Mem hluav-hauv-Khob Kev Rauv Txawv

Zoo Siab

• Txheej txheem cej luam
• Ua rau mem hluav-hauv-khob tsis zoo
• Cov tsos mob ntawm mem hluav-hauv-khob deformity
• Kev kuaj xyuas lub ntsej muag-lub khob ua kom tsis haum
• Kho cov cwj mem-hauv-khob tsis zoo
• Qhov kev xam pom yog

Txheej txheem cej luam

Pencil-hauv-khob deformity yog qhov tsis tshua muaj pob txha pob txha feem ntau cuam tshuam nrog kev mob hnyav ntawm psoriatic mob caj dab (PsA) hu ua kev mob caj dab. Nws kuj tseem tuaj yeem tshwm sim nrog mob caj dab (RA) thiab scleroderma. “Mem hluav-hauv-khob” piav qhia tias cov pob txha cuam tshuam zoo li cas hauv kev xoo hluav taws xob:

• Qhov kawg ntawm tus pob txha tau eroded mus rau hauv lub ntsej muag hliav duab.
• Tus xaum qhuav no tau npog lub pob txha uas txuas ntxiv rau hauv lub khob.

Mem hluav-hauv-khob deformity yog qhov tsis tshua muaj. Kev mob caj dab mob cuam tshuam tsuas yog li ntawm 5 feem pua ​​ntawm cov neeg muaj PsA thiab ntawm cov neeg muaj mob caj dab. Peb feem ntau yuav saib cov cwj mem-hauv-khob tsis haum nrog PsA.

Yog tias koj xoo hluav taws xob lossis xoo hluav taws xob pom kev txawv txav ntawm lub ntsej muag-xaum khob, nws yog ib qho tseem ceeb kom pib kho sai li sai tau kom qeeb los sis txiav qhov cuam tshuam ntxiv. Yog tsis muaj kev kho mob, kev sib koom tes rhuav tshem tau sai.

Thawj cov pob qij txha uas raug cuam tshuam yog feem ntau yog tus thib ob thiab peb tus ntiv tes sib txuas (cov pob txha tsis sib xws). Tus mob tseem tuaj yeem cuam tshuam koj cov ntiv taw pob qij txha.

Txawm hais tias xaum xaum-lub khob ua rau lub ntsej muag feem ntau pom nyob rau hauv PsA, lwm yam mob ntawm kev mob caj dab uas cuam tshuam rau cov pob txha ntawm koj tus txha nqaj qaum thiab nqaj (spondyloarthropathies) kuj tseem tuaj yeem ua rau qhov tsis zoo ntawm cov ntiv tes thiab ntiv taw. Zoo li, nws tshwm sim tsis tshua muaj hauv:

• mauj kev sclerosis (scleroderma)
• Behcet's kab mob
• mauj lupus erythematosus

Ua rau mem hluav-hauv-khob tsis zoo

Mob caj dab mutilans thiab nws cov yam ntxwv ntawm tus cwj mem qhuav-hauv-lub khob tsis ua haujlwm yog daim ntawv tsis zoo tshaj plaws ntawm kev tsis kho.

Cov laj thawj ntawm PsA tseem tsis tau nkag siab. Nws suav hais tias yog kev cuam tshuam nyuaj ntawm noob caj noob ces, lub cev tsis ua haujlwm, thiab ib puag ncig cov khoom. Txog ntawm cov neeg muaj tus mob psoriasis txhim kho PSA.

Muaj tsev neeg muaj keeb kwm mob psoriasis ntau dua qhov koj yuav muaj mob psoriasis thiab PsA. Tab sis muaj qhov sib txawv caj ces sib txawv ntawm psoriasis thiab PsA. Koj yog peb mus rau tsib zaug feem ntau yuav tau PsA ntau dua li qhov koj mus rau ncaus psoriasis.

Kev tshawb fawb caj ces tau pom tias cov neeg muaj PsA uas muaj ob lub noob ib txwm (HLA-B27 lossis DQB1 * 02) muaj kev pheej hmoo ntawm kev tsim muaj kev mob caj dab.

Tej yam ib puag ncig xav pab rau PsA muaj xws li:

• kev ntxhov siab
• kev kis mob (xws li HIV lossis tus kab mob streptococcal)
• kev mob mus rau pob qij txha (tshwj xeeb nrog cov menyuam yaus)

Cov tsos mob ntawm mem hluav-hauv-khob deformity

'Pencil-hauv-khob tsis ua haujlwm yog lub pob txha tsis tshua muaj tshwm sim. Kev xoo hluav taws xob xoo hluav taws xob ntawm qhov deformity no qhia cov pob txha cuam tshuam nrog qhov kawg ntawm pob txha yaig mus rau hauv qhov ua kom pom cov cwj mem xaum qhuav. Tus xaum qhuav no tau npog lub pob txha uas txuas ntxiv rau hauv lub khob. '

