Uma uke wenza noma yikuphi ukufunda ngokuphathelene nesifo senhliziyo, kungekudala, noma uma ukhulumisane nodokotela wakho wamuva mayelana nokuvimbela noma ukwelapha isifo senhliziyo, kungenzeka ukuthi uhlangabezane negama elithi "endlelial dysfunction." Umqondo wokukhubazeka kokuphela kwesikhathi uye waba obalulekile eminyakeni yamuva ekuqondeni kwethu izimo eziningi zenhliziyo, kuhlanganise ne- coronary artery disease (CAD) , umfutho wegazi ophakeme , i-angina ezincane (i- cardiaac syndrome x ), ukungasebenzi kwe-diastolic , nabanye.
Ukungasebenzi kahle kwe-Endothelial yisimo lapho ungqimba wokuphela (ukugeleza kwangaphakathi) kwe-artery encane ehluleka ukusebenza ngokujwayelekile. Ngenxa yalokho, izinto eziningana ezimbi zingenzeka ezicukwaneni ezihlinzekwa yizo zemizimba.
Umsebenzi wekhasi lokugcina
E-arterioles yomzimba (emithanjeni encane eqondisa ngqo ukugeleza kwegazi kuya kwezicubu), i-endothelium ingxenyeni yangaphakathi yamaseli enemisebenzi eminingi emqoka.
I-endothelium igcina ukuhlanjululwa okufanele kanye ne-constriction yemithambo yegazi. Lo msebenzi unquma ngesisekelo esincane sokuthi igazi lithola kangakanani amathissi ahlukahlukene omzimba. I-endothelial "ithoni" nayo inquma kakhulu ukucindezelwa kwegazi lomuntu, nokuthi umsebenzi wenhliziyo kufanele uyenze kangakanani ekupompheni igazi emzimbeni.
I-endothelium ibuye ivikele izicubu ezinhlobonhlobo eziyingozi; ilawula indlela yokugaya igazi ; ilawula uketshezi, i-electrolytes, nezinye izinto eziningi ezidlula phambili naphakathi kwegazi nezicubu; futhi ilawula ukuvuvukala kwezicubu.
Konke lokhu kusho ukuthi ukusebenza kahle kwe-endothelium kubalulekile emsebenzini ojwayelekile wezitho zomzimba nezitho zomzimba.
Uma ukukhubazeka kokuphela kokusebenza kukhona, ikhono lokwenza eyodwa noma ngaphezulu yalezi zinto ezibalulekile liyekethiswa.
Izimbangela Zokungasebenzi
Ngenxa yokuthi i-endothelium ibaluleke kakhulu emisebenzini eminingi ebalulekile, kwenziwa ucwaningo oluningi ukuqonda zonke izimbangela zokungasebenzi kahle kokuphela kwesikhathi.
Kule ndawo kubonakala ukuthi ukungasebenzi kahle kokuphela kokusebenza kuhlobene nokunciphisa amazinga we-nitric oxide (NO) ezindongeni zamathambo egazi.
Awukho igesi elikhiqizwa umfutho we-amino acid (L-arginine). CHA, enesigamu sempilo encane kakhulu, isebenza endaweni yangaphakathi emithanjeni yegazi ukusiza ukulungisa ithoni ye-vascular kanye neminye imisebenzi ebalulekile ekugcineni. Ukuntuleka kwe-NO ukukhiqiza kuholela ekunciphiseni ngokweqile kwemithambo yegazi (okungabangela ukushisa komfutho wegazi), kunomthelela ekusebenzeni kwamaplatelet (okuholele ekunqandeni kwegazi), kwandisa ukuvutha kokuvuvukala ezindongeni zamanzi ezitsheni, futhi kwandisa ukuguqulwa kwezindonga zamanzi ekwenzeni i- lipoproteins nezinyosi ezihlukahlukene.
Ukufingqa, ukukhubazeka kokuphela kwesikhathi kubonakala ngokunciphisa ama-vascular NO amazinga, okuholela ekungahambeni okungajwayelekile emzimbeni wesitsha segazi. Lokhu okungajwayelekile okusebenzayo kuvame ukukhuthaza ukuqina kwe-atherosclerosis . Ngaphezu kwalokho, ukukhubazeka kokuphela kwesikhathi kungabangela ngokuqondile ukungasebenzi okungavamile kwemizwa encane, futhi kucatshangwa ukuthi kuyisici esiyinhloko ekwenzeni i-cardiac syndrome x futhi kungenzeka, ukungasebenzi kwe-diastolic.
Ukukhathazeka okuhlangene nemikhuba
Izindlela eziqondile umuntu azakhela ngazo ukuphela kokusebenza komzimba zisasebenza.
