Розсіяний склероз: симптоми, причини і ознаки, діагностика, профілактика

Розсіяний склероз: симптоми, причини і ознаки, діагностика, профілактика

Загальні відомості про хворобу розсіяний склероз

Розсіяний склероз (РС) – це хронічне захворювання, яке вражає головний і спинний мозок. Причиною його є неправильна робота імунної системи. Її клітини проникають у йнують миелиновую оболонку нервових волокон і призводять до бців. При цьому нервова тканина замінюється на сполучну.

Не варто плутати розсіяний склероз зі старечим захворюванням, яке ми звикли називати «склероз». «Розсіяний» в даному випадку означає те, що вогнища хвороби, як би розкидані по всій нервовій системі. А слово «склероз» – описує характер порушень. Це бцева тканина, яка має вигляд бляшки. Її розміри коливаються від мікроскопічних до декількох сантиметрів.

Розсіяний склероз – це захворювання, яке вражає молодих людей. На відміну від інших неврологічних хвороб, які найчастіше виникають у літньому віці, ця виникає у людей від 15 до 40 років. Відомі випадки, коли РС виявляли у дітей від двох років. А ось після 50 ризик захворіти на цю недугу різко зменшується.

Ця хвороба є досить поширеною. Вона займає друге місце, з причин неврологічної інвалідності молодих людей (після травм). У середньому діагностують 20-30 випадків хвороби на 100 тисяч населення.

Існує цікава закономірність: чим далі від екватора, тим вище відсоток захворюваності. Люди в північних регіонах хворіють набагато частіше (70 випадків на 100 тисяч). Це пов’язують з недостатньою кількістю вітаміну D, який виробляється в організмі людини при дії сонячних променів. Жінки хворіють в 2-3 рази частіше, ніж чоловіки. Але при цьому вони легше переносять хворобу. На тривалість життя хвороба значно не впливає.

Існує зв’язок і з расовою приналежністю. Так японці, китайці та корейці практично не знайомі з цим захворюванням. А найбільше від нього страждають європейці. У великих містах відсоток хворих в кілька разів вище, ніж у сільській місцевості. Ці факти свідчать про те, що фактори несприятливого навколишнього середовища можуть вплинути на виникнення хвороби.

Необхідно відзначити, що миелиновая оболонка має властивості відновлюватися самостійно і під дією лікарських препаратів. Тому у тих хворих, у яких процеси відновлення йдуть швидше, ніж формування бляшок, загострення можуть бути слабкими і дуже рідкісними.

Причини хвороби

Основна причина виникнення розсіяного склерозу – це збій в роботі імунної системи. У нормі головний і спинний мозок захищені гематоенцефалічний бар’єр, через який не проникають мікроорганізми і клітини крові. У пацієнтів в мозок проникають імунні клітини – лімфоцити. Замість того, щоб атакувати чужорідні тіла, наприклад бактерії, вони ведуть боротьбу з клітинами власного тіла. Лімфоцити виробляють антитіла, йнують миелиновую оболонку нервових клітин. Виникає ділянку запалення, на місці якого бцева тканина. Такі бляшки на нервових волокнах порушують проведення імпульсів від мозку до органів. В результаті мозок не може ефективно управляти процесами і діями тіла. Утрудняються хи і мова, знижується чутливість.

Існують фактори, які можуть спровокувати появу захворювання:

    Генетична схильність – наявність змінених генів Сильні стреси Вірусні та бактеріальні захворювання Брак вітаміну D

Деякі вчені пов’язують розвиток хвороби з вакцинацією проти гепатиту В. Але на даний момент немає підтвердження цієї теорії. Також існує думка, що захворювання може викликатися вірусом. Наприклад, мутував збудником кору. На користь цієї теорії свідчить те, що при введенні противірусних інтерферонів стан хворого поліпшується.

Основні симптоми та ознаки

Захворювання розвивається поступово. На перших етапах воно нічим себе не проявляє. Це пояснюється тим, що здорові клітини мозку беруть на себе функцію уражених ділянок.

Найперші ознаки з’являються тоді, коли уражено вже близько 50% нервових волокон. На цій стадії захворювання у хворих виникають такі скарги:

    Одне або двостороннє порушення зору Біль і двоїння в очах Відчуття оніміння і поколювання в пальцях Зниження чутливості шкіри М’язова слабкість Порушення хів

У різних хворих симптоми можуть сильно відрізнятися. Навіть у однієї людини вони можуть з’являтися і зникати або змінюватися іншими.

