Ejiri usoro atherosclerotic site na nguzobe nke atheromatous pụta na oghere nke akwara akwara, ma nke buru ibu ma na-ajụ ajụ, na-egbochi obara na -akpata akụkụ ahụ na akwara, hypoxia na ischemia nke mpaghara ndị emetụtara.
Ọrịa ahụ bụ njirimara ndị agadi, mana enwere ike ịchọpụta ihe ịrịba ama mbụ nke mmebi na ụmụaka na ndị na-eto eto.
Ọ bụghị mgbe niile ka enwere ike ịchọpụta ọnụnọ ọrịa nke ọrịa n'oge oge, mana na ịchọpụta mmalite nke imebi, enwere ike inwe mmetụta dị ukwuu n'ọrịa ahụ.
N'oge mmebi nchọpụta ahụ yana iji usoro ọgwụgwọ zuru oke, ọ nwere ike imetụta ụzọ ọrịa ahụ, belata ihe ize ndụ nke ịmalite ụdị siri ike.
Mmetụta dị otú ahụ na ahụ na - egbochi ihe kpatara nsogbu - ụbụrụ nrugharị nke ụbụrụ, angina pectoris, infarction myocardial, iwepu akwara akwara aka nke ukwu yana ọrịa gangrene.
Ihe na-akpata Atherosclerosis
N'oge a mmepe nke sayensị, ihe ndị na-akpata mmepe nke atherosclerosis n'ime ahụ arụbeghị ọrụ nke ọma. Ọzọkwa, usoro a na-enye aka na ọdịdị ahụ ọrịa esighi ike.
Ndi mmadu kwesiri ntukwasi obi nke oma banyere ogwugwu nke atherosclerosis, nke diri otutu nsogbu. Enwere ike kee ihe niile nwere ike ibute gaa n’otu dị iche iche - anaghị agbanwe ma gbanwee.
Ihe enwere ike igbanwe gunyere:
- Hyperlipidemia n'ihi mmụba nke abụba ụmụ anụmanụ, nri dị elu kọlesterol, nleghara anya nke eriri na ngwaahịa mmiri ara ehi.
- Mmebi nke iguzosi ike n'ezi ihe nke mgbidi vaskụla n'ihi omume ọjọọ - ị drinkingụbiga mmanya ókè, ise anwụrụ.
- Mmega ahụ zuru oke, ma ọ bụ nke ọzọ, ọnụnọ nke arụ ọrụ anụ ahụ dị arọ.
- Ọnụnọ nke ọbara mgbali elu na glucose.
- Ihe ndị ọzọ na-ebute ọrịa ma ọ bụ endocrine (hypothyroidism, Ọrịa Hisenko-Cushing), mmerụ ahụ.
Ọrịa ndị na - anaghị agbanwe agbanwe gụnyere:
- afọ - ihe ize ndụ nke mmepe na-abawanye mgbe afọ 45 - 50 gasịrị;
- okike - nwoke na-enwekarị nsogbu na mmalite nke ọrịa a, ebe ọ bụ na homonụ mmekọahụ nke ụmụ nwanyị na-enwe mmetụta nchebe;
- ọrịa metabolic hereditary - ọrịa dyslipidemia, homocysteinemia.
Nchoputa mbu bidoro site na nchịkọta nke anamnesis (akụkọ ihe mere eme) nke ndụ, nke gụnyere ozi gbasara ọrịa ndị gara aga, mmerụ ahụ na arụmọrụ, ọnụnọ nke ezinụlọ nwere ọrịa obi.
Akụkọ ihe mere eme nke ọrịa ahụ dịkwa ezigbo mkpa - mmalite, ihe mgbaàmà mbụ, oge ha na ụdị ha, ajụjụ na-ebilite ma onye ọrịa ahụ jikọtara mmalite nke ihe mgbaàmà ya na ihe, dịka ọmụmaatụ, nchoputa na ọgwụgwọ emere na mbụ, nsonaazụ ha.
Mgbaàmà nke ọnya ọnya afọ
Mgbaàmà nke usoro atherosclerotic na-adabere na oge mmepe nke usoro ọgbụgba, ọnọdụ ya na ogo nke ijikọ akwara olu na ogo ezughi oke nke inye ọbara.