Kodwa-ke, kubonakala sengathi izifo eziningi zempilo, imikhuba, kanye nezenzakalo ezingenakuvinjelwa zokuphila zingasiza kulo, kufaka phakathi:
- I-hypertension
- Isifo sikashukela
- Ukuphakama kwama-cholesterol e-LDL namazinga we-triglyceride
- Ukubhema
- Indlela yokuphila yama-sedentary
- Ukucindezeleka ngokomzwelo ( Ukucindezeleka kwengqondo, eyaziwa nangokuthi "i-heart syndrome ephukile ," manje kucatshangwa ukuthi ibangelwa uhlobo olunzima futhi olubi lokungasebenzi okuphelile.)
- Izifo
- Ukuhluleka kwenhliziyo
- I-Hypothyroidism
- I-osteoporosis
- Ukuguga
- I-Chemotherapy ne-radiation therapy
- Amathonya we-genetic
Ukuxilongwa
Ukuthola ukuhlolwa ngokusemthethweni kokukhubazeka kokuphela kwesikhathi akudingekile. Ezinye izidakamizwa zokuphela komzimba zingase zibhekwe ngokuphepha kunoma ubani one-CAD, umfutho wegazi ophezulu, noma izinkinga eziyinhloko ezingozini zesifo senhliziyo (ikakhulukazi lezo ezibalwe ngenhla).
Ngakho empeleni kulinganisa umsebenzi wokuphela kwesiguli akuyona into odokotela abayenzayo njalo. Kodwa uma ukuphelelwa yisifo sokuphela komzimba kungasolwa kumuntu ongenakho izizathu ezicacile (njengomuntu ocatshangwa ukuthi une-syndrome ye-x syndrome), ukuxilongwa kungaqinisekiswa yizivivinyo ezilinganisa ikhono lemithambo yegazi ukuze lihlanza futhi / noma likhawuleze ekuphenduleni ukuphathwa kwezidakamizwa.
Ukwelapha
Umsebenzi we-endothelial ungathuthukiswa yizinyathelo zokuphila ezivame ukuba sonke sikwazi ukunciphisa ingozi yesifo senhliziyo, kuhlanganise ukulahlekelwa isisindo, ukuvivinya umzimba, ukuyeka ukubhema, ukulawula ukucindezeleka komfutho wegazi nokulawula isifo sikashukela.
Ezinye zalezi zinyathelo zokulawula ingozi ziye zabhalwa kahle ukuze kuncishiswe ukukhubazeka kokuphela kwesikhathi. Lokhu kufaka:
- Ukusetshenziswa kwesidakamizwa se-statin
- Aspirin
- Ukudla kwaseMedithera
- Ezinye izinyathelo zokudla zihlanganisa amantongomane, amafutha omnqumo, ushokoledi omnyama, itiye elihlaza, ukudla okutshala izimila.
- Ukuzivocavoca kwama-aerobic
- Ukulahlekelwa kwesisindo
Ngaphezu kwalokho, imithi eminingi ihlolisiswa ngokukhethekile ukuze ibone ukuthi ingayithuthukisa yini ukuphela kokusebenza okungasebenzi ekusebenzeni ngendlela emtholampilo. Ezinye ze-agents ezibonakala zibonisa izithembiso zifaka i- nifedipine , ezinye ze- ACE inhibitors , i-estrogen, i- ranolazine , ne- sildenafil .
Izwi elivela
Eminyakeni yamuva abacwaningi bezokwelapha baye bathola ukukhubazeka okungapheli njengento ebalulekile efaka izinkinga ezinhlobonhlobo zezinkinga zenhliziyo. Nakuba ucwaningo olusebenzayo luqhutshwa ukuthola izindlela zokuthuthukisa umsebenzi wokugcina, ngakho-ke ukunciphisa ingozi yesifo senhliziyo, sekukhona okuningi esingakwenza ngakho. Ngokuyinhloko, kufanele siqiniseke ukuthi sisebenzise okuningi, siyeke ukubhema, futhi siqiniseke ukuthi sisebenza nodokotela bethu ukuphatha umfutho wegazi ophezulu noma isifo sikashukela, uma sinemibandela.
> Imithombo:
> Crea F, i-Camici PG, i-Bairey Merz CN. Ukukhubazeka Kwe-Microoncular Micro Corneary: i-Update. I-Eur Heart J 2014; 35: 1101.
> Greenland P, i-Alpert JS, i-Beller GA, et al. Umhlahlandlela we-ACCF / AHA we-AHA Wokuhlola Ingozi Yezinhliziyo Emphakathini Abadala: Umbiko we-American College of Cardiology Foundation / American Heart Association Task Force on Guidelines Practice. J Am Coll Cardiol 2010; 56: e50.