Iipilisi kubandakanywa neCandelo lokuPhepha, iMichiza kunye noPhephelo
I-Myasthenia gravis ibangela ubuthathaka obuthakathaka ngenxa yesistim somzimba sokuhlasela i-neurotransmitter receptors kwimisipha yomzimba. Ekubeni i-muscle ayikwazi ukufumana isignali kwisivumelwano, abantu abane-myasthenia babe buthathaka. Nangona le ngxaki ye-neuromuscular disorder isetyenziswa ukuhlala ikhubaza kwaye ibulawe, ngoku iyakwazi ukulawulwa ngeendlela ezahlukeneyo zokwelapha.
Kukho iindlela ezintlanu zokuphatha i-myasthenia gravis. Ezinye iindlela zisetyenziswe kakuhle kwiimeko ezinzima ukuze kugcinwe umntu ngaphandle kweyunithi yonyango eninzi, nangona oku kusezinye iimfuneko kwiimeko ezinzima. Abanye bathetha ngokubanzi ukukhusela ezo nkathazo ezenzekayo kwindawo yokuqala - isicwangciso sokukhusela.
Gwema Izinto ezikhuselekileyo ukukhusela i-Myasthenic Attacks
Ngenxa yokuba isifo esizimele, nantoni na ephazamisa isistim somzimba singakwazi ukwandisa umngcipheko weengxaki ze-myasthenic, ngokubandezeleka okukhulu okungathumela umntu kwiyunithi yokunyamekela. Ukuqaphela nokukhusela nayiphi na into ebangela ukuba kubekho nto ebalulekileyo ekulawuleni eso sifo. Ngokomzekelo, amayeza asetyenziswa ngokuqhelekileyo njenge-ciprofloxacin okanye enye i- antibiotics , kwaye i-beta-blockers efana nepropranolol, i-lithium, i-magnesium, i-verapamil kunye nokunye, ingangonakalisa iimpawu ze-myasthenia gravis. Ngokuqhelekileyo, abantu abane-myasthenia kufuneka baqaphele ngaphambi kokuqala nawaphi na amachiza amasha baze bajonge emva koko ngenxa yempawu zobuthathaka.
Ukuphathwa kweMpawu zeMyasthenia Gravis
Ubuthathaka be-myasthenia gravis kwenzeka xa i-acetylcholine receptor ihlaselwa ngumzimba womzimba. Ukuxhaswa kwemali ye-acetylcholine ekhoyo kwiqumrhu le-neuromuscular inokukunceda ukunqoba le ntsilelo. Umzimba uvame ukususa i-acetylcholine kwi-synapse ngokusebenzisa i-enzymes ebizwa ngokuba yi-acetylcholinesterases.
Izidakamizwa ezibizwa ngokuba yi-cholinesterase inhibitors (ezithintela isenzo salezi enzymes) zingakhokelela ekubeni i-acetylcholine ishiywe kwi-synapse ixesha elide, livumele ukuba libophelele kwiimitholamli ezibonisa izihlunu.
I-Acetylcholinesterase inhibitors iquka i-pyridostigmine (iMestinon), eyona nto isicatshulwa esisetyenziswayo kwi-myasthenia gravis. Imiphumo emibi ibandakanya ukuhanjiswa, ukuchithwa, kunye nesiphithiphithi. Ukuthatha amayeza ngokutya kunokuncedisa ukunciphisa iziphumo ezibi. Ngokumangalisayo kukuba, ngamanye amaxesha amaninzi anokwenziwa ngama-anticholinesterase amayeza aneempembelelo zecala lobuthathaka, okunokuba nzima ukuhlula kwi-myasthenia ngokwayo. Oku kunqabile kakhulu ukuba i-pyridostigmine isetyenziswe ngaphakathi kwezilwanyana ezinconywayo, nangona kunjalo.
I-Immunotherapy engapheliyo ye-Myasthenia Gravis
Uninzi lwabantu abane-myasthenia gravis luphela luthabatha amachiza ukukhusela iimpawu zokungena kuzo. I-immunotherapy ijolise i-antibodies ephantsi ehlasela ama-acetylcholine receptors. Ngokuguqula umzimba wamasosha omzimba, ubukhulu kunye nobukhulu bokuhlaselwa kokunciphisa.
