Impendulo eqondile
Ukuhlolwa kwe-ASO ukuhlolwa kwegazi okulinganisa ama-antibody e-antistreptolysin O, akhiqizwa ngemuva kokutheleleka nge-Streptococcus yeqembu A. Ukuhlolwa kwe-ASO kusekela ubufakazi bokutheleleka kwe-streptococcal kwakamuva lapho kusolwa ukuthi kukhona isifo sangemva kwe-streptococcal njenge-rheumatic fever noma i-glomerulonephritis. Ukuhlolwa kwe-ASO akukuhloli ukutheleleka komphimbo okukhona njengamanje.
Ukuthatha okhiye
- Ukuhlolwa kwe-ASO kubheka emuva ekuthelelekeni kwangaphambilini, hhayi ekuthelelekeni okusebenzayo.
- I-ASO titre ephakanyisiwe iyodwa ayihloli umkhuhlane wamathambo noma isifo sezinso.
- I-ASO titre evamile ayikukhiphi ukutheleleka kwe-streptococcal kwakamuva, ikakhulukazi ezifweni zesikhumba.
- Amasampula abhangqiwe ahlukene ngamasonto ambalwa, abonisa i-tit ekhuphukayo, anesisindo esingaphezu kokufundwa okukodwa.
- Imiphumela kumele ifundwe kanye nezimpawu, ukuhlolwa kanye nokunye ukuhlolwa ngudokotela owayala ukuhlolwa kwe-ASO.
Nge-shazi
| Isici | Imininingwane |
|---|---|
| Sample | Igazi lemithambo yegazi, ngokuvamile elivela engalweni |
| Ukuzila | Ngokuvamile akudingeki; landela imiyalelo yeyunithi yakho |
| Isikhathi sokukhipha igazi | Cishe imizuzu emi-5 kuya kweyi-10, okuhlanganisa ukubhalisa kanye nokulebula |
| Izindlela | Ama-antibodies alwa ne-streptolysin O, ubuthi obukhiqizwa yiqembu A Streptococcus |
| Ukusetshenziswa Main | Ubufakazi obusekelayo bokutheleleka kwamuva kwe-streptococcal ku-rheumatic fever okusolwayo noma i-post-streptococcal glomerulonephritis |
| Akusetshenziselwa | Ukuthola isifo somphimbo esisebenzayo, noma ukukhetha ama-antibiotics omphimbo obuhlungu |
| Kuvame ukuphindwa | Yebo, isampula yesibili ngemva kwamasonto amabili kuya kwamane ukuze ubheke ukuthambekela okukhuphukayo noma okuwayo |
Obeye aziwe njengo
- Isiqu se-ASO / isiqu se-ASLO
- Ukuhlolwa kwe-antibody ye-Antistreptolysin O
- Ukuhlolwa kwe-Strep antibody
- Okuvame ukukhulunywa ngakho emitholampilo yaseNdiya ngokuthi "ukuhlolwa kwegazi lomkhuhlane wamathambo" noma "ukuhlolwa kwe-ASO kobuhlungu bamalunga", kokubili kuyizincazelo ezikhululekile, hhayi izincazelo ezinembile.
Kuyini ukuhlolwa kwe-ASO
I-Group A Streptococcus ikhipha ubuthi obubizwa ngokuthi i-streptolysin O. Amasosha omzimba asabela ngokwenza ama-antibodies ngokumelene nalolo buthi. Ukuhlolwa kwe-ASO kulinganisa ukuthi kungakanani kwalolo buthi obukhona egazini, okubikwe njenge-titre ku-IU/mL.
Amazinga e-antibody avame ukuqala ukukhuphuka cishe isonto kuya enyangeni ngemva kokutheleleka, afike phezulu emavikini alandelayo, bese ehla kancane kancane ezinyangeni. Ngenxa yalokhu kubambezeleka, ukuhlolwa kwe-ASO kubonisa impendulo yomzimba entweni eseyenzekile kakade. Kuwuphawu lokuvezwa, hhayi inani lamagciwane aphilayo.
Kungani kwenziwa ukuhlolwa kwe-ASO
- Umkhuhlane we-rheumatic osolwayo ophuthumayo: ubuhlungu bamalunga nokuvuvukala, umkhuhlane, i-carditis, i-chorea noma izimpawu zesikhumba eziphawulekayo ngemva kokutheleleka komphimbo. Ubufakazi bokutheleleka kwangaphambilini kwe-streptococcal buyingxenye yezindlela zikaJones.
- I-glomerulonephritis okusolwayo ngemuva kwe-streptococcal: umchamo onombala we-cola, ukuvuvuka kobuso, ukwehla kokukhishwa komchamo noma umfutho wegazi ophakeme enganeni noma kumuntu osemusha ngemuva kokutheleleka emphinjeni noma esikhumbeni.
- Ukugula okungachazeki ngemva komphimbo obuhlungu: lapho ukutheleleka kokuqala kwakuncane, kungelashwa noma kungakaze kuhlolwe.
- Landelela: kuphindaphindwa ngezikhathi ezithile ukuze kuhlolwe ukuthi isiqu siyaphakama noma siyahlala.
