Impendulo eqondile
Ukuhlolwa kwe-cholesterol, okuvame ukubizwa ngokuthi iphrofayili yamafutha noma iphaneli yamafutha, ukuhlolwa kwegazi okulinganisa i-cholesterol iyonke, i-LDL cholesterol, i-HDL cholesterol kanye ne-triglycerides. Iphrofayili yamafutha isiza ukulinganisa ingozi yenhliziyo nokuqapha ukwelashwa. Ukuhlolwa kwe-cholesterol akubonisi imithambo yegazi futhi akukwazi ukuqinisekisa noma ukukhipha imithambo yegazi evalekile.
Ukuthatha okhiye
- Kukala amafutha, hhayi imithambo yegazi: Iphrofayili yamafutha ibika amazinga amafutha egazini; ayibonisi i-plaque noma ukuncipha.
- Izinombolo ziyizimpawu zobungozi, hhayi ukuxilongwa: Izinhloso ziyahlukahluka ngengozi yakho iyonke, hhayi "ngokuvamile" okukodwa okujwayelekile.
- Ukuzila ukudla ngokuvamile akudingeki: Amayunithi amaningi manje ayamukela amasampula angadingi ukuzila ukudla; imiyalelo yeyunithi yakho iza kuqala.
- Imiphumela ingadukisa: ukugula okukhulu, ukutheleleka kwamuva, ukukhulelwa, isifo se-thyroid kanye nama-triglyceride aphezulu kakhulu konke lokhu kushintsha amanani.
- Abantu baseNingizimu Asia bathola izifo ze-metabolic kanye ne-cardiovascular lapho benesisindo somzimba esiphansi, ngakho-ke umbiko "obukeka ujwayelekile" usadinga ukuchazwa ngokwezokwelapha.
Nge-shazi
| Isici | Imininingwane |
|---|---|
| Uhlobo lokuhlola | Ukuhlolwa kwegazi lemithambo yegazi (ngezinye izikhathi ukuhlatshwa ngomunwe ukuze kuhlolwe) |
| Ngokuvamile kubikwa izingxenye | I-cholesterol iyonke, i-LDL cholesterol, i-HDL cholesterol, ama-triglycerides; ngokuvamile i-cholesterol engeyona i-HDL kanye ne-VLDL |
| Amayunithi eNdiya | mg/dL (mmol/L kwamanye amalebhu) |
| Ukuzila | Akudingeki njalo; ukuzila ukudla kungacelwa uma ama-triglyceride kuyiwona agxile kuwo, landela iyunithi yakho |
| Isikhathi sokukhipha igazi | Cishe imizuzu emi-2-5; ukuvakasha okuphelele kuvame ukuba yimizuzu eyi-10-20 okuhlanganisa ukubhalisa nokulinda |
| Lokho engenakukwenza | Awukwazi ukubona ngeso lengqondo imithambo yenhliziyo, awukwazi ukuhlukanisa isifo senhliziyo, awukwazi ukuxilonga ukuhlaselwa yinhliziyo |
| Kuhunyushwe ngu | Udokotela ocele ukuhlolwa, kanye nomfutho wegazi, ushukela, isimo sokubhema, umlando womndeni kanye nemiphumela yezokwelapha |
Obeye aziwe njengo
- Ukuhlolwa kwephrofayili ye-lipid / iphaneli ye-lipid / iphrofayili ye-lipid
- Ukuhlolwa kwegazi le-cholesterol
- "Ukuhlolwa kwe-cholesterol" enkulumweni yansuku zonke; kuvame ukucelwa njengoba "ukuhlolwa kwe-cholesterol" or "ukuhlolwa kwamafutha"
- Iphrofayili ye-lipid yokuzila ukudla (i-FLP) uma kucelwa isampula yokuzila ukudla ngokuqondile
- Ukusetshenziswa kwesiHindi/kwesilungu: i-cholesterol ki jaanch, charbi ki jaanch
Kuyini ukuhlolwa kwe-cholesterol
I-cholesterol iyinto efana namafutha edingekayo kuma-membranes eseli, ama-bile acid, i-vitamin D nama-hormone e-steroid. I-cholesterol ihamba egazini ngaphakathi kwezinhlayiya ezibizwa ngokuthi ama-lipoprotein. Iphrofayili yamafutha ilinganisa ukuthi ingakanani i-cholesterol kanye ne-triglyceride ethwalwa kulezi zinhlayiya.
- I-cholesterol ephelele: inani le-cholesterol elithwalwa kuzo zonke izinhlayiya ze-lipoprotein.
- I-cholesterol ye-LDL: I-cholesterol ethwalwa yi-lipoprotein ephansi. Izinhlayiya ze-LDL zifaka i-cholesterol ezindongeni zemithambo yegazi; ukuvezwa okuphezulu kwe-LDL impilo yonke kuhlotshaniswa nesifo se-atherosclerotic. Emalabhorethri amaningi, i-LDL ibalwa kunokuba ikalwe ngokuqondile.
- I-cholesterol ye-HDL: I-cholesterol kuma-lipoprotein aphezulu. I-HDL ephansi ihlotshaniswa nengozi ephezulu, kodwa ukukhulisa i-HDL ngemithi akubonakali kunciphisa izehlakalo, ngakho-ke i-HDL iwuphawu kunokuba kube yinto ehloselwe ukwelashwa.
- I-Triglycerides: amafutha agcinwe egazini, athonywe kakhulu ukudla kwamuva, utshwala, isifo sikashukela esingalawulwa kanye nezakhi zofuzo.
- I-cholesterol engeyona i-HDL: i-cholesterol iyonke ngaphandle kwe-HDL. I-Non-HDL iwusizo uma ama-triglyceride ephezulu noma isampula ingasheshi ukuzila ukudla.
Ukubiza i-LDL ngokuthi “kubi” kanye ne-HDL ngokuthi “kuhle” kuyindlela emfushane. Kunembile kakhulu ukusho ukuthi izinhlayiya ezithwala i-cholesterol ezingena esifweni sodonga lwemithambo yegazi, futhi leyo ngozi incike esithombeni sonke sezokwelapha.
