I-rheumatoid arthritis isifo esihlala siphazamisayo esichazwe intlungu, ukuvuvukala, nokuqina komnye okanye amaninzi amaninzi. Ukuqhaqhazela okuqhubekayo kunokukhokelela ekulahlekeni kokuhamba, ukuphazamiseka kokugula kunye nokukhubazeka ngokuhlangeneyo. Ngokuhamba kwexesha, intliziyo, imiphunga, amehlo kunye neenkqubo zokujikeleza zingaphinde zithinteke, zandisa ingozi yokukhubazeka nokufa.
Ngokuqonda impawu kunye neempawu zesifo se-rheumatoid arthritis, unokufuna ukuxilongwa kunye unyango ngaphambi kokuba iingxaki ezinzulu ziphuhlise.
Iimpawu zokuQala
Yintoni eyenza i- rheumatoid arthritis ephazamisayo kukuba akukho zihlandlo ezimbini ezifanayo. Ngethuba abanye baya kukhula ngokuthe ngcembe ngexesha elide lokuxolelwa , abanye bathabathe ngokukhawuleza kwaye kunzima.
Ngokuqhelekileyo, iimpawu zokuqala zesifo zihlala zingacacanga, mhlawumbi ukunyamezela okanye ukunyamezela okuphelelwa yinyameko. Amalungu amancinci aqhelekileyo achaphazelekayo okokuqala, afana nalawo anesandla okanye iinyawo. Kwiimeko ezinjengalezi, iimpawu ziza kuhlala zihlala zingapheliyo, ziqhubela phambili ngokuthe gqolo kodwa zihlala zihlala zihlaselwa .
Kodwa, akusoloko kunjalo. Kwimizuzu engama-10 ukuya kwi-20 ekhulwini yamatyala, iimpawu zokuqala ziya kuba ngokukhawuleza kwaye zikhuthele, zilandelwe ixesha elide elingenalo iimpawu. Abanye bangenayo impawu ephakathi kunye neyokuhamba rhoqo.
Izimpawu zokuqala zesifo se-rheumatoid ziquka:
- Intlungu ehlangeneyo , ukuvuvukala, nokuqina
- Ukufudumala nokubomvu malunga nomxube ochaphazelekayo
- Ukuqina koMasa okuqhele ukuphucula ngemizuzu engama-30
- Ukukhathala kunye ne- malaise (ukuvakalelwa ngokuqhelekileyo kokungazinzi)
- Umkhuhlane wezinga eliphantsi kwaye, ngamanye amaxesha, iimpawu ezinjenge-flu
Nangona isi sifo singabandakanya kuphela umxube omnye (i- monoarthritis ), ngokuqhelekileyo kuya kuthintela amajoyina angaphezulu kwexesha ( polyarthritis) .
Umzekelo wamajoyina athatyathekileyo, okwangoku, kuya kubakho ukulinganisa, oku kuthetha ukuba nayiphi na into echaphazelekayo kwelinye icala lomzimba iya kuthinteka kwenye.
Izifo eziqhubekayo
I-rheumatoid arthritis yinkinga engapheliyo, eqhubekayo. Ngaphandle kokuba ukuvuvukala kwangaphakathi kungafakwa ekuxoxweni , eso sifo siya kuqhubela phambili, singabangeli nje ubuhlungu kunye nokuqina kodwa kunciphisa intembeko yendibano ngokwawo.
Ngokuhamba kwexesha, impendulo engapheliyo yokuphendula izonakalisa i- synovial padding kwindawo edibeneyo, isusa i-joint joint and bone tissu, kwaye ibangele ukudibanisa ("ukulungelelanisa") kwamalungu, ukukhawulela ngokwengeziwe kwisihlomelo . Oku kuyinyani ngokukodwa kwimizimba ephethe ubunzima apho umonakalo ungakhokelela ekulahlekelweni kokuhamba.
