I-Gout yindlela ye-arthritis ethinta abantu baseMelika abangaphezu kwezigidi ezintathu ngonyaka. Eyaziwa nangokuthi i-arthritis e-gouty, lesi sifo sibangelwa ukwakheka kwamakhekhedi e-uric acid kuhlangene (okuvame ukwedlula izinyawo ezinkulu), okubangela ubuhlungu obunzima, ubomvu, kanye nesisa. Nakuba izici ezithile, njengezifo zofuzo noma izinkinga zezinso, zingase zikufake ku-gout, ukudla, utshwala, nokukhuluphala kungaphinde kufake isandla.
Ukwelashwa kungafaka ngaphezulu kwe-counter (OTC) nemithi kadokotela ukuze unciphise ubuhlungu futhi kunciphise amazinga we-uric acid. Ungaqhubeka nokunciphisa imvamisa yokuhlaselwa ngokulahlekelwa isisindo, ukusebenzisa njalo, nokugwema ukudla okuqala.
Izimpawu
Izimpawu ze-gout zivame ukuqhubeka futhi zizobe zimbi nakakhulu uma zingashiywanga. Ukuqina nokuphindaphinda kwezimpawu kuhlobene kakhulu nesiteji sesifo.
I-gout engaqondakali iyinkathi ngaphambi kokuhlasela kwakho kokuqala. Kule nkathi lapho ukuphakama okuqhubekayo kwe- uric acid egazini lakho kuzobangela urate (usawoti ovela ku-uric acid) ukubopha nokwenza amakhekhe. Ngenkathi ungenaso izimpawu ngalesi sigaba, ukuqongelela kancane kancane kwamakhemikhali cishe kuzoholela ekuhlaselweni.
I-gout ephakathi kahle iyisiteji lapho uzoqala ukuzwa ukuhlasela okuhlala njalo kusuka kwezinsuku ezintathu ukuya kwezingu-10. Ukuhlaselwa (okuvame ukuthinta inzwane enkulu kodwa futhi amadolo, isinxe, isithende, i-midfoot, i-elbow, isihenqo, neminwe) kuzobangela ubuhlungu obungakazelelwe futhi obukhulu obuhambisana nokuvuvukala, ukuqina, ukubomvu, ukukhathala, kanye nokuphelelwa komkhuhlane.
I-gout yokuphefumula engapheli isigaba esiphezulu sezifo lapho amakristalu e-urate ahlanganiswa khona emagqumeni aqinile okuthiwa tophi . Ukwakhiwa kwalezi zimbangi ezingasetshenziselwa ukuguqula umzimba kungadlulela kancane kancane izicubu ze-bone ne-cartilage futhi kuholele ekuguleni kwamathambo nokukhubazeka okuhlangene .
Izinkinga ze-gout ezingasetshenziswanga zihlanganisa amatshe wezinso nokushona kwezinso zezinso .
Izimbangela
Izimo ezithile zezokwelapha zingakwandisa ingozi ye-gout , mhlawumbe ngenxa yokuthi inciphisa umsebenzi wezinso (ukuvumela i-uric acid ukuba iqoqe) noma kubangele ukuvuvukala okungapheli (okuthi abanye ososayensi bakholelwa ukuthi bakhuthaza ukukhiqizwa kwe-uric acid). Izibonelo zibandakanya isifo sezinso esingapheli (CKD) , ukwehluleka kwenhliziyo yokugcoba (CHF) , isifo sikashukela , nesifo samashubhu se-psoriatic .
Ngokufanayo, izakhi zofuzo zingadlala indima. Esinye isibonelo esinjalo ukuguqulwa kwezakhi zofuzo lwe- SLC2A9 noma i- SLC22A12 yegene esiza ukulawula ukuthi uric acid ukhiqizwa kangakanani umzimba nokuthi kungakanani ukuxoshwa. Ezinye izifo ezihlukumezekayo zihlanganisa isifo sezinso ze-polycystic (PKD) nesifo se-Fabry.
Izindlela ezithile zokuphila eziyingozi zingathonya kokubili ukuthuthukiswa nokuqhubeka nesifo. Zihlanganisa:
- Ukukhuluphala , okuhlobene nokusebenza kwezinso ezincishisiwe
- Ukudla okucebile ku- purines , isakhi esitholakala ekudleni okuthile okwenza i-uric acid
- Iziphuzo eziphezulu kanye neziphuzo ezidakayo ezidambisa umsebenzi wezinso
Imithi ethile ine- diuretic effect engakwandisa ukuhlushwa kwe-uric acid egazini, kuhlanganise ne- cyclosporine , i- Lasix (furosemide) , i-aspirin ye-dose ephansi kanye ne-niacin (i-vitamin B3).
Ukuxilongwa
I-Gout ngokuvamile ihlolwe ngesisekelo sokuhlolwa kwebhu kanye nokuhlolwa ngokomzimba.
Ukuhlola ukuhlolwa kungasetshenziswa ukusekela ukuxilongwa kanye / noma ukuhlola izici zomonakalo ohlangene.
Inqubo yegolide yokuxilongwa yi- synovial fluid analysis lapho i-fluids ehlangene ikhishwa ngenaliti nangesirinji futhi ihlolwe ngaphansi kwe-microscope ngobufakazi bamakristalu e-urate. Amanye amathuluzi okuhlola ahlanganisa ukuhlolwa kwemisebenzi yezinso kanye nokuhlolwa kwe- urinalysis ukusiza ukuhlola ingozi yezinso zezinso.
Ukuhlolwa okuhlukile kwe-imaging kungasetshenziselwa ukuhlola ukuthi inani elihlangene lilimale kangakanani. Phakathi kwazo:
- Ama-ultrasound yiyona ndlela ekhethiwe yokuhlola njengoba ingakwazi ukubona ukulimala kokuqala kokuhlanganyela.
- Ama-X-ray angaveza ukuguguleka okuhlangene kodwa hhayi ngezigaba zokuqala.
- Ukucabangela kwe-magnontic resonance (MRI) nokuhlolwa kwe- tomography (CT) kunganikeza ubufakazi obucacile bokulimala kodwa futhi banokulinganiselwa kwezifo zakuqala.
Ukwelapha
Indlela yokwelashwa kwe-gout iphindwe kathathu: ukuphatha ubuhlungu nokuvuvukala, ukunciphisa amazinga e-uric acid egazini, nokuvimbela ukungena kokudla noma imithi ekhuthaza ukukhiqizwa kwe-uric acid.
Ubuhlungu be-Gout bungaphathwa ngokuphumula kanye nephakeji leqhwa ukuze kunciphise ukuvuvukala kwendawo. Izidakamizwa ze-OTC ezingezona ukuvuvukala (i-NSAID) njenge-Advil (ibuprofen) noma i-Aleve (naproxen) ingasiza.
Amacala amancane noma aphindaphindiwe angase azuze emthonjeni we- corticosteroids (wokunciphisa ukuvuvukala kwe- corticosteroids) (okunikezwa iphilisi noma umjovo ube yingxenye) noma umuthi okhuluma ngomlomo okuthiwa i- Colcyrs (i-colchicine) evimbela ama-enzyme okuvuthayo akhishwe uric acid.
Uma ukudla nokunye ukungenelela kwehluleka ukunikeza usizo, izidakamizwa zokunciphisa i-uric-acid ezifana ne- Uloric (febuxostat) noma i- Zyloprim (allopurinol) ingabekwa. Imiphumela emibi ihlanganisa ukukhushulwa kwesisu, i-nausea, ubuhlungu obuhlangene, nokuphunga komzimba.
I-Krystexxa (i-pegloticase), isidakamizwa esisha se- biologic esithunyelwa ngokumnika okufakwe ngaphakathi, ngokuvamile igcinelwe abantu okunye okunye okunye okunye okwelashwa kwe-gout kwehlulekile.
Ukubhekana
Ngesikhathi i-gout ingalawulwa ngokukhululekile ngemithi nokuphumula, kunezinamba eziningi zokuziqapha ongayenza ukuze uphathe noma unciphise ukuphindaphinda kokuhlasela okunamandla. Zihlanganisa:
- Gwema ukudla okuphezulu okufana ne-isibindi, i-veal, i-mussels, i-tuna, i-bacon, nobhiya
- Ukwandisa ukudla kwakho kwezithelo, imifino, okusanhlamvu okuphelele, kanye nobisi obuphansi kakhulu
- Ukuphuza izibuko zamanzi ezingu-8 kuya kwangu-16 ngosuku ukuze usize ukucacisa i-uric acid ngokusebenzisa ukuchama nokuphucula ukugxila egazini
- Ukuqalisa uhlelo oluhlelekile lokulahlekelwa isisindo uma ukhuluphele noma ukhuluphele kakhulu
- Ukuphakamisa unyawo lwakho ngesikhathi sokuhlaselwa okumangalisayo bese uyibeka ngokuphepha
- Ukusebenzisa idivayisi noma umshini wokuhamba ukuze ugcine ingcindezi enyaweni
- Ukusebenzisa amasu okuphumula ukuphatha kangcono ubuhlungu
Uma izimpawu zakho zingathuthuki emva kwamahora angu-48 noma zihlala isikhathi esingaphezu kweviki, shayela udokotela wakho ukuhlela i-aphoyintimenti. Kwezinye izimo, imithi ingadingeka ukuthi ishintshwe noma ishintshwe uma ihluleka ukunikeza usizo.
> Imithombo:
> Hanani, B; UMatheson, E. noWilke, T. "Ukuxilongwa, Ukwelashwa, Nokuvimbela I-Gout." Am Fam Physician. 2014; 90 (12): 831-836.
> Richette, P. noBarden, T. "Gout." Lancet. 2010; 375 (9711): 318-28. I-DOI: 10.1016 / S0140-6736 (09) 60883-7.
> Zhang, Y .; Chen, C .; Choi, H. et al. "Ukudla okune-Purine-rich rich and gout attack" . 2012; 71 (9): 1448-53. I-DOI: 10.1136 / ngonyaka-2011-201215.