Ƙungiyar Brugada wani abu ne wanda ba a sani ba, rashin ciwo na ƙarancin wutar lantarki na zuciya wanda zai iya haifar da fibrillation ventricular da mutuwa ta kwatsam kamar yadda matasa ke da lafiya. Ya bambanta da mafi yawan sauran yanayi waɗanda ke haifar da mutuwar kwatsam a cikin matasa, maganin arrhythmias wanda cutar Brugada ta haifar yana faruwa a lokacin barci, kuma ba lokacin motsa jiki ba.
Abubuwa
Yawancin mutanen da aka bincikar da ciwo na Brugada sune matasa ga tsofaffi na shekaru, wanda yawancin shekarunsu a lokacin ganewar asali sun kasance 41. An gano cutar ciwon Brugada sau da yawa a cikin maza fiye da mata - a wasu nazarin ilimin likita a cikin maza sau tara fiye da mata. A Amurka, cutar cutar Brugada zata faru a kimanin mutum cikin 10,000. Duk da haka, ya fi yawa-yiwuwar sama da ɗaya a cikin 100-a cikin mutanen yankin kudu maso gabashin Asiya. Abincin rashin lafiya na zuciya kawai shi ne na'urar lantarki; zukatan mutane da ciwon Brugada sune al'ada.
Cutar cututtuka
Matsalar mafi banƙyama da cutar ta Brugada ta faru shine mutuwar mutuwa a lokacin barci. Duk da haka, mutanen da ke fama da ciwon Brugada na iya shawo kan abubuwan da suka shafi hasken haske , rashin hankali , ko haɗuwa (asarar hankali) kafin wannan mummunan aiki. Idan waɗannan nauyin wadanda ba su da kisa sun kawo su ga likita, za a iya gane ganewar asali kuma a magance magani don hana mutuwa ta kwatsam.
An gano cutar ciwo na Brugada a matsayin dalilin da ya faru da "rashin lafiya na kwatsam marar kwatsam ba tare da wata kwatsam ba," ko SUNDS. SUNDS da aka fara bayyana shekaru da dama da suka gabata a matsayin yanayin shafi matasa a kudu maso gabashin Asia. Yanzu an gane cewa wadannan 'yan Asalin Asiya suna da ciwo na Brugada, wanda ya fi yawa a wannan ɓangare na duniya fiye da sauran wurare.
Dalilin
Ciwon sukari na Brugada yana bayyana ne saboda daya daga cikin kwayoyin cutar da ke cutar da kwayoyin zuciya, musamman ma a cikin kwayoyin da ke kula da tashar sodium. An gaji shi ne a matsayin mahimmin tsari , amma ba duk wanda ke da jinsi ko kwayoyin cutar ba yana da alaƙa ta hanya guda.
Ana nuna siginar lantarki wanda ke kula da ƙirar zuciya ta tashoshi a cikin ƙwayoyin zuciya na zuciya, wanda zai ba da damar ƙwayoyin siginar (mai kira ions) don yawo da baya a fadin membrane. Kwayar ions ta hanyar wadannan tashoshi yana haifar da sigina na zuciya. Ɗaya daga cikin tashoshi mafi mahimmanci shine tashar sodium, wadda ta ba da damar sodium shiga cikin kwayoyin zuciya. A cikin ciwo na Brugada, an katange tashar sodium, don haka siginar wutar lantarki ta haifar da zuciya. Wannan canji yana haifar da rashin lafiya na lantarki wanda, a wasu lokuta, zai iya samar da fibrillation ventricular.
Bugu da ƙari, mutanen da ke fama da ciwon Brugada na iya zama nau'i na dysautonomia - rashin daidaituwa tsakanin ƙauna da juyayi . Ana kwashe cewa karuwar yawan ƙararraji na parasympathetic da ke faruwa a lokacin barci yana iya ƙarawa a cikin mutanen da ke fama da ciwo na Brugada, kuma wannan sautin mai karfi na parasympathic zai iya haifar da tashoshi marar haɗari don zama maras tabbas, kuma ya kawo mutuwar kwatsam.
Wasu dalilai da zasu iya haifar da cututtuka mai cututtuka a cikin mutanen da ke fama da cutar Brugada sun hada da zazzabi, yin amfani da cocaine, da kuma amfani da magunguna daban-daban, musamman magungunan antidepressant.
