Atherosclerosis - alamu da magani

Atherosclerosis
Canje-canje a cikin jirgin ruwa (aiwatar da haɓakar atherosclerosis), tarin ƙwayar cholesterol
ICD-10	Ina 70 70.
ICD-10-KM	I70 da I25.1
ICD-9	440 440
ICD-9-KM	440
Cututtuka	1039
Karafarini	000171
eMedicine	med / 182
Raga	D050197

Atherosclerosis (Greekḗḗra, slurry + sklḗrōsis, hardening) cuta ce mai saurin kamuwa da cuta da jijiyoyin jijiyoyi da jijiyoyin hannu, sakamakon cin zarafin sinadarin abinci mai gina jiki da kuma hada sinadarin cholesterol da wasu juzu'i na lipoproteins a cikin kashin jijiyoyin jini. Adibas suna samar da nau'i-nau'i na filayen atheromatous. Sakamakon ci gaba mai haɗuwa da nama a cikinsu (sclerosis), da kuma ƙyalƙyallen bangon jirgin ruwa yana haifar da lalacewa da kunkuntar ƙwayar katako har zuwa cikas (toshewar jirgin ruwa). Yana da mahimmanci don bambance atherosclerosis daga Menkeberg arteriosclerosis, wani nau'i na cututtukan sclerotic of the arteries, wanda aka nuna shi ta hanyar sanya adadin kuzarin salula a tsakiyar membrane na arteries, yaduwar cutar (rabewar wurare), haɓakar aneurysms (kuma ba shinge ba) na hanyoyin jini. Atherosclerosis daga cikin jini na zuciya take kaiwa zuwa ci gaban cututtukan zuciya da jijiyoyin jini.

Etiology

Yawancin nazarin mace-mace daga cututtukan zuciya kamar yadda bayyanuwar jigilar cutar atherosclerosis. A cikin Tarayyar Rasha a 2000, daidaitaccen adadin mace-mace daga cututtukan tsarin wurare dabam dabam shine 800.9 ga mutane dubu 100. Don kwatantawa, a Faransa wannan adadi shine 182.8 (mafi ƙarancin Turai), a Japan - 187.4. An tabbatar da cewa raguwar haɗarin cututtukan zuciya a waɗannan ƙasashe ba shi da alaƙa da ingancin kulawar likita kamar yadda ake yi da salon rayuwa da kuma tsarin abinci.

Shirya Etiology |Ma'anar cutar. Sanadin cutar

Atherosclerosis - wani cuta mai tsari wanda tun farko yana shafar jijiyoyin jini, amma ba duka bane, kawai arteries ne, a jikin bango wanda cholesterol da esters din su ke tarawa, suna haifar da alamun yanayin wannan cutar.

A nan gaba, kamar yadda karfin tasoshin jini da ke fama da cutar atherosclerosis wajen sadar da adadin jinin da ya wajaba don aikin gabobin ciki, zai lalace. Wannan na iya faruwa a hankali ko sannu a hankali - saboda haɓakar filayen atherosclerotic, ko da gaske - tare da haɓakar jijiyoyin bugun jini.

Wani yanayi mai ban mamaki ya taso a cikin magani, lokacin da cin nasarar atherosclerosis na gabobin da yawa akwai sunayen "cututtukan" masu dacewa, kodayake a gaskiya cutar iri ɗaya ce: atherosclerosis, kuma kawai ainihin ƙaddamar da tsari zai iya zama daban. Musamman, idan akwai alamun lalacewar arteries na zuciya (na jijiyoyin zuciya), suna magana ne game da cututtukan zuciya na zuciya (CHD), tare da alamar lalacewar gawarwakin da ke samar da ƙananan ƙarshen - atherosclerosis of the arteries of the endremities ("intermittent claudication"), kuma, alal misali, tare da katsewar wani bututun jini kuma thrombosis na ɗayan tasoshin da ke samar da kwakwalwa - game da cutar mahaifa atherothrombotic.

Abunda ke faruwa da haɓakar atherosclerosis ba za a iya rage su zuwa kowane yanayi ba - yawanci wannan shine haɗarin haddasawa. Koyaya, daga cikin dukkan dalilai, zamu iya bambance waɗanda suke da alaƙa da sifofin ƙwayoyin mutum, da waɗanda ke haifar da hanyar rayuwa. A cikin lamuran da suka shafi “fashewar kwayar halittar jini”, babu wani dalili na daban da zai zama dole ga cigaban cutar, kuma cutar na iya zama da mummunar matsala yayin da, alal misali, infarction na zuciya ko bugun jini ya faru a shekaru na uku ko na hudu na rayuwa, kuma rayuwa kanta tana da matukar muhimmanci. gajeru. Wannan mai yiwuwa ne tare da abinda ake kira familial hypercholesterolemia, a ciki wanda hadaddun kwayoyi masu dauke da sinadarin cholesterol dake cikin jini suke dauke da jijiyoyi (da farko hanta). A sakamakon haka, maida hankali ne cikin jinin wadannan barbashi kuma, a saboda haka, yawan kwayar cholesterol yana ƙaruwa, da kuma yawan ƙwayar cholesterol, har ma da wurinta, suna ƙarewa a bangon artery. Tabbas, wannan tsari yafi rikitarwa kuma a zahiri shine matakan da yawa, amma sakamakonsa na ƙarshe shine samuwar atherosclerotic plaques a bangon jijiyoyin jini. Anaruwar yawan haɗarin dake ɗauke da cholesterol a cikin jini na iya faruwa sau da yawa ba saboda lalacewar kwayoyin ba, amma saboda yanayin rayuwa mara kyau. Wannan nau'ikan abinci yana sauƙaƙe wannan (abinci mai sauri, abinci da yawa da aka sarrafa, nama mai ƙima da kayan kiwo, margarines, samfuran mai tare da mai dabino, da sauransu).

