Yintoni iBronchiectasis?

I-Bronchiectasis yimeko yemiphunga engapheliyo xa imijelo yomoya/i-bronchi (iityhubhu ezithwala umoya zingene ziwukhuphe emiphungeni) zandisiwe, zidumbile, kwaye zihlala zineziva. Lo monakalo unokwenzeka kwindawo enye okanye ezininzi zemiphunga okanye kuyo yomibini imiphunga [1, 2]. 

Kwi-bronchiectasis, i-mucus edla ngokusinceda sicoce uthuli, iintsholongwane, kunye namanye amasuntswana amancinane esiphefumlayo iba ngqindilili kwaye kube nzima ukuyicoca ngokukhohlela. Oku kukhokelela ekudumbeni kunye nosulelo oluthe rhoqo olubangela ukugqabhuka (ukunyuka) kunye nomonakalo omkhulu kwimizila yomoya.

Ngaba lukhona unyango lwe-Bronchiectasis?

Nangona kungekho nonyango lwe-bronchiectasis ngeli xesha, kukho unyango oluya kukunceda uphefumle ngcono, ucoce imiphunga yakho ye-mucus, kwaye uthintele ukuvutha. Wena kunye nabanonopheli bakho banokusebenza kunye nomboneleli wakho wezempilo ukubeka kunye isicwangciso sonyango kwaye ufumane izixhobo zokukunceda ukulawula imeko yakho.

I-GAAPP liLungu eliZingcayo loSuku lweHlabathi lweNzame zokuSebenza eziDibanise iBronchiectasis “Ihlabathi”
Julayi 1, 2022

Uya kufumana izibonelelo ezisekelwe kubungqina ezibonelelwa ziingcali zamazwe ngamazwe ze-bronchiectasis kunye nemibutho yokuxhasa izigulane ezifumaneka ngeelwimi ezininzi nge-World Bronchiectasis Day iphepha lewebhu.

Ibandakanya ulwazi oluninzi malunga nokuxilongwa, ukukhutshwa kwendlela yomoya, amaqela enkxaso yezigulane, kunye nonyango.

Sicebisa kakhulu “iphepha lolwazi olusisiseko” ngebronchiectasis elifumaneka ngeelwimi ezininzi Apha.

Ngo-2023, i-GAAPP irekhode i-webinar yezemfundo kwi-bronchiectasis onokuyifumana Apha. Izithethi zethu ezisuka kwihlabathi jikelele ziquka uLauren Dunlap, ummeli wesigulane (US), Ashok Gupta, MD (India), Ghulam Mustafa, MD (Pakistan), kunye noTonya Winders, MBA (CEO ye-GAAPP).

Eli qela lezinto ezininzi labasebenzi bezempilo ababini kunye nabameli bezigulane ezimbini baxoxe ngezi zihloko zilandelayo:

  • Iimbono zelizwe jikelele ezivela kwi-allergies / immunology kunye neengcali ze-pulmonology ekuxilongweni, i-epidemiology, i-endpoints zonyango, kunye nokuqhubela phambili kunyango lwe-non-CF bronchiectasis (NCFB).
  • Iimeko ezihambelanayo zihlala zinxulunyaniswa ne-NCFB (umzekelo, ukunqongophala komzimba, usulelo).
  • Ulawulo lwezifo kunye neendlela zokuphila ezibandakanyekayo kwimbono yesigulane xa ukhetha iindlela zonyango kunye nebala elihambelana nokuxilongwa.

Zeziphi iimpawu eziqhelekileyo zeBronchiectasis kwaye ifunyaniswa njani?

Abantu bafumana iimpawu ezahlukeneyo ngokuxhomekeke kuhlobo lwabo lwesifo [1, 2].

  • Ukhohlokhohlo oluhlala ixesha elide (ukhohlokhohlo olungapheliyo) kunye okanye ngaphandle kwephlegm
  • Ukuveliswa kwesikhohlela/imikhohlela
  • Ukulahlekelwa bubuthongo ngenxa yokukhohlela
  • Ukuphefumula kancinci (ukuphefumla)
  • Usulelo lwemiphunga rhoqo olufuna unyango (ukugqabhuka/ ukonyuka)
  • Ukulahlekelwa ubunzima obungachazwanga kunye / okanye intlungu yesifuba
  • Umkhuhlane kunye/okanye iingqele

Eyona ndlela iqinisekileyo yokuxilonga i-bronchiectasis kukusebenzisa uvavanyo lwemiphunga (radiology) olubizwa ngokuba yi-computerized tomography (CT). Izikena zingasetyenziselwa ukubonisa ubukho beendlela zomoya ezandisiweyo kunye nokudumba okanye amanxeba afana ne-bronchiectasis. Ukuba ufumana iimpawu, umboneleli wakho wezempilo uyakuthumela kolu vavanyo.

