Ukulwa ne-vasher atherosulinosis namuhla kuyinto eza kuqala kuwo wonke umphakathi wezokwelapha wanamuhla. Ngokusho kwe-World Health Organisation (WHO), lesi sifo sisendaweni yokuqala yezimbangela zesifo senhliziyo nesibalo esikhulu kakhulu sokufa kwabantu. Cishe ngaso sonke isikhathi, izinguquko ze-atherosclerotic ziyisisekelo sokushaywa unhlangothi, ukushaya kwenhliziyo, isilonda se-trophic nezinye izifo.
I-Atherossteosis iyi-lesion ye-enging yangaphakathi nengaphakathi yemikhumbi yi-cholesterol, amafutha amahhala ne-triglycerides, elandelwa ukuphazamiseka kokujikeleza kwesitho esithile noma izicubu.
Kunemibono emibili ebalulekile yokubonakala kwe-atherossteosis, ngayinye enelungelo lempilo. Esokuqala yi-hemodynamic, noma ilimaze umbono. Ithi ukugqugquzelwa kokufakwa kwamafutha kungukwephula ubuqotho bokuqina komkhumbi. Lokhu kungenzeka ngenxa yokuthintana ne-ejenti ethelelekayo (igciwane, i-mycoplasma, isikhunta, amagciwane), ukuhlaselwa yisinambuzane, ukulimala kokwehluleka, ukusabela komzimba, umzimba wangaphandle (izinhlobo ezahlukahlukene zemisebe) noma amakhemikhali (izidakamizwa ezinemiphumela ye-cytotoxic, izithasiselo zokudla, ubuthi ) Isifo se-Hypertensive, okungenye yezimbangela eziphambili, simi ngokwahlukana kulo mongo wale theory. Ngemuva kwalokhu, imvume yodonga lweseli iyashintsha, futhi isisindo se-lipid siba lula kakhulu ukungena ngaphakathi.
Okwesibili, i-metabolic noma i-receptor, ibeka i-etiology phezulu kokukhubazeka kwamafutha kanye ne-carbohydrate metabolism, ukusebenzisana kwama-metabolites angahlukeki kahle aqukethe ama-receptors abucayi ebusweni bangaphakathi bomkhumbi. Ukulawulwa okuhle kwe-neurohumoral yesimo sokukhubazeka se-membrane kuphazamiseka, futhi iseli lokugcina odongeni liba yindawo elula yokuvezwa kwe-lipid.
Yiluphi ushintsho olwenzeka odongeni lomgodi wegazi?
I-pathogenesis yalesi sifo ukwephula ukulingana kwama-low density lipoproteins (LDL) kanye ne-high density (HDL). Badlulisa i-cholesterol yokucubungula ngendlela esebenzayo ukuze ingene ekuhlanganiseni kwama-hormone nama-phospholipids omzimba. Kodwa uma ubuhlobo phakathi kwe-HDL ne-LDL kuphazamiseka njengoba kungu-4 kuye ku-1, ama-enzyme okusebenzisa awaphumeleli futhi namafutha ayingozi angena echibini elijikelezayo.
Ngasikhathi sinye, ifomu lokuhamba elisezingeni eliphakeme lithwala i-lipid ekhubazekile liyise izicubu ze-adipose noma likhiphe ngisho ngaphandle.
Ngokungalingani, kuqala ukungaphuthelwa, ngakho-ke ama-metabolites abambezeleka yonke indlela, ikakhulukazi ngaphakathi kwe-choroid - lokhu kuyi-pathophysiology yenqubo.
Ukuthuthukiswa kwezinguquko ezingenakulungiswa akwenzeki ngokushesha, lapha inqubo ecacile ehleliwe iyahlukaniswa:
- Isigaba seDolipid. Manje akukho ukuguqulwa noma ukuhlukaniswa okunjalo, ukuvuvukala okuncane nje kwe-mucoid, i-hypercholesterolemia (cholesterol ephezulu egazini) kanye nokwanda kokuqina kodonga lweseli. Kepha manje izici zobungozi - ukukhuluphala ngokweqile, isifo sikashukela, isifo se-thyroid, ukubhema, indlela yokuphila yokuhlala, umfutho wegazi ophakeme - ziqala ukwandisa isimo futhi konke kungena esigabeni esilandelayo.
