Ingabe amalunga akho omhlane nawo ayabuhlungu? Ake sifunde nge-spondyloarthritis!

Ingabe uqala usuku lwakho ngomgogodla oqinile nobuhlungu uma uvuka ekuseni? Noma ingabe ngezinye izikhathi uzizwa sengathi ubuhlungu bakho bomhlane busakazekela ezinqeni zakho? Ungase ungakhululeki kancane ngezimpawu ezinjengalezi. Lesi simo kungenzeka ukuthi asibuhlungu nje bomhlane. Namuhla sizokhuluma ngesifo esiyinkimbinkimbi kancane, kodwa esiqondakalayo esibizwa ngokuthi i-Spondyloarthritis .

Kuyini i-spondyloarthritis? Kalula nje...

Kalula nje, i-spondyloarthritis yisimo se-arthritis esenzeka emalungeni omgogodla wakho . Igama elithi "Spondyl-" lisho ukuthi lihlobene nomgogodla. Igama elithi "Arthritis" lisho ubuhlungu nokuqina emalungeni. Lesi simo sithinta kakhulu amalunga axhumanisa umgogodla wakho. Okusho ukuthi, amalunga amancane (ama-facet joints) phakathi kwamathambo omgogodla kanye namalunga e-sacroiliac axhumanisa umgogodla wakho namathambo akho enqulwini. Yingakho ubuhlungu obuphansi emhlane buvame ukuba uphawu oluyinhloko . Kodwa-ke, abugcini emgogodleni. Bungathinta amanye amalunga futhi bubangele ezinye izimpawu.

Khumbula, lesi akusona isifo esisodwa, kodwa yiqembu lezifo ezinezimpawu ezifanayo. Odokotela babiza lesi simo ngokuthi i-spondyloarthropathy . Kusho isifo (`-pathy`) samalunga omgogodla (`arthro-`). Kungenzeka ukuthi uke wezwa nge-osteoarthritis (ebangelwa ukuguguleka kwamalunga) kanye ne -rheumatoid arthritis (RA) (ebangelwa inkinga ngesistimu yomzimba). I-Spondyloarthritis iyisimo esihlukile kuzo zombili lezo, kodwa ingathinta namalunga omgogodla.

Yiziphi izici eziyinhloko zalesi simo? Ake sibheke kabanzi!

Kunezimpawu eziningana eziqondile ezihlobene ne-spondyloarthritis:

• Lesi yisifo samathambo: I-Spondyloarthritis uhlobo lwesifo samathambo oluwela ngaphansi kwesigaba sezifo zamathambo , okuwuhlobo lokuvuvukala kwesifo samathambo . Ukuvuvukala okungapheli kubangela ubuhlungu nokuvuvukala emalungeni. Akusona isimo esibangela ukulimala kwamalunga njenge-osteoarthritis. Isifo samathambo esivuvukalayo ngokuvamile siyisifo sokuzivikela komzimba . Lokhu kusho ukuthi amasosha omzimba wakho ahlasela amalunga akho ngephutha, okubangela ukuvuvukala okuqhubekayo. Lokhu kuvuvukala kungathinta hhayi amalunga kuphela, kodwa nezinye izingxenye zomzimba.

• Lokhu akusikho isifo samathambo esibizwa ngokuthi i-rheumatoid arthritis (RA): Nakuba isifo samathambo esibizwa ngokuthi i-rheumatoid arthritis siwuhlobo lwesifo samathambo, lesi isifo samathambo esibizwa ngokuthi i-rheumatoid arthritis (RA) esisaziyo sonke.Cha. Siyazi lokhu ngoba ukuhlolwa kwegazi kwabantu abane-spondyloarthritis akubonisi ukuba khona kwe-antibody ebizwa ngokuthi i-rheumatoid factor , eqondene ngqo ne-RA. Yingakho odokotela ngezinye izikhathi bebiza lesi simo ngokuthi "i-seronegative spondyloarthropathy ." I-"Seronegative" isho ukuthi ukuhlolwa kwegazi kwe-RA akubonakali. Akukho antibody ethile etholakale ye-spondyloarthritis (SpA).

