Chifukwa Chodzidzimutsa Imfa M'nyamata
Long QT Syndrome (LQTS) ndi matenda obadwa nawo a magetsi a mtima . LQTS angapangitse mtundu wa tachycardia wotchedwa torsades de pointes mwadzidzidzi, wosayembekezeka, wowopsya. Anthu omwe ali ndi LQTS ali pachiopsezo cha syncope (kutaya chidziwitso) ndi imfa mwadzidzidzi, nthawi zambiri ali aang'ono.
Chithunzi - Torsades de pointses. Chithunzi chapamwamba: Chibadwa cha mtima. Chithunzi chachidule: Torsades de pointses. "Torsades de pointes" amatanthawuza kuzungulira pafupi. Mu chigamulochi, mtima wamtima umakhala wofulumira kwambiri, ndipo mawonekedwe a makompyuta a ECG amakhala akusintha nthawi zambiri, nthawi zambiri amafanana ndi mawonekedwe a mawonekedwe monga chithunzichi. Pamene magetsi a mtima amayenda motere, kuyimba bwino sikutheka
Mwachidule
Anthu omwe ali ndi LQTS akhala ndi nthawi yochepa ya QT pa ECGs yawo. Nthawi ya QT imaimira kubwezeretsa, kapena "kubwezeretsa," kwa selo la mtima. Pambuyo pa magetsi a mtima amachititsa kuti selo ya mtima (yomwe imapangitsa kuti imenyedwe), recharging iyenera kuchitika kuti selo likhale lokonzekera mphamvu yotsatira yamagetsi. Nthawi ya QT (yomwe imayesedwa kuchokera kumayambiriro a QRS complex mpaka kumapeto kwa T wave) ndi nthawi yonse yomwe imatenga nthawi kuti ikwaniritse, kenaka yambitseni maselo a mtima. Mu LQTS, nthawi ya QT yayitali. Zomwe sizingatheke pa nthawi ya QT ndizoyendetsa masinthidwe omwe ali ndi LQTS.
Zimayambitsa
LQTS ndi matenda obadwa nawo. Pali majini angapo omwe azindikiridwa omwe amakhudza nthawi ya QT, kotero pali mitundu yambiri ya LQTS. Mabanja ena ali ndi chiwerengero chachikulu cha LQTS. Chifukwa chakuti majini ochuluka angakhudze nthawi ya QT, kusiyana kwakukulu kwa LQTS kwapezeka.
Zina mwa izi ("LICTS") zimakhudzana ndi chiwopsezo choopsa cha arrhythmias ndi imfa yadzidzidzi, yomwe nthawi zambiri imapezeka m'mabanja angapo. Mitundu ina ya LQTS ("LQTS zosiyanasiyana") sangakhale yoopsa kwambiri. Zambiri mwa mitundu imeneyi zimakhala ndi nthawi yoyamba ya QT, ndipo maginito a mtima amangoonekera kokha pamene chinthu china chowonjezera (monga mankhwala osokoneza bongo, kapena kusiyana kwakukulu kwa electrolyte) chimawonjezera nthawi ya QT.
Komabe, nthawi ya QT ikakhala yaitali kwa anthu omwe ali ndi ma LQTS osiyanasiyana, ziwalo zoopsa zimachitika.
Kukula
Classic LQTS ilipo pafupifupi mmodzi mwa anthu 5000. LQTS ndi chimodzi mwa zifukwa zomwe zimayambitsa imfa mwadzidzidzi kwa achinyamata, zomwe zimapangitsa kuti pakati pa 2000 ndi 3000 anthu azifa pa chaka. Zambiri za LQTS ndizofala kwambiri, ndipo zimakhudza anthu 2 mpaka 3%.
Zizindikiro
Zizindikiro za LQTS zimachitika kokha pamene wodwalayo akupanga choopsa cha ventricular tachycardia, ndipo kukula kwa zizindikiro kumadalira kutalika kwa nthawi yomwe arrhythmia ikupitirira. Ngati kamangokhala kanthawi kochepa chabe, masekondi angapo a chizungulire chodetsa nkhawa angakhale chizindikiro chokhacho. Ngati ikupitirira kwa masekondi opitirira 10 kapena kotero, syncope imapezeka. Ndipo ngati izo zatha kwa mphindi zingapo, wozunzidwa nthawi zambiri samabwerezanso kuzindikira.
