Mjeku pran\u00eb jush<\/p>\n
FAKTORET E RREZIKUT TE ARTERIOSKLEROZES KORONARE<\/p>\n
ARTERIOSKLEROZA KORONARE \u00ebsht\u00eb sot shkaku kryesor i s\u00ebmundjeve t\u00eb zemr\u00ebs. Ajo p\u00ebrb\u00ebn shkakun e par\u00eb t\u00eb vdekjeve n\u00eb vendet e zhvilluara. P\u00ebrve\u00e7 vdekshm\u00ebris\u00eb s\u00eb lart\u00eb, ajo u shkakton t\u00eb s\u00ebmur\u00ebve vuajtje fizike dhe morale dhe nj\u00eb pamund\u00ebsi p\u00ebr pun\u00eb, relativisht t\u00eb r\u00ebnd\u00eb dhe t\u00eb zgjatur. Studime t\u00eb gjera klinike dhe epidemiologjike t\u00eb kryera n\u00eb t\u00eb gjith\u00eb bot\u00ebn kan\u00eb b\u00ebr\u00eb t\u00eb mundur t\u00eb p\u00ebrcaktohen nj\u00eb num\u00ebr faktor\u00ebsh, q\u00eb favorizojn\u00eb ose shp\u00ebrthejn\u00eb s\u00ebmundjen dhe q\u00eb jan\u00eb em\u00ebrtuar si “faktor\u00eb rreziku”. Pik\u00ebrisht, njohja, zbulimi dhe m\u00ebnjanimi apo mjekimi i tyre, q\u00ebndron n\u00eb baz\u00eb t\u00eb strategjis\u00eb s\u00eb luft\u00ebs kund\u00ebr s\u00ebmundjes koronare, p\u00ebr parandalimin e saj.<\/p>\n
Po p\u00ebrshkruajm\u00eb disa nga faktor\u00ebt kryesor\u00eb t\u00eb rrezikut:<\/p>\n
1. MOSHA. Esht\u00eb faktor kryesor i arterioskleroz\u00ebs. Shpesht\u00ebsia e shfaqjeve klinike t\u00eb arterioskleroz\u00ebs koronare rritet mjaft me kalimin e mosh\u00ebs. M\u00eb shpesh ajo ndeshet nga mosha 45 deri n\u00eb 65 vje\u00e7. Studime t\u00eb ndryshme kan\u00eb treguar se lezionet anatomike t\u00eb s\u00ebmundjes koronare fillojn\u00eb shum\u00eb her\u00ebt, n\u00eb dekad\u00ebn e dyt\u00eb ose t\u00eb tret\u00eb t\u00eb jet\u00ebs, nd\u00ebrsa manifestimet klinike, m\u00eb shpesh shfaqen mbas mosh\u00ebs 45 vje\u00e7.<\/p>\n
2. SEKSI. Mbizot\u00ebrimi i arterioskleroz\u00ebs koronare te meshkujt \u00ebsht\u00eb mjaft i duksh\u00ebm. K\u00ebshtu, statistika t\u00eb ndryshme japin raporte meshkuj-femra nga 3:1 deri n\u00eb 7:1. P\u00ebr moshat deri 40 vje\u00e7, ky raport \u00ebsht\u00eb shum\u00eb m\u00eb i madh, 10:1, por me rritjen e mosh\u00ebs fillon t\u00eb pak\u00ebsohet, kurse rreth mosh\u00ebs 70 vje\u00e7 ky raport b\u00ebhet, pothuaj i barabart\u00eb. P\u00ebr k\u00ebt\u00eb dukuri i jepet rol veprimit t\u00eb hormoneve fem\u00ebrore gjat\u00eb periudh\u00ebs s\u00eb aktivitetit gjenital.<\/p>\n
3. TURBULLIMET E METABOLIZMIT TE YNDYRNAVE. N\u00eb \u00e7rregullimet e metabolizmit t\u00eb yndyrnave dhe n\u00eb gjenez\u00ebn e arterioskleroz\u00ebs luajn\u00eb rol yndyrnat e marra n\u00eb ushqim. N\u00eb popullsit\u00eb, t\u00eb cilat p\u00ebrdorin ushqime t\u00eb pasura me yndyrna, jan\u00eb gjetur kolesterolemi t\u00eb larta. Duhet sh\u00ebnuar, se yndyrnat e ngopura (n\u00eb p\u00ebrgjith\u00ebsi me origjin\u00eb shtazore) jan\u00eb t\u00eb d\u00ebmshme kurse yndyrnat e pangopura (n\u00eb