Uyazazi i-Takayasu's Arteritis? Ake sixoxe ngayo!

Wake wezwa ngesifo esibizwa ngokuthi i-Takayasu's Arteritis? Igama lingase lizwakale lingavamile, akunjalo? Kodwa yisimo esingavamile esingathinta imithambo yegazi yethu, ikakhulukazi imithambo yegazi emikhulu eqala enhliziyweni kanye namagatsha ahlukana nayo. Ngezinye izikhathi sibizwa nangokuthi 'isifo esingenawo amaphaphu.' Namuhla, sizoxoxa ngaso ngokuningiliziwe, kalula, ukuze nawe usiqonde kangcono.

Iyini ngempela i-Takayasu's Arteritis?

Kalula nje, i-Takayasu's arteritis ukuvuvukala kwemithambo yethu yegazi, okusho ukuvuvukala noma ukuvuvukala (i-vasculitis). Ithinta kakhulu imithambo yegazi emikhulu emzimbeni wethu. Cabanga ngakho, umthambo wegazi oyinhloko othwala igazi elinomoya-mpilo lisuka enhliziyweni yethu liye emzimbeni wonke, esiwubiza ngokuthi 'i-aorta enkulu' noma 'i-aorta'. Lesi sifo sithinta kakhulu i-aorta, kanye neminye imithambo yegazi emikhulu ephuma kuyo futhi ithwale igazi liye ezingalweni zethu, entanyeni nasebuchosheni. Uyazi ukuthi kwenzekani lapho lokhu kuvuvukala kwenzeka? Izindonga zemithambo yegazi yethu ziyalimala. Bese ezinye izingxenye zaleyo mithambo yegazi ziba buthakathaka futhi zingavuvukala njengebhaluni. Lokhu sikubiza ngokuthi 'i-aneurysm'. Futhi, imithambo yegazi ingavuvukala futhi inciphe. Bese ukugeleza kwegazi kuvinjelwa. Ngezinye izikhathi umthambo wegazi ungavaleka ngokuphelele, okubizwa ngokuthi 'ukuvaleka'. Akuvamile, lesi simo singathinta nemithambo yegazi enikeza igazi enhliziyweni, emathunjini, ezinso nasemilenzeni.

Ubani othinteka kakhulu yilesi simo?

I-Takayasu's Arteritis (TAK) yisimo esivame ukuhlasela abantu abasha. Sivame kakhulu kwabesifazane abaneminyaka ephakathi kuka-20 no-40. Iziguli zivame ukuba phakathi kweminyaka engu-15 no-35 uma zitholakala zinalesi sifo. Cishe u-80% kuya ku-90% walabo abanalesi sifo ngabesifazane. Odokotela babona lesi simo kaningi emazweni afana neJapan kanye nabantu baseMexico, amaNdiya, kanye ne-East Asia. Ngisho nasemazweni afana ne-United States, amacala amabili kuya kwamathathu kuphela abantu abayisigidi abatholakala benalesi sifo minyaka yonke. Lokhu kusho ukuthi kuyisimo esingavamile.

I-arteritis kaTakayasu iwuthinta kanjani umzimba wami?

Lapho imithambo yegazi incipha, inani legazi elifinyelela ezithweni nasezicutshini ezinikezwa yilezo zimithambo yegazi liyancipha. Cabanga ngakho njengombhobho wamanzi ovalekile, okunciphisa inani lamanzi ageleza kuwo. Kodwa ku-Takayasu's arteritis (TAK), lezi zinguquko zivame ukwenzeka kancane kancane. Ngakho-ke imizimba yethu inesikhathi sokujwayela ukuthwala igazi ngezindlela ezihlukile. Lezi zindlela ezihlukile zifana nezindlela ezincane esizisebenzisayo lapho umgwaqo omkhulu uvinjiwe. Kodwa lezi zindlela ezidlulayo zingase zingabi njalo zikwazi ukuthwala igazi eliningi njengomzila wegazi omkhulu wokuqala. Ngokuvamile, inani legazi eligeleza lidlula lapho kuvinjiwe lanele ukunikeza izicubu inani elincane lomoya-mpilo negazi ezikudingayo ukuze ziphile. Kodwa akuvamile kakhulu, uma le mithambo yegazi ehlukile ingasebenzi kahle, izicubu zingafa ngoba zintula umoya-mpilo negazi.