I-Edema , ukuvuvukala kwezicubu ezibangelwa ukugcinwa kwamanzi, kuqhelekile. Nge-arthritis ye-rheumatoid, imeko ihlala yimizila, ithetha ukuba iya kubangela ukuvuvukala kumacala omabini omzimba, kaninzi iinyawo, iinyawo, imilenze, iingalo kunye nezandla.
Ekugqibeleni, njengoko izakhiwo ezisemgangathweni zomnxeba zichithwa, ziya kuqala ukulahlekelwa ukuma kunye nokulungelelaniswa, okubangele ukukhubazeka ngokuhlangeneyo. Imizekelo eqhelekileyo yale nto ibandakanya:
- Ukuphambuka kwe-Ulnar (ukuguqulwa kwamalungu amakhulu kwiinkike)
- Isivumelwano sokudibanisa (ukuhlengahlengiswa okubambisanayo)
- Ukuhlukunyezwa kwamandla (ukuchithwa kunye nokuchithwa kakubi kwamathambo esandla)
Ngokuqhelekileyo kweli nqanaba ukuba ezinye, iingxaki ezinokuthi zinokuthi ziphuhlise.
Iingxaki
Ngokungafani ne- osteoarthritis ("i-arthritis" kunye ne-arthritis), i-arthritis ye-rheumatoid ayiyi kuphazamisa kuphela amanxeba kodwa ibangela inkqubo (umzimba wonke) ukuvuvukala okunokuchaphazela zonke iinkqubo zomzimba emzimbeni.
Ngaphantsi komthwalo oqhubekayo wokuvuvukala, imisipha epholileyo kunye neembrane zingaqalisa ukuthenga isivumelwano, zikhuni, kwaye zilahlekelwe ukuguquguquka kwazo. Oku kungakhokelela ekuphumeleleni komzimba, ukufa kweeselfowuni, kunye nokwakhiwa okungavumelekanga kwamanzi kunye nokuphelisa.
Izikhumba zesikhumba kunye neMucous
Amaphesenti angama-20 ukuya kuma-30 ekhulwini abantu abantu abane-rheumatoid arthritis baya kuba nobunzima obuqinileyo phantsi kwesikhumba ebizwa ngokuba ngama- rheumatoid nodules . Zingaba zincinci njenge-pea okanye zinkulu njenge-walnut kwaye zihlala zikhula kwiindawo, iidolo, okanye i-knuckles. Iintlanzi, izilonda, kunye ne-blisters nazo ziyaqheleka kwisigulo esilandelayo.
Enye imeko, eyaziwa ngokuba yi- Sjogren's syndrome , iquka ukutshabalala kweengqungquthela zeendwangu kunye neengqungqungquthela zentsimbi. Ukuvuvuka kwezi zicubu kunokunciphisa inani lezinyembezi kunye namathe, okukhokelela kwamehlo omile nomlomo owomileyo . Ubume obumile, ulusu olomileyo, ukukhwehlela okuqhubekayo kunye nokukhathala nazo ziqhelekile. I-Sjogren's syndrome ichaphazela phakathi kweepesenti ezili-10 kunye neepesenti ezingama-15 zezigulane ze-rheumatoid arthritis kwaye zingakhokelela kwizibilini zamazinyo, izifo zesilonda kunye neengxaki zombono.
Iingxaki zeenhliziyo
I-Pericarditis , ukuvuvukala komlenze ojikeleze intliziyo, ibonakaliswe intlungu yesifuba kunye nokuqokelelwa kwamanzi (i-pericardial effusion). Ukukhathala, ukuphefumula ukuphefumula, kunye nokuphuhliswa kweendununu ziqhelekile. I-Pericarditis iyisalathisi esinamandla se- coronary disease , esibangela isizathu sokufa kubantu abane-rheumatoid arthritis
Ukongeza kwi-heart inflammation, i-rheumatoid arthritis inokuchaphazela imivenge yegazi kwaye ikhokelela kwingxaki ebizwa ngokuba yi- vasculitis . I-Vasculitis ibonakaliswe ngongqoqo lwe-capillaries ukuya kwindawo apho ukujikeleziswa kunokunqunyulwa. Iimpawu eziqhelekileyo ze-vasculitis ziindawo ezimnyama zezicubu ezifile phantsi kweeminwe zakho, ezibizwa ngokuba yi-digital infarts. I-Vasculitis inokuchaphazela neentsholongwane zezandla kunye neenyawo zakho, kubangela ukuva, ukutshisa kunye nokuvutha. I-Fever, ukukhathala, ukulahleka kwesisindo, kunye nentlungu kunye neentlungu ezidibeneyo nazo ziqhelekile.
