Ua ʻike anei ʻoe i ka maʻi ʻo Takayasu? E kamaʻilio kākou e pili ana i ia mea!

Ua lohe paha ʻoe i kahi maʻi i kapa ʻia ʻo Takayasu's Arteritis? He mea ʻē paha ke kani ʻana o ka inoa, ʻeā? Akā, he ʻano laha ʻole ia e hiki ke hoʻopilikia i ko kākou mau kīʻaha koko, ʻoiai nā kīʻaha koko nui loa e hoʻomaka ana ma ka puʻuwai a me nā lālā e lālā ana mai ia mea. I kekahi manawa ua kapa ʻia hoʻi ʻo ia he 'maʻi pulseless.' I kēia lā, e kamaʻilio mākou e pili ana i ia mea me nā kikoʻī, me ka maʻalahi loa, i hiki iā ʻoe ke hoʻomaopopo maikaʻi iā ia.

He aha maoli ka Takayasu's Arteritis?

I ka ʻōlelo maʻalahi, ʻo ka arteritis o Takayasu kahi mumū o ko mākou mau kīʻaha koko, ʻo ia hoʻi ka pehu ʻana a i ʻole ka mumū (vasculitis). Hoʻopilikia nui ia i nā kīʻaha koko nui loa i loko o ko mākou kino. E noʻonoʻo e pili ana i ia mea, ʻo ke kīʻaha koko nui e lawe ana i ke koko momona oxygen mai ko mākou puʻuwai a i ke kino holoʻokoʻa, a mākou e kapa nei ʻo 'aorta nui' a i ʻole 'aorta'. Hoʻopilikia nui kēia maʻi i ka aorta, a me nā kīʻaha koko nui ʻē aʻe e lālā ana mai ia mea a lawe i ke koko i ko mākou mau lima, ʻāʻī, a me ka lolo. Ua ʻike anei ʻoe i ka mea e hana ʻia ke hana ʻia kēia mumū? Ua hōʻino ʻia nā paia o ko mākou mau kīʻaha koko. A laila lilo kekahi mau ʻāpana o kēlā mau kīʻaha koko i nāwaliwali a hiki ke puʻupuʻu e like me ka pōpō. Kāhea mākou i kēia he 'aneurysm'. Eia kekahi, hiki i nā kīʻaha koko ke pehu a haiki. A laila ua kaupalena ʻia ke kahe koko. I kekahi manawa hiki ke ālai loa ʻia kahi kīʻaha koko, i kapa ʻia ʻo 'occlusion'. I ka manawa kākaʻikahi, hiki i kēia kūlana ke hoʻopilikia i nā aʻa e hoʻolako ana i ke koko i ka puʻuwai, nā ʻōpū, nā puʻupaʻa, a me nā wāwae.

ʻO wai ka mea i hoʻopilikia nui ʻia e kēia kūlana?

ʻO ka Takayasu's Arteritis (TAK) kahi maʻi e hoʻopilikia pinepine i nā ʻōpio. ʻO ka mea maʻamau ia i nā wahine ma waena o 20 a me 40 mau makahiki. ʻO ka maʻamau, aia nā maʻi ma waena o 15 a me 35 mau makahiki i ka wā i ʻike ʻia ai. Ma kahi o 80% a 90% o ka poʻe me ka maʻi he mau wahine. ʻIke pinepine nā kauka i kēia maʻi ma nā ʻāina e like me Iapana a me nā poʻe o Mekiko, India, a me ka Hikina Hikina o ʻAsia. ʻOiai ma nā ʻāina e like me ʻAmelika Hui Pū ʻIa, ʻelua a ʻekolu wale nō hihia hou no kēlā me kēia miliona o ka poʻe i ʻike ʻia i kēlā me kēia makahiki. ʻO ia hoʻi, he maʻi kakaikahi ia.

Pehea ka hopena o ka maʻi arteritis o Takayasu i koʻu kino?

