Ngati mwakhala mukuwerengapo za matenda a mtima posachedwa, kapena ngati mwakhala ndi nkhani yatsopano ndi dokotala wanu zokhudza kupewa kapena kuchiza matenda a mtima, mwina mwakhala mukukumana ndi mawu akuti "endothelial malingaliro". Lingaliro la kutha kwa zovuta limakhala lofunika m'zaka zaposachedwa kuti timvetsetse mavuto ambiri a mtima, kuphatikizapo matenda a mitsempha yamtundu wa matenda (CAD) , kuthamanga kwa magazi , microvascular angina ( matenda a mtima mtima x ), kutayika kwa diastolic , ndi ena.
Endothelial kutayika ndi njira yomwe mapeto a mkati mwake (mkati mwake amatha) a mitsempha yaying'ono ikulephera kugwira ntchito bwinobwino. Zotsatira zake, zinthu zingapo zoipa zingathe kuchitika kumatenda omwe amaperekedwa ndi mitsempha imeneyo.
Ntchito ya Endothelial Layer
Mu arterioles ya thupi (mitsempha yaing'ono yomwe imayendetsa bwino kuthamanga kwa magazi kupita kumatenda), endothelium ndi kupangira mkati mwa maselo omwe ali ndi ntchito zingapo zovuta.
The endothelium imasungunula bwino ndi kuyimba kwa mitsempha ya magazi. Ntchitoyi imatsimikizira pa kamphindi kochepa kuti magazi amalandira bwanji ziwalo zosiyanasiyana za thupi. Endothelial "toni" imayikanso kuti munthu ayambe kuthamanga kwa magazi, komanso kuti mtima umayenera kugwira ntchito yotani magazi kumtunda.
The endothelium imatetezeranso tizilombo tosiyanasiyana poizoni; imayendetsa njira yothandizira magazi ; imayendetsa madzimadzi, electrolytes, ndi zinthu zina zambiri zomwe zimachitika pang'onopang'ono pakati pa magazi ndi minofu; ndipo amayendetsa kutupa m'magazi.
Zonsezi zikutanthawuza kuti kugwira ntchito moyenera kwa endothelium n'kofunika kwambiri pa ntchito ya thupi ndi ziwalo za thupi.
Pomwe kuthetsa vutoli kulipo, kuthekera kochita chimodzi kapena zambiri mwa ntchito zofunika izi ndikutayika.
Zifukwa za Kusokonekera
Chifukwa mapetolium ndi ofunika kwambiri kuntchito zambiri zofunikira, kufufuza kwambiri kumayesetsedwera kumvetsetsa zonse zomwe zimayambitsa matenda osokoneza bongo.
Panthawiyi, zikuwonekeratu kuti mapeto a malingaliro amatha kugwiritsidwa ntchito pochepetsa kuchepa kwa nitric oxide (NO) muzitsulo zamagazi.
KODI pali mpweya umene umapangidwa ndi metabolism ya amino acid (L-arginine). Ayi, yomwe ili ndi hafu yaifupi kwambiri, imachita mderalo m'mitsempha ya mitsempha kuti ikhale yoyenera kutulutsa mphamvu komanso ntchito zina zofunika kwambiri. Kuperewera kopanda ntchito kumabweretsa mitsempha yambiri ya magazi (yomwe ikhoza kutulutsa magazi), imathandiza kuti mapulaneti apangidwe (kumayambitsa magazi), amachititsa kuti kutupa m'magazi awonjezeke, ndipo kumawonjezera kukwera kwa makoma kuwononga lipoproteins ndi poizoni zosiyanasiyana.
Kufotokozera mwachidule, kuthetsa vutoli kumachepetsedwa ndi kuchepetsa mphamvu za m'magazi, zomwe zimayambitsa zovuta zambiri m'magazi. Zomwe zimakhala zosavomerezekazi zimakonda kulimbitsa thupi la Mulungu. Kuonjezera apo, mapeto otha kupweteka amatha kupangitsa kuti mitsempha yaing'ono ikhale yopanda mphamvu, ndipo imalingalira kuti ndiyo yaikulu ya kuchititsa matenda a mtima x ndi zomwe zingatheke, kutayika kwa diastolic.
Kusokonezeka Kotsutsana ndi Zizolowezi
Njira zenizeni zomwe munthu amatha kupweteka kwake kumagwiritsabe ntchito.
