Zakale zapitazo, chifukwa chachikulu chomwe madotolo anachizira kuti cholesterol ikhale "yapamwamba kwambiri ya mafuta m'thupi." Ngati mayesero a magazi a cholesterol amawoneka ngati "okwezeka kwambiri," dokotala wanu angayamikire chithandizo-mwina ndi kusintha kwa moyo, monga zakudya ndi zochita masewera olimbitsa thupi, kapena mwinamwake ndi mitundu yambiri ya mankhwala omwe angathe kuchepetsa mpweya wa mafuta m'thupi .
Zaka zingapo za kafukufuku wa zamankhwala, komabe, zinapangitsa akatswiri kuganiza kuti izi ndizolakwika. Mu 2013, malangizo atsopano anafalitsidwa ndi gulu la akatswiri ochokera ku American Heart Association ndi American College of Cardiology. Zotsatirazi zimalimbikitsa njira yosiyana yothetsera cholesterol.
Masiku ano, zopereka za mankhwala sizidalira kokha za mitsempha ya cholesterol, koma m'malo mwake, pa mlingo wonse wa matenda a mtima. Mabala a cholesterol amalingalira, koma ndi chimodzi mwa zinthu zambiri zomwe zimayambitsa chiopsezo cha mtima.
Ndiye Ndani Amene Amafunika Kuchitidwa?
Kufotokozera, malinga ndi malangizo a 2013, ngati mukufunikira kuchiritsidwa zimadalira chiwopsezo chanu chokhala ndi matenda a mtima. Ngakhale kuti mlingo wa cholesterol wanu wa LDL umapangitsa kuti pakhale ngozi imeneyi, chiopsezo chanu chikhoza kukhala chachikulu ngati mlingo wa LDL uli pamwamba kapena ayi.
Kuwona chiopsezo chanu chonse kumatanthauza kuti dokotala wanu adzafunika kulingalira mbiri yakale ya zamankhwala, kuyesa thupi, ndi inde, zotsatira za labu lanu.
Izi zikatha, dokotala wanu akuyenera kukupatsani gawo limodzi mwa magawo asanu omwe ali ndi chiopsezo:
Gawo 1: Inu muli m'gulu ili ngati muli kale ndi matenda a atherosclerosis omwe atulutsa vuto la matenda. Gawo 1 likuphatikizapo anthu omwe ali ndi zotsatirazi:
- Matenda a mitsempha yam'mimba (CAD) yomwe yatulutsa angina , kapena matenda oopsa a mtima, kapena amene amafuna chithandizo chamankhwala opatsirana kapena opaleshoni
Gawo 2: Chigawo chachiwiri chimaphatikizapo anthu omwe ali ndi vuto la cholesterol LDL kuposa 189 mg / dL. Anthu ambiri mu Gawo 2 adzakhala ndi mtundu umodzi wa hypercholesterolemia. Chodziwika, ichi ndicho chokhacho chimene chithandizochi chimalimbikitsidwa kokha chifukwa chakuti ma cholesterol ali "okwera kwambiri."
Gawo 3: Gawo lachitatu likuphatikizapo anthu a zaka zapakati pa 40 ndi 75 omwe ali ndi shuga , ndipo omwe sali mu Gawo 1 kapena 2.
Gawo 4: Gawo lachinayi limaphatikizapo anthu omwe sali m'gulu limodzi la magawo atatu oyambirira, koma omwe amakhala ndi chiopsezo cha mtima wawo amawaika pa chiopsezo chachikulu cha matenda a mtima. Mwachindunji, awa ndi anthu omwe chiopsezo chokhala ndi vuto lalikulu la mtima (monga matenda a mtima kapena kupwetekedwa mtima) ndi 7.5% pa zaka khumi zotsatira. Pofuna kuthandizira kulingalira za chiopsezo cha zaka khumi, NHLBI yapereka chophatikizira chosavuta pa intaneti pano.
Gawo lachisanu: Gawo lachisanu limaphatikizapo aliyense yemwe sagwirizana nawo magawo anayi oyambirira. Anthu awa ali pangozi ya mtima wamtima ndipo samafuna chithandizo.
Ndi Ndani Amene Akufunika Kutengedwa? Aliyense m'magulu 1 - 4 ali ndi chiopsezo chachikulu cha mavuto aakulu a mtima m'zaka zingapo, ndipo amafunika kuzunzika kuti athe kuchepetsa ngozi.
Kodi Ndi Chithandizo Chamtundu Chotani Choyankhidwa?
