Hoʻohālikelike ke kaʻina o ka atherosclerotic e ka hoʻokumu ʻana o ka mau atheromatous masses i ka lua o nā ʻalapau, ʻoi aku ka nui a me ka nui ma ke kiko, ke kāohi ʻana i ke kahe koko i nā kino a me nā kiko, hypoxia a me ischemia o nā wahi i hoʻopili ʻia.
ʻO kēia maʻi ka mea maʻamau o nā poʻe kahiko, akā hiki nō ke ʻike i nā hōʻailona mua i hōʻino ʻia i nā keiki a me nā ʻōpio.
ʻAʻole hiki ke ʻike mau i ka neʻe ʻana o ka maʻi o ka pathology me ke kūpono o ka manawa, akā naʻe, me ka ʻike mua ʻana i kahi hala ʻole, hiki i ka hopena nui ke ʻano o nā maʻi.
I ka wā o ka haʻi hewa ʻana a me ka hoʻohana ʻana i ka manawa kūpono o ka papa kūpono o ka lāʻau lapaʻau, hiki iā ia ke hoʻoikaika i ke ʻano o ka maʻi, ka hōʻemi ʻana i ka pilikia o ka hoʻomohala ʻana i nā ʻano pilikia.
ʻO kēlā hopena i ke kino e pale i ka loaʻa ʻana o nā hoʻopiʻi - ka maʻi kaulahao o ke kano, ka angina pectoris, kaʻi myocardial, ka holo ʻana o nā ʻili o ke kino o lalo a me ka loaʻa ʻana o gangrene.
Nā kumu o ke Atherosclerosis
I kēia manawa i ka hoʻomohala ʻana o ka ʻepekema, ʻaʻole paʻa ka hoʻomohala i nā kumu o ka hoʻomohala ʻana i ka atherosclerosis i ke kino. Eia nō hoʻi, ka hoʻomohala ʻole ʻia ka hana i hāʻawi ʻia i ke ʻano o nā patology.
Pono nā kumu palekana e pili ana i ka hoʻomohala ʻana o ka atherosclerosis, ke ʻano nui o ka hoʻonui ʻia ʻana o ka maʻi pili. Hiki ke hoʻokaʻawale ʻia nā mea āpau āpau i kekahi mau pūʻulu - ʻaʻohe hoʻololi a hoʻololi ʻia.
ʻO nā ʻano hoʻohuli ʻano:
- ʻO ka Hyperlipidemia ma muli o ka nui o kaʻai ʻana i nā momona holoholona, nā meaʻai kiʻekiʻe i ka cholesterol, ka haʻalele ʻana i nā fiber a me nā huahana waiwai.
- ʻO ka hōʻinoʻana i ka kūʻokoʻa o ka paia vascular ma muli o nā hana maikaʻi - ke inu nui, ka ulaula.
- ʻO ka hana pilikino kūpono ʻole, a i ʻole wīwī, ke hele ʻana o nā hana kino kino.
- ʻO ka heleʻana o ke koko kiʻekiʻe a me ka glucose.
- ʻO nā kumu ʻē aʻe ka maʻi ʻeha a me ka endocrine (hypothyroidism, Theenenko-Cush's syndrome) i nā maʻi, nā hōʻeha.
ʻO nā maʻi ʻaʻole i hoʻololi ʻia:
- makahiki - hoʻonui ʻia ka pilikia o ka ulu ʻana ma hope o 45 - 50 mau makahiki;
- kāne kāne - ʻoi aku ka hopena o ka kāne ma ka hoʻomaka ʻana o kēia maʻi, ʻoiai ʻoiai he hopena palekana ka wahine a nā wahine;
- maʻi lahuli metabolic huahelu - ʻohana dyslipidemia, homocysteinemia.
Hoʻomaka ka hoʻomaka mua ʻana me kahi hōʻiliʻili piha o kahi anamnesis (mōʻaukala) o ke ola, e loaʻa ana ka ʻike e pili ana i nā maʻi ma mua, nā hōʻeha a me nā hana hana, ka ʻike ʻana o ka ʻohana i nā maʻi cardiovascular.
