Atherosclerosis ndi matenda amkati: ubale

Atherosulinosis ndi matenda amkati ogwirizana ndi mtima dongosolo nthawi zambiri amapezeka.

Vutoli limafotokozedwa chifukwa chakuti kuphwanya lipid ndi mapuloteni kagayidwe kawiri kawiri zimachitika kapena zomwe zimayambitsa matenda amtima uliwonse.

Chifukwa chake, kudziwitsidwa koyambirira kwa atherosulinosis kumatenga gawo lofunikira - njira yovuta, chifukwa matenda poyamba sanali kudziwulula.

Magawo a chitukuko ndi zomwe zimayambitsa atherosulinosis

Ndi atherosulinosis, pamakhala kuchuluka kwa cholesterol ndi zigawo za lipid pakati komanso mkati mwa choroid, chifukwa chomwe calcium yamchere imayikidwa pamitsempha yamagetsi apakatikati ndi yayikulu komanso minofu yolumikizana imakula.

Zizindikiro zoyambirira za atherosulinosis zimawonekera pamene mtsempha umatsekeka ndi theka.

Zizindikiro za matendawa zimatengera gawo la ziwiya zomwe zakhudzidwa.

Ndi mwambo kupatula magawo atatu a chitukuko cha matenda.

Choyamba ndi kukhazikitsidwa kwa zingwe zamafuta - kale chiwonetsero cha matendawa. Amayamba chifukwa chodzikundikira ndi ma macrophages komanso maselo osalala a minyewa, omwe amaphatikizana ndi lipids. Popita nthawi, mzere wamafuta umayamba, koma kupezeka kwake sikutanthauza kuti munthu amadwala atherosclerosis. Ngakhale mu makanda, mawanga amafuta amawonedwa m'matumba okhala ndi awiri a 1-2 mm.

Chachiwiri ndi kukula kwa zolembera zamkati mwa chotengera. Amakhala ndi ma esters ndi cholesterol makhiristo, omwe ndi ofewa, komanso zigawo za lipid - kapangidwe kofiyira. Kuchulukana kwa mafupa am'manja kumapangitsa kuchepa kwa mitsempha. Cholesterol imachokera m'magazi, ikudziunjikira pamakoma a chotengera.

Chachitatu - kukhalapo kwa zovuta zovuta - gawo lomaliza pakupanga atherosulinosis. Zikuwoneka pamene makulidwe amphatso ya fibrous amana amakhala ochepera 65, komanso kupezekanso kwa miccracks ndi zilonda pamtunda pake. Izi zimakhudza kuphatikiza kwa mapulateleti ku kapisozi, komwe kumayambitsa kupindika, kugunda kwa mtima, kugunda kwa mtima ndi zina zomwe zimachitika chifukwa cha kufooka kwa magazi kapena kuchepa kwathunthu m'mitsempha.

Kapangidwe ka ma atheromatous amana kumawonedwa ngati njira yachilengedwe, koma pali zinthu zingapo zomwe zingachedwetse kapena kuthamanga.

Pathanatomy imaphatikizapo zifukwa izi:

1. Jenda ndi zaka. Matendawa amakula mwa amuna katatu kapena kawiri kuposa akazi. Komanso, zizindikiro zoyambirira mwa amuna zimawonekera pa zaka 45, ndipo zazimayi - kuyambira zaka 55.
2. Mitundu Mulinso zinthu monga zochitika za chitetezo chamthupi, kupezeka kwa chibadwa cha dyslipoproteinemia ndi mahomoni ena.
3. Zizolowezi zoipa. Choopsa kwambiri pamtima chimasuta, Ndudu iliyonse imakhala ndi nicotine yambiri komanso phula lovulaza. Simungathe kuthana ndi mowa, ngakhale 100 g ya vinyo wofiirira wouma pakudya kwamadzulo ndi njira yabwino yopewera kuthamanga kwa magazi.

Kuphatikiza apo, chomwe chimayambitsa masinthidwe a pathological amatha kukhalapo kwa kunenepa kwambiri.

Kunenepa kwambiri kumayambitsa matenda ambiri - atherosulinosis, matenda ashuga, etc., motero, muyenera kusintha thupi.

Mitundu yayikulu ya atherosulinosis

Pali mitundu ingapo yayikulu ya matenda.

