Koj puas xav tias koj tsis muaj zog thiab? Tej zaum qhov no yog ib yam mob hu ua myopathy!

Puas muaj tej lub sij hawm koj xav tias koj ob txhais ceg tsis muaj zog thiab nkees? Koj puas pom tias nws nyuaj rau ua tej yam yooj yim xws li sawv ntawm lub rooj zaum, tsa ib yam khoom hnyav, lossis txhuam koj cov plaub hau? Yog tias koj xav tias koj cov leeg nqaij tsis muaj zog yam tsis muaj laj thawj, tsis txhob tsuas yog tsis quav ntsej nws li ib txwm muaj. Tej zaum qhov ua rau muaj cov tsos mob no yog ib qho mob hu ua 'myopathy', uas peb yuav tham txog hnub no. Tsis txhob txhawj, peb yuav tham txog qhov no hauv txoj kev yooj yim uas koj tuaj yeem nkag siab.

Myopathy yog dab tsi? Hais yooj yim xwb...

Mob myopathy, hais yooj yim xwb, yog ib pawg kab mob uas cuam tshuam rau cov leeg nqaij uas txuas rau peb cov pob txha. Cov kab mob no ua rau peb cov leeg nqaij tsis muaj zog thiab ua rau lawv tsis muaj zog. Ib yam li lub cav tsheb tsis muaj zog, nws nyuaj rau tsav tsheb, thaum cov leeg nqaij tsis muaj zog, nws nyuaj rau peb lub cev ua haujlwm txhua hnub.

Puas muaj ntau hom mob myopathy sib txawv?

Yog, myopathies muaj peev xwm muab faib ua ntau txoj kev sib txawv. Lawv feem ntau muab faib ua ob pawg: cov myopathies uas tau txais los ntawm noob caj noob ces thiab cov myopathies uas tau txais los ntawm noob caj noob ces. Cia peb saib txhua hom no.

Cov Myopathies uas tau txais los ntawm noob caj noob ces yog dab tsi?

Cov no yog hom myopathy uas tshwm sim los ntawm kev txais cov noob caj noob ces tsis zoo uas muaj nyob hauv peb lub cev thaum yug los, feem ntau los ntawm peb niam lossis txiv.

• Cov kab mob congenital myopathies:

Cov tsos mob feem ntau pib thaum yug los lossis thaum yau. Txawm li cas los xij, lawv qee zaum tuaj yeem tshwm sim thaum lawv tseem hluas lossis tom qab ntawd. Ib qho tshwj xeeb ntawm hom no yog tias qhov tsis muaj zog tsis yog tsuas yog nyob rau ntawm cov leeg nqaij ze ntawm lub cev, tab sis tuaj yeem cuam tshuam rau tag nrho cov leeg nqaij ntawm lub cev, thiab tus kab mob feem ntau tsis loj hlob.

• Cov tsos mob ntawm mitochondrial myopathies:

Peb cov hlwb muaj cov chaw tsim khoom me me hu ua mitochondria uas tsim lub zog. Hom mob myopathy no yog tshwm sim los ntawm qhov tsis zoo hauv cov mitochondria no. Ntxiv rau qhov tsis muaj zog ntawm cov leeg nqaij, cov mob no kuj tseem tuaj yeem cuam tshuam rau lwm cov kab ke hauv lub cev, xws li lub plawv, lub hlwb, thiab lub plab zom mov. Lawv tuaj yeem tshwm sim los ntawm kev hloov pauv caj ces, txawm tias muaj keeb kwm tsev neeg lossis tsis muaj.

• Cov teeb meem metabolic myopathy:

Qhov mob myopathy no yog tshwm sim los ntawm qhov tsis zoo ntawm cov noob caj noob ces uas tsim cov enzymes uas pab cov leeg nqaij ua haujlwm thiab txav mus los kom zoo. Nws tuaj yeem ua rau qaug zog thaum lub sijhawm ua si, mob ntawm lub xub pwg nyom thiab lub duav thaum ua si, lossis mob hu ua rhabdomyolysis, uas cov leeg nqaij tawg yam tsis raug mob. Qee zaum cov tsos mob tuaj yeem tuaj thiab ploj mus, nrog rau cov leeg nqaij tsis muaj zog thiab tom qab ntawd rov qab mus rau qhov qub.

