Kodi thupi lanu likumva ngati lalephera kulamulira? Tiyeni tiphunzire za izi (Autoimmune Autonomic Ganglionopathy - AAG)!

Kodi nthawi zina mumamva chizungulire mwadzidzidzi? Kapena mumamva ngati pali chinthu chachilendo m'mimba mwanu, pakamwa panu pauma, kapena simungathe kulamulira kupuma kwanu? Ngakhale izi zingawoneke ngati zinthu wamba, nthawi zina pangakhale nkhani yovuta kwambiri kumbuyo kwawo. Imeneyo ndi imodzi mwa matenda osowa, koma ofunika kudziwa, omwe tikambirane lero.

Kodi "Autoimmune Autonomic Ganglionopathy - AAG" iyi ndi chiyani? Tiyeni timvetse mosavuta, sichoncho?

Mwachidule, ``Autoimmune Autonomic Ganglionopathy'' kapena ``(AAG)'' ndi vuto lomwe chitetezo cha thupi lathu, ndiko kuti, chitetezo chamthupi, chimaukira molakwika dongosolo lathu la mitsempha lodziyimira palokha. Tangoganizirani, izi zili ngati zomwe zingachitike ngati gulu lankhondo lomwe likuyenera kuteteza dziko lathu litaukira malo athu ofunikira molakwika.

Dongosolo lathu la mitsempha lodziyimira palokha la thupi lili ngati "dongosolo lathu lodziyimira palokha". Izi zikutanthauza kuti, limalamulira zinthu zambiri zomwe zimachitika zokha, popanda ife kuzindikira. Mwachitsanzo:

• Kupuma kwanu
• Kugunda kwa mtima (kugunda kwa mtima)
• Kuthamanga kwa magazi
• Kutuluka thukuta
• Kugaya chakudya

Zambiri mwa zinthuzi sizinthu zomwe timaganizira. Zimachitika zokha. Dongosolo la mitsempha lodziyimira palokha ndilo limathandiza kuti ntchito zake zizigwira ntchito bwino. Mu AAG, dongosolo lofunikali limawonongeka. Ili ndi vuto lotchedwa autonomic neuropathy, kapena dysautonomia.

N’chifukwa chiyani thupi lathu limachita izi? Kodi zifukwa zake ndi ziti?

Ndipotu, ngakhale madokotala sanganenebe chomwe chimayambitsa `(AAG)` imeneyi. Koma pali mfundo zina zomwe zapezeka.

• Nthawi zambiri, kutanthauza kuti , pafupifupi anthu atatu mwa asanu aliwonse omwe ali ndi ``AAG'', vutoli limachitika atachira ku matenda ena, kapena atatenga kachilombo. Zili ngati zotsatirapo za matendawa.
• Anthu ena amatha kukhala ndi vuto lotchedwa paraneoplastic AAG. Apa ndi pamene ma antibodies ena omwe chitetezo chathu cha mthupi chimapanga poyankha matenda monga khansa amapita kukaukira dongosolo la mitsempha lodziyimira palokha.

Kodi izi zimachita chiyani ku matupi athu? Tiyeni tiwone bwino.

Dongosolo lathu la mitsempha lodziyimira palokha lili ndi magulu a maselo a mitsempha otchedwa autonomic ganglia . Izi zili ngati malo olumikizirana sitima. Mauthenga osiyanasiyana amatumizidwa ndi kulandiridwa kudzera mwa awa. Kusinthana kwa mauthenga kumeneku ndikofunikira kuti zochita za thupi lathu, ndiko kuti, zochita zomwe sitizilamulira (reflexes), zilamuliridwe.

Mu AAG, chitetezo chathu chamthupi chimaukira ma receptors enaake mu ganglia iyi. Ma receptors ndi malo omwe mauthenga amalandiridwa. Chifukwa chake ma receptors awa akawonongeka, mauthenga amitsempha sapita kapena kulowa bwino. Zotsatira zake, zinthu zomwe zimachitika zokha, monga kulamulira kuthamanga kwa magazi ndi thukuta, zimayamba kusokonekera.

Tangoganizirani, ngati 'cholumikizira' mu 'switch board' ya nyumba yanu chatayika, magetsi sadzayatsidwa, fan sidzazungulira, ndi zina zotero. Umu ndi momwe zilili ndi izi.

Kodi vutoli limatchedwa `(AAG)` lofala bwanji?

Izi ndi zachilendo kwambiri. Mwachitsanzo, ku United States, anthu pafupifupi 100 okha ndi omwe amapezeka ndi matendawa chaka chilichonse. Choncho sizichitika kawirikawiri ku Sri Lanka. Choncho musachite mantha mukamva izi, izi sizichitika kwa anthu ambiri.

Kodi zizindikiro za `(AAG)` ndi ziti? Kodi timazizindikira bwanji?