- Isigaba se-Lipid, i-lipoidosis. Lapho amafutha engena esitokisini, alahlekelwa umsebenzi wawo futhi aphendule ngokungenakuphikwa kulokho okwenziwa ngaphakathi. Igobolondo elivuvukayo manje liqukethe i-foamyritritritrit, kanti ingqamuzana uqobo libizwa ngokuthi yi-xanthoma, elihumusha ngokuthi "ophuzi." Ngeso elinqunu, ungabona izindawo ezinamafutha kanye nemifantu emboza umkhumbi. Ngisho nakulesi sigaba, ukulwa okusebenzayo ne-atherosclerosis kungenziwa ngezindlela zokwelapha. Ukuvimbela kuzosiza futhi ukungalindi ukuthuthuka okuqhubekayo kwenqubo ye-pathological.
Isigaba sokugcina yi-atheromatosis kanye nezinye izinkinga. Lapho ukungena ngaphakathi sekuvele kungaphakathi esitokisini, kuqalwa uchungechunge lokuphendula kwezinyathelo zomzimba, okuqinisa inqubo. Ukwakhiwa kweplatelet esakhiweni se-atherosclerosis kuholela ku-thrombus futhi kuqhubeke i-embolism, kunciphisa i-lumen.
Ukuqhuma kwama-fibrin filaments kuholela ekuwohlokeni kwezicubu ezikhethekile ezigoqa umkhumbi, futhi endaweni yawo kukhona izicubu eziyisisekelo ezixhunyiwe. Ngenxa yalokhu, ukwakheka okwakhiwe kungavuza ngosawoti we-calcium, okuzokwenza kube yi-pathology yokuhlinzwa. Ukuqhekeka komkhumbi kungenzeka futhi, okuthi uma kwenzeka kutholakala ishubhu enkulu enkulu, efana ne-aorta, kuholela ekufeni.
Cishe ukulimala kwesilonda.
Ukuhlukaniswa kwanamuhla kwe-atherosclerosis
Ukuhlukaniswa kusekelwe emgomweni wokusebenziseka kwendawo yokubhala.
Imiphumela kanye nokwelashwa kuncike endaweni lapho kugxilwe khona kuqala.
Indawo yendawo kumele ibhekwe lapho kutholwa inkinga.
Izindawo eziyinhloko zomonakalo zibandakanya:
- I-Aorta. Kulokhu, umthambo omkhulu kunayo yonke isitsha somzimba womuntu. Ngenxa yalokhu, ilahlekelwa yi-elasticity yayo, amandla ayo okuphendula kalula ezinguquko ekushweni kwenhliziyo nomfutho wegazi. Udonga luba lukhuni futhi lube brittle. Imvamisa nalokhu kuhlukahluka kwalesi sifo, ingcindezi ephansi, ye-diastolic iyakhuphuka, ngoba ukumelana nokugeleza kwegazi okuphelele kuyanda. Imiphumela engaba khona yi-arterial hypertension, i-aneurysm ye-aortic nokugqabuka kwayo.
- Imithambo ye-Coronary. Lezi yizitsha ezondla inhliziyo - esinye sezitho ezidliwayo kakhulu ngokuya ngezakhi zomsoco nomoya-mpilo. Lapho ukuhamba kwegazi ku-myocardium kuncipha, i-hypoxia iyanda, idlula kumonakalo we-ischemic. Lokhu kuholela kwisifo esiyinhloko sabadala - i-myocardial infarction.
