CHD kurapwa: zvinodhaka. Nechirwere chemwoyo - kurapwa, mishonga uye zviratidzo

Nechirwere chemwoyo - a pathological mamiriro kunokonzerwa kwokushayiwa nerubatsiro pomwoyo nokuda aienda pamusoro lumen ari coronary tsinga kana spasm. It inobatanidza pasi dzinoverengeka diagnoses, akadai angina pectoris, myocardial infarction, cardio, kungoerekana cardiac rufu uye nevamwe.

Nhasi ndiro chirwere rakajairika munyika yaro muboka, uye pokutanga kutanga pakati zvinokonzera rufu uye vakaremara mune zvose dzakabudirira.

predisposing zvinhu

Nhasi wakasuduruka nzira dzekuziva dzatinogona kufanotaura kukura chirwere. Nechirwere chemwoyo hakusi kurwadziwa. Hapana chete mazita uye kupatsanura zvinhu njodzi, dzikarongwa maererano zvimwe unhu kuti pave chirwere ichi.

1. zvoutachiona:
   - zera makore 50;
   - chechikadzi - zvikuru nevakawanda nevanhu;
   - nemagene kubatwa kuti chirwere dismetabolic.
2. anatomi:
   - cheBP;
   - kufutisa;
   - kuvapo chirwere cheshuga.
3. Lifestyle:
   - kutyora zvokudya;
   - kusvuta;
   - nokusarovedza muviri kana kunyanya muviri;
   - kushandisa doro.

Kukura chirwere

Pathogenetic zvinokonzera chirwere angava zvose extra- uye intravascular nematambudziko, akadai aienda pamusoro coronary arteries nokuda atherosclerosis, thrombosis kana spasm, kana BP yakakwirira tachycardia. Kunyange zvakadaro, pakutanga, pamusana chomwoyo vanofanira atherosclerosis. Pakutanga, mumwe munhu nezvechinhu chimwe metabolic nyonganyonga, izvo zvinoratidzwa anosimbirira zvibereko lipids muropa.

Danho iri kugadzira lipid zvivako zviri mudziyo masvingo uye propotevanie navo muzvitokisi endothelial. Kuvakwa atherosclerotic plaques. Ivo kuparadza rusvingo midziyo ropa, zvichiita zvikuru kusimba. In mamiriro ichi kunogona kuva zvaitika vaviri - angava Dombo kubva clot uye kuzadza vakakwira tsinga ropa aibuda kana mudziyo dhayamita zvokuti diki kuti ropa haagoni kutenderedza uye kufudza nzvimbo yakajeka. Panguva ino, zvakanga wakaumba ischemic pachoto, uye ipapo necrosis. Kana wose muitiro kunoitika mumoyo, hosha inonzi coronary tsinga chirwere.

Kune akawanda zvekuchipatara siyana uye avo kubata CHD. Formulations vanosarudzwa nokuda munhu pathophysiological zvinoriumba.

Sudden cardiac rufu

Zvikasadaro aizivikanwa cardiac kusungwa. Inogona kuva zvaitika zviviri: Mumwe anofa anopinda yevanenge kana. Rinobatanidzwa kungoerekana myocardial kusagadzikana. Zvinonzi chirwere - zvagara kana pasina chikonzero kufungidzira imwe mhando CHD. Treatment, zvinodhaka kusarudza kuti utano nenyanzvi kuramba zvakafanana mune yevanenge. Chimwe ezvinhu - rufu ikaitika pakarepo uye pamberi pezvapupu, kana mukati maawa kutanga chomwoyo matanhatu. Zvikasadaro, yatova pasi yakasiyana kupatsanura.

angina

Uyu ndiwo mumwe siyana coronary tsinga chirwere. Rinewo yayo okuwedzera kupatsanura. saka:

1. Yakagadzikana angina.
2. Vasospastic angina.
3. Kusagadzikana angina, izvo zvinozoita rakakamurwa:
   - budiriro;
   - kutanga yakabuda;
   - mangwanani postinfarction.
4. Angina Printsmetalla.

