Masiku ano, nthano ya kuopsa kotheratu ya cholesterol ikutchuka kwambiri pakati pa anthu opanda maphunziro apadera azachipatala. Inde, pali chowonadi china kwa ichi: cholesterol yayikulu ndi matenda owopsa a thupi. Komanso cholesterol ndi gawo limodzi lofunika kwambiri pakusunga homeostasis ya chamoyo.
Anthu ambiri, atamva za zovuta zowopsa za cholesterol, amatengera kudzipatula kwathunthu kwamafuta azakudya. Kuletsa kumeneku kumawononga thanzi. Sikuti aliyense amadziwa kuti chinthuchi chimakhudzidwa ndi kapangidwe ka maselo, kudziwa mphamvu ndi kutanuka, kumathandizira mayendedwe amkati komanso kunja, ndipo amatenganso gawo pazinthu zomwe zimagwira ntchito m'thupi.
Kuchuluka kwa cholesterol ndi chakudya kumatha kuyambitsa kuphwanya kwa lipid metabolism, yomwe pamapeto pake imayambitsa chitukuko cha atherosulinosis.
Pokhudzana ndi mawonekedwe a cholesterol awa, kuwunika pafupipafupi kuchuluka kwake, kuzindikira kwakanthawi ndikusintha kotembenuka kuchokera pazomwe zikufunika.
Ntchito ya cholesterol mthupi
Mwa kapangidwe ka mankhwala, cholesterol ndi mowa wa hydrophobic. Amasungunuka m'madzi, ndipo chifukwa cha lipophilicity amatha kulowa mkati mwa cell membrane.
Ambiri mwa cholesterol amapangidwa moyenerera m'thupi, gawo laling'ono - limabwera ndi chakudya.
Lipid imanyamulidwa m'magazi pogwiritsa ntchito mapuloteni onyamula. Amatha kugwira mamolekyulu a cholesterol ndikuwanyamula kupita komwe akupita. Kutengera kuchuluka kwa mamolekyulu a cholesterol, ma protein a lipid-protein amagawidwa m'mitundu iyi:
- otsika osalimba lipoproteins (LDL) ndi kachulukidwe kochepa kwambiri (VLDL) ndi kutchulidwa kwa atherogenic zotsatira;
- ma lipoproteins apamwamba kwambiri komanso okwera kwambiri (HDL, HDL), mosiyana, amatha kuyeretsa magazi a chylomicrons zovulaza.
Mitundu yoyendera iyi ili ndi malire okhazikika a seramu. Kusagwirizana kwa chiwerengero chawo kumatha kuyambitsa matenda a systemic.
Ntchito zofunika za cholesterol m'thupi zimaphatikizapo:
- Kuwonetsetsa kapangidwe ka chipupa cha khungu ndikusintha kwowonjezeranso kuchuluka kwake.
- Kutenga nawo mbali mayamwidwe a cholecalceferol.
- Kutenga nawo gawo kapangidwe ka mahomoni a steroid a ma adrenal glands ndi mahomoni ogonana (androgen, testosterone, estrogen). Ndi kuchepa kwa cholesterol, mavuto okhala ndi uchembele ndi ubereka mwa akazi ndi potency mwa abambo amakula.
- Kutenga mbali mu kapangidwe ka bile.
- Kutenga gawo pakuphatikizidwa kwa neural kulumikizana komanso ma nerve synapses.
Kupatuka kwa cholesterol ndi milingo ya lipoprotein ndi chizindikiro cha kufooka kwa lipid metabolism. Kuchuluka kwa mafuta m'thupi kwa nthawi yayitali kumabweretsa chitukuko cha atherosulinosis m'mawonekedwe ake onse azachipatala.
Zotsatira zoyipa za cholesterol m'thupi
Malinga ndi ziwerengero zapadziko lonse lapansi, choyambitsa chachikulu cha imfa ndi matenda amtima. Atherosulinosis imakhala ndi gawo lalikulu pakati pa matenda onse a mtima ndi mtsempha wamagazi.
