Pane vanhu mumhuri yako vakamborwara nemoyo vasati vakura, kureva kuti, pazera remakore 40-50 here? Kana kuti zvakajairika here kuti vanhu mumhuri yako vagare vachiti, "Cholesterol yakakwira, cholesterol yakakwira"? Kazhinji, tinofunga kuti chikonzero cheizvi zvinhu zvakaita sezvatinodya nezvatinonwa, uye kusaita maekisesaizi. Izvozvo ndezvechokwadi, uye izvozvo zvinewo mhedzisiro. Asi dzimwe nguva, chikonzero chaicho chiri shure kweiyo cholesterol yakakwira chingave dambudziko mukati memuviri wedu, mumajini edu. Ndizvo zvatinodaidza kuti `Familial Hypercholesterolemia` kana `FH` mukurapa. Nhasi, tichataura nezvazvo zviri nyore, nenzira yaunogona kunzwisisa.
Zvichitaurwa zviri nyore, chii chinonzi Familyal Hypercholesterolemia (FH)?
Familyal Hypercholesterolemia chirwere chemajini chinotorwa kubva kuna amai, baba, kana vese. Apa ndipo apo cholesterol "yakaipa", kana kuti LDL cholesterol, mumiviri yedu inenge yakakwira zvikuru kubva pakuzvarwa.
Funga nezvetsinga dzedu dzeropa setsinga dzeropa. Iyi `LDL` cholesterol yakaita serukoko rweyero, rwakaita senakisi runonamira pamadziro etsinga idzodzo. Kazhinji, idzi dzinoungana zvishoma nezvishoma. Asi mumunhu ane `FH`, huwandu hwe`LDL` cholesterol hwakakwira zvekuti rukoko urwu rwakaita senakisi runotanga kuungana nekukurumidza uye zvakakora mukati metsinga dzeropa. Tinodana izvi kuti `atherosclerosis`. Nekufamba kwenguva, rukoko urwu runokura uye runotetepa tsinga dzeropa, dzimwe nguva dzichidzivhara zvachose. Ndipo panoitika zvinhu zvinotyisidzira hupenyu zvakaita sekurwadziwa kwemoyo nekurohwa nesitiroko.
Huwandu hwecholesterol ye `LDL` yemunhu ane hutano hwakanaka hunofanira kunge huri pasi pe 100 mg/dL. Zvisinei, mumunhu ane `FH`, kukosha uku kunogona kunge kwakakwira zvakanyanya, senge 160 mg/dL, 190 mg/dL . Mune zvimwe zviitiko zvakakomba, inogona kutopfuura 400 mg/dL. Chinhu chine njodzi ndechekuti sezvo chirwere ichi chave chiripo kubva paudiki, kana chikasarapwa, njodzi yekubatwa nechirwere chemwoyo yakanyanya pazera diki kupfuura munhuwo zvake.
Nyaya iyi inganzwika seinotyisa zvishoma, asi mashoko akanaka ndeekuti kana ukaiona nekukurumidza, ukatora mishonga yakakodzera, uye ukachinja mararamiro ako, unogona kuidzora zvachose uye kurarama hupenyu hwakanaka.
Kune mhando mbiri huru dzeFH.
Dambudziko iri rakakamurwa kuita mhando mbiri huru zvichienderana nekuti tinorigara nhaka sei. Izvi zviri nyore kunzwisisa.
Fungidzira kuti miviri yedu ine 'mirairo' miviri yekudzora cholesterol. Mumwe watinowana kubva kuna amai vedu, uye mumwe kubva kuna baba vedu.
1. Heterozygous FH: Iyi ndiyo mhando inonyanya kuwanikwa. Chinoitika pano ndechekuti pane chikanganiso mu 'bhuku remirairo' (gene) chinogarwa nhaka kubva kumubereki mumwe chete , angava amai kana baba. Izvi zvinoreva kuti rimwe bhuku rakanaka, uye rimwe bhuku rine chikanganiso chidiki. Izvi zvinoita kuti kudzora cholesterol kuve kwakaoma zvishoma.
2. Homozygous FH: Izvi hazviwanzoitiki, uye zvakanyanya kuipa.Rudzi. Chinoitika pano ndechekuti 'mirairo' yakagamuchirwa kubva kuna amai nababa haina kunaka. Zvadaro nzira inodzora cholesterol inova isina simba. Mazinga echolesterol e'LDL' evanhu ava akakwira zvikuru.
`FH` chirwere chemajini chiri muchikamu che`autosomal dominant`. Izvi zvinongoreva kuti mwana haafanire kugara nhaka yejini rakakanganisika kubva kuvabereki vese kuti agare nhaka yechirwere ichi, zvakakwana kuti agare nhaka kubva kumubereki mumwe chete .
Izvi zvinoreva kuti kana uine `FH`, pane mukana we50% wekuti mwana wako achagara nhaka chirwere ichi. Saizvozvowo, pane mukana we50% wekuti vanun'una vako vachavawo nechirwere ichi.
