Yin maganin cutar Chagas ya dogara da lokacin da aka gano cutar . Mutanen da aka bincikar da su a lokacin karamin cutar sun kamu da su fiye da wadanda aka gano a lokacin kwanakin lokaci.
Yin maganin cututtukan ƙwayoyin cuta
Abinda ke da kyau kawai don magance cutar Chagas - wato, kawar da Trypanosoma cruzi (T.
cruzi) kwayoyin jiki daga jiki - idan an fara fara magani a farkon cutar, a lokacin karamin lokaci.
A cikin kowane mutum da aka gano tare da ƙwayar cuta T. cruzi, ko kuma idan an gano jarirai da kamuwa da cutar ta jiki, dole ne a bayar da magani tare da maganin antitrypanosomal. Magunguna guda biyu da aka nuna suna da tasiri a kan T. cruzi su ne benznidazole da nifurtimox. Mata masu juna biyu ba za su karbi wadannan kwayoyi ba.
Idan an gama cikakken magani na ko dai ɗaya daga cikin wadannan kwayoyi, an kawar da kwayar cutar T. cruzi zuwa kashi 85 cikin dari.
Benznidazole
Benznidazole yawanci yana da ƙananan sakamako masu illa kuma yana da sau da yawa magani na zabi. Dole ne a dauki wannan magani don kwanaki 60. Sakamakonsa mafi rinjaye shine fatawa na fata.
Nifurtimox
Nifurtimox (wanda ba'a yarda da ita a Amurka) ya sa ya haifar da bayyanar cututtuka na gastrointestinal. Har ila yau, yana iya samar da rashin barci, rashin jinƙai, da ƙananan neuropathy .
Wadannan sakamako masu illa sun iyakance amfani. Wannan magani ya kamata a dauki akalla kwanaki 90.
Yin maganin cutar rashin lafiya
Tare da cututtukan Chagas na kullum, kawar da magungunan T. Cruzi tare da maganin antitrypanosomal ya fi wuya fiye da yadda yake a lokacin karamin lokaci, kuma ba zai yiwu ba.
Duk da haka, mafi yawan masana sun bada shawarar yin maganin benznidazole ko nifurtimox idan mutumin da ya kamu da cutar yana cikin lokaci wanda ba shi da tabbacin cutar Chagas na yau da kullum (wato, ba shi da cututtukan zuciya ko kuma gastrointestinal symptoms na cutar Chagas), kuma yana da shekaru 50.
Mutanen da suka kai shekaru 50 suna da mummunar tasiri daga sakamakon illa daga kwayoyi antitrypanosomal, amma har yanzu ana iya la'akari da farfadowa.
An ba da shawarar likita na Antitrypanosomal idan cutar ta Chagas ta kasance a yanzu, idan cutar Chagas ta da yawa ta kasance ba (kamar megacolon ), ko kuma idan babbar hanta ko cutar koda yake. A cikin wadannan mutane akwai yiwuwar kawar da ƙwayar T. Cruzi mai ragu, kuma hadarin sakamako mai zurfi yana da tsawo.
Yin maganin Cutar Cardiac Chagas
Jiyya tare da kwayoyin antitrypanosomal ba amfani ga kafa cutar ta Chagas ba. Maimakon haka, ya kamata a yi amfani da magani musamman don kula da cututtukan zuciya da kanta.
Cutar cututtukan Chagas wani nau'i ne na cututtukan zuciya wanda ke haifar da rashin tausayi na zuciya , kuma mutanen da ke fama da wannan cuta ya kamata su karbi dukkanin maganin likitoci don maganin cututtukan zuciya .
Karɓar Zuciyar Zuciya
Harkokin lafiyar likitanci sun hada da magani tare da beta blockers , ACE masu hanawa , da kuma spironolactone. An yi amfani da maganin diuretic don taimakawa wajen rage harshe da dyspnea.
Kwayar maganin maganin cardiac (CRT) ya zama kamar amfani da cututtukan zuciya a Chagas kamar yadda yake a cikin wani nau'i na zuciya. Duk da haka, amfani da CRT wajen magance rashin ƙarfi na zuciya yana da iyakancewa ga mutanen da suka bar rassan reshe , ko suna da cutar Chagas ko wani nau'i na cututtukan zuciya.
Kuma, Abin takaici, a cikin Chagas cuta cutacciyar shinge mai amfani ya fi kowa yafi lakabin shinge-don haka CRT ya dace da ƙananan mutane da rashin tausayi na Chagas fiye da sauran nauyin zuciya.
Mutane da ke fama da cutar Chagas sunyi aiki tare da cututtukan zuciya kamar yadda marasa lafiya da wasu nau'o'in zuciya rashin nasara. Ɗaya daga cikin damuwar yin aikin tiyata a Chagas cutar cututtukan zuciya shine cewa maganin immunosuppressive da ake buƙatar bayan dasawa zai iya haifar da kamuwa da T. Cruzi kamuwa da cutar. Duk da haka, binciken binciken asibiti ya nuna cewa mayar da kamuwa da kamuwa da cuta bayan an dasa shi ba ya zama matsala ta kowa a cutar Chagas ba.
