Lapho Wena Stop Ukubuyela emuva Kodwa MS wakho Worsens
Kulinganiselwa ukuthi amaphesenti angama-85 abantu abane- multiple sclerosis (MS) aqale ahlolwe ngokuthi abuyela kabusha MS (RRMS). Iningi lalaba bantu ekugcineni lizokuthuthukisa i-MS yesibili (i-SPMS) ehamba phambili, ekhonjiswe ngokuqhubekayo okuqhubekayo kwezimpawu nokukhubazeka futhi okuncane noma akukho ukubuyela emuva .
Ngaphambi kokwelashwa kwesifo-ukuguqulwa kwavela kabanzi, cishe amaphesenti angama-90 abantu abane-RRMS ekugcineni athuthukisa i-SPMS engakapheli iminyaka engu-25 nengxenye engakapheli iminyaka engu-10.
Manje akucaci ukuthi iziphi izifo ezithinta izifo ezithinta izifo zine-MS, kodwa kuthathwa (futhi zithemba) ukuthi le nxenye iphansi, kanti i-SPMS ihamba kancane ukuthuthukisa.
Ngubani okungenzeka ukuthi uhambe ukusuka ku-RRMS ku-SPMS?
Abantu bangashintsha ekubeni ne-RRMS ku-SPMS nganoma yisiphi isikhathi, futhi inqubo ivame kancane kancane. Eqinisweni, kuvame ukungena endaweni ephakathi kwe-RRMS ne-SPMS-uma umuntu ehamba esigabeni sokuqhubeka se-MS kodwa okwamanje ukuthola ukuphindaphindiwe kwe-MS. Ngokuvamile, lokhu kuguquka kwenzeka eminyakeni engaba ngu-5 kuya kwengu-20 emva kokuqala kwezifo.
Ngokwezizathu ezingase zithinte ukuguqulwa kusuka ekubuyiseni kabusha kwe-MS kuya kwi-MS eyimpumelelo yesibili, izifundo (ezinganeni ezingakazwelwa ze-MS) zibonisa ukuthi amadoda avela ukuthuthukisa i-SPMS esheshayo futhi esemncane kunabesifazane. Ngaphezu kwalokho, labo abanezimpawu zemoto ekuqaleni kwe-MS yabo, njengokubunzima ukuhamba, bathuthukise i-SPMS ngokusheshisa.
Izimpawu I-RRMS Eye Yaba Khona Noma Kuba SPMS
Kubalulekile ukuqonda ukuthi ayikho imikhombandlela ecacile noma imigomo echaza lapho umuntu ehamba esuka ku-RRMS ku-SPMS. Nokho, ngezansi kukhona ezinye izinkomba noma izimpawu zokuthi umuntu onama-MS nodokotela wakhe angasebenzisa uma enquma ukuthi lokhu kuguqulwa noma kwenzeka.
Imithi yakho ayisebenzi kahle: Naphezu kwemizamo yakho emihle nokunamathela , abanye abantu abane-RRMS kwizidakamizwa zamanje eziguqula izifo baqala ukukhombisa ukukhubazeka okwandayo ngaphandle kokunyuka okuhambelana nenani lezilonda emikhankaso yabo ye-MRI. Lokhu kungaba yisibonakaliso sokuthi bayahamba esigabeni sokuqhubeka se-MS noma i-SPMS.
Ngakolunye uhlangothi, imithi yakho engasebenzi ingase ibe ngenxa yesinye isizathu. Isibonelo, uma ukuvimbela ama-antibodies kwesinye sezidakamizwa ezisekelwe e-interferon kukhona, i-neurologist yakho ingakushintshela kwenye.
Ngaphandle kwalokho, abanye abantu bakhathazeka ukuthi bangena esigabeni sokuqhubeka se-MS ngoba bayeka ukubuyela emuva. Kodwa lokhu kungaba yinto enhle kakhulu, njengoba kungase kusho ukuthi ukwelashwa kwakho ukuguqula isifo kusebenza.
Ukubuyela kabusha kuyashintsha: Umlando wemvelo we-RRMS ukuba nenombolo yokubuyiselwa emuva empeleni iyancipha ngokuhamba kwesikhathi. Kodwa-ke, ukubuyela emuva okuzokwenzeka kungase kube nzima kakhulu, kuletha izimpawu eziningi, kunokuba nje kuthinte indawo eyodwa yomsebenzi. Ngaphezu kwalokho, ukutakula kusuka ekubuyiseleni okuvame ukuphela, okusho ukuthi ngisho nangemva kokuba isigaba esibucayi sokuphindaphinda siphelile, ezinye izimpawu kanye / noma ukukhubazeka kuhlala. Ukwengeza, lo muntu akasabe esabela (nakancane) ku -Solu-Medrol ngenkathi lokhu kubuyela emuva.
Ukukhubazeka okukhulu: Uma kulinganiswa yi- Expanded Status Scale (EDSS), abantu abane-RRMS bavame ukuba namaphuzu amane noma ngaphansi. Ngakolunye uhlangothi, abantu abane-SPMS banamaphuzu ayisithupha noma ngaphezulu-okusho ukuthi uhlobo oluthile lusizo oludingekayo ukuhamba. Abantu abane-RRMS abafinyelela ezingeni le-4 kuya ku-5,5 (kuboniswe ukungakwazi ukuhamba ngamamitha angaphezu kuka-500 ngaphandle kokuphumula) ngokuvamile bahlakulele i-SPMS ngaphakathi kwesikhathi esifushane.
Kuzobe kukhona nokungajwayelekile okutholakala ngesikhathi sokuhlolwa kwegazi. Lokhu kubonisa ukuthi ubuchopho abukwazi ukukhokhela ukudilizwa kwe-MS.
Okokugcina, abantu abathuthukisa i-SPMS bathambekele ekuboniseni ukuphazanyiswa okungaphezulu kwengqondo. Lokhu kungenzeka kakhulu ngenxa yezinga eliphezulu le-atrophy ebuchosheni, elihlobene kakhulu nokusebenza okungaqondakali . Lokho okushiwo ngempela ukuthi ubuchopho abukwazi ukukhokhela umonakalo, ikakhulukazi lapho kukhona khona ukubhujiswa okuphelele kwe-axonal (i-nerve fiber), okuholela emigodini emnyama.
Inani elikhulu lomonakalo obonwe kwi-MRI:
- Umthwalo omkhulu we-lesion: Lokhu kusho ukuthi kukhona inani elikhulu lezilonda, ezivame ukuba:
- Emaphethelweni ama-ventricles (emithonjeni ebuchosheni egcwele cerebrospinal fluid)
- Ukuqokwa
- Igxile ebuchosheni bomgogodla nomugogodla
- Umonakalo omkhulu we-axonal kanye "nezimbobo ezimnyama:" Izindawo ezibonisa amabala amnyama (hypointense) ku-scan ye-T1 zibhekwa ngokuthi "izimbobo ezimnyama." Lezi yizindawo lapho kuvuke ukuvuvukala okuphindaphindiwe, okuholela ekubhujisweni okuphelele kokubili kwe-myelin i-axons ngokwabo. Lezi zindawo zihambisana ngokukhubazeka.
- Ukwandiswa kwezingqalasizinda ze-CSF ebuchosheni: Lesi yisilinganiso se- atrophy , njengoba kunesisindo esincane sobuchopho, ngakho-ke izikhala ezungeze ngaphakathi nangaphakathi kobuchopho zikhula.
- Nciphisa izilonda ezithuthukisa i-gadolinium: Ngokudabukisayo, inani lezilonda ezintsha, ezisebenzayo ze- gadolinium-enhancing linciphisa ngezigaba kamuva ze-RRMS. Lokhu kungenxa yokuthi lesi sifo cishe sinokukhubazeka kakhulu kunokuvutha.
Izwi elivela
Ngenkathi isifo sakho sokuguqula isifo singasiza ekunciphiseni ukuguqulwa kusuka ekubuyiseni kabusha kwe-MS kuya kwi-MS yesibili eqhubekayo, le nqubo isengenzeka nakwezinye. Ngakho-ke ungazibeki icala uma usuka esigabeni sokubuyela emuva se-MS kuya esigabeni sokuqhubeka-kuyinqubo yemvelo, eyingqayizivele kumuntu ngamunye, hhayi ngenxa yento oyenzile.
Imithombo
Coyle, Patricia K. noHalper, ngoJuni. Ukuphila ne-Progressive Multiple Sclerosis: Ukunqoba Izinselele (2nd Ed.) ENew York: Ukushicilelwa Kwezokwelapha zeDemos. 2008.
Koch M, Kingwell E, Rieckmann P, Tremlett H, UBC MS Clinic Izinzwa ze-neurologists. Umlando wemvelo we-multiple sclerosis. Journal of Neurology, Neurosurgery, & Psychiatry, 2010; 81 (9): 1039-43.
Lublin FD et al. Ukuchaza inkambo yemitholampilo ye-multiple sclerosis. I-Neurology. 2014 Jul 15; 83 (3): 278-86.
I-National MS Society. I-MS eqhubekayo eqhubekayo.
Tremlett H, Yinshan Zhao, Devonshire V. Umlando wemvelo we-multiple-progressive multiple sclerosis. I-Multiple Sclerosis , ngo-2008; 14 (3): 314-24.