Ingabe ngezinye izikhathi uzizwa uqinile uma uvuka ekuseni? Noma ingabe uzwa ubuhlungu emhlane usuku lonke? Kunezinhlobo ezimbili ze-arthritis ezithinta umgogodla ezinezimpawu ezifanayo. Enye yi -DISH (Diffuse Idiopathic Skeletal Hyperostosis) kanti enye yi -AS (Ankylosing Spondylitis) . Izimpawu zazo zombili ziyafana, okungasidida ngezinye izikhathi. Ngakho-ke namuhla, ake sixoxe ngalezi zifo ezimbili ngokuningiliziwe futhi siqonde ngokucacile ukuthi umehluko uyini, ukuthi izimpawu ziyini, nokuthi singazelapha kanjani.
Yini ebangela lezi zifo ezimbili?
Kalula nje, zombili lezi zifo zithinta amalunga kanye nemisipha emgogodleni wethu, kodwa indlela eziwuthinta ngayo ihlukile kancane.
Kuyini i-DISH (i-Diffuse Idiopathic Skeletal Hyperostosis)?
I-DISH yisimo lapho usawoti we-calcium uqongelela khona emithanjeni nasemisipha ezungeze umgogodla wethu. Le calcium ibangela ukuthi lezo zindawo zibe nzima kancane kancane njengethambo, njengokungathi ithambo elisha liyakhula. Odokotela abazi kahle ukuthi yini ebangela lokhu. Kodwa bakholelwa ukuthi izakhi zofuzo, izici zemvelo, noma inhlanganisela yakho kokubili kungadlala indima.
I-Ankylosing Spondylitis (AS) ikhula kanjani?
Kukholelwa ukuthi izici zofuzo kanye nezemvelo zidlala indima ku-AS. Abantu abane-gene ye-HLA-B27 basengozini enkulu yokuthola lesi sifo. Lawa ma-HLA asiza amasosha omzimba wethu ukuhlukanisa phakathi kwamaseli ethu kanye nabahlaseli bangaphandle. Kodwa-ke, ucwaningo lusaqhubeka mayelana nokuthi le gene ethile ibangela kanjani i-AS. Ku-AS, amasosha omzimba ahlasela amalunga emgogodleni wethu. Lokhu kubangela ukuvuvukala, okubangela ukuqina nobuhlungu emgogodleni.
Ubani okungenzeka kakhulu ukuthi athole lezi zifo?
Kunomehluko ocacile phakathi kweminyaka kanye nezici eziyingozi zokuthola lezi zifo ezimbili. Ake sikuqonde kalula kusukela kuleli thebula.
| Ulwazi | I-DISH (i-Diffuse Idiopathic Skeletal Hyperostosis) | I-AS (i-Ankylosing Spondylitis) |
|---|---|---|
| Ubudala obuthintekile | Ngokuvamile kuvame kakhulu kubantu abaneminyaka engaphezu kwengu-50 ubudala . | Ngokuvamile kuqala esemncane , phakathi kweminyaka eyi-15-30. |
| Iqembu elithintekile | Kuvame kakhulu kwabesilisa kunabesifazane. | Kuvame kakhulu kwabesilisa kunabesifazane. |
| Ezinye izinto eziyingozi |
|
Into ebalulekile ukuthi abantu abaningi abane-DISH abanazo izimpawu. Ngokuvamile kutholakala ngengozi uma kuthathwa i-X-ray ngesinye isizathu.
Yimiphi umehluko wezimpawu?
Nakuba izimpawu eziyinhloko zalezi zifo zombili kungubuhlungu bomhlane nokuqina, kunomehluko ocacile lapho ubuhlungu buvela khona, ukuthi buzizwa kanjani, kanye nezinye izimpawu ezihambisana nakho.
| Isici | Njengoba kubonwe ku-DISH | Njengoba kubonwe ku-AS |
|---|---|---|
| Indawo lapho ubuhlungu buvela khona | Ubuhlungu buvame ukwenzeka emhlane ongaphezulu . | Ubuhlungu buqala emhlane ongezansi . |
| Umphumela wokuzivocavoca | Akukho mphumela okhethekile. | Ubuhlungu nokuqina komzimba kuncipha lapho uzivocavoca futhi uhamba. |
| Ukuhlungu obusemhlane | Ubuhlungu bungenzeka ezindaweni ezifana namahlombe, izindololwane, amadolo, kanye nezithende. | Ubuhlungu bungase buvele ezimbanjeni, emahlombe, ezinqeni, emadolweni, noma ezinyaweni. |
| Ezinye izici ezikhethekile | Ukukhula kwamathambo entanyeni kungabangela ubunzima bokugwinya noma ukusha ngenxa yokucindezeleka kwemizwa. | Izimpawu ezithinta umzimba wonke ziyaboniswa. Isibonelo: - Ukwehlisa isisindo - Ukukhathala okukhulu - Izifo zesikhumba (ukuqubuka) - Ubuhlungu besisu - Izinguquko zombono (ububomvu, ubuhlungu) |
Udokotela uzihlukanisa kanjani futhi azihlonze kanjani lezi zifo ezimbili?
Ukuxilonga lezi zimo ezimbili kungaba nzima kancane. Uma unokungabaza ngokuxilonga kwakho, akukho okubi ngokubona omunye udokotela ukuze uthole umbono wesibili.
