Gout

Gout ke mofuta oa ramatiki. E etsahala ha uric acid e haella maling mme e baka ho ruruha manonyellong.

Gout e bohloko ke boemo bo bohloko bo atisang ho ama lenonyeletso le le leng feela. Gout e sa foleng ke linako tse pheta-phetoang tsa bohloko le ho ruruha. Ho ka ameha manonyeletso a fetang a le mong.

Gout e bakoa ke ho ba le boemo bo phahameng ho feta bo tloaelehileng ba uric acid 'meleng oa hau. Sena se ka etsahala haeba:

• 'Mele oa hau o etsa uric acid e ngata haholo
• 'Mele oa hau o thatafalloa ke ho tlosa uric acid

Ha uric acid e bokella mokelikeli o pota-potileng manonyeletso (synovial fluid), ho hlaha likristale tsa uric acid. Likristale tsena li etsa hore lenonyeletso le ruruhe, le bake bohloko, ho ruruha le mofuthu.

Ha ho tsejoe hore na sesosa sa 'nete ke sefe. Gout e ka matha ka malapeng. Bothata bo atile haholo ho banna, ho basali ka mor'a ho khaotsa ho ilela khoeli, le ho batho ba noang joala. Ha batho ba ntse ba tsofala, gout e ba ho tloaelehileng.

Boemo bo kanna ba hlaha ho batho ba nang le:

• Lefu la tsoekere
• Lefu la liphio
• Botenya
• Sickle cell anemia le li-anemia tse ling
• Lefuemia le mefuta e meng ea kankere ea mali

Gout e ka hlaha kamora ho noa meriana e sitisang ho tlosoa ha uric acid 'meleng. Batho ba noang meriana e itseng, e kang hydrochlorothiazide le lipilisi tse ling tsa metsi, ba ka ba le boemo bo phahameng ba uric acid maling.

Matšoao a gout e matla:

• Maemong a mangata, ke 'mele o le mong feela kapa manonyeletso a' maloa a amehang. Hangata menoana e meholo ea maoto, lengole kapa maqaqailana e ameha. Ka linako tse ling manonyeletso a mangata a ruruha ebe a ba bohloko.
• Bohloko bo qala ka tšohanyetso, hangata bosiu. Bohloko bo lula bo le matla, bo hlalosoa e le ho khobotla, ho sithabetsa kapa ho bohloko.
• Lenonyeletso le bonahala le futhumetse ebile le le lefubelu. Hangata e bonolo ebile ea ruruha (ho bohloko ho beha lakane kapa kobo holim'a eona).
• Ho ka ba le feberu.
• Tlhaselo e kanna ea fela ka matsatsi a 'maloa, empa e kanna ea khutla nako le nako. Litlhaselo tse ling hangata li nka nako e telele.

Bohloko le ho ruruha hangata lia fela kamora tlhaselo ea pele. Batho ba bangata ba tla ba le tlhaselo e 'ngoe likhoeling tse 6 ho isa ho tse 12 tse tlang.

Batho ba bang ba ka ba le gout e sa foleng. Sena se boetse se bitsoa ramatiki ea gouty. Boemo bona bo ka lebisa tšenyo e kopaneng le tahlehelo ea motsamao manonyellong. Batho ba nang le gout e sa foleng ba tla ba le bohloko ba manonyeletso le matšoao a mang boholo ba nako.

Li-depositi tsa uric acid li ka theha makhopho ka tlase ho letlalo ho potoloha manonyeletso kapa libaka tse ling tse kang litsoeng, menoana le litsebe. Hlama e bitsoa tophus, ho tsoa Selatineng, ho bolelang mofuta oa lejoe. Tophi (makhopho a mangata) a ka hlaha kamora hore motho a be le gout ka lilemo tse ngata. Makhopo ana a ka tsoa lintho tse chalk.

Liteko tse ka etsoang li kenyelletsa:

• Tlhahlobo ea mokelikeli oa Synovial (e bontša likristale tsa uric acid)
• Uric acid - mali
• Li-x-ray tse kopaneng (e ka ba tse tloaelehileng)
• Tlhatlhobo ea synovial
• Uric acid - moroto

Tekanyo ea uric acid maling a fetang 7 mg / dL (milligrams desilitara ka ngoe) e phahame. Empa, ha se motho e mong le e mong ea nang le boemo bo phahameng ba uric acid ea nang le gout.

Nka meriana bakeng sa gout kapele kamoo u ka khonang haeba u ka ba le tlhaselo e ncha.

Nka li-anti-inflammatory drug (NSAIDs) tse kang ibuprofen kapa indomethacin ha matšoao a qala. Bua le mofani oa tlhokomelo ea bophelo ka lethal dose e nepahetseng. O tla hloka tekanyetso e matla ho feta matsatsi a 'maloa.

• Moriana oa ngaka o bitsoang colchicine o thusa ho fokotsa bohloko, ho ruruha le ho ruruha.
• Corticosteroids (joalo ka prednisone) le eona e ka sebetsa hantle. Mofani oa hau a ka kenya ente e chesang le li-steroid ho kokobetsa bohloko.
• Ka tlhaselo ea gout manonyeletsong a mangata ho ka sebelisoa moriana o nang le ente o bitsoang anakinra (Kineret).
• Hangata bohloko bo fela ka mor'a lihora tse 12 ho qala kalafo. Boholo ba nako, bohloko bohle bo felile nakong ea lihora tse 48.

U kanna ua hloka ho noa meriana ea letsatsi le letsatsi joalo ka allopurinol (Zyloprim), febuxostat (Uloric) kapa probenecid (Benemid) ho fokotsa sekhahla sa asiti ea uric maling a hau. Ho theola acid ea uric ho ea tlase ho 6 mg / dL ho hlokahala ho thibela li-depositi tsa uric acid. Haeba u na le tophi e bonahalang, uric acid e lokela ho ba tlase ho 5 mg / dL.

U kanna ua hloka meriana ena haeba:

• U na le litlhaselo tse 'maloa selemong sona seo kapa litlhaselo tsa hau li matla haholo.
• U na le tšenyo manonyeletso.
• O na le tophi.
• U na le lefu la liphio kapa majoe a liphio.

Lijo le phetoho ea bophelo li ka thusa ho thibela litlhaselo tsa gouty:

• Fokotsa joala, haholo joala (veine e ngoe e ka thusa).
• Fokotsa boima ba 'mele.
• Ikoetlise letsatsi le letsatsi.
• Fokotsa ho ja nama e khubelu le lino tse tsoekere.
• Khetha lijo tse phetseng hantle, joalo ka lihlahisoa tsa lebese, meroho, linate, linaoa, litholoana (tse sa tsoekere haholo) le lithollo.
• Kofi le vithamine C li tlatsetsa (li ka thusa batho ba bang).

Kalafo e nepahetseng ea litlhaselo tse matla le ho theola acid ea uric boemong bo ka tlase ho 6 mg / dL e lumella batho ho phela bophelo bo tloaelehileng. Leha ho le joalo, mofuta o matla oa lefu lena o ka fetela ho gout e sa foleng haeba asiti e phahameng ea uric e sa alafshoe hantle.

Mathata a ka kenyelletsa:

• Lefu la gouty ramatiki.
• Majoe a liphio.
• Li-depositi liphio, tse lebisang ho hloleheng ha liphio tse sa foleng.

Tekanyo e phahameng ea uric acid maling e amahanngoa le kotsi e eketsehileng ea lefu la liphio. Liphuputso li ntse li etsoa ho fumana hore na ho theola uric acid ho fokotsa menyetla ea lefu la liphio.

Letsetsa mofani oa thepa ea hau haeba u e-na le matšoao a lefu le matla la gouty kapa haeba u ba le tophi.

U kanna oa sitoa ho thibela gout, empa u ka khona ho qoba lintho tse bakang matšoao. Ho nka meriana ho theola uric acid ho ka thibela tsoelo-pele ea gout. Ha nako e ntse e tsamaea, li-depositi tsa hau tsa uric acid li tla nyamela.

Gouty ramatiki - a hlobaetsang; Gout - a hlobaetsang; Hyperuricemia; Ho tsoa gout; Tophi; Podagra; Gout - sa foleng; Gout e sa foleng; Gout e bohloko; Matšoao a bohloko a ramatiki

• Majoe a liphio le lithotripsy - ho tsoa
• Liphio tsa liphio - ho itlhokomela
• Liphio tsa liphio - seo u lokelang ho se botsa ngaka ea hau
• Mekhoa ea ho ntša metsi ka makhetlo a mangata - ho tsoa

• Likristale tsa uric acid
• Tophi gout ka letsohong

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Edwards NL. Maloetse a Crystal deposition. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 25th ed. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 273.

FitzGerald JD, Neogi T, Choi HK. Bohlophisi ba litaba: se ke oa lumella ho se tsotelle ha gout ho lebisa ho gouty arthropathy. Ramatiki Rheumatol. 2017; 69 (3): 479-482. PMID: 28002890 www.ncbi.nlm.nih.gov/pubmed/28002890. (Lebokose)

Khanna D, Fitzgerald JD, Khanna PP, le al. 2012 K'holejeng ea Amerika ea Rheumatology tataiso bakeng sa taolo ea gout. Karolo ea 1: mekhoa ea kalafo ea nonpharmacologic le pharmacologic ea hyperuricemia. Tlhokomelo ea Ramatiki Res (Hoboken). 2012; 64 (10): 1431-1446. PMID: 23024028 www.ncbi.nlm.nih.gov/pubmed/23024028.

Khanna D, Khanna PP, Fitzgerald JD, le al. Tataiso ea 2012 ea College ea Rheumatology ea Amerika bakeng sa taolo ea gout. Karolo ea 2: kalafo le antiinfigueatory prophylaxis ea lefu le bohloko la ramatiki. Tlhokomelo ea Ramatiki Res (Hoboken). 2012; 64 (10): 1447-1461. PMID: 23024029 www.ncbi.nlm.nih.gov/pubmed/23024029.

Liew JW, Gardner GC. Ts'ebeliso ea anakinra ho bakuli ba sepetlele ba nang le ramatiki e amanang le kristale. J Rheumatol. 2019 pii: jrheum. 181018. [Epub pele ho khatiso]. PMID: 30647192 www.ncbi.nlm.nih.gov/m/pubmed/30647192.