p\u00ebrgjith\u00ebsi me origjin\u00eb bimore) nuk e kan\u00eb k\u00ebt\u00eb veprim t\u00eb d\u00ebmsh\u00ebm. Aktualisht i kushtohet r\u00ebnd\u00ebsi lipoproteinave (HDL dhe LDL), q\u00eb transportojn\u00eb kolesterolin e serumit t\u00eb gjakut. Esht\u00eb p\u00ebrcaktuar se lipoproteinat me densitet t\u00eb ul\u00ebt (LDL) kan\u00eb rol aterogjen. Disa hiperlipidemi ndikohen shum\u00eb nga kufizimi n\u00eb ushqim i alkoolit, i sheqernave dhe i yndyrnave, duke dh\u00ebn\u00eb vet\u00ebm yndyrna t\u00eb desaturuara (vaj misri, margarin\u00eb etj.).<\/p>\n
4. DIABETI I SHEQERIT. T\u00eb dh\u00ebnat epidemiologjike tregojn\u00eb se s\u00ebmundja koronare \u00ebsht\u00eb 2-3 her\u00eb m\u00eb e shpesht\u00eb dhe shfaqet relativisht m\u00eb her\u00ebt te diabetik\u00ebt, se sa te jo diabetik\u00ebt. Kjo \u00ebsht\u00eb m\u00eb e shprehur n\u00eb seksin fem\u00ebr. Tek diabetik\u00ebt vdekshm\u00ebria nga infarkti i miokardit \u00ebsht\u00eb dy her\u00eb m\u00eb e lart\u00eb, se sa te jo diabetik\u00ebt.<\/p>\n
5. HIPERTENSIONI ARTERIAL. Studime t\u00eb ndryshme tregojn\u00eb se arterioskleroza koronare \u00ebsht\u00eb m\u00eb e shpesht\u00eb n\u00eb personat me hipertension. Luan rol si rritja e presionit sistolik, ashtu dhe e atij diastolik. Hipertensioni arterial favorizon shfaqjen e t\u00eb gjitha nd\u00ebrlikimeve ishemike, jo vet\u00ebm koronare, por edhe aksidentet vaskulare trunore, si dhe prekjen e arterieve t\u00eb an\u00ebsive t\u00eb poshtme. Rritja e presionit n\u00eb brendi t\u00eb en\u00ebs s\u00eb gjakut shton penetrimin e yndyrnave aterogjene n\u00ebp\u00ebr cip\u00ebn e brendshme t\u00eb arteries.<\/p>\n
6. DUHANI. P\u00ebrdorimi i duhanit \u00ebsht\u00eb fenomen social i r\u00ebnd\u00ebsish\u00ebm i shekullit t\u00eb XX, i cili, nd\u00ebr t\u00eb tjera, ndikon edhe n\u00eb rritjen e s\u00ebmundshm\u00ebris\u00eb dhe vdekshm\u00ebris\u00eb nga s\u00ebmundjet e zemr\u00ebs dhe t\u00eb en\u00ebve t\u00eb gjakut. Studime t\u00eb shumta arrijn\u00eb n\u00eb t\u00eb nj\u00ebjtin p\u00ebrfundim, se konsumi i madh dhe i vazhduesh\u00ebm i duhanit pak\u00ebson shpres\u00ebn p\u00ebr nj\u00eb jet\u00eb t\u00eb gjat\u00eb. K\u00ebshtu, p\u00ebr ata q\u00eb pijn\u00eb mbi 6 cigare n\u00eb dit\u00eb me thithje t\u00eb tymit, rreziku i s\u00ebmundjes koronare \u00ebsht\u00eb dyfish, kurse p\u00ebr ata me mbi 20 cigare \u00ebsht\u00eb trefish. Edhe vdekshm\u00ebria shtohet mjaft te duhanpir\u00ebsit. Ajo \u00ebsht\u00eb m\u00eb e rritur tek ata, q\u00eb e thithin tymin, sesa tek ata q\u00eb nuk e thithin. Konsumi i madh i duhanit shton, gjithashtu, mund\u00ebsin\u00eb e nj\u00ebj\u00eb vdekjeje t\u00eb papritur. Nga ana tjet\u00ebr, studime t\u00eb shumta tregojn\u00eb, se v\u00ebrehet nj\u00eb ulje e vdekshm\u00ebris\u00eb n\u00eb personat, q\u00eb kan\u00eb l\u00ebn\u00eb duhanin. K\u00ebshtu, pak\u00ebsimi i vdekshm\u00ebris\u00eb \u00ebsht\u00eb i duksh\u00ebm n\u00eb vitin e par\u00eb, pas ndalimit t\u00eb duhanit, nd\u00ebrsa n\u00eb fund t\u00eb 10 vjet\u00ebve niveli i vdekshm\u00ebris\u00eb s\u00eb atyre q\u00eb pinin duhan ishte i af\u00ebrt me at\u00eb t\u00eb atyre, q\u00eb nuk kan\u00eb p\u00ebrdorur duhan.<\/p>\n
