Iingozi zempilo ukusuka kumanzi kunye nokungunda
Ubuncinci zithathu izinto ezinokubangela impilo enkenenkene kubantu abanamajoni omzimba asempilweni emva kokudibana nokumanzi kunye nokungunda: usulelo, ukwaliwa kunye netyhefu.
Xa ukungunda kuphazamisekile, amasuntswana okungunda (i-spores kunye nezinye i-debris) kunye neekhemikhali eziguqukayo zikhutshwa ngokukhawuleza emoyeni kwaye zinokuphefumlelwa lula kwimiphunga kunye nezono zakhe nabani na okufutshane.
La masuntswana kunye neekhemikhali zidla ngokubangela utywala (kubandakanywa ne-sinus allergies) kwaye ngamanye amaxesha kubangele i-alveolitis ye-alveolitis (hypersensitivity pneumonitis). Ngokunqabileyo, zinokukhula kwaye zikhule kwiindawo ezincinci ezinje ngezono - ngamanye amaxesha nakwimiphunga ngokwazo.CPA, ABPA). Kutshanje kuye kwacaca ukuba kumanzi, kwaye mhlawumbi nokungunda, kunokubangela kwaye kwandise isifo sombefu.
Imingundo emininzi inokwenza iindidi ezahlukeneyo zetyhefu ezinoluhlu lweziphumo ebantwini nakwizilwanyana. Ii-Mycotoxins zikhona kwezinye zezinto zokungunda kunokuba zisasazwe emoyeni, ngoko ke kunokwenzeka ukuba ezi zinokuphefumlelwa kuzo. Ezinye izinto ezimelene nazo zaziwa njengetyhefu. Ubungqina obukhoyo bucebisa ukuba akukho mycotoxin yaneleyo inokuphefumlelwa ukuba ibangele iingxaki ezinxulumene ngqo nobutyhefu bayo - kukho iimeko ezimbini okanye ezintathu ezingenakuphikiswa ezake zaxelwa kwaye ibe nye kuphela kwikhaya elinongundo. Amathuba okuba neempembelelo zempilo eziyityhefu (okt hayi izinto ezibangwa kukutya okuthile) okubangelwa kukusezela izinto eziyityhefu azikaqiniseki.
Kukho ezinye izinto eziyityhefu ezivela kubumba kwikhaya elifumileyo:
- Iikhemikhali eziguquguqukayo zeorganic (VOCs) ezingamavumba akhutshwa zezinye iimicrobes
- Iiproteases, iiglucans kunye nezinye izinto ezicaphukisayo
- Kwakhona qaphela ukuba kukho uluhlu olukhulu lwezinye (ezingezongungu) izinto ezicaphukisayo / ze-VOC ezinokubakho kumakhaya afumileyo.
Zonke ezi zinokuba negalelo kubunzima bokuphefumla.
Ukongeza kwezo zigulo ziphawulwe ngasentla singongeza ezi zigulo zilandelayo ezinonxulumano oluqinileyo (inyathelo elinye kude kwaziwa ukuba libangelwa) izifo zokuphefumla, iimpawu eziphezulu zokuphefumula, ukhohlokhohlo, ivili kwaye Dyspnoea. Kusenokubakho iingxaki zempilo ezingekachazwa ezibonakala zisanda ukusuka ekuchanabekeni ixesha elide 'kukungunda okuyityhefu' kwikhaya elifumileyo, kodwa ezi zikude nokuba nobungqina obubambekayo bokuzixhasa okwangoku.
Bubuphi ubungqina bokuba ukufuma kubangela ezi ngxaki zempilo?
Kukho uluhlu 'oluqinisekileyo' (jonga ngasentla) lwezigulo ezibonwa njengenenkxaso eyaneleyo kuluntu lophando ukuze silujonge ngokweenkcukacha, kodwa ezinye ezininzi azinankxaso yaneleyo kuluntu lwenzululwazi ukwenza isigqibo. Kutheni uzikhathaza ngale nto?
