Ðe wò akɔtavea menye vevesese dzro aɖe ko oa? Mina míasrɔ̃ nu tso Ankylosing Spondylitis (AS) ŋu .

Ne èfɔ tso aba dzi le ŋdi me la, ɖe wò akɔta sẽ hele veve sema? Ðe wòsena le eɖokui me abe ɖe vevesesea nu fa le azɔlizɔzɔ vi aɖe alo nane si ŋu viɖe le wɔwɔ vɔ megbea? Ame geɖe susuna be akɔtave alo nane si tso ɖeɖiteameŋu gbɔ koe esia nye, gake ɣeaɖewoɣi la, ate ŋu anye nane si de to wu ƒe gɔmedzedze. Egbea míele nu ƒom tso nɔnɔme sia tɔgbe ŋu, si nye Ankylosing Spondylitis (AS). Mègatsi dzi o, nu vevitɔe nye be nànya nu tso esia ŋu nyuie eye nàdi atike nyuitɔ.

Nuka tututue nye Ankylosing Spondylitis (AS)?

Kpuie ko la, Ankylosing Spondylitis (AS) nye ƒunukpeƒetetedɔ ƒomevi aɖe. Le esia me la, míaƒe ŋutilã ƒe dɔlélenutsiŋutete dzea ƒunukpeƒe siwo le míaƒe akɔta. Esia nana dɔdzẽ nɔa akɔta ƒe ƒunukpeƒewo. Zi geɖe la, esia dzea egɔme tso akɔta ƒe akpa si le anyime wu, si nye ƒunukpeƒe siwo do ƒome kple akɔtaƒuwo (sacroiliac joints).

Le gɔmedzedzea me la, vevesese sia dzea egɔme tso akpa ɖeka, eye le kwasiɖa alo ɣleti ʋɛ aɖewo megbe la, ate ŋu akaka ɖe akpa evea siaa. Ɣeaɖewoɣi la, vevesese sia ate ŋu aɖo akɔta hã. To vovo na akɔtave si sɔ la, vevesese sia nu metsina ne wogbɔ ɖe eme o, gake nusi ɖe dzesi wue nye be eƒe lãme sẽ vie ne wole kame dem kple ne wole zɔzɔm .

Le ɣeyiɣi aɖe megbe la, dɔdzẽ sia ate ŋu ana ɖeɖi tea ŋuwò ŋutɔ ɣesiaɣi. Esia le alea elabena ŋutilãa zãa ŋusẽ geɖe tsɔ wɔa avu kple dɔdzẽ sia.

Nukae wòle be míawɔ le gɔmedzedzea me?

Ne dzesi siawo le ŋuwò la, nu gbãtɔ si wòle be nàwɔe nye be nàkpɔ ƒunukpeƒeŋutinunyala, si nye ɖɔkta si bi ɖe ƒunukpeƒedɔlélewo me. Ana atikewɔwɔ ƒe ɖoɖo si sɔ na wò la wò.

• Vevesesenutsitikewo: Be nàɖu vevesese kple abi dzi le eƒe gɔmedzedze la, wò ɖɔkta ate ŋu aŋlɔ NSAID (Nonsteroidal anti-inflammatory drugs) , abe ibuprofen alo naproxen ene na wò.
• Kamedede: Kamedede le abe atike ene na amesi ŋu AS le. Enye atikewɔwɔ ƒe ɖoɖoa ƒe akpa aɖe. Le kamedede me la, .
• Eɖua dɔlélea dzi be wòagagblẽ ɖe edzi o.
• Eɖea vevesese kple lãmekasese dzi kpɔtɔna.
• Kpena ɖe ame ŋu be ŋutilã nate ŋu atrɔ ɖe nɔnɔmewo ŋu.
• Ƒo nu kple wò kamedededɔwɔla be wòato kamedede ƒe ɖoɖo si le dedie si sɔ na wò vɛ.
• Nuɖuɖu: Ele vevie ŋutɔ be nàxɔ nuɖuɖu si tsia dzodzodzoetsitsi nu. De amagbe dama siwo ƒe aŋgbawo le, amagbe siwo le amadede vovovowo me (e.g., spinach, tomatos), broccoli, kple cabbage wò nuɖuɖu me. Te ɖa le nuɖuɖu siwo ŋu wotrɔ asi le siwo me sukli, wɔ ɣi, ami siwo mele lãmesẽ me o, kple nusiwo wotsɔ wɔe sɔ gbɔ ɖo ŋu.
• Ƒo asa na atamanono:Ne atamanolae nènye la, dzudzɔ atamanono kaba ale si nàte ŋui. Sigaretnono ate ŋu ana nɔnɔme sia nagado gã ɖe edzi. Ne ehiã la, ƒo nu kple wò ɖɔkta be wòakpe ɖe ŋuwò.

Alesi dɔlélea yia ŋgɔe le ɣeyiɣi aɖe megbe (Progression) .

Zi geɖe la, AS yia ŋgɔ blewu tso akɔta ƒe akpa si le anyime va ɖoa kɔ gbɔ. Scanwo abe MRI ene ate ŋu aɖe alesi gbegbe wogblẽ nu le akɔta ŋui afia. Ðewohĩ asesẽ be woakpɔ tɔtrɔ siawo le ƒe ʋɛ gbãtɔawo me, gake wova dzena le ɣeyiɣi aɖe megbe.

