Ese ufite calcium mu mitsi y'umutima wawe? (Coronary Artery Calcification)

Ese wigeze wibaza niba imiyoboro mito ya kalisiyumu ishobora kwibumbira mu mitsi minini ijyana amaraso mu mutima wawe? Ni nk'ikimenyetso cya lime mu miyoboro y'amazi uko igihe kigenda gihita. Ibi ni byo mu buvuzi twita calcification y'imitsi y'umutima (CAC) . Hari igihe ibi bishobora kubaho nta bimenyetso bigaragara. Ariko kubimenya ni ingenzi cyane ku buzima bw'umutima wawe.

Kugabanya imitsi ya Coronary Artery Calcification ni iki?

Mu magambo make, iki ni igihe kalisiyumu yirundanyije mu nkuta z'imitsi ibiri y'ingenzi itanga amaraso mu mutima wawe, yitwa imitsi y'umutima . Ibi ntibibaho mu ijoro rimwe. Ubusanzwe bifata imyaka itanu kugira ngo kalisiyumu yirundanye mu mitsi yawe, nyuma y'igihe runaka iyo ufite plaque (izwi nka atherosclerosis ). Tekereza nk'umuyoboro ufite umwanda n'imyanda, hanyuma uwo mwiyongere ukagira ubunini.

Imiterere ya kalisiyumu muri iyi mitsi ni ikimenyetso cy'ingenzi cy'indwara y'imitsi ifata umutima . Ibi bituma muganga wawe asuzuma ibyago byo kurwara indwara z'umutima.

Iyo ibinure byibumbiye mu mitsi, bigabanya urujya n'uruza rw'amaraso. Urabizi, imitsi y'umutima itanga amaraso akungahaye kuri ogisijeni mu mitsi y'umutima. Rero, niba amaraso atembera muri iyo mitsi yazibye, ushobora kubabara mu gituza (angina) , cyangwa se indwara y'umutima ikagira ingaruka mbi kurushaho.

Hari ubwoko bubiri bw'ingenzi bw'umunyungugu wa kalisiyumu:

Abaganga babibona mu buryo bubiri bw'ingenzi, bitewe n'urwego rwa kalisiyumu ruri mu rukuta rw'imitsi:

1. Gushyira mu nda: Ibi biba mu gice cyo hagati cy'urukuta rw'imitsi. Ubwo bwoko bukunze kugaragara mu mitsi y'umutima.

2. Gushyira hagati y'imitsi: Ibi biba mu gice cyo hagati cy'urukuta rw'imitsi.

Ni iyihe sano iri hagati y’ibice bya kalisiyumu mu mitsi n’indwara ya atherosclerosis?

Hari isano ikomeye hagati y’ibyo byombi. Ingano ya kalisiyumu mu mitsi yawe ishobora kuguha ishusho y’ingano ya atherosclerosis ufite, ari na yo ubwinshi bw’ibinure mu mitsi yawe. Atherosclerosis ni igihe ibinure byiyongera mu mitsi yawe, bikayigabanya. Bituma bigorana ko amaraso atembera neza. Kalisiyumu ishobora gutuma iki kibazo kirushaho kuba kibi.

Ni nde urebwa cyane n'iki kibazo?

Abantu barwaye indwara z'umutima bakunze kubona calcium iri muri iyo mitsi.

• Ukurikije imyaka:Iyo turebye ku bantu barengeje imyaka 70, abagabo barenga 90% na 67% by'abagore bafite iyi ndwara. Mbere yo gucura, abagore barindwa ibyago byo kurwara iyi ndwara (atherosclerosis) bitewe n'imisemburo ya estrogen . Niyo mpamvu abagore barwara iyi ndwara nyuma y'imyaka 10-15 ugereranije n'abagabo.
• Ubwoko/Imoko: Ubushakashatsi bumwe bwagaragaje ko abazungu ari bo bafite amahirwe menshi yo kurwara iyi ndwara kurusha andi moko.
• Ku bagabo: Abagabo bafite ibyago byinshi byo kurwara iyi ndwara (Coronary Artery Calcification).

Ni ibihe bintu bishobora gutera ibyago? (Niba ufite ibi bintu, nawe ushobora kuba uri mu kaga)

Hari abantu bashobora kurwara iyi ndwara. Reba niba ufite kimwe muri ibi bintu bishobora gutera iyi ndwara:

• Niba ufite indwara idakira y'impyiko .
• Niba ufite ibibazo by'isukari mu maraso nka Diyabete Mellitus .
• Iyo urugero rwa cholesterol mbi (LDL - Low-Density Lipoprotein) ruri hejuru kandi urugero rwa cholesterol nziza (HDL - High-Density Lipoprotein) rukaba ruri hasi.
• Igipimo cya BMI (Body Mass Index) , ni ukuvuga niba igipimo cy'uburemere bw'umubiri kiri hejuru (umubyibuho ukabije).
• Niba hari umuntu wo mu muryango wawe ufite amateka yo kugira kalisiyumu mu mitsi y'umutima nk'iyi (hereditary predisposition).
• Niba ufite umuvuduko w'amaraso ukabije .
• Niba ufite amateka yo kunywa itabi cyangwa gukoresha ibindi bicuruzwa by'itabi.
• Uko imyaka igenda yiyongera.
• Iyo hari ibitagenda neza mu misemburo ya parathyroid .
• Iyo urugero rwa fosifeti mu maraso ruri hejuru.
• Iyo urugero rwa kalisiyumu mu maraso ruri hejuru.

Ibi bigira izihe ngaruka ku mubiri? Bigira izihe ngaruka ku mubiri?

Iyo kalisiyumu yibumbiye mu mitsi y'umutima, ituma ikomera . Ibi bigabanya ubushobozi bwayo bwo gufunga no kwaguka neza. Ibi byongera ibyago byo kurwara indwara z'umutima.

Muri make, iyi calcium igabanya amaraso agera ku mitsi y'umutima wawe. Tekereza nka moteri ikora idahagarara. Iyo itakaje amaraso yayo, izagira ibibazo, si byo se?

Ikindi kintu ni uko iyo imiyoboro ya kalisiyumu iri mu mitsi, bigora abaganga gukora uburyo bumwe na bumwe bwo kuvura, nko gukoresha Percutaneous Coronary Intervention (PCI) , cyangwa nkuko twese tubizi , Angioplasty, kuko iyi miyoboro ya kalisiyumu ishobora kubangamira uburyo stent ishyirwa mu mitsi ikoreshwa neza.

Ibimenyetso ni ibihe?

Akenshi, abantu bafite iyi ndwara (Coronary Artery Calcification) ntibagaragaza ibimenyetso . Icyo ni cyo kintu giteje akaga cyane. Ariko uko igihe kigenda gihita, uko iyi ndwara irushaho gukomera, hari ibimenyetso bimwe na bimwe bishobora kugaragara. Ni ibi bikurikira:

• Angina ihoraho: Ubu ni ububabare bwo mu gituza cyangwa kubabara mu gituza bikunze kubaho mu gihe cy'imyitozo ngororamubiri cyangwa iyo umuntu azamuka ingazi. Bugabanuka iyo umuntu aruhutse.
• Guhumeka nabi.
• Indwara y'umutima.

Icy'ingenzi: Niba ufite ibi bimenyetso, menya neza ko wagisha inama kwa muganga.

Kuki ibi bibaho? Impamvu ni izihe?

Ubusanzwe nyuma y'imyaka 40, kalisiyumu mu maraso yacu ishobora gutangira kwirundanya mu bice bitandukanye by'umubiri. By'umwihariko, inkuta z'imitsi yangiritse, yabyimbye, cyangwa irimo gusanwa ni zo zishobora kwibasirwa cyane n'iyi miyoboro ya kalisiyumu.

Iyi gahunda ishobora gutangira mu myaka ya za 20 , ariko muganga ayireba gusa iyo ari nini bihagije ku buryo ishobora kubonwa mu isuzuma ry’ishusho . Kandi, abantu benshi bari mu myaka ya za 20 na 30 ntibakora ibi bizamini buri gihe.

Imiterere ya kalisiyumu itangira ari uduce duto cyane (0.5µm - mikorometero). Uko igihe kigenda gihita, uko ibinure byiyongera, iyi miterere ya kalisiyumu ishobora gukura irenga milimetero 3. Abashakashatsi bemeza ko iyi miterere mito ya kalisiyumu (mikorokalisiyumu) ​​iri mu gice cy’imbere cy’urukuta rw’imitsi itangirana n’urupfu rw’uturemangingo tw’imitsi yoroshye.

Ubibona ute? Ni ubuhe bwoko bw'ibizamini bikorwa?

Hari ibizamini byihariye byo gupima indwara bishobora kumenya iyi ndwara (Coronary Atherosclerosis), ni ukuvuga ibinure byinjira mu mitsi, mbere yuko ikomera. Kimwe muri ibyo by'ingenzi ni scan (Computed Tomography - CT) , cyangwa (Multidetector Computed Tomography - MDCT) .