Zizindikiro za matendawa zimatha kusiyana malinga ndi munthu aliyense. Si aliyense amene angakumane ndi zizindikiro zomwezo. Zizindikiro zodziwika bwino ndi izi:

• Kudzimbidwa: Izi zikutanthauza kudzimbidwa komanso kuvutika kupita kuchimbudzi.
• Magulu a maso otambasuka (Adie's pupils): Nthawi zina diso limodzi lokha ndi lomwe limatha kutambasuka ndipo limatha kukhudzidwa ndi kuwala.
• Pakamwa pouma kapena maso ouma: Kumva ngati palibe malovu kapena misozi m'maso.
• Kukomoka / Kusanza: Mungagwe mwadzidzidzi popanda chifukwa chomveka.
• Kuchepa kwa magazi m'thupi (neurogenic orthostatic hypotension): Kumva chizungulire komanso kufooka mutu ukayimirira kuchokera pamalo okhala kapena kutuluka pabedi. Izi zimachitika chifukwa cha kutsika kwadzidzidzi kwa kuthamanga kwa magazi .
• Kuvuta kukodza / Kusunga mkodzo: Kumva ngati simungathe kukodza ngakhale mukufuna kukodza.

Pafupifupi anthu awiri mwa atatu aliwonse omwe ali ndi AAG apezeka kuti ali ndi ma antibodies ambiri otchedwa ganglionic acetylcholine receptor antibodies (ma antibodies a g-AChR) m'magazi mwawo. Ofufuza amakhulupirira kuti pali mgwirizano pakati pa kuchuluka kwa ma antibodies a g-AChR awa ndi kuopsa kwa zizindikiro.

Kodi dokotala amazindikira bwanji matenda a `(AAG)` awa?

Ngati muli ndi zizindikiro ngati izi, chinthu choyamba chomwe dokotala angachite ndikukufunsani za zizindikiro zanu ndikukuyesani. Kenako, angachite mayeso apadera kuti awone momwe dongosolo lanu la mitsempha likuyendera.

Nazi zina mwa izo:

• Mayeso a m'mimba: Mwachitsanzo, mayeso a ``Gastric empting``. Izi zimayesa momwe chakudya chimatulukira mofulumira m'mimba mwanu.
• `Quantitative sudomotor axon reflex test (QSART)`: Izi zimayesa momwe ma glands anu a thukuta akugwirira ntchito.
• `Kuyesa thukuta lotentha`: Kuyesaku kumachitika kuti mudziwe ngati thukuta la thupi lachepa kapena lakwera, komanso chomwe chimayambitsa.
• `Mayeso a tebulo lopendekeka`: Mu mayesowa, mumagonekedwa pabedi lapadera ndipo bedi limazunguliridwa pang'onopang'ono molunjika, poona momwe kugunda kwa mtima wanu ndi kuthamanga kwa magazi zimasinthira.
• Kusanthula mkodzo: Izi zingakupatseni lingaliro la momwe chikhodzodzo chanu chikugwira ntchito bwino.

Kuphatikiza apo, kuyezetsa magazi kungachitike kuti muwone kuchuluka kwa ma `(g-AChR antibodies)` omwe atchulidwa pamwambapa . Ngati kuchuluka kwa ma antibodies awa kuli kwakukulu, ndi umboni wina woti akhoza kukhala `(AAG)`. Komabe, kuyezetsa magazi kumeneku ndi kosiyana ndi kuyezetsa kwa `AChR antibody`, komwe kumagwiritsidwa ntchito kuyang'ana matenda ena amitsempha otchedwa `(Myasthenia Gravis).`

Kodi pali mankhwala ochizira izi? Kodi chingachitike n’chiyani?

Popeza AAG ndi vuto losowa kwambiri, palibe muyezo, "iyi ndiyo njira yochizira" pakadali pano. Nthawi zambiri , cholinga chachikulu chimakhala pakuwongolera zizindikiro.

Madokotala amapanga dongosolo la chithandizo pophatikiza njira zosiyanasiyana zochiritsira. Zina mwa izo ndi izi:

• Kusinthana kwa plasma / plasmapheresis: Izi zimaphatikizapo kutenga magazi anu ena, kuchotsa zinthu zovulaza monga ma antibodies kuchokera mu plasma, kenako kubwezera magazi oyeretsedwawo m'thupi lanu.
• Chithandizo cha Intravenous immunoglobulin (IVIG): Izi zimaphatikizapo kupereka thupi lanu immunoglobulin (gawo la plasma lomwe limalimbana ndi matenda) yotengedwa kuchokera kwa anthu athanzi. Izi zimathandiza kukhazika mtima pansi chitetezo cha mthupi.
• Mankhwala oletsa kutupa m'mitsempha: Mankhwala ambiri oletsa kutupa monga methylprednisolone (Solu-Medrol®) kapena hydrocortisone (Solu-Cortef®), amaperekedwa kudzera mu jakisoni.
• Mankhwala oletsa chitetezo chamthupi: Mankhwalawa amagwira ntchito pochepetsa kugwira ntchito mopitirira muyeso kwa chitetezo chamthupi. Mwachitsanzo, mankhwala monga rituximab (Rituxan®).

Kodi pali njira yopewera vutoli la `(AAG)`?

