I-artererating atherosclerosis inqubo enzima yesifo sezinhliziyo, esizibonakalisa ngokwedlule kwesibambiso semikhumbi yohlobo lwensimbi nomsipha ngamaseli anwebekile, anama-protein angena ngaphakathi.
Lokhu kuholela ekuwohlokeni kwe-trophism yendawo enikezwe amandla yi-artery. Iziguli zithola ukungakhululeki okuhle ngezindlela zokufika kwesikhathi ze-atherosclerosis zamaphethelo aphansi.
Kulesi simo, ukugeleza kwegazi emisipha kuncishiswa kakhulu, i-lactic acid nama-metabolites akhululwa kancane, ngakho-ke kubuhlungu obungabekezeleleki. Cabanga i-etiology ne-pathogenesis yalesi sifo.
Izizathu kanye nendlela yokuthuthuka
Kunezizathu eziningi zokukhula kwalesi sifo. Indlela yokubangela i-atherossteosis ayifundiswanga, kepha emithini yesimanje esekelwe ebuchosheni, amaqembu enobungozi alesi sifo ayakhiwa. Lokhu kusho ukuthi uma isiguli sinamaphuzu alandelayo, khona-ke ithuba lezinguquko ze-atherosclerotic liyanda.
Lezi zinto zibandakanya:
- Ukhuluphele. Abantu abakhuluphele bathambekele kakhulu ekuguleni ngenxa yokuphazamiseka emendweni eminingi ye-metabolic. Njengoba Amafutha amahhala esuswa izicubu ze-adipose, la ma-triglycerides afanayo, i-cholesterol, izinto ze-lipid zingangena kumaseli endothelial odongeni lwe-vascular. Eqenjini elilodwa lengozi kungenzeka ukuthi kunamafutha amaningi, ukudla okunama-khalori amaningi kuhambisana nokuntuleka kwe-enzyme.
- Ubudala, ubulili Abesifazane bathambekele kakhulu kwi-atherosulinosis ngenxa yokuba khona kwe-estrogen, evimba inqubo yokuhlukaniswa kolwelwesi lweseli. Amadoda agula kaningi. Futhi, abantu ngemuva kweminyaka engama-40 basengozini yalesi sifo ngenxa yokuwohloka kwemvelo kwe-collagen odongeni lwe-vascular kanye nokulahleka kokuqina kwabo.
- Ukubhema. I-Nicotine nezinye izakhi zentuthu kagwayi zibangela ukuqhuma okuqinile kwemithambo yegazi, ebanciphisa ngokuhamba kwesikhathi. Kulula kakhulu ukungena odongeni lwe-cholesterol kunokufaka kokuthile okubalulekile.
- Isifo sikashukela mellitus. Kulokhu, i-lipid oxidation ayidluleli kuze kube sekupheleni, futhi izinto ezingacoliswanga kahle kufanele zijikeleze ngokukhululeka egazini, lapho zingena khona ngocosheni wazo wethropiki.
Umfutho wegazi ophakeme, indlela yokuphila yokuhlala phansi, kanye nelifa ngendlela yokuba khona kwezihlobo zezifo zenhliziyo - lolu akulona uhlu oluphelele lwezinto eziholela ekutholeni isifo sokuqina kwemithambo yegazi.
Kwenzekani emzimbeni? Ekuqaleni, ushintsho alubalulekile, lungabonakala kuphela indlela ye-biochemical. I-cholesterol emzimbeni ithwalwa ngezindlela zokuhamba zobuningi obuphakeme nobuphansi. Owokuqala kubizwa ngokuthi yi-cholesterol ebizwa ngokuthi “ewusizo”, ngale ndlela uthuthwa ngenxa yokwakheka kwama-hormone kanye nokulawulwa kokuqalwa kokuqina, nokulahlwa. Uhlobo lwesibili yi-cholesterol transporter yokugcina. Imvamisa, kufanele ibe ngaphansi kane kuneyokuqala, kepha kwesinye isikhathi ibhalansi iyacasuka. Ngemuva kwalokho ukufakwa kwamafutha kuqala. Lokhu kubizwa ngokuthi isigaba se-dolipid.
Kunezigaba eziningana zokuqhubeka kwesifo
- Isigaba sokuqala - I-Lipoidosis. Kulesi sigaba, kutholakala kuphela amabala nemifudlana ye-lipid, okuyisibonakaliso sokuqala se-atherosclerosis.
- I-Atheromatosis - i-plaque iyanwebeka, ivala i-lumen ngisho nangokwengeziwe, igcotshwe ngama-capillaries ne-fibrin. Izimpawu zokuqala zesifo sezivele sobala.
