Atherosclerosis bụ ọrịa na-adịghị ala ala nke obi na nnukwu arịa, nke a na-enwe mbibi nke akwara ozi na nkwanye ugwu nke atheromatous na ya na mmechi nke lumen na mmepe nke nsogbu site na ụbụrụ, obi, akụrụ, na nsọtụ ala.
Ọrịa a na-aputa ihe n’ebe ndị agadi nọ, n’agbanyeghi na ugbu a obere cholesterol n’arịrị n’arụ arịa ọbara na-achọpụta n’etiti ụmụaka na ndị nọ n’oge uto.
Na enweghị ọgwụgwọ kwesịrị ekwesị, atherosclerosis nke nsonye ọ bụla na-eduga ischemia na hypoxia nke akụkụ na sistem, mgbanwe trophic na necrotic anụ ahụ na anụ ahụ dị nro.
Enwere ike kewaa ihe kpatara oria a na uzo abuo - a gbanwere ma megharia ya.
Nke mbu gunyere ihe nwere ike imetuta mgbanwe site na ndu ndu ya, lekwa ufodi n’ime ha:
- Ndụ ibi ndụ na-arụ ọrụ ọtụtụ mgbere ọrụ.
- Imebi nri nwere ezi mmanu - nri adighi adi nma nke nwere otutu abuba, nri eghe nri bara ụba n’ime cholesterol.
- Omume ọjọọ - ị excessiveụbiga mmanya ókè, ise anwụrụ.
- Nchegbu na oke ibu nke uche.
- Ọbara mgbali anụ ya na ihe ngosipụta nke nrụgide dị elu karịa 140 site na 90 milimita nke Mercury na izu ike na ọtụtụ nha.
- Ọrịa shuga na-arịa ọrịa glycemic adịghị mma na ọnọdụ ketoacidotic ugboro.
- Hypercholesterolemia - mmụba na ọnụ ọgụgụ cholesterol zuru ezu (karịa 5.5 mmol / l), dyslipidemia - mmebi nke ruru n'etiti lipotroteins nke ụmụ irighiri dị iche (mmụba nke lipoproteins dị ala, triglycerides, mbelata lipoproteins dị elu).
- Ibu oke ibu n’ime akwa n’etiti ndi nwoke kariri 102 cm, n’ime ndi nwanyi kariri 88 cm.
Ihe ndị a na - agaghị enwe ike ịgụnye bụ akụkọ banyere ezinụlọ nwere ibu arọ (hypercholesterolemia na dyslipidemia, ọnwụ site n'aka ndị ikwu nke ọrịa obi ruo afọ 50), afọ (na ụmụ nwoke, atherosclerosis na - etolite mgbe afọ iri anọ na anọ gasịrị, n'ime ụmụ nwanyị - mgbe 55 gasịrị), okike ( ọtụtụ mgbe na-etolite n'ime ụmụ nwoke, ebe ọ bụ na homonụ mmekọahụ nke ụmụ nwanyị nwere mmetụta na-egbochi arịa ọbara).
Usoro nke Pathogenetic nke e guzobere iche
Nchikota nke hyperlipidemia na mmebi akwara na-eduga n'ịmepụta kọlọji cholesterol na protein, na mbufe ha n'okpuru akwara akwara.
A na-ejide Lipids site na macrophages, nke na-agbanye mkpụrụ ndụ xanthomatous, na-abawanye ụba na nha.
Mkpụrụ ndụ ndị a na-emepụta ihe na itughari maka sel ọcha na platelet. Enwere mkpọkọ na nchịkọta nke platelet, oke nke ihe thrombotic.
Ihe ncheta na-eto ngwa ngwa, na-egbochi oghere nke arịa ahụ n'ihi nguzobe akwara anụ ahụ na taya ya.
Ọzọkwa, n'okpuru ihe ndị na-akpata uto, a na-achịkwa capliles maka inye ọbara ka ọtụtụ n'ime ndị na-ekwenye ekwenye. Oge ikpeazu mmepe bụ negirossi nke ebe ihe ncheta, akwara na -akasị ya na olu ala.
A na-eji mgbanwe mgbanwe a na-enwe na ọrịa atherosclerosis site n'ọrịa, site na obere ruo na nke siri ike.
Oge mbu nke mmepe nke atherosclerosis bụ dolipid, enweghị mgbanwe ọ bụla akọwapụtara. Ihe eji mara ya bụ mmụba nke ngwangwa nke akwara, na-emebi iguzosi ike n’ezi ihe ya - na-ele anya ma ọ bụ ngụkọta, ịsụsọ akụkụ mmiri dị n'ime oghere ahụ.