• Cov leeg nqaij dystrophy:

Hauv cov rooj plaub no, cov leeg nqaij maj mam qaug zog thiab atrophy vim muaj qhov tsis zoo lossis tsis muaj cov protein txhawb nqa uas cov leeg nqaij xav tau. Hauv txhua rooj plaub, cov caj npab thiab/lossis ob txhais ceg raug cuam tshuam rau ntau qib. Qee zaum cov leeg nqaij ntawm lub qhov muag lossis lub ntsej muag kuj tuaj yeem raug cuam tshuam.

Cov kab mob myopathies uas tau txais yog dab tsi?

Cov no yog cov hom mob myopathies uas tshwm sim tom qab hauv lub neej. Lawv tuaj yeem tshwm sim los ntawm ntau yam, suav nrog lwm yam kab mob, kev kis kab mob, kev raug tshuaj, thiab kev tsis sib npaug ntawm cov electrolyte hauv lub cev.

• Kab mob autoimmune / inflammatory myopathy:

Qhov uas tshwm sim hauv qhov no yog tias peb lub cev lub cev tiv thaiv kab mob tawm tsam peb cov leeg nqaij. Yog li ntawd, cov leeg nqaij ua haujlwm tsis zoo. Nws zoo li peb tus kheej tiv thaiv tawm tsam lawv tus kheej.

• Toxic myopathy:

Tus mob no tshwm sim thaum muaj tshuaj lom lossis tshuaj cuam tshuam cov qauv lossis kev ua haujlwm ntawm cov leeg.

• Cov tshuaj lom: Cawv, toluene (ib yam khoom uas yaj tau yooj yim pom muaj nyob rau hauv cov khoom xws li xim uas qee tus neeg nqus pa kom qaug cawv).
• Cov Tshuaj: Cov tshuaj Checkpoint inhibitor immunotherapy (piv txwv li, pembrolizumab, nivolumab), corticosteroids (piv txwv li, prednisone), cov tshuaj txo cov roj cholesterol (statins), amiodarone, colchicine, chloroquine, cov tshuaj antivirals thiab protease inhibitors rau kev kis tus kab mob HIV, omeprazole.

• Cov kab mob endocrine myopathy:

Tus mob no tshwm sim thaum cov tshuaj hormones hauv peb lub cev ua haujlwm cuam tshuam rau cov leeg nqaij.

• Cov qog thyroid: Txawm hais tias cov tshuaj hormones thyroid qis (hypothyroidism) feem ntau tshwm sim, cov teeb meem kuj tuaj yeem tshwm sim vim yog cov tshuaj hormones thyroid siab (hyperthyroidism).
• Parathyroid caj pas: Hyperparathyroidism ua rau cov calcium ntau ntxiv hauv cov ntshav.
• Cov qog adrenal: 'Addison's kab mob' thiab 'Cushing's syndrome'.

• Cov kab mob myopathies uas kis tau los ntawm kev sib kis:

Ntau yam kab mob sib kis tuaj yeem cuam tshuam rau kev ua haujlwm ntawm cov leeg nqaij.

• Cov kab mob kis: HIV, mob khaub thuas, Epstein-Barr.
• Kab mob bacterial: 'bacterial pyomyositis'.
• Kab mob Lyme.
• Cov kab mob parasitic: 'trichinosis', 'toxoplasmosis', 'cysticercosis'.
• Cov kab mob fungal: Candida, Coccidiomycosis.

• Kev tsis sib npaug ntawm cov electrolyte:

Kev nce lossis txo qis ntawm cov electrolytes tseem ceeb hauv peb lub cev tuaj yeem cuam tshuam rau kev ua haujlwm ntawm cov leeg nqaij.

• Potassium: txo qis ('hypokalemia'), nce ('hyperkalemia').
• Magnesium: Ntau ntxiv ('Hypermagnesemia').

