ʻEha pū kekahi kou mau hono kua? E aʻo kākou e pili ana i ka spondyloarthritis!

Ke hoʻomaka nei hoʻi ʻoe i kou lā me ke kua ʻoʻoleʻa a me ka ʻeha ke ala ʻoe i ke kakahiaka? A i ʻole ke manaʻo nei ʻoe i kekahi manawa e pālahalaha ana kou ʻeha hope i kou mau puʻupuʻu? Hiki paha iā ʻoe ke ʻoluʻolu iki me nā hōʻailona e like me kēia. ʻAʻole paha kēia ʻano he ʻeha kua maʻalahi. I kēia lā e kamaʻilio mākou e pili ana i kahi maʻi paʻakikī iki, akā hiki ke hoʻomaopopo ʻia i kapa ʻia ʻo Spondyloarthritis .

He aha ka spondyloarthritis? I ka pōkole...

I ka ʻōlelo maʻalahi, ʻo ka spondyloarthritis kahi maʻi arthritis e kū mai ana i nā hono o kou iwi kuamoʻo . ʻO "Spondyl-" ke ʻano e pili ana i ka iwi kuamoʻo. ʻO "Arthritis" ke ʻano o ka ʻeha a me ka ʻoʻoleʻa i nā hono. Hoʻopilikia nui kēia ʻano i nā hono e hoʻopili ai i kou iwi kuamoʻo. ʻO ia hoʻi, nā hono liʻiliʻi (nā hono facet) ma waena o ka vertebrae a me nā hono sacroiliac e hoʻopili ai i kou iwi kuamoʻo i kou mau iwi ʻūhā. ʻO ia ke kumu e lilo pinepine ai ka ʻeha o ke kua haʻahaʻa i ka hōʻailona nui . Eia naʻe, ʻaʻole i kaupalena ʻia i ka iwi kuamoʻo. Hiki iā ia ke hoʻopili i nā hono ʻē aʻe a hana i nā hōʻailona ʻē aʻe.

E hoʻomanaʻo, ʻaʻole kēia he maʻi hoʻokahi, akā he hui o nā maʻi me nā hōʻailona like. Ua kapa pū nā kauka i kēia maʻi ʻo spondyloarthropathy . ʻO ia hoʻi, he maʻi (`-pathy`) o nā hono o ka iwi kuamoʻo (`arthro-`). Ua lohe paha ʻoe i ka osteoarthritis (i hoʻokumu ʻia e ka ʻaʻahu hui) a me ka rheumatoid arthritis (RA) (i hoʻokumu ʻia e kahi pilikia me ka ʻōnaehana pale). He ʻano ʻokoʻa ka spondyloarthritis mai nā mea ʻelua, akā hiki iā ia ke hoʻopilikia i nā hono o ka iwi kuamoʻo.

He aha nā ʻano nui o kēia maʻi? E nānā pono kākou!

Aia kekahi mau hōʻailona kikoʻī e pili ana i ka spondyloarthritis:

• He maʻi rumatika kēia: ʻO ka Spondyloarthritis kahi ʻano o ka arthritis e hāʻule ana ma lalo o ka māhele o nā maʻi rumatika , ʻo ia ke ʻano mumū o ka arthritis . ʻO ka mumū mau ke kumu o ka ʻeha a me ka pehu ʻana i nā hono. ʻAʻole ia he kūlana e hōʻino ai i nā hono e like me ka osteoarthritis. ʻO ka arthritis mumū ka maʻamau he maʻi autoimmune . ʻO ke ʻano kēia, ua kuhihewa ka ʻōnaehana pale o kou kino i kou mau hono ponoʻī, e hoʻoulu ai i ka mumū mau. Hiki i kēia mumū ke hoʻopilikia ʻaʻole wale i nā hono, akā i nā ʻāpana ʻē aʻe o ke kino.

