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კრაზანასა და ფუტკრის ალერგია

თარიღი: 24 ივლისი, 2025

როგორც კრაზანები, ასევე ფუტკრები, მიეკუთვნებიან მწერების ჰიმენოპტერას (Hყმენოპტერა) რიგს, მაგრამ მათი შხამები განსხვავებულია. 

ფუტკრის შხამი შეიცავს: 

ფოსფოლიპაზა A2-ს 

მელიტინს (ტკივილისა და ანთების გამომწვევი მთავარი კომპონენტი) 

ჰიალურონიდაზას 

 

კრაზანას შხამი შეიცავს: 

ანტიგენ 5-ს

ფოსფოლიპაზა A1-ს

ჰიალურონიდაზას

დამატებით ფერმენტებსა და ცილებს 

ფუტკრის შხამზე ალერგიულ პირებს შესაძლოა არ განუვითარდეთ ალერგია კრაზანას შხამზე და პირიქით. მიუხედავად ამისა, ზოგიერთ შემთხვევაში ალერგიული რეაქცია აღინიშნება ორივე შხამზე, თუმცა ეს შედარებით იშვიათად გვხვდება.

ვინ არიან რისკის ქვეშ?

მეფუტკრეები, მებაღეები, გარე სივრცის მუშაკები 

ატოპიის ისტორიის მქონე პირები (ეგზემა, ასთმა, ალერგიული რინიტი) 

პირები, რომლებსაც ადრე ჰქონდათ სისტემური რეაქციები ნაკბენზე 

 

კრაზანას ან ფუტკრის ნაკბენზე ალერგიის სიმპტომები:

ადგილობრივი რეაქცია ნაკბენის არეში:

სიწითლე, ტკივილი, შეშუპება 

ხანგრძლივობა: ჩვეულებრივ, რამდენიმე საათიდან რამდენიმე დღემდე.

 

2. დიდი ზომის ადგილობრივი რეაქცია (LLღ): 

შეშუპება ვრცელდება ნაკბენის არეალის მიღმა (მაგ., მთელ კიდურზე) 

ხანგრძლივობა: შეიძლება გაგრძელდეს რამდენიმე დღე 

 

3. სისტემური ალერგიული რეაქცია (ანაფილაქსია): 

გვხვდება მოზრდილების 3%-მდე, ბავშვებში უფრო იშვიათად;

ხანგრძლივობა: რამდენიმე წუთიდან ერთ საათამდე.

სიმპტომები: 

ჭინჭრის ციება, ქავილი, სიწითლე 

სახის, ენის ან ყელის შეშუპება 

სუნთქვის გაძნელება, ხიხინი

მუცლის სპაზმები, ღებინება

დაბალი არტერიული წნევა, გონების დაკარგვა 

გულის გაჩერება (ექსტრემალურ შემთხვევებში) 

 

4.დაგვიანებული ან ბიფაზური რეაქცია: 

სიმპტომები ბრუნდება საწყისი გაუმჯობესებიდან რამდენიმე საათში 

საჭიროებს მონიტორინგს გადაუდებელი დახმარების განყოფილებაში

 

 

დიაგნოზი:

1. დეტალური ანამნეზი 

 

2. შრატის სპეციფიკური IგE-ს ტესტირება (IმმუნოჩAP ტესტი ბზიკის, კრაზანას, ფუტკრის მიმართ) 

 

3. საბაზისო ტრიპტაზის მაჩვენებლის განსაზღვრა (პოხიერი უჯრედების პათოლოგიის გამოსარიცხად, განსაკუთრებით მძიმე შემთხვევებში) 

 

4. კომპონენტებით განსაზღვრული დიაგნოსტიკა (მოლეკულური დიაგნოსტიკა, რაც იძლევა საშუალებას გავიგოთ თუ რომელ კომპონენტზეა პაციენტი ალერგიული, რამდენად საშიშია შემდეგი რეაქცია და ა. შ); 

 

 

მკურნალობა 

ანაფილაქსიის დროს: 

ეპინეფრინის (EპიPენ)  აუტოინექტორის დაუყოვნებელი გამოყენება კუნთში;

აუცილებელია დაუყოვნებლივ სასწრაფო დახმარების გამოძახება.

