Zvirwere Zvirwere Nezvirwere Kuregererwa Kunosimbiswa
Rheumatoid arthritis yakasiyana neysteoarthritis ("kupfeka-uye-macho" arthritis) pakuti ndiyo chirwere chemagadzirirwo emunhu umo masimba ezvirwere zvemusununguko anorwisa zvisiri izvo masero nemasukisi, kunyanya aya emajoini. Sezvo zvakadaro, chirwere chacho hachigoni kuongororwa nezviratidzo chete. Pane kudaro, unofanirwa kushandisa sangano rekuongororwa-kusanganisira kuongorora mumuviri, kuongororwa kwekufungidzira, uye kuongororwa kweropa-kuti uone kana mhinduro yacho inosangana nechirevo chechirongwa chechirwere.
Kuita izvi hakusi kungoita kuti kuongororwa kwakarurama, kunobatsira kutsanangura nzira yakakodzera yekurapa.
Kuongorora Panyama
Imwe yezvigadzirwa zvokutanga zvekuongorora ndeyekuongorora kwepanyama. Chinangwa chekuongororwa ndechokuti, muchikamu, kuziva hutano hwehutano hwakakonzerwa nekudzimara kuti huve nani kusiyanisa kubva kune anonyanya kufunga, osteoarthritis .
Pakati pemakakatanwa makuru:
- Rheumatoid arthritis inotanga kuchinja majosi akawanda ( polyarthritis ). Osteoarthritis inowanzobata maoko, tsoka, uye mabvi uye kazhinji inosanganisira imwe sangano ( monoarthritis ).
- Rheumatoid arthritis inowedzera kuva yakasiyana, zvinoreva kuti zviratidzo zvekubatana kune rumwe rutivi rwemuviri zvinowanzoonekwa kune rumwe rutivi rwemuviri. Osteoarthritis inowanzobatanidza (kana kusinganzwisisiki kana zvakanyanyobatanidzwa pamwe chete).
- Nokuti rheumatoid arthritis inokonzera systemic (muviri wose) kuputika, kuneta , malaise, uye kunyange nefivha yepamusoro-fevha inowanzove. Osteoarthritis, iyo isiri chirwere chinoputira, kazhinji haisi kuendeswa nezviratidzo izvi.
- Kuoma kwemanheru kunowanzojairika ne rheumatoid arthritis asi kunowedzera kupedza maminetsi makumi matatu chete uye kunatsiridza nekunyoroka. Sezvo osteoarthritis inosanganisira kugadziriswa kwekugadzirisa masangano pamwe chete, kuoma kwemangwanani kuchagara kwenguva refu.
Mukuwedzera pakuongorora zviratidzo zvako zvepanyama, chiremba achaongorora nhoroondo yemhuri yako.
Rheumatoid arthritis inogona kutarisa mumhuri, kaviri kudarika ngozi yako yechirwere kana yechipiri chechidimbu ichi ine uye katatu chiitiko chako kana munhu wekupedzisira wemhuri akabatwa.
Dhiyabhorosi Miedzo
Dhiyabhorosi miedzo inoshandiswa pamigariro miviri inokosha pakutsvaga rhumatoid arthritis: kuisa serostatus yako uye kuyera nekucherechedza chiyero chekuputika mumuviri wako.
Serostatus
Serostatus (risina kushandurwa se "chitema cheropa") rinoreva mazita anokosha echirwere muropa rako. Kana izvi zvikamu zvinowanikwa mukuongorora ropa, unonzi uri kushanda. Kana isingawanikwi, iwe unogona kuiswa sejeronegative. Migumisiro yekusarudzira inogona kuve yakarongeka seyoyo yakanaka, yakanaka, kana yakakwirira / yakasimba.
Pane miedzo miviri inoshandiswa kugadzira serostatus yako:
- Rheumatoid factor (RF) chiratidzo che autoantibody chinowanika mu80 muzana yevanhu vanorwara nechirwere. Autoantibodies ndiwo mapuroteni anobudiswa nemuviri unorwisa masero ane utano. Kunyange zvazvo huwandu hwakawanda hweRF hunosimbisa zvakasimba rheumatoid arthritis, inogona kuitika nedzimwe zvirwere zvinokonzerwa nemakondomu zvakadai se lupus kana kwete-autoimmune zvinetso zvakadai sekenza uye zvirwere zvisingaperi.
- Anti-cyclic citrullinated peptide (anti-CCP) chimwe chimiro che autoantibody chinowanika muhuzhinji hwevanhu vane rheumatoid arthritis. Izvo zvakanyatsojeka zvekuedza-kukwanisa kwayo kunyatsoziva anti-CCP-yakadaro inogona kugara ichiona nhengo dzemhuri dziri pangozi dzechirwere kunyange kana dzisina zviratidzo.
