Umhlahlandlela Wokusebenza Kwe-arthritis (Reiter's Syndrome)

1 -

Kuyini I-Arthritis Engasebenzi? (I-Reiter's Syndrome)

Ukuphendula

I-arthritis esebenzayo iyinhlobo ye-arthritis eyenzeka njengendlela "yokusabela" kokutheleleka kwenye indawo emzimbeni. Ukuvutha kuyisenzo esithinta izicubu ukulimala noma izifo futhi kubhalwe ngu:

• ukuvuvukala
• ubomvu
• ukushisa
• ubuhlungu

Ngaphandle kwalokhu kuvuvukala okuhlangene, i-arthritis esebenzayo ihlotshaniswa nezinye izimpawu ezimbili:

• ubomvu nokuvuvukala kwamehlo
• ukuvuvukala komzila we-urinary

Lezi zimpawu zingenzeka zodwa, ndawonye, ​​noma cha.

I-Reiter

I-arthritis esebenzayo isaziwa nangokuthi i-Reiter's syndrome, futhi udokotela wakho angase abhekisele kuso njengesipulyloththroloththropathy ye-seronegative. I-spondyloarthropathies ye-seronegative yiqembu lezinkinga ezingabangela ukuvuvukala emzimbeni wonke, ikakhulukazi emgodleni. Izibonelo zezinye iziphazamiso kuleli qembu zihlanganisa:

• i-psoriatic arthritis
• i-spondylitis e-ankylosing

Ukutheleleka

Eningi, i-arthritis esebenzayo iyabangela ukutheleleka kwe-venereal kwisisu noma i-urethra, noma, kubantu besifazane, isisu esisakazwa ngokuxhumana kocansi. Leli fomu le-disorder ngezinye izikhathi libizwa ngokuthi i-genitourinary noma i-urogenital arthritis esebenzayo.

Olunye uhlobo lwe-arthritis elisebenzayo lubangelwa ukutheleleka emaphethelweni emathumbu ngokudla noma ukuphatha izinto ezingcolile ngamagciwane. Leli fomu ngezinye izikhathi libizwa ngokuthi i-enteric noma emathunjini e-arthritis esebenzayo.

Izimpawu ze-arthritis ezisebenzayo zihlala ezinyangeni ezingu-3 kuya kwezingu-12, nakuba izimpawu zingabuya noma zikhule zibe yisifo sesikhathi eside emaphesenti amancane abantu.

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Yini Ebangela I-Arthritis Esebenzayo?

I-Chlamydia

I-arthritis esebenzayo ngokuvamile iqala cishe emasontweni angu-1 kuya kwangu-3 ngemuva kokutheleleka. I-bacterium ngokuvamile ehlotshaniswa ne-arthritis esebenzayo yilezi: I-Chlamydia trachomatis, eyaziwa ngokuthi i-chlamydia.

Ngokuvamile kutholakala ngokuxhumana kocansi. Ubufakazi obunye bubonisa ukuthi izifo zokuphefumula ne-Chlamydia pneumoniae zingabangela isifo samathambo esifanele.

Izifo ze-GI Tract

Izifo ezitholakala emgodleni wokugaya okungase zenze i-arthritis esebenzayo zibandakanya:

• I-Salmonella
• Shigella
• Yersinia
• I-Campylobacter

Abantu bangenwa yi-bacteria emva kokudla noma ukuphatha ukudla okungalungile, okufana nezinyama ezingagcinwa ekushiseni okufanele.

I-HLA B27

Odokotela abazi kahle ukuthi kungani abanye abantu bevezwa kula mabhaktheriya bakha i-arthritis engasebenzi futhi abanye abakwenzi, kodwa baye babona isifo somzimba, i-leukocyte antigen yabantu (HLA) B27, okwandisa ithuba lomuntu lokuthuthukisa isifo samathambo esiyingozi. Cishe abantu abangu-80% abane-arthritis yokuhlolwa okusebenzayo bahle ku-HLA-B27. Kodwa-ke, ukuzuza ifa le-HLA-B27 akusho ukuthi uzothola isifo samathambo asebenzayo. Amaphesenti ayisishiyagalombili abantu abanempilo banegciwane le-HLA-B27, futhi cishe ingxenye eyodwa kuphela kwesikhombisa kuzoba ne-arthritis esebenzayo uma bethola izifo ezibangelwa ukukhubaza.

Ingabe kuyathelelana?