Ọkpụkpụ mucoid, mkpo nke fibrin na fibrinogen, protein ndị ọzọ dị na plasma, obere lipoproteins na cholesterol dị ala.
Iji chọpụta usoro a, o zuru ezu iji usoro ọmụmụ ihe omimi banyere nhazi akwara vaskụla ma jiri ụcha pụrụ iche - thionine na-acha anụnụ anụnụ, nke a na-ahụ metachromasia na mpaghara ndị emetụtara na-acha odo odo.
A na-egosipụta ọkwa nke abụọ - lipoidosis - inyefe cholesterol na lipoproteins n'ụdị abụba na ntụpọ edo edo na-enweghị ebili karịa ọkwa nke endothelium.
Enwere ike ịhụ mgbanwe ndị dị otú ahụ na nhazi nke akwara ọbara ọbụna na ụmụaka na ndị nọ n'oge uto, ọ bụchaghị na-enwe ọganihu n'ọdịnihu. A na-edebe Lipids n'okpuru intima n'ime macrophages, ma ọ bụ sel ụfụfụ, yana sel akwara dị mma nke akwara ọbara. Ọ ga-ekwe omume ịchọpụta usoro a site na ịkọ akụkọ, Sudan na-ebu mmanụ 4, 5, oke uhie O.
Nyere na atherosclerosis bụ ọrịa na-eji nwayọ nwayọ, ọkwa a nwere ike ịdị ogologo oge ma ghara ibute ihe mgbaàmà dị egwu.
Nnukwu arịa, dị ka aorta, akwara akwara akwara, arịa nke ụbụrụ, akụrụ, na imeju, na-aga mgbanwe mbụ.
Ntughari nke usoro a dabere na njirimara nke hemodynamics na saịtị nke bifurcation nke arịa, dị ka aortic bifurcation n'ime akwara iliac.
Agba nke atọ nke mmepe nke ihe ncheta atherosclerotic bụ liposclerosis - ịdọpụta eriri na ụyọkọ na endothelium, mmụba nke fibroblasts, mwepu nke ihe na eto na mmepe nke ihe jikọrọ anụ ahụ.
Ọrịa pathophysiological ọzọ nke ncheta atherosclerotic
Site na Morphologically, a na-ebulite ugwu ahụ karịa ọkwa dị omimi, elu nke arịa ahụ na-agbaze, heterogeneous. Nkume ndị dị otú ahụ nwere ike imechi oghere akwara ma duga ischemia nke akụkụ ahụ na sistemụ, dabere na ọnọdụ ahụ, na-eduga na nsogbu ndị dị ka ọrịa strok, transient ischemic Attack, infarction myocardial, iwepu arịa nke obere oke.
Uzo ozo bu oria bu atheromatous, nke emere ka ogha aru nke ihe di iche iche mebie ya.
A na-achọpụta kristal nke cholesterol, abụba nke abụba, iberibe nke eriri collagen, mkpụrụ ndụ xanthoma na T na B lymphocytes na mpaghara detrital. A na - ekewapụta uka a site na oghere nke arịa site na capsule nke ihe ncheta, nke mejupụtara anụ ahụ na - ejikọta.
Nzọụkwụ ọzọ bụ ọnya ọgbụgba, nke emere site na mkpọmkpọ nke ihe ncheta ahụ, na mwepụta nke ihe ndị dị na ya n'ọbara, ịmepụta ọnya atheromatous. Ihe egwu dị na ogbo a bụ enweghị ike nke ụdị paịlị ndị a, ohere nke ịmalite ịrịa ọrịa ọgbụgba na ọnya nke mkpụrụ ndụ na akwara.
Na saịtị nke ọnya afọ, aneurysm nwere ike ịmalite - protrusion nke vaskụla mgbidi, na ọbụna mgbaze. Agba ikpeazụ nke usoro ahụ bụ ịmịnye ihe ncheta, ya bụ, itinye sọlfọ nnu n'ime ya.
N'ihi nke a, a na-arụkọta mpaghara emetụtara n'ụgbọ ahụ, a na-akụ mmụọ ikike ọfụma ma ọ bụ anọghị ya kpamkpam.
