Atherosclerosis: Zizindikiro ndi mankhwala akulu

Atherosulinosis ndi matenda ophatikizika a polyetiological, omwe amathandizana ndi kupezeka kwa lipids mu chipolopolo chawo chamkati, kukula kwa njira zotupa, zomwe zimabweretsa zovuta zina zotchulidwa chifukwa cha kufinya kwa mitsempha kapena mapangidwe magazi.

Atherosulinosis imadziwika kwambiri pakati pa anthu amakono, ndipo ndi njira zolakwika zamankhwala zingayambitse mavuto.

Mawonekedwe ake oyamba nthawi zambiri amachotsedwa, ndipo anthu samawaganizira, amabwera kwa madokotala pokhapokha pakabuka zovuta. Ichi ndichifukwa chake mutu wa atherosulinosis ndi wofunikira kwambiri.

Kodi chifukwa chiyani ma arteriosulinosis amachitika?

Monga tafotokozera pamatanthauzidwe a atherosulinosis omwe, matendawa ali ndi zifukwa zosiyanasiyana.

Zachidziwikire, chilichonse payekhapayekha chingayambitse kukulitsa kwa zotupa zam'mimba. Komabe, kuphatikiza kofala kwambiri kwa zifukwa zitatu kapena zingapo zomwe pamodzi zimathandizira kuti chiwopsezo cha matenda chikwaniritse.

Chifukwa chake, pali magulu atatu a chiopsezo cha atherosulinosis. Gulu loyamba limaphatikizanso zinthu zomwe sizingasinthe.

Okhwima ndi kukalamba - anthu opitilira zaka 40-50 ndi omwe ali pachiwopsezo chachikulu, chifukwa zotengera zawo sizikhalanso zamphamvu komanso zotanuka ngati paubwana wawo, ndipo njira za metabolic nthawi zambiri zimasokonezedwa ndikusokonekera.

Kukhazikika kwa chiwopsezo - ndi amodzi mwa malo oyamba mndandanda wazomwe zimayambitsa atherosclerosis. Achibale apafupi nthawi zambiri amadwala atherosulinosis ofanana ndi zizindikiro, komanso amatha kusiyanitsa mitundu yamatenda a lipid metabolism, yomwe ndiyofunikira mwachindunji pakukula kwa matendawa.

Amuna - amayamba kuzindikira zoyamba za atherosulinosis pafupifupi zaka 10 m'mbuyomu komanso nthawi zinayi kuposa akazi.

Kusuta - khalani ndi zotsatira zoyipa kupumira ndi mtima. Chifukwa chokhala ndi chikumbumtima chambiri, chiwopsezo cha bronchitis chambiri chimakulirakulira. Munjira, chikonga chimachepetsa mphamvu zotupa za khoma lamitsempha, zimathandizira kupezeka kwake ndikuwononga pang'ono. Ichi ndi chikhalidwe chabwino kwambiri cholowera ma atstergenic cholesterol mu nembanemba yamitsempha, ndipo kenako kupanga mapangidwe a atherosulinotic.

Matenda oopsa a arterial - ndimatenda amtunduwu, kuthamanga kwa magazi kumachulukirachulukira, ndipo zotengera zili munkhokwe. Kupindika kwa nthawi yayitali kwamitsempha yamagetsi kumapangitsa kuti minyewa yawo ikhale yofooka, kuwonongedwa kwa gawo lina la mafayilo a choroid, omwe, nawonso, amathandizira kulowerera kwa cholesterol yowonjezereka komanso mawonekedwe ake mkati mwake.

Gulu lachiwiri la zinthu zomwe zili pachiwopsezo ndi zinthu zomwe zingasinthe. Munthu akhoza kuzikhudza pang'ono. Izi ndi zinthu monga:

• Hyperlipidemia, hypercholesterolemia ndi hypertriglyceridemia ndi kuchuluka kwa lipids (mafuta), cholesterol yathunthu ndi triglycerides. Zimachitika chifukwa cha kusokonekera kwa lipid kagayidwe kake komwe mapangidwe oyamba a zolembera amapangidwira, makamaka ndi kuwonjezeka kwa cholesterol yolumikizana ndi lipoproteins yotsika.
• Glucose okwera (hyperglycemia) ndi matenda a shuga - pafupifupi odwala onse omwe ali ndi matenda ashuga amakumana ndi zovuta zingapo pakapita nthawi, pakati pawo omwe micangiopathy ndi macroangiopathy (kuwonongeka kwa ziwiya zazing'onoting'ono ndi zazikulu), zomwe zimayamba chifukwa chodziwonetsa zambiri kuchuluka kwa shuga. Zikachitika, zombozo zimawonongeka kuchokera mkati, ndipo palibe zopinga zomwe zingalepheretse kulowa kwa cholesterol mkati mwake.
• Kuchepa kwakukulu kwa lipoproteins okwera - cholesterol yokhudzana ndi mtundu uwu wa lipoproteins imatchedwa "zabwino", ndipo kuchuluka kwake sikumabweretsa mapangidwe. Mankhwala, madokotala akuyesera kuti akwaniritse kuchuluka kwa lipoprotein okwera komanso kuchepa kwa mapuloteni otsika kwambiri (atherogenic).
• Metabolic syndrome ndi kuphatikiza kwa zizindikiro, zomwe zimaphatikizira kuchuluka kwa mafuta m'mimba (kapena kunenepa kwambiri pakati, mtundu wam'mimba), kulolerana kwa glucose wamagazi (mulingo wosakhazikika, koma osafikira shuga), kuchuluka kwakukulu kwa triglycerides ndi matenda oopsa;
• Kuperewera kwa Hormonal - azimayi omwe ali ndi nyengo yanthawi yayitali, komanso kuchokera kwa munthu yemwe ali ndi endocrine pathologies (hyperthyroidism, matenda a Itsenko-Cushing) amatenga kwambiri matendawa.

Ndipo pamapeto pake, gulu lomaliza la zoopsa - lotchedwa "ena." Izi zikuphatikiza ndi izi:

1. Kulephera kuchita masewera olimbitsa thupi, kapena kukhala moyo wawofuwofu, ndi anthu omwe amakhala nthawi yambiri muofesi, pakompyuta kapena kunyumba, amalemera msanga, amasiya kuchita masewera olimbitsa thupi, amakhala olimba mtima, zotengera zawo zimasowa mphamvu komanso kunenepa. Zonsezi ndi khomo lotseguka la cholesterol.
2. Zochitika pafupipafupi - zochitika zina zovuta zimakhudza kwathunthu ziwalo zonse. Amayambitsa mantha amanjenje, zomwe zimabweretsa kutulutsidwa kwa adrenaline yambiri. Adrenaline, nayenso amawonda kwambiri mitsempha yamagazi. Kubwereza pafupipafupi kwa ma episkopi kotere sikuwonetsedwa bwino m'mitsempha yosalala, ndipo kumabweretsa zotsatirazi.

Kuphatikiza apo, kumwa mowa mwauchidakwa kuli m'gulu lino - mowa ndi chilengedwe chake ndi mankhwala osokoneza bongo. Ndi kudya mosasintha, mwadongosolo m'thupi, pang'onopang'ono amawononga minofu yonse, kusokoneza kagayidwe kameneka mwa iwo, kuphatikizapo lipid metabolism.

Kupitilira apo, cholesterol ikhoza kuikidwa mwanjira ya zolembedwa.

Zina za pathogenesis ya atherosulinosis

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 ndi atherosulinosis: kusiyana ndi chiyani? Sclerosis imasiyana ndi atherosulinosis chifukwa imachitika popanda kukhudzana ndi atherogenic lipids, ndi atherosclerosis omwe amatenga nawo mbali.

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 kw botilo ndikuyambitsa kusokonezeka kwakukulu kwa hemodynamic, komwe kukuwonetsa kuwukira kwa angina.

Malinga ndi pathogenesis, magawo atatu a atherosclerosis amadziwika.

Choyamba ndi kupangika kwa malo a lipid. Amawonetsedwa m'madera ochepa a khoma lamitsempha. Gawoli limadziwika ndi kusowa kwa zizindikiro.

Lachiwiri - limatchulidwanso liposulinosis. Pakadali pano, kufupika kwa cholesterol kumachitika, amayamba kuwola, ndipo zinthu zomwe zimayamba kuwola zimapangitsa kuti poizoniyu azikhala ndi poizoni ndipo amachititsa kuti minyewa yolimba ipangidwe. Chifukwa cha izi, pali kupatula pang'ono kwa lumen ya mtima komanso kuchepa kwa microcirculation.

Chachitatu ndi atherocalcinosis. Gawo limadziwika ndi mawonekedwe athunthu azachipatala, komanso zovuta zofanana.

Pa siteji yodwala, kuukira kwapafupipafupi kumatha kuchitika, pamakhala chiopsezo chotenga myocardial infarction, stroke kapena gangore.

Chithunzi cha chipatala cha atherosulinosis

Mawonetseredwe azachipatala a atherosulinosis amatengera komwe malo a atherosulinotic, ndiko kuti, pomwe chombo chidawonongeka.

Zizindikiro zake ndizosiyanasiyana. Pali zotengera zingapo zazikulu zomwe zimatengedwa ndi matendawa. Njira yopatsirana ya atherosulinotic ikhoza kukhudza ziwiya zotsatirazi.

Mitsempha yama coronary - imanyamula magazi okhala ndi mpweya wabwino kumtima. Zikaonongeka, myocardium simalandira mpweya wokwanira, ndipo izi zimatha kudziwoneka ngati mawonekedwe a angina. Angina pectoris ndi chiwonetsero chachindunji cha matenda a mtima (CHD), omwe odwala amamva kupweteka kwamphamvu, kupweteka kovuta kumbuyo kwa sternum, kupuma movutikira komanso kuwopa kufa.

Angina pectoris amatchedwa angina pectoris. Zizindikiro zotere nthawi zambiri zimachitika pakulimbitsa thupi mosiyanasiyana, komabe, poyenda mwamphamvu, zimatha kusokoneza pakupuma. Kenako amapezeka ndi kupuma kwa angina pectoris. Kuwonongeka kwakukulu m'mitsempha kumatha kubweretsa coronarosulinosis (m'malo mwake kulocha mkati mwa mitsempha ya m'mimba ndi minyewa yolumikizana), ndipo, kumatha kuyambitsa kuphwanya kwa myocardial - necrosis, "necrosis" ya malo opatsirana myocardial. Tsoka ilo, pafupifupi theka la zochitika, vuto la mtima likhoza kufa.

Aorta - dipatimenti ya thoracic nthawi zambiri imavutika. Pankhaniyi, zizindikirazi zidzakhala zofanana ndi coronary atherosulinosis. Odwala azidzadandaula za kupweteka kolimba, kupweteka, kuwotcha pachifuwa, chomwe chidzaperekedwe kumanja ndi kumanzere, khosi, kumbuyo ndi kumbuyo m'mimba. Zomverera zoterezi zimakulira ndi kuchuluka kulikonse, mwamphamvu.

Ndi kukula kwakukulu kwa msempha, kumatha kukhala kuphwanya kwa kumeza ndi kutsekemera kwa mawu chifukwa cha kukakamira kwa kubalirana kwa laryngeal nerve. Chipilala cha aortic chimathanso kukhudzidwa. Pankhaniyi, madandaulo a odwala amatha kukhala osamveka, mwachitsanzo, chizungulire, kufooka wamba, nthawi zina kukomoka, kupweteka pang'ono pachifuwa. Chitsa cha brachiocephalic (brachiocephalic) chimachokera ku khola la msempha - chotengera chachikulu kwambiri, chomwe chimatha kukhudzidwa ndi kuwonongeka kwa nembanemba.

Mitsempha yamagazi (mitsempha ya ziwalo) - ili ndi chizindikiro chotchulidwa. Pazizindikiro zoyambirira za atherosulinosis, odwala amasokonezeka ndi kukhumudwa kwam'maganizo, amakhala okhudza mtima kwambiri, kusintha kwawo kumasintha nthawi zambiri. Pakhoza kukhala ndi mutu komanso kanthawi kochepa owonongeka a cerebrovascular (ma kanthawi pang'ono ischemic). Kwa odwala otere, chizindikiro cha Ribot ndichikhalidwe: amatha kukumbukira molondola zomwe zinachitika zaka khumi zapitazo, koma sitinganene konse zomwe zinachitika tsiku limodzi kapena awiri apitawa. Zotsatira za kuphwanya kotereku sizabwino - kugwa kwam'mimba kumatha kuchitika (imfa ya gawo laubongo).

