Daawooyinka ay ka mid yihiin Ka-hortagga Ka-hortagga, Daawooyinka, iyo Qalliinka
Myasthenia gravis wuxuu sababaa daciifnimada murqaha sababtoo ah nidaamka difaaca jirka ee weerarta daaweynta neurotransmitter ee maskaxda. Maadaama muruqyada aaney helin calaamadda qandaraaska, dadka qaba myasthenia ayaa daciif ah. Inkasta oo khalkhalka noocan ah ee loo yaqaan 'neuromuscular disorder' ayaa loo adeegsadaa marwalba iyo xitaa dhimasho, hadda waxaa badanaa lagu maamuli karaa daweyno kala duwan.
Waxaa jira shan siyaabood oo guud oo lagu daaweyn karo gravis myasthenia. Qaar ka mid ah hababka ugu fiican ayaa loo isticmaalaa dhibaatooyinka ba'an si loo ilaaliyo qof ka baxsan qaybta daryeelka degdegga ah, inkastoo tani mararka qaarkood lagama maarmaan u tahay xaaladaha ba'an. Kuwa kale waxaa loogu talagalay inay ka sii fogaadaan dhibaatooyinkaas oo ka dhacaya meesha ugu horeysa - istaraatiijiyad ka hortag ah.
Iska ilaali dildilayaasha si looga hortago weerarrada Myasthenic
Sababtoo ah waa cudur wadajir ah, wax kasta oo kor u qaadaya nidaamka difaaca waxay kordhin kartaa khatarta ah dhibaatada maskaxda, iyada oo ay sii xumaanayso taas oo qof u diri karta qaybta daryeelka degdegga ah. Ogaanshaha iyo iska ilaalinta wax kasta oo kiciya ayaa ah qodob muhiim ah oo lagu maareeyo cudurka. Tusaale ahaan, daawooyinka sida caadiga ah loo isticmaalo sida ciprofloxacin ama antibiyootigyada kale, iyo beta-blockers sida propranolol, lithium, magnesium, verapamil iyo wax kale, waxay ka sii dari karaan calaamadaha miyasteniia gravis. Guud ahaan, dadka qaba myasthenia waa in ay aad u taxaddaraan ka hor intaanad bilaabin daawo cusub oo si taxadar leh u fiirso calaamadaha daciifnimada.
Daweynta Astaamaha Myasthiaia Gravis
Jilicsanaanta miisaaniyada myasthiaia wuxuu dhacaa marka daaweeye acetylcholine lagu soo weeraro nidaamka difaaca jidhka. Kordhinta qaddarka acetylcholine ee laga heli karo qaybta neuromuscular-ka ayaa ka caawin kara in laga gudbo khaladkaan. Jirku wuxuu caadi ahaan ka nadiifiyaa acetylcholine laga bilaabo imtixaanka iyadoo la isticmaalayo enzymes loo yaqaan 'acetylcholinesterases'.
Daawooyinka loo yaqaan 'cholinesterase inhibitors' (taas oo xannibaysa ficilada buzannadahan) waxay keeni kartaa in acetylcholin laga tago synapse muddo dheer, taas oo u oggolaaneysa in ay ku xirto kuwa duuban ee muruqyada jilicsan ee qandaraaska.
Cudurka Acetylcholinesterase waxaa ka mid ah pyridostigmine (Mestinon), taas oo ah daawada ugu weyn ee loo isticmaalo myasthenia gravis. Dhibaatooyinka kale waxaa ka mid ah shuban, shuban, iyo lallabo. Qaadashada daawada cuntada waxay kaa caawin kartaa dhimista waxyeelooyinkaas. Dareemidda, mararka qaarkood daawada anticholinesterase xad-dhaaf ah waxay leedahay saameyn is barbardhaaf ah oo daciifnimo, taas oo ku adkaan karta in ay kala soocdo myasthiaia laftiisa. Tani waa mid aad dhif u ah haddii pyridostigmine loo isticmaalo qiyaasaha lagu taliyey, inkastoo.
Immunotherapy Chronic for Myasthenia Gravis
Dadka intooda ugu badan ee qaba myasthenia gravis waxay ku dhammaadaan daawo si ay uga hortagaan astaamaha soo socda. Immunotherapy ayaa bartilmaameed u ah difaaca jirka ee astaamaha ah ee weeraraya acetylcholine reseptors. Marka la beddelo nidaamka difaaca, xaddiga iyo darnaanta weerarrada ayaa la dhimayaa.
Glucocorticoids sida prednisone waxaa badanaa loo isticmaalaa in lagu xakameeyo nidaamka difaaca ee dadka qaba myasthenia. Fursadaha kale waxaa ka mid ah salka loo yaqaan "cyclosporine", "azathioprine", iyo mycophenolate.
Dhammaan daawooyinkan ayaa leh saameyno waxyeello u leh, qaar ka mid ah kuwan oo aad u daran. Khatarta daawada waa in si taxadar leh looga miisaamey faa'iidooyinka yaraanta weerarrada myastheniia oo ka sii yar iyo kuwa yaryar.
Daaweynta Immunomodulating Rapid Immunomodulating for Myasthenia Gravis
Halka wakiilada immunotherapy joogtada ah loogu talagalay in ay shaqeeyaan muddo dheer, xaaladaha qaarkood waxay u baahan yihiin tallaabo degdeg ah. Tusaale ahaan waxay noqon kartaa dhibaato maskaxiyan ah, ama ka hor qaliinka ama dhacdooyinka kale ee lagama maarmaanka ah ee la filayo in laga yaabo in ay sii xumayso dhibaatadaas oo kale. Immunotherapy degdeg ah ayaa shaqeeya maalmo gudahood, laakiin faa'idooyinkooda oo kaliya waxay socdaan toddobaadyo, waxaana badanaa lagula taliyaa muddo dheer.
Is-beddelka plazma (plasmapheresis) ayaa ka saareysa unugyada difaaca jirka. Nidaamku waa qaali, waxaana caadi ahaan dhacaa shan jeer 7 ilaa 14 maalmood. Dhibaatooyinka waxaa ka mid noqon kara arrin xasaasiyadeed, unugyada dhiigga ee unugyada, murqaha muruqyada, iyo waxyaabo kale oo badan.
Immunoglobulin (IVIG) ayaa inta badan lagu muujiyey inuu ku caawiyo cudurada uu sababo fal-celin-la'aaneed, laakiin habka saxda ahi ma cadda. Daaweynta badanaa waxay ka kooban tahay laba illaa shan maalmood oo duritaan ah. Dhibaatooyinka kale badanaaba waa mid fudud laakiin waxay ku jiri karaan kelyo la'aan, qoorgooye , iyo fal-celin xasaasiyadeed.
Daaweynta Qalliinka ee Myasthenia Gravis
Inta badan dadka qaba myasthenia gravis waxay leeyihiin astaamo aan caadi ahayn oo ku jira thymus, oo ah habka difaaca jirka ee saldhigga qoorta. Mararka qaarkood calaamadaha maan-dooriyeyaasha ee dadku waxay hagaajiyaan ama xitaa xalliyaan ka dib markii sabbabta la soo saaro inta lagu gudajiro habka loo yaqaan thymectomy. Si kastaba ha ahaatee, ma jirto damaanadqaad ah natiijada noocaas ah, si kastaba ha ahaatee. Boqolkiiba sagaashan ee dadka qaba myasthenia waxay leeyihiin qanjidhada thymus (thymoma), dhakhtarradu waxay isku raaceen in qalliin lagu tilmaamay kiisaskan. Hadduu thymectomy lagu sheego kiisaska kale waa mid aan cadayn, waana in laga wada hadlo dhakhtarka neerfaha oo kiiskiisa ku salaysan.
Khadka hoose
Myasthenia gravis waa cudur halis ah, laakiin waxaa jira fursado badan oo daaweyn ah oo la heli karo si loo yareeyo daciifnimada marka uu dhaco iyo in la yareeyo jirrooyinka iyo darnaanta weerarrada. Sababtoo ah waxyeellooyinka daaweyneed oo dhan ee daawooyinka, daaweyntu waa in lala hadlo dhakhtarka neerfaha isagoo aqoon fiican u leh miisaaniyadda myasthenia iyo dhibaatooyinka iman kara.
Ilaha:
Adams iyo Victor Principles of Neurology, 9th ed: McGraw-Hill Companies, Inc., 2009.
Braunwald E, Fauci ES, iyo al. Mabaadii'da Harrison ee Daawooyinka Gudaha. 16th ed. 2005.
Sieb, JP (2014) Myasthenia gravis: cusbooneysiin cusbitaal. Immunology-ga Daaweynta iyo Imtixaanka 175 (3): 408-18.
Diidmada: Macluumaadka ku yaala boggan waa ujeedo waxbarasho kaliya. Waa inaan loo isticmaalin beddelka daryeelka shakhsi ahaaneed ee dhakhtar shati leh. Fadlan u tag dhakhtarkaaga si loo ogaado iyo daaweynta wixii astaamo ah ama xaaladda caafimaad .