• Mob hnyav myopathy hauv chav kho mob hnyav:

Qhov no yog ib qho mob uas cuam tshuam rau cov ceg thiab cov leeg nqaij ua pa ntawm cov neeg uas mob hnyav thiab tau txais kev kho mob hauv chav saib xyuas mob hnyav (ICU) . Nws tuaj yeem tshwm sim los ntawm kev tsis txav mus los ntev lossis los ntawm kev siv cov tshuaj so cov leeg, corticosteroids, thiab cov tshuaj pw tsaug zog uas siv thaum lub sijhawm kho mob.

Leej twg muaj feem yuav mob myopathy ntau dua? Tus mob no feem ntau tshwm sim li cas?

Myopathy yeej tuaj yeem tshwm sim rau txhua tus neeg, tab sis qee tus neeg muaj kev pheej hmoo siab dua me ntsis.

Tej yam uas yuav ua rau muaj kev pheej hmoo ntxiv:

• Yog tias ib tug neeg hauv tsev neeg muaj tus kab mob myopathy, ces muaj feem ntau yuav tau txais tus kab mob no los ntawm noob caj noob ces.
• Ua txiv neej. Qee hom mob myopathy kis tau los ntawm X chromosome, yog li ntawd lawv yuav cuam tshuam rau cov txiv neej ntau dua li cov poj niam. Txawm li cas los xij, cov hom mob myopathy uas muaj txij thaum yug los uas kis tau los ntawm lwm cov chromosomes cuam tshuam rau txhua tus neeg sib npaug.
• Muaj kab mob autoimmune, metabolic, lossis endocrine.
• Kev raug tshuaj lossis tshuaj lom (saib ntu ntawm kev mob myopathy uas peb tau tham ua ntej).

Qhov tshwm sim ntawm tus kab mob myopathy sib txawv nyob ntawm hom kab mob. Piv txwv li, tus kab mob myopathy uas tshwm sim tom qab hauv lub neej:

• Cov kab mob inflammatory thiab endocrine myopathies feem ntau tshwm sim ntau dua li lwm hom, thiab lawv feem ntau tshwm sim rau cov poj niam dua li cov txiv neej.
• Muaj li ntawm 9 txog 32 tus neeg ntawm txhua 100,000 tus neeg uas muaj mob inflammatory myopathies.
• Nruab nrab ntawm 25% thiab 79% ntawm cov neeg laus uas muaj mob hypothyroidism yuav muaj cov tsos mob ntsig txog cov leeg nqaij, tab sis qhov tshwm sim ntawm cov mob myopathy pom tseeb yuav qis li 10%.

Cov kab mob myopathies uas tshwm sim los ntawm cov leeg nqaij feem ntau yog cov leeg nqaij dystrophies, uas feem ntau tshwm sim ntau dua rau cov txiv neej.

• Duchenne's thiab Becker's muscular dystrophies yog cov hom mob uas pom ntau tshaj plaws, cuam tshuam txog li 7 tus neeg ntawm 100,000 tus neeg thoob ntiaj teb.
• Cov kab mob Mitochondrial cuam tshuam rau ib tus neeg hauv 5,000 tus neeg, thiab feem ntau ntawm cov no cuam tshuam rau cov leeg nqaij pob txha.
• Lwm hom mob myopathies uas muaj txij thaum yug los tsis tshua muaj.

Yog li, cov tsos mob ntawm myopathy yog dab tsi?

Ntau hom mob myopathy muaj ntau yam tsos mob uas pom ntau. Cov no yog:

• Cov leeg tsis muaj zog.Tshwj xeeb tshaj yog cov leeg ntawm lub xub pwg nyom, caj npab sab saud, thiab ncej puab (cov no yog cov uas raug cuam tshuam ntau tshaj plaws thiab hnyav tshaj plaws).
• Cov leeg nqaij ntswj, mob nqaij, thiab mob ntswj.
• Xav tias nkees sai thaum tawm dag zog lossis ua ib txoj haujlwm me me.
• Xav tias tsis muaj sia nyob thiab tsis muaj zog.

