Kodi mwamvapo za matendawa? Tiyeni tikambirane za Microscopic Polyangiitis (MPA)!

Moni! Lero tikambirana za vuto lomwe silimamveka kawirikawiri, koma lingakhale lofunika kwambiri. Limatchedwa microscopic polyangiitis, kapena mwachidule mu Chingerezi `(Microscopic Polyangiitis)`, kapena `(MPA)`. Ngakhale dzinalo lingamveke lovuta pang'ono, tiyeni tiyesere kulimvetsa mosavuta. Musadandaule, ndili pano kuti ndikufotokozereni.

Kodi MPA iyi ndi chiyani kwenikweni?

Mwachidule, MPA ndi matenda osowa kwambiri omwe mitsempha yaing'ono kwambiri m'thupi mwathu imatupa, kapena monga momwe madokotala amatchulira, kutupa. Kutupa kumeneku kwa mitsempha yamagazi nthawi zambiri kumatchedwa vasculitis . Tangoganizirani, pali mitsempha yambiri yopyapyala m'thupi mwathu yomwe imanyamula magazi ngati mapaipi amadzi. Mitsempha yotereyi ikatupa kuchokera mkati, magazi omwe amayenda kudzera mwa iyo amatsekedwa. Ndiye chimachitika ndi chiyani? Ziwalo zathu zofunika kwambiri, ndiko kuti, ziwalo za thupi zomwe zimafunikira kudyetsedwa ndi mitsempha yamagazi imeneyo, zimatha kuwonongeka. Madera omwe amakhudzidwa kwambiri ndi MPA ndi awa:

• Impso
• Mapapu
• Thupi la mitsempha (zinthu monga mitsempha yathu)
• Khungu
• Mafupa (kumene mafupa athu amalumikizana)

Ndibwino kudziwa kuti pali mtundu wina wa vasculitis womwe uli ndi zizindikiro zofanana ndi MPA, wotchedwa Granulomatosis wokhala ndi Polyangiitis (GPA). Poyamba unkatchedwa Wegener's granulomatosis. Mankhwala a matenda onsewa ndi ofanana kwambiri.

Ndiye, kodi 'Vasculitis' iyi ndi chiyani kwenikweni?

Matenda a Vasculitis, monga ndanenera kale, ndi kutupa kwa mitsempha yamagazi. Izi zikachitika, makoma a mitsempha yamagazi iyi amatha kufooka. Nthawi zina amatha kufooka ndikutupa ngati baluni - madokotala amatcha izi kukhala aneurysm. Nthawi zina, makoma a mitsempha yamagazi awa amatha kuonda kwambiri ndikuphulika. Izi zimapangitsa kuti magazi atuluke m'minofu yozungulira. Monga momwe chitoliro chamadzi chimatsekeredwa ndi magazi oundana, matenda a vasculitis amachititsa kuti mitsempha yamagazi ikhale yopapatiza ndipo nthawi zina imatsekeka kwathunthu. Popeza magazi sangayende kudzera mwa iwo, ziwalo zomwe zimalandira mpweya ndi michere ina kuchokera ku mitsempha yamagazi imeneyo zimawonongeka. MPA imakhudza makamaka mitsempha yamagazi yaying'ono ndi yapakatikati .

Ndani amene ali ndi mwayi waukulu wopanga MPA iyi?

Uwu ndi matenda osowa kwambiri. Malinga ndi ziwerengero, akuti pakati pa anthu 13 ndi 19 mwa anthu miliyoni (100,000) amadwala matendawa. Izi zikutanthauza kuti ndi osowa kwambiri, eti? Matendawa amatha kufalikira kwa aliyense wazaka zilizonse , ndipo palibe kusiyana pakati pa amuna ndi akazi , onse awiri amatha kudwala matendawa mofanana.

N’chifukwa chiyani MPA iyi inapangidwa?

