Atherosulinosis munthawi yathu ino imakhudza anthu ambiri. Mwachilengedwe, atherosulinosis ndi matenda osachiritsika, omwe amapezeka nthawi zambiri omwe amatha kupangitsa kuti zinthu zambiri zichitike.
Pakukonzekera kwa pathological process, atherosulinotic plaque amangoikidwa m'matumbo, omwe, pakapita nthawi, amawachepetsa mphamvu zawo ndikuwonjezeranso zovuta zina zomwe zimatulutsa ziwalo zogwirizana ndi ziwalo.
Ndikofunikira kuti aliyense athe kuzindikira mawonetseredwe oyamba a matendawa, makamaka momwe gawo loyambirira la atherosclerosis limawonekera.
Nthawi zambiri imakhala yofatsa kwambiri, yodwala, motero, matendawa amapezeka kawiri kawiri pambuyo pake.
Kodi chimayambitsa matendawa ndi chiyani?
Atherosulinosis imatha kuchitika motsogozedwa ndi zinthu zambiri zatsikulo. Choyambitsa chachikulu ndichotsatira chophatikizika cha zinthu zingapo pamodzi.
Malinga ndi chidziwitso chamakono chachipatala, pali mitundu itatu ya zoopsa zomwe zimapangitsa kuti matendawa atukuke. Gulu loyamba ndi zomwe zimadziwika kuti sizingasinthe, chachiwiri ndi chosinthika (chachitatu), ndipo chachitatu ndichinthu chosinthanso.
Gulu loyamba la zinthu zomwe zimakhudza dongosolo la atherosulinosis ndi izi:
- Makamaka.
- Zaka za munthu.
- Kuyanjana pakati pa amuna ndi akazi.
- Kukhalapo kwa zizolowezi zoyipa.
- Kukhalapo kwa kuthamanga kwa magazi
Gulu lachiwiri la zinthu ndi monga:
- kuchuluka kwa cholesterol, lipids ndi triglycerides;
- matenda a shuga ndi hyperglycemia;
- milingo yotsika kwambiri ya lipoproteins;
- kukhalapo kwa kagayidwe kachakudya matenda.
Gulu lachitatu limaphatikizidwa ndikukhala moyo wongokhala, kupsinjika m'maganizo, kukhalapo kwa zizolowezi zoyipa.
Makhalidwe a zinthu zosasintha zomwe zimayambitsa matenda a atherosulinosis
Kudziwitsa zam'badwo - mwatsoka, zovuta zambiri zomwe zimakhudzana ndi kuperewera kwa lipid (mafuta) metabolism zimabadwa ndipo zimayambitsidwa ndi zolakwika zina mu chromosomes. Ndipo popeza cholesterol yowonjezera mthupi ndi imodzi mwazomwe zimayambitsa atherosulinosis, ndiye kuti cholowa pamenepa ndi amodzi mwa malo oyamba.
M'badwo wa munthu - anthu azaka zapakati pa 40 ndi kupitilira amatenga matenda. M'zaka izi, kukonzanso kwachuma kwa thupi kumayamba, mphamvu yawo yam'mimba imataya mphamvu komanso kutanuka, mavuto okhala ndi kupanikizika ndi kagayidwe ka magazi nthawi zambiri amayamba;
Amuna kapena amuna - amuna amadwala atherosulinosis pafupifupi nthawi zinayi kuposa akazi, komanso zaka 10 m'mbuyomu.
Kusuta kwa nthawi yayitali komanso pafupipafupi - nikotini ndi poizoni yemwe amakhudza thupi pang'onopang'ono, zomwe zimawononga maselo a kupuma komanso mtima. Pafupifupi onse omwe amasuta amakhala ndi matenda opatsirana. Koma zombozo, mothandizidwa ndi chikonga zimakhala zosalimba komanso zomveka, chifukwa cholesterol imalowa mkatikati mwa mtima ndipo imayikidwa mu ziwonetsero.
Hypertension ndi kuchuluka kwa magazi pafupipafupi, nthawi zambiri popanda chifukwa chomveka. Poterepa, zombozi nthawi zambiri zimakhala zomangika. Kupindika kwa nthawi yayitali nthawi zonse kumavulaza minyewa yam'mitsempha, ndipo izi zimapangitsa kuwonongeka kwa gawo la myocyte (maselo osalala).
Ma sewerolo amakanika kuyankha mwachangu ku vuto la mitsempha, ndipo mamolekyulamu a lipid amatha kulowa mosavuta kuzungulira kwawo ndipo, monga momwe akuyembekezerera, amapanga mafoto.
Makhalidwe azinthu zosintha pang'ono
Kuchuluka kwa cholesterol, lipids ndi triglycerides - hypercholesterolemia, hyperlipidemia ndi hypertriglyceridemia. Chofunika kwambiri ndikuwonjezereka kwa kachulukidwe kokhala ndi cholesterol yotsika, komwe, kwenikweni, ndi atherogenic.
Matenda a shuga ndi hyperglycemia (shuga m'magazi) - onse odwala matenda ashuga amakumana ndi zovuta posachedwa. Awa ndi matenda a shuga a retinopathy (kuwonongeka kwa retina), mitsempha (kuwonongeka kwa mitsempha), nephropathy (kuwonongeka kwa impso) ndi angiopathy (kuwonongeka kwamitsempha). Pali microangiopathy - kuwonongeka kwa ziwiya zazing'ono, ndi macroangiopathy - pamene zombo zazikulu zimavutika. Zonsezi zimachitika chifukwa cha kuchuluka kwa shuga pamitsempha yamagazi, ndichifukwa chake amawonongeka pang'onopang'ono.
Mlingo wotsika kwambiri wa lipoprotein wapamwamba - cholesterol yomwe imagwirizanayi imatchedwa "yabwino" chifukwa si gawo lamipanda. Mankhwala okwanira, kuchuluka kwawo kwakanthawi ndi kuchuluka kwa otsika a lipoprotein amafunikira.
Metabolic syndrome ndimawu amodzimodzi pakuwonetsa zingapo. Izi zimaphatikizapo kunenepa kwambiri kwam'mimba (kuchuluka kwa mafuta m'mimba), kutsika kwa glucose kulolera (kusakhazikika kwa ndende), kuchuluka kwa triglycerides m'magazi, ndi matenda oopsa.
Chizindikiro cha zinthu zomwe zingasinthe
Gulu lachitatu la zinthu za mpunga ndi omwe amatchedwa "ena." Amadalira kwathunthu ndi munthu yemwe, ndipo kupezeka kwawo m'miyoyo yathu kungathetsedwe kwathunthu.
Kukhala moyo wongokhala - Mwasayansi, izi ndi zopanda ntchito. Kwa anthu ambiri, ntchito imalumikizidwa ndi makompyuta, zojambula zosatha, ndipo zonsezi zimachitikanso muofesi yabwino. Ntchito ngati izi zimakhudza mphamvu yayikulu yathupi. Anthu amapeza mapaundi owonjezera, amakhala olimba, nkhawa zowonjezereka zimawoneka, zomwe, zimakhudza dongosolo la mtima.
Kukhumudwa kwambiri - nkhawa ndi chimodzi mwazomwe zimayambitsa matenda oopsa. Monga mukudziwira, pomwe zombozo zimayang'aniridwa nthawi yayitali. Panthawi imeneyi, minyewa yamitsempha yama mitsempha imakumana ndi microdamage. Izi zimakhudza ziwalo zawo ziwiri - mucosa ndi serous. Ngakhale kuvutikira kwakanthawi kochepa kwamitsempha yamagetsi kumakhala chitseko cha mafuta owonjezera m'thupi.
Uchidakwa wopitilira - Mowa mowa wa Ethyl mwanjira yake ndi wa poizoni. Amagawa mitundu yonse ya njira zama metabolic mthupi, izi zimawonetsedwa mu metabolism yamafuta.
Miyezo ya lipid m'magazi imasokonekera, ndipo njira yopangira zolembera zamtundu wa chembere imayamba.