Bayyanar cututtuka na Atherosclerosis

Atherosclerosis na dogon lokaci (shekaru da shekarun da suka gabata) yana faruwa ba tare da alamu ba. Haka kuma, yawanci ana shafa tasoshin ruwa da yawa, tunda atherosclerosis cuta ce ta tsarin. Idan an sami ɓarna na ɓoye a wani ɓangare na gado na jijiyoyin jiki, wataƙila, ana samun filaye a wasu wuraren waha na jijiyoyin jiki. Farkon bayyanar cututtuka yana alaƙa da alamomi na raguwar kwararar jini a cikin jirgin ruwan da aka shafa. Idan irin wannan cutar tana da alaƙa da ƙuntatawa na zubar da jini, alamu na ischemia na kullum (sakamakon raguwar yaduwar jini) na sashin da ya dace.

Misali, idan matattarar ƙwayar atherosclerotic na ƙayyadaddun ƙarancin zubar jini yana gudana a cikin tasoshin jini na zuciya, abin da ake kira "angina pectoris" yana haɓaka - ciwon kirji ko rashin jin daɗi (nauyi, ƙonawa, matsi a kirji) yayin ƙoƙarin jiki - tafiya, gudana, ɗaga nauyi. Idan abu ɗaya ya faru a cikin jijiyoyin ƙananan ƙarshen, wata alama ta haɓaka da ake kira "tsaka-tsaki ta tsinkaye," a lokacin da jin zafi, ƙonawa ko gajiya mai ƙarfi a cikin tsokoki na kafa yana bayyana yayin tafiya. Waɗannan bayyanar cututtuka suna wucewa da sauri idan kun daina, amma tashi bayan ɗan lokaci tare da ci gaba da tafiya.

Mene ne jijiyoyin bugun jini na jijiyoyin jiki?

Atherosclerosis na jiragen ruwa (idan kuka ayyana shi a takaice) cuta ce da ta shafi babba da ta waje. An sanya masa lamba dangane da cututtukan kasa da kasa (Lambar ICD 10 - І 70). Kididdiga ta duniya ta ce ana lura da ci gaban cutar a bayan shekaru 50. Mafi sau da yawa, arteries tare da na roba da tsoka-na roba tsari na jijiyoyin bugun gini suna shiga cikin tsarin jijiyoyin cuta.

Babban abin da ake bukata don ci gaban cutar ita ce take hakkin mai metabolismtasowa karkashin rinjayar dalilai da yawa. Tsarin ilimin halittar jini na jini yana canzawa - a cikin plasma yawan haɗuwar cholesterol ya fara ƙaruwa, wanda baya fuskantar jinkiri. Rashin daidaitaccen daidaituwa tsakanin ƙwayar atherogenic (LDL) da ƙananan rigakafin ƙwayoyin cuta na antiatherogenic (HDL), wanda ke ba da gudummawa ga haɓaka canje-canje na cututtukan cuta wanda ke shafar jijiyoyin jijiyoyin jiki.

Severin E. S. yayi bayani dalla-dalla game da abubuwan da ake amfani da su na ilimin halittar mahaifa atherosclerosis a cikin littafinsa “Biochemistry na Atherosclerosis”

Haɓaka cutar ta wuce matakai da yawa - kasancewar bayyanar cututtuka na asibiti ya dogara da ita. A cikin maras lafiya da atherosclerosis, atherosclerotic plaques (tarin kitse) waɗanda suke da haɗuwa da yawan ƙwayar cuta ana sanya su cikin jini. Duk waɗannan canje-canjen suna haifar da gaskiyar cewa ganuwar gado na jijiyoyin jiki sun zama bakin ciki, an keta ayyukansu na asali. Tsarin ci gaban dystrophy shine halayyar yanayin haɓaka na ƙwayar jijiyoyin bugun jini.

Societyungiyar Nationalasa don Nazarin Atherosclerosis (NLA) ta rarraba cutar a matsayin cuta ta ciki kuma suna ɗaukar ta a matsayin likita da matsalar zamantakewa. An tabbatar da wannan ta hanyar ƙididdiga game da mace-mace a duniya da kuma a cikin Rasha.

A pathogenesis na atherosclerosis

Yawan cholesterol da ke zuwa tare da abinci ba ya taka muhimmiyar rawa ga ci gaban atherosclerosis, sabanin imani da ya wanzu shekaru da yawa. Saboda haka, babu hujjar kimiyya da za ta iya hana sinadarin cholesterol abinci, kuma duk cutarwar da ke kewaye da yaki da cholesterol ba ta da ma'ana. Gaskiyar ita ce kusan dukkanin cholesterol an kafa su a cikinmu - a fannoni da yawa a ƙarƙashin rinjayar abin da muke ci, nau'ikan abincin da aka lissafa a sama suna ba da gudummawar haɓakar kwalar cholesterol ɗinmu.

Cholesterol kanta abu ne mai mahimmanci, kuma kowane ɗayan ƙwayoyinmu suna iya yin amfani da shi kamar yadda ake buƙata. Amma yayin da karfin jikin mutum yayi amfani da shi da kuma amfani da sinadarin cholesterol dinsa, to kuwa hankalin sa a cikin jini yana karuwa, tare da duk wani sakamako da zai haifar. Abubuwan da ke canza abubuwan da ke tattare da sunadarai na abubuwan rage kiba, wadanda suma sun hada da cholesterol, suna rage karfin amfani da cholesterol din. Wannan, alal misali, shan sigari, ciwon sukari, kumburi mai kumburi. Wadannan dalilai iri daya suna lalata ganuwar jijiyoyin jini, ta haka ne ke sanya kwarin jiki ya shiga cikin barbashi na jini a cikin su.

