I-Atherossteosis yisifo esingapheli se-polyetiological vascular sifo, esihambisana nokubekwa kwamapididi egobolondweni labo langaphakathi, ukuthuthukiswa kwezinqubo zokulimala ezingapheli, okuholela ekuphazamiseni kokuphazamiseka kwegazi okuhlukahlukene ngenxa yokuncipha kwe-lumen ye-vascular noma ukwakheka kwezigaba zegazi.
I-Atherossteosis yaziwa kakhulu ngokwanda kwabantu besimanje, futhi nangezindlela ezingalungile zokwelashwa kungaholela emiphumeleni edabukisayo.
Ukubonakaliswa kwayo kokuqala kuvame ukusulwa, futhi abantu akuvamile ukubanaka, kuza kodokotela kuphela ngemuva kokuvela kwezinkinga. Yingakho isihloko se-atherosclerosis sisebenza kahle.
Kungani i-arteriosulinosis yenzeka?
Njengoba kukhonjisiwe encazelweni ye-atherosclerosis uqobo, lesi sifo sinezimbangela ezahlukahlukene.
Vele, ngulowo nalowo angaholela ekukhuleni kwezilonda ze-vascular. Kodwa-ke, ukuhlanganiswa okuvame kakhulu kwezizathu ezintathu noma ngaphezulu ezithi zihlanganyele engcupheni eyandayo yokuwohloka komzimba.
Ngakho-ke, kunamaqembu amathathu ezici zobungozi ze-atherossteosis. Iqembu lokuqala lifaka izinto ezingenakuphikwa.
Ukuvuthwa nokuguga - abantu abaneminyaka engaphezu kwengama-40-50 yibona abasengozini enkulu, ngoba imikhumbi yabo ayisenamandla futhi i-elastic njengasebusheni babo, futhi izinqubo ze-metabolic zivame ukuphazamiseka futhi zihlanekezelwe.
Isibindi sokuqothuka - kungenye yezindawo zokuqala ohlwini lwezimbangela ze-atherosulinosis. Izihlobo ezisondelene zivame ukuhlushwa i-atherosclerosis efanayo nasezimpawu, futhi zize zihlukanise izinhlobo zofuzo zokuphazamiseka kwe-lipid metabolism, okuyizidingo eziqondile zokuthuthukiswa kwalesi sifo.
Abesilisa - baqala ukuqaphela izimpawu zokuqala ze-atherosclerosis ngokwesilinganiso eminyakeni eyi-10 ngaphambili futhi kaningi kaningi kunabesifazane.
Ukubhema - kube nomphumela oqondile oqondile ezinhlelweni zokuphefumula nezemithambo yegazi. Ngenxa yokuchayeka njalo kwe-nicotine, izigameko ze-bronchitis ezingamahlalakhona ziyanda. Endleleni, i-nicotine inciphisa izakhiwo zobunwebu besithambo, ikhuphula ukuqina kwayo futhi ichithe ingxenye yayo. Lesi yisimo esihle kakhulu sokufakwa kwe-cholesterol ye-atherogenic kulwelwesi lwemithambo yegazi, futhi kamuva ekwakhekeni okusheshayo kwezigcawu ze-atherosulinotic.
I-Arterial hypertension - ngale ndlela, ingcindezi yegazi icishe inyuke njalo, nemithambo isesimweni se-spasmodic. Ukuqina okuqhubeka isikhathi eside kwemithambo kuholela ekunciphiseni kokuqina kwemisipha yabo, ukubhujiswa kwengxenye yemicu ye-choroid, okubuye futhi, kusize ukungenela kwe-cholesterol eyeqile nokufakwa kwayo engxenyeni engaphakathi yemithambo yegazi.
Iqembu lesibili lezinto eziyingozi liyizinto ezinamandla noma eziguqukayo. Umuntu angabathinta kancane. Lezi yizici ezifana:
- I-Hyperlipidemia, i-hypercholesterolemia ne-hypertriglyceridemia inani elikhulayo lama-lipids (amafutha), i-cholesterol ephelele ne-triglycerides. Kungenxa yokwephulwa kwe-lipid metabolism ukuthi izindlela zokuqala zokwakheka kwama-plaque zenziwa, ikakhulukazi ngokukhuphuka kwe-cholesterol ehlotshaniswa ne-low density lipoproteins.
