Ngaba uyayazi i-Takayasu's Arteritis? Makhe sithethe ngayo!

Ngaba wakha weva ngesifo esibizwa ngokuba yiTakayasu's Arteritis? Eli gama lisenokuvakala lingaqhelekanga, akunjalo? Kodwa yimeko engaqhelekanga enokuchaphazela imithambo yegazi yethu, ingakumbi imithambo yegazi emikhulu eqala entliziyweni kunye namasebe aphuma kuyo. Ngamanye amaxesha ikwabizwa ngokuba 'sisifo esingenamaphaphu.' Namhlanje, siza kuthetha ngaso ngokweenkcukacha, ngokulula, ukuze nawe usiqonde ngcono.

Yintoni kanye kanye i-Takayasu's Arteritis?

Ngamafutshane, i-Takayasu's arteritis kukudumba kwemithambo yegazi yethu, oko kuthetha ukudumba okanye ukudumba (vasculitis). Ichaphazela ngakumbi imithambo yegazi emikhulu emzimbeni wethu. Cinga ngayo, umthambo wegazi oyintloko othwala igazi elineoksijini ukusuka entliziyweni yethu ukuya emzimbeni wonke, esiwubiza ngokuba yi-'aorta enkulu' okanye 'aorta'. Esi sifo sichaphazela kakhulu i-aorta, kunye neminye imithambo yegazi emikhulu ephuma kuyo kwaye ithwale igazi kwiingalo zethu, entanyeni nasebuchotsheni. Uyazi ukuba kwenzeka ntoni xa oku kudumba kusenzeka? Iindonga zemithambo yegazi yethu zonakele. Emva koko ezinye iindawo zemithambo yegazi ziba buthathaka kwaye zinokudumba njengebhaluni. Oku sikubiza ngokuba yi-'aneurysm'. Kwakhona, imithambo yegazi inokudumba kwaye inciphe. Emva koko ukuhamba kwegazi kuyathintelwa. Ngamanye amaxesha umthambo wegazi unokuvaleka ngokupheleleyo, okubizwa ngokuba yi-'occlusion'. Amaxesha amaninzi, le meko inokuchaphazela nemithambo yegazi ehambisa igazi entliziyweni, emathunjini, ezintso nasemilenzeni.

Ngubani ochaphazeleka kakhulu yile meko?

I-Takayasu's Arteritis (TAK) yimeko edla ngokuchaphazela abantu abaselula. Ixhaphake kakhulu kubasetyhini abaphakathi kweminyaka engama-20 nama-40. Izigulana zihlala ziphakathi kweminyaka eli-15 nama-35 ubudala xa zifunyaniswa ukuba zinayo. Malunga nama-80% ukuya kuma-90% abo banesi sifo ngabafazi. Oogqirha babona le meko rhoqo kumazwe anjengeJapan kunye nabantu baseMexico, eIndiya, naseMpuma Asia. Kwanakumazwe anjenge-United States, zimbini ukuya kwezintathu kuphela iimeko ezintsha kwisigidi sabantu ezifunyaniswayo minyaka le. Oku kuthetha ukuba yimeko engaqhelekanga.

I-arteritis kaTakayasu iyichaphazela njani umzimba wam?

Xa imithambo yegazi incipha, inani legazi elifikelela kwizitho zomzimba kunye nezicubu ezibonelelwa yile mithambo yegazi liyancipha. Cinga ngayo njengombhobho wamanzi ovalekileyo, onciphisa inani lamanzi adlulayo. Kodwa kwi-Takayasu's arteritis (TAK), olu tshintsho ludla ngokwenzeka kancinci kancinci. Ngoko ke imizimba yethu inexesha lokuqhela ukuthwala igazi ngeendlela ezahlukeneyo. Ezi ndlela zingafaniyo zifana neendlela ezincinci esizisebenzisayo xa indlela ephambili ivaliwe. Kodwa ezi ndlela zisenokungakwazi ukuthwala igazi elininzi njengomzila wegazi omkhulu wokuqala. Ngokwesiqhelo, inani legazi elidlulayo ngaphaya kokuvaleka lanele ukunika izicubu umlinganiselo omncinci weoksijini kunye negazi ezifunekayo ukuze ziphile. Kodwa kunqabile kakhulu, ukuba le mithambo yegazi ingasebenzi kakuhle, izicubu zinokufa kuba zingenayo ioksijini kunye negazi.

