ʻO ka atherosclerosis kahi maʻi lōʻihi o ka puʻuwai a me nā moku nui, ke ʻano hōʻino ʻia e ka pā ʻana i ka paia arterial a me ka haʻalele ʻana o nā ʻano atheromatous ma luna o ke pani hou ʻana o ka lumen a me ka hoʻomohala ʻana o nā hoʻopiʻi mai ka lolo, puʻuwai, aʻeha, haʻahaʻa.
ʻO ka maʻi iā ia iho e loaʻa nui i nā ʻelemakule, ʻoiai aia i kēia manawa ke waiho iki i nā kolamu liʻiliʻi ma nā paia o nā kīʻaha koko a hiki i nā keiki a me nā ʻōpio.
I ka haʻalele ʻana o ka hoʻomaʻamaʻa kūpono, ʻo ka atherosclerosis o kekahi hoʻokolohua e alakaʻi i ka ischemia a me hypoxia o nā kino a me nā ʻōnaehana, nā loli trophic a me ka necrotic i ka ʻeha a me ka ʻōpala palapu.
Hiki ke hoʻokaʻawale i nā kumu o kēia ala i nā pūʻulu ʻelua - loli a ʻano modifiable.
ʻO ka mea mua me nā kumu i hiki ke hoʻololi ʻia e nā loli ola a me nā lāʻau lapaʻau, eia kekahi o lākou:
- ʻO kahi hana maʻalahi me kahi hana ʻoi loa ka hana.
- Hōʻino ka meaʻai kūponoʻole - ka meaʻai maʻamau me ka nui o nā momona, nā meaʻai i momona i momona i ka kolamu.
- Kūʻai maikaʻi - inu nui, ulaula.
- Hoʻopilikia nui ke kaumaha a me ke noʻonoʻo.
- Hypertension arterial me nā hōʻailona o ke kaomi ma luna o 140 ma 90 o ke aniani o ka mercury i ka hoʻomaha me nā ana he nui.
- ʻO ka maʻi mellitus me ka mana o ka glycemic maikaʻi a me nā kūlana ketoacidotic pinepine.
- ʻO ka Hypercholesterolemia - he hoʻonui i ka nui o ka nui o ka kolamu (ma mua o 5.5 mmol / l), dyslipidemia - kahiʻole o ka ratio ma waena o nā lipotroteins o nāʻokoʻa like ʻole (he hoʻonui i ka lipoproteins haʻahaʻa, triglycerides, kahi hoʻemi i nā lipoproteins kiʻekiʻe).
- ʻO ka hoʻonāʻana i kahi'ōpū me ka pūhaka i nā kāne ma mua o 102 cm, a i nā wahine nui aku ma mua o 88 cm.
ʻO nā mea hiki ʻole ke kumu ke hoʻopili i ka mōʻaukala ʻohana kaumaha. (Hypercholesterolemia familial a me ka dyslipidemia, make mai nā hoahānau o nā maʻi cardiovascular a hiki i 50 mau makahiki he nui), mau makahiki (i nā kāne, ka atherosclerosis e ulu ma hope o 45 mau makahiki, i nā wahine - ma hope o 55), ka wahine ulu pinepine nā kāne i ka kāne, ʻoiai nā hāmeʻe wahine wahine i hopena hoʻomalu i nā pili koko.
Nā mīkini hana pathogenetic o ka hoʻopili ʻana i ka pōpoki
ʻO ka hui pū ʻana o ka hyperlipidemia a me ka hōʻino kaulua e alakaʻi i ka hoʻokumu ʻana o nā paʻakikī i hoʻololi ʻia me nā protein, a me kā lākou neʻe ma lalo o ka intima o nā lāʻau.
Hoʻopaʻa ka lipids e nā macrophages, e huli ana i nā ʻāpana xanthomatous, e hoʻonui nui ana i ka nui.
Hāpai kēia mau sela i ka ulu a me nā mea e neʻe ana no nā pū ke koko keʻokeʻo a me nā platelets. Aia ka adhesion a me ka hoʻohui o platelets, ka hāʻawiʻana o nā mea thrombotic.
Kūleʻa ka plak i ka wikiwiki, e pale ana i ka lumen o ka moku ma muli o ka hoʻokumu ʻia ʻana o kahi kikoʻehā e hoʻopili ai a me ka pa.
Eia kekahi, ma lalo o ka hopena o nā mea ulu, ua kūkulu ʻia nā capillaries no ka hāʻawi ʻana i ke koko i ka nui o ka atheromatous. ʻO ka pae hope o ka hoʻomohala ʻana, ʻo ka necrosis o ke kikowaena o ka pākī, kona sclerosis a me ka calculification.
ʻO ka hoʻololi ʻana o ka Moramona i ka ulu ʻana o ka atherosclerosis e hōʻike ʻia e ka ulu ʻana o ka maʻi, mai ka liʻiliʻi a hiki i ka paʻakikī loa.
ʻO ke kumu mua o ka hoʻomohala ʻana o ka atherosclerosis, aia ka dolipid, ʻaʻohe ʻano loli o ka morphological. Hoʻohālikelike ia me ka hoʻonui ʻia o ka permeability o ka paia vaskular, kahi hōʻino o kona kūpaʻa - focal a ʻokoʻa paha, e hoʻokaʻawale ana i ke kahe o ke koko i loko o ka wahi subendothelial.
Ka huehue ʻo Mucoid, hōʻiliʻili i nā fibrin a me nā fibrinogen, nā protein protein ʻē aʻe, nā lipoproteins haʻahaʻa haʻahaʻa a me ka cholesterol.
E hōʻike i kēia hana, ua lawa ka hoʻohana ʻana i ka noiʻi hīmeniʻo no ka hoʻomākaukau ʻana o ka paia vascular a hoʻohana i nā pahu kikoʻī - nā thionine manga, i ʻike ʻia a metachromasia a ʻike ʻia nā wahi i pili ʻia i ka poni.
ʻO ke kolu o ka lua - ka lipoidosis - ke ʻano o ka wehe ʻana o ka cholesterol a me nā lipoproteins i ke ʻano o nā momona momona a me nā ʻāpana ʻulaʻula i kū aʻe ma luna o ke kiʻekiʻe o ka endothelium.
Hiki ke mālama ʻia kēlā mau hoʻololi i ke ʻano o nā kīʻaha koko akā i nā keiki a me nā wā ʻōpio, ʻaʻole pono hoʻi e holomua i ka wā e hiki mai ana. Hoʻokomo ʻia nā lipid ma lalo o ke intima i nā macrophages, a i ʻole nā ʻupena o ka foamy, a me nā palahalaha o nā ʻōpū o nā kahe koko. Hiki nō hoʻi ke nānā i kēia hana i ka histologically, ke lawe ʻia nei e ka Sudan 4, 5, momona ʻulaʻula.
ʻO ka hāʻawi ʻana i ka atherosclerosis kahi maʻi holomua holomua, hiki i kēia ke lōʻihi ke lōʻihi a ʻaʻole i kahi kumu koʻikoʻi koʻikoʻi.
ʻO nā kīʻaha nui, e like me ka aorta, nā mea puhi coronary, nā kīʻaha o ka lolo, nā pēpē, a me nā ʻūhā, e hele i nā loli pathological mua.
ʻO ke kaona o ke kaʻina hana i kau ʻia i nā hiʻohiʻona o ka hemodynamics ma nā pae o ke bifurcation o nā moku, e like me ke bifurcation aortic i loko o ka arela iliac.
ʻO ke kolu o ka hoʻomohala ʻana i ka pāpaʻi atherosclerotic ka liposclerosis - ka hoʻokumu ʻana o nā fib elastic a me collagen i ka endothelium, ka hoʻomaikaʻi ʻana i nā fibroblasts, ka haʻalele ʻana i nā mea ulu a me ka hoʻomohala ʻana o ka ʻōpio hoʻohui.
ʻO ka hoʻomohala hou pathophysiological o ka pāpaʻi atherosclerotic
Morphologically, hoʻāla ʻia nā pākeke ma luna o ka pae o intima, lilo ka ʻili o ka moku i tuberous, heterogeneous. Hiki i kēia mau pālani ke hoʻopaʻa i ka lumen o ka wahī a alakaʻi i ka ischemia o nā ʻāpana a me nā ʻōnaehana, hilinaʻi, i ke kahua kahi, e alakaʻi ai i nā hoʻopiʻi e like me ka stroke, ka neʻe ʻana mai i ka ischemic attack, myocardial infarction, obliteration of the vessel of the lower end.
ʻO ka pae hou o ka holomua o ka maʻi he atheromatous, i hōʻike ʻia e ka ʻōpala o ka ʻaoʻao kumu o ka pākeke, ka hakahaka.
ʻO nā crystals o ka cholesterol, nā momona momona, nā ʻāpana o nā huakaʻi kolagya, nā cell xanthoma a me nā T me B lymphocytes e ʻike ʻia i ka papalapa detrital. Ua hoʻokaʻawale ʻia kēia mea laʻu mai ka lua o ka moku e ka capsule o ka pākeke, ka mea i hoʻopili ʻia i ka ʻili o kahi.
ʻO ka hana hope e hōʻike ai i ka ulia, ke ʻano he waimaka o ka membrane pāka, a me ka hoʻokuʻu i nā mea i loko o ke kahe koko, ke ʻano o ka ulia atheromatous. ʻO ka pōʻino o kēia kaʻina ke ka ka like ʻana o nā pālima, ka hiki ke hoʻomohala ʻana i nā ʻāpana ischemic a me ka thromboembolic o nā aʻalē a me nā kiko.
Ma ka pūnaewele o ka ulia ulcer, hoʻomohala ʻia ka aneurysm - protrusion o ka paia vascular, a me nā hōʻino. ʻO ka pae hope o ke kaʻina hana pathological ka peni o ka pākeke, ʻo ia hoʻi, ka haʻalele ʻana o nā paʻakai kalala i loko.
