Isifo sokuqaqamba kwamalunga esikhathini sethu sithinta inani elikhulu labantu. Ngokwemvelo yayo, i-atherosclerosis yisifo esingalapheki, ukuvela kwayo okungahle kucasule izici eziningi.
Ngesikhathi sokuthuthuka kwenqubo ye-pathological, ama-atherosulinotic plaque afakwa emikhunjini, okuthi ngokuhamba kwesikhathi, anciphise ukukhanyisa kwawo ngokuningana futhi aholele ekuphazamisekeni kokujikeleza kwegazi okungaphezulu noma okungaphansi kwezitho ezihambisanayo nezinqubo zezitho.
Kubalulekile kumuntu ngamunye ukuthi akwazi ukubona ukubonakaliswa kokuqala kwalesi sifo, ikakhulukazi ukuthi isigaba sokuqala se-atherossteosis sibukeka kanjani.
Imvamisa imnene kakhulu, ihlulwe emtholampilo, ngakho-ke lesi sifo sivame ukutholakala ezigabeni zakamuva.
Yini imbangela yalesi sifo?
I-atherossteosis ingenzeka ngaphansi kwethonya lezinto eziningi ze-etiological. Imbangela ejwayelekile umphumela ohlanganisiwe wezinto eziningana ndawonye.
Ngokusho kwemininingwane yesimanje yezokwelapha, kunezinhlobo ezintathu zezinto ezisengcupheni ezibangela ukuthuthukiswa kwalesi sifo. Iqembu lokuqala liyizinto okuthiwa zingenakuguqulwa, elesibili libuye liguqulwe ngokwengxenye (okwesibili), kuthi okwesithathu kube yizinto eziguqukayo.
Iqembu lokuqala lezinto ezithinta inqubo ye-atherosclerosis lifaka okulandelayo:
- Isakhi sofuzo.
- Iminyaka yomuntu.
- Ukuzibandakanya kobulili.
- Ukuba khona kwemikhuba emibi.
- Ukuba khona komfutho wegazi ophakeme njalo
Iqembu lesibili lezici lifaka:
- amanani andisiwe we-cholesterol, lipids ne-triglycerides;
- isifo sikashukela i-mellitus ne-hyperglycemia;
- amazinga aphansi we-lipoproteins ephezulu yokuqina;
- ukuba khona kwe-metabolic syndrome.
Iqembu lesithathu lifaka phakathi indlela yokuphila yokuhlala phansi, ingcindezi engokomzwelo, ukuba khona kwemikhuba emibi.
Ukubonakaliswa kwezinto ezingenakuphikwa kufaka isandla ku-atherossteosis
I-genetic predisposition - ngeshwa, izinkinga eziningi ezihambisana nokulimala kwe-lipid (fat) metabolism zitholwa njengefa futhi zibangelwa yiphutha elithile kuma-chromosomes. Futhi njengoba i-cholesterol ethe xaxa emzimbeni ingenye yezimbangela eziphambili ze-atherosclerosis, khona-ke ifa kuleli cala kungenye yezindawo zokuqala.
Iminyaka yomuntu - abantu abaneminyaka yobudala engama-40 kuya phezulu batholakala kakhulu kulesi sifo. Ngale minyaka, ukuhlengahlengiswa kabusha kwama-hormone okusebenzayo komzimba kuqala, amasistimu abo emithambo alahlekelwa amandla nokuqina, izinkinga zokucindezela kanye ne-metabolism zivame ukuqala;
Ubulili besilisa - amadoda ahlushwa yi-atherossteosis cishe kaningi kaningi kunabesifazane, futhi eminyakeni eyi-10 ngaphambili.
Ukubhema isikhathi eside nokuhlala njalo - i-nicotine ubuthi obuthinta kancane umzimba umzimba, olimaza amaseli wezinhlelo zokuphefumula nezinhliziyo. Cishe bonke ababhemayo bahlushwa yi-bronchitis engapheli. Ngokuqondene nemikhumbi, ngaphansi kwethonya le-nicotine iba ntekenteke futhi ibuye ivunyelwe, ngenxa yokuthi i-cholesterol ingena ngokukhululekile odongeni lwe-vascular futhi ifakwa ngendlela yamaphothi.
