PC Types
PC inobata zvikuru vechidiki kusvika makore makumi matatu. Vakadzi vanowanzorwara. Kune machina mana makuru ezvirwere:
• Kudzokorora-kugadzirisa hurumende-hurumende kunotora maitiro echinhu chinopesana chekuvhiringidza kwakanyanya kwebasa rekutya nekuregererwa; inenge chetatu chevarwere;
• Chechipiri kufambira mberi kwePC - varwere vanoita zvirwere zvisingaperi zvekutya zvinowanzokonzerwa; muchizhinji chevarwere, PC yekudzorera-yakagadzirisa inopinda muforomu iyi;
• PC inonyanya-inopfuurira ine kukura zvishoma kwezviratidzo zvepfungwa pasina kuwedzera; vanenge 15 muzana yevarwere;
• PC inonyadzisa - kutanga kurwisa kwekwenyoro zvishoma uye inenge yakakwana kupora pasina kuwedzera kwechirwere; hazviwanzoitiki.
Zviratidzo zvePC zvinogona kusiyana zvichienderana nemhando yehutachiona hwehutachiona.
• Mutsara wesimbi
Mukugadzirwa kwepakiti yePC pamusana wesimbi, iyo inopinza mafungiro kubva ku retina kuenda kuuropi, murwere anoura marwadzo muziso pamwe chete nemaziso asinganzwisisiki. Kudzorera, kana zvichibvira, kunotora mwedzi misere.
• Uropi hunoita Kubatanidzwa kwehuropi, iyo inokonzera kufamba kwemaziso, kunzwisisika kwezviso zvemaziso, kutaura, kumedza uye pfungwa yekuenzanisa, zvinogona kutungamirira pakuonekwa kaviri kana kukanganisa kushamwaridzana kwavo.
• Mutsara wemutsara Kushungurudzika kwekuyerera kwemaitiro emagunha pamwero wepelinha kunosangana nekushaya simba uye kuderera kunzwisisika mumakumbo, pamwe nekushaya simba kwechirwere nemukumbo.
Kufambira mberi
Nekuvandudzwa kwechikamu chechipiri-chinopfuurira chechirwere, kushungurudzika kunoramba kuripo kunoonekwa:
• kurasikirwa kwehutano hwemaoko;
• kusava nesimba nekugadzikana kwemakumbo ezasi;
• kuwedzerwa kuwedzerwa kwekuzora uye kukanganiswa kwekuvhenekera;
• kusakanganwa mupfungwa uye kukanganisa: kushungurudzika kazhinji kune dzimwe nguva zviratidzo zvikuru;
• mafungiro akachinja; kunyange zvazvo inowanzobatanidzwa nePC euphoria, kuora mwoyo kuchiri kuwedzera.
Mune matanho ekutanga ePC, foci yekuputika kwakanyanya kunoonekwa muuropi, iyo inoporesa nekuumbwa kwezvitsvuku (plaques). Kakawanda kazhinji aya aya anowanikwa munzvimbo dzinowanikwa nguva (nzvimbo dzakapoteredza dzimba dzemhepo dzinokonzerwa nemhepo), mumutsara wemagunha uye maziso emagetsi. Mune dzimwe nzvimbo, ropa-uropi hunopesana (semipermeable muganhu pakati peropa nehutano hwehupi) hwakavhiringidzika, iyo inobvumira masero mashomanana kuti ataure kumadziro emidziyo yeropa ndokubva apinda.
Kuparadzwa kwe myelin sheath
Basa rinokosha mukurudzirwa kwechirwere ndeyeboka re lymphocytes rinoita kune rimwe kana mamwe maevelopin envelope antigens. Apo idzi lymphocytes (macrophage) dzinobatana nemaantijeni, mamwe makemikari anosunungurwa anoita kuti kuumbwa kwemononuclear magetsi. Macrophage uye masero emagetsi anowanikwa (anowanikwa mukati memagetsi ehurumende) anorwisa myelin sheath panzvimbo dzakasiyana-siyana, izvo zvinotungamirira mukuparadzwa kwayo uye kudzvinyirirwa kwe axon. Vamwe oligodendrocytes (masero anogadzira myelin) anofa, vamwe vanogona kudzorera zvishoma zvakasara myelin sheath. Gare gare, pakurwisana nemashure ekusimba kwekuvhiringidza, kupararira kwe astrocytes (imwe mhando ye CNS masero) inoonekwa pamwe nekugadzirwa kwegliosis (fibrosis). Zvinhu zviviri zvakakonzera kutungamira kwePC - iyo genetic chiitiko chezvakatipoteredza.
