Mob raum raug mob Vim Myoglobin Cast Nephropathy hauv Kev Teeb Meem Ntawm Tus Kab Mob Coronavirus 2019-kev kho mob Rhabdomyolysis: Ib Daim Ntawv Qhia Txog Ⅱ

Kev kuaj mob diferential

Cov kev kuaj mob sib txawv rau rhabdomyolysis thiab myoglobin cast nephropathy yog dav [1-4]. Kev raug mob los yog cov leeg nqaij ntau dhau vim kev siv ntau dhau xws li kev tawm dag zog hnyav tuaj yeem ua rau tus txheej txheem no. Toxin-mediated rhabdomyolysis vim yog cov tshuaj xws li cocaine tau txiav txim siab, tab sis tus neeg mob no tsis muaj keeb kwm ntawm kev quav yeeb tshuaj. Nws kuj tsis tau tshaj tawm tej kab lossis tsiaj tom. Drug-induced rhabdomyolysis yog ib qho ua tau txij li nws nyob ntawm statin tsawg kawg ib xyoos. Txawm li cas los xij, feem ntau ntawm statin-induced myopathies tshwm sim hauv ib nrab xyoo ntawm kev pib, txawm tias qhov tshwm sim tuaj yeem tshwm sim tsis tshua muaj tom qab lub sijhawm no [5]. Tere yog ib tug xov tooj ntawm contributors rau rhabdomyolysis, nrog rau kev siv cov tshuaj kws kho mob (piv txwv li, salicylates, antipsychotics, thiab benzodiazepines) thiab nonmedical siv tshuaj (piv txwv li, cocaine, cannabis, gamma hydroxybutyrate / gamma-butyrolactone, amphetamine, heroin , thiab alco hol), nrog rau kev raug mob los yog txo qis perfusion hauv qhov chaw ntawm qaug dab peg. Nws tsis pom zoo siv cawv, thiab tsis muaj lwm yam xwm txheej no tau tshaj tawm los ntawm tus neeg mob. Qhov no yuav tsis yog thawj etiology ntawm nws rhabdo myolysis, muab nwsmob raum raug mobmob siab txawm tias nws cov tshuaj statin tau tuav thaum mus pw hauv tsev kho mob. Tsis tas li ntawd, myopathy lossis myositis vim muaj ntau yam etiologies suav nrog kev kis tus kab mob - txawm tias tsis tshua muaj - yuav tsum tau txiav txim siab, raws li tau sau tseg nrog qhov sib txuam ntawm SARS-CoV-2 tus kab mob thiab nws rhabdomyolysis. Lwm cov kab mob sib kis uas tuaj yeem ua rau mob raum raug mob thiab rhabdomyolysis suav nrogmob khaub thuas, kab mob adenovirus,kab mob coxsackievirus, Epstein-Barr tus kab mob, cytomegalovirus, Human Immunodeficiency Virus(HIV), herpes simplex virus, parainfluenza virus [5]. Tsis tas li ntawd, electrolyte lossis osmolar abnormalities kuj yuav raug txiav txim siab ib yam nkaus, txawm hais tias cov no tsis ua rau tus neeg mob qhov teeb meem no.

NYEM QHOV NO kom tau txais CISTANCHE rau kev tiv thaiv lub raum tsis zoo

Kev kho mob

Tus neeg mob nws thiaj li yuav tsum tau hemodialysis tsis tu ncua rau 5 hnub, kom txog thaum nws lub raum ua haujlwm thiab cov zis tso zis maj mam rov zoo. Ib lub lis piam tom qab thiab tom qab ntawd, nws tau tsim tawm ntau tshaj li ib liter ntawm cov zis txhua hnub thiab tsis tas yuav hloov lub raum, thiab nws tus Quinton catheter raug tshem tawm.

Cov txiaj ntsig thiab kev ua raws Nws tau raug tso tawm mus rau qhov chaw kho mob luv luv uas nws nyob rau ob peb lub lis piam vim nws lub xeev deconditioned. Thaum kawg, tus neeg mob lub raum ua haujlwm tau zoo rov qab mus rau nws cov hauv paus ntsiab lus 6 lub lis piam tom qab nws kuaj pom thawj zaug ntawm COVID-19. Tus neeg mob tau tshaj tawm tias nws ua tsaug rau nws txoj kev txhim kho hauv nws tus mob. Thaum kawg nws tau txais nws koob thib ob ntawm mRNA-1273 COVID-19 tshuaj tiv thaiv 6 lub hlis tom qab qhov ntsuas tau mus pw hauv tsev kho mob. Nyob rau hauv ib ntus, hauv kev teeb tsa ntawm nws ntau yam mob sib kis, nws tau mus pw hauv tsev kho mob ntau zaus hauv ib ntus nrog rau kev ua tsis tiav kom muaj kev vam meej muab 30- phaus poob hauv qhov teeb meem ntawm deconditioning, mob ntsws obstructive pulmonary exacerbation, atrial fibrillation nrog ceev ventricular teb, thiab cov zej zog kis mob ntsws. Tom qab 6 lub hlis tom qab, nws lub raum ua haujlwm nrog rau creatinine thiab glomerular pom tus nqi tseem nyob li qub. Txawm li cas los xij, qhov no tuaj yeem cuam tshuam los ntawm kev poob phaus. Nws tsis muaj mob los yog mob.

Daim duab 3 Lub raum biopsy histopathology nyob rau hauv lub teeb microscopy nrog immunohistochemistry zoo heev rau myoglobin nyob rau hauv casts hauv tubules (pom los ntawm xub) (cell marque, thawj magnification, 200 ×). B Granular casts nrog diffuse mob tubular raug mob (hematoxylin thiab eosin; thawj magnification, 200 ×). C Ultrastructural kev tshawb fawb qhia corrugation ntawm glomerular qab daus daim nyias nyias thiab segmental ko taw txheej txheem effacement (thawj magnification, 6300 ×)

Kev sib tham thiab xaus

Peb piav qhia txog qhov xwm txheej no ntawm COVID-19- cuam tshuammob raum raug mobnrog rhabdomyolysis thiab lub raum tsis zoo rau lub raum biopsy ua qauv qhia txog myoglobin cam khwb cia nephropathy, ntxiv rau cov xwm txheej txwv thiab cov ntaub ntawv tshaj tawm ntawm COVID-19- cuam tshuam rau mob raum mob thiab rhabdomyolysis.

Nws tau kwv yees tias, txog li ib ntawm kaum tus neeg mob uas muaj lub raum tsis zoo, rhabdomyolysis tej zaum yuav yog lub hauv paus etiology [2]. Raws li cov leeg nqaij tawg, myoglobinemia tuaj yeem tshwm sim, ua rau myoglobinuria thiab myoglobin cam khwb cia nephropathy [2]. Hauv ib txoj kev tshawb fawb uas tau txheeb xyuas cov txiaj ntsig ntawm 27,850 lub raum biopsies ua nyob rau hauv ib lub tsev kawm ntawv, 214 tus neeg mob ntawm myoglobin pov tseg tau raug sau tseg, qhia tias qhov tshwm sim tsis yog qhov tsis tshua muaj [2].

Mob raum raug mobnyob rau hauv cov neeg mob uas muaj tus kab mob COVID-19 tuaj yeem tshwm sim raws li ntau yam ntawm cov kab mob pathophysiologic uas yuav tshwm sim ib leeg lossis ua ke, suav nrog mob ntsws, vascular, glomerular, thiab interstitial raug mob [3, 4]. Hauv ib txoj kev tshawb fawb, kwv yees li ib ntawm plaub tus neeg tau pw hauv tsev kho mob nrog COVID-19 tau raug mob raum mob [3]. Lub pathophysiology ntawm mob raum raug mob vim yog COVID-19 tseem tsis tau paub meej. Ib qho kev xav ntawm lub cev muaj xws li kev ua phem rau hauv zos thiab lub cev, thiab tom qab cytokine (uas yog qog necrosis factor (TNF)-) tso tawm, uas ua rau raug mob ntawm endothelial system thiab coagulopathy, nrog rau kev ua kom lub zog ntawm renin-angiotensin system [3] , 5] ib. Cov txheej txheem caj ces hauv qab tau tshaj tawm xws li qhov tshwm sim ntawm COVID-19- txuam nrog glomerulopathy hauv cov neeg uas muaj qee yam apolipoprotein L1 genotypes [4]. Hauv qhov xwm txheej no, tus neeg mob lub raum biopsy qauv histopathology muaj qhov tsis zoo SARS-CoV-2 immunostaining. Nws tsim nyog hais tias lub raum tsis ua haujlwm vim yog COVID-19 feem ntau tsis ncaj qha rau SARS-CoV-2. Cov kev tshawb fawb txog kev puas hlwb tau pom tias SARS-CoV-2 tus kab mob RNA tuaj yeem kuaj pom hauv lub raum cov ntaub so ntswg los ntawm kev kuaj PCR, tab sis cov kab mob kis feem ntau yog qis dua hauv lub raum dua li hauv lub ntsws [3]. Txawm hais tias thaum muaj kab mob siab heev tau sau tseg hauv lub raum, xaus lus tias kev raug mob cytopathic ncaj qha yog qhov etiology ntawm lub raum tsis ua haujlwm tseem muaj teeb meem [4]. Qhov tseem ceeb, qhov mob hnyav ntawm COVID-19- cuam tshuam rau lub raum raug mob kuj tseem tuaj yeem yog vim muaj ntau yam xws li hypovolemia, poob siab, thiab kev siv tshuaj los yog qhov sib txawv ntawm lub raum raug mob uas tej zaum yuav tshwm sim rau cov uas muaj mob hnyav dua ntawm COVID{{24 }} [4] ib.

Lwm qhov tshwm sim ntawm lub raum tsis ua haujlwm hauv COVID-19 suav nrog hematuria thiab proteinuria [5]. Cov neeg mob uas muaj tus kab mob COVID-19-induced rhabdomyolysis tuaj yeem tshwm sim nrog cov tsos mob: myalgias, tshuaj yej-xim zis, thiab cov leeg tsis muaj zog [5]. Rhabdomyolysis tuaj yeem tshwm sim raws li qhov tshwm sim lig ntawm COVID-19 tshwm sim lub lis piam mus rau hli tom qab kuaj pom tus kab mob [5]. Hauv cov neeg mob no, cov txiaj ntsig ntawm kev kuaj ntshav xws li kev kuaj lub raum ua haujlwm ntxiv rau cov ntshav creatine kinase yuav tsum tau saib xyuas, ntxiv rau cov zis tso zis [5]. Angiotensin-hloov enzyme 2 (ACE 2), ib feem tseem ceeb ntawm renin-angiotensin-aldosterone system uas hloov angiotensin II rau angiotensin, yog ib qho enzyme thiab receptor, uas SARS-CoV-2 receptor binding domain khi thiab nkag mus rau hauv lub cell. Angiotensin-converting enzyme (ACE) 2 receptors raug sau tseg ntawm lub qhov ncauj mucosal hauv ob sab phlu, uas xav tias yuav pab txhawb rau SARS-CoV-2 kis. ACE 2 kuj tseem muaj feem ntau ntawm cov kab mob hauv lub raum, thiab kev tshawb pom ntawm cov proteinuria thiab hematuria tau raug sau tseg hauv cov neeg mob uas muaj COVID-19 [6]. Hais txog kev kho mob, cov kua dej tso rau hauv cov hlab ntsha tuaj yeem siv los kho mob raum tsis ua haujlwm kom sib npaug ntawm cov hlab ntsha hauv lub cev tsis txaus thiab kho qhov poob nrog kev kho cov zis tso zis [5]. Electrolyte txawv txav yuav tsum tau saib xyuas thiab kho kom tsim nyog [5]. Ntxiv mus, kev kho lub raum hloov yuav raug qhia rau cov neeg uas muaj theem III mob raum raug mob [5].

Thaum cov ntaub ntawv tsis tshua muaj tshwm sim thiab cov xwm txheej ntawm COVID-19- cuam tshuam txog rhabdomyolysis yav dhau los tau piav qhia [5, 7, 8], muaj cov ntaub ntawv txwv tsis pub tshaj tawm ntawm COVID-19- ntsig txog rhabdomyolysis qhov twg etiologies tau qhia meej meej tom qab lub raum Kev kuaj mob thiab kuaj kab mob [7] Yog li, peb tshaj tawm cov ntaub ntawv no rau lub teeb pom kev siab tias myoglobin cam khwb cia nephropathy tuaj yeem tshwm sim tsis tshua muaj vim yog COVID-19- kho rhabdomyolysis thiab ua rau mob hnyav, tab sis thim rov qab, lub raum tsis txaus.

Cov lus tshaj tawm kev ncaj ncees pom zoo thiab tso cai los koom

Kev pom zoo tau muab los koom nrog los ntawm tus neeg kawm rau ib daim ntawv qhia rooj plaub. Raws li Yale Institutional Review Board (IRB) cov ntaub ntawv: "Feem ntau, cov ntaub ntawv tshawb fawb tsis raug tshuaj xyuas los ntawm IRB. Cov ntaub ntawv tshawb fawb tsis ua raws li Txoj Cai Lij Choj

txhais ntawm kev tshawb fawb vim nws tsis yog ib tug systematic tshawb nrhiav tsim los tsim los yog pab mus rau generalizable kev paub. Raws li cov ntaub ntawv ceeb toom, los ntawm cov ntsiab lus, muaj ib qho piv txwv loj heev, lawv tsis tau tsim los ua kwv yees ntawm cov xwm txheej zoo sib xws thiab yog li tsis ua raws li qhov yuav tsum tau ua ntawm cov ntsiab lus no thiab yog li tsis raug rau IRB tshuaj xyuas. "

Cov ntaub ntawv

1. Najafan B, Fogo AB, Lusco MA, Alpers CE. AJKD atlas ntawm lub raum pathology: myoglobin cam khwb cia nephropathy. Am J Raum Dis. 2017; 69(2): e7–8. https://doi.org/10.1053/j.ajkd.2016.12.002.

2. Liapis H, Boils C, Hennigar R, Silva F. Myoglobin pov rau hauv lub raum biopsies: immunohistochemistry thiab morphologic spectrum. Hum Pathol. 2016; 54:25–30. https://doi.org/10.1016/j.humpath.2016.02.026.

3. Legrand M, et al. Pathphysiology ntawm COVID-19- cuam tshuam rau lub raum raug mob. Nat Rev Nephrol. 2021; 11:751–64.

4. Smith KD, Shreeram A. Pathogenesis ntawm tus kab mob coronavirus 2019-associ ated raum raug mob. Cov txiaj ntsig ntawm Nephrol Hyperten. 2021; 30(3):324–31.

5. Chetram VK, Ahmad AI, Farid S, Sood T. Mob raum raug mob thib ob rau rhabdomyolysis thiab COVID-19: daim ntawv tshaj tawm thiab cov ntaub ntawv tshuaj xyuas. Cas Rep Nephrol. 2021; 2021: 5528461. https://doi.org/10.1155/2021/5528461.

6. Chenna A, et al. Mob raum raug mob nyob rau hauv ib rooj plaub ntawm cov neeg mob confrmed COVID-19 (tus kab mob coronavirus 2019): lub luag hauj lwm ntawm angiotensin-hloov enzyme 2 thiab renin-angiotensin system blockade. Cas Rep Nephrol. Xyoo 2020; 2020: 8811931.

7. Chedid NR, Udit S, Solhjou Z, et al. COVID-19 thiab rhabdomyolysis. J Gen Intern Med. 2020; 35:3087–90. https://doi.org/10.1007/ s11606-020-06039-y.

8. Sharma P, et al. COVID-19-sociated raum raug mob: ib rooj plaub ntawm kev kuaj pom lub raum. J Am Soc Nephrol. 2020; 9:1948–58.

Supportive Service Ntawm Wecistanche-Qhov loj tshaj plaws cistanche exporter nyob rau hauv Tuam Tshoj:

Email: wallence.suen@wecistanche.com

Whatsapp / Tel: +86 15292862950

Khw Muag Khoom Kom Paub Ntxiv Specifications:

https://www.xjcistanche.com/cistanche-shop

Nyem qhov no kom tau txais Natural organic CISTANCHE EXTRACT nrog 25% ECHINACOSIDE thiab 9% ACTEOSIDE rau raum kab mob