Ubani okufanele athole lolu vivinyo
- Izingane kanye nentsha enezinhlungu ezintsha zamalunga ezifudukayo kanye nokuvuvukala, umkhuhlane, noma ukunyakaza okungajwayelekile okungazikhetheli emasontweni ambalwa ngemva komphimbo obuhlungu.
- Abantu abanomchamo omusha onombala wetiye noma we-cola, ukuvuvukala eduze kwamehlo noma umfutho wegazi omusha ngemuva kokutheleleka emphinjeni noma esikhumbeni.
- Abantu abahlolwa ngenxa yesifo senhliziyo esisolwayo samathambo, kanye nokuhlolwa kwezokwelapha kanye ne-echocardiography.
- Iziguli ezihlolwa ngochwepheshe ukuze zithole ukuvezwa okuthile kwezinzwa noma kwe-nephrological ngemva kokutheleleka.
Ubani ovame ukungadingi ukuhlolwa kwe-ASO: noma ubani onomphimbo olula obuhlungu. Ukuhlolwa kwe-throat swab noma ukuhlolwa kwe-antigen okusheshayo kuphendula lowo mbuzo. Ukuhlolwa kwe-ASO akufanele futhi kusetshenziswe njengokuhlolwa okuvamile kubantu abaphilile, noma njengokuhlolwa okuvamile kokukhathala okungacacile noma ubuhlungu bamalunga obuhlala isikhathi eside, ngoba ukuphakama kwama-titre kuvamile kubantu abaningi abangenazo izifo.
Lokho ukuhlolwa kwe-ASO okungenakukuthola noma okungakukhiphi
- Ayikwazi ukuxilonga ukutheleleka komphimbo okusebenzayo kwe-streptococcal. Ama-antibodies athatha isikhathi ukuvela, ngakho-ke ekuqaleni kokutheleleka ukuhlolwa kwe-ASO kungaba okuvamile ngenkathi umphimbo ugcwele amagciwane.
- Ayikwazi ukuxilonga umkhuhlane wamathambo noma i-glomerulonephritis ngokwayo. Ukuhlolwa kwe-ASO kunikeza ubufakazi obubodwa obusekelayo. Ukuxilongwa kuncike ezicini zokwelashwa, ukuhlolwa, i-echocardiography, ukuhlolwa komchamo kanye nokusebenza kwezinso.
- I-ASO titre evamile ayikuvimbeli ukutheleleka kwe-streptococcal kwakamuva. Ingxenye yabantu abangenwe yileli gciwane ayikaze ithole impendulo ye-ASO elinganisekayo. Ukutheleleka kwesikhumba kwe-streptococcal (i-pyoderma, impetigo) kuvame ukukhiqiza impendulo ye-ASO embi; i-anti-DNase B ngokuvamile iwusizo kakhulu lapho.
- I-ASO titre ephakanyisiwe ayikutsheli ukuthi ukutheleleka kwenzeke nini, ukuthi kube kubi kangakanani, noma ukuthi izinkinga zizolandela yini. Ama-Titre angahlala ephakeme izinyanga eziningi ngemva kokululama ngokuphelele.
- Ukuhlolwa kwe-ASO akubonisi uhlobo lwebhaktheriya, futhi akuqondisi ukukhetha ama-antibiotic.
- Ayikwazi ukuhlola umonakalo wevalvu yenhliziyo. Lokho kudinga i-echocardiography.
Umphumela ongabonisi ama-antibodies aphakanyisiwe awufani nokutheleleka okungafakwanga. Uma izimpawu ziqhubeka noma ziba zimbi naphezu komphumela we-ASO ojwayelekile, buyela kudokotela wakho ukuze ahlolwe kabusha.
Ukuhlolwa okuhlobene kodwa okuhlukile
| test | Umbuzo uyaphendula | Umehluko obalulekile ekuhlolweni kwe-ASO |
|---|---|---|
| Isiko le-throat swab | Ingabe i-group A Streptococcus ikhona emphinjeni njengamanje? | Ithola ukutheleleka kwamanje; ukuhlolwa kwe-ASO akwenzi. Kuthatha isikhathi ukuthi isiko likhule. |
| Ukuhlolwa kokutholwa kwe-antigen okusheshayo (i-RADT) | Ingabe i-antigen ye-streptococcal ikhona emphinjeni namuhla? | Impendulo esheshayo eseceleni kombhede mayelana nokutheleleka kwamanje. I-RADT engemihle enganeni ivame ukuqinisekiswa ngokusetshenziswa kwe-culture. |
| I-Anti-DNase B | Ingabe kukhona ubufakazi bokuthi ama-antibody athelelekile muva nje nge-streptococcal? | Olunye uphawu lwe-antibody. Ngokuvamile luwusizo kakhulu ngemva kokutheleleka kwesikhumba futhi luhlala isikhathi eside. Ngezinye izikhathi kwenziwa ngokuhlolwa kwe-ASO lapho eyodwa yodwa ingakaqiniseki. |
| I-CRP kanye ne-ESR | Ingabe kukhona ukuvuvukala okusebenzayo emzimbeni? | Izimpawu zokuvuvukala ezingaqondile ezisetshenziswa ukusekela nokuqapha umsebenzi womkhuhlane wamathambo. Azisho lutho nge-Streptococcus ngokuqondile. |
| I-Echocardiography (ukuhlolwa kwe-echo) | Ingabe ama-valve enhliziyo noma imisipha yenhliziyo iyathinteka? | Izithombe zenhliziyo. Okubalulekile ekuxilongweni kwe-rheumatic carditis; ukuhlolwa kwe-ASO akukwazi ukuhlola ama-valve. |
| Inqubo yomchamo kanye ne-microscopy, i-serum creatinine | Ingabe izinso zihilelekile? | Ithola igazi namaprotheni emchameni futhi ikala ukusebenza kwezinso ku-glomerulonephritis okusolwa ukuthi i-post-streptococcal glomerulonephritis. |
| I-rheumatoid factor / anti-CCP | Ingabe lokhu kuyisifo samathambo esibizwa ngokuthi i-rheumatoid arthritis? | Izimo ezihluke ngokuphelele. Ngokuvamile zididaniswa nokuhlolwa kwe-ASO ngoba zombili zihlelwe ubuhlungu bamalunga. |
Lezi zivivinyo azihlelwa kusukela kokuhle kakhulu kuya kokubi kakhulu. Ukuthi yikuphi okuza kuqala kuncike ekubonakaleni: umphimbo obuhlungu namuhla ukhomba ekuhlolweni kwe-swab noma ekuhlolweni okusheshayo kwe-antigen; ukuvuvukala kwamalunga okuhambisana nomkhuhlane emasontweni kamuva kukhomba ekuhlolweni kwezokwelapha, izimpawu zokuvuvukala, i-echocardiography kanye nokuhlolwa kwe-ASO ndawonye; umchamo oshintshile umbala ukhomba ekuhlolweni komchamo kanye nokusebenza kwezinso kuqala.
Ungalungiselela kanjani
- Ukuzila ukudla ngokuvamile akudingeki ekuhlolweni kwe-ASO. Amanye amalabhorethri acela ukuzila ukudla okufushane uma kwenziwa ezinye izivivinyo ezifana nama-lipid ngesikhathi esifanayo.
- Tshela udokotela we-phlebotomist kanye nodokotela ocelayo ngayo yonke imithi, okuhlanganisa ama-antibiotic, ama-steroid kanye nanoma yiziphi izithako ze-AYUSH, amakhambi noma zejimu, njengoba lokhu kungathinta isithombe sezokwelapha kanye nokuchazwa kwemiphumela.
- Ungaqali, umise noma ushintshe noma yimuphi umuthi onikezwe udokotela ukuze ulungiselele lokhu kuhlolwa. Khuluma nodokotela kuqala.
- Phatha umuthi kadokotela, imibiko ye-ASO yangaphambilini kanye nanoma yimiphi imibiko ye-throat swab noma ye-echo yangaphambilini, ukuze ilabhorethri kanye nodokotela wakho bakwazi ukuqhathanisa izitayela.
Imiyalelo yokulungiselela, ukuphathwa kwamasampula kanye nemikhuba yokubika yizindaba zokusebenza ezihlukile phakathi kwamalebhu. Imiyalelo enikezwa yiyunithi eqoqa isampula yakho iza kuqala kuneseluleko esijwayelekile.
Izingane
Chaza ukudonswa kwegazi ngamagama alula bese uletha into eduduzayo. Ukhilimu wokuhlanza igazi ungafakwa kusenesikhathi kwezinye izingxenye uma uhlelwe kusengaphambili. Kusetshenziswa ithubhu elincane lezingane.
ukukhulelwa
Ukuthatha igazi njalo ngokuvamile kulula kakhulu ekukhulelweni. Tshela abasebenzi uma uzizwa ubuthakathaka lapho uhleli noma ulele phansi, ukuze indawo yokuma ingalungiswa.
Abantu abanezinkinga zokopha noma abasebenzisa imithi yokunciphisa igazi
Yazisa abasebenzi abaqoqayo kusengaphambili. Kufakwa ingcindezi eqinile nende ngemva kokususwa kwenaliti. Ungazilungiseli wena izilinganiso ze-anticoagulant.
Abantu abadala kanye nabantu abanemithambo ebuthakathaka
Kungenzeka kakhulu ukuthi kube nokuphuka. Khuluma nganoma yiziphi imidwebo enzima yesikhathi esidlule ukuze kusetshenziswe udokotela we-phlebotomist onolwazi kanye nenaliti encane.
Kwenzekani ngesikhathi sokuhlolwa kwe-ASO
Kufakwa i-tourniquet, isikhumba siyahlanzwa, bese kuthathwe isampula encane yegazi emthanjeni, ngokuvamile emgodleni wengalo noma endololwaneni. Kufakwa ingcindezi ngemva kwalokho bese kufakwa ibhandeji elincane. Iningi labantu lizwa ukulunywa isikhashana.
Inqubo ithatha isikhathi esingakanani
Ukukhishwa kwegazi ngokwako kuthatha cishe imizuzu emi-2 kuya kwemi-5. Kubandakanya ukubhaliswa, ukuqinisekiswa kanye nengcindezi yangemva kokukhishwa, hlela imizuzu eyi-10 kuya kwengama-20 endaweni yokuqoqwa. Isikhathi sokucubungula ilabhorethri kanye nezikhathi zokubika ziyahlukahluka phakathi kwezikhungo; buza ideski lokuqoqwa ukuthi umbiko wakho uzotholakala nini. Uma udokotela wakho ecele amasampula abhangqiwe, ukukhishwa kwesibili kuvame ukuhlelwa cishe emavikini ama-2 kuya kwangama-4 kamuva.
Ukuqonda umbiko wakho we-ASO
Imiphumela ye-ASO ibikwa njenge-titre kumayunithi aphesheya nge-millilitre (IU/mL). Akukho ukunqunywa okukodwa okujwayelekile. Ilabhorethri ngayinye ibeka isikhathi sayo sokubhekisela ngokusekelwe endleleni esetshenzisiwe (i-nephelometry, i-turbidimetry noma i-latex agglutination) kanye nenani labantu elibakhonzayo. Ubudala bubalulekile futhi, njengoba izingane zesikole zivame ukuba ne-titres ephezulu kunabantu abadala ngenxa yokuchayeka njalo.
Ngenxa yalesi sizathu, funda ububanzi bezinkomba obuphrintiwe embikweni wakho kunokuba ububanzi obucashunwe kuwebhusayithi. Ukuqhathanisa umphumela we-ASO nesibalo esivela elabhorethri ehlukile noma indlela ehlukile kungadukisa.
Kusho ukuthini ukuthi i-ASO titre ephakanyisiwe
I-titre ephakanyisiwe ikhombisa ukuthi isimiso somzimba sokuzivikela sike sabhekana ne-group A Streptococcus esikhathini esithile esikhathini esidlule. Ayiqinisekisi ukutheleleka kwamanje, ayiqinisekisi umkhuhlane wamathambo, futhi ayibikezeli izinkinga. Izingane eziningi ezinempilo kanye nabantu abadala, ikakhulukazi ezindaweni lapho ukutheleleka kwe-streptococcal kuvame khona, baphatha i-titre ephakanyisiwe ngaphandle kokugula.
Kusho ukuthini ukuthi i-ASO titre evamile noma ephansi
I-titre evamile yenza ukutheleleka kwe-streptococcal kwakamuva kungabi namathuba amaningi kodwa ayikukhiphi ngaphandle, ikakhulukazi uma isampula ithathwe kusenesikhathi, noma uma ukutheleleka bekusesikhumbeni kunokuba kube emphinjeni. I-Anti-DNase B ingangezwa ezimweni ezinjalo.
Kungani lo mkhuba ubaluleke ngaphezu kwenombolo eyodwa
I-tit ekhuphuka ngokusobala phakathi kwamasampula amabili athathwe emavikini ambalwa iwubufakazi obuqinile bokutheleleka kwamuva kunenani elilodwa eliphakeme. I-tit ewayo iphakamisa ukutheleleka okuyaphela. Udokotela wakho uchaza indlela yokushintsha kanye nezimpawu kanye nezinye izivivinyo.
Akukho mphumela wokuhlolwa kwe-ASO okufanele uhunyushwe njengokuxilongwa. Ukuhumusha kungokwasemtholampilo ocele ukuhlolwa futhi uyazi umongo wakho wezokwelapha.
Uma imiphumela ye-ASO ingadukisa
Izimo ezingaphakamisa i-ASO ngokungafanele
- Amasampula e-lipid (amafutha) noma ane-hemolysis angaphazamisa izindlela ze-turbidimetric kanye ne-nephelometric.
- Ezinye izimo zesibindi kanye ne-hyperlipidemia kuye kwahlotshaniswa nokwenyuka okungaqondile.
- Ukuthwala i-streptococcal ngaphandle kokugula, ukuthwala into ephilayo ngaphandle kokulimala kusengakhiqiza ama-antibodies, abese kuthiwa yisifo ngokungalungile.
- Ama-antibodies aqhubekayo avela ekuthelelekeni ezinyangeni ezedlule, ahlobene nesikhalazo samanje.
- Ukusebenzisa isikhawu somuntu omdala sengane yesikole, okungenza isiqu sobuntwana esijwayelekile sibukeke singajwayelekile.
Izimo ezingase zehlise i-ASO titre ngamanga
- Ukuhlolwa kusenesikhathi kakhulu, ngaphambi kokuba ama-antibodies abe nesikhathi sokukhula.
- Ukwelashwa kwasekuqaleni ngama-antibiotic okutheleleka kokuqala, okunganciphisa impendulo yama-antibody.
- Ukutheleleka kwesikhumba kwe-streptococcal, okuvame ukudala impendulo ebuthakathaka ye-ASO.
- Ukunciphisa amasosha omzimba ngenxa yezifo noma imithi, okunciphisa ukukhiqizwa kwama-antibody.