Rakajairika ndiyo mhando wokutanga. Heart Association refu yakatanga pakurapa nechirwere chemwoyo angina. Mishonga inofanira kutorwa kugara uye kwenguva yakareba, dzimwe nguva muupenyu. Kana ukatevera kunenge, zvinokwanisika kuti vamwe nguva kure utano zvinovapandukira.

myocardial infarction

Chiripo kufungisisa mashoko ari unonzi, electrocardiograph, rabhoritari uye nhoroondo zvokurapa zviratidzo. The kupfuura mashoko pamusoro makemikari idzi kuwedzera sezvo LDH (lactate dehydrogenase), alt (alanine aminotransferase) uye ACAT (aspartate aminotransferase), ayo anowanzoita akanyudzwa mukati muchitokisi uye kuoneka muropa chete panguva kuparadzwa kwayo.

Mwoyo kurwisa - ichi ndechimwe ndechekuti, izvo zvinogona kukonzera kusingadzoreki ischemic mwoyo chirwere. Treatment, mishonga, care - zvose izvo zvinogona kunonoka, pashure kusachengeteka kukuru kurwisa zvishoma kwazvo nguva inopedzwa pariri kudzorera kukuvadza.

Diagnostics

Chokwadi, chero Ongororo chinotanga kuongorora uye kuongorora. Unganidza date kare. Chiremba kufarira zvichemo muchipfuva marwadzo pashure muviri, kuvapo dyspnea, kurukutika, utera, palpitations sei zvakadaro. Zvinokosha kucherechedza manheru kuzvimba, inodziya kuti ikabatwa. Zvino, sezvo ari nokurapa CHD. Kugadzirira zvakawanda kuudza chiremba. Somuenzaniso, "nitroglycerin". Kana kunobatsira kuderedza akangokudenha, zvinonzi dzinenge nguva dzose anotaura nyasha angina.

Kuongorora Mumuviri zvinosanganisira nokuyerwa kumanikidzwa, respiratoria uye kupomba, uye kuteerera mwoyo nemapapu. Chiremba anoedza kunzwa kanganisika ruzha, wakawedzera mwoyo pasi, uyewo wheezing uye matema mumapapu, izvo zvaizoita kutaura mira kwendangariro.

Zvadaro, chiremba anotumira murwere kuti murabhoritari uye kuongorora chaiko. On pachisara isu kare, uye kudzidza Zvinonyanyozivikanwa ari ECG, echocardiography uye Ultrasound mwoyo.

mabatiro

Saka takaenda chaizvo core. Tiri kuziva pakurapa coronary tsinga chirwere. Drugs kutamba aitungamirira basa mariri, asi kwete chete vanoita kuti pave kuvandudzika utano. Chekutanga zvose zvakafanira kutsanangurira murwere kuti aizofanira kuchinja zvachose mararamiro avo. Bvisa kunyanya muviri yokufudza hope uye nokuzorora uye yakanaka kudya kunovaka. Diet vanofanira kubhadhara vainyatsotarisirwa. Zvinofanira zvine zvakafanira kuti mwoyo potassium, calcium yavaibvisa, asi muganhu yaunodya munyu, mvura, mishonga ane zvakawandisa kwemafuta mhuka uye makabhohaidhiretsi. Kana munhu kufuta, zvinokosha kuita kururamiswa yayo.

Asi vamwe pane kuti pharmacological nzira kunge vakava kubvisa dambudziko iri sezvo nechirwere chemwoyo. Treatment - gadziriro muchimiro mapiritsi, capsules, Nezvakakuyiwa uye mhinduro. Zvakakodzera vakasarudzwa uye kugara kushandiswa, unogona kubudirira nemigumisiro yakanaka.

Antiplatelet yomuchipatara

zvinodhaka kuti kurapwa boka tsinga chirwere coronary vari rakakamurwa classifications akawanda, asi rakajairika - the mashandiro nezvaaiita. Her tichashandisa. zvinodhaka Antiplatelet kuvandudza ropa riyerere. Ivo sei coagulation uye anticoagulation gadziriro, vanoverengeka dissociating navo, uye nokudaro vawane liquefaction. Izvi zvinosanganisira "asipurini", "Clopidogrel", "Warfarin" uye vamwe. Kupa kuti, nguva dzose unofanira kuongorora mabasa ari INR (International normalized reshiyo), kunyenyeredza chimiro chomunhu ropa.

