Alzheimer: izimbangela kanye nokwelashwa, ngokuyisisekelo, izimpawu kokuqala, ukuthuthukiswa, isithombe yesifo i-Alzheimer

Alzheimer - isifo okuholela ekufeni amangqamuzana obuchopho. Ehamba iziyaluyalu kakhulu engqondweni futhi zisebenza kahle. Omunye sezinzwa izifo uhlelo, izinqubo zazo akukaqondwa ngokugcwele.

izindlela ukuxilongwa

Ithuluzi eliyinhloko ucwaningo on ukuthuthukisa komqondo kuyinto neuroimaging. Ngenxa yale njongo, CT, i-MRI, ama-PET ingqondo. Udokotela ehlola degree of ukubhujiswa ukwabelana ngabanye, kanye Kuhlola izimbangela futhi isifo concomitant.

Ukusebenzisa inqubo Bheka kusivumela ukuba bagcine umsebenzi ubuchopho kanye nezinga ukungakhuli ukuxhumana kwemizwa. Laboratory ihlaziya eqinisekisa Alzheimer zikhombisa ukwehla okukhulu ngo-α-β-42 kanye nokwenyuka ngesikhathi esisodwa tau amaprotheni.

Izimbangela Isifo se-Alzheimer

Ingqikithi Alzheimer ongakabi embulelwe ososayensi ngokusebenzisa. Namuhla, kukhona eyeza nezazi zezinkanyezi ezikhuluma ambalwa ngezimbangela zokuziphendukela ukuvela nokuthuthukiswa isifo, kodwa akekho kubo nokho ukuthola ukuqashelwa international. Indawo aholayo phakathi ucwaningo ezihlongozwayo kuthatha isici zofuzo.

Phakathi kwezinye izinto, ukuhlukanisa amaqembu 3 isifo ingozi:

• nekorrigiruemye;
• kancane correctable;
• correctable.

Alzheimer kubangela kanye nokwelashwa yalesi sifo - zonke lezi imibuzo izici nekorrigiruemyh abasakwazi eziyinkimbinkimbi futhi kungalungiswanga okwamanje.

Isici zofuzo ukuthuthukiswa

zokugula Ukubambezeleka isesikhathini 10% azo zonke izigameko. Ukuthuthukiswa Alzheimer ku indlela zofuzo iqala ngaphambi engu-65 ubudala. Gene idluliselwa i autosomal imfashini evelele: ngisho noma umzali wesibili akuyona inkampani yenethiwekhi, ngocansi kubo isakhi sofuzo enempilo esikhundleni sokugembula. enganeni Amathuba ngokuvamile kwenzeka kwesigamu amacala.

Naphezu efakazelwe isici zofuzo, ososayensi bayaqiniseka ukuthi ukuthuthukiswa lesi sifo neqhaza izinhlobo ezahlukene kuma-chromosome. Okusanda, ngokuhamba ucwaningo kwatholakala ukuthi isakhi sofuzo isici kwatholakala chromosome 14, okuyinto 70% amacala kuholela ukuthuthukiswa lesi sifo.

Ukwephulwa ne-chromosome 21 ezibangela -Down syndrome, e-5% amacala kuholele kuqala zesifo i-Alzheimer. I ezingavamile kakhulu zokugula - isakhi sofuzo isici ku-chromosome 1 - has a okungenzeka eliphansi "umndeni" izifo.

engcupheni okusezingeni eliphezulu

izimbangela Nekorrigiruemye kukhona kwezinso azalwa naso noma bathenga yokwakheka noma bokuphila, okuyinto kakade ayikwazi ukulungiswa noma ukushintshwa. Lezi zinto zibandakanya:

• ukuguga (kweminyaka engu-80);
• kokuba owesifazane;
• ukuhlukumezeka cranial;
• yokucindezeleka okukhulu nokucindezeleka;
• ukuntuleka "ukuqeqeshwa" ngoba ingqondo.

Ngokwengxenye izici eliguqulekayo bakha iqembu izifo ezibangela oyingozi noma ezingamahlalakhona ukuntuleka komoya-mpilo kule cerebral cortex amaseli:

• nomfutho wegazi ophezulu;
• isifo sokuqina kwemithambo yegazi imithambo entanyeni, inhloko, ubuchopho;
• umzimba lipid;
• sikashukela;
• isifo senhliziyo.