• I-Enthesitis: Esinye isibonakaliso esibalulekile se-spondyloarthritis ukuvuvukala (i-enthesitis) kuma-entheses akho . Odokotela bayakufuna lokhu lapho bexilonga lesi simo. Ama-Entheses ayizicubu ezixhumene ne-fibrous. Ngokuqondile, "amalunga" lapho imisipha yakho nemisipha ixhumana khona namathambo akho. I-Spondyloarthritis ingabangela i-enthesitis ezingxenyeni ezahlukene zomzimba. Izithende namadolo yizindawo ezivame kakhulu lapho lesi simo sibonakala khona.

• Izakhi zofuzo ze-HLA-B27: Phakathi kuka-80% no-95% wabantu abane-spondyloarthritis abadabuka eNyakatho Yurophu banezakhi zofuzo ze-HLA-B27 . Lesi sakhi sofuzo asivamile kubantu abanalesi sifo kwamanye amaqembu ezinhlanga. Futhi, ukuba nalesi sakhi sofuzo akusibangela lesi sifo ngokuzenzakalelayo. Kodwa-ke, kuvamile ngokwanele ukuthi udokotela angase ahlole lesi sakhi sofuzo ukuze asize ekuxilongeni lesi sifo.

Sivame kangakanani lesi sifo?

Nakuba abantu abaningi bengazi okuningi ngayo, i-spondyloarthritis empeleni iyisimo esivame kakhulu kune-rheumatoid arthritis . Kulinganiselwa ukuthi cishe u-0.5% kuya ku-2% wabantu emhlabeni unesimo esithile se-spondyloarthropathy.

Yiziphi izinhlobo eziyinhloko ze-spondyloarthritis?

Kunezifo eziningana ezihlukene eziwela ngaphansi kwesihloko esijwayelekile se-spondyloarthritis. Odokotela bahlukanisa lezi zifo ngezigaba ezimbili eziyinhloko: i-axial spondyloarthritis kanye ne-peripheral spondyloarthritis .

I-Axial Spondyloarthritis

Kuthinta kakhulu amalunga omzimba wakho we-axial , okuyintamo , isifuba, nomgogodla . Njengoba lesi sifo siqhubeka, amanye amalunga kanye nezitho zomzimba zingathinteka.

I-Ankylosing Spondylitis uhlobo olubi kakhulu lwe-axial spondyloarthritis. Ibonakala ngezinguquko ezisobala emathanjeni omgogodla, okuthiwa i-ankylosis.(njengokuhlangana kwamathambo). Ngokuvamile, lolu uhlobo oluvame kakhulu lwe-spondyloarthritis.

I-Peripheral Spondyloarthritis

Lolu hlobo luqala ngokuthinta amalunga akho angaphandle bese lufaka izicubu zomzimba. Okungukuthi, amalunga angaphandle kohlaka lwe-axial (isibonelo, amalunga asezithweni). Njengoba lesi sifo siqhubeka, umgogodla ungase uthinteke noma ubhujiswe.

I-peripheral spondyloarthritis ivame ukuhlanganisa ukuvuvukala kwezinye izitho zomzimba. Izinhlobo ezahlukene zingathinta izitho ezahlukene (njengamehlo, isikhumba, namathumbu). Kodwa-ke, izimpawu zingafana kancane. Ezinye zezinhlobo eziyinhloko yilezi:

• I-Psoriatic Arthritis: Lesi yisimo se-arthritis esenzeka kanye ne -psoriasis , isifo sesikhumba esizimele esibangela ukuqubuka kwesikhumba okuvuvukalayo. (Engxenyeni yethu yomhlaba, lokhu kubizwa nangokuthi "isikhumba esinama-scaly"). Ngokuvamile kuthinta amalunga amancane ezandla nezinyawo, okubangela ukuvuvukala nobuhlungu eminweni.
• I-Enteropathic Arthritis: Lesi yisifo samathambo esenzeka kanye ne -Inflammatory Bowel Disease (IBD) . Igama elithi "Enteropathic" lisho ukuthi lithinta amathumbu akho.
• I-arthritis esabelayo: Lesi yisimo sokuzivikela komzimba esenzeka ngenxa yokutheleleka emathunjini akho noma emgudwini womchamo. Singathinta amehlo akho, isikhumba, esinyeni, izitho zangasese, noma amathumbu. Ngokuvamile kuba okwesikhashana, kodwa kungahlala izinyanga ezifika kwezingu-12. Kwabanye abantu, kungaba yi-arthritis engapheli.

I-Spondyloarthritis Engahlukaniseki

Lokhu ukuxilongwa okunikezwayo uma izimpawu zakho ngokuvamile zihambisana neze-spondyloarthritis, kodwa zingahambisani kahle nanoma yiluphi uhlobo oluthile.