З часом, в результаті збільшення кількості склеротичних бляшок, з’являються й інші ознаки захворювання.

Спазм і хворобливі відчуття в м’язах. Затримка сечовипускання і запори, з часом хворий може втратити здатність контролювати процеси спорожнення сечового міхура і кишечника. Зміни в сексуальному житті. Поява патологічних пірамідних рефлексів, яких не буває у здорових людей. Їх може виявити лише лікар-невролог. Підвищена стомлюваність при виконанні фізичних дій. Неповний параліч кінцівок, утруднення хів. Паралічі черепних нервів: окорухового, трійчастого, лицьового, під’язикового. Ритмічні хи очних яблук. Порушення поведінки і зниження інтелекту. Неврози, емоційна нестійкість, чергування депресії і ейфорії.

Стан багатьох хворих тимчасово погіршується після прийому гарячої ванни, перебування в жаркому приміщенні, під час гарячки. Це необхідно враховувати і намагатися уникати перегріву, який може спровокувати напад.

Перебіг хвороби характеризується періодами загострення і ремісії, коли симптоми значно слабшають. Правильно підібране лікування дозволяє значно скоротити тривалість періоду загострення і продовжити період відносного здоров’я.

Діагностика

Правильна і своєчасна постановка діагнозу дозволяє забезпечити хворій людині довгі роки повноцінної і активного життя. Тому при появі одного або декількох неврологічних симптомів, перерахованих вище, необхідно звернутися до лікаря.

Для диференціальної діагностики розсіяного склерозу важливі наступні фактори:

    Наявність мінімум двох випадків появи ознак розсіяного склерозу тривалістю більше 24 годин. Інтервал між ними – близько місяця. При проведенні магнітно-резонансної томографії були помічені вогнища склерозу – ділянки демієлінізації.

Для уточнення діагнозу лікар може призначити додаткове обстеження. Наприклад, імунологічний аналіз крові або проведення електроміографії.

Профілактика

Оскільки на сьогоднішній день механізми, які запускають хворобу, ще до кінця не вивчені, то про конкретні профілактичних заходах говорити рано. Але вже зараз канадські вчені проводять випробування вакцини проти розсіяного склерозу. За прогнозами вона з’явиться у продажу через 5-10 років. Про лікування стовбуровими клітинами читайте в цьому матеріалі.

Поки лікарі рекомендують вести здоровий спосіб життя, правильно харчуватися і уникати стресів.

Для профілактики загострень у хворих на розсіяний склероз рекомендують:

    Уникати стресів і розумових переутомлений; Фізичні навантаження повинні бути регулярними (заняття спортом), але не виснажливими (про ЛФК читайте тут); Відмовитися від алкоголю та куріння; Правильно харчуватися, не зловживати жирними продуктами (як правильно харчуватися при даному захворюванні описано тут); Нормалізувати свою вагу; Чи не перегріватися; Чи не користуватися гормональними контрацептивами; Навіть у періоди ремісії (ослаблення симптомів) регулярно приймати лікування.

Такі заходи допоможуть зменшити прояви хвороби і продовжити періоди здоров’я.

Детально про лікування розсіяного склерозу читайте в цьому матеріалі.

Наслідки захворювання

У 25% випадків захворювання протікає доброякісно. Хворі довгі роки зберігають працездатність і можуть самостійно себе обслуговувати. В інших випадках (10%) інвалідизація настає через 5 років після виявлення захворювання.

Хвороба протікає легше, якщо вона почалася в ранньому віці, має періоди тривалої ремісії. Першим симптомом було порушення зору. У цьому випадку можна сподіватися на більш легкий перебіг захворювання. Отже, розсіяний склероз – це хронічне захворювання нервової системи, яке пов’язане зі збоєм в роботі імунітету. На даний момент не можна точно сказати, які фактори викликають початок хвороби. Є безліч лікарських препаратів, які знімають прояви захворювання.

Перебіг хвороби індивідуально у кожного пацієнта і є надія, що при правильному лікуванні людині вдасться навіть у похилому віці зберегти розумове і фізичне здоров’я.

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