He mea koʻikoʻi nō ka mōʻaukala o ka maʻi - ka hoʻomaka, nā hōʻailona mua, ko lākou lōʻihi a me ke kūlohelohe, kū mai ka nīnau inā he hui pū kekahi me ka hoʻomaka ʻana i nā hōʻailona me kekahi mea, no ka laʻana, kahi maʻi maʻi a me ka mālama ʻana i hana ma mua, ko lākou mau hopena.
Hoʻomaopopo o nā leʻaleʻa atherosclerotic
Hoʻomaopopo ka hōʻailona o ke kaʻina atherosclerotic i ka lōʻihi o ka hoʻomohala ʻana o ke kaʻina pathological, kona wahi a me ka kiʻekiʻe o ka piʻihihi o ka nui o ke kanalelo a me ka pae o ka ʻike ʻole o ke kahe koko.
ʻO ka atherosclerosis Coronary, a i ʻole ka angina mau, aia nā hōʻailona ma hope nei - ʻeha ka hoʻihoʻi ʻana i ka wā ma hope o ka sternum, tachycardia a me nā arrhythmias.
Me ka atherosclerosis o ka aorta (ka moku nui loa i loko o ke kino), ʻike ʻia kēlā mau hiʻohiʻona - he mahuahua mau i ka neʻe ʻana o ke koko, ke ʻano ʻā ʻana, ʻāʻī paha i nā lima a me nā wāwae, pallor o ka ʻili o nā haʻahaʻa haʻahaʻa, a he hōʻemi i ko lākou naʻau, flatulence, a me nā ʻeha ʻeha.
Hōʻike ka pōʻino i nā mākaki cerebral ma ka ʻeha, ka hoʻohālikelike, ka tinnitus, ua hoʻemi ʻia ka hoʻomanaʻo a me nā pono cognitive, hoʻonui i ka hana intracranial.
ʻO ka paʻakikī o nā hana diagnostic e komo pū me nā haʻawina hoʻokolohua a me nā pono.
Ke loaʻa nei ka Laboratory i nā ʻano loiloi maʻamau a me nā ʻano loiloi.
ʻO nā mea kikoʻī ka helu ʻana o ka helu koko a me kahi helu kelepona keʻokeʻo, kahi urinalysis maʻamau, a me ka glucose wikiwiki.
ʻO ka kikoʻī maʻamau ka nānā ʻana o ka biochemical me ka hoʻoholo ʻana o ka hoʻopili lipid, ka electrophoresis o ka lipoproteins serum, e helu ana i ka pae o ka plasma apo-B ka nui, nā hana diagnostic immunological a me ka hoʻoholo ʻana i ka coagulogram.
ʻO nā diagnostics hana ʻoihana loea
Ke hoʻoholo nei kahi hōʻike koko i ka pae o ka hemoglobin, ka nui o nā cellula ʻulaʻula, platelets a me nā keʻena koko keʻokeʻo i pākahi kālā, a me ka pākēneka erythrocyte sedimentation (SOE).
Hoʻohe ʻia ke koko no ke kaila i ke kakahiaka ma kahi ʻōpū ʻole, aia nā hua ma ke ʻano he ʻelua i mau hola.
Ma kēia loiloi, hiki ke hōʻike ʻia ka hiki ʻana o ka atherosclerosis e ke piʻi ʻana o SOE - kahi hōʻailona o ka pane ʻana i nā maʻi maʻi (ʻo ke kumu maʻamau no nā kāne he 1 a 10 mm i kēlā me kēia hola, no nā wahine - mai 2 a 15. Pono e hoʻomanaʻo ʻia o kēia kaha he nonspecific, a hiki ʻole ke loiloi pololei i ka wehe ʻana i ka hōʻona o ka momona momona.
