Momwe kusuta kumakhudzira cholesterol

Kuchuluka kwa zotsatira zoyipa za cholesterol pamitsempha yamagazi kumatsimikiziridwa osati ndi kukhalapo kwa chinthu, monga momwe zimakhalira ndi poizoni, koma ndi kuchuluka kwake, muyeso wa mamolekyulu / ogwiritsa ntchito.

Ma mamolekyule osungirako ndi otsika osalimba a lipoproteins (LDL). Ntchito yawo ndikupereka mafuta achilengedwe m'maselo omwe amafunikira, chifukwa cholesterol imachita ntchito zingapo zofunika - imagwira nawo ntchito posinthana ndi mavitamini, mahomoni, ndikupanga gawo lama cell.

Ma molekyulu ogwiritsira ntchito amaphatikizidwa ndi highensensity lipoproteins (HDL). Amatsuka magazi kuchokera ku cholesterol yochulukirapo ndikubwezera ku chiwindi, komwe imatuluka ndi bile. Chifukwa cha mtundu wa zovuta za HDL, nthawi zambiri chimatchedwa "cholesterol yabwino", ndikuchiyerekeza ndi LDL "yoyipa", yomwe imawonjezera chiopsezo chotchinga mitsempha yamagazi.

Njira ya kaphatikizidwe kamitundu yonse ya lipoprotein imayendetsedwa ndi zinthu zambiri - kagayidwe kazakudya, mawonekedwe amtundu, zizolowezi zoyipa.

Ubwenzi wa kusuta fodya ndi cholesterol "woipa" owonjezereka wafotokozedwa m'mapepala ambiri asayansi. Ndudu za fodya zimakhudza mwachindunji kuchuluka kwa lipoprotein yapamwamba komanso yotsika, kuletsa kaphatikizidwe ka "ogwiritsa ntchito" zamafuta.

Zochita zachipatala zimatsimikizira kuti munthu amene amasuta fodya kwambiri wokhala ndi cholesterol yochepa ali ndi mwayi wopezeka ndi vuto la mtima kapena sitiroko kuposa munthu yemwe samadalira ndudu koma amakhala ndi zotsatirapo zoipa. Mphamvu ya kusuta pa cholesterol, kuchuluka kwa lipoprotein sikuti chifukwa chokhacho chowonjezera chiopsezo cha ischemia. Mavuto osuta fodya:

kuchuluka kwa malinga a mtima,
makulidwe a oxipation a otsika osalimba lipoproteins, kuchuluka kwa thrombosis,
kuchuluka kwa mitsempha ya chithokomiro,
kuchepa kwa okosijeni wa okosijeni operekedwa ku maselo.

Kuyanjana kwa ma free radicals ndi LDL

Kusuta kangapo kumawonjezera mwayi wa magazi, kutsekeka kwa mitsempha ya m'mimba. Izi zikuchitika chifukwa cha kuyanjana kwa maulere pa utsi wa fodya ndi LDL:

LDL imakumana ndi ma free radicals ndipo imapitilira ma oxidation. Lipoproteins ya Oxidized amatha kupanga zigawo za atherosulinotic. Zitsulo zophatikizira zamagalimoto zimakhala ndi mphamvu yofanana ndi utsi wa ndudu.
Gawo la mamolekyulu owonongeka omwe amalowera mkati mwa endothelium yamatumbo omwe amayendamo. Mapangidwe omwe amaphatikizidwa amapita pang'onopang'ono kusintha kwamankhwala, kupangitsa chitetezo cha mthupi.
Kudziteteza, thupi limaloza kumalo komwe kuli chifanizo, monocytes omwe amapanga ma cytokines, amachititsa kuti mtima wa endothelium upange mamolekyu apadera omwe amalumikizana ndi monocytes.
Mocytes okulitsidwa amasinthidwa kukhala ma macrophages, amayamba kuyamwa LDL yosinthika, yopanga atherosranceotic plaque.
Mapeto a kutupa ndikutsuka kwa “matayala” opanga minofu yokhwima. Komabe, mkati mwa chinsalachi muli zinthu zoopsa, motero nthawi zambiri thupi limapangira chovala cha magazi kuzungulira malo otupa - magazi. Amatha kubisa chotengera, kusiya magaziwo kupita kumankhwala.

Ngati njira yofotokozedwera mapangidwe a atherosselotic plaques ndi thrombosis ikupezeka m'mitsempha yama ubongo kapena ziwiya zaubongo, kuyimitsa kwamitsempha kumayambitsa kukula kwa vuto la mtima kapena sitiroko. Chiwopsezo cha hemorrhagic stroke imachulukanso nthawi zambiri: chifukwa chake izi zimachitika chifukwa cha ziwiya za "galasi" ndikukhalapo kwa mitundu yamagawo.

Kukana ndudu kapena kusinthidwa?

Carbon monoxide ndi imodzi mwazinthu zazikulu za utsi wa fodya. Ili ndi chiyanjano chachikulu kwambiri cha hemoglobin kuposa mpweya. Izi zikutanthauza kuti ischemia imayamba m'misempha ya omwe amasuta fodya asanachitike. Kukana chizolowezi choyipa kumachepetsa chiopsezo cha hemorrhagic stroke, yomwe imayamba chifukwa cha kusintha kwazomwe zimapangitsa kuti magazi azikhala ndi vuto la kuperewera kwa mpweya.

Njira yotchuka yochotsa fodya - ndudu zamagetsi - poyang'ana koyamba, ilibe chidacho. Kafukufuku akuwonetsa kuti kuchuluka kwa cholesterol m'thupi la osuta otere si kochepera kuposa momwe amakhalira osuta fodya. Kuphatikiza apo, pamlingo womwewo wa chikonga, kuchuluka kwa ma spasms am'mimba kumakhalabe, komwe kumakulitsa chiopsezo chokhudzana ndi stroke, vuto la matenda oopsa.

Hookah sayenera kuonedwa ngati njira yokhayo yotetezeka ku ndudu: pakatha mphindi 30 kupuma utsi wake, munthu amalandira mlingo wa kaboni monoxide wofanana ndi ndudu 5.

Njira yanzeru kwambiri yothana ndi vuto la kubadwa kwa mtima kapena matenda opha ziwopsezo, komanso atherosulinosis ndi kukana ndudu ndi Hookah.

Malinga ndi madokotala, kusapezeka kwa zizolowezi zoyipa, zolimbitsa thupi zolimbitsa thupi ndi njira yabwino kwambiri yowonjezera kuchuluka kwa HDL ndi 10-15%.

Zinthu zomwe zidakonzedwa ndi olemba polojekitiyi
malingana ndi ndondomeko yakusinthaku.

Cholesterol yayikulu. Kodi chiwopsezo chake ndi chiyani ndipo ndi zotsatila za matendawa?

Cholesterol ndi chinthu chokhala ngati mafuta (mowa wamafuta) chofunikira pakuchita bwino kwa thupi. 80% ya zomwe zili mthupi zimapangidwa ndi chiwindi, ndipo zotsalazo zimadza ndi chakudya. Imafunikira pakupanga mahomoni, komanso imagwira nawo limodzi kapangidwe ka maselo, kukhala gawo la nembanemba.

Pali mitundu iwiri ya cholesterol:

Low Density Lipoprotein (LDL) - Ndikofunikira pakupanga mahomoni Lipid yamtunduwu imatchedwa "yoyipa." Chowonadi ndi chakuti ndi kuchuluka kwa thupi m'thupi, limakhazikika m'matumba, ndikupanga zolembedwa za atherosrance.
High Density Lipoprotein (HDL) - Ma lipids amenewa amathandiza kutsitsa milingo ya LDL mwa kutulutsa mopitilira muyeso kuchokera mthupi ndikuyipititsa ku chiwindi, komwe imakonzedwa. Mtunduwu umadziwika kuti "cholesterol yabwino."

Ndipo zonse zitha kukhala bwino, koma chowonadi ndi chakuti kuchuluka kwa mafuta m'thupi kumabweretsa matenda owopsa:

ischemia
atherosulinosis
sitiroko
myocardial infaration
imfa ya coronary.

Uwu si mndandanda wathunthu wazotsatira, motero cholesterol iyenera kuyang'aniridwa mosamala. Mkulu aliyense amayenera kukayezetsa magazi zaka zisanu zilizonse.

Momwe kusuta kumakhudzira cholesterol

Kusuta kumangokhala mliri wamakono. Timangokhalira kumakambirana za kuopsa kwa ndudu, ngakhale pamatumba m'malo otsatsa, nthawi zambiri timawona zithunzi zoyipa. Zachidziwikire, aliyense amadziwa momwe chizolowezichi chimavulaza mapapu, kupuma komanso mtima. Nthawi yomweyo, palibe amene anaganiza za momwe kusuta ndi mafuta a cholesterol amagwirizana.

Tsiku lililonse timamva pa wailesi, kuwerenga zolemba ndikuwona mapulogalamu omwe amalankhula za kuopsa kwa utsi wa chikonga ndi utsi. Nthawi yomweyo, timayiwala za zinthu zingapo zoipa zomwe zimabisidwa mu ndudu imodzi. Ma resini ndi poizoni onsewa ali ndi vuto lowononga mthupi, makamaka makina amitsempha.

Chosangalatsa ndichakuti kusuta sikukukhudzanso cholesterol, koma lipoprotein yotsika pang'ono imawonongeka ndi ma free radicals, ndiye kuti, amapangidwa. Tiyenera kudziwa kuti zitsulo zolemera zimayambitsa zomwezi.

Kumbukirani kuti ndi oxidized LDL yomwe imalumikiza kukhoma lamitsempha yamagazi kuti ipange zolembera za atherosrance. Kuphatikiza apo, zimatha kuyambitsa kuwonongeka kapena kutupa. Ambiri amalankhula za kuopsa kwa cholesterol komanso kuopsa kochulukitsa, koma zoona zake kuti ma cell owonongeka ndi owopsa. Ichi ndichifukwa chake wosuta yemwe amakhala ndi cholesterol yotsika amakhala wokonda matenda amtima kuposa wosasuta ndi mkulu.

Zomwe zimachitika mthupi pambuyo makulidwe a oxidation a LDL:

Ma lipoproteins otsika kwambiri amadziwika ndi ma radicals aulere ndipo amawonjezeredwa.
Ma mamolekyulu ena owonongeka amalowera kumtunda kwa minyewa yam'mimba, ndikumapangitsa kutupa.
Chotsatira pakubwera mayankho omwe amachititsa kusintha kwa LDL, ndipo kusatetezeka kwawo kumazindikira kuti ndi kowopsa.
Chitetezo cha mthupi chimayamba kuthana ndi zowonongeka potumiza ma monocytes, omwe amatulutsa ma cytokines. Izi zimakhalanso ndi vuto lotupa.
Potengera kukhalapo kwa ma cytokines, endothelium imasunga mamolekyulu omatira omwe amamatira ku monocytes.
Monocytes amasintha kukhala ma macrophages. Amamwa LDL mpaka atasandulika kukhala lipid pakati pa zolembedwa za atherosrance. Imapitilizabe kulimbana ndi LDL, kuwagwira.
Ngati kutupa sikuyimitsidwa, ndiye, pamapeto pake, macrophages amaphulika mkati mwa zotengera, ndikumamasula zoopsa.

Ndikofunika kusiya njira yotupa pakanthawi kuti muchepetse mapangidwe a atherosulinotic malo, mapangidwe omwe amabweretsa zotsatira zoyipa. Ngati njirayi imayimitsidwa munthawi yake, ndiye kuti kukula kwamakinidwe kumapangika m'matumbo, omwe sikubwezeranso ngozi m'thupi.

Chimachitika ndi chiyani ngati njirayi singayime? Kalanga, zotsatira zake zimakhala zachisoni kwambiri. Ngati njira yotupa ikupitirirabe, ndiye kuti lipid nuclei yatsopano mwachilengedwe imalowa m'magazi. Amakumana nawo ngati ngozi, ndikupanga magazi, omwe ayenera kupewa kufalikira kwa lipid. Ndipo zonse zingakhale bwino, koma chifukwa cha njirayi, mwayi wa thrombosis ndiwokwera. Chovala chimatchinga kulowa mu minofu ya mtima, ndipo chimaleka kulandira okosijeni, motero, mu minofu ndondomeko ya necrotic iyamba. Kenako pamabwera vuto la mtima.

Chifukwa chake, ndikofunikira kuzindikira, inde, ndikofunikira kuti musapitirire muyeso wovomerezeka wa lipoprotein m'thupi, koma kumbukirani kuti awa siwope. Kusuta kumabweretsa zotsatira zoyipa, ngakhale mutakhala ndi cholesterol yeniyeni.

Kusintha ndudu ndi zida zamagetsi kapena ndi hooka

Kusiya kusuta, ambiri amasuta ndudu zamagetsi kapena kuluka, osazindikira kuti sakuthetsa vutolo, koma amawonjezera vutolo. Kuyesera kuthana ndi ndudu sikuthandizanso thanzi lanu, komanso kuvulaza. Malinga ndi Hilary Waring, kwa theka la ola limodzi osuta fodya (10 mg wa fodya), mumapuma mpweya wa monoxide wambiri ndendende ndi ndudu zosachepera 4-5. Chizindikiro choterechi chimabweretsa kuwonongeka kwa maselo aubongo komanso chifukwa chakutha kukumbukira. Chifukwa chake, musaganize kuti Hookah ndi malo achitetezo a ndudu.

Monga akatswiri a zamankhwala a ku America apeza, ndudu zamagetsi sizipulumutsanso iwo amene akufuna kusiya kusuta. Pankhaniyi, munthu amapuma utsi, wadzadza ndi zinthu zonse zomwezo za fodya. Zimakhudza thupi mosasuta ndudu wamba. Chinyezi kuchokera ku nthunzi chimakhala pa mucosa potero ndikupanga sing'anga pakukula kwa mabakiteriya. Munthu amayamba kudwala pafupipafupi, chifukwa chitetezo chamthupi sichitha kulimbana ndi matenda ambiri.

Pomaliza

Tili ndi thanzi limodzi ndipo sitiyenera kuliwononga ndi chinthu choyipa monga kusuta. Kuphatikiza apo, sizivuta kusiya izi, chifukwa zimawoneka koyamba. Chofunika kwambiri, kumbukirani kuti kusuta sikuyenera thanzi lanu labwino, kapena, moyo. Chifukwa, monga zidakwaniritsidwa, kusuta ndi cholesterol ndizogwirizana kwambiri ndipo zimatha kudzetsa matenda ena owopsa kwambiri.

Musaiwale kuti kusaka njira zina sikungabweretse zotsatira zomwe mukufuna, koma kungakulitse njira yopangira zovuta. Osasinthira vuto limodzi kukhala linzake, siyani kusuta. Ganizirani zinthu zina zosangalatsa zomwe zidzakuthandizani kuti mupumule komanso kuti mupumule pamavuto. Chitani masewera olimbitsa thupi ,wonongerani nthawi yochulukirapo mu mpweya wabwino, kucheza ndi okondedwa, okondedwa ndi abwenzi. Dzikondeni nokha ndikukhala athanzi.

Mphamvu ya chikonga pa cholesterol ndi mitsempha yamagazi

Ndianthu ochepa omwe amaganiza momwe kusuta fodya kumawononge thanzi. Nicotine ndi mankhwala oopsa omwe amapezeka mu utsi wa fodya ndipo amalowa m'thupi munthu akayamba kusuta. Poizoni amakwiya chitukuko cha atherosulinosis, zomwe zimapangitsa kuti chiwopsezo cha magazi chiwonjezeke.

Atherosulinosis ndi matenda omwe ndi achilengedwe mwachilengedwe. Matendawa amakhudza bedi lamitsempha la ziwalo zonse ndi machitidwe. Pomwe ikupita patsogolo, makoma amitsempha yamagazi amakhala owuma, komwe kumayambitsa stenosis ya lumen yawo. Zotsatira zake ndikuchepa kwa magazi, kuchepa kwa minyewa kumasokonezeka, matenda amkati mwa chibadwa cha ischemic (vuto la mtima, gangrene, stroke) limachitika. Izi ndichifukwa choti kuchuluka kofunikira kwa michere sikumalowa minofu, mpweya wawo umasokonekera.

Cholesterol ndi mankhwala achilengedwe omwe amapangidwa ndi thupi pokonza mafuta kagayidwe. Pali magawo angapo a cholesterol, omwe amatchedwa oyipa komanso abwino (LDL, HDL). Imakhala ndi gawo limodzi lofunikira mu njira zambiri zazamoyo. Pali cholesterol yakunja, yomwe imadzazana ndi chakudya. Zakudya zokhala ndi mafuta ochulukirapo zimayambitsa hypercholesterolemia (kuwonjezereka kwa lipids yotsika-m'magazi). Cholesterol chabwino (HDL) sichimavulaza thupi. M'malo mwake, amagwira ntchito ngati wotsutsa wa LDL.

Kuwonjezeka kwakukulu kwa ma lipids otsika kwambiri m'magazi kumabweretsa kuti ma atherosrance a cholesterol cholembera mumitsempha amafikira zazikulu komanso zimalepheretsa magazi kuyenda bwino. Zotsatira za masinthidwe a pathological awa ndi matenda oopsa a mtima, ubongo.

Osuta kwambiri saganiza za momwe kusuta kumakhudzira cholesterol komanso ngati mulingo wake m'magazi umakwera kufikira mavuto atayamba ndi mtima.

Malingaliro monga kumwa pafupipafupi, kusuta fodya ndi mafuta amthupi ndi olumikizidwa mosiyanasiyana. Kusuta ndi njira yotentha fodya ndikutulutsa utsi wa caustic. Utsi uwu ndiwowopsa chifukwa uli ndi mpweya wa monoxide, nikotini, ma carcinogenic. Carbon monoxide ndi mankhwala omwe amatha kulumikizana ndi hemoglobin, ndikuchotsa mamolekyu a oxygen m'maso mwake. Chifukwa chake, thupi la anthu omwe amasuta fodya limaperewera. Ndikusuta Njira ya oxidation ya LDL. Izi ndichifukwa cha zovuta zamagetsi. Okosijeni, cholesterol yoyipa nthawi yomweyo imayamba kuyikika pachimake cha zotengera, ndikupanga cholesterol.

Ngozi yayikulu ndikusuta kwa omwe ali nako shuga wamkulu m'magazi. Ichi ndi chizindikiro cha matenda otchedwa matenda a shuga. Izi ndizowopsa pamatengera - zimapangitsa kuti makoma awo akhale otetezeka momwe angathere. Ngati wodwala matenda a shuga sangasiye chizolowezi chochita zoipa, ndiye kuti izi zimangokulitsa vutolo. Zotsatira za kusuta ndi matenda ashuga zimapweteka kwambiri - odwala ali pachiwopsezo chotsirizidwa ndikumapeto kwake ngakhale kufa.

