Spondylitis Ankylosing

ʻO Ankylosing spondylitis (AS) kahi ʻano mau o ka maʻi ʻōmaʻomaʻo. Hoʻopili ka hapa nui i nā iwi a me nā hono ma ke kumu o ka iwi kuamoʻo kahi e hoʻopili ai me ke pelvis. Hiki i kēia mau hui ke lilo i pehu a me ka wela. I ka hala ʻana o ka manawa, hui pū paha nā iwi iwi ʻeha.

ʻO AS ka lālā nui o ka ʻohana o nā ʻano like like o ka arthritis i kapa ʻia spondyloarthritis. ʻO nā lālā ʻē aʻe e pili ana i ka maʻi psoriatic, arthritis of bowel disease a me ka reactive arthritis. ʻO ka ʻohana o ka maʻi ʻōmaʻomaʻo he mea maʻamau a hoʻopili ʻia a 1 i 100 mau kānaka.

ʻAʻole maopopo ke kumu o AS. He mea nui paha kā Genes. ʻO ka hapa nui o ka poʻe me AS he maikaʻi no ka moʻokūʻauhau HLA-B27.

Hoʻomaka pinepine ka maʻi ma waena o 20 a 40 mau makahiki, akā hoʻomaka paha ia ma mua o ka makahiki 10. Hoʻonui ia i nā kāne ma mua o nā wahine.

Hoʻomaka ʻo AS me ka ʻehaʻeha o ke kua i hiki a hala. Lilo ka ʻehaʻeha i hope i ka hapa nui o ka manawa ke holo ke ʻano.

• ʻOi aku ka maikaʻi o ka ʻeha a me ka ʻoʻoleʻa i ka pō, i ke kakahiaka, a i ʻole ke emi o kāu hana. E hoʻāla mai paha ka hoʻoluhi iā ʻoe mai ka hiamoe ʻana.
• Hoʻonui pinepine ka ʻeha me ka hana a hoʻoikaika kino paha.
• E hoʻomaka paha ka ʻeha o ke kua ma waena o ka pelvis a me ka iwi kuamoʻo (sacroiliac ami). I ka hala ʻana o ka manawa, pili pū paha ia i nā mea āpau a ʻāpana paha o ka iwi kuamoʻo.
• E lilo paha kāu iwi kuamoʻo i mea maʻalahi. I ka hala ʻana o ka manawa, kū paha ʻoe i kahi kūlana hunched i mua.

ʻO nā ʻāpana ʻē aʻe o kou kino e hiki ke hoʻopili ʻia:

• ʻO nā hono o nā poʻohiwi, nā kuli a me nā kuʻekuʻe wāwae, he pehu a ʻeha paha
• ʻO nā hono ma waena o kou iwi ʻaoʻao a me ka iwi umauma, i hiki ʻole ai iā ʻoe ke hoʻonui ākea i kou umauma
• ʻO ka maka, he pehu paha a ʻulaʻula paha

ʻO ka luhi kekahi hōʻailona maʻamau.

ʻO nā ʻōuli liʻiliʻi e pili pū ana me:

• Ke kuni liʻiliʻi

Hiki paha iā AS me nā kūlana ʻē aʻe, e like me:

• ʻO Psoriasis
• Ulcerative colitis a i ʻole Crohn maʻi
• Kū hou a mau paha ka maka o ka maka (iritis)

E komo pū paha nā hoʻāʻo:

• CBC
• ESR (kahi ana o ka mumū)
• HLA-B27 antigen (kahi e ʻike ai i ka ʻaoʻao i pili i ka ankylosing spondylitis)
• Rheumatoid ololi (i mea e maikaʻi ʻole)
• X-kukuna o ka iwi kuamoʻo a me ka pelvis
• MRI o ka iwi kuamoo a me ka pelvis

Kauoha paha kāu mea mālama ola i nā lāʻau e like me NSAID e hoʻemi i ka pehu a me ka ʻeha.

• Hiki ke kūʻai ʻia i kekahi mau NSAID ma kahi kūʻai (OTC). Hoʻopili kēia i ka aspirin, ibuprofen (Advil, Motrin), a me naproxen (Aleve, Naprosyn).
• Kau ʻia nā NSAID ʻē aʻe e kāu mea hāʻawi.
• E kamaʻilio i kāu mea hoʻolako a mea kauka paha i mua o ka hoʻohana lōʻihi ʻana i kēlā me kēia lā o kēlā me kēia NSAID ma kahi kūʻai.

