Ankylosing spondylitis

Ankylosing spondylitis (AS) yog kev mob caj dab ntev. Nws feem ntau cuam tshuam cov pob txha thiab pob qij txha ntawm lub hauv paus ntawm tus nqaj qaum qhov twg nws txuas nrog pelvis. Cov pob qij txha no tuaj yeem hloov o thiab o. Sijhawm dhau sijhawm, cov pob txha caj qaum uas raug cuam tshuam yuav koom ua ke.

AS yog tus tswvcuab tseem ceeb ntawm tsev neeg ntawm cov ntaub ntawv zoo sib xws ntawm kev mob caj dab hu ua spondyloarthritis. Lwm tus tswvcuab suav nrog kev mob caj dab, mob caj dab ntawm cov mob nyhuv hnyuv thiab mob caj dab. Tsev neeg ntawm kev mob caj dab zoo li tshwm sim ntau heev thiab cuam tshuam txog li 1 leeg ntawm 100 leej.

Cov laj thawj ntawm AS tsis paub. Cov caj ces zoo li ua si. Feem ntau cov neeg nrog AS yog qhov zoo rau HLA-B27 noob.

Tus kab mob feem ntau pib ntawm hnub nyoog 20 thiab 40, tab sis nws yuav pib ua ntej hnub nyoog 10. Nws cuam tshuam ntau dua cov txivneej hauv cov poj niam.

AS pib mob nraub qaum uas dhia los thiab mus. Mob qes qis yuav tshwm sim feem ntau thaum lub sijhawm hloov zuj zus.

• Qhov mob thiab txhav yuav mob hnyav dua thaum hmo ntuj, sawv ntxov, lossis thaum koj tsis tshua muaj siab ntseeg. Qhov tsis xis nyob yuav ua rau koj tsaug zog.
• Qhov mob feem ntau tau zoo dua tuaj nrog kev ua si lossis qoj ib ce.
• Mob nraub qaum yuav pib nyob nruab nrab ntawm ntawm lub plab mog thiab txha nraub qaum (pob qij txha sacroiliac). Ua haujlwm dhau sijhawm, nws yuav cuam tshuam tag nrho lossis ib feem ntawm nqaj qaum.
• Koj lub nqaj qaum yuav yog qhov hloov tau tsis tau. Ua haujlwm dhau sijhawm, koj tuaj yeem sawv ntsug rau qhov haujlwm hunched rau tom ntej.

Lwm qhov ntawm koj lub cev uas raug cuam tshuam yog:

• Cov pob qij txha ntawm lub xub pwg nyom, hauv caug thiab pob taws, uas tuaj yeem o thiab mob
• Cov pob qij txha nruab nrab ntawm koj tus tav thiab lub mis, kom koj tsis tuaj yeem nthuav koj lub hauv siab siab
• Qhov muag, uas yuav muaj o thiab liab

Nkees kuj yog cov tsos mob tshwm sim.

Cov tsos mob tshwm sim tsawg yog:

• Me ntsis ua npaws

AS tuaj yeem tshwm sim nrog lwm yam mob, xws li:

• Psoriasis
• Kev mob Ulcerative colitis lossis Crohn
• Rov muaj dua lossis mob qhov muag o

Kev ntsuam xyuas yuav muaj xws li:

• CBC
• ESR (kev ntsuas kev mob)
• HLA-B27 antigen (uas tshawb pom lub gene txuas nrog rau ankylosing spondylitis)
• Qhov zoo tshaj yuav Rheumatoid (uas yuav tsum muaj qhov tsis zoo)
• Kev xoo hluav taws xob ntawm tus nqaj qaum thiab mob lub plab mog
• MRI ntawm cov nqaj qaum thiab lub plab mog

Koj tus kws kho mob yuav sau ntawv tawm tshuaj xws li NSAIDs kom txo qhov mob o thiab mob.

• Qee cov NSAIDs tuaj yeem yuav tom cov khoom lag luam (OTC). Cov no suav nrog tshuaj aspirin, ibuprofen (Advil, Motrin), thiab naproxen (Aleve, Naprosyn).
• Lwm cov NSAIDs yog kws kho mob tau sau tseg.
• Tham nrog koj tus kws kho mob lossis kws muag tshuaj ua ntej siv cov tshuaj NSAID ntev li niaj hnub siv.