- Isigaba sokugcina yi-fibrosis noma i-calcification. I-plaque ingashintshwa ngokuphelele yizicubu ezithintekayo, noma ofakwe usawoti bese uqinise, obethela izinketho zokwelashwa ekungeneleleni okuhlanzekile.
Iziphi izinhlobo ze-atherosclerosis ezikhona?
I-atherossteosis ingathinta noma yimiphi imikhumbi emikhulu noma emaphakathi emzimbeni wonke.
Izinhlobo eziyingozi yilezi - i-coronary (ukuqhuma kwemithambo epheka inhliziyo), i-cerebral (isibonakaliso sedumbe le-brachiocephalic kanye ne-carotid artery basin), imikhawulo ephansi (ukulimaza komthambo womuntu wesifazane kubude bawo bonke).
Ukuhlukaniswa kwe-atherosulinosis obliterans yamaphethelo aphansi kwenziwa ngokulandela izici eziningana - izimpawu, ukuphazamiseka kokusebenza kanye nezimpawu ze-morphological.
Okusemqoka kufanele kucatshangwe:
Umsebenzi okhubazekile:
- 1 - umuntu ngeke abuzwe ubuhlungu lapho ehamba ngisho nebanga elingaphezu kwekhilomitha. Mhlawumbe ukuvela kobuhlungu ngokuzikhandla okukhulu ngokomzimba. Kwezimpawu ezengeziwe, ukudideka emunweni, umuzwa wokubanda kokuqhamuka, isikhumba sonyawo onyaweni, ukukhubazeka kungenzeka.
- 2a - Ubuhlungu buvela ebangeni eli-1 km. Iminwe ithatha umbala obabazekayo ngenxa yokuqina kwegazi emithanjeni, i-hyperkeratosis (isikhumba esomile), izipikili ezibunjiwe. Kulesi sigaba, akusekho ukuthi kunqume ukugeleza kwemithambo ye-distal emilenzeni.
- I-2b - isiguli ngeke sikwazi ukuhamba ngamamitha angama-250 ngezinyawo ngaphandle kokuma ngenxa yobuhlungu obukhona ngemuva kokuphumula okufishane.
- I-3 - Ubuhlungu buvela ngokungazenzisi, futhi isiguli sidlula kancane amamitha angama-50 ngaphandle kokuma. Lesi sigaba sihambelana cishe nokuvinjezelwa okuphelele kwe-lumen yomkhumbi. Izinwele emlenzeni ziyaphuma, ngoba umsoco awanele. Kuvele imifantu esikhunjeni, iba mncane futhi ithathe umbala wemabula.
- I-4 - ukubonakaliswa kwezimpawu zangaphandle ngesimo sezilonda ze-trophic kanye ne-foci ye-necrosis. Lesi yisimo esiyingozi esigcwele ukukhubazeka. Isigaba seqembu lezigilamkhuba sibuye sivezwe ngemihelo ebuhlungu yasebusuku engenakudedelwa ngabanukubezi. Iminwe iphenduka ibomvu, kanti unyawo luyajuluka.
Ngokusho kwasendaweni okwakugxilwe kuyo:
- Inqubo ithinta i-iliac artery kanye ne-aorta yesisu.
- Ngokuthuthuka okwengeziwe, kufakwa i-femoral artery kanye namagatsha okuqala okuvela.
- Umthambo olandelayo we-popliteal artery kanye nemikhumbi yengxenye ye-tibial kuyathinteka.
- Ukunqotshwa okuyinkimbinkimbi kwalezi zingxenye ezingenhla.
- Isifo se-Multifocal - kunezindlela eziningi ezibhekiswe kuwo wonke umzimba, ifomu elijwayelekile.
I-atherosclerosis yamaphethelo aphansi nayo ihlukaniswa ngokwesilinganiso sokuqhubeka kwesifo (esibuhlungu futhi esingamahlalakhona), izinga lokulondolozwa kokuhlinzekwa kwegazi okujikelezayo (kunxephezelwe, kuncishisiwe, kubolile).
Ungasithola kanjani lesi sifo ngesikhathi?
Noma yikuphi ukuxilongwa kuqala ngokuhlolwa kwe-subjential, okungukuthi, ngezikhalazo zesiguli.
Izici ezijwayelekile zokunakekelwa kwe-atherossteosis zamaphethelo aphansi zifaka phakathi umunyu, umunyu ovuthayo lapho uhamba emlenzeni ongezansi (ngomonakalo we-aorta esiswini, emuva kanye nezinhlungu, kanye nokuntuleka kwamacala angama-50%), umuzwa ovuthayo, ukuzindla kwamalunga, ukucekelwa phansi kwesikhumba kwemilenze, ushintsho imibala yabo, ukunyamalala kokushaya.