Zithini iimpawu zesi sifo?

Abanye abantu abane-Takayasu arteritis (TAK) basenokungabi nazo naziphi na iimpawu. Nangona kunjalo, malunga nesiqingatha sezigulane zinokuba nengxaki yokungakhululeki ngokubanzi kunye nobuthathaka. Iimpawu zokuqala (inqanaba loku-1): Ezi ziimpawu ezibonakala ekuqaleni kwesi sifo:

• Ifiva.
• Ndiziva ndidiniwe kakhulu ( Ukudinwa ).
• Intlungu yezihlunu namalungu .
• Ukutya akunancasa .

Iimpawu zesigaba esilandelayo (isigaba sesi-2): Njengoko isifo siqhubeka, iimpawu ezifana nezi zinokuvela:

• Iintlungu zesifuba .
• Ubunzima bokuphefumla .
• Intloko ebuhlungu .
• Ndiziva ndinesizungu.

Iimpawu ezibangelwa kukuncitshiswa kwemithambo yegazi kunye nokuncipha kokunikezelwa kwegazi:

• Ukudinwa, iintlungu, okanye ukuqaqamba kweengalo nemilenze.
• Intlungu yesisu ngenxa yokuncipha kokuhamba kwegazi emathunjini.
• Uxinzelelo lwegazi oluphezulu ngenxa yokuncipha kokuhamba kwegazi ukuya kwizintso.
• Istroke (oku kunqabile kakhulu).
• Ukuhlaselwa yintliziyo (oku nako kunqabile).

Yintoni eyabangela i-arteritis kaTakayasu?

Enyanisweni, akukho mntu waziyo unobangela ochanekileyo we-Takayasu's arteritis (TAK).. Kodwa oogqirha nabaphandi bacinga ukuba isenokuba 'yimeko yokuzikhusela komzimba'. Oko kukuthi, inkqubo yethu yokuzikhusela yomzimba, elwa nesifo, ihlasela ngempazamo izicubu zayo eziphilileyo. Kungathi ukuzikhusela kwethu kuyasenzakalisa. Abanye abaphandi bacinga ukuba ezinye iimeko ze-arteritis kaTakayasu zinokubangelwa yijini ezuzwe kubazali bobabini. Abo bazali basenokungabi nazimpawu, kuba baphethe ikopi enye kuphela yejini. Kodwa ukuba uzuze loo jini kubazali bobabini, unokuba nale meko kunye neempawu zayo.

Sifunyaniswa njani esi sifo?

Ugqirha wakho uza kuxilonga i-arteritis kaTakayasu ngokujonga izinto ezininzi kunye, hayi enye kuphela.

• Imbali epheleleyo yezonyango kunye novavanyo lomzimba: Oku kwenzelwa ukuthintela ezinye iimeko ezineempawu ezifanayo nezakho. Xa ugqirha wakho esebenzisa i-stethoscope ukuhlola imithambo yegazi yakho, unokuva isandi esingaqhelekanga esibizwa ngokuba yi-'bruit' ngaphakathi kwimithambo yegazi. Xa imithambo yegazi imincinci kakhulu, kunzima ukuba igazi lihambe kuyo, apho isandi sivakala khona.
• Ii-X-reyi: Ezi zibonisa apho umthambo wakho womthambo wonakaliswe khona kunye nobunzima bomonakalo.
• Uvavanyo lokufumanisa ukuncitshiswa kwemithambo yegazi okanye ii-aneurysms: Kukho iindlela ezahlukeneyo zokuvavanya oku.

Zithini iimvavanyo zokuxilonga?

