Mukayamba kudwala matenda ashuga amtundu wa 2, pamakhala zoyipa kwambiri pamtima wanu

Tikulankhula ndi Director of the Republican Science Scientical Center of Cardiology, Doctor of Medical Sayansi, Pulofesa, Membala Wofanana wa NAS A.G. MROCHEKOM:

- Alexander Gennadievich, tonse anthu omwe tili ndi matenda ashuga tili ndi chidwi kwambiri ndi vutoli: matenda a shuga ndi mtima zimalumikizana bwanji, bwanji zili pachiwopsezo chachikulu cha matenda athu, ndizotheka kupewa matenda oopsa a mtima ngati matenda ashuga amalamulidwa mosamala, kapena ndi choncho? kupha mosalephera.

- Tisankhe mafunso anu onse mu dongosolo. Ndikuganiza kuti sichinsinsi, osati kwa madokotala okha, komanso kwa odwala, kuti matenda a shuga komanso a mtima ndiogwirizana. Kupatula apo, kuchuluka kwa glycemia kumakhudza mwachindunji kapangidwe ka magazi ndi mkhalidwe wamatumbo. Ndipo mtima ndi mota womwe umapopa magazi ndikuyiyendetsa kudzera mu ziwiya. Ngakhale mgalimoto, injini imalephera msanga ngati ingoyendera mafuta "achilendo".

Ganizirani izi: mwa mayi wopanda matenda ashuga asanafike pokhapokha atasiya kusuta, kupatula kuti amasuta ndipo ali ndi cholesterol yachilendo, kawirikawiri madokotala sazindikira atherosclerosis, matenda amtima. Ndi infracation ya myocardial osakwana zaka 45-50, makamaka amuna amalowa zipatala. Mu matenda a shuga, matenda amtima amayamba kale kwambiri mwa amuna ndi akazi. Ndipo imapita patsogolo mwachangu. Chifukwa chake, odwala matenda ashuga ndi gawo lapadera, lovuta la odwala la mtima, ndipo ambiri a iwo. Ndipo ambiri awa ndi anthu omwe ali ndi matenda ashuga a 2.

- Chifukwa?

- Monga lamulo, matenda awo a shuga amaphatikizidwa ndi zovuta zina zazikulu: matenda oopsa, kunenepa kwambiri, kuchuluka kwa cholesterol ndi mafuta acids m'magazi - zomwe zili zovuta (kapena ngakhale pamaso pa 2-3 a zovuta izi) zimatchedwa metabolic syndrome. Nthawi zambiri, panthawi ya matendawa, odwalawa amakhala ndi matenda a mtima - atherosulinosis, matenda a mtima a ischemic. Mu matenda a shuga, amakula msanga kwambiri ndipo amafunikira chithandizo champhamvu kwambiri.

- Owerenga athu amadziwa kwambiri momwe matenda a shuga padziko lonse lapansi akupangidwira, ndi zovuta zazikulu ziti za endocrinologists zomwe zikugwira ntchito lero. Ndi mbali ziti pankhani ya matenda ashuga yomwe sayansi ya mtima imayang'ana?

- Choyamba, kukula kwa lingaliro la metabolic syndrome kuyenera kutchedwa gawo lofunikira kwambiri la vuto la kugunda kwa mtima ndi sitiroko, yomwe imapangitsa malo oyamba a matenda amtima pakati pa zomwe zimayambitsa kufa. Sizowopsa kuti madokotala amatcha metabolic syndrome "chiboliboli chakufa." Ndikofunika kumvetsetsa: kagayidwe kachakudya sikunena mwachidule zovuta zilizonse zomwe zimapezeka munthawi ino - zimalimbikitsana wina ndi mnzake zomwe zimapangitsa kuti wina akhale ndi vuto limodzi.

Kafukufuku wambiri akuchitika padziko lonse lapansi pazotsatira zomwe zimachitika chifukwa cha matenda ashuga komanso matenda a mtima. Asayansi amafunsa mafunso mwachitsanzo: kodi kuchepa kwa kuthamanga kwa magazi kumakhudza bwanji njira ya matenda ashuga, kodi hyperglycemia imakhudza bwanji ziwiya zamatumbo?

- Maphunzirowa ali kale ndi mapulogalamu othandiza - adathandizira kupanga mankhwala odalirika, njira zabwino zamankhwala?

- Zachidziwikire, pali njira yochokera ku sayansi kupita ku mtima wazothandiza, koma osati mwachangu momwe wodwala amaganizira. Mwina chofunikira kwambiri ndikuti mankhwala alandila umboni wotsimikizika wokhuza kufunikira kwa kupewa. Popeza zikutsimikiziridwa kuti matenda ashuga amakhumudwitsa kukula kwa matenda amtima kwambiri kuposa zinthu zina zambiri zowopsa, anthu omwe ali ndi matenda ashuga ayenera:

• mosamalitsa kuposa wina aliyense, kuti azilamulira kuchuluka kwa kuthamanga kwa magazi ndi cholesterol m'magazi (kutanthauza kuti samangoyesa kuchuluka ndi kukayezetsa magazi, komanso kutsatira mosamalitsa zidziwitso zonse za dotolo ngati zikuwonetsa kuti sizili bwino).
• gwiritsani ntchito kuchepa thupi. Kupambana kwakukulu mugawo lovutali, kumachepetsa chiopsezo cha matenda a mtima, ndizosavuta kukhalabe ndi magazi komanso mafuta amthupi.
• Chofunika kwambiri, kuti muchepetse kukula kwa zovuta zonse za matenda ashuga, komanso mumtima, kuphatikizapo, munthu ayenera kuyesetsa kukhalabe ndi shuga. Pewani onse hyperglycemia ndi hypoglycemia.

- Ndipo ndikufunsanso funso lomwe limakondweretsa anthu ambiri, kuphatikiza inemwini: kwa mtima, zomwe zili zofunikirabe - kodi shuga "ndiyabwinobwino komanso ndikukwera pang'ono 'kapena" wabwinobwino komanso pang'ono pang'ono'?

- Monga wa mtima, ndikusankha njira yachiwiri. Koma mapangidwe oterewa amatsogolera ku nkhawa - munthu amadzipereka, akuganiza kuti: "Pang'ono - siwowerengeka." Ndikofunikira kuti shuga akhale ngati wathanzi!

- Madokotala onse amangokhalira kulankhula zofunikira pakupewa, koma anthu samawamvera. Mukuganiza kuti ndichifukwa chiyani ambiri ali ofunitsitsa kudzisamalira okha, kugula mankhwala okwera mtengo, kupita kwa madokotala, koma sangathe kudzipangitsa okha kusintha moyo wawo, kudya pang'ono, ndikuwongolera matenda awo a shuga.

- Ponena za anthu omwe ali ndi matenda ashuga, ndikutsimikiza amafunika kupitiliza kukonzanso akatswiri pamatenda awo. Likadali lotsika kwambiri pano, chifukwa chake zovuta. Magazini yanu imatchedwa Life ndi Shuga, chifukwa sitinena kuti nthenda, koma timati ndi moyo watsopano.

