I-COPD vs Asthma: Umahluko oPhambili uchazwa

Ukungakwazi ukuphefumla rhoqo, ukuphefumla kancinci, kunye nokuxinana kwesifuba kunokwenza imisebenzi elula yemihla ngemihla ibonakale idinisa. Nangona ezi mpawu zihlala zikhomba kwiimeko zokuphefumla ezingapheliyo, ukuchonga isifo esibangela ingxaki kubalulekile ukuze unyango lusebenze kakuhle. 

Ezimbini zezona zifo zokuphefumla ezingapheliyo zixhaphakileyo kwihlabathi liphela yi-asthma kunye ne-Chronic Obstructive Pulmonary Disease (COPD).

Abantu abaninzi abanengxaki yokuphefumla bayazibuza: Ngaba i-COPD iyafana ne-asthma? Nangona zombini ezi meko zichaphazela inkqubo yokuphefumla kwaye zithintela ukuhamba komoya okuqhelekileyo, zizinto ezahlukeneyo zonyango ezinezizathu ezahlukeneyo, iipatheni zokudumba, kunye neziphumo zexesha elide.

Yintoni umahluko omkhulu phakathi kwe-asthma kunye ne-COPD?

Umahluko ophambili phakathi kwe-COPD kunye ne-asthma usekutshintsheni kwendlela yomoya kunye notshintsho kwimiphunga yesakhiwo:

• Isifuba ngokuyintloko sisifo esingapheliyo sokudumba kweendlela zomoya esibonakaliswa kukuthinteleka komoya oguquguqukayo noguqukayo. Phakathi kokudumba, ukusebenza kwemiphunga kunokubuyela esiqhelweni, ingakumbi ngonyango olufanelekileyo.
• COPD yimeko eqhubekayo, engenakuguqulwa equka i-bronchitis engapheliyo kunye ne-emphysema. Ibangela umonakalo osisigxina kwizicubu zemiphunga kunye neengxowa zomoya, nto leyo ekhokelela ekuncipheni kokuhamba komoya okuqhubekayo okuya kuba mandundu ngokuhamba kwexesha.

Nangona i-asthma ichaphazela kuphela iindlela zomoya eziqhubayo, i-COPD yonakalisa zombini iindlela zomoya kunye ne-lung parenchyma (izicubu ezinoxanduva lokutshintshiselana ngegesi).

Itheyibhile yokuthelekisa: I-COPD vs i-Asthma ngokujonga nje

Ukuze uqonde ngokukhawuleza umahluko phakathi kwe-COPD kunye ne-asthma, jonga uthelekiso lweklinikhi oluhambelanayo ngezantsi:

Iimpawu zahluke njani phakathi kwezi meko zimbini?

Ukuqonda umahluko phakathi kwe-COPD kunye ne-asthma kubandakanya ukuvavanya izinto ezibangela iimpawu, ukuphindaphinda, kunye nempembelelo yemihla ngemihla.

Iimpawu zeSifo soMfuba

• Uhlobo lweSiqendu: Iimpawu zenzeka xa kuqhuma (ukuhlaselwa yi-asthma) kunye nexesha lokuphefumla okuqhelekileyo.
• Izinto Ezithile Ezibangela Ingxaki: Ukuvutha kubangelwa luthuli, impova, i-dander yezilwanyana zasekhaya, umthambo, umoya obandayo, okanye usulelo lwentsholongwane.
• Ukuba mandundu ebusuku: Ukukhohlela nokuphefumla rhoqo kuphazamisa ubuthongo kusasa okanye ebusuku kakhulu.
• Ukhohlokhohlo olomileyo: Ukukhwehlela okunxulumene noko kudla ngokuba komile, kukhatshwa kukuphefumla okukhulu.

Iimpawu zeMpawu zeCOPD

• Ukuphefumla Okungapheliyo: Ukuphelelwa ngumphefumlo (dyspnoea) kwenzeka yonke imihla, ingakumbi xa usebenza nzima njengokunyuka izinyuko.
• Ukukhwehlela Okungapheliyo: Ukukhohlela kuyaqhubeka kwaye kudla ngokuvelisa inani elikhulu le-sputum okanye i-mucus etyebileyo.
• Ukudinwa Okuqhubekayo: Ukuphelelwa yioksijini kunye nomgudu owandileyo wokuphefumla kukhokelela ekudinweni emzimbeni ngokuhamba kwexesha.
• Usulelo oluQhelekileyo lweSifuba: Izigulana zihlala zihlushwa yi-bronchitis enzima yasebusika kunye nosulelo lwesifuba.

Zithini Izinto Eziphambili Ezibangela Ubunzima Nezinto Ezibangela Ubungozi?

Ukuqonda izinto ezibangela oku kunceda ukucacisa umahluko phakathi kwe-asthma kunye ne-COPD.

