Q. Makore maviri akapfuura chiremba wangu akandiisa pa 80 mg ye atorvastatin nokuti cholesterol yangu yakanga yakwira, uye mwoyo wangu wekutsvaga calcium scan yakaratidza mazana maviri. Kubvira panguva iyoyo my cholesterol yangu yasvika zvakanaka - asi patakadzokorora calcium scan vhiki yevhiki yangu calcium chikamu chaiva kusvika 290! Kana iyo statin iri kushanda, nei my calcium score ichikwira zvakanyanya? Izvo chirwere changu chechirwere chinotapira chirwere chinowedzera kuipa here?
A. Maitiro e coronary artery calcium score kuti awedzere neine statin therapy ave nzvimbo yekukakavadzana uye kunetseka pakati pevanhu vane cardiologists. Zvisinei, humwe uchapupu hwakanakisisa iye zvino hunoratidza kuti, sekunyanyisa sezvinogona kurira, izvi zvingava chinhu chakanaka. Inogona kuratidzira kuti statins iri kugadzirisa chigoni chemarita epakiti.
Zvimwe Zvakaitika Zviri Mukati.
Atherosclerosis inobata makanda mumasvingo eerteri, kusanganisira coronary arteries. Aya mahwendefa anogona kukura zvakakura zvakakwana kuti asanyanya kubvisa arteri uye kubudisa zviratidzo, zvakadai sekungina kana kujekesa . Zvisinei, dambudziko rechokwadi nemarata aya ndeokuti vanogona kuparara kamwe kamwe, zvichikonzera kuitika kamwe kamwe kwetari - izvo zvinowanzoita kuti munhu arwise mwoyo , kana kurohwa .
Mabheti ndiwo mabhuku emhando dzakawanda, kusanganisira lipids, masero ekuvhiringidza, masero e-fibrotic, uye calcium. Ndiyo calcium mu atherosclerotic plaques inowanikwa ne-cardiac calcium scan - yakakwirira calcium score, iyo yakazara yakawanda is atherosclerosis.
Saka, apo chiremba wako akakutanga iwe paatorvastatin, iye haasi kungobata cholesterol yako, asi wakabatawo zviratidzo zvako zve atherosclerotic plaques.
Statins Uye The Calcium Score
Tsvakurudzo dzinoverengeka dzakaratidza zvino kuti kurapa murwere ane atherosclerosis nemasimoni kunogona kuwedzera mwoyo wekodhium score.
Sezvo mitemo inofungidzirwa kuti ibatsire kudzivisa uye kunyange kubatsira kubvisa chirwere chetachiona chirwere, ichi chigumisiro chinoratidzika sechinyadzisa. Muna 2015, chidzidzo chakabudiswa mu Journal of the American College of Cardiology iyo inobatsira kutsanangura kuti nei kuwedzera kwe calcium kunoreva.
Vatsvakurudzo vakaongorora zvidzidzo zvisere zvakasiyana-siyana zvakashandisa intravascular ultrasound (IVUS, catheter technique) kuongorora ukuru uye kuumbwa kwe atherosclerotic plaques kune varwere vanobatwa nemashizha. Vakawana zvinhu zviviri. Kutanga, chirwere chepamusoro-dose chimiro chetachiona chakanga chichida kukonzera matanda. Chechipiri, apo mabhokisi acho akanga achiderera, kuumbwa kwavo kwakanga kuri kuchinja. Mushure mokurapa kwechirongwa, iyo yakawanda yepayipi inosungirwa mukati memasque yakaderera, uye yakawanda yemasero e-fibrotic uye calcium yakawedzera. Iko kushanduka - kushandura chidimbu "chisina kumira" chisina kugadzikana kune rimwe rakagadzikana "rakaoma" chigadziko - chinogona kupa ruvara rusingakwanisi kupera kamwe kamwe. (Izvi zvinonyatsoenderana nekuti statin therapy inowedzera kuderedza dambudziko rekurwadziwa kwemwoyo kune varwere vane chirwere chetachiona.)
Mukupfupisa, uchapupu huripo hunosimbisa pfungwa yokuti utachiona hwemagetsi hausi kungotapudza cholesterol maitiro, asiwo hunochinja huripo huripo hunoita kuti dzive dzisina ngozi.
Sezvimwe chikamu chekuita izvi, mahwendefa anogona kunge akawedzera kuverengwa - uye naizvozvo, calcium score inokwira. Kuwedzera kaccium score neyemagadzirirwo emitemo, saka, inogona kuratidza kubudirira kwehutano, uye haifaniri kuva chikonzero chemashoko.
Kunyange zvazvo dzidziso iyi isina kugadziriswa nesayenzi, panguva ino inonyatsokodzera uchapupu huripo.
The Bottom Line
Chirwere chemoyo chinokanganisa chinogona kuva chinhu chinobatsira pakucherechedza kuvapo kana kusavapo kwekodonary artery disease. Kana calcium iripo, atherosclerosis iripo - uye hupenyu hutsinye hwekuchinja huripo. Mukuwedzera, kufungisisa kwakasimba kunofanira kupiwa kune statin therapy uye prophylactic aspirin.
Asi, kana chirwere chetemineni chakatanga, kududzira pashure pekuwedzera kwekasiki kunopinda dambudziko. Kana iyo calcium score inokwira, inogona kunge isina kuratidza kuipa kweCAD, asi pane, inogona kuva yakakosha yekushandiswa kwemaitiro.
Sezvo mutemo wehuwandu, vanachiremba havafanire kuronga miedzo iyo yavanoziva kare mberi kwavo zvichida havazokwanisi kududzira. Kunyange zvazvo kuongorora kaccium scan kunoita kuti vanhu vakawanda vari panjodzi yekurwara zvirwere, vachidzokorora iyo calcium scans mushure mekunyorwa kwemasimoni yakatangwa kungangodaro kunokonzera kushushikana, pasina kuwedzera ruzivo rwakakosha.
Sources:
Puri R, Nicholls SJ, Shao M, et al. Mhedziso yemasitadhi pa serial coronary calcification panguva yekufambira kweatheroma uye kuregererwa. J Am Coll Cardiol 2015; 65: 1273-1282.
Shaw LJ, Narula J, Chandrashekhar Y. Nyaya isingagumi pamakoronic calcium. J Am Coll Cardiol 2015; 65: 1273-1282