I-arthritis esebenzayo ayithathelisi; okungukuthi, umuntu onenkinga ayikwazi ukudlulisela i-arthritis komunye umuntu. Kodwa-ke, amabhaktheriya angabangela i-arthritis esebenzayo angadluliselwa kusuka kumuntu kuya komuntu.

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Yiziphi Izimpawu Ze-Arthritis Esebenzayo?

Izimpawu

Ngokuvamile, amadoda aphakathi kweminyaka engama-20 no-40 kungenzeka ukuthi ahlakulele isifo samathambo asasebenzi. Kodwa-ke, ubufakazi bubonisa ukuthi nakuba amadoda angaphezu kwesishiyagalolunye amathuba okuba abesifazane bahlakulele isifo samathambo ngenxa yokugula okutholakala khona, abesifazane nabesilisa banamathuba okulingana nokuhlakulela isifo samathambo ngenxa yokutheleleka kokudla. Abesifazane abane-arthritis esebenzayo ngokuvamile babe nezimpawu ezinamandla kunamadoda.

I-arthritis esebenzayo iningi ngokuvamile ibangela ukuvuvukala kwe:

• i-urogenital tract
• amalunga
• amehlo

Izimpawu Ezijwayelekile Ezivamile

Izimpawu ezingavamile ezikhona izilonda zomlomo kanye nezikhukhula zesikhumba. Noma iyiphi yalezi zimpawu kungenzeka ibe mnene kangangokuthi iziguli aziboni. Ngokuvamile bafika bese behamba isikhathi esingaphezu kwamasonto ambalwa kuya ezinyangeni eziningana.

I-Urogenital Tract

I-arthritis esebenzayo isithinta kakhulu i-urogenital tract, kuhlanganise ne:

• i-prostate noma i-urethra emadodeni
• urethra, isisu, noma ubulili kwabesifazane

Amadoda angaqaphela isidingo esengeziwe sokuvuthwa, ukuzwa okuvuthayo lapho uchama, ubuhlungu be-penis nokukhishwa kwamanzi okuphuma emthonjeni. Amanye amadoda ane-arthritis esebenzayo ahlakulela i-prostatitis. Izimpawu ze-prostatitis zingabandakanya ukushisa nokushisa, kanye nesidingo esikhulu sokuvuthwa nokuzwa okuvuthayo uma uchama.

Abesifazane abane-arthritis esebenzayo bangase bahlakulele izinkinga emgqatsheni we-urogenital, njenge-cervicitis noma i-urethritis, engabangela ukuzwa okuvuthayo ngenkathi uchama. Ngaphezu kwalokho, abanye besifazane nabo bahlakulela i-salpingitis noma i-vulvovaginitis. Lezi zimo zingase zidale noma zingabangeli noma yiziphi izimpawu ze-arthritic.

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Kuthiwani Nge-Arthritis, Ubuhlungu Ohlangene, Ezinye Izimpawu?

I-Paint Pain

Izimpawu zobuhlungu ezihlangene zesifo samathambo esiphelele ngokuvamile zihilela ubuhlungu nokuvuvukala ku:

• amadolo
• amaqabunga
• izinyawo

Amapulangwe, iminwe, namanye amalunga aphethwe kancane kancane. Abantu abane-arthritis esebenzayo bavame ukuthuthukisa i- tendinitis . Kwabaningi abane-arthritis evuselelayo, lokhu kubangela ubuhlungu be-ankle noma i-Achilles tendinitis. Abanye abane-arthritis esebenzayo baphinde bahlakulele isisindo sezithende, okungukuthi ukukhula kwebony isithende esingabangela ubuhlungu bangezinyawo ezingapheli. Cishe isigamu sabantu abane-arthritis esebenzayo bayabika ubuhlungu obuncane obubuhlungu kanye nobuhlungu bezinhlanzi.

I-arthritis esebenzayo nayo ingabangela i-spondylitis noma i-sacroiliitis. Abantu abane-arthritis esebenzayo abanegciwane le-HLA-B27 banamathuba amaningi okuthuthukisa i-spondylitis kanye / noma i-sacroiliitis.