- Ukuhlolwa sekwephuzile kakhulu, ngemuva kokuba ama-titres esehlile kakade.
Ukuqhathaniswa kwelebhu ehlukahlukene
Izindlela ezahlukene kanye nezikhawu ezahlukene zokubhekisela kusho ukuthi imibiko emibili evela kuma-laboratories amabili ingase ingafani ngqo. Ekuqapheni okulandelanayo, ukusebenzisa i-laboratory efanayo kanye nendlela lapho kusebenza khona kwenza lo mkhuba ube nenjongo kakhudlwana.
Izingozi nokuphepha kokuthathwa kwegazi
Ukuhlolwa kwe-ASO kuhilela ukudonswa kwegazi okujwayelekile emithanjeni. Imiphumela eqashelwayo yileyo yanoma yikuphi ukubhoboza kwemithambo yegazi, futhi ngokuvamile incane.
Okuvamile, ngokuvamile okuncane
- Ubuhlungu obufushane noma ukuhlaba endaweni yenaliti
- Ukulimala okuncane noma ubuthakathaka usuku olulodwa noma ezimbili
- Ubuthakathaka, ikakhulukazi kulabo abakhathazekile noma abangakadli
Okungajwayelekile
- Ukuquleka ngesikhathi noma ngemva nje kokudonswa
- I-hematoma enkulu, evame kakhulu kubantu abasebenzisa imithi yokuvimbela ukugabha kwegazi noma abanezinkinga zokopha
- Phinda uzame uma imithambo yegazi kunzima ukuyifinyelela
ezingavamile
- Ukutheleleka kwendawo endaweni yokubhoboza
- Ukucasuka kwemizwa okubangela ukuthuthumela engalweni
Imiphumela kanye nokuhlangenwe nakho kuyahlukahluka kuye ngezimo zomtholampilo ngazinye.
Amafulege abomvu
Isimo esiphuthumayo manje
- Ukuphelelwa umoya lapho uphumule, ubuhlungu besifuba, noma ukungakwazi ukulala phansi
- Ukunciphisa ngokushesha noma ukungabikho komchamo ophumayo ngenxa yokuvuvukala
- Ukuquleka, ukudideka noma ikhanda elibuhlungu elihambisana nomfutho wegazi ophakeme kakhulu
- Umkhuhlane omkhulu onentamo eqinile, ukozela, noma ukutheleleka kwesikhumba okusabalala ngokushesha futhi okubuhlungu kakhulu
Ngosuku olufanayo
- Umchamo omusha onombala we-cola noma onamabala egazi, noma ukuvuvukala okuzungeze amehlo
- Umkhuhlane omusha onamajoyinti abuhlungu, avuvukile, ashisayo, ikakhulukazi enganeni noma esemncane
- Ukushaya kwenhliziyo, ukukhathala okungavamile lapho uzikhandla, noma ukuvuvukala kweqakala ngemva kokutheleleka komphimbo muva nje
- Ukunyakaza okusha okungahleliwe noma ushintsho olusheshayo ekubhaleni noma ekuhlanganiseni komntwana
- Umphimbo obuhlungu kanye nokuvuza amathe, ubunzima bokugwinya noma ubunzima bokuvula umlomo
I-aphoyintimenti ejwayelekile
- I-ASO titre ephakanyisiwe ibikwe kumuntu ozizwa kahle
- Ubuhlungu obuncane bamalunga obuhlala isikhathi eside ngaphandle komkhuhlane noma ukuvuvukala
- Ukuxoxa ngokuthi kuyadingeka yini ukuhlolwa kwe-ASO okuphindaphindiwe noma i-anti-DNase B
- Ukuhlela ukulandelwa kwesikhathi eside kokuvimbela i-penicillin uma kutholakale ukuthi umkhuhlane wamathambo ukhona
Izimo ezikhethekile
Izingane kanye nentsha
Leli yiqembu lapho ukuhlolwa kwe-ASO kuvame ukuba usizo kakhulu emtholampilo, ngoba umkhuhlane we-rheumatic obukhali kanye ne-post-streptococcal glomerulonephritis kuthinta kakhulu izingane kanye nabantu abasha. Izibalo eziyisisekelo ziphakeme ngokwemvelo ezinganeni zesikole, ngakho-ke inani eliphakanyisiwe kancane kumntwana ophilile livame ukukhombisa ukuchayeka okuvamile esikhathini esidlule kunokuba kubonise isifo.
ukukhulelwa
Ukuhlolwa kwe-ASO kwenziwa ngesikhathi sokukhulelwa lapho kuboniswe khona ngokwezokwelapha. Owesifazane onesifo senhliziyo esaziwayo samathambo udinga ukubuyekezwa kwenhliziyo kanye nokuhlolwa kokubeletha, njengoba ukukhulelwa kwandisa umthwalo kuma-valve athintekile. Ukuhlolwa kwe-ASO akuhloli ukusebenza kwe-valve.
