Izinhlobo ze-PC
I-PC ithinta kakhulu abantu abasha kuya eminyakeni engama-30. Abesifazane bavame ukugula njalo. Kunezinhlobo ezine eziyinhloko zezifo:
• Isimo se-PC esivamile-sokubuyisa sithatha indlela yokushintsha ukuphazanyiswa okunamandla komsebenzi wezinzwa nokuxolelwa; cishe okwesithathu kweziguli;
• Okwesibili iPP ethuthuka - iziguli zihlakulela ukuphazamiseka okuphazamiseka okuphazamiseka okuvame ukungonakaliswa; eziningi iziguli, i-PC yokubuyiselwa kabusha ibuyele kuleli fomu;
• i-PC eyinhloko eqhubekayo ethuthukiswa kancane kancane kwezimpawu zegazi ngaphandle kokucindezela; cishe iziguli ezingu-15%;
• i-PC enobungozi - ukuhlaselwa okuyisisekelo kwezinga eliphansi kanye nokulula okuphelele ngaphandle kokuqhubeka kwesifo; kuyinto engavamile kakhulu.
Izimpawu ze-PC zingashintsha kuye ngokuthi hlobo luni lwezintambo zesisindo ezithintekile.
• I-nertic optic
Ekubunjweni kwamacwecwe e-PC emlenzeni we-optic, ohambisa izimpucuko kusuka ku-retina kuya ebuchosheni, isiguli siqala ubuhlungu emehlweni lapho kuhlangene nombono ongacacile. Ukubuyiswa, uma kunokwenzeka, kuthatha izinyanga eziyisishiyagalombili.
• Ubuchopho buba khona Ukubandakanyeka kobuchopho, obangela ukunyakaza kwamehlo, ukuzwela kwezicubu ebusweni, inkulumo, ukugwinya kanye nokulinganisela, kungaholela embonweni kabili noma ukuphazanyiswa kokunyakaza kwabo obungane.
• Intambo yomgogodla Ukuphazamiseka kokugeleza kwemizwa ye-nerve ezingeni lomgogodla kuhambisana nobuthakathaka futhi kunciphise ukuzwela emilenzeni, kanye nokungahambi kahle kwesisu nesisu.
Ukuqhubeka
Ngokuthuthukiswa kwesigaba sesibili saleso sifo, ukuphazanyiswa okuqhubekayo kubonakala:
• ukulahleka kokungahambisani kwezandla;
• ubuthakathaka nokuqina kwamalungu angaphansi;
• ukuvama kokwanda kokuvuthwa nokungahambisani kwamanzi;
• Inkumbulo engenakonakala nokugxila: lokhu ukuphazanyiswa okuvame ngezinye izikhathi izimpawu eziyinhloko;
• ukushintsha kwemizwa; nakuba ngokuvamile kuhlotshaniswa ne-PC euphoria, ukucindezeleka kusekhona ngokwengeziwe.
Ekuqaleni kwe-PC, i-foci ye-inflammation ebonakalayo ivela ebuchosheni, ephulukisa ngokubunjwa kwezibazi (amapulethi). Ngokuvamile lezi zigcawu zifakwa ezikhaleni ezingezansi (izindawo ezizungeze ama-ventricles agcwele amanzi ochopho), emgodini womgogodla nama-optic neva. Kulezi zindawo, ukuvinjelwa kwegazi-ingqondo (imingcele emincane phakathi kwegazi kanye nezicubu zobuchopho) ibonakalisiwe, okuvumela amangqamuzana athile axhumane nezindonga zegazi bese engena kuwo.
Ukubhujiswa komgodla we-myelin
Indima ekhethekile ekuthuthukiseni lesi sifo kungokwesigaba se-lymphocyte esabela kumuntu oyedwa noma ngaphezulu we-myelin imvilophu antigens. Lapho lezi zymphocytes (macrophages) zihlangana nama-antigens, kukhishwa amakhemikhali athile akhuthaza ukwakhiwa kwamangqamuzana e-mononuclear. Ama-Macrophages namaseli agciliziwe asetshenziswe (atholakala ohlelweni lwesigungu sezinzwa) ahlasela isheath yami ye-myelin kumasayithi ahlukahlukene, okuholela ekubhujisweni nasekukhonjisweni kwe-axon. Amanye ama-oligodendrocyte (amangqamuzana akhiqiza i-myelin) ayafa, abanye bangabuyisela kancane kancane isheath elilahlekile le-myelin. Kamuva, ngokumelene nesizinda sokwehla kwesibalo sokushisa, ukwanda kwamanye ama-astrocytes (olunye uhlobo lwamaseli we-CNS) kubonakala ngokuthuthukiswa kwe-gliosis (fibrosis). Izici ezimbili ezibalulekile ziholela ekuthuthukiseni i-PC - isici sezakhi zofuzo.