Lipoproteins ndi mamolekyulu a cholesterol yaulere amatha kuyikika pamakoma a endothelium ndikupanga cholesterol plaques.
Atherosulinosis imayamba pamene mbanda zimakhazikika pakhoma la mtima, zomwe patapita kanthawi zimayamba kuchuluka ndikuwonjeza mchere wa calcium.
Pali stenosis ya chotengera, kuchepa kwa elasticity, komwe kumabweretsa kusakwanira kwa trophic magazi.
Pali mitundu iwiri ya atherosulinosis: chapakati komanso cham'mbali. Ndi chapakati, mitsempha yam'mimba imakhudzidwa ndi njira ya pathological, ndipo ndi njira yopumira, mitsempha yonse yamkati ya thupi.
Pakatikati, nthawi zambiri pamakhala kuphwanya kwamtundu wamagazi wamatenda, chifukwa chake pamakhala vuto lotupa kwambiri.
Potsutsana ndi kuphwanya umphumphu wa atherosulinotic plaque, dongosolo la coagulation la magazi limayambitsa. Kusintha kwatsatanetsatane kumayambitsidwa komwe kumayambitsa kupangidwa kwa magazi. Ngati thrombus yayikulu ikwaniritsidwa, thrombus imatha kuchoka ndipo thromboembolism imatha kuchitika.
Popeza khoma la chotengera lidapendekera, sichachilendo kuti atherosulinosis ichite ziwombo ndi zotupa m'mitsempha.
Zizindikiro za metabolism yamafuta
Mphamvu ya cholesterol m'thupi imachitika chifukwa chongochulukitsa kuchuluka kwake koyenera m'magazi. Kuphwanya kofananako kumachitika ndi kuwonongeka kwa metabolic. Nthawi zambiri pamachitika kusintha kotereku komwe sikunakhudzidwe ndi thanzi la munthu.
Kusintha kwa cholesterol yoyenera kumachitika chifukwa chophwanya mafuta a metabolism. Mwambiri, ziwerengero za cholesterol izi zimawonetsa atherosulinosis. Koma nthawi zambiri pamakhala kuchuluka kwa cholesterol yomwe imatuluka ndi ma pathologies otsatirawa:
- matenda a chiwindi, mwachitsanzo, hepatosis yamafuta, hepatitis yamavuto osiyanasiyana, hepatic carcinoma, etc;
- matenda a impso, purine ndi kwamikodzo dongosolo kagayidwe: aimpso kulephera, amyloidosis a impso, gout;
- matenda a kapamba: kapamba, chotupa, kapamba ka necosis;
- kagayidwe kazinthu kagayidwe: matenda a shuga;
- kuchepa kwa chithokomiro;
- kunenepa kwambiri komanso kunenepa kwambiri, chifukwa chakuwonongeka kwakanthawi kwa depot yamafuta.
Zizindikiro zoyambirira za atherosulinosis zimayamba chifukwa cha stenosis yamitsempha yamagazi pakukula kwa zolembedwa za atherosulinotic, komanso kutsekeka kwa magazi m'm ziwalo ndi ziwalo.
Zizindikiro zazikulu zikuphatikiza:
- Matenda a mtima. Makamaka, matenda a mtima a coronary nthawi zambiri amawonetsedwa ndi angina pectoris. Matendawa amakula motsutsana ndi maziko a ziwongo zamatumbo zamatumbo zosinthika. Zizindikiro zake ndi kupweteka kwakanthawi kochepa m'chifuwa kumbuyo kwa sternum poyankha kupsinjika kwamthupi kapena m'malingaliro. Kuukira kumachotsedwa mothandizidwa ndi nitroglycerin.
- Dyspnea ndi chizindikiro cha matenda a mtima a ischemic.
- Kuphwanya miyendo ya mtima.
- Cyanosis ya zotumphukira madera a thupi ndi acrocyanosis.
- Kutupa.
- Ululu m'miyendo mukamayenda, zomwe zimayambitsidwa ndi kufalikira kwa endarteritis.
