Ndi mayeso ati omwe amayenera kuchitika ngati mukukayikira atherosulinosis

Kwa zaka zambiri osavutika ndi CHOLESTEROL?

Mutu wa Bungwe: “Mudzadabwa momwe zimakhalira zosavuta kuchepetsa mafuta m'thupi mwakumwa tsiku lililonse.

Kuphatikizika kwa magazi ndi njira yovuta kuphatikiza yamphamvu, ntchito yake ndiyo kuletsa magazi. Komabe, sizingatheke kapena kuchedwa posakhalitsa chimodzi mwazinthu zopanga, mndandanda womwe umatsegula fibrinogen. Chinthu choyamba chomwe chimakhudzidwa pakukhazikitsa coagulation hemostasis (FI), mapuloteni a plasma amapanga m'chiwindi ndipo samangokhala chinthu chowundana, komanso zinthu zomanga zomwe zimathandizira kulimbitsa malo owongoka (njira yotsatizanso). Kuphatikiza apo, fibrinogen ndi ya mapuloteni oyipa kwambiri, chifukwa chake, amawerengedwa poyang'ana matenda opatsirana.

Tsiku ndi tsiku glycoprotein wosungunuka wamadzi amapangidwa kuchokera 2 mpaka 5 g / l; theka-moyo wake (kapena kufalitsa theka-moyo) pafupifupi masiku 4.

Mtengo wa fibrinogen ndi zofunikira zake mu plasma

Panthawi yadzidzidzi (kutuluka magazi), kuyankha mwachangu kwa dongosolo la coagulation ndi fibrinogen (fibrinogen A), kusungunuka mu plasma ndikuzungulira mozungulira kudzera m'magazi panthawi ya 2.0-4.0 g / l, kutsata, kuyamba kugwira ntchito ndikuyesayesa kuyimitsa magazi. Kuti muchite izi, imawola pansi pa enzymatic ya thrombin kupita ku chinthu chapakatikati chomwe chimatchedwa fibrin monomer kapena fibrinogen B, kotero kuti pa gawo lotsatira (ndi kutenga nawo gawo kwa FXIII) imasandulika polymer ya insoluble. Titha kuwona fayilo ya fibrin m'magazi ophatikizidwa ndi chubu choyeserera ngati mawonekedwe amtundu wazoyera wa fibrin. Mafelemu a Fibrin opangidwa pachilonda cha chinthu chamoyo amatenga nawo mbali pakukonza minofu, ndikuwathandiza kuchira. Amakhalabe m'malo mwake, ndikupanga maziko a thrombus, omwe amatseka bowo mumtsempha wamagazi.

Kuphatikiza pa kutenga nawo gawo pakuphatikizana ndi kuphatikizana kwa ma platelet, fibrinogen ilinso ndi maudindo ena:

• Zimathandizira kulumikizana kwa khoma la mtima ndi zinthu zomwe zimapangidwa ndimagazi,
• Ndi chinthu chodziwitsa mamvekedwe a magazi,
• Ndi gawo la mapuloteni a pachimake gawo, chifukwa chake kukwera kwake kumadziwika m'mitundu yambiri yovuta.

Nthawi zonse glycoprotein wofunika kwambiri kwa anthu athanzi alibe zambiri zomwe zimakhala kuchokera ku 2.0 mpaka 4.0 g / l (kapena 5.8 mpaka 11.6 μmol / l).

Gawo lotsika kwambiri limawonedwa mwa akhanda, omwe amachokera ku 1.25 mpaka 3.0 g / l.

Mwa akazi, fibrinogen imawonjezeka panthawi yapakati. Pafupifupi nthawi yakubereka, kuphatikizira kwake kumatha kufika pa 6.0 g / l ndipo imawerengedwa kuti ndi yabwinobwino kuti chamoyo chikukonzekera chochitika chofunikira (kachitidwe kakuphatikizidwe kakuyenera kukhala kakukonzekera, chifukwa zonse zimatheka panthawi yobereka). Komabe, pa nthawi ya pakati, kuchuluka kwa fibrinogen kumatsitsidwanso, komwe kumawonedwa pakuwonongeka kwa placental, amniotic fluid embolism, ndi zovuta zina zazikulu.

Zopangidwa mwachilengedwe zinachulukitsa Factor I mwa akazi ndipo nthawi yomwe akusamba, ndiye kuti, njira yophatikizika yogonana "yofowoka", kusintha njira yachilengedwe yomwe imachitika mthupi la mkazi, imagwira ntchito mosiyana ndi njira yaimuna hemostasis. Nthawi zina, fibrinogen mwa akazi imadzuka ndikugwa pazifukwa zomwezo mwa amuna, ndiye kuti, ndikupanga matenda ena.

Pankhani yokhudzana ndi matenda a labotale, fibrinogen ndi yosangalatsa chifukwa gawo lake lokwezeka limawonedwa ngati chiopsezo cha thrombosis ndikupanga mitundu yambiri yamtima.

Factor I waposa wabwinobwino - zikutanthauza chiyani?

Fibrinogen pamwambamwamba limatanthawuza kuti njira ya heestasis imayendetsedwa ndipo pamakhala chiwopsezo cha kuchuluka kwa magazi kapena gawo lodana kwambiri la kutupa, lomwe limakhala loopsa, likuchitika m'thupi. Chifukwa chake, kuchuluka kwazinthuzi kumadziwika m'mikhalidwe yowopsa yokhudza ziwalo zofunika kwambiri komanso chamoyo chonse:

1. Kutupa, kutupa ndi neoplasms yoyipa yokhudza kupuma kwamatenda (chibayo cha mitundu ingapo, chifuwa chachikulu, khansa yam'mapapo),
2. Matenda a impso komanso a impso (pyelonephritis, glomerulonephritis, nephrotic ndi hemolytic-uremic syndromes),
3. Matenda omwe amayambitsidwa ndi kuwonongeka kwa minofu yolumikizika (collagenoses - nyamakazi, scleroderma),
4. Matenda amagetsi
5. Munthu neoplasi aliyense (makamaka khansa yamapapo),
6. Pachimake yotupa matenda a chiwindi ndi peritoneum (pachimake peritonitis),

Fibrinogen pamwambapa wamba imakonda kuwonetsedwa mu atherosulinosis ndi matenda ashuga. Kuphatikiza apo, zabwino za chinthu choyambirira m'magulu a 4.5 - 5 - 6 g / l zimatha kukhazikitsidwa mwa odwala omwe amadziona kuti ali ndi thanzi labwino, koma osagwirizana ndi ndudu, komanso ali muubwana wawo komanso / kapena kulemera "koyenera".

Fibrinogen imakwezedwa mu nthawi yovuta kwambiri yokhudzana ndi matenda aliwonse, yotupa komanso necrotic, kotero sizosadabwitsa kuti imatentha kwambiri chifukwa cha kutentha, kuwonda kapena kupweteka kwambiri kwa myocardial, kuvulala ndi kuwotcha, komanso ngati pakuchitika maopareshoni ambiri. Pakalipano, kuwonjezera, mwachitsanzo, ndi rheumatoid polyarthritis mpaka 5-6 kapena 10 g / l, kuyesa kwa labotale kwa collagenoses sikunenedwe mwachindunji. Monga chisonyezo chodziwika, zomwe zikuwonjezereka za FI zimaganiziridwa mukamaunika momwe mawonekedwe a kupangidwira, kayendetsedwe ka mtima komanso kudziwa gawo loyipa la njira yotupa (limodzi ndi maphunziro ena a labotale).

Ndikufuna kuwonetsa chidwi cha odwala kuti kuwonjezeka kwa kuchuluka kwa fibrinogen m'magazi kungachitike chifukwa chogwiritsa ntchito mankhwala ena, omwe nthawi zambiri amagwiritsidwa ntchito mu gynecology popewa mawonetsero olakwika a kusintha kwa kubereka kapena kupewa kutenga pakati posafuna kutenga pakati (estrojeni, njira yoletsa pakamwa). Kukhazikika kosalamulirika kwa mankhwalawa kumatha kukulitsa kuchuluka kwa fibrinogen, ndikuwonetsa ku thrombosis, monga momwe zimasonyezedwera munthawi yapamwamba mu gawo la "Zotsatira zoyipa". Kusuta, komwe kumathandizira kuwonjezeka kwa magazi ndi zina zomwe zikuika pachiwopsezo cha kukhazikika kwa mtima, kumachulukitsa vutoli, motero, kugwiritsa ntchito mankhwalawa poganiza za gulu linalake la odwala sikuchitidwa, zomwe ziyenera kukumbukiridwa ndi azimayi omwe akuvutika ndi kutentha kwambiri ndikuyesera kuthana nawo pogwiritsa ntchito mahomoni ndalama "zolangizidwa" ndi mnansi.

Mitundu ya mayeso a atherosulinosis

Kukhalapo kwa matenda wodwala kungathandize kudziwa zotsatirazi zoyesa zamatenda a atherosulinosis:

• mkodzo
• magazi wamba
• zamitundu mitundu
• coagulogram
• ntchito ya chiwindi,
• kupezeka kwa mapuloteni.

Kuwerengera kwathunthu kwamwazi kumatsimikizira kuchuluka kwa:

Muyenera kuyiyika pamimba yopanda kanthu. Ndiye kuchuluka kwa magazi kwa atherosulinosis kudzakhala kolondola. Tenga kuchokera pachala, ndikumanga ndi singano yapadera. Zowonongeka - sizipereka chidziwitso chokwanira. Ndi shuga wowonjezereka, kafukufuku wa kagayidwe kazachilengedwe adzafunika. Kuchuluka kwa mafuta m'thupi kumapangitsa kuti magazi ake azingokhalira kukhoma.

Mkodzo umapereka umboni wa kusagwira bwino ntchito kwa ziwalo zamkati. Zotsatira zake zidzakhala zokonzekera maola 4-5. Coagulogram imazindikiritsa zizindikiro zowonjezera kuchuluka kwa magazi, kupatsidwa zinthu za m'magazi, kuchepa kwa ntchito ya fibrinolysis. Ubwino - zizindikiro zimakupatsani mwayi wodziwa chiopsezo chokhudzana ndi mapangidwe a magazi.

Kafukufuku wazinthu zam'magazi amakulolani kudziwa kukhalapo kwa:

• cholesterol yathunthu
• triglycerides
• "Chofunika" HDL cholesterol (high density lipoproteins),
• "Zosafunika" LDL cholesterol (otsika ochepa lipoproteins).

Ndikofunikira kuichotsa kuchokera mu mtsempha pamimba yopanda kanthu. Maola 10 tisanayambe phunziroli, simungathe kumwa madzi otsekemera, tiyi, khofi. Osachulukitsa thupi ndi zolimbitsa thupi masiku 4 musanakhale mpanda. Zotsatira zake zakonzeka mumaola atatu.

Ndi chiwopsezo chowonjezeka cha atherosulinosis, kuyang'anira kuwonetsetsa kwa kolesteroli kofunikira. Odwala otere ayenera kupereka magazi osachepera 2 pachaka.

Zotsatira ziti zomwe zikuwonetsa kukula kwa matendawo

Ndi kuyesedwa kwa magazi ambiri, kuchuluka kwa ESR (erythrocyte sedimentation rate) kumawonetsa chitukuko cha atherosulinosis: chizolowezi kwa amuna ndi 1-10 mm / h, kwa akazi - 2-15 mm / h. Ngati chizindikirocho chikukula koposa, chiwonetsero cha ziwalo zamkati chimachitika.

Ngati kuwonjezeka kwa LDH (lactate dehydrogenase) kumadziwika pakamayesedwe kwamkodzo ndi magazi, pamakhala chiopsezo cha ischemia, myocardial infarction.

Mfundo zotsatirazi ndizofunikira kudziwa matenda:

• ngati pali chiwopsezo cha matenda a mtima, onani ALT ndi AST, mapuloteni othandizira,
• ndi minofu ischemia, chizindikiro cha potaziyamu chidzakulitsidwa.

Kuphwanya mafuta kagayidwe kamaonetsa kukula kwa atherosulinosis.

Zizindikiro:

• kuchuluka cholesterol, triglycerides, LDL,
• utachepa HDL
• otsika apolipoprotein A1,
• mtengo wambiri wa apolipoprotein B

Mwazi umawerengetsa atherosulinosis

Milingo ya cholesterol imatengera kuzunzidwa kwa mafuta, okazinga zakudya. Mtengo umayambira 3 mpaka 5 mm / l. Zizindikiro zotere zikutanthauza kuti wodwalayo alibe matenda.

Kuwerengera magazi a atherosulinosis:

• m'munsi - 5.2-6.5 mm / l,
• zolimbitsa - 6.5-7.9 mm / l,
• kuchuluka - oposa 8.0 mm / l.

Kukhazikika kwa mapangidwe a atherosselotic mu ziwiya zaubongo, mtima, ndi ziwalo zamkati kumatsimikizira kuchuluka kwa homocysteine. Kukula kwake ndi kusinthasintha kuyambira 9 mpaka 11 MKm / l.

• HDL - 0,8-2.2 mm / l,
• LDL - osapitilira 3.5 mm / l.

Kolesterol yathunthu siyenera kukhala yapamwamba kuposa 8 mmol / l, popeza pamakhala chiwopsezo chokhala ndi ischemia.

• C cholesterol chonse - kuyambira 3.1 mpaka 5 mmol / l,
• triglycerides 0,14-1.82 mmol / l,
• "Yofunikira" cholesterol ya HDL ndi 1 mmol / L (kwa abambo, cholesterol yachilendo ya HDL imaposa 1.68 mmol / L, kwa akazi - oposa 1.42 mmol / L),
• Zosafunika "LDL cholesterol si zoposa 3 mmol / l.

Kukhalapo kwa triglycerides oposa 2.29 mmol / l kumawonetsa kuti wodwala ali ndi ischemia, pali kuthekera kwa matenda ashuga.

Ngati mulingo wawo ukuchokera ku 1.9 mpaka 2.2 mmol / L, ndiye kuti gawo loyambalo la matendawa limatheka.

Ngati HDL mwa amuna ndi ochepera 1.16 mmol / l, mwa akazi - m'munsi mwa 0.9 mmol / l, ndiye kuti pamakhala matenda, ischemic matenda a mtima.

Ngati mulingo wa 1.16-1.68 mmol / l mwa amuna, 0.9-1.42 mmol / l mwa akazi, ndiye gawo loyambirira la matendawo.

Mfundo za Atherogenicity Index:

Mlozo ungasiyane kutengera zaka, mtundu wa wodwala:

1. mwa amuna ndi akazi mzaka 20-30, zomwe zili - 2,5 ndi 2.2,
2. mwa amuna azaka 40-60 - 3,5.5.

Ndikupatuka pang'ono kwa zizindikirozo panjira, dokotala amatha kukupatsani zakudya. Koma kuti tisunge HDL pang'ono, kugwiritsa ntchito mafuta azomera ndikofunikira.

Coagulogram amawonetsa zotsatira za magazi, magazi.

Zizindikiro zotsatirazi ndizomwe zimachitika:

• prothrombin nthawi - 11-16 masekondi,
• nthawi ya thrombin - masekondi 11-18,
• mapuloteni a fibrinogen ndi 2-4 g / l.

Ndi mayeso ati omwe amafunikira kudutsidwa

Atherossteosis, kuzindikira kwake, kuyesa kumafuna kuchita kwakanthaŵi.

Pozindikira atherosulinosis, njira zotsatirazi zimagwiritsidwa ntchito:

1. Multispiral CT scan ya aorta, mitsempha ya impso, miyendo, ziwiya zamatumbo.
2. CT ya msempha.
3. MRI yamatumbo a miyendo.
4. Peripheral tomographic arteriography.

Njira zake zimagwiritsidwa ntchito pamavuto posonyeza opereshoni. Amapereka chithunzithunzi chokwanira cha magazi a wodwala.

Kuti mudziwe chitukuko cha atherosulinosis, madandaulo a odwala amatengedwa. Kapangidwe kozindikira koyenera kumafunikira kuyesedwa kwa magazi a lipid. Kufufuza kwathunthu kumathandizira kuyendetsa ultrasound, angiography. Zidziwitso zomveka zimaperekedwa ndi njira za tomographic.

Zoyambitsa Atherosulinosis

Pakadali pano pa chitukuko cha sayansi, zomwe zimayambitsa kukula kwa atherosulinosis mthupi sizinakhazikike molondola. Komanso, limagwirira lomwe limathandizira kuti mawonedwe azitsamba asakhazikike molondola.

Zodziwikiratu zomwe zingayambitse chiopsezo cha chitukuko cha atherosclerosis, kupezeka kwake komwe kumakulitsa mwayi wamatenda amisala. Zowopsa zonse zitha kugawidwa m'magulu angapo - osasinthika komanso osinthika.

Zambiri zomwe zingasinthidwe ndi izi:

1. Hyperlipidemia chifukwa cha kuchuluka kwa mafuta a nyama, zakudya zamafuta ambiri, kunyalanyaza fiber ndi mkaka.
2. Kuphwanya kukhulupirika kwa khoma la mtima chifukwa cha zizolowezi - kumwa kwambiri, kusuta.
3. Masewera olimbitsa thupi osakwanira, kapena mosinthanitsa, kukhalapo kwa ntchito yolimbitsa thupi.
4. Kukhalapo kwa kuthamanga kwa magazi ndi shuga.
5. Zina zomwe zimayambitsa matenda opatsirana kapena endocrine (hypothyroidism, Itsenko-Cushing's syndrome), kuvulala.

Matenda osasinthika akuphatikizapo:

• m'badwo - chiwopsezo cha kukula chikukula pambuyo pa zaka 45 - 50,
• jenda - abambo amakonda kupezeka matenda amtunduwu, chifukwa mahomoni ogonana achikazi amateteza,
• cholowa matenda kagayidwe - dyslipidemia, homocysteinemia.

Kuzindikira koyambirira kumayambira ndikujambula kwathunthu kwa anamnesis (mbiri) ya moyo, yomwe imaphatikizapo zambiri zokhudzana ndi matenda akale, kuvulala ndi maopareshoni, kukhalapo kwa banja lomwe limakonda matenda amtima.

Mbiri ya matendawa ndiyofunika kwambiri - kumayambiriro, zizindikiro zoyambirira, nthawi yawo komanso chikhalidwe chawo, funso limakhala loti kodi wodwalayo angagwirizanitse kuyambika kwa chizindikiro ndi china chake, mwachitsanzo, kuzindikira ndi chithandizo chomwe chachitika kale, zotsatira zake.

Zizindikiro za zotupa za atherosulinotic

Zizindikiro za njira ya atherosulinotic zimatengera nthawi yomwe chitukuko cha matenda apezeka, malo ake komanso kuchuluka kwa kugundika kwamitsempha ya m'mitsempha komanso kuchuluka kwa kuperewera kwa magazi.

Coronary atherosulinosis, kapena angina yokhazikika, ali ndi zizindikiro zotsatirazi - kupweteka kwakanthawi kwakumbuyo kumbuyo kwa sternum, tachycardia ndi arrhythmias.

Ndi atherosulinosis ya msempha (chotengera chachikulu mthupi), mawonetseredwe oterewa amawonekera - kuchuluka kosalekeza kwa kuthamanga kwa magazi, kumverera koyaka, kukwawa pa manja ndi miyendo, kukhudzika kwa khungu lam'munsi, kuchepa kwa mphamvu zawo, kutsekeka, komanso kupweteka kwam'mimba.

Kuwonongeka kwa mitsempha ya ziwonetsero kumawonetsedwa ndi mutu, chizungulire, tinnitus, kuchepa kwa kukumbukira ndi kuthekera kwazindikiritso, kuchuluka kwazovuta zamkati.

Zovuta zakuzindikira zimaphatikizapo maphunziro a labotale ndi othandizira.

Laborator imaphatikizapo njira zamatenda osiyanasiyana komanso zowunikira.

Zapadera zimaphatikizapo kuyesa kwa magazi ndi kakhazikitsidwe ka leukocyte, uinalysis, komanso kutsimikiza mtima kwa glucose.

Zapadera ndi kusanthula kwamachitidwe am'manja ndi kutsimikiza kwa lipid sipekitiramu, ma electrophoresis a serum lipoproteins, kuwerengetsa kuchuluka kwa mapuloteni a plasma apo-B, njira zodziwikiratu matenda ndi kutsimikiza kwa coagulogram.

General matenda zasayansi diagnostics

Kuyesedwa kwa magazi kumatsimikizira kuchuluka kwa hemoglobin, kuchuluka kwa maselo ofiira am'magazi, maselo am'magazi oyera ndi maselo oyera am'magazi, komanso kuchuluka kwa erythrocyte sedimentation rate (SOE).

Magazi kuti aunikidwe amatengedwa m'mawa pamimba yopanda kanthu, zotsatira zake zimakhala zokonzekera m'maola angapo.

Mukuwunikaku, kupezeka kwa atherosulinosis kungasonyezedwe ndi kuwonjezeka kwa SOE - chisonyezo cha mayankho otupa (chizolowezi cha amuna ndi 1 mpaka 10 mm pa ola limodzi, kwa akazi - kuyambira 2 mpaka 15). Kumbukirani kuti chizindikirochi sichachidziwikire, ndipo ndizosavuta kuzindikira kuti kuphwanya mafuta kagayidwe.

Pakuwunika kwamkodzo, magawo amatero amatsimikiza - mtundu, mawonekedwe, mphamvu inayake, kupezeka kwa mapuloteni, shuga, mchere ndi zina zowonjezera - maselo, zinthu zowola, ma enzymes.

Chizindikiro chomwe chingawonetse kuchepa kwa metabolism ndi metabolism ya minofu ya mtima ndi lactate dehydrogenase (LDH).

Enzime iyi ndiyophulika kwa glucose, kupezeka kwake mkodzo kumawonetsa mtima ischemia kapena infaration ya myocardial.

Mlingo wa glucose umatsimikiziridwa kuti upezeke koyambirira kwa matenda osokoneza bongo, kuchuluka kwa kulolera kwa glucose ndi matenda ena a endocrine, chizindikiro chodziwika bwino chimachokera ku 3,3 mpaka 5.5 mmol.

Kuwonjezeka kwa shuga kumawonetsa chitukuko cha matenda a shuga, omwe amatha kupezeka ndi matenda a mtima ndi matenda a mtima.

Matenda Othandizira Odwala a Clinical Laboratory

Mayeso apadera a kupangika kwa atherosulinosis kumapangitsa kuti athe kudziwa molondola kuchuluka ndi mtundu wa kusintha kwa kagayidwe ka lipid, kupezeka kwa dyslipidemia ndi kuchuluka kwa atherogenicity.

Kuyesa kotsimikizika koyamba ndi kuzindikira mtundu wa mawonekedwe a lipid kapena kutsimikiza kwa cholesterol yathunthu ndi zigawo zake.

Zizindikiro zazikulu za lipids ndi kuchuluka kwa cholesterol yokwanira, kuchuluka kwa lipoproteins otsika kwambiri (kuchuluka kwa atherogenic), kuchuluka kwa lipoproteins apamwamba (antiatherogenic), triglycerides, chylomicrons.

Nthawi zambiri, mulingo wa cholesterol wokwanira umachokera pa 3,1 mpaka 5 mmol pa lita, gawo la HDL siliri lotalika 1 mmol pa lita, zomwe LDL ndi VLDL zimakhala mpaka 3 mmol, triglycerides zili mpaka 1,7 mmol.

Kuwonjezeka kwa zisonyezo zonse, kupatula HDL, kumawonetsa kuphwanya kwa metabolidi ya lipid komanso kuthekera kwakukulu kokulitsa kwa atherosulinosis ndi kuletsedwa kwakukulu kwa magazi komanso ngakhale kupindika kwamitsempha. Komanso kuwonjezereka kwa triglycerides kokha ndi chizindikiro chosavomerezeka, kuwonetsa kukula kwa angina pectoris ndi matenda a shuga.

Plasma electrophoresis imapangidwa kuti iwone milingo ya lipoprotein - mapuloteni onyamula omwe amanyamula mafuta. Ndi hyperlipidemia, kuchuluka kwa otsika kwambiri komanso ochepa kwambiri a lipoproteins kumawonjezeka, ndipo HDL, m'malo mwake, imachepetsedwa. Kusanthula kumeneku sikutanthauza kukonzekera mwapadera, sikuyenera kuchitika pamimba yopanda kanthu, magazi a venous amakhala ngati zinthuzo.

Kuphatikiza kwa atherogenicity kumatsimikiziridwa - kuchuluka kwa HDL kumachotsedwa pamtengo wa lipids wathunthu ndipo zotsatira zake zimagawidwa ndi kuchuluka kwa kupsinjika kwambiri kwa lipids.

Makhalidwe abwinobwino a chizindikirochi ndi mpaka 3 mayunitsi.

Mlingo woyenera kuyambira 3 mpaka 4 umatanthawuza chiopsezo chachikulu cha matenda a mtima, kuwonjezeka kwa zotupa zopitilira 5 - atherosrance

Apo-B-lipoprotein ndi puloteni yoyendera yomwe imasamutsa triglycerides kuchokera kumatumbo kupita ku chiwindi chifukwa cha kuphatikiza kwamafuta amkati mwa mafuta.

Mwambo kwa amuna ndi kuyambira 60 mpaka 138 mg / dl, kwa akazi - 52 - 129.

Ndi kuwonjezeka kwa msinkhu wake, motero, ma triglycerides nawonso amawonjezeka, chomwe chimakhala chosavomerezeka kuchipatala.

Njira zodziwonera za immunosorbent zogwirizana ndi enzyme zimathandizira kudziwa kukhalapo kwa ma antibodies komanso kufalitsa ma cell immune.

Kukula kwa matenda amtima kumalumikizidwa ndi kukhalapo kwa plasma ya antibodies kwa cardiolipin ndi cardiomyosin, zomwe ndi myocardial element.

Ubwino wa njirazi ndi kulondola kwapamwamba posankha kukula kwa kusintha kwa ma pathological, kusowa kwa maphunziro apadera.

Kuti mupeze njira yoyambukira magazi, coagulogram imachitika.

Pali zizindikiro zingapo mmenemo, zikuluzikulu ndizo kuchuluka kwa mapulateleti, nthawi ya prothrombin, fibrinogen, nthawi ya thrombin, nthawi yokhazikitsidwa ndi gawo la thromboplastin nthawi ndi mayeso a ethanol.

Pulogalamu yamapulatifomu imachokera ku 180 mpaka 320 Giga pa lita imodzi (kapena madigiri 10 mpaka 9 pa lita), prothrombin nthawi kuchokera masekondi 10 mpaka 16, fibrinogen kuchokera magalamu 2 mpaka 4 pa lita, nthawi yayikulu kuchokera masekondi 12 mpaka 18 ndi ethanol kuyesa - kuphatikiza chimodzi kapena kuchepera.

Njira zodziwitsa ena za zida

Kutsimikizira kapena kukana matendawa, njira zogwiritsa ntchito poyang'ana thupi la wodwalayo zimagwiritsidwa ntchito.

Kugwiritsa ntchito njirazi kumathandizira kuzindikira komwe kumayambitsa matenda.

Kuphatikiza apo, kugwiritsa ntchito njira zapadera zowunikira mozama kumathandizira kudziwa kukula kwa matendawa ndikuganiza zogwiritsa ntchito njira zina zodziwonetsa m'thupi.

Njira zodziwitsa anthu za zida ndi izi:

1. X-ray ya chifuwa, x-ray yamitsempha yamagazi (angiography - aortography, coronarography).
2. Kuyeza kwa kuthamanga kwa magazi ndi kutsimikiza kwa kalozera wamchiwongo.
3. Electrocardiography, echocardiography.
4. Dopplerography kapena ultrasound yamitsempha.
5. Kuyesa kwa kupsinjika kuti mudziwe kuchuluka kwa ischemia.
6. MRI kapena MSCT yamitsempha yamagazi (aorta, ziwiya zam'mimba komanso malekezero ochepa).

Pakuwonekera kwa ziwalo za chifuwa chamkati, kuwonjezeka kwa kukula kwa mtima, komwe ndi madipatimenti amanzere, kuwonjezeka kwa chipilala, kugwirana kwa ma cell, kuwunika kwamakoma a ziwiya kumawonedwa. Zambiri zamkati mwa mtima ndi msempha weniweni ndizotheka. Komanso, pamene mapangidwe am'mitsempha m'mimba amathandizira mu njirayi, mawonekedwe am'mapapu amathandizidwa chifukwa cha mtima.

Pa electrocardiography, zosintha zambiri zimakhala zopanda tanthauzo, ndipo zimayamba chifukwa cha myocardial ischemia. Opaleshoni monga zizindikiro zakumanzere kwamitsempha yamitsempha yamagazi, arrhythmias, ndikusintha kwa conduction (blockade) kumawonedwa.ECG imagwiritsidwa ntchito pozindikira atherosulinosis ya mtima.

Chofunikira pakuzindikira ndicho kupsinjika nthawi zonse. Odwala ayenera kulangizidwa kuti azitenga magazi tsiku lililonse kapena masiku awiri aliwonse, ndikukhala ndi diary ya muyeso. Kuwunikira koteroko kuthandizira kuwona kukwera kwa kukakamizidwa mu magawo oyambilira ndikuletsa kuwoneka kwa zizindikiro zabodza ndi "chithokomiro choyera."

Pakati pa kuyeza, index ya ankolo-brachial imawerengezedwanso, ndiye kuti, kuchuluka kwa kuthamanga kwa magazi paphewa ndi chidendene. Mtengo wabwinobwino wa muyeso woterewu kuchokera pa 1 mpaka 1.3.

Kafukufuku wapadera kuti azindikire patency ya mtima:

• angiography
• dopplerography,
• magonedwe amatsenga,
• mitundu yosiyanasiyana yamakedzana.

Angiography ndi kafukufuku wosiyana ndimitsempha yamagazi, yomwe imayikidwa pakuyika othandizira m'magazi. Njirayi imakuthandizani kuti mudziwe kukula ndi kutalika kwa mitsempha, kuwona momwe mulili komanso kuchuluka kwake.

Dopplerography yamitsempha yamagazi kapena ultrasound - mayeso ofunikira, kuwonjezera pazomwe tatchulazi, amathandizanso kuthamanga kwa magazi m'mitsempha. Nthawi zambiri, kafukufuku wobwereza kapena wa patatu amachitika.

Maphunziro a Tomographic pakadali pano ndi njira zofunikira kwambiri zowunikira kudziwa malo a atherosrance. Kukula kwake kwamakhalidwe ndi chimodzimodzi ndi angiography - wothandizira mosiyanasiyana amalumikizidwa kudzera m'mitsempha ndipo wodwala amayikidwa mu tomograph.

Pogwiritsa ntchito MRI kapena CT, mutha kudziwa mawonekedwe amitsempha yamagazi, malo omwe ali, kuwonongeka kwake ndi kuchuluka kwa lumen, mkhalidwe wamagazi am'deralo komanso mitsempha yolumikizana.

Zizindikiro za atherosulinosis zafotokozedwa mu kanema munkhaniyi.

Sonyezani shuga yanu kapena sankhani jenda kuti muyimikize.

Zizindikiro zazikulu za atherosulinosis

Kuwonetsedwa kwa atherosulinosis kumadalira kwenikweni pa ziwalo za zotupa.

Amatha kukhala matenda a mtima, ubongo, impso komanso miyendo.

Pankhani ya kuwonongeka kwa mtima, kupweteka kumayang'aniridwa m'dera la chifuwa, pomwe ululu umatha kuperekedwa khosi, mikono, kumbuyo kapena kumbuyo kwamimba. Payokha, ndikofunikira kudziwa kuti atherosulinotic lesion ya aorta, monga lamulo, sikuwoneka mwanjira iliyonse.

Matenda a impso amawonekera makamaka mu mawonekedwe a matenda oopsa, pomwe kuwoneka kwa mutu ndi chizungulire, kuwonjezera pa izi, kupuma movutikira kumachitika.

Atherosulinosis m'mitsempha ya ubongo imayambitsa kukwiya, kupweteka mutu komanso chizungulire. Odwala ambiri amaonanso kuchepa kwa ndende komanso kukumbukira zinthu zina, nthawi zina amakhala akusowa tulo ngakhale kukomoka.

Matenda a malekezero a m'munsi sangathe kuwonekera mwanjira iliyonse. Theka la odwala amamva kupweteka m'misempha pakuyenda, omwe amaperekedwa kwa ana ang'ono ngakhale m'chiuno.

Njira yovuta ya matendawa imabweretsa zowawa, khungu limachepa komanso kukokana ngakhale pakupuma.

Palinso kufooka mmadera akumunsi, kumverera kwa dzanzi, kuchepa tsitsi, kuphwanya chikhalidwe cha misomali, m'malo ovuta kwambiri, zilonda zimatha kupanga.

Choopsa kwambiri ndi atherosulinosis obliterans.

Kuyesa kwa magazi a atherosulinosis

Kuwunikira kwa atherosclerosis ndikofunikira mwachangu ngati pali matenda alionse, ndipo kuwunika kwa milomo ya lipid kumachitika.

Kuyesedwa kwa magazi kuchipatala ndikofunikira pakuwonetsetsa kuti matendawa ndi olondola komanso odalirika.

Pambuyo pakuwunikira ma laboratori ndikotheka kupereka mankhwala oyenera.

Monga lamulo, kuwunika kwa matenda monga atherosulinosis kungafune:

• kusanthula kwakanthawi kwamkodzo ndi magazi (kuyesa kwa magazi mosiyanasiyana kwa atherosulinosis sikuyenera kuwonjezedwanso, chifukwa ndizolondola kwambiri,
• kusanthula kwa kudziwa kuchuluka kwa michere m'chiwindi,
• kusanthula kwa kukhalapo ndi kuchuluka kwa mapuloteni m'magazi,
• kusanthula kwa coagulograms.