Sikoyenera kupanga kuperewera mwa munthu wokhala ndi matenda aliwonse. Ndikofunikira kukhazikitsa kufunikira kwa chidziwitso ndi kutha kukhala ndi moyo mokwanira m'mikhalidwe imeneyi. Pali chowonadi chochuluka mu nthabwala kuti kulibe anthu athanzi, pali anthu oyesedwa bwino. Aliyense ali ndi mavuto ake azaumoyo, muyenera kukhala nawo, ndikukhala ndi moyo wautali. Mu Center yathu, odwala omwe ali ndi vuto la mtima osakwanira amaloŵedwa m'malo ndi ena atsopano, ochita kupanga; kuwonongeka kwa ziwiya zazikulu za coronary, kugwirizanitsa kwa mitsempha yam'mimba kumachitika. Maopaleshoni akuluakuluwa komanso odula mtengo amathandiza odwala kutalikitsa moyo wawo ndikupangitsa kuti akhale bwino. Koma munthu ayenera kuphunzira kukhala moyo watsopano. Kusiya china chake, kupanga china chake kukhala chizolowezi cha tsiku ndi tsiku. Kupatula apo, adayamba kugwira ntchito ndi moyo wake wakale, zomwe zikutanthauza kuti muyenera kusintha kuti mukhale ndi moyo. Opaleshoni sikuti kuphika. Monga mukuwonera, sikuti odwala matenda ashuga okha omwe amawongolera chitsogozo chokhwima kwa munthu.

- Ndiuzeni moona, ndi matenda a shuga a 2, matenda amtima ndiwosapetseka?

- Ngati mumayendetsa shuga m'magazi, kuwunika bwino, kuthamanga kwa magazi ndi cholesterol, ndiye kuti mavuto a mtima amatha kupewedwa. Ndikubwerezanso, zatsimikiziridwa mwasayansi kuti kuletsa zovuta za matenda ashuga kumabweretsa zotsatira zabwino kwambiri. Zatsimikizidwanso kuti magawo omwe amapezeka monga kuchita masewera olimbitsa thupi nthawi zonse, kusiya kusuta fodya, kumwa mowa mwauchidakwa, kudya zakudya zomanga thupi (zakudya zambiri pamalo oyamba) ndizofanana pakathekedwe kake ka mphamvu ya mankhwala, mwachitsanzo, antihypertensives. Ndipo kuwongolera kuthamanga kwa magazi anu m'magazi a shuga ndikofunikira kwambiri.

Mwa njira, anthu omwe ali ndi matenda amtundu wa 1 amakhala ndi zovuta zochepa ndi mavuto, pokhapokha atalandira vutoli. Ndipo ndi matenda amtundu wa 2 shuga, mbali inayo, shuga wambiri amathandizira zochitika zam'mitima yachifundo, "zomwe zimayambitsa" kuthamanga kwa magazi, ndipo imakwera. Kumbali ina, kuthamanga kwa magazi kumapangitsa kuti insulin ikane ma cell, i.e. zimathandizira kukula kwa matenda ashuga. Onani momwe zonse zimalumikizirana.

Koma pali mbali yachiwiri kufunso. Mu shuga, kuphatikiza pa kugonjetsedwa kwa ziwiya zazikulu za coronary, ma capillaries amakhudzidwanso (microangiopathy). Yesetsani kumuyendetsa wodwala, mumupatsenso kugwedeza kwamitsempha. Chombo chapakati chitha kusinthidwa, koma ma capillaries? Chifukwa chake, kwa odwala omwe ali ndi matenda ashuga, opaleshoni yamtima sikuwonetsedwa nthawi zonse - mwina sitingakwaniritse zomwe tikufuna.

Izi ndi zomwe matenda ashuga amachita - zimakhudza kawiri mtima. Ndipo kuphatikizira kumalimbikitsa mantha amanjenje (autonomic neuropathy), kupondera "mitsempha yopumula", ndipo mtima umagwira ntchito nthawi zonse ndi kupsinjika kowonjezereka. Zombozi sizabwino, ndipo nthawi zonse zimakhala zovuta. Ndipo ngati tiganizira za matenda oopsa (kuthamanga kwa magazi). Kulemera kwambiri kwa thupi kumasintha ma magazi ambiri, motero kumawonjezera kulakalaka, motero kuchuluka kwa shuga m'magazi. Pofuna kuthana ndi hyperglycemia mwa odwala omwe ali ndi matenda a shuga a 2, masiku ano endocrinologists adayamba kuwapatsa mankhwala a insulin. Koma pazifukwa zina ambiri amamuopa. Monga wokonda zamtima, ndinganene kuti insulini ilibe phindu lililonse pamatumbo. Ndipo mulingo wokwezeka wamagazi - chowonadi chotsimikiziridwa - chimayambitsa kukulitsa kwa microangiopathies, ndipo izi ndizovuta m'maso, impso, miyendo ndi mtima.

Ndimatenga nawo mbali pamisonkhano yambiri yasayansi yapadziko lonse lapansi yomwe imafotokoza za matenda ashuga komanso mtima. Pamisonkhano imeneyi, nthawi zonse kumatsimikizika kuti odwala matenda ashuga amakhala ndi zovuta zambiri zamtima kuposa za endocrinological.

- Munatchula za insulin mu mtundu 2 wa matenda ashuga. Kuchokera pakuwona kwa omvera zamtima, ndipo ndibwino - mapiritsi kapena insulin? Komabe, mapiritsiwa ali ndi zovuta zake.

- Chifukwa chake simungathe kufunsa funso. Ndikofunikira kuyandikira aliyense payekhapayekha. Uku ndikulankhula pakati pa wodwala ndi endocrinologist.

- Zikomo chifukwa chokambirana chosangalatsa komanso chothandiza!

Nkhaniyi idayendetsedwa ndi Lyudmila MARUSHKEVICH

Kuwonongeka kwa mtima mu shuga: mawonekedwe azithandizo

Mwa odwala ambiri omwe ali ndi matenda ashuga, mtima umakhudzidwa. Chifukwa chake, pafupifupi 50% ya anthu ali ndi vuto la mtima. Kuphatikiza apo, mavuto oterewa amakula ngakhale adakali ang'ono.

Kulephera kwa mtima mu shuga kumalumikizidwa ndi shuga wambiri m'thupi, chifukwa cha momwe cholesterol imayikidwa pamakoma a mtima. Izi zimabweretsa kuchepetsedwa pang'onopang'ono kwa kuwala kwawo ndi mawonekedwe a atherosulinosis.

Poyerekeza ndi machitidwe a atherosulinosis, ambiri odwala matenda ashuga amakhala ndi matenda a mtima. Komanso, ndi kuchuluka kwa glucose, kupweteka m'dera lachiwalo kumatha kuloledwa kwambiri. Komanso, chifukwa cha kukula kwa magazi, mwayi wa thrombosis umakulanso.

Kuphatikiza apo, odwala matenda ashuga nthawi zambiri amatha kukulitsa magazi, zomwe zimapangitsa kuti pakhale zovuta pambuyo pa vuto la mtima (aortic aneurysm). Pothana ndi vuto lakusintha kwa infa, kumachitika kwambiri mobwerezabwereza kwa mtima kapena ngakhale kufa. Chifukwa chake, ndikofunikira kwambiri kudziwa kuwonongeka kwa mtima mu shuga komanso momwe mungachitire ndi zovuta zoterezi.

