Anthu omwe ali ndi matenda amtundu wa matenda (CAD) ali aang'ono angakhale ndi vuto lobadwa ndi cholesterol, makamaka ngati matenda a mtima asanakwane akuwoneka akuthamangira m'banja. Mtundu wambiri wa majini okhudza cholesterol ndi mtundu wa hypercholesterolemia.
Mankhwala otchuka a hypercholesterolemia ndi matenda omwe amachititsa kuti LDL cholesterol ikhale yochuluka kuyambira nthawi yoberekera.
Anthu omwe ali ndi matenda a hypercholesterolemia amakhala ndi chiopsezo chachikulu cha matenda a CAD, msanga , ndi pakhosi . Ndipotu, anthu ambiri omwe ali ndi matenda a myocardial atsikana ali ndi vutoli.
Mwamwayi, mwaukali kuti athetse kuchepetsa mafuta m'thupi, vuto la matenda a mtima lingachepe kwambiri. Pachifukwa ichi, ndikofunika kupeza matenda a hypercholesterolemia monga momwe angathere - ndikuonetsetsa kuti mamembala a munthu aliyense ali ndi vutoli.
Zimayambitsa
Mankhwala otchuka a hypercholesterolemia angayambidwe ndi zofooka zosiyanasiyana zamtunduwu, zambiri zomwe zimakhudza receptor kwa LDL cholesterol. Pamene wolandira LDL sakugwira ntchito, LDL cholesterol sichiyeretsedwa bwino kuchokera m'magazi. Chifukwa chake, cholesterol cha LDL chimamanga m'magazi. Mafuta ambiri a LDL otchedwa cholesterol amawopsa kwambiri ku matenda a atherosclerosis ndi matenda a mtima.
Zambiri zomwe zimayambitsa matenda a hypercholesterolemia zimatha kulandira kwa atate, mayi, kapena makolo onse awiri. Anthu omwe adzalandira zosawerengeka kuchokera kwa makolo onse awiri amatchulidwa kuti ndi ochepetsetsa kwa azimayi odwala matendawa. Mtundu wa homozygous wa hypercholesterolemia ndi mtundu woopsa kwambiri wa matendawa.
Zimakhudza munthu mmodzi mwa anthu 250,000.
Anthu amene amalandira jini losasamalidwa kuchokera kwa kholo limodzi lokha amatchedwa heterozygous kwa hypercholesterolemia. Uwu ndiwo mawonekedwe ochepa kwambiri a matendawa, koma amachulukitsanso kwambiri mtima wa munthu. Pafupifupi munthu mmodzi mwa anthu 500 ali ndi hypercholesterolemia ya heterozygous.
Ndiwo anthu ambiri.
Zosintha zosiyana zoposa 1000 zokhudzana ndi jini la kulandira LDL zadziwika, ndipo aliyense wa iwo amakhudza mlandizi wa LDL mosiyana. Pa chifukwa ichi, si onse omwe ali ndi hypercholesterolemia omwe ali achibale omwe ali nawo. Kulemera kwake kumasiyana mosiyanasiyana, malingana ndi mtundu wa mtundu wa genetic mutation umene munthuyo ali nawo.
Kudziwa
Madokotala amapanga matenda a hypercholesterolemia achibale poyeza kuchuluka kwa magazi, komanso kuganizira mbiri ya banja ndi kuunika kwa thupi.
Kuyesedwa kwa magazi kwa anthu omwe ali ndi matenda a hypercholesterolemia amasonyeza kuti thupi lonse limakhudzidwa kwambiri ndi mafuta a kolesteroloni. Nthenda yonse ya kolesterolo yomwe ili ndi matendawa nthawi zambiri imakhala yaikulu kuposa 300 mg / dl akuluakulu, ndipo oposa 250 mg / dl ana. Kalasi ya cholesterol ya LDL imakhala yaikulu kuposa 200 mg / dl akuluakulu, ndipo oposa 170 mg / dl ana.
Mabala a Triglyceride nthawi zambiri sali okwera kwambiri kwa anthu omwe ali ndi vutoli.
Aliyense amene ali ndi matenda a hypercholesterolemia amakhala ndi achibale omwe ali ndi vutoli. Choncho mbiri ya banja ya matenda oyambirira a mtima akhoza kukhala chitsimikizo champhamvu kwa dokotala kuti aganizire izi.
Mankhwala otchuka a hypercholesterolemia angapangitsenso kuti munthu akhale ndi mafuta akuluakulu kuti azikhala ndi maulendo, mawondo, makatani, komanso maonekedwe a maso. Mafuta oterewa amatchedwa xanthomas . Cholesterol imaikidwa pamaso, otchedwa xanthelasmas , amakhalanso wamba. Nthawi zonse wodwala ali ndi xanthomas kapena xanthelasmas, matenda a hypercholesterolemia ayenera kumalowa m'malingaliro a dokotala.
Kuzindikira kuti mankhwala a hypercholesterolemia amadziwika bwino akhoza kupangidwa ngati mitsempha ya LDL yapamwamba kwambiri, magulu a triglyceride ndi achilendo, ndipo mbiri ya banja ndi yogwirizana. Ngati xanthomas kapena xanthelasmas alipo, matendawa angaganizidwe moyenera. Kuyeza kwa majeremusi kungakhale kothandiza (koma kawirikawiri sikofunikira) poyambitsa matendawa, ndipo kungakhale kofunika kwambiri pofuna kulangiza uphungu.
