Sebelisa Nakong ea Pele ea Trimester eketsa Mathata a Tsoalo
Le hoja lithethefatsi tse ngata tse sebelisetsoang ho phekola khatello ea meriana li ka nkoa ka mokhoa o sireletsehileng ho basali ba nang le moimana, mefuta e 'meli e haufi-ufi ea meriana ea khatello ea mali e lokela ho qojoa. Li-angiotensin li fetola li-enzyme (ACE) inhibitors le lithethefatsi tsa angiotensin II (ARB). Meriana e meng ea lithethefatsi e baka likotsi tse kholo ho lesea le ntseng le hōla, 'me ha ea lokela ho sebelisoa neng kapa neng nakong ea bokhachane.
Ho utloisisa ACE Inhibitors le li-ARB
ACE inhibitors le lithethefatsi tsa ARB li sebetsa ka ho thibela likarolo tsa tsela ea renin-angiotensin , e 'ngoe ea mekhoa e meholo ea' mele ea ho fetola khatello ea mali. Ka ho thibela ka mofuthu tse ling tsa limolek'hule tse kopanetsoeng ke tsela ea renin-angiotensin, ACE inhibitors le li-ARB li ka fokotsa khatello ea mali ho bakuli ba bangata ba nang le khatello ea kelello .
Lebaka Leo Lithethefatsi tsena li sa lokelang ho sebelisoa nakong ea bokhachane
Phuputso e tsoang Tennessee ka 2006 e ile ea qala ho fumana bothata ba ACE inhibitors ho basali ba nang le bakhachane. Bacha ba ka bang 30 000 ba tsoaloang ho tloha ho boitsebiso bo bolokiloeng ke Tennessee Medicaid, bana ba 411 ba ne ba pepesehetse lithethefatsi tse matlafatsang nakong ea halofo ea pele. Ba neng ba pepesitsoe ho ACE inhibitors (masea a 209) ba ne ba le kotsing ea bokooa ba tsoalo bo neng bo le boemong bo ka holimo ho makhetlo a mararo ho feta ba sa tsejoang ho ACE inhibitors: tse robong li ne li e-na le mahlomola a pelo, tse tharo li ne li e-na le mekhoa e meholo ea methapo, 'me tse tšeletseng li na le mefuta e meng ea tsoalo litšitiso.
Ka kakaretso, karolo ea 7 lekholong ea masea a pepesehileng ho ACE inhibitors ka pele ho halofo ea boraro e na le mokhoa o itseng oa bokooa, ho bapisoa le kotsi ea 2.6% har'a masea a sa kang a pepesehela meriana efe kapa efe ea antihypertensive. Bana ba neng ba e-na le lithethefatsi tse seng matla ho feta li-ACE inhibitors ha baa ka ba eketsa kotsi ea kotsi.
Ho tloha tlhahlobo eo ea pele, liphuputso tse ling tse 'maloa li tiisitse hore ACE inhibitors nakong ea bokhachane e amahanngoa le kotsi e eketsehileng ea bokooa ba tsoalo le mathata a mang.
Ho phaella moo, lipatlisiso tse latelang li bontšitse hore tšebeliso ea li-ARB nakong ea bokhachane ba pele bo amahanngoa le mefuta e tšoanang ea bokooa ba pelehi. Haeba ho le joalo, kotsi e nang le li-ARB e bonahala e phahame ho feta ACE inhibitors.
Tšebeliso ea ACE inhibitors le li-ARB nakong ea bobeli ba boraro le boraro ba boimana bo boetse bo baka mathata a tebileng, le hoja e le a mofuta o fapaneng.
Li sebelisitsoe hamorao nakong ea bokhachane, lithethefatsi tsena li baka mathata a tebileng a liphio ho lesea, ho kenyeletsa le ho se sebetse ka mokhoa oa bokooa kapa ho se sebetse ha liphio . Tšebeliso ea nakong ea bokhachane ea lithethefatsi tsena e ka boela ea baka boima bo tlaase, ho lieha ho hola, le ho pepa pele ho nako.
The Bottom Line
Ka lebaka la likotsi tse tebileng tse entsoeng ke masea ao 'mè a nkang li-ACE inhibitors kapa li-ARB ka nako leha e le efe nakong ea bokhachane, le hobane likarolo tse ling tsa meriana li sireletsehile ebile li atleha ho phekola khaello ea meriana ho basali ba nang le bakhachane, lingaka tse ngata li khothalletsa hore meriana ena e se ke ea sebelisoa bohle ho basali ba lilemo tsa ho beleha.
Haeba ho phekola khaello ea meriana e lekaneng ho ke ke ha etsoa ntle le ho eketsa ACE inhibitors kapa li-ARB, basali ba lilemo tsa ho beleha ba lokela ho nka mehato ea ho qoba ho ima. Ba lokela ho khaotsa ho noa meriana leha e le efe nako ea nako ea ho ea khoeli e lieha ka lihora tse fetang 48, 'me ba etse tlhahlobo ea bokhachane.
Lisebelisoa
Cooper WO, Hernandez-Diaz S, Arbogast PG, le al. Matšoao a maholo a li-congenital ka mor'a hore ho hlahisoe ke ACE inhibitors ka mor'a hore ho be le li-trimester. N Engl J Med 2006; 354: 2443-24511.
Friedman JM. ACE inhibitors le congenital anomalies. N Engl J Med 2006; 354: 2498-2500.
Bullo M, Tschumi S, Bucher BS, le al. Bokhachane phello ka mor'a ho pepesa li-enzyme tse inhibitors kapa bahanyetsi ba angiotensin: tlhahlobo e hlophisitsoeng. Hypertension 2012; 60: 444.