Choyamba, mitsempha yamagazi imadwala kuchuluka kwa glucose. Matenda a shuga ndi kuthamanga kwa magazi amawonera nthawi imodzi mu 80% ya odwala. Ngati matenda oopsa ndi vuto lathanzi la matenda amtundu 1, ndiye kuti matenda amtundu 2 angadziwike ngakhale matenda osokoneza bongo asanafike.
Hypertension imakulitsa njira ya matenda ashuga, imachulukitsa mwayi wolumikizidwa katatu, khungu, chifukwa cha kuwonongeka kwa retina ndi girala lamiyendo - nthawi 20. Chifukwa chake, zofuna za anthu odwala matenda ashuga ndizovuta kuposa anthu athanzi. Chithandizo cha matenda oopsa chimayamba nthawi yomweyo, monga zizindikiro zoyambirira zamatenda a mtima zimawonekera. Amaganizidwanso chidwi posankha mankhwala, chifukwa cha matenda ashuga, mapiritsi okha ndi omwe amalembedwa omwe sangakulitse zovuta zomwe zilipo.
Zomwe zimayambitsa kuthamanga kwa magazi mwa odwala matenda ashuga
Ndi matenda a shuga amtundu woyamba, chomwe chimayambitsa matenda oopsa ndi nephropathy. Awa ndi vuto lomwe limayamba pang'onopang'ono pomwe minyewa ya impso imawonongeka chifukwa cha kuchuluka kwa glucose m'matumbo, komwe kumawonjezera kukodza, mapuloteni amayamba kulowa mkodzo, ndipo pamapeto pake, kulephera kwaimpso kumachitika. Nthawi zambiri wodwala akanyalanyaza chithandizo chamankhwala chamatenda a shuga, ma nephropathy amapita patsogolo msanga.
Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale
- Matenda a shuga -95%
- Kuthetsa kwa mitsempha thrombosis - 70%
- Kuthetsa kwa kugunda kwamtima kwamphamvu -90%
- Kuthana ndi kuthamanga kwa magazi - 92%
- Kuwonjezeka kwa mphamvu masana, kukonza kugona usiku -97%
Glomeruli yowonongeka imayamba kugwira ntchito mwachangu renin, chinthu chomwe chimakulitsa kamvekedwe ka mtima. Kupanikizika kumakulanso gawo lachitatu la nephropathy, pamene impso zimayamba kusefa mkodzo katatu pang'onopang'ono. Pakalipano, njira ziwiri zimayambira: glomeruli yowonongera imayambitsa matenda oopsa, ndipo iwonso imakulitsa mitsempha yamagazi, kuphatikizanso impso. Kupsyinjika kotere ndikokhazikika komanso kosavomerezeka. Ndi kusintha kosasintha kwa impso, imawonedwa mwa odwala onse omwe ali ndi matenda ashuga.
Anthu odwala matenda ashuga a mtundu wachiwiri amakumana ndi matenda oopsa kwambiri m'mbuyomu ngakhale atadwala matenda ashuga. Kuthamanga kwa magazi ndi chimodzi mwazizindikiro za metabolic syndrome, poyambira matenda ashuga. Glucose imayamba kukhudza zombozo ngakhale mfundo zake zisanakhale zokwera. Pali umboni kuti njirayi imayamba pomwe glucose ali pamwamba 6 mmol / L. Makoma a zotengera adawonongeka, zolembera zimayamba kupanga pa iwo, mawonekedwe akuwala. Mabwenzi odalirika a shuga - kunenepa kwambiri komanso kusayenda - imathandizira kuyambika kwa matenda oopsa.
Chiyanjano pakati pa mtundu wa chithandizo cha matenda ashuga komanso kuchuluka kwa kuchuluka kwa matenda oopsa mwachangu, mwachangu, shuga, ndizochedwa magazi m'matumbo.