Ke emi nā kīʻaha koko, emi ka nui o ke koko e hiki aku ana i nā ʻōpū a me nā ʻiʻo i hoʻolako ʻia e kēlā mau kīʻaha koko. E noʻonoʻo e like me ka paipu wai i paʻa, kahi e hōʻemi ai i ka nui o ka wai e kahe ana. Akā i loko o ka arteritis o Takayasu (TAK), hana pinepine kēia mau loli me ka mālie a me ka mālie. No laila, loaʻa i ko mākou kino ka manawa e maʻa ai i ka lawe ʻana i ke koko ma o nā ala ʻē aʻe. Ua like kēia mau ala ʻē aʻe me nā ala liʻiliʻi a mākou e hoʻohana ai i ka wā e ālai ʻia ai ke alanui nui. Akā, ʻaʻole hiki i kēia mau ala ke lawe i ka nui o ke koko e like me ke kīʻaha koko nui mua. ʻO ka maʻamau, ʻo ka nui o ke koko e kahe ana ma mua o ka mea i ālai ʻia ua lawa ia e hoʻolako i nā ʻiʻo me ka liʻiliʻi o ka oxygen a me ke koko e pono ai lākou e ola. Akā, he mea kākaʻikahi loa, inā ʻaʻole hana pono kēia mau kīʻaha koko ʻē aʻe, hiki i nā ʻiʻo ke make no ka mea ua nele lākou i ka oxygen a me ke koko.

He aha nā hōʻailona o kēia maʻi?

ʻAʻole paha e loaʻa i kekahi poʻe me ka Takayasu arteritis (TAK) kekahi mau hōʻailona. Eia nō naʻe, ma kahi o ka hapalua o nā maʻi e ʻike paha i ka malaise maʻamau a me ka nāwaliwali. Nā hōʻailona mua (kahua 1): Eia nā hōʻailona e ʻike ʻia i ka hoʻomaka ʻana o ka maʻi:

• Kuni.
• Manaʻo luhi loa ( Fatigue ).
• ʻEha nā ʻiʻo a me nā hono .
• ʻAʻohe ʻono o ka meaʻai .

Nā hōʻailona o ke kahua ma hope (kahua 2): I ka holomua ʻana o ka maʻi, hiki ke ʻike ʻia nā hōʻailona e like me kēia:

• ʻEha ka umauma .
• Paʻakikī ka hanu ʻana .
• ʻEha poʻo .
• Manaʻo puni.

Nā hōʻailona i hoʻokumu ʻia e ka ʻūlū ʻana o nā kīʻaha koko a me ka emi ʻana o ke kahe koko:

• Luhi, ʻeha, a ʻūmiʻi paha ma nā lima a me nā wāwae.
• ʻEha ka ʻōpū ma muli o ke emi ʻana o ke kahe koko i nā ʻōpū.
• Ke koko kiʻekiʻe ma muli o ka emi ʻana o ke kahe o ke koko i nā puʻupaʻa.
• Hahau (he mea kākaʻikahi loa kēia).
• Ka hāʻule puʻuwai (he mea kākaʻikahi nō hoʻi kēia).

He aha ke kumu o ka arteritis o Takayasu?

ʻO ka ʻoiaʻiʻo, ʻaʻohe mea i ʻike i ke kumu pololei o ka arteritis o Takayasu (TAK).Akā, manaʻo nā kauka a me nā mea noiʻi he 'kūlana autoimmune' paha ia. ʻO ia hoʻi, hoʻouka hewa ka ʻōnaehana pale o ko mākou kino, ka mea e hakakā nei i ka maʻi, i kona mau ʻiʻo olakino ponoʻī. Me he mea lā e hōʻino ana kā mākou mau pale ponoʻī iā mākou. Manaʻo kekahi poʻe noiʻi he hiki ke hana ʻia kekahi mau hihia o ka arteritis o Takayasu e kahi gene i hoʻoilina ʻia mai nā mākua ʻelua. ʻAʻole paha i loaʻa i kēlā mau mākua nā hōʻailona, ​​no ka mea, hoʻokahi kope wale nō o ka gene kā lākou e lawe nei. Akā inā hoʻoilina ʻoe i kēlā gene kikoʻī mai nā mākua ʻelua, hiki iā ʻoe ke hoʻomohala i ke kūlana a me kāna mau hōʻailona.

