{"id":2774,"date":"2021-04-29T12:56:39","date_gmt":"2021-04-29T10:56:39","guid":{"rendered":"https:\/\/panakea.net\/?p=2774"},"modified":"2025-03-20T14:44:41","modified_gmt":"2025-03-20T13:44:41","slug":"mozganska-kap-dejavniki-tveganja-za-mozgansko-zilne-bolezni","status":"publish","type":"post","link":"https:\/\/panakea.net\/sl\/blog\/mozganska-kap-dejavniki-tveganja-za-mozgansko-zilne-bolezni\/","title":{"rendered":"MO\u017dGANSKA KAP &#8211; Dejavniki tveganja za mo\u017egansko-\u017eilne bolezni"},"content":{"rendered":"<h3><strong>Nespremenljivi dejavniki tveganja<\/strong><\/h3>\n<ul>\n<li>starost<\/li>\n<li>spol<\/li>\n<li>genska obremenjenost<\/li>\n<li>rasa<\/li>\n<\/ul>\n<h3><strong><br \/>\nSpremenljivi dejavniki tveganja<\/strong><\/h3>\n<ul>\n<li>visok krvni tlak<\/li>\n<li>sladkorna bolezen<\/li>\n<li>visoka raven holesterola<\/li>\n<li>debelost<\/li>\n<li>atrijska fibrilacija<\/li>\n<li>visoka zo\u017eitev notranje karotidne arterije<\/li>\n<li>miokardni infarkt<\/li>\n<li>telesna neaktivnost<\/li>\n<li>\u010dezmerno pitje alkohola<\/li>\n<li>nepravilna prehrana<\/li>\n<li>stres<\/li>\n<\/ul>\n<p><img fetchpriority=\"high\" decoding=\"async\" src=\"https:\/\/panakea.net\/sl\/wp-content\/uploads\/sites\/2\/2021\/04\/shutterstock_1904008372-scaled-e1622727351712.jpg\" alt=\"\" width=\"1102\" height=\"300\" \/><\/p>\n<h3><strong>Kaj lahko storimo sami, da posku\u0161amo prepre\u010diti mo\u017egansko kap?<\/strong><\/h3>\n<p>Smernice za preventivo IMK in TIA priporo\u010dajo nadzor in zdravljenje dejavnikov tveganja za mo\u017egansko-\u017eilne dogodke, in sicer v prvi vrsti redne nadzore krvnega tlaka ter redni nadzor holesterola in glukoze v krvi. Dejavnike tveganja nadzorujemo s spremembo \u017eivljenjskega sloga in z zdravili, ki jih izbere zdravnik za vsakega bolnika individualno. Vrednost krvnega tlaka naj bo pod 140\/90 mmHg, pri pridru\u017eeni sladkorni bolezni pod 130\/85 mmHg. Bolnikom, ki niso do\u017eiveli IMK ali TIA zaradi sr\u010dne embolije, priporo\u010dajo zdravljenje s statini, ne glede na raven serumskega holesterola. Priporo\u010dene vrednosti celokupnega holesterola so 5 mmol\/l, HDL pod 2,6 mmol\/l ali celo pod 1,8 mmol\/l. Pri bolnikih z nevalvularno atrijsko fibrilacijo smernice priporo\u010dajo protikoagulacijsko zdravljenje z enim od novih antikoagulantnih zdravil, kot so dabigatran, rivaroksaban in apiksaban, ali z varfarinom, \u010de so nova antikoagulantna zdravila kontraindicirana [1].<\/p>\n<h3>Smernice za izbolj\u0161anje<\/h3>\n<p>V smernicah odsvetujejo kajenje in \u010dezmerno u\u017eivanje alkohola, priporo\u010dajo redno telesno aktivnost in dieto z malo soli in zasi\u010denih ma\u0161\u010dob, z veliko sadja in zelenjave ter hrano, bogato z vlakninami. Osebam s pove\u010danim indeksom telesne te\u017ee priporo\u010dajo zmanj\u0161anje telesne te\u017ee in ustrezno dieto ter zdravljenje morebitnih motenj spanja, kot je obstrukcijska apneja. Bolnikom z mo\u017egansko kapjo neznanega vzroka ob odprtem ovalnem oknu v srcu z velikim tveganjem za mo\u017egansko kap priporo\u010dajo znotraj\u017eilno zapiranje odprtega ovalnega okna [1].<\/p>\n<p>V preventivi vnovi\u010dnega ishemi\u010dnega mo\u017eganskega dogodka, to je za tiste bolnike, ki so TIA ali mo\u017egansko kap \u017ee do\u017eiveli in ki ne zahtevajo protikoagulacijskega zdravljenja, priporo\u010damo protitromboti\u010dno zdravljenje s protiagregacijskimi zdravili, kot je npr. Aspirin 100 mg ali Klopidogrel 75 mg do\u017eivljenjsko ali za kraj\u0161e obdobje kombinacijo obeh. Izjema so bolniki s specifi\u010dnimi indikacijami, kot je nestabilna angina pektoris ali miokardni infarkt brez Q-zobca ali nedavna vstavitev \u017eilne opornice v koronarne arterije v srcu. Bolnikom z nevalvularno atrijsko fibrilacijo po IMK ali TIA priporo\u010damo oralna protikoagulacijska zdravila. Svetujemo nova protikoagulacijska zdravila ali varfarin z vzdr\u017eevanjem INR 2,0 do 3,0, kadar novih protikoagulacijskih zdravil zaradi razli\u010dnih razlogov bolnik ne sme jemati. Jemanje teh zdravil bolnikom s so\u010dasnimi boleznimi, kot so epilepti\u010dni napadi, neustreznost zdravila, nenadzorovana epilepsija in krvavitve iz prebavil, v smernicah odsvetujemo. Visoka starost za oralno protikoagulacijsko zdravljenje ni kontraindicirana [1].