Kodi atherosulinosis ndi chiyani ndipo zimayambitsa chiyani?

Atherosulinosis
Zosintha mu chotengera (njira yopanga atherosulinosis), kuchuluka kwa mafuta m'thupi
ICD-10	Ine 70 70.
ICD-10-KM	I70 ndi I25.1
ICD-9	440 440
ICD-9-KM	440
Diseasesdb	1039
Medlineplus	000171
eMedicine	med / 182
Mesh	D050197

Atherosulinosis (Greek athḗra, slurry + sklḗrōsis, kuumitsa) ndi matenda osachiritsika am'mitsempha ya zotanuka ndi zotupa. Amayamba chifukwa chophwanya lipid ndi kagayidwe kazakudya ndipo amaphatikizidwa ndi kuyamwa kwa cholesterol komanso tizigawo ting'onoting'ono ta lipoprotein mu lumen. Madipozomu amapanga mawonekedwe a atheromatous malo. Kukula kwa minyewa yolumikizika mwa iwo (sclerosis), ndi kuwerengera kwa khoma la chotengera kumayambitsa kusinthika ndikuchepetsa kwa lumen kuti isokonezedwe (kufalikira kwa chotengera). Ndikofunikira kusiyanitsa atherosulinosis kuchokera ku Menkeberg arteriosulinosis, mtundu wina wa zotupa zam'mitsempha, zomwe zimadziwika ndi kuphatikizika kwa mchere wa calcium mkati mwa membrane wapakati wamitsempha, kuphatikizana kwa zotupa (kusowa kwa zolembera), kukula kwa aneurysms (ndipo osati kufalikira) kwamitsempha yamagazi. Atherosulinosis ya mitsempha ya mtima imatsogolera pakukula kwa matenda a mtima.

Etiology

Kuwerengera kwambiri kwaimfa kwa matenda amtima monga chiwonetsero cha matenda a mtima. Mu Russian Federation mchaka cha 2000, chiwerengero chokhazikika cha anthu omwe amafa kuchokera kumatenda oyenda mozungulira anali 800.9 pa anthu zana limodzi. Poyerekeza, ku France chiwerengerochi ndi 182.8 (otsika kwambiri ku Europe), ku Japan - 187.4. Zatsimikiziridwa kuti kuchepetsa chiopsezo cha matenda amtima m'mayikowa sikugwirizana kwambiri ndi kuchuluka kwa chisamaliro chachipatala monga momwe ziliri ndi moyo komanso kadyedwe.

Sinthani ya Etiology |Tanthauzo la matendawa. Zomwe zimayambitsa matendawa

Atherosulinosis - matenda a dongosolo omwe poyamba amakhudza mitsempha yamagazi, koma osati onse, koma mitsempha yokha, m'makoma omwe cholesterol ndi ma esters ake amadzisonkhanitsa, ndikupanga zigawo zomwe zimadziwika ndi matendawa.

M'tsogolomu, monga kuthekera kwa mitsempha yamagazi yomwe ikukhudzidwa ndi atherosulinosis kupereka magazi ofunikira kuti ntchito ya ziwalo zamkati ichepe, ziwalo izi zimakhudzidwa. Izi zitha kuchitika pang'onopang'ono - pang'onopang'ono - chifukwa cha kukula kwa zolengedwa zam'matumbo, kapena ndendende - ndi kukula kwa mtima.

Zinthu zodabwitsa zacitika mu zamankhwala, chifukwa cha kugonjetsedwa kwa atherosulinosis kwa ziwalo zingapo pali mayina a "matenda" ofanana, ngakhale kuti matendawa ndi ofanana: atherosclerosis, ndipo kungoyambitsa kwawokha kwa njira kungakhale kosiyana. Makamaka, ngati pali zizindikiro zowonongeka m'mitsempha ya mtima (coronary), amalankhula za mtima wamatumbo (CHD), ndi chidziwitso chowonongeka m'mitsempha yopereka malekezero - atherosulinosis yamitsempha yam'munsi yopanda malire ("intermittent claudication"), mwachitsanzo, ndi kupindika kwa atherosocolotic ndi thrombosis imodzi mwa zotengera za ubongo - za ischemic atherothrombotic stroke.

Kupezeka ndi chitukuko cha atherosulinosis sichitha kuchepetsedwa ku chifukwa chimodzi - nthawi zambiri izi ndizosakaniza. Komabe, pazifukwa zonse, titha kusiyanitsa zomwe zimakhudzana ndi chibadwa cha munthu, ndi zomwe zimayambitsidwa ndi njira yamoyo. Milandu yomwe imakhudzana ndi "kuwonongeka kwa majini", palibe chifukwa china chomwe chingakhale chofunikira pakukula kwa matendawa, ndipo matendawa amatha kukhala owopsa kwambiri mwachitsanzo, kubadwa kwa myocardial infarction kapena stroko kumachitika m'zaka zachitatu kapena zinayi za moyo, ndipo moyo pawokha ndiwofunika kwambiri. kufupikitsa. Izi ndizotheka ndi dzina lotchedwa Famer hypercholesterolemia, momwe lipid zovuta zomwe zimakhala ndi cholesterol yoyenda m'magazi sizingatengeke bwino ndi minofu (makamaka chiwindi). Zotsatira zake, kuchuluka kwa magazi a tinthu timeneti, ndipo motero, cholesterol imawonjezereka, ndipo cholesterol yowonjezereka, komanso zigawo zake, zimathera khoma lamitsempha. Zachidziwikire, njirayi ndiyovuta kwambiri ndipo kwenikweni imakhala yamagulu ambiri, koma chotsatira chake ndikupanga mapangidwe atherosselotic m'makoma amitsempha yamagazi. Kuwonjezeka kwa kuchuluka kwa tinthu tokhala ndi cholesterol m'magazi kumatha kuchitika kawirikawiri osati chifukwa cha kuwonongeka kwa chibadwa, koma chifukwa cha moyo wopanda thanzi. Izi zimapangidwira makamaka ndi mitundu ina ya chakudya (chakudya chofulumira, zakudya zambiri zopakidwa, nyama yamafuta ndi mafuta amkaka, margarines, zinthu zamafuta amafuta, ndi zina zambiri).

Zizindikiro za Atherosulinosis

Atherosulinosis kwa nthawi yayitali (zaka ndi makumi) zimachitika popanda zizindikiro. Kuphatikiza apo, nthawi zambiri zotengera zambiri zimakhudzidwa pang'onopang'ono, chifukwa atherosulinosis ndi matenda achilengedwe. Ngati chikhodzodzo cha atherosulinotic chapezeka mu gawo lina la mtima, makamaka, zolembazo zimapezekanso m'madziwe ena. Kukhazikika kwa zizindikiro kumalumikizidwa makamaka ndikuwonetsa kuchepa kwa kuthamanga kwa magazi mu chotengera chomwe chikukhudzidwa. Ngati zotupa zoterezi zimagwirizanitsidwa ndi kuletsa kwamtsempha wamagazi, zizindikiritso za ischemia (zotsatira za kuchepa kwa magazi) zokhudzana ndi magazi zimachitika.

Mwachitsanzo, ngati ma atherosselotic plaque ofunikira kukula kwa magazi m'mitsempha ya mtima, otchedwa "angina pectoris" amayamba - kupweteka pachifuwa kapena kusasangalala (kuwonda, kuwotcha, kufinya pachifuwa) panthawi yolimbitsa thupi - kuyenda, kuthamanga, kukweza zolemera. Ngati zomwezo zimachitika m'mitsempha yam'munsi, chizindikiro chimayamba kutchedwa "interlaent claudication," pomwe ululu, kuwotcha kapena kupsya mtima m'miyendo yamiyendo kumawoneka poyenda. Zizindikiro zimadutsa mwachangu ngati mungoyima, koma kwezani pakapita kanthawi ndikupitilizabe kuyenda.

Kodi mitsempha ya mitsempha

Atherosclerosis yamatombo (ngati mumawafotokozera mwachidule) ndi matenda omwe amakhudza ziwiya zazikulu komanso zam'mbali. Amapatsidwa nambala malinga ndi gulu la matenda padziko lonse lapansi (Khodi ya ICD 10 - І 70). Ziwerengero zapadziko lonse lapansi zimati kukula kwamatenda kumadziwika pambuyo pa zaka 50. Nthawi zambiri, mitsempha yokhala ndi zotanuka komanso zotanuka-kukhazikika kwa khoma lamitsempha imathandizira pakuchitika kwa pathological.

Chofunikira kwambiri pakukula kwa matendawa ndi kuphwanya mafuta kagayidwekukulira mothandizidwa ndi zifukwa zingapo. The biochemistry yamagazi ikusintha - mu plasma ndende ya cholesterol imayamba kuchuluka, yomwe sizimangokhala kuchepa kokha. Kusamala koyenera pakati pa cholesterol cha atherogenic (LDL) ndi antiatherogenic (HDL) kumaphwanyidwa, zomwe zimapangitsa kukulitsa kwa kusintha kwa zam'magazi zomwe zimakhudza kama wamitsempha.

Severin E. S. anafotokozeranso mwatsatanetsatane mbali zamankhwala am'kati mwake zam'mimba zomwe zimapezeka m'buku lake "Biochemistry of Atherosranceosis"

Kukula kwa matendawa kudutsa magawo angapo - kukhalapo kwa mawonetseredwe azachipatala kumadalira. Odwala omwe ali ndi atherosulinosis, ma atherosulinotic plaque (kuchuluka kwamafuta) omwe amakonda kupitirira muyeso amawaika m'mitsempha yamagazi. Kusintha konseku kumabweretsa kuti makhoma am'bedi lamimba azikhala ochepa, ntchito zawo zoyambira zimaphwanyidwa. Limagwirira a chitukuko cha dystrophy ndi khalidwe la gawo lapamwamba la mtima atherosulinosis.

National Society for the Study of Atherosulinosis (NLA) imawerengetsa matendawa ngati matenda amkati ndipo imawawona ngati vuto lazachipatala komanso chikhalidwe cha anthu. Izi zimatsimikiziridwa ndi ziwerengero zakufa padziko lapansi ndi Russia.

The pathogenesis of atherosulinosis

Kuchuluka kwa cholesterol yomwe imabwera ndi chakudya sichimagwira gawo lofunikira pakukula kwa atherosulinosis, mosiyana ndi chikhulupiriro chomwe chidakhalapo kwazaka zambiri. Chifukwa chake, palibe chifukwa chilichonse chasayansi chololezera cholesterol mu chakudya, ndipo Hyper yonse yozungulira kulimbana ndi cholesterol yopanda tanthauzo ilibe tanthauzo. Chowonadi ndi chakuti pafupifupi cholesterol yonse imapangidwa mkati mwathu - m'njira zambiri mothandizidwa ndi zomwe timadya, ndipo mitundu yazakudya yomwe yatchulidwa pamwambapa imathandizira kuti mafuta azithamanga kwambiri a cholesterol yathu.

Cholesterol palokha ndi chinthu chofunikira, ndipo gawo lililonse la maselo athu limatha kulipanga momwe limafunikira. Koma mphamvu ya thupi yogwiritsira ntchito ndi kugwiritsa ntchito cholesterol yake itachepa, ndiye kuti kuchuluka kwake m'magazi kumawonjezeka, ndizotsatira zake zina zonse. Zinthu zomwe zimasintha kapangidwe kazinthu zina zama lipid, zomwe zimaphatikizanso cholesterol, zimachepetsa kugwiritsa ntchito cholesterol yanu yanu. Izi, mwachitsanzo, kusuta, shuga, kutupa kosatha. Zomwezi zimawononga makhoma amitsempha yamagazi, potero zimathandizira kulowetsa ma lipid tinthu tomwe timakhala ndi cholesterol mkati mwake.

