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Kev cuam tshuam ntawm COVID-19 Tus kab mob kis thoob ntiaj teb rau cov menyuam yaus nrog CKD lossis kev txhaj tshuaj tiv thaiv kab mob

Mar 28, 2023

Kev kis kab mob yog ib qho kev txhawj xeeb loj rau cov menyuam yaus ntawm KRT thiab nrog CKD. Cov xwm txheej txaus ntshai muaj xws li kev tiv thaiv kab mob, ntau yam kev sib cuag hauv chav lim ntshav, thiab mus ntsib tsev kho mob (1).

Ltalis yog ib lub teb chaws cuam tshuam ntau tshaj plaws los ntawm tus mob hnyav ua pa nyuaj ua pa mob coronavirus 2 (SARS-CoV-2) tshwm sim (2). Txawm tias cov neeg laus nrogCKDthiab cov neeg tau txais kev hloov hauv lub raum tau paub tias muaj kev pheej hmoo ntau dua rau cov kab mob hnyav vim yog kev tiv thaiv kab mob thiab comorbidities (3), tsis tshua paub txog cov neeg mob sib npaug.

Nyob rau hauv xyoo tas los no, kev tshawb fawb txog kev siv cov qia hlwb thiab cov tshuaj suav tshuaj ntsuab rau kev kho mob raum tau txais txiaj ntsig zoo. Lub ntsiab mechanism ntawm ob txoj kev kho mob yog los txhawb kev kho cov mob raum cov ntaub so ntswg thiab tiv thaiv lub raum tshuav nyiaj li cas. Cov tshuaj suav tshuaj ntsuab, cistanche, tau siv hauv cov tshuaj suav tshuaj los kho ntau yam kab mob raum txij li thaum ub. Nws tau tshaj tawm tias cistanche muaj peev xwm txo qhov mob,txo lub raum fibrosis,thiab txhawb cov synthesis ntawm extracellular matrix Cheebtsam. Nws tau raug tshaj tawm tias cov teebmeem no yog vim nws cov khoom siv bioactive, suav nrog ntau cov tshuaj phenolic, triterpenoids, thiab coumarins. Ntawm qhov tod tes, stem cell technology tau ua rau muaj kev hloov pauv hauv kev kho mob. Kev tshawb fawb tau pom tias cov qia hlwb tuaj yeem sib txawv rau ntau hom ntawm lub raum hlwb thiab ua cov haujlwm kho mob, suav nrog kev tiv thaiv cov ntaub so ntswg ntxiv rau lub raum, ua rau cov nqaij mos fibrosis, thiabkho cov ntaub so ntswg puas raum.

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Nyem rau ntawm Cistanche Tubulosa Ntxiv

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Thaum kawg, kev sib xyaw ntawm cov tshuaj suav tshuaj suav nrog kev tshawb fawb niaj hnub tuaj yeem yog tus yuam sij rau kev kho ntau yam kab mob raum. Cov tswv yim no tau maj mam lees txais los ntawm cov neeg kho mob thiab cov kev tshawb fawb tau pom tias kev kho mob ua ke ntawm cistanche thiab qia cell kho yuav txo tau qhov kev tuag ntawm cov neeg tuag.kab mob raum.

Hauv kev xaus, kev siv ntawmcistanchethiab qia cell kho hauv kev kho mob ntawmkab mob raumqhia tau hais tias muaj peev xwm zoo thiab xav tau kev tshawb fawb ntxiv. Kev sib xyaw ua ke ntawm ob txoj kev kho mob tuaj yeem muab kev kho mob zoo dua rau cov neeg uas ntsib cov kab mob raum.

