Ka Moho ʻana o ka ʻAkāwauwahine a me nā Kulanui o ka Makahiki ʻĀkau o ka ULBRISTAN

HE MELE NO KA PILI KAHUIA O UZBEKISTAN

MoʻIʻI KEKAHI MAU LOA

NA ANO O KA AHAHUI A HOSPITAL KA MANA O KE KAHI MAU KOA MA KA AOAO KINO O NA MAUI O NA MAUI AUPAHANA.

KEKAHI MAKAU ANA I KE KACʻ F LELEI PILI

KAHANUI

NO KA HOOLAHA NO KA IV KULANA O KA PALAPALA HOOPAU

Ke kumu o ke kūkā:ʻO ka familiarization o nā haumāna me ke haukapila, ka maʻi maʻi, ka maʻi hoʻokaʻawale, ka hoʻopiʻi ʻana a me ka mālama ʻana i ka atherosclerosis, ka maʻi naʻau coronary, angina pectoris.

Nā haka hoʻonaʻauao: e aʻo i nā haumāna i ke kumu o ka noʻonoʻo noʻonoʻo, loiloi olakino, nā pilikia o ka deontology, etika a me ka aesthetics e like me nā koi o ke aʻo ʻana i ke kauka ma ka pae o nā kūlana o ka honua.

ʻO ka hoʻolālā pōkole no ke kumuhana:ʻO kēia kumuhana kekahi o ka nui i ka lapaʻau. ʻO kēia no ka piʻi nui o ka atherosclerosis o ka lehulehu, ka hopena koʻikoʻi o ka hopena kūpono o ka maʻi o ka maʻi. ʻO ka mea nui o nā hōʻailona nui o nā maʻi, ʻo ka mea nui o ka hoʻonaninani o kēia lā ka mea nui loa i ka lā maʻamau o ke kauka.

ʻO ke kumu a me nā pahuhopu o ka kūkā - 5 mau minuke

ʻO ka ʻatikala a me ka pathogenesis - 15 mau minuke

Kukeʻana a me ke haukapila - 25 mau minuke

Wehe - 5 mau minuke

Hōʻikeʻike o ka mea maʻi - 10 mau minuke

Nā laboratory Laboratory me nā mea kōkua - 10 mau minuke

Ka hopena ʻokoʻa - 5 mau minuke

Hana - 15 mau minuke

Hoʻohālikelike Pane i nā nīnau - 5 mau minuke

ʻO ka atherosclerosis kahi maʻi maʻi o ka nāhele o ke ʻano elastic a me ka muscular-elastic type, ke ʻano o ka wehe a me ka hōʻiliʻili o nā lipoproteins plasma a me ka kolamu i ka intima, e alakaʻi ana i ka loli kūlohelohe a me ka hoʻoliu, hoʻopili ʻia e ka hana reactive o ka palaki hoʻohui a me ke ʻano o nā pli fibrous i loko o ka paia arterial. A ke hopena, aia kahi kūloli kūloko o ka lumen o nā wahī a me ka nalowale o kā lākou elasticity.

Hoʻokomo ʻia nā leherosexerotic vascular lesial o nā wahi like kekahi kumu kumu o ka morbidity a me ka make ma nā ʻāina kūkulu. Loaʻa nā kāne i ka atherosclerosis 4-6 mau manawa pinepine ma mua o nā wahine.

ʻO ka etiology o atherosclerosis ka paʻakikī a multifaceted. I kēia manawa, ʻo nā kumu nui e pili ana i ka hoʻomohala ʻana i ka atherosclerosis: ka maʻi arterial, dyslipoproteinemia. ʻO nā kumu haʻahaʻa he haʻahaʻa loa i ke kino kino a me ka ʻelemakule.

ʻAʻole maopopo i ka pathogenesis o atherosclerosis. Hoʻokomo ʻia nā hypotheses 2 nui: lipid a me ka endothelial. Wahi a ka lipid hypothesis, ka nui o ka pae o ka lipoproteins plasma haʻahaʻa haʻahaʻa (LDL) waiwai i ka kolamu e hāʻawi i ka komo ʻana o ka mea i loko o ka paia vascular. Eia kekahi, hoʻonā LDL i ka hyperplasia o nā pūpū uaua o ka vascular a waiho i nā loli i ka palu cell e pili ana i ka endothelium a me subendothelium. Aia nā hōʻike e pili ana i nā hopena hiki o LDL i ka hoʻokumu ʻana i ka cell cell form, hoʻōla o ka ulu ulu, a i ka hopena ma ka hoʻokumu ʻana i nā fibrosis kūloko.

E like me ka hypothesis endothelial, poino ka mea i hoʻoneʻe ʻia i ka endothelial (ka palena o loko o nā moku) hoʻoheheʻe ʻia i ka kahe o ke ʻano o ka maʻi immunological cellulite ke alakaʻi nei i kahi palaki o ka fibrous ma ka wahi o ka pōʻino. Hoʻopili kēia i ka hoʻohui i ke platelet, chemocytosis o monocytes a me T-lymphocytes me ka hoʻokuʻu i nā platelet a me nā monocyte-hoʻouluulu i nā mea e hoʻoulu ai i ka neʻe ʻana o ka nūlau hāmeʻa neʻe mai ka papaʻi i ka intima, a me ka hoʻololi o nā huaola ʻē aʻe (macrophage, endothelial) e hāpai i ka momona lipplast a me ka ulu ʻana. ʻO ka hoʻololi ʻana o nā pūhaka, i ka hoʻokumu ʻana o nā mea endothelial buta (multinuclear) nui, e alakaʻi ana i ko lākou unrecognizability e ko lākou ake ʻana i ka maʻi kūlohelohe, ʻimi ʻia e ka huli hou ʻana o ke ʻano antigen-antibody, ka hoʻokumu ʻana o kahi maʻi mumū, i hoʻopau ʻia me ke ʻano o kahi pākia. He pili pili nā hypotheses ʻelua a ʻaʻole hui pū kekahi, akā e hoʻopili kekahi i kekahi.
I kēia mau makahiki i hala, ua kau ʻia ka viral a me herpes-viral hypotheses o ka etiology o atherosclerosis. Ua hoʻokūpaʻa ʻia ka maʻi pālolo o Epstein-Barr, nā huakiko Coxsackie a me nā mea ʻē aʻe e hana i ka hōʻino i nā membraes o nā pona endothelial, ka pākīpī o nā lipid huʻihuli a me ka hōʻemi kino ʻole. Ke lōʻihi ka manawa, lilo ka pelidinous ke kīkē. I kēlā me kēia wahi o ka hoʻomohala, hiki ke hoʻopōʻino i ka wā maʻamau a i ʻole ka piʻi nui ʻana i ke kahe koko (fissure a i ʻole nā ​​manawa), a ke alakaʻi nei kēia i ke ʻano o kahi kīʻaha koko, a, no laila, ʻoi aku ka maikaʻi o ka pohō ʻana o ke kahe koko.

Hāʻawi ʻia i ka mea nui o ka hoʻāla a me ka maʻi immunological i loko o ke pathogenesis o atherosclerosis, kahi papa holomua holomua ka manaʻo ʻano like o ka maʻi: nā manawa o ka hana o ke kaʻina e hoʻololi ʻia e nā wā o ka mālie.

Hoʻoholo ʻia ka kiʻi lapaʻau o ka maʻi i ʻole me ka nui o ka paʻakikī a me ka hoʻomāhuahua o nā loli i nā moku, e like me kā lākou kelokona ʻana. ʻO nā wahi thoracic a me nā iho i lalo o ka aorta, ka coronary, ka carotid maʻamau, cerebral, renal, mesenteric a me nā wahī femoral e pili pinepine loa. E like me ka hoʻokalakupua ʻana o ke kaʻina atherosclerotic, hele mai nā hōʻailona lapaʻau i ka mua e pili ana i ke kino i ka pīhoihoi nui ka neʻe ʻana o ke koko (e ʻike i nā ʻāpana kūpono).

ʻO ka manaʻo o ka hanana o ke kaʻina hana, ua manaʻo ʻo ia e hoʻokaʻawale i nā manawa 2 i ka hoʻomohala ʻana o ka maʻi: ka wā mua (preclinical) a me ka manawa o nā hōʻike lapaʻau. I ka wā mua, ʻaʻohe loli i nā kino. Hoʻohālikelike ia e nā maʻi neurovascular nonspecific e like me ka vasospasm, cholesterinemia a me ka dyslipidemia.

I ka lua o ka manawa mua, ke hoʻomaka nei nā mea hōʻailona a me nā hōʻailona me ka mismatch ma waena o ke koi o ka oxygen i nā hanana a me nā ʻili a me ke hiki ʻana o kona hoʻopuka ʻana ma o nā moku e hoʻololi ʻia e ke kaʻina atherosclerotic. I ka manawa mua, ua hōʻike ʻia kēia ʻokoʻa kuʻuna me ka hoʻōho ma ke kino, inā he piʻi nui ka koi o ka oxygen-metabolic (no ka laʻana, me ka angina pectoris, claudication intermittent), a ma hope me ka hoʻomohala ʻana o ka atherosclerosis a me kahi hoʻēmi i ka lumen o ka moku, hoʻomaka kēia ʻōpū ma ke ʻano me ka hapa iki a ʻo ka hoʻomaha hoʻi. ʻO ka latent (asymptomatic) o ke ala ka maʻi e hiki ai a hiki i ka lumen o ke kiko ke hōʻemi i ka 70-75%.

