Ukubhema nokukhuluphala kufaka umthwalo wokuvuvukala
Abantu ngezinye izikhathi bacabanga ukuthi i-arthritis ye-rheumatoid ne-osteoarthritis yizinto ezifanayo. Ngenkathi i-osteoarthritis ibangelwa ukugqoka nokudabuka kwesikhathi esigcwele kwesifo samathambo esihlangene, i-rheumatoid isifo esiyinkimbinkimbi kakhulu futhi esididayo lapho isimiso somzimba sokuzivikela sibhekela amangqamuzana namascuba, kuhlanganise nalawo amalunga, isikhumba, nezinye izitho.
Njengazinye izifo ezizimele, ezifana ne-lupus ne-psoriasis, imbangela eyimbangela ye-arthritis ye-rheumatoid ayiqondakali kahle.
Lokho esikwaziyo ukuthi izici ezithile-kuhlanganise nokubhema nokukhuluphala-kungakubeka engozini ephakeme yokungatholi kuphela lesi sifo kodwa ubhekene nezimpawu ezimbi kakhulu.
Ezinye zezinto ezibeka ingozi ngenxa ye-arthritis ye-rheumatoid ziguquguqukayo (okusho ukuthi singashintsha), kanti ezinye ezingenakuguqulwa futhi zengozi engokwemvelo.
Izingozi ezingekho ezingaguquguquki
I-arthritis ye-rheumatoid ithinta amanye amaqembu ngaphezu kwamanye. Izinto ezintathu ezingaguquguquki ezivame ukuxhunyaniswa nesifo ziyisikhathi, ubulili, nomlando womndeni wesifo samathambo.
Ubudala
Nakuba i-arthritis ye-rheumatoid ingahlasela nganoma yisiphi isikhathi, ukuqala kwezimpawu kuvame ukuqala phakathi kweminyaka engama-40 no-60. Ngaphezu kwalokho, ingozi izokwandisa omdala okhulile. Ngokuvamile, izinkinga zokuthuthukisa isifo samathambo zizophindwa kathathu phakathi kweminyaka yobudala engama-35 no-75, zikhuphuka kusuka kumacala angu-29 kubantu abangu-100 000 kuya kuma-99 amacala angaba ngu-100 000, ngokusho kocwaningo oluvela eMayo Clinic.
Ubulili
Abesifazane kanamathuba amathathu okuthola i-arthritis ye-rheumatoid kunamadoda. Ngenkathi incazelo yalokhu kungavumelani akude iqine, ama-hormone akholelwa ukuthi adlala indima enkulu.
Lokhu kuboniswa ngokuyingxenye yocwaningo oluye lwabonisa ukuthi abesifazane bazovame ukuthuthukisa lesi sifo ngemuva kokushiya okukhulu emahomoni abo.
Lokhu kwenzeka ngezinye izikhathi ngokushesha emva kokukhulelwa noma ngokulandelana kokuqala kokuya esikhathini. I-Estrogen , noma ngokuqondile ukuchithwa kwe-estrogen, ikholelwa ukuthi iyona yecala.
Ngakolunye uhlangothi, ukubuyisela i-estrogen kunganikeza inzuzo yokuvikelwa kwabesifazane asebekhulile abangase bangabe besengozini.
Inzuzo efanayo ingadluliselwa kwabesifazane abasebasha abasebenzisa inhlanganisela yokubeletha ngomlomo (aka "iphilisi"). Ngokusho kwabacwaningi be-Karolinska Institute e-Stockholm, abesifazane abaye basebenzisa isisu sokuvimbela ukubeletha esine-estrogen iminyaka engaphezu kwengu-7 banomthelela wamaphesenti angaba ngu-20 kunciphise ingozi yokudla kwesifo samathambo uma kuqhathaniswa nabesifazane abangazange bathathe iphilisi.
I-Genetics
Uma unomzali noma umntakwabo ene-arthritis ye-rheumatoid, ingozi yakho yokuthuthukisa lesi sifo iphinde ibe mithathu kathathu kunabantu abaningi. Isihlobo sesibili-izihlobo cishe okungenani kabili ingozi yakho. Lezi zibalo zisiza ukubonisa indima ebalulekile i-genetics edlalayo ekuthuthukiseni isifo se- autoimmune .
Ngokwesifundo se-2017 eshicilelwe kuyi-Lancet, izakhi zofuzo zidlala ingxenye phakathi kwamaphesenti angu-40 namaphesenti angu-65 azo zonke izigameko eziqinisekisiwe. Ngenkathi izitoli eziqondene nezakhi zofuzo zingakabonakali, abantu abanezifo ezizimela ngokuzenzakalelayo bakholelwa ukuthi banezakhi ezithile noma eziningi ezishintsha indlela isimiso somzimba sokuzivikela sibheka futhi sibheke ama-agent abangela isifo.
Esikhathini sesimiso sokuzivikela somzimba esivame ukusebenza, umndeni wezakhi zofuzo obizwa ngokuthi i- human leukocyte antigen (HLA) isisiza ukuba isimiso somzimba samasosha omzimba sikwazi ukuhlukanisa amangqamuzana ayo avela kulabo abahlaseli bangaphandle. Nge-arthritis ye-rheumatoid nezinye izifo ezizimele, ezinye izinguquko ze-HLA zingaqeda ukuthumela imilayezo engafanele kwisistimu yomzimba, iyala ukuthi ihlasele amangqamuzana ayo kanye nama-tissue. Enye yezinguquko ezihlotshaniswa nalokhu yi- HLA-DR4 .
I-HLA-DR4 ixhunyaniswe nezinye izifo ezizimele, kuhlanganise i- lupus , i- polymyalgia rheumatica , nesifo sofuba esibangelwa yi-autoimmune hepatitis. Okunye ukuguqulwa kwegciwane le-HLA kuthiwa kuhlanganiswe.
Izindlela Zengozi Yokuphila
Izindlela zokuphila zengozi yizo ezingaguquguqukayo. Ukushintsha lezi zici kungase kunganciphisi kuphela ukucindezeleka kokugula kwakho, bangase banciphise ingozi yakho ukuthi isifo siyithole kuqala. Ukubhema nokukhuluphala yizinto ezimbili ezivelele kakhulu.
Ukubhema
Ukubhema kunobungane obangela imbangela nomphumela nge-arthritis ye-rheumatoid. Akukona nje ukuthi ugwayi ukwandisa ingozi yokuthola lesi sifo, angakwazi ukusheshisa ukuqhubeka kwezibonakaliso zakho, ngezinye izikhathi kakhulu.
Ukubuyekezwa okuphelele kwezifundo zomtholampilo ezenziwa abacwaningi e-Kobe University Graduate School of Medicine waphetha ngokuthi ukubhema okukhulu (okuchazwa njengokubhema ipakethe kagwayi ngosuku ngeminyaka engaphezu kwengu-20) cishe kuphindwe kabili ingozi ye-rheumatoid arthritis. Amadoda cishe angaba kabili angathinteka kunabesifazane futhi ngokuvamile abhekene nezimpawu ezimbi nakakhulu.
Ngaphezu kwalokho, ababhemayo abahlolwayo nge- rheumatoid factor (RF) banamathuba amathathu okuthola i-arthritis ye-rheumatoid kunabalingani babo abangabhemi, kungakhathaliseki ukuthi bangamanje noma ababhemayo odlule. Njengobungozi bayo abazimele, ukubhema kuyaziwa ngokukhuthaza ukufa kwe-cell, ukwandisa ukuvuvukala, futhi kuvuselele ukukhiqizwa kwama- radicals mahhala okulimaza okwedlulele kakade ama-tissue ahlangene.
Ngisho noma uthatha imithi yokwelapha lesi sifo, ukubhema kungaphazamisa umsebenzi wabo futhi kubenze baphumelele. Lokhu kufaka phakathi imithi eyisisekelo njenge methotrexate kanye ne-TNF-blockers entsha efana ne- Enbrel (etanercept) ne- Humira (adalimumab) .
Ukukhuluphala
I-arthritis ye-rheumatoid ibonakala ngokuvuvukala okungapheli okwenyuka kancane kancane futhi kubhubhise amathambo kanye nezicubu ezihlangene. Noma yini engeza kulokhu ukuvuvukala kuzokwenza izinto zibe zimbi nakakhulu.
Ukukhuluphala yisinye isimo esinjalo esingabangela ukuvuvukala kwesistimu, okubangelwa ukuqoqwa kwama-adipose (amafutha) amangqamuzana kanye nokukhiqizwa kwamaprotheni okuvuvukala okuthiwa yi- cytokines . Uma amangqamuzana adipose anakho emzimbeni wakho, ephakeme ukuhlushwa kwama-cytokines.
Ngakho-ke, akumangazi ukuthi abantu abanesisindo sokudla ngokweqile bazobhekana nokuwohloka okusheshayo kwamalungu abo uma kuqhathaniswa nabantu abanesisindo esivamile futhi banezinkinga eziningi ezihlobene nesifo, kubandakanya i- pericarditis (ukuvuvukala kwekhanda lensiza), i- pleuritis (ukuvuvukala kwendwangu amaphaphu), kanye ne- vasculitis (ukuvuvukala kwemithambo yegazi).
