Kodi inunso muli ndi zizindikiro izi? Tiyeni tikambirane za sarcoidosis!

Kodi nthawi zina mumamva ngati pali chinthu chachilendo m'thupi lanu, koma simungathe kuchidziwa bwino? Pali matenda ena omwe amabuka m'thupi lanu nthawi ndi nthawi, koma ngati mukuwadziwa bwino, mutha kuwaletsa. Sarcoidosis ndi imodzi mwa matenda amenewa. Lero, tikambirana izi mosavuta, m'njira yomwe mungamvetse.

Kodi Sarcoidosis ndi chiyani?

Mwachidule, sarcoidosis ndi matenda omwe chitetezo cha mthupi lanu chimagwira ntchito mopitirira muyeso ndikupanga ziphuphu zazing'ono m'mbali zosiyanasiyana za thupi. Ziphuphu zimenezi zimatchedwa granulomas . Zizindikiro zimadalira komwe granulomas izi zimapangidwira komanso kukula kwake. Nthawi zina sipangakhale zizindikiro konse, kapena zimatha kuyambira kusapeza bwino pang'ono mpaka zizindikiro zoopsa. Choopsa kwambiri ndichakuti nthawi zina granulomas izi zimatha kuyambitsa zipsera za minofu, zotchedwa fibrosis , zomwe zingawononge mapapo kwamuyaya, mwachitsanzo.

Ma granuloma amenewa amatha kupangika kulikonse m'thupi. Koma amapezeka kwambiri m'mapapo ndi m'malo olumikizirana mafupa . Kuphatikiza apo, amathanso kupangika pakhungu, m'maso, ndi minofu, zomwe zimayambitsa zizindikiro.

Kodi granuloma ndi chiyani?

Kodi mungaganizire za nkhondo yaying'ono yomwe ikuchitika m'thupi lanu? Granuloma ndi imeneyo basi. Chitetezo chanu cha mthupi chimaganiza kuti china chake choipa chalowa m'thupi lanu. Choncho, maselo oyera amagazi amasonkhana mozungulira chinthu choipacho, n’kuchizungulira, n’kuchipatula ku thupi lonse. Zili ngati kugwira mdani. Maselo oyera amagazi ogwidwawa amapanga minofu ya ulusi mozungulira. Ndicho chifukwa chake granuloma imamva ngati chotupa chaching'ono mukamachikhudza.

Ndani amene akukhudzidwa kwambiri ndi vutoli?

Sarcoidosis ingakhudze aliyense, koma anthu ena amakhala ndi mwayi waukulu woidwala. Mwachitsanzo, vutoli limapezeka kwambiri mwa anthu akuda kuposa oyera. Limakhudzanso akazi pang'ono kuposa amuna. Nthawi zambiri limapezeka mwa anthu azaka zapakati pa 25 ndi 40 .

Imeneyi si matenda obadwa nawo. Izi zikutanthauza kuti, si matenda omwe amapatsirana mwachindunji kuchokera kwa mayi kupita kwa bambo. Komabe, ngati wachibale wapafupi m'banja mwanu (makolo, ana, abale ndi alongo) ali ndi vutoli, inunso muli pachiwopsezo chotenga matendawa.

Sarcoidosis imaonedwa kuti ndi matenda osowa kwambiri . Mwachitsanzo, ku United States, nthawi iliyonse odwala amakhala osakwana mazana awiri zikwi.

Kodi zizindikiro za sarcoidosis ndi ziti?

Monga ndanenera kale, zizindikiro zimadalira komwe granulomas imapangidwira m'thupi. Anthu ambiri amakumana ndi zizindikiro m'mapapo. Komabe, zizindikirozi zimatha kuwonekera kulikonse pathupi, pakhungu, m'maso, m'malo olumikizirana mafupa. Nthawi zina pangakhale zizindikiro wamba, monga kumva kufooka ndi kutopa, kapena sipangakhale zizindikiro konse.

