Chiropa chako chakanyanya kukora here? Ngatidzidzei nezvezita idzva rechirwere chechiropa chine mafuta (Steatotic Liver Disease)!

"Ah, chiremba, ndine mafuta akawanda muchiropa changu..." Wakambonzwa here chimwe chinhu chakadai? Kana kuti une chirwere ichiwo here? Usazvidya moyo. Nhasi tiri kutaura nezvechirwere ichi chekuwanda kwemafuta muchiropa, kana kuti nemamwe mazwi, Steatotic Liver Disease. Kare, taidaidza ichi kuti "chiropa chine mafuta akawanda." Chii chaizvo ichi? Sei chakapihwa zita idzva? Ngatitaurei nezveizvi zvese zviri nyore.

Sei zita rekuti "Fatty Liver" rakachinjwa?

Taimbodaidza chirwere ichi kuti “chirwere chechiropa chine mafuta akawanda.” Asi muna 2023, nyanzvi dzezvekurapa dzakasarudza kuchinja zita racho kuita “chirwere chechiropa chine mafuta akawanda.” Pane zvikonzero zviviri zvikuru zveizvi. Chimwe ndechekuti zita idzva rinotsanangura zvakanyatsonaka zvinokonzera chirwere ichi. Semuenzaniso, nepo kufuta kuri chimwe chezvikonzero, kune zvimwe zvinhu zvine njodzi zvisina chekuita nehuremu. Chimwe chikonzero ndechekuti izwi rekuti “chiropa chine mafuta akawanda” dzimwe nguva rinogona kunyadzisa uye kunyadzisa vanhu vane chirwere ichi, saka kuchinja zita racho kwakabatsira kuderedza kusimbisa izvozvo. Zvichitaurwa zviri nyore, “steatosis” izwi rinoshandiswa navanachiremba kutsanangura kuunganidzwa kwemafuta munhengo (kazhinji chiropa). Chiropa chine hutano, chinoshanda zvakanaka chine mafuta mashoma. Kuunganidzwa kwemafuta uku kunova dambudziko kana kukadarika 5% yehuremu hwechiropa.

Ndeapi marudzi echirwere chechiropa chine mafuta (SLD)?

Vanachiremba vanoisa SLD mumapoka zvichienderana nezvikonzero zvayo uye zvimwe zvirwere zvine chekuita nayo. Ngatitarisei mhando huru dzechirwere ichi.

1. Chirwere chechiropa chine chekuita nedoro (ALD)

Chinoitika ndechekuti kana ukanwa doro rakawandisa, mafuta anoungana muchiropa chako. Funga nezvazvo, kana ukanwa doro, chiropa chako ndicho chinochisefa. Mukuita izvi, mamwe masero echiropa anofa. Kazhinji, chiropa chinogona kugadzira masero matsva ekutsiva akarasika. Asi kana ukaramba uchinwa doro rakawandisa, chiropa hachigone kuita basa iri nemazvo. Ndipo panotanga kuungana mafuta muchiropa chako, chirwere chinonzi steatosis .

2. Chirwere chechiropa chinonzi steatotic liver disease (MASLD) chinokonzerwa nekutadza kushanda zvakanaka kwemuviri (metabolic dysfunction-associated steatotic liver disease)

Izvi zvaimbonzi chirwere chechiropa chisina doro (NAFLD). Izvi zvinokonzerwa nekuti mafuta ari muchiropa haakonzerwi nekunwa doro zvakanyanya. Zita idzva rinoti zvinhu zvikuru zvinobatsira mukukura kwechiropa chine mafuta zvinhu zvinokonzera njodzi dzemwoyo nemetabolism . Zvichitaurwa zviri nyore, zvinokonzerwa nemamwe mamiriro ezvinhu nehunhu hunokanganisa hutano hwemwoyo wako.

Zvinhu zvikuru zvinokonzera njodzi yekukura kweMASLD ndeizvi:

• Kufuta
• Chirwere cheshuga cherudzi rwechipiri
• Kukwira kweropa
• Kusarongeka kwemafuta mumuviri - Izvi zvinoreva kusaenzana kwemafuta ari muropa, akadai secholesterol netriglycerides.

Kunyangwe ukanwa doro shoma pasvondo, kureva kuti, pasi pe140 magiramu pasvondo kuvakadzi uye pasi pe210 magiramu pasvondo kuvarume, unogona kunzi MASLD. (Semuenzaniso, muUnited States, bhodhoro redoro remaunzi gumi nemaviri rine anenge magiramu gumi nemana edoro.)

3. Kuwanda kwemafuta uye kuzvimba muchiropa nekuda kwekusashanda zvakanaka kwemuviri (Metabolic-associated steatohepatitis - MASH)

MASH imhando yeMASLD yakakomba. Mumamiriro ezvinhu aya, chiropa chinozvimba uye chinozvimba nekuda kwekuungana kwemafuta muchiropa. Zvadaro, chiropa chinokuvara uye chinotanga kuva nemavanga (fibrosis) . Kare, izvi zvainzi non-alcoholic steatohepatitis (NASH).

4. MASLD uye kushandisa doro zvakanyanya (MetalALD)

Kana uine MetalALD, zvinoreva kuti zvinhu zvinokonzera njodzi yekugaya chikafu pamwe nekushandisa doro zvakakonzera kuunganidzwa kwemafuta muchiropa chako. Muchiitiko ichi, une zvinhu zvinokonzera njodzi yemwoyo neropa, uye unonwa doro rinodarika magiramu 140 pasvondo kuvakadzi uye rinodarika magiramu 210 kuvarume.

Kana doro kana kuti zvinhu zvinokonzera njodzi yekugaya chikafu zviri izvo zvinogona kukonzera kuunganidzwa kwemafuta muchiropa zvinogona kusiyana kubva pamunhu kusvika pamunhu.

5. Mamwe marudzi eSLD

SLD inogona kuitika pasina kushandisa doro kana zvinhu zvinokonzera njodzi yekugaya chikafu. Semuenzaniso, mimwe mishonga nezvimwe zvirwere zvinogona kukonzera mafuta kuungana muchiropa. Dzimwe nguva vanachiremba havakwanise kuwana chikonzero chakajeka. SLD isina chikonzero chakajeka inonzi cryptogenic SLD .

Dambudziko guru riri mu fatty liver disease (SLD) here?

Kazhinji, mafuta ari muchiropa haakonzeri matambudziko makuru kana kukanganisa mashandiro echiropa. Zvisinei, dzimwe nguva chirwere ichi chinogona kuipa zvishoma nezvishoma uye kukura kuva chirwere chechiropa. Izvi zvinowanzoitika muzvikamu zvakasiyana-siyana:

• Chiropa : Chiropa, icho chinotanga chazara nemafuta, chinozvimba uye chinozvimba. Kuzvimba uku kunokuvadza chiropa. Chirwere ichi chinonzi steatohepatitis. Semuenzaniso, MASLD inova MASH sezvinotevera.
• Fibrosis: Mavanga anotanga kuumbwa munzvimbo dzine kukuvara kwechiropa kunokonzerwa nekuzvimba. Izvi zvinoita kuti chiropa chiome zvishoma. Maitiro aya anonzi fibrosis .
• Kurwara kwechiropa: Apa ndipo apo nhengo dzechiropa dzine hutano dzinotsiviwa nenhengo dzakawanda dzine mavanga. Apa ndipo patinoti chirwere chechiropa . Kana chikarapwa zvakanaka, chirwere ichi chinogona kukonzera zvirwere zvinouraya zvakaita sekutadza kushanda kwechiropa uye kenza yechiropa. Semuenzaniso, vanhu vanosvika 90% vanorwara nechirwere chehepatocellular carcinoma (HCC) , rudzi rwekenza yechiropa, vane chirwere ichi.

Ndezvipi zviratidzo zvechirwere chechiropa chine mafuta (SLD)?

Havasi vese vane SLD vanozosangana nezviratidzo. Dzimwe nguva, kana zviratidzo zvikaitika, zvinogona kusanganisira:

• Kurwadziwa mudumbu kana kunzwa kuzara muchikamu chepamusoro chedumbu.
• Kunzwa kuneta zvakanyanya kana kushaya simba (kuneta).

Zvisinei, vanhu vazhinji vanongoona zviratidzo chete kana SLD yakura kuita cirrhosis . Kana cirrhosis yatanga, zviratidzo zvakaita se:

• Kusvotwa.
• Chikafu hachina kunaka.
• Kuonda pasina chikonzero.
• Kutsvuka kweganda uye machena emaziso (jaundice).
• Ascites - Izvi zvinoreva kuti dumbu rakazara nemvura.
• Kuzvimba (edema) kwemakumbo, maoko, kana zvitsitsinho.
• Kubuda ropa (chiremba anogona kuona izvi mugurokuro, mudumbu, kana mudundundu).

Ndezvipi zvinokonzera chirwere chechiropa chine mafuta (SLD)?

Pane zvikonzero zvakawanda zvinoita kuti chirwere cheSLD chitange kukura. Zvisinei, kana uine zvinhu zvinokonzera njodzi dzemwoyo nekugaya chikafu , kana ukashandisa doro nenzira isina kunaka, kana kuti uine zvese zviri zviviri, une mukana mukuru wekuva nechirwere cheSLD.

Uri panjodzi huru yekubatwa neSLD kana uine zvinhu izvi:

• Dambudziko rekushandisa doro - kureva kunwa doro kakawanda kana zvakawandisa.
• Metabolic syndrome - Izvi zvinosanganisira insulin resistance, high blood pressure, high cholesterol, uye high triglycerides levels.
• Chirwere cheshuga cherudzi rwechipiri.
• Kurema kwakanyanya - Izvi zvinoreva kuti indekisi yehuremu hwemuviri wako (BMI) iri pakati pe25 ne29.9 kg/m2.
• Kufuta zvakanyanya - BMI i30 kg/m2 kana kupfuura.
• Chirwere chePolycystic ovary (PCOS).
• Kusakwanisa kufema zvakanaka pakurara.
• Hypothyroidism. (Kushaya hosha yethyroid).
• Kuderera kwemazinga ehomoni yepituitary (Hypopituitarism).
• Kuderera kwemahormone epabonde (Hypogonadism).
• Kuramba uchitora mimwe mishonga. Semuenzaniso, Amiodarone (Amiodarone - Cordarone®), Diltiazem (Diltiazem - Cardizem®), Tamoxifen (Tamoxifen - Nolvadex®) kana ma steroids. (Mimwe mishonga inogona kukonzera mafuta kuungana muchiropa semhedzisiro.)

Ndezvipi zvinetso zvinogona kuitika nekuda kweSLD?

Kana chikasarapwa, chiropa chinoputika chinogona kukura kuita cirrhosis , izvo zvinogona kukonzera kutadza kwechiropa, kenza yechiropa, uye mamwe magomarara kunze kwechiropa. Vanhu vane MASLD ndivo vari panjodzi huru yechirwere chemwoyo. Zvakakosha kuyeuka kuti chirwere chemwoyo, kwete chirwere chechiropa, ndicho chinokonzera rufu pakati pevanhu vane MASLD.

Chirwere chechiropa chine mafuta (SLD) chinoonekwa sei?

Nekuti SLD kazhinji haina zviratidzo, chiremba wako anogona kunge ari iye wekutanga kuona dambudziko racho. Kana ma enzymes echiropa chako akakwira panguva yekuongororwa kweropa kune zvimwe zvirwere, inogona kuva chiratidzo chekunyevera. Ma enzymes echiropa akakwira anogona kureva kuti chiropa chako chakuvara.

Kuti aongorore chirwere chacho, chiremba wako anogona kuita zvinotevera:

• Nhoroondo yezvekurapa: Kubvunza nezvezvirwere zvako, kuti unonwa doro rakawanda sei, uye mishonga yaunoshandisa.
• Kuongororwa kwemuviri: Tarisa zviratidzo zvecirrhosis, zvakaita sekukura kwechiropa uye jaundice .
• Maitiro ekutora mifananidzo: Miedzo yakaita se ultrasound , CT scan (Computed Tomography scan) , kana MRI (Magnetic Resonance Imaging) inoshandiswa kutsvaga kuzvimba uye mavanga muchiropa. Muedzo we ultrasound unonzi FibroScan® unogona kushandiswa kuona huwandu hwemafuta nemavanga muchiropa.
• Kuongororwa kwechiropa: Kuongororwa kwechiropa uku kunoitwa kuti kuonekwe kuti chirwere chechiropa chakura zvakadii. Nzira chete yekusiyanisa MASLD neMASH ndeyekuongororwa chiropa .

Chirwere chechiropa chine mafuta (SLD) chinorapwa sei?

Hapana mushonga chaiwo wechirwere ichi. Asi vanachiremba vanonyanya kukoshesa kukubatsira kudzora zvinhu zvinokonzera njodzi. Izvi zvinosanganisira kuchinja mararamiro ako izvo zvinogona kuvandudza hutano hwako.

Chiremba wako anogona kukurudzira zvinotevera:

• Rega kunwa doro zvachose: Kunyangwe kana SLD yako isina kukonzerwa nekushandisa doro, dzivisa doro zvachose.
• Kuderedza huremu: Kurovedza muviri, kuchinja zvekudya pasi pekutarisirwa kwenyanzvi yezvekudya, uye mimwe mishonga, yakaita seGLP -1RA, zvinogona kukubatsira kuderedza huremu. Unogona zvakare kufunga nezvekuvhiyiwa kuderedza huremu.(Bariatric surgery) inogonawo kukodzera.
• Tora mishonga yekudzora mamiriro emuviri: Tora mishonga yawakanyorerwa kuti udzore chirwere cheshuga, cholesterol, uye mafuta eropa (triglycerides). Mune zvimwe zviitiko, ungangodawo kutora vhitamini E nethiazolidinediones (mishonga yechirwere cheshuga yakaita seActos® neAvandia® ).
• Baiwa majekiseni eHepatitis A neHepatitis B : Utachiona uhwu hune njodzi zvikuru kana uchitova nechirwere chechiropa.

Kana mushonga wauri kutora uri kukonzera mafuta kuungana muchiropa chako, chiremba wako anogona kuchinja mushonga wako.

Nzira yekudzivirira chirwere chechiropa chine mafuta (SLD) sei?

Nzira yakanakisisa yekudzivirira SLD ndeyekuchengetedza hutano hwako hwese:

• Rovedza muviri nguva dzose.
• Deredza kunwa kwako doro.
• Ramba uine huremu hwakanaka kwauri.
• Kana uine chirwere cheshuga cherudzi rwechipiri kana chirwere chemetabolic, tora mishonga yako yawakanyorerwa sezvawakanyorerwa.

Chirwere chechiropa chine mafuta (SLD) chinorapika here?

Zvichienderana nekuoma kwechirwere chako, SLD inogona kugadziriswa uye mamwe mavanga anogona kugadziriswa. Chiropa chako chine kugona kunoshamisa kwekuzvirapa. Kana ukatevera hurongwa hwekurapa hwachiremba wako nemazvo, unogona kuderedza huwandu hwemafuta nekuzvimba kwechiropa chako. Unogona kudzivirira kukuvara kuti kusawedzere kuipa, uye mune dzimwe nguva, kunyange kudzora kukuvara kwechiropa nekukurumidza.

SLD inogona kukonzera rufu here?

Kune vanhu vazhinji, SLD haikonzeri matambudziko makuru kunze kwekunge yakura kusvika pakuva cirrhosis . Vanhu vazhinji vane SLD vanorarama hupenyu hwakajairwa.

