Mitundu ya ma atherosulinotic plaques ndi atherosulinosis: gulu la matendawa
Kutenga kwa matenda a atherosulinosis
mavuto ena a vasomotor
malamulo and chibadwa matenda lipid kagayidwe
matenda endocrine (matenda ashuga, hypothyroidism, kusakwanira kwamtundu)
coronary artery atherosulinosis
atherosulinosis ya msempha ndi nthambi zake
matenda amiseche
aimpso mtsempha wamagazi
atherosulinosis ya mesenteric mitsempha
zotumphukira ochepa atherosulinosis
ІІІ. Nthawi zachitukuko:
b) atherosulinosis yokhala ndi maphunziro apamwamba
nthawi yowonetsera matenda
Gawo I - ischemic
II siteji - necrotic (thrombonecrotic)
ІІІ siteji - fibrous
ІV. Magawo achitukuko
gawo lopita patsogolo (yogwira)
gawo lokhazikika (losagwira)
gawo la kukhululuka (chikhululukiro)
Mawonekedwe amasinthidwe ofunikira kwambiri a atherosulinotic
Kukula kwa kusintha kwa atherosclerotic mu ziwiya zamtima kumadziwika ndi nthawi yayitali kwambiri. Zoposa chaka chimodzi zimatha kuchokera pakuwonekera kwamafuta oyamba padziko lapansi pamitsempha yayitali kupita kumapangidwe a cholesterol plaques.
Nthawi zambiri, zizindikiritso zomwe zimachitika pakadali pano pomwe cholesterol yomwe ikupezeka imasokoneza kwambiri magazi. Nthawi imeneyi, kukula kwa zovuta monga mtima ischemia kumawonedwa.
Matenda amtunduwu amaphatikizidwa ndi kuwoneka kwa kugunda kwa angina pectoris ndi arrhythmia, kuphatikiza apo, pali kufupika kwa m'munsi.
Kupititsa patsogolo kwa matendawa kumabweretsa kusakwanira kwa ntchito ya chamanzere kwamitsempha, kuwonjezeka kwa thupi kumawonedwa. Chovuta kwambiri cha matendawa ndi matenda obisika.
Matumbo a matendawa amadziwika ndi kukhalapo kwa magawo atatu pakukula kwake:
- Yoyamba ndiyoyambira, yodziwika ndi mawonekedwe a zovuta zamagulu.
- Wachiwiri umadziwika ndi kuti zonyansa zamakhalidwe olowa nawo zokhudzana ndizogwira ntchito zimathandizira, ndipo mawonetsedwe amachitidwe omwe akukonzekera adayamba kulimbikira.
- Chachitatu - chomaliza chimawonekera ndi kukhalapo kwa pafupipafupi kuukira kwa ischemic, komwe kumayambitsa necrosis ya zigawo zaubongo ndi kutayika kwa ntchito zina ndi munthu.
Zizindikiro zazikulu ndikusakhazikika pamalingaliro, kuchepa kwa kukumbukira kwa ntchito ndi kuchepa kwa luso la luntha. Kupita patsogolo kwakukulu, paresis ndi ziwalo zimayamba.
Kugwetsa ma atherosulinosis a malekezero am'munsi kumadziwika ndi mapangidwe a cholesterol amana mkati mwa mitsempha yomwe imapatsa magazi ku ziwalo za m'munsi.
Choyambitsa chachikulu ndi shuga ndi mitsempha ya varicose. Mu mtundu wamatendawa, madontho a LDL ndi VLDL amapezeka mu mtsempha wamagazi.
Kukula kwa matendawa kumadzetsa maonekedwe monga kuziziritsa komanso kuzizira m'miyendo, ndipo pambuyo pake kumangokhala kudandaula.
Atherosclerosis obliterans kumabweretsa kusintha kwa chilengedwe kwa mapazi ndi kuchepa kwa kukula kwa tsitsi pa nthambi. Gawo lomaliza limadziwika ndi mawonekedwe a minofu necrosis. Zomwe zimabweretsa gangore.
Cholesterol ikayikira mawonekedwe aorta, aneurysm imatha, yomwe ikakwatulidwa, imatsogolera kuimfa.
Multifocal atherosulinosis ndi chotupa chotupa cha ziwiya zamagetsi. Matendawa amadziwika kuti amatenga pafupifupi ziwiya zonse zonyamula magazi am'thupi mthupi.
Zosiyanasiyana sizikhala ndi zodziwikiratu, zomwe zimapangitsa kukhala chimodzi mwazowopsa komanso zovuta kudziwa.
Popita nthawi, m'magawo apambuyo pake, zizindikiro za kuwonongeka kwa ma coronary, mitsempha ya mitsempha ndi mitsempha ya miyendo imawonekera.
Kugawa malinga ndi kukula kwa zolembedwa
Katswiri wa Soviet muzochitika zamtima A. L. Myasnikov adati gulu la matenda amtunduwu malingana ndi zomwe zimachitika m'matumbo.
Kugawika kwa zolembedwa za atherosulinotic kumayambitsa kugawanika kwa matendawa m'magulu ndi magawo omwe Myasnikov amafotokozera.
Pali mitundu ingapo ya zolembera zamatumbo a thupi.
Masiteji atatu amadziwika ndi mapangidwe ophatikizika.
Pa gawo loyamba, mapangidwe a zisindikizo za cholesterol m'mitsempha. Gawo ili limadziwika ndi kupita patsogolo pang'onopang'ono. Palibe zizindikiro za pakadali pano matendawa, ndipo kupezeka kwa matendawa ndikovuta kwambiri.
