Cudurka 'ankylosing spondylitis'

Ankylosing spondylitis (AS) waa nooc joogto ah oo arthritis ah. Waxay badanaa ku dhacdaa lafaha iyo kala-goysyada salka lafdhabarta halka ay ku xirmaan miskaha. Kala-goysyadaasi way bararaan oo bararaan. Waqti ka dib, lafaha lafdhabarta ee ay saameysey ayaa isku soo dari kara.

AS waa xubinta ugu weyn ee qoyska noocyo la mid ah arthritis-ka loo yaqaan 'spondyloarthritis'. Xubnaha kale waxaa ka mid ah cudurka loo yaqaan 'psoriatic arthritis', 'arthritis of inflammatory mindhicir disease' iyo 'arthritis reactive'. Qoyska arthritis-ku wuxuu umuuqdaa inuu yahay mid caadi ah wuxuuna saameeyaa ilaa 1 qof 100kii qofba.

Sababta AS lama yaqaan. Hidda-wadayaasha ayaa u muuqda inay door ka ciyaarayaan. Inta badan dadka qaba AS waxay ku wanaagsan yihiin hiddo-wadaha HLA-B27.

Cudurku wuxuu badanaa bilaabmaa inta udhaxeysa 20 ilaa 40, laakiin wuxuu bilaaban karaa kahor da'da 10. Wuxuu ku dhacaa ragga badan dumarka.

AS wuxuu ku bilaabmaa xanuunka dhabarka oo hooseeya oo yimaada oo socda. Xanuunka dhabarka ee hooseeya wuxuu noqdaa mid jira inta badan markay xaaladdu sii socoto.

• Xanuun iyo qallafsanaan ayaa ka sii daran habeenkii, subaxa, ama marka aad dhaqdhaqaaq yar tahay. Raaxo-xumadu waxay kaa toosi kartaa hurdada.
• Xanuunku badanaa wuu ku fiicnaadaa dhaqdhaqaaqa ama jimicsiga.
• Xanuunka dhabarka ayaa laga yaabaa inuu ka bilowdo inta u dhexeysa miskaha iyo lafdhabarta (xirmooyinka sacroiliac). Waqti ka dib, waxay ku lug yeelan kartaa dhammaan ama qayb ka mid ah lafdhabarta.
• Lafdhabarkaaga hoose ayaa laga yaabaa inuu noqdo mid jilicsan. Waqti ka dib, waxaad ku istaagi kartaa booska horay loo riixay.

Qaybaha kale ee jirkaaga ee laga yaabo inay saameeyaan waxaa ka mid ah:

• Kala-goysyada garbaha, jilbaha iyo anqawyada, oo laga yaabo inay bararaan oo xanuun yeeshaan
• Kala-goysyada u dhexeeya feerahaaga iyo lafta naaska, si aadan si buuxda u ballaarin karin laabtaada
• Isha, oo yeelan kara barar iyo casaan

Daalku sidoo kale waa astaamo caan ah.

Calaamadaha aan caadiga ahayn waxaa ka mid ah:

• Qandho yar

AS waxaa ku dhici kara shuruudo kale, sida:

• Cudurka psoriasis
• Cudurka 'Ulcerative colitis' ama 'Crohn disease'
• Cudurka indhaha oo soo noqnoqda (iritis)

Tijaabooyinka waxaa ka mid noqon kara:

• CBC
• ESR (cabir caabuq)
• HLA-B27 antigen (oo ogaada hidda-wadaha ku xiran ankylosing spondylitis)
• Cudurka rheumatoid (kaas oo noqon kara mid xun)
• Raajooyinka laf-dhabarka iyo miskaha
• MRI ee laf-dhabarka iyo miskaha

Bixiyaha daryeelka caafimaadkaaga ayaa kuu qori kara daawooyin sida NSAIDs si loo yareeyo bararka iyo xanuunka.

• Qaar ka mid ah NSAID-yada ayaa laga iibsan karaa dukaanka miisaska (OTC). Kuwaas waxaa ka mid ah asbiriin, ibuprofen (Advil, Motrin), iyo naproxen (Aleve, Naprosyn).
• Waxyaabaha kale ee NSAID-yada ah ayaa loo qoraa bixiyahaaga.
• La hadal daryeel bixiyahaaga ama farmashiistahaaga kahor isticmaalka maalinlaha ah ee muddada dheer ee nooc kasta oo laga iibsado NSAID.