Ziyini izimpawu zalesi sifo?

Abanye abantu abane-Takayasu arteritis (TAK) bangase bangabi nazimpawu. Kodwa-ke, cishe ingxenye yeziguli ingase ibe nenkinga yokugula kanye nobuthakathaka. Izimpawu zokuqala (isigaba 1): Lezi yizimpawu ezibonakala ekuqaleni kwesifo:

• Ukuba nomkhuhlane.
• Ukuzizwa ukhathele kakhulu ( Ukukhathala ).
• Ubuhlungu bemisipha namalunga .
• Ukudla akunambitheki .

Izimpawu zesigaba esilandelayo (isigaba sesi-2): Njengoba isifo siqhubeka, izimpawu ezifana nalezi:

• Ubuhlungu besifuba .
• Ubunzima bokuphefumula .
• Ikhanda elibuhlungu .
• Ukuzizwa unesizungu.

Izimpawu ezibangelwa ukuncishiswa kwemithambo yegazi kanye nokuncipha kokunikezwa kwegazi:

• Ukukhathala, ubuhlungu, noma ukuqaqamba kwezingalo nemilenze.
• Ubuhlungu besisu obubangelwa ukwehla kokugeleza kwegazi emathunjini.
• Umfutho wegazi ophezulu ngenxa yokuncipha kokugeleza kwegazi ezinso.
• Isifo sohlangothi (lokhu akuvamile kakhulu).
• Ukuhlaselwa yinhliziyo (lokhu nakho akuvamile).

Yini eyabangela i-arteritis kaTakayasu?

Eqinisweni, akekho owazi imbangela eqondile ye-Takayasu's arteritis (TAK).. Kodwa odokotela nabacwaningi bacabanga ukuthi kungaba 'isimo sokuzivikela komzimba'. Okusho ukuthi, isimiso somzimba wethu sokuzivikela, esilwa nezifo, sihlasela ngephutha izicubu zaso ezinempilo. Kunjengokungathi izivikelo zethu ziyasilimaza. Abanye abacwaningi bacabanga ukuthi amanye amacala e-arteritis kaTakayasu angabangelwa yi-gene ezuzwe kubazali bobabili. Labo bazali bangase bangabi nazimpawu, ngoba baphethe ikhophi eyodwa kuphela ye-gene. Kodwa uma uzuza leso gene kubazali bobabili, ungahlakulela lesi simo kanye nezimpawu zaso.

Lesi sifo sitholakala kanjani?

Udokotela wakho uzoxilonga i-arteritis kaTakayasu ngokubheka izici eziningana ndawonye, ​​hhayi eyodwa kuphela.

• Umlando ophelele wezokwelapha kanye nokuhlolwa ngokomzimba: Lokhu kwenzelwa ukuqeda ezinye izimo ezinezimpawu ezifanayo nezakho. Uma udokotela wakho esebenzisa i-stethoscope ukuhlola imithambo yegazi yakho, angase ezwe umsindo ongavamile obizwa ngokuthi 'i-bruit' ngaphakathi kwemithambo yegazi. Uma imithambo yegazi imincane kakhulu, kunzima ukuthi igazi ligeleze kuyo, okuyilapho umsindo uzwakala khona.
• Ama-X-ray: Lokhu kubonisa lapho umthambo wakho womthambo wobuchopho ulimele khona kanye nobukhulu bomonakalo.
• Ukuhlolwa kokuthola ukuncipha kwemithambo yegazi noma ama-aneurysm: Kunezindlela ezahlukene zokuhlola lokhu.

Yiziphi izivivinyo zokuxilonga?

