Waxa kale oo laga yaabaa inay dalbato fayruska sambalilized iyo arthritis-ka
Waxaa la ogyahay in dadka qaba rheumatoid arthritis (RA) ay halis dheeraad ah ugu jiraan cudurrada iyo dhimashada cudurrada wadnaha iyo xididada - khatarta la sheegay in la barbardhigayo dadka qaba nooca 2aad ee sokorowga. Dadka qaba rheumatoid arthritis-ka, waxaa jira khatar dheeraad ah oo ka iman karta infekshanka miyokardiyoolka (wadna xanuunka) iyo dhimasho deg-deg ah. Cudurka 'myocardial infarction' ayaa ah in ka badan laba jeer ka badan dadka qaba rheumatoid arthritis marka la barbar dhigo dadweynaha guud.
Xidhiidhka dhabta ah ee u dhaxeeya cudurka wadnaha iyo rheumatoid arthritis waa mid adag oo u muuqda inuu la xidhiidho dhowr arrimood. Calaamadaha halista ah ee wadnaha (tusaale ahaan, hypertension, cayilka, sigaarcab, sokorowga, kolestaroolka sare), iyo sidoo kale calaamadaha xanuunka 'rheumatoid arthritis-ka', ayaa waxtar u leh.
Khatarta Wadnaha ee ku dhaca Rheumatoid Arthritis: Waxa aan ognahay
Sannado badan, cilmi baarayaashu waxay baranayeen ururka iyo in fiiro gaar ah loo siiyo cilladaha wadnaha khatarta ah ee dadka qaba noocyada xanuunka arthritis . Xitaa waxaa la sheegay in rheumatoid arthritis lafteeda ay tahay arrin khatar ah oo ku xiran cudurada wadnaha. Natiijooyinka ay cilmi-baadhayaashu muujiyeen waxaa ka mid ah:
- Waxaa jira khatar dheeraad ah oo ah cudurrada wadnaha iyo xididada oo horayba u dhacda cudurka rheumatoid arthritis-ka, taas oo xitaa laga yaabo in cudurku horay u dhaco.
- Caabuqa ayaa door weyn ka ciyaara cudurrada wadnaha.
- Dadka qaba rheumatoid arthritis-ka waxay u muuqdaan in ay xawaareynayaan atherosclerosis , taas oo lafteeda loo arko xaalad barar ah. Waxay noqon kartaa in geedi-socodka bararka ee rheumatoid arthritis ay la socdaan cytokine proinflammatory cytokines waxay gacan ka geystaan samaynta huurada.
- Dhiig-baxa oogada ee rheumatoid arthritis-ku wuxuu ku kordhiyaa kororka cillad-darrada , diiqadda oksidheer , iyo dhaqdhaqaaqa iyo socdaalka ee leukocytes (unugyada dhiiga cad) ee ku jira maraakiibta dhiigga. Adhesive of leukocytes ilaa endothelium vaskelium waa sifaha kala duwan ee geedi socodka bararka.
- Xanuun habeysan oo la xidhiidha rheumatoid arthritis-ka oo lagu daro waxyaabo halis ah wadnaha oo ku xiran qaab nololeedka ayaa gacan ka gaysan karta cudurrada wadnaha iyo xididada rheumatoid arthritis.
Maxay Isku xirnaanta Muhiim u tahay?
Qiyaastii badh ka mid ah dhimashada dhammaan dadka qaba rheumatoid arthritis-ku waxay la xiriiraan cudurka wadnaha. Dhimashada wadnaha iyo xididdada wadnaha ayaa kor u kacaya boqolkiiba 50 waxaana sii kordhaya khatarta cudurrada wadnaha iyo xididada wadnaha iyo xididada 48 boqolkiiba kuwa qaba rheumatoid arthritis marka la barbar dhigo dadweynaha guud (Avina-Zubieta).
Dadka qaba cudurka rheumatoid ee arthritis-ka muddo dheer, kuwa leh muuqaal dheeraad ah (sida, waxay saameyneysaa wax ka badan kuwa kaladuwan), iyo sidoo kale kuwa qaba rheumatoid-ka iyo anti-CCP (autoantibodies) waxay leeyihiin khatarta ugu weyn ee dhimashada wadnaha iyo xididdada. Maareynta halista waa muhiim.
Talooyinka EUs ee Hagaajinta Khatarta Wadnaha Wadnaha ee RA
Sannadkii 2009, Midowga Yurub (EUL) ayaa isugu soo ururay koox hawleed si loo soo bandhigo talooyin ku saabsan maaraynta khatarta wadnaha ee dadka qaba rheumatoid arthritis. Talooyinka ayaa la cusbooneysiiyay sannadka 2015/2016.
Waxaa jira saddex mabaadi 'aasaasi ah oo ay bixiso EULAR - iyo 10 talooyin oo la soo bandhigay, mid baa cusub oo lixna waa laga bedelay 2009kii.
Mabaadiida Guud:
1) Dhakhaatiirtu waa inay ka warqabaan khatarta sare ee cudurrada wadnaha iyo xididada dadka qaba rheumatoid arthritis marka la barbar dhigo dadweynaha guud.
2) Dhakhtarka rheumatologu waa in uu hubiyaa in maaraynta khatarta cudurada wadnaha iyo xididdada cudurrada wadnaha ee rheumatoidthritis lagu sameeyo.
3) Isticmaalka NSAIDs (daawooyinka nonsteroid anti-inflammatory) iyo corticosteroids waa inay ku xiran tahay talooyin gaar ah oo ka yimid EULAR iyo ASAS (Qiimaynta Bulshada Caalamka ee Spondyloarthritis).
Talooyinka 10aad waxaa ka mid ah:
1) Dhaqdhaqaaqa cudurrada waa in si fiican loo xakameeyo rheumatoid arthritis, ankylosing spondylitis , iyo cudurka psoriatic arthritis si loo yareeyo khatarta cudurrada wadnaha.
2) Qiimeynta khatarta cudurada wadnaha iyo xididada waxaa lagula talinayaa kuwa qaba rheumatoid arthritis-ka, ankylosing spondylitis, ama xanuunka psoriatic arthritis ugu yaraan hal mar shantii sano oo kasta iyo suurta gal ah ka dib isbedel weyn ee daaweynta.
3) Qiyaasta khatarta cudurada wadnaha ee dadka qaba rheumatoid arthritis, spolitylitis ankylosing, ama xanuunka psoriatic arthritis waa in la sameeyaa iyada oo la raacayo tilmaamaha qaranka, iyo habka saadaalinta halista SCORE CVD haddii aysan jirin tilmaamo.
4) Wadarta kolesteroolka iyo lipoprotein cholesterol waa in loo isticmaalaa qiimeynta khatarta wadnaha ee rheumatoid arthritis, ankylosing spondylitis, iyo cudurka psoriatic arthritis iyo lipids waa in la cabiraa marka firfircoonidu ay tahay mid xasilloon ama midabtakoor. Lipids aan soomanayn waa mid la aqbali karo.
5) Moodooyinka khatarta ah ee wadnaha iyo xididada waa in loogu talagalay dadka qaba rheumatoid arthritis by ku dhufo 1.5.
6) Baarista asxaabta asxaabta asaasiga ah ee loo yaqaan 'ultrasound carotid ultrasound' ayaa loo tixgelin karaa inay tahay qayb ka mid ah qiimeynta khatarta wadnaha iyo xididada rheumatoid arthritis.
7) Talooyinka hab-nololeedku waa inay xoogga saaraan cuntada caafimaadka leh, jimicsiga joogtada ah, iyo joojinta sigaarka.
8) Maaraynta khatarta cudurada wadnaha iyo xididada waa in la sameeyaa iyadoo la raacayo tilmaamaha qaran ee rheumatoid arthritis-ka, ankylosing spondylitis, iyo xanuunka psoriatic arthritis. Anti-hypertensives iyo statins ayaa loo isticmaali karaa maadaama ay ku jiraan dadweynaha guud.
9) NSAID waa in loo qoraa digniin loogu talagalay rheumatoid arthritis iyo psoriatic arthritis, gaar ahaan dadka qaba cudurada wadnaha ama calaamadaha khatarta ah.
10) Daaweynta muddada dheer, qiyaasta corticosteroids waa in loo dhigaa mid hooseeya oo waa in la xakameeyaa haddii waxyeellada ama waxqabadka cudurka ee hooseeya uu dhaco. Sii wadista corticosteroids waa in si joogta ah dib loogu noqdaa.
Natiijooyinka Cilmi-baarista lagu soo bandhigay 2016-ka ACR kulan-sanadeedka
Kulanka sannadlaha ah ee Kuliyadda Maraykanka ee Rheumatology, oo la qabtay November 2016, waxaa jiray ugu yaraan saddex daraasadood oo lagu soo bandhigay khatarta wadnaha ee rheumatoid arthritis. Mid ka mid ah daraasaadka (Aqoonsiga Aqoonsiga: 664363 ACR Newsroom) ayaa ku soo gabagabeeyey in mudo 15 sano ah, dadka qaba rheumatoid arthritis ay labalaabaan halista dhacdooyinka wadnaha iyo xididada sida dadka guud ahaan-heerka u dhigma nooca 2aad ee sonkorowga.
Daraasad kale (Aqoonsi Aqoonsi: 663451 ACR Newsroom) ayaa lagu qiimeeyay in dadka qaba rheumatoid arthritis firfircoon laakiin aan lahayn cudurka wadnaha ee loo yaqaan 'cardiovascular' ayaa leh caddayn ku saabsan caabuqa miyir-baarista. Waxay sidoo kale tixgeliyeen in caabuqa miyir-baarista uu ka jawaab celiyey daaweynta DMARD (cudur-is-beddelidda daawooyinka ladagaallanka roodhiga) . Cilmi-baarayaashu waxay soo gabagabeeyeen in ay u muuqatay in ay noqotey caabuqa miyir-baarista waxayna u muuqatay in ay ka jawaabto daaweynta DMARDs.
Daraasaddan saddexaad (Aqoonsi Aqoonsi: 664367 ACR Newsroom) ayaa xoogga saaray maareynta cudurrada wadnaha iyo xididada dadka qaba cudurada wadajirka ah. Waxaa la soo gabagabeeyay in kastoo helitaanka dawooyinka anti-hypertensive iyo lipid-hoos u dhaco, in yar oo ka mid ah tirada bukaanada ayaa loo qorey daawooyinka.
Khadadka hoose
Mudo dheer, khatarta sii kordheysa ee cudurrada wadnaha iyo xididdada ee rheumatoid arthritis-ka ayaa la iska indha-tiray oo aan hoos loo maamulin. Khatarta ay ku soo rogtay hypertension, cayilka, sigaarka, iyo dyslipidemia, oo ay weheliyaan geedi-socodka bararka ee ka socda rheumatoid arthritis-ka, waa in aan la iska indhatirin. Waxaa jira baahi loo qabo rheumatoloji iyo takhaatiirta daryeelka aasaasiga ah si ay ula shaqeeyaan si loo xakameeyo isirrada wadnaha halista ah iyo waxqabadka cudurka ee la xiriira rheumatoid arthritis.
Inkastoo cilmi-baadhistu ay diiradda saartay muhiimadda ay leedahay maareynta qatarta wadnaha ee la xiriirta rheumatoid arthritis-ka, xitaa baaritaan dheeraad ah ayaa loo baahan yahay. Bartilmaameedyada daaweynta ee si fiican loo qeexay ayaa weli jira. Waxaa weli jirta baahi loo qabo tilmaamo qeexan si loo yareeyo khatarta cudurrada wadnaha iyo xididada dadka qaba rheumatoid arthritis-ka ama cudurrada kale ee isqaadsiinta.
> Ilo:
> Agca R. et al. Talooyinka EUments ee maaraynta khatarta cudurada wadnaha ee bukaanka qaba rheumatoid arthritis iyo noocyada kale ee xanuunada wadajirka ah: 2015/2016 update. Annals of Cudurada Rheumatic . Oktoobar 2016.
> Barber CE et al. Nusqaamaha ee wax ka qabashada Halista wadnaha iyo xididada Rheumatoid Arthritis: Qiimaynta Waxqabadka Isticmaalka Tilmaamaha Tayada Wadnaha. Wargeyska Rheumatology . Nofeembar 2016.
> Solomon DH et al. Sharaxidda khatarta wadnaha iyo xididada ee rheumatoid arthritis-ka: Ciladaha khatarta ah ee caadiga ah ee ka soo horjeeda calaamadaha rheumatoid arthritis. Annals of Cudurada Rheumatic . Nofeembar 2010.
> Tornadre, Anne et al. Maareynta khatarta wadnaha iyo xididada ee qaba bukaanka qaba arthritis-ka: murugo wax ku ool ah. Horumarinta Therapeutic ee Cudurka Musqulaha . 2016.
> van-Breulelen-van der Stoep DF et al. Khatarta wadnaha iyo xididada ee rheumatoid arthritis: sida loo yareeyo halista? Atherosclerosis . November 2013.