Ndizofunikira kudziwa kuti kusanthula kwa ma biochemical kwamalonda kumakupatsani mwayi wowerengera magazi a atherosclerosis, omwe ndi kuchuluka kwa cholesterol, lipoproteins ndi triglycerides. Kuwonjezeka kwa atherogenicity kukuwonetsa kufalikira kwa matendawa komanso kuthekera kwa matenda a m'mitsempha.

Mgwirizano wa atherogenic ndi chizindikiro cha cholesterol yathunthu, yomwe imayenera kukhala 1.98-2.51. Kuchulukirapo kwa chizindikiro ichi kukuwonetsa kuwopsa kwa thanzi laumunthu, mtima wake. Kutsika kwakukulu pamlingo uwu ku chisonyezo pansipa 0.9 kumawonetsa chiopsezo chowonjezereka ndikuwoneka kwa atherosulinosis.

Zizindikiro za atherosulinosis zitha kukhala motere:

• kuchuluka kwa mafuta m'thupi omwe ali pansipa 5.0 akuwonetsa kuti chiopsezo chotenga matendawa kulibe,
• Zizindikiro 5.2-6.5 zikuwonetsa kuti munthu ali pachiwopsezo,
• 6.5-8.0 ndi chisonyezo cha Hypercholesterolemia (chikutsimikizira chiopsezo chotenga atherosulinosis),
• cholesterol yomwe ili pamwamba pa 8.0 imawonetsa njira yanenedwayo yamatenda.

Kuzindikira koyenera kumafunikira njira zowonjezera zowunikira, pamaziko omwe adotolo athe kudziwa za matenda omwe alipo, ndikuwapatsanso chithandizo choyenera.

Ndikulimbikitsidwa kuti pafupifupi munthu aliyense wazaka zopitirira 40 ayesedwe kuchuluka kwa cholesterol, izi zithandiza kuzindikira matendawa munthawi ndikuyamba chithandizo chake.

Zofunikira pakuwonjezera Cholesterol

Zomwe zimapangitsa kuti mapangidwe a atherosselotic akhale ambiri.

Nkhani za owerenga athu

Kumenya matenda oopsa kunyumba. Patha mwezi kuchokera pamene ndayiwala za kupanikizika. O, momwe ndimayesera zonse - palibe chomwe chinathandiza. Ndi kangati kamene ndinapita kuchipatalako, koma ndinalandira mankhwala osapindulitsa kangapo konse, ndipo nditabwerako, madotolo adangokhala osagwirizana. Pomaliza, ndinalimbana ndi ziyesozi, ndipo zikomo zonse. Aliyense amene ali ndi mavuto opsinjika ayenera kuwerenga!

Mwa zina zofunika kwambiri pakukula kwa matendawa, monga kusuntha pang'ono, kugwiritsa ntchito molakwika zizolowezi, kupezeka kwambiri kwa thupi ndi chibadwa cholowa.

Khalidwe labwino. Poterepa, pali kuwonongeka pakubwera kwa magazi ndikuwoneka kwa cholesterol yoyika pazitseko zamitsempha yamagazi.

Kusuta. Chimodzi mwazomwe zimayambitsa matendawa. Nicotine imapangitsa magazi kukhala akukulira, zomwe zimapangitsa kuti magazi aziwonekera. Kusuta kumakhalanso ndimitsempha yamagazi ndipo, chifukwa chake, kumawonjezera chiopsezo cha matenda omwe amatsutsana ndi mtima.

Kunenepa kwambiri Vuto lina lomwe limafala kwambiri ndi matendawa, pomwe mumapezeka mafuta ochulukirapo osati amawoneka, komanso ziwiya.

Makamaka. Osati zofala, koma m'malo mwake zovuta za matendawa. Gulu lomwe likuika pachiwopsezo ndi anthu omwe achibale awo amadwala cholesterol yayikulu kapena matenda amtima. Matenda a shuga komanso matenda oopsa m'mbale ndi zinthu zazikulu zomwe zili pachiwopsezo.

Pambuyo pakufufuza, komanso kuzindikira zotsatira ndikuwunika momwe ziliri, dokotala amayenera kupereka chithandizo choyenera. Mwachitsanzo, zimawoneka ngati zothandiza kugwiritsa ntchito vitamini E ngati njira imodzi yotsitsira cholesterol.

Izi zimapezeka mu zakudya monga mbewu za mpendadzuwa, phwetekere, mtedza ndi mafuta amitundu osiyanasiyana.

Kutsitsa cholesterol ndikuchiza atherosulinosis

Ma acid a Omega-3 ndi njira yabwino yolimbana ndi cholesterol.Kuchuluka kwakukulu kwa zinthuzi kulipo mu mackerel, koma kuyamwa bwino ndikofunika kugula kukonzekera kwapadera komwe kuli ndi chinthu ichi.

Mapuloteni a soya ndi tiyi wobiriwira amathandizanso kuti magazi athetse kwambiri, pomwe woyamba amalimbikitsa kupanga kwa asidi wa bile omwe amasintha kugaya, pomwe tiyi wobiriwira amathandizira kukonza kagayidwe ndikuchotsa mafuta ochulukirapo.

Chithandizo cha matendawa makamaka chimadalira zovuta. Nthawi zina, dokotala amalimbikitsa kutsatira zakudya zapadera, komanso kuchita masewera olimbitsa thupi olimba komanso olimbitsa thupi. Milandu yoopsa kwambiri ya matendawa ingafune mankhwala komanso ngakhale kuchipatala. Njira imodzi kapena ina, kupezeka kwakanthawi kofunikira kumafunika.

Popewa matenda a atherosulinosis ayenera:

1. Tsatirani zakudya.
2. Siyani kusuta.
3. Khalani ndi moyo wokangalika.
4. Yenderani kuthamanga kwa magazi anu.
5. Onaninso mkhalidwe wa matenda osachiritsika.

Monga chithandizo chamankhwala a atherosulinosis, dokotalayo angalimbikitse kugwiritsa ntchito ma statins omwe amasokoneza kupanga ma enzymes, omwe amathandizanso kupanga cholesterol.

Chizindikiro cha cholesterol "yoyipa", komanso kupezeka kwa kufalikira kwa ma atherosulinosis, zimakhudza mwachindunji lingaliro la adokotala kuti apereke mankhwala ena. Chinthu chachikulu musanatenge izi kapena mankhwalawa ndikuzidziwa nokha zomwe zingakhale ndi zotsatirapo zoipa.

Pamaso pa zotsutsana zilizonse, ma fanizo a mankhwala omwe amakhazikitsidwa ayenera kusankhidwa.

Matenda a mtima komanso mikwingwirima ndizomwe zimayambitsa pafupifupi 70% ya imfa zonse padziko lapansi. Anthu asanu ndi awiri mwa anthu khumi amafa chifukwa chotseka mitsempha ya mtima kapena ubongo.

Choyipa chachikulu ndikuti anthu ambiri saganiza kuti ali ndi matenda oopsa. Ndipo amaphonya mwayi wokonza kena kake, kumadzipangitsa kufa.

• Mutu
• Zosangalatsa pamtima
• Madontho akuda patsogolo pa maso (ntchentche)
• Kupanda chidwi, kusakwiya, kugona
• Masomphenya opanda pake
• Kutukwana
• Kutopa kwambiri
• Kutupa kwa nkhope
• Kunenepa komanso kuzizira kwa zala
• Kupanikizika kumapitilira

Ngakhale chimodzi mwazizindikirozi chikuyenera kukupangitsani kuganiza. Ndipo ngati pali awiri, musazengereze - muli ndi matenda oopsa.

Momwe mungathanirane ndi matenda oopsa pakakhala kuchuluka kwa mankhwala omwe amawononga ndalama zambiri?

Mankhwala ambiri sangachite bwino, ndipo ena amatha kupweteketsa! Pakadali pano, mankhwala okhawo ovomerezeka ndi Unduna wa Zaumoyo pa mankhwalawa ndi awa.

Kuti Institute of Cardiology, limodzi ndi Unduna wa Zaumoyo, ukuchititsa pulogalamu “ wopanda matenda oopsa". Momwe mankhwalawo amapezeka zaulere, onse okhala mumzinda ndi dera!

Zambiri

Dokotala aliyense woyenera amadziwa kuti ndikofunikira kwambiri kuyamba kulandira chithandizo kwa wodwala aliyense yemwe ali ndi mbiri yachipatala, chomwe sichinthu chongophatikizanso chidziwitso chokhudza thanzi la munthu.

Monga lamulo, kuyezetsa kulikonse kwachipatala kumayamba ndi kufunsa wodwalayo payekha za matenda kapena njira zina zopangira opaleshoni zomwe adakumana nazo kale, za zovuta zomwe zimachitika kapena kubadwa kwa matenda obadwa nawo.

Kenako dotolo amakupangira mayeso angapo a labotale kapena kungoyesa kumene komwe kungathandize kuwonjezera ma anamnesis ndi chidziwitso pakukula kwa matendawo, komanso ndi chidziwitso chofunikira posankha njira ya chithandizo kapena matenda ena.

Maphunziro a coagulological (mwachidule coagulogram) khalani malo ofunika pakati pa kuyezetsa magazi a labotale, omwe amayenera kuchitika pokonzekera opareshoni, mwachitsanzo, ndikukonzekera gawo laesesan kapena nthawi mimba.

Kodi coagulogram ndi chiyani?

Odwala ambiri amayamba kuda nkhawa pachabe akamva kuchokera kwa sing'anga wodabwitsika ngati kuti sakumva mawu oyambira coagulogram kapena ayi makulidwe. Ndiye kupenda uku ndi kotani ndipo ndikuti ukuperekedwa?

Choyamba, ndikofunikira kudziwa kuti iyi ndi njira yodziwika bwino yowerengera zamankhwala zamakono machitidwe a heestasis thupi la munthu, lomwe limayang'anira ntchito zofunika monga: Kuletsa magazi kuwonongeka kuundana kwa magazi kapena zombo, komanso kusunga magazi abwinobwino ngati magazi.

Chifukwa chake yankho la funso ndi chiyani makulidwe - Kafukufuku yemwe amatsimikiza momwe kayendedwe ka thupi ka heestatic limagwirira ntchito bwino. Kuyesedwa kwa magazi kwa coagulogram kumathandizira kuphunzira ntchito yofunika kwambiri ya magazi monga kuthekera kwa coagrate, i.e. kapangidwe ka magazi.

Kupeza zotsatira coagulology, adotolo amatha kulosera pasadakhale zotsatira za opareshoni kapena mwana. Zambiri zokhudzana ndi kuchuluka kwa magazi ndizofunikira munthawi zadzidzidzi, mwachitsanzo, ngati munthu wavulala, kuchuluka kwake kumapitilira masekondi ndipo muyenera kuyimitsa posachedwa magazi.

Chifukwa chake, sikoyenera kuda nkhawa kwambiri kuti kafukufukuyu amawononga ndalama zingati. Kupatula apo, mtengo wa heestasiogram sungafanane ndi chikhulupiriro chakuti wodwalayo adzakhala bwino.

Zisonyezo zoika kusanthula kwa mankhwalawa monga heestasiogram ndiye kupezeka kwa matenda otsatirawa mwa wodwala:

• matumbo
• sitiroko
• thromboembolism
• mtima thrombosisndi mitsempha ya varicose miyendo yotsika
• matenda ammbuyo mawonekedwe osakhazikika
• preeclampsia,
• yotupa njira pachimake siteji,
• hemorrhagic pathologies, mwachitsanzo, thrombocytopenia, hemophiliakapena matenda a Willebrand.

Kuphatikiza apo, kuwunika koteroko kuyenera kufotokozedwa kuti athe kudziwa kuchuluka kwa kuchuluka kwa magazi pakukonzekera zochitika, mwachitsanzo, gawo la cesarean, komanso panthawi yomwe ali ndi pakati kuti awone ngati ali ndi matenda a heestasis komanso asanafike pawokha kubala mwana. Pa khadi losinthanitsa la mayi aliyense wogwira ntchito, kuyezetsa magazi monga coagulogram kumangoyenera kupezeka.

Dongosolo la heestasis yamunthu

Popeza tazindikira kuti kusanthula uku ndi chiyani, ndikofunika kupenda mwatsatanetsatane lingaliro loti magazi. Mwina ndiyenera kuyamba ndi tanthauzo. Chifukwa chake, dongosolo la hemostasis la thupi la munthu ndilofunikira kwambiri kwachilengedwe, ntchito zazikulu zomwe zitha kuganiziridwa ndikusunga magawo akuluakulu a magazi, komanso kusiya magazi.

Thupi laumunthu siliri pachabe lotchedwa chilengedwe chonse ndikufanizira ndi makina ovuta. Ndipo dongosolo lotsogola limatha kukhala chitsanzo chabwino cha momwe anthu anapangidwira mwaluso. Magazi ndi chinthu chapadera chachilengedwe chomwe chimatha kugwira ntchito modabwitsa m'thupi lathu.

Sikuti imangoyenderera kokha kudzera m'matombo, komanso imawonongera anthu mitsempha ndi mitsempha m'moyo wake wonse chifukwa cha luso lakelo kuundana kwa magazi kapena ma wandiweyani wandiweyani, i.e. coagrate.

Pali magawo atatu ofunikira amachitidwe a heestasis yaumunthu:

• Maselo am'mimba endothelium (gawo lamkati lopangidwa ndi maselo lathyathyathya okhala ndi mitsempha ya magazi ndi mitsempha ya mtima), yomwe, pamene makoma amitsempha atang'ambika kapena kuvulala kwina kothekera kubisa zinthu zotere monga adama, thrombomodulin ndi nitric oxide. Nawonso, zimayambitsa mapangidwe a magazi.
• Mapulatifomu kapena mbale yamagazi, kuthekera kwina 'kumamatirana' wina ndi mnzake kuti apange choyambirira mapangidwe olowa.
• Zinthu za m'madzi a plasma (okwana 15 a plasma factor, most are michere) kupanga monga zotsatira za mankhwala CHITSITzomwe zimayenera kuti zithetse magazi.

Pofotokoza mwachidule zonse pamwambapa, titha kuyankha mosakayikira funso loti kuyezetsa magazi kwa hemostasis panthawi yapakati kumawoneka bwanji, pokonzekera opareshoni yomwe yakonzedwa kapena panthawi yodziwitsa. Kusanthula kumeneku kumapereka lingaliro la momwe magazi a wodwalayo amayambira bwino. Mwanjira ina, momwe madokotala amaletsera magazi kutulutsa magazi chikachitika.

Decoding magazi coagulogram

Kuyesedwa kwa magazi kwa coagulogram kumaphatikiza Zizindikiro zambiri zomwe muyenera kuziwerenga moyenera, i.e. mvetsetsa ndikusanthula, mwanjira ina, kuwongolera. Tsoka ilo, si dokotala aliyense yemwe ali ndi luso lotha kuzindikira ma hemostasiogram. Ndipo ndi katswiri wodziwa bwino kwambiri yekha amene amatha kumasulira molondola magawo ena a kuwunikaku.

Pambuyo pakuyesa mayeso a magazi a wodwalayo ndikupeza zotsatira zake, dotolo wothandizirapo amafananizira kupanga kwa coagulogram ndi chizolowezi chokhazikitsidwa kwa odwala achikulire, komanso ana. Ndikofunikira kukumbukira kuti kuchuluka kwa kusokonezeka kwa mwana, bambo kapena mayi wapakati ndi kosiyana kwambiri. Izi zimachitika, choyambirira, ku mawonekedwe a magwiridwe antchito aanthu opanga magulu amisinkhu yosiyanasiyana.

Zizindikiro za Coagulogram

Ganizirani magawo a kuyezetsa magazi m'magazi, mwachitsanzo, zofunikira za hemostasiogram. Kenako tikhala pa iliyonse mwatsatanetsatane, komanso tikambirana za coagulogram yowonjezera.

Ndikofunikira kudziwa kuti tebulo ili m'munsiyi likuwonetsa zosankha zingapo zodziwika bwino za magawo a heestasiogram monga nthawi ya magazi ndi nthawi ya magazi. Izi ndichifukwa chakutanthauzira kosiyanasiyana kwa zigawozi ndi akatswiri omwe akuchita nawo kafukufuku wawo.

• kuyambira mphindi 8 mpaka 12,
• kuyambira mphindi 5 mpaka 10.

• osapitilira mphindi 4
• kuyambira 2 mpaka 4 mphindi,
• osapitilira mphindi 8.

*International Unit (ME)kapena Yogwira Ntchito (UNIT), i.e. muyeso wa mlingo wa chinthu malinga ndi kwachilengedwe.