Iimvavanyo ezongezelelweyo zinokubandakanya iinkcubeko ze-mucus yakho yomoya ukuvavanya iintsholongwane (iibhaktheriya, i-fungi, okanye i-mycobacteria) ukubona ukuba ufuna unyango ngamayeza okubulala iintsholongwane. 

Zeziphi izizathu ze (okanye iiNdawo zoMngcipheko) zeBronchiectasis? 

Kukho izinto ezininzi ezinokubangela i-bronchiectasis, kubandakanywa iimeko zonyango esele zikhona ezihlala zibizwa ngokuba yi-co-morbidities, kunye ne-genetic, i-auto-immune, kunye nezizathu ezinxulumene nosulelo. [3] Unyango luxhomekeke kuhlobo lwebronchiectasis onalo.

I-Bronchiectasis ekuqaleni yayibizwa ngokuba "sisifo esinqabileyo," kodwa ngophando oluthe kratya kunye nokwanda kokuqonda okukhokelela ekuxilongweni okungcono, ngoku yamkelwe njengesifo sesithathu semiphunga esixhaphakileyo kwihlabathi emva kwe-asthma kunye ne-COPD, [1] echaphazela abantu abadala kunye nabantwana abaninzi. . 

Usulelo oluqatha

  • Isifo sephepha (TB) kunye nenyumoniya zezona zizathu zixhaphakileyo kwihlabathi [4] ngakumbi kumazwe aseAsia afana neIndiya. [5]
  • Isifo semiphunga ye-NTM yimeko enqabileyo ebangelwa lusulelo lwe-mycobacteria engeyiyo-tuberculous. [14]

Iziphazamiso zemfuza

  • Izigulana eziphambili zeciliary dyskinesia (PCD) zihlala zifumana imeko kwangethuba ebomini kwaye zifuna ukuxilongwa okukhethekileyo kunye nonyango. [6]
  • Ukusilela kwe-Alpha-1 ye-antitrypsin (i-COPD yofuzo) ifuna uvavanyo lwemfuzo ukuxilonga. Unyango olukhethekileyo (unyango olongezelelekileyo) luyafumaneka kwamanye amazwe. [3]
  • I-Cystic fibrosis isoloko ifunyaniswa kubantwana abasebenzisa uvavanyo lwemfuzo kwaye ifuna unyango olukhethekileyo. [15]
  • I-immunodeficiency ephambili kunye nezinye iimeko ezizimeleyo ezifuna ukuxilongwa okukhethekileyo kunye nonyango. [3]

Isifuba

Isifuba idla ngokufunyanwa njenge-comorbidity kwi-bronchiectasis [7] kwaye izifundo zibonise ukuba abantu abane-asthma kunye ne-bronchiectasis basabela kakuhle kunyango lwe-corticosteroid. [8]

Isifo esinganyangekiyo semiphunga

Isifo esinganyangekiyo semiphunga (COPD) ihlala ikhona [9, 10] kunye ne-bronchiectasis kwaye babelana ngeempawu ezininzi ezibangelwa ukuvaleka kweendlela zomoya, kodwa ezi ziimeko ezimbini ezahlukeneyo.

I-rhinosinusitis engapheliyo

I-rhinosinusitis engapheliyo (ukudumba kwezono, imingxuma engenanto entloko) kucingelwa ukuba inxulumene nohlobo lokudumba olubizwa ngokuba yi-eosinophilic bronchiectasis. [11, 12]

Isifo se-reflux yesisu

Isifo se-gastrointestinal reflux (GERD/GORD) kukunqwenela izinto zesisu kwimiphunga; oku kucingelwa njengomngcipheko kwiimeko ezininzi zemiphunga. [13]