- I-glucose ephakeme yegazi (i-hyperglycemia) nesifo sikashukela - cishe zonke iziguli ezinesifo sikashukela ziba nezinkinga eziningi ngokuhamba kwesikhathi, phakathi kwazo lapho i-microangiopathy kanye ne-macroangiopathy (ukulimala kwemikhumbi emincane nemikhulu), ekhula ngenxa yemiphumela ephezulu ukugxila koshukela. Lapho zenzeka, imikhumbi ibhujiswa ngokoqobo ingaphakathi, futhi akunazithiyo ekungeneni kwe-cholesterol kuzo.
- Ukuqoqwa okuphansi kwama-lipoprotein aphezulu kwabantu - i-cholesterol ehlotshaniswa nalolu hlobo lwama-lipoprotein ibizwa ngokuthi "kuhle", futhi inani lawo ngokweqile aliholeli ekwakhiweni kwama-plaque. Ngesikhathi sokwelashwa, odokotela bazama ukufeza ukwanda kwama-lipoprotein asezingeni eliphakeme kanye nokwehla kwamaprotheni aphansi kakhulu (atherogenic).
- I-Metabolic syndrome iyinhlanganisela yezimpawu, ezibandakanya ukufakwa kwamafutha amaningi esiswini (noma ukukhuluphala kwaphakathi, uhlobo lwesisu), ukubekezelela okungahambi kahle ku-glucose yegazi (izinga layo elingazinzile, kepha elingakabi yisifo sikashukela), ukugcwala okwandisiwe kwama-triglycerides nomfutho wegazi ophakeme;
- Ukungalingani kwe-Hormonal - abesifazane besikhathi se-climacteric, kanye nomuntu ovela ku-endocrine pathologies (hyperthyroidism, isifo sika-Itsenko-Cushing) baba sengozini enkulu yalesi sifo.
Futhi ekugcineni, iqembu lokugcina lezinto zobungozi - elibizwa ngokuthi "abanye." Lokhu kufaka lokhu okulandelayo:
- Ukuntula ukuzivocavoca, noma indlela yokuphila yokuhlala isikhathi eside, kungabantu abachitha isikhathi sabo esiningi ehhovisi, ekhompyutheni noma ekhaya, bathola isisindo ngokushesha, balahlekelwe amandla nokuqina komzimba, babe ngabasebenza ngokomzwelo, izikebhe zabo ziphelelwe amandla nobunzima, bese bethambekela ekujuleni kwenhliziyo. Konke lokhu kuyisango elivulekile le-cholesterol.
- Ukuhlangenwe nakho okwenziwa njalo - Izimo ezicindezelayo zithinta kabi zonke izinhlaka zezitho. Zenza kusebenze uhlelo lozwela oluzwela, okuholela ekukhululweni kwenani elikhulu le-adrenaline. I-Adrenaline yona iqinisa imithambo yegazi ngokuqinile. Ukuphindaphinda kaningi kweziqephu ezinjalo akuboniswa kahle emisipha ebushelelezi yemithambo, futhi kuholela emiphumeleni engenhla.
Ngaphezu kwalokho, ukusetshenziswa kabi kotshwala kungokwaleli qembu - utshwala ngokwemvelo bunobuthi bamakhemikhali. Ngokudla okungokomzimba okuhlala njalo, okuhleliwe, kancane kancane ubhubhisa zonke izicubu, kuphazamise imetabolism kuzo, kufaka phakathi i-lipid metabolism.
Ngaphezu kwalokho, i-cholesterol ingabekwa ngokukhululekile ngendlela yamacwecwe.
Izici ze-pathogenesis ze-atherosulinosis
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 kanye ne-atherosulinosis: uyini umehluko? I-Sclerosis ihlukile kwe-atherossteosis ngoba yenzeka ngaphandle kokuchayeka kuma-liphero atherogenic, kanye ne-atherossteosis ngokubamba kwabo iqhaza.
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, kuboniswe ekuhlaselweni kwe-angina.
Ngokusho kwe-pathogenesis, izigaba ezi-3 ze-atherosclerosis ziyahlukaniswa.
Esokuqala ukwakheka kwezindawo ezinamaphaphu. Zibonwa kuphela ezindaweni ezilinganiselwe odongeni lwe-vascular. Lesi sigaba sibonisa ukuntuleka kobunzima bezimpawu.
