Atherosclerosis le mafu a ka hare a amanang le tsamaiso ea methapo ea pelo hangata a fumanoa kapele.
Ketsahalo ena e hlalosoa ke taba ea hore tlolo ea "metabolid ea lipid" le "protein" hangata ke litlamorao kapa sesosa sa lefu la pelo.
Ka hona, tlhahlobo ea pele ea lefu la atherosclerosis e bapala karolo ea bohlokoa - mohato o rarahaneng, hobane pathology qalong hoo e ka bang ha e iponahatse.
Mehato ea tsoelo-pele le lisosa tsa atherosulinosis
Ka atherosclerosis, ho na le kokoana-hloko ea cholesterol le lipid ka choroid e bohareng le e ka hare, ka lebaka leo letsoai la khalsiamo le kenngoang methapong ea methapo e mahareng le e kholo le lithane tse sebetsanang le tsona lia hola.
Matšoao a pele a atherosclerosis a hlaha ha methapo ea methapo e koetsoe ke nako e fetang halofo.
Matšoao a lefu lena a ipapisitse le sebaka sa likepe tse amehang.
Ke moetlo ho arola methati e meraro ea nts'etsopele ea pathology.
Ea pele ke nts'etsopele ea methapo ea mafura - pele e ne e le ponahatso ea lefu lena. E hlaha ka lebaka la ho bokellana ha li-macrophage le lisele tse boreleli tsa mesifa, tseo le tsona li bokellang lipids. Kamora nako, mokokotlo oa mafura oa hlaha, empa boteng ba hae ha se kamehla bo bolelang hore motho o kula ka lefu la atherosulinosis. Leha ho masea, matheba a mafura a bonoa ka har'a likepe tse nang le bophara ba 1-2 mm.
Ea bobeli ke khōlo ea lejoe le thata le fumanehang kaharekeng ea sekepe. E entsoe ka likristale tsa esters le cholesterol, e leng motheo o bonolo, le likarolo tsa lipid - lesela le thata. Ho eketseha ha matlapa a khoheli ho baka ho fokola ha leseli la mokokotlo. Cholesterol e tsoa maling, e bokellana maboteng a sejana.
Ea boraro - ho ba teng ha mathata a rarahaneng - mohato oa ho qetela ho nts'etsopele ea atherosulinosis. E hlaha ka ho fokotseha ha botenya ba koae ea li-fibrous depositi e ka tlase ho 65, hammoho le ho hlaha ha li-microcracks le liso tsa eona holim 'a eona. Sena se kenyelletsa ho hokahana ha liplatelete ho sephutheloana, se bakang ho ruruha ha methapo, stroke, ho nyekeloa ke pelo le methapo e meng e amanang le ho potoloha ha mali kapa ho khaotsa ho felletseng hoa methapo ea methapo.
Ho thehoa ha li-amana tsa atheromatous ho nkoa e le ts'ebetso ea tlhaho, empa ho na le lintlha tse 'maloa tse ka e fokotsang kapa ea potlakisang.
Pathanatomy e kenyelletsa mabaka a joalo:
- Bong le lilemo. Lefu lena le hlaha ho banna makhetlo a makhetlo a 3-4 ho feta ho basali. Ho feta moo, matšoao a pele ho banna a hlaha a le lilemo li 45, le basali - ho qala ka lilemo tse 55.
- Liphatsa tsa lefutso Ho kenyelletsa lintlha tse kang ts'ebetso ea boits'ireletso ba mmele, ho ba teng hoa lefu la dyslipoproteinemia le litekanyetso tsa li-hormone.
- Mekhoa e mebe. Ho kotsi ka ho fetisisa bakeng sa tsamaiso ea methapo ea pelo le ho tsuba, joalo ka Ho tsuba ka leng ho na le nicotine e ngata le tar e kotsi. U ka e tlatsa joala, leha e le 100 g ea veine e khubelu e omileng lijong tsa hoseng ke tšireletso e ntle ea khatello e phahameng ea mali.
Ntle le moo, sesosa sa liphetoho tsa pathological e kanna ea ba ho ba teng ha boima bo feteletseng.
Ho nona ho baka mafu a mangata - atherosclerosis, lefu la tsoekere, joalo-joalo, o hloka ho ntlafatsa boima ba 'mele.
Mefuta e ka sehloohong ea atherosulinosis
Hona le mefuta ea mantlha ea lefu lena.
E atileng ka ho fetisisa ke ho khetholloloa ha atherosulinosis, ho latela sebaka sa lesion ea methapo ea methapo ea methapo ea mali.
Mefuta ea lefu lena e hlaha ka boithatelo le ka tatellano.
Mefuta e latelang ea atherosulinosis e khetholloa:
- Atherosclerosis ea likepe tsa coronary, hangata e bonahatsoa ke bohloko ba pelo. Ka lebaka la tšenyo ea methapo ea pelo, ho phalla ha oksijene ho ea myocardium hoa senyeha. Ka lebaka leo, tsoelo-pele ea lefu lena ea methapo e lebisa ho angina pectoris, ho nyekeloa ke pelo, lefu la pelo le ho bolaoa ke lefu la pelo ka tšohanyetso.