Veprimi i d\u00ebmsh\u00ebm i duhanit realizohet n\u00ebp\u00ebrmjet dy faktor\u00ebve: nikotin\u00ebs dhe monoksidit t\u00eb karbonit. Monoksidi i karbonit pak\u00ebson sasin\u00eb e oksigjenit t\u00eb p\u00ebrdorsh\u00ebm nga miokardi, kurse nikotina shton pun\u00ebn e zemr\u00ebs. T\u00eb dy shpejtojn\u00eb formimin e trombit dhe favorizojn\u00eb zhvillimin e arterioskleroz\u00ebs. N\u00eb t\u00ebr\u00ebsi mund t\u00eb vler\u00ebsohet se pirja e duhanit \u00ebsht\u00eb faktor rreziku i r\u00ebnd\u00ebsish\u00ebm i arterioskleroz\u00ebs.<\/p>\n
7. FAKTORET PSIKOEMOCIONALE. Arterioskleroza \u00ebsht\u00eb m\u00eb e shpesht\u00eb n\u00eb profesionet intelektuale, sesa n\u00eb ato me pun\u00eb dore, n\u00eb qytete, m\u00eb shum\u00eb sesa n\u00eb fshatra, n\u00eb vendet e industrializuara, m\u00eb shum\u00eb sesa n\u00eb vendet m\u00eb pak t\u00eb zhvilluara. Ndikojn\u00eb, pra, mikrostreset e p\u00ebrs\u00ebritura n\u00eb jet\u00ebn e p\u00ebrditshme.<\/p>\n
8. OBEZITETI. Esht\u00eb treguar se ekziston nj\u00eb lidhje midis grad\u00ebs s\u00eb obezitetit (dhjamosjes) dhe rrezikut kardiovaskular. Ky rrezik shtohet n\u00eb m\u00ebnyr\u00eb proporcionale me rritjen n\u00eb pesh\u00eb dhe b\u00ebhet m\u00eb i duksh\u00ebm, kur rritjes n\u00eb pesh\u00eb i shtohen dhe faktor\u00ebt e tjer\u00eb t\u00eb rrezikut.<\/p>\n
9. FAKTORET FAMILJARE. Esht\u00eb v\u00ebn\u00eb re prej koh\u00ebsh, se n\u00eb disa familje ka nj\u00eb shpesht\u00ebsi m\u00eb t\u00eb madhe t\u00eb s\u00ebmundjes ishemike t\u00eb zemr\u00ebs (angina pectoris, infarkt i miokardit) dhe raste me vdekje t\u00eb papritur. Megjithat\u00eb, p\u00ebrgjegj\u00ebsia e trash\u00ebgimis\u00eb, si faktor rreziku, \u00ebsht\u00eb e dyshimt\u00eb dhe duhet t\u00eb merret me rezerv\u00eb.<\/p>\n
10. JETA SEDENTARE. Personat, q\u00eb b\u00ebjn\u00eb jet\u00eb sedentare, pa shum\u00eb l\u00ebvizje, kan\u00eb nj\u00eb shpesht\u00ebsi m\u00eb t\u00eb lart\u00eb p\u00ebr t\u00eb zhvilluar infarkt miokardi. K\u00ebshtu, rezulton se ushtrimi fizik \u00ebsht\u00eb i dobish\u00ebm n\u00eb luft\u00eb kund\u00ebr zhvillimit t\u00eb arterioskleroz\u00ebs.<\/p>\n
Ekzistojn\u00eb dhe faktor\u00eb t\u00eb tjer\u00eb t\u00eb rrezikut, por me ndikim m\u00eb t\u00eb vog\u00ebl. Duhet p\u00ebrmendur, se faktor\u00ebt e rrezikut m\u00eb shpesh ndodhen t\u00eb kombinuar, gj\u00eb q\u00eb shton rrezikun p\u00ebr zhvillimin e s\u00ebmundjes.<\/p>\n
