Mitundu ya PC
PC imakhudza makamaka achinyamata mpaka zaka 30. Akazi nthawi zambiri amadwala. Pali mitundu inayi yambiri ya matenda:
• Kachilombo ka PC-kachiwiri kamene kamatengera mtundu wa kusokonezeka kwapadera kwa ntchito yamanjenje ndi kukhululukira; pafupifupi atatu mwa odwala;
• Pachiwiri pang'onopang'ono PC - odwala amakhala ndi matenda osokonezeka maganizo omwe angathe kuwonongeka; mwa odwala ambiri, PC yobwezeretsa kachiwiri imalowa mu fomu iyi;
• Pulogalamu yamakono yoyamba yopanga pang'onopang'ono yokhala ndi zizindikiro zokhudzana ndi ubongo popanda zovuta; odwala pafupifupi 15%;
• Kachilombo koyambitsa matenda a PC - chiwopsezo choyambirira cha pang'onopang'ono ndi kuyeretsa kwathunthu popanda matenda; ndizovuta kwambiri.
Zizindikiro za PC zingasinthe malinga ndi mtundu wa mitsempha yokhudzana ndi mitsempha.
• Mitsempha ya optic
Pogwiritsa ntchito mapulogalamu a PC pa mitsempha ya optic, yomwe imatulutsa malingaliro kuchokera ku retina kupita ku ubongo, wodwalayo amapanga ululu m'maso pamodzi ndi masomphenya osamveka. Kubwezeretsa, ngati n'kotheka, kumatenga miyezi isanu ndi itatu.
• Ubongo umayambira Kugwira ntchito kwa ubongo, komwe kumayambitsa kayendetsedwe ka maso, kukhudzidwa kwa matenda a nkhope, kulankhula, kumeza ndi kulingalira bwino, kukhoza kuwonetsa masomphenya awiri kapena kusokonezeka kwa kayendetsedwe kawo kochezeka.
• Chingwe cha m'mphepete Kusokonezeka kwa mitsempha ya mitsempha pamtunda wa msana kumaphatikizapo kufooka ndi kuchepa kwa ziwalo, komanso kuchepa kwa chikhodzodzo ndi matumbo.
Kupititsa patsogolo
Ndi chitukuko cha gawo lachiwiri la matendawa, kusokonezeka kwambiri kosalekeza kumachitika:
• Kutayika kwachinyengo cha manja;
• kufooka ndi kukhwima kwa miyendo ya m'munsi;
• Kuwonjezeka kwafupipafupi kwa kukodza ndi kusakanikirana;
• Kulephera kukumbukira ndi kusinkhasinkha: kusokonezeka kwafupipafupi nthawi zina ndizo zizindikiro zazikulu;
• kusinthasintha; ngakhale kuti nthawi zambiri zimagwirizanitsidwa ndi PC zowonjezereka, kuvutika maganizo kumakhalabe kofala kwambiri.
Kumayambiriro kwa PC, ziphuphu zoopsa zimapezeka mu ubongo, zomwe zimachiritsa ndi kupanga mapulogalamu. Kawirikawiri timapepala timene timapangidwira m'mipata yambiri (malo omwe ali pafupi ndi mazenera odzaza ubongo), mu msana wam'mimba ndi mitsempha ya optic. M'madera amenewa, malire a ubongo (ubongo wamkati pakati pa magazi ndi minofu ya ubongo) yawonongeka, yomwe imalola maselo ena kuti alumikizane ndi makoma a mitsempha ndiyeno alowa mkati mwawo.
Kuwonongedwa kwa chida cha myelin
Udindo wapadera pa chitukuko cha matendawa ndi gulu la ma lymphocytes lomwe limagwira ndi ma antigen enanso kapena ma invelopu amodzi. Pamene ma lymphocyteswa amagwirizana ndi ma antigen, mankhwala ena amamasulidwa omwe amachititsa mapangidwe a maselo a mononuclear. Macrophages ndi maselo amodzi omwe amapezeka m'magulu a mitsempha yam'madzi amachititsa kuti awononge malo a myelin m'malo osiyanasiyana, omwe amachititsa kuti awonongeke. Ma oligodendrocyte ena (maselo opanga myelin) amamwalira, ena amatha kubwezeretsa pang'onopang'ono mpweya wanga wa myelin. Pambuyo pake, motsutsana ndi chiwonongeko cha kutupa, kuchulukitsidwa kwa astrocytes (mtundu wina wa maselo a CNS) ukuwonetsedwa ndi chitukuko cha gliosis (fibrosis). Zinthu ziwiri zikuluzikulu zimayambitsa kukula kwa PC - chibadwa cha chilengedwe.
