So wunim Takayasu Arteritis no ho asɛm? Momma yɛnka ho asɛm!

So woate yare bi a wɔfrɛ no Takayasu Arteritis ho asɛm pɛn? Ebia edin no bɛyɛ te sɛ nea ɛyɛ nwonwa kakra, ɛnte saa? Nanso ɛyɛ tebea a ɛntaa nsi a ebetumi aka yɛn mogya ntini, titiriw mogya ntini akɛse a efi ase wɔ koma no mu ne nkorabata a efi mu ba no. Ɛtɔ mmere bi nso a wɔfrɛ no ‘yare a enni koma mu.’ Ɛnnɛ, yɛbɛka ho asɛm kɔ akyiri, tiawa koraa, sɛnea ɛbɛyɛ a wo nso wobɛte ase yiye.

Dɛn ankasa ne Takayasu Arteritis?

Sɛ yɛbɛka no tiawa a, Takayasu ntini mu yare no yɛ yɛn mogya ntini a ɛyɛ hyew, a ɛkyerɛ sɛ ɛho ahonhon anaasɛ ɛyɛ hyew (vasculitis). Ɛka mogya ntini akɛse a ɛwɔ yɛn nipadua mu no titiriw. Susuw ho hwɛ, mogya ntini titiriw a ɛde mogya a oxygen pii wom fi yɛn koma mu kɔ nipadua no nyinaa mu, a yɛfrɛ no ‘aorta kɛse’ anaa ‘aorta’. Saa yare yi ka aorta, ne mogya ntini akɛse afoforo a efi mu ba na ɛde mogya kɔ yɛn nsa, yɛn kɔn, ne yɛn amemene mu no titiriw. So wunim nea ɛba bere a ɔfe yi ba no? Yɛn mogya ntini no afasu asɛe. Afei saa mogya ntini no afã horow bi yɛ mmerɛw na etumi butuw te sɛ balloon. Yɛfrɛ eyi sɛ ‘aneurysm’. Afei nso, mogya ntini no tumi ahonhon na ɛyɛ teateaa. Afei wɔbara mogya a ɛsen no. Ɛtɔ da bi a mogya ntini bi tumi siw koraa, a wɔfrɛ no ‘occlusion’. Ɛntaa mma sɛ saa tebea yi betumi aka ntini a ɛde mogya kɔ koma, dwensɔtwaa, asaabo, ne nan mu no nso.

Hena na tebea yi ka no kɛse?

Takayasu Arteritis (TAK) yɛ tebea a ɛtaa ka mmerante ne mmabaa. Ɛtaa ba mmea a wɔadi fi mfe 20 kosi 40. Mpɛn pii no, ayarefo no di mfe 15 kosi 35 bere a wohu sɛ wɔwɔ bi no. Wɔn a wɔwɔ yareɛ no mu bɛyɛ 80% kɔsi 90% yɛ mmaa. Nnuruyɛfo hu saa tebea yi mpɛn pii wɔ aman te sɛ Japan ne nnipa a wofi Mexico, India, ne Asia Apuei fam. Wɔ aman te sɛ United States mpo mu no, nnipa ɔpepem biako biara mu nnipa foforo baanu kosi baasa pɛ na wohu afe biara. Eyi kyerɛ sɛ ɛyɛ tebea a ɛntaa nsi koraa.

Ɔkwan bɛn so na Takayasu ntini mu yare no ka me nipadua?