Zimayambitsa zovuta za mtima ndi zomwe zimayambitsa chiopsezo

Matenda a shuga amakhala ndi moyo waufupi chifukwa cha kuchuluka kwa shuga m'magazi. Matendawa amatchedwa hyperglycemia, yomwe imakhudza mwachindunji mapangidwe a atherosulinotic malo. Yotsirizika kapena yotseka lumen ya ziwiya, zomwe zimatsogolera ku ischemia ya minofu yamtima.

Madokotala ambiri ali ndi chitsimikizo kuti shuga yowonjezera imakhumudwitsa kusokonekera - malo okhala ndi lipid. Chifukwa cha izi, makoma azotengera amakhala mawonekedwe ovomerezeka ndi mawonekedwe.

Hyperglycemia imathandizanso kutsegula kwa kuphatikiza kwa oxidative ndikupanga ma free radicals, omwe amakhalanso ndi vuto la endothelium.

Pambuyo pa maphunziro angapo, unansi unakhazikitsidwa pakati pa kuthekera kwa matenda a mtima m'matumbo a shuga ndi kuchuluka kwa hemoglobin ya glycated. Chifukwa chake, ngati HbA1c iwonjezeka ndi 1%, ndiye kuti chiopsezo cha ischemia chikuwonjezeka ndi 10%.

Matenda a shuga ndi matenda amtima atha kukhala zogwirizana ngati wodwala akumana ndi zovuta zina:

1. kunenepa
2. ngati m'modzi wa abale a wodwalayo adwala matenda amtima.
3. Nthawi zambiri kuthamanga kwa magazi
4. kusuta
5. uchidakwa
6. kukhalapo kwa cholesterol ndi triglycerides m'mwazi.

Ndi matenda ati amtima omwe atha kukhala chopinga cha matenda ashuga?

Nthawi zambiri, ndi hyperglycemia, matenda ashuga a mtima amayamba. Matendawa amawoneka pomwe malungo osokoneza bongo a myocardium ali ndi odwala omwe ali ndi vuto la shuga.

Nthawi zambiri matendawa amakhala ngati asymptomatic. Koma nthawi zina wodwalayo amakhala ndi vuto lopweteka komanso kugunda kwa mtima (tachycardia, bradycardia).

Nthawi yomweyo, chiwalo chachikulucho chimasiya kupopa magazi ndikugwira ntchito mopangika, chifukwa cha zomwe kukula kwake kumakulira. Chifukwa chake, matendawa amatchedwa mtima wodwala. Pathology mu ukalamba imatha kuwonetsedwa ndi kuyendayenda kuzungulira, kutupa, kufupika ndi kupweteka pachifuwa komwe kumachitika pambuyo pochita masewera olimbitsa thupi.

Matenda a mtima omwe ali ndi matenda a shuga amayamba kuchulukitsa katatu kuchulukirapo kuposa kwa anthu athanzi. Ndizofunikira kudziwa kuti chiwopsezo cha matenda a mtima sichimadalira kukula kwa matenda oyamba, koma kutalika kwake.

Ischemia mu odwala matenda ashuga nthawi zambiri amapezeka popanda kutchulidwa, zomwe nthawi zambiri zimabweretsa kukula kwa kupweteka kwa minofu ya mtima. Komanso, matendawa amapitilira mafunde, pomwe kuukira kwadzaoneni kumaloledwa ndi matenda osachiritsika.

Zomwe zimachitika ndi matenda amtima wapamtima ndikuti patatha kukoka kwa magazi mu myocardium, motsutsana ndi maziko a matenda a hyperglycemia, mtima, kulephera kwa mtima, komanso kuwonongeka kwamitsempha yama mtima kumayamba kukula msanga. Chithunzi cha matenda a ischemia mu odwala matenda ashuga:

• kupuma movutikira
• arrhasmia,
• kupuma movutikira
• kukanikiza ululu mumtima
• nkhawa zokhudzana ndi mantha a imfa.

Kuphatikiza kwa ischemia ndi matenda a shuga kungayambitse kukulitsa kwa myocardial infarction. Kuphatikiza apo, kuphatikizika uku kumakhala ndi zinthu zina, monga kusokonezeka kwa mtima, edema yam'mapapo, kupweteka kwamtima kumayang'ana ku clavicle, khosi, nsagwada kapena phewa. Nthawi zina wodwala amamva kupweteka kwambiri pachifuwa, mseru komanso kusanza.

Tsoka ilo, odwala ambiri amakhala ndi vuto la mtima chifukwa samakayikira kupezeka kwa matenda ashuga. Pakadali pano, kudziwitsidwa ndi hyperglycemia kumabweretsa zovuta zakupha.

Mu odwala matenda ashuga, mwayi wopanga angina pectoris amawirikiza. Mawonetsero ake akuluakulu ndi palpitations, malaise, thukuta ndi kufupika kwa mpweya.

Angina pectoris, yomwe idawuka motsutsana ndi maziko a matenda ashuga, ili ndi mawonekedwe ake. Chifukwa chake, kukula kwake sikukhudzidwa ndi kuopsa kwa matenda oyambitsidwa, koma kutalika kwa chotupa cha mtima. Kuphatikiza apo, mwa odwala omwe ali ndi shuga ambiri, magazi osakwanira ku myocardium amakula msanga kuposa mwa anthu athanzi.

Mu anthu ambiri odwala matenda ashuga, Zizindikiro za angina pectoris ndizofatsa kapena sizipezeka konse. Kuphatikiza apo, nthawi zambiri amakhala ndi zolakwika mu nthito ya mtima, yomwe nthawi zambiri imatha ndi imfa.

Zotsatira zinanso za matenda a shuga a mtundu wachiwiri ndi kulephera kwa mtima, komwe, monga zovuta zina zamtima zomwe zimachitika chifukwa cha hyperglycemia, ndizomwe zimafotokozera. Chifukwa chake, kulephera kwa mtima ndi shuga wambiri kumakonda kumangidwa adakali aang'ono, makamaka amuna. Zizindikiro za matendawa ndi monga:

1. Kutupa ndi kupindika kwa miyendo,
2. Kukula kwa mtima kukula,
3. kukodza pafupipafupi
4. kutopa,
5. kuchuluka kwa thupi, komwe amafotokozera posungiramo madzi m'thupi,
6. chizungulire
7. kupuma movutikira
8. kutsokomola.

Diabetesic myocardial dystrophy imatithandizanso kuphwanya mtundu wa kugunda kwa mtima. Pathology imachitika chifukwa cha kusayenda bwino kwa kagayidwe kachakudya, komwe kanayambitsidwa ndi kuchepa kwa insulin, komwe kumapangitsa gawo la glucose kupyola maselo a myocardial. Zotsatira zake, mafuta ac oxidized amadziunjikira mu minofu ya mtima.

Njira ya dystrophy ya myocardial imatsogolera ku mawonekedwe a foci a kusokonezeka kwa conduction, kusinthana kwa arrhythmias, extrasystoles kapena parasystoles. Komanso, microangiopathy mu shuga imathandizira kugonjetsedwa kwa ziwiya zazing'ono zomwe zimadyetsa myocardium.

Sinus tachycardia kumachitika ndi mantha kapena thupi kwambiri. Kupatula apo, kuthamanga kwa mtima kugwira ntchito ndikofunikira kuti thupi lipereke zakudya komanso mpweya wabwino. Koma ngati shuga wamagazi akukulira pafupipafupi, ndiye kuti mtima umakakamizidwa kugwira ntchito mopitilira muyeso.