I ka hoʻāʻo ʻana i ka urine, ua hoʻoholo ʻia kēlā mau hiʻohiʻona - ke aniani, ka ʻike leʻa, ke koʻikoʻi maoli, ka manawa o ka protein, glucose, paʻakai a me nā mea hou aku - nā pūlima, nā huahana decay, nā enzyme.
He hōʻailona e hōʻike ai i ka emi ʻana o ka metabolism a me ka metabolism o ka puʻuwai naʻau o ka lactate dehydrogenase (LDH).
ʻO kēia enzyme kahi hua hōʻeha o ka glucose, ʻo kona heleʻana i ka urine e hōʻike ai i ka ischemia cardiac a i ʻole myocardial infarction.
Hoʻoholo ʻia ka pae glucose no ka hoʻomaka ʻana i ka maʻi mellitus o ka maʻi mellitus, hoʻonui i ka hoʻohaʻahaʻa glucose a me nā maʻi endocrine ʻē aʻe, ʻo ka hōʻailona maʻamau ka 3.3 a i 5.5 mmol.
Ke hoʻonui nei i ka glucose e hōʻike i ka hoʻomohala ʻana o ka maʻi mellitus o ka maʻi, hiki ke loaʻa me ka maʻi naʻau coronary a me ka atherosclerosis.
Nā Kaukaʻikaʻi Hoʻoikaika ʻoihana Makemika
ʻO nā hoʻokolohua kūikawā no ka hoʻokumu ʻana o ka atherosclerosis e hiki iā ia ke hoʻoholo pololei me ka kūlike a me ka ʻano o ka hoʻololi ʻana i ka hana lipid metabolism, ka hiki ʻana o ka famlial dyslipidemia me atherogenicity coefficient.
ʻO ka hōʻike mua loa ka ʻike me ke ʻano o ke ʻano o ka lapalapa o ka lipid pae a i ʻole ka hoʻoholo ʻana o ka kolamu a me nā haʻalulu.
ʻO nā hōʻailona nui o ka lipid ka pae o ka kolamu o ka nui o ka cholesterol, ka nui o nā lipoproteins density haʻahaʻa (hapa atherogen), ka nui o ka lipoproteins density kiʻekiʻe (antiatherogenic), triglycerides, chylomicrons.
Ma ka maʻamau, ʻo ka pae o ka nui o ka cholesterol he 3.1 a 5 mmol no ka pākika, he hapa o HDL ʻaʻole i emi mai ka 1 mmol i ka pākeke, ua ʻike ʻia nā kiko o LDL a me VLDL i 3 mmol, ʻo ka triglycerides e piʻi i ka 1.7 mmol.
ʻO ka hoʻonui nui aʻe i nā ʻōkuhi āpau, koe wale nō no HDL, e hōʻike ana i ka hala ʻana o ka hana lipid metabolism a he nui ka hopena o ka hoʻomohala ʻana i ka atherosclerosis me kahi palena nui o ke kaʻe o ke koko a hiki i ka vascular obliteration. Eia kekahi, ʻo ka nui o ka triglycerides wale nō kahi hōʻailona maikaʻi ʻole, e hōʻike ana i ka hiki ʻana o ka angina pectoris a me nā maʻi mellitus.
Hoʻolālā ka electrophoresis Plasma e hoʻoholo i nā pae o lipoproteins - lawe i nā mea momona a lawe i nā momona. Me ka hyperlipidemia, e hoʻonui ana ka nui o ka lipoproteins kahaha haʻahaʻa a haʻahaʻa, a me HDL, ma ka ʻaoʻao ʻē aʻe, ua hoʻemi ʻia. ʻAʻole pono kēia ʻano noiʻi ʻana i ka hoʻomākaukau kūikawā, ʻaʻole hiki ke lawe ʻia ia ma kahi ʻōpū ʻole, koko koko ʻokoʻa e like me ka waihona.
