UTUMIKI WA WOPHUNZITSA KWAMBIRI NDI WOPHUNZITSA KWAMBIRI KWA RepublicIC YA UZBEKISTAN

UTHENGA WABWINO WA CHIPEMBEDZO CHA UZBEKISTAN

TASHKENT MEDICAL ACADEMY

KUDZICHEPETSA KWAULERE NDIPONSO ZOSAVUTA ZA ZOPHUNZITSA ZITANI

LEMBA LOPHUNZITSIRA UTHENGA WABWINO

ZITHUNZI

KWA Ophunzira a IV KALATA YOPHUNZITSIRA MITU YA NKHANI

Cholinga cha nkhaniyi:Kudziwa bwino ophunzira omwe ali ndi chipatalachi, kuwunika, kuwunika matenda osiyanasiyana, kuwonetsa zovuta komanso kuchiza matenda a atherosclerosis, matenda amtima, angina pectoris.

Zolinga zamaphunziro: kuphunzitsa ophunzira zoyambira zamalingaliro azachipatala, malingaliro azachipatala, nkhani za deontology, zamakhalidwe ndi aesthetics malinga ndi zofunikira zophunzitsira dokotala pamlingo wadziko lonse lapansi.

Mfundo zazifupi pamutuwu:Mutuwu ndi imodzi mwazachipatala. Ichi ndi chifukwa chachikulu cha atherosulinosis ya anthu, kufunikira kwakwaniritsa kuzindikira kwa matendawa panthawi yake. Kufunika kwa zizindikiro zazikulu zamatenda, mfundo zamakono zamankhwala ndizofunika kwambiri pamoyo wa tsiku ndi tsiku wa dokotala.

Cholinga ndi zolinga za phunziroli - mphindi 5

Etiology ndi pathogenesis - mphindi 15

Gulu ndi chipatala - mphindi 25

Phula - mphindi 5

Kuwonetsedwa kwa wodwala - Mphindi 10

Laboratory ndi chida diagnostics - Mphindi 10

Kusiyanitsa mosiyanasiyana - mphindi 5

Chithandizo - mphindi 15

Pomaliza Mayankho a mafunso - mphindi 5

Atherossteosis ndi matenda osakhazikika am'mitsempha ya zotanuka ndi zotupa-zotanuka, zomwe zimadziwika ndi kufalikira komanso kuchuluka kwa plasma lipoproteins ndi cholesterol mu intima, zomwe zimapangitsa kuti masinthidwe azovuta komanso ma cell, otsatiridwa ndi kuchuluka kwa minofu yolumikizana komanso mapangidwe a mafupa am'manja. Zotsatira zake, pali kufupikitsa kwa lumen kwa mitsempha ndi kutayika kwa kutanuka.

Zilonda zam'mimba za Atherosulinotic zamalo osiyanasiyana ndi chimodzi mwazomwe zimayambitsa kuvulala komanso kufa kwa anthu m'maiko otukuka. Amuna amakhala ndi atherosclerosis nthawi zambiri kuposa akazi.

The etiology ya atherosulinosis ndi yovuta komanso yopanga. Mpaka pano, zinthu zazikulu zomwe zingayambitse matenda a atherosulinosis ndi: ochepa matenda oopsa, dyslipoproteinemia (kuchuluka kwa lipoproteins otsika kwambiri komanso otsika kwambiri), kusuta, kuperewera kwa shuga, kunenepa kwambiri, abambo, kudziwikiratu chibadwa. Zomwe zimapangidwiratu ndizolimbitsa thupi pang'ono komanso kukalamba.

Pathogenesis ya atherosulinosis sichimamveka bwino. 2 mfundo zazikuluzikulu zimayikidwa patsogolo: lipid ndi endothelial. Malinga ndi lipid hypothesis, kuwonjezeka kwa milingo yokhala ndi michere ya m'magazi ochepa (LDL) okhala ndi cholesterol yambiri kumathandizira kulowa kolowera mkati mwa khoma lamitsempha. Kuphatikiza apo, LDL imayambitsa hyperplasia yama cell minofu yam'mimba ndipo imayambitsa kusintha kwa kuchuluka kwa maselo a endothelium ndi subendothelium. Pali malipoti a zovuta zomwe zingachitike LDL pa mapangidwe a tsinde, kutseguka kwa chinthu chokulirapo, ndipo pamapeto pake pakupangidwa kwa fibrosis yakudziko.

Malinga ndi endothelial hypothesis, kuwonongeka kwa endothelial wosanjikiza (mkati mwa zotengera) kumayambitsa ngozi ya ma cell a immunological komwe kumapangitsa kuti pangidwe ka fayilo ya fibrous pamalo owonongeka. Izi zikuphatikiza kuphatikizidwa kwa maselo othandiza magazi kuundana, chemocytosis ya monocytes ndi T-lymphocyte ndikutulutsa kwa zinthu zina zopangitsa kuti maselo osunthika amasunthe kuchokera ku media kupita ku intima, komanso kusintha kwa maselo ena (macrophage, endothelial) omwe amalimbikitsa minofu yosalala ya minofu ndi kukula. Kusintha kwa maselo, makamaka kupangika kwa maselo akuluakulu (amphweya) a endothelial, kumabweretsa kusazindikira kwawo ndi chitetezo chawo, kutsatiridwa ndi kusintha kwa zochita za antigen, kupanga gawo lotupa, komwe kumatha ndikupanga zolembera. Maganizo onsewa ndi ogwirizana ndipo samasiyana pakatikati, koma amagwirizana.
M'zaka zaposachedwa, ma viral and herpes-virot hypesheses a etiology ya atherosulinosis ayikidwa patsogolo ndipo akuphunziridwa kwambiri. Zakhazikitsidwa kuti kachilombo ka Epstein-Barr, ma virus a Coxsackie ndi ena amatsogolera kuwonongeka kwa ziwalo za endothelial maselo, kuchepa kwa lipid metabolism komanso kufooka kwa chitetezo cha m'thupi. Atherosranceotic plaque imakula pang'onopang'ono zaka zambiri ndipo pamapeto pake imayambitsa kukomoka kwa lumen kapena kutsiriza occlusion ya chotengera. Popita nthawi, chikhazikikacho chimakhala cha kalidinous. Panthawi iliyonse ya chitukuko, imatha kuwonongeka mosazungulira kapena kuwonjezeka kwambiri kwa magazi (kuthinana kapena kupasuka), ndipo izi zimapangitsa kuti pakhale magazi othamanga ndipo, potero, angawononge kwambiri magazi.

Popeza kufunikira kwakukulu kwa ma cellular ndi immunological mu pathogenesis ya atherosclerosis, pang'onopang'ono pang'onopang'ono mapikidwe ake amadziwika ndi matendawa: nthawi zina zochitika zimachitika m'malo mwa bata.

Chithunzi cha matendawa chimatsimikiziridwa kuti sichachuluka kwambiri ndi kuuma komanso kuchuluka kwa kusintha kwa zotengera, monga momwe zimapangidwira. Magawo a thoracic komanso otsika aorta, coronary, carotid, matenda amkati, aimpso, mesenteric ndi akazi aakazi nthawi zambiri amakhudzidwa. Malinga ndi kufalikira kwa njira ya atherosulinotic, zizindikiro zamankhwala zimabwera patsogolo zomwe zimagwirizanitsidwa ndi chiwalo chomwe magazi amayenda kwambiri (onani magawo omwe akukhudzidwa).

Mosasamala kanthu za momwe ntchitoyi idatithandizira, adafotokozera za magawo awiri pakubadwa kwa matendawa: nthawi yoyambayo (preclinical) ndi nthawi yowonetsera matenda. Mu nthawi yoyambirira, palibe kusintha kwa ziwalo. Amadziwika ndi zovuta zamitsempha zama neva monga vasospasm, cholesterinemia ndi dyslipidemia.

Mu nthawi yachiwiri, poyamba, zizindikilo ndi zizindikilo zimawonetsa kusamvana pakati pa kufunikira kwa oksijeni wa ziwalo zomwe zimakhudzidwa ndi minyewa komanso minyewa komanso kuthekera kwa kubala kwake kudzera m'matumba osinthidwa ndi njira ya atherosulinotic. Poyamba, kusinthika kumeneku kumawululidwa pokhapokha ngati pali mphamvu zolimbitsa thupi, pomwe mpweya-metabolic umafuna kwambiri (mwachitsanzo, ndi angina pectoris, intermittent claudication), ndipo pambuyo pake ndi kupita patsogolo kwa atherosclerosis ndi kuchepa kwa lumen ya chotengera, kusalinganika kumeneku kumayamba kuwoneka ndi katundu pang'ono komanso ngakhale kupuma. Njira yotsalira (asymptomatic) yamatenda imatheka mpaka kuunika kwa mitsempha kumatsika mpaka 70-75%.

Pankhani yakuphwanya umphumphu wa zolembedwazi, pamene njira ya thrombosis iyamba, monga lamulo, kufalikira kwamatenda koopsa, kumawonetsedwa pakupanga kosakhazikika kwa angina kapena kulowerera kwa myocardial, ngati titenga matenda a mtima monga chidziwitso (onani ISCHEMIC HEART matenda a matenda).

ATOROSCLEROSIS YA AORTA imayamba kale kwambiri kuposa mbali zina zamatumbo ndipo ndizofala kwambiri (makamaka m'chigawo cha thoracic), komabe, mawonekedwe ake azachipatala amawonetsedwa pang'ono kapena kulibe. Nthawi zina

ululu wammbuyo (aortalgia) ukugwedezeka m'chigawo cholumikizana. Ndi atrophy ya minofu wosanjikiza, aneurysm imapangidwa m'magulu a msempha omwe amakhudzidwa ndi atherosulinosis ndi kupangika kwa maselo a cellular kapena kupatsirana. Kuwonjezeka kwa kukula kwa aneurysm kumabweretsa kukakamizidwa kwa ziwalo zoyandikana ndi hemodynamics. Ndi aortic aneurysm, kupweteka kumachitika, kutulutsa komwe kumadalira malo omwe adapangidwira (ndi aneurysms of the aorta ascort - pain pain, aortic arches - maumivu pachifuwa otulutsa khosi, phewa, kumbuyo, kutsika kwa msempha - kupweteka kumbuyo. Zizindikiro zina za aortic aneurysm zimadziwika - kupweteka mutu, kutupa kwa nkhope (chifukwa cha kufinya kwa vena cava), kupsya mtima, chifuwa, kupuma movutikira, dysphagia (chifukwa cha kukakamira kwa mitsempha yobwereza komanso kukakamiza kwa trachea).

Moyenerera anaulula kukula kwa malire a mtima wopingasa, kung'ung'udza kwa systolic m'mbali yachiwiri yolumikizira kumanja kwa sternum.

Panthawi ya aortic insufficiency (sclerotic m'chilengedwe), mu gawo lachitatu lamkati kumanja kwa sternum, systolodiastolic kung'ung'udza kumamveka kuphipha. Panthawi ya atherosselotic zotupa zam'mimba, kapena kupweteka kwa m'mimba m'mimba, kupweteka kwam'mimba, kumverera kolemetsa, komanso kusokonezeka kwa vuto layspeptic. M'matumbo am'mimba, mapangidwe opatsirana amatha kutsimikizika ndi palpation, pomwe kumangokhala kulira kwa systolic.

The aneurysms yomwe imayamba kukula pang'onopang'ono. Panthawi yowunika mwamphamvu, kuwonjezeka kwapachaka kwa aneurysm kwa 0,5 masentimita kunadziwika.

Vuto lowopsa la aneurysm ndi kuwonongeka kwa khoma lake ndikutumphuka ndi zotsatira zakupha. Chiwopsezo cha kupasuka chikuwonjezeka ndi aneurysms ya thoracic aorta wopitilira 6 masentimita (makamaka motsutsana ndi maziko a kuthamanga kwa magazi), dera lachiberekero - kuposa masentimita 5.Chidziwitso chodzidzimutsa pamiyeso iyi pachaka ndi 30-40%, ndipo ndi kuchuluka kwawo kowonjezereka kwambiri ( mainchesi 7-10 cm - 45%, mainchesi 10 cm - 60%).

ATHEROSCLEROSIS YA MALO OTSOGOLA ATHAUKA amathandizira pakukula kwa kuperewera kwa magazi kwa ubongo, ischemia yake. Mawonetsedwe azachipatala a matendawa amayamba chifukwa chosowa magazi m'madera ena a ubongo. Ischemia yocheperako - kuchepa kwadzidzidzi, ndikuwonjezereka kwa magazi - nthawi zambiri kumalumikizidwa ndi kuphipha kwa mitsempha ya ziwalo zam'mimba ndipo imayambitsa zovuta zina - sitiroko.

Kutopa, kudodometsa, kuyang'ana mozama ndizikhalidwe kwambiri. Kukumbukira zochitika zamasiku ano kumachepetsedwa pomwe kukumbukira kwapaukadaulo kumasungidwa. Kuda nkhawa ndi mutu wosalekeza, phokoso m'mutu, nthawi zina chizungulire, kugona kwambiri, kugona, kusokonekera, kukakamizidwa

mzimu. Popita nthawi, zizindikiro zimapita patsogolo, izi zimachulukirachulukira. Pomaliza, III, siteji, encephalopathy imatchulidwa, nzeru zimachepa, kusokonezeka kwapakati, zizindikiro za parkinsonism (kuuma, amimia) zimachitika.

