Indlela Yokuzivocavoca Ne-Rheumatoid Arthritis Treatment Kungasiza
Kungenzeka ukuthi uhlangabezane ne-sarcopenia yegama lapho ufunda ngesifo samathambo e-rheumatoid. Yini ngempela i-sarcopenia, futhi kungani kufanele ukhathazeke ngakho? Yiziphi izinyathelo ongazithatha ukuze usize ukubhekana nayo?
Kuyini i-Sarcopenia?
Ngokuvamile, i-sarcopenia yisimo esibangela ukulahlekelwa okubuhlungu kwezicubu zomzimba zamasipha. Kungacatshangwa ukuthi uhlobo lwamahlumela aluchitheka .
Abacwaningi bokuqala basebenzisa leli gama ukuchaza ukuhlukunyezwa kwemisipha okwenzeka ngesikhathi sokuguga okujwayelekile kodwa kamuva nje, abanye baye baqala ukusebenzisa igama ukuchaza ukuchithwa kwemisipha okungabangela noma kube nzima ngenxa yezimo ezithile zezokwelapha, njenge- arthritis ye-rheumatoid . Uma kuqhathaniswa nabantu abangenayo i-arthritis ye-rheumatoid, abantu abane-arthritis ye-rheumatoid bangase babe nesifo esinzima sokushiya okwenzeka ekuqaleni. Lokhu ngezinye izikhathi kubizwa ngokuthi i-rheumatoid sarcopenia.
Ukusetshenziswa kwe-Muscle evamile
Usebenzisa imisipha yamathambo ukwenza ukunyakaza okuzithandela kwezitho zakho, i-torso, nezinye izingxenye zomzimba wakho. Lezi zinhlanzi zamathambo zakhiwa yizintambo zomzimba ezide. Lezi zindwangu ziqukethe amaprotheni akhethekile angakwazi ukudonsa ngokumelana ukuze anciphise imisipha, noma aphumule ukuze imisipha ikhule. Baphendula ngezibonakaliso ezivela kwi-neurons (futhi ekugcineni ebuchosheni) ukukuvumela ukuthi uhambise umzimba wakho.
Amanye amangqamuzana e-muscle asebenza ukulungisa ukugqoka nokuphumula okujwayelekile kumzimba wesisindo, ngakho-ke awunciphisi ngokuhamba kwesikhathi.
Izinguquko eSarcopenia
E-sarcopenia, izinguquko eziningana zenzeka ngaphakathi kwemisipha:
- Ezinye zezinsimbisi ze-muscle ziqala ukuhlaziya.
- Amanye amafayili e-muscle alahlekelwa ukuxhumana kwawo ne-neurons.
- Imisipha ye-muscle yehla ngosayizi jikelele.
- Imisipha ye-muscle yehla ngenani eliphelele.
- Amanye amaprotheni asetshenziselwa ukunyakaza kwemisipha aqala ukudiliza, futhi izinhlelo zokulungisa amaselula azisebenzi kahle ukuzilungisa.
- Eminye imicu ye-muscle ingathathelwa esikhundleni ngamathambo amafutha.
Izinkinga Ezivela eSarcopenia
Ngenxa yalokhu konke, imisipha iba mincane. Akumangalisi ukuthi lokhu kungaholela ezinkingeni eziningana, okufaka okulandelayo:
- Ukwehlisa amandla emisipha
- Ukukhubazeka okukhulu
- Inkohlakalo eyanda
- Ikhwalithi yokunciphisa jikelele yokuphila
- Ibhalansi empofu
- Ingozi ekhulayo yokuwa okungathí sina (okungahle kube yingozi)
Yini Ebangela Sarcopenia?
