | Puas muaj ib qho tshuaj tiv thaiv kab mob tawm tsam qhov Fc ntawm IgG? | Tsis tshua meej. Qhov mob rheumatoid factor yuav pom tau tias muaj txiaj ntsig zoo rau cov kab mob hepatitis C, cov kab mob ntev, Sjören's syndrome, lwm yam kab mob autoimmune thiab rau qee tus neeg laus uas noj qab nyob zoo. Feem ntau, Anti-CCP yog qhov tshwj xeeb dua ntawm ob qho kev kuaj no; ob qho kev kuaj no yog ua ke, tsis hloov pauv tau. |
| CRP thiab ESR | Tam sim no muaj mob o ntau npaum li cas? | Cov no qhia txog kev ua o thiab siv rau kev saib xyuas. Lawv tsis yog cov kab mob tshwj xeeb thiab nce ntxiv thaum muaj kev kis kab mob. |
| ANA (antinuclear antibody) | Puas muaj kab mob sib txuas xws li lupus? | Cov tshuaj tiv thaiv kab mob sib txawv, cov kab mob sib txawv. ANA tuaj yeem pom zoo rau cov neeg noj qab haus huv thiab rau cov mob pob qij txha rheumatoid. |
| HLA-B 27 | Puas yuav muaj mob spondyloarthritis? | Muaj feem cuam tshuam rau cov kab mob nraub qaum thiab cov pob qij txha loj asymmetric, tsis yog rau mob caj dab rheumatoid. |
| Kev ntsuas cov kua qaub uric acid hauv cov ntshav thiab cov kua dej sib koom ua ke | Qhov no puas yog mob gout? | Anti-CCP tsis hais dab tsi txog mob pob qij txha crystal. Kev nqus cov pob qij txha tseem yog txoj kev siv los ntsuas qhov crystal. |
| Kev X-ray ntawm cov pob qij txha, ultrasound, MRI | Puas muaj mob synovitis lossis kev puas tsuaj ntawm cov qauv? | Cov duab qhia txog lub cev thiab kev o; anti-CCP qhia txog lub cim qhia txog kev tiv thaiv kab mob. Tsis muaj ib qho twg hloov tau lwm qhov. |
| Kev ntsuam xyuas Anti-CCP2 piv rau anti-CCP3 | Siv cov peptide tiam twg? | Cov chaw tsim khoom sib txawv siv cov peptides, units thiab cut-offs sib txawv. Cov nqi los ntawm ob lub chaw soj nstuam feem ntau tsis sib piv ncaj qha. |
Kev xeem twg yuav tsum ua ntej
Tsis muaj ib qho kev kuaj mob twg uas yeej ib txwm los ua ntej. Qhov kev txiav txim nyob ntawm qhov teeb meem kev kho mob:
- Cov pob qij txha me me ntawm tes thiab taw o tuaj tau ntau lub lis piam: kev kuaj mob ntxiv rau CRP/ESR, rheumatoid factor thiab antiCCP ua ke, feem ntau nrog kev thaij duab tes thiab ko taw.
- Mob hnyav sai sai rau ib qho pob qij txha, tshwj xeeb tshaj yog tus ntiv taw loj: mob gout lossis mob septic arthritis yog qhov txhawj xeeb; kev nqus cov pob qij txha thiab uric acid yog qhov tseem ceeb dua li anti-CCP.
- Mob pob qij txha tom qab kub taub hau thiab pob khaus hauv thaj chaw muaj tus kab mob dengue lossis chikungunya: ua ntej yuav tsum tau soj ntsuam seb ua rau muaj tus kab mob no yog vim li cas; mob pob qij txha tom qab mob chikungunya tuaj yeem zoo li mob pob qij txha rheumatoid tau ntau lub hlis.
- Mob nraub qaum qis hauv ib tug tub hluas: kev ntsuam xyuas kab mob spondyloarthritis, tsis yog anti-CCP.
- Mob pob qij txha nrog rau pob khaus, mob qhov ncauj, plaub hau poob lossis mob raum: kev ntsuam xyuas lupus suav nrog ANA.