Renal arterial atherosulinosis, yomwe imatsogolera kupitiriza impso, ndiyomwe imayambitsa matenda oopsa. Kung'ung'udza kwa systolic kumamveka pamtunda wofinya wamtsempha wama impso. Mu mkodzo, proteinuria yocheperako, kusintha kwakung'ono mu mkodzo (maselo ofiira ofiira, maselo a hyaline).

Zoyambitsa Atherosulinosis

Tiyenera kudziwa kuti matenda a atherosclerosis ndi matenda amkati amathandizana. Mwachitsanzo, zimatha kuyambitsa matenda matenda ashugapopeza matenda a mtima komanso Mitima zimachitika m'mbuyomu ndipo kuchuluka kwa cholesterol m'matombo ndikokwera. Komanso, zomwe zimayambitsa chitukuko cha matendawa zimaphatikizapo kuthamanga kwa magazi komanso kupezeka kwa zizolowezi zoipa (kusuta). Koma kanjedza ndikuphwanyidwa kwa cholesterol metabolism.

Ganizirani zomwe zingayambitse matendawa:

• zaka Munthu akamakula, amakhala pachiwopsezo chowonjezereka cha ma atherosulinotic. Makamaka omvera zaumoyo wawo azikhala anthu azaka zopitilira 50,
• jenda Asayansi apeza kuti amuna amakonda kwambiri matenda a atherosulinosis. Kuwonetsedwa kwa zizindikiro zoyambirira ndikotheka kuchokera pazaka za 45, ndipo nthawi zina kale. Ngakhale mwa akazi zizindikiritso za matendawa zimatha kuonekera pokhapokha ngati muli ndi zaka 55,
• cholowa. Kukhazikika kwa chibadwa kumatenga gawo lalikulu pakupanga matenda a atherosulinosis. Kafukufuku akuwonetsa kuti omwe achibale awo adadwala matenda am'mitsempha yamagazi amakhala atadwala kale matenda,
• kuperewera kwa zakudya m'thupi. Kugwiritsa ntchito zakudya zamafuta ndi zakudya zopanda pake, komanso kukonda chakudya, kungayambitse kukula kwa matenda. Chifukwa chake, ndikofunikira kudya bwino komanso nthawi. Momwe chakudya chimakhalira masamba, mbewu, nyemba ndi nsomba,
• onenepa kwambiri. Izi sizikutanthauza kuti zimayambitsa matenda osachiritsika, koma kunenepa kwambiri kumatha kuyambitsa matenda a shuga, omwe amachititsa kuti matendawa azitha.
• zizolowezi zoipa. Kusuta ndiye mdani wamkulu wamitsempha yamagazi ndi chimodzi mwazomwe zimayambitsa atherosulinosis.

Mitundu ndi zizindikiro za atherosulinosis

Pali mitundu ingapo ya matenda amtunduwu momwe kuwonongeka kumachitikira:

• matenda amitsempha yamagazi (atherosranceotic cardiossteosis), yomwe imayambitsa chitukuko cha matenda a mtima, matenda a mtima ndi angina pectoris,
• msempha, womwe umakhudza machitidwe onse amkati ndi ziwalo,
• mitsempha yamagazi yomwe imayendetsa magazi kupita ku ubongo,
• zotupa za impso, zomwe zimabweretsa zovuta impso ndi matenda oopsa
• ziwiya zam'mwamba ndi zam'munsi, matendawa amatchedwa kuchepa kwa atherosclerosis.

Kodi matendawa amadziwoneka bwanji, kodi ndikufunika ndikuyang'ana ku dotolo?

Pa gawo loyambirira, matendawa samawoneka mwachangu, chifukwa chake, kupezeka kwake kumatha kutsimikiziridwa ndi akuwunikira. Popita nthawi, zomwe zimadziwika kuti "chizindikiro cha nyongolotsi" (mitsempha ya m'mimba yofooka) zitha kuwoneka.

Mtsogolomo, zizindikiro za matendawa zimawonekera kutengera ndi malo a chotupa. Chifukwa chake, ndi kuwonongeka kwa msempha, kupweteka kumatha kuchitika kumbuyo kwa mphamvu zamphamvu zingapo, mpaka kumbuyo, khosi kapena m'mimba, komanso chachiwiri cha mtima. Matendawa akakhudza mitsempha ya coronary, izi zimatha kudziwika ndi zizindikiro za matenda am'mitsempha. Mitima - angina pectoris, tachycardia, kulephera kwa mtima, chisokonezo, ndi zina zambiri. Ndi kuwonongeka kwa mitsempha ya chithokomiro chamunthu, phokoso mkati makutu, chizungulire, kupweteka mutu pafupipafupi, kutopa, mavuto atulo amawoneka, kukumbukira kumakulirakulira.

Ngati mitsempha yakhudzidwa impso, imadziwonekera mu mawonekedwe a kuperewera kwa impso ndi vasorenal. Kuwonongeka kwa ziwiya zam'munsi zam'munsi (zomwe zimadziwikanso kuti matenda a Lerish) kumawonetsedwa ndi kutopa msanga, kupweteka mwadzidzidzi poyenda, khungu la miyendo, kuzizira, kusokonezeka kwa khungu. Ngati atherosulinosis yafika m'mitsempha ya mesenteric, izi zitha kutsimikizidwa ndi ululu womwe umachitika mwadzidzidzi mukatha kudya ndikuyenda limodzi ndi nseru, ndipo nthawi zina kusanza, kusokonezeka kwa stool, thrombosis, chifukwa cha momwe matumbo a necrosis amapangidwira. Pathology yamitsempha yama pulmonary imatha kuwonetsedwa ndi kutupika kwa miyendo, kutupa kwa mitsempha ya khosi, hemoptysis, kung'ung'udza kwa systolic pazomwe zimachitika m'mitsempha.

Matenda a Atherosulinosis

Kuti muwone kuti munthu wapanga atherosclerosis, mutha kulankhulana othandiziraomwe adzagawireko kuchuluka akuwunikira. Matenda aliwonse amatha kuwonekera mosiyanasiyana, motero muyenera kuyang'ana mwatsatanetsatane, kudziwa mtundu wa matenda. Pakupezeka kwamitundu ingapo, zovuta za njira ya atherosulinosis ndi kuopsa kwa zovuta ziyenera kukhazikitsidwa, zomwe zikuwonetsedwa pakupezedwa. Pokhapo ndiye kuti mankhwalawo adzakhazikitsidwa molondola ndikubweretsa zotsatira zabwino.

Kuzindikira kwa matenda a pathology nthawi zambiri kumakhala ndi maphunziro azachipatala komanso kugwiritsa ntchito njira zina zowonera matendawa.Njira yoyamba yodziwitsira matenda ikuphatikiza kuphatikiza madandaulo a wodwala, kufufuza ndi kufufuza, zomwe zimaloleza katswiriyo kudziwa momwe amaperekera, momwe amaponyera komanso kulimbitsa chotengera. Ndikofunika kwambiri kuuza katswiri za zikhalidwe zoyipa zomwe muli nazo ndi moyo wanu, zakudya. Zowunikira zowonjezera zimachitika pochita kusanthula, komanso kutenga nawo mbali pazida zamankhwala. Izi zitha kukhala maphunziro monga electrocardiography, Makina a Ultrasound Mitsempha yamagazi, ma x-ray amitsempha yamagazi ndi chifuwa, kusanthula kwamomwe kumachitika magazi.

