Iintlobo zePC
I-PC ithintela kakhulu abantu abaselula ukuya kwiminyaka engama-30. Abafazi bahlala begula. Kukho ezine ezineentlobo zesifo:
• Ixesha eliqhelekileyo-ukukhupha i-PC-state ithatha uhlobo lokuphazamiseka okukhulu komsebenzi wesifo kunye nokuxolelwa; malunga nesithathu sezigulane;
• Okwesibini iPP iqhubela phambili - izigulana zihlakulela izifo eziphazamisayo ezingapheliyo ezinokungonakali; kwisininzi sezigulane, i-PC yokubuyisela-i-reout-recking iya kule fomu;
• I-PC ephambili ephambili kunye nophuhliso oluqhubekayo lweempawu zeengxaki ngaphandle kokunyanzelisa; malunga ne-15% yezigulane;
• I-PC enobungozi - ukuhlasela okuphambili kwinqanaba elincinci kunye nokuphulukana okupheleleyo ngaphandle kokunyuka kwesifo; kakhulu kunqabile.
Iimpawu zePC ziyahlukahluka ngokubhekiselele kumhlobo wentsholongwane yentsholongwane echaphazelekayo.
• I-nertic optic
Ekubunjweni kwamacwecwe e-PC kwi-nertic optic, eyenza iziphumo ezivela kwi-retina ukuya kwingqondo, isigulane senza intlungu kwiso ngokudibene nombono ongacacanga. Ukubuyiswa, ukuba kunokwenzeka, kuthatha iinyanga ezilisibhozo.
• Ingqondo iqhube Ukubandakanywa kwengqondo yengqondo, ejongene nokunyakaza kwamehlo, ukukhathazeka kwezicubu zomzimba, ukuthetha, ukugwinya kunye nomlinganiselo wokulinganisela, kunokukhokelela kwimibono emibini okanye ukuphazanyiswa kwamanyathelo abo abanobubele.
• Intambo yomgca Ukuphazamiseka kokuhamba kwemiphumo yesibindi kwinqanaba lomgudu womgudu kuhamba kunye nobuthathaka kunye nokunciphisa ububele emilenzeni, kunye nokungasebenzi kwesisu kunye namathumbu.
Inkqubela
Ngokuphuhliswa kwesigaba sesibini esiqhubekayo sesifo, kukho ukuphazamiseka okuqhubekayo:
• ukulahleka kokuxhamla kwezandla;
• ubuthathaka nobunzima bezitho ezingaphantsi;
• ukwanda kwexesha lokuvuthwa kunye nokungahambisani nomzimba;
• Imemori engaphumeleli kunye nokugxininisa: ezi ziphazamiso zihlandlo ngamanye amaxesha iimpawu eziphambili;
• ukuguquka kwemizwelo; nangona idla ngokuxhamla kunye nePC, ukuxinezeleka kusekhona.
Kwizigaba zokuqala zePC, i-foci ye-inflammation ebonakalayo ivela kwingqondo, ephilisa ngokubunjwa kweetyala (iplats). Ngokuqhelekileyo ezi zifake zifakwe kwiindawo ezingenasiphelo (iindawo ezijikeleze ama-ventricle azaliswe ngamanzi), kumgca womgogodla kunye nemigodi ye-optic. Kule mimandla, umqobo wegazi-ingqondo (umda ongenakulinganiswa phakathi kwegazi kunye neethambo zesisongo) ubonakaliswe, okuvumela iiseli ezithile ukuba zidibanise neendonga zeemithwalo zegazi uze ungene kuwo.
Ukutshatyalaliswa kwesithintelo se-myelin
Inxaxheba ekhethekileyo ekuphuhlisweni kwesi sifo kungenxa yeqela lama-lymphocytes asabela kwi-antigens enye okanye ngaphezulu. Xa ezi i-lymphocytes (macrophages) zibandakanya nama-antigens, iikhemikhali ezithile zikhutshwa zikhuthaza ukubunjwa kwamaseli enyukliya. I-macrophages kunye neeseli zesalathisi ezisebenzayo (ezifunyenwe kwinkqubo yesistim ephakathi) zihlasela i-myelin sheath kwiindawo ezahlukileyo, ezikhokelela ekutshatyalalisweni nasekukhutshweni kwe-axon. Ezinye i-oligodendrocyte (iiseli ezivelisa i-myelin) ziyafa, ezinye ziyakwazi ukubuyisela ingxenye encinane i-myelin sheath. Kamva, malunga nemvelaphi yokuxhaswa kwe-inflammation, ukunyuka kwama-astrocytes (olunye uhlobo lweeseli ze-CNS) lubonwa ngokuphuhliswa kwe-gliosis (fibrosis). Izinto ezibini ezibalulekileyo zikhokelela ekuphuhlisweni kwePC - i-genetic factor of the environment.
