Mutu ndi mavuto a maso omwe amabwera chifukwa cha ukalamba: Tiyeni tiphunzire za Giant Cell Arteritis (GCA) kapena Temporal Arteritis?

Kodi munthu wokalamba m'banja mwanu, mwina amayi anu, abambo anu, kapena agogo anu, nthawi zambiri amadandaula za mutu? Kodi maso anu amaoneka ofooka pang'ono nthawi imodzi? Ndiye ichi ndi chinthu chomwe chingakhale chofunikira kwa inu. Lero tikulankhula za matenda otchedwa Giant Cell Arteritis (GCA) , omwe kale ankadziwika kuti Temporal Arteritis , omwe nthawi zambiri amakhudza akuluakulu. Palibe choopa, chinthu chofunikira kwambiri ndikudziwa izi.

Kodi GCA ndi chiyani? N’chifukwa chiyani ingakhale yoopsa?

Mwachidule, Giant Cell Arteritis (GCA) ndi matenda omwe amayambitsa kutupa m'mitsempha ikuluikulu yamagazi m'thupi lanu (makamaka yomwe ili m'mutu, khosi, ndi m'manja). Madokotala amatchanso kuti "vasculitis." Mitsempha yamagazi ikatupa motere, makoma ake amakhuthala, zomwe zimapangitsa kuti magazi alowe m'malo mwake. Taganizirani ngati chitoliro chamadzi chomwe chimatsekedwa kuti chisayende. Pamene kuyenda kwa magazi kwasokonekera motere, kumatha kuwononga ziwalo zofunika kwambiri ndi minofu yomwe magazi amaperekedwa ndi mitsempha yamagaziyo.

Mitsempha ya temporal, yomwe ili mbali zonse za mphumi yanu, imapereka magazi ku chigaza chanu, minofu ya nsagwada, ndi mitsempha ya optic, yomwe ndi mitsempha yomwe imakupatsirani kuwona. Ngati GCA ikhudza mitsempha ya temporal iyi, ingayambitse mavuto akulu, monga khungu . GCA ingakhudzenso aorta, mtsempha waukulu kwambiri wamagazi m'thupi, ndi nthambi zake. Kutupa kwa aorta kumeneku kumatchedwa aortitis, ndipo kungayambitse mavuto aakulu azaumoyo.

GCA ikhoza kuchitika limodzi ndi matenda ena otupa, Polymyalgia Rheumatica, kapena PMR . Tidzakambirana zambiri za PMR mtsogolo.

Kodi GCA ndi matenda oopsadi?

Inde, GCA ndi matenda omwe angakhale aakulu ngati sapezeka ndi kuchiritsidwa msanga . Izi zili choncho chifukwa:

• Maso anu akhoza kuwonongeka . Mungataye maso anu mwadzidzidzi, kapena mungakhumudwe ndi diso limodzi kapena onse awiri.
• Mitsempha yanu yamagazi ikhoza kuwonongeka . Mwachitsanzo, vuto lotchedwa aneurysm, lomwe ndi mtsempha wamagazi womwe umatupa ngati baluni ndikuphulika, limawonjezera chiopsezo chophulika.
• Matenda ena, monga sitiroko kapena kuukira kwa ischemic kwa nthawi yochepa (komwe kumatchedwanso "mini-stroke"), amatha kuchitika.

Ndicho chifukwa chake ndikofunikira kwambiri kudziwa zizindikiro izi.

Kodi GCA ndi yofala bwanji?

Ngakhale kuti GCA ndi imodzi mwa mitundu yofala kwambiri ya vasculitis, ndi matenda osowa kwambiri . Malinga ndi ziwerengero ku United States, anthu 19-23 okha ndi omwe amadwala matendawa pa anthu 100,000 aliwonse. Ngakhale kuti palibe ziwerengero zenizeni ku Sri Lanka, ndibwino kuda nkhawa ndi izi pamene chiwerengero cha anthu okalamba chikuwonjezeka.

Kodi zizindikiro za GCA (Temporal Arteritis) ndi ziti?

Chizindikiro chachikulu komanso chodziwika bwino cha GCA ndi mutu waukulu, wopitirira womwe umamveka ngati kupweteka kopweteka mbali imodzi kapena zonse ziwiri za mutu.Koma kuwonjezera pa izi, zizindikiro zina zingawonekere:

• Kufewa mukayika dzanja lanu pakhungu kapena mbali zonse ziwiri za mphumi (pamwamba pa makutu).
• Kupweteka kwa nsagwada , makamaka mukamadya kapena kutafuna.
• Mavuto a masomphenya : Kuona kawiri, kuona zinthu mopanda nzeru, kapena kutaya masomphenya mwadzidzidzi kwa kanthawi kochepa.
• Kutopa .
• Malungo .
• Kutaya chilakolako cha chakudya kapena kuchepetsa thupi .
• Kupweteka kwa minofu : Kupweteka m'mapewa, m'manja apamwamba, m'chiuno, m'ntchafu zapamwamba, m'munsi mwa msana, ndi m'matako.

