Nuwamba 16, 2019 - Daga Tracie White
gwadawa
David Maron
Marasa lafiya da ke fama da cututtukan zuciya mai tsanani amma kwanciyar hankali waɗanda aka bi da su tare da magunguna da shawarwarin salon rayuwa kaɗai ba su da haɗarin kamuwa da bugun zuciya ko mutuwa fiye da waɗanda ke fuskantar hanyoyin tiyata masu ɓarna, bisa ga babban gwajin asibiti na tarayya wanda masu bincike a Stanford suka jagoranta. Makarantar Magunguna da Makarantar Kiwon Lafiya ta Jami'ar New York.
Gwajin ya nuna, duk da haka, a cikin marasa lafiya da ke fama da cututtukan jijiyoyin jini waɗanda kuma ke da alamun angina - ciwon ƙirji wanda ke haifar da ƙuntataccen jini zuwa zuciya - jiyya tare da hanyoyin da za su iya lalacewa, irin su stent ko tiyata, ya fi tasiri wajen kawar da bayyanar cututtuka. da inganta ingancin rayuwa.
"Ga marasa lafiya da ciwon zuciya mai tsanani amma kwanciyar hankali wadanda ba sa so su fuskanci wadannan hanyoyin da suka shafi rikici, waɗannan sakamakon suna da ban sha'awa sosai," in ji David Maron, MD, farfesa na likitanci da kuma darektan rigakafin cututtukan zuciya a Makarantar Magungunan Stanford, kuma Mataimakin shugaban gwajin, wanda ake kira ISCHEMIA, don Nazarin Ƙasashen Duniya na Kwatancen Lafiyar Kiwon Lafiya tare da Hanyoyi na Likita da Cin Hanci.
"Sakamakon ba ya nuna cewa ya kamata a yi hanyoyin da za a hana faruwar cututtukan zuciya," in ji Maron, wanda shi ne shugaban Cibiyar Nazarin Rigakafin Stanford.
Abubuwan kiwon lafiyar da aka auna ta hanyar binciken sun hada da mutuwa daga cututtukan zuciya, ciwon zuciya, asibiti don angina maras kyau, asibiti don ciwon zuciya da farfadowa bayan an kama zuciya.
Sakamakon binciken, wanda ya ƙunshi mahalarta 5,179 a wurare 320 a cikin ƙasashe 37, an gabatar da su a ranar 16 ga Nuwamba a Taron Kimiyya na Ƙungiyar Zuciya ta Amirka na 2019 da aka gudanar a Philadelphia.Judith Hochman, MD, babban jami'in kula da kimiyyar asibiti a NYU Grossman School of Medicine, ita ce shugabar gwajin.Sauran cibiyoyin da ke da hannu tare da nazarin binciken sune Cibiyar Zuciya ta Mid America ta Saint Luke da Jami'ar Duke.Cibiyar Zuciya, Lung, da Cibiyar Jini ta Kasa ta zuba jari fiye da dala miliyan 100 a cikin binciken, wanda ya fara shigar da mahalarta a cikin 2012.
'Daya daga cikin tambayoyin tsakiya'
"Wannan ya kasance ɗaya daga cikin tambayoyin tsakiya na maganin cututtukan zuciya na dogon lokaci: Shin maganin likita ne kawai ko kuma maganin likita tare da hanyoyin cin zarafi na yau da kullum shine mafi kyawun magani ga wannan rukunin marasa lafiya na zuciya?"in ji mai binciken co-bincike Robert Harrington, MD, farfesa kuma shugaban magani a Stanford da Arthur L. Bloomfield Farfesa na Medicine."Ina ganin wannan a matsayin rage yawan hanyoyin cin zarafi."
gwadawa
Robert Harrington
An tsara binciken ne don yin la'akari da aikin asibiti na yanzu, wanda marasa lafiya da ke da mummunar toshewa a cikin arteries sukan yi amfani da angiogram da revascularization tare da stent implant ko kewaye tiyata.Har zuwa yanzu, an sami ƙananan shaidar kimiyya don tallafawa ko waɗannan hanyoyin sun fi tasiri wajen hana cututtuka na zuciya fiye da kawai kula da marasa lafiya da magunguna irin su aspirin da statins.
Harrington, wanda ke duba marasa lafiya a kai a kai ya ce "Idan ka yi tunani game da shi, akwai fahimtar cewa idan akwai toshewa a cikin jijiya da kuma shaidar cewa toshewar yana haifar da matsala, buɗe wannan toshewar zai sa mutane su ji daɗi kuma su rayu tsawon lokaci," in ji Harrington, wanda ke ganin marasa lafiya akai-akai. tare da cututtukan zuciya na zuciya a Stanford Health Care.“Amma babu wata shaida da ke nuna cewa lallai hakan gaskiya ne.Shi ya sa muka yi wannan nazari.”