Umfutho wegazi ophakeme ukwanda njalo komfutho wegazi, imvamisa ngaphandle kwesizathu esicacile. Kulokhu, izikebhe cishe zihlala zingaphansi kwe-spasm. I-spasm ende ihlala ilimaza ulwelwesi lwemisipha yemithambo yegazi, futhi lokhu kuholela ekubhujisweni kwengxenye yama-myocyte (amaseli abushelelezi bemisipha).
Imikhumbi ihluleka ukuphendula ngokushesha ekuthonyweni yizinzwa, futhi ama-molecule we-lipid angangena kalula kolwelwesi lwawo, futhi, njengoba bekulindelekile, enze izingqimba.
Isimo sezici eziguquguqukayo
Amanani andayo we-cholesterol, lipids ne-triglycerides - hypercholesterolemia, hyperlipidemia kanye ne-hypertriglyceridemia. Okubaluleke kakhulu izinga elikhulayo lokuphamba kwabantu i-lipoprotein cholesterol, okuyiqiniso, yi-atherogenic.
Isifo sikashukela i-mellitus ne-hyperglycemia (ushukela wegazi ophakeme) - bonke abantu abanesifo sikashukela baba nezinkinga ezithile kungekudala. Lezi yi-retinopathy yesifo sikashukela (ukulimala kwe-retinal), i-neuropathy (ukulimala kwezinzwa), i-nephropathy (ukulimala kwezinso) kanye ne-angiopathy (ukulimala kwemithambo). Kukhona i-microangiopathy - ukulimala kwemikhumbi emincane, kanye ne-macroangiopathy - lapho imikhumbi emikhulu ihlupheka. Konke lokhu kungenxa yomphumela wokugxila okuphezulu koshukela emithanjeni yegazi, yingakho bebhujiswa kancane kancane.
Izinga eliphansi lama-lipoprotein aphezulu kwabantu - i-cholesterol ehambisana nayo ibizwa ngokuthi "muhle" ngoba akuyona ingxenye yamathafa. Ukuze uthole ukwelashwa okuphelele, izinga labo lenyuka kanye nokuqoqwa okuncane kwama-lipoprotein aphansi kuyadingeka.
I-Metabolic syndrome yigama elejwayelekile ekubonisweni okuningi. Lokhu kufaka phakathi ukukhuluphala esiswini (ukufakwa kwamafutha ikakhulu esiswini), ukuncipha kokubekezelela ushukela (ukuqina kokuhlushwa), ukukhuphuka kwe-triglycerides egazini, kanye nomfutho wegazi ophakeme.
Isimo sezici zobungozi eziguqukayo
Iqembu lesithathu lezinto zerayisi yilokho okubizwa ngokuthi "abanye." Bancike ngokuphelele futhi ngokuphelele kumuntu uqobo, futhi ukuba khona kwabo ezimpilweni zethu kungaqedwa ngokuphelele.
Ukuphila kokuhlala phansi - Ngokhuluma ngokwesayensi, lokhu kungukusebenza komzimba. Kubantu abaningi, umsebenzi uxhumekile ngamakhompiyutha, ukuqoshwa okungapheli, futhi konke lokhu kuyenzeka nehhovisi elinezinto ezinhle. Umsebenzi onjalo uthinta kabi amandla omzimba ajwayelekile. Abantu basheshe bathola amakhilogremu angeziwe, babe yiziqhwaga kancane, bangaba nengcindezi eyengeziwe, okuyilapho, izothinta uhlelo lwe-vascular kabi.
Ukuqothuka ngokweqile kwemizwelo - izingcindezi zingenye yezimbangela ezisongela umfutho wegazi ophakeme. Njengoba wazi, kuyilapho izikebhe zifakwa ku-spasm ende. Ngalesi sikhathi, ulwelwesi lwemisipha yemithambo luba ngaphansi kwemicrosamage. Lokhu kuthinta ezinye ezimbili zolwelwesi lwazo - i-mucosa ne-serous. Ngisho nokuhlukumezeka okuncane emithanjeni iba isango lokuthola i-cholesterol ethe xaxa emzimbeni.
Utshwala obungamahlalakhona - I-Ethyl yotshwala ngemvelo yayo ingeyezinto ezinobuthi. Uhlukanisa ngendlela efanele zonke izinhlobo zezinqubo ze-metabolic emzimbeni, lokhu kubonakala kumetabolism yamafutha.
Ibhalansi ye-lipid esegazini iyaphazamiseka, bese inqubo yokuqanjwa kwama-atherosulinotic plaque isiqalile.