• ʻAʻole kēia he rheumatoid arthritis (RA): ʻOiai he ʻano arthritis ka rheumatic arthritis, ʻo kēia ka rheumatoid arthritis (RA) a mākou a pau i ʻike ai.ʻAʻole. Ua ʻike mākou i kēia no ka mea ʻaʻole hōʻike nā hoʻokolohua koko no ka poʻe me ka spondyloarthritis i ke alo o kahi antibody i kapa ʻia ʻo rheumatoid factor , kahi mea kūikawā iā RA. ʻO ia ke kumu i kapa ai nā kauka i kēia kūlana he "seronegative spondyloarthropathy ." ʻO ke ʻano o "Seronegative" ʻo ia hoʻi he maikaʻi ʻole ka hoʻokolohua koko no RA. ʻAʻohe antibody kikoʻī i loaʻa no ka spondyloarthritis (SpA).

• ʻO ka Enthesitis: ʻO kekahi hōʻailona koʻikoʻi o ka spondyloarthritis ka mumū (enthesitis) i loko o kāu mau entheses . Nānā nā kauka i kēia i ka wā e ʻike ai i ke kūlana. He ʻiʻo hoʻopili fibrous nā entheses. ʻOi aku ka pololei, ʻo ia nā "hui" kahi e pili ai kou mau tendon a me nā ligaments i kou mau iwi. Hiki i ka spondyloarthritis ke hana i ka enthesitis ma nā ʻāpana like ʻole o ke kino. ʻO nā kuʻekuʻe wāwae a me nā kuli nā wahi maʻamau e ʻike ʻia ai kēia kūlana.

• ʻO ka gene HLA-B27: Ma waena o 80% a me 95% o ka poʻe me ka spondyloarthritis o ka hanauna ʻEulopa ʻĀkau he gene HLA-B27 . ʻAʻole maʻamau kēia gene i ka poʻe me ka maʻi ma nā hui lāhui ʻē aʻe. Eia kekahi, ʻo ka loaʻa ʻana o kēia gene ʻaʻole ia e hoʻoulu koke i ka maʻi. Eia nō naʻe, he mea maʻamau ia e hiki ai i ke kauka ke hoʻāʻo no kēia gene e kōkua i ka ʻike ʻana i ka maʻi.

Pehea ka maʻamau o kēia maʻi?

ʻOiai ʻaʻole ʻike nui ka poʻe he nui e pili ana i ia mea, ʻo ka spondyloarthritis kahi maʻi i ʻoi aku ka maʻamau ma mua o ka rheumatoid arthritis . Ua manaʻo ʻia aia ma kahi o 0.5% a 2% o ka heluna kanaka o ka honua i loaʻa i kekahi ʻano spondyloarthropathy.

He aha nā ʻano nui o ka spondyloarthritis?

Aia kekahi mau maʻi like ʻole e hāʻule ana ma lalo o ke poʻo inoa maʻamau o ka spondyloarthritis. Ua hoʻokaʻawale nā ​​​​kauka i kēia mau mea i ʻelua mau māhele nui: axial spondyloarthritis a me peripheral spondyloarthritis .

ʻO ka Spondyloarthritis Axial

Hoʻopilikia nui ia i nā hono o kou iwi axial , ʻo ia hoʻi ka ʻāʻī, ka umauma, a me ka iwi kuamoʻo . I ka holomua ʻana o ka maʻi, hiki ke hoʻopilikia ʻia nā hono ʻē aʻe a me nā ʻōpū paha.

He ʻano koʻikoʻi ʻo Ankylosing Spondylitis o ka axial spondyloarthritis. Hōʻike ʻia ia e nā loli maopopo i nā iwi o ka iwi kuamoʻo, i kapa ʻia ʻo ankylosis.(e like me ka hui pū ʻana o nā iwi). Ma keʻano laulā, ʻo kēia ke ʻano maʻamau o ka spondyloarthritis.

ʻO ka Spondyloarthritis Peripheral

Hoʻopilikia mua kēia ʻano i kou mau hono peripheral a me nā entheses. ʻO ia hoʻi, nā hono ma waho o ka iwi axial (no ka laʻana, nā hono i loko o nā lālā). I ka holomua ʻana o ka maʻi, hiki ke hoʻopilikia ʻia a luku ʻia paha ka iwi kuamoʻo.