Cov tib neeg uas muaj mem hluav-hauv-lub khob deformity tawm los ntawm PsA tej zaum yuav pom cov tsos mob ntawm daim ntawv no ntawm kev mob caj dab. Cov tsos mob ntawm PSA muaj ntau yam sib txawv thiab tuaj yeem zoo li cov ntawm lwm cov kab mob:

• o cov ntiv tes lossis ntiv taw (dactylitis); cov kev tshawb pom pom dactylitis nyob rau hauv cov neeg muaj PsA
• sib koom tes txhav, o, thiab mob, feem ntau hauv plaub lossis tsawg dua cov pob qij txha thiab asymmetric (tsis muaj qhov sib txuam ntawm ob sab ntawm koj lub cev)
• ntsia thawv hloov, nrog rau pitting thiab sib cais ntawm cov ntsia hlau los ntawm tus ntsia thawv txaj
• mob caj dab mob
• mob pob qij txha ntawm txha nraub qaum thiab mob pob qij txha loj (spondylitis)
• o ntawm ib lossis ob leeg pob qij txha (sacroilitis); ib txoj kev tshawb nrhiav tau pom tias ntawm cov neeg muaj PsA muaj mob sacroiliitis
• o ntawm cov nqaij ntshiv, qhov chaw uas mob caj dab los yog qag nkag rau hauv koj cov pob txha (enthesitis)
• o ntawm txheej nruab nrab ntawm lub qhov muag, ua rau liab thiab qhov muag plooj (uveitis)

Yog tias koj muaj xaum qhuav-hauv-khob qhov ua kom tsis haum, koj tuaj yeem ua cov tsos mob no:

• nce kev mus ncig ntawm daim ntaub overlying ua ke
• kev rhuav tshem cov pob txha hnyav (osteolysis)
• Lub “Opera iav” lossis “telescopic” ntiv tes, uas cov pob txha pob txha poob, uas tsuas yog tawv nqaij xwb

Kev kuaj xyuas lub ntsej muag-lub khob ua kom tsis haum

PsA feem ntau tsis mus kuaj mob, vim nws cov tsos mob sib txawv thiab tsis muaj kev pom zoo ntawm cov txheej txheem. Txhawm rau pab cov qauv kuaj mob, ib pab pawg neeg txawv teb chaws tau tsim cov txheej txheem rau PsA lub npe hu ua CASPAR, kev faib hom rau tus mob psoriatic mob caj dab.

Ib qho ntawm cov teeb meem yog tias mob caj dab tshwm sim ua ntej ntawm tawv nqaij mob psoriasis mob hauv cov neeg uas muaj PsA. Yog li cov tsos mob ntawm daim tawv nqaij yuav tsis qhia qhov tsis meej. Ib qho ntxiv, cov tsos mob ntawm tus mob psoriasis thiab PsA tsis zoo li qub - lawv tuaj yeem flare thiab qis dua.

Koj tus kws kho mob yuav siv keeb kwm kev mob nkeeg, suav nrog koj tsev neeg li keeb kwm kho mob. Lawv yuav nug koj txog koj cov tsos mob:

• Lawv mob hnyav npaum li cas?
• Koj tau nyob ntev npaum li cas?
• Puas yog lawv tuaj thiab mus?

Lawv tseem yuav ua qhov kev soj ntsuam lub cev kom zoo.

Txhawm rau kom paub tseeb tias kev kuaj mob ntawm kev mob caj dab thiab cov cwj mem ntsej hauv lub ntsej muag, koj tus kws kho mob yuav siv ntau dua ib yam kev sim ntsuas, suav nrog:

• Kev xoo hluav taws xob
• sonograph
• MRI scan

Koj tus kws kho mob yuav saib seb cov pob txha puas tsuaj npaum li cas. Sonography thiab MRI kev kos duab tuaj yeem muab cov duab zoo dua tsis muaj dab tsi tshwm sim. Piv txwv li Sonography, tej zaum yuav pom tus mob tias tseem tsis muaj tsos mob dab tsi. MRI tuaj yeem muab cov duab ntxig dua ntawm kev hloov me me hauv koj cov pob txha qauv thiab cov nqaij mos uas nyob ib puag ncig.

Muaj tsawg tsawg tus kab mob uas yuav cuam tshuam nrog mem tes-hauv-khob deformity. Yog tias koj tsis muaj cov tsos mob ntawm daim tawv nqaij ntawm psoriasis, koj tus kws kho mob yuav pom kev kuaj ntshav ntawm rheumatoid mob caj dab thiab lwm yam kab mob uas tuaj yeem ua tus mob no.

PsA yog misdiagnosed. Tab sis kev ua tsis ncaj ncees lawm ntawm mem hluav-hauv-lub khob deformity tsis zoo li, vim nws cov duab X-ray sib txawv. Koj lwm yam tsos mob yuav coj tus kws kho mob mus cuag kom paub qhov mob tseem ceeb.