Pose miedzo miviri isinganzwisisi ndeyekunzwa kwavo, iyo inowanzo pasi pe80 muzana. Izvi zvinorevei kuti maedzo, asi anokosha pakuita kuti aongororwe, anowanzova nemigumisiro isina kunaka kana yezvakaipa . Ndicho chikonzero chekuti vanoshandiswa sechikamu chekuongororwa kwekutarisa pane kungova zviratidzo chete.
Kuvhiringidza Markers
Kuvhiringidza ndiko kunotsanangurira chirwere cherheumatoid arthritis. Kuedzwa kunoitwa kuti uongorore huwandu hwekuvhiringidza kuburikidza nokutarisa pamakona makuru muropa. Izvi hazviiti kuti tibatsire kusimbidzirwa kwekutanga asi zvinoshandiswa muhupenyu hwose hwechirwere kuti tiongorore mhinduro dzedu kumushonga .
Nokuda kweizvi, vanachiremba vachashandisa zviyero zviviri zvinokosha:
- Erythrocyte sedimentation rate (ESR) muedzo unoyera kuyerwa kweropa iro masero matsvuku eropa anotarisa kusvika pasi perefu refu yakagadzirwa tube, inozivikanwa seWestergren tube, muawa. Kana paine kuvhunika, masero matsvuku eropa achabatana pamwe chete uye anonyura nokukurumidza. Icho chisingaenzaniswi chekuvhiringidza asi imwe inokwanisa kupa mazano makuru ekukosha kwekuongororwa.
- C-reactive protein (CRP) rudzi rwepuroteni inoberekwa nechiropa mukupindura kubvumira. Kunyange zvazvo zvisingaiti, ndiyo imwe nzira yakananga yemhinduro yekuvhiringidza.
ESR neRPP zvinogonawo kushandiswa kuongororesa kuregererwa kweArthritis , hutsika hwechirwere chekuita uko kuputika kunowedzera kana kuderera.
Kufungidzira Miedzo
Basa rekufungidzira miedzo mu rheumatoid arthritis ndechokuona zviratidzo zvekubatana kwekubatana, zvinosanganisira kubuda kwefupa uye kukweta kwekateti uye kukwirira kwezvikamu zvakabatana. Vanogonawo kubatsira kutarisa kufambira mberi kwechirwere uye kutanga apo chirwere chinodiwa.
Chiyero chega chega chinogona kupa zvakasiyana uye zvakajeka maonero:
- X-rays inonyanya kubatsira pakutsvaga kudengenyeka kwemapfupa uye kukuvadza pamwe. Kunyange zvazvo X-rays inonzi inofanirwa kunyanya kufungidzira arthritis, haisi iyo inobatsira mumatangiro epakutanga kwechirwere apo kuchinja mushuga uye synovial tishu zvisingaratidziki.
- Magnetic resonance imaging (MRI) inoyerera inogona kutarisa kunze kwefupa uye kuchinja kwemavara muzvibvumirano zvinobatanidza uye kunyange zvakanaka kuziva kuwirirana kwechirwere muzvirwere zvokutanga.
- Ultrasounds zviri nani zvakare pakuona kuputika kwekutanga kwekubatanidzwa uye kunogona kuratidza nzvimbo dzakasiyana dzekubatana kwekubatana. Ichi chinhu chinokosha chinopiwa kuti kuputika dzimwe nguva kunoramba kuchioneka zvisinei nekuti ESR neRPP vanotiudza kuti munhu ari mukuregererwa. Mukudaro, kurapwa kwaizoenderera mberi kusvikira panguva yakadai sekuregererwa kwechokwadi kunowanikwa.
Chikamu Criteria
Muna 2010, American College of Rheumatology (ACR) yakagadzirisa mararamiro ayo akareba kwenguva refu ekuratidza rheumatoid arthritis. Iko kushandurwa kwakagadziriswa, muchidimbu, kuburikidza nekufambira mberi mukutsvaga magetsi. Kunyange zvazvo kuenzanisa kunoratidzirwa kune chinangwa chekuongorora zvipatara, zvinoshandiswa mumakiriniki ekudzidzira kupa huwandu hwakawanda hwekuongororwa kwechokwadi.