Zizindikiro zomwe zimawonedwa kawirikawiri:

• Malungo
• Kutopa nthawi zonse, kutopa
• Kupweteka kwa mafupa
• Kupweteka kwa minofu kapena kufooka
• Thukuta usiku
• Ma lymph nodes otupa
• Kuchepetsa thupi popanda chifukwa
• Kupanga miyala ya impso

Zizindikiro zokhudzana ndi mapapo:

• Chifuwa (nthawi zambiri chifuwa chouma)
• Kuvuta kupuma, kupuma movutikira (dyspnea)
• Kupweteka pachifuwa
• Kupuma movutikira (kuimba mluzu)

Zizindikiro zokhudzana ndi maso:

• Kusawona bwino kapena kutayika kwathunthu kwa masomphenya (chifukwa cha matenda monga matenda a optic neuritis)
• Kupweteka kwa maso
• Kufiira kapena kutupa kwa maso (monga `uveitis` kapena `conjunctivitis`)
• Kusamva kuwala (kulephera kuyang'ana kuwala)

Zizindikiro zokhudzana ndi khungu:

• Ziphuphu pansi pa khungu kuzungulira zipsera kapena zojambula pakhungu
• Mawanga owala kapena amdima pakhungu
• Matumbo ofiira kapena ofiirira pamphuno kapena masaya (`lupus pernio`)
• Matumbo ofiira komanso ofewa m'mimba (erythema nodosum)

Zizindikiro zokhudzana ndi mtima:

• Kupweteka pachifuwa
• Kumva mtima wako ukugunda modabwitsa (kugunda kwa mtima)
• Matenda a mtima (arrhythmia)
• Kulephera kwa mtima
• Kuvuta kupuma

Zizindikiro zokhudzana ndi dongosolo lamanjenje:

• Ludzu lobwerezabwereza kapena kukodza kwambiri (Diabetes insipidus)
• Kufooka kapena kufooka kwa minofu ya nkhope (Bell's palsy)
• Mutu
• Kugwidwa ndi khunyu

Kodi magawo a sarcoidosis ya m'mapapo ndi ati?

Sarcoidosis, matenda omwe amakhudza mapapo, nthawi zina amafotokozedwa pang'onopang'ono. Izi zimatchedwa dongosolo la Siltzbach classification .

Koma ndikofunikira kukumbukira: Magawo awa sakutanthauza kuopsa kwa matendawa. Simuyenera kupitirira muyeso wonse. Amagawidwa m'magulu kutengera momwe mapapu anu amaonekera pa X-ray ya pachifuwa. Ndiko kuti, komwe ma granulomas ali.

Munthu amene ali ndi sarcoidosis amatha kubwereranso pakati pa magawo awa, kapena ma granulomas amatha kutha kwathunthu. Gawo lokhalo losasinthika ndi gawo lachinayi. Apa ndi pamene kuwonongeka kosatha kwa mapapo kumachitika, kotchedwa pulmonary fibrosis.

• Gawo 0:Kuwunika kwa X-ray sikusonyeza zizindikiro za sarcoidosis m'mapapo. Mapapo ndi ma lymph nodes amaoneka bwino.
• Gawo 1: Ma granuloma amapezeka m'malo olumikizirana mafupa okha.
• Gawo 2: Ma granuloma amapezeka m'maselo a lymph ndi m'mapapo.
• Gawo 3: Ma granuloma amapezeka m'mapapo okha.
• Gawo 4: X-rays imasonyeza pulmonary fibrosis, zomwe zikutanthauza kuti mapapo amavulala kosatha.

Kodi n’chiyani chimayambitsa sarcoidosis?

Chifukwa chenicheni cha vutoli sichinadziwikebe. Kafukufuku akusonyeza kuti vutoli limayamba chifukwa cha kuphatikiza kwa majini ndi zinthu zachilengedwe. Izi zikutanthauza kuti chitetezo cha mthupi cha anthu ena chingakhudzidwe kwambiri ndi ma antigen ena, monga mabakiteriya ndi mavairasi. Ngakhale chitetezo cha mthupi chimakhudzidwa, sarcoidosis si matenda a autoimmune .

Popeza sitikudziwa bwino majini ndi zinthu zomwe zimayambitsa matendawa, n'zovuta kuneneratu kuti ndani adzayambitsa matendawa.

Kodi matenda a Löfgren ndi chiyani?

