Cov tsos mob ntawm cov txheej txheem inflammatory teb rau qhov kev txiav txim ntawm cov kab mob pathological yog cov lus teb txaus ntawm lub cev. Inflammation yog ib qho txheej txheem nyuaj uas txhim kho nyob rau hauv lub zos los yog nyob rau theem, tshwm sim nyob rau hauv teb rau qhov kev txiav txim ntawm txawv teb chaws neeg sawv cev. Lub luag haujlwm tseem ceeb ntawm kev txhim kho cov tshuaj tiv thaiv kab mob yog txhawm rau tshem tawm cov kab mob pathological thiab kho lub cev. Cov kws kho mob ua paug yog cov kws kho mob ncaj qha koom nrog cov txheej txheem no.
Qis txog cov ntsiab cai ntawm kev mob tshwm sim
Lub cev tiv thaiv kab mob yog tus saib xyuas tib neeg kev noj qab haus huv. Thaum qhov kev xav tau tshwm sim, nws nkag mus rau hauv kev sib ntaus sib tua thiab rhuav tshem cov kab mob, kab mob, fungi. Txawm li cas los xij, nrog kev ua kom muaj zog ntxiv ntawm kev ua haujlwm, cov txheej txheem ntawm kev sib ntaus cov kab mob tuaj yeem pom qhov muag lossis cov tsos ntawm cov duab kho mob tuaj yeem hnov. Nws yog nyob rau hauv xws li mob tshwm sim raws li kev tiv thaiv ntawm lub cev.
Dab tsiCov txheej txheem mob inflammatory thiab nws cov kab mob ntev. Thawj tshwm sim los ntawm qhov tshwm sim ntawm qhov tshwm sim ntawm qhov ua rau khaus khaus (kev raug mob, kev puas tsuaj, kev tsis haum tshuaj, kab mob). Cov kab mob rhiab heev muaj qhov tshwm sim ntev thiab tsis tshua pom cov tsos mob tshwm sim.
Nyob rau hauv cov lus teb hauv zos ntawm lub cev tiv thaiv kab mob hauv cheeb tsam ntawm qhov raug mob lossis raug mob, cov tsos mob hauv qab no tshwm sim:
- mob;
- tawv nqaij hyperemia;
- kev ua txhaum ntawm lub xeev ua haujlwm;
- hyperthermia (nce kub).
x
Stages ofitis
Cov txheej txheem ntawm o yog ua raws li kev sib koom ua ke ntawm kev tiv thaiv ntawm daim tawv nqaij, ntshav thiab lub cev tiv thaiv kab mob. Tam sim ntawd tom qab kev sib cuag nrog tus neeg sawv cev txawv teb chaws, lub cev teb nrog vasodilation hauv cheeb tsam ntawm traumatization ncaj qha. Muaj qhov nce hauv permeability ntawm lawv cov phab ntsa thiab nce hauv zos microcirculation. Humoral tiv thaiv hlwb tuaj ntawm no nrog rau cov ntshav ntws.
Nyob rau theem ob, lub cev tiv thaiv kab mob pib tawm tsam cov kab mob uas nyob ntawm qhov chaw puas. Cov txheej txheem hu ua phagocytosis pib. Neutrophil hlwb hloov lawv cov duab thiab nqus cov kab mob pathological. Ntxiv mus, cov tshuaj tshwj xeeb raug tso tawm, tsom rau kev puas tsuaj ntawm cov kab mob thiab cov kab mob.
Nyob rau hauv parallel nrog cov kab mob, neutrophils kuj rhuav tshem cov hlwb qub uas nyob hauv thaj tsam ntawm qhov mob. Yog li, kev txhim kho ntawm theem peb ntawm lub cev cov tshuaj tiv thaiv pib. heartho, raws li nws yog, yog tiv thaiv los ntawm tag nrho cov kab mob. Qee lub sij hawm muaj kev hnov mob hauv qhov chaw no. Cellular mediators ntawm o pib tsim los ntawm mast hlwb, uas tso cai rau koj mus ntxuav lub raug mob cheeb tsam ntawm co toxins, co toxins thiab lwm yam tshuaj.
Cov ntsiab lus dav dav ntawm tus neeg nruab nrab
Cov neeg kho mob ntawm qhov mob yog cov tshuaj nquag ntawm cov hauv paus chiv keeb, kev tso tawm uas yog nrog los ntawm cov theem tseem ceeb ntawm kev hloov pauv. Lawv yog lub luag hauj lwm rau qhov tshwm sim ntawm manifestations ntawm inflammatory tshuaj. Piv txwv li, nce permeability ntawm phab ntsa ntawm cov hlab ntsha los yog ib cheeb tsam ntawm qhov kub thiab txias nyob rau hauv qhov chaw ntawm qhov raug mob.
Lub ntsiab nruab nrab ntawm qhov mob yog tso tawm tsis yog thaum lub sij hawm kev loj hlob ntawm cov txheej txheem pathological. Lawv txoj kev loj hlob tsis tu ncua. Nws yog tsom rau kev tswj lub cev ua haujlwm ntawm cov ntaub so ntswg thiab cellular theem. Nyob ntawm qhov kev taw qhia ntawm kev nqis tes ua, modulators muaj qhov cuam tshuam:
- ntxiv (ntxiv);
- synergetic (muaj zog);
- antagonistic (tsis muaj zog).
Thaum kev puas tsuaj tshwm sim los yog ntawm qhov chaw ntawm kev ua ntawm cov kab mob, tus neeg nruab nrab txuas tswj cov txheej txheem ntawm kev sib cuam tshuam ntawm cov tshuaj tiv thaiv kab mob thiab kev hloov pauv ntawm cov yam ntxwv theem ntawm cov txheej txheem.
Nyob ntawm tus neeg kho mob inflammatory
Txhua tus kab mob inflammatory tau muab faib ua ob pawg loj, nyob ntawm lawv lub hauv paus chiv keeb:
- Humoral: kinins, ntxiv derivatives, ntshav coagulation yam.
- Cellular: vasoactive amines, arachidonic acid derivatives, cytokines, lymphokines,lysosomal yam, reactive oxygen metabolites, neuropeptides.
Humoral inflammatory mediators yog nyob rau hauv tib neeg lub cev ua ntej qhov kev cuam tshuam ntawm cov kab mob pathological, uas yog, lub cev muaj cov khoom ntawm cov khoom no. Lawv deposition tshwm sim nyob rau hauv hlwb nyob rau hauv ib tug inactive daim ntawv.
Vasoactive amines, neuropeptides thiab lysosomal yam tseem ceeb kuj yog cov qauv ua ntej. Cov tshuaj uas tseem tshuav nyob rau hauv pab pawg ntawm cellular mediators yog tsim ncaj qha rau hauv tus txheej txheem ntawm kev loj hlob ntawm inflammatory teb.
YComplement derivatives
Cov neeg kho mob ua paug muaj xws li kev qhuas cov khoom siv. Cov pab pawg no ntawm cov tshuaj lom neeg lom neeg yog suav tias yog qhov tseem ceeb tshaj plaws ntawm cov humoral modulators. Cov derivatives suav nrog 22 cov protein sib txawv, qhov tsim ntawm qhov tshwm sim thaum lub sij hawm ua kom muaj zog ntxiv (kev tsim cov tshuaj tiv thaiv kab mob los yog cov tshuaj tiv thaiv kab mob immunoglobulins).
- Modulators C5a thiab C3a yog lub luag haujlwm rau cov theem mob ntawm qhov mob thiab yog cov tshuaj histamine liberators tsim los ntawm mast hlwb. Lawv qhov kev txiav txim yog tsom rau kev nce qib ntawm vascular cell permeability, uas yog nqa tawm ncaj qha lossis tsis ncaj los ntawm histamine.
- Modulator C5a des Arg nce permeability ntawm venules ntawm qhov chaw ntawm cov tshuaj tiv thaiv kab mob thiab nyiam cov hlwb neutrophil.
- C3b txhawb phagocytosis.
- C5b-C9 complex yog lub luag haujlwm rau lysis ntawm cov kab mob thiab cov kab mob pathological.
Cov pab pawg neeg nruab nrab no yog tsim los ntawm cov ntshav thiab cov ntaub so ntswg. Ua tsaug rau kev nkag mus raupathological cheeb tsam, exudation txheej txheem tshwm sim. Ntxiv derivatives tso tawm interleukins, neurotransmitters, leukotrienes, prostaglandins thiab platelet activating yam.
Kinins
pawg tshuaj no yog vasodilators. Lawv yog tsim nyob rau hauv cov ntaub so ntswg kua thiab plasma los ntawm tej globulins. Cov neeg sawv cev tseem ceeb ntawm pab pawg yog bradykinin thiab kallidin, cov nyhuv ntawm qhov tshwm sim hauv qab no:
- koom nrog kev cog lus ntawm cov leeg ntawm cov pab pawg du;
- los ntawm kev txo cov vascular endothelium, lawv nce cov txheej txheem ntawm phab ntsa permeability;
- pab ntshav thiab ntshav siab;
- nthuav cov nkoj me me;
- ua rau mob thiab khaus;
- pab kom rov tsim dua thiab collagen synthesis.
Qhov kev txiav txim ntawm bradykinin yog txhawm rau qhib kev nkag ntawm cov ntshav plasma mus rau qhov ua kom pom tseeb ntawm qhov mob. Kinins yog cov tshuaj kho mob inflammatory. Lawv irritates lub zos receptors, ua rau tsis xis nyob, mob, khaus.
YProstaglandins
Prostaglandins yog cellular mediators ntawm o. Cov pab pawg neeg ntawm cov tshuaj no belongs rau derivatives ntawm arachidonic acid. Qhov chaw ntawm prostaglandins yog macrophages, platelets, granulocytes thiab monocytes.
Prostaglandins yog cov neeg kho mob inflammatory nrog cov haujlwm hauv qab no:
- khaus ntawm qhov mob receptors;
- vasodilation;
- nce hauv cov txheej txheem exudative;
- tauhyperthermia hauv qhov txhab;
- nrawm ntawm kev txav ntawm leukocytes mus rau thaj tsam pathological;
Leukotrienes
Cov tshuaj lom neeg lom neeg muaj feem cuam tshuam rau cov kws kho mob tshiab. Qhov ntawd yog, nyob rau hauv lub cev nyob rau hauv ib lub xeev ntawm lub cev tsis muaj zog, lawv cov naj npawb tsis txaus rau cov lus teb tam sim rau qhov ua rau khaus.
Leukotrienes provoke nce permeability ntawm phab ntsa vascular thiab qhib nkag rau leukocytes rau thaj tsam pathology. Lawv yog cov tseem ceeb nyob rau hauv lub genesis ntawm inflammatory mob. Cov tshuaj muaj peev xwm tsim tau nyob rau hauv tag nrho cov qe ntshav, tshwj tsis yog rau erythrocytes, thiab nyob rau hauv lub adventitia ntawm lub ntsws hlwb, cov hlab ntsha thiab mast hlwb.
Nyob rau hauv rooj plaub ntawm cov txheej txheem inflammatory teb rau cov kab mob, kab mob los yog ua xua, leukotrienes ua rau bronchospasm, provoking kev loj hlob ntawm o. Cov nyhuv zoo ib yam li kev ua ntawm histamine, tab sis ntev dua. Lub hom phiaj ntawm lub cev rau cov tshuaj nquag yog lub plawv. Kev tso tawm ntau, lawv ua rau cov leeg mob plawv, ua rau cov ntshav khiav qis thiab nce qib ntawm cov lus teb inflammatory.
Thromboxanes
Pab pawg ntawm cov tshuaj tiv thaiv nquag no yog tsim nyob rau hauv cov ntaub so ntswg ntawm tus po, hlwb hlwb, lub ntsws thiab cov qe ntshav, platelets. Lawv muaj cov nyhuv spastic ntawm cov hlab ntsha, txhim kho cov txheej txheem ntawm thrombus tsim thaum lub plawv ischemia, txhawb cov txheej txheem ntawm platelet aggregation thiab adhesion.
YBiogenic amines
Cov neeg nruab nrab ntawm qhov mob yog histamine thiab serotonin. Cov tshuaj yog provocateurs ntawm thawj zaug cuam tshuam ntawm microcirculation nyob rau hauv lub cheeb tsam ntawm pathology. Serotonin yog ib qho neurotransmitter uas tsim nyob rau hauv mast hlwb, enterochromaffins thiab platelets.
Qhov kev ua ntawm serotonin txawv nyob ntawm nws qib hauv lub cev. Nyob rau hauv ib txwm muaj mob, thaum tus nqi ntawm tus neeg nruab nrab yog physiological, nws tsub kom lub spasm ntawm cov hlab ntsha thiab tsub kom lawv lub suab. Nrog rau kev txhim kho ntawm cov tshuaj tiv thaiv inflammatory, tus lej nce sharply. Serotonin dhau los ua vasodilator, nce permeability ntawm phab ntsa vascular thiab dilating cov hlab ntsha. Ntxiv mus, nws qhov kev txiav txim yog ib puas npaug ntau dua li qhov thib ob neurotransmitter ntawm biogenic amines.
Histamine yog tus neeg kho mob inflammatory uas muaj ntau yam cuam tshuam rau cov hlab ntsha thiab hlwb. Ua rau ib pawg ntawm histamine-rhiab heev receptors, cov tshuaj dilates cov hlab ntsha thiab inhibits lub zog ntawm leukocytes. Thaum kis mus rau lwm qhov, nws ua rau cov hlab ntsha nqaim, ua rau muaj kev nce siab hauv intracapillary thiab, qhov sib txawv, txhawb kev txav ntawm leukocytes.
Ua haujlwm ntawm neutrophil receptors, histamine txwv lawv txoj haujlwm, ntawm monocyte receptors - txhawb qhov kawg. Yog li, cov neurotransmitter tuaj yeem muaj cov tshuaj tiv thaiv inflammatory tib lub sijhawm.
Cov nyhuv vasodilating ntawm histamine yog txhim kho los ntawm kev ua haujlwm nrog acetylcholine, bradykinin thiab serotonin.
Lysosomal Enzymes
Cov neeg nruab nrab ntawm kev tiv thaiv kab mob yog tsim los ntawm monocytes thiab granulocytes ntawm qhov chaw ntawm cov txheej txheem pathological thaum lub sij hawm stimulation, emigration, phagocytosis, cell puas thiab tuag. Proteinases, uas yog lub ntsiabib feem ntawm lysosomal enzymes, muaj qhov kev txiav txim ntawm antimicrobial tiv thaiv, lysing txawv teb chaws puas pathological microorganisms.
Ntxiv rau, cov tshuaj nquag ua kom cov permeability ntawm cov phab ntsa vascular, hloov pauv qhov nkag mus ntawm leukocytes. Nyob ntawm seb cov enzymes tso tawm ntau npaum li cas, lawv tuaj yeem txhim kho lossis ua kom tsis muaj zog ntawm kev tsiv teb tsaws ntawm leukocyte hlwb.
Cov lus teb inflammatory tsim thiab pheej mus ntev vim qhov tseeb tias lysosomal enzymes qhib lub zog ntxiv, tso cytokines thiab lymokines, qhib coagulation thiab fibrinolysis.
YCationic proteins
Cov kab mob sib kis muaj xws li cov protein uas muaj nyob rau hauv neutrophic granules thiab muaj kev ua haujlwm siab microbicidal. Cov tshuaj no ua ncaj qha rau ntawm lub cell txawv teb chaws, ua txhaum nws cov txheej txheem membrane. Qhov no ua rau kev tuag ntawm tus kab mob pathological. Tom ntej no los cov txheej txheem ntawm kev puas tsuaj thiab cleavage los ntawm lysosomal proteinases.