Iyo 2010 ACR / EULAR Classification Criteria inotarisa matanho mana emakiriniki akasiyana uye inoyera iwo pachiyero che 0 kusvika ku5. Nhamba yakawanda ye 6 kusvika ku10 inogona kupa chivimbo chakasimba chokuti iwe, chaizvoizvo, une rheumatoid arthritis.
| Zvikonzero | Kukosha | Points |
| Nguva yezviratidzo | Pasi pemavhiki matanhatu | 0 |
| Mavhiki anopfuura matanhatu | 1 | |
| Kubatana pamwe | Chimwe chibatanidzwa chikuru | 0 |
| Nhengo mbiri kusvika kune gumi huru | 1 | |
| Chikamu chimwe chete kune zvitatu zvishoma (pasina kubatanidzwa kwemasungano makuru) | 2 | |
| Zvikamu zvina kusvika ku10 zviduku zvishoma (pasina kubatanidzwa kwemasungano makuru) | 3 | |
| Anowedzera mairi gumi (ane zvinyorwa zvishoma) | 5 | |
| Serostatus | RF uye anti-CCP hazvina kunaka | 0 |
| Low RF uye pasi anti-CCP | 2 | |
| High RF uye high anti-CCP | 3 | |
| Kuvhiringidza mavara | Kazhinji ESR uye CRP | 0 |
| Abnormal ESR uye CRP | 1 |
Kuona Kuregererwa
Kuongorora chirwere chekuregererwa hakusi yakarurama purogiramu. Hazvirevi kungoongorora zvirwere chete asi kuongorora kunotenderera kune izvo iwe, semurwere, unonzwa nezvehutano hwako. Kunyatsoona kuregererwa kwekuregererwa kwakakosha nokuti inotarisa kuti mamwe marapirwo anogona kumira here kana kuti kuita izvozvo kungave kusati kwasvika uye kunokonzera kudzoka zvakare .
Kuita izvi, ACR yakamisa izvo zvinonzi DAS28, iyo ine maitiro mana akasiyana. "DAS" ndicho chirevo che "chirwere chekuita zvirwere," asi 28 inoreva nhamba yezvibatano zvinongororwa muongororo.
DAS inotarisa zvinotevera:
- Nhamba yezvibatano zvinyorohwa chiremba wako anowana (kunze kwe28)
- Nhamba yezvikwata zvinoputika chiremba wako anowana (kunze kwe28)
- Yako ESR neRPP zvinowanzoitika (zvakajairika zvichienderana nekusingaperi)
- Iwe unonzwa sei hutano hwako huripo nekuisa mararamiro ako pamutsetse we-10 centimita umo mugumo mumwechete "wakanaka kwazvo" uye umwe "wakaipa kwazvo"
Izvi zvinogadziriswa zvive muhutano hwakawanda hwemasvomhu kuti uone chikamu chako chose. DAS28 yepamusoro kupfuura 5.1 inoreva chirwere chinoshingaira, pasi pe2 3.2 inoratidza hutachiona hwechirwere, uye pasi pe2.6 inofungidzirwa kuregererwa.
Kusiyanisa Kuziva
Nenzira imwechete iyo kuongorora kunogona kubatsira kusiyanisa pakati pehutachi hutachiona uye osteoarthritis, vamwe vanogona kurairwa kuti vaone kana pane zvimwe zvinokonzera zviratidzo zvenyu. Izvi zvinonyanya kuitika kana rhumumatoid arthritis yemigumisiro yekuedza isinganzwisisiki, inonzwisisika, kana yakaipa.
Izvi zvinogona kusanganisira zvirwere zvekudzivirira muviri, zvirwere zvinogadzirisa zvirwere, uye zvirwere zvisingaperi zvinoputira zvakadai se:
- Fibromyalgia
- Chirwere cheRyme
- Myelodysplastic syndromes
- Paraneoplastic syndromes
- Polymyalgia rheumatica
- Psoriatic arthritis
- Sarcoidosis
- Sjogren syndrome
- Systemic lupus erythematosus (lupus)
> Sources:
> Aletaha, D .; Neogi, T .; Silman, A. et al. "2010 Rheumatoid Arthritis Classification Criteria: An American College yeRheumatology / European League Against Rheumatism Kubatana Pakutanga e." Arthritis Rheum. 2010: 62 (9): 2565-81 DOI: 10.1002 / mifananidzo.27584.
> Anderson, J .; Caplan, L .; Yazdany, J. et al. "Rheumatoid Arthritis Disease Nzira dzekuita Nhanho: American College of Rheumatology Zvirongwa zveKushandiswa muKiriniki Dzidzo." Arthritis Care Res. 2012; 64 (5): 6. DOI: 10.1002 / acr.21649.
> Bykerk, V. uye Masarotti, E. "Mutsva weC ACR / EULAR rekuregererwa kwemashoko: chikonzero chekuvandudza zvitsva zvekuregererwa." Rheumatology . 2012; 51: vi16vi20. DOI: 10.1093 / rheumatology / kes281.
> Smolen, J .; Aletaha, D .; uye McInnes, I. "Rheumatoid arthritis. " Lancet. 2017; 388 (10055): 2023-38. DOI: 10.1016 / So140-6736 (16) 30173-8.