Isuzuma rya CT ry'umutima rishobora kwerekana neza calcium iri mu mitsi yawe y'umutima. Ibi byitwa ikizamini cya calcium y'imitsi y'umutima (CAC) . Bireba cyane cyane:

• Kalisiyumu ingana iki ishyirwa mu mubiri?
• Ubucucike bw'ayo mafaranga ni ubuhe?
• Ni zingana iki?

Akoresheje aya makuru, muganga wawe abara agaciro kitwa Agatston score . Aya manota ashobora kuva kuri 0 kugeza kuri 400 cyangwa arenga. Uko amanota aba menshi, niko ibyago byo kurwara indwara y'umutima cyangwa stroke byiyongera mu myaka 10 iri imbere.

Abaganga basanze iki kizamini (CAC) gishobora guhanura neza ibyago by'indwara z'umutima n'amaraso mu gihe kizaza. Ariko, ushobora kwishyura iki kizamini ukoresheje amafaranga yawe.

Amanota ya CAC (Amanota ya Agatston) asobanura iki?

Dore uko ibyo bimenyetso bikunze gusobanurwa:

• Amanota 0: Nta kibazo cy'uburwayi.
• Amanota 1 kugeza 99: Indwara yoroheje.
• Amanota kuva ku 100 kugeza kuri 399: Indwara iri hagati.
• Amanota ari hejuru ya 400: Indwara ikomeye.

Uretse iki kizamini (CAC), hari ibindi bizamini bidakunze kwangirika bigenzura ubwinshi bwa kalisiyumu mu mitsi yawe y'umutima:

• Ultrasound y'umutima (IVUS): Iyi mashini ikoresha icyuma gipima amaraso gifite katheteri (umuyoboro muto) ifatanye ku mpera kugira ngo irebe imbere mu mitsi. Ibisubizo bigaragazwa kuva mu cyiciro cya mbere kugeza mu cyiciro cya kane, aho icyiciro cya karusiyamu igaragara cyane.
• Intravascular Optical Coherence Tomography (IVOCT): Ibi bigaragaza ingano ya kalisiyumu iri mu mitsi yawe n'uburyo ifite ubunini. Ikoresha urumuri rwa hafi ya infrared kugira ngo ikore amashusho y'imbere mu mitsi.

Ni ubuhe buryo bwo kuvura ibi?

Abaganga ntibarabona uburyo busanzwe bwo kuvura indwara zo mu mitsi y'umutima. Ariko, mu bihe bikomeye, abaganga bamwe bakoresha uburyo bushya bwitwa intravascular lithotripsy . Ibi bikubiyemo kohereza igikoresho muri catheter mu mitsi no kuyikoresha mu gutanga umuvuduko w'amaraso kugira ngo gisenye calcium iri mu rukuta rw'imitsi. Hanyuma hashobora gushyirwaho stent kugira ngo imitsi ikomeze gufungura.

Ubundi buryo bwo kuvura bukoreshwa mu kunoza urujya n'uruza rw'amaraso mu mitsi harimo:

• Kugabanya imitsi, gupima imiterere y'umubiri cyangwa guca ibyuma hakoreshejwe laser: Ibi bikubiyemo gukata no gukuraho ibinure (plaque) na calcium mu mitsi.
• Gukata, gupima cyangwa gukoresha umuvuduko mwinshi wa balloon angioplasty: Ibi bikubiyemo gushyira balloon mu cyuma kugira ngo isunike ibinure na calcium ku nkuta z'imitsi.

Ese hari ingorane zishobora kubaho mu gihe cyo kuvurwa?

Nkuko bigenda ku buvuzi ubwo aribwo bwose, hari ingorane zimwe na zimwe zishobora kubaho muri ubu buvuzi.

Ingorane zo kurwara Lithotripsy mu mitsi:

• Arrhythmia ( umuvuduko w'umutima udasanzwe)
• Aneurysm ( kubyimba cyangwa gucika intege k'umuyoboro w'amaraso)
• Ingorane zo kuva amaraso
• Igisebe cy'imitsi
• Urupfu (rudakunze kubaho cyane)

Ingorane zo kubagwa kwa Rotational Atherectomy:

• Guca imitsi y'amaraso
• Indwara y'umutima
• Urupfu (rudakunze kubaho cyane)
• Gufata Imitsi y'Impyiko mu Buryo bw'Impanuka (CABG) mu Buryo bwihutirwa

Ingorane zo mu mitsi yo mu bwonko:

• Indwara y'umutima
• Igisebe cy'imitsi
• Arrhythmia
• Kuva amaraso
• Amaraso apfutse

Izi ngorane ntizibaho kuri buri wese, ariko ni ngombwa kuzimenya. Muganga wawe azagusobanurira izi ngaruka igihe azaba yagusabye uburyo bwo kuzivura.