Ukuqedwa isifo kunciphisa ingozi yesifo i-Alzheimer.
Ukuze correctable - siqedwa ngokuphelele - izici kungabandakanya:

• wanciphisa ukuhileleka ngokomzimba;
• yokuntuleka ekukhuleni, elinganiselwe;
• ukwehluleka ukuhambisana nezimiso eziyisisekelo zokuphila ezinempilo.

Pathologies akuzona 100% isiqinisekiso sokuthuthukiswa lesi sifo kodwa ngokuvamile sibandulele ke, okubenze bafinyelela isiphetho mayelana kungenzeka engcupheni kanye nokuvinjelwa.

isigaba zentuthuko

Ososayensi bathole ukuthi i-Alzheimer (izimpawu eziyinhloko) ubonakala eminyakeni 15-20, ukuze ezinzima isithombe zokwelapha, okuyinto nzima kakhulu ukuvimbela izifo. Namuhla, sinikezwa 3 sokugembula inqubo zinyathelo:

1. Oku-emitholampilo - zokugula esewusana, CNS iziyaluyalu kuyagcinwa.
2. Inkathi ukwephulwa ezincane - iziguli zingase uphawule lube buthaka amakhono engqondo nawokuxoxa inkumbulo ukungakhuli.
3. Izinga kokuqala komqondo - emjikelezweni kwangaphakathi uqala ubona okuthile okungahambi kahle. Ngokuvamile, ungaqinisekisa khona lesi sifo emtholampilo.

Ngamunye izigaba has izici zayo siqu futhi Tindlelanchubo okuhlinzeka izikhungo zokunakekela zezokwelapha.

Ukuthuthukiswa lesi sifo esemncane

isifo Early Alzheimer eba ngaphambi kweminyaka eli-65, kunzima ukuxilonga ngesikhathi ngenxa nonspecific isithombe emtholampilo. Izimpawu zokuqala avele ifomu lokukhohlwa, ukungakwazi ukuhlela futhi benze izinto engangizenza kalula ngaphambili. Isiguli ngokushesha Ufika bakhathala umsebenzi engqondo: ukugcina ulwazi imemori zaya ziba nzima.

Alzheimer: izimbangela kanye nokwelashwa ngendlela efanele usaqala

Esigabeni sokuqala eba phakathi neminyaka engu-7. izinguquko zokuqala isimo lesiguli zenzeke ngaphansi kwethonya izici ezahlukene. Endabeni i imbangela ezimisiwe wonke amabutho wathumela ziqedwe yayo. Njengomthetho, impatho wendawo linikeza imiphumela emihle.

iziguli Alzheimer kungase esekhala:

• izinkinga inkumbulo;
• ukubukeka lokukhohlwa;
• ukulahlekelwa ikhono ukucabanga;
• iziyaluyalu psycho-ngokomzwelo.

Mhlawumbe Alzheimer wayesenze amaphutha abe izihlobo sobala. Izimpawu zokuqala kungukuthi njalo ngqo abonisa ubuchopho ukungasebenzi, kodwa abaningi namanje ufune usizo lwabezokwelapha nesikhathi ukuze ufunde mayelana uphethwe.

inkumbulo iziyaluyalu abe uhlobo yesikhathi esifushane neyesikhathi eside, kanti isiguli akakwazi uqaphela ukuwohloka njalo. I lokukhohlwa eziyingozi kakhulu: Ngokuvamile abantu kwesokunxele Alzheimer ku igesi noma ugesi, okuholela izehlakalo uhlamvu kakhulu. Mhlawumbe ukulahlekelwa yokukhuluma memory-non-oluyingozi ngesimo ekukhohlweni izenzakalo ezenzeka esikhathini esidlule. sokubuyiselwa izinkumbulo kwengxenye kwenzeka ngesikhathi izinhlangano. inkumbulo iziyaluyalu bathuthuke ngokushesha: ngemva kwezinyanga ezingu-6 kuphela, izimpawu ziba evelele futhi iyingozi ukuphila kwesiguli.

Ukulahlekelwa ikhono ukucabanga lincike ezingeni intelligence ekuthuthukiseni lesi sifo. Ngezinye izikhathi uphawu isici ushintsho abukhali izithakazelo: ubukele i-TV esikhundleni ukufunda izincwadi nzima nangezinye izikhathi. Iphazamiseke inqubo ulwazi kanye bezibona ambient ukucutshungulwa imvelo, lapho isiguli kulahleka space kanye nesikhathi.

nokugula ngengqondo efana amandla Alzheimer ukushayela

izinkinga ezingokwengqondo nezingokomzwelo Serious kungabangela isifo i-Alzheimer. Izimbangela izimpawu ezinjalo kanye nokwelashwa amanga kobuchopho nokuhlukumeza conduction Izinzwa amaza. Ezinganele acetylcholine zamagama kuholela ekwakhekeni amyloid zingcwecwe. ukucindezeleka eside zibulale ukusebenza isimiso sezinzwa, futhi sinombono umsebenzi ezibuthakathaka ekuthuthukiseni komqondo.

