Dhibaatooyinka hurdadu waxay ku badan yihiin dadka qaba rheumatoid arthritis . Daalidda waxaa loo aqoonsanayaa inay tahay dhibaato aad u weyn u ah dadka qaba cudurka. Hal mar, waxaa la sheegay in aan la caddeyn haddii apnea uur-jiifka la xiriirta rheumatoid arthritis. Apnea hurdada hurdada waa mid ka mid ah saddexda nooc ee hurdada hurdada.
Maxay tahay fikirka hadda jira? Ma jirtaa halis dheeraad ah oo ku dhici karta hurdada hurdada ee hurdada ah haddii aad qabtid rheumatoid arthritis?
Miyuu hurdada u hibeynayaa sababaha hurdada hurdada iyo daalka oo ah cabashooyinka caamka ah ee dadka qaba rheumatoid arthritis? Aynu tixgelinno waxa cilmi-baarayaashu go'aaminayaan.
Astaamaha Rheumatoid Arthritis
Rheumatoid arthritis waa nooc daba-dheer, oolajiimo ah , nooca arthritis-ka ah . Inkasta oo xanuunka wadajirka ah iyo dhaawaca wadajirka ahi uu yahay dabeecada rheumatoid arthritis, waxaa jiri kara saameyn habeysan iyo muujin dheeraad ah. Qiyaastii 1.5 milyan oo qof oo ku nool Mareykanka ayaa qaba rheumatoid arthritis-ka, sida ay sheegtay Xarunta Xakamaynta iyo Kahortagga Cudurrada (CDC).
Hurdada Hurdada ee Hurdada
Hurdada hurdada ayaa ah tan ugu caansan ee neefsashada ee la xiriira hurdada. Hooska hurdada, neefsashada qofka waa la joojiyaa, ama asal ahaan waxay joojisaa, inta lagu jiro hurdada. Waqooyiga Ameerika, qiyaasta soo kordhay - marka cambaarta hurdada ah ee loo yaqaan 'apnea hypopnea index' (AHI) oo ka badan 5 dhacdo saacaddiiba sida ay go'aamisay polysonogram - 20 ilaa 30 boqolkiiba ragga iyo 10 ilaa 15 boqolkiiba dumarka.
Inkastoo loo yaqaan 'apnea' loola jeedo joojinta ku-meel-gaadhka ah ee neefsashada, hypopnea waxaa loola jeedaa neefsashada oo gaabis ah ama neefsashada. Dhacdooyinka hurdada ee hurdada ayaa keena in ay yaraadaan oksijiinka.
Waxyaabaha halista ah ee la xiriira hurdada hurdada waxaa ka mid ah:
- Horumarinta da'da
- Lab ama dheddig lab ah
- Cayilka
- Dhibaatooyinka unugyada jilicsan ee hawo-mareenka ama jimicsiga
Waxyaabaha kale ee khatarta ah ee la aqoonsaday waxaa ka mid ah sigaar-cabista, cirridka sanka, cillad-maskaxeed, iyo taariikhda qoyska ee hurdada hurdada. Xaalado caafimaad oo gaar ah ayaa lala xiriiriyay heer sare oo ah hurdada hurdada, oo ay ku jiraan uurka, heerka tallaalka dambe ee kalyaha, wadnaha wadnaha oo aan shaqayn, cudurada sanbabada ee joogtada ah iyo stroke. Cilmi-baadhayaashu waxay kaloo heleen isku-xir u dhexeeya rheumatoid arthritis-ka iyo khatarta korodhka uur-jiifka hurdada.
Hurdada Xanuunka Apnea iyo Rheumatoid Arthritis ayaa ku xiran
Sida laga soo xigtay natiijooyinka daraasaddan lagu daabacay BMJ Open (2016), tirada guud ee hurdada ee hurdada ee hurdada ayaa 75 boqolkiiba ka sareeya tirada dadka qaba rheumatoid arthritis marka loo eego kuwa aan lahayn rheumatoid arthritis. Natiijooyinka ayaa laga soo qaatay daraasadii ugu horreeysay ee dib u soo celinta ee isticmaala macluumaadka dadweynaha ee ku saleysan dadweynaha. Daraasadaha hore ee hurdada hurdada iyo xiriirka suurtogalka ah ee lala yeesho rheumatoid arthritis waxay ku saleysneyn warbixinno kiis ama daraasad kiis oo yar oo cabbirka tusaalaha ah.
