Atherosclerotic okike mmepe nkebi

1. Mmepe nke atherogenic dyslipoproteinemia, yana ọdịdị nke lipoproteins gbanwee, nke mkpụrụ ndụ endothelial na-ejide ma na-agafere na subendothelial oghere.

2. Mbibi nke endothelium nwere lipoproteins gbanwere ma ọ bụ ihe ndị ọzọ (nje, nje na-alụso ọrịa ọgụ, nsí nje, wdg).

3. Mmụba nke vaskụla permeability na exudation nke plasma mejupụtara, gụnyere lipoproteins na intima.

4. Mgwakọta nke platelet na monocytes na endothelium, Mbugharị nke monocytes n'ime intima, ntụgharị ha gaa na macrophages na-arụ ọrụ na mmepụta nke ọtụtụ cytokines (interleukin -1, ihe na-akpata platelet, ihe na-akpata akwara necrosis), na-eme ka mpụga sel na ịmụba.

5. Mbugharị nke intima na ịmụba nke akwara mkpụrụ ndụ (HMC) n'okpuru mmetụta nke uto platelet nke macrophages, endothelium na HMC n’onwe ha, bụ ndị na-ewere ọgwụ sịntetik (ha na-abụkarị ihe na-agbanwe agbanwe), mejupụta collagen na eriri na-agbanwe, proteinoglycans, ntụgharị. guzobe ntọala nke ncheta atherosclerotic.

6. Ngbanwe mgbanwe nke lipoproteins chiri anya, nguzobe nke ogige na proteoglycans, ijide ha site na macrophages, nke, mgbe ejiri usoro a kpochapu ya na ikpochapu (nke kachasi lysosomes), ma gha abia n’ime fodi ma obu xanthoma (nke sitere na Greek xantos - odo). A na-etolite akụkụ nke mkpụrụ ndụ xanthoma site na HMCs, nke, nwere ndị na-anabata ya maka β-VLDLPs gbanwetụrụ, na-amịchaghị ha.

7. Mgbanwe ndị na-esochi ihe ncheta ahụ bụ njikọta na ike a na-ahụ maka ya, na ntinye nke mkpụrụ ndụ ndị ọzọ (T na B lymphocytes, fibroblasts), necrosis nke akụkụ akụkụ nke ihe ncheta ahụ, sclerosis, hyalinosis, calcification.

Mgbanwe Morphological.

Na atherosclerosis na intima nke aorta na akwara, a gummy, detritus fat-protein (atheré) and focal development of connective tissue (sklerosis) pụtara, nke na - eduga na ịkpụbe ihe nchekasị nke atherosclerotic nke na - ekpu oghere nke arịa. Na-emetụta akwara ndị dị n'ụdị olu na -akpata ihe, i.e. akwara akwara nke nnukwu ihe di omimi, obere akwara umeji na-esite n’azu.

Mgbanwe Macroscopic na-egosipụta ike usoro.

1. Akụ na abụba - ebe edo edo ma ọ bụ edo edo na-acha ọcha (tụrụ), nke ụfọdụ na-ejikọ ma mepụta ibe ya, mana anaghị ebili n’elu nke intima ahụ. Ha na-ebu ụzọ pụta na aorta na akuku ikpeazu na mgbe ọpụpụ nke alaka ya, ma emesịa na nnukwu akwara.

2. Iberibe ite nwere - okirikiri ma ọ bụ nke na-acha ọcha ma ọ bụ nke na-acha odo odo na-agbago n’elu elu nke intima, na-ejikọkarị ma na-enye intima ahụ ihe na-emenye ụjọ, na-esochikwa oghere nke akwara ọbara. Ọtụtụ mgbe, ebe a na -eme akwa n'ime akpa nwa, n'ime akwara obi, ụbụrụ, akụrụ, aka na aka, na akwara akwara. Ọtụtụ mgbe, a na-emetụta akụkụ ahụ nke akwara ọbara nke na-enwe mmetụta metụtara hemodynamic (na-arụ ọrụ) - na mpaghara branching na ịkụda akwara.

3. Nsogbu ọnya.

- ogwe osisi nwere ọnya ọgbụgba (ọnyá afọ),

- obara na otiti nke ihe diiri (hematoma intramural),

- imeju nke thrombotic overlays na saịtị nke ọnya nke ihe ncheta.

Ọrịa ọnya metụtara ya na mmepe nke nkụchi obi (na nke ukwu nke thrombosis), embolism na thrombotic na atheromatous pụta, nguzobe arịa ọzọ na ọnya ọgbụgba, yana ọbara ọgbụgba mgbe arịa ọnya na - eme ya.

4. Calcification (atherocalcinosis) - agba nke ikpeazụ nke atherosclerosis, nke a na-eji ntinye nke sọlfọsị na mbadamba ihe.

A na - ahọpụta usoro nke usoro atherosclerosis morphogenesis:

A naghị eme usoro nke dolipid macroscopically. A na - ahụta mmebi anya (rue mbibi zuru oke) nke endothelium yana mmụba nke intima membranes, nke na - eduga na mkpokọta protin plasma, fibrinogen (fibrin) na akpụkpọ ahụ dị n'ime ya na nguzobe nke ngwugwu parietal thrombi, mkpo nke acid glycosaminogly intura ya lipoproteins nke ukwuu na obere njupụta, cholesterol, protein, mbibi nke na-agbanwe na collagen, proliferation nke mkpụrụ ndụ akwara. Iji mata ọkwa a, ojiji nke anwụrụ thiazine dị mkpa. Iji maa atụ, maka iji agba mmiri ọgwụ toluidine na-acha anụnụ anụnụ (thionine) mee ihe, ị nwere ike lelee nchapụta nke odo odo (ihe mejupụtara metachromasia) na mpaghara mmalite nhazi nke anụ ahụ njikọ. Ihe e ji mara lipoidosis bụ nke nwere ike ịmịkọta akpụkọta nke lipids (cholesterol), lipoproteins, nke na-eduga n'ịmepụta ntụpọ na akwara. Dịka ọ na-adị, oghere ndị dị otú ahụ na-apụta n'ụdị patị edo edo edo nwere ike ịjiko oge ụfọdụ ma mepụta ọnya dị larịị nke na-agbagoghị elu nke mmekọrịta ahụ. Na mpaghara ndị a, mgbe ị na-etinye ntanetị na abụba, dịka ọmụmaatụ, Sudan III, IV, oke uhie O na ndị ọzọ, a na-ahụ lipids n'ụba. Lipids na - aumụkọta akwara mkpụrụ ndụ na akwara sịga, nke a na-akpọ foamy, ma ọ bụ xanthoma, sel (sitere na Grik. Hanthos - edo edo). Ihe nwere ike ịmị mkpụrụ na-apụta na endothelium, nke na-egosi ịba ụba nke intima site na plasma lipids ọbara. Ahụhụ na mbibi nke oghere na-agbanwe agbanwe. Nke mbu, nkpuru osisi na abuba di iche-iche putara na aorta na ebe o ghapuru ngalaba ya, emesia na nnukwu akwara. Ọdịdị nke ntụpọ ndị dị otú ahụ apụtaghị ọnụnọ nke atherosclerosis, ebe ọ bụ na enwere ike ịhụ ọdịdị nke egbugbere anụ ahụ n'oge ọ bụ nwata, ọ bụghị naanị aorta, kamakwa na akwara akwara obi. Na afọ, egbugbere ọnụ egbugbere ọnụ, ihe a na-akpọ ngosipụta nke "akwara ọrịa n'oge mbụ", n'ọtụtụ ihe na - apụ n'anya abụghị isi mmalite nke mgbanwe atherosclerotic. Enwere ike ịchọpụta mgbanwe ndị yiri ya na arịa ọbara na-eto eto na ụfọdụ ọrịa na-efe efe. Na liposclerosis, fibroblasts na-abawanye, uto nke na-akpali mbibi nke nnukwu mkpụrụ ndụ (mkpụrụ ndụ xanthoma) na uto nke anụ ahụ na - ejikọ njikọ n'ime intima. Mgbatị ahụ na-esote anụ ahụ yana njikọta ihe ncheta. Nnukwu ihe, oghere ndị dị na mbara ala dị okirikiri, okirikiri ma ọ bụ nke na-acha ọcha, na-acha ọcha ma ọ bụ nke na-acha ọbara ọbara na-eto n’elu iru mmiri ahụ. Ojiji e ji eme ihe pụrụ iche na-enye ohere ịchọpụta egbugbere ọnụ n'ime paịlị. Iberibe ihe ndị a dị warara, nke na-esite na imebi ọbara (ischemia) n'ahụ ma ọ bụ akụkụ ya. Ọtụtụ mgbe, a na-ahụ ọkwa plasta dị n'ime afọ nwa, na alaka ndị na-esite na aorta, na akwara nke obi, ụbụrụ, akụrụ, akụkụ ala, akwara carotid, wdg. Na atheromatosis, oke akwara dị na etiti akụkụ nke ihe ncheta ahụ na akụkụ ụdọ na eriri na-agbanwe agbanwe. A na-ahụ kristal nke cholesterol na ọdụdụ abụba, iberibe nke elastic na eriri collagen, ụmụ irighiri nke abụba na-anọpụ iche (atheromatous detritus) na-etolite n'ụdị amorphous nke ọma. Achọpụtara ọtụtụ mkpụrụ ndụ xanthoma, lymphocytes na plasmocytes. Atheromatous pụta na-esite na lumen arịa ahụ site na akwa nke tozuru oke, anụ ahụ na - ejikọ aka (mkpuchi ihe). Mgbanwe nke mgbanwe atheromatous na-eduga mbibi nke taya ihe. Egosiputa oge a site na otutu nsogbu di iche iche. Ọyị na - abịa n ’ọnya ọgbụgba, yana ịmalite ọnya afọ atheromatous. Etu ọnụ nke ọnya dị otú ahụ bụ sap, enweghị nhịahụ, akwara na-akpụ ala ahụ, mgbe ụfọdụkwa ogho nke mgbidi. Ọ na-abụkarị ntụpọ thrombotic na-ekpuchi mmebi ahụ. N'ihi ụsọ nke akụkụ miri emi nke mgbidi arịa, ọgbụgba (protrusion nke mgbidi) nwere ike etolite. Otutu mgbe, obara na esi n’etiti etiti n’iru na mgbe ahu itufu ndu ohuru. Ihe egwu nke nsogbu ndị a dị na ọghọm ma ọ bụ iro azụ, ma ọ bụ mgbidi arịa na saịtị nke ọnya atheromatous. Enwere ike ịhapụ mmiri nke Atheromatous site na iyi ọbara wee mepụta emboli. Atherocalcinosis bụ ihe a na-eji icheta nnu sọlfọ n’ime iberibe iberibe, i.e. ha na akpo ha. Nke a bụ ọkwa ikpeazụ nke atherosclerosis. Agbanyeghị, a gharịrị icheta na ị ga-ahụrịrị idozi sọlfọ a ga-ebido n’oge ọ malitere. Ohere dị iche iche ga-achọ njupụta nke mgbidi, mgbidi nke arịa ahụ na ebe mmanụ na-emebi emebi. A na-edobe nnu nnu n'ime anụ ahụ atheromatous, na anụ ahụ fibrous, n'ime ihe dị n'etiti eriri na-agbanwe agbanwe. Clinical N'ezie. Atherosclerosis bụ ọrịa na-ala ala azụ. Ihe eji mara ya bụ mmiri ebili-mmiri, nke na-agụnye mwepụta nke usoro atọ dị mkpa:

- njigide;

Usoro mmụta a na - adịghị agwụ agwụ gụnyere na ịbelata lipidosis na mgbanwe nke ochie - liposclerosis, atheromatosis na atherocalcinosis. N'oge nrụgide nke usoro a, enwere ike idobe mmiri nke lipids site na macrophages.

N'agbanyeghị agbụrụ mgbanwe nke atherosclerotic, a na-amata ìgwè abụọ nke nsogbu: ala ala na oke.

Ọrịa na-adịghị ala ala Ihe ncheta nke Atherosclerotic, na-abanye n'ime oghere nke arịa ahụ, na-eduga na nchikota (stenosis) nke lumen (stenotic atherosclerosis). Ebe o bu na ikpoputa ihe n’ime arịa a bu ihe eji nway oo emechi, ischemia na –adighi ike putara na mpaghara obara obara. Oge na-adịghị ala ala nke akwara mmiri na-esochi hypoxia, dystrophic na mgbanwe atrophic na anụ ahụ na ịbawanye uru nke akwara. Ikewapụ akwara vaskụla n’arụ ahụ na-eduga n’inwe obere nlele imeju.

