Esikhathini esedlule, isizathu esiyinhloko odokotela ababeka ukwelashwa kwe-cholesterol "kwakuyizinga eliphezulu le-cholesterol." Uma ukuhlolwa kwegazi kwe-cholesterol kuthathwa njengokuthi "kuphakame kakhulu," udokotela wakho mhlawumbe angancoma ukwelashwa-mhlawumbe ngezinguquko zokuphila, ezifana nokudla nokudla ukuzivocavoca, noma mhlawumbe nenye yezinhlobo eziningana zemithi ekhona yokunciphisa amazinga e-cholesterol .
Eminyakeni eminingana yocwaningo lwezokwelapha, nokho, kwaholela ochwepheshe ukuba baphendule ngokuthi lokhu kwakuyindlela engafanele. Ngo-2013, imihlahlandlela emisha yanyatheliswa yiqembu labachwepheshe be-American Heart Association kanye ne-American College of Cardiology. Lezi ziqondiso zincoma indlela ehluke ngokuphelele yokwelapha i-cholesterol.
Namuhla, izincomo zokwelashwa azisekelwe kuphela kumazinga e-cholesterol, kodwa kunalokho, ezingeni eliphelele leengozi yomzimba. Amazinga e-cholesterol ngokwawo acatshangelwa, kodwa kuphela njengenye yezinto eziningi ezibeka ingozi yomzimba.
Ngakho-ke Obani Abadinge Ukubhekwa?
Ukuphindaphinda, ngokusho kwemihlahlandlela ka-2013, ukuthi ngabe udinga ukuphathwa kuncike ezingeni lakho lonke lezinkinga zokuthuthukisa isifo senhliziyo. Ngenkathi izinga lakho le- LDL le-cholesterol ngokuqinisekile lifaka isandla kule ngozi, ingozi yakho ingase ibe phezulu kakhulu ngabe izinga le-LDL liphakanyisiwe noma cha.
Ukulinganisa ingozi yakho yonke kusho ukuthi udokotela wakho uzodinga ukucabangela umlando wakho wezokwelapha, ukuhlola ngokomzimba, futhi yebo, imiphumela yebhu yakho.
Uma lokhu sekuqedile, udokotela wakho kufanele akunike kwenye yezinhlobo ezinhlanu zemingcipheko:
Isigaba 1: Ulapha kulesi sigaba uma usuvele waziwa ukuthi une- atherosclerosis eveze inkinga yomtholampilo. Isigaba 1 sihlanganisa abantu abaye banakho okulandelayo:
- i-coronary artery disease (i-CAD) eyenze i- angina , noma i-infarction ye-myocardial (ukuhlasela kwenhliziyo), noma lokho kudinga ukwelashwa ngokuhlinzwa okugcoba noma okudlulayo
Isigaba sesi-2: Isigaba 2 sihlanganisa abantu abanamazinga e-LDL ama-cholesterol amakhulu kune-189 mg / dL. Iningi labantu abakwiCandelo 2 lizoba neyodwa yezinhlobo ze-hypercholesterolemia yomndeni. Ngokuphawulekayo, lena yodwa isigaba lapho ukwelashwa kunconywa kuphela ngoba amazinga e-cholesterol "aphakeme kakhulu."
Isigaba 3: Isigaba sesi-3 sihlanganisa abantu abaneminyaka engama-40 no-75 abanesifo sikashukela , futhi abangabani kwiZigaba 1 noma 2.
Isigaba sesi-4: Isigaba sesi-4 sihlanganisa abantu abangekho kwezinye izigaba ezintathu zokuqala, kodwa izifo zabo zengozi zomzimba zibabeka engozini enkulu yezifo zenhliziyo. Ngokuyinhloko, laba bantu abanengozi yokuthi babe nesifo senhliziyo (njengokushaya kwenhliziyo noma isifo sohlangothi) okungenani ngu-7.5% eminyakeni eyishumi elandelayo. Ukuze usize ukulinganisa ingozi yakho engama-10, i-NHLBI inikeze ikhodi yokubala engozini ekhona lapha.
Isigaba sesi-5: Isigaba sesi-5 sihlanganisa wonke umuntu ongahambisani nezigaba ezine zokuqala. Laba bantu basengozini ephansi yengqondo futhi abadingi ukwelashwa.
Obani Okudingeka Ukubhekwa? Wonke umuntu osesigabeni 1 - 4 unengozi enkulu yokubhekana nezinkinga ezinkulu zemithwalo yempilo eminyakeni embalwa, futhi kudingeka aphathwe kabi ukuze anciphise ingozi.
Ngabe Kunjani Ukwelashwa Kunconywa?
Imihlahlandlela ka-2013 ye-cholesterol yenza ushintsho oluphawulekayo kulokho ukwelashwa kunconywa kubantu abakwezinhlobo eziphezulu zokubeka ingozi. Nakuba imihlahlandlela emidala igcizelela ukunciphisa i-cholesterol ukukhomba amazinga wokwelapha, iziqondiso ezintsha azikho. Kunalokho, bagcizelela ukunciphisa ingozi yomzimba jikelele kunokuba batusa amazinga e-cholesterol. Lokhu kuncishiswa kwemingcingo kusekelwe ekuguquleni kokuphila okunonya, nasekusetshenzisweni kwezidakamizwa ze- statin .
Ukuphikisana Isigaba Esizungezile 4
Abantu abangezigaba 1 kuya kwezingu-3 banokungabazeki ukuthi banengozi enkulu yokuthuthukisa izinkinga zenhliziyo, futhi ngokusobala badinga ukwelashwa okunamandla ukunciphisa leyo ngozi.
Ngakolunye uhlangothi, isigaba sesi-4 sasungulwa ukuthola labo bantu abasengozini enkulu, kodwa ingozi ehle kakhulu, futhi engacacile, kunezigaba ezintathu zokuqala. Ukuchaza ukuthi ubani okufanele abekwe esigabeni se-4, ngakho-ke, kuwuhlelo oluthile oluyinkimbinkimbi futhi luzovuleka ngokusobala ukugxeka.
Kunezinhlobo ezimbili ezijwayelekile zokugxeka ezenziwe ngeSigaba 4. Izicelo zokuqala ukuthi iSigaba 4 sihlanganisa abantu abaningi kakhulu. Laba bahlaziyi bakhomba ukuthi wokubala engozini ehlinzekwa yi-NHLBI ibeka kakhulu ukugcizelela eminyakeni yobudala. Ngenxa yalesi sizathu, abantu abaningi abangaphezu kweminyaka engama-60 bazothola noma basondelene kakhulu no-7.5% we-cutoff. Ngaphezu kwalokho, tshela laba bahlaziyi, ingozi engama-10 engama-7.5% ngokwawo ikhululekile kakhulu. Izincomo zokwelashwa esikhathini esedlule zenzeke kakhulu ekunqophiseni ama-10%. Ngokusho kokunciphisa ukwelashwa kwe-7.5%, bathi, ungeze abantu "abaningi kakhulu" ohlwini lwezokwelapha.
Uhlobo lwesibili lokugxekwa mayelana neSigaba 4, akumangazi ukuthi, abantu abaneleyo bahlanganisiwe ohlwini lwezokwelapha. Laba bahlaziyi bakhomba ukuthi i-NHLBI yokubala engozini ihlanganisa kuphela lezo zinto ezibeka engozini eziye zafakazwa "ezivivinyweni ezilawulwa kahle" ukuze zibandakanye kakhulu engozini yemvelo: iminyaka, i-LDL, namazinga e-HDL ama-cholesterol, ngabe ngabe okwamanje uyabhema, futhi kungakhathaliseki ukuthi kunezifo eziphakeme ze-systolic. Ishiya ezinye izinto ezibeka ingozi ezivunywa kakhulu njengezibalulekile, kodwa okwamanje azihambisani nezindinganiso eziqinile ze-NHLBI zokufaka. Izingozi ezinjalo zibandakanya umlando womndeni wezifo zenhliziyo ngaphambi kwesikhathi, umlando odlule wokubhema, amazinga e-CRP aphakeme , indlela yokuphila yangasese, kanye ne- coronary artery calcium scan . Uma lezi zici ezibalulekile zobungozi zifakiwe, abantu abaningi bazokwazi ukuhlangabezana nezinqubo zokwelapha.
Ukungqubuzana okunjalo-kungakhathaliseki ukuthi isigaba 4 sihlanganisa kakhulu noma abantu abambalwa kakhulu-sinobuchule kunoma yikuphi ukusikisela okungukuthi i-cutoff inqunywe ngokweqile yiqembu lezazi.
Kungakhathaliseki ukuthi izici ezingobungozi zomuntu zanele ngokwanele ukugunyaza ukwelashwa okufanele, okungenani kancane, kushiywe kwesiguli ngasinye kanye nodokotela wabo. Ingozi engakanani umuntu ozimisele ukwamukela ukuthi abe nesifo senhliziyo noma isifo sohlangothi phakathi neminyaka eyishumi elandelayo? 7.5%? 10% Olunye uhlobo? Ingabe i-NHLBI yokubala engozini kufanele yamukeleke ngokubheka ubuso, noma ingabe kufanele kubhekwe izici ezengeziwe zokufaka ingozi ekunqumeni ukwelashwa?
Ngokuqinisekile kufanelekile iphaneli lobuchwepheshe ukwenza izincomo kule ndaba. Kodwa ngenxa yemibuzo enjengaleyo, ukuthi ngokwemvelo kufanele imiswe ngabanye, lezo zincomo akufanele zibophezele. Isinqumo sokugcina sokuthi kufanele siphathe kanjani kufanele sishiye odokotela neziguli ngabanye.
> Imithombo:
Stone NJ, uRobinson J, uLichtenstein AH, et al. Isiqondiso se-ACC / AHA sika-2013 ekwelapheni i-cholesterol yegazi ukunciphisa ingozi ye-atherosclerotic engqondweni kubantu abadala: Umbiko we-American College of Cardiology / American Heart Association. J Am Coll Cardiol 2013.