Ingabe isibindi sakho sinamafutha? Ake sifunde nge-MASH (Metabolic Dysfunction-Associated Steatohepatitis)!

Wake wezwa ngesifo lapho amafutha eqongelela khona esibindini? Ngezinye izikhathi, lesi simo singaba sibi kakhulu ngaphandle kwezimpawu ezinkulu. Namuhla, sizokhuluma ngesifo esisodwa esinjalo esingathinta isibindi sethu buthule. Lokhu kubizwa ngokuthi i-MASH (Metabolic Dysfunction-Associated Steatohepatitis).

Iyini ngempela i-MASH (i-Metabolic Dysfunction-Associated Steatohepatitis)?

Kalula nje, i-MASH yisimo lapho isibindi sakho sinamafutha amaningi kakhulu, okubangela ukuvuvukala , isimo esifana nokulimala. Cabanga ngale ndlela: uma unenxeba, indawo iba bomvu, ivuvuke, futhi ishise, futhi kwenzeka into efanayo ngaphakathi kwesibindi. Igama lalesi simo yi-NASH (i-steatohepatitis engeyona utshwala).

Lesi simo, esibizwa ngokuthi i-MASH, siyingxenye yeqembu elibanzi lezifo zesibindi elibizwa ngokuthi i-MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease). Lokhu kubangelwa ukunqwabelana kwamafutha esibindini ngezizathu ezingezona ezokusebenzisa utshwala.

Into ebaluleke kakhulu ukuthi uma lokhu kungelashwa kahle, ngokuhamba kwesikhathi kungaholela ezimweni ezifana ne-cirrhosis, okubangela ukuthi isibindi sibe lukhuni futhi sibe nezibazi, noma ngisho nezifo eziyingozi njengomdlavuza wesibindi. Ngakho-ke, kubaluleke kakhulu ukuqaphela lokhu.

Yiziphi izimbangela ezivame kakhulu ze-MASH? Ubani osengozini?

Imbangela eyinhloko ye-MASH ukunqwabelana kwamafutha amaningi esibindini, okulimaza isibindi futhi kubangele ukuvuvukala. Lesi simo singavela uma kunezinkinga ngokuguqulwa kukashukela namafutha emzimbeni wethu. Ake sibheke izimbangela eziyinhloko kanye nezici eziyingozi ezithinta lokhu:

• Ukukhuluphala ngokweqile noma ukukhuluphala ngokweqile: Lokhu kuyimbangela enkulu.
• Isifo sikashukela sohlobo 2: Abantu abanesifo sikashukela basengozini enkulu yokuthola i-MASH.
• I-cholesterol ephezulu: Amazinga aphezulu e-cholesterol embi egazini.
• Ama-triglyceride aphezulu: Lokhu futhi uhlobo lwamafutha egazini. Ukwanda kwalawa nakho akukuhle.
• Umfutho wegazi ophakeme: Sikubiza ngokuthi umfutho wegazi ophakeme.
• Ukumelana ne-insulin: Lapho amangqamuzana omzimba engasabeli kahle ku-insulin. Lesi yisimo esandulela isifo sikashukela.

Khumbula, ngezinye izikhathi noma ngabe unesisindo esijwayelekile, uma une-cholesterol ephezulu, umfutho wegazi ophakeme, noma izimo ezifana nesifo sikashukela, ungase ube sengozini ethile yokuthola i-MASH. Ngakho-ke, uma unezinye zalezi zici eziyingozi, kuwukuhlakanipha ukubona udokotela wakho bese uhlolwa i-MASH.

Ziyini izimpawu ze-MASH? Uzibona kanjani?

Nansi inkinga: I-MASH ivame ukungabi nazimpawu ezicacile ezigabeni zokuqala.Lesi sifo sikhula kancane eminyakeni eminingi. Ezinye izimpawu ziqala ukuvela kuphela ngemva kokuba isibindi sonakele kakhulu. Uma izimpawu zivela, zingase zihlanganise:

• Ukukhathala: Ukuzizwa ukhathele ngisho noma ungenzi lutho.
• Ukungakhululeki noma ubuhlungu esiswini sakho esingaphezulu kwesokudla: Lapho isibindi sikhona.
• Ukwehlisa isisindo okungachazeki.
• Ubuthakathaka bemisipha noma ukulahleka kwemisipha.
• Isisu noma imilenze evuvukile.
• Uma isimo sibi kakhulu, amehlo nesikhumba siba phuzi (i-jaundice): Lokhu yilokho esikubiza ngezinye izikhathi ngokuthi i-jaundice.

