Mbudzi 16, 2019 - NaTracie White
test
David Maron
Varwere vane chirwere chemoyo chakanyanya asi chakasimba vanorapwa nemishonga uye mazano emararamiro ega havasisiri panjodzi yechirwere chemoyo kana kufa pane avo vanovhiyiwa, maererano nehombe, inotsigirwa nemari yekiriniki yekuyedza inotungamirwa nevatsvaguri paStanford. Chikoro cheMishonga uye chikoro chekurapa cheNew York University.
Muedzo wacho wakaratidza, zvisinei, kuti pakati pevarwere vane coronary artery disease vaivawo nezviratidzo zveangina - kurwadziwa muchipfuva kunokonzerwa nekudzivirirwa kweropa kuyerera kusvika kumoyo - kurapwa nemaitiro ekupinda, senge stents kana bypass kuvhiyiwa, kwainyanya kubatsira pakubvisa zviratidzo. nekuvandudza mararamiro ehupenyu.
"Kune varwere vane chirwere chemoyo chakanyanya asi chakasimba vasingadi kuita maitiro aya, izvi zvinokurudzira," akadaro David Maron, MD, purofesa wekiriniki yemishonga uye mutungamiriri wekudzivirira cardiology paStanford School of Medicine, uye. co-sachigaro wekutongwa, inonzi ISCHEMIA, yeInternational Study yeComparative Health Effectiveness neMedical and Invasive Approaches.
"Mhedzisiro yacho hairatidze kuti vanofanirwa kuvhiyiwa kuitira kudzivirira zviitiko zvemoyo," akawedzera Maron, anove mukuru weStanford Prevention Research Center.
Zviitiko zvehutano zvakayerwa nechidzidzo zvinosanganisira rufu kubva kune chirwere chemwoyo, chirwere chemwoyo, kuchipatara kune angina isina kugadzikana, kuchipatara nokuda kwekushaya simba kwemoyo uye kudzorerwa shure kwekusungwa kwemwoyo.
Mhedzisiro yechidzidzo ichi, iyo yaisanganisira vatori vechikamu 5,179 munzvimbo mazana matatu nemakumi matatu munyika makumi matatu nenomwe, yakapihwa Mbudzi 16 kuAmerican Heart Association's Scientific Sessions 2019 yakaitirwa muPhiladelphia.Judith Hochman, MD, mukuru wedhipatimendi wekiriniki sainzi paNYU Grossman Chikoro cheMishonga, aive sachigaro wekutongwa.Mamwe masangano ane chekuita nekuongorora kwechidzidzo ichi aive Saint Luke's Mid America Heart Institute uye Duke University.National Heart, Lung, uye Blood Institute yakaisa mari inodarika zana remamiriyoni emadhora muchidzidzo ichi, icho chakatanga kunyoresa vatori vechikamu muna 2012.
'Mumwe wemibvunzo yakakosha'
"Iyi yanga iri imwe yemibvunzo yakakosha yemishonga yemoyo kwenguva yakareba: Kurapa kwekurapa kwega kana kurapwa kwakasanganiswa nemaitiro echinyakare maitiro ekurapa kwakanyanya kweboka iri revarwere vemoyo yakagadzikana?"akadaro muongorori-muongorori Robert Harrington, MD, purofesa uye sachigaro wemishonga paStanford uye Arthur L. Bloomfield Purofesa weMishonga."Ini ndinoona izvi sekudzikisa huwandu hwemaitiro ekupinda."
test
Robert Harrington
Chidzidzo chacho chakagadzirirwa kuratidza maitiro ekiriniki aripo, umo varwere vane zvivharo zvakakomba mutsinga dzavo vanowanzoita angiogram uye revascularization ne stent implant kana bypass kuvhiyiwa.Kusvika parizvino, pave paine humbowo hushoma hwesainzi hunotsigira kuti maitiro aya anoshanda zvakanyanya mukudzivirira njodzi yemoyo pane kungorapa varwere nemishonga yakadai seaspirin uye statins.
"Ukafunga nezvazvo, pane intuitiveness yekuti kana paine kuvharika mutsinga uye humbowo hwekuti kuvharika uku kuri kukonzera dambudziko, kuvhura kuvharika uku kuchaita kuti vanhu vanzwe zviri nani uye vararame kwenguva refu," akadaro Harrington, anogara achiona varwere. ane chirwere chemoyo kuStanford Health Care.“Asi hapana humbowo hunoratidza kuti ichi ichokwadi.Ndosaka takaita chidzidzo ichi.”