Daraasada cilmibaarista ee BMJ Open ayaa waxay qeexaysaa in khatarta hurdo la'aanta hurdada ay ka weyn tahay ragga, marka dadka da'da ah la barbardhigo dadka da'da yari, iyo kuwa qaba comorbidity. Halista hurdada hurdada ayaa la ogyahay inay la xiriirto hypertension, hyperlipidemia, cudurka wadnaha ee ischemic, iyo cayilka.
Marka la eego rheumatoid arthritis-ka, xaalado gaar ah ayaa u muuqda in ay gacan ka geysan karaan khatarta sare ee hurdada hurdada, oo ay ku jiraan micrognathia, unugyada taranka ee isgoysyada, ku lug lahaanshaha iskudhufka isku-dhafan, ka-qaybgalka isugeynta cricoarytenoid, iyo cayilka.
- Micrognathia waa xaalad halka daanka hoose uu ka yar yahay kan caadiga ah. Tani waxay badanaa u tahay dabeecadda 'idiopathic' ee arthritis-ka . Waxa kale oo ay u dhici kartaa micrognathia-ga weyn ee la xariira xanuunka rheumatoid-ka, xaaladaha qaarkood sababtoo ah burburinta iskudhufka isku-dhafan, taasoo horseedi karta xannibaadda hawo-mareenka sare iyo hurdada hurdada ee hordhac ah.
- Dhibaatooyinka ku dhaca afka ilmo galeenka wuxuu ku dhici karaa rheumatoid arthritis-ka, gaar ahaan, xasilooni la'aanta is-goysyada dhuunta ilmo-galeenka, nadiifinta mandheerta-ilmo-galeenka, iyo sidoo kale waxyaabo aan caadi ahayn, sida jiritaanka osteophytes . Maqnaanshaha ilmo-galeenka ayaa sababi kara dhuumaha sare ee hawo-mareenka, isku-buuqa maskaxda, wuxuuna saameyn karaa darnaanta hurdada hurdada. Fiyuuska ku dhaca dhuunta ilmagaleenka (qalliinka) ayaa laga yaabaa inuu caawiyo si loo saxo cilladda gaarka ah iyo hagaajinta hurdada hurdada.
- Ka-qaybgalka isku-duwidda isku-darka ah-Burburinta iskudhufka isweydaarsiga ee ku lug leh rheumatoid arthritis waxay yareyn kartaa cabbirka hawo-mareenka sare wuxuuna gacan ka geystaa hurdada hurdada ee kuwa saameynaya.
- Ka-qaybgalka isku-jirka ee Cricoarytenoid -Kooxyada cricoarytenoid waxay ku yaalaan inta u dhaxeysa cirridka iyo xayawaanka aryteniiga ah ee ku yaala derbiga dambe ee caarada. Isku-xirka cricoarytenoid furan, xiro, oo adkee xadhkaha dhawaaqa inta lagu hadlayo iyo neefsashada. Xanuunnada aan caadiga ahayn waxay ku dari karaan inay hurdo kudhibaan dadka qaba rheumatoid arthritis.
Cunsurrooyinka hidde-galka, ku-soo-saarka xaaladaha degaanka qaarkood, dabeecadaha kale, doorashooyinka qaab-nololeedka ama dabeecadaha, sida cuntooyinka aan fiicnayn (sida sonkorta ama dufanka), cabbitaan culus ama sigaar-cabid, iyo jimicsi aan ku filneyn ayaa sidoo kale laga yaabaa inay wax ku biiriyaan .
Waxaa sidoo kale la soo jeediyay in xiriirka loo yaqaan ' cardiovascular disease' iyo 'rheumatoid arthritis' ay qayb ahaan u noqon karaan hurdada hurdada. Hurdada hurdada ee hurdada ayaa lagu xidhay barar , xajin , iyo cillad wareer . Maaddaama arrimo wax ku ool ah loo aqoonsaday, sababaha iyo saameyntu waxay noqdaan kuwo muuqda oo baahida loo qabo maamulida walxaha kasta waa cad.
Waxyaabaha loo baahan yahay waa in laga fekeraa marka laga eego sida cudurrada roodhumku ula xiriiraan hurdada hurdada. Tusaale ahaan, waxaa la go'aamiyey in dadka qaba hurdada hurdada ee hurdada ahi ay sare u kaceen falcelinta degdega ah ( CRP , sicir-dhimista ) iyo cyokokine pro- clamokines . Waxaa la soo sheegay in qaar ka mid ah interleukins, gaar ahaan IL-1, IL-2, IL-6, IL-8, IL-18, iyo TNF-alpha ay dhiirigeliyaan non-REM (dhaqdhaqaaqa dhaqsaha oo degdeg ah). IL-4, IL-10, IL-13, iyo TNF-beta ayaa joojiya hurdo la'aanta REM-ka.