- Kuphwanya ntchito za abale: chidwi, kukumbukira, malankhulidwe, ndi zina zambiri. Ntchito ya CNS imakulirakulira chifukwa cha kuwonongeka m'mitsempha ya chithokomiro, matenda oopsa a muubongo amakula, maselo amafa. Pamapeto pake, dementia wa mtima wopangidwa amapangidwa.
Kuphatikiza apo, mapangidwe a xanthomas ndi xanthelasma (kudzikundikira kwa ma lipid misa pansi pa khungu) ndi chizindikiro cha kusokonezeka kwa lipid metabolism.
Chithandizo cha zamankhwala cholesterol
Msika wama pharmacological umapereka mankhwala ambiri omwe amakhudza kuchuluka kwa lipids. Mankhwala osokoneza bongo amayikidwa pakadalibe zotsatira za njira zopanda mankhwala.
Pokhapokha popewa kugwiritsa ntchito mankhwala osagwiritsa ntchito mankhwala osokoneza bongo, magulu otsatirawa a mankhwalawa amalembedwa:
- Statins, limagwirira zake ntchito kuti kupondereza kaphatikizidwe wa cholesterol mu hepatocytes poletsa enieni michere. Muyenera kuwatenga kamodzi patsiku, madzulo. Kuyankha kwakukulu kwa labotale kumawonedwa pakatha milungu ingapo kuchokera poyambira mankhwalawa. Imakhala ndi mavuto osiyanasiyana: nseru, kusanza, kupweteka kwa epigastric, myalgia. Statin amachepetsa cholesterol ndi theka. Kutalika kwa mankhwala a statin kumafuna kuwunika ma enzymes a chiwindi kamodzi pa miyezi isanu ndi umodzi. Oimira gulu lino ndi atorvastatin, rosuvastatin, etc.
- Fibates. Gulu la mankhwalawa lili ndi njira yosiyaniranasiyana. Chizindikiro pakugwiritsa ntchito kwawo sikuti ndikuchulukanso kwa cholesterol, komanso kukula kwa triglycerides. Amatha kuwonjezera kuchuluka kwa antiatherogenic lipoproteins mu seramu yamagazi. Gwiritsani ntchito limodzi ndi gulu la ma statins ndikoletsedwa. Akaphatikizidwa, zimakhudza m'mimba, zimayambitsa kusanza kwambiri, kutsegula m'mimba, kupweteka. Muzochita zapakhomo, clofibrate, fenofibrate ndi gemfibrozil amagwiritsidwa ntchito kuchokera pagulu la fibrate.
- Otsatira a bile acid. Ubwino wa gululi la mankhwalawa ndikuchepa kwa kuyambiranso kwa kayendedwe kazinthu. Zinthu izi zimatha kulumikizana ndi bile acid, ndikugwira mamolekyulu a cholesterol. Mu chiwindi, bile synthesis imayendetsedwa, yomwe imagwiritsa ntchito cholesterol yambiri. Chithandizo chochizira chimachitika patatha mwezi umodzi kuyambira chiyambi cha mankhwala. Kuphatikiza ndi mankhwala ena ndizotheka. Sizikulimbikitsidwa kugwiritsa ntchito mankhwalawa kwa nthawi yayitali, chifukwa cha kuphwanya kwa lipid metabolism. Woimira wodziwika bwino wa gululi ndi cholestyramine.
- Cholesterol reuptake inhibitors. Mankhwalawa salola kuti cholesterol imidwe m'makoma a matumbo.
Njira izi zimagwiritsidwa ntchito mosamalitsa monga adanenera dokotala chifukwa cha zovuta zoyipa.
Njira zina zochizira atherosulinosis
Njira zina zochiritsira ndi njira yabwino kwambiri yowonjezera yochiritsira yotsogola kapena yodziwika bwino kumayambiriro kwa matendawo.
Amakhudzanso cholesterol ndi lipoprotein komanso mphamvu yokhudzana ndi chitetezo chathupi.