Njengoba kungekho zimpawu ezigabeni zokuqala, kubaluleke kakhulu ukuhlolwa njalo, ikakhulukazi uma unezici eziyingozi njengokukhuluphala ngokweqile, isifo sikashukela, noma i-cholesterol ephezulu. Yilapho-ke ungakwazi khona ukubona lesi simo kusenesikhathi.

Yiziphi ezinye izinkinga ezingaba khona ngenxa ye-MASH?

Uma i-MASH ingelashwa kahle, ingaholela ezinkingeni ezinkulu, ngezinye izikhathi ezisongela ukuphila. Nakhu ukuthi ziyini:

• I-fibrosis yesibindi: Lokhu kuwukuqhekeka kwesibindi. Ngokuhamba kwesikhathi, lokhu kuqhekeka kuyanqwabelana, okuholela ekuqineni kwesibindi.
• I-Cirrhosis: Lesi yisimo lapho isibindi siba nezibazi ezinkulu futhi ukusebenza kwaso kuphazamiseka. Lesi yisimo esihlala njalo, okusho ukuthi kunzima ukusibuyisela emuva.
• Ukwehluleka kwesibindi: Isibindi siyayeka ukusebenza kahle. Lokhu kungenzeka ngokuzumayo. Uma lokhu kwenzeka, ungadinga usizo lwezokwelapha ngokushesha noma ukufakelwa isibindi.
• I-carcinoma yesibindi: I-MASH yandisa ingozi yokuthola lolu hlobo oluvamile lomdlavuza wesibindi.
• Isifo senhliziyo: Abantu abane-MASH basengozini enkulu yokuthola izifo ezihlobene nenhliziyo njengokuhlaselwa yinhliziyo kanye nesifo sohlangothi.

Cabanga nje, konke kuqala ngamafutha amancane esibindini. Yingakho sithi, ungashalazeli ngisho nento encane kakhulu.

Odokotela bahlonza kanjani isifo se-MASH?

Ngenxa yokuthi i-MASH ayibangeli izimpawu ekuqaleni, kunezinyathelo eziningana okudingeka uzithathe ukuze uyixilonge. Udokotela uzokwenza ukuhlolwa ngokomzimba kuqala. Uzobe esekubuza ngezinye izimo zezokwelapha ezingase zandise ingozi yakho yokuthola i-MASH (isb. isifo sikashukela, i-cholesterol). Ngaphezu kwalokho, bangenza izivivinyo ezilandelayo:

Ukuhlolwa kwegazi

Udokotela wakho uzoyala ukuhlolwa kwegazi ukuze kuhlolwe umonakalo wesibindi noma ukuvuvukala. Lokhu kungafaka:

• I-CBC (Inani Eliphelele Legazi): Inani eliphelele lamaseli egazi.
• I-BMP (Iphaneli Eyisisekelo Ye-Metabolic): Ukuhlolwa kwenqubo ye-metabolic eyisisekelo.
• Iphaneli ye-lipid: Hlola amazinga amafutha njenge-cholesterol kanye ne-triglycerides.
• I-Hemoglobin A1C: Ukuhlolwa kokuhlola ukulawulwa kwesifo sikashukela.

Ukuhlolwa kwezithombe

Lezi zivivinyo zingathatha izithombe (izithombe) zengaphakathi lesibindi sakho. Udokotela wakho uzobheka lezi zithombe ukuze ahlole noma yiziphi izinguquko esibindini sakho ezihlobene nesimo se-MASH. Izivivinyo ezinjengalezi zingenziwa:

• Ukuskena kwe-CT (ukuskena kwe-CT - Ukuskena kwe-Computed Tomography)
• Ukuskena nge-ultrasound
• I-FibroScan®: Lolu uhlobo olukhethekile lwe-ultrasound olulinganisa ukuqina kwesibindi. Lokhu kunganikeza umbono we-fibrosis yesibindi.
• I-magnetic resonance elastography kanye ne-proton density fat fraction (MRE-PDFF): Lokhu kungalinganisa ngokunembile inani lamafutha esibindini.