Kungani kwenziwa ukuhlolwa kwe-cholesterol
- Ukuqagela ingozi yenhliziyo nemithambo yegazi: Amanani amafutha atholakala ekuhlolweni kwengozi kanye nobudala, ubulili, umfutho wegazi, isifo sikashukela kanye nokubhema.
- Ukuqapha ukwelashwa kokwehlisa amafutha: ukuze ubone impendulo kuma-statin noma olunye ukwelashwa olunikezwe udokotela wakho.
- Ukuhlolwa kanye nezinye izimo: isifo sikashukela, isifo sezinso esingamahlalakhona, i-hypothyroidism, i-polycystic ovary syndrome (i-PCOS; i-PCOD iyisimo esifanayo, akusona isifo esihlukile), kanye nesifo sesibindi esinama-steatotic kufaka phakathi i-MASLD.
- Ukuphenya nge-hypercholesterolaemia yomndeni okusolwayo uma i-cholesterol iphezulu kakhulu, kuba khona i-tendon xanthomas, i-corneal arcus esemncane, noma isifo senhliziyo esemncane ezihlotsheni eziseduze.
- Ukuphenya ama-triglyceride aphezulu kakhulu, okungaba nomthelela ekuthuthukisweni kwe-pancreatitis ebukhali.
Ubani okufanele ahlolwe i-cholesterol
- Abantu abadala abangenaso isifo senhliziyo esaziwayo: iphrofayili ye-lipid eyisisekelo lapho umuntu esemdala, ngokuhlolwa okuphindaphindiwe ngezikhathi ezithile okunqunywe udokotela wakho ngokusekelwe engcupheni yakho. Izikhawu ezihleliwe ezicashunwe ku-inthanethi azisebenzi kuwo wonke umuntu.
- Abantu abanesifo sikashukela, umfutho wegazi ophakeme, isifo sezinso esingamahlalakhona noma ukukhuluphala ngokweqile.
- Ababhemayo nabasebenzisi bakagwayi ongenantuthu.
- Noma ubani onomlando womndeni wokuhlaselwa yinhliziyo kusenesikhathi, isifo sohlangothi noma i-cholesterol ephezulu kakhulu, ikakhulukazi umzali noma umfowabo othintekile ngaphambi kweminyaka engaba ngu-55 (abesilisa) noma engu-65 (abesifazane).
- Abantu asebevele bethola ukwelashwa kokwehlisa amafutha, zokuqapha.
- Izingane kanye nentsha kuphela uma kukhona inkomba ethile, umlando womndeni oqinile, okusolwa ukuthi une-hypercholesterolaemia yomndeni, noma isimo esihambisana nokuguqulwa kwe-metabolic. Ukuhlolwa kwe-cholesterol njalo ezinganeni akuyona into evamile.
- Abantu abadala baseNingizimu Asia: xoxa nodokotela wakho ngokuhlolwa kwangaphambi kwesikhathi, njengoba ingozi yokuphazamiseka kwe-metabolic kanye ne-cardiovascular ibonakala ku-BMI ephansi kanye nobubanzi besinqe kunakwabanye abantu abaningi.
Lokho ukuhlolwa kwe-cholesterol okungenakukuthola noma okungakukhiphi
- Awukwazi ukubona imithambo yakho. Iphrofayili yamafutha ayinikezi ulwazi mayelana ne-plaque, ukuncipha noma ukugeleza kwegazi. I-cholesterol evamile ayikuvimbeli isifo semithambo yenhliziyo; ingxenye enkulu yabantu abanesifo senhliziyo inamanani angavamile amafutha.
- Awukwazi ukuxilonga noma ukukhipha isifo senhliziyo. Ubuhlungu besifuba budinga ukuhlolwa kwezokwelapha, i-ECG kanye ne-cardiac troponin, hhayi iphrofayili yamafutha.
- Awukwazi ukukala i-lipoprotein(a) noma i-apolipoprotein B ngaphandle kokuthi lokhu kuhlelwe ngokuqondile. I-Lipoprotein(a) inqunywa kakhulu ngofuzo futhi ingakhulisa ingozi ngisho noma iphrofayili ejwayelekile yamafutha ibonakala iyamukeleka.
- Ayikwazi ukuthola imbangela umphumela ongajwayelekile. I-cholesterol ephezulu ingaba yi-genetic, ukudla, noma ibangelwe yi-hypothyroidism, isifo sezinso, isifo sesibindi, utshwala noma imithi ethile.
- Awukwazi ukuqinisekisa ukuxilongwa kwezakhi zofuzo. I-Familial hypercholesterolaemia isolwa ngamanani amafutha kanye nomlando womndeni, futhi iqinisekiswa yizindlela ezikhethekile zokwelashwa kanye nokuhlolwa kwezakhi zofuzo.
- Awukwazi ukubikezela umcimbi ngamunye. Ukuqagela ingozi kuchaza amathuba phakathi kwamaqembu, hhayi ukuqiniseka komuntu oyedwa.
Iphrofayili yamafutha ebukeka ingalungile noma ibukeka ijwayelekile isho ukuthi amafutha angajwayelekile awatholakalanga kuleyo sampula. Akusho ukuthi isifo senhliziyo asifakiwe. Uma izimpawu ezifana nokungakhululeki esifubeni, ukuphelelwa umoya noma ukushaya kwenhliziyo kuqhubeka naphezu kombiko ojwayelekile, buyela kudokotela wakho.