Pehea e ʻike ʻia ai kēia maʻi?

E ʻike kāu kauka i ka maʻi arteritis o Takayasu ma ka nānā ʻana i kekahi mau kumu i hoʻokahi, ʻaʻole hoʻokahi wale nō.

• He mōʻaukala lapaʻau piha a me ka hoʻokolokolo kino: Hana ʻia kēia e kāpae i nā kūlana ʻē aʻe i loaʻa nā hōʻailona like me kāu. Ke hoʻohana kāu kauka i ka stethoscope e nānā i kou mau kīʻaha koko, lohe paha lākou i kahi leo ʻē i kapa ʻia ʻo 'bruit' i loko o nā kīʻaha koko. Ke haiki loa nā kīʻaha koko, paʻakikī ke kahe o ke koko ma o lākou, ʻo ia ka manawa e lohe ʻia ai ke kani.
• Nā kukuna X: Hōʻike kēia i kahi i hōʻino ʻia ai kou aʻa a me ke koʻikoʻi o ka pōʻino.
• Nā hoʻāʻo e ʻike i ka hāiki ʻana o nā kīʻaha koko a i ʻole nā ​​aneurysms: Aia nā ʻano hoʻāʻo like ʻole no kēia.

He aha nā hoʻokolohua diagnostics?

Aia kekahi mau hoʻokolohua e hiki ke kōkua i ke kauka e hōʻoia i ka hōʻoia:

• Magnetic Resonance Imaging (MRI): He hoʻāʻo kēia ʻaʻole hoʻohana i nā kukuna X. Hana ʻia nā kiʻi me ka hoʻohana ʻana i kahi magnet nui, nā nalu ikehu electromagnetic, a me kahi kamepiula.
• ʻO ke kiʻi ʻana o ka Computed Tomography (CT): Hoʻokumu nā kukuna X a me nā kamepiula i nā kiʻi o nā ʻōpū o loko, me nā kīʻaha koko nui.
• Angiography: Pili kēia i ka lawe ʻana i nā kiʻi X-ray o loko o kou mau kīʻaha koko. Hoʻokomo kāu kauka i kahi ʻōmole lahilahi a lōʻihi i kapa ʻia he catheter i loko o kahi aʻa nui ma kou ʻūhā a lima paha a alakaʻi iā ia i luna i ke aʻa e pono ai ke nānā ʻia. A laila, hoʻokomo ʻia kahi dye kūikawā (mea hoʻohālikelike) ma o ka catheter i loko o ke kīʻaha koko. Ke lawe ʻia nā X-ray, hōʻike maopopo ka dye i nā kīʻaha koko i nā kiʻi. I kekahi manawa, hiki ke hoʻohana ʻia kahi MRI e hana i kahi angiography.
• Positron Emission Tomography (PET scan): Ma kēia hoʻāʻo, hoʻokomo kāu kauka i kahi mea radioactive ma o kahi nila i loko o kahi aa koko ma kou lima. Ke hele ka mea ma kou kino, ʻike kahi scanner iā ia a hana i nā kiʻi.
• Ultrasound: Kōkua kēia i ka hana ʻana i nā kiʻi o nā kīʻaha koko me ka hoʻohana ʻana i nā nalu kani.

Pehea e mālama ʻia ai ka arteritis o Takayasu?

Hiki i nā lāʻau lapaʻau ke kāohi i ka mumū, a i ʻole ka mumū. Eia nō naʻe, pono paha kekahi poʻe i ke ʻoki ʻana e pale aku i kahi kīʻaha koko i paʻa a hana i kahi ala hou no ke kahe ʻana o ke koko. Corticosteroids: ʻO nā Corticosteroids, e like me ka prednisone (e.g., Rayos®, Sterapred®) a i ʻole prednisolone (e.g., Flo-Pred®, Orapred®), nā lāʻau lapaʻau maʻamau no ka arteritis o Takayasu (TAK).