Ọrịa siri ike. Ọ bụ ihe kpatara ọbara ọgbụgba, emboli, spasm nke arịa ọbara. Nnukwu akwara vaskụla na - eme, ya na ụkọ akwara nke akwara (isi ischemia), nke na - eduga n'ọzụ nke nkụchi obi (dịka ọmụmaatụ, infarction myocardial, isi awọ nke ụbụrụ, ụbụrụ gangrene, wdg). Mgbe ụfọdụ, mgbazinye arịa arịa na - egbu egbu nwere ike ịhụta.

Usoro nke Pathogenetic nke e guzobere iche

Nchikota nke hyperlipidemia na mmebi akwara na-eduga n'ịmepụta kọlọji cholesterol na protein, na mbufe ha n’etiti akwara akwara.

A na-ejide Lipids site na macrophages, nke na-agbanye mkpụrụ ndụ xanthomatous, na-abawanye ụba na nha.

Mkpụrụ ndụ ndị a na-emepụta ihe na itughari maka sel ọcha na platelet. Mgbakwunye Platelet na nchịkọta, ihe nke thrombotic na-ahapụ.

Ihe ncheta na-eto ngwa ngwa, na-egbochi oghere nke arịa ahụ n'ihi nguzobe akwara anụ ahụ na taya ya.

Ọzọkwa, n'okpuru ihe ndị na-akpata uto, a na-achịkwa capliles maka inye ọbara ka ọtụtụ n'ime ndị na-ekwenye ekwenye. Agba nke ikpeazụ nke mmepe bụ negirosisi nke ebe ihe ncheta, akwara na -akasị ya na olu ala.

A na-eji mgbanwe ọrịa Morphological na nmeghari atherosclerosis site na mgbasa nke ọrịa, site na obere ruo na nke siri ike.

Oge mbu nke mmepe nke atherosclerosis bụ dolipid, enweghị mgbanwe ọ bụla akọwapụtara. Ejiri ya na mmụba na ngwangwa nke akwara, na-emebi iguzosi ike n’ezi ihe ya - na-ele anya ma ọ bụ mkpokọta, ịsụsọ akụkụ mmiri dị n'ime oghere subendothelial.

Ọkpụkpụ Mucoid, mkpo nke fibrin na fibrinogen, protein ndị ọzọ dị na plasma, obere lipoproteins na cholesterol dị ala.

Iji chọpụta usoro a, o zuru ezu iji nyocha nke akụkọ ihe mere eme nke nkwonkwo akwara olu wee jiri ntutu na-acha anụnụ anụnụ - nke thachine na-acha anụnụ anụnụ, nke enwere ihe mejupụtara metachromasia na mmachi nke mpaghara emetụtara na-acha odo odo.

A na-egosipụta ọkwa nke abụọ - lipoidosis - inyefe cholesterol na lipoproteins n'ụdị abụba dị iche iche na agba odo na-enweghị ebili karịa ọkwa nke endothelium.

Enwere ike ịhụ mgbanwe ndị dị otú ahụ na nhazi nke akwara ọbara ọbụna na ụmụaka na ndị nọ n'oge uto, ọ bụchaghị na-enwe ọganihu n'ọdịnihu. A na-edebe Lipids n'okpuru intima n'ime macrophages, ma ọ bụ sel ụfụfụ, yana sel akwara dị mma nke akwara ọbara. Ọ ga-ekwe omume ịchọpụta usoro a site na ịkọ akụkọ, Sudan na-ebu mmanụ 4, 5, oke uhie O.

Nyere na atherosclerosis bụ ọrịa na-eji nwayọ nwayọ, ọkwa a nwere ike ịdị ogologo oge ma ghara ibute mgbaàmà dị egwu.

Nnukwu arịa, dị ka aorta, akwara akwara akwara, arịa nke ụbụrụ, akụrụ, na imeju, na-aga mgbanwe mbụ.

Ntughari nke usoro a dabere na njirimara nke hemodynamics na saịtị nke bifurcation nke arịa, dị ka aortic bifurcation n'ime akwara iliac.

Agba nke atọ nke mmepe nke ihe ncheta atherosclerotic bụ liposclerosis - ịdọpụta eriri na kọlọkọ na endothelium, mmụba nke fibroblasts, mwepu nke ihe na eto na mmepe nke ihe jikọrọ anụ ahụ.

Atherosclerosis Age Factor

A maara ihe ize ndụ nke atherosclerosis na-abawanye na afọ. Maka ụmụ nwoke, nke a karịrị afọ 40, maka ụmụ nwanyị - afọ 50-55. N'oge ị dị obere, phospholipids ndị nwere ike iji nke ọma, mucopolysaccharid acid (karịsịa hyaluronic acid), scleroproteins (collagen) dị na mgbidi arịa ahụ na nnukwu ọnụọgụ.

Ihe ndị a niile na-arụ ọrụ na metabolism, nke na-enye mgbidi vaskụla na elasticity na ikike ịza ngwa ngwa maka mgbanwe dị iche iche. Na afọ, ọnụ ọgụgụ nke phospholipids na-ebelata, n'etiti acid mucopolysaccharides, ọnụ ọgụgụ chondroitine sulfates na-abawanye, nke na-eme ka ndagide nke mgbidi arịa ahụ.

Na etiti etiti, ihe chromotropic nke ọdịdị mucoid na-agbakọ, ọnụ ọgụgụ scleroproteins na-abawanye. Collagen eweputaghi nke oma. Nzube nke endothelium ka mmetụta arụmọrụ na-abawanye, a na-ahụ mgbasawanye nke subendothelial oyi akwa.

N'ime oghere nke arịa ahụ, akwara akwara pụrụ iche na-apụta, nke ọnọdụ ọnọdụ myofibrils nọ na mpụta nke cytoplasm. N'ime mkpụrụ ndụ ndị dị otú a, ogige protein na-agbakọ.

Na mgbakwunye, mgbanwe na profaịlụ akwara ọbara (dyslipidemia), nke a na-ahụta dị ka ihe nwere ike ibute ọrịa ọzọ, na-amalite ịmalite ịkarị oge karịa.

Agbanyeghị, afọ afọ na mgbanwe metụtara ya na sistemu na arụ ọrụ nke mgbidi akwara, yana mgbanwe na mpaghara akwara ọbara, enweghị ike ịtụle isi ihe etiological nke atherosclerosis. Naanị ha na-egbochi ihe gbasara mmepe ya.

Akpachapụ anya ketara eketa

Ihe nketa nwere ike imetụta mmepe nke atherosclerosis n'ihi mgbanwe nke mkpụrụ ndụ ihe nketa na ọrụ nke ọtụtụ sistemụ enzyme. Karịsịa, nke a gosipụtara site na nnwale nke ha nwara ibute ụmụ anụmanụ atherosclerosis site na inye ha nnukwu kọlestrọl.

