Ukwelashwa Kufaka Ukugwema Ukuqeda, Imithi, Nokuhlinzwa
I-Myasthenia gravis ibangela ubuthakathaka obuthakathaka ngenxa yesimiso somzimba sokuzivikela esihlasela i-neurotransmitter receptors emathisini omzimba. Njengoba imisipha ingakwazi ukuthola isignali ukuze inkontileka, abantu abane-myasthenia babe buthakathaka. Nakuba lesi sifo se-neuromuscular junction esetshenziswa ngaso sonke isikhathi ukukhubaza ngisho nokubulala, manje kungasetshenziswa ukuphathwa ngezindlela ezihlukahlukene zokwelapha.
Kunezindlela ezinhlanu ezijwayelekile zokwelapha i-myasthenia gravis. Ezinye izindlela zisetshenziswe kangcono ezinkingeni ezinzima ukuze ugcine umuntu ekhanda lokunakekelwa okukhulu, nakuba lokhu kusadingeka ngezinye izikhathi ezimweni ezimbi kakhulu. Ezinye zisetshenziselwa ukugwema izinkinga ezinjalo ezenzeka kuqala - isu lokuvimbela.
Gwema izinkinga ukuvimbela ukuhlaselwa kwe-Myasthenic
Ngenxa yokuthi isifo esizimele, noma yini ephazamisa isimiso somzimba samasosha omzimba singase sikhulise ingozi yenkinga ye-myasthenic, ngokuhlukumezeka okukhulu okungathumela umuntu ekamelweni lokunakekelwa okukhulu. Ukukwazisa nokugwema noma yikuphi ukuphazamisa kuyisici esibalulekile ekulawuleni lesi sifo. Isibonelo, imithi evame ukusetshenziswa-efana ne-ciprofloxacin noma amanye ama-antibiotic , kanye ne-beta-blockers efana ne-propranolol, i-lithium, i-magnesium, i-verapamil nokuningi, ingaba nzima kakhulu izimpawu ze-myasthenia gravis. Ngokuvamile, abantu abane-myasthenia kufanele baqaphele ngaphambi kokuqala noma imuphi umuthi omusha bese bebukela ngokucophelela emva kwalokho ngenxa yezibonakaliso zobuthakathaka.
Ukwelapha Izimpawu Ze-Myasthenia Gravis
Ubuthakathaka be-myasthenia gravis buba khona lapho i-acetylcholine receptor ihlaselwa yisistimu yomzimba yomzimba. Ukwengeza inani le-acetylcholine elitholakalayo ekuhlanganiseni kwe-neuromuscular kungasiza ekunqobeni lokhu kunciphisa. Umzimba uvame ukususa i-acetylcholine kusukela e-synapse ngokusebenzisa ama-enzyme okuthiwa i-acetylcholinesterases.
Izidakamizwa ezibizwa ngokuthi i-cholinesterase inhibitors (ezivimbela isenzo salezi zinkimbinkimbi) zingenza ukuba i-acetylcholine ishiywe ku-synapse isikhathi eside, ivumele ukuthi ibophezele kumamukeli abonisa ukuthi imisipha iyayinkontileka.
Ama-inhibitors e-Acetylcholineterase afaka i-pyridostigmine (i-Mestinon), okuyisidakamizwa esiyinhloko esisetshenziselwa i-myasthenia gravis. Imiphumela emibi ihlanganisa isifo sohudo, ukuchotshozwa, nesicashu. Ukuthatha imithi ngokudla kungasiza ukunciphisa lemiphumela emibi. Ngokumangazayo, ngezinye izikhathi imithi yokwelapha i-anticholinesterase inomthelela ohlangothini obuthakathaka obuthakathaka, okungaba nzima ukuhlukanisa ne-myasthenia ngokwayo. Lokhu akuvamile kakhulu uma i-pyridostigmine isetshenziselwa ukulinganisa okuphakanyisiwe, noma kunjalo.
Immunotherapy Chronical for Myasthenia Gravis
Abantu abaningi abane-myasthenia gravis baqeda ukuphuza imithi ukuvimbela izimpawu zokungena. I-Immunotherapy ihlose ama-antibodies angaphansi ahlasela ama-acetylcholine receptors. Ngokushintsha isimiso somzimba sokuzivikela, ubukhulu nobukhulu bokuhlaselwa kuncishisiwe.