Makhe sijonge amagqabantshintshi enkqubo ekusekwe ngayo ikhonkco le-causal phakathi kwesifo kunye nonobangela waso:
Unobangela kunye nefuthe
Kukho imbali ende yabaphandi abahlukeneyo kwixesha elidlulileyo becinga ukuba unobangela ocacileyo wesigulo yayingoyena nobangela kwaye oku kuthintele inkqubela ekunyangeni. Omnye umzekelo ngo malariya. Ngoku siyazi ukuba isifo seengcongconi sibangelwa ngumbungu omncinci weparasitic osasazwa yingcongconi efunxa igazi (uphando olwenziwe UCharles Louis Alphonse Laveran, awathi wafumana ibhaso likaNobel ngowe-1880). Ngaphambi kweli xesha kwakucingelwa ukuba, njengoko abantu babethanda ukufumana isifo seengcongconi kwiindawo ezithile zehlabathi ezinemigxobhozo emininzi kwaye zinuka kakubi ngokubanzi 'yayingumoya ombi' owawubangela isigulo. Iminyaka yachithwa kuzama ukuthintela isifo seengcongconi ngokususa ivumba elibi!
Sibonisa njani isizathu kunye nesiphumo? Lo ngumbandela onzima othe wafumana ingqwalasela enkulu ukusukela kwiimpikiswano zokuqala malunga nokuba ukutshaya okanye hayi ukutshaya umhlaza - bona ingxoxo eneenkcukacha yoku apha. Le mpikiswano yakhokelela ekupapashweni kwe Iikhrayitheriya zaseBradford Hill ngenxa yobudlelwane besizathu phakathi konobangela wesifo kunye nesifo ngokwaso. Nangona kunjalo, kusekho indawo enkulu yengxoxo kunye nokwenza uluvo - unobangela onokubakho wesigulo isengumcimbi wokwamkelwa komntu ngamnye kunye neqela kuluntu lophando lwezonyango.
Ukuza kuthi ga ngoku kumanzi, i Umbutho WezeMpilo Wehlabathi Ingxelo kunye nophononongo olulandelayo lusebenzise le ndlela ilandelayo:
Ubungqina be-epidemiological (okt bala amanani eemeko zokugula ozifumanayo kwindawo yokurhanelwa (apho abantu bachanabeke kwisizathu esikrokrelekayo)): izinto ezintlanu ezinokuthi ziqwalaselwe ngolandelelwano lokuncipha kokubaluleka.
- Ubudlelwane be-Causal
- Kukho unxulumano phakathi kwesizathu nesigulo
- Ubungqina obulinganiselweyo okanye obucetywayo bombutho
- Ubungqina obunganelanga okanye obaneleyo bokuqinisekisa ukuba kukho umbutho
- Ubungqina obulinganiselweyo okanye obucetywayo bokungabikho kombutho
Ubungqina beklinikhi
Uphononongo olubandakanya amavolontiya abantu okanye izilwanyana zovavanyo ezivezwe kwiimeko ezilawulwayo, amaqela omsebenzi okanye ngokweklinikhi. Uninzi lwezi zifundo zisekelwe kumaqela amancinci abantu, kodwa zombini ukuvezwa kunye neziphumo zonyango zibonakaliswe ngcono kunokuba zinjalo kwizifundo ze-epidemiological. Ibonisa ukuba zeziphi iimpawu ezinokuthi zenzeke ukuba iimeko zilungile.
Ubungqina betyhefu
Isetyenziselwa ukuxhasa ubungqina be-epidemiological. Ayonelanga ngokwayo ukubonisa unobangela okanye isiphumo, kodwa iluncedo ukubonisa indlela iimpawu ezithile ezinokuthi zenzeke ngayo phantsi kweemeko ezithile. Ukuba akukho bungqina be-epidemiological, akukho ngcebiso yokuba iimeko ezifunekayo kuphawu oluthile ngokwenene zenzeka phantsi kweemeko 'zobomi benene'.
Zeziphi iziphumo zempilo esiqinisekileyo ukuba zibangelwa kukufuma?
Ubungqina be-Epidemiological (Ukubaluleka okuPhambili)
Uhlaziyo lwakutsha nje lweZiko lamaYeza lophononongo lokuvezwa kokusingqongileyo kwangaphakathi lutshilo ukuba i-asthma Phuhliso, ukuqina kwesifuba (ukuba mandundu), isifuba sangoku (isifuba siyenzeka ngoku), zi ezibangelwa iimeko ezifumileyo, mhlawumbi kuquka nokungunda. Ukucaphula ingxelo yangaphambili ye-WHO, kukho "ubungqina obaneleyo bobudlelwane phakathi kwezinto ezinxulumene nobumanzi bangaphakathi kunye noluhlu olubanzi lweziphumo zempilo yokuphefumla, kubandakanya izifo zokuphefumla, iimpawu eziphezulu zokuphefumula, ukhohlokhohlo, ivili kwaye Dyspnoea“. Sinokongeza hypersensitivity pneumonitis kolu luhlu emva Mendell (2011).