Komabe, mwa anthu odwala matenda ashuga, myocardium sangathe kudwala mwachangu. Zotsatira zake, okosijeni ndi zakudya sizimalowa mumtima, zomwe nthawi zambiri zimayambitsa matenda a mtima ndi kufa.

Ndi matenda ashuga a mtima, kusinthasintha kwa mtima kumayamba. Mwa chikhalidwe ichi, arrhythmia imachitika chifukwa cha kusinthasintha kwa kukokana kwa zotumphukira zamisempha, zomwe NS iyenera kuwongolera.

Vuto lina la matenda ashuga ndi orthostatic hypotension. Amawonetsedwa ndi kuchepa kwa kuthamanga kwa magazi. Zizindikiro za matenda oopsa ndi chizungulire, malaise, ndi kukomoka. Komanso, amadziwika ndi kufooka atadzuka ndi kupweteka kumutu kosalekeza.

Popeza kuwonjezeka kwa shuga m'magazi kumakhala zovuta zambiri, ndikofunikira kudziwa momwe mungalimbitsire mtima matenda ashuga komanso njira zamankhwala zosankha ngati matendawa adayamba kale.

Mankhwala ochizira matenda a mtima odwala matenda ashuga

Maziko amathandizidwe othandizira ndikuletsa zomwe zingachitike ndikuletsa kupitilira kwa zovuta zomwe zilipo. Kuti muchite izi, ndikofunikira kusintha glycemia, kuchepetsa kuchuluka kwa shuga ndikuletsa kuti isakwere ngakhale maola awiri mutatha kudya.

Pachifukwa ichi, ndi matenda amtundu wa 2 shuga, othandizira ochokera ku gulu la Biguanide ndi omwe amapatsidwa. Awa ndi Metformin ndi Siofor.

Mphamvu ya Metformin imatsimikiziridwa ndi kuthekera kwake kulepheretsa gluconeogeneis, kutsegula glycolysis, yomwe imapangitsa kuti khungu lizisungidwa ndi pyruvate ndi lactate mu minofu ndi mafuta. Komanso, mankhwalawa amalepheretsa kukula kwa kufalikira kwa minofu yosalala ya mtima ndikukhudza mtima.

Mlingo woyambirira wa mankhwalawa ndi 100 mg patsiku. Komabe, pali zotsutsana zingapo za kumwa mankhwalawa, makamaka omwe ali ndi vuto la chiwindi ayenera kukhala osamala.

Komanso, ndi matenda a shuga a mtundu 2, Siofor nthawi zambiri amalembedwa, omwe amakhala othandiza kwambiri makamaka ngati kudya komanso kuchita masewera olimbitsa thupi sikumathandizira kuti muchepetse kunenepa. Mlingo watsiku ndi tsiku amasankhidwa payekha kutengera kuchuluka kwa shuga.

Kuti Siofor ikhale yogwira mtima, kuchuluka kwake kumathandizidwa nthawi zonse - kuchokera pa mapiritsi 1 mpaka 3. Koma mlingo waukulu wa mankhwalawa suyenera kupitanso magalamu atatu.

Siofor imaphatikizidwa chifukwa cha matenda a shuga omwe amadalira insulin 1, kulowetsedwa kwa myocardial, pakati, kulephera kwa mtima ndi matenda akulu am'mapapo. Komanso, mankhwalawa satengedwa ngati chiwindi, impso komanso matenda a matenda ashuga sizigwira bwino ntchito. Kuphatikiza apo, Siofor sayenera kuledzera ngati ana kapena odwala opitilira 65 amathandizidwa.

Pofuna kuthana ndi angina pectoris, ischemia, kuti muchepetse kukhazikika kwa myocardial infarction komanso mavuto ena a mtima omwe amapezeka chifukwa cha matenda ashuga, ndikofunikira kumwa magulu osiyanasiyana a mankhwala:

• Mankhwala a antihypertensive.
• Ma ARB - kupewa myocardial hypertrophy.
• Beta-blockers - sinthasintha kugunda kwa mtima ndikuchepetsa kuthamanga kwa magazi.
• Ma diuretics - kuchepetsa kutupa.
• Mitsempha - siyani kugunda kwamtima.
• ACE inhibitors - ali ndi mphamvu yolimbitsa mtima,
• Ma Anticoagulants - amachepetsa magazi.
• Glycosides - yowonetsedwa kwa edema ndi atrase fibrillation.

Kuchulukitsitsa, ndi matenda a shuga a 2, omwe amayenda ndi mavuto a mtima, dokotala amapatsa Dibicor. Imayendetsa kagayidwe kachakudya minofu, kuwapatsa mphamvu.

Dibicor imakhudza bwino chiwindi, mtima ndi mitsempha yamagazi. Kuphatikiza apo, pakatha masiku 14 kuyambira chiyambi cha mankhwalawa, pali kuchepa kwa ndende yamagazi.

Kuchiza ndi vuto la mtima kumatenga mapiritsi (250-500 mg) 2 p. patsiku. Komanso, Dibikor tikulimbikitsidwa kumwa mu mphindi 20. musanadye. Mlingo wokwanira wa tsiku ndi tsiku wa mankhwala ndi 3000 mg.

Dibicor imaphatikizidwa muubwana nthawi yapakati, mkaka wa m`mawere ndi vuto la taurine tsankho. Kuphatikiza apo, Dibicor sangatengedwe ndi mtima glycosides ndi BKK.

Ambiri odwala matenda ashuga amasamala za momwe angachitire ndi matenda a mtima opaleshoni. Chithandizo chowongolera chimachitika polimbitsa mtima ndi mothandizidwa ndi mankhwala sizinabweretse zotsatira zomwe mukufuna. Zisonyezo za opaleshoni ndi:

1. kusintha kwa mtima,
2. Ngati chifuwa chimakhala chowawa nthawi zonse,
3. kutupa
4. arrhasmia,
5. amakayikira mtima
6. pang'onopang'ono angina pectoris.

Kuchita opaleshoni ya mtima kulephera kumaphatikizapo balloon vasodilation. Ndi chithandizo chake, kupendekera kwamtsempha, komwe kumalimbitsa mtima, kumathetsedwa. Panthawi ya ndalamayi, catheter imayikidwa m'mitsempha, pomwe baluni imabweretsa kumalo ovuta.

Kuluma kwa aortocoronary nthawi zambiri kumachitika ngati ma mesh adalowetsedwa m'mitsempha, omwe amalepheretsa mapangidwe a cholesterol. Ndipo kulumikizana kwa mitsempha yodutsa m'mitsempha yamagetsi kumapangitsa kuti magazi azikhala mwaulere, zomwe zimachepetsa kwambiri ngozi yobwereranso.

Ngati wodwala matenda a shuga a mtima, chithandizo cha opaleshoni chokhazikitsidwa ndi pacemaker chimasonyezedwa. Chipangizocho chimagwira kusintha kulikonse mu mtima ndikuwakonza nthawi yomweyo, zomwe zimachepetsa mwayi wa arrhythmias.

