Markaad joojiso inaad qabsatid laakiin MS Your Worsens
Qiyaastii 85% dadka qaba sclerosis multiple (MS) ayaa markii ugu horreysaba lagu ogaadey inay dib u soo noqdaan MS (RRMS). Dadka intooda ugu badani waxay ugu dambeyn soo afjari doonaan MS-ga horumarka ah (SPMS), taas oo lagu gartaa sii wannaagsanaanta calaamadaha iyo naafonimada iyo yaraanta ama dib u soo noqoshada .
Ka hor inta aan la daaweynin daaweynta cudurka, ayaa si ballaadhan loo heley, qiyaastii boqolkiiba 90 dadka qaba RRMS waxay ugu dambayntii sameeyeen SPMS muddo 25 sano ah iyo qiyaastii 10 sano gudahood.
Hadda ma cadeeynin waxa saameynaya daaweyn-isbeddelidda daaweyntu waxay ku yeelanayaan horumarka MS, laakiin waxa la moodaa (oo rajeynaya) in saamigaan uu hooseeyo, SPMS waxay hoos u dhigeysaa horumarinta.
Yaa Loogu Teedho Inuu Ka Bixiyo RRMS-ga SPMS?
Dadku way isbedeli karaan markay RRMS u diri karaan SPMS wakhti kasta, habsocodkana sida caadiga ah ayaa tartiib tartiib ah. Xaqiiq ahaan, waxaa badanaa jira aag cagaaran oo u dhexeeya RRMS iyo SPMS- marka qofku u wareegayo marxaladda hormarinta ee MS laakiin wali wuxuu mararka qaar dib ugu soo noqdaa MS. Guud ahaan, isbedelkan wuxuu dhacaa 5 illaa 20 sano kadib markii uu cudurku soo gaadhay.
Marka laga eego qodobbada saameyn kara ka-gudbinta MS-ga ee dib-u-qaadista MS-da, horumarinta (bukaanada MS ee aan la daaweyn) waxay muujinaysaa in ragga ay u muuqdaan inay horumarinayaan SPMS dhakhso iyo da 'yar da' yar marka loo eego haweenka. Waxaa intaa dheer, kuwa leh calaamadaha maasuqu ee bilowga MS, sida socodka dhibta, waxay horumariyaan SPMS si dhakhso ah.
Calaamadaha in RRMS ay noqdaan ama noqdaan SPMS
Waxaa muhiim ah in la fahmo in aysan jirin tilmaamo cad ama shuruudo qeexaya marka qof ka guuro RRMS-ga SPMS. Hoosta, inkastoo, ay yihiin qaar ka mid ah xuruufaha ama calaamadaha qofka qaba MS iyo dhakhtarkiisa ayaa isticmaali kara goorta la go'aaminayo in isbadalkan uu dhacay ama uu dhacay.
Daawooyinkaagu si fiican uma shaqeeyaan: Inkastoo ay jiraan dadaal iyo adeecnaan , dadka qaarkood ee qaba RRMS ee daawooyinka hadda jira ee isbeddelaya waxay bilaabayaan inay muujiyaan itaal-darro sii kordhaya iyada oo aan loo kordhin tirada lafaha ee baaritaankooda MRI-ga. Tani waxay noqon kartaa calaamad muujinaysa in ay u wareegayaan wajiga horumarka ee MS ama SPMS.
Dhanka kale, daawadaadu ma shaqeyneyso sababo kale. Tusaale ahaan, haddii dhexdhexaadinta daawooyinka difaaca ee mid ka mid ah daawooyinka interferon-ku salaysan, dhakhtarkaaga neerfaha ayaa kuu beddeli kara mid kale.
Haddii kale, dadka qaarkood waxay ka walwalayaan inay galayaan marxaladda hormariska ah ee MS sababtoo ah waxay joojiyaan in dib loo soo celiyo. Laakiin tani waxay noqon kartaa wax aad u fiican, maadaama ay macnaheedu tahay in daaweyntaada isbeddel-ku-beddelidda daaweyntu ay shaqaynayso.
Dib-u-dhaca wuxuu isbeddelayaa: Taariikhda dabiiciga ah ee RRMS waa inay lahaato tirada soo noqoshada dhab ahaantii ay hoos u dhacdey waqti ka dib. Si kastaba ha ahaatee, dib u soo noqoshada waxay noqon kartaa mid aad u daran, waxay keeni kartaa calaamado badan, halkii ay saameyn ku yeelan lahaayeen hal aag oo hawl ah. Intaa waxaa dheer, ka soo kabashada dib-u-dhac waxay u egtahay inaysan dhammaystirnayn, taasoo macnaheedu yahay xitaa ka dib marxaladda ba'an ee soo noqoshada la soo gudbiyo, astaamaha qaarkood iyo / ama naafanimada ayaa weli ah. Waxaa intaa sii dheer, qofka kama jawaabayo sidoo kale (ama dhammaanba) Solu-Medrol inta lagu guda jiro soo noqoshada.
