Atherosclerosis cuta ce ta dogon lokaci na zuciya da manyan tasoshin, ana lalata shi ta hanyar bango mai jijiya da adana yawan atheromatous akan shi tare da kara rufewar lumen da ci gaban rikice-rikice daga kwakwalwa, zuciya, kodan, ƙananan hancin.
Cutar da kanta tana faruwa ne musamman a cikin tsofaffi, kodayake yanzu ƙananan ƙwayar cholesterol a jikin bangon jijiyoyin jini ana gano su ko da yara da matasa.
Idan babu ingantaccen magani, atherosclerosis na kowane wuri yana haifar da ischemia da hypoxia na gabobin da tsarin, trophic da necrotic canje-canje a cikin fata da kyallen takarda mai taushi.
Abubuwan da ke haifar da wannan ilimin cutar za a iya kasu kashi biyu - masu gyara da marasa canji.
Na farko ya hada da dalilan da zasu iya yin tasiri ga canje-canjen rayuwa da magani, anan ga wasu daga cikinsu:
- Rayuwa mai matsakaici tare da aiki mafi yawan kullun.
- Take hakkin wani m rage cin abinci - wani na yau da kullum rage cin abinci mai yawa mai, soyayyen abinci mai arziki a cikin cholesterol.
- Halaye mara kyau - yawan shan ruwa, shan taba.
- Damuwa da yawan wahalar tunani.
- Hauhawar jini a cikin jijiya tare da alamu na matsin lamba sama da 140 ta 90 millimeters na Mercury a hutawa tare da ma'auni da yawa.
- Ciwon sukari mellitus tare da mummunan glycemic iko da yanayin ketoacidotic akai-akai.
- Hypercholesterolemia - karuwa a cikin adadin jimlar cholesterol (fiye da 5.5 mmol / l), dyslipidemia - cin zarafin rabo tsakanin lipotroteins na ɓangarori daban-daban (haɓaka ƙananan lipoproteins mai yawa, triglycerides, raguwa a cikin yawan ƙwayoyin lipoproteins mai yawa).
- Yawan kiba na ciki tare da kugu a cikin maza ya wuce cm 102, kuma a cikin mata sama da 88 cm.
Abubuwan da ba za su iya tasiri ba sun hada da tarihin dangi mai wulakantar da kansa (dangi na hypercholesterolemia da dyslipidemia, mutuwar daga dangi na cututtukan zuciya har zuwa shekaru 50), shekaru (a cikin maza, atherosclerosis yana tasowa bayan shekaru 45, a cikin mata - bayan 55), jinsi ( mafi sau da yawa yana haɓakawa cikin maza, kamar yadda kwayoyin halittar jima'i na mace suna da tasirin kariya daga tasoshin jini).
Hanyoyin Pathogenetic na kirkirar plaque
Haɗin jini tare da lalacewar jijiyoyin jiki yana haifar da haifar da rikitattun abubuwa masu tasirin cholesterol tare da sunadarai, da sauyawarsu a ƙarƙashin yanayin cikin jijiya.
Ana amfani da lipids ta macrophages, wanda ke juya cikin sel xanthomatous, yana ƙaruwa sosai da girma.
Waɗannan ƙwayoyin suna haifar da haɓaka da ƙaura don abubuwan farin jini sel da platelet. Akwai adhesion da tarawar platelet, rabe-raben abubuwanda suke haifar da rashin ruwa.
Jirgin yana girma cikin sauri, yana toshe katakon jirgin ruwa saboda ƙirƙirar tsarin haɗin nama da taya.
Furtherari, a ƙarƙashin rinjayar abubuwan haɓaka, an kafa capillaries don samar da jini ga yawancin atheromatous. Mataki na ƙarshe na ci gaba shine necrosis na tsakiyar farfajiya, da ƙwayar cutawar jikinta da kuma kashinta.
Canje-canje na ƙwayoyin cuta a cikin abin da ya faru na atherosclerosis ana nuna shi ta hanyar ci gaba da cutar, daga ƙarami zuwa mai tsanani.
