Ukuqala Kwe-Arteritis Yeselula Ekhulu? Izimpawu, Izimbangela, Nokwelashwa

I-arteritis yeselula enkulu yisimo lapho i-arteries elikhanda lakho nekhoneni zakho ziba luvalo futhi zifike. Lo luvalo lubonakala kakhulu kuma-arteries e-temporal, okuyizitsha zegazi ezihamba eceleni kwekhhanda lakho eduze kwitempile zakho.

Ungase uzwe odokotela bebiza lesi simo ngokuthi i-temporal arteritis ngenxa yendawu lapho iqala khona. Ukuvuvukala kungenza lezi arteries zibe zinzima futhi zibuhlungu, okunciphisa ukugeleza kwegazi ezindaweni ezibalulekile njengeziso zakho, ubuchopho, nekhanda.

Ziyini izimpawu ze-Arteritis Yeselula Ekhulu?

Isimpawu esivamile kakhulu yinhloko ebuhlungu kakhulu, ehlala ihlala, ehluke kunanoma iyiphi inhloko okade uyithola ngaphambili. Le nhloko ivame ukubamba ohlangothini olulodwa noma kokubili kwekhhanda lakho, ikakhulukazi eduze kwendawo yethapile.

Nazi izimpawu eziyinhloko ongazihlangabezana nazo:

• Ukuhlunguluka kwenhloko okukhulu, ngokuvamile endaweni yethapile
• Ubuhlungu bekhanda lapho uhlanza izinwele zakho noma ulele epilini
• Ubuhlungu noma ukubamba kwesigaxa lapho uqamula noma ukhuluma
• Izinkinga zobuso, kufaka phakathi ukubona okuphazamisekile noma ukubona okubili
• Ukukhathala nokubona sengathi awuhlali kahle
• Ukuthuthumela nomkhuhlane ebusuku
• Ukwehliswa kwesisindo okungathandeki
• Ukuqina kwamahlombe namagxolo

Ukushintsha kobuso kufanele kunakekelwe ngokukhethekile ngoba kungabonisa inkinga enkulu. Abanye abantu bahlangabezana nokwehliswa kobuso okwesikhashana okuza nokwehla, kanti abanye bangase baphawule ukubona kwabo kuqala noma kube mnyama.

Ezimeni ezingavamile, ungase uthuthukise ukwehliswa kobuso ngokungazelelwe, okungapheli kwelinye noma zombili iziso. Lokhu kwenzeka lapho i-arteries ezivuvukile zinciphisa ukugeleza kwegazi enerveni yobuso, futhi kubhekwa njengesiphuthumayo sezokwelapha.

Yini ebangela i-Arteritis Yeselula Ekhulu?

Imbangela eqondile ye-arteritis yeselula enkulu ayiqondakali ngokuphelele, kodwa odokotela bakholelwa ukuthi kwenzeka lapho isimiso sakho sokugcina sihlasele izitsha zakho zegazi. Lo mpendulo we-autoimmune uqalisa ukuvuvukala odongeni lwe-arterial.

Izici eziningi zingase zifake isandla ekuthuthukiseni lesi simo:

• Ubudala - cishe kubonakala kubantu abadala kuno-50, ngokuthuthuka okuphezulu phakathi kweminyaka engama-70-80
• Ubulili - abesifazane banethuba elingaphezulu kabili lokuthuthukisa uma kuqhathaniswa namadoda
• I-Genetics - izici ezithile ezifuywe zingase zikhulise ukuqina kwakho
• Indawo yomhlaba - ivame kakhulu kubantu baseYurophu yaseNyakatho namazwe aseScandinavia
• Ukutheleleka - abanye abacwaningi bacabanga ukuthi ukutheleleka kwe-viral noma i-bacterial kungase kuqalise lesi simo kubantu abathintekayo

Izici zemvelo zingase futhi zidlale indima, nakuba abacwaningi basafunda le miqondiso. Isimo sihlala sivela ngezigaba, ngezimo eziningi ezivela ngezikhathi ezithile noma eminyakeni.

Ezimeni ezingavamile, i-arteritis yeselula enkulu ingahlotshaniswa nezinye izimo ze-autoimmune noma ithuthukiswe kanye ne-polymyalgia rheumatica, ebangela ubuhlungu bemisipha nokuqina.

