Izifundo Fumana uxhumano olunokwenzeka phakathi kwama-Statins kunye nokuvutha
Ucwaningo luye lwafumanisa iziphumo ezinobuncedo beemimiselo , kuquka ulwalamano phakathi kwama-statins nokuvuvukala .
Yintoni ukuvuvukala?
Ukuvuvukala kuyincenye yesabela somzimba ngokuqhelekileyo kwingozi okanye intsholongwane. Xa ufumana ukulimala okwenzakala (ukuchithwa okanye ukusika), indawo ejikelezileyo ngokubanzi iyavuleka kwaye ivule kancane. Ezi zibonakaliso zangaphandle zokuvuvukala, imiqondiso yomzimba ehambelana nomonakalo.
Ingxenye yendalo yokuphulukisa. Kodwa akusoloko kunceda.
Ukuvuvukala kwenzeka xa i-immune system ithumela kwiiseli ezimhlophe zegazi ezimhlophe kwindawo ewonakalisiweyo. Ezi seteli zikunceda ukulwa naluphi na ukhuseleko kwaye zihlambulule iiseli ezifile ezishiywe emva. Inqubo efanayo eyenzekayo ngokunqunyulwa, ukunyunyuzwa okanye ukuxhamla kwenzeka nakwenzakalo kwintliziyo yomzimba okanye iirriyiti.
Indima ye-LDL i-Cholesterol ekuvukeleni
Ngendlela efanayo, umzimba uthumela amajoni omzimba wokumothusa kwiindawo ezifudumeleyo ezijikelezayo-oko kukuthi, iiplats ezakhiwe yi-cholesterol embi ( LDL ) kwiindonga zombane. Ngelishwa, xa i- macrophages ithatha le mihlaba, ingaba ne-cholesterol kwaye iqukumbele yongeze kwi-mass mass (kunye ne-mess) ye-plaque. Nangona kuthethwa ukulwa nomlenze, impendulo yokuvuvukala impela yenza i-plaque ibe yomelele kwaye iyancipha ngakumbi, kwaye leyo ingakhokelela ekuhlaselweni kwentliziyo okanye ngesifo.
Ukongezelela, ukuvuvukala entliziyweni nasemithanjeni yegazi kubangela ukuba iindonga zeendonga zegazi zibe "ezinamathele" kwaye zilungele ukutsala iiseli zegazi ezongezelelweyo kunye ne-cholesterol, ezenza i-plaque, okanye iipiliti kwiipasiti zokuhlala ezikhoyo. Ekugqibeleni, le nkqubo inokubangela ukuhamba kwegazi kunye ne-oxygen.
Ukuba ityitha echaphazelekayo inika intliziyo okanye ingqondo, kwakhona, umphumo unokuba sisifo senhliziyo okanye isifo .
Iprotheni eSebenzayo yeC-C in Inflammation
Xa ukuvuvukala kubakho nawuphi na emzimbeni, amaprotheni athile akhululwa kwigazi elingenakulinganiswa ngeemvavanyo zegazi. Ezinye iimvavanyo, ezifana ne- erythrocyte sedimentation rate (ESR, okanye i-"sed rate") zilinganiso eziqhelekileyo zokuvuvukala. Iprotheni esebenzayo e-C (i-CRP) yinye isilinganiselo sokuvuvukala okanye isifo kumzimba. Amanqanaba e-CRP ngaphezulu kwe-10 mg / L yimiqondiso yokuba ukutshaya kubakho endaweni ethile emzimbeni. Nangona kunjalo, xa i-CRP iphakanyiswa ngokukhawuleza, phakathi kwe-1 mg / L ukuya ku-3 mg / L, iboshwe kwiingxaki zesimo senhliziyo, oko kukuthi, intliziyo kunye nemithambo yegazi.
Nangona amazinga aphezulu e-CRP inxalenye yempendulo yendalo yomzimba kwiinkathazo, nazo ziindaba ezimbi. Bangakwazi ukuxela ukuhlaselwa kwentliziyo kubantu abangakaze babe nako ngaphambili. Kwimeko yezigulane ezithatha iinkqubo ezithile zeentliziyo - kuquka i- angioplasty , ukufakwa kweentsimbi kunye ne- coronary arter -pass - kunye nabo baneentlungu zesifuba-ezinxulumene nentliziyo - enginezinzile zesifo okanye angina ezingaqinisekanga-ezi nqanaba eziphezulu ze-CRP zidibene ingozi yokunyuka kwesifo senhliziyo okanye isifo soxinzelelo kunye nokufa okukhulu.
Ngakolunye uhlangothi, ukuthintela ukuvuvukala kunceda abantu abasengozini yesifo senhliziyo. Izinto ezibalulekileyo zeengxaki zentliziyo zibandakanya uxinzelelo oluphezulu lwegazi , isifo sikashukela , i-cholesterol ephezulu, ukutshaya okanye intsapho yentsholongwane yesifo.
Ziziphi izitatimende ezenzayo ekuvukeleni nasekunciphiseni amanqanaba e-CRP?
Iitatimins ziyinxalenye ebalulekileyo yamachiza ephantsi kwezinga le-cholesterol. Iitatimins zinceda ukunqanda isifo senhliziyo, ukushaywa komzimba kunye nenye ingozi enxulumene ne-cholesterol embi kakhulu (i-LDL) egazini. Ngokuzithoba ziphakamisa amanqanaba egazi ye-cholesterol enhle ( HDL ). Iitatimins zisebenza ngokuthintela i-enzyme ebizwa ngokuba yi-HMG-CoA yokunciphisa into ebalulekileyo ekwenzeni i-cholesterol embi kumafutha azalisiweyo ekudleni.
Ukongezelela ekunciphiseni amazinga e-cholesterol amabi, ama- statins nawo anceda ukuhla kwezinga legazi le-CRP. Nangona umphumo we-cholesterol-blocking effect uqondwa kakuhle, iindlela zokunciphisa i-CRP kunye nokuvuvukala azikwazi ngokupheleleyo. Iingcali zenzululwazi zikholelwa ukuba i-statins ivimba iiprotheni kunye neeseli ze-immune ezikhutshwe njengenxalenye yomzimba oqhelekileyo wokuvuvukala. Ukunciphisa eli nqanaba leeprotheni kuvimbela ukuvuvukala kungenzeki.
Kwakhona kubonakala ukuba ukusetyenziswa kwexesha elide leemimiselo kubangelwa ukuvuvukala okuncinci kwintliziyo kunye neengxaki ezimbalwa. Izifundo zezigulane ezithatha i- angioplasty ngokubonisa ukuba abantu ababethatha i-statins ngaphambi kwenkqubo babe namazinga angaphantsi kwe-CRP emva koko kwaye babengenakukwazi ukuhlaselwa yintliziyo okanye bafe ngonyaka emva kwenkqubo.
Izifundo zezigulane ezinemivimbo ye-ischemic ziye zafumanisa ukuba kwithuba elifutshane kunye no-1 ngonyaka emva kokuphazamiseka, izigulane ezithatha izitho zinezikhundla eziphantsi zeRPP kunye neziphumo eziphuculweyo. Ezi nzuzo zazibandakanya ukuphazamiseka kwamathambo amaninzi, njengentetho kunye neengxaki zokunyakaza. Kwakukho negalelo eliphantsi lokufa kunyaka emva kokuhlaselwa. Ukongezelela, ama-statins anciphisa ingozi yokuphazamiseka komntu kubantu abaye bafumana isiganeko esibuhlungu, njengesihlungu senhliziyo.
Kanye njengoko ubukho be- CRP egazini bunokuqikelela iingxaki zentliziyo, ukunciphisa amanqanaba e-CRP kunciphisa ingozi ye-cardiovascular attacks of heart or other cardiovascular events, kubandakanywa nesifo. Nangona indlela echanekileyo isacacile, izazinzulu zenze ikhonkco ecacileyo phakathi kwama-statins kunye nokunciphisa amanqanaba e-CRP. Ngaphezu koko, uphando lubonisa ukuba inzuzo enkulu ekuthatheni i-statins yilabo bantu baqala ngamanqanaba aphezulu e-CRP; ezi zinzuzo zingaphezulu kunokuba zingabalwa ngempembelelo kwizinga le-cholesterol yedwa.
Kubalulekile ukuba ukhumbule ukuba amanqanaba e-CRP aphantsi kunye nama-statins akwanele ngokwabo ukukhusela isifo senhliziyo. Nangona iinqanaba eziphantsi zeRPP zinenzuzo, yonke into eyenza ingozi ye-cardiovascular risk factor - njengesifo sikashukela, ukunyuswa kwengcinezelo yegazi , ukutshaya, ukukhuluphala kunye / okanye i- cholesterol ephezulu-inokubangela isifo senhliziyo kwaye iphakamisa umngcipheko wokuba nesifo senhliziyo okanye isifo. Indlela efanelekileyo yokukhusela le micimbi kukusebenzisa, ukulandela ukutya okunempilo, okunomsoco ophantsi kwaye uthathe imithi enqunyiwe njengoko kunconywe ngumboneleli wakho wezempilo ukuze uncede unciphise ubuninzi bakho engozi.
Imithombo:
Chan, uAlbert W., et al. "Ulwalamano lokuvuvukala kunye neNzuzo yeeNkcazo Emva kokungenelela kweCononary Percutaneous." Ukujikeleza 107 (2003): 1750-6.
UDi Napoli, Mario, noFrancesca Papa. "Ukuvuvukala, izitatimende, kunye nesiphumo emva kwesifo seSikemikhe." Stroke 32 (2001): 2446-a.
UHennekens, uCharles H. "Ukukhusela okuPhambili kweCoronary Heart Heart and Stroke." UpToDate.com. NgoDisemba 8, 2015.
Jonsson N, no-K Asplund. "Ngaba Ukuxhatshazwa Ngama-Statins Ukuphucula Isiphumo Sokliniki Emva Kwesiqhwaba? I-Case Case-Referent Study." Stroke 32 (2001): 1112-5.
S., et al. Ukunciphisa i-Myocardial Ischemia nge-Aggressive Cholesterol Lowering (MIRACL) Abaphandi Bokufunda. "Ukuvuvukala, iStatin Therapy, kunye neengozi yeStroke emva kwesifo seCoronary Acute kwiSifundo seMIRACL." I-Arteriosclerosis, iThrombosis, neVascular Biology 28 (2008): 142-7.
URossens, uRobert S. "Iinkqubo zoNcedo lweLipid ezantsi kwezilonda ezinezifo zentliziyo yeCoronary Heart". UpToDate.com . Ngomhla wama-16, 2015.
URosenson, uRobert S. "Uqheliso lweNyango ye-Hypercholesterolemia." UpToDate.com . 2008. UpToDate. 30 kuMatshi2008
UWalter, uDirk H. et al. "I-Statin Therapy, Ukuvuvukala kunye Neziganeko zeCoronary eziPheleleyo kwizigulane zilandela ukufakwa kweCoronary Stent Implantation." Umbhalo we-American College of Cardiology . 38 (2001): 2006-12.
Ewe, Edward TH, H. Vernon Anderson, uVincenzo Pasceri, noJames T. Willerson. "Iprotheni esebenzayo yeC-C: Ukudibanisa ukuvuvukala kwiinkxalabo ze-Cardiovascular." Ukujikeleza 104 (2001): 974-5.