Matambudziko okurara anowanikwa pakati pevanhu vane rheumatoid arthritis . Kuneta kunoonekwa sechinetso chikuru kune avo vanorarama nechirwere. Pane imwe nguva, zvakanzi hazvina kunyatsojeka kana kuvhiringidzika kwepabonde kunokonzerwa nehutatoid arthritis. Kuvhiringidza kubatwa nehope ndechimwe chemarudzi matatu ekurara kwepabonde.
Chii chiri kufunga kwemazuva ano? Pane njodzi yakakwirira yekudzivirira kubvisa chirwere chekushaya hope kana uine rheumatoid arthritis?
Izvo zvinokanganisa kurara kwepabonde chikonzero chekuvhiringidzika kwehope uye kuneta izvo zvinowanzonyunyuta zvevanhu vane rheumatoid arthritis? Ngationgororei izvo vatsvakurudzi vakatsunga.
Rheumatoid Arthritis Basics
Rheumatoid arthritis inogara isingagumi, iyo inogadzirisa muviri , iyo inoputira chirwere cheArthritis . Nepo hutano hwakakosha huri pamwe nekuvhiringidzika kwekubatana hunoenderana nehutamu hutachiona, pane zvingava nemigumisiro yechiratidzo uye zviratidzo zvisingatauriki zvakare. Vanenge mamiriyoni 1.5 vanhu muUnited States vane rheumatoid arthritis, maererano neCenters for Disease Control and Prevention (CDC).
Kurara Apnea Basics
Kurara kwepabhesi ndiyo inowanzobatwa nehope yepamusoro yekufema. Nekupererwa kwehope, kufema kwomunhu kunoparadzaniswa, kana kunonyanya kumira, munguva yehope. MuNorth America, inofungidzirwa yakawanda-apo kuvhiringidzika kwekurara kwepabonde kunotsanangurwa sepnea-hypopnea index (AHI) yepamusoro yezviitiko zvishanu paawa yakasarudzwa nepolysonogram-iri 20 kusvika ku30 muzana muvarume uye 10 kusvika ku15 muzana pakati pevakadzi.
Kunyange zvazvo apnea inoreva kukanganisa kwenguva pfupi kwekufema, hypopnea inoreva kukurumidza kufema kana kufema. Zvikamu zvekurara apnea zvinoguma nekuderedza oksijeni yakagadzirisa.
Zvinokonzera njodzi zvinokonzerwa nehope dzepabonde dzinosanganisira:
- Kufambira mberi
- Murume wevakadzi
- Kuwedzera muviri
- Craniofacial kana kuti kumusoro airway soft tissue zvisiri izvo
Zvimwe zvinokonzera njodzi izvo zvave zvichionekwa zvinosanganisira kusvuta, kuputika kwemazamu, kubuda kwemwedzi, uye nhoroondo yemhuri yekurara kwepabonde. Zvimwe zvirwere zvehutano zvakabatanidzwa nehupamhi hwehutachiona hwekurara, kusanganisira kuberekwa, kuguma-dhigirii real real disease, congestive moyo kusakundikana, chirwere chisingaperi chemapapu, uye chirwere. Vatsvakurudzi vakawanawo kuwirirana pakati pehutamuid arthritis uye kuwedzera kwengozi yekuvhiringidza kupona kwepabonde.
Kurara kweApnea uye Rumatoid Arthritis Inogona Kubatanidzwa
Maererano nemigumisiro yekuongorora yakabudiswa muBomJ Open (2016), kuwanda kwehuwandu hwekudzivirira hutano hwepabonde hwaiva ne75% muboka revanhu vane rheumatoid arthritis vachienzaniswa nevaya vasina rheumatoid arthritis. Zvakawanikwa zvakawanikwa kubva pakudzidza kwekutanga kwekutsvaga kwekushandiswa kwakashandiswa munharaunda yose yevanhu-based data. Ongororo dzakapfuura dzekurara kwepanea uye iyo inogona kushamwaridzana ne rheumatoid arthritis yakanga yakavakirwa pamishumo yepamusoro kana kuongororwa kwenyaya nekadiki sampuli soro.
