I-Atherossteosis yisifo esithinta izikebhe zezinhlobo zezinhlangothi nokunwebeka kwemisipha, sibaphuca impahla yabo yemvelo ekufezeni umsebenzi othola ukwethuka kanye nokuqina kwegazi.
Kulokhu, i-fat-protein detritus inqwabelana odongeni lomkhumbi, namafomu e-plaque. I-plaque ephumela lapho iyakhula ngokushesha futhi ikhule, ikhuphuka ngokweqile kwegazi kuze kube yilapho ivimba ngokuphelele.
Izici ze-etiological eziholela ekwakhiweni kwezinguquko ze-atherosulinotic ziguqulwe ngokofuzo futhi aziqondi ngokuphelele.
Kepha lezi zinto ezilandelayo ngokwezibalo zikhulisa ithuba lokugula:
- Ukubhema - imithamo ejwayelekile ye-nicotine, okuyi-mediator kwifomu lemvelo elingaphakathi ngaphakathi komzimba, ikhulula ukulawulwa kokuqothuka kwemithambo nokuphumula, okubenza babe buthaka ngokwengeziwe futhi batholakale ekungeneni kwezinto ze-atherossteotic.
- Isifo sikashukela mellitus - ukuphazamiseka okujwayelekile kwe-carbohydrate metabolism kulimaza cishe konke ukusabela kwe-metabolic emzimbeni, kufaka phakathi i-metabolism yamafutha. Izinhlobo ezingaphansi kwama-oxid ze-lipid zingena egazini futhi zizungeze lapho zize zingene odongeni.
- I-Arterial hypertension - umfutho ophakeme uholela ekuwohlisweni kwesivumelwano semithambo yegazi, futhi kulula kakhulu ukungena kumaseli angenakususwa. Futhi, i-angiotensin 2, i-vasoconstrictor eqinile, ikhulisa ukuqina kwezitho zamangqamuzana.
- Ukukhuluphala ngokweqile - uma ama-enzyme engakwazi ngisho ukubhekana namafutha omzimba wawo, asikwazi ukukhuluma ngokuvuselela i-cholesterol engaphandle.
- Ukungalingani kwezindlela zokuhamba ze-cholesterol - uma ama-lipoprotein aphezulu kakhulu eba ngaphansi kokujwayelekile, khona-ke i-cholesterol "embi" ingena futhi ingene kumaseli we-endothelial.
- I-Hypodynamia - indlela yokuphila yokuhlala phansi yenza buthaka inhliziyo nemithambo yegazi, izicubu zabo zemisipha ziwohloka njengezingadingekile.
- Izindlela zokuvimbela inzalo ngomlomo ziphazamisa ukulingana kwama-hormone kwabesifazane. Kuyaziwa ukuthi amadoda agula ngokwesilinganiso amahlandla ama-5 kaningi, ngoba abesifazane bane-angioprotector yemvelo - i-estrogen ye-sex sex. Ukuphuza amaphilisi kwehlisa ukugxila kwalo.
- Ukulayisha kwengqondo, amazinga okuxineka okwesikhashana ukumelana komzimba.
- Ukudla kakhulu ama-carbohydrate.
Imvamisa, izici zithinta eyodwa ngasikhathi, isikhathi esiningi isiguli sinamasethi ahlukahlukene kanye nezinhlanganisela zazo.
Indlela esebenza ngayo i-atherosclerosis ayaziwa ngokuqinisekile, kepha kunezinkolelo-mbono eziningana ezichaza inqubo.
Kuhlaka lwe-pathology yesimanjemanje, i-pathogenesis ye-atherosulinosis ngezigaba ivezwa ngendlela yemibono emibili ehamba phambili - lipidogenic ne-non-lipidogenic.
Eyokuqala yazo isuselwa ekushintsheni kwe-biochemical ekwakhekeni kwegazi kanye nezinhlelo ze-enzyme, inganaki isimo sokuqala se-vascular tube.
