ÀâòîÀâòîìàòèçàöèÿÀðõèòåêòóðàÀñòðîíîìèÿÀóäèòÁèîëîãèÿÁóõãàëòåðèÿÂîåííîå äåëîÃåíåòèêàÃåîãðàôèÿÃåîëîãèÿÃîñóäàðñòâîÄîìÄðóãîåÆóðíàëèñòèêà è ÑÌÈÈçîáðåòàòåëüñòâîÈíîñòðàííûå ÿçûêèÈíôîðìàòèêàÈñêóññòâîÈñòîðèÿÊîìïüþòåðûÊóëèíàðèÿÊóëüòóðàËåêñèêîëîãèÿËèòåðàòóðàËîãèêàÌàðêåòèíãÌàòåìàòèêàÌàøèíîñòðîåíèåÌåäèöèíàÌåíåäæìåíòÌåòàëëû è ÑâàðêàÌåõàíèêàÌóçûêàÍàñåëåíèåÎáðàçîâàíèåÎõðàíà áåçîïàñíîñòè æèçíèÎõðàíà ÒðóäàÏåäàãîãèêàÏîëèòèêàÏðàâîÏðèáîðîñòðîåíèåÏðîãðàììèðîâàíèåÏðîèçâîäñòâîÏðîìûøëåííîñòüÏñèõîëîãèÿÐàäèîÐåãèëèÿÑâÿçüÑîöèîëîãèÿÑïîðòÑòàíäàðòèçàöèÿÑòðîèòåëüñòâîÒåõíîëîãèèÒîðãîâëÿÒóðèçìÔèçèêàÔèçèîëîãèÿÔèëîñîôèÿÔèíàíñûÕèìèÿÕîçÿéñòâîÖåííîîáðàçîâàíèå×åð÷åíèåÝêîëîãèÿÝêîíîìåòðèêàÝêîíîìèêàÝëåêòðîíèêàÞðèñïóíäåíêöèÿ

Ãëàâà 3. ÑÒÐÎÅÍÈÅ ÃËÀÇÍÎÃÎ ßÁËÎÊÀ. 1. Êðîâîòîê â êàïèëëÿðàõ õîðèîèäåè îäèí èç ñàìûõ èíòåíñèâíûõ — 800—1200/100 ãð/ìèí

×èòàéòå òàêæå:
  1. I. ÃËÀÂÀ ÏÀÐÍÛÕ ÑÒÐÎÔ
  2. II. Ãëàâà î äóõîâíîé ïðàêòèêå
  3. II. Ïîñòðîåíèå õàðàêòåðèñòè÷åñêîãî ãðàôèêà ÷àñîâîé ïðîèçâîäèòåëüíîñòè.
  4. III. Ãëàâà î íåîáû÷íûõ ñïîñîáíîñòÿõ.
  5. IV. Ãëàâà îá Îñâîáîæäåíèè.
  6. IV. Ãëàâà ïîäðàçäåëåíèÿ ïî ñòðàíå
  7. MathCad: ïîñòðîåíèå, ðåäàêòèðîâàíèå è ôîðìàòèðîâàíèå ãðàôèêîâ â äåêàðòîâîé ñèñòåìå êîîðäèíàò.
  8. Toxoplasma gondii. Ñòðîåíèå, öèêë ðàçâèòèÿ, ïóòè çàðàæåíèÿ, ìåðû.
  9. V. Ïîñòðîåíèå îäíîãî òðåíèðîâî÷íîãî çàíÿòèÿ
  10. XI. ÃËÀÂÀ Î ÑÒÀÐÎÑÒÈ
  11. XIV. ÃËÀÂÀ Î ÏÐÎÑÂÅÒËÅÍÍÎÌ
  12. XVIII. ÃËÀÂÀ Î ÑÊÂÅÐÍÅ

 


1. Êðîâîòîê â êàïèëëÿðàõ õîðèîèäåè îäèí èç
ñàìûõ èíòåíñèâíûõ — 800—1200/100 ãð/ìèí.

2. Ê õîðèîèäåå íàïðàâëÿåòñÿ 85% âñåãî
îáúåìà êðîâè, íàïðàâëåííîãî ê ãëàçíîìó ÿáëî­
êó (ê ñåò÷àòêå òîëüêî 4%).

