ʻO hypercholesterolemia ʻohana

ʻO ka hypercholesterolemia ʻohana kahi maʻi i hala i nā ʻohana. Kuhi ia i ka kiʻekiʻe kiʻekiʻe o ka LDL (ʻino) kolesterol. Hoʻomaka ke ʻano i ka wā hānau a hiki ke hōʻeha i ka puʻuwai i ka wā ʻōpio.

Pili nā kumuhana pili:

• ʻO ka hyperlipidemia hui pū ʻia
• ʻO ka hypertriglyceridemia ʻohana
• ʻO ka dysbetalipoproteinemia ʻohana

ʻO ka hypercholesterolemia ʻohana kahi maʻi maʻi. Hoʻokumu ʻia ia e kahi kīnā ma chromosome 19.

ʻAʻole hiki i ke kīnā ke lawe i ke kino o ka lipoprotein haʻahaʻa (LDL, a i ʻole maikaʻi ʻole) koloma mai ke koko. Loaʻa kēia i kahi pae kiʻekiʻe o LDL i ke koko. Hoʻonui kēia iā ʻoe i ka hoʻopili ʻana o nā aʻa mai atherosclerosis i ka wā ʻōpio. Hoʻohui pinepine ʻia ke ʻano i loko o nā ʻohana ma kahi ʻano autosomal. ʻO ia ka mea e pono ai ʻoe e kiʻi i ka moʻokūʻauhau ʻole mai hoʻokahi makua i mea e loaʻa ai ka maʻi.

I nā hihia kakaikahi, hiki i kahi keiki ke hoʻoilina i ka ʻāpana mai nā mākua ʻelua. Ke kū kēia, ʻoi aku ka nui o ka piʻi ʻana o ka pae kolesterol. ʻO ka makaʻu no ka hōʻeha puʻuwai a me nā maʻi puʻuwai he kiʻekiʻe, ʻoiai i ka wā kamaliʻi.

I nā makahiki mua ʻaʻole paha he hōʻailona.

Nā ʻōuli e kū aʻe paha:

• Waiho ʻia nā ʻili momona i kapa ʻia he xanthomas ma luna o nā ʻāpana o nā lima, kuʻekuʻe lima, kuli, nā kuʻekuʻe wāwae a puni ke kole o ka maka.
• ʻO nā waihona Cholesterol i ka maka maka (xanthelasmas)
• ʻO ka ʻeha o ka umauma (angina) a i ʻole nā ​​hōʻailona ʻē aʻe o ka maʻi coronary artery hiki ke loaʻa i ka wā ʻōpio
• ʻO ka cramping o hoʻokahi a i ʻole ʻelua mau keiki bipi ke hele wāwae
• Nā ʻeha ma nā manamana wāwae e hoʻōla ʻole ai
• ʻO nā ʻōuli e like me nā ʻōuli e like me ka pilikia o ka kamaʻilio ʻana, hāʻule ʻana ma kekahi ʻaoʻao o ka maka, nāwaliwali o ka lima a me ka wāwae, a me ka nalo ʻana o ke kaulike

Hiki i kahi hoʻokolohua kino ke hōʻike i ka ulu ʻana o ka ʻili momona i kapa ʻia xanthomas a me nā waihona kolesterol i ka maka (corneal arcus).

E nīnau ka mea mālama ola i nā nīnau e pili ana i kāu moʻolelo olakino pilikino a ʻohana. Aia paha:

• ʻO ka moʻolelo ʻohana ikaika o ka hypercholesterolemia ʻohana a i ʻole ka hōʻeha puʻuwai mua
• ʻO ke kiʻekiʻe kiʻekiʻe o ka LDL kolamu ma nā mākua ʻelua a ʻelua paha

ʻO nā kānaka mai nā ʻohana me ka mōʻaukala ikaika o nā puʻuwai puʻuwai e pono e hana i nā hoʻokolohua koko e hoʻoholo ai i nā pae lipid.

Hōʻike paha nā hōʻike koko:

• ʻO ke kiʻekiʻe kiʻekiʻe o ka huina kolesterol
• Papa kiʻekiʻe LDL
• Nā pae triglyceride maʻamau

Nā hoʻokolohua ʻē aʻe i hana ʻia e hoʻopili ʻia:

• ʻO nā noiʻi o nā hunaola i kapa ʻia fibroblasts e ʻike pehea e omo ai ke kino i ka LDL kolamu
• Hōʻike genetic no ka hemahema e pili ana i kēia ʻano

ʻO ka pahuhopu o ka mālama ʻana e hōʻemi i ka makaʻu o ka maʻi puʻuwai atherosclerotic. ʻO ka poʻe e loaʻa wale i hoʻokahi kope o ka ʻāpana hemahema mai ko lākou mau mākua hiki ke hana maikaʻi me nā loliʻai a me nā lāʻau statin.

NA OLELO OLA

ʻO ka hana mua e hoʻololi i ka mea āu e ʻai ai. ʻO ka hapa nui o ka manawa, e paipai ka mea hāʻawi iā ʻoe e hoʻāʻo i kēia no nā mahina he nui ma mua o ke kuhikuhi ʻana i nā lāʻau. Hoʻololi nā hoʻololi papaʻai i ka hoʻohaʻahaʻa ʻana i ka nui o nā momona āu e ʻai ai no ka mea ma lalo o 30% o kāu mau calorie. Inā ʻoi aku ka momona, kōkua nui ka lilo ʻana o ka paona.

Eia kekahi mau ala e ʻoki ai i ka momona momona o kāu papaʻai.