I-Pathanatomy ne-pathophysilogy ye-atherosulinosis
Zonke izinqubo ezenzeka emikhunjini ene-atherosulinosis zifundwa ngokuningiliziwe yisayensi ebizwa ngokuthi yi-pathological anatomy (pathanatomy) kanye ne-pathological physiology (pathophysiology). Bachaza pathogenesis ephelele yesifo.
Ukulimala odongeni lomkhumbi ngaphansi kwethonya lezinto ezingaphandle kubizwa ngokuthi ukuguqulwa. Ukushintshana kuholela ekungasebenzi kahle kolayini lwangaphakathi lwemithambo - i-endothelium. Ngenxa yokungasebenzi kahle kokuqina kokuqina, ukuqina kwemisipha kukhuphuka ngokumangazayo, ukukhiqizwa kwezinto ezikhethekile ezivuselela ukuqina kwegazi okusebenzayo kanye nokuncipha kwe-lumen yomkhumbi kuyanda.
Ukuguqulwa kwe-vascular esimweni se-atherosclerosis kwenzeka ngaphansi kwethonya le-cholesterol eyeqile, izifo ezahlukahlukene, noma ama-hormone ngokweqile. Ngemuva kwesikhathi esithile, kuba nokufakelwa, okungukuthi, ukufakwa kokulengiswa kwangaphakathi kwemithambo ngokujikeleza amaseli egazini elibizwa ngokuthi ama-monocytes. Ama-monocytes aphenduka amaseli ama-macrophage, anamandla okuqongelela ama-cholesterol esters. Ama-esters anqwabelene aguqulwa abe ngamaseli we-foam, akha imigwaqo ebizwa ngokuthi yi-lipid ku-intima (i-lining yangaphakathi) yemithambo yegazi. Ama-Macrophages ahlanganisa izinto ezikhethekile ezikhuthaza ukuhlanganiswa kwezicubu ezihlangene. Ukuxhumeka okuvamile kwemithambo yomzimba kuthathelwa indawo izicubu ezithintekayo. Ezincwadini zesayensi, le nqubo ibizwa nge-sclerosis. I-Sclerosis nayo ingenzeka ngemuva kokufakelwa kwe-myocardial.
Zonke izinqubo ezingenhla ziholela ekulimazeni okungapheli emikhunjini. I-Atherossteotic plaque iqala ukwakheka. Kuyi-cholesterol yeseli evaliwe. Izindawo zokuqala zakuqala futhi sekwephuzile ziyahlukaniswa. Ama-mapema, noma aphansi, ama-plaque uqobo aphuzi, angama-eccentric futhi awatholwa ngezindlela ezengeziwe zokucwaninga. Uma i-plaque ephuzi yonakele noma iqhuqiwe, khona-ke ifomu legazi, okuholela kulokho okubizwa ngokuthi yi-acute coronary syndrome.
Isikhathi eside, ifomu lesikhathi sekwephuzile, noma elimhlophe. Babizwa nangokuthi yi-fibrotic. Atholakala ngokujulile azungeze wonke umkhawulo womkhumbi futhi abangela ukuphazamiseka okukhulu kwe-hemodynamic futhi kuvezwe ekuhlaselweni kwe-angina.
Ngokuvumelana nalo lonke ushintsho oluchaziwe lwe-pathological, izigaba ezi-5 ze-atherosclerosis ziyahlukaniswa:
- Isigaba seDolipid - kulokhu, imikhumbi ngokwayo ayikabhujiswa, kuphela imvume yazo yokuqina kwe-lipoprotein cholesterol (i-atherogenic cholesterol) inyuka.
- I-Lipoidosis yisigaba sokwakhiwa kwemichilo ye-lipid lapho ama-lipoprotein kuphela aqala ukuqongelela ekujuleni kwenhliziyo kwemithambo yegazi.
- I-Lipossteosis - izicubu ezihlanganayo ezisunguliwe ziqala ukungeza ekuqongeleleni kwe-lipid okuhlanganisiwe, ngenxa yokuthi ama-plaque akhuphuka ngosayizi;
- I-Atheromatosis iyi-ulceration ye-atherosulinotic plaque.
Isigaba sokugcina yi-atherocalcinosis - kukhona ukunqwabelana kanye nokubekwa kosawoti we-calcium ebusweni be-plaque.
Izimpawu zokukhula kwe-atherosulinosis
I-atherossteosis itholakala ngokususelwa kwizikhalazo zeziguli. Empeleni, lokhu kuyimpawu yesifo. Kuya ngqo endaweni yenqubo ye-pathological. Kunemithi eminingana eyinhloko ehlupheka kakhulu.