Matenda a Löfgren ndi chiyambi chadzidzidzi cha sarcoidosis. Amadziwika ndi kuphatikiza kwa zizindikiro zomwe zimakhudza ziwalo zingapo za thupi:

• Matenda a nyamakazi m'malo angapo olumikizirana mafupa.
• Malungo.
• Matumbo ofiira komanso ofewa m'malo olumikizirana mafupa (erythema nodosum).
• Kutupa kwa ma lymph nodes pachifuwa.

Nkhani yabwino ndi yakuti matenda a Löfgren nthawi zambiri amatha mkati mwa miyezi 6 mpaka zaka ziwiri.

Kodi sarcoidosis imapezedwa bwanji?

Sarcoidosis nthawi zambiri imazindikiritsidwa ndi dokotala amene amakuyesani ('kuyesani thupi'), amachita mayeso ojambulira zithunzi monga X-ray pachifuwa, ndipo amatenga chitsanzo chaching'ono cha granuloma yokayikitsa kuti akayezedwe (biopsy) . Popeza matendawa amatha kukhala ndi zizindikiro zofanana ndi matenda ena, dokotala wanu angafune mayeso ena kuti athetse matenda ena.

Kodi mayeso oyezetsa matenda ndi ati?

Mayeso ojambula zithunzi ndi ma biopsies ndi mayeso ofala kwambiri omwe amagwiritsidwa ntchito pozindikira sarcoidosis, koma dokotala wanu angakupatseni mayeso ena kutengera zizindikiro zanu.

• Mayeso ojambulira: Izi zimagwiritsa ntchito makina apadera kujambula zithunzi za zinthu zomwe zili m'thupi lanu. Dokotala wanu angakupatseni ma X-ray pachifuwa, ma CT scan, kapena ma MRI.
• Kufufuza za matenda a chibadwa:Mtundu wa biopsy wochitidwa umasiyana malinga ndi komwe granuloma ikukayikiridwa. Biopsy yochokera pakhungu, conjunctiva, ndi ma lymph nodes ena si nkhani yaikulu ndipo ingachitike popanda kuduladula kwakukulu.

Nthawi zina, kuti mutenge minofu kuchokera m'mapapo, muyenera kugwiritsa ntchito njira yovuta kwambiri. Izi zimachitika poika machubu ang'onoang'ono, makamera, ndi zida zoyezera kudzera m'mphuno kapena pakhosi, kapena mwa kudula pang'ono. Zitsanzo:

• ``Kutsukidwa kwa singano yopyapyala yoyendetsedwa ndi ultrasound (EBUS-TBNA) yoyendetsedwa ndi endobronchial ultrasound''
• "Bronchoscopic transbronchial biopsy"
• `Mediastinoscopy` (Izi ndi njira zovuta zachipatala, ndipo zimachitidwa ndi dokotala pokhapokha ngati pakufunika kutero)

Mayeso ena:

• Mayeso a ntchito ya m'mapapo: Izi zimayesa momwe mapapu anu akugwirira ntchito. Izi ndi mayeso osavuta.
• Mayeso a magazi ndi mkodzo (`Mayeso a labu`): Yang'anani momwe ziwalo zina, monga chiwindi ndi impso, zikugwirira ntchito.
• Electrocardiogram (EKG kapena ECG): Kuyesa kwachizolowezi komwe kumayang'ana momwe magetsi a mtima wanu amagwirira ntchito.
• Mayeso ojambulira zinthu za nyukiliya: Izi zikuphatikizapo ma PET scan ndi gallium scan. Mayesowa amagwiritsa ntchito zinthu zochepa zowononga ma radiation kuti aone ngati pali kutupa m'thupi.
• Kuyesa koyeretsedwa kwa mapuloteni opangidwa (PPD): Uku ndi kuyesa kosavuta pakhungu. Kumayesa ngati pali matenda a chifuwa chachikulu (TB). Izi ndizofunikira chifukwa nthawi zina chifuwa chachikulu chimatha kuoneka ngati sarcoidosis.
• Kuwunika nyale: Dokotala akuyang'ana mkati mwa diso lanu kuti awone ngati sarcoidosis ikuyambitsa mavuto a maso.

Kodi sarcoidosis imachiritsidwa bwanji?

