Kwixesha elidlulileyo, isizathu esinyanisekileyo sokuba oogqirha babeke unyango lwe-cholesterol "liphezulu ye-cholesterol." Ukuba uvavanyo lwakho lwegazi lwe-cholesterol lubonwa "luphakame kakhulu," ugqirha wakho mhlawumbi unokunyusa unyango-mhlawumbi ngeenguqu zokuphila, ezifana nokutya kunye ukusetyenziswa, okanye mhlawumbi kunye neentlobo ezininzi zamachiza afumanekayo ukunciphisa ama- cholesterol .
Kwiminyaka emininzi yophando lweklinikhi, nangona kunjalo, iholele iingcali ekugqibeleni ukuba le ndlela yayingalunganga. Ngo-2013, izikhokelo ezintsha zapapashwa yiqela leengcali ezivela kwi-American Heart Association kunye ne-American College of Cardiology. Ezi zikhokelo zincoma indlela eyahlukileyo yokuphatha i-cholesterol.
Namhlanje, iingcebiso zonyango azisekelwe kuphela kwizinga le-cholesterol, kodwa kunoko, kwinqanaba elipheleleyo leengozi yengqondo. Amazinga e-Cholesterol ngokwabo athatyathwa, kodwa nje kuphela nje kwizinto ezininzi ezibeka umngcipheko wentliziyo.
Ngoobani Abafuna Ukuphathwa?
Ukuphindaphinda, ngokwemiqathango ye-2013, nokuba uya kufuneka uphathwe kuxhomekeke kwinqanaba lakho elipheleleyo lomngcipheko wokuphuhlisa isifo senhliziyo. Nangona i- LDL ye-cholesterol yenqanaba ngokuqinisekileyo igalelo kule mngcipheko, umngcipheko wakho unokuba phezulu kakhulu ukuba ingaba liphezulu le-LDL liphakanyisiwe okanye cha.
Ukulinganisa umngcipheko wakho jikelele kuthetha ukuba ugqirha wakho uya kufuna ukuqwalasela imbali yakho yezonyango, ukuhlolwa ngokomzimba, kunye nowe, iziphumo zakho zebhu.
Xa oko kwenziwa, ugqirha wakho kufuneka akunike enye yezinto ezinobungozi ezintlanu:
Icandelo 1: Uloluhlu ukuba sele uyaziwa ukuba unesifo sokuthi u-atherosclerosis evelise ingxaki yeklinikhi. Udidi 1 luquka abantu abaye banakho na oku kulandelayo:
- I-coronary artery disease (CAD) eyenze i- angina , okanye i-myocardial infarction (intliziyo yesifo), okanye leyo idinga unyango ngokugqithisa okanye ngokugqithisa
Udidi lwe-2: Udidi lwe-2 lubandakanya abantu abanama-cholesterol ama-LDL angaphezulu kwe-189 mg / dL. Uninzi lwabantu kwiCandelo 2 luya kuba nolunye lweefom ze-hypercholesterolemia. Ngokuphawulekayo, le yodwa inqanaba apho unyango lucebisa kuphela ngenxa yokuba ama-cholesterol amanqanaba "aphezulu kakhulu."
Udidi lwe-3: Udidi lwe-3 lubandakanya abantu abaphakathi kweminyaka engama-40 no-75 abanesifo sikashukela , nabangabikho kwiCandelo 1 okanye-2.
ICandelo le-4: Udidi lwe-4 luquka abantu abangekho nawaphi na amacandelo amathathu okuqala, kodwa izinto ezinobungozi bomzimba wazo zibeka engozini ephezulu yezifo zenhliziyo. Ngokukodwa, ngaba ngabantu abanomngcipheko wokuba nesifo esibi kakhulu senhliziyo (njengentliziyo yesifo okanye isifo soxinzelelo) ubuncinane 7.5% kwiminyaka eyi-10 ezayo. Ukukunceda ukuqikelela umngcipheko we-10 wakho weminyaka, i-NHLBI inikeze i-calculator ye-risk-line elula apha.
Udidi 5: Udidi lwesi-5 luquka wonke umntu ongafanelanga kwiindidi zokuqala ezine. Aba bantu basemngciphekweni we-cardiovascular risk kwaye abadingi unyango.
Ngubani omele ayenze? Wonke umntu kwiCandelo 1 - 4 unomngcipheko ophezulu weengxaki ezinengqondo zengqondo kwiminyaka embalwa, kwaye kufuneka ziphathwe kakubi ukuze zinciphise umngcipheko.
Yiluphi unyango olukhuthazwayo?
Izikhokelo ze-2013 kwi-cholesterol ziye zatshintshwa ngokuphawulekayo kwiphi unyango olucetyiswayo kubantu abakwiindawo ezinobungozi obuphezulu. Nangona izikhokelo ezindala zigxininise ukunciphisa i-cholesterol ukujolisa kumanqanaba enyango, izikhokelo ezintsha azikho. Kunoko, bagxininisa ukunciphisa ubungozi benhliziyo yonke kunokuba bathakise amanqanaba e-cholesterol. Ukunciphisa umngcipheko kusekelwe ekutshintsheni kokuguquka kokuphila, kunye nokusetyenziswa kweziyobisi ze- statin .
Ingxabano ephakathi kweCandelo 4
Abantu abasemagqabeleni 1 ukuya ku-3 banokubeka ingozi enkulu ekuphuhliseni iingxaki zentliziyo, kwaye ngokucacileyo badinga unyango olunefuthe lokunciphisa umngcipheko.
Udidi lwe-4, ngakolunye uhlangothi, lusekwe ukufumana abo bantu basengozini ephakamileyo, kodwa umngcipheko othe wancinci, kwaye ungabonakali kangangoko, kunamacandelo amathathu okuqala. Ukuchaza ukuba ubani omele abekwe kwisiGaba sesi-4, ngoko ke, uqobo luyinkqubo engqalileyo kwaye iya kuvuleka ukuba ivulekele.
Kukho iintlobo ezibini zokugxekwa ezenziwe malunga neCandelo 4. Amabango okuqala ukuba iCandelo 4 linabantu abaninzi kakhulu. Aba bahlaziyi balichaza ukuba i-calculator yomngcipheko ehlinzekwe yi-NHLBI ibeka ingqalelo enkulu kwiminyaka. Ngenxa yesi sizathu, abantu abaninzi abangaphezu kweminyaka engama-60 baya kufumana okanye basondele kakhulu kwi-codff 7.5%. Ukongezelela, bathethe aba bagxeki, umngcipheko weminyaka eli-10 we-7.5% ngokwawo ukhululekile kakhulu. Iingcebiso zonyango kwixesha elidlulileyo zithatha ngakumbi kwi-cutoff ye-10%. Bathi banciphise ngokukhawuleza unyango lwe-7.5%, bathi, ungeze abantu "baninzi" kuloluhlu lwezo kunyango.
Uhlobo lwesibini lokugxekwa malunga neCandelo lesi-4, akumangalisi, lithetha ukuba abantu abaneleyo bayabandakanywa uluhlu lwezokwelapha. Aba bagxeki bathi i-NHLBI yingozi yokubala iquka iimeko ezinobungozi "ezibonakalisiwe" kwizilingo ezilawulwa kakuhle ukuxhasa kakhulu ingozi yomzimba: ubudala, i-LDL kunye ne-HDL ye-cholesterol amanqanaba, nokuba ngaba okwamanje uyabhema, kwaye ingaba omnye uye waphakamisa uxinzelelo lwegazi lwe-systolic. Ishiya ezinye izinto ezinobungozi ezisemgangathweni ezithatyathwa njengezona zibalulekileyo, kodwa ezingakhange zihambisane nemilinganiselo eqinile yeNHLBI yokufakwa. Iimeko ezinobungozi ezinjalo ziquka imbali yentsapho yezifo zesifo se-cardiovascular premature, umlando odlulileyo wokutshaya, amazinga e-CRP aphakamileyo , indlela yokuphila yokuhlala, kunye ne- coronary artery calcium scan . Ukuba ezi zinto zibalulekileyo zengozi zifakiwe, abaninzi abantu baya kuhlangabezana neendlela zokunyanga.
Ingxabano enjalo-ingaba iCandelo 4 libandakanya kakhulu okanye limbalwa kakhulu abantu-lihambelana naluphina isincophiso esinqunywe ngokukhawuleza yiqela leengcali.
Ingaba iimeko zomngcipheko zomntu zaneleyo ukulungiselela unyango kufuneka, ubuncinci, kushiywe kumguli ngamnye kunye nodokotela. Umngcipheko ongakanani umntu ozimisele ukuwamkela ukuba ahlaselwe yintliziyo okanye ahlaselwe yintlungu ngexesha leminyaka eli-10 ezayo? 7.5%? 10% Ezinye ixabiso? Ngaba i-NHLBI yokubala ingozi iyakwamkelwa ngokubaluleka komntu, okanye ingabe imingcipheko eyongeziweyo ingacingwa malunga nokuthatha isigqibo ngonyango?
Ngokuqinisekileyo kulungelelanisa iphaneli yeengcali ukwenza iingcebiso malunga noku. Kodwa ngenxa yemibuzo enjengaleyo, ukuba ngokwemvelo kufanele imiselwe ngabanye, ezo ngcebiso akufanele zibophe. Isigqibo sokugqibela sokuba unyango kufuneka sishiye kumagqirha kunye nezigulane.
> Imithombo:
Stone NJ, uRobinson J, uLichtenstein AH, et al. 2013 ACC / AHA isikhokelo kwonyango ye-cholesterol yegazi ukunciphisa ingozi ye-carrososis kubantu abadala: ingxelo ye-American College of Cardiology / American Heart Association. J Am Coll Cardiol 2013.