I ka hihia o ka hōʻino kūlike o ka pākela, i ka wā e hoʻomaka ana ke kaʻina o ka trombosis, ma ke ʻano he kānāwai, he nui o ka hōʻeha ʻana o ka maʻi mai i hōʻike ʻia, hōʻike ʻia i ka hoʻomohala ʻana o ka angina hiki ʻole a i ʻole myocardial infarction, inā e lawe mākou i ka maʻi naʻau coronary ma ke ʻano he hoʻohālike (e ʻike i ka HANʻU KĀHUI ISCHEMIC).

Hoʻoulu ʻo ATOROSCLEROSIS o AORTA ma mua o nā ʻona vascular ʻē aʻe a he mea maʻamau loa (ʻoi aku hoʻi i ka līlati thoracic), akā, na nā hanana loiloi ma mua e hōʻike iki a i ʻole hele ʻole ʻia. Kū ala i kekahi manawa

hōʻeha i ka ʻeha retrosternal (aortalgia) e ʻike ana i ka ʻāina intercutaneous. Me ka atrophy o ka pape hooweliweli, ua hoʻopaʻa ʻia ka aneurysm i nā ʻāpana o ka aorta i pā ʻia e ka atherosclerosis me ka hoʻokumu ʻana o ka hoʻopale saccular a i ʻole e pālahalaha aku ai. ʻO ka hoʻonui nui aʻe o ka nui o ka aneurysm e alakaʻi i ka hoʻonui nui ʻana i nā kiko kikoʻī a me nā hemodynamics impaired. Me kahi aneurysm aortic, hōʻeha ka ʻeha, ke ʻano o ka noho ʻana i nā wahi o kona neʻe ʻana (me nā aneurysms o ka aorta piʻi - ʻeha nā ʻōpū, nā ʻōpū aortic - e hāhā ana nā umauma e ʻāʻī i ka ʻāʻī, ke poʻohiwi, ke kua, aorta e hoʻihoʻi ana i nā ʻeha o hope. ʻO nā hōʻailona ʻē aʻe o ka aneurysm aortic i ʻike ʻia - nā ʻeha, ka ʻōpū o ka maka (no ka mea ʻala ʻia ʻo vena cava), mauʻu, wīwī, pōkole o ka hanu, dysphagia (ma muli o ke kaomi ʻana o ka neʻe hou a me ka hoʻoluhi ʻana i ka trachea).

Hōʻike pololei loa i ka hoʻonui ʻia o nā palena o ka pua vascular, ʻōpiopio systolic i ka lua o ka lumi intercostal ma ke ʻākau o ka sternum.

I ka hihia o ka aortic insufficiency (sclerotic ma ke ʻano), ma ke kolu o ke kaʻina intercostal a i kahi ʻākau o ka sternum, systolodiastolic mur amu e lohe ʻia ana. I nā hihia o ka lesher atherosclerotic o ka ʻōpū o ka ʻōpū a i ʻole ka hoʻomohala ʻana i ka aneurysm ma loko, ʻeha ka ʻōpū, ka ʻeha kaumaha, a me nā maʻi dyspeptic i kū mai. Ma ka ʻōpū o ka pūpū, hiki ke hoʻoholo ʻia kahi hoʻokumu pulsating e ka palpation, ma luna kahi o ke amuamu systolic.

ʻO ka aneurysms hopena e hoʻonui malie i ka nui. I ka wā o ka nānā ʻana aku, ʻike nui ʻia ka makahiki nui o ka aneurysm o ke anawaena o 0.5 cm.

ʻO kahi hoʻopiʻi maikaʻi loa o ka aneurysm ka hoʻopauʻana o kona pā a wāwahi i kahi hopena momona. Hoʻopili ka huli ʻana o ka nahu me nā aneurysms o ka thoracic aorta ma mua o 6 cm ka diameter (ʻoi aku hoʻi i ke ʻano o ke kiʻekiʻe o ke koko), ʻo ka ʻōpū o ka ʻōpū - ʻoi aku ma mua o 5 cm. ʻO ka hopena o ka ulahā i kēia mau nui i ka makahiki he 30-40%, a me kā lākou hoʻonui hou aʻe i hoʻonui nui aʻe ( aniani 7-10 cm - 45%, diameter 10 cm - 60%).

ʻO ka ATHEROSCLEROSIS o nā makana o kā ka BRAIN e kōkua i ka hoʻomohala ʻana o ka loaʻa ʻole o ka huehue o ka hāʻawi koko i ka lolo, kona ischemia. ʻO ka hōʻike ʻana o nā maʻi maʻi o ka maʻi ma muli o ka nele o ke koko i kekahi mau wahi o ka lolo. Ischemia ka wā neʻe - ka hiʻona nui, hoʻohaʻahaʻa nui i ke kahe o ke koko - e pili pinepine ana me ka spasm o ka palaki cerebral a ʻo ia hoʻi ka harbinger o kahi hoʻopiʻi lohi hou aʻe - nā māpē.

ʻO ka palupalu, hoʻouluulu, paʻakikī paʻakikī e like me ke ʻano. Hoʻopili ʻia ke hoʻomanaʻo no nā hanana i kēia manawa a mālama ʻia ka hoʻomanaʻo ʻoihana. E hopohopo nei e pili ana i nā ʻeha mau loa, ka walaʻau i ke poʻo, i kekahi manawa hōʻeha, moe nui ka hiamoe, mau huhū, ʻāhewa ʻia.

moemoe. Ma ka lōʻihi o ka manawa, holomua nā hōʻailona, ​​hoʻonui ʻia kēia mau maʻi. Ma ka hopena hope loa, ua hoʻohele ʻia ke kahua, ka hoʻopuka ʻana o ka encephalopathy, ua emi ke akamai, ua hōʻemi ʻia ka naʻau o nā ʻano, nā hōʻailona pili o ka parkinsonism (paʻakikī, hoʻopaia).

ʻO ka atherosclerosis arenalialʻo Renal, ke alakaʻi nei i ka ischemia renal i hoʻomau, ʻo ia ke kumu o ka hypertension arterial kiʻekiʻe. Lohe ʻia ka ʻōhumu Systolic ma luna o ka wahi liʻiliʻi o ka pā hāmeʻa. I loko o ka wai, i ka proteinuria hōʻoluʻolu, nā hoʻololi liʻiliʻi i ka hoʻowalewale o ka urine (ʻo nā koina koko hoʻokahi, nā cylinders hyaline).

Nā kumu o ke Atherosclerosis

Pono e hoʻomanaʻo ʻia e hele lima me nā maʻi kūloko. No ka laʻana, hiki ke hoʻonāukiuki i ka hoʻomohala ʻana o kahi maʻi maʻi mellitus maʻiʻimai ka maʻi vascular a mau naʻau e hiki ana i kahi makahiki mua a me ka piʻi o ka hōʻemi o ka kolamu ma nā moku. Eia kekahi, nā kumu o ka hoʻomohala ʻia o ka maʻi ke komo ʻana i ke koko kiʻekiʻe a me ka hele ʻana o nā hana ʻino (ʻoka). Akā aia ke kipi i ka pale hewa o ka metabolism cholesterol.

E noʻonoʻo i nā mea pili i ke kūkulu ʻia ʻana o ka maʻi:

• makahiki E lilo ana ka ʻelemakule i kahi kanaka, ʻoi aku ka nui o ke kuʻikahi o ka hoʻomaʻamaʻa ʻana i ka hōʻike atherosclerotic. ʻO ka mālama pono ʻana i ko lākou olakino he mau kānaka ma mua o 50 makahiki,
• kāne male Ua ʻike nā poʻe ʻepekema ʻoi aku ka ʻoi aku o ka poʻe kāne i ka atherosclerosis. ʻO ka hōʻike ʻana i nā hōʻailona mua loa e hiki mai ka makahiki 45, a ma kekahi mau hanana ma mua. ʻOiai i loko o nā wahine ka hoʻomaka ʻana o nā hōʻailona o ka maʻi e ʻike wale ʻia mai nā makahiki he 55,
• hoʻoilina. E hoʻokau kokoke ka predisposition genetic i ka nui o ka hana i ka hana o ka atherosclerosis. Hōʻike nā haʻawina ʻo ia nā mea i loaʻa i ka ʻohana i loaʻa i ka maʻi vascular coronary e hoʻomaka ʻeha i loko o ka maʻi i ka wā ʻelemakule,
• ke ola kino. ʻO ka hoʻohana ʻana i ka momona momona a me nā meaʻai waiʻai launa, a me ka makemake hoʻi i ka mea ʻai, hiki ke hoʻoulu i ka hoʻomohala ʻana o nā pathology. No laila, he mea nui loa ka ʻai ʻana i ka manawa a ma ka manawa. ʻO ke kumu o ka ʻaiʻai he laupala, nā mea kanu, nā ʻōpala, a me nā iʻa.
• momona momona. ʻAʻole kēia e haʻi pololei i ke alakaʻi ʻana i kēia maʻi maʻi, akā, ʻo ka huelo e hiki ai ke hoʻowalewale i ka maʻi diabetes, a ma kahi e hoʻonāukiuki ai i ka atherosclerosis,
• mau ʻano maikaʻi. ʻO ka ulaula ka ʻenemi nui o nā kīʻaha koko a ʻo kekahi o nā kumu o ka atherosclerosis.