Zomwe zili pamwambazi zikuwonetsa kuti kusuta ndi cholesterol kumalumikizana. Kukula kwa kusintha kwa zam'thupi m'thupi kumadalira pang'ono momwe munthu amasuta. Zokwanira 2-3 ndudu patsikukotero kuti cholesterol mulingo wambiri kuposa wabwinobwino. Kusuta kwakutali, kumawononga magazi ndi ziwalo zofunika kwambiri.

Kusuta kumathandizira kukulitsa kwa atherosulinosis

Kusuta ndiko chizolowezi cha anthu ambiri azaka zogwira ntchito, omwe zaka zawo zimasiyana kuyambira 18 mpaka 50 ndi akulu.Achinyamata amayamba kusuta fodya chifukwa chakuwona ngati ndudu chizindikiro cha kukula, ufulu. Popita nthawi, kudalira kwamaganizidwe kumakhala ndi zofunikira zathupi, sizovuta kuthana nokha.

Asayansi atsimikizira kuti kusuta kumachulukitsa chiopsezo chokhala ndi zotupa zam'magazi a mtima. Atherosclerosis ndi kusuta ndi anzanga osatha. Matendawa amatengedwa ngati njira yayikulu ya omwe amasuta. Chinotine, chomwe chimapangidwa panthawi yophatikizana ndi fodya, ndiye poizoni wamphamvu kwambiri pazamoyo zonse. Kulowa m'mapapu kulowa m'magazi, chinthu ichi chimayambitsa vasospasm, kuchuluka kwa kukakamira kwazinthu, kukweza nkhawa pamtima, kuchuluka kwa cholesterol, komwe kumakhala mkati mwa magazi.

Popita nthawi, mafupa amatha zilonda, ndipo kulowa m'magazi, kumakhala chifukwa cha kutsekeka kwathunthu kwa lumen ya mtima. Kwa moyo ndi thanzi, vuto linalake ndi kutsekereza kwa m'mapapo, m'mitsempha ya m'mimba, ndi ziwiya zamagetsi zomwe zimadyetsa ubongo. Kuphatikiza pakukweza cholesterol komanso kupanga atherosulinosis, kusuta kumayambitsa:

matenda a oncological (makamaka a ziwalo zam'mimba zopuma),
matenda am'mimba dongosolo (zilonda zam'mimba ndi duodenum, gastritis, esophagitis),
kuwonongeka kwa mano
chepetsa khungu
mavuto ndi ziwalo za njira yoberekera.

Kusuta fodya pa nthawi ya pakati kumakhala ndi zovulaza osati kokha mthupi la mayi. Izi zikuwoneka ndikuchedwa kuyambuka kwa mwana wosabadwayo, kubadwa kwa mwana wolumala, imfa yake ya intrauterine.

Fodya wamagetsi, Hookah, Cigars

Masiku ano zilipo njira zina zakusuta fodya. Anthu ambiri omasuta fodya wamba anayamba kukonda ndudu zamagetsi. M'masiku amakono, izi zimatchedwa vape. Kusiya kusuta kwachikhalidwe ndikusinthira mpweya wambiri sikuthetsa vuto lowonjezera mafuta m'thupi. Mpweya wotentha uli ndi chuma chambiri chogwiritsa ntchito mwaulere, makina ochita zomwe sizosiyana ndi fodya. Kuphatikiza apo, chinyezi chonyowa cham'mimba zimayambitsa kupuma komwe kumayambitsa kukwiya, komwe kumayambitsa matenda.

Hookah ndi ndudu osavulaza kuposa ndudu zachizolowezi. Kusuta fodya kapena fodya, kumatenga nthawi yambiri kuti musute fodya wa fodya 5-6. Momwemo, katundu pa kupuma, dongosolo la mtima limachulukitsa, kuchuluka kwa cholesterol yamagazi kumakwera. Chifukwa chake, njira yamakono yosuta fodya yachikhalidwe imakhala ndi kuvulaza thupi.

Kusuta, hypercholesterolemia ndi mtima atherosulinosis ndi maubwenzi atatu omwe amagwirizana. Ngati pali zina zowonjezera, chiwopsezo cha matendawa chimachitika mwachangu kwambiri.

Pofuna kuti musagwidwe ndi matenda a lipid metabolism, komanso mogwirizana ndi atherosclerosis, muyenera kusiya zosokoneza bongo, kutsatira mfundo za zakudya zoyenera, perekani thupi lanu mokwanira kuchita masewera olimbitsa thupi, kuyang'anira kuchuluka kwa mafuta m'thupi. Ngati ichulukira, muyenera kufunsa dokotala nthawi yomweyo. Siyani kusuta!

Kodi cholesterol ndi chiyani?

Cholesterol, kapena cholesterol, ndi chinthu chonga mafuta (mowa wonenepa), chofunikira kuti chitetezo chazonse chizigwira ntchito. Imalimbikitsa mapangidwe a nembanemba am'maselo, amatenga nawo mbali popanga mahomoni a steroid m'matumbo a adrenal, mahomoni ogonana, komanso mapangidwe a bile ndi chiwindi. Kusunga chitetezo chathupi komanso kugwira ntchito kwa ubongo kumalumikizidwa ndi kutenga nawo mbali.

Ambiri mwa cholesterol m'thupi amapangidwa ndi chiwindi (pafupifupi 80%), ena onse amabwera ndi chakudya.

Pali mitundu iwiri ya cholesterol:

Low Density Lipoprotein (LDL) amathandizira kupanga mahomoni. Amatchulidwanso kuti "yoyipa," kapena "yopweteka." Chifukwa chakuti ndi zochulukirapo, mapangidwe a atherosselotic amapezeka m'matumbo, zomwe zimabweretsa matenda amtima.
High density lipoprotein (HDL) imathandizira kuthana ndi cholesterol "yoipa" yowonjezereka ponyamula kupita nayo ku chiwindi ndi kukonzanso. Cholesterol iyi imatchedwa "zabwino," kapena "yopindulitsa."

Choopsa ndichakuti kukwera kwa cholesterol m'mwazi, kapena m'malo mwa "zoyipa" ndi "zabwino", pamakhala matenda omwe ali ndi mtima wamatenda, stroke, kugunda kwamtima, matenda amitsempha, kupangika kwa miyala ya cholesterol m'mitsempha ya ndulu.

