Tsarin atherosclerotic yana da alaƙa da samuwar ƙwayoyin atheromatous a cikin ƙwayar jijiya, musamman babba da matsakaici a diamita, toshe hanyoyin jini zuwa ga gabobin da kyallen takarda, hypoxia da ischemia na wuraren da abin ya shafa.
Cutar tana halayyar tsofaffi, amma yana yiwuwa a gano alamun farko na lalacewa a cikin yara da matasa.
Ba koyaushe ba zai yiwu a bincika kasancewar cututtukan cututtukan cututtukan cututtukan cuta a cikin yanayin da ya dace, amma tare da gano wani wuri na cin zarafi, yiwuwar yin tasirin gaske a yayin cutar ta bayyana.
Yayin cutarwar da aka gano da kuma amfani da isasshen hanya don maganin, zai iya yin tasiri kan cutar, yana rage haɗarin haɓaka siffofin masu tsauri.
Irin wannan tasirin ga jikin mutum yana hana faruwar rikice-rikice - cuta mai rarrabawa a kwakwalwa, angina pectoris, rauni na zuciya, katsewa da jijiyoyin gwiwa da kuma tashin hankali.
Sanadin Atherosclerosis
A halin yanzu ci gaban kimiyya, abubuwan da ke haifar da ci gaban atherosclerosis a cikin jiki ba a tabbatar da su ba. Hakanan, hanyar da ke bayar da tasirin gudummawa ga bayyanar ilimin halittar cuta ba a tabbatar da hakan ba.
Amintaccen kafaffen dalilai na haɗari don haɓakar atherosclerosis, kasancewar abin da ke ƙara haɓaka yiwuwar rikicewar cututtukan cuta. Duk al'amuran haɗari za a iya rarrabu cikin kungiyoyi da yawa - ba a iya daidaitawa da daidaitawa ba.
Canza dalilai sun hada da:
- Hyperlipidemia saboda yawan ƙwayar dabbobi, abinci mai yawa cikin cholesterol, sakaci na fiber da samfuran kiwo.
- Take hakkin mutuncin bango na jijiyoyin jiki saboda halaye marasa kyau - yawan shan ruwa, shan taba.
- Rashin cikakken aiki na jiki, ko akasin haka, kasancewar aiki mai nauyi na jiki.
- Kasancewar hauhawar jini da hawan jini.
- Sauran dalilai sune cututtukan cututtukan fata ko endocrine (hypothyroidism, Cutar ta Itenko-Cushing) cututtukan, raunin da ya faru.
Cututtukan da ba za a iya gyarawa sun hada da:
- shekaru - hadarin ci gaba yana ƙaruwa bayan shekaru 45 - 50;
- jinsi - maza sun fi saurin kamuwa da wannan cuta, kamar yadda kwayoyin halittar jima'i na mata suna da tasirin kariya;
- rikice-rikice na rayuwa - iyali dyslipidemia, homocysteinemia.
Binciken farko ya fara ne da cikakken tattara bayanan aikin anamnesis (tarihin) rayuwa, wanda ya haɗa da bayani game da cututtukan da suka gabata, raunin da aka yi da kuma aiki, kasancewar dangi na kamuwa da cututtukan zuciya.
Tarihin cutar kuma yana da mahimmanci - farawa, alamu na farko, lokacin su da yanayin, tambayar ta samo asali game da ko mai haƙuri ya haɗa farkon bayyanar cututtuka tare da wani abu, alal misali, gwaji da magani da aka yi a farkon, sakamakon su.
Bayyanar cututtuka na raunuka na atherosclerotic
Bayyanar cututtuka na atherosclerotic tsari ya dogara da tsawon lokacin haɓaka aikin halayyar cuta, wurin sa da kuma matakin kwanciyar hankali na jijiyoyin jijiya da kuma ƙarancin ƙarancin wadatar jini.
Maganin jijiyoyin zuciya na atherosclerosis, ko angina pectoris mai tsayayyen yanayi, yana da alamomin masu zuwa - lokaci-lokaci yana narkarda ciwo a bayan mafitsara, tachycardia da arrhythmias.
Tare da atherosclerosis na aorta (mafi girman jirgin ruwa a cikin jikin mutum), ana ganin irin waɗannan alamun - ci gaba mai ƙarfi a cikin karfin jini, ƙonewa mai ƙonewa, rarrafe a hannaye da ƙafa, pallor na fata na ƙananan ƙarshen, raguwa a cikin jijiyoyinsu, rashin jin daɗi, da ciwon ciki.
Lalacewa ga ƙwayar jijiyoyin jiki yana bayyana ta hanyar ciwon kai, farin ciki, tinnitus, rage ƙwaƙwalwar ajiya da iyawar hankali, daɗa matsa lamba na intracranial.
Hadaddun matakai na ganewar asali sun hada da dakin bincike da na kayan aiki.
Dakin gwaje-gwaje ya haɗa da ɗakunan asibiti da takamaiman hanyoyin bincike.
Onesayyadaddu sun haɗa da adadi na jini tare da farin farin ƙwayar sel, fitsarin urinal, da glucose mai azumi.