Mataki na farko na ci gaban atherosclerosis shine dolipid, bashi da takamaiman canje canje. An kwatanta shi da karuwa a cikin rudin bango na jijiyoyin bugun gini, cin zarafin amincinsa - mai da hankali ko duka, gumi na ɓangaren ruwa na jini zuwa cikin subendothelial sarari.
Juzuwar mucoid, tarin ƙwayoyin fibrin da fibrinogen, sauran sunadarai na plasma, ƙarancin lipoproteins da ƙwayoyin cholesterol.
Don bincika wannan matakin, ya isa a yi amfani da nazarin ilimin tarihi game da shirye-shiryen bango na jijiyoyin bugun gini da amfani da takamaiman fenti - blue thionine, wanda ake lura da metachromasia kuma wuraren da abin ya shafa suna cikin shunayya.
Mataki na biyu - lipoidosis - ana nuna shi ta hanyar ajiyar ƙwayar cholesterol da lipoproteins a cikin nau'i na kitse mai launin rawaya waɗanda basu tashi sama da matakin maganin endothelium ba.
Irin waɗannan canje-canje a cikin tsarin jijiyoyin jini za a iya lura har a cikin yara da matasa, kuma ba lallai ba ne ci gaba a nan gaba. Ana ajiye lipids a ƙarƙashin gamsai a cikin macrophages, ko sel mai kumburi, da ƙwayoyin tsoka mai laushi na jijiyoyin jini. Hakanan ana iya gano cutar wannan mataki tarihi ne, Sudan ce ke daukar nauyin 4, 5, mai ja O.
Ganin cewa atherosclerosis cuta ce mai sannu a hankali, wannan matakin na iya ɗaukar dogon lokaci bawai haifar da alamun bayyanar cututtuka ba.
Manyan tasoshin, kamar aorta, jijiyoyin zuciya, tasoshin kwakwalwa, kodan, da hanta, suna yin canje-canje na farko na cutar.
Ididdigar tsarin yana dogara da fasalin hemodynamics a rukunin shawo kan tasoshin, kamar iska mai ƙarfi a cikin jijiyoyin jijiyoyin kiɗa.
Mataki na uku na haɓakar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta shine liposclerosis - haɓakar ƙwayoyin roba da na collagen a cikin endothelium, yaduwar ƙwayoyin fibroblasts, rabuwarsu da abubuwan haɓaka da haɓakar ƙwaƙwalwar matasa.
Pathoarin ci gaban cututtukan ƙwayoyin cuta na ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar mahaifa
A zahiri, filayen suna sama sama da matakin kusanci, saman jirgin ruwa ya zama bututu, mara nauyi. Irin waɗannan lamuran za su iya taƙaita lumen na jijiya kuma su kai ga ischemia na gabobin da tsarin, dangane da wurin, ya kai ga rikice-rikice kamar bugun jini, rauni na ischemic attack, infarction na myocardial, sharewa daga tasoshin ƙananan ƙarshen.
Mataki na gaba na ci gaba da cuta shine atheromatous, yana nuna lalacewar ɓangaren ɓangaren ɓoyayyen cuta, rarrabuwar shi.
Kiristocin cholesterol, kitse mai kauri, gutsuttsuran ƙwayoyin collagen, ƙwayoyin xanthoma da ƙwayoyin T da B an gano su a cikin ƙayyadaddun taro. Wannan matattara yana rabuwa da gangar jikin jirgin ruwa ta capsule na plaque, wanda ya kunshi nama mai hadewa.
Mataki na gaba shine ulceration, wanda halayyar ƙwayar mahaifa, keɓancewa, da sakin abubuwanda ke cikin jini, kasancewar ƙwanƙwaran mahaifa atheromatous. Hadarin wannan matakin shine rashin kwanciyar hankali na irin waɗannan lamuran, yiwuwar haɓaka mummunan cutar mahaifa da rauni na jijiyoyin jini da kasusuwa.
A wurin da aka samu ciwan mahaifa, ana iya haifar da ciwan ciki - tsotsar bango na jijiyoyin jiki, har ma da fashewa. Mataki na karshe na aikin jijiyoyin halittar jijiyoyin halittar cuta shine tabbatar da kwanciyar hankali, shine sanya ma'adinan kalis a ciki.
