Giant cell arteritis - haddasawa, bayyanar cututtuka da magani

Giant cell arteritis shine granulomatous vasculitis, yawanci yana shafar tasoshin kai da wuyansa. Ba a san abubuwan da ke haifar da wannan yanayin ba, amma ana la'akari da abubuwan muhalli da kwayoyin halitta. Irin wannan kumburi yawanci yana faruwa a cikin tsofaffi bayan shekaru 70, yawanci a cikin mata.

Menene katuwar arteritis?

Wannan rashin lafiya shine granulomatous, na kullum, tsarin tsarin da na farko na vasculitis na ƙananan ko babba, yawanci yana shafar tasoshin kai da wuyansa. Musamman ya shafi jijiyoyi na wucin gadi, ido, jijiyoyi na vertebral da kuma jijiya ta tsakiya. Sau da yawa, a cikin yanayin giant cell arteritis, za mu iya lura da haɗin gwiwa na rheumatic polymyalgia (cututtukan rheumatic daga rukuni na cututtuka na ƙwayoyin cuta). Kumburi na arteries ya fi kowa a cikin tsofaffi, fiye da shekaru 70, yawanci a cikin mata; Mafi girman abin da ya faru shine a cikin ƙasashen Scandinavian. Dalilin cutar ba a san shi sosai ba, rawar da tsarin rigakafi na salula ke da shi akan lamina na ciki (membrane elastica interna) ko ƙwayoyin tsoka mai santsi na bangon jirgin ruwa an sanya shi.

Abubuwan da ke haifar da giant cell arteritis

Ko da yake ba a yi cikakken bayani kan illolin wannan cuta ba, an ce wasu dalilai na taka rawa:

1. kwayoyin halitta,
2. muhalli,
3. m.

An tabbatar da dalilai na faruwar iyali na giant cell arteritis ta gaskiyar cewa wannan kumburi ya fi yawa a Scandinavia da marasa lafiya na asalin Scandinavian da ke zaune a wasu sassan duniya (irin su Amurka). Haka kuma cutar na iya faruwa a matsayin martani ga masu kamuwa da cuta (watau ƙwayoyin cuta da fungi) a cikin mutanen da ke da yanayin halitta.

Giant cell arteritis na iya zama alaka da wadannan pathogens:

1. faren B19,
2. Parainfluenza nau'in 1,
3. chlamydia,
4. mycoplasma.

Kuna so ku kula da tsarin jinin ku? Order Circulation - Likita Life kari na abinci, wanda aka tsara don kare arteries daga kumburi da kuma kula da dace aiki na dukan zuciya da jijiyoyin jini tsarin.

Alamun giant cell arteritis

Aortic baka rassan, yawanci rassan carotid artery na waje, suna shiga cikin yanayin cutar, amma kumburi kuma yana iya shafar sauran arteries, misali .:

1. kashin baya,
2. na ɗan lokaci
3. ciliary na baya,
4. matsanancin mahaifa,
5. jugular ciki,
6. ido,
7. tsakiyar retina.

Yana da wuya cewa kumburi yana rinjayar iliac, brachial da arteries na mata. A gefe guda, ana iya samun shigar da aorta na ciki.

Alamun asibiti:

1. ciwon kai (mafi yawan lokuta a cikin yanki na wucin gadi ko occipital; suna aiki musamman da dare kuma suna hana majiyyaci barci).
2. rikicewar gani har zuwa ciki har da asarar hangen nesa (masu jinya sau da yawa suna fama da hangen nesa biyu da amblyopia na wucin gadi); rashin lafiyar gani; kumburi da orbital tissues,
3. Matsakaicin hankali a kan wani kauri mai kauri da bugun jini na wucin gadi wanda ake iya gani da karkace,
4. dysphagia,
5. claudication na jaw da harshe (alamar da ke faruwa a cikin rabin marasa lafiya); dalilin shine ischemia na tsokoki masu yawa; na iya haɗawa da harshe, haifar da gyambo mai raɗaɗi ko tsokar da ke cikin tsarin hadiyewa,
6. ƙananan zazzabi ko zazzabi, wanda zai iya kaiwa digiri 40 a ma'aunin celcius,
7. rauni,
8. nauyi asara
9. rashin ci
10. ciwon ido,
11. ciwon tsoka,
12. bayyanar cututtuka na arteries na zuciya da jijiyoyin jini,
13. bayyanar cututtuka na rheumatic polymyalgia game da tsokoki na kafada da bel na hip.

