Gout chirwere cheArthritis chinokanganisa mamiriyoni matatu eAmerica gore negore. Iyo inozivikanwa seye gouty arthritis, chirwere chinokonzerwa nekuumbwa kweuric acid makristani mubatanidzwa (kazhinji kazhinji gumbo guru), zvichikonzera kurwadziwa kukuru, kubwinya, uye unyoro. Kunyange zvazvo zvimwe zvikonzero, zvakadai sejenetics kana zvinetso zvepvo, zvinogona kukugadzirisa kuti uite gout, kudya, doro, uye kuneta kunogonawo kupa.
Kurapa kunogona kusanganisira over-the-counter (OTC) uye mishonga yemishonga inoderedza marwadzo uye kuderedza uric acid mazinga. Iwe unogona kuwedzera kuderedza kuwandisa kwekurwiswa nekuderedza uremu, kushandisa nguva dzose, nekudzivirira kudya kwekutora.
Zviratidzo
Zviratidzo zvegout zvinowanzove zviri kufambira mberi uye zvichawedzerwa kudarika kwenguva kana zvisingazotenderwi. Kuoma uye kudzokorora kwezviratidzo zvinowanzoenderana nechikamu chechirwere.
Gout Asymptomatic ndiyo nguva isati yatanga kurwisa. Ndiyo panguva ino iyo kukwirira kunogara kweuric acid muropa rako kuchakonzera urate (munyu unobva kuUric acid) kusunga nekuumba makristasi. Nepo iwe usingazovi nehumwe zviratidzo panguva iyi, kuwedzera zvishoma nezvishoma kwekristasi zvichange zvisingatongotungamiri kurwisa.
Gout inonyatsotaridzika inotamba apo iwe uchatanga kuona kutambudzwa kunogara chero mazuva matatu kusvika kune gumi. Kuvhiringidzwa (kazhinji kacho kunobata chigunwe chikuru asiwo mabvi, chiuno, chitsitsinho, midfoot, zvigaro, chiuno, neminwe) zvinokonzera kurwadziwa nekukurumidza zvakapfurikidza nekuputika, kuoma, kubwinya, kuneta, uye dzimwe nguva fivha ine simba.
Gout tophaceous isingagumi isati yakagara yakakura yezvirwere umo makirasi e-urate anowedzera mumakumbo akaoma anonzi tophi . Kuumbwa kwevanhu ava vari mineralized kunogona kuwedzera zvishoma nezvishoma mapfupa uye mapfupa emapfupa uye zvinotungamirira kune chirwere chisingaperi chemaarthritis nekubatana kwekubatana .
Zvinetso zve gout risina kunyoreswa zvinosanganisira mazinyo emabwe uye kuora kwepfungwa .
Zvinokonzera
Zvimwe kurapwa zvinogona kuwedzera mungozi yako yegout , zvichida nokuti inokonzera kushanda kwepfungwa (kubvumira uric acid kuunganidza) kana kuti kunokonzera kusagadzikana kusingaperi (izvo mamwe masayendisiti anotenda kukurudzira uric acid production). Mienzaniso inosanganisira chirwere chepfungwa chisingaperi (CKD) , congestive heart failure (CHF) , chirwere cheshuga , uye psoriatic arthritis .
Saizvozvowo, zvizvarwa zvinogona kuita chikamu. Chimwe chimiro chakadai chinonzi genetic mutation yeSLC2A9 kana SLC22A12 gene iyo inobatsira kutonga kuti uric acid yakawanda inogadzirwa sei nemuviri uye kuti zvakadzingwa sei. Zvimwe zvinokonzerwa nezvinokonzerwa nehutachiwana zvinosanganisira polycystic kidyo chirwere (PKD) uye Fabry chirwere.
Mararamiro mamwe mararamiro ane ngozi anogona kukanganisa zvose kukura uye kufambira mberi kwechirwere chacho. Dzinosanganisira:
- Kuwedzera muviri , izvo zvinosanganiswa nemishonga yakagadzikana
- Zvokudya zvinopfuma mu purines , chigamba chinowanikwa mune zvimwe zvokudya zvinoumba uric acid
- High-fructose zvinwiwa uye zvinwiwa zvinodhaka izvo zvinokanganisa mafungiro empi
Mamwe mishonga ine chirwere chemauretic chinogona kuwedzera kuiswa kweuric acid muropa, kusanganisira cyclosporine , Lasix (furosemide) , pasi-aspirin, uye niacin (vitamini B3).
Kuziva
Gout inowanzoongororwa pamusana peongororo yekuongorora uye kuongorora mumuviri.
Kuenzanisa miedzo inogona kushandiswawo kutsigira kuongororwa uye / kana kuongorora maitiro ehutano hwekubatana.
