Fiye da kawai shingles
Varicella zoster virus (VZV) yana da hanyoyi daban-daban don taimakawa wajen raunana mutane. Da farko, shi kawai yana haifar da kaza. Yawancin lokaci, kodayake kwayar cutar ba zata tafi ba lokacin da ragowar ya rage. Maimakon haka, cutar ta shiga cikin ɓoyewa, tana jinginewa a cikin kwayoyin jikinsu na ganglionic kusa da kashin baya, suna jiran damar samun wani bayyanar.
Shingles yana daya daga cikin hanyoyin da aka fi sani da VZV ya dawo don zagaye na biyu.
Kwayar cutar tana tashi tare da fata wanda bazarin yake fama da shi, wanda ya haifar da raguwa. Ko da bayan raguwa ya ɓace, ciwo zai iya ci gaba a cikin abin da ake kira neuralgia ne.
Shingles yana da sanannun sanannen amma VZV zai iya haifar da gajerun jini, meningoencephalitis, myelopathy, necrosis retinal, vasculopathy, ko rashin lafiya Ramsay Hunt. Duk waɗannan rikitarwa na iya faruwa ba tare da raguwa ba ko watanni bayan rash. Kayan gwaje gwaje-gwaje na al'ada kamar su VZV DNA ko ƙwayoyin mawuyacin ƙwayoyin ruwa (CSF) suna da taimako idan akwai, amma cutar zata iya faruwa ko da waɗannan binciken basu da shi. Ko da yake ana buƙatar da asibiti, jiyya na cututtuka na jiki wanda VZV zai haifar zai iya zama ƙalubale.
Herpes Zoster
Harshen daji, wanda ake kira shingles, yana daya daga cikin siffofin da aka fi sani da VZV. Saboda yana gabatarwa tare da halayyar halayyar, wasu mutane ba sa tunanin shi a matsayin cuta ne.
Duk da haka, ƙaddarar ta yadu akan abin da ake kira rarraba dermatomal , ma'anar wani sashi na fata wanda ba wanda yake da nasaba da asali. Wannan shi ne saboda tushen tushen jijiya, ko kuma ganglion, inda aka sa kwayar cutar ta kwanta har sai da damar da za ta sake kunna. A gaskiya ma, yanayin hoton jima'i (MRI) na iya nuna haɓakawa ga ganglion wanda ya shafa.
Rashin lafiya yana da zafi. Jiyya yana tare da nacyclovir na kimanin kwana bakwai.
Posthelpetic Neuralgia
Ƙananan ƙananan hanyoyi na gaba sun nuna gaskiyar cewa herster zoster shine ainihin rashin lafiya ne. Ko da bayan raguwa ya ɓace, jin zafi a kan abin da aka gano zai iya ci gaba. Idan har haka ya wuce fiye da watanni uku, za'a iya gane ganewar asibiti na zamani (PHN). Babban mahimmancin haɗari don bunkasa PHN yana da shekaru, tare da fiye da kashi 30 cikin wadanda suka wuce shekaru 60 tare da shingles zasu ci gaba da PHN. Kwayar cutar na iya zama saboda mummunan kumburi saboda kamuwa da cututtuka masu kama da sauri, kamar yadda kwayoyin cututtukan ƙwayoyin cuta sun kasance a cikin mutane tare da PHN har tsawon shekaru 2, da kuma VZV DNA da sunadaran da aka samu a cikin jinin marasa lafiya da PHN. Wasu marasa lafiya sun inganta tare da maganin maganin rigakafin maganin rigakafi, kodayake maganin maganin maganin maganin maganin maganin cutar ta HIV bai yarda da shi ba, kuma akwai buƙatar bukatun gwaji. Zai iya zama matukar wuya a magance ciwo na PHN. Mai amfani da antidepressant tricyclic, gabapentin, pregabalin ko lidocaine yawanci shine na farko na farfadowa, wanda ya biyo bayan opioids, tramadol, ko capsaicin a matsayin na biyu ko na uku.
Hadin maganin zai iya zama mafi tasiri. Hanyar cututtukan farfajiyar jiki na ɓoye na ciki, wanda ake sanyawa matakan mai da hankali a ƙarƙashin mafi yawan ciwo, yana iya ba da taimako.
Zoster Sine Herpete
Mafi mahimmanci shine, "zoster sine herpete" za a dauka a matsayin ƙananan yanayi, amma ba a taɓa yin amfani da shi ba. Ana iya gano cutar a cikin CSF. Sauran cututtuka na ciwo mai tsanani, irin su radiculopathy da cututtuka na ciwon sukari, dole ne a gudanar da binciken neuroimaging. Jiyya ya ƙunshi acyclovir mai girma, tare da jiyya na ciwo a cikin wani salon kama da PHN.