Heerka weyn ee naafanimada: Marka la cabiro Nidaamka Naafanimo ee Ballaarinta (EDSS), dadka qaba RRMS waxay u muuqdaan inay leeyihiin dhibco afar ama in ka yar. Dadka leh SPMS, oo dhinaca kale ah, waxay caadi ahaan leeyihiin dhibco lix ama ka badan oo micnaheedu yahay in nooc ka mid ah gargaar loo baahan yahay si loo socdo. Dadka qaba RRMS oo gaara heerka 4 ilaa 5.5 (oo muujinaya awood la'aanta socodka in ka badan 500 mitir oo aan haysan nasasho) ayaa caadi ahaan horumariya SPMS muddo gaaban.
Waxaa sidoo kale jiri doona waxyaabo aan caadi ahayn oo la helo inta lagu jiro baadhitaanka dareemayaasha. Tani waxay muujinaysaa in maskaxdu aanay dib u dhimi karin dabaysha ka iman karta MS.
Ugu dambeyn, dadka soo koraya SPMS waxay u muuqdaan inay muujinayaan dhibaatooyin badan oo garasho leh. Tani waxay u badan tahay inay ugu wacan tahay heerka ugu badan ee maskaxda ku jirta maskaxda, taas oo aad u sarreeya qummanaanta garashada . Tani waxa ay macnaheedu tahay in maskaxdu aysan dib u dhicin waxyeellada, gaar ahaan marka ay jirto burbur axonal ah (fareemka dhagta), taasoo keenaysa godadka madow.
Qadarka weyn ee waxyeellada lagu arkay MRI:
- Cufnaan ka weyn: Tani waxay ka dhigan tahay in tirada guud ee dhaawacyada, oo noqonaya:
- Goobaha ku wareegsan (guntimaha maskaxda ee ay ka buuxaan dheecaanka cerebrospinal)
- Burburinta
- Isku-kalsoonaanta maskaxda maskaxda iyo xudunta lafdhabarta
- Dhibaatooyin badan oo axonal ah iyo "godad madow:" Meelaha laga arko mugdi (madoow) dhibco mug leh T1 ayaa loo yaqaan "godadka madow." Kuwani waa meelaha laga helay infakshinka soo noqnoqda, taasoo horseedi karta burburka labadaba iyo xaglaha laftooda, meelahaasina si xoog leh ayey u dhigmaan iinta.
- Horumarinta xarumaha CSF-ku-fiiqan maskaxda: Tani waa cabbir ah qaliinka , sababtoo ah waxaa jira unugyo yar oo maskaxda ah, sidaas darteed meelaha maskaxda ku hareereysan iyo gudaha maskaxdu way sii weynaanayaan.
- Hoos-u-dhac ku yimaada dhaawacyada is-beddelka ah ee loo yaqaan 'gadolinium-ka': Dhab ahaan, tirada dhaawacyada cusub ee firfircoon ee gadolinum-ka ah ayaa hoos u dhaca marxaladaha dambe ee RRMS. Tani waa sababta oo ah cudurku wuxuu u badanyahay inuu noqda mid ka sii daraya marka loo barbardhigo infakshan.
Ereyga
Inkasta oo daaweyntaada isbeddelidda cudurka-daaweynta ay kaa caawin kartaa in ay yareeyso kala-guurka ka soo-noqoshada MS-ga ee dib-u-qaadista MS-ga horumarka ah, geeddi-socodkan wali wuu ku dhici karaa qaar. Sidaa ha u dhigin khaladkaaga haddii aad ka soo guurtay marxaladda ku-soo noqoshada MS-ga ee wajiga hore-waa geedi socod dabiici ah, oo u gaar ah qof kasta, oo aanad ka ahayn wax aad samaysay.
Ilaha
Coyle, Patricia K. iyo Halper, Juun. Ku noolaanshaha Nooca Cagaarshow Multiple: Ciribtirka Caqabadaha (Ed 2. 2nd) New York: Daabacaadda Daaweynta Caafimaadka. 2008.
Koch M, Kingwell E, Rieckmann P, Tremlett H, UBC MS Clinic Neurologists. Taariikhda dabiiciga ah ee muruqyada isku xiga ee labaad. Journal of Neurology, Neurosurgery, & Psychiatry, 2010; 81 (9): 1039-43.
Lublin FD et al. Qeexida koorsada daaweynta ee sclerosis badan. Nuurolojiyada. 2014 Jul 15; 83 (3): 278-86.
Society MS Society. MS Advanced Progressive MS.
Tremlett H, Yinshan Zhao, Devonshire V. Taariikhda dabiiciga ah ee muruqyada kala duwan ee isku xiga. Cudurka 'Multiple Sclerosis' , 2008; 14 (3): 314-24.