Binciken giant cell arteritis

Akwai gwaje-gwaje iri uku a cikin gano cututtuka.

1. Nazarin hoto - sun haɗa da: Doppler duban dan tayi, arteriography, CT, MR, PET. Waɗannan karatun suna nuna fasalin kumburin bangon jijiyoyin jini) ko rikitarwa daban-daban, misali aneurysms, ɓarna aortic, ɓoyewar jijiyoyin da ke ciki.

2. Binciken dakin gwaje-gwaje - ESR sau da yawa sama da 100, kasancewar manyan sunadaran lokaci mai ƙarfi, leukocytosis, ƙwayoyin rigakafi na pANCA suna da wuya.

3. Kwayoyin halittar jini na wucin gadi - nuna fibrinous necrosis tare da granulomatous kumburi daga cikin jirgin ruwa bango tare da gaban giant Kwayoyin da zai iya ƙunsar guntu na ciki lalace na roba membrane.

Likitan ya yi ganewar asali bisa ga alamun asibiti da aka ambata a sama tare da sakamakon gwajin da aka ambata a sama. Akwai wasu sharuɗɗa waɗanda ke taimakawa don bambanta giant cell arteritis daga wasu yanayi:

1. shekaru sama da 50,
2. OB darajar sama da 50 mm / h,
3. Ciwon kai,
4. positive artery biopsy,
5. ciwo saboda matsewar jijiya na ɗan lokaci,
6. raunin bugun jini na jijiya na wucin gadi a karkashin matsi.

Giant cell arteritis ya kamata a bambanta da sauran tsarin vasculitis, ciwon kai na asali daban-daban, atherosclerosis, ciwon glaucoma, polyangiitis nodosa, granulomatosis hade da polyangiitis, da cutar Taksayasu.

Giant cell arteritis magani

Jiyya shine gabaɗaya steroids (fararen allurai na prednisone 60-80 MG / rana, bayan gafara 10-20 mg / rana). Bayyanar bayyanar cututtuka na ido a cikin mai haƙuri shine nuni ga gudanarwa na IV methylprednisolone a cikin kashi na 500-1000 MG na kwanaki 3 a jere. A cikin sake dawowa, gabaɗaya ya isa ƙara yawan adadin, sai dai idan bayyanar cututtuka na ido ko jijiya sun haɓaka. Wasu marasa lafiya da ke da katuwar ƙwayoyin arteritis suna fuskantar koma baya, waɗanda ke nuni ga corticotherapy har zuwa shekaru da yawa.

Don rigakafin makanta da bugun jini, ana ba marasa lafiya shawarar shan acetylsalicylic acid.

Shin giant cell arteritis zai iya haifar da rikitarwa?

Bayan 'yan shekaru bayan an gano cutar, aneurysms masu son fashewa na iya bayyana. Bugu da ƙari, ɓarna aortic na iya faruwa. A cikin marasa lafiya waɗanda cutar ta shafi jijiyoyi na ido, akwai yiwuwar makanta, sau da yawa biyu (50% na lokuta).

Hasashen cutar yana da kyau kamar yadda ba kasafai ake yin kisa ba. Jiyya tare da corticosteroids yana haifar da gafarar bayyanar cututtuka kuma yana rage zafi. Bugu da ƙari, yana hana matsalolin ido.

Lit.: [1] Stegman CA, Kallenberg CGM: Abubuwan asibiti na vasculitis na farko. Springer Semin Immunopathol 2001, 23; 231-51. [2] Janette JC, Falk RJ, Andrassy K. i wsp. Shawarar Taron Yarjejeniya Ta Cikin Gida. Arthritis Rheum 1994, 37; 187-92. [3] Małdyk H.: Zapalenia naczyń. Pol Arch Med Wew 1994, 91; 395-401.

Source: A. Kaszuba, Z. Adamski: "Lexicon of dermatology"; Bugu na XNUMXst, Czelej Publishing House