Iwe unogona kunge wakanzwa aspirin-yakawedzera zvirwere zvekupemha (AERD) inonzi Samter's triad kana aspirin-inokonzerwa nechirwere chemafi. Pane mitemo mitatu iyo vanhu vane AERD vose vane: asthma, chirwere chechiini nemaspine, uye kunzwisiswa kwemishonga inonzi NSAIDS (kunyanya aspirin nemamwe mishonga inodzivirira enzyme inonzi COX-1).
AERD inokanganisa 0.3 kusvika ku9,9 muzana yehuwandu hwevanhu uye 10 kusvika ku20 muzana yevanhu vakaonekwa kuti vane asthma. Zvisinei, iyo pathophysiology haina kunyatsonzwisiswa. Zvinoratidzika kuti zvinokanganisa marudzi ose emadzinza akaenzana, nemavhareji anokwana makore makumi matatu, asi asingaoneki kuti akagara nhaka uye inowanzokonzera vakadzi kupfuura varume.
Kana iwe uchifungidzira kuti uri kurwara kana kuti wakamboonekwa, pane dzakawanda zvakaswedera kuzokubatsira kurarama zviratidzo uye kurarama zvakanaka. Hezvino izvo zvaunoda kuziva.
Zviratidzo
Kana iwe uine AERD unogona kutambura nekubatanidzwa kwevamwe kana zviratidzo zvose zvinotevera:
- Chronic sinusitis
- Nasal polyps
- Kurasikirwa kwekunhuhwirira
- Asthma
- Kugadziriswa kweNSAID (aspirin kana mishonga yakadaro), iyo inogona kusanganisira kusanganisa kwemvura, kuputika, kuora musoro, kupwanyisa, kukwezva, kuputika, bronchospasm, laryngospasm kana kurwadziwa kwepfupa. Zviratidzo izvi zvinogona kuitika zvakare mushure mekunwa doro.
Iwe unogona kunge wakaoma kurapa zviratidzo nenzira dzinowanzoitika.
Semuenzaniso, nasal polyps inogona kudzokera nokukurumidza mushure mekuvhiyiwa chirwere. Kusangana nekuoma kufema kufema kunogona kutungamirira kunonetsa kurara usiku uye nekuzorora kwekurara uye pamwe nekuneta kwezuva.
Izvo zvinowanzoonekwawo kuti vanhu vane zvirwere zvakanyanyisa zvinogona kuita kuti AERD yavo iwedzere.
Izvi zvinogona kusanganisira allergenic rhinosinusitis , GERD, kana kuti kurovedza muviri-kunokonzerwa nechirwere chemafi . Iyi mitemo inofanira kutarisirwa zvakasiyana nedare reAERD uye chiremba wenyu anogona kukurudzira zvakanakisisa masarudzo.
Kuziva
Kana iwe uine chirwere chechirwere, chirwere chechiini nemaspine, uye wakanga uine kana unofungidzira iwe unogona kunge wakaita zvinoenderana neNSAID, chiremba wako angangopokana kuti une AERD. Mimwe miedzo inobatsira ichasimbisa izvi.
Chimwe chiyero chinetso cheAspirin, chinosanganisira kupa madiki madhirwe eAspirin kwemazuva mashomanana mune zvekurapa uko iwe unogona kuongororwa kuti uite. Mushure mokupa chirwere che aspirin chiremba wako anogona kuedza mapapu ako simba kuti aone kana yakaderera.
Chiremba wako angasarudza kuronga zvimwe zviedzo kuti zvibatsire mukuongororwa kweAERD, kusanganisira kuongorora ropa. Eosinophils ichena masero eropa, zvikamu zvemuviri wemuviri. Vanhu vane AERD vanowanzova nenhamba zhinji dze eosinophils mumapapiro avo uye dzinogona kunge dzakasimudza mazinga eropa zvakare. Zvimwe masero omusununguko akadai semamiti masero anogonawo kuwedzerwa. Iwe unogonawo kuva nepamusoro yezvikamu zvinonzi cysteinyl leukotrienes. CT inoongorora, kana zvimwe zviitiko zvekufungidzira kuti zvibatsire kufungidzira zvitadzo zvako.
Zvinofanira kutariswa kuti hapana chimwe chezviedzo izvi chinotsanangurira kuongororwa kweAERD asi chinogona kubatsira chiremba wako kuwana mifananidzo yakajeka yemamiriro ako.
Treatment uye Management
Hakuchina mushonga weAERD, uye sezvakambotaurwa kare pathophysiology yechirwere ichi haisanzwisiswi neasayendisiti nevashandi vezvoutano. Zvisinei, kune nzira dzakasiyana-siyana dzokurapa dzinowanikwa kukubatsira iwe zviri nani kuchengeta zviratidzo.
Imwe nzira ndeyekudzivisa zvachose aspirin nemamwe mishonga yeNSAID (chero mishonga inhibisa enzyme COX-1). Acetaminophen inogona kushandiswa panzvimbo yemishonga iyi, asi zvinonyoreswa chete mumadhora mashoma (kusvika 500mg).