Sakamakon haka, yankin da abin ya shafa na jirgin ruwa an haɗo, an hana lalacewa ko kuma ba ya nan.
Bayyanar cututtuka na tsarin jijiyoyin jini na iya zama polymorphic, wato, filayen da suka manyanta tare da abubuwan kara kuzari da kuma gurbatattun wurare masu ma'ana a lokaci guda.
Magungunan atherosclerotic kansu zasu iya zama rikitarwa ta hanyar basur, ƙwayar jini, da kuma kyankyasar garkuwar jiki.
Asibiti, filayen atherosclerotic sun kasu kashi biyu.
A cikin nau'ikan nau'ikan farko, murfin ƙwayar haɗin an bayyana shi sosai, mai yawa, ba mai haɗari ga lalacewa da sakin abubuwan da ke ciki, sabili da haka baya haifar da rikitarwa na atherosclerosis. Wadannan filayen ana nuna su ta hanyar rikice-rikice - ƙwaƙwalwar ischemia na gabobin ko kyallen takarda, sclerosis, dystrophy ko atrophy, angina pectoris barga, rashin ƙarfi na jijiyoyin jiki.
A nau'in na biyu, taya yana iya zama hawaye da kuma fita daga tsakiyarsa, rikice-rikice - matsanancin rashin jijiyoyin jiki da ischemia na gabobin, rashin angina da ciwo mai saurin cizo, ƙwaƙwalwar ƙwaƙwalwa, ƙwaƙwalwar ƙwaƙwalwa.
Abubuwan da ke tattare da lura da cutar atherosclerosis da rigakafin ta
Kulawar da aka riga aka kirkira allunan atherosclerotic, da aka gano a asibiti da ma'ana, ya ƙunshi tsarin haɗin gwiwa, kuma ya haɗa da mahimmancin daidaita abubuwan da za'a iya canzawa.
Wannan hadaddun ya hada da - tsarin abinci mai gina jiki, amfani da kayan lambu da 'ya'yan itace sabo, hatsi, kayan kiwo da kuma kafa tsarin sha.
Hakanan yana da mahimmanci a daina shan sigari, yawan shan barasa, isasshen motsa jiki (tafiya, gudu, iska).
Babban magani shine magani, wannan ya haɗa da magunguna waɗanda aikin aikin magunguna yana da niyya don rage ƙwayar cholesterol da sassanta:
- statins (Atorvastatin, Lovastatin, Simvastatin);
- fibrates;
- probucol;
- nicotinic acid.
Hakanan an yi amfani dashi:
- wakilan antiplatelet (Acetylsalicylic acid, Magnikor);
- maganin cututtukan jini (heparin);
- magungunan vasoactive (Cilostazolum);
- maganin antispasmodics (Drotaverinum, Papaverineum);
- shirye-shiryen bitamin.
A cikin maganganu masu tsanani na cutar, tare da rikitarwa mai zurfi, raunin trophic na kyallen takarda mai laushi da reshe na gangrene, ana amfani da maganin tiyata - daga ƙananan rauni mai rauni don sake dawo da jini (tsayawa, tiyata, balloon angioplasty), cirewar tasoshin da aka shafa (endarterectomy tare da ƙarin tasoshin jijiyar jirki) kafin tsoma baki don manufar cire kyallen takaddara mai lalacewa (necrectomy, cire wani reshe).
Yin rigakafin ƙara ƙwayar cholesterol da haɓakar atherosclerosis shine farkon - a cikin mutane masu lafiya, da sakandare - tare da cutar da ta riga ta kamu da ita.
Babban matakan rigakafin farko shine ingantaccen abinci, motsa jiki na yau da kullun, ƙaddamar da halaye marasa kyau, matsin lamba na kulawa da matakan cholesterol, manyan masu bincike na yau da kullun.
Don rigakafin sakandare, ya zama dole don fara tare da lura da cututtukan concomitant, rage karfin jini, ɗaukar statins da wakilai na antiplatelet, ganewar asali da kuma lura da rikitarwa.
An bayyana etiology na atherosclerosis a cikin bidiyon a cikin wannan labarin.
