Kodi mukudziwa za matenda a Takayasu's Arteritis? Tiyeni tikambirane za izi!

Kodi mudamvapo za matenda otchedwa Takayasu's Arteritis? Dzinali lingamveke lachilendo pang'ono, eti? Koma ndi vuto losowa lomwe lingakhudze mitsempha yathu yamagazi, makamaka mitsempha yayikulu kwambiri yamagazi yomwe imayambira mumtima ndi nthambi zomwe zimafalikira kuchokera pamenepo. Nthawi zina imatchedwanso 'matenda opanda kugunda kwa mtima.' Lero, tikambirana za matendawa mwatsatanetsatane, mosavuta, kuti inunso mumvetsetse bwino.

Kodi matenda a Takayasu's Arteritis ndi chiyani kwenikweni?

Mwachidule, matenda a Takayasu's arteritis ndi kutupa kwa mitsempha yathu yamagazi, zomwe zikutanthauza kutupa kapena kutupa (vasculitis). Amakhudza makamaka mitsempha yayikulu yamagazi m'thupi lathu. Taganizirani izi, mitsempha yayikulu yamagazi yomwe imanyamula magazi ochulukirapo kuchokera mumtima mwathu kupita ku thupi lonse, lomwe timalitcha 'aorta yayikulu' kapena 'aorta'. Matendawa amakhudza kwambiri aorta, ndi mitsempha ina yayikulu yamagazi yomwe imatuluka m'magaziwo ndikunyamula magazi kupita m'manja, m'khosi, ndi muubongo. Kodi mukudziwa zomwe zimachitika kutupa kumeneku kukachitika? Makoma a mitsempha yathu yamagazi amawonongeka. Kenako ziwalo zina za mitsempha yamagaziyo zimakhala zofooka ndipo zimatha kutupa ngati baluni. Timatcha izi 'aneurysm'. Komanso, mitsempha yamagazi imatha kutupa ndikupapatiza. Kenako kuyenda kwa magazi kumakhala kocheperako. Nthawi zina mitsempha yamagazi imatha kutsekedwa kwathunthu, yotchedwa 'kutseka'. Nthawi zina, vutoli lingakhudzenso mitsempha yomwe imapereka magazi kumtima, matumbo, impso, ndi miyendo.

Ndani amene akukhudzidwa kwambiri ndi vutoli?

Matenda a Takayasu's Arteritis (TAK) ndi matenda omwe nthawi zambiri amakhudza achinyamata. Amafala kwambiri mwa akazi azaka zapakati pa 20 ndi 40. Odwala nthawi zambiri amakhala azaka zapakati pa 15 ndi 35 akapezeka ndi matendawa. Pafupifupi 80% mpaka 90% ya omwe ali ndi matendawa ndi akazi. Madokotala amawona vutoli nthawi zambiri m'maiko ngati Japan ndi anthu ochokera ku Mexico, India, ndi East Asia. Ngakhale m'maiko ngati United States, milandu iwiri kapena itatu yokha ndi yomwe imapezedwa chaka chilichonse. Izi zikutanthauza kuti ndi matenda osowa kwambiri.

Kodi matenda a Takayasu's arteritis amakhudza bwanji thupi langa?

Mitsempha yamagazi ikachepa, kuchuluka kwa magazi komwe kumafika m'ziwalo ndi minofu yomwe imaperekedwa ndi mitsempha yamagaziyo kumachepa. Taganizirani izi ngati chitoliro chamadzi chotsekedwa, chomwe chimachepetsa kuchuluka kwa madzi omwe amadutsa. Koma mu Takayasu's arteritis (TAK), kusinthaku kumachitika pang'onopang'ono komanso pang'onopang'ono. Chifukwa chake matupi athu amakhala ndi nthawi yozolowera kunyamula magazi kudzera m'njira zina. Njira zina izi zili ngati njira zazing'ono zomwe timagwiritsa ntchito pamene msewu waukulu watsekedwa. Koma njira izi sizingathe kunyamula magazi ambiri monga momwe mtsempha waukulu woyamba umagwirira ntchito. Nthawi zambiri, kuchuluka kwa magazi komwe kumadutsa kutsekeka kumakhala kokwanira kupatsa minofu mpweya ndi magazi ochepa omwe amafunikira kuti ikhale ndi moyo. Koma nthawi zambiri, ngati mitsempha yamagazi inayi sikugwira ntchito bwino, minofu imatha kufa chifukwa imasowa mpweya ndi magazi.

