Indwara ya hypercholesterolemia yo mu muryango - Icyo ugomba kumenya kuri yo

Ese mu muryango wawe hari abantu bagiye bagira indwara z'umutima mbere y'uko basaza, ni ukuvuga bafite imyaka 40-50? Cyangwa ni ibisanzwe ko mu muryango wawe bahora bavuga bati "Cholesteroli nyinshi, Cholesteroli nyinshi"? Akenshi, dutekereza ko impamvu yabyo ari ibintu nk'ibyo turya n'ibyo tunywa, tudakora siporo. Ibyo ni ukuri, kandi nabyo bigira ingaruka. Ariko rimwe na rimwe, impamvu nyayo y'iyi cholesterol nyinshi ishobora kuba ikibazo mu mubiri wacu, mu turemangingo twacu. Ibyo ni byo twita 'Familial Hypercholesterolemia' cyangwa 'FH' mu buvuzi. Uyu munsi, tuzaganira kuri ibi mu buryo bworoshye, mu buryo ushobora gusobanukirwa.

Mu magambo make, ni iki kivugwa mu ndwara ya Family Hypercholesterolemia (FH)?

Indwara ya hypercholesterolemia yo mu muryango ni indwara iterwa n'uturemangingo dukomoka kuri nyina, se, cyangwa bombi. Ibi ni igihe cholesterol "mbi", cyangwa cholesterol ya LDL, mu mibiri yacu iba iri hejuru cyane kuva tuvutse.

Tekereza imiyoboro y'amaraso yacu nk'imitsi. Iyi cholesterol ya `LDL` imeze nk'urukuta rw'umuhondo, rufite ibisigazwa rufata ku nkuta z'iyo mitsi. Ubusanzwe, iyi cholesterol igenda yiyongera buhoro buhoro. Ariko ku muntu ufite `FH`, urugero rwa cholesterol ya `LDL` ruba ruri hejuru cyane ku buryo uru rukuta rufite ibisigazwa rutangira kwiyongera vuba cyane kandi mu buryo bunini mu mitsi y'amaraso. Ibi twita `atherosclerosis`. Uko igihe kigenda gihita, uru rukuta rukura kandi rugafunga imitsi y'amaraso, rimwe na rimwe rukayifunga burundu. Ni bwo ibintu bishobora gushyira ubuzima mu kaga nko gutera umutima no gucika kw'imitsi.

Igipimo cya cholesterol ya `LDL` ku muntu muzima gikwiye kuba kiri munsi ya 100 mg/dL. Ariko, ku muntu ufite `FH`, iki gipimo gishobora kuba kinini cyane, nko 160 mg/dL, 190 mg/dL . Mu bihe bimwe na bimwe bikomeye, gishobora no kurenza 400 mg/dL. Ikintu kibi cyane ni uko kubera ko iyi ndwara yabayeho kuva mu bwana, iyo itavuwe, ibyago byo kurwara indwara z'umutima biba byinshi cyane ku muntu ukiri muto cyane ugereranije n'umuntu usanzwe.

Iyi nkuru ishobora kumvikana nk'aho iteye ubwoba gato, ariko inkuru nziza ni uko iyo uyimenye hakiri kare, ukanywa imiti ikwiye, kandi ugahindura imibereho yawe, ushobora kuyigenzura neza no kubaho ubuzima bwiza.

Hari ubwoko bubiri bw'ingenzi bwa FH.

Iyi ndwara igabanyijemo ubwoko bubiri bw'ingenzi bitewe n'uburyo tuyiragwa. Ibi biroroshye cyane kubyumva.

Tekereza ko imibiri yacu ifite 'amabwiriza' abiri yo kugenzura cholesterol. Rimwe turyahabwa na mama, irindi turyahabwa na data.

1. Heterozygous FH: Ubu ni bwo bwoko bukunze kugaragara cyane. Ikigaragara hano ni uko hari inenge mu 'gitabo cy'amabwiriza' (gene) ikomoka ku mubyeyi umwe gusa , yaba nyina cyangwa se. Ibi bivuze ko igitabo kimwe ari cyiza, ikindi gitabo kikaba gifite ikosa rito. Ibi bituma kugenzura cholesterol bigabanuka gato.

2. Homozygous FH: Ibi ni gake cyane, kandi birakomeye cyane.Ubwoko. Ikibaho hano ni uko 'amabwiriza' yombi atangwa na mama na papa aba afite inenge. Hanyuma uburyo bwo kugenzura cholesterol buba buke cyane. Igipimo cya cholesterol ya `LDL` cy'aba bantu kiba kiri hejuru cyane.

`FH` ni indwara iterwa n’uturemangingo mu cyiciro cya `autosomal dominant`. Ibi bivuze ko umwana adakeneye kuragwa gene ifite inenge n’ababyeyi bombi kugira ngo araragwe iyo ndwara, ahubwo birahagije kuyiragwa n’umubyeyi umwe gusa .

Iyi ndwara ikunze kugaragara gute? Ni ibihe bimenyetso?

Bivugwa ko umuntu umwe kuri buri bantu 250 ku isi afite indwara isanzwe yitwa 'Heterozygous FH'. Ariko ikibabaje cyane ni uko abantu 9 kuri 10 muri bo batazi ko bafite iyi ndwara .