Nthawi yopanga magazi

Kuyeserera kwa magazi kwa wodwalayo kumapatsa dokotala lingaliro la nthawi yomwe thupi liyenera kupanga magazi. Palibe chidule pamwambapa. Pakufufuzako, zinthu zachilengedwe (magazi) zomwe zimatengedwa kuchokera kwa wodwala kuchokera mu mtsempha zimayikidwa mu chubu chosawoneka bwino ndi chowuma, ndipo pambuyo pake, nthawi imalembedwa ndipo amadikirira mpaka mawonekedwe owoneka a magazi.

Nthawi yakukhathamira kwa magazi ndikwabwinobwino, dokotala amatha kunena kuti njira ya hemostasis imagwira ntchito molondola, komanso kupatula zochitika zina, mwachitsanzo, hemophilia kapena DICMomwe magazi samapangidwira konse. Pakakhala kupatuka pa nthawi yabwinobwino yamagazi (kuchuluka kapena kuchepa kwa zizindikiro), munthu ayenera kumvetsetsa zifukwa zake.

Mwachitsanzo, nthawi yayitali kukhetsa magazi imatha kuchitika hemophilia, lupus erythematosus kapena nyamakazikomanso peritonitiswodwala matenda a chiwindiat chibayo ndi kukhalapo kwa chotupa choyipa.Nthawi yofupikitsa magazi ikhoza kukhala chizindikiro cha kukula anaphylactic kapena hemorrhagic manthakomanso myxedema.

Kuphatikiza apo, zisonyezo zonse za coagulogram, kuphatikiza ndi izi, zimatha kupatuka pazomwe zimachitika nthawi yapakati. Monga lamulo, azimayi amaphunzira kaye mayina azotsatira zoyeseza magazi pakubala, akafunsidwa kuti apereke mayeso ambiri a labotale kuti ayang'anire ndikusintha mwachangu mkhalidwe waumoyo wa mayi ndi mwana wosabadwa.

Zosintha zomwe zimachitika mwachangu mthupi la mayi wapakati sizidutsa popanda kutsatira katundu, komanso machitidwe a magazi. Ndizofunikira kudziwa kuti pang'onopang'ono kuchepa kwapang'onopang'ono nthawi yanthawi yoyambira kuyambira pa trimester yoyamba, ndipo kachitatu chidziwitso ichi chikhoza kukhala chosiyana kwambiri ndi chizolowezi. Komabe, musachite mantha, chifukwa awa ndi amodzi mwa njira zoteteza zomwe zimathandiza kukonzekeretsa thupi la mkazi kuti abereke mwana ndikuchepetsa kutaya magazi.

Kupuma nthawi

Malinga ndi malamulowo, kutalika kwa magazi sikuyenera kukhala kochepera kapena kupitirira mphindi zochepa kuchokera pakubadwa, kotchedwa heestasis yapamwamba. Kuti mutsirize njirayi, i.e. Kupanga kwa magazi kumayenera kutenga pafupifupi mphindi 10. Nthawi yowundana ndi chizindikiro chofunikira kwambiri, chomwe chimagwira gawo lalikulu pakukonzekera wodwalayo kuti achitidwe opareshoni, mwachitsanzo, akamachita gawo la cesarean.

Kuchuluka kwa magazi mwa akazi sikusiyana ndi miyezo yomwe imakhazikitsidwa kwa akuluakulu. Kuchulukitsa kwa ana kumadalira msinkhu wa mwana. Pafupifupi, kutalika kwa magazi hakuyenera kupitirira mphindi 2-4, ndipo magazi amayamba kupanga mkati mwa mphindi 2-5.

Nthawi yodulira ikhoza kuchuluka ndi:

• hemophilia,
• thrombocytopenia, i.e. chifukwa chosowa magazi m'matumbo,
• hemorrhagic fevermwachitsanzo, liti Ebole kapena Crimea-Congo,
• kuwonongeka kwa chiwindi mowa (kuledzera),
• thrombocytopathy
• bongo wa mankhwala osokoneza bongo.

Momwe mungayesere kuyesa kwa magazi?

Kuti dokotalayo alandire zidziwitso zosasinthika atapanga mayeso a labotale, munthu ayenera kuyandikira popereka mayesero aliwonse, kuphatikiza magazi. Zachilengedwe zimaperekedwa m'mawa, nthawi zonse pamimba yopanda kanthu. Tiyenera kukumbukira kuti osachepera 8, ndipo makamaka maola 12, ayenera kutha kuchokera nthawi yomaliza.

Kuphatikiza apo, ndikofunika kupewa kumwa zakumwa zoledzeretsa komanso mankhwala patsiku lomaliza phunzirolo, chifukwa izi zingakhudze zotsatira za kusanthula. Wodwala akakakamizidwa kumwa mankhwala aliwonse, sayenera kuiwala kudziwitsa akatswiri za zamankhwala za izi.

Ngati mtengo watsitsidwa

Kuchuluka kwa fibrinogen sikutanthauza chilichonse chabwino; kuchuluka kwake mu madzi am'magazi kumatsika kwa anthu ambiri, makamaka, matenda akulu:

• Kuchepa ndi kusakhalapo kwa chinthu choyambirira chifukwa cha kubadwa kwa chibadwa (hypo- and afibrinogenemia), komanso kuchepa komwe kumachitika chifukwa cha zovuta zina mu hepatatic system (hypo-, dis-, afibrinogenemia, kumwa coagulopathy),
• DIC-syndrome (yomwazikana intravascular coagulation) m'njira zosiyanasiyana,
• Momwe magazi atayika,
• Obstetric pathology (gestosis, kubereka mwachangu komanso kovuta, gawo la cesarean),
• Kulephera kwa chiwindi (pachimake komanso chovuta), zotupa zina zazikulu zamaselo a chiwindi parenchyma (pambuyo pa zonse, maselo a chiwindi okha ndi omwe amapanga mapuloteni awa),
• Zowonongeka kwa hepatocytes ndi zinthu zina zotchedwa hepatotropic poisons. Izi zitha kukhala poyizoni mwangozi ndi toadstool kapena kugwiritsa ntchito mankhwala ena (maantibayotiki, anabolic steroids) mwamankhwala.
• Thrombolysis (kusungunuka kwa thrombus kotchinga magazi ofunikira ndikubwezeretsa kutuluka kwa magazi m'dera lomwe lakhudzidwa ndikugwiritsa ntchito mankhwala apadera a thrombolytic pharmacological),
• Bacteria matenda a meningitis (meningococcus)
• Prostate khansa mu gawo la metastasis,
• Mafupa a m'mafupa (zotupa zam'mafupa),
• Kuchiza ndi katsitsumzukwa (L-asparaginase - enzyme yomwe imathandizira kugawanika kwa katsitsumzukwa ndikuthandizira kuchepetsa mulingo wake mu maselo a chotupa a m'magazi, L-asparaginase imagwiritsidwa ntchito limodzi ndi mankhwala ena mankhwalawa a lymphoblastic leukemia ndi non-Hodgkin's lymphoma),
• Hemoblastosis (myelo native leukemia, polycythemia),
• Kuperewera kwa vitamini B12 ndi ascorbic acid mthupi,
• Kugwiritsa ntchito ma androgens, maantibayotiki ena, ma anabolics, barbiturates (phenobarbital), mafuta a nsomba.

Monga momwe zilili ndi michere yambiri ya fibrinogen, osati ya zonse zomwe zili pamwambapa, kuwunika kofunikira kumabweretsa gawo lina lapadera, chifukwa si glycoprotein iyiyomwe imayambitsa matenda omwe ali pamwambapa, koma "kung'amba" m'thupi chifukwa cha matenda kumayambitsa dongosolo hemostasis komanso kuchuluka kwa mapuloteni ena amasiyanasiyana. Chifukwa chake, sizokayikitsa kuti pakudziwidwa ndi bacterious meningitis kapena khansa ya prostate, kuyesedwa kwa labotale kudzayikidwa koyamba. Komabe, mikhalidwe iyi imatha kupotoza zotsatira komwe kusanthula kwa fibrinogen ndikofunikira. Ndipo izi zikuyenera kuganiziridwa.

Kufunika kwa fibrinogen mu diagnostics a labotale ndi mawonekedwe a kuwunika

Choyamba, kuwunika kwa fibrinogen kumagwiritsidwa ntchito ngati chisonyezero cha dongosolo la hemostatic (monga chinthu chosagwirizana) komanso kutupa (ngati puloteni yovuta kwambiri) - Ichi ndiye cholinga chake chachikulu.

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

Tanthauzo la fibrinogen limaphatikizidwa ndi mayeso odziwika bwino amtundu wa biochemical monga coagulogram (hemostasiogram), omwe, kuphatikiza FI, akuphatikiza zizindikiro zingapo (APTT, PTV, PTI, INR). Mwanjira yazotsatira za coagulogram, Factor I ili pansi pa nambala yoyamba, ndiye kuti, titha kunena kuti idayikidwa pamalo apamwamba. Palibe mimba imodzi yomwe ili yokwanira popanda kusanthula uku (kaya ndiyabwino kapena yachilendo), ndipo pafupifupi sikumachitika popanda kupangika kwa coagulogram (ndi fibrinogen mmenemu), kuzindikira kwa matenda amtima omwe amaphatikizidwa ndi chiopsezo cha thrombosis, stroko, ndi mtima.

Sipangakhale zoletsa zilizonse pazakudya ndi kaonedwe musanaunike, komabe, kugwiritsa ntchito mankhwala ena omwe amakhudza kuphatikizana kwa magazi kuyenera kuyimitsidwa.

Sokerani pazotsatira kuti muwonjezere "kupambana":

• Heparin
• Kulera kwamlomo
• Estrogen.

Kuphatikiza apo, tisaiwale kuti kuchuluka kwa fibrinogen pang'onopang'ono kumakwera pang'onopang'ono ndi nthawi yachitatu ya mimba, komanso kumadzuka pambuyo pazinthu zingapo zopangira opaleshoni zomwe zimapangitsa kuti njira yopangika iyambike.

Zinthu zina zomwe zimagwiritsidwa ntchito ngati mankhwala zimatha kuchepetsa zofunikira za chinthu choyamba:

1. Kuzungulira kwa heparin,
2. Maanabolic steroids,
3. Androgens
4. Valproic acid
5. Mafuta a nsomba
6. Asparaginase.

Kukhalapo kapena kusapezeka kwa fibrinogen m'magazi omwe atengedwa mu chubu choyesera kumasiyanitsa plasma ndi seramu. Seramu ya mapuloteni iyi imatha, idalowa mu mawonekedwe a polymer ya fibrin. Pankhaniyi, zinthu zowerengera za fibrinogen m'magazi ziyenera kusankhidwa kokha ndi zoteteza (sodium citrate), apo ayi chinthu choyamba, chitadutsa gawo loyambika, ndikupanga mafayilo osakwanira ndipo kuwunikira sikungatheke.

Kodi chimapangitsa magazi kunenepa?

Hypercoagulation ya magazi nthawi zambiri siyenderana ndi mapangidwe magazi m'magazi amitsempha.Ngakhale kuti kuyezetsa matenda a labotale kungawonetsetse kuti wodwalayo akuchulukirachulukira, sayenera kuchita mantha komanso kumwa mankhwala osokoneza bongo mosaganizira. Ngati magazi amapangika mwa iye, mawonekedwe ake Amasulidwa, chifukwa chake adzakhala Wosasunthika.

Zomwe zimayambitsa hypercoagulation zimatha kukhala zosiyanasiyana. Mwa odwala ena, mavuto a magazi amakula chifukwa cha khansa. Mwa anthu ena, cholowa chimayambitsa matenda opatsirana. Ndikofunikanso kudziwa zotsatirazi zomwe zingasinthe kapangidwe ka magazi:

• kuvulala kwamitsempha, kuphatikizapo atherosulinosis,
• thrombophilia (hemato native),
• kunenepa kwambiri (gawo lililonse la kunenepa kwambiri),
• kumangokhala
• zizolowezi zoipa
• erythremia, hemangioma kapena antiphospholipid syndrome,
• opaleshoni yamtima, pomwe adapangira valavu yokumba,
• matenda a autoimmune
• mimba kapena njira zakulera, ndi zina.

Momwe mungadziwire matenda?

Zovuta zakuzindikira kuti matendawa ali munjira yoti Hypercoagulation ilibe chithunzi chotchulidwa. Odwala ena omwe ali ndi vutoli amadandaula za ulesi, kufooka kwakukulu, kupweteka m'mutu. Kuti muzindikire matendawa, ndikofunikira kupita kukayezetsa labotale, komwe kumakhala kusakanikirana kwa magazi a venous. Wothandizira labotalo azindikira mwachangu kuti zinthu zakuthupi zomwe zimatengedwa kwa wodwalayo zili ndi zizindikiro za kuchepa kwa magazi, chifukwa magazi adzatseka nthawi yomweyo mu singano.

Coagulogram imapangitsa kukhala kosavuta kuzindikira hypercoagulable syndrome, chifukwa panthawi yoyesedwa zasayansi, kusintha kwa zizindikiro zotsatirazi kudzapezeka:

Hypercoagulation Chithandizo

Odwala omwe apezeka ndi matendawa sayenera kudzimva okha, chifukwa izi zimabweretsa zotsatira zosasangalatsa. Afunika kulumikizana ndi achipatala komwe thandizo lingaperekedwe. Akatswiri ogwiritsa ntchito mawonekedwe osachepera amasankha chithandizo cha odwala oterewa payekhapayekha, poganizira mawonekedwe onse a matupi awo.

Nthawi zambiri, madokotala amakupangira mankhwala (mwachitsanzo, mankhwala apadera a Thrombo ACC omwe amapangidwa pamaziko a aspirin) omwe amapanga maselo othandiza kuphatikiza ndi maphikidwe a mankhwala achikhalidwe. Chitsanzo ndi meadowsweet. Kuchokera pachomera ichi, sikuti ma tinctures okha amapangidwa, komanso kukonzekera kosiyanasiyana. Zida zake zapadera zimatha kukhala cholowa m'malo mwa aspirin. Madokotala ambiri amatenga mankhwala opatsirana kudzera m'magazi a mtima ndi magazi.

Ngati wodwala apakati ayenera kuthandizidwa, ndiye akatswiri amasankha maphunziro a mankhwalawa mosamala kwambiri. Nthawi zambiri, gulu lotere la odwala limalembedwa kuti heparins (ochepa maselo kulemera). Mankhwala a hypercoagulation, mutha kumwa mankhwala otsatirawa (mukakambirana ndi adokotala):

• Aspirin
• Pentoxifylline
• Curantin
• Clopidogrel.

Pochiza odwala omwe, kuphatikiza ndi matenda, matenda ena, madokotala amapereka Warfarin kapena Sinkumar (ndi anticoagulants). Mlanduwo ukamakopeka ndi magazi ambiri, magazi operekedwa amawathira magazi. Colloidal kapena mchere wa saline amathanso kuloledwa.

Kuti mankhwalawa abweretse zotsatira zomwe akufunazo, odwala ayenera kutsatira malangizo onse a adokotala ndikutsatira malangizo otsatirawa:

• khalani ndi moyo wathanzi
• lekani zizolowezi zoyipa (mwachitsanzo, kusuta, kumathandizira kukulitsa kukopa,
• idyani pomwe
• osatengera mphamvu zolimbitsa thupi,
• kukhala nthawi yochulukirapo panja, etc.

Kodi ndiyenera kutsatira zakudya zamagulu ogwiritsira ntchito magazi?

Kwa odwala omwe adapezeka kuti ali ndi hypercoagulable syndrome pansi pa ma labotale, madokotala amalimbikitsa mwamphamvu kuti, kuwonjezera pamankhwala osokoneza bongo, kuunikanso zakudya zawo. Ndikofunikira kupatula zinthu izi:

• chakudya chilichonse zamzitini
• ankasuta nyama
• zakudya zamafuta ndi zokazinga,
• marinade
• maswiti
• ufa
• bulwheat
• nthochi
• mbatata
• chakudya chokometsera komanso chamchere kwambiri
• mowa
• zakumwa zoziziritsa kukhosi, etc.

Tikulimbikitsidwa kuti tiwonjezere zinthu za mkaka wowawasa (wokhala ndi mafuta ochepa), zipatso, ndiwo zamasamba, koko, chokoleti chakuda, adyo, muzu wa ginger, mandimu, artichok, ndi zina.

Odwala omwe hypercoagulation inayamba chifukwa chosakhala bwino kapena amangokhala, ayenera kulabadira thanzi lawo. Izi ndichifukwa choti gulu ili la odwala lili pachiwopsezo chachikulu chodwala.

Hypercoagulation ndi Mimba

Pa nthawi ya pakati, magazi amatuluka mosavuta chifukwa cha zinthu zina, nthawi zina popanda gawo la thupi la mayi kapena moyo wake.

• impso, matenda a chiwindi,
• mavuto ndi mtima
• kusintha maselo
• mavuto, kukhumudwa, matenda amanjenje,
• Ukalamba (mavuto nthawi zambiri amapezeka mwa amayi omwe ali ndi zaka zopitilira 40), etc.

