Ingabe bakhona abantu emndenini wakho abake baba nokuhlaselwa yinhliziyo ngaphambi kokuba baguge, okungukuthi, lapho beneminyaka engu-40-50? Noma ingabe kuvamile ukuthi abantu emndenini wakho bahlale bethi, "I-cholesterol ephezulu, i-cholesterol ephezulu"? Esikhathini esiningi, sicabanga ukuthi isizathu salokhu yizinto ezifana nalokho esikudlayo nesikuphuzayo, nokungazivocavoci. Lokho kuyiqiniso, futhi lokho kunomthelela. Kodwa ngezinye izikhathi, isizathu sangempela sale cholesterol ephezulu kungaba yinkinga emizimbeni yethu, ezizakhini zethu zofuzo. Yilokho esikubiza ngokuthi 'i-Familial Hypercholesterolemia' noma 'i-FH' kwezokwelapha. Namuhla, sizokhuluma ngalokhu kalula, ngendlela ongayiqonda.
Kalula nje, iyini i-Familial Hypercholesterolemia (FH)?
I-Familial Hypercholesterolemia yisimo sofuzo esizuzwa kumama, kuyise, noma kokubili. Lokhu kwenzeka lapho i-cholesterol "embi", noma i-LDL cholesterol, emizimbeni yethu iphezulu kakhulu kusukela ekuzalweni.
Cabanga ngemithambo yegazi yethu njengemithambo yegazi. Le cholesterol ethi 'LDL' ifana nongqimba oluphuzi, olufana ne-wax olunamathela odongeni lwaleyo mithambo yegazi. Ngokuvamile, lokhu kwakheka kancane kancane. Kodwa kumuntu one-'FH', izinga le-'LDL' cholesterol liphezulu kakhulu kangangokuthi lolu ngqimba olufana ne-wax luqala ukwakheka ngokushesha okukhulu futhi lube lujiyile ngaphakathi kwemithambo yegazi. Lokhu sikubiza ngokuthi 'i-atherosclerosis'. Ngokuhamba kwesikhathi, lolu ngqimba luyakhula futhi lunciphise imithambo yegazi, ngezinye izikhathi luyivimbele ngokuphelele. Yilapho-ke kwenzeka khona izinto ezisongela ukuphila njengokuhlaselwa yinhliziyo kanye nohlangothi.
Izinga le-cholesterol ye-'LDL' yomuntu ophilile kahle kufanele libe ngaphansi kuka-100 mg/dL. Kodwa-ke, kumuntu one-'FH`, leli nani lingaba phezulu kakhulu, njenge-160 mg/dL, 190 mg/dL . Kwezinye izimo ezinzima, lingadlula ngisho no-400 mg/dL. Into eyingozi kakhulu ukuthi njengoba lesi simo besikhona kusukela ebuntwaneni, uma singelashwa, ingozi yokuthola isifo senhliziyo iphezulu kakhulu esemncane kakhulu kunomuntu ojwayelekile.
Le ndaba ingase izwakale iyesabisa kancane, kodwa izindaba ezinhle ukuthi uma uyiqaphela kusenesikhathi, uthatha imithi efanele, futhi wenze izinguquko endleleni yokuphila, ungayilawula ngokuphelele futhi uphile impilo enempilo.
Kunezinhlobo ezimbili eziyinhloko ze-FH.
Lesi simo sihlukaniswe ngezinhlobo ezimbili eziyinhloko ngokusekelwe endleleni esisizuza ngayo njengefa. Kulula kakhulu ukukuqonda lokhu.
Ake sithi imizimba yethu inemiyalelo emibili yokulawula i-cholesterol. Eyodwa siyithola kumama wethu, kanti enye siyithola kubaba wethu.
