Essential hypertension-What is essential hypertension?
Essential hypertension - Disease Overview
Blood pressure measurement Hypertension (hypertension) is the adult (≥ 18 years), systolic blood pressure ≥ 140mmHg in a quiet state (18.7kPa) and (or) diastolic blood pressure ≥ 90mmHg (12.0kPa), often accompanied by fat and glucose metabolism disorders, as well as the organ of the heart, brain, kidney and retina functional or organic changes, that is, the organ remodeling (remodeling) is characterized by systemic disease. Variety of risk factors and pathogenesis of the disease may have caused dysfunction of the central nervous system, humoral, endocrine, genetic, kidneys, blood vessels, baroreceptor dysfunction, cell membrane ion transport abnormalities, as well as environmental factors, living habits, social factors and so may be involved in the pathogenesis process. For reasons not fully elucidated high blood pressure, called essential hypertension. Clear, the cause of high blood pressure just a manifestation of certain diseases, known as the secondary (symptomatic) hypertension.
Hypertension classification and typing:
An etiology can be divided into primary and secondary (symptomatic) two categories.
Blood pressure levels classified according to the 1999 WHO-ISH hypertension treatment guidelines, hypertension is the case of not taking antihypertensive medication, 18-year-old adult systolic blood pressure ≥ 140mmHg (18.7kPa) and (or) diastolic blood pressure ≥ 90mmHg (12.0kPa).
Adult self-test blood pressure 135/85mmHg (18.0/11.3kPa) normal, 24h blood pressure monitoring during the day and sleep at night <135/85mmHg (18.0/11.3kPa), <120/75mmHg (16.0/10.0kPa) normal, more than The above data is high blood pressure.
Essential hypertension - symptoms and signsHypertension right ventricular enlargement, symptoms of hypertension according to clinical characteristics and progression of speed, can be divided into a jog (slow type) hypertension and radical (malignant) hypertension. (% Of essential hypertension in 95% ~ 99%) belong to jog hypertension essential hypertension, more common in the elderly, which is characterized by insidious onset, slow progress in the course of more than 10 years to decades , so very few symptoms early, about half of the patients due to a medical examination or measurement of blood pressure when the medical treatment of other diseases, only occasional blood pressure.Target organ damage symptoms
(1) heart: heart damage symptoms of hypertension and blood pressure continues to rise about, which can increase the left ventricular afterload, leading to cardiac hypertrophy, followed caused the chambers of the heart to expand and repeated heart failure attack.
(2) kidney: primary hypertensive renal damage and to the renal arteriolosclerosis, in addition, adjustment disorder is also related to the kidney itself. Early urinary symptoms, nocturia increased with urinary electrolyte excretion increased with disease progression, indicating that the renal concentration function has begun to decline, followed by the urine abnormalities, such as proteinuria, tubular, red blood cells, renal function diminished urine relative density (specific gravity) is often fixed at about 1.010, β2-microglobulin in urine increased due to renal tubular damage to make. Hypertension and severe kidney damage can occur when the symptoms of chronic renal failure.
(3) of the brain: high blood pressure can lead to cerebral small artery spasm, resulting in headache, dizziness, stretching, vertigo and other symptoms when blood pressure suddenly increased significantly hypertensive encephalopathy, severe headache, vomiting, vision loss, convulsions , coma, cerebral edema and intracranial hypertension symptoms, if not timely rescue can be fatal. Brain the most important complications of hypertension cerebral hemorrhage and cerebral infarction.
Essential hypertension - disease etiologyHypertension treatment instrument high blood pressure related to many factors, including the following factors:(1) gender and age the world's most areas, the prevalence of hypertension in men than in women.
(2) career in the mental and the intense work of hypertension prevalence than manual workers, urban residents than rural residents a high prevalence and early age of onset.
(3) the diet and blood pressure has been confirmed that excessive sodium intake, heavy drinking, long-term drinking strong coffee, lack of calcium in the diet, saturated fatty acids in the diet too much, unsaturated fatty acids and saturated fatty acid ratio lower, can promote increased blood pressure .
4 smoking
Obesity and ultra volume
6 genetic
Seven different regions of the regional differences in population blood pressure levels are not the same northern areas, the average population systolic blood pressure higher than the southern region, the prevalence of hypertension also increased accordingly.
8 psychological factors.
Essential hypertension - pathophysiologyBlood pressure measurement to count the pathogenesis of essential hypertension, the following factors play an important role in the pathogenesis of hypertension.(1) the pathogenesis of
(1) cardiac output changes: early hypertensive patients often have increased cardiac output, showed that the increase in cardiac output play a role in the initiating mechanism of essential hypertension may be associated with sympathetic activation and catecholamine secretion of active substances related to the increase .
(2) the kidneys factors: renal regulation of water, electrolytes, blood volume and excretion of metabolites of the main organs, abnormal renal function can lead to water and sodium retention and increased blood volume, causing high blood pressure.
(3) The renin - angiotensin - aldosterone system (RAAS): The system consists of a series of hormones and enzymes composed of RAAS plays an important role in regulating water and electrolyte balance and blood volume, vascular tone and blood pressure.
(4) membrane ion transport abnormalities: through the cell membrane on both sides of sodium and potassium ion concentration and gradient has been confirmed in patients with essential hypertension exist within the sodium, potassium co-operation dysfunction and sodium pump inhibition, intracellular sodium ion increased.
(5) increase in sympathetic activity: the sympathetic nerves are widely distributed in the cardiovascular system. The role of increased sympathetic activity in the heart, can lead to faster heart rate, myocardial contractility and to strengthen and increase in cardiac output; role in vascular α receptor allows small artery contraction, the increase in peripheral vascular resistance and blood pressure.
(6) increased vascular tone, wall thickening: blood circulation to regulate their own imbalances, leading to increased tension of small arteries and small veins, hypertension.
(7) vasodilators: the body in addition to the liters of blood pressure, material and systems, there are many endogenous decompression (vasodilator) substances and systems to be antagonistic to maintain relatively stable blood pressure. Have a strong vasodilator prostaglandin (PG) substances (such as of PGl2, PGF2, and PGA2, etc.) to reduce, increase peripheral vascular resistance, so that the blood pressure.
2 of Pathology
Artery (1): mainly for high blood pressure early arterial contraction and tension increased over time, high blood pressure by affecting the vascular endothelium and smooth muscle cells, leaving the artery wall intimal permeability changes, manifested as intimal surface is not smooth, not smooth, followed by the increased permeability of the arterial wall, circulating red blood cells, platelets into the intima and adhesion in the area and intimal deposition and proliferation of smooth muscle cells from the middle tour to the thickening of the intima, connective tissue increased, so the wall thickening and hardening, luminal narrowing, or occlusion, can lead to arteriosclerosis.
(2) of the heart: heart hypertension one of the target organ, the disease can lead to cardiac function and changes in the structure, long-term blood pressure and heart continues to remain overloaded state, can cause left ventricular hypertrophy, mainly for the left Room concentric hypertrophy, ie, wall, interventricular septum was symmetrical hypertrophy, ventricular cavity does not expand, more common in peripheral resistance was significantly increased cardiac output is relatively low nor heart failure in patients with hypertension; cardiac output is relatively high or repeated heart failure patients, can be expressed as eccentric hypertrophy, the ventricular cavity to expand, but the wall and the room cavity ratio does not increase.
(3) kidney: primary benign hypertension on kidney damage manifested as benign renal arteriosclerosis, due to the slow progress of the disease, elderly patients with a higher prevalence, it is the pathological basis of hypertensive kidney disease to afferent arterioles and interlobular arteriosclerosis mainly followed can cause renal ischemia, atrophy, fibrosis and necrosis, leading to chronic renal insufficiency, kidney disease can aggravate high blood pressure, creating a vicious cycle.
(4) brain: the brain is high blood pressure the most important target organ, is also suffering from hypertension the main reason of death or disability.
(5) Other: high blood pressure the body can affect all organs, ocular lesions are also common hypertensive complications, retinal arteriosclerosis and retinopathy is the most important, can be expressed as retinal vascular spasm, contraction, exudation, hemorrhage, and optic disc edema can lead to patients with visual acuity and ocular symptoms appears.
Essential hypertension - diagnostic testsBlood pressure measurement except first diagnosis of primary hypertension secondary hypertension.Stage, grade, and risk stratification of hypertension:
(1) the classification of hypertension: the medication, systolic blood pressure (SBP) ≥ 18.7kPa (140mmHg) and (or) diastolic blood pressure (DBP) ≥ 12.0kPa (90mmHg). Grading standards of the 1999 WHO recommended blood pressure levels of adults over the age of 18.
(2) hypertension in the standard of risk stratification.
Laboratory tests:
Urine and renal function test may be negative or have a small amount of protein and red blood cells. Often rapidly progressive hypertension in patients with urinary protein, red blood cells and tubular renal dysfunction often have a lot of protein, red blood cells and casts.
(2) renal dysfunction, urine specific gravity low and fixed, to reduce the excretion of phenol red, serum creatinine and urea nitrogen levels, urea or endogenous creatinine clearance rate of less than normal.
(3) plasma renin activity and angiotensin II concentration, both may be normal, increase or decrease. Also measured plasma atrial natriuretic peptide concentration, and often reduced.
Other laboratory examinations:
1.X-ray examination of left ventricular hypertrophy to expand, aortic widening, extension and twist the heart shadow was the change in aortic type. Visible pulmonary congestion signs of left ventricular dysfunction.
2 ECG left ventricular hypertrophy, strain. In addition, there may be a variety of arrhythmias, left bundle branch block graphics. And coronary heart disease, angina or myocardial infarction may be the corresponding ECG changes.
Echocardiography, two-dimensional ultrasound early left ventricular wall pulsatility enhanced hypertension heart disease, more common septal hypertrophy, left ventricular posterior wall hypertrophy and left atrium were enlarged, ultrasound Doppler mitral enable the detection of early diastolic blood flow slowed down, end-diastolic velocity increased.
Fundus examination showed retinal artery spasm and (or) sclerosis, serious bleeding and oozing, optic disc edema.
Arterial blood pressure monitoring nearly 10 years the rapid development of new diagnostic technologies, contribute to the diagnosis of hypertension and determine the treatment effect.
Differential diagnosis:Must bear in mind the two majority in the diagnosis of hypertension in the differential diagnosis: First, the majority of the hypertensive population with essential hypertension; two patients with secondary hypertension, the majority of the etiology and kidney, including renal parenchyma ( renal hypertension, renin tumors, etc.), renal artery (renovascular hypertension), as well as the adrenal cortex, primary aldosteronism, and adrenal medulla chromaffin cell tumor. Differential diagnosis, it is impossible it is not necessary to the implementation of the measures of each of the differential diagnosis of each type of secondary hypertension in patients with hypertension.