Rashin ciwon thromboembolism (yanayin da yakan haifar da kyamara mai zurfi , kwariyar zuciya , ko bugun jini ) ya karu a cikin kowa da ciwon zuciya, amma yana ganin ya zama wani hadarin gaske ga mutanen dake fama da cututtukan zuciya na Chagas. Yawancin mutanen da ke fama da cututtukan zuciya na Chagas ya kamata a sanya su a kan korar kwayoyin halitta (tare da Coumadin ko wani magani na NOAC ), ko kuma aspirin prophylactic don rage yawan hadarin thromboembolism.
Yin maganin Arirhythmias cardiac da kuma hana Rashin Mutuwar Mutuwa
Koma don hana ko magance cututtukan zuciya na zuciya mai tsanani shine wajibi ne ga mutanen da ke fama da cututtukan zuciya na Chagas saboda sun kasance da haɗari ga ƙwayoyin zuciya biyu (jinkirta rhythms) da kuma tachycardias (damun zuciya).
Bradycardias yana faruwa tare da wasu mita a cikin mutane da cutar Chagas. Hannun kalmomi suna haifar da cutar ta kuskuren sinus kuma ta hanyar zuciya . Idan jinkirin jinkirin zuciya yana haifar da bayyanar cututtuka, ko kuma idan ya bayyana yana iya haifar da alamar bayyanar cututtuka irin su syncope , farfado da mai samin buƙata ya zama dole.
Babban mahimmancin damuwa da ya shafi cututtukan zuciya na zuciya a cikin mutanen da ke fama da cutar ta Chagas, duk da haka, mutuwa ce ta mutuwa ta hanyar tachycardia ventricular ko fibrillation ventricular . Rashin samun ciwon maganganun arrhythmias na rayuwa yana da alaka da lalacewar lalacewar zuciya da Chagas ya yi.
Idan aikin zuciya na zuciya ya ɓaci har zuwa maƙasudin cewa waɗannan maganganu masu haɗari sun faru ne, musamman ma za a iya faruwa, dole ne a yi la'akari sosai da shigar da defibrillator mai gina jiki . Duk da haka, musamman ma a Latin Amurka, inda ba a iya samun likitancin ilmin defibrillator mai sauƙi, marasa lafiya da Chagas suna iya magance su tare da maganin maganin ƙwayar cuta ta hanyar maganin ƙwayar cuta, maimakon ƙoƙarin rage haɗarin mutuwa ta mutuwa.
Yin maganin cututtuka na Gastrointestinal
Tunanin Antitrypanosomal ba ya inganta cutar ciwon gastrointestinal da Chagas ya haifar. Anyi amfani da magani don rage cututtuka ta hanyar rage ƙwanƙwasa gastrointestinal da sarrafa iko da maƙarƙashiya da magunguna da abinci. Zai yiwu zama mai sauki idan mai amfani megacolon ko megaesophagus ya kasance.
Rigakafin
A cikin shekarun nan da suka gabata, kasashen Latin Amurka da dama sun yi ƙoƙari don kawar da cutar ko kuma rage yawan cutar Chagas.
Kullum, wadannan kokarin sun mayar da hankalin akan kawar da kwayoyin cutar-wato, "gwangwani" wanda ke kawo T T. cruzi daga mutum zuwa ga mutum. An kawar da maganin kwashe gwangwani ta hanyar amfani da kwari a cikin gidajen mutane. Wadannan ƙoƙarin sun taimaka sosai amma basu kawar da matsalar ba - kuma cutar Chagas na ci gaba da kasancewa a wurare da dama a Latin Amurka.
Gwajin Prenatal na T. cruzi ya taimaka wajen rage cutar ta cutar. Ba za a iya magance mata ba tare da kwayoyin antitrypanosomal yayin da suke ciki, amma magani kafin daukar ciki yana da tasiri sosai. Mata a halin yanzu an kamu da su tare da T. cruzi kuma an umurce su kada suyi nono, duk da cewa ba a tabbatar da cutar ta hanyar nono ba.
> Sources:
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> Cututtuka na Bern C. Chagas. N Engl J Med 2015; 373: 456.
> Martí-Carvajal AJ, Kwong JS. Ƙirƙirar Pharmacological Domin Kula da Zuciyar Marasa cikin Marasa lafiya tare da Chagas Cardiomyopathy. Cochrane Database Syst Rev 2016; 7: Cd009077.
> Pinazo MJ, Cañas E, Elizalde JI, et al. Bincike, Gudanarwa da Jiyya na Kwayoyin Gastrointestinal Cigar Cgas A Yankuna A Ina Trypanosoma Cruzi Cutar Ƙari Ba Ya Ƙarshe. Gastroenterol Hepatol 2010; 33: 191.
> Pinazo MJ, Muñoz J, Posada E, et al. Jinƙai na Benznidazole A Cikin Kula da Cututtukan Chagas a cikin Matasan. Antimicrob Agents Checker 2010; 54: 4896.