Imiba engxaki
Ukuvuvukala kwimbumba ejikeleze imiphunga, ebizwa ngokuba yi- pleuritis , kunokukhokelela kwisakhiwo somsila kunye nomda wokuphefumla. Emva kwexesha, ukuvuvukala nokuphuhliswa kweenqununu kungabangela ukonakala okunzima (fibrosis) kwendwangu yecala. Ababhemayo abane-rheumatoid arthritis bathatywe ngokukodwa ngolu hlobo kwaye banako ukufumana isifo esingapheliyo se-pulmonary disease (COPD) kunabalingani babo abangafuni ukutshaya.
Iimpawu ze-pleuritis ziquka ukuqina kwesifuba, ukuphefumula okufutshane, ukuphefumula ngokukhawuleza, kunye nokukhwehlela komile.
Iingxaki Zamehlo
I-Sjogren's syndrome yimbangela enkulu yeengxaki zesifo se-rheumatoid eye-related arthritis. Ukutywa kwexesha elide kwisoloko kunokukhokelela ekubhenkeleni, isilonda, intsholongwane, kunye nokugqithiswa kwe- cornea .
I-Scleritis yenye inkxalabo yamehlo ebangelwa ukuvuvukala kwe-sclera (umhlophe welihlo). Esi sifo sibonakala ngokubomvu, ukugqithisa ngokugqithiseleyo, kunye nobuthaka obukhulu bokukhanya. Emva kwexesha, ukuvutha kungabangela ukulahleka kombono kunye nokulimala kwamehlo, kubandakanya i-glaucoma, i-cataract, kunye ne-peripheral keratitis yesilonda (isilonda sesibini se-corneas).
Prognosis
Kwabantu abalawulwa yi-rheumatoid arthritis, kunokubakho ixesha xa intlungu kunye nokuvuvukala kuya kuphazamiseka ngokukhawuleza. Kungase kubangele ukuphazamiseka, ukuxinezeleka, impendulo eyancipheko kunyango, ukusuleleka okanye okanye ukutya okunye esikudlayo. Ngamanye amaxesha, akukho nto iyaziwayo.
Iimvula zidla ngezinye iinyanga ngaphambi kokuba zixazululwe ngokwazo okanye zilawulwe phantsi kwonyango .
Ubunzima kunye nobuqili bala maqabile bubalulekile njengoko banokunika iinkcukacha malunga nokuba isifo siphuthuma kwaye sisiphumo siphi na isiphumo esisiphumo (ukuhlaziya). Phakathi kwezinto ezinokuchaphazela ukuxela:
- Ukufunyaniswa kwisifo esincinci (phantsi kweminyaka engama-40) okanye unesi sifo kwiminyaka emininzi
- Ukuba nomonakalo omkhulu kunye nokuxilongwa
- Iziphumo ezintle ezintle kwi- anti-CCP ekuxilongweni
- Iisoloko eziqhelekileyo, ezinzima, okanye ezihlala ixesha elide
- Ukuba lixesha elide, ukutshaya okukhulu
- Ubukhulu (ubunzima bomzimba obuninzi ngaphezu kwama-30)
- Ukwandiswa kwenani lamalungu achaphazelekayo
- Ukulawulwa kwezifo ezimbi (kubandakanywa ukuqeshwa kwabangenayo, izikhala kwiinkatho, njl.
