Horton's disease: zvinokonzera, zviratidzo, kuongororwa uye kurapwa

Chirwere cheHorton ndechimwe chezvirwere zvakanyanya uye zvinotyisa mumidziyo yeropa. Zvine ngozi uye maitiro ekurapa zvichaudzwa sei pano.

Chimiro chechirwere

Horton's disease inozivikanwawo pasi pemazita akadaro se giant cell temporal arteritis kana vasculitis. Ichi chirwere ndechechikwata che autoimmune uye chiri kupisa. Kungofanana nedzimwe hutsika hunoshandiswa, inowanzokonzera mishonga, mitsetse uye mimwe miviri yeropa guru. Kazhinji kacho chirwere ichi chinowanikwa munzvimbo yekarotid shell.

Iyi syndrome inonzi zita rechiremba Horton. Chirwere chakawanikwa muAmerica, mumakumi matatu emakore zana remakumi maviri. Nhamba dzinoratidza kuti arteritis yenguva inowanzowanikwa kumaodzanyemba kweEurope nemaScandinavia. Sezvo mutemo, chirwere ichi chinokanganisa vanhu vezera rekuchembera, uye vakadzi vanorwara kaviri kazhinji kupfuura varume.

Zvinotarisirwa

Zvinotendwa kuti chirwere cheHorton chinokonzerwa nedonho rehutachiona hwevanhu. Kuwanda kweropa kuongororwa kunoratidza kuti zvirwere zvinowedzera munzvimbo ye arteri vasculitis. Uyezve, kukura kwechirwere ichi kunogona kuvimba nekuvapo mumuviri wevirus viruses, zvakadai sa herpes, hepatitis, causative vabati vemapfudze. Mukuwedzera kune zvose zvataurwa pamusoro apa, masayendisiti anewo maonero pamusoro pezvinoita kuti zvizvarwa zvivepo, sezvo izvi zvinoratidza kuvapo kwemajeni akafanana mune varwere.

Chirwere cheHorton, zviratidzo zvaro ndezvipi zvakasiyana-siyana, zvinogona kuratidza zviratidzo zvavo kubva kwemavhiki akawanda kusvika kumwedzi yakawanda. Dzimwe nguva kukura kwechirwere kunowedzera shure kwehutachiona, hwehutachiona kana hwechirwere. Zviratidzo zvechirwere zvinogona kugoverwa muhuwandu, kuratidzwa kwezvipembenene zvevascular uye kudonha muhuwandu hwekuona. Sezvo mutemo, kuvapo kwechimwe chezvinhu izvi kunotsanangura kuti chiremba chinoshanda kupi.

Zvose zviratidzo

Kuratidzwa kwechirwere cheHorton kuwedzera kwekushisa kwemuviri, kazhinji uye kunorwadza musoro, kukurumidza kuora muviri, kupera simba nokukurumidza, kukanganiswa kwehope, kuwirirana uye kurwadziwa kwemisimba. Kana urombo huri mumusoro, hunogona kuitika zvose muchikamu chimwe chedehenya uye mune dzimwe nguva kamwechete uye, sekutonga, ine unhu hwekutsvaira. Kazhinji kazhinji, kurwadziwa kunoitika usiku uye kunowedzera zvakanyanya nenguva. Mukuwedzera kune migraine, varwere vangave vachitambudzwa nekushaya simba kwechizoro, kurwadziwa mukutaura kana kudya, uye kusuruvara kunofadza muchiso. Marwadzo mumisungo uye majoini anowanikwa munzvimbo ino, sekutonga, munharaunda yemapfudzi kana mahudyu. Chimiro chemarwadzo muzvibatanidza chine zvimwe zvakafanana neArthritis.

Vascular bless

Zvikepe pasi pehutachiona hwaHorton zvinopindirana. Kazhinji vanotaridzika sezviputi, zvinorwadza uye zvinopisa kusvika kune. Muzviitiko izvi, hapana zviratidzo zvekutsvaira kana kufamba kweropa. Izvo zvinokwanisika kuva nezvisimbiso uye kuvhuvhuta pachikanda. Uyezve, kakawanda nzvimbo dzeganda iri pedyo nemasiteri inoshandura ruvara rwavo kune reddish-burgundy. Panogona kunge kune edema muHorton's syndrome.

Chirwere chinowanikwa munzvimbo yekati carotid arteri inonyanya kuipa. Izvi zvinokonzerwa nekuti kuonekwa kwekunze kwezviratidzo kwakaoma. Matambudziko edzidziso yechirwere ichi anowiriranawo nechokwadi chokuti kukanganisa kwakanyanya kune mudziyo mukuru, usina kuonekwa munguva, kunogona kutungamirira kumigumisiro yakaipisisa, yakadai sokurohwa uye kuora.

Kuwa maziso

Chimwe chikamu chinotambura zvikuru kubva pakubudirira kweHorton's disease maziso. Kuratidzwa kwezvirwere zvevascular zvinowanzobatanidzwa nekuwedzera kwezvinetso, kurwadziwa, kuwirirana uye zvimwe zvisiri izvo mukuona. Izvi zvakakonzerwa zvikuru nekushayikwa kwemazipa ekupararira kweropa panzvimbo ino. Nekurapa kwakakodzera kunotanga, mitezo yakakomba inogona kudziviswa, zvisinei kana murwere ari panjodzi yekugadzikana kweptic nerve atrophy uye kuvepo kwekupofu.

Diagnostics

Ichi chirwere chinowanikwa zvikurukuru kuburikidza nekunze kwekliniki yekuongororwa, pamwe nekutsvakurudza kwakawanikwa kuongororwa. Mukucherechedza mamiriro emurwere, kunyanya kubhadharwa kune hutano hwehutano. Zvakakosha kuziva kuti chirwere ichi chinogona kukanganisa huwandu hwekuona, saka kuongorora kwayo kunopiwa basa rinokosha. Sezvidzidzo zvebhroreta, bhiopsy kubva mumudziyo wakakuvadzwa inotorwa, uye ultrasound dopplerography, magintic resonance imaging kana kuti computed tomography yeuropi inorayirwa murwere.

Zvitsvakurudzo

Maererano nemashoko akawanikwa panguva yekuongororwa, zvinokwanisika kutonga danho rechirwere uye kusarudza pakurapa. Sezvo mutemo, zvigumisiro zvakaoma ruzivo rwakagadzirwa mushure mokuongorora nekuongorora kwebhakato.

Somugumisiro weropa-sampuli, kuvapo kwekushaya kukwana kwemasero eropa, kuwedzera mumwero weeukocytes nekuwedzerwa kwe erythrocyte sedimentation kunosimbiswa. Mukuongorora kwakakwana, kuchinja kwehuwandu hwepuroteni zvikamu zveropa uye nekuderera muhuwandu hweAlubinsin kazhinji kunowanikwa kubva mumutsipa.

Mukudzidza kwechiono, vanachiremba vanonyanya kunyatsotarisa kugadziriswa kwehuwandu hwavo uye kuvapo kwekukanganisa uye kuparadzwa kwemukati pasi weziso.

Nyuchi uye tsvakurudzo yemasero emagetsi akaparara inoita kuti zvive nyore kugadzira kuchinja kwakanaka muhupamhi uye chimiro chemudziyo muHorton's syndrome. Chirwere ichi chinowanzowanikwa muchimiro chegranular nodules mu arteri masvingo. Kubudirira kwakadaro hakugone asi kunokanganisa kushanda kwechombo chacho pachako: panguva yakakodzera lumen yacho inowedzera uye yakaoma.

Zvisinei, pane zviitiko apo kushanduka kwakadaro mumutambo kana mutsva hazvionekwi. Izvi zvinogona kutsanangurwa nekuti iko kukanganisa kumudziyo kunonyanya-kufanana uye kwete nguva dzose kunogadziriswa kugadzirwa. Izvi zvinokonzerwa nekuti chiremera chetari chikamu uye chikamu chechiopsy zvinogona kutora chikamu chisingabatsiri chetari.

Mukuwedzera, zvose zvinorondedzerwa zviratidzo zvinovimba chete nezviratidzo zvehupenyu hwemumwe munhu murwere, kusanganisira panguva yake, mararamiro uye zvimwe zvinhu. Nokudaro, Association yeAmerican Rheumatologists inotsanangura mazita, zvichiratidza kuti chirwere chechirwere chinoshandiswa zvikuru nemhando dzakasiyana siyana dzevanhu. Dzinosanganisira nguva yemurwere, kunyanya kana ane makore anopfuura makumi mashanu.

Matambudziko mukutsvaga

Panosimbisa zviratidzo zveHorton's disease, inofanirawo kusiyaniswa nezvirwere zvakafanana, zvakadai seArthritis, rheumatism, neuralgia, chirwere che lymphatic system, systemic vasculitis. Izvi zvinonyanya kuitika kuvanhu vakura. Dzidzo yacho inogona kusiyana nedzimwe machechi emakore, sezvo kazhinji kuchinja mumasuru uye mishonga inosangana nedzimwe zvirwere zvinokodzera kutsanangurwa kweHorton's syndrome. Chirwere chacho chinokanganiswa, somuenzaniso, ne atherosclerosis. Zvisinei, marwadzo ari mumusoro munyaya iyi ndeye zvakasiyana zvachose. Pamusoro pezvo, vasculitis inoratidzirwa nehuwandu hwepamusoro hwe erythrocyte sedimentation uye kuchinja kwakajeka mumasvingo emirwere yeropa, iyo inoratidzwa munguva yebiopsy. Dzimwe nguva zviratidzo izvi zvinokanganisa zvinogona kukonzera dambudziko remurwere mubvunzo wechiremba waanoshandisa.

Kurapa

Kurega kwechirwere ichi kunoitwa nekushandiswa kweglucocorticoids. Semitemo, pakutanga kwekurapa chiremba anopa chirwere ichi kumishonga iyi, iyo inotora kwemakore maviri. Dzidzo yacho inoguma kana murwere ane rusununguko rwakakwana kubva muchirwere uye hapana kudzoka zvakare. Kushandiswa kwekarticosteroids kunobatsira chaizvo pane chirwere cheHorton.

Kurapa nemishonga inouraya inogadziriswa zvichienderana nechirongwa chakakodzera, tichifunga nezvehu nuances rwechikoro chechirwere chacho. Nekukura kunononoka, murwere anorayirwa kutora mapiritsi ane prednisolone mukuverenga kubva pamamirigramu 20 kusvikira ku80 pazuva. Nekukurudzirwa kwakasimba kwechirwere ichi, zvinonyanya kukosha kushandisa shanduko yekurapa nehombe huru ye methylprednisolone. Mushure memwedzi wekurapa kwakanyanya, kuderedza kuyerwa kunogona kuitika. Muchiitiko ichi, vhiki imwe neimwe chirwere chechirwere chinoderedzwa kusvika pakugadzirisa, izvo zvinenge ma 5-7.5 milligrams pazuva. Pashure pemakore maviri ekurapa, pangava nemubvunzo pamusoro pekugumiswa kwemishonga nemhaka yekushayikwa kwekudzoka zvakare. Kwemwedzi mitanhatu yekupedzisira, murwere angave ari pane chirwere chekuchengetedza chemamiriyoni 2-2.5 emadhimoni pamusi.

Zvisinei, mamiriro ezvinhu apo kurapwa ne glucocorticoids hakuiti kuti zvinotarisirwa zvinogona kuitika. Munyaya iyi, zvinokurudzirwa kutungamirira cytostatics. Uyezve, kuwedzera kune hormone therapy, anticoagulant magadzirira uye antihistamine inogona kurongerwa.

Zviratidzo zvechirwere

Zvinofanira kuonekwa kuti chirwere chakadaro hachisi mungozi kuhupenyu hwomurwere, sekutonga. Zvimwe zviitiko zvisingawanzoregi, zvinoregererwa zvechirwere zvinogona kutungamirira pakuonekwa kusina kunaka, kusanganisira upofu, uyewo nekusimudzirwa kwekurohwa, kushaya mwoyo uye necrosis. Zvisinei, chirwere chinogona kurapwa muhuwandu hwemhosva. Zvakafanotaurwa nemishonga yakasarudzwa zvakanaka zvakanyanya kufarirwa. Mukusavapo kwekudzoka zvakare mumakore maviri anotevera ehupenyu, murwere anoudzwa kuti, zvichida, haazoiti muupenyu hwake hwekupedzisira. Kazhinji zvinetso panguva yekurapa zvinogona kusanganiswa chete nekusawirirana kwevamwe kune varwere vane chirwere cheraticoid therapy. Usakanganwa mutemo mukuru wekubudirira kurapwa - kuongororwa kunofanira kuitwa chete nechiremba! Iye anewo kodzero yega yekupa kurapa.

Sezvo chimwe chezvikonzero zvechirwere ichi chiri chiitiko chehutachiona, zvakakosha kuti titevedzere mararamiro ane hutano uye tifambise kuoma kwehupenyu. Inofanirawo kuyeukwa kuti mikana yekuvandudza vasculitis inogadziriswa nemaitiro, uye kwete pasi pengozi yakawanda.

Uyezve, varwere vanowanzoda kufarira mubvunzo uyu: hurema hwakapiwa muHorton's disease here? Semitemo, kusagadzikana kwakakomba mune chirwere kunogona kutungamirira pakuwedzera kwayo, nokuti nzira yakaoma yechirwere ichi, inozviratidza mumusoro wemusoro wakaoma uye kubvarura, haibvumiri mushandi kuita mabasa ake kwenguva refu, muchiedza chakajeka, kusanganisira.