Ukuhlolwa okuhlobene kodwa okuhlukile, nokuthi kuqhathaniswa kanjani
Lezi zivivinyo ziphendula imibuzo ehlukene. Akukho okungcono kakhulu emhlabeni wonke, futhi ukuthi yikuphi okuza kuqala kuncike enkingeni yezokwelapha, ukuhlola umuntu omdala ongenazo izimpawu, ukuphenya ubuhlungu besifuba, noma ukuthola ama-triglyceride aphezulu kakhulu.
| test | Umbuzo uyaphendula | Umkhawulo wokhiye |
|---|---|---|
| Iphrofayili ye-lipid (ukuhlolwa kwe-cholesterol) | Ingakanani i-cholesterol ne-triglyceride ejikeleza egazini? | Akusho lutho ngemithambo yegazi ngokwayo |
| I-Apolipoprotein B | Zingaki izinhlayiya ze-atherogenic ezikhona? | Akutholakali kuwo wonke amalebhu; akudingeki ekuhlolweni okuvamile okuningi |
| I-Lipoprotein (a) | Ingabe kukhona isici esiyingozi se-lipid esizuzwe njengefa kakhulu, esizimele? | Ngokuvamile kulinganiswa kanye; akukho ukwelashwa kokwehlisa okusungulwe kabanzi emisebenzini evamile |
| hs-CRP | Ingabe kukhona ukuvuvukala okuphansi okungathuthukisa ingozi? | Akucaci; kuphakama nganoma yikuphi ukutheleleka noma ukuvuvukala |
| ECG | Ingabe ukusebenza kukagesi kwenhliziyo kwamanje akujwayelekile? | I-ECG evamile yokuphumula ayikuvimbeli ukugula kwenhliziyo |
| Ukuphumula kwe-2D echo ("ukuhlolwa kwe-echo") | Imisipha yenhliziyo, ama-valve kanye nokusebenza kokumpompa kusebenza kanjani? | Ayiboni ngeso lengqondo imithambo yenhliziyo; iwusizo eNdiya ekuhlolweni kwesifo senhliziyo esibangelwa amathambo |
| Ukuhlolwa kokucindezeleka / i-echo yokucindezeleka | Ingabe inhliziyo ibonisa i-ischaemia lapho uzikhandla? | Kudinga ikhono lokusebenzisa noma ukucindezeleka kwezokwelapha; kuvela imiphumela emihle nengemihle engamanga |
| I-CT coronary angiography / i-coronary calcium score | Ingabe kukhona i-plaque noma i-calcification emithanjeni yenhliziyo? | Ukuchayeka emisebeni; isilinganiso se-calcium singase sibe phansi naphezu kwe-plaque ethambile engakakalwanga |
| I-HbA1c ("ukuhlolwa kweshukela kwezinyanga ezi-3") | Ingakanani i-glucose egazini elijwayelekile? | Umbuzo ohlukile ngokuphelele; ukuthembeka kuncishiswe yi-hemoglobinopathy, isici se-thalassemia kanye ne-anemia, okuvamile eNdiya |
| Ukuhlolwa kokusebenza kwesibindi (SGPT/ALT, SGOT/AST) | Ingabe kukhona ukulimala kwesibindi noma i-cholestasis? | Kuvame ukuhlolwa eceleni kwamafutha, kodwa akuhloli ubungozi benhliziyo nemithambo yegazi |
Iphrofayili yamafutha nayo ihlukile ekuhlolweni kwe -LDL okuqondile kanye ne -lipoprotein electrophoresis , okuyizivivinyo ezikhethekile ezisetshenziswa lapho kubalwa i-LDL ingathembekile noma kusolwa ukuthi kukhona ukuphazamiseka kwamafutha okungajwayelekile.
Indlela yokulungiselela ukuhlolwa kwe-cholesterol
Imiyalelo yokulungiselela iyasebenza futhi iyahlukahluka phakathi kwama-laboratory nezikhungo zokuqoqa. Imiyalelo enikezwa yiyunithi eyenza ukuhlolwa kwakho ihlala iza kuqala kunesiqondiso esijwayelekile ku-inthanethi.
- Ukuzila ukudla: Ama-laboratory amaningi kanye neziqondiso manje sezamukela amaphrofayili e-lipid angalali ukuze kuhlolwe njalo, ngoba umphumela wokudla ku-cholesterol iyonke kanye ne-LDL uphansi. Isampula yokuzila ukudla (ngokuvamile cishe amahora angu-9-12, amanzi avunyelwe) ingase icelwe uma amazinga e-triglyceride ekhuphukile kakhulu, lapho kusolwa ukuthi i-hypercholesterolaemia yomndeni, noma ngenqubo yendawo.
- Amanzi: amanzi alula ngokuvamile avunyelwe. Uma unikezwe imikhawulo yoketshezi ngenxa yokwehluleka kwenhliziyo noma isifo sezinso, landela lowo mkhawulo bese utshela abasebenzi abaqoqayo.
- Utshwala: Utshwala ngosuku olulodwa noma ezimbili ezandulele bungakhuphula kakhulu ama-triglycerides. Tshela ilabhorethri uma uke waphuza utshwala muva nje.
- Ukudla okungajwayelekile kwakamuva noma ukuzivocavoca okunzima: khuluma ngalokhu, njengoba kungashintsha amanani e-triglyceride.
- Imithi nama-supplements: Bhala konke okuthathayo, okuhlanganisa ama-steroid, ukwelashwa ngama-hormone, imithi ye-thyroid, ama-antiretroviral, i-isotretinoin, amalungiselelo e-AYUSH, izithako zokuzivocavoca nezokwakha umzimba, kanye namafutha enhlanzi. Ungayeki, ungaqali noma ushintshe noma yimuphi umuthi owunikezwe udokotela ukuze uhlolwe, khuluma nodokotela kuqala.
Uma unesifo sikashukela ekwelashweni kokwehlisa i-glucose
Ukuzila ukudla isikhathi eside kungabangela i-hypoglycemia, ikakhulukazi nge-insulin noma i-sulfonylureas. Buza ithimba lakho lesifo sikashukela ngaphambi kokuzila ukudla, cela isikhathi sokuthatha i-glucose ekuseni kakhulu, phatha i-glucose nawe, bese utshela abasebenzi be-phlebotomy ukuthi uzila ukudla ngesikhathi sokwelashwa.
Uma ukhulelwe noma uncelisa
I-cholesterol kanye ne-triglycerides ziyanda ngokomzimba ngesikhathi sokukhulelwa, ngakho-ke ukuhlolwa okuvamile ngokuvamile kuyahlehliswa. Ukuzila ukudla isikhathi eside kuvame ukugwenywa ngesikhathi sokukhulelwa. Ukuhlolwa ngesikhathi sokukhulelwa kwenziwa kuphela ngesizathu esithile, njengesifo esibi kakhulu samafutha noma i-pancreatitis esolwayo ye-hypertriglyceridaemic.