Kuchiza
Chiwerengero cha PC (chiwerengero cha anthu pa nthawi inayake) mu dziko chimasiyana kwambiri. Ndizosiyana, matendawa amapezeka kawirikawiri pamene amachoka ku equator ndi ndende zapamwamba m'madera oposa 30 pa maiko onse. N'chizoloŵezi chosiyanitsa madera atatu padziko lonse lapansi, kusiyana ndi kuchuluka kwa ziwalo zambiri za m'mimba: malo apamwamba, apakati ndi otsika. Kusintha malo okhala ndi kusintha m'dera loopsya kumabweretsa kuwonjezeka kapena kuchepa pa chiopsezo cha munthu payekha kukhala ndi PC, mwachindunji, malo omwe anakonza. Pofuna kufotokoza malowa, zinthu zambiri zachilengedwe zafufuzidwa. Udindo wa tizilombo toyambitsa matenda, makamaka ma virus a chimfine ndi canine (omwe amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda) ayambe kuganiza, koma mpaka pano chiwerengero cha ma PC sichikutsimikiziridwa.
Zosowa zamtundu
Anthu omwe ali ndi mbiri ya banja la PC amakhala odwala kwambiri. Mwachitsanzo, mayi yemwe mlongo wake ali ndi PC, chiopsezo chodwala chimakula nthawi 40 poyerekezera ndi mkazi wopanda amnesis ofanana. Ngati mukudwala matenda amodzi mwa mapasawo, wachiwiri ali pachiopsezo chotenga PC ndi mwayi wa 25%.
Chitetezo cha mthupi
Asayansi ena amanena kuti chitetezo cha mthupi mwa odwala opatsirana (mavairasi, mabakiteriya) kapena kuperewera kwa chitetezo cha mthupi kumateteza kukula kwa matenda. Akatswiri ena amakhudzidwa ndi chikhalidwe cha PC, momwe ma chitetezo cha mthupi amawononga thupi la thupi. Kuzindikira kwa PC kumachokera ku kujambula kwa magnetic resonance kapena kufufuza kwa cerebrospinal fluid. Pofuna kuchiza matendawa kwa nthawi yayitali, mankhwala monga beta-interferon amagwiritsidwa ntchito. Pogwiritsa ntchito PC, mitundu ikuluikulu ya kafukufuku imagwiritsidwa ntchito:
• Kujambula kwamaginito (MRI);
• Kusanthula khungu lamadzimadzi (COC).
Mt-kuphunzira
Kugwiritsira ntchito makina a MRI kunachulukitsa kwambiri kulondola kwa ma PC, komanso kunamvetsetsa bwino momwe chikhalidwechi chikuyendera. Mipata yomwe ili pakatikati ya mitsempha ya mtunduwu imakhala ndi mtundu wapadera pa zithunzi, zomwe, kuphatikizapo malo apakati mu ubongo, zimayambitsa kukayikira pa PC. MPT imathandiza kwambiri pa matenda a PC, koma kugwiritsa ntchito njirayi sikungatheke poyang'anira njira ya matendawa. Tsoka ilo, palibe malemba ovomerezeka pakati pa MP-chithunzi ndi mawonetseredwe a chipatala cha matendawa.
CSF yophunzira
CSF imazungulira mkati mwa zinyama za ubongo, komanso kusamba pamwamba pa ubongo ndi msana. Pa PC kusintha kwina kwa mapuloteni ndi mapangidwe am'manja kumatchulidwa, zomwe, komabe, siziri zenizeni. Odwala 90% mwa CSF, mtundu wapadera wa immunoglobulin (oligoclonalD) umapezeka.
Mayesero ena
Kuti muyese kayendetsedwe ka mapulaneti, mwachitsanzo, kupyolera m'magetsi a mitsempha, mayesero enieni amachitika. Pakalipano, phunziro ili likuonedwa kuti ndi lopanda ntchito. Mayeso a magazi ndi mayesero ena sali ofunikira pozindikira PC, koma angagwiritsidwe ntchito kuti asiye zikhalidwe zina zofanana. Kuchiza kwa PC kumaphatikizapo njira zosiyanasiyana.
Kuukira kwakukulu
Ma PC ambiri amachitikira mosavuta ndipo samafuna chithandizo chamankhwala. Mu njira yovuta kwambiri, corticosteroids imapatsidwa mawonekedwe a mapiritsi kapena insuffins. Mankhwalawa amatchepetsera nthawi ya chiwonongeko, koma samakhudza zotsatira zomaliza.
Zizindikiro zamaganizo
Mankhwala ena amatha kuthetsa zizindikiro za matendawa.