ʻO ka maʻamau, pili ka peripheral spondyloarthritis i ka mumū ma nā ʻōpū ʻē aʻe. Hiki i nā ʻano like ʻole ke hoʻopilikia i nā ʻōpū like ʻole (e like me nā maka, ka ʻili, a me nā ʻōpū). Eia nō naʻe, hiki ke like iki nā hōʻailona. ʻO kekahi o nā ʻano nui:

• ʻO ka Psoriatic Arthritis: He ʻano arthritis kēia e kū pū ana me ka psoriasis , kahi maʻi ʻili autoimmune e hoʻoulu ai i ka ʻulaʻula ʻili. (Ma ko mākou ʻāpana o ka honua, ua kapa ʻia kēia he "ʻili scaly"). Hoʻopilikia pinepine ia i nā hono liʻiliʻi o nā lima a me nā wāwae, e hoʻoulu ai i ka pehu a me ka ʻeha ma nā manamana lima.
• ʻO ka ʻArthritis Enteropathic: He ʻano ʻāʻī kēia e kū pū ana me ka Maʻi ʻŌpū Mumū (IBD) . ʻO ke ʻano o "Enteropathic" e pili ana i kou ʻōpū.
• ʻO ka maʻi ʻaʻai reactive: He ʻano maʻi autoimmune kēia e kū mai ana ma muli o kahi maʻi i loko o kou ʻōpū a i ʻole ke ala mimi. Hiki iā ia ke hoʻopilikia i kou mau maka, ʻili, ʻōpū mimi, nā ʻōpū wahine, a i ʻole nā ​​ʻōpū. He manawa pōkole wale nō ia, akā hiki ke mau a hiki i 12 mau mahina. I kekahi poʻe, hiki ke lilo i ka maʻi ʻaʻai mau.

ʻO ka Spondyloarthritis i hoʻokaʻawale ʻole ʻia

ʻO kēia ka hōʻailona i hāʻawi ʻia inā kūlike kāu mau hōʻailona me nā spondyloarthritis, akā ʻaʻole kūpono i kekahi ʻano kikoʻī.

ʻO ka Spondyloarthritis ʻōpio

He ʻano kēia o ka spondyloarthritis e kū mai ana i ka wā kamaliʻi, ma mua o ka piha ʻana o 16 makahiki. Hiki i nā keiki ke hoʻomohala i kahi ʻano kikoʻī a i ʻole ka hui pū ʻana o nā ʻano like ʻole.

He aha nā hōʻailona o ka Spondyloarthritis?

Hiki ke like pinepine nā hōʻailona o nā ʻano spondyloarthritis like ʻole. ʻOiai ʻoi aku ka kikoʻī o kekahi mau hōʻailona i kekahi mau ʻano, hiki ke ʻike ʻia kekahi o nā hōʻailona i kēlā me kēia ʻano.

ʻO nā hōʻailona nui paha:

• ʻEha ma ke kua haʻahaʻa, i kekahi manawa e pālahalaha ana i nā puʻupuʻu (sacroiliitis). No kekahi poʻe, ua like paha kēia me ka ʻeha e puka mai ana mai loko mai o ka iwi ʻūhā.
• ʻO ke ʻoʻoleʻa o nā hono i ke kakahiaka, kahi e hoʻomaha iki ai ke neʻe ʻoe a puni. Ua like ia me kou ala ʻana i ke kakahiaka, ua like kou kino me ka lāʻau, a hemo wale ia ke neʻe iki ʻoe a puni.
• ʻEha ma ke kua waena a me luna, ʻeha ʻiʻo umauma, a ʻeha paha ka ʻāʻī.
• Ke kūlou mālie ʻana o ka iwi kuamoʻo (e like me ka scoliosis).
• ʻEha a me ka ʻoʻoleʻa ma nā hono o nā lālā - nā pūhaka, nā poʻohiwi, nā kuli, nā kuʻekuʻe lima, nā pulima lima, nā kuʻekuʻe wāwae.
• Pehu nui o nā manamana lima ("sausage fingers" a i ʻole dactylitis). ʻO kēia ka wā e pehu loa ai kekahi manamana lima a manamana wāwae paha, e like me ka sausage.
• Nā hōʻailona o ka ʻōnaehana hoʻoheheʻe, no ka laʻana, ka ʻeha o ka ʻōpū a me ka maʻi pā.
• ʻEha a me ka mumū o ke ala mimi.
• ʻŌhūhū ʻili maneʻo a unahi (psoriasis).
• Nā lua liʻiliʻi ma nā kui (nail psoriasis).
• Luhi mau loa.
• ʻAʻohe ʻono o ka meaʻai.
• Ka mumū o nā maka (uveitis). Hiki i kēia ke hana i ka ʻulaʻula, ka ʻeha, a me ka ʻike i ka mālamalama.
• Nā ʻeha waha.
• ʻEha kuʻekuʻe wāwae (ma muli o ka enthesitis).
• Ka hoʻokumu ʻia ʻana o nā iwi liʻiliʻi.

