Achiza Kurapa Zvinangwa
"Tora kurongedza" ndiyo nheyo kana nzira iyo yakabudirira pakurapa zvimwe zvirwere nemamiriro. Nzira iyi pakutanga yakashandiswa kurapa huwandu hwehutachiona, high cholesterol, uye chirwere cheshuga. Asi, huwandu hwave hwakawedzera uye hunoita kuti hutsva huve hwakaita nzira yawo mukufunga kwevanorwara vezvirwere zverheumatic .
A kubata nechinangwa chirongwa chinofanira kuva nezvinhu izvi zvitatu:
- chinangwa
- nzira yekuyera kana chinangwa chacho chave chakaroverwa kana kuti chakabudirira
- zvinoshandiswa pakushandisa nzira dzekurapa izvo zvinoita kuti zvikwanise kurova chinangwa
Nehutano hwehutano hwepachiviripa, chirwere chekuda ropa chinotarisirwa kuverenga chinopfuura 150/100 mm Hg, uye zvisingasviki 140/90 iri kunyanya kushanda mukuderedza mamiriro evanhu vane moyo. Kuzadzisa zvinangwa zvehuwandu hwekushusha kweklesterol uye LDL, zvinyorwa zvinowanzomirirwa. Kune varwere vane chirwere cheshuga, kune kliniki mazano ekuti ropa glucose uye hemoglobin A1C. Chii chinoonekwa sechinangwa mu rheumatology?
Bata kune Target muRheumatoid Arthritis
Mu rheumatoid arthritis , chinangwa chikuru ndechekuregererwa. Icho chirwere chepfungwa chinowedzerawo chimwe chinangwa, zvichida zvakanyanya kufanirwa uye zvinowanzoitika mune dzakawanda zviitiko. Kuti urove chinangwa, kuputira kunofanira kudzora kana kubviswa. Izvi zvinoenzaniswa nekuongorora zvirwere zvekuita. DAS28 (Chirwere Chebasa Dhiyabhorosi ) kana CDAI (Clinical Disease Activity Index) ndeimwe yenzira dzekuita zvirwere zvinogona kuongororwa.
Izvo zvakanyanya kuwanda kwechirwere chekuona kurapa zvisati zvatemwa, asi DAS28 pasi pe2.6 inowanzoonekwa seiri kuratidza kuregererwa mune rhumumidhi arthritis murwere.
Chimwe chikamu chinokosha chisingafaniri kuregererwa - zvinangwa zvekurapa zvinofanira kuenzaniswa. Kurwisa , nhoroondo yezviitiko zvinodhaka zvinodhaka, uye zvipi zvinoshandiswa zvakagadziriswa zvinofanira kuongororwa pazvinenge zvichigadzirisa chinangwa chinangwa.
Bata kune Target muLupus
Rimwe boka rezvematongerwo enyika rave richirikudzidzira kubata kune chinangwa cherongwa hwe lupus . Bhizimisi rakasimbisa kuti kuregererwa kwechiratidzo kuratidzwa, uyewo zviratidzo zve systemic zve lupus, ndicho chinangwa chikuru chekurapa lupus. Imwe inobata kutsvaga chinangwa che lupus chinosanganisira kudzivirira mahara , kusanganisira nephritis , neuropsychiatric zviratidzo, uye jikelele lupus zviratidzo. Kudzivirira kukanganisa kwakagadziriswa sechinangwa, nechinangwa chokudzivirira kukanganisa kwechigungu chekutanga uye chekupedzisira kuburikidza nekudzivirira chirwere chekuita nekusvibisa kubva kumishonga. Kuchengetwa kwakabhadharwa nehutano hwehupenyu hwehutano hunokosha zvakare.
Kuenderera mberi, boka rebasa rinoda kuwedzera tsanangudzo dze lupus remission uye zvishoma nezvakanaka zvirwere zvekuita. Panewo chidiro chekuongorora zviri nani kwemaira.
Kunyange zvazvo kune tariro yezvinodhaka zvemishonga mutsva mune ramangwana, pane dzakawanda zvakagadzirwa uye zvakatengerwa rheumatoid arthritis kubvira muna 1998 (apo Enbrel yakava yekutanga biologic drug inogamuchirwa ne rheumatoid arthritis). Nezvemishonga iyo ikozvino inoshandiswa kurapa lupus, boka rebasa richatsvaga kutsvaga kana kune nhamba yakaderera ye steroid iyo inofungidzirwa yakachengeteka mukubata kune chinangwa.
