I-Ankylosing spondylitis

I-Ankylosing spondylitis (AS) yindlela engapheliyo yesifo samathambo. Ichaphazela ikakhulu amathambo kunye namalungu kwisiseko somqolo apho idibana khona nesinqe. La malungu angadumba kwaye adumbe. Ixesha elingaphezulu, amathambo omqolo ochaphazelekayo angadibana.

AS lilungu eliphambili losapho lweendlela ezifanayo zesifo samathambo ekuthiwa sispondyloarthritis. Amanye amalungu abandakanya i-psoriatic arthritis, isifo samathambo sokudumba kunye nesifo samathambo esisebenzayo. Intsapho ye-arthritis ibonakala ixhaphake kwaye ichaphazela ukuya kwi-1 kubantu abayi-100.

Unobangela we-AS awaziwa. Imfuza ibonakala ngathi idlala indima. Uninzi lwabantu abane-AS bathembele kuhlobo lwe-HLA-B27.

Esi sifo sihlala siqala phakathi kweminyaka engama-20 ukuya kuma-40, kodwa sinokuqala ngaphambi kweminyaka eyi-10. Sichaphazela abesilisa abangaphezu kwabasetyhini.

AS iqala ngeentlungu ezisezantsi ezisezayo nezihambayo. Intlungu ebuyela umva iba khona ixesha elininzi njengoko imeko iqhubeka.

• Ubuhlungu kunye nokuqina kubi kakhulu ebusuku, kusasa, okanye xa ungasebenzi. Ukuphazamiseka kunokukuvusa ebuthongweni.
• Intlungu ihlala ilunga ngomsebenzi okanye ngokwenza umthambo.
• Intlungu ebuyela emva ingaqala phakathi kwe-pelvis kunye nomqolo (amalungu e-sacroiliac). Ixesha elingaphezulu linokubandakanya konke okanye inxenye yomqolo.
• Umqolo wakho osezantsi unokuba bhetyebhetye kancinci. Ixesha elingaphezulu, unokuma kwindawo ebheke phambili.

Amanye amalungu omzimba wakho anokuchaphazeleka kubandakanya:

• Ukudityaniswa kwamagxa, amadolo kunye namaqatha, anokudumba abe buhlungu
• Amalungu aphakathi kweembambo zakho kunye nethambo lesifuba, ukuze ungakwazi ukwandisa isifuba sakho ngokupheleleyo
• Iliso, elinokudumba nokubomvu

Ukukhathala kukwayimpawu eqhelekileyo.

Iimpawu eziqhelekileyo ziquka:

• Umkhuhlane omncinci

I-AS inokwenzeka nezinye iimeko, ezinje:

• Unyango
• Ulcerative colitis okanye isifo seCrohn
• Ukudumba kwamehlo okuphindaphindiweyo okanye okungapheliyo (iritis)

Uvavanyo lunokubandakanya:

• I-CBC
• I-ESR (umlinganiselo wokuvuvukala)
• I-anti-HLA-B27 antigen (efumanisa uhlobo lomzimba olunxulunyaniswe ne-ankylosing spondylitis)
• I-rheumatoid factor (ekufuneka ingalunganga)
• I-X-ray yomqolo kunye ne-pelvis
• I-MRI yomqolo kunye ne-pelvis

Umboneleli wakho wezempilo unokuyalela amayeza afana nee-NSAID ukunciphisa ukudumba kunye nentlungu.

• Ezinye ii-NSAID zingathengwa ngaphezulu kwe-counter (i-OTC). Oku kubandakanya i-aspirin, ibuprofen (Advil, Motrin), kunye ne-naproxen (Aleve, Naprosyn).
• Ezinye ii-NSAID zichazwe ngumboneleli wakho.
• Thetha nomboneleli wakho okanye usokhemesti ngaphambi kokusebenzisa imihla ngemihla ixesha elide kuyo nayiphi na i-NSAID engaphezulu kwe-counter.

Unokufuna amayeza anamandla ukulawula iintlungu kunye nokudumba, ezinje:

• Unyango lweCorticosteroid (njenge-prednisone) esetyenziselwa ixesha elifutshane
• Isulfasalazine
• I-biologic TNF-inhibitor (efana ne-etanercept, adalimumab, infliximab, certolizumab okanye golimumab)
• I-biologic inhibitor ye-IL17A, secukinumab

Utyando, njengokutshintsha kwe-hip, lunokwenziwa ukuba iintlungu okanye umonakalo odibeneyo unzima.

Ukuzivocavoca kunokunceda ukuphucula ukuma nokuphefumla. Ukulala phantsi ngomqolo ebusuku kunokukunceda uhlale uhleli kakuhle.

Isifundo sesi sifo kunzima ukuqikelela. Ixesha elingaphezulu, imiqondiso kunye neempawu ze-AS flareup (ukubuyela umva) kunye nokuzola (uxolelo). Uninzi lwabantu luyakwazi ukusebenza kakuhle ngaphandle kokuba banomonakalo omkhulu esinqeni okanye emqolo. Ukujoyina iqela lenkxaso labanye abanengxaki efanayo kunokunceda.

Unyango nge-NSAIDS ludla ngokunciphisa iintlungu kunye nokudumba. Unyango nge-TNF inhibitors kwangoko kwesi sifo lubonakala lucotha ukuqhubela phambili kwamathambo omqolo.

Ngokuqhelekileyo, abantu abane-ankylosing spondylitis banokuba neengxaki nge:

• I-Psoriasis, ingxaki yesikhumba engapheliyo
• Ukuvuvukala kwiso (iritis)
• Ukudumba emathunjini (colitis)
• Isingqisho sentliziyo esingaqhelekanga
• Ukurhawuzelela okanye ukuqina kwethishu yemiphunga
• Ukurhabaxa okanye ukuqina kwentliziyo yesivalo sentliziyo
• Ukulimala kwentambo yomqolo emva kokuwa

Fowunela umnikezeli wakho ukuba:

• Unempawu ze-ankylosing spondylitis
• Une-ankylosing spondylitis kwaye uphuhlise iimpawu ezintsha ngexesha lonyango

Ukudumba; ISpondyloarthritis; I-HLA-Spondylitis

• Umqolo womqolo
• Umlomo wesibeleko

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van der Linden S, Brown M, Gensler LS, Kenna T, Maksymowych WP, Taylor WJ. I-Ankylosing spondylitis kunye nezinye iindlela ze-axial spondyloarthritis. Ku: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, ii-eds. Incwadi kaFirestein kunye noKelly yeRheumatology. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2021: isahluko 80.

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UWerner BC, uFeuchtbaum E, uShen FH, uSamartzis D.I-Ankylosing spondylitis yomqolo wesibeleko. Ku: Shen FH, Samartzis D, Fessler RG, ii-eds. Incwadi yesicatshulwa yomlomo wesibeleko. IPhiladelphia, PA: Elsevier Saunders; 2015: isahluko 28.