Isikhokelo sokuSetyenziswa kweArthritis (Reiter's Syndrome)

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Yintoni eyenzekayo kwiArthritis? (Reiter's Syndrome)

Ukuphendula

I-arthritis echaphazelekayo yintlobo yesifo se-arthritis esenzeka njengendlela "yokusabela" kwintsholongwane kwenye indawo emzimbeni. Ukuvuvukala kukusabela kwamancuksi ukulimala okanye izifo kwaye kuphawulwe ngu:

• ukuvuvukala
• obomvu
• bushushu
• intlungu

Ngaphandle kwesi sigulana esivumelanayo, isifo samathambo sisebenzisana nezinye iimpawu ezimbini:

• ubomvu nokuvuvukala kwamehlo
• ukuvuvukala kwephepha lomchamo

Ezi zimpawu zenzeke zodwa, kunye kunye okanye kungenjalo.

SikaReiter

I-arthritis esebenzayo isaziwa ngokuba yi-Reiter's syndrome, kwaye ugqirha wakho unokubhekisela kuye njengento yesiphononthroloththropathy. I-sponeyloarthropathies ye-seronegative yiqela leengxaki ezingabangela ukuvuvukala emzimbeni wonke, ngakumbi emgodini. Imizekelo yezinye iziphazamiso kweli qela zibandakanya:

• i-psoriatic arthritis
• spondylitis engavumelekanga

Sulelo

Kwimininzi, i-arthritis esebenzayo ishukunywe yintsholongwane ye-venereal kwi-vessie okanye i-urethra, okanye, kubasetyhini, isondo esisoloko sisasazeka ngoqhagamshelwano lwezesondo. Eli hlobo lentsholongwane ngamanye amaxesha luthiwa yi-genitourinary okanye i-urogenital yempatho ye-arthritis.

Enye ifom ye-arthritis eyenzekayo yintlungu kubangelwa isifo kwi-intestinal tract ngokutya ukutya okanye ukuphatha izinto ezihlambulukile neebhaktheriya. Ngamanye amaxesha le fomu ibizwa ngokuthi i-enteric okanye isisu sesifo somzimba esisisigxina.

Iimpawu ze-arthritis ezisebenzayo zihlala zihlala kwiinyanga ezi-3 ukuya kwezi-12, nangona iimpawu zingabuya okanye ziphuhlise isifo esihlala ixesha elide kwipesenti zabantu.

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Yintoni Ebangelwa Ukusebenza Kwe-arthritis?

Chlamydia

I-arthritis esebenzayo iqala ngokuqala malunga neeveki ezi-1 ukuya kwezi-3 emva kokusuleleka. Ibhaktheriya esoloko idibaniswa ne-arthritis esebenzayo yile: I-Chlamydia trachomatis, eyaziwa ngokuba yi-chlamydia.

Ngokuqhelekileyo ifunyenwe ngokuqhagamshelana ngesondo. Olunye ubungqina lubonisa ukuba izifo zokuphefumula kunye neClamydia pneumoniae zingabangela isifo se-arthritis esisebenzayo.

Izifo zoLuntu lweGI

Izifo kwi-digestive tract ezingabangela ukuba i-arthritis esebenzayo zibandakanya:

• Salmonella
• Shigella
• Yersinia
• Campylobacter

Abantu banokusulelwa yi-bhakteria emva kokutya okanye ukuphatha ukutya okungafanelekanga, okufana nezidlo ezingagcinwa ngexesha lokushisa okufanelekileyo.

HLA B27

Oogqirha abazi kakuhle ukuba kutheni abantu abathile bavelele kwiibhaktheriya bahlakulela i-arthritis engasebenzi kunye nabanye, kodwa bafumene i-genetic factor, i-anti-leukocyte antigen (HLA) B27, eyandisa amathuba omntu wokuphucula i-arthritis engasebenzi. Phantse ama-80% abantu abaneemvavanyo zokuphefumula i-arthritis ezenzelwe i-HLA-B27. Nangona kunjalo, ukuzuza ifa le-HLA-B27 akuthethi ukuba uya kufumana i-arthritis esebenzayo. Iipesenti ezisibhozo zabantu abanempilo banegciwane le-HLA-B27, kwaye kuphela malunga nesihlanu kubo baya kuhlakulela i-arthritis esebenzayo xa beqhawula izifo ezibangelwayo.

Ingaba iyesulela?

I-arthritis esebenzayo ayifakwanga; oko kukuthi, umntu onenkinga ayinakuyidlulisela kwenye i-arthritis komnye umntu. Nangona kunjalo, iibhaktheriya ezinokubangela i-arthritis esebenzayo zingadluliselwa kumntu kumntu.

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Ziziphi iimpawu zeArthritis esebenzayo?

Iimpawu

Ngokubanzi, amadoda phakathi kweminyaka engama-20 no-40 banokuthi bahlakulele i-arthritis engasebenzi. Nangona kunjalo, ubungqina bubonisa ukuba nangona amadoda angama-9 anamava angaphezu kwamabhinqa ukuhlakulela i-arthritis echaphazelekayo ngenxa yokusuleleka kwiintsholongwane, abafazi kunye namadoda banokulingana nokuhlakulela isifo se-arthritis ngenxa yesifo esithwala ukutya. Abasetyhini abane-arthritis esebenzayo basoloko beba neempawu ezinzima kunamadoda.

Isifo se-arthritis esisebenzayo ngokugqithiseleyo sinokubangela ukuvuvukala:

• urogenital tract
• maqela
• amehlo

Iimpawu Eziqhelekileyo Eziqhelekileyo

Izimpawu ezingaqhelekanga zizilonda zomlomo kunye neengqumbo zesikhumba. Naliphi na le mpawu ingaba mnene kangangokuthi izigulane aziziboni. Ngokuqhelekileyo beza baze bahambe ixesha elidlulileyo kwiiveki eziliqela.

ITrogenital Tract

I-arthritis esebenzayo idla ngokuchaphazela i-urrogenital tract, kubandakanywa:

• iprotrate okanye utyhila emadodeni
• urethra, uterus, okanye isini kubasetyhini

Amadoda angakubona isidingo esinyukayo sokuvuthwa, ukuvutha komlilo xa uchama, ubuhlungu be-penis kunye nokukhutshwa kwamanzi okuphuma kwipenisi. Amanye amadoda ane-arthritis esebenzayo ahlakulela i-prostatitis. Iimpawu zeprotatitis zingabandakanywa umkhuhlane kunye nezikhuku, kunye nesidingo sokwanda kwamanzi kunye nokuvutha komlilo xa uchama.

Abasetyhini abane-arthritis esebenzayo bangabangela iingxaki kwi-urrogenital tract, efana ne-cervicitis okanye i-urethritis, enokubangela ukuvutha komlilo ngexesha lokuvuthwa. Ukongezelela, abanye abafazi bahlakulela i-salpingitis okanye i-vulvovaginitis. Ezi meko zinakho okanye zingabangeli nayiphi na impawu ze-arthritic.

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Kuthiwani NgeArthritis, Intlungu Ehlangeneyo, Ezinye Izibonakaliso?

Intlungu ehlangeneyo

Iimpawu zobudlelwane ezidibeneyo zesifo se-arthritis sisebenza ngokubanzi ziquka intlungu kunye nokuvuvukala kule:

• ngamadolo
• iinyawo
• iinyawo

Izibonda, iminwe, kunye namanye amalunga athatyathwa ngaphantsi. Abantu abane-arthritis esebenzayo bavame ukuhlakulela i- tendinitis . Kwabaninzi abane-arthritis esebenzayo, oku kubangela intlungu ye-ankle okanye i-Achilles tendinitis. Abanye abane-arthritis esebenzayo bahlakulela i-heel spurs, okuyi-bony ukukhula kwisithende esinokubangela intlungu engapheliyo. Phantse isiqingatha sabantu abaneengxelo ezichaphazelekayo ze-arthritis ingxelo engaphantsi kwemva kunye nentlungu.

I-arthritis esebenzayo nayo ingabangela i-spondylitis okanye i-sacroiliitis. Abantu abane-arthritis esebenzayo abanegciwane le-HLA-B27 banakho amathuba okuphuhlisa i-spondylitis kunye / okanye i-sacroiliitis.