Nzira yegoridhe yekuongororwa ndiyo inonzi synovial fluid analysis iyo inonzi fluid inogadziriswa ine nheyo uye seringiri uye inoongororwa pasi microscope nokuda kweuchapupu hwehuate makristasi. Zvimwe zvinoshandiswa pakutsvaga zvinosanganisira kuongorora maitiro eimpemhi uye urinalysis kuti ubatsire kutarisa dambudziko reinyopi matombo.
Kusiyana kwekufungidzira kuongororwa kunogona kushandiswa kutarisa kuti yakawanda yakakanganiswa sei. Pakati pavo:
- Ultrasounds ndiyo nzira inoshandiswa yekuedza sezvo ichigona kuwona kuparara kwekubatana kwekutanga.
- X-rays inogona kuratidza kukanganiswa pamwe chete asi kwete mumatangiro ekutanga.
- Magnetic resonance imaging (MRI) uye inonzi tomography (CT) kuongorora kunogona kupa uchapupu hwakajeka hwekukuvara asiwo kune zvisingakwanisi muzvirwere zvepakutanga.
Kurapa
Nzira yekurovedza gout inowanikwa katatu: kutarisa kurwadziwa nekuputika, kuderedza uric acid muropa, nekudzivirira kudya kwekudya kana mishonga inokurudzira uric acid yekugadzira.
Gout kurwa kunowanzobatwa nezororo uye yejaji pakudzivirira kupfugama kwemukoko. OTC isina anti-inflammatory drugs (NSAIDs) seAppil (ibuprofen) kana Aleve (naproxen) inogonawo kubatsira.
Mhosva dzakakura kana dzinowanzodzoka dzinogona kubatsirwa nekuputika-kuderedza kushanda kwe corticosteroids (yakapiwa kana nemapiritsi kana jekisi mujoka) kana kuti mishonga yemuromo inonzi Colcyrs (colchicine) iyo inovhara maperembudzi anopisa anokonzerwa neUric acid.
Kana kudya uye zvimwe zvinopindira zvinokundikana kupa ruzivo, uric-acid-kuderedza zvinodhaka zvakadai seUloric (febuxostat) kana Zyloprim (allopurinol) inogona kurongerwa. Zvimwe zvinokonzera zvinosanganisira kuvhiringidzika mumimba, kushungurudza, kurwadziwa pamwe chete, uye kuputika kwemasumbu.
Krystexxa (pegloticase), mishonga mitsva inonzi biologic inopihwa nekuputika kwepachivande, inowanzochengeterwa vanhu mune dzimwe mimwe mishonga yose yegout yakakundikana.
Kutsungirira
Kunyange zvazvo gout inogona kudzorwa zvakanyanya nemishonga uye zororo, kune nzira dzakawanda dzekutarisira iwe unogona kutendeuka kuzobata kana kuderedza kudzokorora kwekurwadza kwakanyanya. Dzinosanganisira:
- Kudzivisa zvinhu zvakakwirira-purine zvakadai seropa, veal, mussels, tuna, bacon, uye doro
- Kuwedzerwa kudya kwako kwezvibereko, miriwo, zviyo zvose, uye mukaka usina mafuta
- Kunwa magirasi masere kusvika ku16 emvura pazuva kuti ubatsire kujekesa uric acid kuburikidza nekuzora nekuderedza kuwandisa muropa
- Kutanga chirongwa chekureruka kwekureruka kana iwe uri kunyanya kuwandisa kana kuora
- Kusimudza rutsoka rwako munguva yekurwadza kwakanyanya uye kuichengeta zvakanaka
- Kushandisa imwe tsanga kana kuti kufamba kuti uchengetedzwe kubva kune tsoka
- Kushandisa nzira dzekuzorora kuti uchengete zviri nani kurwadziwa
Kana zviratidzo zvako zvisingavandudzi mushure memaawa makumi maviri kana makumi mana kana kupfuura kwevhiki, tumira chiremba wako kuti arongedze nguva. Mune zvimwe zviitiko, mishonga inogona kudiwa kuchinjwa kana kugadziriswa kana iri kutadza kupa rubatsiro.
> Sources:
> Hanani, B; Matheson, E. naWilke, T. "Kuziva, Kurapa, nekudzivirira kweGout." Am Fam Physician. 2014; 90 (12): 831-836.
> Richette, P. naBarden, T. "Gout." Lancet. 2010; 375 (9711): 318-28. DOI: 10.1016 / S0140-6736 (09) 60883-7.
> Zhang, Y ;; Chen, C .; Choi, H. et al. "Zvokudya zvepurini zvinokonzerwa nekudya uye kunowanzoitika." Ann Rheum Dis. 2012; 71 (9): 1448-53. DOI: 10.1136 / annrheumdis-2011-201215.