I-nitrate ibe yinto ephambili ekunyangeni i-angina iminyaka engaphezu kwe-100. Namhlanje, i-nitrate isetyenziselwa ukunyanga iziqulatho eziqhelekileyo ze-angina (ngohlobo lwe-nitroglycerin okanye i-nitroglycerin oral spray), kwaye ngokungapheliyo (kwifom yefilda okanye njengesikhumba somnxeba) ukunceda ukukhusela i-angina.
I-Nitrates isebenza njani?
I-nitrate isebenza ngokuphucula iirriyiti kunye nemivilini, zombini entliziyweni nakwezinye indawo emzimbeni.
Ukuhlanjululwa ngokubanzi kwemithambo yegazi kunciphisa uxinzelelo kwi-heart muscle, kwaye ngoko kunciphisa inani le-oksijini intliziyo ifuna. Ukunciphisa iimfuno ze-oksijini zenhliziyo kuvumela intliziyo ukuba yenze umsebenzi ongakumbi ngaphandle kokuphuhlisa i- ischemia , nangona igazi liphuma emithambo ye - coronary arteries ivinjiwe yi- atherosclerosis .
Iitrotary iyanciphisa imitha yeeronari. Ekubeni iimpawu ze-coronary zixutywe xa i-atherosclerotic plaque ivimbela ukuhamba kwegazi, oku kusebenza ngokukhawuleza kukusetyenziswa ngabantu abanomdla we- coronary disease . Nangona kunjalo, kubantu abane- Prinzmetal angina - eyona nto ibangelwa yi-coronary artery spasm - i-nitrate ihlala isinceda kakhulu.
Ziyasetyenziswa Njani AmaNitrate?
I-Sublingal (SL) nitroglycerin (nitroglycerin ekhutshwa ngokukhawuleza ukusuka phantsi kolwimi) yindlela edala kunazo zonke yeyeza-nitrate. I-SL nitroglycerin yindlela ekhawulezayo yokukhupha isiqhelo se-angina esilethwa ngumsebenzi okanye uxinzelelo, kwaye ngokuqhelekileyo unikezela ukuphucula ngemizuzu embalwa.
Kwakhona, ukuthatha i-SL nitroglycerin nje ngaphambi kokuba uthathe inxaxheba kwimisebenzi enokubangela iimpawu (njengokunyuka kwentaba okanye ukuhamba ebandayo) kunokunceda ukukhusela iziqendu ze-angina. I-SL nitroglycerin iqala ukuxuba imilambo yegazi ngaphakathi kwemizuzu emibini, kwaye umphumo wayo unokugqibela ukuya kwimitha engama-30.
I-nitrolyerin spray, ehanjiswe emlonyeni ngesisithi se-doered device, isebenza ngokufanayo kwi-SL nitroglycerin - yindlela enye yokuhambisa i-nitroglycerin i-action-acting act.
I-nitrate esifutshane (SL okanye isiqendu) kufuneka iqhutywe yiyiphi na ephathekayo nge-angina.
I-nitrate ende ende (iipilisi okanye i-skin patches) ithathwa njengendlela yesibini yokwelapha ye-angina. Ziyalelwe ukuba i- beta blockers (unyango lokuqala) alukwazi ukunyamezela, okanye alukwazi ukuphelisa iimpawu.
Ifom ye-nitrates yindlela eqhelekileyo eqhelekileyo isosorbide dinitrate (Isordil, Sorbitrate). Nge-nitrate yomlomo, umphumo kwimithambo yegazi iqala malunga nemizuzu engama-30, kwaye ihlala ifikelela kwiiyure ezithandathu.
Iingubo ze-nitroglycerin ezitshintshileyo, ezithumela i-nitroglycerin ngesikhumba, zinika i-nitrate unyango olululo kwiiyure eziyi-8 ukuya kwe-14.
Ukunyamezela
Ingxaki enkulu ekusebenziseni i-nitrate ende ende ibe yinto "yokunyamezela." Ukunyamezela kwe-nitrate kuthetha ukuba iinzuzo zonyango lwe-nitrate ziya kuncitshiswa xa i-nitrate isetyenziswe nge-clock. Ukuthetha nje, xa imithwalo yegazi ihlala ibonakaliswe kwi-nitrate, iyeka ukuxubusha ekuphenduleni i-nitrate, kunye nempembelelo echasayo yeso sidakamizwa iphela.
Ukunyamezela kwe-nitrate kunokuthintelwa ngokucwangcisa i-dosing ye-nitrate yonyango engapheliyo yokubonelela ngexesha elide le-nitrate.
Ngoko: i-nitrate yomlomo okanye i-nitrate yolondolozo lweelinen kufuneka isetyenziswe kuphela kwiiyure eziyi-12 ukuya kwi-16 ngosuku, ngeeyure ezisibhozo ukuya kwe-12 ikhefu "i-nitrate-free". Kuba ezininzi izigulane kuthetha ukuba i-nitrate isetyenziselwa ngexesha lokuvuka, kwaye kungekhona ngexesha lokulala. Kwezinye izigulane ezine-angina zantlanu, kodwa ikhefu elingenayo i-nitrate lingadinga ukucwangciswa ngexesha lokuvusa.
Ezinye iindlela zokuqapha kunye neNitrate
Ama-nitrate akufanele asetyenziswe kwizigulane ezine- hypertrophic cardiomyopathy (apho i-nitrates ingabangela ingozi eyingozi kwigazi ngaphakathi), okanye kwizigulane ezithatha iViagra (sildenafil) okanye ezinye i-agents ezifanayo ze-erectile dysfunction.
( Ukuthatha nitrate kunye ne-Viagra kunye kunokuvelisa i-hypotension enkulu - uxinzelelo lwegazi oluphantsi.)
Ama-Asiya athambekele ekubeni neempendulo ezancinci kwi-nitrate, kwaye abanako ukufumana inzuzo ekusebenziseni kwabo.
Iziphumo eziqhelekileyo ezichaphazelekayo ze-nitrate zintloko kunye nokuxubha, nangona i-head headness evela kwi-hypotension ingenzeka. Izigulane ezineembali ze- migraine ziyaba nzima ukunyamezela i-nitrate.
Imithombo:
Fihn SD, Gardin JM, Abrams J, et al. I-ACCF / AHA / ACP / AATS / PCNA / SCAI / I-ATS / PCN / SCAI / i-STS isikhokelo sokuxilongwa kunye nokulawulwa kwezigulane ezinezifo zesimo senhliziyo esisisigxina: isishwankathelo esiphetheyo: ingxelo ye-American College of Cardiology Foundation / i-American Heart Association iqela elikhokelayo, kunye ne-American College of Physicians, i-American Association ye-Thoracic Surgery, i-Preventive Cardiovascular Association, i-Society for Cardiovascular Angiography kunye neNongenelelo, kunye noMbutho weeNgcali zeTriracic. Ukuhamba ngo-2012; 126: 3097.