Ukuphulwa isimo esingokomzwelo icuphe Alzheimer. I kokuqala nezimpawu zesifo sokuphazamiseka kwengqondo ukuzwakala alamu eqinile, ukwenza izenzo enemikhuba ezingadingekile, izikhalazo wobuthongo ukubuyisa futhi fitful. Ngezinye izikhathi, basuke babe ukuhlaselwa ka sengqondo acute, elinesimo yokwesaba uvalo yoshushiso, melancholy. Avuse ushintsho esimweni yanoma yiluphi uhlobo: kusukela rearrangement ifenisha ngaphambi kokuthuthela kwenye ekhaya. Ukuqhubeka kwesifo kuhambisana ukushintsha kwezinkathi kokukhathazeka okuvamile ukuze ukunganakwa. ukwelashwa Human iziyaluyalu kakhulu engqondweni kuhilela ikakhulu ukusetshenziswa antidepressant futhi izidakamizwa psychotropic.

Isifo se-Alzheimer: Ubangela, ekwelapheni esigabeni 2nd

inkumbulo Ukulimala kabi, isici kuphela lesi sifo sobala futhi ezinzima ngaphezulu esigabeni yentuthuko zokugula yesibili. Isiguli awukhumbuli izenzakalo ezithile, ngisho nalapho usizo associative nezinye izihlobo. Okokuqala, iziguli ukhohlwe sigameko muva nje, kanti esikhathini eside esadlulako uhlala imemori.

Ukuphulwa ngekhanda short-term kuholele orientation ayilungile ngesikhathi. Dementia abakwazi ngokunembile Ukusetha isikhawu isikhathi esisodwa noma omunye umcimbi. Luyathuthukiswa isifo ngokulinganisela siyenzeka ngokugcwalisa nhlobo inkumbulo Izinkumbulo okungase abe okuqukethwe fancy.

Inchubekelembili kuholele ekulahlekelweni Imininingwane yolwazi imithwalo ehlukahlukene, ikakhulu kukhiqizwa lapho usukhulile futhi kokuba isakhiwo eziyinkimbinkimbi. Agcinwayo kuphela lawo makhono eziye agome ekuqaleni ebuntwaneni futhi njalo aphindaphindwe inkambo yokuphila. Ngokwesibonelo, ukwazi yolimi lwebele, izindlela zokuxhumana nabantu futhi self-service.

Isici esiphawulekayo komqondo esigabeni 2nd - kulondolozwe inkumbulo ngokomzwelo futhi engekho langempela. Ngokuvamile iziguli ungakhumbuli ukuthi banayo enabantwana noma abazukulu, kodwa nabo kubangela injabulo, injabulo.

ukulahlekelwa ingqondo

Isici alawula esigabeni 2 nd - ukwephula amakhono engqondo, okwagcina kuholele ekulahlekelweni ukuzimela. Ukuthuthukisa komqondo zingahlukaniswa zibe imnene, ngokulinganisela futhi ezinzima.

Ukubonakaliswa unomsangano omncane sivezwe kula ukulahlekelwa ikhono lokuphatha imali: akunakwenzeka ugcwalise akhawunti, ukubala inani ukukhokha. Kancane kancane balahlekelwa silulumagama aluthola, kuba ayindlala. Ngokuvamile, iziguli kulesigaba uzame ukugwema kocansi. Siyabhubha emihle motor amakhono yezandla, okuholela incwadi ngokungakhethi. Kunamaphutha okwedlulele kolimi, okuyinto ebingekho ekuqaleni.

komqondo Ezintsha elinesimo ukulahlekelwa kwemakhono eKufundza neKubhala, ngokuvamile inkulumo lesiguli iba sona ngenxa ekukhohlweni amagama esikhundleni okwalandela ngumuntu ofanayo-Ukushaywa. Indoda iba olungenakuzisiza ngaphezulu: ayikwazi ngokuzimela ukuze ukugqoka ngendlela evumelana nesimo sezulu, thola indlela yabo ekhaya, akhohlwe ukuvala isitofu noma amanzi. On the 2 nd esiteji yesifo i-Alzheimer ngokulinganisela komqondo nesineke okufunile usizo njalo kanye khona izihlobo.

obangwa

Esigabeni yokugcina Alzheimer libhekene ukwencika ephelele kwabanye. Isiguli akakwazi ukwenza ukudla kwazo, ukuya ethoyilethi, ukuze afeze izinqubo yokuhlanzeka. Inkulumo iba incoherent futhi engaqondakali, Gait ephazamisekile, okwenza kube nzima ukuba ngokuzimela ukuhambisa.

