Ukubhema kunye nokukhuluphala kwongeza kwimizi yokuvuvukala
Ngamanye amaxesha bacinga ukuba i-rheumatoid arthritis kunye ne-osteoarthritis zizinto ezifanayo. Ngelixa i-osteoarthritis ibangelwa iingubo zokugqoka kunye neendlebe zexesha elide, i-rheumatoid arthritis yinkinga enzima kakhulu kwaye ididayo apho isimiso somzimba sokuzivikela sikhusela iiseli kunye nezicubu zayo, kubandakanywa namalungu, isikhumba kunye nezinye izitho.
Njengazinye izifo ezizimele, ezifana ne-lupus kunye ne-psoriasis, isizathu esiyimbangela yesifo se-rheumatoid arthritis asiqondwa kakuhle.
Oko siyaziyo kukuba izinto ezithile-kuquka ukutshaya nokunyanya-kunokukubeka engozini enkulu yokufumana kuphela eso sifo kodwa ufumana iimpawu ezimbi.
Ezinye zeengxaki zobungozi be-rheumatoid arthritis ziguquguqukayo (intsingiselo yokuba sinokuziguqula), ngelixa ezinye ezingenakuguqulwa kunye nendawo engozini.
Izinto ezingenakuguqulwa kweengozi
I-rheumatoid arthritis ithinta amanye amaqela ngaphezu kwabanye. Izinto ezintathu ezingatshintshiyo eziqhelekileyo ezidibaniswa nesi sifo zibudala, isini, kunye nentsapho yembali yesifo se-rheumatoid arthritis.
Ubudala
Nangona i-rheumatoid arthritis ingakwazi ukubetha naluphi na ubudala, ukuqala kweempawu kudla ngokuqala phakathi kweminyaka engama-40 no-60. Ngaphezu koko, umngcipheko uya kukwandisa umdala okhulayo. Ngokubanzi, iingxaki zokuphuhlisa i-rheumatic arthritis ziya kuba ngaphezu kwesithathu phakathi kweminyaka yobudala engama-35 no-75, zanda ukusuka kwiimeko ezingama-29 kubantu abayi-100 000 ukuya kuma-99 kwii-100,000 kwi-100,000, ngokutsho kophando olusuka kwi-Clinical Mayo.
Ngesini
Abasetyhini banamathuba amathathu okufumana i-rheumatoid arthritis kunamadoda. Nangona inkcazo yaloluhluko lukude, ama-hormone akholelwa ukuba adlala indima enkulu.
Oku kubonakaliswe kwinxalenye yocwaningo oluye lwabonisa ukuba abafazi baya kudla ukukhula kwesi sifo emva kokutshintsha okukhulu kwiimononi zabo.
Ngamanye amaxesha kwenzeka ngokukhawuleza emva kokukhulelwa okanye kwi-tandem ngokuqala kokuphuma kwesisu. I-Estrogen , okanye ngokukhawuleza ukuchithwa kwe-estrogen, ikholelwa ukuba iyona yecala.
Ngakolunye uhlangothi, ukutshintshwa kwe-estrogen kunokunikezela ngenzuzo yokukhusela kwabasetyhini abadala abangenako ukususelwa kwisifo.
Inzuzo efanayo inokunwezelwa kwabasetyhini abancinci abathatha inxaxheba yentsebenziswano yomlomo (aka "pilisi"). Ngokomphandi kwi-Institute of Karolinska eStockholm, abafazi abaye basebenzisa i-estrogen-containing containing contraceptive iminyaka engaphezu kwe-7 babekho iipesenti eziphantse kwi-20 eyanciphisa umngcipheko we-rheumatoid arthritis xa kuthelekiswa nabasetyhini abangazange bathathe ipilisi.
Genetics
Ukuba unomzali okanye umntakwabo ene-arthritis ye-rheumatoid, umngcipheko wokuphuhlisa eso sifo ubukhulu kathathu kunabantu bonke. Isibini sesiganeko sesibini esingaphantsi komngcipheko wakho. La manani anceda ekuboniseni indima ephambili eyenziwa yi-genetics ekuphuhliseni i- dismune disorder .
Ngokomxholo we-2017 opapashwe kwi-Lancet, i-genetic idlala inxalenye phakathi kwama-40 ekhulwini kunye nama-65 ekhulwini kuwo onke amacala aqinisekisiweyo. Nangona iimvume zokuzalwa zeemfuyo zingakabonakali, abantu abanezifo ezizimelayo zikholelwa ukuba zinomnye okanye utshintsho oluninzi olutshintsho indlela indlela yokuzivikela yombutho eyaziwa ngayo kwaye ijolise kwiinkampani ezibangelwa zizifo.
