NKWUKWU NIILE KAR ANDR AND EGO NA-EME OFBỌCH U UZBEKISTAN

NWA ANYA NA AHUIKE NZUZU UZBEKISTAN

TASHKENT MEDICAL ACADEMY

AKWKWỌ NKE AKW ANDKWỌ ANDB ANDR AND NKE NA ỌB OFR OF AH OF́MAT M N'EDLỌ NCHE

AKW TEKWỌ AKW ONKWỌ AKW ONKWỌ AKW FKWỌ NSỌ

EGO

Maka umu akwukwo nke akwukwo nke ano

Ebumnuche nkuzi:Ilimata ụmụ akwụkwọ na ụlọ ọgwụ, nchoputa, nchọpụta ihe dị iche, nhịahụ na ọgwụgwọ nke atherosclerosis, ọrịa obi obi, angina pectoris.

Ebumnuche mmụta: ịkụziri ụmụ akwụkwọ ihe ndabere nke echiche ụlọ ọgwụ, arụmụka ahụike, okwu banyere deontology, ụkpụrụ omume na usoro iwu dị ka achọrọ ọzụzụ dọkịta na ọkwa nke ụkpụrụ mba ụwa.

Ozizi obere maka isiokwu:Isiokwu a bụ otu n'ime isi na usoro ọgwụgwọ. Nke a bụ n'ihi oke ọnya nke atherosclerosis nke ndị bi na, mkpa dị oke mkpa nyocha nke oge a. Uru nke ihe ịrịba ama nke ọrịa, ụkpụrụ nke ọgwụgwọ ọhụụ dị oke mkpa na ndụ dọkịta kwa ụbọchị.

Ebumnuche na ebumnuche nkuzi - nkeji 5

Etiology na pathogenesis - nkeji iri na ise

Nkewa na ụlọ ọgwụ - nkeji iri abụọ na ise

Ezumike - Nkeji 5

Ngosipụta nke onye ọrịa - nkeji 10

Nnyocha ụlọ nyocha na akụrụngwa - nkeji 10

Oria di iche - nkeji 5

Ọgwụgwọ - nkeji iri na ise

Mmechi Azịza nye ajụjụ - nkeji 5

Atherosclerosis bụ ọrịa na-adịghị ala ala nke akwara ndị na -akpata akwara na akwara, nke nkwakọba na mkpokọta nke plasma lipoproteins na cholesterol na intima, na-eduga na usoro mgbanwe yana akụkụ nke ekwentị, ndị na-esote mmeghachi nke akwara na njikọta anụ ahụ na ntanetị nke oghere dị ọkụ na mgbidi mgbidi. N'ihi nke a, enwere mbelata mpaghara nke akwara ndị dị na mbelata ịdị ọcha ha.

Ọrịa ọnya atherosclerotic nke ọrịa dịgasị iche iche bụ otu n'ime ihe na-akpata ọrịa na ọnwụ na mba ndị mepere emepe. Getmụ nwoke na-enweta atherosclerosis ugboro 4-6 karịa karịa ụmụ nwanyị.

Usoro etiology nke atherosclerosis bụ ihe dị mgbagwoju anya ma nwee ọtụtụ. Ruo ugbu a, isi ihe dị egwu maka ịmalite atherosclerosis bụ: ọbara mgbali akwara, dyslipoproteinemia (mmụba nke ogo lipoproteins dị ala na mbelata nke ukwuu), ị smokingụ sịga, ọrịa shuga, oke ibu, ụmụ nwoke, atụmanya mkpụrụ ndụ ihe ga - eme tupu afọ ndụ atherosclerosis. Ihe ndị na-ebute ụzọ bụ arụ ọrụ arụ ọrụ na agadi.

A na-aghọtaghị pathogenesis nke atherosclerosis nke ọma. 2 eburu ụzọ chee echiche ga - atụba: lipid na endothelial. Dabere na hypothesis nke lipid, mmụba nke ọkwa plasma lipoproteins dị ala (LDL) bara ụba na cholesterol na-eme ka ntinye nke ikpeazụ banye na mgbidi vaskụla. Na mgbakwunye, LDL na-akpali hyperplasia nke akwara akwara vaskụla ma na-eme mgbanwe na sel na-abawanye nke endothelium na subendothelium. Enwere akụkọ nke nsonaazụ enwere ike nke LDL na sel stem, ịgbalite uto nke uto, na n'ikpeazụ na nguzobe fibrosis mpaghara.

Dabere na hypothesis endothelial, mbibi nke endothelial oyi akwa (ihe dị n'ime n'ime arịa ahụ) na-akpalite mmeghachi omume mgbochi sel na-eduga n'ịbepụta ihe ncheta ahụ na saịtị ahụ mebiri. Nke a gụnyere nchịkọta platelet, chemocytosis nke monocytes na T-lymphocytes na mwepụta nke platelet na monocyte na - ewepụta ihe na - eme ka mwepu akwara mkpụrụ ndụ dị mma site na mgbasa ozi ruo intima, na mgbanwe nke mkpụrụ ndụ ndị ọzọ (macrophage, endothelial) nke na-akwalite ire ụtọ anụ ahụ hyperplasia na uto. Mgbanwe nke mkpụrụ ndụ, ọkachasị na nguzobe akụrụngwa (multinuclear) endothelial sel, na-eduga n’inwezighi ikike ha site na sistemụ mgbochi nke onwe ha, na-esochi nlọghachi nke mmeghachi nke antigen-antibody, nguzobe usoro mbufụt, nke na-akwụsị site na ịhe e dere ede. Ma hypotheses nwere mmekọrịta chiri anya ma bụrụkwa ndị na-anọghị otu, kama ha na-emekọ ibe ha.
N'afọ ndị na-adịbeghị anya, etinyela echiche nke viral na herpes-viral hyesheses nke etiology nke atherosclerosis ma na-amụ ya nke ọma. Emebere ya na nje Epstein-Barr, nje Coxsackie na ndị ọzọ na-eduga na mmebi nke mkpụrụ ndụ endothelial, nwere ike ịmịcha mkpụrụ ndụ na enweghi ike ime ya. Ihe ncheta Atherosclerotic ji nwayọ nwayọ karịa ọtụtụ afọ ma emesịa na-eduga na stenosis nke lumen ma ọ bụ imezu ihe mkpuchi nke arịa ahụ. Ka oge na-aga, ihe e dere ede na-eme kalidinous. Mgbe ọ bụla enwere mmepe, ọ nwere ike imebi ya na mberede ma ọ bụ nwee mmụba dị ukwuu na mgbali ọbara (mgbali ma ọ bụ mgbapu), nke a na-edugakwa n'ichebe ọbara ma, n'ihi ya, na-enwewanye nnukwu mmụba nke ọbara.

N’inye nnukwu mkpa nke mmeghachi omume cellular na immunological na pathogenesis nke atherosclerosis, usoro iji nwayọọ nwayọọ na-aga n’ihu bụ njiri mara ọrịa ahụ: a na-eji oge udo dochie oge ọrụ nke usoro ahụ.

A na-ekpebi onyonyo nke ọrịa a ka ọ dị oke site na ịdị njọ na njupụta nke mgbanwe na arịa ndị ahụ, dịka mpaghara ha. Akụkụ thoracic na nke na-agbadata nke aorta, coronary, carotid nkịtị, akụkụ ụbụrụ, akwara, mesenteric na akwara metụtara. Dabere na nsonaazụ atherosclerotic na-egosi, ihe ịrịba ama nke ụlọ ọgwụ na-ebute ụzọ na-esonyere akụkụ ahụ nke mgbasa ọbara kachasị emetụta (lee akụkụ dị mkpa).

Na agbanyeghi ka usoro a si arụ ọrụ, ọ tụrụ aro ịkọwapụta oge abụọ na mmepe nke ọrịa ahụ: oge ​​mbido (usoro izizi) na oge ngosipụta nke ụlọ ọgwụ. N’oge mbido, enweghị mgbanwe n’arụ ahụ. Ihe akparamagwa ya bu oria akwara na akaghi aru dika vasospasm, cholesterinemia na dyslipidemia.

N'ime oge nke abụọ, na mbido, akara na akara a na - egosi njikọta dị n’etiti ihe oxygen na - achọ n’ahụ na anụ ahụ emetụtara na ohere nke ibuga ya site na arịa ndị usoro atherosclerotic na - agbanwe. Na mbido, ekpughere nghọtahie a naanị na mgbalị anụ ahụ, mgbe chọrọ oxygen-metabolic na-abawanye nke ọma (dịka ọmụmaatụ, ya na angina pectoris, ngbanyeghị ngbanwe), ma na-esote ya na ọganihu nke atherosclerosis na mbelata nke oghere nke arịa ahụ, enweghi echiche a na-amalite ịpụta na obere ngwa ngwa na ọbụna izu ike. Latzọ ọrịa latent (asymptomatic) ga-esi kwe omume ruo mgbe oghere nke akwara na-agbada ruo 70-75%.

N'ọnọdụ imebi iguzosi ike n'ezi ihe nke ihe ncheta, mgbe usoro nke thrombosis bidoro, dịka iwu, oke iwe ahụ na - apụta, gosipụtara na mmepe nke angina na-ejighi ike ma ọ bụ infịction myocardial, ọ bụrụ na anyị were ọrịa obi obi dịka ọmụmaatụ (lee ISCHEMIC HEART DISEASE).

ATOROSCLEROSIS OF AORTA na-etolite na mbụ karịa mpaghara vaskụla ndị ọzọ ma bụrụkwa ihe zuru oke (ọkachasị mpaghara mpaghara thoracic), etu ọ dị, ekpughere ngosipụta ya na obere oge ka ọ bụ anọghị ya. Mgbe ụfọdụ ibilite

Ihe mgbu azụ (aortalgia) na –eme ka mpaghara intercutaneous. Na atrophy nke uru ahụ, a na-amalite aneurysm na ngalaba nke aorta metụtara atherosclerosis na nguzobe nke akwara ma ọ bụ na-agbasawanye ndọtị. Mmụba na ụba nke aneurysm na-eduga n'inwekwu nrụgide na akwara ndị dị n'akụkụ yana hemodynamics na-arịa ya. Site na ọgbụgba ọwụwa ọgbụgba, ihe mgbu na-apụta, ịkọwapụta ya dabere na ebe etolite ya (ya na azụ ọwụwa aka - ụta mgbu, aortic arches - pain mgbu na-eme ka olu, ubu, azụ, na-agbadata aorta - azụ mgbu). A na-ahụta mgbaàmà ndị ọzọ nke aortic aneurysm - isi ọwụwa, akụkụ ihu (n'ihi ụsọ vena cava), ihu ure, ụkwara, mkpụmkpụ ume, dysphagia (n'ihi mkpakọ nke akwara ugboro ugboro na nrụgide na trachea).

Egosiputara mgbasawanye nke ókèala akwara vaskụla, systolic ntamu na oghere intercostal nke abụọ n'aka nri nke sternum.

N'ọnọdụ ụkọ akwara ozi (sclerotic okike), na oghere intercostal nke atọ n'akụkụ aka nri nke sternum, a na-anụ ntamu systolodiastolic na-agwụ ike. N'ihe gbasara ọnya ọgbụgbọ na ọnya afọ ma ọ bụ mmepe nke aneurysm na ya, mgbu afọ, afọ nke ike, na nsogbu nke dyspeptik na-apụta. N'ime oghere dị n'ime apịtị, enwere ike ikpebi plọg nke palpation, nke a na-anụ ntamu systolic.

Ihe ndị na-esite na ya pụta bụ nwayọ n'ike. N'oge nlere anya siri ike, arịgoro elu na afọ ọhụụ nke 0,5 cm.

Nsogbu siri ike nke ọrịa ọgbụgba bụ mbibi nke mgbidi ya na ntipịa ihe na-akpata ọnwụ. Ihe ọghọm nke nkụda mmụọ na-abawanye na ọrịa nke thoracic aorta karịa 6 cm na dayameta (ọkachasị na ndabere nke ọbara mgbali elu), mpaghara afọ - karịa 5 cm.Etule nke mgbapu na nha ndị a n'afọ bụ 30-40%, yana mmụba ha na-abawanye nke ọma ( dayameta 7-10 cm - 45%, dayameta 10 cm - 60%).

AKWTHERKWỌ ANY OF NA-AKPATA MARA ANARA BRAIN na-enye aka na mmepe nke ụkọ ọbara na-adịghị ala ala, ụbụrụ ya bụ oshimia. Ihe ngosiputa ulo ogwu nke oria a bu n'ihi enweghi obara n’iru ya n’ebe ufodu ụbara. Ischemia a na –ejere obere oge - mbelata nke ukwuu n’ọbara - a na - ejikọ ya na spasm nke akwara ụbụrụ ma bụrụkwa ihe na - akpata ọghọm ndị ọzọ.

Ike ọgwụgwụ, ndọpụ uche, itinye uche n'ihe bụ njiri mara. Icheta ihe omume ugbu a na-ebelata ebe echekwara ndi ọkachamara. Na-echegbu onwe gị banyere isi ọwụwa, mkpọtụ isi, mgbe ụfọdụ, anya isi, ụra na-aka njọ, iwe, na-ebelata

ọnọdụ. Ka oge na-aga, mgbaàmà na-aga n’ihu, nsogbu ndị a ka njọ. Na ngwụcha, III, ogbo, akpọ encephalopathy, akpọlata ọgụgụ isi, ọgba aghara interventricular, ihe mgbaàmà nke parkinsonism (isi ike, amimia) na-apụta.

Atherosclerosis na-emetụta akwara, na-eduga n'ịkwụ ụgwọ akwara na-adịgide adịgide, bụ ihe na-akpata ọbara mgbali elu dị elu. A na-anụ mkpesa Systolic na oghere dị warara akwara akwara. Na mmamịrị, proteinuria na-agafeghị oke, obere mgbanwe na mkpụkọ mmamịrị (otu mkpụrụ ndụ ọbara uhie, hyaline cylinders).

Ihe na-akpata Atherosclerosis

Okwesiri iburu n'uche na atherosclerosis na ọrịa nke ime na-aga aka. Dịka ọmụmaatụ, nwere ike ịkpasu mmepe nke ọrịa ọrịa shuga mellituskemgbe ọrịa vaskụla na obi ime na mgbe ị dị obere ma ọnụego cholesterol n'ime arịa ndị a dị elu. Ọzọkwa, ihe ndị na-akpata mmepe nke ọrịa gụnyere ọbara mgbali elu na ọnụnọ nke àgwà ọjọọ (ise siga). Mana nkwụ ka bụ mmebi nke metabolism metabolism.

Tụlee ihe ndị dị ize ndụ maka mmepe nke ọrịa:

• afọ Ka mmadụ na-akawanye okenye, ọ ga-enwe ihe egwu karịa ka ọ pụta ihe ngosipụta anherosclerotic. Kpachapụ anya na ahụike ha kwesịrị ịbụ ndị gbara afọ 50,
• okike Ndị ọkà mmụta sayensị achọpụtala na ụmụ nwoke na-enwekarịkarị atherosclerosis. Ngosipụta nke ihe ịrịba ama ndị mbụ ga-ekwe omume site na afọ 45, na n'ọnọdụ ụfọdụ na mbụ. Mgbe ụmụ nwanyị, akara ngosi nke ọrịa ahụ nwere ike ịmalite ịpụta naanị afọ 55,
• ketara eketa. Ọkpụkpọ mkpụrụ ndụ ihe nketa na-arụ ihe fọrọ nke nta ka ọ bụrụ isi ọrụ na ịmepụta atherosclerosis. Mmụta emere gosiri na ndị ndị ikwu ha butere ọrịa obi na-arịa ọrịa obi na -efekarị ọrịa n’etiti ha,
• erighị ihe na-edozi ahụ. Ojiji nke oke abụba na nri raff, yana agụụ maka nri, nwere ike ibute mmepe ọrịa. N’ihi ya, ọ dị ezigbo mkpa iri nri n’oge na n’oge. Ntọala nke ihe oriri kwesịrị ịbụ akwụkwọ nri, ahịhịa, mkpụrụ osisi na azụ,
• ibu oke ibu. Nke a apụtaghị na ọ na-eduga kpọmkwem na mmepe nke ọrịa a na-adịghị ala ala, kama, oke ibu nwere ike ibute ọrịa shuga, nke na-akpalitekwa atherosclerosis,
• omume ojoo. Ụ sịga bụ isi onye iro nke arịa ọbara na otu n’ime ihe na-akpata atherosclerosis.

Pesdị na akara nke atherosclerosis

E nwere ọtụtụ ụdị ọrịa a na - emebi emebi:

• akwara akwara (atherosclerotic cardiosclerosis), nke na-akpalite mmepe nke nkụchi obi, ọrịa obi na akwara na angina pectoris,
• aorta, nke na - emetụta ihe niile dị n’ime na akụkụ ahụ,
• arịa ọbara nke na-ahụ maka ịbara ụbụrụ nye ụbụrụ,
• arịa akụrụngwa, nke na-eduga n'ịrụ ọrụ nke ọma akụrụ na ọbara mgbali elu,
• Ọrịa dị na ala akụkụ nke ala na nke ala, a na-akpọ ọrịa a obliterating atherosclerosis.

Kedu ka ọrịa a si egosipụta onwe ya, ihe mgbaàmà dị a shouldaa ka m kwesịrị ịchọ ma gaa hụ dọkịta?

Na nmalite mmalite ahụ, ọrịa ahụ apụtaghị ozugbo, yabụ, ọnụnọ ya nwere ike ikpebi site na ya nyocha. Ka oge na-aga, ihe a na-akpọ "mgbapụta ikpuru" (akwara akwara akwara).

N’ọdịnihu, akara ngosi nke ọrịa ahụ ga-apụta dabere na ọnọdụ ọnya ahụ. Yabụ, na mbibi nke aorta, mgbu nwere ike ime n'azụ azụ nke ike dị iche iche, na-agbatị na azụ, olu ma ọ bụ afọ dị elu, yana ọbara mgbali elu nke vaskụla nke abụọ. Mgbe ọrịa a metụtara akwara ọbara, a ga - achọpụta ihe nke a site na ngosipụta nke ọrịa akwara ọbara. obi - angina pectoris, tachycardia, nkụchi obi, ọgba aghara, wdg. Na mmebi nke ụbụrụ nke mmadụ, mkpọtụ n'ime ntị, ọgbụgba, isi ọwụwa ugboro ugboro, ike ọgwụgwụ, nsogbu ịrahụ ụra na-egosi, ebe nchekwa na-aka njọ.

Ọ bụrụ na emetụta akwara akụrụ, ọ na-egosipụta onwe ya n'ụdị ụkọ akwara na-adịghị ala ala na ọbara mgbali vasorenal. A na - egosipụta mmebi nke arịa nke mpaghara ala (nke a na - akpọkwa ọrịa Lerish's syndrome) site na abụba ngwa ngwa, ihe mgbu na - apụta na mberede mgbe ọ na - aga ije, ọnya akpụkpọ ahụ n'ụkwụ, oyi, ọrịa akpụkpọ ahụ trophic. Ọ bụrụ na atherosclerosis erute na mesenteric arteries, nke a nwere ike ikpebi site na ihe mgbu na-eme na mberede mgbe nri ma soro ya ọgbụgbọ, na oge ụfọdụ ọgbụgbọ, ọnya ọgbụgba, thrombosis, n'ihi nke akwara necrosis amalite. A pụrụ igosipụta ịmị mkpụrụ nke akwara ọbara site na ọzịza nke ụkwụ, ọzịza nke akwara nke olu, ụkwara ume ọkụ, mkpesa systolic n'ihi akwara akwara.

Nchoputa nke Atherosclerosis

Iji gosipụta na mmadụ etolite atherosclerosis, ịnwere ike ịkpọtụrụ ya dibịanke ga-ebunye nnukwu ego nyocha. Ọrịa ọ bụla nwere ike igosipụta onwe ya n'ụzọ dị iche iche, yabụ ịkwesịrị ịlele ihe niile n'ụzọ zuru ezu, chọpụta ụdị ọrịa ahụ. N'oge nyocha n'ọtụtụ ọnọdụ, ekwesiri ịhazi ihe mgbagwoju anya nke atherosclerosis na ihe ize ndụ nke nsogbu, nke egosipụtara na nchọpụta ahụ. Naanị mgbe ahụ ka akwadoro ọgwụgwọ ahụ n'ụzọ ziri ezi ma rụpụta nsonaazụ bara uru.

Nchọpụta nchọpụta ọrịa na - ejikarị ọmụmụ gbasara ọgwụ na iji ụzọ ndị ọzọ maka ịchọpụta ọrịa ahụ.Uzo mbu nke ichoputara gunyere mkpocha nke mkpesa nke onye ọrịa, nyocha na nyocha, nke na-enye onye okacha amara aka ichoputa udiri nke pokopoko, otu esi akpochi ma mee ka akwara di. Ọ dị ezigbo mkpa ịgwa onye ọkachamara banyere omume ọjọọ dị ugbu a na ụdị ndụ ị na-ebi. A na-eme nyocha ndị ọzọ site na ịme nyocha, yana yana ntinye nke ngwaọrụ ahụike. Nke a nwere ike ịbụ ọmụmụ dịka electrocardiography, Nyocha ultrasound arịa ọbara, x-ụzarị akwara ọbara na obi, nyocha ihe banyere ndụ.

Ọgwụ Atherosclerosis

Usoro ọgwụgwọ Ekwesịrị ijikọ atherosclerosis - ọgwụ na ọgwụ ọjọọ. Nke ikpeazụ bụ iwepụ ihe ndị nwere ike ịgbanwe. A na-atụ aro ka onye ọrịa ahụ na-ebi ndụ dị mma, zere omume ọjọọ, gụnyere ị alcoholụ mmanya na-aba n'anya, ịchịkwa ibu, zere nsogbu ụjọ na ọnọdụ nrụgide.

Antiatherosclerotic pụrụ iche nri. Ọ dabere na iji ihe oriri nwere obere kalori na obere ihe abụba anụmanụ. A na-ebelata nri ndị nwere carbohydrates na -agaghị agbari ma ọ bụ kpochapụ kpam kpam na nchịkọta nhọrọ. Otu na-aga maka nri cholesterol dị elu.

Ogwu ọgwụ kwesịrị ịgụnye vitamin B3 na PP.

Ọgwụ ọgwụgwọ atherosclerosis, nke bụ ọgwụgwọ ịwa ahụ, adịkarịghị eji, ọkachasị n'ọnọdụ ndị ahụ mgbe arịa ndị emetụtara anaghịzi anabata ụzọ ichebe ọgwụgwọ. A na-eji ọgwụgwọ ịwa ahụ mee ihe maka mmebi nke akwara ndị dị n’ime, ọ na-abụ prosthetics nke arịa ma ọ bụ wepu thrombus guzobere.

Atherosclerosis bụ ọrịa dị oke njọ, ọ dị mkpa ịnwa igbochi mmepe ya n'ụzọ niile enwere ike, n'ihi na mgbochi dị mma mgbe niile karịa ọgwụgwọ. Ihe mgbochi gụnyere: nnabata na mgbochi atherosclerotic nri (nke a bụ nhọrọ kachasị mma), ma ọ bụ opekata mpe, ezi nri, na-eri nri, ịhapụ omume ọjọọ, na -eme ọrụ dị mma na ndụ, yana ịha ahụkarị.

Ọ bụrụ n ’ị na-enyo na ị nwere atherosclerosis, kpọtụrụ ndị ọkachamara na Center anyị nke ga-enyere gị aka ozugbo!

Atherosclerosis na ọrịa dị n'ime: mmekọrịta

• Na-akwadokwa ọkwa shuga ruo ogologo oge
• Weghachi nrụpụta insulin nke pịkụl

Ndị na-agụ akwụkwọ anyị ejirila Aterol belata cholesterol. Thehụ ihe ndị ama ama n’ahịa a, anyị kpebiri inyefe ya n’aka gị.

A na - achọpụta ọrịa Atherosclerosis na ọrịa ndị dị n'ime ya na usoro akwara ozi ozugbo.

A kọwara ihe ịtụnanya a site na eziokwu ahụ bụ na imebi lipid na protein metabolism na-abụkarị nsonaazụ ma ọ bụ ihe kpatara ọrịa ọ bụla.

Ya mere, nyocha nke mbu nke atherosclerosis na-arụ ọrụ dị mkpa - usoro dị mgbagwoju anya, n'ihi pathology na mbụ ọ naghị egosipụta onwe ya.

Usoro nke mmepe na ihe na-akpata atherosclerosis

Na atherosclerosis, enwere mkpokọ cholesterol na irighiri akwara ndị dị n'etiti choroerol na mkpụrụedemede dị n'etiti na nke dị n'ime, n'ihi nke a na-edobe nnu ndị a na-etinye nnu na akwara ndị a na-ajụ.

Ihe mgbaàmà mbụ nke atherosclerosis na-apụta mgbe ihe karịrị ọkara na-egbochi akwara ozi.

Ihe ịrịba ama nke oria a dabere na mpaghara nke arịa ndị emetụtara.

Ọ bụ omenala ekewapụ atọ maka mmepe nke ọrịa.

Nke mbu bu nbido ibelata abuba - ekpughere oria a bu oria. Ọ na - ebilite n'ihi nchịkọta nke macrophages na mkpụrụ ndụ akwara dị larịị, nke na - agbakọba egbugbere ọnụ. Ka oge na-aga, abụba na-apụta, ma ọnụnọ ya apụtaghị na mmadụ na-arịa ọrịa atherosclerosis. Ọbụna na ụmụ ọhụrụ, a na-ahụ ntụpọ abụba n'ime arịa nwere dayameta 1-2 mm.

Nke abụọ bụ uto nke ihe dị n'ime oghere nke arịa ahụ. Ọ mejupụtara kristal esters na cholesterol, nke bụ isi dị nro, yana irighiri akwara - okpu mkpuchi. Mmụba nke okwute ndị na-emebi emebi na-eme ka mbelata akwara ozi. Cholesterol na - abịa site n'ọbara, na - agbakọta na mgbidi arịa.

Nke ato - ọnụnọ nke nsogbu dị mgbagwoju anya - agba nke ikpeazụ na mmepe nke atherosclerosis. Na-egosiputa nbelata nke ọkpụrụkpụ nke ihe nkwụnye ego nke ihe na-erughị 65 micron, yana ihe microcracks na ọnya dị n'elu ya. Nke a gụnyere mgbakwunye platelet na kapịlị, nke na-ebute ọbara ọgbụgba, ọnya obi, nkụchi obi na ọrịa ndị ọzọ metụtara mmịnye ọbara ma ọ bụ nkwụsị ya kpamkpam na akwara ozi metụtara.

A na-ewere nguzobe nke nkwụnye ego atheromatous dị ka usoro eke, agbanyeghị, enwere ọtụtụ ihe nwere ike belata ya ma ọ bụ mee ngwa ngwa.

Patanatomi gụnyere ihe ndị a:

1. Okike na afọ. Ọrịa a na-etolite n'ime ụmụ nwoke 3-4 ugboro karịa karịa n’ebe ụmụ nwanyị nọ. Ọzọkwa, ihe ịrịba ama mbụ n’ime ụmụ nwoke na-apụta mgbe ha dị afọ iri anọ na anọ, na maka ụmụ nwanyị - malite na afọ iri ise na ise.
2. Jenetik Ọ gụnyere ihe dịka ọrụ nke sistemụ mgbochi, ọnụnọ nke dyslipoproteinemia, na ọkwa nke homonụ.
3. Omume ojoo. Ihe kachasị dị ize ndụ maka usoro obi bụ ị isụ sịga, Sịga ọ bụla nwere nnukwu nicotine na tar nke na-emerụ ahụ. Gaghị adoụbiga mmanya ókè, ọ bụ ezie na 100 g nke mmanya na-acha ọbara ọbara na-egbu egbu n'oge nri abalị bụ mgbochi dị mma maka ọbara mgbali elu.

Na mgbakwunye, ihe kpatara mgbanwe nke ọrịa nwere ike ịbụ ọnụnọ nke oke ibu.

Oké ibu na-akpata ọtụtụ ọrịa - atherosclerosis, ọrịa shuga, wdg, ya mere, ịkwesịrị idozi oke ahụ.

Maindị isi nke atherosclerosis

Enwere ọrịa dị iche iche.

Ihe a na-ahụkarị bụ nhazi ọkwa nke atherosclerosis, dabere na ọnọdụ ọnya ọgbụgba nke atheromatous nke arịa ọbara.

Thedị ọrịa ahụ na-apụta ma onwe ya na usoro.

A na - amata ụdị atherosclerosis ndị a:

• Atherosclerosis nke akwara ọbara, bụ nke ihe mgbu na-egosipụtakarị. N'ihi mmebi nke akwara ndị dị na obi, ọpụpụ ikuku oxygen na myocardium na-akụghasị. N'ihi ya, ngaghari nke ọrịa na - eduga na angina pectoris, nkụchi obi, ọrịa obi na akwara na mberede ọnwụ.
• Aodị aortic bụ ọnya nke akwara ọbara nke kachasị na anụ ahụ - aorta. Mmepe nke plasta cholesterol na-emetụta ọrụ nke akụkụ niile na sistem.
• Atherosclerosis nke arịa gbasara akụrụngwa. N'ime akara nke ọrịa, mgbu n'oge urination, ọnụnọ ọbara na mmamịrị, mwakpo nke ọgbụgbọ na ọgbụgba kwesịrị pụta ìhè. Mmepe nke ọrịa a gụnyere ọbara mgbali elu na ọdịda akụrụ.
• Atherosclerosis nke arịa ụbụrụ. Brainbụrụ bụ otu n’ime njikọ dị n’ime sistemụ akwara etiti, yabụ, agụụ oxygen n’arụ a na-ebute nsonaazụ dị egwu, dịka ọmụmaatụ, ọrịa strok ma ọ bụ ntụgharị ọnya ọnya.
• Na-ehichapụ atherosclerosis nke ala na nke elu ahụ. Na mbido, a ga-ahụ ihe iriba ama dịka ntutu dara n’ụkwụ na aka ya, aka nke mkpịsị aka ya, ihe mgbu, aka na ụkwụ, wdg.
• Atherosclerosis nke akwara akwara na-enye eriri afọ. Isi ihe ngosipụta nke ọrịa ahụ bụ mwakpo nke azụ ime - colic dịka ihe mgbu nke ime ime. Ihe dị ize ndụ bụ thrombosis nke alaka nke arịa ọbara na necrosis nke akụkụ eriri afọ na mesentery.

N'agbanyeghị ụdị ọrịa, ihe mgbapụta na mpụta nke ọnya anụ ahụ atheromatous nwere ike ịpụta:

1. xanthomas - ụdị dị ka "tubercles" nke dị na mpaghara nkwonkwo na akwara,
2. Senile arch - ọdịdị nke agba dị iche iche na-acha odo odo n'akụkụ ọnụ cornea.

Na mgbakwunye, xanthelasms nwere ike ịpụta - nguzo nke ntụpọ odo na akpụkpọ ahụ, na - enwekarị agwa dị egwu, n'ihi nkwanye cholesterol na triglycerides.

Hydị Hyperlipidemia nke Fredrickson

Hyperlipidemia bụ usoro akụrụngwa nke oke mmiri nke lipids na lipoproteins na plasma ọbara.

Ọrịa a bụ isi ihe na mmepe nke ọrịa obi, gụnyere atherosclerosis.

Hypercholesterolemia - Ọrịa concomitant

Hypercholesterolemia n'echiche bụ ọrịa nke na-abụghị ọrịa. Kama, obu ihe aka n’ile na ito nke oria ufodu.

A na-eji Hypercholesterolemia site na plasma cholesterol dị elu. A na-ahọpụta usoro mbụ na nke abụọ nke ọrịa a.

E kee hypercholesterolemia nke izizi n’ime otutu:

• Ezinaụlọ N'ime obi mmepe ya bụ ọrụ na-arụ ọrụ nke ndị na-anabata LDL. Ọzọkwa, a na-ahụ homozygotes na ugboro 1 n'ime otu nde. N'ime ndị ọrịa, ịta cholesterol dịgasị iche site na 15 ruo 31 mmol / L. Ọtụtụ mgbe, ọrịa obi na-ebilite ebilite ruo afọ 20.
• Polygenic. O gosiputara onwe ya dika ihe si na nri iri nri ma obu oke ibu megide ndi aru riri nne. Chota cholesterol n'ime plasma ọbara sitere na isii ruo 8 mmol / L. N'ime ndị ọrịa nwere ọrịa obi na - ebido n'isi afọ 60.
• Ejikọtara ezinụlọ. Ọnọdụ ndị a na-etolite na 1-2% nke mmadụ.

Hypercholesterolemia nke abụọ bụ ọrịa na-apụta na ọrịa akwara, ọrịa mellitus (ụdị nke m na nke II), hypothyroidism, pancreatitis, ọrịa imeju, oke ibu, na ọrịa ọnya biliary.

Formdị a na - eme ọtụtụ ugboro karịa nke mbụ.

Ọgwụgwọ na mgbochi ọrịa

A gaghị agwọtakwa Atherosclerosis kpamkpam, mana ọ ga - ekwe omume ịkwụsị itinye oghere nke cholesterol site na nyocha na ọgwụgwọ oge.

Usoro nyocha maka echere na atherosclerosis gụnyere akụkọ banyere ahụike, nyocha mbụ nke onye ọrịa, ụlọ nyocha na ụzọ nyocha. N'etiti nnwale nnwale kachasị, a na-amata kọlestrọl na nchịkọta atherogenicity. Diagnozọ nyocha dị iche iche gụnyere angiography, coronography, aortography, ultrasound of the renal arteries, resovasography and ultrasound.

N'ime 80% nke ikpe, ọgwụ ọgwụ na-enyere aka iwepụ akara nke ọrịa ma gbochie nsonaazụ dị egwu. Dọkịta depụtara ọgwụ ndị a:

1. Statins bụ ọgwụ kachasị ewu ewu na ọgwụgwọ nke atherosclerosis. Ebumnuche ha bụ iwelata ọrụ nke imeju na mmepụta cholesterol. Ihe atụ nke ụdị ọgwụ ọjọọ bụ rosuvastatin na atorvastatin.
2. Ihe nlere nke LCD na egbochi mgbochi nke bile acid na imeju. Ngwọta dị irè bụ Colesevelam na Colestyramine. N'ihi iji usoro LCD eme ihe, ịba ụba nke cholesterol iji hụ na usoro ịgbari nri nkịtị.
3. Fibrates bụ ọgwụ na-emebi triglycerides, si otú a na-eme ka metabolism lipid dị ike. N'ime ụlọ ahịa ọgwụ ị nwere ike ịzụta, dịka ọmụmaatụ, Trikor ma ọ bụ Atromid.
4. Niacin bụ ọgwụ na-arụ ọrụ dị mkpa na ọgwụgwọ nke atherosclerosis. Ọ na - arụpụta ọgwụ antispasmodic na vasodilator, mana anaghị agbada cholesterol. Ọgwụ nke nwere nicotinic acid bụ nke a machibidoro ọrịa shuga mellitus, ọrịa nke gallbladder na imeju.

N'ọnọdụ dị elu, a na-edenye ịwa ahụ. A na-ezo aka na angioplasty n'ụzọ ndị na-adịghị ala ala, yana akụkụ vaskụla prostudor na shunting na-ezo aka na usoro ọgụ.

Maka ọgwụgwọ na mgbochi nke atherosclerosis, a ghaghị ịhụ ihe oriri pụrụ iche. Ọ kachasị mma ịgbaso nri obere carb na cholesterol dị elu. Ọ na-ewepu ikere ngwaahịa dị otu a:

• anụ mara abụba na efere azụ,
• chokole, muffin, achicha na achịcha ọcha.
• achịcha dị mbadamba, achịcha na-egbu egbu,
• Ngwa ahịa mmiri ara ehi,
• ihe oriri, nri ngwa ngwa, abụba trans,
• kọfị siri ike na tii ojii, soda.

Kama, nri nwere ụdị anụ na azụ nwere obere abụba, nri, akwụkwọ nri na mkpụrụ osisi, ngwaahịa nri lactic acid, achịcha aja aja na ọka dị iche iche.

A kọwara mmetụta nke atherosclerosis na akụkụ ahụ dị n'ime ime na vidiyo ahụ n'isiokwu a.

• Na-akwadokwa ọkwa shuga ruo ogologo oge
• Weghachi nrụpụta insulin nke pịkụl

Nnukwu ọnụọgụ nke atherogenicity

Atherosclerosis bụ ọrịa nke ekwuru ihe ọjọọ ya na nso nso a. Emebere ya na ndị mmadụ na-arịa ọrịa atherosclerosis nwere ụba ọnụọgụ atherogenic (CA). Ha ji okpukpu isii karịa oge ha ga-ahụ dọkịta nwere ihe mgbaàmà nke ọrịa obi obi, yana ugboro anọ yie n'ụlọ ọgwụ na enyo infarction ma ọ bụ ọrịa strok na-enyo enyo. Usoro nke pathogenetic nke mmepe nke ọrịa nwere mejupụtara metabolism abụba na nrụpụta nke akpọrọ "cholesterol plaques" n'elu mmiri nke arịa, nke na - eme ka oghere nke arịa dị iche iche ghara ịdị, na - agbaghasị inye ọbara akụkụ ahụ niile ma nwee ike ịbawanye n'ihe egwu nke ọrịa obi na ụbụrụ.

Ngwakọta nke atherogenicity - isi ihe na-egosi profaịlụ lipid

Atherogenicity coefficient - usoro maka usoro nke oke lipoproteins dị elu na nke dị ala, na-egosipụta ogo mmepe nke atherosclerosis.

All lipids dị n’ahụ na-abịa na nri ma ọ bụ na-emeju na imeju. Ebe ọ bụ na abụba bụ hydrophobic n'okike, ha enweghị ike ịghagharị ọbara n'enweghị nsogbu. Maka ngagharị ha, a ga-achọ protein na-ebu ibu pụrụ iche. Ngwakọta kemịkal nke lipids na protein na-akpọ lipoprotein.

Ọkpụkpụ nke abụba nwere ike ịnwe oke. Ya mere, abụba niile na-agagharị n'ime ọbara na-ekewa n'ime nnukwu lipoproteins densens (HDL), lipoproteins dị ala (LDL) yana ogo dị ala (VLDL). LDL na VLDL dị ka abụba “na-emerụ ahụ”. Na mgbakwunye, ha na-edozi na mgbidi akwara, na-ewusi ya ike site na njikọ ahụ anụ ahụ, ịkpụzi akwa ma na-enwe oghere atherosclerotic (cholesterol). Ikike dị otú ahụ na-adọghachi oghere nke arịa ahụ, na-akụghasị ọkọnọ ọbara na akụkụ anụ ahụ. Ọ na-emetụta obi na ụbụrụ karịsịa, na-achọ oke oxygen na nri.Nnukwu npoproteins dị ukwuu, n'ụzọ megidere, a na-akpọ lipids “bara uru”, ebe ha na-ebufe abụba na sel nke anụ ahụ, yabụ, belata ntinye uche ya na ọbara ma sachapụ arịa ọbara.

Ngwakọta nke atherogenic bụ ihe ngosipụta nke oke abụba “dị mma” na nke “na-emerụ ahụ”. A na-ekpebi mgbe ọ nwetara nsonaazụ ọbara nyocha biochemical maka lipids ma na-agbakọ usoro ahụ:

KA = (cholesterol zuru ezu - HDL) / HDL

KA = (LDL + VLDL) / HDL (usoro ahụ chọrọ profaịlụ lipid na-amụba amụba ka ọ ga-amụ ọ bụghị naanị ogo dị elu ma dị ntakịrị).

Normkpụrụ ya dabere na akụrụngwa nke otu ụlọ nyocha, mana na nkezi, ọ bụ 2-3. Site na ọkwa HDL na-ezughị ezu, ọ ga-abawanye. N'ọnọdụ ụfọdụ, ọ nwere ike iru 7-8 ma chọọ usoro ọgwụgwọ siri ike. Nnukwu ọnụọgụ atherogenic na usoro ahụike dị ụkọ.

Ndị na-agụ akwụkwọ anyị ejirila Aterol belata cholesterol. Thehụ ihe ndị ama ama n’ahịa a, anyị kpebiri inyefe ya n’aka gị.

Kedu ihe ndekọ atherogenic dị elu pụtara?

