Zvinokonzera, pathogenesis uye zviratidzo zve gout

Mune rimwe remapoka ezvirwere zverheumatic ndiyo inonzi microcrystalline kana masametric arthritis. Imwe yakadaro yemaArthritis ndiyo gout, zviratidzo uye zviratidzo zvave zvichizivikanwa kubva panguva yaHippocrates. Chirwere ichi chinoitika nekuda kwekushayikwa kusina kukwana kweUric acid uye kuwedzera kwehuwandu muropa, pamwe chete nekudzivirira kwemafuro (urates) mumatumbu. Nokudaro, zviratidzo zve gout zvirwere zvinoratidzirwa nekutanga kwechirwere chinonzi acute arthritis, pamwe nekuumbwa kwetifusi, zvakananga gouty nodes.

Zita rechirwere rakapiwa nevaGiriki. Yokutanga inozivikanwa kusvika zuva rinotsanangurwa nezvechirwere ichi chakapiwa nechiremba wechiGiriki Saranus. Ichi chirwere chakatambudzwa kuMacedonia, Newton uye nemamwe akawanda mazita anozivikanwa ezvakaitika kare.

Nhamba yevanhu vanoona zviratidzo zvegout , gore negore Inowedzera. Izvi zvinowanzobatanidzwa nekuwedzera kwehupenyu hwehupenyu uye chikafu. Hazvisi pasina kuti chirwere ichi chinonziwo "chirwere chechihedheni".

Chinetso chechirwere ichi ndechekukurumidza kuongororwa, kazhinji kacho kakatova mumutambo usingagumi, apo kwete chete majoini anowanikwa mukurwadziwa.

Zviratidzo zvekutanga zvegout zvinowanzotanga kuvhiringidza varume vane makore mapakati. Asi munguva pfupi yapfuura chirwere chacho chakanyanya "kugadziriswa". Inogonawo kuwanikwa mumakore makumi matatu nemakore evechiduku. Chikamu chikuru chevaya vanotsvaka rubatsiro nerunyoro chinotanga nekuonekwa kwekutambudzika uye kurira kwekutanga (huru) netsoka dzetsoka. Iyi ndiyo nzira yakasarudzwa. Zvose zvinorwadza zvinoratidzwa mune dzimwe nhengo dzetsoka, uyewo muzvikamu zvakakura zvemuviri.

Kuti uchinzwisise pathogenesis yechirwere, munhu anofanira kunge ane pfungwa yekushandurwa kwechinyakare ye uric acid. Mune vanhu, ndiwo mugumisiro wekutsvaga kwemapirini. Mumuviri wedu, zvitubu zvekugadzirwa kweAic acid ndiwo mishonga yatinopedza, ine purines (nyama, maruva, waini tsvuku, hove, etc.), nucleoproteins yemasero. Kubva mumuviri, uric acid inodedzwa kuburikidza nemukumbo, kuparadzaniswa kwemimba yemukaka, uye nemugini (chikamu chayo chikuru).

Zvinokonzera chirwere chacho

Zvinonyatsozivikanwa kuti zviratidzo zve gout zvinowanikwa apo kuwedzerwa kweyero yeric acid mumuviri uye kuderedza kusviba kwayo mumuguta. Kuwedzera kwekugadzirwa kweAic acid kunogona kuva mugumisiro wekushandisa zvakanyanya mishonga ine purines, uye kuwedzerwa kwemukati mazana e purines mumuviri.

Inonyanya kushandisa hyperuricemia uye yechipiri inoratidzika. Gout inowanikwa sechikonzero chekutanga. Chikamu chekuwedzera kweUric acid muropa kazhinji chikonzero chekushaya simba, myeloma, mamwe marudzi eukemia uye anemia, uye anozviratidzawo nekushandiswa kwemimwe mishonga, yakadai se diuretics.

Iyo yakawandisa yakakwana yeAsiri muropa inotungamirira pakuiswa kwayo muzviviri nematukisi. Nenzira ye urate sodium inowanikwa mumasokisi e synovial, inopinda mu synovial fluid. Inotama inopinda mukati megoroti, zvichiita kuti igumbuke uye kuipa.

Zviratidzo zveGout

Sezvatotaurwa pamusoro apa, sarudzo yekare ndeyokukundikana kubatana kwegunwe guru. Mukati mawo, huwandu hwehutric acid mumuviri hahupi hunoita kuti zviratidzo zvivepo, uye kutarisa kunowanikwa mukukundwa kwechibatanidzwa ichi. Kazhinji kuputika kwechirwere kunokonzerwa nekudya zvakanyanya, hypothermia, trauma kana utachiona. Kazhinji, kurwisa kweArthritis kunopesana nehupenyu hwehupenyu hwakakwana, kunyange zvazvo dzimwe nguva zviratidzo zvinonzwisisika zvinoratidzika, zvakadai sekugara mafungiro ekuchinja, kusagadzikana zvakanyanya, nezvimwewo.

Kazhinji marwadzo anooneka usiku uye kamwe-kamwe. Marwadzo akasimba zvokuti hazvibviri kugunzva nhengo. Panguva imwe chete, edema uye kubwinya zvinowoneka. Pashure pezuva rimwe kana maviri, marwadzo anopfuura. Chimwe chinhu chinoratidza marwadzo anokonzerwa nekutanga kusingatarisirwi uye kwakasimba uye kuguma kumwe chete kamwe kamwe. Kana majoi makuru akanganiswa, ipapo kliniki yemufananidzo inofanana nephlegmon. Tofuy inogona kuumbwa muzvibatanidza. Izvo zviputi zvinowanikwa pasi peganda kana mujoka (deposits of urates). Muropa, uric acid inowanikwa yakawedzerwa.

Kurapa

Kana paine kurwisa kwakaoma, colchicine, anti-inflammatory, anesthetic drugs (NSAIDs) anoshandiswa. Chinhu chinotarisirwa kuti uite ndeyekutevera kudya kunze kwekudya nyama, doro, kurega.

Nhanho yechipiri ndiyo kutungamirirwa kwezvinodhaka zvinoderedza kuumbwa kweuric acid mumuviri. Kugadzirira kwakadaro is allopurinol kana yakafanana. Ichi chinodhaka chinoshandiswa kwekusingaperi nekurapa kwenguva refu.