Kwimisipha yomzimba yokusebenza ngokuqhelekileyo, intsapho yegesi ebizwa ngokuba yi- human leukocyte antigen (HLA) iyanceda i-immune system ihlukanise iiseli zayo kwintlekele yangaphandle. Nge-arthritis ye-rheumato kunye nezinye izifo ezithintekayo, ezinye iinguqulelo ze-HLA zingaphelela ukuthumela imiyalezo engafanele kwi-system immune, iyala ukuba ihlasele iiseli zayo kunye nezicubu. Enye yeenguqu ezijongene nale nto yi- HLA-DR4 .
I-HLA-DR4 idibaniswa nezinye izifo ezizimele, eziquka i- lupus , i- polymyalgia rheumatica , kunye ne-autoimmune hepatitis. Ezinye iinguquko ze-gene zeHLA zikholelwa ukuba zixhunyiwe.
Izinto zokuPhila kweengozi
Imiba yobungozi bokuphila yilezo eziguqulwayo. Ukutshintsha le miba kunokuba kunganciphise ubunzima besifo sakho, banokunciphisa umngcipheko wesi sifo ukuwufumana kwindawo yokuqala. Ukubhema kunye nokukhuluphala yizinto ezimbini ezibalulekileyo.
Ukutshaya
Ukubhema kunobungqina obunobangela kunye nefuthe kunye nesifo se-rheumatoid arthritis. Akugcini nje ukuba iigarethi zandisa ingozi yokufumana eso sifo, zinokukhawulezisa ukuqhubela phambili kweempawu zakho, ngamanye amaxesha.
Uphononongo olunzulu lwezifundo zeekliniki ezenziwa ngabaphandi kwiSikolo soPhulo lweYunivesithi yaseKobe kwiSatifikethi seMatriki sagqiba ekubeni ukutshaya kakhulu (kuchazwa njengokutshiza ipakethi yee-cigarettes ngosuku kwiminyaka engaphezu kwe-20) iphantse iphindwe kabini umngcipheko we-rheumatoid arthritis. Amadoda acinga phinda kabini ukuba achaphazelekayo kunabasetyhini kwaye ngokuqhelekileyo azive zibonakalisa iimpawu ezimbi kamsinya.
Ngaphezu koko, ababhemayo abavavanya i-positive rheumatoid factor (RF) banamathuba amathathu okufumana i-rheumatoid arthritis kuneentlobo zabo ezingabhiyiyo, nokuba ngaba bangokutshaya okanye ababhemayo. Njengeyona nto eyimfuneko yengozi, ukutshaya kuyaziwa ukukhuthaza ukufa kweeseli, ukwandisa ukuvuvukala, nokukhuthaza ukuveliswa kwezinto ezikhululekile ezonakalisa izidakamizwa ezidibeneyo.
Nangona uthabatha imishanguzo yokunyanga kwesi sifo, ukutshaya kunokuphazamisa umsebenzi wabo kwaye kubenze baphumelele. Oku kuquka amachiza asekelwe njenge- methotrexate kunye ne-TNF-blockers entsha enjenge- Enbrel (etanercept) kunye ne- Humira (adalimumab) .
Ukunyanya
I-rheumatoid arthritis ibonakalisa ukuvuvukala okungapheliyo okwehliswayo kwaye kutshabalalise amathambo kunye nezixube ezihlangeneyo. Nantoni na eyongeza kule ngqumbo iya kwenza izinto zibe zibi nakakhulu.
Ubukhulu besinye isimo esinokubangela ukuvuvukala kwenkqubo, kubangelwa ukuqokelela i-adipose (ioli) kunye ne-hyperproduction of protective inflammatory proteins eziziwa njenge- cytokines . Uninzi lweeseli ezisekho emzimbeni wakho, eziphakamileyo ze-cytokines.
Ngoko-ke, akumangalisi ukuba abantu abanomdla kakhulu baya kuhlaselwa ngokukhawuleza kwamalungu abo xa kuthelekiswa nabantu abanobunzima obuqhelekileyo kwaye baneengxaki ezinxulumene nezifo, kubandakanya i- pericarditis (ukuvuvukala kwimbumba yentliziyo), i- pleuritis (ukuvuvukala kwimbane imiphunga), kunye ne- vasculitis (ukuvuvukala kwemithambo yegazi).
Ukongezelela, ukunyuka komzimba okwenyukayo akunakunceda kodwa ukongeza uxinzelelo kumalungu axhatshaziweyo, ngokukodwa ngamadolo, amaqatha, kunye neenyawo, okubangelwa ukulahleka okukhulu kokuhamba kunye nentlungu.
Ukunyaniseka kunokukuphanga ubuchule bakho bokufezekisa ukuxolelwa, imeko yesifo esiphantsi kwesifo apho ukuvuvukala kungaphantsi kolawulo. Ngokomphando ovela kwi-College ye-Weill Cornell Medical College, abantu abane-mass-index index (BMI) engaphezu kwe-30-inkcazo yekliniki yokunyanya-ngamaphesenti angaphantsi kwama-47 afuna ukufezekisa ukuxolelwa xa kuthelekiswa nabantu abane-BMI ngaphantsi kwe-25.
Uxinzelelo lwangokwenyama kunye nolwaMoya
Nangona iimpawu ze-rheumatoid arthritis zihlala zihlaselwa ngenxa yesizathu esicacileyo, kukho iimeko ezinokubangela ukuphazamiseka kweempawu.
Ukuxhaswa komzimba ngenye yezo zinto. Nangona indlela yoku kuqondwa kakuhle, kukholelwa ukuba ukukhululwa ngokukhawuleza nokugqithiseleyo kwama-hormone ezixinzelelekileyo, ezifana ne-cortisol kunye ne-adrenaline, kunokuba nomphumela wokungqongqo obangela ukuphendula ngokuzenzekelayo. Ngoxa le nto ingabhubhisa iindleko ezininzi zokwenza utyando lwe-rheumatoid, ibonisa ukuba umsebenzi owenziwe ngokomzimba kufuneka ufaneleke, ngakumbi ngokubhekiselele kumalungu.
Impendulo yomzimba kwisifo somzimba ingabonakaliswa yempendulo yayo ekuxinzeleleni ngokomzwelo. Nangona izazinzulu zingasayi kubambisana ngokucacileyo phakathi koxinzelelo kunye neempawu ze-rheumatoid arthritis , abantu abaphila nesi sifo baya kudlala ukuba i-flare-ups ihamba phambili ngokukhawuleza, ukuxinezeleka okanye ukukhathala.
Ezinye izinto eziqhelekileyo zibandakanya izifo, kubandakanya ukubandayo okanye umkhuhlane, ezidibaniswa nokusebenza komzimba. I-Flare-ups ingenzeka kwakhona ngokuphendula ukutya okuthethile oyidlayo, okukholelwa kuyo okuxhomekeke kwimpendulo ephikisayo apho isistim somzimba sokuzivikela sisabela ngokungaqhelekanga.
Zonke ezi zinto zibeka amaqondo ahlukeneyo oxinzelelo emzimbeni apho amajoni omzimba asabela kuwo, ngamanye amaxesha angalunganga.
Imithombo:
> Alpizar-Rodriquez, D .; Pluchino, N .; Canny, G. et al. "Inxaxheba yezinto ze-hormone zezilwanyana ekuphuhliseni i-rheumatoid arthritis." Rheumatology. 2017; 56 (8): 1254-63. INGXELO: 10.1093 / rheumatology / kew318.
> Doran, M .; Pond, G; Crowson, C. et al. "Ukunyamekela kwiziganeko nokufa kwi-rheumatoid arthritis eRochester, eMinnesota, ngaphezu kweminyaka engamashumi amane." I- Arthritis Rheum. 2002; 46: 625-3. INGXELO: 10.1002 / ubugcisa.509.
> Orellana, C; Saevarsdottir, S .; Klareskog, uL. et al. "Ukukhulelwa komlomo, ukuncelisa kunye nomngcipheko wokwenza i-rheumatoid arthritis: iziphumo ezivela kwisifundo se-EIRA saseSweden." I- Annal Rheumatic Dis. 2017; 76: 1845-52. INGXELO: 10.1136 / annrheumdis-2017-211620.
> Schulman, E .; Bartlett, S; Schieir, O. et al. "Ukugqithisa umzimba kunye nokunyaniseka kukunciphisa amathuba okufumana ukuxolelwa okusisigxina kwi-Arthritis yokuqala ye-Rheumatoid: Iziphumo ezivela kwiCanada ye-Arthritis Cohort Study." I- Arthritis Care Res. 2017. INGXELO: 10.1002 / acr.23457.
> Sugiyama, D .; Nishimura, K .; UTamaki, K. et al. "Impembelelo yokubhema njengengozi yokuphuhlisa i-rheumatoid arthritis: uhlalutyo lweemeta zophando. " Uchaza iRheum Dis. 2010; 69 (1): 70-81. INGXELO: 10.1136 / 2008.2009.