Eminyakeni engama-20 edlule, imiphumela yocwaningo isinikeze ulwazi olusha olubalulekile ngezimbangela zesifo senhliziyo. Ososayensi nodokotela bafunde lukhulu ngezimbangela zokulimala kwemithambo yegazi ku-atherosulinosis nokuthi ihlotshaniswa kanjani nesifo sikashukela. Ngezansi kwendatshana uzofunda izinto ezibaluleke kakhulu okudingeka uzazi ukuze uvikele ukushaya kwenhliziyo, unhlangothi kanye nokwehluleka kwenhliziyo.
I-cholesterol ephelele = "enhle" cholesterol + "embi" cholesterol. Ukuhlola ubungozi besigameko senhliziyo esihambisana nokusatshalaliswa kwamafutha (lipids) egazini, kufanele kubalwe isilinganiso se-cholesterol ephelele nesilinganiso esihle. I-triglycerides yegazi esheshayo nayo iyabhekwa. Kuvela ukuthi uma umuntu ephethe i-cholesterol ephezulu, kodwa i-cholesterol ephezulu, lapho-ke ingozi yakhe yokufa ngenxa yokuhlaselwa yisifo senhliziyo ingaba ngaphansi kunaleyo ene-cholesterol ephansi ngenxa yezinga eliphansi le-cholesterol enhle. Kubuye kwafakazelwa ukuthi akukho ukuxhumana phakathi kokudla amafutha wezilwane ezigcwele kanye nengozi yengozi yenhliziyo. Ukube nje awuzange udle okubizwa nge- "trans fats", aqukethe imargarine, imayonnaise, amakhukhi efektri, amasoseji. Abenzi bokudla bathanda amafutha we-trans ngoba angagcinwa kumashalofu wesitolo isikhathi eside ngaphandle kokunambitheka okumunyu. Kepha zilimaza ngempela inhliziyo nemithambo yegazi. Isiphetho: yidla ukudla okulula okulula, bese upheka ngokwakho.
Ukwelashwa Kwe-Myocardial infarction
Isifo senhliziyo
Angina pectoris
Umfutho wegazi ophakeme
Njengomthetho, iziguli ezinesifo sikashukela ezingalawuleki kahle ezifweni zazo ziye zaphakamisa ushukela ngokungalapheki. Ngenxa yalokhu, banezinga le-cholesterol “embi” egazini labo, futhi “okuhle” akwanele. Lokhu kungenxa yokuthi iningi labanesifo sikashukela lilandela ukudla okunamafutha amancane, odokotela abasabancoma. Ucwaningo lwakamuva luveze ukuthi izinhlayiya ze-cholesterol “embi”, eye yafakwa i-oxidized noma i-glycated, okungukuthi, ehlanganiswe noshukela, ethinteka kakhulu yimithambo yegazi. Ngokuphikisana nesizinda sikashukela ophezulu, imvamisa yalokhu kusabela ikhuphuka, yingakho ukugcwala kwe-cholesterol eyingozi egazini kukhuphuka.
Ungayihlola kanjani ngokunembile ingozi yokuhlaselwa yisifo senhliziyo nokushaywa unhlangothi
Ngemuva kweminyaka yama-1990s, kwatholakala izinto eziningi egazini lomuntu okuthi ukugxilisa ingqondo kwakhe kubonise ubungozi bokuhlaselwa yisifo senhliziyo nokushaywa unhlangothi. Uma ziningi zalezi zinto egazini, ubungozi buphakeme, uma bunganele, ubungozi buphansi.
Uhlu lwabo lubandakanya:
- i-cholesterol enhle - ama-lipoprotein aphezulu kwabantu (okukhona, kungcono);
- i-cholesterol embi - ama-lipoprotein aphansi;
- cholesterol embi kakhulu - lipoprotein (a);
- triglycerides;
- i-fibrinogen;
- i-homocysteine;
- Amaprotheni e-C-esebenzayo (okungafanele adidaniswe ne-C-peptide!);
- ferritin (iron).
Uma ukugcwala kwanoma iyiphi enye yalezi zinto esegazini kungaphezu kokujwayelekile, khona-ke lokhu kusho ingozi eyengeziwe yenhlekelele yenhliziyo, isb., Isifo senhliziyo noma unhlangothi. Kuphela ngama-lipoprotein aphakeme kakhulu lapho okuphambene khona - lapho kukhona okuningi, okungcono. Ngaphezu kwalokho, ukuhlolwa kwegazi kwezinto ezibalwe ngenhla kwenza ukuthi sikwazi ukubikezela ubungozi bokuhlaselwa yinhliziyo nokushaywa unhlangothi ngokunembe kakhulu kunesivivinyo esihle sangaphambili se-cholesterol ephelele. Bheka futhi i-athikili "Izivivinyo Zesifo Sikashukela", zonke lezi zivivinyo zichazwe ngokuningiliziwe.
I-insulin ethe xaxa egazini nasengozini ye-inhliziyo
Kwenziwe ucwaningo lapho amaphoyisa angama-7038 aseParis ahlanganyela khona iminyaka engu-15. Iziphetho ngemiphumela yako: uphawu lokuqala lwengozi enkulu yesifo senhliziyo liyizinga elikhulayo le-insulin egazini. Kukhona ezinye izifundo eziqinisekisa ukuthi i-insulin ngokweqile inyusa umfutho wegazi, i- triglycerides, futhi yehlisa ukugcwala kwe-cholesterol enhle egazini. Le mininingwane yayikholisa kangangokuba yethulwa ngonyaka ka-1990 emhlanganweni waminyaka yonke wodokotela nososayensi be-American Diabetes Association.
Ngemuva komhlangano, kwathathwa isinqumo sokuthi "zonke izindlela ezikhona zokwelapha isifo sikashukela ziholela eqinisweni lokuthi izinga le-insulin yesiguli liphakanyiswa ngokuhlelekile, ngaphandle kokuthi isiguli silandela ukudla okwe-carbohydrate ephansi." Kuyaziwa futhi ukuthi i-insulin ethe xaxa iholela eqinisweni lokuthi amaseli wezindonga zemithambo yegazi emincane (ama-capillaries) alahlekelwa kakhulu ngamaprotheni awo futhi abhujiswe. Le ngenye yezindlela ezibalulekile zokuthuthukisa ubumpofu kanye nokwehluleka kwezinso kushukela. Kodwa-ke, ngisho nangemva kwalokhu, i-American Diabetes Association iphikisana nokudla okune-carbohydrate eningi njengendlela yokulawula isifo sikashukela sohlobo 1 nohlobo 2.
Ngabe isifo sokuqina kwezinzwa sikhula kanjani kushukela
Amazinga amaningi we-insulin egazini angaba khona nesifo sikashukela sohlobo 2, futhi uma isifo sikashukela singakabi, kepha ukumelana ne-insulin kanye nesifo se-metabolic sekuvele kusakhula. Lapho i-insulin ijikeleza kakhulu egazini, kukhiqizwa i-cholesterol emibi kakhulu, bese amangqamuzana amboza izindonga zemithambo yegazi evela ngaphakathi akhula futhi aba mnyama. Lokhu kwenzeka noma ngabe kunomphumela olimazayo ushukela wegazi ophakamile onawo. Umphumela owonakalisayo woshukela ophezulu ugcwalisa ukulimala okubangelwa ukugcwala okuningana kwe-insulin egazini.
Ngaphansi kwezimo ezijwayelekile, isibindi sisusa i-cholesterol “embi” emgodini wegazi, futhi futhi siyeke ukukhiqizwa kwayo lapho okuhlushwa okungenani kungaphezulu kokujwayelekile. Kepha ushukela ubopha izinhlayiya ze-cholesterol embi, bese ama-receptors esibindini angakuboni. Kubantu abanesifo sikashukela, izinhlayiya eziningi ze-cholesterol embi ziphenduka zibe yi-glycated (exhumeke ne-glucose) ngakho-ke ziyaqhubeka nokusakazeka egazini. Isibindi asinakubona futhi sibahlunge.
Ukuxhunyaniswa kwe-glucose nezinhlayiya ze-cholesterol embi kungahle kwehle uma ushukela wegazi wehlela kokujwayelekile futhi sekudlule amahora angama-24 selokhu kwasungulwa lolu xhumo. Kepha ngemuva kwamahora angama-24 kuba nokuhlelwa kabusha kwezibopho ze-elektroni emolekweni yokuhlangana ye-glucose ne-cholesterol. Ngemuva kwalokhu, ukusabela kwe-glycation kubuye kungaphenduki. Ukuxhumeka kwe-glucose ne-cholesterol ngeke kwehle, noma ngabe ushukela wegazi wehlela kwesejwayelekile. Lezi zinhlayiya ze-cholesterol zibizwa ngokuthi "imikhiqizo ye-glycation end". Ziyanqwabelana egazini, zingene ezindongeni zemithambo yegazi, lapho zakha khona ama-atherosclerotic plaque. Ngalesi sikhathi, isibindi siyaqhubeka nokuhlanganisa ama-lipoprotein aphansi, ngoba ama-receptors awo awayiboni i-cholesterol, ehambisana ne-glucose.
Amaprotheni asemangqamuzaneni akha izindonga zemithambo yegazi nawo angabopha ushukela, futhi lokhu kubenza banamathele. Amanye amaprotheni ajikeleza egazini anamathela kuwo, futhi ngenxa yalokho ama-atherosclerotic plaque akhula. Amaprotheni amaningi ajikeleza egazini abopha ku-glucose futhi abe glycated. Amangqamuzana amhlophe egazi - ama-macrophages - amunca amaprotheni ama-glycated, kufaka phakathi i-cholesterol ye-glycated. Ngemuva kwalokhu kunyelwa, ama-macrophages ayavuvukala, futhi ububanzi bawo banda kakhulu. Ama-macrophages anamagazi amaningi agcwele kakhulu amafutha abizwa ngokuthi amaseli we-foam. Banamathela kuma-atherosclerotic plaque akhiwa odongeni lwemithambo yegazi. Njengomphumela wazo zonke izinqubo ezichazwe ngenhla, ububanzi bezithambo zemithambo yegazi etholakalayo kancane kancane buncipha.
Ungqimba oluphakathi kwezindonga zemithambo emikhulu yamaseli abushelelezi. Balawula ama-atherosclerotic plaque ukuze abagcine bezinza. Uma izinzwa ezilawula amangqamuzana emisipha ebushelelezi zihlushwa isifo sikashukela sezinzwa, khona-ke la maseli uqobo ayafa, i-calcium ifakwa kuwo, bese ziqina. Ngemuva kwalokho, ngeke besakwazi ukulawula ukuqina kwe-atherosselotic plaque, futhi kunengozi eyandayo yokuthi i-plaque izowa. Kwenzeka ukuthi ucezu luphume endaweni equkethe i-atherosclerotic plaque ngaphansi kwengcindezi yegazi, ehamba ngomkhumbi. Ivala umthambo omkhulu kangangokuba ukuphuma kwegazi kuyeke, futhi lokhu kubangela ukushaya kwenhliziyo noma unhlangothi.
Kungani ukuthambekela okwandayo kwezigaxa zegazi kuyingozi?
Eminyakeni yamuva nje, ososayensi baqaphele ukwakheka kweziqalo zegazi emithanjeni yegazi njengesizathu esikhulu sokuqhuma kwabo nokuhlaselwa yinhliziyo. Uvivinyo lungakhombisa ukuthi mangakanani ama-platelet akho - amaseli akhethekile anikeza ukuqubuka kwegazi - athambekele ukunamathela ndawonye futhi enze izigaxa zegazi. Abantu abanenkinga yokuthambekela okuningana kokwakheka kwegazi basengozini enkulu kakhulu yokuhlaselwa yisifo sohlangothi, ukushaya kwenhliziyo, noma ukuvalwa kwemithambo ekhipha izinso. Elinye lamagama ezokwelapha okuhlaselwa yisifo senhliziyo yi-coronary thrombosis, i.e., ukuvalwa kwemithambo yomunye wemithambo emikhulu yemithambo yegazi.
Kucatshangwa ukuthi uma umkhuba wokwakha izingqimba zegazi wanda, khona-ke lokhu kusho ukuthi kunengozi ephezulu yokufa ngokuhlaselwa yisifo senhliziyo ukwedlula i-cholesterol ephezulu yegazi. Le ngozi ikuvumela ukuthi unqume ukuhlolwa kwegazi kwezinto ezilandelayo:
- i-fibrinogen;
- lipoprotein (a).
I-Lipoprotein (a) ivimbela ukugoqeka kwegazi okuncane ukuba kungakhuli, kuze kuba nesikhathi sokuguquka kube esikhulu futhi kudale usongo lokuvalwa kwemithambo ye-coronary. Izici zobungozi ze-thrombosis zanda noshukela ngenxa kashukela wegazi ophakeme. Sekufakazelwe ukuthi kuma-platelet ashukela abanamathela ngokuqinile ngokwengeziwe futhi banamathela ezindongeni zemithambo yegazi. Izici zobungozi besifo senhliziyo esisibalile ngenhla ziyajwayezwa uma isifo sikashukela sisebenza ngenkuthalo uhlelo lohlobo lwe-1 yesifo sikashukela noma uhlelo lwe-2 yesifo sikashukela futhi sigcina ushukela wakhe uzinzile.
Ukwehluleka kwenhliziyo kwisifo sikashukela
Iziguli ezinesifo sikashukela zifa ngenxa yokuhluleka kwenhliziyo kaningi kakhulu kunabantu abanoshukela wegazi ojwayelekile. Ukwehluleka kwenhliziyo nokuhlaselwa yinhliziyo yizifo ezihlukile. Ukwehluleka kwenhliziyo kuwukuqina kwensipha yenhliziyo, yingakho lingakwazi ukudonsa igazi elanele ukusekela imisebenzi ebalulekile yomzimba. Ukuhlaselwa yisifo senhliziyo kwenzeka ngokuzumayo lapho igazi ligqokisa omunye wemithambo ebalulekile yokuhambisa igazi enhliziyweni, kuyilapho inhliziyo uqobo ihlala iphilile.
Abaningi abanesifo sikashukela abanokulawula okukuqhathanisa nesifo sabo bakhula ne-cardiomyopathy. Lokhu kusho ukuthi amangqamuzana emisipha yenhliziyo athathelwa indawo kancane kancane ngezicubu zeminyaka edlule iminyaka. Lokhu kwehlisa inhliziyo kangangokuba iyeke ukubhekana nomsebenzi wayo. Akunabufakazi bokuthi i-cardiomyopathy ihlotshaniswa nokudla kwamafutha okudla noma amazinga we-cholesterol yegazi. Futhi iqiniso lokuthi liyenyuka ngenxa kashukela omningi wegazi liqinisekile.
IGlycated hemoglobin kanye nengozi yokuhlaselwa yinhliziyo
Ngo-2006, kwaqedwa isifundo lapho abantu abangama-7321 abondlekile bahlanganyela khona, akekho noyedwa kubo owayephethwe yisifo sikashukela ngokusemthethweni. Kwavela ukuthi kukho konke ukunyuka okungu-1% enkombeni ye-hemoglobin ye-glycated ngenhla kwe-4,5%, imvamisa yezifo zenhliziyo ikhuphuka amahlandla ayi-2,5. Futhi, kukho konke ukunyuka okungu-1% enkombeni ye-hemoglobin ye-glycated ngaphezulu kwezinga le-4,9%, ingozi yokufa kusuka kunoma iziphi izimbangela ikhuphuka ngama-28%.
Lokhu kusho ukuthi uma une-hemoglobin eyi-5.5% glycated hemoglobin, lapho-ke ingozi yakho yokuhlaselwa yisifo senhliziyo iphakeme izikhathi ezingama-2,5 kunomuntu omncane onama-hemoglobin we-4,5% glycated. Futhi uma une-hemoglobin ye-glycated egazini ka-6.5%, khona-ke ingozi yakho yokuhlaselwa yisifo senhliziyo inyuka cishe izikhathi eziyi-6.25! Noma kunjalo, kukholelwa ngokusemthethweni ukuthi isifo sikashukela silawulwa kahle uma ukuhlolwa kwegazi kwe-hemoglobin ye-glycated kukhombisa umphumela we-6.5-7%, futhi kwezinye izigaba zabanesifo sikashukela kuvunyelwe ngisho nangaphezulu.
Ushukela wegazi ophakeme noma i-cholesterol - yini eyingozi kakhulu?
Imininingwane evela ezifundweni eziningi iqinisekisa ukuthi ushukela ophakanyisiwe uyisizathu esiyinhloko sokuthi ukuqoqwa kwe-cholesterol embi ne-triglycerides egazini kukhuphuke. Kodwa hhayi i-cholesterol iyisici sangempela sengozi yengozi yemithambo yegazi. Ushukela ophakanyisiwe ngokwawo uyingozi enkulu yesifo senhliziyo. Eminyakeni eminingi, ushukela 1 nohlobo 2 sikashukela kuye kwazanywa ukwelapha “ngokudla okunempilo okune-carbohydrate.” Kwavela ukuthi imvamisa yezinkinga zesifo sikashukela, kufaka phakathi ukuhlaselwa yisifo senhliziyo kanye nemivimbo, ngemuva kwesizinda sokudla okunamafutha amancane sanda kuphela. Ngokusobala, izinga elikhulayo le-insulin egazini, bese likhuphuka ushukela - lokhu kuyimbangela yangempela yobubi. Isikhathi sokushintshela ohlelweni lokwelapha isifo sikashukela sohlobo lwe-1 noma uhlelo lokwelapha isifo sikashukela esiwuhlobo 2 olunciphisa ngempela ingozi yezinkinga zesifo sikashukela, yandisa impilo, futhi ithuthukise ikhwalithi yayo.
Lapho isiguli esinesifo sikashukela noma umuntu onesifo se-metabolic syndrome eshintshela ekudleni okune-carbohydrate ephakeme, ushukela wegazi lakhe uyawa bese esondela kwesejwayelekile. Ngemuva kwezinyanga ezimbalwa "zempilo entsha", ukuhlolwa kwegazi kwezingozi zobungozi zenhliziyo kudinga ukuthathwa. Imiphumela yabo izokuqinisekisa ukuthi ubungozi bokuhlaselwa yisifo senhliziyo kanye nokwehla kwehle. Ungaphinde uthathe lezi zivivinyo ezinyangeni ezimbalwa. Mhlawumbe, izinkomba zezinto ezibeka engcupheni yenhliziyo zisazothuthuka.
Izinkinga ze-thyroid nokuthi ungazelapha kanjani
Uma, ngokumelene nesizinda sokugadwa ngokucophelela kokudla okune-carbohydrate ephansi, imiphumela yokuhlolwa kwegazi kwezingozi zobungozi zenhliziyo iba yimbi kakhulu, khona-ke ihlala njalo (!) Iphenduka ukuthi isiguli sinamazinga ancishisiwe ama-hormone e-thyroid. Lokhu kungukuzisola kwangempela, hhayi ukudla okugcwele ngamafutha ezilwane. Inkinga ngama-hormone egilo kudingeka ixazululwe - ukwandisa izinga labo. Ukuze wenze lokhu, thatha amaphilisi anqunywe yi-endocrinologist. Ngasikhathi sinye, ungalaleli izincomo zakhe, usho ukuthi udinga ukulandela indlela "yokudla" enempilo.
Indlala yegilo ebuthakathaka ibizwa ngokuthi yi-hypothyroidism. Lesi yisifo se-autoimmune esivame ukwenzeka ezigulini ezinesifo sikashukela sohlobo 1 nezihlobo zazo. Amasosha omzimba ahlasela ama-pancreas, futhi imvamisa i-yegilo gland nayo ingena ngaphansi kokusatshalaliswa. Ngesikhathi esifanayo, i-hypothyroidism ingaqala iminyaka eminingi ngaphambi noma ngemuva kwesifo sikashukela sohlobo 1. Akubangeli ushukela wegazi ophakeme. I-Hypothyroidism iyodwa iyingozi enkulu kakhulu yokuhlaselwa yisifo senhliziyo nokushaywa unhlangothi kunoshukela. Ngakho-ke, kubaluleke kakhulu ukuyiphatha, ikakhulukazi ngoba akunzima. Ukwelashwa kuvame ukuthatha amaphilisi ama-1-3 ngosuku. Funda ukuthi yiluphi uvivinyo lwama-hormone egilo okudingeka uluthathe. Lapho imiphumela yalesi zivivinyo ithuthuka, imiphumela yokuhlolwa kwegazi kwezici zengozi yemithambo yegazi nayo ihlala ithuthuka.
Ukuvimbela Isifo Sokuthinteka Kwezinhliziyo Kwisifo Sikashukela: Ukutholwa
Uma ufuna ukunciphisa ingozi yokuhlaselwa yisifo senhliziyo, unhlangothi, kanye nokwehluleka kwenhliziyo, imininingwane ekulesi sihloko ibaluleke kakhulu. Ufundile ukuthi ukuhlolwa kwegazi kwe-cholesterol ephelele akuvumeli ukubikezelwa okuthembekile kwengozi yengozi yemithambo yegazi. Isigamu sokuhlaselwa yinhliziyo senzeka kubantu abane-cholesterol ejwayelekile. Iziguli ezinolwazi ziyazi ukuthi i-cholesterol ihlukaniswe “ngokuhle” nokuthi “kubi”, nokuthi kunezinye izinkomba zokuthi ubungozi besifo senhliziyo buthembekile kune-cholesterol.
Kulesi sihloko, sikhulume ngokuhlolwa kwegazi kwezici zobungozi zesifo senhliziyo. Lawa ngama-triglycerides, i-fibrinogen, i-homocysteine, amaprotheni e-C-reactive, i-lipoprotein (a) ne-ferritin. Ungafunda okuningi ngabo esihlokweni esithi "Isifo Sikashukela". Ngincoma kakhulu ukuthi uyifunde ngokucophelela, bese uvivinya njalo. Ngasikhathi sinye, izivivinyo ze-Homocysteine ne-lipoprotein (a) ziyabiza kakhulu.Uma ingekho imali eyengeziwe, khona-ke kwanele ukuthatha ukuhlolwa kwegazi nge-cholesterol "enhle" ne "embi", i-triglycerides ne-C-reactive protein.
Landela ngokucophelela uhlelo lokwelapha isifo sikashukela sohlobo lwe-1 noma uhlobo 2 lokwelashwa sikashukela. Le yindlela engcono yokunciphisa ubungozi bengozi yemithambo yegazi. Uma ukuhlolwa kwegazi kwe-serum ferritin kukhombisa ukuthi une-iron ethe xaxa emzimbeni, lapho-ke kungakuhle ukuba ube ngumnikeli wegazi. Hhayi ukusiza labo abadinga ukunikela ngegazi, kodwa futhi nokususa i-iron ethe xaxa emzimbeni wabo futhi ngaleyo ndlela banciphise ingozi yokuhlaselwa yisifo senhliziyo.
Ukulawula ushukela wegazi kushukela, amaphilisi adlala indima yesithathu uma kuqhathaniswa nokudla okune-carbohydrate kancane, ukuzivocavoca, kanye nemijovo ye-insulin. Kepha uma isiguli esinesifo sikashukela sesivele sinesifo senhliziyo kanye / noma umfutho wegazi ophakeme, lapho-ke ukuthatha i-magnesium nokunye okuhlinzekelwa yinhliziyo kubalulekile njengokulandela ukudla. Funda isihloko esithi "Ukwelashwa kwe-hypertension ngaphandle kwezidakamizwa." Ichaza ukuthi ungasiphatha kanjani isifo se-hypertension nesifo senhliziyo ngamathebhulethi e-magnesium, i-coenzyme Q10, i-L-carnitine, i-taurine kanye namafutha enhlanzi. Lezi makhambi zemvelo zibalulekile ekuvimbeleni ukushaya kwenhliziyo. Ezinsukwini ezimbalwa nje, uzozwa enhlalakahleni yakho ukuthi bathuthukisa ukusebenza kwenhliziyo.