Madokotala sanapezebe chifukwa chenicheni chomwe chimayambitsa kukula kwa MPA.. Iyi si khansa, si matenda opatsirana, ndipo si matenda omwe nthawi zambiri amapezeka m'mabanja. Komabe, kafukufuku wapeza kuti chitetezo chathu chamthupi ndicho chimayambitsa izi. Mwachidule, chitetezo chamthupi, chomwe chili ngati msilikali amene akuyenera kuteteza thupi lathu ku matenda, molakwika chimayamba kuukira mitsempha yake yamagazi . Pamenepo mitsempha yamagazi iyi imatupa, zomwe zimapangitsa kuti ziwalo ziwonongeke. Kodi sizomvetsa chisoni zimenezo?

Kodi zizindikiro za MPA ndi ziti? Kodi timazizindikira bwanji?

Popeza MPA imatha kukhudza ziwalo zosiyanasiyana, zizindikiro zake zimasiyana kwambiri . Si aliyense amene angakumane ndi zizindikiro zomwezo. Anthu ena angakumane ndi zizindikiro zodziwika bwino monga:

• Kumva kutopa nthawi zonse, kumva ulesi
• Malungo
• Chilakolako cha chakudya
• Kuchepetsa thupi

Kuphatikiza apo, zizindikiro zinazake zimatha kuchitika kutengera chiwalo chomwe chakhudzidwa. Mwachitsanzo:

• Ngati mapapo akhudzidwa: Kuvutika kupuma, kapena kutsokomola magazi pang'ono.
• Ngati dongosolo la mitsempha lakhudzidwa: kumva zachilendo monga dzanzi m'miyendo, kutaya kumverera pambuyo pake m'malo amenewo, kapena kuchepa kwa mphamvu m'miyendo.
• Ngati zimakhudza khungu: Ziphuphu pakhungu, mwachitsanzo, mawanga ofanana ndi eczema .
• Ngati minofu ndi mafupa zakhudzidwa: kupweteka m'malo amenewo.

Chofunika kwambiri ndichakuti ngakhale MPA itawononga impso, sizingasonyeze zizindikiro zilizonse kumayambiriro! Wodwalayo sangazindikire mpaka ntchito ya impso itasokonekera kwambiri . Ichi ndichifukwa chake ndikofunikira kwambiri kuti madokotala ayese mkodzo ngati pali vuto la vasculitis .

Chizindikiro chimodzi kapena zingapo mwa izi zitha kuchitika limodzi.

Kodi madokotala amazindikira bwanji MPA?

Kuzindikira matenda a MPA kuli ngati kufufuza mobisa. Madokotala amasonkhanitsa chidziwitso kuchokera ku magwero osiyanasiyana. Akakayikira matendawa, amachita izi:

• Amakufunsani za mbiri yanu ya matenda: zizindikiro zomwe muli nazo komanso nthawi yomwe mwakhala nazo.
• Kuyezetsa thupi kumachitika: kuti adziwe ziwalo za thupi zomwe zakhudzidwa ndi matendawa komanso kuti apeze matenda ena omwe angakhale ndi zizindikiro zofanana.
• Kuyezetsa magazi : kuona ziwalo zomwe zili m'thupi zomwe zakhudzidwa, makamaka `antineutrophil cytoplasmic antibodies (ANCA)`Kufufuza ngati pali ma antibodies m'magazi. Ngati mayeso a `(ANCA)` awa ali `positive`, ndi umboni wabwino kukayikira kuti matenda a `(MPA)` alipo. Komabe, mayeso a magazi okha sangatsimikizire kuti `(MPA)` alipo, komanso sangadziwe momwe matendawa alili.
• Kuyezetsa mkodzo: Yang'anani mapuloteni ochulukirapo kapena maselo ofiira a m'magazi mumkodzo (izi ndizofunikira kwambiri kuti mudziwe ngati impso zakhudzidwa).
• Mayeso ojambulira: Ma X-ray, ma scan a computed tomography (CT), kapena ma scan a magnetic resonance (MR) angachitike kuti aone ngati pali zolakwika m'malo monga mapapo.

MPA ikangoganiziridwa, chidutswa chaching'ono cha minofu chimatengedwa kuchokera ku chiwalo chokhudzidwacho ndikuchiyang'ana (biopsy) . Iyi ndiyo njira yokhayo yotsimikizira ngati muli ndi vasculitis. Komabe, biopsy imachitika pokhapokha ngati pali zolakwika zomwe zimawonekera kuchokera ku mayeso azachipatala, ma scan, kapena kufufuza thupi.