Komabe, zikuwonekeratu kuti mavuto ambiri azachipatala, zizoloŵezi, ndi zosayembekezereka zochitika m'moyo zingathandize, kuphatikizapo:
- Kuthamanga kwa magazi
- Matenda a shuga
- Kutsekula kwa LDL cholesterol ndi ma triglyceride
- Kusuta
- Kukhala moyo wosadzikonda
- Kupsinjika maganizo ( Kuvutika maganizo, komwe kumatchedwanso "mtima wosweka mtima ," tsopano ukuganiza kuti ukuyambitsidwa ndi mawonekedwe ovuta komanso ovuta a endothelial operewera.)
- Matenda
- Kulephera kwa mtima
- Hypothyroidism
- Osteoporosis
- Kukalamba
- Chemotherapy ndi mankhwala opangira ma radiation
- Zotsatira za majini
Kudziwa
Sitiyenera kuonetsetsa kuti matendawa satha. Matenda ena omwe amatha kupweteka kwambiri amatha kuganiziridwa mosamala kwa aliyense yemwe ali ndi CAD, matenda oopsa, kapena zifukwa zazikulu za matenda a mtima (makamaka omwe atchulidwa pamwambapa).
Kotero kwenikweni kuyeretsa mapeto a wodwala sizomwe madokotala amachita nthawizonse. Koma ngati kugwiritsidwa ntchito mosavuta kumaganiziridwa mwa munthu popanda zifukwa zomveka (monga munthu amene amaganiza kuti ali ndi matenda a mtima x), matendawa angatsimikizidwe ndi mayesero omwe amatha mphamvu ya mitsempha ya magazi kuti ichepetse kapena / kumayendetsedwe ka mankhwala.
Kuchiza
Endothelial ntchito ikhoza kukhala bwino ndi miyeso ya moyo yomwe timalimbikitsidwa tonsefe kuchepetsa chiopsezo cha matenda a mtima, kuphatikizapo kutaya thupi, kuchita masewera olimbitsa thupi, kusuta fodya, kuchepetsa matenda a shuga, ndi matenda a shuga.
Zina mwa njirazi zowononga zoopsa zatsimikiziridwa bwino kuti zithetse kuchepa kwa matenda. Izi zikuphatikizapo:
- Kugwiritsa ntchito mankhwala osokoneza bongo
- Aspirin
- Zakudya za Mediterranean
- Zakudya zina monga mtedza, mafuta a maolivi, chokoleti chakuda, tiyi wobiriwira, zakudya zamasamba.
- Zochita masewera olimbitsa thupi
- Kutaya thupi
Kuonjezera apo, mankhwala ambiri akuwerengedweratu kuti awone ngati angathe kusintha endothelial kutayika mwa njira yamaganizo. Ena mwa othandizira omwe akuwoneka kuti akuwonetsa malonjezanowa ndi nifedipine , ena ACE inhibitors , estrogen, ranolazine , ndi sildenafil .
Mawu Ochokera
M'zaka zaposachedwapa ochita kafukufuku wa zamankhwala apeza kuti mapeto amatha kusokonekera monga chofunikira kwambiri chothandiza mitundu yonse ya mavuto a mtima. Ngakhale kufufuza mwakhama kukuchitika kuti mudziwe njira zothetsera mapeto a endothelial, choncho kuchepetsa chiopsezo cha matenda a mtima, pali zambiri zomwe tingachitepo. Makamaka, tiyenera kuyesetsa kuchita masewera olimbitsa thupi, kusiya kusuta, ndikuonetsetsa kuti timagwira ntchito ndi madokotala kuti tizitha kudwala matenda a shuga kapena matenda a shuga ngati tili ndi izi.
> Zotsatira:
> Crea F, Camici PG, Bairey Merz CN. Coronary Microvascular Kusokonekera: Zowonjezera. Mtima; 35: 1101.
> Greenland P, Alpert JS, Beller GA, et al. 2010 ACCF / AHA Mndandanda wa Kuunika kwa Mitsempha ya M'mtima ku Asymptomatic Akuluakulu: Lipoti la American College of Cardiology Foundation / American Heart Association Ntchito Yogwira Ntchito Zothandiza. J Am Coll Cardiol 2010; 56: e50.