Ukubaluleka kweMyocardium
Q. Umyeni wam unesifo senhliziyo ngenxa yesifo sakhe somzimba. Ugqirha wokuqala esiwubonile wambonisa ukuba ukuqhutyelwa kokuhlinzwa akuyi kwenza nantoni na ngenxa yokuba umzobo ovaliweyo uhlinzeka ngesisu senhliziyo esele sefile. Kodwa ugqirha wesibini uthi kunokwenzeka ukuba intloko yenhliziyo ayonakaliswa ngokupheleleyo, kodwa nje "ukugubha." Uthi ukuhlinzwa ngokugqithiseleyo kunokuvumela ukuba isisipha 'siphakamise,' kwaye intliziyo yakhe ayiphumeleli. Yintoni onokuyithetha ngayo nge-hibernating muscle ye-heart, kwaye ucinga ukuba isifo se-cardiologist yesibini sinokulungile?
Impendulo:
Ingqiqo ebalulekileyo ye-"carbogradium yokugubha i-hibernating" (i-myocardium ithetha i-muscle muscle) ibonakala ibonakala ingangaphandle kwabanye oogqirha, kodwa izazi ze-cardiologists ziyazi kakuhle. Kwabanye abantu abane- coronary artery disease (CAD) , iinxalenye zesifo senhliziyo ezibonakala ngathi zonakaliswe kakhulu kwaye zingasebenzi-nene zisasebenza, kwaye "zinokuvuselelwa" ukuba i-blood supply iyabuyiselwa.
Kuqikelelwa ukuba phakathi kwama-20 ukuya kuma-50% abantu abanesifo senhliziyo ababangelwa yi-CAD banomlinganiselo omkhulu we-myocardium, kwaye ngoko ke banako ukuphucula ukuphucula okubonakalayo xa ukuphuma kwegazi kungabuyiselwa kwisisu sabo senhliziyo.
Indlela "endala" yokucinga ngeentliziyo ezinokukhubazeka
Ingcamango yezobugqirha zendabuko ayizange ishiye indawo yinto efana nokugubha i-myocardium.
Imisipha yentliziyo isebenza ngokuqhelekileyo njengoko nje kukho ukuhamba kwegazi okwaneleyo. Ukuba ukuhamba kwegazi kungeneli ukwenzela ukuhlangabezana neemfuno zesisu senhliziyo (umzekelo, xa umntu oneCAD eqala ukusebenzisa), i-muscle iya kuba yinkqubo yesikhombisi (i-oksijeni yindlala), kwaye i- angina ingenzeka.
I-Ischemic heart muscle ayisebenzi ngokuqhelekileyo. Enyanisweni, ukwenza i- echocardiogram ngexesha lokuzivocavoca yindlela enye yokufumanisa i-ischemia, ekubeni uvavanyo lwe-echo lunokujonga ngetekisi zesistim senhliziyo esiphumelele ukuba zivumelane ngokuqhelekileyo xa zithathwa i-oksijeni eyaneleyo.
Indlela oogqirha abayicinga ngayo ngeCAD, nokuba i-ischemia yayiza kudala (kuba, umzekelo, umntu ono-CAD wayeya kusebenzisa xa i-angina ibonakala), okanye i-ischemia yayiya kuqhubeka kuze kube yintliziyo yehla (i-myocardial infarction, okanye ukufa kwentliziyo imisipha) yenzeka.
Ngako-classics, i-myocardium enikezwe ngumzobo we-coronary disord could be in one of three states: evamile, ischemic, okanye ifile.
Kodwa kuvela ukuba isisu senhliziyo sinokuqhubeka sisesigxina sesine, i-state ekubhekiselwe kuyo njenge-hibernation.
Yintoni I-Myocardium Ekhuselekileyo?
I-myocardium engabonakaliyo yinto efana nayo. Njengababhere ekufukeleni ubusika, nangona konke ukubonakala kwintliziyo ye-hibernating isifo, kodwa kunoko nje ucinga nje ngokuthi "lihle". Akusekho imisebenzi ngokuqhelekileyo - ayiyikubambisana nentliziyo nganye, kwaye ayinakuncedisa emsebenzini wentliziyo.
Kodwa akukho nokufa. Kuphela kwimeko yokuzikhusela. Ivale yonke imisebenzi yayo engaxakekanga ngokukhawuleza ukuba ihlale iphila.
I-Heart muscle ingangena kwisimo se-hibernation xa i-CAD ikhulile ngokwaneleyo ukuvelisa i-ischemia engasigxina kwaye ingapheliyo, kunokuba i-ischemia ebonakalayo kwaye ihamba ngokuphindaphindiweyo (yinto eninzi kubantu abane-angina). Ngoko, ngokubalulekileyo, intliziyo ye-muscle ayifumaneli ukuhamba okwaneleyo kwegazi ukuze isebenze ngokuqhelekileyo, kodwa - kungekudala - ukufumana igazi elifanelekileyo ukuze uhlale uphila.
Kutheni i-Myocardium ekhuselekileyo ibalulekile?
Intliziyo yeentliziyo ezinobungozi yinto ebalulekileyo kuba isistim isasenokwenzeka kwaye i-hibernation ingasuswa.
Ukuba i-blood supply muscle ye-muscle ingabuyiselwa - ngokusebenzisa utyando olusasazwayo okanye ukugquma -kunethuba elihle lokuba i-myocardium yokugubha i-hibernating "ivuke," kwaye iqale kwakhona ukufaka isandla kumsebenzi wentliziyo. Ngomntu onokuphelelwa yintliziyo , oku kwandisa amandla enhliziyo kungenza konke umehluko.
Kwimeko yendoda yakho Kuzwakala ngathi ugqirha wesibini ubone ubungqina bokuba umyeni wakho unokuba ne-carbohydri ehlaziwayo, kwaye ukuvula omnye okanye ngaphezulu kweempawu ze-coronary and surgery kungavumela ubuncinane inxalenye yentliziyo yakhe ukuba iqale ukusebenza kwakhona.
Kukho iimvavanyo ezizodwa ezenziwa ngabadlali be-cardiologists ukuncedisa ukuhlula i-myocardium kwi-muscle ye-heart engenakwenzeka (oko kukuthi, efile), kuquka i- MRI izifundo , kunye nokuhlolwa okuthe ngqo kwe-echocardiographic.
Ngaphantsi
Ekubeni olu hlobo lokuvavanya aluyiyo ingenelo kwaye luyingozi engenazo ingozi, ukusukela ithuba lokubamba i-mber cardidium kubonakala kunengqiqo kwimeko yendoda yakho.
Ukuba olu vavanyo lubonisa ukuba unokufumana ininzi enkulu ye-myocardium yokugubha i-myocardium, ngoko "ukuvusa" ukuba inxalenye yesifo senhliziyo ingasenza intliziyo yakhe ingaphumeleli kakhulu. Ngoko kuya kwenza ingqiqo enzulu ukuqwalasela ngokugqithiseleyo ukutyunjwa kwe-carpologist kukukhuthaza ukuba uvavanyo luxhasa ubukho be-myocardium.
> Imithombo:
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> Kim SJ, uPeppas A, Hong SK, et al. Ukunyamezela okukrakrayo Ukuzikhusela kunye nokukhuselwa kweMyocardial: Ukuhamba / umsebenzi kunye neendlela zeMetabolic. Circ Res 2003; 92: 1233.
> Parasher PS, Daher IN. Ukubuyiswa kweMyocardial emva kwe-Hypoxia: Ukubuyiswa ngokumangalisayo. Echocardiography 2008; 25: 1011.
> Rahimtoola SH, iLa Canna G, uFerrari R. I-Myocardium Inobungozi: Elinye iqela le-Puzzle Falls Falls. J Am Coll Cardiol 2006; 47: 978.
> Yancy CW, Jessup M, Bozkurt B, et al. I-ACCF / I-AHA Isikhokelo Sokulawulwa Kwentliziyo Yokwehluleka: Ingxelo ye-American College of Cardiology Foundation / i-American Heart Association iqela leMisebenzi yeZikhokelo. J Am Coll Cardiol 2013; 62: e147.