Atherosclerosis ndi matenda omwe amakhudza ziwiya za zotanuka ndi zotupa, zotayira, zomwe zimawalepheretsa kupanga zinthu zachilengedwe pokwaniritsa ntchito yododometsa komanso kuphatikizika kwa magazi.
Mwanjira iyi, mafuta-protein detritus amadziunjikira mu khoma la chotengera, ndi mafomu. Chikwangwani chomwe chotsatira chikukula msanga ndikukula, kukulira magazi mpaka kutsekeka kwathunthu.
Zomwe zimapangitsa kuti pakhale kusintha kwa ma atherosselotic zimapangidwira ndipo sizimamvetsetsa bwino.
Koma zinthu zotsatirazi zimabweretsa mwayi wodwala.
- Kusuta - Mlingo wokhazikika wa chikonga, womwe ndi mkhalapakati mwa thupi mkati, umamasula kayendedwe ka mtima komanso kupuma, zomwe zimapangitsa kuti azikhala osalimba komanso azitha kulowa mkati mwa zinthu za atherosclerotic.
- Matenda a shuga - matenda ovuta a kagayidwe kazakudya amachititsa kuti zinthu zina zilizonse zovuta kupezeka m'thupi, kuphatikizapo mafuta kagayidwe. Mitundu ya lipids yokhala ndi oxid yomwe imalowa m'magazi ndikuzungulira pamenepo mpaka ikulowera khoma.
- Matenda oopsa a arterial - kuthamanga kwa magazi kumayambitsa kufooka kwa mgwirizano wamitsempha yamagazi, ndipo ndizosavuta kulowa ma cell osasunthika. Komanso, angiotensin 2, vasoconstrictor wolimba, amathandizira kutsimikiza kwa ma membrane a maselo.
- Kunenepa kwambiri - ngati ma enzymes sangathe kuthana ndi mafuta amthupi lawo, sitingathe kuyambiranso kukonzanso cholesterol yakunyumba.
- Kusavomerezeka kwamayendedwe amafuta a cholesterol - ngati ma lipoprotein okwera kwambiri amakhala ocheperako, ndiye kuti cholesterol "yoyipa" imalowerera ndikualowa m'maselo a endothelial.
- Hypodynamia - moyo wongokhala umafooketsa mtima ndi mitsempha yamagazi, minyewa yawo imayamba kuzimiririka ngati yosafunikira.
- Njira zakulera zamkamwa zimasokoneza kuchuluka kwa mahomoni mwa akazi. Amadziwika kuti amuna amadwala kangapo kangapo, chifukwa azimayi amakhala ndi chiopsezo chachilengedwe - mahomoni a estrogen. Kutenga mapiritsi kumachepetsa kutsika kwake.
- Psychoemotional katundu, nkhawa yamagetsi kwakanthawi.
- Kudya mafuta ochulukirapo.
Nthawi zambiri zinthu zimakhudza munthu nthawi imodzi, nthawi zambiri wodwala amakhala ndi magulu osiyanasiyana komanso osiyanasiyana.
Makina a atherosulinosis sakudziwika kwenikweni, koma pali malingaliro angapo omwe amafotokozera njirayi.
Mu dongosolo la zamakono zamakono, pathogenesis ya atherosulinosis mu magawo imawonetsedwa mwa malingaliro awiri otsogolera - lipidogenic ndi sanali lipidogenic.
Yoyamba mwa iwo idakhazikika pakusintha kwamomwe michere imapangidwa ndimagazi ndi ma enzyme, osasamala za momwe zimakhalira kale.
Magawo otsatirawa a etiopathogenis amadziwika mu izi:
- Gawo la Dolipid. Pali zotupa zochepa za endothelial, kuchuluka kwamphamvu kwa cell membrane, komwe mapuloteni am magazi, fibrin, amalowera kale. Ndodo ya Flat parietal thrombi. Intima yam'madziyo imadzazidwa ndi glycosaminoglycans, kutupa kwa mucoindoid kumawonekera.
- Lipoidosis Kutseka kolowera mkati mwa membrane wamkati ndi lipids (cholesterol), mapangidwe amalo amafuta ndi mikwingwirima, omwe amawoneka ndi maliseche. Maselo achinyengo omwe amatchedwa xanthomas omwe anapeza pano. Kuyankha kwa autoimmune kwa thupi kuti lisinthe kapangidwe kake kamayamba, ndipo zotanuka zimagwa.
- Lipossteosis Akatswiri a tizilombo timene timasiyanitsa gawo ili pakati pa ena, chifukwa maselo amatupa ndipo amadzaza ndi detritus burst, zomwe zimabweretsa kutulutsidwa kwa zinthu zofunikira m'zinthu zozungulira. Pambuyo pa izi, minofu yolumikizana imakula kwambiri, ndipo mawonekedwe oyamba ofunikira am'mimba.
