Aortoarteriit nonspecific: Zviratidzo neMarapirwo Nzira

Pari zvino pane akawandisa zvirwere zvinogona kukanganisa siyana nhengo uye muviri enyika. Asi pakati pavo pane vaya vanosarudza kusarudza imwe pabonde. Munyaya ino, isu tinyatsoziva rimwe zvirwere izvi - ndiko aortoarteriit nonspecific, izvo kazhinji chirwere hadzi pabonde, uye vechiduku. The anowanzodanwa chirwere chirwere munyika Asian. Ngatitarisei ayo zvinokonzera, zviratidzo, uye panguva imwe chete kukurukura kana zvichibvira kutsungirira zvokurwara ichi.

Musimboti chirwere

Nonspecific aortoarteriit chinhu rheumatic chirwere umo pane kurasikirwa romukati pose arteries uye awo. Kana kushoma mberi, ari vascular rusvingo thickening, mvere tsandanyama rukoko anotanga kuputsa uye ne connective zvinyama, uye ropa midziyo kuonekwa granulomas rinoumbwa muchitokisi hombe.

Somugumisiro pezvakaitwa zvakadaro ropa midziyo richikura uye kuzvimba hwapedyo imwe aneurysm. Kana muitiro haagumiri ipapo painoguma ari unooma pamusoro kwakavharwa nenyama fibers pakati mvere tsandanyama tishu. Tangai kutambura nhengo uye munyama nokuda ropa riyerere vasingadzoreki. Munyika dzakawanda hurongwa kupatsanura zvirwere, hosha mumwe ane pachake remitemo rayo, kwete kunze nonspecific aortoarteriit. ICD M31.4 paakavapa iye bumbiro remitemo (kutsemuka Arch chirwere).

Zvinokonzera chirwere

Saka kure, zvinokonzera kuti kutsamwisa kukura chirwere ichi, uye hauna dzatangwa. Vanotsvakurudza Most vari kuita nyaya iyi, muri pfungwa kuti hazvisi yokupedzisira basa iri kuridzwa ne zvirwere, izvo zvinozoita kuti immunodeficiency inoti. pfungwa yakadaro rakaumbwa nokuti kuti non-chaizvo aortoarteriit kazhinji chokuita nezvirwere, izvo kwakavakirwa zvirwere zvirwere.

Pari, pane boka remasayendisiti vari vachida nyasha dzidziso autoimmune chirwere kukura. Uchapupu kuti ndiyo vasabatwa varwere yeplasma antiaortalnyh antibodies.

Tinogona kutaura kuti mashandiro ose autoimmune chirwere chinogona yasimbiswa, asi kana zviri chikuru, kana ari kupindura kushoma - Unoreva kure zvakaoma.

kupatsanura zvirwere

Aortoarteriit nonspecific rinogona mhando dzakasiyana zvichienderana zvakakanganisa nzvimbo:

1. Mhando rokutanga - iyi nyaya akarova kutsemuka chete Arch uye zviduku mapazi kuti riwedzere nawo.
2. In yechipiri mhando vanokanganiswa tsinga iri thoracal uye abdominal.
3. The mhando wechitatu - kukanganiswa kutsemuka yokufeva pamwe thoracal uye abdominal.
4. Wechina kunoratidzwa maronda ari pulmonary tsinga.

Nokuti chero zano kana kutanga nonspecific aortoarteriit (Takayasu nechirwere), urema anotyisidzira kurwara kakawanda. Kunyanya kana chirwere kunonoka.

symptomatology chirwere

Aortoarteriit nonspecific zviratidzo zvakasiyana, izvozvo zvinoenderana chimiro chirwere. Takayasu chirwere angava chisingaperi uye rikwanise kutotanga.

The chenjera chokutambudzika chirwere kunoratidzwa anotevera zviratidzo:

• General kuneta.
• Panguva yechiitwa, marwadzo mune tsandanyama uye mapfundo.
• Rinooneka haemorrhagic mapundu.
• Iva erythema nodosum.
• Kuwedzera miganhu mwoyo.
• Rinooneka systolic uye pano neapo diastolic kunyunyuta.
• Rare zviitiko abdominal marwadzo.
• Kana isu tiite rabhoritari nemiedzo, vakaratidza mwero kupererwa, kuvapo C-reactive mapuroteni.

Kazhinji, kuratidzwa zviratidzo zvakadai misdiagnosed - "dzinonzi rheumatoid arthritis", "TB" kana "sepsis." Izvi, zvinosuruvarisa rinowanikwa muna 95% nyaya.