Pono paha ʻoe i nā lāʻau i ʻoi aku ka ikaika e kaohi i ka ʻeha a me ka pehu ʻana, e like me:

• Hoʻohana ʻia ʻo Corticosteroid therapy (e like me prednisone) no nā wā pōkole
• Sulfasalazine
• Kahi mea kāohi TNF-biologic (e like me etanercept, adalimumab, infliximab, certolizumab a i ʻole golimumab)
• He mea kāohi biologic o IL17A, secukinumab

ʻO ke kaha, e like me ke kuapo ʻana o ka uha, hiki ke hana ʻia inā ʻeha a ʻeha pū paha nā ami.

Hiki i nā hoʻoikaika kino ke kōkua i ka hoʻomaikaʻi ʻana i ke kūlana a me ka hanu ʻana. ʻO ka moe pālahalaha ʻana ma kou kua i ka pō hiki ke kōkua iā ʻoe e mālama i kahi kūlana maʻamau.

ʻO ka papa o ka maʻi paʻakikī e wānana. Ma ka hala ʻana o ka manawa, nā hōʻailona a me nā ʻōuli o AS flareup (hoʻi hou) a mālie (remission). Hiki i ka hapa nui o ka poʻe ke hana maikaʻi ke ʻole ka nui o nā hōʻino i nā hiʻupuʻu a i ʻole ke kuamoʻo. ʻO ke komo ʻana i kahi hui kākoʻo o nā poʻe ʻē aʻe me ka pilikia like e kōkua pinepine paha ia.

ʻO ka mālama ʻana me ka NSAID e hoʻoliʻiliʻi pinepine i ka ʻeha a me ka pehu. ʻO ka mālama ʻana me nā mea kāohi TNF i ka wā mua o ka maʻi e hōʻike lohi i ka holomua o ka iwi kuamoʻo.

Kākaʻikahi ka poʻe me ka ankylosing spondylitis e pilikia paha me:

• ʻO Psoriasis, kahi maʻi ʻili mau
• Hoʻonā i ka maka (iritis)
• Ka hoʻohauna i loko o ka ʻōpū (colitis)
• Rhythm puʻuwai maʻamau
• ʻO ka scarring a manoanoa paha o kaʻiʻo māmā
• ʻO ka scarring a i ʻole ka mānoanoa o ka kiwikā puʻuwai aortic
• ʻO ka ʻeha o ke kuamoʻo ma hope o ka hāʻule

Kāhea i kāu mea hāʻawi inā:

• Loaʻa iā ʻoe nā ʻōuli o ka ankylosing spondylitis
• Loaʻa iā ʻoe ka ankylosing spondylitis a hoʻomohala i nā ʻōuli hou i ka wā o ka mālama ʻana

Spondylitis; Spondyloarthritis; HLA - Spondylitis

• Iwi kuamoʻo
• Spondylosis cerviera

Gardocki RJ, Pāka AL. Nā maʻi Degenerative o ka iwi kuʻi a me ka lumbar. I: Azar FM, Beaty JH, Canale ST, hua. ʻO Campbell's Operative Orthopedics. 13th ed. Piladelapia, PA: Elsevier; 2017: chap 39.

Inman RD. ʻO nā spondyloarthropathies. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 249.

van der Linden S, Brown M, Gensler LS, Kenna T, Maksymowych WP, Taylor WJ. ʻO ka Ankylosing spondylitis a me nā ʻano o ka axial spondyloarthritis. I: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, hua. ʻO Firestein & Kelly's Textbook of Rheumatology. 11th hua. Piladelapia, PA: Elsevier; 2021: chap 80.

Ward MM, Deodhar A, Gensler LS, et al. Hoʻohou 2019 o ke Kulanui ʻAmelika o Rheumatology / Spondylitis Association o ʻAmelika / Spondyloarthritis Research a me ka hoʻomaʻamaʻa pūnaewele manaʻo no ka hoʻomaʻamaʻa ʻana o ankylosing spondylitis a me nonradiographic axial spondyloarthritis. Hoʻomaʻamaʻa Hoʻōla Pā (Hoboken). 2019; 71 (10): 1285-1299. PMID: 31436026 pubmed.ncbi.nlm.nih.gov/31436026/.

ʻO Werner BC, Feuchtbaum E, Shen FH, Samartzis D. Ankylosing spondylitis o ka iwi kuamoʻo. I: Shen FH, Samartzis D, Fessler RG, nā hua. Puka puke o ka iwi kuamoʻo. Piladelapia, PA: Elsevier Saunders; 2015: chap 28.