Kukula kwa zolembedwa za atherosclerotic ndi njira yomwe idatalikirana zaka zambiri ndi makumi. Ngati chikhomo cha khoma la chotchacho chikufika pakukula kwakukulu (pafupifupi 70% ya chimbudzi cha chotengera kapena kupitilira pamenepo), chimatha kubweretsa zopinga zambiri pakuyenda kwa magazi komanso kwa magazi kupita ku chinthu chogwirizana - mwachitsanzo, mtima kapena ubongo. Mapepala ang'onoang'ono amakhalanso osatetezeka - zikwangwani zikaphulika (izi ndizotheka ngati "matayala" awo akucheperachepera pazifukwa zosiyanasiyana), mafomu omwe ali pamalo omwe akuphulika, omwe atseka kwathunthu kuwonongera kwa botilo. Pankhaniyi, chifukwa choletsa kwambiri kuyenda kwa magazi, maselo ambiri am'thupi omwe amapereka chotengera ichi ndi magazi amafa (myocardial infarction (mwachitsanzo, infarction ya myocardial kapena infarction ya ubongo - sitiroko).

Zizindikiro potengera kutulutsa ndi gawo la chitukuko

Symbomatology ya matendawa imatengera kuti ndi ziwiya ziti zomwe zimakhudzidwa ndi atherosulinosis komanso pa gawo la kukula kwake. Ndi chitukuko cha matenda a m'mitsempha, ziwiya zomwe zimanyamula magazi ku ziwalo (mitsempha, ma arterioles, capillaries) zimakhudzidwa makamaka. Ma depherits a atherosulinotic samapangidwa mu lumen ya mitsempha - izi zikufotokozedwa ndi kapangidwe ka malinga a gawo ili la kama.

Matendawa akamakula, amadutsa magulu angapo otsatizana:

Gawo loyambirira. Kusintha kwazomwe zimachitika pakangopita kanthawi kochepa kwambiri chifukwa cha kuchuluka kwa mafuta m'thupi m'magazi kumachulukitsidwa kwambiri. The endothelium yamitsempha imayamba kubisalira zinthu zomwe zimapangidwa kuti zichepetse kuchuluka kwa mamolekyulu amafuta ozungulira. Popita nthawi, njira zowonjezera zamkati zamitsempha yamagazi zimatha. Endothelium imakhala yopyapyala, edema yake yotchulidwa imapangidwa, ma microcracks amawoneka. Potengera zakusintha kwakusaku, sitimayo imakhala yosatetezeka isanayambike mafuta achilengedwe pamakoma awo ngati mawanga kapena mikwingwirima yosaoneka ndi maliseche.
Gawo la kusintha kwa sclerotic. Madimbidwe ndi mafiyilo amafuta pakapita nthawi amayamba kudziunjikira tinthu tating'onoting'ono tosiyanasiyana tomwe timatulutsa tinthu tating'ono tawo. Chifukwa chake, ndiye kuti mwala wooneka bwino kwambiri. Kapholo kophimba mafuta mkati mwa cholendacho ndi kotakasuka. Zimakonda kuoneka ndi microtraumas, yomwe imakhala yowopsa pamene nyukiliya itatuluka ndikualowa m'magazi. A embolus yamafuta angayambitse zovuta za atherosclerosis monga mtima thrombosis.
Kubwezeretsa Gawo. Pakadali pano, kukula kwa intravascular pathological neoplasms kumapitilira. Mafuta a nucleus capsule amayamba kudziunjikira mchere wa calcium, zomwe zimapangitsa kuti iume. Popita nthawi, malembedwe amakula, zomwe zimatsogolera ku stenosis yayikulu kapena kutsekeka kwathunthu kwa lumen m'dera lomwe lakhudzidwa. Zotsatira zake ndi ischemia yovuta kapena yosatha yamisempha ndi ziwalo zomwe mitsempha yamagazi yowonongeka imanyamula magazi.

Zamankhwala mawonetseredwe oyambilira Izi mitsempha yam'mimba imakhala kulibe kapena kufotokozedwa pang'ono. Zizindikiro zoyambirira za atherosulinosis zimawonekera pa gawo la kusintha kwa sclerotic. Kenako wodwalayo amayamba kufotokozera madandaulo ake, omwe amapangidwa malinga ndi kutanthauzira kwa pathological process. Zadziwika kuti zotumphukira za atherosclerosis mwa akazi ndizochepa kwambiri kuposa amuna.

Njira ya atherosclerotic imatha kukhudza thoracic ndi m'mimba msempha. Kwa nthawi yayitali, matendawa amapita mosadziwika. Zizindikiro zoyambirira za aortic atherosulinosis zikupweteka zowopsa mu chifuwa, zomwe zimatha kupatsa msana, malo apamwamba am'mimbamo. Ululuwu umasiyana ndi ululu wa angina chifukwa umatha kukhala masiku angapo ndipo umakhala ngati funde.

Kuvulala kwam'mimba kwa gawo lalikulu la chotupa kumadziwika ndi kukhalapo kwa kupweteka kosalekeza pamtunda wonse wam'mimba, kupangika kwa mpweya kwambiri, kuphwanya kwamatumbo. Ngati gawo la msempha limakhudzana ndi pathological momwe limayambira kumanzere akumanzere kumanzere, odwala amakhala ndi nkhawa chifukwa cha kupweteka kwa mwendo, dzanzi, kutupa, kusinthasintha kwa minofu yofewa yam'mapazi am'munsi.

Ndi atherosulinosis ya mitsempha ya impso, chizindikiro choyamba cha kuchipatala ndicho kuwonjezeka kwa magazi. Awa ndi otchedwa sekondale, omwe amapezeka ngakhale kwa odwala omwe poyamba anali ndi kuthamanga kwa magazi. Chifukwa chophwanya kukula kwa fungo la impso ndi khoma lamitsempha, kuchuluka kwamapuloteni, maselo ofiira am'magazi, ndi masilindala kumatsimikizika panthawi ya urinalysis. Ndi kuwonongeka kwa mitsempha ya impso imodzi, chipatala cha matendawa chimakula nthawi yayitali. Atherosclerosis ya ziwiya za impso, yofalikira mbali zonse ziwiri, ikuwonetsedwa ndi kuwonjezereka kwa kuthamanga kwa magazi, komwe kumalimbana ndi mankhwala a antihypertensive.

Kuwonongeka kwa atherosulinotic mu ziwiya zaubongo ndi carotid mitsempha kumadziwika chifukwa cha kupweteka kwam'mutu, kusowa tulo, komanso kuchepa kwa luso la kuzindikira. M'milandu yapamwamba, kuphwanya kwamphamvu kwa malingaliro a malingaliro ndi zochita zawo kumadziwika.

Zilonda zam'mimba za m'matumbo a coronary, kuukira kwa ululu kumbuyo kwa sternum, komwe kumakhala ndi kuphika, ndi chikhalidwe. Dzina la sayansi pazomwezi zimapweteka ndi angina pectoris. Ululu umatha kuchitika panthawi yolimbitsa thupi komanso kupuma kokwanira. Zovuta kumbuyo kwa sternum zimazimiririka atangotenga nitroglycerin.

Ngati pathological ndondomeko imalimba ndi zotumphukira mitsempha, chifukwa cha momwe magazi amathandizira kumunsi amachitika, odwala amadandaula za kupweteka, dzanzi, kutupa miyendo. Mukamayenda, kuchepa kwamkaka kumachitika, poyamba zopweteka zimagwira ntchito zolimbitsa thupi, koma pambuyo pake zimachitika ndi kupumula kwathunthu. Khungu la miyendo limakhala louma, lozizira, lotuwa. Popita nthawi, mawanga a bulauni amawonekeranso, omwe amasintha kukhala zolakwika zazilonda ndi madera a necrosis. Kusintha kumeneku kukuwonetsa kukula kwa ischemia yofewa.

Mavuto a Atherosulinosis

Milandu pomwe kuchuluka kwa magazi kudzera m'mitsempha omwe akukhudzidwa kumachepera msanga - ndipo izi zimachitika ngati mawonekedwe a atherosulinotic plaque komanso mawonekedwe a thrombus m'derali - Zizindikiro zomwe zimakhudzana ndi kuwonongeka kwa chiwalo chogwirizana zimakulanso chimodzimodzi: myocardial infarction, stroke, gangrene of the limb limb, etc. .

Matenda a Atherosulinosis

Mwanjira zosiyanasiyana, zolembera za khoma la mitsempha yomwe ili m'makoma amitsempha imapezeka mwa achikulire ambiri omwe ali ndi moyo wamakono "wamadzulo", koma kutali ndi zonse, njirayi imafika poyambira pamene zizindikiro za chipatala zimawonekera. Ngati palibe zizindikiro zakuchipatala zomwe zimatha kuphatikizidwa ndi kuchepa kwa magazi m'mitsempha inayake, dokotala amawunika kuopsa kwa atherosulinosis ndi kufa chifukwa cha matenda omwe amaphatikizana ndi izi pozindikira zomwe zimatchedwa chiopsezo cha atherossteosis. Chofunika kwambiri mwa iwo ndi amuna, azaka, (zaka khumi zilizonse zomwe akukhala, chiopsezo cha matenda omwe amachitika ndi atherosulinosis), kuthamanga kwa magazi, kuthanso kwa cholesterol (makamaka kachulukidwe kachulukidwe ka lipoprotein cholesterol), kusuta, matenda ashuga, kunenepa kwambiri, kuchuluka kwa kubadwa kwa majini etc. Chiwopsezo cha kufa ndi matenda omwe amachitika ndi atherosulinosis kwa zaka 10 zitha kuwerengedwa panokha pogwiritsa ntchito chowerengera cha pakompyuta. Ngozi yayikulu imaganiziridwa ngati ipitilira 5%. 5% - zikuwoneka kuti ndizocheperako. Komabe, ziyenera kukumbukiridwa kuti uwu ndi chiopsezo cha imfa. Chiwopsezo cha matenda omwe sapha omwe akuwopseza kuti apanga panthawiyi ndi kuchuluka kwa nthawi 3-5. Kuphatikiza apo, chiopsezo chenicheni chimakhala chachikulu kuposa chiwerengedwe, chifukwa chowerengera chimangoyang'ana zinthu zisanu zokha zomwe zimayambitsa ngozi, ndipo pali zochulukirapo. Mwachitsanzo, kupezeka kwa matenda ashuga kumawonjezera chiwopsezo chowerengeredwa mwa amuna katatu, ndipo mwa akazi ndi katatu!

Popeza chiopsezo chachikulu kwambiri cha atherosulinosis cha malo aliwonse ndi cholesterol yamagazi (makamaka kachulukidwe kachulukidwe ka lipoprotein cholesterol), kuyezetsa magazi komwe nthawi zambiri kumatchedwa "lipid mbiri" (komwe kumaphatikizidwa ndi lingaliro la "kuyesa kwamwazi wamagazi") kumachitika nthawi zambiri. Izi sizitanthauza kungoyesa kuchuluka kwa cholesterol yathunthu, komanso kugawidwa kwake m'magawo awiri (ndipo tsopano akupezeka atatu) lipoprotein cholesterol: kachulukidwe kachulukidwe ka lipoprotein cholesterol ndi kuchuluka kachulukidwe lipoprotein cholesterol. Kuphatikiza apo, mbiri ya lipid imaphatikizapo kuyesa kuchuluka kwa mafuta a triglycerides (mafuta) m'magazi. Zotsatira zake, ndikotheka kuwunikira molondola kuopsa kwa matenda omwe amachitika ndi atherosulinosis ndikuwonetsa zolinga zakuchiritsa. Kuphwanya komwe komwe kumapezeka mu lipid sikufanana pakokha ndi matendawa "atherosulinosis", koma kumawonjezera chiwopsezo cha matendawa mokulira, kumakhala kowopsa kwambiri komwe kumadziwika ndi zovuta zam'magazi.