1. I-Heterozygous FH: Lolu uhlobo oluvame kakhulu. Okwenzekayo lapha ukuthi kukhona iphutha 'encwadini yemiyalelo' (i-gene) elizuzwe njengomzali oyedwa kuphela , kungaba umama noma ubaba. Lokhu kusho ukuthi incwadi eyodwa ilungile, kanti enye incwadi inephutha elincane. Lokhu kubangela ukuthi ukulawulwa kwe-cholesterol kungenzeki kahle.
2. I-Homozygous FH: Lokhu akuvamile kakhulu, futhi kuyingozi kakhulu.Uhlobo. Okwenzekayo lapha ukuthi kokubili 'imiyalelo' etholwe kumama nobaba inephutha. Khona-ke indlela elawula i-cholesterol iba buthakathaka kakhulu. Amazinga e-cholesterol 'e-LDL' kulaba bantu aphezulu kakhulu.
I-'FH' isifo sofuzo esigabeni 'se-autosomal dominant'. Lokhu kusho ukuthi ingane akudingeki ithole ifa lofuzo olunephutha kubazali bobabili ukuze ithole lesi sifo, kwanele ukusithola kumzali oyedwa kuphela .
Lokhu kusho ukuthi uma une-`FH`, kunethuba elingu-50% lokuthi ingane yakho izozuza lesi simo njengefa. Ngokufanayo, kunethuba elingu-50% lokuthi izingane zakini nazo zizoba nalesi simo.
Sivame kangakanani lesi simo? Ziyini izimpawu?
Kulinganiselwa ukuthi umuntu oyedwa kwabangu-250 emhlabeni unesifo esivamile esithi 'Heterozygous FH'. Kodwa into edabukisayo kakhulu ukuthi abangu-9 kwabangu-10 balaba bantu abazi ukuthi banalesi sifo .
Ngokuvamile, i-FH ayibonisi zimpawu ezithile ezigabeni zokuqala. Ungase ungazi ukuthi une-FH uze ube nokuhlaselwa yinhliziyo, njengobuhlungu besifuba. Kodwa-ke kungase kube sekwephuzile. Lokhu kungenxa yokuthi ukufakwa kwe-cholesterol emithanjeni yegazi yomuntu one-FH kuqala ukwakheka kusukela ngosuku azalwa ngalo.
Ngokuhamba kwesikhathi, ukunqwabelana kwe-cholesterol kungaholela ezimbangela ezilandelayo.
| Isibonakaliso | Incazelo elula |
|---|---|
| Isifo senhliziyo esemncane | Ubuhlungu besifuba (i-angina) obuvela ngesikhathi sokuzivocavoca noma sokuphumula, ukuhlaselwa yinhliziyo noma isifo sohlangothi esemncane (amadoda - angaphansi kweminyaka engu-55 ubudala, abesifazane - angaphansi kweminyaka engu-65 ubudala). |
| Ama-Xanthomas | Amaqhubu aphuzi abangelwa ukugcwala kwe-cholesterol ngaphansi kwesikhumba. Lokhu kuvame ukubonakala ezindololwaneni, emadolweni, emalungeni eminwe, kanye nasezindaweni ezizungeze i-Achilles tendon (ngaphezu kwesithende). |
| I-Xanthelasmas | Ama-cholesterol aphuzi akheka ngaphansi kwesikhumba azungeze amajwabu amehlo. |
| I-Corneal Arcus | Indandatho emhlophe, empunga, noma eluhlaza okwesibhakabhaka ezungeze iso elimnyama. Lokhu kuvame kakhulu kubantu abadala, kodwa uma kubonakala kumuntu ongaphansi kweminyaka engu-45 , kungaba uphawu lwe-FH. |
| Ukupheqa uhlamvu lwemali | Ubuhlungu emilenzeni engezansi, ikakhulukazi lapho uhamba. Lokhu kungase kube ngenxa yokuncipha kwemithambo yegazi ehambisa igazi emilenzeni. |
I-FH itholakala kanjani?
Uma udokotela wakho esola ukuthi une-FH, uzobheka izinto eziningana ukuqinisekisa ukuthi unesifo.