Ngaphezu kwalokho, isisindo somzimba esandayo asikwazi ukusiza ngaphandle kokufaka ukucindezeleka kumajoyini athintekile, ikakhulukazi emadolweni, emaceleni nasezinyaweni, okuholela ekulahlekelweni okukhulu kokuhamba nokuhlupheka.
Ukukhuluphala kungakuphanga futhi ikhono lakho lokufezekisa ukuxolelwa, isimo sesifo esiphansi lapho ukuvuvukala kungaphansi kokulawula. Ngokusho kocwaningo oluvela kwi-Weill Cornell Medical College, abantu abanomlando wesikhumba somzimba (BMI) abangaphezu kuka-30-incazelo yokuthoma yokukhuluphala-bangamaphesenti angama-47 angaphansi afuna ukuzuza ukukhululwa uma kuqhathaniswa nabantu abane-BMI ngaphansi kwama-25.
Ukucindezeleka ngokomzimba nangokomzwelo
Nakuba izimpawu ze-arthritis ze-rheumatoid zivame ukungena ngenxa yezizathu ezicacile, kunezimo ezingase zenze ukukhuphuka kwezimpawu kungazelelwe.
Ukuxoshwa komzimba kungenye yalezi zinto. Ngenkathi isimiso salokhu singacaciswanga kahle, kukholelwa ukuthi ukukhululwa okungazelelwe nokugqamile kwama-hormone okucindezeleka, njenge-cortisol kanye ne-adrenaline, kungase kube nomphumela ongqongqozayo oqinisa impendulo yokuzimela. Yize lokhu kungabonakali nganoma iyiphi indlela izinzuzo ezinkulu zokuzivocavoca ekwelapheni isifo sofuba, kuphakamisa ukuthi umsebenzi womzimba kufanele ufaneleke, ikakhulukazi uma amalunga ekhonjelwe.
Ukusabela komzimba ekucindezelekeni ngokomzimba kungase kuboniswe ukusabela kwayo ekucindezelekeni ngokomzwelo. Nakuba ososayensi bengakatholi ubudlelwane obucacile phakathi kokucindezeleka nesifo se-rheumatoid arthritis , abantu abaphila nalesi sifo bayovame ukubika ukuthi ukuqhuma okusheshayo kungaphambi kwesikhathi sokukhathazeka ngokweqile, ukucindezeleka noma ukukhathala.
Ezinye izinto ezivamile ezibandakanya ukutheleleka, kuhlanganise nomkhuhlane noma umkhuhlane, okuhlobene nokusebenza komzimba. Ama-flare-up angase ayenze ekuphenduleni ukudla okunye okudlayo, okuyinto ekholelwa ukuthi ixhunyaniswe nempendulo ephikisayo lapho isimiso somzimba samasosha omzimba sibheka ngokungavamile.
Zonke lezi zici zibeka izinyathelo ezihlukahlukene zokucindezeleka emzimbeni wesimiso somzimba sokuzivikela, ngezinye izikhathi esibi.
Imithombo:
> Alpizar-Rodriquez, D .; I-Pluchino, i-N .; Canny, G. et al. "Indima yezinsikazi ze-hormonekazi ekuthuthukiseni isifo samathambo esifubeni." I-rheumatology. 2017; 56 (8): 1254-63. I-DOI: 10.1093 / rheumatology / kew318.
> Doran, M .; I-Pond, G .; Crowson, C. et al. "Amathrendi ekufweni nokufa kwesifo samathambo eRochester, Minnesota, ngaphezu kweminyaka engamashumi amane." I- Arthritis Rheum. 2002; 46: 625-3. I-DOI: 10.1002 / art.509.
> Orellana, C; Saevarsdottir, S .; Klareskog, L. et al. " Ukuvimbela isisu ngomlomo, ukuncelisa ingane kanye nengozi yokuhlaselwa isifo samathambo: imiphumela evela kwisifundo se-EIRA saseSweden." I- Annal Rheumatic Dis. 2017; 76: 1845-52. I-DOI: 10.1136 / annrheumdis-2017-211620.
> Schulman, E .; U-Bartlett, uS .; Schieir, O. et al. "Ukukhuluphala ngokweqile nokukhuluphala kunciphisa amathuba okuthola ukuxoshwa okuqinisiwe ku-Rheumatoid Arthritis yokuqala: Imiphumela evela eSifundweni SeCanada yaseCanada Early Arthritis." Ukunakekelwa Kwe-Arthritis Res. 2017. DOI: 10.1002 / acr.23457.
> 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.