Zilonda zam'magazi a ma mitsempha enieni, kuti adziwe, amafunikira maphunziro osiyanasiyana othandiza, kutengera mtundu womwe dokotala akuwonetsa. Kupezeka kwachilengedwe kofalikira kwambiri kwa atherosulinosis ndi mitsempha ya carotid. Kuti muchite izi, gwiritsani ntchito ma ultrasound awo (masinthidwe amtundu wa mitsempha ya brachiocephalic). Kafukufukuyu amatipangitsa kuti tiziunikira momwe khoma lilili polumikizira izi pang'onopang'ono kuzidziwitsira bwino pang'onopang'ono mpaka pabedi lonse lamankhwala. Zimamveka kuti ngati ma atherosselotic plaques amapezeka m'mitsempha ya carotid, amathanso kupezeka m'matumbo ena, chifukwa chake, wodwala wotereyu amafunika mankhwala kuti achepetse cholesterol ndikuwonjezera zina zomwe zingayambitse matenda a atherosulinosis (mwachitsanzo, kuthamanga kwa magazi, kulemera kwa thupi, kusuta).

Ndiosavuta kuyerekezera kupezeka kwa zolembera zamatumbo. Izi zimachitika pogwiritsa ntchito njira yomweyi ya akupanga. Mapilala opezeka m'matumbo amtima ndi ovuta kuwona. Komabe, posankha chithandizo, chithandizo chokhacho chomwe chili m'mitsempha yama coronary chomwe chimalepheretsa kuthamanga kwa magazi, ndikupangitsa kuti zizindikirika, ndizofunikira - pakuwonongeka kwakukulu kwa ziwiya izi, tikulankhula za "angina pectoris", omwe amapezeka ndikuwunikira kwa mawonetsedwe apachipatala omwe adakhalapo (mwachizolowezi, kupweteka kumeneku kapena kusokonezeka pachifuwa komwe kumachitika poyenda, kuthamanga kapena kukweza zolemera ndikudutsa mphindi zochepa pakupumula) ndikuchita kafukufuku ndi zochitika zolimbitsa thupi momwe magetsi matchati chitumbuwa, echocardiogram kapena scintigraphic chifanizo cha mtima kuti kudziwa umboni cholinga cha ischemia, T. e. ndi mismatch zosakhalitsa pakati yobereka magazi myocardium ndi zosowa m'menemo pansi pa katundu. Muzochitika zomwe dokotala angaganize kuti pali zisonyezo zakuchita opaleshoni yam'mitima ya mtima, amapanga maganizidwe a X-ray pamitsempha yamtima ndikuyambitsa kwa wopikisana naye, pomwe mutha kuwona mwachindunji kuwunikira kwa mitsempha ya mtima ndi zovuta zomwe zilipo mu zotengera izi kuti mufotokozere dongosolo la opereshoni ndikusankha njira yake.

Chithandizo cha Atherosulinosis

Iyenera kulekanitsidwa, kumbali imodzi, miyeso yomwe cholinga chake ndi kupewa atherosulinosis ndikuletsa kuthamanga kwake, komanso, njira, zochizira matenda, zomwe zimatengera zilonda zam'magazi.

Masiku ano, palibe njira yoti ikonzeke "kuwonongeka" pamtundu wa majini, chifukwa chomwe chitukuko cha atherosulinosis chikufulumira. Chifukwa chake, kuti muchepetse kapena kuchepetsa kufalikira kwake, zochizira ndi prophylactic zotsatira za atherosulinosis zimapangidwa makamaka kuti muchepetse mavuto obwera chifukwa cha chiopsezo cha atherosulinosis, kuphatikizapo kukwaniritsa kuchepa kwa cholesterol yamagazi, ndipo koposa zonse, lipoprotein cholesterol kachulukidwe kakang'ono. Kutsitsa cholesterol yamagazi ndipo, koposa zonse, kuisunga pakulondola kwazaka zambiri kumatha kuyimitsa kupitilira kwa atherosulinosis komanso kuisintha pang'ono. Zochitika izi zimachitika zonse ziwiri pakukonza momwe zinthu ziliri, komanso munjira ya mankhwala. Komabe, anthu ambiri nthawi zambiri amakhala osakonzeka kusintha kwakukulu m'miyoyo yawo ndipo amadalira kwambiri zinthu zina zakunja zomwe madotolo akadapanga pa iwo, kapena pazinthu zomwe zimachitika pakapangidwe ka mankhwala omwe. Pankhani imeneyi, pali malingaliro olakwika ambiri komanso zabodza, zomwe amati sizothandiza, "njira zothandizira", mankhwala osokoneza bongo komanso ma bioadditives. Osatinso vinyo wofiira, mafuta anyama, kapena tincture wa adyo, kapena kuwotcha kwa laser magazi, kapena kuyang'anira matumbo, komanso ziwonetsero zina zambiri "zochizira", sizitha kuchitira zotupa zamatenda a atherosselotic.

