I-Tophi iindidi ze-sodium urate ze-monohydrat crystals ezifakwe kwiindawo ezinxulumene nabantu abanegalelo. Kukho izigaba ezintathu zentsholongwane: i-asymptomatic (ngaphandle kwempawu) i- hyperuricemia , i-gout yexesha (iziqulatho zesifo se-arthritis esichukumisayo esicatshulwa ngamaxesha angabonakaliyo), kunye ne-arthritis engapheliyo. Kukho kwisigaba sesithathu, isifo samathambo esingapheliyo, apho i-tophi ibonakala ikhona.
I-Tophi inokukrokrelwa ngokukhawuleza xa isigaba se-arthritis esisisigxina.
Xa ifomu iTophi
Ngethuba lesigaba esingapheliyo sesifo samathambo, akukho zihlandlo ezingenabuhlungu. Ixesha elithile phakathi kokuhlaselwa kokuqala kwe-gout kwisigaba esingasasigxina se-arthritis kunye ne-tophi ebonakalayo kwiimeko zezigulane ezingagulwanga. Iziphumo zoFundo (uHench, uP. et al.) Zibonise ukuba ixesha eliqhelekileyo ukusuka ekuhlaselweni kwe-gout lokuqala ekuqaleni kwe-arthritis engapheliyo okanye ukuphuhliswa kwe-tophi ebonakalayo yayingu-11.6 iminyaka. Kuhlolisiso olubandakanya izigulane ezine-gout eziphambili ezingaphezu kwe-1,100, abo bangenawo ama-tophi babenamazinga e-serum urate we-10.3 +/- 1.3 milligrams / deciliter. Abo babephethe ama-tophi amakhulu ayenamazinga e-serum urate ye-11.0 +/- 2.0 milligrams / decilter.
Kutheni ifomu le-Tophi
Isilinganiselo se-tophi sokwenziwa kwe-correlates kunye nobukhulu kunye nobude be-hyperuricemia. I-ghafti ye-Tophaceous ivela ngenxa yokuba umzimba awukwazi ukuphelisa urate ngokukhawuleza njengoko kuveliswa.
Njengoko uqokelelo lwe-urate luqokelele, urate i-crystal deposits ifom.
Nangona izinga le-urum urate yinto ebalulekileyo ehambelana nokuqulunqwa kwe-tophi, kunokubakho nezinye izinto ezinobangela, kubandakanywa: ubudala bokuqala, ukuhamba kwemigodi emine kodwa engaphendulwanga, umyinge weentlobo ezine zegout ngonyaka, kunye nomphetho ophezulu nokubandakanyeka kwepolyarticular .
Ukuphuhliswa kokuqala kwe-tophi-kubantu abaye banomdla ongaphantsi kweminyaka eyi-10-kwenzeka kuma-15 ekhulwini abantu. Isikhundla se-Creatinine sisisigxina esizimeleyo esiye sadibana nokuqeqeshwa kwe-tophi yokuqala.
Lapho ifomu iTophi
I-Tophi inokufakwa kwi-cartilage, iimbrane ze-synovial, i-tendon, kunye nezicubu ezithambileyo. Ngoxa i-tophi ingafumaneka naphi na emzimbeni, ixhaphake kwiminwe, izibonda, iindlebe, amadolo, i-olecranon bursa, kunye neengcinezelo (umz., Umbala we-ulnar we-forearm, i-Achilles tendon). Kwiifisi ezixhumeneyo, i-tophi inokufumaneka kwi-pyramid ye-renal, i-valves yenhliziyo, kunye ne-sclera.
Izinto zeTophi
I-Tophi ayinabuhlungu, kodwa ke ukuvuvukala okunzima kunokuhlakulela kubo. Kukho ukutshabalaliswa kwamalungu kunye nokukhubazeka okunokwenzeka, ngokukodwa kwezandla kunye neenyawo. Ikhumba elilele phezu kwe-tophus linokuthi lube ngumsila kwaye ekugqibeleni lilonda. I-white chalky okanye i-pasty substance, eyenziwe ngamakristal urate, ingaxoshwa kwi-tops. I-Tophi ingabonwa nge ultrasonography, i-MRI, kunye ne-CT. Imifanekiso enemifanekiso eninzi ye-tophi ivela kwi-CT scan.
Umgangatho woBomi
Abaphandi babecinga impembelelo ye-tophi kunye neendlela ezininzi zokuhlaselwa kwe-gout acute malunga nomgangatho wobomi obunxulumene nempilo.
Uphononongo ( iMpilo kunye neMigangatho yeZiphumo zoBomi ka- 2012) ibandakanye izigulane ezingama-620 ezinegciwane elibiweyo, i-12.3 ekhulwini yabanike i-tophi. Kwakukho mgangatho ophantsi wezempilo obunxulumene nobomi be-tophi kunye ne-gout flares.
ILizwi
Umgangatho we-urum urate yinto ephambili ebandakanyeka nokuqeqeshwa kwe-tophi. Abanye abantu abafumana ukuhlaselwa kwe-gout bayeke ukunikela ingqwalasela ngexesha lesigaba esingenasifo phakathi kokuhlaselwa. Kodwa, kubalulekile ukuqapha amanqanaba e-uric acid rhoqo. Kubalulekile ukuphatha igciwane kunye nokuzama ukuyilawula ngokufanelekileyo, kungekhona nje xa iimpawu zibonakala.
Ubukho be-tophi budibaniswe nomgangatho wezempilo. Kumele ube yinjongo yakho ukuzama ukukhusela i-tophi ngokulawula u-hyperuricemia kunye ne-gout ngokufanelekileyo.
> Imithombo:
> Dalbeth, Nicola, et al. Ukucocwa kwe-Creinine eyancitshiswayo kudibaniswa nokuPhuhliswa koPhuhliso lweTophi engezantsi kwiBantu abaneGout. Iingxaki ze-BMC zeMisculoskeletal. Disemba 21, 2013.
> Hench, P. Ukuxilongwa kwe-gout kunye ne-arthritis. I-Lab Lab I-Med Med 220: 48-55. 1936.
> Khanna PP et al. I-Tophi kunye ne-Frequency Gout Flares Zidibanisene neziMpawu kwiMigangatho yoBomi, uMveliso, kunye nokuNyuka kweMithombo yoLondolozo lwezeMpilo: Iziphumo ezivela kwi-Survey-sectional Survey. IMpilo kunye neMigangatho yeZiphumo zoBomi. NgoSeptemba 22, 2012.
> Ukuqala kwiRheumatic Diseases. Arthritis Foundation. Uluhlu lwesithathu. Page 243.
> Kelley's Bookbook yeRheumatology. Elsevier Saunders. INguqulelo yesithoba. Umqulu II. P.1558-1560.