- Ukuvuvukala okungalawulwayo njengoko kulinganiswa yi- ESR kunye ne- CRP
- Intlungu ngokubanzi kunye nokuqina okungaziphuculanga
Abantu abanezinye iinkalo okanye ezininzi zezi mpawu banokugula kakhulu ngaphandle kokuba izinto ezinobungozi (ezifana nokubhema okanye ukubambelela kweziyobisi) zingatshintshwa.
Izinto ozilindile emhlabane
I-rheumatoid arthritis idibene nokunciphisa ixesha lokuphila ngenxa yeengxaki zexesha elide. Ngaphandle kokuba i-dismune disorder iphathwa ngokufanelekileyo, iimpawu eziqhubekayo zinganciphisa iminyaka engama-10 ukuya kwe-15 ukusuka kwimpilo yakho.
Isifo se-Cardiovascular remains sisona sizathu esibangela ukufa kubantu abane-arthritis ye-rheumatoid, imeko eyenziwayo ngokunyanya, ukutshaya, kunye nezinye izinto ezinobungozi. Uphando lubonisa ukuba amaninzi engama-40 ekhulwini ekufeni kubantu abane-arthritis ye-rheumatoid ingabonwa ngokuthe ngqo kwiintlanganiso ze-cardiovascular.
Ukuba ne-arthritis ye-rheumatoid iphindaphinda umngcipheko wokuhlaselwa yintliziyo okanye ukushaywa yintlungu. Umngcipheko phantse uhamba kathathu xa unesi sifo kwiminyaka eyi-10 okanye ngaphezulu. Ukunciphisa ukulahlekelwa, ukusetyenziswa, kunye nokuyeka ukutshaya kunokutshintsha kakhulu loo mingeni kungakhathaliseki ukuba isiphi isifo sesifo.
Nini ukubona iDokotela
I-rheumatoid arthritis inokuyikrakra, kungekhona nje ngenxa yeempawu kodwa ukungaqiniseki kwinto ezayo. Ungavumeli ukuba oku kukumise ekubeni uthathe inyathelo xa unokrokrela ukuba unesifo.
Inzuzo yokuxilongwa kwangaphambili kukuba kukuvumela unyango lokuqala. Ukubeka nje, ngokukhawuleza ukuba ubekwe kwiimichiza zokuguqula izifo , iziphumo zakho ezide ziza kuba ziphumo.
Kule nto, kufuneka ubone ukuba ugqirha ukuba unayo na le mpawu:
- Ubuhlungu, ukuvuvukala, okanye ukuqina kumalungu amaninzi okanye amaninzi
- Amaqumrhu abomvu okanye afudumele kumgca
- Ukuqina okuhlangeneyo rhoqo ekuseni
- Ubunzima ukuhamba ngokubambisana okanye ukwenza imisebenzi yemihla ngemihla
- Isiqendu sentlungu edibeneyo kunye nokuqina okuqhubekayo kweentsuku ezingaphezu kweentsuku
Oku kuyinyani ngokukodwa xa unentsapho yembali ye-rheumatoid arthritis. Ukuba nomntakwabo okanye umzali ene-arthritis ye-rheumatoid iphantse ifake i-risk of rheumatoid arthritis, ngelixa unesihlobo esisekondari sesibini sinyusela umngcipheko.
> Imithombo:
> Singh, J .; Saag, K .; Bridges, L. et al. "Inkcazo yase-American American College of Rheumatology Guideline ye-Treatment of Rheumatoid Arthritis." I- Arthritis Care Res. 2016: 68 (1); 1-25. INGXELO: 10.1002 / acr.22783.
> Smolen, J .; Aletaha, D .; kunye noMcInnes, I. "I-rheumatoid arthritis. " Lancet. 2017; 388 (10055): 2023-38. INGXELO: 10.1016 / So140-6736 (16) 30173-8.
> Van den Hoek, J .; Boshuizen, H .; Roorda, L. et al. "Ukufa kwabantu kwizigulane ezine-arthritis ye-rheumatoid: uneminyaka eyi-15 yokufunda isifundo seqela." I- Rheuma Int. 2017; 37 (4): 487-93. INGXELO: 10.1007 / s00296-016-3638-5.