Xa Uyeka Ukubuyela Kwakho Kodwa I-MS Worsens yakho
Ingqikelelo ye-85 ekhulwini yabantu abane- multiple sclerosis (MS) baqale baxilongwa ngokuba ne-relapsing-remitting MS (RRMS). Uninzi lwaba bantu ekugqibeleni luya kuphuhlisa i-MS ye-SEC (i-SPMS) ehamba phambili eyona nto ibonakaliswe ngokunyuka okuqhubekayo kweempawu kunye nokukhubazeka kwaye kuncinci okanye akukho ukubuyela kwakhona .
Ngaphambi kokuba unyango luguqulwe ngamagciwane, malunga neepesenti ezingama-90 zabantu abane-RRMS ekugqibeleni bahlakulele i-SPMS kwiminyaka engama-25 kunye nesiqingatha kwiminyaka eyi-10.
Ngoku kuyacaca ukuba yintoni imiphumo yokuguqulwa kwezifo ezithintekayo kwi-MS, kodwa kuthathwa (kwaye ithemba) ukuba le nxalenye iphantsi, kwaye i-SPMS ilungele ukuphuhlisa.
Ngubani omele ukuba ahambe kwi-RRMS kwi-SPMS?
Abantu banokutshintsha ekubeni babe ne-RRMS kwi-SPMS naliphi na ixesha, kwaye inkqubo idla ngokuthe gqolo. Enyanisweni, kukho indawo ebomvu phakathi kwe-RRMS kunye ne-SPMS-xa umntu ehamba kwisigaba sokuqhubela phambili se-MS kodwa ufumana i-MS ngokuphindaphindiweyo. Ngokuqhelekileyo, le nto iguquka phakathi kweminyaka emi-5 ukuya kwe-20 emva kokuqala kwezifo.
Ngokweziganeko ezinokuchaphazela ukutshintshwa ukusuka ekubuyiseleni kwakhona-ukubuyisela i-MS ukuya kwi-MS eqhubela phambili, uphando (kwizigulane ezingaphelelwanga ze-MS) zibonisa ukuba amadoda avela ekuphuhliseni i-SPMS ngokukhawuleza kwaye emncinane kunabesifazane. Ukongeza, abo baneempawu zemoto ekuqaleni kwe-MS yabo, njengobunzima bokuhamba, ukuphuhlisa i-SPMS ngokukhawuleza.
Iimpawu ezenziwa yiRRMS okanye Ngaba yi-SPMS
Kubalulekile ukuqonda ukuba akukho zikhokelo ezicacileyo okanye iinkqubo ezichazwe xa umntu ehamba esuka kwi-RRMS kwi-SPMS. Ngezantsi, kunjalo, ezinye izikhokelo okanye iimpawu ukuba umntu one-MS kunye noogqirha wakhe angayisebenzisa xa eqikelela ukuba le nto yenzekile okanye yenzekile.
Amayeza akho asebenzi kakuhle: Nangona kukho imizamo engcono kunye nokunyanzelisa , abanye abantu abane-RRMS kwizidakamizwa eziguqukayo ezikhoyo ziqala ukubonisa ukukhubazeka okwandayo ngaphandle kokunyuka okufanayo kwinani lezilonda kwi-MRI scans. Oku kungabonakalisa ukuba bahamba kwisigaba esiqhubekayo se-MS okanye iSMS.
Ngakolunye uhlangothi, amayeza akho angasebenziyo ngenxa yesinye isizathu. Ngokomzekelo, ukuba i- antibodies kwi- antibodies enye yee-interferon-based based drugs ikhona, i-neurologist yakho ingakuguqulela kwenye.
Ngaphandle koko, abanye abantu bayakhathazeka ukuba bangena kwisigaba sokuqhubeka se-MS kuba bayeke ukubuyela kwakhona. Kodwa le nto ingaba yinto enhle kakhulu, njengoko kungathi ukunyanga kwakho ukuguqulwa kwesifo kusebenza.
Ukubuyiselwa kwakhona kuya kutshintshwa: Imbali yendalo ye-RRMS kukuba ukuba inani lokubuyiselwa kwakhona liyancipha ngokwenene. Nangona kunjalo, ukubuyela kwakhona okwenzekayo kunokuba nzima kakhulu, ukuzisa iimpawu ezininzi, kunokuba kuthintele indawo enye yomsebenzi. Ukongezelela, ukubuyisela ekubuyiselweni kwakhona kubonakala kungaphelelanga, oku kuthetha ukuba nangona emva kwesigaba esibucayi sokuphindaphinda, kudlula iimpawu kunye / okanye ukukhubazeka. Ukongezelela, loo mntu akaphendulanga (okanye nakwonke ) kwiSolu-Medrol ngelixesha lokubuyela kwakhona.