Mwa kuchuluka kwa mankhwalawa omwe ali ndi mphamvu yotsimikizika yomwe ingalepheretse kukula ndi kupitilira kwa atherosulinosis, komanso mpaka kumayambitsa chitukuko, umboni wawukulu kwambiri ma statins (atorvastatin, rosuvastatin, pitavastatin, simvastatin). Ma Statin samangoletsa kuchuluka kwa cholesterol kwathunthu ndi cholesterol yomwe ili m'magawo otsika kwambiri a lipoprotein, komanso, pogwiritsa ntchito nthawi yayitali, ma statin amatha kuyimitsa kapena kuchepetsa kufalikira kwa zolembedwa za atherosclerotic, kuchepetsa chiopsezo cha kuphwanya kwa myocardial ndi stroke, komanso kuwonjezera kuchuluka kwa moyo m'matenda omwe amayenderana ndi ndi atherosulinosis. Pofuna kuwerengera zotulukapo zotere, ma statin amayenera kumwedwa kwa zaka zingapo komanso Mlingo woyenera, womwe unakhazikitsidwa m'maphunziro omwe adapeza omwe amapeza zotsatira zabwino za ma statins.

Palinso mankhwala ena omwe amasintha ma biochemical magawo a magazi, kuwonetsa mawonekedwe a lipid, ndipo potero amachepetsa chiopsezo cha matenda ndi mavuto omwe amadza chifukwa cha atherosclerosis. Kupatula ma statin, izi ezetimibe (ezetrol), yomwe imalepheretsa kuyamwa kwa mafuta am'mimba m'matumbo, komanso zomwe zidawonekera posachedwa kumaby - ma antibodies a enzyme omwe adapezeka mu 2003, adafupikitsidwa ngati PCSK9 (evolokumab ndi alirokumab amalembetsedwa ku Russia). Kuti tisamafewe, titha kunena kuti enzyme iyi - PCSK9 - imayang'anira kuchuluka kwa mayamwidwe a cholesterol m'magazi ndimaselo a chiwindi. Zowona, Kumabs pakadali pano ndiokwera mtengo kwambiri, koma iyi ndiye njira yawo yokha. Pali magulu ena a mankhwala omwe angakhudze mbiri ya lipid poyang'ana kusintha kwake, koma kufunika kwake ndizochepa.

Ziwonetsero Kupewa

Pazithandizo ndi kupewa matenda a atherosulinosis, momwe zimayambira pazinthu zazikulu zonse za chiopsezo cha chiwopsezo chake ndizofunikira:

kutsitsa magazi
kukonza kwathanzi,
kusuta kusuta
Kuchotsa kunenepa kwambiri ndi kusagwira ntchito.

Muzochitika izi pamene kukula kwa atherosulinosis kukafika pagawo lomwe matendawo azizindikiro za matenda omwe amapezeka ndi atherosulinosis, matendawa pawokha amayamba kuthandizidwa, kapena ndendende, zotupa za atherosulinotic za chiwalo chimodzi kapena china: mtima, ubongo, impso, m'munsi. miyendo. Ndipo nthawi zambiri chithandizo ichi chimatha kuchitidwa opareshoni. Nthawi zambiri, chithandizo choterechi chimakhala ndi njira zochitira opaleshoni yomwe imabwezeretsa patency yamitsempha yomwe yakhudzidwa ndi atherosulinosis. Mwachitsanzo, pakuwonongeka kwa mitsempha ya mtima, izi zitha kukhala zopweteka kwambiri kukhazikitsa chikhazikitso chapadera pamalo opendekera - stent, yomwe imachitidwa mwa kupopera chotupa, kapena pakhoza kuchitidwa opaleshoni "yayikulu" pakutseguka kwa chifuwa ndikuyika njira yodutsa magazi - zimapewa. Nthawi yomweyo, atherosulinosis monga matenda amtundu amakhalabe, ndipo chithandizo cha opaleshoni sichingachotse kufunika kwa mankhwalawa - choyambirira, ndikusintha zinthu zomwe zingachitike pachiwopsezo, pakati poti kuchuluka kwa magawo a lipoproteins okhala ndi cholesterol ndikofunikira kwambiri.

Zoyambitsa ndi zotsatira zake

Atherosclerosis samawoneka popanda chifukwa chodziwika bwino. Kukula kwake kumathandizidwa ndi kuphatikiza zinthu za atherosulinosis. Nthawi zambiri odwala amafunsa madokotala kuti: "Tandiuza chifukwa chiyani ndidadwala matendawa komanso ndimatha kuthana nawo?"

Propaedeutics yamatenda amkati, omwe madokotala amaphunzira ngati ophunzira, amatsimikiza kuti malingaliro cholesterol ndi atherosulinosis mosalephera olumikizidwa. Izi ndi zowona, chifukwa motsutsana ndi maziko a kusokonekera kwamafuta metabolism kumachitika Hyperlipidemia. Zosokoneza pantchito ya chiwindi, zomwe zimalepheretsa kuphwanya cholesterol yaulere, zimayambitsanso izi. Chifukwa chake, madontho amafuta amalowa mu kayendedwe kazinthu, zomwe zimapangitsa kuti azikundana ndi endothelium ndikupanga ma atherosranceotic amana.

Chifukwa chake, matenda a lipid metabolism ndi choyambitsa zochitika atherosulinosis zombo.