Chithandizo cha Atherosulinosis

Chithandizo atherosclerosis iyenera kuphatikizidwa - mankhwala osokoneza bongo komanso osagwiritsa ntchito mankhwala. Chotsirizacho ndikuchotsa zoopsa zomwe zingasinthidwe. Wodwala amalimbikitsidwa kukhala ndi moyo wokangalika, kupewa zizolowezi zoipa, monga kumwa mowa, kuwongolera kunenepa, kupewa mavuto amanjenje komanso ovuta.

Anti antiososotic wapadera chakudya. Zimakhazikitsidwa ndikugwiritsa ntchito zakudya zomwe zimakhala ndi zopatsa mphamvu zochepa komanso zochepa zamafuta a nyama. Zakudya zomwe zimakhala ndi zopatsa mphamvu zamagetsi zimatha kuchepetsedwa kapena kuchotsedweratu paliponse pazosankhazo. Zomwezi zimaphatikizanso zakudya zomwe zimakhala ndi mafuta ambiri.

Mankhwala mankhwala ziyenera kuphatikizapo mavitamini B3 ndi PP.

Chithandizo chowongolera cha atherosulinosis, chomwe ndi chithandizo cha opaleshoni sichimagwiritsidwa ntchito kawirikawiri, makamaka ngati ziwonetserozo sizikulabadira chithandizo chamankhwala. Chithandizo cha opaleshoni chimagwiritsidwa ntchito pakuwononga mitsempha yamkati, imakhala mu ma prosthetics a chotengera kapena kuchotsa kwa thrombus yopangidwa.

Atherosclerosis ndi matenda oopsa, ndikofunikira kuyesa kuletsa chitukuko chake m'njira zonse zotheka, chifukwa kupewa nthawi zonse kuli bwino kuposa chithandizo. Njira zopewera zimaphatikizapo: kutsatira anti-atherosulinotic Zakudya (iyi ndi njira yabwino kwambiri), kapena kudya zakudya zabwino, kusiya kudya, kusiya zizolowezi zoyipa, kukhalabe ndi moyo wabwino komanso wathanzi.

Ngati mukukayikira kuti muli ndi atherosmithosis, kulumikizana ndi akatswiri a Center yathu omwe angakuthandizeni!

Atherosulinosis ndi Mkati Amkati: Ubale

• Imakhazikika pamisempha ya shuga kwa nthawi yayitali
• Imabwezeretsa kapangidwe ka insulin

Owerenga athu adagwiritsa ntchito bwino Aterol kutsitsa cholesterol. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

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

Magawo a chitukuko ndi zomwe zimayambitsa matenda a atherosulinosis

Ndi atherosulinosis, pamakhala kuchuluka kwa cholesterol ndi zigawo za lipid pakati komanso mkati mwa choroid, chifukwa chomwe mchere wamkati wa calcium umayikidwa 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.

Yoyamba ndikutukula kwa mafambo amafuta - kale anali chiwonetsero cha matendawa. Amakhala chifukwa chodzikundikira ndi ma macrophages komanso maselo osalala a minofu, omwe amadziunjikira 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. Imawoneka ndi kuchepa kwa makulidwe amkati mwa michere yokhala ndi ma microus osakwana 65, komanso kupezeka 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, komabe, pali zinthu zingapo zomwe zingachepetse 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, komanso kwa akazi - kuyambira zaka 55.
2. Mitundu Mulinso zinthu monga zochitika za chitetezo chamthupi, kupezeka kwa chibadwa cha dyslipoproteinemia, ndi kuchuluka kwa mahomoni.
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 kulemera kwakukulu.

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, vuto la 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. Poyamba, monga kufooka kwa tsitsi miyendo ndi manja, kufalikira 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 a m'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 matenda ena a 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 a mtima amakhala atafika zaka 20.
• Polygenic. Zimadziwonetsera ngati chifukwa chamakhalidwe oyenera kudya kapena kunenepa kwambiri chifukwa cha chikhalidwe chamakolo. 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 pathologies, matenda a shuga (mtundu 1 ndi 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 chamankhwala.

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 zomwe matendawa amateteza komanso kupewa. 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 zitsimikizike bwino pakudya.
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.

Kwa mankhwalawa komanso kupewa matenda a atherosclerosis, zakudya zapadera ziyenera kuchitika. Ndikofunika kutsatira zakudya zamafuta ochepa okhala ndi mafuta ambiri. Sizikuphatikiza kumwa zinthu monga:

• nyama yamafuta ndi nsomba zam'madzi,
• chokoleti, muffin, makeke ndi mikate yoyera,
• pickles, kuzifutsa ndi kusuta mbale,
• mafuta amkaka,
• zakudya zosavuta, chakudya chofulumira, mafuta othandizira,
• khofi wamphamvu ndi tiyi wakuda, koloko.

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

Zotsatira za atherosulinosis ziwalo zamkati zikufotokozedwa mu kanema munkhaniyi.

• Imakhazikika pamisempha ya shuga kwa nthawi yayitali
• Imabwezeretsa kapangidwe ka insulin

Kukwanira kwakukulu kwa atherogenicity

Atherosulinosis ndi matenda omwe zotsatira zake zowopsa zanenedwa posachedwa. Zakhazikitsidwa kuti anthu omwe ali ndi vuto la atherosulinosis ali ndi cohero lokwanira la atherogenic (CA). Ali ndi mwayi wowona dokotala nthawi yayitali kwambiri ndipo nthawi 4 akhoza kugonekedwa m'chipatala ndi matenda opha ziwalo zam'mnyewa wamtima kapena sitiroko. Njira ya pathogenetic yokhazikitsira matendawa imakhala ndi kuperewera kwamafuta komanso mapangidwe otchedwa "cholesterol plaques" mkati mwa ziwiya, zomwe zimachepetsa kwambiri lumen ya zotengera, kusokoneza kupezeka kwa magazi kwa ziwalo zonse ndipo kungakulitse chiwopsezo cha matenda owopsa a mtima ndi ubongo.

Kuthekera kwa atherogenicity - chisonyezo chachikulu cha mbiri ya lipid

Atherogenicity coeffnty - njira yofunika yogwiritsira ntchito kuchuluka ndi kutsika kwa lipoproteins, kuwonetsa kukula kwa atherossteosis.