Chodziwika kwambiri ndikugawika kwa atherosulinosis, kutengera malo omwe zotupa za atheromatous malo amitsempha yamagazi.

Mitundu ya matendawa imawoneka palokha komanso mwadongosolo.

Mitundu yotsatirayi ya atherosulinosis imasiyanitsidwa:

• Atherosulinosis yamitsempha yama coronary, yomwe nthawi zambiri imawonetsedwa ndi kupweteka kwa mtima. Chifukwa cha kuwonongeka m'mitsempha ya mtima, kutuluka kwa mpweya kupita myocardium kumasokonekera. Zotsatira zake, kupita patsogolo kwa matenda am'mimba kumayambitsa angina pectoris, kugunda kwa mtima, matenda a mtima komanso ngakhale kufa mwadzidzidzi kwamtima.
• Fomu ya msempha ndi chotupa cha chotupa chachikulu kwambiri m'thupi - msempha. Kukula kwa cholesterol plaques kumakhudza ntchito ya ziwalo zonse ndi machitidwe.
• Matenda a mitsempha. Mwa zina mwa matendawa, kupweteka pakukodza, kupezeka kwa magazi mkodzo, kuwukira kusanza ndi mseru kuyenera kuyatsidwa. Kukula kwa matendawa kumaphatikizapo matenda oopsa komanso kulephera kwaimpso.
• Atherosulinosis ya ziwiya zamafuta. Ubongo ndi amodzi mwamalumikizidwe amkati mwa dongosolo lamanjenje, chifukwa chake, kufa ndi njala kwa chiwalochi kumabweretsa zotsatira zoyipa, mwachitsanzo, kugunda kwa stroko kapena kufupika kwa ischemic.
• Kuletsa atherosulinosis ya m'munsi komanso kumtunda. Pachiyambi, zizindikiro monga kuchepa kwa tsitsi kumiyendo ndi manja, kufiyira kwa zala, kupweteka, miyendo yolowedwa, ndi zina zotere.
• Atherosulinosis ya mesenteric mitsempha yomwe imadyetsa matumbo. Zowonetsera zazikulu za matendawa ndi kuwopsa kwa chifuwa cham'mimba - kupweteka kwamkati ngati m'mimba. Ngozi ndi thrombosis ya nthambi zamitsempha yamagazi ndi necrosis yamatumbo khoma ndi mesentery.

Mosasamala mtundu wamtundu wa matenda, zizindikiro zakunja za zotupa zam'mimba za atheromatous zitha kuwoneka:

1. xanthomas - mawonekedwe omwe amafanana ndi "ma tubercles" omwe amapezeka m'dera lamalumikizidwe ndi tendons;
2. senile Chipilala - mawonekedwe a mamba achikasu m'mphepete mwa ziphuphu.

Kuphatikiza apo, xanthelasms amatha kuwoneka - mapangidwe achikuda amtundu pakhungu, nthawi zambiri amakhala ndi mawonekedwe a tubidal, chifukwa chogwiritsa ntchito cholesterol ndi triglycerides.

Mitundu ya Hyperlipidemia ndi Fredrickson

Hyperlipidemia ndi njira yowonjezera yachilendo ya lipids ndi lipoproteins m'madzi am'magazi.

Matendawa ndi omwe amapangitsa kuti pakhale matenda a mtima komanso matenda a mtima.

Hypercholesterolemia - Matenda Olumikizana

Hypercholesterolemia m'lingaliro ndi matenda omwe si matenda. M'malo mwake, ndizomwe zimayambitsa kukula kwa mitundu ina ya matenda.

Hypercholesterolemia imadziwika ndi mkulu wa plasma cholesterol. Mitundu yoyamba komanso yachiwiri ya matendawa imadziwika.

Hypercholesterolemia yoyamba imagawidwa m'mitundu yosiyanasiyana:

• Banja Pamtima pa chitukuko chake ndi chovuta pantchito ya ma LDL receptors. Kuphatikiza apo, ma homozygotes amawonetsedwa pafupipafupi 1 mwa 1 miliyoni. Odwala, kuchuluka kwa cholesterol kumasiyana 15 mpaka 31 mmol / L. Nthawi zambiri, matenda amkati am'mimba amayamba mpaka zaka 20.
• Polygenic. Zimadziwonetsera ngati chifukwa chamakhalidwe oyenera kudya kapena kunenepa kwambiri komwe kumayambira pakubwera kumene kwa anthu omwe ali ndi chibadwa chololedwa. Kuchuluka kwa cholesterol m'madzi a m'magazi kumachokera ku 6 mpaka 8 mmol / L. Odwala odwala matenda a mtima amapezeka zaka 60 zisanachitike.
• Banja Losakanikirana. Izi subspecies zimangokhala mu 1-2% ya anthu.