Essential hypertension - treatment optionsHypertension treatment instrument. The basic principles(1) the treatment of hypertension must take comprehensive measures: the varying degrees of hypertension should be treated separately. Moderate and severe hypertension should begin as soon as possible treatment; mild hypertension, diastolic blood pressure continued after the 90 ~ 99mmHg patients with non-drug measures, invalid application of antihypertensive drugs.
(2) non-drug treatment measures: such as weight loss, weight control, low-salt diet, quit alcohol, appropriate sports and doing qigong, tai chi, etc., applicable to various degrees of hypertension. Mild hypertension by about half a year of non-drug therapy should be used antihypertensive drugs. Already and have diabetes, left ventricular hypertrophy, coronary heart disease patients, even if the blood pressure mildly elevated early drug treatment to reduce and reduce cardiac complications.
(3) mild to moderate hypertension: the general use of an antihypertensive drug can be effective, should be based on the patient's general condition, the choice of side effects, easy to take drugs; severe hypertension or severe complications of hypertension should be used in combination, to control blood pressure as soon as possible, generally two to three kinds of antihypertensive drugs can be. Antihypertensive drugs is best to apply the long-acting agents, the antihypertensive effect can be maintained at more than 24h, 24h blood pressure trough to peak ratios should be> 50% in order to avoid wide fluctuations in blood pressure one day.
(4) the principle of individualized: each hypertensive patients is variable, its pathogenesis is not the same on the response to antihypertensive drugs are also different, so must be treated in the clinical treatment process, select the most appropriate drug and dose. to obtain the best effect.
(5) except in cases of hypertensive crisis, hypertensive encephalopathy, hypertensive emergency, blood pressure should be decreased gradually after a few days or 1 to 2 weeks as well, to avoid short-term blood pressure dropped sharply, to avoid the heart, brain, renal agenesis blood symptoms, especially in elderly patients.
(6) of antihypertensive therapy: blood pressure control in patients with severe hypertension, elderly patients with hypertension or with marked cerebral arteriosclerosis, renal insufficiency, by the joint treatment of blood pressure still can not be ≤ 140/90mmHg or 140/90mmHg following the symptoms actually worsened, the blood pressure is controlled at 140 to 150/90 ~ 95mmHg can lower blood pressure, too much may even lead to heart, brain, kidney ischemia, aggravate the disease and complications.
(2) non-drug treatment (1) weight loss, weight control (2) low-salt diet (3) limit alcohol consumption and smoking cessation (4) sports.
Hypertension Yishi fruit. Drug treatment(1) commonly used antihypertensive drugs:
① diuretic antihypertensive drugs: thiazides: hydrochlorothiazide thiophene hydrochloride (hydrochlorothiazide in urine plug, of hydrochlorothiazide, of HCT) 12.5 to 25mg, 1 times / d; benzyl fluoride thiophene hydrochloride (bendrofltlazide) 5mg, 1 to 2 / d; cyclopentyl thiazide 0.25mg 1 / d; hydrogen fluoride thiazine (hydroflumethiazide) 12.5mg, 1 / d; parked and thiazide (thiazide) (polythiazide) 2mg, 1 times / d; A chlorine thiazide 2.5mg, 1 times / d; the B thiazide (ethiazide) 2.5mg, 1 times / d; ring thiazide (cyclothiazide) 0.5 to 1 mg / d. (b) of chlorthalidone and similar to the thiazide diuretics: ① The Chlorthalidone (chlorthalidone) 12.5 to 25mg / d, day or once every other day; 2 chlorine Sauron (chlorine ring indanone) 20 ~ 40mg / d, 1 or 2 times service; ③ The US Fuxi Te (times can be reduced mefruside bycaron) 25 ~ 50mg / d; ④ The indapamide (indapamide) is a diuretic and antihypertensive drugs with calcium antagonism, 1.25 to 2.5 mg, 1 / d; the ⑤ Kuiyi yl ketones (quinethazone,) 25 ~ 50mg / d. (c) the medullary loop of the ascending branch of the diuretic antihypertensive drugs, according to Thani acid (ethacrynic acid), furosemide and mercury Sali (less) the end of the (d) distal convoluted tubule and collecting tube cortex diuretic antihypertensive drugs: spironolactone (security the spironolactone antisterone, contained spironolactone), triamterene (triamterene, three ammonia neopterin), amiloride (amlodipine and topiramate microphone, amiloride).
The ② adrenergic blockers: A.β blockers include: (a) propranolol (of propranolol, propranolol) (b) A atenolol (atendol, tenormin, atenolol) c. America Trotsky Seoul (of metoprolol, betaloc, metoprolol, methoxy B peace of mind) (d) thiophene timolol (timolol, timolol): is a potent non-selective beta receptor blockers, 2 hours after taking up the role of peak 5 10mg / d, 2 ~ 3 times / d. e. nadolol (nadolol, Kang Jiaer more naphthalene hydroxyl peace of mind): is a non-selective beta-blockers For no endogenous sympathomimetic activity, is a long-acting formulations, oral administration of 1 / d dose 40 ~ 200mg. f. Betaxolol (betaxolol): selective β1 receptor blockers, without intrinsic sympathomimetic activity at a dose of 5 ~~ 20mg / d. (g) Bisoprolol (bisoprolol, Concord): is a selective β1 receptor blocker use for the 2.5 ~ 10mg, 1 / d. B. acting on the central α-receptor blocking drugs: clonidine (of clonidine, catapres, clonidine) b. To Guanidine that benzyl (chlorine pressure guanidine) (c) methyldopa (methyldopa, aldomet) d. Guanidine France Xin (guanfacine) e hydrochloride Los non-Western set (lofexidinehydrochloride) C. ganglion blockers: a. U.S. Kala Ming (mecamylamine) b. camphor sulfonamide Mi Fen (Mi-fen, Alfonso Linate) c Pan will pyridine (pempidine, the, Wujia piperidine).
③ vasodilators: can be divided into two categories, one is a direct effect on vascular smooth muscle to cause vasodilation, including nitrates, sodium nitroprusside, hydrazine, hydralazine and other drugs; indirect vasodilators, including calcium antagonists alpha receptor blockers and angiotensin-converting enzyme inhibitors.
④ angiotensin-converting enzyme inhibitors: the commonly used drugs: captopril (captopril, captopril): 15 ~ 30min after oral administration began to buck up to the peak effect in 1 ~ 1.5h lasted 8 ~~ 12h typical doses of 6.25mg, 3 times / d, increasing to 12.5 ~ 25mg, 3 times / d, the maximum dose is 100 to 150mg / d. Adverse reactions are dizziness, abdominal discomfort, headache, fatigue, loss of appetite and coughing, impaired renal function should reduce the dose or extend the delivery time. Should not also apply to the retention of potassium-sparing diuretics or potassium preparations, in order to avoid potassium increased; is a second generation of angiotensin converting enzyme inhibitors, without thiol (SH), the maximum antihypertensive effect of enalapril (for enalapril): medication after 6 ~ 8h appear, lasted for 12 ~ 24h. Began to measure the 5mg, 1 ~ 2 times / d, the usual dose is 10 to 20mg / d, the maximum dose of 40mg / d. Adverse events with captopril, but lighter; lisinopril (lisinopril has been used): a long-acting formulations, mechanism of action similar to enalapril. Usage: a starting dose of 5mg / d, gradually increase the amount, the usual dose of 20 ~ 40mg / d, the maximum dosage should not exceed 80mg / d; ramipril (the ramipril, Ruitai) and: long-acting ACEI agents a starting dose of 2.5mg / d, increasing to 5 ~ 10mg / d; lisinopril (lisinopril has been used): the starting dose of 10mg / d, increasing to 80mg / d; Cilazapril (cilazapril, inhibace, ): start the dosage of 2.5mg / d, depending on blood pressure can be gradually increased to 5 ~ 20mg / d; benazepril (benazepril): The starting dose of 5mg / d, increasing to 10 ~ 40mg / d, sub- 1 to 2 doses; perindopril (perindopril, acertil, Acertil): The starting dose of 4 mg / d, may be increased to 8mg / d; fosinopril (fosinopril, monopril, Monopril): a starting dose of 10mg / d, may be increased to 20 to 30mg / d; the the ⑩ hydrochloride Quinapril (quinaprilhydrochloride, accupril): a starting dose of 5mg / d, may be increased to 20mg / d.
⑤ The of Ang II receptor l subtypes (AT1) antagonists: their chemical structure can be divided into three categories: ① The biphenyl tetrazole, the main drugs: losartan (losartan, cozaar Cozaar), the usual dose 50mg / d, if necessary, may be increased to 100mg / d; commonly used doses of irbesartan (irbesartan) for 75 ~~ 300mg / d; Kant losartan (the candesartan) commonly used dose of 4 to 32mg / d; Suosha Tan ( the tasosartan) the usual dose of 100 ~ 200mg / d; ② The non-biphenyl tetrazole, the main drugs: Ipp losartan (eprsatan,) the usual dose of 400 to 800mg / d; Tian Mei losartan (with telmisartan) 20 to 160mg / d ; ③ non-heterocyclic valsartan (valsartan, diovan, Diovan) commonly used dose is 80 to 160mg / d.
Essential hypertension - Prognosis PreventionThe prognosis of the treatment of high blood pressure medicines: Hypertension is a heterogeneous disease of genetic susceptibility and environmental factors, the strength of individual risk factors and causative agent different, different individual life when the incidence varies from person to person. At the same time, the hypertension early lack of clinical symptoms, it is difficult to determine one patients with hypertension duration of the "starting point". On the other hand, the natural course of disease or prognosis of hypertension by a variety of other risk factors, therefore, accurately describe the course of hypertension more difficult. Hypertensive patients with average life expectancy of 15 to 20 years shorter than normal, but different in different individuals.Prevention: the prevention of hypertension should not only reduce the prevalence of hypertension, is more important is to reduce or delay the emergence of cardiovascular and cerebrovascular complications. Hypertension prevention and divided into three: to take preventive measures in the primary prevention of high-risk groups for hypertension, but also for the general population, in the presence of risk factors but have not yet developed hypertension. Secondary prevention system for the diagnosis of patients with essential hypertension in a planned comprehensive treatment to prevent exacerbations or complications, in essence, arteriosclerosis, stroke, coronary heart disease, such as a prevention. Tertiary prevention refers to the rescue of the weight in patients with hypertension in critical condition, prevent complications and reduce deaths, but also include the rehabilitation after the successful rescue. Clearly, hypertension prevention emphasis in primary prevention and secondary prevention.
Hypertension is a preventive measure
(1) lose weight: overweight and obesity is a major risk factor of hypertension, according to the standard body mass index> 23 referred to as overweight. The weight loss of the main measures is to restrict over-eating, increasing physical activity.
