Umbuzo: Apheresis I-LDL i-Cholesterol
Umzala wam oneminyaka engama-12 ubudala unamazinga aphezulu kakhulu e-cholesterol, athethayo ngenxa yokufa. Eli nqanaba liphezulu kakhulu kangangokuba oogqirha bakhe bayancoma ukuba uqale unyango oluthiwa "apheresis." Ukusuka kumncinci ndiyazi ngalo, oku kukuvakala kakhulu kum. Ngaba unganditshela nge-apheresis, nokuba ingaba yinto efanelekileyo yengane?
Impendulo: Kukho iintlobo ezininzi zeengxaki zefa ze- LDL cholesterol . Eyona ndawo ixhaphakileyo yile yenyango ye-hypercholesterolemia (FH). Abantu abane-FH, ngokukodwa abo banesimo esibi kakhulu seengxaki, banomngcipheko omkhulu wokuba nesifo se-cardiovascular premature. Amanqanaba aphezulu e-LDL e-cholesterol kule meko akhona ukusuka ekuzalweni, kwaye aqala ukulimaza inkqubo ye-cardiovascular ebuncinane-ngoko ke abantu abane-hypercholesterolemia yomhlobo kufuneka baphathwe ngisho nangona bantwana.
I-mainstay yonyango ye-FH kukusetyenziswa kweziyobisi ze- statin . Kulo maninzi abantu abaneli meko, ama-statins aya kunciphisa amazinga e-cholesterol ye-LDL ngokubanzi. Kodwa kulabo abaneendlela ezinzima kakhulu zeempawu zesifo abahluleki ukusebenza kakuhle, kwaye ingozi yomzimba ihlala iphezulu kakhulu. Aba bantu kuthiwa "banokuxhatshazwa ngamachiza e-hypercholesterolemia."
Kukho iindlela ezininzi zokunyanga izigulane ezine-hypercholesterolemia ezingamelana neziyobisi; akukho nanye kubo elula okanye enomdla. Kwiindlela ezikhoyo, lowo oye wafumana uvavanyo oluninzi yi-apheresis.
Apheresis
Kwi-apheresis, igazi le-cholesterol-laden blood is pumped out of a vessel, kwaye iqhutywe ngendlela ekhupha iiprotheni (ezibizwa ngokuba yi-lipoproteins) eziqukethe i-LDL-cholesterol.
Ekugqibeleni, igazi elincitshisiweyo le-cholesterol libuyiselwa kwi-circulation circulation. (Le nkqubo ifana ne- hemodialysis esetyenziselwa izigulane ezinokuphelelwa yintliziyo.)
I-Apheresis iyanciphisa amanqanaba e-LDL ye-cholesterol ngamanqaku angama-75%. Nangona kunjalo, kuba isibindi kulezi zigulana senza i-LDL ye-cholesterol eninzi, amazinga e-LDL abuyele emva kweentsuku ezimbalwa. Ngoko i-apheresis idla ngokufuneka iyenze ubuncinane kanye ngeveki, kwaye ngamanye amaxesha kabini ngeveki.
Ukuqalisa ukwelashwa kwe-apheresis, ngokucacileyo, kukuzibophezela okukhulu ngexesha kunye nokuphazamiseka, kwaye libiza kakhulu. Ukongezelela, inokuvelisa iziphumo ezintle eziqhelekileyo, ezibandakanya uxinzelelo lwegazi oluphantsi, i- anemia , kunye nentloko. Ekugqibeleni, njengoko kunjalo kwiigulane ezine-hemodialysis, abo banesifo se-apheresis bafuna ukuba nenkqubo yokucubungula ukwenza i-fistula ehamba phambili (edibanisa i-artery kunye ne-vein ngaphansi kwesikhumba), eyenza lula ukufikelela kwiimitha zegazi ezifunekayo yi-apheresis .
Ukuphumelela kwe-apheresis kubantwana abaneengxaki ezinzima ze-cholesterol kuye kwafundwa. Nantsi i- UpToDate , inkcazelo yekhompyutheni yoogqirha kunye nezigulane, kufuneka uthethe ngeziphumo ze-apheresis kubantwana:
Ukhuseleko kunye nokusebenza kweLDL-apheresis elide elide liye lahlolwa kwisifundo sezingane ezili-11 ezinomdlavuza we-hypercholesterolemia (kubandakanywa nabantwana abane-homozygous FH) abaphethwe iminyaka emi-2 ukuya kwe-17. Kwakungekho nto yokufa kwegazi, ukungabikho komonakalo we-myocardial infarctions, okanye inkqubo ye-coronary revascularization. Ukunyanzeliswa kwezilonda ze-coronary artery, kunye nokuthintela ukuphuhliswa kwezilonda ezintsha ze-aortic kunye ne-coronary lesions, kuboniswe.Ngamanye amazwi, nangona zonke iingxaki ze-apheresis, ubuncinci olunye lubonakala lubonisa ukuba le ndlela yonyango - kubantwana, ubuncinane - ayinciphisi kuphela amanqanaba e-LDL ye-cholesterol, kodwa ibonakala iphinde inciphise kakhulu umngcipheko wokuphucula isifo se-cardiovascular premature . Ngoko naphezu kwazo zonke izithintelo zalo, i-apheresis yinto emele iqwalaselwe kubantwana abaneendlela ezinzima ze-hypercholesterolemia ezingaphenduliyo kwiimimiselo.
Ixesha elide
Ngethamsanqa, ngoku kubonakala ukuba i-apheresis ayinakuzibophelela. Ngombulelo ophuhliso lwakutshanje olwenziwe uphando kwi-genetic yabantu, uphuhliso olutsha oluthembekileyo luye lwaphuhliswa, olujoliswe kwiingxaki ezithile ze-genetic ezivelisa i-FH. Amachiza amatsha phantsi kophuhliso anethuba elihle kakhulu lokunciphisa ngokuphumelelayo i-LDL cholesterol ukuya ekujoliswe kumanqanaba. Kuchanekile ukuba ukhangele i-apheresis kubantwana abane-FH njengesilinganiselo esilula - njengendlela yokugcina imithwalo yegazi "ihlambuluke" ngelixa silindele ngakumbi, kwaye kulula kakhulu, unyango lwezokwelapha.
Ufuna ukufunda ngaphezulu? Jonga isihloko se-UpToDate, "I-Hypercholesterolemia yesiFundo" malunga nolwazi olongezelelweyo lwezonyango.
Imithombo:
I-Rosenson RS, i-SD Ferranti, i-Durrington P. unyango lwe-hypercholesterolemia enganyangekiyo. Isemgangathweno. Kufumaneka, ngoJulayi 2012.