Udokotela uzoqala ngokukubuza ngezimpawu zakho kanye nomlando wezokwelapha. Ngemuva kwalokho uzokwenza ukuhlolwa ngokomzimba. Ngaphezu kwalokho, angayala lezi zivivinyo.
Ukuhlolwa Kwegazi
Ku-AS, ukuhlolwa kwe -HLA-B27 gene kuvame ukuba kuhle. Ukuhlolwa okulinganisa ukuvuvukala emzimbeni, njenge-C-reactive protein (CRP) kanye ne-ESR, nakho kungaphakama. Lokhu kuvame ukungashintshi ku-DISH.
Ukuhlolwa Kwezithombe
Lezi zivivinyo zithatha izithombe zangaphakathi lomzimba futhi zibheke izinguquko emgogodleni nasemalungeni.
- I-X-ray: Bheka izinguquko emathanjeni.
- I-MRI (I-Magnetic Resonance Imaging): Thola izithombe ezinemininingwane zomgogodla, amalunga, kanye nezicubu ezixhumeneyo.
- I-CT scan (i-Computed Tomography): Thola izithombe ezinemininingwane eminingi.
Lezi zifo ezimbili zingahlukaniswa ngokusekelwe kulokho okubonwa kulezi zivivinyo.
- Uma une-AS: Ukuvuvukala nokuqina kwamalunga e-sacroiliac ( sacroiliitis)Ungakubona. Ngezinye izikhathi izinhlungu zixhumene ndawonye futhi zibukeke njengoqalo. Lokhu kubizwa ngokuthi uqalo oluyinhlungu .
- Uma une-DISH: Ungabona izicubu ezixhumanisayo ezihamba phambili komgogodla ziqina futhi ziphenduka ithambo. Kodwa ngeke usibone isimo se-Sacroiliitis. Lesi ngesinye sezici eziyinhloko ezihlukanisa lezi zinto ezimbili.
Yiziphi izindlela zokwelapha lokhu?
Kokubili i-AS ne-DISH azikwazi ukwelapheka ngokuphelele. Kodwa-ke, ngokwelashwa okufanele, izimpawu zingalawulwa futhi impilo evamile ingaholwa. Kuzo zombili lezi zifo, umgogodla uyacindezelwa, ngakho-ke ingozi yokuqhekeka iphezulu ngisho nangengozi encane. Ngakho-ke, kubaluleke kakhulu ukuqaphela.
Ukwelashwa okuvamile kokubili:
- Ukwelashwa ngokomzimba kanye nokuzivocavoca: Lokhu kubalulekile ukuqinisa imisipha ezungeze umgogodla nokugcina ukuguquguquka kwamalunga.
- Iziqeda-buhlungu: Ama-NSAID (izidakamizwa ezingezona eze-steroidal ezilwa nokuvuvukala) njenge-ibuprofen ne-naproxen zinciphisa ubuhlungu nokuvuvukala.
- Imijovo ye-steroid: Imijovo ye-steroid ngqo emalungeni abuhlungu inganikeza impumuzo yesikhashana.
- Ukuhlinzwa: Lokhu akuyona indlela yokwelapha evamile, kodwa uma unezimpawu ezinzima ezingenakukwazi ukulawulwa ngezinye izindlela zokwelapha, udokotela wakho angase akuncomele ukuhlinzwa.
Ukwelashwa okuqondile kwe-AS:
Ngaphezu kokwelashwa okukhulunywe ngakho ngenhla kwe-AS, kuneklasi ekhethekile yemithi enciphisa ukuvuvukala ngokushintsha ukusebenza kwesimiso somzimba sokuzivikela. Lezi zibizwa ngokuthi ama-DMARD (imithi yokuguqula izifo elwa namathambo) . Ezinye izibonelo yilezi:
- I-Interleukin-17 (IL-17) inhibitors (isb, i-secukinumab, ixekizumab)
- Izithibi ze-JAK (isib., i-tofacitinib, i-upadacitinib)
- Ama-TNF inhibitors (isib., i-adalimumab, i-etanercept, i-infliximab)
- I-Methotrexate
- I-Sulfasalazine
Udokotela wakho uzonquma ukuthi yimuphi kule mithi ofaneleka kakhulu kuwe.
Umlayezo Wokuya Nawe Ekhaya
- I-DISH kanye ne-AS yizinhlobo ezimbili ze-arthritis ezithinta umgogodla. Nakuba izimpawu zifana, izimbangela nemiphumela kuhlukile.
- I-DISH ivame ukwenzeka kwabesilisa abaneminyaka engaphezu kwengu-50 futhi imvamisa ayinazo izimpawu. I-AS ingaqala esemncane.
- Indawo lapho ubuhlungu bukhona (i-DISH - ngaphezu kwehlombe, i-AS - ngaphansi kwehlombe) kanye nempendulo yokuzivocavoca (ubuhlungu buyancipha ku-AS) kusiza ukuhlukanisa lokhu kokubili.
- Udokotela wakho uzokwenza ukuxilongwa okunembile ngokusekelwe emlandweni wakho wezokwelapha, ukuhlolwa, ukuhlolwa kwegazi, kanye nokuhlolwa kwezithombe (ikakhulukazi ama-X-ray nama-MRI).
- Nakuba lezi zifo zingelapheki ngokuphelele, ukwelashwa ngokomzimba, imithi, kanye nezinguquko endleleni yokuphila kungakusiza ukuthi uphathe izimpawu zakho futhi uphile impilo ephumelelayo. Khuluma nodokotela wakho njalo ngalokhu.
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