Rheumatoid arthritis

Rheumatoid arthritis (RA) chirwere chinotungamira mukuzvimba kwemajoini uye matukisi akapoteredza. Icho chirwere chenguva refu. Inogonawo kukanganisa dzimwe nhengo.

Chikonzero cheRA hachizivikanwe. Icho chirwere chinodzivirira. Izvi zvinoreva kuti immune system yemuviri inokanganisa kurwisa zvinyama zvine hutano.

RA inogona kuitika chero zera, asi inowanzo kwana muzera repakati. Vakadzi vanowana RA kakawanda kupfuura varume.

Utachiona, majini, uye shanduko yemahormone inogona kunge yakabatana nechirwere. Kusvuta kunogona zvakare kuve kwakabatana neRA.

Izvo ishoma pane osteoarthritis (OA). OA inova mamiriro anoitika muvanhu vazhinji nekuda kwekusakara nekubvarura majoini sezvavanokwegura.

Kazhinji yenguva, RA inobata majoini kumativi ese emuviri zvakaenzana. Minwe, mawoko, mabvi, tsoka, magokora, makumbo, mahudyu nemapendekete ndizvo zvinonyanya kutapurwa.

Chirwere ichi chinowanzotanga zvishoma nezvishoma. Zviratidzo zvekutanga zvinogona kusanganisira:

• Minor majoini kurwadza
• Kuomarara
• Kuneta

Zvimwe zviratidzo zvinogona kusanganisira:

• Kuomarara kwemangwanani, kunogara kweinopfuura 1 awa, kwakajairika.
• Majoini anganzwa kudziya, nyoro, uye kuomarara kana zvisina kushandiswa kweawa.
• Marwadzo akabatana anowanzonzwikwa mubatanidzwa mumwe chete kumativi ese emuviri.
• Majoini anowanzozvimba.
• Nekufamba kwenguva, majoini anogona kurasikirwa nhanho yavo yekufamba uye anogona kuve akaremara.

Zvimwe zviratidzo zvinosanganisira:

• Kurwadziwa pachifuva kana uchitora mweya (pleurisy)
• Akaoma maziso nemuromo (Sjögren syndrome)
• Ziso kupisa, kuchenesa, uye kubuda
• Nodules pasi peganda (kazhinji chiratidzo chechirwere chakakomba)
• Unhu, kugwinha, kana kupisa mumaoko nemakumbo
• Kurara matambudziko

Kuongororwa kweRA kunoitwa kana:

• Iwe une kurwadziwa uye kuzvimba muzvikamu zvitatu kana kupfuura.
• Arthritis yave iripo kwenguva yakareba kupfuura mavhiki matanhatu.
• Une bvunzo yakanaka yerheumatoid factor kana anti CCP antibody.
• Wakwidziridza ESR kana CRP.
• Dzimwe mhando dzeArthritis dzakatemwa kunze.

Dzimwe nguva kuongororwa kweRA kunoitwa kunyangwe pasina ese mamiriro ezvinhu akaratidzirwa pamusoro kana iyo arthritis iri neimwe nzira yeRA.

Iko hakuna bvunzo inogona kuona zvechokwadi kana uine RA. Vazhinji vanhu vane RA vanozove nemimwe miitiro yekuedza isina kujairika Nekudaro, vamwe vanhu vanozove nemhedzisiro mhedzisiro kune ese mabvunzo.

Mairi maviri emabara bvunzo ari akanaka muvanhu vazhinji uye anowanzo batsira mune kuongororwa ndeaya:

• Rheumatoid chinhu
• Anti-CCP antibody

Iyi bvunzo yakanaka mune vazhinji varwere vane RA. Iyo anti-CCP antibody bvunzo yakanyanya kunangana neRA.

