Odokotela base-rheumatoid arthritis babhekisela ezifweni ezingapheli zesimiso, lapho izingxenye ezincane zendawo zihlupheka khona. Kukholelwa ukuthi lesi sifo sizenzekelayo - umzimba uchitha izicubu zawo ngenxa yokungasebenzi kahle ohlelweni lwawo lokuvikela.
Izimbangela ze-arthritis ye-rheumatoid
Ukusesha izimbangela ze-arthritis ye-rheumatoid kwenzelwe odokotela amashumi eminyaka. Kunezimpawu eziningi eziqinisekisa isimo esithathelwanayo sesifo:
- isiqalo esibukhali nesubacute;
- ukuthuthumela;
- ukwanda kokushisa;
- ukuvuvukala kwama-lymph nodes.
Ngenye indlela, izici eziningi zibonisa ukuthi isifo samathambo asisifo esithathelwanayo:
- kwenzeka ngaphandle kokuthembela kwenkathi yonyaka (nakuba kunesixhumanisi sezulu);
- azikho amacala okudluliselwa ngegazi nokuguqulwa komzimba;
- Akukho ukuthuthukiswa kokwelashwa ngama-antibiotics kanye nezidakamizwa ze-antiviral.
Izizathu ezichazwe ngenhla zenza odokotela ukuthi izici ezikhuluma ngesifo esithathelwanayo sesifo zifakazela umzabalazo wokuzivikela nomzimba wakho. Uhlelo lokuzivikela lubhubhisa izicubu ezihlangene zamalunga nezinye izitho, zibona njengabafokazi. Kuye kwafakazelwa ukuthi izifo eziningi ezithathelwanayo zingakwandisa ingozi ye-rheumatoid arthritis, phakathi kwabo;
- i-rubella ;
- i-herpes;
- I-Epstein-Barr virus ;
- ukushisa kwesibindi B nabanye.
Izakhi zofuzo zokuthi i-rheumatoid arthritis izokwenzeka kumuntu othile omncane, kodwa ukhona. Ososayensi kakade bathole izakhi zofuzo ezikhethekile, njengokuthi, i-DRB1, okushintsha ama-receptors ezindaweni eziphezulu ze-membrane yeseli. Ngenxa yalokhu, amasosha omzimba awaqapheli amangqamuzana omzimba wawo futhi ufuna ukuwabhubhisa.
Ezokwelapha, kukhona umqondo wesifo se-rheumatoid. Lona uhlobo lwe-antibodies oluphikisana ne-immunoglobulin yabo G. Le-immunoglobulin ikhiqizwa ngamangqamuzana afaka ngaphakathi engxenyeni yangaphakathi. Ama-antibodies kanye ne-immunoglobulin G enza isakhiwo esiyinkimbinkimbi esibangela ukuvuvukala okulimaza izicubu ezihlangene. Ukuba khona kwesifo somzimba esifubeni kungabonakali nje ngesifo samathambo, kodwa futhi nokuthi umuntu usanda kuhlupheka ngesifo esithathelwanayo.
Ezinye izici ezenza ukubonakala kwamathambo e-rheumatoid avele:
- ukungenelela kokuhlinzwa;
- ukulimala;
- ibanda;
- ukucindezeleka;
- inhlamba;
- ukukhulelwa, i-lactation, ukusa esikhathini;
- ukudla kokudla.
I-arthritis ye-juvenile i-rheumatoid arthritis ifomu lesifo esitholakala kubantwana nasebancane. Loluhlobo lwe-arthritis lubonakala ukuthi akuzona nje izingxenyana ezincane kodwa futhi ezinamakhulu ezihlupheka, kanye nezinye izitho zangaphakathi - izinso, inhliziyo, amaphaphu. Ukuvela kwesifo esingathí sina kungabangela izinto eziningi:
- wahlushwa kabi;
- ukuhlukunyezwa;
- i-supercooling;
- ukujova kwama-collagen amalungiselelo;
- izakhi zofuzo;
- ukuzivivinya umzimba noma ukutholakala nge-immunodeficiency.
I-rheumatoid arthritis - izimpawu
Uma sicabangela izibonakaliso zesifo samathambo, kufanele sicatshangelwe ukuthi akuzona kuphela amalunga, kodwa futhi zonke izinhlelo zenyama zingathinteka. Uphawu oluyinhloko lesi sifo lubuhlungu emajoyini, inhlawulo yayo ivela emomoyeni kuya kumnandi, njalo noma ngezikhathi ezithile. Lesi sifo siqala ngamajoyini ezandla, izinyawo, amadolo, ama-elbows, amahlumela amakhulu athathwe kaningi. Ngaphandle kobuhlungu obuhlangene, kukhona ukuvuvukala, okuyinto yehla ngokusetshenziswa kwezidakamizwa ezilwa nokuvuvukala. Ezifo ezinzima, amajoyina avuvuka, ahlambalaze futhi ahlasele. Ekuseni, isiguli sinokuhamba okukhawulelwe.
I-arthritis yezingane iqala ngokuvuvukala nokuvuvukala kwamajoyina amakhulu - amadolo, i-hip, i-ankle. Lesi sifo sihambisana nomkhuhlane, ukushisa kwe-polymorphous (ngesikhathi somkhuhlane), i-hepatolienna syndrome, i-lymphadenopathy, izitho zangaphakathi. Imisipha enamathele ezinhlangeni ezigulayo i-atrophied. Isikhumba endaweni yezingxube ezishisayo ziba mncane. Izakhiwo ze-articular zamathambo zingaba ne-coalesce futhi zakha isakhiwo esiqinile, lesi simo sibizwa ngokuthi i-ankylosis.
Njengoba kunomonakalo wezinso nge-arthritis yezingane, i-amyloidosis iqala, okuholela ekuhlulekeni kwezinso. Izimpawu zokulimala kwezinso ziyiprotheni emcimbini, ukuvuvukala, ukuqoqwa emisipha ye-urea. Uma lesi sifo sithinta inhliziyo, i-juvenile rheumatoid arthritis inzima yi-myocarditis noma i- pericarditis . Lapho iziphunga zamaphaphu zenzeka nge-pleurisy noma ngokukhipha ama-alveolitis. I-Hepatolienal syndrome inqunywa ukwanda kwesibindi nesipere. Nge-lymphadenopathy, i-lymph nodes endaweni yokwanda okuhlanganyelwe okuhlangene.
I-rheumatoid arthritis - izimpawu zokuqala
Ezimweni ezingu-90%, amalunga ezandla aqale ahlaziywe. Uma i-arthritis ye-rheumatoid yezandla itholakala, ukubonakala kwezimpawu zokuqala kungenzeka kakhulu ngenkathi ebandayo. Esikhathini esifushane, kuze kube nesithombe esicacile sokuvuvukala kwamajoyina, ubuthakathaka, ukujuluka, ukulahlekelwa isisindo, ubuhlungu besisu, ukungafihli komkhuhlane ukuze kube nemingcele ehambisana nezigulane.
I-rheumatoid arthritis yeminwe - izimpawu zokuqala:
- ukuhamba kuphulwa, ukuzwa okubuhlungu kubonakala, ukubomvu nokuvuvukala kuyabonakala, izinga lokushisa kuma-joint interphalangeal joints landa;
- izimpawu zivela emathanjeni e-metacarpophalangeal, khona-ke ezinhlanganiseni zamakhanda;
- isiguli asikwazi ukufaka isandla sakhe enqabeni;
- iqala ukuvuvukala kwe-tendon muscle.
I-arthritis ye-rheumatoid - degree
Emithi yomtholampilo, amazinga amane noma izigaba zesifo samathambo e-rheumatoid zihlukaniswa:
- Eyokuqala ibonakala ngokuncipha kwamathambo endaweni ehlangene, ukulimala kwamalungu ezandla, ukunciphisa amalunga okuhlanganyelwa kanye nesigaba sokuqala se-periarticular osteoporosis, phakathi nalesi sikhathi ama-cysts emathanjeni amathambo aqala ukwakha, lesi sifo sivame ukuvela ngokungenakulinganiswa noma ngezimpawu ezincane.
- Owesibili ukuthuthukisa ukuguguleka kwamathambo, ama-cartilages aqala ukubola, ukuhamba kwamalungu amaningi amakhulu kunciphisa, i-edema nokubomvu kubonakala ezindaweni ezithintekile, isifo sobuhlungu siba khona.
- Okwesithathu - izicubu zethambo zincipha kakhulu, ukukhula kwezicubu ezixhumeneyo kuphuthumayo, ukuhamba kwamalunga kungalinganiselwe, futhi kutholakala usawoti.
