Atherosclerotic cardiosulinosis (mabitso a mang bakeng sa lefu lena - myocardiosclerosis, sclerosis ea pelo) ke ts'oaetso e fetelletseng ea lisele tse nang le "myocardium" ka lebaka la li-cholesterol amana le likepe tsa coronary. Letšoao le ka sehloohong la lefu lena ke lefu la methapo ea methapo e tsoelang pele, le bonahatsoang ke ho se sebetse ha pelo, arrhythmia, ho nyeleha ha pelo le bohloko ba pelo.
Tlhahlobo ea methapo e kenyelletsa mekhoa e fapaneng - electrocardiography, echocardiography, ergometry ea baesekele, cholesterol, lipoprotein le liteko tsa meriana.
Ha tlhahlobo e tšepahalang ea kalafo e etsoa ka potlako, ke moo mokuli a lokelang ho emisa phetoho ea methapo ea methapo ea methapo. Phekolo e reretsoe ho tloaetsa ho potoloha ha mali methapong ea "coronary", phepelo le morethetho, ho tlosa bohloko le ho fokotsa khatello ea cholesterol.
Lisosa le pathogenesis ea lefu lena
Ho lefu la pelo, ho lumeloa hore atherosselotic cardiosulinosis ke pontšo ea IHD. Boloetse bona bo etsa hore sebaka sa mesifa ea myocardial e lule e le teng ka maqeba.
Lebaka le ka sehloohong la nts'etsopele ea ts'ebetso ea methapo ea methapo ke ho hlahisoa ha li-cholesterol plaque ka har'a likepe tsa coronary tse etsahalang ho feta lilemo tse 50.
Li-depositi tse joalo ke litholoana tsa mathata a metabolism ea lipid, ha mali a eketsa litaba tsa lipenshene tsa lisele tse tlase (LDL) - liprotheine tse khethehileng tse tsamaisang cholesterol liseleng. Ha li qhibilihe maling, ka hona, ha ho e-na le tse ling tse ngata marakong a methapo ea mali, sethala se qala ho ba ka sebopeho sa cholesterol.
Tabeng ena, ho na le ho fokotseha ha methapo e phahameng ea methapo ea methapo ea methapo (HDL), e seng atherogenic. Mekha ea bona e phahameng ea mali ke sesupo sa metabolism e tloaelehileng ea lipid. Li-protein tsena li qhibiliha hantle maling le ho thibela ho bopa lipalo.
Lipid metabolism disorder le eona e etsahala ho batho ba sa khomareleng mokhoa o motle oa bophelo. Lintho tse eketsang kotsi ea myocardiosulinosis li kenyeletsa:
- ho se ikoetlise le ho nona haholo;
- tšebeliso e ngata ea lijo tse nang le k'holeseterole e phahameng;
- ho ba teng ha lefu la tsoekere mellitus (mofuta oa 1 kapa 2);
- tšebeliso ea lithibela-pelehi tsa li-hormone;
- mekhoa e mebe - ho tsuba le joala.
Sehlopha sa kotsi se kenyeletsa banna ba baholo ho feta lilemo tse 45, batho ba nang le lefu la tsoekere, batho ba botsofaling le ba nang le tloaelo ea ho ja lefu lena. Ho ke ho hlokomeloe hore boteng ba lefu la pelo le lefu la tsoekere le eketseha ka 80% menyetla ea lefu la pelo.
Ho shoa ha mesifa ea mesifa ea myocardium ho nka nako e telele. Ka lebaka la lefu la li-receptor, maikutlo a sebopeho sa tiske ho ea ho oksijene a fokotseha, mme ka nako eo a eketsa lebelo la nts'etsopele ea IHD.
Mefuta le mefuta ea myocardiossteosis
Boloetse bona bo iponahatsa ka mefuta e 'meli - e kenyelletsa tsepamiso e nyane le tse kholo. Phapang e kholo pakeng tsa mefuta e 'meli ea lefu lena ke sebaka sa sebaka se amehileng.
Tlhahlobo ea "diagnostic" tse nyane tse tataisang "e bolela hore lefu lena le amme libaka tse sa feteng 2 mm ka bophara. Ka hona, ka foromo e kholo-e tsepamisitsoeng, libaka tse nkeloang ke lithane tse amanang le tsona li na le bophahamo bo fetang 2 mm.
Ho na le karohano ea myocardiossteosis, ho nahanoa ka mekhoa ea pathogenetic. Ho latela sekaseka sena, mefuta e meraro ea lefu la pelo e ka khetholloa:
- Ischemic. Psychology e tsoela pele ka nako e telele, 'me e ama mesifa ea pelo hampe. Mofuta ona oa lefu o hlaha ka lebaka la ho se lekane ho potoloha ha mali le tlala ea moea.
