Raynaud's Phenomenon Inotsanangurwa
Raynaud's phenomenon chirwere chinosangana nemidziyo yeropa muminwe, zvigunwe, nzeve, nemhino. Ichi chirwere chinoratidzirwa nekurwiswa kwepisodic, kunonzi vasospastic kurwisa, izvo zvinokonzera mishonga yeropa mumitauro (zvigunwe nezvigunwe) kuti zvive zvishoma (zvishoma). Raynaud's phenomenon inogona kuitika pachayo, kana inogona kuva yechipiri kune dzimwe mamiriro.
Kunyange zvazvo kuongororwa kunopesana, kuongororwa kwemazuva ano kunoratidza kuti chiitiko chaRaynaud chingakanganisa 5 kusvika ku10 muzana yevanhu vakawanda muUnited States. Vakadzi vane huwandu kupfuura varume kuti vave nechirwere. Raynaud's phenomenon inoratidzika kuva yakajairika kune vanhu vanogara munzvimbo dzakaoma. Zvisinei, vanhu vane chirwere chinorarama munzvimbo dzakashata zvinogona kuve nekurwiswa kwakawanda panguva dzekunaya kwemamiriro okunze.
Chii Chinoitika Panguva Yechirwere?
Kune vanhu vakawanda, kurwiswa kunowanzokonzerwa nekuratidzwa kunotonhora kana kushungurudzika mupfungwa. Kazhinji, kutambudza kunobata zvigunwe kana zvigunwe asi zvinogona kukanganisa mhino, miromo, kana nzeve yelobe.
Kuderedza Kuwedzerwa Ropa kuDambudziko
Kana munhu achinzwa kutonhora, muviri unowanzopindurwa ndedze kutapudza kurasikirwa kwehuni uye kuchengetedza ushu hwayo hunhu. Kuti uchengetedze kutonhora uku, mishonga yeropa iyo inodzora ropa ichiyerera kusvika paganda rinoshandura ropa kubva mumaritiro pedyo nepamusoro kusvika kumavheiri ari mukati memuviri.
Kune vanhu vane Raynaud's phenomenon, ichi chimiro chechimiro chechimiro chinowedzera chichimbomira nekudzvinyirira kwepasmodic kamwechete kwemiduku midzi yeropa inopa ropa kuminwe nezvigunwe. Mishonga yeminwe nezvigunwe zvinogonawo kuparara. Somugumisiro, ropa rinopera kumigumo rakaderera zvikuru, zvichiita kuti zvigadziriswe zvinosanganisira kugadzirwa kweganda uye zvimwe zvinoshanduka.
Kuchinja Muganda Muvara uye Kunzwa
Kamwe apo kurwiswa kunotanga, munhu angatora zvikamu zvitatu zvemuvara weganda (kuchena, bhuruu, uye tsvuku) muminwe kana zvigunwe. Mutemo wekuchinja kwemuvara hausi wakafanana kune vanhu vose, uye kwete munhu wose ane mavara ose matatu.
- Pallor (kuchena) kunogona kuitika mukupindura kupera kwe arterioles uye kuparara kwekupedzisira kwemajetari ejjita.
- Cyanosis (blueness) inogona kuonekwa nokuti minwe kana zvigunwe hazviwanikwi ropa rakakwana re-oxygen.
Zvigunwe kana zvigunwe zvingave zvakare zvinonzwa zvakaneta uye zvisina simba. Pakupedzisira, sezvo arterioles ichiwedzera uye ropa rinodzokera kumajeri, kubwinya kunogona kuitika. Sezvo kurwisa kuri kuguma, kuputika uye kurira kunogona kuitika muminwe nezvigunwe. Kurwisa kunogona kupera kubva pasi pemaminitsi kusvika maawa akawanda.
Phenomenon yaRaynaud akadaro sei?
Vanachiremba vanorondedzera chiitiko chaRaynaud sechinangwa chekutanga kana chechipiri . Mumabhuku ekurapa, "chinonyanya kuitika raRaynaud" chinogonawo kunzi:
- Raynaud's disease
- Idiopathic Raynaud's phenomenon
- primary Raynaud's syndrome
Izwi rokuti idiopathic uye chekutanga rinoreva kuti chikonzero hachizivikanwi.
