Penzura-mu-Mukombe Kukanganisika

Zvemukati

• Mhedziso
• Zvinokonzera penzura-mu-mukombe kushata
• Zviratidzo zvepenzura-mu-mukombe kushomeka
• Kuongorora penzura-mu-mukombe kushomeka
• Kurapa penzura-mu-mukombe kuora
• Maonero

Mhedziso

Penzura-mu-mukombe kushomeka isingawanzo pfupa kusagadzikana kunonyanya kusanganiswa neyakaomarara fomu ye psoriatic arthritis (PsA) inonzi arthritis mutilans. Izvo zvinogona zvakare kuitika ne rheumatoid arthritis (RA) uye scleroderma. "Penzura-mukombe" inotsanangura zvinoita pfupa rakakanganiswa muX-ray:

• Kupera kwebhonzo kwakakanganisa kuita rakarodzwa penzura.
• Iyi "penzura" yakasakara pamusoro pefupa rakabatana kuita chimiro chemukombe.

Penzura-mu-mukombe kushomeka hakuwanzo. Arthritis mutilans inongobata chete zvikamu zvishanu muzana zvevanhu vane PsA uye nezvevanhu vane rheumatoid arthritis. Tichanyanya kutarisa penzura-mu-mukombe kukanganisika nePsA.

Kana yako X-ray kana zviyero zvichiratidza chero zviratidzo zvepenzura-mu-mukombe kushomeka, zvakakosha kutanga kurapwa nekukurumidza sezvinobvira kunonoka kana kumisa kumwe kuora. Pasina kurapwa, kubatana kwemajoini kunogona kuenderera nekukurumidza.

Iwo ekutanga majoini anokanganiswa anowanzo kuve wechipiri uye wechitatu munwe majoini (distal interphalangeal majoini). Mamiriro acho anogonawo kukanganisa zvigunwe zvako zvechigunwe.

Kunyangwe penzura-mu-mukombe kushomeka kunowanzoonekwa muPsA, mamwe marudzi eArthritis anokanganisa mapfupa emusana wako nemakumbo (spondyloarthropathies) anogona zvakare kukonzera kusagadzikana kweminwe nezvigunwe. Zvakare, zvinoitika zvisingawanzo mu:

• systemic sclerosis (scleroderma)
• Chirwere cheBehcet
• systemic lupus erythematosus

Zvinokonzera penzura-mu-mukombe kushata

Arthritis mutilans uye hunhu hwayo penzura-mu-mukombe kushomeka ndiyo yakanyanya kuoma fomu isina kurapwa PsA.

Zvinokonzera PsA hazvina kunyatsonzwisiswa. Inofungidzirwa sekudyidzana kwakaomarara kwemageneti, immune immune kusagadzikana, uye zvakatipoteredza zvinhu. Nezve vanhu vane psoriasis vanokudziridza PsA.

Kuve uine nhoroondo yemhuri ye psoriasis inowedzera njodzi yako yekuwana psoriasis uye PsA. Asi pane misiyano yakasarudzika yemarudzi pakati pe psoriasis nePsA. Iwe uri katatu kana kashanu mukana wekuti ugare nhaka PsA kupfuura zvaungagare nhaka psoriasis.

Tsvagurudzo yegenetic yakawana kuti vanhu vane PsA vane maviri chaiwo majini (HLA-B27 kana DQB1 * 02) vane njodzi yakawedzera yekuvandudza arthritis mutilans.

Zvakatipoteredza zvinhu zvinofungidzirwa kuti zvinopa PsA zvinosanganisira:

• kunetseka
• zvirwere (zvakadai seHIV kana zvirwere zve streptococcal)
• kushungurudzika kwemajoini (kunyanya nevana)

Zviratidzo zvepenzura-mu-mukombe kushomeka

'Penzura-mu-mukombe kuremara chirwere chisingawanzo. X-ray yeiyi hurema inoratidza pfupa rakabatwa nemhedzisiro yefupa rakadzvanywa kuita penzura. Iyi "penzura" yakasakara pamusoro pefupa rakabatana kuita chimiro chemukombe. ‘

Vanhu vane penzura-mu-mukombe kushomeka kunobva kuPsA vanogona kuona zviratidzo zveichi chimiro cheArthritis. Zviratidzo zvePsA zvakasiyana uye zvinogona kufanana neizvo zvimwe zvirwere:

• kuzvimba minwe kana zvigunwe (dactylitis); zvidzidzo zvakawana dactylitis iripo mune vanhu vane PsA
• kuomarara kwekubatana, kuzvimba, uye kurwadziwa, kazhinji muzvikamu zvina kana zvishoma majoini uye asymmetric (kwete mubatanidzwa wakafanana kumativi ese emuviri wako)
• nzara shanduko, kusanganisira kukanda uye kupatsanura kwembambo kubva pamubhedha wechipikiri
• kurwadziwa kwemutsipa
• kuzvimba arthritis yemuzongoza uye makuru majoini (spondylitis)
• kuzvimba kweimwe kana maviri majoini esacroiliac (sacroiliitis); kumwe kuongorora kwakaratidza kuti kune vanhu vane PsA vane sacroiliitis
• kuzvimba kweiyo entheses, iyo nzvimbo panopinda tendon kana mitsipa mapfupa ako (enthesitis)
• kuzvimba kwepakati wepakati peziso, zvichikonzera kutsvuka uye kusaona zvakanaka (uveitis)

Kana iwe uine penzura-mu-mukombe kushomeka, iwe unogona zvakare kuve nezviratidzo izvi:

• kuwedzerwa kwekufamba kwenyama inopfuura mubatanidzwa
• kukuvadza kwakanyanya kwemapfupa (osteolysis)
• "Opera girazi" kana "telescopic" minwe, mune iyo pfupa nyama inodonha, ichisiya chete ganda

Kuongorora penzura-mu-mukombe kushomeka

PsA inowanzoenda isingazivikanwe, nekuda kwezviratidzo zvakasiyana uye kushomeka kwechibvumirano pane zvinotarisirwa. Kubatsira kuenzanisa kuongororwa, boka renyika dzese rheumatologists rakagadzira zvirevo zvePsA inozivikanwa seCASPAR, nzira dzekumisikidza psoriatic arthritis.

Imwe yematambudziko ndeyekuti arthritis inoitika pamberi peganda psoriasis zviratidzo mune zvevanhu vane PsA. Saka zviratidzo zveganda zvinogona kusapa ruzivo. Mukuwedzera, zviratidzo zve psoriasis nePsA hazviwanzo - zvinogona kuputika uye kudzikira.

Chiremba wako achatora nhoroondo yezvokurapa, kusanganisira nhoroondo yemhuri yako yekurapa. Ivo vachakubvunza iwe nezve ako zviratidzo:

• Zvakanyanya sei?
• Une nguva yakareba sei uine ivo?
• Vanouya voenda here?

Vachaitisawo kunyatsoongorora muviri.

Kuti usimbise kuongororwa kweArthritis mutilans uye penzura-mu-mukombe kushomeka, chiremba wako anoshandisa anopfuura anopfuura rumwe rudzi rwekufungidzira bvunzo, kusanganisira:

• X-ray
• sonograph
• MRI scan

Chiremba wako achatarisa kuomarara kwekuparadzwa kwemapfupa. Sonography uye MRI imaging inogona kupa yakajeka mufananidzo wezviri kuitika. Sonography, semuenzaniso, inogona kuona kuzvimba iyo parizvino isina zviratidzo. MRI inogona kupa yakadzama pikicha yeshanduko diki mune yako mapfupa dhizaini uye yakatenderedza tishu.

Kune mashoma kwazvo zvirwere izvo zvinogona kusanganisira penzura-mu-mukombe kuremara. Kana iwe usina zviratidzo zveganda zve psoriasis, chiremba wako angangotarisa mamaki eropa erheumatoid arthritis uye zvimwe zvirwere zvinogona kukonzera kusagadzikana uku.

PsA inoonekwa zvisizvo. Asi kuongororwa kusanzwisisika kwepenzura-mu-mukombe kushomeka hakugone, nekuda kweiyo yakajeka X-ray mufananidzo. Zvimwe zviratidzo zvako zvinotungamira chiremba mukusvika pakuongororwa kwechirwere chiri pasi.

Kurapa penzura-mu-mukombe kuora

Chinangwa chekurapa penzura-mu-mukombe chakaremara ndechekuti:

• kudzivirira chero kumwe kuparara kwemapfupa
• kupa zororo
• ipa kurapwa kwemuviri uye kwebasa kuchengetedza kushanda kwemaoko ako netsoka

Kunyatso kurapwa kunoenderana nekuomarara kwekuremara kwako uye pachikonzero chakakonzera.

