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"code": "C46",
"name": "Саркома Капоши",
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"lead": "Нарушение здоровья, относящееся к группе злокачественные новообразования мезотелиальной и мягких тканей",
"description": "Саркома Капоши – множественные злокачественные образования на коже с поражением ее сосудов. Чаще всего заболевание поражает мужчин. Саркома Капоши проявляется как беспорядочное новообразование сосудов и пролиферация (разрастание) веретенообразных клеток сосудов. \r\n\r\n ",
"etiology": "<p>Саркома Капоши занимает первое место среди злокачественных новообразований, поражающих больных ВИЧ-инфекцией, достигая цифр 40—60 %. </p>\r\n<p>Вирус герпеса 8-го типа обнаруживается практически у 100 % пациентов, страдающих саркомой Капоши. </p>\r\n<p>К группам риска по развитию саркомы Капоши относятся: </p>\r\n<ul>\r\n<li>ВИЧ-инфицированные мужчины; </li>\r\n<li>пожилые мужчины средиземноморского происхождения; </li>\r\n<li>лица из экваториальной Африки; </li>\r\n<li>лица с пересаженными органами (реципиенты). </li>\r\n</ul>",
"pathogenesis": "<p>Патогенез, также как и причины появления саркомы, до конца не изучен. Основной версией патогенеза начальной стадии считается образование раковых клеток из из эндотелия кровеносных или лимфососудов. </p>\r\n<p>На сегодняшний день ученым удалось выделить цитокины, оказывающие стимулирующее действие на клеточные структуры саркомы Капоши. К ним относят: фактор роста фибробластов, интерлейкин 6, трансформирующий фактор роста. В возникновении опухоли у больных СПИДом большое значение отводят онкостатину. </p>\r\n<p>Саркома Капоши является не совсем обычной злокачественной опухолью. Слабая митотическая активность, зависимость процесса от иммунного статуса пациента, возможность обратного развития очагов опухоли, отсутствие клеточной атипии и гистологическое выявление признаков воспаления подтверждают предположение о том, что в начале своего возникновения саркома Капоши скорее представляет собой реактивный процесс, нежели истинную саркому. </p>",
"diagnostics": "<p>Диагностика саркомы Капоши основана на ее типичных клинических проявлениях и данных биопсииобразований. </p>\r\n<p>Гистологическое исследование выявляет в коже множественные новообразованные сосуды и пролиферацию веретенообразных клеток — молодых фибробластов. Наличие гемосидерина и экстравазатов (геморрагических экссудатов) позволяет отличить саркому Капоши от фибросаркомы. </p>\r\n<p>Пациентам проводят иммуннологические исследования крови и анализ на ВИЧ т вирус герпеса 8 типа. </p>\r\n<p>Для выявления поражений внутренних органов при саркоме Капоши применяют УЗИ брюшной полости и сердца, гастроскопию, рентгенографию легких, сцинтиграфию скелета, КТ почек, МРТ надпочечников и т. п. </p>",
"treatment": "<p>Важным моментом в лечении саркомы Капоши является терапия основного заболевания для повышения иммунного статуса организма. </p>\r\n<p>Системное лечение саркомы Капоши обычно назначается пациентам с благоприятным иммунологическим фоном при бессимптомном течении болезни. Оно состоит в интенсивной полихимиотерапии. </p>\r\n<p>В лечении классической и эпидемической формы саркомы Капоши успешно применяются интерфероны: α-2a, α-2b и β. Они препятствуют пролиферации фибробластов и способны инициировать разрушение (апоптоз) опухолевых клеток. </p>\r\n<p>Местное лечение саркомы Капоши включает криотерапию, инъекции химиотерапевтических препаратов и интерферона в опухоль, аппликации динитрохлорбензола и мази проспидия хлорида, др. методы. При наличие болезненных и крупных очагов поражения, а также для лучшего косметического эффекта проводится локальное облучение. </p>",
"prevention": "<p>Основной мерой профилактики заболевания является своевременное и правильное лечение иммунодефицитных состояний. Так, применение антиретровирусных препаратов у ВИЧ-инфицированных больных позволяет длительное время поддерживать нормальную функцию иммунной системы, тем самым предотвращая появление саркомы Капоши.</p>",
"clinical_picture": "<p>Симптомы саркомы Капоши: </p>\r\n<ul>\r\n<li>сформировавшаяся опухоль на коже или слизистой рта имеет тёмный цвет. Если на неё надавить, то она не будет бледнеть; </li>\r\n<li>для опухолей характерна симметричность поражения;</li>\r\n<li>сформированная саркома Капоши имеет чёткую форму и лишь немного возвышается над кожей; </li>\r\n<li>на ранних стадиях развития, сформированные на слизистой рта или коже пятна, имеют небольшие размеры и гладкую поверхность. По мере своего роста они начинают немного шелушиться. На поздних стадиях центр опухоли западает и может изъязвляться; </li>\r\n<li>такого симптома, как боль, при саркоме Капоши обычно не наблюдается. Иногда в месте локализации ракового образования отмечается жжение или зуд; </li>\r\n<li>часто при поражении слизистой рта в патологический процесс вовлекается небо и лимфоузлы, расположенные ближе всего к саркоме. </li>\r\n</ul>\r\n<p>При поражении слизистой рта наблюдается появление следующих симптомов: </p>\r\n<ul>\r\n<li>болевые ощущения во рту; </li>\r\n<li>затруднение приёма пищи, если саркома локализуется ближе к горлу во рту; </li>\r\n<li>некоторое затруднение дыхания. Особенно ярко данный симптом проявляется, если образование сформировалось не только во рту, но и на слизистой верхних воздухоносных путей. </li>\r\n</ul>",
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}
]
}