Ngaba ukhe weva ngesi sifo? Makhe sithethe ngokuba yintoni iMicroscopic Polyangiitis (MPA)!

Molo! Namhlanje siza kuthetha ngemeko engaqhelekanga ukuviwa ngayo, kodwa enokuba yinto ebaluleke kakhulu. Ibizwa ngokuba yi-microscopic polyangiitis, okanye ngesiNgesi `(Microscopic Polyangiitis)`, okanye `(MPA)` ngamafutshane. Nangona igama lisenokuvakala liyinkimbinkimbi kancinci, masizame ukuliqonda ngokulula. Ungakhathazeki, ndilapha ukukuchazela.

Yintoni kanye kanye le MPA?

Ngamafutshane, i-MPA sisifo esingaqhelekanga apho imithambo yegazi emincinci kakhulu emzimbeni wethu idumba, okanye njengoko oogqirha beyibiza njalo, idumba. Oku kudumba kwemithambo yegazi kudla ngokubizwa ngokuba yi-vasculitis . Khawucinge nje, kukho imithambo emininzi emincinci emzimbeni wethu ethwala igazi njengemibhobho yamanzi. Xa imithambo enjalo idumba ngaphakathi, igazi elihamba ngayo liyavaleka. Kwenzeka ntoni ke ngoko? Iinkqubo zethu zomzimba ezibalulekileyo, oko kukuthi, amalungu omzimba afuna ukondliwa yimithambo yegazi, zinokonakala. Iindawo ezixhaphake kakhulu yi-MPA zezi:

• Izintso
• Imiphunga
• Inkqubo yemithambo-luvo (izinto ezifana nemithambo-luvo yethu)
• Ulusu
• Amalunga (apho amathambo ethu adibana khona)

Kulungile ukwazi ukuba kukho olunye uhlobo lwe-vasculitis oluneempawu ezifanayo neze-MPA, olubizwa ngokuba yiGranulomatosis enePolyangiitis (GPA). Ngaphambili lwalubizwa ngokuba yiWegener's granulomatosis. Unyango lwezifo zombini lufana kakhulu.

Ngoko ke, yintoni kanye kanye le 'Vasculitis'?

I-Vasculitis, njengoko benditshilo ngaphambili, kukudumba kwemithambo yegazi. Xa oku kusenzeka, iindonga zale mithambo yegazi zinokuba buthathaka. Ngamanye amaxesha zinokuba buthathaka kwaye zidumbe njengebhaluni - oogqirha bakubiza oku ngokuba yi-aneurysm. Ngamanye amaxesha, ezi ndonga zemithambo yegazi zinokuba buthathaka kakhulu kwaye ziqhume. Oku kubangela ukuba igazi livuze kwizicubu ezingqongileyo. Kanye njengokuba umbhobho wamanzi uvalwa lihlwili, i-vasculitis ibangela ukuba imithambo yegazi inciphe kwaye ngamanye amaxesha ivalwe ngokupheleleyo. Ekubeni igazi lingenako ukuhamba kuzo, amalungu afumana ioksijini kunye nezinye izondlo kuloo mithambo yegazi ayonakala. I-MPA ichaphazela kakhulu imithambo yegazi emincinci nephakathi .

Ngubani onokuthi aphuhlise le MPA?

Esi sisifo esingaqhelekanga ngokwenene. Ngokwezibalo, kuthiwa phakathi kwe-13 ne-19 kwizigidi zabantu (amawaka alishumi) banesifo. Oko kuthetha ukuba sinqabile kakhulu, akunjalo? Esi sifo sinokukhula nakubani na waluphi na ubudala , kwaye akukho mahluko phakathi kwamadoda nabafazi , bobabini banokukhula ngokulinganayo.

Kutheni le MPA yenziwe?

Oogqirha abakafumani sizathu sithile sokuphuhliswa kwe-MPA.. Lo asingomhlaza, asisosifo esosulelayo, kwaye asisosifo esidla ngokusasazeka kwiintsapho. Nangona kunjalo, uphando lufumanise ukuba inkqubo yethu yokuzikhusela komzimba inoxanduva loku. Kalula nje, inkqubo yokuzikhusela yomzimba, efana nejoni elimele ukukhusela imizimba yethu kwizifo, ngempazamo iqala ukuhlasela imithambo yegazi yayo . Kulapho ke le mithambo yegazi idumba khona, ibangela umonakalo kumalungu omzimba. Akukubi oko?