YePsA-inoenderana nepenzura-mu-mukombe kushomeka, chiremba wako anogona kuraira nonsteroidal anti-anogumbura zvinodhaka (NSAIDs) kuti abvise zviratidzo. Asi mishonga iyi haimise kuparadza kwemapfupa.

Kuti anonoke kana kumisa kurasikirwa kwepfupa, chiremba anogona kupa chirwere-chinogadzirisa antirheumatic zvinodhaka (DMARDs) kana mukanwa mamorekuru madiki (OSMs) akadai se:

• methotrexate
• tofacitinib (Xeljanz)
• apremilast (Otezla)

Boka remishonga inonzi biologics inhibit tumor necrosis factor (TNF-alpha), iyo inoita basa muPsA. Mienzaniso inosanganisira:

• etanercept (Enbrel)
• infliximab (Remicade, Inflectra, Renflexis)
• adalimumab
• golimumab
• certolizumab pegol

Biologics inovhara interleukin 17 (IL-17), iyo inosimudzira kuzvimba, inosanganisira:

• secukinumab (Cosentyx)
• ixekizumab (Taltz)
• brodalumab (Siliq)

Zvimwe biologics izvo chiremba wako anogona kupa zvinosanganisira:

• ustekinumab (Stelara), iyo inovhara mamorekuru ekuzvimba IL-23 uye IL-12
• abatacept (CTLA4-Ig), inovhara mashandiro eT maseru, mhando yesero yakakosha kumhinduro ye immune system

Musanganiswa wekurapa ungangodikanwa mumamiriro akaomesesa. Kunyangwe mimwe mishonga iri pasi pekuvandudzwa kana mumakiriniki miedzo inotarisa kune mamwe maseru kana zvigadzirwa zvawo zvinofungidzirwa kuti zvinokonzeresa kuzvimba uye kuparadzwa kwemabhonzo.

Kurapa kwepanyama uye kwekuita basa kunogona kubatsira kugadzirisa chiratidzo, kuchengetedza kuchinjika, kudzikamisa kushushikana pamaoko nemakumbo, uye kudzivirira majoini kubva mukukuvara.

Kurukura nachiremba wako nezvekusanganiswa kwekurapa kungave kwakanakira iwe. Bvunza zvakare kana kiriniki kuyedzwa inogona kunge iri sarudzo. Ive neshuwa yekukurukura mhedzisiro yeDMARDs, yemumuromo madiki mamorekuru (OSMs), uye biologics. Uyezve funga mutengo, nekuti mimwe mishonga mitsva inodhura kwazvo.

Mune zvimwe zviitiko, kuvhiya kwekuvakazve kana kutsiva kwemajoini kunogona kuita sarudzo.

Kuvhiya kwePSA hakuwanzoitika: Imwe ongororo yakawana kuti chete chikamu che7 muzana chevanhu vane PsA vakavhiyiwa mazino. Ongororo ya2008 yePsA nekuvhiya zvakaratidza kuti kuvhiyiwa mune zvimwe zviitiko kwakabudirira kubvisa marwadzo uye kugadzirisa basa remuviri.

Maonero

Penzura-mu-mukombe deformity haigone kurapwa. Asi zvakawanda zviripo zvekurapa zvinodhaka zvinogona kudzora kana kumira kumwe kuora kwemapfupa. Uye zvinotovimbisa mishonga mitsva iri kuvandudzwa.

Kurapa kwepanyama kunogona kubatsira mukusimbisa mhasuru uye kuchengetedza majoini, maoko, uye tsoka kusanduka uye kushanda. Nyanzvi yekurapa inogona kubatsira nemidziyo yekubatsira mukufamba uye kuita mabasa ezuva nezuva.

Kudya chikafu chinopesana-nekuzvimba uye kugara uchirovedza muviri kunogona kubatsira hutano hwako hwese.

Kutanga kuraira kana kujoina boka rekutsigira kunogona kubatsira iwe kubata nekushushikana uye kuremara. Iyo Arthritis Foundation neNational Psoriasis Foundation zvese zvinopa rubatsiro rwemahara.