Musamman sune nazarin kimiyar kwayoyi tare da tabbatar da kwayar cutar lipid, electrophoresis na serum lipoproteins, kirga matakin matakin furotin na B-pla, hanyoyin bincike na rigakafi da kuma tantancewar coagulogram.
Janar dakin gwaje-gwaje na asibiti
Gwajin jini yana ƙayyade matakin haemoglobin, adadin ƙwayoyin ja, faranti da farin jini a cikin naúra, da kuma yawan tsinkewar erythrocyte (SOE).
Ana ɗaukar jini don bincike tare da safe a kan komai a ciki, sakamakon yana kan matsakaici a shirye a cikin 'yan sa'o'i biyu.
A cikin wannan bincike, ana iya nuna kasancewar atherosclerosis ta hanyar ƙaruwa a cikin SOE - mai nuna alamar amsawar kumburi (ƙimar maza tana zuwa 1 mm zuwa 10 mm kowace awa, ga mata - daga 2 zuwa 15). Dole ne a tuna cewa wannan alamar ba ta da ƙaranci, kuma ba shi yiwuwa a binciki ainihin gano take hakkin mai.
A cikin bincike na fitsari, irin waɗannan sigogi an ƙaddara - launi, bayyana, takamaiman nauyi, kasancewar furotin, glucose, salts da ƙarin abubuwan haɗin - sel, kayan lalata, enzymes.
Mai nuna alama wanda zai iya nuna rashin aiki mai narkewa da haɓakar ƙwayar zuciya shine lactate dehydrogenase (LDH).
Wannan enzyme shine rushewar glucose, kasancewar sa a cikin fitsari yana nuna rashin isheemiyar zuciya ko infarction na zuciya.
An ƙaddara matakin glucose don bayyanar cututtuka na farko na ciwon sukari mellitus, kara haƙuri da glucose da sauran cututtukan endocrine, alamar yau da kullun tana daga 3.3 zuwa 5.5 mmol.
Increaseara yawan glucose yana nuna haɓakar ciwon sukari, wanda zai iya faruwa tare da cututtukan zuciya da na atherosclerosis.
Musamman Takaddun Nazarin Clinical
Musamman gwaje-gwaje don samar da atherosclerosis suna sa ya yiwu a ƙayyade ƙimar daidai da nau'in canje-canje a cikin metabolism na lipid, kasancewar dyslipidemia na familial da atherogenicity coefficient.
Gwajin takamaiman na farko shine gano yanayin yanayin kwayar lipid ko ƙaddarawar yawan ƙwayoyin cuta da gabobinsa.
Babban alamun alamun lipids shine matakin jimlar cholesterol, yawan adadin lipoproteins mai yawa (guntun atherogenic), yawan adadin lipoproteins mai yawa (antiatherogenic), triglycerides, chylomicrons.
A yadda aka saba, matakin jimlar cholesterol daga 3.1 zuwa 5 mmol kowace lita, wani sashe na HDL ba kasa da 1 mmol a kowace lita, abubuwan LDL da VLDL sun kai 3 mmol, triglycerides sun haura zuwa 1.7 mmol.
Anaruwar duk alamu, banda HDL, yana nuna cin zarafin haɓakar lipid da babban yuwuwar haɓakar atherosclerosis tare da ƙuntataccen ƙuntatawa wurare dabam dabam na jijiyoyin jini har ma da gushewar jijiyoyin bugun jini. Hakanan, karuwa a cikin triglycerides shi kadai alama ce mara kyau, yana nuna ci gaban angina pectoris da ciwon sukari mellitus.
Ana yin plasma electrophoresis don ƙayyade matakan lipoproteins - sunadarai masu ɗaukar jigilar fitsari. Tare da hyperlipidemia, yawan lipoproteins mai ƙarancin raguwa da ƙarancin girma yana ƙaruwa, kuma HDL, akasin haka, yana raguwa. Wannan bincike baya buƙatar shiri na musamman, maiyuwa bazai gudana akan komai a ciki ba, jini mai ɓacin rai ya zama kayan.
An ƙaddara ikon yin amfani da atherogenicity - an rage yawan HDL daga ƙimar adadin yawan lipids kuma an rarraba sakamakon sakamakon yawan lipids masu yawa.
Kayan al'ada na wannan alamar suna zuwa raka'a 3.
Matsakaicin matakin 3 zuwa 4 yana nufin babban haɗarin haɓakar ƙwayar cuta na tsarin jijiyoyin jini, haɓaka sama da 5 - cututtukan atherosclerotic na arteries sun riga sun fara.
Apo-B-lipoprotein shine furotin na jigilar jigilar abubuwa wanda ke canza triglycerides daga hanji zuwa hanta don kwayar tarin mai mai yawa.
Ka'ida ga maza sun kasance daga 60 zuwa 138 mg / dl, ga mata - 52 - 129.
Tare da haɓaka a cikin matakinsa, bi da bi, triglycerides kansu kuma suna ƙaruwa, wanda alama ce ta asibiti mara kyau.