Kupatula zosakhumudwitsa, mayi aliyense woyembekezera ayenera kuwongolera heestasis. Kuti izi zitheke, ndikokwanira kutenga coagulogram kamodzi pamwezi (ngati matendowo atsimikiziridwa, ndiye kuti kuwunikirako kuyenera kutengedwa kamodzi pakatha masabata awiri) kuti magazi awoneke. Ngati ma pathologies aliwonse apezeka, odwala oterowo amasankhidwa ndi mankhwala otetezeka omwe sangavulaze mwana wosabadwayo. Kukhala moyang'aniridwa ndi madokotala omwe akupita kukamwa komanso kumwa mankhwalawa, azimayi oyembekezera amatha kupulumuka nthawi yovutayi ndikubereka ana athanzi.

Zoyambitsa Atherosulinosis

Matenda amtima ndiwachiwiri kwambiri omwe amafa ku Russia pambuyo pa oncology. Atherosulinosis ndi imodzi mwazinthu zovuta kwambiri za mtima ndi mtsempha wamagazi. Awa ndi matenda omwe kusintha kosasintha m'mitsempha yayikulu kumachitika chifukwa cha kuchuluka kwa cholesterol mwa iwo. Kuchokera pamenepa, zonunkhira za m'madzi zija zimachepera, zimakhala zopanda pake. Zotsatira zake, pali zizindikiro za matenda a mtima, matenda a ischemic, momwe ubongo umavutikira. Poyerekeza ndi matendawo, zotupa za m'munsi zimatha. Kuzindikira kwa atherosulinosis kumaphatikizapo kudziwa mulingo wa lipids m'magazi, ma X-ray ndi mayeso a ultrasound a mitsempha yamagazi ndi ultrasound ya mtima. Chithandizo cha matenda a zamitsempha zimachitika mu zamankhwala, opaleshoni komanso mothandizidwa ndi zakudya zapadera.

Zomwe zimayambitsa atherosulinosis ndikuphwanya lipid(i.e. mafuta) ndi kagayidwe kazakudya m'makoma amitsempha yamagazi, chifukwa cha momwe mitsempha imakhudzidwira. Zolemba za cholesterol zimawoneka, zomwe zimaphatikizapo cholesterol, mafuta ochepa osalimba komanso calcium. Unyinji umapangidwa m'malo owonongeka ndi mitsempha yamagazi. Chopangiracho sichikula, chocheperako chimalembetsa. Pamalo pomwe chiwiya chidawonongeka, magazi amayamba. Imatseka gawo lopapatiza la m'magazi. Choopsa chachikulu cha thrombosis ndikuti kachidutswa kake kamatha kuchoka ndikuletsa magazi a ziwalo zopatsa mpweya. Izi zimawatsogolera kuti afe.

Pali zinthu zingapo zomwe zimayambitsa chitukuko cha atherosulinosis:

• cholowa
• zizolowezi zoipa
• kumangokhala
• kagayidwe kachakudya
• matenda ashuga
• kunenepa
• matenda oopsa
• kuperewera kwa zakudya m'thupi
• zaka 45
• amuna amuna (nthawi zambiri kuposa azimayi amakhala pachiwopsezo chotenga matenda)
• matenda a chithokomiro.

Ngati munthu akuphatikizidwa pazinthu ziwiri zomwe zili pachiwopsezo, amafunika kumuwunika chaka ndi chaka ndi mtima wamankhwala. Mwa izi, mawunikidwe otsatirawa ndi njira zofufuzira zitha kuyikidwa: kuyesa magazi ndi mkodzo kokwanira, kuyesa kwa magazi ndi zamkati, coagulogram, magazi a cholesterol ndi mahomoni a chithokomiro, ultrasound yamtima ndi mitsempha yamagazi, chifuwa cha x-ray, komanso dopplerography ndi angiography.

Zizindikiro za atherosulinosis

Atherosulinosis imayamba osati mu ziwiya za mtima, komanso ziwalo zina. Zizindikiro za matendawa zimadalira malo omwe zotupa zam'magazi zimayambira.

1. Mu coronary atherosulinosis, i.e. kuwonongeka kwamitsempha yamtima ndi cholesterol malo, zizindikirika izi:

• kupweteka m'mbali ya kumanzere kwa chifuwa, kufikira kumanzere, phewa, phewa,
• kufooka miyendo, kuzizira,
• kupweteka pakhungu,
• kusokonezeka kwa mtima
• pre-syncope.

1. Ndi atherosulinosis ya msempha, mtsempha waukulu wamitsempha, ziwonetsero zotsatirazi zamankhwala zimawonedwa:

• kuthamanga kwa magazi
• kumverera koyaka mu chifuwa
• chizungulire
• kukhalapo kwa wen, makamaka pankhope,
• kukalamba msanga.

1. Ndi atherosulinosis yam'mimba, i.e. ndi kuwonongeka kwa msempha mu peritoneum:

• chisangalalo
• kulephera kwa aimpso
• phokoso mokhumudwa
• kupweteka kwambiri pamimba.

1. Ndi atherosulinosis ya m'munsi malekezero, zizindikiro zimachitika:

• chikopa pakhungu loyambira
• kumverera kosalekeza kwamiyendo m'miyendo.

1. Ndi matenda a ubongo a ziwongo

• kupweteka mutu komanso chizungulire,
• tinnitus
• kutopa,
• kuthamanga kwa magazi
• mavuto amakumbukiro
• kupuma movutikira.

Njira zamakono zodziwikitsira matenda a atherosulinosis

Pamodzi ndi kuyesedwa kwa magazi a lipid ndi biochemical, komwe kwakhala kukugwiritsidwa ntchito pozindikira atherosclerosis kuyambira pakati pa zaka zana zapitazi, pali njira zina zophunzitsira, kuphatikiza za zasayansi. Izi zikuphatikiza:

1. X-ray kusiyanitsa angiography.
2. Ultrasound yamitsempha yamagazi.
3. Njira ya Angiography ya Makompyuta
4. MRI ya zombo zapamimba.
5. Electron mtengo Tomography.

Ndikofunikira kuganizira mwatsatanetsatane mawonekedwe amtundu uliwonse.

Kusanthula kwa magazi ndi mkodzo ndi atherosulinosis

Kuyesedwa kwa magazi kofotokozedwa ndi adotolo kuti adziwe kuchuluka kwa erythrocyte sedimentation rate (ESR), hemoglobin, zomwe zili m'maselo ofiira a m'magazi, maselo oyera am'magazi ndi mapulateleti. Magazi amachotsedwa chala m'mawa, musanayesedwe, muyenera kupewa kudya ola limodzi.

ESR yowonjezereka ikhoza kuwonetsa kukhalapo kwa atherosulinosis. Chifukwa chake kwa amuna, nthawi zambiri 1-10 mm / h, kwa akazi - 2-15 mm / h. Chizindikiro chomwe chiri kunja kwa mtundu wabwinobwino kwambiri chikuwonetsa kukhalapo kwa zotupa m'mthupi.

Zotsatira za kafukufukuyu zakonzedwa pasanathe maola awiri ndi atatu.

Urinalysis

General urinalysis ikhoza kuwonetsa ma pathologies a ziwalo zosiyanasiyana. Ndi atherosclerosis, gawo lothandiza kwambiri LDH ndilactate dehydrogenase ndi mankhwala a glucose metabolism. Chizindikiro ichi mu mkodzo chimatha kudziwa kuti khungu lilibe mpweya. Kuchita koteroko kumachitika ndi kuwonongedwa kwa myocardium. Ngati mulingo wadutsa, izi zikuwonetsa ischemia kapena myocardial infarction.

Kukonzekera kwapadera kwa urinalysis sikofunikira, kupatula chimbudzi chokwanira cha ziwalo zakunja. Zotsatira za phunziroli zakonzedwa patatha maola ochepa.

Mapazi amwazi

Chomwe chimawonetsera kwambiri pakupezeka kwa atherosermosis ndi kuphatikiza kwa magazi, komwe kumakupatsani mwayi wodziwa magazi. Kafukufukuyu amatchedwa mbiri ya lipid ndipo ali ndi zofunikira zingapo:

• cholesterol yathunthu
• triglycerides
• HDL (lipoproteins highens) - otchedwa "cholesterol wathanzi"
• LDL (lipoproteins low) - - otchedwa "cholesterol yoyipa."

Kutanthauzira kwa zotsatira: zikhalidwe za zisonyezo zonse siziyenera kupitirira 5.9 - 6.5 mmol / l, pomwe kwa akazi siziyenera kuchepera - mpaka 5.2 mmol / l. Ngati phunziroli lidawonetsa kupitirira mpaka 7.9 mmol / l, ziwerengero zotere sizomwe zimakhala zikhalidwe, koma zikuwonetsa kuchuluka kwa mafuta ndi mbale zosuta mu chakudya cha wodwalayo. Manambalawa atha kubwezeretsedwa ngati mukutsatira zakudya.

HDL yachilendo - 08 - 2.2 mmol / l, ndi LDL - mpaka 3.5. Pankhaniyi, cholesterol yathunthu sayenera kupitirira 8 mmol / l, apo ayi izi zikuwonetsa kukula kwa matenda a mtima.

Chosangalatsa kwambiri pakuwunika kumeneku ndi magazi am'kati. Mutha kupeza zotsatira zake mkati mwa maola awiri.

Kusanthula uku kumafunikira kukonzekera kwapadera: ziyenera kutengedwa mosamalitsa pamimba yopanda kanthu! Maola 10 musanapereke magazi, simuyenera kumwa chakudya chilichonse, zakumwa zakumwa musanamwe madzi. Nthawi yomweyo, kulimbitsa thupi kwambiri kuyenera kusiyidwa kwa masiku 3-4 osasintha zakudya panthawiyi!

Serum Lipoprotein Electrophoresis

Kuyesedwa kwa magazi uku ndikofunikira pakuwunika kwa atherosclerosis chifukwa chakuti imalola kudziwa udindo wa magazi lipoprotein pakukula kwa matendawa. Magazi a lipoprotein ndi ma mamolekyulu omwe amayenda ndi mafuta (lipids) m'madzi am'magazi.

Ndi atherosclerosis, pali kuwonjezeka kwa LDL ndi kuchepa kwa HDL, zomwe zimakhazikika zomwe tidakambirana pamwambapa.

Kusanthula uku kumachitika pa zida zapadera - mapuloteni a seramu amasankhidwa kukhala tizigawo ndimagetsi amagetsi. Kukonzekera kusanthula sikofunikira. Mlandu wamagazi amatengedwa chifukwa cha iye.

Kutsimikiza kwa protein-apo-B mu seramu yamagazi

Apo-B-protein ya magazi ndi chizindikiro cha atherosulinosis wodwala. Ntchito yake ndikusamutsa triglycerides kuchokera m'matumbo kupita ku maselo amafuta. B-lipoproteins amathandizira kulowetsedwa kwa cholesterol m'makoma a chotengera. Ngati yatukulidwa, monga chizindikiro cha LDL, izi zikuwonetsa chiopsezo chachikulu chokhala ndi myocardial infarction. Nthawi zambiri, chizindikiro ichi mwa amuna ndi 60-138 mg / dl, mwa akazi - 52-129.

Asanabadwe, maola 8-10 musanawunike, simungathe kudya, zakumwa. Zotsatira za kafukufukuyu zitha kuwonedwa patangopita maola ochepa.

Immunological njira kutsimikiza lipoproteins m'magazi

Lipoprotein A amapangidwa m'chiwindi. Amakhala ndi mapuloteni komanso mafuta. Ntchito yake yayikulu ndikuyendetsa mafuta m'thupi. Amasiyana ndi LDL pokhapokha mapuloteni okwera.

Ngati zomwe zili mwa abambo ndi akazi ndizoposa 30 mg / dl, wodwalayo ali pachiwopsezo chachikulu chotenga myocardial infarction ndi ischemia.

Monga phunziroli, magazi a venous amagwiritsidwa ntchito. Zotsatira zake zakonzedwa maola ochepa.

Enzyme immunoassay

Enzyme immunoassay imakupatsani mwayi wofufuza kuti athe kukhala ndi matenda amtima wabwino mwa anthu. Kafukufukuyu adakhazikitsidwa motengera "antigen-antibody" - izi ndi zomwe zimachitika momwe yankho la chitetezo (antibody) limayamba pomwe chinthu china chakunja (antigen) chilowa m'thupi. Ndi kuchuluka ndi kuchuluka kwa ma antibodies, kupezeka kwa kutupa kumaweruzidwa. Zotsatira zake, kupezeka kwa ma antibodies ku myocardium ndi cardiomyosin kumawonetsedwa, zomwe zikuwonetsa kukhalapo kwa matenda.

Mwa zabwino za njirayi ndikulondola kwambiri, chovuta ndikuti kupenda kusanachitike, adotolo ayenera kulingalira kuti ndi ma antigen omwe adayambitsa zomwe zimachitika mthupi.

Monga kwachilengedwe, magazi a venous amagwiritsidwa ntchito, omwe amayeretsedwa ndi ma reagents apadera. Kusanthula kumaperekedwa pamimba yopanda kanthu. Zotsatira zake zakonzedwa mkati mwa masiku awiri ndi atatu.

Cheke cha Coagulogram

M'matenda a mtima ndi mitsempha yamagazi, coagulogram imagwiritsidwa ntchito ngati njira yodziwira matenda, yomwe imawonetsa momwe njira zopangira magazi ndikupangidwira magazi zimayambira. Zizindikiro zingapo zakhudzidwa motere, zomwe zili zenizeni zomwe ndizotsatirazi:

• prothrombin nthawi - 11-16 masekondi,
• Mapuloteni a fibrinogen - 2-4 g / l,
• nthawi ya thrombin - masekondi 11-18.

Kutsika kwa thrombin ndi prothrombin nthawi kumawonetsa chizolowezi cha hypercoagulation, i.e. inapita patsogolo njira ya coagulation komanso chizolowezi cha thrombosis. Zotsatira zake ndi khalidwe la atherosulinosis.

Kukonzekera kusanthula kumaphatikizapo kukana chakudya ndi zakumwa (kupatula madzi) kwa maola 12. Pakadutsa masiku 3-4, ndikofunikira kupewa kumwa mankhwala onse, komanso kulimbitsa thupi kwambiri komanso kupsinjika, ngati zingatheke. Katswiri wa labu amatenga magazi kuchokera mu mtsempha popanda thandizo la alendo. Kusanthula kwakonzedwa mkati mwa maola 1-2.

Pang'ono pang'ono pazokhudza magazi

Magazi ndi madzi apadera omwe samatha kungoyendayenda kudzera m'matumbo, komanso amapanga magulu owuma (magazi kuwundana). Khalidweli limamupangitsa kuti atseke mipata yamagetsi yapakati komanso yaying'ono, ndipo nthawi zina imakhudza kwambiri anthu. Kusungidwa kwamadzi amadzimadzi ndi kuwundana kwa magazi kumayendetsedwa ndi kayendetsedwe ka heestatic. Dongosolo la coagulation kapena hemostasis dongosolo lili ndi zinthu zitatu:

• maselo am'mitsempha, makamaka makulidwe amkati (endothelium) - khoma la chotengera likaonongeka kapena kupindika, zinthu zingapo zomwe zimagwira ntchito (nitric oxide, prostacyclin, thrombomodulin) zimamasulidwa maselo a endothelial, omwe amayambitsa maselo a thrombosis,
• mapulateleti ndimitsempha yamagazi yomwe imathamangira pamalo owonongeka. Amamatirana ndikuyesera kutseka bala (kupanga pulawo yayikulu yokhotakhota). Ngati mapulateleti sangathetse magazi, zotulutsa za plasma zimayatsidwa,
• zinthu za plasma - zinthu 15 zimalowa mu hemostasis dongosolo (zambiri ndi ma enzymes), omwe, chifukwa cha kusintha kambiri kwamankhwala, amapanga mawonekedwe owonda a fibrin omwe pamapeto pake amasiya kutuluka magazi.

Chimodzi mwa zinthu zophatikizika ndichakuti pafupifupi onsewa amapangidwa m'chiwindi ndi gawo la Vitamini K. Human hemostasis imawongoleredwanso ndi machitidwe a anticoagulant ndi fibrinolytic. Ntchito yawo yayikulu ndikupewa kuwonongeka kwa mano.

Chizindikiro chokhazikitsidwa ndi heestasiogram

• Kawunikidwe pafupipafupi.
• kuyeserera asanachitike opaleshoni,
• kubadwa pawokha kapena gawo la cesarean,
• matenda oopsa
• kuwunikira mankhwala osagwirizana ndi anticoagulants (aspirin, warfarin, trental), kukonzekera kwa heparin (clexane, fraxiparin),
• matenda a hemorrhagic pathologies (hemophilia, thrombocytopathy ndi thrombocytopenia, von Willebrant matenda),
• mitsempha ya varicose yam'munsi yam'munsi (onani chithandizo cha mitsempha ya varicose kunyumba),
• pachiwopsezo chachikulu cha thrombosis (atria fibrillation, matenda a mtima),
• tanthauzo la DIC
• kutenga njira zakulera za pakamwa, glucocorticosteroids, anabolics,
• matenda a chiwindi (cirrhosis),
• pachimake zotupa mu thupi,
• matenda osiyanasiyana thromboses - ziwiya am'munsi malekezero, matumbo, ischemic sitiroko, pulmonary thromboembolism.