Uma unesifo sezinso esingamahlalakhona, ukwehluleka kwenhliziyo noma ukuncishiswa koketshezi
Ungandisi amanzi athathwayo ukuze "wenze imithambo ibe lula". Gcina isilinganiso sakho soketshezi olunqunyiwe bese wazisa abasebenzi abaqoqayo.
Izingane kanye nabantu abadala
Izingane akufanele zizile ukudla isikhathi eside ngaphandle kweseluleko sezingane. Abantu abadala ababuthakathaka bangase baphelelwe amanzi emzimbeni noma babe nesiyezi lapho bezila ukudla; ukuqokwa kusenesikhathi kanye nosizo lomsizi. Khuluma nganoma yisiphi isifo sokopha noma umuthi wokunciphisa igazi ngaphambi kokuthatha isidakamizwa.
Kwenzekani ngesikhathi sokuhlolwa kwe-cholesterol
- Ukulungiselela: isikhumba, ngokuvamile ngaphakathi kwendololwane, sihlanzwa ngesibulali-magciwane bese kufakwa i-tourniquet.
- Iqoqo lesampula: isampula encane yegazi idonswa epayipini elibhalwe ilebula. Lesi sinyathelo sithatha cishe imizuzu emi-2-5.
- Ngemva kokudweba: Kucindezelwa umzuzu owodwa noma emibili. Gcina ingalo iqondile kunokuyigoba, okunciphisa ukuklwebheka.
- Ukuvakasha okuphelele: ngokuvamile imizuzu eyi-10-20 kufaka phakathi ukubhalisa, nokulinda isikhathi eside ngezikhathi ezimatasa.
- Amadivayisi okuhlola izinti zeminwe ngezinye izikhathi zisetshenziswa emakamu nasemakhemisi. Imiphumela yokunakekelwa iwusizo ekuhlolweni kodwa ayinembile kangako njengokuhlaziywa kwelebhu, futhi inani elingavamile kufanele liqinisekiswe kusampula yelebhu yemithambo yegazi.
Iningi labantu libuyela emisebenzini evamile ngokushesha. Tshela abasebenzi kusenesikhathi uma uke waquleka ngesikhathi sokuhlolwa kwegazi.
Ukuqonda umbiko wakho we-cholesterol
Umbiko we-lipid ubala ingxenye ngayinye enesikhathi sokubhekisela selabhorethri. Izikhawu zokubhekisela kanye namayunithi okubika ahlukile phakathi kwamalabhorethri, ngakho qhathanisa inani lakho nobubanzi obuphrintiwe embikweni wakho kunesibalo esicashunwe kwenye indawo.
Izimiso ezibalulekile zokuhumusha umbiko:
- Akukho mgomo owodwa okhona emhlabeni wonke. Izinga le-LDL elibhekwa njengelamukelekayo lihluka kakhulu phakathi komuntu osemusha ongenazo izici eziyingozi nomuntu oke waba nokuhlaselwa yinhliziyo, i-stent, isifo sohlangothi, isifo sikashukela esinezinkinga, noma i-hypercholesterolaemia yomndeni. Izinhloso eziphansi ziyasebenza njengoba ingozi ikhuphuka.
- Ingozi iyanda, ayihlukaniswa ngokwezigaba. Ingozi yenhliziyo nemithambo yegazi iyanda njalo nge-LDL futhi ayivulwa ngomkhawulo. Izikhawu ziyizinto ezilula zokwenza izinqumo.
- I-LDL ebaliwe ingaba engathembekile uma ama-triglyceride ephezulu noma kumasampula angalali. Kulezi zimo i-cholesterol engeyona i-HDL noma i-LDL elinganiswe ngqo ithembeke kakhulu.
- I-HDL akuyona into okufanele uyilandele. I-HDL ephezulu kakhulu ayilona ubufakazi bokuvikelwa.
- Ama-Triglycerides ashintsha kakhulu phakathi kwamasampula. Inani elilodwa eliphakeme livame ukudinga ukuphindwa ngaphambi kokuba kufinyelelwe iziphetho.
- Isithombe sokushaya kwethrendi. Uma kubhekwa ukwelashwa, indlela yokushintsha ngokuhamba kwesikhathi ibaluleke ngaphezu kokufundwa okukodwa.
Akukho mafutha atholakalayo ahlonza isifo senhliziyo ngokwawo. Umbiko wakho kumele uhunyushwe ngokomongo wezokwelapha ngudokotela owucelile, kanye nomfutho wegazi, i-glucose noma i-HbA1c, isimo sokubhema, umlando womndeni, okutholakele ekuhlolweni, kanye nokuthwebula izithombe lapho kufanele khona.
Lapho imiphumela ye-cholesterol ingadukisa khona
Imiphumela engase iphakanyiswe ngamanga
- Ukudla okunamandla noma okunamafutha kwakamuva, noma utshwala: kuphakamisa ama-triglycerides, futhi kungaphazamisa ngokungaqondile i-LDL ebalwe.
- I-hypothyroidism engalashwanga: kuphakamisa i-cholesterol ephelele kanye ne-LDL; ukwelapha i-thyroid kuvame ukuthuthukisa iphrofayili yamafutha.
- I-Nephrotic syndrome, isifo sesibindi se-cholestatic, isifo sikashukela esingalawulwa: kungakhuphula kakhulu amafutha.
- Ukukhulelwa: ukwanda kwe-cholesterol kanye ne-triglycerides emzimbeni, ikakhulukazi ku-trimester yesithathu.
- Imithi ethile, kufaka phakathi ama-corticosteroids, amanye amalungiselelo ama-hormone, i-isotretinoin, ama-antiretroviral athile kanye namanye ama-immunosuppressants; amanye ama-beta-blockers amadala kanye nama-thiazides anemiphumela emincane.
