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Микроангиопатия

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Микроангиопатия (гиалиноз и склероз артериол), характерная для гипертонической болезни, начиная уже со 2-й ее стадии, наряду с гиперпластическими изменениями эндотелия и гладкомышечных клеток артериол.
Также для любой формы артериальной гипертензии характерна гипертрофия (рабочая) миокарда, преимущественно левого желудочка. Толщина его стенки увеличивается с 1,2-1,3 см (в норме) до 2-2,5 см (а масса сердца – с 250-280 г до 350-500 г). Гипертрофия миокарда проходит стадии становления, компенсации и декомпенсации (обычно в течение многих лет). На стадии компенсации (концентрическая гипертрофия миокарда) сократительная способность миокарда повышена, полости не расширены, признаки сердечной недостаточности отсутствуют. На стадии декомпенсации сократительная способность миокарда падает (из-за нарастания гипоксии кардиомиоцитов и развития их жировой дистрофии — «тигровое сердце»), полости сердца расширяются за счет давления крови (эксцентрическая гипертрофия миокарда) и прогрессирует хроническая сердечная недостаточность (ее морфологический субстрат — хроническое общее венозное полнокровие).
Смерть больных при артериальной гипертензии может наступить от острой (при инфаркте миокарда) или хронической сердечной (сердечно-сосудистой) недостаточности, поражений головного мозга (цереброваскулярные болезни, в частности, кровоизлияние в головной мозг или его оболочки, инфаркт головного мозга), почечной недостаточности (атеро-артериолосклеротический нефросклероз, или первично-сморщенная почка).
 

 

 


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Отправлен: 28.12.2012 1:18:37

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RE: Микроангиопатия
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RE: Микроангиопатия
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