Izigaba ezilandelayo ze-etiopathogenesis zihlukaniswa kuso:
- Isigaba seDolipid. Kunezilonda ezilinganiselwe ze-endothelial, ukukhuphuka kokuqina kolwelwesi lweseli, lapho amaprotheni egazi, i-fibrin, selivele lingene khona. Induku ye-Flat parietal thrombi. I-Intima yomkhumbi igcwele ngama-glycosaminoglycans, ukuvuvukala kwe-mucoindoid kubonakala.
- I-Lipoidosis Ukungeniswa okuqondile kokuphuma kolwelwesi lwangaphakathi olunama-lipids (cholesterol), ukwakheka kwezindawo ezinamafutha nemivimbo, ezibonakalayo esweni elinqunu. Amaseli we-Foamy abizwa ngama-xanthomas anqwabelana lapha. Impendulo ye-autoimmune yomzimba ekushintsheni ekwakhiweni kwayo iqala, bese ulwelwesi lwama-elastic luwohloka.
- I-Lipossteosis Izazi zesifo sezinambuzane zihlukanisa lesi sigaba phakathi kwabanye, ngoba kuso amaseli avuvukala futhi agcwele ukugqekeza, okuholela ekukhulisweni kwezinto ezisebenzayo ezithweni ezizungezile. Ngemuva kwalokhu, izicubu ezixhunyayo zikhula ngokuqinile, futhi amafomu okuqala athambile e-fibrous plaque.
- I-Atherosis Lapho ukwakheka kwezintambo ze-fibrin kuthatha amanoni, kuba ophuzi. I-seal iyaqhekeka ngaphakathi futhi kwesinye isikhathi ingafinyelela isilinganiso esikhulu. Itshe elinjalo lisibekela ngokuqinile ukukhanyisa komkhumbi.
- Ulceration. Enye yezimo ezingenzeka ngesikhathi se-pathogenesis, kodwa ayidingekile. “Isembozo” sokubumba siyabola, bese isilonda sakha endaweni yaso. Ukulimala kungahle kuvinjwe ngamaplanethi, okuzoholela ku-fibrosis enkulu kakhulu, noma ukungena ezingxenyeni ezijulile, i-aneurysm izoqala.
- I-Atherocalcinosis. Ukuphazanyiswa kokuphendula kugcwalisa ukungena ngaphakathi kokuqina kwe-calcium, okubambezeleka phakathi kwemicu. Manje lo mbala lunamatshe futhi kunzima ukulususa, futhi ukwahlukana kugcwele i-embolism.
Ithiyori engeyona i-lipidogenic inendlela efanayo yokuqalwa kwezifo, kepha imbangela yokulimaza i-artery ngabenzeli abangagulisi, imisebe, into yamakhemikhali noma umthelela ohlukumezanayo.
Isimo se-polyetiological of atherosclerosis asikwazi ukwaliwa.
I-Atherossteosis yisifo se-lipid. Izinto eziyinhloko ezibangela ukuguqulwa okuguqukayo yi-triglycerides yamahhala, amafutha e-acid kanye ne-cholesterol.
Zinezindlela zombili zangaphandle nezangaphakathi zokungena ekusakazweni kwamahhala. Ukuthola umbono ofanele we-cholesterol metabolism, sizohlaziya inqubo ngokulandelana. Lapho i-cholesterol ingena emzimbeni kanye nokudla kanye namanye amafutha ezilwane, iyagcotshwa futhi iphulwe emathunjini amancane, emva kwalokho ukumunca kuqala.
Njengoba isisekelo segazi singamanzi, futhi namafutha angapheleli kuwo kuzobangela i-heterogeneity yokugeleza nokumbundana, amafomu okuhamba ayadingeka. Lawa ngama-chylomicrons, i-HDL ne-LDL (lipoprotein ephansi nephezulu).
I-HDL ithwala i-cholesterol "ezuzisayo", ngokuqhutshwa kwayo ibe amandla, ukwakheka kwama-hormone nokugcina ubujamo be-membranes.