Kancane kancane ahlahlele lapho uvuleka reflex. Ukufa kwenzeka ngenxa yokukhathala nokunwetshiwe ka sepsis noma izifo ezingathi sína kwababhemayo.

Komqondo Parkinson

Parkinson futhi Alzheimer ngoba umuntu ovamile has isithombe efanayo yomtholampilo, i ukusazi ngokunembile isifo esikuphethe can kuphela onguchwepheshe. I komqondo okuholela inezici ehlukile. Alzheimer libhekene ukwephulwa inkumbulo kanye nezobunhloli. Parkinsonism kuphela okwehlisa yokukhuluma futhi umcabango siyenzeka. Isici esivamile se-izifo neurodegenerative ukuwohloka kwezimiso uthi ngokwengqondo nangokomzwelo. Iziguli isikhathi eside e ehlaselwe ukucindezeleka futhi sengqondo oyingozi.

Isithombe siveza ukuthi isifo i-Alzheimer (ngenhla) futhi Parkinson (isithombe ngezansi) kuthinte ubuchopho ngokwamazinga ehlukene. Lesi sifo wokuqala ikhulela Lobe yesikhashana futhi hippocampus okwenzeka amyloid zingcwecwe kuholele kokufa emsipheni uxhumano (ubuchopho uqala "zome").

Parkinson uhlasela kakhulu uhlelo zemisipha: yomgogodla uzimisele ngaphezulu, isiguli siya njalonjalo. Ngabe uyakhathazeka nge ukundindiza Ngokuqhubeka, ukunyakaza babe diskoordinirovannymi.

Ukwelashwa nokuvikelwa usaqala

Sibukeze Imibandela, okungukuthi i-Alzheimer. Ubangela kanye nokwelashwa isifo okwamanje abaziqondanga ngokugcwele nesayensi. Odokotela njalo ukwenza ucwaningo ukuthola izidakamizwa ngempumelelo, kodwa izidakamizwa akayena set up esiyingqayizivele, akwazi ukunqoba lesi sifo.

Ukwelashwa eziyinkimbinkimbi ehlanganisa:

• ekwelapheni yezifo zengqondo;
• oluqinisayo jikelele zomzimba;
• esungula umzimba kwenza ubuchopho;
• beqinisa imithambo yegazi;
• ukuphathwa jikelele Alzheimer.

isikhathi esibalulekile ukuqala ukuthatha imithi ukuqinisekisa ukuhambisana obuphelele nazo zonke izincomo wezokwelapha. Bukela ukuqhubeka kwesifo kuyadingeka the Dynamics.

Ukuze ekwelapheni okuncane komqondo ukusetshenziswa amalungiselelo anjalo:

• "Piribedil" - kuthuthukisa ukudluliselwa nerve amaza e-neurotransmission dopaminergic futhi noradrenalinergicheskih CNS. Inkumbulo namakhono engqondo.
• "Pentoxifylline," "Vinpocetine" - kuthuthukisa kwegazi, ukuvimbela ukwakheka thrombi izitsha palsy.
• Ginkgo biloba akhiphe - ezizokhuthaza ukukhiqizwa kwamangqamuzana neurotransmitters, ivikela amangqamuzana obuchopho ubuthi, ngcono kwegazi.
• "Cinnarizine," "Nimodipine" - ukwandisa imithambo yegazi ubuchopho, ukuvikela amaseli emiphumeleni elimazayo-calcium ngokweqile.
• Pyrrolidone nemikhiqizo yalo - kuthuthukisa supply umoya-mpilo ebuchosheni kunomthelela ukuzinza wamaprotheni zamagama e amangqamuzana obuchopho.
• "Aktovegin" "Cere" - neqhaza ekubuyiselweni iketango ulwazi, ukuze sikhuthaze intracellular exchange izinqubo.

Ukwelapha i-hormone

Ososayensi uvumile ukuthi ukuthuthukiswa yesifo i-Alzheimer ekunciphiseni e acetylcholine zamagama. Ukungalingani phakathi zokukhiqiza futhi acetylcholine neurotransmitter acetylcholine, elibangela lesi okusithiyayo imisebenzi neuronal. Amaseli babe esishwabene, synapse isikhala akhishwe, futhi izinzwa afe. Kuvulwa-100% amacala Alzheimer isifo kufakazela. Photo of ubuchopho bomuntu enempilo futhi ogulayo asivumela ukubona zokugula ngisho umuntu ovamile.

Encishisiwe ukubuyisela acetylcholine zamagama ivumela ukuxhumana phakathi sezinzwa ukubambezela yonke izinqubo kumiswa amyloid zingcwecwe. Isiyazanywa baye babonisa kusebenta cholinesterase inhibitor. In iziguli nge ukwehla komuntu olahlekelwa yingqondo, inkumbulo kubuyiselwa, kubuyisele amakhono self-service futhi orientation emkhathini kanye nesikhathi.

Namuhla ubhekwa 3 Izidakamizwa ukuthi zivimbela cholinesterase:

• "Aritsept" ( "donepezil" "Aricept") - kunomphumela emaphakathi, isicelo ku 5.10 mg ngosuku.
• 'Reminyl' (galantamine hydrobromide) - kunomphumela jikelele, cishe non-enobuthi, ezinhle ngokugxila. Sebenzisa 8-12 mg ngosuku.
• "Exelon" ( "rivastigmine") - kunomthelela emaphakathi, kuphumelela ngaphezu nezinye izidakamizwa e amafomu ngokushesha ethuthuka yesifo i-Alzheimer. Iyatholakala ngesimo amaphilisi, usimende, nodaka. umthamo Ukuqala - 3 mg ngosuku.

Ukusetshenziswa cholinesterase inhibitor imithi ukunikeza cishe nemiphumela efanayo, kodwa nesineke ngamunye usabela ngendlela ehlukile yokwelapha i-hormone. Uma omunye izidakamizwa akaphenduli, udokotela ubuyisela Analogue yalo. Ukwahlulela umphumela wokwelashwa kungenzeka kuphela ngemuva eyokwenza izifundo zezinyanga ezintathu we-umthamo esiphezulu.

I Izimo ezisemqoka izifo yaleli pheshana emathunjini, inhliziyo futhi ngomgudu womchamo. Isicelo somoya bronchial nesokuwa nayo Kunconywa.

Ukwelashwa nokuvikelwa obangwa

izinguquko ezingenakuhlehliswa ebuchosheni kubangela isifo i-Alzheimer. Izimbangela isifo - nenkinga njalo wokuhlupha abacwaningi. Ngesikhathi sigaba lokugcina isifo kungenzeka ukuthi usebenzise eyodwa kuphela izidakamizwa evunywe ezweni imithi - "Memantine". izinqubo esiwohlozayo e izinzwa kungalawulwa ngendlela eyodwa cholinesterase kuphela, isimo siba more xaka. astrocytes ubuchopho, aqala ukukhiqiza i-ubuthi obubangelwa - glutamate, ebulala izinzwa kanye astrocytes ngokwabo.

"Memantine" ulawula exchange of glutamate, okuyinto evimbela isimo lokudakwa ubuchopho. Ochwepheshe abaningi abaqhuba ukusetshenziswa "Memantine" kanye inhibitor cholinesterase, okuvame linikeza imiphumela emihle.

Umuthi is kahle ziqondakala umzimba, it has a Izimo ezimbalwa (isithuthwane futhi kahle umsebenzi kwezinso). US kanye EU amazwe ukusebenzisa "Memantine" ekwelapheni isifo i-Alzheimer iminyaka 10.

ukwelashwa okunezimpawu

Ukwelashwa kusekelwe ukusetshenziswa abakhethayo serotonin reuptake inhibitor ( "Fluoxetine", "citalopram") futhi norepinephrine. Ngaphezu nomthelela omuhle izidakamizwa psyche ukusiza ukuqeda izimpawu yingqondo omnene. Ukusebenzisa antidepressant ejwayelekile kungaholela ukuthuthukiswa yesifo i-Alzheimer, ngakho ngokucindezeleka okukhulu linqume tricyclic antidepressant.

Lapho esetshenziswa neuroleptics iziyaluyalu ngengqondo. Nokho, kufanele sikhumbule ukuthi bathuthukisa Inkulumo komqondo. Sebenzisa kuphela ezimweni ezimbi kakhulu, odokotela linqume izidakamizwa imiphumela omnene kuphela.