Kugwiritsira ntchito mankhwala osokoneza bongo (ACE) omwe amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda . Kwa anthu omwe ali ndi vuto la mtima, ACE inhibitors awonetseredwa kuti athe kuchepetsa kufunika kokhala opaleshoni, kusintha zizindikiro, komanso kukhalabe ndi moyo nthawi yaitali. Ngati mwapezeka kuti muli ndi mtima wosagonjetsa mtima , muyenera kuchiritsidwa ndi ACE inhibitor pokhapokha ngati dokotala wanu ali ndi chifukwa chabwino chosachitira.
Kodi ACE Inhibitors Amatani?
ACE inhibitors amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda (RAAS) . RAAS ndi mpweya wa ma enzyme omwe amagwira ntchito pamodzi kuti athetse magazi, komanso sodium m'magazi.
Pamene magazi akuthamangira ku impso afupika, puloteni yotchedwa renin imatulutsidwa m'magazi. Renin amachititsa enzyme yina, angiotensin I, kuonjezera. Angiotensin Ndimasinthidwa ndi ACE mu angiotensin II. Angiotensin II imayambitsa magazi, ndipo (mwa kuyambitsa kutulutsa kwa hormone aldosterone kuchokera ku adrenal glands) zimapangitsa thupi kukhala ndi sodium.
RAAS imayamba kugwira ntchito nthawi yambiri mu anthu omwe ali ndi mtima wosayenerera, zomwe zimapangitsa kuti thupi lizikhala ndi mphamvu ya magazi, ndipo zimapangitsa mtima kugwira ntchito molimbika kuposa momwe ziyenera kukhalira.
ACE inhibitors amagwira ntchito potseka mawonekedwe a angiotensin II. Kwa anthu omwe ali ndi vuto la mtima, amachepetsa kuthamanga kwa magazi ndipo amachepetsa kuchepetsa mphamvu.
Mwa njira iyi, ACE inhibitors amachepetsa nkhawa pamtima ndikulola minofu ya mtima yofooka kupopera bwino kwambiri.
ACE inhibitors ndi othandiza kwambiri pochiza matenda oopsa , ndipo awonetsedwa kuti apangitse zotsatira za anthu omwe ali ndi vuto la mtima . Kuphatikiza apo, akhoza kuthandizira kuwononga kwa impso kwa anthu omwe ali ndi shuga .
ACE Inhibitors mu Kulephera kwa Mtima
Mayesero angapo akuluakulu a zachipatala ayang'ana kugwiritsa ntchito ACE poletsa anthu omwe ali ndi vuto la mtima. Zonsezi zinapindulitsa kwambiri. Kufufuza kwa mayesero asanu omwe anaphatikizapo anthu opitirira 12,000 omwe ali ndi mtima wosagwirizana kunasonyeza kuti ACE inhibitors yachepetsa kwambiri kufunikira kokhala opaleshoni, kupulumuka, komanso kuchepetsa kuopsa kwa mtima. Zizindikiro za kuperewera kwa mtima monga dyspnea (kupuma pang'ono) ndi kutopa zinathandizidwanso.
Zotsatira zamakono zochokera ku American College of Cardiology ndi American Heart Association zimalimbikitsa kwambiri kuti ACE inhibitors apatsedwe kwa aliyense amene ali ndi mtima wolephera, komanso kuwonjezera pa aliyense amene ali ndi kachigawo kakang'ono kotsekemera kotsitsimula (kosakwana 0,4) kaya alibe anali ndi mtima weniweni kulephera.
Ambiri a ACE inhibitors ali pamsika, ndipo kawirikawiri amaganiza kuti ndi opindulitsa mofananamo pochiza mtima kulephera. Amagwiritsiridwa ntchito ndi ACE omwe amadziwika ndi captopril (Capoten), enalapril (Vasotec), lisinopril (Zestril), ramipril (Altace), ndi trandolarpril (Mavik).
Poyamba kulamula, ACE inhibitors amayamba kawirikawiri, ndipo mlingowo umakula pang'onopang'ono kufika pa mlingo wapamwamba womwe umagwiritsidwa ntchito mu mayesero a zamankhwala.
Kuchulukitsa mlingowo pang'ono kumathandiza kuchepetsa mavuto. Ngati mankhwala omwe ali pamwambawa sakulekerera, chithandizochi chimapitilira pa mlingo wapansi, wabwino kwambiri. Akatswiri ambiri amakhulupirira kuti mankhwala ochepa a ACE omwe amatetezedwa amakhala ofunika kwambiri, koma apamwamba amakhala okondedwa chifukwa amayesedwa mozama m'maphunziro azachipatala.
