Takayasu nehosha: Zviratidzo neMarapirwo

Mumakore achangopfuura, vanhu zvachose yakadzokororwa mafungiro ayo vakananga akasiyana siyana zvirwere. Vanhu vakawanda nhasi vanosarudza kuva nemararamiro ane utano, edza kudya zvakanaka, kutamira kure netsika dzakaipa. matanho akadai kushanda kudzivirira zvirwere zvakawanda. Zvinosuruvarisa, kunyange nzira yakarurama muupenyu haisi 100% zvinovimbisa kuti munhu asingadi kubata ichi kana kuti chirwere.

Vhuṱanzi

chirwere Takayasu kuti - iri chaizvo kwakakomba kuzvimba echirwere hunhu, iro rinopembererwa huru nenhumbi ropa. chikuru basa ravo uchatamisa ropa kubva mumwoyo. Chokwadi, atadze kushanda zvakanaka mumuviri kunokanganisa muviri wose. Zvikasadaro, chirwere ichi anonzi pulseless chirwere, Takayasu kuti urwere kana nonspecific aortoarteritis.

Mberi kuzvimba yeropa uye awo zvishoma nezvishoma kukuvaradzwa yomukati penyika nhumbi pachavo. Somugumisiro, pane thickening zvomusoro nevamwe. Kune Kuparara pakati mvere tsandanyama rukoko. The lumen pakati yeropa sequentially ngapaonekwe granuloma, iine kazhinji masero hofori. pezvakaitwa zvose izvi zvinokonzera protrusion nokuwedzera mudziyo ropa pacharo, pokubatana aneurysm. Kana mamwe kuchiita chirwere kufa anonzi kwakavharwa nenyama fibers. Somugumisiro, zvishoma nezvishoma zvakashatirisa chokubuda ropa kuti rinobatanidza ischemia zvomukati uye munyama. Zvino pamusoro dzaparadzwa masvingo vakaumba microthrombuses uye atherosclerotic plaques.

chirwere Takayasu chiri kunyanya chirwere mune vasikana nevakadzi vane makore kubvira 15 kusvika 25 makore. In mushonga, aizivikanwawo zviitiko chirwere pavarwere makono.

Zviratidzo zvokutanga kazhinji kuoneka pakati makore 8-12. Zvakakosha kuziva kuti hosha yapararira kunyanya South America uye Southeast Asia, asi zviitiko Takayasu chirwere nhasi dziri kunyorwa zvikuru kure kumatunhu.

A Nhoroondo shoma

Muna 1908, imwe ophthalmologist kubva Kunyika Sunrise Sun M. Takayasu akatsanangura Kumwe kuchinja kunotanga iri the retina dzakaonekwa unotevera kuongorora musikana. Zvegore, dzimwe nyanzvi kubva Japan akaona zvakafanana deformation pamusoro fundus kubva varwere vavo, kuti pamwe kushaya vainzi pulsation pamusoro TOUR tsinga. Zvinokosha kuziva kuti shoko rokuti "chirwere Takayasu kuti," akatanga kuti vachishingaira inoshandiswa mukurapa chete muna 1952.

The zvikonzero

The etiologic mutumwa chirwere pari kuzivikanwa. Nyanzvi akabatanidza chirwere nomwoyo anozivikanwa streptococcal chirwere, nokushingaira akakurukura basa mycobacterium tibhii.

Nhasi, masayendisiti anodavira kuti kumusoro pokutanga pakugadzirwa autoimmune zvirwere ane kusaenzana kunzi sero-yairevererwa kutapata. Zvinokosha kuona kuti mune ropa varwere, kazhinji akacherekedza nokuwedzera CD4 + T-lymphocytes, uye kuderera kwemitambo CD8 + T-lymphocytes. Uyewo, vanamazvikokota rokuongorora Kuwedzera kwenhamba achiparadzira masoja zvivako, vakawedzera basa elastase uye cathepsin G. chaiwo

Sezvo Classified nonspecific aortoarteriit?

Takayasu chirwere, inobva anatomi ari lesion, conditionally rakakamurwa marudzi anoverengeka.

1. The mhando wokutanga. Akarova kutsemuka Arch uye zvose mapazi kuvakoka kubva.
2. The mhando wechipiri. Kunetsekana abdominal uye thoracal yeropa.
3. The mhando wechitatu. Akarova kutsemuka Arch pamwe thoracal uye abdominal.
4. The mhando wechina. The chirwere kunosanganisira pulmonary tsinga.

zviratidzo

Chokutanga, varwere kutanga vachinyunyuta pamusoro nechitarisiko marwadzo ari maoko, utera, kusagadzikana mune chipfuva uye mutsipa. Somugumisiro, pane symptomatology hunhu chetsinga zvirwere. Somuenzaniso, akapararira nezvechii, ungaderedza kuita, ndangariro matambudziko.