Kwa iwo okhala ndi mitundu yosiyanasiyana ya LQTS, zigawozi zimayambitsidwa ndi kutuluka kwadzidzidzi kwa adrenaline; monga momwe zingathere pakuchita mwakuthupi, podabwa kwambiri, kapena pakukwiya kwambiri.
Mwamwayi, anthu ambiri omwe ali ndi mitundu yosiyanasiyana ya LQTS sakhala ndi zizindikiro zoopsa.
Kudziwa
Madokotala ayenera kuganizira za LQTS kwa aliyense amene ali ndi syncope kapena kumangidwa kwa mtima, komanso m'banja la munthu yemwe ali ndi LQTS odziwika.
Mnyamata aliyense yemwe ali ndi syncope yomwe imapezeka nthawi ya masewera olimbitsa thupi, kapena muzochitika zina zomwe adrenaline angakhalepo, ayenera kukhala ndi LQTS mwachindunji.
Kuzindikira kwa LQTS kaŵirikaŵiri kumapangidwa mwa kuyang'ana nthawi yochepa ya QT pa ECG. Nthawi zina mayesero amafunika kuti atulutse zovuta za ECG. Kuyesedwa kwa mafupa a LQTS ndi mitundu yake ikugwiritsidwa ntchito kwambiri kuposa momwe zinalili zaka zingapo zapitazo.
Kuchiza
Odwala ambiri omwe ali ndi LQTS oposa amachizidwa ndi beta blockers . Olemba Beta amatsutsa zochitika za adrenaline zomwe zimayambitsa magulu a arrhythmias mwa odwala awa.
Mwatsoka, sizinatsimikizire kuti beta-blockers amachepetsa kwambiri chiwerengero cha syncope ndi imfa mwadzidzidzi kwa odwala omwe ali ndi LQTS.
Ndikofunika kwambiri kwa anthu omwe ali ndi LQTS ndi mitundu yake kuti asapewe mankhwala ambiri omwe amachititsa kuti nthawi ya QT ikhale yaitali. Mwa anthu awa, mankhwala oterowo mwachiwomveka amachititsa zizindikiro za ziphuphu. Mankhwala omwe amathera nthawi ya QT ndi ovuta kwambiri. Amayi akuluakulu, ndizovuta, mankhwala osokoneza bongo ; mankhwala ambiri ochepetsa kupanikizika, komanso mankhwala opha tizilombo monga erythromycin, clarithromycin erythromycin, ndi azithromycin. CredibleMeds ali ndi mndandanda wa mankhwala omwe nthawi zambiri amatenga nthawi ya QT.
Kwa anthu ambiri omwe ali ndi LQTS, mankhwala osokoneza bongo ndi othandizira kwambiri. Chogwiritsiridwa ntchitochi chiyenera kugwiritsidwa ntchito kwa odwala amene apulumuka mtima wam'mimba, ndipo mwinamwake odwala amene ali ndi syncope chifukwa cha LQTS makamaka ngati syncope ikupezeka pamene akutha kutenga beta.
Kwa anthu omwe sangathe kulekerera beta blockers kapena amene ali ndi zochitika panthawi yachipatala, anasiya opaleshoni yachipatala yachipanikizi (LCSD) opaleshoni.
Zowonjezera zowonjezera zowonjezera zingagwiritsidwe ntchito ndi LQTS mtundu 3.
Zotsatira
> Kodi matenda aakulu a QT ndi chiyani? - NHLBI, NIH. National Institutes of Health. http://www.nhlbi.nih.gov/health/health-topics/topics/qt/. Idasinthidwa pa 21 September, 2011. Inapezeka pa July 27, 2016.
> Alders M, > Christiaans > I. Long Long QT matenda . NCBI Bookshelf; June 18, 2015. http://www.ncbi.nlm.nih.gov/books/NBK1129/. Inapezeka pa July 27, 2016.
Moss AJ. QT Syndrome Yakale. JAMA 2003; 289: 2041.
Li H, Fuentes-Garcia J, Towbin JA. Mfundo zamakono zokhudzana ndi matenda a QT. Mwana wamwamuna Cardiol 2000; 21: 542.