I-Spondyloarthritis Yabantwana

Lesi yisimo se-spondyloarthritis esenzeka ebuntwaneni, ngokuvamile ngaphambi kweminyaka eyi-16. Izingane zingase zibe nohlobo oluthile noma inhlanganisela yezinhlobo ezahlukene.

Ziyini izimpawu ze-Spondyloarthritis?

Izimpawu zezinhlobo ezahlukene ze-spondyloarthritis zivame ukufana. Nakuba ezinye izimpawu ziqondene kakhulu nezinhlobo ezithile, noma yiziphi izimpawu zingabonakala kunoma yiluphi uhlobo.

Izimpawu eziyinhloko zingaba:

• Ubuhlungu emhlane ongezansi, ngezinye izikhathi bukhuphukela ezinqeni (sacroiliitis). Kwabanye abantu, lokhu kungase kuzwakale njengobuhlungu obuvela ngaphakathi kwethambo lesinqe.
• Ukuqina kwamalunga ekuseni, okuncipha kancane uma uhambahamba. Kufana nokuthi uma uvuka ekuseni, umzimba wakho uzizwa njengokhuni, futhi uyakhululeka kuphela uma uhambahamba kancane.
• Ubuhlungu emhlane ophakathi nongaphezulu, ubuhlungu bemisipha yesifuba, noma ubuhlungu bentamo.
• Ukugoba kancane kancane komgogodla (njenge-scoliosis).
• Ubuhlungu nokuqina kwamalunga ezitho - izinqe, amahlombe, amadolo, izindololwane, izihlakala, amaqakala.
• Ukuvuvukala okukhulu kweminwe ("iminwe yesoseji" noma i-dactylitis). Lokhu kwenzeka lapho umunwe noma uzwane olulodwa luvuvukala ngokuphelele, lubukeka njengesoseji.
• Izimpawu zesistimu yokugaya ukudla, isibonelo, ubuhlungu besisu kanye nesifo sohudo.
• Ubuhlungu nokuvuvukala komgudu womchamo.
• Ukuqubuka kwesikhumba okulumayo, okunamaqhubu (i-psoriasis).
• Imigodi emincane ezinziphoni (i-nail psoriasis).
• Ukukhathala okungapheli.
• Ukudla akunambitheki.
• Ukuvuvukala kwamehlo (uveitis). Lokhu kungabangela ukubomvu, ubuhlungu, kanye nokuzwela ukukhanya.
• Izilonda zomlomo.
• Ubuhlungu besithende (ngenxa ye-enthesitis).
• Ukwakheka kwama-spurs amancane ethambo.

Okubalulekile, izimpawu ze-spondyloarthritis zivame ukuqala ukuvela ngaphambi kwezinye izinhlobo ze-arthritis, ngokuvamile ngaphambi kweminyaka engu-45. Lezi zimpawu zingase ziqale kancane kancane futhi zibe zimbi kancane kancane. Ezimweni eziningi, lezi zimpawu zihlala zingapheli.

Ziyini izimbangela ze-spondyloarthritis?

Izimpawu ze-Spondyloarthritis zibangelwa ukuvuvukala okungapheli emalungeni akho nakwezinye izicubu. Lokhu kuvuvukala kubangelwa ngokuzenzakalelayo amasosha omzimba wakho. Lokhu yilokho esikubiza ngokuthi isifo sokuzivikela komzimba .

Abacwaningi abakaqondi ngokugcwele ukuthi kungani lezi zifo zokuzivikela komzimba zenzeka. Kodwa-ke, kubonakala sengathi kunezici eziningana ezidlala indima. Izimo eziningi zokuzivikela komzimba, okuhlanganisa ne-spondyloarthritis, zibonakala zinezakhi zofuzo .

Umndeni wezakhi zofuzo we-HLA (Human Leukocyte Antigen) uvame ukuhlotshaniswa nesifo samathambo esivuvukalayo. Iphrotheni ekhiqizwa yilezi zakhi zofuzo isetshenziswa isimiso sokuzivikela komzimba ukuhlukanisa phakathi kwamangqamuzana akho namaseli angaphandle. Ukwehluka okuthile kulezi zakhi zofuzo kungabangela ukuthi isimiso sokuzivikela somzimba singasebenzi kahle. Lokhu kungabangela ukuthi isimiso sokuzivikela somzimba singakwazi ukubona amaseli akho ngendlela engafanele futhi sihlasele amaseli akho.