- Postinfarction (lebitso le leng - post-necrotic). E tšoauoa ka ho theoa ha maqeba libakeng tse necrotic tsa myocardium. Li tla ka boholo bo fapaneng, ka tlhaselo ea pelo e latelang li ka li kopanya le maqeba a khale, tsa baka maqeba a maholo. Ka lebaka la ho hola ha sebaka sa leqeba, mokuli o na le khatello ea mali e amang mali.
- Phetoho (e kopantsoe). E kopanya mefuta e 'meli e kaholimo ea pathology. Bakeng la lefu la pelo le tsoakiloeng, ho ata ha mesifa ea "fibrous" ho etsahala butle, 'me ka linako tse ling ho hlahella ka necrotic ka mor'a ho hlaseloa ke pelo khafetsa.
Khafetsa, myocardiosulinosis e tsamaisana le mafu a kopaneng. Tsena li kenyelletsa ischemia, myocardial dystrophy, tšenyeho ea sebopeho sa mesifa le mathata a metabolic pelong.
Matšoao le matšoao a lefu lena
Coronarocardiosclerosis ke lefu le hlahang ka nako e telele, ka hona, matsatsing a pele motho a ka se utloe matšoao leha e le afe. Khafetsa, liphetoho tsa pele tsa pathological li bonoa ka karolo ea electrocardiogram (ECG).
Ho na le lihlopha tse tharo tsa matšoao, ho latela ho kula ha lefu lena. Li ka bolela tlolo ea tšebetso ea contractile ea pelo, morethetho le ho nyehlisoa, hammoho le ho haella hoa matla a itseng.
Haeba qalong ea nts'etsopele ea lefu la atherosselotic cardiosulinosis mokuli ha a utloe bohloko, joale ha nako e ntse e tsamaea o ka tletleba ka bohloko bo emeng ka letsoho la sternum ho le letsohong le letšehali, scapula kapa epigastric. Ho na le kotsi ea ho hlaseloa ke pelo khafetsa.
Ha lithane tse hokahaneng li hasana myocardium, mokuli o na le matšoao a latelang:
- ho fokotsa matla a ho sebetsa;
- ho hema ka thata (pele - ka mokhathala, ebe - ha o tsamaea);
- litlhaselo tsa asthma ea pelo;
- pulmonary edema.
Ha myocardiosclerosis e tsamaisana le ho nyekeloa ke pelo, ho latela mekhoa e latelang ea methapo:
- Mokelikeli o emeng mats'oafong.
- Puffuffal Peripheral.
- Keketseho ea boholo ba sebete (hepatomegaly).
- Nts'etsopele ea pleurisy le ascites.
Leqhubu la pelo le mathata a ho tsamaisoa ke moriana hammoho le myocardiosclerosis li etsa hore ho be le liphetho tse fetang e le 'ngoe. Ka lebaka leo, extrasystole e ka hlaha - likarolo tse sa tloaelehang tsa likarolo tsa motho ka mong kapa pelo eohle; fibrillation ea atria - likonteraka tse matla tsa atria le fiberrillation ea lihlopha tse itseng tsa mesifa ea lefutso; atrioventricular le intraventricular blockade.
Haeba matšoao a qalong a bonoa nako le nako, joale ha a ntse a kula a fetoha ketsahalo e tloaelehileng.
Ha o kopanya myocardiosclerosis le atherosulinosis ea aorta, mokuli e moholo oa ho potoloha le methapo ea mokokotlo (macroangiopathy), mokuli o tletleba ka matšoao a kang ts'ebetso ea boko e ntseng e mpefala, ho tsekela, ho holofala, joalo-joalo.
Kotsi ea lefu lena ke hore ka mor'a ho mpefala ha maemo, ho ka ba le ntlafatso e khuts'oane.
Ho ntlafala ho lekanang le bophelo bo botle ho ka nka lilemo tse ka bang tharo, empa ho ba le pherekano e mpe phepelong ea mali, e bakang matšoao a matla a myocardiosclerosis.
Litholoana tsa kalafo e sa sebetseng
Ka nts'etsopele ea lefu la pelo, ho bohlokoa haholo ho e khetholla ka nako le ho qala kalafo e sebetsang. Ho seng joalo, kotsi ea ho ba le mathata a maholo e ka etsahala.
Tsoelo-pele e tsoelang pele ea psychology e baka mathata a mangata. Ka lebaka la hore pelo e sitoa ho leleka mali ka botlalo, litletlebo tsa mokuli li ka tsamaisana le ho hema hanyane, ho akheha, ho ruruha ha likarolo tse phahameng, pallor ea letlalo, bohloko maotong le ho ruruha ha methapo ea mokokotlo.
