Okubalulekile mayelana nesifo se-Rheumatoid Arthritis
I-arthritis ye-rheumatoid isifo esivuvukala esingapheli esithinta okungaphezu kwamalungu akho kuphela. Ngokungafani ne-osteoarthritis, ebangelwa ukugqoka isikhathi eside nokuqothuka kwe-cartilage ehlangene, i-rthumic arthritis yinkinga yokuzimela komzimba lapho isimiso somzimba sokuzivikela sikhusela izicubu namaseli akhe, kufaka phakathi amalunga, isikhumba, amehlo, inhliziyo, amaphaphu, kanye nezinzwa.
Ngokuhamba kwesikhathi, ukuvuvukala okuqhubekayo kungabangela ukulahlekelwa okuqhubekayo kokuhamba, ubuhlungu, nokukhubazeka okuhlangene.
Nakuba ososayensi bengakatholi ukwelashwa kwe-arthritis ye-rheumatoid, i-physiotherapy kanye nezidakamizwa ezintsha ze-biologic zinikeza usizo kubantu ababalelwa ku-1.5 million baseMelika abaphila nalesi sifo.
Izimpawu
I-arthritis ye-rheumatoid ihlasela kakhulu amalunga. Iphethini nezici zesifo zingahlukahluka komuntu oyedwa kuya kwesinye. Kwabanye, izimpawu zizoshaya ngokuzumayo futhi zikhulu. Kwabanye, izibonakaliso zingathuthuka kancane kancane, ngokuvamile ziqala ukukhukhumaza noma ukuqina komzimba ezinhlangothini ezincane, ikakhulukazi lezo zeminwe noma izinzwani, ngaphambi kokuba ziqhubeke zimbi nakakhulu.
-
Okufanele Ukwazi Nge-Rheumatoid Sarcopenia
-
Ingabe i-Polyarthritis, Inflammatory, ne-Rheumatoid Arthritis yona?
Ngokuhamba kwesikhathi, amanye amalunga angathinteka. Indlela yokubandakanyeka ijwayele ukulinganisa, okusho ukuthi izimpawu ezenzeka ngakolunye uhlangothi lomzimba zizovamiswa ngakolunye uhlangothi.
Izimpawu ezivamile nezimpawu zesifo samathambo zihlanganisa:
- Uthando oluhlangene, ukufudumala, ukuvuvukala, nobuhlungu
- Ukukhathala, i-low-grade fever, kanye nokulahlekelwa kwesisindo
- Ubunzima bokusa kwelanga obuhlala njalo ehoreni
Njengoba lesi sifo sithuthuka, izicubu ezihlangene zingahlanganiswa ndawonye (zithinteka), okuholela ekulahlekelweni kokunyakaza. Ukuguguleka kwe-cartilage, i-ligaments, ne-bone kungagcina kubangele ukuhlanganiswa ukulahlekelwa ngokuphelele ukulungiswa nokuma, okwenza kube nokukhubazeka okuhlangene okukhulu futhi ngezinye izikhathi okungaqondakali.
Amanye amaqembu aphethwe
Ukuvuvukala okwenziwa yi-arthritis ye-rheumatoid kungathinta nezinye izitho, futhi kubangele kokubili izimpawu zendawo kanye nezimo (umzimba wonke). Okuvamile kakhulu kwezinkinga ezingezona ezibandakanya:
- Ama-nodules ama-rheumatoid , amaqabunga aqinekile ayenzeka ngaphansi kwesikhumba, ngokuvamile avame ukuzungeza ama-elbows, izithende, noma ama-knuckles
- I-Pleuritis , ukuvuvukala kwendwangu yamaphaphu, okwenza ukuphefumula, ukuphefumula ngokushesha, nokukhwehlela owomile
- I-Pericarditis , ukuvuvukala kwebhande elizungezile inhliziyo, okwenza ubuhlungu besifuba, ukuqina kwesifuba nokukhathala
- I-Vasculitis , ukuvuvukala kwemithambo yegazi, okwenza imfiva, ukukhathala, ukulahlekelwa kwesisindo, nobuhlungu bomzimba
- I-scleritis , ukuvuvukala kwezimhlophe zeso, kubangele ukubomvu, ukubhuka, ukuzwela ukukhanya, nokulahleka kombono
Ngokuvamile, ezinye izitho ezinjengezinso, isibindi, amathambo, nezicubu zomzimba zingathinteka.
> Izimpawu ezijwayelekile zesifo samathambo esifubeni esandleni.
Izimbangela
Njengazinye izifo ezizimele , imbangela eqondile ye-rheumatoid arthritis ayiziwa.
Ukukhuluma ngesitatimende, abesifazane banamathuba amathathu okuthola lesi sifo kunomuntu. Ingozi ihlose ukwandisa ngobudala, lapho kuqala izimpawu ngokuvamile ezivela phakathi kweminyaka engama-40 no-60.