3. Êðîâü â ïîñòêàïèëëÿðíûõ êðîâåíîñíûõ
ñîñóäàõ õîðèîèäåè ñòîëü æå áîãàòà êèñëîðî­
äîì, êàê è àðòåðèàëüíàÿ êðîâü [117, 293, 828].

4. Êðîâîîáðàùåíèå â ñîñóäàõ õîðèîèäåè íå
àóòîðåãóëèðóåòñÿ, ïîñêîëüêó íàñûùåíèå êðî­
âè óãëåêèñëûì ãàçîì ìèíèìàëüíîå [114, 117,
1196].

5. Ìàêñèìàëüíàÿ ñòèìóëÿöèÿ ñèìïàòè÷åñ­
êîé íåðâíîé ñèñòåìû ïðèâîäèò ê óìåíüøåíèþ
îáúåìà êðîâîîáðàùåíèÿ òîëüêî íà 60% [114,
117, 1196]; ñòåíêà êàïèëëÿðíûõ ñîñóäîâ íå ãåð­
ìåòè÷íà è ïðîíèöàåìà äëÿ ðàçëè÷íûõ âåùåñòâ,
âêëþ÷àÿ áåëêè.

Òàêèì îáðàçîì, èìåþùèåñÿ àíàòîìè÷åñêèå è ôèçèîëîãè÷åñêèå ñâåäåíèÿ íå ïîçâîëÿëè èññëå­äîâàòåëÿì îáúÿñíèòü ìåõàíèçìû ðàçâèòèÿ èøå­ìèè õîðèîèäåè. Òåì íå ìåíåå, ó÷àñòêè èøåìèè, à òàêæå èíôàðêòà õîðèîèäåè, íå ñòîëü óæ è ðåäêîå ÿâëåíèå [77, 333, 515].

Áûëè ïðîâåäåíû ìíîãî÷èñëåííûå ýêñïåðè­ìåíòàëüíûå èññëåäîâàíèÿ, ñâîäèâøèåñÿ ê ââå­äåíèþ â êðîâÿíîå ðóñëî ìèêðî÷àñòèö øàðîâèä­íîé ôîðìû [80, 210, 464, 893, 1198, 1199] èëè ôëþîðåñöåèíà [77, 257, 460, 515, 1108]. Íî è ïðè ýòîì, îáúÿñíåíèÿ ýòîìó ÿâëåíèþ íàéäåíî íå áûëî. Ëèøü èñïîëüçîâàíèå ôëþîðåñöåèíà ïîçâîëèëî íàáëþäàòü íàïîëíåíèå ó÷àñòêîâ õî-ðèîêàïèëëÿðíûõ ñîñóäîâ ôëþîðîñöåèíîì â âè­äå ñåêòîðîâ. Ïîñëåäîâàòåëüíîñòü è ïëîùàäü íàïîëíåíèÿ ñîñóäîâ êðîâüþ ÷åòêî ñîîòâåòñò­âîâàëà ñòðîåíèþ «õîðèîêàïèëëÿðíîé äîëüêè». Äîëüêà íà÷èíàëà íàïîëíÿòüñÿ êðîâüþ ñ öåíò­ðàëüíûõ ó÷àñòêîâ è ëèøü ñïóñòÿ íåñêîëüêî ñå­êóíä êðîâü ïîñòóïàëà ê ïåðèôåðèè. Ïîñêîëüêó ñòðîåíèå «äîëüêè» â ðàçëè÷íûõ ó÷àñòêàõ óâå-àëüíîãî òðàêòà ðàçëè÷íî (ñì. âûøå), ðàçëè÷íà è ñêîðîñòü êðîâåíàïîëíåíèÿ õîðèîèäåè â ðàç­ëè÷íûõ ó÷àñòêàõ.