Coronary atherosclerosis, ma ọ bụ angina kwụsiri ike, nwere ihe mgbaàmà ndị a - oge mgbu na-akpata mgbu na-akpata n'azụ sternum, tachycardia na arrhythmias.
Na atherosclerosis nke aorta (arịa kachasị ukwuu na ahụ), a na-ahụta ụdị ngosipụta ndị a - mmụba na-aga n'ihu na ọbara mgbali elu, ụfụ na-enwu ọkụ, na-agagharị aka na ụkwụ, pallor nke akpụkpọ ahụ nke akụkụ ala, mbelata uche ha, flatulence, na mgbu afọ.
A na-egosipụta mmebi nke akwara akụkụ ahụ site na isi ọwụwa, ọgbụgbọ, tinnitus, ebelata ikike na ikike ọgụgụ isi, ịba ụba intracranial.
Usoro ihe omimi di omimi banyere ime nyocha na ihe omumu.
Laboratory gụnyere usoro ọgwụgwọ na ụzọ nyocha akọwapụtara ọhụụ.
Ndị ụfọdụ akọwapụtara gụnyere ọnụ ọgụgụ ọbara n'oghere nke ọnụ ọgụgụ ọbara na-acha ọcha, nyocha nke ọkpọ, yana glucose na-ebu ọnụ.
Nyocha dị iche iche bụ nyocha nke ihe eji egbu egbu na mkpebi nke akwara dị egwu, electrophoresis nke serum lipoproteins, na-agụta ọkwa nke protein plasma apo-B, usoro nchọpụta ọgwụ na mkpebi siri ike nke coagulogram.
Nnyocha ụlọ nyocha izugbe
Nyocha ọbara na-ekpebi ọkwa nke haemoglobin, ọnụ ọgụgụ mkpụrụ ndụ ọbara ọbara, platelet na sel ọbara ọcha kwa olu nke otu, yana ọ̀tụ̀tụ̀ erythrocyte sedimentation (SOE).
A na-anara ọbara iji mee nyocha n'ụtụtụ na afọ na-enweghị isi, nsonaazụ ya dị ka nkezi nke dị njikere n'ime awa ole na ole.
Na nyocha a, enwere ike igosipụta ọnụnọ nke atherosclerosis site na mmụba na SOE - ihe na-egosi mmeghachi omume mbufụt (ụkpụrụ maka ụmụ nwoke ruru 1 ruo 10 mm kwa elekere, maka ụmụ nwanyị - site na 2 ruo 15). Ekwesịrị icheta na ihe ngosi a bụ ihe na-enweghị atụ, ọ gaghị ekwe omume ịchọpụta n'ụzọ ziri ezi nchọpụta nke mebiri metabolism.
Na nyocha nke mmamịrị, a na-ekpebi paramita ndị dị otú ahụ - agba, nghọta, ike ndọtị akọwapụtara, ọnụnọ nke protein, glucose, nnu na ihe ndị ọzọ - mkpụrụ ndụ, ngwaahịa ire ere, enzymes.
Ihe ngosipụta nke nwere ike igosipụta nsogbu metabolism na metabolism nke akwara obi bụ lactate dehydrogenase (LDH).
Enzyme a bụ nsị nke glucose, ọnụnọ ya na mmamịrị na-egosi ọrịa ischemia ma ọ bụ infarction myocardial.
A na-ekpebi ọkwa glucose maka nchọpụta mbụ nke mellitus ọrịa shuga, ịbawanye nnabata glucose na ọrịa endocrine ndị ọzọ, ihe ngosipụta nkịtị bụ nke 3.3 ruo 5.5 mmol.
Mmụba na glucose na-egosi mmepe nke ọrịa shuga mellitus, nke nwere ike ibute ọrịa obi na akwara obi na atherosclerosis.
Nchọpụta nyocha Ọpụrụiche Na-adị Iche Iche
Nnwale ụfọdụ maka mmepụta nke atherosclerosis na-eme ka o kwe omume karịa ikpebi ogo na ụdị mgbanwe nke metabolism lipid, ọnụnọ nke ezinụlọ dyslipidemia na atherogenicity na-arụkọ ọrụ.