- Okwesine , i- osteoporosis ekhulayo iqala, inqwaba yezinyosi kanye nama-cysts abonakala emathanjeni amathambo, i-ankylosis yamadolo, amahlombe, amajoyini we-hip kwenzeka, imisipha i-atrophied futhi izicubu ezithambile ze-joint ziyancipha ngokuphelele.
I-rheumatoid arthritis - ukuxilongwa
Ukuze kudlule ukuhlaziywa kwesifo samathambo e-rheumatoid kuqala ngokuhlaziya okujwayelekile kanye nokwenyama kwegazi okubonisa isithombe sokuthuthukisa inqubo yokuvuvukala:
- ukunciphisa i-hemoglobin (normally 120-160 g / l), ukwanda kwenani lama-leukocytes (4000-9000 per ml wegazi) ne-ESR (2-15 mm / h);
- ukwanda kwe-fibrinogen (2-4 g / l), amaprotheni asebenzayo eC (ngaphansi kuka-5 mg / l), ama-sialic acids (620-730 mg / l noma 2-2.36 mmol / l), haptoglobin (0.44-3 , 03 g / l).
Uma i-arthritis ecatshangelwa ukuthi i-rheumatoid imisiwe:
- ucwaningo lwe-rheumatoid factor of blood;
- ukuhlaziywa kwe-synovial fluid (okuqukethwe komgudu ohlangene);
- i-arthroscopy - ukuhlolwa okuhlangene usebenzisa i-optical instrument;
- i-radiography, i- scintigraphy , i-imagination magnontic resonance, i-ultrasound yokujoyina kwesiguli.
I-ACCP ku-arthritis ye-rheumatoid iyinhlangano evamile
I-Citrulin i-amino acid ekhombisa ukuvuvukala okuqhubekayo. Umzimba uyaqaphela amaprotheni futhi uhlanganisa ama-antibodies enza izinqubo ze-autoimmune. Ucwaningo lwe-anti-citrulline antibodies - I-ATSTSP ene-arthritis ye-rheumatoid - ingenye yezinto ezibonisa kakhulu esigabeni sokuqala. Njengoba isifo sesifo sifinyelele, ukuhlolwa kuqinisile ngamaphesenti angu-90-98. Isimiso esivamile se-ATSTSP - 3,0-3,1 U / ml, ukushintsha okuncane kunokwenzeka ngokuya ngobudala nobulili.
I-arthritis ye-rheumatoid arthritis
Cishe amaphesenti angu-20 weziguli atholakala ukuthi une-arthritis ye-rheumatoid (seronegative) ene-negative rheumatoid factor of 25-30 IU per milliliter yegazi. Lolu hlobo lwesifo lunokubikezela okuhle, kodwa luyaqhubeka lubi kakhulu ekwelapheni okuyisisekelo, okudinga udokotela ukuba akhethe imithi ngayinye. Njengoba kutholakala ukuthi imiphumela yokuhlolwa engamanga ngezinye izikhathi ihlangene, kuyadingeka ukuyithatha izikhathi eziningana.
I-arthritis ye-rheumatoid ye-rheumatoid
Ezimweni eziningi, isifo se-rheumatoid arthritis sihambisana nesimo esihle se-rheumatoid factor - ezingaphezu kuka-25 IU per milliliter yegazi. Loluhlobo lwesifo luyinto enesisindo. I-index ephakeme, okungekho embi kakhulu ukubikezelwa kwesifo. Ukukhula kwe-factor kungabangelwa nje isifo samathambo, kepha futhi ngesifo esithathelwanayo, ngakho-ke kubalulekile ukucabangela ezinye izindlela.
I-rheumatoid arthritis - ukwelashwa
Kusukela ekusebenziseni udokotela ozozinquma indlela yokwelapha isifo samathambo, izinga lempilo yesiguli kanye nobude balo lithembele. Ukungathí sina kwalesi sifo kudinga isiguli ukuba singabi nciphisa ubuhlungu futhi sifune usizo lwezokwelapha ngokushesha, futhi kudokotela ukuze senze ucwaningo olunzulu ukuze sibone isigaba sesifo kanye nokwelashwa okufanele.
