Mmene Matenda ndi Matenda Amakhululukira Zatsimikiziridwa
Matenda a nyamakazi amasiyana ndi osteoarthritis ("kuvala" ndi "kutupa" nyamakazi) chifukwa ndi matenda omwe amachititsa kuti chitetezo cha mthupi chiteteze maselo ake ndi ziwalo zake, makamaka ziwalozo. Choncho, matendawa sangathe kupeza zizindikiro zokha. M'malo mwake, muyenera kugwiritsa ntchito mayesero osiyanasiyana-kuphatikizapo kuunika kwa thupi, kuyesa zojambula, ndi mayeso a magazi - kuti mudziwe ngati zotsatirazo zikugwirizana ndi tanthauzo la matendawa.
Kuchita zimenezi sikungowonetsetsa kuti matendawa ali olondola, zimathandiza kudziwa njira yoyenera yothandizira.
Kufufuza Kwambiri
Chimodzi mwa zipangizo zoyambirira za kugwiritsira ntchito ndikuyezetsa thupi. Cholinga cha kafukufuku ndi mbali imodzi, kuti adziwe momwe zimakhalira kupweteka ndi kupweteka kwabwino kuti zikhale bwino kusiyanitsa izo ndi chiganizo chotheka kwambiri cha osteoarthritis .
Zina mwa kusiyana kwakukulu:
- Matenda a nyamakazi amatha kukhudza ziwalo zingapo ( polyarthritis ). Osteoarthritis nthawi zambiri imakhudza manja, mapazi, ndi mawondo ndipo nthawi zambiri zimakhala ndi umodzi umodzi ( monoarthritis ).
- Matenda a nyamakazi amayamba kukhala ofanana, kutanthauza kuti zizindikiro zovomerezeka pambali imodzi ya thupi nthawi zambiri zimayikidwa mbali ina ya thupi. Osteoarthritis nthawi zambiri imagwirizanitsa (kapena yopanda malire ngati ophatikizira ambiri akukhudzidwa).
- Chifukwa chakuti nyamakazi ya nyamakazi imayambitsa kutentha thupi, kutopa , malaise, komanso ngakhale kutentha thupi kumakhala kofala. Matenda a osteoarthritis, omwe si matenda opweteka, nthawi zambiri sakhala limodzi ndi zizindikirozi.
- Kuuma kwa mmawa kumakhala kofala ndi nyamakazi ya nyamakazi koma imakhala nthawi yokha mphindi 30 zokha ndikukhala ndi kayendedwe kabwino. Popeza kuti mafupa a osteoarthritis amawonongeka, zimakhala zovuta kwambiri.
Kuphatikiza pa kuunika zizindikiro zanu, dokotala adzakumbukira mbiri ya banja lanu.
Matenda a nyamakazi amatha kugwiritsidwa ntchito m'mabanja, kuwirikiza kawiri chiopsezo cha matendawa ngati wachibale wachiwiri amakhala ndi chiopsezo ngati wina wa m'banja lanu akukhudzidwa.
Mayesero a Lab
Mayeso a Lababu amagwiritsidwa ntchito pa zifukwa zikuluzikulu ziwiri pakupeza nyamakazi ya nyamakazi: kuti awonetse masewero anu ndi kuyesa ndi kuyang'anira mlingo wa kutupa thupi lanu.
Serostatus
Serostatus (kutembenuzidwa mosamasuliridwa kuti "chikhalidwe cha magazi") amatanthauza zizindikiro zofunika za matendawa m'magazi anu. Ngati mankhwalawa amapezeka pamayesero a magazi, amati ndiwe wosasinthika. Ngati iwo sapezeka, mungakhale ngati gulu la seronegative. Zotsatira zowonjezereka zingathe kusankhidwa kukhala zochepa, zabwino, zabwino, kapena zapamwamba / zamphamvu.
Pali mayesero awiri ogwiritsidwa ntchito pofuna kukhazikitsa serostatus yanu:
- Chifuwa chachikulu (RF) ndi mtundu wa autoantibody womwe umapezeka mu 80 peresenti ya anthu omwe amadwala matendawa. Autoantibodies ndi mapuloteni opangidwa ndi thupi lomwe limayambitsa maselo abwino. Ngakhale kuti RF ikuluikulu imagwiritsa ntchito matenda a nyamakazi, imatha kuchitika ndi matenda ena omwe amachititsa kuti munthu asatenge matenda monga matenda a khansa kapena matenda osagwirizana ndi khansa komanso matenda aakulu.
- Peptide ya anti-cyclic citrullinated (anti-CCP) ndi mtundu wina wa autoantibody womwe umapezeka mwa anthu ambiri omwe ali ndi nyamakazi ya nyamakazi. Kuwunika kwakukulu kwa mayesero-mphamvu yake yodziwitsa bwino anti-CCP-ndi kotere kumatha kuzindikira anthu omwe ali ndi chiopsezo cha matendawa ngakhale alibe zizindikiro.
