Matenda Horton anati: zimayambitsa, zizindikiro, matenda ndi mankhwala

Mmodzi wa zambiri ndi oopsa thanzi la matenda mtima ndi matenda Horton a. Kusiyana ndi zoopsa ndi mmene kuchitiridwa, adzakhululukidwa panopa.

Nature wa matenda

matenda Horton a imatchedwanso pansi mayina monga chimphona selo arteritis zosatha kapena vasculitis. Izi matenda limabweretsa gulu la autoimmune ndi yotupa khalidwe amavala. Monga ena zokhudza zonse vasculitis, izo kawirikawiri zimakhudza mitsempha, mitsempha, ndi ziwiya zina zikuluzikulu magazi. Nthawi zambiri matenda isanafalikire mu carotid m'chimake.

Matendawa chikutchedwa dokotala Horton a. Matendawa anapeza mu America mu mmasate zaka mazana makumi awiri. Kafukufuku amasonyeza kuti arteritis kanthawi ndi ambiri kumpoto kwa Ulaya ndi maiko Masewerera a Nordic. Monga ulamuliro, matendawa amakhudza anthu a zaka zopuma pantchito, ndi akazi zowawa pafupifupi kuwirikiza kawiri amuna.

prerequisites

Akukhulupirira kuti matenda Horton akupezeka chifukwa dontho la chitetezo chokwanira anthu mlingo. zoyesa magazi amasonyeza kuti malo a chotupa mtsempha wamagazi vasculitis kumanga chitetezo. Komanso chitukuko cha matenda amadalira kukhalapo mu thupi la mavairasi yosokera monga nsungu, matenda a chiwindi, wothandizila chimfine. Koposa zonse za pamwamba, palinso asayansi ndi chiphunzitso cha zotheka majini chingawapangitse kukhala zidakwa, monga umasonyeza kuli milandu jini chomwecho.

matenda Horton ndi zizindikiro zimene ziri yosiyanasiyana mu chikhalidwe, akhoza kuonetsa zizindikiro zawo kwa masabata angapo miyezi ingapo. Nthawi zina chitukuko cha matenda ndi inapita patsogolo pambuyo akuvutika matenda enaake kapena chimfine matenda. Zizindikiro za matendawa akhoza kugawidwa ambiri, zizindikiro za zotupa mtima ndi kuchepa kwa masomphenya. Monga ulamuliro, pamaso pa imodzi mwa iwo ndi kudziwa dokotala zolankhulirana.

zizindikiro Common

Chiwonetsero cha matenda Horton ndi malungo, kawirikawiri ndi woopsa mutu, kusowa mofulumira kulemera, kutopa, matenda tulo, kupweteka kwa m'malo olumikizirana mafupa ndi minofu. Koma ululu m'mutu, iwo angayambe gawo limodzi a Chigaza, ndi angapo nthawi imodzi ndipo, monga ulamuliro, ali ndi khalidwe kugunda. Nthawi zambiri, ululu limapezeka pa usiku, ndipo kenako pokhapokha kwambiri. Kuwonjezera odwala migraine akhoza kuganizira scalp dzanzi, ululu pamene akulankhula kapena kudya, zomverera zosasangalatsa m'dera nkhope. Kupweteka kwa minofu ndi mafupa ndi isanafalikire, kawirikawiri m'dera mapewa kapena ntchafu. Chikhalidwe cha molumikizana mafupa ali ndi chikhalidwe ofanana ndi nyamakazi.

matenda mtima

Nsupa, matenda Horton linakhala compaction. Iwo zambiri za mtundu tinatake tozungulira kupweteka ndi kutentha kwa kukhudza. Choncho ziwiya ngati palibe zizindikiro za kugunda kwa mtima ndi kayendedwe magazi. Pa khungu ngati n'kotheka kukhalapo kwa zisindikizo ndi kutupa. Komanso, nthawi zambiri kwa pafupi mitsempha khungu kusintha mtundu pabuka-burgundy. Mwina kuoneka edema pa matenda Horton.

The matenda, moyenda m'dera la mkati mtsempha wamagazi carotid, makamaka oopsa. Ichi ndi chifukwa chakuti chizindikiritso cha zizindikiro kunja zovuta. Zovuta kumene matenda chifukwa chakuti kuwonongeka kwambiri kwa ziwiya lalikulu si wapezeka mu nthawi, kungachititse kuti mavuto aakulu oipa, monga sitiroko ndi kukha magazi.