Ma lipids onse m'thupi mwina amabwera ndi chakudya kapena amapangidwa m'chiwindi. Popeza mafuta ndi hydrophobic mwachilengedwe, sangathe kuzungulira magazi momasuka. Pakuyenda kwawo, mapuloteni approtein apadera othandizira amafunikira. Kapangidwe kazinthu kena ka lipids ndi mapuloteni amatchedwa lipoprotein.

Kapangidwe ka mamolekyulu kakhoza kukhala ndi zovuta zingapo. Chifukwa chake, mafuta onse omwe amayenderera m'magazi amagawika m'magulu akuluakulu (HDL), ma lipoproteins otsika (LDL) komanso otsika kwambiri (VLDL). LDL ndi VLDL amaonedwa ngati mafuta "owopsa". Kuchulukirapo, amakhala pamakoma amitsempha, amalimbikitsidwa ndi minyewa yolumikizana, ma calcified ndi mawonekedwe a atherosclerotic (cholesterol) malo. Mapepala oterewa amachepetsa mphamvu yonyamula ziwiya, kusokoneza magaziwo kupita ku ziwalo ndi minyewa. Mtima ndi ubongo zimakhudzidwa makamaka, zomwe zimafunikira kuchuluka kwa mpweya ndi michere yambiri.Ma lipoproteins apamwamba kwambiri, m'malo mwake, amatchedwa lipids "zofunikira", chifukwa amasamutsa mafuta m'maselo a thupi motero, amachepetsa kuyika kwake m'magazi ndikuyeretsa mitsempha yamagazi yatsopano.

Kuzindikira kwa ma atherogenic ndi chizindikiro cha kuchuluka kwa mafuta "athanzi" komanso "oyipa". Zimatsimikiziridwa pambuyo pakupeza zotsatira za kuyesa kwamwazi wamagazi a lipids ndipo amawerengedwa ndi njira:

KA = (yonse cholesterol - HDL) / HDL

KA = (LDL + VLDL) / HDL (fomuloli imafunikira mawonekedwe owonjezera lipid kuti aphunzire osati okwera komanso otsika kwambiri a lipoproteins).

Zomwe zimakhazikika zimatengera zida za labotale inayake, koma pafupifupi ndi 2-3. Pokhala ndi HDL yokwanira, iwonjezedwa. Nthawi zina, imatha kufikira 7-8 ndipo imafuna njira zochizira zazikulu. Kuchepetsa mphamvu yogwiritsira ntchito ma atherogenic muzochitika zamankhwala ndizosowa.

Owerenga athu adagwiritsa ntchito bwino Aterol kutsitsa cholesterol. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Kodi mlozo wapamwamba wa atherogenic ukutanthauza chiyani?

Kuchulukitsa kwa mphamvu ya ma atherogenic ndi chizindikiro chosavomerezeka. Popeza izi ndizofunikira kwambiri, zimatha kusinthasintha m'moyo wonse ndikukhala osiyana ngakhale kwa odwala omwe ali ndi cholesterol yomweyo. Mwachitsanzo, chizindikiro cha cholesterol yamagazi mwa alendo onse a chipatalachi ndi 5.5 mmol / L. M'modzi mwa izo, imayimilidwa kwambiri ndi lipoprotein yayitali, motero, index ya atherogenic idzakhala yochepa kwambiri, ndipo chiopsezo chokhala ndi atherosclerosis chikhala chotsika. Osatengera izi, ngati LDL imayang'anira HDL, ngakhale mafuta enieni, mafutawo adzakulirakulira, ndipo wodwala amalimbikitsidwa kulandira chithandizo chotsitsa.

Chifukwa chake, index ya atherogenic imatha kutchedwa chizindikiritso cha m'tsogolo: imawunika kuopsa kwa zovuta za atherossteosis (pachimake myocardial infarction, stroke) wodwala wokhala ndi cholesterol yayikulu. Kuchuluka kwa cholesterol sikuti nthawi zonse kumakhala chizindikiro cha atherosulinosis. Ngati imapangidwa makamaka chifukwa cha HDL, chiopsezo cha matenda a mtima ndi ochepa. Kuchuluka kwa LDL kapangidwe ka mafuta omwe amapezeka m'thupi ndi kowopsa. Ngati mndandanda wa atherogenic ukuwonjezereka, muyenera kufunsa dokotala kuti apange dongosolo la chithandizo ndi njira zopewera.

Zifukwa zokulitsira gululi

Mndandanda wokwera wa atherogenic nthawi zambiri umakhala wopanda chidwi ndi wodwala. Choyimira chachikulu ndi moyo womwe umapangidwa ubwana, ndipo munthu amatsatira moyo wonse. Chifukwa chake, pozindikira milingo yayitali ya m'magazi a wodwalayo, ndikulimbikitsidwa kuti aziyang'ana abale ake.

Zomwe zimapangitsa kuti pakhale kuchuluka kwa ma atherogenic:

1. Zizolowezi zolakwika za kudya. Inde, mafuta ndi chinthu chofunikira komanso chofunikira kuti munthu achite ntchito zambiri m'thupi (mwachitsanzo, cholesterol ndichinthu chomanga cha ma membrane am'mimba ndi mahomoni a adrenal, LDL ndiye njira yamayendedwe yamafuta omwe amawapulumutsa ku matumbo ang'onoang'ono kuti asinthe zina zamphamvu mu chiwindi, HDL - lipoprotein, yemwe amasamutsa mafuta kuchokera ku chiwindi kupita ku maselo a chamoyo chonse). Chifukwa chake, mutha kuphatikizira mafuta mu zakudya zanu za tsiku ndi tsiku. Koma si mafuta onse omwe ali ndi thanzi labwino. Chomwe chikuwonjezera kuchuluka kwa ma atherogenic ndichakudya chambiri chamafuta a nyama omwe amapezeka mu nyama yamafuta, mafuta, mafuta, mafinya (impso, ubongo), masoseji, batala, mkaka wamafuta ndi mkaka, mazira azira.
2. Matenda oopsa a magazi amathanso kuwonjezera kukhathamiritsa kwa atherogenic. Malinga ndi ziwerengero, kuthamanga kwa magazi ndi vuto la 35-40% ya okhala m'maiko opitilira zaka zopitilira 45. Kupanikizika kopitilira 140/90 mm Hg. Art. kumakwiyitsa kwambiri kamvekedwe ka mtima, kameneka kamakhudza magazi kupita kwa ziwalo ndi minyewa. Chowonadi ndi chakuti mitsempha imapangidwira kuthamanga kwakanthawi: kufupika kwakanthawi kumachitika panthawi yamasewera kapena nthawi yovuta, katundu wotere "amasuntha" mkati mwa thupi, kugawa kayendedwe ka magazi. Ndi matenda oopsa kwambiri, kamvekedwe ka minofu kofalikira kumawonjezera kuwonongeka kwawo, ndipo mamolekyu otsika a lipoprotein amasintha mwachangu pa microtraumas.
3. Kusuta kumathandizanso kukulitsa mphamvu ya atherogenic. Kupuma pafupipafupi kwa utsi wa fodya kumabweretsa kuchepa kwa kuchuluka kwa okosijeni wamagazi ndi microdamage yosatha kumitsempha yamagazi. Lipids palimodzi ndi mapulateleti amadzaza zoterezi, ndi mitundu ya atherosulinotic (cholesterol).
4. Kuledzeretsa kumabweretsa kubwezeretsanso kwa pathological. Mitsempha yamagalimoto yotumphukira (yapamwamba) imakulitsa, ndi visceral, kulimbitsa mtima, ubongo ndi ziwalo zina zamkati, zopapatiza. Chifukwa chake, kuthiridwa kwa magazi ku ziwalo ndi machitidwe kumasokonekera, ma microdamages amapanga mu ziwiya zopapatiza, ndi mawonekedwe a cholesterol.
5. Chifukwa china chakukwera kwa mtundu ndi shuga yachiwiri ya shuga. Matenda a metabolic amadziwika ndi kuchuluka kwa shuga (shuga) m'magazi. Mamolekyu ake amawononga khoma losalimba lamitsempha, ndipo mawonekedwe ambiri a cholesterol plaques. Kuphatikiza apo, ndi matenda a shuga, osati chakudya chokha, komanso kagayidwe kazakudya kamasokonekera: odwala omwe ali ndi matendawa amakonda kunenepa kwambiri, ngakhale ndi zakudya. Kuchuluka kwa lipids m'thupi ndi matenda a shuga kungayambitsenso kuchuluka.
6. Kunenepa kwambiri ndi chifukwa chinanso chomwe chitha kukulitsira mphamvu ya atherogenic. Pali zinthu zingapo zomwe zimayambitsa kunenepa kwambiri, zomwe zimadziwika kwambiri ndizomwe zimagwiritsidwa ntchito nthawi zambiri (zakumwa pafupipafupi zama calorie, zakudya zokhala ndi mafuta ambiri) ndi endocrine (zovuta zina zamafotokozedwe amthupi a ma processor ofunika). Ndi kunenepa kwambiri, kuchuluka kwa lipids m'magazi kumawonjezeka, chiwopsezo chokhala ndi chidziwitso chowonjezeka ndikukula kwa atherosulinosis kumawonjezeka.
7. Mbiri yabanja. Madotolo amati nthawi zambiri kukhathamiritsa kwa atherogenic kumachulukitsidwa mwa anthu omwe abale awo apamtima amadwala atherosclerosis, matenda amtima, komanso adakumana ndi vuto la mtima limodzi kapena zingapo. Chifukwa chake, tikulimbikitsidwa kuti anthu onse omwe ali ndi mbiri ya mabanja azikhala ndi mayeso pafupipafupi ndi mayeso a cholesterol ndi mbiri ya lipid.
8. Moyo wokhala mokhazikika waposachedwa unayamba chifukwa cha zinthu zomwe zimapangitsa kuti zochitazo zizikula bwino. Zimatsimikiziridwa kuti anthu omwe akukhala ndi moyo wakhama sangakhale ndi mwayi wokulirapo.

Zifukwa zonsezi zimakhudza thupi kwanthawi yayitali, kotero kuwonjezeka kwa mgwirizano wa atherogenic kumakhala kofala kwambiri pazaka zopitilira 40. Komabe, m'zaka khumi zapitazi, ataloggenicity index yowonjezereka imapezekanso mwa achinyamata azaka 13, chifukwa chake, kuphunzira kwa mapangidwe a lipid kukukulira.

Kuopsa kochulukitsa

Kwa zaka zambiri, kuchuluka kwa atherogenicity kwakhala kozizira, kotero ambiri ali ndi malingaliro akuti mkhalidwewu siwowopsa ndipo sufuna chithandizo. Ndi chifukwa chabodza kuti atherosulinosis imatchedwa "wakupha wofatsa," popeza chiwopsezo cha cholesterol plaques ndi coeleffic wokwanira wagona pamavuto akulu omwe amatha kupha.

Mavuto a kuchuluka kwa ma atherogenic:

1. 1. Pachimake myocardial infaration. Minofu ya mtima ndi yomwe imapilira kwambiri mthupi. Amachita ntchito yayikulu yopopera magazi ochuluka m'moyo wonse wa munthu. Chifukwa chake, kuthira kwa magazi ku minofu ya mtima kuyenera kuchitika posachedwa. Magazi okhala ndi mpweya wabwino umalowa mumtima kudzera m'mitsempha yama coronary.

Ndi kuchuluka kwa mphamvu ya ma atherogenic, pamakhala chiopsezo chambiri cha kupangika kwa cholesterol plaque mkati wamatumbo onse amthupi, kuphatikiza ena. Ngakhale kupendekera pang'ono kwa mphamvu ya mitsempha yomwe imadyetsa mtima kumayambitsa kuphwanya kwakukulu kwa magazi ake. Amawonetsedwa ndi kukoka, kupweteka kwam'mbuyo kumbuyo kwa sternum, komwe kumakulitsidwa ndi kulimbitsa thupi. Ngati kuwala kwa mitsempha ya m'magazi “kumatsekeka” ndi madipoziti amafuta, posakhalitsa matenda oopsa monga infracation ya myocardial angachitike.

Kubwezeretsanso kwa odwala pambuyo poyambitsa myocardial kumakhala kotalika komanso kovuta. Odwala otere amafunikira kuwunikidwa kwamoyo ndi dokotala wamtima komanso kukonza pafupipafupi.

1. Stroke, kapena pachimake cerebrovascular ngozi. Ubongo ndi chiwalo china chomwe chimafuna kudya oxygen, glucose komanso michere nthawi zonse. Kusakwanira kwa magazi ku minyewa yamanjenje panthawi ya atherosclerosis kumatha kubweretsa vuto lovuta kwambiri ngati sitiroko - kufa kwa gawo limodzi la minyewa yaubongo ndikupanga matenda amitsempha - kufooka, kusazindikira, kumeza ndi mavuto kupuma, mpaka kumaso ndi kufa.

Momwe mungachepetse kukhathamiritsa kwa atherogenic: mfundo za mankhwala

Ngati pali kuchuluka kwa HDL pakuwunika magazi, kuthekera kwa atherogenic kumakhalanso kokwezeka kuposa kwazololeka. Chifukwa chake, cholinga chachikulu chamankhwala chokhala ndi index yayikulu ya atherogenicity ndikuchepetsa kuchuluka kwa "LP" yoyipa "ndi cholesterol yathunthu m'magazi powonjezera" zothandiza "HDL.