Myopathy zoo li cas tiag?

Hauv ntau yam mob myopathies, cov leeg nqaij ntawm ob sab ntawm lub cev (symmetrical) tsis muaj zog sib npaug. Cov leeg nqaij ze rau nruab nrab ntawm lub cev (proximal muscles), xws li xub pwg nyom, caj npab sab saud, lub duav, thiab lub duav, raug cuam tshuam tshwj xeeb. Yog li ntawd, koj yuav muaj cov tsos mob xws li:

• Nyuaj ua tej yam txhua hnub xws li da dej, hnav khaub ncaws, thiab txhuam koj cov plaub hau.
• Nyuaj siab sawv ntawm lub rooj zaum, nce ntaiv, lossis ua tej haujlwm uas yuav tsum tau tsa tes saum koj lub taub hau (piv txwv li, hloov lub teeb ntawm lub qab nthab).
• Zoo li cov leeg nqaij co thiab ntswj.
• Cov leeg nqaij yuav nkees sai thaum koom nrog ua ib yam dab tsi.
• Ua pa nyuaj thaum lub sijhawm ua si.

Feem ntau nws tsis cuam tshuam rau cov leeg ntawm xib teg thiab xib teg.

Lwm cov tsos mob sib txawv nyob ntawm hom myopathy.

• Cov leeg nqaij tsis muaj zog yuav yog tas li (tsis loj hlob zuj zus) lossis maj mam loj hlob zuj zus. Hauv qee cov kab mob, cov leeg nqaij tsis muaj zog tuaj yeem tuaj thiab mus, thaum lwm lub sijhawm yuav muaj zog ib txwm muaj.
• Kev loj hlob qeeb ntawm kev txawj txav mus los (piv txwv li kev taug kev, dhia, nce ntaiv, tuav ib rab diav lossis cwj mem) rau cov menyuam yaus.
• Tsis muaj peev xwm sib tw nrog lwm tus menyuam thaum ua si kis las lossis ua si sab nraum zoov (piv txwv li, ntes pob).
• Teeb meem nrog cov leeg nqaij uas pab nqos thiab hais lus. Qhov no tuaj yeem ua rau zaub mov daig thiab hais lus tsis meej.

Yog tias kuv xav tias kuv muaj mob myopathy, kuv yuav tsum ua li cas?

Yog koj muaj cov tsos mob no, koj yuav tsum xub nrog koj tus kws kho mob tham ua ntej. Nyob ntawm seb koj cov tsos mob li cas, nws yuav xa koj mus rau ib tus kws tshwj xeeb, xws li kws kho mob hlwb lossis kws kho mob pob qij txha.

Yuav kuaj mob myopathy li cas?

Koj tus kws kho mob yuav nug koj txog koj keeb kwm kev mob nkeeg, seb puas muaj leej twg hauv koj tsev neeg tau muaj cov mob zoo sib xws, koj noj tshuaj dab tsi, thiab koj cov tsos mob. Tom qab ntawd lawv yuav kuaj koj lub cev. Lawv yuav kuaj koj daim tawv nqaij, koj cov reflexes, koj cov leeg nqaij muaj zog, koj lub cev sib npaug, thiab koj qhov kev xav.

Cov hom kev kuaj mob uas tus kws kho mob yuav xaj tau:

• Kev kuaj ntshav:
• Hauv qee qhov myopathies, cov leeg nqaij enzyme xws li creatine kinase (CK) lossis aldolase yuav nce ntxiv vim yog kev tawg ntawm cov leeg nqaij.
• Cov theem electrolyte xws li sodium, magnesium, potassium, calcium, thiab phosphorus.
• Kev kuaj mob rau cov kab mob autoimmune: Piv txwv li, `Antinuclear Antibodies (ANA), `Rheumatoid Factor', `Sedimentation Rate' thiab `C-reactive protein'.
• Kev kuaj mob ntawm cov qog endocrine: piv txwv li, cov theem ntawm cov tshuaj hormones thyroid.
• Kev kuaj hluav taws xob ntawm lub cev (Electromyography - EMG) thiab kev tshawb nrhiav txog kev xa xov ntawm cov hlab ntsha: Cov kev kuaj no ntsuas hom thiab qhov dav ntawm kev puas tsuaj ntawm cov leeg nqaij los ntawm kev ntsuas seb hluav taws xob mus los ntawm cov hlab ntsha li cas thiab ntxig cov koob me me rau hauv cov leeg.
• Kev kuaj duab magnetic resonance imaging (MRI) ntawm cov leeg .
• Kev kuaj noob caj noob ces.
• Kev kuaj cov leeg nqaij: Qhov no suav nrog kev phais tshem tawm ib daim nqaij me me rau kev kuaj.