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Peb tshaj tawm cov ntaub ntawv los ntawm kev soj ntsuam thoob tebchaws uas tau ua los ntawm Italian Society of Pediatric Nephrology thaum lub sijhawm kaw kom nkag siab zoo dua cov kev kho mob ntawm tus kabmob coronavirus 2019.(COVID-19)hauv cov menyuam yaus uas muaj kev tiv thaiv kab mob lossis CKD. Cov ntaub ntawv raug sau los ntawm cov lus nug hauv xov tooj thaum lub Plaub Hlis 13 thiab 24, 2020, thiab cov ntaub ntawv xa mus rau tag nrho lub sijhawm los ntawm kev kuaj pom thawj kis mus rau qhov kev sib kis loj tshaj plaws hauv tebchaws Ltalis (Lub Ob Hlis 20 txog Lub Plaub Hlis 15, 2020). Lub hom phiaj tseem ceeb yog txhawm rau txheeb xyuas cov neeg mob uas muaj tus kab mob COVID hnyav-19 raws li tau hais tseg los ntawm ib qho ntawm cov hauv qab no: kev tuag, kev nkag mus rau Pediatric Intensive Care Unit, lub tshuab ua pa, thiab qhov xav tau hloov pauv kev tiv thaiv kab mob tsis tu ncua vim muaj ntaub ntawv sau tseg.SARS-CoV-2kab mob. Kuj tseem muaj qhov ua npaws, ua pa, plab hnyuv, lossis cov tsos mob xws li mob khaub thuas thiab ua raws li kev ntsuas ntsuas ntsuas. Cov txheej txheem suav nrog yog hnub nyoog, 18 xyoo, thiab ib qho ntawm cov kab mob hauv qab no: thawj lossis theem nrab GN thiab idiopathic nephrotic syndrome xav tau kev kho mob ntev ntev,CKDtheem 3-5, lim ntshav, lossis hloov raum. Lub teb chaws tus nqi ntawm kev koom tes tau suav los ntawm kev kwv yees tus naj npawb ntawm cov xwm txheej tshwm sim. Cov ntaub ntawv hais txog COVID-19 kev ntsuas swab hauv cov neeg sau npe tau muab piv nrog cov neeg Italian dav dav rau tib lub hnub nyoog thiab lub sijhawm. Txoj kev tshawb no tau pom zoo los ntawm pawg neeg saib xyuas kev ncaj ncees hauv zos ntawm txhua lub chaw koom.

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Tag nrho ntawm 1572 tus neeg mob (hnub nyoog nruab nrab, 11.1 xyoo; interquartile range, 7.2–14.7) suav nrog. Cov yam ntxwv ntawm tus neeg mob tau sau tseg nyob rau hauv Table 1. Raws li kev kwv yees tus naj npawb ntawm cov menyuam yaus uas muaj CKD thiab mob GN thiab qhov ntau ntawm cov neeg mob hloov pauv thiab cov neeg mob ntawm kev lim ntshav los ntawm tag nrho Italian pediatric raum hloov chaw zov me nyuam thiab Italian Registry ntawm Pediatric Chronic Dialysis, feem, cov neeg mob cuv npe sawv cev rau 67 feem pua ​​​​ntawm tag nrho cov neeg nyob hauv Italian cov neeg mob nrog rau cov kab mob raum tau hais tseg. Feem ntau (71 feem pua) raug suav hais tias muaj kev pheej hmoo rau kis kab mob vim yog kev tiv thaiv kab mob, nrog 14 feem pua ​​​​tau txais peb lossis ntau tus neeg sawv cev. Ntawm qhov tod tes, 29 feem pua ​​​​ntawm cov neeg mob muaj CKD theem 3-5, nrog 93 rau

lim ntshav. Ntshav siab tau tshwm sim hauv 20 feem pua ​​​​ntawm cov menyuam yaus, thiab 20 feem pua ​​​​ntawm tag nrho cov pab pawg yog nyob rau ntawm renin-angiotensin-aldosterone system blockers. Cov tsos mob tsis tshwj xeeb tau txheeb xyuas hauv 12 feem pua. Cov neeg mob raug cais tawm hauv tsev hauv 83 feem pua ​​​​ntawm cov neeg mob, tseem 35 feem pua ​​​​tsawg kawg tau mus ntsib tsev kho mob thaum lub sijhawm soj ntsuam, thiab 51 feem pua ​​​​muaj cov niam txiv ua haujlwm sab nraud, suav nrog cov neeg ua haujlwm kho mob (Table 1).

