Yin amfani da magungunan enzyme na angiotensin (ACE) mai amfani da magunguna shine muhimmin sashi na zalunta zuciya . A cikin mutane da rashin tausayi na zuciya, an nuna masu maganin ACE don rage yawan buƙata don samun asibiti, inganta bayyanar cututtuka, har ma da cigaba da rayuwa. Idan an gano ku tare da hasara na zuciya , ya kamata a bi da ku tare da mai hana ACE sai dai idan likitan ku na da kyakkyawan dalili kada kuyi haka.
Menene Masu Haramtawa ACE Keyi?
Masu hana ACE sun toshe maɓallin enzyme a cikin tsarin renin-angiotensin-aldostrone (RAAS) . RAAS shi ne ƙaddamar da enzymes wanda ke aiki tare don daidaita jini, da kuma maida hankali da sodium cikin jini.
Lokacin da jini ya gudana zuwa ga kodan an rage, an saki enzyme da ake kira renin cikin jini. Renin yana haifar da wani enzyme, angiotensin I, don ƙara. Angiotensin na canza ta ACE cikin angiotensin II. Angiotensin II yana ƙara yawan karfin jini, kuma (ta hanyar motsawa daga sakin hormone aldosterone daga glandon adrenal) yana sa jiki ya riƙe sodium.
RAAS yana kokarin yin aiki a cikin mutane tare da ciwon zuciya, wanda ya ƙaru riƙe da sodium da karfin jini, kuma ya sa zuciyar ta yi aiki fiye da yadda ya kamata.
Masu hana ACE suna aiki ta hanyar hana jigilar angiotensin II. A cikin mutane tare da ciwon zuciya wannan lowers saukar karfin jini da kuma rage sodium riƙewa.
Ta wannan ma'anar, masu hanawa na ACE sun rage danniya a zuciya kuma sun ba da hankali ga tsofaffin zuciya don tsinkewa da kyau.
Masu maganin ACE suna da amfani sosai wajen kula da hauhawar jini , kuma an nuna su don inganta sakamakon a cikin mutanen da ke da ciwon zuciya . Bugu da ƙari, za su iya taimakawa hana ƙwayar koda ya lalata mutane da ciwon sukari .
Masu hana ACE a Cikin Zuciyar Zuciya
Da dama manyan gwaje-gwaje na asibitoci sun kalli amfani da masu hana ACE a cikin mutanen da ke fama da rashin zuciya. Dukansu sun nuna amfana mai yawa. Wani bincike na irin wadannan gwaje-gwajen guda biyar wadanda suka hada da mutane 12,000 da rashin tausayi na zuciya sun nuna cewa masu hana ACE sun rage mahimmanci don samun asibiti, inganta rayuwarsu, da kuma saukar da hadarin zuciya. Kwayar cututtuka na zuciya rashin ƙarfi irin su dyspnea (shortness of breath) da kuma gajiya sun kuma inganta.
Lissafi na yau da kullum daga Kwalejin Kasuwancin Kasuwancin Amirka da Ƙungiyar Zuciya ta Amirka sun ba da shawarar cewa an ba da masu hana ACE ga duk wanda yake da ciwon zuciya, kuma a kan haka, ga duk wanda ke da haɓakar haɓaka mai haɓaka mai hagu na rage hagu (ƙasa da 0.4) ko suna da yana da ainihin zuciya rashin nasara.
Yawancin masu cin zarafi na ACE suna kan kasuwar, kuma ana ganin cewa suna da amfani sosai wajen kula da rashin cin zarafin zuciya. Masu amfani da ACE da yawa sun haɗa da captopril (Capoten), enalapril (Vasotec), lisinopril (Zestril), ramipril (Altace), da trandolarpril (Mavik).
A lokacin da aka umarce su, an hana masu hanawa ta ACE a ƙananan ƙwayar, kuma sashi ya karu zuwa ƙananan ƙwayoyin da aka yi amfani da ita a gwajin gwaji.
Ƙara zurfin ƙara yawan sashi yana taimakawa kare illa mara kyau. Idan ba a yi jaraba da ƙwayar da aka fi dacewa ba, to magani yana yawan ci gaba a ƙananan, mafi yawan maganin magani. Yawancin masana sunyi imanin cewa ƙananan magunguna na ACE kusan suna da tasiri a matsayin ƙananan ƙwayoyin, amma sun fi dacewa da asali mafi yawa saboda an gwada su a cikin binciken binciken asibiti.
ACE masu hanawa da tseren. Wasu nazarin ya nuna cewa masu hana masu kariya ACE na iya zama marasa tasiri a cikin mutanen baki fiye da launin fata, amma shaidun suna rikicewa. Sharuɗɗa na yau da kullum suna yin amfani da amfani da ACE masu hanawa duk wanda yake da ciwon zuciya, ko da kuwa tseren.