Nini okufanele ubona udokotela nge-Arteritis Yeselula Ekhulu?

Kufanele ufuna ukunakekelwa kwezokwelapha ngokushesha uma uhlangabezana nokushintsha kobuso ngokungazelelwe, izihlungu zezinhlangothi ezibuhlungu kakhulu ezihluke kunama-headache akho avamile, noma ubuhlungu besigaxa lapho uqamula. Lezi zimpawu zingabonisa ukuthi lesi simo sithinta ukugeleza kwegazi ezindaweni ezibalulekile.

Ungalindi uma uqaphela noma yiziphi izinkinga zobuso, ngisho noma zibonakala ziza nokwehla. Ukwehliswa kobuso okuvela ku-arteritis yeselula enkulu kungaba okungapheli uma kungelashwa ngokushesha, ngakho isikhathi sibalulekile ekuvikeleni ukubona kwakho.

Kufanele uxhumane nodokotela wakho uma unezimpawu eziqhubekayo njengezihlungu zezinhlangothi eziqhubekayo, ubuhlungu bekhanda, noma ukukhathala okungachazeki kanye nezinye izimpawu. Ukuxilongwa kwasekuqaleni nokwelashwa kungavimbela izinkinga ezinzima futhi kukusize uzizwe ukhulu ngokushesha.

Ziyini izici ezingozi ze-Arteritis Yeselula Ekhulu?

Ubudala yisici esinamandla kakhulu sokuthuthukisa i-arteritis yeselula enkulu. Isimo silimale kakhulu kubantu abaneminyaka engaphansi kuka-50, futhi ingozi yakho ikhuphuka kakhulu njengoba ukhula, ikakhulukazi ngemuva kweminyaka engama-70.

Izici eziningi zingase zikhulise amathuba akho okuthuthukisa lesi simo:

• Ukuba owesifazane - abesifazane bathuthukisa i-arteritis yeselula enkulu cishe kabili njengendoda
• Ubuzwe baseYurophu yaseNyakatho - abantu baseScandinavia, baseYurophu yaseNyakatho, noma baseMedithera banesilinganiso esiphezulu
• Ukuba ne-polymyalgia rheumatica - cishe u-15-20% wabantu abanesimo semisipha nabo bathuthukisa i-arteritis yeselula enkulu
• Umlando womndeni - ukuba nezihlobo ezinezimo ze-autoimmune kungase kukhulise ingozi yakho kancane
• Izimpawu ezithile ze-genetic - izici ezithile ezifuywe ezihlobene nomsebenzi wesimiso sokugcina

Indawo yomhlaba ibalulekile, ngezilinganiso eziphezulu ezibikiwe emazingeni aseNyakatho nasezindaweni ezithile njengeMinnesota neScandinavia. Noma kunjalo, isimo singase senzeke kuphi noma yikuphi iqembu lezinhlanga.

Ezimeni ezingavamile, abantu abanezimo ze-autoimmune noma labo abake baba nokutheleleka okuthile bangase babe nengozi encane ephakeme, nakuba le miqondiso isafundwa.

Ziyini izinkinga ezingase zenzeke nge-Arteritis Yeselula Ekhulu?

Inkinga enkulu kakhulu ukwehliswa kobuso, okungase kwenzeke ngokungazelelwe futhi kube okungapheli uma isimo singelashwa ngokushesha. Lokhu kwenzeka lapho i-arteries ezivuvukile zinciphisa ukugeleza kwegazi enerveni yakho yobuso noma kuma-arteries anikeza amehlo akho.

Nazi izinkinga eziyinhloko ezingase zithuthuke:

• Ukwehliswa kobuso okungapheli kwelinye noma zombili iziso
• Isifo sobuchopho - uma ukuvuvukala kuthinta i-arteries ehlinzeka ubuchopho
• I-Aortic aneurysm - ukubuthakathaka nokukhula kwe-artery enkulu yomzimba
• Izinkinga zenhliziyo - kufaka phakathi ukuhlaselwa yinhliziyo ezimeni ezingavamile
• Ubuhlungu obuhlala njalo nokukhubazeka okuvela ekuvuvukaleni okuqhubekayo

Izinkinga zobuso zingase zihluke ezigabeni zesikhashana zobuso oludimile kuya ekubulaleni okuphelele, okungapheli. Cishe u-15-20% wabantu abangenayo i-arteritis yeselula enkulu bahlangabezana nokulahlekelwa kobuso.