Hanyoyin bincike na rigakafi da enzyme-mai hade da immunosorbent suna ba da damar tantance kasancewar kwayoyin halittu da kewaya kwayoyin cuta. Haɓaka cututtukan zuciya yana da alaƙa tare da kasancewar a cikin ƙwayar cuta na ƙwayoyin cuta zuwa cardiolipin da cardiomyosin, waɗannan abubuwa ne na myocardial. Amfanin waɗannan hanyoyin shine babban daidaituwa na ƙayyadaddun sha'awar canje-canje na cututtuka, rashin takamaiman horo.
Don bincika tsarin coagulation jini, ana yin coagulogram.
Akwai alamomi da yawa a ciki, babba sune ƙididdigar platelet, lokacin prothrombin, fibrinogen, lokacin thrombin, kunna lokaci na thromboplastin, da kuma gwajin ethanol.
Al'adar farantin ta fara ne daga 180 zuwa 320 Giga kowace lita (ko digiri 10 zuwa 9 a kowace lita), lokacin prothrombin daga 10 zuwa 16, fibrinogen daga gram 2 zuwa 4 a kowace lita, lokacin thrombin daga 12 zuwa 18 seconds da ethanol gwaji - daya da ko debewa.
Hanyoyin ganewar asali na zamani
Don tabbatarwa ko musun ganewar asali, ana amfani da hanyoyin kayan aikin nazarin jikin mai haƙuri.
Yin amfani da waɗannan hanyoyin yana ba da damar gano yankin da cutar take.
Bugu da kari, yin amfani da fasahohi na musamman na gwajin kayan aiki ya sa ya yiwu a tantance matsayin ci gaban cutar da kuma tantance aikace-aikacen wasu hanyoyin bayyanar da likita ga jikin mutum.
Hanyoyin bincike na kankara sun hada da:
- X-ray na kirji, x-rayukan jini (angiography - aortography, coronarography).
- Auna karfin saukar karfin jini tare da karsashin digon-gwiwa.
- Electrocardiography, echocardiography.
- Dopplerography ko duban dan tayi na jijiya.
- Gwajin damuwa na damuwa don sanin matakin ischemia na myocardial.
- MRI ko MSCT na arteries (aorta, tasoshin cerebral da ƙananan ƙarshen).
A kan hoton daukar hoton gabobin kirji, kirji ya sanya girman zuciya, watau sassan na hagu, karuwa a cikin jijiyoyin jijiyoyi, kararraki na jijiyoyin jiki, canjin ganuwar tasoshin. Rashin lafiya na ɓoyayyen zuciya da kuma aorta kanta mai yiwuwa ne. Hakanan, lokacin da jijiyoyin huhu ke shiga cikin aiwatarwa, ana inganta tsarin tsarin huhu saboda ɓangaren jijiyoyin bugun gini.
A kan electrocardiography, yawancin canje-canje ba su da ma'ana, kuma ya tashi da farko saboda ischemia myocardial. An lura da ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa kamar alamun ventricular hauhawar jini, arrhythmias, da canji a hanya (shinge). Ana amfani da ECG a cikin bincike na atherosclerosis na zuciya.
Wani muhimmin sashi na ganowar shine auna karfin matsin lamba. Ya kamata a shawarci marassa lafiya don auna karfin jini a kowace rana ko sau ɗaya a cikin kowace kwana biyu, ci gaba da ma'aunin ma'auni. Irin wannan sa ido zai taimaka wajen gano hauhawar matsin lamba a matakan farko da hana bayyanar alamun alamun karya tare da "farin hauhawar farin gashi."
Yayin aunawa, ana kuma lasafta ƙashin gwiwar maƙura na gwiwa, wato, ragin karfin jini a kafaɗa da idon kafa. Matsakaicin al'ada don irin wannan ma'aunin shine daga 1 zuwa 1.3.
Musamman karatu don sanin yanayin jijiyoyin jini:
- angiography;
- dopplerography;
- hoton sauti
- multispiral lissafin tomography.
Angiography bincike ne da ya bambanta game da tasoshin jini, ya ƙunshi sanya wakilai masu bambanci a cikin hanyar jini. Wannan hanyar tana ba ku damar sanin iyawa da diamita na ƙwaƙƙwarar jijiyoyi, yi tunanin matakin rutsawa da digirinsa.
Dopplerography na hanyoyin jini ko duban dan tayi - bincike ne na ba da labari, ban da damar da ke sama, Hakanan yana ƙayyade saurin tafiyar jini a cikin tasoshin. Mafi sau da yawa, ana yin duwatsun ko nazarin sau uku.
Nazarin ilimin ɗan adam yanzu shine hanyoyin da suka fi dacewa don ƙididdige ƙwayoyin atherosclerotic. Siffar gudanarwa daidai yake da ta angiography - an banbanta wakili a allurar ciki kuma an sanya mai haƙuri a cikin babban dakin wanka.
Ta amfani da MRI ko CT, zaku iya ƙayyade tsarin tasoshin jini, matsayinsu, nakasawa da haɗuwa da ƙwayar lumen, yanayin tafiyar jini da yanki da jijiyoyin wuya.
An bayyana alamun cutar atherosclerosis a cikin bidiyon a cikin wannan labarin.