Êîëè÷åñòâåííûå è êà÷åñòâåííûå õàðàêòåðèñ­òèêè êðîâîîáðàùåíèÿ â «äîëüêàõ» çàâèñÿò îò ìíîãèõ ïðè÷èí è, â ïåðâóþ î÷åðåäü, îò âíóòðè­ãëàçíîãî äàâëåíèÿ [257]. Óñòàíîâëåíî òàêæå, ÷òî âåíîçíàÿ êðîâü îòâîäèòñÿ îò êàæäîé «äîëü­êè» â îòäåëüíîñòè. Ïðè ýòîì êðîâü ñîñåäíèõ «äîëåê» íå ñìåøèâàåòñÿ. Ïî âñåé âèäèìîñòè, òàêàÿ ñèñòåìà êðîâîîáðàùåíèÿ ïðåäîïðåäåëÿ­åò ñóùåñòâîâàíèå íàèáîëåå áûñòðîãî è êîðîò­êîãî ïóòè îòòîêà âåíîçíîé êðîâè èç õîðèîèäåè. Ñ äðóãîé ñòîðîíû, âîçíèêàåò âåðîÿòíîñòü â îïðåäåëåííûõ óñëîâèÿõ âîçíèêíîâåíèÿ èøåìèè õîðèîèäåè íà ãðàíèöå «äîëåê». Íàèáîëåå ÷àñòî èøåìèÿ íàñòóïàåò ïðè îêêëþçèè êîðîòêèõ çàä­íèõ ðåñíè÷íûõ àðòåðèé, à òàêæå ñîñóäîâ ãëàç­íèöû [460, 470].

Ðàçâèòèå èøåìèè õîðèîèäåè íåáëàãîïðèÿòíî âëèÿåò íà ñòðîåíèå è ôóíêöèè ñåò÷àòîé îáîëî÷­êè. Èñ÷åçàþò ôîòîðåöåïòîðû íàðóæíîãî ÿäåð-


íîãî ñëîÿ, íàñòóïàåò ìèãðàöèÿ êëåòîê ïèãìåíò­íîãî ýïèòåëèÿ â ñåò÷àòêó.

Òàêèì îáðàçîì, íà îñíîâàíèè ïðèâåäåííûõ äàííûõ âèäíà íåñîñòîÿòåëüíîñòü êîíöåïöèè î íåâîçìîæíîñòè ðàçâèòèÿ èøåìèè õîðèîèäåè èç-çà áîëüøîãî êîëè÷åñòâà àíàñòîìîçîâ ìåæäó ñîñóäàìè.

Âîçðàñòíûå èçìåíåíèÿ ñîñóäèñòîé îáîëî÷­êè.  ñîñóäèñòîé îáîëî÷êå ãëàçà ñ âîçðàñòîì óìåíüøàåòñÿ êîëè÷åñòâî ýëàñòè÷åñêîé òêàíè [1049], à òàêæå óìåíüøàåòñÿ òîëùèíà è ñàìîé ñîñóäèñòîé îáîëî÷êè [868]. Âîêðóã êðóïíûõ ñî­ñóäîâ ôîðìèðóåòñÿ øèðîêàÿ ïðîñëîéêà âîëîê­íèñòîé òêàíè. Ïðè ýòîì ñîñóäû õîðèîèäåè íà­÷èíàþò íàïîìèíàòü ñîñóäû ðàäóæêè.  äîïîë­íåíèå ê îïèñàííîìó ñêëåðîçó ñîñóäèñòîé ñòåíêè èçìåíÿåòñÿ òàêæå ÷èñëî è êàëèáð ñîñó­äîâ. Ïðèâåäåííûå ñòðóêòóðíûå èçìåíåíèÿ ñî­ïðîâîæäàþòñÿ óìåíüøåíèåì ñêîðîñòè íàïîëíå­íèÿ õîðèîêàïèëëÿðíîãî ñëîÿ, ÷òî ïîêàçàíî ïðè ïîìîùè ôëþîðåñöåíòíîé àíãèîãðàôèè. Ïîÿâëÿ­þòñÿ ïÿòíà ãèïîôëþîðåñöåíöèè, õîòÿ îáùàÿ èíòåíñèâíîñòü ñâå÷åíèÿ ñîõðàíÿåòñÿ íåçàâèñè­ìî îò âîçðàñòà [525].