Zithini iimpawu ze-MPA? Sizibona njani?

Ngenxa yokuba i-MPA inokuchaphazela iinkqubo ezininzi zezitho zomzimba, iimpawu zahlukile kakhulu . Ayingabo bonke abantu abaya kuba neempawu ezifanayo. Abanye abantu banokufumana iimpawu eziqhelekileyo ezifana nezi:

• Ndiziva ndidiniwe ngalo lonke ixesha, ndiziva ndidangele
• Ifiva
• Umnqweno wokutya
• Ukuhla ukusinda

Ukongeza, iimpawu ezithile zinokuvela ngokuxhomekeke kwisitho esichaphazelekileyo. Umzekelo:

• Ukuba imiphunga ichaphazelekile: Ubunzima bokuphefumla, okanye ukukhohlela igazi elincinci.
• Ukuba inkqubo yemithambo-luvo ichaphazelekile: iimvakalelo ezingaqhelekanga ezifana nokungaziva kakuhle kwamalungu, ukuphelelwa luvakalelo kamva kwezo ndawo, okanye ukuncipha kwamandla kwamalungu.
• Ukuba ichaphazela ulusu: Iimpuku zesikhumba, oko kukuthi, amabala afana ne -eczema .
• Ukuba izihlunu kunye namalungu achaphazelekile: iintlungu kwezo ndawo.

Into ebalulekileyo kukuba nokuba i-MPA yonakalisa izintso, isenokungabonakalisi zimpawu kwasekuqaleni! Isigulana sisenokungazi ukuba loo nto ide isebenze kakubi kakhulu . Yiyo loo nto kubaluleke kakhulu ukuba oogqirha benze uvavanyo lomchamo kuyo nayiphi na imeko ye- 'vasculitis' .

Olunye okanye ngaphezulu kwezi mpawu zinokwenzeka kunye.

Oogqirha bayixilonga njani i-MPA?

Ukufumanisa i-MPA kufana nophando olufihlakeleyo. Oogqirha baqokelela ulwazi kwimithombo eyahlukeneyo. Xa kurhanelwa ukuba isifo sikhona, benza oku kulandelayo:

• Bakubuza ngembali yakho yezonyango: zeziphi iimpawu onazo kunye nexesha osele unazo.
• Uvavanyo lomzimba lwenziwa: ukufumanisa ukuba zeziphi iindawo zomzimba ezichaphazelekileyo kunye nokuthintela ezinye izifo ezinokuba neempawu ezifanayo.
• Uvavanyo lwegazi : ukubona ukuba zeziphi izitho zomzimba ezichaphazelekileyo, ingakumbi i-'antineutrophil cytoplasmic antibodies (ANCA)'Ukujonga ukuba kukho ii-antibodies egazini. Ukuba olu vavanyo lwe-`(ANCA)` lulungile, bubungqina obuhle ukurhanela ukuba kukho isifo se-`(MPA)`. Nangona kunjalo, olu vavanyo lwegazi lodwa alunakungqina ukuba kukho i-`(MPA)`, kwaye alunakuchaza ukuba isifo sisebenza kangakanani na.
• Uvavanyo lomchamo: Jonga ukuba akukho protein okanye iiseli ezibomvu zegazi ezigqithisileyo kumchamo (oku kubaluleke kakhulu ukwazi ukuba izintso zichaphazelekile na).
• Uvavanyo lwemifanekiso: Ii-X-ray, ii-computed tomography (CT) scans, okanye ii-magnetic resonance (MR) scans zingenziwa ukujonga iingxaki kwiindawo ezifana nemiphunga.

Xa kurhanelwa ukuba i-MPA ifunyenwe, kuthathwa iqhekeza elincinci lesicubu kwilungu elichaphazelekayo lize lihlolwe (i-biopsy) . Le yindlela yokuqinisekisa ukuba unayo na i-vasculitis. Nangona kunjalo, i-biopsy yenziwa kuphela ukuba kukho iingxaki ezibonakala kwiimvavanyo zonyango, kwiiskeni, okanye kuvavanyo lomzimba.

