Atherosclerosis yog ib yam kab mob uas nrog rau cov kab mob ntawm cov hlab ntsha loj thiab nruab nrab. Nws yog tus cwj pwm los ntawm kev sib sau ntawm lipids, kev loj hlob ntawm cov fibers fibers, tsis ua haujlwm ntawm endothelium ntawm phab ntsa ntawm cov hlab ntsha. Kev loj hlob ntawm atherosclerosis tuaj yeem ua rau hauv zos thiab cov kab mob hemodynamic. IHD, ischemic stroke, obliterating lesions ntawm qis extremities, ntev occlusion ntawm mesenteric hlab ntsha muaj atherosclerosis raws li ib tug pathological hauv paus. Hauv kab lus no, peb yuav xav txog cov theem ntawm vascular atherosclerosis.
Kev piav qhia tus kab mob
Atherosclerosis yog ib qho mob ntawm cov hlab ntsha, uas yog nrog los ntawm cov txheej txheem ntawm cov roj cholesterol tso rau hauv cov hlab ntsha sab hauv. Yog li ntawd, muaj qhov nqaim ntawm lawv cov lumen, cov khoom noj khoom haus ntawm cov khoom siv ntshav tau cuam tshuam. Atherosclerosis cuam tshuam tshwj xeeb rau cov hlab ntsha nruab nrab thiab loj ntawm lub cev ntawm cov leeg-elastic thiab elastic hom. Thawj muaj xws li cov hlab ntsha ntawm lub hlwb, lub plawv, carotid. Rau qhov thib ob - lub aorta thiab lwm yam lojcov hlab ntsha. Qhov no piav qhia vim li cas atherosclerosis yog ib qho ua rau muaj kab mob hauv cov hlab ntsha, cov hlab ntsha hauv qis qis, cerebral stroke, myocardial infarction.
kuaj mob
Kev kuaj mob ntawm tus kab mob suav nrog ntsuas cov ntshav lipid, kuaj ultrasound ntawm lub plawv thiab cov hlab ntsha, kuaj mob angiographic. Kev kho mob ntawm atherosclerosis tuaj yeem yog cov tshuaj kho mob, nws tuaj yeem hais qhia hauv kev noj zaub mov. Yog tias tsim nyog, phais revascularization yog ua.
Xav txog cov theem tseem ceeb ntawm atherosclerosis. Kev puas tsuaj rau cov hlab ntsha hauv atherosclerosis yog lub cev thiab tshwm sim los ntawm kev ua txhaum ntawm cov protein thiab lipid metabolism hauv cov phab ntsa ntawm cov hlab ntsha.
Hauv cov tshuaj niaj hnub no, nws ntseeg tau tias atherosclerosis yog tus cwj pwm los ntawm ntau theem.
1 theem: pib
theem pib ntawm atherosclerosis yog qhov muaj roj (lipid) qhov chaw. Kev puas tsuaj me me rau cov phab ntsa hlab ntsha thiab qeeb ntawm cov ntshav hauv zos ua lub luag haujlwm tseem ceeb hauv cov txheej txheem ntawm cov roj deposition. Cov cheeb tsam uas cov hlab ntsha tuaj yeem cuam tshuam rau atherosclerosis. Loosening thiab o ntawm phab ntsa vascular tshwm sim. Cov tshuaj enzymatic ntawm cov hlab ntsha phab ntsa yaj cov lipids thiab tiv thaiv nws. Txawm li cas los xij, thaum cov peev txheej tau ploj mus, cov complexes ntawm cov tebchaw tau tso rau hauv cov cheeb tsam no, uas feem ntau muaj cov roj cholesterol thiab cov proteins. Lub sijhawm lipid chaw muaj lub sijhawm sib txawv thiab tuaj yeem kuaj pomnyob rau hauv ib tug me nyuam mos. Dab tsi yog lwm theem ntawm atherosclerosis?
Theem 2: Intermediate
theem ntawm liposclerosis tshwm sim nyob rau theem thib ob ntawm kev loj hlob ntawm tus kab mob. Nws yog tus cwj pwm los ntawm kev loj hlob ntawm lipid deposits nyob rau hauv cov hlab ntsha. Maj mam tsim atherosclerotic plaque, uas muaj cov ntaub so ntswg sib txuas thiab cov rog. Atherosclerotic plaques nyob rau theem no tseem ua kua thiab tuaj yeem yaj. Txawm li cas los xij, lawv friability yog qhov txaus ntshai, vim tias lawv tuaj yeem tawg thiab lawv qhov chaw tuaj yeem thaiv lub lumen ntawm cov hlab ntsha.
3 theem: hnyav
Qhov tshwm sim ntawm theem 3 atherosclerosis ntawm cov hlab ntsha hu ua atherocalcinosis. Nrog rau kev txhim kho ntxiv, cov quav hniav thickens, calcium ntsev tau tso rau hauv nws. Xws li cov quav hniav tuaj yeem ruaj khov, lossis nws tuaj yeem loj hlob, yog li deforming thiab nqaim lub lumen ntawm cov hlab ntsha. Nyob rau theem thib peb, qhov tshwm sim ntawm kev txhaws ntawm lumen ntawm cov hlab ntsha los ntawm ib feem ntawm cov quav hniav uas tau tawg, lossis los ntawm kev tsim cov thrombus, yog qhov siab heev. Nws tsis suav nrog kev loj hlob ntawm necrosis, nrog rau gangrene ntawm lub limb lossis lub cev, uas tau muab cov ntshav los ntawm cov hlab ntsha cuam tshuam.
Cov theem no ntawm atherosclerosis hauv txhua tus neeg tuaj yeem mus txawv tebchaws, txhua yam nyob ntawm nws tus kheej tus yam ntxwv. Tab sis tseem lawv muaj cov yam ntxwv zoo ib yam.
Cov laj thawj rau kev txhim kho atherosclerosis yog cais los ntawm cov kws kho mob ua peb pawg loj.
Txoj Kev Tsis Muaj Kev Ruaj Ntseg
thawj pab pawg yog yam tsis raug tshem tawm. Lawv tsis tuaj yeem raug tshem tawm los ntawm kev kho mob lossis kev xav tsis zoo. Cov no suav nrog:
- Hnub nyoog. Kev pheej hmoo ntawm kev tsim cov kab mob xws li atherosclerosis tsuas yog nce nrog lub hnub nyoog. Rau qee qhov, txhua tus neeg uas muaj hnub nyoog 40-50 xyoo tau hloov pauv atherosclerotic.
- Gender. Cov txiv neej, tsis zoo li poj niam, pib raug kev txom nyem los ntawm atherosclerosis ua ntej li ntawm 10 xyoo. Nyob rau tib lub sijhawm, txiv neej mob ntau dua 4 zaug. Tom qab 55 xyoo, qhov tshwm sim ntawm cov txiv neej thiab poj niam yog kwv yees kwv yees. Qhov no yog vim qhov pib ntawm menopause: qib ntawm estrogen txo qis thiab, raws li, lawv txoj haujlwm tiv thaiv txo qis.
- Heredity. Feem ntau, atherosclerosis pib tsim nyob rau hauv cov neeg uas nws cov txheeb ze kuj raug kev txom nyem los ntawm atherosclerosis. Cov kws kho mob tau ua pov thawj tias qhov tshwm sim ntawm kev sib deev muaj feem cuam tshuam rau qhov tseeb tias tus kab mob pib tshwm sim ua ntej hnub nyoog 50.
Txoj kev tshem tawm tau
Pab pawg thib ob yog qhov tshem tau. Qhov ntawd yog, cov uas tus neeg nws tus kheej tuaj yeem cais tawm yog tias nws hloov nws txoj kev ua neej ib txwm muaj. Cov no suav nrog:
- Kev noj zaub mov tsis zoo. Kev loj hlob ntawm atherosclerosis yog nrawm los ntawm kev noj cov tsiaj rog ntau dhau.
- Kev tsis ua haujlwm. Kev ua neej nyob tsis muaj zog ua rau muaj kev cuam tshuam hauv cov metabolism hauv cov rog, pab txhawb kev txhim kho cov kab mob xws li ntshav qab zib, rog rog, atherosclerosis ntawm cov hlab ntsha.
- Kev haus luam yeeb. Tar thiab nicotine muaj qhov tsis zoo rau cov hlab ntsha. Qhov no piav qhia txog qhov cuam tshuam ntawm qhov zoo li no. Kev pheej hmoo ntawm cov kab mob coronary artery, arterial hypertension, hyperlipidemia ntau zausnce nrog xyoo ntawm kev haus luam yeeb.
Ib nrab Tshem Tawm
Pab pawg thib peb yog ib feem tshem tau thiab muaj peev xwm tshem tawm tau. Cov no suav nrog cov kab mob thiab cov kab mob uas tuaj yeem kho nrog kev kho kom tsim nyog. Cov no suav nrog:
- Arterial hypertension. Cov ntshav siab nce ntxiv ua rau muaj zog impregnation ntawm cov hlab ntsha phab ntsa nrog cov rog, thiab qhov no ua rau muaj qhov tseeb tias atherosclerotic plaque pib tsim. Hloov pauv, txo qis elasticity ntawm cov hlab ntsha, uas tshwm sim los ntawm atherosclerosis, pab txhawb kev nce ntshav siab.
- Dyslipidemia. Lub luag haujlwm tseem ceeb hauv kev txhim kho atherosclerosis yog ua los ntawm kev cuam tshuam ntawm cov roj metabolism hauv cov rog, uas tau nthuav tawm hauv kev nce qib ntawm lipoproteins, triglycerides, cholesterol..
- Kab mob ntshav qab zib mellitus, rog rog. Cov xwm txheej no ua rau muaj qhov tshwm sim ntawm theem 3 ntawm atherosclerosis tshwm sim tam sim ntawd los ntawm qhov nruab nrab ntawm 6 zaug. Qhov no tuaj yeem piav qhia los ntawm kev cuam tshuam lipid metabolism, uas cuam tshuam cov kab mob no thiab yog qhov ua rau muaj qhov mob atherosclerotic.
- Intoxication, kis kab mob. Cov tshuaj lom thiab kis kab mob tuaj yeem cuam tshuam rau cov phab ntsa ntawm cov hlab ntsha.
Cov tsos mob ntawm atherosclerosis
Feem ntau yog atherosclerosis ntawm thoracic thiab plab aorta, coronary, mesenteric, raum hlab ntsha, hlwb hlwb thiab qis extremities. Cov theem ntawm atherosclerosis txawv nyob rau hauv uas lawv tuaj yeem yog preclinical (asymptomatic) thiab kho mob. Daim ntawv asymptomatic yog tus cwj pwm los ntawm qib siab ntawm β-lipoproteins lossis cov roj cholesterol hauv cov ntshav. Hauv qhov no, tsis muaj cov tsos mob ntawm tus kab mob. Atherosclerosis kis mus rau hauv daim ntawv kho mob thaum lub lumen ntawm cov hlab ntsha nqaim li 50%. Daim ntawv kho mob muaj peb theem, uas yog ischemic, thrombonecrotic, fibrous.
Nyob rau theem ischemic, circulatory tsis ua hauj lwm ntawm ib yam khoom nruab nrog cev, piv txwv li, myocardial ischemia yuav tshwm sim vim qhov tseeb tias cov hlab ntsha coronary tau raug kev puas tsuaj atherosclerotic. Hauv qhov no, ischemia manifests nws tus kheej hauv daim ntawv ntawm angina pectoris.
Nyob rau theem thrombonecrotic, thrombosis ntawm cov hlab ntsha cuam tshuam tshwm sim. Cov theem fibrous yog tus cwj pwm los ntawm kev loj hlob ntawm cov ntaub so ntswg hauv lub cev uas tsis zoo rau cov ntshav.
Cov tsos mob ntawm atherosclerosis nyob ntawm seb cov hlab ntsha twg tau cuam tshuam los ntawm tus kab mob. Cov tsos mob ntawm atherosclerosis ntawm coronary hlab ntsha yog angina pectoris, cardiosclerosis, myocardial infarction.
