Cov lus nug ntawm dab tsi raws nraim yog atherosclerosis, ib tug kab mob ntawm tsuas yog cov hlab ntsha lossis lub cev tag nrho, yog qhov nyuaj heev.
Tso tawm rau ntawm cov phab ntsa ntawm cov hlab ntsha ntawm cov sib txuas tshwj xeeb ntawm cov roj (cholesterol) thiab protein - qhov no feem ntau qhia tau hais tias muaj kev cuam tshuam ntawm metabolic feem ntau.
Atherosclerosis yog ib hom mob insidious. Koj tuaj yeem nyob ntau xyoo yam tsis muaj kev txhawj xeeb thiab tsis paub txog tias muaj teeb meem, txog thaum mam li nco dheev muaj kev mob hnyav rau ntawm ib tug neeg, ua rau nws xiam oob qhab lossis tag nrho nws lub neej tam sim ntawd.
Tus kab mob no kho tsis tau. Koj tsis tuaj yeem thim rov qab thiab "ntxuav cov hlab ntsha," raws li cov lus tshaj tawm kev tshaj tawm tsis zoo, tab sis koj tuaj yeem ua kom qeeb nws txoj kev txhim kho thiab tiv thaiv cov teeb meem.
Qhov tshwm sim ntawm atherosclerosis feem ntau ua rau neeg tuag taus, yog li "koj yuav tsum paub tus yeeb ncuab hauv tus kheej" thiab nkag siab txog cov txheej txheem thiab cov kev rau lawv thiaj li yuav zam kev puas tsuaj.
Feem ntau, cov teeb meem ntawm atherosclerosis yog ntsib los ntawm cov neeg ntawm hnub nyoog laus. Hauv cov xyoo hluas, txiv neej feem ntau yuav raug kev txom nyem, tab sis ntau xyoo dhau los, qhov pheej hmoo ntawm kev muaj mob tau yog qib. Vim tias cov tshuaj hormones hloov pauv, tus pojniam lub cev tseem qiv nws tus kheej rau qhov txaus ntshai.
Qhov tsis muaj qee yam tshuaj xws li tshuaj estrogen thaum lub sijhawm ntas ua rau kev loj hlob ntawm atherosclerosis. Tus kab mob no tau lees paub tias yog hom kab mob vascular feem ntau nyob hauv lub ntiaj teb, nws lub txim yog lub plawv nres, mob hlab ntsha tawg thiab lwm yam kab mob tuag taus.
Lub ntsiab ntawm atherosclerosis
Muaj ntau ntau ntawm ntau cov laj thawj uas ua rau kev txhim kho ntawm pathology.
Tsis muaj kev pom zoo ntawm cov kws tshawb fawb txog nws cov kev qhia.
Ntau yam ntawm cov neeg ua haujlwm tau paub ntev thiab cov pov thawj, thiab qee qhov tsuas yog "cov neeg phem" thiab kev tshawb fawb tseem muaj txuas ntxiv, tab sis kev ceeb toom yog qhov tsim nyog rau txhua yam.
Yog li, ntawm qhov ua rau ntawm kev txhim kho raug hu ua:
- Neeg muaj keeb. Nws yog qhov tseeb tias cov caj ces tuaj yeem txiav txim siab cov txheej txheem yam ntxwv ntawm phab ntsa vascular, uas ua rau pom cov plaques.
- Haus Yeeb. Tsis muaj qhov tsis lees paub tias qhov pom thiab kev loj hlob ntawm atherosclerosis ntau dua nyob rau hauv cov neeg haus luam yeeb.
- Kev tsis sib haum xeeb ntawm cov lipid metabolism - cuam tshuam nrog keeb kwm keeb kwm poj niam (kev hloov pauv muaj hnub nyoog hauv keeb kwm hormonal, vim kev tsim cov roj (cholesterol) ua haujlwm) lossis nrog lub neej tsis ncaj ncees. Qhov zoo tshaj yuav tshwj xeeb tshaj yog tuag ua ke nrog txoj hlab ntshav txhaws thiab rog rog.