Hana mana kēia mau lāʻau lapaʻau i ka hoʻopau ʻana i ka mumū hana i loko o nā kīʻaha koko a hoʻihoʻi i ka maʻi i ke kala ʻana.

E hoʻemi mālie kāu kauka i ka nui o ka prednisone i ka nui haʻahaʻa loa e hōʻemi i nā hopena ʻaoʻao. Hiki i kekahi poʻe ke hoʻōki mālie i ka lawe ʻana i ka lāʻau me ka ʻole o ka hoʻi hou ʻana o nā hōʻailona. Eia naʻe, ʻaʻole pono loa kēia mau corticosteroids no kekahi poʻe. Eia kekahi, ʻoi aku ma mua o ka hapalua o ka poʻe e lawe nei i kēia mau lāʻau lapaʻau e ʻike paha i ka hoʻi ʻana mai o nā hōʻailona a i ʻole ka ʻino ʻana o ko lākou kūlana. Nā lāʻau lapaʻau immunosuppressive: Hoʻomaʻamaʻa pinepine nā kauka i nā lāʻau lapaʻau e kāohi ana i ka ʻōnaehana pale, e like me:

• ʻO Methotrexate (e.g. Rheumatrex®, Trexall®)
• Azathioprine (e.g. Imuran®, Azasan®)
• ʻO Mycophenolate (e.g. Cellcept®, Myfortic®)
• ʻO Leflunomide
• ʻO Cyclophosphamide

Ke hoʻohana ʻia kēia mau immunosuppressants me ka prednisone, ma kahi o 50% o ka poʻe i loaʻa mua i nā flares hiki ke hoʻopau ʻia ko lākou mau hōʻailona a hiki ke hoʻōki mālie i ka lawe ʻana i ka prednisone. Nā mea hoʻopaʻa Tumor-Necrosis Factor (TNF): Hiki ke hāʻawi ʻia i kekahi poʻe nā lāʻau lapaʻau i kapa ʻia ʻo TNF inhibitors e kōkua i ke kaua ʻana i ka mumū. ʻO nā hiʻohiʻona o kēia mau mea:

• ʻEtanercept
• ʻInfliximab
• ʻO Tocilizumab

Ma keʻano holoʻokoʻa, ma kahi o 25% o ka poʻe me ka arteritis o Takayasu ʻaʻole hiki ke hoʻomalu piha i ka maʻi me ka hoʻomau ʻole ʻana o ka lāʻau lapaʻau.

He aha nā hopena ʻaoʻao o ka lāʻau lapaʻau?

Hiki i nā lāʻau lapaʻau i hoʻohana ʻia e mālama i ka arteritis o Takayasu ke loaʻa kekahi mau hopena koʻikoʻi. Eia nō naʻe, hiki i nā lāʻau lapaʻau ʻē aʻe ke kōkua i ka kaohi ʻana i kēia mau hopena ʻaoʻao. Hiki i nā hopena ʻaoʻao ke komo pū me:

• Ua emi ke kū'ē ʻana i nā maʻi.
• Ka emi ʻana o ka nui o ka iwi (osteoporosis).
• Paʻakikī i ka ʻike ʻana.
• Nā ʻōʻili.

Hoʻomaka ka hana a nā Corticosteroids i loko o kekahi mau hola o ka hoʻomaka ʻana o ka lāʻau lapaʻau, no laila e hiki koke iā ʻoe ke hōʻoluʻolu.

He aha nā lāʻau ʻē aʻe i hoʻohana ʻia?

