ATHEROSCLEROSIS THIAB KAB MOB SAB HAUV: KEV TXHIM KHO KAB MOB THIAB KEV PUAS TSUAJ RAU LUB CEV

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Atherosclerosis thiab kab mob sab hauv cuam tshuam nrog cov hlab plawv feem ntau tau kuaj tam sim ntawd.

Qhov tshwm sim no tau piav qhia los ntawm qhov tseeb tias kev ua txhaum ntawm lipid thiab protein ntau yog ib qho kev rau txim lossis lub hauv paus ntawm txhua yam kab mob plawv.

Yog li, kev kuaj mob thaum ntxov ntawm atherosclerosis ua lub luag haujlwm tseem ceeb - cov txheej txheem nyuaj, vim yog pathology thaum xub thawj yuav luag tsis pom nws tus kheej.

Cov theem muaj kev txhim kho thiab cov ua kom mob atherosclerosis

Nrog atherosclerosis, muaj kev txuam nrog cov roj thiab lipid feem ntawm cov nruab nrab thiab sab hauv choroid, vim tias cov tshuaj calcium calcium tso rau ntawm cov hlab ntsha ntawm nruab nrab thiab loj caliber thiab cov nqaij sib txuas.

Thawj cov tsos mob ntawm atherosclerosis tshwm thaum cov leeg raug txhaws ntau dua ib nrab.

Cov cim ntawm tus kab mob nyob ntawm thaj tsam ntawm cov hlab ntsha cuam tshuam.

Nws yog txoj kev cais kom cais peb qib ntawm kev txhim kho pathology.

Thawj yog qhov kev loj hlob ntawm cov roj ua rog - yav tas los ua kom pom kab mob. Nws tshwm sim los ntawm kev sib txuam ntawm cov macrophages thiab cov leeg nqaij mos, uas ua rau cov lipids sib txuam. Sij hawm dhau mus, ib qho roj ntsha loj tuaj, tab sis nws lub xub ntiag tsis txhais tau tias ib tus neeg mob atherosclerosis. Txawm tias nyob hauv menyuam yaus, cov roj ntsha tuaj yeem pom nyob hauv cov hlab nrog lub taub ntawm 1-2 hli.

Qhov thib ob yog qhov kev loj hlob ntawm lub hau fibrous nyob rau sab hauv lub nkoj. Nws muaj esters thiab roj muaju hauv cov roj, uas yog qhov muag muag, thiab lipid feem - ib qho tshuaj ntsiav tuab heev. Qhov loj zuj zus ntawm fibrous plaques ua rau txoj kev nqaim ntawm lumen ntawm cov leeg. Cov roj khov ua los ntawm cov ntshav, txuam hauv cov phab ntsa ntawm lub nkoj.

Qhov thib peb - qhov muaj cov nyom tsis meej - theem kawg hauv kev txhim kho atherosclerosis. Caw nrog qhov txo qis hauv cov tuab ntawm cov tshuaj ntsiav ntawm cov tawv fibrous tsawg dua 65 microns, nrog rau qhov tshwm sim ntawm microcracks thiab mob rau ntawm nws qhov chaw. Qhov no hais txog qhov txuas ntawm cov platelets mus rau lub tsiav tshuaj, uas ua rau mob thrombosis, mob stroke, plawv nres thiab lwm yam kab mob cuam tshuam nrog cov ntshav ncig tsis zoo los yog nws ua tiav qhov kev txiav tawm hauv cov hlab ntsha cuam tshuam.

Qhov tsim ntawm atheromatous tso nyiaj yog suav tias yog cov txheej txheem ntuj, tab sis muaj qee yam ntawm ntau yam uas tuaj yeem ua kom qeeb lossis ua kom nrawm dua.

Pathanatomy suav nrog cov laj thawj:

Tub los ntxhais thiab hnub nyoog. Tus mob no tshwm sim rau cov txiv neej 3-4 npaug ntau dua li cov poj niam. Ntxiv mus, thawj cov cim qhia hauv cov txiv neej tshwm sim uas muaj hnub nyoog 45 xyoos, thiab poj niam - pib txij li 55 xyoos.
Noob caj noob ces Nws suav nrog ntau yam xws li kev ua haujlwm ntawm lub cev tiv thaiv kab mob, qhov muaj cov kab mob dyslipoproteinemia muaj keeb thiab qib hormonal.
Cov cwj pwm tsis zoo. Qhov phom sij tshaj plaws rau cov hlab plawv yog haus luam yeeb, raws li Txhua tus luam yeeb muaj qhov ntau ntawm cov nicotine thiab cov muaj phom sij. Koj tsis tuaj yeem sib xyaw nrog cawv, txawm tias 100 g ntawm liab cawv liab thaum noj hmo yog kev tiv thaiv zoo ntawm ntshav siab.

Tsis tas li ntawd, qhov ua kom hloov pauv pathological yuav yog lub cev nyhav dhau los.

Kev pham ua rau ntau yam kabmob - atherosclerosis, ntshav qab zib, thiab lwm yam, yog li ntawd, koj yuav tsum kho lub cev qhov hnyav.

Lub ntsiab ntawm atherosclerosis

Muaj ob peb hom kabmob tseem ceeb.

Qhov ntau tshwm sim yog kev faib tawm ntawm atherosclerosis, nyob ntawm qhov chaw ntawm lub qhov txhab ntawm atheromatous plaques ntawm cov hlab ntsha.

Cov hom kab mob tshwm sim ob leeg kheej thiab ntawm kab ke.

Cov kab mob atherosclerosis hauv qab no yog cov txawv:

Atherosclerosis ntawm cov hlab ntshav hlab ntsha, feem ntau tshwm sim los ntawm kev mob plawv. Vim yog kev puas tsuaj rau cov hlab ntsha hauv lub plawv, qhov khiav ntawm oxygen mus rau myocardium cuam tshuam. Raws li qhov tshwm sim, kev loj hlob ntawm tus kab mob pathology ua rau angina pectoris, mob plawv nres, mob plawv thiab ua rau lub plawv tuag sai.
Daim aortic yog ib qho kev txhab ntawm cov leeg ntshav ntau tshaj plaws hauv lub cev - aorta. Txoj kev loj hlob ntawm cov plahaum roj ntsha muaj feem cuam tshuam rau kev ua haujlwm ntawm txhua yam hauv nruab nrog cev thiab kab ke.
Atherosclerosis ntawm lub raum hlab ntsha. Ntawm cov tsos mob ntawm tus kab mob, mob thaum tso zis, qhov muaj ntshav nyob hauv cov zis, tawm tsam ntuav thiab xeev ntuav yuav tsum qhia kom meej. Kev loj hlob ntawm tus kab mob entails hnyav dua tawg thiab lub raum tsis ua haujlwm.
Atherosclerosis ntawm cerebral hlab ntsha. Lub paj hlwb yog ib qho kev sib txuas tseem ceeb ntawm lub hauv nruab nrab lub paj hlwb, yog li, oxygen tshaib plab ntawm cov khoom nruab nrog no ua rau muaj kev rau txim loj, piv txwv li, mob hlab ntsha tawg lossis hloov ischemic tawm tsam.
Obliterating atherosclerosis ntawm qis dua thiab sab saud. Thaum pib, cov phiajcim xws li ploj ntawm cov plaub hau ntawm txhais ceg thiab caj npab, liab ntawm cov ntiv tes, mob, nqaij hlav ntawm lub ntsej muag, thiab lwm yam yog pom muaj.
Atherosclerosis ntawm cov hlab ntsha mesenteric uas pub plab hnyuv. Cov cim tseem ceeb ntawm tus kab mob yog kev tawm tsam ntawm lub plab toad - colic-zoo li kev mob plab. Qhov phom sij yog thrombosis ntawm cov ceg ntawm cov hlab ntshav nrog necrosis ntawm lub plab hnyuv phab ntsa thiab mesentery.

Tsis hais hom mob pathology, sab nraud cov tsos mob ntawm atheromatous vascular lesions yuav tshwm sim:

xanthomas - cov ntaub ntawv zoo ib yam li "tubercles" uas muaj nyob rau thaj tsam ntawm cov pob qij txha thiab cov leeg;
senile koov - qhov pom tshwm ntawm cov nqaij tawv daj ua ke raws ntug ntawm lub qhov muag ntawm lub qhov muag.

Tsis tas li ntawd, xanthelasms yuav tshwm sim - kev tsim cov xim daj rau ntawm daim tawv nqaij, feem ntau muaj cov cim tuberous, vim tias ua haujlwm ntawm cov cholesterol thiab triglycerides.

Hom Mob hyperlipidemia los ntawm Fredrickson

Hyperlipidemia yog pathological dhau ntawm cov theem ib txwm ntawm lipids thiab lipoproteins hauv ntshav ntshav.

Tus kab mob no yog qhov tseem ceeb ntawm kev txhim kho cov kab mob plawv, suav nrog atherosclerosis.

Hom thiab tus txheeb ze zaus	Qhov ntsuas	Lipid uas ua rau hyperlipidemia	Thawj hyperlipidemia	Thib ob hyperlipidemia
І (1%)	Kev puas tsuaj ntawm lipoprotein lipase (LPLase), hyperchilomicronemia	Feem ntau cov triglycerides	Genetic LPL tsis muaj peev xwm	Kev tsim kho ntawm pancreatitis, mauj lupus erythematosus (SLE), mob ntshav qab zib
IIa (10%)	Siab LDL	Cov roj khov ua tiav	Familial hypercholesterolemia	Qhov tshwm sim ntawm nephrosis, hypothyroidism, mob huam sai sai, idiopathic hypercalcemia
IIb (40%)	Siab siab ntawm LDL thiab VLDL	Cov roj khov thiab triglycerides	Familial hypercholesterolemia thiab hyperlipidemia	Kev txhim kho mob ntshav qab zib, mob ntshav qab zib
III (1%)	Siab STD	Cov roj khov thiab triglycerides	Tus kab mob plab siab dysbetalipoproteinemia	Qhov tshwm sim ntawm hypothyroidism, dysglobulinemia, ntshav qab zib
IV (45%)	Muaj zog VLDL Concentration	Triglycerides	Familial hypertriglyceridemia, nrog rau kev sib koom ua ke thiab tsev neeg hyperlipidemia	Cov tsos ntawm SLE, lub raum tsis ua haujlwm, mob ntshav qab zib mellitus, mob nephrotic syndrome, glycogenosis
V (5%)	Cov theem siab ntawm VLDLP thiab chylomicrons	Feem ntau cov roj (cholesterol) thiab triglycerides	Familial hypertriglyceridemia, ua ke thiab tsev neeg hyperlipidemia	Kev tsim kho cov ntshav qab zib, glycogenosis, nephrotic syndrome, hypothyroidism, dysglobulinemia

Hypercholesterolemia - Cov Kab Mob Kis

Hypercholesterolemia hauv kev nkag siab yog ib qho mob ntsws uas tsis yog kabmob. Hloov, nws yog ib qho kev zam rau kev txhim kho ntawm qee lub pathologies.

Hypercholesterolemia yog tus cwj pwm los ntawm cov ntshav khov hauv ntshav siab. Cov qauv mob thawj thiab theem siab ntawm tus mob no tau txawv.

Thawj hypercholesterolemia tau muab faib ua ntau hom:

Tsev neeg Hauv plawv ntawm nws txoj kev txhim kho yog qhov ua tsis zoo hauv kev ua haujlwm ntawm LDL receptors. Ntxiv mus, homozygotes raug pom nrog zaus ntawm 1 hauv 1 lab. Hauv cov neeg mob, cov concentration ntawm cov roj (cholesterol) sib txawv los ntawm 15 txog 31 mmol / L. Feem ntau, mob plawv mob hlwb txog rau 20 xyoo.
Polygenic. Nws qhia tau nws tus kheej qhov tseeb uas yog los ntawm kev noj zaub mov tsis zoo los yog rog rog tiv thaiv keeb kwm yav dhau los ntawm kev quav tshuaj tiv thaiv kab mob. Cov ntsiab lus ntawm cov roj (cholesterol) hauv cov ntshav ntshav li ntawm 6 txog 8 mmol / L. Hauv cov neeg mob uas muaj mob plawv ua ntej 60 xyoo.
Tsev Neeg Sib Koom. Cov subspecies no tsuas muaj hauv 1-2% ntawm tib neeg.