Amehlo

I-Conjunctivitis, ukuvuvukala kwimbumba ebomvu ehlanganisa isohlo kunye nejwabuzele, ikhula malunga nesiqingatha sabantu abane-arthritis esebenzayo. Abanye abantu banokuphuhlisa i-uveitis. I-Conjunctivitis kunye ne-uveitis ingabangela:

• kubomvu kwamehlo
• intlungu kunye nefuthe
• Umbono obolileyo

Ukubandakanyeka kwamehlo kwenzeka ngokukhawuleza kwinqanaba le-arthritis esebenzayo, kwaye iimpawu zingafika kwaye zihambe.

Izilonda

Phantse i-25% yamadoda ane-arthritis esebenzayo ikhula ezincinci, ezingafihliyo, izilonda ezingenabuhlungu ekupheleni kwepenisi. Ipesenti emancinci yamadoda nabasetyhini zihlakulela okanye zincinci, izigulane ezinzima kwiindawo ezinyaweni kwaye, kaninzi, kwiintendelezo zezandla zabo okanye kwenye indawo. Abanye abane-arthritis esebenzayo bahlakulele izilonda zomlomo eziza kwaye zihamba, ngenxa yezi, ezinye izilonda azibuhlungu kwaye zingabonakali.

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Nguwuphi na uhlobo logqirha onokunyanga kwaye ufumane i-Arthritis esebenzayo?

Odokotela abaninzi

Umntu onesifo sokuphefumula i-arthritis mhlawumbi kuyakufuneka abone iintlobo ezahlukeneyo zoogqirha kuba i-arthritis esebenzayo ichaphazela iindawo ezahlukeneyo zomzimba. Nangona kunjalo, kunokunceda oogqirha kunye nesigulane kwigqirha omnye, ngokuqhelekileyo i- rheumatologist (ugqirha onguchwepheshe we-arthritis), ukulawula isicwangciso solawulo olupheleleyo. Lo ugqirha unako ukulungelelanisa unyango kunye nokubeka iliso kwimiphumo emibi evela kumayeza ahlukeneyo isiguli angathatha. Iingcali ezilandelayo ziphatha ezinye iinkalo ezichaphazela amalungu ahlukeneyo omzimba.

• I-Ophthalmologist (ithatha isifo seso)
• I-Gynecologist (ithatha iimpawu zomzimba kubasetyhini)
• I-urologist (ithatha iimpawu zomzimba kumadoda nabasetyhini)
• I-Dermatologist (ithatha iimpawu zesikhumba)
• U-Orthopaedist (wenza utyando olwenziwe kakubi)
• I-Physiatrist ( ilawula iirejimenti zovavanyo)

Uviwo

Ekuqaleni koviwo, ugqirha mhlawumbi uya kuthatha imbali epheleleyo yezonyango kwaye aqaphele iimpawu zangoku kunye nazo naziphi na iingxaki zempilo zangaphambili okanye izifo. Ngaphambi nangemva kokubona ugqirha, maxa wambi luncedo kwisigulane ukugcina irekhodi yeempawu ezenzekayo, xa zivela, kwaye zihlala ixesha elingakanani. Kubaluleke kakhulu ukubika nayiphi na impawu ezinjengomkhuhlane, njengale:

• umkhuhlane
• ukuhlanza
• isifo sohudo

Ezi zibonakalisi zingabakho ubungqina bentsholongwane yebhaktheriya. Ngamanye amaxesha oogqirha bakuthola kunzima ukufumanisa i-arthritis esebenzayo ngenxa yokuba akukho vavanyo lwebhoratri oluthile lokuqinisekisa ukuba umntu une-arthritis esebenzayo.

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I-Arthritis engasebenziyo ichongwa njani?

Ukuxilongwa

Oogqirha banokuyalela ukuhlolwa kwegazi ngenxa ye-genetic factor HLA-B27, kodwa umphumo ontle awuthetha ukuba umntu unenkinga.

Oogqirha banokuyalela ezinye iimvavanyo zegazi ukuze bancede ukulawula ezinye iimeko kwaye baqinisekise ukuxilongwa. Isixhobo se-Rheumatoid okanye i-anti-nuclear anti-tests iyakunceda ukulawula i-arthritis esebenzayo. Abaninzi abanesifo sokuphefumula isifo se-arthritis baya kuba nemiphumo emibi kule mvavanyo. Ukuba iziphumo zokuvavanya zilungile, unakho olunye uhlobo lwe-arthritis, njenge:

• irheumatoid arthritis
• lupus

Oogqirha banokuvavanya isantya se-erythrocyte. Iqondo eliphezulu "sed rate" lisoloko lubonisa ukuvuvukala kwindawo ethile emzimbeni. Ngokuqhelekileyo, abantu abanesifo se-rheumatic abanomlinganiselo ophakamileyo.

• Imibuzo: Ngaba Unayo iLupus?

Izifo

Oogqirha mhlawumbi baya kuvavanya izifo ezinokuthi zidibane ne-arthritis esebenzayo. Izigulane ngokubanzi zivavanyelwe ukusuleleka kwe-Chlamydia (uphando lubonise ukuba unyango lwangaphambili lwe-Chlamydia-induced acetric acid lunganciphisa ukunyuka kwesifo). Iisampuli zeeselingi zingathathwa emqaleni, zixhomekeke kumadoda okanye kwisibeleko kubasetyhini. Iisampuli kunye neesitampu nazo zingavanywa. Isampuli ye- synovial fluid ingasuswa kwi-arthritic joint. Uphando lwe-synovial fluid lunokunceda ukulawula ukusuleleka kwi-joint.

X Ray

Ngamanye amaxesha oogqirha basebenzisa i-x ray ukunceda ukufumanisa i-arthritis esebenzayo kunye nokulawula ezinye izimbangela ze-arthritis. Iimitha ze-X ziyakwazi ukubona ezinye iimpawu ezibandakanya:

• spondylitis
• sacroiliitis
• ukuvuvukala kwezicubu
• umonakalo we-cartilage kunye namalungu
• i-calcium deposits

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I-Arthritis Engasebenziyo Yenzelwa Njani?

I ziDakamizwa

Nangona kungekho nonyango ye-arthritis yokusebenza, ezinye iindlela zonyango ziyanciphisa iimpawu zesifo.

NSAID

Izidakamizwa ezichasene nezidakamizwa (non-steroidal anti-inflammatory drugs) (i-NSAID) zinciphisa ukuvuvukala ngokubambisana kwaye zisetyenziselwa ukuphatha izigulane ezine-arthritis. Ezinye i-NSAID zifumaneka ngaphandle komyalelo onjenge:

• aspirin
• ibuprofen

Ezinye i-NSAID eziqhelekileyo zisebenza ngokugqithiseleyo isifo se-arthritis kufuneka sichazwe ngugqirha onjenge:

• indomethacin
• tolmetin

Corticosteroid Shots

Kulabo abanezibilini eziqhekezayo, ama- injection ye-corticosteroids ngqo kwidibaniselwano echaphazelekayo inokunciphisa ukuvuvukala.

Corticosteroids

Ezi corticosteroids ziza kwi-cream okanye i-lotion kwaye zingasetyenziswa ngqo kwizilonda zesikhumba, ezifana nezilonda, ezinxulumene ne-arthritis esebenzayo. I-corticosteroids yezihloko zanciphisa ukuvuvukala nokukhuthaza ukuphulukiswa.

Antibiotics

I-antibiotics inceda ekupheliseni iintsholongwane ze-bacteria ezibangelwa i-arthritis. I-antibiotic ethile echazwe ngokuxhomekeke kuhlobo lokusuleleka kwintsholongwane. Abanye oogqirha banokumcebisa umntu onomdla we-arthritis esebenzayo ukuthatha ii-antibiotics ixesha elide (ukuya kwiinyanga ezi-3). Uphando lubonisa ukuba kwiimeko ezininzi, lo mkhuba uyimfuneko.

Immunosuppressants / DMARDs

I-DMARD ezifana ne-methotrexate okanye i- sulfasalzine inokunceda ukulawula iimpawu ezinzima ezingenakulawulwa ezinye iziyobisi.

TNF Blockers

I-TNF blockers, efana ne- Enbrel (etanercept) kunye ne- Remicade (infliximab) , inokusebenza ngempatho ye-arthritis kunye nezinye i- spondyloarthropathies .

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Ngaba Unokuzivocavoca Ukuphucula I-Arthritis Esebenzayo?

Ukuzivocavoca kwi-Arthritis esebenzayo

Ngaphambi kokuqala inkqubo yohambo, izigulana kufuneka zithethe nomqeqeshi wezempilo onokuyincoma ukusetyenziswa okufanelekileyo.

Ukuzivocavoca, xa uqaliswa kancane kancane, kunokunceda ukuphucula umsebenzi odibeneyo. Ngokukodwa, ukuqiniswa kunye nokuhamba kweendlela zokunyakaza kuya kugcina okanye kuphuculwe umsebenzi odibeneyo.