ʻO nā ʻano a me nā hōʻailona o ka atherosclerosis

Aia kekahi mau ʻano like o kēia ʻano hana i hiki mai ai ka pōʻino:

• nā coronary arteri (atherosclerotic cardiosclerosis), kahi e hoʻonāukiuki ai i ka hoʻomohala ʻana o ka hōʻeha ʻana i ka naʻau, ka maʻi puʻuwai coronary a me ka pectoris angina,
• aorta, e pili ana i nā ʻōnaehana kūloko a me nā kino,
• koko kīlā nona ke kuleana i ke koko i ka lolo,
• nā ipu ʻai, kahi i alakaʻi i nā kuhihewa ʻōpala a me ka haehae o ka hypertension,
• nā kīʻaha o ke kiʻekiʻe a me lalo, ʻo kēia maʻi i kapa ʻia e obliterating atherosclerosis.

Pehea e hōʻike nei kēia maʻi maʻi, he aha nā hōʻailona e pono ai iaʻu e nānā a nīnau aku i ke kauka?

Ma ka hoʻomaka mua ʻana, ʻaʻole ʻike koke ʻia ka maʻi, no laila, hiki ke hoʻoholo ʻia kona hiki ke hoʻoholo ʻia hoʻokolohua. ^ E Ha yM. ʻO ka manawa i hala, hele ʻia ke kapa ʻia ʻo "worm ʻōlima" (convoluted temporal arteries).

I ka wā e hiki mai ana, e kū like paha nā hōʻailona o ka maʻi ma ka wahi o ka lesion. No laila, me ka pohō o ka aorta, hiki i ka ʻeha ke hōʻeha ma hope o ka sternum o nā ikaika like ʻole, e pā ana i ke kua, ke ʻāʻī a i ʻole ʻōpū hoʻi, a me ka hypertension pae lua. Ke hōʻike nei ka maʻi i ka palau coronary, hiki ke ʻike ʻia kēia e nā hōʻailona o ka maʻi artery coronary. mau naʻau - angina pectoris, tachycardia, puʻuwai puʻe, haunaele, etc. Me ka hana ʻino ʻana i nā mākia cerebral o ke kanaka, kani ʻana i loko ka pepeiao, ʻeha, hōʻeha pinepine, nā luhi, nā pilikia me ka hiamoe, e hoʻomaikaʻi ka hoʻomanaʻo ʻana.

Inā pili nā ʻehā i nā aʻa ʻōpala, ka mea i hōʻike ʻia ʻo ia iho ma ke ʻano o ka pono o ke kūleʻa a me ka vasorenal hypertension. ʻO ka poino i nā moku o nā haʻahaʻa haʻahaʻa (i kapa ʻia ʻo Lerish's syndrome) e hōʻike ʻia e ka wikiwiki wikiwiki, ʻeha loa ke hele ʻana ke kala, ka ʻili o ka ʻili ma nā wāwae, ke anuanu, nā maʻi ʻeha o ka trophic. Inā hiki i ka atherosclerosis ke piʻi i ka areria mesenteric, hiki i kēia ke hoʻoholo i ka ʻeha i hiki koke mai ma hope o ka ʻaina a hele pū pū ʻia me ninini, a i kekahi manawa, huʻi, kīhai i ke kīwaha, thrombosis, ma muli o ia i hana ʻia ai ka pūpū ʻōpū. Hiki i ke ala o nā moku pulmonary ke hōʻike ʻia e ka ʻūhā ʻana o nā wāwae, ka huahuʻi ʻana i nā ʻalopiha o ka ʻāʻī, hemoptysis, sy murical syikohala ma luna o ka artery pulmonary.

Diagnosis o ka Atherosclerosis

No ka hoʻokau ʻana ua hoʻomohala kahi kanaka ma ka atherosclerosis, hiki iāʻoe ke hoʻopili wale ʻia ke kahu maʻiana e kau mua i kahi nui he nui hoʻokolohua. ^ E Ha yM. Hiki i kēlā me kēia mahele ke hōʻike iā ia iho i nā ʻano like ʻole, no laila e nānā ʻoe i nā mea āpau i ka kikoʻī, e hoʻoholo i ke ʻano o ka patology. I ka wā maʻi o ka lehulehu, ʻo ka paʻakikī o ka papa o ka atherosclerosis a me ke kuʻina o nā hoʻopiʻi e pono ai, ʻo ia ka mea i hōʻike ʻia i loko o ka loaʻa ʻana o ka maʻi maʻi. Ma laila wale nō e hoʻoponopono pololei ʻia ai ka lāʻau a lawe mai i nā hopena maikaʻi.

Hoʻopilikia ʻia nā hana maʻamau o nā patology me ka hoʻohana ʻana i nā hana hou no ka nānā ʻana i ka maʻi.ʻO ka ala mua e pili ana i ka maʻi maʻi me ka hōʻiliʻili o nā hoʻopiʻi o ka poʻe maʻi, loiloi a me ka hoʻāʻo, e hiki ai i ka mea loea ke hoʻoholo i ke ʻano o ka pulsation, pehea a twined a hoʻopili ʻia nā moku. He mea nui ia e haʻi i kekahi loea e pili ana i nā ʻano hana ʻino i ke ʻano o ke ʻano a me kou ʻano, nā meaʻaiʻai. Hoʻopau ʻia nā diagnostics hou me ka mālama ʻana i nā loiloi, a me ke komo ʻana o nā mea olakino. ʻO kēia paha nā haʻawina e like me ka electrocardiography, Papaki ʻōnaehana nā kīʻaha koko, x-hihi nā kīʻaha koko a me nā umauma, loiloi biochemical i ke koko.

Hoʻomaʻamaʻa i ke Atherosclerosis

Uila pono ke hui pū me ka atherosclerosis - lāʻau lapaʻau a me ka pono ʻole. ʻO ka mea hope loa e hoʻopau i nā mea kuleana modifiable. Hoʻomaopopo ʻia ka mea maʻi e alakaʻi i kahi ʻano hana ikaika, ke pale aku i nā hana maikaʻi ʻole, ʻo ia hoʻi ke inu ʻana i ka waiʻona, ka pale ʻana o ka paona, pale aku i ke aʻa a me ke kaumaha.

ʻO nā antiatherosclerotic kūikawā mea ʻai. ^ E Ha yM. Ua kau ʻia no ka hoʻohana ʻana i nā meaʻai me nā kalaka liʻiliʻi a me kahi haʻahaʻa haʻahaʻa o nā momona holoholona. ʻO nā meaʻai e loaʻa i nā palaka kūleʻa maʻalahi e hoʻokaʻawale ʻia a kāpae wale ʻia mai ka papa inoa. Hele ka mea like no nā meaʻai kiʻekiʻe i ka cholesterol.

Kauka ʻaiā hānai pono e komo me nā huaola B3 a me PP.

Hoʻomaʻamaʻa ka lāʻau radical o ka atherosclerosis, ʻo ia ke kaʻina hana lapaʻau ʻana, ʻoi loa ia i nā hihia ke pane ʻole nei nā moku i pili ʻia i nā ʻano mālama conservative o ka mālama ʻana. Hoʻohana ʻia ka hana maʻi no ka hōʻino o nā ʻili o nā wahī i loko, i loko o ka prosthetics o ka moku a i ʻole e wehe ai i ka thrombus i hana ʻia.

ʻO ka atherosclerosis kahi maʻi ʻino loa, pono ia e hoʻāʻo e pale i kona hoʻomohala ʻana i nā ala āpau, no ka mea, ʻoi aku ka maikaʻi o ka pale ʻana ma mua o ka mālama ʻana. Pākuʻi ʻia nā hana kūpono: ka hoʻokō ʻana me ka anti-atherosclerotic kākaʻai (ʻo kēia ka koho maikaʻi loa), a ma ka liʻiliʻi o ka ʻai maikaʻi, ke olakino maikaʻi, ka hāʻawi ʻana i nā ʻano maikaʻi ʻole, mālama i ke ʻano ikaika a me ke olakino, a me ka hoʻolilo ʻana i ke kaumaha o ke kino.

Inā kuhi ʻoe i kāu atherosclerosis, hoʻopili koke i nā loea o kā mākou Center e kōkua maoli iā ʻoe!

Atherosclerosis a me nā lāʻau lapaʻau kūloko: pili

• Mālama i nā pae o ke kō no ka lōʻihi
• Hoʻihoʻi hou i ka hana insulin pancreatic

Ua hoʻohana maikaʻi kā mākou poʻe heluhelu iā Aterol e hoʻohaʻahaʻa i ka cholesterol. Ke ʻike nei i ka kaulana o kēia huahana, ua hoʻoholo mākou e hāʻawi iā i kou makemake.

Hoʻomaopopo pinepine ʻia ka atherosclerosis a me nā maʻi kūloko e pili ana i ka ʻōnaehana cardiovascular.

Ua wehewehe ʻia kēia ʻano e ka ʻoiaʻiʻo o ka hōʻino ʻana o ka lipid a me ka protein metabolism ka hopena a i ʻole ke kumu kumu o kekahi maʻi cardiovascular.

No laila, ʻo ka hoʻomaka mua o ka atherosclerosis ke hana koʻikoʻi - he hana paʻakikī loa ia, no ka mea ʻaʻole i hōʻike iki iā ia ma mua.

Nā kahua o ka hoʻolālā a me ke kumu o ka atherosclerosis

Me ka atherosclerosis, aia kahi hōʻuluʻulu o ka kolamu a me nā lipid hapa ma ka waena a me ka choroid i loko, ma ke ʻano o ka paʻakai ʻana o nā paʻakai kalima ma nā keaka o ka nui a me ka nui o ka caliber a me ka hoʻopili.

Hōʻike nā hōʻailona mua o ka atherosclerosis ke ālai ʻia ka ʻehā i ka hapa ma mua o ka hapa.