Kukho iimvavanyo ezininzi ezinokunceda ugqirha ukuqinisekisa ukuxilongwa:

• I-Magnetic Resonance Imaging (MRI): Olu luvavanyo olungasebenzisi ii-X-ray. Imifanekiso yenziwa kusetyenziswa imagnethi enkulu, amaza e-electromagnetic energy, kunye nekhompyutha.
• I-Computed Tomography (CT) scan: Ii-X-ray kunye neekhompyutha zenza imifanekiso yezitho zangaphakathi, kuquka nemithambo yegazi emikhulu.
• I-Angiography: Oku kuquka ukuthatha imifanekiso ye-X-reyi yangaphakathi kwemithambo yegazi yakho. Ugqirha wakho ufaka ityhubhu ebhityileyo, ende ebizwa ngokuba yi-catheter kumthambo omkhulu osesinqeni okanye engalweni yakho aze ayikhokelele kumthambo wegazi ekufuneka uhlolwe. Emva koko, kufakwa idayi ekhethekileyo (izinto ezichaseneyo) nge-catheter kwimithambo yegazi. Xa kuthathwa ii-X-reyi, idayi yenza imithambo yegazi ibonakale ngokucacileyo kwimifanekiso. Ngamanye amaxesha, i-MRI ingasetyenziselwa ukwenza i-angiography.
• I-Positron Emission Tomography (i-PET scan): Kolu vavanyo, ugqirha wakho ufaka into ene-radioactive ngenaliti kwimithambo esengalo yakho. Njengoko into ihamba emzimbeni wakho, iskena siyayibhaqa ize yenze imifanekiso.
• I-Ultrasound: Oku kunceda ekudaleni imifanekiso yemithambo yegazi kusetyenziswa amaza esandi.

Iphathwa njani i-arteritis kaTakayasu?

Amayeza anokulawula ukudumba, okanye ukudumba. Nangona kunjalo, abanye abantu banokufuna utyando ukuze badlule umthambo wegazi ovalekileyo baze benze indlela entsha yokuhamba kwegazi. IiCorticosteroids: IiCorticosteroids, ezifana ne-prednisone (umz., iRayos®, iSterapred®) okanye i-prednisolone (umz., iFlo-Pred®, iOrapred®), zezona ndlela ziqhelekileyo zonyango lwe-Takayasu's arteritis (TAK).

La mayeza asebenza kakuhle ekupheliseni ukudumba okusebenzayo kwimithambo yegazi nokubuyisela esi sifo kwimeko entle.

Ugqirha wakho uza kuyinciphisa kancinci kancinci idosi ye-prednisone iye kwidosi ephantsi kakhulu ukuze kuncitshiswe iziphumo ebezingalindelekanga. Abanye abantu banokuyeka kancinci kancinci ukuthatha amayeza ngaphandle kokuba iimpawu zibuye. Nangona kunjalo, ezi corticosteroids azisebenzi ngokupheleleyo kwabanye abantu. Kwakhona, ngaphezulu kwesiqingatha sabantu abathatha la mayeza banokubona iimpawu zibuya okanye imeko yabo ibe mandundu. Amayeza okunciphisa amasosha omzimba: Oogqirha badla ngokunika amayeza acinezela amajoni omzimba, afana nala:

• I-Methotrexate (umz. iRheumatotrex®, iTrexall®)
• IAzathioprine (umz. Imuran®, Azasan®)
• I-Mycophenolate (umz. i-Cellcept®, i-Myfortic®)
• I-Leflunomide
• I-Cyclophosphamide

Xa ezi immunosuppressants zisetyenziswa kunye ne-prednisone, malunga nama-50% abantu ababekhe baba nee-flares banokusombulula iimpawu zabo baze bayeke kancinci kancinci ukusebenzisa i-prednisone. Izithinteli zeTumor-Necrosis Factor (TNF): Abanye abantu banokunikwa amayeza abizwa ngokuba zii-TNF inhibitors ukunceda ukulwa nokuvuvukala. Imizekelo yale ibandakanya:

• I-Etanercept
• I-Infliximab
• I-Tocilizumab

Lilonke, malunga nama-25% abantu abane-arteritis kaTakayasu abanakukwazi ukulawula ngokupheleleyo esi sifo ngaphandle kokusebenzisa amayeza rhoqo.