Primary Raynaud's Phenomenon
Vanhu vazhinji vane Raynaud's phenomenon vane fomu yepamusoro (iyo yakaipa version).
Munhu ane chinangwa chikuru chaRaynaud haana chirwere chepfungwa kana zvinetso zvoutano zvine chokuita. Vakadzi vakawanda kupfuura varume vanobatwa, uye inenge 75% yezviitiko zvose inowanikwa mune vakadzi vari pakati pemakore 15 ne40.
Kutsvakurudza kunoratidza kuti vanhu vanopfuura 10% vane vasospastic chete vanorwisana kwemakore akawanda, pasina kushandiswa kwemamwe masangano emuviri kana nhengo, zvisingawanzove kana kuti dzichakura nechirwere chechipiri gare gare.
Secondary Raynaud's Phenomenon
Kunyange zvazvo ruzivo rwechirwere raRaynaud rusingawanzozivikanwi kupfuura ruzivo rwekutanga, inowanzova chirwere chakaoma uye chakakomba. Sekondari zvinoreva kuti varwere vane chirwere chakakosha kana kuti chinokonzera Raynaud's phenomenon.
Zvirwere zvinokonzerwa nehutachiona ndizvo zvinowanzokonzera shanduko yechipiri raRaynaud. Zvimwe zvezvirwere izvi zvinoderedza ropa richiyerera kusvika kumajairiri nekukonzera ropa remadziro masvingo kuvhara uye midziyo inowedzera nyore nyore. Raynaud's phenomenon inowanikwa kune varwere vane:
- scleroderma (inenge 85%)
- akabatana nehutachiona hwehutachiona (anenge anenge 85%)
- lupus (systemic lupus erythematosus) (inenge 33%)
Raynaud's phenomenon inogonawo kuitika kune varwere vane zvimwe zvirwere zvinokonzera mishonga , kusanganisira:
- Sjögren's syndrome
- dermatomyositis
- polymyositis
Zvimwe zvikonzero zvinokonzerwa nechirwere chechipiri chaRaynaud, kunze kwezvirwere zvinogadzirisa zvirwere, ndezvi:
- carpal tunnel syndrome
- kubvumira arterial disease
- zvimwe zvinodhaka (zvakadai se beta-blockers, ergotamine kugadzirira, vamwe chemotherapy agents)
- zvinodhaka zvinokonzera vasoconstriction (zvakadai sevamwe vanopfuura-the-inotonhora mishonga uye narcotics)
- vanhu mune mamwe mabasa (zvakadai sevashandi vanobudiswa kune vinyl chloride kana vashandi vanoita zvishandiso zvinodhira)
Vanhu vane ruzivo rwechipiri raRaynaud vanowanzoona zvinetso zvehutano zvakabatanidzwa. Zvinetso zvakakomba zvipembenene zveganda kana chirwere muminwe kana zvigunwe. Zvironda zvinorwadza uye zvipembenene zvinowanzojairika uye zvinogona kuva zvakaoma kurapa. Kushaya simba mumutsipa wehutachiona kunogona kukonzera kuora mwoyo kana kuoma mukugedza.
Kana chiremba achifungidzira chiitiko chaRaynaud, iye achakumbira murwere kuti ave nehuwandu hwezvokurapa. Chiremba achazoongorora murwere kuti atonge zvimwe zvinetso zvehutano. Murwere angangodaro aine kuurayiwa kwevasospastic panguva yekushanya kwehofisi, izvo zvinoita kuti zvive nyore kuti chiremba aongorore ruzivo rweRaynaud. Vanachiremba vazhinji vanozviona zviri nyore kuti vaongorore chiitiko chaRaynaud asi zvakanyanya kuoma kuziva chimiro chechirwere.
Zviratidzo Zvokuziva Kuda kweRennaud's Phenomenon
Vanachiremba vanoshandisa imwe nzira yekuongororwa kuti vaongorore hurumende yekutanga kana yechipiri Raynaud's phenomenon.