Igwani view

limba wina yemwe akuvutika kwambiri mu chitukuko cha matenda Horton ndi diso. Chiwonetsero cha matenda mtima kawirikawiri kwambiri kugwirizana ndi kuwonjezeka mu kuthamanga, ululu, kugawanika ndi kuvutika lina mu masomphenya. Izi makamaka chifukwa chosowa aziyenda moyenera magazi mderali. Nthawi wayamba mankhwala a mavuto aakulu zikhoza kupewedwa, mwinamwake wodwala likuoneka kuti kumaliza manja kwa mitsempha chamawonedwe ndi khungu wotsatira.

diagnostics

Matendawa makamaka wapezeka ndi kuyendera zithunzi zotsatira matenda ndi kafukufuku kusanthula. Pamene mumayesto chikhalidwe wodwalayo powasamalira makamaka thanzi ubongo. Dziwani kuti matenda akhoza bwanji mlingo wa masomphenya, kotero onani amagwira ntchito yofunika kwambiri. Monga zasayansi maphunziro biopsy otengedwa chotengera zowonongeka, komanso mtima ulipo Doppler ultrasound, maginito kumveka kapena yopangidwa tomography ubongo.

Zotsatira za kafukufuku

The tinasonkhanitsa pa deta matenda angathe kuweruza siteji ya matenda ndi kusankha mankhwala. Childs, zimachititsa Integrated mudziwe analandira pambuyo ndime ya kuona ndi zasayansi zofufuza.

Chifukwa cha kukhalapo kwa deta magazi anapereka maselo magazi insufficiency kuwongolera leukocyte ndi erythrocyte sedimentation mathamangitsidwe. Pa kusanthula wodzala mtsempha zambiri wapezeka kusintha chiŵerengero cha tuzigawo twa mapuloteni a mlingo magazi ndi kuchepa kwa albumin.

Mu kuphunzira madokotala kupereka ulemu wapadera kwa kukhazikitsidwa kwa ukulu wake ndi kukhalapo vuto ndi kuwononga pansi mkati mwa diso.

maphunziro Biopsy zakuthupi ma ndi chotengera kuonongeka anali amaloledwa kukhala kusintha chosaopsa mu unyinji ndi dongosolo chotengera pa matenda Horton. Matendawa zambiri amapezeka mu mawonekedwe mu mpanda wa mitsempha granulovidnyh tinatake tozungulira. Izi sangakhoze bwanji magwiridwe a chotengeracho: pa nthawi, lumen amakhala kuchepera chepera.

Komabe, pali milandu pamene asinthire mu mtsempha wamagazi kapena mtsempha si anati. Izi zingathe kufotokozedwa ndi mfundo yakuti imfa ya chotengera ali ndi chikhalidwe akulimbana kwambiri ndi si nthawi zonse amenable kwa kukhazikitsidwa. Ichi ndi chifukwa chakuti chotupa ndi segmental mtsempha wamagazi mu chikhalidwe ndi mu njira ya kutenga biopsy mulole sasintha gawo la mtsempha wamagazi ndi.

Komanso, zizindikiro zonse zimadalira okha maonekedwe a thupi la wodwala aliyense payekha, kuphatikizapo zaka zakubadwa, moyo ndi zinthu zina. Mwachitsanzo, Association of rheumatologists American amapereka zosonyeza kuti m'kupita kwa nthendayo amphamvu kwambiri akulamuliridwa ndi zinthu zosiyanasiyana zimene zingapangitse zaziwerengero. Zikuphatikizapo zaka wodwalayo, makamaka ngati ndi zaka zoposa 50.

Mavuto Kupeza Vuto

Pamene kukhazikitsa Horton zizindikiro matenda ayenera kuwasiyanitsa ndi matenda otere, monga nyamakazi, misempha, neuralgia, pathologies a dongosolo lymphatic, zokhudza zonse vasculitis. Zimenezi ndi zoona makamaka kwa anthu okalamba. Mumayenda akhoza zimasiyana a magulu a zaka zina, chifukwa nthawi zambiri amasintha mu mitsempha ndi mitsempha, amagwirizana ndi diagnoses zina, amafanana syndrome Horton. Matendawa anasokoneza Mwachitsanzo, atherosclerosis. Komabe, mu nkhani iyi kupweteka mutu wake ndi chikhalidwe chosiyana kwambiri. Komanso, vasculitis losiyana mlingo wochuluka kwambiri ya sedimentation ndi kusintha zioneke bwino malinga chotengera, amene amaoneka pa biopsy. Nthawi zina zizindikiro wosanganiza zingachititse vuto la wodwala mu funso, zomwe dokotala zolankhulirana.

chithandizo

Ndiyotani pakuchotsa matenda ikuchitika ndi ntchito glucocorticoids. Childs, kumayambiriro kwa chithandizo, dokotala makhalidwe mankhwala mankhwala chimene chimafika pa zaka ziwiri. Maphunzirowa itatha, ngati wodwalayo akubwera ndi ufulu wonse kwa matenda ndiponso musabise. Ntchito corticosteroids ali kulimbikitsa matenda Horton.

Mankhwalawa ndi wothandizila m'thupi ikuchitika pa dera chogwirizana amaganizira mokoma matenda. Pa chitukuko pang'onopang'ono wodwala ali analamula kuti kupanga miyala yomwe prednisone pa kuchokera mamiligalamu 20 80 patsiku. Ndi wolimba chitukuko cha matenda ndi zambiri zopindulitsa kwa ntchito mankhwala mantha ndi mlingo waukulu wa methylprednisolone. Patapita mwezi umodzi wa mankhwala wochuluka akhoza kuchepetsa mlingo. Pankhaniyi, aliyense mlingo sabata zochepa kuti akhalebe mlingo umene uli pafupi 5-7.5 mamiligalamu patsiku. Patatha zaka ziwiri mankhwala akhoza kukhala chiyembekezo chakuti mankhwala, pakalibe musabise. Miyezi isanu ndi umodzi, wodwala akhoza kukhala pa yokonza mlingo wa mamiligalamu 2-2.5 wa mankhwala m'thupi tsiku.

Komabe, zimenezi n'zotheka pamene mankhwala ndi glucocorticoids sapereka zotsatira ankafuna. Mu nkhani iyi, m'pofunika kuchitira poika cytostatics. Komanso, kuwonjezera pa mankhwala m'thupi akhoza nane mankhwala kumaliseche anticoagulant ndi mankhwala.

madokotala ananena zawo za matendawa

Tikumbukenso kuti matenda ndi kuukira moyo wa wodwala, monga ulamuliro, si zinkaimira. Ena nthawi zina ya mafunde akuthamanga matenda kungachititse kuti imfa masomphenya, kuphatikizapo khungu, komanso chitukuko cha sitiroko, matenda a mtima necrosis. Komabe, matenda ndi n'ngochiritsika nthawi zambiri. Kuti madokotala ananena zawo kwa mankhwala bwino osankhidwa makamaka yabwino. Popeza zisadzachitikenso mu zaka ziwiri, moyo wodwalayo kuti, osalephera, sadzakhala ndi malo tsogolo la moyo wake. Osowa mavuto pa chithandizo akhoza kugwirizana okha ndi odwala payekha wosalolera ndi mankhwala corticoid. Musaiwale ulamuliro waukulu wa mankhwala bwino - matenda ayenera kuika dokotala! Iye ali ndi ufulu wonse kwa anaika chithandizo.

Monga mmodzi wa zinthu za matendawa ndi kachilombo zachilengedwe ake, ndikofunika kukhala ndi moyo wathanzi ndi kugwira kuwuma kwa thupi. Komanso, dziwani kuti mwayi kukhala vasculitis chibadwa anatsimikiza ndipo musati poyera nokha chiopsezo zosafunika.

Komanso, odwala zambiri chidwi funso: ngati chilema amapereka matenda Horton chiyani? Monga ulamuliro, kusapeza amphamvu ndi matenda zingachititse kuti magazini, chifukwa zimakhala zovuta kuti matenda, amene kumaonekera mu mutu kwambiri ndi misozi, salola wogwira ntchito kugwira ntchito zawo pa nthawi yaitali, mu kuwala komanso.