Koj puas muaj cov calcium deposits nyob rau hauv koj cov hlab ntsha plawv? (Coronary Artery Calcification)

Koj puas tau xav tias seb cov calcium me me puas tuaj yeem tsim tau hauv cov hlab ntsha tseem ceeb uas nqa cov ntshav mus rau koj lub plawv? Nws zoo li cov limescale hauv cov kav dej raws sijhawm. Qhov no yog qhov peb hu ua coronary artery calcification (CAC) . Qee zaum, qhov no tuaj yeem tshwm sim yam tsis muaj cov tsos mob pom. Tab sis kev paub txog qhov no yog qhov tseem ceeb heev rau kev noj qab haus huv ntawm koj lub plawv.

Kev Calcification ntawm Coronary Artery yog dab tsi?

Hais yooj yim xwb, qhov no yog thaum cov calcium sib sau ua ke hauv phab ntsa ntawm ob lub hlab ntsha loj uas muab ntshav rau koj lub plawv, hu ua cov hlab ntsha coronary . Qhov no tsis tshwm sim ib hmos. Feem ntau nws siv sijhawm li tsib xyoos rau cov calcium kom sib sau ua ke hauv koj cov hlab ntsha, tom qab ib lub sijhawm uas koj muaj cov plaque sib sau ua ke (hu ua atherosclerosis ). Xav txog nws zoo li ib lub yeeb nkab uas muaj cov av thiab cov av qias neeg sib sau ua ke, thiab tom qab ntawd qhov sib sau ua ke ntawd tuab dua.

Cov calcium uas tso rau hauv cov hlab ntsha no yog ib qho cim qhia tseem ceeb ntawm kab mob plawv . Qhov no tso cai rau koj tus kws kho mob los soj ntsuam koj qhov kev pheej hmoo ntawm kab mob plawv.

Thaum cov rog no sib sau ua ke hauv cov hlab ntsha, nws txo qhov kev ntws ntawm cov ntshav. Koj paub, cov hlab ntsha coronary muab cov ntshav uas muaj oxygen rau cov leeg plawv. Yog li, yog tias cov ntshav ntws los ntawm cov hlab ntsha no raug thaiv, koj tuaj yeem mob hauv siab (angina) , lossis qhov phem dua, mob plawv nres .

Muaj ob hom calcium deposits tseem ceeb:

Cov kws kho mob pom qhov no ua ob txoj kev tseem ceeb, nyob ntawm seb cov calcium uas nyob hauv phab ntsa ntawm cov hlab ntsha yog dab tsi:

1. Kev tso cov hlab ntsha hauv lub plawv (Intimal deposition): Qhov no tshwm sim hauv txheej sab hauv ntawm phab ntsa hlab ntsha. Hom no feem ntau pom muaj nyob rau hauv cov hlab ntsha hauv lub plawv.

2. Medial deposition: Qhov no tshwm sim hauv txheej nruab nrab ntawm phab ntsa arterial.

Kev sib raug zoo ntawm cov calcium uas tso rau hauv cov hlab ntsha thiab atherosclerosis yog dab tsi?

Muaj kev sib txuas loj ntawm ob qho no. Qhov ntau ntawm cov calcium hauv koj cov hlab ntsha tuaj yeem muab rau koj lub tswv yim ntawm ntau npaum li cas atherosclerosis koj muaj, uas yog kev sib sau ua ke ntawm cov rog hauv koj cov hlab ntsha. Atherosclerosis yog thaum cov rog sib sau ua ke hauv koj cov hlab ntsha, ua rau lawv nqaim. Nws ua rau nws nyuaj rau cov ntshav ntws kom zoo. Calcium tuaj yeem ua rau qhov mob no hnyav dua.

Leej twg raug kev cuam tshuam ntau tshaj plaws los ntawm qhov xwm txheej no?

Cov neeg uas muaj kab mob plawv feem ntau pom cov calcium tso rau hauv cov hlab ntsha no.