Zvisinei, chirwere chechiropa chisina kurapwa chinogona kupedzisira chakonzera kutadza kwechiropa kana kenza yechiropa. Chiropa inhengo inokosha kwauri. Ndosaka zvichikosha kuchengetedza chiropa chako kana ukaona kuti une SLD.

Chii chinonzi kudya kwakanaka kumunhu ane SLD?

Kana SLD yako ichibatanidzwa nekuwedzera uremu, tevera kudya kwakaringana kuti uderedze uremu zvishoma nezvishoma asi zvishoma nezvishoma. Vanachiremba vanowanzo kurudzira kusadya zvekudya zvine shuga. Vanokurudzirawo kuedza kudya kweMediterranean . Yakapfuma mumiriwo, michero, nemafuta akanaka. Zvakare, zvinhu zvakaita senzungu, nyemba, zviyo zvese, hove, nehuku isarudzo dzakanaka kune vanhu vane SLD. Zvakakoshawo kudzivirira kudya nyama tsvuku yakawandisa uye kunwa zvinwiwa zvine shuga.

Mibvunzo Inowanzo bvunzwa (Mibvunzo Inowanzo bvunzwa)

Mubvunzo: Chiropa changu chakakuvara zvakadii?

Mhinduro: Chiremba wako anogona kukuudza chokwadi. Achaita bvunzo dzeropa, scan (Ultrasound, FibroScan) kuti aone kuti mafuta akawanda sei muchiropa chako uye kana paine mavanga. Zvadaro achakutsanangurira mamiriro acho ezvinhu.

Mubvunzo: Zvinotora nguva yakareba sei kuti kukuvara kwechiropa kupore?

Mhinduro:Zvinoenderana nemamiriro ako ezvinhu uye zvaunoedza kuita. Kana zviri pakutanga, kana ukadzora kudya kwako woderedza uremu, unogona kuona shanduko yakanaka mumwedzi mishoma. Kana zvakanyanya, sechirwere checirrhosis, zvakaoma kuchirapa zvachose, asi unogona kuchimisa kuti chisanyanya kuipa.

Mubvunzo: Mishonga yandinoshandisa inokanganisa SLD here?

Mhinduro: Ehe, zvinogona. Mimwe mishonga, semuenzaniso, Amiodarone neDiltiazem, inogona kukanganisa chiropa. Ndosaka uchifanira kuudza chiremba wako nezvemishonga yese yaunotora. Iye achabva atarisa kana paine dambudziko nemishonga iyoyo.

Mubvunzo: Chii chinonzi huremu hwakanaka kwandiri?

Mhinduro: Zvinoenderana nehurefu hwako nezera rako. Kazhinji zvakanaka kuchengetedza BMI yako iri pasi pemakore makumi maviri nemashanu. Asi chinhu chakanakisa chekuita kubvunza chiremba wako kana nyanzvi yezvekudya nezvehuremu hwakakunakira. Kunyangwe kuderedza huremu hushoma kunogona kubatsira chiropa chako.

Mubvunzo: Ndingasangana nenyanzvi yezvekudya kuti ndidzidze nezvekudya zvine hutano here?

Mhinduro: Ehe! Ndicho chinhu chakanakisa chekuita. Nyanzvi yezvekudya inogona kukubatsira kugadzira runyorwa rwezvekudya zvakakunakira. Vanogona kukuudza nezvezvinhu zvakaita sekudya kweMediterranean uye zvekudya zviri nyore kugadzira. Kana ukabvunza chiremba wako, anogona kukutumira.

Mubvunzo: Ndingawana sei kurapwa kwedambudziko rekushandisa doro?

Mhinduro: Kana uchinetseka nekurega kunwa doro, usanyara. Zvakajairika. Chinhu chakanakisa chekuita kutaura nachiremba wako nezvazvo. Iye anogona kukubatsira, uye kana zvichidikanwa, kukutumira kune vanopa mazano kana nyanzvi. Yeuka, kurega doro kwakakosha kuti uchengetedze chiropa chako.