Chirwere ichi chakajairika zvakadii? Zviratidzo zvacho ndezvipi?
Zvinofungidzirwa kuti munhu mumwe chete pavanhu 250 pasi rose ane chirwere chakafanana chinonzi 'Heterozygous FH'. Asi chinonyanya kusuwisa ndechekuti vanhu 9 pa10 vevanhu ava havazivi kuti vane chirwere ichi .
Kazhinji, FH hairatidzi zviratidzo zvakananga pakutanga. Ungasaziva kuti une FH kusvika wava nechirwere chemwoyo, sekurwadziwa pachipfuva. Asi zvinogona kunge zvanonoka. Izvi zvinokonzerwa nekuti cholesterol inoiswa mutsinga dzeropa dzemunhu ane FH inotanga kuumbwa kubva pazuva raakaberekwa.
Nekufamba kwenguva, kuunganidzwa kwecholesterol mumuviri kunogona kukonzera zviratidzo zvinotevera.
| Chiratidzo | Tsananguro iri nyore |
|---|---|
| Chirwere chemwoyo mudiki | Kurwadziwa pachipfuva (angina) kunoitika panguva yekurovedza muviri kana kuzorora, kurwara nemoyo kana sitiroko pazera diki (varume - vari pasi pemakore 55, vakadzi - vari pasi pemakore 65). |
| Xanthomas | Mapundu eyero anokonzerwa nekuiswa kwecholesterol pasi peganda. Aya anowanzoonekwa pamagokora, mabvi, majoini eminwe, uye akakomberedza tendon yeAchilles (pamusoro pechitsitsinho). |
| Xanthelasmas | Mafuta eyero echolesterol anoumbwa pasi peganda rakatenderedza maziso. |
| Corneal Arcus | Mhete chena, grey, kana bhuruu yakakomberedza ziso dema. Izvi zvinowanzoitika kuvanhu vakuru, asi kana zvikaonekwa kune munhu ari pasi pemakore makumi mana nemashanu , zvinogona kunge zviri chiratidzo cheFH. |
| Kukanda mari yacho padenga | Kurwadziwa kwemakumbo epasi, kunyanya kana uchifamba. Izvi zvinogona kunge zvichikonzerwa nekutetepa kwetsinga dzinopa ropa kumakumbo. |
FH inoonekwa sei?
Kana chiremba wako achifungidzira kuti une FH, achaongorora zvinhu zvakasiyana-siyana kuti asimbise chirwere chacho.
- Kuongororwa kweropa: Uku ndiko kwakakosha zvikuru. Kuongororwa kweropa kunonzi `Lipid Profile`, kunoongorora huwandu hwecholesterol yako, kunotsvaga huwandu hwakanyanya hwe`LDL` cholesterol. Kana iri kupfuura 190 mg/dL mumunhu mukuru, kana kupfuura 160 mg/dL mumwana, `FH` inofungidzirwa.
- Nhoroondo yezveutano hwemhuri: Izvi zvakakosha zvikuru. Chiremba wako achakubvunza mibvunzo yakaita sekuti, "Baba vako, amai, vanasekuru nasekuru, kana vanun'una vako vakamborwara nemwoyo vachiri vadiki here?" "Pane mumwe munhu mumhuri mako ane cholesterol yakakwira here?"
- Kuongororwa kwemuviri: Chiremba achaongorora muviri wako kana paine zviratidzo zve xanthomas (mapundu eganda) kana corneal arcus (mhete yeziso).
- Kuongororwa kwemajini (kuongororwa kweDNA): Mune zvimwe zviitiko, kuongororwa kwemajini kunogona kuitwa kuti kusimbiswe chirwere chacho. Izvi zvinogona kutarisa zvikanganiso mumajini makuru anokonzera FH (senge APOB, LDLR, kana PCSK9).
Ndezvipi zviri kurapwa?
`FH` hachisi chirwere chatinogona kurapa. Nekuti chinhu chinouya nemajini edu. Asi chinogona kudzorwa zvakanaka . Chinangwa chikuru chekurapa ndechekuderedza huwandu hwecholesterol ye`LDL` zvakanyanya sezvinobvira, zvichideredza njodzi yechirwere chemwoyo.
1. Mishonga (mhando dzemishonga)
Kuchinja mararamiro chete hakuna kukwana kudzora cholesterol kumunhu ane `FH`. Saka , mushonga mumwe chete kana kupfuura unofanirwa kutorwa kweupenyu hwake hwese .
- Mishonga yeStatin:Iyi ndiyo mishonga inonyanya kushandiswa uye yekutanga. Inoshanda nekuderedza kugadzirwa kwecholesterol nechiropa.
- Mishonga inodzivirira PCSK9: Iyi imhando itsva yemishonga inobayiwa jekiseni. Inoshanda zvikuru kuvanhu vane cholesterol yakawanda isingakwanise kudzorwa ne statins chete.