Kufambira mberi chirwere pavaipfuura chirwere

Kana nzendo chirwere rokutanga havana kutora chinobudirira matanho kurapa nayo, zvokurwara ava chisingaperi. Symptomatology kwatova vakasiyana kuti rikwanise chokutambudzika;

• Munenge hapana kupomba rumwe rutivi, uye dzimwe nguva zvose.
• Varwere kazhinji chokunyunyuta pamusoro kurwadziwa wamativi, kuti muwanze mutoro chete yakakura.
• Hands simba, zvakaoma kuti vanhu kubata zvinhu.
• Kazhinji anova nzwa dzungu, izvo zvingaita kuti nokurasikirwa chavanoziva.
• Paunoshanya imwe ophthalmologist padzakacherechedza zvachinja fundus.
• Sezvo izvi inobatanidzwa kazhinji kubva coronary arteries, unogona kuonekwa ischemic kurwisa.
• Kukurirwa ari abdominal yeropa vanotanga kutambura itsvo.
• Chetsinga Zvirwere zvinozarurwa sezvo vasingadzoreki kutarisirwa uye ndangariro, akaderedza kushanda chinzvimbo.
• Kana optic etsinga zvinovhiringidzika, ipapo anotambura chiratidzo, chiratidzo kaviri sokuti, kungava bofu rimwe ziso.
• Nezvokupindira of pulmonary tsinga inoenda kukura kupfupika mweya, kurwadziwa muchipfuva.
• Kutambura zvenguvo maoko.
• Kana nonspecific aortoarteriit kupararira kwacho kunotanga huru arteries, izvo kazhinji kunotungamirira kune vawedzere BP nokuda aienda rwengarava ropa.

Kazhinji rikwanise chokutambudzika chirwere unova chisingaperi kwemakore 6-8. Varwere vanofanira vasingafariri kana vari kuramba uchinetswa muutera, nomusoro, kurwadziwa weboka guru arteries, vakadhakwa Kufambisa uye ndangariro. Unofanira rakagara kuongorora zvizere kuti asimbise kuongororwa zvakarurama.

kuongorora chirwere

Kana paine fungidziro vasiri zvakananga aortoarteriit, mangwanani chirwere kunokosha chaizvo. chirwere ichi kunozivikanwa vanachiremba, kana pane zvinotevera zviratidzo:

• Kana pane musiyano rinokosha BP mumaoko siyana.
• Pulse zvikuru kusimba kana pasina detectable.
• Pane inoratidza claudication.
• Kana kuteerera ruzha kuchengetwa yeropa.
• Kuongorora kwakaratidza tsinga aienda.
• Insufficiency of kutsemuka vharuvhu.
• Persistent kuwedzera kumanikidza.
• ESR ichiwedzerwa nokuda kwechikonzero.

Pakupedzisira, kubatsira rokuongorora zvinotevera ongororo:

1. Nemakemikari Kuongororwa kweropa chinoratidza muropa abnormalities kuti vari runozivisa chirwere ichi.
2. Ultrassom kuongorora nhumbi kuongorora kwavo mamiriro uye mwero ropa riyerere.
3. Angiography pamwe Kusiyana jekiseni anoona arterial constriction.
4. Chest X-ray kuwanikwa nzvimbo maronda ose yeropa uye pulmonary tsinga.
5. Echocardiography kuongorora kushanda mwoyo.
6. By electroencephalography anogona kuziva kuvhiringidzika chepfungwa tsinga.

Saka, chero chirwere, kusanganisira akadai nonspecific aortoarteriit, nhoroondo zvokurapa rinotanga zvizere kuongorora, iyo ndehwokuti kugadzirisa kuongorora chirwere.

differential kuongorora chirwere

Zvakakosha chaizvo kuti chirwere kusiyanisa aortoarteriit vachiberekwa anomalies pamusoro vascular emuviri uye thromboembolism. Nokuti yokupedzisira kunoratidzwa kusachengeteka kukuru nzira zvichibvira paumbwe imwe ropa clot iri mhango mwoyo tsandanyama.

Chimwe chinhu chinokosha ndechokuti asiri yakananga kunokanganisa aortoarteriit boka midziyo, apo nokuti vachiberekwa anomalies vanotambura zvimwe arteries.

Kana iwe vimba chirwere renovascular neBP, zvakakosha kuyeuka kuti rinogona kuva atherosclerosis uye renal nemidziyo. Kana aortoarteriit nonspecific hwapedyo kunyanya vakadzi vaduku, atherosclerosis kunokanganisa varume vakuru.

imwe ongororo yakakwana uye vanokwanisa nyanzvi chete kuchakubatsira kuita zvokuongorora uye kutanga kunobudirira kurapwa.

Clinical syndromes mukati zvokurwara

Sezvo zvokurwara ichi kunogona kukanganisa zvikamu siyana midziyo kupa ropa kuti zvomukati, zvinokwanisika kuti govera zvekuchipatara syndromes akawanda:

1. Deficiency Syndrome ropa kuyerera peripheral. Panguva iyoyo pane kurwadziwa ari maoko chete nokunzwa chiveve muruoko minwe. Kana akarova ne ari vertebral arteries, kurwadziwa kumashure ikoko.
2. Zvemwoyo chirwere - iri chokuita kukura anondibatsira kutenderera. Anogona rokuongorora kuti zviratidzo myocarditis, ischemia.
3. Kana njodzi kutsemuka chematenga, kuti kukura cerebrovascular syndrome. Kunoratidzwa musoro, akaderedza chiratidzo, kuvhiringidza chepfungwa kutenderera.
4. Abdominal chirwere kunoratidzwa kurwadziwa mudumbu, inova paroxysmal zvakasikwa. kuratidzwa ichi kunowanzoitika munzvimbo maronda ari abdominal yeropa.
5. NeBP chirwere - hunoratidzika migumisiro maronda ari renal arteries.

kurapa

Kana nechirwere kuti "nonspecific aortoarteriit" kurapwa zvichiitirwa:

1. Chinokosha kukanganisa ainyanya kuzvimba, zvichida nokuderedza kuti kushoma.
2. Kuzorwa ischemic matambudziko.
3. Bvisai kuratidzwa neBP.