Ni gute nagabanya iyi ngaruka?

Ikintu cyiza cyo gukora ni ukugenzura ibibazo byongera ibyago byo kurwara calcium mu mitsi y'umutima. Ibi birimo:

• Niba urwaye diyabete, genzura neza.
• Niba urugero rwa cholesterol yawe rudasaza, rugenzure.
• Niba ufite umuvuduko w'amaraso ukabije , genzura.
• Niba ufite indwara y'impyiko , shaka ubuvuzi bukwiye.

Uretse ibi bintu, ni ingenzi cyane gukurikiza ubuzima bwiza.

Bizagenda bite ningira iyi ndwara? Ni iki nakwitega?

Iyo usanzwe ufite indwara ya Coronary Artery Calcification, uba ufite ibyago byinshi byo kurwara indwara ya Coronary Artery Disease hamwe n’ingaruka mbi zikomeye ku mitsi y’umutima (Major Additional Cardiovascular Events - MACE) .

Ariko, iyo bigeze ku gipimo cy’intsinzi mu buryo bwo kuvura, Intravascular Lithotripsy yagize ingaruka nziza mu bantu barenga 92%. Mu buryo nk’ubwo, Rotational Atherectomy nayo yagaragaje ingaruka nziza ku kigero cya 90%.

Ariko, calcium iri mu mitsi yongera ibyago byo kunanirwa kuvura nka balloon angioplasty . Bishobora kandi kugorana gushyira stent neza mu mitsi.

Nigute nakwiyitaho? Nkore iki?

Niba ufite calcium mu mitsi y'umutima, ni ngombwa gukurikiza ubuzima bwiza bw'umutima. Ibyo bivuze:

• Kurya ibiryo bifite ibinure bike (gabanya amavuta, ibiryo bikaranze, n'ibiryo byihuse uko bishoboka kose).
• Hagarika burundu gukoresha ibikomoka ku itabi (itabi, beedis, nibindi).
• Kora imyitozo ngororamubiri buri gihe (nk'amaguru nibura iminota 30 ku munsi).
• Komeza umuvuduko w'amaraso yawe na cholesterol yawe bibe bisanzwe (fata imiti nk'uko muganga yabigutegetse kandi ugenzure indyo yawe).

Ni ryari ngomba kujya kwa muganga?

Niba ufite umuvuduko ukabije w'amaraso cyangwa cholesterol nyinshi, jya kwa muganga buri gihe kugira ngo urebe neza ko izo ndwara zigenzurwa neza.Niba ukeneye gahunda yo kunoza ubuzima bwawe bw'umutima n'amaraso, ni byiza guhura na muganga kugira ngo muganire kuri iyo gahunda.

Ni ryari nkwiye kujya mu bitaro byihutirwa (ETU) ?

Niba ubonye ibimenyetso by'indwara y'umutima, nko kubabara cyane mu gatuza, isesemi no kuruka, no kubura umwuka cyane , hamagara 911 ako kanya cyangwa ujye kwa muganga uri hafi yawe . Igihe gishobora kuba itandukaniro hagati y'ubuzima n'urupfu mu gihe nk'iki.

Ni ibihe bibazo ngomba kubaza muganga?

Iyo ugiye kwa muganga, ni byiza kubaza ibi bibazo:

• Ese nkeneye gupimwa niba mfite calcium mu mitsi y'umutima?
• Indwara yanjye ikabije gute (Coronary Artery Calcification)?
• Ni ubuhe buryo bwo kuvura usaba ku ndwara yanjye?
• Ni izihe ngaruka n'inyungu z'ubu buvuzi?
• Ni izihe mpinduka ngomba kugira mu mibereho yanjye?

Reka twibuke muri make (Ubutumwa bwo kujyana mu rugo)

Kumenya niba ufite calcium mu mitsi yawe y'umutima ni ingenzi kugira ngo muganga wawe agufashe gutegura gahunda yo kugufasha. Ushobora gukenera kuvurwa kugira ngo ukure calcium mu mitsi yawe, cyangwa ushobora gukenera gushyiramo ingeso nziza ku mutima mu mibereho yawe. Nubwo udafite ibibazo by'umutima n'amaraso, kurya indyo irimo ibinure bike, gukora imyitozo ngororamubiri no kwirinda kunywa itabi bishobora kugufasha kugira ubuzima bwiza. Wibuke ko umutima mwiza ari wo ufungurira ubuzima bwiza!

Kalisiyumu mu mitsi y'umutima, gukaranga imitsi y'umutima, indwara z'umutima, cholesterol, umuvuduko ukabije w'amaraso, diyabete, indwara z'umutima, indwara z'imitsi