Wadashaqayn Wadajir ah ACR iyo EULAR
Tilmaamaha maamulka ee polymyalgia rheumatica (PMR) ayaa la sii daayay bishii Sebtembar 2015, iyada oo qayb ka ah dadaal iskaashi oo u dhaxeeya Kulliyadda Maraykanka ee Rheumatology (ACR) iyo Ururka Midowga Yurub ee ka hortagga Jirrada (EULAR). Tilmaamaha ayaa ah kuwa ugu horreeya talooyinka caalamiga ah ee daaweynta iyo maareynta bukaanka leh cudurka rheumatica polymyalgia.
Waa maxay Polymyalgia Rheumatica?
Waxaa lagu qiyaasaa in qiyaastii 711,000 qof oo Maraykan ah ay qabaan polymyalgia rheumatica - xaalad inta badan si tartiib ah u kobcisa. Inkasta oo ay calaamaduhu si kedis ah u kicin karaan, taasi ma aha mid ka mid ah rheumatica polymyalgia. Astaamaha waxaa ka mid ah qallafsanaanta muruqyada oo baahsan, iyada oo miskaha iyo garbaha sida caadiga ah ku lug yeeshaan, iyo sidoo kale gacmaha sare, qoorta, iyo dhabarka hoose. Caadiyan ma jiro wax barar ah oo ku dhaca xubnaha. Waxaa suurtagal ah in lagugu sameeyo rheumatica polymyalgia oo ay weheliso cudur kale oo rheumatic ah . Waxaa jira kala duwanaansho balaadhan oo ku saabsan daaweynta polymyalgia rheumatica, sida marka la isticmaalo glucocorticoids ama cudur-is-bedelidda dawooyinka ladagaallanka roodhiga (DMARDs) iyo muddada dheer.
Mabaadi'da iyo Talooyinka Maareynta PMR
Tilmaamaha 2015 ee ACR iyo EULAR waxaa ka mid ah mabaadi'daha aasaasiga ah iyo talooyin gaar ah oo ku saabsan helitaanka daryeelka caafimaadka, u gudbinta takhasuslaha, dabagalka bukaanka, iyo xeeladaha daaweynta gaarka ah.
Talooyinka khaaska ah waxaa loo cayimay sida:
- "si xoog leh lagula taliyaa" marka caddayntu ay tilmaamayso faa'iido weyn oo yar oo aan halis lahayn
- "shuruudo" markii ay jirtay wax yar oo caddaynta caydhin ama macaashku aanu si aad ah uga culus khatarta
Mabaadii'da guud ee soo socota waxaa ka mid ah:
- Hirgalinta habka lagu ogaado polymalgia rheumatica, iyadoo qiimeyn kiliinik ah oo loogu talagalay in laga reebo xaaladaha ka yimaadda polymyalgia rheumatica.
- Kahor daaweynta daaweynta, kiis kasta waa inuu qoraa natiijooyinka baaritaanka sheybaarka.
- Iyadoo ku xiran calaamadaha iyo astaamaha, baaritaano dheeri ah waa in lagu amraa inay ka reebaan xaaladaha takoorka. Iskudhiska waa in la go'aamiyaa. Caqabadaha halista ah ee dib u noqoshada ama daaweynta dheeraadka ah waa in la tixgeliyaa.
- Tixgelinta waa in la siiyaa gudbinta khaaska ah.
- Go'aanka daaweynta waa in lala wadaago bukaanka iyo dhakhtarka.
- Bukaan-socodka waa inuu leeyahay qorshe daaweyn shakhsiyeed oo loogu talagalay rheumatica polymyalgia.
- Bukaan-socodka waa in ay heli karaan waxbarasho ku saabsan daaweynta rheumatica polymyalgia iyo maamulka.
- Bukaan kasta oo loo daaweeyo rheumatica polymyalgia waa in lala socdo iyadoo la adeegsanayo qiimeyn gaar ah. Sannad kowaad, bukaanka waa in la arkaa 4 ilaa 8 asbuuc kasta. Sannadka labaad, booqashooyinka waa in la qorsheeyaa 8-12 usbuuc kasta. Kormeerku waa inuu noqdaa mid loo baahdo dib u noqosho ama qiyaasta horay loo sii ogaado.
