Ƙila Har ila yau Za a Aiwatar da Harshen Cikin Gida da Magunguna
An sani cewa mutanen da ke dauke da cututtuka na rheumatoid (RA) suna fuskantar haɗari ga mummunar cututtuka da mace-mace daga cututtukan zuciya-da hadarin da aka kwatanta da ita a cikin mutane masu ciwon sukari na 2. A cikin mutanen da ke dauke da cututtukan arthritis, akwai ƙananan haɗari na ƙwayar cuta na sirri (ciwon zuciya) da kuma mutuwar kwatsam. Yaduwar mummunar ƙwayar cuta ta jiki shine fiye da sau biyu ya fi girma a cikin mutanen da ke dauke da ciwon maganin ƙwayar maganin ƙwaƙwalwar jini idan aka kwatanta da yawancin jama'a.
Cutar da ke tsakanin cututtukan zuciya da cututtuka na rheumatoid yana da hadari kuma ya bayyana cewa yana da alaka da dalilai da dama. Hanyoyin cututtuka na zuciya na zuciya (misali, hauhawar jini, kiba, shan taba, ciwon sukari, high cholesterol), kazalika da alamar ƙwayoyin cutar ta arthritis, suna da gudummawa.
Raunin jijiyoyin jini a Rheumatoid Arthritis: Abin da muka sani
Shekaru da yawa, masu binciken sunyi nazarin ƙungiyar kuma idan ana kulawa da hankali ga cututtukan cututtuka na zuciya da jijiyoyin jini a cikin mutanen da ke dauke da cututtukan cututtuka . An riga ance cewa cututtuka na rheumatoid kanta kanta wani lamari ne mai hadarin gaske don cututtukan zuciya. Abubuwan da masu binciken suka saukar sun hada da:
- Akwai yiwuwar cutar cututtukan zuciya da ke faruwa a farkon wannan cuta na cututtuka na rheumatoid, wanda zai yiwu har ma da kwanan wata kwanan wata.
- Kumburi yana taka muhimmiyar rawa a cikin cututtukan zuciya.
- Mutane da ke dauke da ciwon haukaran jini suna nuna cewa sun inganta atherosclerosis , wanda ake daukar kansa a matsayin yanayin ƙin ƙananan jini. Wataƙila ƙwayoyin ƙwayar cuta na cututtuka na rheumatoid tare da haɗari na cytokines na proinflammatory suna taimakawa wajen samar da plaque.
- Rashin ƙunƙasar ƙwayar cuta na rheumatoid yana taimakawa wajen ƙara yawan ciwon maganin endothelial , da gajiya mai magunguna , da kuma kunnawa da kuma ƙaura na leukocytes (jini mai tsabta) a cikin jini. Adhesion na leukocytes zuwa maganin endothelium na jijiyoyin ƙwayoyi shine haɓaka bambancin tsarin ƙwayar cuta.
- Rashin kullun tsarin da ke hade da cututtukan arthritis na rheumatoid a hade tare da cututtukan cututtukan zuciya na zuciya da jijiyoyin da suke hade da salon rayuwa na iya taimakawa wajen cutar cututtukan zuciya a cikin rheumatoid arthritis.
Me ya sa haɗin ke da mahimmanci?
Kusan rabin yawan mutuwar mutane a cikin cututtuka na rheumatoid suna hade da cututtukan zuciya. Yayinda cutar mace-mace ta karu da kashi 50 cikin dari kuma hadarin cututtuka na zuciya ya karu da kashi 48 cikin dari na wadanda ke dauke da maganin wariyar launin fata idan aka kwatanta da yawan jama'a (Avina-Zubieta).
Mutanen da suka kamu da ciwon maganin jini a cikin lokaci mai tsawo, waɗanda ke da alamar haɗakarwa (watau, rinjayar fiye da gidajen haɗaka), da wadanda ke da nau'in kwayar cuta da anti-CCP (autoantibodies) suna da mummunar haɗari na mace-mace. Sarrafa haɗarin yana da muhimmanci.
EULAR Turawa don Gudanar da Rashin Ƙwayar Lafiya ta Lafiya a RA
A 2009, EULAR (Ƙungiyar Turai ta Rheumatism) ta haɗu da wani ma'aikacin aiki don bayar da shawarwari game da gudanar da hadarin cututtuka na zuciya ga mutanen da ke dauke da ciwon hauka. An sabunta shawarwarin a 2015/2016.
Akwai ka'idoji guda uku waɗanda EULAR ya bayar da kuma shawarwari guda 10 da aka bayar, wanda sabon sabo ne kuma shida aka sauya tun daga 2009.
Mahimman ka'idoji:
1) Doctors dole su kasance da masaniya game da mummunan cututtuka na cututtuka na zuciya da jijiyoyin jini a cikin mutanen da ke dauke da cututtuka na rheumatoid idan aka kwatanta da yawancin jama'a.
2) Masanin ilimin lissafi ya kamata ya tabbatar da cewa ana gudanar da halayen cutar cututtukan zuciya a cikin marasa lafiya na jini da sauran cututtuka masu haɗari na ƙumburi.
3) Yin amfani da NSAIDs (kwayoyin masu maganin kare ƙwayoyin cuta) da corticosteroids ya kamata suyi daidai da shawarwari masu dacewa daga EULAR da ASAS (Bincike na Spondyloarthritis International Society).
Shawarar 10 Ya hada da:
1) Ayyukan cututtuka ya kamata a sarrafa su da kyau a cikin arthritis na rheumatoid, maganin spondylitis , da kuma cututtuka na psoriatic don rage hadarin cututtukan zuciya.
2) Ana ba da shawarar ƙimar cututtukan cututtuka na cardiovacular ga waɗanda ke dauke da ciwon maganin ƙwayar cuta, ƙananan spondylitis, ko cututtukan cututtuka na psoriatic a kalla sau ɗaya a cikin shekaru biyar da yiwuwar bin wata babbar canji zuwa magani.
3) Sanarwar ƙimar cutar cututtukan zuciya a cikin mutane da cututtuka na rheumatoid, spondylitis ankylosing, ko cututtuka na psoriatic ya kamata a yi bisa ga jagororin kasa, da kuma batun SCORE CVD idan ba'a samu jagora ba.
4) Za a yi amfani da yawan cholesterol da highl density lipoprotein cholesterol a cikin kwayar cutar ƙwayar cutar cututtuka, maganin cututtuka da ƙwayoyin cuta, da kuma cututtukan cututtuka na psoriatic da lipids a yayin da aikin cututtuka ya zama ƙaura ko kuma gafara. Wadanda basu da azumi suna yarda.
5) Ya kamata a daidaita yanayin da aka kwatanta da cututtuka na zuciya da jijiyoyin jini don mutanen da ke dauke da ciwon hauka na rheumatoid ta karuwa da 1.5.
6) Ana yin la'akari da matakan maganin ƙananan ashegotrotic da ke damuwa ta amfani da duban dan tayi a matsayin wani ɓangare na kimar cututtuka na zuciya da jijiyoyin jini a waɗanda ke dauke da ciwon maganin ƙwayar cuta.
7) Salon shawarwarin ya kamata ya jaddada abincin abinci mai kyau, motsa jiki na yau da kullum, da kuma shan taba.
8) Gudanar da hadarin cutar cututtukan zuciya ya kamata a yi bisa ga ka'idoji na kasa don ilimin cututtuka na rheumatoid, maganin spondylitis, da rubutun cututtuka na psoriatic. Za a iya amfani da magungunan jini da ka'idodi kamar yadda suke a cikin yawan jama'a.
9) Dole ne a sanya takardun NSAID tare da la'akari da cututtukan arthritis da cututtuka na jini, musamman ga mutanen da ke da cututtukan zuciya da cututtukan zuciya.
10) Don maganin gogewa, dole ne a rage yawan kashi na corticosteroids kuma ya kamata a yi amfani da shi idan an sake gyara ko rashin lafiya. Ci gaba da corticosteroids ya kamata a yi nazarin akai-akai.