Mimwe bvunzo inogona kuitwa inosanganisira:

• Yakazara kuverenga ropa
• Metabolic pani uye uric acid
• C-inoshanda mapuroteni (CRP)
• Erythrocyte sedimentation chiyero (ESR)
• Antinuclear antibody
• Kuedzwa kwehepatitis
• Yakabatana x-ray
• Joint Ultrasound kana MRI
• Yakabatana fluid fluid

RA kazhinji inoda kurapwa kwenguva refu nenyanzvi yeArthritis inonzi rheumatologist. Kurapa kunosanganisira:

• Mishonga
• Kurapa kwepanyama
• Rovedza muviri
• Dzidzo yekubatsira iwe kuti unzwisise chimiro cheRA, sarudzo dzako dzekurapa, uye kudiwa kwekutevera-kwese.
• Kuvhiya, kana zvichidikanwa

Kurapa kwekutanga kweRA nemishonga inonzi chirwere-kugadzirisa antirheumatic zvinodhaka (DMARDS) inofanira kushandiswa mune vese varwere. Izvi zvinononoka kubatanidza kuparadza uye kudzivirira hurema. Basa reRA rinofanira kuongororwa pashanyo dzese kuti uve nechokwadi chekuti chirwere chiri pasi pesimba. Chinangwa chekurapa ndechekumisa kufambira mberi kweRA.

MISHONGA

Mishonga inorwisa-kupisa: Izvi zvinosanganisira maaspirin uye asiri -steroidal anti-anogumbura (NSAIDs), senge ibuprofen, naproxen uye celecoxib.

• Iyi mishonga inoshanda chaizvo chaizvo kudzora kubatana kuzvimba uye kuzvimba, asi inogona kuve neyakareba-nguva mhedzisiro. Naizvozvo, ivo vanofanirwa kutorwa chete kwenguva pfupi uye mune mashoma madhizaini pazvinogoneka.
• Sezvo ivo vasingadziviriri kubatana kwekubatana kana ikashandiswa yega, DMARDS inofanira kushandiswa zvakare.

Zvirwere zvinoshandura antirheumatic zvinodhaka (DMARDs): Iyi inowanzo kuve mishonga inoedzwa kutanga kune vanhu vane RA. Izvo zvinonyorerwa pamwe nekuzorora, kusimbisa kurovedza muviri, uye anti-kupisa zvinodhaka.

• Methotrexate ndiyo inowanzo shandiswa DMARD ye rheumatoid arthritis. Leflunomide uye hydroxychloroquine inogona zvakare kushandiswa.
• Sulfasalazine mushonga unowanzobatanidzwa ne methotrexate uye hydroxychloroquine (katatu kurapa).
• Zvinogona kunge vhiki kana mwedzi usati waona chero bhenefiti kubva kumishonga iyi.
• Iyi mishonga inogona kunge iine zvakakomba mhedzisiro, saka iwe unozoda kazhinji kuongororwa kweropa kana uchinwa.
• Antimalarial mishonga - Iri boka remishonga rinosanganisira hydroxychloroquine (Plaquenil). Ivo anowanzo shandiswa pamwe ne methotrexate. Zvinogona kunge vhiki kana mwedzi usati waona chero bhenefiti kubva kumishonga iyi.

Corticosteroids - Iyi mishonga inoshanda chaizvo kudzikisa kubatana kuzvimba uye kuzvimba, asi inogona kuve nemhedzisiro-refu. Naizvozvo, ivo vanofanirwa kutorwa chete kwenguva pfupi uye mune mashoma madhizaini pazvinogoneka.

Biologic DMARD vamiririri - Iyi mishonga yakagadzirirwa kukanganisa zvikamu zvemuviri wemuviri zvinoita chinhanho muhurongwa hwehurwere hweRA.

• Vanogona kupihwa kana mimwe mishonga, kazhinji methotrexate, isina kushanda. Biologic zvinodhaka zvinowanzo kuwedzerwa kune methotrexate. Nekudaro, nekuti iwo anodhura kwazvo, inishuwarenzi mvumo inowanzo fanirwa.
• Mazhinji acho anopiwa chero pasi peganda kana mutsinga. Ikozvino kune akawanda akasiyana marudzi e biologic vamiririri.

Biologic uye synthetic agents zvinogona kubatsira pakurapa RA. Nekudaro, vanhu vari kutora mishonga iyi vanofanirwa kutariswa zvakanyanya nekuda kwekushomeka, asi zvakakomba maitiro akashata:

• Zvirwere kubva kubhakitiriya, mavairasi, uye fungi
• Kenza yeganda, asi kwete melanoma
• Kuita kweganda
• Allergic maitiro
• Worsened moyo kutadza
• Kukuvadza kune tsinga
• Yakadzika chena masero eropa kuverenga

Kuvhiya

Kuvhiya kunogona kudikanwa kugadzirisa zvakanyanya zvakakanganiswa majoini. Kuvhiya kunogona kusanganisira:

• Kubviswa kweiyo yakabatana lining (synovectomy)
• Yakazara yekubatanidza yekutsiva, muzviitiko zvakanyanya, inogona kusanganisira yakazara mabvi kutsiva (TKR) uye chiuno kutsiva.

