Mehato ea ntlafatso ea methapo ea methapo

1. Ntshetsopele ea dyslipoproteinemia, e tsamaeang le ponahalo ea lipoprotein tse fetotsoeng, tse ts'oaroang ka matla ke lisele tsa endothelial mme li fetisetsoa sebakeng sa subendothelial.

2. Tšenyo ea endothelium e nang le lipoprotein tse fetotsoeng kapa lintlha tse ling (livaerase, li-immune complexes, chefo ea baktheria, joalo-joalo).

3. Keketseho ea boteng ba vascular le ho phahama ha likarolo tsa plasma, ho kenyeletsoa lipoprotein ka ho putlama.

4. Khokahano ea liplatelete le monocytes ho ea ho endothelium, ho falla ha li-monocytes ho intima, phetoho ea tsona ea ho fetoha li-macrophages le tlhahiso ea li-cytokines tse ngata (interleukin -1, ntlha ea kholo ea liplatelete, ntlha ea tumor necrosis).

5. Ho falla ho kenella le ho atoloha ha lisele tsa mesifa e boreleli (HMC) tlasa ts'usumetso ea kholo ea mokelikeli oa lintho tsa tlhaho tse patiloeng ke li-macrophages, endothelium le HMC ka boeona, tse nkang phenotype ea maiketsetso (hangata contractile phenotype predominates), synthesize collagen le elastic fibers, proteinoglycans, joalo-joalo. theha motheo oa lefapha la atherosselotic.

6. Phetoho e eketsehileng ea lipoprotein tse haufi, sebopeho sa li-complexes tse nang le li-proteinoglycans, ho ts'oaroa ha tsona ke li-macrophages, tseo, ha li felisoa ka ts'ebeliso ea lits'ebetso tsa ho li sebelisa le ho li tlosa (haholo-holo lysosomes), li tlatsitsoe ka lipids mme li fetoha foamy, kapa xanthoma (ho tsoa ho lisele tsa Greek --antant - yellow). Karolo ea lisele tsa xanthoma e thehoa ho tsoa ho li-HMC, tseo, ha li e-na le li-receptors tsa β-VLDLPs tse sa fetoloeng, li a amohela ka mokhoa o sa laoloang.

7. Liphetoho tse ileng tsa latela mokokotlong li amahanngoa le ho etsoa ha li-capillaries ho eona ka lebaka la tšusumetso ea kholo, ho kenella ha lintho tse ling tsa sele (T le B lymphocyte, fibroblasts), necrosis ea likarolo tse bohareng ba lesela, sclerosis, hyalinosis, calcification.

Liphetoho tsa sebopeho.

Ka lefu la atherosclerosis leqebeng la aorta le artery, gummy, fat-protein detritus (atheré) le tlhaiso e sekhahla ea lithane tse amanang (sklerosis) li hlaha, e leng se lebisang ho thehoeng ha sethala sa atherosselotic se nyenyefatsang lumen ea sekepe. Lisele tsa mofuta oa li-elastic le tsa mesifa-elastic lia ameha, i.e. methapo ea methapo e meholo le e bohareng, hangata methapo e menyenyane ea mesifa e kenang tšebetsong ena.

Liphetoho tsa Macroscopic li bonts'a matla a ts'ebetso.

1. Mafahla le metala - libaka tsa 'mala o mosehla kapa o mosehla oa lamunu (matheba), ao ka linako tse ling a kopanang ebe a theha methapo, empa a se ke a phahama ka holim'a sefahleho sa intima. Li qala ho hlaha aorta leboteng le ka morao le ho tloha ha makala a sona a hlaha, 'me hamorao ka har'a methapo e meholo ea methapo.

2. Matlapa a boreleli - liforomo tse tšoeu tse chitja kapa tse bosoeu bo bosoeu bo bosehla bo phahametseng holim'a metsi, hangata li kopana le ho fa sefahleho se phatsimang, se lateloe ke ho fifala ha leseli la mokokotlo. Hangata, ho ba le lipopae li hlaha ka mpeng ea aorta, methapong ea pelo, bokong, liphio, maoto le matsoho le methapo ea methapo ea mokokotlo. Hangata, likarolo tsa methapo ea mali tse nang le litlamorao tsa hemodynamic (mochine) lia ameha - sebakeng sa lekala la makala le ho kobeha ha methapo ea methapo.

3. Liso tse rarahaneng.

- li-fibrous plaque tse nang le ulceration (atheromatous ulcer),

- hemorrhages boteng ba polasetiki (intramural hematoma),

- sebopeho sa lipapatso tsa "thrombotic" setsing sa polokelo ea lejoe.

Liso tse rarahaneng li amahanngoa le nts'etsopele ea lefu la ho nyekeloa ke pelo (ka mokokotlong oa thrombosis), embolism le masapo a mangata a mokokotlo le atheromatous, sebopeho sa aneurysm ea sejana sebakeng sa ulceration, le mali a tsoang ka ntle ha lesapo la mokokotlo le silafalitsoe ke leqeba la sefahleho.

4. Calcification (atherocalcinosis) - karolo ea ho qetela ea atherosclerosis, e khetholloang ka ho hlahisoa ha letsoai la khalsiamo libakeng tse nang le fibrous.

Mehato e latelang ea atherosulinosis morphogeneis e khetholloa:

Mokhahlelo oa dolipid ha o khethoe ka bongata. Microscopically, tsepamisa tšenyo (ho fihlela timetso e felletseng) ea endothelium le keketseho ea boits'oaro ba li-intima membrane li bonoa, e leng se lebisang ho bokelleng ha liprotheine tsa plasma, fibrinogen (fibrin) ka har'a membrane e kahare le ho thehoa hoa parietal thrombi, ho bokellana ha acid glycosaminoglycans le ho hlasela ha tlhaho. lipoprotein tsa hae tse tlaase haholo le tse tlase haholo, k'holeseterole, liprotheine, tšenyo ea lisele tsa elastic le collagen, keketseho ea lisele tse boreleli tsa mesifa. Ho khetholla mohato ona, ho hlokahala hore ho sebelisoe dae ea thiazine. Mohlala, ka lebaka la ts'ebeliso ea mebala ea lithethefatsi ka toluidine putsoa (thionine), o ka sheba ponahalo ea metala e pherese (ketsahalo ea metachromasia) libakeng tseo ho arohantsoeng lithane tse amanang le tsona kapele. Mohato oa lipoidosis o tšoauoa ka ho kenella kahare lipakeng tsa lipids (cholesterol), lipoprotein, e lebisang ho thehoeng ha mathe le lihlopha tsa mafura (lipid). Macroscopically, mafura a joalo a mafura a hlaha ka tsela ea makhapetla a mosehla ao ka linako tse ling a ka kopanang a ba a etsa metopa e melelele e metelele e sa phahameleng ka holimo ho kamano e haufi. Libakeng tsena, ha u sebelisa dae ho mafura, mohlala, Sudan III, IV, bofubelu bo mafura le tse ling, lipids li fumanoa ka bongata. Lipids li bokellana liseleng tse bonolo tsa mesifa le li-macrophage, tse bitsoang lisele tsa foamy, kapa xanthoma, (ho tsoa ho Greek. Hanthos - mosehla). Lipid inclusions le tsona li hlaha ka har'a endothelium, e bonts'ang ho kenella ha intima ka lipidma lipids. Ho ruruha le tšilafalo ea li-membrane tsa elastic li bonoa. Pele ho tsohle, matheba le makala a mafura a hlaha ka aorta le sebakeng seo makala a sona a tsoang teng, ebe ho latela methapo e meholo ea methapo. Ponahalo ea matheba a joalo ha e bolele ho ba teng ha atherosulinosis, hobane ponahalo ea libaka tsa lipid e ka bonoa bongoaneng, eseng feela ka aorta, empa le methating ea pelo. Ka lilemo, lipid libaka, tseo ho thoeng ke lipontšo tsa "phidical mapema lipidosis", maemong a mangata lia nyamela mme ha se sesosa sa liphetoho tse ling. Liphetoho tse tšoanang le tsa methapo ea mali ho batho ba bacha li ka bonoa ho mafu a mang a tšoaetsanoang. Ka liposclerosis, fibroblasts e atoloha, kholo ea eona e tsosetsang ts'enyeho ea li-macrophages (lisele tsa xanthoma) le kholo ea lisele tse nyane tse amanang le "intima". Kamora 'mele ea "tiske" ena e tsamaisana le ho etsoa hoa lets'oao la fibrous. Macroscopically, li-plaque tsa fibrous li boreleli, tse chitja kapa tse chitja, tse bosoeu bo bosoeu kapa bosoeu bo bosehla bo phahametseng holim 'a metsi. Ts'ebeliso ea dae e ikhethileng e lumella lipids hore li fumanoe litsing tsa fibrous. Matlapa ana a nyenyefatsa lumen, e tsamaeang le tlolo ea phallo ea mali (ischemia) ho setho kapa karolo ea eona. Hangata, lipopae tse nang le fibrous li bonoa ka mpeng ea aorta, makaleng a tsoang ho aorta, methapong ea pelo, bokong, lipelong, methapong e ka tlase, methapo ea methapo ea methapo, joalo-joalo ka atheromatosis, lipid masisi a lipid a karolong e bohareng ba lesela lena le haufi le "collagen" le li-elastic fibers lia qepha. Likristale tsa k'holeseterole le mafura a acid, likotoana tsa likhoele tsa elastic le collagen, marotholi a mafura a sa jeleng paate (atheromatous detritus) a fumanoa ka bongata bo bopehileng hantle ba moea. Ho fumanoa lisele tse ngata tsa xanthoma, lymphocyte le plasmocytes. Maqhubu a atheromatous a theotsoe ho lumen sa sekepe ke sekaka sa lithane tse holileng, tse hyalinized (sekoaelo sa polasetiki). Tsoelo-pele ea liphetoho tse atileng li lebisa timetsong ea lebili. Nako ena e tšoauoa ka palo e kholo ea mathata a fapaneng. Ha ho fihla boemo ba ulceration, bo tsamaisana le ho etsoa ha leqeba la atheromatous. Maphethetso a joalo a ka mpefala, ha a lekane, ka tlase a thehoa ke mesifa, 'me ka linako tse ling mokoloto oa boithatelo oa lebota la sekepe. Bofokoli bo bongata hangata bo koaheloa ke ho tlatlapa ka holimo. Ka lebaka la necrosis ea likarolo tse tebileng tsa lebota la sekepe, aneurysm (protrusion ea lebota) e ka theha. Khafetsa mali a tsoa liseleng tse bohareng ebe a li-aneurysms tse bolila. Kotsi ea mathata ana e ka hlaha ka monyetla oa ho phatloha kapa aneurysm, kapa lebota la sejana libakeng tsa liso tsa kahare. Matsoelesa a ka hlatsoa metsi ka molapo oa mali ebe a etsa emboli. Atherocalcinosis e tšoauoa ka ho kenngoa ha letsoai la khalsiamo libakeng tse ling tsa fibrous, i.e. calcation (petration). Ona ke mohato oa ho qetela oa atherosclerosis. Leha ho le joalo, ho lokela ho hopoloa hore ho hlahisoa ha letsoai la calcium ho ka bonoa maemong a eona a pejana. Lithota li fumana letsoalo la majoe, lebota la sekepe se sebakeng sa litlatsetso se senyehile haholo. Metsoako ea khalsiamo e kentsoe matsohong a atheromatous, liseleng tsa fibrous, nthong e arohaneng pakeng tsa likhoele tsa elastic. Thupelo ea bongaka. Atherosclerosis ke lefu le sa foleng le sa feleng. E tšoauoa ka phallo e kang ea leqhubu, e kenyeletsang ho fetoloa ha methati e meraro ea sehlooho:

- botsitso; - boikoetliso ba tšebetso.

Thupelo e sa reroang e kenyelletsa ho rala lipidosis ka liphetoho tsa khale - liposulinosis, atheromatosis le atherocalcinosis. Nakong ea khatello ea ts'ebetso, ho arohana ho hoholo ha lipids ka li-macrophage hoa khoneha.

Ho sa tsotelloe lehae la liphetoho tsa atherosselotic, lihlopha tse peli tsa mathata li khethollotsoe: a sa foleng le a hlobaetsang.