Bhuku rinonzi BMJ Open rinokurukurwa rinotaura kuti njodzi yekudzivirira kuparara kwemahombekombe yakakura kune varume kupfuura vakadzi, kuvanhu vakwegura vanoenzaniswa nevaduku, uye kune avo vane comorbidity. Ngozi yekuberekwa kwepabonde inozivikanwa kuti inobatanidza nehutachiona, hyperlipidemia, ischemic heart disease, uye kuneta.
Nezve rheumatoid arthritis, zvimwe zviitiko zvinoita sezvo zvinoita kuti pave nehuwandu hwehutachiona hwekurara, kusanganisira micrognathia, chirwere chepervical zvisina kunaka, kubatanidzwa kwekubatana kwema temporomandibular, kubatanidzwa kwekodoarytenoid joint, nekuwedzerwa.
- Micrognathia inomirira apo tambo yakaderera iri duku kudarika yakasarudzwa. Izvi zvinowanzowirirana nevana vechidiki idiopathic arthritis . Izvo zvinogonawo kuitika sevanhu vakuru-vakawana micrognathia inosanganisira rheumatoid arthritis, mune dzimwe nguva nekuda kwekuparadzwa kwekubatana kwema temporomandibular, zvichiita kuti kuvharwa kwepamusoro pemhepo uye kubvumira kupererwa kwepnea apnea.
- Cervical spine dambudziko rinogona kuitika ne rheumatoid arthritis, kunyanya, kusagadzikana kwemasangano emagetsi echipito, kushandiswa kwema occipital-cervical region, pamwe chete nezvimwe zvisina kunaka, zvakadai sekuvapo kweasteophytes . Kushandiswa kwechirwere chekodhi kunogona kukonzera mhepo yepamusoro yakadzika, kukanganiswa kwemakumbo, uye kunogona kukanganisa kuoma kwepabhesi yokurara. Occipital-cervical (chirwere) fusion inogona kubatsira kugadzirisa ichocho chisina kumira uye kunatsiridza kurara kwepanea.
- Kubatanidzwa kwemazuva ekupedzisira-Kuparadzwa kwechibatanidzo chema temporomandibular chakakonzerwa nehurumatoid arthritis kunogona kuderedza hukuru hwemhepo yepamusoro uye kunokonzera kurara kwepnea kune avo vanobatwa.
- Kubatanidzwa kweCricoarytenoid-Majoka e - cricoarytenoid anowanikwa pakati pemakungwa emakungwa uye akabatanidza mapuranga emagetsi mumushure wekuseri kwelarynx. Majoo emagetsi anozaruka, akavhara, uye akasimbisa tambo dzemashoko panguva yekutaura nekufema. Kuipa kwemaitiro kunogona kuita kuti munhu arambe apnea muvanhu vane rheumatoid arthritis.
Nhengo dzemazuva ano, kusvibiswa kune dzimwe nzvimbo dzakatipoteredza, zvimwe zvinokonzerwa nemararamiro, uye mararamiro emararamiro kana maitiro, zvakadai sekudya zvishoma-kupfuura-zvakakwana (somuenzaniso, shuga yakawandisa kana mafuta), kunwa doro kana kusvuta, uye kurapa kwakakwana kunogona kuvawo zvikonzero .
Izvo zvakarongedzwawo kuti sangano rinozivikanwa pakati pemoyo wehutachiona uye rheumatoid arthritis inogona, muchikamu, inokonzerwa nekurara kwepnea. Kuvhiringidza kurara kwepabonde kwakabatanidzwa nokuputika , kubatana , uye kuguma kwekusagadzikana . Sezvo zvipo zvinokonzera zvakaonekwa, chinokonzera uye chiito chinowedzera kuve pachena uye chidimbu chekugadzirisa chimwe chinhu chiri pachena.
Izvi zvinofanirwa kuongororwa kubva pane maonero ekuti zvirwere zvakanyanya sei zvakabatana nehope yepamusoro. Semuenzaniso, zvakagadzirirwa kuti vanhu vane hutachiona hwepabonde dzisina kunaka dzakasimudza acute-phase reactants ( CRP , sed rate ) uye pro-inflammatory cytokines . Yakave ichitaura kuti dzimwe interleukins, kunyanya, IL-1, IL-2, IL-6, Il-8, IL-18, uye TNF-alpha vanokurudzira kurara kwe-non-REM (kuratidzwa kweziso nokukurumidza). IL-4, IL-10, IL-13, uye TNF-beta inobvisa kurara kwe-non-REM.
