Umbuzo: Apheresis For LDL Cholesterol
Umshana wami oneminyaka engu-12 ubudala unamazinga aphakeme kakhulu e-cholesterol, athi asho ngenxa yokuzalwa. Izinga lakhe liphakeme kangangokuthi odokotela bakhe batusa ukuthi uqale ukwelashwa okuthiwa "apheresis." Kusuka kancane engikwazi ngakho, lokhu kuzwakale kunzima kimi. Ungangitshela mayelana ne-apheresis, nokuthi ngabe ingumqondo omuhle wengane?
Impendulo: Kunezinhlobo eziningana zezifo ezizuzwa njengefa le- cholesterol ye- LDL . Okuvamile kulezi zihlobo ze-hypercholesterolemia (FH). Abantu abane-FH, ikakhulukazi labo abanezifo ezinzima kakhulu zesifo, banomngcipheko omkhulu wokuba nesifo se-cardiovascular ngaphambi kwesikhathi. Amazinga aphezulu e-LDL ama-cholesterol kuleso simo akhona kusukela ekuzalweni, futhi aqala ukulimaza uhlelo lwe-cardiovascular esemncane - ngakho abantu abane-hypercholesterolemia yomndeni kudingeka baphathwe ngisho ngenkathi beyizingane.
I-mainstay yokwelashwa ye-FH yukusetshenziswa kwezidakamizwa ze- statin . Kubantu abaningi abanalesi simo, izitembu zizonciphisa amazinga e-LDL ama-cholesterol kakhulu. Kodwa kulabo abanezimo ezinzima kakhulu zesimiso sezifo abahluleka ukusebenza kahle, futhi ingozi yomzimba ihlala iphezulu kakhulu. Laba bantu kuthiwa banesifo se-hypercholesterolemia.
Kunezindlela eziningana zokwelapha iziguli ezine-hypercholesterolemia ezingamelana nezidakamizwa; akekho okulula noma kumnandi. Kwezindlela ezitholakalayo, lowo oye wahlolwa kakhulu yi-apheresis.
Apheresis
Ku-apheresis, igazi le-cholesterol-laden likhishwa emthonjeni wegazi, bese lucubungulwa ngendlela esusa amaprotheni (abizwa ngokuthi i-lipoproteins) aqukethe i-LDL-cholesterol.
Okokugcina, igazi elincishisiwe-le-cholesterol libuyiselwa ekusakazweni kwesiguli. (Le nqubo ifana ne- hemodialysis esetshenziselwa iziguli ezinokwehluleka kwezinso.)
U-Apheresis unciphisa amazinga e-LDL ama-cholesterol ngokulinganiselwa ku-75%. Kodwa-ke, ngoba isibindi kulezi ziguli sikhiqiza okuningi kwe-LDL cholesterol, amazinga e-LDL abuyele ezinsukwini ezimbalwa. Ngakho-ke i-apheresis idinga ukuthi yenziwe okungenani kanye ngesonto, futhi ngezinye izikhathi kabili ngeviki.
Ukuqala ukwelashwa kwe-apheresis, kusobala, ukuzibophezela okukhulu ngesikhathi kanye nokuphazamiseka, futhi kuyabiza kakhulu. Ngaphezu kwalokho, ingaveza imiphumela emibi kakhulu ejwayelekile, kuhlanganise nokucindezeleka kwegazi okuphansi, i- anemia , nekhanda. Okokugcina, njengalabo abagulayo abane-hemodialysis, labo abanesifo se-apheresis ngokuvamile badinga ukuthi benze inqubo yokuhlinza ukudala i-fistula ehlukile (ngokuxhuma ngokuxhuma i-artery kanye ne-vein ngaphansi kwesikhumba), okuyinto eyenza lula ukufinyelela njalo emifuleni yegazi edingekayo yi-apheresis .
Ukusebenza kwe-apheresis ezinganeni ezinenkinga enkulu ye-cholesterol kuye kwacutshungulwa. Nakhu okushiwo i- UpToDate , irekhodi lobuchwepheshe labodokotela neziguli, kufanele lisho ngemiphumela ye-apheresis ezinganeni:
Ukuphepha nokusebenza kwe-LDL-apheresis yesikhathi eside kwahlolwa ekuhlolisweni kwezingane ezingu-11 ezine-hypercholesterolemia ezifuywayo (kubandakanya izingane ezine-homozygous FH) ezaphathwa iminyaka emibili kuya kweyishumi nambili. Kwakungekho ukufa komzimba, ukuhlukunyezwa okungasona okubulalayo kwe-myocardial, noma izinqubo ze-coronary revascularization. Ukuhlukunyezwa kwezilonda zamakhemikhali ezinomzimba, kanye nokuvimbela ukuthuthukiswa kwezilonda ezintsha ze-aortic ne-coronary, kwaboniswa.Ngamanye amazwi, naphezu kwazo zonke izithiyo ze-apheresis, okungenani ucwaningo olulodwa lubonakala lubonisa ukuthi le ndlela yokwelashwa - ezinganeni, okungenani - hhayi kuphela inciphisa amazinga e-LDL ye-cholesterol, kodwa futhi ibonakala iyanciphisa kakhulu ingozi yokuthuthukisa isifo senhliziyo ngaphambi kwesikhathi . Ngakho-ke naphezu kwazo zonke izithiyo zalo, i-apheresis yinto okufanele ibhekwe njengabantwana abanezinhlobo ezimbi ze-hypercholesterolemia ezingaphenduli emasimini.
Isikhathi Eside
Ngenhlanhla, manje kubonakala ukuthi i-apheresis ingase ingabi ukuzibophezela impilo yonke. Ngenxa yentuthuko yakamuva yokucwaninga nge-genetics, kunezinhlobo eziningi zokwelapha ezintsha ezithembisayo ezakhiwe, ezihloswe ngezifo ezithile ezakhiwe yi-FH. Imithi emisha ngaphansi kokuthuthukiswa inethuba elihle kakhulu lokunciphisa ngempumelelo i-LDL cholesterol kuze kufike emazingeni ahlose. Kungenzeka ukuthi kulungile ukubuka i-apheresis ezinganeni ezine-FH njengesilinganiso esilinganiselayo - njengendlela yokugcina imithwalo yegazi "ihlanzekile" ngenkathi silindele ukucaca okucacile, futhi kulula kakhulu, ukwelashwa kwezokwelapha.
Ufuna ukufunda kabanzi? Bheka isihloko se-UpToDate, "I-Hypercholesterolemia ejwayelekile" yokwaziswa okwengeziwe kwezokwelapha okujulile.
Imithombo:
I-Rosenson RS, de Ferranti SD, i-Durrington P. Ukwelashwa kwe-hypercholesterolemia emelana nezidakamizwa. Kusesikhathini. Kufinyelelwe, ngoJulayi 2012.