- Isikhathi eside se-tourniquet noma ukulingana okunzima kungathinta abanye abahlaziyi.
- Ama-steroid e-Anabolic kanye nezinye izithako zokuzivocavoca umzimba kungakhuphula i-LDL futhi kwehlise i-HDL kakhulu.
Imiphumela engase yehliswe ngokungeyikho
- Ukugula okubukhali, ukutheleleka okukhulu noma i-sepsis: Ama-lipids awela okwesikhashana.
- Ngemva kokuhlaselwa yinhliziyo noma ukuhlinzwa okukhulu: I-LDL ingase yehle amasonto ambalwa; amasampula athathwe kusenesikhathi kakhulu ngemva kokungeniswa abonakala kakhulu kunalawo athathwe kamuva.
- Hyperthyroidism kuvame ukwehlisa i-cholesterol.
- Isifo sesibindi esithuthukile kanye nokungondleki kahle ukukhiqizwa kwe-cholesterol ephansi.
- Ama-triglyceride aphezulu kakhulu kungabangela ukubala kukaFriedewald kungayithathi kalula i-LDL.
- Ukwehla kwesisindo okukhulu kwakamuva noma ushintsho lwesikhashana ekudleni ngaphambi kokuba ukuhlolwa kungabangela inani eliphansi elingameleli.
Uma umphumela ungahambisani nesithombe sakho sezokwelapha, isampula ephindaphindwayo ngemva kokuba inkinga ebukhali isiphelile, futhi, lapho kufaneleka khona, ukuhlolwa kokusebenza kwe-thyroid, izinso kanye nesibindi, kuvame ukuba nolwazi oluningi kunokusebenza ekufundweni okukodwa.
Izingozi nokuphepha
Ukuthathwa kwegazi okujwayelekile emithanjeni
Isampula yemithambo yegazi inqubo enobungozi obuphansi. Imiphumela engaba khona ihlanganisa ubuhlungu obufushane, ukudumba, ikhanda elikhanyayo noma ukuquleka, futhi akuvamile ukuba ne-hematoma encane, ukuvuvukala komthambo noma ukutheleleka kwendawo. Ukudumba kungenzeka kakhulu uma uthatha imithi yokulwa nama-platelet noma imithi yokulwa nokugabha kwegazi noma unesifo sokopha, tshela abasebenzi kusengaphambili.
Ukuhlolwa kwendawo yokunakekelwa ngeminwe
Ukungakhululeki esihlokweni somunwe kanye nokuphuka okuncane kuyimiphumela evamile. Inkinga enkulu ukuhlaziya, hhayi ngokomzimba: imiphumela yamafutha aqunyiwe ngomunwe ayiqondile kangako, futhi inani elingavamile kufanele liqinisekiswe yisampula yelebhu.
Ingozi yokuzila ukudla, lapho kucelwa ukuzila ukudla
Ukuzila ukudla isikhathi eside kunengozi yangempela kubantu abasebenzisa i-insulin noma i-sulfonylureas, ezinganeni ezincane, ekukhulelweni, nakubantu abadala ababuthakathaka, lapho i-hypoglycemia, ukuphelelwa amanzi emzimbeni noma ukuwa kungenzeka khona. Xoxa ngokuzila ukudla nodokotela wakho okwelaphayo kunokucabanga ukuthi kuyadingeka.
Imiphumela iyahlukahluka kuye ngezimo zomtholampilo ngazinye.
Amafulegi abomvu: nini lapho kufanele ufune usizo kunokulinda ukuhlolwa
Isimo Esiphuthumayo Manje: Shayela izinsizakalo eziphuthumayo noma uye emnyangweni wezimo eziphuthumayo oseduze
- Ubuhlungu besifuba, ingcindezi noma ubunzima obuhlala isikhathi esingaphezu kwemizuzu embalwa, noma busakazekela engalweni, emhlathini, entanyeni noma emhlane
- Ukuphelelwa umoya okukhulu ngokuzumayo, noma ukungakhululeki esifubeni ngenxa yokujuluka, isicanucanu noma ukuquleka
- Ubuthakathaka obungazelelwe noma ukungakhululeki kobuso, ingalo noma umlenze, ukukhuluma okungazelelwe, ukulahlekelwa umbono ngokuzumayo, noma ikhanda elibuhlungu elingachazeki ngokuzumayo
- Ubuhlungu obukhulu, obuqhubekayo besisu esingaphezulu kanye nokuhlanza, ikakhulukazi uma kune-triglycerides ephezulu kakhulu eyaziwayo, lokhu kungabonisa i-pancreatitis ebukhali
- Umkhuhlane noma unyawo olubuhlungu, olubuhlungu, oluphuzi oluhambisana nokulahlekelwa yinhliziyo
Usuku olufanayo noma ukubuyekezwa kwezokwelapha okuphuthumayo
- Ukungakhululeki kwesifuba noma ukuphelelwa umoya okubangelwa ukuzikhandla nokuphumula
- Ama-triglyceride aphezulu kakhulu abikwe yilebhu, noma ngabe isisu sakho asibuhlungu noma cha.
- Ubuhlungu obusha bemisipha obuhambisana nomchamo omnyama ngenkathi usebenzisa i-statin noma omunye umuthi onciphisa amafutha, xhumana nodokotela ngalolo suku; ungamane uyeke umuthi wedwa.
- Ubuhlungu bethole lapho uhamba obuya buba bubi, noma isilonda sezinyawo esingapholi kumuntu onesifo sikashukela
I-aphoyintimenti ejwayelekile
- Inani elingavamile lamafutha esivivinyweni sokuhlolwa okuvamile noma sekamu
- Umlando womndeni wokuhlaselwa yinhliziyo kusenesikhathi, unhlangothi noma i-cholesterol ephezulu kakhulu
- Ama-deposit aphuzi azungeze izinkophe, imisipha iqina emaqakaleni, noma indandatho emhlophe okwesibhakabhaka emaphethelweni e-cornea kumuntu osemusha osemusha
- Kufanele kuqashwe ngesikhathi sokwelashwa kokwehlisa amafutha emzimbeni, noma ukufuna ukuxoxa ngokudla, umsebenzi kanye nokuyeka ukubhema
Izimo ezikhethekile
ukukhulelwa
Amazinga e-lipid ayanda njengengxenye evamile yokukhulelwa, ngakho-ke ukuhlolwa kwe-lipid okuvamile ngokuvamile akuhunyushwa ngendlela evamile futhi kuvame ukuhlehliswa. Ama-statin kanye neminye imithi eminingana yokwehlisa i-lipid ayisetshenziswa ekukhulelweni noma lapho uhlela ukukhulelwa, xoxa ngalokhu nodokotela wakho wezifo zabesifazane kanye nodokotela ngaphambi kokukhulelwa.
