I-Postural orthostatic tachycardia syndrome (i-POTS) yimeko apho izinga lentliziyo linyuka liye lisezingeni elingavamile xa umntu ephakame. Abantu abanePOTS bahlala bebona iimpawu xa bethe tye. Iimpawu eziqhelekileyo zihamba ngokukhawuleza kunye neepilpitations , ezinokuthi zihluke ngokukhawuleza ukusuka ekunciphiseni ukunyanzelisa.
Ukongeza kwinqanaba lentliziyo elikhawulezayo, ngamanye amaxesha banakho ukulahla kwixinzelelo lwegazi xa bemi. Ukufikelela kuma-40% abantu abafumene i-POTS ekugqibeleni baya kuba neqonga elilodwa le- synncope (ukudlula).
I-POTS yintlungu yabantu abaselula. Abaninzi abanalo le meko baphakathi kweminyaka eyi-14 ukuya kwe-45 ubudala, kwaye ngokuqhelekileyo banempilo. Abasetyhini banamathuba amahlanu ukuya kumahlanu amathuba okuphuhlisa ii-POTS kunamadoda. Ubungqina bePOTS bubonakala bukhona kwezinye iintsapho.
Yintoni eyenza i-POTS?
Iingcali azivumelani nezizathu zePOTS. Abanye baye baxela ukuba i-deconditioning (njengokuba emva kokulala embhedeni) okanye ukutyhila amanzi, kodwa le miqathango yesikhashana kwaye ihamba ngokukhawuleza, ngelixa i-POTS ihlala iqhubeka.
Kungenzeka ukuba i-POTS ifom ye- dysautonomia , intsapho yeemeko ezibangelwa ukungalingani kwinkqubo ye- nervous autonomic - inxalenye yesimiso senzwa esilawula imisebenzi "engaziwayo" yomzimba, njengokuguga, ukuphefumla kunye nentliziyo.
Xa inkqubo ye-nervousic ne-hormone iphela, i-symptom iyonke imele ibangele, iquka inkqubo ye-cardiovascular, ukuphefumla, inkqubo yokugaya inyama , izihlunu kunye nesikhumba.
Kukho iindidi ezinama-syndromes ezicingelwa ukuba zibangelwa yi-dysautonomia, kubandakanywa i- fibromyalgia , isifo esingapheliyo sokugula , isifo esilumkileyo se-bowel syndrome kunye ne- sinus tachycardia engalunganga .
Nangona kunjalo, abantu abane-dysautonomia bahlala befumana iimpawu eziba phakathi kwezi ntlobo ezahlukeneyo.
Yintoni eyenza i-POTS-okanye, ngenxa yolu hlobo, nayiphi na i-dysautonomias-ayiyazi. Nangona kunjalo, njengokuba kunjalo kwi-dysautonomias, ukuqala kwe-POTS kudla ngokukhawuleza, kwaye kudla ngokulandela isigulo esichengileyo (njengesifo esibi sengumkhuhlane); isiganeko soxinzelelo (njengothambo oluphukileyo, ukubeletha okanye ukuhlinzwa); ukutyhila kwiibisi (njengeAgent Orange); okanye uxinzelelo olubi lwengqondo (njengengxaki yokulwa noxinzelelo okanye uxinzelelo olusisigxina).
Izifundo kubantu abane-POTS zibonisa ukuba nabo banokuguqula umsebenzi wesistim somnxeba ochaphazela ngokugqithiseleyo imida engezantsi, kwaye unokufumana umthamo wegazi ongaphantsi kunexesha eliqhelekileyo.
Izimpawu ngePOTS
Abantu abane-POTS banokuluhlu lweempawu xa bethe tye; iimpawu ziyahluka ngokukhawuleza ukusuka kumntu kumntu. Kwiinkoliso ezininzi ze-POTS, iimpawu zincinci. Kwabanye, iimpawu ziyakwazi ukukhubazeka.
Iimpawu eziqhelekileyo ziyintetho, ukunyaniseka, ukuzondwa, ukubonwa ngumbono, ubuthathaka, ukunyaniseka kunye neemvakalelo zokuxhalabisa. Ngaphantsi kaninzi, i-syncope iyakwenzeka.
I-POTS ngezinye ilala kunye nezinye i- dysautonomia syndromes , ngoko abantu abanePOTS banako ukufumana iimpawu ezongezelelweyo ezifana nezicathulo zesisu, ukuqhaqhaqhaqha, isifo sohudo, ukuqhaqhaqhaqha, ukunyuka kunye neentlungu kunye nokukhathala okukhulu.
Ukuphucula ngempumelelo intlawulo yenhliziyo eyenzekayo xa ukuma akuqinisekisi ukuba ezi "ezinye" iimpawu (ukuba zikhona) ziya kuhamba.
I-POTS ichongwa njani?
Oogqirha kufuneka bakwazi ukuxilonga i-POTS ngokuthatha imbali yonyango ngokucophelela nokuqhuba uviwo olusemgangathweni. Isihluthulelo sokuxilonga sibonisa ukuba izinga lentliziyo landa ngokungaqhelekanga kwisithuba esithe tye. Oku kuthetha ukuba ukuba unempawu ezibonisa ukuphambuka kwe-POTS, ugqirha wakho kufuneka athathe ingcinezelo yegazi ubuncinane kabini - kanye ngelixa ulala phantsi kwaye kanye ngelixa umile.
Ngokuqhelekileyo, xa umntu ephakanyisiwe, intliziyo yesinyuli iphakama ngama-10 ngeebhokhwe ngomzuzu okanye ngaphantsi.
Nge-POTS, ukwanda kudla kakhulu kuninzi - ngokuqhelekileyo ukushaya kwe-30 ngomzuzu okanye ngaphezulu. Ngamanye amaxesha ukunyuka okungavamile kwentlawulo yenhliziyo kwenzeka kuphela emva kokuba isiguli simile imizuzu emininzi.
Ngenxa yesi sizathu, ukuba i-POTS ikhunjulwa ukuhlolwa kwetafile e-tilt ingaba luncedo ekwenzeni ukuxilongwa.
Ukuba ukwanda okungavamile kwentlawulo yenhliziyo ngelixa ukuma kufunyenwe, ugqirha wakho kufuneka afune ezinye iimbangela ezinokubakho, njengokungcoliswa kwamanzi, ukuhlaselwa kwindlala yokulala, ixesha lokuhlala unobungozi besifo sikashukela okanye iziyobisi ezahlukahlukeneyo (ingakumbi i- diuretics okanye imishanguzo yegazi ). Ukuba akukho nanye kwezi zizathu zikhoyo, ngoko ukuxilongwa kwePOTS kungenziwa ngokuzithemba.
Inyaniso yokuba i-POTS ivelisa le njongo, ukufunyanwa ngokuphindaphindiweyo (oko kukuthi, ukwanda kwenani lentliziyo xa limi), linika abantu abane-POTS ithuba elifanelekileyo malunga nabantu abanezinye iindidi ze-dysautonomia, apho imeko yabo ivelisa embalwa (ukuba naziphi) iinjongo ezifunyenweyo. Abantu abaninzi abanamahlwempu abane-dysautonomia baxelelwa ngaphezu kogqirha omnye ukuba "baxhalabile". Oogqirha balahlekelwa ukuxilongwa ngokupheleleyo kufuneka bangabonakali kubantu abanePOTS.
I-POTS ithathwa njani?
Njengazo zonke i-dysautonomias, ukuphatha i-POTS ngokuqhelekileyo yinto yokulinga-kunye nephutha, ukuzama iindlela ezahlukeneyo zonyango de ukuba iimpawu zibekwe phantsi kolawulo olufanelekileyo-ngokuqhelekileyo inkqubo enokuthatha iiveki okanye iinyanga. Nangona kunjalo, ekubeni nje ugqirha kunye nesigulane zihlala ziqhubeka, iimpawu zilawulwa kwininzi labantu abanePOTS.
Kukho iindlela ezintathu eziqhelekileyo zokonyango - ukwandisa umthamo wegazi, ukusebenzisa unyango, kunye neziyobisi.
Umthambo wegazi ungakulungiswa ngokukhuthaza ukunyusa okumanzi, ukutywala ityuwa eninzi, kunye / okanye ukuthatha i-fludrocortisone, imithi yonyango eyanciphisa amandla eentso ukukhupha i-sodium. Ngenxa yokuba ukuhamba kwamanzi okuqhelekileyo kubonakala ngokuqhelekileyo, kubaluleke kakhulu ukuthatha amanzi okuqala okokuqala-ngaphambi kokuphuma ebhedini, ukuba kunokwenzeka.
Ubu bungqina ngoku lubonisa ukuba uqeqesho lokusebenzisa umzimba olude lwexesha elide lunokuphucula kakhulu i-POTS. Ngenxa yokuba kunokuba nzima kakhulu kubantu abane-POTS ukwenza umsebenzi owenza ukuba bahlale bathembekileyo, isicwangciso somsebenzi esisemthethweni phantsi kolawulo singadingeka. Ngokuqhelekileyo, ezi nkqubo ziza kuqala ngokubhukuda okanye kusetyenziswe imishini yokugungqa, engayifuni ukuhamba ngokuthe tye. Ngokuqhelekileyo, emva kwenyanga okanye ezimbini, umntu onePOTS uyakwazi ukutshintsha ukuhamba, ukuqhuba okanye ukuhamba ngebhayisikili. Ukuba unayo i-POTS, kuya kufuneka uqhubeke nenkqubo yakho yokuqhuba umhlala-phantsi ukugcina iimpawu zakho zingabuyi.
Iziyobisi eziye zasetyenziswa kunye nempumelelo ethile ukuphatha i-POTS ziquka i-midodrine kunye ne- beta blockers . Ezinye iingxelo zibonisa ukuba i-pyridostigmine (i-Mestinon) ingaba luncedo. Ngokwahlukileyo kwezinye iindlela ze-dysautonomia, i-serotonin reuptake inhibitors (SSRIs) ayibonakaliyo nayiphi na inzuzo kwi-POTS.
I-Ivabradine (isilwanyana esisetyenziswe kubantu abane-sinus tachycardia engafanelekanga), nayo isetyenziswe ngokufanelekileyo kwabanye abantu abane-POTS, kwaye izifundo ezisesikweni ziyaqhubeka nokuvavanya iilisi kule njongo.
Oogqirha abaninzi abaphatha i-POTS bazame zonke iindlela ezintathu kwi-bat. Uphulo luqalisiwe ukuphucula ivolumu yomthamo, inkqubo yovavanyo, kwaye unyango lweziyobisi (rhoqo kunye ne-midodrine) luqalisiwe. Ngokukodwa ukuba isicwangciso sexesha elide sokwenza umzimba singasungulwa, unyango lwamayeza kaninzi luyakunqunyulwa ekugqibeleni.
ILizwi
I-POTS yimeko enokuphazamisa nokukhungathekisa abantu abasemncinci, abanye abantu abanempilo abahluphekayo. Iindaba ezilungileyo kukuba, emva kokuxilongwa, umntu ophethe i-POTS kufuneka alindele ukuphumeza ukulawula okugculisayo iimpawu zabo, nje ngokuba bona kunye noogqirha babo abayekanga ukufumana inxaxheba efanelekileyo yonyango oluya kubasebenzela .
> Imithombo:
> Arnold AC, Okamoto LE, Diedrich A, et al. I-Propranolol ephantsi-kunye ne-Exercise Capacity kwi-postural Tachycardia Syndrome: i-Randomised Study. Neurology 2013; 80: 1927.
> Freeman R, Wieling W, Axelrod FB, et al. Ingxelo yesigqibo malunga neNkcazo ye-Orthostatic Hypotension, i-Syncope engokwemvelo kunye ne-Postural Tachycardia Syndrome. Auton Neurosci 2011; 161: 46.
> Kimpinski K, Figueroa JJ, Umculi W, et al. I-Outlook, I-1-year Study-up of Postural Tachycardia Syndrome. IMayo Clin Proc 2012; 87: 746.
> Thieben MJ, uSandroni P, uSletten DM, et al. I-Postural Orthostatic Tachycardia Syndrome: I-Mayo Clinic Experience. IMayo Clin Pro 2007; 82: 308.