I-Gout yindlela ye-arthritis echaphazela ngaphezu kwezigidi ezintathu zaseMelika ngamnye ngonyaka. Eyaziwa nangokuthi i-arthritis enomdla, isifo sibangelwa ukubunjwa kwamakristali e-uric acid (ngokuqhelekileyo uninzi lwezwane), obangela ubuhlungu obukhulu, ubomvu, kunye nobubele. Nangona iimeko ezithile, njengezifo zofuzo okanye iingxaki zeengso, zinokubangela ukuba ugxothwe, ukutya, utywala kunye nokukhuluphala kunokuba negalelo.
Unyango lunokuquka i-over-counter-counter (i-OTC) kunye nezidakamizwa zemithi yokunciphisa intlungu kunye nokunciphisa amazinga e-uric acid. Unokuphinda unciphise ukuhlaselwa kwezilwanyana ngokulahlekelwa ubunzima, ukuqhuba rhoqo, nokuphepha ukutya okubangela.
Iimpawu
Iimpawu zentsholongwane zithatha ukuqhubeka kwaye ziza kuphazamiseka ngaphezu kwexesha xa zingashiywanga. Ubunzima nokuphindaphinda kweempawu zixhomekeke kakhulu kwisigaba sesi sifo.
I-gout ye-Asymptomatic isithuba ngaphambi kokuhlaselwa kwakho kokuqala. Kulo xesha ngeli xesha eliqhubekayo lokuphakama kwe- uric acid egazini lakho kuya kubangela urate (ityuwa ephuma kwi-uric acid) ukubopha nokwenza iikristali. Ngelixa ungeke ufumane nayiphi na impawu kule nqanaba, ukuqokelela ngokuthe ngcembe kwamakristali kuya kuhlaselwa ngokukhawuleza.
I-gout ehambelanayo yinqanaba xa uqala ukufumana ukuhlaselwa okuqhubekayo ukusuka kwiintsuku ezintathu ukuya kwezi-10. Ukuhlaselwa (okuninzi kuchaphazela inzondo enkulu kodwa kunye neendolo, i-ankle, isithende, i-midfoot, i-elbow, isandla kunye neminwe) kuya kubangela intlungu ngokukhawuleza kunye nobuhlungu obuhamba kunye nokuvuvukala, ukuqina, ubomvu, ukukhathala, kunye ne-fever fover.
I-gout yokuphefumula engapheliyo isigaba esiphezulu sesifo apho amakristali e-urate adibanisa kwiindawo ezinzima ezibizwa ngokuba yi- tophi . Ukubunjwa kwala manzi aphantsi komhlaba kungaqhubela phambili i-bone ne-cartilage tissue kwaye iholele kwisifo se-arthritis esingapheliyo kunye nokukhubazeka okuhlangeneyo .
Iingxaki zesifo esingaphendulwanga ziquka amatye eentso kunye nokuchithwa kwemisebenzi yengqondo .
Izizathu
Iimeko ezithile zonyango zinokunyusa umngcipheko we-gout , nokuba ngaba zichaphazela umsebenzi wezintso (ukuvumela i-uric acid ukuba iqokelele) okanye kubangele ukuvuvukala okungapheliyo (apho ezinye iinzululwazi zikholelwa ukukhuthaza ukuveliswa kwe-uric acid). Imizekelo ibandakanya izifo zesifo esiswini esingapheliyo (CKD) , ukungaphumeleli kwentliziyo ye-congestive (CHF) , isifo sikashukela , kunye nesifo se-psoriatic .
Ngokufanayo, i-genetics inokudlala indima. Omnye umzekelo ngumguquko wezofuzo lwe- SLC2A9 okanye i- SLC22A12 yegeni ekunceda ukulawula indlela uric acid eveliswa ngayo ngumzimba kunye nokuba ukhululeka kangakanani. Ezinye iziphazamiso ezizuze ilifa ziquka i- polycystic isifo sesifo (PKD) kunye nesifo se-Fabry.
Ukuphila kwimiba ethile yobungozi kunokuchaphazela kokubili ukuphuhliswa nokuqhubeka kwesifo. Ziquka:
- Ubutyebi , obunxulumene nomsebenzi wezintso ezincitshiwe
- Iidla ezizityebi kwi- purines , i-compound efumaneka kwindawo ethile yokutya eyenza i-uric acid
- Iziphuzo eziphezulu ze-fructose kunye neziyobisi ezinxilisayo ezonakalisa umsebenzi weentso
Amachiza athile aneempembelelo zomsindo onganyusa i-acric acid kwigazi, kuquka i- cyclosporine , i- Lasix (furosemide) , i-aspirin ye-dose ephantsi kunye ne-niacin (i-vitamin B3).
Ukuxilongwa
I-Gout ixilongwa ngokuqhelekileyo kwisiseko seemvavanyo zebhu kunye nokuhlolwa ngokomzimba.
Ukuphonononga iimvavanyo kungasetyenziselwa ukuxhasa ukuxilongwa kunye / okanye ukuvavanya iimpawu zomonakalo odibeneyo.