Imiba yoMngcipheko weMbefu

• I-Atopy kunye ne-Allergies: Imbali yosapho ene-eczema, i-allergy rhinitis, okanye i-allergy asthma iyandisa kakhulu umngcipheko.
• Izinto ezithintela ukungqonge indalo: Ukuchanabeka kwizinto ezibangela i-allergens endlwini (iincukuthu zothuli, ukungunda) kunye nongcoliseko lomoya olujikeleze indlu.
• Ukusabela Okungakhathaliyo Kwindlela Yomoya: Iityhubhu ze-bronchial ezinobuthathaka obugqithisileyo ezithi zitshixize kwaye ziqine ngokukhawuleza.

Izinto ezibangela umngcipheko kwiCOPD

• Umsi wecuba: Ukutshaya icuba, ipayipi, kunye necuba zizinto ezibangela uninzi lwamatyala kwihlabathi liphela.
• Ukuvezwa kokusiNgqongileyo: Umsi wecuba wesibini, umsi we-biomass fuel ovela ekuphekeni kwangaphakathi, kunye nomsi wemizi-mveliso.
• Ukunqongophala kwe-Alpha-1 Antitrypsin: Ingxaki yemfuza ebangela ukuba abantu abangatshayiyo baqalise i-emphysema kwangethuba.
• Izinto eziphambili ezibangela indalo esingqongileyo kunye neengozi zomsebenzi zezona zinto ziphambili izizathu zesifo seCOPD, okukhawulezisa ukuwohloka kwemiphunga ixesha elide.

Oogqirha Bayifumanisa Njani I-COPD vs I-Asthma?

Ukwahlula phakathi kweCOPD kunye ne-asthma kufuna uvavanyo lwezonyango oluchanekileyo oluvela kwingcali ye-pulmonologist.

1. Uvavanyo lwe-Spirometry olusebenzisa iBronchodilator Reversibility: Olu vavanyo lomsebenzi oyintloko wamaphaphu lulinganisa ukuba ungakanani umoya onokuwukhupha kunye nokuba ukhawuleza kangakanani. Ugqirha ulinganisa isiseko sakho, anike i-bronchodilator ephefumlayo, aze aphinde ahlole:
   • Isifuba: Ibonisa ukuphucuka okukhulu kumthamo womoya ophoqelekileyo ($FEV_1$) emva konyango.
   • I-COPD: Ibonisa ukuvaleka komoya okuqhubekayo kunye nokuphuculwa okuncinci kwe-post-bronchodilator.
2. Imbali Yezonyango Neyokuchatshazelwa: Ixesha elineenkcukacha elivavanya iimpawu zesifuba somntwana, imbali yokutshaya, kunye nokuvezwa kweekhemikhali emsebenzini.
3. Umfanekiso woDiagnostic: Ii-X-reyi zesifuba kunye neeskeni zeComputed Tomography (CT) ezinesisombululo esiphezulu zinceda ekuchongeni ukunyuka kwamaxabiso kunye nokutshatyalaliswa kwezicubu zemiphunga ezibonakala kwi-emphysema kwi-COPD.

Zithini iindlela zonyango zonyango ngalunye?

Njengoko iindlela zokudumba kwi-COPD kunye ne-asthma zahlukile kwinqanaba leeseli, amaqhinga okulawula unyango alungiselelwe ngokukodwa isifo ngasinye.

Ulawulo lwe-Asthma

• IiCorticosteroids ezifunxwayo (ICS): Eyona nto ibalulekileyo kunyango lwe-asthma, kujoliswe ekuvuvukeni kwe-eosinophilic ukuthintela ukuhlaselwa.
• Ama-Beta-Agonists aSebenzayo ngokuSebenza ... Ii-inhalers ze-Albuterol/salbutamol zisebenza njengeyeza elikhawulezileyo lokunceda xa uhlaselwa ngamandla.
• Unyango lwebhayoloji: Ii-antibodies ze-monoclonal ze-asthma enzima, engapheliyo ye-allergy okanye i-eosinophilic.

Ulawulo lweCOPD

• IiBronchodilators ezisebenza ixesha elide: IiMuscarinic Antagonists ezisebenza ixesha elide (i-LAMA) kunye neeBeta-Agonists ezisebenza ixesha elide (i-LABA) ziphumza iindlela zomoya ezinciphileyo imini nobusuku.
• Ukuyeka Ukutshaya: Inyathelo elinye elibalulekileyo lokumisa ukwehla okukhawulezileyo komsebenzi wamaphaphu.
• Ukuvuselelwa kwemiphunga: Uqeqesho lokuzilolonga, iingcebiso zesondlo, kunye neendlela zokuphefumla ukuphucula ukunyamezela umthambo.
• Ioksijeni eyongezelelweyo: Imiselwe kwinqanaba eliphezulu ukugcina igazi elaneleyo amanqanaba eoksijini.

Qaphela: Ezinye izigulana zibonisa iimpawu ezifanayo zezi meko zombini, imeko yeklinikhi ebizwa ngokuba yi-Asthma-COPD Overlap (ACO).