Ukuhlukunyezwa
Isigameko se-PC (inani lamacala kubantu ngesikhathi esithile ngesikhathi) emhlabeni lihluka kakhulu. Ngaphandle kwalokho, lesi sifo senzeke kaningi lapho sisuka kude ne-equator sinokuhlushwa okuphakeme kakhulu ezindaweni ezingaphezu kwe-30 ehambisanayo kuwo wonke amazwekazi. Kuvamile ukuhlukanisa izindawo ezintathu emhlabeni wonke, okungafani nokusabalalisa kwe-multiple sclerosis: izindawo eziphakeme, eziphakathi nendawo eziphansi. Ukushintsha indawo yokuhlala nokushintsha endaweni engozini kubangela ukwanda noma ukwehla engozini yomuntu ngamunye wokuthuthukisa i-PC, ngokulandelana, indawo ahlala kuyo. Emzamweni wokuchaza lezi zici zendawo, kunezici eziningi zemvelo eziphenywe. Indima yama-viral agents, futhi ikakhulukazi amagciwane we-canine nezinkinga zesifo se-canine (okwakamuva kubangela isifo esibi ezinja) kwakucatshangwa, kodwa kuze kube manje isimo se-PC esingasetshenziswanga asiqinisekisiwe.
Izici zofuzo
Abantu abanomlando womndeni we-PC banamathuba amaningi okuthuthukisa lesi sifo. Isibonelo, owesifazane ogade udade one-PC, ingozi yokuguga yanda izikhathi ezingama-40 uma kuqhathaniswa nowesifazane ongenalo i-anamnesis efanayo. Uma kugula elinye lamawele, owesibili usemngciphekweni wokuthuthukisa i-PC enamathuba angu-25%.
Ukuphendula komzimba
Abanye ososayensi bakhombisa ukuthi impendulo ye-immunological kuma-agent aphephile (amagciwane, amabhaktheriya) noma ukwehla kwesimiso somzimba sokuvikela omzimba kungenxa yokuthuthukiswa kwesifo. Olunye ochwepheshe bayaqiniseka ukuthi isimo se-PC esizimele, lapho amangqamuzana omzimba abulala khona izicubu zomzimba. Ukuxilongwa kwe-PC kusekelwe ekucabangeni kwamagnetic resonance noma uphenyo lwe-cerebrospinal fluid. Ukuze ukwelashwa kwesikhashana isikhathi eside, izidakamizwa ezifana ne-beta-interferon zisetshenziswa. Ukuhlolwa kwe-PC, izinhlobo ezimbili zokucwaninga zisetshenziswa:
• Ukufaneka kwe-magnontic resonance (MRI);
• ukuhlaziywa kwamanzi kagesi (COC).
I-Mt-study
Ukusetshenziswa kobuchwepheshe be-MRI kwandisa kakhulu ukunemba kwe-PC ukuxilongwa, futhi kwaholela ekuqondeni kangcono uhlobo lwesifo. Ama-plaques esistimu yesimiso esiyinhloko anehlobo oluthile ezithombeni, okuyinto, ngokuhambisana nendawo yangaphakathi ebuchosheni, ebangela ukusola kwi-PC. I-MPT idlala indima ebalulekile ekuxilongweni kwe-PC, kodwa ukusetshenziswa kwalendlela kunciphile kakhulu ngokuqapha inkambo yesifo. Ngeshwa, akukho ukuxhumana okucacile phakathi kwe-MP-picture kanye nokubonakaliswa kwemitholampilo yesifo.
Ucwaningo lwe-CSF
I-CSF ijikeleza ngaphakathi kwezingxenyeni zobuchopho, kanye nokugeza ubuso obuchopho nomgogodla. E-PC ushintsho oluthile lweprotheyini nokubunjwa kwamaselula kuphawulwe, okwamanje, okungaqondile. Ku-90% weziguli ku-CSF, kutholakala uhlobo olukhethekile lwe-immunoglobulin (oligoclonalD).
Okunye ukuhlolwa
Ukukala ukuqhutshwa kwamapulisi, isibonelo, ngokusebenzisa ama-fibre nerve fibers, ukuhlolwa okuqondile kwenziwa. Njengamanje, lolu cwaningo lubhekwa lingasebenzi. Ukuhlolwa kwegazi nezinye izivivinyo akubalulekile ekuhloleni i-PC, kodwa kungasetshenziswa ukukhipha ezinye izimo ezifanayo. Ukuphathwa kwe-PC kuhlanganisa izinkomba ezihlukahlukene.
Ukuhlasela okumangalisayo
Ukuhlaselwa kwe-PC amaningi kwenzeka ngendlela elula futhi akudingi ukwelashwa okuqondile. Ngenkathi eyingozi kakhulu, i-corticosteroids inikezwa ngendlela yamathebulethi noma ama-insuffins angenayo. Lezi zidakamizwa zinciphisa isikhathi sokuhlaselwa, kepha aziphazamisi umphumela wokugcina.
Izinyathelo zesimangaliso
Iminye imithi inganciphisa izimpawu zesifo.