Ukuxhatshazwa
Isiganeko se-PC (inani lamatyala ngobuninzi kwindawo ethile ngexesha) kwihlabathi lihluka ngokubanzi. Ngaphandle kwezinye iimeko, isifo senzeke ngokuphindaphindiweyo njengoko sisuka kude kwi-equator kunye noxinzelelo oluphezulu kwimimandla engaphezu kwe-30 efanayo kuwo onke amazwekazi. Kuqhelekile ukuhlukanisa imimandla emithathu kwihlabathi, ngokungafani nokuxhaphaka kwe-multiple sclerosis: indawo ephakamileyo, ephakathi neyophantsi. Ukutshintsha indawo yokuhlala kunye neenguqu kwindawo yengozi kubangela ukwanda okanye ukuncipha kumngcipheko womntu wokuphuhlisa i-PC, ngokulandelanayo, indawo ahlala kuyo. Kwimizamo yokuchaza ezi ndawo, iimeko ezininzi zendalo zenze uphando. Inendima ye-viral agents, kwaye ngokukodwa imasisi kunye ne-canine isifo segciwane (iintsholongwane ezibangela isifo esibi kwizinja) kwacatshulwa, kodwa kwangoku ubuhlobo obunentsholongwane ye-PC abuqinisekanga.
Izinto zobomi
Abantu abaneenkcukacha zentsapho ye-PC banokuthi bahlakulele isifo. Ngokomzekelo, umfazi onodade ophethe i-PC, umngcipheko wokugula ugxinwa ngamaxesha angama-40 xa kuthelekiswa nomfazi ongenalo i-anamnesis efanayo. Kwimeko yokugula kwesinye iwele, isibini isengozini yokuphuhlisa i-PC kunye nokuhleleka kwe-25%.
Impendulo yomzimba
Ezinye izazinzulu zibonisa ukuba iimpendulo ze-immunological kuma-virus (iintsholongwane, iibhaktheriya) okanye ukungaphantsi komzimba wokhuseleko lomzimba kukuxanduva lokuphuhliswa kwesifo. Ezinye iingcali ziqinisekile ngokuzimela kwe-PC, apho amangqamuzana omzimba atshabalalisa izicubu zomzimba. Ukuxilongwa kwe-PC kusekelwe kwi-imagination magontic resonance okanye uphando lwe-cerebrospinal fluid. Ukusetyenziswa kwexesha elide lesi sifo, izidakamizwa ezifana ne-beta-interferon zisetyenziswa. Ukuxilongwa kwePC, iintlobo ezimbini zophando zisetyenziswa:
• Ukucatshulwa kwe-magnontic resonance (MRI);
• uhlalutyo lwe-cerebrospinal fluid (COC).
Ukufundwa kweMt
Ukusetyenziswa kwethempyutheni ye-MRI kwandisa kakhulu ukuchaneka kwe-PC ukuxilongwa, kwaye kwakhokelela ekuqondeni okungcono uhlobo lwesifo. Iiplati ezisemgangathweni lwenkqubo yentsholongwane zinomhlobo othize kwimifanekiso, leyo, ngokubambisana nokuhlala kwindawo yengqondo, ibangele ukusola kwi-PC. I-MPT idlala indima ebalulekileyo ekuxilongweni kwe-PC, kodwa ukusetyenziswa kwendlela kunqongophe ngokubhekiselele kwinqanaba le sifo. Ngelishwa, akukho ncwadana ecacileyo phakathi kwe-MP-picture kunye nezibonakaliso zeklinikhi zesifo.
Ucwaningo lwe-CSF
I-CSF ijikeleza ngaphakathi kwee-ventricles zeengqondo, kunye nokuhlamba umphezulu wengqondo kunye nentambo yomthambo. Kwi-PC utshintsho oluthile lweprotheni kunye nokwakheka kwamaselula lubonisiwe, okwangoku, akukodwa. Kwi-90% yezigulane kwi-CSF, uhlobo olukhethekileyo lwe-immunoglobulin (oligoclonalD) lufumaneka.
Ezinye iimvavanyo
Ukulinganisa i-conductivity ye-pulses, umzekelo, ngokusebenzisa i-optic nerve fibers, iimvavanyo ezithile zenziwa. Okwangoku, olu phofu lucatshangelwa lingasebenzi. Ukuhlolwa kwegazi kunye nezinye iimviwo akubalulekile ekuhloleni i-PC, kodwa ingasetyenziselwa ukukhuphela ezinye iimeko ezifanayo. Unyango lwePC lubandakanya izikhokelo ezahlukeneyo.
Ukuhlaselwa ngokukodwa
Ukuhlaselwa kwe-PC eninzi kwenzeka ngendlela elula kwaye ayifuni unyango oluthile. Kwixesha elibi kakhulu, i-corticosteroids inikwe ngendlela yamacwecwe okanye i-insuffins. Ezi zi yobisi zinciphisa ixesha lokuhlaselwa, kodwa azichaphazeli umphumo wokugqibela.