Ngemuva kwenhlolokhono, ungaqhubeka nokuxilongwa welabhoratri:
- Ukunqunywa kwenkomba ye-ankle-brachial ukuhlola ukuhamba kwegazi emikhawulweni ephansi. Kubalwa njengokulinganiswa kwengcindezi ephezulu kumthambo we-tibial kuleya emthanjeni we-brachial. Imvamisa ilingana neyodwa.
- Uhlolo lwe-Ultrasound duplex. Kusetshenziswa le ndlela, isimo somthambo owufunayo, izinga lokuvinjwa, kanye nesivinini sokugeleza kwegazi kanye namapharamitha alo okubhekisisa - ubumbano, ukubekelwa phansi kabusha kungenzeka. Le ndlela yokulamula yokuxilonga.
- I-Angiography - ihlangene ne-CT, ivumela udokotela ohlinzayo ukubona ngeso lengqondo inkambo yemithambo yegazi ngokunemba ngangokunokwenzeka futhi athole indawo elimele. Okubi kufaka phakathi kokuhlasela, ngoba ekuhlolweni kuyadingeka ukwethula umehluko we-intravenous.
Ukubheka isimo sezicubu ezithambile, kusetshenziswa i-MRI futhi ukungezwani kwe-oksijini kukalwa, uma kunesidingo, ukuthola ukuthi iziphi izindawo ezisasebenza futhi okufanele zisuswe.
Ukwelashwa nokuvimbela lesi sifo
Ngemuva kokwenza ukuxilongwa emtholampilo, udokotela udlulela ekukhetheni kwendlela yokwelashwa.
Endabeni ye-atherosulinosis, kunemibili kuphela yazo - ukwelashwa noma ukuhlinzwa okuqine.
Kufanele uqonde ukuthi inketho yokuqala kungenzeka kuphela uma kungekho zindlela eziqhubekayo zesifo, ezingasakhishwa ngabathengisi bemithi.
Le mishanguzo ifaka:
- Ukusetshenziswa kwama-antiplatelet agents (Dextran, Reopoliglyukin, Pentoxifylline (Trental), Aspirin, Ticlopidine) ukuvikela amangqamuzana egazi abomvu ukuthi anganamatheli ezingxenyeni ezixinekile zegazi - lokhu kuqinisa ischemia.
- I-Hypolipidemic therapy (ukusetshenziswa kweLovastatin, Simvastatin, Atorvastatin, Ciprofibrate, nicotinic acid).
- Ama-antispasmodics (Drotaverin, No-Shpa, Papaverin) asetshenziselwa ukuthuthukisa ukuhamba kwegazi okwesikhashana endaweni ethintekile kwezicubu. Lokhu kunciphisa izinhlungu futhi kunwebise isigaba sokwenza lesi sifo kuqala, kuvimbele ukubonakala kwezilonda.
- Ngosongo lwe-thromboembolism, i-thrombolytics ne-fibrinolytics (Streptokinase, Heparin, Urokinase) zilawulwa ngokuhlinzwa.
- I-anesthesia yenziwa nge-perirenally noma i-paravertebrally.
Ukwelapha okuhlanganisiwe kubandakanya ukusetshenziswa kwezinqubo ze-physiotherapeutic (electrophoresis, magnetotherapy), i-hyperbaric izication oxygenation kanye ne-ozone therapy.
Izindlela zokuhlinza zokwelapha i-atherosclerosis obliterans of the low m'maphethelo zifaka ukungenelela kwe-endovascular - lokhu kungukusebenza kabusha, lapho, ngaphansi kokuhlolwa kokugcina kokusebenza kwe-x-ray, udokotela ufika endaweni ye-stenotic futhi uyasebenza:
- Meat dilatation noma i-artery steringing yesikhathi eside.
- Ukususwa kodonga lwegazi noma oludumbile.
- Ama-Prosthetics omkhumbi othintekile.
- Ukwethulwa kwe-micro-balloon yokuqeda i-stenosis.
Lezi zindlela zingezesimanje futhi zithola ukubuyekezwa okuhle kakhulu kusuka kuzo zombili iziguli nochwepheshe, ngokungafani nokuncishiswa okudala okwesabekayo.
Ukusebenza okuvulekile emikhunjini yendawo engenhla engaphansi kungukususwa okuphelele komkhumbi othintekayo, ukuvuselelwa okungaqondile noma ukunqunywa.
Ukuvimbela lesi sifo, kunconywa ukunamathela ekudleni okuqinile, ukwandisa ukugeleza kwegazi ngokwandisa umsebenzi onenzuzo womzimba, iya njalo ukuthola i-massage futhi usebenzise ukusikaza, udle ukudla okuncane, lapho kuhlanganiswa khona amafutha + ama-carbohydrate.
Ungalapha kanjani i-atherosclerosis yemilenze uzotshela uchwepheshe kule vidiyo ekulesi sihloko.
