I-Lupus, eyaziwa ngokuba yi-systemic lupus erythematosus okanye i-SLE, isifo esizimele esingasenza sichaphazele phantse nayiphi na inxalenye yomzimba, kodwa ngokuqhelekileyo isikhumba, amaqhina, izintso, imiphunga, ingqondo-nentliziyo.
Iingxaki zentliziyo zibonakala kubantu abane-lupus ngokubanzi bawela kwiintlobo ezinhlanu. Zezi:
- Myocarditis
- Izifo zePericardial
- Iinqununu zomzimba
I-Lupus neCoronary Artery Disease
I-Lupus inxulumene nokunyuka okukhulu kwe- atherosclerosis , okanye ukuqina kwama-arrivri eyenza i-CAD. Ngenxa yoko, iCAD idla ngokuphindaphindiweyo kubantu abane-lupus ngexesha elincinane. Umngcipheko okhulayo we-CAD wangaphambi kwexesha kunye ne-lupus ngowona mkhulu kubasetyhini abaselula.
Isizathu sokuba i-lupus ikhulise umngcipheko we-CAD ibonakala ibini. Okokuqala, abantu abane-lupus bavame ukufumana ubuninzi bezinto ezinobungozi benhliziyo: ukukhuluphala, ukuphila ngokwempilo , ukunyuka kwegazi , ukunyuka kwama-cholesterol , kunye ne-syndrome ye-metabolic . Isizathu sokuba le mingcipheko ixhaphake kubantu abaphila ne-lupus bangakho ngenxa yesifo ngokwalo (okungenza nantoni na engaphezulu kwendlela yokuphila engumceli mngeni), okanye mhlawumbi ekusebenziseni i-steroids ekunyangeni kwe-lupus.
Okwesibini, i-lupus iyanda ukuvuvukala okubonakalayo kwimithanjeni yegazi, kunye nokuvuvukala emitanjeni yegazi ngumqhubi omkhulu we-atherosclerosis, kunye nokuphuka kwamathala .
Ukuthintela i-CAD , ukuxilongwa kwe-CAD , kunye nokunyangwa kwe-CAD kubantu abane-lupus bafana nakweyiphi na enye. Nangona kunjalo, ekubeni ukusabalalisa kwe-CAD, ngakumbi kubantu abaselula, kuphakamileyo kakhulu kwi-lupus, kubalulekile ukuba abo bane-lupus (kunye noogqirha babo) ukuba bajonge iimpawu ezibonisa i-CAD.
Izifo ze-Lupus neenhliziyo zeVilve
ULupus idibene nesifo senhliziyo. Ukuvuvukala okuqhelekileyo okunxulumene ne-lupus kunokubangela iimveliso ezahlukahlukeneyo zokuvuvukala zifakwe kwiintsimbi zentliziyo . Le miveliso evuthayo, edla ngokubandakanya izixhobo zegazi, ama-immune complexes, kunye neeseli ezivuthayo, zingenza "izityalo," ezinokukhula okufana neendwangu.
Ezi zityalo (ezithandwa kakhulu kwi-valve mitral kunezinye iintsimbi zentliziyo) kaninzi azibangeli nayiphi na ingxaki ebonakalayo yeengqondo. Nangona kunjalo, kwabanye abantu abane-lupus izilwanyana zinokuba zikhulu ngokwaneleyo ukuvelisa i- mitral regurgation , ekhokelela ekusileleni kwintliziyo; banokusuleleka, bekhokelela ekupheleni kwe- endocarditis ; okanye zinokubangela ukwakheka kwegazi, okukhokelela ekubetheni .
Ukuba izityalo ziba zikhulu ngokwaneleyo ukuvelisa intliziyo egungqelekileyo (eyinto eqhelekileyo), i- echocardiogram inokukunceda ukuvavanya ubukhulu bezityalo. Ukuba zikhulu ngokwaneleyo, okanye ukuba zibonisa ukukhula okukhulu ngexesha elide, i- endocarditis prophylaxis inokumiselwa. Kwezinye iimeko, i- blood thinners inokucetyiswa ukunciphisa umngcipheko wesifo.
I-Lupus ne-Pericardial Disease
I-Pericardial effusion kunye ne- pericarditis ziqhelekileyo kwi-lupus.
Imiphumo ye-Pericardial ibonakala kubaninzi abangama-50 ekhulwini abantu abane-lupus ngexesha lokugula kwabo.
Ngethamsanqa, i-pericardial effusions ngokuvamile ayivelisi iimpawu, kwaye zivame ukufunyanwa ngengozi, xa wenza i-echocardiogram ngesizathu esithile. Ukunyangwa okuthe ngqo kwezi mpawu ngokuqhelekileyo akuyimfuneko, kwaye i-effectious impulse ihlala isombulula ngokwabo.
Ukongeza kwi-pericardial effusions, i-pericarditis (ukuvuvukala kwimbali ye-pericardial) ingabonwa nakwabantu abane-lupus. Xa i-pericarditis ikhona, ngokuqhelekileyo oko kubonisa ukuba i-lupus isigaba esisebenzayo, oko kukuthi, kuvelisa iingxaki ezibandakanya ezinye iinkqubo zesebe.
I-pericarditis ivame ukuxhaswa njengoko i-lupus flare ekhoyo ilawulwa phantsi. Ukuba kukho unyango oluthile olufunekayo, i-pericarditis ye-lupus ngokuqhelekileyo isabela kunyango kunye neziyobisi ezingekho-steroidal ezichasayo (i-NSAID) .
Lupus kunye neMyocarditis
I-Myocarditis-ukuvuvukala kwintliziyo yentliziyo-ngenhlanhla, ayiqhelekanga kubantu abane-lupus. I-Lupus myocarditis ngokwayo ayivelanga ngokukhawuleza iimpawu, kodwa ekugqibeleni ingabangela ukuba buthathaka kunye nokuhlaziywa kwentliziyo, kunye nokunyamekela ukuhluleka kunye neemeyimu ze-cardiac arrhythmias. Ukuba kunjalo, zonke iimpawu zesifo senhliziyo zingakhula.
I-Myocarditis kwi-lupus idla ngokufunyanwa emva kwenhliziyo ekhulisiweyo ibonakala kwi-x-ray yesifuba okanye i-echocardiogram, kodwa kunokunokukrokra ukuba i- tachycardia engacacanga (intliziyo yezinga elikhawulezayo) ekuphumuleni iyaphawulwa.
Ngokufana ne-pericarditis, i-myocarditis ibonakala ngokuphindaphindiweyo xa i-lupus isigaba esisebenza ngokuqhelekileyo, ngokuquka iinkqubo ezininzi zesebe. Ukuphuculwa kwentshukumo yomzimba kubonwe kwezinye izigulane ezine-lupus myocarditis xa ziphathwa kakubi kwi-lupus esebenzayo , zisebenzisa i-steroids kunye nezidakamizwa zokuzibulala.
Lupus neArrhythmias
Emva kwesiganeko se-lupus myocarditis, iintlobo ezahlukahlukeneyo zebhokisi yenhliziyo zenzeka. Ngokuqhelekileyo ezi zihloko zebhloko zentliziyo zibuhlungu kwaye zizinzileyo, kwaye azidingi ukusetyenziswa kwe- pacemaker .
Ukongeza, i-tachycardia engapheliyo ngexesha lokuphumla ingabonwa kubantu abane-lupus. Le tachycardia inokuvelisa iipilpitations, kwaye ibonakala ngokuqhelekileyo kubantu abaphethwe i-lupus njengamanje kwisigaba esisebenzayo.
Isishwankathelo
Kubantu abane-lupus, kukho ithuba eli-50-50 lokuba inxalenye ethile yokubandakanyeka kwenhliziyo iza kuvela. Bona kunye noogqirha babo kufuneka baqaphele iimpawu ezingabonakalisa iingxaki zentliziyo, ingakumbi isifuba esifubeni kunye nokuphefumula okufutshane, kwaye kufuneka zikhawuleze ukuba zilandele ukuba zikhona izifo zentliziyo ukuba iimpawu ziyavela.
> Imithombo:
> Doria A, Iacacino L, Sarzi-Puttini P, et al. Ukubandakanya iKardiac kwi-Systemic Lupus Erythematosus. Lupus 2005; 14: 683.
> Hak AE, Karlson EW, Feskanich D, et al. I-Lupus Erythematosus ne-Risk of Diseases: Iziphumo ezivela kwi-Nurses's Health Study. Arthritis Rheum 2009; 61: 1396.
> Magder LS, Petri M. Ukunyuka kwezinto kunye Neziphumo zobungozi zeZifo eziMoya eziPhakathi kwezigulane nge-Lupus Erythematosus. Am J Epidemiol 2012; 176: 708.
> Schattner A, Liang MH. Umthwalo we-Cardiovascular Lupus: Umngeni weComplex. Arch Intern Med 2003; 163: 1507.