(2) a reasonable diet: to reduce sodium intake, an appropriate increase of potassium, calcium, magnesium intake, reduce fat in the diet.
(3) limit alcohol consumption: that was a U-shaped curve relationship between alcohol consumption and blood pressure, and a threshold response (40g of alcohol threshold), for the prevention of hypertension, the best non-drinkers; drinking habits. alcohol or to minimize alcohol consumption (<50m1 / d).
(4) increased physical activity: the risk of hypertension of less physical activity is physical activity more than 1.52 times, therefore, advocates insist on regular physical activity, especially aerobic exercise.
(5) psychological balance: the psychological pressure caused by personal factors and environmental factors often makes the patients taken to unhealthy lifestyles, the latter related to increased risk of hypertension and cardiovascular disease should therefore be treated correctly and try to alleviate the psychological pressure .
The rational treatment of hypertension secondary prevention measures for hypertension include:
(1) The application is simple, effective, safe, inexpensive antihypertensive drugs to lower blood pressure to normal.
(2) protection of target organs.
(3) taking into account the treatment of other risk factors.
(4) improve the quality of life. In short, comprehensive measures should be taken to vary the individual therapy, to achieve the best results.
3 to carry out the comprehensive prevention and control of high blood pressure community is a fundamental way.
(1) Hospital Health Education: various types and levels of health care institutions and their staff, the purposes of health care in clinical practice, the implementation of health education, tertiary prevention through health education.
(2) Community prevention and control: the establishment of prevention and control network, and personnel training. Epidemiological investigation, including a baseline survey and forward-looking heart, cerebrovascular disease survey. Population grouping and implementation of interventions, to participate in the prevention and control of the object were randomized three preventive measures, the implementation of the intervention group.
4. Cardiovascular multiple risk factors for joint intervention in several population studies show that, although randomized clinical trials have confirmed the benefits of lower blood pressure, but, after treatment in hypertensive patients with coronary heart disease, the incidence of stroke and total mortality rate was still significantly higher than non-hypertensive patients. Observations suggest that the treatment of hypertensive patients with non-hypertensive patients, the former is more severe atherosclerosis, LVN more obvious. Therefore proposed that produce complications of hypertension, multiple risk factors involved in cardiovascular multiple risk factors for joint intervention in the prevention and treatment of hypertension should be conducted.
The intervention of other risk factors: weight loss, exercise, reduce fibrinogen can improve cardiovascular disease risk, but has not yet been confirmed by large clinical trials. Supplementary anti-oxidative vitamins such as vitamin C, vitamin E and cysteine reduce vitamin such as folate, vitamin B12.
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Friday, March 2, 2012
Rheumatoid Arthritis
Rheumatoid Arthritis-What is rheumatoid arthritis?
Rheumatoid arthritis is a personal disease based non-suppurative inflammation of the joints and joints surrounding tissue, often accompanied by extra-articular disease symptoms, it is called rheumatoid arthritis. Intra-articular synovitis, exudate, cell proliferation, granuloma formation, cartilage and bone destruction, the last ankylosis and dysfunction. Often used traditional Chinese medicine with conservative treatment such as the use of externally bonded drugs for treatment.
Rheumatoid arthritis - an overview of diseaseRheumatoid arthritis Rheumatoid arthritis is a joint synovitis is characterized by chronic, systemic autoimmune autoimmune diseases. Recurrent synovitis lasting, can lead to the destruction of joint cartilage and bone, joint dysfunction, and even disability. Vasculitis lesions involving various organs of the body, the disease also known as rheumatoid arthritis.
Treatment: as yet no effective therapy for treating rheumatoid arthritis, still remain in the treatment of inflammation and its sequelae, comprehensive treatment, most patients are able to get a certain effect. The purpose of the current treatment is:
① control the inflammation of the joints and other organizations, to relieve symptoms;
② preserve joint function and prevent deformity;
(3) to repair damaged joints to relieve pain and restore function.
(A) general therapy: fever, joint pain, systemic symptoms to those who should rest in bed until symptoms disappeared. Until the condition should improve after two weeks and gradually increase their activities to avoid too long in bed lead to joint disuse, and even promote ankylosis. Protein and various vitamins in the diet should be sufficient, anemia significantly to a small amount of blood transfusion, if the chronic lesions, such as tonsillitis patients' health conditions permit, as soon as possible removed.
(B) drug treatment.
(C) treatments.
(D) surgical treatment.
(E) traditional Chinese medicine.
Rheumatoid arthritis - symptoms and signsThe slow onset of symptoms, more than the first weeks to months, fatigue, weakness, weight loss, poor appetite, fever and numbness, tingling and other prodromal symptoms.
A joint symptoms:
(1) of morning stiffness: a joint symptoms often appear before joint pain. Joint stiffness, pain and discomfort started its activities, joint activities increased morning stiffness is lessened or disappeared. Joint morning stiffness morning, afternoon reduced.
(2) joint swelling and pain: mostly symmetry, often invading the metacarpophalangeal joints, wrist, shoulder, interphalangeal joint, ankle and knee. Joints red, swollen, hot, pain, movement disorder.
2, articular manifestations: rheumatoid arthritis, systemic part of the performance or its complications. Joint disease of the disease can be disabling, but not fatal. Articular manifestations are often the cause of death in this disease.
(1) rheumatoid nodules: seen in 15 to 20% of patients, more common in the forearm, often under pressure, stretch side, such as the ulnar and olecranon at. Palpable in the subcutaneous soft amorphous Summary of activities or in the periosteum of the rubber-like summary. Serum rheumatoid factor positive subcutaneous rheumatoid nodules more common.
(2) rheumatoid vasculitis: rheumatoid vasculitis is the basic lesion of the disease, joints and periarticular organizations, other Department of the body can occur vasculitis. Performance Remote vasculitis, skin ulcers, peripheral neuropathy, pericarditis, visceral arteritis, such as heart, lung, intestine, spleen, pancreas, kidney, lymph nodes and testis.
(3) in rheumatic heart disease: cardiac involvement, myocardial, valvular ring or aortic root class rheumatic granuloma formation, or myocardial endocardium and valve ring lymphocyte infiltration or fibrosis.
(4) rheumatoid lung disease: chronic fibrous pneumonia is more common in the pulmonary vascular fibrinoid necrosis and infiltration of mononuclear cells, fever, difficulty breathing, coughing and chest pain.
(5), kidney damage.
(6), ocular manifestations: uveitis is common lesions of juvenile rheumatoid arthritis, adult rheumatoid arthritis is a common cause of keratitis.
(7) Felty syndrome: a severe rheumatoid arthritis, a common cause of splenomegaly, neutropenia, positive rate of serum rheumatoid factor, antinuclear antibodies.
(8), Sjogren's syndrome: a chronic inflammatory autoimmune disease. Mainly affects the lacrimal gland, and the size of the salivary glands, resulting in reduced or lack of glandular destruction and secretion, the clinical manifestations of dry eye and oral mucosa disease group.
(9) gastrointestinal damage.
Introduction to rheumatism refers toEarly morning stiffness: rheumatoid arthritis patients, is often manifested in the morning fingers are stiff gradually ease the sense of economic activities. With the development of pain, morning stiffness and heavier and heavier, longer and longer duration, more than one hour.
Cold: the patient fingers is particularly sensitive to cold, a case of cold water is very white, purple, numbness, formication, or even pain. The cold tip of finger arterial
Cramps, medicine called Raynaud's phenomenon.
Proximal: Rheumatoid arthritis is the best site for the proximal (near the trunk side) interphalangeal joints, metacarpophalangeal joints may be violated, but in no way infringe upon the distal interphalangeal joint. There are many non-specialists often a good proliferative arthritis of the distal interphalangeal joint, or even Kashin-Beck disease misdiagnosed as rheumatoid.
Ulnar deviation: the thumb side means the side of the little finger side of the ulnar. Early rheumatoid you can see finger to ulnar deviation, normal is mostly slightly to refer to lateral deflection, especially the little finger is most apparent.
Muscle wilt: rheumatoid arthritis, an early stage often has a phalanx of muscle atrophy, the formation of the so-called medical "Clostridium" "bean the Link eggplant-shaped" change with the enlargement of the proximal interphalangeal joint.
Color Shen: dorsal lesions interphalangeal joint, often see the pigmentation and hair Gampsocleis (black) color. At the same time, the local skin can be presented keratosis and thickening.
Symmetry: Rheumatoid arthritis refers to the salient features of the joint damage was symmetrical for both hands. Sometimes early only to see the middle finger proximal joint swelling, but should also be a symmetry of left and right middle finger injury, but rarely unilateral, which is common in traumatic arthritis, and tuberculous arthritis.
Rheumatoid arthritis - etiology and pathogenesisAt present, many believe that the disease is an autoimmune disease, the initiating factor is not clear, may be the infectious agent (such as viruses, mycoplasma, or bacteria, etc.) into the human body, which contains certain ingredients (such as oligosaccharides or sugar Peptide Fragments) intake was intra-articular synovial cells and the combination of proteoglycan synthesis by synovial cells, and its structure changed with antigen. This antigen not only allows the body to produce antibodies (IgG), also lead to the Fc fragment of the IgG molecule structure change, the formation of new epitopes, which stimulate the formation of another antibody, that is, rheumatoid factor (RF). RF the most important ingredients in the serum IgM and also IgG, IgA, and IgE. IgM-RF to meet with the 85% to 95% of patients with rheumatoid arthritis, is an important indicator of the clinical diagnosis. Various immunoglobulin types of RF and IgG immune complexes are present in the blood circulation. RF and immunoglobulin synthesis of intra-articular and combine to form immune complexes, circulating RF-IgG complexes can also be deposited in the local tissue, which is closely associated with the organs and tissues of the joints and extra-articular lesions. The RF-IgG complexes in the synovial membrane can be fixed and the activation of complement, generation of C3a and C5a to attract neutrophils and monocytes exudation. Neutrophils, monocytes and synovial cells (type A cells) swallowed the immune complexes, activated and the synthesis and release of lysosomal enzymes, including neutral protease, collagenase, and a variety of media, such as prostaglandins, leukotrienes, IL-1, etc., resulting in the destruction of the synovial membrane and articular cartilage. IL-1 is the main medium of rheumatoid arthritis, generated by activated macrophages and synovial cells. Of IL-1 allows the synovial cells and cartilage cells to synthesize and release collagenase and other proteolytic enzymes, and inhibition of chondrocyte proteoglycan synthesis in itself is an osteoclast activating factor. Is not only the RF, immunoglobulin and complement in the synovial membrane, but also by synovial B cells and plasma cells by immunofluorescence and organizational culture. Even in the initial factor (such as the infectious agent) has ceased to exist, RF continues to produce, resulting in inflammatory lesions is a recurring problem, a chronic inflammation.
