Tophi inobatanidza sodium urate monohydrate makristasi ayo akaiswa mukati uye akapoteredza manotsi evanhu vane gout. Pane zvikamu zvitatu zvegout: asymptomatic (pasina zviratidzo) hyperuricemia , gout mukati (episodes yepamusoro gouty arthritis inogadziriswa neyeymptomatic times), uye chronic gouty arthritis. Icho chiri chikamu chechitatu, chisingaperi gouty arthritis, apo tophi inowanzoonekwa.
Tophi ingangodaro inenge ichifungidzirwa pakarepo apo acute gouty arthritis phase kunyange.
Apo Tophi Form
Munguva yenguva isingaperi gouty arthritis phase, hapana marwadzo asina-nguva. Nguva yakatarisana pakati pekutanga gout kushungurudzika kune asingagumi gouty arthritis phase nevephi inoratidzika inopararira mune zvidzidzo zvevarwere vasingateereri gout. Zvidzidzo zvekudzidza (Hench, P. et al.) Zvakaratidza kuti mavhareji yenguva kubva pakutanga gout attack kusvika pakutanga kwechirwere chisingaperi kana kukura kwevephi inowanikwa yaiva makore 11.6. Mune chidzidzo chinosanganisira varwere vanopfuura 1 100 gout primary, avo vasina tophi vakange vane serum urate mazana gumi 10.3 +/- 1.3 milligrams / deciliter. Vaya vane hofu yakakura yekurove vaiva neserum urate ye 11.0 +/- 2.0 milligrams / decilter.
Chikonzero nei Tophi Form
Muyero wekuti tophi unobatanidza correlates nekuoma uye nguva yehuwandu hwehutachiona. Tophaceous gout inowanzoitika nekuti muviri haugoni kubvisa urate nekukurumidza sezvaunogadzirwa.
Sezvo urate yakawandisa inounganidza, urate kristini mari inogona kuumba.
Kunyange zvazvo uwandu hweSerum urate ndihwo hukuru hunobatanidza ne tophi mazano, pane zvimwe zvinokonzera, zvinosanganisira: kutanga kwehutachiva, nguva yakareba yekushanda asi kusingateereri, mavhareji emakumbo mana gout gore negore, uye polyarticular kubatanidzwa.
Kubudirira kwekutanga kwetipi-kune vanhu vane gout kwemakore anopfuura gumi-kunoitika vanenge 15 muzana yevanhu. Creatinine chibvumirano chinhu chakazvimiririra chakave chakabatanidzwa nekutanga tophi kudzidzira.
Apo Tophi Form
Tophi inogona kuiswa mumusango, senovial membrane, tendon, uye tissue tissue. Kunyange zvazvo tophi inogona kuwanika chero kupi pamuviri, inowanzoonekwa muminwe, maziso, nzeve, mabvi, olecranon bursa, uye zvinokonzerwa nemafungiro (semuenzaniso, chikamu chechirume chemukoko, Achilles tendon). Mumuviri unobatanidza, tophi inogona kuwanika mumapiramidhi emapenzi, mapapiro emwoyo, uye sclera.
Tophi Maitiro
Tophi inoratidzika kusuruvara, zvisinei nokuti kuvhuvhuta kunogona kuitika kune avo. Ikoko kunogona kuparadzwa kwezvibatanidzwa uye kuora kunogona kuitika, kunyanya kwemaoko nemakumbo. Ganda rinorara pamusoro peti tophus rinogona kumira uye pakupedzisira ulcerate. Chinhu chakachena chine tsvina kana chikafu, chakakonzerwa nemakristal, chinogona kudzingwa kubva kuchilonda chinonzi tophus. Tophi inogona kuonekwa ne ultrasonography, MRI, uye CT scan. Mifananidzo yakawanda kwazvo ye tophi inobva CT scan.
Unhu hweHupenyu
Vatsvakurudzi vaifunga nezvekunakirwa kwe tophi uye kuwandisa kwemaitiro anonyanyisa gout pamusoro pehutano hwehutano hwehupenyu.
Chidzidzo ( Utano nehutano hwehupenyu hwehupenyu 2012) zvakabatanidza 620 varwere vane gout-self-report, 12.3 muzana yeavo vaifanira tophi. Ikoko kwakanga kwakaderera hutano hwehupenyu hwehupenyu hunobatanidza nekuvapo kwe tophi uye gout flares.
Shoko Rinobva
Nhamba ye serum urate ndiyo inokosha inobatanidza ne tophi maitiro. Vamwe vanhu vanoona gout kurwisa vanorega kuteerera panguva yechiratidzo chisina maturo pakati pekurwa. Asi, zvinokosha kutarisa uric acid maitiro nguva dzose. Zvakakosha kurapa gout uye kuedza kuzvichengetedza zvakanaka, kwete chete apo zviratidzo zviri pachena.
Kuvapo kwetipi kunobatanidzwa nehutsika hwehupenyu. Inofanira kunge iri chinangwa chekuedza kudzivirira tophi nokutarisa hyperuricemia uye gout zvakanaka.
> Sources:
> Dalbeth, Nicola, et al. Kugadziriswa kweKinininine Kuchengetedzwa Kunosanganiswa Nokukurumidza Kuvandudzwa kweTophi Subcutaneous muvanhu vane Gout. BMC Musculoskeletal Matambudziko. December 21, 2013.
> Hench, P. Kuongororwa kwegout uye gouty arthritis. J Lab Clin Med 220: 48-55. 1936.
> Khanna PP et al. Tophi uye Kakawandisa Gout Flares Vanobatanidza Nechirwere Chekuita Kwehupenyu Hwehupenyu, Kubudirira, uye Kuwedzerwa Kwehutano Hwokushandisa Zvishandiswa: Zviwanikwa Kubva kuChikamu-Chikamu Chekuongorora. Utano Nehutano hweHupenyu Zvibereko. Svondo 22, 2012.
> Primer paRheumatic Diseases. Arthritis Foundation. Rudzi rwechitatu. Peji 243.
> Kelley's Textbook of Rheumatology. Elsevier Saunders. Ninth Edition. Bhuku II. P.1558-1560.