Matenda a Psoriatic ndi a magulu a zinthu, omwe amadziwika kuti spondyloarthropathies . Makamaka, masamu a psoriatic amadziwika kuti ndi kutupa kwa nyamakazi yomwe imakhudzana ndi matenda a khungu psoriasis ndipo kawirikawiri ndi yolakwika chifukwa cha chifuwa chachikulu . Chochititsa chidwi n'chakuti mpaka zaka za m'ma 1950, zizindikiro za kutupa nyamakazi zomwe zimachitika ndi psoriasis zinkaonedwa kuti ndi nyamakazi ya nyamakazi imene imapezeka mwa psoriasis.
Pang'onopang'ono, zinthu ziwirizi zinkawoneka ngati zosiyana ndi zachipatala. M'chaka cha 1964, psoriatic nyamakazi inaikidwa ngati matenda osiyana ndi a American Association of Rheumatism.
Chizoloŵezi chofala kwambiri cha khungu kwa odwala omwe ali ndi nyamakazi ya psoriatic ndi plaque psoriasis (amadziwikanso kuti psoriasis vulgaris), ngakhale kuti njira zina zingathe kuchitika. Nthaŵi zambiri, nyamakazi imayamba mwa anthu omwe agwiritsa ntchito psoriasis. Komabe, odwala ena sangadziwe kuti ali ndi psoriasis (mwachitsanzo, psoriasis sangathe kuzindikiridwa pamphuno), kapena psoriasis ikhoza kukhala ndi matenda a nyamakazi pafupi ndi 15 peresenti ya nyamakazi ya psoriatic.
Zitsanzo za Zizindikiro ndi Zochitika Zapadera
Odwala nyamakazi a Psoriatic arthritis ali ndi zizindikiro ndi zizindikiro za kutukumula, kutsekemera , kapena kutupa kwa msana. Pali njira zisanu zachipatala za nyamakazi:
- Mafuta a oligoarthritis (amachititsa ziwalo zocheperapo kapena zisanu zazikuluzikulu; mgwirizano wokhudzana ndi mbali imodzi ya thupi, osati onse)
- Symmetric polyarthritis (imakhudza ziwalo 5 kapena zingapo; mgwirizano wokhudzana ndi mbali zonse ziwiri za thupi, mwachitsanzo, mawondo onse)
- Kuphatikizana kwapadera (DIP) pakati pa interphalangeal (kumakhudza mapeto a zala ndi zala)
- Spondyloarthritis yovuta (imakhudza ziwalo za msana)
- Arthritis mutilans (kupunduka ndi kuwononga ziwalo zokhudzidwa)
Chizoloŵezi chophatikizidwa pamodzi ndi nyamakazi ya psoriatic sichikhazikitsidwa; izo zingasinthe ndi kusinthasintha. Njira yowonjezereka ndiyo yowopsa kwambiri, yomwe imakhudza oposa 60 peresenti ya odwala omwe ali ndi nyamakazi ya psoriatic. Zotsatira za oligoarticular zimakhudza pafupifupi 13 peresenti ya odwala psoriatic nyamakazi. DIP yaikulu imapezeka ochepera asanu pa odwala. Matenda ambiri a spondyloarthritis amaonedwa kuti ndi osamvetsetseka, ngakhale kuti magulu ena a msana amatha kupezeka mu 40-70 peresenti ya nyamakazi ya psoriatic nyamakazi. Chiwonongeko (mutilans) chimaonedwa kukhala chosowa, ngakhale chikhoza kukula pakapita nthawi, makamaka ngati sichiyenera kuchiritsidwa.
Matenda a psoriatic omwe amathandiza kuti muzindikire matendawa ndi dactylitis ndi enthesitis. Dactylitis imakhala ndi kutupa koboola pakati pa zala kapena zala. Kutsekemera kumatanthauzidwa ngati kutukusira pa tsamba la tendon kapena ligament kuika mu fupa. Kawirikawiri, maofesi omwe amagwiritsidwa ntchito pophatikizapo ndi malo otchedwa Achilles tendon ndi plantar fascia. Zowonjezera zina zomwe zingakhalepo zikuphatikizapo quadriceps kapena patellar tendons, chikhalire cha kaliac, chikhoto cha rotator, ndi epicondyles za golidi. Ululu, ubwino, ndi kutupa zikhoza kuchitika, koma kutenga nawo mbali kwa malowa kungachitike popanda zizindikiro.