Kusuta cholesterol yayikulu

Mphamvu ya kusuta kwa cholesterol yamagazi ndiwowongolera kwambiri. Kulumikizana mwachindunji ndi izi matenda kumayesedwa ndi chizolowezi choyipa monga kusuta. Ngozi ikuwonetsedwa pakuwonjezeka kwa LDL ndi kuchepa kwa HDL. Fodya wambiri akasuta, ndiye kuti kuchuluka kwa zinthu zovulaza m'magazi kumakwera. Izi zakhala zikufotokozedwa kale m'mabuku ambiri asayansi.

Cholesterol chovulaza mothandizidwa ndi mafayilo amtundu wa utsi wa fodya imathandizira kupanga mapangidwe oopsa, omwe amatsogolera matenda a mtima ndi ubongo.

Ma radicals aulere, ngati zitsulo zolemera, amawononga lipoprotein yotsika pang'ono mwa kuwonjezerera. Choopsa ndichakuti ndi LDL yobowoleza yomwe imakhazikika pamatumbo ndikuthandizira kupanga mapangidwe a atherosselotic. Tinthu tating'onoting'ono titha kuyambitsa kuwonongeka kapena kutupa.

Poterepa, munthu amene amasuta fodya komanso wokhala ndi cholesterol yochepa amakhala ndi matenda amtima wambiri kuposa wosasuta fodya wambiri. Pamodzi ndi zakudya zoyenera, ndikukhalabe ndi moyo wathanzi, ndikofunikira kusiya kusuta kwa fodya chifukwa zimakhudza thupi lonse.

Njira zotsatizana zomwe zimachitika m'thupi pambuyo makulidwe a oxidation a LDL chifukwa chosuta:

Mothandizidwa ndi ma free radicals, otsika osalimba lipoprotein amathandizira.
Mamolekyulu owonongeka amaphwanya umphumphu wa minofu yam'mimba yapamwamba ndikupangitsa kutupa.
Zotsatira zamachitidwe amtundu, chitetezo chokwanira chimasinthidwa ndikusintha kowopsa.
Endothelium imatulutsa mamolekyulu omatira omwe amayankha maonekedwe a ma cytokines ndipo amatsatira ma monocytes.
Ma macrophages amapangidwa kuchokera ku monocytes, omwe amawononga lipoproteins yotsika, ndikusintha kukhala zolembedwa za atherosranceotic.
Ngati kutupa sikumayimitsidwa, ndiye kuti macrophages amaphulika mchombo ndikukutulutsa zoopsa zapoizoni.

Ndikofunika kuchitapo kanthu panthawi yopewetsa kutukusira, popanda kuponderezana ndi matendawo. Ngati kutupa kumapitirirabe, ndiye kuti ma lipid nuclei amalowa m'magazi ndi mawonekedwe a magazi, omwe amakhala ndi chiopsezo chakufa kwa anthu, popeza kuti nsaluyo imalepheretsa chiwalo, zomwe zimapangitsa kuti pakhale njira yozungulira.

Kusuta ndi cholesterol yayikulu m'magazi kumayanjana kwambiri ndipo kumabweretsa mavuto akulu mthupi. Asayansi aku Japan achita maphunziro angapo pa ubale wokhudza kusuta fodya komanso mafuta ambiri. Zatsimikiziridwa kuti zovulaza za cholesterol zimalimbikitsidwa pamene ndudu zimasuta.

Kusuta kumawonjezera chiopsezo cha matenda a mtima kwa osuta (20% kuposa anthu osuta). Kuti muthane ndi matenda oyambawa, ndikofunikira kuchita nkhondo yolumikizana nthawi yomweyo ndi kusuta fodya komanso mafuta ambiri.

Kuvulaza kwa njira zina zakusuta

Sikulimbikitsidwa kuti musinthe ndudu zina m'malo mwake. Mwachitsanzo, Hookah ndi malo osavomerezeka a ndudu, chifukwa mukasuta fodya, mpweya wa monoxide umalowerera, womwe mu mphindi 30 wogwiritsa ntchito umafanana ndi ndudu 5 zomwe zagwiritsidwa ntchito, zomwe zimakhala ndi zovuta m'maselo aubongo ndipo mwina zimatha kuzindikira.

Ndudu zamagetsi sizimapulumutsanso ku chizolowezi choyipa. Pomwe mumasuta ndudu yamagetsi, wosuta amaputa utsi womwewo, womwe umapweteketsa thupi. Nthochi imagwira ntchito pa mucosa ndikulimbikitsa kukula kwa mabakiteriya.

Ngakhale akunenedwe kuopsa kwa kusuta ndi zizindikiro zochenjeza pamapaketi a ndudu zokhudzana ndi matenda oyipa omwe akuyembekezera wosuta, kuchuluka kwa anthu omwe amadziwika kuti ali ndi chizolowezi sikuchepa.

Zotsatira za njira zina zakusuta pa cholesterol

Pali njira zingapo zakusuta: ndudu zamagetsi, ma hookah, ndudu, nthenga. Koma palibe amene amachepetsa zomwe zimakhala za lowopoproteins m'magazi ndipo siziwonjezera kuchuluka kwa milomo ya lipoprotein. Zida zonsezi zimakhala ndi nikotini, zomwe zimachepetsa kuchuluka kwa HDL m'magazi. Pankhaniyi, mapangidwe a cholesterol plaque mkati mwa mitsempha ya magazi akupitilira ndipo chiopsezo cha thrombosis sichikuchepa konse.

Zofunika! Simuyenera kugwiritsa ntchito njira zina zakusuta, koma muyenera kungosiya kusuta fodya kuti mukhale ndi thanzi labwino ndikukhalitsa moyo wanu.

Zotsatira za chikonga pa cholesterol

Kodi kusuta kumakhudza bwanji cholesterol yamagazi? Zizolowezi zovulaza, monga mowa ndi kusuta, nthawi zonse zimakhala ndi zotsutsana. Ngati wodwala matenda ashuga amasuta fodya kangapo patsiku, machitidwe onse ndi ziwalo zamkati zimatsutsidwa.

Minyewa, nikotini ndi zinthu zina zimapweteka m'thupi, carbohydrate oxide ndiowopsa kwambiri. Imasinthira okosijeni m'magazi, kupangitsa kuti mpweya ukhale ndi mpweya, kutsitsa kuchuluka kwa hemoglobin, ndipo chinthucho chitha kukulitsa katundu m'misempha ya mtima.