Ðåãåíåðàöèÿ óâåàëüíîãî òðàêòà. Ïîñëå ïî­âðåæäåíèÿ ëþáîãî ó÷àñòêà óâåàëüíîãî òðàêòà íàñòóïàåò ëèøü çàìåñòèòåëüíàÿ ðåãåíåðàöèÿ.  ýòó îáëàñòü ïåðâîíà÷àëüíî ìèãðèðóþò êëåòêè ñîåäèíèòåëüíîé òêàíè (ôèáðîáëàñòû), êîòîðûå ñèíòåçèðóþò ìåæêëåòî÷íîå âåùåñòâî è êîëëà­ãåí, âûïîëíÿþùèå äåôåêò. Çàòåì íàñòóïàåò îðãàíèçàöèÿ âîëîêíèñòîé òêàíè ñ îáðàçîâàíèåì ñîåäèíèòåëüíîòêàííîãî ðóáöà. Ðóáåö, êàê ïðà­âèëî, äîâîëüíî èíòåíñèâíî ïèãìåíòèðîâàí, ïî­ñêîëüêó â íåì ñêàïëèâàþòñÿ çåðíà ìåëàíèíà, âûñâîáîäèâøèåñÿ èç ïîâðåæäåííûõ ñòðîìàëü-íûõ ìåëàíîöèòîâ. Ñóùåñòâóþò îïðåäåëåííûå ðàçëè÷èÿ â ñêîðîñòè çàìåñòèòåëüíîé ðåãåíåðà­öèè ðàäóæíîé îáîëî÷êè. Ýòî ñâÿçàíî ñ òåì, ÷òî ïîñëå åå ïîâðåæäåíèÿ (ðàäèàëüíûå ðàçðûâû) êðàÿ ðàíû ðàñõîäÿòñÿ.  òàêèõ ñëó÷àÿõ ðóáöå­âàíèÿ âîîáùå íå ïðîèñõîäèò.

Ëèòåðàòóðà

1. Àáðàìîâ Â. Ã. Áîëåçíü òðàíñïëàíòàòà ðîãî­
âèöû.— ßðîñëàâëü: Âåðõ.-Âîëæ. êí. èçä-âî, 1972.
215 ñ.

2. Àáðàìîâ Â. Ã. Ê âîïðîñó îá èííåðâàöèè ðîãîâè­
öû // Îôòàëüìîë. æóðí.— 1959. — ¹6. — Ñ. 358—
362.

3. Àðòåìîâ À. Â. Èçìåíåíèå äðåíàæíîé çîíû ãëà­
çà è ñîñóäîâ, îñóùåñòâëÿþùèõ åå òðîôèêó â âîçðàñò­
íîì àñïåêòå // Îôòàëüìîë. æóðí. — 1980. — ¹ 7.—
Ñ. 401—405.

4. Àðòåìîâ À. Â. Ñðàâíèòåëüíàÿ õàðàêòåðèñòèêà
ñîñòîÿíèÿ òêàíåé äðåíàæíîé çîíû ãëàçà, ñîñóäîâ ðà­
äóæêè è öèëèàðíîãî òåëà ó áîëüíûõ ñèñòåìíûìè ñîñó­
äèñòûìè çàáîëåâàíèÿìè è ïðîñòîé ãëàóêîìîé // Òåç.
äîêë. Ìåæäóíàð. êîíô. îôòàëüìîëîãîâ ãîðîäîâ-ïîáðà­
òèìîâ Îäåññû. — Îäåññà, 1981, —Ñ. 181-182.

5. Àðòåìîâ À. Â. Ñîñòîÿíèå äðåíàæíîé çîíû è ñî­
ñóäîâ ïåðåäíåãî îòäåëà ãëàçà ó áîëüíûõ àòåðîñêëå­
ðîçîì, ãèïåðòîíè÷åñêîé áîëåçíüþ, ñàõàðíûì äèàáåòîì


Ëèòåðàòóðà



 


è îòêðûòîóãîëüíîé ãëàóêîìîé: Àâòîðåô. äèñ.... êàíä. ìåä. íàóê. — Îäåññà, 1982.— 20 ñ.

6. Áåëÿåâ Â. Ñ. Ñêëåðîïëàñòèêà â ëå÷åíèè ïðîãðåñ­
ñèðóþùåé ìèîïèè. — Ì.: Èçä-âî Èí-òà äðóæáû íàðî­
äîâ, 1977.— 229 ñ.

7. Áîãîâÿãèí Â. Ë., Ôðàíê Ã. Ì. Ñóáìèêðîñêîïè÷åñ­
êàÿ îðãàíèçàöèÿ è ôóíêöèîíàëüíûå îñîáåííîñòè ìþë-
ëåðîâñêèõ êëåòîê ñåò÷àòêè // Áèîôèçèêà,— 1962.—
Ò. 7. — ¹ 1 — Ñ. 42—50.