Yuav npaj li cas
- Kev yoo mov: Feem ntau qhov kev kuaj anti-CCP nkaus xwb tsis tas yuav yoo mov. Yog tias nws muaj nrog kev kuaj lipid lossis glucose, cov lus qhia ntawm chav sau cov ntshav yuav siv tau.
- Cov tshuaj kho mob: qhia rau cov neeg ua haujlwm sau nqi thiab koj tus kws kho mob txog yam koj noj, suav nrog cov tshuaj steroids, cov tshuaj tiv thaiv kab mob, AYUSH thiab cov tshuaj ntsuab thiab cov tshuaj ntxiv rau hauv lub gym. Tsis txhob pib, tsum lossis hloov cov tshuaj uas tau muab rau kev kuaj mob, nrog koj tus kws sau ntawv tham ua ntej.
- Kev co: Kev haus dej li qub ua rau cov leeg ntshav yooj yim dua rau kev nkag mus rau hauv. Cov neeg uas muaj mob plawv tsis ua haujlwm, mob raum ntev lossis tau teem sijhawm txwv dej yuav tsum ua raws li qhov txwv dej uas lawv tus kws kho mob tau teem tseg.
- sij hawm: tsis tas yuav muaj lub sijhawm tshwj xeeb ntawm ib hnub.
- Cov ntaub ntawv: nqa daim ntawv yuav tshuaj, cov ntawv qhia ua ntej thiab cov txiaj ntsig anti-CCP ua ntej kom lub chaw kuaj mob thiaj li piv tau zoo ib yam.
Cov lus qhia txog kev npaj, cov qauv uas yuav tsum tau ua thiab cov kev coj ua qhia txawv ntawm cov chaw kuaj mob. Cov lus qhia uas koj lub chaw khaws cov khoom muab muaj qhov tseem ceeb dua li cov lus qhia dav dav.
Yog koj xeeb tub
Qhov kev kuaj ntshav nws tus kheej tsis hloov pauv thaum cev xeeb tub. Kev txhais lus ntawm qhov tshwm sim zoo thiab txhua qhov kev txiav txim siab kho mob yuav tsum tau kev pab los ntawm kws kho mob rheumatologist thiab kws kho mob yug menyuam, vim tias ntau yam tshuaj kho mob rheumatoid arthritis tsis haum rau cev xeeb tub.
Yog koj muaj mob ntshav qab zib uas tab tom kho mob kom txo cov piam thaj (glycolysis)
Yog tias qhov kev kuaj anti-CCP muaj nrog rau kev kuaj thaum yoo mov, tham txog lub sijhawm ntawm koj cov insulin lossis cov ntsiav tshuaj nrog koj tus kws kho mob ua ntej kom koj thiaj li tsis txhob noj mov ntev thaum noj tshuaj.
Cov menyuam yaus thiab cov neeg laus dua
Rau cov menyuam yaus, kev kuaj anti-CCP yog xaiv los ntawm cov kws kho mob pob qij txha menyuam yaus. Rau cov neeg laus, qhov muaj cov tshuaj antibody me me feem ntau pom tias muaj thiab yuav tsum tau ceev faj thaum kuaj mob.
Kev mob ntshav los yog anticoagulants
Qhia rau tus kws kho mob ntshav yog tias koj noj warfarin, tshuaj anticoagulant tshiab dua lossis muaj teeb meem los ntshav, yog li ntawd koj tuaj yeem nias kom ruaj khov thiab ntev dua tom qab rub cov ntshav.
Muaj dab tsi tshwm sim thaum lub sijhawm xeem
Qhov kev kuaj anti-CCP siv cov ntshav venous ib txwm muaj.
- Qhov chaw, feem ntau yog sab hauv lub luj tshib, raug ntxuav nrog tshuaj tua kab mob thiab muab ib daim ntaub qhwv caj dab tso rau.
- Muab ib rab koob tso rau hauv thiab muab me ntsis ntshav sau rau hauv ib lub raj uas muaj daim ntawv lo.
- Muab nias rau thiab qhov chaw ntawd raug npog nrog ib daim ntaub qhwv me me.
- Cov neeg feem coob rov qab mus ua ub ua no li qub tam sim ntawd.