Sɛ mogya ntini mu teateaa a, mogya dodow a ɛkɔ akwaa ne ntini a saa mogya ntini no de ma no so tew. Fa no sɛ nsu paipu a asiw, na ɛma nsu dodow a ɛsen fa mu no so tew. Nanso wɔ Takayasu ntini mu yare (TAK) mu no, nsakrae yi taa ba nkakrankakra na ɛba nkakrankakra. Enti yɛn nipadua nya bere de yɛ ne su sɛ ɛde mogya bɛfa akwan foforo so. Saa akwan foforo yi te sɛ akwan nketewa a yɛde twa kwan a yɛde di dwuma bere a wɔasiw ɔkwan kɛse bi no. Nanso ebia ɛnyɛ bere nyinaa na saa akwan a wɔfa so twa kwan yi betumi afa mogya pii te sɛ mfitiase mogya ntini kɛse no. Mpɛn pii no, mogya dodow a ɛsen fa baabi a asiw no dɔɔso sɛ ɛbɛma ntini ahorow no anya mframa pa ne mogya a ehia na ama wɔatumi atra ase no. Nanso ɛntaa mma koraa sɛ sɛ mogya ntini a ɛsesa yi ntumi nyɛ adwuma yiye a, ntini no betumi awuwu efisɛ mframa pa ne mogya nni mu.

Dɛn ne yare yi ho sɛnkyerɛnne?

Ebia nnipa binom a wɔwɔ Takayasu arteritis (TAK) no rennya yare no ho sɛnkyerɛnne biara. Nanso, ayarefo no mu bɛyɛ fã betumi anya adwenemhaw ne mmerɛwyɛ wɔ ɔkwan a ɛkɔ akyiri so. Nsɛnkyerɛnne a edi kan (afã 1): Eyinom ne nsɛnkyerɛnne a ɛda adi wɔ yare no mfiase:

• Huraeɛ.
• Ɔbrɛ kɛse a wɔte nka ( Ɔbrɛ ).
• Ntini ne nkwaa mu yaw .
• Aduan yɛ nea ɛnyɛ dɛ .

Nsɛnkyerɛnne a ɛba akyiri yi (afã 2): Bere a yare no kɔ so no, sɛnkyerɛnne te sɛ:

• Koko mu yaw .
• Ɔhome a ɛyɛ den .
• Tipaeɛ .
• Sɛ wote nka sɛ n’adwene atu afra.

Nsɛnkyerɛnne a efi mogya ntini a ɛyɛ teateaa ne mogya a ɛso tew mu ba:

• Ɔbrɛ, ɛyaw, anaa nsa ne anan a ɛyɛ mmerɛw.
• Yafunu mu yaw esiane mogya a ɛkɔ dwensɔtwaa mu a ɛso tew nti.
• Mogya mmoroso esiane mogya a ɛkɔ asaabo mu a ɛso tew nti.
• Stroke (eyi ho yɛ na yiye).
• Koma mu yare (eyi nso ho yɛ na).

Dɛn na ɛde Takayasu ntini mu yare bae?

Nokwarem no, obiara nnim nea ɛde Takayasu ntini mu yare (TAK) ba ankasa .. Nanso nnuruyɛfo ne nhwehwɛmufo susuw sɛ ebia ɛyɛ ‘autoimmune tebea’. Ɛne sɛ, yɛn nipadua mu tumi a ɛko tia nyarewa a ɛko tia nyarewa no di mfomso tow hyɛ n’ankasa ntini a ɛte apɔw so. Ɛte sɛ nea yɛn ankasa ahobammɔ repira yɛn. Nhwehwɛmufo binom susuw sɛ ebia awosu mu abɔde bi a wonya fii awofo baanu no nyinaa hɔ na ɛde Takayasu ntini mu yare no bi ba. Ebia saa awofo no rennya yare no ho sɛnkyerɛnne, efisɛ wokura awosu mu abɔde no biako pɛ. Nanso sɛ wunya saa awosu mu abɔde pɔtee no fi awofo baanu no nyinaa hɔ a, wubetumi anya tebea no ne ne sɛnkyerɛnne ahorow.

Ɔkwan bɛn so na wohu yare yi?

Wo duruyɛfo no behu Takayasu ntini mu yare no denam nneɛma pii a ɔbɛka abom a ɔbɛhwɛ so, na ɛnyɛ biako pɛ so.