Txhua theem ntawm aortic atherosclerosis yog asymptomatic ntev, txawm tias lawv hnyav heev. Cov tsos mob yog aortalgia (nias thiab kub kub tom qab lub sternum, uas muab rau caj npab, caj dab, nraub qaum, plab). Hauv qhov no, lub sijhawm ntawm aortalgia tuaj yeem nyob ntawm ob peb teev mus rau ob peb hnub.
Yog tias atherosclerosis tau cuam tshuam rau lub plab aorta, nws yuav tshwm sim nws tus kheej nyob rau hauv daim ntawv ntawm mob plab, flatulence, cem quav, tuaj yeem o thiab liab ntawm ko taw, loog ntawm ob txhais ceg, sib quas ntus claudication, necrosis ntawm cov ntiv taw.
Symptomaticsatherosclerosis ntawm cov hlab ntsha mesenteric yog qhia los ntawm kev tawm tsam ntawm "mob plab hnyuv ntxwm", ua txhaum txoj haujlwm ntawm plab zom mov. Qhov no yog vim kev ua txhaum ntawm cov ntshav muab rau cov hnyuv. Cov neeg mob pib mob hauv ob peb teev tom qab noj mov. Tej zaum yuav muaj belching, cem quav, tsam plab, ntshav siab. Nyob rau yav tom ntej, muaj cov tsos mob xws li fetid raws plab, muaj cov khoom tawg ntawm cov rog uas tsis tau zom thiab cov zaub mov tsis zoo.
Yog tias lub raum cov hlab ntsha tau raug mob atherosclerotic, tom qab ntawd cov tsos mob ntawm cov hlab ntsha tuaj yeem tshwm sim. Urinalysis qhia txog qib siab ntawm cov qe ntshav liab, protein thiab casts.
Ntawm ntau theem ntawm atherosclerosis ntawm lub hlwb, cov tsos mob hauv qab no tshwm sim: txo qis kev nco, kev ua haujlwm ntawm lub cev thiab lub hlwb, kev xav, kev txawj ntse. Muaj kiv taub hau thiab pw tsaug zog. Hom atherosclerosis no tuaj yeem nrog los ntawm kev hloov pauv ntawm tus cwj pwm thiab lub siab lub ntsws ntawm tus neeg mob.
Cov theem ntawm obliterating atherosclerosis, uas yog, atherosclerosis ntawm cov hlab ntsha nyob rau hauv qis extremities, yog yus muaj los ntawm: mob thiab tsis muaj zog nyob rau hauv lub plab mog, chilliness ntawm ob txhais ceg, loog loog, trophic mob, pallor ntawm extremities.
Kev kho mob
Thaum kho atherosclerosis, kws kho mob sim ua raws li cov hauv qab no:
- Kev noj zaub mov uas pab txo qis cov roj (cholesterol) zoo nyob rau theem 1 thiab 2 ntawm atherosclerosis).
- Txhawb cov txheej txheem tshem tawm cov roj cholesterol.
- Kev kho tshuaj estrogen hauv cov poj niam laus.
- Kev tshem tawmkab mob.
Tshuaj
Yog tias txoj kev kho mob yog tshuaj, ces kev siv cov tshuaj hauv qab no yog ib txwm:
- Nicotinic acid, uas txo qis cov roj cholesterol. Nws muaj cov khoom tiv thaiv atherogenic.
- Fibrates, uas txo lub cev cov roj synthesis.
- Bile acid sequestrants uas khi thiab tshem tawm cov kua qaub ntawm txoj hnyuv.
- Statins zoo txo cov roj cholesterol.
kev kho mob phais
Yog tias muaj kev pheej hmoo siab lossis muaj feem cuam tshuam ntawm vascular occlusion los ntawm thrombus lossis cov quav hniav, kev kho phais yog qhia. Kev phais plawv tuaj yeem yog ob qho tib si qhib thiab endovascular. Yog tias atherosclerosis ntawm lub plawv hlab ntsha ua rau muaj kev cuam tshuam rau kev loj hlob ntawm myocardial infarction, coronary artery bypass grafting yuav raug sau tseg.
Kab lus tham txog cov theem tseem ceeb ntawm atherosclerosis.