Yuav siv sijhawm ntev npaum li cas: feem ntau qhov kev kos duab nws tus kheej siv sijhawm tsawg dua tsib feeb. Xws li kev sau npe, daim ntawv lo rau cov qauv thiab kev so luv luv tom qab ntawd, xav tias yuav siv sijhawm li 15-30 feeb ntawm qhov chaw sau. Lub sijhawm ua haujlwm hauv chav kuaj txawv ntawm cov chaw kuaj, thiab koj chav haujlwm yuav qhia rau koj thaum twg yuav tsum tau txais daim ntawv qhia.
Nkag siab txog koj daim ntawv qhia txog kev tawm tsam CCP
Cov txiaj ntsig Anti-CCP raug tshaj tawm ua tus lej nrog lub chaw kuaj mob tus kheej qhov kev txiav tawm, thiab feem ntau piav qhia tias tsis zoo, qis zoo lossis siab zoo. Cov kev ntsuam xyuas sib txawv siv cov chav sib txawv thiab cov qhov txwv sib txawv, yog li tus nqi los ntawm ib lub chaw kuaj mob yuav tsum tsis txhob nyeem piv rau lwm lub chaw kuaj mob qhov ntsuas. Ib txwm nyeem koj cov txiaj ntsig piv rau qhov ntau thiab tsawg uas luam tawm ntawm koj daim ntawv qhia.
- Tsis zoo: Cov tshuaj tiv thaiv anti-CCP tsis tau pom ntawm lossis siab dua qhov kev txiav txim siab. Qhov no txo qis, tab sis tsis tshem tawm, qhov tshwm sim ntawm mob caj dab rheumatoid. Mob caj dab rheumatoid seronegative muaj nyob thiab raug kuaj pom hauv kev kho mob.
- Qis zoo: cov tshuaj tiv thaiv kab mob tau pom nyob rau theem me me. Qhov no muaj qhov hnyav tsawg dua li qhov tshwm sim zoo thiab xav tau kev sib raug zoo hauv kev kho mob.
- Zoo siab: feem ntau suav ua tus nqi ntau zaus ntawm qhov txiav tawm. Qhov no muaj kev sib raug zoo nrog mob caj dab rheumatoid thiab, qhov nruab nrab, nrog rau cov kab mob erosive ntau dua. Nws tseem xav tau cov kev tshawb pom sib koom ua ke los ua qhov kev kuaj mob.
Cov lus piav qhia "me me", "nruab nrab" lossis "muaj zog" yog ib qho kev cai hauv chav kuaj mob, tsis yog qib kab mob. Cov neeg mob feem ntau nyeem tus lej siab txhais tau tias yog kab mob hnyav lossis mob hnyav. Tus lej qhia txog kev sib sau ua ke ntawm cov tshuaj tiv thaiv kab mob, tsis yog qhov mob pob qij txha lossis nws puas tsuaj npaum li cas. Cov txiaj ntsig xav tau kev txhais lus hauv cov ntsiab lus kho mob los ntawm tus kws kho mob uas tau thov kom kuaj, thiab cov txiaj ntsig sib txawv nyob ntawm tus kheej qhov xwm txheej kho mob.
Thaum cov txiaj ntsig anti-CCP tuaj yeem ua rau yuam kev
Ntshai tsa los yog zoo yam tsis muaj mob rheumatoid arthritis
- Lwm yam mob autoimmune, suav nrog qee kis ntawm psoriatic mob caj dab, Sjören's syndrome thiab lupus, tuaj yeem qhia tau tias muaj anti-CCP zoo.
- Cov kab mob sib kis mus ntev, suav nrog tus kab mob ntsws hauv qee daim ntawv tshaj tawm, tau cuam tshuam nrog qib qis ntawm kev kuaj mob, uas cuam tshuam rau hauv Is Nrias teb vim muaj tus kab mob ntsws.
- Cov tshuaj tiv thaiv kab mob cuam tshuam, cov tshuaj immunoglobulin siab heev thiab cov yam ntxwv xws li haemolysis lossis lipaemia tuaj yeem cuam tshuam rau immunoassays.
- Cov neeg haus luam yeeb thiab qee tus neeg uas muaj keeb kwm tsev neeg yuav muaj cov tshuaj tiv thaiv kab mob tau ntau xyoo ua ntej muaj mob pob qij txha, lossis tsis tau mob li.
