Me kōrero tātou mō te pūnaha ngaro e whakahaere ana i tō toto toto: (Pūnaha Renin-Angiotensin-Aldosterone - RAAS)!

Kua whakaaro koe kāore tō toto toto i te mea noa iho i waho o tō mana whakahaere? Ina hoki, he pūnaha tino uaua, he pūnaha whakamiharo kei roto i ō tātou tinana hei whakahaere i taua pūnaha. Koinei te pūnaha ka kōrerohia e tātou i tēnei rā. Ko te ingoa o tēnei ko te pūnaha renin-angiotensin-aldosterone , ko te RAAS rānei hei whakarapopototanga. Kaua e manukanuka, ahakoa he roa te ingoa, kia mārama noa tātou.

He aha tēnei RAAS (Pūnaha Renin-Angiotensin-Aldosterone)?

Āe, he aha te RAAS (Pūnaha Renin-Angiotensin-Aldosterone)? He kupu ngāwari noa iho, he pūnaha honohono o ngā homoni, ngā pūmua, me ngā whākōkī i roto i ō tātou tinana e mahi tahi ana. He rite ki tētahi tīma iti kua hoahoatia pai. Ko te mahi matua o tēnei tīma ko te whakahaere i tō tātou toto toto me te nui o te wai i roto i tō tātou tinana, arā, te nui o te toto, mō te wā roa.

Whakaarohia ngā uaua toto o roto i tō tātou tinana he rite ki ngā paipa e kawe ana i te wai. Ko te nui o te toto e rere ana i roto i ēnei paipa, me te pēhanga e pā ana ki ngā pakitara o ngā paipa, koinei te mea e kiia nei e tātou ko te toto toto. Nō reira, ko tā tēnei RAAS he whakanui ake i te mimiti anō o te tote (konutai) me te wai ki roto i te tinana. Kātahi ka piki ake te nui o te wai i roto i te tinana, arā, te rahinga toto. Ka meinga hoki e ia kia whakawhāiti ngā uaua toto. Arā, ka whakahaere i te reo o ngā uaua toto . Mā ēnei katoa ka āwhina ki te pupuri i te toto toto ki te taumata e hiahiatia ana, ki te taumata hauora rānei.

E toru ngā kaiwhakaari matua o tēnei pūnaha RAAS , pērā i ngā kiripuaki matua o tētahi whakaari:

• Renin: He whākōkī tēnei.
• Angiotensin II: He homoni tēnei.
• Aldosterone : He homoni anō hoki tēnei.

Hei whakamārama i ēnei kupu e rua, he momo pūmua motuhake ngā whākōkī e āwhina ana, e tere ake ana hoki i ngā tauhohenga matū i roto i ō tātou tinana. Ka āwhina rātou ki te hanga i ētahi mea hou, me te wawahi i ētahi mea. He karere matū ngā homoni e whakarite ana i ngā mahi a ō tātou tinana. Ka haere rātou i roto i te toto, ka kōrero ki ngā okana, ki ngā uaua, me ngā kiko rerekē he aha te mea hei mahi, me te wā hei mahi. He rite ki te ratonga mēra o tō tātou tinana.

Nā, he aha te toto toto tiketike?

Ina haere koe ki te tākuta, ka inehia e rātou tō toto toto mā te whakamahi i tētahi poroporo i tō ringa. Hei whakamārama, koinei te pēhanga e hangaia ana e te toto i roto i ō uaua i ia wā e pā ana tō ngākau. He mea tino nui tēnei pēhanga noa mō te rere tika o te toto mai i tō tātou ngākau ki ngā okana me ngā kiko katoa o tō tātou tinana.

He maha ngā mea e whakawhirinaki ana ki te toto toto tiketike , pērā i te nui o te toto e pupuhihia ana e tō ngākau me te whānui o ngā uaua e rere ana ō toto.

He maha ngā mea ka pā ki tō toto toto, pērā i ētahi rongoā, te nui o te cholesterol, me te kai hikareti. Heoi, ko te pūnaha matua e whakahaere ana i te toto toto ko te RAAS (Pūnaha Renin-Angiotensin-Aldosterone). Engari kia maumahara, ki te mea he toto toto tiketike tōu (hypertension) he toto toto iti rānei (hypotension), kāore e tika kia raru tonu te pūnaha RAAS. Tērā pea ētahi atu take.

He aha te rerekētanga i waenga i te RAAS me te baroreceptor reflex?

He mea tino nui ēnei e rua mō te whakahaere i te toto toto, engari he iti noa te rerekētanga.

Ko te mahi matua a te RAAS (Pūnaha Renin-Angiotensin-Aldosterone) he whakahaere i te nui o te toto me te ātete o ngā uaua puta noa i te tinana mō te wā roa .

I tētahi atu taha, ka mahi te baroreceptor reflex, e kīia ana rānei e ētahi , ko te baroreflex , ina heke te toto toto mō te wā poto . Arā, ka tere te urupare ki ngā huringa iti, tere o te toto toto mai i te pao o te ngakau ki te pao o te ngakau. Ko ēnei baroreceptor, kei roto i ō tātou uaua, ka tere te whakamōhio i tō tātou pūnaha io autonomic mō ēnei huringa.

He aha ngā okana nui e whai wāhi ana ki te RAAS?

He maha ngā okana, ngā repe, me ngā kiko o roto i tō tātou tinana e mahi tahi ana kia tika ai te mahi a tēnei pūnaha RAAS. Ko ngā mea tino nui o ēnei ko:

• Ngā whatukuhu : Koinei ngā mea tuatahi ka tuku i te renin.
• Ate: Ka hangaia te pūmua e kiia nei ko te angiotensinogen i konei.
• Ngā uaua toto: Koinei ngā mea e whakawhāiti ana, e whakapiki ana hoki i te toto toto.
• Ngā pūkahukahu: Ko te wāhi matua o te whākōkī ACE.
• Ngā repe adrenal: He repe iti, he tapatoru te āhua o ēnei e rua, kei runga ake i ō tātou whatukuhu. Ka whakaputahia e rātou te aldosterone.
• Repe pituitary: He repe iti tēnei, he rite te rahi ki te wheua, kei te pūtake o te roro, i raro i te hypothalamus. Ka whakaputa i te homoni ADH.
• Hypothalamus: He wāhanga tēnei o te roro e whakarite ana i ngā mahi a tō tātou pūnaha io motuhake me te repe pituitary.

Tirohia te maha o ngā mea me mahi tahi kia angitu ai te mea kotahi!

He pēhea rawa te mahi a tēnei pūnaha RAAS?

Āe, me titiro tātou ki te mahi a tēnei RAAS (Pūnaha Renin-Angiotensin-Aldosterone). He tukanga tēnei e whai ana i ētahi taahiraa:

1. Tuatahi, whakaarohia kua heke whakarere tō toto toto . Kua heke rānei te nui o te toto e haere ana ki ngā whatukuhu. I taua wā tonu, ka tukuna e ō tātou whatukuhu atamai e rua tētahi whākōkī e kiia nei ko te renin ki roto i te toto.

2. Kātahi ka haere tēnei renin ka wawahi i tētahi pūmua e kiia nei ko te angiotensinogen , e hangaia ana i roto i tō tātou ate, ka tāpirihia ki te toto. He rite ki te tapahi pepa ki te kutikuti. Kātahi ka hangaia he homoni e kiia nei ko te angiotensin I.

3. Engari kāore tēnei angiotensin I i te tino kaha, arā, kāore he pānga nui (kore mahi). Nō reira, ina rere i roto i te toto, ka pakaruhia e te whākōkī angiotensin-converting (ACE) i roto i ō tātou pukahukahu me ō tātou whatukuhu kia maha atu ngā wahi. Ko te wā tēnā ka hangaia ai te homoni tino kaha e kiia nei ko te angiotensin II .

4. Ko tēnei angiotensin II te tino mahi. Ka meinga ohoreretia e ia ngā pakitara uaua o ō tātou uaua iti, arā, ngā arterioles, kia whakawhāiti. Whakaarohia he rite ki te pēhi i tētahi paipa wai, ā, ka tere haere te wai, ā, ina whakawhāitihia ngā uaua, ka piki ake te toto toto. Ehara i te mea koinā anake, ka tohu tēnei angiotensin II i ō tātou repe adrenal kia tukuna he homoni e kiia nei ko te aldosterone . Ka kī atu hoki ki te repe pituitary kia tukuna te homoni antidiuretic, ADH (Antidiuretic Hormone), Vasopressin rānei.

5. Muri iho, ka mahi tahi te aldosterone me te ADH ki te kī atu ki ngā whatukuhu kia mimiti anō te tote e hiahiatia ana e te tinana, arā, te konutai, ki roto i te tinana, arā, kia puritia. I taua wā anō, ka kī atu te aldosterone ki ngā whatukuhu kia tukuna te pāhare pāporo kāore e hiahiatia ana e te tinana ki roto i te mimi .

6. Nō reira, ina piki te nui o te konutai i roto i te toto, ka tīmata hoki te tinana ki te pupuri i te wai. Kātahi ka piki te rahinga toto katoa, ā, ka piki tahi me tēnā ka piki te toto toto. Koinei te otinga o tēnei pūnaha renin-angiotensin-aldosterone. Ka hoki te toto toto ki te noho noa.

Ka taea te whakahohe i te pūnaha RAAS e ētahi atu homoni. Hei tauira , ka taea hoki e ngā corticosteroids, te estrogen, me ngā homoni tairoi te whakaoho i te pūnaha.

He aha te whanaungatanga i waenga i te ngoikore o te ngākau me te RAAS?

Nā, kia titiro tātou ki tēnei pūnaha RAAS, e kiia nei e ētahi ko te ngoikore o te ngākau.He aha te whanaungatanga i waenga i te mate me te pūnaha RAAS? Inaa, i roto i te tinana o te tangata he mate manawa, he mahi tino nui tā tēnei pūnaha RAAS, ā, he uaua hoki i ētahi wā.

I te tīmatanga, ina kore e taea e te ngākau te pupuhi tika i te toto (arā, ina ngoikore te ngākau), kāore e taea e ia te whakarato toto e ranea ana ki ngā whekau nui o te tinana. I taua wā, ka tīmata ngā huringa o te pūnaha RAAS hei huarahi hei whakakapi i tēnei. Arā, ka ngana te tinana ki te whakakapi i tēnei ngoikoretanga.

Ina koa, ka tukuna e te RAAS he homoni nui ake e kiia nei ko te Angiotensin II hei utu mō te whakahekenga o te rere o te toto. Heoi, mā tēnei tukunga nui ake o te Angiotensin II i roto i te wā ka kino ake te mate o te ngākau. E whakapono ana ngā kaipūtaiao ko tēnei nui rawa o te Angiotensin II ka puta te whakanui me te hanga anō i te ngākau.

Hei whakamārama, ina ngoikore te ngākau, ā, he iti iho te toto e pupuhi ana, ka whakaaro te tinana, 'Āe, he iti taku toto, kāore i te nui.' Nō reira ka whakahohehia te RAAS hei whakanui i te toto me te nui o te toto. Ahakoa he āwhina pea tēnā i te wā poto, i te wā roa, ka nui ake te taumahatanga ki te ngākau kua ngoikore kē.

Nā reira, i te wā e rongoatia ana te hunga whai mate manawa, ka whakamahia e ngā tākuta ngā rongoā e pā tika ana ki te pūnaha RAAS, ā, e whakahaere ana hoki i tana mahi. Ka aukati ēnei rongoā i te pūnaha RAAS kei mahi i te huarahi kore e tika ana. Anei ētahi tauira:

• Ngā aukati-beta
• Ngā aukati whākōkī tahuri-angiotensin (ngā aukati ACE)
• Ngā aukati i te angiotensin receptor (ARB)
• Ngā kaitukino kaiwhakawhiwhi mineralocorticoid (MRA)

Ka whakaitihia e ēnei rongoā te taumahatanga koretake ki te ngākau, ā, ka āwhina ki te whakahaere i te mate ngākau.

Ko te mea nui rawa atu me maumahara tātou ko

Nā, ka kite koe i te hiranga me te matatini o te pūnaha renin-angiotensin-aldosterone (RAAS) mō te whakahaere i te toto toto me te hauora o te ngākau. Ahakoa te āhua uaua, he pūnaha nui tēnei mō te noho ora o te tinana. He rite ki te miihini iti i roto i te tinana.

Mena he āwangawanga āu mō tō toto toto, hei tauira, mena kei a koe ngā tohu o te toto toto tiketike , te toto toto iti rānei, ki te mea rānei kei te whakaaro koe he uaua ki te whakahaere i tō toto toto, tena koa toro atu ki tō tākuta mō ētahi tohutohu.Kei te rite rātou ki te āwhina i a koe, ki te whakautu hoki i ō pātai. He mea nui rawa kia mōhio tātou ki ēnei mea, nā te mea koira anake ka taea ai e tātou te whakatau whai whakaaro mō tō tātou hauora. Ko te mōhio ki tō tinana te huarahi pai ki te ora i te oranga hauora.

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