<\/p>\n<p>Pravilna in pravo\u010dasna diagnoza ter sekundarna preventiva pomembno zmanj\u0161ata umrljivost ter telesno in kognitivno oviranost zaradi vnovi\u010dnega ishemi\u010dnega mo\u017eganskega dogodka.<\/p>\n<p>V zadnjih letih smo pri\u010da velikim korakom pri razumevanju dejavnikov tveganja in prepre\u010devanju mo\u017eganske kapi [2]. \u0160tudije potrjujejo, da so ma\u0161\u010dobe dejavnik tveganja za ateroskleroti\u010dno IMK, medtem ko je atrijska fibrilacija povezana s kardioemboli\u010dnimi kapmi. Genetske analize so dokazale povezanost z dolo\u010denimi vrstami IMK. Mutacije dolo\u010denih genov so povezane z boleznimi velikih \u017eili, drugih s kardioembolijo in tretjih z boleznijo majhnih \u017eil. Genetske \u0161tudije i\u0161\u010dejo tudi nove poti, s katerimi bi se lahko izognili mo\u017eganskim kapem [2]. Dokazano je, da zni\u017eanje krvnega tlaka, zdravljenje s statini, protiagregacijska in protikoagulacijska zdravila ter revaskularizacija karotidnih arterij, v kombinaciji s prehranskimi spremembami, pomembno zmanj\u0161ujejo tveganje za mo\u017egansko kap pri razli\u010dnih populacijah bolnikov. \u0160tudije so pokazale tudi veliko korist vedenjskih sprememb, vklju\u010dno z opustitvijo kajenja in redno telesno dejavnostjo. Mno\u017ei\u010dni pristop k preventivnemu zdravljenju in spodbujanje k zdravemu na\u010dinu \u017eivljenja, vklju\u010dno z oceno tveganja na primarnem nivoju, lahko pomembno spremenijo prihodnost prepre\u010devanja mo\u017eganske kapi [1].<\/p>\n<h3><strong>Avtorja<\/strong><\/h3>\n<p>prim. prof. dr. Bojana \u017dvan, dr. med., vi\u0161ja svetnica, specialistka nevrologinja<br \/>\ndr. Marjan Zaletel, dr. med., specialist nevrolog<\/p>\n<h4><strong>VIRI<\/strong><\/h4>\n<ol>\n<li>Meschia JF, Bushnell C, Boden-Albala B et al. Guidelines for the Primary Prevention of Stroke. A Statement for Healthcare Professionals From the American Heart Association\/American Stroke Association. Stroke. 2014; 45(12): 3754\u2013832.<\/li>\n<li>Boehme AK, Esenwa C, Elkind MSV. 2017 [cited 2019 Jun 13]. Available from: Stroke Risk Factors, Genetics, and Prevention. https:\/\/www.ncbi.nlm. nih.gov\/pmc\/articles\/PMC5321635\/.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Nespremenljivi dejavniki tveganja starost spol genska obremenjenost rasa Spremenljivi dejavniki tveganja visok krvni tlak sladkorna bolezen visoka raven holesterola debelost atrijska fibrilacija visoka zo\u017eitev notranje karotidne arterije miokardni infarkt telesna neaktivnost \u010dezmerno pitje alkohola nepravilna prehrana stres Kaj lahko storimo sami, da posku\u0161amo prepre\u010diti mo\u017egansko kap? Smernice za preventivo IMK in TIA priporo\u010dajo nadzor in&#8230;<\/p>\n","protected":false},"author":1,"featured_media":39143,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[63],"tags":[],"class_list":["post-2774","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-mozgani-in-koncentraicja"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v26.4 (Yoast SEO v28.6) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>MO\u017dGANSKA KAP - Dejavniki tveganja za mo\u017egansko-\u017eilne bolezni - Panakea d.o.o.<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/panakea.net\/sl\/blog\/mozganska-kap-dejavniki-tveganja-za-mozgansko-zilne-bolezni\/\" \/>\n<meta property=\"og:locale\" content=\"sl_SI\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"MO\u017dGANSKA KAP - Dejavniki tveganja za mo\u017egansko-\u017eilne bolezni\" \/>\n<meta property=\"og:description\" content=\"Nespremenljivi dejavniki tveganja starost spol genska obremenjenost rasa Spremenljivi dejavniki tveganja visok krvni tlak sladkorna bolezen visoka raven holesterola debelost atrijska fibrilacija visoka zo\u017eitev notranje karotidne arterije miokardni infarkt telesna neaktivnost \u010dezmerno pitje alkohola nepravilna prehrana stres Kaj lahko storimo sami, da posku\u0161amo prepre\u010diti mo\u017egansko kap? 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