- Cov nqi qis zoo ze rau qhov txiav tawm muaj feem ntau tshaj plaws uas yuav tsis tseem ceeb hauv kev kho mob.
Txawm hais tias mob rheumatoid arthritis los yog mob rheumatoid kuj tsis zoo los yog tsis zoo
- Kab mob rheumatoid arthritis seronegative yog ib hom kab mob uas paub zoo.
- Tej zaum yuav tsis tau pom cov tshuaj tiv thaiv kab mob thaum ntxov ntawm tus mob; kev kuaj dua tom qab yuav raug txiav txim siab los ntawm tus kws kho mob.
- Kev ntsuas qhov rhiab heev txawv ntawm cov platform anti-CCP2 thiab anti-CCP3, yog li ntawd ib lub chaw kuaj mob yuav tshaj tawm tias tsis muaj qhov twg thaum lwm lub tshaj tawm tias muaj qhov tsis zoo.
- Kev kho mob B-cell depleting xws li rituximab tuaj yeem txo cov tshuaj tiv thaiv kab mob yam tsis tau txhais hais tias tus kab mob tau zoo lawm.
Vim li cas rov ua qhov kev xeem tsis tshua pab tau
Cov qib Anti-CCP hloov qeeb qeeb thiab tsis qhia txog qhov mob tshwm sim. Thaum pom tias muaj cov tsos mob zoo, kev rov ua qhov kev kuaj anti-CCP feem ntau tsis ntxiv dab tsi ntau. Kev saib xyuas yog nyob ntawm cov tsos mob, kev kuaj pob qij txha, CRP lossis ESR thiab kev thaij duab.
Kev Pheej Hmoo thiab Kev Nyab Xeeb
Kev kuaj ntshav venous niaj hnub
Qhov tsis xis nyob ntawm qhov koob txhaj tshuaj, cov qhov txhab me me thiab lub taub hau me ntsis yog cov teeb meem ib txwm muaj. Cov teeb meem no feem ntau yuav ploj mus rau lawv tus kheej rau cov neeg feem coob.
Cov teeb meem uas tsis tshua muaj tshwm sim
Feem ntau yuav muaj ntshav los yog mob nqaij loj dua thaum noj tshuaj anticoagulants los yog cov tshuaj uas ua rau ntshav los. Tej zaum yuav muaj kev tsaus muag, qhia rau cov neeg ua haujlwm yog tias koj tau tsaus muag thaum kuaj ntshav ua ntej lawm kom lawv thiaj li coj koj mus pw. Kev kis kab mob ntawm qhov chaw txhaj tshuaj tsis tshua muaj. Kev khaus ntawm cov hlab ntsha ua rau mob pob txha tsis tshua muaj; qhia rau lawv paub thaum ntawd.
Yuav ua li cas tom qab
Nias kom nruj rau ntawm qhov chaw ntawd li ob peb feeb. Hu rau qhov chaw sau cov ntshav lossis koj tus kws kho mob yog tias koj muaj qhov liab ntawm qhov chaw, o zuj zus, kub taub hau lossis loog tas li.
Cov cim liab: thaum cov tsos mob ntawm pob qij txha xav tau kev saib xyuas sai
Xwm txheej ceev: nrhiav kev kho mob tam sim no
- Yuav tsum tau tshem tawm ib qho pob qij txha kub, mob heev, o nrog rau kub taub hau, mob septic arthritis sai sai.
- Qhov tsis muaj zog tshiab ntawm ob txhais ceg, tsis tswj tau lub zais zis lossis quav, lossis mob caj dab hnyav nrog cov tsos mob ntawm lub paj hlwb rau ib tus neeg uas muaj mob pob qij txha rheumatoid ntev.
- Ua tsis taus pa thaum so, mob hauv siab, lossis hnoos ntshav.
- Kub taub hau nrog kev tsis meej pem lossis muaj kab mob ntawm daim tawv nqaij uas kis sai sai thaum noj tshuaj tiv thaiv kab mob.
Tib hnub ntawd los yog tsis pub dhau 24-48 teev
- Kub taub hau nrog ntau lub pob qij txha tshiab o.