Sanin asali
Rashin ƙwayar wutar lantarki ta hanyar ciwon Brugada zai iya haifar da halayyar halayya a kan ECG , abin da ake kira Brugada. Wannan tsari ya ƙunshi wani ɓangaren ƙwayar cuta mai tsabta , tare da haɓaka daga cikin sassan ST inda take jagorancin V1 da V2.
Ba duk wanda ke fama da ciwon Brugada yana da tsarin "hali" na Brugada akan ECG ba, ko da yake suna iya samun wasu canje-canje masu ban sha'awa.
Don haka, idan an yi la'akari da rashin lafiya na Brugada (saboda, alal misali, syncope ya faru ko wani dan uwan ya mutu a kwatsam a cikin barci), duk wani nau'i na ECG ya kamata a kira shi gwani mai ilimin lantarki, don tantance ko yanayin "Brugoda" na iya zama yanzu.
Idan Kasuwancin ECG ya nuna alamar Brugada, kuma idan ya kasance yana da nau'i na ƙananan nau'i ko rashin aiki, ya tsira daga kamawar zuciya , ko yana da tarihin iyalin mutuwar mutuwa a ƙasa da shekaru 45, hadarin mutuwa ta mutuwa shi ne babban. Duk da haka, idan yanayin Brugada ya kasance babu kuma babu wani daga cikin wadannan abubuwan haɗari, ya zama mummunar mutuwa.
Mutanen da ke fama da cutar Brugada wadanda ke da mummunar haɗari na mutuwar kwatsam ya kamata a magance su da haɗari. Amma a wa anda ke da tsarin Brudada akan ECG amma babu wasu matsalolin haɗari, yin la'akari da yadda mummunan zamu kasance ba kamar yadda aka yanke ba.
An yi amfani da gwajin electrophysiologic don taimakawa wajen wannan shawara mai wuya, ta hanyar bayyana yiwuwar mutuwa ta mutum. Gwargwadon gwajin electrophysiologic don tantance wannan haɗari ya zama kasa da cikakke. Duk da haka, manyan al'ummomin sana'a suna tallafawa wajen yin wannan gwaji a cikin mutanen da ke da tsarin Brugada a kan ECG ba tare da ƙarin matsalolin haɗari ba.
Tsara kwayoyin zasu iya taimakawa wajen tabbatar da ganewar cutar ta Brugada, amma yawanci ba a taimakawa wajen kwatanta yiwuwar mai haƙuri na mutuwa ba. Bugu da ƙari kuma, gwajin kwayar cutar a cikin ciwo na Brugada yana da wuyar ganewa, kuma sau da yawa ba ya samar da amsoshin bayyane. Don haka mafi yawan masana ba su bayar da shawarar yin gwajin kwayoyin cutar yau da kullum ba a cikin mutane da wannan yanayin.
Saboda cutar ciwo na Brugada wani cututtukan kwayoyin halitta ne wanda aka gadonta sau da yawa, shawarwarin yanzu suna kira don nuna dukkanin dangi na farko da duk wanda aka gano da wannan yanayin. Gyaran ya kamata ya hada da nazarin ECG, da kuma kula da lafiyar likita wanda yake nema aukuwa na syncope ko haske mai haske mai tsanani.
Jiyya
Hanyar tabbatarwa kawai ta hana mutuwar kwatsam a cikin ciwo na Brugada yana sanya wani defibrillator mai gina jiki . Gaba ɗaya, ya kamata a guje wa magungunan antiarrhythmic . Saboda hanyar da wadannan kwayoyi ke aiki a kan tashoshi a cikin ƙwayoyin zuciya na zuciya, ba wai kawai sun kasa rage haɗarin fibrillation ventricular a ciwon Brugada ba, amma kuma zai iya haɓaka wannan hadarin.
Ko wani wanda ke tare da ciwo na Brugada ya kamata ya karbi mai ba da izini wanda ya zama mai ƙyama ba zai dogara ne akan ko an yi la'akari da haɗarin mutuwa ta kwatsam ya zama babban ko ƙasa. Idan haɗarin yana da girma (bisa ga alamar cututtuka ko gwajin electrophysiologic), dole ne a bada shawara ga defibrillator. Amma masu ba da izini ba su da tsada kuma suna da rikice-rikice na kansu , don haka idan an la'akari da haɗarin mutuwa ta kwatsam a matsayin ƙananan, waɗannan na'urorin ba a halin yanzu ba.
