Target cholesterol ku IHD

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

Mthupi, cholesterol imathandiza kupanga maselo ndikupanga mahomoni. Mafuta ochuluka kwambiri m'magazi amatha kupanga mkati mwa mitsempha, ndikupanga cholembedwa. Zilonda zazikulu zimalimbikitsa mwayi wokhala ndi vuto la mtima kapena stroke. Kuwunika kwa cholesterol ya LDL nthawi zambiri kumachitika kuti muwonetsetse wa matenda a mtima.

Kodi LDL ndi chiyani?

Mitundu iwiri ya lipoprotein imakhala ndi cholesterol mthupi lonse: kachulukidwe kochepa (LDL) ndi mkulu (HDL). Mlingo wonse wa cholesterol ndi kuphatikiza kwawo ndi triglycerides, mtundu wina wamafuta womwe umasonkhana m'thupi. HDL ndi mtundu "wabwino" womwe umathandizira kuchotsa mafuta m'thupi m'magazi ndikuwabwezera ku chiwindi, komwe amawonongeka ndikuchotsedwamo.

Chifukwa chiyani chimatchedwa "choyipa"?

LDL imatchedwa cholesterol “yoyipa” chifukwa ngati ili yambiri m'magazi, imatha kudzikundikira pang'onopang'ono - mitsempha yomwe imanyamula magazi kuchokera mumtima mwanu kudzera mthupi, kuwapangitsa kukhala ochepera, zomwe zimawonjezera chiopsezo cha matenda a mtima, kugunda kwa mtima, sitiroko ndi matenda a mtima.

LDL imanyamula mafuta ochulukirapo, ndipo ndi mapuloteni ochepa chabe kuchokera ku chiwindi kupita kumadera ena a thupi.

Zambiri pa phunziroli

Munthu aliyense wazaka 20 kapena kupitilira ayenera kuyezetsedwa kamodzi pazaka zisanu. Kusanthula kwa LDL mwa amuna pambuyo pa zaka 60 ndipo akazi pambuyo pa zaka 50, panthawi ya kusintha kwa thupi, kuyenera kumwedwa kamodzi pachaka.

Kusanthula kumachitika ngati mbali ya kuyesa kwamwazi wamagazi - lipid chart yomwe ikuwonetsa ngati muli pachiwopsezo cha matenda a mtima poyang'ana zinthu zomwe zili m'magazi zomwe zimakhala ndi cholesterol.

Kwa anthu omwe ali ndi vuto limodzi kapena zingapo zazikulu za matenda amtima, mbiri ya lipid imayenera kutengedwa nthawi zambiri.

Khalani omasuka kufunsa mafunso anu kwa wazachipatala wa nthawi zonse mwachindunji patsamba lino. Tikuyankha motsimikiza: Funsani funso >>

Zowopsa zazikulu za LDL yayikulu ndizophatikizira:

• kusuta ndudu
• kunenepa kwambiri kapena kunenepa kwambiri,
• osati chakudya chopatsa thanzi
• kusowa zolimbitsa thupi,
• zaka (amuna azaka zopitilira 45 ndi akazi azaka 55 ndi kupitirira),
• kuthamanga kwa magazi
• matenda am'mbuyomu kapena vuto la mtima lomwe lachitika kale,
• shuga kapena prediabetes.

Kwa ana ndi achinyamata, ndikofunikira kuti muwunikenso kamodzi pa zaka 9 mpaka 11, kenaka azaka 17 mpaka 21.

Kodi chingachitike ndi chiyani?

Chakudya chomaliza chichitike osachepera maola 12 musanawunike. Kusanthula kwa cholesterol ya LDL ikhoza kukhala yolakwika ngati masana, kusanachitike, munthu amadya zakudya zamafuta ndi okazinga, zakumwa zoledzeretsa. Zotsatira za phunziroli zimakhudzidwanso ndi zolimba zolimbitsa thupi.

Kumwa mankhwala osiyanasiyana kuyenera kuchepetsedwa kwa milungu ingapo musanapereke magazi. Ngati kusiya kwakanthawi kwa mankhwalawo sikungatheke, ndiye kuti muyenera kuuza dokotala za mankhwala onse ndi Mlingo womwe watengedwa.

Radiography, ultrasound, mayeso a rectal, kapena physiotherapy sayenera kuchitika tsiku lomwelo ngati mayeso a cholesterol.

Kuchiritsa

Kuyesedwa kwa magazi, kusanja komwe sikuli vuto lalikulu, kukuwonetsa kuchuluka kwa cholesterol m'mililita imodzi pa lita imodzi ya magazi (mmol / l). Kholesterol yathunthu ndi HDL ndi zina mwazinthu zambiri zomwe dokotala amagwiritsa ntchito kuneneratu za moyo wanu kapena chiwopsezo cha vuto la mtima kapena sitiroko m'zaka 10 zikubwerazi.

Makhalidwe Abwino

Muyeso wa LDL umasiyanasiyana ndi zaka ndipo zimatengera umunthu wa wodwala. Ngati munthu ali ndi vuto pachiwopsezo cha matenda a mtima, monga kuthamanga kwa magazi, matenda ashuga, kapena munthu akasuta, kukhalabe ndi LDL yotsika kumakhala kofunika kwambiri.

Chifukwa chake, polingalira za mtundu wabwinobwino, kuopsa kapena kupezeka kwa matenda amtima muyenera kuziganizira.

kuyambira wazaka 21 mpaka 503,16-7,151,71-5,230,80-1,660,5-3,7 Amuna 50 ndi akulu4,09-6,862,31-5,340,72-1,940,65-2,94 Akazi

kuyambira wazaka 21 mpaka 503,16-6,81,48-4,820,85-2,250,44-2,42 Akazi

50 ndi okulirapo4,2-7,252,28-5,340,96-2,380,59-2,71 Amayi oyembekezera6,14–10,382,9-8,11,65-4,50,89-5,2

Kukwanira kwa atherogenic

Mgwirizano wa atherogenic (KA) umawonetsa kuchuluka pakati pa mafuta abwino ndi oyipa. Kukula kwa chitukuko cha atherosulinosis kumadalira. Kuwerengera CA, cholesterol yathunthu imatsimikizika kuchokera komwe HDL imachotsedwa ndipo kusiyana kumagawidwa ndi HDL.

Chizindikiro cha spacecraft ndi magawo 2-3. Chizindikiro cha ochepera 2 sichowopsa, mmalo mwake, chikuwonetsa kuti chiopsezo cha atherosulinosis ndichochepa kwambiri. Koma CA yopitilira muyeso ya 3-4 imawonetsa chiopsezo chokulira kwa ma pathologies.

Tiyenera kudziwa kuti CA imasintha ndi zaka. Mtengo wotsika kwambiri umawonedwa mwa akhanda, ndipo m'zaka zapitazi ukuwonjezeka.

Koma ngakhale mwa anthu okalamba, zonenepa sizikhala zopitilira 3.5.

Kuchuluka kwamakhalidwe

Mkhalidwe wapamwamba wa LDL, wotchedwanso hypercholesterolemia, umawonedwa mwa anthu omwe amadya zakudya zambiri zomwe zimakhala ndi mafuta ndipo nthawi zambiri samayambitsa chilichonse. Nthawi zambiri, izi zimachitika pokhapokha pazochitika zovuta. Mwachitsanzo, kugunda kwa mtima kapena sitiroko kumatha kuchitika chifukwa cha kuwonongeka kwa Hypercholesterolemia ndikuchokapo ndi zotsatirazi.

Zochitika izi nthawi zambiri sizichitika mpaka zomwe zimachitika zikupanga mapangidwe am'mitsempha, omwe amakhala ochepa, motero magazi ochepa amayamba kudutsa mwa iwo. Izi zimatha kudzetsa mavuto akulu. Ngati pali cholepheretsa chachikulu m'mitsempha yama coronary, kupweteka pachifuwa kumatha kuchitika chifukwa kuchepa kwa magazi kutsika kwa minofu ya mtima.

Kuyesedwa kwa magazi ndi njira yokhayo yomwe mungadziwire ngati mafuta a m'magazi anu ndi okwera kwambiri.

LDL yachepa

Nthawi zambiri, ngati LDL cholesterol imatsitsidwa, izi zimawonedwa ngati njira yabwinoko kuposa kuti zinali zabwinobwino. Ngakhale zotsatira zenizeni za otsika kwambiri (hypocholesterolemia) pa thanzi zimaphunziridwabe, ofufuza akuda nkhawa ndi momwe hypocholesterolemia imasokonezera thanzi la m'maganizo. Anthu omwe ali ndi cholesterol yotsika nthawi zambiri amakhala ndi zizindikiro za kukhumudwa ndi nkhawa, ndipo popeza cholesterol imagwira nawo ntchito yopanga mahomoni ndi vitamini D, imakhudza thanzi la ubongo. Vitamini D ndiyofunikira pakukula kwa maselo. Ngati maselo a mu ubongo siabwino, munthuyo amakhala ndi nkhawa kapena kukhumudwa. Kugwirizana pakati pa cholesterol yotsika ndi thanzi laumvekedwe sikumveka bwino ndikufufuzidwa.

Vuto lina lokhala ndi cholesterol yotsika ya LDL limalumikizidwa ndi amayi apakati omwe ali ndi vuto lakubadwa asanakwane kapena kubereka mwana wochepa thupi.

Ndi cholesterol yotsika, palibe ululu wa pachifuwa womwe umayimira kuchuluka kwa mafuta m'goli, monga ndi cholesterol yambiri, mwina amayamba chifukwa cha zomwe mumadya kapena momwe muliri. Kuti mubwezere mwakale, ndikofunikira kumvetsetsa kuti kungodya zakudya zokhala ndi cholesterol sikungathetse vutoli, lankhulanani ndi dokotala za zomwe muyenera kuchita pankhaniyi.

Kupewa

Kusintha kwakhalidwe ndi njira yofunika kwambiri kuti mukhale athanzi.

Izi zitha kuthandiza kupewa mavuto akulu obwera chifukwa cha cholesterol yayikulu, monga matenda amtima, matenda ammimba, mtima, komanso sitiroko.

Ndipo ndikofunikira, ngakhale mutamwa mankhwala, kuti muchepetse matendawa.

Kusintha kadyedwe kanu kukhala chakudya chopatsa mphamvu, zipatso, masamba, chimanga chonse, nsomba, mafuta ochepa amkaka angakuthandizeni kuthana ndi kunenepa kwambiri, cholesterol ya LDL, ndi kuthamanga kwa magazi. Kupanga zizolowezi zabwino za kudya ndi gawo la moyo wanu watsiku ndi tsiku ndi zina mwazinthu zabwino zomwe mungachite kuti muchepetse cholesterol yanu ya LDL. Pali mitundu ingapo ya zakudya zomwe mungasankhe, monga zakudya za DASH kapena zakudya za ku Mediterranean.

Ngati muli ndi mafunso okhudza zakudya zomwe muyenera kudya, lankhulani ndi dokotala.

Zakudya zina zam'mera zitha kuthandiza kuchepetsa LDL cholesterol. Koma musagwiritse ntchito mankhwalawa m'malo mwamankhwala omwe dokotala wakupatsani. Kafukufuku sanatsimikizire kuti amachepetsa chiopsezo cha matenda a mtima. Ngakhale mutagwiritsa ntchito zinthu ngati izi, onetsetsani kuti mupitiliza kugwiritsa ntchito zakudya, masewera olimbitsa thupi ndi mankhwala omwe mumalandira.

Monga momwe mungalandire chithandizo chatsopano chilichonse, onetsetsani kuti mwalankhula ndi dokotala. Izi ndizofunikira kwambiri ngati mukutenga ma statins.

Kuphatikizidwa kwa ma statins ndi zina zowonjezera kumatha kuyambitsa zovuta zoyipa.

Kutsitsa LDL, zotsatirazi zimagwiritsidwa ntchito:

• Plantain - imathandizira kuti matumbo ang'onoang'ono amwe kolesterol yocheperako, motero, zochepa zake zimalowa m'magazi anu. Choyimira chachikulu ndi kukhathamiritsa kwamatumbo, ndi kupuma kwakomoka.
• Sterol kapena stanol esters - amatha kuchepetsa kuchuluka kwa cholesterol yomwe matumbo ochepa amatenga, amagwiritsidwa ntchito ndi zakudya.
• Mpunga wofiyira - uli ndi mawonekedwe achilengedwe a lovastatin. Chowonjezera ichi sichingalole kuti thupi lanu lipange cholesterol yochuluka, koma imayambitsa zotsatira zoyipa ngati mankhwala osokoneza bongo, kuphatikizapo rhabdomyolysis ndi hepatitis. Onaninso dokotala nthawi yomweyo ngati simukuchitapo kanthu, monga kupweteka kwambiri kwa minyewa kapena zizindikiro za hepatitis.
• Pali zakudya zina zofunikira monga vitamini E ndi beta-carotene, zomwe zimathandizira cholesterol yocheperako, koma lankhulanani ndi dokotala wanu kuti mutsimikizire kuti ali otetezedwa kwa inu.

Kuchita masewera olimbitsa thupi pafupipafupi ndikofunikanso. Kafukufuku wina akuwonetsa kuti kuchita masewera olimbitsa thupi pafupipafupi kwa milungu 12 kungakulitse cholesterol yanu ya HDL. Milingo yanu ya triglyceride komanso kuthamanga kwa magazi kuyeneranso kukhala kokwanira. Masewera ayenera kuchitika nthawi zosachepera 4-5 pa sabata ngati muli ndi zaka zosakwana 50 komanso nthawi 2-3 ngati ndinu achikulire. Kuchepetsa thupi, ngati kuli kotheka, kudzakuthandizani kukhala athanzi.

Kusuta fodya kulinso kofunikira.

Popeza cholesterol yotsika sizinthu zomwe anthu ambiri amadera nkhawa, njira zopewera ndizosowa kwambiri. Kuyang'ana pafupipafupi kuti mupeze kuchuluka kwa cholesterol. Dziwani za matenda obadwa nawo monga cholowa. Pomaliza, yang'anani zizindikiro za nkhawa ndi kupsinjika, makamaka zomwe zimakupangitsani kukhala wankhanza.

Muyenera kukhala ndi cholesterol yamoyo wanu wonse.

Maganizo olakwika amodzi ndi oti anthu amatha kukhala osayang'anira cholesterol kwazaka zambiri kenako amasankha zochita.

Pofika nthawi imeneyo, zolembera zimatha kukhazikika kale pazenera za mitsempha yanu. Chifukwa chake, ndikofunikira kwambiri kutsatira moyo wathanzi kuyambira ndili mwana.

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

Onani kanema wothandiza pamutuwu.

Momwe mungayesedwe ndi cholesterol komanso momwe mungamvetsetse kuyesedwa kwa magazi

Kuwunikira kwa cholesterol kumaphatikizidwa pakuwunika matenda. Chifukwa chiyani komanso momwe mungaperekere magazi a cholesterol? Kodi cholesterol yamagazi imakhudza bwanji chitukuko cha atherosulinosis? Kodi kufufuza kwathunthu kwamomwe magazi amapanga ndi chiyani?

Cholesterol ndiyofunikira m'thupi lathu. Imathandizira kukhazikika kwa nembanemba ya khungu yamatumbo onse. Cholesterol imapanga chotchinga cha myelin cha ulusi wamitsempha. Ma hormone onse amuna ndi akazi amapangidwa chifukwa cha cholesterol. Mafuta acids ali ndi izi mu kapangidwe kake, ndipo amatenga nawo gawo pazakudya. Zomwe zili mu magazi siziyenera kupitirira 5.5 mmol / l. Kuwonjezeka kwa chizindikiro chachikulu kumayambitsa matenda a atherosclerosis ndipo, chifukwa chake, ischemic matenda a mtima, sitiroko, mtima. Madotolo amalimbikitsa kuti aliyense amene wafika zaka 20 aziyang'anira cholesterol.

Kuti mupeze kusanthula mwachangu komanso kuyeza nyumba, mutha kugwiritsa ntchito kusanthula kwamphamvu kwamwazi wamagazi. Zida zowunikira zowonetsera ndizosavuta kugwiritsa ntchito. Kwa anthu opitilira 60, akuyenera kutenga mayeso a cholesterol chaka chilichonse.

Kupenda kwazinthu zam'thupi

Kafukufuku wama biochemical ndikuwunika mwatsatanetsatane kwa zomwe zikuwonetsa zigawo zonse zamagazi. Kupanga kwake kumalola kuwunika mawonekedwe ndi kuchuluka kwake. Malinga ndi zotsatira za njira yothandizira ma labotale, ndizotheka kudziwa momwe thanzi laanthu likugwirira ntchito ndi makina onse. Kuchulukitsa kwa magazi kwa biochemistry kumatengedwa kuchokera kumitsempha ya ulnar. Kuzindikira gawo lililonse la magazi pogwiritsa ntchito ma reagents apadera. Amakulolani kuti mudziwe cholesterol modabwitsa. Reagents amayeza momwe zinthu zimakhalira pang'onopang'ono.

Cholesterol

Chizindikiro chofunikira kwambiri cha metabolism yamafuta ndi cholesterol. Zizindikiro wamba za munthu wamkulu zimachokera ku 3.0 mpaka 6.0 mmol / L. Mwa amuna, msambo uwu nthawi zonse umakhala waukulu kuposa azimayi. Kuwunika kwa zomwe zili pazinthu kumayang'ana zigawo zake za LDL, HDL, ndi triglyceride. Magawo wamba amakhala ndi matanthawuzo:

1. LDL - mwa amuna osachepera 2.0, osapitirira 4.8 mmol / l, azimayi - kuyambira 1.9 mpaka 4.5 mmol / l.
2. HDL - mwa amuna osachepera 0,7 osaposa 1.6 mmol / l, azimayi - kuyambira 0.9 mpaka 2.3 mmol / l.

Kukula kwa TG kumadalira msinkhu wa munthu ndipo amayeza mmol / l.

Mapuloteni wamba

Mapuloteni amagwira nawo ntchito yonyamula zinthu zachilengedwe. Amapereka cholesterol yopanda madzi kuzinthu zonse zamthupi. Chiwerengero cha mapuloteni onse ndi 62 - 83 g / l. Zosintha mu chizindikiridwe chotsika zikuonetsa matenda a chiwindi, kapamba, oncology. Kuwonjezeka kwa gawoli kungayankhule za matenda owopsa, oncology, rheumatism.

Kugwirizana mu chiwindi, urea amuchotsa impso ndi mkodzo. Amapangidwa ndi chiwindi kuchokera ku poizoni wa ammonia. Mulingo wabwinobwino wa urea mwa munthu wamkulu ndi kuyambira 2,5 mpaka 7.3 mmol / L. Ngati ndende ikuchulukitsidwa, ndiye kuti mudziwe kuchuluka kwa urea mu mkodzo. Pamene urea mumkodzo ndi magazi nthawi yomweyo amakhala ndi gawo lalikulu, ndiye izi zikuwonetsa kulephera kwa mtima, vuto la mtima la impso kapena myocardium, pyelonephritis. Ngati urea m'magazi ndi mkodzo yafupika, ndiye kuti njira zotupa m'magazi zimatheka.

Njira zoyezera serum cholesterol

Kafukufuku wama biochemical a seramu yamagazi a cholesterol ali ndi mitundu:

• mtundu
• nephelometric
• titrometric
• fluorimetric ndi njira zina.

Kuyesa kolesteroli kofala kwambiri ndi mitundu. Otsatsa owonetsa bwino amatengera njira iyi.

Katswiri wonyamula zinthu zosanja

Kuyesedwa kwa magazi kwa biochemical kumagwiritsidwa ntchito ngati kuli koyenera kuyeza mtengo wa cholesterol posachedwa. Zida zopezera zotsatira zowonekera zimakuthandizani kuti muzindikire chizindikiro chonse ndi zigawo zake. Kwa izi, zingwe zoyeserera zimagwiritsidwa ntchito, pomwe ma reagents apadera amayikidwa. Chipangizocho chikuwonetsa momwe cholesterol ikuwunikira.Kusanthula kwamphamvu kumatha kuchitika palokha. Kuti muchite izi, tengani magazi kuchokera pachala cholozera.

Kuboola chala kumachitika ndi malawi, kenako ndikuyika pachiyeso. Milozo yoyesera imaphatikizapo ma reagents: chromogen, peroxidase, cholesterol esterase ndi cholesterol oxidase. Panthawi imeneyi, glucooxidase imalowa munjira ya mankhwala ndi cholesterol. Mphamvu yotulutsidwa imasinthidwa kukhala cholesterol. Chipangizocho chikuwonetsa cholesterol mulingo wa mmol / l kapena g / l.

Kuwona mfundozo kumakupatsani mwayi wowonjezera kuchuluka kwa zinthuzo. Mwa akazi, zizindikirozi izi zisanachitike kusamba, monga lamulo, zimakhala ndi mulingo wabwinobwino. Zotsatira za abambo zimasiyana mosiyanasiyana pakukula. Izi zikufotokozera pafupipafupi matenda a mtima ndi mitsempha yamagazi mwaimuna. Zida zamagetsi zowonetsera sizimapereka zotsatira zolondola nthawi zonse ndipo zimakhala ndi zolakwika zina.

Njira ya Zlatkis-Zach

Kuzindikira kwa serum lipoproteins kumadalira zomwe zimachitika ma mamolekyulu awo aulere. Mwa njira iyi, ma reagents apadera amagwiritsidwa ntchito: sulfuric, acetic, phosphate, chloride chonde. Seramu imawonjezeredwa kwa ma reagents, ndiye chloride chouma chimawonjezeredwa kwa makutidwe ndi okosijeni. Pazochita, yankho limasintha mtundu.

Kuyeza kwa Cholesterol Kwaulere

Mukafunikira kuyang'ana kuchuluka kwa mafuta a cholesterol aulere, ndiye kuti imasiyanitsidwa ndi seramu pogwiritsa ntchito mowa wa ethyl. Kuyeza kachigawo ka LDL ndi cholesterol yaulere, ma reagents digitonin, phwetekere, pyridine sulfate amatengedwa. Panthawi imeneyi, cholesterol imakhazikika mu chubu choyesera ndipo mulingo wa LDL umatsimikiziridwa ndi chinthu ichi.

C cholesterol chonse

Kuwunikira kwa cholesterol yonse sikungathe kuweruzidwa pamakhalidwe azaumoyo wa anthu. Maphunziro a Laborator pa chizindikiro chodziwika ndi kuchuluka kwazomwe zili mu hdl, ldl, triglycerides, VLDL. Kutanthauzira kwa muyeso kumatsimikizira kuchuluka kwawo. Kuwonjezeka kwa zizindikiro zakufunika kwambiri kumatha kuchitika chifukwa cha cholowa. Ndipo ngati munthu yemwe ali ndi vuto lobadwa ndi matenda obwera chifukwa chotenga matenda a Hypercholesterolemia akudya mafuta ochulukirapo a nyama, ndiye kuti mwayi wokhala ndi atherosulinosis ukuwonjezeka.

Lowensens lipoproteins

LDL - mapuloteni amaphatikizika ndi cholesterol. Amapereka ziwalo zonse zamthupi. Kuwonjezeka kwa LDL kumabweretsa mapangidwe, kukula kwa atherosclerosis. Zilonda zopangidwa ndi sclerotic zimachepetsa lumen, potero zimapangitsa magazi kulowa mu mtsempha. Pazowerengera, njira ya colometric imagwiritsidwa ntchito. Magazi amatengedwa kuchokera mu mtsempha kuti apange biomaterial. Kuti mupeze zotsatira zoyenera zowunikira, zofunikira ziyenera kuonedwa:

• mayeso amachitika pamimba yopanda kanthu, kudya zakudya kuyenera kukhala maola 12 maphunziro asanafike,
• Musasute mu ola limodzi musanapereke magazi.

Cholinga cha phunziroli ndikuwona kuwopsa kwa atherosulinosis komanso kuopsa kwa matenda a mtima (coronary mtima matenda). Kuyesedwa kumayikidwa pakamayesedwa pafupipafupi komanso ngati pakufunika kuchuluka kwa ambiri. LDL mwa akazi ndi amuna ndi osiyana.

Tebulo 1. Lipoproteins Yotsika

Zifukwa zazikulu zowonjezera kuchuluka kwa LDL m'magazi ndi:

• zakudya zamafuta ambiri,
• kusowa kwa masewera olimbitsa thupi
• onenepa kwambiri
• zizolowezi zoyipa zimazunza
• shuga ndi matenda oopsa,
• hyperlipoproteinemia,
• Kusokonezeka kwa chiwindi,
• zaka (mwa akazi pambuyo zaka 55).

Kuchuluka kwa LDL kumatha kukhudzidwa ndikusala kudya kwakutali, kutenga corticosteroids, androgens, komanso pakati mwa azimayi.

High Density Lipoproteins

HDL (hdl) ili ndi anti-atherogenic katundu. Kuwonjezeka kwa lipoproteins kumachepetsa chiopsezo cha matenda a mtima, ischemic matenda a mtima. Ma lipids osalimba kwambiri amapangidwa kuchokera ku mapuloteni ndi mafuta ndipo amapangidwa m'chiwindi. Amachotsa cholesterol owonjezereka m'matupi, ndipo mawonekedwe a bile acids amachotsedwa m'chiwindi. Ngati ndende ya HDL yafupika, ndiye kuti izi zikuwonetsa chiopsezo cha atherosulinosis. Mitundu yambiri ya lipid imalepheretsa kukula kwake.

Ndi cholowa chokhala ndi cholowa cha hypercholesterolemia, chakudya chopatsa thanzi chamafuta ambiri, HDL sichitha kuchotsa cholesterol yowonjezera. Idzayikidwa pamakoma amitsempha yamagazi, ndikupanga zolembera za atherosrance. Kuti mudziwe kuchuluka kwa chitukuko cha atherosclerosis, kafukufuku wa zasayansi ndi mankhwala. Chizindikiro cha lipoprotein mwa akazi ndi amuna chimakhala ndi zizindikiro zosiyanasiyana.

Gome 2. Wapamwamba osachulukitsa Lipoproteins

Kutsika kwa HDL kungawonetse kukula kwa atherosulinosis, matenda a chiwindi osachiritsika, komanso matenda a shuga. Mitundu yotsika kwambiri ya milomo yapamwamba imakhala chifukwa cha zifukwa zotsatirazi:

• kunenepa kwambiri
• kutenga ma diuretics, ma progestin, β-blockers,
• kudya zakudya zochuluka
• kusuta fodya.

High osalimba lipids m'munsi LDL ndende. Gawo la cholesterol ili ndi asidi ambiri a polyunsaturated. Amayendetsa magwiridwe antchito amanjenje. Kutsika kwa HDL ndizowopsa.

Triglycerides ndi VLDL

Chizindikiro china chofunikira pakuwunika ndi kuchuluka kwa triglycerides. Amachokera ku glycerol ndi mafuta acids. Zomwe zimachokera ku triglycerides ndi mafuta, omwe amabwera ndi chakudya. Kuwonjezeka kwa triglycerides kukuwonetsa chitukuko cha atherosulinosis, matenda oopsa, matenda a mtima, hepatitis ndi matenda ena angapo. Kuzungulira kwa chisonyezo kumadalira msinkhu wa wodwalayo.

Tebulo 3. Triglycerides

Kutsika kwambiri kwambiri kwa lipids ndizofunikira zazikulu za atherogenicity. Amayendetsa triglycerides ku tinthu tating'ono kuchokera m'chiwindi ndi matumbo. VLDLP imayambitsa kupanga mapangidwe oopsa. Muyezo wa VLDL uyenera kukhala pamtunda kuchokera pa 0.26 mpaka 1.04 mmol / L. Kuyesedwa kwa Laborator kwa zomwe zili mu VLDL kumazindikira mtundu wa dyslipidoproteinemia ndikumakhala chizindikiro cha chithunzi chonse cha metabolidi ya lipid. Njira yamankhwala imatsimikizira kuchuluka kwa glycerol yomwe imapangidwa nthawi ya hydrolysis.

Njira ya enzymatic imakhala ndiubwino pamapangidwe amakanidwe. Kuti muchite izi, triglycerides amachotsedwa mu seramu yamagazi, glycerin yomasulidwa imaphatikizidwa ndi sodium metapasonate. Mwa njira iyi, ma reagents amagwiritsidwa ntchito: heptane, isopropanol, sodium sulfuric acid ndi zina zofunika, komanso yankho la calibration, lomwe ndi gawo la zida. Chinsinsi cha njira yodziwira mulingo wa triglycerides ndiko kuzindikira kwa hyperlipoproteinemia. Kuwonjezeka kwa ndende kumawonetsa kusokonezeka kwa lipid metabolism.

CHD cholesterol ndi kupewa matenda

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

Kukhalapo kwa matenda a mtima kumawonedwa chifukwa chophwanya malamulo okondweretsa kwa nthawi yayitali, kunyalanyaza zamasewera komanso chifukwa cha zizolowezi zoipa. Ndizofunikira kudziwa kuti kukalamba kumathandizanso kupeza mwayi wokhala ndi matenda a mtima.

Kumayambiriro kwa matendawa, kusinthaku kumakhala kochepa, koma m'kupita kwa nthawi kumachulukana ndikuwonekera. M'matumba omwewo, mafuta am cholesterol plaque, omwe amachititsa kuti izi zitheke, mtima wake sukulandila zakudya zoyenera. Kuperewera kwa chithandizo chamanthawi yake kumatha kukhala zotsatira zoyipa - kugunda kwa mtima ndi sitiroko.

Matenda a mtima a coronary amatha kupewedwa ndi zakudya zoyenera, kusintha kwa moyo. Izi zokha, ndizachidziwikire, sizingachiritse kwathunthu matendawa, koma ndizotheka kuthandizira. Komabe, chinthu ichi ndicofunika kwambiri pa thanzi. Kuphatikiza apo, monga prophylaxis, iyi ndiye njira yothandiza kwambiri. Akatswiri atsimikizira kuti kupatsa thanzi kumathandiza kwambiri kupewa matenda a mtima, omwe ndi matenda a mtima.

Nthawi zambiri, chomwe chimayambitsa matenda a mtima ndi cholesterol yayikulu. Thupi limapanga izi zokha mwa zokwanira, koma ndi chakudya limalowa m'thupi mopitirira muyeso.

Pali mitundu iwiri ya ma lipoprotein m'magazi: lipoproteins (high-density lipoproteins (HDL)). Mtundu woyamba ndiwothandiza kwa thupi komanso kukwera msanga, bwino. Mwachitsanzo, imatha kupewa kutsata mafuta m'makoma amitsempha yamagazi, ndikuwongolera momwe thupi liliri. Chikhalidwe cha mtundu wachiwiri sichimavulaza. Amathandizira pakupanga minofu komanso m'njira zina.

Koma kuchuluka kwachilengedwe mthupi kumatha kuvulaza. Chofunikira kwambiri ndichakuti pali kuchuluka kwa ma lipoprotein awiri m'magazi. Ngati yasweka, muyenera kufunsa dokotala.

Mafuta ambiri a cholesterol ndi triglycerides amapanga zipupa pamakoma amitsempha yamagazi. Kukula, amawononga kwambiri thanzi la ziwalo, zomwe ndizomwe zimayambitsa matenda a atherosulinosis. Nthawi zambiri, cholesterol yapamwamba imakhala chifukwa cholakwika ndi michere. Izi makamaka ndizoyamwa zamafuta ambiri a nyama. Kuti muzitha kuyang'anira zizindikiro, muyenera kukayezetsa mwadongosolo. Mutha kuyeza zizindikiro kunyumba pogwiritsa ntchito chipangizo chapadera.

Matenda a mtima ndi cholesterol

Zotsatira za phunziroli zidawonetsa kuti matenda ngati amenewo amakula pafupipafupi kanayi ngati cholesterol imakwezedwa.

Kutsika kwa cholesterol kumabweretsa kuchepa kwa chiwopsezo cha kubadwa pakati.

Kulakwira koyenera nthawi zina kumawonjezera mwayi wa kuchira kwathunthu.

Malinga ndi ziwerengero zamankhwala zomwe zilipo:

• zotsatira zakupha ndi mafuta ambiri (kuyambira 5.5 mpaka 6.0) kuchokera ku ischemia wowirikiza,
• kuopsa kwa matenda a m'matumbo kumawonjezeka motsogozedwa ndi zinthu zina, monga kusuta, shuga, kunenepa kwambiri.

Mlingo wa cholesterol wathunthu umakhudzana mwachindunji ndi kuthekera kwa matenda a m'matumbo a coronary.

Chifukwa chake, ndikulimbikitsidwa kupendedwa ndi cholesterol kuyambira zaka 20. Komanso yang'anani zakudya ndi moyo. Pali zinthu zoopsa zomwe zimakhudza cholesterol komanso kupezeka kwa ischemia:

1. Kusuta.
2. Mowa.
3. Zaka 40+
4. Kuonjezera thupi.
5. Zakudya zopanda pake (kuchuluka kwa mafuta a nyama mu chakudya)
6. Kulephera kuchita zolimbitsa thupi.
7. Hypercholesterolemia.
8. Makamaka.
9. Matenda a shuga
10. Matenda oopsa

Ischemia imapezeka kwambiri mwa amuna, ngakhale kwa azimayi sichoncho. Mowa ndi vuto. Akatswiri ena amati mlingo wocheperako umachulukitsa mulingo wa HDL m'magazi, ndipo ena mwa ena amakana kupindula kwake.

Chimodzi chodziwika kuti mowa wocheperako umatha kukhudza chiwindi, ndipo, monga mukudziwa, ndi kapangidwe ka cholesterol.

Ischemia ndi cholesterol zimadalirana, chifukwa chake ndikofunikira pamaso pamatenda kuti muchepetse mafuta m'magazi, chifukwa moyo wa wodwala umadalira.

Zambiri pazomwe zimayambitsa matenda a mtima

Kuzindikira kumachitika nthawi zambiri ndi dokotala wamtima, kutengera madandaulo a wodwalayo pazizindikiro za matenda. Komanso, maziko azomwe amadzazindikira ndi mayeso. Maphunziro angapo akuchitika, kuphatikizapo kafukufuku wa cholesterol yathunthu komanso kuchuluka kwa lipoproteins. Nthawi zambiri, cholesterol ku IHD imakhala yachilendo kuposa momwe imakhalira. Kuzindikiritsa shuga wamagazi ndi triglycerides kumachitidwanso. Kutengera ndi zotsatira za kusanthula uku, kafukufuku wofunikira amachitidwa - ECG. Cholinga cha phunziroli ndikutsata zomwe mtima umachita, ndikukuthandizani kuti muwunike kuphwanya kwa ntchito yake.

Kuphatikiza ndi njira zina, ultrasound yamtima imagwiritsidwa ntchito mwachangu. Kugwiritsa ntchito, mutha kudziwa momwe thupi limakhalira: kukula kwake, momwe ntchito ya valve, ndi zina zambiri. Kupsinjika kwa chikumbumtima kumagwiritsidwa ntchito ndi katundu pang'ono. Amalembetsa myocardial ischemia. Njira imodzi yodziwira ndi kuyesa ndi zolimbitsa thupi. Izi ndizofunikira ngati kuphwanya kumachitika pokhapokha osangalala, izi zitha kuonedwa koyambirira. Zimagwiritsa ntchito kuyenda, kuphunzitsa thupi, kukwera masitepe. Zambiri zalembedwa pa registrar wapadera.

Pogwiritsa ntchito ma electrocardiography, boma lokhala ndi magetsi mosangalatsa, kayendedwe ka myocardial kumayesedwa. Sensor yapadera imayikidwa kudzera m'mphepete kenako mtima ndikujambulidwa. Adokotala atazindikira kuti ali ndi matendawa, amamulembera mankhwala ndipo amapeza mndandanda wapadera.

Chithandizo chovomerezeka ndi kugwiritsa ntchito mankhwala apadera, omwe nthawi zambiri madokotala amatiuza mankhwala a Simvastatin.

Zakudya za mtima matenda

Mlingo wa cholesterol yathunthu ku IHD nthawi zambiri imakwezedwa, chifukwa chake, chakudya chapadera ndi lamulo lofunikira mu chithandizo. Zakudya zopatsa thanzi za ischemia zimakhazikitsidwa pamaziko a tebulo No. 10, lomwe limapangidwa kuchokera ku atherosulinosis. Pa chithandizo, muyenera kutsatira malamulo ena. Zakudyazo zimatengera kuchepetsa kudya kwamafuta a nyama, kuchepetsa kuchuluka kwa chakudya chamafuta, motero kuchepetsa zakudya zamafuta, kumachulukitsa zakudya zamafuta, kuchulukitsa kuchuluka kwa masamba, acid acid, komanso kuchepetsa mchere.

Ndikofunikira kuti muchepetse kugwiritsa ntchito shuga, kupanikizana, maswiti ndi maswiti osiyanasiyana. Zakudya zambiri zomwe mumadya zimakhala ndi mafuta a nyama, motero muyenera kuchepetsa okhawo owopsa. Muyenera kukana kudya:

• chiwindi
• ubongo
• dzira yolk
• mafuta azitini
• nkhumba yamafuta
• oyisitara
• masoseji,
• sala
• mayonesi
• mafuta
• squid
• mackerel.

Muyenera kuganiziranso za zakudya zomwe ziyenera kupezeka m'zakudya:

1. Zakudya za nsomba ndi nsomba zam'nyanja. Caviar ndi squid samayikidwa, koma nsomba zonse zamchere zamchere zimaloledwa. Zakudya zoterezi zimayenera kudyedwa pafupifupi katatu pa sabata. Mutha kugwiritsanso ntchito seaweed, ndizothandiza pamitundu yonse.
2. 500 magalamu a masamba patsiku, chifukwa ndi magwero a zakudya mthupi.
3. Tirigu wa tirigu yemwe ali ndi pectin.
4. Flaxseed, nthangala za sesame, chifukwa zimakhala ndi zinthu zambiri zomwe zimathandiza mu atherosulinosis ndi ischemia.
5. Kabichi yoyera mwanjira iliyonse ndi masamba aliwonse.
6. Kuchuluka kwa mbatata.
7. Biringanya, beets, kabichi wofiira.
8. Malingoni, viburnum, chimanga, makangaza, rasipiberi, mabulosi abulu, sitiroberi, mphesa, msuzi.
9. Ma Leamu, mankhwala a soya amachepetsa cholesterol yokhala ndi CHIKWANGWANI. Zinthu za Soy zimakhudza thupi.
10. Mafuta ophikira.
11. Zinthu zamkaka zokhala ndi mafuta ochepa.
12. Mkate ndi chinangwa, rye.
13. Porridge ndi mbewu zosiyanasiyana.

Ndikofunikira kukhala ndi tiyi wobiriwira, madzi ndi mandimu, msuzi wa rosehip, mchere womwe umakhalabe madzi pachakudya.

IHD

Mukamachiza, muyenera kutsatira zakudya zapadera zomwe zimathandiza kuchepetsa kuchuluka kwa cholesterol yoyipa.

Zakudya zimayenera kuphikidwa molondola, masamba ayenera kuphika kapena kuwotcha, soseji ndi zinthu zosuta siziyenera konse. Muyenera kudya pafupifupi 5 pa tsiku, koma m'magawo ang'onoang'ono.

Zakudya izi zimapangidwa kwa nthawi yayitali ndipo zimawerengedwa kuti ndizoyenera. Chachikulu ndikuphatikiza malonda ndi mitundu yosiyanasiyana yazakudya.

Zakudya izi zili ndi zabwino komanso zovuta.

• zosiyanasiyana
• kukhuthala kosalekeza, chifukwa cha kusungidwa kwa mbale,
• kusintha mafuta mafuta m'thupi,
• kukonza bwino wodwala.

1. ndizovuta kutsatira zakudya, chifukwa sizachilendo
2. wotupa msanga
3. Ndikosavuta kulekerera pamlingo wamaganizidwe chifukwa cha kusowa kwa zinthu zomwe mukudziwa.

Zakudya zizikhala njira yokhazikika pamoyo. Ngakhale zovuta zoyambira, munthu akhoza kuzolowera.Akatswiri amati simungayang'ane kwambiri zakudya, koma muyenera kuphatikiza chakudya ndi masewera. Ngati ndinu wokalamba, mutha kudziletsa kuti muziyenda, kuyenda njinga. Ili ndi gawo lofunikira kuti muchiritse bwino. Kuphatikiza apo, zakudya zamagulu osiyanasiyana zimakuthandizani kuti muzolowere zakudya zatsopano, ndipo moyo wathanzi umakulitsa nthawi yayitali.

About matenda a mtima ofotokozedwa mu kanema munkhaniyi.

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

Zizindikiro zamatenda am'mtima mwa azimayi

Kwa zaka zambiri, kulimbana ndi matenda oopsa osagonjetseka?

Mkulu wa Sukulu: “Mudzadabwitsidwa momwe kumakhalira kosavuta kuchiza matenda oopsa tsiku lililonse.

Zizindikiro za matenda amtima mwa azimayi ndi ofanana ndi abambo, koma azimayi amakonda kwambiri matendawa. IHD imawoneka ngati minofu yamtima sililandira mpweya wofunikira pazofunikira. Poyerekeza ndi maziko a IHD, matenda a mitsempha ya mtima amatha kukhazikika. Kusiyanitsa pakati pachimake ndi matenda a ischemic. Zotsatira za matendawa ndi imfa yadzidzidzi. Ndikofunika kudziwa kuti: matenda a coronary nthawi zambiri amabweretsa imfa.

Monga taonera kale, matenda a mtima ndi ofala kwambiri mwa akazi. Chifukwa chiyani? Izi ndichifukwa choti azimayi amakhala ndi mahomoni ogonana omwe amateteza makhoma amitsempha yamagazi kuti asawonongeke.

Ndi kusintha kwa msambo, mphamvu ya mahomoni imafooka - izi zikusonyeza kuti m'tsogolomo mkazi amakhala pachiwopsezo chotenga matenda, kuphatikizira matenda a mtima.

Pali mitundu ingapo yamatendawa. Iliyonse ya mitunduyi imasiyana, kutengera momwe chakudya cha oxygen chimatchulira. Nthawi zina matendawa amatha popanda zizindikilo zoonekeratu, koma mkati mwake momwe amakhalapo.

Matenda a mtima amatha kupangitsa angina pectoris. Pankhani yodwala, mkazi samatha kupuma pokhapokha ngati atanganidwa kwambiri, komanso nthawi yovuta. Angina pectoris ndiowopsa: chizindikiro chake chachikulu ndi kupweteka kumbuyo kwa sternum.

Mtundu wotsatira wa matenda a mtima ofunika amatchedwa "angina osakhazikika." Ngati angina akuwonjezeka, izi zikuwonetsa kuti matendawo akupita patsogolo. Ndizofunikira kudziwa: angina pectoris ndi mawonekedwe ake akhoza kukhala harbinger wa vuto la mtima. Ndi matenda a ischemic, kupotoza kwa kayendedwe ka mtima ndikotheka, ndiye matendawa amakhala osachiritsika. Myocardial infaration imatsogolera ku kufa kwa gawo linalake la minofu yamtima.

Kuukira kumeneku kumachitika chifukwa chakulekanitsidwa kwa khoma ndi khoma la mtsempha, kumachitikanso pamene mtsinjewo umatsekedwa. Imfa mwadzidzidzi imaphatikizapo kumangidwa kwamtima chifukwa chakuti mpweya sufika m'misempha yake. Nthawi zambiri, kufa kwadzidzidzi kwamtima kumachitika patachitika vuto lalikulu la mtsempha. Zizindikiro zonse pamwambapa ndi matenda amtundu wa coronary amatha "kuwolana" wina ndi mnzake, zomwe zimawonjezera vutoli. IHD imatha kuchitika motsutsana ndi maziko a arrhasmia.

Kukula kwa CHD

Mtima ndi wofunikira kupopa magazi, koma chiwalochi chimafunikiranso kuthiridwa magazi. Minofu ya mtima imatchedwa myocardium. Amalandira magazi akudutsa m'mitsempha. Mitsempha iyi imagawidwa m'magulu ang'onoang'ono - imapereka michere kumadera ena amtima. Mitsempha ya mitsempha ikacheperachepera, dera linalake la mtima limakumana ndi vuto la mpweya. Zakudya zamthupi sizimagwira, chifukwa cha izi, matenda amtima amayamba. Matenda a mitsempha ya coronary nthawi zambiri amapezeka chifukwa cha mitsempha ya mitsempha.

Zikakhala zoterezi, cholesterol malo omwe amakhazikitsidwa pamakoma awo, ndipo kuwunikira kwa kugumuka kumachepa. Chifukwa chake, magazi amapita moipa kwambiri mumtima. Poyamba, munthu amapuma bwino, koma kuthamanga kapena kulimbitsa thupi pang'ono, ululu umamveka kumbuyo kwa sternum. Momwe malo okhala m'mitsempha yama coronary atatsekedwa, mtima wake umavutika. Ndi matenda oterowo, kagayidwe kamunthu ka minofu kumakulirakulira, ndipo kupweteka kumawonekera kale pakupuma. Poyerekeza ndi kumbuyo kwa zizindikiro za angina pectoris, kulephera kwamtima kosatha kumatha kuchitika.

Ngati chithokomiro cha mitsempha chatseka kwathunthu, kulowetsedwa kwamtima kumachitika, zomwe zimayambitsa kumangidwa kwamtima ndi kufa. Kukula kwa kuwonongeka kwa minofu ya mtima kumadalira momwe kufalikira kunachitikira. Ngati mtsempha waukulu wabowoleka, ntchito za mtima zimakhala zowonongeka: zotsatirazi zimakanika. Choyipa kwambiri ndichotsekerapo m'mitsempha yama coronary - ichi chimatsogolera kuimfa.

Kodi zizindikiro za matenda a mtima ndi chiyani? Chodabwitsa cha matendawa ndikuti amatha kukhala asymptomatic. Panthawi imeneyi, matendawa amatsimikiza ndikuwunika kokwanira. Pali zizindikiro zingapo zamatenda am'mtima: nthawi zambiri, munthu amamva kupweteka kumbuyo kwa sternum. Zomverera zosasangalatsa zimawonekera m'khosi ndi m'manja. Wodwala amatha kupuma movutikira pakamayenda koyenera, zimamuvuta kuti adzuke.

Mawonekedwe okonzedwayo amayambitsa kupuma movutikira komanso kugunda kwamtima kolimba, zosokoneza mu ntchito ya mtima zimawonedwanso. Myocardial infarction imabweretsa zowawa kumbuyo kwa sternum. Amafanana ndi kuukira kwa angina pectoris, koma akuopsa kwambiri. Pankhani ya ululu wotere, mankhwala ochiritsira samathandiza.

Ndikofunika kudziwa kuti njira ya matenda a mtima ndi osasintha. Asayansi sanapangepo mankhwala omwe angachiritse kwathunthu IHD. Njira zamakono zamankhwala zimagwiritsidwa ntchito kuwongolera matendawa komanso kupewa zovuta zake.

Zotsatira zake

Zizindikiro za kuwonongeka kwa mtima zimayenderana bwino ndi impso, ubongo, ndi kapamba. Ndi maphunziro a asymptomatic, kuchuluka kwa cholesterol kumatha kuchuluka mthupi. Izi zimawononga kwambiri mkhalidwe wamitsempha yamagazi. Koma chinyontho cha zombozi chikhoza kukhalabe chachikulu. Matenda a shuga ndi cholesterol okwera nthawi zambiri amatsogolera ku matenda a coronary: cholesterol plaques mu thupi amakula mopitirira 50% ya lumen.

Owerenga athu adagwiritsa ntchito bwino ReCardio kuchiza matenda oopsa. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

Minofu yamtima ikakonzanso, kapangidwe kake kamasintha, izi zimapangitsa kulephera kwa mtima. Odwala amakhala ndi kuwonjezeka pang'onopang'ono kwa zizindikiro zake ngati matendawa sanalandiridwe panthawi yake. Mwa akazi ndi abambo, kupuma movutikira kumachitika kawirikawiri, kupweteka kumbuyo kwa sternum kumawoneka. Pa gawo lotsogola, ululu wake ndi waukulu. Kulephera kwa mtima kwamphamvu kumawonedwa. Kuchulukana komwe kumatheka m'mapapu komanso kuwonjezeka kwamankhwala. Ndi mawonekedwe apamwamba a matenda a mtima, munthu amamva kupweteka kumbuyo kwa sternum ngakhale atapuma. Pamagawo awa, zotsatira zowopsa zimawonekera: myocardial infarction kapena mtima womangidwa.

Palibe mankhwala a CHD. M'moyo wonse, wodwala amafunika kumwa mankhwala osokoneza bongo ndikutsatira mfundo zabwino pazinthu zonse. Ndikofunika kuyamba kulandira chithandizo munthawi yake. Chifukwa chake, ndizotheka kupewa zovuta zowopsa ndikuwongolera moyo wabwino. M'pofunika kudya mothandizana, kugona chabe, koma chinthu chachikulu ndikuyiwala zamakhalidwe oyipa! Kuphatikiza apo, shuga m'magazi amayenera kukhala osinthika. Simungathe kulola kuti thupi likhale ndi cholesterol yayikulu. Pofuna kupewa matenda a mtima, muyenera kukhala ndi moyo wathanzi.

Amayambitsa, Zizindikiro ndi chithandizo cha angina pectoris nkhawa 3 FC

Matenda a mtima ndi chimodzi mwazinthu zofunikira kwambiri zomwe zikukhudza chiwopsezo cha kufa. Zotsatira zoyipazi zimachitika makamaka chifukwa cha matenda a mtima (CHD). Mawonekedwe ake wamba ndi angina pectoris, amenenso ali ndi zovuta zinayi.

• Chofunikira komanso mtundu wa matendawa
• Kodi matendawa amakula bwanji?
• Kuzindikira matendawa
• Ambulansi panthawi yowukira
• Kuchiza matenda

Chofunikira komanso mtundu wa matendawa

Mtima, minofu yayikulu ya thupi, imalandira zakudya kuchokera pakutuluka kwa mpweya ndi michere kudzera m'mitsempha. Zofunikira zatsiku ndi tsiku zimatha kuwonjezeka ngati munthu akuchita zinthu zina zolimbitsa thupi. Chifukwa chake, kutuluka kwa magazi kupita kuchiwalo chachikulu kumakulanso.

Mitsempha yama coronary ndi coronary "yomwe imatumikira" mtima imachokera ku msempha. Ngati sizachilendo, magazi amatuluka. Ndipo izi zikutanthauza kuti gawo lina la minofu ya mtima lidzalandira okosijeni wocheperako komanso zinthu zofunika pakuchita bwino.

Kusowa uku kumatchedwa ischemia. Ngati vutoli limatha kupitirira mphindi 30, mtima umayamba kufa mumtima, womwe umalowetsedwa m'mutu. Pathology imatha kuthandizidwa pakadutsa gawo lovomerezeka la zochitika zolimbitsa thupi ndikutsagana ndi zowawa.

Pali magulu anayi ogwira ntchito a matendawa (FC). Choyimira chachikulu pakusiyanitsa ndiko kuuma kwa mawonekedwe ndi kuvomerezeka kwa zochitika zolimbitsa thupi:

1. FC 1 ndi matenda ochepetsetsa omwe masewera olimbitsa thupi amaloledwa. Kuukira kungatheke pokhapokha ngati mutapanikizika kwambiri.
2. FC 2 imaphatikizapo kuchepa thupi. Ophunzirawa ali ndi odwala omwe angina akuwukira pambuyo pa 500 m kapena akakwera pansi yachiwiri ndi masitepe. Kuphatikiza apo, odwala saloledwa kuyenda nyengo yozizira komanso yamkuntho, zochitika mukangodzuka tulo, kapena kugona mopitirira malire. Zonsezi zimatha kuyambitsanso kuwonongeka m'moyo wabwino.
3. FC 3 imachepetsa kwambiri munthu potengera zochitika zolimbitsa thupi. Kuukira kungayambitse kuyenda kwa liwiro la 100-500 m ndikukwera masitepe kupita pomwepo.
4. FC 4 ndiye mawonekedwe owopsa kwambiri. Uku ndikulumala komwe khunyu limatha kuchitika ngakhale mudakali.

Ndizofunikanso kudziwa kuti odwala omwe ali ndi mtundu wa matenda a FC 3, monga lamulo, amatha kuwongolera kuthekera kwawo. Amathanso kuoneratu njira yakuukiridwa. Izi zimathandizira kuti zisawalowetse pasadakhale ndikuchepetsa mphamvu zopanda pake.

Kodi matendawa amakula bwanji?

Kuwonongeka kwa mtima kungayambitse matenda a shuga, cholesterol deposits ndi zina, chifukwa chomwe zimapezeka m'makoma a mitsempha. Amachepetsa ndima ake m'mitsempha, kusokoneza kayendedwe kabwino ka magazi.

Kuukira kwa matenda a mtima a coronary a angina pectoris omwe ali ndi FC 3 kapena 4 nthawi zambiri kumayendera limodzi ndi kupweteka kwambiri. Koma nthawi zina amatha kuchepetsedwa ndi kupuma movutikira, kutsokomola komanso kufooka. Chomwe chimasiyanitsa matendawa: Mavuto akachitika, mutha kudziwa bwino koyambira ndi kutha kwake.

Ululu umatha kufalikira m'deralo kumanzere kwa thupi, kumbuyo kwa sternum. Nthawi zina imagwira dzanja lamanzere, nsagwada kapena phewa. Nthawi yomweyo, wodwalayo amakumana ndi zovuta komanso kupsinjika m'dera la mtima. Ndi FC 3 kapena 4, kupwetekako kungathenso kuyenda ndi zizindikiro zomwe zatchulidwa pamwambapa - kufupika kwa mpweya, chifuwa, ndi zina.

Pakakhala vuto, munthu, monga lamulo, amamva kupweteka kwakanthawi. Sizingasokonezedwe ndi chilichonse ndipo sizingagonjetsedwe ngati palibe mankhwala oyenera. Mwamwayi, kukomoka nthawi zambiri kumakhala kochepa ndipo nthawi zambiri kumatha mosayembekezereka, pamapeto pa kukhumudwa. Matendawa ndi owopsa, choyambirira, ndimachulukidwe owonjezeka a myocardial infarction.

Nthawi zambiri, kuukira ndi FC 3 kapena 4 kumatenga pafupifupi mphindi 3-5, koma mwa ena odwala amatha kuchedwa kwambiri. Milandu yosasamalidwa makamaka mukachuluka kwambiri, kupweteka kwa wodwala kumatha kukhala ngati mafunde, kuyambira kwambiri mpaka owonjezera. Pankhaniyi, muyenera kuyitanitsa ambulansi nthawi yomweyo, chifukwa ochiritsira wamba sangathetse zovuta.

Ndizofunikiranso kudziwa kuti, kutengera kulosera ndi mtundu wa zomwe akuwomberazi, angina pectoris mu FC 3 kapena 4 ndi okhazikika komanso osakhazikika:

1. Fomu yokhazikika ikuwonetsa kuti wodwalayo amatha kuneneratu za zovuta. Amadziwa kuti akapanda kupitirira masewera olimbitsa thupi, amatha kupewa kupweteka. Pankhaniyi, matendawa ndi osavuta kuwongolera. Chachikulu ndichakuti musanalongosole kuchuluka kwa zomwe zaloledwa ndikuwunika zomwe mungathe kuchita.
2. Panthawi ya mawonekedwe osasunthika, kukomoka kumatha kuyamba popanda zifukwa komanso prerequisites. Kukula kwamatenda kumatanthauzanso kuti mankhwala achilendo sangathandize.

Mitundu yamatendawa imazindikira njira yodziwira ndi kulandira chithandizo, yomwe imaperekedwa kwa wodwala.

Kuzindikira matendawa

Chifukwa cha chithunzi chapadera chachipatala, kupezeka kwa matenda amitsempha yamagazi kumakhala kovuta makamaka kwa akatswiri. Katswiri wamtima amatha kudziwa matendawo pamadandaulo a wodwala. Matendawa ndiwotheka kwambiri ngati wachibale wa wodwalayo akuvutika mwanjira imeneyi ngati FC 3 kapena 4.

Kuti mutsimikizire matendawa, mndandanda wambiri wothandiza pogwiritsa ntchito zida zogwiritsidwa ntchito umagwiritsidwa ntchito.

Kuwunikira kwa Holter

Izi zikuphatikiza:

• electrocardiogram
• Kuwunika kwa Holter ECG
• mayeso opsinjika
• Ultrasound wamtima,
• kuyesa kwamwazi wamagazi,
• myocardial scintigraphy,
• coronary angiography.

Njira yodziwika bwino komanso yotsika mtengo yodziwira ndi mtundu wa electrocardiogram. Kuti mupeze zambiri zolondola, tikulimbikitsidwa kuti muzichita mwachindunji pakakhala vuto.

Kuwunikira kwa Holter kumaphatikizapo ma ECG angapo, zomwe zotsatira zake zimalembedwa tsiku lonse pogwiritsa ntchito zida zapadera. Nthawi yomweyo, wodwalayo amachita bizinesi yake m'njira zonse. Amalemba zowerengera powunika mu buku lake.

Ultrasound yamtima imawulula zodabwitsa pakugwira ntchito kwa zida zamagetsi ndi ma myocardial contractions, omwe nthawi zambiri amayenda ndi ischemia ya minofu yamtima.

Kuyesa kwamwazi wamagazi kumagwiritsidwa ntchito pozindikira momwe mitsempha ya magazi ilili. Makamaka, amawunikira cholesterol ndi kuchuluka kwa zotupa za atherosulinotic, zomwe zimakuthandizani kudziwa kuchuluka kwa kuthamanga kwa magazi.

Ambulansi panthawi yowukira

Angina pectoris ndimatenda osachiritsika. Chifukwa chake, kuchiritsa kwathunthu sikokwanira nthawi zonse komanso pokhapokha pakuchitika opaleshoni.

Koma choyambirira, wodwalayo ndi malo omwe amakhala nawo ayenera kuphunzira momwe angaperekere chithandizo choyambirira cha odwala.

Nitroglycerin ndi kukonzekera motengera izi ndi njira zazikulu zoletsa zovuta. Pazizindikiro zoyambirira, wodwalayo amafunika kuyika piritsi limodzi pansi pa lilime ndikulisungunula. Ngati kuukiridwa ndikulimba, mutha kungopereka awiri. Ndikwabwino ngati mkamwa wamadzi ukadzanyowa. Mlingo wambiri, mapiritsi 5, amatengedwa milandu yayikulu kwambiri, pomwe thandizo silimayembekezera kuchokera kwa madokotala.

Owerenga athu adagwiritsa ntchito bwino ReCardio kuchiza matenda oopsa. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

M'malo mapiritsi, mutha kugwiritsanso ntchito spray. Zotsatira za zochita za nitroglycerin zitha kuwonekera mu mphindi zochepa.

Nthawi zina amayesa kuyimitsa mothandizidwa ndiolol. Uku ndikulakwitsa kwakukulu, chifukwa mankhwalawa sikuti amangothandiza, koma amathanso kuvulaza thanzi.

Koma ena amatha kugwiritsa ntchito njira zosavuta zowongolera zovuta. Pachifukwa ichi, ndikofunikira kukhazikitsa wodwalayo momwe ndingathere, pathupi komanso mwamakhalidwe:

• munthu ayenera kuloledwa kuti ayime kaye ngati ziwopsezo zimachitika chifukwa chovuta kwambiri,
• ngati kupsinjika ndikuchitika, wodwalayo ayenera kulimbikitsidwa,
• Ndikofunikira kupatsa munthu malo okhala kapena theka, komanso kuchuluka kwa mpweya wabwino,
• thupi liyenera kumasulidwa ku zinthu zilizonse zokakamiza, kuphatikizapo lamba, kolala, zovala zakunja,
• Madzi otentha amatha kuyikidwa kumapazi anu.

Kuchiza matenda

Pazithandizo zochizira, aspirin iyenera kugwiritsidwa ntchito. Mankhwalawa amachepetsa kukhuthala kwa magazi ndikuthandizira kuchepa kwake mkati mwa ziwiya.Pa cholinga chomwecho, tikulimbikitsidwa kulandira:

• beta blockers,
• odana ndi calcium
• mankhwala osokoneza bongo antiadrenergic,
• vasodilators.

Monga lamulo, othandizira amaphatikizidwanso munjira ya mankhwala. Ndikofunika kumvetsetsa kuti mankhwalawa amayenera kuyang'aniridwa ndi a mtima. Pamaso pakuzindikira, ndikofunikanso kukhala ndi zizolowezi zingapo zothandiza:

1. Nthawi zonse nyamulani phukusi la nitroglycerin kapena utsi. Muthanso kupanga mankhwala kuntchito komanso kunyumba.
2. Musanakhale ndi kuchuluka kwakuthupi kapena kotengeka, muyenera kuyika cholembera pansi pa lilime.
3. Sungani chikhalidwe chanu chopatsa thanzi komanso khalani ndi regimen. Mkhalidwe wazombo zimatengera izi mwachindunji. Cholesterol chochuluka chimayikidwa pamakoma awo, kulipira kwake magazi ndi chakudya cham'mimba, ndipo kukokoloka kwazitali kumatha.
4. Yang'anirani vutoli ndikupita kumayeso pafupipafupi. Izi ndizofunikira kuti muchepetse kukomoka pang'ono. Kuvutika ndi kunenepa kwambiri, matenda abwinobwino a shuga kapena matenda ena amtima, kuchotsa matendawa ndikovuta kwambiri.
5. Yendani momwe mungathere. Ndi angina pectoris FC 3 masewera ndi kuyenda kwambiri ndizoletsedwa. Komabe, amaloledwa kuti ayende pang'onopang'ono, kuti azitha kugula payokha kapena kuyenda. M'mbuyomu, zikhalidwe zanu zolimbitsa thupi ziyenera kukambidwa ndi katswiri.

Ndikofunikira kukana kusuta komanso kudya mafuta ambiri. Ngati njira zonse zodzitetezera komanso zochizira sizithandiza kukwaniritsa kuchira kwathunthu, kulowereraku kungalimbikitsidwe kwa wodwalayo. Izi zitha kukhala opaleshoni ya opaleshoni kapena mitsempha ya pulasitiki. Chithandizo chokhazikika choterechi chikugwiritsidwa ntchito ngati angina akuwukira mumtundu wa FC 3 kapena 4 amawopseza moyo wa wodwalayo.

Musayambitse matenda omwe angayambitse kukula kwamatenda amtundu wamtima: tachycardia, mitundu yayikulu ya arrhasmia, kugunda kwamtima. Monga lamulo, zovuta zimapita ndipo zimatsogolera kulumala.

- kusiya malingaliro, mukuvomereza Chigwirizano cha Wogwiritsa ntchito

• Arrhasmia
• Atherosulinosis
• Mitsempha ya Varicose
• Varicocele
• Zotupa
• Magazi
• Matenda oopsa
• Hypotension
• Zizindikiro
• Dystonia
• Stroko
• Matenda a mtima
• Ischemia
• Mwazi
• Ntchito
• Mtima
• Zotengera
• Angina pectoris
• Tachycardia
• Thrombosis ndi thrombophlebitis

• Tiyi wamtima
• Hypertonium
• Bongo lamakani
• Normalife
• Allapinin
• Asparkam
• Detralex

Kuyesa kwa magazi, maphunziro owonjezera

Kuyesedwa kwamagazi kosiyanasiyana kumathandizira kuzindikira ngati wodwala ali ndi matenda a mtima kapena ngati ali ndi chiopsezo chotenga kachilomboka. Ndikofunikira kuchita osati kuyesa magazi wamba, komanso kuyesa kwa zamankhwala angapo, kuzindikira kupatuka kwa zizindikiro zazikulu. Komabe, kupatuka kwa zizindikiro kuchokera ku chizolowezi chamagazi sikuwonetsa kuti matendawa alipo. Kuti kuyezetsa magazi kukhala kolondola monga momwe kungathekere, muyenera kukambirana pasadakhale ndi dokotala kukonzekera mayeso ndi zoletsa zina tsiku lisanafike popereka magazi.

Titha kutumizidwa:

• Kuyesa kwa magazi kuti mupeze zomwe zimapezeka, mulingo wa hemoglobin ndi ESR,
• Mbiri ya Plasma lipid,
• Kuyesedwa kwa magazi komwe kumazindikira chizindikiro chomwe chimawonetsa kuchepa kwa matenda a mtima.
• Kutsimikiza kwa shuga wamagazi, osati pamimba yopanda kanthu, komanso ndi katundu,
• Magulu a electrolyte a Plasma,
• Kuzindikiritsa ma enzyme ena ndi mapuloteni a plasma,
• Kuyesedwa kwa magazi kuti mupeze zomwe zikuchitika, makamaka kwa odwala omwe amatenga anticoagulants ndi antiplatelet agents.

Mbiri ya Lipid: cholesterol ndi zina zowonjezera

Ma sampuli am magazi omwe amachokera mu mtsempha wa kubereka amawerengetsa kuchuluka kwa ma lipids a plasma kapena zinthu zina zokhudzana nazo. Akatswiri amagwirizanitsa kuchuluka kwa cholesterol yokwanira ndi kupweteka kwa matenda amtima. Cholesterol ndi mowa wa lipophilic, mafuta omwe amapangidwa ndi chiwindi kapena amabwera ndi zakudya zina. Thupi limafunikira cholesterol kuti ikhale ndi maselo onse. Koma kuzungulira kwake kopitilira kumayambitsa matenda a mtima.

Mfundo zabwino kwa anthu azaka zapakati pa 20 ndi ochepera ndi 2.9-5.1 mmol / L, ndipo kwa anthu azaka zopitilira 21 osaposa 5.5-5.8 mmol / L. Kuwonjezeka kwa kuchuluka kwa cholesterol kumachitika ndi zaka, koma pali malire pamwambapa omwe chiopsezo cha pathologies chimawonjezeka kwambiri.

Kusanthula kungachitike nthawi iliyonse, ngakhale osasala kudya. Komabe, ngati cholesterol imafotokozedwa ngati gawo la mbiri yonse ya lipid, ndikofunikira kuti musamadye ndi kumwa (kupatula madzi) kwa maola 12 musanapereke magazi. Kuti mupeze zotsatira zolondola kwambiri, pafupifupi miyezi iwiri iyenera kudutsa pambuyo pa vuto la mtima, opaleshoni, matenda oopsa, kuvulala kapena kubereka.

High kapena otsika kachulukidwe lipoproteins: udindo matenda

Kuchuluka kwa ma lipoproteins otsika kwambiri, otchulidwa m'magazi, amadziwika kuti cholesterol "yabwino". Amakonda kuphatikizidwa ndi chiopsezo chochepa cha zotupa zam'matumbo, komanso kukula kwa matenda a mtima. Ofufuza ambiri amakhulupirira kuti HDL imamanga cholesterol "yowonjezera", ndikuchotsa plasma.

Mlingo wawo sayenera kukhala wotsika kuposa 1.6 mmol / l, ndipo kukwera kwambiri kwa HDL, ndibwino kwa wodwalayo.

Ma lipoproteins otsika kwambiri omwe amayenda mu plasma nthawi zambiri amatchedwa cholesterol "yoyipa". Akatswiri amagwirizanitsa kuchuluka kwambiri kwa mamolekyulu amenewa ndi kupweteka kwa mtima, kuphatikizapo matenda a mtima, zovuta zake (stroko kapena vuto la mtima) ndi kufa mwadzidzidzi. Kuchepa kwa kachigawo kakang'ono ka LDL kumadziwika kuti ndiko cholinga chachikulu pakupereka mankhwala (ma statins), omwe amachepetsa kuchuluka kwa mafuta m'thupi.

Zomwe tikutsata pa matenda a mtima ndi motere:

• Osachepera 1.8 mmol / L kwa odwala omwe ali ndi vuto la mtima kapena lamitsempha yamagazi ndi anthu omwe ali pachiwopsezo chachikulu chotenga matenda a mtima,
• Zochepera 2,5 mmol / L kwa anthu omwe ali pachiwopsezo chachikulu cha matenda a mtima koma opanda zisonyezo
• Osachepera 3.4 mmol / L kwa anthu athanzi omwe ali ndi chiopsezo chochepa mtsogolo kuti apatsidwe matenda a mtima.

Musanapereke magazi kuti muzindikire izi, kukana kudya ndi kumwa (kupatula madzi) kwa maola 8-12 ndikofunikira. Zopitilira miyezi iwiri ziyenera kudutsa kuchokera nthawi yobadwa, ntchito kapena vuto la mtima, kuvulala kwambiri, kotero kuti kusanthula ndikulondola monga momwe kungathekere.

Magazi triglycerides: bwanji amawazindikira?

Kutalikirana kwambiri kwa magazi triglycerides kumalumikizidwa ndi matenda amtima komanso kuwonongeka kwa mtima. Magazi amakhala ndi mitundu yambiri yama triglycerides munthawi zosiyanasiyana, zomwe zimatengera mowa ndi mafuta omwe amatengedwa, komanso kuchuluka kwa maswiti m'zakudya. Zomwe zimapangitsa kuti ma cell azikhala ndi mankhwalawa amatha kukhala onenepa kwambiri komanso matenda a chithokomiro, kuwonongeka kwa chiwindi.

Mtengo wowunikira womwe muyenera kuyeserera ndi wochepera 1.69 mmol / L. Kuti mawunikidwewo akhale olondola momwe angathere, magazi amayenera kumwedwa pambuyo pakuthamanga kwa maola 12 (mutha kumwa madzi okha).

Kuzungulira kwa shuga m'magazi: bwanji kuwazindikira?

Ndikofunikira kudziwa shuga ya magazi, yochitika mosamalitsa pamimba yopanda kanthu. Milingo yokwera imawonetsa shuga kapena zinthu zomwe zimagwirizanitsidwa ndi kulolerana kwa shuga. Ndi iyo, thupi silimamwa glucose bwino chifukwa cha zovuta ndi kaphatikizidwe kapena kugwira ntchito kwa insulin, makamaka ndi kunenepa kwambiri.

• Mwazi wamagazi ochepera 5.5 mmol / L ndi mtengo wamba,
• Kuyambira 5.6 mpaka 6.9 mmol / L - uwu ndi shuga wamagazi owonjezereka, masiku ano amawonedwa ngati kulekerera kwa glucose, komwe kale kumatchedwa "prediabetes". Odwala omwe shuga ya magazi yawo imasinthasintha mkati mwa izi ali pachiwopsezo chowonjezereka chotenga matenda a shuga, amafunika kudya, kukonza moyo wawo komanso kuchita masewera olimbitsa thupi.
• Kuchuluka kwa 7.0 mmol / L m'magazi awiri kapena kupitilira apo kumawonetsa kuchuluka kwa matenda ashuga.

Hemoglobin A1c (glycated) amawonetsa kuchuluka kwa shuga m'miyezi itatu yapitayo. Kuwonjezeka kwa hemoglobin ya glycated kumavumbula zonse za prediabetes komanso makamaka matenda a shuga.

Amakhulupirira kuti odwala matenda ashuga amatha kuvutika ndi matenda a mtima. Izi zikutanthauza kuti ali ndi chiopsezo chowonjezeka chamtima. Njira zodzitetezera zapadziko lonse lapansi kuti muchepetse chiopsezo cha matenda a m'matumbo a m'magazi ndi monga kuchepetsa ma LDL, kudya, masewera olimbitsa thupi, komanso kuyang'anitsitsa kuthamanga kwa magazi.

Akatswiri amati odwala omwe ali ndi HgbA1c kuchokera ku 5.7% mpaka 6.4% ali pachiwopsezo chotenga matenda a shuga (i.e., amawazindikira prediabetes), kusintha kwa moyo kumatha kukhala kopindulitsa kwa iwo. Milingo ya HgbA1c yoposa kapena yofanana ndi 6.5% imawonetsa matenda ashuga.

Magazi pazophunzirazi amatha kusungidwa nthawi iliyonse, popanda kukonzekera komanso kufa ndi njala.

Ndi myocardial infarction Sinthani

Kusintha kwodziwika bwino kwambiri kwa mtima ndi kuchepa kwa mtima ndi chikhazikitso cha pambuyo pake. Yofala pamitundu yonse yamatenda a mtima wam'mimba ndi chithunzi cha zotupa za mtima (kapena thrombosis) yam'mitsempha yamtima, yomwe nthawi zambiri imapezeka m'magawo a mitsempha yayikulu ya coronary. Nthawi zambiri, nthambi yakumanzere yam'mphepete mwa kumanzere imakhudzidwa, nthawi zambiri mitsempha yoyang'ana kumanja ndi envelopu ya kumanzere kwa coronary. Nthawi zina, stenosis wa thunthu lamanzere m'mimba wapezeka. Mu dziwe la mtsempha wamagetsi omwe akhudzidwa, kusintha kwa myocardial kumatsimikiziridwa nthawi zambiri, kofanana ndi ischemia kapena fibrosis, kusintha kwa mawonekedwe amtundu ndi mawonekedwe (madera omwe akhudzidwa ali moyandikana ndi malo osakhudzidwa ndi myocardium), ndi kufalikira kwathunthu kwa kuwunikira kwa coronary artery mu myocardium, monga lamulo, kufowoka kwaposachedwa. Odwala pambuyo myocardial infarction, mtima aneurysm, kukhathamiritsa kwa gawo lozungulira, kulekanitsa minofu ya papillary ndi chords, ndi intracardiac thrombi atha kupezeka.

Ndi angina pectoris

Palibe kulumikizana kowoneka bwino pakati pa mawonetseredwe a angina pectoris ndi kusintha kwa ma anatomical m'mitsempha yama coronary, koma kwawonetsedwa kuti ma atherosselotic mapepala omwe ali ndi mawonekedwe osalala ophimbidwa ndi endothelium amakhala ndi chikhalidwe cha khola la angina pectoris, pomwe zolembera zokhala ndi ulceration, kupasuka, komanso mapangidwe amapezeka nthawi zambiri mu njira ya angina pectoris. parietal thrombi.

Kuti tiwonetsetse kuti matenda a mtima ndi matenda a coronary, ndikofunikira kukhazikitsa mawonekedwe ake azachipatala (kuchokera manambala omwe afotokozedwawo) malinga ndi njira zomwe ambiri amavomereza pakuwonetsa matendawa. Nthawi zambiri, chinsinsi chofufuzira ndi kuzindikira kwa angina pectoris kapena myocardial infarction - mawonekedwe ofala kwambiri komanso ofala kwambiri a matenda amtima wamatumbo, mitundu ina yazachipatala imakhala yochepa muzochitika zamankhwala zamasiku onse ndipo kuzindikira kwawo ndikovuta.

Imfa Yadzidzidzi ya Coronary

Imfa mwadzidzidzi ya coronary (kumangidwa kwamtima) imakayikiridwa kuti imagwirizanitsidwa ndi kusakhazikika kwa magetsi. Imfa mwadzidzidzi imawerengedwa ngati njira yodziyimira yamatenda a mtima ngati palibe chifukwa chofufuzira mtundu wina wamatenda a mtima kapena matenda ena: mwachitsanzo, imfa yomwe idachitika koyambirira kwa infrection ya myocardial siyikuphatikizidwa mkalasi iyi ndipo iyenera kuonedwa ngati imfa yochokera ku myocardial infarction. Ngati njira zoyambitsanso sizinachitike kapena sizinaphule kanthu, ndiye kuti kumangidwa kwapamtima kumadziwika kuti kumwalira mwadzidzidzi. Zotsirizazi zimafotokozedwa ngati kufa komwe kumachitika pamaso pa mboni nthawi yomweyo kapena mkati mwa maola 6 kuchokera pomwe mtima udayamba.

Angina pectoris Sinthani

Angina pectoris monga mawonekedwe a IHD mawonedwe:

• Khola angina pectoris (wowonetsa gulu lantchito).
• Coronary Syndrome X
• Vasospastic angina pectoris
• Angina wosakhazikika
  • pang'onopang'ono angina
  • angina woyamba
  • choyambirira pambuyo infarction angina

Angina pectoris Sinthani

Angina pectoris yodziwika ndi malo osakhalitsa a kupweteka pachifuwa omwe amayamba chifukwa cha kupsinjika kwa thupi kapena kukhumudwa kapena zinthu zina zomwe zimabweretsa kuchuluka kwa zosowa za myocardium (kuchuluka kwa magazi, tachycardia). Nthawi zambiri za angina pectoris, kupweteka pachifuwa (kuwonda, kuwotcha, kusasangalala) komwe kumawonekera pakukhumudwa kapena kutaya mtima kumafalikira kumanzere kwa mkono wamanzere, tsamba. Osati kwenikweni, kutulutsa kwawoko ndi kuwawa kwawawa sikungachitike. Kuukira kwa angina pectoris kumatenga mphindi 1 mpaka 10, nthawi zina mpaka mphindi 30, koma osatinso. Ululu, monga lamulo, umasiya msanga katundu atayimitsidwa kapena mphindi 2-4 pambuyo podyera pang'ono (pansi pa lilime) la nitroglycerin.

Choyamba chidatulukira angina pectoris ndiwowonekera pazowonetsa ndi zakukula, chifukwa chake, sangathe kupatsidwa gawo lokhazikika la angina pectoris ndi maphunziro ena popanda zotsatira zowunikira wodwalayo pazomwe zimachitika. Kuzindikira kumakhazikitsidwa mu nthawi mpaka miyezi itatu kuyambira tsiku lomwe wodwalayo adayamba kudwala. Munthawi imeneyi, njira ya angina pectoris yatsimikizika: kuphatikiza kwake popanda kanthu, kusintha kwa khola kapena kupita patsogolo.

Kuzindikira khola angina kupanikizika kumakhazikitsidwa pazochitika zakusonyezedwa kwamatenda mwanjira yachilengedwe yovulazidwa ndi ululu (kapena kusintha kwa ECG kusanachitike kuukira) pamtengo wina kwa nthawi yosachepera miyezi itatu. Kuopsa kwa khola la angina pectoris kumakhala gawo lolimbitsa thupi lomwe wodwalayo amakumana nalo, lomwe limatsimikizira gulu lazovuta zake, limasonyezedwa pakupezeka kwa matenda.

Pang'onopang'ono angina pectoris Kupsinjika kumadziwika ndi kuwonjezeka kwapafupipafupi komanso kwakanthawi kwamalingaliro opweteka ndikumachepetsa kulolerako zolimbitsa thupi. Zovuta zimapuma popuma kapena pazochepera pang'ono kuposa momwe zimakhalira, zimakhala zovuta kwambiri kusiya ndi nitroglycerin (nthawi zambiri kuwonjezeka kwa gawo lake limodzi), nthawi zina zimangoyimitsidwa pokhapokha kuyambitsa narcotic analgesics.

Angina pectoris zimasiyana ndi angina pectoris chifukwa chakuti kupweteka kwapweteka kumachitika popanda kulumikizidwa kowoneka ndi zinthu zomwe zimayambitsa kuchuluka kwa zosowa za myocardium. Zovuta zimatha kupuma popanda kupweteketsa mtima, nthawi zambiri usiku kapena m'mamawa, nthawi zina zimakhala ndi mawonekedwe oyenda. Malinga ndi kutanthauzira kwawo, kuthirira ndi kutalika kwa nthawi, kugwira ntchito kwa nitroglycerin, kuukira kwa angina sikumasiyana ndi kuukira kwa angina pectoris.

Angina pectoris, kapena Prinzmetal angina, zikuwonetsa milandu ya angina pectoris yovomerezeka, yokhala limodzi ndi kukwezeka kwakanthawi kwa ECG kwa gawo la ST.

Myocardial infarction Sinthani

Kuzindikira koteroko kumakhazikitsidwa pamaso pa achipatala komanso (kapena) labotale (kusintha kwa ntchito ya enzyme) ndi deta ya electrocardiographic yosonyeza kupezeka kwa chidwi cha necrosis mu myocardium, yayikulu kapena yaying'ono. Ngati wodwalayo wadwala matenda a mtima sagonekedwa ku ICU posachedwa, pakadabuka zovuta zina ndipo zotsatira zake zingaphe.

Chachikulu chachikulu (chapakati) kulowetsedwa kwa myocardial kumayesedwa ndi kusintha kwa pathognomonic ECG kapena kuwonjezeka kwina kwa ntchito ya ma enzymes mu seramu yamagazi (tizigawo tina ta creatine phosphokinase, lactate dehydrogenase, etc.) ngakhale ndi chithunzi cha atypical matenda. Ma enzyme omwe atchulidwa ndi ma enzymes a redox reaction. M'mikhalidwe yokhazikika, amapezeka mkati mwenimweni mwa foni. Ngati khungu lawonongedwa (mwachitsanzo, ndi necrosis), ndiye ma enzymes amamasulidwa ndikutsimikiziridwa mu labotale.Kuwonjezeka kwa kuchuluka kwa ma enzymes awa m'magazi panthawi ya infarction ya myocardial imatchedwa resorption-necrotic syndrome.

Mtundu wa transmural wamtima wamtundu umasiyana ndi ena pamlingo wowonongeka pamisempha yamtima. Ngati matenda a mtima atakhala pokhapokha pakati pa minyewa ya mtima (myocardium) yomwe ikukhudzidwa, ndiye kuti matendawo amasakanikirana ndi mbali zakunja ndi zamkati - epicardium ndi endocardium. gwero losavomerezeka?

Kuzindikira laling'ono loyang'ana Myocardial infarction imadziwika kuti imasintha mozungulira gawo la ST kapena T popanda kusintha kwasinthidwe mu zovuta za QRS, koma pamakhala kusintha kwa zochitika za enzyme. Mosiyana ndi vuto lalikulu la mtima (transmural) kugunda kwa mtima, kupezeka kwa necrosis yaying'ono sikusokoneza kufalitsa kwa kukoka kwa mtima wonse.

Postinfarction mtima

Chizindikiro cha pambuyo-infarction a mtima ndi matenda a mtima zimapangidwa kwa matenda palibe kale kuposa 2 miyezi chichitikire myocardial infarction. Kuzindikiritsidwa kwa post-infarction cardiossteosis ngati njira yodziyimira payokha yamatenda a mtima kumakhazikitsidwa ngati angina pectoris ndi mitundu ina yamatenda a mtima omwe amaperekedwa ndi gulu sanapezeke, koma pali zizindikiro zamankhwala zam'magazi komanso ma electrocardiographic a focal myocardial sclerosis (kulimbikira kwa nthambo, kusokonezeka kwa mtima, kusakhazikika kwa mtima. ECG). Ngati palibe zizindikiro zamagetsi zamagetsi zamatenda a mtima panthawi yayitali yoyesedwa, wodwalayo atha kufotokozeredwa ndi zolembedwa zamankhwala zokhudzana ndi nthawi ya kuphwanya myocardial. Kuzindikiritsa kumawonetsa kukhalapo kwa aneurysm wamtima, mkombedwe wamkati wamkati, kusokonezeka kwa minyewa ya mtima, intracardiac thrombosis, imafotokozera mtundu wa conduction komanso kusinthasintha kwa mtima, mawonekedwe ndi gawo la kulephera kwa mtima.

Fomu lokhazikika

Mtima arrhythmias kapena zizindikiro zamanzere zamitsempha yama mtima kulephera (mwa mawonekedwe a dyspnea, mtima mphumu, pulmonary edema) zimachitika monga kufanana kwa kuukiridwa kwa mphamvu kwaina kapena angina mosavomerezeka. Kuzindikira mitundu iyi ndikovuta ndipo kumapeto kwake kumapangidwa pazotsatira za maphunziro a electrocardiographic m'masampuli okhala ndi katundu kapena polojekiti yowunikira ndi deta kuchokera pakusankha kwa coronary angiography.