Mathata a sa foleng Letlapa la atherosclerotic, le kenellang ka har'a lumen ea sekepe, le lebisa ho fokotseng (stenosis) ea lumen (stenotic atherosclerosis). Kaha ho thehoa hoa lejoe ka sekepeng ke ntho e liehang ho etsahala, ischemia e sa feleng e ba teng sebakeng sa phepelo ea mali ea sekepe sena. Ho haella ha methapo ea pelo ka nako eohle ho tsamaisana le phetoho ea hypoxia, dystrophic le atrophic ka hara setho le ho eketsoa hoa lithane tse amanang. Ho theoha butle-butle ha metsoako ho lebisa ho sclerosis e nyane.

Mathata a hlobaetsang. Li bakoa ke ho ba teng hoa methatsana ea mali, emboli, spasm ea methapo ea mali. Acute vaslation occlusion e etsahala, e tsamaisana le ho hlobaela ha methapo ea pelo (acute ischemia), e lebisang ho holisoeng ha ho nyekeloa ke pelo (ho etsa mohlala, myocardial infarction, ho nolofatsa ha boko, litho tsa mokokotlo, joalo-joalo). Ka linako tse ling ho phatloha ha sekepe se bolaeang ho ka bonoa.

Metsoako 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. Likhakanyo tsa liplatelete le lintho tse kopana, lia lokolloa.

Letlapa leo le hola ka potlako, le thibela lumen ea sekepe ka lebaka la sebopeho sa sebopeho sa lisele tsa tai se sebetsang.

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. Mohato 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 atherosclerosis ke dolipid, ha e na liphetoho tse ikhethang tsa morphological. E tšoauoa ka keketseho ea permeability ea mokokotlo oa 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 tlhahlobo ea nalane ea litokisetso tsa lebota la vascular le ho sebelisa dae e ikhethang - thionine e putsoa, ​​moo ho nang le ketsahalo ea metachromasia le lits'oants'o tsa libaka tse anngoeng ke 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 esita 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, lijana tsa bokong, liphio le sebete, li etsa 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 mabaka a kholo le nts'etsopele ea lisele tse nyane tse amanang.

Fheror ea Atherosulinosis

Kotsi ea atherosulinosis e tsejoa e eketseha le lilemo. Bakeng sa banna, sena se lilemo tse fetang 40; bakeng sa basali, o lilemo li 50-55. A sa le monyane, lipalo tse ngata tsa phospholipids tse bonolo tse sebelisoang habonolo, li-mucopolysaccharides tse fumanehang hantle (haholo-holo hyaluronic acid), li-scleroproteins (collagen) li teng ka leboteng la sekepe ka bongata bo boholo.

Lintho tsena kaofela li nka karolo ho mafolofolo metabolism, e fanang ka lebota la vascular ka botsitso le bokhoni ba ho arabela kapele liphetoho tse fapaneng. Ka lilemo, palo ea li-phospholipids ea fokotseha, har'a li-mucopolysaccharides tsa acid, karolo ea sondates ea chondroitine e eketseha, e tlatsetsang ho thateng ha lebota la sekepe.

Karolong e bohareng, ntho ea chromotropic ea tlhaho ea mucoid ea bokellana, palo ea li-scleroprotein ea eketseha. Collagen ha e nkuoe hantle. Boikutlo ba endothelium ho tšusumetso ea ts'ebetso bo eketseha, ho atoloha ha karolo ea subendothelial ho bonoa.

Bophahamong ba likepe, ho hlaha lisele tse khethehileng tsa mesifa, tse khetholloang ka sebaka sa myofibrils bokaholimo ba cytoplasm. Liseleng tse joalo, li-protein li bokellana.

Ntle le moo, liphetoho lipolotong tsa mali (dyslipidemia), tse nkoang e le sesosa sa kotsi, le tsona li qala ho hola hangata botsofaling.

Leha ho le joalo, lebaka la lilemo le liphetoho tse amanang le sebopeho le tšebetso ea lebota la arterial, hammoho le liphetoho mokhoeng oa mali oa lipid, li ke ke tsa nkuoa e le lintho tsa mantlha tsa etiological. Ba mpa ba rerile ho hola.

Boitšisinyo

Lintho tse amang maikutlo li ka ama nts'etsopele ea atherosulinosis ka lebaka la liphetoho tse ikemiselitseng liphatsa tsa lefutso ts'ebetsong ea lits'ebetso tse 'maloa tsa enzyme. Haholo-holo, sena se netefatsoa ke liteko tseo ba ileng ba leka ho li bakela atherosulinosis liphoofolong ka ho li fepa cholesterol e ngata.

Litekong, ts'ebetso ea methapo ena ea methapo ha e tsoelepele, hobanets'ebetso ea enzymatic ea marako a lijana ho eona e phahame haholo. Ho mebutlanyana, ho fapana le hoo, ho na le khoholeseterole e potlakileng haholo leboteng la methapo. Leha ho le joalo, ho tlameha ho hlakisoa mona hore ketsahalong ena ha re bue ka atherosclerosis, empa ke feela tlolo ea metabolism ea lipid, e lebisang ho pepeseng k'holeseterole e ngata.

Sebopeho sa lefutso la atherosulinosis se boetse se netefatsoa ke ho ba teng ha lefu le joalo ka hypercholesterolemia ea bohlokoa ea lelapa, eo ho eona ho nang le bofokoli bo nang le tlhaho liphatseng tsa lefutso tse ikarabellang bakeng sa metabolism ea cholesterol. Tabeng ena, litho tse ngata tsa lelapa le le leng, ho tloha bongoaneng, li tsoela pele ka potlako ho atherosclerosis e matla.

Har'a lintho tse ka bang kotsi tse ka qojoang, ho tsuba koae (ho lemalla koae) ho lokela ho beoa sebakeng sa pele. Kahoo, le haeba a sebelisa nicotine ka tekano (ho fihlela lisakerete tse 15 ka letsatsi), menyetla ea ho lemala ha methapo ea methapo ea methapo e atoloha habeli.