Zithini iziphumo ebezingalindelekanga zonyango?

Amayeza asetyenziswa ukunyanga i-Takayasu's arteritis anokuba nemiphumo emibi kakhulu. Nangona kunjalo, amanye amayeza anokunceda ukulawula le miphumo emibi. Iziphumo ebezingalindelekanga zingabandakanya:

• Ukuncipha kokuxhathisa izifo.
• Ukuncipha kobunzima bamathambo (i-osteoporosis).
• Ubunzima bokubona.
• Ukuxhuzula.

Ii-corticosteroids ziqala ukusebenza kwiiyure ezimbalwa emva kokuqala unyango, ngoko ke ungaziva ukhululekile ngokukhawuleza.

Zeziphi ezinye iindlela zonyango ezisetyenziswayo?

Kwezinye iimeko, uxinzelelo lwegazi oluphezulu (uxinzelelo lwegazi oluphezulu) lunokubangelwa kukuncitshiswa kwemithambo yegazi ukuya kwizintso. Kwimeko enjalo, ugqirha angasebenzisa into efana nebhaluni ukwandisa umthambo wegazi oncitshisiweyo, obizwa ngokuba yi-angioplasty. Okanye, utyando lwe-bypass lungenziwa ukuvumela igazi ukuba lihambe ngokwesiqhelo liye kwizintso. Oku kunokunceda ukulungisa uxinzelelo lwegazi ngaphandle kokuthatha amayeza oxinzelelo lwegazi oluphezulu. Abanye abantu banokuba neengxaki ezinkulu ngemithambo yegazi encitshisiweyo ezingalweni okanye emilenzeni, okwenza kube nzima ukuhamba okanye ukwenza eminye imisebenzi. Utyando lwe-bypass lunokulungisa ezi ngxaki. Ukuba kukho i-aneurysm, inokulungiswa ngotyando okanye nge-bypass. Abanye abantu abane-arteritis kaTakayasu banokufuna nokutshintshwa kwe-aortic valve.

Ndingazinyamekela njani?

Abantu abaninzi abane-Takayasu's arteritis nabo banoxinzelelo lwegazi oluphezulu (uxinzelelo lwegazi oluphezulu). Kubalulekile ukulawula oku. Ukuba awunyangi uxinzelelo lwegazi oluphezulu, izinto ezinje ngezi zinokwenzeka:

• Istroke.
• Isifo sentliziyo.
• Ukungasebenzi kakuhle kwezintso.

Ukuba uthatha amayeza athintela inkqubo yakho yokuzikhusela komzimba, cinga ngokufumana la mayeza okugonya ukuze akukhusele kwiintsholongwane:

• Ugonyo lomkhuhlane.
• Ugonyo lwe-pneumonia.
• Ugonyo lweHerpes zoster (Shingles).

Yintoni enokulindelwa ngumntu one-arteritis kaTakayasu?

Nangona kungekho nyango lwe-Takayasu's arteritis, sisifo esinokunyangwa. Uninzi lwabantu abanesifo bayaphila ngonyango. Nangona kunjalo, abantu abaninzi banokukhubazeka ngandlela ithile, okanye bangabi bakhubazekile ngokupheleleyo, ngenxa yesi sifo. Iziphumo zesifo zinokuba nefuthe elikhulu kwimisebenzi yemihla ngemihla. Malunga nesiqingatha sabantu abane-Takayasu's arteritis kufuneka benze utshintsho kwimisebenzi yabo. Nangona kunjalo, malunga ne-25% yabantu abanesifo baphila ubomi obuqhelekileyo. Abanye abangama-25% kuye kwafuneka benze utshintsho kwimisebenzi yabo. Abantu abaphila nesi sifo esinganyangekiyo kufuneka bahlolwe rhoqo ngugqirha kwaye, ukuba kuyimfuneko, batshintshe amayeza abo. Oogqirha kufuneka bajonge iziphumo ebezingalindelekanga zamayeza kwaye benze uvavanyo lwegazi. Oku kulandelayo kunokuba ziingxaki ze-Takayasu's arteritis:

• Ukumelwa yintliziyo.
• Istroke.
• Amahlwili egazi.
• Uhlaselo lwentliziyo.