Kuchita kwawo kwachilengedwe kumachitika chifukwa cha kukondoweza m'thupi lamphamvu zake kuthana ndi kuphwanya kwa homeostasis, komanso mwachindunji pama molekyulu a lipids "zovulaza".
Chithandizo cha makolo polimbana ndi matenda a atherosulinosis ndi monga:
- kukonzekera kwa nicotinic acid, kapena Vitamini PP, kudya pafupipafupi komwe kumachepetsa milingo ya atherogenic lipids, TAG, ndipo mulingo wa antiatherogenic lipids ukuwonjezeka;
- polyunsaturated Omega-3,6 mafuta acids, omwe amasintha machitidwe a thupi, kutsitsa cholesterol, amatulutsa magazi, kulimbitsa endothelium; kudya pafupipafupi kumachepetsa kufa kwa mtima ndi 40%;
- tocopherol, kapena Vitamini E, ndi antioxidant omwe amalepheretsa njira za oxidative m'maselo, komanso amalepheretsa mapangidwe a atherosranceotic malo;
- tiyi wobiriwira wachilengedwe amakhala ndi ma phytoncides ambiri omwe amagwira ntchito, omwe amachepetsa ntchito ya thrombosis, komanso okhudza bwino mlingo wa kupanikizika kwachilengedwe;
- adyo, chifukwa cha zinthu zambiri zomwe zimagwira, amatha kusintha magazi m'magazi ndikuletsa mapangidwe a magazi;
- soya amalepheretsa kaphatikizidwe ka liphero la atherogenic, komanso amathandizanso kupanga ma asidi a bile, omwe amalimbikitsa kugwiritsidwa ntchito kwa mafuta m'thupi;
- Mavitamini a B amathandizira kuti magazi aziyenda bwino komanso kuti magazi azisintha.
Ndi ochepa mafuta a cholesterol ndi atherogenic lipoproteins, wodwalayo akulimbikitsidwa kuti azichita kusintha kwamoyo. Ndikofunika kuyamba kudya moyenera ndikuyang'anira kudya kwanu. Zochita zolimbitsa thupi zolondola ziyeneranso kuyambitsidwa.
Mtengo wawo umakhala kutsika kwa shuga ndi mafuta aulere chifukwa cha kuchuluka kwa mphamvu ya myocardium.
Zomwe Zimakhudza Cholesterol
Popeza timvetsetsa kuti cholesterol yayikulu imakhudza bwanji thanzi lathu, anthu ambiri adzafuna kusintha moyo wawo. Gawo ili ndilofunika kwambiri komanso lofunikira kwambiri pochiza matenda a atherosulinosis.
Izi ndichifukwa choti anthu ambiri omwe akudwala atherosulinosis adayamba kale kukhala ndi moyo wosalondola. Kupewera kwakukulu kwa matenda amtima wapamtima ndikusintha kwamoyo munthawi yake.
Zinthu zotsatirazi zimakhudza kwambiri chitukuko cha zotupa zamatenda a atherosulinotic:
- moyo wongokhala;
- kunenepa kwambiri komanso kunenepa kwambiri;
- kusuta;
- kuchuluka kwa zakudya zopezeka m'mafuta ambiri ndi mafuta olimbitsa othamanga;
- kutengera kwa chibadwa;
- mawonekedwe azaka;
- mtundu 2 shuga;
- kuyanjana amuna.
Kuwongolera njira ya moyo kumapereka chokwanira mu mwezi kuyambira pachiyambi cha zakudya zoyenera komanso maphunziro akuthupi.
Kuchita masewera olimbitsa thupi kumalimbitsa thanzi, kumalimbitsa thupi, kumachulukitsa zochita za metabolic. Kuchita zolimbitsa thupi pafupipafupi kumachepetsa kufunikira kwa mpweya wa myocardial, kumapereka kutuluka kwa magazi kuchokera mu minofu ya mtima. Moyo wathanzi ndiwo chinsinsi cha thanzi la mtima.
Momwe cholesterol imakhudzira thupi lonse lapansi ifotokozeredwa ndi katswiri muvidiyoyi.