Na oke, usoro a na - eto eto anaghị etolite, n'ihiọrụ enzymatic nke mgbidi nke arịa dị n'ime ha dị oke elu. Na oke bekee, na ntụle, enwere otutu ngwa ngwa cholesterol na mgbidi akwara. Agbanyeghị, ekwesịrị ime ya ebe a na nke a anyị anaghị ekwu maka atherosclerosis, kama ọ bụ naanị imebi metabolism, na-eduga n'inwe oke cholesterol.

A na - egosipụtakwa ụdị ihe ketara eketa nke atherosclerosis site na ịdị adị nke ọrịa dịka hypercholesterolemia dị mkpa (familial xanthomatosis), nke enwere nkwarụ sitere na mkpụrụ ndụ ihe ọmụmụ enzyme na - ahụ maka cholesterol metabolism. N'okwu a, ọtụtụ ndị otu ezinụlọ, na-amalite site na nwata, na-etolite nnukwu ọrịa atherosclerosis ngwa ngwa.

N'ime ihe ndị a pụrụ izere, ị tobaccoụ sịga (ihe ọ nụ nụ nicotine) kwesịrị ka etinye ya n'ọnọdụ mbụ. Yabụ, ọbụlagodi na iji ọgwụ nicotine dị ala (ihe ruru sịga 15 kwa ụbọchị), ihe ọghọm nke mmebi vaskụla atherosclerotic na-abawanye elu.

Hypodynamia

Emega ahụ ezughị ezu, nke ghọrọ otu n'ime nsogbu kachasị njọ nke mmadụ. N'ime ụwa nke ọgbara ọhụrụ, ọ na - eme dị ka ihe dị iche nke ihe na - akpata atherosclerosis. Enweghi ike nke mmega ahụ gụnyere mgbanwe na metabolism, gụnyere metabolism lipid, nke na-arụ ọrụ dị mkpa na pathogenesis nke ọrịa a.

Ibu oke ibu na oke ibu

Ọtụtụ nyocha nke ụlọ ọgwụ na-egosi na atherosclerosis "eji ụkwụ na-ebute oke na oke." E gosipụtara mmekọrịta nke ọnọdụ abụọ a site na nkwupụta na-esonụ: atherosclerosis nwere ike ịmalite na-enweghị oke ibu, mana enweghi oke ibu na-enweghị atherosclerosis. Site na oke ibu, ọkwa nke triacylglycerides n'ime ọbara na-ebilikarị.

Mgbanwe ndị ọzọ na ụdịdị ọbara na-apụta, na-eso akpata mmepe nke atherosclerosis. Agbanyeghị, ekwesịrị ịmara na oke ibu na oke ibu na-eduga mgbanwe ndị yiri ya na metabolism naanị mgbe ọ gachara afọ ụfọdụ.

Ọrịa endocrine

Dysfunction nke gia endocrine nwere nnukwu mmetụta na pathogenesis nke usoro atherosclerotic. Yabụ, na ọrịa shuga, atherosclerosis na-amalite n’ihu ike. Nke a bụ n'ihi, kachasị, na eziokwu ahụ bụ na ụkọ insulin na-eduga n'ịba ụba nke cholesterol endogenous.

Ọrụ dị mkpa na mmepe nke atherosclerosis na-ejikwa hypothyroidism. A maara homonụ thyroid na-abawanye ọrụ lipolysis. Site na ụkọ homonụ ndị a, mgbochi nke lipolysis nwere ike ime, nke ga-eduga mmebi nke metabolism lipid n’ozuzu ya, n’ihi nke a, mmepe nke dyslipidemia.

Enwere ike ibute ọrịa metabolism abụba site na nsị nke akụkụ endocrine ndị ọzọ: glandia gland, gital Genital, wdg.

Ọrịa Neurogenic (nrụgide mmetụta uche)

Na mmepe nke atherosclerosis, ihe a na-arụ ọrụ dị oke mkpa. Atherosclerosis bụ ihe ziri ezi ugbu a n'usoro usoro a na-akpọ ọrịa nke mmepeanya - otu ụdị ọrịa nwere ọnọdụ gbasaa gbasaa na ụwa na narị afọ nke 20. na mmalite nke narị afọ nke XXI. na esonyere mmụba na ije ndụ, na-eduga na oge nke nrụgide psychoemotional.

Dabere na ọnụ ọgụgụ sitere na Healthtù Ahụ Ike inwa, na mba ndị nwere oke ọrụ mmepụta, atherosclerosis na-akpata ọnwụ ọtụtụ ugboro karịa mba ndị nwere akụ na ụba na-emepe emepe. Nke a bụ n'ihi eziokwu ahụ bụ na, site na azụmazụ ọganihu nke sayensị na teknụzụ, ibu dị na sistemụ ụjọ na-atụ mmadụ na-arụ ọrụ na ngalaba dị iche iche bara uru na-abawanye ụba.

Ọtụtụ nnwale na nyocha ụlọ ọgwụ na-akwado ọrụ cortical neurosis na mmalite na mmepe na - esote usoro atherosclerotic.

Achọpụtakwara na atherosclerosis bụ ihe a na-ahụkarị n'etiti ndị bi n'obodo ukwu karịa ndị bi n'ime ime obodo, yana n'etiti ndị na-arụ ọrụ ọrụ uche karịa anụ ahụ.

Otu usoro nke nsogbu nke neurogenic na-emetụta ọnọdụ nke mgbidi vaskụla bụ mmebi nke trophism nke mgbidi vaskụla, na-esite na ogologo oge neurogenic spasm nke vasa vasorum - obere arịa ndị na-ebute mgbidi akwara. Enwere ike ịkwalite usoro a site na ikpughe oke catecholamines, nke a na-ahụkarị maka ọnọdụ ndị na-akpata nrụgide. N'ihi mmetụta ndị a, a na-akụghasị usoro ọrụ metabolic na mgbidi vaskụla, nke na-ekepụta usoro maka mmepe nke usoro atherosclerotic.

Banyere ihe ndị dị ize ndụ dị ka ọbara mgbali elu, dyslipidemia, postmenopausal estrogen erughi na homocyteinemia, ha na - ekere òkè kpọmkwem na pathogenesis nke atherosclerosis, ya mere a ga - atụle ya na ngalaba na - esote.