I-Takayasu arteritis sisifo esihlala ixesha elide esikhula kancinci. Uya kufuna unyango lwexesha elide, rhoqo ngamayeza. Kumazwe afana ne-United States neJapan, malunga ne-3% yabantu abane-Takayasu arteritis bafa kumyinge weminyaka emihlanu yesifo. Oku kusenokuba kungenxa yokuba oogqirha bayakwazi ukufumanisa isifo kwangethuba baze basinyange ngokuchanekileyo. Kwezinye iindawo zehlabathi, isiphumo sinokuba sibi ngenxa yokulibaziseka ekuxilongweni nasekunyangweni okanye ukufikelela okungafanelekileyo kwiinkonzo zempilo. Ukuba ayinyangwa, i-Takayasu arteritis inokubulala.

Ndingayinyamekela njani impilo yam?

Kubalulekile ukugcina umkhondo wendlela oziva ngayo kwaye uhlale unxibelelana rhoqo nogqirha wakho ukuze ukwazi ukufumana naziphi na iimpawu ezintsha okanye eziya zisiba mandundu kwangethuba.

Ndifanele ndimbone nini ugqirha?

Ukuba iimpawu zakho ze-Takayasu arteritis ziyabuya ngexesha okanye emva konyango, bona ugqirha wakho ngoko nangoko. Ukuba uceba ukukhulelwa, thetha nogqirha wakho ngayo loo nto. Kunokwenzeka ukuba ukhulelwe ngempumelelo nge-Takayasu arteritis, kodwa kubalulekile ukwazi indlela yokuyilawula.

Ndingaya nini kwiYunithi yoNyango oluNgxamisekileyo (i-ETU) ?

Ukuba unayo nayiphi na kwezi mpawu, fowunela u-911 ngoko nangoko (eSri Lanka, fowunela i-1990 Suwaseriya Ambulance Service okanye uye kwisibhedlele esikufutshane):

• Iintlungu zesifuba.
• Ubunzima bokuphefumla.
• Ukubetha kwentliziyo okubuthathaka.
• Iimpawu zokuhlaselwa yintliziyo (umz., iintlungu eziqatha esifubeni eziphuma engalweni, ukubila, isicaphucaphu).
• Iimpawu zestroke (umz., ukugoba kwelinye icala lobuso, ukungaziva mnandi engalweni, ubunzima bokuthetha).

Ndingayibuza yiphi imibuzo ugqirha wam?

• Kuza kufuneka ndithathe amayeza e-arteritis kaTakayasu ixesha elingakanani?
• Kufuneka ndize kangaphi kwixesha lokulandela?
• Ngaba imeko yam ingalawulwa ngaphandle kotyando?
• Kufuneka ndenze uvavanyo lokufota kangaphi?

Okokugqibela, yintoni ekufuneka uyikhumbule (Umyalezo Wokuya Ekhaya)

Ngenxa yokuba i-Takayasu's Arteritis yimeko ehlala ixesha elide, okanye 'engapheliyo', kuya kufuneka ubone ugqirha rhoqo. Ekuhambeni kwexesha, iimpawu zakho zinokutshintsha ukusuka ekubeni phantsi kolawulo ukuya ekubeni phantsi kolawulo. Yiyo loo nto kubalulekile ukuhlala unxibelelana nogqirha wakho rhoqo. Ungoyiki ukuxelela ugqirha wakho ukuba ubona naluphi na utshintsho kwimpilo yakho. Ugqirha wakho uya kufuna ukwazi ngayo, kuba kulapho anokukunceda khona.

Khumbula, nokuba unesifo esi, ngonyango olufanelekileyo nokulandela iingcebiso zonyango, nawe ungaphila ubomi obuhle. Hlala uqinile!

I-Takayasu's arteritis, i-Takayasu's arteritis, isifo esingenantliziyo, i-vasculitis, i-aorta, i-arteritis, isifo semithambo yegazi, uxinzelelo lwegazi oluphezulu, isifo sokuzikhusela komzimba