Ama-Chylomicrons ahambisa ama-triglycerides, umkhiqizo oyisisekelo wokuqhekeka kwe-lipid.
I-LDL ihlotshaniswa ne-cholesterol "embi" futhi ifaka isandla ekuqongeleleni kwayo i-endoplasmic reticulum yeseli ize ibe yi-xanthomic.
Izinguquko ekusondeleni zihlukaniswe futhi zahlelwa. Ingxenye yokuqala ye-plaque iselula, etholakala ku "lid" fibrin. Kunezinto eziningi ezibushelelezi zemisipha, ama-macrophage nama-leukocytes okuthi kube nezici zokukhula okucashile, ukwanda, amakhemikhali, abameli bokulwa nokuvuvukala. Ukuvuvukala okungacaciswanga.
Kube sekulandela i-matrix ye-extracellular yezicubu ezithintekayo, equkethe imicu ye-collagen kanye ne-elastic fibers, ama-proteinoglycans, adingekayo ekwakhiweni kabusha kwesithambo somthambo.
Ingxenye ejulile etholakala ngaphakathi kwangaphakathi. Lesi isikhungo se-necrotic se-cholesterol enezilinganiso zayo, amakristalu. Ukuqanjwa kuhlanganisa nezinsalela zamaprotheni ngemuva kokuqhuma kwamaseli.
Ngenxa yokubekwa phansi kwabalawuli be-humoral, kunzima ukungena ngaphakathi kwe-plaque futhi uchithe ukugxila kokuvuvukala.
I-pathogenesis ye-atherossteosis ayihlanganisi kuphela isifinyezo sezinguquko ezibalulekile zokwethulwa kanye nezimpawu zokubeletha ezikoleni zezokwelapha.
Igcizelela ikhambi le-pathogenetic lenkinga, linganiselana ngamacala wangempela emitholampilo.
Ngakho-ke, kuyadingeka ukuthi ube nomqondo wezinhlobo zokwelapha ze-atherosulinosis, ezihluke ngokubonakalayo emiphumeleni nasemiphumeleni yayo.
Ukuhlukaniswa kwemitholampilo nokwenziwe ngeso lengqondo kubukeka kanjena:
- I-atherosclerosis ye-aorta. Ifomu elivame kakhulu. Izinguquko zibizwa kakhulu esifundeni sesisu. Isimo siyinkimbinkimbi ngokulahleka kwe-elasticity kanye nokunyuka komfutho wegazi. Ukugeleza kwegazi ezingxenyeni zesibeletho sesisu kuya ngokuqina, ukufakelwa kwezinso, i-aneurysms, i-atrophic yezicubu eziseduze, i-thromboembolism kungenzeka.
- Imithambo ye-Coronary. Inhliziyo idla inani elikhulu le-oxygen ukuze izitholele njalo. Ngakho-ke, ngokuqhekeka kwemikhumbi okuyihlinzekayo, kuvela i-myocardial hypoxia kanye nesifo senhliziyo (coronary heart isifo (CHD)). Izimpawu ezijwayelekile nalo zinobuhlungu besifuba, bufika engalweni yangakwesokunxele, isikhafu, umhlathi. Ubuthakathaka obunokwenzeka, ukufupheka komoya, ukukhwehlela, ukuvuvukala. Umphumela unamandla amakhulu - ukubekelwa phansi kwenhliziyo.
- Imithambo yobuchopho. Zonke izifo ze-cerebrovascular uqala lapha. Nge-thrombosis ye-arotot yangaphakathi ye-carotid artery, kwenzeka ukuthi unhlangothi lwe-ischemic. Ifomu elingamahlalakhona ligcwele izinguquko ze-atrophic ku-cortex ye-cerebral, encephalopathies, dementia.
- Imithambo yethambo. I-Narrowing ivame ukwenzeka endaweni yokuphuma kwe-arteriarenalis esivela kwinsika eyinhloko. Umphumela we-atherosulinosis yemithambo yezinso yi-atherosclerotic wrinkled figo. Ukuntuleka kwemvelo akwenzeki, yize i-pathology ibonakaliswa yi-hypertension yesibili.