Usoro eji ebu amụma

Dika echiche nke ugbua, mmepe nke atherosclerosis bu n'ihi nchikota nke uzo abuo abuo na-enye aka na nmeghari nke metabolism nke oma nke lipids na protein n’ime akwara akwara:

• mgbanwe (mmebi) nke mgbidi ụlọ na mbufụt ogologo oge na-esochi,

• dyslipidemia - mgbanwe na profaịlụ nke ọbara.

Mgbanwe

Mgbanwe mgbidi mgbidi nwere ike ịrụpụta ihe ndị a:

• ọbara mgbali ikena nke a na saịtị bifurcation artery mgbidi na-enwe nsogbu ube na-adịghị ala ala, n'ihi nke nkụcha mmụọ na-eme mgbe niile,

• ise sigana-enye aka na vasospasm, nchịkọta platelet, yana mmụba nke cytokines na-akwado mbufụt,

• ndị na-efe efedị ka Chlamydia Pneumoniae na Cytomegalovirus, nke ezinụlọ Herpesviridae, ụmụ nje ndị a nwere ike inwe mmetụta cytopathic kpọmkwem, yana ịkwalite nchịkọta platelet na ịmalite nzaghachi ọrịa na-akpata mbibi endothelial,

• hycysteinemia (mmụba nke amino acid homocysteine ​​n'ime ọbara) bụ ihe na - enye aka na ịkpụpụta oke ikuku oxygen, nke na - emebi mgbidi vaskụla, na mgbakwunye, homocysteine ​​na - eme ka ọ bụrụ ihe na - adịghị mma nke lipoproteins dị ala na mmụba nke uru akwara vaskụla. Iji nọgide na-enwe sel nke homocysteine ​​n'ime ọbara, a chọrọ vitamin Bg, B12 na folic acid, ndị na-etinye aka na itinye n'ọrụ nke amino acid a. A na-ahụta mbibi nke endothelium nke akwara ndị dị ugbu a dị ka ihe na-akpata mmepe nke atherosclerosis.

Dyslipidemia

Dyslipidemia bụ mgbanwe nke profaịlụ akwara ọbara, nke e ji mmụba nke cholesterol, njupụta nke lipoproteins dị ala (VLDL) dị ala, yana mbelata nke nnukwu lipoproteins dị elu (HDL). Cholesterol na metabolites ndị ọzọ na-egbu mmiri, ebe ha bụ ihe ndị nwere hydrophobic, ka enwere ike ibuga ya na ọbara naanị ma ọ bụrụ na etolite usoro ụgbọ njem pụrụ iche - lipoproteins, nke nwere protein n'ụdị ha na-enye solubility mmiri.

Enwere ụdị lipoproteins dị iche iche:

• LDL - bute cholesterol site na umeji gaa na akwara na mgbidi vaskụla,

• VLDL - na - ebugharị triglycerides, phospholipids na cholesterol site na imeju gaa na akwara, nwere cholesterol dị ala karịa LDL,

• APVP - bute cholesterol site na mgbidi nke arịa ọbara na anụ ahụ na imeju.

Mgbe ị na-atụle pathogenesis nke atherosclerosis, a na-ekekarị lipoproteins n'ime otu abụọ: atherogenic, i.e., na-enye aka na mmepe nke atherosclerosis (LDL na, ruo obere obere, VLDL) na mgbochi heterogenous (HDL).

Agbanyeghị, ekwesịrị iburu n'uche na lipoproteins na-egosipụta akụrụngwa atherogenic / mgbochi atherogenic mgbe ọkwa ha dị n'ọbara gbanwere na, nke kachasị, bụ naanị megide ndabere nke mgbanwe na usoro mkpali na mgbidi akwara.

N'ime usoro ọgwụgwọ, ndepụta kachasị enweta na-egosipụta steeti profaịlụ akwara dị larịị nke kọlestrọl ọnụ. Nọmalị, ọ bụ 3.9-5.2 mmol / L. Ndị ọrịa nwere mkpokọta cholesterol nke 5.2-6.76 mmol / L bụ “otu ihe ọghọm dị obere” maka mmepe nke atherosclerosis, hypercholesterolemia (karịa 6.76 mmol / L) na-egosi nnukwu ihe egwu.

Estrogens nwere mmetụta dị ka ihe ana - eme n’ime ntupo estrogen-phospho-lycetin, na - egbochi mmepe nke dyslipidemia n’ime ụmụ nwanyị na - amụ nwa. N'ime ụmụ nwanyị postmenopausal na ụmụ nwoke, usoro nchekwa a adịghị.

Usoro nke mmebi vaskụla atherosclerotic

Nke mbu, ekwesiri iburu n'uche na ibu cholesterol na mgbidi vaskụla na phagocytosis nke oke ya site na macrophages bụ usoro nkịtị. Agbanyeghị, n'ọnọdụ nkịtị, macrophages na-ejide obere cholesterol ma hapụzie akwara akwara.

Site na mmepe nke atherosclerosis, LDL na-ata ahụhụ peroxidation site na ntinye nke ụdị oxygen na-emegharị, na-agbanwe n'ime LDL 'gbanwetụrụ', nke nwere ike imubanye na nnukwu macrophages. N'ihi ya, a na-etolite mkpụrụ ndụ ụfụfụ. Nke ọzọ, mkpụrụ ndụ ụfụfụ na-emebi. N'ọnọdụ a, akụrụngba nke protein na-esite na ha na-agbakọ na subendothelial oyi akwa nke akwara. A na edobere Lipids n’ime sel (macrophages na sel muscle dị mma) yana oghere dị n’etiti oghere.

N'aka nke ozo, macrophages na - arụ ọrụ na sel ndị mejupụtara mgbidi vaskụla na - ezobe ihe ndị na - akpali mkpagharị akwara sel ahụ dị mma n'ime intima.

Macrophages ndị na-arụ ọrụ na-egbochikwa cytokines na-akwalite Mbugharị nke mkpụrụ ndụ T na monocytes n’ime intima, ma na-akpali imepụta ihe ndị na-akpata uto (na-eme ka mkpụrụ ndụ akwara dị mma) yana njikọ nke ụdị oxygen na-eme ka ọ dị mma (oxidize LDL). Mkpụrụ ndụ akwara dị nro na-ebuwanye ibu ma na-emepụta ụyọkọ pọlo, nke na-etolite ntọala nke njiri anụ ahụ dị na atherosclerotic.

Ozo Atherosclerosis

1. Dolipid ogbo. Ejiri mara ya na mgbanwe na mbufụt n'ime mgbidi akwara na mmepe nke dyslipidemia. Agbanyeghị, enweghị akara mkpụrụ ndụ anya a na-ahụ anya nke atherosclerosis.

2. Lipoidosis. Na intima, edobere protein protein, sclerotic usoro amalite.

3. Liposclerosis. E guzobere ihe ncheta atherosclerotic: mkpo nke oke nwere protein na-aga n'ihu na imepụta oge nke anụ ahụ njikọ.

4. Atheromatosis. N'oge a, ihe ncheta bụ akwa ihe jikọrọ anụ ahụ jupụtara na detritus, nke bụ ngwaahịa mebiri emebi nke lipids na protein.

5. Atherocalcinosis. A na-etinye salsị nnu n'ime ihe ncheta.

6. Atherosclerosis. Iberibe ihe erimeri na-adị ezigbo mkpa, ihe e dere ede na-egbu mara, ihe ndị dị n’ime ya na-abanye n’ọbara.

Nsonaazụ Atherosclerosis

1. Stenosis nke akwara ozi.

2. Mwepu ma ọ bụ ntiwa nke ọrịa anherosclerotic, na-ekepụta ọnọdụ maka mmepe nke thrombosis (usoro a na - ahụkarị maka ọria infarction na - adịghị ala ala).

3. Mbelata ike nke akwara vaskụla, nke na-ebute mmepe nke ọrịa ọgbụgba na ihe ọghọm nke imebi ha na-esote.

4. Nbibi nke ihe ncheta nke atherosclerotic, ya na nkewa nke obere iberibe, nke, si otú a, gbanwee ghọọ emboli. A na-agafere nke ikpeazụ nke na-agba ọbara na obere akwara, ma na-egbochi ha, na-akpata ischemia anụ ahụ.

Ọrụ nke atherosclerosis na pathology nke usoro akwara obi

Na atherosclerosis, akwara ndị a na - ebutekarị nsogbu (egosipụtara n'ibelata ugboro ole):

• akwara ozi na akwara ozi,

• akwara carotid akwara,

• akwara ụbụrụ (karịsịa okirikiri nke Willis).

Atherosclerosis bụ ihe na - akpatakarị ọrịa ndị na - esote:

• nnukwu myocardial infarction (na 95% nke ikpe),

• nnukwu ihe ọria ụbụrụ (infarction ụbụrụ),

• oghere akwara na -

• egbe nke mpaghara ala,

Paragraf anọ ndị mbụ na-egosi ọnọdụ ebe atherosclerosis bụ ihe kpatara mpaghara mgbidi nke arịa arịa, na-ebute mbelata na lumen ha, n'ihi ya, pat patrol, nke na-eduga na mmepe nke ischemia. Usoro ozo nke ischemia jikọtara na eziokwu na atherosclerosis na-ebute mmalite nke ọgbụgba ọbara.

Usoro nke ihe okike

Ihe ndị mejupụtara ihe ncheta ahụ bụ anụ ahụ na-egbu egbu na lipids, nke kachasị cholesterol. Usoro ncheta echichi nwere ọtụtụ usoro. N'ihi ọnọdụ ụfọdụ, dịka ọmụmaatụ, microdamage na mgbidi arịa ahụ, a na-emepụta ọnọdụ maka lipids iji banye n'ime mmiri ahụ. N'ebe a, enwere mkpokọta lipoproteins dị ntakịrị nke cholesterol buru ibu. Ekwenyere na ka mkpụrụedemede dị ala wee bụrụ atherogenic, ha ga-enwerịrị peroxidation. Ngbanwe dị otú ahụ nwere ike imebi njikọ ha na mkpụrụ ndụ ma bute iwe nke monocytes. A na-ejide Lipids site na monocytes, gafere na ogbo nke macrophages ma ghọọ mkpụrụ ndụ ụfụfụ. Site na ihe ochie, nka gosiputara site n’ile anya ndi nwere abuba. Ọzọkwa, ka mgbanwe nke atherosclerotic na-aga n'ihu na ebe a na-etinye lipid, uto nke anụ ahụ na - ejikọta ya na nguzobe nke ihe ọkụkụ na - eme.

Ihe ncheta bu ihe eji aru aru, ya na akwara eji aru ike, n’ime ya bu akwara ubara na kristal cholesterol. Ihe e ji mara atheromatosis bụ mmebi emebi nke eriri anụ ahụ, akwara akwara na lipids. N'ebe a na-emebi emebi ahụ, a na-eme oghere ebe enwere protein-abụba dị. Mkpụrụ ahụ na - ejikọ ha na oghere nke arịa.

Nsogbu ndị sitere na nrịba nke atherosclerosis na mgbapu ihe ncheta

Atherosclerotic ọnya nke ọbara arịa nke obi (akwara akwara akwara) na-eduga mmepe nke ọrịa obi. Atherosclerosis nke akwara ndị ụbụrụ nwere ike ibute ọrịa strok, na mmebi nke mesheyerical artery na-agbagha site na ischemia eriri afọ (mesenteric thrombosis). Nsogbu ndị siri ike na-apụta mgbe ọrịa ihe ncheta bilitere na nkwarụ ya ma banye na oke ihe atheromatous banye n'ime oghere nke arịa ahụ, nke na-eme ka akpọnwụ tolite.

Nsogbu dị egwu n'ihi ọnya ọgbụgbọ na akwara anụ ahụ bụ ihe mere ọgbụgba ahụ na - emetụta ihe ọgbụgba ahụ. Aortic aneurysm bụ ndọtị akụkụ nke aorta, nke kpatara mgbanwe na mpaghara anụ ahụ na - ejikọta. Ogbugbu nke aorta na saịtị nke aneurysm ma ọ bụ thrombosis ya na - edugakarị ọnwụ nke onye ọrịa.

Oge ọgwụgwọ ahụike oge maka metabolism lipa na-enyere aka belata mmepe nke atherosclerosis, zere nnukwu nsogbu ma melite ogo ndụ.

Mmalite nke usoro atherosclerotic

A na-ezo aka na mbido mbụ nke atherosclerosis na akwụkwọ a dịka oge (asymptomatic) oge. N'oge a, usoro metabolic na-agbagha - mmụba nke cholesterol, mmebi nke cholesterol na phospholipids. Ha bụ ihe kachasị akpata mmepe nke atherosclerosis. Oge nsogbu dị otú a nwere ike ịbụ ihe akwụghị ọtọ ma na-agbanwe ya na ugboro ugboro. Na ọkwa a, ọnweghị ọnya anụ ahụ dị na arịa ndị ahụ, etolite ihe ncheta ahụbebeghị, ihe mgbazinye ọrịa pathognomonic egosighi. Na ọkwa a, ọ ga-ekwe omume ịchọpụta ndọpụ iche na ngosipụta nke usoro metabolic naanị site na nyocha ụlọ nyocha pụrụ iche.

Oge mmebi nke vaskụla

Ihe eji mara atherosclerosis site na mgbanwe nke nje na mgbidi akwara ndị ahụ. A na-ahụ usoro nke soki nke mmepe nke atherosclerosis:

Lipid stains - Nke a bụ ọkwa izizi nke ọrịa, nke a bụ ngwụcha nke mgbidi arịa arịa nwere oke olu. Usoro dị otú a dị n'ime impregnation dị n'akụkụ akụkụ dị iche iche nke mgbidi mgbidi. Ọpụpụ, mpaghara ndị dị ka mpempe na-acha odo odo na-acha ogologo oge ụgbọ ahụ. Ọrịa na ọrịa ndị ọzọ a na-ahụ anya anaghị anọ. Pathofọdụ usoro ọrịa na ọrịa, dịka ọmụmaatụ, ọrịa shuga (ọrịa shuga mellitus), ọbara mgbali elu, oke ibu, nwere ike ime ka e nwee ike ịmalite ihie ụzọ.

Guzobe ihe ncheta nke fibrous - ogbo nke ọrịa ahụ, ebe akụkụ ahụ akọwapụtara nke arịa ụgbọ mmiri (ntụpọ egbugbere ọnụ) na-amalite ịmị ọkụ. Usoro ahụ ji alụso ọrịa ọgụ na-azaghachi na usoro dị otú ahụ ma na-ahapụ ndị mgbasa ozi mbufụt na ntiwapụ. Mmeghachi omume dị ogologo dị otú a na-eduga ná mmebi nke abụba a gwakọtara na mgbidi (necrosis ha pụtara), ebe saịtị nke sclerosis na - ebido - anụ ahụ na - ejikọta. N'ihi nke a, ịkpụzi ihe ọgbụgba na-eme ka mmiri banye n'ime oghere nke arịa ahụ, n'eziokwu, na-ekpebi ogo stenosis na ọbara ọgbụgba na-arịa.

Mgbagide ncheta ekike - agba ikpeazụ nke ọrịa ahụ, nke nsogbu na-esite na usoro ndị a na-eche na plasta. Ihe ngosi a bu ihe ngosi nke oria.

Ọnọdụ nke mmepe nke atherosclerosis na ọkwa cellular

Iji chọpụta mgbanwe ndị dị na mkpụrụ ndụ akwara ahụ, a na-achọpụta ihe akụkọ ihe mere eme na mpempe arịa ndị emetụtara. Dabere na ha, ha na-egosipụta ọdịiche:

1. Dolipid - ụba permeability nke vaskụla mgbidi na ya n'ihu ọzịza. Ọkpụkpụ ọbara, ụmụ irighiri ihe na polysaccharides bụ ọnya nke ọbara. Ọrịa metabolic na-eme.
2. Lipoid. Mgbanwe Metabolic siri ike, a na-ahụ mpempe abụba na-acha odo odo. N'ebe ndị a, akụrụngwa cholesterol na sel ụfụfụ jupụtara. A na-egosipụta Atherosclerosis nke ogbo nke lipoidosis site na mgbaze nke otu akụkụ nke arịa nwere mkpụrụ ndụ xanthoma.
3. Liposclerosis - na ebe nke infiltration, mkpali Filiks ọganihu, nke na-esonyere ifịk ifịk germination nke connective eriri na mgbidi akwara. N’akụkụ ọnụ ụzọ ahụ, a na-akpụbe obere arịa nke na-enye ihe ncheta ahụ abụba na protein.
4. Atheromatosis. N'oge a, e bibiri plasta cholesterol site na akụkụ ya etiti rue mpụta. Na mpaghara ire ere, a ga-ahụ nke ọma na a na-ahụ kristal cholestals na ogige. Ihe mejupụtara ihe ncheta ahụ bụ ụmụ irighiri abụba tojuru etoju, sel nke xanthoma gbara anụ ahụ jikọrọ ọnụ. Na ara - hematoma.
5. Udiri ogbo. N’ime usoro a nke atherosclerosis, a na-egbu ihe ncheta ma ihe ndị dị n’ime ya banye n’ọbara. Enwere nzere na oyi akwa nke akwara dị mma nke mgbidi vaskụla, ọ nwere ọdịdị na-ezighi ezi. A na-eziga platelet na ihe ndị ọzọ nke sisọmu ọbara ọbara na ntụpọ nke pụtara. Ha na-amalite usoro nke thrombosis nke parietal.
6. Atherocalcinosis. N'ime ihe owuwu nke thrombus guzobere, sọlfọ salts na-agbasa ma na-ebute echiche a na atherosclerosis. Kpụkọta akpụkọ amalitela na ụdi akụkụ nke mgbidi a na-esote, na-ebute akwara na nsogbu okirikiri.

Otu nsogbu nke ọrịa ahụ bụ atherosclerosis obliterans nke ala akụkụ (OASNK). Site na ọrịa vaskụla a, enwere mmebi nke ọbara na-erughị ala. E nwere ụzọ anọ, dabere na mgbaàmà nke atherosclerosis. N’agba nke mbụ, a na-ahụ ihe mgbu n’akpụ ụkwụ naanị n’ọkpụkpụ anụ ahụ. Na ọkwa nke abụọ nke ngaghari nke ọrịa - mgbe ị na-agagharị narị mita abụọ, na ọkwa nke atọ - ruru narị mita abụọ. Ọ dị mkpa icheta ọkwa nke ihe mgbu sithe na-egosipụta ihe mgbu na izu ike - nke anọ. Ha na-adigide na uwa ma na-ebute ya site na usoro ọnya anụ ahụ na akwara nke akwara vaskụla na usoro nke atherosclerosis.

Ọnọdụ dabere na lesion lekwasịrị anya

N'ịkọwapụta ọrịa ọ bụla, a na-amata usoro nke mmepe nke atherosclerosis. Ugbu a, anyị ga-atụle atụmatụ na ọdịiche anyị na atherosclerosis vaskụla maka ngalaba ọ bụla nke usoro akwara obi.