Nyochaa akọwapụtara nke mbụ bụ njirimara ụdị ọdịdị dị iche iche ma ọ bụ mkpebi nke cholesterol na ụmụ irighiri ya.
Ihe kacha egosi nke lipids bu ogo cholesterol zuru oke, oke nke lipoproteins dị ala (nke dị na atherogenic), oke nke lipoproteins dị elu (antiatherogenic), triglycerides, chylomicrons.
Dika odi, ogo cholesterol zuru oke sitere na 3.1 ruo 5 mmol kwa otu, akụkụ nke HDL erughi 1 mmol kwa otu obula, ọdịnaya nke LDL na VLDL ruru 3 mmol, triglycerides ruru 1.7 mmol.
Mmụba n'ihe ngosipụta niile, ewezuga HDL, na - egosi mmebi nke metabolism lipid na nnukwu ihe nwere ike imepụta atherosclerosis nwere nnukwu mmachi nke mgbasa ọbara na oburisa vaskụla. Ọzọkwa, mmụba nke triglycerides naanị bụ ihe ngosi na-adịghị mma, na-egosi mmepe nke angina pectoris na ọrịa shuga mellitus.
A na-arụ plasma electrophoresis iji chọpụta ọkwa nke lipoproteins - protein na-ebugharị nke na-ebu abụba. Site na hyperlipidemia, ọnụ ọgụgụ lipoproteins dị ala na nke dị ala na-abawanye, na HDL, n'ụzọ megidere, belatara. Nchịkọta a anaghị achọ nkwadebe pụrụ iche, enwere ike ghara iburu ya na afọ efu, ọbara venous na-eje ozi dị ka ihe.
A na-ekpebi ọnụọgụ atherogenicity - a na-ewepụ ọnụọgụ nke HDL site na uru nke ngụkọta egbugbere ọnụ yana ihe na-ebute site na ọnụọgụ nke lipids dị elu.
Nkpụrụ dị iche iche nke ihe ngosi a dị narị atọ.
Ọnụọgụ ọnụọgụ site na atọ ruo na nke anọ pụtara nnukwu ihe ize ndụ nke ịmalite ọrịa nke akwara obi, mmụba nke ihe karịrị 5 - ọnya akwara akwara amalitela.
Apo-B-lipoprotein bụ protein na-ebugharị nke na-ebufe triglycerides site na eriri afọ gaa na imeju maka njikọta oke abụba.
Iwu maka ụmụ nwoke sitere na 60 ruo 138 mg / dl, maka ụmụ nwanyị - 52 - 129.
Site na mmụba n'ogo ya, n'otu aka ahụ, triglycerides n'onwe ha na-abawanye, nke bụ akara aka ọjọọ.
Zọ nyocha nke immunosorbent immunosorbent na-enwete enzyme na enzyme na-eme ka o kwe omume ịchọpụta ọnụnọ nke ọgwụ mgbochi na okirikiri nje na-egbochi. Mmepe nke oria obi jikọtara ya na ọnụnọ dị na plasma nke mgbochi na cardiolipin na cardiomyosin, nke bụ ihe myocardial. Abamuru nke ụzọ ndị a bụ oke ziri ezi nke ikpebi ọchịchọ nke mgbanwe mgbanwe, enweghị ọzụzụ a kapịrị ọnụ.
Iji chọpụta usoro coagulation ọbara, a na-eme coagulogram.
Enwere ọtụtụ ihe ngosi na ya, ndị bụ isi bụ ọnụ ọgụgụ platelet, oge prothrombin, fibrinogen, oge thrombin, arụ ọrụ akụkụ thromboplastin na-arụ ọrụ, na ule ethanol.
Usoro platelet bụ site na 180 ruo 320 Giga kwa lita (ma ọ bụ 10 ruo 9 ogo kwa liter), oge prothrombin site na 10 ruo 16 sekọnd, fibrinogen dị gram 2 ruo 4 kwa lita, thrombin oge site na 12 ruo 18 sekọnd na ethanol. nnwale - otu gbakwunyere ma ọ bụ mwepu.
Diagnozọ nchọpụta usoro
Iji kwado ma ọ bụ gọnarị nchoputa ahụ, a na-eji ụzọ ịlele ahụ onye ọrịa si arụ ọrụ.