- Bukaanku waa in ay si toos ah u helaan xirfadlayaasha daryeelka caafimaadka si ay u soo sheegaan isbedelada, sida ciriiriga ama dhacdooyinka xun.
Talooyin khaas ah oo loogu talagalay maaraynta rheumatica polymyalgia waxaa ka mid ah:
- Talo xoog leh oo loogu talagalay isticmaalka glucocorticoids halkii laga heli lahaa NSAIDs (daawooyinka nonsteroid anti-inflammatory), marka laga reebo koorso gaaban oo ah NSAID ama xanuunada bukaanka qaba xanuun la xiriira xaalado kale.
- Talo aad u adag oo ku saabsan muddada ugu habboon ee daaweynta glucocorticoid (ie, u isticmaal daroogada muddada ugu yar ee loo baahan yahay si loo helo jawaab waxtarka leh).
- Talada ku-meel-gaadhka ah ee qiyaasta bilowga ah ee ku-oolka ah ee glucocorticoids inta u dhaxeysa 12.5 iyo 25 mg prednisone maalin kasta. Qiyaas ka sarreeya ayaa loo tixgelin karaa dadka khatarta ugu jira inay ku noqdaan dib-u-dhac iyo khatarta ugu hooseysa ee dhacdooyinka xun. Qadar yar ayaa laga yaabaa in loo tixgeliyo kuwa qaba comorbidities ama waxyeelada halista ah ee saameynaha la xiriira isticmaalka glucocorticoids. Qiyaasta bilawga ah ee 7.5 mg / maalintii ayaa xaalad ahaan la niyadjabay, qiyaasta daawada 30 mg / maalintii ayaa si adag looga niyad jabay.
- Talo si adag loogu talagalay jadwalada isku dhafka shakhsi ahaaneed iyo kormeer joogta ah. Jadwalka la soo jeediyey ee ku-soo-koobidda hore waa inuu ku dhajiyo qiyaasta afka ah ee 10 mg horay u-qiyaasta u dhiganta maalintii 4 ilaa 8 toddobaad. Daaweynta dib u noqoshada, prednisone afka waa in kor loo qaado qiyaasta bukaan-socodka ay qaadatay kahor-celinta kadibna tartiib tartiib tartiib tartiib tartiib tartiib ah 4 ilaa 8 usbuuc si hoos loogu dhigo qiyaasta soo-noqoshada. Marka lagu dhammeeyo raajada, prednisone afka ayaa lagu xiri karaa 1 mg 4dii asbuuc ama 125 mg iyadoo la isticmaalayo jadwal maalmeed kale illaa laga sii daayo prednisone, iyada oo bixinta cilladuhu aan la joojin.
- Talada ku-meel-gaadhka ah ee isticmaalka methylprednisolone ee maaddada (intramuscular intramuscular) halkii galka ama glucocorticoids.
- Talada ku-meel-gaadhka ah ee qiyaasta hal mar halkii loo kala qaybin lahaa qiyaasta maalinlaha ah ee glucocorticoids.
- Talada ku habboon ee isticmaalka hore ee methotrexate marka lagu daro glucocorticoids, gaar ahaan bukaannada qaarkood.
- Talo aad u xooggan oo ka soo horjeeda isticmaalka xannibaadayaasha TNF .
- Talada ku habboon ee barnaamijka jimicsiga shakhsi ahaaneed si uu u ilaaliyo murqaha iyo shaqada, iyo sidoo kale yareynta khatarta dhacdooyinka .
- Talo xoog leh oo looga hortago isticmaalka dhirta dabiiciga ee Shiinaha Yanghe iyo Biqi.
Ilaha:
2015 Talooyinka Maareynta Polymyalgia Rheumatica. Dejaco C. et al. Arthritis & Rheumatology Cf. 67 Maya 10. Oktoobar 2015.
http://www.rheumatology.org/Portals/0/Files/2015%20PMR%20guidelines.pdf
Polymyalgia Rheumatica. Kulliyadda Maraykanka ee Rheumatology. La sii daayay June 2015.
http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Polymyalgia-Rheumatica