Kuthamanga kwa magazi kwa odwala matenda ashuga

Matenda a shuga ndi matenda oopsa, omwe amaphatikizidwa ndi kusowa kwa insulin komanso kuphwanya njira za metabolic m'thupi. Zimakhala zoyambitsa zovuta zambiri. Ndikakhala ndi shuga wambiri, magawo amitsempha yamagazi amawonjezereka, magazi amakhala amanenepa kwambiri. Zonsezi zimabweretsa mavuto ndi kuthamanga kwa magazi. Kodi matenda a shuga amawoneka bwanji ndikuchita nawo?

Mtundu woyamba wa shuga

Mtundu woyamba wa matenda ashuga, womwe umayambitsa kuthamanga kwa magazi (BP) ndi kuwonongeka kwa impso (diabetesic nephropathy). Vutoli limapezeka mu 35- 40% ya anthu odwala matenda ashuga ndipo amapita magawo atatu.

• Microalbuminuria: mamolekyu ang'ono a proteinin a albin amapezeka mumkodzo.
• Proteinuria: impso zimagwira ntchito yosefera kwambiri komanso moyipa. Mkodzo umakhala ndi mapuloteni akuluakulu.
• Kulephera kwa impso.

Pa gawo loyamba, kuchuluka kwa mapuloteni mumkodzo kumakwera mpaka 20%, pa gawo lachiwiri - mpaka 50-70%, ndipo kachitatu - mpaka 70-100%. Chizindikiro chachikulu ichi, chimakweza magazi a wodwalayo.

Kuphatikiza pa mapuloteni, sodium satha bwino. Ndi kuchuluka kwake, madzi amadzaza m'magazi. Zotsatira zake, kuchuluka kwa magazi ozungulira kumawonjezeka. Chithunzi chomwecho chimawonedwa ndi kuchuluka kwa shuga. Thupi la wodwala yemwe ali ndi matenda ashuga amayesera kulipirira kusokonezeka kwa impso, chifukwa chake kuthamanga kwa magazi kumakwera.

Type 2 shuga

Njira ya pathological imayamba kale asanayambike matenda a shuga a 2. Wodwalayo amakhala ndi insulin kukana - kuchepa kwa chidwi cha minyewa chifukwa cha insulin. Hormone yambiri imazungulira m'magazi, zomwe zimayambitsa matenda oopsa.

Chifukwa cha atherosclerosis, lumen ya mitsempha ya magazi imachepa. Izi zimathandizanso kukulitsa matenda oopsa. Nthawi yomweyo, kunenepa kwam'mimba kwapezeka (m'dera m'chiuno). Minofu ya Adipose imatulutsa zinthu zomwe, kulowa m'magazi, zimawonjezera kukakamiza kwa wodwala yemwe ali ndi matenda ashuga.

Zomwe zimatithandizira kukulitsa matenda oopsa mu shuga mellitus ndi:

• kupsinjika kapena kupsinjika,
• kuperewera kwa zakudya m'thupi
• katundu wambiri pophunzira ndi pantchito,
• mavuto kupuma
• kusowa kwa mavitamini, michere ndi zinthu zina zofunika mthupi,
• matenda a endocrine
• poyizoni ndi zebaki, cadmium kapena lead.

Mavuto omwewo atha kukhala omwe amachititsa komanso zotsatira za matenda oopsa.

Mavuto opsinjika ndi matenda a shuga amapezeka mwamwayi panthawi yoyeserera. Chimakula mchikakamizo cha zinthu zingapo. Chifukwa chake, sichikhala chovuta nthawi yayitali kukhazikika kwa matendawo komanso kuuma kwa matendawa.

Nthawi zina ndi matenda oopsa mu diabetes, chizungulire, kupweteka mutu, nseru, ndi kuwonongeka kwa mawonekedwe owoneka bwino. Komabe, nthawi zambiri, matenda oopsa amakhala asymptomatic.

Zakudya za matenda oopsa

Kuthamanga kwa magazi m'magazi a shuga kumakhala kodzaza ndi mawonekedwe a concomitant pathologies, kulemala ndi kufa. Chifukwa chake, ndikofunikira kuchepetsa kuthamanga kwa magazi mpaka kufika pa chandamale: 130/80 mm RT. Art.

Zakudya zama carb zotsika mtengo ndiyo njira yabwino yochepetsera ndikukhalitsa ndende yamagazi. Kufunikira kwa mahomoni m'thupi kumachepa, komwe kumapangitsa zotsatira za chithandizo cha matenda oopsa. Zakudya izi ndizoyenera pokhapokha kulephera kwaimpso. Imakhala yothandiza komanso yotetezeka kwathunthu pa gawo la microalbuminuria. Ndi proteinuria, chisamaliro chapadera komanso kufunsana ndi dokotala kumafunika.

Zakudya zotsika mtengo zamatumbo zimatanthauzira kuletsa kwakadyedwe ka zakudya kokhala ndi index yayikulu ya glycemic. Izi zikuphatikizapo kaloti, mbatata, zipatso zotsekemera, makeke, mkate, nkhumba, mpunga, pasitala, jamu, uchi, nkhuyu, nthochi, mphesa, zipatso zouma. Timadziti tosunthidwa kumene kuchokera ku zitsamba zimathandizira kukula kwa shuga m'magazi.

Tayani mchere wa patebulo kwathunthu. Zimalimbikitsa kusungidwa kwamadzi mthupi komanso kuwonjezeka kwa kuthamanga kwa magazi. Fomu yobisika, mchere umapezeka m'mbale ndi zinthu zambiri: masangweji, mkate, sopo, pitsa, nyama yosuta.

Chithandizo chachikulu cha matenda oopsa

Mankhwala ogawa amagawa mitundu yayikulu ya kuthamanga kwa magazi m'magulu asanu: calcium antagonists, diuretics, ACE inhibitors, beta-blockers, angiotensin-II receptor blockers.

Otsutsa a calcium. Pali mitundu iwiri ya calcium calcium blockers: 1,4-dihydropyridines ndi non-dihydropyridines. Gulu loyamba limaphatikizapo Nifedipine, Amlodipine, Isradipine, Lacidipine, Felodipine. Kwa wachiwiri - Diltiazem ndi Verapamil. Ma dihydropyridine omwe amakhala atatenga nthawi yayitali amakhala otetezeka kwambiri kwa matenda ashuga okhala ndi matenda am'mitsempha. Contemplate: osakhazikika angina, kugunda kwa mtima ndi kuphwanya kwa mtima mkati.

Zodzikongoletsera. Nthawi zambiri kuthamanga kwa magazi kumachitika mu shuga mellitus chifukwa cha kuchuluka kwa magazi ozungulira. Ma diuretics amathetsa vutoli.

Gulu la okodzetsa:

• thiazide: hydrochlorothiazide,
• Osmotic: Mannitol,
• ngati thiazide: indapamide retard,
• kuteteza potaziyamu: Amiloride, Triamteren, Spironolactone,
• loopback: Torasemide, Bumetanide, Furosemide, ethaconic acid.

Zopitsa za loop ndizothandiza pakulephera kwa impso. Amayikidwa ngati matenda oopsa akuphatikizidwa ndi edema. Thunder-ngati ndi thiazide okodzetsa, mosiyana, amatsutsana mu kulephera kwa aimpso. Osmotic ndi potaziyamu osunga diuretics sagwiritsidwa ntchito pa matenda ashuga.