Sakamakon binciken da aka gabatar a shekara ta 2016 na ACR
A taron shekara-shekara na Kwalejin Rheumatology na Amurka, wanda aka gudanar a watan Nuwamba 2016, akwai akalla karatu uku da aka gabatar wanda ya shafi hadarin zuciya na zuciya a cikin cututtukan arthritis. Ɗaya daga cikin nazarin (Labari na ID: 664363 ACR Newsroom) ya tabbatar da cewa a tsawon shekaru 15, mutanen da ke dauke da maganin cututtuka na rukuni na biyu suna da hadarin cututtuka na zuciya kamar yadda yawancin jama'a suke yi-wata kudi mai kama da irin ciwon sukari 2.
Wani binciken (Labari na ID: 663451 ACR Newsroom) ya tantance ko mutanen da ke dauke da ciwon maganin ƙwayar cuta amma babu cututtuka na zuciya da cututtukan zuciya suna da alamun rashin ƙonewa. Har ila yau, sun yi la'akari da cewa mummunan mummunar ƙwayar cuta ta mayar da ita ga maganin DMARDs (cututtuka masu maganin cututtuka na cutar) . Masu bincike sun tabbatar da cewa akwai mummunan ciwon kullun kuma ba zai iya amsa maganin DMARDs ba.
Nazarin na uku (Labari na ID: 664367 ACR Newsroom) ya maida hankalin akan maganin cututtukan cututtuka na zuciya da cututtukan zuciya a cikin mutane da cututtukan cututtuka masu ciwo. An kammala cewa duk da cewa akwai magungunan magungunan anti-hypertensive da kuma lipid-lowering, an rage wa marasa lafiya mafi yawan marasa lafiya.
Layin Ƙasa
Tun da daɗewa, yawan ƙwayar cutar cututtukan zuciya a cikin mutanen da ke dauke da cututtuka na rheumatoid an yi watsi da su kuma an kasa gudanar da su. Rashin hawan jini, kiba, shan taba, da dyslipidemia, tare da tsarin ƙwayar cuta wanda ke gudana a cikin arthritis na rheumatoid, kada a manta. Akwai buƙatar rheumatology da kuma likitoci na farko suyi aiki tare tare da su don magance cututtuka na zuciya da jijiyoyin zuciya da kuma cututtuka da suka shafi cututtuka na rheumatoid.
Duk da yake bincike ya mayar da hankali akan muhimmancin kula da cutar da cutar da jijiyoyin jini tare da cututtuka na rheumatoid, ana bukatar karin bincike. Har ila yau, har yanzu ana ci gaba da samun nasarar magance matsalar. Har yanzu akwai bukatar ƙarin jagororin da suka dace don rage haɗarin cututtukan zuciya na zuciya a cikin mutane da cututtuka na rheumatoid ko wasu cututtukan haɗin gwiwar ƙwayoyin cuta.
> Sources:
> Agca R. et al. Umurnin EULAR don maganin haɗarin cutar cututtukan zuciya cikin marasa lafiya da cututtuka na rheumatoid da wasu nau'o'in cututtuka na haɗin gwiwar ƙaddara: 2015/2016 sabuntawa. Annals na Rheumatic Diseases . Oktoba 2016.
> Barber CE et al. Gaps a magance Rashin Tsarin Kwayoyin Lafiya a Rheumatoid Arthritis: Tattaunawa Ayyukan Yin Amfani Amfani da Abubuwan Hulɗa na Kwayoyin Kwayoyin Cutar. Jaridar Rheumatology . Nuwamba 2016.
> Sulemanu DH et al. Bayyana cututtukan zuciya da cututtukan zuciya da cututtuka na rheumatoid: maganganu na haɗari na al'ada da alamun ƙananan cututtukan arthritis. Annals na Rheumatic Diseases . Nuwamba 2010.
> Tournadre, Anne et al. Gudanar da hadarin zuciya da jijiyoyin jini a marasa lafiya tare da cututtukan ƙwayoyin cuta na ƙwayoyin cuta: m sharudda. Ci gaba da lafiya a ciwon ƙwayoyin cuta . 2016.
> van-Breulelen-van der Stoep DF et al. Kwayar cututtukan zuciya a cikin cututtuka na rheumatoid: yadda za a rage haɗarin? Atherosclerosis . Nuwamba 2013.