Atherosclerosis: nā kumu, nā hōʻailona a me nā mea e pono ai ʻoe e ʻike

Lohe pinepine mākou a pau i nā mea e like me ke 'kolesterol kiʻekiʻe' a me nā 'kīʻaha koko i ālai ʻia'. Akā, ua noʻonoʻo paha ʻoe pehea e hana maoli ai kēia i loko o ko mākou kino? Ua like ko mākou mau kīʻaha koko me nā alanui i loko o ko mākou kino no ke kahe ʻana o ke koko. Lawe kēia mau alanui i ke koko maʻemaʻe a waiwai i ka oxygen mai ko mākou puʻuwai a i nā ʻōpū ma o ko mākou kino. E noʻonoʻo, he aha ka mea e hana ʻia inā e paʻa mālie kēia mau alanui i ka momona a me nā ʻōpala? ʻO ia ka mea a mākou e kapa nei he atherosclerosis i ka lāʻau lapaʻau.

I ka ʻōlelo maʻalahi, he aha ka atherosclerosis?

ʻO Atherosclerosis ka hōʻiliʻili mālie ʻana o ka momona, ka cholesterol, ka calcium, a me nā mea ʻē aʻe i loko o nā paia o ko kākou mau kīʻaha koko (ʻoi aku hoʻi nā aʻa) e hana i kahi 'plaque' . Ua kapa ʻia kēia ʻo 'atheroma' ma nā ʻōlelo lapaʻau. I ka ulu mālie ʻana o kēia plaque, mānoanoa a paʻakikī ka paia o ke kīʻaha koko. Kāhea mākou i kēia "paʻakikī o nā kīʻaha koko" a i ʻole "paʻakikī o nā kīʻaha koko".

ʻO ka mea weliweli e pili ana i kēia, ʻo ia ka hana mālie loa o kēia kaʻina hana, me ka ʻole o nā hōʻailona i nā pae mua. ʻAʻole paha ʻoe e ʻike i kekahi loli no nā makahiki. Akā i ka hala ʻana o ka manawa, ulu kēia palaki a hoʻohaiki i ka lumen (ka hakahaka e kahe ai ke koko) i loko o ke kīʻaha koko.

E noʻonoʻo i kahi alanui ʻehā alahele e hoʻemi ʻia i hoʻokahi alahele ma muli o ke kaʻa nui. Ua emi nui ke kahe ʻana o ke koko. ʻO ke ʻano kēia, ua nele ko kākou mau kino i ka oxygen a me nā meaʻai e pono ai. ʻO ka mea ʻoi aku ka weliweli, hiki i kēia kīʻaha koko ke haki koke ma muli o ke kahe koko wikiwiki. Ke hana ʻia kēlā, hana ko kākou kino i kahi ʻūpā koko e ho'ōla i ka ʻeha.

He aha ka mea e hana ʻia ke ālai ʻia ke kahe koko ma kēia ʻano? Aia ia i kahi e hana ʻia ai ke koko. No ka laʻana, inā hana ia i loko o kahi aʻa coronary e hoʻolako ana i ke koko i ka puʻuwai, ʻaʻole e loaʻa i ka puʻuwai ka oxygen lawa, e hana ana i ka hōʻeha puʻuwai .

Pehea ka maʻamau o kēia ʻano?

He maʻi maʻamau loa ka Atherosclerosis. ʻO nā pilikia i hoʻokumu ʻia e ka hōʻiliʻili ʻana o ka momona i loko o nā aʻa, e like me nā hōʻeha puʻuwai a me nā hahau, ke kumu nui o ka make ma ka honua holoʻokoʻa. Hōʻike nā noiʻi he nui ka poʻe waena o ka makahiki i loaʻa i ke ʻano, akā ʻo ka hapalua o lākou ʻaʻole ʻike.

He aha nā hōʻailona o kēia?

E like me kā mākou i ʻōlelo ai ma mua, ʻaʻohe hōʻailona i nā pae mua. Hoʻomaka ka ʻike ʻia ʻana o nā hōʻailona ke ālai ʻia kahi kīʻaha koko ma mua o 70%. ʻIke wale ka hapa nui o ka poʻe i kēia maʻi ma hope o kahi pilikia, e like me ka hōʻeha puʻuwai a i ʻole ka hahau ʻana.

Ma muli o kahi i ālai ʻia ai ke kīʻaha koko, hiki ke ʻike ʻia nā hōʻailona ma nā ʻāpana like ʻole o ke kino.

No ke aha e paʻa ai nā kīʻaha koko penei? He aha nā kumu?

Manaʻo nā kānaka ʻepekema aia kekahi mau kumu nui o ka atherosclerosis.

• Hoʻonui ʻia ka nui o ka cholesterol maikaʻi ʻole (LDL) a me nā triglycerides.
• Ka hoʻohana ʻana i nā huahana paka (puhipaka).
• Ke koko kiʻekiʻe.
• Ka maʻi diabetes.

Hiki i kēia mau mea ke hōʻino i ka uhi palupalu i loko o ko kākou mau kīʻaha koko (endothelium). ʻO kēia pōʻino ka mea e hoʻomaka ai ke kaʻina hana o ka atherosclerosis. ʻAʻole hiki mai kēia pōʻino i ka pō hoʻokahi, akā i loko o kahi manawa lōʻihi loa.

E nānā pono kākou i nā ʻanuʻu o kēia kaʻina hana.

He hana kēia i hana ʻia no nā makahiki. Eia nā ʻanuʻu nui.

1. Ka pōʻino o ka endothelial: Hiki i nā mea e like me ke kolamu kiʻekiʻe, nā mea ʻawahia i loko o nā cigarette, a me ke koko kiʻekiʻe ke hōʻino i ka uhi o loko o nā kīʻaha koko. Ke hana ʻia kēia pōʻino, huki ʻia nā hunaola koko keʻokeʻo i ka wahi. Hōʻiliʻili kēia mau hunaola a hoʻoulu i ka mumū i loko o ke kīʻaha koko.

2. Ka hoʻokumu ʻana o nā kaha momona: ʻO kēia ka hōʻailona mua i ʻike ʻia o ka atherosclerosis. Hoʻāʻo nā hunaola koko keʻokeʻo i hōʻea i kahi i hōʻino ʻia e wehe i nā ʻāpana cholesterol ma ka ʻai ʻana iā lākou. Ua kapa ʻia kēia mau hunaola i piha i ka cholesterol ʻo 'nā hunaola foam'. Ke make lākou, waiho lākou i kahi kaha melemele a i ʻole kahi kiko ma ka paia o ke kīʻaha koko.

3. Ka hoʻonui ʻia ʻana o ka pāpaʻi:I ka hoʻomau ʻana o ka hōʻiliʻili ʻana o nā ʻāpana make a me nā ʻōpala ʻē aʻe, ulu mālie ka puʻupuʻu momona liʻiliʻi i loko o kahi palaki nui. A laila, hana ʻia kahi pāpale fibrous o nā ʻiʻo laumania a puni kēia palaki. Pale kēia i nā ʻāpana o ka palaki mai ka haki ʻana a me ka hōʻuluʻulu ʻana i loko o ke koko. I ka ulu nui ʻana o kēia palaki, e emi ana ka hakahaka no ke kahe ʻana o ke koko.

4. Ka haki ʻana o ka palaki: ʻO kēia ka hihia weliweli loa. Hiki i ka palaki e hoʻopuni ana i ka palaki ke pohā koke. Ke hana ʻia kēia, hana ʻia kahi ʻūpā koko ma ia wahi. Hoʻopaʻa loa kēia ʻūpā koko i ke kīʻaha koko, e hoʻōki ana i ke kahe ʻana o ke koko. ʻO kēia ke kumu o ka hōʻeha puʻuwai a i ʻole ka hahau.

He aha nā kumu pilikia no kēia?

Nui nā kumu pilikia e kōkua i ka ulu ʻana o ka atherosclerosis. Hiki iā mākou ke hoʻololi i kekahi o kēia mau mea, akā ʻo kekahi, e like me ka makahiki, ʻaʻole hiki iā mākou.

He aha nā pilikia e hiki ke hoʻopilikia i ka atherosclerosis?

ʻO ka hoʻopilikia ʻana o ke kahe koko ke alakaʻi i kekahi mau pilikia koʻikoʻi. ʻO nā mea nui:

• Maʻi ʻaʻa coronary
• Maʻi hohola
• Nā ʻano puʻuwai maʻamau ʻole (Arrhythmia)
• Ka hāʻule ʻana o ka puʻuwai
• Hahau
• Hoʻouka ischemic kuikilana (TIA)
• ʻO ka maʻi aʻa peripheral
• Maʻi puʻupaʻa mau loa (CKD)
• Ka hoʻonāwaliwali ʻana o nā kīʻaha koko, e hoʻoulu ai iā lākou e puʻupuʻu (aneurysms) a pahū.

Pehea e ʻike ai i kēia maʻi?

E hahai ana kāu kauka i kekahi mau ʻanuʻu e ʻike ai i kēia kūlana a i ʻole e helu i kou pilikia no ia.

1. He hoʻokolokolo kino piha: Pili kēia i ka hoʻohana ʻana i kahi stethoscope e hoʻolohe i kou puʻuwai a me ke kani o ke koko e kahe ana ma o kou mau kīʻaha koko. No ka laʻana, inā lohe ʻoe i kahi kani "whooshing" ("bruit") i ka wā e hoʻolohe ana i nā aʻa carotid ma kou ʻāʻī, he hōʻailona paha ia o kahi ʻūlū koko i loko o ke aʻa.

2. Ke nīnau nei e pili ana i kou mōʻaukala olakino a me ka mōʻaukala ʻohana: Hiki i kēia ʻike ke kōkua i ka loiloi ʻana i kou pilikia.

3. Ke nīnau nei e pili ana i kou nohona: Ke nīnau nei e pili ana i nā mea e like me ka puhipaka ʻana a me ke ʻano o kāu ʻai.

4. Ke kauoha ʻana i nā hoʻāʻo koko: Hiki i kēia ke haʻi iā ʻoe i nā mea he nui e pili ana i kāu mau pae cholesterol, nā pae kō, a me ka hana o ka puʻuwai.

Nā hoʻāʻo e hōʻoia i ke kūlana

I kekahi manawa, pono nā hoʻokolohua hou aʻe e hōʻoia i ka hōʻailona a hoʻolālā i ka lāʻau lapaʻau.

• Angiography: He hoʻāʻo e hoʻohana ana i nā kukuna X-ray kūikawā a me ka dye e ʻike pono i kahi a me ka nui o nā kīʻaha koko i ālai ʻia.
• ECG (Electrocardiogram): Ana i ka hana uila, ka wikiwiki, a me ke kuʻina o ka puʻuwai.
• Echocardiogram: Lawe i nā kiʻi o nā valves a me nā keʻena o ka puʻuwai e ʻike ai i ke ʻano o ka puʻuwai e pamu ana i ke koko.
• Hoʻāʻo koʻikoʻi hoʻoikaika kino: Ana ʻia kou helu puʻuwai i kou wā e hoʻoikaika kino ai (e hele ana ma luna o ka treadmill).
• ʻO ke Kiʻi Ultrasound: Hoʻohana ʻia kēia hoʻāʻo e nānā i ka mānoanoa o nā kīʻaha koko i ka ʻāʻī (Carotid ultrasound) a i ʻole ka ʻōpū (Abdominal ultrasound) a inā he mau waihona momona ko lākou.
• CT scan: Lawe kēia scan i nā kiʻi o loko o ke kino a hiki ke ʻike i ka mānoanoa a me ka hoʻohaiki ʻana o nā kīʻaha koko nui.

Pehea e mālama ʻia ai?

ʻO ka mālama ʻana no ka atherosclerosis e komo pū me nā hoʻololi ʻana i ke ʻano o ka nohona, nā lāʻau lapaʻau, a, inā pono, ke ʻoki kino a i ʻole nā ​​​​lāʻau lapaʻau ʻē aʻe. E hoʻomohala kāu kauka i kahi hoʻolālā lapaʻau e kūpono loa iā ʻoe.

1. Nā loli o ke ʻano o ka nohona

ʻO kēia nā mea nui loa. Hiki i kēia mau hoʻololi ke hōʻemi nui i ka pilikia o nā pilikia.

• E hōʻalo i nā huahana paka a pau. Inā ʻoe e puhipaka, e haʻalele koke.
• E ʻai i ka ʻai olakino no ka puʻuwai. ʻOi aku ka maikaʻi o ka ʻai ʻana i ka ʻai Mediterranean e komo pū ana me ka nui o nā mea kanu, nā huaʻai, nā legumes, nā iʻa, a me nā momona olakino e like me ka ʻaila ʻoliva, a emi iho ka ʻiʻo ʻulaʻula a me nā meaʻai i hana ʻia.
• E hoʻoikaika kino i kēlā me kēia lā. E hoʻomaka me nā hele wāwae pōkole a hoʻoikaika kino a hiki i ka hoʻoikaika kino no 30 mau minuke ma ka liʻiliʻi i ka lā, i ka hapa nui o nā lā o ka pule.

2. Nā lāʻau lapaʻau (nā ʻano lāʻau lapaʻau)

Hiki i nā lāʻau lapaʻau ke kōkua i ka kaohi ʻana i nā kumu pilikia no ka hōʻiliʻili ʻana o ka momona. Hiki i kāu kauka ke ʻōlelo aku:

• Nā lāʻau hoʻohaʻahaʻa cholesterol (e.g., statins).
• Lāʻau hoʻohaʻahaʻa koko.
• Nā lāʻau lapaʻau e kaohi ai i nā pae kō koko.
• Hiki ke kuhikuhi ʻia nā lāʻau lapaʻau e pale ai i ke kāpili ʻana o ke koko (e like me ka aspirin).

3. Nā ʻano lapaʻau a me nā ʻoki kino

Inā paʻa loa nā kīʻaha koko a i ʻole kiʻekiʻe ka pilikia o nā pilikia, pono paha ʻoe e hoʻohana i kēia ʻano lāʻau.

• ʻO ke kau ʻana o Angioplasty a me Stent: He kaʻina hana e hoʻokomo ʻia ai kahi pōpō liʻiliʻi i loko o kahi kīʻaha koko i paʻa, e hoʻopiha ʻia e hoʻonui i ka kīʻaha, a ua hoʻokomo ʻia kahi ʻōmole liʻiliʻi e like me ka ʻupena (stent) e pale aku ai i ka pani hou ʻana.
• ʻO ke kāpili ʻana o ke ala koko coronary (CABG): He kaʻina hana e kāpae i kahi kīʻaha koko i paʻa a hana i kīʻaha koko hou me ka hoʻohana ʻana i kahi ʻāpana koko i lawe ʻia mai kahi ʻāpana ʻē aʻe o ke kino.

He aha kāu e hana ai?

Mai hopohopo inā ʻike ʻoe he maʻi kou. ʻO ka mea nui loa, ʻo ia ke hana pū me kāu kauka.

• E hele i nā keʻena lapaʻau i ka manawa i hoʻonohonoho ʻia e like me kāna e ʻōlelo ai iā ʻoe.
• E nānā pinepine i kou koko, ka cholesterol, a me ke kōpaʻa a mālama iā lākou i kaohi.
• Inā ʻike ʻia kekahi mau hōʻailona hou a i ʻole e loli nā hōʻailona e kū nei, e haʻi koke aku i kāu kauka.
• E mālama pono hoʻi i kou olakino noʻonoʻo. He mea maʻamau ka hopohopo a me ka makaʻu i ka wā e noho ana me kahi maʻi e like me kēia. E kamaʻilio me kou ʻohana, nā hoaaloha, a i ʻole ke kākāʻōlelo e pili ana i ia mea inā pono.

Āhea ʻoe e hele ai i ka Emergency Treatment Unit (ETU)?

Inā ʻike ʻoe a i ʻole kekahi mea kokoke iā ʻoe i nā hōʻailona o ka hōʻeha puʻuwai (ʻeha nui o ka umauma, paʻakikī ka hanu ʻana, ʻeha e pālahalaha ana ma ka lima hema) a i ʻole ka hahau ʻana (kūlou ana ma kekahi ʻaoʻao o ka maka, paʻakikī ke ʻōlelo, nalowale ka ʻike ma kekahi ʻaoʻao o ke kino) , e kāhea koke i ka 1990 no kahi kaʻa kaʻa a i ʻole e hele i ka haukapila kokoke loa ʻo Emergency Department (ETU). He mau pilikia kēia e pono ai ka mālama koke ʻia.