Mwinamwake mwamvapo aspirin-owonjezereka matenda opatsirana (AERD) amatchedwa triter kapena aspirin-yomwe inayambitsa asthma. Pali zinthu zitatu zomwe anthu omwe ali ndi AERD onse ali ndi: mphumu, matenda a sinus ndi mapulopa amphongo , komanso kumvetsetsa mankhwala omwe amatchedwa NSAIDS (aspirin ndi mankhwala ena onse omwe amachititsa kuti tizilombo toyambitsa matenda titchedwa COX-1).
AERD imakhudza anthu oposa 0,3 mpaka 0.9 peresenti ya anthu ambiri ndipo 10 mpaka 20 peresenti ya anthu amene amapezeka kuti ali ndi mphumu. Komabe, mphamvu yake ya pathophysiology sikumveka bwino. Zikuwoneka kuti zimakhudza mafuko onse mofanana, ndi zaka zambiri zomwe zimayamba zaka 35, koma zimawoneka kuti sizinatengedwe ndipo zimakhudza amai kusiyana ndi amuna.
Ngati mukukayikira kuti mwapezeka ndi matendawa kapena mulipo, pali angapo omwe akubwera kudzakuthandizani kuthetsa zizindikiro ndikukhala bwino. Nazi zomwe muyenera kudziwa.
Zizindikiro
Ngati muli ndi AERD mukhoza kuvutika chifukwa cha kuphatikiza zina kapena zizindikiro zotsatirazi:
- Chronic sinusitis
- Zosintha zamkati
- Kutaya kununkhiza
- Phumu
- Zotsatira za NSAID (aspirin kapena mankhwala ofanana), omwe angaphatikizepo kusokonezeka kwa mphuno, kuthamanga, kupwetekedwa mutu, kupopera, kukopa, kupweteka, bronchospasm, laryngospasm kapena kupweteka pachifuwa. Zizindikirozi zingakhalenso pambuyo pa kumwa mowa.
Mukhoza kukhala ovuta kuchiza zizindikiro mwa njira zonse.
Mwachitsanzo, mankhwala amkati amatha kubwerera mofulumira atatha opaleshoni. Kusakanikirana ndi kupuma kovuta kungayambitse kuvutika usiku komanso kuwonongeka kwa kugona komanso kutopa kwa tsiku.
Zimakhalanso zachilendo kuti munthu akhale ndi matenda olekanitsa omwe angachititse kuti AERD ikhale yoipa kwambiri.
Izi zingaphatikizepo vuto la rhinosinusitis , GERD, kapena asthma . Izi ziyenera kuyang'aniridwa mosiyana ndi AERD ndipo dokotala wanu akhoza kulangiza njira zabwino kwambiri.
Kudziwa
Ngati muli ndi mphumu, matenda a sinus ndi mapulopa amphongo, ndipo mwakhala ndikuganiza kuti mwakhala mukuchitapo kanthu ku NSAID, dokotala wanu angakayikire kuti muli ndi AERD. Mayesero owonjezera angakhale othandiza potsimikizira izi.
Mayeso amodzi ndi vuto la aspirin, lomwe limaphatikizapo kupereka mankhwala ochepa a aspirin masiku angapo kuchipatala kumene mungathe kuyang'aniridwa kuti muyankhe. Atakupatsani mlingo wa aspirin dokotala wanu angayese mapapu anu kuti awone ngati yatsika.
Dokotala wanu angasankhe kukonza mayeso ena kuti athandizidwe pa matenda a AERD, kuphatikizapo mayesero a magazi. Maosinophils ndi maselo oyera a m'magazi, zigawo za chitetezo cha mthupi. Anthu omwe ali ndi AERD amakonda kukhala ndi mapuloteni ambirimbiri omwe amapezeka m'mimba mwawo ndipo akhoza kukhala ndi magazi ambiri. Maselo ena otetezeka kuthupi monga maselo amtundu angathenso kukwezedwa. Mwinanso mukhoza kukhala ndi zinthu zotchedwa cysteinyl leukotrienes. Kufufuza kwa CT, kapena mayesero ena okuthandizani kuti muwone ngati mukuchimwa.
Tiyenera kukumbukira kuti palibe mayesero awa omwe ali otsimikiziridwa kuti ali ndi matenda a AERD koma akhoza kuthandizira dokotala kuti apeze chithunzi chowonekera bwino cha matenda anu.
Chithandizo ndi Utsogoleri
Palibe mankhwala a AERD, ndipo monga tafotokozera kale kuti matenda opatsirana matendawa sakudziwitsidwa ndi asayansi ndi azachipatala. Komabe, pali njira zambiri zamankhwala zomwe zingakuthandizeni kuti muzitha kusamalira zizindikiro.
Njira imodzi ndiyo kupewa aspirin ndi mankhwala ena a NSAID (mankhwala omwe amaletsa COX-1). Acetaminophen ikhoza kugwiritsidwa ntchito mmalo mwa mankhwalawa, koma makamaka muzitsamba zochepa (mpaka 500mg).
Kupewa aspirin sikungayambitse zizindikiro zina monga nsanza zamatenda, matenda a sinus kapena zizindikiro za mphumu.