Momwe mungakonzekerere coagulogram?

• Zomwe zimadyedwa pamimba yopanda kanthu, ndikofunikira kuti chakudya cham'mbuyomu chinali zaka 12 zapitazo,
• Madzulo tikulimbikitsidwa kuti tisamadye zonunkhira, mafuta, zakudya zosuta, mowa,
• ndizoletsedwa kusuta musanatenge zinthu,
• Ndikofunika kuti musamamwe ma anticoagulants mwachindunji komanso osawonekera, chifukwa kupezeka kwawo m'mwazi kumatha kupotoza zophatikizira za coagulogram,
• ngati kumwa mankhwalawa ndikofunikira kwa wodwalayo, ndikofunikira kuchenjeza dokotala wothandizira yemwe akuwunika kusantaku.

Kodi kuyezetsa magazi m'magazi?

• Zinthu zimatengedwa ndi syringe wosalala kapena dongosolo la magazi a Vacutainer,
• kuyezetsa magazi kuyenera kuchitidwa ndi singano yovomerezeka popanda kugwiritsa ntchito alendo,
• Mitsempha yam'mimbayo iyenera kukhala ya atraumatic, apo ayi, minofu yambiri ya thromboplastin imalowa mu chubu, chomwe chimapangitsa zotsatira zake,
• wogwira ntchito mu labotolo amadzaza machubu awiri ndi zinthu, pomwe wachiwiri ndiomwe umatumizidwa kuti ukawerengedwa.
• chubu iyenera kukhala ndi coagulant yapadera (sodium citrate).

Kodi ndingapeze kuti kusanthula?

Phunziroli litha kuchitidwa ku chipatala chawekha kapena chapagulu kapena labotale yomwe ili ndi zofunikira. A heestasiogram ndi zovuta kuyeserera kuti ichite ndipo imafuna kuyenerera kokwanira kwa madokotala ogwira ntchito. Mtengo wa mayeso umasiyanasiyana kuchokera ku ruble 1000 mpaka 3000, mtengo umatengera kuchuluka kwa zinthu zomwe zatsimikiziridwa.

Prothrombin nthawi

Prothrombin nthawi ndi chiyani? Ichi ndi chimodzi mwazizindikiro zazikulu zasayansi za coagulogram ogwiritsidwa ntchito ndi madokotala kuyerekeza dongosolo lama hepatatic la thupi lathunthu, komanso kudziwa mphamvu ya mankhwala omwe amalepheretsa magazi kuwundana.

PV ikuwonetsa gawo la 1 ndi lachiwiri la kuphatikizika kwa plasma. Mwanjira ina, kupanga kwa thrombin kuvala magazi ndi kuwonjezera kwa thromboplastins ndi calcium. Pa gawo ili, mawonekedwe achidule a PV nthawi zina amavomerezedwa. Magazi othandizira magazi monga chiwembu cha mayiko wamba (INR)ndi prothrombin index (PTI) zimachokera ku prothrombin nthawi, kuchuluka kwake komwe kumasiyanasiyana kutengera zaka komanso jenda ya wodwala.

Mwachitsanzo, kuchuluka kwa nthawi ya thrombin mwa akazi ndi amuna ndi masekondi 11 mpaka 15. Kwa ana, miyezo imakhazikitsidwa kutengera zaka zawo. Mwachitsanzo, kwa akhanda - masekondi 13-17 kapena masekondi 14-19 kwa ana asanakwane. Kwa mwana wamkulu (kuyambira zaka 10), chizolowezi chimakhala masekondi 12-16, komanso chocheperako - 13-16 masekondi.

Nthawi ya thrombin yoposa yachilendo - zikutanthauza chiyani? Kupatuka kuzisonyezo zokhazikitsidwa ndi gawo ili la coagulogram zitha kutanthauza izi:

• kuipa vitamini K mthupi
• ndende yochepa kapena kusowa kwa zomwe zikuchitika 1,2,5,7, komanso 10,
• Kusokoneza magwiridwe antchito a chiwindi, kulephera kwa chiwindi kapena matenda ena aliwonse
• kupezeka DIC.

Nthawi ya Prothrombin kuchuluka, izi zikutanthauza chiyani? Monga lamulo, chiwonetsero chowonjezera cha PV chimagwirizanitsidwa ndi wodwala yemwe amamwa mankhwala a gulu la anticoagulants, i.e. mankhwala okhala ndi anticoagulant katundu, mwachitsanzo Heparin, Coumadinilin kapena Warfarin.

Angiography yamitsempha yamagazi

Njira imeneyi imatchulidwanso kuti kusiyanasiyana kwa x-ray. Amagwiritsidwa ntchito kuyerekeza momwe ziwiya zam'mtima, ubongo, zam'munsi zimayambira. Kuti muchite izi, wogwirizira wosemphana amabweretsedwa mu zotengera ndipo ma x-ray angapo amatengedwa. Njirayi imakupatsani mwayi wowunika mitsempha yonse yamagazi, mosasamala kanthu za kukula kwake. Phunziroli limachitika ndi atherosulinosis.

Njirayi ili ndi ma contraindication, ngakhale alipo ochepa:

• matenda amisala
• Thupi lawo siligwirizana ndi ayodini (asanachitike njirayi amayesa kuti amvetsetse),
• aimpso, chiwindi ndi kulephera kwa mtima,
• mimba ndi mkaka wa m`mawere.

Angiography yamitsempha yamagazi imafunika kukonzekera kwambiri kwa wodwala! Amamuika m'chipatala, kuyezetsa magazi koyenera kumachitika, kuphatikizapo matendawo omwe sagwirizana ndi sing'anga, mkodzo, ndipo atatha kukonzekera njirayi.

Pamaso pa njirayi, wodwalayo amalimbikitsidwa kupewa kudya kwa maola 8. Pamaso pa angiography pansi pa opaleshoni yam'deralo, kuyamwa pang'ono kumapangidwa ndipo kumayambitsa mtsempha kumayikidwa pomwe catheter adayikiridwa. Kudzera mu izi, wothandizira wosiyana angalowe mchombo.

Pambuyo pamapangidwe pafupifupi mphindi 40, catheter amachotsedwa. Chida chomwe chimagwiritsidwa ntchito pa angiography chimadzipukula tokha ndi impso patsiku.

Mitundu Yadziko Lapansi Yofanizira

Prothrombin coeffnty (yofupikitsidwa ngati PTI) kapena INR poyesa magazi, ndi chiyani? Muyenera kuyamba ndi maziko pang'ono. Dongosolo loterolo monga INR mu heestasiogram lidawoneka mu 1983, pomwe World Health Organisation (apa WHO) idasankha kukhazikitsa ntchito zama labotolo zofufuza ndikubweretsa zisonyezo zonse zakuwunika kwa magazi kukhala mtundu umodzi womwe umamveka kwa asing'anga padziko lonse lapansi.

M'mbuyomu, aliyense wogwiritsa ntchito ntchito angagwiritse ntchito zosiyana thromboplastin reagents, zomwe zitha kupotoza zotsatira zomaliza. Dongosolo la coagulogram limafupikitsidwa ngati INR kapena INR. M'mankhwala apakhomo, mutha kupeza m'malo mwa INR chizindikiro monga prothrombin index, chomwe chikuwonetsa momwe magazi a wodwalayo amayambira bwino.

Komabe, chifukwa cha njira zosiyanasiyana zothandizira kudziwa tsambali, silimadziwika kuti ndi losakhazikika chifukwa chake ndi chikhalidwe kugwiritsa ntchito INR kunjaku. Pakuyezetsa magazi kwa PTI ndi INR, zofunikira zimayikidwa pa:

• IPT - 70-100, komanso kwa odwala omwe akutenga Warfarin – 24,0-42,6,
• INR - 0.82-1.18.

Ndiye kodi INR ikuyezetsa magazi ndi chiani? Ichi ndi chizindikiro chomwe sichiri kanthu kuposa kuchuluka kwa kusanthula kwa PV kwa wodwala ndi PV ya oyang'anira sampuli. Chiwonetsero cha INR pakuwunika magazi a anthu malinga ndi miyezo yapadziko lonse lapansi chimatha kuyambira 0.82 mpaka 1.18.

Wodwala akapatuka pazomwe zili pamwambapa, matenda otsatirawa atha kupezeka:

• yokwezeka PV ndi INR: aakulu chiwindi, kusocha vitamini K, matenda ammbuyo, amyloidosis, DIC, otsika fibrinogen, nephrotic syndrome, dysbiosis yamatumbo, kufooka kwa chinthu(2,5, 7 ndi 10),
• ndi zizindikiro zochepetsedwa za PV ndi INR: mtima thromboembolism, kuchuluka kwa zinthu 7, thrombosis kapena kutsegulafibrinolysis.

Kuphatikiza apo, kuchuluka kwa INR ndi PV kungasonyeze kupezeka kwa mankhwala a anticoagulant m'magazi a wodwala. Chifukwa chake, chikhalidwe cha INR mutatenga Warfarin osiyana ndi miyezo yokhazikitsidwa. Kwa odwala omwe amamwa mankhwalawa ndi mankhwalawa ofanana ndi iwo pochita, mitundu yotsatirayi yamakhalidwe abwino a INR imagwiritsidwa ntchito - 2.0-3.0.

Chikhalidwe cha INR m'magazi mwa akazi nthawi zambiri chimasiyana ndi zofunikira zonse. Koma pakukonzekera kwa mwana, thupi lachikazi limasintha kwambiri kotero kuti zomwe zimachitika mu INR panthawi ya pakati sizingafanane ndi ziwerengero zomwe tafotokozazi.

Yogwira gawo la thrombin

Kuyesa kwa magazi a APTT - ndi chiyani? Ichi ndi chizindikiro chinanso cha kusanthula, komwe kumapereka chidziwitso pakuyenda kwa zinthu za m'magazi zomwe zimapangidwira kuti magazi asiye kutuluka mwachangu. Dongosolo ili silifupikitsidwa ngati APTTV.

Kuyesa kwa magazi a APTT - ndi chiyani? Nthawi zambiri pamakhala dzina lotere monga adamulowetsa gawo la thromboplastin. APTT komanso APTT imapereka chidziwitso pakuwonekera kwa kupanga kwa fibrin kuvala komanso kumawonetsa bwino mkati mwa hemostasis. Amakhulupirira kuti chizindikiro cha APTT ndicholondola kwambiri, koma nthawi yomweyo ndiye chokhwima kwambiri, monga zimatha kusiyanasiyana kutengera ma reagents omwe amagwiritsidwa ntchito poyesa labotale.

Chizindikiro chachilendo cha APTT m'magazi a anthu chimayikidwa masekondi 22.5-35,5. Chikhalidwe cha APTT mwa akazi chimagwiranso ntchito pamwambapa. Komabe, komanso momwe zimakhalira ndi magawo ena a coagulogram, chizolowezi cha APTT nthawi yapakati sichimatsatira malamulo onse. Onani zifukwa zomwe zikupatuka kwa chizindikirochi.

Monga lamulo wamba, ngati APTT yakwezeka, izi zikutanthauza kuti dongosolo lotsekemera silinakhazikika kapena wodwala akutenga Heparin mwachitsanzo, fanizo lake Fraxiparin, ClexanekomansoZibor.

Ngati zifukwa zomwe zili pamwambazi sizikuphatikizidwa, ndipo APTT ndi yapamwamba kuposa yachilendo, izi zikutanthauza kuti wodwalayo amatha kudwala matenda monga:

• fibrinolysis
• zopezeka kapena zoberekera zina coagulation chinthu akusowa(8, 9, 11, 10, 12, 2 ndi 5),
• DIC (2 kapena 3 magawo),
• autoimmune pathologies (pafupipafupi zokhudza zonse lupus erythematosus),
• matenda a chiwindi.

APTT ikatsitsidwa, amatanthauza chiyani? Ngati mtengo wa chisonyezo uli pansipa, ndiye kuti izi zikuwonetsa kuti kuthekera kwa magazi kugundana kumachepetsedwa. Zoyambitsa zazikulu izi:

• DIC 1 digiri
• kuchuluka coagulability
• cholakwika pakupanga mayeso a labotale, mwachitsanzo, zitsanzo zosayenera za magazi.

Soluble Fibrin Monomeric Complexes

Zoschulidwa mu coagulogram amasankhidwa kukhala RFMK. Kusanthula kwa RFMK, ndi chiyani? Yambani ndi kufotokozafibrin monomer zovutaKodi zopangidwa ndi kusweka kwa magazi okwanira mu ndondomekoyi fibrinolysis. Malinga ndi ofufuza, chizindikirochi ndizovuta kudziwa chokhazikika, popeza ma protein osungunuka a fibrin-monomer amachotsedwa mwachangu m'magazi.

Makulidwe monga RFMC amatenga gawo lalikulu pakuwonetsetsa DIC-syndrome (dzina lathunthu - logledzera intravascular coagulation syndrome). Chikhalidwe cha RFMC m'magazi a anthu ndi 0.355-0.479 IU. Komabe, panthawi yapakati, miyambo ya RFMC imatha kusiyana kwambiri kuchokera pamwambowu. Popeza thupi lachikazi likukonzekera mwachangu kubadwa komwe kukubwera, magawo ake ammagazi, kuphatikiza kuthekera kwake kwa kugundana, amasintha nawo.

Umu ndi mtundu wazida zodzitetezera zomwe zimathandizira kuchepetsa ngozi yotulutsa magazi. Kupatuka kwa mulingo wa RFMC pa nthawi ya pakati mpaka 5.1 ml kumawerengedwa kuti ndi kwabwinobwino. pa 100 ml. magazi. Ngati RFMC ichulukitsidwa, kodi kuwunika kotereku kumatanthauza chiyani?

Coagulogram wodwala yemwe ali ndi RFMC akwezedwa, zifukwa zake zingakhale motere:

• kugwedeza
• thromboembolism mitsempha yakuya ya miyendo kapena zam'mapapo.
• sepsis,
• preeclampsia kapena preeclampsia pa nthawi yapakati,
• matenda a zotumphukira zimakhala,
• aakulu kapena aimpso kulephera.

Kuwonjezeka kwa chizindikiro ichi kumapezeka kawirikawiri kwa odwala omwe apangapo opaleshoni yaposachedwa. Chifukwa chake, munthawi yogwirira ntchito, kuwunikira kwa RFMC kumatha kupatuka panjira wamba.

Nthawi Yothandizanso Kuyambiranso

Zomwe zimafotokozedwazo ndi ABP ndipo zikuwonetsa nthawi yomwe ikufunika kutiapangidwe ka fibrin m'magazi amwazi odzaza ndi mapuloteni ndi calcium. Dongosolo ili limagwiritsidwanso ntchito poyesa njira zopangira magazi lonse lathunthu. ABP ikuwonetsa kuyanjana kwa ma cellular ndi plasma a hemostasis.

Ndizachilendo kuti phindu la chizindikiro ichi limatha kusiyanasiyana kutengera ma reagents omwe amagwiritsidwa ntchito maphunziro a labotale. Monga lamulo, nthawi yofupikiranso nthawi yowonjezera imawonetsa wodwala kuti apange kuwundana kwamagazi, ndipo wotalika akuwonetsa hemophilia, komanso kuchepa kwa chiwerengero cha maselo amwazi ndi kusintha kwa machitidwe awo oyambira.

Mlozera wa Prothrombin. Nthawi zonse kwa akazi

Dongosolo lalifupi la paramuyi posanthula ndi IPT. Kuyesedwa kwa magazi kwa PTI - ndi chiyani? Mlozera wa Prothrombin- Uku ndiko kuwerengera kwa mtengo wokhazikika wa prothrombin nthawi ya chizindikiro cha prothrombin nthawi yochulukitsidwa ndi 100% mukuwunika kwa wodwalayo.

Ndizofunikira kudziwa kuti chizindikirochi sichikugwiritsidwa ntchito pafupifupi, popeza bungwe la WHO limalimbikitsa kuti kugwiritsa ntchito chizindikiro choterechi kukana mayeso a labotale ngati INR. Mlingo wa IPT m'magazi kwa munthu wathanzi umakhazikitsidwa pa 73-122%.

Monga lamulo wamba, kuchuluka kwa PTI mwa akazi sikuyenera kusiyana ndi zomwe zili pamwambazi kupatula nthawi yomwe mayi ali ndi pakati, pamene kuchuluka kwa magazi kumawonjezeka. Chifukwa chake, ngati mkazi wapatuka pazikhalidwe, mkazi yemwe ali mu coagulogram ayenera kufunsa dokotala kuti amupatse upangiri.Dongosolo ili limakulirakulira, monga lamulo, ngati thupi la munthu likusowa vitamini K, palinso kuchepa kwa zinthu zomwe zikukula.

Kuphatikiza apo, kuwonjezereka kwa IPT kumachitika chifukwa chamankhwala ndi anticoagulants monga Sinkumar, Warfarinkapena Neodicumarinkomanso mukamatenga Heparina ndi fanizo lake. IPT imachepa ndi kuwonongeka kwa chiwindi, mwachitsanzo, ndi cirrhosis ndi hepatitis, ndi mtima thrombosis komanso nthawi yapakati.

Mlingo wa Prothrombin wa azimayi m'magazi

Mu he hetaticatic, zinthu 15 zophatikizika zimagwira ntchito yofunika, i.e. zinthu zomwe zimadziwika ndi ntchito yake. Chimodzi mwazinthu zofunikira kwambiri chimaganiziridwa prothrombin kapena factor II, yomwe imadziwikanso kuti thrombogen. Awa ndi mapuloteni omwe ali patsogolo pa thrombin, pomwe, amachititsa kuti magazi azithamanga - amathandizira kupanga magazi (magazi).

Mlingo wa prothrombin m'magazi wotsimikiza kugwiritsa ntchito mayeso otsatirawa:

• PV Mwachangu - zofunikira kwa akazi ndi 78-142%,
• INR kapena INR - chikhalidwe kwa akazi ndi 0.85-1.15.

Ngati gawo la chinthu II ndilokwera kuposa momwe limakhalira, ndiye kuti magazi amayambika chifukwa choti magazi amakhala amitsempha, chifukwa chake, mitsempha yamagazi imatsekeka. Muno, thupi la wodwala lili pachiwopsezo chachikulu kuposa kale. Mikwingwirima ndi mtima, komanso kwambiri kumawonjezera mwayi wokhala ndi zotupa zoyipa kapena thromboembolism.

Mu malo omwe mulingo thrombogen yafupika, mapangidwe a magazi amayamba pang'onopang'ono, omwe amadzaza ndi kuwonongeka kwakukulu kwa magazi atatuluka magazi. Monga lamulo, zifukwa zomwe zimapangitsa kuti musavutike mu hemostatic system ndi: kusowa kwa vitamini K m'thupi kapena zinthu zina zatsopano komanso zopezedwa.

Magazi coagulogram: decoding, miyambo, zimayambitsa kupatuka

Coagulogram (hemostasiogram) ndi kuyesa kwa magazi komwe kumachitika pophunzira index yake. Kuwona coagulogram yamagazi ndikofunikira kwambiri pakukonzekera kwa wodwala kuti achite opareshoni. Zimathandizira kupewa zovuta zazikulu monga thrombosis komanso magazi. Kuwerenga kwa coagulability kumachitika nthawi ya pakati, komanso ngati pali mbiri ya matenda a chiwindi, mtima ndi mitsempha yamagazi. Kupezeka kwa autoimmune pathologies ndikuwonetsanso pophunzira ma coagulograms amwazi. Kusanthula kumakupatsani mwayi wofufuza chomwe chimayambitsa magazi.

Dongosolo la coagulation dongosolo (heestasis) limateteza munthu ku kuwonongeka kwa magazi owopsa ngati akuphwanya umphumphu wamakhoma wamitsempha motsutsana ndi maziko a kuvulala koopsa ndi njira zopangira opaleshoni. Mitundu yamanjenje ndi endocrine imayang'anira Heestasis yokwanira m'thupi. Kuti magazi athe kugwira bwino ntchito zake zoyambira (kuphatikiza minofu yokhala ndi mpweya komanso michere komanso kuwongolera kutentha kwa thupi), iyenera kukhala ndi katundu wachilengedwe, mwachitsanzo, kusungunuka kwa madzi. Hypocoagulation (kuchepa kwa coagulability) motsutsana ndi maziko amomwe ma pathologies osiyanasiyana amatha kubweretsa kuwonongeka kwa magazi. Hypercoagulation ndiomwe imayambitsa mapangidwe amagazi (magazi kuwuma), kutsekereza kuunikira kwamitsempha yamagazi. Zotsatira za thrombosis, minofu ischemia imayamba, kutsogoza, kuphatikizapo kugunda kwa mtima ndi stroko.

Zigawo zazikulu za heentatic system ndi:

• mtima khoma maselo endothelial,
• mapulateleti
• zinthu za m'magazi.

Nthawi ya Thrombin

Dzina lalifupi - TV. Gawo ili limafotokoza gawo lomaliza la heestasis ndipo limatalika kutalika kwa nthawi yomwe kuli kofunikira kuti pakhale chovala fibrin ikawonjezeka m'madzi a m'magazi thrombin. Kuwunikira pa TV kumachitika nthawi zonse kuphatikiza PV ndi APTT kuti mupeze matenda opatsirana kwambiri ophatikizika a fibrinogens, komanso kuwunika mphamvu ya mtundu wa fibrinolytic ndi heparin.

Antithrombin III

Izi lakuthupi anticoagulant mu kapangidwe kake amatanthauza glycoproteins, i.e. zinthu zomwe zingalepheretse 9,10 ndi 12 coagulation zinthu ndi thrombin. Amapangidwa m'maselo a chiwindi. Zizindikiro zodziwika za gawo ili la coagulogram zimasiyanasiyana kutengera zaka za wodwalayo.

Akuluakulu, kuchuluka kwa 75-125% kudzakhala kwabwinobwino, kwa akhanda - 40-80%, kwa ana azaka zapakati pa 10 mpaka 16 - 80-120%, ndi kufikira zaka 10 - 60-100%. Ngati antithrombin 3 ali wotsika, amatanthauza chiyani? Kutsika kwa gawo la mankhwalawa kumatha kuphatikizidwa ndi kukhalapo kwa matenda monga DIC, sepsis, ischemia, cirrhosis, thromboembolismkapenathrombosis.

Kuphatikiza apo, antithrombin III amatha kuchepa mu nthawi yomaliza yam'mimba komanso pamene wodwala atengedwa Heparina kapena fibrin zoletsa. Ma antithrombin 3 akwezedwa, matupi opatsirana amatha kukhala zifukwa, mwachitsanzo, peritonitis, pyelonephritisndi chibayo, komanso chiwindi ndi kuchepa vitamini K.

Chizindikiro chinanso cha coagulogram yowonjezereka, mothandizidwa ndi momwe dokotala amawunikira osati kupangika kwa magazi, komanso dongosolo la anticoagulant la thupi la munthu. D-dimer - Izi ndi zopindika za fibrin. Zotsatira zowonjezereka za ndalamayi, zomwe zikuwonetsa kukula kwa matenda a chiwindi m'thupi la wodwalayo, ndizofunikira.DIC, thrombosis, ischemia, nyamakazi, kulowerera m'mitsempha.

Kuphatikiza apo, kuwonjezeka kwa D-dimer ndi chizindikiro cha osuta kwambiri.

Coagulogram pa nthawi yapakati

Kodi coagulogram ndi chiyani panthawi yoyembekezera? Awa ndi omwe amapezeka nthawi yomweyo azimayi omwe amapatsidwa nthawi yodzala, komanso asanakonzekere kubereka.

Pa nthawi yoyembekezera, zizindikiritso zonse za kusanthula kwa magazi sizigwirizana ndi zomwe anthu ambiri amavomereza.

Izi zimachitika makamaka chifukwa chakuti dongosolo la mayi woyembekezera limasinthika kwambiri, komanso thupi lonse lathunthu chifukwa cha mawonekedwe ena oyenda magazi - utero-placental. Udindo wofunikira umaseweredwa ndi kukula kwa mahomoni, komwe kumakhalapo progesterone.

Ndizofunikira kudziwa kuti panthawi yoyembekezera, ntchito yovala monga 7,8 ndi 10, komanso fibrinogen imachulukitsidwa kwambiri. Umu ndi mtundu wa zida zachilengedwe zodzitetezera zomwe zimapangidwa kuti zithandizire kukulitsa mwayi wazotsatira zabwino pakubala.

Zidutswa za Fibrin zimayikidwa pazitseko zamitsempha yamagazi ndipo, motero, dongosolo la fibrinolysis limapanikizidwa. Izi zimathandizira kuti thupi la mkazi lizisewera mosataya nthawi chifukwa chakuphwa kapena kutayika kwa m'mimba, kutulutsa magazi kwa chiberekero ndi kupanga magazi owundana.

Kuwunikira zizindikiro za coagulogram pa nthawi yapakati

Momwe mungatengere coagulogram?

Tidakambirana za chomwe chiri coagulogram ndi chifukwa chake amatsimikizira izi. Tsopano tilingalira momwe tingapezere hemostasiogram molondola kuti, potengera zotsatira zake, adotolo amatha kunena molondola ndikusankha njira yabwino yothandizira.

Chifukwa chake, ngati mukufunikira kuyesa magazi pakupanga magazi, kumbukirani malamulo otsatirawa:

• magazi amaperekedwa kokha pamimba yopanda kanthu, ndibwino kuti mukatha kudya chakudya chotsatira kupitirira maola 12,
• dzulo la kusanthula, simuyenera kudya zakudya zonunkhira kwambiri, muyenera kupewa nyama zosuta komanso zakudya zamafuta kwambiri,
• Ndi koletsedwa kumwa mowa uliwonse, ngakhale chakumwa chilipo pang'ono.
• osasuta
• Ndikulimbikitsidwa kuti musamwe mankhwala musanawunike, ndipo ngati mankhwala ndi ofunika, muyenera kudziwitsa othandizira ndikuwonetsa kuti ndi mankhwala ati omwe amakupatsirani.

A heestasiogram yokhazikika imatha kuchitika m'makiriniki ambiri aboma, ndipo kuwunikira kowonjezereka kapena kwatsatanetsatane kumapezeka kawirikawiri m'mabungwe azachipatala omwe amalipira. Mwachitsanzo, mu labotale ya Invitro, coagulogram imatha kupangidwa mwachangu kwambiri. Monga lamulo, zotsatira za phunziroli zimatha kutengedwa m'masiku angapo.Ichi ndichifukwa chakufunika kachitidwe kazithunzithunzi zingapo zomwe zimafuna nthawi yambiri, zomwe sitingapewe.

Komabe, mulimonsemo, mutha kupeza zotsatira za kuwunika kolipira mofulumira kwambiri kuposa momwe zimakhazikitsidwa m'boma, komwe labotaleyo imakhala yolemedwa kwambiri chifukwa cha kuchuluka kwa odwala kapena sipangakhale chilichonse chofunikira pankhaniyi. Mtengo wowunikira umatengera kuchuluka kwa magawo omwe amafunikira kuti aphunziridwe ndipo amasiyanasiyana kuchokera ku ruble 1000 mpaka 3000.

Momwe mungaperekere magazi ku coagulogram

Mwazi umachokera mu mtsempha. Kuti mupewe kusokoneza komanso kutanthauzira molakwika za zotsatirazi, muyenera kukonzekera kusanthula koyenerera.

Malamulo oyambira omwe ndiofunika kuti wodwala azitsatira:

• Maola 8 mpaka 12 kusanthula komwe simuyenera kudya,
• tsiku loti musadye kwambiri usiku,
• mowa, tiyi, timadziti ndi zakumwa zina siziyikidwa pambali - mutha kumwa madzi oyera okha,
• anthu omwe ali ndi vuto la chikumbumtima sayenera kusuta osachepera ola limodzi asanakonze,
• Ndikofunikira kupatula kupsinjika kwakuthupi ndi m'maganizo kwa mphindi 15 musanawunike.

Zofunika:ngati wodwala atenga anticoagulant pharmacological othandizira, ayenera kudziwitsa adotolo! Ngati mukutola kwazinthu zofufuzira za magazi a coagulogram ndikuwonekera kapena kukomoka kuyamba, muyenera kudziwitsa ogwira ntchito azaumoyo za kusintha kwa moyo wabwino.

Kodi coagulogram wamagazi ndi wofunikira liti?

Zizindikiro zakusanthula:

• kuchuluka kwa thrombosis,
• kukwiya kwam'mbuyomu ndi kukwapula,
• matenda amitsempha,
• matenda a chiwindi
• mimba
• kukonzekera opareshoni.

Magazi amatengedwa ndi syringe wosabala kapena kugwiritsa ntchito njira yapadera ya vacuum. Ulendo wamkono sudzatha. Kuboola kwake kuyenera kukhala kwa atraumatic kuti tipewe kupotoza chifukwa cha kulowetsedwa kwa minofu yambiri. Ma machubu awiri ali ndi magazi, koma chachiwiri chokha ndi chomwe chimagwiritsidwa ntchito pakufufuza. Thumba losabala lili ndi anticoagulant - sodium citrate.

Magazi coagulogram ana

Magazi a coagulogram nthawi zonse mu ana amasiyana kwambiri ndi zomwe zimachitika mwa achikulire. Chifukwa chake, mu makanda obadwa kumene, mulingo wabwinobwino wa fibrinogen umachokera ku 1.25 mpaka 3.0 g / l.

Zizindikiro za kafukufuku wa mwana

• hemophilia wokayikitsa
• matenda a hematopoietic dongosolo pathologies,
• opaleshoni yomwe ikubwera.

Magazi coagulogram pa nthawi yoyembekezera

Zofunika:pakubala kwa mwana, kuphunzira kwa magazi a coagulogram kumachitika katatu konse (mumtundu uliwonse wa trimesters).

Pa nthawi yoyembekezera, magawo a heestatic magawo amasintha, omwe amayamba chifukwa cha kukonzanso kwina kwa thupi la mkazi, kuchuluka kwa magazi ozungulira ndikupanga gawo lowonjezera la magazi.

Mu trimester yoyamba, nthawi yowundana, monga lamulo, imakulira kwambiri, ndipo mu trimester yachitatu imafupikitsidwa kwambiri, mwakutero kupereka mkazi kuteteza ku kutaya magazi komwe kungachitike pakubala. A magazi coagulogram amakupatsani mwayi kuti muwone kuwopsa kwa kuchotsa mimbayo kapena kubadwa msanga chifukwa kupangika kwa magazi. Kuphwanya kwamphamvu kovutikira kwa mayi woyembekezera kumakhudza mbali yayikulu ya ubongo wa mwana wosabadwa.

Kafukufuku wovomerezeka wa coagulogram wamagazi ndikofunikira ngati mkazi ali ndi matenda amitsempha (makamaka, mitsempha ya varicose) kapena ngati chiwindi chikuwoneka. A coagulogram wamagazi amayesedwanso kuti achepetse chitetezo chokwanira komanso vuto loipa la Rhesus.

Zotsatira za zisonyezo zamagazi amodzi mwa amayi apakati:

• nthawi ya thrombin - masekondi 11-18.,
• APTTV - 17-20 sec.,
• fibrinogen - 6 g / l,
• prothrombin - 78-142%.

Zofunika:Kupatuka kwa prothrombin mulingo wabwinobwino kungawonetse kusokonekera kwachilengedwe!

Lotin Alexander, wowonera zachipatala

28,941 malingaliro onse, 1 malingaliro lero

Kukayikira kwa atherosclerosis: kuyesa komwe kumayenera kuchitidwa kutsimikizira kapena kutsutsa kuti matendawa ali

Ndi atherosclerosis, mafuta amadziunjikira ndi kuchuluka kwa minyewa yolumikizana mu khoma lakale kumachitika. Kukhulupirika kwa chigoba chamkati cha ziwiya kumaphwanyidwa, lumen yawo imakhala yochepa, zomwe zimabweretsa cholepheretsa magazi kulowa ziwalo ndi minofu. Kuzindikira kumafunikira kuonana ndi akatswiri, a mtima, akatswiri ena, komanso kuwunika kwa magazi a lipid sipekitiramu, ma ultrasound a mtsempha wamagazi, mtima, angiography.

Werengani nkhaniyi

Kuyesedwa ndi akatswiri a atherosulinosis

Nthawi zambiri, kuganiza kwa kukhalapo kwa atherosulinosis wodwala kumatha kuchitika kwa GP kapena dokotala wabanja. Ntchito yosintha makoma amitsempha yamagazi imayamba kukhala pafupifupi mwa anthu onse patatha zaka 45.

Koma mawonetsedwe ake ndi kuuma kwake ndi kosiyana. Dokotala atazindikira madandaulo, amaperekanso mayeso okhudza magazi ake kuti atsimikizire cholesterol yokwera, otsika kachulukidwe lipids ndi ECG.

Kutsatira atazindikira koyambirira, monga lamulo, tikulimbikitsidwa kukaonana ndi akatswiri oterowo kuti mumupime mozama:

• mtima - amawunika kuwonongeka kwa mtima ndi mitsempha yayikulu,
• opaleshoni ya mtima - akuwulula zovuta m'magawo otsika,
• neurologist - amawona kuchuluka kwa kayendedwe ka magazi m'mitsempha ya ubongo,
• endocrinologist - amawunika chithokomiro, mahomoni, ndi zina zambiri. (ndipo atherosulinosis nthawi zambiri chimakhala chizindikiro cha matenda ashuga)
• Optometrist - imasanthula masinthidwe m'mawonedwe.

Kodi adokotala adzaawululira chiyani pakuwunika

Pozindikira, madandaulo otsatiraŵa odwala ndi ofunika:

• mutu, chizungulire, tinnitus,
• kufooka paroxysmal ndi dzanzi mu miyendo,
• pakuchita masewera olimbitsa thupi kumakhala kovuta kupuma, kuwonjezeka kwa mtima ndi kupweteka kumbuyo kwa sternum,
• mukamayenda muyenera kuyima chifukwa cha ululu m'miyendo.

Pazowunikira, zizindikiro zosadziwika

• xanthomas - mawanga achikaso pazotsika m'maso,
• xanthelasma - madipoziti a cholesterol panja pa molumikizana ndi mafupa,
• kuwoneka ngati iris ngati mwezi,
• mitsempha yakanthawi kochepa yakanthawi kochepa.
• kusiyana pakudzazidwa kwa mbulu pamiyendo.

Nthawi zambiri kuthamanga kwa magazi kumapezeka, kung'ung'udza kwa systolic m'dera la pamwamba pa mtima, kofikira 2 kamvekedwe ka msempha.

Kuyesedwa kwa magazi, kuphatikizapo biochemical

Kuyesedwa kwa magazi kambiri sikothandiza kwambiri, shuga akhoza kuchuluka, komwe kumafunikira kafukufuku wozama wa carbohydrate metabolism.

Mu coagulogram, Zizindikiro zakuchulukira kwa njira yogwiritsa ntchito magazi, kuchepa kwa ntchito za fibrinolysis ndi maplatelet amawululidwa. Izi zitha kukhala zothandiza pakuwunika chiopsezo cha thrombosis.

Kuti muwunikenso zowerengetsera zam'makalata, Zizindikiro zotsatirazi zitsimikiza:

• protein-c yogwira, ALT ndi AST pakagwiritsidwa ntchito ngati akukayikira,
• magazi potaziyamu - kuchuluka ndi minofu ischemia.

Kudziwika kwa lipid kagayidwe

Chizindikiro chachikulu cha labotale cha atherosulinosis ndi kusokonekera kwamafuta kagayidwe. Zizindikiro zake:

• kuchuluka kwa cholesterol, triglycerides ndi otsika kwambiri otsika lipoproteins,
• kutsika kwa ma lipoproteins apamwamba kwambiri,
• apolipoprotein A1 pansipa
• apolipoprotein wokwera.

Kuti mudziwe kuopsa kwa matenda amtima, chizindikiritso chimagwiritsidwa ntchito, chomwe chimatchedwa index ya atherogenic. Uwu ndi chiŵerengero cha anthu ambiri okhala ndi cholesterol yotsika kwa lipoproteins. Ngati ili pansipa 2.9, ndiye kuti wodwalayo ali ndi mwayi wochepa wokhala ndi atherosulinosis, chiopsezo chapakati chimafika ku 4.9, ndipo mitengo yokweza imawonetsa kuwonongeka kwa mitsempha ya 100% atherosranceotic.

Ultrasound yamitsempha yamagazi, kuphatikizapo miyendo yam'munsi

Patency yotsimikiza imatsimikizika, kusokonezeka kwa magazi, mawonekedwe a thrombosis, kapena kuvalidwa kwa zolengeza za atherosselotic. Njirayi imagwiritsidwa ntchito pakuchepa kwamapazi pamapazi, mitsempha ya popliteal and femal, komanso kusiyana pakudzaza kwa ma pulse kumapeto pang'ono. Chizindikiro chosalunjika ndikuchiritsa pang'onopang'ono mabala pamalo opaka magazi.

Kuunika kwa X-ray

Amakulolani kuti mupeze zizindikiro za atherosulinosis ya mtima (mitsempha ya m'mimba), msempha, chotupa cham'mimba:

• kukula kwa mtima kukukulira, makamaka chifukwa chamanzere am'manzere,
• pakhoza kukhala zizindikiro za aneurysm ya khoma - malo ophulika, nthawi zambiri kumanzere,
• kutalika kwa msempha, kugwedeza kwamwala, kusiyanasiyana kwa mthunzi, malo ophunzitsira,
• ndi kuwonongeka kwa chotupa cha m'mapapo, mapangidwe a pulmonary amalimbikitsidwa, pali kusintha kwa aneurysmal mu nthambi.

X-ray (kuyerekezera mwachindunji): zilonda za atherosulinotic aortic ulcer ndi aneurysm yabodza (yowonetsedwa ndi muvi).

Kuyesa kwa Kupsinjika kwa Matenda a Atherosulinosis

Gwiritsani ntchito zosankha zingapo zolimbitsa thupi kuti muzitha kulolera:

• kukwera papulatifiti (kuyesa kwa Master),
• njinga yamasamba - kukwera njinga yapadera,
• kusenda - kuyenda poyenda.

Njinga ergometry

Pankhani ya matenda ophatikizika kapena thrombophlebitis, komanso kuwonekera konse, amasinthidwa ndi mayeso a pharmacological ndi Isadrin kapena Ergometrin.

Izi zimawerengedwa kuti ndi zabwino (matendawa adatsimikiziridwa) ngati wodwala akukhala kumbuyo kwa kupsinjika, kotheka kwa angina pectoris, wamkulu kuposa wabwinobwino, kuchuluka kwa mtima, kutsika kwa 25% kapena kutsika, ndikusintha komwe kudali gawo la ST lachibale ndi kudzipatula.

Mndandanda wa Ankle-brachial

Kupanikizika paphewa kumayeza m'njira imodzi pamalo apamwamba, kenako cuff imayikidwa masentimita 5 pamwamba pa phazi. Cholozera chimawerengedwa ndikugawa zizindikiro za kupanikizika kwa systolic - chidendene pafudzi. Zachilendo pakupuma kuyambira 1 mpaka 1.3.

Kuyeza kwa LPI

Kusintha kwa mgululi, munthu akhoza kukayikira ngati matenda:

• osakwana 0,4 - kufalikira kwamitsempha yamagazi, chiopsezo cha zilonda zam'mimba ndi zilonda zam'mimba,
• kuchokera pa 0,41 mpaka 0,9 - kusokonezeka pang'ono kapena kosadukiza kwazowunikira, kuwunika kwa angiographic ndikofunikira,
• kuchokera pa 0,9 mpaka 1 - malire apamwamba, abwinobwino, amatha kupweteka,
• zopitilira 1.3 - khoma la zotengera ndi wandiweyani, wosasunthika, chizindikiro cha matenda a shuga kapena kulephera kwa impso.

Dopplerography

Kugwiritsa ntchito dopplerometry, kuthamanga kwa magazi mu ziwiya za khosi, ubongo ndi m'munsi mwake kumatsimikizika. Nthawi zambiri, kuwunika komwe kumachitika kawiri kawiri kapena katatu, kumayesedwa ndikuwunika komwe kusanthula kwa magazi kumachitika, komwe malo opangira ma atherosselotic amawonera.

Ultrasound ya ziwiya za khosi: stenosis ya kunja carotid mtsempha wamagazi chifukwa cha atherosulinosis

Kusintha kwa mtima

Podzaza vasculature ndi wothandizira, kupendekera kwa lumen, kufalikira (kufalikira), dera la zotupa ndi boma la kayendedwe ka magazi am'magawo, chitukuko cha zozungulira - makatani amatha kupezeka.

Mitundu yotsatirayi yoyesera imagwiritsidwa ntchito:

• aortography
• zotumphukira,
• makulidwe.

Njira zakufufuzira

Ndi njirayi, sing'anga wosanjikiza amailowetsa kudzera m'mitsempha, kenako mothandizidwa ndi tomograph chithunzi cha veterial network chimapezeka. Pogwiritsa ntchito zida, kuphwanya kwa kapangidwe kake, malo ake ndi kagwiritsidwe ntchito ka ziwiya zazikulu ndi zodutsa zimapezeka. Pozindikira matenda a atherosulinosis:

• MRI yamatumbo a miyendo,
• CT ya msempha
• zotumphukira tomographic arteriography,
• multispiral CT scan ya msempha, ziwalo zam'mimba, mitsempha ya impso ndi miyendo.

MRI ya ziwiya zam'munsi

Njirazi ndi zina mwazidziwitso zopindulitsa kwambiri, zimagwiritsidwa ntchito pozindikira kuchuluka kwa kulowererapo kwa opaleshoni komanso pazochitika zovuta kudziwa.

Kuti muzindikire atherosulinosis, madandaulo komanso zowunika za wodwalayo zimawaganiziridwa, koma kuti mutsimikizire za matendawa, ndikofunikira kupenda kupezeka kwa magazi a lipid, komanso kuyesa kwa ultrasound ndi angiographic kwa arterial network. Zopindulitsa kwambiri ndi njira za tomographic.

Kanema wothandiza

Pazambiri zamakono zokhudzana ndi matenda a atherosulinosis, onani vidiyo iyi:

Atherosulinosis yamitsempha yama khosi imakhala ndi zovuta zina kwa wodwala. Ndikofunika kwambiri kuti muchepetse kukula kwa matendawa. Nanga bwanji ngati matendawa ayamba kale?

Ngati mwadzidzidzi kulira, kupweteka poyenda, ndiye kuti zizindikirazi zitha kuwonetsa kuchepa kwa matenda a m'matumbo am'munsi. Mukadwala matendawa, omwe amadutsa m'magawo anayi, ntchito yodulira ingafunike. Kodi ndi njira ziti zomwe zingagwiritsidwe ntchito?

Ngati atherosclerosis ikuwoneka, ndipo cholesterol satenga nthawi yayitali. Kodi cholesterol imadziwika bwanji? Zoyenera kuchita ukakanidwa?

Tsoka ilo, matenda a atherosulinosis oyamba samapezeka nthawi zambiri. Amadziwika m'magawo amtsogolo, pamene zizindikiro za aortic atherosulinosis zikuwonetsedwa m'mavuto azaumoyo akuluakulu. Kodi ma ultrasound ndi njira zina zofufuzira zikuwonetsa chiyani?

Cerebral atherosulinosis yamitsempha yama ziwongo imawopseza miyoyo ya odwala. Mothandizidwa ndi munthu, munthu amasintha ngakhale umunthu. Zoyenera kuchita

Matenda awiri, atherosulinosis ndi matenda oopsa, amalumikizidwa, zimapangitsanso kuti magazi awonongeke. Chakudya chopatsa thanzi ndichofunika kwambiri pakubwezeretsa mitsempha yamagazi. Popanda kudya, chithandizo chimakhala chopanda ntchito.

Chifukwa cha kuchuluka kwa shuga, cholesterol, kuthamanga kwa magazi, zizolowezi zoipa, kufukiza kwa atherosulinosis kumayamba. Ndikosavuta kuzindikira nthawi yayitali ya BCA, mitsempha ya m'mimba ndi carotid, ziwiya zamagawo am'munsi, matenda a ubongo, komanso ovuta kuchiza.

Kucheka kwa matumbo kungayambitse matumbo. Zizindikiro - kupweteka, nseru, kusazindikira ndi ena. Mankhwalawa ndiwotalikirapo komanso ovuta.

Matenda a mitsempha ya mitsempha ya impso amakula chifukwa cha ukalamba, zizolowezi zoipa, kunenepa kwambiri. Poyamba, Zizindikiro zimabisidwa, ngati zikuwoneka, ndiye matendawa amakula kwambiri. Pankhaniyi, mankhwala kapena opaleshoni ndiyofunikira.

Yophatikizidwa ya tomographic angiography

Pogwiritsa ntchito njirayi, ziwiya zaubongo, mtima, khosi, peritoneum zimayesedwa. Zotsatira za kafukufukuyu, zithunzi za mitsempha yamagazi zamagawo osiyanasiyana a thupi lathu zimawonekera. Dokotala amatha kuwunika momwe alili, kayendedwe ka magazi, ndi zina zambiri.

Phunziroli limachitika pogwiritsa ntchito x-ray ndi kusiyanitsa kwapakati. Komabe, ma tomographs amakono amatulutsa radiation kangapo, motero ndi otetezeka kuposa x-ray wamba. Ngati mayesowa atachitika popanda kusiyanitsa madzimadzi, kukonzekera sikofunikira, apo ayi wodwala ayenera kukana kudya kwa maola 4-5.

Wodwalayo amaikidwa patebulo lapadera, kufunsidwa kuti atule pansi ndikuchotsa zinthu zachitsulo, ndiye kuti amayikidwa m'mutu wa tomograph, pomwe mayeso amachitika. Wodwala amakhala pamenepo yekha kwa mphindi 30. Ngati phunzirolo likuchitika pogwiritsa ntchito sing'anga yosiyana, imaperekedwa kwa mphindi zingapo phunzirolo lisanachitike kudzera mu catheter m'msempha.

Kugonekedwa kuchipatala kwa njira iyi sikofunikira. Ngakhale zabwino za CT angiography, ali ndi zotsutsana:

• claustrophobia (kuopa malo okhala),
• mimba
• kulemera kwambiri
• arrhasmia,
• Matupi a ayodini omwe amapezeka ndi iodine -
• zaka za ana mpaka zaka 5-7.

Kuyesa kwa Ultrasound

Mukazindikira atherosulinosis, njira ya ultrasound imagwiritsidwa ntchito.Ndi chithandizo chake, ziwiya zamtima, nthambi zam'munsi komanso ma carotid artery zimayesedwa. Pamaso pa cholesterol malo, kuchepa kwa magazi ndi kupezeka kwa malo amisamba ndi magazi kumadziwika. Maphunziro apadera a njira yoperekedwayo safunikira. Wodwalayo atangopatsidwa ma Ultra zotsatira zomwe zitha kutanthauziridwa ndi dokotala.

MRI ya mitsempha

Ubwino wosasinthika wa kulingalira kwa maginito ndikuti kumakuthandizani kuwona momwe zinthu zimayendera m'thupi zomwe sizipezeka pakuzindikira ultrasound kapena x-ray!

Chifukwa cha njirayi, mutha kuwona malo omwe amachokera ma atherosulinotic malo, kudziwa zovuta zamomwe zimapangidwira m'mitsempha yamagazi ndikuzindikira kuchuluka kwake.

Ndondomeko yopanda ululu ndipo imatenga mphindi 40. Wodwalayo amizidwa patebulo lapadera, lomwe kenako limatsikira ndi kapamwamba kuzunguliridwa ndi maginito. Mu ofesi yotsatira muli makompyuta omwe amapatsa dokotalayo chidziwitso chenicheni chazomwe zimachitika m'thupi momwe adafunsiramo.

Maora 2-3 musanachitike njirayi, sikulimbikitsidwa kudya chakudya, ndipo pakhomo lolowera kuofesi muyenera kuchotsa zinthu zonse zachitsulo ndi zida, mwinanso phunziroli lingakhale lolondola.

Electron mtengo Tomography

Njira imeneyi ndiyofunikira pophunzira ntchito ya mtima, yomwe imawonetsedwa pa pilo powunika mbali zitatu. Ndi chithandizo chake, mutha kuwona zomwe zikuchitika m'mitsempha yama coronary, mwachitsanzo, ma calcium calcium mumatumba.

Njira yake ilibe zotsutsana, kupatula pakati, chifukwa chachikulu - radiation - imatha kukhala ndi vuto pa mwana wosabadwayo.

CRT imathamanga kwambiri. Pakangopita masekondi angapo, chipangizocho chimayang'ana pamtima komanso m'mitsempha yamagazi ndikusamutsa zidziwitso pakompyuta. Njira yonseyi imatenga mphindi 10. Zotsatira zimaperekedwa kwa wodwala pambuyo phunzirolo.

Kuteteza kwa Atherosulinosis

Chifukwa cha kuchuluka kwa matenda a atherosulinosis, mabungwe azachipatala amapanga ma memos popewa matenda. Malangizo omwewa ndi ofanana kwa ma memos onse. Amatsata zotsatirazi:

1. Kukana zizolowezi zoipa.
2. Yang'anirani kulemera, kupewa kunenepa kwambiri.
3. Chepetsani chakudya chama calorie: kuchepetsa kugwiritsa ntchito mafuta, mafuta osenda komanso osuta.
4. Chitani masewera olimbitsa thupi pafupipafupi.
5. Pewani kupsinjika.

Ngati mutsatira malamulo osavuta awa, muthanso kukhala ndi thanzi lanu kwa nthawi yayitali. Komabe, matendawa akapezeka, muyenera kufunafuna chithandizo chamankhwala posachedwa. Ndi dokotala yekhayo amene angatchule mayeso ndi njira zoyenera zomwe zingathandize kuti adziwe zoyenera ndikuyamba kulimbana ndi atherosulinosis.