Ziziphi iindlela zonyango ze-MPA? (Unyango)

Injongo ephambili yonyango lwe-MPA kukulawula inkqubo yethu yomzimba yokuzikhusela, engasebenzi kakuhle. Amayeza okunciphisa umzimba ngawona asetyenziswa kakhulu koku. Kukho iintlobo ezahlukeneyo zala mayeza, kodwa ichiza ngalinye linemiphumo emibi, ngoko ke kufuneka lisetyenziswe kuphela phantsi kwengcebiso kagqirha.

• Ukuba i-MPA ichaphazele kakhulu iinkqubo zomzimba ezibalulekileyo , ii-corticosteroids zihlala zinikwa kunye nelinye iyeza lokuthintela amasosha omzimba, njenge-cyclophosphamide (Cytoxan®) okanye i-rituximab (Rituxan®).
• Ukuba isifo asibi kakhulu , iyeza elibizwa ngokuba yi-" Methotrexate " lingasetyenziswa kuqala kunye ne-"Corticosteroids".

Injongo ephambili yonyango kukuyeka yonke imonakalo ebangelwa yi-MPA kunye nokuzisa isifo kwinqanaba apho silawulwa ngokupheleleyo. Oku kubizwa ngokuba yi-"remission." Xa isifo sibonakala siphucuka, oogqirha banciphisa kancinci idosi ye-corticosteroids baze ekugqibeleni bazame ukuyiyeka ngokupheleleyo. Ukuba kusetyenziswa i-cyclophosphamide, inikwa kuphela de kufikelelwe i-remission (ngesiqhelo iinyanga ezintathu ukuya kwezintandathu). Emva koko, ukuze kugcinwe i-remission, enye i-immunosuppressant itshintshelwa kwi-methotrexate, i-azathioprine (Imuran®) okanye i-mycophenolate mofetil (Cellcept®) iyasetyenziswa. Ubude bolu nyango lolondolozo bungahluka kumntu nomntu. Kwiimeko ezininzi, ubuncinane unyaka okanye emibini.La mayeza ayanikwa, baze oogqirha bazame ukunciphisa umthamo baze bawuyeke. Cinga ngako, amanye amachiza asetyenziswa kwezi ndlela zonyango akwasetyenziswa nakwezinye izifo. Umzekelo, amayeza abizwa ngokuba yi-`(Azathioprine)` kunye ne-`(Mycophenolate mofetil)` anikwa ukuthintela umzimba ukuba ungalamkeli ilungu emva kokufakelwa amalungu. Amayeza abizwa ngokuba yi-`(Methotrexate)` anikwa nezifo ezifana ne-rheumatoid arthritis kunye ne-psoriasis. Amayeza abizwa ngokuba yi-`(Cyclophosphamide)` kunye ne-`(Methotrexate)` nawo anikwa ngeedosi eziphezulu kwezinye iintlobo zomhlaza, kwaye ngelo xesha abizwa ngokuba yi-`(chemotherapy)`. Kodwa ungoyiki , anikwa i-`vasculitis` kwiidosi eziphantsi ngokuphindwe ka-10 ukuya kwi-100 kuneedosi ezinikwa umhlaza. Apha, umsebenzi ophambili wala mayeza akukokubulala iiseli zomhlaza, kodwa kukulawula umsebenzi wenkqubo yomzimba yokuzikhusela. I-Rituximab liyeza kudidi lwamayeza abizwa ngokuba yi-biologic agents. Isebenza ngokujolisa inxalenye ethile yenkqubo yomzimba yokuzikhusela. Uphando lwakutshanje lufumanise ukuba iRituximab isebenza kakuhle njengeCyclophosphamide ekunyangeni i-MPA enzima.