• Ukuqiniswa kokuzilolonga kwakha imisipha ejikeleze umdibaniselwano ukusekela kangcono.
• Imizimba yokumisa imisipha engashukunyanga nayiphi na ijoyina ingenziwa nangona umntu ekhubekileyo kunye nentlungu.
• Izenzo zokuhamba ezihamba phambili zithuthukisa ukunyakaza nokuguquguquka nokunciphisa ubunzima kwiqela elichaphazelekayo.
• Ukuzivocavoca: Uphuhliso olubalulekileyo lweArthritis
• Indlela Yokuzivocavoca Xa Unayo I-Arthritis

Buyela emva kokuzivocavoca kwe-Arthritis esebenzayo

Ukuzilolonga ukunweba nokwandisa umva kunokunceda kakhulu ekukhuseleni ukukhubazeka kwexesha elide kwizigulane ezineentlungu zengqondo okanye ukuvuvukala.

Ukuxilongwa kwamanzi kwi-Arthritis esebenzayo

Ukusetyenziswa kwe-Aquatic nako kunokuba luncedo kwi-arthritis. Ukunyuka kwamanzi kukunciphisa kakhulu uxinzelelo kumalungu akho, okwenza kube lula ukwenza uluhlu oluthile lokuhamba.

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Yintoni iNgqungquthela yabantu abaye bahlaziya isifo seArthritis?

Prognosis

Uninzi lwabantu abane-arthritis esebenzayo bayaphuma ngokugcwele kwiimpawu zokuqala zeempawu kwaye banakho ukubuyela kwimisebenzi eqhelekileyo ukuya kwiinyanga ezimbini ukuya kwezi-6 emva kokuba iimpawu zokuqala zivele. Kwiimeko ezinjalo, iimpawu zesifo se-arthritis zingadlulela kwiinyanga ezili-12, nangona ezi ziqhelekile kakhulu kwaye aziphazamisi imisebenzi yansuku zonke.

Arthritis engapheliyo

Phantse iipesenti ezingama-20 zabantu abane-arthritis esebenzayo baya kuba nezifo ezingapheliyo (ixesha elide) i-arthritis, edla ngokulula.

Izifundo zibonisa ukuba phakathi kweepesenti ezingama-15 no-50 zezigulane ziza kuvelisa iimpawu kwakhona emva kwexesha lokuqala kwe-flare. Kungenzeka ukuba ukuhlaziywa okunjalo kubangelwa ukubuyiswa kwakhona. Intlungu ebuhlungu kunye ne-arthritis yimiqondiso edla ngokuphindaphindiweyo.

Ipesenti encinci yezigulane ziza kuba nezifo ezingapheliyo, ezinamandla kakhulu ezinzima ukulawula ngonyango kwaye zingabangela ukukhubazeka ngokuhlangeneyo.

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Yintoni Abaphandi Abafundi Ngokufunda Nge-Arthritis Esebenzayo?

Uphando lweArthritis Research

Abaphandi bayaqhubeka nokuphanda iimbangela ze-arthritis esebenzayo kunye nophando lwezo sifundo. Umzekelo:

• Abaphandi bazama ukuqonda kangcono ulwalamano phakathi kokusuleleka kunye ne-arthritis esebenzayo. Ngokukodwa, bazama ukucacisa ukuba kutheni isifo sisenza i-arthritis kwaye kutheni abanye abantu abahlakulela izifo bafumana isifo se-arthritis xa abanye bengenalo. Iingcali zenzululwazi zifunda nokuba kutheni abantu abane-genetic HLA-B27 basengozini kunabanye.
• Abaphandi bahlakulela iindlela zokufumana indawo yebhaktheriya ebangela umzimba. Ezinye izazinzulu zicinga ukuba emva kokuba iibhaktheriya zingene emzimbeni, zithunyelwa kumajoyina, apho zihlala khona zingenamali encinci.
• Abaphandi bavavanya uphando lwe-arthritis. Ngokukodwa, bavavanya ukusebenzisa i-antibiotics ngokudibanisa ne-TNF inhibitors kunye namanye amayeza angenakuxilongwa, njengemettretreate ne-sulfasalazine.

_{Umthombo: I-NIH Publication No. 02-5039}