 

დამატებითი მკურნალობა: 

ანტიჰისტამინური საშუალებები, კორტიკოსტეროიდები, ბრონქოდილატატორები, ინტრავენური სითხეები

 

უფრო მსუბუქი რეაქციების დროს: 

ანტიჰისტამინური საშუალებების მიღება ქავილის შესამსუბუქებლად; 

ცივი კომპრესის ან ყინულის კუბის დადება ნაკბენის ადგილზე, კიდურის აწევა;

ადგილობრივი სტეროიდული მალამოები;

ტკივილის შემამსუბუქებელი საშუალებები.

 

ხანგრძლივი მართვა  

ალერგენსპეციფიკური იმუნოთერაპია (VIთ),  ასევე ცნობილია როგორც ალერგიის საწინააღმდეგო ვაქცინაცია (ინიშნება 3-5 წლის მანძილზე)

 

ეფექტურობა:  98%-მდე უზრუნველყოფს მძიმე ალერგიული რეაქციების პრევენციას.

 

რეკომენდაცია პაციენტებისთვის, ვისაც აქვს ნაკბენებზე სისტემური რეაქცია:

1. ეპინეფრინის ავტოინექტორის გამოწერა!  (ალერგიის შემთხვევაში ყოველთვის თან იქონიეთ და გამოიყენეთ სისტემური რეაქციის პირველივე ნიშნისთანავე)

 

2. სამედიცინო სამაჯურის, პასპორტის ტარება 

 

მნიშვნელოვანია პაციენტისათვის უგონო მდგომარეობაში ან საზოგადოებრივ ადგილებში ასეთი სამაჯურების ტარება;

 

პრევენცია 

მოერიდეთ გარეთ ფეხშიშველ სიარულს 

არ ატაროთ ყვავილებიანი ტანსაცმელი ან სუნამოები გარე სივრცეში ყოფნის დროს 

შეინარჩუნეთ სიმშვიდე, თუ ფუტკარი ან კრაზანა ახლოს არის - მოერიდეთ მკვეთრ მოძრაობებს და მშვიდად გაეცალეთ

საკვები ბუნებაში არ დატოვოთ ღია მდგომარეობაში. 

გამოყენებამდე შეამოწმეთ ფეხსაცმელი, ტანსაცმელი და ღია კონტეინერები მათში მწერების არსებობაზე

დაიქირავეთ პროფესიონალები ბუდეების მოსაშორებლად. გაითვალისწინეთ, ფეხსახსრიან მწერებზე არ მოქმედებს მწერების საწინააღმდეგო საშუალებები. 

 

ბავშვები ვს მოზრდილები

ბავშვებს უფრო მეტად აქვთ გამოხატული კანის მხრივი რეაქციები

მოზრდილებში უფრო მეტად სავარაუდოა მძიმე ან ფატალური რეაქციების განვითარება. 

ალერგენსპეციფიკური იმუნოთერაპია (VIთ) ბავშვებში ჩატარება განიხილება თუ გვხვდება სისტემური რეაქცია.

 

პაციენტებს, რომლებსაც აღენიშნებათ სისტემური რეაქციები და მომატებული ტრიპტაზას დონე სისხლის შრატში, შეიძლება ჰქონდეთ:

მასტოციტოზი

მონოკლონური მასტოციტების აქტივაციის სინდრომი (MMAშ) 

აღნიშნული  პაციენტები მიეკუთვნებიან,  სისტემური რეაქციების განვითარების მაღალი რისკის ჯგუფს, მათ შორის ერთჯერადი ნაკბენის ან დანესტვრის შემთხვევაშიც კი