Cationic proteins txhawb kev tso tawm ntawm cov neurotransmitter histamine, nce vascular permeability, nrawm adhesion thiab migration ntawm leukocyte hlwb.
Cytokines
Cov no yog cellular inflammatory mediators tsim los ntawm cov hlwb hauv qab no:
- monocytes;
- macrophages;
- neutrophils;
- lymphocytes;
- endothelial cells.
Ua haujlwm ntawm neutrophils, cytokines nce qib ntawm vascular phab ntsa permeability. Lawv kuj txhawb nqa leukocyte hlwb rauKev tua, nqus thiab kev puas tsuaj ntawm cov neeg txawv teb chaws nyob hauv cov kab mob, txhim kho cov txheej txheem ntawm phagocytosis.
Tom qab tua cov kab mob pathological, cytokines txhawb kev tsim kho thiab kev loj hlob ntawm cov hlwb tshiab. Cov tshuaj cuam tshuam nrog cov neeg sawv cev los ntawm lawv pawg neeg nruab nrab, prostaglandins, neuropeptides.
Reactive Oxygen Metabolites
Ib pawg ntawm cov dawb radicals, uas, vim muaj qhov tsis sib xws ntawm cov khoom siv hluav taws xob, muaj peev xwm cuam tshuam nrog lwm cov molecules, koom tes ncaj qha hauv kev txhim kho cov txheej txheem inflammatory. Oxygen metabolites uas yog ib feem ntawm cov neeg nruab nrab suav nrog:
- hydroxyl radical;
- hydroperoxide radical;
- superoxide anion radical.
Lub hauv paus ntawm cov tshuaj nquag no yog txheej txheej ntawm arachidonic acid, phagocytic tawg thaum txhawb, thiab oxidation ntawm me me molecules.
Oxygen metabolites nce lub peev xwm ntawm phagocytic hlwb los rhuav tshem cov neeg ua haujlwm txawv teb chaws, ua rau muaj roj oxidation, kev puas tsuaj rau cov amino acids, nucleic acids, carbohydrates, uas ua rau vascular permeability. Raws li modulators, metabolites muaj peev xwm nce o los yog muaj cov nyhuv anti-inflammatory. Lawv tseem ceeb heev rau kev txhim kho cov kab mob ntev.
Neuropeptides Neuropeptides
pab pawg no suav nrog calcitonin, neurokinin A thiab tshuaj P. Cov no yog cov paub zoo tshaj plaws neuropeptide modulators. Cov nyhuv ntawm cov tshuaj yog nyob ntawmCov txheej txheem hauv qab no:
- kev nyiam ntawm neutrophils rau qhov ua kom pom kev mob;
- nce vascular permeability;
- pab nrog kev cuam tshuam ntawm lwm pab pawg ntawm neurotransmitters ntawm rhiab receptors;
- nce rhiab heev ntawm neutrophils rau venous endothelium;
- kev koom tes hauv kev tsim ntawm qhov mob thaum lub sij hawm inflammatory teb.
Ntxiv rau tag nrho cov saum toj no, cov kws kho mob nquag muaj xws li acetylcholine, adrenaline thiab norepinephrine. Acetylcholine koom nrog hauv kev tsim cov arterial hyperemia, dilates cov hlab ntsha hauv lub hom phiaj ntawm pathology.
Norepinephrine thiab epinephrine ua raws li kev hloov pauv ntawm qhov mob, inhibiting kev loj hlob ntawm vascular permeability.
Kev txhim kho ntawm cov lus teb inflammatory tsis yog kev ua txhaum ntawm lub cev. Ntawm qhov tsis sib xws, nws yog qhov qhia tau tias lub cev tiv thaiv kab mob tiv thaiv nws txoj haujlwm.
