Ingabe uvame ukuzizwa ukhathele, unemfiva engachazeki, futhi wehlise isisindo ngenxa yobuhlungu bamalunga? Nakuba lokhu kungase kubonakale njengezinto ezivamile, ngezinye izikhathi okufihliwe ngemuva kwalezi zimpawu kungaba yisifo esingakazwa kakhulu ngaso futhi okufanele sikhathazeke ngaso kancane. Namuhla sikhuluma ngesifo esingavamile kodwa esibalulekile okufanele sisiqaphele. Lokhu kubizwa ngokuthi i-microscopic polyangiitis, noma i-MPA njengoba odokotela besibiza kanjalo.
Kalula nje, iyini i-Microscopic Polyangiitis (MPA)?
Kalula nje, i-MPA yisimo lapho imithambo yegazi emincane nephakathi (imithambo yegazi) emzimbeni wethu ivuvukala khona, okungukuthi, ivuvukala. Kwezokwelapha, sivame ukubiza lokhu kuvuvukala kwemithambo yegazi ngokuthi 'i-vasculitis'. Lesi yisifo esingavamile kakhulu.
Uma imithambo yegazi ivuvukala ngale ndlela, iqala ukulimaza izitho ezihlinzeka ngegazi kuzo. Izitho eziyinhloko ezingathinteka ku-MPA yilezi:
- Izinso
- Amaphaphu
- Imizwa
- Isikhumba
- Amalunga (amalunga)
Kuyini 'i-Vasculitis'? Kubangelwa yini?
Cabanga ngohlelo lwemithambo yegazi emzimbeni wethu njengohlelo lwamapayipi athwala amanzi. Uma la mapayipi evuvukala noma evuvukala, kungavela izinkinga eziningana.
1. Ubuthakathaka bomthambo wegazi: Ngenxa yokuvuvukala, udonga lomthambo wegazi luba buthakathaka futhi lungavuvukala njengebhaluni. Lokhu sikubiza ngokuthi ``(Aneurysm)``. Ngezinye izikhathi le ndawo ebuthaka ingaqhuma futhi yophe igazi ezicutshini ezizungezile.
2. Ukuncishiswa kwemithambo yegazi: Enye into ukuthi imithambo yegazi ingaba mincane ngenxa yokuvuvukala ngaphakathi kwayo, futhi ngezinye izikhathi ivaleke ngokuphelele. Khona-ke izitho ezithola igazi nomoya-mpilo kuleyo mithambo yegazi ziqala ukulimala. Njengoba nje umuthi ufa lapho uncishiswa amanzi.
Yilokho okwenzekayo ku-MPA. Ngenxa yokuthi imithambo yegazi emincane iyathinteka, ilimaza izitho ezizwelayo ezihlinzeka ngegazi, njengezinso namaphaphu.
Ubani othola lesi sifo? Sibangelwa yini?
Lesi yisifo esingavamile kakhulu. Ngokwezibalo, lesi sifo sithinta abantu abaphakathi kuka-13 no-19 kwabayizigidi emhlabeni. Singakhula nganoma yisiphi isikhathi futhi kubonakala sengathi sithinta abesilisa nabesifazane ngokulinganayo.
Imbangela eqondile yalesi sifo ayikatholakali okwamanje, kodwa lokhu kusobala kakhulu:
- Lokhu akusiwo umdlavuza.
- Akusona isifo esithathelwanayo.
- Ngokuvamile akusona isifo esizuzwe njengefa.
Ucwaningo luye lwabonisa kakhulu ukuthi lesi yisimo esibangelwa ukungasebenzi kahle kwesimiso somzimba wethu sokuzivikela. Kalula nje, isimiso somzimba sokuzivikela, okufanele sivikele imizimba yethu, siqala ngephutha ukuhlasela imithambo yegazi yethu. Yilokho okubangela lokhu kuvuvukala.
Ziyini izimpawu zesifo se-MPA?