• Aduruyɛ ho abakɔsɛm a edi mũ ne nipadua mu nhwehwɛmu: Wɔyɛ eyi de yi tebea afoforo a ɛwɔ sɛnkyerɛnne a ɛte sɛ wo de no afi hɔ. Sɛ wo duruyɛfo de afiri a wɔde tie asɛm di dwuma de hwehwɛ wo mogya ntini mu a, ebia wɔbɛte nnyigyei bi a ɛyɛ soronko a wɔfrɛ no ‘bruit’ wɔ mogya ntini no mu. Sɛ mogya ntini no yɛ teateaa dodo a, ɛyɛ den sɛ mogya bɛfa mu, na ɛno ne bere a wɔte nnyigyei no.
• X-ray: Eyinom kyerɛ baabi a wo ntini no asɛe ne sɛnea asɛe no mu yɛ den.
• Nhwehwɛmu a wɔyɛ de hu mogya ntini a ɛyɛ teateaa anaa ntini a ɛma mogya tu: Akwan ahorow wɔ hɔ a wɔfa so yɛ eyi ho nhwehwɛmu.

Dɛn ne nhwehwɛmu ahorow a wɔde hu yare no?

Nhwehwɛmu ahorow pii wɔ hɔ a ebetumi aboa oduruyɛfo no ma wahu sɛ ɔwɔ yare no:

• Magnetic Resonance Imaging (MRI): Eyi yɛ sɔhwɛ a wɔmfa X-ray nni dwuma. Wɔde magnet kɛse, anyinam ahoɔden asorɔkye, ne kɔmputa na ɛyɛ mfonini ahorow no.
• Computed Tomography (CT) scan: X-ray ne kɔmputa yɛ akwaa a ɛwɔ nipadua no mu ho mfonini, a mogya ntini akɛse ka ho.
• Angiography: Eyi hwehwɛ sɛ wode X-ray twa wo mogya ntini no mu mfonini. Wo duruyɛfo de afiri a ɛyɛ tratraa tenten bi a wɔfrɛ no catheter hyɛ ntini kɛse bi a ɛwɔ w’asen anaa wo nsa mu mu na ɔkyerɛ no kwan kɔ ntini a ɛsɛ sɛ wɔhwehwɛ mu no mu. Afei, wɔde ade titiriw bi a wɔde yɛ ade (ade a ɛma nneɛma bɔ abira) fa catheter no mu gu mogya ntini no mu. Sɛ wɔtwa X-ray a, aduru no ma mogya ntini no da adi pefee wɔ mfonini ahorow no mu. Ɛtɔ mmere bi a, wobetumi de MRI nso ayɛ angiography.
• Positron Emission Tomography (PET scan): Wɔ sɔhwɛ yi mu no, wo duruyɛfo de ade bi a ɛma anyinam ahoɔden fa ade bi mu gu ntini bi a ɛwɔ wo nsa mu mu. Bere a ade no fa wo nipadua mu no, scanner bi hu no na ɛyɛ mfonini ahorow.
• Ultrasound: Eyi boa ma wɔde nnyigyei asorɔkye yɛ mogya ntini ho mfonini.

Ɔkwan bɛn so na wɔsa Takayasu ntini mu yare no?

Nnuru tumi siw ɔfe, anaa ɔfe ano. Nanso, ebia ebehia sɛ wɔyɛ nnipa binom oprehyɛn na ama wɔatwa mogya ntini bi a asiw ho na wɔayɛ ɔkwan foforo a mogya bɛfa so. Corticosteroids: Corticosteroids, te sɛ prednisone (e.g., Rayos®, Sterapred®) anaa prednisolone (e.g., Flo-Pred®, Orapred®), ne ayaresa a wɔtaa de sa Takayasu ntini mu yare (TAK).

Saa nnuru yi yɛ anwonwade wɔ mogya ntini mu ɔfe a ɛyɛ nnam a woyi fi hɔ na ɛma yare no fi hɔ no mu.

