Chirwere chepfungwa chenzeve chemukati ndechimwe chinhu chisingawanzoiti chinoguma nekuderera kunonoka mukukwanisa kwako kunzwa uye dzimwe nguva zviratidzo zvakadai sechezzinesi kana kurasikirwa kwehuwandu.
Chii Chiri Muchivanze Chetema Zvirwere Zvisingagadziriswi uye Chii Chinokonzera Iyo?
Zvirwere zvinotapira zvinokanganisa nzeve dzomukati hazvisi zvose zvinonzwisiswa, zvisinei, zvinowanzobatanidza zvikamu zvemuviri wezvirwere (immune cells kana antibodies) izvo zvikonzero zvisingazivikanwi zvinotanga kurwisa zvivako zvinoumba nzeve yomukati.
Pane zvinyorwa zvakawanda pamusoro pekuti izvi zvinoitika sei izvi zvinowanzowanzoenderana nezvimwe zvakare-existent autoimmune disorder yakadai se:
- Mishonga yepamusoro (inowanzotaurirana nezvezvokudya)
- Cogan's syndrome
- Systemic lupus erythematosus (inofungidzirwa kuva yakajairika asi kunzwa kurasikirwa kunogona kunge kwakabatana nemigumisiro yemishonga inoshandiswa kurapa chirwere ichi)
- Sjogren's syndrome (dzimwe nguva inonzi yakaoma-eye syndrome)
- Rheumatoid arthritis (nharo)
- Ankylosing spondylitis
- Ulcerative colitis
- Wegener's granulomatosis
- Scleroderma
- Psoriatic arthritis
- Chirwere cheBehcet
- Kudzokorora polychondritis (yakajairika)
- Polyarteritis nodasa
Zvimwe zvirwere zvinotapukira zvakabatanidzwawo nekurasikirwa kwekunzwa kunzwa. Izvi zvinosanganisira:
- Chirwere cheRyme
- Syphilis
Izvi zvirwere zvinofungidzirwa kuti zvinosanganiswa nekuwedzera kwekushandiswa kwemasikirwo uye kusangana kunotevera kwemukati wezeve neavo masimba. Zvimwe zvinokonzera zvikonzero kana mamiriro akafanana anosanganisira:
- Post-traumatic hydrops (iyo inowanzosangana iyo inoitika mushure mekukuvara kwemukoko)
- Kugadziriswa kwekugadzirisa kana kutaridzika kwemafupa
- Meniere's disease
Kunzwa kurasikirwa kunokonzerwa nechirwere che autoimmune ndicho chikonzero chisingawanzoiti chekunzwa kurasikirwa kwekunzwa kusvika 1 peresenti yematambudziko.
Zviratidzo zveAinimmune Inner Ear Disease
Chiratidzo chinonyanya kukosha chechirwere chemukati chemuteereri ndezvekushungurudzika kwekunzwa kunowanzoitika munzeve mbiri (bilaterally).
Uku kurasikirwa kwekunzwa kunowanzotaridzirwa se sensorineural uye kazhinji kunowirirana nezviratidzo zvekuzvidzivirira zvakadai sekuzorora kana kurasikirwa kwekuenzanisa. Kurasikirwa kwekunzwa kunowanzoitika pane imwe nguva kwemwedzi mishomanana.
Kuongororwa Kuzvidzivirira Kwemukati Mazwi Ezvirwere
Kana iwe uine zviratidzo zvehutachiona hwemukati huri mukati mako chiremba wako angashandisa kusanganiswa kwezviedzo zvakasiyana-siyana kubatsira kubatsira kuti izvi zviongororwe. Heano mamwe ematambudziko ako chiremba angasarudza kuronga:
- Ropa rekuedza kuti ribatsire kusimbisa kana kutonga kunze kwechirwere chinonzi autoimmune disorder (ANA, erythrocyte sedimentation rate, rheumatoid factor, human leukocyte antigens, C-reactive protein).
- Mimwe miedzo yeropa inogona kusanganisira: anti-cochlear antibody test, lymphocyte transformation assay, Lyme titer.
- Zviyero zvakasiyana-siyana zvekunzwa zvinosanganisira: audiometry, ABR, otoacoustic emission testing , ECOG (electrocochleography).
- Chiremba wako anogonawo kusarudza kuedza mishonga yemununosuppressive kana corticosteroid uye ona kana iwe uchipindura. Kupindura kwakanaka kunobatsira kutsigira kuongororwa kwechirwere chemukati chinonzwa. Zvisinei, kana iwe usingapinduri kumishonga hazvireve kuti hauna chirwere chepfungwa chenzeve mukati.
- Rotary chair test: Ichi chiyero chinobatsira kuziva kana chinetso chekuzorora kana kusava nematambudziko chinokonzera kubva ku vestibular system kana imwe chikamu chemuviri.
Hapana yero miedzo yakanyorwa pamusoro apa inonyatsotaura nezvekudzivirira mukati mechirwere chepfungwa chenzeve asi inoshandiswa kubatsira kubvisa kunze kana kusimbisa mamiriro akafanana. Kuongororwa kunobva mukubatanidzwa kwezviratidzo zvako, nhoroondo yezvechiremba, chiongorori chechiremba panguva yekuongorora kwepanyama uye chero mimwe miedzo inobatsira.