Kodi zizindikiro za matendawa ndi ziti?

Anthu ena omwe ali ndi Takayasu arteritis (TAK) sangakhale ndi zizindikiro zilizonse. Komabe, pafupifupi theka la odwala amatha kukhala ndi vuto la kutopa komanso kufooka. Zizindikiro zoyambirira (gawo 1): Izi ndi zizindikiro zomwe zimawonekera kumayambiriro kwa matendawa:

• Malungo.
• Kumva kutopa kwambiri ( Kutopa ).
• Kupweteka kwa minofu ndi mafupa .
• Chakudya chilibe kukoma .

Zizindikiro za siteji yotsatira (gawo lachiwiri): Pamene matendawa akupita patsogolo, zizindikiro ngati izi zingawonekere:

• Kupweteka pachifuwa .
• Kuvuta kupuma .
• Mutu .
• Kumva chizungulire.

Zizindikiro zomwe zimachitika chifukwa cha kuchepa kwa mitsempha yamagazi komanso kuchepa kwa magazi:

• Kutopa, kupweteka, kapena kupweteka m'manja ndi miyendo.
• Kupweteka m'mimba chifukwa cha kuchepa kwa magazi kupita m'matumbo.
• Kuthamanga kwa magazi chifukwa cha kuchepa kwa magazi kupita ku impso.
• Stroke (izi sizichitika kawirikawiri).
• Matenda a mtima (izi ndizosowanso).

Kodi n’chiyani chinayambitsa matenda a arteritis a Takayasu?

Ndipotu, palibe amene akudziwa chomwe chimayambitsa matenda a Takayasu's arteritis (TAK).Koma madokotala ndi ofufuza amaganiza kuti mwina ndi 'autoimmune condition'. Izi zikutanthauza kuti, chitetezo cha mthupi lathu, chomwe chimalimbana ndi matenda, chimaukira minofu yake yathanzi molakwika. Zili ngati chitetezo chathu chikutivulaza. Ofufuza ena amaganiza kuti milandu ina ya arteritis ya Takayasu ikhoza kuchitika chifukwa cha jini yochokera kwa makolo onse awiri. Makolo amenewo sangakhale ndi zizindikiro, chifukwa amakhala ndi kopi imodzi yokha ya jini. Koma ngati mutenga jini imeneyo kuchokera kwa makolo onse awiri, mutha kukhala ndi vutoli ndi zizindikiro zake.

Kodi matendawa amapezeka bwanji?

Dokotala wanu adzazindikira matenda a arteritis a Takayasu mwa kuyang'ana zinthu zingapo pamodzi, osati chimodzi chokha.

• Kuwunika mbiri yonse yachipatala ndi thupi: Izi zimachitika kuti tipewe matenda ena omwe ali ndi zizindikiro zofanana ndi zanu. Dokotala wanu akagwiritsa ntchito stethoscope kuti aone mitsempha yanu yamagazi, angamve phokoso lachilendo lotchedwa 'bruit' mkati mwa mitsempha yamagazi. Mitsempha yamagazi ikachepa kwambiri, zimakhala zovuta kuti magazi adutsemo, zomwe zimapangitsa kuti phokosolo limveke.
• Ma X-ray: Izi zimasonyeza komwe mtsempha wanu wawonongeka komanso kuopsa kwa kuwonongekako.
• Mayeso ozindikira kuchepa kwa mitsempha yamagazi kapena aneurysms: Pali njira zosiyanasiyana zoyesera izi.

