Atherossteosis ke lefu le sa feleng la pelo le likepe tse kholo, le tšoauoang ke tšenyo leboteng le kahar'a masapo a batho ba nang le lona ka ho koaloa hoa lumen le nts'etsopele ea mathata a tsoang bokong, pelong, liphioleng, le liphihlelong tse tlase.
Lefu lena ka bolona le hlaha ho batho ba baholo, leha ho le joalo hona joale li-cholesterol tse fokolang maboteng a methapo ea mali li fumanoa esita le ho bana le lilemong tsa bocha.
Ha ho sa sebelisoe kalafo e nepahetseng, atherosclerosis ea leha e le efe ea lehae e lebisa ho ischemia le hypoxia ea litho le litsamaiso, liphetoho tsa trophic le necrotic letlalong le linama tse bonolo.
Lisosa tsa ts'ebetso ea lefu lena li ka aroloa ka lihlopha tse peli - tse ka fetolehang le tse sa fetoloeng.
Ea pele e kenyelletsa mabaka a ka susumetsoang ke liphetoho tsa bophelo le meriana, tse latelang ke tsena:
- Mokhoa oa bophelo oa ho lula fatše le mosebetsi oa ho lula fatše.
- Tlolo ea lijo tse nang le phepo e ntle - lijo tse sa tloaelehang tse nang le mafura a mangata, tse halikiloeng tse nang le cholesterol.
- Mekgwa e mebe - ho nwa haholo, ho tsuba.
- Khatello ea maikutlo le khatello ea kelello.
- Phekolo ea methapo ea methapo e nang le matšoao a khatello e kaholimo ho 140 ka li-millimeter tsa 90 tsa phomolo ka phomolo ka mehato e 'maloa.
- Letšollo mellitus e nang le taolo e mpe ea glycemic le maemo a khafetsa a ketoacidotic.
- Hypercholesterolemia - keketseho ea palo ea cholesterol e felletseng (ho feta 5.5 mmol / l), dyslipidemia - tlolo ea tekanyo lipakeng tsa lipotrotein tsa likaroloana tse fapaneng (keketseho ea lipoprotein tse fokolang, triglycerides, ho fokotseha ha lipoprotein tse phahameng haholo).
- Ho ba le botenya ka mpeng ka letheka ho banna ho feta lisentimitara tse 102, mme ho basali ho feta 88 cm.
Lintho tse ke keng tsa susumetsoa li kenyelletsa nalane e boima ea lelapa (hypercholesterolemia le dyslipidemia, mafu a tsoang ho beng ka lefu la pelo ho fihlela a fihla ho lilemo tse 50), lilemo (ho banna, atherosranceosis li hlaha kamora lilemo tse 45, ho basali - kamora 55), bong ( hangata e hlaha ho banna, kaha lihormone tsa basali tsa thobalano li na le tšusumetso methapong ea mali).
Mekhoa ea pathogenetic ea sebopeho sa majoe
Ho kopana ha hyperlipidemia le ho senyeha ha methapo ea methapo ho lebisa sebopeho sa li-cholesterol tse fetotsoeng le liprotheine, le phetisetso ea tsona tlasa methapo ea methapo.
Lipids li haptjoa ke li-macrophages, tse fetohang lisele tsa xanthomatous, li eketseha haholo ka boholo.
Lisele tsena li hlahisa lintlha tsa kholo le tsa ho falla bakeng sa lisele tse tšoeu tsa mali le liplatelete. Ho na le khokahano le kopanyo ea liplatelete, kabo ea lintlha tsa thrombotic.
Polao e hola ka potlako, e thibela lumen ea sekepe ka lebaka la sebopeho sa sebopeho se sebetsanang le thaere.
Ho feta moo, tlas'a ts'usumetso ea kholo ea maemo, li-capillaries li thehoa bakeng sa phepelo ea mali ho bongata bo atileng haholo. Mokhahlelo oa ho qetela oa nts'etsopele ke necrosis ea bohareng ba lesela, sclerosis le calcification.
Liphetoho tsa morphological ho ba teng ha atherosulinosis li tšoauoa ka tsoelo-pele ea lefu lena, ho tloha ho hanyane ho isa ho le leholo.
Mohato oa pele oa nts'etsopele ea atherosulinosis ke dolipid, ha e na liphetoho tse ikhethang tsa morphological. E tšoauoa ka keketseho ea tumello ea lerako la methapo, tlolo ea botshepehi ba eona - e tsepamisitsoeng kapa e felletseng, ho fufuleloa ha karolo e metsi ea mali sebakeng sa subendothelial.
Ho ruruha ha Mucoid, ho bokellana ha fibrin le fibrinogen, liprotheine tse ling tsa plasma, lipoprotein tse fokolang le cholesterol li thehiloe.
Ho tseba sethala sena, ho lekane ho sebelisa thuto ea nalane ea litokisetso tsa lebota la methapo le ho sebelisa dae e khethehileng - thionine e putsoa, eo metachromasia e shejoang le libaka tse amehileng li pherese.
Mokhahlelo oa bobeli - lipoidosis - e tšoauoa ka ho hlahisoa ha k'holeseterole le lipoprotein ka sebopeho sa methapo ea mafura le matheba a maputsoa a sa phahamang kaholimo ho endothelium.
Liphetoho tse joalo ka sebopeho sa methapo ea mali li ka bonoa le ho bana le lilemong tsa bocha, 'me ha li hlile ha li tsoele pele nakong e tlang. Lipids li kenngoa ka tlase ho intima ho li-macrophages, kapa lisele tse foamy, le lisele tse boreleli tsa methapo ea mali. Hape hoa khoneha ho fumana sethala sena ka nalane, lits'oants'o li etsoa ke Sudan 4, 5, mafura a mafubelu a O.
Ka lebaka la hore atherosclerosis ke lefu le ntseng le tsoela pele butle, sethaleng sena se ka nka nako e telele se sa bake matšoao a bohlokoa a kliniki.
Likepe tse kholo, tse kang aorta, methapo ea methapo ea mokokotlo, likepe tsa boko, liphio le sebete, li fetoloa ke liphetoho tsa pele tsa methapo.
Boemo ba lehae ba ts'ebetso bo latela likarolo tsa hemodynamics libakeng tsa bifurcation tsa likepe, joalo ka aortic bifurcation methapong ea liacac.
Mokhahlelo oa boraro oa nts'etsopele ea "atherosulinotic plaque" ke liposulinosis - sebopeho sa li-fiber le li-collagen ka har'a endothelium, ho atoloha ha li-fibroblasts, karohano ea bona ea lintlha tsa kholo le nts'etsopele ea lisele tse nyane tse amanang.
Tsoelo-pele e eketsehileng ea pathophysiological ea plaque atherosulinotic
Ka morphologic, li-plaque li phahamisoa ka holim'a bophahamo ba moalo, bokantle ba sekepe bo fetoha bo bongata, bo na le matla a mangata. Matlapa a joalo a ka koala leseli la mokokotlo mme a lebisa ho ischemia ea litho le lits'ebetso, ho latela sebaka, ho lebisa ho mathata a kang ho otloa, ho ts'oaroa ha nakoana ke ischemic, infarction ea myocardial, ho felisoa ha likepe tse pheletsong e tlase.
Mokhahlelo o latelang oa ho hlohlelletsa mafu o atile hantle, o tšoauoa ka ho bola ha karolo e bohareng ea lesela, ho hlophisoa ha lona.
Likristale tsa k'holeseterole, mafura a acid, likotoana tsa likhoele tsa collagen, lisele tsa xanthoma le T le B lymphocyte li fumanoa ka bongata bo nyonyehang. Boima bona bo arohantsoe le bokaholimo ba sekepe ke capule ea lesela, e nang le lithane tse sebetsanang.
Mokhahlelo o latelang ke ulceration, e tšoauoa ka ho petsoha hoa membrane ea "plaque", le ho tsoa ha litaba tsa eona methapong ea mali, ho etsoa ha seso sa atheromatous. Kotsi ea mohato ona ke ho se tsitse ha li-plaque tse joalo, monyetla oa ho nts'etsapele li-ischemic le thromboembolic lesions tsa litho le lisele.
Sebakeng sa sebopeho sa ulcer, aneurysm e ka nts'etsapele - protrusion ea lebota la vascular, esita le ho phatloha. Mohato oa hoqetela oa ts'ebetso ea methapo ea methapo ea methapo ke ho hlakoloa ha lesela, ke hore, ho hlahisoa ha letsoai la calcium ho lona.