Amehlo

I-Conjunctivitis, ukuvuvukala kwendwangu yamangcwaba ehlanganisa i-eyeball nejwabu leso, iqala cishe cishe kwesigamu sabantu abane-arthritis esebenzayo. Abanye abantu bangase bahlakulele u-uveitis. I-Conjunctivitis ne-uveitis ingabangela:

• ukubomvu kwamehlo
• ubuhlungu beso nokucasuka
• umbono ongenalutho

Ukubandakanyeka kweso ngokuvamile kwenzeka esikhathini sokuqala kwamathambo, futhi izimpawu zingase zifike.

Izilonda

Amadoda angama-25% ane-arthritis esebenzayo ahlakulela izilonda ezincane, ezingajulile, ezingenabuhlungu ekugcineni kwepenisi. Amaphesenti amancane amadoda nabesifazane athuthukisa ukuqhuma noma amancane, ama-nodules aqinile ezinyaweni ezinyaweni futhi, kaningi, ezintendeni zezandla zabo noma kwenye indawo. Abanye abane-arthritis esebenzayo bahlakulela izilonda zomlomo eziza futhi ziyahamba, kwabanye, lezi zilonda azibuhlungu futhi zingabonakali.

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Uhlobo luni loDokotela olungasiphatha futhi lubona i-arthritis engasebenzi?

Odokotela abaningana

Umuntu one-arthritis esebenzayo mhlawumbe kuzodingeka abone izinhlobo eziningana zezidokotela ngoba i-arthritis esebenzayo ithinta izingxenye ezihlukene zomzimba. Kodwa-ke, kungase kube usizo odokotela nesiguli ngodokotela oyedwa, ngokuvamile u- rheumatologist (udokotela onguchwepheshe we-arthritis), ukuphatha uhlelo oluphelele lokuphathwa. Lo dokotela angalungisa izindlela zokwelashwa futhi aqaphele imiphumela emibi evela emithini ehlukahlukene isiguli esingasithatha. Ochwepheshe abalandelayo baphatha ezinye izici ezithinta izingxenye ezahlukene zomzimba.

• I-ophthalmologist (ithinta isifo se-iso)
• I-gynecologist (ithatha izimpawu zobulili kwabesifazane)
• Urologist (uphatha izimpawu zobulili kumadoda nabesifazane)
• Dermatologist (uphatha izimpawu zesikhumba)
• I-Orthopaedist (yenza ukuhlinzwa kumajoyina awonakele kakhulu)
• I-Physiatrist (iqondisa imiyalo yokuzivocavoca)

Ukuhlolwa

Ekuqaleni kokuhlolwa, udokotela cishe uzothatha umlando ophelele wezokwelapha futhi aqaphe izimpawu zamanje kanye nanoma yiziphi izinkinga zempilo zangaphambili noma izifo. Ngaphambi nangemva kokubona udokotela, ngezinye izikhathi kuyasiza ukuthi isiguli sigcine irekhodi lezimpawu ezenzekayo, uma zenzeka, nokuthi zihlala isikhathi eside kangakanani. Kubaluleke kakhulu ukubika noma yiziphi izimpawu ezifana nomkhuhlane, njenge:

• umkhuhlane
• ukuhlanza
• isifo sohudo

Lezi zimpawu zingase zibe ubufakazi bokutheleleka kwebhaktheriya. Ngesinye isikhathi odokotela bakuthola kunzima ukuxilonga i-arthritis esebenzayo ngoba akukho ukuhlolwa okuqondile kwe-laboratory ukuqinisekisa ukuthi umuntu une-arthritis esebenzayo.

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I-Arthritis Engasebenzi Yayitholaphi?

Ukuxilongwa

Odokotela bangase bahlele ukuhlolwa kwegazi ngesici se-gene HLA-B27, kodwa umphumela omuhle awusho njalo ukuthi umuntu unenkinga.

Odokotela bangase bahlele ezinye izivivinyo zegazi ukuze basize ukulawula ezinye izimo bese uqinisekisa ukuxilongwa. Isibalo se-rheumatoid noma i-antinuclear antibody test kungaba usizo lokulawula amandla e-arthritis asebenzayo. Abaningi abane-arthritis esebenzayo bayothola imiphumela emibi kulezi zivivinyo. Uma imiphumela yokuhlola ihle, ungase ube nolunye uhlobo lwe-arthritis, njenge:

• i-arthritis ye-rheumatoid
• lupus

Odokotela bangase bahlole nesilinganiso sedimentation se-erythrocyte. "Izinga eliphakeme" eliphakeme livame ukukhombisa ukuvuvukala endaweni ethile emzimbeni. Ngokujwayelekile, abantu abanesifo se-rheumatic babe nesilinganiso esiphakeme.