• ʻAi liʻiliʻi ka pipi, ka moa, ka puaʻa, a me ka hipa
• Hoʻololi i nā huahana waiū momona piha me nā huahana momona momona
• Hoʻopau i nā momona trans

Hiki iā ʻoe ke hoʻohaʻahaʻa i ka nui o ke kolamu āu e ʻai ai ma ka hoʻopau ʻana i nā yolks hua manu a me nā ʻokena e like me ke ake.

Hiki ke kōkua i ke kamaʻilio ʻana me kahi kaukaʻai hiki ke hāʻawi iā ʻoe i ka ʻōlelo aʻo e pili ana i ka hoʻololi ʻana i kāu ʻano ʻai. Hiki ke kōkua i ka hōʻemi ʻana a me ka hoʻoikaika mau i ka hoʻohaʻahaʻa i kāu pae kolesterol.

NA LAAU LAPAAU

Inā hoʻololi ʻole ka nohona i kāu pae kolesterol, hiki i kāu mea hāʻawi ke paipai iā ʻoe e lawe i nā lāʻau. Nui a hewahewa nā ʻano lāʻau i loaʻa e kōkua i ka hoʻohaʻahaʻa ʻana i ke kiʻekiʻe o ke kō, a hana lākou i nā ʻano like ʻole. ʻOi aku ka maikaʻi o kekahi i ka hoʻohaʻahaʻa ʻana i ka LDL cholesterol, maikaʻi kekahi i ka hoʻohaʻahaʻa ʻana i nā triglycerides, ʻoiai kōkua kekahi e hoʻonui i ka HDL kolesterol. Nui nā poʻe e kau ana i nā lāʻau.

Hoʻohana pinepine ʻia nā lāʻau lāʻau Statin a maikaʻi loa. Kōkua kēia mau lāʻau i ka hoʻohaʻahaʻa i kou makaʻi o ka puʻuwai a me ka hahau.

Pākuʻi ʻia lākou:

• Lovastatin (Mevacor)
• ʻO Pravastatin (Pravachol)
• Simvastatin (Zocor)
• Fluvastatin (Lescol)
• Atorvastatin (Lipitor)
• ʻO Pitivastatin (Livalo)
• Rosuvastatin (Crestor)

ʻO nā lāʻau e hoʻohaʻahaʻa ana i ka kolesterol me:

• ʻO nā resins acid-sequestering bile.
• ʻO Ezetimibe.
• Fibrates (e like me gemfibrozil a i ʻole fenofibrate).
• ʻAkika nikotinikika.
• Nā mea kāohi iā PCSK9, e like me alirocumab (Praluent) a me evolocumab (Repatha). Hōʻike kēia i kahi papa hou o nā lāʻau e mālama i ke kiʻekiʻe o ka cholesterol.

Pono paha ka poʻe me kahi ʻano koʻikoʻi o ka maʻi i kahi lapaʻau i kapa ʻia apheresis. Lawe ʻia ke koko a me ka plasma mai ke kino. Lawe nā kānana kūikawā i ke keu ʻoi aku ka LDL kolesterol, a hoʻihoʻi ʻia ka wai koko i ke kino.

Maikaʻi kou hilinaʻi ʻana i ka pili pono o kāu hahai ʻana i ka ʻōlelo aʻoaʻo a kāu mea hāʻawi. Ke hoʻololi nei i ka papaʻai, hoʻoikaika kino, a me ka lawe pololei ʻana i kāu lāʻau i hiki ke hoʻohaʻahaʻa i ka pae kolesterol. Hiki i kēia mau hoʻololi ke kōkua i ka hoʻolōʻihi i kahi puʻuwai puʻuwai, keu hoʻi no ka poʻe me ke ʻano milder o ka maʻi.

ʻO nā kāne a me nā wahine me ka hypercholesterolemia ʻohana maʻamau i ka nui o ka makaʻu o ka puʻuwai mua.

Kūleʻa ka makaʻu o ka make ma waena o nā poʻe me ka hypercholesterolemia ʻohana. Inā hoʻoili ʻoe i ʻelua kope o ka ʻāpana hemahema, loaʻa iā ʻoe kahi hopena ʻilihuna. ʻO kēlā ʻano hypercresterolemia ʻohana ʻaʻole ia e pane maikaʻi i ka mālama ʻana a hiki paha ke hōʻeha i ka puʻuwai mua.

Komo pū nā pilikia:

• ʻO ka puʻuwai puʻuwai i ka wā ʻōpio
• Maʻi maʻi puʻuwai
• Hahau
• Maʻi maʻi kīnā

E ʻimi koke i ka lāʻau lapaʻau inā loaʻa iā ʻoe ka ʻeha o ka umauma a i ʻole nā ​​hōʻailona ʻē aʻe o ka hōʻeha puʻuwai.

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe kahi moʻolelo pilikino a ʻohana paha o ka pae kiʻekiʻe kolesterol.

ʻO ka papaʻai haʻahaʻa i ka kolesterol a me ka momona momona a waiwai i ka momona momona ʻole e kōkua i ka mālama ʻana i kāu pae LDL.

ʻO ka poʻe me ka mōʻaukala ʻohana o kēia ʻano, ʻoiai inā lawe nā mākua ʻelua i ka ʻāpana hemahema, makemake paha lākou e ʻimi i nā ʻōlelo aʻo kūpuna.

ʻAno II hyperlipoproteinemia; Hypercholesterolemic xanthomatosis; ʻO ka hoʻololi haʻahaʻa lipoprotein haʻahaʻa

• Cholesterol - he aha e nīnau aku ai i kāu kauka

• Xanthoma - pili loa
• ʻO Xanthoma ma ke kuli
• Ka paʻa artery coronary

ʻO Genest J, Libby P. Nā maʻi lipoprotein a me nā maʻi maʻi ʻōpū. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier; 2019: chap 48.

Robinson JG. Nā maʻi o ka lipid metabolism. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 195.