Ama-glucocorticoids afana ne-prednisone asetshenziselwa ukuvimbela isimiso somzimba sokuzivikela sabantu abane-myasthenia. Ezinye izinketho zihlanganisa i-cyclosporine, i-azathioprine, ne-mycophenolate.
Zonke lezi mithi zinemiphumela emibi, ezinye zazo ezimbi kakhulu. Izingozi zemithi kumele zihlolwe ngokucophelela ngezinzuzo zokuhlaselwa okuncane kakhulu kwe-myasthenia.
Ukwelashwa Okusheshayo Kwe-Immunomodulating for Myasthenia Gravis
Nakuba ama-immunotherapy agents angapheli ahloselwe ukusebenza isikhathi eside, ezinye izimo zidinga isinyathelo esisheshayo. Isibonelo kungaba inkinga ye-myasthenic, noma ngaphambi kokuhlinzwa noma enye imicimbi edingekayo engalindeleka ukuthi ingabangela ukwanda okunjalo. Ukuzivikela okusheshayo kusebenza ezinsukwini ezimbalwa, kodwa izinzuzo zabo ziphela kuphela amasonto, futhi ngokuvamile azikhuthazwa esikhathini eside.
Ukushintshaniswa kwe-plasma (plasmapheresis) kususa ama-antibodies ekusakazweni. Le nqubo iyabiza, futhi ngokuvamile ivela izikhathi ezinhlanu ngaphezulu kwezinsuku ezingu-7 kuya kwezingu-14. Izinkinga zingabandakanya i-arrhythmia, ukungavamile kwegazi kwegazi, imisipha yomzimba, nokuningi.
I-immunoglobulin engathandeki (IVIG) ivame ukuboniswa ukuthi iyasiza ezifweni ezibangelwa ukusabela okuzenzakalelayo, kodwa indlela eqondile ayiyona into ecacile. Ukwelashwa kuvame ukuba nezinsuku ezimbili ukuya kwezinhlanu zokujova. Imiphumela emibi ngokuvamile ilula kodwa ingabandakanya ukungaphumeleli kwe-renal, i- meningitis , nokuphendula kwe-allergen.
Ukwelapha Okuhlinzekwayo kwe-Myasthenia Gravis
Iningi labantu abane-myasthenia gravis banezinhlobo ezingavamile ku-thymus yabo, isitho somzimba sokuzivikela emzimbeni entanyeni. Ngezinye izikhathi izimpawu ze-myasthenic zabantu ziyathuthukisa noma zixazululwe ngemuva kokuthi i-thymus isuswe ngesikhathi senqubo ebizwa ngokuthi i-thymectomy. Asikho isiqinisekiso somphumela onjalo, noma kunjalo. Inani eliphakeme kakhulu labantu abane-myasthenia bane-thymus tumor (thymoma), futhi odokotela bayavuma ukuthi ukuhlinzwa kuboniswa kulezi zimo. Kungakhathaliseki ukuthi i-thymectomy iboniswe kwezinye izimo ayicacile kangako, futhi kufanele ikhulunywe nengqikithi yezinzwa kuleso simo ngamacala.
Ngaphansi
I-Myasthenia gravis yisifo esibi, kodwa kunezinketho eziningi zokwelashwa ezitholakalayo kokubili ukunciphisa ubuthakathaka lapho kwenzeka futhi kusize ukunciphisa ukuvama nokuqina kokuhlaselwa. Ngenxa yemiphumela emibi nayo yonke imithi, inkambo yokwelashwa kufanele ixoxwe nomjozi wezinzwa owazi kahle i-myasthenia gravis nezinkinga zayo ezingase zibe khona.
Imithombo:
Adams kanye Nemigomo kaVictor ye-Neurology, 9th ed: The McGraw-Hill Companies, Inc., 2009.
I-Braunwald E, Fauci ES, et al. Izimiso zikaHarrison zeMithi yangaphakathi. 16th ed. 2005.
Sieb, JP (2014) I-Myasthenia gravis: isibuyekezo somtholampilo. Immunology Clinic & Testing (175): 408-18.
QAPHELA: Ulwazi olukulesi sayithi lunguzinhloso zemfundo kuphela. Akufanele isetshenziswe njengengxenye yokunakekelwa ngumuntu udokotela olayisenisi. Sicela ubheke udokotela wakho ukuze ahlolwe futhi aphathwe noma yiziphi izimpawu noma isimo sezokwelapha .