Ngenxa yokuthi i-MPA ithinta izitho eziningi zomzimba, izimpawu zingahlukahluka kakhulu, futhi zingahluka kumuntu nomuntu.
| Ingxenye ethintekile | Izimpawu ezingaba khona |
|---|---|
| Izici ezivamile | Ukukhathala, umkhuhlane, ukuphelelwa yisifiso sokudla, ukwehla kwesisindo, ubuhlungu bemisipha namalunga. |
| Amaphaphu | Ubunzima bokuphefumula, ukukhwehlela igazi. |
| Imizwa | Imizwa engavamile (njengokushaqeka kukagesi, izintuthwane ezigijimayo), kulandelwa ukungabi namandla, ukulahlekelwa amandla. |
| Isikhumba | Amabala abomvu noma ansomi esikhumbeni (ukuqubuka). |
| Izinso | Yilapho ingozi ikhona khona. Uma izinso zithintekile , ngokuvamile azikho izimpawu ezigabeni zokuqala. Ungase ungakuboni ngisho kuze kube yilapho izinso zakho ziqala ukusebenza. |
Njengoba isifo sezinso singavela ngaphandle kwezimpawu, kubaluleke kakhulu ukuthi kuhlolwe umchamo wanoma ubani osolwa ngokuba ne-vasculitis.
Udokotela usithola kanjani lesi sifo?
Ukuxilonga i-MPA akuyona inqubo yesinyathelo esisodwa. Udokotela kumele ahlanganise izici eziningana ukuze afinyelele esiphethweni.
- Uzocelwa imininingwane: Udokotela uzolalela ngokucophelela izimpawu zakho, ukuthi zaqala kanjani, kanye nomlando wakho wezokwelapha.
- Ukuhlolwa ngokomzimba: Udokotela wakho uzohlola umzimba wakho ukuze azame ukuthola ukuthi yiziphi izitho zomzimba ezithintekile.
- Ukuhlolwa kwegazi nomchamo: Ukuhlolwa kwegazi kubheka ngqo i-antibody ebizwa ngokuthi ``(ANCA - Antineutrophil Cytoplasmic Antibodies)``. Lokhu kungaba kuhle ezifweni ezifana ne-MPA. Futhi, ukuhlola umchamo ngamaprotheni namaseli abomvu egazi kubalulekile ukuze wazi isimo sezinso.
- Ama-scan: Ama-X-ray, ama-CT scan, noma ama-MRI scan asetshenziselwa ukuhlola ukukhubazeka kwezitho zomzimba ezifana namaphaphu.
- I-Biopsy: Uma kusolwa ukuthi lesi sifo sikhona, kuthathwa ingxenye encane yezicubu endaweni ethintekile (isib., izinso, isikhumba) bese ihlolwa ngaphansi kwesibonakhulu. Lena yindlela engcono kakhulu yokuqinisekisa ukuthi une-vasculitis.
Ukuthi nje ukuhlolwa kwegazi kwe-ANCA kutholakale ukuthi unalesi sifo akusho ukuthi unesifo. Kuwusizo kuphela ekuxilongweni. Ukuze kube yiqiniso, i-biopsy ivame ukudingeka.
Yiziphi izindlela zokwelapha i-MPA?
Umgomo oyinhloko wokwelapha i-MPA ukulawula ukusebenza ngokweqile kwesimiso sethu somzimba nokuvimbela umonakalo emithanjeni yegazi. Kusetshenziswa imithi yokucindezela amasosha omzimba kulokhu.
Uma isifo sibi kakhulu
Uma izitho ezibalulekile njengezinso namaphaphu zithinteka kakhulu, ama-corticosteroids avame ukunikezwa kanye nomunye umuthi onamandla wokucindezela amasosha omzimba njenge-Cyclophosphamide (Cytoxan®) noma i-Rituximab (Rituxan®).
Uma lesi sifo singesibi kangako
Ezimweni ezingembi kangako, ama-corticosteroids kanye ne-methotrexate kungasetshenziswa kuqala.
Umgomo wokwelashwa ukulawula ngokuphelele lesi sifo nokusenza singasebenzi. Lokhu kubizwa ngokuthi ukuya 'ekukhululweni'. Uma lesi sifo sesilawulwa, udokotela uzonciphisa kancane kancane umthamo wama-steroid.
