Odwala ambiri omwe ali ndi matenda ashuga ali ndi mitundu yonse yamatenda omwe amakumana ndi vuto lomwe limakhudza munthu komanso limakhudza ziwiya zonse ndi ziwalo. Chimodzi mwazovuta izi ndi matenda a shuga.
Chinsinsi cha matendawa ndikuti dongosolo lonse la mtima limakhudzidwa. Ngati ziwiya zochepa zokha zowonongeka, ndiye kuti matendawa amawerengedwa ngati diabetesic microangiopathy.
Ngati ziwiya zazikulu zokhazokha zagwidwa, matendawa amatchedwa matenda ashuga macroangiopathy. Koma siliri vuto lokhalo lomwe wodwala matenda ashuga angakhale nalo. Ndi angiopathy, homeostasis imakhudzidwanso.
Chizindikiro Chokhudza Matenda Aakulu a shuga
Mukamaganizira za zizindikiro zazikulu za microangiopathy, zinthu zitatu zazikulu zimadziwika, zotchedwa Virchow-Sinako triad. Zizindikiro izi ndi ziti?
- Makoma azombo amayenda.
- Kuphatikizika kwa magazi kumakhala kusokonekera.
- Kuthamanga kwa magazi kumachepa.
Zotsatira za kuchuluka kwa ntchito ya magazi a m'magazi komanso kuchuluka kwa magazi, kumayamba kuchepa. Zida zathanzi zimakhala ndi mafuta apadera omwe samalola magazi kutsatira khoma. Izi zimathandizira kutuluka kwamagazi koyenera.
Mitsempha yosokonekera siyingatulutse izi, ndipo kuchepa kwa magazi kumachitika. Mavuto onsewa samatsogolera pakuwonongeka kwa mitsempha yamagazi, komanso mapangidwe a microtubus.
Panthawi yopanga matenda a shuga, kusintha kwamtunduwu kumaphatikizapo zombo zambiri. Nthawi zambiri malo omwe akukhudzidwa ndi awa:
- ziwalo zamawonedwe;
- myocardium;
- impso
- zotumphukira mantha dongosolo;
- khungu mawonekedwe.
Zotsatira zakuphwanya izi, monga lamulo, ndi:
- neuropathy;
- matenda ashuga nephropathy;
- mtima
- dermatopathy.
Koma Zizindikiro zoyambirira zikuwonekera kumadera akumunsi, komwe kumachitika chifukwa cha kusayenda bwino kwamitsempha yamagazi m'derali. Kulembetsa kwamilandu yotere ndi pafupifupi 65%.
Madokotala ena amakonda kunena kuti microangiopathy si matenda osiyana, ndiye kuti ndi chizindikiro cha matenda ashuga. Kuphatikiza apo, amakhulupirira kuti microangiopathy ndi zotsatira za neuropathy, zomwe zimachitika kale.
Asayansi ena amati mitsempha ya m'mimba imayambitsa neuropathy, ndipo izi siziphatikizidwa ndi kuwonongeka kwa mtima. Malinga ndi lingaliro ili, matenda a shuga amachititsa neuropathy, ndipo microangiopathy ilibe kanthu.
Koma palinso lingaliro lachitatu, otsatira ake omwe amati kuphwanya kwamanjenje kungayende bwino m'mitsempha yamagazi.
Matenda a shuga a shuga a shuga amagawidwa m'mitundu ingapo, omwe amayamba chifukwa cha kuwonongeka kwakumapeto.
- Ndi zero zero yakuwonongeka khungu pakhungu la munthu kulibe.
- Gawo loyamba - pali zolakwika zochepa pakhungu, koma sizikhala ndi zotupa ndipo zimangokhala zochepa patokha.
- Pa gawo lachiwiri, zotupa zowonekera kwambiri pakhungu zimawonekera zomwe zimatha kuzama kotero kuti zimawononga tendons ndi mafupa.
- Gawo lachitatu limadziwika ndi zilonda za pakhungu ndi zizindikiro zoyambirira za kufa kwa minofu pamiyendo. Mavuto oterewa amatha kuchitika limodzi ndi njira zotupa, matenda, edema, hyperemia, abscesses ndi osteomyelitis.
- Pa mulingo wachinayi, gulu la chala chimodzi kapena zingapo zimayamba kukula.
- Gawo lachisanu ndi phazi lonse, kapena ambiri amakhudzidwa ndi gangrene.
Makhalidwe a macroangiopathy
Chochititsa chachikulu pakufa kwakukulu kwa odwala omwe ali ndi matenda ashuga ndi matenda ashuga macroangiopathy. Ndi macroangiopathy yomwe nthawi zambiri imapezeka mwa odwala matenda ashuga.