ACE zoletsa amamulembera ngati wodwala anayamba matenda a shuga. Mankhwalawa amakhalanso mankhwala osokoneza bongo oyamba. Amawonjezera kukhudzika kwa minofu ku insulin ndikuletsa kukula kwa matenda a shuga a mtundu 2. Hyperkalemia, kuchuluka kwa seramu creatinine, pakati ndi mkaka wa m`mawere.

Beta blockers. Pali ma hydrophilic ndi lipophilic, omwe amasankha komanso osasankha, omwe alibe ntchito za mkati ndi zaumunthu. Mapiritsi amalembedwa chifukwa cha kulephera kwa mtima, matenda a mtima, kuvulala kwatha. Nthawi yomweyo, amalimba zizindikiro za hypoglycemia yomwe ili pafupi.

Angiotensin-II receptor blockers. Ngati chifuwa chowuma chikuwoneka kuchokera kwa ACE inhibitor mwa wodwala matenda a shuga, mankhwalawa amalembedwa kuti athetse mavuto a impso komanso kuthamanga kwa magazi. Mosiyana ndi zoletsa za ACE, iwo amachepetsa bwino mpweya wamanzere wamitsempha.

Ndalama zowonjezera

Ndi matenda oopsa oopsa, mankhwala a gulu lowonjezereka ndi othandiza. Izi zikuphatikizapo Rasilez (a renin inhibitor) ndi alpha-blockers. Amatchulidwa monga gawo la mankhwala ophatikiza.

Rasilez ndi mankhwala atsopano. Amayikidwa nthawi yomweyo ndi angiotensin II receptor blockers kapena ACE inhibitors. Kuphatikiza koteroko kumapereka tanthauzo kuteteza impso ndi mtima. Mankhwalawa amathandizira chidwi chamtundu wa insulin komanso kusintha magazi m'thupi.

Alfa oletsa. Pazithandizo zokhala ndi kuthamanga kwa magazi, osankha alpha-1-blockers amagwiritsidwa ntchito. Gululi limaphatikizapo prazosin, terazosin ndi doxazosin. Ndi matenda ashuga, alpha-blockers ali ndi phindu pa metabolism. Amawonjezera kukhudzika kwa minofu kupita ku mahomoni, kutsitsa shuga m'magazi, komanso kusintha triglycerides ndi cholesterol.Kulephera kwa mtima, mtima wodzipha. Zotsatira zoyipa: hypotension ya orthostatic, kukomoka, kudzipereka, kutupa kwamiyendo, tachycardia wolimbikira.

Kupsinjika kwakukulu

Lamulo lalikulu popewa zovuta za matenda ashuga ndi kuwunika kosalekeza m'magazi a shuga. Kuchulukirapo kwa shuga kumakhudza madera amitsempha yamagazi. Izi ndi zomwe zimabweretsa kuphwanya magazi. Zakudya zokhala ndi zopatsa mphamvu zochepa, kuchita masewera olimbitsa thupi komanso mankhwala othandizira zimathandizira kupewa mavuto.

Kuthamanga kwa magazi kwa odwala matenda ashuga ndi vuto lalikulu. Wodwala ayenera kutsatira mosamalitsa malingaliro onse a akatswiri. Pokhapokha ngati mutatha kuchita izi mutha kuwonjezera moyo wanu ndikukhalabe ovomerezeka.

Zoyambitsa Hypertension mu shuga

Mtundu 1 komanso matenda ashuga 2, zomwe zimayambitsa matenda oopsa amatha kusintha. Mtundu woyamba wa matenda a shuga, matenda oopsa mu 80% amayamba chifukwa cha kuwonongeka kwa impso (matenda ashuga nephropathy). Mtundu wachiwiri wa matenda ashuga, matenda oopsa oopsa nthawi zambiri amakula mwa wodwala kwambiri kuposa zovuta za kagayidwe kazakudya komanso matenda a shuga enieni. Hypertension ndi imodzi mwazigawo za metabolic syndrome, yomwe imayambitsa matenda a shuga.

Zomwe zimayambitsa kukula kwa matenda oopsa mu shuga ndi pafupipafupi

Zolemba pagome. Isolated systolic hypertension ndi vuto linalake kwa okalamba. Werengani zambiri mu nkhani ya "Isolated systolic hypertension in the older." Matenda enanso a endocrine - atha kukhala pheochromocytoma, hyperaldosteronism, Syenko-Cushing's syndrome, kapena matenda ena osowa.

Chofunikira pa matenda oopsa - kutanthauza kuti dokotala sangathe kukhazikitsa chomwe chikuwonjezera kuthamanga kwa magazi. Ngati matenda oopsa aphatikizidwa ndi kunenepa kwambiri, ndiye kuti, chifukwa chake, kusalolera kumapangitsa kuti pakhale chakudya chamafuta komanso kuchuluka kwa insulin m'magazi. Izi zimatchedwa "metabolic syndrome," ndipo zimayankha bwino akalandira chithandizo. Zitha kukhalanso:

• kuchepa kwa magnesium m'thupi,
• kupsinjika kwamalingaliro
• kuledzera ndi Mercury, lead kapena cadmium,
• kuchepa kwa mtsempha waukulu chifukwa cha atherosulinosis.

Ndipo kumbukirani kuti ngati wodwalayo akufuna kukhala ndi moyo, ndiye kuti mankhwala alibe mphamvu :).

Mtundu 1 wa shuga wambiri

Mtundu woyamba wa matenda a shuga a mellitus, chachikulu komanso chowopsa chowonjezera cha mavuto ndi kuwonongeka kwa impso, makamaka, matenda a shuga. Vutoli limayamba mu 35-40% ya odwala omwe ali ndi matenda amtundu 1 ndipo amadutsa magulu angapo:

• gawo la microalbuminuria (mamolekyu ang'onoang'ono a proteinin a albumin amawonekera mkodzo),
• gawo la proteinuria (impso limasefukira bwino ndipo mapuloteni akuluakulu amawonekera mkodzo),
• gawo la matenda aimpso kulephera.

• Kuwonongeka kwa impso mu matenda a shuga, momwe amathandizira komanso kupewa
• Ndi mayeso ati omwe muyenera kudutsa kuti muwone impso (kutsegula pawindo lina)
• Zofunika! Zakudya za Impso za Matendawa
• Mitsempha yam'mimba
• Matenda a impso

Malinga ndi Federal State Institution Endocrinological Research Center (Moscow), pakati pa odwala omwe ali ndi matenda amtundu woyamba 1 popanda matenda a impso, 10% amadwala matenda oopsa. Odwala omwe ali ndi gawo la microalbuminuria, mtengowu umakwera mpaka 20%, pamlingo wa proteinuria - 50-70%, pa gawo la kulephera kwa impso - 70-100%. Mapuloteni ochulukirapo amene amachitika mumkodzo, magazi ake amayamba kukwera kwambiri - uwu ndi lamulo wamba.

Kuchepa kwa magazi ndi kuwonongeka kwa impso kumayamba chifukwa chakuti impso siziyenda bwino ndi mkodzo. Sodium m'magazi imakhala yayikulu ndipo madzimadzi amapanga kuti ayipiritse. Kuchuluka kwa magazi ozungulira kumawonjezera kuthamanga kwa magazi. Ngati kuchuluka kwa glucose kumachulukitsidwa chifukwa cha matenda ashuga m'magazi, ndiye kuti kumakoka madzi ambiri ndi magazi kuti magazi asakhale onenepa kwambiri. Chifukwa chake, kuchuluka kwa magazi ozungulira kukukulirakulira.

Matenda oopsa oopsa komanso matenda a impso amapanga njira yoipa. Thupi limayesetsa kulipirira ntchito yovuta ya impso, chifukwa chake kuthamanga kwa magazi kumakwera. Iyenso, imakulitsa kupanikizika mkati mwa glomeruli. Zomwe zimatchedwa kusefa mkati mwa impso. Zotsatira zake, glomeruli imafa pang'onopang'ono, ndipo impso zimagwira ntchito kwambiri.

Izi zimatha ndi kulephera kwa aimpso. Mwamwayi, koyambirira kwa matenda ashuga nephropathy, kuzungulira kwazovuta kungathe kuthyoka ngati wodwala amathandizidwa mosamala. Chinthu chachikulu ndikuchepetsa magazi kuti akhale abwinobwino. ACE inhibitors, angiotensin receptor blockers, komanso okodzetsa amathandizanso. Mutha kuwerenga zambiri za iwo pansipa.

Matenda oopsa komanso matenda a shuga a 2

Kale kwambiri asanayambike matenda a shuga enieni a 2 enieni, matendawa amayamba ndi insulin. Izi zikutanthauza kuti mphamvu ya minofu ya zochita za insulin yafupika. Kuti alipire insulin, kuchuluka kwambiri kwa insulini kumazungulira m'magazi, ndipo pakokha kumawonjezera kuthamanga kwa magazi.

Pakupita kwa zaka, kuunikira kwa mitsempha yamagazi kumachepa chifukwa cha atherosulinosis, ndipo izi zimakhalanso "gawo" lofunikira pakukweza kwa matenda oopsa. Mofananamo, wodwalayo amakhala ndi kunenepa kwam'mimba (mozungulira m'chiuno). Amakhulupirira kuti minofu ya adipose imatulutsa zinthu m'magazi zomwe zimapangitsanso magazi.

Kuphatikiza konseku kumatchedwa metabolic syndrome. Zotsatira zake kuti matenda oopsa amathanso kuyamba kale kuposa mtundu wa shuga wachiwiri. Nthawi zambiri amapezeka wodwala nthawi yomweyo akapezeka ndi matenda a shuga. Mwamwayi, kudya zakudya zamagulu ochepa kumathandizira kuwongolera matenda amtundu wa 2 komanso matenda oopsa nthawi imodzi. Mutha kuwerenga zambiri pansipa.

Hyperinsulinism ndi kuchuluka kwa insulini m'magazi. Imachitika poyankha kukana insulin. Ngati kapamba amayenera kutulutsa insulin yochulukirapo, ndiye kuti "imatopa" kwambiri. Akasiya kupirira pazaka zambiri, shuga m'magazi amadzuka ndikuwonjezera matenda a shuga a 2.

Momwe hyperinsulinism imathandizira magazi:

• amathandizira mantha amanjenje,
• impso zimapindika sodium ndi madzimadzi kulowa mkodzo,
• Sodium ndi calcium zimadziunjikira mkati mwa maselo,
• owonjezera insulin amathandizira kukulitsa makoma amitsempha yamagazi, omwe amachepetsa kuthamanga kwawo.

Mawonekedwe a chiwonetsero chachikulu cha matenda ashuga

Ndi matenda a shuga, gawo lachilengedwe la kusinthasintha kwa magazi masiku ano limasokonekera. Nthawi zambiri, mwa munthu m'mawa komanso usiku nthawi yogona, kuthamanga kwa magazi kumakhala kotsika 10-20 kuposa masana. Matenda a shuga amabweretsa chifukwa chakuti ambiri odwala matenda oopsa kuthamanga usiku sikuchepa. Kuphatikiza apo, kuphatikiza kwa matenda oopsa ndi matenda ashuga, kupsinjika kwa usiku nthawi zambiri kumakhala kwakukulu kuposa kupanikizika kwa usana.

Vutoli limaganiziridwa kuti limabwera chifukwa cha matenda ashuga a m'mimba. Mwazi wakukwera wamagazi umakhudza dongosolo lazinthu zamagetsi, zomwe zimayang'anira moyo wa thupi. Zotsatira zake, kuthekera kwa mitsempha yamagazi kuwongolera kamvekedwe kawo, i., Kupendekera ndi kumasuka kutengera katundu, kukuwonongeka.

Mapeto ake ndikuti kuphatikiza kwa matenda oopsa ndi matenda ashuga, sikuti kungoyeserera kamodzi kokha ndi tonometer ndikofunikira, komanso kuwunika kwa maola 24 tsiku lililonse. Imachitika pogwiritsa ntchito chipangizo chapadera.Malinga ndi zotsatira za kafukufukuyu, mutha kusintha nthawi yomwe mukumwa komanso muyezo wa mankhwala kuti mukapanikizike.

Zochita zimawonetsa kuti odwala omwe ali ndi matenda amtundu woyamba 1 komanso mtundu wa 2 amakhala amakonda kwambiri mchere kuposa omwe amakhala ndi matenda osokoneza bongo omwe alibe shuga. Izi zikutanthauza kuti kuchepetsa mchere mu chakudya kumatha kukhala ndi mphamvu yochiritsa. Ngati muli ndi matenda ashuga, yesani kudya mchere wocheperako kuti muchepetse kuthamanga kwa magazi ndikuwunika zomwe zimachitika mwezi umodzi.

Kuthamanga kwa magazi mu shuga kumakhala kovuta ndi orthostatic hypotension. Izi zikutanthauza kuti kuthamanga kwa magazi a wodwalayo kumachepa kwambiri ndikusuntha kuchoka pakulankhula kukhala pamalo oyimirira kapena kukhala. Orthostatic hypotension imadziwonetsera pambuyo pakuwuka kwakuthwa kwa chizungulire, kumachita khungu m'maso kapenanso kukomoka.

Monga kuphwanya gawo la circadian kuthamanga kwa magazi, vutoli limachitika chifukwa cha chitukuko cha matenda ashuga. Mchitidwe wamanjenje mwapang'onopang'ono umataya mphamvu yake yolamulira mamvekedwe a mtima. Munthu akamadzuka mwachangu, katunduyo amadzuka. Koma thupi lilibe nthawi yowonjezera kutuluka kwa magazi kudzera m'matumbo, ndipo chifukwa cha izi, thanzi likuipiraipira.

Orthostatic hypotension imasokoneza kuzindikira ndi chithandizo cha kuthamanga kwa magazi. Kuyeza kuthamanga kwa magazi mu shuga ndikofunikira m'malo awiri - kuyimirira ndikugona. Ngati wodwala ali ndi vutoli, ndiye kuti ayenera kudzuka pang'onopang'ono, "monga thanzi lake".

