Nyamakazi ya Achinyamata Idiopathic

Zamkati

• Kodi zizindikiro za matenda a nyamakazi achichepere ndi ati?
• Kodi mitundu yamatenda aamuna achichepere ndi chiyani?
• Kodi matenda a nyamakazi a achinyamata amapezeka bwanji?
• Kodi matenda a nyamakazi aana amathandizidwa bwanji?
• Chithandizo chamankhwala
• Njira zamoyo
• Kudya bwino
• Kuchita masewera olimbitsa thupi pafupipafupi
• Thandizo lakuthupi
• Kodi mavuto azovuta zamatenda amwana achichepere ndi ati?
• Kodi malingaliro a ana omwe ali ndi nyamakazi ya achinyamata ndi otani?

Kodi juvenile idiopathic arthritis ndi chiyani?

Matenda aamuna achichepere (JIA), yemwe kale ankatchedwa nyamakazi ya nyamakazi, ndiye nyamakazi yodziwika kwambiri mwa ana.

Matenda a nyamakazi ndi omwe amakhala ndi nthawi yayitali ndi:

• kuuma
• kutupa
• kupweteka m'malo olumikizirana mafupa

Ana pafupifupi 300,000 ku United States ali ndi vuto la nyamakazi. Ana ena ali ndi nyamakazi kwa miyezi ingapo, pomwe ena ali ndi nyamakazi kwa zaka zingapo. Nthawi zambiri, vutoli limatha kukhala moyo wonse.

Zomwe zimayambitsa JIA sizikudziwika. Komabe, ofufuza amakhulupirira kuti makamaka ndimatenda amthupi okha. Mwa anthu omwe ali ndi matenda omwe amadzichitira okhaokha, chitetezo cha mthupi molakwika chimagunda maselo osavulaza ngati kuti ndiwowopsa.

Milandu yambiri ya JIA ndiyofatsa, koma milandu yayikulu imatha kubweretsa zovuta, monga kuwonongeka kwamagulu ndi kupweteka kwakanthawi. Kudziwa zizindikiritso za JIA ndikofunikira kuti mupeze chithandizo chisanachitike.

Chithandizo nthawi zambiri chimakhala ndi:

• kuchepa kwa kutupa
• kusamalira ululu
• kukonza ntchito
• kupewa kuwonongeka kwamagulu

Izi zitha kuthandiza kuwonetsetsa kuti mwana wanu amakhala ndi moyo wokangalika, wopindulitsa.

Kodi zizindikiro za matenda a nyamakazi achichepere ndi ati?

Zizindikiro zodziwika bwino za JIA ndi izi:

• kupweteka pamodzi
• kuuma
• Kuchepetsa mayendedwe osiyanasiyana
• malo ofunda ndi otupa
• kutsimphina
• kufiira m'deralo
• zotupa zam'mimba zotupa
• malungo obwerezabwereza

JIA itha kukhudza gawo limodzi kapena zingapo. Nthawi zina, vutoli limatha kukhudza thupi lonse, kumayambitsa zotupa, malungo, ndi ma lymph node otupa. Subtype iyi imatchedwa systemic JIA (SJIA), ndipo imachitika pafupifupi 10 peresenti ya ana omwe ali ndi JIA.

Kodi mitundu yamatenda aamuna achichepere ndi chiyani?

Pali mitundu isanu ndi umodzi ya JIA:

• Zokhudza JIA. JIA yamtunduwu imakhudza thupi lonse, kuphatikiza mafupa, khungu, ndi ziwalo zamkati.
• Oligoarticular JIA. Mtundu uwu wa JIA umakhudza zosakwana zisanu. Amapezeka pafupifupi theka la ana onse omwe ali ndi nyamakazi.
• Polyarticular JIA. JIA yamtunduwu imakhudza maphatikizidwe asanu kapena kupitilira apo. Puloteni yotchedwa rheumatoid factor ikhoza kukhalapo kapena mwina sipangakhalepo.
• Matenda a achinyamata a psoriatic. Mtundu uwu wa JIA umakhudza malo am'mimbamo ndipo umachitika ndi psoriasis, ndichifukwa chake amatchedwa nyamakazi ya ana ya psoriatic.
• JIA yokhudzana ndi matenda opatsirana. Mtundu uwu wa JIA umakhudza mafupa kukumana ndi tendon ndi ligaments.
• Nyamakazi yosadziwika. Mtundu wa JIA umakhala ndi zizindikilo zomwe zimatha kupitilira magawo awiri kapena kupitilira apo kapena osagwirizana ndi mitundu ina iliyonse.

