Mankhwala Ophatikizapo Kupewa Kupewa, Mankhwala, ndi Opaleshoni
Myasthenia gravis amachititsa kufooketsa kwa mthupi chifukwa cha chitetezo cha mthupi chitetezera mapuloteni a neurotransmitter pa minofu ya minofu. Popeza minofu silingathe kulandira chizindikiro, anthu omwe ali ndi mysthenia amafooka. Ngakhale kuti matendawa amachititsa kuti nthawi zonse asawonongeke, ndipo nthawi zambiri amatha kusamalidwa ndi njira zosiyanasiyana zochiritsira.
Pali njira zisanu zokha zothandizira myasthenia gravis. Njira zina zimagwiritsidwa ntchito bwino pa zovuta zovuta kuti munthu asatuluke kuchipatala chokwanira, ngakhale kuti nthawi zina izi zimafunikira nthawi zambiri. Zina zimatetezedwa kuti zipewe zovuta zoterezi zikuchitika poyamba - njira yothetsera vutoli.
Pewani Zoyambitsa Kuletsa Kuukira Kwambiri
Chifukwa ndi matenda omwe amadzimadzimitsa okha, chilichonse chimene chimasokoneza chitetezo cha mthupi chikhoza kuonjezera chiopsezo cha mavuto aakulu, ndi kuvulaza kwakukulu komwe kungatumize munthu ku chipatala chachikulu. Kuzindikira ndi kupewa chilichonse chimene chimayambitsa ndizofunikira kwambiri pakuyendetsa matendawa. Mwachitsanzo, mankhwala omwe amagwiritsidwa ntchito kawirikawiri monga ciprofloxacin kapena maantibayotiki ena, ndi beta-blockers monga propranolol, lithiamu, magnesium, verapamil ndi zina, zingawononge zizindikiro za myasthenia gravis. Kawirikawiri, anthu omwe ali ndi myasthenia ayenera kukhala osamala kwambiri asanayambe mankhwala atsopano ndikuyang'anitsitsa pambuyo pa zizindikiro zofooka.
Kuchitira Zizindikiro za Myasthenia Gravis
Kufooka kwa myasthenia gravis kumachitika pamene acetylcholine receptor imayesedwa ndi chitetezo cha thupi. Kuwonjezera pa kuchuluka kwa acetylcholine komwe kulipo pamagulu a chipwirikiti kumathandiza kuthana ndi vutoli. Thupi limatulutsa acetylcholine kuchokera ku synapse pogwiritsa ntchito michere yotchedwa acetylcholinesterases.
Mankhwala otchedwa cholinesterase inhibitors (omwe amachititsa kuti mavitaminiwa asatengeke) angathe kuchititsa kuti acetylcholine asalowe mu synapse kwa nthawi yayitali, kuti izigwirizane ndi mapulogalamu omwe amavomereza minofu kuti agwirizane.
Acetylcholineterase inhibitors ndi pyridostigmine (Mestinon), yomwe ndi mankhwala aakulu omwe amagwiritsidwa ntchito pa myasthenia gravis. Zotsatirapo zimaphatikizapo kutsegula m'mimba, kupweteka, ndi mseru. Kutenga mankhwala ndi chakudya kungathandize kuchepetsa zotsatirazi. Chodabwitsa, nthawi zina mankhwala ochepetsa anticholinesterase amachititsa kuti pakhale zovuta kuzisiyanitsa ndi myasthenia iwowo. Izi sizodziwika ngati pyridostigmine imagwiritsidwa ntchito mkati mwa mankhwala ovomerezeka, komabe.
Matenda a Immunotherapy a Myasthenia Gravis
Anthu ambiri omwe ali ndi myasthenia gravis amatha kumwa mankhwala kuti ateteze zizindikiro kuti zisabwere. Immunotherapy imayambitsa ma antibodies omwe amayambitsa acetyllox receptors. Mwa kusintha masewera a chitetezo cha mthupi, mafupipafupi ndi kuopsa kwa zigawenga zimachepetsedwa.
Mankhwala a glucocorticoids monga prednisone amagwiritsidwa ntchito popewera chitetezo cha mthupi cha anthu ndi myasthenia. Zosankha zina ndi monga cyclosporine, azathioprine, ndi mycophenolate.