ʻO ka mea nui, ʻo nā hōʻailona o ka spondyloarthritis e hoʻomaka mua ana e ʻike ʻia ma mua o nā ʻano arthritis ʻē aʻe, ma mua o 45 mau makahiki. Hiki i kēia mau hōʻailona ke hoʻomaka mālie a ʻoi aku ka ʻino. I ka hapanui o nā hihia, mau kēia mau hōʻailona.

He aha nā kumu o ka spondyloarthritis?

ʻO nā hōʻailona spondyloarthritis ke kumu o ka mumū mau loa i loko o kou mau hono a me nā ʻiʻo ʻē aʻe. Hoʻokumu ʻia kēia mumū e kāu ʻōnaehana pale ponoʻī. ʻO kēia ka mea a mākou e kapa nei he maʻi autoimmune .

ʻAʻole maopopo loa i nā kānaka noiʻi ke kumu o kēia mau maʻi autoimmune. Eia nō naʻe, me he mea lā he nui nā kumu e pāʻani i kahi kuleana. Nui nā maʻi autoimmune, me ka spondyloarthritis, me he mea lā he ʻāpana genetic .

Hoʻopili pinepine ʻia ka ʻohana HLA (Human Leukocyte Antigen) o nā genes i ka arthritis mumū. Hoʻohana ʻia kahi protein i hana ʻia e kēia mau genes e ka ʻōnaehana pale e haʻi i ka ʻokoʻa ma waena o kāu mau cell ponoʻī a me nā cell haole. Hiki i kekahi mau ʻokoʻa o kēia mau genes ke hana hewa i ka ʻōnaehana pale. Hiki i kēia ke hana i ka ʻōnaehana pale e kuhi hewa i kāu mau cell ponoʻī a hoʻouka i kāu mau cell ponoʻī.

He aha nā mea hoʻonāukiuki no ka spondyloarthritis?

ʻOiai aia kahi mana hoʻoilina, ʻaʻole ia wale nō ke kumu o ka maʻi. ʻOiai he nui ka poʻe me ka spondyloarthritis i loaʻa ka gene HLA-B27 , ʻaʻole nā ​​​​mea āpau me kēlā gene e loaʻa i ka spondyloarthritis.

Pono kekahi mea ʻē aʻe e hoʻoulu i kēia kaʻina hana. He ʻokoʻa nā manaʻo o nā kānaka noiʻi e pili ana i nā mea e hoʻoulu ai i kēia. ʻO kekahi o kēia mau mea e komo pū me nā maʻi koʻikoʻi, nā mea ʻawahia o ke kaiapuni, ka puhipaka, a me ka hoʻohana ʻana i ka waiʻona.

ʻO kekahi manaʻo, ua pili paha ka spondyloarthritis i kahi kaulike ʻole (dysbiosis) i loko o kou microbiome ʻōpū . ʻO ka poʻe me ka spondyloarthritis (SpA) he haʻahaʻa ka ʻano like ʻole o nā microbes ʻōpū, kahi e maʻalahi ai ka ulu ʻana o nā microbes ʻino. ʻO kēia kaulike ʻole i loko o ka ʻōpū ('gut dysbiosis`) hiki ke hoʻolilo iā ʻoe i mea maʻalahi i nā maʻi, hoʻoulu i ka mumū mau loa i loko o ka ʻōpū, a hoʻonāwaliwali i kāu ʻōnaehana pale. ʻO ka hui pū ʻana o kāu mau microbes ʻōpū kekahi mea āu e hoʻoilina ai i kekahi ʻano i ka wā hānau.

Pehea e ʻike ʻia ai ka spondyloarthritis?

Hiki ke paʻakikī iki ka ʻike ʻana i ka spondyloarthritis, ʻoiai inā ʻaʻohe ou hōʻailona maopopo. Loaʻa i kekahi poʻe ka ʻeha a me ka ʻoʻoleʻa o nā hono, a he nui paha nā kumu ʻē aʻe.

E nīnau mua ke kauka iā ʻoe e pili ana i kāu mau hōʻailona a nānā i nā hōʻailona ʻē aʻe āu i ʻōlelo ʻole ai akā pili paha. E nīnau pū lākou e pili ana i kou mōʻaukala olakino a me ka mōʻaukala olakino o kou ʻohana.

A laila, e nānā kino ʻia kou iwi kuamoʻo a i ʻole nā ​​hono ʻē aʻe e ʻike i ka mamao e hiki ai iā ʻoe ke hoʻoneʻe iā lākou. E lawe ʻia nā kukuna X e nānā i nā hōʻike o ka arthritis a i ʻole enthesitis, akā ʻaʻole ʻike mau ʻia kēia hōʻike ma nā kiʻi.

Hiki ke hana ʻia nā hoʻāʻo koko e nānā i nā hōʻailona o ka mumū a i ʻole ka maʻi autoimmune. Hiki iā lākou ke hoʻāʻo no ka gene HLA-B27 . Hiki i kēia mau hoʻāʻo ke kōkua i ka hoʻokaʻawale ʻana i ka spondyloarthritis (SpA) mai nā maʻi ʻē aʻe.

He aha nā lāʻau lapaʻau no ka spondyloarthritis?

Aia ka lāʻau lapaʻau i kāu mau hōʻailona kikoʻī. Hahai nā kauka i kahi ala hana maʻamau i ka lāʻau lapaʻau, e hoʻomaka ana me ka hoʻoikaika kino a me nā lāʻau hōʻoluʻolu ʻeha ma luna o ke kauka (OTC nonsteroidal anti-inflammatory drugs / NSAIDs) .

Inā ʻaʻole lawa kēia mau mea e kāohi i kou ʻeha a me kou mumū, hiki i kāu kauka ke kuhikuhi:

• Hāʻawi ʻia nā pana Cortisone i kēlā me kēia manawa e hōʻemi i ka ʻeha kūloko.
• ʻO nā DMARD kuʻuna a biologic paha (Disease-Modifying Anti-Rheumatic Drugs / DMARDs). He mau lāʻau kēia e hoʻololi i ke ʻano o ka maʻi.

No kekahi mau ʻano spondyloarthritis kikoʻī, e like me ka psoriatic arthritis a me ka enteropathic arthritis, aia kekahi mau lāʻau lapaʻau e pili ana i ke kūlana kumu (psoriasis a i ʻole ka maʻi ʻōpū mumū (IBD)).

Pehea ke koʻikoʻi o kēia kūlana? Pehea kākou e neʻe ai i mua?

Inā lilo ka maʻi ʻāʻī mumū i mea koʻikoʻi a mau no ka manawa lōʻihi, hiki ke loaʻa kekahi mau pilikia koʻikoʻi. Eia nō naʻe, ʻo kēia mau pilikia e hoʻopilikia pinepine i kou ʻano ola ma mua o kou ola. No ka laʻana, ua emi paha kou neʻe ʻana i nā hono a me ka piʻi ʻana o ka pilikia o ka haki ʻana o ka iwi. Eia naʻe, ʻaʻole e loaʻa i nā kānaka a pau nā hōʻailona koʻikoʻi, a hiki i ka lāʻau lapaʻau ke kōkua i ka kaohi ʻana i ka holomua o ka maʻi.

ʻOkoʻa ka wikiwiki o ka holomua ʻana o ka spondyloarthritis mai kēlā me kēia kanaka. No kekahi poʻe, lohi ka holomua a hiki ke hoʻomalu maʻalahi ʻia me ka lāʻau lapaʻau. No kekahi poʻe, hiki ke holomua i ka ankylosing spondylitis, kahi kūlana e hoʻoulu ai i ka fusion spinal, i loko o kekahi mau makahiki.

Hoʻopilikia ke koʻikoʻi o kou mumū i ka wikiwiki o ka holomua ʻana o ka spondyloarthritis. ʻO ka hahai pono ʻana i kāu lāʻau lapaʻau hiki ke kōkua i ka kaohi ʻana i ka mumū a pale i nā pilikia.

He aha kāu e hiki ai ke hana i kou wā e noho ana me ka spondyloarthritis?

No kekahi mea me ka rumatika, he mea nui ka hoʻoikaika kino mau e mālama i ka neʻe ʻana o nā hono e like me ka hiki. Wahi a ka nui o nā kauka he ʻoi aku ka nui a me ka maikaʻi o kēia ma mua o nā lāʻau lapaʻau āpau.

Inā ʻaʻole ʻoe maopopo i ke ʻano o ka hoʻoikaika kino kūpono iā ʻoe, e nīnau i kāu kauka. Paipai ka nui o nā kauka i ka hoʻōla kino e pili ana i nā hono kikoʻī a i ʻole nā ​​​​wahi pilikia.

He hui pili ka spondyloarthritis, akā he ʻokoʻa. ʻOiai ke ʻike nei nā kauka iā lākou ma o ko lākou ʻano like, he ʻokoʻa kēlā me kēia ʻano - a me ka maʻi o kēlā me kēia kanaka.

No nā kānaka he nui, he maʻi ola ka spondyloarthritis. Eia nō naʻe, hiki ke ʻokoʻa ka nui o kona hopena i kou ola. ʻO kāu kauka kou hoa hana maikaʻi loa i ka mālama ʻana i kāu mau hōʻailona a me nā mea āu e manaʻo ai.

ʻO nā mea nui loa āu e hoʻomanaʻo ai

ʻAe, ua kamaʻilio nui mākou e pili ana i ka spondyloarthritis. I ka pōkole, eia kekahi mau mea e hoʻomanaʻo ai:

• ʻO ka spondyloarthritis kahi maʻi ʻeha e kū mai ana i nā hono o ka iwi kuamoʻo.
• He maʻi autoimmune kēia; ʻo ia hoʻi, hoʻouka kāu ʻōnaehana pale ponoʻī i kou mau hono.
• ʻO nā hōʻailona nui ka ʻeha o ke kua (ʻoi aku ka ʻino i ke kakahiaka), ka ʻoʻoleʻa o nā hono, a me ka enthesitis (ka mumū o nā hono kahi e hoʻopili ai nā aʻalolo i nā iwi).
• ʻOiai paha ua pili ka gene HLA-B27 , ʻaʻole ia wale nō ke kumu.
• Aia nā ʻano like ʻole, e like me Ankylosing Spondylitis a me Psoriatic Arthritis.
• Hoʻohana ʻia nā hōʻailona, ​​​​nā hoʻokolohua, a i kekahi manawa nā hoʻokolohua genetic e ʻike ai i ka maʻi.
• Hoʻokomo ʻia ka lāʻau lapaʻau i ka hoʻoikaika kino, nā lāʻau ʻeha, a i kekahi manawa nā lāʻau lapaʻau kikoʻī (DMARDs) .
• He mea nui ka hoʻoikaika kino mau a me ka hahai ʻana i nā ʻōlelo aʻoaʻo lapaʻau no ka mālama ʻana i kēia ʻano.

Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​mai makaʻu e ʻike i ke kauka a loaʻa ka ʻōlelo aʻo. ʻO ka ʻike mua ʻana a me ka mālama ʻana e kōkua nui i ka mālama ʻana i kou ola maikaʻi.

ʻO ka Spondyloarthritis, Spondyloarthropathy, ʻO ka rumatika hope, ʻO ka mumū o nā hono, ʻEha hope, Nā maʻi Autoimmune, HLA-B27, Ankylosing Spondylitis, Psoriatic Arthritis