I kekahi mau hihia, hiki ke hana ʻia ke koko kiʻekiʻe (hypertension) e ka hoʻohaiki ʻana o nā aʻa koko i nā puʻupaʻa. I kēia hihia, hiki i ke kauka ke hoʻohana i kahi mea e like me ka balloon e hoʻonui i ke kīʻaha koko i hoʻohaiki ʻia, i kapa ʻia ʻo angioplasty. A i ʻole, hiki ke hana ʻia kahi hana bypass e ʻae i ke koko e kahe maʻamau i nā puʻupaʻa. Hiki i kēia ke kōkua i ka hoʻomaʻamaʻa ʻana i ke koko me ka ʻole o ka lawe ʻana i ka lāʻau koko kiʻekiʻe. Loaʻa paha i kekahi poʻe nā pilikia koʻikoʻi me nā kīʻaha koko i hoʻohaiki ʻia i ko lākou mau lima a i ʻole nā ​​​​wāwae, e paʻakikī ai ke hele a hana paha i nā hana ʻē aʻe. Hiki i ke ʻoki bypass ke hoʻoponopono i kēia mau pilikia. Inā he aneurysm, hiki ke hoʻoponopono ʻia me ke ʻoki a i ʻole ka bypass. Pono paha kekahi poʻe me ka arteritis o Takayasu e loaʻa kahi pani valve aortic.

Pehea wau e mālama ai iaʻu iho?

He nui ka poʻe me ka arteritis o Takayasu i loaʻa i ke koko kiʻekiʻe (hypertension). He mea nui e kaohi i kēia. Inā ʻaʻole ʻoe e mālama i ke koko kiʻekiʻe, hiki i nā mea e like me kēia ke hana:

• Hahau.
• Maʻi puʻuwai.
• Ka hāʻule ʻana o nā puʻupaʻa.

Inā ʻoe e lawe i nā lāʻau lapaʻau e hoʻopau i kāu ʻōnaehana pale, e noʻonoʻo e loaʻa i kēia mau lāʻau lapaʻau e pale aku i nā maʻi:

• Lāʻau pale maʻi flū.
• Lāʻau pale niumonia.
• Lāʻau pale no ka Herpes zoster (Shingles).

He aha ka mea hiki i kekahi me ka arteritis ʻo Takayasu ke manaʻo?

ʻOiai ʻaʻohe lāʻau lapaʻau no ka arteritis o Takayasu, he maʻi ia e hiki ke mālama ʻia. Hoʻōla ka hapa nui o ka poʻe me ka maʻi me ka lāʻau lapaʻau. Eia nō naʻe, hiki i ka nui o ka poʻe ke lilo i kīnā i kekahi ʻano, a i ʻole kakaikahi loa, ma muli o ka maʻi. Hiki i nā hopena o ka maʻi ke loaʻa ka hopena koʻikoʻi i nā hana o kēlā me kēia lā. Ma kahi o ka hapalua o ka poʻe me ka arteritis o Takayasu e pono e hoʻololi i kā lākou hana. Eia nō naʻe, ma kahi o 25% o ka poʻe me ka maʻi e ola maʻamau. ʻO kekahi 25% i pono e hana i kekahi mau hoʻololi i kā lākou mau hana. Pono ka poʻe e noho ana me kēia maʻi mau e loaʻa nā nānā lapaʻau maʻamau a, inā pono, nā hoʻololi i kā lākou mau lāʻau lapaʻau. Pono nō hoʻi nā kauka e nānā i nā hopena ʻaoʻao o nā lāʻau lapaʻau a hana i nā hoʻāʻo koko. Hiki i kēia mau mea ke lilo i mau pilikia o ka arteritis o Takayasu:

• Ka hāʻule ʻana o ka puʻuwai.
• Hahau.
• Nā ʻūpā koko.
• He hōʻeha puʻuwai.