Kunezivivinyo eziningana ezingasiza udokotela ukuqinisekisa ukuxilongwa:

• Ukufanekisa Ukuzwakala Kwe-Magnetic (MRI): Lokhu ukuhlolwa okungasebenzisi ama-X-ray. Izithombe zenziwa kusetshenziswa i-magnet enkulu, amaza kagesi kagesi, kanye nekhompyutha.
• I-Computed Tomography (CT) scan: Ama-X-ray namakhompyutha adala izithombe zezitho zangaphakathi, okuhlanganisa nemithambo yegazi emikhulu.
• I-Angiography: Lokhu kuhilela ukuthatha izithombe ze-X-ray zangaphakathi kwemithambo yegazi yakho. Udokotela wakho ufaka ithubhu elincane, elide elibizwa ngokuthi i-catheter emthanjeni omkhulu osesinqeni sakho noma engalweni bese eliqondisa liye emthanjeni wegazi okudingeka uhlolwe. Ngemuva kwalokho, kufakwa idayi ekhethekile (izinto ezihlukile) nge-catheter emthanjeni wegazi. Lapho kuthathwa i-X-ray, idayi yenza imithambo yegazi ibonakale ngokucacile ezithombeni. Ngezinye izikhathi, i-MRI ingasetshenziswa futhi ukwenza i-angiography.
• I-Positron Emission Tomography (i-PET scan): Kulolu vivinyo, udokotela wakho ufaka into ekhipha imisebe ngenaliti emthanjeni osengalweni yakho. Njengoba into ihamba emzimbeni wakho, isithwebuli siyayibona bese sidala izithombe.
• I-Ultrasound: Lokhu kusiza ukudala izithombe zemithambo yegazi kusetshenziswa amaza omsindo.

Iphathwa kanjani i-arteritis kaTakayasu?

Imithi ingalawula ukuvuvukala, noma ukuvuvukala. Kodwa-ke, abanye abantu bangadinga ukuhlinzwa ukuze badlule umthambo wegazi ovinjiwe futhi bakhe indlela entsha yokugeleza kwegazi. Ama-Corticosteroids: Ama-Corticosteroids, njenge-prednisone (isb., i-Rayos®, i-Sterapred®) noma i-prednisolone (isb., i-Flo-Pred®, i-Orapred®), yizindlela zokwelapha ezivame kakhulu ze-Takayasu's arteritis (TAK).

Le mithi isebenza kahle ekuqedeni ukuvuvukala okusebenzayo emithanjeni yegazi kanye nokwehlisa lesi sifo.

Udokotela wakho uzonciphisa kancane kancane umthamo we-prednisone ube umthamo ophansi kakhulu osebenzayo ukuze kuncishiswe imiphumela emibi. Abanye abantu bangayeka kancane kancane ukuthatha imithi ngaphandle kokubuya kwezimpawu. Kodwa-ke, lawa ma-corticosteroids awasebenzi ngokuphelele kwabanye abantu. Futhi, abantu abangaphezu kwengxenye abathatha le mithi bangase babuyelwe yizimpawu noma isimo sabo sibe sibi kakhulu. Imithi yokucindezela amasosha omzimba: Odokotela bavame nokukunikeza imithi ecindezela amasosha omzimba, njenge:

• I-Methotrexate (isib. iRheumatotrex®, iTrexall®)
• I-Azathioprine (isb. Imuran®, Azasan®)
• I-Mycophenolate (isib. i-Cellcept®, i-Myfortic®)
• I-Leflunomide
• I-Cyclophosphamide

Uma lezi zithiyo zokucindezela amasosha omzimba zisetshenziswa ne-prednisone, cishe abantu abangu-50% ababeneziqhumane ngaphambili bangaxazululeka izimpawu zabo futhi bangayeka kancane kancane ukuthatha i-prednisone. Izithiyo ze-Tumor-Necrosis Factor (TNF): Abanye abantu banganikwa nemithi ebizwa ngokuthi izithiyo ze-TNF ukusiza ukulwa nokuvuvukala. Izibonelo zalezi zifaka:

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

Sekukonke, cishe abantu abangu-25% abane-arteritis kaTakayasu ngeke bakwazi ukulawula lesi sifo ngokuphelele ngaphandle kokwelashwa okuqhubekayo.