Kodi mankhwala a MPA ndi otani? (Chithandizo)

Cholinga chachikulu cha chithandizo cha MPA ndikulamulira chitetezo chathu chamthupi, chomwe chikulephera kugwira ntchito bwino. Mankhwala oletsa chitetezo chamthupi ndi omwe amagwiritsidwa ntchito kwambiri pa izi. Pali mitundu ingapo ya mankhwala awa, koma mankhwala aliwonse ali ndi zotsatirapo zake, kotero ayenera kugwiritsidwa ntchito pokhapokha ngati dokotala akuwalangiza.

• Ngati MPA yakhudza kwambiri ziwalo zofunika kwambiri , corticosteroids nthawi zambiri imaperekedwa pamodzi ndi mankhwala ena oletsa chitetezo chamthupi, monga cyclophosphamide (Cytoxan®) kapena rituximab (Rituxan®).
• Ngati matendawa si oopsa kwambiri , mankhwala otchedwa " Methotrexate " angagwiritsidwe ntchito poyamba pamodzi ndi "Corticosteroids".

Cholinga chachikulu cha chithandizo ndikuletsa kuwonongeka konse komwe kumachitika chifukwa cha MPA ndikubweretsa matendawa pamalo pomwe amatha kulamulidwa mokwanira. Izi zimatchedwa "kukhululukidwa." Matendawa akamaoneka kuti akuchepa, madokotala amachepetsa pang'onopang'ono mlingo wa corticosteroids ndipo pamapeto pake amayesa kuwaletsa kwathunthu. Ngati cyclophosphamide igwiritsidwa ntchito, imaperekedwa mpaka kukhululukidwako kukwaniritsidwa (nthawi zambiri miyezi itatu mpaka isanu ndi umodzi). Kenako, kuti apitirize kukhululukidwa, mankhwala ena oletsa chitetezo chamthupi amasinthidwa kukhala methotrexate, azathioprine (Imuran®) kapena mycophenolate mofetil (Cellcept®) amagwiritsidwa ntchito. Kutalika kwa chithandizo chosamalira ichi kumatha kusiyana malinga ndi munthu. Nthawi zambiri, ndi chaka chimodzi kapena ziwiri.Mankhwalawa amaperekedwa, kenako madokotala amayesa kuchepetsa mlingo ndikusiya. Taganizirani izi, mankhwala ena omwe amagwiritsidwa ntchito pochiza matendawa amagwiritsidwanso ntchito pa matenda ena. Mwachitsanzo, mankhwala otchedwa `(Azathioprine)` ndi `(Mycophenolate mofetil)` amaperekedwa kuti aletse thupi kukana chiwalo pambuyo poika ziwalo zina. Mankhwala otchedwa `(Methotrexate)` amaperekedwanso pa matenda monga nyamakazi ya rheumatoid ndi psoriasis. Mankhwala otchedwa `(Cyclophosphamide)` ndi `(Methotrexate)` amaperekedwanso pamlingo waukulu wa mitundu ina ya khansa, ndipo panthawiyo amatchedwanso `(chemotherapy)`. Koma musachite mantha , amaperekedwa pa `vasculitis` m'mlingo womwe ndi wotsika nthawi 10 mpaka 100 kuposa mlingo woperekedwa wa khansa. Pano, ntchito yayikulu ya mankhwalawa si kupha maselo a khansa, koma kuwongolera ntchito ya chitetezo chamthupi. Rituximab ndi mankhwala omwe ali mgulu la mankhwala otchedwa biologic agents. Imagwira ntchito poyang'ana gawo linalake la chitetezo chamthupi. Kafukufuku waposachedwapa wapeza kuti Rituximab ndi yothandiza ngati Cyclophosphamide pochiza MPA yoopsa.

Popeza mankhwalawa amafooketsa chitetezo chamthupi , pali chiopsezo chotenga matenda oopsa. Kuphatikiza apo, pali zotsatirapo zoyipa zomwe zimapezeka mu mankhwala aliwonse oletsa chitetezo chamthupi. Chifukwa chake, ndikofunikira kwambiri kukhala pansi pa kuyang'aniridwa ndi dokotala nthawi zonse kuti mudziwe zotsatirapo zoyipa mukamagwiritsa ntchito mankhwalawa. Ngakhale mankhwalawa ataloledwa poyamba, zinthu zitha kusintha pakapita nthawi. Chifukwa chake, ndikofunikira kwambiri kupitiriza kutsatira upangiri wachipatala ndikuyesedwa kofunikira. Nthawi zina, ngakhale mutasiya kumwa mankhwalawa, muyenera kusamala ndi zotsatirapo zoyipa zomwe zingachitike kwa nthawi yayitali.

Kodi odwala a MPA angachiritsidwe bwanji? (Outlook)

Popeza MPA ndi matenda osowa, n'zovuta kupereka ziwerengero zenizeni za kuchira. Komabe, pa avareji, anthu opitilira 80% omwe ali ndi MPA sakhala ndi zotsatirapo za matendawa patatha zaka zisanu. Zotsatirazi zimasiyana malinga ndi kuopsa kwa matendawa. MPA imatha kupita patsogolo pang'onopang'ono, ndipo ngakhale ndi matenda oopsa, odwala ambiri amachira bwino kwambiri . Poyamba chithandizo msanga komanso kuyang'aniridwa ndi dokotala, kuwonongeka kwa ziwalo kumatha kuchepetsedwa. Ngakhale omwe ali ndi milandu yoopsa kwambiri ya MPA amatha kupeza nthawi yochira ngati ayamba chithandizo msanga ndikuchita zomwe madokotala awo amawauza kuti achite. Ngakhale atatha nthawi yochira, MPA ikhoza kubwerera. Izi zimatchedwa "kubwereranso." Izi zimachitika kwa anthu pafupifupi 50% omwe ali ndi MPA. Kubwereranso kumeneku kungakhale kofanana ndi zizindikiro zomwe munali nazo mutapezeka koyamba, kapena kungakhale kosiyana. Kuti muchepetse chiopsezo chobwereranso kwambiri,Ngati mukupeza zizindikiro zatsopano, ndikofunikira kuuza dokotala wanu nthawi yomweyo. Ndikofunikanso kuonana ndi dokotala wanu nthawi zonse kuti akayezedwe magazi ndi zithunzi. Chithandizo cha kubwereranso kwa matendawa ndi chimodzimodzi ndi cha munthu amene wangopezeka kumene ndi matendawa. Anthu ambiri omwe ali ndi MPA amatha kuchira kachiwiri.

Ndiye, ndi zinthu ziti zofunika kwambiri zomwe muyenera kukumbukira kuchokera pa zomwe takambiranazi?

Chabwino, takambirana zambiri za `(MPA)` iyi tsopano. Zinthu zofunika kwambiri zomwe muyenera kukumbukira kuchokera pa zonsezi ndi izi:

• (MPA) ndi matenda osowa koma omwe angakhale oopsa omwe mitsempha yamagazi ya thupi imatupa chifukwa cha kulephera kugwira ntchito bwino kwa chitetezo chamthupi.
• Kawirikawiri zimakhudza impso, mapapo, mitsempha, khungu, ndi mafupa . Ngakhale impso zimakhudzidwa kwambiri, poyamba sizingakhale ndi zizindikiro .
• Ndikofunikira kwambiri kuzindikira matendawa ndikuyamba kulandira chithandizo msanga.
• Chithandizo chimaphatikizapo mankhwala omwe amaletsa chitetezo cha mthupi. Kuwunika ndi kuyezetsa matenda nthawi zonse ndikofunikira mukamagwiritsa ntchito mankhwalawa.
• Ngakhale matendawa atapita (kuchira), amatha kubwereranso (kubwereranso) . Choncho dziwani zizindikiro zatsopano.
• Nthawi zonse lankhulani momasuka ndi dokotala wanu , funsani mafunso, ndipo muuzeni zakukhosi kwanu. Ndicho chinthu chabwino kwambiri kuchita.

Ndikukhulupirira kuti izi zikuthandizani. Ngati muli ndi nkhawa iliyonse yokhudza zizindikiro zilizonse, chonde musaiwale kufunsa upangiri kwa dokotala.