Isifo sobuchopho yinkinga enkulu kodwa engavamile engase ibe khona uma ukuvuvukala kusakazeka kuma-arteries anikeza ubuchopho bakho. Ezimeni ezingavamile kakhulu, isimo singase sithinte i-aorta, siholele kuma-aneurysms athuthuka eminyakeni kamuva futhi adinge ukulandelelwa.

Izindaba ezinhle ukuthi ngokwelashwa okufanele, izinkinga eziningi zingavikeleka noma ingozi yazo inciphisa kakhulu.

I-Arteritis Yeselula Ekhulu ixilongwa kanjani?

Udokotela wakho uzoqala ngokubuza ngezimpawu zakho futhi enze ukuhlolwa komzimba, anikeze ukunakekelwa okukhethekile ezitempilini zakho nase-temporal arteries. Bazozwa ubuhlungu, ukuvuvukala, noma i-pulse encishisiwe kulezi arteries.

Izivivinyo eziningi zisiza ukuqinisekisa ukuxilongwa:

• Izivivinyo zegazi - ukuhlola izimpawu zokuvuvukala njenge-ESR ne-CRP
• I-Temporal artery biopsy - ukususa ingxenye encane ye-artery ukuze ihlolwe
• I-Ultrasound ye-temporal arteries - ukubuka izimpawu zokuvuvukala
• Ukuhlolwa kwamehlo - ukuhlola izinkinga zobuso noma ukonakala kwe-optic nerve
• I-MRI noma i-CT scans - kwezinye izimo ukuvimbela ezinye izimo

I-temporal artery biopsy ithathelwa ingqondo njengendlela ebaluleke kakhulu yokuxilongwa, nakuba kuyindlela encane yokwelapha. Udokotela wakho uzoqeda ingxenye encane ye-temporal artery, ngokuvamile ngaphansi kokwelashwa kwendawo, futhi ayihlole ngaphansi komkhiqizo we-microscope ukuze kube khona ukushintsha okubalulekile.

Izivivinyo zegazi ezibonisa izimpawu zokuvuvukala eziphakeme zisekela ukuxilongwa, kodwa imiphumela evamile ayikhiphi lesi simo. Ezimeni ezingavamile lapho imiphumela ye-biopsy ingacaci, udokotela wakho angase asebenzise amasu okubuka okuphambili noma alandelele impendulo yakho ekwelapheni.

Yikuphi ukwelashwa kwe-Arteritis Yeselula Ekhulu?

Ukwelashwa kuqala ngokushesha nge-corticosteroids enkulu, ngokuvamile i-prednisone, ukuze kunciphisa ukuvuvukala ngokushesha futhi kuvimbele izinkinga. Abantu abaningi baqala ukuzizwa bekhulu ezinsukwini ezimbalwa ngemuva kokuqala ukwelashwa, nakuba inkambo ephelele ivame ukuphela izinyanga kuya eminyakeni.

Nanku lokho ukwelashwa okuvamile okuhilela:

• I-prednisone enkulu yomlomo (40-60mg nsuku zonke) ekuqaleni
• Ukuncipha kancane komthamo eminyakeni engu-1-2
• Ukulandelelwa njalo ngezivivinyo zegazi nokuhlolwa kwamehlo
• I-calcium ne-vitamin D supplements ukuvikela amathambo
• Imithi eyengeziwe njenge-methotrexate kwezinye izimo

Uma uhlangabezana nezinkinga zobuso, udokotela wakho angase akunikeze imithamo ephakeme ye-steroids ekuqaleni, ngezinye izikhathi nge-IV, ukuvimbela ukonakala kwamehlo okungapheli. Umgomo ukunciphisa ukuvuvukala ngokushesha ngangokunokwenzeka.