Mmụba dị elu nke ọnụọgụ atherogenic bụ akara na-adịghị mma. Ebe obu na urua di nkpa, o gha agbanwee rue ndu obula di iche karie ndi obia nwere otu cholesterol. Iji maa atụ, onye na-egosi cholesterol ọbara n’etiti ndị ọbịa n’ụlọ ọgwụ bụ 5.5 mmol / L. N’ime otu n’ime ha, mkpụrụedemede dị elu na-anọchite anya ya, yabụ, ndepụta atherogenic ga-adị n’usoro etu o kwesiri, ihe egwu nke ibute atherosclerosis ga-adị ala. Kama nke ahụ, ọ bụrụ na LDL nwere ike karịa HDL, ọbụlagodi cholesterol nkịtị, a ga-amụba ọnya ọnụ, a ga-atụ aro onye ọrịa ka ọ chọọ iwelata ya.

Ya mere, enwere ike ịkpọ atherogenic index na-egosi prognostic egosi: ọ na-enyocha ihe ize ndụ nke nsogbu nke atherosclerosis (nnukwu myocardial infarction, ọrịa strok) na onye ọrịa nwere cholesterol dị elu. Mmụba cholesterol anaghị abụkarị mgbaàmà nke atherosclerosis. Ọ bụrụ na etolitepụtara n'ihi HDL, ihe ọghọm nke ọrịa vaskụla pere mpe. Ngwakọta nke abụba dị na ahụ ya bụ ihe dị ize ndụ. Ọ bụrụ na ọnụ ọgụgụ atherogenic na-abawanye, ị ga-agakwuru dọkịta gị iji wepụta usoro ọgwụgwọ na usoro mgbochi.

Ebumnuche maka ịbawanye ọnụọgụ

Ndepụta ọrịa atherogenic na-abụkarị onye ọrịa na-ahụ ya. Ihe kachasị dị ize ndụ bụ ụdị ndụ a na-etolite na nwata, mmadụ na-esokwa ya na ndụ niile. Ya mere, mgbe ị na-achọpụta ọkwa dị elu nke ọbara onye ọrịa, a na-atụ aro ịlele ndị otu ezinụlọ ya.

Ihe mere maka ụba ọnụọgụ atherogenic:

1. Azụ iri nri. N’ezie, abụba bụ ihe dị mkpa ma dị mkpa maka mmadụ ịrụ ọtụtụ ọrụ n’ime ahụ (dịka ọmụmaatụ, cholesterol bụ ihe eji ewu ụlọ maka mkpụrụ ndụ ụkwara na homonụ adrenal), LDL bụ ebufe ebu n’ọkụ na-anapụta ha n’obere mgbiri afọ maka inwekwu mgbanwe kemịkalụ n’ime imeju, HDL - lipoprotein, nke na-ebufe abụba site na imeju na sel nke mkpụrụ ndụ niile). Ya mere, ị nwere ike ma ọ bụ chọọ ịgụnye abụba na nri gị kwa ụbọchị. Ma ọ bụghị abụba niile na-enwe ahụ ike. Ihe kpatara ụba ọnụọgụ atherogenic bụ oke oriri nke abụba anụmanụ nke a hụrụ na anụ nwere abụba, abụba, abụba, akụrụ (akụrụ, ụbụrụ), sausages, bọta, mmiri ara ehi na ngwaahịa mmiri ara ehi.
2. Ọbara mgbali elu pụkwara ime ka ọnụọgụ ọgwụ atherogenic dịkwuo elu. Dabere na ọnụ ọgụgụ, ọbara mgbali elu bụ nsogbu nke 35-40% nke ndị bi na mba ndị mepere emepe karịa afọ 45. Nrụgide karịrị 140/90 mm Hg. Art. A na-akpalite ụda olu ike, nke na-emetụta ọbara ịba uru na akwara. Ihe mere bu na akwara akwara iji mee ka odi ike: obere oge dị mkpụmkpụ ga - ekwe omume n'oge egwuregwu ma ọ bụ ọnọdụ ndị na - akpata nrụgide, ibu dị otú ahụ “na - achịkọta” ihe dị n'ime ahụ, na - ekenye usoro ọbara. Site na ọbara mgbali elu, ụda akwara na-adịwanye elu na-enye aka na mmebi ha, ụmụ irighiri mmiri lipoprotein dị ala na-edozi ngwa ngwa na microtraumas.
3. Ụ sịga nwekwara ike ime ka ọnụọgụ ọgwụ atherogenic dịkwuo elu. Smoke smokeụ anwụrụ ọkụ oge niile na-eduga n'ịbelata ọdụ oxygen oxygen na microdamage na-adịgide adịgide na arịa ọbara. Lipids na platelet mejuputara ọnya a ngwa ngwa, a na-enwekwa ihe ncheta (cholesterol).
4. Abuse abuseụbiga mmanya na-aba n'anya na-eduga na nhazi usoro nke mgbali vaskụla. Akwara akwara (akwara) gbasaa, na visceral, na-edozi ahụ, ụbụrụ na akụkụ ahụ ndị ọzọ dị n’ime, warara. Yabụ, inye ọbara nye anụ ahụ na sistem na-agbagha, microdamages na-arịa n'ime arịa dị warara, na ngwugwu cholesterol.
5. Ihe ọzọ kpatara ọnụego ụba ahụ bụ ụdị shuga mellitus nke II. Ejiri ọbara ọbara a na-egbu n’ọbara. Molemụ irighiri ihe ya mebiri emebi mgbidi akwara dị mma, ọnụ ọgụgụ buru ibu nke akwa kọlọdirol arụ. Na mgbakwunye, na-arịa ọrịa shuga, ọ bụghị naanị carbohydrate, kamakwa, ọ na-agbagha metabolism: ndị ọrịa nwere ọrịa a na-abụkarị oke ibu, ọbụna na nri. Pụbiga ihe ọ inụ liụ n’ahụ n’arụ ọrịa shuga nwekwara ike iduga n’inwe ọtụtụ ihe.
6. Oké ibu bụ ihe ọzọ nwere ike ime ka ọnụọgụ atherogenic dịkwuo elu. Enwere ọtụtụ ihe na-eduga na oke ibu, ihe ndị a na-ahụkarị bụ ihe mmezi (ị regularụ calorie, nri na-eju afọ) na endocrine (nsogbu dị iche iche nke usoro hormonal nke usoro dị mkpa). Site na oke ibu, ọkwa lipids n'ọbara na-abawanye, ihe ize ndụ nke ịmepụta ihe na-egosiwanye na mmepe nke atherosclerosis na-abawanye.
7. Akụkọ gbasara ezinụlọ. Dọkịta kwuru na ọtụtụ mgbe a na-enwe ọnụọgụ atherogenic na ndị mmadụ n'ọbara n'ihi ọrịa atherosclerosis, ọrịa obi, ma nwee otu ma ọ bụ karịa nkụchi obi. Ya mere, a na-atụ aro ka ndị niile nwere akụkọ ntolite ezinụlọ nwee nyocha na ule oge ha maka cholesterol na profaịlụ dị mma.
8. Beganzọ ndụ ịnọ nkịtị na-adịkarị nso malitere ịbụ ndị e mere ka ihe ndị nwere ike ịba ụba ọnụọgụ atherogenic. E gosiputara na ndi mmadu ndi mmadu na-ebi ndu ha kariri ka ha ga-enwe oke nke atherogenicity.

Ihe ndị a niile na-emetụta ahụ ogologo oge, yabụ mmụba na ọnụọgụ atherogenic bụ ihe a na-ahụkarị karịa afọ 40. Agbanyeghị, n'ime afọ iri gara aga, a na-ahụkwa ihe ngosipụta atherogenicity na-eto eto na ndị nọ n'afọ iri na ụma dị afọ 13-15, ya mere, ọmụmụ banyere usoro egbugbere ọnụ na-ewu ewu.

Ihe egwu nke ịbawanye ọnụọgụ

Kemgbe ọtụtụ afọ, mmụba nke atherogenicity abụwo nke asymptomatic, ọtụtụ nwere echiche na ọnọdụ a adịghị ize ndụ na ọ chọghị ọgwụgwọ. Ọ bụ maka ụdị adịgboroja a ka akpọrọ atherosclerosis “onye na-egbu egbu,” ebe ọ bụ na ihe egwu nke kọlọdirol na ọnụọgụ atherogenic dị elu bụ nnukwu nsogbu nwere ike ibute ọnwụ.

Mkpakọ nke ọnụọgụ atherogenic mụbara:

1. 1. Nnukwu myocardial infarction. Akwara obi bụ ihe na-adịgide n’ime ahụ. Ọ na-arụ nnukwu ọrụ nke ịmị nnukwu ọbara n'ọtụtụ ndụ mmadụ. Yabụ, inye ọbara a anụ ahụ kwesịrị ịpụta na-egbu oge. Oxygen bara ụba ọbara na-abanye n'obi site na akwara akwara.

