ʻO ka atherosclerosis kahi maʻi e hoʻopilikia ai i nā moku o nā ʻano elastic a me ka muscular-elastic, e hoʻihoʻi ana iā lākou i nā mea kūlohelohe o ka hoʻokō ʻana i ka hana hoʻomohala a hoʻoneʻe i ke koko.
I kēia hihia, hōʻiliʻili ka protein-detritus momona i loko o ka paia o ke kīʻaha moku, a me kahi ʻano pākaʻi. Hoʻonui wikiwiki a pālahalaha i ka hopena a e ulu a nui aʻe ka kahe o ke koko a paʻa ʻole ia.
ʻO nā mea etiological e alakaʻi i ke kūkulu ʻana i nā loli atherosclerotic he genetically predisposed a ʻaʻole maopopo.
Akā ʻo nā mea e hōʻike nei i ka statistically hiki ke hoʻonui i ka manawa e maʻi ai:
- ʻO ka ulaula - nā noke maʻamau o ka nikotine, kahi mea paʻa ma kahi ʻano endogenous kūlohelohe i loko o ke kino, e wehe i nā hoʻoponopono o nā hōʻino vascular a me ka hoʻomaha, e hoʻolilo iā lākou i nā mea hou a maʻalahi no ka komo ʻana i nā mea atherosclerotic.
- Diabetes mellitus - kahi maʻi maʻamau o ka mea nui i ka hoʻoliʻiʻana o ka hōʻemi i ka hoʻoneʻe i kahi kokoke i nā mea hoʻokūkū āpau i loko o ke kino, me ka momona metabolism. Hoʻokomo ʻia nā ʻano o loko o ka lipid i ke kahe a kahe a laila i komo lākou i ka pā.
- Hypertension arterial - kiʻekiʻe ke kiʻekiʻe e alakaʻi i ka nāwaliwali o ka hoʻopaʻa ʻia ʻana o nā kīʻaha koko, a ua maʻalahi hoʻi ke komo i loko o nā kōpeke i ka hoʻoneʻe ʻole. Eia kekahi, angiotensin 2, kahi vasoconstrictor ikaika, e hoʻonui i ka pagkamatina o nā membranes.
- Loaʻa - inā hiki i nā huakaʻi ke hoʻokō i ka momona o ko lākou kino, ʻaʻole hiki iā mākou ke kamaʻilio e pili ana i ka hoʻoiho hou ʻana i ka cholesterol exogenous.
- ʻO kahi hemahema o nā mea hele i ka kolamu - inā lilo ka lipoproteins kiʻekiʻe e hoʻemi loa i ka maʻamau, a laila "hewa" ka kolamu "lanakila a infiltrates i nā cell endothelial.
- Hypodynamia - kahiʻano maʻalahi i nāwaliwali o ka puʻuwai a me nā kīʻaha koko, ua hōʻemi ko lākou mākala ma muli o ka nele ʻole.
- Hōʻalo nā contraceptives kūloko i ka paleʻana o ka hormonal i nā wahine. Ua ʻike ʻia e maʻi maʻi nā kāne ma ka awelika o 5 mau manawa pinepine, no ka mea, aia ka wahine i kahi angioprotector kūlohelohe - ka estrogen sex wahine. ʻO ka lawe ʻana i nā paila e hoʻohaʻahaʻa i kāna koʻo ʻana.
- ʻO ka ukana psychoemotional, ke kiʻekiʻe o ke kaumaha ma kahi manawa ke kūʻokoʻa nei i ka pale o ke kino.
- Ke kōpae ʻana o nā momona o ka nui.
ʻO kekahi mea maʻamau, pili i nā hopena i ka wā hoʻokahi, ʻo ka manawa pinepine ka mea maʻi i nā ʻōnaehana like a me nā hui pū ʻana o lākou.
ʻAʻole ʻike ʻia ka mīkini o ka atherosclerosis no kekahi mau, akā he nui nā mau manaʻo e wehewehe i ke kaʻina hana.
I ka papa o kēia kulekele hou, ka hōʻaia ʻana o ka pathogenesis o atherosclerosis ma ke ʻano o ke kumu ʻelua alakaʻi - lipidogenic a me ka non-lipidogenic.