Pathanatomy ndi pathophysilogy ya atherosulinosis
Njira zonse zomwe zimapezeka m'matumbo omwe ali ndi atherosulinosis zimaphunziridwa mwatsatanetsatane ndi sayansi yotchedwa pathological anatomy (pathanatomy) ndi pathological physiology (pathophysiology). Amafotokoza pathogenesis yathunthu yamatenda.
Kuwonongeka kwa khoma la chotengera motsogozedwa ndi zina zakunja kumatchedwa kusinthika. Kusintha kumayambitsa kukanika kwa mzere wamkati wamitsempha - endothelium. Chifukwa cha kusokonekera kwa endothelial, kupezeka kwamitsempha yamagazi kumawonjezeka kwambiri, kupanga zinthu zapadera zomwe zimapangitsa kuti magazi azigwira komanso kutsekeka kwa lumen ya chotengera kumawonjezereka.
Kusintha kwamasamba mu vuto la atherosulinosis kumachitika mchikakamizo cha cholesterol yochulukirapo, matenda osiyanasiyana, kapena mahomoni owonjezera. Pakapita kanthawi, kumakhala kulowetsedwa, ndiko kuti, kulowetsedwa, kwamkati mwa mitsempha mozungulira kuzungulira maselo m'magazi otchedwa monocytes. Ma monocytes amasintha kukhala ma cell a macrophage, omwe amatha kudziunjikira cholesterol esters. Ma esters omwe amasonkhanitsidwa amasinthidwa kukhala ma cell foam, omwe amapanga zomwe zimatchedwa lipid strips pa intima (zingwe zamkati) zam'mitsempha. Ma macrophages amapanga zinthu zapadera zomwe zimathandizira kaphatikizidwe ka minofu yolumikizana. Zingwe zabwinobwino za mitsempha imasinthidwa ndi minofu yolumikizana. M'mabuku asayansi, njirayi imatchedwa sclerosis. Sclerosis imatha kuchitika pambuyo poyambira m'mnyewa wamtima.
Njira zonse pamwambapa zimayambitsa kutupa kosalekeza m'matumbo. Phale la atherosulinotic amapanga pang'onopang'ono. Ndi cholesterol yozungulira ya cell cell. Zilembo zoyambirira komanso mochedwa zimasiyanitsidwa. Zoyambirira, kapena zoyambirira, zolemba zokha ndi zachikaso, zimakhala zodzikongoletsera ndipo sizipezeka ndi njira zina zowonjezera. Ngati chikwangwani chachikaso chawonongeka kapena kupangidwanso, ndiye kuti pamavala magazi, omwe amatsogolera ku otchedwa acute coronary syndrome.
Kwa nthawi yayitali, mochedwa, kapena zoyera, mapangidwe a malo. Amadziwikanso kuti fibrotic. Amakhala mozungulira mozungulira kuzungulira kwa botilo ndipo amayambitsa kusokonezeka kwakukulu kwa hemodynamic ndipo akuwonetsedwa pakuwukira kwa angina.
Malinga ndi kusintha konse komwe kufotokozedwera, magawo 5 a atherosulinosis amadziwika:
- Gawo la Dolipid - pankhani iyi, zombo zomwe sizinawonongeke, kupezeka kwawo kokha kwa lipoprotein cholesterol (atherogenic cholesterol) kumawonjezeka.
- Lipoidosis ndi gawo la mapangidwe a lipid mizere pamene lipoproteins imangoyamba kudziunjikira mu kukula kwa mitsempha.
- Liposulinosis - minofu yongopangika kumene imayamba kuwonjezera pazodzikundikira za lipid, chifukwa zomwe zolembera zimachulukana kukula;
- Atheromatosis ndi ulceration wa atherosulinotic plaque.
Gawo lotsiriza ndi atherocalcinosis - pali kudzikundikira ndikuwonekera kwa mchere wa calcium pamtunda wa zolembazo.
Zizindikiro zakukula kwa atherosulinosis
Atherosulinosis imadziwika chifukwa cha kudandaula kwa odwala. Kwenikweni, uwu ndi chizindikiro cha matenda. Zimatengera mwachindunji komwe njira ya matenda. Pali mitsempha yambiri yayikulu yomwe imavutika nthawi zambiri.