Kodi mayeso oyezetsa matenda ndi ati?

Pali mayeso angapo omwe angathandize dokotala kutsimikizira matendawa:

• Kujambula Magnetic Resonance (MRI): Iyi ndi njira yoyesera yomwe sigwiritsa ntchito X-ray. Zithunzi zimapangidwa pogwiritsa ntchito maginito akuluakulu, mafunde amagetsi, ndi kompyuta.
• Kujambula kwa Computed Tomography (CT): X-ray ndi makompyuta amapanga zithunzi za ziwalo zamkati, kuphatikizapo mitsempha yayikulu yamagazi.
• Angiography: Izi zimaphatikizapo kujambula zithunzi za X-ray za mkati mwa mitsempha yanu yamagazi. Dokotala wanu amaika chubu chopyapyala, chachitali chotchedwa catheter mu mtsempha waukulu womwe uli m'mimba mwanu kapena m'dzanja lanu ndikuchitsogolera ku mtsempha womwe ukufunika kuunika. Kenako, utoto wapadera (zosiyana ndi zinthu) umalowetsedwa kudzera mu catheter kupita mu mtsempha wamagazi. X-ray ikatengedwa, utotowo umapangitsa kuti mitsempha yamagazi iwonekere bwino pazithunzizo. Nthawi zina, MRI ingagwiritsidwenso ntchito kuchita angiography.
• Positron Emission Tomography (PET scan): Mu mayesowa, dokotala wanu amabaya mankhwala owopsa kudzera mu singano mu mtsempha womwe uli m'dzanja lanu. Pamene mankhwalawa akuyenda m'thupi lanu, scanner imazindikira ndi kupanga zithunzi.
• Ultrasound: Izi zimathandiza kupanga zithunzi za mitsempha yamagazi pogwiritsa ntchito mafunde a phokoso.

Kodi arteritis ya Takayasu imachiritsidwa bwanji?

Mankhwala amatha kuletsa kutupa, kapena kutupa. Komabe, anthu ena angafunike opaleshoni kuti adutse mtsempha wamagazi wotsekedwa ndikupanga njira yatsopano yoti magazi aziyenda. Corticosteroids: Corticosteroids, monga prednisone (monga Rayos®, Sterapred®) kapena prednisolone (monga Flo-Pred®, Orapred®), ndi mankhwala odziwika bwino a Takayasu's arteritis (TAK).

Mankhwalawa amagwira ntchito zodabwitsa pochotsa kutupa m'mitsempha yamagazi ndikuchepetsa matendawa.

Dokotala wanu adzachepetsa pang'onopang'ono mlingo wa prednisone kufika pa mlingo wotsika kwambiri kuti achepetse zotsatirapo zake. Anthu ena amatha kusiya pang'onopang'ono kumwa mankhwalawo popanda zizindikiro kubwerera. Komabe, corticosteroids iyi sigwira ntchito mokwanira kwa anthu ena. Komanso, anthu opitilira theka omwe amamwa mankhwalawa amatha kukumana ndi zizindikiro zobwerera kapena kuipiraipira kwa matenda awo. Mankhwala oletsa chitetezo chamthupi: Madokotala nthawi zambiri amaperekanso mankhwala omwe amaletsa chitetezo chamthupi, monga:

• Methotrexate (monga Rheumatoidrex®, Trexall®)
• Azathioprine (e.g. Imuran®, Azasan®)
• Mycophenolate (monga Cellcept®, Myfortic®)
• Leflunomide
• Cyclophosphamide

Mankhwala oletsa chitetezo chamthupi amenewa akagwiritsidwa ntchito ndi prednisone, pafupifupi 50% ya anthu omwe kale anali ndi ziphuphu amatha kuchira ndipo pang'onopang'ono amatha kusiya kumwa prednisone. Mankhwala oletsa kutupa (TNF): Anthu ena angapatsidwenso mankhwala otchedwa TNF inhibitors kuti athandize kulimbana ndi kutupa. Zitsanzo za izi ndi izi:

• Etanercept
• Infliximab
• Tocilizumab

Ponseponse, pafupifupi 25% ya anthu omwe ali ndi arteritis ya Takayasu sangathe kulamulira matendawa mokwanira popanda mankhwala opitilira.

