Gout ndi Hyperuricemia
Chilimwe chotentha, nyama yokazinga ndi nsomba, zakumwa zoziziritsa kukhosi, mpweya woziziritsa … si "muyezo wanu wa moyo", koma samalani ndi uric acid wokwera kwambiri, zomwe zimayambitsa matenda a gout!
Gu Bingjie, wachiwiri kwa dokotala wamkulu wa dipatimenti ya matenda a nyamakazi ndi chitetezo chamthupi ku Chipatala Choyamba cha Nanjing, anati masiku angapo apitawa, odwala pafupifupi 20 omwe ali ndi hyperuricemia ndi gout amawonedwa tsiku lililonse, 90% mwa iwo ndi amuna, ndipo zaka zoyambira matendawa zikuchepa kwambiri.
Nanga kodi gout imachitika bwanji ndipo n’chifukwa chiyani imafala kwambiri mwa amuna?
Gout imagwirizana ndi kuchuluka kwa uric acid m'magazi
Gout, matenda otupa omwe amayamba chifukwa cha kuyika kwa makristalo a urate m'malo olumikizirana mafupa chifukwa cha kuchuluka kwa uric acid, komanso hyperuricemia ndi gout ndi matenda osiyanasiyana.
Muzochitika zachibadwa, 90% ya uric acid idzayamwanso ndi thupi, ndipo 10% yotsalayo idzatulutsidwa m'thupi mu mawonekedwe a mkodzo, thukuta, ndi ndowe kuti mulingo wa uric acid m'thupi ukhalebe wofanana. Komabe, pamene ma purine ambiri adyedwa mu uric acid wochuluka, kapena kagayidwe ka uric acid sikangathe kutulutsidwa, muyezowo udzasweka, zomwe zimapangitsa kuti uric acid isungidwe m'magazi, ndipo magazi akamayenda m'ziwalo zonse za thupi, m'malo olumikizirana mafupa kudzera mu kuyenda pang'onopang'ono kwa magazi, kutentha kochepa kudzaikidwa kuti apange makristasi a urate, zomwe zimapangitsa kutupa, zomwe zimayambitsa kupweteka kwambiri.
Muzochitika zachibadwa, 90% ya uric acid idzayamwanso ndi thupi, ndipo 10% yotsalayo idzatulutsidwa m'thupi mu mawonekedwe a mkodzo, thukuta, ndi ndowe kuti mulingo wa uric acid m'thupi ukhalebe wofanana. Komabe, pamene ma purine ambiri adyedwa mu uric acid wochuluka, kapena kagayidwe ka uric acid sikangathe kutulutsidwa, muyezowo udzasweka, zomwe zimapangitsa kuti uric acid isungidwe m'magazi, ndipo magazi akamayenda m'ziwalo zonse za thupi, m'malo olumikizirana mafupa kudzera mu kuyenda pang'onopang'ono kwa magazi, kutentha kochepa, kudzaikidwa kuti apange makristasi a urate, zomwe zimapangitsa kutupa, zomwe zimayambitsa kupweteka kwambiri.
N’chifukwa chiyani matenda a gout “amakomera” makamaka amuna?
Kuphatikiza apo, kafukufuku wasonyeza kuti mahomoni, monga olamulira kagayidwe kachakudya kofunikira, amatenga gawo pakupanga ndi kutulutsa uric acid, kuphatikizapo mahomoni ogonana, adrenocorticotropic hormone, thyroid hormone, insulin, ndi zina zotero. Pamene dongosolo la endocrine silikuyenda bwino, kutulutsa kapena kugwira ntchito kwa mahomoniwa kungakhudzidwe, zomwe zimapangitsa kuti uric acid ichuluke, zomwe zimayambitsa matenda a gout.
Palinso kusiyana kwachibadwa kwa mahomoni pakati pa amuna ndi akazi, ndipo ma androgens ndi ambiri mwa amuna ndipo ma estrogen mwa akazi. Estrogen imatha kupititsa patsogolo kutulutsa uric acid komanso kuletsa kupangika kwa urate. Ma androgens, kumbali ina, amaletsa kutulutsa uric acid mu impso ndikuchepetsa kagayidwe kachakudya ka impso, zomwe zimapangitsa kuti uric acid ikhale yambiri m'thupi, motero zimapangitsa kuti ma crystals a uric acid apangidwe mwachangu. Deta ikuwonetsa kuti mwa anthu ambiri, amuna opitilira 95% a gout amapezeka, ndipo azimayi ndi ochepa kuposa 5%, ndipo chiŵerengero cha amuna kwa akazi chili pafupi ndi 20:1.
Kodi ndingachepetse bwanji chiopsezo changa cha gout?