Second hypercholesterolemia ndi matenda omwe amapezeka ndi aimpso, shuga mellitus (mtundu I ndi mtundu II), hypothyroidism, kapamba, matenda a chiwindi, kunenepa kwambiri, komanso matenda ammimba.

Fomuyi imachitika nthawi zambiri kuposa yoyamba.

Chithandizo ndi kupewa matendawa

Atherosclerosis sangathe kuchiritsidwa kwathunthu, koma ndizotheka kuti musatsegulidwe ndikuchokera kwa cholesterol chikhazikitso ndikuwonetsetsa komanso kulandira chithandizo nthawi yomweyo.

Njira zoyesera za atherosulinosis yomwe akuganiza kuti ikuphatikizapo mbiri yachipatala, kufufuza koyambirira kwa wodwala, ma labotale ndi njira zofufuzira. Mwa mayeso akuluakulu a labotale, cholesterol yathunthu ndi mphamvu ya atherogenicity imasiyanitsidwa. Njira zodziwitsira zida ndi zida monga angiography, coronografia, aortography, ultrasound yamitsempha yamagazi, resovasography ndi ultrasound.

Mu milandu 80%, chithandizo chamankhwala chimathandiza kuthetsa zizindikiro za matendawa komanso kupewa zovuta. Dokotalayo amapereka mankhwala otsatirawa:

1. Statin ndi mankhwala otchuka kwambiri pochiza matenda a atherosulinosis. Kuchita kwawo ndikufuna kuchepetsa ntchito ya chiwindi pakupanga cholesterol. Zitsanzo za mankhwalawa ndi rosuvastatin ndi atorvastatin.
2. LCD zotsatila zomwe zimalepheretsa kapangidwe ka bile acid m'chiwindi. Zithandizo zothandiza ndi Colesevelam ndi Colestyramine. Chifukwa chogwiritsa ntchito ma LCD ogwiritsira ntchito, kulandidwa kwa cholesterol kumawonjezereka kuti zitsimikizire njira yabwinobwino yogaya.
3. Fibates ndimankhwala omwe amawononga triglycerides, potero amatulutsa kagayidwe ka lipid. Mu mankhwala omwe mutha kugula, mwachitsanzo, Trikor kapena Atromid.
4. Niacin ndi mankhwala omwe amathandiza kwambiri pakuchiza matenda a atherosulinosis. Amapanga antispasmodic ndi vasodilator kwenikweni, koma osachepetsa cholesterol. Mankhwala omwe amakhala ndi nicotinic acid amatsutsana ndi matenda a shuga, matenda a ndulu ndi chiwindi.

Muzochitika zapamwamba, opaleshoni imayikidwa. Angioplasty amatchulidwa njira zochepa zowononga, ndipo ma prosthetics am'mimba ndi mankhwalawa amatchulidwa njira zowukira kwambiri.

Pa mankhwalawa komanso kupewa matenda a atherosulinosis, zakudya zapadera ziyenera kuchitika. Ndikofunika kutsatira zakudya zamafuta ochepa zamafuta ambiri. Sizikuphatikiza kumwa zinthu monga izi:

• nyama yamafuta ndi mbale za nsomba;
• chokoleti, muffin, makeke ndi mikate yoyera;
• pickles, kuzifutsa ndi kusuta mbale;
• mafuta mkaka wamafuta;
• zakudya zosavuta, chakudya chofulumira, mafuta opatsirana;
• khofi wamphamvu ndi tiyi wakuda, koloko.

M'malo mwake, chakudyacho chimapangidwa ndi mitundu yamafuta ochepa a nyama ndi nsomba, zitsamba, masamba ndi zipatso, mafuta ochepa a lactic acid, buledi wa bulauni ndi mbewu zina zosiyanasiyana.

Zotsatira za atherosulinosis ziwalo zamkati zikufotokozedwa mu kanema munkhaniyi.