- Atherosis Mapangidwe a ulusi wa fibrin amatola mafuta, amakhala wachikasu. Chisindikizo chimasokonekera mkatikati ndipo nthawi zina chimatha kufikira kuchuluka kwakukulu. Chikwangwani chotere chimaphimba mwamphamvu chinyontho cha chotengera.
- Kukweza. Chimodzi mwazomwe zingakhalepo patathogenesis, koma osafunikira. "Chovala" cha mapangidwe chimawola, ndipo zilonda zimapangika m'malo mwake. Zowonongeka mwina zitatsekedwa ndi mapulateleti, zomwe zimatsogolera ku fibrosis yokulirapo, kapena kulowa mkati mwakuya, aneurysm iyamba.
- Atherocalcinosis. Zomwe zimachitika pakumalizira zimamaliza kulowa mkati mwa makulidwe a calcium, omwe amachedwa pakati pa ulusi. Tsopano chinsalachi ndichopanda miyala ndipo nkovuta kuchichotsa, ndipo kupatikako ndi kodzadza ndi embolism.
Chiphunzitso chosakhala cha lipidogenic chimakhala ndi mtundu wofanana wa chitukuko cha matenda, koma chomwe chimayambitsa chiwopsezo cha mitsempha ndi othandizira opatsirana, ma radiation, mankhwala osokoneza bongo kapena zoopsa.
Makhalidwe a polyetiological a atherosulinosis sangathenso kukanidwa.
Atherosulinosis ndi matenda a lipid. Zinthu zazikulu zomwe zimayambitsa kusinthika kwaulere ndi triglycerides yaulere, mafuta acids ndi cholesterol.
Amakhala ndi njira zakunja ndi zamkati zolankhulira mwaulere. Kuti mudziwe bwino za kagayidwe kake kolesterol, tifufuza njirayi molondola. Kolesterol ikalowa m'thupi limodzi ndi chakudya ndi mafuta ena a nyama, imaphatikizika ndikuthyoledwa m'matumbo aang'ono, pambuyo pake kumayamwa.
Popeza maziko a magazi ndi madzi, ndipo mafuta osakwanira m'matimuwo amachititsa kuti magazi azituluka komanso ma embolism, njira zoyendera ndizofunikira. Awa ndi ma chylomicrons, HDL ndi LDL (lipoproteins otsika komanso okwera).
HDL imanyamula "cholesterol" yopindulitsa, chifukwa imagwiritsa ntchito mphamvu, kaphatikizidwe ka mahomoni ndikusunga kachulukidwe kamakina.
Ma Chylomicrons amayendetsa ma triglycerides, chinthu choyambira chosokoneza lipid.
LDL imalumikizidwa ndi "cholesterol" yoyipa "ndipo imathandizira kuti ikwaniritse mu endoplasmic reticulum ya cell mpaka itakhala xanthomic.
Zosintha muubale zimayanjanitsidwa ndipo zimayikidwa. Gawo loyamba la zolembazo ndi ma cellular, omwe ali mu "chivindikiro" cha fibrin. Pali zinthu zambiri zosalala minofu, macrophages ndi leukocytes zomwe zimayambitsa kukula kwachuma, kuchuluka, chemokines, oyimira pakati otupa. Kutupa kosatchulidwa.
Kenako pakubwera matracellular matrix okhala ndi minyewa yolumikizana, yokhala ndi ulusi ndi zotanuka, mapuloteni, ofunikira pakapangidwe ka mafupa a fibrous.
Chozama kwambiri chomwe chili mkati mwake. Ili ndi likulu la necrotic la cholesterol lokhala ndi zigawo zake, makhiristo. Zomwe zimapangidwazo zimaphatikizanso zotsalira za mapuloteni ataphulika maselo.
Chifukwa cha magawo aomwe amaongolera, zimakhala zovuta kulowa mkati mwa chinsalu ndikuwononga cholinga cha kutupa.
Pathogenesis ya atherosulinosis sikuti imangopereka chidule chabe cha kusintha kwakukulu kwa zomwe zikuwonetsedwa komanso zolembedwa m'masukulu azachipatala.
Imayambitsa yankho la pathogenetic ku vutoli, moyang'anizana ndi zochitika zenizeni zamankhwala.
Chifukwa chake, ndikofunikira kukhala ndi lingaliro la mitundu yamatenda a atherosulinosis, omwe amasiyana mawonekedwe ndi zotsatira zake.
Gulu la magulu azachipatala komanso automiki limawoneka motere:
- Matenda a Msempha. Mawonekedwe ambiri. Zosintha zimatchulidwanso m'chigawo cham'mimba. Mkhalidwewo umapanikizika ndi kutayika kwa elasticity komanso kuthamanga kwa magazi. Mwazi umayenda mu ziwalo zam'mimbamo zam'mimbamo, kupindika kwa impso, aneurysms, atrophic ya oyandikana ndi zimakhala, thromboembolism ndizotheka.