Izakhi zofuzo zibonakala zidlala indima ebalulekile ekuthuthukiseni lesi sifo, zibalwa phakathi kwamaphesenti angu-40 kuya kuma-65 amaphesenti azo zonke izimo, ngokusho kocwaningo lwango-2017 olwanyatheliswa kuyi-Lancet. Ngenkathi izindlela eziqondile zingakabonakali, abantu abanezifo ezizimele bazikholelwa ukuthi zinezakhi eziguquguqukayo ezithinta izifo ezithinta umzimba futhi zihlasela ama-agent abangela izifo.
Esikhathini sesimiso sokuzivikela somzimba esivame ukusebenza, umndeni wezakhi zofuzo obizwa ngokuthi i- human leukocyte antigen (HLA) isisiza ukuba amasosha omzimba ahlukanise amaseli awo avela kulabo abahlaseli bangaphandle njengama-virus namagciwane. Ngesifo samathambo, ezinye izinguquko ze-HLA zingase zifundise ngokungaqondile umzimba ukuba zihlasele amaseli awo. Enye yezinto ezivame kakhulu inguquko eyaziwa ngokuthi i- HLA-DR4 .
Ngokungaqondakali, i-arthritis ye-rheumatoid ijwayele ukugijima emndenini.
Empeleni, ukuba nomlando womndeni wesifo kungandisa ingozi ngamaphesenti angu-300.
Ezinye izici, ezifana nokukhuluphala nokubhema, nazo zingafaka isandla. Ukukhuluphala akugcini nje ukucindezeleka kumajoyini afintekile, ukuqoqwa kwamafutha amaningi ngokweqile kudala umphumela wokuvuvukala. Ukubhema , okwamanje, kungandisa ingozi yezifo ezingokomzimba ngamaphesenti angaba ngu-300, ikakhulukazi kubantu abamhlophe abasebenza isikhathi eside, ababhema kakhulu,
Ukuxilongwa
Awukho uhlolo olulodwa lwe-lab noma i-X ray engahlolisisa i-arthritis ye-rheumatoid. Ukuze wenze ukuxilongwa, udokotela kuzodingeka ahlaziye umlando wakho wezokwelapha, enze ukuhlolwa ngokomzimba, futhi ahlele inhlanganisela yokuhlolwa kwebhu neyokucabanga.
Izivivinyo zamalebhu ezisetshenziswa ngokujwayelekile zihlanganisa:
- Isisindo se-rheumatoid (RF) , i-antibody etholakala ngamaphesenti angu-80 abantu abaphila nesifo
- Isilinganiso se-erythrocyte sedimentation (ESR) , esilinganisa ukuvuvukala emzimbeni
- Iprotheyini esebenzayo ka-C (i-CRP) , into ekhiqizwa yisibindi okuyi-marker of inflammation
- Ukuhlolwa kwe-anti-cyclic citrullinated (anti-CCP) , okuthola elinye i-antibody esitholakala kubantu abane-arthritis ye-rheumatoid
-
Ungase Uthuthukise I-Apnea Yokulala Uma Unesifo Se-Rheumatoid Arthritis
-
I-Amjevita I-FDA-Iyavunyelwa njenge-Biosimilar ku-Humira
I-X ray kanye nokufaneka kwemifanekiso yamagnetic resonance (MRI) ingasetshenziswa kulo lonke lesi sifo ukuhlola ukuqhubeka kwesifo nokuqapha ukusebenza kahle kokwelashwa.
Ukwelapha
Nakuba kungekho ukwelashwa kwamathambo e-rheumatoid, ukusungulwa kwezidakamizwa ezintsha ze-biologic kuye kwaba nethemba kulabo abahlulekile ukuthola ukukhululeka ngezinkinga zokudabukisa ubuhlungu zendabuko kanye ne-steroids. Ukwelashwa namuhla kuvame ukuhlanganisa inhlanganisela yemithi yokwelapha.
Phakathi kwazo:
- Izidakamizwa ezingezona ukuvuvukala (ama-NSAID) afana ne-Advil (ibuprofen) ne-Aleve (naproxen) angasiza ekunciphiseni ubuhlungu nokuvuvukala kwesifo samathambo esifinyeleleka kancane kuya esilinganisweni. Ama-NSAID anamandla atholakalayo ngedokotela. Imiphumela emibi ihlanganisa ukucasuka kwesisu, ukucindezela kwegazi eliphezulu, ukukhala ezindlebeni, izilonda zesisu, nobuthi besibindi.
- Imithi ye-Corticosteroid , njenge- prednisone , inganikeza ukuphumula okuncane okubuhlungu nokuvuvukala ngenkathi kunciphisa umonakalo ohlangene. Imiphumela emibi ingase ihlanganise ukuphazamiseka kwamathambo, inzuzo yesisindo, ukulimala okulula, i-cataracts, i-glaucoma, nesifo sikashukela.
- Izidakamizwa zokuguqula izifo zokulwa nezifo (DMARDs) zisebenza ngokwenza izimpendulo zamasosha omzimba zibhebhetheke futhi zinciphise ukuqhubeka kwesifo. Ama-DMARD avamile ahlanganisa i- methotrexate , i-Arava (i-leflunomide), i-Azulfidine (i-sulfasalazine) ne-Plaquenil (i-hydroxychloroquine). Imiphumela emibi ingafaka ingozi eyengeziwe yokutheleleka nokulimala kwesibindi.