Yiziphi izimbangela ze-spondyloarthritis?

Nakuba kunethonya lezakhi zofuzo, akuyona yodwa imbangela yalesi sifo. Nakuba abantu abaningi abane-spondyloarthritis benezakhi zofuzo ze-HLA-B27 , akuwona wonke umuntu onaleso sakhi sofuzo ozoba ne-spondyloarthritis.

Kumelwe kube nokunye okuhilelekile ukuze kuqalwe le nqubo. Abacwaningi banemibono ehlukene ngalezi zinto ezibangela lokhu. Ezinye zazo zihlanganisa izifo ezithathelwanayo, ubuthi obungokwemvelo, ukubhema, kanye nokusebenzisa utshwala.

Enye inkolelo-mbono ukuthi i-spondyloarthritis ingahlotshaniswa nokungalingani (i-dysbiosis) ku -microbiome yamathumbu akho. Abantu abane-spondyloarthritis (SpA) banezinhlobo ezincane zamagciwane amathumbu, okwenza kube lula ukuthi amagciwane ayingozi achume. Lokhu kungalingani kwamathumbu ('i-gut dysbiosis') kungakwenza ube sengozini enkulu yokutheleleka, kubangele ukuvuvukala okungapheli emathunjini, futhi kwenze buthaka amasosha omzimba wakho. Ukuhlanganiswa kwamagciwane amathumbu akho nakho kuyinto oyizuza njengefa ngezinga elithile lapho uzalwa.

Itholakala kanjani i-spondyloarthritis?

I-Spondyloarthritis ingaba nzima ukuyixilonga, ikakhulukazi uma ungenazo izimpawu ezicacile. Abanye abantu bamane banobuhlungu nokuqina kwamalunga, futhi kungaba nezinye izimbangela eziningi.

Udokotela uzoqala ngokukubuza ngezimpawu zakho bese ehlola ezinye izimpawu ongazishongo kodwa ezingase zihlobene. Uzophinde akubuze ngomlando wempilo yakho kanye nomlando wempilo yomndeni wakho.

Ngemuva kwalokho, umgogodla wakho noma amanye amalunga azohlolwa ngokomzimba ukuze kubonakale ukuthi ungawahambisa ibanga elingakanani. Kuzothathwa ama-X-ray ukuze kubhekwe ubufakazi be-arthritis noma i-enthesitis, kodwa lobu bufakazi abubonakali njalo ezithombeni.

Ukuhlolwa kwegazi kungenziwa futhi ukuhlola izimpawu zokuvuvukala noma isifo sokuzivikela komzimba. Kungahlola futhi i-HLA-B27 gene . Lokhu kuhlolwa kungasiza ukuhlukanisa i-spondyloarthritis (SpA) kwezinye izifo.

Yiziphi izindlela zokwelapha i-spondyloarthritis?

Ukwelashwa kuncike ezimpawini zakho ezithile. Odokotela balandela indlela yokwelapha isinyathelo ngesinyathelo, beqala ngokuzivocavoca kanye nemithi yokunciphisa ubuhlungu etholakala ngaphandle kwemithi kadokotela (imithi ye-OTC engeyona i-steroidal anti-inflammatory / NSAIDs) .

Uma lokhu kunganele ukulawula ubuhlungu nokuvuvukala kwakho, udokotela wakho angase asikisele:

• Imijovo ye-Cortisone inikezwa ngezikhathi ezithile ukuze kuncishiswe ubuhlungu bendawo.
• Ama-DMARD avamile noma e-biologic (Izidakamizwa Zokulwa Nezifo Ezishintsha Isifo / ama-DMARD). Lezi yizidakamizwa eziguqula uhlobo lwesifo.

Kwezinye izinhlobo ezithile ze-spondyloarthritis, njenge-psoriatic arthritis kanye ne-enteropathic arthritis, kunezinye izindlela zokwelapha eziqondene ngqo nesimo esiyisisekelo (i-psoriasis noma isifo samathumbu esivuvukalayo (IBD)).

Sibi kangakanani lesi simo? Siqhubekela kanjani phambili?