Owesibili - ubizwa nangokuthi i-lipossteosis. Kulesi sigaba, ukuvuvukala kwe-cholesterol plaque kwenzeka, baqala ukubola, futhi imikhiqizo yokubola ikhulisa inqubo enobuthi futhi inikeze ukwakheka kwezicubu ezihlangene, okuholela ekwakhekeni kwe-fibrous plaque. Ngenxa yalokhu, kukhona ukuhlukaniswa okuyingxenye kwe-lumen ye-vascular kanye nokwehla kwe-microcirculation.
Owesithathu yi-atherocalcinosis. Isiteji sikhonjiswa ngokuvela kwesithombe esiphelele somtholampilo, kanye nezinkinga ezihlangene.
Esigabeni esibulalayo, ukuhlaselwa okuvela njalo kwe-angina kungenzeka, kunengozi yokuqalwa kwe-myocardial infarction, unhlangothi noma i-gangrene.
Isithombe somtholampilo se-atherosulinosis
Ukubonakaliswa komtholampilo kwe-atherosclerosis kuxhomeke endaweni okukhona kuyo ama-atherosulinotic plaques, okuwukuthi, kulapho umkhumbi kulimele khona.
Izimpawu zalo ziyahlukahluka kakhulu. Kunemikhumbi emikhulu eminingana engatholwa yilesi sifo. Inqubo yokusabalalisa ye-atherosclerotic engathinta imikhumbi elandelayo.
Imithambo ye-Coronary - ithwala igazi elinothile oksijini enhliziyweni. Lapho zonakalisiwe, i-myocardium ayitholi umoya-mpilo owanele, futhi lokhu kungaziveza ngendlela yokuhlaselwa kwe-angina enobuntu. I-Angina pectoris iyisibonakaliso esiqondile sesifo senhliziyo (CHD), lapho iziguli zizwa khona ukushiswa okuqinile, kobuhlungu obucindezelayo ngemuva kwe-sternum, ukufushane komoya nokwesaba ukufa.
I-Angina pectoris ibizwa nge-angina pectoris. Izimpawu ezinjalo zivame ukwenzeka ngesikhathi sokuzivocavoca komzimba okuhlukahlukene, noma kunjalo, ngezinqubo ezinzima zokugijima, zingaphazamisa ukuphumula. Ngemuva kwalokho zitholakala nokuphumula kwe-angina pectoris. Ukulimala okukhulu emithanjeni kungaholela ekutheni i-coronarossteosis (ithathe indawo yangaphakathi kwangaphakathi emithanjeni yama-coronary izicubu ezithintekayo), yona, kuholele ekuqhekekeni kwe-myocardial - necrosis, "necrosis" yesayithi ye-myocardial. Ngeshwa, cishe isigamu samacala, ukuhlaselwa yinhliziyo kungaholela ekufeni.
I-Aorta - umnyango we-thoracic uvame ukuhlupheka. Kulokhu, izimpawu zizofana ne-coronary atherosulinosis. Iziguli zizokhononda ngobuhlungu obuqinile, obuqandayo, obuvuthayo endaweni yesifuba, obuzonikeza isandla sokudla nesinxele, intamo, emuva nangemuva kwesisu. Imizwa enjalo izokhula ngemithwalo yanoma yikuphi ukushuba, imizwa eqinile.
Ngokwanda okukhulu kwe-aorta, kungahle kube nokuphulwa kokugwinya nokuqina kwezwi ngenxa yokucindezelwa kwe-laryngeal nerve ejwayelekile. I-arch ye-aortic nayo ingathinteka. Kulokhu, izikhalazo zeziguli zingangacaci, ngokwesibonelo, isiyezi, ubuthakathaka obujwayelekile, kwesinye isikhathi ukwehluleka, izinhlungu esifubeni esincane. Isiqu se-brachiocephalic (brachiocephalic) sisuka ku-arch ye-aortic - isikebhe esikhulu kakhulu, esingalimala kuso ulwelwesi lwama-membrane we-aortic.
Imithambo ye-Cerebral (imithambo ye-cerebral) - inophawu olubekiwe. Ngezibonakaliso zokuqala ze-atherosclerosis, iziguli ziphazamiseka ngenxa yokulimazeka kwenkumbulo, ziba touchy kakhulu, imizwa yazo ihlala ishintsha. Kungahle kube nokulimala kwekhanda nezingozi zesikhashana ze-cerebrovascular (ukuhlaselwa kwesikhashana kweschemic). Ezigulini ezinjalo, uphawu lweRibot luphawu: bangakhumbula ngokuthembekile izehlakalo zeminyaka eyishumi eyedlule, kodwa bacishe bangasho ukuthi kwenzekeni ngosuku noma ezimbili ezedlule. Imiphumela yokwephulwa okunjalo ayimnandi kakhulu - isifo sohlangothi singakhula (ukufa kwengxenye yobuchopho).