Zakudya Zosiyanasiyana za Matendawa

Tsamba lathu lidapangidwa kuti ipititse patsogolo zakudya zamafuta ochepa a mtundu 1 ndi matenda ashuga a 2. Chifukwa kudya zakudya zamagulu ochepa ndiye njira yabwino yochepetsera ndikukhala ndi shuga. Kufunika kwanu kwa insulini kudzachepa, ndipo izi zikuthandizani kukonza zotsatira za chithandizo cha matenda oopsa. Chifukwa chakuti insulin yochulukirapo imazungulira m'magazi, magaziwo amathanso. Takambirana kale mwatsatanetsatane pamwambapa.

Tikupangira zolemba zanu:

Zakudya zotsika mtengo zamatenda a shuga ndizoyenera ngati simunayambe kulephera impso. Mtundu wakudya uwu ndiotetezeka kwathunthu komanso wopindulitsa panthawi ya microalbuminuria. Chifukwa chakuti shuga wa m'magazi akayamba kukhala wabwinobwino, impso zimayamba kugwira ntchito mwachizolowezi, ndipo zotsalazo za albin mkodzo zimayamba kuchita bwino. Ngati muli ndi gawo la proteinuria - samalani, kuonana ndi dokotala. Onaninso Zakudya za Matenda a Impso.

Maphikidwe a chakudya chamafuta ochepa a mtundu 1 ndi matenda ashuga 2 amapezeka pano.

Kodi shuga ayeneranso kutsitsidwa mpaka pati?

Odwala omwe ali ndi matenda oopsa omwe ali ndi matenda opatsirana a shuga ndi odwala omwe ali ndi chiopsezo chachikulu kapena chovuta kwambiri cha mtima. Amalimbikitsidwa kuti achepetse kuthamanga kwa magazi mpaka 140/90 mm RT. Art. M'milungu inayi yoyambirira, ngati amalola kugwiritsa ntchito mankhwala osankhidwa bwino. M'masabata otsatirawa, mutha kuyesa kuchepetsa kupanikizika mpaka pafupifupi 130/80.

Chinthu chachikulu ndikuti kodi wodwalayo amalola bwanji kugwiritsa ntchito mankhwala osokoneza bongo komanso zotsatira zake? Ngati zili zoipa, ndiye kuti kuthamanga kwa magazi kuyenera kukhala pang'onopang'ono, m'magawo angapo. Iliyonse ya magawo awa - mwa 10-15% ya magawo oyambirira, mkati mwa masabata 2-4. Wodwala akangosintha, onjezani kuchuluka kapena muonjezere kuchuluka kwa mankhwalawa.

Ngati mumachepetsa kuthamanga kwa magazi m'magawo, ndiye kuti izi zimapewa zigawo za hypotension ndipo motero zimachepetsa chiopsezo cha myocardial infarction kapena stroke. Malire otsika a ngalande yokhazikika magazi ndi 110-115 / 70-75 mm RT. Art.

Pali magulu a odwala matenda ashuga omwe amachepetsa kuthamanga kwa magazi awo "kumtunda" mpaka 140 mmHg. Art. ndipo kutsika kumakhala kovuta kwambiri. Mndandanda wawo ukuphatikizapo:

• odwala omwe ali kale ndi ziwalo zolimbana, makamaka impso,
• odwala matenda amtima,
• okalamba, chifukwa cha ukalamba wokhudzana ndi msana kuwonongeka kwa atherosulinosis.

Matenda Oseketsa Matenda a shuga

Zitha kukhala zovuta kusankha mapiritsi opondera magazi kwa wodwala yemwe ali ndi matenda ashuga.Chifukwa kuchepa kwa chakudya m'thupi kumabweretsa kuletsa kugwiritsa ntchito mankhwala ambiri, kuphatikizapo matenda oopsa. Posankha mankhwala, adotolo amaganizira momwe wodwalayo amalamulirira matenda ake a shuga komanso matenda omwe ali nawo, kuphatikiza matenda oopsa, omwe amapanga kale.

Mapiritsi abwino opanikizika a shuga ayenera kukhala ndi zinthu zotsatirazi:

• Amachepetsa kuthamanga kwa magazi, pomwe amachepetsa mavuto
• osachulukitsa magazi, musachulukitse cholesterol yoyipa ndi ya triglycerides,
• Tetezani mtima ndi impso ku zovuta zomwe matenda ashuga komanso kuthamanga kwa magazi zimayambitsa.

Pakadali pano pali magulu 8 a mankhwalawa olembetsa matenda oopsa, pomwe asanu ndi omwe ali akulu ndi atatu owonjezera. Mapiritsi, omwe ali m'magulu owonjezera, amadziwika, monga lamulo, ngati gawo la mankhwala ophatikiza.

Magulu Othandizira Mankhwala

Pansipa timapereka malingaliro othandizira kuti mankhwalawa athandizidwe kwa odwala omwe ali ndi matenda oopsa omwe ali ndi vuto la matenda a shuga a mtundu woyamba kapena a 2.

Diuretics (okodzetsa) pokakamiza

Gulu la okodzetsa

Zambiri pazamankhwala onse a diuretic awa zimatha kupezeka pano. Tsopano tiyeni tikambirane momwe okodzetsa amathandizira matenda oopsa mu shuga.

Matenda oopsa mwa odwala omwe ali ndi matenda ashuga nthawi zambiri amakula chifukwa chakuti kuchuluka kwa magazi ozungulira kumakulitsidwa. Komanso, odwala matenda ashuga amasiyanitsidwa ndi kuwonjezereka kwa mchere. Pankhaniyi, ma diuretics nthawi zambiri amathandizidwa kuti azichiza kuthamanga kwa magazi mu shuga. Ndipo kwa odwala ambiri, mankhwala a diuretic amathandiza bwino.

Madokotala amayamika thiazide diuretics chifukwa mankhwalawa amachepetsa chiopsezo cha kugunda kwamtima ndi kugwidwa ndi 15-25% mwa odwala omwe ali ndi matenda oopsa. Kuphatikiza ndi omwe ali ndi matenda ashuga a 2. Amakhulupilira kuti mu Mlingo wocheperako (ofanana ndi hydrochlorothiazide, Seleta-blockers osankha amakhala ndi vuto lalikulu pa kagayidwe kachakudya ka shuga. Izi zikutanthauza kuti ngati ma beta-blockers akuyenera kutengedwa ndi wodwala, mankhwala a mtima-osokoneza bongo ayenera kugwiritsidwa ntchito. nebivolol (Nebilet) ndi carvedilol (Coriol) - amatha kusintha kagayidwe kazakudya zamafuta ndi mafuta, zimakulitsa chidwi cha minofu kulowa insulin.

Zindikirani Carvedilol siosankha beta-blocker, koma ndi imodzi mwazamankhwala omwe amagwiritsidwa ntchito kwambiri, amagwira ntchito moyenera ndipo, mwina, sikuti akuipiraipira kagayidwe kachakudya matenda ashuga.

Ogwiritsa ntchito beta-blockers amakono, kuposa mankhwala am'mibadwo yam'mbuyomu, akulimbikitsidwa kuti azikonda odwala omwe ali ndi matenda ashuga, komanso odwala omwe ali pachiwopsezo chokhala ndi matenda a shuga a 2. Mosiyana ndi izi, ma beta-blockers osasankha omwe alibe ntchito ya vasodilator (propranolol) amawonjezera chiopsezo cha matenda ashuga a 2.