Izingane kanye nentsha
Ukuhlolwa kuhloswe kunokuthi kube yinto evamile: umlando womndeni oqinile wesifo senhliziyo nemithambo yegazi, okusolwa ukuthi une-hypercholesterolemia yomndeni, noma isimo esaziwayo se-metabolic. Ukuhumusha kusebenzisa amanani okubhekisela ezinganeni futhi kufanele kube ngudokotela wezingane. Ukuzila ukudla isikhathi eside ezinganeni kudinga iseluleko sezingane.
Abantu abadala abadala
Izinqumo ezisekelwe ezingozini empilweni yakamuva zilinganisa impilo iyonke, eminye imithi kanye nobuthakathaka, hhayi izinombolo zamafutha kuphela. Izinqumo zokuqala noma zokuqhubeka nokwelashwa kufanele zenziwe ngabanye nodokotela okwelaphayo.
Isifo sikashukela esitholakala emithini yokwehlisa ushukela
Ukukhubazeka kwamafutha egazini kubantu abanesifo sikashukela kuvame ukubonakala njengokuphakama kwama-triglycerides kanye ne-HDL ephansi ene-LDL ebonakala ingavamile, yingakho i-cholesterol engeyona i-HDL iwusizo. Ukuzila ukudla ngaphambi kokuhlolwa kudinga ukuhlela ukugwema i-hypoglycemia.
Isifo sezinso ezingapheli
I-CKD ishintsha amaphethini amafutha futhi ikhulisa ngokuzimela ingozi yenhliziyo nemithambo yegazi. Ukukhetha ukwelashwa kanye nemithamo kuyahlukahluka ku-CKD ethuthukile nakubantu abasebenzisa i-dialysis, ngakho-ke lezi zinqumo zifanele udokotela wezinzwa noma udokotela.
Isifo sendlala yegilo
I-hypothyroidism engelashwanga iyimbangela evamile futhi ephuthekayo kalula yokwanda kwe-cholesterol. Ukusebenza kwe-thyroid kuvame ukuhlolwa ngaphambi kokuthi kuthiwe umuntu unesifo samafutha esiyinhloko.
Izimo zesibindi
Isifo sesibindi esibizwa ngokuthi i-steatotic liver disease (SLD) sivame ukuhambisana nokukhubazeka kwamafutha. Amagama asetshenziswa njengamanje yi-MASLD (isifo sesibindi esibizwa ngokuthi i-steatotic dysfunction-associated metabolic dysfunction, esasibizwa ngokuthi i-NAFLD), i-MASH (esasibizwa ngokuthi i-NASH), kanye ne-MetalALD lapho ukuphuza utshwala obuningi nakho kunomthelela khona. "Amagremu" esibindi esibizwa ngokuthi i-ultrasound fatty liver ayachaza futhi ancike ku-opharetha futhi awalinganisi ukuvuvukala noma i-fibrosis. ENdiya, ukulimala kwesibindi okubangelwa izidakamizwa ngenxa yokwelashwa okulwa nesifo sofuba, imikhiqizo yamakhambi kanye ne-AYUSH kanye nezithako zokudla ejimini, kanye ne-hepatitis E, konke kubalulekile lapho ukuhlolwa kwesibindi (SGPT/ALT, SGOT/AST) kungavamile kanye nama-lipid.
Ukuhlolwa kwe-cholesterol kumongo waseNdiya
- Ingozi ngosayizi womzimba ophansi: Abantu baseNingizimu Asia bavame ukuba nokumelana ne-insulin, i-dyslipidemia kanye nesifo senhliziyo esiphansi kwe-BMI kanye nobubanzi besinqe kunabanye abantu abaningi, futhi ngokuvamile besebancane. Isisindo "esivamile" asisusi isidingo sokuhlolwa.
- Iphethini evamile yamafutha: Ama-triglyceride aphakanyisiwe ane-HDL ephansi, kanye nengxenye ephezulu ye-LDL encane exinene, avame ukubonakala. Kulesi simo, i-cholesterol engeyona i-HDL inikeza isithombe esiphelele kune-LDL yodwa.
- I-Lipoprotein (a): Kubikwa ukuthi amazinga aphezulu avamile kubantu baseNdiya futhi awabonwa yiphrofayili ejwayelekile yamafutha. Buza udokotela wakho ukuthi isilinganiso esisodwa sikufanele yini.
- Amakamu okuhlola kanye namadivayisi ekhemisi zitholakala kabanzi. Phatha imiphumela yekamu engavamile njengesiqondiso sokuhlolwa kwephrofayili yamafutha elabhorethri kanye nokubonisana nodokotela, hhayi njengokuxilongwa.
- I-terminology ekhawunteni: Amafomu elabhorethri kanye nabasebenzi bangabhekisela ku-"lipid profile", "FLP", "cholesterol test" noma nje "cholesterol". Ukuhlolwa okuhlobene kuvame ukuhleleka ndawonye futhi kuqanjwe ngamagama ajwayelekile, i-HbA1c ngokuthi "ukuhlolwa kweshukela kwezinyanga ezi-3", i-echocardiography ngokuthi "ukuhlolwa kwe-echo", kanye nama-enzyme esibindi njenge-SGPT kanye ne-SGOT.