The results show that, in addition to the above humoral immune factors of the disease and cellular immunity is also closely related to. With synovitis into a chronic, T cells and plasma cells increased significantly, which is the T4 helper cells. Synergy T4 and B cells, involved in RF and immunoglobulin synthesis of synovial HLA-DR positive macrophages and dendritic cells increase with T4 interaction with the immune mechanisms of joint damage.
On the infection of the relationship of the factors of the disease in recent years, noting the role of Epstein-Barr virus infection. EB virus core antibody, about 65% to 93% in the serum of patients with rheumatoid arthritis and other arthritis patients compared with only 10% to 29%; and B cells, cells of the patients transformed by Epstein-Barr virus can produce the RF.
Rheumatoid arthritis - disease etiologyCause of 1) dysfunction often makes the patient's work, family life and sexual life is limited, which can cause emotional disorders such as anxiety, depression and treatment of non-cooperation.
(2) drug treatment in patients with rheumatoid arthritis can lead to psychotic symptoms. Non-steroidal anti-inflammatory drugs (NSAIDs) can cause cognitive impairment, delirium, mania and psychotic symptoms, the elderly are more vulnerable to such side effects. NSAIDs increase blood concentration of lithium salt treatment of the lithium salt concentration and toxic concentration close Therefore, if the patient taking lithium salt at the same time, the need for regular testing of blood lithium concentration. Glucocorticoids can cause mood swings, sleep disorders, delirium, and psychotic symptoms, symptoms related to the dose of the drug.
Will not be geneticRheumatoid arthritis will not be genetic, related to the event of having children, young patients very concerned about.
Genealogical survey results show that the family of patients with rheumatoid arthritis, rheumatoid arthritis, the incidence of family than healthy people 2 to 10 times higher. Have reported 29 pairs of monozygotic twins children, there are two pairs suffering from rheumatoid arthritis, another although separated in two places, but the age of 53 and 56 years of age are rheumatoid arthritis occurs.In the survey of 100 cases of rheumatoid arthritis patients, found that family history in only five cases, some brothers and sisters is not the only one suffering from rheumatoid arthritis, some parents also suffer from rheumatoid arthritis. But whether genetic too, there is no direct evidence. In addition to genetic factors, but should also consider the impact of all aspects of the same family environment, nutritional status, and psychological situation.
Abroad there have been suffering from rheumatoid arthritis twin children 28 pairs, of which 25 to have a person suffering from rheumatoid arthritis, the other three pairs are both suffering from rheumatoid arthritis. American scholars had investigated the family history of the Indian residents suffering from rheumatoid arthritis, can not put forward the conclusions of this disease with genetic factors.Thus, by early family investigation and twins prevalence of rheumatoid arthritis have a slight familial aggregation tendencies and sick twins phenomenon, suggesting that genetic factors in the pathogenesis of rheumatoid arthritis a certain role. Studies have shown that rheumatoid arthritis patients have an HLA-DR4 (human leukocyte antigen DR4) common genetic, rheumatoid arthritis and HLA-DR4, especially in severe cases, but not with this gene will suffering from rheumatoid arthritis. Rheumatoid arthritis genetic susceptibility, but not the only factor, the incidence is the result of various factors.
Rheumatoid arthritis - health careMorning and walking rheumatoid arthritis patients can not only enhance physical fitness, to promote their recovery and to increase joint activities, thereby reducing the ankylosis and deformity, reduce the formation of disability. Its main methods are:
1) fast walking, and go down. This is generally easy to grasp and to adhere to an effective fitness method. The so-called fast walking 120 steps per minute, the time from short to long. The so-called go down, that is, back walk, flat trail or on the square, every 100-200 steps with fast walking alternating. Better physique of patients, but also for the sprints, long-distance and varied pace.
2) can practice tai chi, tai chi sword, five birds and other traditional Chinese martial arts.
3) Cycling jump elderly disco, traditional dance, aerobics and other exercise, all contribute to the treatment of rheumatoid arthritis disease joint gymnastics streets simple joint functional exercise.
Shijiazhuang, Hebei Hospital Rheumatology experts say, patients with rheumatoid arthritis can choose according to their own illness, physical condition and their hobbies, etc. 1-2. Mild selectable action complex activity slightly larger activities such as tai chi, tai chi sword, elderly disco; serious condition, action is not convenient alternative movements are simple and the activities of small activities such as walking, jogging, Qigong. Patients can select different parts of the joint lesions joint gymnastics.
Rheumatoid arthritis - DiagnosisDiagnostic blood: positive cells are hypochromic anemia, lymphocytes and platelets increase in the active stage performance. ESR. Eosinophilia is a symbol of rheumatoid arthritis with severe systemic complications.
Hyperviscosity syndrome: rheumatoid factor IgM and IgG complexes can form sticky aggregates, causing hyperviscosity syndrome.
Rheumatoid factor: lymphocytes and plasma cells in the synovium of patients with rheumatoid arthritis can produce large amounts of rheumatoid factor, IgM, IgG and IgA rheumatoid factor
X-ray examination: joint X-ray film can be seen fuzzy articular surface erosion damage. Early in the disease near the joints, osteoporosis, soft tissue swelling, bone erosion. Late necrosis of articular cartilage allows the joint space narrowing and fibrosis.
Rheumatoid arthritis - hazardsRheumatoid arthritis rheumatoid arthritis treatment in a timely manner, the dangers of large, common, mainly of the following, namely:
, Rheumatoid arthritis can lead to kidney disease; rheumatoid arthritis, renal dysfunction, and long-term use of anti-rheumatic drugs and non-steroidal anti-inflammatory drug related. After stopping the treatment, you can gradually improve. Long-term use of non-steroidal anti-inflammatory analgesics, may cause interstitial nephritis, although progress is slow, but can lead to renal failure, so the elderly and patients with kidney disease should be used cautiously.
2, rheumatoid arthritis, can cause skin diseases; representative for rheumatoid nodules. In addition, the malignant rheumatoid arthritis can cause necrotizing vasculitis, a purpura, ulcers and gangrene mixed existence of skin lesions, 13 parts of common lower extremity.
3, rheumatoid arthritis can lead to respiratory diseases; common pleurisy and interstitial pneumonia, especially the chronically ill elderly.
4, rheumatoid arthritis can cause eye; rheumatoid involving the eyes, about 15% of patients with Sjogren's syndrome can occur, causing the cornea and conjunctiva is dry and does not apply to a small number of patients with concurrent scleritis, iritis, occurs in edge of the cornea 2 to 3 mm.
, Rheumatoid arthritis can lead to heart disease; rheumatoid arthritis complicated by pericarditis can be as high as 20% to 50%, a few of the formation of rheumatoid nodules, the majority of asymptomatic, often found in the cardiac ultrasound examination. But also may cause left ventricular failure.
6, rheumatoid arthritis can cause nervous system disease; patients with rheumatoid arthritis tend to neurological dysfunction. Its causes and cervical spinal cord compression due to synovitis, tendon synovitis of peripheral nerve compression can be nerve dysfunction.
Rheumatoid arthritis is a personal disease based non-suppurative inflammation of the joints and joints surrounding tissue, often accompanied by extra-articular disease symptoms, it is called rheumatoid arthritis. Intra-articular synovitis, exudate, cell proliferation, granuloma formation, cartilage and bone destruction, the last ankylosis and dysfunction. Often used traditional Chinese medicine with conservative treatment such as the use of externally bonded drugs for treatment.
Rheumatoid arthritis - an overview of diseaseRheumatoid arthritis Rheumatoid arthritis is a joint synovitis is characterized by chronic, systemic autoimmune autoimmune diseases. Recurrent synovitis lasting, can lead to the destruction of joint cartilage and bone, joint dysfunction, and even disability. Vasculitis lesions involving various organs of the body, the disease also known as rheumatoid arthritis.
Treatment: as yet no effective therapy for treating rheumatoid arthritis, still remain in the treatment of inflammation and its sequelae, comprehensive treatment, most patients are able to get a certain effect. The purpose of the current treatment is:
① control the inflammation of the joints and other organizations, to relieve symptoms;
② preserve joint function and prevent deformity;
(3) to repair damaged joints to relieve pain and restore function.
(A) general therapy: fever, joint pain, systemic symptoms to those who should rest in bed until symptoms disappeared. Until the condition should improve after two weeks and gradually increase their activities to avoid too long in bed lead to joint disuse, and even promote ankylosis. Protein and various vitamins in the diet should be sufficient, anemia significantly to a small amount of blood transfusion, if the chronic lesions, such as tonsillitis patients' health conditions permit, as soon as possible removed.
(B) drug treatment.
(C) treatments.
(D) surgical treatment.
(E) traditional Chinese medicine.
Rheumatoid arthritis - symptoms and signsThe slow onset of symptoms, more than the first weeks to months, fatigue, weakness, weight loss, poor appetite, fever and numbness, tingling and other prodromal symptoms.
A joint symptoms:
(1) of morning stiffness: a joint symptoms often appear before joint pain. Joint stiffness, pain and discomfort started its activities, joint activities increased morning stiffness is lessened or disappeared. Joint morning stiffness morning, afternoon reduced.
(2) joint swelling and pain: mostly symmetry, often invading the metacarpophalangeal joints, wrist, shoulder, interphalangeal joint, ankle and knee. Joints red, swollen, hot, pain, movement disorder.
2, articular manifestations: rheumatoid arthritis, systemic part of the performance or its complications. Joint disease of the disease can be disabling, but not fatal. Articular manifestations are often the cause of death in this disease.
(1) rheumatoid nodules: seen in 15 to 20% of patients, more common in the forearm, often under pressure, stretch side, such as the ulnar and olecranon at. Palpable in the subcutaneous soft amorphous Summary of activities or in the periosteum of the rubber-like summary. Serum rheumatoid factor positive subcutaneous rheumatoid nodules more common.
(2) rheumatoid vasculitis: rheumatoid vasculitis is the basic lesion of the disease, joints and periarticular organizations, other Department of the body can occur vasculitis. Performance Remote vasculitis, skin ulcers, peripheral neuropathy, pericarditis, visceral arteritis, such as heart, lung, intestine, spleen, pancreas, kidney, lymph nodes and testis.
(3) in rheumatic heart disease: cardiac involvement, myocardial, valvular ring or aortic root class rheumatic granuloma formation, or myocardial endocardium and valve ring lymphocyte infiltration or fibrosis.
(4) rheumatoid lung disease: chronic fibrous pneumonia is more common in the pulmonary vascular fibrinoid necrosis and infiltration of mononuclear cells, fever, difficulty breathing, coughing and chest pain.
(5), kidney damage.