Kukula kwa mitsempha ya m'mimba kumachepetsanso pogwiritsa ntchito jekeseni ya steroid, kuchotsa opaleshoni, kapena kuphatikiza zonse ziwiri. Ziphuphu zamchere zomwe zimakhala ndi steroids komanso ulimi wothirira m'mimba zingathandizenso kuthana ndi zizindikiro zina za m'mphuno ndi mavuto a sinus.
Mankhwala a montelukast ndi zafirlukast amagwiritsidwanso ntchito komanso amakhala othandiza kuthetsa zizindikiro kusiyana ndi mankhwala ena a mphumu, kuphatikizapo beta-agonists. Mankhwala a corticosteroids amagwiritsidwanso ntchito poyendetsa mphumu ndipo zingakhale zofunikira kugwiritsa ntchito mankhwalawa tsiku ndi tsiku. Nthawi zina mankhwala a prednisone amagwiritsidwa ntchito, koma nthawi zambiri ngati mankhwala ena alephera kuthetsa zizindikiro kuyambira pakamwa pamatumbo amakhala ndi zotsatira zovuta kwambiri.
Aspirin Desensitization
Njira ina, yomwe yasonyezeratu yothandiza kwambiri, ndiyo kutsatira aspirin deensitization. Kafukufuku wasonyeza kuti aspirin deensitization yotsatiridwa ndi mlingo wa tsiku ndi tsiku wothandizira aspirin ingachepetse kupanga mapangidwe amtundu wa nasal komanso matenda a sinus komanso kusintha masewera a mphumu.
Mlingo wa aspirin umaperekedwa kuchipatala kumene mungathe kuyang'aniridwa kuti muyankhe. Malo ochiritsira nthawi zambiri ndichipatala omwe ali ndi odwala omwe akudziwa bwino ntchito (chipatala chachipatala sichiri chofunikira). Mlingo umayambira pang'ono ndipo pang'onopang'ono kuwonjezeka mu kuchulukitsa njira yanu kupita kuchipatala. Izi ndizofanana ndi chithandizo cha immunotherapy kwa chifuwa.
Umboni umasonyeza kuti aspirin deensitization ndi yotsika mtengo kwambiri ndipo ndi yopindulitsa kwa anthu ambiri omwe ali ndi matenda a AERD. Kupititsa patsogolo kumaonekera patatha milungu inayi yokha. Kafukufuku wasonyeza kusintha kwa masamba amtundu, kumva kununkhira, komanso kuchepetsa kuchuluka kwa mankhwala oyenera kuteteza zizindikiro za mphumu.
Si anthu onse omwe ali ndi AERD omwe ali oyenera aspirin desensitization. Musakhale ndi chithandizochi ngati muli ndi pakati, muli ndi zilonda za m'mimba, matenda otha magazi, kapena zizindikiro zosasimbika za mphumu.
Pali zoopsa zomwe zimayambitsidwa ndi aspirin desensitization ndipo izi zimaphatikizapo kuchotsa zizindikiro za AERD kuphatikizapo mavuto aakulu a kupuma. Komanso, zotsatira zina zomwe zimapezeka pakamwa aspirin, monga vuto la m'mimba kapena kutuluka m'mimba, zimatha kukhala ndi aspirin deensitization. Muyenera kuyankhula ndi dokotala wanu kapena wamankhwala zokhudzana ndi zotsatira zake ndipo onetsetsani kuti aspirin sichidzasokoneza mankhwala ena omwe mungakhale nawo.
Mutatha kumwa aspirin deensitization m'pofunika kupitiriza kumwa mlingo wokwanira wa aspirin tsiku ndi tsiku kuti mupitirize kuchitapo kanthu. Poyamba mlingo umenewu ukhoza kukhala wokwana 1300 mg pa tsiku, koma, dokotala wanu amachepetsetsa kuchuluka kwa aspirin. Mankhwala osachepera 81mg pa tsiku (mlingo wamba kwambiri kwa anthu omwe ali ndi matenda a mtima) awonetsedwa bwino.
Ngati mukuvutika kwambiri ndi zotsatira zake komanso zotsatila zomwe mwangowerenga, dziwani kuti ndondomekoyi ndi sitepe ndi sitepe, choncho yesetsani kuganizira chinthu chimodzi panthawi imodzi. Dokotala wanu adzakutsogolerani inu, zotsatira zoyendetsa, ndikudziwitseni zotsutsana.
> Zotsatira:
> Aspirin-Kuwonjezeka kwa Matenda a Kutupa (AERD). American Academy of Allergy Chifuwa ndi Immunology. Chiwongola dzanja
> Rachel U. Lee ndi Donald D. Stevenson. Aspirin-Kuwonjezera Matenda Opuma Opaleshoni: Kufufuza ndi Kulamulira. Kutsekula kwa mphumu ya Immunol Res. 2011 Jan; 3 (1): 3-10.
> John W Steinke ndi Jeff M Wilson. Matenda a aspirin-owonjezereka odwala: zizindikiro zogonana ndi matenda opita kuchipatala. J Nthendayi. 2016; 9: 37-43.