Haɓaka kayan wasan wuta na atherosclerotic shine tsari wanda aka shimfida shekaru da shekaru da yawa. Idan plaque a bango na jirgin ruwa ya kai girman girma (kusan kashi 70% na lumen jirgin ruwa ko ƙari), zai iya ƙirƙirar manyan shingaye ga kwararawar jini da kuma samar da jini ga ɓangaren da ya dace - alal misali, zuciya ko kwakwalwa. Hakanan ƙananan filayen ba su da haɗari - lokacin da waɗannan ɓarna na katsewa (wannan yana yiwuwa a lokuta idan "taya" ta zama bakin ciki saboda dalilai daban-daban), suturar suttura a wurin fashewa, wanda zai iya toshe bakin kogin. A wannan yanayin, saboda ƙuntataccen ƙuntatawa cikin kwararawar jini, yawancin adadin ƙwayoyin jikin da ke ba da wannan jirgin ruwa tare da jini ya mutu (infarction myocardial (alal misali, infarction myocardial infarction ko cerebral infarction - bugun jini)).

Bayyanar cututtuka dangane da ƙasan gari da kuma matakin ci gaba

Kwayar cutar ta dogara ne da tasoshin jijiyoyin cutar atherosclerosis da kan ci gabanta. Tare da haɓakar ƙwayar cuta, tasoshin da ke ɗaukar jini zuwa gabobin (arteries, arterioles, capillaries) suna fuskantar cutar da farko. Ba a samar da adibas na atherosclerotic a cikin lumen na jijiyoyin - an bayyana wannan ta hanyar tsarin ganuwar wannan sashin gado na jijiyoyin bugun gini.

Yayinda cutar ke ci gaba, yana bi ta matakai da dama na nasara:

1. Mataki na farko. Canje-canje na ilimin cututtukan cututtukan cuta yana faruwa ne kawai a ɗan gajeren lokaci bayan ɗaukar yawan cholesterol a cikin jini na jini yana ƙaruwa sosai. The vascular endothelium yana fara ɓoye abubuwa masu aiki waɗanda aka tsara don magance yawan ƙwayoyin ƙwayoyin mai da ke gudana a cikin kewaya. A tsawon lokaci, hanyoyin biyan diyya na hanyoyin cikin jini yana ƙare. Endothelium ya zama na bakin ciki, an kirkiro edemarsa, microcracks ya bayyana. A kan asalin waɗannan canje-canjen marasa kyau, tasoshin sun zama marasa ƙarfi kafin barkewar barbashi mai ƙiba a bangon su ta hanyar aibobi ko raunin da ba bayyananniyar ido ba.
2. Matsayi na sclerotic canje-canje. Matattara da tsokoki na tsawon lokaci suna fara tara abubuwa na salula na kayan haɗin gwal akan farjin su. Don haka, ƙwayar atheromatous ta bayyana. Kabba mai rufe kakin jikin plaque din ya zama sako-sako. Yana da kusanci ga bayyanar microtraumas, wanda yake da haɗari lokacin da ƙungiyar ta faɗi kuma ta shiga cikin jini. Mai kitse embolus na iya haifar da rikitarwa na atherosclerosis kamar su thrombosis na jijiyoyin jini.
3. Matakan saukarwa. A wannan matakin, ci gaba da ci gaban cututtukan cututtukan ƙwayoyin jijiyoyin ƙwayoyin cuta. Kafewar ƙwayar ƙwayar mai mai ƙarfi tana fara aiki da ƙarfi a cikin ƙwayoyin ƙwayoyin salula, wanda ke ba da gudummawa ga tasirin sa. A tsawon lokaci, shimfidu na ƙaruwa, suna haifar da babban ƙarfi ko cikakkiyar shinge na lumen na yankin da abin ya shafa na gado na jijiyoyin bugun gini. Sakamakon wannan shine ischemia mai raɗaɗi ko mara nauyi na kyallen da gabobin jikinsu wanda lalatawar jini ke ɗaukar jini.

Asibiti bayyanuwar farko Wannan ilimin cututtukan jijiyoyin jiki ba ya nan ko kuma an bayyana shi kaɗan. Alamar farko na atherosclerosis suna bayyana a matakin canje-canje na sclerotic. Sannan mai haƙuri ya fara gabatar da koke-koke na halayyar, wanda aka kafa dangane da ƙaddamar da tsarin cutar. An tabbatar da cewa kewaye mahaifa a cikin mata ya zama ruwan dare fiye da na maza.

Tsarin atherosclerotic na iya shafar thoracic da ciki aorta. Na dogon lokaci, cutar ba ta sane. Alamar farko na aortic atherosclerosis sune ke rage zafin jin zafi a cikin kirji, wanda zai iya ba wa kashin kashin baya, saman bene na rami na ciki. Wannan zafin ya banbanta da zafin angina domin hakan zai iya kasancewa har zuwa wasu kwanuka da yawa kuma yana kama da kala-kala.

Lalacewa ga ɓangaren ciki na babban jijiya an san shi da kasancewar azaba koyaushe a kan dukkan benaye na ciki, ƙurar iskar gas mai ƙarfi, ƙetare motsi na hanji. Idan wani ɓangare na aorta ya shiga cikin hanyar cututtukan cututtukan ƙwaƙwalwar ƙwayar cuta inda ya shiga cikin dama da hagu iliac arteries, marasa lafiya suna damuwa game da ciwon kafa, ƙanƙancewa, kumburi, canje-canje na jijiyoyin jijiya a cikin ƙananan laushi na ƙarshen ƙananan ƙarshen.