Shawarwarin Gwaji
Kowace lokacin da aka gano wani saurayi tare da yanayin kwakwalwa wanda zai iya haifar da mutuwar kwatsam, dole ne a tambayi tambaya game da ko lafiya don yin motsa jiki. Wannan shi ne saboda yawancin arrhythmias wadanda suke samar da mutuwar kwatsam ga matasa suna iya faruwa a yayin yin aiki.
A cikin ciwo na Brugada, da bambanci, fatal arrhythmias zai iya faruwa a lokacin barci fiye da lokacin motsa jiki. Duk da haka, an yi la'akari da shi (tare da ƙananan shaida ko a'a) cewa yin aiki mai tsanani zai iya haifar da haɗari mafi girma fiye da na al'ada ga mutane da wannan yanayin. Saboda haka ne ciwon daji na Brugada ya ƙunshi a cikin jagororin da aka tsara ta hanyar masana'antun masana da suka magance shawarwari na motsa jiki a matasa 'yan wasan da ke cikin halin zuciya.
Da farko, sharuɗɗan game da motsa jiki da ciwon sukari na Brugada sun kasance masu ƙyama. Taron taron na Bethesda na shekara ta 36 na shekara ta 2006 akan shawarwari ga 'yan wasa masu gasa da ciwon kwakwalwa ta jiki sunyi shawarar cewa mutanen da ke fama da cutar Brugada su guje wa duka motsa jiki mai tsanani.
Duk da haka, wannan ƙayyadadden ƙuntataccen abu an gane shi a baya ya zama mai tsanani. Bisa ga gaskiyar cewa cutar da aka gano tare da cutar Brugada ba ta faruwa a lokacin motsa jiki, wadannan shawarwari sun kasance masu sassaucin ra'ayi a cikin shekara ta 2015 a karkashin sabon jagororin daga Cibiyar Zuciya ta Amurka da Kwalejin Kwalejin Nahiyar Amirka.
Bisa ga mafi yawan 'yan kwanan nan, shawarwarin 2015, idan matasa masu fama da cutar Brugada ba su da alamun da suka shafi motsa jiki, yana da kyau a gare su su shiga cikin wasanni masu gasa idan:
- Su, likitocin su, da iyaye ko masu kula da su sun fahimci yiwuwar hadarin da ake ciki, kuma sun yarda su dauki matakan da ake bukata.
- Ƙwararren ƙwararrun waje na waje (AED) wani ɓangaren al'ada ne na kayan aikin wasanni na sirri.
- Jami'an teams suna da damar yin amfani da AED kuma suna yin CPR idan ya cancanta.
Takaitaccen
Ciwon daji na Brugada wani yanayi ne wanda ba shi da kyan gani wanda ke haifar da mutuwar kwatsam, yawanci lokacin barcin, a cikin matasa masu lafiya. Trick shine don tantance wannan yanayin kafin wani abu mai ban mamaki ya faru. Wannan yana buƙatar likitoci su kasance masu faɗakarwa-musamman ma a duk wanda ya yi aiki tare ko kuma wani ɓangare na launi na haske-zuwa ga binciken ECG da aka gani da aka gani a cikin ciwo na Brugada.
Mutanen da aka gano tare da ciwo na Brugada zai iya kusan kullun kaucewa sakamakon mummunar sakamako tare da magani mai dacewa, kuma suna iya sa ran rayuwa ta al'ada.
> Sources:
> Gundumar Lissafi na Birnin Brugada P, Brugada J., Tsakanin Tsakanin Tsakanin Tsaro da Mutuwar Kwayoyin Cardiac Mutuwar: Bambanci da Bincike na Electrocardiographic. Rahoton Multicenter. J Am Coll Cardiol 1992; 20: 1391.
> Maron BJ, Zipes DP, Kovacs RJ, et al. Yiwuwa da rashin daidaituwa da shawarwari ga 'yan wasa masu gasa da ciwon kwakwalwa na zuciya. Yanayin 2015; DOI: 10.1161 / CIR.0000000000000236.
> Sio SG, Wilde AA, Horie M, et al. HRS / EHRA / APHRS Bayanin Kwararrun Masana'antu game da Bincike da Gudanarwa na marasa lafiya tare da Gidajen Arrhythmia Aikin Gida: Takardun da HRS, EHRA, da APHRS suka amince a watan Mayu 2013 da ACCF, AHA, PACES, da AEPC a Yuni 2013. Zuciya ta Tsakiya 2013 ; 10: 1932.
> Zipes, DP, Ackerman, MJ, Estes NA, 3rd, et al. Task Force 7: Arrhythmias. J Am Coll Cardiol 2005; 45: 1354.