Atherogenic: tlhaloso, likotsi, thibelo

Atherogenic: tlhaloso, likotsi, thibelo

Lentsoe "atherogenic" le bolela lintho kapa lintlha tse khonang ho hlahisa atheroma, kapa deposit of plaques e entsoeng ka LDL-cholesterol, lisele tsa ho ruruha le khetla ea fibrous. Ketsahalo ena e kotsi haholo haeba mothapo o fana ka setho sa bohlokoa se kang pelo kapa boko. Ke sesosa sa mafu a mangata a pelo, ho kenyelletsa le stroke le myocardial infarction. Thibelo ea eona ea mantlha e kenyelletsa ho amohela mekhoa e metle ea bohloeki le lijo. Thibelo ea bobeli e fanoa ho bakuli ba seng ba ntse ba e-na le matšoao kapa bothata. Tabeng ena, sepheo ke ho fokotsa kotsi ea ho ba le bothata bo bocha, sebakeng se le seng kapa sebakeng se seng sa methapo ea mali.

Lentsoe atherogenic le bolela'ng?

Lentsoe "atherogenic" le bolela lintho kapa lintlha tse khonang ho hlahisa atheroma, ke hore "deposit of plaques" e entsoeng ka lipids, lisele tsa ho ruruha, lisele tse boreleli tsa mesifa le lisele tse kopanyang. Li-plaque tsena li ikamahanya le marako a ka hare a methapo e bohareng le e meholo, haholo-holo ea pelo, boko le maoto, 'me e lebisa phetohong ea sebaka sa ponahalo le tlhaho ea marako ana. 

Ho kenngoa ha li-plaque tsena ho ka lebisa mathateng a tebileng a kang lefu la methapo ea pelo ka ho baka:

  • ho ruruha le ho lahleheloa ke elasticity ea lerako la arterial (atherosclerosis);
  • ho fokotseha ha bophara ba artery (stenosis). Ketsahalo ena e ka fihla ho feta 70% ea bophara ba mothapo. Sena se bitsoa tight stenosis;
  • ho thijoa ka mokhoa o sa fellang kapa ka ho feletseng ha methapo ea mali (thrombosis).

Re bua ka lijo tsa atherogenic ho hlalosa lijo tse nang le mafura a mangata, joalo ka lijo tsa Bophirimela tse nang le mafura a mangata haholo le li-trans fatty acids ka mor'a hore hydrogenation ea mafura a mafura a sebelisoe ke indasteri.

Lisosa tsa ho thehoa ha li-atheromatous plaque ke life?

Khatelo-pele ea li-plaque tsa atheromatous e ka bakoa ke lintlha tse 'maloa, empa sesosa se ka sehloohong ke k'holeseterole e feteletseng maling, kapa hypercholesterolemia. Ha e le hantle, ho thehoa ha letlapa la atheromatous ho itšetlehile ka ho leka-lekana pakeng tsa lijo tsa k'holeseterole, boemo ba eona ba ho potoloha le ho felisoa ha eona.

Nakong ea bophelo, mekhoa e mengata e tla qala ho baka likheo leboteng la arterial, haholo-holo libakeng tsa bifurcation:

  • arterial hypertension eo, ntle le ts'ebetso ea eona ea mochini leboteng, e fetolang phallo ea intracellular ea lipoprotein;
  • lintho tsa vasomotor, tse kang angiotensin le catecholamines, tse khonang ho pepesa collagen ea sub-endothelial;
  • hypoxiant, joalo ka nicotine, e bakang khatello ea maikutlo e lebisang ho phatlalatseng ha li-intercellular junctions.

Litlolo tsena li tla lumella ho fetela leboteng la methapo ea lipoprotein tse nyane joalo ka HDL (High Density Lipoprotein) le LDL (Low Density Lipoprotein) lipoprotein. K'holeseterole ea LDL, eo hangata e bitsoang "cholesterol e mpe", e teng maling e ka haka. Ka hona, e baka liso tsa pele, tse bitsoang lipid streaks. Tsena ke li-deposit tse etsang litsela tsa lipid tse phahamisitsoeng leboteng le ka hare la mothapo oa mali. Butle-butle, LDL-cholesterol e ea oxidize moo 'me e fetoha ho ruruha leboteng la ka hare. E le ho e felisa, ba qetellang ba hira li-macrophage tse nang le LDL-cholesterol. Ntle le mokhoa ofe kapa ofe oa taolo, li-macrophages li fetoha tse ngata, li shoa ke apoptosis ha li ntse li qabeletsoe sebakeng seo. Mekhoa e tloaelehileng ea ho felisa litšila tsa lisele tse sa khoneng ho kenella, li bokella letlapa la atheroma le ntseng le hōla butle-butle. E le ho arabela mochine ona, lisele tse boreleli tsa mesifa ea lerako la methapo li fallela ka har'a letlapa ho leka ho arola sehlopha sena sa ho ruruha ha lisele. Ba tla etsa fibrous screed e entsoeng ka likhoele tsa collagen: kaofela li etsa poleiti e thata kapa e sa tsitsang. Tlas’a maemo a itseng, plaque macrophages e hlahisa liprotease tse khonang ho sila collagen e hlahisoang ke lisele tse boreleli tsa mesifa. Ha ts'ebetso ena ea ho ruruha e fetoha e sa foleng, ketso ea liprotheine holim'a likhoele li khothalletsa ho ntlafatsoa ha screed e fetohang e fokolang le e ka senyang. Tabeng ena, lerako le ka hare la mothapo le ka 'na la phatloha. Liplatelete tsa mali li kopana le maloanlahla a lisele le lipids tse bokelletsoeng ka har'a plaque ho etsa lesela, le tla fokotsa lebelo ebe le thibela phallo ea mali.