(6), ocular manifestations: uveitis is common lesions of juvenile rheumatoid arthritis, adult rheumatoid arthritis is a common cause of keratitis.
(7) Felty syndrome: a severe rheumatoid arthritis, a common cause of splenomegaly, neutropenia, positive rate of serum rheumatoid factor, antinuclear antibodies.
(8), Sjogren's syndrome: a chronic inflammatory autoimmune disease. Mainly affects the lacrimal gland, and the size of the salivary glands, resulting in reduced or lack of glandular destruction and secretion, the clinical manifestations of dry eye and oral mucosa disease group.
(9) gastrointestinal damage.
Introduction to rheumatism refers toEarly morning stiffness: rheumatoid arthritis patients, is often manifested in the morning fingers are stiff gradually ease the sense of economic activities. With the development of pain, morning stiffness and heavier and heavier, longer and longer duration, more than one hour.
Cold: the patient fingers is particularly sensitive to cold, a case of cold water is very white, purple, numbness, formication, or even pain. The cold tip of finger arterial
Cramps, medicine called Raynaud's phenomenon.
Proximal: Rheumatoid arthritis is the best site for the proximal (near the trunk side) interphalangeal joints, metacarpophalangeal joints may be violated, but in no way infringe upon the distal interphalangeal joint. There are many non-specialists often a good proliferative arthritis of the distal interphalangeal joint, or even Kashin-Beck disease misdiagnosed as rheumatoid.
Ulnar deviation: the thumb side means the side of the little finger side of the ulnar. Early rheumatoid you can see finger to ulnar deviation, normal is mostly slightly to refer to lateral deflection, especially the little finger is most apparent.
Muscle wilt: rheumatoid arthritis, an early stage often has a phalanx of muscle atrophy, the formation of the so-called medical "Clostridium" "bean the Link eggplant-shaped" change with the enlargement of the proximal interphalangeal joint.
Color Shen: dorsal lesions interphalangeal joint, often see the pigmentation and hair Gampsocleis (black) color. At the same time, the local skin can be presented keratosis and thickening.
Symmetry: Rheumatoid arthritis refers to the salient features of the joint damage was symmetrical for both hands. Sometimes early only to see the middle finger proximal joint swelling, but should also be a symmetry of left and right middle finger injury, but rarely unilateral, which is common in traumatic arthritis, and tuberculous arthritis.
Rheumatoid arthritis - etiology and pathogenesisAt present, many believe that the disease is an autoimmune disease, the initiating factor is not clear, may be the infectious agent (such as viruses, mycoplasma, or bacteria, etc.) into the human body, which contains certain ingredients (such as oligosaccharides or sugar Peptide Fragments) intake was intra-articular synovial cells and the combination of proteoglycan synthesis by synovial cells, and its structure changed with antigen. This antigen not only allows the body to produce antibodies (IgG), also lead to the Fc fragment of the IgG molecule structure change, the formation of new epitopes, which stimulate the formation of another antibody, that is, rheumatoid factor (RF). RF the most important ingredients in the serum IgM and also IgG, IgA, and IgE. IgM-RF to meet with the 85% to 95% of patients with rheumatoid arthritis, is an important indicator of the clinical diagnosis. Various immunoglobulin types of RF and IgG immune complexes are present in the blood circulation. RF and immunoglobulin synthesis of intra-articular and combine to form immune complexes, circulating RF-IgG complexes can also be deposited in the local tissue, which is closely associated with the organs and tissues of the joints and extra-articular lesions. The RF-IgG complexes in the synovial membrane can be fixed and the activation of complement, generation of C3a and C5a to attract neutrophils and monocytes exudation. Neutrophils, monocytes and synovial cells (type A cells) swallowed the immune complexes, activated and the synthesis and release of lysosomal enzymes, including neutral protease, collagenase, and a variety of media, such as prostaglandins, leukotrienes, IL-1, etc., resulting in the destruction of the synovial membrane and articular cartilage. IL-1 is the main medium of rheumatoid arthritis, generated by activated macrophages and synovial cells. Of IL-1 allows the synovial cells and cartilage cells to synthesize and release collagenase and other proteolytic enzymes, and inhibition of chondrocyte proteoglycan synthesis in itself is an osteoclast activating factor. Is not only the RF, immunoglobulin and complement in the synovial membrane, but also by synovial B cells and plasma cells by immunofluorescence and organizational culture. Even in the initial factor (such as the infectious agent) has ceased to exist, RF continues to produce, resulting in inflammatory lesions is a recurring problem, a chronic inflammation.
The results show that, in addition to the above humoral immune factors of the disease and cellular immunity is also closely related to. With synovitis into a chronic, T cells and plasma cells increased significantly, which is the T4 helper cells. Synergy T4 and B cells, involved in RF and immunoglobulin synthesis of synovial HLA-DR positive macrophages and dendritic cells increase with T4 interaction with the immune mechanisms of joint damage.
On the infection of the relationship of the factors of the disease in recent years, noting the role of Epstein-Barr virus infection. EB virus core antibody, about 65% to 93% in the serum of patients with rheumatoid arthritis and other arthritis patients compared with only 10% to 29%; and B cells, cells of the patients transformed by Epstein-Barr virus can produce the RF.
Rheumatoid arthritis - disease etiologyCause of 1) dysfunction often makes the patient's work, family life and sexual life is limited, which can cause emotional disorders such as anxiety, depression and treatment of non-cooperation.
(2) drug treatment in patients with rheumatoid arthritis can lead to psychotic symptoms. Non-steroidal anti-inflammatory drugs (NSAIDs) can cause cognitive impairment, delirium, mania and psychotic symptoms, the elderly are more vulnerable to such side effects. NSAIDs increase blood concentration of lithium salt treatment of the lithium salt concentration and toxic concentration close Therefore, if the patient taking lithium salt at the same time, the need for regular testing of blood lithium concentration. Glucocorticoids can cause mood swings, sleep disorders, delirium, and psychotic symptoms, symptoms related to the dose of the drug.
Will not be geneticRheumatoid arthritis will not be genetic, related to the event of having children, young patients very concerned about.
Genealogical survey results show that the family of patients with rheumatoid arthritis, rheumatoid arthritis, the incidence of family than healthy people 2 to 10 times higher. Have reported 29 pairs of monozygotic twins children, there are two pairs suffering from rheumatoid arthritis, another although separated in two places, but the age of 53 and 56 years of age are rheumatoid arthritis occurs.In the survey of 100 cases of rheumatoid arthritis patients, found that family history in only five cases, some brothers and sisters is not the only one suffering from rheumatoid arthritis, some parents also suffer from rheumatoid arthritis. But whether genetic too, there is no direct evidence. In addition to genetic factors, but should also consider the impact of all aspects of the same family environment, nutritional status, and psychological situation.
Abroad there have been suffering from rheumatoid arthritis twin children 28 pairs, of which 25 to have a person suffering from rheumatoid arthritis, the other three pairs are both suffering from rheumatoid arthritis. American scholars had investigated the family history of the Indian residents suffering from rheumatoid arthritis, can not put forward the conclusions of this disease with genetic factors.Thus, by early family investigation and twins prevalence of rheumatoid arthritis have a slight familial aggregation tendencies and sick twins phenomenon, suggesting that genetic factors in the pathogenesis of rheumatoid arthritis a certain role. Studies have shown that rheumatoid arthritis patients have an HLA-DR4 (human leukocyte antigen DR4) common genetic, rheumatoid arthritis and HLA-DR4, especially in severe cases, but not with this gene will suffering from rheumatoid arthritis. Rheumatoid arthritis genetic susceptibility, but not the only factor, the incidence is the result of various factors.
Rheumatoid arthritis - health careMorning and walking rheumatoid arthritis patients can not only enhance physical fitness, to promote their recovery and to increase joint activities, thereby reducing the ankylosis and deformity, reduce the formation of disability. Its main methods are:
1) fast walking, and go down. This is generally easy to grasp and to adhere to an effective fitness method. The so-called fast walking 120 steps per minute, the time from short to long. The so-called go down, that is, back walk, flat trail or on the square, every 100-200 steps with fast walking alternating. Better physique of patients, but also for the sprints, long-distance and varied pace.
2) can practice tai chi, tai chi sword, five birds and other traditional Chinese martial arts.
3) Cycling jump elderly disco, traditional dance, aerobics and other exercise, all contribute to the treatment of rheumatoid arthritis disease joint gymnastics streets simple joint functional exercise.
Shijiazhuang, Hebei Hospital Rheumatology experts say, patients with rheumatoid arthritis can choose according to their own illness, physical condition and their hobbies, etc. 1-2. Mild selectable action complex activity slightly larger activities such as tai chi, tai chi sword, elderly disco; serious condition, action is not convenient alternative movements are simple and the activities of small activities such as walking, jogging, Qigong. Patients can select different parts of the joint lesions joint gymnastics.
Rheumatoid arthritis - DiagnosisDiagnostic blood: positive cells are hypochromic anemia, lymphocytes and platelets increase in the active stage performance. ESR. Eosinophilia is a symbol of rheumatoid arthritis with severe systemic complications.
Hyperviscosity syndrome: rheumatoid factor IgM and IgG complexes can form sticky aggregates, causing hyperviscosity syndrome.
Rheumatoid factor: lymphocytes and plasma cells in the synovium of patients with rheumatoid arthritis can produce large amounts of rheumatoid factor, IgM, IgG and IgA rheumatoid factor
X-ray examination: joint X-ray film can be seen fuzzy articular surface erosion damage. Early in the disease near the joints, osteoporosis, soft tissue swelling, bone erosion. Late necrosis of articular cartilage allows the joint space narrowing and fibrosis.
Rheumatoid arthritis - hazardsRheumatoid arthritis rheumatoid arthritis treatment in a timely manner, the dangers of large, common, mainly of the following, namely:
, Rheumatoid arthritis can lead to kidney disease; rheumatoid arthritis, renal dysfunction, and long-term use of anti-rheumatic drugs and non-steroidal anti-inflammatory drug related. After stopping the treatment, you can gradually improve. Long-term use of non-steroidal anti-inflammatory analgesics, may cause interstitial nephritis, although progress is slow, but can lead to renal failure, so the elderly and patients with kidney disease should be used cautiously.
2, rheumatoid arthritis, can cause skin diseases; representative for rheumatoid nodules. In addition, the malignant rheumatoid arthritis can cause necrotizing vasculitis, a purpura, ulcers and gangrene mixed existence of skin lesions, 13 parts of common lower extremity.
3, rheumatoid arthritis can lead to respiratory diseases; common pleurisy and interstitial pneumonia, especially the chronically ill elderly.
4, rheumatoid arthritis can cause eye; rheumatoid involving the eyes, about 15% of patients with Sjogren's syndrome can occur, causing the cornea and conjunctiva is dry and does not apply to a small number of patients with concurrent scleritis, iritis, occurs in edge of the cornea 2 to 3 mm.