Gawo lachiwiri, kukuwonjezeka pang'onopang'ono m'derali komanso kuchuluka kwa mafuta pamafuta. Kukula kumeneku kumatsogolera kukuwonekera pang'ono kwa lumen, komwe kumapangitsa mawonekedwe a mawonekedwe. Gawo ili la mapangidwe a cholesterol amana limazindikiridwa popanga ma diagnostics a hardware.
Pa gawo lachitatu la mapangidwe, cholesterol amana imatenga miyeso yambiri ndikukhalanso yofewa. Pakadali pano, chiopsezo chotumphukira zolembedwazo kuchokera ku endothelium kapena kutsekeka kwa chotengera kumawonjezeka. Zomwe zimayambitsa kukula kwa vuto la mtima. Stroke ndi zovuta zina mu mtima dongosolo.
Gawo lotsiriza la mapangidwe a zolembera amadziwika ndi mawonekedwe awonetsedwe athunthu azizindikiro okhala ndi matendawa.
Mitundu itatu yamapepala imasiyanitsidwa ndi kapangidwe kawo komanso kufalikira kwake.
Atherossteotic zolembera za kukhazikika kochepa. Kudzikundikira kwa kholesterol kumapangika kapangidwe kake kamene kamasiyana ndi kayendedwe ka magazi. Chosanja ndi ichi ndi chovuta kwambiri. Amadziwika ndi kukula msanga, ndipo kukula kwake kumayendetsedwa ndi zizindikiro za kuchepa kwa coronary. Nthawi zambiri, zolembera zotere zimapezeka pokhapokha matendawa atadwala.
Mapilala apakati okhazikika. Mitundu iyi imakhala ndi mawonekedwe otayirira ndipo imakutidwa ndi membrane wa fibrous, yemwe amakonda kupasuka. Ndi kukula kwa mapangidwe amenewa, mawonekedwe a magazi, omwe ali ndi mwayi wambiri wopatukana komanso kayendedwe ka magazi. Mapilogalamu amtunduwu amapezeka mosavuta ndikuchiritsidwa.
Masamba olimba kwambiri amakhala ndi ulusi wa collagen ndipo amakhala ndi zotanuka kwambiri. Mapangidwe awa amadziwika ndi kukula pang'onopang'ono ndikuwerengera nthawi imodzi. Kapangidwe kameneka kumapangitsa kuti zikhale zovuta panjira yofufuza kuti ayese stenosis ya lumen.
Kuphatikiza pa izi, madongosolo amawagawa kukhala amtundu umodzi komanso mphamvu. Kutengera mtundu wa zolembera, kusankha njira zamankhwala kumadalira.
Zambiri mwatsatanetsatane za atherosulinosis zimaperekedwa mu kanema munkhaniyi.
Clinical angiology
- matenda a mitsempha ndi mitsempha yotupa komanso yotupa, ya etiology ndi pathogeneis, zamankhwala ndizodziwitsa, chithandizo komanso kupewa matenda a mtima.
Atherosulinosis - Matenda ofala odziwika ndi zotupa za zotupa za zotanuka ndi zotupa komanso zotupa m'magawo a kukula kwa kukhazikika kwa khoma lawo la minofu yolumikizana ndi lipid kulowa mkati mwa membrane wamkati. Pokhudzana ndi kufumbwa komwe kumachitika, makoma amitsempha amayamba kuwonda, kutsekeka kwake kumayambira, ndipo mapangidwe amwazi amapangika nthawi zambiri. zomwe zimatsogolera ku ziwalo kapena (ndi) zovuta zamagazi. Ambiri okalamba amadwala, maphunzirowa nthawi zambiri amakhala ovuta, milandu ya kulumala ndi kufa kwa odwala imawonedwa nthawi zambiri. Kutengera ndi kuchuluka kwa atherosulinosis ndi kuthekera kwake mu mtima, mawonekedwe ena a zamankhwala amawonedwa, ena omwe amasiyanitsidwa mu magawo osiyanasiyana komanso ngakhale mitundu ya nosological (matenda a mtima, atherosranceosis ya msempha, chotupa cha mitsempha, mitsempha ya mesenteric, etc.
The etiology ndi pathogenesis ya atherosulinosis ndi zovuta komanso osamveka bwino.
Zowopsa zoposa 30 za atherosulinosis zimafotokozedwa. Makamaka chosavomerezeka ndikusakanikirana kwa zinthu zoopsa monga cholowa cholemetsa, mantha amisempha, matenda oopsa, hypercholesterolemia, kuperewera kwa zakudya m'thupi, ndi hypokinesia. Komabe, palibe umboni wotsimikiza kuti chilichonse mwazinthu izi "zothandiza" payekhapayekha zimatsogolera pakupanga kwa atherosclerosis. M'malo mwake, izi ndi zinthu zomwe zimayambitsa chiwopsezo kapena chiwonetsero cha matenda a atherosulinosis. Pakati pa malingaliro a chiyambi cha atherosulinosis, chiphunzitso cha kulowetsedwa kwa cholesterol, chomwe chadziwika kwambiri, chinali chokhazikitsidwa ndi data ya kafukufuku woyeserera wa N. N. Anichkov ndi S. S. Khalatov (1912), pantchito zawo zotsatila, komanso ntchito za A. L. Myasnikov. Malinga ndi chiphunzitso cholowetsedwa cha J. Page (1954), chomwe chimapangitsa kuti ma lipoprotein akhazikike kudzera mu khoma lamitsempha, imasungidwa, imasungidwa kumtundu wamkati ndikatulutsidwa kwa lipids, makamaka cholesterol. Zomwe zimapangitsa izi ndi: 1) kusintha kwa kapangidwe ka magazi (hypercholesterolemia). kuwonjezeka kwa lipoprotein ena, 2) kuphwanya kwazolowera kwa khoma lamkati pakokha. Zambiri zolemba (D. S. Fredrickson et al. 1967) zikuwonetsa kuti metabolidi ya lipid amatenga gawo lalikulu pakuyambira kwa atherosulinosis. Olembawo adafotokozera gulu la hyperlipoproteinemia ndikuwonetsa kufunikira kwa mitundu yawo pawokha pakupanga atherosulinosis. Magulu a hyperlipoproteinemia adakhazikitsidwa pakusintha kwa magawo asanu a lipid kuphatikizika kwa plasma ndi seramu yamagazi: zomwe zimakhala ndi ma chylomicrons, cholesterol, triglycerides, beta-lipoproteins (otsika Mlomo lipoproteins - LDL), pre-beta lipoproteins - lowLens. Pankhaniyi, mitundu isanu ya hyperlipoproteinemia - HFL idadziwika (A. N. Klimov, 1978, D. S. Fredrick-son, 1969). Popanga atherosulinosis, kupezeka kwa mitundu yachiwiri ndi ya IV ya HFL ndikofunikira kwambiri, makamaka kawirikawiri - mitundu ya III komanso mitundu ya V.