- Qhov muag liab tshiab uas mob lossis hloov pauv sai sai hauv kev pom kev.
- Mob qhov txhab ntawm daim tawv nqaij, loog tshiab lossis ko taw poob.
- Poob phaus yam tsis paub ua ntej nrog rau o ntawm cov pob qij txha.
Kev teem caij tsis tu ncua
- Mob pob qij txha thiab o uas kav ntev tshaj rau lub lis piam.
- Feem ntau thaum sawv ntxov yuav mob heev thiab ntev tshaj 30 feeb.
- Nyuaj siab tuav, qhib lub hub los yog ua ib lub nrig.
- Ib qho txiaj ntsig anti-CCP zoo pom ntawm pob khoom kho mob uas tsis muaj cov tsos mob ntawm pob qij txha, qhov no xav tau kev pom zoo los ntawm kws kho mob rheumatologist, tsis yog kev ntshai.
Cov xwm txheej tshwj xeeb
Cev xeeb tub thiab npaj tsev neeg
Mob pob qij txha caj qaum feem ntau zoo dua thaum cev xeeb tub thiab tej zaum yuav mob hnyav dua tom qab. Kev kuaj pom tias muaj tus kab mob Anti-CCP tsis hloov kev nyab xeeb ntawm kev kuaj ntshav, tab sis kev npaj tshuaj yuav tsum pib ua ntej cev xeeb tub nrog kws kho mob pob qij txha thiab kws kho mob yug menyuam ua ke.
Cov menyuam yaus thiab tub ntxhais hluas
Feem ntau cov mob pob qij txha idiopathic rau cov menyuam yaus tsis muaj anti-CCP. Yog tias muaj qhov tshwm sim zoo rau ib tug menyuam yaus ces tsuas yog txhais tau tias muaj txiaj ntsig zoo hauv kev ntsuam xyuas ntawm tus kws tshwj xeeb xwb.
Cov laus
Cov mob polymyalgia rheumatica, osteoarthritis thiab crystal arthritis feem ntau tshwm sim rau lub neej tom qab thiab zoo li mob rheumatoid arthritis. Cov neeg mob uas muaj cov tshuaj antibody tsawg hauv pawg no yuav tsum tau ceev faj tshwj xeeb.
Kab mob raum ntev, mob plawv tsis ua haujlwm thiab ntshav qab zib
Cov mob no tsis hloov qhov kev kuaj anti-CCP nws tus kheej, tab sis lawv muaj feem cuam tshuam loj heev rau cov tshuaj mob pob qij txha uas tsim nyog. Qhia koj keeb kwm kev kho mob tag nrho rau tus kws kho mob uas sau ntawv rau koj.
Cov neeg twb tau txais kev kho mob lawm
Yog tias koj noj tshuaj methotrexate, tshuaj steroids, tshuaj biologics lossis lwm yam tshuaj uas tiv thaiv kab mob, tsis txhob tsum lawv ua ntej kuaj ntshav tshwj tsis yog tias koj tus kws kho mob hais kom koj ua.
Kev sim anti-CCP hauv Is Nrias teb
- Kev tsis meej pem ntawm cov lus siv yog ib qho uas ntau tus neeg ntsib. Muaj ntau tus neeg mob thov kom muaj "kev kuaj mob RA factor" thaum tus kws kho mob rheumatologist tau thov kom muaj anti-CCP. Lawv yog cov kev kuaj sib txawv uas ntsuas cov tshuaj tiv thaiv kab mob sib txawv, thiab ob qho tib si yuav raug xaj.
- Kab mob tom qab kis kab mob yog ib qho tseem ceeb heev. Kab mob Chikungunya thiab dengue rov tshwm sim dua hauv ntau lub xeev Is Nrias teb, thiab mob pob qij txha tom qab mob chikungunya tuaj yeem mob mus ntev ntau lub hlis thiab yuam kev rau mob pob qij txha rheumatoid. Anti-CCP feem ntau tsis zoo rau cov rooj plaub no, uas pab tau.
- Kab mob ntsws tseem ceeb ob zaug. Kev kis tus kab mob mus ntev qee zaum tuaj yeem txuas nrog cov tshuaj tiv thaiv kab mob qis, thiab qhov tseem ceeb dua, kev tshuaj ntsuam xyuas kab mob ntsws latent yog tus qauv ua ntej pib ntau yam kev kho mob hauv Is Nrias teb.
