Ndezvipi Zviitiko Zvengozi?
Kuparara kwekubatana kwechikwata ndeyekuti vanachiremba, vatsvakurudzi, nevarwere vane zvirwere zveArthritis uye rheumatic vanoedza kudzora. Icho chigumisiro chekugara kwenguva refu synovial kutuka. Mishonga inokurudzirwa nechinangwa chairo mupfungwa-chimwe chazvo ndechokuderedza kufambira mberi kwezvirwere.
Chokutanga uye chakakosha, zvakakosha kunzwisisa kuti kuwedzera kwekubatana kwekubatana, kana kusingatariswi, kunogona kubatanidzwa nekugadzikana kwebasa nekuremara.
Ndezvipi zvinhu zvinofanirwa kuparidzirwa nehurombo husina kunaka nehuwandu hunovhiringidza hutano?
Usual Factors Associated With Progressive Joint Damage
Chiratidzo chakasimba chekuwedzera kwekubatana pamwe chete muhutachi hutachiona chinonzi seropositivity . Izvozvo zvakati, seronegativity haitadzisi kupfurikidza kunowedzera kukanganisa. Ndinogona kuzvipupurira izvozvo kubva pane zvakaitika pakutanga.
Kukurumidza kufambira mberi kwekukuvadza pamwe chete kunowanzobatanidzwa nekuve kwakanaka kune zvose rheumatoid factor uye anti-CCP -zvinowanzoita kana mumwe munhu akanaka pane zvimwe, pane zvose. Zviitiko izvo zvinongoratidzira kuvhiringidza mashoma nekukuvadza kunowedzera zvinosanganisira:
- X-ray uchapupu kana hutano hwechipatara hwekubatana pamwe chete
- Kuwedzera kwenhengo dzinobatanidzwa nehushandi synovitis, unyoro, kuzvimba, kana kubatana
- Yakawanda yeyerythrocyte sedimentation rate (sed sed) kana C-reactive protein (CRP) . Nokuderera kwechitsiko, rimwe nerimwe ra1mm / awa rinowirirana rinobatanidzwa ne2 muzana rakawedzerwa ngozi yekufambiswa kwekubatana pamwe chete.
- Zvakanaka zvekurwisa CCP
- Chinhu chakanaka cheHLA-B27 , HLA-B39, kana HLA-DQw3.
- High level yemishonga inoshandiswa, kusanganisira corticosteroids , inoshandiswa kurapa kupisa muzvikamu zvakakanganiswa
- Kunyatsopindura mishonga
- Kupera basa rekubatanidza sezvinotsanangurwa neEalth Assessment Assessment Questionnaire
- Kurambidza hupenyu hwehupenyu
Zvinangwa Zvokurapa
Kusimbiswa kwehuwandu hwehutachi hutsva hwehutano huri pane zvirwere zvepakutanga, uyewo kuti kufungidzirwa kwepakutanga nekurapa kunogona kuchinja sei kufambira mberi. Maererano nemigumisiro yekuongorora yakabudiswa muArthritis uye Rheumatism , pakati pe60 kubva muzana uye 95 kubva muzana yevanhu vane rheumatoid arthritis inokura kana kudengenyeka kumwe kunoratidzika kweruzhinji (kureva, pane x-ray) mukati memakore matatu kusvika ku8 mushure mokutanga kwechirwere.
Maererano nemigumisiro yakataurwa mumusangano wegore negore weAmerican College of Rheumatology, vatsvakurudzi vakatsanangurawo kuti kuparara kwekubatana kwechikwata kuchiri kuonekwa pakati pevanhu vane rheumatoid arthritis kwemakore mashanu. Izvo zvinoratidzikawo kuti ndizvo zviri munharaunda inenge hafu ye rhumumidhi arthritis varwere vanorapwa nemishonga inonzi biologic .
Ive FDA yave ichiziva kuti kudzivirira kana kuderera kwehuwandu hwemashoko akabatanidzwa muhutachi hutachiona ndechimwe chinangwa chekurapa. Dhiyabhorosi ye FDA inobvumira kudhinda kushandiswa kwemazita emamwe maDMARDs (zvirwere-kuchinja anti-rheumatic drugs) uye biologic zvinodhaka zvinoreva kuti mishonga inononoka kufambira mberi kwehuwandu hwemagetsi.