Morbidity
Chiitiko chePC (nhamba yematambudziko mune imwe nguva pane imwe nguva munguva) munyika inosiyana-siyana. Nezvimwe zvisiri izvo, chirwere ichi chinowanzoitika kakawanda sezvo chichibva kure neEquator uye chakanyanya kukwirira mumatunhu ari pamusoro penzvimbo ye30 yakafanana pamakondinendi ose. Zvinowanzosiyanisa zvikamu zvitatu munyika yose, zvakasiyana nehuwandu hwema multiple sclerosis: nzvimbo dzakakwirira, dzakadzika uye dzisina ngozi. Kuchinja nzvimbo yekugara nekushandura munharaunda yenjodzi kunotungamirira ku kuwedzera kana kuderera muhutano hwemunhu wekugadzira PC, maererano, nzvimbo yaakagadzirisa. Mukuedza kutsanangura izvi nzvimbo, nzvimbo dzakawanda dzezvakatipoteredza dzakatsvakurudzwa. Basa revachirwere, uye kunyanya yemasera uye canine zvirwere zvepine (izvo zvinopedzisira zvinokonzera chirwere chakakomba muimbwa) chaifungidzirwa, asi kusvika ikozvino hutachiona hwePC hauna kugadziriswa.
Genetic factors
Vanhu vane nhoroondo yemhuri yePC vane mikana yekuwedzera chirwere chacho. Somuenzaniso, mukadzi ane hanzvadzi ine PC, njodzi yokurwara inowanikwa ka40 kana ichienzaniswa nemukadzi asina anamnesis akafanana. Kana pane kurwara kweimwe remapatya, wechipiri ari pangozi yekugadzira PC pamwe nemukana we 25%.
Zvirwere zvekudzivirira muviri
Mamwe masayendisiti anoratidza kuti maitiro ekudzivirira mafungiro kune vanopararira (mavairasi, mabhakitiriya) kana kuderera kwekudzivirirwa kwezvirwere mumuviri kunokonzera kukura kwechirwere. Dzimwe nyanzvi dzinogutsikana nezvehupenyu hwomoto hwePC, umo masero ezvirwere zvemuviri anoparadza miviri yenyama. Kuongororwa kwePC kunobva pane magnetic resonance imaging kana kufungidzirwa kweperebrospinal fluid. Nekurapwa kwenguva refu kwechirwere, zvinodhaka zvakadai se beta-interferon zvinoshandiswa. NePC diagnostics, maviri maitiro makuru ekutsvakurudza anoshandiswa:
• Magnetic resonance imaging (MRI);
• kuongororwa kweperebrospinal fluid (COC).
Mt-study
Kushandiswa kwekombiyuta yeMRI yakawedzera kukururama kwePC kutsvaga, uyewo zvakaita kuti pave nokunzwisisa zviri nani mararamiro echirwere chacho. Mabheti ari pakati nepakati yenheyo ane mhando chaiyo mumifananidzo, iyo, pamwe chete nemunharaunda muuropi, inokonzera kushungurudza paPC. MPT inotora basa rinokosha pakutsvaga kwePC, asi kushandiswa kwemuitiro kunogadzikana zvikuru maererano nekucherechedza chirwere chechirwere chacho. Zvinosuruvarisa, hapana mutsara wakajeka pakati peP-MP-picture uye zviratidzo zvechipatara zvechirwere.
CSF kudzidza
CSF inopararira mukati memhepo inobva muuropi, pamwe nekushambidza hupamhi hwepfungwa uye musipinha. PaCP dzimwe shanduko dzemapurotini uye masero ezvinyorwa anoonekwa, izvo, zvisinei, hazvisi zvakananga. Mune varwere makumi mapfumbamwe (90%) muCSF, rudzi rwemuviri rwemumunoglobulin (oligoclonalD) inowanikwa.
Mimwe miedzo
Kuyera conductivity yepulses, somuenzaniso, kuburikidza ne optic nerve fibers, zviitiko zvakananga zvinoitwa. Parizvino, chidzidzo ichi chinoonekwa sechisina kushandiswa. Kuyera ropa uye mamwe mimwe miongororo haisi inokosha pakutsvaga PC, asi inogona kushandiswa kurega mamwe mamiriro akafanana. Kurapa kwePC kunosanganisira nzira dzakasiyana-siyana.
Kurwisa kwakanyanya
Zvizhinji zvePC zvinotambudzwa zvinowanzoitwa nyore uye hazvitsvaki kurapwa kwakananga. Mune imwe nzira yakaoma, corticosteroids inopiwa nenzira yehwendefa kana kuti inhaffins inhaffins. Iyi mishonga inoderedza nguva yekurwisa, asi haibatsiri pakupedzisira.
Symptomatic measures
Mimwe mishonga inogona kubvisa zviratidzo zvechirwere.
