Dokotala wanu akalankhulapo za kuthamanga kwa magazi anu, kapena kufotokoza mankhwala omwe mumamwa kuti muchepetse kuthamanga kwa magazi, mwina mudamvapo mayina monga ACE inhibitors ndi ARBs. Lero tikambirana za dongosolo lomwe lili kumbuyo kwa zonsezi, lomwe nthawi zonse limayang'anira kuthamanga kwa magazi athu, monga gulu la akatswiri odziwa bwino ntchito mkati mwa thupi lathu. Timatcha izi kuti Renin-Angiotensin-Aldosterone System, kapena RAAS mwachidule. Ngakhale dzinali lingamveke ngati lovuta pang'ono, ntchito yake ndi yosavuta komanso yofunika kwambiri.
Mwachidule, kodi RAAS ndi chiyani?
Tangoganizani kuti thupi lanu lili ndi chitetezo chomwe chimayang'anira kuthamanga kwa magazi nthawi zonse ndipo chimayankha mwachangu chikatsika kwambiri. Ndicho chimene RAAS ili. Ndi gulu la mahomoni, ma enzyme, ndi mapuloteni. Cholinga chachikulu cha dongosololi ndikusunga kuthamanga kwa magazi ndi kuchuluka kwa magazi athu pansi pa ulamuliro kwa nthawi yayitali.
Dongosololi limathandiza kuwonjezera kupanikizika kwathu m'njira zitatu zazikulu:
- Kuchulukitsa kuyamwa kwa sodium (mchere) ndi impso: Pamene mchere ukuwonjezeka m'thupi, madzi nawonso amakhalabe m'thupi.
- Kuchuluka kwa kuyamwanso kwa madzi (kusunga madzi): Izi zimawonjezera kuchuluka kwa magazi m'thupi.
- Kamvekedwe ka mitsempha yamagazi: Kulimba kwa mitsempha yathu yamagazi. Monga momwe kufinya chitoliro chamadzi kumathandizira kuti madzi aziyenda mofulumira, mitsempha yamagazi ikagundana, kuthamanga kwa magazi kumawonjezeka.
Pali osewera atatu ofunikira mu timu yayikulu iyi. Tiyeni tidziwe bwino.
| Chosakaniza chachikulu | Ntchito yomwe ikuchitidwa |
|---|---|
| Renin | Iyi ndi enzyme yopangidwa ndi impso zathu. Ili ngati mlonda. Ndi chizindikiro choyamba choyambitsa dongosololi likawona kuti kuthamanga kwa magazi kukutsika. |
| Angiotensin II | Uyu ndiye mtsogoleri wa gululi. Ndi mahomoni amphamvu kwambiri. Amagwira ntchito zambiri zofunika, monga kutsekereza mitsempha yamagazi ndikuuza thupi kuti lisunge mchere ndi madzi. |
| Aldosterone | Homoni iyi imachokera ku ma adrenal glands, omwe ali pamwamba pa impso zathu. Ntchito yake yayikulu ndikuuza impso kuti zisunge sodium (mchere) m'thupi ndikutulutsa potaziyamu mu mkodzo. |
Kodi dongosolo la RAAS limagwira ntchito bwanji?
Izi zili ngati zochitika za unyolo. Chinthu chimodzi chikachitika, chimayambitsa china chake. Tiyeni timvetse izi ngati nkhani yosavuta.
Tangoganizani kuti pazifukwa zina (monga mwataya madzi ambiri m'thupi lanu - kutaya madzi m'thupi, kapena mwataya magazi pang'ono pangozi yaying'ono) kuthamanga kwa magazi anu kumatsika.
1. Chizindikiro choyamba: Impso zanu zili ngati masensa. Zikazindikira kuchepa kwa kuthamanga kwa magazi, zimasangalala ndipo zimatulutsa enzyme yotchedwa renin m'magazi.
2. Kumasulira koyamba: Pamene renin iyi ikuyenda m'magazi, imakumana ndi puloteni yotchedwa angiotensinogen, yomwe imapangidwa m'chiwindi chathu ndikutulutsidwa m'magazi. Renin imaphwanya puloteni iyi ndikuigwiritsa ntchito kupanga mahomoni otchedwa angiotensin I. Koma angiotensin I iyi sigwira ntchito, zomwe zikutanthauza kuti singagwire ntchito kwambiri.
