I-Atherosclerosis: Izimbangela, Izimpawu kanye nokuthi yini okudingeka uyazi

Sonke sivame ukuzwa izinto ezifana 'ne-cholesterol ephezulu' kanye 'nemithambo yegazi evalekile'. Kodwa wake wazibuza ukuthi lokhu kwenzeka kanjani ngempela emizimbeni yethu? Imithambo yethu yegazi ifana nemigwaqo emizimbeni yethu yokujikeleza kwegazi. Le migwaqo ithwala igazi elihlanzekile, elicebile ngomoya-mpilo lisuka enhliziyweni yethu liye ezithweni zomzimba wonke. Cabanga nje, kwenzekani uma le migwaqo ivaleka kancane kancane ngamafutha kanye nemfucumfucu? Yilokho esikubiza ngokuthi i-atherosclerosis kwezokwelapha.

Kalula nje, kuyini i-atherosclerosis?

I-atherosclerosis ukwakheka kancane kancane kwamafutha, i-cholesterol, i-calcium, nezinye izinto ngaphakathi kwezindonga zemithambo yethu yegazi (ikakhulukazi imithambo yegazi) ukuze kwakheke 'i-plaque' . Lokhu kubizwa ngokuthi 'i-atheroma' ngokwezokwelapha. Njengoba le plaque ikhula kancane kancane, udonga lwemithambo yegazi luyaqina futhi luqine. Lokhu sikubiza ngokuthi "ukuqina kwemithambo yegazi" noma "ukuqina kwemithambo yegazi".

Into eyesabekayo ngalokhu ukuthi le nqubo yenzeka buthule kakhulu, ngaphandle kwezimpawu ezigabeni zokuqala. Ungase ungaboni noma yiziphi izinguquko iminyaka eminingi. Kodwa ngokuhamba kwesikhathi, le plaque iyakhula futhi inciphise i-lumen (isikhala lapho igazi ligeleza khona) ngaphakathi komthambo wegazi.

Cabanga ngomgwaqo onemizila emine oncishiswa ube umzila owodwa ngenxa yokuminyana kwezimoto. Ukugeleza kwegazi kuncishiswe kakhulu. Lokhu kusho ukuthi izitho zethu zintula umoya-mpilo nezakhamzimba ezizidingayo. Okuyingozi nakakhulu ukuthi lo mthambo wegazi ungaqhekeka ngokuzumayo ngenxa yokugeleza kwegazi okusheshayo. Uma lokho kwenzeka, imizimba yethu yakha ihlule legazi ukuze ipholise inxeba.

Kwenzekani uma ukugeleza kwegazi kuvinjiwe ngale ndlela? Kuya ngokuthi ihlule lakhiwa kuphi. Isibonelo, uma kwenzeka emthanjeni wenhliziyo ohlinzeka ngegazi enhliziyweni, inhliziyo ngeke ithole umoya-mpilo owanele, okubangela ukuhlaselwa yinhliziyo .

Sivame kangakanani lesi simo?

I-atherosclerosis empeleni iyisimo esivame kakhulu. Izinkinga ezibangelwa ukunqwabelana kwamafutha emithanjeni yegazi, njengokuhlaselwa yinhliziyo kanye nohlangothi, ziyimbangela ehamba phambili yokufa emhlabeni jikelele. Ucwaningo lubonisa ukuthi abantu abaningi abaseminyakeni ephakathi banesi simo, kodwa cishe ingxenye yabo ayazi nokuthi sikhona.

Ziyini izimpawu zalokhu?

Njengoba sishilo ekuqaleni, azikho izimpawu ezigabeni zokuqala. Izimpawu ziqala ukuvela lapho umthambo wegazi uvaleka ngaphezu kuka-70%. Abantu abaningi bathola kuphela ukuthi banalesi simo ngemva kwesimo esiphuthumayo, njengokuhlaselwa yinhliziyo noma isifo sohlangothi.

Kuye ngokuthi umthambo wegazi uvalekile kuphi, izimpawu zingavela ezingxenyeni ezahlukene zomzimba.

Kungani imithambo yegazi ivaleka kanje? Ziyini izimbangela?

Abacwaningi bakholelwa ukuthi kunezimbangela eziningana eziyinhloko ze-atherosclerosis.

• Amazinga aphezulu e-cholesterol embi (LDL) kanye nama-triglycerides.
• Ukusetshenziswa kwemikhiqizo kagwayi (ukubhema).
• Umfutho wegazi ophezulu.
• Isifo sikashukela.

Lezi zinto zingalimaza ulwelwesi oluthambile ngaphakathi kwemithambo yegazi yethu (i-endothelium). Lo monakalo yiwona oqala inqubo ye-atherosclerosis. Lo monakalo awenzeki ngobusuku obubodwa, kodwa uqhubeka isikhathi eside kakhulu.

Ake sibheke izinyathelo zale nqubo ngokuningiliziwe.

Lena inqubo ebilokhu iqhubeka iminyaka eminingi. Lezi yizinyathelo eziyinhloko.

1. Umonakalo we-endothelial: Izinto ezifana ne-cholesterol ephezulu, ubuthi obukugwayi, kanye nomfutho wegazi ophezulu kungalimaza ulwelwesi lwangaphakathi lwemithambo yegazi. Uma kwenzeka lo monakalo, amangqamuzana amhlophe egazi akhangwa yile ndawo. Lawa maseli ayaqoqana futhi abangele ukuvuvukala ngaphakathi kwemithambo yegazi.

2. Ukwakheka kwemigqa yamafutha: Lesi yisibonakaliso sokuqala esibonakalayo se-atherosclerosis. Amaseli amhlophe egazi afike endaweni yomonakalo azama ukususa izinhlayiya ze-cholesterol ngokuzigwinya. Lawa maseli agcwele i-cholesterol abizwa ngokuthi 'amaseli e-foam'. Uma efa, ashiya imigqa ephuzi noma ibala odongeni lwemithambo yegazi.

3. Ukwandiswa kwe-plaque:Njengoba amangqamuzana afile kanye nezinye izinsalela ziqhubeka nokuqongelela, iqhubu elincane elinamafutha likhula kancane kancane libe yi-plaque enkulu. Bese kuba nesivalo esinemicu samangqamuzana emisipha abushelelezi azungeze le plaque. Lokhu kuvimbela izingcezu ze-plaque ukuthi zingaqhekeki futhi zihlangane egazini. Njengoba le plaque ikhula ibe nkulu, isikhala sokugeleza kwegazi siba sincane.

4. Ukuqhuma kweplaque: Lesi yisimo esiyingozi kakhulu. Iplaque ezungeze iplaque ingaqhuma ngokuzumayo. Uma lokhu kwenzeka, kwakheka ihlule legazi kuleyo ndawo. Leli hlule legazi livimba ngokuphelele imithambo yegazi, limise ukugeleza kwegazi. Yilokhu okubangela ukuhlaselwa yinhliziyo noma isifo sohlangothi.

Yiziphi izinto ezibangela lokhu?

Kunezici eziningi eziyingozi ezifaka isandla ekuthuthukisweni kwe-atherosclerosis. Ezinye zazo singazishintsha, kodwa ezinye, njengobudala, asikwazi.

Yiziphi izinkinga ezingaba khona ngenxa ye-atherosclerosis?

Ukuphazamiseka kokujikeleza kwegazi kungaholela ezinkingeni eziningi ezinkulu. Eziyinhloko yilezi:

• Isifo semithambo ye-coronary
• Isifo senhliziyo
• Izigqi zenhliziyo ezingavamile (i-Arrhythmia)
• Ukwehluleka kwenhliziyo
• Isifo sohlangothi
• Ukuhlaselwa kwe-ischemic yesikhashana (i-TIA)
• Isifo semithambo yegazi engaphandle
• Isifo sezinso esingamahlalakhona (CKD)
• Ubuthakathaka bemithambo yegazi, okubangela ukuba ivuvuke (ama-aneurysms) futhi iqhume.

Ungasithola kanjani lesi sifo?

Udokotela wakho uzolandela izinyathelo eziningana ukuze axilonge lesi simo noma abale ingozi yakho yaso.

1. Ukuhlolwa okuphelele ngokomzimba: Lokhu kuhilela ukusebenzisa i-stethoscope ukulalela inhliziyo yakho nomsindo wegazi ogeleza emithanjeni yakho yegazi. Isibonelo, uma uzwa umsindo othi "whooshing" ("bruit") lapho ulalele imithambo ye-carotid entanyeni yakho, kungaba uphawu lokuqhekeka kwegazi emithanjeni.

2. Ukubuza ngomlando wakho wezokwelapha kanye nomlando womndeni: Lolu lwazi lungasiza ekuhloleni ubungozi bakho.

3. Ukubuza ngendlela ophila ngayo: Ukubuza ngezinto ezifana nokuthi uyabhema yini nokuthi ukudla kwakho kunjani.

4. Uku-oda ukuhlolwa kwegazi: Lokhu kungakutshela okuningi ngamazinga akho e-cholesterol, amazinga kashukela, kanye nokusebenza kwenhliziyo.

Ukuhlolwa kokuqinisekisa isimo

Ngezinye izikhathi, kudingeka ukuhlolwa okwengeziwe ukuqinisekisa ukuxilongwa nokuhlela ukwelashwa.