• Imibuzo: Ungaba Lupus?

Izifo

Odokotela cishe bazohlola ukutheleleka okungase kuhlotshaniswe nesifo samathambo esisebenzayo. Iziguli ngokuvamile zihlolwe ukutheleleka kwe-Chlamydia (ucwaningo luye lwabonisa ukuthi ukwelashwa okusheshayo kwe-arthritis eyenziwa yi-Chlamydia okubangelwa ukwelashwa kunganciphisa ukuqhubeka kwesifo). Amasampuli eselula angathathwa emphinjeni, urethra emadodeni noma emlonyeni wesibeletho kubesifazane. Amasampuli e-Urine nesitoloni nawo angahlolwa. Isampula se- synovial fluid ingasuswa ekuhlanganyeleni kwe-arthritic. Izifundo ze-synovial fluid zingasiza ukulawula ukutheleleka kuhlangene.

X Rays

Ngezinye izikhathi odokotela basebenzisa i-x ray ukusiza ukuxilonga i-arthritis esebenzayo nokulawula ezinye izimbangela ze-arthritis. Imilayezo ye-X ingathola ezinye izimpawu ezifaka:

• i-spondylitis
• sacroiliitis
• izicubu ezithambile zokuvuvukala
• umonakalo we-cartilage namalungu
• i-calcium deposits

7 -

I-arthritis engasebenziyo iphathwa kanjani?

Izinketho Zezidakamizwa

Nakuba kungekho ukwelashwa kwe-arthritis esebenzayo, ezinye izindlela zokwelashwa zikhulula izimpawu zesifo.

Ama-NSAID

Izidakamizwa ezingekho ukuvuvukala (ama-NSAID) anciphisa ukuvuvukala okuhlangene futhi zivame ukusetshenziselwa ukuphatha iziguli ezine-arthritis esebenzayo. Amanye ama-NSAID atholakale ngaphandle kwemithi kadokotela efana nalokhu:

• i-aspirin
• ibuprofen

Amanye ama-NSAID avame ukuphumelela kakhulu emthonjeni we-arthritis kufanele ahlelwe udokotela njengalokhu:

• indomethacin
• tolmetin

I-Corticosteroid Shots

Kulabo abanokuvuvukala okukhulu, amajoli we-corticosteroids ngqo ekuhlanganyeleni abathintekile anganciphisa ukuvuvukala.

Corticosteroids yezihloko

Lezi zi-corticosteroids zifika ukhilimu noma u-lotion futhi zingasetshenziswa ngokuqondile ezilonda zesikhumba, ezifana nezilonda, ezihlotshaniswa nesifo samathambo esisebenzayo. I-corticosteroids yezihloko zinciphisa ukuvuvukala nokukhuthaza ukuphulukiswa.

Ama-antibiotics

Ama-antibiotics asiza ekuqedeni ukutheleleka kwama-bacteria okubangela isifo samathambo esisebenzayo. I-antibiotic ethize enqunyiwe incike kuhlobo lokutheleleka kwe-bacterial. Abanye odokotela bangancoma ukuthi umuntu one-arthritis esebenzayo athathe ama-antibiotic isikhathi eside (kuze kube izinyanga ezingu-3). Ucwaningo lubonisa ukuthi ezimweni eziningi, lo mkhuba kuyadingeka.

Ama-Immunosuppressants / DMARD

Ama-DMARD afana ne-methotrexate noma i- sulfasalzine angasiza ukulawula izimpawu ezinzima ezingenakulawulwa ezinye izidakamizwa.

TNF Blockers

I-TNF blockers, efana ne- Enbrel (etanercept) ne- Remicade (infliximab) , ingase isebenze ngempumelelo ye-arthritis esebenzayo kanye namanye ama- spondyloarthropathies .

8 -

Ingabe Ukuzivocavoca Kungathuthukisa I-Arthritis Esebenzayo?

Ukuzivocavoca for Arthritis Acactive

Ngaphambi kokuqala uhlelo lokuzivocavoca, iziguli kufanele zikhulume nochwepheshe wezezempilo ongakwazi ukuncoma ukuqeqeshwa okufanele.

Ukuzivocavoca, lapho uqaliswa kancane kancane, kungasiza ukuthuthukisa umsebenzi ohlangene. Ngokuyinhloko, ukuqinisa nokuzivocavoca umzimba kuzogcina noma kuthuthukise umsebenzi ohlangene.