Pamene mayesero onsewa saperewera ndikumvetsetsa kwawo, komwe kumakhala pansi pa 80 peresenti. Izi zikutanthawuza kuti mayesero, pamene ali ofunikira popanga matenda, amatha kukhala ndi zotsatira zosamveka kapena zabodza . Ndi chifukwa chake amagwiritsidwa ntchito monga gawo la chidziwitso osati monga zizindikiro zokha.
Makina Opusa
Kutupa ndi chizindikiro cha nyamakazi ya nyamakazi. Kuyesedwa kwachitidwa kuti tiyese msinkhu wa kutupa mwa kuyang'ana pa zilembo zazikulu mu magazi. Izi zimatithandiza kuti titsimikizidwe kuti tiyambe kuchipatala koma timagwiritsidwa ntchito panthawi yonse ya matendawa kuti tiwone momwe tikumvera.
Kuti izi zitheke, madokotala adzagwiritsa ntchito njira ziwiri zofunika:
- Mlingo wa Erythrocyte sedimentation (ESR) ndiyeso yomwe imayendera momwe maselo ofiira a m'magazi amatha kukhalira pansi pa chubu chowongolera, chotchedwa Westergren tube, mu ola limodzi. Ngati pali kutupa, maselo ofiira amagawani pamodzi ndikumira mofulumira. Ndiyeso yeniyeni yeniyeni ya kutupa koma imodzi yomwe ingapereke zidziwitso zofunika zomwe zimapindulitsa.
- Puloteni wothandizira kwambiri (CRP) ndi mtundu wa mapuloteni opangidwa ndi chiwindi chifukwa cha kutupa. Ngakhale kuti sizinali zenizeni, ndizoyeso yowonjezera ya kuyankhidwa kotupa.
ESR ndi CRP zingagwiritsiridwenso ntchito kuti apeze chikhululukiro cha matenda a arthritis , chikhalidwe cha matenda otsika komwe kutupa kuli kocheperako.
Mayesero Ojambula
Udindo wa kujambula mayeso mu nyamakazi ya nyamakazi ndiyo kudziwa zizindikiro za kuwonongeka kwa mgwirizano, kuphatikizapo kutuluka kwa mafupa ndi khunyu komanso malo ophatikizana. Angathandizenso kuwunikira kukula kwa matendawa ndi kukhazikitsa pamene opaleshoni ikufunika.
Mayeso alionse angapereke nzeru zosiyana ndi zina:
- X-ray ndi othandiza kwambiri pozindikira kutentha kwa mafupa ndi kuwonongeka kwa mgwirizano. Ngakhale kuti X-ray imatengedwa ngati chida chachikulu chogwiritsira ntchito nyamakazi, sizili zothandiza pamayambiriro a matendawa pamene kusintha kwa magazi ndi synovial tisses siwonekeratu .
- Zithunzi zojambulidwa ndi maginito (MRI) zikhoza kuyang'ana kupyola fupa ndi malo omwe amasinthasintha mthupi mwake komanso ngakhale kutsekula komwe kumayambitsa matenda oyambirira.
- Ultrasound ndi bwino pakuwona kuphulika koyambirira kwa mgwirizano ndipo zingathe kuwulula malo enieni a kutukumula. Izi ndizofunika kwambiri kuti kutupa nthawi zina kungapitirize kuoneka ngakhale kuti ESR ndi CRP zikutiuza kuti munthuyo ali mu chikhululukiro. Zikatero, chithandizo chikanapitilizidwa mpaka nthawi yomwe chikhululukiro chenicheni chidzapindulidwe.
Zotsatira za Malemba
Mu 2010, American College of Rheumatology (ACR) inayambitsanso njira zowonjezereka za matenda a nyamakazi. Zomwe zinawongosoledwazo zinalimbikitsidwa, mwa zina, mwa kupita patsogolo kwa mateknoloji. Ngakhale kuti ziwerengerozi zimagwiritsidwa ntchito pofuna kufufuza zachipatala, zimagwiritsidwa ntchito muzipatala kupereka chitsimikizo chachikulu chotsimikizirika.