Mitsempha yama coronary - imakhudzidwa nthawi zambiri. Nthawi yomweyo, atherosulinosis imasokonekera nthawi zambiri, ndiye kuti, kuphimba kwathunthu ndikuwunika kwa chotengera. Nthawi zambiri imafotokozedwa m'matumbo a mtima (CHD). Odwala nthawi zambiri amakhala ndi vuto lakuwotcha, kupweteka kupweteka kumbuyo kwa sternum, yomwe nthawi zambiri imakhudzana ndi kuchita masewera olimbitsa thupi kapena kuvuta kwambiri. Zovuta zina zimatha kutsagana ndi kupuma pang'ono komanso kumva kwambiri kufa. Ndi kuwonongeka kwakukulu m'mitsempha, kubowoleza kwam'maso kumatha kuyamba.
Chipilala cha Aortic - ndi kugonjetsedwa kwake, odwala amatha kudandaula za chizungulire, kutayika kwakanthaŵi, kudzimva kufooka. Ndi chotupa chochulukirapo, pamakhala kuphwanya kwa kumeza ndi mawu osokosera.
Mitsempha yamagazi - nthawi zambiri imakhudzidwa ndi ukalamba. Gawo loyambirira la matenda a m'matumbo a mitsempha imayendera limodzi ndi kupweteka m'mutu, kuwonongeka kwa kukumbukira, kusokonezeka kwa malingaliro, kukwiya kwa wodwala komanso kusakhazikika pamalingaliro. Pafupifupi odwala onse, pali chizindikiro cha Ribot, momwe amakumbukira zinthu zomwe zakhala zikuchitika kwanthawi yayitali, koma sanganene zomwe zinachitika m'mawa kapena dzulo. Chifukwa cha matenda amtundu wa m'mimba, sitiroko imayamba.
Mitsempha yama Mesenteric ndi ziwiya za mesentery zamatumbo. Pankhaniyi, odwala adzadandaula za kutentha, kupweteka kwam'mimba kosapweteka, kusokonezeka kwa chopondapo.
Mitsempha yamkati - koyambirira, kupweteka kochepa kumbuyo kumachitika. Kenako, kupanikizika kumatha kuchuluka mosaganizira, komwe kumakhala kovuta kwambiri kuchepetsa ndi mankhwala.
Mitsempha yam'munsi yotsika - nthawi zambiri amavutika odwala omwe ali ndi matenda ashuga. Anthu amadandaula za kuzizira kwamiyendo, kugona kwawo, komanso kusokonekera kwa tsitsi pakhungu la miyendo. Nthawi zina miyendo imatha kutembenukira buluu. Komanso, odwala sangayende mtunda wautali kwa nthawi yayitali, ndipo amakakamizika kuima kwakanthawi, miyendo yawo ikayamba kuzimiririka, kutembenuka, kuyamba kupweteka, ndipo "zopindika" zimayenda mozungulira miyendo yawo. Zizindikiro zake ndi claudication syndrome. Popita nthawi, zilonda zam'mimba zimatha kuwoneka pakhungu. M'tsogolomu, izi zimayamba kukhala zigawenga.
Zombo zonse, kupatula ubongo, zimatchedwa extracranial, kapena extracranial.
Kuchiza komanso kupewa matenda a atherosulinosis kumakhala kotsatira kutsatira zakudya zomwe dokotala amatenga, kumamwa mankhwala a anticholesterolemic omwe amathandizira kuyeretsa kwamitsempha yamagazi. Mufunikanso kuchita masewera olimbitsa thupi pafupipafupi, mungathenso kutsatira malingaliro a kagwiritsidwe ntchito ka mankhwala wowerengeka, omwe angathe kukonzekera kunyumba. Zikhala zofunikira kuthandizidwa kwakanthawi komanso osasokonezedwa, chifukwa zotsatira zoyambirira zitha kuonekera patatha chaka chimodzi.
Momwe mungadziwire atherosclerosis m'magawo oyamba akufotokozedwa mu kanema munkhaniyi.