Imithambo ye-Mesenteric (noma i-mesenteric) - kulokhu, imithambo edlula ebunzini besisu iyathinteka. Inqubo enjalo ayivamile. Abantu bazokhathazeka ngeminjunju evuthayo esiswini, ukuphazamiseka kokugaya ukudla (ukuqunjelwa noma isifo sohudo). Umphumela owedlulele ungaba ukuhlaselwa yisifo senhliziyo, kanye nokulimala okulandelayo.
Imithambo yezinso yizinqubo ezimbi kakhulu. Okokuqala, iziguli ziqala ukwandisa ingcindezi, futhi cishe akunakwenzeka ukuyinciphisa ngosizo lwezidakamizwa. Lokhu kubizwa ngokuthi yi-renal (sekondari, uphawu). Kungaba khona nobuhlungu esifundeni se-lumbar, ukuphazamiseka okuncane lapho uchama. Inqubo enkulu ingaholela ekukhuleni kwehluleke kwezinso.
Imithambo yemikhawulo ephansi - lokhu kufaka phakathi okwesifazane, okuvelelayo, okubucayi kanye nemithambo yonyawo lwangemuva. I-atherossteosis yabo ivame ukweqisa, okungukuthi, ixhumanise ukukhanyisa komkhumbi.
Isibonakaliso sokuqala yi- "intermittent claudication" syndrome - iziguli azikwazi ukuhamba isikhathi eside ngaphandle kokuma. Ngokuvamile kufanele ziyeke ngoba zikhononda ngokuxineka kwezinyawo nemilenze, umuzwa ovuthayo kuzo, isikhumba esimile noma i-cyanosis, umuzwa "wokuqubuka". Ngokuqondene nezinye izikhalazo, zivame ukuphazamisa ukukhula kwezinwele emilenzeni, ukuncipha kwesikhumba, ukubukeka kwezilonda ezinde ezingapholi isikhathi eside, kuguqula ukwakheka nombala wezipikili.
Noma yikuphi ukulimala okuncane esikhunjeni kuholela kwizilonda ezindexekile, ezingagcina zikhula zaba yi-gangrene. Lokhu kuyingozi kakhulu kubantu abanesifo sikashukela, ngakho-ke kunconywa kakhulu ukuthi banakekele izinyawo zabo, bagqoke izicathulo ezingaxubeki ngokungafanele, bangazidli izinyawo futhi bazinakekele kakhulu. Ukudonsa kwemithambo yethambo yemikhawulo engezansi nakho kungashabalala.
Zonke lezi zibonakaliso ezingenhla zihlanganiswe ne-Lerish syndrome.
Izindlela zokuxilonga ze-atherosulinosis
Ukuxilongwa kwe-atherosclerosis kususelwa kumibandela eminingana. Okokuqala, izikhalazo zesiguli ziyahlolwa, futhi kuya ngazo, umuntu angaqagela kuphela lapho kwenzeka khona izinguquko.
Ukuqinisekisa ukutholwa kokuqala, izindlela zokucwaninga zaselebhu kanye nezinsizakalo zinqunyelwe.
Phakathi kwezindlela zokucwaninga elebhu, kukhethwa ukuhlolwa kwegazi elinamakhemikhali, okuzohlola izinga le-cholesterol ephelele. Imvamisa nge-atherosclerosis, izokwandiswa. Isimo se-cholesterol isiyonke ngu-2.8-5.2 mmol / L. Ukuze uthole isithombe esinemininingwane eminingi yokwakheka kwe-lipid kwegazi, kuchazwa iphrofayili ye-lipid.
Ibonisa amazinga azo zonke izinhlobo zama-lipid emzimbeni wethu:
- i-cholesterol ephelele;
- density lipoproteins ("kubi" cholesterol);
- i-lipoproteins ephansi kakhulu;
- kwabantu abaphakathi kwe-lipoprotein;
- density lipoproteins ("okuhle" cholesterol);
- triglycerides;
- chylomicrons.
Izinguquko ezijwayelekile kuphrofayili ye-lipid zingukukhuphuka kwezinga le-lipoproteins ephansi kanye nokwehla kwenani lamazinga aphezulu we-lipoprotein.
Ukubonwa kweziguli okunembe ngokwengeziwe, kuthunyelwa i-angiography (ukuhlolwa kwamathambo ngokufakwa kwesehlukisi esehlukile), i-intravascular ultrasound, i-computer tomography (CT) kanye ne-magnetic resonance imaging (MRI).
Lezi zindlela zikuvumela ukuba ubone ukuba khona kwezinguquko ezahlukahlukene ekwakhiweni kwemithambo yegazi, ukunquma izinga le-stenosis (unciphise) futhi uvikele ukulimala okwengeziwe.
Amaqhinga okwelapha i-atherossteosis
Ukwelashwa kwe-atherossteosis kuyinqubo ende, enzima, futhi kudinga ukuvezwa okuningana kusuka esigulini nodokotela abakhona.
Siqukethe izigaba eziningana okumele zilandelwe zihlanganiswe.
Kufanele ilashwe kancane futhi ihlanganiswe, ngakho-ke izimpawu nokwelashwa kwe-atherosclerosis kuxhunyiwe ngokuphelele. Nazi izimiso eziyisisekelo zokwelapha:
- ukwelashwa kwezidakamizwa;
- ukwelashwa kokudla;
- ukusebenza ngokomzimba okunengqondo;
- ukusetshenziswa kwezindlela zemithi yabantu (ngokuzithandela);
- ukuvimbela ukusakazeka kwenqubo.
Ukwelashwa kwezidakamizwa ze-atherosclerosis kubandakanya ukusetshenziswa kwezidakamizwa ezokwehlisa i-lipid (ukwehlisa izinga lama-lipids, ikakhulukazi i-cholesterol). Lawa ngamaqembu izidakamizwa ezinjengama-statins (Atorvastatin, Rosuvastatin, Akorta), i-fibrate (Fenofibrate, Besofibrate), i-anion exchange resins (Cholestyramine, Colestipol) nokulungiselela kwe-nicotinic acid (Nicotinamide, Vitamin B3) Adakwa kakhulu ngaphambi kokulala, ngoba inani elikhulu kakhulu le-cholesterol likhiqizwa ngumzimba wethu ebusuku. Ukusetshenziswa kwama-vitamin complexes, amaminerali kanye nezinto zokulandela umkhondo, okuzosiza ekuthuthukiseni ukuhamba kwegazi nokunciphisa ukuphazamiseka, kuyanconywa nako. I-Antispasmodics (Papaverine, No-Shpa), ekhipha imithambo yegazi, isebenza kahle.
Ukudla kweziguli ezine-atherossteosis kungukudonswa ekudleni kokubhema, ngosawoti, ekudleni okuthosiwe, noma yikuphi ukudla okusheshayo, amaswidi, usawoti omningi, i-legumes, inyama enamafutha. Esikhundleni salokho, kunconywa ukuthi udle imifino nezithelo ezintsha, amajikijolo ahlukahlukene, inyama enamafutha amancane, ukudla kwasolwandle futhi uphuze okungenani amalitha nengxenye amanzi ahlanziwe ngosuku.
Ukuzivocavoca umzimba kuyadingeka ekunciphiseni isisindo nasekuqiniseni jikelele komzimba. Isisindo esengeziwe siyisici sobungozi obuqondile ekwakhiweni kwesifo sikashukela sohlobo 2, lapho imikhumbi ihlupheka khona, futhi ne-atherosclerotic lesion ngeke ibazuzise. Kulokhu, kunconywa ukuhamba nsuku zonke okungenani isigamu sehora ngosuku. Ungenza ama-jog light, hhayi ukuzivocavoca umzimba okukhulu kakhulu, njengokuqina komzimba.
Amakhambi e-Ftu muhle kakhulu ekwelashweni ekhaya. Kungaba imbewu yefilakisi, uwoyela onamafutha, ama-infusions kanye nama-decoctions avela kumakhambi ahlukahlukene. Izithasiselo ezisebenzayo (Biology) ezisebenzayo (izithasiselo zokudla) nazo kufanelekile.
Ukuvimbela ukwanda kwe-cholesterol ukuvikela ukuqhubeka kwesifo. Ukuze wenze lokhu, udinga ukuyeka imikhuba emibi (ukuphuza utshwala nokubhema), ukuzibandakanya ezemidlalo ngokulandelana, ukulandela ukudla futhi ube novalo oluncane.
Ungayiphatha kanjani i-vasher atherosclerosis echazwe kule vidiyo ekulesi sihloko.
