Myasthenia gravis

Myasthenia gravis chirwere che neuromuscular. Neuromuscular kusagadzikana kunosanganisira mhasuru uye tsinga dzinozvidzora.

Myasthenia gravis inofungidzirwa kuti iri mhando ye autoimmune kusagadzikana. Chirwere chekuzvimiririra chinoitika kana immune system ichirwisa zvisirizvo zvinyama zvine hutano. Maantibodies mapuroteni anogadzirwa nema immune system kana aona zvinhu zvinokuvadza. Maantibodies anogona kugadzirwa kana immune system ichikanganisa kuona nyama dzakagadzikana sechinhu chinokuvadza, senge iri nyaya yemyasthenia gravis. Mune vanhu vane myasthenia gravis, muviri unoburitsa masoja ekudzivirira anodzivirira maseru emhasuru kubva pakutambira mameseji (maurotransmitter) kubva kumasero etsinga.

Mune zvimwe zviitiko, myasthenia gravis inosanganiswa nemamota eiyo thymus (nhengo yemasoja emuviri).

Myasthenia gravis inogona kukanganisa vanhu chero zera. Inowanzoitika kune vakadzi vadiki nevarume vakuru.

Myasthenia gravis inokonzera kushomeka kwemhasuru dzekuzvidira. Aya ndiwo mhasuru dzaunogona kudzora. Autonomic mhasuru yemoyo uye yekugaya nzira kazhinji haina kukanganiswa. Iko kushomeka kwemhasuru yemyasthenia gravis inowedzera nekuita uye inovandudza nekuzorora.

Uku kushomeka kwemhasuru kunogona kutungamira kune akasiyana zviratidzo, kusanganisira:

• Kufema kunetseka nekuda kwekushaya simba kwechifuva chemadziro emadziro
• Kutsenga kana kumedza kunetsekana, zvichikonzera kugara uchidzedzereka, kudzipwa, kana kumedzera mate
• Kunetsekana kukwira masitepisi, kusimudza zvinhu, kana kusimuka kubva pachigaro
• Zvakaoma kutaura
• Kumusoro musoro uye maziso
• Kushomeka kumeso kana kushaya simba kwetsandanyama dzechiso
• Kuneta
• Hoarseness kana kuchinja izwi
• Kuona kaviri
• Dambudziko rekutarisa rakadzikama

Anopa hutano anoita bvunzo dzepanyama. Izvi zvinosanganisira yakadzama tsinga system (neurological) bvunzo. Izvi zvinogona kuratidza:

• Tsvina yemhasuru, nemhasuru dzemaziso dzinowanzo kanganiswa
• Kazhinji mafungiro uye kunzwa (kunzwa)

Miedzo inogona kuitwa inosanganisira:

• Acetylcholine receptor antibodies inosangana neichi chirwere
• CT kana MRI scan yechifuva kutsvaga bundu
• Nerve conduction zvidzidzo zvekuyedza kukurumidza kwemasaini emagetsi kuburikidza nemutsinga
• Electromyography (EMG) kuyedza hutano hwemhasuru uye tsinga dzinodzora mhasuru
• Pulmonary basa bvunzo kuyera kufema uye mashandiro emapapu ari kushanda
• Edrophonium bvunzo kuti uone kana mushonga uyu unodzosera zviratidzo kwenguva pfupi

Iko hakuna kuzivikanwa kurapa kwe myasthenia gravis. Kurapa kunogona kukubvumidza iwe kuti uve nenguva pasina chero zviratidzo (kuregererwa).

Mararamiro ehupenyu anogona kazhinji kukubatsira iwe kuenderera nemabasa ako ezuva nezuva. Izvi zvinotevera kukurudzirwa:

• Kuzorora mukati mezuva rose
• Uchishandisa chigamba cheziso kana kuona kaviri kunonetsa
• Kudzivirira kushungurudzika uye kupisa kupisa, izvo zvinogona kuita kuti zviratidzo zviwedzere

Mishonga inogona kupihwa inosanganisira:

• Neostigmine kana pyridostigmine yekuvandudza kutaurirana pakati pemitsipa nemhasuru
• Prednisone nemimwe mishonga (yakadai seazathioprine, cyclosporine, kana mycophenolate mofetil) kudzvinyirira immune system kupindura kana uine zviratidzo zvakakomba uye mimwe mishonga isina kushanda zvakanaka.