Sarcoidosis nthawi zambiri imachiritsidwa kuti ichepetse zizindikiro ndikuletsa kuwonongeka kwa ziwalo. Kumbukirani, ma granuloma amayamba chifukwa cha kutupa komwe kumachitika chifukwa cha maselo oteteza thupi. Chifukwa chake, chithandizocho chimaphatikizapo mankhwala omwe amasintha kapena kulamulira chitetezo cha mthupi. Chithandizo chimasiyana malinga ndi komwe granuloma ili m'thupi.

Palibe mankhwala enieni a sarcoidosis. Koma nthawi zambiri imadzichira yokha . Ngati zizindikiro sizikuvutitsa kwambiri kapena sizikuika moyo pachiswe, nthawi zina sarcoidosis sichitha kuchiritsidwa nthawi yomweyo. M'malo mwake, inu ndi dokotala wanu mudzagwira ntchito limodzi kuti muwone zizindikiro zanu.

Kodi mankhwala a sarcoidosis ndi ati?

Mankhwalawa amagwira ntchito posintha kapena kulamulira chitetezo cha mthupi ndikuchepetsa kutupa. Ena mwa mankhwala omwe amagwiritsidwa ntchito kwambiri ndi awa:

• Mankhwala a Corticosteroids:Mankhwala monga prednisone ndi cortisone. Mankhwalawa amachepetsa kutupa m'thupi. Amapezeka ngati mapiritsi oti mumeze, ngati chopumira chopopera mkamwa, kapena ngati kirimu wa pakhungu kapena m'maso.
• Mankhwala oletsa chitetezo chamthupi: Izi zimathandiza kuti chitetezo chamthupi chisawononge ziwalo ndi kuyambitsa kutupa. Methotrexate ndi mtundu wa mankhwala omwe amagwiritsidwa ntchito kwambiri pochiza sarcoidosis.
• Ma antibodies a anti-tumor necrosis factor-alpha (anti-TNF-alpha antibodies): Mankhwala monga infliximab. Mankhwalawa amagwira ntchito poletsa mankhwala enaake m'thupi kuti achepetse kutupa. Mankhwalawa amaperekedwa ndi dokotala ngati njira yothira (monga madzi amchere) m'mitsempha.
• Mankhwala Oletsa Kutupa Osagwiritsa Ntchito Ma steroid (NSAIDs): Mankhwalawa amapereka mpumulo wakanthawi ku zizindikiro zoyambitsidwa ndi kutupa, koma nthawi zambiri saperekedwa kwa nthawi yayitali.

Kodi mavuto/zotsatira zake za chithandizo ndi ziti?

Mankhwala a Corticosteroids angakulitse chiopsezo chanu chodwala. Angayambitsenso zotsatirapo zingapo. Zitsanzo zake ndi izi:

• Kukhala wamkulu kwambiri.
• Kusowa tulo.
• Ziphuphu.
• Kudwala matenda a shuga mwa anthu omwe ali ndi vuto la shuga.
• Kuthamanga kwa magazi.
• Glaucoma.
• Ma cataract.
• Kuchepa kwa mafupa (Osteoporosis).
• Kuvutika maganizo ndi kuvutika kulamulira malingaliro.
• Khungu lomwe limatupa mosavuta.

Pazifukwa izi, madokotala amangolangiza mankhwala a sarcoidosis ngati ubwino wake ukuposa zoopsa zake.

Kodi ndidzamva bwino msanga bwanji nditalandira chithandizo?

Zingatenge milungu ingapo mpaka miyezi ingapo kuti zizindikiro zisinthe mutayamba kulandira chithandizo cha sarcoidosis. Dokotala wanu adzakuyang'anirani ndipo angakuyezeninso kuti aone ngati chithandizocho chikugwira ntchito.

Ndi zakudya ziti zomwe sizili bwino kudya mukakhala ndi sarcoidosis?

Kafukufuku wina akusonyeza kuti njira zina zodyera zimatha kuchepetsa kutupa m'thupi. Kudya zakudya zambiri zochokera ku zomera monga ndiwo zamasamba ndi zipatso , kuchepetsa nyama ndi tchizi, komanso kuchepetsa chakudya monga shuga ndi buledi kungathandize ndi zizindikiro za sarcoidosis. Koma onetsetsani kuti mwafunsa dokotala wanu musanayambe kudya zakudya zatsopano.

Kodi sarcoidosis ingapewedwe?