Thib ob hypercholesterolemia yog ib tug mob uas tshwm sim nrog lub raum pathologies, mob ntshav qab zib mellitus (hom I thiab hom II), hypothyroidism, pancreatitis, kab mob siab, rog thiab mob biliary huam.

Daim ntawv no tshwm sim ntau dua li thawj zaug.

Kev kho thiab tiv thaiv tus kab mob

Atherosclerosis tsis tuaj yeem kho kom zoo, tab sis nws muaj peev xwm txwv kev tso tseg ntawm cov plahaum roj av nrog kev kuaj mob thiab kev kho mob tsis tu ncua.

Kev kuaj mob rau cov neeg mob atherosclerosis xws li keeb kwm kev mob, kev kuaj mob ntawm tus neeg mob, kuaj thiab cuab txoj kev tshawb fawb. Ntawm cov kev sim ntsuas tseem ceeb, tag nrho cov roj (cholesterol) thiab atherogenicity coefficient yog txawv. Cov kev kuaj mob muaj xws li angiography, mob hlwb, aortography, ultrasound ntawm cov hlab ntsha hlaus, resovasography thiab ultrasound.

Hauv 80% ntawm cov neeg mob, kev kho tshuaj kho pab tshem tawm cov tsos mob ntawm tus kabmob thiab tiv thaiv qhov tshwm sim loj. Tus kws kho mob sau ntawv rau cov tshuaj nram qab no:

Statins yog cov tshuaj uas nrov tshaj plaws nyob rau hauv kev kho mob ntawm atherosclerosis. Lawv qhov kev ua yog txhawm rau txo qis kev ua haujlwm ntawm lub siab hauv kev tsim cov roj (cholesterol). Piv txwv ntawm cov tshuaj no yog rosuvastatin thiab atorvastatin.
LCD muab tshuaj kho uas ua rau cov nyom ntawm bile acids nyob rau hauv daim siab. Cov tshuaj kho tau zoo yog Colesevelam thiab Colestyramine. Raws li qhov tshwm sim ntawm kev siv cov tshuaj ntu LCD, kev noj cov roj cholesterol kom ntau ntxiv kom ntseeg tau cov txheej txheem kev zom mov.
Fibrates yog cov tshuaj uas rhuav tshem cov roj triglycerides, ua rau cov metabolism hauv cov roj ntsha tsis muaj zog. Hauv cov tsev muag tshuaj koj tuaj yeem yuav, piv txwv li, Trikor lossis Atromid.
Niacin yog tshuaj uas ua lub luag haujlwm tseem ceeb hauv kev kho mob atherosclerosis. Nws ua cov nyhuv antispasmodic thiab vasodilator, tab sis tsis txo cov roj cholesterol. Tshuaj uas muaj cov nicotinic acid yog contraindicated rau hauv cov ntshav qab zib mellitus, kab mob ntawm lub gallbladder thiab mob siab.

Hauv kev kis mob siab, kev phais mob raug kho. Angioplasty raug xa mus rau txoj kev tsis tshua muaj nqis, thiab vascular prosthetics thiab shunting yog xa mus rau txoj kev tsis muaj nqi.

Txog kev kho thiab tiv thaiv ntawm atherosclerosis, yuav tsum muaj kev noj haus tshwj xeeb. Nws yog qhov zoo tshaj rau ua raws li cov zaub mov muaj carb qis nrog cov roj (cholesterol). Nws tsis suav nrog kev noj haus ntawm cov khoom lag luam zoo li no:

rog nqaij thiab ntses tais diav;
chocolate, muffin, pastries thiab khob cij dawb;
pickles, pickled thiab smoked lauj kaub tais diav;
cov khoom noj muaj roj rog;
cov khoom noj yooj yim, cov zaub mov nrawm, cov rog pauv;
muaj zog kas fes thiab dub tshuaj yej, dej qab zib.

Hloov chaw, kev noj haus yog muaj ntau yam muaj roj thiab nqaij ntses tsawg, muaj tshuaj ntsuab, zaub thiab txiv hmab txiv ntoo, cov khoom noj muaj roj lactic acid tsawg, mov ci dub thiab ntau yam zaub mov noj.

Cov nyhuv ntawm atherosclerosis rau ntawm cov khoom nruab nrog sab hauv tau piav qhia hauv video hauv kab lus no.

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