ʻO ka hakakā i ka atherosclerosis vascular i kēia lā he mea nui no ka kaiaulu olakino āpau. Wahi a ka World Health Organization (WHO), aia ka maʻi mua ma waena o nā kumu o nā maʻi cardiovascular me ka nui loa o ka make. Kokoke mau, nā loli o ka atherosclerotic ʻo ke kumu o ka hōʻeha ʻana, ka puʻuwai puʻuwai, ulia trophic a me nā maʻi ʻē aʻe.
ʻO ka atherosclerosis kahi leona o ka laka o loko a me ka waena o nā moku ma kolamu, nā kīʻaha manuahi a me nā triglycerides, i ukali ʻia e nā neʻe hele i loko o kekahi ʻāpana a me nā kiko.
ʻElua mau ʻano nui no ka hōʻike ʻana o ka atherosclerosis, kēlā me kēia kuleana i ke ola. ʻO ka mea mua he hemodynamic, a i ʻole kaʻino. ʻLelo ʻia ʻo ia ka mea hoʻowalewale no ka hoʻopili ʻana i ka momona o ka intima o ka moku. Hiki paha kēia i ka pili me ka ʻaihue hopohopo (virus, mycoplasma, fungus, bacteria), ke komo ʻana o ka punawai, ka hōʻeha ʻeha, ke ʻano ʻomaʻomaʻi, ke ʻano kūlohelohe (nā ʻano like ʻole o ka radiation) a i ʻole nā mea kanu (nā lāʻau me nā hopena cytotoxic, hoʻohui i nā meaʻai, nā meaola ) ʻO ka maʻi hypertensive, ʻo ia kekahi o nā kumu nui, e kū kaʻawale ma kahi o kēia kuʻuna. Ma hope o kēia, loli ka hāmeʻe o ka pā o ka cell, a lilo ka nui o ka lipid i mea maʻalahi i loko.
ʻO ka lua, metabolic a receptor paha, e kau ana i ka etiology ma luna o ka hoʻopiʻi ʻana o ka momona a me ka hoʻoliʻiʻana o ka momona, ka pilina o nā metabolites hoʻokaʻawale ʻole me nā naʻau ʻokoʻa ma loko o ka ʻaoʻao o ka moku. Hoʻololi ʻia ka hoʻoponopono neho neurohumoral o ke kāmeʻa o ka membrane, a lilo ka pona endothelial i ka paia i wahi maʻalahi no ka hoʻoiho lipid.
He aha nā hoʻololi i loaʻa i ka paia o ke kahawai?
ʻO ka pathogenesis o ka maʻi ka mea kue i ka pale o ka lipoproteins haʻahaʻa haʻahaʻa (LDL) a me nā kiʻekiʻe kiʻekiʻe (HDL). Ke hoʻoneʻe nei lākou i ka kolamu no ka hoʻōla ʻana i kahi hana ikaika i hiki ai iā ia ke komo i loko o ke synthes o nā hormones a me ka phospholipids o ke kino. Akā inā he pilikia o ka pilina ma waena o HDL a me LDL e like me 4 i ka 1, hoʻomaʻamaʻa ka hoʻohana ʻana i nā enzyme a hōʻeha nā momona i loko o ka loko ʻauʻau.
I ka manawa like, lawe ka mīkini hoʻowali kiʻekiʻe i ka lipid deactivated i ka iwi adipose a wehe paha ia i waho.
Me kahi paleʻoleʻole, hoʻomaka ia e nalowale, no laila ke hoʻopanepae nā metabolites i nā ala a pau, inā nui i loko o ka choroid - ʻo ia ke pathophysiology o ke kaʻina.
ʻAʻole hiki koke i ka hoʻomohala ʻana i nā loli hou ʻole.
- Hana kahua Dolipid. I kēia manawa ʻaʻohe deformation a i ʻole nā unorganization e like me nā ʻano, he paka iki wale nō ka nui o ka mucoid, hypercholesterolemia (kiʻekiʻe kolamu ma ke koko) a hoʻonui i ka hāmeʻe o ka pā o ke kelepona. Akā i kēia manawa nā mea pōʻino - ka nui o ke kala, ka maʻi diabetes, ka maʻi thyroid, ka ulaula, ke ʻano hoʻonaninani, ke ʻano kiʻekiʻe o ke koko - hoʻomaka e hoʻonāukiuki i ke kūlana a ua holo nā mea a pau i kahi pae hope aʻe.
- Hopu lipid, lipoidosis. Ke komo nā paʻaka i ka pūlea, hemo ka hana a hiki mai ka pane ʻana i ka hohonu. E pili ana i ka lipine palani i kēia mau lā, ʻo ka xanthoma ke ʻano he "melemele." Me ka maka kapa ʻole, hiki ke ʻike i nā wahi grease a me nā strat e uhi ana i ka moku. ʻOiai i kēia hana, hiki i ka hakakā maikaʻi ke hakakā me ka atherosclerosis e hiki ke hoʻokō me nā lāʻau lapaʻau. E kōkua hoʻi ka mea hoʻohana ʻole no ke kali ʻana i ka hoʻomohala hou ʻana o ka ʻōnaehana pathological.
ʻO ka papa hope loa he atheromatosis a me nā hoʻopiʻi hou. Ke hele nei ka infiltrate i loko o ka pūpihi, kahi wali pane o ke kino e hoʻomaka, ka mea i hoʻonāukiuki i ke kaʻina hana. Hoʻonohonoho ka platelet i ka pūnaewele o ka atherosclerosis alakaʻi i kahi thrombus a me ka embolism hou, hoʻopili ʻia i ka lumen.
ʻO ka hōʻiliʻili ʻana o nā filament fibrin e hiki ʻole ke alakaʻi i ka hōʻemi ʻana o ka lau kūikawā e hoʻopili ana i ka moku, a ma kona wahi aia kahi kikoʻī ʻaka pili. A hiki i kahi hopena, hiki ke hoʻokaʻawale ka mea i hana ʻia me ka paʻakai kalima, kahi e hoʻokau ʻia ai ka pathology. Hiki hoʻi kahi ʻoloka o ka moku, aia ma kahi pā nui o ke kolamu, e like me ka aorta, aneane hiki ʻole i ka make.
He ulia paha ka lesion.
Ka papa ʻōlelo o ka atherosclerosis
Kuhi ʻia ka papa hoʻonohonoho o ke ʻano o ka localization o ka pākana.
Aia nā hopena a me ka mālama ʻana i kahi ma kahi o ke kumu mua.
Pono e noʻonoʻo ʻia nā wahi kūloko i ka wā e nānā ai i kahi pilikia.
ʻO nā wahi nui o ka pōʻino i loaʻa:
- Aorta. I kēia hihia, ʻo ka lāʻau nui loa ʻo ia ka moku o ke kino o ke kanaka. Ma muli o kēia, nalowale kāna elasticity, ka hiki ke pane aku i ka loli i ka loli ʻana o ka puʻuwai a me ke koko. Hele paʻa ka pā. Hoʻololi pinepine me kēia ʻano like ʻole o ka maʻi, haʻahaʻa, piʻi ke diastolic pressure, no ka mea ke piʻi nei ka pale ʻana o ke kahe koko o peripheral. Hiki i nā hopena hopena he hypertension arterial, auric aneurysm a me kona ʻoka.
- Nā ʻāpana ʻala. ʻO kēia nā kīʻaha e hānai i ka naʻau - kekahi o nā mea ʻai e hoʻopau nui ai i nā mea o ka momona a me ka oxygen. Ke kahe nei ke kahe koko i loko o ka myocardium, hoʻonui ʻia ka hypoxia, e hele ana i ka pōʻino ischemic. Ke alakaʻi nei kēia i kahi maʻi nui o ka poʻe kahiko - myocardial infarction.
- ʻO ka ʻuhane. Inā hele ʻia ka atherosclerosis i loko o ka loko o ke kīlea o ka ʻāuna kūloko, a i ʻole a me ka vertebral, ke ʻōlelo nei lākou i kona ʻano cerebral. ʻAʻole ʻike ke ʻano o nā ʻōuli ma kēia hihia, akā me ka menacingly - hoʻomanaʻo ʻole, ka hiamoe, ka hoʻonohonoho ʻana, nā hana cognitive. Nā hopena thrombogenic o nā plak atherosclerotic hiki ke alakaʻi i ka thromboembolism cerebral, ka manawa ischemic.