ACE inhibitors ndi mtundu. Kafukufuku wina amasonyeza kuti ACE inhibitors sangakhale ogwira mtima kwambiri kwa anthu akuda kuposa azungu, koma umboni umatsutsana. Zotsatira zamakono zimalimbikitsa kugwiritsa ntchito ACE zowononga aliyense amene ali ndi mtima wosalimba, mosasamala mtundu.
ACE inhibitors ndi chikhalidwe. Maphunziro a zachipatala sanawonetsere kukula kwakukulu kwa phindu ndi ACE zowonongeka kwa amayi monga tawonetsedwa mwa amuna. Komabe, kuponderezedwa kwa umboni kumagwiritsabe ntchito kugwiritsa ntchito ACE ziwalo mwa akazi onse omwe ali ndi vuto la mtima.
Zotsatira Zoipa za ACE Inhibitors
Ngakhale kuti ACE inhibitors amavomerezedwa bwino, zotsatira zina zimachitika.
ACE inhibitors angachepetse kuthamanga kwa magazi kwambiri, kutulutsa zizindikiro zafooka, chizungulire , kapena syncope . Vutoli likhoza kupezedwa poyambira ndi mlingo wotsika ndipo pang'onopang'ono kumanga mlingo wapamwamba.
Makamaka mwa anthu omwe ali ndi matenda a impso, kugwiritsa ntchito ACE inhibitors kungachepetse ntchito ya impso. Pachifukwachi, ntchito ya impso (kuyesera magazi) iyenera kuyang'aniridwa ndi anthu omwe ali ndi matenda a impso ndipo akuyamba ACE inhibitors.
ACE inhibitors angayambe kuchulukitsa magazi a potaziyamu. Ngakhale kuti izi zimakhala zochepa kwambiri komanso osati za mankhwala. Komabe, mwa anthu ena (pafupifupi 3%) mazinga a potaziyamu akhoza kukhala okwera kwambiri.
Zotsatira zapamwamba kwambiri za ACE inhibitors ndi chifuwa chouma, chifuwa chachikulu , chomwe chikhoza kuwonedwa mwa anthu 20 peresenti opatsidwa mankhwalawa. Ngakhale si vuto lalikulu, zotsatirazi zimakhala zosokoneza kwambiri ndipo nthawi zambiri zimafuna kuti musiye mankhwala.
Kawirikawiri, anthu omwe amatenga ACE inhibitors amatha kukhala ndi angioedema -wawopsya ngati momwe amachitira.
Ma ARBs monga Wothandizira ACE Kuletsa
Mankhwala a Angiotensin II (ARB mankhwala) ali ofanana ndi ACE inhibitors chifukwa amalepheretsa kutuluka kwa RAAS ndi kuchepetsa zotsatira za mavitamini a angiotensin II. Chifukwa chakuti ma ARB amangowononga chifuwa ndi angioedema, nthawi zina amagwiritsidwa ntchito monga choloweza mmalo mwa anthu omwe adzipweteka ndi ACE inhibitors.
Ma ARBs awonetsedwa kuti ndi othandiza pochiza mtima kulephera, ngakhale pang'ono kuposa ACE inhibitors. Kuonjezera apo, ARBs zimakhala zogwira mtima monga ACE inhibitors pochiza matenda oopsa. Mankhwala osokoneza bongo omwe amagwiritsidwa ntchito kawirikawiri amaphatikizapo amatsenga (Atacand), lasartan (Cozaar), ndi valsartan (Diovan). Mankhwala ena a ARB amapezekanso.
Mfundo Yofunika Kwambiri
Ngati muli ndi vuto la mtima, kuchepetsa zizindikiro zanu ndi kukwaniritsa zotsatira zanu, muyenera kuitanitsa ACE inhibitor pokhapokha pali chifukwa chabwino kwambiri.
> Zotsatira:
> Flather MD, Yusuf S, Køber L, et al. Kuchiza kwa nthawi yaitali ACE-inhibitor Thandizo kwa Odwala Ndi Mtima Kusalephereka kapena Kulephera Kwambiri Kuchokera M'mimba: Kuwunika Kwambiri kwa Deta Kuchokera Kwa Odwala Onse. ACE-Inhibitor Myocardial Infarction Gulu Lokambirana. Lancet 2000; 355: 1575.
> McMurray JJ, Adamopoulos S, Anker SD, et al. Malangizo a ESC Ofufuza ndi Kuchiza Kulephera kwa Mtima Wosatha ndi Wosatha 2012: Task Force for Discover and Treatment of Heart and Chronic Heart Failure 2012 ya European Society of Cardiology. Yakhazikitsidwa mogwirizana ndi Heart Failure Association (HFA) ya ESC. Mtima; 33: 1787.
> Yambani CW, Jessup M, Bozkurt B, et al. 2013 ACCF / AHA Fuideline ya Kulephera kwa Mtima Kulephera: Lipoti la American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines. J ndi Coll Cardiol 2013; 62: e147.