Kudzivisa aspirin hakuzogadziri zvimwe zviratidzo zvakadai semaspirp, sinus zvirwere kana zviratidzo zvechirwere kunyange zvakadaro.
Kukura kwepaspalpips kunogona kuderedzwa nekushandisa steroid injini, kubviswa kushandiswa, kana kusanganiswa kwezvose. Zvinyorwa zveNasal zvine steroid uye kunwisa kunogonawo kubatsira pakuchengetedza zvimwe zviratidzo zveputi uye zvinetso zvechivi.
Iyo mishonga montelukast uye zafirlukast inowanzoshandiswa uye inowanzove yakakosha mukugadzirisa zviratidzo kupfuura mamwe mishonga yemidzimu, kusanganisira beta-agonists. Inhaled corticosteroids inoshandiswawo kuchengetedza asthma uye inogona kudiwa kushandisa madawa aya zuva nezuva. Dzimwe nguva prednisone yemuromo yakashandiswa, asi kazhinji chete kana mamwe mishonga yakundikana kudzora zviratidzo sezvo oral steroid inowanzova nemigumisiro yakaipa isina kunaka.
Aspirin Desensitization
Imwe nzira, iyo yakaratidza kuti inobudirira zvikuru, ndeyokutora aspirin deensitization. Dzidzo dzakaratidza kuti aspirin deensitization yakateverwa nehuwandu hwekuchengetedza zuva rose hweAspirin inogona kuderedza kuumbwa kwehupfumi hwepaspine uye hwechi sinus pamwe nekuvandudza chikwata chema asthma.
Mazai eAspirin anopiwa mune zvekurapa kwaunogona kuongororwa kuti uite. Chirongwa chekurapa kazhinji kliniki ine vashandi vezvechiremba vane ruzivo (inpatient hospitalization haigoni kudiwa). Izvozvo zvinotanga kubuda zviduku uye zvishoma nezvishoma zvinowedzera muhuwandu hwekudzivisa hutsika yako kumishonga. Izvi zvakafananawo nekurapa kwema immunotherapy nekuda kwechirwere.
Uchapupu hunoratidza kuti aspirin deensitization inodhura zvikuru uye inobatsira vanhu vakawanda vane chirwere cheAERD. Kuvandudza kunogona kuonekwa pashure pemavhiki mana chete ekurapwa. Zvidzidzo zvakaratidza kuvandudza mune zvinyorwa zvekunze, pfungwa yekunhuwa, uye kuderedza kuwanda kwemishonga inotarisirwa kudzora zviratidzo zvemafi.
Haasi vanhu vose vane AERD vakakodzera aspirin deensitization. Iwe haufaniri kuva nemishonga iyi kana iwe uri nepamuviri, uine zvironda zvepamu, zvirwere zvekubuda ropa, kana zviratidzo zvisingaverengeki zvechirwere.
Pane zvipingamupinyi zvinosangana ne aspirin deensitization uye izvi zvinosanganisira kugadzirisa zviratidzo zveAERD yako kusanganisira zvinetso zvekufema zvakanyanya. Uyewo, chero migumisiro inogona kuitika paunotora aspirin, yakadai sematambudziko emuviri kana kubuda ropa, inogona kuitika panguva yaA aspirin deensitization. Iwe unofanirwa kutaura nachiremba wako kana mhizha nezvemigumisiro inogona kuitika uye ita nechokwadi kuti aspirin haichazopindi mimwe mimwe mishonga yaungatora.
Mushure mekunge mava ne aspirin deensitization zvakakosha kuti varambe vachiita chirongwa chekuchengetedza aspirin zuva rega roga kuti varambe vachida zvekuita. Pakutanga chiyero ichi chinogona kunge chakakura se 1300 mg pazuva asi, zvakakodzera, chiremba wako achaderera zvishoma nezvishoma muwandu we aspirin uri kutora. Maitiro akaderera se 81mg pazuva (chirwere chinowanzoonekwa nevanhu vane zvirwere zvepfungwa) zvakaratidzwa zvakabudirira.
Kana iwe uchinetseka nemigumisiro nemitemo yauri kungoverenga pamusoro payo, ziva kuti chiitiko chacho nhanho-nhanho, saka edza kufunga pane chimwe chinhu panguva imwe. Chiremba wako achakutungamirira iwe rose, nharaunda dzemigumisiro, uye unoziva chero zvinopesana.
> Sources:
> Aspirin-Yakanyanya Kuwedzera Kufuridza Matenda (AERD). American Academy of Allergy Chirwere uye Immunology. https://www.aaaai.org/conditions-and-treatments/library/asthma-library/aspirin-exacerbated-respiratory-disease
> Rachel U. Lee naDonald D. Stevenson. Aspirin-Yakanyanya Kuwedzera Kufuridza Zvirwere: Kuongorora nekugadzirisa. Allergy Pure Immunol Res. 2011 Jan; 3 (1): 3-10.
> John W Steinke naJeff M Wilson. Aspirin-yakawedzera chirwere chokuputira: maitiro ekugadzirisa zvirwere uye kufambira mberi kwekliniki. J Nyuchi Dzemarudzi. 2016; 9: 37-43.