Funso: Apheresis Kwa LDL Cholesterol
Mwana wanga wamwamuna wazaka 12 ali ndi cholesterol chokwanira kwambiri, chomwe amati amachokera ku chibadwidwe. Mlingo wake ndi waukulu kwambiri moti madokotala akulangiza kuti ayambe mankhwala otchedwa "apheresis." Kuchokera pazing'ono zomwe ndikudziwa za izi, izi zimveka zomveka kwambiri kwa ine. Kodi mungandiuze za apheresis, komanso ngati ndibwino kwa mwana?
Yankho: Pali mitundu yosiyanasiyana ya zovuta zomwe tinabadwa nazo za LDL cholesterol . Ambiri mwa awa ndi a hypercholesterolemia (FH). Anthu omwe ali ndi FH, makamaka omwe ali ndi mitundu yovuta kwambiri ya matendawa, ali ndi chiopsezo chachikulu chokhala ndi matenda asanatengeke. Chomera cha LDL cholesterol chomwe chili pamtundu uwu chimachitika kuchokera pa kubadwa, ndipo zimayambitsa kuwononga mtima wa mtima ali wamng'ono - choncho anthu omwe ali ndi matenda a hypercholesterolemia ayenera kuthandizidwa ngakhale ali ana.
Njira yaikulu yothandizira FH ndiyo kugwiritsa ntchito mankhwala osokoneza bongo . Kwa anthu ambiri omwe ali ndi vutoli, maimidwe amachepetsa kuchepa kwa mafuta a kolesterolini a LDL. Koma mwa iwo omwe ali ndi machitidwe aakulu kwambiri a zilembo za matenda sagwira ntchito bwino, ndipo chiopsezo cha mtima chimakhala chokwera kwambiri. Anthuwa amati ali ndi "mankhwala osokoneza bongo a hypercholesterolemia."
Pali njira zingapo zothandizira odwala okhala ndi mankhwala osokoneza bongo hypercholesterolemia; Palibe chilichonse chophweka kapena chosangalatsa. Mwa njira zomwe zilipo, amene adayesedwa kwambiri ndi apheresis.
Apheresis
Mu apheresis, mwazi wamagazi wa mafuta m'thupi umatulutsidwa kuchokera muziwiya zamagazi, ndiyeno umakonzedwa m'njira yomwe imachotsa mapuloteni (otchedwa lipoproteins) omwe ali ndi LDL-cholesterol.
Potsirizira pake, magazi ochepa omwe amachepetsa amatsitsimutsidwa kwa wodwalayo. (Njira imeneyi ndi yofanana ndi hemodialysis yomwe imagwiritsidwa ntchito kwa odwala ali ndi impso kulephera.)
Apheresis amachepetsanso kuchepetsa mphamvu ya kolesterolini ya LDL pafupifupi 75%. Komabe, chifukwa chiwindi mwa odwalawa akupanga ambiri LDL cholesterol, mizere ya LDL imabweranso mmasiku angapo. Choncho apheresis amafunika kuchitidwa kamodzi pa sabata, ndipo nthawi zina kawiri pa sabata.
Kuika pa apheresis mankhwala, mwachiwonekere, ndiko kudzipereka kwakukulu mu nthawi ndi zovuta, komanso ndi okwera mtengo kwambiri. Kuphatikiza apo, ikhoza kubweretsa mavuto ambiri omwe amapezeka, kuphatikizapo kuthamanga kwa magazi, kuchepa kwa magazi , ndi kupweteka mutu. Pomalizira, monga momwe odwala ali ndi hemodialysis, omwe ali ndi apheresis amafunika kuchitidwa opaleshoni kuti apange fistula (kutsegula mitsempha ndi mitsempha pansi pa khungu), zomwe zimachepetsa mosavuta mitsempha ya magazi yomwe apheresis imafunikira .
Kuchita bwino kwa apheresis kwa ana omwe ali ndi matenda akuluakulu a kolesterolini waphunzira. Apa pali zomwe UpToDate , mauthenga apakompyuta kwa madokotala ndi odwala, ayenera kunena za zotsatira za apheresis mwa ana:
Kutetezeka ndi kuthandizira kwa LDL-apheresis kwa nthawi yaitali kunawerengedwa pofufuza ana khumi ndi anayi omwe ali ndi matenda oopsa a hypercholesterolemia (kuphatikizapo ana omwe ali ndi homozygous FH) amene anachiritsidwa zaka 2 mpaka 17. Panalibe imfa zakufa, zoperewera zopanda mfuti zapachikapu, kapena njira zowonongeka zowonongeka. Kugonjetsedwa kwa zida za mitsempha yamakono, komanso kuteteza chitukuko cha zilonda zatsopano za aortic ndi zakuthengo, zinawonetsedwa.Mwa kuyankhula kwina, ngakhale zovuta zonse za apheresis, kafukufuku umodzi amawoneka kuti amasonyeza kuti mtundu uwu wa mankhwala - mwa ana, osachepera - amachepetsa khungu la kolesterolini ya LDL, komanso amawonekeratu kuchepetsa chiopsezo chokhala ndi matenda a msinkhu asanakwane . Tsono ngakhale ziri zovuta zonse, apheresis ndi chinthu chomwe chiyenera kuonedwa mwa ana omwe ali ndi mitundu yosiyanasiyana ya hypercholesterolemia yomwe silingayankhe kwa maimuna.
Nthawi Yaitali
Mwamwayi, tsopano zikuwoneka kuti apheresis sangakhale kudzipereka kwa moyo wonse. Chifukwa cha zomwe zakhala zikuchitika pa kafukufuku wokhudzana ndi maumunthu a anthu, mankhwala angapo ochiritsidwa atsopano akukonzekera, omwe amawoneka kuti ali ndi matenda omwe amabweretsa FH. Mankhwala atsopano omwe ali pansi pa chitukuko ali ndi mwayi wabwino kwambiri wochepetsa bwino kuchepetsa cholesterol cha LDL mpaka pamagulu. Ndibwino kuti muwone apheresis mwa ana omwe ali ndi FH ngati mlingo woyenera - ngati njira yopezera mitsempha ya magazi kukhala "yoyera" pamene tikuyembekezera zowonjezereka, komanso zosavuta kwambiri, chithandizo chamankhwala.
Mukufuna kuphunzira zambiri? Onani mutu waToDate, "Familial Hypercholesterolemia" kuti mudziwe zambiri zachipatala.
Zotsatira:
Rosenson RS, de Ferranti SD, Durrington P. Chithandizo cha mankhwala osakanizidwa ndi hypercholesterolemia. Zaposachedwa. Idapezeka, July 2012.