Indlela yokuzivocavoca kunye ne-Rheumatoid Arthritis Treatment Unokunceda
Unokufumana i-term sarcopenia xa ufunda ngesifo se-rheumatoid arthritis. Yona yintoni enye i-sarcopenia, kwaye kutheni ufanele ukhathazeke ngako? Ziziphi na amanyathelo onokuzithatha ukunceda ukulungisa?
Yintoni i-Sarcopenia?
Ngokuqhelekileyo, i-sarcopenia yimeko edala ukulahlekelwa kakubi kwezicubu zomzimba zesisu. Inokuthi ithathelwe ingqalelo uhlobo oluthile lokuxhatshazwa kwemisipha .
Abaphengululi bokuqala basebenzisa eli gama ukuchaza ukuxhatshazwa kwemisipha eyenzeka ngexesha lokuguga ngokuqhelekileyo kodwa kungekudala, abanye baye baqalisa ukusebenzisa igama ukuchaza ukuchithwa kwemisipha engabangela okanye ibuhlungu kakhulu kwiimeko ezithile zonyango, ezifana nesifo se-rheumatoid arthritis . Xa kuthelekiswa nabantu abangenayo i-arthritis ye-rheumatoid, abantu abane-arthritis ye-rheumatoyi banokuthi bafumane ubunzima bokulahleka kwemisipha eyenzeka ngaphambili kwimpilo. Ngamanye amaxesha ibizwa ngokuba yi-rheumatoid sarcopenia.
Usetyenziso lweMisipha eqhelekileyo
Usebenzisa imisipha yamathambo ukuze wenze ukunyakaza okuzithandela kwezitho zakho, i-torso, kunye nezinye iindawo zomzimba wakho. Ezi zihlunu ze-squelettes zakhiwa ngamafayili omzimba omdala. Ezi zixhobo ziqulethe iiprotheyini ezikhethekileyo ezinokutsalana ngokumelanayo ukuze zinciphise iintlobo, okanye ziphumle ukuze izihlunu zide. Bayasabela kwiimpawu ezisuka kwi-neurons (kwaye ekugqibeleni ukusuka ebuchosheni) ukuvumela ukuba uthumele umzimba wakho.
Ezinye iiseli ezisisigxina zisebenza ukulungisa iingubo eziqhelekileyo kunye nokugqabhuka kwiisisipha ze-muscle, ngoko ayihlaziyi ixesha.
Iinguqu kwiSarcopenia
Kwi-sarcopenia, utshintsho oluninzi luvela ngaphakathi kwe-muscle:
- Ezinye zeemfayili ze-muscle ziqala ukuhlaziywa.
- Ezinye iimbumba ze-muscle zilahlekelwa ukuxhamla kwazo kwi-neurons.
- Iimfayili zomzimba zinciphisa ngobukhulu obukhulu.
- Iifayili zomzimba zinciphisa kwinani elipheleleyo.
- Ezinye zeeprotheni ezisetyenziselwa ukunyakaza kwemisipha ziqala ukudiliza, kwaye iinkqubo zokulungiswa kwamaseli azisebenzi kakuhle ukuzilungisa.
- Ezinye iifayili zomsila zingathatyathwa ngamathambo enqatha.
Iingxaki ezivela eSarcopenia
Ngenxa yento yonke, i-muscle iba yincinci. Akumangalisi ukuba oku kungakhokelela kwiinkalo ezininzi, kubandakanywa oku kulandelayo:
- Ukunciphisa amandla omzimba
- Ukukhubazeka okukhulu
- Ukwanda kwetyala
- Ukunciphisa ubuninzi bomgangatho wobomi
- Uhlalutyo olubi
- Ukongeza umngcipheko wokuwa kwezulu (okungasongela ubomi)
Yintoni eyenza uSarcopenia?
