Xa umntu enesihlungu, unyango olungcono (zombini unyango olunzima, kunye nonyango lokuthintela olunye uhlangothi) kuxhomekeke kwizinto ezenzileyo . Ngoko kubaluleke kakhulu ukuba oogqirha bawubhale phantsi kwesizathu saso nasiphi na isifo.
Ngelishwa, ukuya kuma-40 ekhulwini kwabemi baseMerika abanomdla wokuphela kwesigxina ekupheleni kokuhlaselwa kwe- cryptogenic stroke , oko kuthetha ukuba nangemva kokuvavanywa ngokupheleleyo kwezobugqirha, imbangela yokubethelwa kwabo isaziwa.
Ngaphandle kokungazi isizathu, unyango olungcono lwe-stroke lwawo kuphela lunokusekelwe kumsebenzi wokuqikelela.
Kwiminyaka emininzi abaphandi bazama ukuqonda ukuba zeziphi iimeko zonyango ezinokubangela ukubetha ngaphandle kokushiya isicatshulwa esicacileyo, oko kukuthi, zeziphi iimeko zonyango ezinokuthi zivelise imivimbo ye-cryptogenic. Amacandelo amabini ayenzileyo athatyathelwe ingqalelo i- patent foramen ovale (PFO) kunye ne-fibrillation ye-atrial . Ukugqiba ukuba ngaba i-PFO inokuba yimbangela ye-stroke ye-cryptogenic ibonakalise nzima kwaye ingqubuzana.
Ingxabano encinane yingozi engabonwa yi-friday frillation. Isisu, inkxalabo eyoyikisayo ye-friday fibrillation, rhoqo rhoqo kwizigulane ezine-arrhythmia. Kwaye ngoku kubonakala ukuba ukufabiliswa kwe-atrial kungabangela isizathu esiqhelekileyo sesifo sokukrakra njengokuba sasiqaphela ngaphambili.
I-Fibrillation ye-Atrial & Cryptogenic Stroke
Nangona kubangelwa ukuba kubangele iimpawu ezibalulekileyo (ezifana neepilpitations kunye nobunzima obunzima), iziqulatho ze-fibrillation ye-arrivals zingenzeka ngaphandle kokuvelisa nayiphi na impawu. Kule meko, akukho isigulane okanye ugqirha unokuba naluphi na uluvo lokuba i-fibrillation ye-agriyo eyenzekayo. Ngoku ngoku kucaca ngokucacileyo ukuba ezi ziqendu ze "subclinical" (okokuthi, ezingabonakaliyo) i-fibrillation yearriyibangela ebalulekileyo ye-cryptogenic stroke.
Ucwaningo lwe-CRYSTAL-AF, oluzama ukulinganisa ukuba i-fibrillation ye-acillation ephindaphindiweyo ingabangela njani ukubethelwa kwe-cryptogenic, yabheka abantu abangama-414 ababenokubethelwa kwangaphambili kwe-cryptogenic. Abaphandi bafake umboniso omncinci wendlela yokujonga umphefumlo-i-Device reveal (i-Medtronic, Inc.) -kuzo ezinokubeka iliso kwisimo somntu kwisithuba seminyaka emithathu.
Ekupheleni kweso sifundo, iipesenti ezingama-30 zezigulane ezinezigulane zengqondo zenziwe zaba neziqulatho ze-fibrillation zangaphambili ezingabonakali. Ngokwahlukileyo, kwiqela elilawulayo lezigulane ezingama-220 ezibethelwa i-cryptogenic stroke zahlolwa ngaphandle kokubekwa kwenyameko kwangexesha elide, iziqulatho ze-fibrillation ye-acrial zabonwa ngaphantsi kweepesenti ezimbini.
Oku kuphakamisa izinto ezimbini ezintsha ngefayibrillation ye-atrial kunye ne-cryptogenic stroke. Okokuqala, i-fibrillation ye-acillination ye-acrypt mhlawumbi ixanduva lwamacala amaninzi kakhulu okubetheka kwe-cryptogenic kunokuba saziwa ngaphambili. Kwaye okwesibini, iliso elide lexesha elide lingafuneka ukuba lichonge izigulane ezinengxaki. (Ixesha eliqhelekileyo iliso elinyanisiweyo lale ndawo lisetyenziswe kule sifundo ngaphambi kokuba kufumaneke i-fibrillation ye-agriyiti yimihla engama-84.)
Esi sifundo asiqinisekisi ukuba i-fibrillation ye-agriyo yayijongene nezibetho ze-cryptogenic kuzo zonke izi gulane, kwaye akukho nto ibonisa ukuba ukusebenzisa izidakamizwa ezichasayo kunokuphucula iziphumo zabo.
Iimvavanyo zemizekelo yeziphumo zangexesha elide ziya kubakho ukubonisa ngokucacileyo ezi zinto. Kodwa siyazi ukuba abantu abane-stroke e-cryptogenic banomngcipheko ophezulu wokubethelwa kwexesha eliqhelekileyo, ukuba i-fibrillation ye-agriyo yandisa kakhulu umngcipheko wesifo, kwaye loo unyango olwaphulo-mthetho luyanciphisa umngcipheko wokuba uhlangothi lwe-friday frillation. Ngale ngongoma engqondweni, iipesenti ezingama-97 zezigulane kwizifundo ze-CRYSTAL-AF eziye zachongwa njenge-subclinical frillment fibrillation zafakwa kwiidakamizwa ezichasene noogqirha.
UkuLinda kweNkatha Yentliziyo
Ngokusekelwe kulokho esikuziyo namhlanje, ukubeka esweni kwexesha elide kufuneka kuthathelwa ingqalelo kwizigulane eziye zine-cryptogenic stroke, ingakumbi ukuba oogqirha bazo batshintshe iingcebiso zabo zonyango ngokusekelwe kwisiphumo sohlolo.
Ukubekwa esweni kwangexesha elide kunokwenzeka ngokuqhelekileyo kwimizimba yesiganeko. Iindlebe zeenhliziyo ezixakekayo zingasetyenziswa ngokususela kwiintsuku ezingama-30, ixesha lokubeka iliso eliye laboniswa ukufumanisa inani elininzi lezigulane ezine-fibrillation ye-acill. Kwaye ukujonga i-cardiac-long-long-long-car -ac-stages-usetyenziso kwi-CRYSTAL-AF yokufunda kunye neendlela ezincinci "zesizukulwana esilandelayo" ziyafumaneka ekusebenziseni ukliniki.
Ukuba wena okanye othandekayo uye waba ne-cryptogenic stroke, kwaye ukuba ugqirha wakho unokutshintsha unyango lwakho kuxhomekeke ekubeni ingafunyanwa ngumbono we-fridayyria, kufuneka uxoxe nogqirha ngokubhekiselele kwimeko yokujonga ilanga elide.
Imithombo:
Iziphumo ze-CRYSTAL-AF Trial. I-International Stroke Conference (ISC) 2014. I-Abstract LB11. Kuhanjiswe ngoFebruwari 14, 2014.
Liao J, Khalid Z, Scallan C, et al. Ukuqapha kwengqondo okungabonakaliyo ekuboneni i-paroxysmal fibrillation okanye i-flutter emva kwe-acrochemic stroke. Stroke 2007; 38: 2935.
Hylek EM, Hamba AS, Chang Y, et al. Umphumo wokuqina kwe-antiticoagulation ngomlomo ngokuqina kwesithintelo nokufa kwi-fibrillation ye-atrial. N Engl J Med 2003; 349: 1019.