I-arthritis ye-rheumatoid - ukwelashwa, izidakamizwa
Amalungiselelo e-arthritis e-rheumatoid enza imisebenzi emibili:
- esiteji esiyingozi - vimbela lesi sifo;
- ngemuva kokuqeda ukukhushulwa - kube nomthelela osekelayo.
Uma ukwelashwa kwe-rheumatoid arthritis kwenziwa, izidakamizwa ezisha izizukulwane ziyanciphisa izimpawu futhi zisize ukuvimbela lesi sifo:
- anti-inflammatory (nonsteroidal) - i-Ibuprofen, i- Diclofenac , i-Meloxicam - inqunywe esigabeni esicacile sokunciphisa ubuhlungu be-syndrome, ukuqina;
- i-glucocorticoids - i-Prednisolone, i-Methylprednisolone - inciphisa ukuvuvukala nobuhlungu, ukunciphisa izinqubo ze-pathological kumalungu;
- i-antimetabolites - i-Azathioprine, i- Methotrexate - yehlisa izinqubo ezilimazayo emthonjeni we-rheumatoid arthritis;
- ama-immunosuppressants - I-Ciclosporin, i-Penicillamine - ikhambi le-arthritis ye-rheumatoid isetshenziselwa ukwelashwa okuhlangene nama-antimetabolites.
I-arthritis ye-rheumatoid - ukwelashwa ngamakhambi abantu
Ukuxilongwa kwe-arthritis ye-rheumatoid yeminwe namanye amalunga kudinga ukusebenzisa nje kuphela ukwelashwa okuvamile kwezidakamizwa, kuyadingeka futhi kusetshenziswe amakhambi omuntu anisiza ukunciphisa ubuhlungu nokuvuvukala.
- Ukucindezela okwenziwe ngewayini elibomvu. Iwayini kufanele lifudumale, lifakwe nge-gauze bese licindezela ngokuhlanganyela imizuzu engu-15.
- Umhluzi we-laurel. I isipuni sempahla eluhlaza kufanele ibiliswe ku-200 ml amanzi ngamaminithi angu-10, umhluzi kufanele uhanjiswe amahora angu-8. Phuza u-70 ml kathathu ngosuku ngaphambi kokudla.
- Amafutha avela emasinini. Hlanganisa i-powder lwesinaphi, amafutha omifino nobusi ngokulinganisa okufanayo nomunwe wokufanisa. Faka isicelo samafutha ehlangene bese uyigcina.
Ukudla okunomuthi we-rheumatoid arthritis
Ukudla okunomsoco we-arthritis ye-rheumatoid kuyadingeka ukunciphisa izinga lokuthuthukiswa kwesifo. Amakhomishana wezondlo zokudla kulezi zifo:
- Ukufaka inhlanzi yamafutha e-marine edlayo, egcwele ama-amino acids amafutha, anciphisa ukuwohloka kwamalungu.
- Ukuze udle irayisi elibilisiwe - lisusa ama-salts amaningi kanye nezinye izinto eziyingozi.
- Nciphise inani lama-carbohydrates, okubabayo, okuthosiwe, amafutha ezilwane, ukudla okusemathinini - lokhu kuzosiza ukunciphisa isisindo, isinkwa esivela kulesinkwa esiphelele sivumelekile.
- Nciphisa usawoti, ngakho-ke ungaphansi komzimba.
- Ukwandisa inani lemifino nezithelo ezintsha (ngaphandle kwamazambane, ama-eggplants), ikakhulukazi i-carotenoids - izaqathe, ummbila, ama-orang, ama-apricot.
I-rheumatoid arthritis - ukubikezela
Uma ulandela izincomo zikadokotela, landela ukudla futhi ugcine indlela yokuphila enempilo - ukubikezelwa kwesiguli kungase kube kuhle. Yebo, isifo samathambo sonyawo, izandla kanye namanye amalunga uzoqhubeka nokuwabhubhisa, kodwa kuyinto engokoqobo ukufezekisa ukuxolelwa. Kubaluleke kakhulu ukuthi ungalimazi impilo yakho, ngakho udinga:
- Yeka utshwala ne-nicotine.
- Ukuze ulahlekelwe isisindo.
- Gwema izifo ezithathelwanayo kanye ne-hypothermia.
- Ukuphumula okwesikhashana.
- Ingabe ukubhukuda, ukuvocavoca, ukuhamba.