May Me Also Apply to Ankylosing Spondylitis & Psoriatic Arthritis
Zvinonyatsozivikanwa kuti vanhu vane rheumatoid arthritis (RA) vari pangozi yakawanda yekuparara uye kufema kubva muhutano hwepfungwa-yengozi iyo inonzi inofananidzwa neicho kune vanhu vane chirwere cheshuga chechipiri. Muvanhu vane rheumatoid arthritis, kune ngozi yakawanda yekunyarara myocardial infarction (kurwisa kwemwoyo) uye kamwe kamwe rufu. Kuwandisa kwemyocardial infarction kunopfuura kaviri pane yakanyanya kune vanhu vane rheumatoid arthritis yakaenzana nehuwandu hwevanhu.
Ukama hunokonzera pakati pehutano hwehutachiona uye rheumatoid arthritis hwakaoma uye hunoratidzika kunge hune chokuita nezvinhu zvakawanda. Nzira dzepfungwa dzepfungwa dzepfungwa dzinokonzerwa nehutano (semuenzaniso, kuwedzera kwehutano, kuwedzera muviri, kusvuta, chirwere cheshuga, cholesterol yakakwirira), uyewo rheumatoid arthritis severity markers, zvinowedzera.
Mwoyo Mungozi muRheumatoid Arthritis: Zvatinoziva
Kwemakore mazhinji, vatsvakurudzi vave vachidzidza sangano uye kana kutarisirwa kwakakwana kunobhadharwa nemwoyo yehutano zvinhu mune vanhu vane maronda anokonzera arthritis . Izvo zvakatove zvataurwa kuti rhumatoid arthritis pachayo ndiyo yakazvimirira pangozi yehutano hwehutano. Zviwanikwa izvo vatsvakurudzi vakazvizivisa zvinosanganisira:
- Pane ngozi yakawandisa yehutano hwehutano hunoitika pakutanga kwechirwere chechirwere che rheumatoid arthritis, iyo inogona kutotanga kupera zuva.
- Kuvhiringidza kunoita basa rinokosha mukati mehutano hwepfungwa.
- Vanhu vane rheumatoid arthritis vanoita sevari kukurumidza kushaya atherosclerosis , iyo iyo pachayo inofungidzirwa sechirwere chinopisa. Zvichida kuti kupisa kwehutachiwana rheumatoid arthritis pamwe nehuwandu hwezvinyorwa zvinokonzerwa neprotofinimatory cytokines zvinobatsira pakuumbwa kwepakiti.
- Izvo zvinokonzerwa nekuputika kwerheumatoid arthritis kunobatsira pakuwedzera endothelial kusagadzikana , kushungurudzika kweiiiii , uye kushandiswa uye kubuda kweeukocytes (masero matsvuku eropa) mukati memidziyo yeropa. Kubata kwekaukocyte kuenda kune vascular endothelium ndiyo chiratidzo chekusiyanisa chekuvhiringidza.
- Kurwisana kunokonzerwa nehutachi hutachiona huchibatanidza nehutano hwemwoyo hunokonzerwa nehupenyu hunoita kuti uwedzere chirwere chepfungwa chepfungwa mu rheumatoid arthritis.
Nei Kutaurirana Kwacho Kwakakosha?
Inenge hafu yevose vanofa muvanhu vane rheumatoid arthritis inobatanidza nehutano hwepfungwa. Kufa kwepfungwa kunowedzera ne50 muzana uye ngozi yehutano hwemwoyo inowanikwa ne48 muzana kune avo vane rheumatoid arthritis kana vachienzaniswa nevanhu vazhinji (Avina-Zubieta).
Vanhu vane chirwere cherheumatoid kwenguva yakareba, avo vane zviratidzo zvekare (kureva, zvinokanganisa zvinopfuura mazangano chete), pamwe chete nevaya vane rhumumatoid uye anti-CCP (autoantibodies) vane ngozi yakanyanya yehutano hwehutano. Kutarisira dambudziko kunokosha.
EULAR Zvirongwa zvekutarisira Mwoyo Yehutano mu RA
Muna 2009, EULAR (yeEuropean Against Against Rheumatism) yakaunganidza boka rekuisa mazano ekugadzirisa mishonga yemwoyo muvanhu vane rheumatoid arthritis. Mazano acho akavandudzwa muna 2015/2016.
Pane mitemo mitatu yakatarisa inopiwa neEULAR-uye yegumi zvinokurudzirwa zvakapiwa, imwe yacho itsva uye matanhatu yakashandurwa kubva muna 2009.
Kukurukura Mazano:
1) Vanachiremba vanofanira kuziva nezvehutano hwepamusoro hwehutano hwehutano muvanhu vane rheumatoid arthritis vachienzaniswa nehuwandu hwevanhu.
2) Rheumatologist inofanirwa kuve nechokwadi chokuti hutano hwehutano hwehutano hunoitwa muhutatoid arthritis varwere nezvimwe zvirwere zvinoputira.
3) Kushandiswa kweNSAIDs (nonsteroidal anti-inflammatory drugs) uye corticosteroids inofanira kunge yakaenderana nemazano anobva kuEULAR uye ASAS (Kuongorora kweSpondyloarthritis International Society).
Zvinokurudzirwa 10 Zanganisira:
1) Chiito chezvirwere chinofanira kutarisirwa zvakanaka mu rheumatoid arthritis, ankylosing spondylitis , uye psoriatic arthritis kuitira kuti vaderedze ngozi yehutano hwehutano.
2) Kuongorora kwehutachiona hwehutachiona hunokurudzirwa kune avo vane rheumatoid arthritis, ankylosing spondylitis, kana psoriatic arthritis kamwe chete pamakore mashanu uye zvichida kutevera chero shanduko huru yekurapa.
3) Kuongororwa kwehutachiona hwehutano hwehutachiona muvanhu vane rheumatoid arthritis, ankylosing spondylitis, kana psoriatic arthritis inofanira kuitwa maererano nemitemo yenyika, uye SCORE CVD ngozi inofanirwa kutaurira muenzaniso kana pasina mirayiridzo iripo.
4) Kose cholesterol uye yakakura-simba lipoprotein cholesterol inofanira kushandiswa muhutano hwehutano hwehutamuidhi arthritis, ankylosing spondylitis, uye psoriatic arthritis uye lipids inofanira kuyerwa kana chirwere chekuita chichigadzikana kana mukuregererwa. Non-fasting lipids inogamuchirwa.
5) Utano hwehutano hwehutano hwakanaka hunofanirwa kuchinjwa kuvanhu vane rheumatoid arthritis nekuwedzera ne 1.5.
6) Kuongorora maitiro eatrosclerotic plaques usingashandisi inoshandisa carotid ultrasound inogona kuonekwa sechikamu chepfungwa dzehutano hwehutano kune avo vane rheumatoid arthritis.
7) Upenyu hukurudziro inofanirwa kunofanirwa kusimbisa kudya kwakakwana, kugara uchirovedza muviri, uye kusvuta kusvuta.
8) Mwoyo wehutachiona hwehutachiona hunofanira kuitirwa maererano nemitemo yenyika ye rheumatoid arthritis, ankylosing spondylitis, uye psoriatic arthritis. Anti-hypertensives nemasimoni zvinogona kushandiswa sezvavari muhuwandu hwevanhu.
9) NSAID dzinofanirwa kurongerwa nekuchenjerera rheumatoid arthritis uye psoriatic arthritis, kunyanya kune vanhu vane hutano hwehutano hwemwoyo kana kuti vanoziva ngozi.
10) Nokurapa kwenguva yakareba, chirwere che corticosteroids chinofanira kuchengetedzwa pasi uye chinofanirwa kuchinjwa kana kuregererwa kana kuti chirwere chepasi chinowanikwa. Kuenderera mberi kwe corticosteroids kunofanirwa kuongororwa nguva dzose.
Zvitsvakurudzo Zvakawanikwa Mukuratidza Gore ra2016 ACR Musangano
Pamusangano wegore negore weAmerican College of Rheumatology, yakagadzirirwa munaNovember 2016, pakanga paine zvidzidzo zvitatu zvakapiwa izvo zvaiva nehutano hwemwoyo mu rheumatoid arthritis. Chimwe chezvidzidzo (chinyorwa ID: 664363 ACR Newsroom) chakagumisa kuti kwemakore gumi nemashanu, vanhu vane rheumatoid arthritis vane kaviri kungozi yezviitiko zvepfungwa sezvakawanda vanhu-chiyero chakafanana nechipiri cheshuga cheshuga.
Chimwe chidzidzo (chinyorwa ID: 663451 ACR Newsroom) yakaongororwa kuti vanhu vane chirwere chinonzi rheumatoid arthritis asi hapana anozivikanwa nehutano hwepfungwa ine uchapupu hwemyocardial kuvhiringidzika. Vakatarisawo kana kuputika kwemyocardial kwakaitwa kurapwa neDMARDs (zvirwere-kuchinja anti-rheumatic drugs) . Vatsvakurudzi vakagumisa kuti pane yakaonekwa seine myocardial kuvhiringidza uye yakaratidzika seyopindura kurapwa neDMARDs.
Chidzidzo chechitatu (chinyorwa ID: 664367 ACR Newsroom) chakanyanyisa kune kutungamirirwa kwehutano hwemwoyo muvanhu vane zvirwere zvinoputika. Izvo zvakagumiswa kuti pasinei nekuwanika kwehutachiona hwehutachiona hwehutachiona uye hwemapidhi, kunodarika huwandu huwandu hwevarwere hunorayirwa madhiragi.
The Bottom Line
Kwekureba kwenguva refu, kuwedzera kwehutano hwehutano hwemwoyo muvanhu vane rheumatoid arthritis kwave kuchikanganwa uye inotarisirwa pasi. Ngozi inokonzerwa nehuwandu hwehutachiona, kunyanya kudha, kusvuta, uye dyslipidemia, pamwe chete nekuvhiringidza kunoitwa mu rheumatoid arthritis, hakufaniri kuregererwa. Pane chido cherheumatology uye vanachiremba vanonyanya kushandiswa kushanda pamwe chete kuti varware mishonga yehutano zvinokonzera uye zvirwere zvepabonde zvine chokuita nerheumatoid arthritis.
Kunyange zvazvo kutsvakurudza kwave kwakaratidza kukosha kwekutarisana nehutano hwemwoyo hunobatanidza ne rheumatoid arthritis, kunyanya kutsvakurudza kunodiwa. Zvirongwa zvinorondedzerwa zvinorapwa zvinoramba zvichiri kushayikwa. Izvo zvinoramba zvichiri kudiwa kwemamwe mazano akajeka ekugadzirisa zvakakonzerwa nengozi yehutano hwehutano kune vanhu vane rheumatoid arthritis kana zvimwe zvirwere zvinoputika zvinoputika.
> Sources:
> Agca R. et al. EARAR mazano ekurapa kwepfungwa chirwere chekuchengetedza njodzi kune varwere vane rheumatoid arthritis uye mamwe maitiro ekuvhiringidza kwekubatana: 2015/2016 update. Annals weRheumatic Diseases . October 2016.
> Barber CE et al. Zvipingamupinyi Mukutaura Nezvemwoyo Mungozi muRheumatoid Arthritis: Kuongorora Kushanda Kushandisa Kushandiswa Kwemakirini Emwoyo. Nyaya yeRheumatology . November 2016.
> Soromoni DH et al. Kutsanangura mungozi yemwoyo inosanganisira rheumatoid arthritis: tsika dzenjodzi dzinokonzera kuve zviratidzo zve rheumatoid arthritis severity. Annals weRheumatic Diseases . November 2010.
> Tournadre, Anne et al. Kutarisana nehutano hwemwoyo kune varwere vane chirwere chinoputira arthritis: mazano anobatsira. Kurapa Kwokurapa muMusculoskeletal Disease . 2016.
> van-Breulelen-van der Stoep DF et al. Dambudziko rehutano muhutachi hutachiona: ungadzikisa sei ngozi? Atherosclerosis . November 2013.