ʻO ke kumu, ke hoʻopihapiha ʻia ka wahi i hoʻopili ʻia o ka moku, ʻae ʻole ke ʻano o ka patency a i ʻole hele.
Hiki ke ʻike ʻia nā ʻōmole o nā pilikia hoʻonaninani o nā moku koko me ka polymorphic, ʻo ia hoʻi, hiki ke nānā ʻia nā palaka me nā momona a me nā momona momona.
Hiki i nā plat Atherosclerotic iā lākou iho ke paʻakikī e ka hemorrhage, ke koko koko, a me ka maloʻo capsule.
Hoʻokaʻawale ʻia nā lāʻau lapaʻau atherosclerotic a paʻa i ka paʻa ʻole.
I nā kīpē o ka hua mua, i hoʻākāka maikaʻi ʻia ka uhi kiko, ʻaʻole paʻa i ka hina ʻana a me ka hoʻokuʻu i nā mea, a no laila ʻaʻole alakaʻi i nā hoʻonāukiuki a ka atherosclerosis. Hōʻike kēia mau paʻi i ka hoʻopiʻi kino - ischemia kūloko o nā kola a me nā kiko, ka sclerosis, dystrophy a atrophy, stabil angina pectoris, maʻi vascular insufficiency.
Ma ka lua o nā ʻano, hoʻowalewale ke kahe i ka waimaka a i ke puka ʻana mai o kona poʻokela, nā maʻi - hoʻopiʻi kūloko o ka vascular a me ka ischemia o nā ʻōpū, ka pupule hiki ʻole a me ke ʻano o ka coronary syndrome, nā hāmeʻe hina o ka lolo, gangrene o nā hopena.
ʻO nā kumu kumu o ka mālamaʻana i ka atherosclerosis a me kona pale
ʻO ka mālama ʻana i nā plakika atherosclerotic i kūkulu ʻia, ka maʻi maʻi ʻana a me ka objectively, i hui ʻia me ke ʻano hoʻohui, a komo pū me ke hoʻoponopono ʻana i nā mea hoʻololi.
Hoʻopili kēia kāpili - ka hoʻoponopono o ka meaʻai, ka hoʻohana ʻana o nā lau hou i nā lau ʻai a me nā hua ʻai, nā cereals, nā huahana waiʻai a me ka hoʻokumu ʻana o kahi ʻano inu wai.
He mea nui hoʻi e hoʻōki i ka ulaula, inu ka inu ʻana i ka ʻona ʻawaʻawa, lawa ka hana kino (hele, holo, aerobics).
ʻO ka lapaʻau nui ka lāʻau lapaʻau, pili kēia i nā lāʻau lapaʻau e nānā ana i ka hana pharmacological i ka hoʻohaʻahaʻa ʻana i ka kolamu a me kāna mau haʻawina:
- statins (Atorvastatin, Lovastatin, Simvastatin);
- nā paʻakau;
- probucol;
- hoʻōla nicotinic.
Hoʻohana ʻia:
- nā hui antiplatelet (Acetylsalicylic acid, Magnikor);
- anticoagulants (heparin);
- vasoactive lāʻau (Cilostazolum);
- antispasmodics (Drotaverinum, Papaverineum);
- Hoʻomākaukau vitamin.
Ma nā hihia koʻikoʻi o ka maʻi, me ka hoʻopiʻi o nā maʻi, nā hōʻeha o ka trophic o nā palupalu palupalu a me nā limu gangrene, hoʻohana ʻia ke ʻano lapaʻau - mai nā hana hana traumatic e hoʻihoʻi ai i ke kahe koko (stenting, bypass surgery, balloon angioplasty), ka lawe ʻana i nā moku i hoʻopilikia ʻia (endarterectomy me nā moku prosthetics hou) ma mua o nā wawaheo ka hemo ʻana o nā kiko non-viable (necrectomy, amputation a kahi limu).
ʻO ka hoʻomaʻemaʻe i ka hoʻonui ʻana i ka kolamu a me ka hoʻomohala ʻana i ka atherosclerosis ka mea nui - i ka poʻe olakino, a me ke kekona - me kahi maʻi i hōʻike ʻia.
ʻO nā ala nui o ka pale mua ʻana he meaʻai kūpono, ke ʻano kino, hoʻōlo i nā hana maikaʻi, ke nānā ʻana i ke kaomi a me ka pae o ka kolamu, nā loiloi maʻi maʻamau e nā loea maʻamau.
No ka pale ʻana i ka lua, pono ia e hoʻomaka me ka mālama ʻana i nā maʻi hoʻohālikelike, e hoʻohaʻahaʻa ana i ke koko, ka lawe ʻana i nā statins a me nā ʻaina antiplatelet, ka wā kūpono a me ka mālama ʻana i nā ʻōnaehana.
ʻO ka etiology o atherosclerosis i wehewehe ʻia i ka wikiō ma kēia atikala.