• Nrog hnub nyoog:Yog tias peb saib cov neeg uas muaj hnub nyoog tshaj 70 xyoo, ntau dua 90% ntawm cov txiv neej thiab 67% ntawm cov poj niam muaj tus mob no. Ua ntej lub sijhawm tas sij hawm, cov poj niam tau tiv thaiv qee yam ntawm kev pheej hmoo ntawm kev mob atherosclerosis (atherosclerosis) vim yog cov tshuaj hormone estrogen . Yog vim li cas cov poj niam thiaj mob no li 10-15 xyoo tom qab cov txiv neej.
• Haiv Neeg/Pawg Neeg: Qee qhov kev tshawb fawb tau pom tias cov neeg dawb muaj feem yuav muaj tus mob no ntau dua li lwm haiv neeg.
• Rau cov txiv neej: Cov txiv neej muaj feem yuav mob qhov no ntau dua (Coronary Artery Calcification).

Cov yam uas ua rau muaj kev pheej hmoo yog dab tsi? (Yog tias koj muaj cov no, koj kuj yuav muaj kev pheej hmoo thiab)

Muaj ib txhia neeg yuav muaj tus mob no ntau dua. Mus saib seb koj puas muaj tej yam uas ua rau koj muaj feem yuav mob no:

• Yog koj muaj kab mob raum ntev .
• Yog tias koj muaj teeb meem ntshav qab zib xws li ntshav qab zib mellitus .
• Yog tias cov roj cholesterol phem (LDL - Low-Density Lipoprotein) siab thiab cov roj cholesterol zoo (HDL - High-Density Lipoprotein) qis.
• Tus nqi BMI (Body Mass Index) , uas yog, yog tias lub cev hnyav siab (rog dhau).
• Yog tias ib tug neeg hauv koj tsev neeg muaj keeb kwm ntawm cov calcium deposits nyob rau hauv cov hlab ntsha coronary (genetic predisposition).
• Yog koj muaj ntshav siab .
• Yog tias koj muaj keeb kwm haus luam yeeb lossis siv lwm yam khoom luam yeeb.
• Nrog hnub nyoog nce ntxiv.
• Yog tias muaj qhov tsis zoo ntawm cov tshuaj hormones parathyroid .
• Yog tias cov phosphate hauv cov ntshav siab dhau.
• Yog tias cov calcium hauv cov ntshav siab dhau.

Qhov no ua li cas rau lub cev? Nws cuam tshuam li cas rau nws?

Thaum cov calcium sib sau ua ke hauv koj cov hlab ntsha hauv lub plawv, nws ua rau lawv tawv . Qhov no txo ​​lawv lub peev xwm los cog thiab nthuav dav kom zoo. Qhov no ua rau koj muaj feem yuav mob plawv ntau ntxiv.

Hais yooj yim xwb, qhov calcium uas sib sau ua ke no ua rau cov ntshav uas mus txog koj cov leeg plawv tsawg zuj zus. Xav txog nws zoo li lub cev uas ua haujlwm tas li. Yog tias nws tsis muaj ntshav txaus, nws yuav muaj teeb meem, puas yog?

Ib qho ntxiv yog tias thaum cov calcium deposits muaj nyob rau hauv cov hlab ntsha, nws nyuaj rau cov kws kho mob ua qee yam kev kho mob, xws li Percutaneous Coronary Intervention (PCI) , lossis raws li peb txhua tus paub , Angioplasty, vim tias cov calcium deposits no tuaj yeem cuam tshuam rau kev xa tawm ntawm stent uas muab tso rau hauv cov hlab ntsha.

Cov tsos mob yog dab tsi?

Feem ntau, cov neeg uas muaj tus mob no (Coronary Artery Calcification) tsis muaj tsos mob dab tsi li . Qhov ntawd yog qhov txaus ntshai tshaj plaws. Tab sis dhau sij hawm, thaum tus mob no zuj zus tuaj, tej zaum yuav muaj tej tsos mob tshwm sim. Lawv yog:

• Mob Angina ruaj khov: Qhov no yog mob hauv siab lossis tsis xis nyob uas feem ntau tshwm sim thaum lub sijhawm ua si lossis thaum nce ntaiv. Nws ploj mus thaum so.
• Ua tsis taus pa.
• Mob plawv nres.

Tseem Ceeb: Yog tias koj muaj cov tsos mob no, nco ntsoov nrhiav kev pab kho mob.

Vim li cas qhov no thiaj tshwm sim? Yog vim li cas?