He maʻi lōʻihi ka maʻi Takayasu arteritis e ulu mālie ana. Pono ʻoe i ka lāʻau lapaʻau lōʻihi, pinepine me ka lāʻau lapaʻau. Ma nā ʻāina e like me ʻAmelika Hui Pū ʻIa a me Iapana, ma kahi o 3% o ka poʻe me ka maʻi Takayasu arteritis e make ana i loko o ka awelika o ʻelima mau makahiki o ka maʻi. Malia paha kēia no ka hiki i nā kauka ke ʻike mua i ka maʻi a mālama pono iā ia. Ma nā wahi ʻē aʻe o ka honua, hiki ke ʻoi aku ka ʻino o ka hopena ma muli o ka lohi o ka ʻike ʻana a me ka mālama ʻana a i ʻole ke komo ʻole ʻana i nā lawelawe olakino. Inā ʻaʻole mālama ʻia, hiki i ka maʻi Takayasu arteritis ke make.

Pehea wau e mālama ai i koʻu olakino?

He mea nui e mālama i kou ʻano a noho mau me kāu kauka i hiki iā ʻoe ke hopu i nā hōʻailona hou a i ʻole e ʻoi aʻe ana ka ʻino i ka wā mua.

Āhea wau e ʻike ai i ke kauka?

Inā hoʻi mai kāu mau hōʻailona Takayasu arteritis i ka wā a ma hope paha o ka mālama ʻana, e ʻike koke i kāu kauka. Inā ʻoe e hoʻolālā ana e hāpai, e kamaʻilio me kāu kauka e pili ana i ia mea. Hiki ke loaʻa kahi hāpai holomua me Takayasu arteritis, akā he mea nui e ʻike pehea e hoʻokele ai.

Āhea wau e hele ai i kahi Emergency Treatment Unit (ETU) ?

Inā loaʻa iā ʻoe kekahi o kēia mau hōʻailona, ​​e kelepona koke i ka 911 (ma Sri Lanka, e kelepona i ka 1990 Suwaseriya Ambulance Service a i ʻole e hele i ka haukapila kokoke loa):

• ʻEha ka umauma.
• Paʻakikī ka hanu ʻana.
• Ka naʻau palupalu.
• Nā hōʻailona o ka hāʻule puʻuwai (e laʻa, ʻeha nui o ka umauma e hoʻolaha ana i lalo o ka lima, ka hou ʻana, ka luaʻi).
• Nā hōʻailona o ka hahau ʻana (e.g., ke kūlou ʻana ma kekahi ʻaoʻao o ka maka, ka mae ʻana o ka lima, ka paʻakikī i ka ʻōlelo ʻana).

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

• Pehea ka lōʻihi e pono ai iaʻu e lawe i ka lāʻau lapaʻau no ka arteritis o Takayasu?
• ʻEhia pinepine e pono ai iaʻu e hele mai no nā hālāwai hoʻomaʻamaʻa?
• Hiki ke hoʻomalu ʻia koʻu kūlana me ke ʻoki ʻole ʻana?
• ʻEhia pinepine e pono ai iaʻu e hana i nā hoʻokolohua kiʻi?

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)

No ka mea, he maʻi lōʻihi a i ʻole "mau" ka Takayasu's Arteritis, pono ʻoe e ʻike pinepine i ke kauka. I ka hala ʻana o ka manawa, hiki i kāu mau hōʻailona ke hele mai ka mana i ka mana. No laila he mea nui e hoʻomau i ka launa pū me kāu kauka. Mai makaʻu e haʻi i kāu kauka inā ʻike ʻoe i kekahi mau loli i kou olakino. Makemake kāu kauka e ʻike e pili ana i ia mea, no ka mea, ʻo ia ka manawa e hiki ai iā ia ke kōkua iā ʻoe.

E hoʻomanaʻo, ʻoiai me kēia maʻi, me ka mālama pono ʻana a me ka hahai ʻana i nā ʻōlelo aʻoaʻo lapaʻau, hiki iā ʻoe ke ola i kahi ola maikaʻi. E ikaika!

ʻO ka arteritis o Takayasu, ka arteritis o Takayasu, ka maʻi pulseless, vasculitis, aorta, arteritis, maʻi aʻa koko, ke koko kiʻekiʻe, ka maʻi autoimmune