Ucaphulo

  1. Barbosa M, Chalmers JD. I-Bronchiectasis. Cofa uMed. Ipapashwe kwi-intanethi nge-30 kaSeptemba 2023. doi:10.1016/j.lpm.2023.104174.
  2. Macfarlane L, Kumar K, Scoones T, Jones A, Loebinger MR, Lord R. Ukuxilongwa kunye nokulawulwa kwe-non-cystic fibrosis bronchiectasis. UClin Med (eLond). 2021;21(6):e571-e577. doi:10.7861/clinmed.2021-0651 
  3. Martins M, Keir HR, Chalmers JD. I-Endotypes kwi-bronchiectasis: ukuya kwiyeza elichanekileyo. Uphononongo olubalisayo. Pulmonology. 2023;29(6):505-517. doi:10.1016/j.pulmoe.2023.03.004
  4. Chandrasekaran R, Mac Aogáin M, Chalmers JD, Elborn SJ, Chotirmall SH. Ukwahluka kweJografi kwi-etiology, i-epidemiology kunye ne-microbiology ye-bronchiectasis. BMC Pulm Med. 2018;18(1):83. Ipapashwe 2018 May 22. doi:10.1186/s12890-018-0638-0.
  5. Dhar R, Singh S, Talwar D, et al. Iziphumo zeklinikhi ze-bronchiectasis e-Indiya: idatha evela kwi-EMBARC / iNethiwekhi yoPhando lwe-Respiratory ye-India registry. Eur Respir J. 2023;61(1):2200611. Ipapashwe 2023 Jan 6. doi:10.1183/13993003.00611-2022.
  6. Kos R, Goutaki M, Kobbernagel HE, et al. Inkcazo yokuvumelana kwe-BEAT-PCD: isiphumo esisisiseko sokungenelela kwezifo ze-pulmonary kwi-primary ciliary dyskinesia. ERJ Vula iRes. 2024;10(1):00115-2023. Ipapashwe 2024 Jan 8. doi:10.1183/23120541.00115-2023
  7. Polverino E, Dimakou K, Traversi L, et al. I-Bronchiectasis kunye ne-asthma: Idatha evela kwi-European Bronchiectasis Registry (EMBARC). J Iklinikhi yokunyanga i-Immunol. Ipapashwe kwi-intanethi ngoFebruwari 22, 2024. doi:10.1016/j.jaci.2024.01.027.
  8. Cordeiro R, Choi H, Haworth CS, Chalmers JD. Ukusebenza kunye nokhuseleko lwe-antibiotics e-inhaled kunyango lwe-bronchiectasis kubantu abadala: ukuhlaziywa okucwangcisiweyo okuhlaziyiweyo kunye nohlalutyo lwe-meta. Ibhokisi le. Ipapashwe kwi-intanethi ngoFebruwari 1, 2024. doi:10.1016/j.chest.2024.01.045.
  9. Polverino E, De Soyza A, Dimakou K, et al. Umbutho phakathi kwe-Bronchiectasis kunye ne-Chronic Obstructive Pulmonary Disease: Idatha evela kwi-European Bronchiectasis Registry (EMBARC). Ndingu-J Respir Crit Care Med. Ipapashwe kwi-intanethi kaJanuwari 25, 2024. doi:10.1164/rccm.202309-1614OC.
  10. UMartinez-Garcia MA, uMiravitles M. Bronchiectasis kwizigulane zeCOPD: ngaphezu kwe-comorbidity? [ulungiso olupapashiweyo luvela kwi-Int J Chron Obstruct Pulmon Dis. 2019 Jan 18; 14:245]. Int J Chron Obstruct Pulmon Dis. 2017;12:1401-1411. Ipapashwe 2017 Meyi 11. doi:10.2147/COPD.S132961
  11. Shteinberg M, Chalmers JD, Narayana JK, et al. I-Bronchiectasis eneRhinosinusitis eNgapheliyo inxulunyaniswa ne-Eosinophilic Airway Inflammation kwaye yahlukile kwi-Asma. UAnn Am Thorac Soc. Ipapashwe kwi-intanethi kaJanuwari 9, 2024. doi:10.1513/AnnalsATS.202306-551OC.
  12. UGuan WJ, u-Oscullo G, Yena MZ, uXu DY, uGómez-Olivas JD, uMartinez-Garcia MA. Ukubaluleka kunye nendima enokwenzeka ye-Eosinophils kwi-Non-Cystic Fibrosis Bronchiectasis. J Ikliniki ye-Allergy Pract Immun. 2023 Epreli;11(4):1089-1099. doi: 10.1016/j.jaip.2022.10.027. Epub 2022 Oct 30. PMID: 36323380.
  13. Durazzo M, Lupi G, Cicerchia F, et al. Ukunikezelwa kwe-Extra-Esophageal ye-Gastroesophageal Reflux Disease: Uhlaziyo luka-2020. J kwiKlinikhi. 2020;9(8):2559. Ipapashwe 2020 Aug 7. doi:10.3390/jcm908255.
  14. Henkle E, Aksamit TR, Barker AF, et al. I-Pharmacotherapy ye-Non-Cystic Fibrosis Bronchiectasis: Iziphumo ezivela kuLwazi lwe-NTM kunye noPhando lwezigulane zoPhando kunye ne-Bronchiectasis kunye ne-NTM yoBhaliso loPhando. Ibhokisi le. 2017;152(6):1120-1127. doi:10.1016/j.chest.2017.04.167.
  15. Bell SC, Mall MA, Gutierrez H, et al. Ikamva lokhathalelo lwe-cystic fibrosis: imbono yehlabathi. [ulungiso olupapashiweyo luvela kwiLancet Respir Med. 2019 Dec;7(12):e40]. I-Lancet Respir Med. 2020;8(1):65-124. doi:10.1016/S2213-2600(19)30337-6.