Imithi enamandla njenge-'Cyclophosphamide' inikezwa kuphela kuze kube yilapho isifo sesilawulwa (cishe izinyanga ezi-3-6). Ngemva kwalokho, ushintshelwa ku-'Maintenance Medication', njenge-'Azathioprine (Imuran®)' noma i-'Mycophenolate Mofetil (Cellcept®)', ukuze isifo silawulwe futhi sivinjwe ukuthi singabuyi. Lokhu kwelashwa kokunakekelwa kungadinga ukuthathwa okungenani unyaka noma emibili.
Ingabe nawe unokwesaba ukuthi, "Lezi izidakamizwa zomdlavuza, akunjalo?"
Abantu abaningi banombuzo lapha. Imithi ebizwa ngokuthi i-'Cyclophosphamide' kanye ne-'Methotrexate' nayo inikezwa umdlavuza, ngakho bathi le mithi 'ye-Chemotherapy'. Yebo, le mithi inikezwa nomdlavuza. Kodwa umthamo onikezwa i-'Vasculitis' uphansi ngokuphindwe ka-10-100 kunomthamo onikezwa umdlavuza. Lapha, umsebenzi wale mithi awukona ukubulala amangqamuzana omdlavuza, kodwa ukulawula ukusebenza kwesimiso somzimba sokuzivikela.
Ngenxa yokuthi le mithi icindezela amasosha omzimba, kunengozi yokuthola izifo ezinkulu. Futhi, yonke imithi ingaba nemiphumela emibi. Ngakho-ke, kubaluleke kakhulu ukuhlolwa ngesikhathi futhi ube ngaphansi kokuqashwa njalo kwezokwelapha, njengoba kunqunywe udokotela.
Impilo izoba njani ngalesi sifo?
Nakuba i-MPA iyisifo esibi kakhulu, ngokwelashwa okufanele, abantu abaningi bangasilawula ngempumelelo lesi simo. Imiphumela iyahlukahluka kuye ngokuthi lesi sifo sibi kangakanani. Kodwa-ke, ngokuvamile, abantu abangaphezu kuka-80% bayaphila futhi baphila kahle ngemva kweminyaka emihlanu betholakale benalesi sifo.
Ukutholwa kusenesikhathi kanye nokwelashwa kusenesikhathi kungasiza ekunciphiseni ukulimala kwezitho zomzimba. Kubalulekile futhi ukuthintana njalo nodokotela wakho.
Ngemva kokuba lesi sifo sesilawulwa, okungukuthi, ngemva kokungena ku-"Remission", singabuya ngezinye izikhathi. Lokhu sikubiza ngokuthi "Relapse". Cishe ama-50% eziguli abhekana nalolu hlobo lokubuyela emuva kwesifo. Ngakho-ke, kufanele wazise udokotela wakho ngokushesha nganoma yiziphi izimpawu ezintsha ozivezayo.
Umlayezo Wokuya Nawe Ekhaya
- I-MPA yisifo esingavamile lapho amasosha ethu omzimba ehlasela khona imithambo yegazi.
- Lokhu kungalimaza izitho ezibalulekile njengezinso, amaphaphu, kanye nemizwa. Ikakhulukazi uma izinso zithintekile, kungase kungabi khona zimpawu ezigabeni zokuqala.
- Ukuxilongwa kusenesikhathi kanye nokwelashwa kungavimbela umonakalo wesikhathi eside.
- Ngenxa yokuthi imithi yokucindezela amasosha omzimba isetshenziselwa ukwelashwa, kubaluleke kakhulu ukuba ngaphansi kokuqashwa kwezokwelapha nokuzivikela ezifweni.
- Ngisho noma lesi sifo silawulwa, kungenzeka ukuthi siphinde sibuye. Ngakho-ke, uma uhlangabezana nanoma yiziphi izimpawu ezintsha, ngisho nezincane, tshela udokotela wakho ngokushesha.
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