Kupanikizika kwa matenda a shuga: njira ndi zoyambitsa za matenda

Kuthamanga kwa magazi m'magazi a shuga ndi vuto lodziwika lomwe odwala amakhala nalo. Malinga ndi ziwerengero, matenda oopsa amapezeka mu 60% ya anthu odwala matenda ashuga. Kupenda matenda a ubongo kumawonjezera thanzi lathu, kumachulukitsa matendawo. Poyerekeza ndi kuyambika kwa kuthamanga kwa magazi, chiopsezo chotenga zovuta zazikulu (stroke, kugunda kwa mtima) zimawonjezeka, zotsatira zake zimapha.

Kwa odwala omwe ali ndi matenda amtundu wa 1, matenda amtundu wa 2, kupanikizika kumawoneka ngati kwabwinobwino, osapitirira 130/85 mm Hg. Art. Kuwoneka kwa matenda oopsa nthawi zambiri kumachitika chifukwa cha zotupa zam'mimba zopezeka pamaso pa okwera shuga. Ganizirani kuchepetsa kuthamanga kwa magazi anu chifukwa cha matenda ashuga.

Pathogenesis, zomwe zimayambitsa matenda

Mtundu woyamba wa shuga, ntchito ya impso imalephera chifukwa cha glomerular microangiopathy (kuwonongeka kwa ziwiya zazing'ono). Zotsatira zake, mapuloteni amatulutsidwa limodzi ndi mkodzo. Vutoli limatchedwa proteinuria ndipo limayendera limodzi ndi kukwera kwa magazi.

Kupanikizika kwambiri kumapangitsa glomeruli kufa pang'onopang'ono. M'tsogolo, kulephera kwa impso kumawonekeranso. Mu milandu 10%, matenda oopsa alibe njira iliyonse yokhudzana ndi matenda amtundu 1, koma nthendayi ndi yofanana. Odwala awa amakhalanso ndi impso.

Odwala omwe ali ndi matenda a shuga a 2, matenda oopsa amayamba kale kuposa matenda ashuga kapena amagwirizana ndi matendawa. Zilonda zam'mimba zimayambitsa kukula kwa matenda mu 15-20% yokha ya odwala. Mu milandu 30-30%, kupsinjika kumadzuka kusokonezeka kwa metabolic kusanachitike.

Pathology imayamba ndi chitukuko cha insulin (kutsitsa chidwi cha minyewa mpaka insulin). Kuti alipirire vutoli, insulini imakwera, yomwe imayambitsa kuchuluka kwa magazi.

The pathogenesis of hypertension:

1. Mchitidwe wamanjenje wachifundo umayendetsedwa;
2. Njira yachilendo ya kuchotsa kwa sodium, madzimadzi amasokonezeka;
3. Sodium, calcium imadziunjikira mkati mwa maselo;
4. Makoma a zombo amawotchera, kutanuka kwake kumachepa.

Zotsatira zoyipa zomwe zimapangitsa kuti matenda asokonezeke mwanjira yoyamba ndi matenda a shuga a 2 ndi motere:

• Zaka zotsogola;
• Kuchepa kwa micronutrient m'thupi;
• Kuledzera kwakukulu;
• Kupsinjika pafupipafupi;
• Atherosulinosis;
• Kunenepa kwambiri
• Zochitika zina za endocrine dongosolo.

Zovuta zotheka

Kuthamanga kwa magazi m'magazi a shuga kumawonjezera zovuta zingapo kangapo:

• Kulephera kwamkaka - nthawi 25;
• Zilonda zosachiritsa, gangren - 20 times;
• Matenda a mtima - kasanu;
• Stroke - kanayi;
• Kuwonongeka kwakuthwa mu mawonekedwe a ntchito - maulendo 15.

Mu odwala matenda ashuga ambiri, kuthamanga kwa magazi kumakhala kovuta chifukwa cha hypotension ya orthostatic. Pathology imadziwika ndi kutsika kwakuthwa kwa kuthamanga kwa magazi pakukwera pamalo abodza. Imadziwoneka ngati yakuda m'maso, chizungulire, kukomoka. Zomwe zimapangitsa kuti khungu lisamveke bwino ndi matenda a shuga.

Zizindikiro

Kwa ambiri, matenda oopsa samadziwonetsa, mwa odwala ena, kuchuluka kwa mavuto kumayendetsedwa ndi:

1. Chizungulire;
2. Mutu;
3. Zowonongeka;
4. Kufooka;
5. Kutopa.

Pali magawo atatu a matenda oopsa mu shuga, omwe amadziwika ndi izi:

1. Zofewa. Kupsinjika kwapamwamba ndi 140-159, otsika - 90-99 mm RT. st.;
2. Wofatsa. Kuthamanga kwa magazi - 160-179, kutsika - 100-109 mm RT. st.;
3. Zovuta. Kupanikizika kumapitilira chizindikiro 180/110 mm RT. Art.