- Kev puas tsuaj rau sab hauv cov hlab ntsha thaum kis mob nrog qee cov kab mob (mob) lossis mob chlamydia - cov kev xav tseem xav tau pov thawj, tab sis muaj kev soj ntsuam.
- Autoimmune ntshawv siab - ib qho kev ua yuam kev hauv lub cev tsis muaj zog, hauv lub hlwb ntawm lawv tus kheej cov hlab ntsha tau pom los ntawm lub cev raws li txawv teb chaws.
- Kev ua txhaum ntawm cov kab mob antioxidant ntawm lub cev thiab kev hloov pauv ntawm cov qauv ntawm cov leeg nqaij ntawm cov hlab ntsha, qhov hu ua peroxide thiab monoclonal theory.
- Lipoprotein infiltration, uas yog, qhov kev tso tawm ntawm lipids nyob rau hauv cov hlab ntsha ntawm cov hlab ntsha yog vim li cas tseem tsis tau pom tseeb.
Muaj lwm lub tswv yim, tab sis txawm li cas los xij, kev ua neej, khoom noj khoom haus, kev tawm dag zog, thiab qhov tsis muaj qhov tsis zoo yog qhov tseem ceeb.
Cov pathophysiology ntawm cov txheej txheem tau muab faib ua ntau theem.
Qhov "lipid stain" nyob rau thawj theem yog hloov los ntawm "kua quav ua kua", thaum tso nyiaj xoob yog qhov txaus ntshai vim qhov yooj yim ntawm kev sib cais ntawm cov khoom ntiag tug los ntawm lawv, thiab cov txheej txheem xaus nrog kev ua kom tiav thiab tuab ntawm qhov tso nyiaj vim yog cov calcium ntau nyob hauv lawv.
Kev txhim kho ntawm atheromatosis yog kawg theem ntawm cov txheej txheem uas cov quav hniav raug mob, raug rhuav tshem nrog kev tsim cov ntshav txhaws thiab mob txhab. Ib feem ntawm cov quav hniav pov tseg tuaj yeem sib kis tau los ntawm cov hlab ntsha mus rau yuav luag txhua qhov ntawm lub cev thiab kabmob, ua rau muaj kev tsis sib haum xeeb ntau.
Atherosclerotic plaques tuaj yeem cuam tshuam tsis tsuas yog sab hauv puab ntawm cov hlab ntsha - lawv pom, piv txwv li, ntawm lub plawv li qub lossis tendons.
Kev pom thiab cov kev mob tshwm sim ntawm atherosclerosis
Kev tshwm sim ntawm atherosclerosis - qhov no yog qhov tshwm sim, qhov tseeb, twb muaj teeb meem, vim hais tias thaum xub thawj nws yog "neeg tua ntsiag to thiab ntsiag to" uas tsis ua rau muaj kev tsis txaus siab.
Hmoov tsis zoo, feem ntau muaj cov kab mob atherosclerosis hauv tib neeg ua kev paub tsuas yog posthumously.
Nws kuj tseem tshwm sim uas twb tau nqaim me ntsis ntawm lub lumen ntawm cov leeg tuaj yeem ua rau ischemia, uas yog, tsis muaj ntshav txaus, thiab ua rau tus neeg mob muaj teeb meem ntau.
Atherosclerosis muaj ntau-ib tog - muaj cov qhov txhab hauv zos thiab dav dav, thiab cov chaw kuaj mob yog vim thaj chaw hauv ib cheeb tsam thiab qhov neeg muaj ntau qib ntawm cov txheej txheem pathological.
Feem ntau cov teeb meem yog cov txheej txheem hais tawm atherosclerotic hauv ib lossis ob lub plab hnyuv siab raum, uas txiav txim siab cov tsos mob ntawm tus kab mob.
Cov kabmob twg uas feem ntau raug kev txom nyem?
Dab tsi cuam tshuam rau atherosclerosis? Cia peb ua tib zoo xav txog txhua yam khoom hauv nruab nrog cev.
Lub hlwb. Thaum cov hlab ntsha ntawm lub hlwb lossis carotid cov hlab ntsha tau sib chwv nrog ib qho quav atherosclerotic, nws cov seem ua haujlwm, uas yog, emboli, lossis tawg ntawm lub nkoj nrog plaque ulceration, mob hlab ntsha tawg - kev ua txhaum ntawm cov hlab hlwb. Nws cov tsos mob tuaj yeem muaj ntau yam thiab nyob ntawm qhov chaw thiab qhov loj ntawm "tuag" lub hlwb ntaub. Hmoov tsis zoo, qhov no yog ib qho ntawm cov teeb meem feem ntau ua rau tuag thiab muaj mob xiam oob qhab loj hauv atherosclerotic lesions.
Plawv Qhov no kuj yog ib qho ntawm qee qhov xwm txheej tsis zoo cuam tshuam nrog kev txhim kho ntawm cov hlab plawv, mob angina pectoris, thiab tom qab myocardial infarction nyob rau hauv cov ntshav qab zib, uas yog, necrosis ntawm qee qhov ntawm lub plawv mob vim qhov tsis muaj ntshav txaus.
Aorta. Qhov tseem ceeb tshaj plaws thiab lub nkoj loj tshaj plaws hauv tib neeg lub cev yog kab tias tsis tshua muaj kev txom nyem, tab sis nws qhov txhab yog ib txwm mob hnyav - tus mob anortic aneurysm, uas yog, thinning thiab stratification ntawm nws lub phab ntsa nrog kev tsim ntawm ib hom "hnab", uas tuaj yeem ua rau tawg - qhov xwm txheej zoo li no, muaj peev xwm nres loj heev los ntshav thiab cawm tus neeg mob yog ntsuas hauv feeb, lossis txawm vib nas this.
Lub raum. Kev mob ntshav hauv lub raum tuaj yeem ua rau mob ntev, uas yuav xav tau kev txhim kho ntawm cov leeg ntshav liab los yog cov kev mob siab ntawm ib qho uas twb muaj lawm; thiab nws kuj tseem tuaj yeem ua rau tawg "ntse" nrog kev txhim kho lub raum infarction thiab nws qhov mob hnyav, txawm tias ua rau tuag taus.
Txoj hnyuv. Yog, tseem muaj ischemic mob hnyuv nrog qhov kev hem thawj ntawm txoj kev loj hlob, lub npe hu ua mesenteric thrombosis - ib nrab ntawm cov leeg mob necrosis thiab mob peritonitis. Txoj kev muaj mob hnyav, nyuaj rau kev kuaj pom tus kab mob, feem ntau tuag taus.
Cov hlab ntsha ntawm cov qis qis. Cov tsos mob - sib quas ntus claudication, trophic mob rwj thiab txawm tias mob caj dab, uas yog, cov nqaij mos necrosis vim tsis muaj ntshav txaus.
Nyiaj txiag cov hlab. Los ntawm cov kev mob ntsws me ua kom tiav qhov tsis pom kev thiab qhov muag tsis pom kev - qhov no yog qhov pom ntawm lub qhov muag puas tsuaj hauv tus kab mob no.
Feem ntau, atherosclerotic vascular kev puas tsuaj tshwm sim nyob rau hauv qhov chaw ntawm lawv cov ceg, qhov twg cov ntshav ntws tsis sib luag ntawm txhua qhov chaw thiab cov xwm txheej zoo yog tsim rau kev ua haujlwm ntawm cov cholesterol nyob ntawm phab ntsa - qhov no yuav yog qhov chaw sib cais ntawm cov carotid leeg rau hauv cov ceg sab hauv thiab sab nraud, ntu pib ntawm lub raum lossis ceg ntawm cov leeg txoj hlab ntshav.
Kev kuaj mob thiab kho mob
Txhua tus kws kho mob muaj peev xwm ua ntej txhua tus ua tib zoo mloog cov lus tsis txaus siab thiab sau anamnesis - uas yog, nws yuav nthuav dav nug tus neeg mob txog nws txoj kev xav, ntau npaum li cas thiab kev kho mob ntawm kev txhim kho cov tsos mob, concomitant kab mob thiab keeb yam muaj keeb.
Thaum kuaj, tus kws kho mob yuav mloog zoo rau cov tsos mob ntawm lub plawv tsis ua haujlwm ntawm cov plab hnyuv siab raum, muaj cov yam ntxwv "ntiv nplhaib" atherosclerotic "rau ntawm iris thiab ntsuas" zoo "ntawm cov mem tes rau ntawm cov hlab ntsha palpable.
Tom qab theem no, koj tuaj yeem ntsuas qhov ua tau thiab theem ntawm cov txheej txheem atherosclerotic.
Raws li kev soj ntsuam ntxiv - qhov no yog kev kuaj ntshav rau cov kab mob biochemical thiab qhov lipid profile, thiab ultrasound dopplerography, duplex, triplex thiab X-ray kuaj ntshav nrog cov kev qhia ntawm tus neeg sawv cev tshwj xeeb - txhua qhov no tso cai rau peb los ntsuas qhov tob ntawm kev puas tsuaj rau cov hlab ntsha thiab qhov muaj peev xwm ntawm kev rau txim loj.
Kev kuaj mob tau tsim tsa. Yuav ua li cas Txoj kev cawm seej tseem ceeb yog kev kho lub neej, raws li tau hais dhau los, nws yog tias rau feem ntau txiav txim siab qhov ua tiav ntawm kev kho.
Tseem muaj ntau pawg tshuaj uas tsim los txhim kho qhov teeb meem:
- Daim ntawv sau tshuaj uas muaj ntau tshaj plaws yog ib pawg statins (Atoris, Torvakard, Vasilip thiab lwm tus), cov tshuaj tsim los txo cov roj (cholesterol) siab, ua kom cov lipid metabolism thiab tiv thaiv cov plaque ntawm cov hlab ntshav.
- Pab pawg thib ob - cov tshuaj tiv thaiv antiplatelet (nto moo tshaj plaws thiab ntau yam - acetylsalicylic acid, Aspirin), uas tiv thaiv kom tsis txhob mob thrombosis thiab txhim kho "fluidity" ntawm cov ntshav.
- Hauv qhov chaw thib peb yog beta-blockers (Atenolol, Corvitol), uas "thim" cov leeg plawv, txo cov zaus ntawm kev tawm tsam, txo qhov xav tau cov as-ham, txo qis ntshav siab thiab qhov ntxim nyiam ntawm lub plawv nres.
- ACE inhibitors (angiotensin-hloov enzyme) - Prestarium, Enalapril - lawv txo qis ntshav siab, thiab qeeb kev txhim kho ntawm atherosclerosis.
- Diuretics - tseem txo cov ntshav siab, txo cov ntshav ntawm lub cev mus rau hauv cov hlab ntshav cov ntshav, thiab yog ib feem ntawm ntau cov tshuaj sib xyaw.
- Lwm tus - piv txwv, rau kev kho mob ntawm angina pectoris lossis ntshav qab zib mellitus, uas tseem cuam tshuam cov cuam tshuam ntawm atherosclerosis.
Yog tias kev kho tshuaj tsis txaus, siv cov hauv kev ua haujlwm xws li angioplasty, bypass phais, endarterectomy - uas yog, mechanically nthuav lumen ntawm cov hlab ntsha cuam tshuam, hloov qhov puas lawm lossis cia cov ntshav ntws "bypass".
Thaum muaj kev cuam tshuam loj heev - kev mob plawv lossis mob hlab ntsha tawg - muaj peev xwm ntawm kev kho mob thrombolytic, uas yog, kev txhim kho ntawm lub thrombus hauv lub sijhawm mob sai; hmoov tsis zoo, cov nyhuv tsis tuaj yeem ua tiav tas li, ntxiv rau, cov tshuaj no tuaj yeem ua rau ntshav los ntshav.
Tus kws tshaj lij hauv cov yeeb yaj kiab hauv tsab xov xwm no yuav tham txog atherosclerosis.