Mankhwalawa ali ndi zotsatira zake, zina mwazo ndizovuta kwambiri. Mavuto a mankhwalawa ayenera kuyesedwa mosamala phindu la zigawenga zochepa za myasthenia.
Matenda Odzidzimutsa Odzidzidzimutsa Odwala a Myasthenia Gravis
Ngakhale kuti odwala omwe ali ndi matenda osapatsirana amatha kugwira ntchito kwa nthawi yaitali, zina zimafuna kuchita mofulumira. Chitsanzo chikanakhala mavuto aakulu, kapena opaleshoni kapena zochitika zina zofunikira zomwe zingayembekezere kuwonjezera vutoli. Mankhwala opatsirana mofulumira amagwira ntchito mkati mwa masiku, koma ubwino wawo umangokhala kwa milungu ingapo, ndipo nthawi zambiri samalangizidwa pa nthawi yaitali.
Kusinthanitsa kwa plasma (plasmapheresis) kumachotsa ma antibodies kuchokera m'kufalitsidwa. Njirayi ndi yamtengo wapatali, ndipo nthawi zambiri imapezeka kawiri pa masiku asanu ndi awiri kapena asanu ndi awiri. Mavuto angaphatikizepo arrhythmia, kuchepa kwa maselo a magazi, mitsempha ya minofu, ndi zina zambiri.
Mankhwala osokoneza bongo (IVIG) amasonyezedwa kuti ndi othandiza pa matenda omwe amachitidwa ndi magalimoto okhaokha, koma ndondomeko yeniyeniyo sichidziwika bwino. Chithandizochi chimakhala ndi masiku awiri kapena asanu a jekeseni. Zotsatira zake nthawi zambiri zimakhala zofewa koma zimatha kuphatikizapo kuchepa kwa nsomba, kupweteka kwa mimba , ndi kusintha kwa matenda.
Kuchiza Opaleshoni ya Myasthenia Gravis
Anthu ambiri omwe ali ndi myasthenia gravis ali ndi vuto lalikulu m'mutu mwawo, chitetezo cha chitetezo cha mthupi pamunsi pa khosi. Nthawi zina zizindikiro za anthu zimapangitsa kuti mankhwalawa asinthe kapena kutsekemera pambuyo poti thymus imachotsedwa pa njira yotchedwa thymectomy. Palibe chitsimikiziro cha zoterezi, komabe. Anthu ambiri omwe ali ndi myasthenia ali ndi tumimba (thymoma), ndipo madokotala amavomereza kuti opaleshoni imasonyezedwa m'mabukuwa. Kaya thymectomy imasonyezedwa nthawi zina sikumveka bwino, ndipo ikuyenera kukambidwa ndi katswiri wa zamaganizo pa nkhaniyi.
Pansi
Myasthenia gravis ndi matenda aakulu, koma pali njira zambiri zothandizira zomwe zingapezeke kufooka pamene zimachitika ndikuthandizira kuchepetsa kuchuluka kwa chiwonongeko. Chifukwa cha zotsatira zake ndi mankhwala onse, njira yopaleshoni imayenera kukambidwa ndi katswiri wa sayansi ya ubongo ndi kudziwa bwino myasthenia gravis komanso mavuto ake.
Zotsatira:
Adams ndi Victor's Principles of Neurology, 9th ed: The McGraw-Hill Companies, Inc., 2009.
Braunwald E, Fauci ES, ndi al. Mfundo za Harrison za Mankhwala a M'kati. 16th ed. 2005.
Sieb, JP (2014) Myasthenia gravis: ndondomeko ya wodwala. Immilology & Clinic 175 (3): 408-18.
KUDZIZIRANI: Zomwe zili pa tsamba ili ndi zolinga za maphunziro okha. Sitiyenera kugwiritsidwa ntchito ngati choloweza m'malo mwa chisamaliro cha munthu wodwala wovomerezeka. Chonde funsani dokotala wanu kuti apeze matenda ndi chithandizo cha chilichonse chokhudza zizindikiro kapena matenda .