ʻO kekahi hoʻi o nā wahi nui o ka hana ʻino o nā moku o nā wāwae. ʻO ka atherosclerosis obliterans o nā haʻahaʻa haʻahaʻa e lawe ai i ka mea hōʻeha nui ma ka maʻi ma muli o kāna hōʻailona ʻehaʻeha.
ʻO ka Physiology ka maikaʻi o ka hoʻopiʻi ʻana i nā waʻalā mai nā ʻōpū o nā wāwae, ka mea i hoʻokumu ʻia ma hope o ka hoʻomaʻamaʻa ʻana ma o ka huahana. ʻO kēia ka mea nui i ka waika lactic. ʻAʻole hiki i kēlā mea maʻi ke hele i kahi lōʻihi lōʻihi no ka ʻeha hiki ʻole ke holo ma hope o ke kū ʻana.
I nā pilikia nui, aia ka ʻeha i ka pō a i ka pō, ua uhi ʻia ka limu me ka ʻulaʻulaʻula-ʻula a me nā ʻeha trophic.
Ua lilo kēia i mea kuhikuhi alapiʻi no ka amputation, akā i kēia manawa ke mau ala o ka endovascular hou loa no ka pale ʻana i ka necrosis humuhumu palupalu.
Nā hiʻohiʻona o ka maʻi me ka pōʻino o ka keiki
Malia paha kahi hoʻomohala ʻana o kahi maʻi i ka ʻōnaehana vascular o nā keiki.
ʻO Arteriarenalis, ka mea e halihali i ke koko i ka lolo, ʻo ia kekahi o ke koʻi i ke koko e mālama pono i ka kānana maʻamau. No laila, ʻo ia kekahi o ka mea mua e hana i nā loli pathological.
I kēia kūlana, hoʻomaka ka vasorenal hypertension - he ulu paʻa i ka neʻe koko. ʻO kēlā mau ʻōuli e like me ka ʻōlelo aʻo mua e pili ana i ka hoʻomohala ʻana o ka atherosclerosis o nā ʻalihi renal.
Hoʻolāwī pū kekahi pū kekahi ʻenehana mesenteric. ʻO ka thrombosis o kēia kīʻaha piha piha ke kīwī e hānai i nā ʻōpū i hiki aku ai i ka hoʻoneʻe septic formidable - gangrene intestinal.
ʻO nā hōʻailona mua o ka maʻi he "ʻōpū o ka ʻōpū" - kahi ʻeha ʻeha i loko o ka ʻōpū, e like me colic.
Ma ke kiko o ka lesi, ka ʻano like:
- Hōʻailona maʻalahi (a hiki i ka 6% o ka mānoanoa laulā, a hiki i ka 12% o ka hopena endothelium, a hiki i kahi hapaha o ka moku ke kau ʻia i loko o ke kaʻina pili.
- Hoʻopilikia ka hopena (hōʻemi ma mua o 50% o ka mānoanoa pale ākea).
- Lā ʻia (infiltration komo iʻoi aʻe ma mua o 50% o ka mānoanoa, kēlā.
Pono ke kaukaina e hoʻoholo i kahi mamao loa i hala ka pōʻino.
Koho e pili ana i kēia mau ʻike, ʻo ka papa kuhikuhi o ka maʻi maʻi like penei.
ʻAʻole koʻikoʻi nā loli i nā ʻōhua koʻikoʻi, akā nānā nā wahi o ka pōʻino o ischemic. ʻO ka stenosis koʻikoʻi, kahe o ke koko ma lalo o ka maʻamau.
Hoʻokumu i ka mua o ka thrombosis, aia nā nekrosis o nā liʻiliʻi a me nā nui, nā hōʻike kino mai nā hōʻeha i nā pōpoki ʻai, kahi huaʻōlelo pili paʻa. ʻO ka maʻi fibrosis vascular a me ka hoʻomaʻamaʻa ʻana o nā pīhoihoi kūlohelohe. ʻIke ʻia nā ʻeha ma ko lākou ʻaoʻao, ka hemorrhages ma ka stroma, parenchyma.
Hoʻomaʻamaʻa a me ka pale ʻana o ka maʻi
Ma mua o ka hoʻoholo ʻana i ka ʻenehana a me ka mālama ʻana i ka mea maʻi, hoʻokaʻawale ka ʻenehana i kahi ʻenehana kūikawā a me nā hoʻokolohua instrumental.