- Ingqondo. Uma i-atherosclerosis yenzeka echibini le-artery ejwayelekile noma yangaphakathi, kanye ne-vertebral, bakhuluma ngesimo sayo sokuzala. Izimpawu kuleli cala ngeke zivele ngokushesha, kepha ngamadoda - imemori engenamqondo, ukulala, ukuxhumanisa, imisebenzi yokuqonda. Imiphumela ye-Thrombogenic ye-atherosulinotic plaques ingaholela ku-cerebral thromboembolism, stroke ischemic.
Futhi enye yezindawo eziphambili zomonakalo yimikhumbi yemilenze. I-atherossteosis obliterans yemikhawulo engezansi iletha isiguli ukujabha okukhulu ngenxa yesimpawu saso sobuhlungu esishiwo.
I-physiology ukugcotshwa okungekuhle kwama-asidi kusuka emisipha yemilenze, eyakheka ngemuva kokuzivocavoca njengomkhiqizo owenziwe ngomkhiqizo. Lokhu ikakhulukazi acid lactic. Isiguli esinjalo asikwazi ukuhamba amabanga amade ngenxa yobuhlungu obungabekezeleleki obudlula ngemuva kokuma.
Ezimweni ezisezingeni eliphakeme, izinhlungu zikhona ubusuku nemini futhi ziyaqina ebusuku, kanti isigaxa saso simbozwe ngopende abomvu aphuzi nezilonda ezindexekile.
Lokhu bekuyinkomba eqondile yokunqunywa, kepha kulezi zinsuku kunezindlela zesimanje zokuvimbela ukunqanda izicubu ezithambile.
Izici zalesi sifo ngomonakalo wezinso
Mhlawumbe ukuthuthukiswa kwezifo ohlelweni lwezinso lwezinso.
I-Arteriarenalis, ethwala igazi iye ezinso, inomunye wegazi omningi kakhulu wokugcina ukuhlungwa okuvamile. Ngakho-ke, kungenye yezokuqala ukwenza izinguquko ze-pathological.
Kulesi simo, i-vasorenal hypertension iqala - ukwanda okuzinzile kwengcindezi yegazi. Isibonakaliso esinjalo siyisixwayiso sokuqala mayelana nokuthuthukiswa kwe-atherosulinosis yemithambo ye-renal.
Imithambo ye-mesenteric nayo ingathinteka. I-thrombosis yalezi zinto ezigcwele igazi ezondla amathumbu ngokuholela kuholela ekuvuvukeni okukhulu kwe-septic - i-gangrene yamathumbu.
Izimpawu zokuqala zalesi sifo "zi-toad yesisu" - ubuhlungu obukhali besisu, obufana ne-colic.
Ngokwezinga le-lesion, ukwahlukaniswa okulandelayo:
- Kuvezwe ngesizotha (kuze kufinyelele ku-6% wonkana odongeni, kuze kube yi-12% yendawo ye-endothelium, kuze kufike kukota yomkhumbi ngobude ifakiwe kwinqubo ye-pathological).
- Kakhulu (ngaphansi kwama-50% alo lonke ugqinsi lodonga luyathinteka).
- Kumenyezelwe (ukungena ngaphakathi ungene ngaphezu kwe-50% yobukhulu, ngokulandelana).
Umtholampilo udinga ukuthola ukuthi ukulinyazwa kwezicubu ze-ischemic kudlule kangakanani.
Ngokusekelwe kule mininingwane, ukuhlukaniswa komtholampilo kungokulandelayo.
Izinguquko ezithweni ezibalulekile azibucayi, kepha izindawo zomonakalo we-ischemic ziyabhekwa. I-stenosis enamandla, ukuphuma kwegazi ngaphansi kwejwayelekile.
Ngokuya ngokubakhona kwe-thrombosis, kukhona i-necrosis yamasayizi amancane namakhulu, ukubonakaliswa komtholampilo kusuka kumonakalo kuya ezithweni eziqondisiwe, inkimbinkimbi yesibonakaliso esidaluliwe. I-Vascular fibrosis kanye nokwehluleka kwezitho eziqondile zokuhluleka. Izibazi zibonakala ebusweni bazo, kuphahlazeka ku-stroma, parenchyma.