Kho cov cwj mem-hauv-khob tsis zoo

Lub hom phiaj ntawm kev kho rau tus cwj mem-hauv-khob tsis haum yog:

• tiv thaiv kev ua kom tsis muaj pob txha txuas ntxiv
• muab tshuaj kho mob
• muab kev pabcuam rau lub cev thiab kev ua haujlwm kom tswj tau txoj haujlwm ntawm koj txhais tes thiab txhais taw

Cov kev kho tshwj xeeb yuav yog nyob ntawm qhov mob hnyav ntawm koj deformity thiab ntawm qhov pib vim li cas.

Rau PsA-cuam tshuam cwj mem-hauv-khob tsis ua haujlwm, koj tus kws kho mob tuaj yeem sau tshuaj nonsteroidal anti-inflammatory tshuaj (NSAIDs) kom txo cov tsos mob. Tab sis cov tshuaj no yuav tsis txwv pob txha puas.

Txhawm rau kom qeeb los sis txiav pob txha, tus kws kho mob tuaj yeem sau tshuaj kho cov kabmob antirheumatic (DMARDs) lossis qhov ncauj me me ntawm qhov ncauj (OSMs) xws li:

• methotrexate
• tofacitinib (Xeljanz)
• tshuaj tua kab (Otezla)

Ib pawg ntawm cov tshuaj hu ua biologics inhibit qhov mob necrosis factor (TNF-alpha), uas yog lub luag haujlwm hauv PsA. Piv txwv li:

• etanercept (Enbrel)
• infliximab (Remicade, Inflectra, Renflexis)
• adalimumab
• golimumab
• certolizumab pegol

Cov roj ntsha ua txhawm rau thaiv interleukin 17 (IL-17), uas txhawb kev o, suav nrog:

• secukinumab (Cosentyx)
• ixekizumab (Taltz)
• brodalumab (Siliq)

Lwm yam roj ntsha uas koj tus kws kho mob yuav sau muaj xws li:

• ustekinumab (Stelara), uas yog cov tshuaj loog tiv thaiv lub cev liag-IL-23 thiab IL-12
• abatacept (CTLA4-Ig), uas thaiv kev ua haujlwm ntawm T cell, ib hom cell tseem ceeb rau kev tiv thaiv kab mob tiv thaiv kab mob

Txoj kev kho ua ke yog tej zaum yuav xav tau nyob rau hauv cov mob feem ntau. Txawm tias ntau dua cov tshuaj muaj nyob rau hauv kev txhim kho lossis hauv kev soj ntsuam hauv chav kawm uas tsom lub hlwb tshwj xeeb lossis lawv cov khoom xav tias ua rau mob thiab pob txha puas tsuaj.

Kev siv dag zog thiab kev tawm dag zog hauv lub cev tuaj yeem pab rau cov kev mob tshwm sim, tswj kev yoog raws, txo kev ntxhov siab ntawm tes thiab taw, thiab tiv thaiv cov pob qij txha los ntawm kev raug mob.

Sab laj nrog koj tus kws kho mob txog kev sib txuas nrog kev kho mob tej zaum yuav zoo tshaj rau koj. Tsis tas li ntawd nug seb puas muaj kev sim saib mob puas yog ib qho kev xaiv ua tiav. Nco ntsoov tham txog cov kev mob tshwm sim ntawm DMARDs, qhov ncauj me me molecules (OSMs), thiab cov roj av. Kuj tseem xav txog tus nqi, vim tias qee cov tshuaj tshiab yuav kim heev.

Qee qhov xwm txheej, kev phais kho dua tshiab lossis kev sib koom tes sib koom tes yuav yog qhov kev xaiv.

Kev phais mob rau PSA tsis yog muaj ntau: Ib txoj kev tshawb nrhiav pom tias tsuas muaj 7 feem pua ​​ntawm cov tib neeg uas muaj PsA tau phais pob qij txha. Xyoo 2008 tshuaj xyuas ntawm PSA thiab kev phais mob sau tseg tias kev phais mob qee qhov ua tau zoo tuaj yeem hnov ​​mob thiab txhim kho lub cev.

Qhov kev xam pom yog

Cwj mem-hauv-khob tsis tuaj yeem kho tsis tau. Tab sis ntau txoj kev siv tshuaj kho mob tuaj yeem qeeb lossis nres txuas ntxiv pob txha tsis zoo. Thiab tseem haj yam muaj siab dua cov tshuaj tshiab nyob hauv kev txhim kho.

Kev tawm dag zog lub cev tuaj yeem pab ntxiv dag zog rau cov leeg thiab ua kom koj cov pob qij txha, tes, thiab taw ua haujlwm yooj yim thiab ua haujlwm. Tus kws qhia ua haujlwm yuav tuaj yeem pab nrog cov cuab yeej siv kom pab tau txoj kev mus ncig thiab ua haujlwm txhua hnub.

Noj zaub noj kom zoo los tiv thaiv kev ua rog thiab ua kom tawm dag zog tas li yuav pab tau koj kev noj qab haus huv tag nrho.

Pib kev sab laj lossis koom nrog pawg txhawb pab yuav pab koj tiv thaiv kev ntxhov siab thiab xiam oob qhab. Lub Pob Txha Lub Pob Txha thiab Lub Tebchaws Psoriasis Foundation ob leeg muab kev pab dawb.