Mishonga Inosanganisira Kutamba Kuzvidzivirira, Mishonga, uye Kuvhiya
Myasthenia gravis inokonzera musimba kushaya simba nekuda kwechirwere chemuviri chekuzvidzivirira neurotransmitter receptors pamasumbu emasumbu. Sezvo musumbu isingakwanisi kugamuchira mucherechedzo kune chikwangwani, vanhu vane myasthenia vanova vasina simba. Kunyange zvazvo chirwere ichi chinonzi neuromuscular disordination chinoshandiswa kugara chichigadzirisa uye kunyange chiuraye, zvino chinogona kutariswa nemishonga yakasiyana-siyana.
Kune nzira shanu dzese dzekurapa myasthenia gravis. Dzimwe nzira dzinoshandiswa zvakanyanya mumatambudziko akaoma kuitira kuti munhu agare kunze kwechikwata chekuchengetedza zvakanyanya, kunyange ichi ichiri dzimwe nguva chinodiwa mumamiriro ezvinhu akaoma. Zvimwe zvinoreva zvakanyanya kudzivisa matambudziko akadaro achiitika pakutanga - nzira yekudzivirira.
Dzivisa Matanho Kuvhara Kurwisa Kwangu
Nemhaka yokuti chirwere chinoputika, chinhu chipi nechipi chinokonzera masimba ezvirwere zvinogona kuwedzera kungozi yematambudziko epfungwa yangu, ine kuipa kwakanyanya kunogona kutumira mumwe munhu kune huru yekuchengetedza. Kucherechedza nekudzivisa chero chinokonzera chinhu chinonyanya kukosha mukutarisa chirwere. Semuenzaniso, kazhinji-inoshandiswa mishonga inonzi ciprofloxacin kana mamwe maantibioti , uye beta-blockers sepropranolol, lithium, magnesium, verapamil nezvimwe, zvinogona kukuvadza zviratidzo zve myasthenia gravis. Muzhinji, vanhu vane myasthenia vanofanira kuva vakangwarira vasati vatanga chero mishonga mitsva uye vanyatsocherechedza shure kwezviratidzo zvekushaya simba.
Kurapa Zviratidzo zveMyasthenia Gravis
Kushaya simba kwe myasthenia gravis kunoitika apo acetylcholine receptor inorwiswa nemasimba emuviri. Kuwedzera kwemari yeacetylcholine inowanikwa pakusanganiswa neuromuscular kunogona kukunda kukanganisa uku. Muviri unowanzotsanangurira acetylcholine kubva muchirwere chinoenderana nemakemikari anonzi acetylcholineterases.
Zvinodhaka zvinonzi cholinesterase inhibitors (izvo zvinoita kuti maitiro enzymes aya aite) zvinogona kuita kuti acetylcholine isara mu synapse kwenguva refu, ichibvumira kuti inonamatira kune zvinogamuchirwa zvinoratidza zvirwere kuti zvibvumirane.
Acetylcholinesterase inhibitors inosanganisira pyridostigmine (Mestinon), iyo ndiyo mishonga inoshandiswa mu myasthenia gravis. Zvimwe zvinosanganisa zvinosanganisira kubuda, kuputika, uye kuora mwoyo. Kutora mishonga nechingwa kunogona kubatsira kuderedza midzi iyi yemigumisiro. Zvinoshamisa kuti pane dzimwe nguva zvakanyanya kunyanya kushandisa anticholinesterase mishonga ine mhirizhonga yechirwere chekushaya simba, izvo zvingave zvakaoma kusiyanisa kubva ku myasthenia pachayo. Izvi hazviwanzoitiki kana pyridostigmine inoshandiswa mukati mekurudzirwa, asi.
Chronic Immunotherapy for Myasthenia Gravis
Vanhu vazhinji vane myasthenia gravis vanopedzisira vatora mishonga kuti vadzivirire zviratidzo kuti vasati vauye. Immunotherapy inorwisa maitiro anokonzera masimba anokonzera acetylcholine receptors. Nokuchinja maitiro ezvirwere zvemuviri, huwandu uye hutsinye hwekurwiswa kunoderedzwa.