Pofuna kupewa kuthamanga kwamatenda am'mimba komanso zovuta zomwe zimadza pambuyo pake, odwala matenda ashuga amayenera kuyesetsa kuthana ndi zovuta pa 130/85 mm Hg. Art. Izi zidzakulitsa zaka 15-20.

Chithandizo

Ndi kupsinjika kowonjezereka, muyenera kufunsa katswiri, kudzipereka nokha sikokwanira. Njira zochizira ndi monga:

• Mankhwala. Gwiritsani ntchito mankhwala omwe amachepetsa kuthamanga kwa magazi. Nthawi zambiri amaika diuretics, ACE zoletsa, zomwe zimachepetsa chiopsezo cha kuwonongeka kwa impso.
• Zakudya Thupi la wodwala yemwe ali ndi matenda ashuga amamvera sodium, chifukwa chake, ndi kuthamanga kwa magazi, muyenera kuchepetsa mchere muzakudya. Nthawi zambiri izi zimathandiza.
• Kuchepetsa thupi. Izi zidzasintha zonse.
• Kutsatira zochitika tsiku ndi tsiku, kukhalabe ndi moyo wathanzi. Zochita za locomotor, masewera amakhala ndi zotsatira zabwino m'mitsempha yamagazi, amachepetsa kuchuluka kwa shuga m'magazi.

Mapiritsi oopsa

Mankhwala ndi Mlingo amasankhidwa kotero kuti kupanikizika kumachepa pang'onopang'ono. Nthawi yokwanira yokwaniritsira izi ndi pafupifupi masabata 8 kuyambira pamene mudayamba kumwa mankhwalawa. Kuchepetsa kwambiri kuthamanga kwa magazi kumakhala chifukwa chakuyenda bwino kwa magazi, ziwopsezo zamagulu ndi machitidwe.

Kusintha kwa carbohydrate metabolism mu odwala matenda ashuga kumapangitsa kuti zikhale zovuta kusankha mankhwala. Mankhwala amatengedwa poganizira momwe thupi la wodwalayo lilili komanso kuopsa kwa matenda ake.

Pofuna kuchepetsa kuthamanga kwa magazi mu mtundu woyamba wa 2 ndi matenda ashuga 2, mankhwala a magulu otsatirawa amagwiritsidwa ntchito:

• Diuretics (Furosemide, Diacarb);
• ACE inhibitors (Captopril, enalapril);
• Beta-blockers (Nebile, Trandat, Dilatrend);
• Alfa-adrenergic blockers (Doxazosin, Prazosin, Terazosin);
• Calcium Antagonists (Diltiazem, Verapamil);
• Agonists (zolimbikitsa) za imidazoline receptors (Albarel, Physiotens).

Tiyeni tikambirane mwatsatanetsatane gulu lililonse la mankhwala.

Zodzikongoletsera

Pali magulu anayi a okodzetsa:

• Thiazide;
• Thuazide-ngati;
• Loopback;
• Kuteteza potaziyamu.

Ma diuretics ngati Thiazide omwe samakhudzana ndi kuchuluka kwa glucose amakhala ndi zotsatira zabwino. Mtundu woyamba wa 1 komanso wa 2 shuga, thiazide diuretics amagwiritsidwa ntchito mopitirira 12,5 mg. Magulu onsewa a okodzetsa amateteza kupezeka kwa zovuta mu impso, myocardium, komabe, mankhwalawa sangagwiritsidwe ntchito chifukwa cha kulephera kwa impso.

Zopopera za loop sizimagwiritsidwa ntchito, chifukwa, thupi limataya potaziyamu. Komabe, amawonetsedwa chifukwa cha kulephera kwa impso, momwe kukonzekera kwa potaziyamu kumayikidwa.

ACE zoletsa

Amalepheretsa enzyme yomwe imakhudzidwa ndi kapangidwe ka angiotensin, komwe kumayambitsa kuthamanga kwa magazi. Mankhwala amaletsa kukula kwa zovuta mu impso, mtima. Pakudya, kuchuluka kwa shuga sikuchuluka.

Mankhwalawa amakhala ndi vuto lofatsa, kuchepa kwamphamvu kwa magazi kumatheka pambuyo pa masabata awiri. Mtundu woyamba wa 2 komanso wa matenda ashuga a 2, mankhwalawa amalephereka ngati matendawa apezeka ndi matenda am'mitsempha a impso. Mwa odwala ena, amayambitsa chifuwa. Tiyenera kudziwa kuti ngati matenda oopsa azikhala kwambiri, zoletsa za ACE sizingakhale ndi vuto lochizira.

Beta blockers

Pali magulu awiri:

1. Kusankha. Chitani pokhapokha pa mtima;
2. Osasankha. Zimakhudza minofu yonse ya thupi.

Osasankha beta-blockers amalembedwa pakati pa odwala matenda ashuga chifukwa amalimbikitsa shuga. Kusankha kumayikidwa ngati shuga ndi kuthamanga kwa magazi zimaphatikizidwa ndi ma pathologies ena:

1. Ischemia
2. Matenda a mtima;
3. Kulephera kwa mtima.

Mankhwala oterewa amagwiritsidwa ntchito nthawi imodzi ndi diuretics. Ma blockers sagwiritsidwa ntchito pochiza kuthamanga kwa magazi kwa odwala mphumu.

Otsutsa a calcium

Imachepetsa njira yogwiritsira ntchito calcium m'maselo, zomwe zimayambitsa vasodilation ndikuchepetsa kuthamanga kwa magazi. Pali magulu awiri:

1. Dihydropyridine. Kuchulukitsa kugunda kwa mtima, kuchepetsa mwayi wokhala ndi vuto la mtima.
2. Nedihydropyridine. Kuchepetsa kugunda kwa mtima, koyenera kuchitira matenda oopsa, omwe adawoneka kumbuyo kwa nephropathy. Zimathandizira kupewa kuwonongeka kwa impso mu shuga.

Onsewo ndi ena angagwiritsidwe ntchito nthawi imodzi ndi okodzetsa, ACE inhibitors. Osagwiritsa ntchito chifukwa cha kulephera kwa mtima, kusakhazikika kwa angina pectoris.

Agonists (zolimbikitsa) za imidazoline receptors

Mankhwala amachepetsa mphamvu ya masheya amanjenje, chifukwa, kugunda kwa mtima kumachepa, kuthamanga kwa magazi kumachepa. Kugwiritsira ntchito nthawi yayitali kumakongoletsa mtima.

Zoyipa:

• Bradycardia
• Kulephera kwa mtima;
• Odwala sinus syndrome
• Matenda a chiwindi.

Alfa oletsa

Block postsynaptic alpha adrenergic receptors, kupereka kuchepa kwamphamvu kwa kuthamanga popanda kukulitsa mtima. Mu shuga, mankhwalawa amachepetsa kuchuluka kwa shuga, kukulitsa chidwi cha insulin.

Chithandizo cha zakudya

Kwa matenda oopsa omwe amapezeka ndi matenda amtundu wa 1 kapena shuga 2, samalani kwambiri ndi zakudya. Zakudya zamafuta ochepa zimachepetsa shuga komanso kuchepetsa magazi.

Tsatirani malangizowa:

1. Zakudyazo ziyenera kukhala ndi mavitamini, kufufuza zinthu mokwanira;
2. Kuchepetsa kudya kwamchere. Zomwe zimachitika tsiku lililonse sizoposa tiyi 1. l;
3. Pewani zakudya zomwe zimakhala ndi sodium;
4. Idyani nthawi zambiri - osachepera 5 p / tsiku, m'magawo ang'onoang'ono;
5. Osamadya asanagone. Chakudya chomaliza sichikhala pasanathe maola 2 asanagone;
6. Idyani zakudya zamafuta ochepa, amakonda mafuta ovuta;
7. Idyani zakudya zopatsa potaziyamu. Macroelement amakulitsa makoma amitsempha yamagazi ndikuthandizira kuchepetsa kuthamanga.

Phatikizani masamba anu azakudya zamasiku onse, zipatso zomwe zimaloledwa kwa odwala matenda ashuga. Zogulitsa zina:

• Mkate wa Wholemeal;
• Nyama yokonda, nsomba;
• Mkaka wopanda mafuta, mkaka;
• Msuzi wamasamba;
• Zakudya Zam'nyanja;
• Zipatso zouma;
• Mazira
• Mafuta ophikira.

Kuti musinthe kukoma kwa mbale, gwiritsani ntchito zokometsera, zitsamba zonunkhira, mandimu.

Wolemba:

• Zinthu zopangidwa ndi ufa wa tirigu;
• Zakudya zosuta;
• Mafuta a nsomba, nyama;
• Msuzi wokhazikika;
• Maapulo;
• Marinade
• Zakumwa zoziziritsa kukhosi
• Zakumwa zoledzeretsa.

Kukhala wonenepa kwambiri kumapangitsa kuti matenda ashuga akhale ochulukirapo. Kuti muchepetse thupi, tikulimbikitsidwa kuti muchepetse kudya kalori tsiku ndi tsiku, kuwonjezera zolimbitsa thupi.

Kusintha kwamoyo

Kukhala ndi moyo wathanzi kumathandiza kuchepetsa kuthamanga kwa magazi mu mtundu 1 ndi matenda ashuga a 2. Zofunika:

1. Kupuma kwathunthu;
2. Kusiya mowa kapena kuchepetsa kumwa;
3. Kusuta kupatula. Nikotini imawonjezera chiwopsezo cha mtima ndi mtima;
4. Kupewa zinthu zosautsa mtima.

Kuchita masewera olimbitsa thupi pafupipafupi (kuchita masewera olimbitsa thupi, kuyenda mothamanga, ndi zina zambiri) ndikofunikira. Kusisita kumakhala ndi zotsatira zabwino. Matenda a Normalization opsinjika mothandizidwa ndi mankhwala, zakudya, kuchuluka kwa zochitika zamagalimoto kungachepetse maphunziro a matenda oopsa mu shuga ndipo zimapangitsa kukhala bwino.

Kanema wofananira: