Isifo sokuphefumla esongezelelweyo (AERD) esaziwa ngokuba yiSamter's Triad, yimeko yezonyango enzima ebandakanya indibaniselwano yezinto ezintathu eziphambili. i-asthma, iiaspirin ukungahambi, yaye iipolyps ngeempumlo. Ukuba ucinga ukuba unokuba ne-AERD okanye ukhathalele umntu onokuthi, eli nqaku liphonononga kanye ukuba yintoni na, indlela ukunganyamezeli i-aspirin kunye ne-asthma kunokuchaphazela ngayo abantu, kwaye loluphi unyango olukhoyo.
I-AERD yimeko yokuphefumla enezinto ezintathu- isifuba, i-polyps ephindaphindayo, kunye nobuntununtunu kwi-aspirin kunye nezinye iziyobisi ezingezizo-steroidal ezichasayo (njenge-ibuprofen, naproxen okanye i-diclofenac.
Le meko ifumana igama layo kwingcali yokugonywa kwamajoni omzimba uMax Samter, owayichonga okokuqala, ngelixa i-'Triad' ibhekisa kumalungu amathathu aphambili abandakanyekayo.
Xa abantu abane-AERD bethatha i-aspirin okanye ezinye ii-NSAID, bafumana impendulo egwenxa ebangela iingxaki zokuphefumla eziphezulu nezisezantsi. Impendulo ivela phakathi kwemizuzu engama-30-120 emva kokuthatha i-aspirin kwaye ingaba yingozi.
Iimpawu eziphezulu zokuphefumula zibandakanya:
- Ukudibanisa kwamanzi
- intloko ebuhlungu
- Iintlungu zesinus
- Ukukrazula
- Impumlo exineneyo okanye ebalekayo.
- Ukuphulukana nevumba okanye incasa.
Iimpawu zokuphefumla ezisezantsi zibandakanya:
- Ukugubha
- Ukuhlahlela
- Ubungqina bentloko
- Ukuphefumula okunzima.
Kusenokubakho nezinye iimpawu, ezifana neentlungu zesisu kunye nokugabha. Malunga nama-20% abantu nabo banokufumana a ukukhawuleza. Abanye abantu abane-AERD nabo baye bafumane ukusabela okufanayo okuthambileyo ukuya kwephakathi xa besela utywala, obufana newayini ebomvu okanye ibhiya.
Abo bane-AERD bahlala benembali yosulelo lwesifo esinganyangekiyo kunye neepolyps eziphindaphindayo zempumlo. Abanye abantu bafumana ilahleko ngenxa yoko kwaye iimpawu zabo azinakuphendula kakuhle kunyango oluqhelekileyo.
I-AERD luhlobo lwe isifo esiqhutywa yi-eosinophil (EDD), ihamba ne eosinophilic esophagitis kwaye dermatitis atopic.
Yintoni ebangela iSamter's Triad?
Akukho sizathu saziwayo se-AERD. Nangona kunjalo, uphononongo lubonakalisile ukuba abantu banamathuba okuba babe nayo ukuba banesifo sombefu, izehlo eziphindaphindayo zesifo sempumlo, kunye nosulelo lwesono.
Asinguye wonke umntu onesifo sombefu oya kuphuhlisa i-AERD. Uphando lubonisa ukuba i-asthmatics yabantu abadala ine-7% yamathuba okuba ne-AERD, ngelixa abantu abane Isifo sombefu Ngaba i-15% inokwenzeka ukuba ibe ne-AERD. Abo baneesifuba sombefu kunye neempumlo ngeempumlo ukuya kuma-40% kusenokwenzeka ukuba banaso.
Iimpawu kunye neempawu kunokwenzeka ukuba zibonise kuqala xa abantu sele bekhulile kwi-30s nakwi-40s yabo.
Ufunyaniswa njani uSamter's Triad?