Choyamba, ziwiya zazikulu zam'munsi zimakhudzidwa, chifukwa cha momwe mitsempha yam'mimba komanso matenda ammimba imagwirira ntchito.
Macroangiopathy imatha kukhazikika pakuwonjezera kukula kwa matenda a atherosulinotic. Matendawa amagawidwa m'magawo angapo chitukuko.
- Poyamba, m'mawa wodwalayo wawonjezera kutopa, thukuta kwambiri, kufooka, kugona, kumva kuzizira m'miyendo ndi kugona kwawo pang'ono. Izi zimawonetsera kubwezeretsedwa kwa kufalikira kwazungulira.
- Mu gawo lachiwiri, miyendo ya munthu imayamba kugoneka, amasungika kwambiri, mawonekedwe akumisomali akuyamba kusweka. Nthawi zina lameness amapezeka pamenepa. Ndipo pamakhala kupweteka m'miyendo, poyenda komanso popuma. Khungu limakhala lotuwa komanso loonda. Zosokoneza m'malumikizidwe zimawonedwa.
- Gawo lotsiriza ndilopanda matenda a shuga kumapazi, zala ndi mwendo wotsika.
Kodi kuchitira angiopathy
Macro ndi microangiopathy mu shuga amathandizidwanso chimodzimodzi. Choyambirira chomwe wodwala amayenera kuchita ndikubweretsa njira ya thupi yokhala yokhazikika. Carbohydrate metabolism iyenera kubwezeretsedwanso, chifukwa ndi hyperglycemia yomwe ndiyomwe imayambitsa kukula kwa mtima wamatumbo.
Chofunikanso kwambiri pakuthandizira mankhwalawa ndikuwunika momwe metabolidi a lipid amawonongera. Ngati miloproteins yokhala ndi zizindikiro zotsika kwambiri imachulukana mwadzidzidzi, ndipo kuchuluka kwa ma triglycerides, m'malo mwake, kutsika, izi zikusonyeza kuti ndi nthawi yophatikiza mankhwala a hypolipidic pamankhwala.
Tikulankhula za ma statins, ma fibrate ndi ma antioxidants. Macro- ndi microangiopathy mu matenda osokoneza bongo amachitidwa ndi kukakamizidwa kuphatikizidwa kwa achire mankhwala a metabolic kanthu, mwachitsanzo, trimetazidine.
Mankhwalawa amathandizira kuti makutidwe ndi okosijeni a glucose mu myocardium, omwe amapezeka chifukwa cha oxidation wamafuta acids. Mankhwalawa onse amtundu wa matendawa, odwala amapatsidwa anticoagulants.
Awa ndimankhwala omwe amathandizira kusungunuka kwamagazi m'magazi ndikuchepetsa mphamvu ya maselo othandiza kugwirira ntchito akapezeka ndi macroangiopathy.
Chifukwa cha zinthuzi, magazi samakhala osasinthasintha ndipo simapangidwira chifukwa chotchinga mitsempha yamagazi. Ma Anticoagulants akuphatikizapo:
- Acetylsalicylic acid.
- Tiklid.
- Vazaprostan.
- Heparin.
- Dipyridamole.
Zofunika! Popeza matenda olembetsa magazi nthawi zambiri amakhala alipo m'matenda a shuga, ndikofunikira kupereka mankhwala omwe amathandizira magazi. Ngati chizindikirochi ndichabwinobwino, ndikulimbikitsidwa kuyang'anira nthawi zonse.
Mu shuga mellitus, mulingo woyenera kwambiri ndi 130/85 mm Hg. Njira zowongolera zoterezi zikuthandizira kupewa kwa nephropathy komanso retinopathy, kuchepetsa kwambiri vuto la kugwidwa ndi matenda a mtima.
Mwa mankhwalawa, otsutsana ndi calcium njira, othandizira ndi zoletsa zina amadziwika.
Pa mankhwala, ndikofunikira kusintha zizindikiro za autonomic homeostasis. Chifukwa cha izi, madokotala amatipatsa mankhwala omwe amalimbikitsa ntchito ya sorbitol dehydrogenase. Ndikofunikanso kuchita ntchito zomwe zimalimbikitsa chitetezo cha antioxidant.
Inde, ndibwino kuteteza matendawa poyamba. Kuti muchite izi, muyenera kukhala ndi moyo wabwino ndikuwunika thanzi lanu nthawi zonse. Koma ngati zizindikiro za matenda ashuga zikuwonekera, muyenera kufunsa kuchipatala.
Njira zamakono zamankhwala othandizira odwala matenda a shuga ndikuthandizira kupewa zingamuthandize munthu kupewa zovuta monga macro- ndi microangiopathy.