Yuav kho tus mob myopathy li cas?

Thaum twg koj paub meej tias koj muaj hom mob myopathy li cas lawm, koj tus kws kho mob yuav tsim ib txoj kev npaj kho mob uas haum rau koj cov tsos mob.

Feem ntau cov kev kho mob suav nrog kev kho lub cev, kev kho mob ua haujlwm, thiab qee hom kev tawm dag zog . Lwm cov kev kho mob yog tshwj xeeb rau hom myopathy. Feem ntau, feem ntau cov myopathies uas tau txais tuaj yeem tswj tau zoo, txo qhov tsis muaj zog thiab cov tsos mob. Qee cov myopathies uas yug los muaj kev kho mob tshwj xeeb uas tuaj yeem qeeb qhov kev loj hlob ntawm tus kab mob. Tam sim no, tsis muaj kev kho mob tshwj xeeb rau feem ntau cov myopathies uas yug los, tab sis kev kho lub cev thiab qee hom kev tawm dag zog tuaj yeem pab tau.

Cov kab mob myopathies uas cuam tshuam nrog kev o thiab autoimmune

Lub hom phiaj ntawm kev kho mob rau cov no yog kom txo qhov o thiab lub cev txoj kev tiv thaiv kab mob autoimmune. Cov kev kho mob rau cov myopathies no suav nrog:

• Cov tshuaj kho mob tiv thaiv kab mob/tshuaj tiv thaiv kab mob: Piv txwv li, methotrexate, cyclosporine, tacrolimus, azathioprine, mycophenolate, rituximab, thiab cov tshuaj immunoglobulin txhaj rau hauv cov hlab ntsha (IVIg) lossis hauv qab daim tawv nqaij (SubQIg).
• `Corticosteroids`: Piv txwv li `prednisone` los yog `methylprednisolone`.

Cov kab mob myopathies uas tau txais los ntawm noob caj noob ces thiab noob caj noob ces

Ntau yam kab mob myopathies uas muaj txij thaum yug los thiab cov kab mob caj ces tsis muaj kev kho mob tshwj xeeb lossis kho tau tag nrho.Kev tswj hwm feem ntau yog los ntawm kev tswj cov tsos mob thiab ntau yam kev kho mob. Muaj ntau qhov kev sim tshuaj kho mob tab tom ua nyob rau hauv ntau qhov chaw tshawb fawb txog kev kho mob thiab kev kho mob gene.

Cov mob hu ua Duchenne muscular dystrophy thiab Pompe kab mob tuaj yeem kho tau nrog cov tshuaj tshwj xeeb.

Lwm yam mob myopathies uas tau txais

Cov kws kho mob kho cov kab mob myopathies uas tshwm sim los ntawm endocrine, tshuaj lom, thiab kev kis kab mob los ntawm kev kho cov kab mob uas ua rau muaj myopathy. Cov kab mob toxic myopathies raug kho los ntawm kev tso tseg cov tshuaj uas ua rau muaj teeb meem (piv txwv li, cawv, toluene) lossis tshuaj (piv txwv li, statins). Cov tsos mob ntawm cov leeg nqaij uas tshwm sim los ntawm cov kab mob bacteria, viruses, lossis lwm yam kab mob feem ntau zoo dua thaum kho cov kab mob ncaj qha nrog cov tshuaj tua kab mob.

Kuv yuav ua li cas thiaj saib xyuas kuv txoj kev noj qab haus huv?