Maganin Nasar N
Rashin kamuwa da ido tare da VZV zai iya haifar da mutuwar mutuwar mutum a cikin rami. Wannan yana fama da ciwo a kusa da idanu, da kuma hangen nesa. Bisa gawar hangen nesa ya ɓace a farkon. Lokacin da likita ya yi nazari na asusun ajiya, zasu iya ganin lalata da kuma tsabtace kwanciyar hankali. Sauran ƙwayoyin cuta, kamar HSV da cytomegalovirus, kuma zai iya haifar da ƙananan necrosis. Yawancin lokaci, wannan yana faruwa a marasa lafiya da AIDS wanda ƙwayoyin T-cell sun kasance marasa ƙarfi (<10 sel / mm 3). Jiyya ne yawanci tare da IV acyclovir, da steroids da aspirin. Injections injections na antiviral jamiái sun kasance tasiri.
Meningoencephalitis
Maganar maningoencephalitis tana nufin ƙonewar kwakwalwa da kayan kyama. Wannan na iya haifar da ciwon kai, da canje-canje mai hankali, da kuma alamun bayyanar da ke ciki ko alamu kamar maganganun magana ko rauni a gefe ɗaya na jiki. Wannan zai iya faruwa ko da ba tare da furta ba. MRI zai iya nuna haɓakawa na kyallen takarda da ke kewaye da kwakwalwa, da kuma ƙuƙwalwar lumbar iya nuna alamun VZV IgG da IgM ko VZV DNA a cikin ruwan sanyi. Jiyya yana da ciwon haɗari mai tsanani acyclovir sau uku kowace rana har zuwa kwanaki 10 zuwa 14.
Myelopathy
Maganin rashin tausayi yana nufin lalata launi. Wannan zai iya haifar da rauni na ci gaba da kafafun kafa, da mawuyacin hali ko rashin ƙarfi na mafitsara da kuma jinji. MRI zai iya nuna babban launi ko bugun jini a cikin lakabi. Cerebrospinal fluid karatu iya nuna irin wannan binciken da aka sa ran a cikin VZV meningoencephalitis, tare da anti-VZV antibodies ko VZV DNA. Kamar yadda na VZV meningoencephalitis, magani yana tare da haɗari mai ƙarfi acyclovir.
Vasculopathy
VZV zai iya tasiri tasirin jini na kwakwalwa da tsarin jin dadi, wanda zai haifar da alamun ƙwayoyin cututtuka da aka haifar da rage yawan jini. Wannan na iya haifar da ciwon kai, canje-canje mai hankali, da kuma alamomin maganganu da kuma alamun bayyanar. MRI zai nuna raunuka da ke kusa da jigon launin toka-fari, yawanci a cikin kwakwalwa. Wani lokaci, VZV zai iya magance tasirin jiki na jiki, wanda zai haifar da lalacewa ta jiki tare da asarar hangen nesa da ciwo kusa da idanu. Nazarin CSF sunyi kama da abin da aka samo a cikin meningoencephalitis ko rashin tausayi, kuma magani yana dauke da kashi IV acyclovir.
Ramsay Hunt Syndrome
Bugu da ƙari, ganglia na tushen dorsal a kusa da kashin baya, VZV na iya kasancewa a cikin ganglia na jijiyoyin cranial. Lokacin da kwayar cutar ta sake haifar da ganglia ta jiki, zai iya haifar da bayyanar cututtuka da aka sani da ciwo na Ramsay Hunt, wanda zai iya haifar da rashin lafiyar launin fuska ga kwakwalwar cutar ta Bell, da kuma sauran alamomi. Alamar alama ta Ramsay Hunt ita ce tsaka-tsaki a cikin membrane na kunne
Yin rigakafi na Zoster Rashin lafiya
VZV ta latse har zuwa 90% na mutane. An gabatar da rigakafin VZV a shekara ta 2006 don bunkasa rigakafi ga sakewa VZV. Ana maganin maganin alurar rigakafi a halin yanzu don mutanen da ba su da kariya a cikin shekaru 60 idan babu tarihin zoster. Duk da tasirinta, an yi maganin alurar riga kafi, kuma an yi la'akari da rashin daidaituwa bisa ga kabilanci da kabilanci.
> Sources:
> Nagel MA, Gilden D. Ƙwararren gwagwarmayar da ke fama da cututtukan cutar varicella-zoster. Harkokin Ciwon Nazarin Halitta na Yau 2013; 3: 109-117