Imithambo ye-Coronary - iyathinteka kaningi. Ngasikhathi sinye, i-atherossteosis ivame ukuqothuka, okungukuthi, cishe ukumboza ngokuphelele ukukhanya komkhumbi. Kuvame ukuvezwa kwisifo senhliziyo (i-coronary heart isifo (CHD)). Iziguli zivame ukuzwa iminjunju ebukhali yokutsha, icindezela izinhlungu ngemuva kwe-sternum, okuvame ukuhlotshaniswa nokuzivocavoca ngokomzimba noma ukweqisa ngokomzwelo. Ukuhlaselwa kungahambisane nokuphefumula kanye nomuzwa wokwesaba okukhulu ngokufa. Ngomonakalo omkhulu emithanjeni, ukufakwa kwe-myocardial infarction kungakhula.
I-arch ye-aortic - ngokunqotshwa kwayo, iziguli zingakhalaza ngesiyezi, ukulahleka kokungazi ngezikhathi ezithile, umuzwa wobuthakathaka. Nge-lesion ebanzi ngokwengeziwe, kungahle kube nokuphulwa kwesenzo sokugwinya nezwi elinamandla.
Imithambo ye-Cerebral - imvamisa iyathinteka esegugile. Isigaba sokuqala se-cerebral artery atherosclerosis sihambisana nobuhlungu ekhanda, ukukhubazeka kwenkumbulo, ukuguquguquka kwemizwelo, ukucasuka kwesiguli nokuqina kokuphetha. Cishe kuzo zonke iziguli, kunophawu lweRibot, lapho bekhumbula khona izinto ezenzeka kudala, kepha abakwazi ukusho ukuthi kwenzekeni namhlanje ekuseni noma izolo. Njengomphumela we-cerebral atherossteosis, unhlangothi lungakhula.
Imithambo ye-Mesenteric yimikhumbi yobungani besisu. Kulokhu, iziguli zizokhononda ngokushiswa, ubuhlungu besisu obungabekezeleleki, ukuphazamiseka kwesisu.
Imithambo ye-real - ekuqaleni, kubuhlungu obuncane emuva. Ngemuva kwalokho, ingcindezi ingakhula ngokungenangqondo, okunzima kakhulu ukuyinciphisa ngemithi.
Imithambo yemikhawulo ephansi - imvamisa ihlupheka ezigulini ezinesifo sikashukela. Abantu bayokhononda ngokupholisa okuvame kwezinyawo, ukushuba kwegundane, nokukhubazeka kwezinwele ezikhubazekile esikhunjeni semilenze. Kwesinye isikhathi imilenze ingaphenduka iluhlaza okwesibhakabhaka. Futhi, iziguli azikwazi ukuhamba amabanga amade isikhathi eside, futhi ziyaphoqeleka ukuba zime ngezikhathi ezithile, njengoba imilenze yazo iqala ukushwabana, iphenduka ibala, iqale ukulimala, bese kuthi "izigaxa ze-goose" zizungeze izinyawo zazo. Lezi zimpawu ziyi-claudication syndrome eyenzeka ngezikhathi ezithile. Ngokuhamba kwesikhathi, izilonda eziyinqaba zingabonakala esikhumbeni. Ngokuzayo, lokhu kungakhula kube yi-gangren. Uma i-gangrene ikhula, ukunqunywa kwamaphethelo aphansi nge-atherossteosis kuphoqelekile.
Yonke imithambo, ngaphandle kwengqondo, ibizwa ngokuthi yi-extracranial, noma i-extracranial.
Ukwelashwa nokuvimbela i-atherossteosis kuqukethe okulandelayo ngokudla okunqunywe ngudokotela, ukuthatha izidakamizwa ze-anticholesterolemic ezisiza ekuhlanzeni imithambo yegazi kuma-plaque. Udinga nokuzivocavoca njalo, futhi ungalandela izincomo zokusebenzisa amakhambi abantu, ezingalungiswa ekhaya. Kuzodingeka ukuthi welashwe isikhathi eside futhi ngaphandle kweziphazamiso, ngoba umphumela wokuqala uzobonakala ngemuva konyaka.
Ungayithola kanjani i-atherossteosis ezigabeni zokuqala ichazwe kuvidiyo kule ndatshana.