Matenda a mitsempha yambiri yomwe imayambitsa matenda a hypercholesterolemia amayamba muunyamata. Choncho ana m'mabanja omwe ali ndi matendawa ayenera kuyang'anitsitsa maulendo apamwamba a cholesterol a LDL ali ndi zaka eyiti. Ngati ma cholesterol awo ali okwera, mankhwala opangidwa ndi statins ayenera kuganiziridwa mozama.
Lizani ku Matenda a Mtima
Asanayambe kupezeka kwa mankhwala osokoneza bongo , chiŵerengero cha matenda a mtima asanakwane chinali chokwanira kwambiri kwa anthu omwe ali ndi azimayi odwala matenda a hypercholesterolemia komanso achibale awo. Phunziro lalikulu lomwe linayambika m'ma 1970 (lisanakhazikitsidwe), 52 peresenti ya achibale a odwala omwe ali ndi matenda a hypercholesterolemia anali ndi matenda a mtima ali ndi zaka 60 (poyerekezera ndi chiopsezo cha 13 peresenti), ndipo 32 peresenti ya achibale awo anali ndi matenda a mtima ali ndi zaka 60 (poyerekezera ndi chiopsezo choyembekezeredwa cha 9 peresenti.) Phunziroli linapangitsa kuti banja likhale lachikhalidwe.
Chithandizo
Kukula kwa mankhwala amphamvu, "kachiwiri-generation" mankhwala osintha mankhwala akusintha kayendetsedwe ka hypercholesterolemia. Asanakhalepo ndi mankhwala amphamvuwa, chithandizo cha matendawa chinkafunika kugwiritsa ntchito mankhwala ambiri, kuphatikizapo mankhwala osokoneza bongo amodzi oyamba. Ngakhale njira iyi yambiri yogwiritsira ntchito mankhwala inachepetsanso odwala matenda a mtima, matendawa angakhale ovuta kulekerera ndipo zinali zovuta kusamalira.
Ndi chitukuko cha statins -atorvastatin (Lipitor) yachiwiri, mphamvu ya rosuvastatin (Crestor), kapena simvastatin (Zocor) - njira yothetsera matenda a hypercholesterolemia ya banja yasintha. Chithandizo tsopano chayamba ndi mlingo waukulu wa mankhwala a statin mmodzi, wachiwiri. Mankhwalawa nthawi zambiri amachititsa kuchepa kwakukulu kwa mitsempha ya cholesterol ya LDL, ndipo ikhoza kutulutsa kachilombo kokhala ndi miyala ya atherosclerotic .
Maphunziro omwe ayang'ana kuwonjezerapo zina zowonjezera (makamaka Ezitimibe / Vytorin ), mpaka zakale zachibadwidwe chazachiwiri alephera kusonyeza zotsatira zina zowonjezera pa zotsatira zachipatala. Choncho, kwa odwala omwe ali ndi hypercholesterolemia (mtundu wa "milder"), chiwerengero chachikulu, mankhwala osakaniza okha omwe ali ndi zaka zisanu ndi ziwiri, akhalabe chithandizo chovomerezeka.
Mu 2015, a FDA adavomereza gulu latsopano la mankhwala- PCSK9 inhibitors -kwa odwala ndi hypercholesterolemia. Pamene imodzi mwa mankhwalawa ikuwonjezeredwa ku statin, kuchepetsedwa kwakukulu kwa ma LSL cholesterol kumatha kungapezeke. Ntchito ya PCSK9 inhibitors pochiza matenda a hypercholesterolemia omwe sagwiritsidwa ntchito masiku ano sakudziwika bwino, popeza mayesero a chipatala akuwonetsera kuti kuphatikiza uku kumapangitsa kuti zotsatira zachipatala zikhalepobe. Komabe, mankhwala atsopanowa amatha kuwonjezeredwa ku mazenera akuluakulu ngati LDL cholesterol imakhalabe yowonjezera pa mankhwala okhaokha.
Ngakhale kuti cholesterol chokwera kwambiri chimaonjezera chiopsezo cha matenda a mtima mwa anthu omwe ali ndi matenda a hypercholesterolemia, zina zomwe zimayambitsa matenda a mtima zimakhala zofunikira kwambiri. Choncho chofunika kwambiri pa chithandizo chawo ndi kuwongolera mwankhanza zoopsa zina zonse za matenda a mtima, makamaka kusuta, kunenepa kwambiri, kusowa zochita zolimbitsa thupi, komanso kuthamanga kwa magazi .
Fomu ya Homozygous
Odwala omwe ali ndi vuto lodziwika bwino la matenda a mtima, amakhala ndi chiopsezo cha mtima kwambiri moti mankhwalawa amawoneka mwamsanga pamene matendawa amapezeka. Chifukwa cha kukula kwa cholesterol kwa odwalawa, zowonjezera zowonjezera ndikuyamba kupereka mankhwala ndi ma PCSK9 inhibitor.
Ngakhale ndi mtundu uwu wa mankhwala osokoneza bongo, nthawi zina ma cholesterol amakhalabe apamwamba. Pazochitikazi, mankhwala ndi apheresis angafunikire kubweretsa mafuta m'thupi.
Chidule
Mankhwala otchuka a hypercholesterolemia ndi matenda aakulu okhudza cholesterol. Anthu omwe ali ndi matenda a hypercholesterolemia amafunika kuchitidwa nkhanza kuti achepetse mitsempha ya cholesterol komanso kuchepetsa mavuto ena a mtima, pofuna kuchepetsa chiopsezo cha matenda a mtima msanga. N'kofunikanso kuti mamembala awo ayesedwe pa vutoli.
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