Uma isifo samathambo esivuvukalayo siba sibi kakhulu futhi sihlala isikhathi eside, kungase kube nezinkinga ezinkulu. Kodwa-ke, lezi zinkinga zivame ukuthinta ikhwalithi yempilo yakho kunokuphila kwakho. Isibonelo, ungase ube nokunyakaza kwamalunga okunciphile kanye nengozi eyengeziwe yokuphuka kwamathambo. Kodwa-ke, akuwona wonke umuntu ozoba nezimpawu ezinzima, futhi ukwelashwa kungasiza ekulawuleni ukuqhubeka kwalesi sifo.

Izinga lokuthuthuka kwe-spondyloarthritis liyahlukahluka kumuntu nomuntu. Kwabanye, ithuthuka kancane futhi ingalawulwa kalula ngokwelashwa. Kwabanye, ingathuthuka ibe yi -ankylosing spondylitis, isimo esibangela ukuhlangana komgogodla, phakathi neminyaka embalwa.

Ubukhali bokuvuvukala kwakho buthinta indlela i-spondyloarthritis eqhubeka ngayo ngokushesha. Ukulandela ukwelashwa kwakho kungasiza ekulawuleni ukuvuvukala nokuvimbela izinkinga.

Yini ongayenza uma uphila ne-spondyloarthritis?

Kunoma ubani onesifo samathambo, ukuvivinya umzimba njalo kubalulekile ukuze amalunga aqhubeke nokuhamba kahle ngangokunokwenzeka. Odokotela abaningi bathi lokhu kubaluleke kakhulu futhi kusebenza kahle kunanoma yimuphi umuthi.

Uma ungaqiniseki ukuthi hlobo luni lokuzivocavoca olukufanele, buza udokotela wakho. Odokotela abaningi batusa ukwelashwa ngokomzimba okuhlose amalunga athile noma izindawo eziyinkinga.

I-Spondyloarthritis iyiqembu lezifo ezihlobene, kodwa ezihlukile. Nakuba odokotela bezichaza ngokufana kwazo, uhlobo ngalunye - kanye nesifo somuntu ngamunye - luhlukile.

Kwabaningi, i-spondyloarthritis iyisimo esihlala isikhathi eside. Kodwa-ke, izinga elithinta ngalo impilo yakho lingahluka. Udokotela wakho uzoba ngumlingani wakho ongcono kakhulu ekuphatheni izimpawu zakho nokuthi yini ongayilindela mathupha.

Izinto ezibaluleke kakhulu okufanele uzikhumbule

Kulungile, ngakho-ke sesikhulume kakhulu nge-spondyloarthritis. Ngamafuphi, nazi ezinye izinto okufanele uzikhumbule:

• I-Spondyloarthritis yisifo samathambo esibangelwa ukuvuvukala okwenzeka emalungeni omgogodla.
• Lesi yisifo esibangelwa ukuzivikela komzimba ; lokho kusho ukuthi amasosha omzimba wakho ahlasela amalunga akho.
• Izimpawu eziyinhloko ubuhlungu bomhlane (ikakhulukazi ekuseni), ukuqina kwamalunga, kanye ne-enthesitis (ukuvuvukala kwamalunga lapho imisipha inamathela khona emathanjeni).
• I-HLA-B27 yesakhi sofuzo ingase ihileleke, kodwa akuyona yodwa imbangela.
• Kunezinhlobo ezahlukene, njenge-Ankylosing Spondylitis kanye ne-Psoriatic Arthritis.
• Izimpawu, izivivinyo, kanye nokuhlolwa kwezakhi zofuzo ngezinye izikhathi kusetshenziswa ukuxilonga lesi sifo.
• Ukwelashwa kuhlanganisa ukuzivocavoca umzimba, izinhlungu zobuhlungu, kanye nemithi ethile ngezinye izikhathi (i-DMARD) .
• Ukuzivocavoca njalo nokulandela iseluleko sezokwelapha kubaluleke kakhulu ekulawuleni lesi simo.

Uma unalezi zimpawu, ungesabi ukubona udokotela bese uthola iseluleko. Ukuxilongwa kusenesikhathi kanye nokwelashwa kuzosiza kakhulu ekugcineni impilo yakho isezingeni eliphezulu.

I- Spondyloarthritis, i-Spondyloarthropathy, i-arthritis yomgogodla, ukuvuvukala kwamalunga, ubuhlungu bomhlane, izifo zokuzivikela komzimba, i-HLA-B27, i-Ankylosing Spondylitis, i-Psoriatic Arthritis