- Ukuhlolwa kwegazi: Lokhu kubaluleke kakhulu. Ukuhlolwa kwegazi okubizwa ngokuthi i-`Lipid Profile`, okuhlola amazinga akho e-cholesterol, kubheka amazinga aphezulu ngokungavamile e-`LDL` cholesterol. Uma ingaphezu kuka- 190 mg/dL kumuntu omdala, noma ingaphezu kuka- 160 mg/dL enganeni, kusolwa ukuthi i-`FH`.
- Umlando wezokwelapha womndeni: Lokhu kubaluleke kakhulu. Udokotela wakho uzokubuza imibuzo efana nokuthi, "Ingabe ubaba wakho, umama, ugogo nomkhulu, noma abafowenu bake baba nokuhlaselwa yinhliziyo besebancane?" "Ingabe ukhona emndenini wakho one-cholesterol ephezulu?"
- Ukuhlolwa komzimba: Udokotela uzohlola umzimba wakho ukuthi akaboni yini izimpawu ze-xanthomas (izigaxa zesikhumba) noma i-corneal arcus (izindilinga zamehlo) okukhulunywe ngazo ngaphambili.
- Ukuhlolwa kwezakhi zofuzo (ukuhlolwa kwe-DNA): Kwezinye izimo, ukuhlolwa kwezakhi zofuzo kungenziwa ukuqinisekisa lesi sifo ngokuqinisekile. Lokhu kungahlola amaphutha ezakhi zofuzo eziyinhloko ezibangela i-FH (njenge-APOB, i-LDLR, noma i-PCSK9).
Yiziphi izindlela zokwelapha?
I-'FH' akuyona isifo esingaselapha. Ngoba yinto eza nezakhi zofuzo zethu. Kodwa ingalawulwa kahle kakhulu . Umgomo oyinhloko wokwelashwa ukunciphisa amazinga e-cholesterol 'e-LDL' ngangokunokwenzeka, kuncishiswe ingozi yesifo senhliziyo.
1. Imithi (izinhlobo zemithi)
Ukushintsha indlela yokuphila kuphela akwanele ukulawula i-cholesterol kumuntu one-`FH`. Ngakho-ke , umuthi owodwa noma ngaphezulu kumele uthathwe impilo yakhe yonke .
- Ama-statin:Lena imithi evame kakhulu futhi esetshenziswa kakhulu. Isebenza ngokunciphisa ukukhiqizwa kwe-cholesterol yisibindi.
- Ama-inhibitor e-PCSK9: Lawa uhlobo olusha lwemithi ejovwayo. Asebenza kahle kakhulu kubantu abanamazinga e-cholesterol angenakulawulwa ngama-statin kuphela.
- I-Ezetimibe: Lo muthi usebenza ngokunciphisa ukumuncwa kwe-cholesterol ekudleni esikudlayo. Uvame ukunikezwa kanye nama-statin.
- Eminye imithi: Ngaphezu kwalokho, kuneminye imithi efana ne-'Bile acid sequestrants' kanye ne-'Fibrates'. Udokotela wakho uzonquma ukuthi yimuphi umuthi ofaneleka kakhulu kuwe.
2. Izinguquko endleleni yokuphila
Kanye nokuthatha imithi, kubalulekile futhi ukulandela indlela yokuphila enempilo. Lokhu akugcini nje ngokwandisa ukusebenza kahle kwemithi, kodwa futhi kunganciphisa kakhulu ingozi yesifo senhliziyo.