I-Sarcopenia iyenzeka njengenxalenye yokuguga, kwanabantu abangenayo i-rheumatoid arthritis. Ngomnyaka weshumi elinesibhozo wobomi, abantu abaninzi baye balahlekelwa kuma-50 ekhulwini kwi-mass mass. Izinto ezininzi ezahlukeneyo zinokudlala indima kule lahleko, kuquka:
- Iyancipha kwiirmone ezithile
- Iiphysical physiology
- Inani elinciphile leeseli ezinama-muscle
- Ukungondleki kwesondlo
- Umsebenzi owenziwe owenziwe ngomzimba
- Ukwanda kwesifo esingapheliyo
Ukuvuvukala okubangela i-Sarcopenia kwi-Rheumatoid Arthritis
Ukuvuvukala kukubaluleke kakhulu okubalulekileyo kwe-sarcopenia kubantu abane-arthritis ye-rheumatoid. Ngexesha lokuvuvukala, amaseli athile omzimba omzimba omzimba akhulula ama- cytokines avuzayo .
Ezi ziimpawu zeempawu ezicacileyo ezenza impendulo yokuvuvukala emzimbeni. Le mpendulo ixanduva elincinci lokunciphisa ubunzima besisu obufumaneka kubantu abadala.
Kwi-rheumatoid arthritis, le mpendulo yokuvuvukala iphakanyisiwe. Amaseli omzimba omzimba akhulula iiptotokines ezinokutsha ezifana ne-interleukin 6 (IL-6) kunye ne-tumor necrosis factor-α (TNF-α). Ekugqibeleni, la ma-cytokines anceda ukuphazamisa iimpawu zesifo se-rheumatoid njenge-arthritis njengentlungu kunye kunye nokuvuvukala. (Kungenxa yoko ezinye iziyobisi ezisetyenziselwa ukuphatha i-rheumatoid arthritis, njenge- TNF-inhibitors , zenzelwe ukunceda ukuvimba ezi cytokines.)
Ezi i-cytokines ezivuthayo zinezinye iziphumo, kuquka ukunyuka kwama-muscle. Yingakho abantu abane-arthritis ye-rheumatoid banokuthi babe ne-sarcopenia yangaphambili kunye ne-sarcopenia enamandla. Phakathi kwezigulane ezine-arthritis ye-rheumatoid, abantu abanamazinga aphezulu ale cytokines ezinobungcipheko banomngcipheko omkhulu wokuba ne-sarcopenia kwaye banciphisa amandla angama-muscular.
Ezinye izinto ezibangela i-Sarcopenia kwi-Rheumatoid Arthritis
Ubuhlungu ngokwawo yinto enye eyona nto ibangela ukwanda kwe-sarcopenia kubantu abane-arthritis ye-rheumatoid. Ukuba ungeyintlungu engapheliyo kunye nobunzima obuvela kwi-arthritis yakho ye-rheumatoid, unokuphepha into eyenziwa ngumzimba eyonakalisa le mpawu. Emva kwexesha oku kunokubangela uhlobo lwe-atrophy ye-muscle ebizwa ngokuba yi- atrophy . Ukubeka nje, oku kunciphisa ubukhulu besisu obuya kwenzeka xa i-muscle ingayitholi umzimba.
Abantu abane-arthritis ye-rheumatoid esebenzayo bangaphinda basebenzise iiprotheyini ezininzi kunye neekhalori ngaphezu kwesiqhelo ngenxa yesifo sabo. Ekubeni iprotheni iyadingeka ukugcinwa kwemisipha, oku kungonakalisa i-rheumatoid sarcopenia.
Ukuxilongwa kwe-Rheumatoid Sarcopenia
Buza ugqirha wakho ukuba unenkxalabo malunga nokunciphisa amandla emisipha ngenxa yesifo se-rheumatoid arthritis. Ugqirha wakho angasebenzisa iimvavanyo ezahlukeneyo ukuze abone ukuba unayo i-sarcopenia. Ezi ziquka oku kulandelayo:
- Uvavanyo lweBIA (uhlalutyo lwe-impedance ye-bioelektrical impedance)
- Uvavanyo lwe-DEXA (i-extra-energy-ray-ray absorptiometry)
- Uvavanyo lokuvavanya amandla omzimba kunye nokusebenza komzimba jikelele
I-BIA inguvavanyo olungenakuvakalayo olusebenza ngokuthumela iqondo eliphantsi kakhulu elingaphantsi komzimba. Iindidi ezahlukileyo zezicubu zinciphisa ukuhamba kumagangatho ahlukeneyo. Ngokusekelwe ekumeni okubalwe kulolu hlobo lokuhamba kombane, ochwepheshe angalinganisa ixabiso elibizwa ngokuthi "i-fat-free-mass" (FFM) engasetyenziselwa ukuhlola ubunzima bomzimba.