- Sebopeho sa aortic ke lesion ea methapo e meholo ka ho fetisisa 'meleng - aorta. Ntshetsopele ea li-cholesterol plaque e ama mosebetsi oa litho tsohle le litsamaiso.
- Atherosclerosis ea lijana tsa renal. Har'a matšoao a lefu lena, bohloko nakong ea ho choachoasela, boteng ba mali ka moroto, litlhaselo tsa ho hlatsa le ho nyekeloa hoa pelo li lokela ho totobatsoa. Ho hola ha lefu lena ho kenyelletsa khatello e matla ea mali le ho se sebetse hantle ha methapo.
- Atherosclerosis ea likepe tsa likhoerekhoere. Boko ke e 'ngoe ea lihokela tsa tsamaiso ea methapo e bohareng, ka hona, tlala ea oksijene ea setho sena e lebisa litlamorao tse mpe, mohlala, ho hlaseloa ke lefu la sethoathoa kapa la nakoana.
- Ho senya atherosulinosis ea likarolo tse tlase le tse holimo. Tšimolohong ho bonahala lintho tse kang ho lahleheloa ke moriri maotong le matsohong, ho thatafala ha menoana, bohloko, maoto le matsoho, joalo-joalo.
- Atherosclerosis ea mesenteric artery e fepang mala. Liponahatso tse ka sehloohong tsa lefu lena ke litlhaselo tsa menoana ea ka mpeng - bohloko ba mala a ka mpeng. Kotsi ke thrombosis ea makala a methapo ea mali e nang le necrosis ea leboteng la mala le mesentery.
Ho sa tsotelehe mofuta oa pathology, matšoao a ka ntle a liso tsa methapo ea atheromatous a ka hlaha:
- xanthomas - liforomo tse tšoanang le "li-tubercles" tse fumanehang sebakeng sa manonyeletso le tendon;
- senile arch - ponahalo ea metsero e soeufetseng mabopong a koli.
Ntle le moo, li-xanthelasms li ka hlaha - sebopeho sa matheba a mosehla letlalong, hangata se na le sebopeho sa lefu, ka lebaka la ho kenngoa ha k'holeseterole le triglycerides.
Mefuta ea Hyperlipidemia ke Fredrickson
Hyperlipidemia ke mokhoa o fetelletseng oa lipids le lipoprotein maling a mali.
Lefu lena ke lona sesosa se ka sehloohong sa nts'etsopele ea maloetse a amanang le pelo le pelo, ho kenyelletsa le atherosclerosis.
| Mofuta le maqhubu a amanang | Matšoao | Lipid e bakang hyperlipidemia | Hyperlipidemia ea mantlha | Hyperlipidemia ea bobeli |
| І (1%) | Khaello ea lipoprotein lipase (LPLase), hyperchilomicronemia | Haholo-holo triglycerides | Khaello ea liphatsa tsa lefutso | Ntshetsopele ea pancreatitis, systemic lupus erythematosus (SLE), lefu la tsoekere |
| IIa (10%) | LDL e phahameng | Cholesterol | Hypercholesterolemia ea lelapa | Ho hlaha ha nephrosis, hypothyroidism, a hlobaetsang le porphyria, idiopathic hypercalcemia |
| IIb (40%) | Tlhoriso e kholo ea LDL le VLDL | Cholesterol le triglycerides | Hypercholesterolemia ea lelapa le hyperlipidemia | Nts'etsopele ea lefu la tsoekere, nephrotic syndrome |
| III (1%) | STD e phahameng | Cholesterol le triglycerides | Dysbetalipoproteinemia ea lelapa | Ho hlaha hoa hypothyroidism, dysglobulinemia, lefu la tsoekere |
| IV (45%) | Ho eketsa phallo ea VLDL | Khaled | Famertal hypertriglyceridemia, hammoho le hyperlipidemia ea lelapa | Ponahalo ea SLE, ho se sebetse hantle ka mpeng, lefu la tsoekere, lephrotic syndrome, glycogenosis |
| V (5%) | Maemo a phahameng a VLDLP le chylomicrons | Boholo ba k'holeseterole le triglycerides | Hypertriglyceridemia ea lelapa, e kopaneng le hyperlipidemia ea lelapa | Ntshetsopele ea lefu la tsoekere, glycogenosis, nephrotic syndrome, hypothyroidism, dysglobulinemia |
Hypercholesterolemia - Mafu a Kopaneng
Hypercholesterolemia ka tsela e itseng ke lefu leo e seng lefu. Ho fapana le moo, ke mokhoa oa pele ho nts'etsopele ea li-pathologies tse itseng.
Hypercholesterolemia e tšoauoa ka cholesterol e phahameng ea plasma. Mefuta ea mantlha le ea bobeli ea lefu lena e khetholloa.