Palibe njira yotsimikizika yopewera izi, chifukwa sizichitika kawirikawiri. Komabe, matenda ena, monga khansa, amatha kuwonjezera chiopsezo chanu chotenga matendawa. Ngati mwakhalapo ndi khansa, nazi zinthu zina zomwe mungachite kuti musamalire thanzi lanu lonse:

• Kuchita masewera olimbitsa thupi nthawi zonse: makamaka masewera olimbitsa thupi.
• Ngati muli ndi `(Dysautonomia)`, kudya zakudya zokhala ndi mchere wambiri ndi madzi akumwa kungathandize kuchepetsa kuthamanga kwa magazi anu. (Izi ndi zomwe muyenera kukambirana ndi dokotala wanu.)
• Kuthana ndi nkhawa: Gwiritsani ntchito njira zabwino monga kuchita masewera olimbitsa thupi, kulankhula ndi mnzanu, komanso kulemba m'buku lolembamo nkhani.
• Gonani bwino: Gonani maola osachepera 7-8 patsiku.
• Kuvala zovala zopondereza: Izi zimathandiza kuti magazi aziyenda bwino komanso kuchepetsa kutupa (makamaka miyendo).

Kodi vuto la `(AAG)` limeneli lingachiritsidwe kotheratu? N’chiyani chidzachitike mtsogolomu?

Ndiyenera kunena, ngakhale ndili wachisoni,AAG sichitha. Komabe, anthu ambiri amatha kuthana ndi zizindikiro zawo bwino kwa nthawi yayitali. Chodabwitsa n'chakuti, pafupifupi munthu m'modzi mwa atatu aliwonse omwe ali ndi AAG amachira pang'onopang'ono popanda chithandizo chilichonse. Komabe, anthu ambiri amakumana ndi zizindikiro zina pa moyo wawo wonse.

Kodi mukufuna kufunsa dokotala chiyani china?

Ngati mukuganiza kuti muli ndi vuto ngati ili, ndikofunikira kwambiri kuonana ndi dokotala wabwino ndikufunsa mafunso awa:

• Kodi ndi chifukwa chiyani chomwe chingayambitse zizindikiro zanga?
• Ndi mayeso ati omwe ndiyenera kuchita kuti ndidziwe ngati ndili ndi `(AAG)`?
• Kodi njira zochiritsira za `(AAG)` ndi ziti?
• Kodi pali kuthekera kotani kuti zizindikiro za `(AAG)` zitha kuchepa ngakhale popanda chithandizo?
• Ndi kusintha kotani kwa moyo komwe ndiyenera kuchita kuti ndikhale ndi thanzi labwino?

Ndi matenda ena ati a chitetezo chamthupi omwe amagwirizana ndi autonomic neuropathy?

``(AAG)`` ndi yapadera chifukwa, kumbali imodzi, ndi matenda okhudzana ndi chitetezo chamthupi, ndipo kumbali inayo, ndi matenda a autoimmune a dongosolo lamanjenje.

Kuphatikiza apo, pali matenda ena okhudzana ndi chitetezo chamthupi omwe amawonjezera chiopsezo chokhala ndi "dysautonomia" (matenda a autonomic nervous system). Zitsanzo zina ndi izi:

• Matenda a Celiac
• Matenda a Guillain-Barré (Guillain-Barré syndrome)
• `(Lupus / systemic lupus erythematosus)` (matenda a Lupus)
• `(Nyamakazi ya mafupa)` (Nyamakazi ya mafupa)` (Nyamakazi ya mafupa)
• Sjögren's Syndrome (Sjögren's Syndrome)

Kotero mutha kuwona, izi ndi zochitika zomwe zingagwirizane.

Pomaliza, zinthu zoti muzikumbukira (Uthenga Wopita Nawo Kunyumba)

Chabwino, tsopano mukudziwa kuti `(Autoimmune Autonomic Ganglionopathy - AAG)` ndi matenda osowa kwambiri omwe chitetezo chathu chimaukira dongosolo lathu la mitsempha. Zizindikiro zake zitha kuphatikizapo kutaya mwadzidzidzi chidziwitso, kuchepa kwa 'kupanikizika' mukamayimirira, ndi mavuto am'mimba.

Musachite mantha mukamva izi. Izi sizichitika kawirikawiri. Komanso, mankhwala oletsa chitetezo chamthupi ndi `plasmapheresis` amagwiritsidwa ntchito ngati mankhwala a izi. Ngakhale kuti sizingachiritsidwe kwathunthu, anthu ambiri amatha kuwongolera bwino zizindikirozo ndikukhala moyo wabwinobwino.

Chofunika kwambiri ndikuonana ndi dokotala woyenerera mwamsanga ngati muli ndi zizindikirozi. Ngati muzizizindikira msanga, mutha kuyamba kulandira chithandizo ndikuchepetsa mavuto omwe angakukhudzeni. Simuli nokha, ndipo pali madokotala omwe angakuthandizeni.

` Autoimmune Aneurysmal Ganglionopathy, AAG, Autoimmune Nervous System, Chitetezo cha Mthupi, Matenda a Mitsempha, Zizindikiro, Chithandizo