Lipid metabolism imasokonezedwa ndi zinthu zoopsa. Izi zikuphatikiza:

Mawonekedwe azaka. Mu ana, matendawa ndi osowa kwambiri, nthawi zambiri amapezeka mwa anthu omwe afika zaka 40. Malinga ndi ziwerengero, anthu omwe adutsa malire a senile ali ndi matenda ambiri a mtima.
Zogonana. Oyimira abambo amatenga matendawa kale kuposa amayi. Izi zimachitika chifukwa cha kukhalapo kwa ma anti-atherosulinotic mahomoni m'thupi la mkazi, omwe amapangidwa mwachangu mu nthawi yobereka. Pambuyo pa zaka 55, chiopsezo chotenga matenda a atherosulinosis ndi ofanana amuna ndi akazi. Izi ndichifukwa choti kuzimiririka kwa ntchito yakubereka ya thupi lachikazi nthawi zambiri kumachitika pazaka izi.
Khalidweli. Ngati achibale apafupi kwambiri anali ndi vuto la mitsempha ya atherosselotic, ndiye kuti chiwopsezo chikuwonjezeka.
Kukhalapo kwa zizolowezi. Kukonda zakumwa zoledzeretsa ndi ndudu kumayambitsa mavuto a mtima kwakanthawi.
Zowonjezera pazakudya zomwe zimakhala ndi unyinji wa nyama ndi mafuta osinthidwa.
Makhalidwe ongokhala. Kuperewera kwa ntchito zolimbitsa thupi kumabweretsa kuchepa kwa kagayidwe kazinthu, kuchuluka kwa mapaundi owonjezera, kuwonongeka kwa magazi ndi kuchepa kwa okosijeni wa ziwalo ndi minofu.
Mkhalidwe wopsinjika nthawi zonse. Kupanga kosalekeza kwa mahomoni opsinjika kumapangitsa khoma lamitsempha kukhala pachiwopsezo cha cholesterol.
Matenda oopsa. Kuwonjezeka kwa kuthamanga kwa magazi kumayambitsa kutsika kwa mitsempha yamagazi, yomwe ndi yabwino kupanga mapangidwe a atherosulinotic.

Atherosclerosis ndiowopsa chifukwa cha zovuta zake, zomwe nthawi zambiri zimapha.

Kwambiri zotsatira zoyipa matenda:

matenda am'mimba (ischemic, hemorrhagic),
myocardial infarction (chachikulu, transmural),
Kusintha kwachilengedwe kwamankhwala ofewa (gangrene of the m'mphepete),

Pakaperekedwa chithandizo chamwadzidzidzi, zovuta izi nthawi zambiri zimabweretsa kufa!

Pankhani ya psychosomatics, pali lingaliro la fanizo la zochitika zamitsempha yamagazi. Mwachitsanzo, Oleg Torsunov amakhulupirira kuti kuwonongeka kwamatenda a mtima kumachitika chifukwa cha kuuma kwa malingaliro, kusakhazikika paulemu, kuyandikana kwa anthu ndi dziko lakunja. Valery Sinelnikov m'buku lake akulemba kuti atherosulinosis imawoneka chifukwa cha kusokonekera kwa mphamvu ya njira zomwe mafunde achisangalalo amayenera kulowa mu thupi la munthu. Ndendende kusowa kwa chisangalalondipo osati njira yolakwika yomwe imatsogolera ku matenda.

Diagnosis: momwe mungayang'anire mitsempha ya magazi a atherosulinosis

Arteriosulinosis yamitsempha yam'mimba imatha kupezeka mwa wodwala akangopima mayeso athunthu.

Pa gawo loyamba, kuonana ndi dokotala kumatsatira. Akatswiri onse omwe amaphunzitsidwa m'mayunivesite azachipatala adadutsa dipatimenti yothandizira zamankhwala, pomwe chidwi chachikulu chinalipira pakuwerenga bwino mbiri yamankhwala. Chifukwa chake, adotolo ayenera kufunsa wodwalayo mwatsatanetsatane zodandaula, mwatsatanetsatane momwe angathere. Pambuyo pokambirana ndi mawu, katswiri amawunika wodwalayo kuti asinthe maonekedwe ake, amayeza magazi.

Gawo lotsatira ndikudziwitsa za zasayansi. Wodwalayo amadzipereka mbiri ya lipid, yomwe imakuthandizani kuzindikira kusalinganika kwa lipid, chifukwa dyslipidemia ndi atherosulinosis ndi malingaliro osasintha. Komanso, adotolo amayenera kuwunika mayendedwe a mkodzo. Izi ndizofunikira kuti mumvetsetse ngati pali zovuta za impso kapena ayi. Komanso kuyezetsa magazi ndi njira yoyenera.

Gawo lomaliza ndi njira zothandiza diagnostics. Mu cardiology, ultrasound imawerengedwa kuti ndiyo njira yophunzirira kwambiri yomwe imatha kuzindikira mtima wamatenda a mtima. Pachifukwa ichi, dopplerometry mode imagwiritsidwa ntchito, mothandizidwa ndi komwe mawonedwe amtundu wa magazi amachitika ndipo magawo am'kati mwa mtima, ataphimbidwa ndi njira ya atherosulinotic, amatsimikiza. Pakuwerenga zamatumbo a coronary ndi chithokomiro, njira ya angiography imagwiritsidwa ntchito.

Momwe mungathanirane ndi atherosulinosis

Odwala omwe ali ndi vuto la mitsempha yam'magazi amakhala ndi nkhawa chifukwa chofunsidwa kuti: "Kodi matendawa amatha?" Mankhwala amakono amakhulupirira kuti atherosermosis sangachiritsidwe konse, koma ndiyotheka kuyimitsa. Chithandizo cha mtima atherosulinosis ndi njira yayitali yomwe iyenera kuyamba atangopezeka matenda. World Health Organisation yakonza malangizo azachipatala othandizira matenda amenewa.

Ochiritsa amapereka njira zawo zochizira matendawa. Mwachitsanzo, Neumyvakin amalimbikitsa kugwiritsa ntchito atherosulinosis kuti adye hydrogen peroxide mkati, ponena kuti iyi ndi njira yakuchira yopambana. Komabe, izi zisanachitike, muyenera kufunsa dokotala, chifukwa kudzipereka nokha sikumabweretsa zotsatira zomwe mukufuna!