Zimathandizira kukana kwa insulini mu zotumphukira, komanso kumakulitsa cholesterol "yoyipa" ndi mafuta a triglycerides (mafuta) m'magazi. Chifukwa chake, salimbikitsidwa kwa odwala omwe ali ndi matenda ashuga kapena omwe ali ndi chiwopsezo chokhala ndi matenda a shuga a 2.

Calcium Channel Blockers (a calcium calcium Antagonists)

Gulu la calcium blockers

Ma calcium antagonists ndi mankhwala a matenda oopsa omwe nthawi zambiri amaperekedwa padziko lonse lapansi. Nthawi yomweyo, madokotala ndi odwala ambiri “pakhungu lawo” akukhulupirira kuti mapiritsi a magnesium ali ndi vuto lofanananso ndi calcium calcium blockers. Mwachitsanzo, izi zidalembedwa m'bukhu la Reverse Heart Disease Now (2008) ndi madokotala aku America a Stephen T. Sinatra ndi a James C. Roberts.

Kuperewera kwa magnesium kumapangitsa kuti kagayidwe kachakudya, ndipo izi ndizomwe zimayambitsa matenda oopsa. Mankhwala ochokera pagulu lotsutsana ndi calcium nthawi zambiri amachititsa kudzimbidwa, kupweteka mutu, kutupa ndi kutupira pamapazi. Kukonzekera kwa Magnesium, mosiyana ndi izi, sikumakhala ndi zotsatira zoyipa. Amathandizira osati matenda oopsa, komanso amachepetsa mitsempha, kusintha matumbo, ndikuwongolera premenstrual syndrome mwa azimayi.

Mutha kufunsa kuti amwe mapiritsi okhala ndi magnesium. Mutha kudziwa zambiri za kukonzekera kwa magnesium pochiza matenda oopsa pano. Ma virnesium othandizira amakhala otetezeka kwathunthu, pokhapokha ngati wodwala ali ndi vuto lalikulu la impso. Ngati muli ndi matenda ashuga a nephropathy pa gawo la kulephera kwa impso, funsani dokotala ngati muyenera kumwa magnesium.

Calcium calcium blockers mu sing'anga achire Mlingo samakhudza kagayidwe kazakudya ndi mafuta. Chifukwa chake, samakulitsa chiwopsezo chokhala ndi matenda ashuga amtundu wa 2. Nthawi imodzimodzi, ma diydropyridine omwe amangokhala pakatikati komanso pamtunda waukulu amawonjezera ngozi ya odwala omwe amwalira ndi mtima ndi zina.

Otsutsa a calcium amayenera kulandira odwala omwe ali ndi matenda a mtima omwe amakhala ndi matenda a mtima.

• angina wosakhazikika,
• pachimake nthawi ya infracation infaration,
• kulephera kwa mtima.

Ma diydropyridine omwe amakhala atatenga nthawi yayitali amadziwika kuti ali otetezeka kwa odwala omwe ali ndi matenda ashuga omwe amakhala ndi vuto la mtima. Koma popewa kulowetsedwa kwa myocardial ndi kulephera kwa mtima, ndi otsika kwambiri kwa ACE zoletsa. Chifukwa chake, amalimbikitsidwa kuti azigwiritsidwa ntchito limodzi ndi ACE inhibitors kapena beta-blockers.

Kwa odwala okalamba omwe ali ndi systolic yokhazikika, othana ndi calcium amawerengedwa ngati mankhwala oyambira kuthana ndi sitiroko. Makamaka kwa odwala matenda a shuga a 2. Izi zikugwira ntchito pa onse dihydropyridines komanso osakhala dihydropyridine.

Verapamil ndi diltiazem atsimikiziridwa kuti ateteza impso. Chifukwa chake, awa ndi ma calcium blockers omwe amaperekedwa kwa odwala omwe ali ndi matenda ashuga. Ma calcium antagonists ochokera ku dihydropyridine gulu alibe nephroprotective. Chifukwa chake, amatha kugwiritsidwa ntchito limodzi ndi ACE inhibitors kapena angiotensin-II receptor blockers.

ACE zoletsa

Ma Ahibuloseti a ACE ndi gulu lofunikira kwambiri la mankhwala othandizira kuthamanga kwa magazi ku matenda ashuga, makamaka ngati vuto la impso likukula. Apa mutha kupeza zambiri mwatsatanetsatane za ACE inhibitors.

Dziwani kuti ngati wodwala atayamba kulumikizana ndi mafupa a m'mitsempha kapena kuti minyewa imodzi ya minyewa, ndiye kuti zoletsa za ACE ziyenera kuchotsedwa. Zomwezo zimapita kwa angiotensin-II receptor blockers, omwe tikambirana pansipa.

Zotsutsana zina pakugwiritsa ntchito zoletsa ACE:

• Hyperkalemia (kuchuluka kwa potaziyamu m'magazi)> 6 mmol / l,
• kuchuluka kwa seramu creatinine wopitilira 30% kuchokera pamlingo woyambirira mkati mwa sabata 1 atayamba chithandizo (pang'onopang'ono - onani!),
• mimba ndi nthawi yoyamwitsa.

Pochizira kulephera kwa mtima kwazovuta zilizonse, ma inhibitors a ACE ndi mankhwala oyambira kusankha posankha, kuphatikiza odwala omwe ali ndi matenda amtundu wa 1 komanso a 2.Mankhwalawa amathandizira chidwi cha zimakhala mpaka insulin motero amakhala ndi prophylactic pakukula kwa matenda a shuga a mtundu 2. Siziwonjezera kuyipa kwa shuga wamagazi, musachulukitse cholesterol "yoyipa".

ACE zoletsa ndi # 1 mankhwala ochizira matenda a shuga. Odwala a Type 1 ndi 2 a shuga amapatsidwa mankhwala ochepetsa a ACE akangoyesedwa atawonetsa microalbuminuria kapena proteinuria, ngakhale kuthamanga kwa magazi kukhalabe kwabwinobwino. Chifukwa amateteza impso komanso kuchedwetsa kukula kwa impso kulephera pakapita nthawi.

Ngati wodwala akutenga zoletsa za ACE, ndiye kuti ndi bwino kuti azithira mchere wambiri osaposa magalamu atatu patsiku. Izi zikutanthauza kuti muyenera kuphika chakudya chopanda mchere konse. Chifukwa imawonjezedwa kale ndi zinthu zomalizidwa ndi zinthu zotsiriza. Izi ndizokwanira mokwanira kuti musakhale ndi vuto la sodium m'thupi.

Mukamalandira chithandizo ndi ACE inhibitors, kuthamanga kwa magazi kuyenera kuyesedwa pafupipafupi, ndipo serum creatinine ndi potaziyamu ziyenera kuyang'aniridwa. Okalamba okalamba omwe ali ndi atherosulinosis yodziwika bwino amayenera kuyezetsa matenda amitsempha yamagazi am'mimbamo asanafotokoze zoletsa ACE.

Angiotensin II receptor blockers (angiotensin receptor antagonists)

Mutha kudziwa zambiri zamankhwala atsopano awa. Kuti muthane ndi kuthamanga kwa magazi komanso vuto la impso mu shuga, angiotensin-II receptor blockers amalembedwa ngati wodwala wapanga chifuwa chowuma kuchokera ku ACE inhibitors. Vutoli limapezeka pafupifupi 20% ya odwala.