3. Kubadwa kwa Mtsogoleri: Tsopano, pamene angiotensin I iyi yogona ikuyenda m'magazi, makamaka m'mapapo mwathu, pali enzyme yapadera pamenepo. Ndiyo Angiotensin-Converting Enzyme (ACE) . Chomwe enzyme iyi ya ACE imachita ndikutenga angiotensin I yogona ndikuyisandutsa angiotensin II yamphamvu kwambiri, yogwira ntchito. Tsopano mtsogoleri weniweni wabadwa.
4. Malamulo a Mtsogoleri: Tsopano angiotensin II wamphamvu iyi ikugwira ntchito yambiri nthawi imodzi:
- Imapita molunjika ku makoma a mitsempha yaing'ono yamagazi m'matupi athu ndikuitseka , ngati kufinya chitoliro cha madzi. Izi zimawonjezera kuthamanga kwa magazi nthawi yomweyo.
- Imapita mwachindunji ku ma adrenal glands, omwe ali pamwamba pa impso, ndipo imawauza kuti apange mahomoni otchedwa aldosterone .
- Zimathandizanso kuti pituitary gland muubongo ipange Antidiuretic Hormone (ADH).
5. Zotsatira zake: Tsopano popeza aldosterone ndi ADH zikugwira ntchito limodzi kuuza impso kuti, " Musatulutse sodium (mchere) ndi madzi m'thupi, sungani m'thupi ." Nthawi yomweyo, aldosterone imatulutsa potaziyamu yomwe thupi silifunikira mu mkodzo.
- Mchere ukasungidwa m'thupi, madzi nawonso amasungidwa.
- Madzi akachuluka m'thupi, magazi onse omwe ali m'mitsempha yathu yamagazi (kuchuluka kwa magazi) amawonjezeka.
- Pamene kuchuluka kwa magazi kukukwera ndipo mitsempha ya magazi ikuchepa, kuthamanga kwa magazi kumawonjezekanso kukhala kwabwinobwino.
Mwachidule, dongosolo la RAAS ndi njira yokhayo yomwe, kuthamanga kwa magazi kukatsika, kumawonjezera kuthamanga kwa magazi mwa kusunga mchere ndi madzi m'thupi, kutseka mitsempha yamagazi, ndi zina zotero.
Kodi pali ubale wotani pakati pa dongosolo la RAAS ndi kulephera kwa mtima?
Iyi ndi mfundo yofunika kwambiri. Muzochitika zachizolowezi, dongosolo la RAAS limathandiza kupulumutsa miyoyo yathu. Komabe, m'mavuto a nthawi yayitali monga kulephera kwa mtima, dongosolo labwinoli limayamba kugwira ntchito motsutsana nafe.
Tangoganizani kuti mtima wa munthu ndi wofooka ndipo sungathe kupopera magazi okwanira m'thupi. Ichi ndi chomwe timachitcha kuti kulephera kwa mtima.
- Pamene mphamvu ya mtima yopopa magazi ikuchepa, kuchuluka kwa magazi omwe amafika m'ziwalo zofunika monga impso kumachepa.
- Pamene magazi opita ku impso achepa, amaganiza kuti, "O, kuthamanga kwa magazi n'kochepa, vuto lalikulu!" Choncho impso zimayamba kugwira ntchito mwachangu ngati zili ndi mphamvu zonse.
- Kenako thupi limapanga angiotensin II ndi aldosterone zambiri. Izi zimawonjezera kuthamanga kwa magazi ndipo zimapangitsa kuti thupi lisunge mchere ndi madzi.
- Koma vuto apa ndilakuti kukwera kwa kuthamanga kwa magazi ndi kuchuluka kwa magazi kumakhala katundu wokulirapo pa mtima wofooka kale komanso wofooka. Zili ngati kuyika katundu wina pa munthu amene sangathe kunyamula katundu wolemera.
- Mtima ukapanikizika kwambiri pakapita nthawi, mtima umafooka, minofu ya mtima imakhuthala, ndipo mtima umakula. Izi zimapangitsa kuti mtima ulephere kugwira ntchito bwino.
Pachifukwa ichi, mankhwala ambiri omwe madokotala amapereka kwa anthu omwe ali ndi vuto la mtima komanso kuthamanga kwa magazi cholinga chake ndi kulamulira momwe dongosolo la RAAS limagwirira ntchito.
