Kana iwe uchive uchiita chero kuverenga pamusoro pehutano hwepfungwa munguva pfupi, kana uine hurukuro ichangopfuura nachiremba wako nezvekudzivirira kana kurapa chirwere chemwoyo, ungangodaro wakatarisana neshoko rokuti "endothelial dysfunction." Pfungwa yekusagadzikana kwekusagadziriswa yakave yakakosha mumakore achangopfuura kunzwisiswa kwehupenyu hwehutano hwakawanda, kusanganisira coronary artery disease (CAD) , hypertension , microvascular angina ( chirwere chemwoyo x ), diastolic dysfunction , nezvimwe.
Endothelial kusagadzikana ndeyemamiriro ezvinhu umo endothelial layer (mukati mechidzitiro) yemidhiyo miduku inokundikana kuita zvakanaka. Somugumisiro, zvinhu zvakawanda zvakashata zvinogona kuitika kumatumbu anopiwa nemariti aya.
Basa reHedothelial Layer
Mu arterioles mumuviri (midzi miduku inonyatsotarisa kubuda kweropa kune mishonga), endothelium inopinza mukati memasero ane mabasa akawanda anokosha.
Iyo endothelium inochengetedza kukodzera kwakakwana uye kusimba kwemidziyo yeropa. Iri basa rinotarisa pane imwe nguva-kusvika-nguva inoratidza kuti ropa rakadini rinogamuchirwa nematunhu akasiyana-siyana emuviri. Endothelial "tone" inonyanya kusarudza kumanikidzwa kweropa romunhu, uye basa rakawanda sei mwoyo unofanirwa kuita mukupwanya ropa kunze kwomuviri.
Iyo endothelium inodzivirirawo maviri kubva pane zvakasiyana-siyana zvakashata; rinodzora ropa rinogadzirisa maitiro; rinodzora maridhi, electrolytes, uye zvimwe zvinhu zvakawanda zvinopfuurira mberi nepakati pakati peropa nemishu; uye inodzora kuvhiringidza mumatumbu.
Izvo zvose izvi zvinoreva kuti kushanda kwakakodzera kwe endothelium kwakakosha nokuda kwechimiro chechimiro chemuviri wemuviri uye nhengo.
Kana endothelial kusagadzikana kuripo, kukwanisa kuita chimwe kana zvimwe zvezvinhu izvi zvinokosha zvinoshandiswa.
Zvinokonzera Kusakosha
Nemhaka yokuti endothelium yakakosha zvikuru kune mamwe mabasa anokosha, zvizhinji zvekutsvakurudza zviri kuitwa kuitira kunzwisisa zvose zvinokonzera kuguma kwekusagadzikana.
Panguva ino zvinoratidzika kuti endothelial kusagadzikana kwakabatana nekuderedza kwemazinga e nitric oxide (NO) muropa remadziro masvingo.
HERE gasi inokonzerwa ne metabolism ye amino acid (L-arginine). HUNI, iyo ine hafu yehupenyu hutapfupi, inoshanda munharaunda mukati memidziyo yeropa kuti ibatsire kutarisa mhedziso nemamwe mabasa anokosha ekupedzisira. Kushayikwa muHOKO kwekugadzira kunoita kuti kuvharidzirwa kwemidziyo yeropa (iyo inogona kukonzera kuwedzera kwehutachiona), kunobatsira kushandiswa kweplatelet (inoita kuti ropa rivhare), kunowedzera kukurudzira kwekuvhiringidza muropa masvingo, uye kunowedzera kukwana kwemadziro emadziro kunokanganisa lipoproteins uye zvakasiyana-siyana zveupisi.
Kutaura muchidimbu, endothelial kusagadzikana kunoonekwa nekuderedza mishonga yakasara NO maitiro, ayo, ayo, anotungamirira kune zvakasiyana-siyana zvisina kumira muropa remutambo basa. Izvi zvisingaiti zvinoshanda zvinowedzera kukurudzira kubwinya kwaMwari . Mukuwedzera, endothelial kusagadzikana kunogona kukonzera zvakananga kusagadzikana kwemaitiro mashoma, uye inofungidzirwa kuti inonyanya kukosha kubudisa chirwere chemwoyo x uye zvinogona, diastolic kusagadzikana.
Kushamwaridzana Kushamwaridzana Nemitemo
Nzira dzakarurama dzinoshandiswa nomunhu kuti ave nekuguma kwekusagadzikana achiri kushandiswa.
Zvisinei, zvinoratidzika zvakajeka kuti zvirwere zvakawanda zvehutano, tsika, uye zviitiko zvisingaitiki zvehupenyu zvinogona kuita kuti, kusanganisira:
- Hypertension
- Chirwere cheshuga
- Yakakura LDL cholesterol uye triglyceride mazinga
- Kusvuta
- Sedentary lifestyle
- Kushungurudzika mupfungwa (Kushungurudzika kwepfungwa, chirwere chinonzi "broken heart syndrome ," zvino chinofungidzirwa kuti chinokonzerwa nechirwere chakaoma uye chakakomba chekusagadzikana kusagadzikana.)
- Zvirwere
- Heart failure
- Hypothyroidism
- Osteoporosis
- Kukwegura
- Chemotherapy uye therapy rayation
- Genetic influences
Kuziva
Kuita chirongwa chekugadziriswa kwekusagadzikana kwekusagadzikana hakuwanzodi. Zvimwe zviyero zvekusagadzikana kwekupedzisira zvinogona kunyatsochengetedzwa kune ani zvake ane CAD, hypertension, kana kuti zvipingamupinyi zvinokonzera chirwere chemwoyo (kunyanya izvo zvakanyorwa pamusoro apa).
Saka kunyanya kuongorora kuguma kwemagariro hakusi chimwe chinhu chinowanzoitwa navanachiremba. Asi kana kugadziriswa kwekusagadzikana kunofungidzirwa mumunhu asina zvikonzero zvakajeka (zvakadai somunhu anofungidzirwa kuva nemararamiro epfungwa x), kuongororwa kunogona kusimbiswa neongororo dzinoyera kukwanisa kwemidziyo yeropa kuwedzera uye / kana kudzivirira mukupindura kumishonga yekushandisa zvinodhaka.
Mishonga
Endothelial basa rinogona kuvandudzwa nemararamiro emararamiro ayo anowanzokurudzirwa tose kuti tiwedzere ngozi yedu yehutano hwehutano, kusanganisira kuora kurasikirwa, kurovedza muviri, kusvuta kusvuta, kuvhara kwehutano hwehutachiona, nekudzivirira chirwere cheshuga.
Zvimwe zvezviitiko izvi zvekuchengetedza njodzi zvakanyatsorongedzerwa kuti kuderedze endothelial kusagadzikana. Izvi zvinosanganisira:
- Kushandiswa kwechirwere chemutemo
- Aspirin
- Zvokudya zveMediterranean
- Zvimwe zviratidzo zvekudya zvinosanganisira makungu, mafuta omuorivhi, chocolate yakasvibirira, green tea, miti-yakagadzirwa zvokudya.
- Aerobic exercise
- Kuonda
Mukuwedzera, mishonga yakawanda iri kuongororwa zvakananga kuti ione kana inogona kugadzirisa endothelial kusagadzikana nenzira inoratidzika. Vamwe vevashandi vanoita sevari kuratidza vimbiso vanosanganisira nifedipine , vamwe ACE inhibitors , estrogen, ranolazine , uye sildenafil .
Shoko Rinobva
Mumakore achangopfuura vaongorori vezvokurapa vakaona kusagadzikana kwekusagadzikana sechinhu chinokosha chinoita kuti zvive nemhando dzakawanda dzematambudziko emwoyo. Kunyange zvazvo kutsvakurudza kushingaira kuchiitwa kuti uwane nzira dzekuvandudza endothelial basa, uye naizvozvo kuderedza dambudziko rehutano hwehutano, pane zvakawanda zvatingaita pamusoro payo. Kunyanya, tinofanira kuve nechokwadi chekuita zvekurovedza muviri, kurega kusvuta, uye tive nechokwadi chekuti tinoshanda nevarapi vedu kugadzirisa dambudziko redu rehutachiona kana chirwere cheshuga, kana tine mamiriro aya.
> Sources:
> Crea F, Camici PG, Bairey Merz CN. Coronary Microvascular Dysfunction: a Update. Eur Moyo J 2014; 35: 1101.
> Greenland P, Alpert JS, Beller GA, et al. 2010 ACCF / AHA Mutungamiri weKutsvaga kweMwoyo Mungozi muAymptomatic Adults: Bhuku reAmerican College of Cardiology Foundation / American Heart Association Task Force pamusoro pekushandisa mazano. J Am Coll Cardiol 2010; 56: e50.