Zvinokonzerwa: Primary Raynaud's Phenomenon
Zviratidzo zvekuongorora zvinoshandiswa kuongororwa nheyo yekutanga raynaud inosanganisira:
- Periodic Vasospastic kurwisa kwepallor (kuchena) kana cyanosis (blueness) (Cherechedza: vamwe vanachiremba vanosanganisira chikonzero chekuwedzera kwekurwisana uku kwemakore maviri)
- Kazhinji maruva nailfold capillary pattern
- Negative antinuclear antibody test (ANA)
- Kazhinji erythrocyte sedimentation rate (ESR)
- Kusabatwa kwepitting zvipembenene kana zvipembenene zveganda, kana chirwere chinouraya (mhuka dzorufu) muminwe kana zvigunwe
Zvinokonzerwa: Secondary Raynaud's Phenomenon
Zviratidzo zvekuongorora zvinoshandiswa kuongorora ruzivo rwechipiri raynaud zvinosanganisira:
- Periodic vasospastic kurwisa kwepallor (kuchena) uye cyanosis (blueness)
- Abnormal nailfold capillary pattern
- Positive antinuclear antibody test (ANA)
- Izvo zvisina kufanira erythrocyte sedimentation rate (ESR)
- Kuvapo kwepitting zvipembenene kana zvironda zveganda, kana chigunun'una muminwe kana zvigunwe
Miedzo yekuongorora kuRennaud's Phenomenon
Chiverengero chekuongorora zvirwere chinogona kurairwa nachiremba wako kuti abatsire kusimbisa kuonekwa kwaRaynaud.
Nailfold Capillaroscopy
Nailfold capillaroscopy (kuongorora magadzirirwo eplassiki pasi pe microscope) inogona kubatsira chiremba kusiyanisa pakati pekutanga uye yechipiri Raynaud's phenomenon.
Pakati pomuedzo uyu, chiremba anoisa donhwe remafuta pamapuranga emurwere, ganda riri pasi pekona. Chiremba anobva aongorora mapepa echipiki pasi pe microscope kuti aone kusakanganiswa kwemidziyo miduku yeropa inonzi capillaries. Kana iyo capillaries ikawedzerwa kana yakaremara, murwere angave ane chirwere chinokonzera maronda.
Chiremba anogonawo kuronga zviratidzo zviviri zvekutsvaga ropa , antinuclear antibody test (ANA) uye erythrocyte sedimentation rate (ESR).
Antinuclear Antibody Test (ANA)
Chirwere chinonzi antinuclear antibody test (ANA) chinosarudza kana muviri uri kubudisa mapuroteni chaiwo (zvirwere) zvinowanzowanikwa kune vanhu vane zvirwere zvinokonzera mishonga kana zvimwe zvinetso zvekudzivirira. Varwere vane zvipembenene izvi zvinokonzera mishonga kana zvimwe zvirwere zvinokonzerwa nemagadzirirwo ega, vanoita zvirwere kumusana, kana kuti nzvimbo yekuraira, yemasero emuviri. Izvi zvinonzi antibodies zvinonzi antitinuclear antibodies uye zvinoedzwa kuburikidza nekuisa ropa revarwere serum pane microscope slide ine masero anoonekwa nuclei. Chimwe chinhu chine dhayi re fluorescent inowanikwa iyo inosungirirwa kumasimba. Pasi pikroscope zvisizvo zvisingazivikanwi zvirwere zvinogona kuonekwa zvakasungirirwa kune nuclei.
Erythrocyte Sedimentation Rate (ESR)
The erythrocyte sedimentation rate (ESR) chirwere chekuongororwa chekuputika.
Chiyero che erythrocyte sedimentation (ESR) chiyero chekuputika mumuviri uye chinotarisa kuti masero matsvuku eropa anotsvaga sei pasina ropa risina kukwana nokuyera muyero apo masero matsvuku eropa anowira pasi pebhubhu munguva. Chiwedzerwa chekuita sediment chinowirirana nekuwedzera kwekusavhiringidza kwakakwana mumuviri. Inowanzozonzi "sedrate" kwenguva pfupi.
Cold Stimulation Test
Chirwere chinokurudzira kuedza ndechimwe chiedzo icho chiremba wako angashandisa kuti aongorore hurumende yaRaynaud. Chirwere chekutsvaira chinotonhora chinoyera kutonhora kwemunwe mumwe nomumwe mushure mokunge uchinge wakanyura mumvura yakashambidzwa nemvura.
Simba inopisa inonamatira kuminwe yako uye kutonhora kunyorerwa kusvikira ushuhuro hwemunwe wako huchienzanisa zvakafanana uye hwakanga huripo huchiiswa mumvura yakashambidzwa nemvura.
Ndeipi tsvakurudzo iri kuendeswa kubatsira vanhu vane Raynaud's Phenomenon?
Vatsvakurudzi vari kudzidza nzira dzekunyatsoongorora hutano hwaRaynaud uye vanofanotaura uye vanocherechedza mararamiro ayo nekubatana nedzimwe zvirwere. Vari kuongororawo kushandiswa kwemishonga mitsva yekuvandudza kuteura ropa muRaynaud's phenomenon. Vatsvakurudzi mu scleroderma nezvimwe zvirwere zvinogadzirisa zvirwere zviri kuongorora zvakare raRaynaud senyaya maererano nezvirwere izvi.
Zvinangwa zvekurapa ndeyokuderedza nhamba uye kuoma kwekuzvidzivirira nekudzivirira kukanganisa kwemhuka uye kurasikirwa muminwe nezvigunwe. Vanachiremba vazhinji vanochengeteka mukurapa varwere vane chinangwa chekutanga uye chechipiri Raynaud's phenomenon; kureva kuti, vanorayira kwete mushonga wezvinodhaka uye maitiro anobatsira kutanga.
Vanachiremba vanokwanisa kupa mishonga kune vamwe varwere, kazhinji avo vane ruzivo rwechipiri raRaynaud.
Mukuwedzera, varwere vanorapwa nokuda kwechipi nechipi chinokonzera chirwere kana chiitiko chinokonzera ruzivo rwechipiri raRaynaud.
Zvisiri-Zvinodhaka Mishonga uye Mazano Okuzvibatsira
Mishonga yakasiyana-siyana yezvinodhaka uye maitiro ekuzvibatsira anogona kuderedza kusuruvara kwekurwiswa kwaRaynaud uye kukurudzira hupenyu hwakanaka.
Tora Gadziriro Panguva Yokurwisa:
Kurwisa hakufaniri kuregererwa. Kureba kwayo nekuoma kunogona kuderedzwa nezviito zvishoma zvishoma. Chinhu chekutanga uye chinonyanya kukosha ndechekudziya maoko kana tsoka. Muchitonhora mamiriro okunze, vanhu vanofanira kupinda mumba. Kumhanyira mvura inodziya pamusoro peminwe kana zvigunwe kana kuidya mumudziyo wemvura inodziya kuchavadziya. Kutora nguva yekuzorora kunowedzera kubatsira kubvisa kurwisa. Kana mamiriro ezvinhu anokonzera kukonzera kukanganisa, munhu anogona kubatsira kubvisa kurwisa nekubuda kunze kwezvinetso zvinotambudza nekuzorora. Vanhu vakarovedzwa mu biofeedback vanogona kushandisa nzira iyi pamwe nekudziya maoko kana tsoka mumvura kuti vabatsire kuderedza kurwisa.
Dziirwa:
Zvakakosha kwete chete kuchengetedza mhedzisiro inopisa asiwo kudzivisa kubvisa chikamu chipi zvacho chemuviri. Munguva inotonhora, vanhu vane Raynaud's phenomenon vanofanira kunyatsoteerera kupfeka.
- Zvikamu zvakasiyana zvezvipfeko zvakasvibiswa, masokisi, hats, uye magirafu kana mittens zvinokurudzirwa.
- Hasha yakakosha nokuti huwandu huzhinji hwehuviri hunoparara kuburikidza nekwakanda.
- Mapazi anofanira kuchengetwa akaoma uye achinaya.
- Vamwe vanhu vanozviona zvichibatsira kupfeka mittens uye masokisi kurara munguva yechando.
- Makemikari anodziya, zvakadai semidziyo midzi inopisa inogona kuiswa muhomwe, mittens, bhoti, kana shangu, inogona kupa kudzivirirwa kwakawedzerwa munguva refu kwenguva refu.
Vanhu vane Raynaud's phenomenon vanofanirawo kuziva kuti mafungiro emhepo anogona kukonzera kurwiswa. Kuvhara mamiriro emhepo kana kupfeka jira kunogona kubatsira kudzivirira kutambudzwa. Vamwe vanhu vanoonawo kuti zvinobatsira kushandisa magirazi ekunwa asingasviki uye kuisa magirafu vasati vatora mazhenje kana kuti friji yezvokudya.
Rega Kusvuta:
Iyo nicotine mumidzanga inokonzera kutonhora kweganda kudonha, izvo zvinogona kutungamirira kukurwisa.
Kuderedza Kushungurudzika:
Kudzvinyirira mupfungwa kunokosha. Kushungurudzika uye kushungurudzika mupfungwa kunogona kukonzera kurwiswa, kunyanya kune vanhu vane ruzivo rweRaynaud, kudzidza kuziva nekudzivisa mamiriro ekumanikidzwa kunogona kubatsira kudzora nhamba yekurwisa. Vanhu vazhinji vakaona kuti kurasikirwa kana kuti biofeedback kurovedza kunogona kubatsira kuderedza nhamba nekuoma kwekurwisa. Biofeedback kurovedza kunodzidzisa vanhu kuunza kutonhora kweminwe yavo pasi pekuzvidira.
Dzidzira:
Vanachiremba vazhinji vanokurudzira varwere vane Raynaud's phenomenon, kunyanya fomu yekutanga, kushandisa nguva dzose.
Vanhu vazhinji vanoona kuti kurovedza muviri:
- inokurudzira hupenyu hwakanaka
- inowedzera simba
- inobatsira kudzora uremu
- anokurudzira kurara
Iwe unofanira kugara uchitaura nachiremba wako usati watanga chirongwa chekuvhiya. Vanhu vane ruzivo rwechipiri raRaynaud vanofanirawo kutaurirana navanachiremba vasati vaita kunze kunze kwechando mumamiriro okunze.
- Kudya / Kuita muviri
Ona Daktari Wako:
Vanhu vane ruzivo rwaRaynaud vanofanira kuona vanachiremba kana vakanetseka kana kutya nokuda kwekurwiswa kana kana vane mibvunzo pamusoro pekuzvitarisira ivo pachavo. Vanofanira kugara vachiona vanachiremba kana kurwisana kunoitika kune rumwe rutivi rwomuviri (rumwe rutivi kana rutsoka rumwe) uye chero nguva kurwisa kunokonzera zvironda kana zvionda paminwe kana zvigunwe.
Chirapa Nemishonga
Vanhu vane ruzivo rwechipiri raRaynaud ndivo vanowedzera kune avo vane maitiro makuru ekurapwa nemishonga.
Vanachiremba vazhinji vanotenda kuti zvinonyanya kushandiswa uye zvakachengeteka zvinodhaka ndeye calcium-channel blockers, iyo inozorodza kusvibiswa kwemisisita uye inoderedza midziyo miduku yeropa. Iyi mishonga inoderedza kuwanda uye kuoma kwekurwiswa kunenge ma 65% evarwere vane ruzivo rwekutanga uye rwechipiri Raynaud's phenomenon. Iyi mishonga inogonawo kubatsira kuporesa zvipembenene zveganda paminwe kana zvigunwe.
Vamwe varwere vakawana zororo nemishonga inonzi alpha blockers inopesana nezviito zve norepinephrine, hormone inotakura midziyo yeropa. Vamwe vanachiremba vanopa mishonga inoderedza midziyo yeropa, yakadai se nitroglycerine paste, iyo inoshandiswa kuminwe, kubatsira kuporesa zvipembenene zveganda. Kakawanda, varwere vane chikwata chechipiri havazopinduri pamwe nekurapa sevaya vane maitiro ekutanga kwechirwere.
Varwere vanofanira kuchengeta mupfungwa kuti kurapa kwaRaynaud's phenomenon hakusi kubudirira nguva dzose.
Kunobva:
NIH Publication Nha. 01-4911