Kūkulu ʻia ka mua o lākou me nā loli o ka biochemical i ka hoʻopili ʻana o ke koko a me nā ʻōnaehana enzyme, me ka mālama ʻole ʻana i ka ʻāina mua o ka puna vascular.
ʻO ka pae aʻe o nā etiopathogenesis e hoʻokaʻawale iā ia:
- Hana kahua Dolipid. Hoʻokahi i nā kaupa endothelial, hoʻonui i ka hiʻona o ka membrane keola, ma o ia mau nā aʻai o ke koko, fibrin, ua komo. Flat parietal thrombi lāʻau. Hoʻopiha ʻia ʻo Intima o ka moku me ka glycosaminoglycans, ʻike ʻia ka pahuhopu mucoindoid.
- Lipoidosis Pākuʻi ʻia ʻana o ka membrane i loko me nā lipids (kolamu), ka hoʻomohala ʻana i nā wahi momona a me nā pā, ka mea i ʻike ʻia i ka maka ʻalo. ʻO nā cell Foamy i kapa ʻia he xanthomas i hōʻiliʻili ʻia ma ʻaneʻi. ʻO ka pane o ka autoimmune i ke kino e hoʻololi i kona hoʻonohonoho ʻana, a me ka hāʻule ʻana o nā membranes elastic.
- Liposclerosis Ka hoʻokaʻawale nā pathophysiologists i kēia papa ma waena o kekahi, no ka mea, ua māla nui nā aela a piha i ka pahū detritus, kahi e hiki ai ke hoʻokuʻu i nā meaola olakino e pili ana i nā kiko. Ma hope o kēia, ulu nui nā loulou, a me kahi ʻano paʻi ʻalā o nā lau male male.
- Hoʻokomo pūpū Ke ʻohi ʻo ke kau ʻana o nā kaula fibrin i ka momona, lilo a pulu. Hōʻalo ka hōʻailona mai loko mai a hiki i kekahi manawa ke hōʻea i nā kūmaha hina. Kūpono kahi pākolo e pani pono i ka lumen o ka moku.
- Holokē. ʻO kekahi o nā hiʻohiʻona hiki i ke ʻano o ka pathogenesis, akā ʻaʻole i koi ʻia. Hōʻalo nā "pani" o ka hoʻokumu ʻana, a me kahi puka ulaula ma kona wahi. E hōʻalo ʻia paha ka pohō i nā platelets, nāna e alakaʻi i nā fibrosis ʻoi aku, a komo i loko o nā papa hohonu, e hoʻomaka ana kahi aneurysm.
- Atherocalcinosis. Hoʻopiha ke kīkala i nā hana i ke komo ʻana i loko o ka mānoanoa o ka calcium, kahi i hana ma waena o nā fibers. He paʻakikī a he paʻakikī ka pāpaʻi, a hemo ke hoʻokaʻawale ʻana me kahi embolism.
ʻO ke kālaiʻike non-lipidogenika e like me ka like o ke ʻano o ka hoʻomohala ʻana i ka maʻi, akā ʻo ka mea hoʻokūkū i loko, ua ʻino ia i ka lāʻau a nā mea maʻi maʻi, radiation, a me ka hopena traumatic.
ʻAʻole hiki ke hōʻole ʻia ka polyetiological ʻano o ka atherosclerosis.
ʻO ka atherosclerosis kahi maʻi lipid. ʻO nā mea nui e kumu ai i nā loli degenerative he mau triglycerides, nā momona momona a me nā kolamu.
Loaʻa iā lāua nā ʻaoʻao o waho a me waho o ka hele ʻana i ke kaʻe manuahi. No ka loaʻa i kahi manaʻo pololei o ka metabolism cholesterol, e hoʻomaʻamaʻa mākou i ke kaʻina e hiki ai. Ke komo nei ʻo cholesterol i ke kino me ka ʻai a me nā ʻano holoholona ʻē aʻe, emulsified ka wā ʻia i loko o ka ʻōpū liʻiliʻi, ma hope o ka hoʻomaka ʻana o ka hoʻopili ʻana.
No ka mea ʻo ka kumu o ke koko ka wai, a me ka momona o ka lau ʻole i loko o ia mea e hoʻomau ai i ka heterogeneity o ka kahe a me ka embolism, pono nā ʻano kākāwaʻa. ʻO kēia nā chylomicrons, HDL a me LDL (nā lipoproteins haʻahaʻa haʻahaʻa a kiʻekiʻe).
Lawe ʻo HDL i ka cholesterol "pono", no kāna hana ʻana i ka ikehu, ka synthesis o nā hormones a mālama i ka neʻe o nā membrane.
Ke halihali nei ʻo Chylomicrons triglycerides, kahi huahana break lipid.
Ua pili pū me LDL i ka cholesterol "kino" a hāʻawi i kāna hōʻiliʻili i ka reticulum endoplasmic o ka pā a lilo ia i xanthomic.
Hoʻokaʻawale ʻia a kau ʻia nā loli i ka pili. ʻO ka māhele mua o ka pākī he cellular, aia ma ka "fibrin" uhi ". Nui nā hui pūpū palupalu, macrophages a me nā leukocytes e noho huna i nā mea ulu ulu, proliferation, chemokines, anti-inflammatory mediators. Hoʻopilikia ʻole ia e ʻike ʻole.
A laila hele mai kahi matrix extracellular o ka hoʻopili hoʻohui, loaʻa nā kolagoli a me nā elastic fibers, proteoglycans, pono no ke kūkulu hou ʻana i ka huakaʻi fibrous.
ʻO ka māhele hohonu hohonu hohonu. He kikowaena necrotic kēia o ka cholesterol me kāna mau esters, crystals. Hoʻokomo pū ka mea hoʻohui i nā koena protein ma hope o ke kīhaʻi ʻana o nā ʻāpana.
Ma muli o ka waiho ʻana o nā regulators humoral, paʻakikī ke komo i loko o ka pākeke a luku i ke kumu o ka mumū.
ʻO ka pathogenesis o ka atherosclerosis ʻaʻole wale nō he loiloi nui o nā loli nui no nā hōʻike a me nā abstract i nā kula olakino.
Hoʻomoe ia i ka hopena o ka pathogenetic i ka pilikia, e hoʻopili ana i nā maʻi kulekele maoli.
No laila, he mea pono e loaʻa i kahi manaʻo o nā ʻano lāʻau lapaʻau o ka atherosclerosis, he kūlike loa i nā hōʻike hōʻike a me nā hopena.
Kahi like ke ʻano me ke ʻano kulekele a me ka anatomical.
- Atherosclerosis o ka aorta. ʻO ka palapala maʻamau. Ua ʻōlelo hou ʻia nā loli i loko o ka ʻōpū o ka ʻōpū. Ua paʻakikī ka kūlana ma ka nalowale o ka elasticity a hoʻonui i ke koko. Hiki ke lele ke kahe i loko o nā mea o ke ana o ka ʻōpū o ka pūpū, nā keiki o ka infarction, ka aneurysms, ka manawa o ka mahele o nā ʻili pili, thromboembolism.
- Nā ʻāpana ʻala. Pau ka naʻau i ka nui o ke oxygen no nā konohiki mau. No laila, me ka pani ʻana o nā moku e hoʻolako ana iā ia, ulu ka myocardial hypoxia a me ka maʻi naʻau coronary (CHD). ʻO nā hōʻailona maʻamau me ka ʻōpū o ka umauma, e hoʻonui ana i ka lima hema, scapula, ʻākoakoa. Hiki i ka palupalu, pōkole o ka hanu, ka umu, ka pua. He hopena maikaʻi loa ka hopena - infarction myocardial.
- Nā ʻehu o ka noʻonoʻo. Hoʻomaka nā maʻi cerebrovascular āpau ma aneʻi. Me ka thrombosis o ka arote carotid kūloko, hele mai kahi maʻi ischemic. Hoʻopiha ka puka maʻi me nā loli atrophic i ka cortex cerebral, encephalopathies, dementia.
- Nā lāʻau hīmeni. Lā pinepine ʻia ke kikoo ʻana ma ke kahua o ka hoʻokuʻu ʻana o ka pā ʻana o ka arteriarenalis mai ka pou nui. ʻO ka hopena o ka atherosclerosis o nā hua renal kahi o ka atherosclerotic wrinkled kidney. ʻAʻole i kūlike ka nele, ʻoiai ke hōʻike ʻia ka pathology e ka hypertension lua.