- Izithasiselo kanye nemithi yendabuko: Tshela udokotela wakho ngayo yonke imikhiqizo ye-AYUSH, yezitshalo noma yejimu oyisebenzisayo. Eminye ithinta amafutha, eminye ithinta isibindi, kanti izimangalo zokukhangisa mayelana nokwelapha i-cholesterol ephezulu azivunyelwe ngaphansi koMthetho Wezidakamizwa Nemithi Yomlingo (Izikhangiso Ezingavunyelwe) ka-1954.
- Ubumfihlo bedatha: Amarekhodi ezempilo kanye nanoma yikuphi ukubhukha ku-inthanethi noma ithuluzi lokulanda imibiko kuphathwa ngaphansi koMthetho Wokuvikelwa Kwedatha Yomuntu Siqu Yedijithali, ka-2023.
- Imihlahlandlela: Isiqondiso sokuphathwa kwamafutha e-India esivela ezinhlanganweni ezifana ne-Lipid Association of India, kanye nesiqondiso samazwe ngamazwe esivela ku-ESC/EAS kanye ne-ACC/AHA, sibuyekezwa njalo. [Qinisekisa uhlelo lwamanje, KUZOQINISEKISWA]
Izindleko kanye nomshuwalense eNdiya
Iphrofayili ye-lipid ezimele ingenye yezivivinyo zelabhoratri ezingabizi kakhulu eNdiya, ngokuvamile intengo yayo ingama-rupee aphansi angamakhulu amaningi ezindaweni eziningi zelabhoratri, kanti izivivinyo ezengeziwe ezifana ne-apolipoprotein B noma i-lipoprotein(a) zibiza kakhulu. Amanani ahluka kakhulu phakathi kwamadolobha, izinhlobo zelabhoratri kanye namaphakheji.
Izici ezithinta lokho okukhokhayo:
- Kungakhathaliseki ukuthi iphrofayili ye-lipid izimele noma ihlanganiswe kuphakheji yokuhlola impilo
- Inani lamapharamitha, iphaneli eyisisekelo uma kuqhathaniswa nephaneli ye-lipid enwetshiwe ene-apoB, i-apoA1 noma i-lipoprotein(a)
- Isimo sokugunyazwa kwelabhorethri kanye nendlela yokuhlaziya esetshenzisiwe
- Idolobha nendawo; amanani e-metro ngokuvamile ahluka emadolobheni amancane
- Izindleko zokuqoqa isampula yasekhaya kanye nokuqoqwa kwangaphandle kwamahora
- Izinhlelo zikahulumeni kanye namanani ezibhedlela zomphakathi, okungaba mahhala noma okuxhaswe kakhulu
- Ukuthi ukuhlolwa kwenziwa ngesikhathi sokwamukelwa esibhedlela, lapho kuvame ukuba yingxenye yebhili iyonke
Umshwalense: izivivinyo zokuxilonga iziguli zangaphandle azivame ukumbozwa umshwalense wezempilo oyisisekelo ngaphandle kokuthi inqubomgomo ifaka i-OPD noma inzuzo yokuhlola impilo. Izivivinyo ezenziwa ngesikhathi sokungeniswa esibhedlela okumboziwe noma inqubo yokunakekelwa kwasemini evunyiwe ngokuvamile ziyabuyiselwa. Izinhlelo eziningi zempilo yenkampani zifaka phakathi iphrofayili yamafutha. Qinisekisa ukumbozwa nomshwalense wakho noma i-TPA ngaphambi kokuhlolwa.
Izinganekwane namaqiniso
| Inganekwane | Iqiniso |
|---|---|
| Abantu abancane abadingi ukuhlolwa kwe-cholesterol | Ukukhubazeka kwamafutha kanye ne-hypercholesterolaemia yomndeni kwenzeka kunoma yimuphi usayizi womzimba, kanti abantu baseNingizimu Asia bathuthukisa ingozi yokuguqulwa kwe-metabolic ku-BMI ephansi. |
| Umbiko we-cholesterol ojwayelekile usho ukuthi inhliziyo yami iphilile | Iphrofayili yamafutha ayibonisi imithambo yegazi. Abantu abaningi abanesifo senhliziyo banenani lamafutha elingavamile |
| Kumelwe uzile ukudla amahora angu-9-12 njalo | Amayunithi amaningi amukela amasampula okungazili ukudla ukuze ahlolwe njalo; ukuzila ukudla kucelwa ngezizathu ezithile futhi kuyahlukahluka ngokwenqubo |
| Amaqanda noma i-ghee yimbangela eyinhloko ye-cholesterol ephezulu | I-cholesterol yegazi iqhutshwa kakhulu yizakhi zofuzo kanye nephethini yokudla iyonke. Ukudla okukodwa akubalulekile kakhulu kunephethini iyonke kanye nezakhi zofuzo zomuntu ngamunye. |
| Imithi ye-cholesterol ingamiswa uma isijwayelekile | Amazinga avame ukukhuphuka futhi ngemva kokuyeka. Noma yiluphi ushintsho kumele lunqunywe ngudokotela, hhayi ngokuzimela |
| I-HDL ephezulu isho ukuthi uvikelekile | I-HDL iwuphawu lobungozi, hhayi isivikelo. I-HDL ephezulu kakhulu ayibonakali ukuthi iyavikela |
| Imikhiqizo yezitshalo ingalapha i-cholesterol ephezulu | Akukho mkhiqizo okufanele ukhangiswe njengomuthi. Ezinye izithako zemithi kanye nezokujima zingalimaza isibindi |
| I-cholesterol kufanele ibe phansi ngangokunokwenzeka kuwo wonke umuntu | Imigomo isekelwe ezingozini futhi ihlukaniswe ngabanye, futhi ibekwa udokotela wakho |
Imibuzo ejwayelekile ukubuzwa
Ingabe ngidinga ukuzila ukudla ngaphambi kokuhlolwa kwe-cholesterol?
Ngokuvamile akunjalo. Ukuze kuhlolwe ubungozi obujwayelekile, amalabhorethri amaningi kanye neziqondiso zamukela iphrofayili yamafutha angewona ukuzila ukudla, ngoba ukudla kuthinta i-cholesterol iyonke kanye ne-LDL kancane kuphela. Ukuzila ukudla kungase kucelwe uma ama-triglyceride ephezulu kakhulu noma kusolwa ukuthi kukhona isifo se-lipid esibangelwa ufuzo. Landela imiyalelo enikezwa yiyunithi yakho yokuqoqa.