Umgangatho wegolide wokuxilongwa yi- synovial uhlalutyo lwamanzi apho i-fluids ehlangeneyo ikhishwa ngenaliti kunye nesirinji kwaye ihlolwe phantsi kwe-microscope ngobungqina besikristali. Ezinye izixhobo zokuxilonga zibandakanya iimvavanyo zentsholongwane kunye ne- urinalysis ukukunceda ukuvavanya umngcipheko wamatye entso.
Iimvavanyo ezahlukeneyo zengqondo zingasetyenziselwa ukuvavanya ukuba idibeneyo yonakaliswe kangakanani. Phakathi kwabo:
- I-ultrasounds yindlela ekhethiweyo yokuvavanya njengoko iyakwazi ukufumana umonakalo wokuqala wokudibanisa.
- I-ray-ray ingabonakalisa ukukhutshwa komdaniso ohlangeneyo kodwa kungekhona kumanyathelo okuqala.
- Ukucatshulwa kwemifanekiso ye-Magnetic (MRI) kunye nokuhlolwa kwe-tomography (CT) kunokwenzela ubungqina obucacileyo bomonakalo kodwa banemida yabo kwizifo zakuqala.
Unyango
Indlela yokwenza unyango lwe-gout iphindwe kathathu: ukulawula intlungu kunye nokuvuvukala, ukunciphisa amanqanaba e-uric acid egazini, nokunciphisa ukungenisa ukutya okanye amayeza anokukhuthaza uric acid production.
Iintlungu ze-Gout zihlala ziphathwa ngokuphumla kunye nepakethe ye-ice ukunciphisa ukuvuvukala kwendawo. I-OTC engekho imilingo yokuchasana nezidakamizwa (i-NSAID) njenge-Advil (ibuprofen) okanye i-Aleve (naproxen) inokukunceda.
Amacala amaninzi okanye aphindaphindiweyo anokufumana inzuzo ekunciphiseni ukunciphisa i- corticosteroids (enikwe ipilisi okanye injola ibe yimbutho) okanye isilwanyana somlomo esibizwa ngokuba nguColcyrs (colchicine) esithintela i-encyme ezivuthayo ezikhishwe yi-uric acid.
Ukuba ukutya kunye nezinye iindlela zokungenelela zihluleka ukubonelela ukuphucula, izidakamizwa zokunciphisa i-uric-acid ezifana ne- Uloric (febuxostat) okanye i- Zyloprim (allopurinol) inokumiselwa. Imiphumo emibi ibandakanya ukuguliswa kwesisu, isicupunu, intlungu edibeneyo, kunye ne-muscle ache.
I-Krystexxa (i-pegloticase), inkunkuma entsha ye- biologic ehanjiswe ngokunyuswa kwe-intravenous, ngokuqhelekileyo igcinelwe abantu abathile ezinye ezinye izifo zonyango zihlulekile.
Ukujamelana
Nangona i-gout ingakwazi ukulawulwa ngokubanzi kunye neyeza kunye nokuphumla, kukho iinkqubo zokuzinyamekela ukuziphendulela okanye ukunciphisa ukuphindaphinda kokuhlaselwa kwamandla. Ziquka:
- Ukuphepha ukutya okuphakamileyo okunjengobindi , i-veal, i-mussels, ityhuna, i-bacon, kunye nobhiya
- Ukwandisa ukutya kwakho kweziqhamo, imifuno, izityalo ezipheleleyo kunye nobisi obuncinane beoli
- Ukusela iziglasi zamanzi ezisibhozo ukuya kwezi-16 ngemini ukukunceda ukucoca i-uric acid ngokucoca nokuphucula iimbono kwigazi
- Ukuqalisa isicwangciso sokulahleka kwesisindo sokuba ukhuluphele okanye ukhuluphele
- Ukuphakanyiswa kweenyawo zakho ngexesha lokuhlaselwa ngokukhawuleza kwaye uyikhuse ngokukhuselekileyo
- Ukusebenzisa ifowuni okanye ukuhamba kwesoxhobo ukugcina uxinzelelo unyawo
- Ukusebenzisa iindlela zokuphucula ukuphucula kakuhle intlungu
Ukuba iimpawu zakho aziphuculanga emva kweeyure ezingama-48 okanye ezidlulileyo ngaphezu kweveki, biza ugqirha wakho ukuba uhlele iseshoni. Kwezinye iimeko, amayeza angadinga ukutshintshiswa okanye ahlengahlengiswe ukuba ahluleki ukubonelela.
> Imithombo:
> Hanier, B; UMatheson, E. noWilke, T. "Ukuxilongwa, unyango kunye nokukhuselwa kweGout." Am Fam Physician. 2014; 90 (12): 831-836.
> Richette, P. noBarden, T. "Gout." Lancet. 2010; 375 (9711): 318-28. INGXELO: 10.1016 / S0140-6736 (09) 60883-7.
> Zhang, Y; Chen, C; Choi, H. et al. "Ukutya kwe-Purine-rich riches and gout attacks." U- Ann Rheum Dis. 2012; 71 (9): 1448-53. INGXELO: 10.1136 / annrheumdis-2011-201215.