Amaphuzu amasha okucwaninga ekuthambekeni okusha okuphazamisayo
Phakathi neminyaka engu-20 eyedlule, inani lezinxephezelo liye lahla. Noma kunjalo, lesi simo sisebenza kubantu abadala. Ngokuqondene nabantu abadala, kuhlanganise naminyaka eyizinkulungwane, kuye kwaba nokwanda kwenani lokushaya. Lokhu kwanda cishe kunomthelela ekukhuleni kwezinye izinto ezibeka ingozi phakathi kwabantu abasha, kuhlanganise nokukhuluphala, isifo sikashukela, nesifo sofuba.
Isibungu
Esihlokweni se-2017 eshicilelwe ku- JAMA Neurology , uGeorge kanye nabalobi ababambisene nabo bahlola imvamisa eyandayo yokushaya isicic acute phakathi kwabantu abasha.
Abacwaningi bahlaziya izikhungo ezingama-362,339 eziphakathi kuka-2003 no-2004 kanye nezibhedlela ezingu-421.815 kusukela ngonyaka ka-2011 no-2012 ukucacisa ukuthi kwenzekani ngesifo sohlangothi. Basebenzisa futhi idatha kusukela phakathi kuka-2003 no-2012 ukucacisa ukusabalalisa kwezinkinga ezinhlanu zempilo yengqondo ezinomdlavuza ophezulu: isifo somfutho wegazi, isifo sikashukela , ukukhathazeka kwe-lipid, ukukhuluphala , nokusetshenziswa kogwayi.
UGeorge kanye nabalingani bakhe bathola ukuthi izinga lokugonywa ngenxa yesifo socwaningo lwe-ischemic lukhuphuke ngamaphesenti angaba ngu-50 abesilisa nabesifazane abaphakathi kuka-18 no-34. Ngokuqondile, amadoda, phakathi kuka-2003 no-2012, kwaba nokwanda kusuka ku-11.2 kuya ku-18.0 imivimbo emibili 10,000 hospitals. Kwabesifazane, kwaba nokwanda okuvela ku-3.8 kuya ku-5.8 izigubhu ezinzima ngezighedlela ezingu-10 000.
Ukubuyela emuva ngisho nangaphezulu, kusukela ngo-1995 no-1996, izinga lokushaywa yisifo sohlangothi seluphindwe kabili kubantu abesilisa abaneminyaka ephakathi kuka-18 no-34.
Nazi ezinye iziphumo ezivela kuleso sifundo mayelana nezimo ezingozini zomzimba eziphakathi kwabantu abaneminyaka ephakathi kuka-18 no-64 ababoshwe esibhedlela ngenxa yesifo esibucayi se-ischemic phakathi kuka-2003 no-2012:
- Amanani okushisa kakhudlwana akhule phakathi kwamaphesenti angu-4 namaphesenti angu-11.
- Amanani we-lipid disorder (okungukuthi, i-hypercholesterolemia noma i-cholesterol ephezulu) yanda phakathi kwamaphesenti angu-12 namaphesenti angu-21.
- Amanani wesifo sikashukela akhule phakathi kwamaphesenti angu-4 namaphesenti angu-7.
- Amanani kagwayi asetshenziselwa ukwanda phakathi kwamaphesenti amahlanu namaphesenti angu-16
- Amanani okukhuluphala anyuke phakathi kwamaphesenti angu-4 namaphesenti angu-9.
Kuphenyo lokuqala, iScientific American ithathe imiphumela yalolu cwaningo isinyathelo esisodwa. Babheka ngokuqondile ukuthi e-United States kwakukhona ukwenyuka okuphakeme kakhulu ekushayweni phakathi kwabantu abasha. Bathola ukuthi ukwanda okukhulu kunazo zonke kwakuseNtshonalanga neMidwest. Ukwengeza, imizi yakubona ukwanda okukhulu kunezindawo zasemaphandleni.
Nakuba iNingizimu ibizwa ngokuthi "iStroke Belt," futhi inani eliphakeme kunazo zonke lezibethithi zenzeka lapho, ukwanda okukhulu kunomvuthwandaba wokushaya isifo phakathi kwabantu abasha kwenzeka eNtshonalanga naseMidwest. Inani lemivimbo eSouth lalivele liphakeme; ngakho-ke, ukunyuka okuhambisanayo kwezivunguvungu zesisindo akusho kakhulu eNtshonalanga naseMidwest, lapho izinga lokushaywa komzimba liphansi.
Ubuchwepheshe bungabamba iqhaza ekukhuphukeni okuphawulekayo kwezivunguvungu ezibhekene naso eNtshonalanga naseMidwest.
Ngokuqondile, eNyakatho Ntshonalanga, lapho izinga lokushaywa komzimba phakathi kwabantu abasha elingazange likhule kakhulu, ukucabangela ukuxilonga okunjengeMRI kungase kube khona kalula futhi imivimbo eminingi ingatholakala.
Ngemivimbo eminingi etholakalayo esisezingeni eliyisisekelo, kungase kube nokwanda okuncane kwesihlobo emvamisa yesifo. Ngamanye amazwi, izindawo ezinjengeNyakatho-mpumalanga ngeke zibe nokwanda okukhulu kwemvamisa yesifo ngoba ukutholakala kwethempelithi ye-MRI kusho ukushaywa okuningi okutholwe ukuthi kuqala ngawo.
Ukusetshenziswa kwezidakamizwa ezingekho emthethweni, njenge-meth ne-crack, kungadlala indima ekwandeni kwemivimbo ephawulekayo ye-ischemic.
Ochwepheshe bacabanga ukuthi esinye sezizathu zokuthi izibhamu zivame kangakanani ezindaweni zasemadolobheni kunokuhlala ezindaweni zasemaphandleni ngoba izindawo zasemadolobheni zingcolile kakhulu.
Ngaphezu kwalokho, ngoba izibhedlela eziningi zasezindaweni zasemakhaya ziye zavinjelwa eminyakeni yamuva, abantu abahlala ezindaweni zasemaphandleni bangahamba beya ezibhedlela zasemadolobheni ukuze bathole ukwelashwa, ngaleyo ndlela bahlasele izinga lokushaywa kwezidakamizwa ezindaweni zasemadolobheni.
Kumele sihlale sikhumbula ukuthi zonke lezi zincazelo-imifanekiso yokuxilonga, izidakamizwa, ukungcola, kanye nokuntuleka kokunakekelwa kwempilo yasemaphandleni-ziyizicabangela nje. Ucwaningo olungaphezulu kufanele lwenziwe ukuqonda izitayela ezivame ukuvama.
Ukwandisa izinga lokushaywa komzimba phakathi kwabantu abasha kufakazela ukwanda okwezinye izifo ezingozini yempilo, ezifana nokukhuluphala ngokweqile nesifo sikashukela.
Ukukhuluphala
Eminyakeni yamuva, abezindaba baye babika ukuthi kube nokunciphisa ukukhuluphala kwengane. Lesi simangalo, noma kunjalo, asilungile. Eqinisweni, ucwaningo oluthile lubonisa ukuthi kuye kwaba nokunciphisa ukukhuluphala ngokweqile ezinganeni ezincane ezincane ezingenayo imali ezincane noma ezindaweni ezithile. Lolu cwaningo, kodwa, alukwazi ukudluliselwa kubantu abaningi. Idatha ephakathi kuka-2007 no-2010 ikhombisa ukuthi akubanga nciphisa ukukhuluphala. Eqinisweni, kube nokwanda kwezinhlobo ezinzima zokukhuluphala kubantu abasha.
Ku-athikili ka-2014 eyanyatheliswa ku- JAMA Pediatrics , i-Skinner no-Skelton bahlola izigaba ezingezansi ze-US phakathi kuka-1999 no-2012. Lawa masampula ahlanganisa izingane eziphakathi kweminyaka emibili no-19 ubudala.
Abacwaningi bathola ukuthi kungase kube nokuqiniswa ekukhusheni ngokweqile. Kodwa-ke, kube khona i-spike eklasini ephakeme yokukhuluphala (okungukuthi, i-BMI engama-35 noma ngaphezulu). Inothi, izinhlobo ezimbi kakhulu zokukhuluphala zihambisana eduze neengozi ze-cardiometabolic, kuhlanganise nokushaya.
Thayipha isifo sikashukela sesi-2
Esifundweni sika-2017 esashicilelwe ku- JAMA , iMeya-Davis kanye nabalobi ababambisene nabo bathole ukuthi isifo sikashukela sikashukela se-2 senyuke phakathi kuka-2002 no-2012. Uhlobo lwesibili lwesifo sikashukela luyisifo sengqondo senhliziyo futhi lunegalelo lokushaya.
Ukusebenzisa ukuhlaziywa kwesibalo sabantu, izingane ezineminyaka ephakathi kuka-10 no-19 ubudala, zathola ukuthi kunamaphesenti angu-4,8 okwenyuka kwengozi yesifo sikashukela se-type 2. Lokhu kwanda kwakhulunywa ngokukhethekile phakathi kwezinhlanga ezincane nezinhlanga. Ngokwesibonelo, phakathi kwentsha yaseMelika yaseMelika, kwaba nokwanda kusuka kumaphesenti angu-3.1 kuya ku-8.9%.
Okuphawulayo, imiphumela yalolu cwaningo ivumelana nokuthola okuvela kumcwaningi wangaphambilini owenziwa ngabacwaningi abafanayo: Phakathi kuka-2001 no-2009, kwanda nokwanda kwesifo sikashukela sohlobo lwe-2 phakathi kwentsha.
Imiphumela
Ukwehla kwesifo sohlangothi kanye nezingozi ezihlobene nabantu abasha kubhekene okungenani izizathu ezimbili:
- Izibhamu zingabangela ukukhubazeka okukhulu, futhi uma umuntu osemusha ekhutshazekile ngenxa yokushaywa yisifo sokushaya, ukukwazi kwakhe ukwenza ukuphila kuyonakele. Imithelela engokomzwelo neyomnotho ayithinti nje kuphela umuntu okhubazekile ohlobene nesifo sohlangothi, kodwa futhi namalungu omndeni. Izibhamu zingaqondisa ukuphila ngokubi kakhulu.
- Nakuba izigameko zokuqala zivame ukuba zimbi, umlando wokushaywa komuntu osemncane usebenza njengodayari emayini yamalahle. Izigubhu zesikhathi esizayo ziyingozi kakhulu futhi zikhungatheka kuneyokuqala. Ngakho-ke, lokhu kwanda kwemvamisa yokushaywa kwabantu abadala kungase kube uphawu lokuqala lwesifo esiyingozi kakhulu esingase sidlale emashumini ambalwa eminyaka alandelayo.
Ukwelapha
Ukubona umkhuba wokwanda kwesifo sohlangothi kanye nezinkinga zempilo yengqondo phakathi kwabantu abasha kuyisinyathelo sokuqala. Umbuzo omkhulu kunendlela yokuphatha lokho okungaba yisifo esibucayi.
Ku-athikili ka-2015 ku- Stroke okuthiwa "Ukukhuluphala Kwandisa Ingozi Yokuphazamiseka Kwabasebasha Abadala I-Opportunity for Prevention," uKernan noDearborn bhala lokhu okulandelayo:
Enkampeni eyodwa, yibo ababona ukuthi ukukhuluphala kuhlotshaniswa nengozi eyengeziwe yokushaywa yisifo sokushaya isisu futhi bathi kuyisici esibalulekile sokuvimbela okuyisisekelo nesekondari. Ngakolunye uhlangothi, yibo abavuma ukuthi ukukhuluphala kwandisa ukushaywa komzimba kodwa bathi kuphumelela kakhulu ukuphatha umphumela wokukhuluphala okubangelwa ubungozi bokushaya (okungukuthi, umfutho wegazi ophezulu kanye ne-dyslipidemia) kunokukhuluphala ngokwayo.
Ngamanye amazwi, akukacaci ukuthi ukuvimbela isifo kufanele kugxile ekutheni ukukhuluphala noma izimo ezibangelwa ukukhuluphala, njengokucindezela kwegazi eliphezulu ne-cholesterol ephakeme.
Abalobi bathi uma sinezinketho zokwelapha okungcono kakhulu, ngeke kube nombuzo wokuthi ukukhuluphala kufanele kube ukugxila kokuvimbela isifo phakathi kwabantu abasha. Ngaphezu kwalokho, ukwelapha umfutho wegazi ophakeme, nakuba kuyimbangela ekuthuthukiseni isifo, ungashiya ezinye izinto ezingasalashwa.
Futhi, ngokusho kwabacwaningi:
Ukuthola imithi efanele yokwelashwa okunciphisa ingozi (isb., Ukwelashwa komfutho wegazi ophezulu) usazoshiya iziguli eziningi ezitholakale zivelele engozini engalashwa. Lokhu kuyiqiniso ikakhulukazi ngoba ukwelashwa okunciphisa ukwelashwa kwezinkinga zezifo ezinesisindo ekukhulupheni kungukuthi ukwelashwa ngokweqile. Ucwaningo aluzange luqiniseke ukuthi ukulawulwa okuqinile kwesifo sikashukela kunciphisa ingozi yezifo zamathambo; azikho izindlela zokwelapha ezicatshangwayo zokuphatha ukuvuvukala kokukhuluphala, kanti iziguli eziningi ezincane manje azibhekwa njengokhetho lwezokwehlisa ukwehlisa i-lipid.
Ngamanye amazwi, kunzima ukuphatha iziguli ngenxa yezimo eziyingozi ngenxa yesifo esiwumphumela wokukhuluphala. Ukulawulwa kwesifo sikashukela kungakabonakali ukunciphisa ingozi yokushaya isifo. Ngaphezu kwalokho, ayikho indlela ecacile yokuphatha ukuvuvukala okuhambisana nokukhuluphala okubangela ukushaywa nesifo senhliziyo. Okokugcina, intsha eningi ayingeke ifanelekele ukwelapha okunciphisa i-lipid, njengeziqu zemvelo .
Izwi elivela
Ucwaningo luye lwaveza ukwanda kwesifo sohlangothi nesifo esithile senhliziyo phakathi kwabantu abasha. Lokhu kutholakala ngokuphathelene nokuthi kungabangela ukukhathazeka okukhulu kakhulu, ngesimo esiphezulu kakhulu sesifo esibi kakhulu, isifo esibucayi se-ischemic eminyakeni ezayo.
Okwamanje, ayikho indlela evunyelwene ngayo yokuvimbela ukushaywa yisifo, isifo esingakwazi ukukhubaza futhi sithinte kakhulu abantu nemindeni. Iseluleko esingcono kakhulu sokuvimbela umuntu osemusha ukuthi sikwazi ukulinganisa izici zokufaka ingozi yokushaya isicic acutechemism ukuqala. Abantu abasha kudingeka bagweme ukukhululeka, gwema ukubhema, futhi bathole ukwelashwa okufanelekile komfutho wegazi ophezulu.
Okokugcina, sicela uhlale ukhumbule ukuthi kuphela uhlangothi oluthile-oluphakathi kwamaphesenti angu-5 no-10-olwenzeka ezinganeni nakubantu abadala. Ayikho inamba yemivimbo ethinta izinkulungwane zeminyaka iningi lomvimbo. Noma kunjalo, noma yikuphi ukuhlukunyezwa okunzima okuthinta umuntu osemncane kuhlobene kakhulu, futhi izandiso ezikhulayo ziyimpumelelo yomphakathi.
> Imithombo:
> George, MG, Tong, X, Bowman, BA. Ukuqhathaniswa Kwezinto Zingozi Zezinhliziyo Nezigubhu Ezinganeni Ezincane. I-JAMA Neurology. 2017; 74: 695-703.
> Kernan, WN, Dearborn, JL. Ukukhuluphala Kwandisa Ingozi Yokushaywa Ngesisindo Kwabancane Abadala Amathuba Okuvimbela. Isibungu. 2015; 46: 1435-1436.
> Maron, DF. Izinkulungwane Eziningi Zinezigubhu. Scientific American. NgoJuni 28, 2017. [e-pub]
> Mayer-Davis, EJ, et al. Amathrendi Emithelela yohlobo 1 nohlobo lwesifo sikashukela phakathi kwabeNtsha, 2002-2012. I-New England Journal of Medicine. 2017; 376: 1419-1429.
> Skinner, AC, Skelton, JA. Ukuvama nokuThambekela kokukhuluphala nobukhulu obukhulu phakathi kwezingane e-United States, 1999-2012. I-JAMA Pediatrics. 2014; 168: 561-566.