Matenda omwe amakhudzidwa kwambiri, nthawi zambiri amatenga matendawa.

Kodi matenda a nyamakazi a achinyamata amapezeka bwanji?

Wothandizira zaumoyo wa mwana wanu atha kudziwa matenda a JIA pochita mayeso owoneka bwino ndikupempha mbiri yakale yazachipatala.

Akhozanso kuyitanitsa mayeso osiyanasiyana azidziwitso, monga:

• Mayeso othandizira mapuloteni a C. Kuyesaku kumayeza kuchuluka kwa mapuloteni othandizira C (CRP) m'magazi. CRP ndichinthu chomwe chiwindi chimatulutsa chifukwa cha kutupa. Chiyeso china chomwe chimazindikira kutupa, kuchuluka kwa sedimentation kapena erythrocyte sedimentation rate (ESR), chitha kuchitidwanso.
• Kuyesa kwaminyewa. Kuyesaku kumazindikira kupezeka kwa nyamakazi, antibody wopangidwa ndi chitetezo chamthupi. Kupezeka kwa antibody uyu nthawi zambiri kumawonetsa matenda a rheumatic.
• Antinuclear antibody. Antinuclear antibody ndi antibody wa nucleic acid (DNA ndi RNA) yomwe imapezeka makamaka pakatikati mwa selo. Nthawi zambiri zimapangidwa ndi chitetezo chamthupi mwa anthu omwe ali ndi matenda omwe amadzichitira okha. Kuyesedwa kwa antiinuclear antibody kumatha kuwonetsa ngati puloteni ilipo m'magazi.
• Mayeso a HLA-B27. Chiyesochi chimafufuza cholozera chomwe chimakhudzana ndi JIA yokhudzana ndi enthesitis.
• X-ray kapena MRI scan. Kuyesaku koyerekeza kumatha kugwiritsidwa ntchito kuthana ndi zovuta zina zomwe zitha kuyambitsa kutupa kapena kupweteka limodzi, monga matenda opatsirana. Kujambula kumatha kuwunikiranso zomwe zapezedwa (zizindikilo) zama subsets am'mimba yotupa.

Kodi matenda a nyamakazi aana amathandizidwa bwanji?

Mankhwala osiyanasiyana amatha kusamalira ndi kuchepetsa zovuta za JIA. Opereka chithandizo chamankhwala nthawi zambiri amalangiza kuphatikiza mankhwala kuti athetse ululu ndi kutupa komanso kuti azitha kuyenda komanso kulimba.

Chithandizo chamankhwala

Mankhwala osagwiritsidwa ntchito poletsa kutupa (NSAIDs), monga ibuprofen (Advil) ndi naproxen (Aleve), amagwiritsidwa ntchito pochepetsa kutupa ndi kutupa molumikizana ndi mankhwala ena. Kugwiritsa ntchito aspirin ndikosowa chifukwa cha zovuta zomwe zingachitike mwa ana.

Mankhwala olimba nthawi zambiri amapatsidwa, monga kusinthitsa matenda osokoneza bongo (DMARDs) ndi biologics.

Ma DMARD amayesetsa kusintha matendawa, potero amapondereza chitetezo cha mthupi kuti chiteteze ziwalozo.

Kugwiritsira ntchito DMARD kumalimbikitsidwa pa NSAID zokha. Wopereka chithandizo chaumoyo wa mwana wanu angayambe kumwa mankhwala ndi DMARD kapena popanda NSAID musanagwiritse ntchito biologics.

Zitsanzo zina za ma DMARD omwe amagwiritsidwa ntchito pochiza JIA ndi awa:

• methotrexate
• sulfasalazine
• chinyama

Ndikofunika kuzindikira kuti methotrexate ikulimbikitsidwa pano kuposa ma DMARD ena.

Biologics imagwira ntchito yolunjika mwachindunji mamolekyulu kapena mapuloteni omwe akukhudzidwa ndi matendawa. Chithandizo ndi biologics chitha kuphatikizidwa ndi mankhwala a DMARD.

