Tophi ndi magulu a sodium urate monohydrate amakristasi omwe amaikidwa mkati ndi kuzungulira ziwalo za anthu omwe ali ndi gout. Pali magawo atatu a gout: osymptomatic (popanda zizindikilo) hyperuricemia , gout nthawi (magulu a acute gouty amtundu wotchulidwa ndi asymptomatic nthawi), ndi matenda aakulu nyamakazi. Ndilo gawo lachitatu, nyamakazi yambiri yamatenda, pamene tophi amawonekera.
Tophi akhoza kukayikiridwa panthawi yovuta kwambiri yodwala nyamakazi ya nyamakazi.
Pamene Fomu ya Tophi
Pakati pa matenda aakulu a nyamakazi, palibe nthawi yopweteka. Nthawi yoyamba pakati pa chiwopsezo choyamba cha matenda a nyamakazi ya nyamakazi ndi tophi yowoneka imasiyanasiyana ndi maphunziro a odwala opatsirana osagwidwa. Zotsatira za Phunziro (Hench, P. et al.) Zasonyeza kuti nthawi yochulukirapo poyambitsa matenda a gout kumayambiriro kwa matenda a nyamakazi kapena chitukuko cha tophi chowonekera chinali zaka 11.6. Pa kafukufuku wokhudzana ndi odwala gout oyambirira oposa 1,100, omwe alibe tophi anali ndi mphamvu ya urate ya 10.3 +/- 1.3 milligrams / deciliter. Anthu okhala ndi tophi wambiri amakhala ndi ma digiri 11.0 +/- 2.0 milligrams / decilter.
Chifukwa Fomu ya Tophi
Mlingo wa tophi umapangidwira mgwirizano ndi kuuma kwa nthawi ndi nthawi ya hyperuricemia. Gout tophaceous amapezeka chifukwa thupi silingathe kuchotsa mkangano mofulumira.
Mukamasonkhanitsa mavitamini ochulukirapo, kuyamwa kristalo kungapangidwe.
Ngakhale kuti mlingo wa seramu urate ndi chinthu chofunika kwambiri chogwirizana ndi tophi, pangakhale zinthu zina zowonjezera, kuphatikizapo: msinkhu wa gout, kutentha kwa nthawi yaitali koma osaphunzitsidwa, pafupifupi masewera anayi pa chaka, ndi pamwamba ndi kulowerera polyarticular .
Kukula koyamba kwa tophi-mwa anthu omwe akhala ndi gout zaka zosachepera 10-amapezeka pafupifupi 15 peresenti ya anthu. Chilolezo cha Creatinine ndicho chodziimira chomwe chagwirizanitsidwa ndi mapangidwe oyambirira a tophi.
Kumene Fomu ya Tophi
Tophi ikhoza kuikidwa m'matumbo, tizilombo toyambitsa matenda, timatope, ndi tizilombo tofewa. Ngakhale kuti tophi ikhoza kupezeka paliponse m'thupi, zimakhala zala zambiri, zala, makutu, mawondo, olecranon bursa, ndi zipsyinjo (mwachitsanzo, mbali ya ulnar ya ambalo, Achilles tendon). Mu tizilumiki togwirizanitsa, tophi angapezeke m'mapiramidi a nsapato, ma valves a mtima, ndi scleru.
Zojambula za Tophi
Tophi ndi zopweteka kwambiri, komabe kutentha kwakukulu kumakhala kozungulira. Pakhoza kukhala chiwonongeko cha ziwalo ndi zofooka zikhoza kuchitika, makamaka manja ndi mapazi. Khungu lomwe limakhala pamwamba pa tophus likhoza kukhala lamtundu ndipo kenako ulcerate. Chovala choyera kapena chodyera, chokhala ndi makina amchere, chingachotsedwe ku ulcerated tophus. Tophi ikhoza kudziwika ndi ultrasonography, MRI, ndi CT scan. Zithunzi zambiri za tophi zimachokera ku CT.
Mtundu wa Moyo
Ochita kafukufuku adaganizira za momwe tophi amakhudzidwira ndi kuchuluka kwa zida zoopsa za gout zokhudzana ndi thanzi labwino.
Phunziro ( Health and Quality of Life Outcomes 2012) linaphatikizapo odwala 620 omwe ali ndi gout odzidzimutsa, 12.3 peresenti ya iwo ankayenera kuti tophi. Panali kuchepa kwa umoyo wathanzi wokhudzana ndi kukhalapo kwa tophi ndi gout flares.
Mawu Ochokera
Mlingo wa sirum urate ndicho chofunikira kwambiri chogwirizana ndi mapangidwe a tophi. Anthu ena omwe amachitidwa ndi matenda a gout amalephera kumvetsera panthawi yomwe alibe chizindikiro pakati pa zovuta. Koma, ndikofunika kuyang'anira miyeso ya uric acid nthawi zonse. Ndikofunika kuchiza gout ndikuyesa kuyendetsa bwinobwino, osati pokhapokha ngati zizindikiro zikuwonekera.
Kukhalapo kwa tophi kumagwirizana ndi khalidwe lochepa la moyo. Iyenera kukhala cholinga chanu kuyesetsa kupewa tophi pogwiritsa ntchito hyperuricemia ndi gout bwino.
> Zotsatira:
Dalbeth, Nicola, et al. Kusintha kwa Creatinine Kumachepetsa Kukula Kwambiri Kwambiri kwa Tophi Yogwiritsa Ntchito Anthu Omwe Amakhala ndi Gout. Matenda a BMC Musculoskeletal. December 21, 2013.
> Hench, P. Kupezeka kwa gout ndi gouty nyamakazi. J Lab Clin Med 220: 48-55. 1936.
> Khanna PP et al. Tophi ndi Frequency Gout Flares Zimayenderana ndi Kuwonongeka kwa Moyo, Kuchita Zowonjezera, ndi Kuonjezera Kugwiritsa Ntchito Zothandizira Zaumoyo: Zotsatira Kuchokera Pambuyo Pachigawo. Zotsatira zaumoyo ndi zotsatira za moyo. September 22, 2012.
> Yambani pa Rheumatic Diseases. Arthritis Foundation. Kachitidwe Kachitatu. Tsamba 243.
> Kelley's Textbook of Rheumatology. Elsevier Saunders. Kusindikiza Kwachisanu ndi Chinayi. Volume II. P.1558-1560.