| Okufanele ngikwenze | Okufanele ukugweme |
|---|---|
| Ukudla okunempilo enhliziyweni: Imifino, izithelo, ubhontshisi, okusanhlamvu okuphelele okune-fiber (irayisi elinsundu, i-oats), inhlanzi (i-salmon, i-mackerel, i-herring), ubisi olunamafutha aphansi kanye nenyama. | Amafutha agcwele kanye nama-trans: Ukudla okuthosiwe, ukudla okusheshayo, imikhiqizo yokubhaka (amakhekhe, ama-patties), inyama enamafutha, ukusetshenziswa ngokweqile kwamafutha kakhukhunathi namafutha esundu. |
| Ukuzivocavoca okuvamile: Zivocavoce njengokuhamba ngokushesha, ukugijima, noma ukugibela ibhayisikili okungenani imizuzu engama-30 ngosuku, okungenani izinsuku ezi-5 ngesonto. | Ukubhema notshwala: Ukubhema kufanele kuyekwe ngokuphelele. Kulimaza kakhulu imithambo yegazi. Ukusetshenziswa kotshwala kufanele kuncishiswe. |
| Ukugcina isisindo esinempilo: Ukulawula isisindo somzimba kunganciphisa ukucindezeleka enhliziyweni. | Iziphuzo ezinoshukela kanye nokudla okunoshukela omningi: Lokhu kungaholela ekukhuluphaleni kanye nezinye izinkinga zempilo. |
3. Ezinye izindlela zokwelapha ezithile
Kubantu abane-homozygous FH enzima kakhulu, imithi yodwa ingase ingakwazi ukulawula i-cholesterol yabo. Kulaba bantu, kwenziwa ukwelashwa okubizwa ngokuthi i-LDL apheresis. Lokhu kufana ne-dialysis. Kuthathwa igazi elincane, lidluliselwe emshinini, osusa i-LDL cholesterol embi, bese ulibuyisela emzimbeni. Lokhu kwenziwa kanye noma kabili ngesonto.
Uma une-FH, yini okufanele uyenze?
Uma kutholakale ukuthi une-'FH', akukhona ngawe kuphela. Kungumyalezo obalulekile womndeni wakho wonke.
Uma une-FH, kungumthwalo wakho ukuthi abazali bakho, izingane zakini, nezingane zakho bahlolwe i-cholesterol. Lokhu sikubiza ngokuthi 'ukuhlolwa kwe-cascade.' Lokhu kungasiza ekuboneni amanye amalungu omndeni ngaphambi kokuba kuvele izimpawu bese uqala ukwelashwa nawo.
Uma ingane inomlando womndeni we-`FH`, i-cholesterol ingahlolwa ngisho naseminyakeni engu-2. Ngenxa yokuthi ukwelashwa kwalesi simo kuqala ngokushesha, izinkinga ezingaba khona zingancishiswa esikhathini esizayo.
Uma une-'FH', ungesabi. Hlala uxhumane nodokotela wakho. Thatha imithi yakho ngesikhathi. Yenza izinguquko endleleni yokuphila. Khona-ke nawe ungaphila impilo ende nenempilo njengawo wonke umuntu.
Umlayezo Wokuya Nawe Ekhaya
- I-Familial Hypercholesterolemia (FH) yisifo esidluliselwa ngofuzo esidluliselwa esizukulwaneni ngesizukulwane futhi sibangela amazinga aphezulu e-cholesterol embi (LDL) kusukela ekuzalweni.
- Uma kukhona emndenini wakho oke waba nesifo senhliziyo esemncane noma ene-cholesterol ephezulu, kubaluleke kakhulu ukuthi uhlolwe i-FH.
- Abantu abaningi abanalesi simo abazi ukuthi banalesi sifo. Ukutholwa kusenesikhathi kungasindisa izimpilo.
- Imithi yempilo yonke kanye nendlela yokuphila enempilo kubalulekile ekuphatheni i-FH.
- Uma kutholakale ukuthi une-`FH`, hlola abazali bakho, izingane zakini, nezingane zakho. Kuzosiza ekusindiseni izimpilo zabo.
- Ngokwelashwa okufanele, ungaphila impilo enempilo nende ngokuphelele. Ngakho ungesabi, thintana nodokotela wakho bese uthola ukwelashwa.
💬 Comments (0)
Awekho amazwana athunyelwe okwamanje. Faka amazwana akho lapha okokuqala ngqa.
Engeza amazwana akho