Ka lebaka leo, sebaka se amehang sa sekepe se kopantsoe, patency ha e na botsitso kapa ha e eo ho hang.
Lipontšo tsa mathata a sebopeho sa methapo ea mali e ka ba polymorphic, ka mantsoe a mang, matlapa a holileng a nang le lipalo le matheba a mafura a ka bonoa ka nako e ts'oanang.
Litlhapi tsa atherosselotic ka botsona li ka thatafatsoa ke ho tsoa mali, ho choachoasela ha mali le ho phatloha ha capule.
Ka kliniki, li-plaque tsa atherosselotic li arotsoe ka mokhoa o tsitsitseng ebile o sa tsitsa.
Methapo ea mofuta oa pele, sekoaelo se kopaneng sa lithane se hlalositsoe hantle, ha se na letsoele ebile ha se tloaeloe ho rusolla le ho lokolla se kahare, ka hona ha se lebise mathateng a tebileng a atherosclerosis. Li-plaque tsena li tšoauoa ka mathata a sa foleng - ischemia e sa foleng ea litho kapa mesifa, sclerosis ea bona, dystrophy kapa atrophy, angina pectoris e tsitsitseng, ho hloka taolo ea methapo e sa foleng.
Mofuta oa bobeli, lebili le tšekalla meokho le ho tsoa ha nko ea lona, mathata - ho hloleha ha methapo ea pelo le "ischemia" ea litho, ho se tsitse ha angina le lefu la mokokotlo la pelo, ho ferekana ha bokong, lefu la seoa le leholo.
Lintho tsa motheo tsa kalafo ea atherosulinosis le thibelo ea eona
Phekolo ea li-plaque tsa atherosselotic tse seng li entsoe, tse fumanoang ka mokhoa oa phekolo le ka mokhoa o hlakileng, li na le mokhoa o kopanetsoeng, mme o kenyelletsa khalemelo e tlamang ea lintlha tse ka fetoloang.
Motsoako ona o kenyelletsa - taolo ea phepo e nepahetseng, ts'ebeliso ea meroho le litholoana tse ncha haholo, lijo-thollo, lihlahisoa tsa lebese le ho theha 'muso oa ho nooa.
Ho bohlokoa hape ho emisa ho tsuba ka ho felletseng, ho itlopa joala ka tsela e leka-lekaneng, ho ikoetlisa ka ho lekaneng (ho tsamaea, ho matha, ho fofa moea).
Phekolo ea mantlha ke meriana, hona ho kenyelletsa lithethefatsi tseo ts'ebetso ea eona ea meriana e ikemiselitseng ho theola cholesterol le likaroloana tsa eona:
- li-statins (Atorvastatin, Lovastatin, Simvastatin);
- fibrate;
- probucol;
- nicotinic acid.
E boetse e sebelisoa:
- li-antiplatelet agents (Acetylsalicylic acid, Magnikor);
- anticoagulants (heparin);
- lithethefatsi tse vasoactive (Cilostazolum);
- antispasmodics (Drotaverinum, Papaverineum);
- Litokisetso tsa vithamine.
Maemong a tebileng a lefu lena, ka mathata a maholo, ho ruruha ha lisele tse bonolo le leqeba la mokokotlo, ho sebelisoa kalafo ea ts'ebetso - ho tsoa lits'ebetsong tse tlase tsa maikutlo ho khutlisetsa phallo ea mali (letsoalo, ts'ebetso ea bongaka, balloon angioplasty) ho tlosoa hoa lisele tse sa sebetseng (necenessomy, phunya leoto).
Thibelo ea cholesterol e ntseng e eketseha le nts'etsopele ea atherosclerosis ke ea mantlha - ho batho ba phetseng hantle, hape bobeli - ka lefu le seng le fumanehile.
Mehato e ka sehloohong ea thibelo ea mantlha ke lijo tse nang le phepo e ntle, boikoetliso bo itekanetseng ba mmele, ho tlohela mekhoa e mebe, ho shebella khatello le boemo ba cholesterol, tlhahlobo ea khafetsa ke ngaka e akaretsang.
Bakeng sa thibelo ea bobeli, ho hlokahala hore u qale ka kalafo ea maloetse a kopaneng, ho theola khatello ea mali, ho nka li-statins le li-antiplatelet agents, ho tseba ka nako le ho phekola mathata.
Etiology ea atherosclerosis e hlalositsoe videong ena.