Waxa kale oo laga yaabaa inaad u baahato daawooyin adag si aad u xakameyso xanuunka iyo bararka, sida:

• Daaweynta Corticosteroid (sida prednisone) oo loo isticmaalo muddo gaaban
• Sulfasalazine
• Cilmiga nafleyda ee TNF-inhibitor (sida etanercept, adalimumab, infliximab, certolizumab ama golimumab)
• Cilmiga nafleyda ee IL17A, secukinumab

Qalliinka, sida beddelista sinta, waxaa la sameyn karaa haddii xanuun ama dhaawac wadajir ah uu daran yahay.

Jimicsiyadu waxay gacan ka geysan karaan hagaajinta booska iyo neefsashada. Ku jiifsiga dhabarka habeenkii habeenkii ayaa kaa caawin kara inaad joogtid qaab caadi ah.

Jidka cudurka waa adag tahay in la saadaaliyo. Waqti ka dib, astaamaha iyo astaamaha xanuunka 'AS flareup' (soo noqoshada) iyo aamusnaan (gaf). Dadka badankood waxay awoodaan inay sifiican ushaqeeyaan ilaa ay waxyeello badan kasoo gaaraan miskaha ama lafdhabarta. Ku biirista koox taageero oo kuwa kale ah oo isla dhibaatadaas leh ayaa badanaa caawin kara.

Daaweynta NSAIDS waxay badiyaa yareysaa xanuunka iyo bararka. Daaweynta daaweynta TNF ee bilowga hore ee cudurka waxay umuuqataa inay hoos u dhigeyso horumarka laf-dhabarka.

Marar dhif ah, dadka qaba ankolosing spondylitis waxaa laga yaabaa inay dhibaatooyin ku qabaan:

• Cudurka psoriasis, oo ah cillad maqaarka oo joogto ah
• Caabuq isha ku dhaca (iritis)
• Caabuq ku dhaca xiidmaha (colitis)
• Wadna garaac aan caadi ahayn
• Nabar ama xoqid unugyada sambabka ah
• Nabar ku yeelashada ama dhagid waalka wadnaha wadnaha
• Dhaawaca lafdhabarta ka dib dhicitaan

Wac adeeg bixiyahaaga haddii:

• Waxaad leedahay astaamo xanuunka 'ankylosing spondylitis'
• Waxaad qabtaa ancholosing spondylitis oo waxaad yeelataa calaamado cusub inta lagu jiro daweynta

Spondylitis; Spondyloarthritis; HLA - Spondylitis

• Laf-dhabarka
• Spondylosis afka ilmo-galeenka

Gardocki RJ, Park AL. Ciladaha xumaada ee laf-dhabarka iyo laf-dhabarka. Gudaha: Azar FM, Beaty JH, Canale ST, eds. Xarunta Campbell ee lafaha. 13aad. Philadelphia, PA: Elsevier; 2017: cutubka 39.

Inman RD. Spondyloarthropathies. Gudaha: Goldman L, Schafer AI, eds. Daawada Goldman-Cecil. 26aad. Philadelphia, PA: Elsevier; 2020: cutubka 249.

van der Linden S, Brown M, Gensler LS, Kenna T, Maksymowych WP, Taylor WJ. Cudurka 'Ankylosing spondylitis' iyo noocyada kale ee axka spondyloarthritis. Gudaha: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, eds. Firestein & Kelly's Buugga Cilmiga Rheumatology. 11aad. Philadelphia, PA: Elsevier; 2021: cutubka 80.

Ward MM, Deodhar A, Gensler LS, iyo al. Cusbooneysiinta 2019 ee Kulliyadda Mareykanka ee Rheumatology / Spondylitis Association of America / Spondyloarthritis Research and Network Network Talooyin ku saabsan daaweynta ankylosing spondylitis iyo nonradiographic axial spondyloarthritis. Arthritis Care Res (Hoboken). 2019; 71 (10): 1285-1299. PMID: 31436026 pubmed.ncbi.nlm.nih.gov/31436026/.

Werner BC, Feuchtbaum E, Shen FH, Samartzis D. Ankylosing spondylitis ee laf-dhabarka ilmo-galeenka. Gudaha: Shen FH, Samartzis D, Fessler RG, eds. Buug-gacmeedka laf-dhabarka ilmo-galeenka. Philadelphia, PA: Elsevier Saunders; 2015: cutubka 28.