Heerarka cytokine inflammatory waxay u dhigantaa heerka darnaanta hurdada hurdada. Heerarka sare ee TNF-alpha ayaa lala xiriiriyay hurdo xumo hordhac ah iyo hypoxia. Tani waxay sharxi kartaa sababta ay dadka qaba rheumatoid arthritis-ka loola dhaqmo xannibaadayaasha TNF waxay ogaadaan in heerka daalku uu hagaagayo. Daraasad dheeraad ah ayaa loo baahan yahay si loo soo gabagabeeyo saameynta daaweynta roodhida ee roodhida gaarka ah.
Sidee Loo Daboolaa?
Urur-ku-xigeenka rheumatoid-ka iyo hurdada hurdada ayaa si weyn uga qayb qaadan karta cudurrada iyo dhimashada dadka ee labada xaaladoodba. In ururku ka qaybqaato khatarta sii kordheysa ee cudurrada wadnaha ee rheumatoid arthritis-ka ayaa laga yaabaa inay tahay mid ugu muhiimsan.
Cilmi-baareyaasha roodhiyeyaashu waa inay raadiyaan calaamadaha hurdada hurdada ee bukaankooda marka ay waraysanayaan iyo qiimeynayaan, iyo, haddii la tilmaamay, tixraac takhtar takhasus ah ama xarun hurdada. Hurdada hurdada waxaa caadi ahaan lagu maamulaa isticmaalka qalabka CPAP . U hoggaansanaanta qalabyada CPAP waa mushkilad dadka qaarkood. Waxaa laga yaabaa in sida ugu fiican loo sharaxo sida qallafsan. Hababka kale ee suurtogalka ah ee maaraynta huritaanka hurdada ayaa ku lug leh jumlad gaar ah inta lagu jiro hurdada si loo ilaaliyo marin-haweedka, miisaan lumis, iyo isticmaalka qalabka si loo soo riixo horukaca suura-galnimada, taas oo yaraynaysa marin-haweedka. Dhibaatooyinka qaarkood waa in aan la iska indhatirin.
Khadadka hoose
Marka qof qaba rheumatoid arthritis uu ka cabanayo dhakhtarkooda ku saabsan daal, waa inaan hore loo tirtirin sidii dabeecad caadi ah oo la xidhiidha cudurka. Looma maleynayo in daalka uu si fudud u la xidhiidho hurdada hurdada iyo hurdada hurdada ee la xidhiidha xanuunka. Inkastoo taasi run ahaantii ay dhici karto in kiisaska intooda badan, shaqada adag ee go'aaminta waa in la fuliyaa. Hurdada hurdada waa in la dhigaa gudaha ama dibedda. Saameynaha suurtagalka ah ee hurdada hurdada aan la daaweynin waa mid aad u wanaagsan.
> Ilo:
> Ataka, H. et al. Fusion-ku-qabashada Fiktooriya ayaa suurtogal u ah in la hagaajiyo hurdo la'aanta bukaan-jiifka qaba bukaan-socodka qaba Rheumatoid Arthritis iyo Nabarada faafa ee sareeya. Spine. 2010 Sept 1; 35 (18): E971-5.
> Shen, Te-Shun iyo al. Khatarta Cudurka Hurdada ee Hurdada ee Bukaannada qaba Rheumatoid Asthirad: Cilmi-baaris Cafis ah oo ku saleysan dadweynaha oo ku salaysan dadweynaha. BMJ Open. 2016; 6 (11): e013151.
> Shoda, Naoki et al. Hurdada Hurdada ee Rheumatoid Xanuunka Arthritis Bukaanno leh Nuucyada Cudurdaarka ah: Noocyada Hoos u Dhaca iyo Raadiyeynta Raadiyaha. Saxaafada Yurubta. Juun 2009; 18 (6): 905-910.
> Strohl, Kingman P MD. Guudmarka Cudurka Hurdada Hurdada ee Dadka waaweyn. UpToDate. La daabacay Juun 24, 2016.
> Taylor-Gjevre, Regina M., Nair, Bindu V., iyo Gjevre, John A. Joogitaanka Hurdada Hurdada ee la Xiriira Cudurka Rheumatiska. Rheumatology (2013) 52 (1): 15-21.