Kuthatha isikhathi esingakanani ukuhlolwa kwe-cholesterol?
Ukudonswa kwegazi ngokwako kuthatha imizuzu emibili kuya kwemihlanu. Ukuvakasha konke kuvame ukuba yimizuzu eyishumi kuya kwengamashumi amabili kufaka phakathi ukubhalisa nokulinda, isikhathi eside ngezikhathi ezimatasa. Uma kucelwe isampula yokuzila ukudla, isikhathi sokuzila ukudla ngaphambi kwesikhathi yisikhathi esiyinhloko, hhayi ukuhlolwa.
Ingabe i-cholesterol yami ingaba phezulu noma ngibukeka ngiphilile futhi ngizivocavoca?
Yebo. I-Familial hypercholesterolaemia kanye ne-lipoprotein (a) ephakanyisiwe kuzuzwe njengefa futhi akuhlobene nokuqina komzimba noma usayizi womzimba. Abantu abancane, abakhuthele nabangabhemi bangase babe ne-LDL ephezulu kakhulu. Lesi esinye sezizathu ezenza kube wusizo ukuthola iphrofayili yamafutha eyisisekelo kanye nengxoxo yomlando womndeni.
Uyini umehluko phakathi kokuhlolwa kwe-cholesterol kanye ne-echo noma i-ECG?
Ukuhlolwa kwe-cholesterol kulinganisa amafutha egazini. I-ECG iqopha umsebenzi kagesi wenhliziyo, kanti i-2D echo ifanekisela imisipha yenhliziyo nama-valve. Iphrofayili yamafutha noma i-echo yokuphumula ayibonisi imithambo yenhliziyo, ngakho ayikho neyodwa engakwazi ukuhlukanisa isifo semithambo yenhliziyo ngokwayo.
I-cholesterol yami ingaphezu kwamandla. Ingabe kufanele ngiqale umuthi?
Leso sinqumo asithathwa ngenombolo kuphela. Udokotela wakho ulinganisa ubudala, umfutho wegazi, isifo sikashukela, ukubhema, ukusebenza kwezinso, umlando womndeni kanye nengozi iyonke ngaphambi kokukweluleka ngemithi, ukushintsha indlela yokuphila, noma ukuhlolwa okuphindaphindiwe kamuva. Ungalokothi uqale noma uyeke umuthi owehlisa amafutha ngaphandle kokukhuluma nodokotela.
Kungani ama-triglyceride ami ashintshe kangaka phakathi kokuhlolwa okubili?
Ama-triglyceride ayahlukahluka kakhulu. Ukudla kwamuva nje, utshwala, ukugula okukhulu, ukulawulwa kabi kwesifo sikashukela, ukushintsha kwesisindo ngisho nesikhathi sosuku konke kushintsha inani. Umphumela owodwa we-triglyceride ephezulu uvame ukuphindwa, ngokuvamile njengesampula yokuzila ukudla, ngaphambi kokuba kufinyelelwe noma yisiphi isiphetho.
Ingabe ukuhlolwa kwe-cholesterol okuhlatshwe ngomunwe ekamu lezempilo kuthembekile?
Amadivayisi okugwaza ngeminwe afanelekile ekuhlolweni nasekushukumiseni isinyathelo esengeziwe, kodwa awanembile kangako njengokuhlaziywa kwelebhu futhi angahlukanisa kabi amanani omngcele. Uma ukuhlolwa kwekamu kungavamile, yiba nephrofayili yamafutha elabhorethri yemithambo yegazi bese uxoxa ngomphumela nodokotela ngaphambi kokwenza izinqumo.
Ukuhlolwa kwe-cholesterol kufanele kuphindwe kangaki?
Isikhathi sokuphumula sincike engcupheni yakho nokuthi uyalashwa yini. Umuntu ongenazo izici eziyingozi kanye nomphumela ojwayelekile angalinda iminyaka; umuntu oqala noma olungisa ukwelashwa kokwehlisa amafutha angaphinde ahlolwe phakathi kwamasonto kuya ezinyangeni. Udokotela wakho ubeka isikhathi sokuphumula sesimo sakho.
Ingabe ukushintsha indlela yokuphila kukodwa kungayehlisa i-cholesterol?
Indlela yokudla, umsebenzi womzimba ojwayelekile kanye nokuyeka ugwayi kuthuthukisa amafutha kanye nengozi yenhliziyo kubantu abaningi, futhi kuyazuzisa noma kunjalo. Kodwa-ke, izifo zofuzo ezifana ne-familial hypercholesterolaemia zivame ukudinga imithi. Imiphumela iyahlukahluka kuye ngezimo zomtholampilo ngazinye.
Imithombo
- Rinella ME, et al. Isitatimende sokuvumelana se-Delphi sezinhlangano eziningi mayelana nokuqamba amagama okusha kwesifo sesibindi esinamafutha. 2023.
- Iziqondiso ze-European Society of Cardiology / European Atherosclerosis Society mayelana nokuphathwa kwe-dyslipidaemias. [Qinisekisa uhlelo lwamanje, KUZOQINISEKISWA]
- Isiqondiso se-American College of Cardiology / American Heart Association mayelana nokuphathwa kwe-cholesterol egazini. [Qinisekisa uhlelo lwamanje, KUZOQINISEKISWA]
- Izitatimende zokuvumelana ze-Lipid Association of India mayelana nokuphathwa kwe-dyslipidaemia kumaNdiya. [Qinisekisa uhlelo lwamanje, KUZOQINISEKISWA]
- Umthetho Wezidakamizwa Nemithi Yomlingo (Izikhangiso Ezingaphikiswa), ka-1954, Uhulumeni waseNdiya.
- Umthetho Wokuvikelwa Kwedatha Yomuntu Siqu Yedijithali, 2023, Uhulumeni waseNdiya.