Kuthekera kwa atherogenic kumatha kuchepetsedwa pogwiritsa ntchito njira zotsatirazi:

1. Zakudya Kutsitsa cholesterol yayitali ndi njira yayitali. Gawo loyamba limakhala losagwiritsa ntchito mankhwala osokoneza bongo ndipo makamaka kudya. Othandizira amalimbikitsa kuti muchepetse kapena kuthetseretu zakudya zamafuta a cholesterol kuchokera m'zakudya - nyama yamafuta a nkhumba ndi mutton, mafuta anyama, nyama yankhumba, masoseji ndi masoseji, kirimu lolemera komanso zinthu zina zamkaka, mazira a mazira. Zinthu zonsezi zimapatsa cholesterol yambiri ndipo ndizosayenera ndi coeff kukwana okwanira atherogenicity. M'malo mwake, zakudya zokhala ndi thanzi, zamafuta osakanizidwa ndi HDL ziyenera kuphatikizidwa muzakudya. Izi zikuphatikiza: mafuta a masamba (madotolo amalimbikitsa kupanga masaladi a masamba tsiku ndi tsiku, kuwapatsa mafuta ndi mpendadzuwa kapena mafuta a azitona), nsomba zofiira, mtedza.
2. Kusintha kwamoyo. Kuti muchepetse kuchuluka kwake, muyenera kusiya kusuta ndi kumwa mowa. Ndikulimbikitsidwa kuti muziyenda tsiku lililonse mu mpweya watsopano, kuchita masewera olimbitsa thupi, kuchita masewera olimbitsa thupi omwe mukugwirizana ndi adokotala (kusambira, kuyenda, kuyenda, kuyenda pamahatchi, ndi zina zambiri).
3. Chithandizo cha matenda oyanjana. Kumwa pafupipafupi mankhwala a antihypertensive (kukakamiza-kutsitsa) kwa matenda oopsa: zomwe otsutsa amakumana nazo kwa odwala oopsa ayenera kukhalabe pa mulingo wa 130-140 / 80 mm Hg. Art. ndi pansipa. Komanso, odwala matenda a shuga a mellitus, omwe ali ndi chidziwitso chowonjezeka cha atherogenicity, amawonetsedwa kuti azitsatira kudya osati kokha ndi zoletsa zamafuta a nyama, komanso chakudya chamafuta ndi shuga mosavuta. Nthawi zambiri kuchuluka kwa shuga m'magazi kumatheka chifukwa cha kumwa mankhwala ochepetsa shuga.
4. Kuchepetsa kunenepa kwambiri. Kufunsana zaumoyo.
5. Ngati ndi kotheka, chotsani kapena chepetsani zinthu zovuta kuntchito komanso kunyumba.

Chithandizo cha mankhwala a kuchuluka kwa atherogenicity okwanira kumakhala kuchepetsa kuchepa kwa magazi osachepera lipoproteins ndi cholesterol yathunthu m'magazi, kuthetsa ziwopsezo za pathogenetic zopangira atherosranceotic plaque. Mankhwala omwe amachepetsa kukhathamiritsa kwa atherogenicity akuphatikizapo:

• Statins (Atorvostatin, Rozuvostatin, Simvastatin) ndi mankhwala othandiza kwambiri omwe angachepetse kuyanjana kwa atherogenic. Amachepetsa kapangidwe ka cholesterol mu chiwindi ndi 30%, amachepetsa kuchuluka kwa lipoproteins otsika, ndikuchuluka. Malinga ndi ziwerengero, kugwiritsa ntchito ma statins kwa zaka 5 kapena kupitirira kumachepetsa chiopsezo chokhala ndi mtima wamatenda a atherosulinosis ndi 40%.
• Fibrate (Ciprofibrate, Fenofibrate) - gulu lina la mankhwala kuti muchepetse cholesterol yathunthu komanso cohero loti atherogenic. Monga ma statins, michere imatsitsa LDL kwambiri ndikuwonjezera milingo ya HDL.
• Sequestrants ya bile acids (cholestyramine) - njira yomangira mafuta acids m'matumbo ndikuletsa kuyamwa kwawo m'magazi. Zomwe zimagwiritsidwa ntchito ngati mankhwala ochepetsa thupi. Nthawi zambiri zotchulidwa kuwonjezera pa ma statins ndi ma fibrate, kuti azichita bwino.

Ndani amalimbikitsidwa kuti achepetse kuchuluka kwa ma atherogenic

Kutsika kwa chizindikiro kumeneku kumachitika kawirikawiri monga gawo la zovuta za atherosulinosis. Monga lamulo, odwala oterewa amalembetsa kale ndi dokotala ndipo amawonedwa chifukwa cha matenda a mtima kapena a discirculatory encephalopathy (cholesterol plaques m'mitsempha ya ubongo). Amatha kudandaula za kukoka pafupipafupi, kupweteka pachifuwa, kufupika, kuchita masewera olimbitsa thupi, kupweteka mutu, kuiwalika. Nthawi zambiri, powunika kwa odwala oterewa, pali kuchuluka kwakukulu kwa cholesterol ndi dyslipidemia.

Chifukwa chake, ndikofunikira kulabadira kuwonjezeka kwa mphamvu ya ma atherogenic kumayambiriro kwa matendawa, pomwe zovuta za metabolism yamafuta zimayankhidwa pang'ono. Ngakhale anthu athanzi labwino kwambiri omwe alibe madandaulo amalangizidwa kuti apange kuwunika kwa cholesterol ndi lipoproteins kamodzi pa zaka 3-5. Kuzindikira thanzi lanu komanso kuyeserera pafupipafupi kudzakuthandizani kukhala ndi thanzi komanso moyo wautali.

Kodi m'matumbo aortic atherosulinosis, zizindikiro ndi njira zochizira

Atherosulinosis ya m'mimba msempha - ndi chiyani? Kodi matendawa ali ndi zomwe zimayambitsa komanso zodziwikiratu zomwe zimapangitsa kuti azindikire koyambirira? Kodi kuopsa kwa matenda otere ndi chiani?

Ganizirani momwe limagwirira ntchito matendawo, momwe mankhwalawa amagwiritsidwira ntchito ndi mankhwala amakono komanso momwe mungapewere, ngati sichoncho matendawa, ndiye kupitirira kwake.

Atherosclerosis yam'mimba msempha ndi limagwirira zake kukula

Atherosulinosis ndi matenda omwe amafala kwambiri mwa anthu amisinkhu yosiyanasiyana, ngakhale atakhala kuti ndi amuna kapena akazi. Ndi chitukuko chake, ziwiya za thupi lonse lathuli zimakhudzidwa. Chifukwa chachikulu ndikuwonjezereka kwa cholesterol ndi mawonekedwe a cholesterol (atherosulinotic) zolembera zomwe zimachepetsa lumen ya zombo.

Mimba ya m'mimba imayimira zombo zazikulu kwambiri. Ndiye "kholo" lama mitsempha yomwe imapereka magazi kwa ziwalo zonse zamkati ndi miyendo yotsika. Atherosulinosis ya m'mimba msempha ndi njira yofunika kwambiri, yomwe imabweretsa zovuta zingapo zosasangalatsa.