Mukukumbukira pamene ndinatchula vuto lina lomwe nthawi zambiri limabwera ndi GCA, Polymyalgia Rheumatica (PMR)? Ilinso ndi vuto lomwe limayambitsa kutupa. PMR imayambitsa kupweteka kwambiri ndi kuuma , makamaka m'mapewa ndi m'chiuno. PMR imathanso kuchitika yokha (ndizofala kwambiri kuti PMR imachitika yokha kuposa GCA). Komabe, pafupifupi 40-60% ya anthu omwe ali ndi GCA adzakhalanso ndi PMR. Komanso, 10-20% ya anthu omwe ali ndi PMR yokha adzadwala GCA mtsogolo.

Kodi chimayambitsa GCA ndi chiyani?

Ofufuza sakudziwabe chomwe chimayambitsa GCA, koma ambiri amakhulupirira kuti ndi matenda omwe amayambitsa chitetezo chamthupi kapena kutupa kwa thupi. Mwachidule, ndi pamene chitetezo cha mthupi lanu chimaukira mitsempha yanu yamagazi yathanzi molakwika .

Matendawa amapezeka kwambiri mwa okalamba, kotero anthu ena amaganiza kuti akugwirizana ndi ukalamba. Amaganiziridwanso kuti amayamba chifukwa cha majini ndi zinthu zina zachilengedwe (monga matenda omwe amakhudza chitetezo cha mthupi).

Ndani amene amakhudzidwa kwambiri ndi GCA?

Ngakhale aliyense angathe kukhala ndi GCA, anthu otsatirawa ali pachiwopsezo chachikulu:

• Okalamba : GCA nthawi zambiri imakhudza anthu azaka zopitilira 50. Chiwopsezo chotenga matendawa chimawonjezeka ndi ukalamba. Chimafala kwambiri mwa anthu azaka zapakati pa 70 ndi 80.
• Akazi : Matendawa amapezeka kwambiri mwa akazi kuposa amuna. Komabe, amuna ali pachiwopsezo chachikulu cha khungu chifukwa cha matendawa.
• Anthu Azungu : Kafukufuku wasonyeza kuti GCA imakhudza anthu azungu ochokera kumpoto kwa Ulaya nthawi zambiri kuposa mafuko ena. Komabe, izi sizikutanthauza kuti mafuko ena sangathe kuikulitsa.

Kodi GCA imapezedwa bwanji?

Ngati muli ndi zizindikiro za GCA, dokotala wanu adzakufunsani kaye za mbiri yanu yachipatala kenako adzakuyesani thupi. Adzayang'ana ngati pali kugunda kwa mtima kofooka m'manja ndi miyendo yanu. Adzayang'ananso mutu wanu kuti awone ngati muli ndi ululu pakhungu lanu komanso ngati mitsempha yamagazi mbali zonse ziwiri za mphumi yanu yatupa.

Ndi mayeso ati omwe amagwiritsidwa ntchito pozindikira GCA?

Dokotala adzayamba kaye walamula kuti ayese magazi angapo kuti aone kuchuluka kwa kutupa m'thupi lanu. Mwachitsanzo:

• (Chiwerengero cha Kutuluka kwa Mchere m'thupi) (ESR)
• `(Mapuloteni Ogwira Ntchito a C)` (CRP)

Mayeso awa angakuthandizeni kudziwa kuchuluka kwa kutupa m'thupi lanu. Angathenso kuyeza kuchuluka kwa hemoglobin m'magazi anu, gawo lonyamula mpweya m'maselo ofiira amagazi anu, kuti aone ngati muli ndi vuto la kuchepa kwa magazi m'thupi.

Ngati dokotala wanu akukayikira GCA (Temporal Arteritis), angakupatseni ultrasound ya mitsempha ya temporal, ultrasound ya mitsempha ya pamphumi panu. Kapena, angakupatseni biopsy ya mitsempha ya temporal . Izi zimaphatikizapo dokotala wophunzitsidwa kutenga chitsanzo chaching'ono cha mitsempha ya pamphumi panu ndikutumiza kwa dokotala wa matenda kuti akafufuze pogwiritsa ntchito maikulosikopu. Izi zifufuza zizindikiro za kutupa (vasculitis) mu mitsempha yamagazi. Iyi ndiye mayeso akuluakulu otsimikizira GCA.

Nthawi zina mayeso awa angafunikenso:

• Kuyesa kwa ``(Computed Tomography)`` kapena ``(CT)```
• Kujambula kwa Magnetic Resonance (MRI)
• Ultrasound ya mitsempha yayikulu yamagazi
• Kuyesa kwa `(Positron Emission Tomography)` kapena `(PET)`

Kodi mankhwala a GCA (Temporal Arteritis) ndi ati?

Chithandizo cha GCA chiyenera kuyamba mwamsanga, makamaka kuti chisawononge masomphenya .

Chithandizo chachikulu ndi mtundu wa mankhwala otchedwa ``glucocorticoid''. Mtundu wofala kwambiri wa mankhwala ndi ``prednisone.'' Muyamba ndi ma milligrams 40 mpaka 60 (mg) patsiku (mwa) ndipo pang'onopang'ono muchepetse mlingo. Ngati muli kale ndi vuto la masomphenya kapena kutaya masomphenya, dokotala wanu angakupatseni mlingo waukulu wa ``glucocorticoids'' kudzera mu cannula yomwe imayikidwa mumtsempha (``(IV)'').

Chofunika: Glucocorticoids ndi mankhwala ofunikira kwambiri poletsa GCA. Komabe, mankhwalawa angayambitse zotsatira zina zoyipa, kotero dokotala wanu adzakuyang'anirani mosamala.

Ma glucocorticoids amafooketsa chitetezo chamthupi chanu, zomwe zingakupangitseni kuti mutenge matenda ambiri ndikupangitsa kuti akhale oopsa kwambiri . Angathenso kuonda mafupa anu , zomwe zimawonjezera chiopsezo chanu cha kusweka kwa mafupa.

Zotsatira zina zomwe zingachitike ndi izi:

• Matenda a Cataract
• Kuthamanga kwa magazi
• Shuga wambiri m'magazi
• Kusowa tulo
• Kusintha kwa maganizo
• Kufooka kwa minofu ndi kufooka kwa minofu, makamaka m'miyendo
• Kutupa, makamaka pankhope ndi miyendo
• Kulemera

Mukumwa mankhwala ochepetsa mafupa (glucocorticoids), dokotala wanu angayang'ane kuchuluka kwa mafupa anu. Angakulangizeninso kuchita masewera olimbitsa thupi, calcium ndi vitamini D, komanso mankhwala oletsa kufooka kwa mafupa (osteoporosis) kuti mafupa anu akhale olimba.

Mu 2017, bungwe la U.S. Food and Drug Administration linavomereza mankhwala atsopano a biologic otchedwa tocilizumab (Actemra®) ochizira GCA. Mankhwalawa amaperekedwa ngati jakisoni pansi pa khungu kapena ngati IV. Angathandize kuchepetsa kufunikira kwa glucocorticoids. Komabe, tocilizumab ili ndi zotsatira zake zoyipa, zomwe dokotala wanu adzakufotokozerani.

Ndiyenera kupita kwa dokotala liti?

Ngati muli ndi zizindikiro za GCA, zizindikiro za matenda, kapena zizindikiro zina zatsopano, pitani kwa dokotala nthawi yomweyo . Kupita kwa dokotala nthawi zonse komanso kuyezetsa magazi ndi kusanthula kungathandize kuzindikira kubwereranso msanga kwa matendawa.

Ndi mafunso ati omwe ndiyenera kufunsa dokotala?

Mungathe kufunsa dokotala wanu mafunso monga:

• Kodi mumalimbikitsa chithandizo chanji?
• Ndi zotsatirapo ziti zomwe ndiyenera kudziwa panthawi ya chithandizo?
• Kodi ndingatani kuti ndichepetse zotsatirapo zoyipa za chithandizo?
• Kodi mavuto omwe angakhalepo chifukwa cha vutoli ndi ati?
• Kodi ndimayang'anira bwanji vuto langa?
• Kodi zizindikiro za kubwereranso m'mbuyo ndi ziti?
• Ndi zizindikiro ziti zomwe ndiyenera kukufunsani?

Kodi munthu amene ali ndi GCA amakhala ndi moyo wautali bwanji?

Kukhala ndi GCA sikunapezeke kuti kumafupikitsa nthawi yoyembekezera moyo, koma zinthu zosiyanasiyana zingakhudze izi. Ngati matendawa apezeka ndi kuchiritsidwa msanga, zotsatira zake zimakhala zabwino kwambiri , ndipo zizindikiro zimayamba kusintha pakatha masiku ochepa.

Komabe, ngati sichilandira chithandizo mwachangu, GCA ingayambitse mavuto omwe angawononge moyo monga kutayika kwa masomphenya kosatha, kuchepa kwa magazi m'thupi, komanso kufooka kwa ziwalo. Chifukwa chake, ndikofunikira kwambiri kuwonana ndi dokotala nthawi yomweyo ngati muli ndi zizindikiro zokhudzana ndi GCA.

Chithandizo chikayamba, chiopsezo chachikulu chomwe mumakumana nacho ndi zotsatirapo zake . Komanso, ngakhale GCA itachiritsidwa poyamba ndi chithandizo chopambana, nthawi zina imatha kubwereranso (`kubwereranso`) . Ofufuza sakudziwabe chifukwa chake izi zimachitika.

Kodi ndimadzisamalira bwanji ndikakhala ndi GCA?

Kukhala ndi GCA kungakhale kovuta. Kuti muthane ndi vuto lanu ndikuchepetsa zotsatirapo za glucocorticoids, yesani izi:

• Idyani zakudya zabwino komanso zopatsa thanzi : zinthu monga nyama yopanda mafuta ambiri, nyemba, tirigu wonse, zipatso ndi ndiwo zamasamba zatsopano.
• Pezani vitamini D ndi calcium yokwanira kuti muteteze mafupa anu.
• Chitani masewera olimbitsa thupi kwa mphindi zosachepera 30 patsiku.
• Gonani bwino kwa maola osachepera asanu ndi awiri mpaka asanu ndi atatu usiku uliwonse.
• Imwani mankhwala omwe mwapatsidwa pa nthawi yake .
• Pitani kwa dokotala nthawi zonse .
• Chitani zinthu zodzitetezera ku matenda .

Ndi zinthu ziti zomwe ndiyenera kupewa ndikakhala ndi GCA?

Ngati muli ndi GCA, ndi bwino kupewa zinthu izi:

• Zinthu zomwe zimawonjezera chiopsezo chanu chodwala : Chifukwa chakuti mankhwala a GCA amafooketsa chitetezo chamthupi chanu, mumakhala ndi mwayi waukulu wotenga matenda. Funsani dokotala wanu za njira zina zochepetsera chiopsezo chanu chotenga matenda, monga kupewa kudwala, kusamba m'manja pafupipafupi, komanso kupewa anthu odwala.
• Kusuta : Kusuta kungakulitse chiopsezo chanu chokhala ndi GCA. Thanzi la mitsempha yanu yamagazi lidzasintha mukangosiya kusuta, zomwe zidzakuthandizani kwa moyo wanu wonse.
• Kumwa mowa : Mowa ungasokoneze thanzi la mtima wanu ndi mitsempha yamagazi. Ungalimbikitsenso kutayika kwa mafupa komanso kusokonezana ndi mankhwala omwe mumamwa pa vuto lanu.

Mfundo zofunika kwambiri (Uthenga Wopita Nawo Kunyumba)

Giant Cell Arteritis (yomwe kale inali Temporal Arteritis) ingakhale vuto lalikulu. Komabe, ngati mutapezeka ndi matendawa msanga ndikupita kukayezetsa dokotala wodziwa bwino ntchito yanu, mungakhale ndi zotsatira zabwino kwambiri . Zizindikiro ndi zotsatirapo zake zingakhudze thanzi lanu la maganizo, ntchito yanu, komanso mbali zambiri za moyo wanu. Koma simuli nokha. Pemphani dokotala wanu kuti akuthandizeni kupeza gulu lothandizira anthu omwe adakumanapo ndi zinthu zofanana. Kugawana zomwe mwakumana nazo ndi upangiri wanu ndi ena kungakhale kotonthoza.

Kumbukirani, ngati muli ndi zizindikiro zachilendo monga mutu, kupweteka kwa nsagwada, kapena mavuto a maso (makamaka ngati muli ndi zaka zoposa 50), musanyalanyaze ndipo funsani upangiri wa dokotala nthawi yomweyo. Chithandizo chachangu chingapewe mavuto aakulu.

` Giant Cell Arteritis, Temporal Arteritis, GCA, Mutu, Kuwona, Kutupa kwa Mitsempha ya Magazi, Thanzi la Okalamba, Polymyalgia Rheumatica, Prednisone, Vasculitis