Beta-blockers

Ane zvainoita receptors vari pamasvingo midziyo ropa, kuderera kwemwoyo. Somugumisiro, unoparadza zvishoma okisijeni uye zvishoma vachida ropa, kuti kujekesa coronary arteries zvikuru nomufaro. Ichi chimwe chezvinhu zvakafanana zvinodhaka mu ischemic mwoyo chirwere. Treatment, dose kusarudzwa uye vakarondedzera zvinodhaka kuvimba nezvirango. Kune vanosarudza uye vasiri kusarudza Beta-blockers. Vamwe vavo anoshanda zvakawanda zvakanaka, apo vamwe - zvishoma makasimba, asi nemhedziso contraindication ndiyo kuvapo murwere nhoroondo Árbol asima kana zvimwe zvirwere obstructive zvemapapu. Pakati rakajairika zvinodhaka - "Biprolol", "whiskey", "Carvedilol".

statins

Doctors kupedza nesimba nokuda nokurapa CHD. Kugadzirira kuvandudzika, kukura nzira itsva, akaita tsvakurudzo vakapinda zvinokonzera chirwere. Rimwe itsva nzira izvi ndizvo zvainoita precipitating zvinhu, kureva dyslipidaemia kana kusaenzana ropa kwemafuta. Zvinonzi kwakaratidza kuti rutapudzo kuti remafuta akawandisa kunotungamirira nomumugwagwa kwaitora nguva paumbwe atherosclerosis. Uye ichi ndicho chikonzero chikuru nechirwere chemwoyo. Zviratidzo, kurapwa, zvinodhaka - izvi zvose kutoziva uye dzakabudirira, zvakakodzera chete kuti kukwanisa kushandisa mashoko aripo nokuda kubatsira murwere. Mienzaniso inoshanda mishonga anogona kuva "Lovastatin," "Atorvastatin", "Simvastatin" uye vamwe.

nitrates

Basa zvinodhaka izvi ndeimwe chirwere zvinhu zvinobatsira kuzosimbisa pamberi chirwere. Asi ivo zvakakodzera sechikamu chirongwa, izvo zvaisanganisira pakurapa coronary tsinga chirwere. Zvinodhaka uye gadziriro vakasarudzwa nokungwarira kugadziriswa dose, dosing maitikiro. Ivo sei tsandanyama kumeso ari mudziyo masvingo. Relaxing tsandanyama idzi awedzere dhayamita ari lumen, saka kuwedzera uwandu huri kuuya ropa. Rinobatsira kutapudza ischemia uye marwadzo kurwiswa. Asi, zvinosuruvarisa kuti nitrates haagoni kudzivirira kuva mwoyo kurwiswa pose mupfungwa, uye asingadi kuwedzera upenyu anotarisirwa, saka kushandisa zvinodhaka izvi inokurudzirwa chete panguva kurwiswa ( "Dinisorb", "Izoket"), uye pahwaro zvechigarire kusarudza chimwe chinhu .

anticoagulants

Kana, kunze angina mune murwere kune ngozi thrombotic zviitiko, akagadza zvinodhaka izvi nokuda nechirwere chemwoyo. Zviratidzo uye kugadzirira kurapwa kuvimba kana koshesa kana zvimwe kubatanidza pathological muitiro. Chimwe chezvinhu dzakakurumbira zvombo dzino ndechokuti "Heparin". It chinotarisirwa zvikuru chete dose kuti rikwanise myocardial infarction, uye ipapo mukati wandei mazuva rutsigiro dhigiri plasma. Zvakakodzera nokungwarira kuongorora ropa pakugwamba nguva.

diuretics

Kugadzirira pakurapa coronary tsinga chirwere havasi pathogenic chete asiwo symptomatic. Ivo zvazvinoita kubatana kwakadaro neBP. Kana isu kuwedzera uwandu emura kuti achaponesa muviri, zvinokwanisika kuti artificially kudzibatsira chaiko tsika, uye kubvisa ngozi reinfarction. Asi regai variitewo kutsanya, kuti arege kutsamwisa mumwe kuparara. Kune mhando dzakawanda zvinodhaka izvi, zvichienderana chikamu ripi loop pakati Henle (nephron chidimbu) kukanganiswa. A chiremba nomazvo achasarudza mishonga iyi ezvinhu. Mumwe usingabereki kuwedzera murwere ezvinhu. Stay utano!