I-Sarcopenia iyenzeka njengengxenye yokuguga, ngisho nabantu abangenayo i-arthritis ye-rheumatoid. Ngeminyaka eyishumi nesishiyagalombili yokuphila, abantu abaningi baye balahlekelwa ngamaphesenti angama-50 emisipha yabo yokuqala. Izici eziningi ezihlukene zingadlala indima kulokhu kulahlekelwa, kubandakanya:
- Iyanqamuka kwamanye amahomoni
- I-physiology ye-muscle eguquguqukile
- Izinombolo ezincishisiwe zamaseli omzimba we-muscle
- Ukudla okunomsoco
- Ukunciphisa umsebenzi wokuzivocavoca
- Ukuvuvukala okungapheli okwandisa
Ukuvuvukala Okubangela I-Sarcopenia ku-Rheumatoid Arthritis
Ukuvuvukala kuyimbangela ebaluleke kakhulu ye-sarcopenia kubantu abane-arthritis ye-rheumatoid. Ngesikhathi sokuvuvukala, amaseli e-immune ethize e- cytokines okuvuvukala komzimba.
Lezi zimoya ezicacile eziveza ukuphendula okuvuvukala emzimbeni. Le mpendulo inomthwalo wemfanelo ekunciphiseni ubuhlungu besisindo esitholakala kubantu abadala.
Ku-arthritis ye-rheumatoid, le mpendulo yokuvuvukala ikhulisiwe. Amangqamuzana omzimba akhipha amakhophi amaningi okuvutha njenge-interleukin 6 (IL-6) ne-tumor necrosis factor-α (TNF-α). Ekugcineni, la ma-cytokines asiza ukuveza izimpawu zesifo se-rheumatoid arthritis njengobuhlungu obuhlangene nokuvuvukala. (Yingakho ezinye izidakamizwa ezisetshenziselwa ukwelapha isifo samathambo e-rheumatoid, njenge- TNF-inhibitors , zenzelwe ukusiza ukuvimba lezi cytokines.)
Lezi-cytokines ezinokuvutha zinezinye izimo, kuhlanganise nokwanda kwe-muscle. Yingakho abantu abane-arthritis ye-rheumatoid kungenzeka ukuthi babe ne-sarcopenia yokuqala kokuqala kanye ne-sarcopenia enamandla kakhulu. Phakathi kweziguli ezine-arthritis ye-rheumatoid, abantu abanamazinga aphezulu ala cytokines ezinokuvutha banengozi enkulu yokuba ne-sarcopenia futhi banciphise amandla emisipha.
Ezinye Izinto Ezibangela I-Sarcopenia E-Rheumatoid Arthritis
Ubuhlungu ngokwayo esinye isici esikhulu esibangela ingozi ye-sarcopenia kubantu abane-arthritis ye-rheumatoid. Uma ubuhlungu obungaphenduliwe nobunzima obuvela ku-arthritis yakho ye-rheumatoid, ungagwema umsebenzi womzimba okhubaza lezi zimpawu. Ngokuhamba kwesikhathi lokhu kungabangela uhlobo lwe-atrophy ye-muscle olubizwa ngokuthi i-atrophy yokusebenzisa kabi . Kulula nje, lokhu kunciphisa usayizi we-muscle okwenzeka lapho isisulu singatholi umzimba ovamile.
Abantu abane-arthritis esebenzayo bangase basebenzise amaprotheni amaningi nama-khalori kunokuvamile ngenxa yesifo sabo. Njengoba amaprotheni adingekayo ekunakekelweni kwemisipha, lokhu kungase kubize nesifo se-rheumatoid sarcopenia.
Ukuxilongwa kwe-Rheumatoid Sarcopenia
Buza udokotela wakho uma unenkinga mayelana nokunciphisa amandla esisindo ngenxa ye-arthritis ye-rheumatoid. Udokotela wakho angasebenzisa ukuhlolwa okuhlukile ukubona ukuthi kungenzeka yini ukuthi ube ne-sarcopenia. Lokhu kungafaka okulandelayo:
- Ukuhlolwa kwe-BIA (ukuhlaziywa kwe-impedance ye-bioelectrical)
- Ukuhlolwa kwe-DEXA (i-absorptiometry kabili-ene-X-ray absorptiometry)
- Ukuhlola ukuhlola amandla omzimba kanye nokusebenza komzimba jikelele
I-BIA yisilingo esingavumelekile esisebenza ngokuthumela izinga eliphansi ngokweqile emzimbeni. Izinhlobo ezahlukene zezicubu zinciphisa ukugeleza kuya emazingeni ahlukene. Ngokususelwa ekubalweni okubalwe kulokhu kugeleza kagesi, ochwepheshe angalinganisa inani elibizwa ngokuthi "i-fat-free mass" (FFM) engasetshenziselwa ukuhlola ubunzima be-muscle.
