Umfanekiso wekliniki
Iimpawu ze-arteritis zesikhashana zi:
- intloko;
- ukungabikho komonakalo okubonakalayo (umz., umbono obini);
- ukulahlekelwa ngokukhawuleza kwemboniso yeso linye;
- iintlungu ezinqabileyo emlonyeni okanye indlebe xa kuhlafuna - kubonwa kwi-50% yezigulane;
- Ububele besikhumba se-scalp.
Phantse kwikota yamatyala, i-arteritis yexesha lexeshana ihambisana ne-rheumatic polymyalgia (isifo esibonakaliswe intlungu kunye nokuqina koxinzelelo lwegxala kunye nebhande lomkhonto). Ngamanye amaxesha umfanekiso wekliniki wesi sifo ukhululekile, kunye nokusabalalisa kweempawu ezifana nokukhathala, ukudandatheka, ixesha elide lomkhuhlane, ukulahleka kwesisindo kunye nesondlo. Ukuxilongwa kwangaphambili kwe-arteritis yesikhashana kunciphisa kakhulu umngcipheko wokuphuhlisa ubumfama. Isiseko sokufumanisa i-diagnostic ivame ukuhlolwa kwedatha yangaphandle kunye neziphumo zokuhlolwa kwegazi. Emva kokuvavanywa, ugqirha ugxininisa ukukhathazeka kwi-artery yesikhashana kunye nokunciphisa okanye ukungabikho kwe-pulsation yayo.
Uviwo
- Ukuhlolwa kwe-oculist.
- Uvavanyo lwegazi - ngokuqhelekileyo i-anemia yezinga eliphezulu kunye nokuphakama kweeplatelet kufunyanwa. Uphawu lokubaluleka oluphawulekayo lukhuphuke kakhulu kwi-ESR (izinga lokutywiliswa kwe-erythrocyte) ngaphezulu kwe-50 ml / h. Nangona kunjalo, malunga ne-10% yezigulane, i-ESR inokuhlala kwimida eqhelekileyo, yenza kube nzima ukuxilonga.
- Udonga lweedriyiti. Ukuqinisekisa ukuxilongwa, kucetyiswa ukuba kuqhutywe i-biopsy yodonga lwe-artery yesikhashana. Le nkqubo iqulethe i-fragment encinci yerteri ephantsi kwesikhumba, phantsi kwe-anesthesia yendawo. I-specimen efunyenwe yi-biopsy ihlolwe ngenxa yobungqina bomsindo, kunye neeseli ezinkulu ezinkulu (ngoko ke igama elithi giant cell arteritis). Phantse i-20% yezigulane ezinepolymyalgia ye-rheumatic zineempawu ze-biopsy zangexesha elifanayo ezifana neziganeko kwizigulane ezine-arteritis zesikhashana. Ngamanye amaxesha umthambo we-biopsy uvelisa umphumo ongeyiphutha, okungenzeka ngenxa yobungqina bendawo engaguqukiyo okanye uqaliswe ngonyango lwe-steroid.
Iimbangela ze-arteritis zesikhashana azange zichazwe. Kukho ukucinga ukuba esi sifo sidibene neempendulo ze-immune kwi-walls of arteries. Kukholelwa ukuba indlela efanayo ifana nephuhliso le-rheumatic polymyalgia. Ukulahlekelwa kombono kwi-arteritis yesikhashana kubangelwa ukuxubusha kweemitha zegazi ze-retina. Ukungabonakali kwexesha elibonakalayo kunye nentlungu emhlanjeni inxulumene nomqobo wokukhawuleka kwegazi. Iinkcukacha ezibonisa ukuba isifo esithathelwanayo sesifo asifumaneki. I-arteritis yesikhashana ayiyona isifo esiyifa. Nangona kunjalo, ulwahlulo lwentlupheko ekuhlaleni lubonisa ukuba ukuveliswa kwemvelo kunokuthatha indima ekuphuhlisweni kwayo. I-arteritis i-dynamical positive dynamics ijongwa emva kweentsuku ezimbini okanye ezintathu zonyango ezinezinga eliphezulu ze-steroids. Esemngciphekweni wokulahleka kombono, ezinye iingcali zincoma ukuqala unyango nge-intravenous steroids. Xa kuphuhliswa iziphazamiso ezibonakalayo, ukulawulwa ngomlomo kwe-prednisolone kwisantya esincinci se-60 mg ngosuku kuyacetyiswa. Nge-arteritis yexesha elibalulekileyo, kubalulekile ukuba ungayihlehlisi ukuqaliswa kwonyango de kubekho iziphumo ze-biopsy. I-biopsy ye-Arterial kufuneka yenziwe ngokukhawuleza. Ngeli veki yokuqala yonyango lwe-steroid, iziphumo zakhe zihlala zilungile.
Ukulandela ixesha elide
Kwiimpembelelo zokuqala zonyango, i-dose ye-steroids iyancipha kancane kancane kwinqanaba lokugcina elincinci (7.5-10 mg ngosuku). Oku kunciphisa kakhulu umngcipheko weempembelelo zonyango lwe-steroid (umzekelo, i-osteoporosis okanye ukunciphisa ukunyanzelwa kwezifo). Kwezinye iimeko, i-immunosuppressants (umzekelo, i-azathioprin okanye i-methotrexate) imiselwe endaweni ye-steroids, ikakhulu kulawo gulane achaphazeleka kakhulu ngokupheliswa kwe-corticosteroids. Ukuthintela ukuphindaphinda kwesi sifo kufuneka kuthathe iminyaka emibili.
Ukuvavanya ukuphumelela kwonyango lwenziwe:
- Ukujonga ngokukhawuleza ubunzima beempawu;
- ukulawulwa kwe-ESR kwizinto ezinamandla.
Ukuxhamla ngokuxhomekeka kuxhomekeke ekuxhaseni kokuqala kokonyango. Xa kunesifo esibucayi esingabonakaliyo, ithuba lokubuyiswa ngokupheleleyo lincinci. Nangona kunjalo, ngokumalunga nemvelaphi yonyango, ukuphuculwa kwincinane kwintsebenzo ebonakalayo kunokwenziwa. Ukuqhubela phambili kwesi sifo emva kokuqala kwonyango lwe-steroid akunakwenzeka. Ukunciphisa umthamo we-steroids kunokubangela ukuphindaphinda kwesi sifo. Nangona kunjalo, umngcipheko wokuphindaphinda uyancitshiswa emva kweminyaka emine nesiqingatha kunyango, okanye unyaka okanye ngaphezulu emva kokuphela kwayo. Ukugqitywa ngokugqibeleleyo kuya kufumaneka emva kweminyaka emibili ukususela ekuqaleni kokunyango.
Ukuxhatshazwa
I-arteritis yesikhashana ivame ukukhula kubantu abadala kuneminyaka engama-50. Abafazi bayagula kabini ngokuphindaphindiweyo njengamadoda. Ukusabalalisa kwe-arteritis yesikhashana kuyahluka ukusuka kwilizwe elizweni. Ngokomyinge, phakathi kwabantu abangaphezu kweminyaka engama-50, iziganeko ziyi-0.49-23.3 amacala kwi-100 000 yabemi ngonyaka.