- Ezetimibe: Mushonga uyu unoshanda nekuderedza kunyudzwa kwecholesterol kubva muzvikafu zvatinodya. Unowanzopihwa pamwe chete ne statins.
- Mimwe mishonga: Pamusoro pezvo, kune mimwe mishonga yakaita se `Bile acid sequestrants` ne `Fibrates`. Chiremba wako ndiye achasarudza kuti ndeipi mishonga yakakunakira.
2. Kuchinja mararamiro
Pamwe chete nekutora mishonga, zvakakoshawo kutevedzera mararamiro ane hutano. Izvi hazvingobatsiri chete pakushanda kwemishonga, asi zvinogonawo kuderedza njodzi yezvirwere zvemwoyo.
| Zvekuita | Zvekudzivirira |
|---|---|
| Zvekudya zvine hutano pamoyo: Muriwo, michero, nyemba, zviyo zvisina fibrous (mupunga webrown, oats), hove (salmon, mackerel, herring), mukaka usina mafuta akawanda nenyama. | Mafuta akaguta uye emafuta etrans: Zvikafu zvakakangwa, chikafu chinokurumidza, zvigadzirwa zvebhekari (makeke, mapatties), nyama ine mafuta, kushandisa mafuta ekokonati zvakanyanya nemafuta emuchindwe. |
| Kurovedza muviri nguva dzose: Ita maekisesaizi akadai sekufamba nekukurumidza, kumhanya, kana kutasva bhasikoro kwemaminitsi makumi matatu pazuva, mazuva mashanu pasvondo. | Kusvuta nedoro: Kusvuta kunofanira kumira zvachose. Kunokuvadza zvakanyanya mitsipa yeropa. Kunwa doro kunofanira kuderedzwa. |
| Kuchengetedza huremu hwakanaka: Kudzora huremu hwemuviri kunogona kuderedza kushushikana pamoyo. | Zvinwiwa zvinotapira uye zvekudya zvine shuga yakawanda: Izvi zvinogona kukonzera kuwedzera uremu nezvimwe zvinetso zvehutano. |
3. Mamwe marapirwo chaiwo
Kune vanhu vane homozygous FH yakanyanya, mishonga yega ingasakwanise kudzora cholesterol yavo. Kune vanhu ava, kurapwa kunonzi LDL apheresis kunoitwa. Izvi zvakafanana nedialysis. Ropa diki rinotorwa, ropfuudzwa nemuchina, rinobvisa cholesterol yakaipa yeLDL, rozodzorerwa mumuviri zvakare. Izvi zvinoitwa kamwe chete kana kaviri pasvondo.
Kana uine FH, unofanira kuitei?
Kana ukaonekwa uine `FH`, hazvisi zvako chete. Ishoko rakakosha kumhuri yako yese.
Kana uine chirwere cheFH, ibasa rako kuti vabereki vako, vanun'una vako, nevana vako vaongororwe cholesterol. Tinoti izvi 'kuongorora kwecascade.' Izvi zvinogona kubatsira kuziva vamwe vemumhuri zviratidzo zvisati zvaonekwa uye kutanga kurapwa navo zvakare.
Kana mwana ane nhoroondo yemhuri ye 'FH', cholesterol inogona kuongororwa kunyangwe kubva pazera remakore maviri. Nekuti kurapwa kwechirwere ichi kunotanga nekukurumidza, mikana yematambudziko inogona kuderedzwa mune ramangwana.
Kana uine `FH`, usatya. Gara uchitaurirana nachiremba wako. Inwa mishonga yako nenguva. Shandura mararamiro ako. Ipapo iwewo unogona kurarama hupenyu hurefu, hune hutano sevamwe vese.
Mharidzo Yekuenda Nayo Kumba
- Familyal Hypercholesterolemia (FH) chirwere chemajini chinopfuudzwa kubva kuchizvarwa kuenda kune chimwe uye chinokonzera huwandu hwakanyanya hwecholesterol yakaipa (LDL) kubva pakuzvarwa.
- Kana mumwe munhu mumhuri yako akamborwara nechirwere chemwoyo achiri mudiki kana kuti aine cholesterol yakakwira, zvakakosha kuti aongororwe FH.
- Vanhu vazhinji vane chirwere ichi havazivi kuti vane chirwere ichi. Kuonekwa kwacho nekukasika kunogona kuponesa hupenyu.
- Mishonga yehupenyu hwese uye mararamiro ane hutano zvakakosha pakurapa FH.
- Kana ukaonekwa uine `FH`, bvunza vabereki vako, vanun'una vako, nevana vako kuti vaongororwewo. Izvi zvichabatsira kuponesa hupenyu hwavo.
- Kana ukarapwa zvakanaka, unogona kurarama hupenyu hune hutano hwakakwana uye hwakareba. Saka usatya, bvunza chiremba wako kuti uwane kurapwa.
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