- Mitsempha yama coronary. Mtima umadya mpweya wambiri kuti uzisinthasintha. Chifukwa chake, ndi blockage yamafuta omwe amapatsirana, myocardial hypoxia ndi matenda a mtima (CHD) amakula. Zizindikiro zodziwika bwino ndi izi ndizopweteka pachifuwa, mpaka dzanja lamanzere, scapula, nsagwada. Kuchepera kufooka, kufupika, kutsokomola, kutupa. Zotsatira zake ndizowopsa - kuphatikizidwa kwa mtima.
- Mitsempha ya ubongo. Matenda onse amitsempha amayambira apa. Ndi thrombosis yamkati mwa carotid mtsempha wamagazi, kumachitika sitikali. Fomu yovuta imakhala ikuwoneka ndi kusintha kwa ma atrophic mu ubongo, encephalopathies, dementia.
- Mitsempha yammbali. Kuchepetsa kumachitika kawirikawiri pamalo a arteriarenalis omwe amatulutsa kuchokera pa chipilala chachikulu. Zotsatira za atherosclerosis ya aimpso minofu ndi atherosclerotic khansa impso. Zosakwanira sizichitika, ngakhale kuti matenda a pathology amawonetsedwa ndi matenda oopsa.
- Mitsempha yamatumbo. The terminal boma mogwirizana ndi chitukuko cha aseptic kutupa kwamatumbo m'dera la chotchinga chotupa (gangrene) ndi peritonitis. Potengera maziko a matenda aschemia, kuukira kwa "chifuwa cham'mimba" kumachitika - colic atatha kudya, omwe amachotsedwa ndi nitroglycerin.
Atherosulinosis yamitsempha yam'munsi yamendo imasiyananso. Kuthana ndi atherosulinosis ya malekezero akumunsi kumapangitsa wodwalayo kupweteka kwambiri komanso kuvutika. Lactic acid samachotsedwapo minofu yofewa, makamaka minofu.
Odwala oterewa sangathenso kuyenda miyendo 200 osayima, chifukwa ululu wosalephera ukuwonjezeka ndi chilichonse. Mochulukitsa, zilonda zam'mimba ndi gangrene ya miyendo ndizotheka.
Mavuto amagawidwa pachimake komanso chovuta, kutengera kutaya kwake. Pachimake ndi omwe amafa kwambiri ndipo amayambitsa kuwonongeka mwachangu kwa maola angapo. Uku ndi kupweteka kwambiri kwa mtima (ischemia), kutsatiridwa ndi kuwonongeka kwa ziwalo zolunjika. Cholinga chake ndimagazi, emboli, vasospasm yokhala ndi chidwi chambiri. Zaphatikizidwanso apa ndikukhazikika kwa aneurysm yamatumbo omwe amayanjana ndi magazi akulu owopsa.
Mavuto osokonezeka amatha kuchitika kwa zaka zambiri, koma njira yokhala asymptomatic imawapangitsa kukhala osavulaza. Awa ndi zotupa za m'deralo za m'madzi a chotengera china, kusinthasintha kwa mitundu ndi zinthu zina mwa ziwalo, kukula kwa minofu yolumikizika, khansa.
Angina pectoris, infarction ya myocardial, mapapo komanso kuchepa kwa magazi, kusokonezeka kukumbukira, luso la magalimoto, kudzutsidwa ndi kugona, kugumuka, kutupa ndi kupweteka - iyi si mndandanda wathunthu wazotsatira zonse zamatenda. Kuti mupewe izi, muyenera kuyamba kupewa pakali pano, chifukwa mwina kumachedwa.
Kupewa kukwera kwa cholesterol kumakhala ndi chithandizo cha zakudya, zolimbitsa thupi, kukana mafuta azakudya komanso zizolowezi zoyipa. Chithandizo cha mankhwalawa nthawi zambiri chimakhazikika (mankhwala) kapena opaleshoni yokhala ndi mawonekedwe.
Zofunikira zazikulu za matendawa ndizakukula kwa makoma a mtima komanso kutayika kwawo. Matenda a Hyalinosis ndi Menckenberg nawonso ali m'gululi, koma atherosclerosis yatenga malo oyamba kuchuluka kwazaka zambiri.
Masiku ano ndi matenda ofala kwambiri m'maiko otukuka, 150 mwa 100,000 akudwala, ndipo izi zikukula. Atherosulinosis palokha siyowopsa monga zovuta zake zosalephera, ndizomwe zimayambitsa kufa kwa matenda amtima.
The pathogenesis of atherosulinosis ikufotokozedwa mu kanema munkhaniyi.
