Unoziva here nezveTakayasu's Arteritis? Ngatitaurei nezvazvo!

Wakambonzwa nezvechirwere chinonzi Takayasu's Arteritis here? Zita racho ringanzwika serisinganzwisisike, handiti? Asi chirwere chisingawanzoitiki chinogona kukanganisa mitsipa yedu yeropa, kunyanya mitsipa mikuru yeropa inotangira mumoyo nemapazi anobuda kubva pairi. Dzimwe nguva chinonziwo 'chirwere chisina pulseless.' Nhasi, tichataura nezvazvo zvakadzama, zviri nyore, kuitira kuti iwewo unzwisise zviri nani.

Chii chaizvo chinonzi Takayasu's Arteritis?

Zvichitaurwa zviri nyore, arteritis yaTakayasu kuzvimba kwetsinga dzedu dzeropa, zvinoreva kuzvimba kana kuzvimba (vasculitis). Inonyanya kukanganisa tsinga huru dzeropa mumuviri wedu. Funga nezvazvo, tsinga huru yeropa inotakura ropa rakawanda reokisijeni kubva pamoyo wedu kuenda kumuviri wese, yatinodaidza kuti 'aorta huru' kana kuti 'aorta'. Chirwere ichi chinonyanya kukanganisa aorta, nedzimwe tsinga huru dzeropa dzinobva pairi dzotakura ropa mumaoko edu, mumutsipa, nepfungwa. Unoziva here zvinoitika kana kuzvimba uku kukaitika? Madziro etsinga dzedu dzeropa anokuvara. Zvadaro dzimwe nzvimbo dzetsinga idzodzo dzinova dzisina simba uye dzinogona kuzvimba sebharumu. Tinodaidza izvi kuti 'aneurysm'. Zvakare, tsinga dzeropa dzinogona kuzvimba uye kutetepa. Zvadaro kuyerera kweropa kunodzikira. Dzimwe nguva tsinga yeropa inogona kuvharika zvachose, inonzi 'occlusion'. Kashoma, chirwere ichi chinogonawo kukanganisa tsinga dzinopa ropa kumoyo, mudumbu, itsvo, nemakumbo.

Ndiani anonyanya kukanganiswa nemamiriro ezvinhu aya?

Takayasu's Arteritis (TAK) chirwere chinowanzo bata vechidiki. Chinonyanya kubata vakadzi vari pakati pemakore makumi maviri nemakumi mana. Varwere vanowanzova pakati pemakore gumi nemashanu nemakumi matatu nemashanu pavanoonekwa kuti vane chirwere ichi. Vanenge 80% kusvika 90% yeavo vane chirwere ichi vakadzi. Vanachiremba vanoona chirwere ichi kakawanda munyika dzakadai seJapan nevanhu vanobva kuMexico, India, neEast Asia. Kunyangwe munyika dzakadai seUnited States, vanhu vaviri kusvika vatatu chete vanoonekwa gore rega rega. Izvi zvinoreva kuti chirwere ichi hachiwanzoitiki.

Kurwara kweTakayasu kunokanganisa sei muviri wangu?

Kana mitsipa yeropa yadzikira, huwandu hweropa hunosvika munhengo nematishu anopiwa netsinga idzodzo dzeropa hunoderera. Funga nezvazvo sepombi yemvura yakavharika, izvo zvinoderedza huwandu hwemvura inoyerera nepakati. Asi muTakayasu's arteritis (TAK), shanduko idzi dzinowanzoitika zvishoma nezvishoma. Saka miviri yedu ine nguva yekujaira kutakura ropa kuburikidza nedzimwe nzira. Idzi nzira dzinoshandiswa dzakafanana nedzinoyambuka mugwagwa mukuru dzatinoshandisa kana mugwagwa mukuru wakavharwa. Asi idzi nzira dzinogona kusakwanisa kutakura ropa rakawanda serekutanga tsinga huru yeropa. Kazhinji, huwandu hweropa rinoyerera kupfuura pakavharika hwakakwana kupa matishu huwandu hushoma hweokisijeni neropa ravanoda kuti vararame. Asi kashoma, kana idzi nzira dzeropa dzisingashande zvakanaka, matishu anogona kufa nekuti anoshaikwa okisijeni neropa.

Ndezvipi zviratidzo zvechirwere ichi?

Vamwe vanhu vane Takayasu arteritis (TAK) vanogona kunge vasina zviratidzo. Zvisinei, inenge hafu yevarwere vanogona kunge vaine kusagadzikana uye kushaya simba. Zviratidzo zvepakutanga (danho rekutanga): Izvi ndizvo zviratidzo zvinoonekwa pakutanga kwechirwere:

• Kupindwa nechando.
• Kunzwa kuneta zvakanyanya ( Kuneta ).
• Kurwadziwa kwetsandanyama nemajoini .
• Chikafu hachina kunaka .

Zviratidzo zvepadanho rekupedzisira (danho rechipiri): Sezvo chirwere ichi chichienderera mberi, zviratidzo zvakaita seizvi zvinogona kuoneka:

• Kurwadziwa kwechipfuva .
• Kutadza kufema zvakanaka .
• Musoro .
• Kunzwa dzungu.

Zviratidzo zvinokonzerwa nekutetepa kwetsinga dzeropa uye kushomeka kweropa:

• Kuneta, kurwadziwa, kana kurwadziwa mumaoko nemakumbo.
• Kurwadziwa kwemudumbu nekuda kwekudzikira kweropa rinoyerera muura.
• Kukwira kweropa nekuda kwekudzikira kweropa rinopinda muitsvo.
• Kurohwa nestroke (izvi hazviwanzoitiki).
• Kurwiswa nemoyo (izvi hazviwanzoitikiwo).

Chii chakakonzera arteritis yaTakayasu?

Kutaura zvazviri, hapana anoziva chikonzero chaicho cheTakayasu's arteritis (TAK).Asi vanachiremba nevaongorori vanofunga kuti ingave 'autoimmune condition'. Kureva kuti, masoja emuviri wedu, ayo anorwisa zvirwere, anorwisa zvisizvo nhengo dzawo dzine hutano. Zvinoita sekunge dziviriro yedu iri kutikuvadza. Vamwe vaongorori vanofunga kuti dzimwe nyaya dzeTakayasu's arteritis dzinogona kukonzerwa nejini rakagarwa nhaka kubva kuvabereki vese. Vabereki ivavo vangave vasina zviratidzo, nekuti vane kopi imwe chete yejini. Asi kana ukagara nhaka jini iroro kubva kuvabereki vese, unogona kuva nechirwere chacho nezviratidzo zvaro.

Chirwere ichi chinoonekwa sei?

Chiremba wako achaongorora arteritis yaTakayasu nekutarisa zvinhu zvakati wandei pamwe chete, kwete chimwe chete.

• Nhoroondo yakakwana yezvekurapa uye kuongororwa kwemuviri: Izvi zvinoitirwa kubvisa zvimwe zvirwere zvine zviratidzo zvakafanana nezvako. Kana chiremba wako achishandisa stethoscope kuongorora mitsipa yako yeropa, anogona kunzwa ruzha rusina kujairika runonzi 'bruit' mukati memitsipa yeropa. Kana mitsipa yeropa yakanyanya kutetepa, zvinonetsa kuti ropa riyerere nepakati payo, ndipo panonzwika ruzha.
• X-rays: Izvi zvinoratidza pakanga pakuvara tsinga yako uye kuoma kwekukuvara kwacho.
• Kuongororwa kwekuona kutetepa kwetsinga dzeropa kana aneurysms: Kune nzira dzakasiyana dzekuongorora izvi.

Ndezvipi zviedzo zvekuongorora chirwere?

Kune miedzo yakati wandei inogona kubatsira chiremba kusimbisa chirwere ichi:

• Magnetic Resonance Imaging (MRI): Iyi bvunzo isingashandise X-rays. Mifananidzo inogadzirwa uchishandisa magineti makuru, mafungu emagetsi emagetsi, uye komputa.
• Kuongororwa kweComputed Tomography (CT): X-rays nemakombiyuta zvinogadzira mifananidzo yenhengo dzemukati, kusanganisira mitsipa mikuru yeropa.
• Angiography: Izvi zvinosanganisira kutora mifananidzo yeX-ray yemukati metsinga dzeropa. Chiremba wako anoisa chubhu yakatetepa, refu inonzi catheter mutsinga huru iri muhudyu mako kana ruoko uye anoitungamira kusvika kutsinga inoda kuongororwa. Zvadaro, dhayi yakakosha (zvinhu zvakasiyana) inopinzwa kuburikidza necatheter mutsinga dzeropa. Kana X-ray yatorwa, dhayi inoita kuti tsinga dzeropa dzionekwe zvakajeka mumifananidzo. Dzimwe nguva, MRI inogona kushandiswawo kuita angiography.
• Positron Emission Tomography (PET scan): Muongororo iyi, chiremba wako anobaya chinhu chine radioactive kuburikidza netsono mutsinga iri muruoko rwako. Chinhu ichi pachinofamba mumuviri wako, scanner inochiona uye inogadzira mifananidzo.
• Ultrasound: Izvi zvinobatsira kugadzira mifananidzo yetsinga dzeropa uchishandisa mafungu eruzha.

Arteritis yaTakayasu inorapwa sei?

Mishonga inogona kudzora kuzvimba, kana kuzvimba. Zvisinei, vamwe vanhu vangada kuvhiyiwa kuti vasapinde mutsinga yeropa yakavharika uye kugadzira nzira itsva yekuti ropa rifambe. Corticosteroids: Corticosteroids, yakadai seprednisone (semuenzaniso, Rayos®, Sterapred®) kana prednisolone (semuenzaniso, Flo-Pred®, Orapred®), ndiyo nzira inonyanya kushandiswa pakurapa Takayasu's arteritis (TAK).

Mishonga iyi inoshanda zvinoshamisa mukubvisa kuzvimba kuri kuitika mutsinga dzeropa uye kuita kuti chirwere chisanyanya kuipa.

Chiremba wako achaderedza zvishoma nezvishoma mushonga weprednisone kusvika padanho rakaderera rinoshanda kuderedza migumisiro yakaipa. Vamwe vanhu vanogona kurega kutora mushonga zvishoma nezvishoma pasina zviratidzo zvinodzoka. Zvisinei, mishonga iyi yecorticosteroid haishande zvizere kune vamwe vanhu. Uyewo, vanhu vanopfuura hafu vanotora mishonga iyi vanogona kudzoka kwezviratidzo kana kuipa kwechirwere chavo. Mishonga inodzvinyirira immune system: Vanachiremba vanowanzo nyora mishonga inodzvinyirira masoja emuviri, yakaita se:

• Methotrexate (semuenzaniso Rheumatoidrex®, Trexall®)
• Azathioprine (semuenzaniso Imuran®, Azasan®)
• Mycophenolate (semuenzaniso Cellcept®, Myfortic®)
• Leflunomide
• Cyclophosphamide

Kana mishonga iyi yekudzivirira muviri ikashandiswa pamwe chete neprednisone, vanhu vanosvika 50% vakambova nekuputika kweganda vanogona kupora zviratidzo zvavo uye vanogona kurega kutora prednisone zvishoma nezvishoma. Mishonga yekudzivirira Tumor-Necrosis Factor (TNF): Vamwe vanhu vanogonawo kupihwa mishonga inonzi TNF inhibitors yekubatsira kurwisa kuzvimba. Mienzaniso yeiyi inosanganisira:

• Etanercept
• Infliximab
• Tocilizumab

Kazhinji, vanhu vanosvika 25% vane arteritis yaTakayasu havakwanise kudzora chirwere ichi zvizere vasina mishonga inorapwa nguva dzose.

Ndezvipi migumisiro yekurapwa?

Mishonga inoshandiswa kurapa Takayasu's arteritis inogona kuva nemigumisiro yakakomba. Zvisinei, mimwe mishonga inogona kubatsira kudzora migumisiro iyi. Migumisiro inogona kusanganisira:

• Kusakwanisa kurwisa hutachiona.
• Kuderera kwehuremu hwemapfupa (osteoporosis).
• Kuoma kuona.
• Kubatwa nepfari.

Corticosteroids inotanga kushanda mukati memaawa mashoma mushure mekutanga kurapwa, saka unogona kunzwa zororo nekukurumidza.

Ndedzipi dzimwe nzira dzekurapa dzinoshandiswa?

Mune zvimwe zviitiko, BP yakakwira (hypertension) inogona kukonzerwa nekutetepa kwetsinga dzinoenda kuitsvo. Muchiitiko ichi, chiremba anogona kushandisa chimwe chinhu chakaita sebharumu kuwedzera tsinga yeropa yakatetepa, iyo inonzi angioplasty. Kana, kuvhiyiwa kwe bypass kunogona kuitwa kuti ropa riyerere zvakanaka kuenda kuitsvo. Izvi zvinogona kubatsira kugadzirisa BP pasina kushandisa mishonga yeBP yakakwira. Vamwe vanhu vanogona kunge vaine matambudziko akakomba netsinga dzeropa dzakatetepa mumaoko avo kana makumbo, zvichiita kuti zviome kufamba kana kuita zvimwe zvinhu. Kuvhiyiwa kwe bypass kunogonawo kugadzirisa matambudziko aya. Kana paine aneurysm, inogona kugadziriswa nekuvhiyiwa kana bypass. Vamwe vanhu vane Takayasu's arteritis vangangodawo kutsiva aortic valve.

Ndinozvitarisira sei?

Vanhu vazhinji vane chirwere cheTakayasu's arteritis vanewo BP yakakwira (BP yakakwira). Zvakakosha kudzora izvi. Kana usingarape BP yakakwira, zvinhu zvakaita seizvi zvinogona kuitika:

• Kurohwa nechirwere.
• Chirwere chemwoyo.
• Kukundikana kweitsvo.

Kana ukatora mishonga inodzikisira masoja emuviri wako, funga nezvekutora majekiseni aya kuti uzvidzivirire kubva kuzvirwere:

• Jekiseni refuruu.
• Mushonga wepneumonia.
• Mushonga weHerpes zoster (Shingles).

Chii chingatarisirwa nemunhu ane chirwere cheTakayasu's arteritis?

Kunyangwe pasina mushonga weTakayasu's arteritis, chirwere chinorapika. Vanhu vazhinji vane chirwere ichi vanopora nekurapwa. Zvisinei, vanhu vazhinji vanogona kuremara kusvika pamwero wakati, kana kuti kashoma zvachose, nekuda kwechirwere ichi. Mhedzisiro yechirwere ichi inogona kukanganisa zvakanyanya mabasa ezuva nezuva. Vanhu vanenge hafu vane Takayasu's arteritis vanofanira kuchinja mabasa avo. Zvisinei, vanhu vanenge 25% vane chirwere ichi vanorarama hupenyu hwakajairika. Vamwe 25% vakatofanira kuchinja mabasa avo. Vanhu vanorarama nechirwere ichi chisingaperi vanofanira kuongororwa nachiremba nguva dzose uye, kana zvichidikanwa, kuchinja mishonga yavo. Vanachiremba vanofanirawo kutarisa migumisiro yemishonga uye kuongorora ropa. Zvinotevera zvinogona kuva matambudziko eTakayasu's arteritis:

• Kukundikana kwemoyo.
• Kurohwa nechirwere.
• Kugwamba kweropa.
• Kurwara nemoyo.

Takayasu arteritis chirwere chinokura zvishoma nezvishoma. Uchada kurapwa kwenguva refu, kazhinji nemishonga. Munyika dzakadai seUnited States neJapan, vanhu vanosvika 3% vane Takayasu arteritis vanofa mukati meavhareji yemakore mashanu echirwere ichi. Izvi zvinogona kunge zvichikonzerwa nekuti vanachiremba vanokwanisa kuona chirwere ichi nekukurumidza uye kuchirapa nemazvo. Mune dzimwe nzvimbo dzepasi, mhedzisiro yacho inogona kuipa nekuda kwekunonoka kuongororwa nekurapwa kana kusawana rubatsiro rwehutano zvakanaka. Kana chikasarapwa, Takayasu arteritis inogona kuuraya.

Ndingachengetedza sei hutano hwangu?

Zvakakosha kuti ugare uchicherechedza manzwiro ako uye ugare uchisangana nachiremba wako nguva nenguva kuitira kuti ugone kuona zviratidzo zvitsva kana kuti zvinoramba zvichiwedzera nekukurumidza.

Ndinofanira kuona chiremba rini?

Kana zviratidzo zveTakayasu arteritis yako zvikadzoka panguva yekurapwa kana mushure mekurapwa, enda kuna chiremba wako nekukasika. Kana uchironga kubata pamuviri, taura nachiremba wako nezvazvo. Zvinokwanisika kuva nepamuviri unobudirira neTakayasu arteritis, asi zvakakosha kuziva maitiro ekuzvibata.

Ndinofanira kuenda kuEmergency Treatment Unit (ETU) riini?

Kana uine chimwe chezviratidzo izvi, fonera 911 nekukasika (muSri Lanka, fonera 1990 Suwaseriya Ambulance Service kana kuenda kuchipatara chiri pedyo):

• Kurwadziwa kwechipfuva.
• Kutadza kufema zvakanaka.
• Kurova kwemoyo kusina simba.
• Zviratidzo zvechirwere chemwoyo (semuenzaniso, kurwadziwa kwakanyanya kwechipfuva kunoyerera neparuoko, kudikitira, kuda kurutsa).
• Zviratidzo zvestroke (semuenzaniso, kurereka kurutivi rumwe rwechiso, kusanzwa simba muruoko, kuoma kutaura).

Mibvunzo ipi yandinofanira kubvunza chiremba wangu?

• Ndichatora mushonga weTakayasu's arteritis kwenguva yakareba sei?
• Ndinofanira kuuya kakawanda sei kuzosangana nevamwe?
• Ko dambudziko rangu rinogona kugadziriswa pasina kuvhiyiwa here?
• Ndinofanira kuita bvunzo dzemifananidzo kangani?

Pakupedzisira, zvekurangarira (Mharidzo Yekuenda Kumba)

Nekuti Takayasu's Arteritis chirwere chinogara kwenguva refu, kana kuti 'chisingaperi', uchafanira kuona chiremba nguva nenguva. Nekufamba kwenguva, zviratidzo zvako zvinogona kubva pakudzorwa kusvika pakudzorwa. Ndosaka zvichikosha kugara uchitaurirana nachiremba wako nguva dzose. Usatya kuudza chiremba wako kana ukaona shanduko muhutano hwako. Chiremba wako achada kuziva nezvazvo, nekuti ndipo paanogona kukubatsira.

Yeuka, kunyangwe uine chirwere ichi, kana ukarapwa zvakanaka uye ukatevedzera mazano echiremba, iwewo unogona kurarama hupenyu hwakanaka. Ramba wakasimba!

Kurwara kweTakayasu, arteritis yaTakayasu, chirwere chisina pulse, vasculitis, aorta, arteritis, chirwere chetsinga dzeropa, BP yakakwira, chirwere che autoimmune