• Kulephera kwa chikhodzodzo
Kawirikawiri, odwala ayamba kukakamiza kukodza ndi kukonzanso mkodzo - kuthetsa zizindikiro izi zimagwiritsa ntchito mankhwala monga oxybutynin ndi tolterodine. Nthawi zina, kuti muchepetse mkodzo usiku, perekani dememopressin. Kugonjetsa kowonongeka kwa nthawi zonse kumalola odwala kuteteza zizindikiro za kukomoka kwa ubongo ndi kuchepetsa chiopsezo cha matenda. Matenda a m'mimba safala kwambiri.
• Kupanda mphamvu
Kupanda mphamvu kwa amuna omwe ali ndi PC ndizochiritsidwa sildenafilom.
• Kuthamanga kwa minofu Kufooka kwa minofu yosazolowereka, komwe kumakhala kwa PC, kawirikawiri kumayendera bwino mankhwala osokoneza bongo, omwe amakhalanso ndi zotsatira zambiri.
• Kupweteka
Kuchepetsa matenda opweteka amaika ndalama monga amitriptyline. Kutenga nthawi yaitali kwa PC kumaphatikizapo kugwiritsa ntchito mawonekedwe a immunomodulating omwe amayang'anira chitetezo cha mthupi. Pakalipano, mankhwala omwe amagwiritsidwa ntchito pazinthu izi ndi beta-interferon.
Zilumikizidwe
Zilumikizidwe zimapangidwa mu thupi lathu ndipo zimabwera mu mitundu itatu: alpha-interferons alibe zotsatira pa PC; beta-interferons amachititsa chidwi chachikulu cha kukopa; Gamma-interferons zimayambitsa matenda owonjezera. Njira yeniyeni ya beta-interferon sichidziwika. Interferon beta ndi yosiyana kwambiri ndi interferon beta, pamene interferon beta ikugwirizana kwathunthu. Maperetoni onse amachepetsa kuchepa kwa PC ndi pafupifupi 30%; ochita kafukufuku ena amasonyeza kuti amachepetsa kuopsa kwa kuwonjezereka. Mitundu yosiyanasiyana ya interferons imakhala ndi zotsatira zosiyana malinga ndi mawonekedwe a matendawa. Beta-interferon sichigwira ntchito motsutsana ndi PC yobwezeretsanso, komabe imachepetsa kukula kwa kachilombo koyambitsako kachiwiri. Interferon beta-1a kukonzekera, kenaka, ali ndi zotsatira zosiyana. Panthawi ya chithandizo, kusokoneza thupi kumapangika m'thupi la wodwala, zomwe zimapangitsa kuti mankhwalawo asapindule bwino. Mitundu yonse ya beta-interferon imayambitsa kusintha kwakukulu kwa pulogalamu ya MP ndi kuchepa kwa chiwerengero cha zilonda.
Mankhwala ena
Kukonzekera kokonza makina a acetate ali ndi mankhwala ofanana ndi mapuloteni omwe amapanga myelin. Monga betreferenon beta, imachepetsa kuchulukitsa kwa zovuta, koma sizimakhudza kukula kwa matenda. Katemera wamwezi uliwonse amathandiza kuchepetsa chiwerengero cha zigawenga komanso kuchepetsa matendawa. Mafunso ambiri okhudzana ndi kugwiritsira ntchito mankhwalawa samakhala osayankhidwa. Enanso, omwe amadziwika bwino kwambiri omenyera mavitamini amapita kuchipatala. PC ndi matenda osokoneza ubongo omwe amapita patsogolo. Komabe, pali njira zingapo zomwe zimathandiza odwala kuthana ndi mavuto a tsiku ndi tsiku.
• Zakudya
Amakhulupirira kuti chakudya chokhala ndi mafuta ochepa a nyama komanso kukhalapo kwa mafuta osatetezedwa (monga mafuta a mpendadzuwa) kumathandiza kwambiri odwala.
• Zochita zambiri
Mtundu wa moyo wa wodwala ndi PC umachokera kuzinthu monga kudzipangira yekha, mlingo woyendayenda komanso kufunika kwa mankhwala osokoneza bongo nthawi yayitali. Ndikofunikira kwambiri kuti wodwala aperekedwe ndi chithandizo chamankhwala choyenerera ndi chisamaliro cha akatswiri.
• Chiwonetsero
Pafupifupi zaka 20 kuyambira pamene matendawa ayamba, 50% odwala amatha kupirira kunja kwa mamita 20. Chiwerengero cha moyo wa odwala amenewa ndi otsika kuposa anthu.