Ho kopana ha liphetoho tsa myocardial le stenosis ea methapo ea mokokotlo (> 70%) ho na le mathata a mangata. Har'a bona, ho bohlokoa ho totobatsa:
- ho hloleha ha pelo ka pelo, ho bonahatsoang ke pelo e mpe haholo ea pulmonary, cardiogenic shock le pulmonary edema;
- dilatation ea methapo ea pelo, i.e. keketseho ea boholo ba likamore tsa eona;
- thromboembolism (ho thijoa ha sekepe ke thrombus) le thrombosis;
- ho phatloha ha aorta le aneurysm (vasodilation);
- fibrillation ea lefutso;
- pulmonary edema;
- tlolo ea conduction le morethetho;
- paroxysmal tachycardia.
Lipalo-palo tse nyahamisang li bonts'a hore ho 85% ea linyeoe tsa litlamorao tsa myocardiosclerosis, ho hlaha sephetho se bolaeang.
Ka hona, mokuli le ngaka ba na le mosebetsi o thata - ho latela melao eohle ea kalafo ea lithethefatsi, ho ja le ho thibela litlamorao tsa atherosselotic cardiossteosis.
Melao-motheo ea ho hlahloba lefu lena
Ho tseba lefu leha e le lefe pele ho nako e se e le halofo ea kalafo e atlehileng. Tabeng ena, lefu la pelo le bonoa nakong ea lithuto tsa tlhahlobo ea lefutso, joalo ka nako e telele ha a iketsetse maikutlo.
Ngaka e hlahloba mokuli ho latela nalane le matšoao a amanang le eona. Ha a bokella anamnesis, setsebi se khetha hore na mokuli o na le lefu la methapo ea methapo, ho tsitsinyeha ha morethetho, atherosclerosis, ho nyekeloa ke pelo, jj.
Ho netefatsa kapa ho hana tlhahlobo eo ea bongaka, ngaka e laela ho etsa tlhahlobo ea tlhahlobo ea tlhahlobo. Ho hlokahala: tlhahlobo ea mali a biochemical (LHC). Boteng ba myocarodiosulinosis, ho na le cholesterol e phahameng le beta-lipoprotein; electrocardiogram (ECG). Phuputso ena e bonts'a matšoao a ho hloleha ha pelo, morethetho oa pelo le ho hloleha ha lets'ollo, hypertrophy ea methapo e lekaneng, le boteng ba maqeba a kamora lefutso.
Echocardiography (EchoCG) le ergometry ea baesekele le tsona lia hlokahala (ho sebelisa mokhoa ona oa ho hlahloba, ho ka etsahala ho hlakisa tekanyo ea ho se sebetse hantle ka myocardial).
Mekhoa e meng ea tlhahlobo ea lefu la pelo le kenyelletsa:
- rhythmocardiography - bakeng sa ho ithuta tsa pelo;
- polycardiography - ho lekola ts'ebetso ea contractile;
- ho rekota ha nako e telele ho ECG, ho bontšang mosebetsi oa pelo bakeng sa lihora tse 24;
- coronography - ho khetholla sebaka le boemo ba ho fokotseha ha methapo ea methapo ea mokokotlo;
- ventriculography - ho lekola ts'ebetso ea contractile ea li-ventricle;
- liteko tsa pharmacological;
- MRI ea pelo;
- Ultrasound ea mokokotlo le mokokotlo oa mokokotlo;
Ntle le moo, radiograph ea sternal e ka sebelisoa.
Pheko ea atherosclerotic cardiosclerosis
Liphetoho tsa pelo le ketsahalo e ke keng ea fetoloa, ka hona e tšoaroa ka thata. Litla-morao tsa "coronary artery stenosis" le "cholesterol" li felisoa, ka potlako o ka emisa tsoelo-pele ea lefu lena.
Ka kakaretso, kalafo ea myocardiosclerosis e etselitsoe ho loants'oa matšoao a ho hloleha ha pelo, ho emisa ts'ebetso ea atherosselotic, le ho tlosa mabaka a kotsi a kang ho tsuba, ho nona le lefu la tsoekere haholo.
Phekolo ea lefu lena e kenyelletsa mekhoa ea bongaka le ea ho buoa.