Wo duruyɛfo no bɛtew prednisone dodow so nkakrankakra akodu dodow a etu mpɔn a ɛba fam sen biara so na ama nea efi mu ba no so atew. Nnipa binom tumi gyae aduru no nom nkakrankakra a yare no ho sɛnkyerɛnne nsan mma bio. Nanso, saa corticosteroids yi ntumi nyɛ adwuma koraa mma nnipa binom. Afei nso, nnipa a wɔnom nnuru yi mu bɛboro fã betumi asan anya yare no ho sɛnkyerɛnne asan aba anaasɛ wɔn tebea no asɛe. Nnuru a ɛma nipadua no tumi ko tia nyarewa: Nnuruyɛfo nso taa kyerɛw nnuru a esiw nipadua no mu tumi a ɛko tia nyarewa ano, te sɛ:

• Methotrexate (sɛ nhwɛso no, Rheumatrex®, Trexall®) .
• Azathioprine (sɛ nhwɛso no, Imuran®, Azasan®) .
• Mycophenolate (sɛ nhwɛso no, Cellcept®, Myfortic®) .
• Leflunomide a wɔde yɛ aduru
• Cyclophosphamide a wɔde yɛ aduru

Sɛ wɔde saa nnuru a ɛma nipadua no tumi ko tia nyarewa yi di dwuma ne prednisone a, nnipa a kan no na wɔwɔ flares no mu bɛyɛ 50% betumi asiesie wɔn sɛnkyerɛnne no na wɔde nkakrankakra agyae prednisone nom. Tumor-Necrosis Factor (TNF) inhibitors: Wobetumi ama nnipa binom nnuru a wɔfrɛ no TNF inhibitors nso de aboa ma wɔako atia ɔfe. Eyinom ho nhwɛso bi ne:

• Etanercept a ɛyɛ aduru a wɔfrɛ no Etanercept
• Infliximab a wɔde di dwuma
• Tocilizumab a wɔde di dwuma

Sɛ yɛka ne nyinaa bom a, nnipa a wɔwɔ Takayasu ntini mu yareɛ no mu bɛyɛ 25% rentumi nni yareɛ no so koraa a wɔankɔ so annom nnuru.

Dɛn ne ayaresa no mu nsunsuanso bɔne?

Nnuru a wɔde sa Takayasu ntini mu yare no betumi anya nkɛntɛnso bɔne bi a anibere wom. Nanso, nnuru afoforo betumi aboa ma wɔadi saa nsunsuanso bɔne yi so. Nneɛma bɔne a ebetumi afi mu aba no bi ne:

• Nkwammoaa a wɔko tia no so tew.
• Nnompe mu duru a ɛso tew (nnompe mu yare).
• Ɛyɛ den sɛ wubehu ade.
• Akisikuru a ɛma obi ho kyere no.

Corticosteroids fi ase yɛ adwuma wɔ nnɔnhwerew kakraa bi akyi bere a woafi ayaresa ase no, enti ebia wobɛte ahotɔ nka ntɛm.

Ayaresa afoforo bɛn na wɔde di dwuma?

Wɔ tebea horow bi mu no, mogya mmoroso (hypertension) betumi afi ntini a ɛyɛ teateaa a ɛkɔ asaabo no mu no mu aba. Wɔ saa tebea yi mu no, oduruyɛfo no betumi de biribi te sɛ balloon atrɛw mogya ntini a ayɛ teateaa no mu, na wɔfrɛ no angioplasty. Anaasɛ, wobetumi ayɛ oprehyɛn a wɔde twa asaabo no ho hyia na ama mogya atumi akɔ asaabo no mu sɛnea ɛsɛ. Eyi betumi aboa ma mogya mmoroso ayɛ nea ɛfata a wonnom mogya mmoroso nnuru. Ebia nnipa binom behyia ɔhaw a emu yɛ den wɔ mogya ntini a ɛyɛ teateaa wɔ wɔn nsa anaa wɔn nan mu, na ɛma ɛyɛ den sɛ wɔbɛnantew anaa wɔbɛyɛ nneɛma afoforo. Oprehyɛn a wɔde twa kwan nso betumi asiesie ɔhaw ahorow yi. Sɛ ntini bi wɔ hɔ a, wobetumi de oprehyɛn anaa bypass asiesie. Ebia ɛho behia nso sɛ nnipa binom a wɔwɔ Takayasu ntini mu yare no yɛ aortic valve foforo.