Hoʻokumu nā hōʻailona o nā maʻi i ka wahi o nā moku i hoʻopilikia ʻia.

He mea maʻamau ia e hoʻokaʻawale i nā ʻakolu he nui o ka hoʻomohala ʻana o nā ʻatikala.

ʻO ka mea mua ke hoʻomohala ʻana i nā koina momona - ma kahi o kahi hōʻike o ka maʻi. Aia ia e like me ka hōʻiliʻili o nā macrophages a me nā ʻōpū palupalu i hoʻolōʻihi ʻia, a me ka hōʻuluʻulu ʻana i nā lipids. Ka lōʻihi o ka manawa, ulu ka palaha momona, akā ʻaʻole i ʻike mau ʻia kona hele ʻana me kahi maʻi me ka atherosclerosis. ʻOiai i nā pēpē, ʻike ʻia nā wahi momona ma nā moku me ka diameter o 1-2 mm.

ʻO ka lua ʻo ia ka ulu ʻana o ka pākī fibrous e noho ana i loko o ka pa o loko o ka moku. Loaʻa ia i nā esters a me nā crystals cholesterol, he mau leʻalulu ia, a me nā lipid lipid - he capsule wiwo ʻole. Ke māhuahua o nā palakela fibrous e hoʻopili ai i ka lumen o ka arela. ʻO ke kololi mai ke koko, e ʻohi ana i nā paia o ka moku.

ʻO ke kolu - ka hiki ʻana o nā pilikia paʻakikī - kahi hana hope loa i ka hoʻolālā ʻana o ka atherosclerosis. Hōʻike ʻia me ka hoʻohaʻahaʻa ʻana i ka mānoanoa o nā molina o nā waihona fibrous i emi ma lalo o 65 microns, a me ka loaʻa ʻana o nā microcracks a me nā ʻūhā ma luna o kona wahi. Hoʻopili kēia i ka hoʻopili ʻana o nā platelets i ka capsule, ke kumu e hōʻeha ai i ka trombosis, stroke, hōʻeha naʻau a me nā ala ʻē aʻe e pili ana i ka pīhoihoi koko a i ʻole pau ʻole o kona pau ʻana i ka lāʻau pili.

Manaʻo ʻia ka hana ʻana o nā waihona aheromatous he ʻano kūlohelohe ia akā naʻe, he nui nā mea e hiki ke hoʻoluliluli a e hoʻolele ai.

ʻO Pathanatomy nā kumu like ʻole:

1. ʻO ke kāne a me ka makahiki. Hoʻoulu kēia maʻi i nā kāne 3-4 mau manawa pinepine ma mua o nā wahine. Eia kekahi, ʻo nā hōʻailona mua o nā kāne e hūnā i nā makahiki 45, a no nā wahine - hoʻomaka mai 55 makahiki.
2. Nā genetics Loaʻa iā ia nā mea e like me ka hana o ke ʻano o ke kino, ka piha ʻana o ka dyslipoproteinemia me ka nui o ka hanana, a me nā pae hormonal.
3. ʻAno maikaʻi. ʻO ka mea pōʻino loa no ka ʻōnaehana cardiovascular ka mea i ulaula, e like me Aia i kēlā me kēia mau palaka ke loaʻa ka nui o ka nicotine a me ka pā maikaʻi. ʻAʻole hiki iā ʻoe ke hoʻohala aku iā ia me ka waiʻona, ʻoiai inā ka 100 g o ka waina ʻulaʻula maloʻo i ka ʻaina ʻaina he pale maikaʻi loa ia ke koko kiʻekiʻe.

Eia kekahi, ʻo ke kumu o nā loli pathological hiki ke loaʻa i ka nui o ka paona.

ʻO ke kīpopeka he kumu i nā maʻi he nui - atherosclerosis, maʻi maʻi maʻi, a me nā mea hoʻi, no laila, pono ʻoe e hoʻoponopono i ke kaumaha o ke kino.

ʻO nā ʻano nui o ka atherosclerosis

Nui a ʻano mau ʻano maʻi like.

ʻO ka maʻamau maʻamau ka helu ʻana i ka atherosclerosis, kau ʻia i ka wahi o ka lesion o nā kōla atheromatous o nā kīʻaha koko.

Hōʻike kūlohelohe nā ʻano o ka maʻi.

Loaʻa nā ʻano o ka atherosclerosis i kēia manawa:

• Atherosclerosis o nā moku coronary, hōʻike pinepine ʻia e ka ʻeha naʻau. Ma muli o ka hoʻopilikia ʻana i nā ʻili o ka puʻuwai, pilikia ka kahe o ka oxygen i ka myocardium. A ʻo kahi hopena, ke alakaʻi nei ka pathology i ka pectoris angina, ka hōʻeha ʻana o ka naʻau, ka maʻi naʻau coronary a me ka make pū kekahi.
• ʻO ka puka aortic kahi lesion o ka nui loa i ke kino - ka aorta. Hoʻokumu ka hoʻomohala ʻana i ka palakika kolesterol i ka hana o nā mea āpau a me nā ʻōnaehana.
• Atherosclerosis o nā moku ʻōla. I waena o nā hōʻailona o ka maʻi, ka ʻeha i ka wā o ka urination, ke hele ʻana i ke koko i ka urine, nā hōʻeuʻeu o ka luaʻi a me ka lua. ʻO ka hoʻomohala ʻana o ka maʻi e komo ai i ka hypertension koʻikoʻi a me ka hāʻule ʻole ʻōna.
• Atherosclerosis o nā moku serebral. ʻO ka lolo kekahi o nā loulou nui o ka ʻōnaehana o ka puni, no laila, ka pōloli o ka oxygen hele a hiki i kēia mau hopena i nā hopena koʻikoʻi, no ka laʻana, he hōʻeha a i ʻole ka lele ischemic attack.
• Obliterating atherosclerosis o nā lalo a me luna. I ka hoʻomaka ʻana, ʻo nā hōʻailona e like me ka nalowale o ka lauoho ma nā wāwae a me nā lima, ʻulaʻula ʻole o nā manamana lima, ʻehaʻeha, nā wāwae a me nā mea ʻē aʻe, a me nā mea ʻē aʻe.
• Atherosclerosis o nā nānika mesenteric e hānai ana i nā ʻokiʻawa. ʻO nā hōʻike nui o ka maʻi he mau hōʻeuʻeu o ka ʻōpū o ka ʻōpū - colic-like ʻeha o ka ʻōpū. ʻO ka pōʻino ka trombosis o nā lālā koko o ke koko me ka necrosis o ka paia ʻōpū a me ka mesentery.

ʻOiai ke ʻano o ke ʻano o ke ala, hiki ke hōʻike mai nā hōʻailona o waho o nā maʻi hōʻuluʻulu o atheromatous:

1. xanthomas - nā ʻano hoʻohālikelike i nā "tubercles" e waiho ana ma nā wahi o nā ʻōpū a me nā tendons,
2. senile arch - ke ʻano o nā kaila melemele ma ke kihi o ka cornea.

Eia kekahi, hiki ke hele aku ʻo xanthelasms - ke hoʻokumu ʻana o nā wahi melemele ma ka ʻili, pinepine ke ʻano o ka tuberous, ma ke ʻano o ka hoʻohemo ʻana i nā cholesterol a me nā triglycerides.

Nā ʻano o Hyperlipidemia e Fredrickson

ʻO ka Hyperlipidemia he pathological nui loa o ka pae maʻamau o nā lipids a me nā lipoproteins i loko o ke kaila koko.

ʻO kēia maʻi ka mea nui i ka hoʻomohala ʻana o nā maʻi cardiovascular, e komo pū ana me ka atherosclerosis.

Nā maʻi Hypercholesterolemia - Hoʻolaha i nā maʻi maʻi

ʻO ka Hypercholesterolemia ma ke ʻano he maʻi ia e maʻi ai. Ma ke ʻano, he hana kūpono ia no ka hoouka ʻana o kekahi mau ala.

Hōʻike ka Hypercholesterolemia i ka cholesterol plasma kiʻekiʻe. Hoʻokaʻawale ʻia nā hiʻohiʻona mua a me ke kula ʻelua o kēia maʻi.

Ua hoʻokaʻawale ʻia ka hypercholesterolemia mua i nā ʻano he nui:

• Nā ʻohana I ka puʻuwai o kāna hoʻomohalaʻana i kahi hana hewa i ka hana o nā mea hoʻokae LDL. Eia kekahi, nānā nā homozygotes me ka pinepine o 1 i 1 miliona. I ka maʻi, hiki i ka neʻe ʻana o ka cholesterol me nā 15 a 31 mmol / L. I ka nui o nā hihia, hoʻomaka nā maʻi naʻau coronary e kū i ke makahiki o 20.
• Polygenic. Hōʻike ia iā ia iho ma muli o ka hana kūpono ʻole o ka ʻai a i ʻole hoʻi i ke kikowaena kūlohelohe i kahi moʻomeheu o ka hoʻoilina. ʻO ka paʻa ʻana o ke kolamu ma ka plasma koko mai nā 6 a 8 mmol / L. I nā maʻi me ka maʻi naʻau coronary e hele mua ma mua o 60 mau makahiki.
• ʻAiʻaka ʻia ka ʻohana. Hoʻokumu kēia subspecies i 1-2% wale nō i nā kānaka.

ʻO ka hypercholesterolemia ka lua kahi maʻi kahi e hele pū me nā ala renal, diabetes mellitus (type I a me II), hypothyroidism, pancreatitis, maʻi o ka ʻōpū, ka momona, a me nā maʻi maʻi biliary.