Zomwe zimayambitsa kupsinjika kwa shuga:
| Matendawa | Feature | Kuchuluka kwa matenda ashuga,% | |
| Mtundu 1 | Mtundu 2 | ||
| Matenda a shuga | Kuwonongeka kwa glomeruli la impso. | 80 | 15-20 |
| Chofunikira pa matenda oopsa | Kuchulukirachulukira kwakukakamiza kopanda chifukwa. | 10 | 30-35 |
| Isolated systolic hypertension | Kuchulukitsa kwapanthawi, kumayamba kukalamba. | 5-10 | 40-45 |
| Matenda a endocrine | Ma tumor, zovuta m'matimu a pituitary, gren adrenal, chithokomiro cha chithokomiro. | 1-3 | 1-3 |
| Matenda a shuga | Kuchepetsa chotengera chachikulu chomwe chimadyetsa impso. | palibe deta | 5-10 |
Ubwenzi wapakati pa matenda oopsa ndi insulin
Amadziwika kuti insulin imagwira ntchito ngati vasodilator. Chifukwa chiyani, ndiye kuti mtundu wachiwiri wa matenda ashuga, wodziwika ndi kuchuluka kwa insulin, womwe umagwirizana kwambiri ndi matenda oopsa? Chowonadi ndi chakuti mwa odwala oterowo mumakhala kukana insulini - mkhalidwe womwe umasokoneza kuzindikira kwa insulin ndi maselo amthupi. Kupitilira kafukufuku woyeserera, zidapezeka kuti hyperinsulinemia kuphatikiza ndi insulini kukana kumabweretsa kutulutsidwa kwa norepinephrine ndikuwonetsa kwakukulu kwa dongosolo lamanjenje lamanjenje. Komanso, odwala matenda ashuga okhala ndi kunenepa kwambiri, ntchito zake ndizokwera mu impso, zotsika mu mtima. Chifukwa cha izi, impso zimasunga sodium ndi madzi, zimonjezera kukonzanso. Zotsatira zake, kupanikizika m'matumba kumadzuka.
Zinapezeka kuti kuchuluka kwa chisangalalo, motero kuchuluka kwa matenda oopsa, zimatengera mwachindunji cholozera cha misa. Mafuta ochulukirapo m'thupi, pomwe wodwala yemwe ali ndi matenda ashuga amakumana ndi mavuto ambiri, ndipo kukwera kwake kumawonetsa kuchuluka kwambiri.
Zizindikiro ndi zizindikiro za matenda oopsa mu shuga
Kupsinjika kwa magazi ndi mtengo wosinthika. Masana amasintha ndi 10-20%, nthawi zambiri amatsika usiku ndi m'mawa, okwera gawo la masana. Malire apamwamba a nthawi zonse kwa anthu athanzi ndi 140/90. Chithandizo chimafunikira ngati mulingo uwu mobwerezabwereza.
Mu shuga mellitus, mawonekedwe a kugwedezeka amasokonezeka. Kupsinjika usiku kumatha kukhala chimodzimodzi ngati masana, kapenanso kukwera. Zotsatira zake, zombo zimatha mofulumira, angiopathy ndi neuropathy zikuyenda bwino. Chifukwa cha chiwopsezo cha matenda oopsa mu shuga, m'mphepete chitseko cha odwala chatsitsidwa kukhala 130/85. Ngati kupanikizika kumapitilira gawo ili kapena kukwera kangapo pa sabata, muyenera kufunsa dokotala kuti akupatseni mankhwala.
Zizindikiro za matenda oopsa:
- mutu, nthawi zambiri kumbuyo kwa mutu;
- Chizungulire
- kutopa
- kupweteka mumtima, nthawi zambiri mukatha kudya kapena kudya kwambiri;
- kuvutika kugona
- kuchuluka kukodza usiku chifukwa cha nocturia.
Orthostatic hypotension imatha kuonedwanso: kuchepa kwapang'onopang'ono ndikusintha kwakuthwa kwamthupi, nthawi zambiri mukamadzuka. Zizindikiro zake ndi chizungulire, mseru. Kuukira kotereku kumadutsa mwachangu, m'mphindi zochepa.
Zizindikiro za matenda oopsa amathanso kusakhalapo, chifukwa kupanikizika kumakula pang'onopang'ono, ndipo thupi limatha kusintha ndikusintha. Ngati matenda a asymptomatic sapezeka mu nthawi, vutoli litha kukhala pamavuto oopsa kwambiri.
Pofuna kuti matendawa achoke mu nthawi, dongosolo loyesa matenda a shuga limaphatikizanso kuyang'anira kukakamizidwa, komanso pamavuto okayikitsa komanso kukayikira kwamankhwala usiku - ndikuwunikira maola 24.
Momwe mungalimbanirane ndi kupsinjika mu shuga
Ganizirani njira zoyenera zothanirana ndi kuthamanga kwa magazi.
Kumbukirani: Kuthamanga kwambiri kwa magazi kumatha kukhala matenda a sitiroko.
Kugwiritsa ntchito mankhwala osokoneza bongo
Mapiritsi opanikizika amagwiritsidwa ntchito kwa anthu odwala matenda ashuga omwe ali ndi malire. Mankhwalawa sayenera kukhudza kagayidwe, osachulukitsa njira ya mtima wamatenda, kuthandiza mtima ndi impso. Simungathandize kuchepetsa kupanikizika ndi matenda oopsa, chifukwa izi zingapangitse kuchuluka kwa matenda ashuga. Dongosolo la chithandizo cha munthu payekha limapangidwira wodwala aliyense. Ndi kukwezedwa pang'ono, mankhwalawa omwe akukhala nthawi yayitali amakonda, piritsi limodzi tsiku lonse. Chithandizo cha matenda oopsa pamafunika njira yolumikizirana, pogwiritsa ntchito mankhwala ochokera m'magulu angapo.