Ho phalla ha k'holeseterole 'meleng ho fanoa ke LDL le HDL lipoprotein tse tsamaisang k'holeseterole, ho tloha lijong tse maling, ho tloha maleng ho ea sebeteng kapa methapong, kapa ho tloha methapong ho ea sebeteng. Ke ka lebaka lena, ha re batla ho lekola kotsi ea atherogenic, re lekanya lipoprotein tsena ebe re bapisa bongata ba tsona:

  • Haeba ho na le lipoprotein tse ngata tsa LDL, tse isang k’holeseterole methapong, kotsi e khōlō. Ke ka lebaka lena LDL-cholesterol e bitsoang atherogenic;
  • Kotsi ena ea fokotseha ha boemo ba mali ba HDL lipoprotein, bo tiisang hore k’holeseterole e khutlela sebeteng moo e sebetsoang pele e tlosoa, e phahame. Ka hona, HDL-HDL-cholesterol e tšoaneleha e le tšireletso ea pelo ha boemo ba eona bo le holimo, hape e le kotsi ea pelo ha boemo ba eona bo le tlaase.

Ke matšoao afe a bakoang ke ho thehoa ha li-atheromatous plaque?

Ho hola ha li-atheromatous plaque ho ka kena-kenana le phallo ea mali butle-butle mme ho lebisa ho ponahalo ea matšoao a sebakeng seo:

  • bohloko;
  • botsoa;
  • phefumoloho e khutšoanyane;
  • ho hloka botsitso ha u tsamaea, joalo-joalo.

Mathata a tebileng a atherosclerosis a hlaha ka lebaka la ho phatloha ha li-atherosclerotic plaques, ho fella ka ho thehoa ha lesela kapa thrombus, e thibelang ho phalla ha mali le ho baka ischemia, liphello tsa eona e ka ba tse tebileng kapa tse bolaeang. Methapo ea litho tse fapaneng e ka ameha:

  • lefu la methapo ea pelo, ka pelong, ka angina kapa angina pectoris e le letšoao, le kotsi ea ho ba le lefu la myocardial;
  • li-carotids, molaleng, ka kotsi ea kotsi ea cerebrovascular (stroke);
  • aorta ea mpa, tlas'a diaphragm, e nang le kotsi ea ho phatloha ha aneurysm;
  • methapo ea tšilo ea lijo, ka maleng, e nang le kotsi ea ho ba le mesenteric infarction;
  • methapo ea renal, boemong ba liphio, e nang le kotsi ea ho ba le infarction ea renal;
  • methapo ea maoto a tlase e nang le sesupo sa ho hlotsa hoa maoto a tlase.

Tsela ea ho thibela le ho loantša ho thehoa ha li-atherosclerotic plaques?

Ntle le lefutso, bong le lilemo, thibelo ea ho thehoa ha li-atheromatous plaque e itšetlehile ka tokiso ea mabaka a kotsi a pelo:

  • ho laola boima ba 'mele, khatello e phahameng ea mali le lefu la tsoekere;
  • ho khaotsa ho tsuba;
  • ho ikoetlisa kamehla;
  • ho amohela mekhoa e metle ea ho ja;
  • moeli oa ho noa joala;
  • taolo ea khatello ea maikutlo, joalo-joalo.

Ha letlapa la atheromatous le se na thuso ebile ha le e-s'o fane ka tšusumetso, thibelo ena ea mantlha e ka ba e lekaneng. Haeba mehato ena ea pele e hlōleha, ha plaque e fetohile, phekolo ea meriana e ka 'na ea buelloa. E ka boela ea fanoa hang-hang haeba ho na le kotsi e kholo ea mathata. E khothalletsoa ka mokhoa o hlophisitsoeng bakeng sa thibelo ea bobeli ka mor'a ketsahalo ea pele ea pelo. Kalafo ena ea lithethefatsi e kenyelletsa:

  • lithethefatsi tsa antiplatelet, tse kang aspirin ka tekanyo e nyane, ho fokotsa mali;
  • Lithethefatsi tse fokotsang lipid (li-statins, fibrate, ezetimibe, cholestyramine, li le mong kapa li kopane) ka sepheo sa ho fokotsa boemo ba k'holeseterole e mpe, ho etsa hore boemo ba k'holeseterole e be bo tloaelehileng le ho tsitsisa plaque ea atheromatous.

Ha u tobane le li-plaque tse tsoetseng pele tsa atheromatous tse nang le stenosis e thata, ho ka nahanoa ka revascularization ka coronary angioplasty. Sena se lumella ho atolosoa ha sebaka sa atheromatous ka lebaka la balune e ruruhileng sebakeng seo mothapong o nang le ischemia. E le ho boloka phallo le ho tsosolosa phallo ea mali, mochine o monyenyane oa mochine o bitsoang stent o kenngoa 'me o siuoa sebakeng seo.

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