The aorta bụ arịa nke nnukwu caliber, nwere ọtụtụ ngalaba ma na-enye ọbara n'ihe fọrọ nke nta ka ọ bụrụ akụkụ niile dị mkpa nke ahụ mmadụ. Usoro atherosclerotic na-aka nke afọkarị nwa karịa na thoracic. Site na ọnọdụ a ka elekwasị anya, nhazi ọkwa dị ka ndị a:

1. Nke mbu. Ihe eji mara ya bụ cholesterol, nke na-agbakọ n'ime intima ma jiri nwayọ na-etolite ọnya anụ ahụ. Oge ọnya a achịchaghị oke ma ọ dabere na oke iwe nke ihe ndị dị ize ndụ maka atherosclerosis.
2. Nke abụọ bụ fibrosis. E guzobere ihe ncheta atherosclerotic n'ihi uto nke anụ ahụ njikọta na gburugburu ọgbụgba akwara.
3. Nke ato bu atherocalcinosis. Na ebe, ọnya ahụ nke sitere na thrombotic a na-ahapụ ma ọ bụrụ na a na-eme ka nnu sọlfọ na-atụgharị uche, n'ihi nke mgbidi vaskụla na-agbasa n'ime lumen ma na-ebute nbibi ya - stenosis.

Egwuregwu arịa

Atherosclerosis na-arịa arịa na-enye ụbụrụ nri. Na ọnụnọ nke ọtụtụ mpaghara mmepe nke ọrịa, a na-achọpụta otutu ọrịa atherosclerosis. Usoro nke mmepe nke ụdị nke atherosclerosis bụ ndị a:

1. Nmalite - gosipụtara site na nkwarụ ncheta, nsogbu ehighị ụra, ọgbụgbọ. Ahụ ọnya anụ ahụ dị obere.
2. Mkpokọta - otu ihe mgbaàmà ahụ dị na ogbo nke mbụ, mana ogo ha siri ike karịa. Ọzọkwa, ọnọdụ mgbanwe na-apụta, arụmọrụ ya na-ada. Ihe nrochi ahu n’ime uko siri ike.
3. Decompensatory - ọgbụgba ahụ na - agbanwe agbanwe, dementia na - etolite, ọrụ ọgụgụ isi belata, mgbali na - ebelata, ọkwa ọgụgụ isi na - agbada.

Akwụkwọ nke ala akụkụ ala

Site n'ịkọwa usoro dị n'ụkwụ ụkwụ, ikpochapụ atherosclerosis nke arịa nke ala ala akụkụ ahụ. Ngwọta ọhụụ, a na-atụpụta nhazi ọkwa nke mmepe ya:

1. Nmalite. Ihe mgbu na mpaghara ikpere ala naanị nwere nnukwu ahụ ike.
2. Oge etiti. Mgbu na - aputa mgbe ị na - agabiga narị abụọ
3. Di nkpa Ije ije ihe karịrị mitị iri ise na-aga n'ihi ihe mgbu na-egbochi ya.
4. Mgbagha ogbo. Nnukwu ọgbụgba, neetị ụkwụ, n'ihi na nke enweghị ike ịzọ ụkwụ ukwu.

Ọkpụkpụ akwara obi nke obi

Ọkpụkpụ akwara (ha na akwara akwara) akwara na - enye obara n'ime obi nye onwe ya. N'adịghị ka ụdị na mpaghara ndị ọzọ, mmeri ha na-eme ngwa ngwa. Enwere ụzọ ihe atọ dị mkpa maka mmepe nke atherosclerosis na ngalaba a:

1. Nke mbu. Ihe ngosi doro anya nke atherosclerosis na-anọkarị oge, mana mgbanwe ụfọdụ na ECG nwere ike ịmaliteworị - ntakịrị mgbanwe na oge S-E, karịchaa mgbe mgbatị ahụ gasịrị. Njirimara nke usoro nke akwara a na akwara akwara akwara bụ usoro dystrophic na akwara obi.
2. Nke abuo. N'akwụkwọ ahụ, a na-akpọ ya necrotic n'ihi nguzo nke ngalaba necrosis muscle nwere necus na usoro nke degenerative Filiks. Nwere ike gbagwojuru anya site na nkụchi obi ogologo oge. A na-ahụta ọkwa a nke ọrịa site na mgbaàmà ndị a na-ahụkarị. Na ECG, mgbanwe ndị dị na S-T na ebili mmiri T na Q bụbu ndị anya nke ọma.
3. Nke ato. Ndị ọkachamara n'ịgwọ ọrịa na-akpọkarị ọkwa a atherosclerotic cardiosclerosis. Enwere ike iche ma ọ bụ nke a na - akọkarị maka ịme ọfụma. Ihe na-akpata myocardium na-esite na ya nwere ike ịdị ka ọhụhụ. Ihe mgbaàmà nke ogbo ahụ dị oke njọ - atria fibrillation atonia, ọrịa na - ada ada, ọbara ọgbụgba na okirikiri nke mgbasa ọbara, akwara obi, ihe mgbochi - sinoatrial, atrial, atrioventricular, wdg. Na ECG - ọnụego mgbanwe na-apụtaghị mgbe niile na ọtụtụ mgbanwe ndị ọzọ na-adịghị mma.

Ọkpụkpụ akwara

Akpụ akwara nwa na-anọkarị n'ihe ize ndụ n'ọnụ ma ọ bụ n'akụkụ akụkụ. Na atherosclerosis nke akwara ndị a, usoro nke mmepe nke ọrịa bụ ndị a:

1. Agba mbu. N'ime akwụkwọ a na-akpọ ya "ischemic", nke a na-eji mbelata mgbali olu ke akwara. Usoro Ischemic na akụrụ na-ebute mmụba n'ọbara ma na-eduga n'ọbara na-ekweghị ala ala (ọbara mgbali akwara).
2. Agba nke abụọ. E gosipụtara site na parenchyma necrosis na thrombosis na usoro akụrụ nke akụrụ.
3. Agba nke ato. A na-esonyere ya na mgbaàmà nke nephrocirrhosis, ọdịda akụrụ na-amalite, mgbanwe nke mmamịrị na mmamịrị n'ihi mbibi na mgbaze nke glomeruli.

Atherosclerosis bụ ọrịa nwere ọrịa nke nwere ike imetụta akụkụ ọ bụla nke akwara vaskụla nke ahụ mmadụ. Maka ọgwụgwọ na mgbochi, ịkwesịrị ilelee cholesterol ọbara oge niile, na-agbaso ụzọ ndụ dị gara gara nke ọma ma gakwuru ndị ọkachamara dị mkpa n'oge.