Abantu abadala abadala
Umkhuhlane omusha we-rheumatic fever awuvamile kubantu abadala, ngakho-ke i-ASO titre ephezulu kuleli qembu cishe ayichazi izimpawu futhi kufanele kufunwe ezinye izimbangela.
Abantu abanesifo sezinso esingamahlalakhona
I-post-streptococcal glomerulonephritis iyimbangela eyodwa kuphela yokuvuvukala kwezinso. Kubantu abanesifo sezinso esikhona, ukuhlolwa kwe-ASO kufanele kufundwe kanye nokutholakele komchamo, amazinga ahambisanayo lapho kuboniswe khona, kanye nokuhlolwa kwe-nephrology.
Abantu abacindezelwe amasosha omzimba
Izimpendulo zama-antibody zingancishiswa yisifo noma ngokwelashwa okucindezela amasosha omzimba, ngakho-ke i-ASO titre evamile ayiduduzi kangako kuleli qembu.
Isifo senhliziyo esinama-rheumatic esisunguliwe
Uma isifo senhliziyo esibangelwa amathambo sesitholakele, ukuphathwa kugxila ekuvimbeleni kwesibili kanye nokulandelela inhliziyo, hhayi ekulandeleni ngokuphindaphindiwe i-ASO titre. Ukuhlolwa kwe-serial ASO akulinganisi umonakalo we-valve noma kuqondise ubude besikhathi sokuvimbela.
Ukuhlolwa kwe-ASO kumongo waseNdiya
Umkhuhlane we-rheumatic obukhali kanye nesifo senhliziyo se-rheumatic kusalokhu kuyimbangela ebalulekile yesifo senhliziyo esingavinjelwa eNdiya, ikakhulukazi phakathi kwezingane kanye nabantu abadala abasebasha, futhi kuvame kakhulu lapha kunasemazweni amaningi anemali engenayo ephezulu. Lokhu kwenza izimo zezokwelapha ngemuva kokuhlolwa kwe-ASO zibaluleke ngempela enkambisweni yaseNdiya, futhi kuchaza nokuthi kungani amazinga e-antibody angemuva kubantu abaningi angaba phezulu kunezibalo zaseNtshonalanga ezishicilelwe.
Amaphuzu awusizo abalulekile endaweni:
- Itemu: Isivivinyo sibhalwa kabanzi ngokuthi "i-ASO titre" noma "i-ASLO" emibhalweni yaseNdiya. I-echocardiogram ivame ukubizwa ngokuthi "isivivinyo se-echo".
- Uku-oda ngokweqile ngenxa yobuhlungu bamalunga: Ukuhlolwa kwe-ASO kuvame ukucelwa kunoma yimuphi umuntu omdala onezinhlungu zamalunga. Kubantu abadala abanezinhlungu zamalunga ezingapheli futhi abangenazo izimpawu zomkhuhlane wamalunga, i-titre ephakanyisiwe ivame ukukhombisa ukuchayeka esikhathini esidlule futhi ayichazi izimpawu. I-Anti-CCP, i-rheumatoid factor, i-uric acid noma i-imaging kungaba yindlela efanele yokubuza.
- Ukusetshenziswa kwama-antibiotic ngaphandle kwemithi kadokotela kuvamile futhi kunganciphisa impendulo ye-antibody, kwehlise i-tit naphezu kokutheleleka kwangempela kwakamuva.
- Izifo zesikhumba njenge-impetigo kanye ne-pyoderma ehlobene nokhwekhwe kuvamile futhi kuvame ukuhlotshaniswa ne-post-streptococcal glomerulonephritis kune-rheumatic fever; Izimpendulo ze-ASO ngemva kokutheleleka kwesikhumba zivame ukuba buthakathaka, ngakho-ke i-anti-DNase B ingase ikhethwe.
- Ukuvimbela okwesibili: lapho kuqinisekiswa khona umkhuhlane we-rheumatic obukhali, ukuvimbela ama-antibiotic isikhathi eside kanye nokulandelela kwenhliziyo okuhlelekile kubalulekile. Noma yiluphi ushintsho ohlelweni lokuvimbela kumele luvele kudokotela olaphayo.
Izindleko kanye nomshuwalense eNdiya
Ukuhlolwa kwe-ASO kuwukuhlolwa kwe-serum okungabizi kakhulu uma kuqhathaniswa namaphaneli e-imaging noma e-immunology akhethekile, yize intengo eqondile ihlukahluka kakhulu phakathi kwamadolobha, izintambo zelebhu, izikhungo zikahulumeni kanye nezibhedlela ezizimele. Izindleko ezicashunwe noma kuphi ku-inthanethi ziyizinkomba kuphela; qinisekisa inkokhelo yamanje ngqo nelebhu ngaphambi kokuba isampula yakho iqoqwe.
Izici ezithonya lokho okukhokhayo:
- Indlela esetshenzisiwe: Ukuhlolwa kwe-latex agglutination kuvame ukushibhile kune-quantitative nephelometry noma i-turbidimetry.
- Ukubika okunekhwalithi uma kuqhathaniswa nokubika okunenani: Isiqu sezinombolo ngokuvamile sibiza okungaphezu kwesikrini esihle/esibi.