Anthu ndi njira zina

Kuphatikiza pa upangiri wa mchiritsi Neumyvakin, njira zina zamankhwala zimapereka malingaliro ambiri pazomwe angachite ndi mtima wamatenda a mtima. Akatswiri ena amati chithandizo cha homeopathy sichingangolepheretsa mapangidwe okha, komanso kudziwikiratu kama wokhala ndi lipid inclusions. Komabe, umboni waboma kapena wotsutsa chidziwitsochi sunalandiridwe, chifukwa chake, aliyense ayenera kusankha payekha kuti athandizidwe ndi chithandizo cha homeopathy.

Ena amakhulupirira kuti physiotherapy imakhala ndi zotsatira zabwino polimbana ndi mtima wamatenda. Physiotherapy ndi nthambi yamankhwala yomwe cholinga chake ndikuwonjezera magazi m'magazi omwe akhudzidwa ndikuwongolera gawo lama cellcirculatory. Madokotala amalimbikitsa kugwiritsa ntchito njira za physiotherapy, koma kuphatikiza ndi mankhwala komanso kudya mokwanira.

Maphunziro akuthupi

Oimira mankhwala amakono amakhulupirira kuti mankhwalawa atherosulinosis ayenera kuchitika kumbuyo kulimbitsa thupi mokwanira. Chifukwa cha masewera olimbitsa thupi olimbitsa thupi ndi abwino, omwe odwala amatha kuchita motsutsana ndi dokotala, palokha komanso moyang'aniridwa ndi wophunzitsa zolimbitsa thupi.

Mothandizidwa ndi kupsinjika kwa thupi, magazi amayenda bwino, ndipo kuperekera kwa oksijeni ku ziwalo za ischemic ndi minofu kumawonjezeka. Ndi kuphunzitsidwa mokhazikika, kagayidwe kazinthu ndi mphamvu zimasintha, kuwotcha mapaundi owonjezera, katundu pa mtima zimachepa, odwala amamva mizimu yabwino, kuchuluka kwa mphamvu ndi mphamvu.

Lamulo lalikulu ndikuti zolimbitsa thupi ziyenera kuterolimbikani ndikukula pang'onopang'ono. Pogwiritsa ntchito masewera olimbitsa thupi moyenera, chiopsezo chovulaza sichochepa.

Mankhwala

Masiku ano, mankhwala amadziwa momwe mungachotsere kupita patsogolo kwa mitsempha ya mitsempha. Mankhwala amabwera patsogolo, kudya pafupipafupi komwe kumatha kuletsa matendawa. Madokotala amalembera odwala monga mankhwalawa monga: statins, antiplatelet agents, anion exchange resins, fibroic acid zotumphukira.

Chofunikira kwambiri ndikuti chithandizo chikuyenera kuchitika motsutsana ndi maziko a kukonza zakudya. Kuti muchite izi, muyenera kusiya zakudya zomwe zimakhala ndi mafuta ambiri azinyama, zakudya zosavuta zamafuta. Zokonda ziyenera kuperekedwa pazinthu zopanga mapuloteni, komanso zomwe zimaphatikizapo zovuta za mafuta, fiber, ndi masamba azomera.

Mankhwala othandizira opaleshoni ndi njira ina yoletsa kupititsa patsogolo kwa atherosclerosis. Nthawi zambiri, kuchitapo kanthu pochita opareshoni, monga kupweteka kwa stenting ndi ma bypass, ntchito pofuna kupewa zovuta za atherosulinosis (kuwonongeka kwa ischemic mu minofu ya ubongo, myocardium, malekezero am'munsi, ziwalo zam'mimba.

Chomwe chimapangitsa kununkha ndikuti pakupyoza pakhungu pogwiritsa ntchito zida zapadera, stent yapadera imayikidwa mu kama wamitsempha, yomwe imayikidwa pamalo a chotupa cha atherosranceotic. Chifukwa chake, kuunikira kwa chotengera kumakulakulitsidwa, chotchinga kuyenda kwa magazi chimachotsedwa. Njirayi imatchulidwa kuti kulowerera kosasokoneza.

Opaleshoni yam'mimba - Uku ndi kulowereraku, komwe cholinga chake ndi kupanga magazi kulowa m'malo owonongeka a kama.

Ndi atherosclerosis ya ziwiya zamiyendo, pakabwera chipatala cha gangrene, kuduladula miyendo yam'munsi kumachitidwa. Izi ndizoyenda mwamphamvu zomwe zimachitika pazifukwa zama Thanzi. Ngati dzanja silinadulidwe, wodwalayo amayembekeza mwachangu kufa!

Ndi anthu angati omwe amakhala ndi atherosulinosis

Atamva kuti ali ndi vuto la mtima kapena matenda ena, odwala akuganiza kuti ndi sentensi. Monga tafotokozera pamwambapa, mankhwala amakono amakhulupirira kuti sizotheka kuchiritsa matendawa kwathunthu. Komabe, ngati muyamba chithandizo cha atherosulinosis munthawi, chiyembekezo chamoyo ndimaona zabwino.

Pali malingaliro osiyana. Katswiri wasayansi ya zaumoyo, a Gorodissky B.V. akuti atherosulinosis yamitsempha imatha. Adapanga izi, akuyankhula mu pulogalamu ya "All About Health". Komabe, koma kufa kwa odwala kumachitika chifukwa cha zovuta za matendawa, makamaka ngati thandizo loyambira linaperekedwa pa nthawi yolakwika. Chifukwa chake, kudziwika kwakanthawi kwa atherosulinosis ndikofunikira kwambiri.

Okalamba kukonzanso pambuyo pake pakukonzekera zovuta ndizofunikira kwambiri kwa anthu, chifukwa moyo wawo wamtsogolo umadalira izi. Kuti zotsatira zoyipa za atherosulinosis sizingachitike modabwitsa, madokotala amalimbikitsa kupewa matendawa. Amakhala ndi kuwongolera kwapazaka zamapulogalamu, kusintha kwa zakudya, kukonza thupi, kukhalanso ndi masewera olimbitsa thupi, kusunga thupi moyenera.