Isizathu esiqhelekileyo sokufa ngokukhawuleza kubantu abaselula
Ixesha elide le-QT Syndrome (i-LQTS) yintlupheko ezuze ilifa lenkqubo yombane wenhliziyo . I-LQTS inokukhokelela kwinto engazelelwe, engalindelekanga, esongela ubomi be- tachycardia ye- ventricular ebizwa ngokuba yi- torsades of pointes . Abantu abane-LQTS basemngciphekweni we- syncope (ukulahlekelwa kwengqondo) kunye nokufa ngokukhawuleza, ngokuqhelekileyo esemncinane.
Umzobo - Torsades of pointes. Umfanekiso ophezulu: Isiqhelo sentliziyo. Umzantsi osezantsi: Torsades of pointes. "I-Torsades de pointes" ithetha ukuhluthwa kwinqanaba. Kulo lungqungquthela, isandi senhliziyo sikhawuleza ngokukhawuleza, kwaye ukuma kwezinto ezinzima kwi-ECG zihlala ziguquka, zihlala zifana neprogram yomtshini wesininzi njengolu mfanekiso. Xa intsebenzo yombane yendlela eziphatha ngayo ngale ndlela, ukupompa okusebenzayo akunakwenzeka
Sibanzi
Abantu abane-LQTS baye bachitha ixesha elide kwi-QT kwi- ECG yabo. Ixesha le-QT limela ukubuyiswa kwexesha, okanye "ukuhlawula," kweseli yesifo. Emva kokuba umtsalane weentliziyo ugqugquzela iseli senhliziyo (oko kubangela ukuba ibethwe), ukuhlaziya kufuneka kwenzeke ukwenzela ukuba iselungele ilungele umbane olandelayo. Ixesha le-QT (elilinganiselwa ukusuka ekuqaleni kweQRS ezinzima ukuya ekupheleni kwe-T wave) lide ubude bexesha elithathayo ukuze likhutshwe, kwaye lizalise i-cell cell. Kwi-LQTS, ixesha le-QT lide. Ukungaqhelekanga kwixesha le-QT lijongene nama-arrhythmias anxulumene ne-LQTS.
Izizathu
I-LQTS yintlungu ezuze ilifa. Iindiza ezininzi ziye zachongwa ezichaphazela ixesha lokuhamba kwe-QT, ngoko ke iintlobo ezininzi ze-LQTS zikhona. Ezinye iintsapho zineziganeko eziphezulu kakhulu ze-LQTS. Ngenxa yokuba izityalo ezininzi zinokuphazamisa ixesha le-QT, ukuhlukahluka kwe-LQTS kuye kwachongwa.
Ezinye zezi ("i-classic" ze-LQTS) zidibaniswa neziganeko eziphezulu ze-arrhythmias kunye nokufa ngokukhawuleza, okuqhelekileyo kuvela kwiintsapho ezininzi. Ezinye iifom ze-LQTS ("i-LQTS variants") ingaba yingozi kakhulu. Uninzi lwezi zimilo zemizimba zibonakaliswa ngethuba eliqhelekileyo lexesha lokuqala le-QT, kwaye i-arrhythmias ye-cardiac ngokubanzi ibonakala kuphela xa enye into eyongezelelweyo (njengonyango lweziyobisi, okanye ukungalingani okukhulu kwe-electrolyte) yenza ixesha lokwenza i-QT.
Nangona kunjalo, xa izikhathi ze-QT zenza ixesha elide kubantu abaneendlela ezinjalo ze-LQTS, i-arrhythmias eziyingozi zenzeka.
Ukukhula
I-LQTS ze-Classic zikhoyo malunga nabangama-5000 abantu. I-LQTS yenye yezona zizathu eziqhelekileyo zokufa ngokukhawuleza kubantu abancinci, okubangelwa ukufa phakathi kuka-2000 no-3000 ngonyaka. Iintlobo zee-LQTS zixhaphake kakhulu, kwaye mhlawumbi zichaphazela ukufikelela kwi-2 - 3% yabemi.
Iimpawu
Iimpawu ze-LQTS zivela kuphela xa isigulane sikhula isiqhelo se-tachycardia engozini, kwaye iqondo leempawu lixhomekeke kubude bexesha lokugcina i-arrhythmia. Ukuba ihlala nje imzuzwana nje, imizuzwana embalwa yokwehliswa komdaka ogqithiseleyo ingaba yodwa impawu. Ukuba iqhubeka iminyaka engaphezu kwe-10 okanye, i-syncope iyenzeka. Yaye ukuba ihlala ngaphezu kwemizuzu embalwa, ixhoba ngokuqhelekileyo aliyi kuphinda liphinde likwazi.
Kuzo zineentlobo ezahlukeneyo ze-LQTS, iziqwenga zivame ukubangelwa ukugqabhuka ngokukhawuleza kwe-adrenaline; ezinokuthi zenzeke ngexesha lokuzikhandla ngokomzimba, xa ziphazamiseka kakhulu, okanye xa zithukuthela kakhulu.
Ngenhlanhla, abaninzi abantu abaneengxaki ze-LQTS abazange bafumane iimpawu ezisongela ubomi.
Ukuxilongwa
Oogqirha kufuneka bacinge nge-LQTS kunoma ubani oye waba ne-syncope okanye ukuboshwa kwentliziyo, kunye namalungu entsapho omntu onamaLQTS awaziwayo.
Naliphi na umntu omncinci onesivumelankulu esenzeka ngexesha lokuzilolonga, okanye nakweyiphi na imeko apho kuphakanyiswe khona amanqanaba e-adrenaline, kufuneka ukuba ii-LQTS zigwebe ngokuthe ngqo.
Ukuxilongwa kwe-LQTS ngokuqhelekileyo kwenziwa ngokuqwalasela ixesha eliqhelekileyo lexesha le-QT kwi-ECG. Ngamanye amaxesha ukuhlolwa kweetreadmill kuyimfuneko ukukhupha i-ECG engafanelekiyo. Uvavanyo lwe-Genetic lwe-LQTS kunye neendidi zayo ziba zixhaphake ngokuqhelekileyo kunokuba kusekuncinane nje iminyaka embalwa edlulileyo.
Unyango
Izigulane ezininzi ezine-LQTS zinyango ziphathwa nge- beta blockers . Ababethi beta bethintela ukunyuka kwe-adrenaline ezenza iziqwenga ze-arhythmias kwezi zi gulane.
Ngelishwa, akukabonakali ukuba i-beta-blockers iyanciphisa kakhulu iziganeko ze syncope kunye nokufa ngokukhawuleza kwizigulane ezine-LQTS.
Kubaluleke kakhulu kubantu abane-LQTS kunye neentlobo zayo ezihlukeneyo ukukhusela amaninzi amaninzi abangela ukongezwa kwexesha le-QT. Kula bantu, ezo ziyobisi ziyakwazi ukukhupha iziqwenga ze-torsades of pointes. Izidakamizwa ezenza ixesha elide le-QT litshatyalaliswe. Abaphambili abaphulaphuli, ngokukrakra, iziyobisi ezidlulileyo ; iimithi ezininzi zokuxhatshazwa, kunye namayeza anjenge-erythromycin, i-clarithromycin erythromycin, ne-azithromycin. I-CredibleMeds igcina uluhlu lwezilwanyana ezivame ukulinda ixesha le-QT.
Kubantu abaninzi abane-LQTS, i- defibrillator enokutsha iyona yonyango olungcono. Esi sixhobo sifanele sisetyenziswe kwizigulane eziye zahlala ziboshwe, kwaye mhlawumbi kwizigulane ezine syncope ngenxa ye-LQTS ngakumbi ukuba i-syncope iyenzeka ngelixa sele ithatha i-block blockers.
Kubantu abangenako ukunyamezela i-beta blockers okanye abasenayo imicimbi ngexesha lonyango, ukutyalwa kwe-cardica yokunikwa kwengqondo (LCSD) kungenziwa.
I-block block ye-sodium ingasetyenziswa kunye ne-LQTS uhlobo lwe-3.
Imithombo
> Yintoni i-QT syndrome ende? - NHLBI, NIH. AmaZiko eZiko lezeMpilo. http://www.nhlbi.nih.gov/health/health-topics/topics/qt/. Ukuhlaziywa kweSeptemba 21, 2011. Kufumaneka ngoJulayi 27, 2016.
> Alders M, > Christiaans > I long QT syndrome . Iincwadi zeNcwadi zeNCBI; NgoJuni 18, 2015. http://www.ncbi.nlm.nih.gov/books/NBK1129/. Kufumaneka ngoJulayi 27, 2016.
Moss AJ. Long QT Syndrome. JAMA 2003; 289: 2041.
Li H, Fuentes-Garcia J, Towbin JA. Iingcamango zangoku kwi-QT syndrome. Umntwana weCardiol 2000; 21: 542.