Tare da atherosclerosis na arteries na kodan, alamar farko na asibiti shine karuwa a hawan jini. Wannan shine abin da ake kira hauhawar jini na sakandare, ana gano shi har a cikin waɗancan marasa lafiya waɗanda da farko basu da karfin jini. Sakamakon cin zarafin tace zakalwa da bangon jijiyoyin jiki, an samar da adadin furotin, da jinin jini, da kuma sillinders yayin aikin urinalysis. Tare da lalacewar arteries na koda ɗaya, asibitin na cutar yana haɓaka dogon lokaci. Atherosclerosis na tasoshin kodan, wanda ke yaduwa a bangarorin biyu, yana bayyana ta hanyar ci gaba da hauhawar jini, wanda ke tsayayya da magungunan antihypertensive.

Atherosclerotic lalacewar tasoshin kwakwalwa da carotid arteries an san shi da kasancewar kullun ciwon kai, rashin bacci, da raguwa cikin damar-hankali na ƙwaƙwalwar-mnemonic. A cikin manyan al'amurra, an lura da saurin jujjuyawar aikin tunani da halayen halayen.

Don raunuka na atherosclerotic na jijiyoyin jijiyoyin zuciya, hare-hare na jin zafi a bayan sternum, wanda ke da halin yin burodi, halayyar halayya ce. Sunan kimiyya game da waɗannan sassan maganganun shine angina pectoris. Raɗaɗi na iya faruwa duka yayin aiki na jiki da kuma cikin cikakken hutawa. Rashin damuwa a bayan sternum ya ɓace nan da nan bayan shan nitroglycerin.

Idan tsarin binciken ya ƙunshi jijiyoyin mahaifa, saboda wanda ake yin jigilar jini zuwa ƙarshen ƙarshen, marasa lafiya sun koka da jin zafi, ƙanƙancewa, kumburin kafafu. Lokacin tafiya, lameness na lokaci-lokaci yakan faru, da farko jin zafi yayin aiki na jiki, amma daga baya yana faruwa tare da cikakken hutawa. Fata na ƙafafu ya bushe, sanyi, kodadde. A lokaci mai tsawo, aibobi launin ruwan kasa sun bayyana akan sa, wanda ya juya zuwa lahani na ciki tare da wuraren ƙoshin ƙwayoyin cuta. Wadannan canje-canjen suna nuna ci gaban ischemia mai taushi.

Hadaddiyar cutar Atherosclerosis

A cikin yanayin da ƙarar jini ya gudana ta hanyar jijiya ta shafa yana raguwa da sauri - kuma wannan yana faruwa idan an lalata ƙwayar cutar atherosclerotic da ƙirar thrombus a wannan yanki - alamun da ke tattare da lalacewar ƙwayar da ke dacewa da haɓakawa daidai da sauri: infarction myocardial, bugun jini, gangrene na ƙananan ƙarshen, da sauransu. .

Bayyanar cutar Atherosclerosis

Zuwa digiri ɗaya ko wata, allunan atherosclerotic a cikin bangon arteries suna cikin yawancin manya waɗanda ke da rayuwar "yamma" ta zamani, amma nesa da duka, wannan tsari ya kai matakin lokacin da alamun asibiti suka bayyana. Idan babu alamun cututtukan asibiti da za a iya danganta su da raguwar hauhawar jini a cikin wasu jijiyoyin jini, likitan ya kimanta haɗarin atherosclerosis da mutuwa daga cututtukan da ke tattare da shi ta hanyar gano abubuwan da ake kira abubuwan haɗari don atherosclerosis. Mafi mahimmancin su shine jinsi na maza, shekaru (tare da kowace shekara da shekaru suna rayuwa, haɗarin cututtukan da ke haɗuwa da atherosclerosis yana ƙaruwa), hawan jini, hawan jini (musamman ƙarancin lipoprotein cholesterol), shan sigari, ciwon sukari, kiba, yawan ƙwayoyin cuta. da sauransu. Hadarin mutuwa daga cututtukan da ke da alaƙa da atherosclerosis na shekaru 10 masu zuwa za a iya ƙididdige kansu ga kanku ta amfani da na'urar injin lantarki. Ana la'akari da babban haɗari idan ya wuce 5%. 5% - da alama kaɗan. Koyaya, dole ne a ɗauka cikin zuciya cewa wannan shine haɗarin mutuwa. Hadarin cututtukan da ba masu cutarwa ba wadanda ke barazanar haɓakawa a wannan lokacin ya ninka sau 3-5. Haka kuma, haƙiƙar haɗari galibi ya fi wanda aka ƙididdige shi, tunda mai ƙididdigar lissafi tana la'akari da mahimman abubuwan haɗari 5, kuma akwai da yawa daga cikinsu. Misali, kasancewar kamuwa da cutar siga yana kara yawan hadarin dake cikin maza zuwa sau 3, kuma a cikin mata sau 5!

Tunda mahimmancin haɗarin atherosclerosis na kowane wuri shine haɓakar jini mafi girma (musamman ƙarancin lipoprotein cholesterol), ana yin gwajin jini yawanci ana kiranta “bayanin lafiyar lipid” (wanda ke kunshe cikin manufar “gwajin jini na ƙirar ƙwayar cuta”) yawanci ana yin shi. Wannan ya nuna ba wai kawai auna ma'aunin yawan cholesterol bane, har ma da rarrabuwa a kashi biyu (kuma yanzu yana cikin kashi uku) lipoprotein frapo: low destity lipoprotein cholesterol da babban yawa na lipoprotein cholesterol. Bugu da ƙari, bayanin martaba na lipid ya ƙunshi ɗaukar cakuda triglycerides (fats) a cikin jini. A sakamakon haka, yana yiwuwa a iya tantance yanayin haɗarin cututtukan da ke da alaƙa da atherosclerosis da kuma shimfida wuraren da za a magance tasirin warkewa. Laifukan da aka gano a cikin bayanan furotin ba a cikin su suke da alaƙa tare da cutar "atherosclerosis" ba, amma suna kara haɗarin wannan cutar zuwa mafi girma, yayin da aka sami mummunan tasirin ƙwayoyin cuta.

