Atherosclerotic cardiosclerosis yog ib qho kev loj hlob ntawm kev sib txuas ntawm cov caws pliav uas tshwm sim hauv myocardium (cov leeg nqaij ntawm lub plawv), uas tshwm sim los ntawm kev puas tsuaj rau cov hlab ntsha. Tus kab mob no loj heev, thiab txhua tus neeg uas raug mob los ntawm nws yuav tsum tau saib xyuas los ntawm kws kho plawv. Tab sis nws lub xub ntiag tsis yog kab lus yog tias cov tsos mob tau kuaj pom lub sijhawm thiab kev kho mob pib. Txawm li cas los xij, lub ntsiab lus tseem ceeb, yog li nws tsim nyog them me ntsis ntxiv rau nws qhov kev txiav txim siab.
Pathogenesis
Atherosclerotic cardiosclerosis yeej tsis tsim ntawm nws tus kheej. Nws ib txwm tshwm sim los ntawm cov teeb meem metabolic thiab ischemia tshwm sim hauv myocardium (CHD). Nws yog vim li no tias qhov kev loj hlob qeeb ntawm dystrophy thiab atrophy pib, raws li qhov tshwm sim ntawm cov nqaij fibers tuag. Tom qab ntawd, thaj chaw ntawm necrosis thiab nti me me tsim nyob rau hauv lawv qhov chaw. Vim qhov kev tuag ntawm receptors, qhov rhiab heev ntawm cov ntaub so ntswg myocardial rau cov pa oxygen txo, thiab qhov no ua rau muaj kev mob plawv ntxiv.
Rau atheroscleroticcardiosclerosis yog tus cwj pwm los ntawm kev kawm ntev thiab nthuav dav. Raws li nws nce mus, kev kho mob hypertrophy tshwm sim. Tom qab ntawd muaj qhov nthuav dav ntawm sab laug ventricle, cov cim qhia ntawm lub plawv tsis ua haujlwm tau pom tseeb dua.
Nws yog ib qho tseem ceeb kom nco ntsoov tias cov txheej txheem pathogenetic txawv. Yog li, cardiosclerosis yog ischemic, postinfarction thiab sib xyaw. Yog tias peb tham txog etiology, ces muaj myocardial, post-infarction, atherosclerotic thiab thawj hom.
Cas thiab kab mob
Cardiosclerosis tshwm sim nyob rau hauv txhua rooj plaub vim atherosclerotic lesions ntawm cov hlab ntsha, los ntawm cov ntshav mus rau myocardium yog nqa tawm. Qhov laj thawj yog qhov ua txhaum ntawm cov roj cholesterol metabolism. Nws yog tus uas tau nrog ntau dhau ntawm cov rog zoo li cov tshuaj hauv cov hlab ntsha sab hauv.
Yuav ua li cas sai sai atherosclerotic cardiosclerosis txhim kho nyob ntawm peb yam:
- Kev muaj ntshav siab. Nws tshwm sim los ntawm cov ntshav siab tsis tu ncua los ntawm 140/90 mm Hg. Art. thiab saum toj no.
- Tendency rau vasoconstriction. Qhov no yog lub npe ntawm qhov nqaim ntawm lumen ntawm cov hlab ntsha, cov hlab ntsha tshwj xeeb.
- noj ntau dhau ntawm cov khoom noj muaj calorie ntau, cov zaub mov muaj rog.
Raws li kev cuam tshuam ntawm cov xwm txheej no, muaj kev ua txhaum ntawm permeability ntawm phab ntsa vascular. Tom qab ntawd, cov plaque uas muaj lipids yog tsim nyob rau sab hauv ntawm lub nkoj. Nws yog nws tus uas dhau los ua kev cuam tshuam rau cov ntshav ntws,vim nws thaiv lub txaj vascular.
Yog tias lub lumen raug kaw los ntawm 70%, cardiomyocytes (myocardial cells) vim ua rau cov pa oxygen tshaib plab plam lawv lub peev xwm los cog lus thiab ua cov impulses. Yog li ntawd, lawv rov tsim dua thiab tuag. Nov yog qhov caws pliav.
pib theem: cov tsos mob
Atherosclerotic cardiosclerosis ntawm qib 1 feem ntau tsis qhia los ntawm cov cim qhia. Tus kab mob tuaj yeem ua rau nws tus kheej hnov tsuas yog tom qab kev tawm dag zog lub cev. Tab sis feem ntau, cov tsos mob hauv qab no yog cov yam ntxwv ntawm daim duab kho mob:
- Ua tsis taus pa uas tshwm sim txawm tias tom qab siv lub cev me me. Raws li tus kab mob no zuj zus, nws pib cuam tshuam tus neeg txawm tias thaum taug kev.
- Kev mob plab thiab tsis muaj zog. Thaum lub sij hawm, cov tsos mob no nce.
- kiv taub hau thiab mob taub hau. Qhov no tej zaum yuav nrog tinnitus. tshwm sim vim kev tshaib plab oxygen ntawm lub hlwb.
- Mob siab nrog tus cwj pwm mob. Nws yuav dhau ob peb feeb lossis kav ntev li teev.
- Angina. Nyuaj mob hauv lub plawv tawg mus rau sab laug pob txha, caj npab thiab lub xub pwg hniav.
- Lub plawv dhia tsis xwm yeem. Lawv tuaj yeem tshwm sim hauv atrial fibrillation, extrasystole thiab tachycardia. Nws tsis yog qhov tsis yooj yim rau cov neeg mob cardiosclerosis kom muaj lub plawv dhia ntau tshaj 120 neeg ntaus ib feeb.
- Edematous syndrome hauv ko taw thiab ob txhais ceg. Raws li txoj cai, nws ua rau nws tus kheej hnov thaum yav tsaus ntuj. Kuj tshwm sim vim circulatory tsis ua hauj lwm.
Ntau tus neeg tsis themvim kev saib xyuas rau cov kev tshwm sim no, ua rau txhua yam rau lawv txoj haujlwm ntau dhau thiab ua rau qaug zog. Tab sis nws tsis pom zoo kom tsis quav ntsej cov tsos mob, vim tias thaum pib ntawm tus kab mob nws yooj yim dua los tiv thaiv qhov tshwm sim ntawm cov teeb meem txaus ntshai.
Progressive form
Atherosclerotic cardiosclerosis ntawm 2nd degree yog tus cwj pwm los ntawm kev nce ntxiv ntawm tag nrho cov tsos mob saum toj no thiab ntxiv rau lwm yam, hnyav dua. Yav tom ntej, cov kev tshwm sim hauv qab no ua rau lawv tus kheej hnov:
- Congestion in the ntsws. Cov tsos mob muaj xws li ua pa nrawm, tawv nqaij daj, tachycardia, hws txias, hnoos ntshav, qaug zog, thiab tsis xis nyob thaum pw.
- Ntau daim siab (hepatomegaly). Tab sis qhov no yog qhia los ntawm xeev siab, plab zom mov, nce hauv plab hauv ntim, kub siab.
- Cov kua dej ntau hauv plab (ascites). Ib qho kev xav ntawm qhov puv thiab hnyav tshwm sim hauv plab, thiab qhov tsis xis nyob kuj nrog belching, flatulence, o ntawm ob txhais ceg.
- mob ntsws thiab parietal pleura (pleurisy). Qhia tau tias mob hauv siab thiab hnoos heev.
Tsis tas li ntawd, tom qab ntawd, atrioventricular thiab intraventricular blockade tsim, peripheral edema tshwm, kiv taub hau ua ntu zus, thiab nco tsis zoo.
Diagnosis
Hais txog cov tsos mob thiab ua rau atherosclerotic cardiosclerosis, nws tseem tsim nyog tham txog seb tus kab mob no kuaj tau li cas.
Ua ntej tshaj, tus kws kho mob tau paub txog keeb kwm ntawm tus kab mob. ATFeem ntau ntawm cov neeg mob, cov neeg uas tau pom cov tsos mob ntawm atherosclerotic cardiosclerosis muaj keeb kwm ntawm arrhythmia, myocardial infarction, kab mob coronary, thiab lwm yam.
Tom qab ntawd, tus kws kho mob tshuaj xyuas tus neeg mob. Thiab tom qab ntawd xa mus rau cov txheej txheem hauv qab no:
- EKG. Yuav tsum tau kuaj xyuas lub plawv tsis ua hauj lwm, myocardial hypertrophy thiab muaj cov caws pliav ntawm nws.
- kuaj ntshav biochemical. Nrog nws cov kev pab, nws tuaj yeem kuaj pom beta-lipoproteins thiab cov roj cholesterol siab hauv cov ntshav.
- Echocardiogram. Cov txheej txheem no yuav qhia txog qhov txawv txav hauv myocardial contractions.
- Velergometry. Txoj kev tshawb fawb no pab txheeb xyuas cov qib ntawm myocardial cov leeg tsis ua haujlwm thiab ventricular reserves.
Tab sis cov no tsis yog tag nrho cov txheej txheem uas tus neeg yuav tsum tau ua. Tsis tas li ntawd, lub suab paj nruag, coronography, MRI, polycardiography thiab ventriculography feem ntau tau sau tseg. Lwm tus neeg tuaj yeem raug xa mus kuaj mob atherosclerotic cardiosclerosis rau kev saib xyuas ECG. Thiab kom paub meej qhov muaj effusion, ultrasound ntawm lub plab thiab lub plab kab noj hniav thiab lub hauv siab x-ray yog ua.
kev kho mob
Tom qab lees paub qhov kev kuaj mob ntawm atherosclerotic cardiosclerosis, ib tus neeg tau txais kev kho mob. Raws li txoj cai, ib txheej ntawm cov tshuaj, kev siv uas yog tsim nyog los tshem tawm cov tsos mob ntawm tus kab mob thiab normalize kev noj qab nyob zoo, yog raws li nram no:
- Cardiac glycosides: Korglikon thiab Digoxin. Txhim khontshav mov, normalize lub plawv dhia thiab siab, txo qhov ntim ntawm cov ntshav ncig.
- Nitropreparations: Nitrosorbide thiab Sustak. Txhim kho microcirculation, nce myocardial contractility thiab nthuav cov hlab ntsha.
- YVasodilators: Molsidomin. Nws muaj txiaj ntsig zoo rau elasticity thiab lub zog ntawm cov hlab ntsha.
- Calcium antagonists: Amlodipine. Txo qhov zaus ntawm contractions thiab nthuav cov hlab ntsha.
- Cytoprotectors: "Mildronate" thiab "Preductal". Txhim kho myocardial contractility thiab metabolism, rov ua haujlwm ntawm cardiomyocytes.
- Potassium channel activators, xws li Nicorandil. Txo cov ntshav siab, nce elasticity ntawm cov hlab ntsha thiab nthuav lawv.
- Beta-blockers: Metoprolol thiab Atenolol. normalize lub plawv dhia, txo qhov zaus thiab lub zog ntawm lub plawv contractions, nce lub sij hawm ntawm myocardial so.
- tshuaj tiv thaiv kab mob: Aspirin thiab Ticlopidin. Lawv tiv thaiv kev tsim cov ntshav txhaws thiab adhesion ntawm platelets.
- statins: Atorvastatin thiab Lovastatin. Lawv normalize qib roj cholesterol hauv cov ntshav thiab tiv thaiv kev tsim cov atherosclerotic plaques tshiab.
Nws yuav tsum tau muab sau tseg tias yog ib tus neeg muaj cov kab mob sib xws thiab muaj kev pheej hmoo (txog ntshav siab, piv txwv li, lossis ntshav qab zib mellitus), ces tus kws kho mob tau sau cov tshuaj uas tswj cov ntshav qabzib, nrog rau cov tshuaj diuretics thiab tshuaj tiv thaiv hypertensive.
tshuaj kho lwm yam
Lawv kuj tsim nyog hais. Muaj peev xwmKev kho mob ntawm atherosclerotic cardiosclerosis nrog pej xeem cov tshuaj yuav tsum tau tham nrog koj tus kws kho mob, tej zaum tsis xav tau nws. Tab sis feem ntau, cov zaub mov hauv qab no nyiam tshaj plaws:
- YMix cumin txiv hmab txiv ntoo (1 tsp) thiab hawthorn cag (1 tbsp), ncuav boiling dej (300 ml), cia nws brew rau hmo ntuj. Lim thaum sawv ntxov. Haus ib hnub nyob rau hauv sib npaug zos rau 5 receptions.
- Sib tov ua ke tsawg dua periwinkle nplooj (1.5 tsp), tshuaj ntsuab mistletoe dawb (1.5 tsp), hawthorn paj (1.5 tsp) thiab yarrow tshuaj ntsuab (1 tbsp. l.). Ncuav dej npau npau tshaj ib diav ntawm qhov sib tov (300 ml) thiab cia nws brew rau 1 teev. Haus qhov tshwm sim hauv 4 koob tshuaj.
- Ua ke nrog goose cinquefoil (30 g), aroma rue (30 g), lily ntawm lub hav paj (10 g) thiab txiv qaub balm (20 g). Noj 1 tbsp. l. sau thiab ncuav ib khob ntawm boiling dej. Infuse rau 1 teev, ces lim. Haus peb zaug ib hnub ua ntej noj mov rau 1 tbsp. l.
- Sib tsoo elecampane (300 g), muab tso rau hauv lub khob ntim thiab ncuav vodka (500 ml). Rau 14 hnub xa mus rau qhov chaw txias thiab lim. Haus peb zaug ib hnub, 30 grams, diluted nyob rau hauv ib tug me me dej.
- Txiv hmab txiv ntoo ntawm prickly hawthorn (30 pieces) ncuav ib khob ntawm boiling dej. Cia nws brew. Berries tuaj yeem raug tshem tawm kom muaj txiaj ntsig zoo dua. Ua cov tshuaj no txhua hnub.
- Buckwheat paj (1 tablespoon) brew nrog boiling dej (500 ml) thiab cia nws brew rau 2 teev. Ces lim. Haus 1/2 khob peb zaug ib hnub, ib txwm sov.
Kuj tiv nrog cov neeg mob atherosclerotic cardiosclerosis nrog kev cuam tshuam ntawm kev sib dhosKev siv cov kua txiv hmab txiv ntoo liab, decoction ntawm rowan bark, infusion ntawm nws cov txiv hmab txiv ntoo, nrog rau cranberries, blackberries thiab noog cherry nyob rau hauv txhua daim ntawv yuav pab tau.
Surgery
Nws yuav tsum tau ua yog tias tus neeg kuaj mob atherosclerotic cardiosclerosis tsis pom kev txhim kho tom qab siv tshuaj kho.
Nyob ntawm rooj plaub, ib qho ntawm cov haujlwm hauv qab no yuav raug qhia:
- Coronary artery bypass grafting. Tus kws phais neeg tsim ib txoj hauv kev rau cov ntshav ntxiv los ntawm cov hlab ntsha prosthetic (shunts). Qhov no yuav pab kho cov ntshav khiav thiab tshem tawm cov constriction.
- Kaw vascular angioplasty. Thaum lub sijhawm ua haujlwm no, tus kws phais tau nthuav tawm thaj tsam ntawm stenosis nrog cov quav hniav, uas yog ua los ntawm kev qhia lub zais pa tshwj xeeb. Nws kuj pab normalize ntshav ncig. Thiab thaum lub sijhawm ua haujlwm, stenosis raug tshem tawm.
- Stenting. Tus kws phais tau teeb tsa lub thav duab tshwj xeeb (stent) rau hauv lub lumen ntawm cov hlab ntsha nqaim, ua tsaug uas nws muaj peev xwm tshem tawm cov stenosis thiab normalize cov ntshav ntws.
- Tshem tawm ntawm aortic aneurysm. Tus kws kho mob tshwj xeeb tau tshem tawm qhov tsis xws luag lossis nqa tawm nws cov protrusion nrog shunting lossis prosthetics.
Txhua yam haujlwm saum toj no yog txhawm rau tshem tawm cov pa oxygen tshaib plab thiab cuam tshuam rau cov ntshav ib txwm ua rau lub plawv.
Kev noj haus
Ntau tau hais saum toj no txog dab tsi atherosclerotic cardiosclerosis yog. Yuav ua li cas kho tus kab mob no kuj meej, yog li tam sim no nws tsim nyog saib me ntsismuab kev xav txog cov ntsiab cai ntawm kev noj haus. Nws yuav tsum tau soj ntsuam yam tsis poob. Nrog cardiosclerosis, daim ntawv teev cov khoom noj txwv tsis pub zoo li no:
- Fried and cholesterol-rich food (fish, nqaij, hnyuv ntxwm, lard).
- Qee zaub: radishes, dos, taum, parsley, peas, qej.
- Cawv.
- Lub zog thiab ntshav siab haus dej (muaj zog tshuaj yej, cocoa, kas fes).
- S alt.
- Yuav khoom noj.
- Butter, tsiaj rog, margarine, cream.
- Hard cheeses.
- Eggs.
- Txhua yam qab zib heev, ntsim, ntsim thiab ntsev.
- khoom qab zib.
Thiab ntawm no yog cov npe ntawm cov zaub mov pom zoo:
- Txiv kab ntxwv thiab txiv hmab txiv ntoo: cherries, grapes, tangerines, bananas, txiv apples, kiwi.
- Ntaus, tab sis me me.
- Nyiaj teb: qos yaj ywm, txiv lws suav, carrots.
- khoom noj mis tsis muaj rog.
- Durum pasta.
- Cov kua txiv tshiab los ntawm carrots, txiv apples thiab txiv kab ntxwv.
- Y Khoom noj muaj phosphorus thiab calcium.
Kev nyiam yuav tsum tau muab rau cov zaub mov steamed thiab boiled. Ginger, kua txob liab, horseradish thiab turmeric raug pom zoo ua seasonings - lawv tuaj yeem txo cov roj cholesterol.
Koj yuav tsum tau hloov mus rau cov khoom noj muaj feem. Muaj 5-6 zaug hauv ib hnub nrog qhov sib npaug ntawm cov pluas noj. Tab sis qhov kawg yuav tsum yog 2-3 teev ua ntej yuav mus pw.
Huab cua
Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias nws tsis tuaj yeem kho tau tag nrho atherosclerotic cardiosclerosis. Kev tuag rau cov neeg raug kev txom nyem los ntawm lawv yog hem, txawm li cas los xij, tsis tas li. Thiab qhov no yog xov xwm zoo.
Nrog rau qhov mob me me thiab mob me me (qhov no yog kwv yees li 75% ntawm cov neeg mob), cov neeg mob tuaj yeem ruaj khov los ntawm kev siv tshuaj. Ntau tus neeg nyob hauv lub hnub nyoog laus yog tias lawv tau kuaj xyuas tas li nrog kws kho mob plawv, haus cov tshuaj, thiab ua raws li kev noj zaub mov qis.
Yog tias tus neeg mob tig mus rau tus kws kho mob lig, thaum nws nthuav dav, kev hloov pauv tau tshwm sim hauv myocardium, ces yuav muaj teeb meem ntawm atherosclerotic cardiosclerosis. Kev tuag hauv cov xwm txheej zoo li no tshwm sim hauv 80%. Tom qab kev phais, hauv 90% ntawm cov neeg mob, tus mob ntawm cov neeg mob zoo zuj zus tuaj, thiab cov tsos mob zoo dua.
Txawm li cas los xij tus kab mob pathology tau kuaj pom hauv ib tus neeg, nws yuav tsum tau saib xyuas tas li, tshuaj xyuas thiab kho los ntawm tus kws kho plawv tshwj xeeb. Qhov no yog qhov tsim nyog los tiv thaiv kev kis kab mob thiab ua kom lub neej zoo.