Zoyesa kwambiri ndi LDL ndi VLDL. Mu pathogenesis ya atherosulinosis imalumikiza kufunikira kwa kuchuluka kwa atherogenic lipoproteins (LDL ndi VLDL) ndi antiatherogenic alpha lipoproteins, kapena highensens lip liprrinsins (HDL). Chifukwa chake, tikulankhula zakufunika kwa pathogenesis ya atherosulinosis kwambiri osati hyperlipoproteinemia monga dyslipoproteinemia, i.e., kusalingana pakati pa atherogenic ndi antiatherogenic lipids. Kuphatikiza pa kusintha kwakachulukidwe komanso koyenera kwa plasma lipids, gawo lofunikira pakukonzekera kwa atherosulinosis imaseweredwa ndi polymorphism yovuta kwambiri ya mphamvu ya maselo a endothelial ndi maselo olimba a chotengera cha chotengera (E.I. Chazov, 1982).
M'zaka zaposachedwa, chiphunzitso cha thrombogenic cha chiyambi cha atherosulinosis chatchulidwanso mwachangu. Mmenemo, malo apadera amaperekedwa ku ubale wa mapulateleti ndi khoma lamitsempha, monga: kusalingana pakati pakupanga kwa maselo othandizira, omwe amachititsa kuphatikizika kwa maselo, komanso kuperekera kwa prostacyclin - prostoglandin kuchokera ku khoma la mtima wokhala ndi vasodilating ndi antiplatelet.
Mitundu yotsatirayi ya kusintha kwa atherosselotic ndi yodziwika bwino: 1) mafupa am'maso ndi mawanga, malo amtundu wachikaso wotumbululuka omwe samatuluka pamwamba pamtunda komanso omwe ali ndi lipids, 2) malembedwe owoneka bwino, nthawi zina amakhala ngati owoneka bwino kapena pang'ono pang'ono a galatinous, akumera pamwamba pamtunda, Pakati pawo, 3) mafelemu am'mimba okhala ndi zilonda zam'mimba, ma hemorrhages ndi kugwiritsa ntchito ma thrombotic misa, 4) calcation kapena atherocalcinosis - nthawi zina kuyika kwamchere yambiri kumapangidwe am'mimba. Zosintha izi zimatha kupezeka nthawi imodzi, zimapereka chithunzi cha zotupa zosiyanasiyana komanso kusiyanasiyana. Atherosulinosis imasankha maselo amodzi pamlingo wokulirapo, zomwe zimapangitsa kuti pakhale magulu ena azachipatala ndi matenda. Chifukwa chake, msempha (makamaka gawo lake lam'mimba), mitsempha yam'mimba, mitsempha ya m'magazi, ndi mafupa am'mimbayi imakhudzidwa makamaka. M'dziko lathu, gulu la atherosulinosis lomwe A. A. Myasnikov (1955, 1960) amavomereza. Malinga ndi gawoli, nthawi ziwiri za atherosulinosis zimasiyanitsidwa. Mu nthawi yoyamba yamatendawa (preclinical), palibe kusintha kwa ziwalo, komabe, vuto la lipid metabolism, kuchuluka kwamitsempha, komanso kusintha kwa njira ya mitsempha, yomwe imawonetsedwa ndi ma spasms ambiri komanso am'madera. Nthawi yachiwiri ndi nthawi ya mawonetseredwe azachipatala, omwe agawika magawo atatu: I - ischemic, yodziwika ndi ischemia ya nthawi ndi nthawi ya ziwalo zingapo zofunika, II - thrombonecrotic, momwe kusintha kwakasinthika kwa ziwalo zam'magazi kumachitika chifukwa cha thrombosis yamitsempha yamagazi, III - fibrous, kapena cirrhotic, ndi chitukuko mu ziwiya ndi ziwalo zolumikizana minofu ndi kuphwanya kwakukulu kwa ntchito ya chiwalo. Kugawidwa pamwambapa kumasiyanitsidwa ndi kafotokozedwe ka nthawi ndi magawo, komabe, pochita motere nthawi zambiri samawonedwa. Chifukwa chake, ndimatenda am'mitima ya coronary, gawo la thrombonecrotic limachitika kawirikawiri pambuyo pa fibrotic (myocardial infarction pamasamba a atherosclerosis ndi aortic fibrosis, coronary artery of the heart, atherosclerotic cardiosranceosis. Mwachiwonekere, magawo omwe akufotokozedwawo amakhala ndi kuchuluka kwa kuwonongeka kwa ziwalo zokhudzana ndi atherosulinosis m'malo mwa gawo la chitukuko cha atherosulinosis ngati matenda wamba, omwe anadziwika ndi A. L. Myasnikov iyemwini. A. M. Wiechert et al. (1975) amakhulupirira kuti nthawi ya matendawa iyenera kuganiziridwa kuti athe kuthandizidwa komanso kudalirika pakuzindikira atherosulinosis. Olembawo adawerengera nthawi zotsatirazi:
2. Nthawi yamankhwala yovomerezeka ngati kusintha kwamphamvu kwa mitsempha kapena ntchito yawo ya hemodynamic kumapezeka pokhapokha pogwiritsa ntchito njira zothandizira - kutsimikizira kufalikira kwa mafunde amkati, rheovasography, angiography, ndi zina. Palibe zizindikiro zina zamankhwala. Kudalirika kwa kulumikizana pakati pa zotupa zotupa ndi ma atherosclerosis kumawonjezeka ndi kupezeka kwa munthawi yomweyo kwamatenda a lipid metabolism.