Glucocorticoids yakadai sa prednisone inowanzoshandiswa kudzivisa maitiro ezvirwere zvevanhu. Zvimwe zvinogona kusanganisira cyclosporine, azathioprine, uye mycophenolate.
Zvose izvi zvinodhaka zvinogona kuve nemigumisiro, dzimwe dzese dzakanyanya kuoma. Njodzi dzemishonga dzinofanirwa kuongororwa zvakaenzana pamusoro pezvibatsiro zvishoma nezvishoma zvakanyanya kurwiswa kwemaasthenia.
Rapid Immunomodulating Zvirwere zveMyasthenia Gravis
Kunyange zvazvo zvirwere zvisingawaniki zvirongwa zvinoshandiswa kushanda kwenguva yakareba, mamwe mamiriro ezvinhu anoda chiito nokukurumidza. Muenzaniso ungadai uri dambudziko re myasthenic, kana kusati kwambovhiyiwa kana chimwe chiitiko chakakosha chaizotarisirwa kuti chiwedzere kuipa kwakadaro. Rapid immunotherapies inoshanda mukati memazuva, asi maitiro avo anongoguma kwemavhiki, uye ivo havawanzokurudzirwa kwenguva yakareba.
Plasma shanduko (plasmapheresis) inobvisa zvirwere zvinoparadzirwa. Izvi zvinodhura, uye zvinowanzoitika kanenge ka5 pane mazuva manomwe kusvika ku14. Zvinetso zvinogona kusanganisira arrhythmia, ropa remaitiro asina kukwana, maronda emasumbu, nezvimwe.
Intravenous immunoglobulin (IVIG) inowanzoratidzwa kuti inobatsira mune zvirwere zvinokonzerwa nehutachiona hwemotokari, asi kunyatsogadzirwa hakusi pachena. Mishonga inowanzosanganisira mazuva maviri kusvika mashanu ejojo. Zvimwe zvinowanzova zvinyoro asi zvinogona kusanganisira kusakundikana kwechirwere, meningitis , uye zvinokonzerwa nemagetsi.
Kurapa Kwokurapwa kweMyasthenia Gravis
Vanhu vazhinji vane myasthenia gravis vane chisingaoneki mumishonga yavo, muviri wechirwere chemuviri mujinga mehuro. Dzimwe nguva vanhu vane zviratidzo zvesimba zvinokurudzira kana kunyange kugadzirisa mushure mokunge thymus ibviswa mukati meitiro inonzi thymectomy. Hapana chivimbo chekudaro, zvisinei. Chimwe chikamu chepamusoro chevanhu vane myasthenia vane thymus tumor (thymoma), uye vanachiremba vanobvumirana kuti kuvhiyiwa kunoratidzwa munezviitiko. Kunyangwe iwe thymectomy inoratidzirwa pane dzimwe nguva haisi yakanyatsojeka, uye inofanira kukurukurwa neyeurologist pane imwe nyaya nemhosva.
Pasi Pasi
Myasthenia gravis chirwere chakakomba, asi kune dzakawanda nzira dzokurapa dzinowanikwa kune dzose mbiri dzinoderedza kusava nesimba kana zvichiitika uye kubatsira kuderedza kuwanda uye kuoma kwekurwiswa. Nemhaka yemigumisiro ine mishonga nemishonga yose, iyo nzira yekurapa inofanira kukurukurwa neyeurologist ine ruzivo rwakanaka rwemaastastia gravis uye zvingangodaro zvinetso.
Sources:
Adams naVictor's Principles of Neurology, 9th ed: The McGraw-Hill Companies, Inc., 2009.
Braunwald E, Fauci ES, et al. Harrison's Principles of Internal Medicine. 16th ed. 2005.
Sieb, JP (2014) Myasthenia gravis: chiitiko chechiremba. Clinical & Experimental Immunology 175 (3): 408-18.
ZVINOKUDZIDZA: Mashoko ari panzvimbo ino ndeongangwa dzekudzidzisa chete. Icho hachifaniri kushandiswa sechinzvimbo chekuchengetedza iwe pachako nechiremba ane chiremba. Ndapota ona chiremba wako kuti aongororwe uye kurapwa chero kupi zvako pamusoro pezviratidzo kana chirwere chechiremba .