Iyini imiphumela emibi yokwelashwa?

Imithi esetshenziswa ukwelapha i-Takayasu's arteritis ingaba nemiphumela emibi kakhulu. Kodwa-ke, eminye imithi ingasiza ekulawuleni le miphumela emibi. Imiphumela emibi ingafaka:

• Ukwehliswa kokumelana nezifo.
• Ukwehla kwesisindo samathambo (i-osteoporosis).
• Ubunzima bokubona.
• Ukuquleka.

Ama-Corticosteroids aqala ukusebenza zingakapheli amahora ambalwa kusukela ekuqaleni kokwelashwa, ngakho-ke ungase uzizwe ukhululekile ngokushesha.

Yiziphi ezinye izindlela zokwelapha ezisetshenziswayo?

Kwezinye izimo, umfutho wegazi ophezulu (umfutho wegazi ophezulu) ungabangelwa ukuncipha kwemithambo yegazi eya ezinso. Kulesi simo, udokotela angasebenzisa into efana nebhaluni ukwandisa umthambo wegazi oncishisiwe, okubizwa ngokuthi i-angioplasty. Noma, ukuhlinzwa kwe-bypass kungenziwa ukuze igazi ligeleze kahle liye ezinso. Lokhu kungasiza ekwenzeni umfutho wegazi ube ngokwejwayelekile ngaphandle kokuthatha imithi yomfutho wegazi ophezulu. Abanye abantu bangase babe nezinkinga ezinkulu ngemithambo yegazi emincane ezingalweni noma emilenzeni yabo, okwenza kube nzima ukuhamba noma ukwenza eminye imisebenzi. Ukuhlinzwa kwe-bypass nakho kungalungisa lezi zinkinga. Uma kukhona i-aneurysm, ingalungiswa ngokuhlinzwa noma nge-bypass. Abanye abantu abane-arteritis kaTakayasu bangadinga nokufakwa esikhundleni se-aortic valve.

Ngizinakekela kanjani?

Abantu abaningi abane-Takayasu's arteritis nabo banomfutho wegazi ophakeme (umfutho wegazi ophakeme). Kubalulekile ukulawula lokhu. Uma ungelaphi umfutho wegazi ophakeme, izinto ezinjengalezi zingenzeka:

• Isifo sohlangothi.
• Isifo senhliziyo.
• Ukwehluleka kwezinso.

Uma uthatha imithi ecindezela amasosha omzimba wakho, cabanga ngokuthola lezi zinhlobo zemithi yokugoma ukuze uvikele ezifweni:

• Umuthi wokugomela umkhuhlane.
• Umuthi wokugomela i-pneumonia.
• Umuthi wokugomela i-Herpes zoster (Shingles).

Yini umuntu one-arteritis kaTakayasu angayilindela?

Nakuba kungekho ukwelashwa kwe-Takayasu's arteritis, kuyisifo esingelapheka. Iningi labantu abanalesi sifo liyalulama ngokwelashwa. Kodwa-ke, abantu abaningi bangakhubazeka ngezinga elithile, noma bangakwazi ukukhubazeka ngokuphelele, ngenxa yalesi sifo. Imiphumela yalesi sifo ingaba nomthelela omkhulu emisebenzini yansuku zonke. Cishe ingxenye yabantu abane-Takayasu's arteritis kufanele benze izinguquko emisebenzini yabo. Kodwa-ke, cishe abantu abangu-25% abanalesi sifo baphila impilo evamile ngokuphelele. Abanye abangu-25% kuye kwadingeka benze izinguquko ezithile emisebenzini yabo. Abantu abaphila nalesi sifo esingamahlalakhona badinga ukuhlolwa njalo kwezokwelapha futhi, uma kudingeka, izinguquko emithini yabo. Odokotela kudingeka futhi baqaphe imiphumela emibi yemithi futhi benze ukuhlolwa kwegazi. Okulandelayo kungaba yizinkinga ze-Takayasu's arteritis:

• Ukwehluleka kwenhliziyo.
• Isifo sohlangothi.
• Amahlule egazi.
• Ukuhlaselwa yinhliziyo.