Tsis muaj cov neeg mob ua tiav cov txheej txheem rau qhov muaj mob hnyavCOVID-19.

Txawm li cas los xij, kev sim swab tau ua nyob rau hauv 84 tus neeg mob, feem ntau cov menyuam yaus cov tsos mob (46 ntawm 84) lossis cov neeg muaj tus mob SARS-CoV-2 (plaub ntawm 84). Ib feem pua ​​​​ntawm cov neeg mob tau txais kev kuaj swab piv nrog cov neeg noj qab haus huv Italian cov neeg mob (5 feem pua ​​​​vim 1 feem pua ​​; P50.005); Txawm li cas los xij, qhov feem pua ​​​​ntawm cov kev ntsuam xyuas zoo tsis txawv txav (4 feem pua ​​​​vim 2 feem pua ​​; P50.43). Tsuas yog peb tus neeg mob (0.19 feem pua) tau kuaj pom qhov zoo rau SARS-CoV-2, txhua tus nyob hauv thaj tsam Italian cuam tshuam phem tshaj plaws (Lombardy). Ib qho yog nyob rau hauv kev kho cov tshuaj tiv thaiv kab mob rau Henoch-Schönlein purpura thiab lwm qhov ob muajCKDSecondary rau congenital txawv txav ntawm lub raum thiab urinary ib ntsuj av. Ob leeg muaj cov tsos mob (ua npaws thiab ua pob khaus); lwm tus yog asymptomatic thiab raug kuaj vim yog tsev neeg raug. Tsis muaj leej twg muaj leukopenia lossis xav tau x-ray. Cov kev kho mob hauv paus tsis tau hloov kho, thiab txhua tus me nyuam muaj chav kho mob me me, raws li cov neeg mob yav dhau los hauv cov neeg zoo sib xws (4,5).

Qhov hnyav ntawmCOVID-19Hauv cov neeg laus cov neeg laus zoo li cuam tshuam nrog kev muaj cov kab mob sib kis, suav nrog kev tiv thaiv kab mob, kub siab, thiab CKD. Txawm hais tias muaj cov yam ntxwv zoo sib xws, tsis muaj tus neeg mob hauv peb cov pej xeem uas tsis muaj zog tiv thaiv COVID-19. Qhov txaus ntshai ntawm tus kab mob SARS-CoV-2 tsis yog qhov tseem ceeb, thiab qhov sib piv ntawm qhov zoo rau kev sim ua tau zoo sib xws nrog rau cov neeg mob hauv plab.

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Peb txoj kev tshawb fawb muaj qee qhov kev txwv, suav nrog cov peev txheej rov qab los ntawm kev tshawb fawb thiab tag nrho cov kev sim swab me me ua tau. Peb tsis tau lub hom phiaj los ntsuas qhov muaj feem ntau ntawm SARS-CoV-2 tus kab mob vim tias txoj cai nruj heev ntawm kev sim swab nyob rau hauv qhov chaw hauv tebchaws Ltalis thaum lub sijhawm muaj tus kabmob kis loj tshaj plaws, txwv kev tshuaj xyuas rau cov menyuam yaus uas muaj tsos mob xwb. Hloov chaw, peb tau npaj txoj kev tshawb fawb pragmatic los qhia meej txog qhov tshwm sim tiag tiag ntawm tus kab mob thiab nthuav tawm cov lus pom zoo hauv kev kho mob nyob rau lub sijhawm tsis paub tseeb.