Iqondo elikhudlwana lokukhubazeka: Xa lilinganiselwe yi- Expanded Status Status Scale (EDSS), abantu abaneRRMS banamathuba amane okanye ngaphantsi. Ngaphandle kolunye uhlangothi, abantu abane-SPMS, banesiphelo sesithandathu okanye ngaphezulu-kuthetha ukuba uncedo oluthile lufunekayo ukuhamba. Abantu abane-RRMS abafikelela kumgangatho we-4 ukuya ku-5.5 (kuboniswe ukungakwazi ukuhamba ngaphezu kweemitha ezingama-500 ngaphandle kokuphumla) ngokuqhelekileyo kuphuhlisa i-SPMS ngaphakathi kwexesha elifutshane.
Kuya kubakho ukungaqhelekanga okufumanekayo ngexesha lovavanyo lwegazi. Oku kubonisa ukuba ingqondo ayikwazi ukuhlawula ukuxoshwa kwe-MS.
Ekugqibeleni, abantu abaphuhlisa i-SPMS bathambekele ekuboniseni ukuphazamiseka okungakumbi. Oku kunokwenzeka ngenxa yezinga eliphezulu le-atrophy kwingqondo, ehambelana kakhulu nokungaziqondi kakuhle . Oko kuthetha oko kukuba ingqondo ayikwazi ukuhlawula umonakalo, ingakumbi apho kukho i-axonal epheleleyo (intambo ye-nerve fiber), eya kubangela izimbobo ezimnyama.
Inani elikhulu lomonakalo obonwe kwi-MRI:
- Umthwalo omkhulu wesilonda: Oku kuthetha ukuba kukho inani elikhulu lezilonda, ezithatha ukuba:
- Kujikeleze iivolricle (iingqungquthela ezisengqondweni ezizaliswe ngogesi)
- Ukuqhekeka
- Igxininiswe kwingqondo yomsindo kunye nomtya womgca
- Umonakalo omkhulu we-axonal kunye "nezimbobo ezimnyama:" Iindawo ezibonakalisa njengama-dark (hypointense) amabala kwi-T1 scan zibizwa ngokuba "izimbobo ezimnyama." Le yimiba apho kukho ukuvutha okuphindaphindiweyo, okukhokelela ekubhujisweni ngokupheleleyo kwe-myelin kunye ii-axons ngokwabo. Ezi ndawo zihambelana nokukhubazeka.
- Ukwandiswa kwama-ventricle ezaliswe yi-CSF ebuchosheni: Lo mlinganiso we- atrophy , njengoko kukho ubuncinci beethambo, ngoko ke izikhala ezungeze ngaphakathi nangaphakathi kwengqondo zikhula.
- Ukunciphisa izilonda zokuphucula i-gadolinium: Ngokudlulileyo, inani elitsha, elisebenzayo lezilonda zokuphucula i-gadolinium linciphisa kwizigaba ezilandelayo zeRRMS. Oku kungenxa yokuba isifo sinokuba sisifo esiphezulu kunokuba sigwebise.
ILizwi
Ngelixa unyango lwakho lokuguqulwa kwesifo lunokunceda ukuphuculwa kwenguqu ukusuka ekubuyiseleni i-MS ukuya kwi-MS encinci yokuqhubekayo, le nqubo isenokwenzeka nakwezinye. Ngoko musa ukuzibeka enetyala xa usuke uhamba ukusuka kwisigaba sokubuyela kwakhona se-MS ukuya kwisigaba sokuqhubeka-yinkqubo yemvelo, eyahlukileyo kubo bonke abantu, kwaye kungekhona ngenxa yento oyenzayo.
Imithombo
UCoyle, uPatricia K. kunye noHalper, ngoJuni. Ukuphila kunye neProgressive Multiple Sclerosis: Ukulwa neengxaki (2nd Ed.) ENew York: iDemos Publishing Medical. 2008.
Koch M, Kingwell E, Rieckmann P, Tremlett H, UBC MS Clinic Iingcali ze-neurologists. Imbali yendalo yenkqubela yesibini eqhubekayo. I-Journal ye-Neurology, i-Neurosurgery, ne-Psychiatry, ngo-2010; 81 (9): 1039-43.
Lublin FD et al. Ukuchaza inkqubo yeklinikhi ye-multiple sclerosis. Neurology. 2014 Julayi 15; 83 (3): 278-86.
National Society of MS. MS Progressive Progressive.
UTrmlett H, uYinshan Zhao, Devonshire V. Imbali yendalo ye-sclerosis yamanyathelo aphezulu. Multiple Sclerosis , 2008; 14 (3): 314-24.