Fungidzira, unongoerekana wava nedambudziko rekufamba, worasikirwa nechiyero chako, wonzwa dzungu wodonha paunomira wakagara. Zvakajairika kunzwa kutya zvikuru kana zvinhu izvi zvatanga kuitika kamwe kamwe. Kunyangwe dzimwe nguva tisinganyatsoteerera izvi, zvinogona kuva zviratidzo zvekutanga zvezvirwere zvisingawanzoitiki. Nhasi tichataura nezvechimwe chirwere chisingawanzoitiki, asi chakakomba chetsinga. Icho chinonzi Multiple System Atrophy , chirwere icho isu vanachiremba nevarwere tinochidaidza kuti (MSA) muchidimbu. Kunyangwe ichi chiri nyaya yakaoma zvishoma, tichataura nezvacho zviri nyore, nenzira yaunogona kunzwisisa.
Zvichitaurwa zviri nyore, chii chinonzi MSA iyi?
MSA chirwere chisingawanzoitiki chetsinga umo zvikamu zveuropi hwedu zvinopera simba zvishoma nezvishoma zvofa. Nekufamba kwenguva, kugona kwemuviri nemabasa anodzorwa nezvikamu izvi zveuropi zvakakuvara zvinopera zvishoma nezvishoma. Kutaura chokwadi, iyi inyaya inosuwisa zvikuru, nekuti chirwere ichi chinoguma nerufu.
Kare, vanachiremba vaitumidza muunganidzwa uyu wezviratidzo nemazita matatu. Aiva:
- Chirwere cheShy-Drager
- Kupera kwemafuta emupontocerebellar muzvikamu zvidiki
- Kuora kweStriatonigral
Asi gare gare, vaongorori vakaona kuti zvirwere izvi zvitatu zvaive nezvinhu zvakawanda zvakafanana. Saka, vakazvibatanidza zvese ndokuzvitumidza kuti "Multiple System Atrophy" (MSA). "Multiple System" zvinoreva "systems dzinoverengeka." Izvi zvinoreva kuti chirwere ichi chinokanganisa systems dzinoverengeka mumuviri wedu. Zviratidzo zvinoenderana nekuti ndeapi mativi europi akakuvara. Ndosaka munhu wega wega achisangana nemusanganiswa wezviratidzo zvakasiyana.
Gare gare, chirwere ichi chakaiswa muzvikamu zvakasiyana, zvichibva pazviratidzo zvachinoratidza. Saka, kune mhando mbiri dzeMSA.
| Rudzi rweMSA | Tsananguro uye zvinhu zvikuru |
|---|---|
| MSA-C | 'C' pano inomiririra 'Cerebellar'. Cerebellum chikamu cheuropi chinotungamira mafambiro edu. Zviratidzo zvikuru zverudzi urwu kurasikirwa nekuenzana (ataxia) . Izvi zvinoreva kuti hatigone kudzora makumbo edu nemazvo, senge patinenge tichifamba. Pamusoro pezvo, kune matambudziko nemabasa emuviri otomatiki (autonomic dysfunction) uye kuwa kakawanda. |
| MSA-P | 'P' pano inomiririra 'Parkinsonism'. Rudzi urwu rweMSA-C rune zviratidzo zvakafanana nechirwere cheParkinson. Semuenzaniso, kudedera, kufamba zvishoma nezvishoma, uye kuomarara. Kunyangwe zviratidzo zveParkinson izvi zvirizvo zvikuru pakutanga, nekufamba kwenguva, zviratidzo zvakafanana nezvezvimwe MSA-C (kurasikirwa nechiyero, matambudziko nemabasa ega) zvinogonawo kuoneka. |
Ndiani ari panjodzi huru yekubatwa neMSA?
MSA inowanzobata vanhu vakuru, kunyanya mushure memakore makumi matatu. Zviratidzo zvinowanzoonekwa pakati pemakore makumi mashanu nemakumi mashanu nemapfumbamwe. Chirwere ichi chinogona kubata chero munhu, zvisinei nekuti murume kana mukadzi.
Ichi chirwere chisingawanzoitiki. Zvichienderana nehuwandu, kune vanhu vatsva vanosvika 0.6 kusvika 0.7 chete pavanhu 100,000 pagore. Izvi zvinoreva kuti ichi hachisi chirwere chinowanzoitika munharaunda yedu.
Chirwere cheMSA chinokanganisa sei muviri wedu?
MSA inokonzera kuti masero afe munzvimbo dzakasiyana dzeuropi. Zviratidzo zvinoenderana nekuti ndeapi mativi europi akakuvara. Zvikamu zvikuru zveuropi zvinokanganiswa ndeizvi:
- Basal Ganglia: Izvi zviri pakati chaipo peuropi. Zvakaita senzvimbo inobatanidza zvikamu zvakasiyana zveuropi. Ndiko kuburikidza nechikamu ichi apo zvikamu zvakasiyana zveuropi zvinoungana pamwe chete uye zvinoshanda pamwe chete.
- Brainstem: Apa ndipo panodzorwa maitiro emuviri wedu akakosha kuti tirarame. Semuenzaniso, zvinhu zvakaita sekufema, kurova kwemoyo, uye BP. Zvinhu izvi zvinoitika zvoga pasina kufunga nezvazvo, handiti? Apa ndipo panodzorwa zvinhu.
- Cerebellum: Iyi iri kumashure kwemusoro, pedyo nehwaro. Iyi ndiyo chikamu chikuru cheuropi hwedu chinoronga mafambiro emuviri wedu uye chinochengetedza kuenzana kwedu. Pamusoro pezvo, tsvakurudzo yakawana kuti chikamu ichi chinobatanidzwawo mumanzwiro edu nekuita sarudzo.
Saka, kana zvikamu izvi zveuropi zvakuvara, maitiro ese anodzorwa nezvikamu izvozvo anotanga kushata. Semuenzaniso, kana `(brainstem)` yakuvara, pane matambudziko akakomba nemaitiro ega ega akadai seBP.
Ndezvipi zviratidzo zvikuru zveMSA?
MuMSA, zvimwe zviratidzo zvinowanikwa mumhando dzese dziri mbiri. Pamusoro pezvo, kune zvimwe zvinhu zvakanangana nerudzi rumwe nerumwe. Chinhu chikuru chinowanikwa mumhando dzese mbiri idzi kusashanda zvakanaka kwemuviri . Zvichitaurwa zviri nyore, maitiro anoitika otomatiki mumuviri wedu haashande nemazvo.
Zviratidzo zveKusashanda zvakanaka kweAutonomic
- Kushaya Simba remuviri: Ichi ndicho chiratidzo chekutanga chinowanikwa nevanhu vazhinji. Paunomira kamwe kamwe kubva panzvimbo yawakagara kana kuti wakarara , BP yako inodonha kamwe kamwe . Izvi zvinogona kukonzera dzungu, kuona zvisipo, uye kutofenda.
- Kusakwanisa kudzora weti netsvina: Kutadza kudzora weti netsvina zvinogona kuitika kana usingazvitarisire.
- Kusashanda zvakanaka pabonde: Matambudziko akadai sekusashanda zvakanaka kwepabonde, kunyanya kuvarume, anoitika panguva yepabonde.
- Matambudziko ekurara: Zvikuru sei, chirwere chinonzi ``(REM) sleep behavior disorder'' chinogona kuonekwa. Pakurota, unofambisa muviri wako, unoridza mhere, uye unofambisa nhengo dzako uchipindura zviroto zvako.
- Kudzikira kwedikita (Anhidrosis): Kugona kwemuviri kudikita kunodzikira zvakanyanya.
- Zviratidzo zvakaita sematambudziko ekuona, muromo wakaoma, kufema usina simba pakurara, uye kuvimbiwa zvinowanzoitikawo.
Zvakakosha kuti, kusashanda zvakanaka kwemuviri uku kunogona kuitika mwedzi, kana kunyange makore, zviratidzo zvekufamba kwemuviri zvisati zvatanga (zvakadai sekufamba netsoka uye kudedera). Izvi zvinoitika pakati pe20% ne75% yevarwere veMSA.
Hunhu hwepfungwa nehwemanzwiro
Vanenge chikamu chimwe muzvitatu chevarwere vane MSA vanosangana nematambudziko ekugona kwavo kufunga nekuisa pfungwa dzavo pachinhu chimwe chete. Vanonetsekawo kudzora manzwiro avo, izvo zvinogona kukonzera matambudziko akasiyana-siyana ehutano hwepfungwa.
- Kunetseka
- Kuora mwoyo
- Kuchema kana kuseka zvisina kukodzera
- Kurwiswa kwekutya
- Pfungwa dzekuzvikuvadza kana kuzviuraya
Zviratidzo zvine chekuita nekufamba
Hunhu uhwu hunosiyana zvichienderana nemhando mbiri dzeMSA dzatakambokurukura.
| Hunhu hweMSA-C (Cerebellar) | Zviratidzo zveMSA-P (Parkinsonism) |
|---|---|
| Chiratidzo chikuru iataxia , zvinoreva kurasikirwa nekubatana kwenhengo. | Zviratidzo zvikuru iParkinsonism , zvinoreva zviratidzo zvakafanana nechirwere cheParkinson. |
| - Kufamba kwemakumbo nemakumbo zvisina kudzorwa. | - Kufamba kunonoka zvikuru (bradykinesia) . |
| - Kuwedzera kwekubvunda kwemakumbo kana uchiedza kuita chimwe chinhu (Action tremble). | - Kunzwa kusimba uye kuomarara mumuviri, uye chimiro chinoita sechakakotama. |
| - Kufamba netsoka dziri kure zvisina kujairika, sekufamba kwekufamba-famba. | - Kudonha kakawanda paunenge uchifamba. |
| - Kudhonza maziso uye kufamba-famba (nystagmus) kusingadzoreki. | - Kusanzwisisa uye kusanzwisisa mazwi pakutaura. |
Chii chinokonzera MSA?
Chinokonzera MSA chaicho hachisati chazivikanwa . Zvisinei, masayendisiti anofungidzira kuti inokonzerwa nepuroteni inonzi alpha-synuclein . Puroteni iyi inofungidzirwa kuti inoungana zvisina kujairika munzvimbo dzakasiyana dzeuropi, zvichikonzera kukuvara kwemasero europi. Zvinoshamisa kuti puroteni iyi inofungidzirwawo kuti ndiyo inokonzera chirwere cheParkinson.
Mapuroteni akakosha pakushanda kwemiviri yedu. Zvisinei, kana mapuroteni aya akaungana panzvimbo dzisiridzo, nenzira isiriyo, anogona kukuvadza masero. Ndizvo zvinoitika muMSA.
Tsvagiridzo ichiri kuenderera mberi yekuti sei iyi alpha-synuclein protein ichiungana muuropi. Zvinofungidzirwa kuti zvinogona kunge zvichikonzerwa nekuchinja kwemajini. Kunyanya, pane humbowo hwekuti mhando yeMSA-C inogona kutapuriranwa kubva kuchizvarwa kuenda kune chimwe chizvarwa kusvika pamwero wakati. Zvisinei, hapana hukama hwakadaro hwemajini hwakawanikwa hwemhando yeMSA-P.
Zvakakosha: MSA haisi chirwere chinotapuriranwa. Haipfuurirwi kubva kumunhu mumwe kuenda kune mumwe nenzira ipi zvayo.
MSA inoonekwa sei?
Ichi ndicho chikamu chakaoma zvikuru chechirwere. Ndiyo chete nzira yekusimbisa MSA nechivimbo che100%.ndeyekuongorora tsinga dzeuropi mushure mekunge mumwe munhu afa. Chikonzero cheizvi ndechekuti parizvino hapana tekinoroji yekuona kana alpha-synuclein protein iri muuropi hwemunhu mupenyu.
Zvisinei, murwere achiri mupenyu, vanachiremba vanogona kufungidzira chirwere ichi. Vanoshandisa zvinhu zvakaita sezviratidzo, nhoroondo yezvekurapa kwemurwere, nhoroondo yemhuri, uye mhinduro kune mamwe marapirwo. Kazhinji, vanachiremba vanogona kutanga vaongorora chirwere cheParkinson. Zvisinei, sezvo zvimwe zviratidzo zvichikura nekufamba kwenguva, kana mushonga weParkinson ukarega kushanda, chirwere chingada kuchinjwa kuita MSA.
Kusiyana kukuru pakati peMSA nechirwere chaParkinson
| Hunhu | Kupera Kwemasero Akawanda (MSA) | Chirwere cheParkinson |
|---|---|---|
| Kukurumidza kupararira kwechirwere ichi | Zviratidzo zvinokurumidza kuipa. | Chirwere ichi chinokura zvishoma nezvishoma . |
| Kusasimba otomatiki | Matambudziko akakomba (semuenzaniso, matambudziko eBP) anowanzoonekwa mugore rekutanga rekutanga kwekurwara. | Zvinogona kutora makore kuti zviratidzo izvi zvionekwe. |
| Kudedera | Kudengenyeka kwacho kwaderera, pamwe hakutombovipo zvachose . | Kudedera kunoitika panguva yekuzorora chiratidzo chikuru . |
| Mhinduro kuna Levodopa | Vashoma vanobvuma mushonga uyu.Kana kuti kwete zvachose. | Inopindura zvakanaka pamushonga uyu. |
Kuongororwa kwezvirwere
Kune bvunzo shoma kwazvo dzinogona kuona MSA zvakananga. Kazhinji, bvunzo dzakawanda dzinoitwa kuti pasave nedzimwe zvirwere uye kuunganidza humbowo hunotsigira fungidziro yekuti MSA ingave ndiyo yakakonzera chirwere ichi.
- Kuongororwa kweMRI (Magnetic Resonance Imaging): Izvi dzimwe nguva zvinogona kuratidza kukuvara kwezvikamu zveuropi. MuMSA-C, kunyanya, patani inonzi "hot cross bun" inogona kuonekwa muchikamu cheuropi. Inotaridzika sehot cross bun. Zvisinei, chiratidzo ichi chinogona kuonekwawo mune zvimwe zvirwere, saka hachisi chiratidzo cheMSA.
- Kuongororwa kwemajini: Izvi zvinogona kutarisa kushanduka kwemajini kune chekuita neprotein yealpha-synuclein.
- Kuongororwa kweganda: Imwe tsvakiridzo itsva inoratidza kuti bvunzo iyi inogona kubatsira kuona kana alpha-synuclein iripo mutsinga dzeganda. Zvisinei, izvi zvichiri muchikamu chekutsvagisa.
Chiremba wako achakutsanangurira kuti ndeapi maedzo aanofunga kuti anodiwa, zvichienderana nemamiriro ako ezvinhu, uye zvaunotarisira kubva kwavari.
Pane mushonga weMSA here?
Zvinosuwisa kuti pari zvino hapana mushonga weMSA . Saka, chinangwa chikuru chekurapa ndechekudzora zviratidzo uye kuchengetedza hupenyu hwakanaka kwenguva yakareba sezvinobvira.
Kurapwa kunoitwa kunoenderana nezviratidzo zvemurwere uye kuoma kwazvo. Semuenzaniso, mishonga yeBP inopihwa yekurapa hypotension ye orthostatic, mishonga inorerutsa tsandanyama, uye mimwe mishonga yekudzora weti. Zvakare, zvinhu zvakaita se physiotherapy uye kurapa kutaura zvakakosha zvikuru.
Kana iwe kana mumwe munhu waunoziva aine chirwere ichi, usaedza kuzvirapa kana kugadzirisa zviratidzo. Gara uchiona chiremba ane hunyanzvi uye tevera mazano avo.
Munhu ane chirwere ichi angatarisira remangwana rerudzii?
MSA chirwere chinoenderera mberi. Vanhu vanosvika hafu yevanobatwa nechirwere ichi vanoda rubatsiro rwekufamba (senge tsvimbo kana chinofamba netsoka) mukati memakore mashanu kubva pakutanga kwezviratidzo. Vanhu vanosvika 60% vanoda wiricheya mukati memakore mashanu. Pamakore matanhatu kusvika masere, varwere vazhinji vanenge vakarara pamubhedha.
Sezvo chirwere ichi chichienderera mberi, nzira dzakasiyana-siyana dzekurapa dzinodiwa kuti muviri urambe uchishanda zvakanaka.
- Tracheostomy inzira inogadzirwa buri diki pahuro uye pombi inoiswa kuti ibatsire nematambudziko ekufema.
- Kupa chikafu nechubhu kana murwere asingakwanise kumedza.
- Kuvhiya nechubhu kana dzimwe nzira dzekuvhiya kuti udzore weti netsvina.
Kazhinji, avhareji yehupenyu hwemurwere ane MSA kubva panguva yekuongororwa chirwere ichi inenge iri pakati pemakore matanhatu kusvika gumi. Mune dzimwe nguva dzisina kunyanya kuoma, zvinokwanisika kurarama kusvika makore gumi nemashanu. Zvisinei, kana chirwere chacho chakanyanya kuoma, hupenyu hunogona kupfupika.
Rufu runonyanya kukonzerwa nematambudziko anokonzerwa nechirwere ichi. Semuenzaniso:
- Chirwere chemabayo.
- Sepsis (chepfu muropa) inokonzerwa nehutachiona hwemunzira yeweti.
- Rufu rusingatarisirwi runokonzerwa nematambudziko ekudzora kufema kweuropi panguva yekurara.
Tinotarisira sei vadikanwi vedu?
Zviratidzo zvemunhu ane MSA zvichiwedzera nekufamba kwenguva, anogona kupedzisira asisakwanise kurarama ari ega. Anogonawo kurasikirwa nepfungwa, kutaura, uye kuzvisarudzira ega.
Saka, zvakakosha zvikuru kutaura nezveramangwana nevadikanwi vako pakutanga kwechirwere, murwere achiri kuziva. Kana uri mumamiriro ezvinhu ausingakwanise kuita sarudzo, zvinova nyore kune wese munhu kana ukakwanisa kukurukura pachine nguva kuti ndeapi sarudzo dzinofanira kuitwa nezvekurapa kwako uye kugadzirira magwaro epamutemo.
Unofanira kuona chiremba rini?
Zviratidzo zvakawanda zvekutanga zveMSA zvinhu zvaunofanira kutaura nachiremba.
- Unzenza hwepabonde.
- Kuramba uchingonzwa dzungu uye kurasikirwa nepfungwa paunomira.
- Matambudziko ekurara, kunyanya sleep apnea.
Kana chiremba wako akakuudza kuti une chirwere chekufamba seParkinson's, zvakakosha kutaura nezvekuchinja kwezviratidzo zvako. Kunyanya kana mushonga (levodopa) weParkinson's usingashande, icho chiratidzo chikuru chekuti ungave uine MSA.
MSA chirwere chakakomba uye chinouraya. Ichokwadi kuti hapana mushonga wechirwere ichi. Zvisinei, zviratidzo zvakawanda zvinogona kurapwa. Kuburikidza nekurapwa ikoko, hupenyu hwemurwere hunogona kuchengetedzwa zvakanaka kwemakore mazhinji. Nguva iyoyo mukana unokosha wekugara uchifara nevadikanwi vake uye kunakidzwa nehupenyu zvizere.
Mharidzo Yekuenda Nayo Kumba
- MSA chirwere chisingawanzoitiki, chinouraya chetsinga chinoparadza zvikamu zveuropi zvishoma nezvishoma.
- Kune mhando mbiri huru: MSA-C (kurasikirwa nepfungwa ndiko kwakanyanya) uye MSA-P (hunhu hweParkinsonism ndihwo hwakanyanya).
- Kusashanda zvakanaka kwemuviri, sekuderera kweBP kana wamira uye kurasikirwa nekudzora weti, kunoitika pakutanga.
- MSA inokura nekukurumidza kupfuura chirwere cheParkinson uye hainyanyi kupindura mishonga yeParkinson.
- Kunyange hazvo pasina mushonga wechirwere ichi, kune mishonga yekudzora zviratidzo uye kuvandudza hupenyu.
- Zvakakosha kuziva zviratidzo nekukurumidza, kutsvaga mazano echiremba, uye kuronga remangwana.
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