Txawm hais tias yog vim li cas tsis meej, qhov tshwm sim ntawmCOVID-19paub tias muaj tsawg nyob rau hauv cov menyuam yaus cov pej xeem, nrog rau feem ntau benign kho mob sib. Xav txog qhov raug rau hauv tsev kho mob ib puag ncig hauv ntau tshaj li ib feem peb ntawm cov neeg mob, peb cov ntaub ntawv qhia tau hais tias txawm tias cov menyuam yaus nyob rau theem siab ntawm CKD lossis ntawm kev siv tshuaj tiv thaiv kab mob yog qhov pheej hmoo ntawm kev kho mob.COVID-19.

Qhia tawm

E. Benetti qhia txog kev ua haujlwm nrog Pediatric Nephrology Dialysis thiab Transplant Unit, Azienda Ospedale Università Padova. R. Chimenz qhia txog kev ua haujlwm nrog Università degli Studi di Messina. C. Corrado qhia txog kev ua haujlwm nrog Ospedale Civico Palermo. M. Giordano qhia txog kev ua haujlwm nrog Pediatric Hospital Giovanni XXIII. I. Guzzo qhia txog kev ua haujlwm nrog Bambino Gesù Children's Hospital. L. Massella qhia txog kev ua haujlwm nrog Bambino Gesù Children's Hospital thiab Research Institute thiab ua haujlwm ntawm pawg thawj coj saib xyuas ntawm Nephron, ntu "Case Studies in Genetics." A. Mastrangelo qhia txog kev ua haujlwm nrog Fondazione Istituto di Ricerca e Cura a Carattere Scientififico Ca' Granda Ospedale Maggiore Policlinico Milano. G. Montini tshaj tawm cov lus pom zoo nrog Alnyalam thiab Bayern. W. Morello ceeb toom tau txais kev qhuas los ntawm Sanofifi-Genzyme. A. Pasini qhia txog kev ua haujlwm nrog Azienda Ospedaliero Universitaria, Policlinico Sant'Orsola-Malpighi. L. Peruzzi qhia txog kev ua haujlwm nrog Regina Margherita Children's Hospital, Citta della Salute e della Scienza di Torino, thiab tau txais kev qhuas los ntawm Alnylam, Chiesi, thiab Dicerna. L. Annicchiarico Petruzelli qhia txog kev ua haujlwm nrog Santobono Pausilipon. G. Puccio ceeb toom tau txais honoraria los ntawm Associazione per il Bambino Nefropatico Onlus thiab ua tus kws pab tswv yim los yog tswv cuab ntawm EuroMediterranean Biomedical Journal. E. Vidal qhia txog kev ua haujlwm nrog University of Udine, Udine, Ltalis; tau txais kev qhuas los ntawm Bellco-Medtronic; thiab ua tus lwm thawj ntawm European Society for Pediatric Nephrology / European Renal Association-European Dialysis thiab Transplant Association Registry. Tag nrho cov neeg sau ntawv tseem tshuav tsis muaj dab tsi los qhia tawm.

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Nyiaj txiag

Txhua theem ntawm txoj kev tshawb no tau txais kev txhawb nqa los ntawm Associazione del Bambino Nefropatico (ABN Onlus) thiab La Rete del Mare.

Kev lees paub

A. Mastrangelo, G. Montini, W. Morello, L. Peruzzi, thiab E. Vidal conceptualized txoj kev kawm; A. Mastrangelo, G. Montini, W. Morello, thiab L. Peruzzi tsim txoj kev kawm; A. Mastrangelo thiab W.Morello tsim cov cuab yeej sau cov ntaub ntawv; G. Montini thiab L. Peruzzi ua haujlwm sib sau ua ke; E. Benetti, R. Chimenz, C. Corrado, M. Giordano, I.Guzzo, L.Massella, M.Materassi, A.Pasini, C. Pecoraro, LA Petruzzelli, thiab E. Vidal sau cov ntaub ntawv; A. Masrangel, G. Montini, W. Morello, thiab L. Peruzzi tau saib xyuas kev sau cov ntaub ntawv; G. Puccio tau ua qhov kev ntsuam xyuas thawj zaug; G. Puccio thiab E. Vidal ua qhov kev txheeb xyuas qhov tseeb; A. Mastrangelo thiab W. Morello tau sau cov ntawv thawj zaug; E. Benetti, R. Chimenz, C. Corrado, M. Giordano, I. Guzzo, L. Massella, A. Mastrangelo, M. Materassi, W. Morello, A. Pasini, C. Pecoraro, LA Petruzelli, G. Puccio , thiab E. Vidal tau tshuaj xyuas thiab kho cov ntawv sau; G. Montini thiab L. Peruzzi tau tshuaj xyuas cov ntawv sau rau cov ntsiab lus tseem ceeb; thiab txhua tus kws sau ntawv tau pom zoo cov ntawv sau kawg uas tau xa tuaj thiab pom zoo kom lav ris rau txhua yam ntawm txoj haujlwm.

Cov ntaub ntawv

1. Scaggs Huang FA, Danziger-Isakov L: Kev pheej hmoo kis kab mob hauv cov menyuam yaus lub raum hloov pauv. Pediatr Nephrol 34: 1155–1166, 2019
2. Fagiuoli S, Lorini FL, Remuzzi G;Covid-19 Bergamo HospitalCrisis Unit: Kev hloov kho thiab cov lus qhia hauv lub xeev Bergamo. N Engl J Med 382: e71, 2020
3. Akalin E, Azzi Y, Bartash R, Seethamraju H, Parides M, Hemmige V, Ross M, Forest S, Goldstein YD, Ajaimy M, Liriano-Ward L, Pynadath C, Loarte-Campos P, Nandigam PB, Graham J , Le M, Rocca J, Kinkhabwala M: COVID-19 thiab hloov raum. N Engl J Med 382: 2475–2477, 2020 10.1056/NEJMc2011117
4. Marlais M, Wlodkowski T, Vivarelli M, Pape L, To ¨nshoff B, Schaefer F, Tullus K: Qhov hnyav ntawm COVID-19 hauv cov menyuam yaus ntawm cov tshuaj tiv thaiv kab mob. Lancet Child Adolesc Health 4: e17–e18, 2020 10.1016/S2352-4642(20)30145-0

5. Melgosa M, Madrid A, Alva ´rez O, Lumbreras J, Nieto F, Parada E, Perez-Beltra ´n V; Spanish Pediatric Nephrology Association: SARS-CoV-2 kab mob hauv cov me nyuam Spanish nrog rau mob raum pathologies. Pediatr Nephrol 35: 1521–1524, 2020

*Covid-19 Task Force ntawm Italian Society of Pediatric Nephrology cov tswv cuab yog Licia Peruzzi, Elisa Benetti, Chiara Benevenuta, Milena Brugnara, Luca Casadio, Roberto Chimenz, Giovanni Conti, Ciro Corrado, Roberto Dall'Amico, Bruno Gianoglio , Mario Giordano, Chiara Gualeni, Stefano Guarino, Isabella Guzzo, Angelan La Manna, Claudio La Scola, Laura Martelli, Laura Massella, Antonio Mastrangelo, Giovanni Montini, William Morello, Antonello Pani, Teresa Papalia, Andrea Pasini, Carmine Pecorael, , Marco Pennesi, Luigi Annicchiarico Petruzzelli, Fabrizio Pugliese, Ilse Maria Ratsch, Paola Romagnani, Marco Materassi, RosaMaria Roperto, Chiara Tamburello, Gianluca Vergine, Antonio Vergori, Federica Alessandra Vianello, thiab Enrico Vidal.

AM thiab WM pab sib npaug rau txoj haujlwm no ua thawj tus kws sau ntawv.

Nug ntau ntxiv: david.deng@wecistanche.com WhatApp:86 13632399501

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