Enye indlela ukuhlolwa kwe-DEXA (okuvame ukusetshenziselwa ukuhlola i-osteoporosis). Lona olunye uvivinyo olungenabuhlungu olusebenzisa i-X ray ngezinga eliphansi kakhulu lemisebe. Kulesi simo, ingasetshenziswa ukubala inani elibizwa ngokuthi i-body mass mass (LBM), esinye isilinganiso semisipha yomzimba.
Udokotela wakho angase akucele ukuthi wenze imisebenzi ehlukahlukene yemisebenzi, njengokuhamba ngokushesha noma ucindezela idivayisi yesandla.
Qaphela ukuthi abantu abane-rheumatoid sarcopenia abalahlekelwa isisindo somzimba jikelele. Ku-rheumatoid sarcopenia, ingxenye yamaphrotheni e-muscle ingasuswa esikhundleni samanoni. Ngenxa yalokhu, isisindo singase singashintshi kakhulu, ngisho noma umuntu elahlekelwe imfucumfucu esebenzayo. Yingakho inkomba yomzimba (BMI) akuyona ukuhlolwa okuhle kwe-rheumatoid sarcopenia. Lokhu kuhlolwa akulinganisi ukuthi ubukhulu buvela kumisipha noma kumanoni. Abanye abantu abane-rheumatoid sarcopenia bayobe banciphise i-BMI, kodwa kwezinye abantu i-BMI ingaba evamile noma yanda.
I-cachexia ye-Rheumatoid
Enye inkulumo ehlobene ongase uyizwe i-cachexia ye-rheumatoid. I-cachexia ibhekisela esimweni sesisindo esinzima, amafutha, kanye nokulahleka kwemisipha okwenzeka ngenxa yesimo esikhulu sezokwelapha, njengomdlavuza. Ngencazelo, abantu abaningi abane-cachexia ye-rheumatoid nabo bane-rheumatoid sarcopenia. Kodwa akuwona wonke umuntu one-rarumatoid sarcopenia ene-cachexia ye-rheumatoid.
Kodwa-ke, ngisho nabacwaningi abasebenzisi njalo lawo magama. Isihloko singadideka kokubili odokotela neziguli, ngoba imiphakathi yezokwelapha ayizange ibe nenqubo eqondile yokuthola abantu abane-rheumatoid sarcopenia kanye ne-cachexia ye-rheumatoid. Ngokwengxenye ngenxa yalokhu, asinakho ukulinganisela okuhle kokusabalala kwezimo. Siyazi ukuthi iziguli eziningi ezine-arthritis ye-rheumatoid zinenani lobukhulu obuthakathaka obukhulu.
Ukuvimbela Nokuphatha I-Rheumatoid Sarcopenia
Abacwaningi abazange basungulwe iziqondiso ezicacile zokwelashwa kwe-rheumatoid sarcopenia. Kodwa-ke, ochwepheshe bayaqaphela amasu amabili jikelele okuphathwa nokwelashwa:
- Ukwandisa ukwelashwa kwesifo se-arthritis ye-rheumatoid ngokwayo.
- Phishekela umthamo wokuzivocavoca owanele futhi ohlala njalo.
Ukugcina i-arthritis yakho ye-rheumatoid ngokwayo kungaphansi kwezinto ezinhle kakhulu ongayenza ukuze uvimbele uphinde uphathe i-rheumatoid sarcopenia. Izidakamizwa ezinjenge-TNF-blockers kanye nezidakamizwa ze-IL-6 inhibitor zingasiza ekunciphiseni ukuvuvukala okudambisa i-rheumatoid sarcopenia.