Ho na le lithethefatsi tse ngata tse loantšang matšoao a lefu la pelo. Ngaka e ka fana ka litlhare tse latelang ho mokuli:
- lithethefatsi tsa nitro - bakeng sa vasodilatation, ho eketsa contractility ea myocardial le microcirculation;
- cardiac glycosides - ho nolofatsa ho otla ha pelo, phallo ea mali, khatello ea mali le ho ntlafatsa phallo ea mali;
- calcium antagonists - ho fokotsa khafetsa ha likonteraka le ho eketseha ha methapo ea kutlo;
- vasodilators - ho matlafatsa le ho eketsa elasticity ea marako a methapo ea mali;
- li-activator tsa liteishene tsa calcium - ho eketsa elasticity le ho atoloha ha methapo ea methapo, ho fokotsa khatello ea mali;
- beta-blockers - ho theola matla le sekhahla sa pelo, etsa hore morethetho oa pelo o fokotsehe le ho eketsa nako ea ho phomola;
- li-statins - ho nolofatsa metabolism ea lipid, ho fokotsa cholesterol ea LDL le ho thibela ho thehoa ha cholesterol plaque;
- li-antithrombotic agents - bakeng sa thibelo ea ho khokhotheha ka liplatelete le maratsoana a mali;
- li-cytoprotectors le lithethefatsi tse ntlafatsang metabolism - ho potlakisa lits'ebetso tsa metabolic, ho tsosolosa ts'ebetso ea cardiomyocyte le contractility ea myocardial.
Maemong moo kalafo ea lithethefatsi e sa tlise sephetho se lakatsehang, ho etsoa opereishene.
Hona le mefuta e fapaneng ea ts'ebetso e etselitsoeng ho felisa tlala ea pelo ea oksijene: corteryary artery bypass grafting, e emisang phepelo ea mali ho fihla pelong; stenting, ho felisa vasen stenosis le normalizing phallo ea mali; angioplasty e koetsoeng ea methapo ea mali, e thibelang vasoconstriction.
Ho feta moo, ho tlosoa ha aneurysm ho etsoa, ts'ebetso ena e tlosa litšitiso ho potoloha ha mali hantle.
U ka thibela nts'etsopele ea lefu lena joang?
Mehato ea ho thibela bokuli e kenyelletsa ho fetola boima ba 'mele le lijo, ho tlohela mekhoa e mebe le ho bapala lipapali.
Mokhoa feela o kopaneng oa kalafo le thibelo o ka matlafatsa ts'ebetso ea pelo le ho thibela nts'etsopele ea maloetse a kotsi.
Karolo e ikhethang e fanoa phepelong, hobane li-depositi tsa atherosulinotic li amana ka kotlolloho le metabolism ea methapo ea methapo. Molao-motheo o ka sehloohong oa phepo e khethehileng ke ho fokotsa ho ja k'holeseterole.
Malebela mabapi le ho latela lijo tse tlase tsa k'holeseterole bakeng sa lefu la pelo:
- Ho fokotsa tšebeliso ea lihlahisoa tsa liphoofolo - lihekseke tsa lehe, offal (bokong, sebete), mafura, margarine, botoro, chisi. Lihlahisoa tsena tse eketsang cholesterol li hloka ho tlohelloa hang.
- Hoa hlokahala ho ntlafatsa lijo ka mefuta e nang le mafura a fokolang, nama, lihlahisoa tsa lebese tse nang le mafura a mangata, meroho e tala le litholoana, le lijo tse phahameng ka har'a fiber ea tlhaho.
- Fokotsa tšebeliso ea letsoai ho ligrama tse 5 ka letsatsi. Sebakeng seo, o ka eketsa horseradish, ginger, konofolo. Sena se tla thusa ho fokotsa palo ea mokelikeli o eketsehileng 'meleng.
- Kantle ho soseji ea lijo, soseji, lijo tse potlakileng, lihlahisoa tse se nang letho, kofi e matla le tee, li-confectionery, li-buns, lijo tse ka makotong, tse halikiloeng, tse tsubeloang le tse mafura.
- Hoa hlokahala ho fokotsa tšebeliso ea lijo tse nang le lik'habohaedreite tse ngata. Tsena li kenyelletsa likuku, ice cream, liswiti, chokolete, morara, bijoux, bohobe bo tšoeu, metsi a monate a khabisitsoeng ka khabone.
- Khetho e lokela ho fuoa lijo-thollo tse fapaneng - oatmeal, buckwheat, nyalothe, hobane Li na le limatlafatsi tse ngata tsa tlhaho, tse thusang ho tloaela tšilo ea lijo le ho loants'a liponto tse ling.
- Lijo li nooa ka likarolo tse nyane makhetlo a 5-6 ka letsatsi. Lijo tsa ho qetela e lokela ho ba bonyane lihora tse peli pele u phomola bosiu.
Karolo e ngoe ea bohlokoa ea thibelo ea methapo ea pelo ke ts'ebetso ea 'mele. Letsatsi le leng le le leng ho khothalletsoa ho tsamaea moeeng o mocha bonyane metsotso e 40. U ke ke ua hana boithabiso bo sebetsang - lipapali, ho sesa, jj.
Leha ho le joalo, ka matšoao a matla a ho se lekane ha coronary, phepo e nepahetseng, mokhoa oa ho nooa, ho ikoetlisa le ho etsa lintho tse etsahalang letsatsi le letsatsi li ikemiselitsoe ke ngaka ea pelo.
Cardiossteosis e hlalositsoe ka videong ena.