, Rheumatoid arthritis can lead to heart disease; rheumatoid arthritis complicated by pericarditis can be as high as 20% to 50%, a few of the formation of rheumatoid nodules, the majority of asymptomatic, often found in the cardiac ultrasound examination. But also may cause left ventricular failure.
6, rheumatoid arthritis can cause nervous system disease; patients with rheumatoid arthritis tend to neurological dysfunction. Its causes and cervical spinal cord compression due to synovitis, tendon synovitis of peripheral nerve compression can be nerve dysfunction.
Rheumatoid arthritis - treatment programThe therapeutic purposes of treatment is to relieve joint pain, prevent joint damage, and to retain and improve joint function. Take different approaches to treatment at different stages of the disease, specific methods are:
A physical therapy: local hyperthermia, hot water bath, spa bath, steam therapy and paraffin therapies and pain can alleviate morning stiffness disappeared, patient feel comfortable. Acute exudative lesions can be used cold to reduce pain. Infrared, ultra-short wave or short wave diathermy therapy, etc. may also increase local blood circulation, promote inflammation and swelling subside, reduce pain, and to enhance the role of drugs on the local.
Surgery.
3. Drug treatment:
(A) of salicylates: aspirin is still the first choice for treatment of rheumatoid arthritis drugs.
(B) anti-inflammatory pain: non-steroidal anti-inflammatory drugs, the better its analgesic, antipyretic and anti-inflammatory effects.
(C) isobutyl styrene-acrylic acid: anti-inflammatory, analgesic and antipyretic action compared with aspirin 10 times more side effects than aspirin small.
(IV) corticosteroids: acute inflammation have a significant effect, the side effects of long-term application more vulnerable to relapse after discontinuation.
(E) penicillamine: Application penicillamine treatment, in addition to the joint symptoms, can reduce the erythrocyte sedimentation rate and C-reactive protein, rheumatoid factor became negative.
(Vi) to sparse tensiomin candied acid.
(7) Tripterygium: anti-inflammatory, antibacterial, immune regulation, the role of the blood circulation, pesticides, etc..
(Eight) gold preparation: It may interfere with cellular biochemical reactions. Have significant effect on joint pain and morning stiffness, and also enable the erythrocyte sedimentation rate and C-reactive protein improved the efficiency up to 70-90%.
(I) immunosuppressants: have a certain effect on the disease, commonly used are cyclophosphamide, azathioprine.
(J) the efficient treatment of rheumatoid arthritis drugs: Kanlisa,
Rheumatoid arthritis - Chinese medicine treatmentChinese medicine is an integral part of traditional medicine, is profound, long history, is the quintessence of China for thousands of years cured of incurable diseases, has been the people pride. For the treatment of joint diseases, a lot of people trust the Chinese medicine massage, massage and Chinese medicine treatment. Joint massage, physical therapy practices, as long as formal medical treatment, patients can rest assured.
The traditional theory of Chinese medicine for the arthritis treatment that the "Cold Wind evil, Blockage of the meridians, resulting in blocked meridians, General pain", so the Chinese medicine treatment is generally comfortable and easy to antispasmodic tongluo, for the purpose of promoting blood circulation, Chinese medicine is a combination of the principles of acupuncture and drugs, has a good effect.
The pure Chinese medicine town bone dispels wind and paste to start from the get rid of evils, strengthening and restoring both the selection of rare herbs, a reasonable set of square, fine compatibility, and finally was completely cured of arthritis and chronic problem of the magic of. Clematis Xing Meng good to go pass the twelve regular channels, not only eradicates rheumatism, but also the flow of qi and relieve pain; Notopterygium, independent living with Qufeng wins wet Chubi analgesic effect; fine Cincinnati temperature divergence aromatic through up to the Tongli Jiuqiao; goodness of pangolins walk channeling, up organs, outside the flow of qi, blood stasis and strong; the Achyranthes efficacy by promoting blood circulation, liver and kidney, strong bones and muscles, and Water Tonglin; Wujiapi rheumatism, bugan, kidney, strong bones and muscles; Dipsacus liver or kidney, strong bones and muscles, adjust blood, continued folding injury; cinnamon make up the fire yang, pain and cold and warm Tongmai.
Clinical manifestationsA body heat most of the patients with irregular mild or moderate fever, but also showed a remittent fever or persistent low heat. Pulse rate and Discovery, profuse sweating, often out of proportion with the body temperature.
The typical performance. Arthritis is migratory polyarthritis, often symmetrical tired knee, ankle, shoulder, wrist, elbow, hip and other joints; local was redness, swelling, heat, pain, inflammation, but not purulent. The incidence of several joints of some patients at the same time, the hands, feet small joints or spine joints may also be involved. Usually attack one month after the streptococcal infection, anti-streptococcal antibody titer can often be increased. After the acute inflammation subsided, the joint function is fully restored, is not left behind ankylosis and deformity, but often recurrent. Typical in recent years, rare. No significant relationship between the degree of joint local inflammation with or without carditis or valvular heart disease.
3 carditis is the most important clinical manifestations, 65% to 80% of pediatric patients with heart change. Acute rheumatic carditis is the most common cause of congestive heart failure in childhood.
Skin changes as urticaria, rash, erythema multiforme, erythema nodosum, annular erythema, annular erythema were more common, and diagnostic significance. Common in the limbs inside and trunk, flush the red ring of light, the early emergence of smaller, after rapidly expand to the surrounding edge of the mild Long straight, normal skin color ring. Sometimes fused into a flower ring. Erythema are not itchy and not hard, press the fade, which lasted up to several months.
Chorea often occurs in 5 to 12-year-old rheumatism of children, more females than males. More than the incidence in post-streptococcal 2 June. Department of rheumatic fever and inflammation violation of the central nervous system, including the performance of the basal ganglia, cerebral cortex, cerebellum, and striated, slow onset. Clinical manifestations: mental disorder onset, often emotional restlessness, irritability, comprehension and memory loss; involuntary movements; decreased muscle strength and work of economic imbalance.
6. Other performance in addition to the typical manifestations of rheumatoid even involving other parts of the rheumatic pleurisy, peritonitis, vasculitis, should attract attention.
A physical therapy: local hyperthermia, hot water bath, spa bath, steam therapy and paraffin therapies and pain can alleviate morning stiffness disappeared, patient feel comfortable. Acute exudative lesions can be used cold to reduce pain. Infrared, ultra-short wave or short wave diathermy therapy, etc. may also increase local blood circulation, promote inflammation and swelling subside, reduce pain, and to enhance the role of drugs on the local.
Surgery.
3. Drug treatment:
(A) of salicylates: aspirin is still the first choice for treatment of rheumatoid arthritis drugs.
(B) anti-inflammatory pain: non-steroidal anti-inflammatory drugs, the better its analgesic, antipyretic and anti-inflammatory effects.
(C) isobutyl styrene-acrylic acid: anti-inflammatory, analgesic and antipyretic action compared with aspirin 10 times more side effects than aspirin small.
(IV) corticosteroids: acute inflammation have a significant effect, the side effects of long-term application more vulnerable to relapse after discontinuation.
(E) penicillamine: Application penicillamine treatment, in addition to the joint symptoms, can reduce the erythrocyte sedimentation rate and C-reactive protein, rheumatoid factor became negative.
(Vi) to sparse tensiomin candied acid.
(7) Tripterygium: anti-inflammatory, antibacterial, immune regulation, the role of the blood circulation, pesticides, etc..
(Eight) gold preparation: It may interfere with cellular biochemical reactions. Have significant effect on joint pain and morning stiffness, and also enable the erythrocyte sedimentation rate and C-reactive protein improved the efficiency up to 70-90%.
(I) immunosuppressants: have a certain effect on the disease, commonly used are cyclophosphamide, azathioprine.
(J) the efficient treatment of rheumatoid arthritis drugs: Kanlisa,
Rheumatoid arthritis - Chinese medicine treatmentChinese medicine is an integral part of traditional medicine, is profound, long history, is the quintessence of China for thousands of years cured of incurable diseases, has been the people pride. For the treatment of joint diseases, a lot of people trust the Chinese medicine massage, massage and Chinese medicine treatment. Joint massage, physical therapy practices, as long as formal medical treatment, patients can rest assured.
The traditional theory of Chinese medicine for the arthritis treatment that the "Cold Wind evil, Blockage of the meridians, resulting in blocked meridians, General pain", so the Chinese medicine treatment is generally comfortable and easy to antispasmodic tongluo, for the purpose of promoting blood circulation, Chinese medicine is a combination of the principles of acupuncture and drugs, has a good effect.
The pure Chinese medicine town bone dispels wind and paste to start from the get rid of evils, strengthening and restoring both the selection of rare herbs, a reasonable set of square, fine compatibility, and finally was completely cured of arthritis and chronic problem of the magic of. Clematis Xing Meng good to go pass the twelve regular channels, not only eradicates rheumatism, but also the flow of qi and relieve pain; Notopterygium, independent living with Qufeng wins wet Chubi analgesic effect; fine Cincinnati temperature divergence aromatic through up to the Tongli Jiuqiao; goodness of pangolins walk channeling, up organs, outside the flow of qi, blood stasis and strong; the Achyranthes efficacy by promoting blood circulation, liver and kidney, strong bones and muscles, and Water Tonglin; Wujiapi rheumatism, bugan, kidney, strong bones and muscles; Dipsacus liver or kidney, strong bones and muscles, adjust blood, continued folding injury; cinnamon make up the fire yang, pain and cold and warm Tongmai.
Clinical manifestationsA body heat most of the patients with irregular mild or moderate fever, but also showed a remittent fever or persistent low heat. Pulse rate and Discovery, profuse sweating, often out of proportion with the body temperature.
The typical performance. Arthritis is migratory polyarthritis, often symmetrical tired knee, ankle, shoulder, wrist, elbow, hip and other joints; local was redness, swelling, heat, pain, inflammation, but not purulent. The incidence of several joints of some patients at the same time, the hands, feet small joints or spine joints may also be involved. Usually attack one month after the streptococcal infection, anti-streptococcal antibody titer can often be increased. After the acute inflammation subsided, the joint function is fully restored, is not left behind ankylosis and deformity, but often recurrent. Typical in recent years, rare. No significant relationship between the degree of joint local inflammation with or without carditis or valvular heart disease.
3 carditis is the most important clinical manifestations, 65% to 80% of pediatric patients with heart change. Acute rheumatic carditis is the most common cause of congestive heart failure in childhood.
Skin changes as urticaria, rash, erythema multiforme, erythema nodosum, annular erythema, annular erythema were more common, and diagnostic significance. Common in the limbs inside and trunk, flush the red ring of light, the early emergence of smaller, after rapidly expand to the surrounding edge of the mild Long straight, normal skin color ring. Sometimes fused into a flower ring. Erythema are not itchy and not hard, press the fade, which lasted up to several months.
