#61
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Ïðîñòî ðàíüøå ÿ íèêîãäà íå îáðàùàë âíèìàíèÿ ,õîòÿ ó ìåíÿ áûëè íåáîëüøèå òÿíóùèå áîëè ñëåâà â ñïèíå è ïîä ëåâûìè ð¸áðàìè.Ïðîñòî äåëî â òîì,÷òî ñíà÷àëà ó ìåíÿ áûâàëè áîëè â æèâîòå(ýòî áûëî ïåðèîäè÷åñêè ) ,à ÷åðåç ïîëãîäà âûðîñëè òðîìáîöèòû è ñòàëè áîëåòü ïàëüöû.È äàæå êîãäà òðîìáîöèòû ñåé÷àñ ñíèçèëèñü äî 408, ïîòîì 550, ïàëüöû âñ¸ ðàâíî ïîêàëûâàþò ,åñëè íå ïèòü àñïèðèí.À ïî ïîâîäó ïîäæåëóäî÷íîé,òàê îíà èíîãäà ïîáàëèâàåò,ìîæåò îò íå¸ è ïîëó÷èëàñü ÿçâà ÄÏÊ è åù¸ òðîìáîöèòû óâåëè÷èëèñü?À íàñ÷¸ò ãèäðåè:å¸ ìîæíî ïðåêðàòèòü â îäèí ìîìåíò èëè ïëàâíî óìåíüøàòü äîçó?
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#62
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Óâàæàåìûé Ëåîíèä,
Ïðîñòèòå, íî ÿ Âàì íå îáåùàë (äà è íå îáÿçàí) òîò÷àñ îòâå÷àòü íà âñå Âàøè âîïðîñû; ïðè Âàøåì çàáîëåâàíèè ëå÷åíèå êîíòðîëèðóåò è/èëè îòìåíÿåò î÷íûé âðà÷, åñëè Âàì íóæíû îòâåòû îò íåãî âíå î÷åðåäè è áûñòðî, òî íà ïðèåìå çàèíòåðåñóéòå åãî ôèíàíñîâî, ïðåäïîëàãàþ, ÷òî îí íå îòêàæåò. Åñòü âîïðîñû ïî ïðîáëåìàì ÆÊÒ - îáðàòèòåñü ê ãàñòðîýíòåðîëîãó, áóäåò î÷åðåäü - çàïèøèòåñü íà ïëàòíûé ïðèåì âíå î÷åðåäè. Âìåñòî "âû êóäà ïðîïàëè" ïðîñòî ïîáëàãîäàðèòå êîíñóëüòàíòà çà åãî áåçâîçìåçäíûé ñîâåò, ýòîãî áóäåò äîñòàòî÷íî, íî ãàäàòü äèàãíîçû/ëå÷èòü ïî èíòåðíåòó â Âàøåé ñèòóàöèè íå ïðåäñòàâëÿåòñÿ âîçìîæíûì.