Enye inketho kuvavanyo lwe-DEXA (oluqhelekileyo lisetyenziselwa ukuhlola i-osteoporosis). Olu lunye luvavanyo olungenalubuhlungu olusebenzisa i-X-ray kunye neqondo eliphantsi kakhulu lombane. Kule meko, ingasetyenziselwa ukubala ixabiso elibizwa ngokuba ngumzimba omzimba (LBM), omnye umlinganiselo wesistim.
Ugqirha wakho unokucela ukuba wenze imisebenzi eyahlukeneyo, njengokuhamba ngokukhawuleza okanye ukucima ifowuni yesandla.
Qaphela ukuba abantu abane-sarcopenia ye-rheumatoid abayi kulahlekelwa ngumzimba wonke. Kwi-rheumatoid sarcopenia, inxalenye yefayili yamaprotheni ayinokuthi ithatyathelwe ngamatye. Ngenxa yoko, ubunzima bungenakuguqulwa kakhulu, nangona umntu sele elahlekelwe yimisipha yomzimba. Yingakho i-index ye-mass mass (BMI) ayilona vavanyo oluhle lwe-rheumatoid sarcopenia. Olu vavanyo alunakali ukuba ubunzima buvela kwi-muscle okanye kumafutha. Abanye abantu abane-rheumatoid sarcopenia baya kuncitshisa i-BMI, kodwa kwezinye i-BMI inokuba yinto eqhelekileyo okanye yonyuka.
I-Cachexia yeRumatoid
Esinye isigama esichaphazelekayo unokuva isicachexia ye-rheumatoid. I-Cachexia ibhekisela kwimeko yobunzima obunzima, i-fat, kunye nokulahleka kwemisipha eyenzeka ngenxa yengxaki enkulu yonyango, njengomhlaza. Ngcaciso, abaninzi abantu abane-cachexia ye-rheumatoid nabo bane-rheumatoid sarcopenia. Kodwa akusiyo wonke umntu one-rarumatoid sarcopenia ene-cachexia ye-rheumatoid.
Nangona kunjalo, ngabaphandi abahlali basebenzisa le miqathango ngokufanayo. Isihloko sinokudideka kubo boogqirha kunye nezigulane, ngenxa yokuba iinkonzo zonyango azizange zenze imigaqo echanekileyo yokuxilonga abantu abane-rheumatoid sarcopenia kunye ne-cachexia ye-rheumatoid. Ngokwengxenye ngenxa yoko, asinakho ukuqikelela ngokufanelekileyo kweemeko. Siyazi ukuba ezininzi izigulane ezine-rheumatoid arthritis zinomlinganiselo obuthathaka obuthathaka.
Ukukhusela nokuPhatha i-Rheumatoid Sarcopenia
Abaphandi abazange benze izikhokelo ezicacileyo zonyango lwe-rheumatoid sarcopenia. Nangona kunjalo, iingcali ziqaphela izicwangciso ezibini zonyango kunye nokukhusela:
- Ukwandisa isifo se-rheumatoid arthritis ngokwayo.
- Ukuphinda ulandelelwaniso olufanelekileyo nolungqinelanayo.
Ukugcina i-arthritis yakho ye-arthritis ngokwayo ilawulwa yiyona nto yezona zinto zingcono ukuzenza nokukhusela i-sarcopenia ye-rheumatoid. Iziyobisi ezifana ne-TNF-blockers kunye ne-IL-6 i-inhibitor iziyobisi zingancedisa ukutshabalala okudlulayo i-rheumatoid sarcopenia.
Okwangoku, alukho uphando oluthe ngqo malunga nokuba ngaba olu unyango olude lwexesha elide luyakunceda ukuphucula i-sarcopenia ngaphezu kwexesha elide. Nangona kunjalo, ubungqina besibini bubonisa ukuba ezi ziyobisi zingenceda.
Kananjalo asinalo ulwazi oluninzi oluthelekisa ukuphumelela kwezidakamizwa ezichasene nezifo ezichasene ne-rheumatic (DMARDS) ekuphatheni i-sarcopenia. Kuyaziwa ukuba unyango lwangexesha elide kunye ne- corticosteroids lunokwenza ukuba i-sarcopenia ibe nzima. Ngokuhamba kwexesha, abaphandi baya kufunda ngakumbi malunga naluphi uhlobo lwezonyango eziza kuba zizona zifanelekileyo kwiigulane nge-sarcopenia.
Ukunyanga
Ukuzivocavoca ngenye inxalenye ebalulekileyo ekujonganeni ne-rarumineid sarcopenia. Ubungqina bubonisa ukuba uqeqesho lokuncintisana ngokukhethekileyo lunokunceda ngazo zonke ezi zilandelayo:
- Ukwandisa amandla omzimba
- Amanqanaba okwehla kwesifo
- Ukunciphisa intlungu yesifo
Izisindo, amanqwanqwa okumelana, okanye umzimba womzimba ungasetyenziselwa ukwenza imisipha isebenze nzima ixesha elifutshane. Olu hlobo loqeqesho lwamandla lunokunceda ukukhusela i-atrophy ye-muscle ye-rheumatoid sarcopenia.
Ubu bungqina bubonisa ukuba ukunyamezela (a) njengokubhukuda) kunokudlala indima yokukhusela. Buza ugqirha wakho ngcebiso ekwenzeni isicwangciso esithile sokuzilolonga. Unokufumana kukunceda ukusebenza nomqeqeshi womntu ngamnye ngexesha elide.
Ukugcina inkqubo yovavanyo rhoqo kunokubonelela enye inzuzo kubantu abane-arthritis ye-rheumatoid. Isi sifo sibonakala senza ingozi yentsholongwane yesifo, kodwa inkqubo yokuzilolonga rhoqo inokunceda ukunciphisa umngcipheko wokuhlasela kwentliziyo kunye neengxaki ezinxulumene nazo. Ukutya ukutya okunempilo entle eneeprotheni ezaneleyo kunye neekhalori kunokukunceda ukunqanda i-rheumatoid sarcopenia.
ILizwi
Ukujongana ne-rheumatoid sarcopenia inokuphazamiseka. Kodwa ukwazi ukuba usemngciphekweni wokulahleka kwemisipha kunokubonelela ngokubakhuthazayo. Ukunciphisa impembelelo ye-sarcopenia, gcina isifo sakho silawulwa kakuhle ngamachiza kwaye siphumelele inkqubo yokuzilolonga.
> De Rocha OM, Batista AP, Maestá N, et al. I-Sarcopenia kwi-cachexia ye-rheumatoid: inkcazo, iinkqubo, iziphumo zeklinikhi kunye neendlela ezinokuthi zenziwe . Bras J Rheumatol . 2009; 49 (3): 288-301.
> Doğan SC, Hizmetli S, Hayta E, Kaptanoğlu E, Erselcan T, uGüler E. Sarcopenia kwabasetyhini abane-arthritis ye-rheumatoid. I-European Journal yeRheumatology . 2015; 2 (2): 57-61. i-doi: 10.5152 / eurjrheum.2015.0038.
> IMasuko K. I-cachexia i-cachexia iphinde ibuyelelwe kwakhona: i-co-morbidity co-morbidity kwi-rheumatoid arthritis. Imida kwiZondlo . 2014; 1: 20. i-doi: 10.3389 / fnut.2014.00020.
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