Mɛyɛ dɛn ahwɛ me ho?

Nnipa pii a wɔwɔ Takayasu ntini mu yare no nso wɔ mogya mmoroso (hypertension). Ɛho hia sɛ wodi eyi so. Sɛ woansa mogya mmoroso a, nneɛma a ɛte sɛɛ betumi asi:

• Nnwodwoɔ.
• Koma mu yare.
• Asaabo a entumi nyɛ adwuma yiye.

Sɛ wonom nnuru a esiw wo nipadua mu ahoɔden a ɛko tia nyarewa ano a, susuw ho sɛ wobɛma saa nnuru yi de abɔ wo ho ban afi ɔyare mmoawa ho:

• Atiridiinini aduru a wɔde bɔ nkurɔfo ho ban.
• Nnuru a wɔde bɔ ahurututu mu yare ho ban.
• Herpes zoster (Shingles) aduru a wɔde bɔ nkurɔfo ho ban.

Dɛn na obi a ɔwɔ Takayasu ntini mu yare no betumi ahwɛ kwan?

Ɛwom sɛ wonni aduru biara a wɔde sa Takayasu ntini mu yare no de, nanso ɛyɛ yare a wotumi sa. Nnipa dodow no ara a wɔwɔ yare no ho tɔ wɔn bere a wɔsa wɔn yare no. Nanso, nnipa pii betumi adi dɛm akodu baabi, anaasɛ ɛntaa mma koraa, esiane yare no nti. Nkɛntɛnso a yare no de ba no betumi anya da biara da dwumadi so nkɛntɛnso kɛse. Ɛsɛ sɛ nnipa a wɔwɔ Takayasu ntini mu yare no mu bɛyɛ fã yɛ nsakrae wɔ wɔn nnwuma mu. Nanso, nnipa a wɔwɔ yareɛ no mu bɛyɛ 25% bɔ wɔn bra a ɛfata koraa. Ɛsɛ sɛ 25% foforo yɛ nsakrae bi wɔ wɔn dwumadi ahorow mu. Ɛsɛ sɛ nnipa a wɔte saa yare a enni sabea yi kɔ aduruyɛ mu nhwehwɛmu daa, na sɛ ɛho hia a, wɔyɛ nsakrae wɔ wɔn nnuru mu. Ɛsɛ sɛ nnuruyɛfo nso hwɛ nneɛma bɔne a nnuru no de ba no so na wɔyɛ mogya mu nhwehwɛmu. Nea edidi so yi betumi ayɛ Takayasu ntini mu yare no ho nsɛnnennen:

• Koma a entumi nyɛ adwuma yiye.
• Nnwodwoɔ.
• Mogya a ɛtwetwe.
• Komayare a ɛma obi nya komayare.

Takayasu arteritis yɛ yare a ɛtra hɔ kyɛ a ɛkɔ so nkakrankakra. Wobɛhia ayaresa a ɛkyɛ, na mpɛn pii no wɔde nnuru. Wɔ aman te sɛ United States ne Japan mu no, sɛ wɔkyekyem pɛpɛɛpɛ a, nnipa a wɔwɔ Takayasu ntini mu yare no mu bɛyɛ 3% wuwu wɔ mfe anum mu wɔ yare no akyi. Ebia eyi te saa efisɛ nnuruyɛfo tumi hu yare no ntɛm na wɔsa no yiye. Wɔ wiase mmeae afoforo no, nea ebefi mu aba no betumi asɛe kɛse esiane sɛ wɔkyɛ wɔ sɛnea wobehu yare no na wɔasa wɔn yare anaasɛ akwahosan ho nhyehyɛe a wonnya no yiye nti. Sɛ wɔansa Takayasu ntini mu yare a, ebetumi akum obi.