Komabe, musanachite izi, ndikofunikira kuti musapangitse shuga kuchuluka, komanso kulipira shuga. Popeza ngakhale kulowererapo pang'ono (mwachitsanzo, kutsegula chikopa, kuchotsedwa kwa misomali), komwe kumachitika pochiza anthu athanzi pamalopo, odwala matenda ashuga amachitidwa kuchipatala cha opaleshoni.

Komanso, asanafike opaleshoni yofunika, odwala omwe ali ndi hyperglycemia amasamutsidwa ku insulin. Pankhaniyi, kuyambitsa insulin yosavuta (3-5 Mlingo) kukuwonetsedwa. Ndipo masana ndikofunikira kuti muchepetse glycosuria ndi shuga wamagazi.

Popeza matenda amtima ndi matenda ashuga ndi malingaliro othandizana, anthu omwe ali ndi glycemia amafunika kuwunika kayendedwe ka mtima. Ndikofunikanso kuwongolera kuchuluka kwa shuga m'magazi, chifukwa ndi hyperglycemia yayikulu, vuto la mtima likhoza kuchitika, mpaka kumwalira.

Mu kanema mu nkhaniyi, mutu wa matenda a mtima mu shuga akupitilizidwa.

Khalidwe laumoyo: Odwala ambiri omwe ali ndi matenda ashuga amalowa mumtambo wakusowa thandizo, osadziwa momwe angasinthire. Chodetsa nkhawa kwambiri ndikuti odwala opitilira theka a odwala matenda ashuga a 2 samadziwa kuti ali ndi matenda ashuga, ndipo 90% ya anthu omwe ali ndi matenda a prediabetes sadziwa za matenda awo.

Odwala ambiri omwe ali ndi matenda a shuga amalowa mumtambo wakuda wopanda thandizo, osadziwa momwe angabwezeretsere izi. Chodetsa nkhawa kwambiri ndikuti odwala opitirira theka omwe ali ndi matenda a shuga a 2 Sindikudziwakuti ali ndi matenda ashuga, komanso 90 peresenti ya anthu omwe ali pachiwonetsero cha prediabetes sazindikira momwe alili.

Mtundu woyamba wa shuga ndi kudalira kwa insulin

Mtundu woyamba wa shuga, womwe umatchedwanso "shuga" - Ichi ndi matenda osachiritsika omwe amadziwika ndi kuchuluka kwa shuga m'magazi, omwe nthawi zambiri amangotchedwa "shuga wamagazi."

Mtundu woyamba wa shuga kapena matenda ashuga wachinyamata ”ndi osowa. Amayamba kukhala ndi anthu osakwanitsa zaka 20 ndipo chithandizo chake sichikudziwika.

Chodetsa nkhawa kwambiri ndichakuti matenda a shuga achichepere akuchulukirachulukira, monganso zomwe zimayambitsa matenda ashuga 2: zaka makumi angapo zapitazi, pakati pa ana oyera omwe sanali ochokera ku Spain omwe ali ndi zaka zapakati pa 10 mpaka 10, ziwerengero zakula ndi 24 peresenti.

Koma kwa ana akuda, vutoli ndilokulirapo: kuwonjezeka kwa 200 peresenti! Ndipo, malinga ndi kafukufuku waposachedwa, pofika chaka cha 2020, ziwerengerozi zidzachulukanso kwa achinyamata onse.

Mtundu woyamba wa matenda ashuga, chitetezo cha mthupi chimapha ma cell a insulin. Zotsatira zake, insulin ya mahomoni imatayika. Anthu odwala matenda ashuga a Mtundu 1 amafunikira insulin yowonjezera kwa moyo wawo wonse, chifukwa kusakhalako kudzatsogolera ku imfa. Palibe mankhwala ochiritsira a matenda ashuga amtundu woyamba 1, kuphatikizira kupatsirana kwa kapamba.

Mtundu 2 shuga: pafupifupi 100 peresenti yovomerezeka

Mtundu wofanana ndi wa shuga ndi mtundu 2, womwe umakhudza 90-95% ya odwala matenda ashuga. Ndi mtundu uwu, thupi limatulutsa insulini, koma satha kuzindikira ndikugwiritsa ntchito moyenera. Imeneyi ndi gawo lonyalanyaza insulin. Chifukwa cha kukana insulini m'thupi, kuchuluka kwa glucose kumawonjezeka, zomwe zimabweretsa zovuta zambiri.

Pakhoza kukhala zizindikiro zonse za matenda ashuga, koma nthawi zambiri zimayiwalika kuti mtundu wachiwiri wa matenda a shuga ndiwotheka kupeweka ndipo pafupifupi 100 peresenti ungathe kuchiritsidwa. Zizindikiro kuti mwina muli ndi matenda ashuga zikuphatikizapo:

Njala yokwanira (ngakhale mutadya)

Kusanza ndi mwina kusanza

Kulemera kapena kuchepa kwachilendo

Kuchepetsa bala

Matenda pafupipafupi (khungu, kwamkodzo, ndi nyini)

Kuchita dzanzi kapena kumangika mikono ndi miyendo

Momwe shuga imamvekera

Matenda A shuga SI matenda a shuga a magazi, koma m'malo mwake ndi kuphwanya chizindikiro cha insulin ndi leptin yomwe imayamba nthawi yayitali., choyamba kuchokera pa gawo la prediabetes, kenako shuga wambiri, ngati simukuchitapo kanthu.

Chimodzi mwazifukwa zomwe jakisoni a mapiritsi a insulin kapena mapiritsi sikuti amangochiritsa matenda a shuga, koma nthawi zina zimangokulitsa. – kungokhala kukana kuthana ndi vuto lakelo.

Pankhaniyi, chinsinsi ndi insulin sensitivity.

Ntchito ya kapamba ndikupanga timadzi tating'onoting'ono timene timatulutsa m'magazi, motero kuyang'anira kuchuluka kwa shuga kofunikira pamoyo.

Ntchito ya insulini ndi kukhala gwero lamphamvu m'maselo. Mwanjira ina, insulin IYOYENERA kuti mukhale ndi moyo, ndipo monga lamulo, kapamba amapanga insulin yochuluka monga momwe thupi limafunikira. Koma zinthu zina zoopsa ndi zochitika zina zitha kupangitsa kuti kapamba asiye kugwira ntchito yake moyenera.

Zoposa zaka 45

Kunenepa kwambiri kapena kunenepa kwambiri

Nkhani Zabanja

Mbiri ya matenda osokoneza bongo

Matenda a Atherosclerotic Cardiovascular Disease

X-HDL pansipa 35 mg / dl

Kusala triglycerides zoposa 250 mg / dl

Chithandizo cha atypical antipsychotic, glucocorticoids

Kugona kwambiri komanso kugona tulo tofa nato

Matenda ena okhudzana ndi kukana insulin

Kukhala wa anthu omwe ali pachiwopsezo chachikulu (African American, Hispanic, Native American or Asia American)

Zotheka kuti ngati muli ndi chimodzi mwambiri mwazinthu izi zowopsa, kapena ngati magazi anu ndi okwera, ndiye kuti mukayezetsa matenda a shuga ndikuyambitsa insulini m'mapiritsi kapena jakisoni, ndipo nthawi zina onse.

Dokotala wanu adzanena kuti cholinga cha majakisoni kapena mapiritsiwo ndikuchepetsa shuga. Amatha kukufotokozerani kuti izi ndizofunikira chifukwa malamulo a insulini amatenga gawo lofunikira pa thanzi lanu komanso moyo wautali.