Hypodynamia

Ho ikoetlisa ka ho sa lekaneng, e fetohileng bo bong ba mathata a tebileng ka ho fetisisa a batho. Lefatsheng la sejoale-joale, e sebetsa e le sesosa sa kotsi sa lefu la atherosclerosis. Khaello ea ts'ebetso ea 'mele e kenyelletsa liphetoho tsa metabolism, ho kenyelletsa le metabolism ea lipid, e phethang karolo ea bohlokoa ho pathogene ea lefu lena.

Ho nona haholo le botenya

Tlhahlobo e mengata ea kliniki e bontša hore atherosclerosis "e tsamaisana le botenya." Kamano ea maemo ana a mabeli e bontšoa ke polelo e latelang: atherosclerosis e ka nts'etsapele ntle le botenya, empa ha ho na botenya ntle le atherosclerosis. Ka botenya, boemo ba li-triacylglycerides maling hangata bo nyoloha.

Liphetoho tse ling mokheng oa mali oa lipid li hlaha, li kenya letsoho kholisong ea atherosclerosis. Leha ho le joalo, ho lokela ho hopoloa hore ho nona haholo le botenya li lebisa ho liphetoho tse tšoanang ho metabolism ea lipid feela kamora ho fihlela lilemo tse itseng.

Mathata a endocrine

Ho se sebetse hantle ha litšoelesa tsa endocrine ho na le phello e kholo ho pathogenesis ea ts'ebetso ea atherosulinotic. Kahoo, ka lefu la tsoekere, atherosclerosis e qala ho tsoela pele haholo. Sena se bakoa, haholoholo, ke taba ea hore khaello ea insulin e lebisa ho ho eketsoa ha cholesterol ea endo native.

Karolo ea bohlokoa ho ntlafatso ea atherosulinosis e boetse e bapaloa ke hypothyroidism. Lihormone tsa qoqotho li tsejoa ho eketsa tšebetso ea lipolysis. Ka lebaka la khaello ea li-hormone tsena, thibelo ea lipolysis e ka hlaha, e tla lebisa tlolong ea metabolism ea lipid ka kakaretso mme ka lebaka leo, nts'etsopele ea dyslipidemia.

Mathata a amanang le metabolism ea mafura a ka bakoa ke ho se sebetse hantle ha litho tse ling tsa endocrine: tšoelesa ea pituitary, gland ea botšehali, jj.

Mathata a Neurogenic (khatello ea kelello le maikutlo)

Nts'etsopele ea atherosmithosis, ntlha ena e bapala karolo ea bohlokoa haholo. Atherossteosis joale e na le mabaka a felletseng ka tatellano ea mafu a bitsoang seteraeke - sehlopha se ikhethileng sa maloetse se ileng sa hasana lefatšeng ka bophara lekholong lena la bo20 la lilemo. le qalong ea lekholo la XXI. hape e amanang le keketseho ea lebelo la bophelo, e lebisang khafetsa khaellong ea khatello ea kelello le kelello.

Ho latela lipalo-palo tse tsoang Mokhatlong oa Lefatše oa Bophelo, linaheng tse nang le tlhahiso e phahameng ea indasteri, atherosclerosis e baka lefu hangata hangata ho feta linaheng tse nang le moruo o tsoelang pele. Sena se bakoa ke taba ea hore khahlano le mokokotlo oa tsoelo-pele ea saense le theknoloji, moroalo oa ts'ebetso ea methapo ea batho ba sebetsang ka kotlolloho makaleng a fapaneng a ts'ebetso e nang le thuso o ntse o eketseha haholo.

Boithuto bo bongata le liteko tsa bongaka li tiisa karolo ea cortical neurosis qalong le nts'etsopele e latelang ea ts'ebetso ea atherosranceotic.

Ho boetse ho hlokometsoe hore atherosclerosis e atile haholo har'a baahi ba litoropo ho feta baahi ba libaka tsa mahaeng, hammoho le har'a batho ba etsang mosebetsi oa kelello ho feta 'meleng.

O mong oa mekhoa eo mathata a neurogenic a amang boemo ba mokokotlo oa vasine ke tlolo ea trophism ea lebota la vascular, e bakoang ke ho phatloha ho sa feleng ha neurogenic ea vasa vasorum - likepe tse nyane tse fanang ka lebota la khale. Mochine ona o ka ntlafatsoa hape ka ho pepesehela li-catecholamine tse ngata, tse etsahalang maemong a sithabetsang. Ka lebaka la tšusumetso ena, lits'ebetso tsa metabolic leboteng la methapo li sitisoa, e leng se etsang hore ho be le lits'ebetso tsa nts'etsopele ea ts'ebetso ea atherosselotic.

Ha e le lintlha tsa kotsi tse kang arterial hypertension, dyslipidemia, tlhaelo ea estrogen ea ho haelloa ke estrogen le Homocyteinemia, ba bapala karolo e tobileng ho pathogenesis ea atherosclerosis, ka hona ho tla tšohloa karolong e latelang.

Mekhoa ea ho rera lintho esale pele

Ho ea ka likhopolo tsa sejoale-joale, nts'etsopele ea atherosulinosis e bakiloe ke ho kopana ha lits'ebetso tse peli tsa sehlooho tse bakang tšitiso ea metabolism e tloaelehileng ea lipids le liprotheine leboteng la artery:

• phetoho (tšenyo) ea lebota la khale le ts'oaetso e ileng ea latela ea nako e telele,

• dyslipidemia - phetoho profil ea mali.

Phetoho

Liphetoho tsa lerako la arterial li ka bakoa ke lintlha tse latelang:

• khatello ea kelello ea methapomoo libakeng tsa bifurcation lebota la artery le ba le khatello ea kelello e eketsehileng ea shear, ka lebaka leo desquamation ea endothelial e etsahala khafetsa,

• ho tsubakenya letsoho ho vasospasm, pokello ea liplatelete, hammoho le tlhahiso e eketsehileng ea li-cytokines tse tšehetsang ho ruruha,

• ts'oaetsojoalo ka Chlamydia Pneumoniae le Cytomegalovirus, bao e leng ba lelapa la Herpesviridae, likokoana-hloko tsena li ka ba le phello e tobileng ea cytopathic, hammoho le ho ntlafatsa pokello ea liplatelete le ho qala karabelo ea 'mele e hlahisang tšenyo ea endothelial,

• homocysteinemia (tekanyetso e ntseng e eketseha ea amino acid homocysteine ​​maling) ke sesosa sa ho theha sebopeho se feteletseng sa li-radicals tsa oksijene tse sa hlokeng moea, tse senyang le lerako la methapo, ho feta moo, Homocysteine ​​e matlafatsa oxidation ea li-lipoprotein tse fokolang le ho eketseha ha lisele tse bonolo tsa mesifa. Ho boloka boemo bo tloaelehileng ba Homocysteine ​​maling, ho hlokahala livithamini tsa Bg, B12 le folic acid, tse amehang ts'ebetsong ea amino acid ena. Tšenyo ea endothelium ea methapo ea kutlo hona joale e nkuoa e le sesosa sa nts'etsopele ea atherosclerosis.