Mɛyɛ dɛn ahwɛ m’akwahosan so?

Ɛho hia sɛ wohwɛ sɛnea wote nka na wo ne wo duruyɛfo di nkitaho daa sɛnea ɛbɛyɛ a wubetumi akyere yare no ho sɛnkyerɛnne foforo biara anaasɛ ɛreyɛ kɛse ntɛm.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wo Takayasu ntini mu yare no ho sɛnkyerɛnne san ba bere a wɔreyɛ ayaresa anaasɛ bere a wɔasa wo yare akyi a, kɔ wo duruyɛfo nkyɛn ntɛm ara. Sɛ woreyɛ nhyehyɛe sɛ wubenyinsɛn a, wo ne wo duruyɛfo nka ho asɛm. Ebetumi aba sɛ wubenya nyinsɛn a edi mu a Takayasu ntini mu yare wom, nanso ɛho hia sɛ wuhu sɛnea wobedi ho dwuma.

Bere bɛn na ɛsɛ sɛ mekɔ Emergency Treatment Unit (ETU) ?

Sɛ wowɔ saa sɛnkyerɛnne yi bi a, frɛ 911 ntɛm ara (wɔ Sri Lanka no, frɛ 1990 Suwaseriya Ambulance Service anaa kɔ ayaresabea a ɛbɛn wo):

• Koko mu yaw.
• Ɔhome a ɛyɛ den.
• Pulse a ɛyɛ mmerɛw.
• Komayare ho sɛnkyerɛnne (sɛ nhwɛso no, koko mu yaw a emu yɛ den a ɛhyerɛn kɔ abasa no so, fifiri, akisikuru).
• Nsɛnkyerɛnne a ɛkyerɛ sɛ obi abɔ akisikuru (s.e., anim a ɛhwe ase wɔ n’anim fã biako, ne nsa a ɛyɛ mmerɛw, ɛyɛ den sɛ ɔbɛkasa).

Nsɛm bɛn na ɛsɛ sɛ mibisa me duruyɛfo?

• Bere tenten ahe na ɛsɛ sɛ menom nnuru a wɔde sa Takayasu ntini mu yare no?
• Mpɛn ahe na ɛsɛ sɛ meba bɛyɛ nhyehyɛe a ɛbɛma wɔadi akyi?
• So wobetumi adi me tebea no so a wɔnyɛ me oprehyɛn?
• Mpɛn ahe na ɛsɛ sɛ meyɛ mfoninitwa nhwehwɛmu?

Awiei koraa no, nea ɛsɛ sɛ wokae (Take-Home Message) .

Esiane sɛ Takayasu Arteritis yɛ tebea a ɛtra hɔ kyɛ, anaasɛ ‘enni sabea’ nti, ɛho behia sɛ wokɔ oduruyɛfo nkyɛn daa. Bere kɔ so no, ebia wo yare no ho sɛnkyerɛnne ahorow no bɛkɔ so afi wo ho so akɔ wo so. Ɛno nti na ɛho hia sɛ wo ne wo duruyɛfo di nkitaho daa no. Sɛ wuhu nsakrae bi wɔ w’akwahosan mu a, nsuro sɛ wobɛka akyerɛ wo duruyɛfo. Wo duruyɛfo no bɛpɛ sɛ ohu ho asɛm, efisɛ ɛno na obetumi aboa wo.

Kae sɛ, sɛ wowɔ saa yare yi mpo, sɛ wosa yare no yiye na wudi aduruyɛ mu afotu akyi a, wo nso wubetumi abɔ bra pa. Tra hɔ pintinn!

Takayasu ntini mu yare, Takayasu ntini mu yare, yare a enni koma mu yare, ntini mu yare, aorta, ntini mu yare, mogya ntini mu yare, mogya mmoroso, autoimmune yare