Chinangwa chekuwana kuregererwa mu rheumatoid arthritis ndechekugadzirisa kukanganisa pamwe. Asi, zvigadziriswa zvigadziriro zvekukwanisa kuregererwa zvichiri kusiya nzvimbo yekuti ive nekufambira mberi kwehuwandu hwekubatana pamwe chete.
Kuregererwa kunotsanangurwa nemiganhu yezvirwere zvechirwere sezvo inosanganiswa nekubatana kwekubatana, panzvimbo pekukanganisa kwekubatana. Kudzora kuvhiringidza kwakakosha pakurapa zvirwere zvekuita mu rheumatoid arthritis. Zvirwere zvekudzivirira muviri zvinobatanidzwa. Nhungamiro yakaoma yemasero omumunyika ari mumurairo wehutachiona hwekuvhiringidza kwechitokines uye chemokines. Ndiyo chirwere chechirwere chechirwere mu rheumatoid arthritis. Panguva imwe chete seyakashandura cytokine, pane zvimwe zvinhu zvakasiyana-siyana zvinoitika pakati penharaunda ye synovial cells, kunyanya fibroblasts, uye cartilage uye bone tissue. Ichi chiitiko, chinowanikwa pamagumisiro emajoini akabatwa, chinokonzera kukanganisa pamwe.
Basa reno synovial rinogona kuita zvakasununguka uye rinokonzera tsandanyama uye kuparadzwa kwemapfupa, zvakasiyana nehuwandu hwechirwere chechinovial. Icho chakaoma, asi chinonyanya kukosha ndechekuti kuparara kwekubatana pamwe chete kunogona kuitika pasinei nekuputika kwakanyatsodzorwa.
Shoko Rinobva
Kune vanhu vane rheumatoid arthritis vasina zvinhu zvinowanzoitika kana kuti biomarkers yekuwedzera kwekubatana kwekubatana, asi vachiri nechinetso chekuwedzera pamwe. Ndiri kureva kune avo vangave vasina kunaka kwerheumatoid factor (seronegative), vasina kunaka ne-anti-CCP, kana kuti vane dare kana CRP iyo isina kunyanya kukwirira. Izvo zvakagadziriswa kuti, mumamiriro ezvinhu akadaro, pane kutaura uye kushandiswa kweMMP-3 (stromolysin-1) uye MMP-1 (collagenase-1) iyo inobatsira kuwedzera kuwirirana kwekubatana. MMP-3 uye MMP-1 ndiwo matrix metalloproteinases (enzyme). Yakakura serum yeMMP-3 neMMP-1 inobatanidza zvikuru nehutano hwemabasa uye inogonawo kunge ichitaura nezvekuparara kwehutachiona hwehutano uye kushandiswa kwebasa.
> Sources:
> Gladman, Ritchlin. Njodzi Dambudziko rekufambisa Dambudziko Rakazara. Kurapa kwePororiatic Arthritis. Kusvika pari zvino. Yakapedzwa musi waSeptember 28, 2016.
> Lafeber Floris PJG et al. Kuwedzera kweZvipembenene Zvose Pasinei Nokudzivirira Kwechiremera muRumatoid Arthritis: Basa reKartilage Kuparadzwa Kunotungamirirwa neSynovial Fibroblast Basa. BMJ Journals. 2012.
> Lillegraven, S et al. Progressive Radiographic Yakazara Kuparara Mukugadzirwa kweRheumatoid Arthritis: Kazhinji uye Yakasimba Yakabatana neSeropositivity. ACR Zvinyorwa: 2660. 2012 ACR Musangano Wegore Negore.
> Paulus HE et al. Kugadzirisa Kurongeka Mubatanidzwa Hwakaita muRheumatoid Arthritis Sekufambira Mberi kana Kusagadzikana Kushandisa Ikamu Dudziro ye Joint Radiographic Change. Arthritis uye Rheumatism. April 2004.
> Al-Bayyoumy SA, et al. Kuwirirana Pakati Pakaitika Kuwedzera Kuda uye Serum Nhamba ye Matrix Metalloproteinases: MMP-3 uye MMP-1 muArma Rheumatoid Arthritis . Ijipiti Rheumatology uye Kuvandudza. July 2007.