Udokotela wakho uzolandelela impendulo yakho ngezivivinyo zegazi eziqondile ezilinganisa amazinga okuvuvukala futhi anciphise kancane umthamo wakho we-steroid njengoba isimo siphulukana. Le nqubo yokunciphisa ilawulwa ngokucophelela ukuvimbela ukubuyela emuva ngenkathi inciphisa imiphumela emibi.

Ezimeni ezingavamile lapho i-steroids ingasebenzi kahle noma ibangela imiphumela emibi enkulu, udokotela wakho angase afake imithi eyengeziwe yokucindezela isimiso sokugcina njenge-methotrexate noma i-tocilizumab.

Ungaphatha kanjani ukunakekelwa kwasekhaya ngesikhathi sokwelashwa kwe-Arteritis Yeselula Ekhulu?

Ukuthatha imithi yakho ngokuqondile njengoba kuyalwe yinto ebaluleke kakhulu ongayenza ekhaya. Ungayeki noma unciphise i-steroids yakho ngaphandle kwesiqondiso sika dokotela wakho, ngisho noma uzizwa ukhulu kakhulu, njengoba lokhu kungabangela isimo sibuyele emuva.

Nazi izindlela eziyinhloko zokunakekelwa kwakho:

• Thatha imithi ngokudla ukuze unciphise ukuvuvukala kwesisu
• Landelela ushukela wakho wegazi uma une-diabetes, njengoba i-steroids ingaphakamisa amazinga e-glucose
• Dla ukudla okunama-calcium amaningi futhi uthathe izithasiselo njengoba kunconywe
• Hlala usebenza ngokuvivinya okumnene ukuze ugcine amandla amathambo
• Thola ukulala okwanele futhi ulawule ukucindezeleka
• Zivikele ekuthelelekeni, njengoba i-steroids inganciphisa ubukhona

Qaphela izimpawu zokuthi isimo sakho singase sibuyele emuva, njengokubuya kwezihlungu zezinhlangothi, ukushintsha kobuso, noma ubuhlungu besigaxa. Xhumana nodokotela wakho ngokushesha uma noma yiziphi lezi zimpawu zibuyela noma zibe zimbi.

Njengoba ukusetshenziswa kwe-steroid isikhathi eside kungase kuthinte amathambo akho, isimo sengqondo, nesimiso sakho sokugcina, landela izincomo zika dokotela wakho zokuvikela amathambo nokuvimbela ukutheleleka. Ukuvivinya okuvamile, ngisho nokuhamba nje, kungasiza ekuqondeni amandla akho nempilo yamathambo.

Kufanele ulungiselele kanjani i-aphoyintimenti yakho yodokotela?

Ngaphambi kwe-aphoyintimenti yakho, bhala zonke izimpawu zakho, kufaka phakathi lapho zaqala khona, zingakanani, nokuthi yini ezenza zibe ngcono noma zimbi. Yiba ocacile nganoma yikuphi ukushintsha kobuso, izindlela zezinhlangothi, noma ubuhlungu besigaxa obukade uhlangabezana nabo.

Letha uhlu oluphelele lwemithi yakho yamanje, kufaka phakathi imithi yokuthengwa ngaphandle komthetho nezithasiselo. Lungiselela futhi ulwazi ngomlando wakho wezokwelapha, ikakhulukazi noma yiziphi izimo ze-autoimmune noma umlando womndeni wezinkinga ezifanayo.

Cabanga ukuletha ilungu lomndeni noma umngani ongasiza ekukhumbula ulwazi olukhulu futhi anikeze ukwesekwa. Bhala imibuzo ofuna ukuyibuza, njengokuthi yini okulindelekile ekwelapheni noma indlela yokuphatha imiphumela emibi.

Unganqikazi ukuchaza ukuthi izimpawu zakho zithinta kanjani impilo yakho yansuku zonke, umsebenzi, noma ubuhlobo. Lolu lwazi lusiza udokotela wakho ukuqonda umthelela ophelele wesimo futhi alungiselele ukwelashwa ngokufanele.

Yini eyinhloko ebalulekile nge-Arteritis Yeselula Ekhulu?

I-arteritis yeselula enkulu yisimo esinzima kodwa esiphatheka kalula uma sibanjwa ngokushesha. Into ebaluleke kakhulu okumele uyikhumbule ukuthi ukwelashwa okusheshayo kungavimbela izinkinga, ikakhulukazi ukwehliswa kobuso, ngakho ungalihli ukufuna ukunakekelwa kwezokwelapha uma unezimpawu ezinkulu.

Ngokwelashwa okufanele, abantu abaningi abane-arteritis yeselula enkulu bangalindela ukuthi izimpawu zabo ziphulukane kakhulu futhi babuyele emisebenzini yabo evamile. Nakuba ukwelashwa kuvame ukudinga imithi yesikhathi eside, umbono ngokuvamile ukhulu kakhulu.

Hlala uxhumene neqembu lakho lokukhathalela impilo kulo lonke ukwelashwa, landela isimiso sakho semithi ngokucophelela, futhi unganqikazi ukuxhumana nodokotela wakho uma unezinxushunxushu. Ukuhlanganyela kwakho okusebenzayo ekwelapheni kuyisihluthulelo somphumela omuhle kakhulu.

Imibuzo evamile ebuzwa nge-Arteritis Yeselula Ekhulu

Q1: Ingabe i-arteritis yeselula enkulu ingabuya emuva kokwelashwa?

Yebo, i-arteritis yeselula enkulu ingase ibuyele emuva, ikakhulukazi uma i-steroids inciphisa ngokushesha kakhulu. Cishe u-40-60% wabantu bahlangabezana okungenani ngokubuyela emuva ngesikhathi sokwelashwa. Kungakho udokotela wakho azonciphise imithi yakho kancane kakhulu futhi akuqaphele eduze ngezivivinyo zegazi eziqondile nokuhlolwa.

Q2: Ngingathanda isikhathi esingakanani ukuthatha i-steroids ye-arteritis yeselula enkulu?

Abantu abaningi badinga ukwelashwa kwe-steroid eminyakeni engu-1-2, nakuba abanye bangase badinge ukwelashwa okude. Udokotela wakho uzonciphise kancane umthamo wakho ngokusekelwe ezimpawu zakho nemiphumela yezivivinyo zegazi. Umgomo ukufumana umthamo omncane onciphisa isimo sakho ngenkathi unciphise imiphumela emibi.

Q3: Ngingabuya yini ukubona kwami uma ngilahlekelwe yikho ngenxa ye-arteritis yeselula enkulu?

Ngeshwa, ukwehliswa kobuso okuvela ku-arteritis yeselula enkulu ngokuvamile okungapheli uma kwenzeka. Noma kunjalo, ukwelashwa okusheshayo nge-steroids enkulu ngezinye izikhathi kungavimbela ukwehliswa kobuso okuqhubekayo futhi kuvikele ukubona kwakho okusele. Kungakho ukunakekelwa kwezokwelapha okusheshayo kubaluleke kakhulu uma uhlangabezana nanoma yikuphi ukushintsha kobuso.

Q4: Ingabe i-arteritis yeselula enkulu ingase ithinte ezinye izingxenye zomzimba wami ngaphandle kwekhanda lami?

Yebo, i-arteritis yeselula enkulu ngezinye izikhathi ingase ithinte i-arteries ezinkulu kulo lonke umzimba wakho, kufaka phakathi i-aorta namagatsha ayo amakhulu. Abanye abantu nabo bathuthukisa i-polymyalgia rheumatica, ebangela ubuhlungu bemisipha nokuqina. Udokotela wakho uzolandelela lezi zinkinga ngesikhathi sokwelashwa kwakho.

Q5: Ingabe kukhona ukwelashwa kwemvelo noma izithasiselo ezingasiza nge-arteritis yeselula enkulu?

Nakuba ukugcina ukudla okuhle nokuthatha izithasiselo ezibhalwe njenge-calcium ne-vitamin D kubalulekile, ayikho ukwelashwa kwemvelo okuqinisekisiwe okungasetshenziswa esikhundleni sokwelashwa kwezokwelapha kwe-arteritis yeselula enkulu. I-Corticosteroids ihlala iyindlela ephumelela kakhulu yokulawula ukuvuvukala nokuvimbela izinkinga ezinzima. Hlala ukhuluma nanoma yiziphi izithasiselo nodokotela wakho ngaphambi kokuzithatha.