- I-biologic response modifiers iyisigaba esisha se-DMARD esetshenziswa ngokuvamile ngokuhlanganiswa ne-methotrexate. Zibandakanya i-Cimzia (certolizumab), i-Enbrel (etanercept), i-Humira (i-adalimumab), i-Orencia (abatacept), ne-Remicade (i-infliximab). Ngokungafani ne-DMARD yesizukulwane esandulele, izici eziqondene nezici ezithile zesistimu ye-immune esikhundleni se-immune system yonke. Imiphumela emibi ihlanganisa ingozi eyengeziwe yokutheleleka.
I-Physiotherapy iyingxenye ebalulekile yokwelashwa kwesifo se-rheumatoid arthritis futhi ingasebenzisa ukushisa, iqhwa, ukugqugquzela kagesi, i-ultrasound, ukuvivinya umzimba okuhamba phambili, nokuzivocavoca okunamandla. Ukwelapha emsebenzini kungase kube usizo uma i-arthritis iphazamisa impilo yakho yansuku zonke noma ikhono lokusebenza.
Imithi eminingi ehambisanayo neyehlukile (i-CAMs), njengamafutha wezinhlanzi, i-borage, kanye ne-evening primrose iye yabonakala inenzuzo ekusekeleni ukwelashwa kwesifo samathambo esifinyeleleka kancane kuya esilinganisweni.
Ukubhekana
I-rheumatoid isifo esiqhubekayo sokuphila esinganciphisa izinga lakho lokuphila nokuzethemba uma uvumela. Ngokuthatha izinyathelo ezisebenzayo ukuze uthuthukise impilo yakho, ungcono ukubhekana nokunciphisa ezinye zezici eziyinselele zesifo.
Ngaphezu kwemithi, ukulahlekelwa isisindo nokuzivocavoca kungasiza ekuthuthukiseni ukuhamba kwakho futhi ugcine kangcono ukuhamba kwakho. Ngisho noma usuvele ubhekene nokukhubazeka, ukuvivinya umzimba okuncane okufana nokuhamba, ukubhukuda, ukuhamba ngebhayisikili, i-yoga, ne-tai chi kungagcina amalunga ahamba ngaphandle kokubeka ukucindezeleka okungadingekile kuma-tissue ahlangene.
Ngokufanayo, izifo zomzimba zengqondo zingasebenza ekusizeni ukuba ubhekane nobuhlungu, ukukhathala nokukhathazeka okuvame ukuyingxenye yesifo. Okukhethwa kukho kuhlanganisa ukuzindla, i-biofeedback, ukuzivocavoca, nokufanekiswa kwezithombe. Ngokuphatha kangcono ukuphendula kwakho ngokomzwelo ngezibonakaliso zakho, ungase uzuze kuphela ukuzwa ukuthula kodwa ukulawula ubuhlungu obungcono.
Izwi elivela
I-arthritis ye-rheumatoid ingase ihlukanise nabantu abathintekile kakhulu lesi sifo. Kungase kungagcini nje ukuvimbela ikhono lakho lokuzibandakanya emisebenzini yansuku zonke, kungakuqeda ukuzethemba kwakho nesithombe sakho sokuzibulala njengoba izidumbu zenyama zibonakala zibonakala.
Ungazivumeli wena noma othandekayo ukuba uhambe wedwa. Khuluma nabangani noma umndeni bese ubatshela ukuthi uyaphi. Abantu abaningi abaqondi nje ukuthi yisiphi isifo samathambo esiyingozi noma izinselele abantu abahlala nesifo ababhekana nazo njalo. Uma uvula ngokwengeziwe futhi ubasize baqonde, bazokwazi ngokwengeziwe ukukusekela.
Kubuye kusize ukufinyelela kwabanye abathintekayo yi-arthritis ye-rheumatoid. Uma ungakwazi ukuthola iqembu lokusekela eduze kwakho, ungaxhuma ngamanethiwekhi okusekela endaweni yakho ngokusebenzisa i-Arthritis Foundation yase-Tucson.
> Imithombo:
> Singh, J .; I-Saag, K .; Amabhuloho, uL. et al. "Umhlahlandlela we-American American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis." Ukunakekelwa Kwe-Arthritis Res. 2016: 68 (1); 1-25. I-DOI: 10.1002 / acr.22783.
> Smolen, J .; Aletaha, D .; noMcInnes, I. "I-rheumatoid arthritis. " Lancet. 2017; 388 (10055): 2023-38. I-DOI: 10.1016 / So140-6736 (16) 30173-8.
> Sugiyama, D .; Nishimura, K .; UTamaki, K. et al. "Impikiswano yokubhema kuyisici esiyingozi ekuthuthukiseni i-arthritis ye-rheumatoid: ukuhlaziywa kwemeta yezifundo zokuhlola. "I- Annals Rheum Dis. 2010; 69 (1): 70-81. I-DOI: 10.1136 / ard.2008.096487.