#16
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Ïîíÿëà Âàñ.À åù¸ ïîäñêàæèòå, ìîæíî ëè óïîòðåáëÿòü êèñëîìîëî÷íûå(êåôèð), ìîæåò òâîðîã, ìàñëî .ñëèâî÷íîå.Èëè ñîâñåì ìîëî÷íîå òîæå èñêëþ÷èòü?
È ïîäñêàæèòå, Ïåïñàí õîðîøåå ëè ñðåäñòâî â ìîåì ñëó÷àå äëÿ çàùèòû ñëèçèñòîé? |
#17
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äåôèöèò ôîëèåâîé ðåäîê ïðè àòðîôèè, òîëüêî åñëè â åäå åå ìàëî, äëÿ àòð. ãàñòðèòà á12 äåôèöèò è æä äåôèöèò áûâàþò â 20-25% ñëó÷àåâ; âû ìîæåòå âñå êóøàòü, ÷òî âàì çàõî÷åòñÿ, ïðî äåîêñèõîëåâóþ çäåñü
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#18
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òåîðåòè÷åñêè - çàáðîç äåîêñèõîëåâîé â ñîñòàâå æåë÷è íà ñëèçèñòóþ äà¸ò àòðîôèþ/ìåòàïëàçèþ, ïîéåòîìó ïðåïÿòñòâèå çàáðîñà - ïðåäóïðåæäåíèå, à âðà÷ ê åíäîãåííîìó çàáðîñó, äîáàâëÿåò åêçîôåííûé çàáðîñ ÷åðåç ðîò. Óðñà- ïîêàçàíà òîëüêî äëÿ ðàñòâîðåíèÿ æåë÷íûõ êàìíåé, òàê êàê ìåíÿåò ëèòîãåííîñòü æåë÷è, íè â êàêèõ äðóãèõ îáëàñòÿõ ìåäèöèíû îíà íå ïîêàçàíà, òàê êàê îò íåå áûâàåò è âðåä â âèäå ïîá. äåéñòâèÿ - ñì. èíñòðóêöèþ
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#19
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Ïî Óðñîñàíó ïîíÿëà, à ñêàæèòå Ìîòèëëèóì â äàííîé ñèòóàöèè ìîæíî?Âðîäå êàê ìîòîðèêó âîññòàíàâëèâàåò
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#20
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âî ïåðâûõ, ó âàñ ìîæåò áûòü àóòîèìóííûé àòðîôè÷åñêèé ãàñòðèò, à íå æåë÷åãåííûé, íåñìîòðÿ íà òî, ÷òî æåë÷ü ïîÿâëÿåòñÿ â ïðîñâåòå æåëóäêà; âî âòîðûõ, ìîòèëèóì òîæå îáëàäàåò ñïåêòðîì ïîá. äåéñòâèÿ è äëÿ íåãî ÍÅÒ òî÷íûõ óêàçàíèé, ÷òî ìîòîðèêó æåë÷åâûâ. ïóòåé îí âîññòàíàâëèâàåò òî÷íî-òàêæå, êàê è ìîòîðèêó êèøå÷íèêà íàïðèìåð; âîò äåôèöèò æåëåçà ñïîñîáñòâóåò íàðóøåíèþ êíåòèêè ÆÏ è êàìíåîáðàçîâàíèþ, ïîåòîìó äåôèöèò æåëåçà êîððèãèðîâàòü æåëàòåëüíî è ñ åòîé ÒÇ
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#21
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Ïîíÿëà è åù¸ âîïðîñ, ïîæàëóéñòà, ÿ òðè ãîäà íàçàä ñäàâàëà íà ïàðèåòàëüíûå êëåòêè-îòðèöàòåëüíî, ñòîèò ëè ïåðåñäàòü?Åù¸ ñëûøàëà, ÷òî àóòîèììóííûé ÷àùå ïîðàæàåò òåëî è äíî æåëóäêà, ðåäêà àíòðàëüíûé îòäåë, íî õî÷åòñÿ óäîñòîâåðèòüñÿ íàâåðíÿêà.
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#22
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Ïàðèåòàëüíûå (îáêëàäî÷íûå) êëåòêè æåëóäêà ðàñïîëîæåíû ïðåèìóùåñòâåííî â æåëåçàõ ñëèçèñòîé îáîëî÷êè äíà æåëóäêà. Èõ ãëàâíàÿ ôóíêöèÿ – ñåêðåöèÿ ñîëÿíîé êèñëîòû, êîòîðàÿ ÿâëÿåòñÿ âàæíûì êîìïîíåíòîì ïèùåâàðåíèÿ ÷åëîâåêà, è âíóòðåííåãî ôàêòîðà Êàñòëà, íåîáõîäèìîãî äëÿ âñàñûâàíèÿ âèòàìèíà Â12 èç ïèùè.
Íàâåðíîå Âû ñäàâàëè íà "àíòèòåëà ê ïàðèåòàëüíûì êëåòêàì", íî ïðèâûêëè ñî âñåìè îáùàòüñÿ êàê ñ ãîïíèêàìè. Èëè åñëè íå âèäèòå ðàçíèöû â ýòèõ ñëîâàõ, òî ëó÷øå è íå ñïðàøèâàòü âîâñå.
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Àëåêñàíäð Èâàíîâè÷ ñ ïîæåëàíèÿìè êðåïêîãî çäîðîâüÿ |
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#23
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Äà, èçâèíèòå, çàáûëà êàê ïðàâèëüíî àíàëèç íàçûâàåòñÿ, íà àíòèòåëà
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#24
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àíòèòåëà ê ïàðèåòàëüíûì êëåòêàì íå âñåãäà áûâàþò ïðè àòðîô. ãàñòðèòå, ãäå-òî â 20-35% èõ íåò, íå çíàþ öåííîñòü îòñóòñòâèÿ èëè ïðèñóòñòâèÿ åòèõ àíòèòåë â ïðîãíîçå
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#25
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Åñëè ÿ ïðàâèëüíî ïîíèìàþ, òî íàëè÷èå àíòèòåë ê ïàðèåòàëüíûì êëåòêàì óêàçûâàåò íà àóòîèììóííîñòü ãàñòðèòà.À ïî ïðîãíîçàì îí áîëåå íåáëàãîïîëó÷íûé, ò.ê. ïðè äðóãîì àòðîôè÷åñêîì ãàñòðèòå(ñâÿçàííûì ñ õåëèêîáàêòåðîì, çàáðîñîì æåë÷è è ò.ä.) ìîæíî ïîñòàðàòüñÿ óñòðàíèòü ïðè÷èíó âîñïàëåíèÿ, ïðè àóòîèììóííîì-íåò.
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#26
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íåò íå òàê:
anti-parietal cell antibodies (anti-PCA), anti-intrinsic factor antibodies (anti-IFA), pepsinogen ratio (PGI/II), and gastrin-17 (G-17) in corpus-restricted atrophic gastritis (CRAG). Our study compared 29 CRAG cases against 58 age- and sex-matched controls with mild or no atrophy. PGI/II value <3 was considered characteristic for atrophy; positive cutoff values for G-17 and anti-H. pylori IgG were >5 pg/L and >30 EIU. Anti-PCA was positive in 65.5% For CRAG cases and 13.8% of the controls (p < 0.0001), anti-IFA was positive in 13.8% and 0% (p = 0.01), respectively. APCA can be found in 85-90% of patients with PA. Their presence is not sufficient for diagnosis, because they are not specific for PA as they are also found in the circulation of individuals with other diseases. APCA are more prevalent in the serum of patients with T1D, autoimmune thyroid diseases, vitiligo, celiac disease.
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |