Ukuguqula izifo zendlebe ngaphakathi kungumzimba ongajwayelekile ongaholela ekunciphiseni okusheshayo ekuzweni kwakho futhi ngezinye izikhathi izimpawu ezinjengesizungu noma ukulahlekelwa ibhalansi.
Iyini Izifo Ezizimele Ezizimele Ngaphakathi Nakho Nalokho Okubangela?
Izifo ezithinta ngokuzenzakalelayo ezithinta indlebe yangaphakathi akuzona zonke eziqondakala kahle, kodwa ngokuvamile zibandakanya izingxenye zesistimu yomzimba (amasosha omzimba noma amasosha omzimba) okungaziwa ngezizathu ezingaziwa ziqala ukuhlasela izakhiwo ezakha indlebe yangaphakathi.
Kunemibono eminingi mayelana nokuthi lokhu kwenzeka kanjani kodwa lokhu kuvame ukuvela ngokuphathelene nesinye isifo esizimele esisebenza ngokuzenzakalelayo njenge:
- Izifo (ngokuvamile okuhlobene nokudla)
- Isifo se-Cogan
- I-systemic lupus erythematosus (ecatshangwa ukuthi iyinto evamile kodwa ukulahlekelwa ukuzwa kungase kuhlobene nemiphumela emibi yemithi esetshenziselwa ukuphatha lesi sifo)
- I-Sjogren's syndrome (ngezinye izikhathi ibizwa ngokuthi i-dry-eye syndrome)
- I-rheumatoid arthritis (impikiswano)
- I-ankylosing spondylitis
- I-colcer ulcerative
- I-granulomatosis ka-Wegener
- Scleroderma
- I-arthritis yengqondo
- Isifo sikaBehcet
- Ukubuyiselwa kabusha kwe-polychondritis (evamile)
- I-Polyarteritis nodasa
Ezinye izifo ezithathelwanayo nazo zihlotshaniswa nokulahlekelwa kwezindlebe ngokuzenzakalelayo. Lokhu kufaka:
- Isifo se-Lyme
- I-Syphilis
Lezi zifo zicatshangelwa ukuthi zihlotshaniswa nokukhiqizwa kwama-antibody okukhulayo nokuhlaselwa okulandelayo kwendlebe yangaphakathi kulawo ma-antibodies. Ezinye izimbangela ezikhona noma izimo ezihlobene zihlanganisa:
- Ama-hydrops ahamba phambili (isimo esingavamile esenzeka ngemva kokulimala kwekhanda)
- Ukulimala okuhlinzekwayo noma ukuthungatha amathambo okwesikhashana
- Isifo sikaMeniere
Ukuzwa ukulahlekelwa okubangelwa yisifo se-autoimmune yisisusa esingavamile sokubala ukulahlekelwa kokuzwa cishe amaphesenti angu-1 amacala.
Izimpawu Zesifo Sokuzizwa Kwangaphakathi Ngaphakathi
Isibonakaliso esivamile kakhulu se-earmmune isifo sokungalaleli ngaphakathi ngokungazelelwe ukulahlekelwa ukuzwa okuvame ukuvela kuzo zombili izindlebe (bilaterally).
Lokhu kulahlekelwa okusheshayo okuvame ukuhlushwa njengokwemvelo futhi kuvame ukuhambisana nezimpawu zokugqoka ezifana nokuzondeka noma ukulahlekelwa ibhalansi. Ukulahlekelwa kwezindlebe ngokuvamile kwenzeka esikhathini esiyizinyanga ezimbalwa.
Ukubona izifo zezintambo zangaphakathi ezizimele
Uma unezibonakaliso zesifo somzimba wangaphakathi we-autoimmune udokotela wakho angasebenzisa inhlanganisela yezivivinyo eziningana ukuze asize ukuqinisekisa ukuthi lokhu kuhlolisiswa. Nazi ezinye zezivivinyo udokotela wakho angakhetha ukuyiyala:
- Ukuhlolwa kwegazi ukusiza ukuqinisekisa noma ukukhipha isifo se-autoimmune esingaphansi (i-ANA, isilinganiso se-erythrocyte sedimentation, i-rheumatoid factor, ama-antigens e-human leukocyte, amaprotheni asebenzayo eC).
- Okunye ukuhlolwa kwegazi kungabandakanya: ukuhlolwa kwe-anti-cochlear antibody, i-lymphocyte transformation transformay, i-Lyme titer.
- Izivivinyo ezihlukahlukene zokuzwa zibandakanya: i-audiometry, i- ABR, ukuhlolwa kwe-otoacoustic emission , i-ECOG (electrocochleography).
- Udokotela wakho angase akhethe futhi ukuzama imithi yokuzivikela noma i-corticosteroid bese ubona ukuthi uyayiphendula yini. Impendulo enhle izosiza ukuqinisekisa ukuxilongwa kwesifo somzimba ngaphakathi ngaphakathi. Kodwa-ke, uma ungaphenduli emithini yemithi akusho ukuthi awunayo isifo sezindlebe ngaphakathi ngaphakathi.
- Ukuhlolwa kwesitulo se-Rotary: Lokhu kuhlolwa kusiza ukucacisa ukuthi ukukhathazeka noma ukuxazulula izinkinga kubangelwa isistimu ye-vestibular noma enye ingxenye yomzimba.
Azikho izivivinyo ezibalwe ngenhla ezicacile zezifo zendlebe ngaphakathi ngaphakathi kodwa zisetshenziselwa ukusiza ukulawula noma ukuqinisekisa izimo ezihambisanayo. Ukuxilongwa kuxhomeke ekuhlanganisweni kwezimpawu zakho, umlando wezokwelapha, okutholakala nodokotela ngesikhathi sokuhlola ngokomzimba kanye nanoma yimiphi imiphumela efanele yokuhlolwa.
Ukwelapha Izifo Zendlebe Zomlomo Ozimele
Ngokuvamile umugqa wokuqala wezokwelapha uyinkambo yemithi ye-steroid yomlomo njenge-prednisone, dexamethasone, noma i-aldosterone. Zivame ukusetshenziselwa isikhathi sezinyanga ezi-1. I-steroids ngokuvamile ayisetshenziselwa abantu abanesifo sikashukela, isifo sesilonda se-peptic, i-glaucoma, noma i-high blood pressure.
I-Steroids iyasebenza cishe ngamaphesenti angu-60 yesikhathi. I-Steroids akumele ivele ishiywe ngokushesha, kodwa kancane kancane ithaqwe.
I-steroids yomlomo ingabangela imiphumela emibi kakhulu kwabanye abantu. Ngenxa yalesi sizathu udokotela wakho angakhetha ukubeka i-steroids ngqo endlebeni yakho yangaphakathi (le ndlela yokuphatha imithi ibizwa ngokuthi i-transtympanic). Lokhu kuhilela ukucubungula okuncane okwenziwe endlebeni yezindlebe (okuthiwa i- myringotomy ) engasetshenziswa njalo nge-anesthetic yendawo noma, uma kudingeka, esibhedlela noma isikhungo sokuhlinzeka ngaphansi kwe-anesthesia jikelele. I- tympanostomy tube ivame ukufakwa ukuze kugcinwe ukuchotshozwa ukuze ukwelashwa kuqhutshwe isikhathi esithile. Inqubo ilula futhi ayibangeli ubuhlungu obukhulu. Uma i-tube isusiwe isisindo siyoziphulukisa ngokwabo ngokushesha.
Uma ungewona ukhetho lwe-steroid therapy noma uma ukwelashwa kwe-steroid akusebenzi kuwe, udokotela wakho angakhetha enye imithi.
Imithi ye-cytotoxic efana ne-methotrexate ne-cyclophosphamide ingase iphumelele ekwelapheni isifo somzimba ngaphakathi ngaphakathi uma i-steroids ihluleka noma ayiyona inketho, noma ngabe imiphumela emibi inganciphisa ukusetshenziswa kwayo. I-Methotrexate ivame ukusetshenziswa ngoba ihlotshaniswa nemiphumela emibi kakhulu kunezinye izidakamizwa ze-cytotoxic futhi uma imiphumela emibi iyenzeka ngokuvamile ivame futhi iguquke.
Imiphumela emibi ye-methotrexate ne-cyclophosphamide ingabandakanya: i-anemia, thrombocytopenia, ubuthi bezinso noma isibindi, ukungasebenzi noma ukukhishwa kwamathambo. Ngenkathi uthatha le mithi, impilo yakho kufanele ihlolwe ngokucophelela udokotela kanye nokuhlolwa kwegazi njalo ukuze kuqashwe umsebenzi wakho wezinso noma wesibindi kungadingeka. Ukwelapha nge-methotrexate kunenani eliphumelelayo lama-69%.
Ezinye imithi udokotela wakho angase akhethe ukuzama zihlanganisa:
- I-Etanercept (i-tumor-necrosis factor factor)
- N-acetylcysteine
Ukucwaninga okufakazela ukuphumelela kwale mithi kunciphise kakhulu ngakho udokotela wakho angakhetha kuphela ukuzama uma ezinye zezokwelapha zihlulekile.
Okunye ukwelashwa okungase kudingeke ukuba kuphinde kucwaningwe yi-plasmapheresis. I-Plasmapheresis iyinkqubo yokuhlunga igazi lomuntu ukususa izingxenye zesistimu yomzimba okucatshangwa ukuthi ihlasela indlebe yangaphakathi (antigen, antibodies, njll). Izinto zamasosha omzimba asusiwe zifakwa esikhundleni saline evamile noma amaprotheni okuthiwa i-albin (noma kokubili). Le ukwelashwa kungabiza futhi kungenzeka ukuthi ingasetshenziswa njengokwelashwa kokuqala komugqa.
Kungakhathaliseki ukuthi ukwelashwa okusetshenzisiwe, ucwaningo luye lwabonisa ukuthi ukwelashwa okusheshayo kuqalisiwe ukusebenza kahle kakhulu. Ngenxa yalesi sizathu kufanele ubone udokotela ngokushesha uma unesifo se-earmune ngaphakathi.
> Imithombo:
> Ukuzibulala ngokuzenzakalelayo izifo zendlebe zangaphakathi (AIED). I-American Hearing Research Foundation iwebhusayithi. http://american-hearing.org/disorders/autoimmune-inner-ear-disease-aied/. Kubuyekezwe ngo-Okthoba 2012. Kufinyelelwe ngoJuni 17, 2017.
> Ukuzibulala ngokuzenzakalelayo Izifo Zendlebe Zangaphakathi (I-AIED's): Izifo ezizimele ngokuzibandakanya kwe-Audio-Vestibular. Iwebhusayithi ye-Audiology Online. http://www.audiologyonline.com/articles/autoimmune-inner-ear-disease-aieds-1160. Kubuyekezwe u-Agasti 2002. Kufinyelelwe ngoJuni 17, 2017.
> Isifo Sokuzenzekelayo Sokutholwa Kwendlebe Nokuphathwa Kwangaphakathi. Iwebhusayithi yeMedscape. I-http://emedicine.medscape.com/article/857511-kuthandwa. Kubuyekezwe u-December 2016. Kufinyelelwe ngoJuni 17, 2017.
> Isihlalo sokujikeleza sihlola. Iwebhusayithi yeMedscape. http://emedicine.medscape.com/article/1832765- ukubukwa kokubukwa. Kubuyekezwe ngo-February 2016. Kufinyelelwe ngoJuni 17, 2017.