Akenshi, FH ntabwo igaragaza ibimenyetso byihariye mu ntangiriro. Ushobora kuba utazi ko ufite FH kugeza igihe ugize indwara y'umutima, nko kubabara mu gatuza. Ariko nyuma bishobora kuba byaratinze. Ibi biterwa nuko cholesterol ishyirwa mu mitsi y'amaraso y'umuntu ufite FH itangira kubaho kuva avutse.

Uko igihe kigenda gihita, kwiyongera kwa cholesterol bishobora gutera ibimenyetso bikurikira.

Ni gute FH ipimwa?

Niba umuganga wawe akeka ko ufite FH, azareba ibintu byinshi kugira ngo yemeze ko ufite indwara.

• Isuzuma ry'amaraso: Iki ni cyo cy'ingenzi cyane. Isuzuma ry'amaraso ryitwa `Lipid Profile`, risuzuma urugero rwa cholesterol yawe, rireba urugero rudasanzwe rwa cholesterol ya `LDL`. Niba irenze 190 mg/dL ku muntu mukuru, cyangwa irenze 160 mg/dL ku mwana, bikekwa ko `FH`.
• Amateka y'ubuzima bw'umuryango: Ibi ni ingenzi cyane. Muganga wawe azababaza ibibazo nk'ibi, "Ese so, mama, ba sogokuru, cyangwa abavandimwe bawe bigeze kugira indwara z'umutima bakiri bato?" "Ese hari umuntu mu muryango wawe ufite cholesterol nyinshi?"
• Isuzuma ry'umubiri: Muganga azasuzuma umubiri wawe niba nta bimenyetso bya xanthomas (utubyimba tw'uruhu) cyangwa corneal arcus (uruziga rw'amaso) byavuzwe haruguru.
• Gupima imiterere y’uturemangingo (ikizamini cya ADN): Hari igihe, gupima imiterere y’uturemangingo bishobora gukorwa kugira ngo byemezwe neza indwara. Ibi bishobora gusuzuma inenge mu turemangingo tw’ingenzi dutera FH (nka APOB, LDLR, cyangwa PCSK9).

Ni ubuhe buryo bwo kuvura?

`FH` si indwara dushobora kuyivura. Kuko ni ikintu kizana n'uturemangingo twacu. Ariko ishobora kugenzurwa neza cyane . Intego nyamukuru yo kuvura ni ukugabanya urugero rwa cholesterol ya `LDL` uko bishoboka kose, bikagabanya ibyago byo kurwara indwara z'umutima.

1. Imiti (ubwoko bw'imiti)

Guhindura imibereho gusa ntibihagije kugira ngo umuntu ufite `FH` agenzure cholesterol. Kubwibyo , umuti umwe cyangwa myinshi agomba gufatwa ubuzima bwe bwose .

• Statine:Iyi ni yo miti isanzwe kandi ikoreshwa ku rwego rwa mbere. Ikora mu kugabanya umuvuduko wa cholesterol mu mwijima.
• Indagihe za PCSK9: Iyi ni ubwoko bushya bw'imiti iterwa inshinge. Igira akamaro cyane ku bantu bafite urugero rwa cholesterol rudashobora kugenzurwa na statins gusa.
• Ezetimibe: Uyu muti ugabanya uburyo cholesterol ikwirakwira mu biribwa turya. Akenshi utangwa hamwe na statine.
• Indi miti: Byongeye kandi, hari indi miti nka `Bile acid sequestrants` na `Fibrates`. Muganga wawe ni we uzaguhitiramo umuti ukubereye.

2. Impinduka mu mibereho

Uretse gufata imiti, ni ngombwa kandi gukurikiza ubuzima bwiza. Ibi ntibituma imiti ikora neza gusa, ahubwo bishobora no kugabanya ibyago byo kurwara indwara z'umutima.

3. Ubundi buryo bwihariye bwo kuvura

Ku bantu bafite FH ikomeye cyane, imiti yonyine ishobora kudashobora kugenzura cholesterol yabo. Kuri abo bantu, hakorwa ubuvuzi bwitwa LDL apheresis. Ibi bimeze nka dialysis. Amaraso make arafatwa, akanyuzwa mu mashini, ikavana cholesterol mbi ya LDL, hanyuma ikongera kuyisubiza mu mubiri. Ibi bikorwa rimwe cyangwa kabiri mu cyumweru.

Niba ufite FH, wakora iki?

Niba waranduye `FH`, ntabwo ari wowe gusa. Ni ubutumwa bw'ingenzi ku muryango wawe wose.

Iyo umwana afite amateka ya `FH` mu muryango, cholesterol ishobora gupimwa no kuva ku myaka 2. Kubera ko iyo iyi ndwara itangiye kuvurwa vuba, ni bwo ingorane zishobora kugabanuka mu gihe kizaza.

Niba ufite `FH`, ntugatinye. Komeza kuvugana na muganga wawe. Fata imiti yawe ku gihe. Hindura imibereho yawe. Hanyuma nawe ushobora kubaho ubuzima burambye kandi bufite ubuzima bwiza nk'abandi bose.