Ngosiputa nke oria aruru n’arụ n’arụ ọbara nwere ike ịbụ polymorphic, ya bụ, a ga-enwe ike ịhụ ebe okwesiri tozuru oke nke nwere akwara na abụba n’otu oge.
Ọrịa ịba ọcha n'anya, ọbara ọgbụgba, na nkwuwa nke okpukpu isi nwere ike ibute ọrịa onwe onye na-arịa Atherosclerotic.
Site na onyonyoo ogwu, ekehe atherosclerotic plaques bu nke anaghi akwusi ike.
Na mbadamba ụdị nke mbụ, a na-akọwapụta mkpuchi akwara jikọtara ọnụ, okomoko, anaghị adịkarị njọ ma na-atọhapụ ọdịnaya, yabụ anaghị ebute nnukwu nsogbu nke atherosclerosis. A na-eji akwa ndị a mara nsogbu ndị na-adịghị ala ala - ischemia na-adịghị ala ala nke akụkụ ahụ ma ọ bụ akwara, sclerosis ha, dystrophy ma ọ bụ atrophy, angina pectoris kwụsiri ike, ụkọ akwara.
Seconddị nke abụọ, taya ahụ na-adịkarị anya mmiri na ọpụpụ nke akwara ya, nsogbu dị iche iche - nnukwu akwara vaskụla ụsọ na ischemia nke akụkụ ahụ, angina na-ejighị n'aka na ọrịa coronary syndrome, isi awọ nke ụbụrụ, agba agba nke nsọtụ ya.
Ihe ndabere nke ọgwụgwọ nke atherosclerosis na mgbochi ya
Ọgwụ ọgwụgwọ emeela ka ọ pụta ìhè na usoro ọgwụgwọ nke atherosclerotic mepụtara n'ụlọ ọgwụ ma jiri obi ọcha mezuo usoro agbakwunyere, ọ na-agụnye mmezi mmachi nke ihe ndị gbanwere.
Ngwakọta a gụnyere - usoro oriri na-edozi ahụ, iji akwụkwọ nri na mkpụrụ osisi ọhụrụ, ọka, ngwaahịa mmiri ara ehi na ịmalite usoro ọchịchị mmanya.
Ọ dịkwa mkpa ịkwụsịcha ị smokingụ sịga, ị alcoholụ mmanya na-egbu egbu, imega ahụ zuru oke (ịga ije, ịgba ọsọ, ikuku.)
Isi ọgwụgwọ bụ ọgwụ, nke a gụnyere ọgwụ ọgwụ ọgwụ nke ebumnuche iji belata cholesterol na nkebi ya:
- statins (Atorvastatin, Lovastatin, Simvastatin);
- fibrates;
- probucol;
- nicotinic acid.
Ejikwala:
- ndị na-egbochi antiplatelet (Acetylsalicylic acid, Magnikor);
- anticoagulants (heparin);
- ọgwụ vasoactive (Cilostazolum);
- antispasmodics (Drotaverinum, Papaverineum);
- nhazi nke vitamin.
N'ọnọdụ dị oke njọ nke ọrịa ahụ, yana nnukwu nsogbu, ọnya trophic nke anụ ahụ dị nro na nkwarụ ụkwụ, a na-eji ọgwụgwọ ịwa ahụ mee ihe - site na arụmọrụ dị ala iji weghachi ọbara ọbara (ịgbanye ụkwụ, ịwa ahụ, balloon angioplasty), mwepụ nke arịa ndị metụtara (endarterectomy na arịa ụgbọ mmiri ndị ọzọ) tupu oge maka ebumnuche ahụ mwepu nke anụ ahụ na - adịghị agbanwe agbanwe (necrectomy, mbepu nke ukwu).
Mgbochi nke ịbawanye cholesterol na mmepe nke atherosclerosis bụ nke mbụ - na ndị ahụike, na nke abụọ - na -arịa ọrịa oria.
Nzọụkwụ ndị mbụ nke mgbochi mbụ bụ nri dị mma, mmega ahụ na-adịghị ala ala, ịhapụ omume ndị na-adịghị mma, nrụgide nlele na ọkwa cholesterol, nyocha ahụike oge niile site na onye na-ahụ maka dọkịta.
Maka mgbochi nke abụọ, ọ dị mkpa ịmalite site na ọgwụgwọ nke ọrịa concomitant, iwetulata ọbara mgbali elu, iwere statins na antiplatelet, nyocha oge na ọgwụgwọ nsogbu.
A kọwara etiology nke atherosclerosis na vidiyo n'isiokwu a.
