IHypercholesterolemia eqhelekileyo

I-hypercholesterolemia eyaziwayo sisifo esidluliswa ziintsapho. Ibangela ukuba i-LDL (embi) inqanaba le-cholesterol liphezulu kakhulu. Imeko iqala ngexesha lokuzalwa kwaye inokubangela ukuhlaselwa yintliziyo besebancinci.

Izihloko ezihambelanayo zibandakanya:

• Usapho oludibeneyo lwe-hyperlipidemia
• Ihypertriglyceridemia eqhelekileyo
• Idysbetalipoproteinemia eqhelekileyo yosapho

I-hypercholesterolemia eqhelekileyo kukuphazamiseka kwemfuza. Kubangelwa sisiphene kwi-chromosome 19.

Isiphene senza ukuba umzimba ungakwazi ukususa i-lipoprotein (LDL, okanye embi) ye-cholesterol egazini. Oku kubangela inqanaba eliphezulu le-LDL egazini. Oku kukwenza ukuba ube nokuncipha kwemithambo ye-atherosclerosis usemncinci. Imeko ihlala idluliswa kwiintsapho ngendlela ebalaseleyo ye-autosomal. Oko kuthetha ukuba ufuna kuphela ukufumana uhlobo olungaqhelekanga lomzali omnye ukuze usifumane esi sifo.

Kwiimeko ezinqabileyo, umntwana unokufumana ilifa kubazali bobabini. Xa oku kusenzeka, ukwanda kwinqanaba le-cholesterol kuba nzima kakhulu. Umngcipheko wokuhlaselwa sisifo sentliziyo kunye nesifo sentliziyo ziphezulu, kwanasebuntwaneni.

Kwiminyaka yokuqala kungabikho zimpawu.

Iimpawu ezinokuthi zenzeke zibandakanya:

• Amanqatha esikhumba anamafutha abizwa ngokuba yi-xanthomas ngaphezulu kwezandla, iingqiniba, amadolo, amaqatha kunye ne-cornea yeliso
• I-cholesterol ifaka kwiinkophe (xanthelasmas)
• Intlungu yesifuba (i-angina) okanye ezinye iimpawu zesifo se-coronary disease zingabakho mncinci
• Ukuxinana kwithole elinye okanye omabini xa uhamba
• Izilonda ezinzwaneni ezingaphilisiyo
• Iimpawu ezinje ngequbuliso ezinje ngengxaki yokuthetha, ukujinga kwelinye icala lobuso, ubuthathaka bengalo okanye umlenze, kunye nelahleko yokulinganisa

Uvavanyo lomzimba lunokubonisa ukukhula kolusu olunamafutha olubizwa ngokuba yi-xanthomas kunye ne-cholesterol deposits kwiso (corneal arcus).

Umboneleli wezempilo uya kubuza imibuzo malunga nembali yakho yonyango kunye nosapho. Kunokubakho:

• Imbali yosapho eyomeleleyo ye-hypercholesterolemia yosapho okanye ukuhlaselwa kwentliziyo kwangoko
• Inqanaba eliphezulu le-LDL cholesterol kubo bobabini okanye bobabini abazali

Abantu abavela kwiintsapho ezinembali eyomeleleyo yokuhlaselwa kwentliziyo kwangoko kufuneka kwenziwe uvavanyo lwegazi ukumisela amanqanaba eepidid.

Uvavanyo lwegazi lunokubonisa:

• Inqanaba eliphezulu le-cholesterol iyonke
• Inqanaba le-LDL ephezulu
• Amanqanaba aqhelekileyo e-triglyceride

Olunye uvavanyo olunokwenziwa lunokubandakanya:

• Izifundo zeeseli ezibizwa ngokuba zii-fibroblast ukubona indlela umzimba oyifunxa ngayo i-cholesterol ye-LDL
• Uvavanyo lwe-Genetic lwesiphene esihambelana nale meko

Injongo yonyango kukunciphisa umngcipheko wesifo sentliziyo. Abantu abafumana ikopi enye yohlobo olunesiphene kubazali babo banokwenza kakuhle ngokutshintsha kokutya kunye neziyobisi ze-statin.

UTSHINTSHO KWIMPILO

Inyathelo lokuqala kukutshintsha into oyityayo. Uninzi lwexesha, umboneleli uya kuncoma ukuba uzame oku iinyanga ezininzi ngaphambi kokuyalela amayeza. Ukutshintsha kokutya kubandakanya ukunciphisa inani lamafutha owadlayo ukuze ibe ngaphantsi kwe-30% yeekhalori zakho zizonke. Ukuba utyebe kakhulu, ukunciphisa umzimba kuluncedo kakhulu.

Nazi ezinye zeendlela zokusika amanqatha apheleleyo kukutya kwakho:

• Yitya inyama yenkomo encinci, inkukhu, inyama yehagu, kunye nemvana
• Faka endaweni iimveliso zobisi ezinamafutha apheleleyo ngeemveliso ezinamafutha asezantsi
• Susa amafutha atshintshiweyo

Ungasithoba isixa secholesterol oyityayo ngokususa izikhupha zamaqanda kunye nenyama yomzimba efana nesibindi.

Kunganceda ukuthetha nomntu otya ukutya okunokukunika iingcebiso malunga nokutshintsha indlela otya ngayo. Ukwehla kobunzima kunye nokuzilolonga rhoqo kunokunceda ukuthoba inqanaba le-cholesterol yakho.

AMAYEZA

Ukuba utshintsho kwindlela yokuphila alutshintshi inqanaba lakho le-cholesterol, umboneleli wakho unokucebisa ukuba uthathe amayeza. Zininzi iintlobo zamachiza akhoyo ukunceda ukuthoba izinga le-cholesterol egazini, kwaye zisebenza ngeendlela ezahlukeneyo. Ezinye zibhetele ekwehliseni i-cholesterol ye-LDL, ezinye zilungile ekwehliseni i-triglycerides, ngelixa ezinye zinceda ukuphakamisa i-cholesterol ye-HDL. Abantu abaninzi baya kuba kumayeza aliqela.

Iziyobisi zestatin zihlala zisetyenziswa kwaye ziyasebenza. La machiza anceda ukunciphisa umngcipheko wokuhlaselwa yintliziyo kunye nokufa icala.

Ziquka:

• ILovastatin (Mevacor)
• I-Pravastatin (Pravachol)
• ISimvastatin (iZocor)
• IFluvastatin (iLescol)
• Atorvastatin (Lipitor)
• I-Pitivastatin (Livalo)
• IRosuvastatin (iCrestor)

Amanye amayeza anciphisa i-cholesterol aquka:

• Iileyile ezikhupha intlaka yeasidi.
• Ezetimibe.
• Iifibrate (njengegemfibrozil okanye i-fenofibrate).
• Nicotinic acid.
• I-PCSK9 inhibitors, ezinje nge-alirocumab (Ixabiso elixabisekileyo) kunye ne-evolocumab (Repatha). Oku kubonisa udidi olutsha lwamachiza ukunyanga i-cholesterol ephezulu.

Abantu abanesimo esibi sesi sifo banokufuna unyango olubizwa ngokuba yiapheresis. Igazi okanye iplasma iyasuswa emzimbeni. Iifilitha ezikhethekileyo zisusa i-cholesterol engaphezulu ye-LDL, kwaye iplasma yegazi ibuyiselwe emzimbeni.

Ukwenza kakuhle kangakanani kuxhomekeke ekubeni ulandela ngaphi na iingcebiso zonyango lwakho. Ukwenza utshintsho kwindlela otya ngayo, ukuzilolonga, nokuthatha amayeza ngokuchanekileyo kungathoba inqanaba le-cholesterol. Olu tshintsho lunokunceda ukulibazisa ukuhlaselwa yintliziyo, ngakumbi kubantu abanesimo esibi sokuphazamiseka.

Amadoda nabasetyhini abane-hypercholesterolemia yosapho ikakhulu basemngciphekweni wokuhlaselwa sisifo sentliziyo kwangoko.

Umngcipheko wokufa uyahluka phakathi kwabantu abane-hypercholesterolemia yosapho. Ukuba uzuza njengelifa iikopi ezimbini zemfuza ezineziphene, uneziphumo ezibi kakhulu. Olu hlobo lwe-hypercholesterolemia yosapho aluphenduli kakuhle kunyango kwaye kunokubangela isifo sentliziyo kwangethuba.

Iingxaki zinokubandakanya:

• Ukuhlaselwa yintliziyo esemncinci
• Isifo sentliziyo
• Ukubetha
• Isifo se-vascular peripheral

Funa unyango ngokukhawuleza ukuba unentlungu esifubeni okanye ezinye izilumkiso zesifo sentliziyo.

Fowunela umboneleli wakho ukuba unembali yobuqu okanye yosapho yenqanaba le-cholesterol ephezulu.

Ukutya okunezinga eliphantsi lecholesterol kunye namafutha atyebileyo kwaye atyebile kumanqatha angafakwanga kunokunceda ukulawula inqanaba lakho le-LDL.

Abantu abanembali yosapho yale meko, ngakumbi ukuba bobabini abazali baphethe ufuzo olungalunganga, banokufuna ukucebisa ngemfuza.

Uhlobo II hyperlipoproteinemia; Xercholesterolemic xanthomatosis; Ubunzima be-lipoprotein receptor mutation

• Ikholesterol - yintoni ekufuneka uyibuze kugqirha wakho

• Xanthoma - kufutshane
• Xanthoma edolweni
• Ukuvaleka kwemithambo yegazi

UGenest J, uLibby P.Lipoprotein ukuphazamiseka kunye nesifo sentliziyo. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ii-eds. Isifo sentliziyo seBraunwald: Incwadi yesifundo seMpilo yeNtliziyo. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2019: isahluko 48.

URobinson JG. Ukuphazamiseka kwemetabolism yelipid. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahl. 195.