3. Nthawi ya mawonekedwe osakhala achindunji a matenda, omwe amadziwika ndi zizindikiro za kuchepa kwakanthawi kwamankhwala mu ziwalo (ischemic siteji ya atherosulinosis malinga ndi A. L. Myasnikov), monga matenda oopsa kapena angioneurosis (izi zimawerengedwa poyesedwa mosiyanasiyana). Zizindikirozi zimaphatikizidwa ndi njira zowoneka za zizindikiro za zotupa za mtima zamatenda kapena kusintha mosalekeza kwa kagayidwe ka lipid. Munthawi imeneyi, kugunda kwamtima mu ziwalo komanso ma scalosis (fibrous site malinga ndi A.L. Myasnikov) ndizotheka, zomwe sizimapangidwira mwachindunji kwa atherosulinosis (zimawonedwa ngati zili ndi vuto loopsa la matenda oopsa, erythremia, vasculitis), nthawi zambiri zimawonedwa ku atherosclerosis. 4. Nthawi ya matenda ochepa ochepa, limodzi ndi vuto la ischemic pamavuto amitsempha yama cell ndi ziwonetsero zina zokhudzana ndi thupi: angina pectoris (kapena ofanana nawo) ndi coronary atherosulinosis, kusinthana ndi lameness ndi mtima wamatsenga wam'mphepete, mkanda wam'mimba ndi kuwonongeka kwa mesenteric mitsempha, etc. Munthawi imeneyi, kusintha kwa ziwalo za fibrotic nthawi zambiri kumapezeka, ndipo kuzindikira kwa atherosclerosis si kovuta makamaka, chifukwa pali kusiyana Moŵa atherosclerosis ndi vasculitis ndi zochepa wamba.
Kutengera komwe kuli atherosulinosis (m'mitsempha ya mtima, aorta, mesenteric ndi zotumphukira m'mitsempha, impso, ubongo, mapapu), nthawi iliyonse pamwambayi imadziwika ndi mawonekedwe amtundu wazachipatala.
Momwe mungasiyanitsire mitsempha ya mitsempha mwa magawo ndi mitundu ya kakulidwe?
Atherosulinosis ndi matenda wamba omwe ma depisiti amadziunjikira m'mitsempha ndikupanga cholesterol plaques. Kugawidwa kwa atherosulinosis kumakupatsani mwayi wowona mawonekedwe a matendawa, kuchuluka kwake ndi malo a chotupa.
Ichi ndi chimodzi mwazofooka zomwe zimakhudza osati achikulire okha, komanso mbadwo wachichepere. Kukula kwa minyewa yolumikizana ndikupanga mafupa a cholesterol kumabweretsa kuwonjezereka kwa lumen ya mitsempha yamagazi ndi kusokonezeka kwa kayendedwe ka magazi. Chifukwa chake, atherosclerosis ndi chimodzi mwazinthu zazikulu zoyambitsa kufa, patsogolo pazotsatira za matenda opatsirana komanso oncological.
Zomwe zimayambitsa matendawa
Chifukwa chachikulu chakukhazikitsidwa kwa atherosulinosis ndi cholowa, chomwe chimadziwoneka chokha chifukwa cha zinthu zobwera chifukwa cha ziwopsezo. Izi siziphatikiza kugwiritsa ntchito mankhwala a mahomoni, zizolowezi zoipa, ndi zina zambiri.
Zinthu zomwe zingayambitse matenda a mtima wa 4th:
- matenda ashuga
- kusokonezeka kwa mahomoni
- matenda oopsa kapena hypotension,
- matenda amtima, kupezeka kwa stroko abale,
- zosintha zokhudzana ndi zaka.
Komabe, pali zoyambitsa matenda zomwe zimatengera moyo wa munthu. Izi zitha kukhala kukhalapo kwa zizolowezi zoipa, chizolowezi chofuna kudya kwambiri komanso kudya mafuta, zakudya zopanda pake, zomwe zotsatira zake zimadzetsa kuwoneka kwambiri, kunenepa kwambiri, kutenga njira zakulera pakamwa kapenanso kusachita masewera olimbitsa thupi.
Chikhalidwe chogonjetsedwa
Kutengera ndi gawo la chitukuko cha matendawa, madigiri ena a atherosulinosis amawerengedwa:
- Ndi atherosulinosis, njira za m'magazi zimakhudza kokha makoma amitsempha, omwe amathera ndikuwonongeka pang'onopang'ono.
Gawo loyamba la mtima wamatenda a mapangidwe ndi ma lipid mawanga. Izi zimachitika chifukwa cha kuchuluka kwa makoma am'mitsempha yama cell ndi mafuta, pomwe amakhala m'malo ochepa. M'malo opezekawa, kumakhala mithunzi yachikasu, yomwe imakhala m'litali yonse yamitsempha yodwala.
Chachilendo cha mawonekedwe 1 ndi kusowa kwa zodziwikiratu, kuwonekera kwa zovuta zilizonse zomwe zingathandize kudziwa kukhalapo kwa vuto komanso munthawi yoletsa kuyipa kwa magazi mu mitsempha.
Mapangidwe a mapanga a lipid amatha kuthamanga chifukwa cha zinthu monga zovuta ndi mapaundi owonjezera, kuthamanga kwa magazi ndi matenda a shuga.
Gawo lachiwiri, lomwe limafotokozedwa ngati gawo la liposulinosis, limadziwika ndi kukula kwa kutupa kwa milomo ya lipid. Njira izi zimatsogolera ku kuti ma membala am'magazi a chitetezo cha mthupi ayamba kuvutika ndi kuwonongeka.
Kukhalitsa kwanthawi yayitali kumayambitsa kuwonongeka kwa nthawi yomweyo kwamafuta omwe adasindikizidwa kukhoma, ndikukula kwa minyewa yolumikizidwa mmenemo. Izi zimatha ndikuwoneka ngati zolembera zamkati, zomwe ndizosiyanitsa ndi nthawi ino.
Kuchepetsa kwa lumen kwa chotengera ndi kuphwanya kwa kayendedwe ka magazi kumachitika chifukwa cha malo okwezeka a cholembera kumapeto kwa mtsempha womwe wakhudzidwa.
Gawo lomaliza pakupanga matenda a mtima ndi mawonekedwe a zovuta zomwe zimakhudzana mwachindunji ndi mapangidwe a mafupa am'manja.
Kuyambira kale mpaka digiri 3, zizindikiro za matendawa zimayamba kuonekera. Gawo la atherosulinosis limatsimikiza ndi atherocalcinosis. Njira zopukusira za plaque zikupita patsogolo, zomwe zimabweretsa kuphatikizika ndi kufalikira kwa mchere wamkati mwa iwo.
Mapepala a Atherosulinotic amatha kudziwonetsera mosiyanasiyana: ikhoza kukhazikika m'malo kapena kukula pang'onopang'ono, chifukwa cha zomwe mapangidwe akusintha kwa lumen ya chotengera chomwe chikukhudzidwa ndikuchepera kwake kumapitirirabe. Zotsatira zake, izi zimapangitsa kuti kusintha kwa magazi kupita ku chiwalo chomwe chimalandila michere kuchokera kumitsempha yomwe yakhudzidwa ndikuyamba kukhala ndi mawonekedwe osakhazikika.
Kuchepa kwa occlusion, i.e., blockage, chifukwa cha magazi am'mimba kapena chifukwa cha kuwola kwa zolembazo, kumatchinga kwathunthu lumen ya chotengera, kumawonjezeka. Njira zimatha ndikugonjetsedwa kwa magazi kupita ku chiwalo kapena nthambi, zomwe zimabweretsa kugunda kwa mtima kapena gangren.
Mavuto amendo
Pali mitundu yotere ya atherosulinosis ya malekezero otsika:
- Matendawa amadziwonekera pokhapokha atachita masewera olimbitsa thupi. Zizindikiro zoyambirira ndikumverera kwa dzanzi, kumva, kuzizira m'miyendo ndi kutopa. Pali zochitika za hyperhidrosis.
- Matenda amtunduwu amakhudza Zizindikiro za mtundu 1, zomwe zikulowerera molumikizana, zomwe zikusonyeza kuti magazi samakwanira kumadera am'munsi panthawi yogwira ntchito.
- Gawo lachitatu, mawonekedwe ndi mawonekedwe a zowawa zomwe zimakhala zosatha. Ngakhale wodekha, panthawi yogona, wodwalayo samva bwino m'miyendo yake.
- Pali zofooka zilonda zam'mimba, zizindikiro za gangore. Ululuwu ndiwofunika kwambiri kotero kuti wodwalayo ayenera kugwiritsa ntchito zolimba zolimba.
Mavuto a minyewa amatha kuzindikiridwa ndi gulu la atherosulinosis ya miyendo yakumapeto A. Pokrovsky. Chifukwa chake, gawo loyambalo limatsimikiziridwa kuti munthu amatha kuyenda mosavuta mtunda wa 1 km.
Pa 2 degrees, claudication yapakati imayamba kuvuta pambuyo pa 0,2 km kapena kuchepera. Pa siteji yachitatu, mtunda umatsikira mpaka 25 m, ndipo pamapeto omaliza, ululu umangosokoneza.
Mitundu ya ma atherosulinotic plaques ndi atherosulinosis: gulu la matendawa
Atherosclerosis ndi matenda osokoneza bongo, omwe amaphatikizidwa ndi mapangidwe a cholesterol amana mkati mwa makoma a ziwiya zamagetsi zamagazi. Mukuyenda patsogolo, kuchuluka kwa minofu yolumikizana ndikupanga mapangidwe a atherosulinotic.
Zotsatira za pathological process, lumen ya ziwiya zimasefukira, zomwe zimapangitsa kuti magazi asokonezeke minofu ndi ziwalo. Zotsatira za kuphwanya kotereku ndikuwoneka ngati kufa ndi maselo, mpweya ndi njala chifukwa chosowa michere.