8. Âûçîâ À. Ë. Ïîòåíöèàëû â ãëèàëüíûõ êëåòêàõ
ñåò÷àòêè //  êí.: Ôóíêöèè íåéðîãëèè.—Òáèëèñè:
Ìåöíèåðåáà, 1979. — Ñ. 49—59.

9. Âèò Ü. Â., Äìèòðèåâ Ñ. Ê- Ãåìîôòàëüìè÷åñêèé
áàðüåð ïðè òðàâìå ãëàçà // Îôòàëüì. æóðí. — 1997. —
¹ 2.— Ñ. 143.

10. Bum Â. Â., Ìàëüöåâ Ý.Â. Îñîáåííîñòè ðåïàðà­
öèè ïîâðåæäåíèé ýïèòåëèÿ ðîãîâèöû è õðóñòàëèêà ó
æèâîòíûõ, ïîäâåðãøèõñÿ õðîíè÷åñêîìó âîçäåéñòâèþ
ìàëûõ äîç èîíèçèðóþùåé ðàäèàöèè è èíòåíñèâíîìó
ñâåòîâîìó îáëó÷åíèþ // Îôòàëüì. æóðí. — 1998. —
¹1. —Ñ. 69—73.

Ì.Âèò Â. Â., Ìàëüöåâ Ý. Â., Ïàâëþ÷åíêî Ê-Ï. Âëèÿíèå ïîâûøåííîé èíñîëÿöèè è ìàëûõ äîç èîíèçè­ðóþùåé ðàäèàöèè íà ðåãåíåðàöèþ ýïèòåëèÿ õðóñòàëè­êà // Îôòàëüì. æóðí. — 1997. — ¹ 5. — Ñ. 445—448.

12. Âèò Â. Â., Þìàøåâà À. À., Áàáàíèíà Þ. Ä.
Ïîñëåîïåðàöèîííûå îñëîæíåíèÿ öèðêëÿæà ðàçëè÷­
íûìè ìàòåðèàëàìè ïî äàííûì ýêñïåðèìåíòàëüíûõ
èññëåäîâàíèé // Îôòàëüì. æóðí. — 1979. — ¹ 4. —
Ñ. 244—247.

13. Âîéíî-ßñåíåöêèé Â. Â., Äóìáðîâà Í. Å. Óëüòðà­
ñòðóêòóðà ìíîãîñëîéíîé âîëîêíèñòîé òêàíè, îáðàçóþ­
ùåéñÿ çà äåñöåìåòîâîé îáîëî÷êîé ïîñëå îæîãà ðîãî­
âèöû ñåðíîé êèñëîòîé // Îôòàëüì. æóðí.— 1971.—
¹8.— Ñ. 599—603.

14. Âîéíî-ßñåíåöêèé Â. Â. Î ïðèðîäå è ðåãåíåðà-
öèîííûõ ñâîéñòâàõ êëåòîê ñòðîìû è ýíäîòåëèÿ ðîãî­
âèöû // Â êí.: Ìàòåðèàëû 3-é êîíôåðåíöèè ïî âîïðî­
ñàì ðåãåíåðàöèè è êëåòî÷íîãî ðàçìíîæåíèÿ, 1962. —
Ñ. 28-30.

15. Âîéíî-ßñåíåöêèé Â. Â. Ïàòîëîãè÷åñêèé ðîñò
ýíäîòåëèÿ ïðè ýêñïåðèìåíòàëüíîì îæîãå ðîãîâèöû
ñåðíîé êèñëîòîé // Ìàòåðèàëû íàó÷í. êîíô., ïîñâÿ­
ùåííîé 90-ëåòèþ ñî äíÿ ðîæäåíèÿ Â. Ï. Ôèëàòîâà,
Êèåâ. 1965 —Ñ. 19—20.

16. Âîéíî-ßñåíåöêèé Â. Â. Ïðîöåññ ïðèæèâëåíèÿ
ðîãîâè÷íîãî òðàíñïëàíòàòà ïðè âíóòðè÷åðåïíîì ïî­
âðåæäåíèè òðîéíè÷íîãî íåðâà // Îôòàëüì. æóðí. —
1959. — ¹ 3. — Ñ. 170—176.

17. Âîéíî-ßñåíåöêèé Â. Â. Ìåòàïëàçèÿ òêàíåé ãëà­
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