• I-Angiography: Ukuhlolwa okusebenzisa ama-X-ray akhethekile kanye nodayi ukuze kubonakale ukuthi imithambo yegazi ivinjiwe kuphi nokuthi ingakanani.
• I-ECG (i-Electrocardiogram): Ilinganisa umsebenzi kagesi, izinga, kanye nesigqi senhliziyo.
• I-Echocardiogram: Ithatha izithombe zama-valve enhliziyo namagumbi ukuze ibone ukuthi inhliziyo ihambisa igazi kahle kangakanani.
• Ukuhlolwa kokucindezeleka kokuzivocavoca: Isilinganiso senhliziyo yakho silinganiswa ngenkathi uzivocavoca (uhamba ku-treadmill).
• I-Ultrasound Scan: Lokhu kuhlolwa kusetshenziselwa ukuhlola ukujiya kwemithambo yegazi entanyeni (i-Carotid ultrasound) noma esiswini (i-abdominal ultrasound) nokuthi ngabe inama-fatty deposits.
• I-CT scan: Lokhu kuskena kuthatha izithombe zengaphakathi lomzimba futhi kungabona ukuqina nokuncipha kwemithambo yegazi emikhulu.

Iphathwa kanjani?

Ukwelashwa kwe-atherosclerosis kuhlanganisa ukushintsha indlela yokuphila, imithi, futhi, uma kudingeka, ukuhlinzwa noma ezinye izindlela zokwelapha. Udokotela wakho uzokwakha uhlelo lokwelashwa olukulungele kangcono.

1. Izinguquko zendlela yokuphila

Lezi yizinto ezibaluleke kakhulu. Lezi zinguquko zinganciphisa kakhulu ingozi yezinkinga.

• Gwema yonke imikhiqizo kagwayi. Uma ubhema, yeka ngokushesha.
• Yamukela ukudla okunempilo kwenhliziyo. Kungcono ukudla ukudla kwaseMedithera okuhlanganisa imifino eminingi, izithelo, ubhontshisi, inhlanzi, namafutha anempilo njengamafutha omnqumo, kanye nenyama ebomvu encane nokudla okucutshunguliwe.
• Vivinya umzimba nsuku zonke. Qala ngokuhamba ngezinyawo okufushane bese usebenza kuze kufike ekuzivocavoceni okungenani imizuzu engama-30 ngosuku, izinsuku eziningi zesonto.

2. Imithi (izinhlobo zemithi)

Imithi ingasiza ekulawuleni izici eziyingozi zokuqongelela amafutha. Udokotela wakho angase akuncome:

• Imithi yokwehlisa i-cholesterol (isib. ama-statin).
• Imithi yokwehlisa umfutho wegazi.
• Imithi elawula amazinga kashukela egazini.
• Imithi evimbela ukujiya kwegazi (isib. i-aspirin) inganikezwa.

3. Izindlela zokwelapha kanye nokuhlinzwa

Uma imithambo yegazi ivalekile kakhulu noma ingozi yezinkinga iphezulu kakhulu, kungadingeka usebenzise lezi zinhlobo zokwelapha.

• Ukufakwa kwe-Angioplasty kanye ne-Stent: Inqubo lapho kufakwa khona ibhaluni elincane emthanjeni wegazi ovinjiwe, lifuthwe ukuze linwebe umthambo, bese kufakwa ipayipi elincane elifana ne-mesh (stent) ukuze livinjwe futhi.
• I-Coronary Artery Bypass Grafting (CABG): Inqubo yokudlula umthambo wegazi ovinjiwe bese kwakhiwa umthambo wegazi omusha kusetshenziswa ucezu lwegazi oluthathwe kwenye ingxenye yomzimba.

Yini okufanele uyenze?

Ungesabi uma uthola ukuthi unalesi simo. Into ebaluleke kakhulu ukusebenzisana eduze nodokotela wakho.

• Yiya emitholampilo ngesikhathi esihleliwe njengoba ekutshela.
• Hlola umfutho wegazi lakho, i-cholesterol, kanye namazinga kashukela njalo bese uwalawula.
• Uma kuvela izimpawu ezintsha noma izimpawu ezikhona zishintsha, tshela udokotela wakho ngokushesha.
• Nakekela impilo yakho yengqondo futhi. Kuvamile ukuzizwa ukhathazekile futhi wesaba uma uphila nesimo esinjengalesi. Khuluma nomndeni wakho, abangani, noma umeluleki ngakho uma kudingeka.

Kufanele uye nini e-Emergency Treatment Unit (ETU)?

Uma wena noma othile oseduze kwakho eba nezimpawu zokuhlaselwa yinhliziyo (ubuhlungu obukhulu esifubeni, ubunzima bokuphefumula, ubuhlungu obuphuma engalweni yesobunxele) noma isifo sohlangothi (ukugoba kolunye uhlangothi lobuso, ubunzima bokukhuluma, ukulahlekelwa ukwazi kolunye uhlangothi lomzimba) , shayela ngokushesha ku-1990 ukuze uthole i-ambulensi noma uye esibhedlela esiseduze noMnyango Wezimo Eziphuthumayo (ETU). Lezi yizimo eziphuthumayo ezidinga ukwelashwa ngokushesha.