Atherosclerotic raunuka na arteries kansu, don ganowa, suna buƙatar bincike daban-daban na kayan aiki, ya danganta da irin fassarar da likita yayi. Yankin da aka fi shigowa dashi don gano atherosclerosis shine ƙwayoyin carotid. Don yin wannan, yi duban dan tayi (gwajin sau uku na shaƙwalwar brachiocephalic). Wannan binciken ya ba mu damar tantance yanayin bangon jijiyoyin bugun gini ta hanyar yin amfani da waɗannan bayanan ƙarin ko successfullyasa da kyau zuwa ga dukkanin jijiyar jijiyoyin bugun zuciya. An fahimci cewa idan har yanzu akwai filayen atherosclerotic a cikin carotid arteries, suma suna iya kasancewa a cikin wasu tasoshin, sabili da haka, irin wannan mara lafiyar zai iya yiwuwa ya nemi magani don rage cholesterol kuma yayi tasiri ga wasu abubuwan haɗari don atherosclerosis (misali, hawan jini, nauyin jikin, shan sigari).

Abu ne mai sauki a tantance kasancewar wuraren kwancen atherosclerotic a cikin tasoshin kafafu. Ana yin wannan ta amfani da hanyar ultrasonic guda. Wuraren da ke cikin tasoshin zuciya sun fi wahalar gani. Koyaya, don yanke shawara game da magani, kawai waɗancan filayen a cikin tasoshin jijiyoyin jini waɗanda ke da matukar muhimmanci toshe hanyoyin jini, suna haifar da alamu, suna da mahimmanci - dangane da lalacewar ƙwayar cuta ga waɗannan tasoshin, muna magana ne game da "angina pectoris", wanda aka gano ta hanyar nazarin abubuwan da suka gabata na asibiti (a cikin hali, wannan zafin) ko rashin jin daɗin kirji wanda ke faruwa lokacin tafiya, gudu ko ɗimbin nauyi da wucewa cikin minutesan mintuna a huta) da yin nazari tare da aikin jiki yayin da ake rikodin ƙwanƙolin lantarki kek Charts, echocardiogram ko scintigraphic image na zuciya domin gano haƙiƙa shaidar ischemia, t. e. wucin gadi mismatch tsakanin jini bayarwa ga myocardium da kuma bukatun cikinta karkashin load. A cikin yanayin da likita ya yanke hukunci cewa akwai alamun yin tiyata a kan tasoshin zuciya, suna yin aikin jijiyoyin zuciya - gwajin X-ray na tasoshin zuciya tare da gabatarwar wani wakili, yayin da zaku iya kai tsaye ganin lumen tasoshin zuciya da maƙarƙashiya da ke cikin waɗannan tasoshin don fitar da tsarin aikin aiki. sannan ka zabi zabinta.

Jiyya na Atherosclerosis

Ya kamata a rabu, a gefe guda, waɗancan matakan waɗanda aka yi niyya don hana atherosclerosis da hana ƙwanƙwasa ci gaban ta / ci gaba, kuma a ɗaya hannun, matakan matakan magance cututtukan, waɗanda suka dogara da cututtukan ƙwayoyin cutar atherosclerotic of arteries.

A zamanin yau, har yanzu babu wata hanyar da za a iya gyara wadancan '' ruduwa '' a matakin kayyade, wanda ya sa ake inganta haɓakar atherosclerosis a cikin wasu mutane. Sabili da haka, don dakatarwa ko rage ci gabanta, warkewa da cututtukan cututtukan ƙwayoyin cuta na atherosclerosis ana nufin su ne kawai don rage mummunan tasirin abubuwanda ke haifar da haɗarin haɗari, ciki har da cimma raguwar cholesterol na jini, kuma sama da duka, "mummunan" lipoprotein cholesterol low yawa. Rage cholesterol na jini kuma, mafi mahimmanci, riƙe shi a mafi ƙarancin shekaru na iya dakatar da ci gaba na atherosclerosis har ma a wani ɓangare juya shi. Ana aiwatar da waɗannan abubuwan biyu a cikin tsarin inganta salon rayuwa, da kuma hanyar magani. Koyaya, mafi yawan mutane ba a shirye suke don manyan canje-canje a rayuwar su ba kuma sun fi dogaro kan wasu tasirin waje waɗanda likitoci za su iya yi a kansu, ko a kan abubuwan da suka faru tsakanin tsarin magani. Dangane da wannan, akwai tarin maganganu iri-iri da kuma tatsuniyoyi, wadanda ake zargin ba su da inganci, “curative” matakan, magunguna da kuma abubuwan sa maye. Babu ruwan inabin jan giya, ko mangwaro, ko tincture na tafarnuwa, ko sanya ruwa ta laser, ko sanya ido a cikin tsarkakewar hanji, da kuma sauran adadin "warkewar" cututtukan, basu da ikon magance cututtukan cututtukan jijiyoyin jiki.