Zotsatira za 2010 ACR / EULAR Criteria zikuyang'ana miyeso inayi yosiyanasiyana ya kuchipatala ndikuyesa muyezo wa 0 mpaka 5. Mbali yowonjezera ya 6 mpaka 10 ikhoza kukhala ndi chidaliro chokwanira kuti iwe uli ndi nyamakazi ya nyamakazi.
| Zotsatira | Phindu | Mfundo |
| Nthawi ya zizindikiro | Pasanathe milungu isanu ndi umodzi | 0 |
| Zoposa masabata asanu ndi limodzi | 1 | |
| Kuphatikizana pamodzi | Mgwirizano umodzi waukulu | 0 |
| Mapepala akuluakulu awiri mpaka 10 | 1 | |
| Gawo limodzi kapena atatu (popanda kuphatikizapo ziwalo zazikulu) | 2 | |
| Mphindi 4 mpaka 10 (popanda kuphatikizapo ziwalo zazikulu) | 3 | |
| Zowonjezera khumi (ndi osachepera kakang'ono) | 5 | |
| Serostatus | RF ndi anti-CCP ndizolakwika | 0 |
| Low RF ndi low anti-CCP | 2 | |
| Pamwamba RF ndi mkulu anti-CCP | 3 | |
| Zolemba zotupa | Zachibadwa ESR ndi CRP | 0 |
| Zachilendo ESR ndi CRP | 1 |
Kuzindikira Kukhululukidwa
Kuzindikira matenda okhululukidwa sikungowonongeka. Sichiyenera kokha kuyesedwa koyeso koma kuyesedwa kovomerezeka kwa zomwe iwe, monga wodwala, umamva za vuto lanu. Kuzindikira bwino kukhululukidwa ndikofunikira chifukwa kumatsimikizira ngati mankhwala ena angayime kapena ngati kuchita zimenezi kungakhale msanga komanso kubwereranso .
Kuti izi zitheke, ACR yakhazikitsa zomwe zimatchedwa DAS28, yomwe ili ndi miyeso inayi. "DAS" ndi chidule cha "chiwerengero cha matenda," pamene makumi asanu ndi awiri (28) amatanthawuza chiwerengero cha ziwalo zomwe zimafufuzidwa pa kufufuza.
DAS ikuyang'ana izi:
- Chiwerengero cha ziwalo zachifundo dokotala wanu amapeza (pa 28)
- Chiwerengero cha ziwalo zotupa zomwe dokotala amapeza (pa 28)
- Zotsatira zanu za ESR ndi CRP (zachibadwa ndi zachilendo)
- Momwe mumamverera thanzi lanu lonse ndi kuwonetsa malo anu pamtunda wa masentimita 10 omwe mapeto ake ali "abwino" ndipo ena "ndi oipa"
Zotsatirazi zimaperekedwera mu ndondomeko yovuta ya masamu kuti muwerenge mapepala anu onse. DAS28 yaikulu kuposa 5.1 imatanthawuza matenda othandizira, zosakwana 3.2 zimapereka ntchito yochepa ya matenda, ndipo osachepera 2.6 amawerengedwa kuti akukhululukidwa.
Kusiyanitsa kusiyana
Momwemonso mayesero angathandize kusiyanitsa chifuwa chachikulu cha nyamakazi ndi osteoarthritis, ena akhoza kulamulidwa kuti adziwe ngati pali zifukwa zina za zizindikiro zanu. Izi ndi zoona makamaka ngati zotsatira za mayeso a nyamakazi zikhoza kukhala zosadziwika, zosavomerezeka, kapena zoipa.
Izi zingaphatikizepo matenda osokoneza bongo, matenda opatsirana, ndi matenda aakulu otupa monga:
- Fibromyalgia
- Matenda a Lyme
- Myelodylastiki syndromes
- Matenda a Paraneoplastic syndromes
- Polymyalgia rheumatica
- Psoriatic nyamakazi
- Sarcoidosis
- Sjogren matenda
- Dongosolo la lupus erythematosus (lupus)
> Zotsatira:
> Aletaha, D .; Neogi, T .; Silman, A. et al. "Chiwerengero cha Matenda a Mitsempha Yachifuwa cha Rumatoid 2010: A American College of Rheumatology / European League Against Rheumatism Co-operative Initiativ e." Arthritis Rheum. 2010: 62 (9): 2565-81 DOI: 10.1002 / chithunzi.27584.
> Anderson, J ;; Caplan, L .; Yazdany, J. et al. "Matenda a Matenda a Matenda a Mitsempha Zochita Ntchito: American College of Rheumatology Malingaliro Ogwiritsidwa Ntchito M'kuchiritsira. 2012; 64 (5): 6. DOI: 10.1002 / acr.21649.
> Bykerk, V. ndi Masarotti, E. "Njira zatsopano zowonjezeredwa za ACR / EULAR: zowonetsera kuti pakhale njira zatsopano zowhululukira." Rheumatology . 2012; 51: vi16vi20. DOI: 10.1093 / rheumatology / kes281.
> Smolen, J ;; Aletaha, D .; ndi McInnes, I. "Matenda a nyamakazi. " Lancet. 2017; 388 (10055): 2023-38. DOI: 10.1016 / So140-6736 (16) 30173-8.