Uyewo, mibvunzo pamusoro peyakakodzera ye hydroxychloroquine kune vose varwere vane lupus varipo.
Shandisai Target for Spondyloarthritis
Muna 2013, imwe nyanzvi yemapurisa yakaona kana varwere vane spondyloarthritis vanogona kubatsirwa kubva pakubatwa nechinangwa. Vakagumisa kuti kubata kune chinangwa kunogona kushandiswa kune spondyloarthritis asi kuti mazano ekujekesa, kuyera kana kunyange kuzadzisa zvinangwa zvekuregererwa kana chirwere chisina kumira chinopera muchikamu chechirwere ichi. Miedzo haisati iripo iyo inotsanangura zviyero zvisingakwanisi zvekuita zvirwere mu spondyloarthritis. Basa rinofanira kuitwa. Kubva ikozvino, mazano akaitwa kuburikidza nehumwe humwe uchapupu.
Chimwe chekudzidza, kunyanya kune psoriatic arthritis , nekuenzanisa boka revarwere vanowirirana ne methotrexate kune rimwe boka rakagamuchira zvakanyanya kunyanya nemishonga. Maererano neRheumatology News, boka rakanyatsotevera rakatevera purogiramu yakasimba uye kana zvishoma zvirongwa zvekushaya zvirwere zvakakundikana kusangana, ipapo chiitiko che methotrexate chakanga chichiwedzera. Zvakare, kana varwere vakakundikana kuwana zvirongwa zvekuita zvirwere, vakapiwa simba rakawanda reDMARD . Kana vakaramba vasina kukwana, boka guru rakapiwa blocker yeTFF . Mhinduro yakaratidza kuti boka rakadzama rakaita zviri nani pane boka rakasara rakasara pa methotrexate pasina chirongwa chekuwedzera kwemishonga kana chirwere chekuita zvirwere.
Uyewo, paEuropean Congress of Rheumatology gore negore (EULAR 2014), kuwedzera kwemakore mashanu ekuongororwa kwakaitwa nemaitiro, anorongedzwa eAngoni (golimumab) kune varwere vane psoriatic arthritis vakaratidza zvirinani zviri nani kwenguva refu kune varwere vanogona kuwana zvishoma nezvishoma zvirwere kuburikidza chinobata chinangwa chinosvika.
The Bottom Line
Vatsvakurudzi vakaita sarudzo yakarongeka yezvinyorwa zvezvesayenzi (Schoels, M. et al.) Pamusoro pekubata kuronga mu rheumatology. Vakagumisa kuti "zvidzidzo zvishomanana chete zvakashandisa nzira dzisinganzwisisiki yekuedza kukosha kwekurapa kune chimwe chinangwa.Asi zvisinei, zvose zvakapa uchapupu huripo hunobatsira hwechirongwa chekurapa kwakadaro. uye varwere vane nguva refu RA [rheumatoid arthritis] havana kuongororwa zvakakwana. "
Nechepfungwa, kuva nezvinangwa zvekurapa, kunyanya zvinangwa zvinogadziriswa, zvinonzwisisika. Kuisa izvi kuita, zvinangwa kana zvinangwa zvinofanira kuva zvakanyatsotsanangurwa nezvirwere zverheumatic.
> Sources:
> 'Shandisai Target': Kufambisa Zvirongwa NeHypertension, Hyperlipidaemia uye Diabetes kuRheumatoid Arthritis. Dan Atar et al. Annals weRheumatic Diseases . April 2010.
> Uchapupu hwekurapa rheumatoid Arthritis kune Target: Zviwanikwa zveMagadzirirwo Emagwaro Kutsvaga. Schoels M. et al. Annals weRheumatic Diseases . April 2010.
> Kubata-Ku-Target muStudio Lupus Erythematosus: Zvirongwa Kubva kune International Task Force. Van Vollenhoven RF et al. Annals weRheumatic Diseases . Yakabudiswa paIndaneti April 16, 2014.
> Kurapa Spondyloarthritis, Kusanganisira Ankylosing Spondylitis uye Psoriatic Arthritis, ku Target: Mazano a International Task Force. Smolen JS et al. Annals weRheumatic Diseases . June 8, 2013.
> Kutora-Ku-Target Approach ye Psoriatic Arthritis Yakawanikwa Inobatsira. Rheumatology News . Doug Brunk. November 4, 2013.
> Kubata kune Target Inoratidza Kuvandudza Kunogadzikana muPororiatic Arthritis. Internal Medicine News . Jennie Smith. June 12, 2014.