Daga cikin adadin magunguna tare da ingantaccen tasiri wanda zai iya hana ci gaba da ci gaban atherosclerosis, har ma da wasu dalilai na haifar da ci gaban da baya, babbar hujja mai tushe gumaka (atorvastatin, rosuvastatin, pitavastatin, simvastatin). Statins ba kawai rage matakin jimlar cholesterol da cholesterol da ke cikin ƙananan lipoproteins mai yawa ba, amma kuma, tare da tsawaita amfani, statins na iya dakatarwa ko rage jinkirin cizon atherosclerotic plaques, rage haɗarin infarction myocardial da bugun jini, da kuma ƙara yawan tsammanin rayuwa a cikin cututtukan da ke hade da tare da atherosclerosis. Don yin la'akari da irin waɗannan tasirin, dole ne a ɗauki gumaka na shekaru da dama kuma a cikin abubuwan da suka dace, waɗanda aka kafa su a cikin waɗancan karatun na asibiti waɗanda suka gano tasirin ƙirar statins.

Akwai wasu magunguna waɗanda ke inganta sigogi na ƙwayoyin cuta na jini, suna nuna bayanan lipid, don haka rage haɗarin cututtuka da rikice-rikice masu alaƙa da atherosclerosis. Bayan statins, wannan ezetimibe (ezetrol), wanda ke hana shan sinadarin cholesterol abinci a cikin hanji, kamar yadda ya bayyana kwanan nan kumaby - magungunan rigakafi ga enzyme da aka gano a 2003, an taƙaice kamar su PCSK9 (evolokumab da alirokumab suna rajista a Rasha). Don sauƙaƙa, zamu iya cewa wannan enzyme - PCSK9 - yana daidaita yawan adadin kuzarin cholesterol da ke cikin jini ta ƙwayoyin hanta. Gaskiya ne, a halin yanzu Kumabs suna da tsada sosai, amma wannan ne kawai ɓarkewar su. Akwai wasu rukunin magunguna waɗanda zasu iya shafar bayanin martaba na lipid a cikin haɓakar haɓakawa, amma ƙimar su ta ragu sosai.

Hasashen Yin rigakafin

Don jiyya da rigakafin cutar atherosclerosis, tasirin akan dukkan abubuwanda ke haifar da damuwa (abubuwan haɗari) na haɓaka na da mahimmanci:

• rage karfin jini
• lafiya,
• shan sigari
• kawar da kiba da rashin aiki.

A cikin waɗannan halayen lokacin da ci gaban atherosclerosis ya isa matakin da alamun bayyanar cututtuka na cutar da ke tattare da atherosclerosis ya bayyana, cutar da kanta ta fara jinya, ko kuma daidai, cututtukan atherosclerotic na ɗaya ko wani sashi: zuciya, kwakwalwa, kodan, ƙananan wata gabar jiki. Kuma galibi wannan magani na iya zama tiyata. Yawanci, irin wannan kulawa ya ƙunshi abubuwan da ke cikin tiyata waɗanda a cikin gida suke dawo da ƙwarewar jijiyoyin da cutar atherosclerosis ke ɗauka. Misali, idan lalacewar jijiyoyin jini na zuciya, wannan na iya zama karamin rauni mai aiki don shigar da sikeli na musamman a inda yadace - mai gurnani, wanda ake yin shi ta hanyar fitsari a cikin jirgin, ko kuma ana iya samun "babban" jijiyoyin bugun zuciya tare da bude kirji da sanya kirji ta hanyoyin jini ya kwarara a cikin zuciya - nisanta. A lokaci guda, atherosclerosis a matsayin cututtukan cuta na tsari, kuma magani na tiyata ta wata hanya ba zai kawar da buƙatar kulawa da ita ba - da farko, ta hanyar daidaita abubuwan haɗari, daga cikin abin da rikicewar rikicewar ƙwayoyin lipoproteins da ke ɗauke da cholesterol yana da matukar muhimmanci.

Sanadin da sakamako

Atherosclerosis ba ya bayyana ba ga wani dalili bayyananne. An inganta ci gabansa ta hanyar haɗuwa da abubuwan atherosclerosis. Sau da yawa marasa lafiya suna tambayar likitoci: "Ku gaya mani dalilin da yasa na kamu da wannan cutar kuma yaya zan ci nasara?"

Propaedeutics na cututtukan ciki, wanda likitoci suka yi nazari a matsayin ɗalibai, sun ƙare cewa matakan cholesterol da atherosclerosis inextricably an haɗa. Gaskiya ne, saboda a kan asalin wahalar mai mai faruwa basir. Rushewa a cikin aikin hanta, wanda ke rasa ikon rushe cholesterol kyauta, shima yana haifar da hakan. Sakamakon haka, saukad da kitse ya shiga cikin keɓaɓɓiyar wurare dabam dabam, wanda ke haifar da tarawa akan haɗuwar endothelium da samuwar adana atherosclerotic.

Dangane da haka, ilimin cututtukan ƙwayar cuta na lipid shine tushen dalili aukuwa atherosclerosis tasoshin.

Maganin motsa jiki na lipid yana damuwa da abubuwan haɗari. Wadannan sun hada da:

1. Siffofin shekaru. A cikin yara, wannan cuta tana da wuya sosai, yawanci tana faruwa ne a cikin mutanen da suka kai shekaru 40. Dangane da kididdiga, yawan mutanen da suka tsallaka zuwa yankin gabbai suna da yawan kashi masu cutar atherosclerosis na jijiyoyin jini.
2. Tasirin Jima'i. Wakilan Maza suna zama mai saukin kamuwa da cutar tun fiye da mata. Wannan ya faru ne sakamakon kasancewar kwayoyin halittar anti-atherosclerotic a jikin mace, wadanda ke haifar da kwazo sosai a lokacin haihuwa. Bayan shekaru 55, hadarin kamuwa da cutar atherosclerosis daidai yake a cikin mata da maza. Wannan ya faru ne saboda gaskiyar cewa ƙarancin aikin haifuwar mace yawanci yakan faru ne a wannan zamanin.
3. Kashi. Idan mafi kusancin dangi yana da lalacewa na jijiyoyin bugun jini na asherosclerotic, to, hadarin yana ƙaruwa da ninki goma.
4. Kasancewar jaraba. Loveaunar barasa da sigari na haifar da matsalolin jijiyoyin jiki a kan lokaci.
5. Addu'a ga abinci wanda ya ƙunshi adadi mai yawa na dabbobi da kuma mai mai mai kyau.
6. M rayuwa. Rashin yawan motsa jiki yana haifar da raguwa a cikin metabolism, tarin karin fam, lalacewar wadatar jini da oxygenation na gabobin da kyallen takarda.
7. Halin matsananciyar wahala. Kullum samar da kwayoyin damuwa wadanda ke haifar da bangon jijiyoyin jiki zai iya zama wa cikin cholesterol.
8. Hawan jini. Aara yawan jini a cikin jini yana haifar da lalata tasoshin jini, wanda yafi dacewa don samuwar atherosclerotic plaques.

Atherosclerosis yana da haɗari ga rikitarwarsa, wanda yawanci yana da m.

Mafi mummunan sakamakon cututtuka:

• ciwon mahaifa (ischemic, basur),
• myocardial infarction (mai da hankali, transmural),
• necrotic canje-canje a cikin kyallen takarda mai laushi (gangrene na ƙananan ƙarshen),

Idan kuwa babu tabbataccen taimako na taimako, to waɗannan rikice-rikice sukan haifar da mutuwa!

Cikin sharuddan psychosomatics, akwai ka'idar metaphysical ka'idar abin da ya faru na atherosclerosis na hanyoyin jini. Misali, Oleg Torsunov ya yi imanin cewa lalacewar na jijiyoyin bugun zuciya na faruwa ne sakamakon tsaurin tunani, rashin saukin hali a halin mutum, kusancin mutum ga duniyar waje. Valery Sinelnikov a cikin littafinsa ya rubuta cewa atherosclerosis yana bayyana ne sakamakon raunin da ya faru na tashoshin makamashi ta hanyar da dole ne raƙuman farin ciki su gudana zuwa ga tunanin mutum. Daidai rashin farin cikikuma ba hanyar rayuwa da bata dace ba tana haifar da rashin lafiya.

Bayyanar cututtuka: yadda ake bincika tasoshin jini don atherosclerosis

Arteriosclerosis na arteries ana iya gano shi a cikin mai haƙuri kawai bayan ya yi cikakken bincike.

A matakin farko, shawarar likita ta biyo baya. Dukkanin kwararru a yayin horarwa a jami'o'in likita sun wuce sashin ilimin likitanci, inda aka ba da babbar kulawa ga cikakken nazarin tarihin likita. Sabili da haka, likita dole ne ya bincika mai haƙuri dalla-dalla game da gunaguni, cikakkun bayanai. Bayan tuntuɓar magana, ƙwararren masanin kimiyya ya bincika mai haƙuri don canje-canje na cututtukan jijiyoyin cuta, yana auna karfin jini.

Mataki na gaba shine binciken maganin dakin gwaje-gwaje. Marasa lafiya yayi sallama bayanin martaba, wanda ke ba ku damar gano rashin daidaituwar ƙwayar lipid, saboda dyslipidemia da atherosclerosis ra'ayoyi ne marasa ma'ana. Hakanan, likita ya kamata ya lura da nazarin asibiti game da fitsari. Wannan ya zama dole don fahimtar ko akwai matsalolin koda ko a'a. Hakanan, daidaitaccen gwajin jini hanya ce mai kyau.

Mataki na karshe shine hanyoyin amfani ganewar asali. A cikin zuciya, ana daukar duban dan tayi hanya mafi bayani wacce zata iya gano bugun jini na atherosclerosis. A saboda wannan, ana amfani da yanayin dopplerometry, tare da taimakon wanda ake aiwatar da kimantawa na gani game da kwararar jini kuma an yanke sassan sassan jijiyoyin bugun gini, wanda tsarin aikin atherosclerotic ya ƙaddara. Don nazarin tasoshin jijiyoyin jini da na jijiyoyin jini, ana amfani da hanyar angiography.

Yadda za a kula da atherosclerosis

Marasa lafiya da ke fama da cutar atherosclerosis na jijiyoyin jini suna damuwa da tambayar: "Shin cutar za a iya warkewa ne?" Jiyya na atherosclerosis na jijiyoyin jiki tsari ne mai tsawo wanda yakamata a fara shi nan da nan bayan gano cutar sankara. Healthungiyar Kiwon Lafiya ta Duniya ta haɗu da jagororin asibiti don maganin wannan ilimin.

Masu warkarwa suna ba da nasu hanyoyin na kawar da cutar. Misali, Neumyvakin ya ba da shawarar yin amfani da atherosclerosis don cinye hydrogen peroxide a ciki, yana mai cewa wannan hanyar warkewa ce ta nasara. Koyaya, kafin wannan, yakamata a nemi likita, saboda magani na kai ba koyaushe yana haifar da sakamakon da ake so ba!

Jama'a da sauran hanyoyin

Baya ga shawarar mai warkarwa na Neumyvakin, wani madadin magani yana ba da adadi mai yawa na yadda za a magance cutar atherosclerosis na jijiyoyin bugun jini. Wasu masana sunyi jayayya cewa lura da cututtukan homeopathy ba kawai zai iya hana ƙirƙirar filaye ba, har ma da share kwatancen jijiyoyin da ke cikin jijiyoyin jiki. Koyaya, ba a karɓi shaidar hukuma ko ɓatancin wannan bayanin ba, saboda haka, kowane mutum dole ne ya yanke shawara don kansa ko za a kula da shi ta hanyar cututtukan gida ko a'a.

Wasu sun yi imani cewa ilimin motsa jiki yana da sakamako mai kyau a cikin yaƙi da jijiyoyin bugun jini na jijiyoyin jini. Maganin motsa jiki shine reshe na magani wanda burin shi shine ƙara samar da jini zuwa kyallen da abun ya shafa ta hanyar inganta ƙwayoyin microcirculatory. Likitoci sun bada shawarar amfani da hanyoyin motsa jiki, amma a hade tare da magunguna da kuma ingantaccen abinci.

Ilimin Jiki

Wakilan likitancin zamani sun yi imanin cewa lura da atherosclerosis ya kamata ya faru a bango isasshen aikin motsa jiki. Don wannan aikin motsa jiki motsa jiki yana da kyau, wanda marasa lafiya zasu iya aiwatarwa bisa shawarar likita, duka biyu kuma a karkashin kulawa na mai koyar da motsa jiki.

A ƙarƙashin tasirin damuwa na jiki akan jiki, zagayawa na jini yana inganta, kuma isar da oxygen zuwa gabobin ischemic da kyallen takarda yana ƙaruwa daidai. Tare da horarwa na yau da kullun, metabolism da makamashi suna inganta, karin fam ƙonewa, nauyin akan tsarin zuciya yana raguwa, marasa lafiya suna jin ruhohi masu kyau, haɓaka mai mahimmanci da ƙarfi.

Babban dokar shi ne cewa aikin motsa jiki ya kamatamai ƙarfi da ƙaruwa a hankali. Tare da motsa jiki na dacewa da motsa jiki na motsa jiki, haɗarin rauni yana da ƙima.

Magungunan magani

A yau, magani ya san yadda za a rabu da ci gaban da jijiyoyin bugun jini na atherosclerosis. Magunguna suna zuwa gaba, yawan cin abinci na yau da kullun wanda ke da ikon dakatar da ci gaban cutar. Likitocin sun ba wa marasa lafiya magani irin su: statins, antiplatelet jami'in, reshen musayar anion, magungunan fibroic acid.

Babban yanayin shi ne cewa ya kamata a gudanar da magani ba tare da tushen gyara abinci ba. Don yin wannan, ƙin abincin da ya ƙunshi kitsen dabbobi mai yawa, carbohydrates mai sauƙi. Ya kamata a zaɓi fifiko ga samfuran furotin, har ma da waɗanda suka haɗa da hadaddun carbohydrates, fiber, da kifayen kayan lambu.

Jiyya na tiyata wata hanya ce ta dakatar da ci gaba na atherosclerosis. Yawanci, ayyukan tiyata, kamar turawa da tiyata, ana amfani dasu don hana rikitarwa na atherosclerosis (lalacewar ischemic ga ƙwaƙwalwar kwakwalwa, myocardium, ƙananan ƙarshen, gabobin ciki).

Babban mahimmancin stenting shine cewa ta hanyar huda fata ta amfani da kayan aiki na musamman, an saka sutura ta musamman a cikin gado na jijiyoyin bugun gini, wanda aka sanya a wurin da cutar ta atherosclerotic rauni. Don haka, ƙwayar jirgi ta faɗaɗa, ana cire shinge na gudanawar jini. Ana amfani da wannan hanyar azaman maraba.

Kewaya tiyata - Wannan wani mamayewa ne mai ban sha'awa, wanda aka yi niyya don ƙirƙirar zubar da jini a cikin yankin da ya lalace na gado na jijiyoyin bugun gini.

Tare da atherosclerosis na tasoshin kafafu, lokacin da asibitin gangrene ya bayyana, an yi yantsun hannu na kasa. Wannan aikin tsattsauran ra'ayi ne wanda ake yi don dalilan kiwon lafiya. Idan ba'a yanke hannu na hannun ba, nan da nan mai lafiya zaiyi tsammanin sakamako mai kisa!

Yaya mutane da yawa suke rayuwa tare da atherosclerosis

Jin jijiyoyin bugun jini na atherosclerosis na daya ko wata fassara, marasa lafiya suna tunanin cewa wannan jumla ce. Kamar yadda aka ambata a sama, maganin zamani ya yi imanin cewa ba zai yiwu a magance cutar baki ɗaya ba. Koyaya, idan kun fara magani don atherosclerosis a lokaci, tsammanin rayuwa dauke quite m.

Akwai ra'ayi akasin haka. Masanin ilimin kimiyyar immunologist Gorodissky B.V. ya ce maganin atherosclerosis na jijiya ne. Ya yanke wannan shawarar, yana magana a cikin shirin "Duk Game da Lafiya". Ya kasance hakane zai iya, amma mutuwar marasa lafiya na faruwa ne daga rikice-rikice na cutar, musamman idan an ba da taimakon farko a lokacin da bai dace ba. Sabili da haka, ganewar asali na atherosclerosis yana da matukar muhimmanci.

A cikin tsofaffi Juyawa daga baya yayin ci gaban rikice-rikice yana da matukar muhimmanci ga mutane, saboda ingancin rayuwar su ta nan gaba ya dogara da wannan. Don haka ba a cika haifar da mummunan haɗarin cutar atherosclerosis ba, likitoci sun ba da shawarar hana cutar. Ya ƙunshi nauyin shekara-shekara na bayanan furotin, daidaitaccen abinci mai gina jiki, riƙe babban matakin motsa jiki, riƙe ingantaccen nauyin jikin mutum.