Site na ịbawanye ụba nke atherogenic, enwere nnukwu ihe ọghọm nke ịmepụta plasta cholesterol na ala nke arịa niile nke ahụ, gụnyere nke akwara. Ọbụladị obere obere akwara ndị na-enye mkpụrụobi na -eme ka mmadụ mebie ọbara ya. E gosipụtara ha site na ịdọpụ, ihe mgbu na-akpata n'azụ azụ ahụ, mgbatị ahụ na-aka njọ. Ọ bụrụ na akwara akwara akwara ji abụba 'kpụrụ akpụ,' n'oge na-adịghị anya ụdị ọrịa a dịka infarction myocardial nwere ike ịpụta.

Mgbake nke ndị ọrịa mgbe infarction myocardial dị ogologo ma sie ike. Ndị ọrịa dị ụdị mkpa a ka ha leba anya na ndụ ha niile site n’aka kadiogwu na usoro ọgwụgwọ oge niile.

1. Ọrịa ụbụrụ, ma ọ bụ nnukwu ọrịa ụbụrụ. Thebụrụ bụ ahụ ọzọ chọrọ ntinye oxygen, glucose na nri. Inye ọbara nke ezughi oke na akwara anụ ahụ n’oge atherosclerosis nwere ike ibute ọnọdụ ọjọọ dị ka ọnya ọnya - ọnwụ nke akụkụ nke akwara ụbụrụ na mmepe nke mgbaàmà akwara - mkpọnwụ, enweghị mmụọ, ilo mmiri na nsogbu iku ume, gụnyere coma na ọnwụ.

Etu esi ewelata ọnụọgụ atherogenic: ụkpụrụ ọgwụgwọ

Y’oburu na enwewanye uzo nke HDL n’inyocha obara, onu ogugu atherogenic nwekwara ike kari elu. Ya mere, ebumnuche ebumnuche e ji agwọ ọrịa nwere atherogenicity dị elu bụ iji belata mkpokọta nke LP “na-emerụ ahụ” na mkpokọta cholesterol n'ime ọbara site n'ịbawanye HDL “bara uru”.

Enwere ike belata ọnụọgụ atherogenic site na iji usoro izugbe ndị a:

1. Nri Ibelata cholesterol di ogologo. Agba nke mbụ bụ ọgwụ anaghị a alwaysụ ọgwụ mgbe niile, karịchaa, iri nri. Ndị na-agwọ ọrịa na-atụ aro ka a na-amachi ma ọ bụ kpochapụ ihe oriri bara ụba na cholesterol site na nri - anụ na-egbu egbu nke anụ ezi na mutton, mmanu abuba, anụ ezi, sausages na sausages, ude abụba na ngwaahịa mmiri ara ehi ndị ọzọ. Ihe ndị a niile bụ isi iyi nke cholesterol buru ibu ma bụrụ ndị a na-achọghị site na ọnụọgụ nke atherogenicity dị elu. Kama nke ahụ, nri ga -eme ka ahụike abụba asịd na HDL kwesịrị itinye aka na nri ahụ. Ndị a gụnyere: mmanụ nri (ndị dọkịta na-atụ aro ịme salads nke akwukwo nri kwa ụbọchị, na-etinye ha na sunflower ma ọ bụ mmanụ olive), azụ uhie, mkpụrụ.
2. Mgbanwe obibi ndu. Iji belata ọnụego ya, ịkwesịrị ịkwụsị ị smokingụ sịga na ị alcoholụ mmanya. A na-atụ aro ka ị na-agagharị kwa ụbọchị na ikuku dị mma, na -eme ọkụ dị mfe, na-eme egwuregwu ndị dọkịta kwenyere (igwu mmiri, njem, ịga ije, ịnya anyịnya, wdg).
3. Ọgwụgwọ oria concomitant. Drugs drugsụ ọgwụ antihypertensive (nrụgide dị ala) maka ọbara mgbali elu: ụkpụrụ mgbaru ọsọ ndị ọrịa na-arịa ọbara mgbali elu kwesịrị ịdịgide na ọkwa 130-140 / 80 mm Hg. Art. na n'okpuru. Ọzọkwa, ndị ọrịa na-arịa ọrịa shuga mellitus, ndị nwere ụba atherogenicity index, ka egosiri na ha na-eri nri ọ bụghị naanị na mmachi abụba anụmanụ, kamakwa n'ụzọ dị mfe carbohydrates na shuga. Ọtụtụ mgbe a na-enweta ntinye glucose n'ọbara site na ị drugsụ ọgwụ na-ebelata shuga.
4. Ibelata oke ibu oke ibu. Ndụmọdụ banyere ihe oriri.
5. Ọ bụrụ na ọ ga-ekwe omume, wepu ma ọ bụ belata ọnọdụ ndị na-akpata nrụgide n'ụlọ ọrụ na n'ụlọ.

Ọgwụ ịba ụba nke ọkwa nke atherogenicity coefficient mejupụtara ibelata mkpokọta lipoproteins dị ala na ngụkọta nke cholesterol n'ime ọbara, na-ewepu ihe ndị dị ize ndụ pathogenetic maka ịmalite ihe ncheta atherosclerotic. Ọgwụ ndị na -ebelata ọnụọgụ nke atherogenicity gụnyere:

• Statins (Atorvostatin, Rozuvostatin, Simvastatin) bụ ọgwụ kachasị dị irè nke nwere ike belata ọnụọgụ atherogenic. Ha na - eji 30% belata njikọta cholesterol n'ime imeju, belata mkpokọta lipoproteins dị ala, ma na - abawanye elu. Dabere na ọnụ ọgụgụ, iji statins mee ihe maka afọ 5 ma ọ bụ karịa na-ebelata ohere nke ịmalite nsogbu nke atherosclerosis na 40%.
• Fibrates (Ciprofibrate, Fenofibrate) - ìgwè ọgwụ ọzọ iji belata cholesterol na mkpokọta atherogenic. Dị ka statins, fibrates belata ọkwa LDL ma mụbaa ọkwa HDL.
• Ndị na - eme ntụpọ nke bile acid (cholestyramine) - ụzọ ejikọ ọdụdụ abụba na eriri afọ ma gbochie ịmịnye ha ọbara. Ejiri mbụ dị ka ọgwụ ọjọọ maka ịbelata ibu. Edebere oge na mgbakwunye na statins na fibrates, iji mee ka ọrụ ha dị elu.

Kedu onye akwadoro ka belata ọnụọgụ atherogenic

Mbelata nke ngosi a na-abụkarị akụkụ nke usoro ọgwụgwọ mgbagwoju anya nke atherosclerosis. Dịka iwu, ndị ọrịa dị otu a abanyelarị na dibia bekee wee debe ha maka ọrịa obi obi ma ọ bụ encephalopathy diski cholesterol na arịa ụbụrụ. Ha nwere ike kpesa mkpesa ugboro ugboro, mgbu mgbu n'obi, mkpụmkpụ ume, mmegha ahụ, isi ọwụwa, na ebe nchekwa. A, na nyocha nke ndị ọrịa dị otú a, enwere nnukwu mmụba nke cholesterol na nnukwu dyslipidemia.

Ya mere, ọ dị mkpa ị attentiona ntị na mmụba nke ọnụọgụ atherogenic na mmalite nke ọrịa ahụ, mgbe a na-egosipụta ntakịrị ihe ịtụnanya metabolism nke abụba. A na-adụ ndị nwere ezi ahụike na-enweghị mkpesa ọ bụla ka ha nyochaa nyocha nke cholesterol na lipoproteins otu ugboro n'ime afọ 3-5. Ilebara ahụike gị anya na nyocha ọgwụ mgbochi mgbe niile ga-enyere gị aka ijigide ahụike na ịdị ogologo ndụ.

Gịnị bụ atherosclerosis abdominal, ihe mgbaàmà na usoro ọgwụgwọ

Atherosclerosis nke eriri afọ - gịnị ka ọ bụ? Ọrịa a nwere ihe ndị akọwapụtara ma dokwa anya ihe mgbaàmà doro anya na-eme ka o kwe omume ịmata ya n’oge mmalite? Kedu ihe ọghọm dị na ọrịa a?