Mishonga inoparadza inosanganisira catheterization, maitiro ekuti chubhu-yakaita catheter inotsvedzerwa mutsinga iri mugomba kana ruoko uye inoiswa mutsinga dzeropa kumoyo.Izvi zvinoteverwa ne revascularization, sezvinodiwa: kuiswa kwe stent, iyo inopinzwa kuburikidza ne catheter kuti ivhure tsinga yeropa, kana cardiac bypass kuvhiyiwa, umo imwe tsinga kana tsinga inoiswazve kuti ipfuure nzvimbo yekuvharika.
Vatsvakurudzi vakaongorora varwere vemwoyo vakanga vakagadzikana asi vachirarama nepakati kusvika kune yakaoma ischemia yakakonzerwa zvikuru neatherosclerosis - deposits of plaque mutsinga.Chirwere chemoyo cheIschemic, chinonziwo coronary artery disease kana coronary heart disease, ndiyo yakajairika mhando yechirwere chemoyo.Varwere vane chirwere vane tsinga dzemwoyo dzakatetepa iyo, kana yakavharwa zvachose, inokonzera chirwere chemoyo.Vanenge mamiriyoni 17.6 vekuAmerica vanogara nemamiriro ezvinhu, izvo zvinoguma nekufa kwe450,000 gore negore, maererano neAmerican Heart Association.
Ischemia, iyo inoderedza kubuda kweropa, inowanzokonzera zviratidzo zvekurwadziwa kwechipfuva zvinonzi angina.Vanenge zvikamu zviviri kubva muzvitatu zvevarwere vemoyo avo vakanyoresa muchidzidzo vakatambura zviratidzo zvekurwadziwa kwechipfuva.
Mhedzisiro yechidzidzo ichi haishande kune vanhu vane acute moyo mamiriro, akadai seavo vane chirwere chemoyo, vaongorori vakati.Vanhu vari kusangana nezviitiko zvemoyo zvakanyanya vanofanirwa kutsvaga kurapwa kwakakodzera.
Kudzidza randomized
Kuitisa chidzidzo, vaongorori vakapatsanura varwere mumapoka maviri.Mapoka maviri aya akagamuchira mishonga uye mazano emararamiro, asi rimwe chete remapoka rakapinda maitiro asina kunaka.Chidzidzo ichi chakatevera varwere vari pakati pe1½ nemakore manomwe, vachichengeta ma tabo pane chero zviitiko zvemoyo.
Mhedzisiro yakaratidza kuti avo vakaita chirongwa chechisimba vaive ne2% yepamusoro mwero wezviitiko zvemoyo mukati megore rekutanga kana zvichienzaniswa neavo vari pakurapa kurapwa chete.Izvi zvakakonzerwa nenjodzi dzekuwedzera dzinouya nekuve nemaitirwo ekupinda, vaongorori vakadaro.Pakazosvika gore rechipiri, hapana musiyano wakaratidzwa.Pakazosvika gore rechina, chiyero chezviitiko chakanga chiri 2% pasi kune varwere vanobatwa nemaitiro emwoyo pane avo vari pamishonga uye mazano ehupenyu chete.Izvi zvakakonzera kusakosha kwakasiyana kwakasiyana pakati pemaitiro maviri ekurapa, vaongorori vakati.
Pakati pevarwere vakarondedzera kurwadziwa kwechipfuva zuva nezuva kana kwevhiki pakutanga kwechidzidzo, 50% yeavo vakabatwa nechisimba vakawanikwa vasina angina mushure megore, zvichienzaniswa ne20% yevaya vanorapwa nemararamiro uye mishonga chete.
"Kubva pamigumisiro yedu, tinokurudzira kuti varwere vose vatore mishonga inoratidzirwa kuderedza dambudziko rekurwadziwa kwemoyo, kuve nekuita muviri, kudya kudya kwakanaka uye kurega kusvuta," akadaro Maron."Varwere vasina angina havazooni kuvandudzwa, asi avo vane angina yehupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi hupi husina kunaka hunoita kuti huve nekuvandudzwa kukuru kwehupenyu hwehupenyu kana vane chirwere chemoyo chinokanganisa.Vanofanira kutaura nevarapi vavo kuti vasarudze kana voitwa revascularization.”
Vaongorori vanoronga kuenderera mberi nekutevera vatori vechikamu kwemamwe makore mashanu kuti vaone kana mhedzisiro inoshanduka nekufamba kwenguva.
"Zvichave zvakakosha kuteedzera kuona kana, nekufamba kwenguva, pachava nemusiyano.Kwenguva yatakatevera vatori vechikamu, pakanga pasina kana pundutso kubva muchirongwa chekupinda, "akadaro Maron."Ini ndinofunga mhedzisiro iyi inofanirwa kushandura kiriniki maitiro.Mazhinji maitiro anoitwa kune vanhu vasina zviratidzo.Zvakaoma kupembedza kuisa stents muvarwere vakagadzikana uye vasina zviratidzo. ”
Nguva yekutumira: Nov-10-2023