Zitsanzo zina za biologics zomwe zingagwiritsidwe ntchito kuthandiza kuchepetsa kutupa ndi kuwonongeka kwamagulu ndi monga:

• akupha (Orencia)
• rituximab (Rituxan)
• tocilizumab (Actemra)
• TNF zoletsa (Humira)

Mankhwala a steroid atha kulowetsedwa mgulu lomwe lakhudzidwa, makamaka ngati zizindikilo zikulepheretsa kuchita zinthu za tsiku ndi tsiku. Komabe, izi sizikulimbikitsidwa pamene mfundo zambiri zimakhudzidwa. Pazovuta kwambiri, opareshoni itha kugwiritsidwa ntchito m'malo mwa ziwalozo palimodzi.

Njira zamoyo

Kuchita masewera olimbitsa thupi ndikusunga zakudya zopatsa thanzi ndikofunikira kwa aliyense, koma ndiopindulitsa makamaka kwa ana omwe ali ndi JIA. Kukhala ndi mwana wanu kusintha njira zotsatirazi kumawathandiza kuthana ndi zizolowezi zawo mosavuta ndikuchepetsa chiopsezo cha zovuta:

Kudya bwino

Kusintha kwamafuta kumakhala kofala kwa ana omwe ali ndi JIA. Mankhwala atha kukulitsa kapena kuchepetsa kudya kwawo, kupangitsa kunenepa mwachangu kapena kuwonda. Zikatere, chakudya chopatsa thanzi chokhala ndi kuchuluka kwama calories chitha kuthandiza mwana wanu kuti akhale ndi thupi loyenerera.

Lankhulani ndi omwe amakuthandizani pazakudya ngati mwana wanu akulemera kapena kuchepa kwambiri chifukwa cha JIA.

Kuchita masewera olimbitsa thupi pafupipafupi

Kuchita masewera olimbitsa thupi katatu pamlungu kumatha kulimbikitsa minofu ndikuthandizira kusinthasintha kwamalumikizidwe, kuti zikhale zosavuta kuthana ndi JIA m'kupita kwanthawi. Zochita zochepa, monga kusambira ndi kuyenda, nthawi zambiri zimakhala zabwino. Komabe, ndibwino kuyankhula kaye ndi wothandizira zaumoyo wa mwana wanu poyamba.

Thandizo lakuthupi

Katswiri wazachipatala atha kuphunzitsa mwana wanu kufunika kotsatira zomwe akuchita ndipo atha kulangiza zolimbitsa thupi malinga ndi momwe alili. Wothandizirayo atha kupereka malingaliro pazolimbitsa thupi zina zomwe zingathandize kumanga mphamvu ndikubwezeretsanso kusinthasintha kwamalumikizidwe olimba, opweteka.

Adzagwira ntchito ndi omwe amakupatsani chithandizo chazachipatala kuti muteteze kuwonongeka kwamagulu ndi zovuta zapafupa / zolumikizana.

Kodi mavuto azovuta zamatenda amwana achichepere ndi ati?

JIA yosachiritsidwa imatha kubweretsa zovuta zina. Izi zikuphatikiza:

• kuchepa kwa magazi m'thupi
• kupweteka kwakanthawi kosatha
• chiwonongeko cha onse
• kukula kochepa
• miyendo yopanda malire
• kusintha kwa masomphenya
• pericarditis, kapena kutupa mozungulira mtima

Kodi malingaliro a ana omwe ali ndi nyamakazi ya achinyamata ndi otani?

Ana omwe ali ndi JIA wofatsa mpaka pang'ono amatha kuchira popanda zovuta. Komabe, JIA ndimkhalidwe wanthawi yayitali womwe umayambitsa ziwonetsero zina. Mwana wanu akhoza kuyembekezera kukhala ndi kuuma ndi kupweteka m'malumikizidwe panthawi imeneyi.

JIA ikapita patsogolo kwambiri, mwayi wopita kukhululukidwa umakhala wotsika kwambiri. Ichi ndichifukwa chake kuzindikira koyambirira ndi chithandizo chake ndizofunikira. Kuchiza mwachangu kumathandiza kuti nyamakazi isakhale yolimba ndikufalikira kuzilumikizidwe zina.