Nga t\u00eb gjitha sa u shpjeguan m\u00eb lart, kuptohet roli i propagand\u00ebs sh\u00ebndet\u00ebsore me popullsin\u00eb, e cila duhet t\u00eb njihet me faktor\u00ebt e rrezikut t\u00eb arterioskleroz\u00ebs, n\u00eb m\u00ebnyr\u00eb q\u00eb t\u00eb nd\u00ebrgjegj\u00ebsohet p\u00ebr luftimin e tyre, pasi k\u00ebshtu mund t\u00eb arrihet nj\u00eb sukses i v\u00ebrtet\u00eb n\u00eb luft\u00ebn kund\u00ebr k\u00ebsaj s\u00ebmundjeje shum\u00eb t\u00eb p\u00ebrhapur dhe t\u00eb rrezikshme p\u00ebr jet\u00ebn e njeriut. Shpjegimet duhet t\u00eb b\u00ebhen t\u00eb vazhdueshme, duke dh\u00ebn\u00eb shembuj konkret\u00eb, p\u00ebr t\u00eb treguar efikasitetin e luft\u00ebs kund\u00ebr k\u00ebtyre faktor\u00ebve. K\u00ebshtu, duhet vepruar n\u00eb mjaft raste, t\u00eb cil\u00ebt i n\u00ebnshtrohen kontrollit periodik n\u00eb institucionet mjek\u00ebsore, nd\u00ebrmjet t\u00eb cilave b\u00ebn pjes\u00eb dhe klinika “Sh\u00ebn Lluka” e Kish\u00ebs Orthodhokse Autoqefale t\u00eb Shqip\u00ebris\u00eb.<\/p>\n
Prof. Dr. Anesti KONDILI<\/p>\n","protected":false},"excerpt":{"rendered":"
Prof. Dr. Anesti Kondili paraqet faktor\u00ebt kryesor\u00eb t\u00eb rrezikut t\u00eb arterioskleroz\u00ebs koronare: mosha, seksi, \u00e7rregullimet e metabolizmit t\u00eb yndyrnave, diabeti, hipertensioni, duhani, faktor\u00ebt psikoemocional\u00eb, obeziteti, trash\u00ebgimia familjare dhe jeta sedentare. P\u00ebrmendet edhe klinika ‘Sh\u00ebn Lluka’ e KOASH.<\/p>\n","protected":false},"template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"nentitulli":"Mjeku pran\u00eb jush","numri":"3 (54)","viti":"1997","muaji":"Mars","muaji_numer":"3","dita":"","faqet":"[4]","fjale_kyce":"[\"arterioskleroz\u00eb\", \"koronare\", \"faktor\u00eb rreziku\", \"kolesterol\", \"duhan\", \"hipertension\", \"diabet\", \"obeziteti\", \"Sh\u00ebn Lluka\", \"klinik\u00eb\", \"kardiovaskular\"]","permbledhje":"Prof. Dr. Anesti Kondili paraqet faktor\u00ebt kryesor\u00eb t\u00eb rrezikut t\u00eb arterioskleroz\u00ebs koronare: mosha, seksi, \u00e7rregullimet e metabolizmit t\u00eb yndyrnave, diabeti, hipertensioni, duhani, faktor\u00ebt psikoemocional\u00eb, obeziteti, trash\u00ebgimia familjare dhe jeta sedentare. P\u00ebrmendet edhe klinika 'Sh\u00ebn Lluka' e KOASH.","autori":"Prof. Dr. Anesti Kondili","kategoria":"Sh\u00ebndet\u00ebsi \/ Mjek\u00ebsi","kryeredaktor":"Thoma Dhima"},"ngjallja_kategoria":[10251],"ngjallja_autori":[10252],"ngjallja_viti":[10219],"ngjallja_kryeredaktor":[9473],"class_list":["post-84002","ngjallja_article","type-ngjallja_article","status-publish","hentry","ngjallja_kategoria-shendetesi-mjekesi","ngjallja_autori-prof-dr-anesti-kondili","ngjallja_viti-10219","ngjallja_kryeredaktor-thoma-dhima"],"acf":[],"yoast_head":"\n