Sikuti kokha, kupezeka kwa gout kapena hyperuricemia kumagwirizananso kwambiri ndi zakudya zosapatsa thanzi komanso zizolowezi za moyo. Chifukwa chake, kuti muchepetse chiopsezo cha gout, mutha kupewa tsiku lililonse pochita izi:
- Lamulirani pakamwa panu: Pewani kudya zakudya zokhala ndi purine yambiri, mutha kudya zakudya zambiri zamchere kuti muchepetse kusungunuka kwa uric acid mumkodzo ndikuwonjezera kuchuluka kwa uric acid yomwe imatuluka.
- Imwani madzi ochulukirapo: M'chilimwe, thupi la munthu limatulutsa thukuta kwambiri, ndipo ngati silikumwa madzi okwanira nthawi yake, limapangitsa kuti magazi azichulukana mosavuta, ndipo kuchuluka kwa uric acid m'magazi kumawonjezekanso, zomwe zimayambitsa gout.
- Kuwongolera Kunenepa: Kunenepa kwambiri si matenda okhawo omwe amakhudza kagayidwe kachakudya, komanso ndi chinthu chodziyimira pawokha chomwe chimayambitsa matenda a hyperuricemia ndi gout chifukwa maselo amafuta amatulutsa ma purines ambiri, omwe amawonjezera kuchuluka kwa uric acid.
- Sunthani miyendo yanu: Kafukufuku wakunja wasonyeza kuti kuchita masewera olimbitsa thupi pang'ono tsiku lililonse (monga kuyenda mwachangu, kuthamanga, kusambira, ndi zina zotero) kwa mphindi 30 mpaka 60, kanayi mpaka kasanu pa sabata, kungachepetse kufalikira kwa matenda a gout.
Kafukufuku Akusonyeza Kuti Kuwala Kofiira Kungachepetse Zizindikiro za Gout
Kuwonjezera pa kukhala ndi moyo wathanzi, mu njira zachipatala zochizira gout, mafupa otupa, ndi ululu zimakhala vuto lalikulu la wodwalayo, pali mabuku ambiri asayansi omwe amanena kuti odwala gout omwe amalandira chithandizo cha kuwala kofiira amatha kusintha kagayidwe ka minofu, kufulumizitsa kuchira kwa mitsempha yowonongeka, ndikufupikitsa nthawi yotupa ndi ululu kuti achepetse ululu wakuthupi ndi wamaganizo wa wodwalayo, ndikulimbikitsa njira yochira, ndipo mu kafukufuku waposachedwapa wawonetsa kuti 88% ya odwala omwe ali ndi gout atalandira chithandizo cha kuwala kofiira asintha kwambiri, ndipo akwanitsa kuthetsa ululu wonse. Mu kafukufuku waposachedwapa wa zachipatala, zawonetsedwa kuti 88% ya odwala gout adasintha kwambiri ululu atalandira chithandizo cha kuwala kofiira, ndipo adakwanitsa kuthetsa ululu wonse.
Zitsimikizo zambiri zachipatala zinanenanso kuti kuwala kofiira kumatha kuyamwa ndi thupi ndi kulowa mwamphamvu, kungathandize kukula kwa mitsempha ya m'mphepete yoonongeka, kotero kuti kupangidwa kwa mitsempha ya myelin kumathandizira kukonzanso ndi kukonzanso mitsempha ya m'mphepete yoonongeka, nthawi yomweyo, kuwala kofiira kumatha kuchepetsa minofu ya m'deralo ya pentazocine, motero kumakhala gawo la mankhwala ochepetsa ululu, zomwe zimathandiza kuchepetsa ululu.
Kabati ya Zaumoyo ya MERICAN yochokera ku chithandizo cha kuwala kofiira imaphatikiza mitundu yosiyanasiyana ya mafunde a kuwala kuti ipange zotsatira zamoyo pakhungu la thupi lonse, zomwe zingathandize kukonza kagayidwe ka minofu ndi thanzi, kukulitsa phagocytosis ndi kutseguka kwa mitsempha yamagazi, ndikuletsa bwino kutulutsa kwa ma cytokines okhudzana ndi ululu, zomwe zimathandiza kuyamwa kwa ma exudates otupa, kuchepetsa ululu wa mafupa a wodwalayo, kuchepetsa index ya uric acid m'magazi, ndikulimbikitsa kusintha kwa zizindikiro zachipatala komanso kukonzanso mafupa.
Masiku ano, gout yakhala "yachinayi pamlingo wapamwamba" pambuyo pa matenda a shuga, kuthamanga kwa magazi ndi kuchuluka kwa mafuta m'thupi. Kutengera moyo wasayansi komanso wathanzi, wowonjezeredwa ndi chithandizo cha kuwala kofiira, ingathe kuchepetsa zizindikiro zosasangalatsa ndikulimbikitsa bwino njira yochira.