Zizindikiro Zogwirizana Zokhudzana ndi Matenda a Mimba
Matenda a kutupiritsa m'matenda ndi matenda opweteka omwe amachititsa msana ndi ziwalo zina zomwe zimapezeka m'matenda opatsirana - Matenda a Crohn ndi ulcerative colitis. Nyamakazi yotupa yogwirizanitsa ndi matenda ena opatsirana, monga matenda a leliac ndi matenda a Whipple, sagwirizananso ndi "nyamakazi".
Nyamakazi yotchedwa entopathic imatchulidwa ngati imodzi mwa spondyloarthropathies . Mankhwala ena otchedwa spondyloarthropathies amawatcha ankylosing spondylitis , psoriatic nyamakazi , ndi nyamakazi yowonongeka . "Intoopathy" imatanthawuza matenda aliwonse okhudzana ndi matumbo.
Kupanga nyamakazi ya Enteropathic
Matenda a nyamakazi amapezeka pafupifupi 20 peresenti ya anthu omwe ali ndi matenda opatsirana, omwe ali ndi chiwerengero chokwanira pakati pa anthu omwe ali ndi matenda a Crohn poyerekeza ndi omwe ali ndi zilonda zam'mimba. M'thupi la nyamakazi, matenda a nyamakazi angayambitse zizindikiro za m'mimba kwa nthawi yaitali.
Mpaka kuti zizindikiro za m'mimba ziwoneke, nyamakazi imatchulidwa ngati Undifferentiated Spondyloarthritis. Komabe anthu ambiri omwe ali ndi nyamakazi yotchedwa entopathic arthritis, amapezeka kale ndi matenda ena opweteka.
Zotsatira zaphunziro zomwe zafalitsidwa mu Clinical Rheumatology zinkanena kuti IL-23, chilengedwe, ndipamwamba kwambiri mwa anthu omwe ali ndi matenda opatsirana, makamaka a Crohn's disease, ndipo ali oposa omwe ali ndi mimba ndi / kapena axial nyamakazi poyerekeza ndi machitidwe.
Mafukufuku ambiri amafunika, koma angakhale kupeza kwakukulu komwe kungayambitse chithandizo chatsopano.
Zizindikiro
Matenda a m'maganizo amatha kukhala ngati axial nyamakazi, nyamakazi yamatenda, kapena yosakaniza. Monga matenda a nyamakazi, zizindikiro za kupweteka kwapweteka ndi kuuma zikufanana ndi ankylosing spondylitis ndipo zingayambitse zizindikiro za m'mimba.
Monga nyamakazi yodwala nyamakazi, pamakhala kachitidwe ka pauciarticular (ziwalo zinayi kapena zochepa zomwe zimakhudzidwa) ndi nyamakazi yosakanikirana (ziwalo zokhudzidwa sizili mbali imodzi ya thupi). Matenda a m'mimba akhoza kuchitika panthawi imodzimodziyo ngati nyamakazi kapena nyamakazi ingakhoze kuchitika pamaso pa matenda a m'mimba.
Kudziwa
Kulankhulana momasuka ndi dokotala wanu za zizindikiro zanu zonse ndi malo oyamba. Kawirikawiri madokotala amayesera kuyesa:
- kuperewera kwa magazi
- CRP yokwezeka ndi ESR yosonyeza kutupa
- kusowa kusintha kwakukulu pa x-ray ya ziwalo zamkati
- sacroiliac ndi msana wa x-ray omwe amafanana ndi ankylosing spondylitis
Kafukufuku wina, wofalitsidwa mu Selfimmunity Reviews, adawona momwe ntchito yakumaliseche ndi Rheumatologic Clinic ikugwira ntchito. Kafukufukuyu anawulula kuti anthu omwe ali ndi spondylitis anali ndi chiwopsezo chachikulu cha maonekedwe ena opatsirana m'mimba ndipo analandira chithandizo chambiri ndi TNF blockers kusiyana ndi anthu otupa matumbo.
Anthu omwe anali ndi chiwopsezo amayambitsa spondylitis yokhala mkati mwazaka khumi pakati pa 1980 ndi 1990 ndi 1991 mpaka 2001 anawona kuchedwa kwakukulu pakuzindikira. Zakhala bwino kwambiri.
Anthu omwe anali ndi matenda opatsirana pogonana pakati pa 2002 mpaka 2012 adachepetsa kuchepetsa matendawa.
Zikuwoneka kuti zipatala zomwe zimakhala ndi njira zosiyanasiyana, zogwirizana ndi zizindikiro zomwe zimagwirizanitsa ndi m'mimba, zimakhala zogwirizana ndi matendawa.
Chithandizo
Matenda a m'magulu amtunduwu amachitidwa mofanana ndi ena a spondyloarthropathies a zizindikiro zofanana. Vuto ndiloti zikhalidwe zonsezi ziyenera kuthandizidwa - matenda a nyamakazi komanso matenda a matumbo-koma monga NSAID zitha kuchiza matenda a nyamakazi, mankhwalawa angapangitse kuti matendawa akhale ovuta kwambiri.
Mankhwala a TNF, omwe amachititsa Remicade (infliximab), Humira (adalimumab) ndi Cimzia (certolizumab pegol) amagwiritsidwa ntchito bwino pochiza matenda opatsirana.
Zimathandizanso kudwala nyamakazi.
Mawu Ochokera
Mogwirizana ndi Spondylitis Association of America, njira ndi kuopsa kwa nyamakazi yazamagulu zimasiyana ndi munthu. Ngakhale kuti matenda amtundu wa nyamakazi amatha kukhala odziletsa komanso otsika pambuyo pa milungu isanu ndi umodzi, kubwereza kumakhala kofala. Ndipo, nyamakazi ya nyamakazi ya nyamakazi ingakhale yachilendo ndipo ingakhale yogwirizana ndi chiwonongeko chogwirizana. Palibe mankhwala omwe amadziwika kuti amathandiza munthu kugwidwa ndi matenda a m'mimba, koma mankhwala amathandiza kuchepetsa matenda ndi nyamakazi.
> Zotsatira:
> Kupangidwira kwapopopycondomarthritis. Choyamba pa Rheumatic Diseases. Kusindikiza kwachisanu ndi chitatu. Lofalitsidwa ndi Arthritis Foundation.
> Gheita, TA. Kuphatikizidwa kwa IL-23 m'magulu a nyamakazi odwala matenda opatsirana omwe amatupa matenda: zotsatira zoyambirira. Clinical Rheumatology. 2014 May; 33 (5): 713-7.
> Conigliaro P., et al. Zotsatira za njira zosiyana siyana za odwala matenda opatsirana pogonana. Zomwe Zimapangidwira Zokha. 2016 Feb; 15 (2): 184-90.
> Zambiri za Arthritis Arthritis / Arthritis Yokhudzana ndi Kutupa Kwambiri. Spondylitis Association of America.