- Ukuhlanganisa: Ukuhlolwa kwe-ASO kuvame uku-oda nge-CRP, i-ESR kanye nokubalwa kwegazi okuphelele; amazinga ephakheji anganciphisa izindleko zokuhlolwa ngakunye.
- Ukuhlolwa okuphindaphindiwe: amasampula abhangqiwe asho ukukhokha kabili.
- Iqoqo lasekhaya kunezela ishaja ye-phlebotomy kumanethiwekhi amaningi.
- Ukucutshungulwa okuphuthumayo noma kwangemva kwamahora okusebenza kungase kudonse i-premium.
- Ukugunyazwa kanye nesigaba sedolobha: Amalabhorethri agunyazwe yi-NABL emadolobheni amakhulu ngokuvamile akhokhisa imali eningi.
Umshwalense: izivivinyo zokuxilonga iziguli zangaphandle azimbozwa umshwalense wezempilo ojwayelekile ngaphandle kokuthi umgibeli we-OPD afake isicelo. Uma ukuhlolwa kwe-ASO kuyingxenye yesigameko sesibhedlela esingenisiwe, kuvame ukufakwa esicelweni sokulaliswa esibhedlela. Ukumbozwa kwesikimu sezempilo sikahulumeni nesifundazwe kuyahluka ngohlelo. Hlola nomshwalense wakho noma ideski lokukhokhisa esibhedlela.
Izinganekwane namaqiniso
| Inganekwane | Iqiniso |
|---|---|
| I-ASO titre ephezulu isho ukuthi une-rheumatic fever. | I-tit ephezulu ibonisa kuphela ukuchayeka esikhathini esidlule ku-group A Streptococcus. I-rheumatic fever iwukuxilongwa kwezokwelapha kusetshenziswa izindlela ezichaziwe, lapho ukuhlolwa kwe-ASO kuyisici esisodwa esisekelayo. |
| Umphumela ojwayelekile we-ASO uvimbela ukutheleleka kwe-streptococcal. | Kwenza kube lula, hhayi ukukhishwa ngaphandle. Ukuhlolwa kwasekuqaleni, ama-antibiotic angaphambilini, izifo zesikhumba kanye nokucindezela amasosha omzimba konke kungagcina inani eliphansi. |
| Ukuhlolwa kwe-ASO kukutshela ukuthi udinga ama-antibiotics yini ukuze uphathe umphimbo obuhlungu. | Akunakwenzeka. Ukutheleleka komphimbo kwamanje kuhlolwa ngokuhlolwa kwezokwelapha, ukuhlolwa okusheshayo kwe-antigen noma ukukhuliswa komphimbo. |
| Kufanele uphinde isivivinyo se-ASO kuze kube yilapho inombolo yehla. | Ama-Titre ancipha kancane ezinyangeni futhi angahlala ephakanyisiwe isikhathi eside ngemva kokululama. Ukuphishekela inani ngaphandle kwezimpawu akuvamile ukuba usizo. Landela uhlelo lukadokotela wakho. |
| Zonke izimo zobuhlungu bamalunga zidinga ukuhlolwa kwe-ASO. | Kubantu abadala abanobuhlungu obungapheli bamalunga futhi abangenazo izici zangemuva kwe-streptococcal, ukuhlolwa kwe-ASO akuvamile ukushintsha ukuphathwa futhi kungabangela ukukhathazeka okungadingekile. |
| Noma yiluphi uhla lwereferensi ye-ASO yelabhorethri luyasebenza embikweni wakho. | Izikhawulo ziyahlukahluka ngokwendlela kanye nenani labantu. Sebenzisa ububanzi obuphrintiwe embikweni wakho. |
Imibuzo ejwayelekile ukubuzwa
Ingabe ukuzila ukudla kuyadingeka ngaphambi kokuhlolwa kwe-ASO?
Ukuzila ukudla ngokuvamile akudingekile ekuhlolweni kwe-ASO, njengoba amazinga e-antibody engathinteki ekudleni kwakamuva. Amanye amalabhorethri asacela ukuzila ukudla okufushane uma kuthathwa ukuhlolwa kwe-lipid noma kwe-glucose kusampula efanayo. Landela imiyalelo ethile enikezwe yilabhorethri eqoqa igazi lakho.
I-ASO titer iphakama isikhathi esingakanani ngemva komphimbo obuhlungu?
Ama-antibodies e-Antistreptolysin O avame ukuqala ukwanda cishe isonto elilodwa kuya kwamane ngemva kokutheleleka komphimbo we-streptococcal futhi afinyelele esicongweni emavikini alandelayo. Ukuhlolwa kusenesikhathi kakhulu kunganikeza umphumela ojwayelekile naphezu kokutheleleka kwangempela. Yingakho odokotela bevame ukucela isampula yesibili emavikini ambalwa kamuva ukuze babheke ukuthambekela okukhulayo.
Ingabe i-ASO tit ingahlala iphezulu unomphela?