Hoʻoholo ʻia ka pakanā o ka atherogenicity - ua hoʻemi ʻia ka nui o nā HDL mai ka waiwai o nā lipid āpau a hoʻokaʻawale ʻia ka hopena ma ka helu o nā lipid kiʻekiʻe.
Nā kūlike kūpono o kēia hōʻailona i ka 3 ʻāpana.
Ua hoʻolōʻihi ʻia ka coefficient level mai 3 a 4 i ka hoʻomohala nui ʻana o ka hoʻomohala ʻana i nā pathology o ka ʻōnaehana cardiovascular, ka nui aʻe o nā ʻoi aku o 5 - nā atherosclerotic lesi o nā mau huhū.
ʻO Apo-B-lipoprotein kahi protein transport e hoʻoneʻe i ka triglycerides mai ka ʻōpū i ka ate no ka synt syntous o nā pūhui momona endogenous.
ʻO ke kumu maʻamau no nā kāne mai 60 a 138 mg / dl, no nā wahine - 52 - 129.
Me ka hoʻonui ʻana o kona pae, kēlā, e hoʻonui pū ʻia nō hoʻi ka triglycerides, ʻo ia kahi hōʻailona lapaʻau maikaʻi ʻole.
ʻO ke ʻano immunological a me ka enzyme e pili ana i ka immunosorbent diagnostic e hiki ai i ke koho ʻana i ka hele ʻana o nā antibodies a me nā ʻōnaehana pale. Hoʻopili ʻia ka hoʻomohala ʻana o nā maʻi naʻau i ka hiki i ke plasma o nā mea kū i ka cardiolipin a me ka cardiomyosin, ʻo ia nā mea myocardial. ʻO ka maikaʻi o kēia mau kaʻina hana ʻo ke kiʻekiʻe kūpono o ka hoʻoholo ʻana i ka makemake o nā loli pathological, ka nele o nā hoʻomaʻamaʻa maʻamau.
E hōʻike i kahi ʻōnaehana kahe koko, hana ʻia kahi coagulogram.
Aia kekahi mau hōʻailona ma loko, ʻo ka mea nui, ka helu platelet, ka manawa prothrombin, fibrinogen, manawa thrombin, hoʻāla manawa tromboplastin manawa, a me ka hoʻāʻo ʻana.
ʻO ke kumu platelet mai 180 a 320 Giga i pāhau (a he 10 a 9 paha i kēlā me kēia pā lita), ʻo ka manawa prothrombin mai 10 a 16 kekona, ʻo fibrinogen mai 2 a 4 mau grika no ka lita, ka manawa thrombin mai 12 a 18 kekona a me ka ethanol hoʻokolohua - hoʻokahi i hoʻohui ʻia a minamina paha.
Mau hana hoʻokalakupua instrumental
E hōʻoia a ʻae paha i ka maʻi maʻi, hoʻohana ʻia nā ʻoihana nui o ka hoʻokolokolo ʻana i ke kino o ka mea maʻi.
ʻO ka hoʻohana ʻana i kēia mau hana e hiki ai ke hoʻomaopopo i ka wahi o localization o ka maʻi.
Eia kekahi, ʻo ka hoʻohanaʻana i nā loea kūikawā o ka hoʻokolohua instrumental e hiki ai ke hoʻoholo i ke kiʻekiʻe o ka hoʻomohala ʻana i ka maʻi a hoʻoholo i ka noi ʻana o kekahi mau ʻano o nā hopena olakino e pili ana i ke kino.
Nā ʻōnaehana diagnostic hoʻokomo pili i:
- X-ray o ka umauma, x-hihi o nā kīʻaha koko (angiography - aortography, coronarography).
- Hoʻomoe i ke kahe o ke koko me ka hoʻoholo ʻana o ka mokumoku ankle-brachial.
- Electrocardiography, echocardiography.
- Dopplerography aiʻole i ka ultrasound o nā lāʻau.
- ʻO nā hoʻokolohua koʻikoʻi e hoʻoholo ai i ke kiʻekiʻe o ischemia myocardial.