Mitsempha ya Mesenteric (kapena mesenteric) - pamenepa, zotengera zodutsa m'matumbo am'mimba zimakhudzidwa. Izi zimachitika kawirikawiri. Anthu azikhala ndi nkhawa ndi zowawa zam'mimba, matenda ammimba (kudzimbidwa kapena kutsegula m'mimba). Zotsatira zopitilira muyeso zimatha kukhala kugunda kwa mtima m'matumbo, komanso pambuyo pake.

Mitsempha ya impso ndi njira yofunika kwambiri. Choyamba, odwala amayamba kuwonjezera kukakamiza, ndipo ndizosatheka kuti muchepetse mothandizidwa ndi mankhwala. Awa ndi omwe amatchedwa kuti aimpso (sekondale, chisonyezo). Pakhoza kukhalanso kupweteka m'dera lumbar, kusokonezeka pang'ono pokoka. Njira yayikulu ikhoza kutsogolera kukula kwa impso.

Mitsempha yam'munsi yotsika - izi zimaphatikizapo zachikazi, popliteal, tibial ndi mitsempha ya kumbuyo. Awo atherosulinosis nthawi zambiri imathetsa, ndiye kuti, kubowola lumen kwa chotengera.

Chizindikiro choyamba ndi "intermittent claudication" syndrome - odwala sangayime kwa nthawi yayitali osayima. Nthawi zambiri amayenera kusiya chifukwa amadandaula kuti thupi ndi miyendo yake yakomoka, dzuwa likuwoneka, khungu lotuwa kapena ngakhale cyanosis, kumverera kwa "tsekwe". Zokhudza madandaulo ena, omwe nthawi zambiri amasokoneza kukula kwa tsitsi pamiyendo, kuwonda pakhungu, mawonekedwe a zilonda zam'mimba zosachiritsika, kusintha kwa mawonekedwe ndi mtundu wa misomali.

Kuwonongeka kochepa kwambiri pakhungu kumayambitsa zilonda zam'mimba, zomwe pambuyo pake zimayamba kukhala zowonda. Izi ndizowopsa kwa odwala matenda ashuga, chifukwa chake ndikulimbikitsidwa kuti asamalire mapazi awo, kuvala nsapato zosasunthika, osapsa mapazi awo ndikuwasamalira. Mphamvu zamkati mwa zotumphukira za m'munsi zitha kupezekanso.

Zizindikiro zonse pamwambazi zimaphatikizidwa mu Lerish syndrome.

Njira yodziwitsa atherosulinosis

Kuzindikira kwa atherosclerosis kumakhazikitsidwa m'njira zingapo. Choyamba, madandaulo a wodwala amayesedwa, kutengera ndi iwo, munthu akhoza kungoganiza kumene zosinthazo zinachitika.

Kuti muwonetsetse matenda oyambira, njira zogwiritsira ntchito zasayansi ndi zothandizira zimayikidwa.

Pakati pa njira zofufuzira zasayansi, kuyesedwa kwa biochemical magazi, komwe kumayesa kuchuluka kwa cholesterol yonse. Nthawi zambiri ndi atherosulinosis, imachulukitsidwa. Chikhalidwe cha cholesterol chonse ndi 2.8-5.2 mmol / L. Kuti mumve zambiri mwatsatanetsatane wazomwe lipid imapangidwira magazi, lipid mbiri imayikidwa.

Zimawonetsa milingo yamitundu yonse ya lipids m'thupi lathu:

• cholesterol yathunthu;
• otsika osalimba lipoproteins ("yoyipa" cholesterol);
• otsika kachulukidwe lipoproteins;
• kachulukidwe kachulukidwe lipoproteins;
• highensene lipoproteins ("wabwino" cholesterol);
• triglycerides;
• ma chylomicrons.

Kusintha kwa makulidwe a lipid ndikuwonjezeka kwa milomo ya lipoprotein otsika kwambiri komanso kuchepa kwa chiwerengero cha lipoproteins yapamwamba.