Amanqaku amachiza
Amanye amayeza angakunceda iimpawu zesifo.
• Ukungasebenzi kwebladder
Ngokuqhelekileyo, izigulana ziye zandisa ukwanda kwe-urinate kunye nokugcinwa kwe-urinary - ukuxhoma le mpawu zisebenzisa izidakamizwa ezifana ne-oxybutynin kunye ne-tolterodine. Ngamanye amaxesha, ukunciphisa umonakalo wamanzi emini, misela i-desmopressin. Ukuzihlaziya ngokwesiqhelo kweso sityalo kuvumela izigulane ukulawula iimpawu zokungabikho komzimba kunye nokunciphisa ingozi yokusuleleka. Ukuphazamiseka kwamathumbu akuqhelekanga.
• Ukungabi namandla
Ukungabi namandla kumadoda anePC kuyaphiliswa kakuhle sildenafilom.
• Ukusasazeka kwezihlunu Ubunzima obungavamile obungumzimba, oqhelekileyo kwi-PC, ngokuqhelekileyo uphendukela kakubi kwiziyobisi, ezinokuba nemiphumo emibi.
• Ubuhlungu
Ukunciphisa i-syndrome yeentlungu zonyula imali efana ne-amitriptyline. Ukunyanga kwexesha elide le-PC kubandakanya ukusetyenziswa kwamagunya e-immunomodulating alawula umzimba womzimba. Okwangoku, iilisi eziphambili ezisetyenziselwa le njongo yi-beta-interferon.
Interferons
I-intelferons zenziwe ngokusemgangathweni emzimbeni wethu kwaye zize zintathu iintlobo: i-alpha-interferons ayinayo impembelelo kwi-PC; i-beta-interferons idlala indima ephambili yokukhanga; i-gamma-interferons kubangela ukugqithisa kwesi sifo. Indlela echanekileyo yezenzo ze-beta-interferon ayiyazi. I-intelon beta ihluke kakhulu kwi-beta ye-interferon yendalo, ngelixa i-interferon beta ihambelana ngokupheleleyo. Zonke i-interferons ze-beta zinciphisa inani le-PC lokuhlaselwa yi-30%; abanye abaphandi bacetyisa ukuba banciphisa ubunzima bokugqithisa. Iintlobo ezahlukeneyo ze-interferons zineempembelelo ezahlukeneyo kuxhomekeke kwisimo sesifo. I-beta-interferon ayinakucala ngokubhekiselele kwi-PC yokubuyisela kwakhona, nangona ityhutyha ukuphuhliswa kwesantlukwano sesibini esiqhubekayo sesifo. I-Interferon beta-1a amalungiselelo, kwakhona, anemiphumo eyahlukileyo. Ngethuba lokunyanga, ukuxhatshazwa kwamagciwane okuqulunqa isifo kumzimba wesigulane, impembelelo yayo kwimpumelelo yonyango ayicacanga. Zonke iindidi ze-beta-interferon zikhokelela ekuphuculeni okubonakalayo kwipateni-iphethini ngokuncipha kwinani lezilonda.
Ezinye iziyobisi
I-acetate yokulungisa i-acetate yelungelelaniso inomlinganiselo ofanayo weekhemikhali kunye neproteinyini ephezulu eyenza i-myelin. Njengama-interferons e-beta, ukunciphisa ubude bezinto ezinzima, kodwa aluchaphazeli ukuqhubela phambili kwesi sifo. I-immunoglobulin rhoqo yenyanga i-immunoglobulin inceda ukunciphisa inani lokuhlaselwa nokunciphisa isi sifo. Imibuzo eninzi malunga nokusebenza ngokuthelekiswa kwazo zonke izi yobisi ayinakuphendulwa. Enye, i-immunomodulators ekhethekileyo iqhutyelwa izifundo zonyango. I-PC yisifo esingapheliyo sesifo se-neurological course. Nangona kunjalo, kukho iindlela ezininzi ezinceda izigulane zijongane neenkxalabo zemihla ngemihla.
• Ukutya
Kukholelwa ukuba ukutya kunye namafutha omzimba angaphelelanga kunye nobukho be-fatty acids (ezifana neoli ye-sunflower) lunomphumo onokubaluleka kwimpilo yezigulane.
• Izinto eziqhelekileyo
Umgangatho wobomi wesigulane ngePC ngenxa yezinto ezifana nokukwazi ukuzinzela inkonzo, izinga lokuhamba kunye nesidingo sokusetyenziswa kwexesha elide kweziyobisi. Kubaluleke kakhulu ukuba isigulane sinikezelwa ngononophelo olufanelekileyo lwezonyango kunye nokunakekelwa kwengcali.
• Ukuchazwa
Phantse iminyaka engama-20 ukususela kwesi sifo, i-50% yezigulane ziyakwazi ukumelana nomgama ongaphandle kweemitha ezili-20. Umyinge wokuhlala kwexesha lezigulane kuncinci kunabantu.