Ankylosing spondylitis

Ankylosing spondylitis (AS) ke mofuta o sa foleng oa ramatiki. E ama masapo le manonyeletso botlaaseng ba mokokotlo moo e hokahanang le noka. Manonyeletso ana a ka ruruha a ba a ruruha. Ha nako e ntse e ea, masapo a mokokotlo a amehileng a ka kopana.

JOALOKA setho se ka sehloohong sa lelapa la mefuta e tšoanang ea ramatiki e bitsoang spondyloarthritis. Litho tse ling li kenyelletsa ramatiki ea psoriatic, ramatiki ea maloetse a ho ruruha le ramatiki e sebetsang. Lelapa la ramatiki le bonahala le atile haholo 'me le ama motho a le mong ho ba 100.

Lebaka la AS ha le tsejoe. Liphatsa tsa lefutso li bonahala li bapala karolo. Batho ba bangata ba nang le AS ba na le tšepo bakeng sa liphatsa tsa lefutso tsa HLA-B27.

Lefu lena hangata le qala lipakeng tsa lilemo tse 20 ho isa ho tse 40, empa le ka qala pele ho lilemo tse 10. Le ama banna ho feta basali.

JOALOKAHA e qala ka bohloko ba morao bo tlase bo tlang le bo fetang. Mahlaba a morao haholo a ba teng hangata ha boemo bo ntse bo tsoela pele.

• Bohloko le ho satalla ho mpefala bosiu, hoseng, kapa ha o sa sebetse hakaalo. Bohloko bo ka u tsosa borokong.
• Bohloko hangata bo ntlafala ka ho ikoetlisa kapa ho ikoetlisa.
• Bohloko ba morao bo ka qala bohareng ba noka le mokokotlo (manonyeletso a sacroiliac). Ha nako e ntse e ea, e ka kenyelletsa mokokotlo kaofela kapa karolo ea mokokotlo.
• Mokokotlo oa hau oa mokokotlo o ka fokotseha. Ha nako e ntse e tsamaea, u ka ema u eme ka pele.

Likarolo tse ling tsa 'mele oa hau tse ka amehang li kenyelletsa:

• Manonyeletso a mahetla, mangole le maqaqailana, a ka ruruhang a ba a opa
• Manonyeletso pakeng tsa likhopo tsa hao le lesapo la sefuba, hore o tle o se ke oa khona ho holisa sefuba sa hau ka botlalo
• Leihlo, le ka bang le ho ruruha le bofubelu

Mokhathala hape ke letšoao le tloaelehileng.

Matšoao a sa tloaelehang a kenyelletsa:

• Feberu e nyane

AS e kanna ea etsahala ka maemo a mang, joalo ka:

• Psoriasis
• Ulcerative colitis kapa lefu la Crohn
• Ho ruruha khafetsa kapa ho sa foleng ha mahlo (iritis)

Liteko li ka kenyelletsa:

• CBC
• ESR (tekanyo ea ho ruruha)
• HLA-B27 antigen (e fumanang liphatsa tsa lefutso tse amanang le ankylosing spondylitis)
• Rheumatoid factor (e lokelang ho ba mpe)
• X-ray ea mokokotlo le noka
• MRI ea mokokotlo le noka

Mofani oa hao oa tlhokomelo ea bophelo a ka u fa meriana e kang li-NSAID ho fokotsa ho ruruha le bohloko.

• Li-NSAID tse ling li ka rekoa ho feta-the-counter (OTC). Tsena li kenyelletsa aspirin, ibuprofen (Advil, Motrin), le naproxen (Aleve, Naprosyn).
• Li-NSAID tse ling li laeloa ke mofani oa hau.
• Bua le mofani oa hau kapa setsebi sa metsoako pele ho ts'ebeliso ea nako e telele ea NSAID efe kapa efe.

U kanna ua hloka meriana e matla ho laola bohloko le ho ruruha, joalo ka:

• Phekolo ea Corticosteroid (e kang prednisone) e sebelisetsoa nako e khuts'oane
• Sulfasalazine
• Biologic TNF-inhibitor (joalo ka etanercept, adalimumab, infliximab, certolizumab kapa golimumab)
• Sesebelisoa sa biologic inhibitor sa IL17A, secukinumab

Ho buuoa, joalo ka ho khutlisoa ha letheka, ho ka etsoa haeba bohloko kapa tšenyo ea lenonyeletso e le matla.

Ho ikoetlisa ho ka thusa ho ntlafatsa maemo le phefumoloho. Ho robala ka mokokotlo bosiu ho ka u thusa ho lula u eme hantle.

Tsela ea lefu lena e thata ho bolela esale pele. Ha nako e ntse e tsamaea, matšoao le matšoao a AS flareup (relapse) le khutso (remission). Batho ba bangata ba khona ho sebetsa hantle ntle le hore ba senyehe haholo lethekeng kapa mokokotlong. Ho kenella sehlopheng sa ts'ehetso sa ba bang ba nang le bothata bo tšoanang hangata ho ka thusa.

Kalafo ea NSAIDS hangata e fokotsa bohloko le ho ruruha. Kalafo e nang le li-inhibitors tsa TNF qalong ea lefu lena e bonahala e lieha ho nyoloha ke ramatiki ea mokokotlo.

Hangata, batho ba nang le ankylosing spondylitis ba ka ba le mathata ka:

• Psoriasis, lefu le sa foleng la letlalo
• Ho ruruha ka leihlong (iritis)
• Ho ruruha ka maleng (colitis)
• Pina e sa tloaelehang ea pelo
• Ho rorisa kapa ho tenya hoa lisele tsa matšoafo
• Ho qhekella kapa ho tenya ha avalic valve ea pelo
• Mokokotlo oa mokokotlo o lemetse kamora ho oa

Bitsa mofani oa hau haeba:

• U na le matšoao a ankylosing spondylitis
• U na le ankylosing spondylitis mme u hlahisa matšoao a macha nakong ea kalafo

Sefuba; Spondyloarthritis; HLA - Spondylitis

• Mokokotlo oa masapo
• Cervical spondylosis

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Inman RD. Li-spondyloarthropathies. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 249.

van der Linden S, Brown M, Gensler LS, Kenna T, Maksymowych WP, Taylor WJ. Ankylosing spondylitis le mefuta e meng ea axial spondyloarthritis. Ka: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, bahlophisi. Firestein & Kelly's Textbook ea Rheumatology. 11th ed. Philadelphia, PA: Elsevier; 2021: khaolo ea 80.

Ward MM, Deodhar A, Gensler LS, le al. Tlhabollo ea 2019 ea American College of Rheumatology / Spondylitis Association of America / Spondyloarthritis Research and Treatment Network Litlhahiso tsa kalafo ea ankylosing spondylitis le nonradiographic axial spondyloarthritis. Tlhokomelo ea ramatiki Res (Hoboken). 2019; 71 (10): 1285-1299. PMID: 31436026 phatlalalitsoe.ncbi.nlm.nih.gov/31436026/.

Werner BC, Feuchtbaum E, Shen FH, Samartzis D. Ankylosing spondylitis ea lesapo la mokokotlo. Ka: Shen FH, Samartzis D, Fessler RG, bahlophisi. Buka ea sengoloa ea Cervical Spine. Philadelphia, PA: Elsevier Saunders; 2015: khaolo ea 28.