Feem ntau tom qab muaj hnub nyoog 40 xyoo, cov calcium hauv peb cov ntshav yuav pib sib sau ua ke hauv ntau qhov chaw ntawm lub cev. Tshwj xeeb, cov phab ntsa ntawm cov hlab ntsha uas tau puas tsuaj, o, lossis tab tom kho yog cov uas yooj yim rau cov calcium no.

Cov txheej txheem no yeej pib tau thaum koj muaj hnub nyoog 20 xyoo , tab sis tus kws kho mob tsuas pom nws thaum nws loj txaus kom pom tau ntawm kev kuaj duab . Thiab, ntau tus neeg uas muaj hnub nyoog 20 thiab 30 xyoo tsis tau ua cov kev kuaj no tsis tu ncua.

Cov calcium uas tso rau hauv cov hlab ntsha pib ua cov khoom me me heev (0.5µm - micrometers). Raws li lub sijhawm dhau mus, thaum cov rog sib sau ua ke, cov calcium uas tso rau hauv cov hlab ntsha no tuaj yeem loj dua 3 millimeters. Cov kws tshawb fawb ntseeg tias cov calcium me me no (microcalcification) hauv txheej intimal ntawm phab ntsa hlab ntsha pib nrog kev tuag ntawm cov leeg nqaij du.

Koj nrhiav tau qhov no li cas? Ua li cas thiaj kuaj tau?

Muaj cov kev kuaj duab tshwj xeeb uas tuaj yeem kuaj pom qhov mob no (Coronary Atherosclerosis), uas yog, cov rog nyob hauv cov hlab ntsha, ua ntej nws hnyav zuj zus. Ib qho tseem ceeb tshaj plaws ntawm cov no yog (Computed Tomography - CT) scan, lossis (Multidetector Computed Tomography - MDCT) .

Kev kuaj CT ntawm lub plawv tuaj yeem pom tseeb tias muaj cov calcium nyob hauv koj cov hlab ntsha hauv lub plawv. Qhov no hu ua kev kuaj calcium hauv lub plawv (CAC) . Nws feem ntau nrhiav rau:

• Muaj pes tsawg calcium uas tau muab tso rau hauv?
• Qhov ntom ntawm cov deposits no yog dab tsi?
• Lawv loj npaum li cas?

Siv cov ntaub ntawv no, koj tus kws kho mob xam tus nqi hu ua Agatston score . Qhov qhab nia no tuaj yeem yog txij li 0 txog 400 lossis siab dua. Qhov qhab nia siab dua, qhov ntau koj yuav muaj feem yuav mob plawv lossis mob hlwb hauv 10 xyoo tom ntej.

Cov kws kho mob tau pom tias qhov kev kuaj mob (CAC) no tuaj yeem kwv yees tau qhov kev pheej hmoo ntawm kev mob plawv yav tom ntej. Txawm li cas los xij, koj yuav tsum tau them rau qhov kev kuaj mob no los ntawm koj tus kheej lub hnab tshos.

Qhov qhab nia CAC (Agatston Score) txhais li cas?

Nov yog li cas cov cim no feem ntau txhais tau:

• Qhab Nia 0: Tsis muaj mob.
• Qhab nia 1 txog 99: Kab mob me me.
• Cov qhab nia txij li 100 txog 399: Mob theem nrab.
• Qhab nia siab tshaj 400: Kab mob hnyav heev.

Ntxiv rau qhov kev kuaj no (CAC), muaj lwm yam kev kuaj uas tsis tshua muaj kev cuam tshuam uas tuaj yeem kuaj xyuas cov calcium uas tso rau hauv koj cov hlab ntsha hauv lub plawv:

• Kev Siv Ultrasound Hauv Lub Plawv (IVUS): Qhov no siv lub cuab yeej ultrasound nrog lub catheter (lub raj nyias nyias) txuas rau qhov kawg los saib sab hauv cov hlab ntsha. Cov txiaj ntsig tau muab qib los ntawm Class I mus rau Class IV, nrog Class IV qhia txog cov calcium uas muaj ntau tshaj plaws.
• Kev Siv Duab Kos Hauv Cov Hlwb (Intravascular Optical Coherence Tomography - IVOCT): Qhov no qhia tau tias muaj pes tsawg calcium nyob hauv koj cov hlab ntsha thiab nws tuab npaum li cas. Nws siv lub teeb ci ze-infrared los tsim cov duab ntawm sab hauv ntawm cov hlab ntsha.