Dyslipidemia

Dyslipidemia ke phetoho pontšong ea lipid ea mali, e tšoauoang ka keketseho ea cholesterol e felletseng, lipenshene tsa methapo ea methapo ea methapo (LDL), lipoprotein tse tlase haholo (le "density lipoprotein") le phokotseho ea lipoprotein tse phahameng. Cholesterol le li-metabolite tse ling tsa lipid, e le lintho tsa hydrophobic, li ka tsamaisoa ka mali ha feela ho thehiloe litsamaiso tse khethehileng tsa lipalangoang - lipoprotein, tse nang le liprotheine ka sebopeho sa tsona tse fanang ka solubility ka metsing.

Hona le mefuta e fapaneng ea lipoprotein:

• LDL - tsamaisa k'holeseterole ho tloha sebete ho ea lithong le leboteng la methapo,

• VLDL - ho tsamaisa li-triglycerides, phospholipids le cholesterol ho tloha sebete ho ea ho li-tishu, li na le cholesterol e tlase ho feta LDL,

• APVP - tsamaisa k'holeseterole e tsoang marakong a methapo ea mali le lisele ho ea sebete.

Ha u nahana ka pathogenesis ea atherosulinosis, lipoprotein hangata e arotsoe ka lihlopha tse peli: atherogenic, i.e., e kenya letsoho kholisong ea atherosulinosis (LDL le, ho isa tekanyong e tlase, VLDL) le anti-heterogenous (HDL).

Leha ho le joalo, ho lokela ho hopoloa hore lipoproteins li bonts'a thepa ea atherogenic / anti-atherogenic ha maemo a bona a tloaelehileng maling a fetoha mme, ka ho fetisisa, ke feela khahlano le semelo sa phetoho le ts'oaetso leboteng la arterial.

Ts'ebetsong ea bongaka, index e fumanehang ka ho fetisisa e bonts'ang boemo ba profid ea lipid ke boemo ba cholesterol e felletseng. Ka tloaelo, ke 3.9-5.2 mmol / L. Bakuli ba nang le cholesterol e felletseng ea 5.2-6.76 mmol / L ba theha "sehlopha se kotsing ea ho lekana" bakeng sa nts'etsopele ea atherosulinosis, hypercholesterolemia (e fetang 6,76 mmol / L) e bonts'a kotsi e kholo.

Estrogens e na le phello e tloaelehileng ho index ea estrogen-phospho-lycetin, e thibela nts'etsopele ea dyslipidemia ho basali ba lilemo tsa ho ba le bana. Ho basali ba postmenopausal le ho banna, mokhoa ona oa ts'ireletso ha o eo.

Mekhoa ea ho senyeha ha methapo ea methapo ea methapo

Pele ho tsohle, ho lokela ho hopoloa hore ho tsamaisoa ha cholesterol leboteng la vascular le phagocytosis ea ho fetella ha eona ka macrophages ke ketso e tloaelehileng. Leha ho le joalo, tlasa maemo a tloaelehileng, macrophages a hapa cholesterol e lekanyelitsoeng ebe a siea lebota la artery.

Ka nts'etsopele ea atherosclerosis, LDL e feta tlokotsing ka ho nka karolo ha lintho tse sebetsang tsa oksijene, 'me e fetoha "LML" e fetotsoeng, e ka bokellanang ka bongata bo boholo. Ka lebaka leo, ho thoeng lisele tse bitsoang foam lia thehoa. Kamora moo, lisele tsa foam lia timetsoa. Maemong ana, maselese a lipid-protein a tsoang ho tsona a bokellana karolong e ka holimo ea mokokotlo. Lipids li kenngoa kahare ho lisele kahare (li-macrophages le lisele tse boreleli tsa mesifa) le sebakeng se kopaneng.

Ka lehlakoreng le leng, li-macrophages tse entsoeng ka liplatelete le lisele tse etsang masapo a sephiri a sephiri se khothalletsang ho falla ha sele e bonolo.

Li-macrophage tse sebetsitsoeng le tsona li etsa hore li-cytokine tse sebetsang li khothaletse ho fallisoa ha lisele tsa T le li-monocytes ho kena kahare, hape li khothaletse tlhahiso ea kholo (etsa hore ho eketsehe ha lisele tsa mesifa tse boreleli) le mofuta oa mefuta ea oksijene e sebetsang (oxidize LDL). Lisele tsa mesifa e boreleli li qala ho eketseha le ho hlahisa collagen, e leng motheo oa mothapo oa methapo ea methapo ea methapo ea methapo.

Stage Atherosulinosis

1. Mokhahlelo oa Dolipid. E tšoauoa ka phetoho le ho ruruha leboteng la methapo le nts'etsopele ea dyslipidemia. Leha ho le joalo, ha ho na matšoao a bonahalang a morphological a atherosclerosis.

2. Lipoidosis. Ka mokhoa o ts'oaroang, lipid-protein tse ngata li kenngoa, ts'ebetso ea sclerotic e qala.

3. Liposulinosis. Letlapa la atherosselotic le thehoa: ho bokellana ha lipid protein tse ngata ho tsoela pele ka kholo e ts'oanang ea lithane tse amanang.

4. Atherosis. Mothating ona, lejoe lena ke sekoaelo se kopaneng sa "tis" se tlatsana le "detritus", e leng sehlahisoa sa tšilafalo sa lipids le liprotheine.

5. Atherocalcinosis. Letswai la khalsiamo le kentsoe polokelong.

6. Atherosclerosis. Membrane ea polasetiki e ba tšesaane haholo, li-ulcerates tsa "plaque," le litaba tsa eona li kena maling.

Liphetho tsa Atherosulinosis

1. Stenosis ea methapo ea methapo.

2. Ho phatloha kapa ho foqoha ha seretse se phahameng ka ho fetesisa, ho theha maemo a nts'etsopele ea thrombosis (mochine o tloaelehileng haholo oa ho hlaha ha infraction ea myocardial e mpe).

3. Ho fokotseha ha matla a lerako la methapo, ho bakang kholo ea li-aneurysms ka kotsi ea ho phatloha ha tsona ho latelang.

4. Ho bola hoa lets'oao la atherosselotic, ho tsamaisana le karohano ea likhechana tse nyane, tseo, li fetohang emboli. Motsoako ona o phalloang ke mali o fetisetsoa methapong e nyane ebe, oa o koala, o baka ischemia.

Karolo ea atherosclerosis ho lefu la methapo ea pelo le pelo

Ka atherosclerosis, methapo e latelang ea methapo e ameha hangata (e bontšoa ho fokotseha ha tatellano ea khafetsa):

• methapo ea methapo ea popliteal le ea basali,

• methapo e kahare ea carotid,

• methapo ea mokokotlo (haholo-holo selikalikoe sa Willis).

Atherosclerosis ke sesosa se atileng haholo sa maemo a latelang a pathological:

• infarction e mpe ea myocardial (maemong a 95%),

• kotsi e mpe ea methapo ea pelo -

• mesenteric artery occlusion,

• bohlasoa ba liphello tse tlase,

Litemana tse 'ne tsa pele li supa maemo ao atherosulinosis e leng sesosa sa botsitso ba sekepe, mme se fella ka ho fokotseha ha lumen ea bona, ka lebaka leo, patency, e lebisang kholisong ea ischemia. Mochine o mong oa ischemia o amahanngoa le taba ea hore atherosulinosis hangata e qala ho etsoa ha methapo ea mali.

Mehato ea popo

Likarolo tse ka sehloohong tsa lejoe lena ke li-tiske tsa fibrous le lipids, haholo-holo cholesterol. Ts'ebetso ea ho hlophisoa ka polasetiki e na le mekhahlelo e mengata. Ka lebaka la maemo a itseng, ho etsa mohlala, microdamage leboteng la sekepe, maemo a etselitsoe ho kenella ha lipids ho fihla sehlohlolong sa sekepe. Sebakeng sena, ho na le pokello ea lipoprotein tse fokolang tse tlatsitsoeng ka k'holeseterole. Ho lumeloa hore e le hore lipid-density lipids li fetohe sebopeho se matla, li lokela ho feta tlung. Phetoho e joalo e ka senya botsitso ba bona liseleng mme ea lebisa ho halefeng ha li-monocytes. Lipids li tšoaroa ke li-monocytes, li fetela sethaleng sa li-macrophage ebe li fetoha lisele tse foamy. Morphologically, sena se bonahala ka ponahalo ea lihlopha tsa mafura. Ho feta moo, ha liphetoho tsa atherosselotic li ntse li tsoela pele sebakeng sa lipid, ho hola ha lisele tse sebetsanang le ho thehoa hoa lesapo la mokokotlo.

Letlapa ke sebopeho se kopantsoeng le li-collagen le lisele tse boreleli tsa mesifa, tseo kahare ho tsona ho nang le lisele tsa bubble le likristale tsa cholesterol. Mohato o latelang oa atheromatosis o tšoauoa ka ho bola ha lejoe ka litšila tsa likhoele tsa collagen, lisele tsa mesifa le lipids. Sebakeng sa ho phatloha hoa lejoe, ho thehoa patsi moo karoloana ea protheine e nang le eona. Lithane tse hokahaneng li li arohanya le lumen tsa sekepe.

Mathata a hlahisoang ke ho eketseha ha atherosulinosis le ho phatloha ho hoholo hoa makhopho

Atherosclerotic lesion ea methapo ea mali ea pelo (methapo ea methapo ea kutlo) e lebisa kholong ea lefu la pelo. Atherosulinosis ea methapo ea kutlo ea mokokotlo e ka baka ho ruruha, 'me tšenyo ea methapo ea methapo e thatafatsoa ke ischemia (mesenteric thrombosis). Ho na le mathata a tebileng ha ho hlaha hemorrhage ea plaque ka ho phatloha ha eona le ho kenella ha matla a atheromatous ka har'a lumen ea sekepe, e leng se etsang hore ho be le sebopeho sa "thrombus".

Khatello e mpe ka lebaka la ho ruruha ha makhopho aorta ke ketsahalo ea auricm ea sebakeng sa leseli. Aortic aneurysm ke katoloso ea karolo ea aorta, e bakiloeng ke phetoho ea karolo ea eona ea tishu e kenang. Ho phatloha ha aorta sebakeng sa aneurysm kapa thrombosis ea eona hangata ho lebisa lefung la mokuli.

Ho kenella ka nako ea bongaka bakeng sa metabolism e senyehileng ea lipid ho thusa ho liehisa kholo ea atherosclerosis, ho qoba mathata a tebileng le ho ntlafatsa bophelo.

Qalo ea ts'ebetso ea atherosselotic

Mokhahlelo oa pele oa atherosclerosis o bitsoa ka har'a lingoliloeng e le nako ea preclinical (asymptomatic). Nakong ena, lits'ebetso tsa metabolic li ferekanngoa - keketseho ea boemo ba cholesterol, tlolo ea tekanyo ea palo ea cholesterol le phospholipids. Ke lisosa tse ka sehloohong tsa nts'etsopele ea atherosulinosis. Linako tse joalo tsa mathata li ka ba tse sa tsitsang mme tsa fapanyetsana khafetsa khafetsa. Mothating ona, ha ho e-na le likokoana-hloko tse sa bonahaleng ka har'a likepe, sebopeho sa polasetiki ha se e-so etsahale, 'me matšoao a kliniki ea pathognomonic ha a hlahe. Mothating ona, ho a khonahala ho tseba ho kheloha ho indices ea metabolism feela ka lithuto tse khethehileng tsa laboratori.

Mekhahlelo ea senya senya

Atherosclerosis e tšoauoa ka liphetoho tsa pathological marakong a methapo ea methapo. Mehato e latelang ea nts'etsopele ea atherosulinosis e khetholloa:

Lipid lits'oants'o - Ona ke ona mokhahlelo oa pele oa tsoelo-pele ea maloetse, e leng boholo ba marako a likepe tsa khale tse nang le metsoako ea lipid. Mochine o joalo oa ho kenella o tsepamisitsoe likarolong tse arohaneng tsa marako a arterial. Kantle, libaka tse joalo li shebahala joalo ka mela ea 'mala o mosehla ho bolelele bohle ba sekepe. Matšoao le mathata a mang a bonahalang ha a eo. Li-pathologies tse ling tsa morao-rao le maloetse, ho etsa mohlala, lefu la tsoekere (lefu la tsoekere), khatello e phahameng ea mali, boima bo feteletseng, li ka baka ho raleha ha lipopae.

Sebopeho sa polasetiki ea fibrous - mohato o latelang oa tsoelo-pele ea lefu lena, moo likarolo tse hlalositsoeng tsa likepe tse senyehileng (libaka tsa lipid) li qalang ho chesoa. Sesole sa 'mele se arabela ts'ebetsong e joalo mme babuelli ba marang-rang ba lokolloe seoa. Karabelo e telele joalo e lebisa ho phatloheng ha mafura a bokelletsoeng leboteng (necrosis ea bona e etsahala), sebakeng seo sclerosis e qalang - lithane tse sebetsanang le tsona lia hola. Ka lebaka leo, sebopeho sa "fibrous plaque" se hlaha ka ho kenella ka har'a lumen ea sekepe, e leng sona se khethollang boemo ba stenosis le phallo ea mali e sa sebetseng.

Sebopeho se thata sa polaka - karolo ea ho qetela ea lefu lena, leo ho lona mathata a bang teng ka lebaka la liprotheine tse ka hara lesapo la mokokotlo. Bohato bona bo khetholloa ka ponahalo ea matšoao a lefu lena.

Mehato ea ntlafatso ea atherosulinosis maemong a cellular

Bakeng sa ho fumana hore na ho na le liphetoho life liseleng tsa mabota a methapo, ho hlokometsoeng nalane ho ile ha etsoa ka likhechana tsa likepe tse amehang. Motheong oa bona, ba khetholla:

1. Dolipid - phumano e eketsehileng ea lerako la methapo le ho ruruha ho eketsehileng. Liprotheine tsa mali, limolek'hule tse kholo le li-polysaccharides li ts'oarehile lesion la artery. Ho ba le mathata a metabolism.
2. Lipoid. Liphetoho tsa metabolism li matlafala, ho fumanoa mafura a 'mala o mosehla. Libakeng tsena, tsepamiso e tletse ka cholesterol le foromo ea lisele tsa foam. Atherosclerosis ea sethala sa poleloidosis e bontšoa ke ho ruruha ha sekhechana sa sekepe se nang le lisele tsa xanthoma.
3. Liposulinosis - libakeng tsa ho kenella, ts'ebetso ea ts'oaetso ea ho ruruha e tsoela pele, e tsamaeang le kholo ea mafolofolo a likhoele tsa "tis" tse sebetsang haufi le lebota la methapo. Haufi le moeli, ho thehoa lijana tse nyane tse fanang ka lesela leo ka mafura le liprotheine.
4. Atherosis. Mothating ona, k'holeseterole ea k'holeseterole e felisoa ho tloha karolong e bohareng ea eona ho ea letsohong. Karolong e bolileng, likristale tsa cholesterol tse liphoofolong tsa manyolo li ka bonoa ka ho hlaka. Sebopeho sa pente ena e thehoa ke limolek'hule tsa mafura a mangata, lisele tsa xanthoma tse pota-potiloeng ke lithane tse sebetsanang. Ho ruruha - hematoma.
5. Boemo ba phallo. Mokhahlelong ona oa atherosclerosis, letheba le senyeha 'me se kahare ho lona se kena maling. Ho na le khoholeho ka mpeng ea mesifa e boreleli ea lebota la vascular, e na le sebopeho se fosahetseng. Liplatelete le likarolo tse ling tsa sistimi ea ho kopanya mali li romeloa ho sekoli se hlahang. Ba qala lits'ebetso tsa parietal thrombosis.
6. Atherocalcinosis. Ka sebopeho sa thrombus e entsoeng, khalsiamo ea khalsiamo e beha le ho otlolla mohopolo ona oa atherosclerosis. Ho etsisoa ho qaleha le ho hola ho latelang ha lebota lena, ho baka tsitsipano le mathata a ho potoloha.

Nyeoe e itseng ea lefu lena ke atherosulinosis obliterans ea lipheletso tse tlase (OASNK). Ka lefu lena la vascular, ho na le tlolo ea phallo ea mali likarolong tse tlase. Ho na le mekhahlelo e mene, ho latela matšoao a atherosclerosis. Mokhahlelong oa pele, bohloko maotong le bonoa ke ho ikoetlisa haholo. Boemong ba bobeli ba lefu lena bo tsoela pele - ha u tsamaea limithara tse makholo a mabeli, ka tekanyo ea 3 - ho fihla ho limithara tse makholo a mabeli. Ho bohlokoa ho hopola hore na ke boemo bofe ba atherosulinosis bo felisang bohloko bo khetholloang ke bohloko nakong ea phomolo - ea bone. Li maemong a sa feleng 'me li bakoa ke ho ruruha ha lisele tsa methapo ea methapo ea kutlo.

Methati ho latela mohopolo oa lesion

Bakeng sa lehae le leng le le leng la lefu lena, mehato ea bona ea nts'etsopele ea atherosclerosis ea khetholoha. Joale re tla sheba likarolo tsa rona le phapang ea methapo ea methapo bakeng sa lefapha le leng le le leng la methapo ea pelo.

Aorta ke sejana sa boleng bo phahameng ka ho fetisisa, e na le makala a mangata ebile e fana ka mali ho hoo e ka bang litho tsohle tsa bohlokoa tsa 'mele oa motho. Lits'ebetso tsa atherosulinotic li ata hangata ka mpeng ho feta a thoracic. Sebakeng sena sa tsepamiso, sehlopha sa mekhahlelo se tjena:

1. Ea pele. E tšoauoa ka li-cholesterol tse kentsoeng, tse bokellanang kahare mme butle-butle li ba le letheba la lipid. Nako ea sethala ha e ea lekanyetsoa mme e itšetlehile ka ho ba mabifi ha lintlha tsa kotsi bakeng sa atherosclerosis.
2. Ea bobeli ke fibrosis. Letlapa la atherosselotic le thehoa ka lebaka la kholo ea lithane tse amanang le potoloho ea lipid.
3. La boraro ke atherocalcinosis. Sebakeng, lesion e lokolloa ho "mesifa" ea thrombotic mme e hlahisa letsoai la calcium, ka lebaka leo leboteng la vascular le kenellang ho lumen mme le baka ho fokotseha ha eona - stenosis.

Likepe tsa likerese

Atherosclerosis e feta likepe tse fepang boko. Boteng ba libaka tse 'maloa tsa nts'etsopele ea lefu lena, tšoaetso ea methapo ea methapo e fumanoa. Mehato ea nts'etsopele ea mofuta ona oa atherosclerosis ke e latelang:

1. Pele - e bonahatsoa ke ho sitoa ho hopola, ho hloka boroko, ho tsekela. Liso tsa methapo e fokolang.
2. Tlatsetso - matšoao a tšoanang le a sethaleng sa pele, empa ho teba ha bona ho matla le ho feta. Ho feta moo, ho feto-fetoha ha maikutlo ho bonahala, ts'ebetso ea senyeha. Pathologies ea likepe e na le matla haholo.
3. Decompensatory - matšoao a teng a lula a le teng, 'dementia ea hlaha, mesebetsi ea kelello e fokotseha, matla a ho hloka kelello, le boemo ba bohlale bo ea fokotseha.

Lisebelisoa tsa libaka tse tlase

Ka ts'ebeliso ea lehae ea mehato maotong, ho hlaha lesapo le senyehileng la methapo ea methapo e tlase. Ka bongaka ba sejoale-joale, ho khethoa karohano e latelang ea li-degree tsa nts'etsopele ea eona:

1. Qalong. Ho utloa bohloko lipelong tse tlase feela ka ho ikoetlisa haholo.
2. Boemo bo bohareng. Bohloko bo hlaha ha o tsamaea limithara tse fetang makholo a mabeli
3. E nyarosang Ho tsamaea ho feta limithara tse mashome a mahlano ho sitisoa ke bohloko bo boholo.
4. Boemo bo rarahaneng. Massive necrotic foci, haholo maotong, ka lebaka leo ho ke keng ha khoneha ho hata leoto le opang.

Methapo ea pelo ea pelo

Methapo ea methapo ea kutlo (coronary) e fana ka phallo ea mali e ka hare pelong. Ho fapana le mefuta e meng le libaka tsa lehae, ho hloloa ha tsona ho etsahala ka potlako haholo. Ho na le mekhahlelo e meraro ea kholo ea nts'etsopele ea atherosulinosis lefapheng lena:

1. Ea pele. Lipontšo tse fosahetseng tsa atherosulinosis hangata ha li eo, empa liphetoho tse ling ho ECG li kanna tsa hlaha - phetoho e nyane kamora nako ea S-E, haholo-holo kamora ho ikoetlisa. Tšobotsi e ka sehloohong ea methapo ena ea methapo ea methapo ea methapo ke tšebetso ea methapo ea kutlo methapong ea pelo.
2. Ea bobeli. Ka har'a lingoliloeng, e ne e bitsoa necrotic ka lebaka la sebopeho sa likarolo tsa pelo le necrosis ea mesifa e nang le tsamaiso ea methapo ea kutlo. E kanna ea thatafatsoa ke ho hlaseloa ke pelo nako e telele. Bohato bona ba lefu lena bo khetholloa ke matšoao a tloaelehileng. Ho ECG, liphetoho mohatsong oa S-T le maqhubu a T le Q li se li bonahala hantle.
3. Ea boraro. Litsebi tsa bongaka hangata li bitsa mohato ona atherosulinotic cardiossteosis. Foci ea scarring e ka fokotsoa kapa ea tloaeleha ho pholletsa le myocardium. Ho hlahella ha myocardium e ka bang ho tšoana le aneurysms. Matšoao a sethala a tebile haholo - atropa ea fibrillation, ho fokotseha ha ts'ebeliso ea mali, methapo ea mali mekhahlelong e 'meli ea potoloho ea mali, lefu la pelo, blockages - sinoatrial, atria, atrioventricular, jj. Ho ECG - ho fokotseha ho sa khaotseng ha voliti le liphetoho tse ling tse ngata tse mpe.

Methapo ea kutlo

Methapo ea methapo ea kutlo e hangata e kotsing ka hanong molomong kapa libakeng tse haufi. Ka atherosclerosis ea methapo ena ea methapo, methati ea kholo ea lefu lena e latelang:

1. Bohato ba pele. Ka har'a lingoliloeng ho thoe "ischemic", e tšoauoa ka ho fokotseha ha khatello ea methapo ea methapo ea kutlo. Lits'ebetso tsa Ischemic ka liphio li baka keketseho ea khatello ea mali mme li lebisa ho phehelleng khatello ea mali (arterial hypertension).
2. Bohato ba bobeli. E bonahatsoa ke parenchyma necrosis le thrombosis tsamaisong ea methapo ea methapo.
3. Bohato ba boraro. E tsamaisana le matšoao a nephrocirrhosis, ho hloleha ha liphio ho hlaha, liphetoho tsa atypical ka moroto ka lebaka la lesupi le ho phatloha ha glomeruli ka bonngoe li ka bonoa.

Atherosclerosis ke lefu le rarahaneng le ka amang karolo efe kapa efe ea methapo ea mmele ea motho. Bakeng sa kalafo le thibelo, o hloka ho lekola cholesterol ea mali khafetsa, ho latela mokhoa oa bophelo bo mafolofolo le ho buisana le litsebi tse amehang ka nako.