Ukuhlolwa kwesibindi

Ngezinye izikhathi, udokotela wakho kungadingeka athathe isampula encane yezicubu esibindini sakho ebizwa ngokuthi i-liver biopsy. Udokotela wezifo uzohlola isampula ngaphansi kwe-microscope ukuze ahlole amafutha, ukuvuvukala, kanye nezibazi esibindini. I-liver biopsy iyindlela engcono kakhulu yokuxilonga i-MASH ngokunembile.

Ngaphezu kwalokho, udokotela wakho angenza ezinye izivivinyo ukuze anqume ukuthi izimpawu zakho zibangelwa yini esinye isifo sesibindi.

Yiziphi izindlela zokwelapha i-MASH?

Ukwelashwa kwe-MASH kugxile ekuthuthukiseni impilo yomzimba wakho kanye nokuvimbela ukulimala okwengeziwe esibindini sakho. Uhlelo lwakho lokwelashwa lungafaka:

Izinguquko zendlela yokuphila

Ukuze ulawule i-MASH, kubalulekile ukudla ukudla okunempilo, ukukhuthala, nokunciphisa isisindo. Udokotela wakho angase akuncomele ukushintsha indlela yokuphila okufana nalokhu:

• Yidla ukudla okunempilo: Uhlelo oluhle lokudla olusiza ukulawula i-MASH ukudla kwaseMedithera noma ukudla okunama-carbohydrate aphansi . Kalula nje, yidla imifino eminingi, izithelo, ubhontshisi, okusanhlamvu okuphelele okune-fiber, amaprotheni asezingeni elihle (inhlanzi, inkukhu), kanye namafutha anempilo (i-avokhado, uwoyela womnqumo, amantongomane). Kufanele unciphise amaswidi, ukudla okunamafutha, kanye nokudla okusheshayo ngangokunokwenzeka.
• Ukuba matasa: okungenani kanye ngesontoZama ukuzivocavoca umzimba ngamandla aphakathi nemizuzu eyi-150 kuya kwengama-300. Izibonelo zifaka phakathi ukuhamba ngokushesha, ukugijima, ukugibela ibhayisikili, nokubhukuda.
• Gwema utshwala ngokuphelele: Ngisho notshwala obuncane bungalimaza isibindi sakho, ngakho-ke kubalulekile ukuyeka utshwala ngokuphelele.

Imithi

Udokotela wakho angase akunike imithi ethile ukusiza ekunciphiseni izimpawu, njengezibazi, ezibangelwa yi-MASH. Isibonelo:

• I-Resmetiron (Rezdiffra®): Lo muthi ungasiza ekunciphiseni noma ekubuyiseleni izibazi zesibindi ezibangelwa yi-MASH. Yiwona kuphela umuthi ovunyelwe yi-U.S. Food and Drug Administration (FDA) ukwelapha i-MASH ezigabeni 2 no-3 ze-fibrosis.
• Ama-agonist e-GLP-1: Le mithi isiza ekunciphiseni ukuvuvukala namafutha esibindini. Izibonelo zifaka phakathi i-liraglutide (Victoza®, Saxenda®), i-semaglutide (Ozempic®, Wegovy®), kanye ne-tirzepatide (Mounjaro®, Zepbound®). Lezi zivame ukusetshenziswa ukwelapha isifo sikashukela.

Ngaphezu kwalokho, udokotela wakho angase akunike eminye imithi noma izithasiselo. Isibonelo, umuthi wesifo sikashukela obizwa ngokuthi i-pioglitazone (Actoplus Met XR®) noma isithasiselo esifana ne-vitamin E singanconywa.

Abacwaningi okwamanje benza izivivinyo zemitholampilo ukuthola imithi emisha ye-MASH. Ungakhuluma nodokotela wakho mayelana nokuthi ungafaneleka yini ukuhlanganyela esivivinyweni esinjalo.