ACE masu hanawa da jinsi. Bincike na asibitoci ba su tabbatar da irin wannan girma ba don amfani da masu cin zarafin ACE a cikin mata kamar yadda aka nuna a maza. Duk da haka, ƙaddamar da shaida har yanzu yana jin dadin amfani da masu hanawa ACE a duk mata da ciwon zuciya.
Hanyoyin Cutar ACE
Duk da yake masu shayarwa na ACE yawanci suna jurewa da kyau, wasu illa masu tasiri zasu iya faruwa.
Masu hana ta ACE na iya rage yawan jini sosai, suna samar da alamun rashin ƙarfi, rashin hankali , ko syncope . Wannan matsala za a iya kauce masa da yawa ta hanyar farawa tare da ƙananan ƙwayar kuma a hankali yana ginawa har zuwa ƙari.
Musamman a cikin mutane da ke da cututtukan cututtukan zuciya, yin amfani da masu hana ACE zai iya ƙara rage aikin koda. Saboda haka, aikin koda (gwaje-gwajen jini) ya kamata a kula da shi a cikin mutanen da ke da ciwon koda kuma suna fara masu hana ACE.
ACE masu hanawa zai iya ƙara yawan jini potassium matakan. Duk da yake wannan sakamako yana yawanci sosai kuma ba mahimmanci ba. Duk da haka, a wasu mutane (kimanin 3%) matakan potassium zasu iya zama maɗaukaki.
Babban sakamako mafi rinjaye na masu hana ACE shine bushe, tarihin hacking, wanda za'a iya gani har zuwa kashi 20 cikin dari na mutanen da aka ba wadannan kwayoyi. Duk da yake ba matsala mai hatsari ba, wannan sakamako na ƙarshe zai iya zama da damuwa kuma yawanci yana buƙatar dakatar da miyagun ƙwayoyi.
Da wuya, mutane masu shan maganin ACE suna iya samun angioedema - mummunar cututtuka-kamar abin da zai iya zama mai hatsarin gaske.
ARBs a matsayin madadin masu hana ACE
Angiotensin II masu karɓar rashawa (magungunan ARB) sunyi kama da masu kwantar da hankalin ACE saboda sun katse katako na RAAS kuma sun rage sakamakon angzyensin II enzyme. Saboda sassan ARBs kawai suna haifar da tari da angioedema, ana amfani da su a wasu lokuta a maimakon mutane waɗanda suka sami wannan mummunan tasiri tare da masu hanawa ACE.
ARBs an nuna su zama masu tasiri a cikin maganin zuciya rashin cin nasara, duk da cewa zuwa karami fiye da masu ƙetare ACE. Bugu da ƙari, ARBs suna da tasiri sosai kamar yadda masu hana ƙin ACE ke kula da hawan jini. Magungunan ARB da aka saba amfani da su sun hada da candesartan (Atacand), lasartan (Cozaar), da valsartan (Diovan). Yawancin magunguna na ARB suna samuwa.
Layin Ƙasa
Idan kuna da kullun zuciya, don rage girman bayyanarku da kuma inganta sakamakonku, ya kamata a ba da izinin mai hana ACE sai dai idan akwai kyakkyawan dalili ba.
> Sources:
> Flather MD, Yusuf S, Køber L, et al. Maganin ACE-Inhibitor Farko A Tsakanin Waɗanda ke Da Cikin Zuciya Kasawa ko Hagu-Dysfunction Ventricular: Tsarin Farko na Bayanan Daga Mutane Masu Turawa. ACE-Inhibitor Ingantation Infarction Group Collaborative Group. Lancet 2000; 355: 1575.
> McMurray JJ, Adamopoulos S, Anker SD, et al. ESC Jagoran Bayanai don Bincike da Gudanar da Raunin Kullun da Bikin Lafiya 2012: Ƙungiyar Ƙungiyar ta Gudanar da Ciwon Bincike da Kulawa da Ƙananan Zuciya da Bikin Ƙasar 2012 na Ƙungiyar Harkokin Kasuwancin Turai. Ci gaba tare da haɗin gwiwar Ƙungiyar Ƙasa (HFA) na ESC. Eur Heart J 2012; 33: 1787.
> Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF / Wurin Kwanciya don Gudanar da Zuciyar Zuciya: Rahoton Cibiyar Kasuwanci ta Kasa na Amirka da Cibiyar Harkokin Kasuwancin Amirka game da Sharuɗan Ɗabi'a. J Am Coll Cardiol 2013; 62: e147.