Kodi zotsatirapo zake ndi ziti?

Mankhwala omwe amagwiritsidwa ntchito pochiza matenda a Takayasu's arteritis akhoza kukhala ndi zotsatirapo zina zoyipa. Komabe, mankhwala ena angathandize kuwongolera zotsatirazi. Zotsatirapo zake zingakhale monga:

• Kuchepa kwa kukana matenda.
• Kuchepa kwa mafupa (osteoporosis).
• Kuvuta kuona.
• Kugwidwa ndi khunyu.

Mankhwala a Corticosteroids amayamba kugwira ntchito patangopita maola ochepa kuchokera pamene chithandizo chayamba, kotero mutha kumva mpumulo mwachangu.

Ndi mankhwala ena ati omwe amagwiritsidwa ntchito?

Nthawi zina, kuthamanga kwa magazi (kuthamanga kwa magazi) kungayambitsidwe ndi kuchepa kwa mitsempha yamagazi kupita ku impso. Pankhaniyi, dokotala angagwiritse ntchito chinthu chonga baluni kuti akulitse mtsempha wamagazi wopapatiza, womwe umatchedwa angioplasty. Kapena, opaleshoni ya bypass ingachitike kuti magazi aziyenda bwino kupita ku impso. Izi zingathandize kubwezeretsa kuthamanga kwa magazi popanda kumwa mankhwala a kuthamanga kwa magazi. Anthu ena akhoza kukhala ndi mavuto aakulu ndi mitsempha yamagazi yopapatiza m'manja kapena m'miyendo yawo, zomwe zimapangitsa kuti zikhale zovuta kuyenda kapena kuchita zinthu zina. Opaleshoni ya bypass ingakonzenso mavutowa. Ngati pali aneurysm, ikhoza kukonzedwa ndi opaleshoni kapena bypass. Anthu ena omwe ali ndi arteritis ya Takayasu angafunikenso kusinthidwa ndi valavu ya aortic.

Kodi ndimadzisamalira bwanji?

Anthu ambiri omwe ali ndi matenda a Takayasu's arteritis alinso ndi kuthamanga kwa magazi (kuthamanga kwa magazi). Ndikofunikira kuwongolera izi. Ngati simukuchiza kuthamanga kwa magazi, zinthu ngati izi zitha kuchitika:

• Stroke.
• Matenda a mtima.
• Kulephera kwa impso.

Ngati mukumwa mankhwala oletsa chitetezo chamthupi chanu, ganizirani kutenga mitundu iyi ya katemera kuti muteteze ku matenda:

• Katemera wa chimfine.
• Katemera wa chibayo.
• Katemera wa Herpes zoster (Shingles).

Kodi munthu amene ali ndi matenda a arteritis a Takayasu angayembekezere chiyani?

Ngakhale kuti palibe mankhwala a Takayasu's arteritis, ndi matenda ochiritsika. Anthu ambiri omwe ali ndi matendawa amachira ndi chithandizo. Komabe, anthu ambiri amatha kulumala pamlingo winawake, kapena nthawi zina kwathunthu, chifukwa cha matendawa. Zotsatira za matendawa zimatha kukhudza kwambiri zochita za tsiku ndi tsiku. Pafupifupi theka la anthu omwe ali ndi Takayasu's arteritis ayenera kusintha ntchito zawo. Komabe, pafupifupi 25% ya anthu omwe ali ndi matendawa amakhala ndi moyo wabwinobwino. Ena 25% adasintha zina pa zochita zawo. Anthu omwe ali ndi matendawa nthawi yayitali ayenera kupimidwa nthawi zonse kuchipatala, ndipo ngati pakufunika, kusintha mankhwala awo. Madokotala ayeneranso kuyang'anira zotsatirapo za mankhwalawo ndikuchita mayeso a magazi. Zotsatirazi zitha kukhala zovuta za Takayasu's arteritis:

• Kulephera kwa mtima.
• Stroke.
• Magazi amaundana.
• Matenda a mtima.