Zotsatira za 2013 za cholesterol zakhala zikusonyeza kusintha kwa mankhwala omwe akulimbikitsidwa kwa anthu omwe ali pachiopsezo chachikulu. Ngakhale zitsanzo zakale zatsindika kuchepetsa kolesterolini kuti zitha kulandira chithandizo chamankhwala, malangizo atsopano sakuchita. M'malo mwake, iwo amatsindika kuchepetsa chiopsezo chachikulu cha mtima mmalo molimbikitsa makina a kolesterolini. Kuchepetsa chiopsezochi kumadalira kusintha kwa moyo wamantha, komanso kugwiritsa ntchito mankhwala osokoneza bongo .
Mtsutso Padziko Lonse 4
Anthu omwe ali mu Gawo 1 mpaka 3 ali ndi chiopsezo chachikulu chokhalira ndi mavuto a mtima, ndipo amafunikira thandizo lachiwawa kuti achepetse vutoli.
Komatu gulu lachinayi linakhazikitsidwa kuti lipeze anthu omwe ali pachiopsezo chokwanira, koma chiwopsezo chochepa kwambiri, komanso chosaoneka bwino, kuposa m'magulu atatu oyambirira. Kufotokozera yemwe ayenera kuikidwa mu Gawo 4, ndiye kuti mwachibadwa ndi njira yosasinthika ndipo mwachibadwa amakhala omasuka kutsutsidwa.
Pali mitundu ikuluikulu yotsutsa yotsutsana ndi Gawo 4. Zoyamba zonena kuti Gawo 4 liri ndi anthu ambiri. Otsutsawa akunena kuti chowerengera chowopsa choperekedwa ndi NHLBI chimatsindika kwambiri za msinkhu. Pachifukwa ichi, anthu ambiri oposa zaka 60 adzapezeka kapena ali pafupi ndi 7.5% cutoff. Komanso, otsutsa awa, chiopsezo cha zaka 10 chokhala ndi 7.5% palokha ndi chomasuka kwambiri. Chithandizo cha mankhwala m'mbuyomu chinkayang'ana kwambiri pa cutoff ya 10%. Pofuna kuchepetsa kulandira chithandizo kwa 7.5%, iwo amati, akuwonjezera "anthu ambiri" ku mndandanda wa mankhwala.
Mitundu yachiwiri yotsutsa za Gawo 4, n'zosadabwitsa, imanena kuti anthu osakwanira ali nawo mndandanda wa mankhwala. Otsutsawa amanena kuti wolemba masewerawa a NHLBI amangophatikizapo zifukwa zokhazo zomwe zakhala "zatsimikiziridwa" m'mayesero ochiritsidwa bwino omwe amathandizira kwambiri kuika moyo wawo pachiswe: zaka, LDL, ndi ma CDL a cholesterol, ngakhale kuti tsopano akusuta, ndipo kaya wina atha kupanikizika kwa systolic magazi. Zimatulutsa zifukwa zina zomwe zimavomerezedwa kuti ndizofunikira, koma zomwe sizikugwirizana ndi mfundo zowonongeka za NHLBI. Zinthu zoterezi zimaphatikizaponso mbiri ya banja ya matenda a mtima asanakwane, mbiri yakale ya kusuta, kuchuluka kwa CRP , moyo wokhala ndi moyo, komanso kacisi yamakono . Ngati zinthu izi zidawopsyezedwa, anthu ambiri angakumane ndi zofunikira zothandizira.
Kutsutsana kotere-kaya mtundu wa 4 uli ndi anthu ochulukirapo kapena ochepa-uli ndi malingaliro aliwonse omwe olemba anzawo amadziwika movomerezeka ndi gulu la akatswiri.
Kaya zochitika za munthu payekha ndizokwanira kuti chithandizo choyenera chikhale choyenera, mwina pang'ono, kuti asiye kwa wodwala ndi dokotala wawo. Kodi ndi chiopsezo chotani chomwe munthu akufuna kuvomereza kuti ali ndi matenda a mtima kapena kupwetekedwa mtima m'zaka 10 zotsatira? 7.5%? 10% Zina zili ndi mtengo wina? Kodi katswiri woopsa wa NHLBI ayenera kuvomerezedwa pamtengo wapatali, kapena kodi zifukwa zowonjezerapo zingaganizidwe posankha chithandizo?
Ndi koyenera kuti gulu la akatswiri apange malingaliro pankhaniyi. Koma chifukwa cha mafunso ngati awa, kuti mwachibadwa ayenera kudziwidwa ndi anthu, malingaliro awo sayenera kumanga. Cholinga chomaliza cha chithandizo cha mankhwala chiyenera kusiya kwa madokotala ndi odwala.
> Zotsatira:
Stone NJ, Robinson J, Lichtenstein AH, et al. 2013 ACC / AHA chitsogozo chochiza magazi a cholesterol kuti athetse vuto la mtima la anthu omwe ali ndi kachilombo ka HIV: Apoti a American College of Cardiology / American Heart Association. J Am Coll Cardiol 2013.