Ubungqina beToxicological (ukubaluleka kwenkxaso yesibini)
Iinkqubo apho ukuvezwa kwe-microbial okungosuleliyo kunegalelo kwiziphumo ezibi zempilo ezinxulumene nokufuma komoya wangaphakathi kunye nokungunda aziwa kakhulu.
Izifundo ze-in vitro kunye ne-vivo zibonise iimpendulo ezahlukeneyo zokudumba, i-cytotoxic kunye ne-immunosuppressive emva kokuvezwa kwi-spores, i-metabolites kunye namalungu eentlobo ze-microbial ezifumaneka kwizakhiwo ezifumileyo, eziboleka ukukholeka kwiziphumo ze-epidemiological.
I-asthma ehambelana nokufunxa, i-sensitization ye-allergies kunye neempawu zokuphefumla ezinxulumene nokuphefumla kunokukhokelela ekusebenzeni ngokuphindaphindiweyo kokhuselo lomzimba, iimpendulo ze-immune ezibaxiweyo, ukuveliswa kwexesha elide labalamlamli abavuthayo kunye nomonakalo wezicubu, okukhokelela ekudumbeni okungapheliyo kunye nezifo ezinxulumene nokudumba, ezifana ne-asthma.
Ukonyuka okubonwayo kwizihlandlo zosulelo lokuphefumla olunxulunyaniswa nezakhiwo ezifumileyo kunokuchazwa ziziphumo zokhuselo lomzimba lwe-microbes ehambelana nesakhiwo esifumileyo kwizilwanyana zovavanyo, eziphazamisa ukhuselo lomzimba kwaye ke ngoko zandise ukuchaphazeleka kusulelo. Enye inkcazo inokuthi izicubu ze-mucosal ezivuthayo zibonelela ngomqobo ongasebenzi kakuhle, okwandisa umngcipheko wosulelo.
Iintlobo ngeentlobo zee-microbial agents ezineentlobo ezahlukeneyo, eziguquguqukayo zokukrala kunye nezinokuba yityhefu zikhona ngaxeshanye nezinye iikhompawundi ezisemoyeni, nto leyo ebangela ukuba kubekho intsebenziswano kumoya wangaphakathi. Ukusebenzisana okunjalo kunokukhokelela kwiimpendulo ezingalindelekanga, nokuba kugxininiso oluphantsi. Kukhangelo lwamacandelo e-causative, izifundo ze-toxicological kufuneka zidityaniswe kunye nohlalutyo olubanzi lwe-microbiological kunye neekhemikhali zeesampulu zangaphakathi.
Ukusebenzisana kweMicrobial kufuneka kuqwalaselwe ngononophelo xa kuvavanywa iziphumo zempilo ezinokuthi zibe sesichengeni kwizakhiwo ezifumileyo. Umahluko kugxininiso olusetyenziswa kwizifundo ngeenkcubeko zeeseli okanye izilwanyana zovavanyo kunye nezo zinokufikelelwa ngabantu nazo kufuneka zigcinwe engqondweni xa kutolika iziphumo.
Ekutolikeni iziphumo zophononongo kwizilwanyana zovavanyo ngokunxulumene nokuba sesichengeni kwabantu, kubalulekile ukuqwalasela umahluko kwiidosi ezihambelanayo kunye nenyani yokuba utyhileko olusetyenziswa kwizilwanyana zovavanyo lunokuba yimiyalelo yobukhulu obuphezulu kunezo zifumaneka kwindawo zangaphakathi.
Ubumanzi bendawo yokuhlala bunxulunyaniswa nokunyuka kwe-50% kwi-asthma yangoku kunye nokunyuka okukhulu kwezinye iziphumo zempilo yokuphefumla, ebonisa ukuba i-21% ye-asthma yangoku e-United States inokuthi ibangelwe kukufuma kunye nokungunda.