Hāʻawi lākou i kahi manawa e hōʻiliʻili ai i ka ʻike holoʻokoʻa e pili ana i ka hoʻomohala ʻana o ka maʻi.
Ma ke kaʻina hana e hoʻoholo ai i ka wahi kūpono, ka pae o ka hōʻino a me nā kaila pili olakino e pono ai.
Hoʻopuka ʻia ka maʻi maʻi ma kēia mau ala:
- ʻO ka hōʻiliʻili o ka ʻikepili, nā hoʻopiʻi hoʻomanawanui a me ka nānā maʻamau.
- ʻO ka hōʻike koko biochemical e ʻike i ke kūlohelohe o ka cholesterol, HDL, LDL, chylomicrons, ke kaʻawale nei i ka triglycerides, nā hōʻailona hōʻailona no ka hōʻino i nā huina (māpuna, ʻōpala, nā pūpū, nā puʻuwai, ka lolo).
- ʻO ka Ultrasonography (ultrasound) e hoʻohana ana i ka hopena Doppler. ʻO kēia ke ala e hiki ai i ka hoʻomaka o ke kīpē, ka nui o ka hoʻomohala ʻana, ka ʻona ʻāina ʻana, ka nui o ka stenosis, ka loaʻa ʻana o ke kahe koko, kona wikiwiki, a me nā ʻano rheological o ke koko.
- ʻO Angiography kahi mākaukau no ka hōʻiliʻili o ka hōʻemi ʻana, no ka mea, me ʻike ʻia nā hiʻohiʻona pilikino o ke ʻano o nā kīʻaha koko.
- Mālama rango MRI.
Inā maʻa mua ke ʻano o ka maʻi, a laila hiki i ke keʻa ʻana i hiki ke loaʻa i kahi hopena. Ka mea e pili ana i ka ulaula, ka inu ʻana i nā nui o nā antioxidants ma ke ʻano o ka huaora, kahe, ka prophylactic i ka hoʻohana ʻana i nā wai ʻona liʻiliʻi e hoʻokaʻawale i nā plher atherosclerotic, ke ʻano hana kino e hoʻomaikaʻi ai i ka helehelena, kaʻai ʻana i ka meaʻai, ka hoʻokaʻa ʻana i nā loina trans a me ka paʻakai ma ka meaʻai, a me ka hoʻohana ʻana i nā ʻano lāʻau lapaʻau hou. ʻonika a me nā decoc.
Inā hele mamao loa ka maʻi a hoʻopilikia me nā hoʻopiʻi ʻana, a laila e hoʻohana ʻia nā lāʻau lapaʻau like:
- Hoʻopau i nā ʻōmole o nā absorption Cholesterol (cholestyramine).
- Nā mea hoʻohiwahiwa o ka synthesis a me ka hoʻoneʻe ʻana i ka cholesterol ma ke kino (Simvastatin, Atorvastatin, Lovastatin) kahi hana lapaʻau pinepine lapaʻau e hoʻohana pinepine ʻia me kahi waihona hōʻike ākea.
- ʻO nā stimulants o nā hana kaohi a me ka hoʻopihapiha o ke kolamu mai ke kino (Essentiale).
- Hōʻalo i ka hoʻohaʻahaʻa hoʻokoe i nā triglycerides koko (Fenofibrate, ka waikawa Nicotinic).
- E hoʻomau i nā antioxidants (tocopherol - ka huaora E, ka waikawa ascorbic - vitamin C).
- Kaʻalo kūlohelohe (methionine, glutamic acid).
- Angioprotectors (Prodectin, Dicinon, Quertin).
ʻO ka hana hoʻomalu no ka mālama ʻana i ka atherosclerosis me ke kiʻekiʻe kiʻekiʻe o ka hiki ke hoʻokaʻawale loa i ka mea maʻi o kahi ʻano hoʻoweliweli, e waiho ana iā ia ma hope aʻe wale nō ka mālama ʻana i ka ʻai a mālama pono i nā moku i ka maʻamau. Hoʻokomo ʻo ka loiloi i ka balon angioplasty a i ʻole ka hoʻokele.
Ua kūkākūkā nā kumu a me ke ʻano o ka atherosclerosis i ke wikiō i kēia ʻatikala.