I-Takayasu arteritis yisifo sesikhathi eside esikhula kancane. Uzodinga ukwelashwa kwesikhathi eside, ngokuvamile ngemithi. Emazweni afana ne-United States neJapane, cishe abantu abangu-3% abane-Takayasu arteritis bafa phakathi neminyaka emihlanu yesifo. Lokhu kungenzeka ngoba odokotela bayakwazi ukuxilonga lesi sifo kusenesikhathi futhi basiphathe ngendlela efanele. Kwezinye izingxenye zomhlaba, umphumela ungaba mubi kakhulu ngenxa yokubambezeleka kokuxilongwa nokwelashwa noma ukufinyelela okungekuhle kwezinsizakalo zezempilo. Uma ingelashwa, i-Takayasu arteritis ingaba yingozi.

Ngingayinakekela kanjani impilo yami?

Kubalulekile ukulandelela ukuthi uzizwa kanjani futhi uhlale uxhumana nodokotela wakho njalo ukuze ukwazi ukuthola noma yiziphi izimpawu ezintsha noma eziya ziba zimbi kusenesikhathi.

Kufanele ngimbone nini udokotela?

Uma izimpawu zakho ze-Takayasu arteritis zibuya ngesikhathi noma ngemva kokwelashwa, bona udokotela wakho ngokushesha. Uma uhlela ukukhulelwa, khuluma nodokotela wakho ngakho. Kungenzeka ukuthi ukhulelwe ngempumelelo nge-Takayasu arteritis, kodwa kubalulekile ukwazi ukuthi ungayiphatha kanjani.

Kufanele ngiye nini e-Emergency Treatment Unit (ETU) ?

Uma unezinye zalezi zimpawu, shayela u-911 ngokushesha (eSri Lanka, shayela i-Suwaseriya Ambulance Service ka-1990 noma uye esibhedlela esiseduze):

• Ubuhlungu besifuba.
• Ubunzima bokuphefumula.
• Ukushaya kwenhliziyo okubuthakathaka.
• Izimpawu zokuhlaselwa yinhliziyo (isib. ubuhlungu obukhulu besifuba obuphuma engalweni, ukujuluka, isicanucanu).
• Izimpawu zesifo sohlangothi (isib., ukugoba kolunye uhlangothi lobuso, ukungazweli engalweni, ubunzima bokukhuluma).

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

• Kuzodingeka ngithathe isikhathi esingakanani imithi ye-arteritis kaTakayasu?
• Kukangaki ngidinga ukuza ngezikhathi zokulandelela?
• Ingabe isimo sami singalawulwa ngaphandle kokuhlinzwa?
• Kukangaki ngidinga ukuhlolwa kwezithombe?

Okokugcina, okufanele ukukhumbule (Umyalezo Wokuya Ekhaya)

Ngenxa yokuthi i-Takayasu's Arteritis iyisimo sesikhathi eside, noma 'esingamahlalakhona', kuzodingeka ubone udokotela njalo. Ngokuhamba kwesikhathi, izimpawu zakho zingase zisuke ekubeni ngaphansi kokulawulwa ziye ekubeni ngaphansi kokulawulwa. Yingakho kubalulekile ukuhlala uxhumana nodokotela wakho njalo. Ungesabi ukutshela udokotela wakho uma ubona noma yiziphi izinguquko empilweni yakho. Udokotela wakho uzofuna ukwazi ngakho, ngoba yilapho angakusiza khona.

Khumbula, ngisho noma unalesi sifo, ngokwelashwa okufanele nangokulandela iseluleko sezokwelapha, nawe ungaphila impilo enhle. Hlala uqinile!

I-Takayasu's arteritis, i-Takayasu's arteritis, isifo esingenawo amaphaphu, i-vasculitis, i-aorta, i-arteritis, isifo semithambo yegazi, umfutho wegazi ophakeme, isifo sokuzivikela komzimba