Popeza chifukwa chenicheni sichikudziwika, palibe njira yopewera sarcoidosis kapena kuchepetsa chiopsezo chotenga matendawa. Komabe, kumwa mankhwala monga momwe dokotala wanu wanenera kungathandize kuchepetsa kuwonongeka kwa ziwalo zomwe zimayambitsa matenda a granuloma.

Kodi chiopsezo cha sarcoidosis ndi chiyani?

Sarcoidosis imasiyana malinga ndi kuopsa kwake. Kwa anthu ambiri, ndi vuto la kanthawi kochepa lomwe limachira lokha kapena ndi chithandizo. Kwa ena, limatha kukhala matenda a nthawi yayitali ('matenda osatha') ndikuwononga kosatha.

Taganizirani izi: Pafupifupi anthu awiri pa atatu omwe ali ndi sarcoidosis adzachira mokwanira (monga matendawo adzachira) mkati mwa zaka ziwiri kapena zitatu. Anthu omwe ali ndi matenda a Löfgren omwe atchulidwa kale ali ndi mwayi waukulu wochira, nthawi zambiri mkati mwa miyezi 6 mpaka zaka ziwiri.

Anthu omwe ali ndi sarcoidosis patatha zaka zitatu ali ndi mwayi waukulu wopeza matenda a nthawi yayitali. Komabe, ngakhale kwa omwe ali ndi sarcoidosis kwa nthawi yayitali, 10% mpaka 20% yokha ya anthu ndi omwe amadwala ziwalo zokhazikika. Vuto lofala kwambiri ndi zipsera m'mapapo.

Odwala ambiri a sarcoidosis amakhala ndi moyo wabwinobwino. Anthu ochepa kwambiri (1% - 5%) ndi omwe amafa. Chifukwa chake, palibe chodetsa nkhawa, vutoli ndi losavuta kulithetsa.

Kodi ndimadzisamalira bwanji ndikakhala ndi sarcoidosis?

Chinthu chabwino kwambiri chomwe mungachite ndikutsatira malangizo a dokotala wanu. Pitirizani kuyang'ana zizindikiro zanu nthawi zonse kuti muwone ngati zasintha. Imwani mankhwala anu monga momwe mwalangizidwira. Ndikofunikanso kukhala chete.

Kodi ndiyenera kupita kwa dokotala liti?

Ngati mukuyamba kukhala ndi zizindikiro zatsopano, ngati zizindikiro zanu zikukuvutitsani, kapena ngati mukumwa mankhwala ndipo mukuvutika ndi zotsatirapo zake, pitani kapena lankhulani ndi dokotala nthawi yomweyo.

Ndi mafunso ati omwe ndiyenera kufunsa dokotala wanga?

Zingakhale zothandiza kufunsa mafunso awa mukapita kwa dokotala wanu:

• Kodi ndi bwino kufunafuna chithandizo kapena kuyang'anira zizindikiro zanga?
• Kodi zimatenga nthawi yayitali bwanji kuti zizindikiro zisinthe?
• Ndingadziwe bwanji ngati chithandizo changa chikugwira ntchito?
• Kodi ndikufunika kusintha moyo wanga?
• Ndiyenera kubweranso liti kudzakuonaninso?

Mwachidule (Uthenga Wopita Nawo Kunyumba)

Sarcoidosis ndi matenda osowa omwe angayambitse zizindikiro zosiyanasiyana. Musadandaule, nthawi zambiri amatha okha kapena ndi chithandizo. Ngakhale kuti amatha kwa nthawi yayitali, amatha kuchiritsidwa bwino ndi mankhwala ndi upangiri wa dokotala. Kumbukirani, nthawi zina zingakhale bwino kungoyang'anira zizindikiro zanu popanda chithandizo. Inu ndi dokotala wanu mungasankhe chomwe chili chabwino kwa inu. Chifukwa chake, khalani olimba mtima ndikutsatira upangiri wa dokotala wanu.

Sarcoidosis , granuloma, chitetezo chamthupi, matenda a m'mapapo, matenda a pakhungu, matenda a maso, matenda a mtima, Sarcoidosis, granuloma, chitetezo chamthupi, matenda a m'mapapo, matenda a pakhungu, matenda a maso, matenda a mtima