• Kusabatwa kwekanyara
Kazhinji, varwere vakanyanya kukurudzirwa kuti vaite urinate uye kuchengetedza urinary - kubvisa zviratidzo izvi kushandisa madhiragi akadai se oxybutynin uye tolterodine. Dzimwe nguva, kuti uderedze urini huripo usiku, rondedzera demopressin. Periodic self-catabolisation ye bladder inobvumira varwere kudzora zviratidzo zvekuvhenekera kusagadzikana uye kunoderedza ngozi yehutachiona. Zvinetso zvemukati hazvina kufanana.
• Kushaya simba
Kushaya simba kune varume vane PC kunorapwa zvakanaka sildenafilom.
• Kutarisa kwemasumbu Kusagadzikana kwemisimba, kusinganzwisisiki kwePC, kazhinji kunopinda zvisina kunaka kumishonga, iyo inewo mimwe miviri yakaipa.
• kurwadziwa
Kuti kuderedza chirwere chinorwadza kuisa mari yakadai seamitriptyline. Nguva refu kurapwa kwePC kunosanganisira kushandiswa kwema immunomodulating agents dzinodzora maitiro ezvirwere mumuviri. Pari zvino, chinodhaka chikuru chinoshandiswa nokuda kwechinangwa ichi ndeche beta-interferon.
Interferons
Interferons inogadzirwa mumitumbi yedu uye inouya mumhando mitatu: alpha-interferons haina zvishoma paCP; beta-interferons inobata basa guru rekukwezva; gamma-interferons inokonzera kuwedzerwa kwechirwere. Iyo chaiyo nzira yekuita kwe beta-interferon haisati yazivikanwa. Interferon beta yakasiyana zvakasiyana neyero interferon beta, apo interferon beta yakafanana zvachose nayo. Zvose zvinokonzerwa ne-beta inopedza nhamba yePC kurwisa ne30%; vamwe vatsvakurudzi vanoratidza kuti vanoderedza kuoma kwekuwedzera. Mhando dzakasiyana-siyana dzeeferferone dzine zvakasiyana-siyana zvichienderana nehuwandu hwechirwere. Beta-interferon haigoni kupikisa PC yekudzorera-yakagadzirisa, zvisinei iyo inononoka kufambira mberi kwechipiri chekuwedzera kwechirwere ichi. Interferon beta-1a kugadzirira, zvakare, ine zvakasiyana. Munguva yekurapwa, kusagadzirisa zvirwere zvinoputika zvinoumbwa mumuviri wemurwere, izvo zvinoita kuti kubudirira kwechirwere zvisanzwisisike. Mhando dzose dze beta-interferon dzinotungamirira kukurudzika kukuru muPP-pattern nekuderera kwehuwandu hwezvionda.
Mamwe madhiragi
Iyo yakagadzirirwa kugadzirira glatiramer acetate ine yakadaro yemakemikari yakagadzirwa neproteinini yakakura inoumba myelin. Kufanana ne-beta interferons, inoderedza kuwandisa kwekuwedzera, asi haipindi kufambira mberi kwechirwere. Nguva nenguva mwedzi unoita kuti muviri uwane immunoglobulin unobatsira kuderedza nhamba yekurwisa uye kuderedza chirwere chechirwere chacho. Mibvunzo yakawanda maererano nekubudirira kwekuenzanisa kwemishonga iyi yose inoramba isina kupindurwa. Zvimwe, mamwe majekiseni anozivikanwa anowanikwa mune zvidzidzo zvechiremba. PC ndeye chirwere chisingaperi chineurological chinopfuurira mberi. Kunyange zvakadaro, kune nzira dzinoverengeka dzinobatsira varwere kubata nematambudziko ezuva nezuva.
• Kudya
Zvinotendwa kuti kudya kunotapudzwa kwemafuta uye kuvapo kwe unsaturated mafuta acids (zvakadai samafuta e-sunflower) kunobatsira pakurarama kwevarwere.
• Zviitiko zvinowanzoitika
Unhu hwehupenyu hwevarwere nePC hunokonzerwa nezvinhu zvakadai sokukwanisa kuzvitakura, ruzivo rwokufamba uye chido chekushandisa kwenguva refu kwemishonga. Zvinonyanya kukosha kuti murwere anopiwa chirongwa chekurapa chakakodzera uye unyanzvi hwekuchengetedza.
• Forecast
Anenge makore makumi maviri kubva pakutanga kwechirwere ichi, 50% yevarwere vanokwanisa kumira kunze kwemakiromita makumi maviri. Ivhareji inotarisirwa kurarama kwevamwe vakadai yakaderera kupfuura yevanhu.