CHIRAPO CHENYAMA

Range-of-kufamba kurovedza muviri uye zvirongwa zvekurovedza muviri zvakatemerwa nachiremba wepanyama anogona kunonoka kurasikirwa kwemajoini basa uye kubatsira kuchengetedza tsandanyama dzakasimba.

Dzimwe nguva, varapi vanoshandisa michina yakakosha kuisa kupisa kwakadzika kana kukurudzira kwemagetsi kudzora marwadzo nekuvandudza kubatana kwekubatana.

Dzimwe nzira dzokurapa dzinogona kubatsira kudzikamisa marwadzo akabatana dzinosanganisira:

• Majoini ekudzivirira pamwe chete
• Kupisa uye kutonhora kurapwa
• Zvipenga kana zvigadzirwa zveththotic kutsigira uye kuenzanisa majoini
• Kugara uchizorora nguva pakati pezviitiko, pamwe ne8 kusvika 10 maawa ekurara husiku humwe

KUDYA

Vamwe vanhu vane RA vanogona kusashivirira kana kusagadzikana kune zvimwe zvekudya. Kudya kwakaringana kunovaka muviri kunokurudzirwa. Zvinogona kubatsira kudya chikafu chine mafuta ehove (omega-3 fatty acids). Kusvuta fodya kunofanira kumiswa. Doro rakawandisa rinofanirawo kudzivirirwa.

Vamwe vanhu vanogona kubatsirwa nekutora chikamu muboka rekutsigira arthritis.

Kunyangwe RA yako ichifambira mberi kana kwete zvinoenderana nekuoma kwezviratidzo zvako uye nemhinduro yako pakurapwa. Zvakakosha kutanga kurapwa nekukurumidza sezvazvinogona. Kugara uchitevera kushanya neiyo rheumatologist inodiwa kugadzirisa kurapwa.

Kukuvara kwekusingaperi kwekubatana kunogona kuitika pasina kurapwa kwakakodzera. Kurapa kwekutanga aine matatu-mishonga DMARD mubatanidzwa unozivikanwa se "katatu kurapwa," kana neiyo biologic kana yakanangwa mishonga yekugadzira inogona kudzivirira marwadzo pamwe uye kukuvara.

Kana isina kurapwa zvakanaka, RA inogona kukanganisa chero chikamu chemuviri. Zvinetso zvinogona kusanganisira:

• Kukuvadza kumaturu emapapu.
• Kuwedzera njodzi yekuomarara kwetsinga, zvichitungamira kuchirwere chemoyo.
• Kukuvara kwepamuviri kana mapfupa emutsipa akakuvara.
• Kuzvimba kwemitsipa yeropa (rheumatoid vasculitis), izvo zvinogona kutungamira kune ganda, tsinga, moyo, uye matambudziko ehuropi.
• Kuzvimba uye kuzvimba kwekunze kwekunze kwemoyo (pericarditis) uye kwemoyo mhasuru (myocarditis), izvo zvinogona kutungamira kukundikana kwemoyo kukundikana.

Zvisinei, izvi zvinetso zvinogona kudzivirirwa nekurapwa kwakakodzera. Mishonga yeRA inogona zvakare kukonzera zvakakomba mhedzisiro. Taura nemupi wako nezve zvingangoitika mhedzisiro yekurapa uye zvekuita kana zvikaitika.

Fonera mupiki wako kana iwe uchifunga kuti une zviratidzo zve rheumatoid arthritis.

Iko hakuna kunozivikanwa kudzivirira. Kusvuta kunoratidzika kunge kuri kuwedzera RA, saka zvakakosha kudzivirira fodya. Kurapa kwakakodzera kwekutanga kunogona kubatsira kudzivirira kumwe kukuvara kwemajoini.

RA; Arthritis - rheumatoid

• ACL yekuvakazve - kubuda
• Kudzosera neketani - kubuda
• Elbow kutsiva - kubuda

• Rheumatoid arthritis
• Rheumatoid arthritis
• Rheumatoid arthritis

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