Ne dɔdzẽ le dzidzim ɖe edzi la, menye akɔta ɖeɖeko ate ŋu agblẽ o, ke ate ŋu agblẽ nu le ŋutilã ƒe akpa bubuwo hã ŋu, vevietɔ teƒe siwo lãkusiwo kple lãkusiwo do ƒome kple ƒuwo (entheses).

Atikewɔwɔ me nɔnɔme bubu siwo do ƒome kplii

• Ŋku ƒe ʋuʋu: AS dɔnɔ siwo ade akpa etɔ̃lia axɔ ŋku ƒe dɔdzẽ (uveitis alo iritis) le woƒe agbemeɣeyiɣi aɖe me. Dzesiawo dometɔ aɖewoe nye ŋku ƒe vevesese, abibi, aɖatsi, nukpɔkpɔ si me mekɔ o, kple kekeli ƒe seselelãme. Ne èkpɔ dzesi siawo dometɔ aɖe la, yi ŋkudɔdala gbɔ enumake. Ne womewɔ atike nɛ o la, nukpɔkpɔ ate ŋu agblẽ.
• Nuɖuɖumeŋusẽ ƒe dɔléle: AS dɔnɔ siwo ade 70% xɔa nuɖuɖumeŋusẽ ƒe dɔdzẽ, gake wo dometɔ geɖe meɖea dzesi aɖeke fiana o. Anɔ abe 10% ene xɔa IBD (Dɔléle si naa Dɔgbo ƒe Dɔléle)., si fia be nɔnɔmewo abe Crohn ƒe dɔléle alo Ulcerative Colitis ene ate ŋu ado mo ɖa.
• Ŋutilãmedɔlélewo: Ame siwo ade 10% hã ate ŋu axɔ psoriasis.

Atikewɔwɔ ne dɔlélea le ŋgɔ yim

Ne NSAID siwo wozãna edziedzi mena gbɔdzɔe wò o la, wò ɖɔkta ate ŋu aŋlɔ atike siwo sesẽ wu siwo woyɔna be biologics . Esiawo ate ŋu awɔ dɔ nyuie wu elabena wotɔa ŋku nusiwo le míaƒe dɔlélenutsiŋutete me siwo nana míexɔa abi la tẽ.

Woate ŋu ana atike siwo xea mɔ na TNF (e.g., Adalimumab (Humira), Etanercept (Enbrel), Infliximab (Remicade)) gbã. Ne esiawo mewɔ dɔ o la, woate ŋu azã atike siwo xea mɔ na IL-17 (e.g., Secukinumab (Cosentyx)). Le ɣeyiɣi sia me la, àte ŋu ahiã ŋku, dɔgboŋutinunya, alo ŋutigbalẽŋutinunyalawo ƒe kpekpeɖeŋu hã.

Dɔlélea ƒe akpa si de ŋgɔ wu

Ne dɔlélea nu sẽ ŋutɔ la, ɖɔkta la agblɔ na wò be "spinal fusion" le ŋuwò. Esia fia be ƒu yeyewo tsina le akɔta ƒe akɔtaƒuwo dome eye wòƒoa wo nu ƒu ɖekae. Woyɔa esia be aklã ƒe fusion .

Fusion sia nana be aklã ƒe gbagbã ƒe afɔkua dzina ɖe edzi. Ate ŋu ana akɔta hã nabɔbɔ ɖe ŋgɔ eye wòanɔ akɔta . Lãmesẽfefewɔwɔ ate ŋu akpe ɖe ame ŋu wòaɖu nɔnɔme sia dzi.

Tsɔ kpe ɖe eŋu la, esia ate ŋu akpɔ ŋusẽ ɖe ƒunukpeƒe siwo le akɔta kple akɔta dome, kple teƒe siwo akɔtaƒuwo do ƒome kple akɔtaƒu le. Ekema ate ŋu asesẽ be woagbɔ ya sesĩe gɔ̃ hã. Le nɔnɔme mawo me la, àte ŋu asrɔ̃ mɔ siwo dzi nàto ana gbɔgbɔ nanɔ bɔbɔe tso gbɔgbɔtsixeŋutinunyala gbɔ.

Ƒã ŋutɔ hafi lãmeka siwo le akɔta ƒe gɔme ƒe gbegblẽ ate ŋu ahe nɔnɔme sesẽ aɖe si woyɔna be cauda equina syndrome vɛ. Ate ŋu ana tsinyegoe kple dɔgbo nagate ŋu aɖu dzi o, gbɔdɔdɔ ƒe dɔmawɔmawɔ nyuie, eye afɔ nase veve ahagbɔdzɔ.

Gake ɖo ŋku edzi be nɔnɔme sesẽ siawo mebɔ kura o. Ne èno atike siwo wò ɖɔkta ŋlɔ na wò eye nèwɔ ɖe eƒe mɔfiamewo dzi la, masesẽ be nàƒo asa na nɔnɔme sesẽ mawo o. Ele vevie be nàyi ɖɔkta gbɔ be woado wò kpɔ ne dzesi aɖeke mele ŋuwò o gɔ̃ hã.

Ɣekaɣie wòle be woakpɔ ɖɔkta

Ne dzesi yeye aɖewo dze le ŋuwò alo ne wò dzesiawo gagblẽ ɖe edzi la, ƒo nu kple wò ɖɔkta enumake. Mègahe ɖe megbe o, vevietɔ ne ame aɖe si ŋu AS le la kpɔ dzesi siwo gbɔna la dometɔ aɖe: