I-Tophi yi-aggregates yama-crystal urate monohydrate amakristali afakwe ngaphakathi nangakuzungezile amalunga abantu abane-gout. Kunezinyathelo ezintathu zomuthi: ukungabonakali (ngaphandle kwezimpawu) hyperuricemia , i-gout yesikhashana (iziqephu ze-arthritis ekhukhumayo eziphethwe yisikhathi), nesifo samathambo esingaguli. Kuphakathi kwesigaba sesithathu, i-arthritis engapheli, lapho i-tophi ivame ukuvela khona.
I-Tophi ingase isolwe ngenkathi isigaba se-arthritis esiyingozi kakhulu.
Lapho Ifomu le-Tophi
Phakathi nesigaba esingenasifo samathambo esihlala njalo, azikho izinkathi ezingenabuhlungu. Isikhathi sesikhathi phakathi kokuhlasela kokuqala kwe-gout kwisigaba esingapheliyo samathambo e-arthritis ne-tophi ebonakalayo ekuhloleni kweziguli ze-gout ezingaphenduliwe. Imiphumela yokufunda (uHench, P. et al.) Yembula ukuthi isikhathi esivela ekuqaleni kokuhlasela kwe-gout ekuqaleni kwe-arthritis esingapheli noma ukuthuthukiswa kwe-tophi ebonakalayo kwakuneminyaka eyi-11,6. Esikhathini sokucwaninga okubandakanya iziguli ezingaphezu kuka-1 100 izigungu eziyisisekelo, labo abangenawo ama-tophi babe namazinga e-serum urate we-10.3 +/- 1.3 milligram / deciliter. Labo abanobuningi obuphezulu be tophi babe namazinga e-serum urate angu-11.0 +/- 2.0 milligram / decilter.
Kungani ifomu le-Tophi
Izinga le-tophi lizoklanywa ngokulingana nobukhulu nobude be-hyperuricemia. I-gout ephezulu ivela ngenxa yokungakwazi komzimba ukuqeda u-urate ngokushesha njengoba kukhiqizwa.
Njengoba i-urate engaphezu kweqoqo iqoqa, urate ama-crystal deposits angakha.
Ngenkathi izinga le-serum urate yiyona nto eyinhloko ehlotshaniswa nokubunjwa kwe-tophi, kungase kube nezinye izici ezithintekayo, kufaka phakathi: ukuqala kokuqala komuthi, isikhathi eside soguqu olusebenzayo kodwa olungaphenduliwe, isilinganiso sezinhlobo ezine zokuhlaselwa kwe-gout ngonyaka, nomkhawulo ophezulu nokubandakanyeka kwepolyarticular .
Ukuthuthukiswa kokuqala kwe-tophi-kubantu abaye banomdlavuza iminyaka engaphansi kwengu-10-kwenzeka kubantu abangamaphesenti angu-15. Isikhundla se-Creatinine yisici esizimele esiye saxhunyaniswa nokwakheka kokuqala kwe-tophi.
Lapho ifomu le-Tophi
I-Tophi ingafakwa kwi-cartilage, i-synovial membrane, i-tendon, nezicubu ezithambile. Ngesikhathi i-tophi ingatholakala noma kuphi emzimbeni, ivame kakhulu eminwe, izinwele, izindlebe, amadolo, i-olecranon bursa, namaphoyinti okucindezela (isb., Isici se-ulnar se-forearm, i-Achilles tendon). Ezingxenyeni ezixhumeneyo, i-tophi ingatholakala emiphakamideni yama-renal, ama-valves enhliziyo, nesipula.
Izici ze-Tophi
I-Tophi ayinabuhlungu, kodwa ukuvuvukala okunzima kungase kuthuthuke kuzo. Kukhona ukubhujiswa kwamajoyina nokukhubazeka okungenzeka, ikakhulukazi kwezandla nezinyawo. Isikhumba esiphezu kwe-tophus singaba yi-taut futhi ekugcineni sibe nesilonda. I-white chalky noma i-pasty substance, eyenziwe ngamakristali e-urate, ingaxoshwa ku-toxics ye-ulcerated. I-Tophi ingatholakala nge-ultrasonography, i-MRI, ne-CT scan. Izithombe eziningi kakhulu ze-tophi zivela ku-CT scan.
Ikhwalithi Yokuphila
Abacwaningi bacabangela umthelela we tophi kanye nemvamisa yokuhlasela okunamandla kwe-gout ekwenzeni impilo ehlobene nempilo.
Ucwaningo ( Impilo kanye Nemigomo Yemiphumela Yokuphila 2012) lathinte iziguli ezingu-620 ezine-gout ezibikiwe, abangu-12.3% abafanele bafike ku-tophi. Kube nekhwalithi yokuphila ehlobene nempilo eyancipha ehlotshaniswa kokubili kwe-tophi ne-gout flares.
Izwi elivela
Izinga le-serum urate yiyona nto eyinhloko ehambisana nokubunjwa kwe-tophi. Abanye abantu abahlangabezana nokuhlaselwa kwe-gout bayeka ukulalela ngesikhathi sesigaba sokungabonakali phakathi kokuhlaselwa. Kodwa, kubalulekile ukuqapha amazinga e-uric acid njalo. Kubalulekile ukwelapha i-gout bese uzama ukuyiphatha kahle, hhayi nje uma izimpawu zibonakala.
Ukuba khona kwe-tophi kuhlotshaniswa nekhwalithi yokuphila eyancipha. Kufanele kube umgomo wakho ukuzama ukuvimbela i-tophi ngokulawula ukuphathwa kwegazi nokugcoba kahle.
> Imithombo:
> Dalbeth, Nicola, et al. Ukukhishwa kwe-Creatinine kuncishisiwe kuhlanganiswa nokuthuthukiswa kokuqala kwe-Tophi encane kubantu abano-Gout. Ukuhlukunyezwa kwe-BMC Musculoskeletal. Disemba 21, 2013.
> Hench, P. Ukutholakala kwe-gout ne-gthy arthritis. UJ Lab Clin Med 220: 48-55. 1936.
> Khanna PP et al. I-Tophi ne-Gout Flavour Ehlangene Nezimo Eziphuthumayo ku-Quality of Life, Ukukhiqiza, Nokusetshenziswa Kwemithombo Yokunakekelwa Kwezempilo: Imiphumela Evela Esihlolweni Esiqhamukayo. Impilo kanye Nemiphumela Yemiphumela Yokuphila. Ngo-Septhemba 22, 2012.
> Ngaphambi kokugula ngezifo. I-Arthritis Foundation. Umqulu wesithathu. Ikhasi 243.
> Kelley's Bookbook of Rheumatology. U-Elsevier Saunders. I-Ninth Edition. Umqulu II. P.1558-1560.