Njengamanje, alukho ucwaningo oluningi mayelana nokuthi lezi zindlela zokwelashwa zesikhathi eside zingasiza ekuthuthukiseni i-sarcopenia ngaphezu kwesikhathi eside. Noma kunjalo, ubufakazi obuncane bukhombisa ukuthi lezi zidakamizwa zingase zizuze.
Asinayo idatha eningi uma kuqhathaniswa nokusebenza kwezidakamizwa eziphikisana nezifo ezihlukahlukene eziguqula izifo (DMARDS) ekuphatheni i-sarcopenia. Kuyaziwa ukuthi ukwelashwa kwesikhashana nge- corticosteroids kungenza i-sarcopenia ibe yimbi nakakhulu. Ngokuhamba kwesikhathi, abacwaningi bazofunda kabanzi mayelana nokuthi iziphi izifo ezithile zokwelashwa ezingase zibe ngcono kunazo zonke iziguli ezine-sarcopenia.
Ukuvivinya umzimba
Ukuzivocavoca yiyona enye ingxenye ebalulekile ekubhekaneni ne-rhyumatoid sarcopenia. Ubufakazi bubonisa ukuthi ukuqeqeshwa kokumelana ikakhulukazi kungasiza kuzo zonke ezilandelayo:
- Ukwandisa amandla omzimba
- Izinga elinciphile lomsebenzi wesifo
- Ukunciphisa ubuhlungu besifo
Izisindo, ama-resistance bands, noma isisindo somzimba womuntu siqu singasetshenziswa ukwenza imisipha isebenze kanzima okwesikhashana. Lolu hlobo lokuqeqeshwa kwamandla lungasiza ukuvimbela isisu se-musrophy sarcopheid sarcopenia.
Ubufakazi bubonisa nokuthi ukuvivinya umzimba okubambisana (njengokubhukuda) kungadlala indima yokuzivikela. Buza udokotela wakho iseluleko ekwakheni uhlelo oluthile lokuzivocavoca. Ungathola ukuthi kuyasiza ukusebenza nomqeqeshi wakho isikhathi esithile.
Ukugcina uhlelo oluvame ukuvivinya umzimba kunganikeza enye inzuzo kubantu abane-arthritis ye-rheumatoid. Lesi sifo sibonakala senza ingozi yesifo senhliziyo isanda, kodwa isimiso sokuvivinya umzimba njalo singasiza ukunciphisa ingozi yokuhlasela kwenhliziyo nezinkinga ezihlobene. Ukudla ukudla okunempilo okunempilo okunamaprotheni anele kanye nama-khalori kungasiza ekuvimbeleni i-rheumatoid sarcopenia.
Izwi elivela
Ukubhekana nesifo se-rheumatoid sarcopenia kungakhungathekisa. Kodwa ukwazi ukuthi usengozini yokulahleka kwemisipha kunganikeza isisusa esengeziwe. Ukuze unciphise umthelela we-sarcopenia, gcina isifo sakho silawulwa kahle ngemithi bese uphishekela uhlelo oluqhubekayo lokuzivocavoca.
> De Rocha OM, Batista AP, Maestá N, et al. I-Sarcopenia ku-cachexia ye-rheumatoid: incazelo, izindlela, imiphumela yomtholampilo kanye nemithi yokwelashwa engaba khona . I-Bras J Rheumatol . 2009; 49 (3): 288-301.
> Doğan SC, i-Hizmetli S, i-Hayta E, i-Kaptanoğlu E, u-Erselcan T, uGüler E. Sarcopenia kulabo besifazane abane-arthritis ye-rheumatoid. Journal European of Rheumatology . 2015; 2 (2): 57-61. doi: 10.5152 / eurjrheum.2015.0038.
> Masuko K. I-cachexia ye-Rheumatoid iphinde ibukezwe: i-co-morbidity in-corbidity in arthritis ye-rheumatoid. Imingcele Yokudla . 2014; 1: 20. doi: 10.3389 / fnut.2014.00020.
> I-Targowski T. Sarcopaenia ne-arthritis ye-rheumatoid. I-Reumatologia . 2017; 55 (2): 84-87. doi: 10.5114 / reum.2017.67603.