Kuchengetedza Zvirwere Zvomukati Mazwi Matambudziko
Kazhinji mutsara wokutanga wehutano inzira yemuromo steroid mishonga yakafanana prednisone, dexamethasone, kana even aldosterone. Inowanzoshandiswa kwenguva inenge inenge mwedzi. Steroid haisi kushandiswa kune vanhu vane chirwere cheshuga, peptic ulcer chirwere, glaucoma, kana kuwedzerwa kweropa.
Steroidsi inoshanda inenge 60 muzana yenguva. Steroid haifaniri kumbomira pakarepo, asi pane zvishoma zvishoma zvishoma.
Oral steroids inogona kukonzera matambudziko makuru mune vamwe vanhu. Nokuda kwaizvozvi chiremba wako angasarudza kuisa steroid zvakananga mukati mako (mukati mokuti nzira yekupa mishonga inonzi transtympanic). Izvi zvinosanganisira kusungirirwa kuduku kunoshandiswa munzeve yekunzwa (inonzi myringotomy ) iyo inowanzoitwa nehutano hwemunharaunda kana, kana zvichidiwa, kuchipatara kana nzvimbo yekuvhiya pasi pevanhu vakawanda anesthesia. Inonzi tympanostomy tube inowanzoiswa kuitira kuchengetedza kusungurudzwa kuvepo kuitira kuti mushonga unogona kupfuurirwa kwenguva. Nzira yacho haisi nyore uye haiwanzokonzera kurwadziwa kukuru. Kana imwechete iyo ikabviswa, iyo incision inoporesa pakarepo zvakakurumidza.
Kana iwe usingabvumirwi steroid therapy kana kana steroid therapy isingashandi kwauri, chiremba wako angasarudza imwe mishonga.
Mishonga inonzi cytotoxic yakadai se methotrexate uye cyclophosphamide inogona kushanda mukurapa chirwere chemukati chemuteereri kana steroid ikakundikana kana isingasarudzo, zvisinei nemigumisiro inogona kugadzirisa kushandiswa kwavo. Methotrexate inowanzoshandiswa nokuti inosanganiswa nemigumisiro shoma kupfuura mamwe madhiragi e-cytotoxic uye kana migumisiro inowanzoitika inowanzova yenyoro uye inoshandiswa.
Zvimwe zvinokonzerwa ne methotrexate uye cyclophosphamide zvinogona kusanganisira: anemia, thrombocytopenia, itsvo kana chiropa kutyisa, kusagadzikana kana kupera kwemapfupa emapfupa. Paunenge uchitora mishonga iyi, hutano hwako hunofanira kunyatsoongororwa nachiremba uye nguva dzose kuongororwa ropa kuitira kuongorora inzwa yako kana chiropa basa rinogona kudiwa. Kurapa ne methotrexate kune kubudirira kweanenge inenge 69 muzana.
Mimwe mishonga yako chiremba angasarudza kuedza inosanganisira:
- Etanercept (a tumor-necrosis factor antagonist)
- N-acetylcysteine
Kutsvakurudza kuri kuratidza kuti kubudirira kwemishonga iyi kwakanyanya kudarika kuitira kuti chiremba wako angangosarudza kuedza ivo kana mamwe marapirwo akakundikana.
Imwe inogona kurapwa inoda kuongororwa zvakare ipurasmapheresis. Plasmapheresis ndiyo nzira yekutsvaga ropa remunhu kuti abvise zvikamu zvemuviri wezvirwere zvezvirwere izvo zvinofungidzirwa kuti zviri kurwisa nzeve dzomukati (antigen, antibodies, etc). Zvinhu zvemuviri wezvirwere zvinoshandiswa zvinoshandiswa zvinotsiviwa nesarine yakakwana kana mapuroteni anonzi albumin (kana maviri). Iro kurapa kunogona kudhura uye hazvibviri kushandiswa sekutanga kwekurapa mutsara.
Pasinei nemishonga inoshandiswa, tsvakurudzo yakaratidza kuti hurongwa hwekurumidza hutanga hunobudirira hunobudirira. Nokuda kwechikonzero ichi iwe unofanira kuona chiremba pakarepo kana uine zviratidzo zvehutachiona hwemukati huri mukati.
> Sources:
> Autoimmune Inner Ear Disease (AIED). American Hearing Research Foundation website. http://american-hearing.org/disorders/autoimmune-inner-ear-disease-aied/. Yakapedzwa muna Gumiguru 2012. Yakasvika muna June 17, 2017.
> Autoimmune Inner Ear Diseases (AIED's): Kuzvidzivirira Zvirwere Nekushandisa-Audio-Vestibular. Audiology Online website. http://www.audiologyonline.com/article/autoimmune-inner-ear-disease-aieds-1160. Yakapedzwa muna August 2002. Yakasvika muna June 17, 2017.
> Kuzvidzivirira kwezvirwere zveInner Ear Treatment & Management. Medscape webusaiti yepaiti. http://emedicine.medscape.com/article/857511-treatment. Yakapedzwa muna December 2016. Yakasvika pana June 17, 2017.
> Rotary Chair Testing. Medscape webusaiti yepaiti. http://emedicine.medscape.com/article/1832765-overview. Yakapedzwa muna February 2016. Yakasvika muna June 17, 2017.