Zina mwa masamu a psoriatic angaphatikizepo tenosynovitis (kutupa kwa bere), mavuto a misomali (monga misomali yosweka), ndi mavuto a maso (mwachitsanzo, uveitis kapena iritis).
Kuwonjezera pa psoriasis ndi kupweteka kwa msomali, mawonetseredwe opatsirana owonjezera amasiyana kwambiri ndi matenda a psoriatic poyerekezera ndi nyamakazi ya nyamakazi. Pakhala pali malingaliro omwe matenda opweteka a matumbo, komanso chiwalo cha kutalika cha edema kapena lymphedema, amakhoza kupezeka pakati pa odwala psoriatic, koma sakhala otsimikizika. Amyloid , pokhala ngati yosawerengeka, yafotokozedwa ndi nyamakazi ya psoriatic.
Kusiyanitsa Matenda a Psoriatic Arthritis ndi Matenda Ena
Akatswiri owona za matendawa amatha kuona njira zomwe zimagwirizanirana pokhapokha posiyanitsa nyamakazi ya psoriatic ndi nyamakazi ya nyamakazi, komanso zizindikiro zina. Dactylitis, kuyanjana kwa DIP, ndi matenda otsekula m'mimba amasonyeza kudwala nyamakazi. Sacroiliitis kapena kupweteka kwa ululu wopweteka kwambiri komwe kumawoneka pa x-ray kapena MRI kumatanthauzanso masamu a psoriatic. Kuphatikizika kwapakati sikukuwoneka ngati kofala ndi nyamakazi ya nyamakazi. Mosiyana ndi zimenezi, kukhalapo kwa chifuwa chachikulu kumatenda kapena maonekedwe ena ena amachititsa kuti matenda a nyamakazi asagwiritsidwe ntchito ndi nyamakazi.
Matenda a Psoriatic ayenera kuzindikiranso ndi ena a spondyloarthropathies, monga nyamakazi yogwira mtima kapena ankylosing spondylitis . Dactylitis ingakhalenso kachipatala ka matenda a kutupa nyamakazi. M'maganizo a psoriatic, sacroiliitis amayamba kukhala ochepa kwambiri (mbali imodzi yoipa kuposa inayo) poyerekeza ndi sacroiliitis ya ankylosing spondylitis, yomwe imakhala yofanana. Ndiponso, nyamakazi ya psoriatic iyenera kudziwika ndi mitundu yodwala ya nyamakazi ya kristalo. Mazira a sirum angakhale opambana m'maganizo a nyamakazi. Kusanthula kwa madzi a Synovial kumathandiza kusiyanitsa awiriwo.
Palibe ma laboratory omwe amafufuza psoriatic nyamakazi. Ngakhale kuti vuto la nthenda ya nthenda yosagwira ntchito nthawi zonse lakhala likuwoneka ngati lopangidwa ndi nyamakazi ya psoriatic, chiwerengero chochepa cha chifuwa chachikulu chikhoza kuchitika ndi psoriatic nyamakazi. Ma antibodies omwe amadziwika kuti anti-CCP , omwe poyamba ankaganiza kuti ali ndi matenda a nyamakazi, amapezeka pafupifupi 5 peresenti ya odwala psoriatic nyamakazi. Zomwe zimayambitsa matenda , CRP , ndi serum amyloid A zingakhale zapamwamba m'matenda a psoriatic, koma osachepera kuposa odwala nyamakazi.
Zotsatira:
Kelley's Textbook ya Rheumatology. Kusindikiza kwachisanu ndi chinayi. Elsevier. Chaputala 77 - Psoriatic Arthritis. Oliver Fitzgerald. Inapezeka pa 03/04/16.
Information Patient: Psoriatic Arthritis (Pambuyo pa Zamaziko) UpToDate. Gladman ndi Ritchlin. Kusinthidwa 4/9/15.