Kana maperembudzi chokuita optic etsinga, varwere ndaona zvinoshamisa kuderera muchiratidzo kana kunyange upofu (kazhinji ziso chete mumwe).

Nokuda kuchinja mune pathological hunhu arterial midziyo dzichiri anonzi kutsemuka insufficiency. dambudziko iri zvinotungamirira myocardial infarction uye zvinetso zviri coronary riparadzirwe.

With zviduku kuchinja zvakananga kupinda abdominal yeropa ropa riyerere kuipa yekudyidzana makumbo kana achifamba, varwere vanowana kusagadzikana uye kurwadziwa.

Kana renal tsinga maronda ari weti panguva inotevera pakudzidza akawana erythrocytes. Mune remangwana, zviri kumusoro chaizvo ndingangokuvara dzichiri thrombosis pamusoro renal tsinga.

Kana kubatanidzwa kushoma pakati pulmonary tsinga, murwere ane kupfupika mweya, kurwadziwa muchipfuva.

In mushonga nhasi ndivo zvinhanho maviri chirwere: chakasimba uye refu. Zvakakosha kuziva kuti chete chiremba anokwanisa zvakarurama kuona magetsi shanduro chirwere. The zvekuchipatara zviratidzo rikwanise chimiro kungava atypical, saka muna nenguva uye akarurama chirwere kungava kwakaoma zvikuru. The ndechokuti chete kuonekwa zvinobvira kwete chete pamwe chirwere ichi sezvo Takayasu chirwere.

Zviratidzo zviri rikwanise kumwedzi:

• uremu;
• iratidzike seiri kubuda;
• zvishomanana kuwedzera tembiricha muviri;
• nekuneta;
• rheumatic kurwadziwa majoini.

Kazhinji chisingaperi danho hwapedyo mukati 6 makore kubvira pakatanga chirwere. It kunoratidzwa akasiyana zvekuchipatara zviratidzo.

chirwere Takayasu raMwari kunooneka pacharo muchimiro kakawanda nomusoro, havachanyatsogoni kufambisa, kusagadzikana mukufamba mapfundo makuru, chirwere tsandanyama simba.

Diagnostics

Zadzisai pamberi chirwere anogona chete vanokwanisa kana murwere ane dzinenge nhatu dzinotevera zviratidzo:

• kunyangarika kurova kwemwoyo muruoko;
• zera pamusoro makore 40;
• pakati BP pamusoro okumusoro nemakumbo musiyano haasi asingasviki 10 mm HG. Article.
• ruzha mukati yeropa;
• kuwedzera Kuramba BP;
• kuramba kuwedzera ESR.

Zvose pamusoro zviratidzo kazhinji anoratidza chirwere Takayasu vake. Zviratidzo zvinogona anosiyana zvishoma uye dzinosiyana nomumwe nyaya imwe neimwe.

Zvakakosha kuziva kuti chiremba anofanira hazvo ngaagadze wokuwedzera kuzviongorora muviri murwere. Rinoreva nokukanganisika / CBC, izvo anobvumira kuona zvishoma yakatsauka kubva ndozvakajairwa, hwokufananidzira chirwere ichi. Zvichaitawo dzinodawo angiography pamwe musiyano jekiseni. Ichi rinokosha X-ray kuongorora nhumbi, vachibvumira kuona nzvimbo aienda pamusoro arteries. Echocardiography chinopa mukana kuongorora mwoyo ushande. Zvinokoshawo ndezvokuti, Ultrasound midziyo. Kuburikidza Ultrasound chiremba awana mufananidzo rakazara ezvinhu coronary midziyo uye ropa riyerere velocity. Zvose pamusoro chirwere nzira tsvakurudzo kubvumira kuti zvichipupurira kuvapo matambudziko akadai aortoarteriit Takayasu.

Chii mushonga inofanira kuva?

Kana isu kufungawo ndechokuti chirwere mberi kunyanya panguva yokuyaruka, kurapwa kunogona kuva kwakaoma. Zvechokwadi zvinoda anokwanisa RUBATSIRO RUNOTARISA nzira uye kuomerera vamwe mitemo muzvidzivirire. In kwakandiomera Muzviitiko kungada nokukurumidza kuvhiya kupindira.