Kuti muwone bwino odwala, amatumizidwa kuti awone ngati ali ndi vuto loyesa () kuti awone ngati ali ndi vuto lothandizira), intravascular ultrasound, complication tomography (CT) ndi imagonance imaging (MRI).

Njirazi zimakupatsani mwayi kuti muwone kukhalapo kwa kusintha kosiyanasiyana mumapangidwe amitsempha yamagazi, kudziwa kuchuluka kwa stenosis yawo (kuchepetsa) ndikuletsa kuwonongeka kwina.

Njira zochizira matenda a atherosulinosis

Chithandizo cha atherosulinosis ndi njira yayitali, yovuta, ndipo imafunikira kukhudzana ndi nthawi yayitali kuchokera kwa wodwala ndi madokotala omwe amapita.

Muli magawo angapo omwe amayenera kutsatiridwa ndikuphatikizana.

Iyenera kuthandizidwa pang'onopang'ono ndikuphatikizidwa, kotero, zizindikiritso ndi chithandizo cha atherosclerosis zimalumikizana kwathunthu. Nazi mfundo zoyambira zamankhwala:

1. mankhwala;
2. zakudya mankhwala;
3. masewera olimbitsa thupi;
4. kugwiritsa ntchito mankhwala azikhalidwe;
5. kupewa kufalikira kwa njirayi.

Kugwiritsa ntchito mankhwala osokoneza bongo a atherosulinosis kumaphatikizapo kugwiritsa ntchito mankhwala ochepetsa mphamvu ya lipid (kutsitsa kuchuluka kwa lipids, makamaka cholesterol). Awa ndimagulu a mankhwalawa monga ma statins (Atorvastatin, Rosuvastatin, Akorta), ma fibrate (Fenofibrate, Besofibrate), anion exchange resins (Cholestyramine, Colestipol) ndi kukonzekera kwa nicotinic acid (Nicotinamide, Vitamini B₃) Amakhala oledzera bwino asanagone, chifukwa cholesterol yochulukirapo imapangidwa ndi thupi lathu usiku. Kugwiritsa ntchito mavitamini, michere ndi zinthu zina, zomwe zingathandize kuti magazi azithamanga komanso kuti achepetse zovuta, timalimbikitsidwanso. Ma Antispasmodics (Papaverine, No-Shpa), omwe amachepetsa mitsempha yamagazi, amagwira ntchito bwino.

Zakudya za odwala omwe ali ndi atherosulinosis ndikuchotsedwako kuchokera pakudya chamafuta, a mchere, okazinga, zakudya zilizonse zothamanga, maswiti, mchere wambiri, nyemba, nyama zonenepa. M'malo mwake, tikulimbikitsidwa kudya masamba ndi zipatso zambiri, zipatso zosiyanasiyana, nyama yochepa yamafuta, nsomba zam'madzi ndikumwa pafupifupi malita ndi theka a madzi oyeretsedwa patsiku.

Kuchita masewera olimbitsa thupi ndikofunikira kuti muchepetse thupi komanso kulimbitsa thupi lonse. Kulemera kwambiri ndi chiopsezo chachindunji cha kukula kwa matenda a shuga a mtundu wachiwiri, momwe zombo zimavutikira, ndipo ngakhale chotupa cha atherosulinotic sichidzawathandiza. Potere, kuyenda tsiku lililonse kwa theka la ola kumalimbikitsidwa. Mutha kuchita nthabwala zopepuka, osati zolimbitsa thupi kwambiri, monga kulimbitsa thupi.

Zithandizo za anthu ndizabwino kwambiri kuthandizira kunyumba. Ikhoza kukhala nthomba za fulakesi, mafuta owonda, ma infusions ndi ma decoctions ochokera ku zitsamba zosiyanasiyana. Zowonjezera pazamoyo (zowonjezera zakudya) ndizoyenera.

Kupewa kukwera kwa cholesterol ndikupewa kupitilira kwa matendawa. Kuti muchite izi, muyenera kusiya zizolowezi zoipa (kumwa mowa ndi kusuta), kuchita masewera olimbitsa thupi, kutsatira zakudya komanso kusakhala ndi mantha.

Momwe mungagwiritsire mtima wa atherosulinosis akufotokozedwa mu kanema munkhaniyi.