Ukwelashwa nokuvimbela lesi sifo
Ngaphambi kokuthatha isinqumo sendlela yokwelapha isiguli, uchwepheshe ubeka izivivinyo ezikhethekile zelebhu kanye nezinsizakalo.
Banikeza ithuba lokuqoqa imininingwane ephelele ngentuthuko yalesi sifo.
In inqubo yokuhlolwa nquma indawo ngqo, ubungako bomonakalo nayo yonke imininingwane edingekayo yomlando wezokwelapha.
Ukuxilongwa kwenziwa ngalezi zindlela ezilandelayo:
- Ukuqoqwa kwemininingwane, izikhalazo zesiguli kanye nokuhlolwa okujwayelekile.
- Ukuhlolwa kwegazi kwe-biochemical ukuthola ukugcwala kwe-cholesterol, i-HDL, i-LDL, i-chylomicrons, ukujikeleza kwe-triglycerides ngokukhululekile, okumaka komonakalo kwizitho ezihlosiwe (amaphaphu, isibindi, izinso, inhliziyo, ubuchopho).
- I-Ultrasonography (i-ultrasound) isebenzisa umphumela we-Doppler. Le ndlela yenza kube nokwenzeka ukuthola umsuka we-plaque, ubungako bayo bokuthuthuka, okwasekhaya, izinga le-stenosis, ukubaluleka kokuhamba kwegazi, ijubane laso, kanye nezici zegazi ezihlangene.
- I-Angiography njengokulungiselela kokungenelela kokuhlinzwa, ngoba ngayo, izici ngazinye zesakhiwo semithambo yegazi ziyabonakala.
- Izicubu ezithambile ze-MRI.
Uma isigaba sesifo sisaqala, khona-ke nokuvimbela abanekhono kungaba nomphumela. Kubandakanya ukuyeka ukubhema, ukusebenzisa amanani amaningi ama-antioxidants ngesimo samavithamini, i-fiber, ukusetshenziswa kwe-prophylactic kwemithamo emincane yotshwala ukuncibilikisa ama-atherosselotic plaque, umsebenzi olinganiselayo womzimba ukwenza ukujikeleza kwegazi, ukwelashwa kokudla, ukukhawulela amafutha kanye nosawoti ekudleni, kanye nokusetshenziswa kweminye amakhambi ama-tincture kanye nama-decoctions.
Uma lesi sifo sesihambile futhi sikhungethwe yizinkinga, khona lapho kusetshenziswa izidakamizwa ezinjalo:
- Ama-cholesterol ukumunca ama-inhibitors (cholestyramine).
- Ama-inhibitors we-synthesis kanye nokudluliswa kwe-cholesterol emzimbeni (Simvastatin, Atorvastatin, Lovastatin) yisisombululo esisetshenziselwa ukwakheka kukhemisi ngokuvamile esinobungqina obubanzi.
- Izithuthukisi ze-metabolism kanye ne-excretion ye-cholesterol evela emzimbeni (i-Essentiale).
- Izidakamizwa ezenza ngokweqile zinciphise igazi triglycerides (Fenofibrate, Nicotinic acid).
- Ama-antioxidants aqondile (tocopherol - Vitamin E, ascorbic acid - Vitamin C).
- Ama-antioxidants aqondile (methionine, glutamic acid).
- Ama-Angioprotectors (Prodectin, Dicinon, Quertin).
Ukuhlinzwa ngenxa yokwelashwa kwe-atherosulinosis ngezinga eliphakeme kungenzeka kunciphise isiguli esimweni esisongelayo, kumshiye ngemuva kwalokho kuphela ukuze alawule ekudleni futhi alondoloze imithambo yegazi ngokujwayelekile. Ukuhlinzwa kuyi-balloon angioplasty noma i-stenting.
Izimbangela nokuhlukaniswa kwe-atherossteosis kuxoxwa ngazo kule vidiyo ekulesi sihloko.