Txawm hais tias myopathy yog congenital, acquired, lossis ntev (mob ntev), muaj tej yam koj ua tau los tswj koj txoj kev noj qab haus huv thiab tswj tus mob. Cov no suav nrog:

• Noj zaub mov zoo thiab sib npaug. Noj ntau yam txiv hmab txiv ntoo thiab zaub sib txawv rau hauv koj cov zaub mov noj.
• Ua kom koj lub cev nquag thiab ua kom lub plawv dhia zoo. Nyob ntawm seb koj muaj hom mob myopathy li cas, tej zaum yuav qhia kom koj tsis txhob tsa qee yam hnyav. Yog li ntawd, nrog koj tus kws kho mob tham ua ntej pib ua ib qho kev tawm dag zog twg.
• Tswj koj qhov hnyav kom noj qab nyob zoo.
• Yog koj muaj pob khaus ntawm daim tawv nqaij los ntawm dermatomyositis, tiv thaiv koj daim tawv nqaij ntawm lub hnub. Qhov no tuaj yeem ua rau pob khaus hnyav dua. Hnav khaub ncaws tiv thaiv thiab lub kaus mom thaum twg ua tau. Tsis txhob hnov ​​​​​​qab siv tshuaj pleev thaiv hnub uas muaj tsawg kawg SPF 30 ua ntej tawm mus sab nraum zoov.
• Yog koj nyuaj nqos, noj cov khoom noj mos los yog cov khoom noj ib nrab khov. Koj tuaj yeem zom koj cov khoom noj. Yog tias koj yog ib tus neeg pw hauv txaj, noj thaum zaum saum txaj.
• Noj tag nrho cov tshuaj uas tau sau tseg raws sijhawm.
• Yog tias pom zoo kom siv kev kho mob xws li kev kho lub cev, kev kho mob ua haujlwm, lossis kev kho kev hais lus, koom nrog lawv.

Nco ntsoov, vim muaj ntau hom mob myopathy, koj tus kws kho mob yuav tsum tsim ib txoj kev npaj kho mob uas tshwj xeeb rau koj hom mob myopathy thiab koj cov tsos mob. Yog li ntawd, nws tseem ceeb heev uas yuav tsum ua raws li nws cov lus qhia kom meej. Tsis tas li ntawd, ua tib zoo saib xyuas koj lub cev. Sau txhua qhov kev hloov pauv hauv koj tus mob lossis qhov hnyav ntawm koj cov tsos mob. Mus ntsib koj tus kws kho mob raws sijhawm (lossis sai dua yog tias koj pom muaj kev hloov pauv). Ua li no, koj tuaj yeem hloov pauv rau koj txoj kev npaj kho mob sai li sai tau thaum cov tsos mob tshwm sim.

Thaum kawg, tej yam tseem ceeb tshaj plaws uas yuav tsum nco ntsoov

Myopathy tsis yog ib yam dab tsi uas yuav tsum ntshai, tab sis nws tsis yog ib yam mob uas yuav tsum tsis quav ntsej.

• Yog koj cov leeg nqaij tsis muaj zog, mob, lossis qaug zog tas li, nco ntsoov mus ntsib kws kho mob.
• Muaj ntau hom myopathy, yog li ntawd, kev kuaj mob kom raug yog qhov tseem ceeb heev.
• Muaj kev kho mob thiab kev tswj hwm rau ntau hom myopathy.
• Los ntawm kev ua raws li koj tus kws kho mob cov lus qhia, noj cov tshuaj uas tau sau tseg, thiab ua neej noj qab nyob zoo, koj tuaj yeem ua neej zoo nrog tus mob no.

Vam tias cov ntaub ntawv no yuav pab tau koj. Yog koj muaj lus nug ntxiv, tsis txhob ntshai tham nrog kws kho mob txhua lub sijhawm.

` Myopathy, cov leeg tsis muaj zog, mob leeg, cov kab mob caj ces, cov kab mob autoimmune, cov tsos mob ntawm cov leeg, kev kho mob myopathy