Takayasu kurapwa zvinoreva kushanda medicaments. Nokuti Kudzikamiswa pamusoro arterial kumanikidzwa, kazhinji basa B-blockers uye kunonzi karusiyamu mugero blockers. Kubvisa mukana ropa clots Varwere dzinorumbidza kutora anticoagulants (rinoreva "heparin" uye vamwe). The kurapa chirwere ichi kunosanganisirawo kushandiswa corticosteroids uye vasodilator zvinodhaka (zvinodhaka "prednisolone" uye m. P.). Zvakakosha kuziva kuti pakupedzisira substantially kuderedza autoimmune norudaviro nomuviri.

Sei munhu anogona here kukurira chirwere Takayasu raMwari? Pakurapa chirwere zvino achishandisa kunzi extracorporeal ropa kururamiswa. Uyu yakaoma chaizvo nzira. Rinoreva rinokosha pakusarudza pathological zvinoumba ropa zvakananga uye kutsamwisa chirwere. Processing kuti zvinhu izvi zvinoitika kunze muviri murwere.

kuvhiya kurapwa

Maererano nezvokurara, kuchinja kurapa hakusi nguva zvinogoneka kukunda Takayasu kuti arteritis. Zviratidzo Rinotarisira kumisa chete kwekanguva. Chokwadi, zvakadaro havana kukwana, anogona kuuya zvekare. Ndokusaka, mune zvimwe zviitiko, vanachiremba zvakasimba kuvakurudzira kuvhiyiwa, izvo zvakazara anodzoreredza patency ari vascular mubhedha.

Huru zvairatidza kuti kuvhiyiwa:

• BP iri pakanyorwa renovascular urwere;
• mhingaidzo of yeropa;
• mukana cardiac ischemia.

Kana isu kutaura pamusoro kunopfuurira maoparesheni, vari kazhinji hunomiririrwa resection pamusoro pathological chidimbu yacho yeropa, vascular yokunzvenga uye endarterectomy. Kana anokwanisa kusvika, murwere inenge nguva kukanganwa pamusoro zvinhu Takayasu kuti arteritis.

dziviriro

Chero zvokurwara, sezvo tichiziva, inogona kudziviswa, uye chirwere ndozvakaitikawo. Matanho airevei nokukurumidza kurapwa ane zvirwere uye nemavhairasi hunhu (pharyngitis, tonsillitis, pyelonephritis uye t. D.). Maererano nenyanzvi, zvirwere izvi chirwere kuri kuva yakanaka hwaro kukura Takayasu kuti chirwere, saka varwere vari pangozi.

Zvinokosha kusimbisa zvirwere rose gore. Nokuti chinangwa ichi, nyanzvi dzinorumbidza kumbotura multivitamin zvivako, mudye zvakanaka, kurovedza muviri.

mataridzikiro

Zvakakwana uye nenguva kurapwa yekudyidzana kunoderedza ngozi rufu. Uyezve, 90% wevarwere nomazvo kurapa kunowedzera upenyu nokuda anenge 15 apfuura.

Kana matambudziko, kazhinji huru kukonzera rufu vari tsaona cerebrovascular (50%) uye myocardial infarction (25%).

mhedziso

Varwere vave chirwere Takayasu kwakaita arteritis, vanofanira kunzwisisa kuti dambudziko iri zvinoda kurapwa kwenguva refu aine pakuomerera kuchengeta zvose chiremba audzwa. Zvikasadaro, kakawanda mukana zvemwoyo chirwere inowedzera.

Kuti kuva inobudirira zvikuru kurapa, varwere vose pasina chaakasiya, vanofanira kugara kumbotambudzika wezvokurapa kuongororwa uye kutora dzakaoma Analyses.

Zvinosuruvarisa kuti kubvisa hosha hazvibviri. Zvisinei, kushandisa zvinodhaka inobvumira kuti uchatamisa chirwere kupinda rokuregererwa iro anobvumira varwere kunakidzwa hwandaiva upenyu, pasina kusangana kusagadzikana uye kwete kufunga kwakadaro dambudziko sezvo Takayasu chirwere. Photo Varwere zvinoratidza zvakajeka mashoko aya.

zvikuru kurapa kubudirira kunoenderana basa pathological kwacho uye kuvapo yematambudziko. Mukuwedzera, kwokutanga vachange nemazvo chirwere, asi fungidziro iri yenhema. Kana uchitenda nyanzvi, pakurwisa zvirwere izvi zvinogoneka uye zvakakodzera.