Ankylosing spondylitis

Ankylosing spondylitis (AS) ndi mtundu wamatenda wamatenda. Amakhudza kwambiri mafupa ndi malo am'munsi mwa msana komwe amalumikizana ndi mafupa a chiuno. Malowawa amatha kutupa ndikutupa. Popita nthawi, mafupa a msana omwe akhudzidwa amatha kulumikizana.

AS ndiye membala wamkulu m'banja lamatenda ofanana otchedwa spondyloarthritis. Mamembala ena amaphatikiza nyamakazi ya psoriatic, nyamakazi yamatenda opatsirana komanso nyamakazi yothandizira. Banja la nyamakazi limawoneka lofala ndipo limakhudza mpaka 1 mwa anthu 100.

Zomwe zimayambitsa AS sizikudziwika. Chibadwa chimakhala ndi gawo. Anthu ambiri omwe ali ndi AS ali ndi chiyembekezo cha mtundu wa HLA-B27.

Matendawa amayamba azaka zapakati pa 20 ndi 40, koma amatha kuyamba asanakwanitse zaka 10. Amakhudza amuna ambiri kuposa akazi.

AS imayamba ndikumva kupweteka kwakumbuyo komwe kumabwera ndikupita. Kupweteka kwakumbuyo kumakhalapo nthawi zambiri mkhalidwewo ukamapita.

• Ululu ndi kuuma kumakulirakulira usiku, m'mawa, kapena mukakhala kuti simukugwira ntchito. Zovuta zimatha kukudzutsani ku tulo.
• Ululu nthawi zambiri umakhala bwino ndikachita masewera olimbitsa thupi.
• Ululu wammbuyo ukhoza kuyamba pakati pa mafupa ndi msana (mafupa a sacroiliac). Popita nthawi, itha kuphatikizira msana wonse kapena gawo lina.
• Msana wanu wam'munsi ukhoza kukhala wosasinthasintha. Popita nthawi, mutha kuyimirira patsogolo.

Ziwalo zina za thupi lanu zomwe zingakhudzidwe ndizo:

• Malumikizidwe amapewa, mawondo ndi akakolo, omwe atha kutupa ndikupweteka
• Malo olumikizirana pakati pa nthiti ndi chifupa chanu, kuti musathe kukulitsa chifuwa chanu kwathunthu
• Diso, lomwe limatha kukhala ndikutupa komanso kufiyira

Kutopa ndichizindikiro chofala.

Zizindikiro zochepa zimaphatikizapo:

• Kutentha pang'ono

AS zitha kuchitika ndi zina, monga:

• Psoriasis
• Ulcerative colitis kapena matenda a Crohn
• Kutupa kwamaso kobwerezabwereza kapena kosatha (iritis)

Mayeso atha kuphatikiza:

• Zamgululi
• ESR (muyeso wa kutupa)
• HLA-B27 antigen (yomwe imazindikira jini yolumikizidwa ndi ankylosing spondylitis)
• Rheumatoid factor (yomwe iyenera kukhala yoyipa)
• X-ray ya msana ndi mafupa a chiuno
• MRI ya msana ndi mafupa a chiuno

Wothandizira zaumoyo wanu akhoza kukupatsani mankhwala monga ma NSAID kuti achepetse kutupa ndi kupweteka.

• Ma NSAID ena atha kugulidwa pa-a-counter (OTC). Izi zimaphatikizapo aspirin, ibuprofen (Advil, Motrin), ndi naproxen (Aleve, Naprosyn).
• Ma NSAID ena amalamulidwa ndi omwe amakupatsani.
• Lankhulani ndi omwe amakupatsani kapena wamankhwala musanagwiritse ntchito nthawi yayitali NSAID iliyonse.

Mungafunenso mankhwala amphamvu kuti muchepetse ululu ndi kutupa, monga:

• Mankhwala a Corticosteroid (monga prednisone) amagwiritsidwa ntchito kwakanthawi kochepa
• Sulfasalazine
• Biologic TNF-inhibitor (monga etanercept, adalimumab, infliximab, certolizumab kapena golimumab)
• Biologic inhibitor ya IL17A, secukinumab

Kuchita opaleshoni, monga kubwezeretsa mchiuno, kumatha kuchitidwa ngati kupweteka kapena kuwonongeka kwamagulu kuli kovuta.

Kuchita masewera olimbitsa thupi kumatha kuthandizira kukonza mawonekedwe ndi kupuma. Kugona pansi msana wanu usiku kungakuthandizeni kuti mukhale okhazikika.

Matendawa ndi ovuta kulosera. Popita nthawi, zizindikilo ndi zizindikilo za AS flareup (kubwereranso) ndikukhazikika pansi (chikhululukiro). Anthu ambiri amatha kugwira ntchito bwino pokhapokha atawonongeka kwambiri m'chiuno kapena msana. Kuphatikizana ndi gulu la ena omwe ali ndi vuto lomwelo nthawi zambiri kumathandiza.

Kuchiza ndi NSAIDS nthawi zambiri kumachepetsa kupweteka ndi kutupa. Chithandizo ndi ma TNF inhibitors koyambirira kwa matendawa chikuwoneka kuti chikuchedwa kuchepa kwa nyamakazi ya msana.

Nthawi zambiri, anthu omwe ali ndi ankylosing spondylitis atha kukhala ndi mavuto ndi:

• Psoriasis, matenda osatha akhungu
• Kutupa m'maso (iritis)
• Kutupa m'matumbo (colitis)
• Nyimbo yachilendo
• Kutupa kapena kukulitsa kwamapapo minofu
• Kukhwimitsa kapena kukulitsa kwa valavu yamitima ya aortic
• Matenda a msana atagwa

Itanani omwe akukuthandizani ngati:

• Muli ndi zizindikiro za ankylosing spondylitis
• Muli ndi ankylosing spondylitis ndikupanga zizindikilo zatsopano mukamalandira chithandizo

Spondylitis; Spondyloarthritis; HLA - Spondylitis

• Mafupa msana
• Cervical spondylosis

Gardocki RJ, Park AL. Matenda osachiritsika a thoracic ndi lumbar msana. Mu: Azar FM, Beaty JH, Canale ST, eds. Opaleshoni ya Campbell. Wolemba 13. Philadelphia, PA: Elsevier; 2017: mutu 39.

Inman RD. Mitundu ya spondyloarthropathies. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 249.

van der Linden S, Brown M, Gensler LS, Kenna T, Maksymowych WP, Taylor WJ. Ankylosing spondylitis ndi mitundu ina ya axial spondyloarthritis. Mu: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, olemba. Buku la Firestein & Kelly la Rheumatology. 11th ed. Philadelphia, PA: Elsevier; 2021: chap 80.

Wadi MM, Deodhar A, Gensler LS, et al. Kusintha kwa 2019 kwa American College of Rheumatology / Spondylitis Association of America / Spondyloarthritis Research and Treatment Network Malangizo othandizira chithandizo cha ankylosing spondylitis ndi nonradiographic axial spondyloarthritis. Chisamaliro cha Arthritis Res (Wopanda nzeru). 2019; 71 (10): 1285-1299. (Adasankhidwa) PMID: 31436026 pubed.ncbi.nlm.nih.gov/31436026/. (Adasankhidwa)

Werner BC, Feuchtbaum E, Shen FH, Samartzis D. Ankylosing spondylitis wa khomo lachiberekero. Mu: Shen FH, Samartzis D, Fessler RG, olemba. Buku la Cervical Spine. Philadelphia, PA: Elsevier Saunders; 2015: mutu 28.