Atha kuwonjezeranso kuti kuchuluka kwa glucose sikungokhala chizindikiro cha matenda ashuga, komanso matenda a mtima, matenda am'mitsempha, stroko, matenda oopsa, khansa, komanso kunenepa kwambiri. Ndipo, zoona, adotolo azikhala zolondola kwathunthu.

Koma apitilira izi? Kodi mudzauzidwa za momwe leptin adzagwirire ntchito imeneyi? Kapena kuti ngati kukana kwa leptin kwatukuka m'thupi, kodi muli panjira yachinsinsi, ngati mulibe kale?

Matenda a shuga, Leptin, ndi Insulin Resistance

Leptin ndi mahomoni opangidwa m'maselo a mafuta. Chimodzi mwamaudindo ake akuluakulu ndikukhazikitsa kulakalaka kudya ndi thupi. Amauza bongo nthawi yakudya, kuchuluka kwa chakudya, komanso nthawi yosiya kudya - ndichifukwa chake imatchedwa "hormone of satiety". Kuphatikiza apo, amauza ubongo momwe angatherere mphamvu zomwe zilipo.

Osati kale kwambiri, kunapezeka kuti mbewa zopanda leptin zimakhala zonenepa kwambiri. Momwemonso, mwa anthu - kukanika kwa leptin kumatsutsana ndi kuperewera kwa leptin, ndizosavuta kupeza kulemera msanga.

Jeffrey M. Friedman ndi Douglas Coleman, ofufuza awiri omwe apeza mahomoni awa mu 1994, ayenera kuthokoza chifukwa chotulutsa leptin komanso udindo wake m'thupi. Chochititsa chidwi, Friedman adatcha leptin liwu lachi Greek loti "leptos," lomwe limatanthawuza "onda, "atazindikira kuti mbewa zomwe zimabayidwa ndi leptin wopanga zimayamba kugwira ntchito ndipo zimalemera.

Koma Friedman akapezanso mlingo waukulu kwambiri wa leptin m'magazi a anthu onenepa, adaganiza kuti china chake chikuyenera kuchitika. Ichi “china” chidakhala kuthekera kwa kunenepa kwambiri kuyambitsa kukana kwa leptin - mwanjira ina, mwa anthu onenepa kwambiri, njira yosonyeza leptin imasuntha, chifukwa thupi limapanga leptin wambiri, monga glucose ngati insulin imayamba.

Friedman ndi Coleman adazindikiranso kuti leptin amachititsa insulin kuwonetsa kulondola komanso kukana insulin.

Mwanjira imeneyi gawo lalikulu la insulin Osati kutsitsa shuga wamagazi, koma pakusunga mphamvu zowonjezera (glycogen, wowuma) kuti mugwiritse ntchito panopo komanso mtsogolo. Kuchepetsa kwake magazi ndi "gawo limodzi" mwanjira iyi yosungira mphamvu. Pamapeto pake, izi zikutanthauza kuti shuga ndimatenda a insulin komanso kuphwanya chizindikiro cha leptin.

Ichi ndichifukwa chake "kuchiritsa" kwa matenda ashuga pakungochepetsa magazi sikungakhale kotetezeka. Chithandizo choterocho sichingaganizire vuto lenileni la kusokonezeka kwa metabolic komwe kumachitika mu khungu lililonse la thupi ngati leptin ndi insulin yolumikizika ndikuleka kugwira ntchito limodzi, monga ziyenera.

Kumwa insulini kungakulitse ngakhale odwala ena omwe ali ndi matenda ashuga a 2, chifukwa pakapita nthawi, izi zimawonjezera kukana kwawo kwa leptin ndi insulin. Zodziwika zokha njira yobwezeretsa yoyenera leptin (ndi insulin) - kugwiritsa ntchito zakudya. Ndipo ndikulonjeza: zidzakhudza kwambiri thanzi lanu kuposa mankhwala kapena mtundu uliwonse wamankhwala.

Fructose: choyambitsa matenda a shuga ndi kunenepa kwambiri

Katswiri wokhudzana ndi kukana kwa leptin komanso momwe amagwirira ntchito ndi matenda a shuga ndi Dr. Richard Johnson, Mutu wa Dipatimenti ya Nephrology, University of Colorado. Buku lake TheFatSwitch (The Fat switchch) limafotokoza zambiri zabodza zokhudzana ndi zakudya komanso kunenepa.

Dr. Johnson akufotokoza momwe kudya kwa fructose kumayambitsa kusintha kwachilengedwe kwamphamvu komwe kumatipangitsa kulemera. Pankhani ya metabolism, uku ndi kuthekera kofunikira kwambiri komwe kumalola mitundu yambiri, kuphatikiza anthu, kuti ikhale ndi moyo panthawi yazakudya.

Tsoka ilo, ngati mukukhala m'dziko lotukuka, kumene kuli zakudya zambiri ndipo limapezeka mosavuta, mafuta osinthika awa amataya mwayi wake wachilengedwe, ndipo, m'malo mothandizira anthu kuti azikhala ndi nthawi yayitali, zimakhala zopanda pake zomwe zimawapha asanachitike.

Mutha kukhala ndi chidwi chofuna kudziwa kuti "kufa ndi shuga" sikokokomeza konse ayi. Kuchuluka kwa fructose pakudya kwa munthu wamba ndikofunikira kwambiri pakuwonjezeka kwa matenda ashuga kudzikoli. Pomwe glucose adapangira kuti thupi lizigwiritsa ntchito mphamvu (50% shuga wokhazikika ndi glucose) fructose amagawika zidole zingapo zomwe zimatha kuwononga thanzi.

Matenda a shuga - Osati Njira Yothetsera

Chithandizo chodziwika bwino cha matenda ashuga amtundu wa 2 chimagwiritsa ntchito mankhwala omwe amalimbikitsa kuchuluka kwa insulin kapena shuga m'magazi.

Monga ndidanenera, vuto ndiloti matenda ashuga SIYO matenda a shuga.

Kumvetsera kwambiri chizindikiro cha matenda ashuga (omwe ndi shuga ochulukirapo m'magazi), m'malo mothetsa chomwe chimayambitsa, ndi ntchito ya nyani, yomwe nthawi zina imatha kukhala yoopsa. Pafupifupi 100 peresenti ya odwala matenda ashuga a mtundu 2 amatha kuthandizidwa popanda mankhwala. Mutha kudabwitsidwa, koma mkatiMutha kuchira ngati mumadya, kuchita masewera olimbitsa thupi ndikukhala ndi moyo moyenera.

Malangizo Othandiza Pazakudya Zazakudya ndi Moyo

Ndawunikira njira zingapo zogwira mtima kuti muwonjezere insulin komanso kumva kwa leptin, ndikuletsa kapena kubwezeretsanso matenda ashuga m'magawo asanu ndi limodzi osavuta komanso osavuta.

Kuchita masewera olimbitsa thupi: Mosiyana ndi malingaliro omwe alipo, kuti musamale komanso musamalimbane ndi matenda, kukhalabe olimbitsa thupi kumathandizira kwambiri pakuwongolera zochitika za matenda ashuga komanso matenda ena. M'malo mwake, iyi ndi imodzi mwanjira zachangu kwambiri komanso zopambana kwambiri zothetsera insulin ndi leptin. Yambirani lero, werengani za Peak Fitness ndi maphunziro apamwamba olimbitsa - nthawi yochepa mu masewera olimbitsa thupi, yabwino.

Kanani mbewu monga chimanga ndi shuga ndi zakudya zonse zophatikizidwa, makamaka omwe amakhala ndi fructose komanso madzi ambiri a chimanga cha fructose. Chithandizo cha matenda ashuga akale sichinaphule kanthu pazaka 50 zapitazi, mwanjira inayake chifukwa cha kuchepa kwakukulu mu mfundo zopatsa thanzi.

Chotsani Zachikhalidwe Zachikhalidwe Chachikulu Chonse, ngakhale "zabwino", monga lonse, organic, kapena mbewu zophuka, kuchokera ku zakudya zawo. Pewani mkate, pasitala, mbewu monga chimanga, mpunga, mbatata ndi chimanga (nazonso ndi njere). Malingana ngati kuchuluka kwa shuga m'magazi sikakhazikika, zipatso zimatha kucheperanso.

Ndikofunika kwambiri kukana nyama yokonzedwa. Pakufufuza kopanda kanthu komwe kuyerekezera kukonzedwa komanso kusakudya kwa nthawi yoyamba, ofufuza a Harvard School of Public Health adapeza kuti kudya nyama yokonzedwa kumalumikizidwa ndi chiwopsezo chodwala matenda a mtima ndi 42 peresenti komanso chiopsezo cha matenda a shuga 2 mwa 19 peresenti. Chosangalatsa ndichakuti, chiwopsezo cha matenda a mtima kapena matenda ashuga mwa anthu omwe amamwa nyama yofiira yaiwisi, monga ng'ombe, nkhumba, kapena mwanawankhosa, sanakhazikitsidwe.

Kuphatikiza pa fructose, siyani mafuta amtundu wa trans, zomwe zimawonjezera chiopsezo cha matenda a shuga ndi kutupa, kusokoneza magwiridwe antchito a insulin receptors.

Idyani mafuta ambiri a omega-3 kuchokera kwa nyama zapamwamba kwambiri.

Penyani kuchuluka kwa insulin yanu. Chofunikanso ndichakuti kusala magazi, kudya insulin, kapena A1-C - kuyenera kukhala pakati pa 2 ndi 4. Kukwera msinkhu, kumakhala kovuta kwambiri kuti mumve insulini.

Tengani mankhwala osokoneza bongo. M'matumbo mwanu muli zinthu zachilengedwe zomwe zimakhala ndi mabakiteriya ambiri. Mabakiteriya opindulitsa kwambiri momwe amakhalamo, amalimbitsa chitetezo chanu chokwanira komanso bwino magwiridwe antchito anu. Sinthani makulidwe anu m'matumbo mwa kudya zakudya zopatsa mphamvu monga natto, miso, kefir, tchizi chaiwisi chophimba, ndi masamba olimidwa. Kuphatikiza apo, mutha kutenga zowonjezera zapamwamba ndi ma probiotic.

Matenda a mtima ndi pafupipafupi komanso osasangalatsa a matenda a shuga. Kuchepa kwa Coronary kumadziwika kwambiri mwa odwala. Ganizirani zazikulu za kuwonongeka kwa mtima mu shuga komanso momwe mungazichiritsire.

Matenda a mtima mu shuga amawonedwa mwa odwala ambiri. Pafupifupi theka la odwala amakhala ndi vuto la mtima. Komanso, ndi matenda ashuga, matendawa amapezeka mwa anthu aang'ono kwambiri.

Kusokonekera mu ntchito ya mtima, kupweteka kumalumikizidwa makamaka chifukwa chakuti shuga wambiri m'thupi amatsogolera pakuyatsidwa kwa cholesterol pamakoma amitsempha yamagazi. Pang'onopang'ono kupendekera kwa minyewa yam'mimba kumawonedwa. Umu ndi momwe atherosulinosis imakhalira.

Mothandizidwa ndi atherosulinosis, wodwala amakhala ndi ischemic matenda a mtima. Odwala nthawi zambiri amakhala ndi nkhawa chifukwa cha ululu wamtima. Ndiyenera kunena kuti malinga ndi momwe shuga imayambira, ndizovuta kwambiri. Ndipo magazi akayamba kuchuluka, pamakhala chiwopsezo chowonjezereka cha magazi kuwundana.

Odwala omwe ali ndi matenda ashuga, kuthamanga kwa magazi kumakwera pafupipafupi. Zimayambitsa zovuta pambuyo poyambira myocardial infarction, yomwe imakonda kwambiri yomwe ndi aortic aneurysm. Ndi machiritso owonongeka a postinfarction chilonda mwa odwala, chiopsezo cha kufa mwadzidzidzi chimawonjezeka kwambiri. Chiwopsezo chobwereza mtima mobwerezabwereza chimakulanso.

Matenda a shuga a mtima ndi vuto la kusokonezeka kwa minofu ya mtima kwa odwala omwe ali ndi vuto la shuga. Nthawi zambiri matendawa alibe chizindikiro, ndipo wodwalayo amangomva ululu wopweteka.

Kusokonezeka kwa mtima kumachitika, makamaka, tachycardia, bradycardia. Mtima sutha kupopa magazi nthawi zonse. Kuchokera pamitolo yowonjezereka, imayamba kukula pang'ono.

Mawonekedwe a matendawa ndi awa:

• kupweteka mumtima,
• kuchuluka kwa edema ndi kufupika kwa mpweya,
• Odwala ali ndi nkhawa za zowawa zomwe sizikudziwika bwinobwino.

Kwa achinyamata, matenda ashuga a mtima nthawi zambiri amapezeka popanda zizindikiro zoopsa.

Ngati munthu wadwala matenda a shuga, ndiye chifukwa cha zinthu zoyipa, chiopsezo chotenga matenda am'mtima chimachulukirachulukira. Izi ndi izi:

• ngati m'modzi mwa abale a wodwala matenda ashuga wadwala matenda a mtima,
• ndi kuchuluka kwa thupi
• ngati chiwopsezo cha m'chiuno chikachuluka, izi zikuwonetsa kunenepa kwambiri, komwe kumachitika chifukwa cha kuchuluka kwa cholesterol m'magazi,
• kuchuluka kwa triglycerides m'magazi,
• kuchuluka kwa magazi,
• kusuta
• kumwa mowa wambiri.

Matenda a Coronary omwe ali ndi matenda a shuga amawopseza moyo wa wodwalayo ndimavuto ambiri owopsa. Ndipo kuphwanya myocardial sikwachilendo: pakati pa odwala omwe ali ndi matenda a shuga, ambiri amafa amadziwika.

Zomwe zimachitika myocardial infarction kwa odwala omwe ali ndi matenda ashuga ndi otere.

1. Ululu wowalira kukhosi, phewa, phewa la phewa, nsagwada. Sichiyimitsidwa potenga nitroglycerin.
2. Kusanza, nthawi zina kusanza. Samalani: Zizindikiro zotere nthawi zambiri zimakhala zolakwika chifukwa cha poizoni wazakudya.
3. Kusokonezeka kwa vuto la mtima.
4. M'dera lachifuwa ndi mtima, kupweteka kwapweteka kumawonekera, komwe ndi kachilengedwe.
5. Pulmonary edema.