Magani masu cin zarafi sun haɗa da catheterization, hanyar da ake zamewar catheter mai kama da bututu zuwa cikin jijiya a cikin makwancinta ko hannu kuma ana zare ta ta hanyoyin jini zuwa zuciya.Bayan haka kuma ana sake dawo da jijiyoyin jini, kamar yadda ake buƙata: sanya stent, wanda aka sanya ta cikin catheter don buɗe magudanar jini, ko tiyata ta hanyar bugun zuciya, inda aka sake tura wata jijiya ko jijiya don wucewa ta wurin toshewar.
Masu bincike sun yi nazarin marasa lafiya na zuciya waɗanda ke cikin kwanciyar hankali amma suna rayuwa tare da matsakaici zuwa matsakaicin ischemia wanda ya haifar da farko ta hanyar atherosclerosis - adibas na plaque a cikin arteries.Ciwon zuciya na Ischemic, wanda kuma aka sani da cututtukan jijiyoyin jini ko cututtukan zuciya, shine mafi yawan nau'in cututtukan zuciya.Marasa lafiya da ke fama da cutar sun rage tasoshin zuciya wanda idan aka toshe gaba daya, suna haifar da bugun zuciya.Kimanin Amurkawa miliyan 17.6 ne ke rayuwa tare da wannan yanayin, wanda ke haifar da mutuwar kusan 450,000 a kowace shekara, a cewar Ƙungiyar Zuciya ta Amurka.
Ischemia, wanda ke rage yawan jini, yakan haifar da alamun ciwon kirji da aka sani da angina.Kimanin kashi biyu bisa uku na wadancan marasa lafiyar zuciya da suka shiga cikin binciken sun sami alamun ciwon kirji.
Sakamakon wannan binciken bai shafi mutanen da ke da matsanancin ciwon zuciya ba, kamar masu ciwon zuciya, in ji masu binciken.Mutanen da ke fuskantar matsalolin zuciya mai tsanani ya kamata su nemi kulawar likita nan da nan.
Nazarin bazuwar
Don gudanar da binciken, masu bincike sun raba marasa lafiya zuwa kungiyoyi biyu.Dukansu ƙungiyoyin sun karɓi magunguna da shawarwarin salon rayuwa, amma ɗaya daga cikin ƙungiyoyin ne kawai aka gudanar da hanyoyin lalata.Binciken ya biyo bayan marasa lafiya tsakanin 1½ da shekaru bakwai, suna kiyaye shafuka akan kowane al'amuran zuciya.
Sakamako ya nuna cewa waɗanda aka yi wa wata hanya ta ɓarna suna da kusan kashi 2% mafi girma na al'amuran zuciya a cikin shekarar farko idan aka kwatanta da waɗanda ke kan maganin likita kaɗai.An danganta wannan ga ƙarin haɗarin da ke tattare da samun hanyoyin ɓarna, masu binciken sun ce.Zuwa shekara ta biyu, ba a nuna bambanci ba.A cikin shekara ta hudu, yawan abubuwan da suka faru sun kasance 2% a cikin marasa lafiya da aka bi da su tare da hanyoyin zuciya fiye da wadanda ke kan magani da shawarwarin salon rayuwa kadai.Wannan yanayin bai haifar da wani babban bambanci tsakanin dabarun jiyya guda biyu ba, in ji masu binciken.
Daga cikin marasa lafiya da suka ba da rahoton ciwon kirji na yau da kullum ko mako-mako a farkon binciken, 50% na wadanda aka bi da su ba tare da lalata ba an gano su ba su da angina bayan shekara guda, idan aka kwatanta da 20% na wadanda aka bi da su tare da salon rayuwa da magani kadai.
"Bisa ga sakamakonmu, muna ba da shawarar cewa duk marasa lafiya su dauki magungunan da aka tabbatar don rage haɗarin ciwon zuciya, yin aiki a jiki, cin abinci mai kyau da kuma barin shan taba," in ji Maron."Marasa lafiya ba tare da angina ba ba za su ga ci gaba ba, amma waɗanda ke da angina na kowane irin tsanani za su kasance suna da mafi girma, ci gaba mai dorewa a cikin ingancin rayuwa idan suna da tsarin zuciya mai lalacewa.Ya kamata su yi magana da likitocin su don yanke shawarar ko za a yi musu reshen jini.”
Masu binciken suna shirin ci gaba da bin mahalarta binciken har tsawon wasu shekaru biyar don tantance ko sakamakon ya canza cikin dogon lokaci.
"Zai zama mahimmanci a bi diddigin don ganin ko, bayan lokaci, za a sami bambanci.A tsawon lokacin da muka bi mahalarta, babu wata fa'ida ta tsira daga dabarun cin zarafi," in ji Maron."Ina ganin yakamata wadannan sakamakon su canza aikin asibiti.Ana yin matakai da yawa akan mutanen da ba su da alamun cutar.Yana da wuya a ba da hujjar sanya stent a cikin marasa lafiya waɗanda ke da kwanciyar hankali kuma ba su da alamun cutar. ”
Lokacin aikawa: Nuwamba-10-2023