Koj kuj tseem xav tau cov tshuaj muaj zog los tswj qhov mob thiab o, xws li:

• Corticosteroid txoj kev kho (xws li prednisone) siv rau lub sijhawm luv
• Sulfasalazine
• Ib txoj kev siv tshuaj tua kab mob TNF-inhibitor (xws li etanercept, adalimumab, infliximab, certolizumab lossis golimumab)
• Ib qho roj ntsha inhibitor ntawm IL17A, secukinumab

Kev phais mob, xws li hloov ntsag, tuaj yeem ua tiav yog tias mob mob lossis mob pob qij txha hnyav.

Cov kev tawm dag zog tuaj yeem pab txhim kho posture thiab ua pa. Pw ncaj ncaj rau ntawm koj sab nraum qab thaum hmo ntuj tuaj yeem pab koj kom nyob tus li qub.

Lub chav kawm ntawm tus kab mob yog qhov nyuaj rau kev twv ua ntej. Sij hawm dhau sijhawm, cov cim thiab cov tsos mob ntawm AS flareup (rov huam dua) thiab ntsiag to (kev kho dua). Feem ntau ntawm cov neeg muaj peev xwm ua haujlwm tau tshwj tsis yog tias lawv muaj kev puas tsuaj ntau rau ntawm lub duav lossis tus txha nraub qaum. Koom tes nrog kev txhawb nqa ntawm lwm tus neeg uas muaj qhov teeb meem qub feem ntau tuaj yeem pab tau.

Kev kho nrog NSAIDS feem ntau txo qhov mob thiab o. Kev kho mob nrog TNF inhibitors thaum ntxov ntawm tus kab mob zoo li maj mam ua mob txha caj qaum.

Tsis tshua muaj, cov neeg muaj ankylosing spondylitis tej zaum yuav muaj teeb meem nrog:

• Psoriasis, daim tawv mob mus ntev
• O hauv lub qhov muag (iritis)
• O hauv hnyuv (colitis)
• Lub plawv dhia tsis zoo
• Caws pliav lossis tuab ntawm cov ntaub so ntswg mob
• Caws pliav lossis ntsuas ntawm lub plawv aortic valve
• Cov pob txha nraub qaum raug mob tom qab lub caij nplooj zeeg

Hu rau koj tus kws khomob yog:

• Koj muaj tsos mob ntawm ankylosing spondylitis
• Koj muaj ankylosing spondylitis thiab pib tsim cov tsos mob tshiab thaum kho

Spondylitis; Spondyloarthritis; HLA - Spondylitis

• Pob txha taub hau
• Cervical spondylosis

Gardocki RJ, Chaw Ua Si AL. Degenerative mob ntawm thoracic thiab lumbar nqaj qaum. Hauv: Azar FM, Beaty JH, Canale ST, eds. Campbell's Kev Ua Haujlwm OrthopedicsCov. 13th ed. Philadelphia, PA: Elsevier; 2017: cha 39.

Inman RD. Lub spondyloarthropathies. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 26th ed. Philadelphia, PA: Elsevier; 2020: chap 249.

van der Linden S, Xim av M, Gensler LS, Kenna T, Maksymowych WP, Taylor WJ. Ankylosing spondylitis thiab lwm yam ntawm axial spondyloarthritis. Hauv: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, eds. Firestein & Kelly Cov Ntawv Phau Ntawv RheumatologyCov. 11th ed. Philadelphia, PA: Elsevier; 2021: chap 80.

Ward MM, Deodhar A, Gensler LS, li al. 2019 Kev Hloov Kho ntawm American College ntawm Rheumatology / Spondylitis Association ntawm America / Spondyloarthritis Kev Tshawb Fawb thiab Kho Network Cov lus pom zoo rau kev kho tus mob ankylosing spondylitis thiab nonradiographic axial spondyloarthritis. Kev Kho Mob Txhaum Cai Res (Hoboken). 2019; 71 (10): 1285-1299. PMID: 31436026 pubmed.ncbi.nlm.nih.gov/31436026/.

Werner BC, Feuchtbaum E, Shen FH, Samartzis D. Ankylosing spondylitis ntawm ncauj tsev menyuam nqaj qaum. Hauv: Shen FH, Samartzis D, Fessler RG, eds. Phau Ntawv ntawm Npaws NcaujCov. Philadelphia, PA: Elsevier Saunders; 2015: chap 28.