Takayasu arteritis ndi matenda a nthawi yayitali omwe amakula pang'onopang'ono. Mudzafunika chithandizo cha nthawi yayitali, nthawi zambiri ndi mankhwala. M'maiko monga United States ndi Japan, pafupifupi 3% ya anthu omwe ali ndi Takayasu arteritis amafa mkati mwa zaka zisanu kuchokera pamene matendawa ayamba. Izi zitha kukhala chifukwa madokotala amatha kuzindikira matendawa msanga ndikuchiza molondola. M'madera ena a dziko lapansi, zotsatira zake zimakhala zoyipa kwambiri chifukwa cha kuchedwa kwa matenda ndi chithandizo kapena kusapeza bwino chithandizo chamankhwala. Ngati sichinachiritsidwe, Takayasu arteritis ikhoza kupha.

Kodi ndingasamalire bwanji thanzi langa?

Ndikofunikira kudziwa momwe mukumvera ndikukhala nthawi zonse ndi dokotala wanu kuti muzindikire zizindikiro zatsopano kapena zoipiraipira msanga.

Kodi ndiyenera kupita kwa dokotala liti?

Ngati zizindikiro za Takayasu arteritis yanu zabwereranso panthawi ya chithandizo kapena mutalandira chithandizo, pitani kwa dokotala nthawi yomweyo. Ngati mukukonzekera kutenga pakati, lankhulani ndi dokotala wanu za vutoli. N'zotheka kukhala ndi mimba yabwino ndi Takayasu arteritis, koma ndikofunikira kudziwa momwe mungathanirane nayo.

Kodi ndiyenera kupita ku Chipinda Chothandizira Anthu Odwala Mwadzidzidzi (ETU) liti?

Ngati muli ndi zizindikiro izi, imbani 911 nthawi yomweyo (ku Sri Lanka, imbani 1990 Suwaseriya Ambulance Service kapena pitani kuchipatala chapafupi):

• Kupweteka pachifuwa.
• Kuvuta kupuma.
• Kugunda kofooka.
• Zizindikiro za matenda a mtima (monga kupweteka kwambiri pachifuwa komwe kumatuluka m'manja, thukuta, nseru).
• Zizindikiro za sitiroko (monga kugwada mbali imodzi ya nkhope, dzanzi m'dzanja, kuvutika kulankhula).

Ndi mafunso ati omwe ndiyenera kufunsa dokotala wanga?

• Kodi ndiyenera kumwa mankhwala a Takayasu's arteritis kwa nthawi yayitali bwanji?
• Kodi ndiyenera kubwera kangati kudzakumana ndi dokotala wotsatira?
• Kodi vuto langa lingathetsedwe popanda opaleshoni?
• Kodi ndimafunika kuchita mayeso ojambulira zithunzi kangati?

Pomaliza, zomwe muyenera kukumbukira (Uthenga Wopita Nawo Kunyumba)

Popeza Takayasu's Arteritis ndi matenda a nthawi yayitali, kapena 'osatha', muyenera kupita kwa dokotala nthawi zonse. Pakapita nthawi, zizindikiro zanu zimatha kusintha kuchoka pa kukhala wodziletsa mpaka kukhala wodziletsa. Ndicho chifukwa chake ndikofunikira kulankhulana ndi dokotala nthawi zonse. Musaope kuuza dokotala wanu ngati muwona kusintha kulikonse pa thanzi lanu. Dokotala wanu adzafuna kudziwa za izi, chifukwa nthawi imeneyo ndi pamene angakuthandizeni.

Kumbukirani, ngakhale muli ndi matendawa, mukalandira chithandizo choyenera komanso kutsatira malangizo a dokotala, inunso mutha kukhala ndi moyo wabwino. Khalani olimba mtima!

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