Kuvhiringidzika kwechitokine mazinga kunokonzerwa nekuoma kwepabhesi yokurara. Nhamba dzepamusoro dzeNATF-alpha dzakabatanidzwa nehutano hwakanyanya hwekuvata apnea uye hypoxia. Izvi zvinogona kutsanangura nei vanhu vane rheumatoid arthritis vanobatwa neTN blockers vanoona kuti kuneta kwavo kunatsiridza. Dzimwe dzidzo dzaizodiwa kuti dzive nemhedziso pamusoro pemigumisiro yehutachiona hwerhematoid arthritis.
Inofanira Kuitwa Sei?
Kushamwaridzana kwerheumatoid arthritis uye kupererwa kwemahombekombe kunogona kubatsira zvikuru kuwedzera kukuvadza uye kufa kune vanhu vane zvinhu zvose. Kuti kushamwaridzana kunogona kuita kuti kuwedzerwa kwehutano hwehutano hwepfungwa mu rheumatoid arthritis varwere zvichida kunonyanya kukosha.
Rheumatologists vanofanira kutarisa zviratidzo zvekurara kwepabonde muvarwere vavo pavanenge vachibvunzurudza uye vachizviongorora uye, kana zvichitaridzirwa, vanotaura kune unyanzvi hwekurara kana kuti kurara kliniki. Kurara kwepabhesi kunowanzochengetedzwa kuburikidza nekushandisa maPPAP . Kutevedzana nePCAP zvishandiso chinetso kune vamwe zvakadaro. Zvinogona kunge zvakanyatsorondedzerwa sezvakaoma. Imwe nzira inogona kuitika yekutungamirirwa kwekuputika kwepabonde kunosanganisira nzvimbo yakananga yemuviri panguva yekurara kuti uchengetedze mhepo, kuora muviri, uye kushandiswa kwezvigadziro kutungamira zvinotarisirwa mberi zvichiita kuti kuderedza kuvharwa kwemhepo. Zvechokwadi, dambudziko harifaniri kuregererwa.
The Bottom Line
Apo mumwe munhu ane rheumatoid arthritis anonyunyutira kunachiremba wavo pamusoro pokuneta, haafaniri kutanga kutaridzwa sechimwe chinhu chinowanzobatanidzwa nechirwere. Hazvifanirwe kufungidzirwa kuti kuneta kunongobatana chete nekuvhiringidzika kwehope uye kuparara kwekubatana kunosangana nemarwadzo. Nezvo izvo zvingava zvechokwadi mune dzimwe nguva, basa rakaoma rekuona chikonzero chinofanira kuitwa. Kurara kwepabhesi kunofanira kutongwa mukati kana kunze. Izvozvo zvinogona kuitika pamusana pekusaporerwa kwepabonde dzisina kurara zvakanyanya zvakasiyana.
> Sources:
> Ataka, H. et al. Occipitocervical Fusion Inogona Kuvandudza Kubata kweApnea muVachipatara neRumatoid Arthritis uye Upper Cervical Izions. Wakapona. 2010 Sept 1; 35 (18): E971-5.
> Shen, Te-Shun et al. Dambudziko rekudzivirira Apnea yokurara muvarwere vane rheumatoid Arthritis: Chidzidzo cheNyika Yose Chidzidzo cheVanhu Chidzidzo Chekudzidza. BMJ Open. 2016; 6 (11): e013151.
> Shoda, Naoki et al. Kurara kweApnea muRheumatoid Arthritis Varwere Nezvipembenene zveEpipitocervical: The Prevalence and Associated Radiographic Features. European Spine Journal. 2009 June; 18 (6): 905-910.
> Strohl, Kingman P MD. Maitiro Okudzivisa Kubata Apnea muVakuru. Kusvika pari zvino. Yakaperedzwa June 24, 2016.
> Taylor-Gjevre, Regina M., Nair, Bindu V., naGjevre, John A. Kubvisa Apnea Yokurara Mukubatana neRheumatic Disease. Rheumatology (2013) 52 (1): 15-21.