• Ukungasebenzi komzimba
Ngokuvamile, iziguli ziye zakhuthaza ukuvuthwa nokugcina umchamo - ukuxazulula lezi zimpawu zisebenzisa izidakamizwa ezifana ne-oxybutynin ne-tolterodine. Ngezinye izikhathi, ukunciphisa umkhiqizo wamanzi emini, misela i-desmopressin. Ukuzihlaziya ngezikhathi ezithile kwesisindo kuvumela iziguli ukuba zilawule izimpawu zokungabikho komzimba futhi zinciphise ingozi yokutheleleka. Ukuphazamiseka kwamathumbu akuvamile.
• Ukungabi namandla
Ukuntula amandla emadodeni aphethe i-PC kuyaphathwa kahle nge-sildenafilom.
• Ubukhulu bemisipha Ukuqina komzimba okungavamile, okujwayelekile ku-PC, kuvame ukuphendula kabi izidakamizwa, ezinemiphumela emibi kakhulu.
• Ubuhlungu
Ukunciphisa i-syndrome yezinhlungu ukhethe izimali ezifana ne-amitriptyline. Ukwelashwa kwesikhashana eside kwe-PC kuhlanganisa ukusetshenziswa kwama-immunomodulating agents alawula ukuphendula komzimba ngomzimba. Okwamanje, izidakamizwa eziyinhloko ezisetshenziselwa le njongo yi-beta-interferon.
Ama-interferons
Ama-interferons ahlanganiswa emzimbeni wethu futhi eze ngezinhlobo ezintathu: i-alpha-interferons inomphumela omncane ku-PC; i-beta-interferons idlala indima enkulu yokukhanga; Ama-gamma-interferons enza ukuthi lesi sifo siphuthumise. Indlela eqondile yezenzo ze-beta-interferon ayiziwa. I-Interferon beta ihluke kakhulu kwi-interferon yemvelo ye-beta, kuyilapho i-interferon beta ihambelana ngokuphelele nayo. Wonke ama-interferon we-beta anciphisa inani lokuhlaselwa kwe-PC ngamaphesenti angu-30; abanye abacwaningi basikisela ukuthi bayanciphisa ubukhulu bokucindezela. Izinhlobo ezahlukene ze-interferon zinemiphumela ehlukile kuye ngokuthi uhlobo lwesifo. I-beta-interferon ayikwazi ukusebenza ngokumelene ne-PC yokubuyisela kabusha, kodwa iyanciphisa ukuthuthukiswa kwesimo esilandelayo sesibili. I-Interferon beta-1a amalungiselelo, futhi, anemiphumela ehlukile. Ngesikhathi sokwelashwa, i-neutralizing antibodies yenziwa emzimbeni wesiguli, ithonya layo ekuphumeleleni kwelashwa akucacile. Zonke izinhlobo ze-beta-interferon ziholela ekuthuthukiseni okukhulu kwi-MP-iphethini ngokunciphisa inani lezilonda.
Ezinye izidakamizwa
I-synthetic preparation glatiramer acetate inesakhiwo esifanayo samakhemikhali neprotheyini esemqoka eyenza i-myelin. Njengama-interferons we-beta, kunciphisa ukuvama kokucindezela, kodwa akuthinti ukuqhubeka kwesifo. I-immunoglobulin yanyangazonke yomsindo iyakusiza ukunciphisa inani lokuhlaselwa nokunciphisa inkinga yesifo. Imibuzo eminingi mayelana nokusebenza okuqhathaniswa kwazo zonke lezi zidakamizwa ahlala engaphenduliwe. Eminye, izibalo ze-immunomodulator eziqondile zizohlolwa izifundo zokwelashwa. I-PC yisifo esingelapheki sezinzwa ngezinga eliqhubekayo. Noma kunjalo, kunezindlela eziningi ezisiza iziguli ukuba zibhekane nokukhathazeka kwansuku zonke.
• Ukudla
Kukholelwa ukuthi ukudla okunamafutha omzimba okulinganiselwe kanye nokuba khona kwamafutha angenasaturated (njengamafutha e-sunflower) kunomphumela omuhle ekwenzeni impilo yeziguli.
• Imisebenzi ejwayelekile
Ikhwalithi yokuphila kwesiguli nge-PC ingenxa yezici ezifana nekhono lokuzibophezela, izinga lokuhamba kanye nesidingo sokusebenzisa isikhathi eside izidakamizwa. Kubaluleke kakhulu ukuthi isiguli sinikezwe ukunakekelwa kwezempilo okufanelekile nokunakekelwa kochwepheshe.
• Isibikezelo
Cishe eminyakeni engama-20 kusukela ekuqaleni kwalesi sifo, iziguli ezingama-50% ziyakwazi ukumelana nebanga langaphandle elingamamitha angaba ngu-20. Isikhathi sokuphila sempilo yeziguli ezinjalo siphansi kunabantu.