Ndi matenda ashuga, chiopsezo cha angina pectoris chambiri. Matendawa amawonetsedwa ndi kupuma movutikira, palpitations, kufooka. Wodwalayo amakhalanso ndi nkhawa chifukwa chothetsa thukuta kwambiri. Zizindikiro zonsezi zimatsitsimuka ndi nitroglycerin.

Angina pectoris yemwe ali ndi matenda ashuga amasiyanitsidwa ndi mawonekedwe otere.

1. Kukula kwa matendawa sikudalira kokha kuwopsa kwa matenda ashuga, koma kutalika kwake.
2. Angina pectoris mu odwala matenda ashuga amapezeka kale kwambiri kuposa mwa anthu omwe alibe kupatuka kwa glucose m'thupi.
3. Ululu ndi angina pectoris, monga lamulo, sutchulidwa. Mwa odwala ena, sizingachitike konse.
4. Nthawi zambiri, odwala amakhala ndi vuto la kugunda kwa mtima, komwe nthawi zambiri kumakhala koopsa.

Poyerekeza ndi matenda ashuga, kulephera kwamtima kumatha kukhala mwa odwala. Ili ndi zambiri zoyenda. Kwa dokotala, chithandizo cha odwala chotere nthawi zonse chimakhudzana ndi zovuta zina.

Kulephera kwa mtima kwa odwala omwe ali ndi matenda a shuga kumawonekera ali aang'ono kwambiri. Akazi amakonda kwambiri kudwala kuposa amuna. Kukula kwakukulu kwa kulephera kwa mtima kwatsimikiziridwa ndi ofufuza ambiri.

Chithunzi cha matenda matendawa chimadziwika ndi zizindikiro zotere:

• kukula kwa mtima,
• kukula kwa edema yokhala ndi miyendo yamtambo,
• kupuma movutikira komwe kumachitika chifukwa cha kusefukira kwamadzi m'mapapu,
• chizungulire komanso kutopa kwakukula,
• kutsokomola
• kukodza pafupipafupi,
• kunenepa kwambiri komwe kumayamba chifukwa cha madzi osungunuka m'thupi.

Chithandizo cha mankhwala osokoneza bongo a mtima

Pochiza matenda a mtima oyambitsidwa ndi matenda ashuga, mankhwala a magulu otere amagwiritsidwa ntchito.

1. Mankhwala a antihypertensive. Cholinga cha mankhwalawa ndikwaniritsa kuthamanga kwa magazi osakwana 130/90 mm. Komabe, ngati kulephera kwa mtima kumakhala kovuta chifukwa cha kuwonongeka kwa impso, kukakamira kocheperako kumalimbikitsidwa.
2. ACE zoletsa. Kusintha kwakukulu mutsogolo kwa njira ya matenda a mtima ndi kugwiritsa ntchito mankhwala ngati amenewa kwatsimikiziridwa.
3. Angiotensin receptor blockers amatha kuyimitsa mtima minofu hypertrophy. Kutumizidwa kumagulu onse a odwala omwe ali ndi vuto la mtima.
4. Beta-blockers amachepetsa kugunda kwa mtima komanso kutsitsa magazi.
5. Nitrate amagwiritsidwa ntchito kuyimitsa kugunda kwamtima.
6. Cardiac glycosides amagwiritsidwa ntchito pochiza atritisation ya atria komanso mu edema yolimba. Komabe, pakadali pano gawo lawo la ntchito likuchepa.
7. Ma Anticoagulants amalembedwa kuti achepetse kukhudzana kwa magazi.
8. Diuretics - zotchulidwa kuti athetse edema.

Odwala ambiri ali ndi chidwi chofuna kudziwa ngati opaleshoni yamphongo imagwiritsidwa ntchito ngati chithandizo cha kulephera kwa mtima. Inde, zimatero, chifukwa opaleshoni yam'mbuyo imapereka mwayi weniweni wochotsa zopinga m'magazi ndikuwongolera mtima.

Zisonyezo za opaleshoni ndi:

• kupweteka kumbuyo kwa sternum
• arrhythmia kuukira
• alina angina,
• kuchuluka kutupa
• amakayikira mtima
• kusintha kwadzidzidzi mu mtima.

Kuchotsa kwamphamvu kwa matenda a mtima m'matenda a shuga ndikotheka kuchitidwa opareshoni. Opaleshoni (kuphatikizapo opaleshoni ya bypass) imachitidwa pogwiritsa ntchito njira zamakono zamankhwala.

Kuchita opaleshoni ya mtima kulephera kumaphatikizapo izi.

1. Balodon vasodilation. Amachotsa kupendekera kwamtsempha komwe kumadyetsa mtima. Pachifukwa ichi, catheter imayikidwa mu arthial lumen, kudzera momwe balloon wapadera amabweretsedwa kudera laling'ono la mtsempha.
2. Coronary mtsempha wamagazi. Kapangidwe kapadera ka ma mesh kumayambitsidwa mu lumen of the coronary artery. Zimalepheretsa mapangidwe a cholesterol plaques. Kuchita uku sikuwononga kwambiri wodwala.
3. Kulumikizana kwa mitsempha ya coronary kumakulolani kupanga njira yowonjezera magazi ndipo kumachepetsa kwambiri kubwereranso.
4. Kukhazikika kwa pacemaker kumagwiritsidwa ntchito mu diabetesic mtima dystrophy. Chipangizocho chikuyankha kusintha kulikonse muntchito zamtima ndikuwongolera. Chiwopsezo cha arrhythmias chimachepetsedwa kwambiri.

Cholinga cha chithandizo cha kusokonezeka kulikonse muntchito ya mtima ndikubweretsa zomwe zikuwonetsa muzochitika zathupi kuti zitheke. Izi zitha kutalikitsa moyo wa wodwala ndikuchepetsa chiopsezo cha zovuta zina.

1. 
   Elena, Yuryevna Lunina Cardiac autonomic neuropathy mu mtundu 2 shuga mellitus / Elena Yuryevna Lunina. - M: LAP Lambert Academic Publishing, 2012 .-- 176 c.
2. 
   Rakhim, Khaitov Immunogenetics a mtundu 1 shuga mellitus / Khaitov Rakhim, Leonid Alekseev und Ivan Dedov. - M: LAP Lambert Academic Publishing, 2013 .-- 116 p.
3. 
   Nikolaychuk L.V. Zakudya zamatenda a shuga. Minsk, kufalitsa nyumba "Mawu Amakono", 1998, masamba 285, kufalitsa makope 11,000.

Ndiloleni ndidziwitse. Dzina langa ndi Elena. Ndakhala ndikugwira ntchito ya endocrinologist kwa zaka zoposa 10. Ndikukhulupirira kuti pakadali pano ndili katswiri pantchito yanga ndipo ndikufuna kuthandiza alendo onse omwe amapezeka pamalowo kuti athetse zovuta osati ntchito. Zinthu zonse za tsambalo amazisonkhanitsa ndikuzikonza mosamala kuti athe kufotokoza zambiri zofunikira. Musanagwiritse ntchito zomwe zikufotokozedwa pa webusaitiyi, kufunsana ndi akatswiri ndizofunikira nthawi zonse.