Gout

I-Gout uhlobo lwesifo samathambo. Kwenzeka lapho i-uric acid yakhela egazini futhi idale ukuvuvukala emajoyintini.

I-Acute gout yisimo esibuhlungu esivame ukuthinta ilunga elilodwa kuphela. I-gout engapheli yiziqephu eziphindaphindiwe zobuhlungu nokuvuvukala. Amalunga angaphezu kwelilodwa angathinteka.

I-Gout ibangelwa ukuba nezinga eliphakeme kunokujwayelekile le-uric acid emzimbeni wakho. Lokhu kungenzeka uma:

• Umzimba wakho wenza i-uric acid eningi kakhulu
• Umzimba wakho unenkinga yokususa i-uric acid

Lapho i-uric acid yakhela kuketshezi oluzungeze amalunga (i-synovial fluid), ama-uric acid crystals form. Lawa makristalu abangela ukuhlangana ukuvuvukala, kubangele ubuhlungu, ukuvuvukala nokufudumala.

Imbangela ngqo ayikaziwa. I-Gout ingahle isebenze emindenini. Inkinga ivame kakhulu kwabesilisa, kwabesifazane ngemuva kokunqamuka kokuya esikhathini, nakubantu abaphuza utshwala. Njengoba abantu bekhula, i-gout iya iba yande kakhulu.

Isimo singaphinde sikhule kubantu abane:

• Isifo sikashukela
• Isifo sezinso
• Ukukhuluphala ngokweqile
• I-Sickle cell anemia nezinye i-anemias
• Umdlavuza wegazi neminye imidlavuza yegazi

I-Gout kungenzeka ngemuva kokuthatha imithi ephazamisa ukususwa kwe-uric acid emzimbeni. Abantu abathatha imithi ethile, efana ne-hydrochlorothiazide namanye amaphilisi wamanzi, bangaba nezinga eliphakeme le-uric acid egazini.

Izimpawu ze-gout acute:

• Ezimweni eziningi, kuthinteka ilunga elilodwa noma ambalwa kuphela. Izinzwani ezinkulu, idolo, noma amaqakala emaqakaleni kuthinteka kakhulu. Kwesinye isikhathi amalunga amaningi ayavuvukala abe buhlungu.
• Ubuhlungu buqala ngokuzumayo, imvamisa ebusuku. Ubuhlungu buvame ukuba bukhulu, buchazwe njengokuphulula, ukuchoboza, noma ukubabaza.
• Ilunga livela lifudumele futhi libomvu. Imvamisa ithambile kakhulu futhi iyavuvukala (kubuhlungu ukubeka ishidi noma ingubo phezu kwayo).
• Kungaba nemfiva.
• Lokhu kuhlasela kungaphela ngezinsuku ezimbalwa, kepha kungabuya ngezikhathi ezithile. Ukuhlaselwa okungeziwe kuvame ukuhlala isikhathi eside.

Ubuhlungu nokuvuvukala kuvame ukuphela ngemuva kokuhlaselwa kokuqala. Abantu abaningi bazoba nokunye ukuhlaselwa ezinyangeni eziyisithupha kuya kweziyi-12 ezizayo.

Abanye abantu bangaba ne-gout engapheli. Lokhu kubizwa nangokuthi i-gouty arthritis. Lesi simo singaholela ekulimaleni ngokuhlanganyela nasekulahlekelweni kokunyakaza emajoyintini. Abantu abane-gout engapheli bazoba nobuhlungu obuhlangene nezinye izimpawu isikhathi esiningi.

Imali e-uric acid ingakha izigaxa ezingaphansi kwesikhumba ezizungeze amalunga noma ezinye izindawo ezinjengezindololwane, izingalo zeminwe nezindlebe. Isigaxa sibizwa ngokuthi itophus, sisuselwa kusiLatin, okusho uhlobo lwetshe. ITophi (izigaxa eziningi) ingakhula ngemuva kokuba umuntu esenesifo segciwane iminyaka eminingi. Lezi zigaxa zingakhipha okokushona.

Ukuhlolwa okungenziwa kufaka phakathi:

• Ukuhlaziywa kwe-Synovial fluid (kubonisa amakristalu e-uric acid)
• Uric acid - igazi
• Ama-x-ray ahlangene (angajwayelekile)
• I-Synovial biopsy
• Uric acid - umchamo

Izinga le-uric acid egazini elingaphezu kuka-7 mg / dL (milligrams nge-deciliter) liphezulu. Kepha, akuwona wonke umuntu onezinga eliphakeme le-uric acid one-gout.

Thatha imithi ye-gout ngokushesha ngangokunokwenzeka uma uhlaselwa kabusha.

Thatha izidakamizwa ezingezona ukuvuvukala (ama-NSAID) ezinjenge-ibuprofen noma i-indomethacin lapho kuqala izimpawu. Khuluma nomhlinzeki wakho wezokunakekelwa kwempilo mayelana nomthamo ofanele. Uzodinga imithamo eqinile izinsuku ezimbalwa.

• Umuthi kadokotela obizwa nge-colchicine usiza ukunciphisa izinhlungu, ukuvuvukala nokuvuvukala.
• ICorticosteroids (efana ne-prednisone) nayo ingasebenza kakhulu. Umhlinzeki wakho angajova ukuhlangana okuvuthayo ne-steroids ukudambisa izinhlungu.
• Ngokuhlaselwa kwe-gout emajoyini amaningi kungasetshenziswa umjovo ojojwayo obizwa nge-anakinra (Kineret).
• Ubuhlungu buvame ukuphela kungakapheli amahora angu-12 aqale ukwelashwa. Isikhathi esiningi, bonke ubuhlungu buhambe kungakapheli amahora angama-48.

Ungadinga ukuthatha imithi yansuku zonke efana ne-allopurinol (Zyloprim), febuxostat (Uloric) noma i-probenecid (Benemid) ukwehlisa izinga le-uric acid egazini lakho. Ukwehlisa i-uric acid ibe ngaphansi kuka-6 mg / dL kuyadingeka ukuvikela imali ye-uric acid. Uma une-tophi ebonakalayo, i-uric acid kufanele ibe ngaphansi kuka-5 mg / dL.

Ungayidinga le mithi uma:

• Uhlaselwa kaningana ngonyaka ofanayo noma ukuhlaselwa kwakho kubi kakhulu.
• Unomonakalo emajoyintini.
• Une-tophi.
• Unesifo sezinso noma amatshe ezinso.

Izinguquko zokudla nezindlela zokuphila zingasiza ekuvimbeleni ukuhlaselwa yi-gouty:

• Nciphisa utshwala, ikakhulukazi ubhiya (elinye iwayini lingasiza).
• Ukuncipha emsimbeni.
• Vivinya umzimba nsuku zonke.
• Nciphisa ukudla kwakho inyama ebomvu neziphuzo ezinoshukela.
• Khetha ukudla okunempilo, okufana nemikhiqizo yobisi, imifino, amantongomane, imidumba, izithelo (ezinoshukela omncane) nezinhlamvu ezigcwele.
• Izithako zekhofi nevithamini C (zingasiza abanye abantu).

Ukwelashwa okufanelekile kokuhlaselwa okunamandla nokwehlisa i-uric acid kuye ezingeni elingaphansi kuka-6 mg / dL kuvumela abantu ukuthi baphile impilo ejwayelekile. Kodwa-ke, uhlobo olubi lwesifo lungaqhubekela phambili lube yi-gout engapheli uma i-uric acid ephezulu ingalashwa ngokwanele.

Izinkinga zingafaka:

• Isifo samathambo esingapheli.
• Amatshe ezinso.
• Imali efakwa ezinso, okuholela ekuhlulekeni kwezinso okungamahlalakhona.

Amazinga aphezulu e-uric acid egazini ahlotshaniswa nengozi eyengeziwe yesifo sezinso. Kuyenziwa ucwaningo ukuthola ukuthi ukwehlisa i-uric acid kunciphisa ubungozi besifo sezinso.

Shayela umhlinzeki wakho uma unezimpawu zesifo samathambo esibuhlungu noma uma uba ne-tophi.

Ungahle ungakwazi ukuvimbela i-gout, kepha ungakwazi ukugwema izinto ezibangela izimpawu. Ukuthatha imithi ukwehlisa i-uric acid kungavimbela ukuqhubekela phambili kwe-gout. Ngokuhamba kwesikhathi, imali yakho ye-uric acid izonyamalala.

I-Gouty arthritis - ebukhali; I-gout - ebukhali; Hyperuricemia; I-gout encane; ITophi; Podagra; I-gout - engapheli; Isifo esingalapheki; I-gout enamandla; I-arthritis enamandla

• Izinso zamatshe kanye ne-lithotripsy - ukukhishwa
• Izinso zezinso - ukuzinakekela
• Izinso zamatshe - okufanele ubuze udokotela wakho
• Izinqubo zomchamo ezinamandla - ukukhipha

• Amakhemikhali e-uric acid
• I-Tophi gout isesandleni

IBurns CM, iWortmann RL. Izici zokwelashwa nokwelashwa kwe-gout. Ku: Firestein GS, Budd RC, Gabriel SE, McInnes IB, O'Dell JR, abahleli. I-Kelley's neFirestein's Textbook of Rheumatology. Umhlaka 10. IPhiladelphia, PA: Elsevier; 2017: isahluko 95.

Edwards NL. Crystal izifo sebethule. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-25. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 273.

UFitzGerald JD, uNeogi T, uChoi HK. Ukuhlela: ungavumeli ukunganakwa yi-gout kuholele ekuthambekeni kwe-gouty. I-Arthritis Rheumatol. 2017; 69 (3): 479-482. I-PMID: 28002890 www.ncbi.nlm.nih.gov/pubmed/28002890.

UKhanna D, uFitzgerald JD, uKhanna PP, et al. Imihlahlandlela ye-American College of Rheumatology yokuphathwa kwe-gout. Ingxenye 1: izindlela zokwelapha ezihlelekile ze-nonpharmacologic kanye ne-pharmacologic ze-hyperuricemia. I-Arthritis Care Res (eHoboken). 2012; 64 (10): 1431-1446. I-PMID: 23024028 www.ncbi.nlm.nih.gov/pubmed/23024028.

UKhanna D, uKhanna PP, uFitzgerald JD, et al. Imihlahlandlela ye-American College of Rheumatology yokuphathwa kwe-gout. Ingxenye 2: ukwelashwa kanye ne-antiinfigueatory prophylaxis ye-acute gouty arthritis. I-Arthritis Care Res (eHoboken). 2012; 64 (10): 1447-1461. I-PMID: 23024029 www.ncbi.nlm.nih.gov/pubmed/23024029.

Liew JW, Gardner GC. Ukusetshenziswa kwe-anakinra ezigulini ezibhedlela ezine-arthritis ehambisana nekristalu. J Rheumatol. I-2019 pii: jrheum. 181018. [I-Epub ngaphambi kokuphrinta]. I-PMID: 30647192 www.ncbi.nlm.nih.gov/m/pubmed/30647192.