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"pathogenesis": "",
"diagnostics": "<p>По характеру регулирующих механизмов выделяют обычно расстройства нервной, эндокринной (гормональной), гормоноидной и метаболической регуляции. В соответствии с регулируемыми сферами жизнедеятельности можно выделить нарушения регуляции поведения, сенсорных, локомоторных, вегетативных и трофических функций. В изменениях регуляции поведения выделяют обычно регуляторные механизмы нарушения мотивации (например, при токсикоманиях, булимии, парарексии и др.), эмоций (аффективные состояния), памяти (в частности, при амнезии). </p>\r\n<p>Регуляторные механизмы расстройств чувствительности в свою очередь обычно разделяют по уровню поражения сенсорных систем (рецепторный, проводниковый, центральный — спинальный, стволовой, таламический, корковый) и их модальности (зрительная, слуховая, обонятельная и т.д.). Нарушения регуляции локомоторных функций включают нарушения регуляции произвольных (парезы и параличи) и непроизвольных (например, судорожные состояния) движений. Изменения регуляции вегетативных функций раскрывают расстройства симпатической и парасимпатической регуляции и также разделяются в соответствии с нарушениями работы анатомо-физиологических систем: патология регуляции кровообращения, дыхания, пищеварения и тд. Патология регуляции трофических функций касается изменения нейроплазматического тока, изменения синтеза в нейронах трофогенов и появления патотрофогенов, возникновения нейрогенных атрофии и дистрофии.</p>\r\n<p>Нарушения регуляции можно дифференцировать по ведущим механизмам, лежащим в основе ее формирования. В связи с этим следует выделять расстройства регуляции, возникающие вследствие изменения прямых и обратных регуляторных связей различного характера (положительных и отрицательных). Чрезмерное усиление прямых положительных (стимулирующих) влияний имеет место при возрастании выработки либеринов гипоталамуса или тропных гормонов гипофиза при гормонпродуцирующих опухолях; обратное явление вплоть до прекращения образования этих соединений имеет место при белковом голодании, повторяющихся микротравмах мозга (у боксеров), расстройствах кровообращения в мозге и в гипофизе и т.д.</p>",
"treatment": "<p>Связь местного и общего в патологии осуществляется не с помощью каких-либо особых механизмов; это взаимодействие обусловлено включением обычных интегративных связей, к которым следует отнести рефлекторные, эндокринные, гормоноидные и метаболические акты. Они существуют и в норме (медиаторы, гормоны, тканевые гормоны, продукты обмена) и проявляют себя при патологии. Интегративные связи, определяющие целостность организма, являются ведущим механизмом формирования в патологии приспособительных процессов — от поведенческих высшей степени сложности до молекулярных. В большинстве случаев взаимоотношения части (местного) и целого (общего) при различных патологических процессах отражаются в виде общеизвестных формул: \"нет ничего местного, все есть общее с местным проявлением\" и соответственно \"всякая болезнь есть страдание всего организма\". Эти формулировки стали незыблемыми, обязательным постулатом, вошедшим во все энциклопедии, руководства и учебники. Ими подчеркивается единство организма как целостной системы и неразрывная связь местного и общего. Однако сегодня на эту связь мы смотрим не только более широко, но по-иному; в указанных выше постулатах не просматриваются диалектические отношения, которые складываются между частью и целым, но отчетливо виден примат последнего, т.е. общего. Объективно существуют и местные (часть), и общие (целое) изменения; утверждения о том, что тот или иной процесс в норме или при патологии есть либо местное, либо общее явление, следует считать односторонним. Любое целое состоит из его частей; целое не представляет собой арифметическую сумму частей, а в соответствии с системным принципом приобретает новое качество, отсутствующее у его частей. Существует организменный уровень состояния системы, например здоровье или болезнь; вместе с тем части целого отражают его свойства и сами вносят вклад в их формирование. Проблема части (местного) и целого (общего) в условиях патологии состоит не столько в их утверждении, сколько в раскрытии конкретных механизмов взаимодействия и роли этих механизмов в развитии и исходе заболеваний.</p>",
"prevention": "",
"clinical_picture": "<p>Местные изменения в тканях становятся пусковым фактором, включающим разнообразные общие перестройки, а последние в конечном итоге направлены на максимальную локализацию патологического процесса, уничтожение здесь же или удаление болезнетворного агента. Таким образом, очевидно, что \"местное\" оказывает влияние на \"общее\", трансформируя его, а свойства организма, т.е. \"общее\", отражаются на местных изменениях.</p>\r\n<p>Существует две формы сигнальной регуляции, а именно: регуляция по отклонению, или рассогласованию (регуляция на выходе системы), и регуляция по возмущению (регуляция на входе системы). Регуляция по отклонению действует в том случае, когда какой-либо регулируемый параметр отклоняется от заданной нормы (АД, объем циркулирующей крови, уровень глюкозы в крови, температура тела, осмотическое давление плазмы крови и т.п.). В данном случае возникает рассогласование между возникшим уровнем и генетически детерминированной нормой; такое отклонение параметра воспринимается регулирующими механизмами, и они нормализуют отклонившийся показатель гомеостаза. Механизмы, работающие на принципе саморегуляции по отклонению, весьма распространены в организме и лежат в основе многообразных приспособительных реакций организма при патологии.</p>\r\n<p>Они включаются при колебаниях температуры среды обитания, кровопотере, дефиците кислорода, анемиях и многих других. В основе такой саморегуляции лежит известный механизм обратной связи, который может обеспечивать автоматизированное подавление (отрицательная обратная связь) регулирующих механизмов, благодаря чему тот или иной процесс сам себя подавляет или, напротив, поддерживает. Так, при повышении температуры среды афферентные сигналы от терморецепторов кожи поступают к соответствующим центрам мозга, которые усиливают теплоотдачу и ограничивают теплопродукцию, сохраняя температуру тела на нормальном уровне. Таким образом, регуляция по рассогласованию определяет нормализацию уже возникшего в организме отклонения. Регуляция по возмущению обеспечивает предупреждение негативных воздействий на входе в систему при формировании возмущающего сигнала. Эта регуляция либо уменьшает силу воздействия, либо снижает чувствительность рецепторных приемников, следствием чего становятся ослабление интенсивности сигнала, сохранение устойчивости процесса и параметра, который он определяет. Здесь происходит не нормализация уже отклонившегося показателя гомеостаза, а предупреждается возможность его отклонения. регуляция организма</p>\r\n<p>Попадание в дыхательные пути раздражающего вещества немедленно формирует стоп-сигнал и остановку дыхания до того, как это вещество проникнет в альвеолы и поступит в кровь, изменив ее постоянство и включив механизмы регуляции по отклонению. Мигание и рефлекторное закрытие глаз предупреждают поступление пыли и изменение состава жидкости, омывающей глазные яблоки; напротив, выделение слезной жидкости уменьшает концентрацию пыли и способствует ее удалению, являясь результатом включения механизмов регуляции по отклонению. Рассмотренные формы саморегуляции существуют и действуют одновременно, взаимно дополняя друг друга и обеспечивая сохранение гомеостаза в здоровом и больном организме. Наряду с этим регуляция по возмущению, как и по отклонению, может стать механизмом формирования расстройств жизнедеятельности в случае инактивации или чрезмерной активации ее механизмов. Утрата болевой чувствительности при сирингомиелии может приводить к тяжелым повреждениям (откусывание языка, распространенные ожоги). Повышение порога возбуждения Na+-рецепторов, возрастание Na+-аппетита и избыточное потребление соли способствуют развитию солевой гипертензии, понижение порога возбуждения вестибулярных рецепторов может стать причиной ортостатического коллапса.</p>",
"image": null,
"image_alt": null,
"standard_type": 3,
"danger": 46,
"published": 1,
"parent": null,
"block_rubric": 250,
"standards": []
}
]
}