Cov kev kho mob rau qhov no yog dab tsi?

Cov kws kho mob tseem tsis tau muaj kev kho mob ib txwm rau kev ua kom cov hlab ntsha hauv lub plawv tsis khov. Txawm li cas los xij, thaum muaj mob hnyav, qee tus kws kho mob siv kev kho mob tshiab hu ua intravascular lithotripsy . Qhov no suav nrog kev muab ib lub cuab yeej los ntawm lub catheter mus rau hauv cov hlab ntsha thiab siv nws los xa cov nthwv dej siab kom rhuav tshem cov calcium uas nyob hauv phab ntsa ntawm cov hlab ntsha. Tom qab ntawd tuaj yeem muab stent tso rau kom cov hlab ntsha qhib.

Qee lwm yam kev kho mob siv los txhim kho cov ntshav ntws hauv cov hlab ntsha suav nrog:

• Kev phais mob rotational, orbital lossis laser atherectomy: Qhov no suav nrog kev txiav thiab tshem tawm cov rog (plaque) thiab calcium los ntawm sab hauv cov hlab ntsha.
• Kev txiav, kev ntaus cim lossis kev siv lub tshuab cua siab los ua angioplasty: Qhov no suav nrog kev tshuab lub tshuab cua kom thawb cov rog thiab calcium tawm tsam phab ntsa ntawm cov hlab ntsha.

Puas muaj teeb meem tshwm sim thaum lub sijhawm kho mob?

Ib yam li kev kho mob twg los xij, qee qhov teeb meem tuaj yeem tshwm sim nrog kev kho mob no.

Cov Teeb Meem ntawm Intravascular Lithotripsy:

• Arrhythmia ( lub plawv dhia tsis zoo)
• Aneurysm ( kev loj hlob lossis qaug zog ntawm cov hlab ntsha)
• Cov teeb meem ntawm kev los ntshav
• Mob stroke
• Kev tuag (tsis tshua muaj)

Cov Teeb Meem ntawm Kev Kho Mob Rotational Atherectomy:

• Kev txiav cov hlab ntsha
• Mob plawv nres
• Kev tuag (tsis tshua muaj)
• Kev Kho Mob Hlwb Thaum Muaj Xwm Ceev (CABG)

Cov Teeb Meem ntawm Kev Kho Mob Coronary Angioplasty:

• Mob plawv nres
• Mob stroke
• Kev mob plawv dhia tsis xwm yeem
• Los ntshav
• Cov ntshav txhaws

Cov teeb meem no tsis tshwm sim rau txhua tus, tab sis nws yog ib qho tseem ceeb uas yuav tsum paub txog lawv. Koj tus kws kho mob yuav piav qhia txog cov kev pheej hmoo no thaum lawv pom zoo rau kev kho mob rau koj.

Kuv yuav ua li cas thiaj txo tau qhov kev pheej hmoo no?

Qhov zoo tshaj plaws uas yuav tsum ua yog tswj cov teeb meem uas ua rau muaj kev pheej hmoo ntawm kev tsim cov calcification ntawm cov hlab ntsha hauv lub plawv. Cov no suav nrog:

• Yog koj muaj ntshav qab zib, tswj nws kom zoo.
• Yog tias koj cov roj cholesterol tsis zoo, sim ua kom nws tsis txhob nce siab.
• Yog koj muaj ntshav siab , tswj nws.
• Yog koj muaj kab mob raum , nrhiav kev kho mob kom zoo.

Ntxiv rau cov no, nws yog ib qho tseem ceeb heev uas yuav tsum ua raws li kev noj qab haus huv.

Yog tias kuv muaj tus mob no, yuav ua li cas? Kuv yuav cia siab li cas?

Yog tias koj raug kuaj pom tias muaj Coronary Artery Calcification, koj muaj feem yuav mob Coronary Artery Disease thiab Major Adverse Cardiovascular Events (MACE) ntau dua.

Txawm li cas los xij, thaum nws los txog rau qhov kev vam meej ntawm cov txheej txheem kho mob, Intravascular Lithotripsy tau ua tiav hauv ntau dua 92% ntawm cov neeg mob. Ib yam li ntawd, Rotational Atherectomy kuj tau pom tias muaj kev vam meej ntawm 90%.