Ojiji nke ụzọ ndị a na-enye ohere ịchọpụta mpaghara mpaghara ọrịa ahụ.
Na mgbakwunye, iji usoro pụrụ iche nke nyocha ihe eji eme ihe na-eme ka o kwe omume ịchọpụta ogo mmepe nke ọrịa ahụ na ikpebi ntinye nke ụzọ ụfọdụ nke ikpughe ahụike si ahụ.
Diagnozọ nyocha dị iche iche gụnyere:
- X-ray nke obi, x-ray nke arịa ọbara (angiography - aortography, coronarography).
- Mmeso ọbara mgbali na mkpebi siri ike na nkwonkwo ụkwụ.
- Electrocardiography, nkuzi ihe omumu.
- Dopplerography ma ọ bụ ultrasound nke akwara ndị ahụ.
- Anwale ule dị iche iche iji chọpụta ogo nke ischemia myocardial.
- MRI ma ọ bụ MSCT nke akwara (akwara, arịa ụbụrụ na nsọtụ ala).
Na onyonyo nke akwara ndị dị na obi, mmụba n'ogo nke obi, ya bụ ngalaba aka ekpe, mmụba n'ọnụ ọnụ, ntụgharị aka, mgbidi nke arịa. Ogbugbu nke oghere obi na aorta n'onwe ya ga - ekwe omume. Ọzọkwa, mgbe akụkụ akwara ọbara na-abanye na usoro a, usoro pulmonary na-eme ka ọ dị mma n'ihi akwara vaskụla.
Na electrocardiography, ọtụtụ mgbanwe abụghị ihe efu, na ebili isi n'ihi ischemia myocardial. Achọpụtara ndị na - ahụ maka ọrịa dị ka ihe mgbaàmà nke ọbara mgbali elu ventricular, arrhythmias, na mgbanwe na ụzọ (mgbochi). A na - eji ECG eme ihe na nchoputa nke atherosclerosis nke obi.
Akụkụ dị mkpa nke nchoputa ahụ bụ nyocha nrụgide oge. A dụrụ ndị ọrịa ọdụ ka ha tụọ ọbara mgbali kwa ụbọchị ma ọ bụ otu ugboro kwa ụbọchị abụọ, debe akwụkwọ ndekọ. Nyochaa dị otú a ga - enyere aka ịchọpụta ịrị elu nke nrụgide na nke mbụ ma gbochie ọdịdị nke ndị na - egosi ụgha na "ọbara mgbali elu na - acha ọcha."
N'oge a na -ekwu ya, a na-agbakwa atụmatụ nkwonkwo ụkwụ nkwonkwo ụkwụ, ya bụ, oke ọbara ọgbụgba dị n’ubu na nkwonkwo ụkwụ. Rategwọ a na-ahụ maka ya bụ ihe dị ka 1 ruo 1.3.
Ihe omumu puru iche iji choputa ikike vaskụla:
- angiography;
- ihe ngosi;
- ihe ndọta;
- multispiral agbakọrọ tomography.
Angiography bu ihe di iche banyere omumu ihe banyere obara, mejuputara ihe ndi di iche na ndi mmadu. Usoro a na - enyere gị aka ikpebi ịdị elu na dayameta nke akwara ndị dị, na-ahụ ọkwa nke overlap na ogo ya.
Dopplerography nke arịa ọbara ma ọ bụ ultrasound - nyocha ihe ọmụma, na mgbakwunye ohere ndị a dị n'elu, na-ekpebikwa ọsọ ọbara dị na arịa ndị ahụ. Ọtụtụ mgbe, a na-eme duplex ma ọ bụ triplex ọmụmụ.
Ihe omumu ihe omumu ihe banyere oria dika ugbua bu uzo ihe bara uru ichoro iji mata ebe anakpo noherosclerotic. Ihe omuma nke omume bu kwa ihe anabataghi ya - onyonye ihe di iche na etinye onwe ya ma etinye ya onye ọrịa.
Site na iji MRI ma ọ bụ CT, ị nwere ike ikpebi nhazi nke akwara ọbara, ọnọdụ ha, nrụrụ na mgbanye nke lumen, ọkwa nke ọbara mpaghara na akwara ike.
A kọwara ihe mgbaàmà nke atherosclerosis na vidiyo n'isiokwu a.