Ngenxa yokuba la mayeza enza buthathaka amajoni omzimba , kukho umngcipheko wokufumana usulelo olukhulu. Ukongeza, kukho iziphumo ebezingalindelekanga ezikhoyo kwiyeza ngalinye lokunciphisa amasosha omzimba. Ke ngoko, kubaluleke kakhulu ukuba phantsi kweliso likagqirha rhoqo malunga neziphumo ebezingalindelekanga xa usebenzisa la mayeza. Nokuba iyeza liyanyamezelwa ekuqaleni, imeko inokutshintsha ngokuhamba kwexesha. Ke ngoko, kubaluleke kakhulu ukuqhubeka nokulandela iingcebiso zonyango kunye nokwenza uvavanyo oluyimfuneko. Ngamanye amaxesha, nokuba uyekile ukusebenzisa eli yeza, kufuneka uqaphele malunga neziphumo ebezingalindelekanga zexesha elide.

Zithini iithemba zokuchacha kwizigulane ze-MPA? (Imbono)

Ngenxa yokuba i-MPA sisifo esingaqhelekanga, kunzima ukunika izibalo ezichanekileyo malunga nokuchacha. Nangona kunjalo, ngokomyinge, abantu abangaphezu kwama-80% abane-MPA abachaphazeleki sisifo emva kweminyaka emihlanu. Ezi ziphumo ziyahluka ngokuxhomekeke kubukhulu besifo. I-MPA inokuqhubeka kancinci, kwaye nangona isisifo esibi, uninzi lwezigulane luyachacha kakuhle kakhulu . Ngokuqala unyango kwangethuba kwaye phantsi kweliso elibukhali lezonyango, umonakalo kumalungu omzimba unokuncitshiswa. Kwanabo baneemeko ezinzima kakhulu ze-MPA banokufikelela kwixesha lokuchacha ukuba baqala unyango kwangethuba baze benze oko oogqirha babo babaxelela ukuba bakwenze. Kwanasemva kwexesha lokuchacha, i-MPA isenokubuya. Oku kubizwa ngokuba "kukubuyela umva." Oku kwenzeka kubantu abamalunga nama-50% abane -MPA. Oku kuphinda kubuye kunokufana neempawu owawunazo xa wawufunyaniswa okokuqala, okanye kunokuba kwahlukile. Ukunciphisa umngcipheko wokuphinda kubuye kakhulu,Ukuba ufumanisa naziphi na iimpawu ezintsha, kubalulekile ukuzixela kugqirha wakho ngoko nangoko. Kubalulekile nokubona ugqirha wakho rhoqo ukuze ahlolwe igazi kunye novavanyo lwemifanekiso. Unyango lokubuyela kwimeko yesiqhelo lufana nolomntu osandul’ ukufunyanwa enesifo. Abantu abaninzi abane-MPA banokubuyela kwimeko yesiqhelo kwakhona.

Ngoko ke, zeziphi izinto ezibalulekileyo ekufuneka sizikhumbule kwizinto esithethe ngazo?

Kulungile, sithethe kakhulu ngale `(MPA)` ngoku. Izinto ezibalulekileyo ekufuneka uzikhumbule kuzo zonke ezi zinto zezi:

• (MPA) sisifo esingaqhelekanga kodwa esinokuba yingozi apho imithambo yegazi emincinci yomzimba idumba ngenxa yokungasebenzi kakuhle kwenkqubo yomzimba yokuzikhusela.
• Idla ngokuchaphazela izintso, imiphunga, imithambo-luvo, ulusu kunye namalungu . Nangona izintso zichaphazeleka kakhulu, kusenokungabikho zimpawu ekuqaleni .
• Kubaluleke kakhulu ukuxilonga isifo nokuqala unyango kwangethuba.
• Unyango lubandakanya amayeza acinezela amajoni omzimba. Ukuhlolwa rhoqo kwezonyango kunye novavanyo kubalulekile xa usebenzisa la mayeza.
• Nokuba isifo siphelile (ukuxolelwa), singabuya (ukubuyela umva) . Ngoko ke qaphela iimpawu ezintsha.
• Soloko uthetha ngokukhululekileyo nogqirha wakho , ubuze imibuzo, kwaye wabelane ngeemvakalelo zakho. Leyo yeyona nto ilungileyo onokuyenza.

Ndiyathemba ukuba olu lwazi luza kukunceda. Ukuba unenkxalabo malunga naziphi na iimpawu, nceda ungalibali ukufuna ingcebiso kagqirha.