Tụlee usoro mmepe nke ọrịa ahụ, nke ọgwụgwọ nke ọgwụ ọgbara ọhụrụ na-eji na otu esi ezere, ma ọ bụrụ na ọ bụghị ọrịa ahụ n'onwe ya, mgbe ahụ ọganihu ya.

Atherosclerosis nke eriri afọ na usoro nke mmepe ya

Atherosclerosis bụ ọrịa a na-ahụkarị na ndị nọ n'afọ ndụ dị iche iche n'agbanyeghị agbụrụ na nwoke. Site na mmepe ya, a na-emetụta arịa nke ahụ mmadụ niile. Isi ihe kpatara ya bụ ịba ụba nke cholesterol na ọdịdị nke plasta cholesterol (atherosclerotic) na-emechi oghere nke arịa.

Aorta nwa bụ onye nnọchi anya nnukwu arịa. Ọ bụ ya bụ "nna nna" akwara ndị na - enye aka na akụkụ ahụ niile dị n’ọkpụkpụ ọbara. Atherosclerosis nke eriri afọ bụ ọrịa dị oke njọ, na-eduga n'ọtụtụ nsogbu na-adịghị mma.

Agba nke usoro mgbanwe nke akwara na-adị n'afọ nke nwa bụ ndị a:

• atherosclerosis nke abdominal aorta na-amalite site na nguzobe na idobe oghere nke cholesterol n'ime arịa a,
• ite ejiri nke nta nke nta dochie arịa ahụ, na-emechi oghere ya. N'otu oge, ije ọbara gafere ụdị arịa a siri ike karị,
• N’ihi ya, akwara ndị dị n’ime ahụ dị ala na-amalite ịta ahụhụ n’ihi enweghị nri na oxygen. Ha na-arụ ọrụ na-adabere na ọkọnọ ọbara, nke na-enye nwa na nwa,
• Mgbanwe ischemic na anụ ahụ na-amalite, sclerosis na necrosis na-esochi.

Treatmentgwọ ọrịa a n'oge a na - eme ka ọ kwe omume izere nsogbu ndị sitere na n ’usoro mgbasa ọbara ọgbụgba.Mana insididness nke ọrịa ahụ bụ na nchọpụta oge mbụ dị oke nsogbu n'ihi nhụchaji ma ọ bụ enweghị mgbaàmà zuru oke.

Ọrịa na ihe na-akpata ya

Atherosclerosis nke aorta ga-enwe ihe ịrịba ama nke atherosclerosis n'ozuzu ya, mana n'otu oge ahụ, a na-ejikọta mgbaàmà ahụ na saịtị nke mmebi kachasị. Nke ahụ bụ, olee nke akụkụ ahụ na-emetụta ụkọ oxygen na nri. Akụrụ na eriri afọ bụ ihe kachasị nwee ike ụdị mmetụta ndị a.

N'ihi ya, ihe mgbaàmà ahụ ga-esonyere akụkụ ndị a:

1. Ibu ibu n’enweghi ihe doro anya mere. Ihe oriri na-abụ otu ihe, mana mmadụ na-anyụ oke. Ibu ibu anaghị aga ngwa ngwa, mana nwayọ.
2. Dyspeptik na-eme na mbu nwa oge, wee nwayọ. A na-enwewanye obi ilu, mgbe ụfọdụ enwere obi mgbawa. Na oche bụ ihe gbajiri, ọtụtụ mgbe ọ bụ afọ ọsịsa, obere oge - afọ ntachi.
3. Mgbe e risịrị nri, mgbu nke afọ na-apụta. Ha abụghị ndị iwe, ha na-egbu mgbu, na-emebi emebi na n'oge na-adịghị anya.
4. Ọzọkwa, mgbe e risịrị nri, enwere mmetụta nke afọ ojuju na nnukwu oke dị na afọ, na-abụkarị akụkụ ala.
5. A na-ebelata oke mmamịrị megide mmalite nke mmụba nke urination. Enwere mmetụta nke ezumike ezumike ezughị ezu.
6. Ike ọgwụgwụ, adịghị ike na-enweghị isi ọbụladị na mmalite nke ụbọchị.
7. N'ihi ịxụbiga ahụ mmanya ọkụ mgbe niile, ịbawanye ahụ ọkụ ka enwee ike ịchọpụta ihe ana - ahụ ụzọ.
8. Mkpịsị aka nke mkpịsị aka niile n'ihi ọrụ akwara nwere nsogbu, akụkụ ihu. A na-ekwupụta mgbaàmà ndị a n'ụtụtụ.

Otu ihe kachasị akpata ọrịa ọgbụgba na-adịkarị bụ ndị a:

• Ibu site n'ihe nketa. Ọzọkwa, nke a nwere ike bụrụ naanị ihe ga - eduga na mmepe nke atherosclerosis n'ihi njirimara nke sistem metabolic ma ọ bụ ọgba aghara ha mgbe a mụrụ ha,
• enweghi mmega ahụ n’ihi ọganihu sayensị na teknụzụ na nkọwapụta ọrụ aka,
• mmetụta nke ihe ndị metụtara gburugburu ebe obibi, ọkachasị na nzaghachi nke ahụ,
• mgbe niile na-akpata nsogbu,
• ọrịa shuga mellitus
• ọrịa na-efe efe, mmịnụ nke ahụ,
• ibu oke ibu
• omume ojoo.

Ofdị pathology na ụzọ ọgwụgwọ

Ọrịa ahụ nwere ike ịnwe ogo ogo dị iche.

Banyere ihe ngosi ndị a, enwere ụdị ọrịa:

• Oge akara aka. Ejiri mara ya na enweghi mgbaàmà zuru oke. Ọbụlagodi usoro ịchọpụta ihe dị egwu anaghị egosi na ọnụnọ nke mgbanwe ọrịa na akwara nke afọ. Nanị ihe ngosipụta dị egwu nke ọrịa ahụ bụ cholesterol dị elu na ọnụnọ nke ụmụ irighiri beta-lipoprotein na biochemistry ọbara. Treatgwọ ọrịa ahụ n’oge a dị mfe. Mgbe ụfọdụ ọ bụ naanị usoro mgbochi na ọgwụgwọ ọgwụ cholesterol ka achọrọ.

• Zoro ezo (latent) oge. Onye ọrịa ahụ nwere ike ọ gaghị enwe mmetụta nke ọrịa na-eyi egwu, mana ọmụmụ ihe omumu gosipụtara mgbanwe ọnọdụ nke aorta na-adị. Metabolism mebiri emebi.
• Oge nke ihe ngosiputaghi. Ọtụtụ mgbe, enwere akara ndị a na-ahụkarị nke ischemia, nke nwere mgbagwoju anya na ngosipụta nke ọbara mgbali elu. Na ọkwa a, ọkachamara ahụ ga-enwe ike ịchọpụta ọrịa ahụ ka ọtụtụ usoro nchọpụta gasị. Ọgwụ ọgwụgwọ na-abụkarị nchekwaba.
• Mmepe nke anakpo arterial occlusion (mgbochi). Mgbanwe mgbanwe na-emetụta akwara nke akụkụ ahụ metụtara. Nchọpụta ahụ esighi ike. Ọgwụgwọ na ọkwa a nwere ike ịbụ nchegharị ma ọ bụ nke ịwa ahụ.

Na atherosclerosis nke eriri afọ, a na-eji usoro nchọpụta dị iche iche. Ọgwụgwọ ga-adabere n'ịdị ogo ọrịa ahụ, ọnọdụ izugbe onye ọrịa, ọnụnọ nke ọrịa na-adịghị ala ala na njirimara mmadụ.

Ọgwụ nchekwa na-emetụta usoro ejiri gboo nsogbu a. Edere usoro iji ọgwụ eme ihe, nke ebumnuche ya bụ iwetulata cholesterol n'ime ọbara, melite steeti ọbara arịa, na-ewusi ọgụ. N'okwu nke ọ bụla, a na-edenye ọgwụ iche iche, na-eburu n'uche njirimara onye ọrịa na ụdị ọrịa ya.

Helpchọ enyemaka n'oge ga - enyere aka izere nsogbu ndị dị ka ischemia nke akụkụ ahụ dị n'ime na akụkụ ala, necrosis na fibrosis nke anụ ahụ. N'okwu ndị kachasị njọ, enwere ike ịnwe nsonaazụ.