- Kab mob ntshav tsis txaus (anemia) feem ntau tshwm sim. Kab mob ntshav tsis txaus hlau thiab kab mob ntshav tsis txaus ntev yog ob qho tib si uas tshwm sim thiab tuaj yeem ua rau cov ntshav tsis meej pem, txawm hais tias ob qho no tsis cuam tshuam rau qhov kev ntsuas anti-CCP nws tus kheej.
- Kev kho tus kheej thiab cov tshuaj ntxiv. Siv cov tshuaj tua kab mob uas yuav tsis tas yuav muaj daim ntawv yuav tshuaj mus ntev, cov tshuaj uas muaj cov tshuaj steroids zais cia, thiab qee cov tshuaj ntsuab lossis cov tshuaj pab kom lub cev ua haujlwm tau zoo tuaj yeem npog cov tsos mob lossis ua rau muaj kev phom sij. Qhia rau koj tus kws kho mob txhua yam koj noj.
- Kev ncua sijhawm rau kev kuaj mob tseem yog ib qho teeb meem uas qhov kev nkag mus rau kev kho mob rheumatology tseem tsawg. Qhov o ntawm cov pob qij txha me me uas tsis tu ncua tsim nyog tau txais kev xa mus rau lwm tus dua li kev siv tshuaj tua kab mob ntau zaus.
Tus nqi thiab kev pov hwm hauv Is Nrias teb
Tus nqi kuaj mob tiv thaiv CCP yog nyob ntawm txhua lub chaw kuaj mob thiab lub nroog, thiab tus nqi hloov pauv raws sijhawm, yog li xyuas tus nqi tam sim no ncaj qha nrog lub chaw kuaj mob uas koj npaj yuav siv. Cov yam uas cuam tshuam rau qhov koj them suav nrog:
- Kev tsim cov kev sim thiab platformkev siv tshuaj anti-CCP2 piv rau anti-CCP3, thiab kev siv tshuaj chemiluminescence tsis siv neeg piv rau ELISA.
- Yuav ua li cas yog bundled mus rau hauv ib qho mob pob qij txha lossis autoimmune panel nrog rheumatoid factor, CRP, ESR thiab tag nrho cov ntshav suav.
- Kev lees paub txog qhov xwm txheej ntawm lub chaw kuaj mob, xws li NABL kev lees paub.
- Cov nqi sau nqi tsev thiab theem nroog.
- Kev kub ntxhov: kev tshaj tawm sai dua yuav raug nqi ntau dua qhov twg muaj.
Tus cwj pwm ntawm kev pov hwm txawv. Feem ntau cov kev kuaj mob sab nraud tsis raug them raws li cov cai lij choj them nqi kho mob hauv tsev kho mob tshwj tsis yog tias koj muaj tus neeg caij OPD lossis qhov kev kuaj mob yog ib feem ntawm kev nkag mus lossis kev saib xyuas menyuam yaus uas tau pom zoo lossis pob khoom uas tau tso cai ua ntej. Paub meej tias kev them nqi nrog koj tus neeg pov hwm lossis lub rooj pov hwm ntawm tsev kho mob ua ntej kuaj. Cov phiaj xwm tsoomfwv thiab cov phiaj xwm kev noj qab haus huv ntawm tus tswv ntiav haujlwm muaj lawv cov cai.