• Ukuzivocavoca umzimba kuqinisa imisipha ezungeze ukujoyina ukusekela kangcono.
• Izenzo zokuqinisa imisipha ezingadluliseli amalunga angenziwa ngisho nalapho umuntu enokuvuvukala nobuhlungu.
• Izenzo zokuhamba phambili zithuthukisa ukunyakaza nokuguquguquka nokunciphisa ukuqina komunye ohlangene.
• Ukuzivocavoca: I-Essential Treatment ye-Arthritis
• Indlela Yokuzivocavoca Uma Unesifo Se-Arthritis

Ukuzivocavoca Emuva We-Arthritis Esebenzayo

Ukuzivocavoca ukwelula nokwandisa emuva kungaba usizo ngokukhethekile ekuvimbeleni ukukhubazeka kwesikhathi eside iziguli ezinezinhlungu zomgogodla noma ukuvuvukala.

Ukuzivocavoca kwamanzi for Arthritis Acactive

Ukuzivocavoca kwe-Aquatic kungase kusize isifo samathambo esisebenzayo. Ukunyuka kwamanzi kuncishisa kakhulu ukucindezela kwamalungu akho, okwenze kube lula ukwenza ububanzi bokuzivocavoca okudingekayo.

9 -

Kuyini Isibikezelo Kwabantu Abasebenzisa I-Arthritis?

Isibikezelo

Abantu abaningi abane-arthritis esebenzayo baphuluke ngokugcwele kusukela ekugqibeleni kokuqala kwezimpawu futhi bayakwazi ukubuyela emisebenzini evamile ezinyangeni ezimbili kuya kwezingu-6 ngemuva kokuba izimpawu zokuqala zivele. Ezimweni ezinjalo, izimpawu ze-arthritis zingadlulela ezinyangeni ezingu-12, nakuba lezi zivame ukuba mnene futhi zingaphazamisi imisebenzi yansuku zonke.

I-arthritis engapheli

Cishe amaphesenti angu-20 abantu abane-arthritis esebenzayo bazoba nezifo ezingapheli (isikhathi eside) samathambo, ngokuvamile evamile.

Izifundo zibonisa ukuthi phakathi kweziguli ezingu-15 no-50 iziguli zizoqala izimpawu futhi ngemuva kwesikhathi esithile ngemuva kokushayeka kokuqala. Kungenzeka ukuthi ukubuyela emuva okunjalo kungenzeka ngenxa yokuvuselelwa. Ubuhlungu be-back and arthritis yizibonakaliso ngokuvamile ezivame ukuvela.

Iphesenti elincane leziguli lizoba nesifo samagciwane esingapheli, esinzima esikusola ukulawula nge ukwelashwa futhi kungabangela ukubola okuhlangene.

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Yini Abacwaningi Abafunda Ngokuphathelene Ne-Arthritis Yokwelapha?

Ucwaningo lwe-arthritis olusebenzayo

Abacwaningi baqhubeka ukuphenya izimbangela ze-arthritis esebenzayo kanye nokwelashwa kokufunda kwalesi simo. Ngokwesibonelo:

• Abacwaningi bazama ukuqonda kangcono ubudlelwane obuphakathi kokutheleleka nesifo samathambo esisebenzayo. Ngokuyinhloko, bazama ukunquma ukuthi kungani ukutheleleka kubangela i-arthritis nokuthi kungani abanye abantu abahlakulela izifo bethola isifo samathambo ngesikhathi abanye bengenalo. Ososayensi nabo batadisha ukuthi kungani abantu abane-genetic factor HLA-B27 besengozini kakhulu kunezinye.
• Abacwaningi bahlakulela izindlela zokubona indawo yebhaktheriya edala emzimbeni. Abanye ososayensi bacabanga ukuthi ngemuva kokuba amabhaktheriya angene emzimbeni, athunyelwa emajoyini, lapho angahlala khona amanani amancane kuze kube phakade.
• Abacwaningi bahlola imithi yokwelapha ye-arthritis esebenzayo. Ngokuyinhloko, bahlola ukusetshenziswa kwama-antibiotic ngokubambisana ne-TNF inhibitors kanye neminye imithi yokuzivikela, njenge-methotrexate ne-sulfasalazine.

_{Umthombo: I-NIH Publication No. 02-5039}