Ukufumana isifo esisesikweni se-AERD kunokuba yinkohliso, kuba akukho vavanyo lunye olunokusetyenziselwa ukufumanisa imeko. Endaweni yoko, isifo sonyango senziwe ngokusekwe kwindibaniselwano yeempawu kunye nokuphendula okwenzeka ngokunxulumene ne-aspirin okanye ezinye ii-NSAID. Ngamanye amaxesha kungathatha ixesha ukuphelisa ezinye izizathu kuqala.
Ukuba awuqinisekanga ukuba usabele kwi-aspirin, inkqubo yomceli-mngeni ngokusesikweni inokuqhutywa phantsi kweliso lonyango ukuvavanya impendulo yakho. Olu luhlobo lokucaphukisa iziyobisi apho iingcali zonyango ziya kuthi zinike izigulana ilawulwa ngeedosi zeziyobisi abazithambisayo, ukujonga iimpendulo zazo kunye nokwenza uxilongo ngokupheleleyo.
Ngaba i-AERD isongela ubomi?
I-AERD sisifo esinganyangekiyo esinokubangela iimpawu eziqhubekayo. Ezi mpawu zinokuba nzima, zichaphazele umgangatho wobomi wabo bane-AERD, kwaye ukufumana indibaniselwano efanelekileyo yonyango kunokuba ngumceli mngeni.
Isifo sombefu yenye yezinto ezintathu eziphambili ze-AERD. Isifo sombefu esingalawulekiyo kakuhle, okanye esingaphenduli kakuhle kunyango, sisongela ubomi. Esi sizathu esinye sokuba nabani na one-AERD kufuneka alandele ukulawulwa kakuhle unyango lwe-asthma cwangciso.
Ukutya kunokuchaphazela njani iSamter's Triad?
Ukusela utywala kunokuchaphazela abo bane-AERD. Abanye abantu, umzekelo, bafunyaniswe benamava okusabela xa besela utywala obufana newayini ebomvu okanye ibhiya, kwaye ke ukunciphisa ukusetyenziswa kotywala kunokuba luncedo.
I-Immunologist uMax Samter ekuqaleni wayecinga ukuba iimpawu ze-AERD zinokuqhubeka ngenxa yokusebenzisa ii-salicylates ekudleni. Olunye uphononongo luye lwaphonononga izibonelelo zokutya okune-salicylate esezantsi kwaye kwafumanisa ukuba kunokuphucula iimpawu zempumlo kwabo bane-AERD. Nangona kunjalo, ubungqina abuqinisekanga kwaye uphando oluthe kratya luyafuneka ukuxhasa le ithiyori, ngakumbi njengokutya okune-salicylate ephantsi kubandakanya ukusika ukutya okunempilo okunesondlo, njengeziqhamo kunye nemifuno, ethintelayo kwaye ayilungelanga impilo yakho ngokubanzi .
Endaweni yoko, ezinye iingcali zicebisa ukuba ukutya okune-omega-6 fatty acids kunye ne-omega-3 fatty acids kunokuba kufanelekile kwi-AERD. Uphando ngezibonelelo zokunciphisa ukusetyenziswa kwe-omega-6 fatty acids lubone iziphumo ezilungileyo. Njengabantu abane-AERD bahlala benamazinga aphezulu e-cysteinyl leukotrienes kunye ne-prostaglandin D2 (i-lipids yokuvuvukala), ethathwe kwimetabolism ye-omega-6 fatty acids, ukunciphisa ezi asidi kunokuba luncedo. Iziphumo zophando zibonise ukuba oku kuncitshiswa kuye kwaphucula iimpawu zesono kunye nolawulo lwesifuba. Nangona kunjalo, kuya kufuneka usoloko uqhagamshelana nogqirha ngaphambi kokutshintsha indlela otya ngayo- banokunika elona cebo lililo kunye nendlela yokwenza njalo kwaye bacebise ukuba ngumbono olungileyo na kuwe.
Ngaba iSamter's Triad autoimmune?
Ngelixa uphando kwi-AERD luqhubeka, okwangoku aluthathwa njengemeko yokuzimela. Ngezifo ezizimelayo, izilwa-buhlungu ezihlasela izicwili emzimbeni - oku akukholelwa ukuba kuyenzeka nge-Samter's Triad.
Endaweni yoko, iSamter's Triad ithathwa njengesifo esisekwe kuyo dysregulation engapheliyo yomzimba.
Uphononongo lubonise ukuba abantu abane-AERD bahlala benamanqanaba aphezulu oosinophil kwiipolyps zabo zempumlo kunye namanqanaba aphezulu eosinophils egazini labo. I-Eosinophils ziiseli zokhuselo lomzimba ezidityaniswe nokudumba kwaye zinokukhokelela ekudumbeni okungapheliyo kwimibhobho yomoya.
Kufunyenwe ukuba abantu abane-AERD banengxaki ye-cyclooxygenase enzyme (COX) kwaye bavelise amanqanaba aphezulu e-leukotrienes- okanye iimolekyuli ezivuthayo. Amanqanaba e-leukotrienes anyuka ngakumbi xa i-aspirin ithathwa, iphakamisa ukuba i-AERD inesifo sesifo esidumbayo.
Zeziphi iindlela zonyango ezikhoyo ze-AERD?
Uninzi lwabantu abane-AERD kuya kufuneka basebenzise amayeza mihla le ukuze bajongane nokulawula iimpawu zabo. Kukho iindlela ezahlukeneyo zonyango ezifumanekayo ezicetyiswayo ngokudibene nabanye - unokuxoxa ngeyona ndlela unokukhetha kuyo nogqirha wakho wosapho okanye ingcali.
Ukulawula iimpawu zesifuba
Nabani na one-AERD kufuneka aziphathe iimpawu zesifuba yonke imihla, ngokuthatha amayeza amiselweyo e-corticosteroid, anje ngesithintelo kunye ne-reliever inhalers.
Steroids
Ukudumba kwesinus kunokulawulwa kukusetyenziswa kwe-intra-nasal steroid sprays kunye ne-steroid rinses. I-Oral steroids ingafuneka amaxesha ngamaxesha ukunyanga iipolyps zempumlo.
Utyando lwempumlo
Utyando lwempumlo lunokusetyenziselwa ukususa ii-polyps ezinengxaki. Nangona kunjalo, bahlala bekhula umva, ke esi ayisosisombululo sexesha elide.
Unyango lwentsholongwane
Unyango lwe-De-sensitization lunokusetyenziselwa ukuphucula ukunyamezelana komntu kwi-aspirin. Le ndlela ibaluleke kakhulu kuye nakubani na ofuna ukuthatha i-aspirin ngenxa yesifo sentliziyo okanye iintlungu ezingapheliyo. Kwabanye abantu, ukungafuneki kwezinto kunokuziphucula iimpawu zesifuba, kunciphise iipolyps zempumlo kunye nokunciphisa ukudumba kwesono.
Ukuphepha i-aspirin
Kweminye, ukuthintela i-aspirin kunye nezinye iziyobisi ze-NSAID yeyona ndlela ilungileyo yokunciphisa umngcipheko wokuphendula okwenzekayo. Nangona kunjalo, kunokuba nzima ukunqanda onke la machiza ngokupheleleyo njengoko ahlala emiselwe ezinye iimeko.
Injections
Inaliti ye-Biologic inokuba luncedo kubantu abane-asthma kunye ne-nasal polyps. I-Biologics luhlobo lweziyobisi ezenziwe okanye ezinemithombo yebhayiloji enceda ukuthintela ukudumba.
Ukuba ucinga unokuba ne-AERD, kuya kufuneka uthethe nengcali kwezonyango enokuthi ikunike iingcebiso.
imithombo
I-Aspirin yandisa izifo zokuphefumla
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