Chorea often occurs in 5 to 12-year-old rheumatism of children, more females than males. More than the incidence in post-streptococcal 2 June. Department of rheumatic fever and inflammation violation of the central nervous system, including the performance of the basal ganglia, cerebral cortex, cerebellum, and striated, slow onset. Clinical manifestations: mental disorder onset, often emotional restlessness, irritability, comprehension and memory loss; involuntary movements; decreased muscle strength and work of economic imbalance.
6. Other performance in addition to the typical manifestations of rheumatoid even involving other parts of the rheumatic pleurisy, peritonitis, vasculitis, should attract attention.
Rheumatoid arthritis - basic therapyTreatment of any disease, the basic treatment is very important to RA is no exception. The basic treatment is the basis of other treatments, and prognosis of disease, prognosis is very important.
1, rheumatoid arthritis - Psychotherapy
Rheumatoid arthritis great health hazards on the human body, some patients with life-long disability, and therefore there is a panic, pessimism and depression status, can not be fully mobilized in patients with intrinsic positive factors, not confidence to closely cooperate with treatment. Psychotherapy is the possibility of doctors seeking truth from facts, objective, science to patients, clarifying the illness, treatment and hope for the future and the prognosis for patients to develop a thorough comprehensive treatment program, only access to the patients' trust in the doctor's considered further basis for treatment.
2, nutrition
Although there is no special requirements of patients with rheumatoid arthritis diet, but long-term illness, chronic wasting prone to thin and protein, vitamin insufficiency in long-term use of non-steroidal anti-inflammatory drugs, resulting in lower gastrointestinal function, digestion, malabsorption, therefore, Balanced nutrition is the basis for rehabilitation of disease, is a comprehensive treatment can not be ignored.
3, exercise
Rheumatoid arthritis patients should be allowed condition, actively strengthen the local function of the overall and joint exercise, to enhance physical fitness, protect or restore joint function. Joint function of the early exercise an active role to preserve joint function and prevent joint deformity. The exercise should be under the guidance of a doctor, regardless of severity, should be taken to combining dynamic and static, to take the initiative to exercise. Step by step, not anxious, and do not give up exercise because of a moment without success.
4, rheumatoid arthritis - physical therapy
Physical therapy is mainly used for local joint disease, RA is a systemic disease caused by immune dysfunction and immune pathological changes, systemic hyperthermia for the treatment of this disease meaning to be explored, therapeutic hypothermia should be controlled to the extent appropriate, otherwise low temperature only may change the body's protein antigen, but control of the adverse condition. Therefore, physical therapy is only applicable in rheumatoid arthritis basic control body in stable condition improves, a small number of swollen joints, muscle cramps, patients with mild deformity without bony ankylosis.
5, rheumatoid arthritis - Massage Therapy
Massage therapy is a safe and effective treatment method. The purpose of kidney and bone health, Shujin, spleen dampness SHUFENGDINGTONG to promote the improvement of the patients involved in the restoration of joint function and general condition, to lay the foundation for further treatment. Massage therapy should be noted that: (1) avoid the crude effect, brutal tactics; (2) a definite purpose, and not blindly start; (3) should not anxious to avoid mis leaving the joint damaged or pathologic fracture. Poor general condition or severe rheumatoid activity of obvious vasculitis patients should be taboo massage therapy to prevent disease progression.
6, rheumatoid arthritis - Replacement Therapy
The 1980s saw the peak tooth shark cartilage powder treatment of rheumatoid arthritis, to restore the body's joints renewable alternative medicine popular in Europe and the United States and other advanced countries, as a new attempt to achieve the fundamental rehabilitation. In Europe, saw the peak tooth shark cartilage powder extract has been identified as arthritis drugs, OAM (alternative Medical Services Bureau) of shark cartilage powder as alternative medicine research and popularization in Japan using the saw peak tooth shark cartilage powder as alternative medicine, widely used in osteoarthritis clinical, and achieved remarkable results, even summed up the best dose for osteoarthritis of 7.5g / day statistical data. Side effects of traditional therapies, the shortage of high operative risk, replacement therapy tends to be more fundamental and security, compared to bright dawn of mankind to overcome rheumatoid arthritis.
1, rheumatoid arthritis - Psychotherapy
Rheumatoid arthritis great health hazards on the human body, some patients with life-long disability, and therefore there is a panic, pessimism and depression status, can not be fully mobilized in patients with intrinsic positive factors, not confidence to closely cooperate with treatment. Psychotherapy is the possibility of doctors seeking truth from facts, objective, science to patients, clarifying the illness, treatment and hope for the future and the prognosis for patients to develop a thorough comprehensive treatment program, only access to the patients' trust in the doctor's considered further basis for treatment.
2, nutrition
Although there is no special requirements of patients with rheumatoid arthritis diet, but long-term illness, chronic wasting prone to thin and protein, vitamin insufficiency in long-term use of non-steroidal anti-inflammatory drugs, resulting in lower gastrointestinal function, digestion, malabsorption, therefore, Balanced nutrition is the basis for rehabilitation of disease, is a comprehensive treatment can not be ignored.
3, exercise
Rheumatoid arthritis patients should be allowed condition, actively strengthen the local function of the overall and joint exercise, to enhance physical fitness, protect or restore joint function. Joint function of the early exercise an active role to preserve joint function and prevent joint deformity. The exercise should be under the guidance of a doctor, regardless of severity, should be taken to combining dynamic and static, to take the initiative to exercise. Step by step, not anxious, and do not give up exercise because of a moment without success.
4, rheumatoid arthritis - physical therapy
Physical therapy is mainly used for local joint disease, RA is a systemic disease caused by immune dysfunction and immune pathological changes, systemic hyperthermia for the treatment of this disease meaning to be explored, therapeutic hypothermia should be controlled to the extent appropriate, otherwise low temperature only may change the body's protein antigen, but control of the adverse condition. Therefore, physical therapy is only applicable in rheumatoid arthritis basic control body in stable condition improves, a small number of swollen joints, muscle cramps, patients with mild deformity without bony ankylosis.
5, rheumatoid arthritis - Massage Therapy
Massage therapy is a safe and effective treatment method. The purpose of kidney and bone health, Shujin, spleen dampness SHUFENGDINGTONG to promote the improvement of the patients involved in the restoration of joint function and general condition, to lay the foundation for further treatment. Massage therapy should be noted that: (1) avoid the crude effect, brutal tactics; (2) a definite purpose, and not blindly start; (3) should not anxious to avoid mis leaving the joint damaged or pathologic fracture. Poor general condition or severe rheumatoid activity of obvious vasculitis patients should be taboo massage therapy to prevent disease progression.
6, rheumatoid arthritis - Replacement Therapy
The 1980s saw the peak tooth shark cartilage powder treatment of rheumatoid arthritis, to restore the body's joints renewable alternative medicine popular in Europe and the United States and other advanced countries, as a new attempt to achieve the fundamental rehabilitation. In Europe, saw the peak tooth shark cartilage powder extract has been identified as arthritis drugs, OAM (alternative Medical Services Bureau) of shark cartilage powder as alternative medicine research and popularization in Japan using the saw peak tooth shark cartilage powder as alternative medicine, widely used in osteoarthritis clinical, and achieved remarkable results, even summed up the best dose for osteoarthritis of 7.5g / day statistical data. Side effects of traditional therapies, the shortage of high operative risk, replacement therapy tends to be more fundamental and security, compared to bright dawn of mankind to overcome rheumatoid arthritis.
Leukemia
Leukemia-What is leukemia?
Leukemia is a malignant clonal disease of hematopoietic stem cells.Leukemia, also known as leukemia. Human bone marrow stem cells can be made every day tens of thousands of red blood cells and white blood cells, leukemia patients with excessive production of immature white blood cells prejudice bone marrow, making the bone marrow production of blood cells function was reduced. Leukemia incidence of pediatric malignancies in the first place.
Leukemia - OverviewThe structure of leukemia Leukemia - under the microscope in 1847 by German pathologist Rudolf Feier Shao identified for the first time. Pathogenic DNA variation due to intracellular formation of bone marrow hematopoietic tissue does not work.
Bone marrow stem cells can be made every day about 5.4 million / 1 mm3 red blood cells and 7400/1 mm3 white blood cells. Leukemia patients with excessive production of immature white blood cells, and prejudice to other bone marrow, which makes the bone marrow production of blood cells function was reduced. Leukemia can spread to the lymph nodes, spleen, liver, central nervous system and other organs. Leukemia is a malignant clone of hematopoietic stem cell disease (clonal disorder) ranks first in the incidence of pediatric malignancies, and its mortality ranked first in cause of death of children and adults under the age of 35 malignant tumors.
Leukemia - the cause ofViral factorsRNA tumor viruses cause leukemia in rats, cats, chickens and cows and other animals had already recognized the role of this virus-induced leukemia and more belong to the T-cell type. [1]Chemical factorsSome of the chemicals caused the leukemia. Such as the high incidence of exposure to benzene and its derivatives in the crowd leukemia in the general population. The report of the nitrosamine substances Phenylbutazone and its derivatives, such as chloramphenicol-induced leukemia can be seen, but also lack of statistics. Some anti-tumor cytotoxic drugs such as nitrogen mustard, cyclophosphamide, procarbazine, VP16, VM26, are recognized to leukemia.
Radiation factorIncluding X-ray and r-ray. Conclusive evidence can be sure a variety of ionizing radiation can cause human leukemia. The occurrence of leukemia depends on the radiation dose absorbed by the body, the whole body or part of the body by the medium-dose or high-dose radiation can induce leukemia. Small doses of radiation, however, whether the cause of leukemia is still uncertain. Hiroshima, Nagasaki after the atomic bomb explosion, serious radiation areas leukemia incidence of unirradiated region of 17 to 30 times. Three years after the explosion, the incidence of leukemia increased year by year, reached the peak at 5 to 7 years. To 21 years, the incidence rate is restored to near the level of Japan as a whole. Radiation workers, radioactive material (such as cobalt-60) regular contact with the incidence of leukemia increased significantly. Accept the diagnosis and treatment of radiation can lead to increased incidence of leukemia.
Genetic factorsChromosomal aberrations in population incidence of leukemia is higher than normal.
Other blood disordersCertain blood diseases may eventually develop into leukemia, such as myelodysplastic syndrome, lymphoma, multiple myeloma, paroxysmal nocturnal hemoglobinuria and so on.
