Aia kekahi pilikia i loko o kou mau kīʻaha koko? E aʻo kākou e pili ana i ka Endothelial Dysfunction.

Ua noʻonoʻo paha ʻoe i ke koʻikoʻi o nā kīʻaha koko i loko o ko kākou kino? Ua like lākou me nā alanui liʻiliʻi e lawe ana i nā leka a me nā meaʻai ma o ko kākou kino. No laila he aha ka mea e hana ai inā he nāwaliwali i loko o ka uhi palupalu i loko o kēia mau alanui, i kapa ʻia ʻo endothelium? ʻO ia ka mea a mākou e kapa nei he "Endothelial Dysfunction". E kamaʻilio hou kākou e pili ana i kēia, ʻae?

He aha ka hana ʻino o ka Endothelial?

I ka ʻōlelo maʻalahi, ʻo ka Endothelial Dysfunction ka wā e hana pono ʻole ai ka papa lahilahi o nā cell i loko o kou mau kīʻaha koko i kapa ʻia ʻo endothelium . ʻO ka maʻamau, kōkua kēia mau cell endothelial i ka mālama ʻana i kou mau kīʻaha koko e wehe (dilated) i ka wā e pono ai. Akā i ka wā e hana ʻia ai kēia hana ʻino, hana ʻia ka mea ʻē aʻe. ʻO ia hoʻi, hoʻomaka nā kīʻaha koko e ʻūlū a wili.

E noʻonoʻo e like me ka paipu wai. Inā ʻaʻole kūpono ka uhi o loko, e paʻakikī ke kahe ʻana o ka wai, ʻeā? Pēlā nō ia. ʻO ke kumu nui o kēia kūlana, he kūlana i kapa ʻia ʻo "Vasospasm" e pili ana i nā aʻa coronary o ka puʻuwai. Ma kēia, ʻoiai ʻaʻohe mea i ālai ʻia i loko o kou mau aʻa coronary, lilo wale nā ​​aʻa i mea haiki. Eia kekahi, hoʻonui ka "Endothelial Dysfunction" i ka pilikia o ka "Atherosclerosis", ʻo ia hoʻi ka waiho ʻana o ka momona ma nā paia o nā aʻa a me ka hoʻohaiki ʻana i nā aʻa.

No laila he aha ke kuleana o kēia endothelium?

Ua uhi ʻia kēlā me kēia kīʻaha koko i loko o ko kākou kino (ʻo ia hoʻi nā aʻa koko, nā veins, nā capillaries) ma loko me kahi papa hoʻokahi o nā cell i kapa ʻia ʻo nā cell endothelial. Ua ʻike anei ʻoe, ʻo kēia endothelium kekahi o nā ʻōnaehana ʻōnaehana nui loa i loko o ko kākou kino!

Hoʻopuka nā pūnaewele endothelial i nā mea like ʻole. Hoʻomalu kēia mau mea i ka wehe ʻana a me ka pani ʻana o nā aʻa (ua kapa ʻia kēia ʻo "Vascular Tone"). ʻO kēia "Vascular Tone" ke hoʻoholo i ko mākou koko, a me ka paʻakikī o ka puʻuwai e pamu i ke koko.

ʻAʻole wale kēlā, akā hana kāu endothelium ponoʻī i nā hana koʻikoʻi ʻē aʻe he nui:

• Hoʻoponopono ia i nā wai a me nā electrolytes i loko o kou koko.
• Kōkua i ke kāpili ʻana o ke koko i ka wā e pono ai.
• Pale i nā mea ʻawahia mai ke komo ʻana i nā ʻiʻo.
• Hoʻoponopono i ka mumū i loko o nā ʻiʻo.

E noʻonoʻo wale i ka nui o ka hana a kēia papa liʻiliʻi o nā cell i loko o ko mākou kino!

Pehea ka maʻamau o kēia kūlana i kapa ʻia ʻo ka endothelial dysfunction?

No ka manawa lōʻihi, ua manaʻo nā loea lapaʻau he pale wale nō ka endothelium i loko o nā kīʻaha koko. Akā ua ʻike ʻia ma hope he ʻōnaehana koʻikoʻi nō hoʻi kēia. ʻO ia ka manawa i hiki ai ke ʻike ʻia kēia ʻano i kapa ʻia ʻo "Endothelial Dysfunction" he maʻi ʻokoʻa.

Ua loaʻa kēia mau mea i ʻike ʻia i ka hopena o nā makahiki 1990, ʻo ia hoʻi, ʻaʻole i ʻike ʻia ke ʻano no ka manawa lōʻihi. No laila, ʻaʻole hiki i nā loea ke ʻōlelo pololei i kona laha ʻana i waena o nā kānaka.

No ke aha e hana ʻia ai kēia hana ʻole o ka endothelial?

ʻO ke kumu nui o kēia kūlana, ʻaʻole lawa ka nui o ke kinoea i kapa ʻia ʻo Nitric Oxide (NO) i loko o nā paia o kou mau kīʻaha koko. ʻO ka mea kupaianaha, ua hana ʻia kēia nitric oxide e kou endothelium ponoʻī! He "(Vasodilator)" kēia nitric oxide, ʻo ia hoʻi, wehe ia i nā kīʻaha koko a ʻae i ke koko e kahe manuahi.

No laila, he aha ka mea e hana ai ke emi iho nā pae nitric oxide?

• ʻO nā kīʻaha koko e hāiki ana: Hiki i kēia ke alakaʻi i ke koko kiʻekiʻe.
• Loaʻa ka mumū i loko o nā paia o ke aʻa: Hiki i kēia ke alakaʻi i ka atherosclerosis, a i ʻole ka paʻakikī ʻana o nā aʻa.
• Hoʻonui ʻia ka hana ʻana o ka platelet: Hiki i kēia ke hana i nā ʻūpā koko.
• Lilo nā paia o nā kīʻaha koko i porous: Hōʻike kēia i nā ʻiʻo i nā lipoproteins ʻino a me nā mea ʻawahia ʻē aʻe.

He aha nā hōʻailona o ka hana ʻole o ka endothelial?

ʻO ka hōʻailona nui o ka maʻi artery coronary (endothelial dysfunction) ʻo ia ka angina , ʻo ia hoʻi ka ʻeha o ka umauma. Loaʻa kēia ʻeha o ka umauma no ka mea ke pani nei kou mau aʻa i ka wā e pono ai e wehe. ʻOi aku ka ʻino o kēia ʻeha o ka umauma i ka wā e hoʻoikaika kino ai.

Hiki i kekahi poʻe ke loaʻa i ka ʻeha mau o ka umauma (`Angina`) ʻoiai ʻaʻole lākou e hana ana i kekahi mea. Hiki i kēia ke lilo i hōʻailona o ka hōʻeha puʻuwai. Inā hana ʻia kēia, ʻo nā hōʻailona e komo pū me ka ʻeha mau o ka umauma, ka luhi nui, a me ka pōkole o ka hanu. He pilikia olakino kēia e pono ai ka mālama koke ʻia.

ʻO wai ka mea i pilikia nui no kēia? (Nā kumu pilikia)

Hiki i kekahi mau kumu ke hoʻonui i kou pilikia o ka hoʻomohala ʻana i ka Endothelial Dysfunction. ʻOi aku kou pilikia inā loaʻa iā ʻoe nā kūlana penei:

• ʻO ka maʻi diabetes (ʻO ka maʻi diabetes mellitus)
• Ke koko kiʻekiʻe (Hypertension)
• Ke kiʻekiʻe o ke kō koko ('Hyperglycemia')
• Kolesterol kiʻekiʻe
• ʻO ka maʻi metabolic
• Puhipaka
• Momona
• ʻO kekahi mau maʻi autoimmune

He aha nā kūlana ʻē aʻe e hiki ke hana ʻia e ka Endothelial Dysfunction?

Hoʻonui kēia kūlana (Endothelial Dysfunction) i ka pilikia o nā maʻi cardiovascular (Cardiovascular Diseases) a me nā maʻi ʻē aʻe he nui. Eia kekahi laʻana:

• ʻO Atherosclerosis a me ka maʻi ʻaʻai coronary
• Nā ʻūpā koko a me nā hahau
• Puʻuwai i hoʻonui ʻia (Hypertrophic Cardiomyopathy)
• Nā Hōʻeha Puʻuwai a me ka Holo ʻole o ka Puʻuwai
• Ke koko kiʻekiʻe (Hypertension)
• Ka hāʻule ʻana o ka puʻupaʻa
• ʻO ka maʻi ʻaʻai peripheral (PAD)
• Ke koko kiʻekiʻe o ka puʻuwai (PH)
• Ka Maʻi ʻAila Liʻiliʻi (Ka Maʻi ʻAila Microvascular Coronary)

He aha nā pilikia o kēia maʻi?

Hiki i ka Endothelial Dysfunction ke alakaʻi i kahi kūlana i kapa ʻia ʻo Acute Coronary Syndrome . He hui pū ʻana kēia o ʻekolu ʻano maʻi artery coronary. Hoʻonui kēia i ka pilikia o ka haki ʻana o kahi waihona momona (plaque) i loko o kahi kīʻaha koko. Hiki i kēlā ʻano waihona haki ke ālai i ke kahe koko i ka ʻiʻo puʻuwai a hoʻoulu i ka hōʻeha puʻuwai.

Pehea e ʻike ʻia ai kēia maʻi? (Diagnosis)

Hoʻohana nā kauka i nā hoʻokolohua kiʻi like ʻole e nānā pololei i ke kahe ʻana o ke koko ma o nā kīʻaha koko. Hiki i kēia mau hoʻokolohua ke kōkua i ke kauka e ʻike inā he mau hōʻailona o ka hana ʻole o ka endothelial. ʻO kēia mau hoʻokolohua:

• ʻElectrocardiogram (ʻElectrocardiogram - EKG)
• ʻO Angiogram, me ka Coronary Computed Tomography Angiogram (CCTA).

Eia kekahi, hiki ke hoʻohana ʻia kekahi mau hoʻokolohua "Stress Imaging" e ʻike ai inā ua emi ke kahe ʻana o ke koko ma o kou mau kīʻaha koko, kahi e hoʻoikaika ai paha kou puʻuwai. Nā Laʻana:

• Echocardiogram (`Echocardiogram - echo`)
• MRI (ʻIkepili MRI)
• ʻO ka Tomography Hoʻokuʻu Positron (PET scan)

Pehea e mālama ʻia ai kēia? (Lāʻau lapaʻau)

Inā loaʻa iā ʻoe ka maʻi coronary a peripheral artery paha (COPD) ma muli o ka endothelial dysfunction, hiki i kāu kauka ke kuhikuhi i kekahi mau lāʻau lapaʻau. Eia kekahi laʻana:

• ʻAspirin a i ʻole nā ​​​​lāʻau hoʻokahe koko.
• Nā lāʻau lapaʻau e kaohi ai i ke koko, e like me nā mea pale o ke kahawai calcium.
• Nā lāʻau hoʻohaʻahaʻa cholesterol e like me nā statins.
• Nā lāʻau lapaʻau e wehe ai i nā kīʻaha koko, e like me nā nitrates.

Eia kekahi, inā loaʻa iā ʻoe ka Endothelial Dysfunction, hiki iā ʻoe ke hōʻemi i kāu mau hōʻailona ma ka hana ʻana i nā hoʻololi i ka meaʻai a me ke ʻano o ka nohona . ʻO kēia mau mea:

• ʻAi ʻana i ka meaʻai olakino no ka puʻuwai a me ka hoʻoikaika kino mau.
• Ke kaupalena nei i ka inu ʻana i ka waiʻona.
• E hoʻemi i ke kaumaha (inā pono) a mālama i ke kaumaha olakino.
• Ke ʻimi nei i nā ala olakino e hoʻokele ai i ke kaumaha .
• E kiʻi i ke kōkua e hoʻōki i ka puhipaka a pale i ka uahi lua.
• Ka kaohi maikaʻi ʻana i nā maʻi e like me ke koko kiʻekiʻe, ka maʻi diabetes, a me ka cholesterol kiʻekiʻe.

He aha ka manaʻolana no nā poʻe me ka Endothelial Dysfunction?

Hiki ke mālama ʻia ka Endothelial Dysfunction me nā loli o ke ʻano o ka nohona a me nā lāʻau lapaʻau.He kūlana hiki ke mālama ʻia. Eia nō naʻe, hiki i kekahi poʻe me ka maʻi ʻaʻai coronary nonobstructive (NOCAD) ke hoʻomau i ka ʻeha o ka umauma ʻoiai ke mālama ʻia.

Hiki i kēia ʻano ʻeha umauma mau ke hoʻopilikia i nā hana o kēlā me kēia lā. Hiki iā ia ke alakaʻi i nā kūlana e like me ka hopohopo a me ke kaumaha. Hiki i ka psychotherapy, ka lāʻau lapaʻau, a me nā ʻano hana hoʻokele kaumaha ke kōkua.

Āhea wau e ʻike ai i ke kauka?

Inā ʻike ʻoe i nā hōʻailona ma lalo nei, e ʻike koke i ke kauka:

• ʻEha umauma
• Paʻakikī ka hanu ʻana
• Nā hōʻailona o ka hōʻeha puʻuwai (e like me ka ʻeha nui o ka umauma, ka ʻeha e hoʻomālamalama ana i ka lima hema, ka ʻeha ma ke ā, ka hou ʻana, ka nausea)
• Luhi nui me ke kumu ʻole

He aha kaʻu e nīnau aku ai i kaʻu kauka?

Hiki iā ʻoe ke nīnau i kāu kauka i nā nīnau penei:

• No ke aha i loaʻa ai iaʻu kēia maʻi (Endothelial Dysfunction)?
• Pono anei au i ka lāʻau lapaʻau?
• He aha nā hoʻololi o ke ʻano o ka nohona a me ka meaʻai e pono iaʻu e hana?
• Aia anei au i ka pilikia o ka loaʻa ʻana o ka maʻi puʻuwai? Pehea e hiki ai iaʻu ke hōʻemi i kēlā pilikia?
• Pono anei au e makaʻala i nā hōʻailona o nā pilikia?

Leka Lawe-Home

ʻO ka Endothelial Dysfunction kahi ʻano maʻi o ke aʻa coronary. Ke lawa ʻole ka nitric oxide i loko o nā paia o kou mau kīʻaha koko, e hāiki nā aʻa. Hoʻemi kēia hāiki ʻana i ke kahe koko i ka puʻuwai. Hoʻoulu kēia ʻano i ka angina, a i ʻole ka ʻeha o ka umauma, a hoʻonui i ka pilikia o ka maʻi puʻuwai.

ʻO ka mea maikaʻi loa, inā ʻike ʻoe iā ia i ka wā mua a loaʻa ka lāʻau kūpono, a me ka hoʻololi ʻana i ke ʻano o ka nohona, loaʻa iā ʻoe kahi manawa kūpono e pale aku iā ʻoe iho mai nā maʻi puʻuwai koʻikoʻi. No laila, mai hoʻowahāwahā i nā hōʻailona. Inā kānalua, he mea naʻauao ke ʻimi i ka ʻōlelo aʻoaʻo lapaʻau.

ʻO ka hana ʻino ʻana o ka Endothelial, ka maʻi puʻuwai, nā kīʻaha koko, Angina, Nitric Oxide, ke kaomi koko, Cholesterol