Ama-titre avame ukwehla kancane kancane ezinyangeni ezimbalwa ngemva kokutheleleka, yize izinga lihluka kakhulu phakathi kwabantu. Abanye abantu bagcina amazinga aphakeme kancane isikhathi eside ngaphandle kokugula. I-titre ephakanyisiwe njalo kumuntu ozizwa ephilile akuyona yona ngokwayo imbangela yokwelashwa noma ukuhlolwa okuphindaphindiwe.
Uyini umehluko phakathi kokuhlolwa kwe-ASO kanye ne-anti-DNase B?
Zombili zithola ama-antibodies eqembu A Streptococcus. Ukuhlolwa kwe-ASO kusabela kahle ngemva kokutheleleka komphimbo kodwa ngokuvamile kubi ngemva kokutheleleka kwesikhumba, lapho i-anti-DNase B isebenza kangcono futhi ihlala isikhathi eside. Odokotela ngezinye izikhathi bayala kokubili uma umphumela owodwa ungacacile kodwa izinsolo zezokwelapha zokutheleleka kwe-streptococcal kwakamuva zisekhona.
Ingabe i-ASO titre ephezulu idinga ama-antibiotic?
I-ASO tit ephakanyisiwe iyodwa ayilona uphawu lwe-antibiotic, ngoba ibonisa impendulo yokuzivikela komzimba esikhathini esidlule kunokuba ibonise ukutheleleka okusebenzayo. Ama-antibiotic anqunyelwe ukutheleleka kwamanje noma njengendlela yokuvimbela isikhathi eside ngemva komkhuhlane wamathambo oqinisekisiwe. Udokotela wakho kuphela onganquma, ngokusekelwe esithombeni sakho esiphelele sezokwelapha.
Ingane yami ine-ASO titer ephezulu kodwa ayinazo izimpawu. Ingabe kufanele ngikhathazeke?
Izingane zesikole zivame ukuba namazinga aphezulu e-ASO ngenxa yokuchayeka njalo kwe-streptococcal, okuvame ukungabonwa. Kumntwana ophilile ongenawo umkhuhlane, ukuvuvukala kwamalunga, ukunyakaza okungavamile noma izinguquko zomchamo, ukuphakama kwe-tit kukodwa akusho ukuthi unesifo. Xoxa ngombiko nodokotela wezingane zakho kunokwenza okuthile ngenani.
Ingabe ukuhlolwa kwe-ASO kungakuthola isifo senhliziyo esinama-rheumatic?
Cha. Ukuhlolwa kwe-ASO akukwazi ukuhlola ama-valve enhliziyo noma imisipha yenhliziyo. Isifo senhliziyo esihambisana namathambo sitholakala futhi siqashwe ngokuhlolwa kwezokwelapha kanye ne-echocardiography, ngezinye izikhathi nge-ECG kanye nesithombe sesifuba. Ukuhlolwa kwe-ASO kunikela kuphela ubufakazi bokuthi ukutheleleka kwe-streptococcal kwenzeke esikhathini esithile ngaphambilini.
Ingabe kufanele ngithole ukuhlolwa kwe-ASO njengengxenye yokuhlolwa kwempilo okuvamile?
Ukuhlolwa kwe-ASO akukhuthazwa njengokuhlolwa okuvamile. Kubantu abangenazo izimpawu ezifanele, ukuphakama kwe-titres kuvamile futhi ngokuvamile akunamsebenzi, okuholela ekukhathazekeni okungadingekile nasekuhlolweni okuqhubekayo. Ukuhlolwa kwe-ASO kuyasiza lapho udokotela esola ngokuqondile inkinga yangemva kwe-streptococcal.
Ingabe ngidinga ukusebenzisa ilebhu efanayo ekuhlolweni kwe-ASO okuphindaphindiwe?
Lapho kusebenza khona, yebo. Amalabhorethri ahlukene asebenzisa izindlela ezahlukene kanye nezikhawu zokubhekisela, ngakho-ke ama-titre awafani ngaso sonke isikhathi phakathi kwawo. Ukusebenzisa ilabhorethri efanayo kanye nendlela yamasampula abhangqiwe kwenza kube lula kudokotela wakho ukwahlulela ukuthi i-titre iyakhuphuka noma yehla ngempela.
Imithombo
- I-World Health Organization, amaphepha emininingwane yesifo samathambo kanye nesifo senhliziyo samathambo kanye nemibiko yobuchwepheshe
- I-American Heart Association, ibuyekeze izindlela zikaJones zokuxilonga umkhuhlane we-rheumatic obukhali enkathini ye-Doppler echocardiography
- I-Indian Academy of Pediatrics, isiqondiso ngomkhuhlane we-rheumatic obukhali kanye nesifo senhliziyo se-rheumatic ezinganeni
- UMkhandlu WaseNdiya Wocwaningo Lwezokwelapha, isiqondiso sokwelashwa kwezifo ezilwa namagciwane kanye nezifo ezithathelwanayo
- Izinkomba ezijwayelekile zelabhorethri yemitholampilo nge-serology ye-streptococcal, okuhlanganisa nemikhawulo ye-ASO kanye nokuhlolwa kwe-anti-DNase B