Ukuhlinzwa kokunciphisa isisindo (ukuhlinzwa kwe-Bariatric)

Uma ukhuluphele kakhulu futhi unesifo sesibindi esibi kakhulu, ukuhlinzwa kokwehlisa isisindo (ukuhlinzwa kwe-bariatric) kungenye indlela yokwelapha. Ukuhlinzwa kwesisu (ukususwa kwengxenye yesisu) noma ukuhlinzwa kwesisu (ukunciphisa isisu) kungakunikeza izinzuzo ezilandelayo:

• Kusiza ukunciphisa isisindo somzimba.
• Umonakalo esibindini obangelwa yi-MASH ungancishiswa ngezinga elithile, futhi mhlawumbe uguqulwe.
• Kunciphisa kakhulu ingozi yokuba nesifo sokuqina kwesibindi, umdlavuza wesibindi, kanye nesidingo sokufakelwa isibindi.

Ingabe i-MASH ingalapheka ngokuphelele?

I-MASH ayilapheki ngaso sonke isikhathi. Kodwa-ke, uma lesi sifo sitholakala kusenesikhathi futhi ukwelashwa kuqalwe kusenesikhathi, ngezinye izikhathi singabuyiselwa emuva noma sivinjelwe ekubeni sibi kakhulu. Lokhu kusho ukuthi kunethuba elihle lokuthi umonakalo owengeziwe esibindini ungavinjelwa.

Umuntu one-MASH angaphila isikhathi esingakanani?

Isikhathi ophila ngaso sincike ekutheni umonakalo ongakanani owenzekile esibindini sakho yi-MASH. Uma lesi sifo sitholakala futhi selashwa kusenesikhathi, abantu abaningi bangaphila impilo evamile.Kodwa-ke, njengoba lesi sifo siqhubekela ezigabeni ezithuthukile, ingozi yokufa kusenesikhathi ngenxa yezinkinga ezifana nokwehluleka kwesibindi kanye nomdlavuza wesibindi iyanda. Kodwa-ke, ukwelashwa kunganciphisa ukuqhubeka kwesifo futhi kuthuthukise ikhwalithi yokuphila. Ukuqala ukwelashwa kusenesikhathi kuyindlela engcono kakhulu yokuthola imiphumela emihle kakhulu.

Kufanele ngimbone nini udokotela?

Uma uzizwa ukhathele ngaso sonke isikhathi, uzwa ubuhlungu noma ukungakhululeki engxenyeni ephezulu kwesokudla yesisu sakho, noma unezimpawu ezifana nokwehla kwesisindo okungachazeki, kubalulekile ukubona udokotela. Lokhu kungaba izimpawu zokuthi kukhona okungahambi kahle ngesibindi sakho. Udokotela wakho uzokwenza izivivinyo ukuze abone ukuthi ngabe yi-MASH noma esinye isifo sesibindi.

Khumbula, izimo ezithile zezokwelapha, njengokukhuluphala ngokweqile kanye nesifo sikashukela sohlobo 2, zandisa ingozi yakho yokuthola i-MASH. Uma unezinye zalezi zimo, udokotela wakho uzohlola njalo ukusebenza kwesibindi sakho.

Okokugcina, izinto ezibaluleke kakhulu okudingeka uzikhumbule

Uma uthola ukuthi une-MASH (i-metabolic dysfunction-associated steatohepatitis), ungase uzizwe ushaqekile futhi wesaba kakhulu. Uma unezimo ezifana nokukhuluphala ngokweqile, umfutho wegazi ophakeme, noma i-cholesterol ephezulu, ungase uzibuze, "Ingabe yimina obangela lokhu?"

Kodwa khumbula into eyodwa. Akukho neyodwa kulezi zimo, okuhlanganisa ne-MASH, eyiphutha lakho. Ithimba lakho lezokwelapha ligxila esikhathini samanje, hhayi esikhathini esidlule. Bazokuchazela ukuthi yiziphi izinyathelo ongazithatha ukuze uphathe i-MASH. Futhi bazoba nawe kuzo zonke izinyathelo zendlela. Ngakho ungesabi.

Into ebaluleke kakhulu ukuqaphela izimpawu, ukuthola izivivinyo ezifanele zezokwelapha uma kunezici eziyingozi, nokulandela iseluleko sezokwelapha. Khona-ke singasindisa isibindi sethu kulesi sitha esithule.

` I-MASH, isibindi esinamafutha, i-cirrhosis, umdlavuza wesibindi, isifo sikashukela, ukukhuluphala ngokweqile, i-cholesterol