- MRI a paha MSCT o nā kīhā (aorta, nā moku cerebral a me nā haʻahaʻa haʻahaʻa).
Ma ka huli ʻana o nā kino o nā umauma umauma, ka nui o ka nui o ka puʻuwai, ʻo ia hoʻi nā keʻena hema, he piʻi ma ka aortic arch, pathological bends, calcification o nā paia o nā moku i mālama ʻia. ʻO Aneurysms o nā puʻuwai ʻelua o ka puʻuwai a me nā aorta hoʻi pono. Eia kekahi, ke kau pū nei ka palu pulmonary i ke kaʻina hana, hoʻonui ʻia ke ʻano o ka pulmonary ma muli o ka vascular.
Ma ka electrocardiography, ʻo ka hapanui o nā loli he nonspecific, a kū ala nui ma muli o ischemia myocardial. Loaʻa nā mea ʻike i nā mea maʻamau e like me nā hōʻailona o ka hypertrophy left ventricular, arrhythmias, a me kahi loli i ka conduction (blockade). Hoʻohana ka ECG i ka hōʻike ʻana o ka atherosclerosis o ka naʻau.
ʻO ka mea nui o ka maʻi e hoʻomaʻamaʻa ʻia ana ʻo ia ka hoʻololi ʻana o ka hoʻoikaika kino. Pono e ʻōlelo ʻia nā mea maʻi e ana i ke kahe o ke koko i kēlā me kēia lā a i ʻole ʻelua i kēlā me kēia lā ʻelua, e mālama i kahi lā o nā ana. E kōkua kēia loiloi e ʻike i kahi piʻi o ke kaomi i nā hana mua a pale i nā ʻano o nā hōʻailona wahaheʻe me ka "keʻokeʻo hypertension keʻokeʻo."
I ka wā o ke ana ʻana, ke helu ʻia nei ka ʻōlelo kikoʻī me ke kuapo, ʻo ia hoʻi, ʻo ia ka māhele o ke neʻe koko ma ka ʻāʻī a me nā kuahi. ʻO ka pae maʻamau no ka ana ʻana mai ka 1 a hiki aku i ka 1,3.
Nā ʻike kikoʻī e hoʻoholo i nā vascular patency:
- angiography;
- luanaola;
- magnetic resonance imaging;
- ka leo kikoʻī compitterless.
He ʻano hoʻohālikelike ka Angiography ma nā kīʻaha koko, aia i ka hoʻokomo ʻana i nā mea kū ʻole i ke kahawai. Hiki i kēia ala ke hoʻoholo iā ʻoe i ka patency a me ke anilani o nā kīhāpai, me ka noʻonoʻo ʻana i ke kiʻekiʻe o ka overlap a me kona pae.
ʻO ka Dopplerography o nā kīʻaha koko a i ʻole ka ultrasound - kahi loiloi ʻikepili, i ka hoʻohui ʻana i nā mea i luna aʻe, ke hoʻoholo nei i ka wikiwiki o ka kahe o ke koko i loko o nā moku. ʻO ka pinepine, ʻo ka hōʻike duplex a i ʻole ka triplex i hana ʻia.
ʻO nā aʻo Tomographic i kēia manawa nā ala hoʻokō waiwai nui loa no ka hoʻoholo ʻana i nā palapika atherosclerotic. ʻO ke ʻano o ke ʻano e like me ka angiography - ua hoʻokomo ʻia kahi ʻāpana kūʻokoʻa me ka hoʻomanawanui a kau ʻia ka mea maʻi i kahi tomograph.
Ke hoʻohana nei i ka MRI a i nā CT paha, hiki iā ʻoe ke hoʻoholo i ke ʻano o nā kīʻaha koko, ko lākou wahi, ka deformations a me ka hakilima ʻana o ka lumen, ke ʻano o ke kahe koko a me nā hālei collateral.
Hōʻike ʻia nā hōʻailona o ka atherosclerosis i ke wikiō i kēia atikala.