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#63
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Âàäèì Âàëåðüåâè÷,ýòî áûëî íàïèñàíî â øóòî÷íîé ôîðìå,âû íå îáèæàéòåñü,à ê âðà÷àì â Ðîññèè è òàê âñå äàâíî õîäÿò ïëàòíî,âû äàâíî çäåñü óæå íå áûëè
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#64
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Äîáðûé äåíü ÂÀÄÈÌ ÂÀËÅÐÜÅÂÈ×. êîíöå íîÿáðÿ 2013 ãîäà áðîñèë ïèòü ãèäðåþ(ñêàçàëà âðà÷) èç-çà íåïåðåíîñèìîñòè(ïîñòîÿííàÿ òîøíîòà, íåïåðåâàðåííàÿ ïèùà â êàëå, âîáùåì áûëî î÷åíü ïëîõî ìíå).Íî ÿ åù¸ áðîñèë ïèòü àñïèðèí(îá ýòîì ìíå âðà÷ íå ãîâîðèë, ýòî è áûëî îøèáêîé).Ñàìîå èíòåðåñíîå â òîì ,÷òî ïàëüöû ïåðåñòàëè áîëåòü.Íî â êîíöå äåêàáðÿ ó ìåíÿ ñëó÷èëñÿ òðîìáîç ñåëåç¸íî÷íîé âåíû ,âîðîòíîé âåíû .Ó ìåíÿ áîëåë âåñü æèâîò,à â áîëüíèöó ïîëîæèëè ÷åðåç 12 äíåé, âçÿëè àíàëèç êðîâè , òðîìáîöèòû áûëè 480(íî áûëà óâåëè÷åíà ñåëåç¸íêà ,îò¸ê ïå÷åíè).2 íåäåëè ìåíÿ ëå÷èëè êëåêñàíîì,êîëîëè ãåïòðàë(äëÿ ïå÷åíè) è ïîäîáðàëè äîçó âàðôàðèíà 2,5 òàáëåòêè.Âûïèñàëè äîìîé, áîëè â æèâîòå óòèõëè,òîëüêî âîò òåìïåðàòóðà áûëà 38 åù¸ ìåñÿö(îäíè âðà÷è ãîâîðèëè èç-çà ïå÷åíè, äðóãèå èç-çà ñåëåç¸íêè).Ïîòîì è òåìïåðàòóðà âðîäå ïðîøëà.Ñåé÷àñ ÿ ïüþ òîëüêî âàðôàðèí.Òðîìáîöèòû ñòîÿò 500-700.Ñêàæèòå ,ìîæíî ëè èõ ñíèçèòü èíòåðôåðîíîì â âèäå ðåêòàëüíûõ ñâå÷åé(íàçûâàþòñÿ âèôåðîí) ÿ ïðî íèõ ÷èòàë ,â íèõ òîò æå èíòåðôåðîí àëüôà 2b,÷òî è â èíòðîíå.
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#65
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ðåêòàëüíûé èíòåðôåðîí â äàííîé ñèòóàöèè Âàì íå ïîìîæåò: òîëüêî ïåãèëèðîâàííûå ôîðìû äëÿ èíüåêöèé èëè àíàãðåëèä
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#66
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Âàäèì Âàëåðüåâè÷, îáüÿñíèòå ïîæàëóéñòà,÷òî çíà÷èò ïåãèëèðîâàííûå ôîðìû?
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#67
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[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#68
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Âàäèì Âàëåðüåâè÷, îáüÿñíèòå ïî÷åìó îáû÷íûå èíòåðôåðîíû íåëüçÿ?
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#69
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Îáû÷íûå èíüåêöèîííûå òîæå ìîæíî, íî ó íèõ âûøå ðèñê ïîáî÷íûõ ÿâëåíèé è íåîáõîäèìîñòü åæåäíåâíûõ èíüåêöèé, òàêæå æåëàòåëüíî ïðèäåðæèâàòüñÿ ðåêîìåíäîâàííûõ äîç, íàñêîëüêî ïîíèìàþ ó ïåãèëèðîâàííûõ èíòåðôåðîíîâ âûøå ýôôåêòèâíîñòü ïî äîñòèæåíèþ ÷àñòè÷íîãî è ïîëíîãî îòâåòà íà ëå÷åíèå - ñâÿçàíî ëè ýòî ñ èõ ëó÷øåé ïåðåíîñèìîñòüþ èëè æå ñ ïîääåðæàíèåì áîëåå ñòàáèëüíîé êîíöåíòðàöèè â êðîâè ïîêà íåÿñíî. Ýòî è äðóãîå çäåñü:
Recombinant IFN-α can control platelet counts but is associated with frequent side effects, which makes its long-term administration difficult, especially as the patient's age increases.... In an attempt to minimize IFN toxicity, a study from the M. D. Anderson group provided the pegylated isoform of IFN-α2a to 39 ET patients who had previously received at least one cytoreductive drug. Hematologic response was 92%, including 86% complete responses, and some molecular responses were also seen. Tolerability was better than that of standard IFN, because only 10% of patients dropped out of the study due to IFN-related side effects. A retrospective study from the French Intergroup on Myeloproliferative Disorders that included 59 patients with high-risk ET treated for a median of 16 months reported 92% hematologic responses, which were complete in 76% of cases, with 81% of patients remaining on treatment at last follow-up. [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |