He mārō tonu ōu oho ake i te ata? He mamae rānei tō tuara mō te rā katoa? E rua ngā momo mate rumatiki e pā ana ki te tuaiwi, ā, he rite tonu ō rātou tohu. Ko tētahi ko te DISH (Diffuse Idiopathic Skeletal Hyperostosis) me tētahi ko te AS (Ankylosing Spondylitis) . He rite tonu ngā tohu o ngā mea e rua, ā, ka pōhēhē pea tātou i ētahi wā. Nō reira, i tēnei rā, me kōrero tātou mō ēnei mate e rua me te mārama ki te rerekētanga, ngā tohu, me pēhea te rongoā i a rātou.
He aha ngā pūtake o ēnei mate e rua?
Ki te kī māmā noa, e pā ana ēnei mate e rua ki ngā hononga me ngā hononga o te tuaiwi, engari he rerekē te āhua o tō rāua pānga ki a rātou.
He aha te DISH (Diffuse Idiopathic Skeletal Hyperostosis)?
Ko te DISH he āhuatanga e hangai ai ngā tote konupūmā ki roto i ngā hononga me ngā uaua e karapoti ana i tō tātou tuaiwi. Mā tēnei konupūmā ka mārō haere aua wāhi pērā i te wheua, me te mea kei te tupu he wheua hou. Kāore ngā tākuta e tino mōhio he aha te take. Engari e whakapono ana rātou ko te ira tangata, ko ngā āhuatanga taiao, ko te huinga rānei o ngā mea e rua ka whai wāhi pea.
Me pēhea te whanaketanga o te Ankylosing Spondylitis (AS)?
E whakaponohia ana he pānga nui tō ngā āhuatanga ira me te taiao ki te AS. Ko te hunga whai ira HLA-B27 he nui ake te mōrearea ki te pangia e te mate. Ka āwhina ēnei HLA i tō tātou pūnaha ārai mate ki te wehewehe i waenga i ō tātou ake pūtau me ngā whakaekenga ke. Heoi, kei te haere tonu ngā rangahau mō te āhua o te takenga mai o te AS e tēnei ira. I roto i te AS, ka whakaekea e te pūnaha ārai mate ngā hononga o tō tātou tuaiwi. Ka puta te mumura, ka puta te pakari me te mamae o te tuaiwi.
Ko wai te mea tino tūpono ka pāngia e ēnei mate?
He mārama ngā rerekētanga o te tau me ngā āhuatanga mōrearea mō te whanaketanga o ēnei mate e rua. Kia mārama ngāwari tātou i tēnei ripanga.
| Ngā mōhiohio | DISH (Te Hiperostosis Angaanga Idiopathic Horapa) | AS (Te Mate Pūngāwerewere o te Huka) |
|---|---|---|
| Tau e pāngia ana | He mea noa tēnei i roto i te hunga neke atu i te 50 tau te pakeke . | I te nuinga o te wā ka tīmata i te wā taitamariki , i waenga i te 15 ki te 30 tau. |
| Rōpū e pāngia ana | He nui ake te kitea i roto i ngā tāne i ngā wāhine. | He nui ake te kitea i roto i ngā tāne i ngā wāhine. |
| Ētahi atu āhuatanga mōrearea |
|
Ko te mea nui, he tokomaha ngā tāngata whai DISH kāore he tohu. He maha ngā wā ka kitea noa iho i te wā e tangohia ana he hihi-X mō tētahi atu take.
He aha ngā rerekētanga o ngā tohu?
Ahakoa ko te mamae o te tuara me te kōpiko o te hope ngā tohu matua o ngā mate e rua, he mārama ngā rerekētanga i waenga i te pūtake o te mamae, te āhua o te mamae, me ētahi atu tohu e haere tahi ana.
| Āhuatanga | E kitea ana i runga i te DISH | E kitea ana i roto i te AS |
|---|---|---|
| Te wāhi e puta ai te mamae | He maha ngā wā ka puta te mamae i te tuara o runga . | Ka tīmata te mamae i te tuara o raro . |
| Te pānga o te whakakori tinana | Kāore he pānga motuhake. | Ka heke te mamae me te kōpiko i te wā e whakakorikori tinana ana, e hikoi ana rānei. |
| Mamae tuara | Ka pā te mamae ki ngā wāhi pēnei i ngā pakihiwi, ngā tuke, ngā turi, me ngā rekereke. | Tērā pea ka pā te mamae ki ngā rara, ki ngā pakihiwi, ki ngā hope, ki ngā turi, ki ngā waewae rānei. |
| Ētahi atu āhuatanga motuhake | Ka uaua pea te horomi , te pāorooro rānei te reo i te tupu o ngā wheua i te kaki nā te pēhanga ki ngā io. | Ka whakaaturia ngā tohu e pā ana ki te tinana katoa. Hei tauira: - Te whakahekenga taumaha - Ngenge rawa - Ngā mate kiri (ngā ponana) - Mamae puku - Ngā panonitanga o te tirohanga (whero, mamae) |
Me pēhea te wehewehe me te tautuhi a te tākuta i ēnei mate e rua?
He uaua pea te tātaritanga i ēnei mate e rua. Mēnā he ruarua āu mō tō tātaritanga, kāore he he o te toro atu ki tētahi atu tākuta mō tētahi atu whakaaro.
Ka pātai tuatahi te tākuta ki a koe mō ō tohu me tō hītori hauora. Kātahi ka tirotirohia e ia tō tinana. Hei tāpiri, ka tonoa pea e ia ēnei whakamātautau.
Ngā Whakamātautau Toto
I roto i te AS, he maha ngā wā ka kitea he pai te whakamātautau mō te ira HLA-B27 . Tērā pea ka piki ake ngā whakamātautau e ine ana i te mumura i roto i te tinana, pērā i te pūmua C-reactive (CRP) me te ESR. Kāore ēnei e rerekē i te nuinga o te wā i roto i te DISH.
Ngā Whakamātautau Whakaahua
Ka tangohia e ēnei whakamātautau ngā pikitia o roto o te tinana, ka rapu hoki i ngā huringa o te tuaiwi me ngā hononga.
- X-ray: Rapua ngā panonitanga o ngā wheua.
- MRI (Whakaahua Āhua Aukume): Tikina he whakaahua taipitopito o te tuaiwi, ngā hononga, me ngā kiko honohono.
- Matawai CT (Tomography Rorohiko): Tikina he whakaahua tino taipitopito.
Ka taea te wehewehe i ngā mate e rua i runga i ngā mea e kitea ana i roto i ēnei whakamātautau.
- Mena kei a koe te AS: Te mumura me te pakari o ngā hononga sacroiliac ( sacroiliitis)Ka kitea. I ētahi wā ka honoa ngā tuaiwi tetahi ki tetahi, ā, he rite te āhua ki te pāpaka. Ka kiia tēnei he tuaiwi pāpaka .
- Mena kei a koe te DISH: Ka kitea e koe te kiko honohono e rere ana i mua o te tuaiwi e matotoru ana, e huri ana hei wheua. Engari kāore koe e kite i te āhua o te Sacroiliitis. Koinei tētahi o ngā āhuatanga matua e wehewehe ana i ngā mea e rua.
He aha ngā maimoatanga mō tēnei?
Kāore e taea te whakaora katoa i te AS me te DISH. Heoi, mā te maimoatanga tika, ka taea te whakahaere i ngā tohumate, ā, ka taea te noho ora noa. I roto i ēnei mate e rua, ka pēhia te tuaiwi, nō reira he nui te tūponotanga o ngā whati ahakoa he aituā iti noa iho. Nō reira, he mea tino nui kia tūpato.
Ngā maimoatanga noa mō ngā mea e rua:
- Te whakaora tinana me te whakakori tinana: He mea nui tēnei hei whakapakari i ngā uaua huri noa i te tuaiwi me te pupuri i te ngāwari o ngā hononga.
- Ngā rongoā mamae: Ka whakaitihia te mamae me te pupuhi e ngā NSAID (ngā rongoā anti-inflammatory kore-steroidal) pērā i te ibuprofen me te naproxen.
- Werohanga steroid: Mā te werohanga steroid tika ki ngā hononga mamae ka taea te whakaora mō te wā poto.
- Pokanga: Ehara tēnei i te maimoatanga noa, engari ki te pāngia koe e ngā tohumate kino kāore e taea te whakahaere mā ētahi atu maimoatanga, ka tūtohu pea tō tākuta kia pokanga koe.
Ngā maimoatanga motuhake mō te AS:
Haunga ngā maimoatanga kua whakahuatia ake nei mō te AS, he momo rongoā motuhake anō kei reira hei whakaiti i te mumura mā te whakarerekē i te mahi a te pūnaha ārai mate. Ko ēnei e kiia ana ko ngā DMARD (ngā rongoā ārai rūmātiki whakarerekē-mate) . Ko ētahi tauira ko:
- Interleukin-17 (IL-17) aukati (hei tauira, secukinumab, ixekizumab)
- Ngā aukati JAK (hei tauira, tofacitinib, upadacitinib)
- Ngā aukati TNF (hei tauira, adalimumab, etanercept, infliximab)
- Methotrexate
- Sulfasalazine
Mā tō tākuta e whakatau ko tēhea o ēnei rongoā te mea tino pai māu.
Karere Tangohia ki te Kāinga
- Ko DISH me AS ngā momo mate rumatiki e rua e pā ana ki te tuaiwi. Ahakoa he rite ngā tohu, he rerekē ngā take me ngā pānga.
- Ko te DISH te mea e pā ana ki ngā tāne neke atu i te 50 tau te pakeke, ā, he maha ngā wā kāore he tohu. Ka tīmata pea te AS i te wā taitamariki.
- Mā te wāhi o te mamae (DISH - i runga ake i te tuara, AS - i raro i te tuara) me te tauhohenga ki te korikori tinana (ka heke te mamae i te AS) ka āwhina i te wehewehe i waenganui i ngā mea e rua.
- Ka whakatauhia e tō tākuta he tātaritanga tika i runga i tō hītori hauora, whakamātautau, whakamātautau toto, me ngā whakamātautau whakaahua (ina koa ko ngā hihi-X me ngā MRI).
- Ahakoa kāore e taea te whakaora katoa i ēnei mate, mā te whakaora tinana, te rongoā, me ngā huringa āhua noho ka āwhina i a koe ki te whakahaere i ō tohumate me te noho angitu i te ao. Kōrero tonu ki tō tākuta mō tēnei.
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