Hypercholesterolemia ea mantlha e arotsoe ka mefuta e mengata:
- Lelapa Boemong ba nts'etsopele ea ona ke ts'ebetso e mpe ts'ebetsong ea li-receptor tsa LDL. Ntle le moo, homozygotes e bonoa ka makhetlo a 1 ho limilione tse. Ho bakuli, khatello ea cholesterol e fapana ho tloha ho 15 ho isa ho 31 mmol / L. Maemong a mangata, lefu la pelo le fetoha ho fihlela lilemo tse 20.
- Polygenic. E iponahatsa e le sesosa sa mekhoa e mebe ea ho ja kapa botenya khahlanong le semelo sa lefutso. Khokahano ea cholesterol ho plasma ea mali e tloha ho 6 ho isa ho 8 mmol / L. Ho bakuli ba nang le lefu la pelo le coronary le hlaha pele ho lilemo tse 60.
- Lelapa Le Kopaneng. Subspecies ena e hlaha feela ho 1-2% ea botho.
Hypercholesterolemia ea bobeli ke lefu le hlahang ka liphekolo tsa lefu la tsoekere, lefu la tsoekere (mofuta oa 1 le mofuta oa II), hypothyroidism, pancreatitis, mafu a sebete, botenya le mafu a amanang le lefu la sethoathoa.
Foromo ena e etsahala hangata ho feta ea pele.
Phekolo le thibelo ea lefu lena
Atherossteosis e ka se phekolehe ka botlalo, empa ho a khonahala ho emisa ho hlahisoa ha li-cholesterol plaque ka tlhahlobo le kalafo e nakong.
Mehato ea ho khetholla maloetse a belaetsitsoeng a kenyelletsa nalane ea bongaka, tlhahlobo ea pele ea mokuli, laboratori le mekhoa ea lipatlisiso. Har'a liteko tse ka sehloohong tsa laboratori, cholesterol e felletseng le coefficient ea atherogenicity lia khetholloa. Mekhoa ea ho hlahloba hore na ho na le lisebelisoa tse kae e kenyelletsa angiography, coronography, aortography, ultrasound ea methapo ea kutlo, resovasography le ultrasound.
Maemong a 80%, phekolo ea lithethefatsi e thusa ho tlosa matšoao a lefu lena le ho thibela litlamorao tse mpe. Ngaka e fana ka litlhare tse latelang:
- Statins ke lithethefatsi tse tsebahalang haholo kalafong ea atherosclerosis. Ketso ea bona e etselitsoe ho fokotsa mosebetsi oa sebete ho hlahiseng cholesterol. Mehlala ea lithethefatsi tse joalo ke rosuvastatin le atorvastatin.
- Li-latter tsa LCD tse thibelang ho kopana ha li-acid acid ka har'a sebete. Lipheko tse sebetsang ke Colesevelam le Colestyramine. Ka lebaka la ho sebelisa li-sequestrant tsa LCD, tšebeliso ea k'holeseterole e eketsoa ho netefatsa ts'ebetso e tloaelehileng ea tšilo ea lijo.
- Fibrate ke lithethefatsi tse senyang li-triglycerides, ka tsela eo li tiisa metabolism ea lipid. Ka k'hemisteng o ka reka, ka mohlala, Trikor kapa Atromid.
- Niacin ke setlhare se etsang karolo ea bohlokoa kalafong ea atherosulinosis. E hlahisa phello ea antispasmodic le vasodilator, empa ha e theole cholesterol. Lithethefatsi tse nang le nicotinic acid li hanyetsoa ho lefu la tsoekere, mafu a gallbladder le sebete.
Maemong a tsoetseng pele, ho buuoa ho buuoa. Angioplasty e bitsoa mekhoa e sa rateheng ea ho kenella, 'me masapo a senya le ho thothomela ha methapo e bitsoa mekhoa e hlaselang haholo.
Bakeng sa kalafo le thibelo ea atherosclerosis, phepo e khethehileng e lokela ho bonoa. Ho molemo ho latela lijo tse nang le carb e tlaase ka k'holeseterole e phahameng. Ha e kenyeletse tšebeliso ea lihlahisoa tse joalo:
- nama e mafura le lijana tsa litlhapi;
- chokolete, muffin, pastries le bohobe bo tšoeu;
- li-pickle, lijana tse halikiloeng le tse tsubeloang;
- lihlahisoa tsa lebese tse mafura;
- lijo tse bobebe, lijo tse potlakileng, mafura;
- kofi e matla le tee e ntšo, soda.
Ho fapana le moo, lijo li matlafalitsoe ka mefuta e fokolang ea nama le tlhapi, litlama, meroho le litholoana, lihlahisoa tse tlase tsa mafura a lactic acid, bohobe bo sootho le lijo-thollo tse fapaneng.
Kameho ea atherosclerosis ho litho tsa ka hare e hlalositsoe videong ena.