- Imithambo yamathumbu. Isimo esibulalayo maqondana nentuthuko yokuvuvukala kwe-aseptic yamathumbu endaweni ye-artery (i-gangrene) ne-peritonitis. Ngokuphikisana nesizinda se-ischemia esingamahlalakhona, ukuhlaselwa kwe "toad yesisu" kwenzeka - i-colic ngokushesha ngemuva kokudla, ekhishwa nge-nitroglycerin.
I-atherosulinosis yemithambo yemilenze ephansi nayo ihlukaniswa. Ukwehlukanisa i-atherosclerosis yamaphethelo aphansi kubangela isiguli ubuhlungu obukhulu nokuhlupheka. I-Lactic acid ayikhishwa kumasunto athambile, ikakhulukazi emisipha.
Iziguli ezinjalo azikwazi ngisho nokuhamba amamitha angama-200 ngaphandle kokuma, ngoba i-pain pain engabekezeleleki iyanda ngezinyathelo zonke. Ezimweni ezimbi kakhulu, izilonda ezinamaqhubu kanye ne-gangrene yomlenze kungenzeka.
Izinkinga zihlukaniswe zibe zimbi futhi zingamahlalakhona, kuya ngezinga lokugeleza. I-acute yizimbangela ezivame kakhulu zokufa futhi zibangela ukubola ngokushesha kwamahora ambalwa. Lokhu ukungasebenzi kahle kwemithambo yegazi (ischemia), okulandelwa ngumonakalo ezithweni ezithambile ezibucayi. Isizathu ukuhlukaniswa kwegazi, i-emboli, i-vasospasm ene-occlusion eshayayo. Kuhlanganiswe nalokhu ukuqhuma kwe-aneurysm yemikhumbi ehambisana nokopha okukhulu okuyingozi.
Izinkinga ezingapheli zingakhula amashumi eminyaka, kepha inkambo ye-asymptomatic ibenza bangabi yingozi. Lezi yizilonda zendawo ze-hypoxic ezisebeleni lomkhumbi othize, izinguquko ze-dystrophic kanye ne-atrophic ezithweni, ukukhula kwezicubu ezithintekayo, umdlavuza.
I-Angina pectoris, infarction ye-myocardial, ukungasebenzi kahle kwamaphaphu kanye ne-hepatic, ukukhubazeka kokukhubazeka, amakhono emoto, ukuvuka kanye nokujikeleza kokulala, ukugxuma kwemizwa, ukuqubuka nobuhlungu - lolu akulona uhlu oluphelele lwayo yonke imiphumela yesifo. Ukugwema lokhu, udinga ukuqala ukuvimbela manje, ngoba kungenzeka kube sekephuze kakhulu.
Ukuvimbela ukwanda kwe-cholesterol kuqukethe ukwelashwa kokudla, ukusebenza ngokomzimba okulinganiselayo, ukwenqaba ukudla okunamafutha nemikhuba emibi. Ukwelashwa ezimweni eziningi kuyinto elondolozekayo (umuthi) noma ukuhlinzwa ngezindlela zokuncipha.
Izici eziphambili zalesi sifo ukuqina kwezindonga ze-vascular kanye nokulahleka kwabo kwe-elasticity. Isifo i-Hyalinosis nesifo se-Menckenberg nayo ingeyeqembu, kodwa isifo sokuqina kwemvelo sithathe indawo yokuqala ukubhebhetheka kwamashumi eminyaka.
Namuhla yisifo esivame kakhulu emazweni athuthukile kwezomnotho, angama-150 kwabangu-100 000 ayagula, futhi lesi silinganiso siyakhula. I-Atherossteosis ngokwayo ayinabungozi njengezinkinga zayo ezingenakugwenywa, okuyizimbangela eziphambili zokufa kwesifo senhliziyo.
I-pathogenesis ye-atherossteosis kuxoxwa ngayo kule vidiyo kulesi sihloko.