Dambudziko redambudziko kurwisa kwekushaya simba kwemhasuru dzekufema. Uku kurwisa kunogona kuitika pasina yambiro kana paine mushonga wakawandisa kana mushoma. Uku kurwisa kazhinji hakugare kupfuura mavhiki mashoma. Ungangoda kubvumirwa kuchipatara, kwaungangoda rubatsiro rwekufema nemhepo inofema.

Maitiro anonzi plasmapheresis anogona zvakare kushandiswa kubatsira kupedza dambudziko. Maitiro aya anosanganisira kubvisa chikamu chakajeka cheropa (plasma), ine ma antibodies. Izvi zvinotsiviwa neplasma yakapihwa isina ma antibodies, kana nemamwe mafluids. Plasmapheresis inogona zvakare kubatsira kudzikisa zviratidzo zvemavhiki mana kusvika matanhatu uye inowanzo shandiswa usati wavhiyiwa.

Mushonga unonzi intravenous immunoglobulin (IVIg) unogona zvakare kushandiswa

Kuvhiya kubvisa thymus (thymectomy) kunogona kukonzera kuregererwa zvachose kana kushomeka kwemishonga, kunyanya kana paine bundu riripo.

Kana iwe uine matambudziko eziso, chiremba wako anogona kukurudzira ma prism lens kuti uvandudze kuona. Kuvhiya kunogona zvakare kukurudzirwa kuti ubate maziso ako eziso.

Kurapa kwepanyama kunogona kubatsira kuchengetedza yako mhasuru simba. Izvi zvinonyanya kukosha kumhasuru dzinotsigira kufema.

Mimwe mishonga inogona kuwedzera zviratidzo uye inofanirwa kudzivirirwa. Usati watora chero mushonga, bvunza chiremba wako kuti zvakanaka here kuti uunwe.

Iwe unogona kurerutsa kushushikana kwehurwere nekujoinha myasthenia gravis rutsigiro boka. Kugovana nevamwe vane zvakajairika zviitiko uye matambudziko zvinogona kukubatsira kuti usazonzwa kusurukirwa.

Iko hakuna mushonga, asi kureba kwenguva refu kunogoneka. Ungatofanira kudzora mamwe mabasa ezuva nezuva. Vanhu vane zviratidzo zvemaziso chete (ocular myasthenia gravis), vanogona kukudziridza yakajairika myasthenia nekufamba kwenguva.

Mukadzi ane myasthenia gravis anogona kutora nhumbu, asi kunyatso chengetedza prenatal kwakakosha. Mwana anogona kunge asina kusimba uye achida mishonga kwemavhiki mashoma aberekwa, asi kazhinji haazogadziri kusagadzikana.

Mamiriro acho anogona kukonzera matambudziko anotyisa kufema. Iyi inodaidzwa kunzi myasthenic dambudziko.

Vanhu vane myasthenia gravis vari pangozi yakanyanya yehumwe autoimmune kusagadzikana, senge thyrotoxicosis, rheumatoid arthritis, uye systemic lupus erythematosus (lupus).

Fonera wako mupi wezvehutano kana iwe ukaita zviratidzo zvemyasthenia gravis.

Enda kuimba yekukurumidzira kana kufonera iyo yemuno emergency emergency (se911) kana uchinetseka kufema kana kumedza matambudziko.

Neuromuscular kusagadzikana - myasthenia gravis

• Mashura epamberi epamusoro
• Ptosis - kudonha kweziso
• Central nervous system uye yekumusoro tsinga system

Chang CWJ. Myasthenia gravis uye Guillain-Barré syndrome. Mune: Parrillo JE, Dellinger RP, eds. Critical Kuchengetedza Mushonga: Nheyo dzeKuongorora uye Management muVakuru. 5 ed. Philadelphia, PA: Elsevier; 2019: chits. 61.

Sanders DB, Guptill JT. Kukanganisa kweiyo neuromuscular transmission. Mune: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology muClinical Dzidzira. 7th ed. Philadelphia, PA: Elsevier; 2016: chits. 109.

Sanders DB, Wolfe GI, Benatar M, uye al. Yenyika dzese kubvumirana kutungamira kwe manejimendi yemasthenia gravis: Executive pfupiso. Neurology. 2016; 87 (4): 419-425. PMID: 27358333 www.ncbi.nlm.nih.gov/pubmed/27358333.