Mob taub hau thiab teeb meem pom kev uas los nrog kev laus: Cia peb kawm txog Giant Cell Arteritis (GCA) lossis Temporal Arteritis?

Puas muaj ib tug neeg laus hauv koj tsev neeg, tej zaum koj niam, koj txiv, lossis koj pog, feem ntau yws txog mob taub hau? Koj lub qhov muag puas zoo li tsis muaj zog me ntsis tib lub sijhawm? Yog li qhov no yog ib yam dab tsi uas yuav tseem ceeb rau koj. Hnub no peb tab tom tham txog ib yam kab mob hu ua Giant Cell Arteritis (GCA) , yav tas los hu ua Temporal Arteritis , uas feem ntau cuam tshuam rau cov neeg laus. Tsis muaj dab tsi yuav ntshai, qhov tseem ceeb tshaj plaws yog kom paub txog qhov no.

GCA yog dab tsi? Vim li cas nws thiaj li txaus ntshai?

Hais yooj yim xwb, Giant Cell Arteritis (GCA) yog ib yam mob uas ua rau cov hlab ntsha loj hauv koj lub cev o (tshwj xeeb tshaj yog cov nyob rau hauv lub taub hau, caj dab, thiab caj npab). Cov kws kho mob kuj hu nws tias "vasculitis." Thaum cov hlab ntsha o li no, lawv cov phab ntsa tuab zuj zus, ua rau txoj kev mus rau cov ntshav nqaim zuj zus. Xav txog nws zoo li cov yeeb nkab dej uas raug thaiv kom tsis txhob ntws. Thaum cov ntshav ntws raug cuam tshuam li no, nws tuaj yeem ua rau cov kab mob tseem ceeb thiab cov nqaij uas cov hlab ntsha ntawd muab cov ntshav rau lawv.

Cov hlab ntsha ntawm lub cev, nyob rau ob sab ntawm koj lub hauv pliaj, muab ntshav rau koj lub taub hau, cov leeg ntawm lub puab tsaig, thiab cov hlab ntsha ntawm lub qhov muag, uas yog cov hlab ntsha uas muab kev pom kev rau koj. Yog tias GCA cuam tshuam rau cov hlab ntsha ntawm lub cev no, nws tuaj yeem ua rau muaj teeb meem loj, xws li dig muag . GCA kuj tseem tuaj yeem cuam tshuam rau lub aorta, cov hlab ntsha loj tshaj plaws hauv lub cev, thiab nws cov ceg. Qhov o ntawm lub aorta no hu ua aortitis, thiab tuaj yeem ua rau muaj teeb meem kev noj qab haus huv loj.

GCA tuaj yeem tshwm sim ua ke nrog lwm yam kab mob o, Polymyalgia Rheumatica, lossis PMR . Peb yuav tham ntxiv txog PMR tom qab.

Puas yog GCA yog ib qho mob hnyav tiag?

Yog, GCA yog ib qho mob uas tuaj yeem loj heev yog tias tsis kuaj pom thiab kho thaum ntxov . Qhov no yog vim:

• Koj lub qhov muag yuav puas lawm . Tej zaum koj yuav pom tsis meej tam sim ntawd, lossis koj yuav dig muag ib lossis ob lub qhov muag.
• Koj cov hlab ntsha tuaj yeem raug puas tsuaj . Piv txwv li, ib qho mob hu ua aneurysm, uas yog cov hlab ntsha uas loj zoo li lub npas thiab tawg, ua rau muaj kev pheej hmoo ntawm nws tawg.
• Lwm yam mob, xws li mob stroke lossis transient ischemic attacks (tseem hu ua "mini-strokes"), tuaj yeem tshwm sim.

Yog vim li ntawd nws thiaj li tseem ceeb heev uas yuav tsum paub txog cov tsos mob no.

GCA feem ntau yog dab tsi?

Txawm hais tias GCA yog ib hom kab mob vasculitis uas tshwm sim ntau tshaj plaws, nws yog ib qho kab mob tsis tshua muaj . Raws li cov ntaub ntawv hauv Tebchaws Meskas, tsuas yog 19-23 tus neeg ntawm 100,000 tus neeg raug kev txom nyem los ntawm tus kab mob no. Txawm hais tias tsis muaj cov ntaub ntawv tseeb hauv Sri Lanka, nws yog qhov zoo uas yuav tsum txhawj xeeb txog qhov no thaum cov pej xeem laus zuj zus.

Cov tsos mob ntawm GCA (Temporal Arteritis) yog dab tsi?

Cov tsos mob tseem ceeb thiab feem ntau ntawm GCA yog mob taub hau hnyav, tsis tu ncua uas zoo li mob ib lossis ob sab ntawm lub taub hau.Tab sis ntxiv rau qhov no, lwm cov tsos mob yuav tshwm sim:

• Mob thaum koj muab koj txhais tes tso rau ntawm lub taub hau lossis ob sab ntawm lub hauv pliaj (saum pob ntseg).
• Mob lub puab tsaig , tshwj xeeb tshaj yog thaum noj mov los yog zom.
• Teeb meem pom kev : Pom ob sab, pom tsis meej, lossis poob qhov muag tam sim ntawd rau lub sijhawm luv luv.
• Qaug zog .
• Ua npaws .
• Tsis qab los noj mov los yog poob phaus .
• Mob leeg : Mob xub pwg nyom, caj npab sab saud, lub duav, sab saud ntawm lub duav, nraub qaum qis, thiab lub pob tw.

Koj puas nco qab thaum kuv hais txog lwm yam mob uas feem ntau nrog GCA, Polymyalgia Rheumatica (PMR)? Qhov no kuj yog ib yam mob uas ua rau o. PMR ua rau mob hnyav thiab mob nqaij , tshwj xeeb tshaj yog nyob rau hauv xub pwg thiab lub duav. PMR kuj tuaj yeem tshwm sim ntawm nws tus kheej (nws yog qhov tshwm sim ntau dua rau PMR tshwm sim ntawm nws tus kheej dua li GCA). Txawm li cas los xij, kwv yees li 40-60% ntawm cov neeg uas muaj GCA kuj tseem yuav muaj PMR. Tsis tas li ntawd, 10-20% ntawm cov neeg uas muaj PMR ib leeg yuav tsim GCA tom qab hauv lub neej.

Dab tsi ua rau GCA?

Cov kws tshawb nrhiav tseem tsis tau paub qhov ua rau muaj GCA, tab sis ntau tus ntseeg tias nws yog tus kab mob autoimmune lossis autoinflammatory. Hais yooj yim, nws yog thaum koj lub cev tiv thaiv kab mob tawm tsam koj cov hlab ntsha noj qab haus huv tsis raug .

Kab mob no feem ntau tshwm sim rau cov neeg laus, yog li ntawd qee tus neeg xav tias nws muaj feem cuam tshuam nrog kev laus. Nws kuj tseem xav tias yog los ntawm cov yam ntxwv caj ces thiab cov yam ntxwv ib puag ncig (xws li cov kab mob uas cuam tshuam rau lub cev tiv thaiv kab mob).

Leej twg raug kev cuam tshuam ntau tshaj plaws los ntawm GCA?

Txawm hais tias leej twg los xij tuaj yeem mob GCA, cov neeg hauv qab no muaj feem yuav mob tshaj plaws:

• Cov Neeg Laus : GCA feem ntau cuam tshuam rau cov neeg hnub nyoog tshaj 50 xyoo. Qhov kev pheej hmoo ntawm kev mob yuav nce ntxiv thaum lawv laus zuj zus. Nws feem ntau tshwm sim rau cov neeg hnub nyoog ntawm 70 thiab 80 xyoo.
• Cov Poj Niam : Cov kab mob no feem ntau tshwm sim rau cov poj niam dua li cov txiv neej. Txawm li cas los xij, cov txiv neej muaj feem yuav dig muag ntau dua vim yog cov kab mob no.
• Cov Neeg Dawb : Kev tshawb fawb tau qhia tias GCA cuam tshuam rau cov neeg dawb ntawm Northern European keeb kwm ntau dua li lwm haiv neeg. Txawm li cas los xij, qhov no tsis tau txhais hais tias lwm haiv neeg tsis tuaj yeem muaj nws.

Yuav kuaj mob GCA li cas?

Yog tias koj muaj cov tsos mob ntawm GCA, koj tus kws kho mob yuav nug koj txog koj keeb kwm kev kho mob ua ntej thiab tom qab ntawd kuaj lub cev. Lawv yuav kuaj xyuas seb puas muaj lub plawv dhia tsis muaj zog hauv koj txhais tes thiab ob txhais ceg. Lawv kuj tseem yuav kuaj xyuas koj lub taub hau kom pom tias koj puas muaj mob hauv koj lub taub hau thiab seb cov hlab ntsha ntawm ob sab ntawm koj lub hauv pliaj puas o.

Cov kev kuaj twg siv los kuaj mob GCA?

Tus kws kho mob yuav xub kom kuaj ntshav ntau zaus kom paub seb koj lub cev o npaum li cas. Piv txwv li:

• (Tus nqi ntawm cov ntshav liab (Erythrocyte Sedimentation Rate)) (ESR)
• '(C-Reactive Protein)' (CRP)

Cov kev kuaj no tuaj yeem muab lub tswv yim rau koj txog qib kev o ntawm koj lub cev. Lawv kuj tseem tuaj yeem ntsuas koj cov hemoglobin, qhov chaw nqa oxygen ntawm koj cov qe ntshav liab, kom pom tias koj puas muaj ntshav tsis txaus.

Yog tias koj tus kws kho mob xav tias muaj GCA (Temporal Arteritis), lawv yuav hais kom kuaj lub plawv temporal artery ultrasound, uas yog lub tshuab ultrasound ntawm cov hlab ntsha hauv koj lub hauv pliaj. Los yog, lawv yuav hais kom kuaj lub plawv temporal artery biopsy . Qhov no suav nrog tus kws kho mob uas tau kawm tiav coj ib qho qauv me me ntawm cov hlab ntsha hauv koj lub hauv pliaj thiab xa mus rau tus kws kho mob kom kuaj xyuas hauv qab lub tshuab microscope. Qhov no yuav kuaj xyuas seb puas muaj cov cim qhia txog kev o (vasculitis) hauv cov hlab ntsha. Qhov no yog qhov kev kuaj tseem ceeb los paub meej tias muaj GCA.

Qee zaum cov kev ntsuam xyuas no kuj yuav tsum tau ua:

• Ib qho kev kuaj mob "(Computed Tomography)" lossis "(CT)"
• Kev tshuaj ntsuam xyuas Magnetic Resonance Imaging (MRI)
• Ultrasound ntawm cov hlab ntsha loj
• Ib qho kev kuaj mob '(Positron Emission Tomography)' lossis '(PET)'

Cov kev kho mob rau GCA (Temporal Arteritis) yog dab tsi?

Kev kho mob rau GCA yuav tsum pib sai li sai tau, tshwj xeeb tshaj yog kom tiv thaiv kev pom kev tsis pom kev .

Kev kho mob tseem ceeb yog ib hom tshuaj hu ua "glucocorticoid". Hom tshuaj uas siv ntau tshaj plaws yog "prednisone." Koj yuav pib nrog 40 txog 60 milligrams (mg) ib hnub (los ntawm qhov ncauj) thiab maj mam txo qhov koob tshuaj. Yog tias koj twb muaj teeb meem pom kev lossis tsis pom kev, koj tus kws kho mob yuav muab cov tshuaj "glucocorticoids" ntau rau koj los ntawm lub cannula uas muab tso rau hauv cov leeg ntshav ("(IV)")

Tseem Ceeb: Glucocorticoids yog cov tshuaj tseem ceeb heev rau kev tswj GCA. Txawm li cas los xij, cov tshuaj no tuaj yeem ua rau muaj qee qhov kev phiv, yog li koj tus kws kho mob yuav saib xyuas koj ze.

Cov tshuaj Glucocorticoids ua rau koj lub cev tiv thaiv kab mob tsis muaj zog, uas ua rau koj muaj feem yuav kis tau kab mob thiab ua rau lawv hnyav dua . Lawv kuj tseem tuaj yeem ua rau koj cov pob txha nyias , ua rau koj muaj feem yuav tawg.

Lwm cov kev mob tshwm sim uas yuav tshwm sim muaj xws li:

• Kab mob qhov muag
• Ntshav siab
• Ntshav qab zib ntau
• Tsis tsaug zog
• Kev hloov pauv ntawm lub siab
• Cov leeg tsis muaj zog thiab qaug zog, tshwj xeeb tshaj yog nyob rau hauv ob txhais ceg
• O, tshwj xeeb tshaj yog nyob rau hauv lub ntsej muag thiab ob txhais ceg
• Qhov hnyav nce

Thaum koj noj glucocorticoids, koj tus kws kho mob yuav kuaj xyuas koj cov pob txha ceev. Nws kuj tseem yuav pom zoo kom koj tawm dag zog, noj cov tshuaj calcium thiab vitamin D ntxiv, thiab tej zaum yuav noj tshuaj los tiv thaiv osteoporosis (pob txha poob) kom koj cov pob txha muaj zog.

Xyoo 2017, Lub Chaw Saib Xyuas Khoom Noj thiab Tshuaj hauv Tebchaws Meskas tau pom zoo rau cov tshuaj tshiab hu ua tocilizumab (Actemra®) rau kev kho mob GCA. Cov tshuaj no yog muab ua kev txhaj tshuaj hauv qab daim tawv nqaij lossis ua IV. Nws tuaj yeem pab txo qhov xav tau glucocorticoids. Txawm li cas los xij, tocilizumab muaj nws cov kev mob tshwm sim, uas koj tus kws kho mob yuav piav qhia rau koj.

Kuv yuav tsum mus ntsib kws kho mob thaum twg?

Yog tias koj muaj cov tsos mob ntawm GCA, cov cim qhia txog kev kis kab mob, lossis muaj cov tsos mob tshiab, mus ntsib koj tus kws kho mob tam sim ntawd . Kev mus ntsib koj tus kws kho mob tsis tu ncua thiab kuaj ntshav thiab luam theej duab tuaj yeem pab nrhiav pom kev rov qab mob dua ('rov qab mob dua') thaum ntxov.

Kuv yuav tsum nug tus kws kho mob li cas?

Koj tuaj yeem nug koj tus kws kho mob cov lus nug xws li:

• Koj pom zoo kom muaj kev kho mob dab tsi?
• Kuv yuav tsum paub txog cov kev mob tshwm sim dab tsi thaum lub sijhawm kho mob?
• Kuv ua tau dab tsi los txo cov kev phiv los ntawm kev kho mob?
• Tej yam teeb meem uas yuav tshwm sim ntawm tus mob no yog dab tsi?
• Kuv yuav saib xyuas kuv tus mob li cas?
• Cov tsos mob ntawm kev rov qab mob dua yog dab tsi?
• Kuv yuav tsum tiv tauj koj yog tias muaj cov tsos mob dab tsi?

Lub neej cia siab ntawm ib tus neeg uas muaj GCA yog dab tsi?

Tsis tau pom tias muaj GCA ua rau lub neej luv dua, tab sis muaj ntau yam uas cuam tshuam rau qhov no. Yog tias kuaj pom tus kab mob thiab kho thaum ntxov, cov txiaj ntsig zoo heev , thiab cov tsos mob pib zoo dua hauv ob peb hnub.

Txawm li cas los xij, yog tias tsis kho sai sai, GCA tuaj yeem ua rau muaj teeb meem loj heev xws li kev pom kev tsis pom kev mus tas li, aneurysms, thiab tuag tes tuag taw. Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum mus ntsib kws kho mob tam sim ntawd yog tias koj muaj cov tsos mob ntsig txog GCA.

Thaum kev kho mob pib lawm, qhov kev pheej hmoo tseem ceeb uas koj ntsib yog cov kev mob tshwm sim ntawm kev kho mob . Tsis tas li ntawd, txawm tias GCA kho tau zoo thaum pib los ntawm kev kho mob zoo, qee zaum nws tuaj yeem rov qab los ('rov qab mob dua') . Cov kws tshawb fawb tseem tsis tau paub tias vim li cas qhov no thiaj tshwm sim.

Kuv yuav saib xyuas kuv tus kheej li cas thaum kuv nyob nrog GCA?

Nyob nrog GCA tuaj yeem nyuaj. Txhawm rau tswj koj tus mob thiab tswj cov kev phiv ntawm glucocorticoids, sim ua cov no:

• Noj cov khoom noj zoo thiab muaj txiaj ntsig zoo : cov khoom xws li nqaij tsis muaj roj ntau, taum pauv, cov nplej tag nrho, txiv hmab txiv ntoo tshiab thiab zaub.
• Tau txais cov vitamin D thiab calcium txaus los tiv thaiv koj cov pob txha.
• Ua qee yam kev tawm dag zog tsawg kawg yog 30 feeb hauv ib hnub.
• Tau tsawg kawg yog xya mus rau yim teev ntawm kev pw tsaug zog zoo txhua hmo.
• Noj cov tshuaj uas tau muab rau koj raws sijhawm .
• Mus ntsib koj tus kws kho mob tsis tu ncua .
• Ua cov kauj ruam los tiv thaiv koj tus kheej ntawm kev kis kab mob .

Thaum kuv muaj GCA, kuv yuav tsum zam tej yam dab tsi?

Yog tias koj muaj GCA, nws yog qhov zoo tshaj kom tsis txhob ua cov no:

• Cov yam uas ua rau koj muaj feem yuav mob : Vim tias cov tshuaj rau GCA ua rau koj lub cev tiv thaiv kab mob tsis muaj zog, koj yuav muaj feem yuav kis tau kab mob ntau dua. Nug koj tus kws kho mob txog lwm txoj hauv kev los txo koj txoj kev pheej hmoo ntawm kev kis kab mob, xws li zam kev mob, ntxuav koj txhais tes ntau zaus, thiab nyob deb ntawm cov neeg mob.
• Haus Luam Yeeb : Kev haus luam yeeb tuaj yeem ua rau koj muaj feem yuav mob GCA. Kev noj qab haus huv ntawm koj cov hlab ntsha yuav zoo dua thaum koj tso kev haus luam yeeb tseg, uas yuav pab tau koj mus tas li.
• Kev haus dej cawv : Cawv tuaj yeem cuam tshuam tsis zoo rau kev noj qab haus huv ntawm koj lub plawv thiab cov hlab ntsha. Nws kuj tseem tuaj yeem ua rau cov pob txha poob sai dua thiab cuam tshuam nrog cov tshuaj uas koj noj rau koj tus mob.

Qee cov ntsiab lus tseem ceeb heev (Cov Lus Qhia Coj Mus Tsev)

Kab mob Giant Cell Arteritis (yav tas los hu ua Temporal Arteritis) yog ib yam mob uas nyuaj heev. Txawm li cas los xij, yog tias koj raug kuaj pom thaum ntxov thiab mus ntsib kws kho mob tsis tu ncua, koj tuaj yeem muaj qhov tshwm sim zoo dua . Cov tsos mob thiab cov kev phiv ntawm kev kho mob tuaj yeem cuam tshuam rau koj txoj kev noj qab haus huv ntawm lub hlwb, koj txoj haujlwm, thiab ntau yam ntawm koj lub neej. Tab sis koj tsis yog tib leeg xwb. Thov koj tus kws kho mob pab koj nrhiav ib pawg neeg txhawb nqa nrog cov neeg uas tau dhau los ntawm cov xwm txheej zoo sib xws. Kev sib qhia koj cov kev paub thiab cov lus qhia rau lwm tus tuaj yeem yog qhov ua rau koj xis nyob.

Nco ntsoov, yog tias koj muaj tej yam tsos mob txawv txawv xws li mob taub hau, mob lub puab tsaig, lossis teeb meem pom kev (tshwj xeeb tshaj yog tias koj muaj hnub nyoog tshaj 50 xyoo), tsis txhob tsis quav ntsej thiab nrhiav kev pab kho mob tam sim ntawd. Kev kho mob sai sai tuaj yeem tiv thaiv tau cov teeb meem loj.

Kab mob Giant Cell Arteritis, Kab mob Temporal Arteritis, GCA, Mob taub hau, Pom kev tsis meej, Kab mob ntshav o, Kev noj qab haus huv rau cov neeg laus, Polymyalgia Rheumatica, Prednisone, Kab mob vasculitis