Leukemia - TypeThere are many types of leukemia, the type of leukemia is mainly distinguished by the type of abnormal blood cells in the blood, academic, multiple classification, FAB classification method commonly used in classification, as well as by the World Health Organization to promote the new WHO classification France. These taxonomies can provide a patient's prognosis and disposal guidance. Clinically, generally divided into acute and chronic leukemia.
Acute lymphoblastic leukemia (ALL)Acute myeloid leukemia (AML)Chronic lymphocytic leukemia (CLL)Chronic myelogenous leukemia (CML)Young type bone marrow mononuclear cell leukemia (JML)Adult T-cell lymphoblastic leukemia (ATL)
Adults the most common in AML and CML, are more common in children is ALL.
Acute leukemia is characterized by the dramatic increase in immature white blood cells, immature white blood cells in general about 5% in the bone marrow. This sharp increase in the phenomenon of immature white blood cells the bone marrow can not produce healthy blood cells, immature white blood cells to replace. Acute leukemia is more common in adolescents and children. The dramatic increase and spread of malignant cells in acute leukemia must be treated immediately. Patients without treatment for months or even weeks of death.
Chronic leukemia is characterized by too much to mature but still not normal blood cells, these cells (white blood cells the majority) to exist in the blood. Chronic leukemia usually occur in adults, is rare in children. The physician will first establish the diagnosis and classification of chronic leukemia, determined in accordance with the diagnosis and classification of treatment guidelines.Leukemia - SymptomsLeukemia, the disease symptoms due to the different types, specific performance will be inconsistent, and its early symptoms of the following six kinds:
Infection feverInfection Fever is the results of patient immune dysfunction. Easily lead to a variety of bacterial, fungal infections, than the average person and easy to spread and difficult to cure. Performance pharyngitis, stomatitis, pneumonia, cellulitis, abscess, enteritis, cystitis. In particular, pneumonia and gastrointestinal infection can cause sepsis or sepsis, a temperature over 38.5 ° C, one of the reasons for patient's death.
AnemiaMore than about 60% of patients with anemia. Due to reduced hemoglobin, the patient's first symptom is anemia, and progressively increased, mainly characterized by pale skin, dizziness, fatigue, palpitations, shortness of breath, sweating and so on.
Leukemia, lymph nodes and hepatosplenomegalyThis feature is most common in acute lymphoblastic leukemia. Over half of patients with leukemia in the neck, supraclavicular fossa, groin, touch to the lymph nodes; abdominal deep palpation, palpable enlargement of the liver and spleen. Of course, hepatosplenomegaly is not a unique leukemia, hepatitis, liver abscess, liver, etc., can have hepatomegaly. Hemolytic anemia, typhoid, etc., may have splenomegaly, should be fully checked to identify with the above situation.
Bone and joint painDue to infiltration of white blood cells, destruction of cortical bone and periosteum. This feature is most common, and the majority of childhood leukemia to acute lymphoblastic leukemia. Sternal tenderness to the diagnosis of disease. Often without joint pain, local redness, swelling, thermal phenomena. The above symptoms, the patients and their families to attract attention, to the hospital early diagnosis, early treatment.
BleedingDue to thrombocytopenia, white blood cell infiltration of small arteries, veins, the blood vessel wall injury, the lack of clotting factor, an increase in anticoagulant factors, the incidence of bleeding in patients with up to 67% to 75%, often skin petechia, ecchymosis , gum bleeding, nose bleeds, the most common. Women may have menorrhagia. Some patients may also occur to internal organs or tissue hemorrhage. Such as gastrointestinal bleeding, the patient may have black or bloody stools, urinary tract bleeding, urine wash the meat in water samples; retinal hemorrhage, the patient depending on the material is unclear, and even blindness; the occurrence of intracranial hemorrhage and subarachnoid hemorrhage can often sudden death.
Severe headacheWhite blood cells in the arachnoid hyperplasia, spinal stenosis, caused by cerebrospinal fluid circulation disorder, the cause of communicating hydrocephalus. May suffer from severe explosive headache accompanied by nausea, vomiting, blurred vision.
Leukemia is a malignant clonal disease of hematopoietic stem cells.Leukemia, also known as leukemia. Human bone marrow stem cells can be made every day tens of thousands of red blood cells and white blood cells, leukemia patients with excessive production of immature white blood cells prejudice bone marrow, making the bone marrow production of blood cells function was reduced. Leukemia incidence of pediatric malignancies in the first place.
Leukemia - OverviewThe structure of leukemia Leukemia - under the microscope in 1847 by German pathologist Rudolf Feier Shao identified for the first time. Pathogenic DNA variation due to intracellular formation of bone marrow hematopoietic tissue does not work.
Bone marrow stem cells can be made every day about 5.4 million / 1 mm3 red blood cells and 7400/1 mm3 white blood cells. Leukemia patients with excessive production of immature white blood cells, and prejudice to other bone marrow, which makes the bone marrow production of blood cells function was reduced. Leukemia can spread to the lymph nodes, spleen, liver, central nervous system and other organs. Leukemia is a malignant clone of hematopoietic stem cell disease (clonal disorder) ranks first in the incidence of pediatric malignancies, and its mortality ranked first in cause of death of children and adults under the age of 35 malignant tumors.
Leukemia - the cause ofViral factorsRNA tumor viruses cause leukemia in rats, cats, chickens and cows and other animals had already recognized the role of this virus-induced leukemia and more belong to the T-cell type. [1]Chemical factorsSome of the chemicals caused the leukemia. Such as the high incidence of exposure to benzene and its derivatives in the crowd leukemia in the general population. The report of the nitrosamine substances Phenylbutazone and its derivatives, such as chloramphenicol-induced leukemia can be seen, but also lack of statistics. Some anti-tumor cytotoxic drugs such as nitrogen mustard, cyclophosphamide, procarbazine, VP16, VM26, are recognized to leukemia.
Radiation factorIncluding X-ray and r-ray. Conclusive evidence can be sure a variety of ionizing radiation can cause human leukemia. The occurrence of leukemia depends on the radiation dose absorbed by the body, the whole body or part of the body by the medium-dose or high-dose radiation can induce leukemia. Small doses of radiation, however, whether the cause of leukemia is still uncertain. Hiroshima, Nagasaki after the atomic bomb explosion, serious radiation areas leukemia incidence of unirradiated region of 17 to 30 times. Three years after the explosion, the incidence of leukemia increased year by year, reached the peak at 5 to 7 years. To 21 years, the incidence rate is restored to near the level of Japan as a whole. Radiation workers, radioactive material (such as cobalt-60) regular contact with the incidence of leukemia increased significantly. Accept the diagnosis and treatment of radiation can lead to increased incidence of leukemia.
Genetic factorsChromosomal aberrations in population incidence of leukemia is higher than normal.
Other blood disordersCertain blood diseases may eventually develop into leukemia, such as myelodysplastic syndrome, lymphoma, multiple myeloma, paroxysmal nocturnal hemoglobinuria and so on.
Leukemia - TypeThere are many types of leukemia, the type of leukemia is mainly distinguished by the type of abnormal blood cells in the blood, academic, multiple classification, FAB classification method commonly used in classification, as well as by the World Health Organization to promote the new WHO classification France. These taxonomies can provide a patient's prognosis and disposal guidance. Clinically, generally divided into acute and chronic leukemia.
Acute lymphoblastic leukemia (ALL)Acute myeloid leukemia (AML)Chronic lymphocytic leukemia (CLL)Chronic myelogenous leukemia (CML)Young type bone marrow mononuclear cell leukemia (JML)Adult T-cell lymphoblastic leukemia (ATL)
Adults the most common in AML and CML, are more common in children is ALL.
Acute leukemia is characterized by the dramatic increase in immature white blood cells, immature white blood cells in general about 5% in the bone marrow. This sharp increase in the phenomenon of immature white blood cells the bone marrow can not produce healthy blood cells, immature white blood cells to replace. Acute leukemia is more common in adolescents and children. The dramatic increase and spread of malignant cells in acute leukemia must be treated immediately. Patients without treatment for months or even weeks of death.
Chronic leukemia is characterized by too much to mature but still not normal blood cells, these cells (white blood cells the majority) to exist in the blood. Chronic leukemia usually occur in adults, is rare in children. The physician will first establish the diagnosis and classification of chronic leukemia, determined in accordance with the diagnosis and classification of treatment guidelines.Leukemia - SymptomsLeukemia, the disease symptoms due to the different types, specific performance will be inconsistent, and its early symptoms of the following six kinds:
Infection feverInfection Fever is the results of patient immune dysfunction. Easily lead to a variety of bacterial, fungal infections, than the average person and easy to spread and difficult to cure. Performance pharyngitis, stomatitis, pneumonia, cellulitis, abscess, enteritis, cystitis. In particular, pneumonia and gastrointestinal infection can cause sepsis or sepsis, a temperature over 38.5 ° C, one of the reasons for patient's death.
AnemiaMore than about 60% of patients with anemia. Due to reduced hemoglobin, the patient's first symptom is anemia, and progressively increased, mainly characterized by pale skin, dizziness, fatigue, palpitations, shortness of breath, sweating and so on.
Leukemia, lymph nodes and hepatosplenomegalyThis feature is most common in acute lymphoblastic leukemia. Over half of patients with leukemia in the neck, supraclavicular fossa, groin, touch to the lymph nodes; abdominal deep palpation, palpable enlargement of the liver and spleen. Of course, hepatosplenomegaly is not a unique leukemia, hepatitis, liver abscess, liver, etc., can have hepatomegaly. Hemolytic anemia, typhoid, etc., may have splenomegaly, should be fully checked to identify with the above situation.
Bone and joint painDue to infiltration of white blood cells, destruction of cortical bone and periosteum. This feature is most common, and the majority of childhood leukemia to acute lymphoblastic leukemia. Sternal tenderness to the diagnosis of disease. Often without joint pain, local redness, swelling, thermal phenomena. The above symptoms, the patients and their families to attract attention, to the hospital early diagnosis, early treatment.
BleedingDue to thrombocytopenia, white blood cell infiltration of small arteries, veins, the blood vessel wall injury, the lack of clotting factor, an increase in anticoagulant factors, the incidence of bleeding in patients with up to 67% to 75%, often skin petechia, ecchymosis , gum bleeding, nose bleeds, the most common. Women may have menorrhagia. Some patients may also occur to internal organs or tissue hemorrhage. Such as gastrointestinal bleeding, the patient may have black or bloody stools, urinary tract bleeding, urine wash the meat in water samples; retinal hemorrhage, the patient depending on the material is unclear, and even blindness; the occurrence of intracranial hemorrhage and subarachnoid hemorrhage can often sudden death.
Severe headacheWhite blood cells in the arachnoid hyperplasia, spinal stenosis, caused by cerebrospinal fluid circulation disorder, the cause of communicating hydrocephalus. May suffer from severe explosive headache accompanied by nausea, vomiting, blurred vision.
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