Matendawa, molingana ndi ziwerengero zopezeka kuchipatala, ndi amodzi mwa matenda ofala kwambiri. Pankhani yaimfa ndikukula kwa kulumala, matendawa ndi mtsogoleri pakati pa matenda ena.
Masiku ano, matenda atha kukhala vuto lomwe limakhudza thupi la okalamba, matendawa ayambanso kukhudzana ndi majeremusi a achinyamata komanso azaka zapakati.
Mitundu yayikulu ya atherosulinosis
Atherossteosis ndi matenda amitsempha omwe amaphatikizidwa ndi kudzikundikira kwa milomo ya lipid pamakoma, kuchuluka kwa minofu yolumikizana ndikupanga cholesterol plaques. Zotsatira zake, kuwala kwa ziwiya zotchinga kumatsekeka, magazi sangathe kuzungulira bwinobwino.
Nthendayi ndi imodzi mwazofala kwambiri, anthu ambiri akumayiko otukuka amapezeka ndi matendawa. Pankhani yakufa ndi kulemala, atherosulinosis imatsogolera matenda ena aliwonse, kuphatikizapo khansa ndi matenda opatsirana.
Chinanso ndichakuti atherosclerosis si matenda okha okalamba. Masiku ano, pali chizoloŵezi chofuna “kukonzanso” matenda.
- Zambiri patsamba lino ndizongowatsogolera zokha ndipo ASATSOGOLA zochita!
- Mutha kukhazikitsa EXACT DIAGNOSIS CHITSITSI chokha!
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Atherossteosis amatanthauza matenda, kuphunzira zomwe zimayambitsa ndi njira zabwino zamankhwala zomwe zimachitika kwambiri. Komabe, sizingatheke kukhazikitsa malingaliro ake.
Zowopsa zoposa 30 zitha kubweretsa chitukuko cha matenda. Komanso, zinthu zimatha kudziwikiratu ku matendawo ndikuyambitsa.
Zina zomwe zimakonzedweratu ndi izi:
- chibadwa, komanso malamulo,
- zizolowezi zoipa, makamaka kusuta,
- onenepa kwambiri
- matenda osiyanasiyana (matenda ashuga, gout, matenda opatsirana, hypothyroidism, matenda a ndulu, nephrosis, komanso matenda ena ogwirizana ndi cholesterol yayikulu).
Kukhalapo kwa zinthu izi sikokwanira pakukula kwa atherosulinosis, ngakhale atha kuwonetsa kwambiri mawonekedwe ake.
Malinga ndi chiphunzitso cha Myasnikov cha neuro-metabolic, zomwe zimayambitsa matendawa zimagawidwa:
Palinso gulu lina lomwe limaganitsa zinthu mu:
Mphamvu yakuthandizira pakudya kwa atherosulinosis idaphunzira ndikupanga zoyeserera za akalulu ndi agalu. Pansi pazachilengedwe, nyama izi sizimakhala ndi matenda.
Phunziroli, nyama zinkapatsidwa chakudya chochuluka cha cholesterol. Zotsatira zake, zidziwitso zidapezeka zomwe zimawonetsa kuchuluka kwakukulu kwa cholesterol m'magazi (patatha miyezi yochepa, zizindikiro zoyambirira zidaposa 400%).
Autopsy idawonetsa zizindikiro za lipoidosis (miyezi 3-4 atatha kuyesera), komanso kupezeka kwa malo a atherosselotic. Chifukwa chake, mwamphamvu, ubale pakati pa chakudya ndi kukula kwa atherosclerosis unatsimikiziridwa.
Komabe, ngakhale ndi izi, pali mfundo zazikulu. Mwachitsanzo, mikhalidwe yofanana mu nyama (m'badwo umodzi, kulemera, kulandira mafuta a cholesterol), kusintha kosiyanasiyana kwa thupi kunabuka.
Kwa ena, kukhazikika kwa mchitidwewo ndi kutha kwa kuchuluka kwa cholesterol kumawonedwa, kwa ena chizindikirochi chimachepera. Pafupifupi 10% ya nyamazo sizinayankhe jekeseni wa cholesterol: kuchuluka kwa zinthu zomwe zili m'magazi sizinawonjezeke, palibe zizindikiro za atherosulinosis.
Titha kudziwa kuti, ngati tili ndi kagayidwe kokwanira, mphamvu ya zakudya zokhala ndi cholesterol sichili chovuta kwambiri, ndipo chakudya chotere sichingakhale chinthu chofunikira kwambiri pakukula kwa atherosulinosis.
Khalidweli
Ofufuzawo akuti kubadwa kwa majini ndiwofunikira mosakayikira pakukula kwa atherosclerosis, koma sikunama pakatikati pake. Amakhulupirira kuti matenda obadwa nawo omwe amaphatikizidwa ndi metabolic metabolism ndi kayendedwe ka mitsempha ya minyewa amatha kupatsirana.
Chifukwa chake, zinthu zamtundu zimawerengedwa ngati maziko, kuphatikiza komwe kumayambitsa zifukwa zina, kumatha kutsogolera matendawa. Asayansi ena amakhulupirira kuti zochita za thupi zimatengera chilengedwe.
Ubwenzi wolunjika pakati pa cholowa ndi kukula kwa atherosulinosis sichitsimikiziridwa. Monga magawo oyambitsa chitukuko cha matendawa, kuphatikiza kwa vuto la lipid metabolism, njira yoyambitsira magazi, zinthu zina zopatsirana zomwe zimakhudzidwa ndi chilengedwe zakunja zimaganiziridwa.
Mphamvu ya zinthu zina
- Kunenepa kwambiri kumatchedwa imodzi mwazifukwa zomwe zingayambitse matenda a atherosulinosis.
- Komabe, sikuti zonse ndizophweka pano. Panalibe ubale wachindunji pakati pa kuchuluka kwa mafuta m'thupi ndi kukula kwa atherosulinosis.
- Amakhulupirira kuti pali kudalira kwina kwa matendawo pamakhalidwe a munthu wonenepa kwambiri: kusachita masewera olimbitsa thupi, kudya kwambiri kumathandizira. Anthu onenepa kwambiri amakhala ndi cholesterol yambiri, komanso kuthamanga kwa magazi.
- Ubale pakati pa kukhalapo kwa matenda ashuga komanso kukula kwa atherosulinosis kumatsimikiziridwa.
- Zimafotokozedwa ndikuti carbohydrate ndi lipid metabolism imakhudzanso.
- Chifukwa chake, kuphwanya kwa kagayidwe kazakudya kamene kamayang'aniridwa mu shuga mellitus kumayambitsanso kuphwanya mafuta kagayidwe.
- Chiyanjano chinapezekanso pakati pa zaka ndi kuchuluka kwa odwala omwe ali ndi atherosulinosis. Ngati pa zaka 30 mpaka 39 peresenti ya anthu omwe ali ndi atherosulinosis ndi 81.5%, ndiye kuti pazaka 40-49 chiwerengerochi chili pafupifupi pafupifupi 85%.
- Koma izi sizofunikira kwambiri, chifukwa nthawi zina palibe zizindikiro za zotupa za atherosclerotic ngakhale mwa anthu okalamba kwambiri.
Ofufuzawo akuti mwa anthu omwe amakhala ndi moyo wakhama, miloproteins yapamwamba kwambiri imapezeka m'magazi kuti ipewe kukula kwa njira za atherosranceotic.
Mitundu ya atherosulinosis imadalira gawo liti la mitsempha yama cell dongosolo.
Pali gulu lina la nthawi ya chitukuko cha atherosulinosis kutengera kuwonekera kwa zizindikiro. Kutengera ndi gulu lino, kuzindikira koyambirira kungachitike:
Werengani zambiri za opaleshoni yamitsempha yamagazi ya atherosulinosis.
Pofikira
Kutengera ndi malo owonongeka, pali mitundu yotsatirayi ya atherosulinosis:
- Awa ndi malo ovutikitsitsa kwambiri.
- Kudzera m'mitsempha iyi, mtima umalandira magazi, motero kuphwanya kayendedwe ka magazi mwa iwo kumabweretsa kukula kwa myocardial infarction ndi angina pectoris.
- Nthawi zambiri, mapangidwe a zolembera amaphatikizidwa ndikupanga mawonekedwe a magazi.
- Magazi akudutsa mu msempha, kupereka trophism pafupifupi ziwalo zonse ndi machitidwe.
- Chifukwa chake, mapangidwe a atherosselotic zolembera mu msempha zimakhudza mkhalidwe wa thupi lonse.
- Ndi kuphwanya kwa magazi kupita ku mitsempha ya carotid, zakudya zaubongo zimachepa, zomwe zimawonetsedwa ndi mutu, chizungulire, kuwonongeka kwa ntchito zowoneka komanso zowongolera, komanso tinnitus.
Matenda oopsa oopsa amayambitsa matenda a mitsempha ya mitsempha. Kusintha kwa makoma a zotengera izi kungapangitse kulephera kwa impso. Ndi kuwonongeka kwa mitsempha yama mesenteric, kupweteka kwa paroxysmal kumawonedwa pamimba, motsatana ndi kuphwanya kwam'mimba.
- Chimodzi mwazizindikiro zoyambirira ndikuwonongeka kwakumbuyo kwakanthawi kochepa.
- M'tsogolo, pamakhala kulumikizika kwamalingaliro komanso kuchepa kwa luntha la ntchito.
- Phokoso ndi kumverera kwa pulsation m'mutu ndizodziwika, kukula kwa kugwedezeka kwamphamvu kumatha.
- Zotsatira zowopsa kwambiri ndizo stroke za ischemic.
- Zizindikiro zoyambirira zimaphatikizapo kupezeka kwa ululu mu minofu ya ng'ombe yomwe imawoneka mukuyenda.
- Mtsogolomo, ululu umafalikira ku nthambi yonse, dzanzi ndi cyanosis zimawonedwa.
- Kutsekeka kwa minyewa ya mwendo ndi phazi kumakula, zilonda zam'mimba zimapangika pakati pa zala ndi pakati pawo, zomwe ndizovuta kuchiza.
Zina mwa zomwe akuwonetsa atherosclerosis kale ndizovuta zake, ndipo kumayambiriro kwake kumakhala kovuta kuzindikira matendawa.
Kukula kopanda koma kosalekeza
Matendawa amatha kumakula ndikuyenda bwino kwa miyezi yambiri, ngakhale zaka zambiri, osadandaula. Pamene munthu nthawi zina amasokonezedwa ndi kuthamanga kwa magazi, kupweteka mutu, angina pectoris ndi kulemera m'miyendo, mitsempha yamagazi mthupi lonse limasinthika kwambiri. Kuwonongeka kwa makoma a mitsempha ndi mitsempha, kuyika kwa lipoprotein komanso kupangidwa kwa zolembedwa za atherosselotic - zonsezi zimachitika mopanda chidwi kwa wodwalayo.
Kutsimikiza kwa atherosulinosis kuli poti zimakhala zovuta kudziwa komanso kudziwa komwe kwawo, makamaka poyambira kukula.
Masiku ano, madokotala amazindikira magawo anayi a atherosulinosis, iliyonse yomwe imadziwika ndi kusintha kwina m'thupi.Mutha kutsatira zizindikiro zazikulu ndikuyamba kulandira chithandizo pokhapokha mutapimidwa mokwanira, mwachitsanzo perekani magazi athunthu a cholesterol, kuchuluka kwa lipoproteins zothandiza komanso zovulaza, ndikukumana ndi ultrasound kapena MRI. Ngati mulemba magawo a atherosulinosis, ndiye kuti zotsatirazi ziyenera kudziwika:
- Zachikale. Itha kutchedwa nthawi ya pre-atherosulinotic nthawi. Nthawi zambiri zimaperekedwa kwa odwala omwe ali pachiwopsezo - ndi zovuta za kudya, zizolowezi zoyipa, kusowa kwa masewera olimbitsa thupi. Ndizotheka kuteteza kuchitika kwa matenda a digiri yachiwiri mukamawongolera moyo wa wodwalayo.
- Atherosulinosis ya gawo lachiwiri. Pakadali pano, pali zopatuka mu cholesterol chizindikiro, kuphwanya umphumphu wa makhoma amitsempha yamagazi. Odwala amayambanso kukulitsa zizindikiro za matendawa - mawanga achikasu pakhungu ndi sclera, kupweteka mumtima ndi angina pectoris, kulemera kwamiyendo.
- Gawo lachitatu limadziwika ndi kuwonjezeka kwa zizindikiro, komanso kuwonjezera kwa zovuta za ischemic. Zizindikiro zonse za matendawa zimayamba kuonekera ndi maliseche.
- Mawonekedwe omaliza a atherosclerosis amadziwika ndi mawonekedwe a lameness yachilendo mwa wodwala, kuwonongeka kwa ziwiya zam'mimba, angina pectoris, kupweteka mutu, etc.
Ngakhale kuti gulu la atherosulinosis ndi chizindikiro chake chachikulu ladziwika kwa nthawi yayitali, ndizosowa kwambiri kudziwa matendawo panthawi yake. Izi zimachitika osati chifukwa cha mankhwala omwe sanakwanitsidwepo, koma chifukwa cha matendawa komanso pang'onopang'ono.
Zosiyanasiyana zamatenda
Tsoka ilo, mwa odwala onse, matendawa amawonekera mosiyanasiyana. Ichi ndichifukwa chake madokotala anapeza gulu la atherosulinosis malinga ndi kutanthauzira kwa matenda amitsempha yamagazi. Ambiri omwe ali ndi zotupa za mtima ndi ziwiya. Pankhaniyi, odwala amatha kukhala ndi matenda a coronary, chiwopsezo cha matenda a mtima ndi angina pectoris. Magawo oyamba komanso otsatirawo a kupita patsogolo kwa matendawa amadziwika ndi kufupika, kuthamanga kwambiri, chizungulire, kutupa kwa minofu yofewa (makamaka m'miyendo).
Ngati cholesterol plaques ayamba kupanga mitsempha yopita ku ubongo, ndiye kuti wodwalayo amavutika ndi zina. Choyamba, wodwalayo azindikira kusokonezeka kwa kukumbukira ndi kusokonezedwa chidwi, mutu, chizungulire komanso tinnitus azikhala nawo nthawi zonse. Kachiwiri, kuwona ndi kumva kudzayamba kuchepa. Kusintha kwa ma atherosulinotic m'thupi, pamapeto pake, kumapangitsa kuti njala ikhale yayitali kwa ubongo, kuonjezera ngozi ya kugwidwa ndi stroke.
Matendawa amatenga matendawa kuchipatala. Mphamvu ya minyewa ya pathologies nthawi zina imabweretsa zotsatira zosasintha.
Cardiologists nthawi zambiri amagwiritsa ntchito mawu akuti multifocal atherosulinosis. Zimafotokozera, osati mtundu wamatenda, koma gawo la kakulidwe kake. Odwala omwe adawonetsa chidziwitso chowopsa ichi ayenera kukonzekera zotsatira zoyipa kwambiri - kudula miyendo chifukwa cha zotupa zamagazi m'magazi angapo amkati.
Chinthu chachikulu ndikupewa
Kuphatikiza pa mankhwala omwe mankhwalawa amathandizira kuchiza matenda a atherosulinosis, odwala ayenera kuyang'anitsitsa njira zodzitetezera. Mosasamala kuti ndi gawo liti lomwe njira yachipatala idapangidwira, odwala ayenera kusintha zakudya zawo, kuwonjezera masewera olimbitsa thupi, ndikutsatira malangizo a dokotala. Kukana zizolowezi zoipa kumathandizanso thanzi la wodwala. Njira zoterezi zimakhudzana ndi kupewa matenda.
Kupewa kwachiwiri kwa atherosclerosis kumatanthauza kugwiritsa ntchito mankhwala a antiplatelet. Amathandizanso osati kuwonda magazi, komanso kuchepetsa chiopsezo cha kuwonongeka kwa mtima, ndikuchepetsa lumen yawo. Odwala amalangizidwa kuti atenge maphunziro a aspirin kapena clopidogrel (kutengera kutengera kwa munthu wina).
Dziwani kuti njira zachiwiri zotetezera zimachitika pokhapokha pakuyang'aniridwa ndi adokotala. Kupanda kutero, mwayi wokhala ndi zovuta zingapo ndi wapamwamba.