Mitundu ya Arthritis Yogwirizana ndi Kutupa
Mitundu yotupa yamagazi ingaphatikizepo ziwalo zingapo panthawi imodzi. Kawirikawiri, chitetezo cha mthupi chogonjetsa kapena chosagwira ntchito ndicho chifukwa cha kutupa . Zomwe zizindikiro za kutupa kwa nyamakazi ndi zopweteka komanso kuuma m'mawa kapena pambuyo pake kapena kupuma. Odwala omwe ali ndi nyamakazi yotupa, nthawi ya kuuma kwa mmawa imatha mphindi 60.
Kutupa, kufiira, ndi kutentha ndizofala m'magulu okhudzidwa kapena kuzungulira. Nyamakazi yotupa imakhudza ziwalo - ziwalo zina za thupi zingakhudzidwe, kuphatikizapo khungu kapena ziwalo. Nyamakazi yotupa ingakhudze anthu a misinkhu yonse, koma nthawi zambiri amawakhudza anthu pachiyambi cha moyo.
Nthawi zambiri kutupa sikuchitika ndi kutupa nyamakazi. Ngakhale kuti izi zingawoneke ngati zosagwira ntchito, odwala matenda a kutupa nyamakazi amatha kupweteka popanda kutupa, kutupa popanda kupweteka, kapena kuperewera kwa thupi popanda kupweteka kapena kutupa.
Mitundu Yopweteka Amagazi
Mitundu itatu yambiri ya matenda a kutupa nyamakazi ndi matenda a nyamakazi , nyamakazi ya psoriatic , ndi ankylosing spondylitis . Koma, palinso ena. Kwa odwala omwe amaonetsa zizindikiro za minofu, zizindikiro zotupa zomwe sizikuphatikizana zingaphatikizepo bursitis , tendinitis , kapena polymyalgia rheumatica .
Odwala omwe ali ndi ziwalo zitatu zomwe zimakhudzidwa amakhala ndi chifuwa chachikulu monga kutupa nyamakazi , gout, pseudogout , nyamakazi yogwira mtima, kapena nyamakazi yotupa - kapena matenda aakulu a kutupa nyamakazi monga psoriatic arthritis, spondyloarthropathy, pauciarticular mwana wamatenda a nyamakazi , kapena nyamakazi imene imayambitsa matenda ndi wosafulumira kuchiza.
Odwala omwe ali ndi ziwalo 4 kapena zingapo zokhudzana ndi matendawa amatha kukhala ndi ziphuphu zoopsa monga tizilombo toyambitsa matenda, nyamakazi yogwiritsira ntchito mankhwala osokoneza bongo, matenda oyambitsa matenda, rheumatic fever, palindromic rheumatism , kapena syittingitis symentitis symmetrical synovitis ndi pitting edema (RS3PE) - kapena matenda aakulu monga nyamakazi ya nyamakazi, nyamakazi yowumitsa thupi , kutupa kwa mafupa , kutupa kwa matenda , lupus , scleroderma , nyamakazi ya nyamakazi, kapena matenda achikulire.
Kodi Matenda a Maginito Amadziwika Motani?
Kuwonjezeka kwapakati pazigawo zotentha zimakhala ngati zizindikiro za kutupa. Ngakhale kuti nthawi zambiri zimagwiritsidwa ntchito, CRP ndi kuchepa kwa dothi , zimasonyeza kuti kutupa, sizimasiyanitsa pakati pa nyamakazi ndi nyamakazi zina zotupa. Komanso, si onse omwe ali ndi nyamakazi yotupa adzakweza CRP kapena kuchepa kwa chiwindi poyamba. Odwala ena amatha kukhala ndi ferritin, haptoglobin, ceruloplasmin, kapena othandizira. Zolemba zina zomwe zimasonyeza kuti munthu ali ndi kutupa kwa nyamakazi ndi nthenda yodwala matenda aakulu, mapiritsi okwera, ndi kuchuluka kwa maselo oyera.
Pali mayesero a serologic kuti athandizidwe ndi matendawa.
Chifuwa chachikulu chotchedwa rheumatoid chimalamulidwa kawirikawiri ngati munthu akuganiza kuti nyamakazi imakhala ndi nyamakazi. Koma, sikuti onse omwe ali ndi nyamakazi ya nyamakazi ndi ofunika chifukwa cha chifuwa chachikulu (chosasinthika). Pafupifupi 20 peresenti ya odwala omwe ali ndi matenda a nyamakazi ndi olakwika chifukwa cha chifuwa chachikulu (seronegative). Kumayambiriro kwa nyamakazi (zizindikiro zosakwana chaka chimodzi) chifuwa chachikulu cha chifuwa chachikulu chokhudzidwa ndi chifuwa chachikulu chimakhala chokhudza 17-59%, malinga ndi Kelley's Textbook of Rheumatology. Chodziwika bwino sichinali chabwino m'matenda a nyamakazi oyambirira, chifukwa zina zikhoza kugwirizanitsidwa ndi vuto la chifuwa chachikulu (mwachitsanzo, matenda a lupus, Sjogren ).
Ngakhale anthu 4 mpaka 5% ali ndi kachilombo ka HIV. Mayesero ena a serologic, monga anti-CCP ndi ANA angapereke zambiri zowunikira, kuphatikizapo CRP, mlingo wa dothi, ndi chifuwa chachikulu.
Kuyesera kwa zizindikiro zina zazamoyo zingakhale zothandiza. Mwachitsanzo, chitsimikizo cha HLA-B27 chikugwirizana kwambiri ndi ankylosing spondylitis. Komanso, kusinkhasinkha kwa madzi a synovial kungapereke chidziwitso chokhudza inflammaton - synovial zamadzimadzi kuchokera kumalo oundana omwe amakhala achikasu ndi osokonezeka, okhala ndi maselo oyera a pamwamba pa maselo 10,000 / mm, omwe ali ndi chiwerengero chachikulu cha neutrophils.
Kujambula kumagwiritsidwanso ntchito monga gawo la chithandizo cha matenda opweteka. Chizindikiro cha X-ray cha kutupa nyamakazi chingaphatikizepo minofu yofewa, chondrocalcinosis , kuthamangitsidwa kwa mgwirizano , osteopenia pafupi ndi mgwirizano, kutayika kwa kanyumba kamodzi , malo ophatikizana , ndi zovuta.
Zotsatira:
Chifuwa cha Arthritis Center. Chipatala cha Opaleshoni Yapadera.
http://www.hss.edu/inflammatory-arthritis-center.asp#.UzS4Q4VsJ4w.
Kelley's Textbook ya Rheumatology. Mutu 42. Polyarticular Arthritis. John J. Cush ndi Kathryn H. Dao. Kusindikiza kwachisanu ndi chinayi. Elsevier Saunders.
Chithandizo cha Dokotala Wachikulire Cholinga cha Matenda a Matenda a Kutupa; Kudziwa. Rheumatology Network. June 2, 2010.
http://www.rheumatologynetwork.com/articles/primary-care-physicians-guide-inflammatory-arthritis-diagnosis.