Mankhwala Ochizira:
| Gululi | Feature | Mankhwala |
| ACE zoletsa | Mankhwala osankhidwa a matenda a shuga amayamba kupatsidwa. Makonda amakhudza kagayidwe kazakudya, katetezani impso. | Captopril, Fosinopril, Enalapril |
| AT1 receptor blockers | Mapiritsi amapereka kutchulidwa yosalala, osakhudza kagayidwe kachakudya kagayidwe. Zochizira matenda oopsa, amatha kuikidwa ndi ACE inhibitors. | Losartan, Valsartan, Teveten |
| Otsutsa a calcium | Amakhala osakanikirana bwino ndi ACE inhibitors, amateteza mtima, komanso amachepetsa kutulutsa kwa mapuloteni ndi impso. | Verapamil, Diltiazem |
| Beta blockers | Onjezerani ku regimen yothandizira pa matenda oopsa ndi kusowa kwa mapiritsi ena. Amatha kukulitsa kulolera kwa glucose, kukulitsa nthawi ya shuga, kuphimba zizindikiro za hypoglycemia. Kugwiritsa ntchito nthawi yayitali ndi kowopsa kwa hyperosmolar coma. | Atenolol, Bisoprolol |
| Zodzikongoletsera | Veroshpiron, Hypothiazide |
Kudya
Kuphatikiza pa mapiritsi, chithandizo cha matenda oopsa mosalephera chimafunikira chakudya chapadera.
Iyenera kupereka:
- Matendawa amasintha shuga pochepetsa chakudya chamagulu m'zakudya, makamaka othamanga.
- Zabwino pang'ono, zakudya zisanu patsiku.
- Anachepetsa kuchuluka kwamadzi m'thupi. Kuti muchite izi, chepetsa mchere wamchere. Nthawi zambiri amalimbikitsa mchere 10 g pa tsiku, ndi matenda oopsa kuchokera ku madigiri 2 ndi kupitirira (> 160/100) - mpaka 4 g.
- Mafuta ochepa a nyama - nyama yokha yazakudya ndi nkhuku zopanda khungu.
- Kukana khofi wamphamvu, tiyi wakuda, mowa kuti muchepetse nkhawa pamtima.
- Zabwino zamasamba. CHIKWANGWANI chochokera kwa iwo chimasokoneza mayamwidwe a cholesterol, potero amachepetsa mawonetseredwe a atherosulinosis.
- Zogulitsa ndi magnesium ndi potaziyamu kamodzi patsiku: amadyera, nyemba, maapricots owuma, prunes, mtedza.
Maziko a zakudya zophatikiza ndi matenda oopsa ayenera kukhala mapuloteni, mafuta osakwaniritsidwa komanso chakudya chamafuta ochepa a GI - Gome la glycemic indices - //diabetiya.ru/produkty/glikemicheskij-indeks-produktov.html.
Zithandizo za anthu
Pali magulu angapo azomera zamankhwala zomwe zingakhale zothandiza kwa odwala matenda oopsa omwe ali ndi matenda a shuga:
- Zitsamba zokhala ndi hypotonic yolimba: hawthorn, mamawort, melilot, adonis.
- Zomera zokhala ndi mphamvu pang'ono: angelica, hops, calendula, linden.
- Mitsitsi yotsitsimutsa yomwe imagwiritsa ntchito matenda oopsa kudzera mumitsempha yamafuta: mandimu, mandimu, valerian, peony.
- Zomera za diuretic: chamomile, lingonberry, bearberry, nettle.
Malipiro a matenda oopsa nthawi zambiri amakhala ndi zitsamba zamagulu onse. Brew iwo monga ambiri ulamuliro: tengani 2 tbsp. supuni ya zopangira, kutsanulira kapu ya madzi otentha ndi zilowerere osamba madzi kwa mphindi 15, ndiye kukulunga. Pakatha mphindi 45, vutani ndi kumwa mankhwalawa katatu Mlingo wogawanika patsiku.
Kupewa
Kuyang'anira malamulo oletsa kupewa matenda oopsa kungathandize kupewa kumwa mankhwala ambiri othamanga magazi kwa anthu odwala matenda ashuga:
- samalani magazi a shuga. Imwani mankhwala onse omwe mumalandira. Shuga yabwinoko imalipidwa, kutsika kwake kumakhala;
- kuchepetsa kulemera kwa thupi kukhala labwinobwino;
- phunzitsani mtima. Gawani ola limodzi osachepera katatu pa sabata kuti muziyenda mwachangu, kuthamanga, kusambira kapena kuyendetsa ndege;
- kusiya kusuta fodya ndi mowa;
- kupatsa thupi zakudya zabwino;
- mumakayezetsa kuchipatala chaka chilichonse, muthandizire angiopathy, neuropathy komanso kusintha kwa matenda ashuga.