- Nā ʻōpala o nā ʻōpū. ʻO ka mokuʻāina ʻo ka pili me ka hoʻomohala ʻana i ka ʻaihue aseptic o nā ipo ma ka wahi o kahi pālua i hoʻopaʻa ʻia (gangrene) a me peritonitis. E kū'ē i ke kua o ischemia maʻi, ua kū mai ka hoʻouka ʻana me ka "wāwae aihilā" colic ma hope koke o ka ʻai ʻana, ka hemo ʻana me ka nitroglycerin.
Hoʻohana pū ʻia nā Atherosclerosis o nā haʻahaʻa wāwae haʻahaʻa. ʻO ka pale ʻana i ka atherosclerosis o nā haʻahaʻa haʻahaʻa e hōʻeha i ka mea maʻi i ka ʻeha nui loa a me ka ʻeha. ʻAʻole kū ʻia nā likika lactic mai nā palupalu palaleka, ma nā ʻili kikoʻī.
ʻAʻole hiki i kēlā mau mea maʻi ke hele wāwae 200 mau mika ʻole e pani, no ka mea ke piʻi nui nei kahi maʻi hōʻehaʻeha me nā wāwae āpau. I nā hihia koʻikoʻi, hiki i nā ulia trophic a me gangrene o ke kino keʻena.
Ua hoʻokaʻawale ʻia nā ʻōkāwili i loko o ka maʻi a me ke aʻeha, me ka ʻano o ka kahe e holo. ʻO ka ʻute ka kumu e make ai ka make a hoʻoiho wikiwiki i kekahi mau hola. ʻO kēia ka maʻi vascular insufficiency (ischemia), i ukali ʻia e nā meaʻino i nā huina huakaʻi nānā. ʻO ke kumu ke koko koko, emboli, vasospasm me ka loaʻa ʻana o kahi kī. Ua komo pū ʻia ma ʻaneʻi kahi hūneʻa ʻana o ka aneurysm o nā moku e pili ana i ka pehu nui.
Hiki i nā hoʻopiʻi maʻi paʻakikī ke hoʻomohala no nā makahiki heʻumi, akā ʻo ka papa asymptomatic e hana ai iā lākou ʻaʻole i emi iki. ʻO kēia mau lesion hypoxic kūloko ma ke kīʻaha o kahi moku, dystrophic a me nā hoʻololi ʻana o ka atrophic i nā kino, ka ulu ʻana o ka pili umauma, nā maʻi.
ʻO Angina pectoris, myocardial infarction, pulmonary a me ka hepatic insufficiency, hoʻōla luhi, ka loea motor, ka ala a me ka hiamoe, ke uhaʻi ʻana o ke ʻano, ke kuʻi ʻana a me ka ʻeha - ʻaʻole kēia he papa inoa piha o nā hopena āpau o ka maʻi. I mea e pale aku ai i kēia, pono ʻoe e hoʻomaka i ke pale ʻana i kēia manawa, no ka mea, hiki i ka hopena.
Hoʻomaʻamaʻa ka hoʻonui ʻana i ka kolamu ma ka mālama i kaʻai ʻana, ka hana kino maʻalahi, hōʻole i nā mea momona a me nā hana maikaʻi. ʻO ka mālama ʻana i ka hapa nui he conservative (lāʻau lapaʻau) a i ʻole ka hana me nā mea i hoʻohālikelike ʻia.
ʻO nā hiʻohiʻona nui o kēia maʻi me ka hoʻomalala ʻana i nā paia o vascular a me ko lākou nalowale elasticity. ʻO ka maʻi ʻo Hyalinosis a me Menckenberg kekahi o kēia pūʻulu, akā ʻo ka atherosclerosis ua noho mua i ka wahi mua i ka laha no nā makahiki he mau makahiki.
I kēia lā ʻo ia ka maʻi maʻamau loa ma nā ʻāina i kūkulu ʻia, 150 mai ka 100,000 he maʻi, a ke ulu nei kēia mahele. Atherosclerosis iho, ʻaʻole ia e like me ka mea weliweli e like me nā hoʻopiʻi hiki ʻole mai, ʻo ia nā kumu nui o ka make mai nā maʻi cardiovascular.
Kūkāʻo ke pathogenesis o atherosclerosis i ke wikiō i kēia ʻatikala.
