Isithombe sezokwelapha
Izimpawu ze-arteritis zesikhashana ziyi:
- ikhanda;
- ukukhubazeka okubonakalayo okwesikhashana (isib. umbono ophindwe kabili);
- ukulahlekelwa okungazelelwe kombono wesiso elilodwa;
- ubuhlungu obukhulu emlonyeni noma endlebeni uma kuhlafuna - kuboniswe ezigulini ezingama-50;
- isisa sesikhumba se-scalp.
Cishe ezingxenyeni zamacala, i-arteritis yesikhashana ihambisana ne-rheumatic polymyalgia (isifo esibonakala ngobuhlungu obukhulu kanye nokuqina kobunzima behlombe nebhande elincane). Ngezinye izikhathi isithombe somtholampilo saleso sifo sinobukhulu, ngokusakazeka kwezimpawu ezinjengokukhathala, ukucindezeleka, ukukhulelwa isikhathi eside, ukulahlekelwa isisindo nesifiso. Ukuxilongwa kokuqala kwe-arteritis yesikhashana kunciphisa kakhulu ingozi yokuthuthukisa ubumpumputhe. Isisekelo sokuxilongwa yi-data yangaphandle yokuhlola kanye nemiphumela yokuhlolwa kwegazi. Lapho ehlolwa, udokotela ubhekisela ekubhekeleni kwesifo somzimba kanye nokwehla noma ukungabi khona kwe-pulsation yayo.
Ukuhlolwa
- Ukuhlolwa kwe-oculist.
- Ukuhlolwa kwegazi - ngokuvamile i-anemia yezinga eliphansi nokuphakama kwamaplatelets itholakala. Uphawu lokubaluleka oluphawulekayo lukhuphuke kakhulu eSRR (isilinganiso se-sedimentation of erythrocytes) esingaphezu kwama-50 ml / h. Kodwa-ke, kuma-10% weziguli, i-ESR ingahlala emingcele evamile, yenza kube nzima ukuyihlolisisa.
- I-artery wall biopsy. Ukuqinisekisa ukuxilongwa, kuhle ukuqhuba i-biopsy yodonga lwe-artery wesikhashana. Le nqubo ihlanganisa ukungxenywa kwechungechunge elincane lomcibisholo otholakala ngqo ngaphansi kwesikhumba, ngaphansi kwe-anesthesia yendawo. I-specimen etholakalayo ye-biopsy ihlolwe ngokuba khona kwezinguquko zokuvuvukala, kanye nama cell giant amaningi (ngakho-ke igama elithi giant cell arteritis). Cishe iziguli ezingu-20% ezine-rymum polymyalgia zinezikhathi ze-artery biopsy imiphumela efana nalezi ezitholakala ezigulini ezine-arteritis zesikhashana. Ngezinye izikhathi i-biopsy yamathambo iveza umphumela ongamanga, okungenzeka ngenxa yokutholakala kwezindawo ze-artery ezingaguquki noma eziqaliswe ukwelashwa kwe-steroid.
Izimbangela ze-arteritis zesikhashana azange zichazwe. Kukhona ukucabanga ukuthi lesi sifo sihlotshaniswa nempendulo yegciwane lesandulela ngculazi ezindongeni ze-arteries. Kukholelwa ukuthi indlela efanayo ehambisana nokuthuthukiswa kwe-polymyalgia ye-rheumatic. Ukulahlekelwa kombono nge-arteritis yesikhashana kungenxa ye-thrombosis yemithambo yegazi ye-retina. Ukukhubazeka okubonakalayo okubukwayo kanye nobuhlungu emhlathini kufakwe ukuvinjelwa okuyingxenye yokugeleza kwegazi. Idatha ebonisa ukuthi isifo esithathelwanayo sesifo ayitholakali. I-arteritis yesikhashana akuyona isifo esiyifa. Kodwa-ke, umehluko wobuhlanga ekubulaleni kubonisa ukuthi ukutholakala kwezakhi zofuzo kungadlala indima ekuthuthukisweni kwayo. Nge-dynamical arteritis esheshayo iyaphazamiseka ngemva kwezinsuku ezimbili noma ezintathu zokwelapha ezinezinga eliphezulu ze-steroids. Lapho engozini yokulahlekelwa umbono, ezinye izazi zincoma ukuthi ziqale ukwelashwa nge-steroids engaphakathi. Uma uthuthukisa ukuphazamiseka okubukwayo, ukuphathwa ngomlomo kwe-prednisolone ngesilinganiso esilinganiselwe sama-60 mg ngosuku kunconywa. Nge-arteritis yesikhashana, kubalulekile ukuthi ungahlehlisi ukuqaliswa kokwelashwa kuze kutholakale imiphumela ye-biopsy. I-biopsy ye-arterial kufanele yenziwe ngokushesha ngangokunokwenzeka. Phakathi nesonto lokuqala lokuphathwa kwe-steroid, imiphumela yakhe ingase ihlale ihle.
Ukulandelwa kwesikhathi eside
Emiphumeleni yokuqala emihle yokwelapha, isilinganiso se-steroids kancane kancane sinciphisa izinga lokugcina elincane (7.5-10 mg ngosuku). Lokhu kunciphisa kakhulu ingozi yemiphumela emibi ye-steroid therapy (isb., Ukuguqulwa kwamathambo noma ukunciphisa ukumelana nezifo). Kwezinye izimo, izivikeli ze-immunosuppressants (isib. I-azathioprine noma i-methotrexate) zinqunywe esikhundleni se-steroids, ikakhulukazi kulawo gulane abathinteka kakhulu ekuqedeni kwe-corticosteroids. Ukuvimbela ukuphindaphinda kwesifo kumele kuhlale iminyaka emibili.
Ukuhlola ukuphumelela kokwelashwa kwenziwa:
- ukubuka ngezikhathi ezithile ubukhulu bezimpawu;
- ukulawula kwe-ESR kumadayimandla.
I-prognosis ixhomeke kakhulu ekuqaliseni kokuqala kokwelashwa. Uma kwenzeka ukukhubazeka okungathí sina okubonakalayo, amathuba okuthola kabusha ngokuphelele aphansi. Noma kunjalo, ngokumelene nemvelaphi yokwelashwa, ukuthuthukiswa okuyingxenye ekusebenzeni okubukwayo kungabonwa. Ukuqhubeka kwesi sifo ngemva kokuqala ukwelashwa kwe-steroid akunakwenzeka. Ukunciphisa umthamo we-steroids kungabangela ukuphindaphinda kwesifo. Kodwa-ke, ingozi yokuphindaphinda iyancipha ngemva kweminyaka eyodwa nengxenye yokwelapha, noma unyaka noma ngaphezulu emva kokuphela kwayo. Ukudilizwa okuphelele kuvame ukutholakala emva kweminyaka emibili kusukela ekuqaleni kokulashwa.
Ukuhlukunyezwa
I-arteritis yesikhashana ivame ukukhula kubantu abadala kuneminyaka engama-50. Abesifazane abagula kabili kaningi njengamadoda. Ukusabalalisa kwe-arteritis yesikhashana kuyahlukahluka ezweni lonke. Ngokwesilinganiso, phakathi kwabantu abaneminyaka engaphezu kwengu-50, lesi sigameko singama-0.49-23.3 amacala kubantu abayi-100 000 ngonyaka.