Hōʻike pinepine kēia puka i ka mea mua.

Hoʻomaʻamaʻa a me ka pale ʻana o ka maʻi

ʻAʻole hiki ke hoʻōla maikaʻi ʻia ka atherosclerosis, akā hiki ke hoʻopau i ka lawe ʻana i nā palaki kolesterol me nā manawa kūpono a me ka mālama ʻana.

Hoʻokomo nā hana Diagnostic no ka atherosclerosis hopohopo i ka mōʻaukala olakino, ka hoʻomaka mua ʻana o ka mea maʻi, ka pūnaka a me nā ʻano hana noiʻi. Ma waena o nā hōʻike kikowaena nui, ʻikeʻokoʻa ka nui o nā kolamu a me ka atherogenicity. ʻO nā ala diagnostic mea hoʻouluulu ʻia ka angiography, coronography, aortography, ultrasound o nā renal arteri, resovasography a me ka ultrasound.

Ma 80% o nā hihia, kōkua ka lāʻau lapaʻau e hoʻopau i nā hōʻailona o ka maʻi a pale i nā hopena koʻikoʻi. Kūkala ke kauka i nā lāʻau lapaʻau penei:

1. ʻO nā statins ka lāʻau kaulana loa i ka mālama ʻana i ka atherosclerosis. ʻO kā lākou hana, ke hoʻōla nei i ka hana o ke akea i ka hana o kolamu. ʻO nā hoʻohālikelike o nā lāʻau lapaʻau ka rosuvastatin a me atorvastatin.
2. LCD sequestrants e pale ai i ke kāpili ʻana o nā waihala bile i ka ate. ʻO nā hoʻoponopono kūpono e Colesevelam a me Colestyramine. I ka hopena o ka hoʻohana ʻana i nā ʻōwili LCD, ua hoʻonui ʻia ka ʻai kolamu e hōʻoia i kahi kaʻina hana kūleʻa maʻamau.
3. ʻO nā Fibrates ka lāʻau i hoʻopau i nā triglycerides, ma laila e hoʻopaʻa ai i ka hana lipid metabolism. Ma loko o ke kalapona āu e hiki ke kūʻai, no ka laʻana, ʻo Trikor a i Atromid paha.
4. He lāʻau lapaʻau ʻo Niacin e hana nui i ka mālama ʻana i ka atherosclerosis. Hoʻopohala ia i ka hopena antispasmodic a me ka vasodilator, akā ʻaʻole i hoʻohaʻahaʻa i ka cholesterol. ʻO nā palaka e loaʻa ai ka acid nikotinic e contraindicated ma ka maʻi diabetes mellitus, nā maʻi o ka pīpī a me ka puʻuwai.

I nā kūlana holomua, kuhikuhi ʻia ka hana. Hoʻonohonoho ʻia ʻo Angioplasty ma nā ʻano minimally invasive, a ua kapa ʻia nā vascular prosthetics a me ka shunting i nā ʻano loea nui.

No ka mālamaʻana a me ka pale ʻana i ka atherosclerosis, pono pono e nānā pono i nā meaʻai kūpono. ʻOi aku ka maikaʻi e hahai i kaʻai palaka haʻahaʻa me ka kolamu kiʻekiʻe. ʻAʻohe ia i ka ʻai ʻana o ia mau huahana:

• iʻa momona a me nā iʻa ʻai,
• sosa, muffin, mau palemele a me nā keʻokeʻo keʻokeʻo,
• pickles, a ʻohiʻoki a miki i nā kīʻaha,
• mea momona momona huahana,
• nā meaʻai kūponoʻai, nā meaʻai wikiwiki, trans fats,
• kīwī ikaika a me ka ʻeleʻele, ka ʻai.

Ma kahi o ka meaʻai momona ua hoʻomehana ʻia me nā ʻano haʻahaʻa haʻahaʻa o ka iʻa a me ka iʻa, nā lauala, nā mea ʻai kiki a me nā huaʻai, nā huahana waʻawaʻa lactic haʻahaʻa, nāʻa brown a me nā ʻano cereals.

ʻO ka hopena o ke atherosclerosis ma luna o nā kino o loko e wehewehe i loko o ke wikiō i kēia ʻatikala.

• Mālama i nā pae o ke kō no ka lōʻihi
• Hoʻihoʻi hou i ka hana insulin pancreatic

Ka mākeke nui o ka atherogenicity

ʻO ka atherosclerosis kahi maʻi kahi e haʻi ʻia nā hopena pōʻino hou e pili ana i kēia manawa. Ua hoʻokūpaʻa ʻia e ka poʻe e hōʻeha nei ma ka atherosclerosis me ka nui o ka koikoi atherogen (CA). ʻO lākou ʻo 6-8 mau manawa hiki ke ʻike i ke kauka me nā hōʻailona o ka maʻi puʻuwai coronary, a me ka 4 mau manawa hou aku i ka haukapila me nā maʻi heococial infarction a i ʻole ka hahau. ʻO ka ʻenehana pathogenetic o ka hoʻomohala ʻana o ka maʻi ma ka hoʻonaninaki ʻana i ka momona o ka momona a me ka hoʻokumu ʻana o nā mea i kapa ʻia ʻo "kolamu pololi" ma ka ʻaoʻao o loko o nā kīʻaha, e hōʻiliʻili nui ana i ka lumen o nā moku, hoʻonāukiuki i ka hoʻokahe koko i nā mea kino āpau a hiki ke hoʻonui i ka hōʻeha o ka naʻau a me ka maʻi ʻōpio.

Ka hoʻomaʻemaʻe o ka atherogenism - kahi hōʻailona nui o ka ʻōlelo lipid

Atherogenicity coefficient - he hana hoʻohui no ka pae o ka lipoproteins kiʻekiʻe a haʻahaʻa haʻahaʻa, e hōʻike ana i ke ana o ka hoʻomohala ʻana i ka atherosclerosis.

Hiki i nā lipids āpau i ke kino ke hele pū me ka meaʻai a hoʻohuihui paha i ka ate. No ka mea ʻo ka momona nā hydrophobic i loko o ke ʻano, ʻaʻole hiki iā lākou ke kaʻi maluhia i ke koko. No ko lākou neʻe, e pono ai nā ʻōmole transporter apoprotein kūikawā. ʻO ka huaʻōlelo o ka pūpū o nā lipids a me nā protein e kapa ʻia he lipoprotein.

Hiki i ka ʻōnaehana molowa ke loaʻa i nā lako like ʻole. No laila, ua hoʻokaʻawale ʻia nā momona āpau i ke koko i nā lipoproteins density kiʻekiʻe (HDL), lipoproteins haʻahaʻa (LDL) a haʻahaʻa loa (VLDL). ʻO LDL a ʻo VLDL i manaʻo ʻia he “mau” ʻawaʻawa. Ma kahi'ē aʻe, noho lākou ma nā paia o nā pili, i hoʻoikaika ʻia e nā ʻili pili, nā hōʻuluʻulu a me nā ʻano pletel atherosclerotic (cholesterol). ʻO kēlā mau pālaʻi e hoʻopili nui i ka lumen o nā moku, hoʻonāukiuki i ka hāʻawi ʻana i ke koko i nā ʻiʻo a me nā kiko. Hoʻopaʻa pinepine ʻia ka puʻuwai a me ka puʻuwai, e koi mau ana i ka nui o nā oxygen a me nā ʻokoʻa.ʻO ka lipoproteins kiʻekiʻe ka mea ʻē aʻe, ma kahi ʻē, i kapa ʻia ʻo "lip" huaʻai, no ka mea e hoʻoneʻe i ka momona i nā ʻāpana o ke kino, a no laila, e hōʻemi i ka hoʻoliʻiliʻi ʻana i ke koko a hoʻomaʻemaʻe i nā kīʻaha koko o nā waihona lipid hou.

ʻO ka mea hoʻohālikelike i ke atherogen he hōʻailona o ke ʻano o ka hoʻohālikelike o nā ʻōpala "olakino" a me "maikaʻiʻole". Hoʻoholo ʻia ma hope o ka loaʻa ʻana o nā hopena o kahi hōʻike koko biochemical no nā lipids a ua helu ʻia ʻo ia e ka ʻano puʻuwai.

KA = (ʻolua helenika - HDL) / HDL

KA = (LDL + VLDL) / HDL (ke koi ʻana i ka ʻōiwi e hoʻonui ʻia i ka ʻaoʻao lipid e hoʻopaʻa ʻaʻole e pili wale ia akā, ʻo ka lipoproteins density haʻahaʻa).

Hoʻokumu ʻia kona ʻano hoʻohālikelike i nā lako hana o kahi ʻōnaehana maʻamau, akā ʻo ka uku maʻamau he 2-3. Me ka nui o ka hiki ʻana o HDL, e hoʻonui ʻia ai. I kekahi mau manawa, hiki ke hiki i 7-8 a pono i ke ana lāʻau lapaʻau koʻikoʻi. Hoʻēmi i ka coefficient atherogenic i ka hana lapaʻau ka ʻinekau.

Ua hoʻohana maikaʻi kā mākou poʻe heluhelu iā Aterol e hoʻohaʻahaʻa i ka cholesterol. Ke ʻike nei i ka kaulana o kēia huahana, ua hoʻoholo mākou e hāʻawi iā i kou makemake.

He aha ka manaʻo o ka index atherogen kiʻekiʻe?

ʻO ka hoʻonui hoʻonui kiʻekiʻe o ka pakanā atherogenic ʻo kahi hōʻailona maikaʻi ʻole. ʻOiai he waiwai kūpono kēia, hiki iā ia ke loli ma waena o ke ola a ʻokoʻa nō ia i nā mea maʻi me ka pae like kolamu. No ka laʻana, ka hōʻailona o ke kolamu koko ma nā malihini kipa ʻelua o 5.5 mmol / L. I loko o kekahi o ia mea, ke hoʻohanohano nui ʻia e nā lipoproteins density kiʻekiʻe, no laila e noho ka index atherogenic i loko o nā palena maʻamau, a e haʻahaʻa ka haʻahaʻa o ka hoʻomohala ʻana i ka atherosclerosis. Ma nā mea ʻē aʻe, inā e hoʻomāhā ʻo LDL ma luna o ka HDL, ʻoiai me ka kolamu maʻamau, e hoʻonui ʻia ka ʻekaʻenehana, a e hōʻike ʻia kahi maʻi maʻi e pili ana i ka hoʻohaʻahaʻa ʻana ia.

No laila, hiki i ka index atherogen hiki ke kapa ʻia he māka prognostic: ke nānā nei i ka hopena o nā hōʻeha o nā hoʻopiʻi o ka atherosclerosis (kaomi myocardial infarction, stroke) i ka mea maʻi me ka cholesterol kiʻekiʻe. Hoʻonui mau i ka kolala he hōʻailona ʻole o ka atherosclerosis. Inā i hoʻokumu nui ʻia ma muli o ka HDL, he liʻiliʻi ka liʻiliʻi o ka maʻi vascular. ʻO ka nui i ka LDL i ka hoʻonohonoho ʻana o nā loina i ka manawa i ʻoi aku ka pilikia. Inā hoʻonui ka index atherogenic, pono ʻoe e kamaʻilio i kāu kauka e huki i kahi papahana o ka mālama ʻana a me nā mea i hoʻopaʻa ʻia.

ʻO nā kumu no ka hoʻonui ʻana i ka ʻoihana paʻa

Kuhi pinepine ʻia e kahi atherogenic kiʻekiʻe i ʻike ʻole ʻia e ka mea maʻi. ʻO ka mea nui i ke ola ka mea i kūkulu ʻia i ka wā kamaliʻi, a hahai ke kanaka iā ia i ke ola holoʻokoʻa. No laila, ke nānā aku i nā pae kiʻekiʻe lipid ma ke koko o ka mea maʻi, ua ʻoi ʻia e nānā i kona ʻohana.

Nā kumu no ka hoʻonui ʻana i ka coefficient hoʻoikaika.

1. ʻAiʻai i ka ʻai ʻana. ʻOiaʻiʻo, he waiwai a pono ka momona i kahi kanaka e hana i nā hana he nui i ke kino (no ka laʻana, he koloka ka pae hale no nā membranes a me nā hormone adrenal, ʻo LDL ke ʻano o nā mea momona e hoʻōla ai iā lākou mai ka ʻōpū liʻiliʻi no ka hoʻohuli hou ʻana i ka biochemical ma loko o ke ake, HDL - ʻO ka lipoprotein, e hoʻoili i nā momona mai nā puʻu i nā pūnaola o ke ʻano holoʻokoʻa). No laila, hiki iā ʻoe ke hoʻolauna i nā momona i kāu papa maʻamau. Akā ʻaʻole like ka momona a pau. ʻO ke kumu o ka hoʻonui nui o ka pakanā atherogenic o ka ʻai nui ʻana i nā momona o nā holoholona i loaʻa i ka momona o ka momona, ka momona, ka momona, ka offal (kidney, brains), sausages, butter, fat milk and milk dairy product, egg yolk.
2. Hiki pū i ka hypertension ulu ke hoʻonui i ka coefficient atherogen. Wahi a nā helu helu, ʻo ke koko kiʻekiʻe ke pilikia o 35-40% o nā poʻe noho o nā ʻāina hoʻomohala ma mua o 45 mau makahiki. Ke kikowaena ma luna o 140/90 mm Hg. ʻAniā. hoʻonāukiuki i ka leo vascular, ka mea e hoʻopilikia i ka hoʻokahe koko i nā kino a me nā kiko. ʻO ka mea ʻoi, ua hana ʻia nā ʻalā no kahi neʻe: he hiki i ko lākou pōkole ka manawa pōkole i ka wā o nā haʻuki a i ʻole ke ʻano kaumaha, ʻo ia ke ʻano "hoʻoweliweli" i nā mālama kūloko o ke kino, e hoʻokaʻawale ana i ke kahe koko. Me ka hypertension arterial, ke ʻano ka nui o ka leo vascular e kōkua i ko lākou pōʻino, a me nā molekole lipoprotein haʻahaʻa haʻahaʻa e noho koke i ka microtraumas.
3. Hiki nō hoʻi i ka ulaula ke hoʻonui i ka coefficient atherogenic. ʻO ka hoʻokomo pinepine ʻana o ka uahi paka i ka hoʻohaʻahaʻa ʻana i ka saturation o ke koko a me ka microdamage mau i nā moku koko. Hoʻopiha koke nā lipids me nā platelets i kēia mau lesion, a me kahi palapala pleka atherosclerotic (cholesterol).
4. Ke alakaʻi nei ka waiʻona i ke alakaʻi ʻana i ke ʻano o ke kaomi vascular. Hoʻonui ka pili o nā Peripheral (superficial), a me ka visceral, e hānai ana i ka naʻau, ka ʻāʻī a me nā kino o loko ʻē aʻe. No laila, ke hoʻopuka nei ke koko i nā ʻāpana a me nā ʻōnaehana, hoʻopili ʻia nā microdamages i nā moku paʻa, a me nā ʻano i nā kolamu kolesterol.
5. ʻO kekahi kumu ʻē aʻe no ka hoʻonui nui ʻana o ka maʻi mellitus type II. Hōʻike ʻia kēia maʻi metabolic e ka nui o ka glucose (gula) i ke koko. Ua hoʻohaumia nā molekui i ka pā maikaʻi o ka pā o nā wahī, a me ka nui o nā kolamu polapika ka hoʻopihapiha. Eia kekahi, me ka maʻi diabetes, ʻaʻole wale nō ka momona, akā ua hoʻopau ʻia ka metabolism momona: nā mea maʻi me kēia maʻi e hopena i ka momona, e like me ka mea eʻai ai. ʻO nā lipids nui i ke kino me ka maʻi diabetes hiki ke alakaʻi pū i ka coefficient hoʻonui.
6. ʻO ke anuanu kahi kumu'ē aʻe e hiki ke hoʻonui i ka coefficient atherogen. Aia kekahi mau kumu e alakaʻi ai i ka momona, ʻo ka maʻamau ka mea maʻamau (ka maʻamau maʻamau o nā meaʻai kiʻekiʻe-calorie, nā mea momona momona, a me ka endocrine (nā ʻano like ʻole o ka hoʻoponopono ʻana i ke ʻano o nā hanana koʻikoʻi). Me ka hiʻona, hoʻonui ka nui o nā lipids i ke koko, i ka hopena o ka hoʻokumu ʻana i kahi hōʻailona i hoʻonui ʻia a me ka hoʻomohala ʻana o ka atherosclerosis.
7. Koiā ʻohana. Hōʻike nā kauka i ka hapanui o ka hoʻonui ʻana i ka koikoi atherogen i loko o nā poʻe e pili ana i nā ʻohana pili koko kokoke i ka atherosclerosis, maʻi cardiovascular, a i hōʻeha ʻia i hoʻokahi a ʻoi aku paha nā puʻuwai a i ʻole nā ​​hōʻeha. No laila, ua hoʻomaopopo ʻia e loaʻa nā ʻike a pau o ka poʻe āpau me ka moʻaukala ʻohana a me nā hōʻike maʻamau no ka cholesterol a me kahi palaka lipid.
8. Ke hoʻomaka nei kahi ala maʻalahi e pili ana i nā mea hiki ke hoʻonui i ka coefficient atherogen. Hōʻoiaʻiʻo ia i ka poʻe e alakaʻi nei i ke ʻano ola e hiki ke hele i ka nui o ka atherogenicity.

ʻO kēia mau kumu āpau e pili ana i ke kino no ka manawa lōʻihi, no laila he nui ka maʻamau o ka koina o ka atherogenic i nā makahiki he 40. Eia nō naʻe, i ka makahiki i hala, ua ʻike ʻia kekahi heʻina nui o ka atherogenicity i loko o nā ʻōpio 13-15 makahiki mau makahiki, no laila ke ʻano nui nei ka noi ʻana o nā hiʻohiʻona lipid.

ʻO ka pōʻino o ka hoʻonuiʻana i ka coefficient

I loko o nā mau makahiki, kahi nui o ka atherogenicity ua like me ka asymptomatic, no laila he nui ka manaʻo i kēia ʻano kīnā ʻole ʻole, ʻaʻole pono ia e mālama ʻia. No kēlā ʻano lohi i kapa ʻia ʻo ka atherosclerosis kapa ʻia he "pepehi kanaka hoʻomohala", ʻoiai ke ʻeha ʻia o nā palaki kolesterol a me ke koikoi kiʻekiʻe atherogenic pili i nā hoʻopiʻi koʻikoʻi e hiki ai i ka make.

ʻO nā pane o ka hoʻonuiʻana i ka koikoi atherogenic:

1. 1. Acocococute huehue. ʻO ka ʻāʻī naʻau ka mea mau loa i loko o ke kino. Hana ʻo ia i kahi hana koʻikoʻi ʻo ka pākuʻi ʻana i ke koko he nui i ke kahe o ke kanaka. No laila, pono e hāʻawi i ke koko i ka ʻili o ka naʻau me ke kali ʻole. ʻO ke koko waiwai momonaʻo Oxygen e komo i ka puʻuwai ma o ka lāʻau coronary.

Me ka piʻi nui o ka atherogenic nui, loaʻa ke kūlana kiʻekiʻe ma ka hoʻokumu ʻana o nā kolana kolesterol ma ka ʻaoʻao o nā moku o ke kino, me nā mea coronary. ʻO kahi ʻilihune liʻiliʻi loa o ka lumen o nā ʻāpana e hoʻopau ai i ka naʻau i ke kahe hewa ʻole ʻana o kona kahe. Hōʻike ʻia lākou e ka huki ʻana, e hoʻā ai i nā hōʻeha ma hope o ka sternum, i hoʻopā ʻia e ka hoʻā ʻana o ke kino. Inā hiki i ka lumen o ka lāʻau coronary ka "clogged" maoli me nā mālama momona, a ma hope koke iho o ka maʻi maʻi nui e like me ka maʻi myocardial infarction.

ʻO ka hoʻihoʻi hou ʻana o nā mea maʻi ma hope o ka infococose myocardial he lōʻihi a paʻakikī. Pono kēlā mau maʻi e kiaʻi e ola ma ke ʻano loiloi a me kahi hoʻoponopono hou.

1. ʻO ka hōʻeha, a i ʻole ulia cerebrovascular ulia. ʻO ka ʻākī kahi ʻē aʻe e pono ai ke komo pinepine o ka oxygen, glucose a me nā mea momona. ʻO ka lawa ʻole o ke koko i ka kaile a me ka wā ma ka atherosclerosis hiki ke alakaʻi i kēlā ʻano maʻi me ka hoʻi - ka make ʻana o kahi ʻāpana o ka lolo me ka hoʻomohala ʻana i nā ʻōnaehana neurological - ka maʻi puʻupaʻa, ka nalowale o ka ʻike, nāwai a me ka hanu ʻana, a hiki i ke koka a me ka make.

Pehea e hōʻemi ai i ka coefficient atherogenic: nā lula pili

Inā he nui pae kiʻekiʻe o ka HDL i nā hoʻokolohua koko, ʻoi aku hoʻi ka meʻelima o ka atherogenic ʻoi aku ka kiʻekiʻe ma mua o kahi maʻamau. No laila, ʻo ka pahuhopu nui o ka mālama ʻana me ka index atherogenicity kiʻekiʻe e hoʻohaʻahaʻa i ka neʻe ʻana o ka "hoʻopōʻino" LP a me ka kolamu holoʻokoʻa i ke koko ma ka hoʻonui ʻana i ka "pono" HDL.

Hiki ke hoʻemi ʻia ka koʻiko atherogen ma o ka hoʻohana ʻana i nā ʻano laulā e pili ana:

1. Kauʻai ʻO ka hoʻohaʻahaʻa nui i ka cholesterol kiʻekiʻe he mau lōʻihi. ʻO ka papa hana mua ka lāʻau lapaʻau ʻole maʻamau a ma ka ʻano, ka mea ʻai. Hoʻokomo ʻo nā Therapist i ka hoʻopiha a hoʻopau loa i nā meaʻai momona piha i ka kolala mai ka meaʻai - ka momona momona o ka puaʻa a me ka mutton, ka lard, ke kalo, nā anana a me nā sausages, nā kirikū kaumaha a me nā huahana waiū, hua ʻala. ʻO kēia mau mea a pau ke kumu no ka nui o ka kolamu a ʻaʻole i kūpono me ka coefficient kiʻekiʻe o ka atherogenicity. Ma kahi'ē aʻe, pono i nā meaʻai me nā momona momona, unsaturated i nā momona momona a me nā HDL e hoʻokomo pū i ka ʻai. Hoʻopili kēia mau: nā aila aila (kaukaʻi nā kauka i nā hana i ka ʻai i nā lā i kēia manawa, e hōʻola ʻia iā lākou me ka pulupulu a me ka ʻaila ʻoliva), nā iʻa ʻula, nā hua.
2. Ke hoʻololi ʻana ke ola. No ka hōʻemi i ka helu, pono ʻoe e hoʻōki i ka inu a me ka inu ʻawa. Hoʻomaopopo ʻia e hele i nā wāwae i kēlā me kēia lā i ka ea hou, e hana i ka hoʻomaʻemaʻe māmā, komo i ka hāmeʻa i ʻae ʻia me ke kauka (ʻaʻau, hele, huakaʻi, hele wāwae, holo lio, etc.).
3. Ke hoʻomaʻamaʻa ʻana o nā maʻi concomitant. Ke hoʻoluhi pinepine nei i nā lāʻau antihypertensive (hoʻohaʻahaʻa i ka lāʻau) no ka hypertension: ʻo nā helu koʻikoʻi neʻe no ka poʻe maʻi hypertensive e noho ma ka pae o 130-140 / 80 mm Hg. ʻAniā. a i lalo. Eia nō kekahi, ʻo nā mea maʻi me ka maʻi mellitus maʻi, kahi nui o ka index atherogenicity, e hōʻike ʻia e hahai i ka ʻai ʻana ʻaʻole wale nō me ka laʻa ʻana o nā momona holoholona, ​​akā hiki ke hoʻēmi i nā kākoi a me ke kō. Loaʻa i ka pinepine o ka makemake o ka glucose i ke koko ma o ka lawe ʻana i nā lāʻau lapaʻau haʻahaʻa.
4. Hoʻemi i ka momona nui i ka momona. ʻO ke kūkākūkā kaiāulu.
5. Inā hiki, hoʻopau a hoʻoemi i nā mea luhi ma ka hana a ma ka home.

Ka lapaʻau ʻana i ka nui o ka kiʻekiʻe o ka pakanā o ka atherogenicity i ka hoʻohaʻahaʻa ʻana i ka lipoproteins hoʻohaʻahaʻa haʻahaʻa a me nā kolamu holoʻokoʻa i loko o ke koko, e hoʻopau ana i nā mea pili pilikia pathogenetic no ka hoʻomohala ʻana i ka pākeke atherosclerotic. ʻO nā lāʻau lapaʻau e hōʻemi i ka coefficient of of atherogenicity e loaʻa:

• ʻO nā statins (Atorvostatin, Rozuvostatin, Simvastatin) nā lāʻau lapaʻau maikaʻi loa e hiki ke hōʻemi i ka coefficient atherogen. Hoemi lākou i ka synthesis o kolamu ma ka kō ma 30%, hoʻohaʻahaʻa i ka hoʻoliʻiliʻi o nā lipoproteins haʻahaʻa haʻahaʻa, a hoʻonui i kiʻekiʻe. Wahi a nā helu helu, hoʻohana maʻamau i nā statins no 5 mau makahiki a i ʻole e hōʻemi i ka hopena o ka hoʻomohala ʻana i nā hoʻopiʻi cardiovascular o ka atherosclerosis e 40%.
• ʻO nā Fibrates (Ciprofibrate, Fenofibrate) - kahi hui'ē aʻe o nā lāʻau lapaʻau e hōʻemi i ka kolamu a me nā mea hoʻokūkū atherogenic. E like me nā statins, hoʻonui i nā pae LDL haʻahaʻa a hoʻonui i nā pae HDL.
• Sequestrants o nā momona bile (cholestyramine) - kahi ala e hoʻopaʻa ai i nā momona momona i loko o ka pākī a pale i ko lākou komo ʻana i ke koko. Ua hoʻohana mua ia e like me nā lāʻa no ka pohō kaumaha. Hoʻomaʻamaʻa pinepine ʻia i ka hoʻohui i nā statins a me nā fibrates, e hoʻomaikaʻi i kā lākou hana.

ʻO ka mea i ʻōlelo ʻia e hōʻemi i ka coefficient atherogenic

ʻO ka emi ʻana o kēia hōʻailona e hana pinepine ʻia ma ke ʻano o ka paʻakikī paʻakikī o ka atherosclerosis. Mālama, ua hoʻopaʻa inoa ʻia nā mea maʻi me kahi kauka a nānā ʻia no ka maʻi puʻuwai coronary a i ʻole ka discirculatory encephalopathy (koleko plakuna i loko o nā ipu o ka lolo). E hoʻohālikelike paha lākou i ka huki pinepine ʻana, nā hana hōʻehaʻeha i ka umauma, ke pōkole o ka hanu, hoʻomaʻamaʻa ʻana, hōʻeha pūhaka, nā luhi. ʻO ka maʻamau, ma ka loiloi o nā mea maʻi, he nui ka hoʻonui nui o ka kolamu a me ka dyslipidemia koʻikoʻi.

No laila he mea koʻikoʻi ke hoʻolohe nui i ka hoʻonui ʻana i ka kaapili atherogen i ka hoʻomaka ʻana o ka maʻi, i ka wā e hōʻike iki ʻia nā mea maʻi o ka momona o ka momona. ʻO nā poʻe olakino maikaʻi loa ʻole kekahi manaʻo hoʻopiʻi e aʻo ʻia e lawe i kahi loiloi no ka cholesterol a me nā lipoproteins i hoʻokahi manawa o 3-5 mau makahiki. E mālama i ka mālama pono ʻana i kou olakino a me nā ʻōpiopio pale pale maʻamau e kōkua i ka mālama i ke olakino a lōʻihi ka lōʻihi.

He aha ka mea aheric aheric atherosclerosis, nā hōʻailona a me nā ala e mālama ai

Atherosclerosis o ka ʻōpū o ka ʻōpū - he aha ia? Aia kēia mau kumu i nā kumu kikoʻī a maopopo like nā hōʻailona i hiki ke hoʻomaopopo iā ia i ka wā mua? He aha ka pilikia o kēia ʻanolani?

E noʻonoʻo i ka ʻōnaehana o ka hoʻomohala o ka maʻi, ka mea i mālama ʻia e ka lāʻau lapaʻau hou a pehea e pale ai, inā ʻaʻole ka maʻi ponoʻī, a laila kona holomua.

Atherosclerosis o ka ʻōpū a me ka ʻaʻa o kona hoʻomohala

ʻO Atherosclerosis kahi papa i maʻamau maʻamau i nā poʻe o nā ʻano ʻokoʻa like ʻole o ka wahine. Me kāna hoʻomohala ʻana, ua pā pono nā kīʻaha o ke kino holoʻokoʻa. ʻO ke kumu nui he hoʻonui mahuahua o ka kolamu a me ka ʻike o nā kolamu (atherosclerotic) pōkole e hoʻopili ana i ka lumen o nā moku.

ʻO ka aorta ʻōpū i koho ʻia nā moku nui. ʻO ia ke "kupuna" o nā ʻōpala e hoʻolako i ke koko i nā ʻōpū āpau i nā puʻupuʻu haʻahaʻa. ʻO ka atherosclerosis o ke ʻōpū o ka ʻōpū he ala paʻakikī loa, ke alakaʻi nei i kekahi o nā hōʻeha maikaʻi ʻole.

ʻO nā pae nui o ka holomua o nā loli pathological i loko o ka ʻōpū o ka ʻōpū:

• Hoʻomaka ka atherosclerosis o ka ʻōpū o ka ʻōpū me ka hoʻokumu ʻana a me ka hoʻohemo ʻana i nā palaki kolesterol ma kēia moku.
• nāwawa piʻi ʻaʻa i ka moku, hoʻopili ʻia kona lumen. I kekahi manawa, ʻo ka neʻe o ke koko ma o ia moku ua ʻoi aku ka paʻakikī.
• ma ka hopena, hoʻomaka ka ʻāpana o ke kino o ke kino i ka ʻohi ʻana i ka ʻai me ka oxygen. E hana pololei ʻia kā lākou hana i ke kahe o ke koko, ka mea e hāʻawi ai i ka aorta ʻōpū,
• Hoʻomaka nā loli Ischemic i nā kiko, ukali ʻia e ka sclerosis a me nā necrosis.

Hoʻomaʻamaʻa kūlou i kēia manawa i ka pale ʻana i nā hoʻopiʻi i hōʻea ʻia mai ke ala o ke kahe koko.Akā ʻo ka paʻakikī o ka maʻi e hoʻomaka ai ka maʻi ʻeha ma muli o ka palaka a ʻole ka loaʻa ʻole o nā hōʻailona.

Nā hōʻailona a me nā kumu

Atherosclerosis o ka ʻōpū pūpū, e loaʻa nā hōʻailona o ka atherosclerosis maʻamau, akā i ka manawa like, ua pili nā hōʻailona me ke kahua o ka hōʻino nui. ʻO ia, ʻo ia kahi maʻi e pili nui ana i ka nele o ka oxygen me nā meaʻai. Hoʻopau loa nā kau a me nā ʻili i kēia mau ʻano.

I ka hopena, e pili nā hōʻailona me kēia mau ʻāpana:

1. Kau ka momona no ke kumu ʻike ʻole. Mālama ka mea ʻai, a nalo ke kanaka i ka paona. ʻAʻole hele wikiwiki i ka momona, akā lohi.
2. Hōʻike pinepine nā hanana Dyspeptic i kēlā me kēia manawa, a laila lohi. Nui ka mahuahua, e loaʻa kekahi manawa he puʻuwai. Ua wāwahi ʻia ka ʻaʻe, pinepine ka maʻi, aʻa iki pinepine - constipation.
3. Ma hope o ka ʻai ʻana, e ala ʻia ana ka ʻeha o ka ʻōpū. ʻAʻole ikaika lākou, kahiʻeha, kūlohelohe i ka kūlohelohe a emi iki ka hōʻemi.
4. Eia kekahi, ma hope o ka ʻai ʻana, ke manaʻo nei ke piha a me ka kaumaha nui i ka ʻōpū, ma ka ʻōpū ma lalo.
5. Hōʻemi ka nui o ka urine e kū'ē i ke kiʻi o kahi hoʻonui i ka urination. Aia kahi manaʻo piha o ka haki ʻana i ka wili.
6. ʻO ka nāwaliwali ākea, nā palupalu lūlū i ka hoʻomaka o ke ao.
7. I ka hopena o ka hoʻolāʻau mau i ke kino, hiki ke ʻike ʻia kahi hoʻonui ʻana i ke aniani kino i nā hōʻailona subfebrile.
8. Ka huki ʻana o nā manamana lima o ke poʻo ma muli o kahi hana renal haʻihaʻi, ka huehue o ka maka. Kūkā ʻia kēia mau maʻi i ke kakahiaka.

I waena o nā kumu kumu maʻamau o ka maʻi aortic a me ka ʻōpala:

• kaumaha e ka hoʻoili. Eia kekahi, hiki i kēia ke kau i ka predisposition i ka hoʻomohala ʻana o ka atherosclerosis ma muli o nā hiʻohiʻona o nā kaʻina metabola a i ʻole nā ​​hopena congenital paha.
• ka nele o ka hoʻokō ʻana ma muli o ka holomua ʻepekema a me ka ʻenehana a me nā kikoʻī o ka hana ʻoihana.
• ka hopena o nā mea o ke kaiāulu, e pili ana i ka pane ʻana o ke kino o ke kino,
• ka hōʻike mau ʻana i nā kūlana kaumaha,
• maʻi mellitus maʻiʻi
• maʻi lēpaa, lilo i loko o ke kino,
• momona momona
• mau ʻano maikaʻi.

Nā ʻano o ke ʻano o nā patula a me nā hana lapaʻau

Hiki i ke aʻo ʻana o nā maʻi ka ʻokoʻa o ka hakakā.

E pili ana i kēia mau kuhikuhi, aia nā ʻano palolo:

• ʻO ka wā preclinical. Uuhi ʻia ke ʻano piha ʻole o nā hōʻailona. ʻOiai nā ala diagnostic diagnostic ʻaʻole e hōʻike i ke alo o nā loli pathological i ka aorta ʻōpū. ʻO ka hōʻike hoʻohālikelike wale nō o ka maʻi ka mea e hoʻokiʻekiʻe ai i ka kolamu a me ka hiki ʻana o nā haʻawina beta-lipoprotein i loko o ka biochemistry koko. ʻO ka hoʻomaʻamaʻaʻana i ka maʻi i kēia papa maʻalahi. I kekahi manawa wale nō nā mea e pale aku ai a me ka hoʻoponopono ʻana i ka lāʻau lapaʻau e pono ai.

• Hūnā (latent) manawa. ʻAʻole paʻa paha ka mea maʻi i nā hōʻailona o kahi maʻi hoʻoweliweli, akā hōʻike nā haʻawina instrumental i nā loli i ke kūlana o ka aorta ʻōpū. Hoʻopilikia i ka molaki lipid.
• ʻO ka manawa o nā hōʻailona kīʻaha ʻole. ʻO ka maʻamau pinepine kekahi mau hōʻailona maʻamau o ka ischemia, kahi e hūnā me ka hōʻike ʻana o ka hypertension. Ma kēia ʻanuʻu, hiki i ka mea loea ke hoʻomaopopo i ka maʻi ma hope o ke ʻano o ka hoʻopaʻa ʻana i ke ʻano diagnostic. Maʻa maʻamau ka mālama ʻana.
• ʻO ka hoʻomohala ʻana o ka hanana arterial occlusion (pōpilikia) Hoʻololi nā loli i loko o nā lau o nā kino i hoʻopili ʻia. ʻAʻole paʻakikī maoli ka maʻi. Hiki i ka hōʻeha ke hoʻomaʻamaʻa ʻia i kēia kahua ka mea i conservative a surgical paha.

Me ka atherosclerosis o ka ʻōpū o ka ʻōpū, ua hoʻohana ʻia nā ʻano diagnostic ʻano. Hoʻokumu ka mea maʻi i ka paʻakikī o ka maʻi, ka kūlana maʻamau o ka mea maʻi, ka hiki ʻana o nā maʻi maʻi concomitant a me nā ʻano pilikino.

Hoʻokomo ʻia ka mālama mālama ʻana i kahi ala komo e hoʻoponopono ai i ka pilikia. Ua kau ʻia ke ʻano o nā lāʻau lapaʻau, ka hana a ke kuhikuhi nei i ka hoʻohaʻahaʻa i ka cholesterol i loko o ke koko, hoʻomaikaʻi i ke ʻano o nā kīʻaha koko, hoʻoikaika i ka pale ʻana. I kēlā me kēia kūlana, ke kuhikuhi pono ʻia nā lāʻau lapaʻau ʻokoʻa, me ka noʻonoʻo ʻana i nā ʻano o ka mea maʻi a me ke ʻano o kāna maʻi.

E kōkua i ka huli ʻana i ke kōkua pono ʻole e hōʻalo i nā hoʻopiʻi e like me ischemia o nā ʻāpana o ke kino a me nā haʻahaʻa haʻahaʻa, necrosis a me nā fibrosis o nā kiko. I nā hihia koʻikoʻi loa, he hopena hōʻeha.