Zvakadini kana munhu ane asiri yakananga aortoarteriit? Chirwere akaita miedzo basa, nyanzvi basa - kuvaka kurapwa zvaiitwa. Zvipatara angava sezvinotevera:

• Mishonga.
• Surgery.

Funga uchapupu uye zvinoitwa yega.

kurapwa zvinodhaka

Mishonga ushandiswe aortoarteriit kana tichifunga kwokuomerwa murwere ezvinhu uye kuerera zvechadenga kushoma. Zvinotevera zvinodhaka ushandiswe unowanzosangana:

• "Prednisolone" mune imwe mari 1-2 MG chete kilogram nokushivirira uremu. Rubvumo rinoitwa kuti 1-2 mwedzi.
• Kana kuzvimba ane simba hunhu, kunoratidzwa kugamuchira aminohinolinovogo zvinodhaka Somuenzaniso, "ita Lago" kuti 0.25 d
• Basic kurapa inobva negashiro "methotrexate". The chipimo chemushonga iri 7-10 MG pa mativi mita muviri huri nharaunda. Kugamuchirwa - kamwe pavhiki.
• Ebetsero vamiririri vane anticoagulants, cardiac uye zvinodhaka kuti kudzikisa BP.

Drug jekiseni rine chimiro hunogara, kana pasina kuvandudzika kana pane nemuumbi nokuvhiringidzirwa yayo, pfungwa, Zvinokurudzirwa kushandisa kuvhiya kupindira.

kuvhiya kurapwa

Kana kuchinja dzokurapa regai kubatsira, uye mamiriro ezvinhu ratowedzera, vanofanira kushandisa kuvhiya hanya. Kuvhiya kunobatsira kudzorera ropa kuyerera kune mapazi uye munyama. Asi chinofanira kurangarirwa kuti kushoma inofanira kumiswa pamberi kuvhiya. Kune nzira dzakawanda kuti yokurapa mhando iyi:

• Endarterectomy. It rinoitwa pamberi yoga segmental occlusion pamusoro arteries, anofamba zvakananga kubva yeropa.
• Agnioplastika akaita kana pane kuchinja nomumwe nhumbi neitsvo.
• Yokunzvenga kusonanidzwa rinoitwa kushandisa chakaita zvokugadzirwa vascular prosthesis. kupindira kwakadaro kunobatsira vakawanda vascular maronda.

Pashure pokuvhiyiwa vapore nguva inokosha, zvaidiwa chiremba audzwa.

Mazano varwere

Takazoziva chii aortoarteriit nonspecific zviratidzo uye kurapwa vakanga vaiona, asi murwere Zvinokosha zvakaenzana kuchengeta zvinotevera:

1. Mumwe murwere anofanira kuziva kuti kurapwa kwezvirwere ichi zvinoda nguva uye kuchengetwa zvose yachiremba kugadza.
2. Zvakakodzera kuomerera Zano uye chipimo chemushonga kurapwa anenge zano chiremba.
3. Sezvo achitora yakawanda zvinodhaka, pane mukana siyana nemigumisiro panguva mushonga. Kuderedza navo, zvinokosha narwo dzose bvunzo uye zvichipfuura nemiedzo.
4. Kana Kushatiswa kudiwa azivise chiremba.

Kana ukaramba vanorumbidza izvi, mishonga yacho chirwere ichava ibudirire.

The fungidziro varwere

Zvinosuruvarisa kuti kubvisa non-zvakananga aortoarteritis zvisingabviri, asi kana zvose chiremba kunenge uye inoshanda kurapwa kunogona kuzadzisa kanganwiro. Izvi zvichaita kuti varwere kuti basa senguva mabasa uye kunzwa marwadzo.

Kubudirira kurapwa kunoenderana kwokuomerwa kuzvimba uye kuvapo yematambudziko, uye sei kururama uye kumhanya nechirwere. Saka somugumisiro yokurapa yakanga yakanaka, zvinokosha kuona chirwere chichiri kutanga.

Special matanho chokudzivirira haana inopiwa.

chirwere Chero kunoda chakakomba nzira, nzira bedzi kuzadzisa kuvandudza kana kunyange kukunda chirwere. Chengetedza utano hwako uye firimu nguva - saka unogona kuona abnormalities vachiri Danho uye kusarudza kunobudirira kurapwa.