Txawm li cas los xij, cov calcium uas tso rau hauv cov hlab ntsha ua rau muaj kev pheej hmoo ntawm kev ua tsis tiav ntawm kev kho mob xws li balloon angioplasty . Nws kuj tseem yuav nyuaj rau tso lub stent kom raug hauv cov hlab ntsha.

Kuv yuav ua li cas thiaj saib xyuas kuv tus kheej? Kuv yuav tsum ua li cas?

Yog tias koj muaj cov calcification ntawm cov hlab ntsha hauv lub plawv, nws yog ib qho tseem ceeb uas yuav tsum ua raws li kev ua neej noj qab haus huv rau lub plawv. Qhov ntawd txhais tau tias:

• Noj cov khoom noj uas muaj roj tsawg (txo cov roj, cov khoom noj kib, thiab cov khoom noj ceev ceev kom ntau li ntau tau).
• Tsum tsis txhob siv cov khoom luam yeeb (luam yeeb, beedis, thiab lwm yam) kiag li.
• Ua si nawv tsis tu ncua (xws li taug kev tsawg kawg 30 feeb hauv ib hnub).
• Ua kom koj cov ntshav siab thiab cov roj cholesterol nyob li qub (noj tshuaj raws li koj tus kws kho mob qhia thiab tswj koj cov zaub mov noj).

Kuv yuav tsum mus ntsib kws kho mob thaum twg?

Yog koj muaj ntshav siab thiab/lossis cov roj cholesterol ntau, mus ntsib kws kho mob tsis tu ncua kom paub tseeb tias cov mob ntawd raug tswj tau zoo.Yog tias koj xav tau ib txoj kev npaj los txhim kho koj txoj kev noj qab haus huv ntawm lub plawv, nws yog ib lub tswv yim zoo kom ntsib nrog kws kho mob los tham txog nws.

Kuv yuav tsum mus rau tsev kho mob sai sai (ETU) thaum twg?

Yog tias koj muaj cov tsos mob ntawm kev mob plawv nres, xws li mob hauv siab hnyav, xeev siab thiab ntuav, thiab ua tsis taus pa hnyav , hu rau 911 tam sim ntawd lossis mus rau tsev kho mob ze tshaj plaws . Lub sijhawm tuaj yeem yog qhov sib txawv ntawm txoj sia thiab kev tuag thaum lub sijhawm zoo li no.

Kuv yuav tsum nug tus kws kho mob li cas?

Thaum koj mus ntsib kws kho mob, nws yuav pab tau koj nug cov lus nug no:

• Kuv puas yuav tsum tau kuaj seb puas muaj calcification ntawm cov hlab ntsha hauv lub plawv?
• Kuv tus mob (Coronary Artery Calcification) hnyav npaum li cas?
• Koj xav kom kuv kho kuv tus mob li cas?
• Cov kev pheej hmoo thiab cov txiaj ntsig ntawm kev kho mob no yog dab tsi?
• Kuv yuav tsum hloov dab tsi hauv kuv txoj kev ua neej?

Cia peb nco ntsoov ua luv luv (Cov Lus Coj Mus Tsev)

Kev paub seb koj puas muaj cov calcium nyob hauv koj cov hlab ntsha hauv lub plawv yog qhov tseem ceeb rau koj tus kws kho mob los tsim ib txoj kev npaj los pab koj. Tej zaum koj yuav xav tau kev kho mob kom tshem tawm calcium ntawm koj cov hlab ntsha, lossis koj tsuas yog yuav tsum tau koom nrog qee yam kev coj ua zoo rau lub plawv rau hauv koj lub neej. Txawm tias koj tsis muaj teeb meem plawv los xij, kev noj zaub mov uas muaj roj tsawg, kev tawm dag zog, thiab kev nyob deb ntawm cov khoom haus luam yeeb tuaj yeem pab koj kom noj qab haus huv. Nco ntsoov, lub plawv noj qab haus huv yog qhov tseem ceeb rau lub neej noj qab haus huv!

Calcium nyob rau hauv cov hlab ntsha ntawm lub plawv, kev sib sau ua ke ntawm cov hlab ntsha hauv lub plawv, kab mob plawv, roj cholesterol, ntshav siab, ntshav qab zib, mob plawv nres, atherosclerosis