Magawo a kupita patsogolo kwa kusintha kwa zam'mimba m'mimba mwa msempha ndi motere:

• atherosulinosis ya m'mimba msempha umayamba ndi kupangidwa kwa cholesterol zolembera mu chotengera ichi,
• pang'onopang'ono matenthedwe amaboweka chotengera, ndikuchepetsa mphamvu yake. Nthawi inayake, kuyenda kwa magazi kudzera m'chiwiya choterocho kumakhala kovuta kwambiri,
• Zotsatira zake, ziwalo zamkati zamkati zimayamba kudwala chifukwa chosowa michere ndi mpweya. Kugwira kwawo mwachindunji kumatengera magazi, omwe amapereka m'mimba msempha,
• Kusintha kwa Ischemic mu minofu kumayamba, kutsatiridwa ndi sclerosis ndi necrosis.

Kusamalira kwakanthawi za matenda amtunduwu kumapangitsa kupewa zovuta zobwera chifukwa cha kufalikira kwa magazi.Koma chodabwitsa cha matendawa ndikuti kuzindikira koyambirira kumakhala kovuta kwambiri chifukwa cha kusachita bwino kapena kusapezeka kwenikweni kwa matendawa.

Zizindikiro ndi Zomwe Zimayambitsa

Atherosulinosis ya m'mimba msempha umakhala ndi zizindikiro za atherosulinosis, koma nthawi yomweyo, zizindikirazi zimagwirizanitsidwa ndi tsamba lowonongeka kwambiri. Ndiye kuti, ndi chiwalo chomwe chimakhudzidwa kwambiri ndi kusowa kwa oxygen ndi michere. Impso ndi matumbo zimatha kutengeka ndi izi.

Zotsatira zake, zizindikirozi zimalumikizidwa ndi ziwalo izi:

1. Kuchepetsa thupi popanda chifukwa. Zakudya zimakhalabe chimodzimodzi, koma munthu akuchepa. Kulemera sikuyenda mwachangu, koma pang'onopang'ono.
2. Dyspeptic phenomena imachitika nthawi ndi nthawi, kenako pang'onopang'ono. Pali kuwonjezeka kwanyengo, nthawi zina kumakhala kutentha. Pondapondayo imaphwanyika, nthawi zambiri imayambitsa m'mimba, kangapo - kudzimbidwa.
3. Mukatha kudya, kupweteka kwam'mimba kumachitika. Samakhala wamphamvu, akupweteka, wachilengedwe ndipo posachedwa kuchepa.
4. Komanso, mutatha kudya, pamakhala kumverera kwadzaza ndi kulemera kwambiri pamimba, nthawi zambiri kumunsi.
5. Kuchuluka kwa mkodzo kumachepetsedwa motsutsana ndi kumbuyo kwa kukodza pokodza. Pali kumverera kosakwanira kutulutsa chikhodzodzo.
6. Kufooka kwathunthu, kutopa kopanda pake ngakhale kumayambiriro kwa tsiku.
7. Chifukwa cha kuledzera kosalekeza kwa thupi, kuwonjezeka kwa kutentha kwa thupi kuzisonyezo zakufe titha kuwonedwa.
8. Kutupa kwa zala zakumapeto chifukwa cha kuwonongeka kwa impso, kutupa kwa nkhope. Zizindikirozi zimatchulidwa makamaka m'mawa.

Mwa zina mwazomwe zimayambitsa matenda am'mimba matenda awa ndi awa:

• olemedwa ndi chibadwa. Kuphatikiza apo, izi zitha kukhala lingaliro lakutsogolo kwa chitukuko cha atherosulinosis chifukwa cha mawonekedwe a kagayidwe kachakudya kapenanso kusokonezeka kwawo,
• kusowa kochita masewera olimbitsa thupi chifukwa cha kupita patsogolo kwa sayansi komanso ukadaulo komanso kutsimikizika kwa ntchito zaluso,
• kutengera kwa zinthu zachilengedwe, makamaka mayankho a chitetezo cha mthupi,
• kumangokhalira kukumana ndi mavuto
• matenda ashuga
• matenda opatsirana, kuledzera kwa thupi,
• onenepa kwambiri
• zizolowezi zoipa.

Mitundu ya matenda ndi njira zochizira

Njira yamatendawa imatha kukhala zovuta pang'ono.

Ponena za izi, pali mitundu ya matenda:

• Nthawi yodzikongoletsa. Amadziwika ndi kusapezeka kwathunthu kwa zizindikiro. Ngakhale zida zodziwikitsa bwino sizikusonyeza kukhalapo kwa kusintha kwa ma pathological m'mimba. Chiwonetsero chokha chowopsa cha matendawa ndi cholesterol yokwezeka komanso kupezeka kwa tizigawo ta beta-lipoprotein mu biochemistry yamagazi. Kuthandiza matendawa pakadali pano ndikosavuta. Nthawi zina njira zodzitetezera komanso kukonza mankhwala a cholesterol ndizofunikira.

• Nthawi yobisika (yaposachedwa). Wodwalayo sangamvebe matenda omwe akuwopseza, koma kafukufuku wothandizira amawonetsa kusintha kwam'mimba. Kusokonekera kwa lipid kagayidwe.
• Nthawi yazizindikiro zosadziwika. Nthawi zambiri pamakhala zizindikiro zofala za ischemia, zomwe zimasokonezedwa ndi chiwonetsero cha matenda oopsa. Pakadali pano, katswiri adzatha kuzindikira matenda atadutsa njira zingapo zodziwitsa anthu za matendawo. Chithandizo nthawi zambiri chimakhala chosasangalatsa.
• Kukula kwa ochepa ochepa occlusion (kulowetsedwa). Kusintha kowoneka bwino mu ziwalo za zomwe zakhudzidwa. Kuzindikira kumakhala kovuta. Kuchiza pamenepa kungakhale kovutitsa kapena kuchitidwa opaleshoni.

Ndi atherosclerosis yam'mimba msempha, njira zosiyanasiyana zodziwira matenda amagwiritsidwa ntchito. Chithandizo chimatengera kuopsa kwa matendawa, momwe wodwalayo alili, kupezeka kwa matenda opatsirana ndi anthu ena.

Chithandizo chowongolera chimaphatikizapo njira yolumikizirana yothetsera vutoli. Njira ya mankhwala anakhazikitsidwa, zomwe zimapangidwa kuti muchepetse mafuta m'thupi, kukonza malo amitsempha yamagazi, kulimbitsa chitetezo chokwanira. Mulimonsemo, mankhwalawa amaperekedwa payekhapayekha, poganizira mawonekedwe a wodwala ndi mawonekedwe a matenda ake.

Kufunafuna nthawi moyenera kungathandize kupewa zovuta monga ischemia yamkati wamkati komanso malekezero ochepa, necrosis ndi fibrosis ya zimakhala. Nthawi zambiri, zakupha zimatha.