Cov lus dab neeg thiab qhov tseeb
| tswvyim hais ua dabneeg | fact |
|---|---|
| Yog tias koj tsis muaj mob rheumatoid arthritis, tus anti-CCP uas tsis zoo txhais tau tias koj tsis muaj mob rheumatoid arthritis. | Kab mob rheumatoid arthritis uas tsis muaj tsos mob feem ntau yog ib yam kab mob uas tsis muaj tsos mob dab tsi li. Kev kuaj mob yog nyob ntawm kev kuaj mob, cov tsos mob, cov cim qhia txog kev o thiab kev siv duab thaij duab nrog rau cov tshuaj tua kab mob. |
| Tus lej anti-CCP siab txhais tau tias mob heev thiab qaug zog sai. | Cov theem siab dua feem ntau cuam tshuam nrog cov kab mob uas ua rau muaj kev puas tsuaj ntau dua thoob plaws cov pej xeem, tab sis tus lej tsis kwv yees qhov mob, kev ua haujlwm lossis qhov tshwm sim ntawm tus neeg. |
| Yuav tsum tau rov ua dua Anti-CCP txhua zaus mus ntsib kws kho mob kom paub seb kev kho mob puas ua haujlwm. | Cov tshuaj Anti-CCP tsis taug qab kev ua haujlwm ntawm tus kab mob zoo. Kev soj ntsuam siv cov lej sib koom ua ke, CRP lossis ESR thiab kev tshuaj xyuas kev kho mob. |
| Anti-CCP hloov qhov kev kuaj mob RA. | Ob qho kev xeem muab cov ntaub ntawv sib txawv thiab feem ntau siv ua ke. |
| Yog tias muaj cov tshuaj anti-CCP zoo hauv kev kuaj mob txhais tau tias mob pob qij txha yuav tsum tsis txhob tshwm sim. | Cov tshuaj tiv thaiv kab mob (antibodies) yeej muaj tau yam tsis muaj kab mob. Yog tias ib tug neeg tsis muaj cov tsos mob ntawm pob qij txha ces yuav tsum tau kev soj ntsuam los ntawm kws kho mob tshwj xeeb, tsis yog kev kho mob nws tus kheej xwb. |
| Kev noj zaub mov ib leeg xwb tuaj yeem ua rau cov qib anti-CCP zoo li qub. | Tsis muaj kev noj zaub mov twg uas tau pom tias yuav pab tiv thaiv cov tshuaj tiv thaiv kab mob. Kev noj zaub mov kom zoo, kev tso tseg haus luam yeeb thiab kev tawm dag zog tsis tu ncua pab txhawb kev noj qab haus huv ntawm cov pob qij txha thiab lub plawv nrog rau kev kho mob uas tau sau tseg. |
Lus nug cov lus nug
Puas yog qhov kev sim anti-CCP zoo dua li qhov kev sim RA factor?
Ob qho kev kuaj no tsis zoo tag nrho. Feem ntau Anti-CCP yog qhov tshwj xeeb dua rau mob pob qij txha rheumatoid, yog li qhov tshwm sim zoo muaj lub ntsiab lus ntau dua. Rheumatoid factor tseem muaj txiaj ntsig thiab zoo rau qee tus neeg mob anti-CCP tsis muaj. Cov kws kho mob feem ntau xaj ob qho tib si, vim tias lawv teb cov lus nug sib tshooj tab sis sib txawv.
Kuv puas yuav tsum tau yoo mov ua ntej kuaj anti-CCP?
Feem ntau tsis tas yuav tsum yoo mov rau qhov kev kuaj anti-CCP nws tus kheej. Yog tias koj tus kws kho mob tau ntxiv cov lipid profile, kev yoo mov glucose lossis lwm yam kev kuaj rau tib qho qauv, cov lus qhia yoo mov yuav siv tau. Ua raws li cov lus qhia uas koj chav sau cov ntshav muab, vim tias cov txheej txheem sib txawv ntawm cov chaw kuaj mob.
Kuv tus kab mob anti-CCP zoo tab sis kuv cov pob qij txha zoo. Yuav ua li cas tam sim no?
Yog tias muaj cov tshuaj tiv thaiv kab mob uas tsis muaj pob qij txha o, ces yog ib qho cim qhia txog kev pheej hmoo, tsis yog kev kuaj mob. Npaj kev tshuaj xyuas mob pob qij txha kom tus kws kho mob tuaj yeem kuaj koj cov pob qij txha thiab txiav txim siab seb puas tsim nyog siv duab los yog saib xyuas. Tsis txhob pib siv tshuaj kho mob pob qij txha los ntawm kev kuaj ntshav xwb.
Cov theem anti-CCP puas tuaj yeem txo qis nrog kev kho mob?
Cov theem yuav poob me ntsis nrog kev kho mob, tshwj xeeb tshaj yog nrog kev kho mob B-cell depleting, tab sis lawv feem ntau tseem zoo txawm tias tus kab mob tau tswj hwm zoo. Cov theem poob qis tsis yog lub hom phiaj kho mob. Cov kws kho mob txiav txim siab cov lus teb los ntawm cov tsos mob, kev kuaj mob pob qij txha thiab cov cim qhia txog kev o.
Ntev npaum li cas ntawm tag nrho cov txheej txheem coj mus ntev?
Qhov kev rho ntshav nws tus kheej tsuas siv sijhawm ob peb feeb xwb. Cia li 15-30 feeb ntawm qhov chaw sau npe rau kev sau npe, kev kuaj ntshav thiab so luv luv. Lub sijhawm ua haujlwm hauv chav kuaj txawv ntawm txhua lub chaw kuaj ntshav, yog li nug koj lub chaw sau ntshav thaum twg koj daim ntawv qhia yuav npaj txhij.
Puas yog mob chikungunya lossis dengue mob pob qij txha ua rau muaj qhov tshwm sim anti-CCP zoo?
Qhov mob pob qij txha tom qab kis tus kab mob chikungunya lossis dengue feem ntau tsis muaj anti-CCP, uas yog ib qho laj thawj uas qhov kev kuaj mob no pab tau hauv Is Nrias teb. Txawm li cas los xij, mob pob qij txha tom qab mob chikungunya tuaj yeem zoo ib yam li mob pob qij txha rheumatoid, yog li tus kws kho mob rheumatologist tseem yuav tsum tau soj ntsuam koj ncaj qha.
Puas siv qhov kev sim anti-CCP rau menyuam yaus?
Tsuas yog xaiv xwb. Feem ntau cov mob pob qij txha idiopathic rau cov menyuam yaus tsis muaj anti-CCP, thiab cov kws kho mob pob qij txha rau menyuam yaus thov kom kuaj thaum muaj tus qauv rheumatoid-factor-positive. Rau cov menyuam yaus, kev txhais lus yeej ib txwm nyob ntawm tus kws kho mob tshwj xeeb qhov kev ntsuam xyuas es tsis yog nyob ntawm tus lej xwb.
Kuv puas yuav tsum tsis txhob noj tshuaj tua kab mob lossis tshuaj steroids ua ntej kuaj?
Tsis txhob tsum tsis txhob noj tshuaj uas tau muab rau qhov kev kuaj no yam tsis tau nrog koj tus kws kho mob tham. Cov tshuaj tiv thaiv kev o thiab cov tshuaj steroids txo cov tsos mob thiab tuaj yeem txo CRP lossis ESR, tab sis lawv tsis ua rau qhov tshwm sim anti-CCP tsis raug. Qhia rau koj tus kws kho mob paub meej tias koj noj dab tsi.
Puas muaj ob lub chaw kuaj mob uas muab tau cov txiaj ntsig anti-CCP sib txawv rau kuv?
Yog. Cov kev ntsuam xyuas sib txawv siv cov peptides, units thiab cut-offs sib txawv, yog li cov nqi tsis sib piv ncaj qha ntawm cov chaw kuaj mob. Yog tias koj tab tom taug qab cov txiaj ntsig dhau sijhawm, siv tib lub chaw kuaj mob qhov twg ua tau thiab ib txwm nyeem cov nqi tawm tsam qhov ntau thiab tsawg uas luam tawm ntawm daim ntawv qhia ntawd.
Qhov chaw
- Aletaha D, Neogi T, Silman AJ, thiab lwm tus. Xyoo 2010 Cov Qauv Kev Faib Kab Mob Rheumatoid Arthritis: ib qho kev koom tes ntawm American College of Rheumatology/European League Against Rheumatism.
- Smolen JS, Aletaha D, McInnes IB. Mob pob qij txha. Lub Lancet.
- Cov lus qhia EULAR rau kev tswj hwm mob rheumatoid arthritis nrog cov tshuaj synthetic thiab biological disease-modifying antirheumatic.
- Cov lus qhia ntawm American College of Rheumatology rau kev kho mob rheumatoid mob caj dab.
- Cov lus qhia ntawm Indian Rheumatology Association txog kev kuaj mob thiab kev tswj hwm mob caj dab rheumatoid.