I-glucocorticoids efana ne-prednisone isoloko isetyenziselwa ukukhusela isistim somzimba sabantu abane-myasthenia. Ezinye iindlela ziquka i-cyclosporine, i-azathioprin, ne-mycophenolate.
Zonke ezi zonyango zichaphazelekayo, ezinye zazo zinzima kakhulu. Izingozi zonyango kufuneka zicingwe ngenyameko malunga neenzuzo zokuhlaselwa okuncinci nakwi-myasthenia.
Ukwelashwa kwe-Immunomodulating kwi-Myasthenia Gravis
Nangona ama-agent angama-immunotherapy anesifo esingapheliyo acwangciselwe ukusebenza ixesha elide, ezinye iimeko zifuna isenzo esheshayo. Umzekelo uya kuba yintlupheko ye-myasthenic, okanye phambi kokuhlinzwa okanye esinye isiganeko esiyimfuneko esilindeleke ukuba sikwazi ukunyusa ingxaki leyo. Ukukhawuleza kwe-immunotherapies isebenza ngaphakathi kweentsuku, kodwa iinzuzo zabo ziphela kuphela kwiiveki, kwaye azinakuthi zinconywe ngexesha elide.
Ukutshintshiselwa kwePlasma (plasmapheresis) kususa amanqindi e-circulation. Le nkqubo ibiza, kwaye iyenzeka ngokuphindwe kabini kwiintsuku ezi-7 ukuya kwezi-14. Iingxaki zingabandakanya i-arrhythmia, i-cell engeyiyo, i-cramps ye-muscle, kunye nokunye.
I-immunoglobulin (i-IVIG) engabonakaliyo ibonakaliswe ukuba iyincedo kwizifo ezibangelwa ukuphendula ngokuzenzekelayo, kodwa indlela echanekileyo ayicacanga. Uphulo luvame ukuqukwa kweentsuku ezimbini ukuya kwiintsuku zokujova. Imiphumo emibi isoloko ilula kodwa ingabandakanya ukungaphumeleli kwe-renal, i- meningitis , kunye neempendulo.
Unyango loPhando lweMyasthenia Gravis
Uninzi lwabantu abane-myasthenia gravis banomsebenzi ongaqhelekanga kwi-thymus yabo, isistim somzimba sokuzivikela kwisiseko sentamo. Ngamanye amaxesha iimpawu ze-myasthenic zabantu ziphucula okanye zitshintsha emva kokuba i-thymus isuswe ngexesha lwenkqubo ebizwa ngokuba yi-thymectomy. Akukho siqinisekiso saloo mphumo, nangona kunjalo. Ipesenti ephakamileyo yabantu abane-myasthenia bane-tummy tumor (thymoma), kwaye oogqirha bavuma ukuba utyando lubonakaliswe kule meko. Ingaba i-thymectomy iboniswe kwezinye iimeko ayicacile, kwaye kufuneka ixoxwe kunye neurologist kwiimeko ngamacala.
Okukwintsusa
I-Myasthenia gravis isifo esibalulekileyo, kodwa kukho iindlela ezininzi zokwelapha ezikhoyo ezimbini ukunciphisa ubuthathaka xa kwenzeka kwaye kuncedise ukunciphisa ubukhulu kunye nobukhulu beentlanzi. Ngenxa yeziphumo ezinobungozi kunye nawo onke amayeza, inkqubo yokonyango kufuneka ixoxwe nge-neurologist enolwazi olufanelekileyo lwe-myasthenia gravis kunye neengxaki zalo.
Imithombo:
I-Adams kunye neMigaqo yeVictor ye-Neurology, 9th: I-McGraw-Hill Companies, Inc., 2009.
Braunwald E, Fauci ES, et al. Iinqununu zeHarrison zeMithi yoPhakathi. 16th. 2005.
I-Sieb, i-JP (2014) I-Myasthenia gravis: ukuhlaziywa kliniki. I-Immunology yeCliniki kunye noVavanyo 175 (3): 408-18.
INKCAZELO: Ulwazi olukule ndawo lusezinjongo zemfundo kuphela. Akufanele isetyenziswe njengendawo yokunyamekelwa ngumntu ogqirha. Nceda ubone ugqirha wakho ukuze ufumane unyango kunye nonyango malunga nayiphi na impawu okanye imeko yonyango .