Mankhwala omwe amakhudza dongosolo la RAAS
Mankhwala angapo akuluakulu a kuthamanga kwa magazi ndi matenda a mtima amaletsa njira zosiyanasiyana mu dongosolo la RAAS ili.
| Mtundu wa mankhwala | Momwe imagwirira ntchito |
|---|---|
| Zoletsa za ACE | Mukukumbukira enzyme ya ACE yomwe imasintha angiotensin I kukhala angiotensin II yamphamvu? Chomwe mankhwala awa amachita ndikuletsa enzyme imeneyo. Kenako kupanga kwa "mtsogoleri" ameneyo kumachepa. |
| Ma ARB a Angiotensin Receptor Blockers (Ma ARB) | Mankhwalawa saletsa kupanga angiotensin II. Koma amaletsa "zipata" (ma receptor) zomwe zimalola angiotensin II kupita kumalo monga mitsempha yamagazi ndikuchitapo kanthu. Zili ngati mtsogoleri akupereka malamulo, koma palibe amene amamvetsera. |
| Otsutsa a Mineralocorticoid Receptor (MRA) | Izi zimaletsa mwachindunji ntchito ya hormone ya aldosterone, yomwe imachepetsa mchere ndi madzi m'thupi. |
| Beta-blockers | Ngakhale izi sizikhudza mwachindunji dongosolo la RAAS, zimathandiza kuchepetsa kupanga kwa renin ndi impso, zomwe zikutanthauza kuti zimalamulira dongosolo lonse kuyambira pachiyambi. |
Kodi pali kusiyana kotani pakati pa RAAS ndi Baroreceptor Reflex?
Dongosolo lina lomwe limalamulira kuthamanga kwa magazi ndi Baroreceptor reflex . Tiyeni timvetse kusiyana pakati pa ziwirizi.
- Baroreceptor Reflex: Iyi ndi njira yomwe imagwira ntchito nthawi yomweyo, mkati mwa masekondi . Tangoganizani kuti mwakhala kenako mwadzidzidzi muyime. Kenako kuthamanga kwa magazi kumachepa pang'ono. Panthawiyo, kuyenda kwa magazi kupita kumutu kumachepa ndipo mungamve chizungulire. Koma sizichitika, eti? Chifukwa cha izi ndi Baroreceptor reflex. Imawonjezera kugunda kwa mtima kwa masekondi angapo, imatsekereza mitsempha yamagazi pang'ono, ndikukonza kuthamanga kwa magazi. Ili ngati zotengera zogwedeza za galimoto, zomwe zimalamulira kusintha kwadzidzidzi.
- Dongosolo la RAAS: Ili ndi dongosolo la nthawi yayitali , lochedwa pang'ono. Limatenga maola, ngakhale masiku, kuti ligwire ntchito. Limalamulira kuthamanga kwa magazi kwa nthawi yayitali mwa kusintha kuchuluka kwa madzi ndi mchere m'thupi. Lili ngati dongosolo loyang'anira injini m'galimoto, poyang'ana momwe galimotoyo imagwirira ntchito kwa nthawi yayitali.
Machitidwe onsewa amagwira ntchito limodzi kuti kuthamanga kwa magazi athu kukhale koyenera.
Uthenga Wopita Nawo Kunyumba
- RAAS (Renin-Angiotensin-Aldosterone System) ndi njira yokhayo yomwe imalamulira kuthamanga kwa magazi ndi madzi m'thupi lathu kwa nthawi yayitali.
- Kuthamanga kwa magazi kukatsika, dongosololi limayamba kugwira ntchito, kusunga mchere ndi madzi m'thupi, kutsekereza mitsempha yamagazi, ndikubwezeretsa kuthamanga kwa magazi kukhala kwabwinobwino.
- Mu matenda monga kulephera kwa mtima ndi kuthamanga kwa magazi, dongosololi likhoza kugwira ntchito mopitirira muyeso, zomwe zingawononge mtima ndi thupi.
- Mankhwala ambiri omwe amagwiritsidwa ntchito pochiza kuthamanga kwa magazi ndi matenda a mtima (monga ACE inhibitors ndi ARBs) cholinga chake ndi kulamulira mwachindunji ntchito ya dongosolo la RAAS ili.
- Ngati muli ndi kuthamanga kwa magazi kapena vuto la mtima, ndikofunikira kwambiri kumwa mankhwala anu monga momwe dokotala wanu wanenera. Musasiye kumwa mankhwala anu kapena kusintha mlingo musanafunse dokotala wanu kaye.
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