Ma radicals aulere amapezeka mu utsi wa fodya, amachititsa njira ya cholesterol oxidation. Madokotala amati lipids yotsika kwambiri imakhala yoopsa ikangowonjezera oxidation. Njira izi zikadzachitika, mafuta ngati:

akuyamba kuyikika pamitsempha.
amachepetsa kutuluka kwa magazi
Kuchepa kwa atherosulinosis, kuwonongeka kwa mitsempha kumawonjezeka.

Mwachilengedwe, sikuti kusuta kokha kumayambitsa makutidwe ndi okosijeni a cholesterol, zotsatira zofananazo zimachitika poizoni wa mankhwala oopsa, mankhwala ophera tizilombo, zitsulo zolemera. Wodwala akakhala pa malo oopsa kuntchito, chizolowezi choipacho chimangokulitsa vutolo.

Osuta fodya nthawi yomweyo amakhala ndi chiopsezo chachikulu cha 50 peresenti chotenga matenda a mitsempha ya mitsempha kuposa munthu wodwala matenda ashuga popanda chizolowezi ichi. Asayansi akunena kuti kusuta kumawonjezera mavuto obwera chifukwa cha cholesterol yayikulu, kumayambitsa kukulitsa ndi kuwonjezereka kwa matenda a mtima, komanso kumachepetsa thanzi.

Utsi uliwonse wapa ndudu ukuwonjezeka:

Kuchuluka kwa cholesterol kumathandizidwanso, kuchuluka kwa mpweya kumachepa, katundu pa mtima ukuwonjezeka.

Ngati wodwala matenda ashuga apezeka ndi zotupa zam'mimba, pambuyo pa mphindi 1-2 magazi amatuluka ndi 20 peresenti poyankha utsi wa fodya, minyewa yam'mimba yotupa, matenda amitsempha yamagazi amakula, ndipo milandu ya angina pectoris imachulukirachulukira.

Kudzidalira kumathandizira coagulability wamagazi, kumawonjezera kuchuluka kwa fibrinogen, kuphatikizika kwa maselo ambiri, komwe kumachulukitsa atherosulinosis, malo omwe alipo a atherosranceotic. Zaka ziwiri mutasiya kusuta, chiopsezo cha kufa chifukwa cha zovuta zam'mimba, vuto la mtima limachepa.

Pazifukwa izi, kusuta fodya ndi cholesterol sikugwirizana.

Zina zomwe muyenera kudziwa

Utsi wina wapoizoni kwambiri wa fodya ndi chikonga. Vutoli limakhudza misempha yamtima, mtsempha wamagazi. Ngati ziwiya zam'munsi zimakhudzidwa ndi pathological process, izi zitha kuwopseza anthu omwe ali ndi matenda ashuga ndi kukula kwa khungu ndi kuduladula miyendo.

Kusuta kwa nthawi yayitali kumayambitsa kusokonezeka kwa minofu ya mtima, kumawonjezera mwayi wamagazi, magazi osokonekera. Posakhalitsa, sinusoidal arrhythmia yapezeka mwa wodwala.

Vuto linanso lalikulu ndi kugonjetsedwa kwa dongosolo la genitourinary, kugaya chakudya, ubongo, chiwindi. Nikotini amachepetsa hemoglobin, zinthu zapoizoni zimayamba kudziunjikira mthupi, ndipo milandu yokhala ndi kukokoloka imayamba kuchuluka.

Odwala matenda ashuga ayenera kumvetsetsa kuti kusintha kwa atherosulinotic ndikovuta kuvuta. Popewa mavuto, tikulimbikitsidwa munthawi yake:

onani dokotala
imani mayeso a cholesterol yathunthu, LDL, HDL,
kumwa mankhwala osokoneza bongo.

Ndiosavuta kusiya mitundu yoyambira ya atherosulinosis, nthawi zina wodwalayo amangofunikira kusiya kusuta.

Osatinso kusuta kovulaza komanso kongokhala, kotero muyenera kusamalira anthu omwe akuzungulirani komanso kuti musawaphetse ndi fodya. Amayi ndi ana amakhudzidwa kwambiri.

Ngati wodwala matenda ashuga asiyiretu chizolowezi cholakwika, pomwe vuto la matumbo a coronary layamba, ischemia imayamba. Zotengera sizitha kupereka myocardium yonse ndi magazi, mtima umakhala ndi zovuta zowonongeka.

Carbon monoxide imayambitsa hypoxia, chifukwa chake matenda a coronary amawerengedwa kuti ndiwo njira yayikulu ya omwe amasuta omwe ali ndi chidziwitso. Pambuyo posuta paketi ya fodya tsiku limodzi kwa nthawi yayitali, pafupifupi 80 peresenti, wodwala matenda ashuga amwalira ndi matenda a mtima.

Wosuta amakhalanso pachiwopsezo cha matenda oopsa, magazi ake amathanso kuipiraipira, ndipo matenda a m'mimba amayamba. Ndi matendawa, kuchuluka ndi kukula kwa zolembedwa za atherosselotic, kuchuluka kwa kuphipha kumachulukirachulukira. Ngati simukuchepetsa magazi, pang'onopang'ono zinthu zimakulirakulira.

Zotsatira zake, magazi samatha kuyenda bwinobwino kudzera m'mitsempha ndi m'mitsempha, mtima suulandila kuchuluka kwa michere ndi mpweya. Matenda owopsa omwe adalumikizana ndi matenda omwe alipo:

mtima kumangidwa
arrhasmia,
matenda a mtima
kulephera kwamtima
pambuyo infarction mtima.

Mavuto owopsa kwambiri ndi kugunda kwa mtima, sitiroko. Ndi iwo, kufa kwa mbali zina za mtima, imfa. Pafupifupi 60 peresenti ya anthu omwe amafa chifukwa cha vuto la mtima, ambiri mwa odwala ndi omwe amasuta.

Chifukwa chake, pali mgwirizano wapakati pa cholesterol ndi kusuta, komwe kumabweretsa matenda oopsa.

Kafukufuku angapo awonetsa kuwonjezeka kwa zotsatira zoyipa za cholesterol mukasuta ndudu.

Momwe mungadzitetezere

Kusankha koyenera komanso koyenera kwambiri kuyenera kusiya kusuta fodya wamba komanso pakompyuta. Kukhala ndi moyo wodwala matenda ashuga popanda zizolowezi zoyipa kumawonjezeka ndi pafupifupi zaka 5-7.

Zaka 10 atasiya kusuta, thupi limabwezeretsedwa ndikuchotsa kwathunthu zinthu zopweteka, ma resini. Chiwopsezo chotukuka ndikupita patsogolo kwa atherosulinosis kumachepetsedwa kukhala mulingo wa odwala opanda zizolowezi zoyipa.

Pakakhala zovuta kwambiri kulimbana ndi kusuta, muyenera kuyesa kuchepetsa kuchuluka kwa ndudu. Kuphatikiza apo, ndikofunikira kubwereza zakudya, kuchotsa mafuta, zakudya zotsekemera ndi mchere. Chifukwa cha izi, titha kuwerengera kuchepa kwa cholesterol yotsika kwambiri m'magazi komanso kupewa magazi kuwundana.

Zabwino zimachitika ndi moyo wokangalika, masewera, kuthamangira m'mawa. Kufikira momwe mungathere, simukuyenera kuyenda pa basi, kupita komwe mukupita poyenda wapansi kapena njinga. M'malo mokweza, amakwera masitepe, ndikofunikira kuyenda masitepe awiri nthawi imodzi.

Njira yabwino ikakhala:

Muyenera kugona mokwanira, kutsatira zomwe mumachita tsiku ndi tsiku, kutentha thupi kwambiri. Mavitamini, michere amawonjezeka pamenyu. Folic acid, mavitamini a magulu B, C, E. amathandiza kuthana ndi zotsatirapo za kusuta.

Kuwopsa kwa kusuta akufotokozedwa mu kanema m'nkhaniyi.

Imakhazikika pamisempha ya shuga kwa nthawi yayitali
Imabwezeretsa kapangidwe ka insulin

Madotolo akhala akukambirana za kuwopsa kwa kusuta pa thanzi la mtima wamankhwala kwazaka zambiri.Kodi pali zoopsya zilizonse zochokera kusuta fodya wa atherosulinosis?

Zimagwira bwanji?

Tisananene mwatsatanetsatane ngati kusuta kumakhudzanso cholesterol yamagazi, timakumbukira mwachidule zomwe cholesterol imachita m'moyo wa munthu.

Mthupi, cholesterol imamanga kumapuloteni amwazi ndikupanga lipoprotein, omwe amakhala osalimba (HDL) ndi otsika (LDL). HDL yokhala ndi kayendedwe ka magazi imaperekedwa ku ziwalo zonse ndi matupi athupi. Nthawi yomweyo, HDLPs imagwira ntchito yoteteza, kuonetsetsa momwe ubongo ukugwirira ntchito komanso chitetezo cha mthupi, ndipo umagwira nawo ntchito yopanga mahomoni, bile ndi mavitamini.

LDL, yomwe imatchedwanso "cholesterol yoyipa," imakhala ndi malo okhala pamakoma amitsempha yamagazi, yochepetsa lumen yawo ndikupanga cholesterol plaques.

Ngati munthu ali ndi moyo wathanzi, amadya moyenera, ndiye kuti thupi lake limasunga cholesterol, pomwe cholesterol "yabwino" imateteza mitsempha yamagazi ku zotsatira zoyipa. Kuchuluka kwa HDL ndi LDL m'magazi kumakhalanso koyenera, kotero chiopsezo cha zovuta zomwe zingatheke ndi dongosolo lamagazi zimachepetsedwa. Komabe, pali zinthu zingapo zoyipa zomwe zingakwiyitse izi.

Kusuta - kuvulaza ziwiya!

Ndipo tsopano tiyeni tiwone bwino za kusuta kwa cholesterol yamagazi. Kafukufuku wa asayansi akuwonetsa kuti kusiya fodya kumapangitsa kuti cholesterol ikhale yabwino, ndikuchepetsa kuchuluka kwa cholesterol "chabwino" ndikuwonjezera "zoipa".

Pankhaniyi, HDL yothandiza sikuti ilibe nthawi yoteteza dongosolo lozungulira kuzungulira LDL yoyipa, chifukwa chake
cholesterol zolembera amapanga mofulumira. Popita nthawi, amayamba kuzimiririka, ndipo nthawi inayake chivundikiro cha zolembera zokhwima ndipo zomwe zili mkati mwake zimagwirizana ndi madzi a m'magazi.

Amakhulupirira kuti pakadali pano magazi amawundana m'mbale, yomwe imatha kutsekeka kwathunthu kapena pang'ono pang'ono. Ndipo pomwepo zimatengera pomwe ndendende momwe magazi amapangidwira ndi momwe amakhalira. Ngati tikulankhula za mitsempha yamtima, ndiye kuti myocardial infarction ndiyotheka.

Kuphwanya magazi m'mitsempha ya bongo kumabweretsa stroko ya atherothrombotic. Ndipo iyi si mndandanda wathunthu wazotsatira zomwe zingachitike.

Mwa njira, kusuta pakokha, kupatula cholesterol, kumapangitsa kuti mitsempha yamagazi ikhale yofiyira ndipo imakonda kupezeka. Kuphatikiza apo, cholesterol zolembera zikupezeka mu chotengera cha "galasi," ndiye kuti izi zimapangitsa kuti zikhale zowonjezereka komanso kupindika.

Kusuta ndi chimodzi mwazinthu zowopsa kwambiri za cholesterol yayikulu.

Zoyenera kuchita?

Tsoka ilo, palibe miseche muzakudya komanso mankhwala omwe angathandize kukhazikitsa cholesterol yoyenera ngati munthu asuta. Choyamba, ndikofunikira kuti muchotse kudalira kwa fodya, kuti mankhwala a cholesterol apamwamba apambane.

Asayansi awonetsa kuti kusiya kusuta kumawonjezera cholesterol "yabwino" mwa 10% . Ndipo ngati muwonjezeranso kuchita masewera olimbitsa thupi pafupipafupi, mupanganso kuwonjezeka kwa HDL - ina pafupifupi 5%. Izi zikuthandizani thupi lanu, ndipo nthawi zina zimatha kuchepetsa kuchuluka kwa mankhwalawa kuti muchepetse kuchuluka kwa lipoproteins (statins) yotsika.

» Kodi kusuta kumakhudza bwanji cholesterol yamagazi?

Zinakhala zotheka kuchiza matenda ashuga, ingotenga 34%.

High cholesterol ndi kusuta zimayambitsa kukula kwa matenda owopsa a mtima, mitsempha yamagazi ndi thupi lonse. Zochita kuchipatala zimawonetsa kuti munthu yemwe amasuta kwambiri yemwe ali ndi cholesterol yotsika pang'ono amakhala ndi chiopsezo chachikulu chodwala matenda a mtima komanso wodwala mtima kuposa wodwala wopanda chizolowezi chomva mankhwala osokoneza bongo.

Zowonongeka pamlingo wamafuta ofanana ndi mafuta ndizotalikira chifukwa chokhacho chomwe chimayambitsa matenda a coronary and atherosclerosis. Kuvulala kwa utsi wa ndudu kumawonetsedwa ndi kuwonjezeka kwa kusokonekera kwa makoma amitsempha yamagazi, kuwonjezeka kwa mwayi wopasuka, kutupa kwa magazi.

Tiyeneranso kumvetsetsa kuti milandu ya spasms ya cerebrovascular ikuchulukirachulukira, kuchuluka kwa mpweya womwe umatengedwa kupita ku maselo amachepetsedwa, ndipo tsogolo la thrombosis limakulitsidwa.

Mphamvu ya mowa

Pa intaneti mutha kupeza ndemanga zambiri kuti zakumwa zina zakumwa zoledzeretsa zimatha kuchepetsa cholesterol. Izi ndizowona, koma pokhapokha ngati pali mowa wambiri womwe umagwiritsidwa ntchito mosiyanasiyana. Mwachitsanzo:

30 ml ya mowa wabwino, ramu wabwino, mowa wamphesa kapena mowa womwe umamwa tsiku lililonse ungachepetse cholesterol yambiri mwa mayunitsi angapo.
Ngati mumamwa vinyo, ndiye kuti saloledwa kupitiliranso 150 ml patsiku - tikulankhula za chakumwa chouma, chopanda mpanda. Mowa wokhawo womwe umachepetsa cholesterol.
Kapu yamowa yokhala ndi voliyumu ya 3 ml imadziwikanso ngati chinthu chovomerezeka.

Ngati kuchuluka kwa mowa kumapitilira, ndiye kuti palibe zotsatira zabwino zomwe zingachitike, zabwino zokha. Ndipo makamaka, cholesterol sichitha.

Chofunika kwambiri ndi vinyo wofiira wouma kuchokera ku mphesa ngati mowa. Adaphunzira kupanga vinyo kale m'mbuyomu, chakumwa ichi chili ndi michere yambiri, mavitamini, michere, motero zimakhudza njira zambiri mthupi la munthu. Makamaka, ma phenolic ophatikizidwa, omwe amakhala ndi vinyo wofiira, amasokoneza kuyamwa kwa mafuta m'mimba. Amathandizanso kuthana kwa chakudya chamafuta. Zonsezi zimathandiza kutsitsa cholesterol.

Zoterezi zikamachitika chifukwa chakugwiritsa ntchito vinyo wofiirayo zikuwatsimikizira ndipo zikuwatsimikizira kuti ali ndi chitsimikiziro chachipatala. Magulu awiri a anthu adatenga nawo gawo pazoyeserazi. Onse aiwo ankadya zakudya zolemera, zamafuta, koma ena a iwo ankamwa kapu ya tsiku patsiku, pomwe ena sanatero. Patatha milungu ingapo, kuyezetsa magazi kunachitika, ndipo kunapezeka kuti iwo omwe amadya nyama ndi vinyo samaposa cholesterol. Mwa omwe amadya nyama yokha, cholesterol idakula kwambiri.

Kuphatikiza apo, vinyoyu ali ndi zinthu zina zambiri zothandiza:

Mavitamini B,
chitsulo, zinc, manganese, mkuwa,
ma tannins ndi antioxidants.

Zinthu zonsezi zimakhudza kapangidwe ka magazi ndi mkhalidwe wamitsempha. Vinyo samalola magazi kufooka ndipo potero amaletsa mapangidwe amitsempha, achepetsa magazi, amapangitsa mitsempha yamagazi kukhala yamphamvu komanso yotanuka.

Chifukwa chake, kutsitsa cholesterol ndikusintha kayendedwe ka magazi, titha kunena kuti vinyo wofiira amakhala ndi zotsatira zochiritsira zosiyanasiyana za matenda amtima.

Koma ichi sichiri chifukwa chosiya mankhwala omwe adapangidwa ndi cardiologist ndikungomwa vinyo wofiira m'malo mwake. Kukonzekera kwamtima kwakukulu sikuphatikizidwa ndi mowa, chiopsezo cha mavuto amabwera, chifukwa chake, kugwiritsa ntchito kwakanthawi kwa mankhwala ndi mowa kuyenera kuvomerezedweratu.

Kusuta ndi cholesterol

Ngati vuto la mowa mthupi lomwe lili ndi cholesterol yambiri limatha kutsutsidwa, ndiye kuti pankhani ya ndudu, zonse ndizomveka. Kusuta kungawononge thanzi la munthu. Nthawi yomweyo, onse omwe ali osuta komanso ongokhala amavutika. Choyipa chachikulu ndi thupi la anthu omwe amasuta kwa zaka zambiri mosaganizira.

Koma nthawi yomweyo, muyenera kumvetsetsa kuti utsi wa ndudu ndi chikonga chokha sizingakhudze kuchuluka kwa cholesterol m'thupi. Komabe, zigawo za utsi wa fodya zimatha kusokoneza kayendedwe ka magazi, zimayipitsa kuchuluka kwa mitsempha yamagazi, zimachulukitsa mphamvu ya zomwe zimachitika mu oxidative. Ngati cholesterol yaukitsidwa, ndiye kuti kusuta komwe kumatha kukhala chinthu chowopsa pakupanga matenda owopsa a mtima ndi mtsempha wamagazi.

Chifukwa chake, kuti mumvetsetse, kuwonjezera kapena kutsitsa cholesterol ya magazi m'magazi, muyenera kuganizira zina zowonjezera komanso momwe wodwalayo alili. Kusuta fodya kumangowonjezera vutolo. Pomwe mowa wapamwamba kwambiri mumagawo ang'onoang'ono umakhala ndi kuchepa kwamitundu ingapo. Nthawi yomweyo, ndizosatheka kukana mankhwala. Muzimwa mowa moyenera ndipo musasute.