Ngaba wena okanye umntu ohlala kusapho lwakho unesifo sentliziyo? Ukuba kunjalo, mhlawumbi uhlala uxhalabile ngamayeza anikwa ngugqirha wakho. Xa intliziyo yakho idinwa kancinci, kubaluleke kakhulu ukuba uhlale uqaphela amayeza anokunceda. Namhlanje siza kuthetha ngamayeza amatsha abonakalise iziphumo eziphumelelayo kakhulu ekunyangeni le meko. Yiyo leyo i-ARNI.
Ngamafutshane, yintoni i-ARNI?
I-ARNI yindibaniselwano yamayeza amabini. Igama layo elipheleleyo yi-Angiotensin Receptor/Neprilysin Inhibitor. Nangona igama lisenokuvakala linzima kancinci, kodwa lilula kakhulu. Yenzelwe ukunyanga izigulana ezinesifo sentliziyo.
Izinto ezimbini eziphambili zeli yeza zezi:
1. I-ARB (i-Angiotensin II Receptor Blocker): Iyeza elithi 'Valsartan' lilelali qela.
2. I-Neprilysin Inhibitor: Iyeza elithi 'Sacubitril' lilelali qela.
Iyeza le-ARNI kuphela elifumanekayo kwihlabathi liphela elidibanisa ezi zimbini yiSacubitril/Valsartan . Eli chiza lavunywa ngo-2015.
Eli yeza lisebenza njani emzimbeni?
Kulungile, ngoku makhe sibone ukuba la mayeza mabini anokunceda njani intliziyo yakho.
Cinga ngemithambo yegazi emzimbeni wakho njengemibhobho ethwala amanzi. Ngamanye amaxesha le mibhobho iyavaleka ize inciphe, nto leyo eyenza kube nzima ngentliziyo yakho ukupompa igazi.
- I-Valsartan (udidi lwe-ARB): Eli yeza lisebenza ngokukhulula nokwandisa imithambo yegazi exineneyo. Kufana nokwandisa umbhobho ovalekileyo. Emva koko igazi lingahamba emzimbeni wonke ngaphandle kokuphazamiseka. Oku kunciphisa uxinzelelo lwegazi.
- I-Sacubitril (i-Neprilysin Inhibitor): Oku kwenza into ebaluleke nangakumbi. Imizimba yethu ngokwendalo ivelisa iihomoni ezinceda iintliziyo zethu. Kodwa i-enzyme ebizwa ngokuba yi-'Neprilysin' iyawatshabalalisa la mahomoni alungileyo. I-Sacubitril iyawuthintela loo enzyme imbi ukuba ingasebenzi. Xa iyeka, imizimba yethu inako:
- Susa i-sodium (ityuwa) engafunekiyo emzimbeni ngomchamo.
- Yenza imithambo yegazi ibe banzi.
- Ukuvelisa umchamo omninzi kunye nokunciphisa ulwelo olugqithisileyo emzimbeni.
Ngamafutshane, indibaniselwano yala mayeza mabini inciphisa umthwalo entliziyweni kwaye yenza umsebenzi wayo ube lula kakhulu. Kufana nokuba nabantu ababini abangakumbi abaze kunceda umntu osebenza nzima.
I-ARNI icetyiswa kubani?
Eli yeza alilungelanga wonke umntu. Ugqirha wakho uya kugqiba ukuba eli yeza likulungele na ngokusekelwe kwizinto ezahlukeneyo.
| Ukufaneleka | Inkcazo |
|---|---|
| Kwabo bangakwaziyo ukupompa intliziyo yabo | Ukuba usandul’ ukufunyanwa uneHeart Failure kwaye i-Ejection Fraction (EF) yakho, elinganisa ukusebenza kakuhle kwentliziyo, yi-40% okanye ngaphantsi (kumntu ophilileyo, eli xabiso limalunga ne-55%-65%). |
| Kwabo batshintsha amayeza besebenzisa amanye amayeza | Ukuba sele usebenzisa ii-ACE inhibitors okanye ii-ARBs xa unesifo sentliziyo, ungatshintshela kwi-ARNIs endaweni yoko. |
Kubaluleke kakhulu: Ukuba utshintshela kwi-ACE inhibitor (umz. i-Enalapril, i-Lisinopril) ukuya kwi-ARNI, linda iiyure ezingama-36 emva kokuyeka i-ACE inhibitor ngaphambi kokuba uqale i-ARNI. Ukungaphumeleli ukwenza njalo kunokubangela i-allergy eyingozi (i-angioedema), evuvukala phantsi kolusu. Ugqirha wakho uza kukucebisa ngale nto.
Iingenelo ze-ARNI kunye nezizathu zokuyisebenzisa
Abantu abaninzi batshintshela kwi-ARNIs ngenxa yeziphumo ebezingalindelekanga, ezifana nokukhwehlela okungapheliyo, eziza namayeza amadala afana ne-ACE inhibitors. Kodwa ayisosizathu sodwa eso. Zininzi iingenelo zokusebenzisa ii-ARNIs.
- Yandisa ubomi: Izifundo zifumanise ukuba eli yeza linciphisa umngcipheko wokufa okunxulumene nesifo sentliziyo.
- Iphucula umgangatho wobomi: Inciphisa iimpawu ezifana nokudinwa nokudinwa, ikunceda ukuba usebenze ngokuqhelekileyo.
- Ilawula ukuqhubela phambili kwesifo: Yehlisa isantya apho ukusilela kwentliziyo kuya kuba mandundu.
- Inciphisa ukulaliswa esibhedlele: Kuye kwafunyaniswa ukuba abantu abasebenzisa eli yeza bambalwa abalaliswa esibhedlele ngenxa yokusilela kwentliziyo.
- Iphucula ukusebenza kwentliziyo: Olunye uphando lubonise ukuba emva kokuthatha i-ARNI unyaka wonke, iqhezu lokukhupha igazi kwizigulane linyuke ukusuka kumyinge we-28% ukuya kwi-38%. Oku kuthetha ukuba amandla okumpompa kwentliziyo aphucuke kakhulu.
Ngokwesifundo esikhulu, abantu abasebenzisa i-ARNI banomngcipheko oncitshisiweyo wama-20% wokufa okanye ukulaliswa esibhedlele ngenxa yesifo sentliziyo.
Ngubani ongafanele asebenzise eli yeza?
Eli yeza alifanelekanga kwabanye abantu. Ukuba ulilungu lala maqela, oogqirha bathi akufanele ulisebenzise eli yeza.
| Imeko | Isizathu |
|---|---|
| Oomama abakhulelweyo okanye abancancisayo | Kuba ingalimaza umntwana. |
| Abantu ababekhe baba ne-angioedema ngaphambili | Ukuba sele ukhe waba ne-angioedema, ukudumba kobuso okanye imilebe, ngenxa ye-ACE inhibitor okanye iyeza le-ARB. |
| Abo sele bethatha i-ACE inhibitor/ARB | Kuyingozi ukuthatha amayeza omabini kunye. |
| Abantu abanesifo sesibindi esinzima | Eli yeza alifanelekanga ukuba unesifo sesibindi esingasebenzi kakuhle. |
| Abantu abasebenzisa i-Aliskiren | Akucetyiswa ukuba uthathe i-ARNI ukuba usebenzisa i-Aliskiren enesifo seswekile okanye isifo sezintso. |
Masifunde nangeziphumo ebezingalindelekanga.
Njengalo naliphi na iyeza, i-ARNI inokubangela iziphumo ebezingalindelekanga ezincinci. Nangona kunjalo, ayinguye wonke umntu ozifumanayo.
- Uxinzelelo lwegazi oluphantsi (Hypotension): Usenokuziva unesiyezi kwaye unesizungu.
- Iziphumo ekusebenzeni kwezintso: Abanye abantu banokubona ukwehla okuncinci kokusebenza kwezintso.
- Ukwanda kwamanqanaba e-potassium egazini (i-Hyperkalemia): Oku kunokwenzeka nakwabanye abantu.
- I-Angioedema: Ukudumba kobuso, imilebe, nolwimi. Oku kunqabile kakhulu , kodwa kunokuba yingozi kakhulu ukuba kwenzeka.
Yiyo loo nto ugqirha wakho eza kujonga igazi lakho (ukujonga amanqanaba ezintso zakho kunye ne-potassium) kunye noxinzelelo lwegazi kwiiveki ezimbalwa zokuqala xa uqala ukuthatha eli yeza. Ukuba kukho naziphi na iingxaki, ugqirha wakho uza kunciphisa umthamo okanye akuxelele into omawuyenze. Ungaze uyeke ukuthatha eli yeza ngaphandle kwengcebiso kagqirha wakho.
Ezi ziphumo bezingalindelekanga zihlala ziphela kwisithuba seeveki ezimbini. Ukuba ziyaqhubeka, yazisa ugqirha wakho ngoko nangoko.
Ndifanele ndimbone nini ugqirha?
Ukuba ufumana naziphi na ezi mpawu ngelixa uthatha i-ARNI, qiniseka ukuba uthethe nogqirha wakho.
- Isiyezi rhoqo
- Ubukrelekrele
- Ngamanye amaxesha ukuquleka
- Uxinzelelo lwegazi oluphantsi kakhulu (ukuba umlinganiselo we-systolic ungaphantsi kwama-90)
Usenokoyika ukutshintshela kumayeza amatsha xa sele uqhele amayeza amadala. Kodwa ukufunda ngonyango olutsha nolusebenzayo kunye nokuthetha nogqirha wakho ngezinto ezilungileyo nezingalunganga kubaluleke kakhulu kwimpilo yakho.
Umyalezo Wokuya Ekhaya
- I-ARNI liyeza eliphumelelayo nelinamhlanje elenziwe ngokudibanisa amayeza amabini okunyanga ukusilela kwentliziyo.
- Oku kuyandisa imithambo yegazi, kususe ityuwa namanzi angafunekiyo emzimbeni, kwaye kunciphisa umthwalo entliziyweni.
- Eli yeza libonelela ngeenzuzo ezininzi, kuquka ukonyuka kwexesha lokuphila, umgangatho wobomi ophucukileyo, kunye nokuncipha kokulaliswa esibhedlele.
- Eli yeza alifanelekanga kubafazi abakhulelweyo, abo babekhe baba ne-angioedema ngaphambili, kunye nabo banezinye iimeko zonyango.
- Iziphumo ebezingalindelekanga ezifana nesiyezi kunye noxinzelelo lwegazi oluphantsi zinokubakho. Ngoko ke, kubalulekile ukuba phantsi kweliso likagqirha rhoqo.
- Ungaze uqale okanye uyeke ukusebenzisa eli yeza ngaphandle kwengcebiso kagqirha. Ukuba uneengxaki, qhagamshelana nogqirha wakho ngoko nangoko.
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