Angiotensin-II receptor blockers ndi okwera mtengo kuposa ACE zoletsa, koma sayambitsa chifuwa chowuma. Chilichonse cholembedwa munkhaniyi pamwambapa pa ACE inhibitors chimagwira ntchito kwa angiotensin receptor blockers. Zowonongera ndizofanana, ndipo ziyeso zomwezi ziyenera kumwedwa pomwa mankhwalawa.

Ndikofunikira kudziwa kuti angiotensin-II receptor blockers amachepetsa michere yamitsempha yamanzere kwambiri kuposa zoletsa za ACE. Odwala amalekerera bwino kuposa mankhwala ena aliwonse okhathamira magazi. Zilibe zotsatira zoyipa kuposa placebo.

Rasilez - zoletsa mwachindunji za renin

Awa ndi mankhwala atsopano. Idapangidwa pambuyo pake kuposa ACE inhibitors ndi angiotensin receptor blockers. Rasilez adalembetsedwa movomerezeka ku Russia
mu Julayi 2008. Zotsatira zamaphunziro a nthawi yayitali ogwira ntchito ake akuyembekezeredwa.

Rasilez - zoletsa mwachindunji za renin

Rasilez imayikidwa limodzi ndi ACE inhibitors kapena angiotensin-II receptor blockers. Kuphatikiza koteroko kwa mankhwalawa kumapangitsa kuteteza mtima ndi impso. Rasilez amasintha cholesterol m'mwazi ndikuwonjezera chidwi cha minofu kufikira insulin.

Alfa oletsa

Pakusamalira kwakanthawi kochepa kwa matenda oopsa, osankha alpha-1-blockers amagwiritsidwa ntchito. Mankhwala omwe ali mgululi akuphatikizapo:

Pharmacokinetics ya kusankha alpha-1-blockers

Zotsatira zoyipa za alpha-blockers:

• orthostatic hypotension, mpaka kukomoka,
• kutupa kwa miyendo
• kusiya magazi (kuthamanga kwa magazi kudumpha "rebound" mwamphamvu)
• wolimbikira tachycardia.

Kafukufuku wina wawonetsa kuti alpha-blockers amawonjezera chiopsezo cholephera mtima. Kuyambira pamenepo, mankhwalawa sanakhale otchuka kwambiri, kupatula nthawi zina. Mankhwalawa amaperekedwa limodzi ndi mankhwala ena oopsa, ngati wodwalayo ali ndi vuto la Prostatic hyperplasia.

Mu shuga, ndikofunikira kuti akhale ndi phindu pa metabolism.Al-blockers amachepetsa shuga m'magazi, amalimbikitsa kukhudzidwa kwa minofu, ndikuwongolera cholesterol ndi triglycerides.

Nthawi yomweyo, kulephera kwa mtima ndi kuphwanya kugwiritsa ntchito kwawo. Ngati wodwala ali ndi autonomic neuropathy yowonetsedwa ndi orthostatic hypotension, ndiye kuti ma alpha-blockers sangadziwike.

Limagwirira chitukuko cha matenda oopsa

Kupsinjika kwa shuga kumatuluka mosiyanasiyana kutengera mtundu wa matenda ashuga. Ndi matenda amtundu wa 1 wodwala, matendawa samakula kwambiri, ndipo nthawi zonse pamakhala mwayi woletsa chitukuko. Mtundu wachiwiri wa matenda a shuga umadzadza ndi zovuta zazikulu mpaka matenda osakanikirana oopsa.

Onani mbali iliyonse mwatsatanetsatane:

Matenda oopsa komanso matenda ashuga 1

Pankhani ya mtundu woyamba, magawo angapo a chitukuko awonedwa:

• microalbuminuria,
• proteinuria
• aakulu aimpso kulephera (CRF).

Popitilirabe matendawa, mwayi wokhala ndi matenda oopsa kwambiri, komanso ubale wofanana pakati pa kuchuluka kwa mitsempha komanso kuchuluka kwa mapuloteni amtunduwu ndikulondola. Chowonadi ndi chakuti pamkhalidwewu, thupi limalephera kuchotsa bwino sodium, kudziunjikira m'magazi ndikuwonjezera kuchuluka kwa kukakamizidwa. Ngati misempha ya shuga imasinthidwa munthawi yake, kupita patsogolo kumatha kupewa.

Zolemba za maphunziro a matenda ashuga

Matenda a shuga ndi owopsa kwa wodwalayo ndikusintha kwadzidzidzi kwakanthawi, mosasamala nthawi yatsiku: ngati munthu wathanzi amakhala ndi kuchepa kwa kukakamizidwa pafupifupi 15% m'mawa, ndiye kuti wodwalayo amatha kumva, m'malo mwake, akuwonjezeka.

Ichi ndichifukwa chake madokotala amalimbikitsa kupanikizika pafupipafupi kuti athe kuwunika momwe wodwalayo alili. Izi zipangitsa kuti wopezekapo amvetsetse bwino kuchuluka kwa mankhwalawa komanso ndandanda yanji ya mankhwalawa imayenera kuperekedwa kwa wodwala.

Monga tanena kale, munthu wodwala matenda ashuga amayeneranso kutsatira njira zina zopatsa thanzi, ndipo maziko ake ayenera kukhala kukana mchere kwathunthu. Kuphatikiza pa kadyedwe kena, munthu amayenera kutsatira ngakhale malamulo monga kukana kuyenda mwadzidzidzi komanso kusintha kosavuta pakati pakuyimirira, kukhala ndi kugona. Zoletsa zonse zimayang'aniridwa ndi malangizo a dokotala wothandizirana ndi zofunikira pakugwiritsa ntchito mankhwalawo.

Ngati wodwala amakhala ndi matenda oopsa komanso matenda a shuga, amadzigwetsa m'magazi a matenda a mtima. Gawo loyamba ndikuchepetsa kuchuluka kwa mavuto m'mitsempha kuti chithandizo china chilolekere bwino. Komanso zakudya zapadera zimayikidwa ndi katswiri wazakudya, ndipo katswiri wina amasankha njira yochizira ndi mankhwala. Kuphatikiza apo, wodwalayo amatha kuchita chithandizo ndi wowerengeka azitsamba, tsopano tikambirana zonse mwatsatanetsatane mwatsatanetsatane.

Mfundo za Combined Antihypertensive Therapy

Kuphatikiza kwa njira zingapo zamankhwala sikothandiza, komanso kwamphamvu ngati kuli ndi maziko olimba. Kuphatikizidwa kopambana pankhani ya matenda oopsa kwambiri kumakupatsani mwayi woletsa zovuta zosiyanasiyana kukwera kwa kuthamanga kwa magazi, ndipo nthawi zina mavuto obwera chifukwa cha mankhwalawo.

Mwachitsanzo, kutenga antagonists a calcium limodzi ndi ACE inhibitors kungachepetse chiopsezo chotupa cham'munsi komanso mawonekedwe a chifuwa chowuma.

Njira za anthu

Mankhwala achikhalidwe ndi njira yoopsa yochizira ngati sayang'aniridwa ndi katswiri wazachipatala kapena sanavomerezeredwe pazifukwa zamankhwala. Chithandizo chachikulu chimachitidwa ndendende ndi ma tincture pazitsamba zomwe zimatha kubwezeretsanso ma microelements ofunikira m'thupi, chifukwa chake kufunsa ndi katswiri ndikofunikira, chifukwa si zitsamba zonse zomwe zimakhala zotetezeka kwa thupi la wodwalayo.

Ndikofunika kukumbukira kuti mankhwalawa wowerengeka azitsamba amatenga nthawi yayitali, ndipo maphunzirowa amatha mpaka miyezi isanu ndi umodzi yopuma pamwezi masiku 10, koma mlingo ungachepetsedwe ngati, patatha miyezi ingapo, kusintha kwodziwikiratu kumaonekera.

Chisamaliro chachikulu chiyenera kuperekedwa kwa masamba a birch, flaxseeds, komanso zitsamba zotsatirazi:

Chosakaniza chilichonse ndizosavuta kuphatikiza ndi china chilichonse mumitundu yosiyanasiyana. Ndikofunika kukumbukira kuti maphikidwe omwe ali ndi maphikidwe a saber ndi oletsedwa. Izi zokha zimangokulitsa kupanikizika m'mitsempha ndipo zimatha kuyambitsa zovuta m'matenda a shuga. Tiona njira yokhazikika ya tincture, yoyesedwa ndi kuvomerezedwa kuti igwiritsidwe ntchito ndi odwala matenda ashuga:

1. Ndikofunikira kusakaniza maluwa a hawthorn, nthangala za katsabola, masamba a oregano, marigold, chamomile, sinamoni, viburnum ya motsutsana ndi motsatizana, mizu ya valerian ndi nsonga za karoti. Chigawo chilichonse chimatengedwa pamlingo wofanana ndi zina zonse.
2. Zosakaniza zonse zomwe zimasonkhanitsidwa zimatsukidwa bwino ndikumadulidwa.
3. Pa supuni ziwiri za zitsamba zosakanikirana, ma millilitita 500 amadzi otentha amatengedwa.
4. Zotsatira zosakanikirazo zimaphatikizidwa kwa maola awiri pamalo otentha.
5. Uchi kapena shuga umawonjezeredwa ndi kulowetsedwa momwe mungafunire.

Kulowetsedwa uku kumayenera kuledzera pasanathe maola 12.

Beta blockers

Mankhwalawa ndi a beta-receptor blockers, omwe amalola kuti achepetse chiopsezo cha kufa chifukwa cha matenda amtima. Chofunika, mtundu uwu wa mankhwala umatha kubisa zizindikiritso za hypoglycemia, motero ndikofunikira kusamala pakumwa mankhwalawo. Beta-blockers ali ndi mitundu ndipo amafunikira odwala:

Madokotala nthawi zambiri amapereka mankhwala a beta-blockers a mtima, koma mankhwala a vasodilator monga Nebivolol nawonso ndi otchuka, omwe amaphatikiza bwino zakudya zawo zamagulu ochepa a shuga. Carvedilol imagwiritsidwanso ntchito kwambiri, yomwe si yosankha beta-blocker, komanso imagwira ntchito kwambiri kuwonjezera chidwi cha zimakhala m'thupi zokhudzana ndi insulin.

Chithandizo cha matenda oopsa a matenda a shuga 2: mapiritsi, zikuonetsa

Matenda oopsa - kuthamanga kwa magazi. Kupanikizika kwa mtundu wa shuga 2 kumayenera kusungidwa pa 130/85 mm Hg. Art. Mitengo yapamwamba imachulukitsa mwayi wokhala ndi stroke (nthawi 3-4), vuto la mtima (nthawi 3-5), khungu (nthawi 10-20), kulephera kwa impso (nthawi 20-25), gangrene ndikoduladula wotsatira (nthawi 20). Kuti mupewe zovuta zoterezi, zotsatira zake, muyenera kumwa mankhwala othandizira odwala matenda ashuga.

Ndi chiyani chophatikiza matenda ashuga ndi kukakamiza? Zimaphatikiza kuwonongeka kwa ziwalo: minofu ya mtima, impso, mitsempha yamagazi, ndi kuwala kwa diso. Matenda oopsa m'magazi a shuga nthawi zambiri amakhala oyambira, amatengera matendawa.

1. Mtundu wa kuthamanga kwa magazi umasweka - poyeza zizindikiro za nthawi yausiku ndizokwera kuposa nthawi yamasana. Cholinga chake ndi neuropathy.
2. Kuchita bwino kwa ntchito yolumikizana ya dongosolo laumwini la autonomic ndikusintha: kayendedwe ka kayendedwe ka mitsempha yamagazi kamasokonekera.
3. Orthostatic mawonekedwe a hypotension amayamba - kuthamanga kwa magazi mu shuga. Kukwera kwakuthwa m'munthu kumayambitsa kuwukira kwa hypotension, kuyipa m'maso, kufooka, kukomoka kumawonekera.

Muyenera kuyamba liti kulandira matenda oopsa mu shuga? Kodi ndimatenda ati omwe amakhala owopsa kwa matenda ashuga? Patangotha ​​masiku ochepa, kupanikizika kwa mtundu wa 2 shuga kumakhala pa 130-135 / 85 mm. Hg. Art., Amafuna chithandizo. Kukwera bwino kwambiri, kumakhala koopsa la zovuta zingapo.

Chithandizo chiyenera kuyambitsidwa ndi mapiritsi a diuretic (okodzetsa). Zofunikira pakubwezeretsa kwa mitundu yachiwiri ya odwala matenda ashuga 1

Chofunikira: Diuretics imasokoneza bwino electrolyte. Amachotsa mchere wamatsenga, sodium, potaziyamu kuchokera m'thupi, chifukwa chake, kuti abwezeretse mawonekedwe a electrolyte, Triamteren, Spironolactone adayikidwa.Ma diuretics onse amalandiridwa pazifukwa zamankhwala.

Kusankhidwa kwa mankhwala ndikofunikira kwa madokotala, kudzipereka nokha ndiwowopsa kuumoyo komanso moyo. Posankha mankhwala opondera odwala matenda ashuga komanso mankhwala ochizira matenda amishuga a 2, madokotala amatsogozedwa ndi momwe wodwalayo alili, mawonekedwe a mankhwala, kaphatikizidwe, ndikusankha mitundu yotetezeka ya wodwala wina.

Mankhwala a antihypertensive malinga ndi pharmacokinetics amatha kugawidwa m'magulu asanu.

Chofunikira: Mapiritsi a kuthamanga kwa magazi - Beta-blockers yokhala ndi vasodilating - mankhwala amakono kwambiri, otetezeka - kukulitsa mitsempha yamagazi, imakhala ndi phindu pa carbohydrate-lipid metabolism.

Chonde dziwani: Ofufuza ena amakhulupirira kuti mapiritsi otetezeka kwambiri a matenda oopsa mu shuga, matenda osagwirizana ndi insulin ndi Nebivolol, Carvedilol. Mapiritsi otsala a gulu la beta-blocker amaonedwa ngati owopsa, osagwirizana ndi matenda oyambitsawa.

Chofunikira: Beta-blockers imatchinga zizindikiro za hypoglycemia, chifukwa chake, iyenera kukhazikitsidwa ndi chisamaliro chachikulu.

Mankhwala ochizira matenda oopsa a 2 mtundu mellitus mndandanda 4

Mapiritsi a ambulansi ochepetsa kuthamanga kwa magazi: Andipal, Captopril, Nifedipine, Clonidine, Anaprilin. Chochitikacho chimatha mpaka maola 6.

Mapiritsi a matenda oopsa mu mtundu 2 wa matenda ashuga 5

Mankhwala ochepetsa kuthamanga kwa magazi sakhala pamndandanda izi. Mndandanda wamankhwala umasinthidwa nthawi zonse ndi zochitika zatsopano, zamakono kwambiri.

Victoria K., 42, wopanga.

Ndakhala ndi matenda oopsa kwambiri komanso matenda ashuga a 2 kwazaka ziwiri. Sindinamwe mapilitsiwo, ndimalandira mankhwala azitsamba, koma sathandizanso. Zoyenera kuchita Mnzanu akuti mutha kuthana ndi kuthamanga kwa magazi ngati mutenga bisaprolol. Ndi mapiritsi ati opanikizika omwe ali bwino kumwa? Zoyenera kuchita

Victor Podporin, endocrinologist.

Wokondedwa Victoria, sindingakulangizeni kuti muzimvera bwenzi lanu. Popanda mankhwala a dotolo, kumwa mankhwala sikofunikira. Kuthamanga kwa magazi kwa odwala matenda ashuga kumakhala ndi etiology yosiyanasiyana (zomwe zimayambitsa) ndipo imafunikira njira ina yothandizira. Mankhwala othandizira kuthamanga kwa magazi amaperekedwa ndi adokotala okha.

Matenda oopsa a arterial amachititsa kuphwanya kwa kagayidwe kazachilengedwe mu milandu ya 50-70%. 40% ya odwala, ochepa matenda oopsa amakhala mtundu 2 shuga. Cholinga chake ndi kukana insulini - kukana insulini. Matenda a shuga ndi kupsinjika amafuna chithandizo chamankhwala.

Chithandizo cha matenda oopsa ndi mankhwala wowerengeka a anthu odwala matenda ashuga ziyenera kuyambitsidwa ndi kusunga malamulo a moyo wathanzi: kukhalabe wathanzi, kusiya kusuta, kumwa mowa, kuchepetsa kuchuluka kwa mchere komanso zakudya zovulaza.

Njira zochizira wowerengeka zochepetsera kuthamanga kwa odwala matenda ashuga amtundu wa 6:

Chithandizo cha matenda oopsa ndi mankhwala wowerengeka azikhalidwe za anthu odwala matenda ashuga sizigwira ntchito nthawi zonse, chifukwa chake, pamodzi ndi mankhwala azitsamba, muyenera kumwa mankhwala. Zithandizo za Folk ziyenera kugwiritsidwa ntchito mosamala, atakambirana ndi endocrinologist.

Zakudya kwa matenda oopsa ndipo mtundu 2 matenda a shuga umalimbana kuchepetsa kuthamanga kwa magazi ndi kusintha magazi ake m'magazi. Zakudya zamagulu olemba matenda oopsa komanso mtundu wa 2 shuga.

1. Zakudya zoyenera (kuchuluka kwake ndi kuchuluka kwake) kwamapuloteni, chakudya, mafuta.
2. Low-carb, wamphamvu mavitamini, potaziyamu, magnesium, kufufuza zinthu.
3. Kumwa mchere woposa 5 g pa tsiku.
4. Wokwanira masamba ndi zipatso.
5. Zakudya zopatsa thanzi (osachepera 4-5 patsiku).
6. Kuphatikiza zakudya No. 9 kapena No. 10.

Mankhwala olembetsa magazi amaimiridwa kwambiri pamsika wamankhwala. Mankhwala enieni, zamagetsi zamapulogalamu amitengo osiyanasiyana ali ndi zabwino zawo, zikuwonetsa komanso kuphwanya.Matenda a shuga ndi matenda oopsa amayenda limodzi, amafunikira chithandizo chamankhwala. Chifukwa chake, mulibe konse muyenera kudzilingalira. Njira zokhazokha zochizira matenda ashuga ndi matenda oopsa, kuikidwa koyenerera ndi endocrinologist ndi cardiologist kumabweretsa zotsatira zomwe mukufuna. Khalani athanzi!

Palibe amene angachiritse matenda ashuga komanso matenda oopsa. Ndinagwiritsa ntchito ziwembu zosankhidwa za madokotala 5 ndi chilichonse kuphatikiza babu. Sindikudziwa komwe madotawa amaphunzitsidwa. Adzakulemberani ndikuganiza chifukwa chake shuga adakula ndi zakudya zabwino. Ndakhala ndikuphunzira kuyenderana ndimankhwala onse ndekha kwa milungu iwiri ndipo palibe madokotala ati amvetse izi. Ndipo izi zitachitika nditapita kuchipatala ndi kukakamizidwa. Alandila shuga 6, atulutsa 20

Inde, sitifuna madokotala. Amakonda odwala "athanzi" kuti abwere kwa iwo. Sindinakumanepo ndi dokotala m'modzi yemwe angakambirane pang'ono. Akukhala, akulemba, sadzafunsa kalikonse, sachita chidwi ndi boma, ndiye kuti muyamba kuyankhula. Ndipo akalemba adzati "ndinu mfulu." Chifukwa chake zimapezeka kuti timachiza matenda oopsa ndipo pambuyo pake timakhalanso ndi matenda ashuga. Ndimatenga Glibomet kuchokera ku matenda ashuga ndikuwerenga kuti mankhwalawa amatsutsana chifukwa cha matenda oopsa. Ngakhale adauza endocrinologist kuti adagula Glibomet, popeza sanapereke chilichonse kwaulere, sanayankhe chilichonse, chabwino, anagula ndikugula, ndipo sanachenjezere kuti mankhwalawa amabwera chifukwa cha matenda oopsa, ngakhale ma fanizo onse ali ndi mankhwala a 2 Metformin komanso Glibenclamide, mayina osiyanasiyana okha ndi makampani osiyanasiyana amatulutsa. Pa amodzi omwe amalemba popanda chenjezo, pomwe iwo amachenjeza kuti kuthana ndi matenda osokoneza bongo sikofunikira, shuga kuchokera kwa iwo amawuka. Ndipo kuvomera chiyani? Mudzafika kwa adotolo ndikudzifunsa ndikuyankha.

Matenda oopsa a matenda a shuga 2: zoyambitsa ndi kulandira

Munthu akakhala ndi matenda ashuga, ndiye kuti kupsinjika kwa matendawa kumakula. Ngati munthu ali ndi kuthamanga kwa magazi ndi matenda a shuga, ndiye kuti ali ndi chiopsezo chachikulu cha matenda a mtima ndi stroko, ndipo izi zimafunikira kale chithandizo cha panthawi yake.

Ngati munthu wakula chotere (kutanthauza kupanikizika kwa matenda ashuga), ndiye kuti chiopsezo cha kugwidwa ndi matenda a mtima chikuwonjezeka nthawi zambiri, ndipo kulephera kwa impso kumachitikanso. Komabe, ziyenera kudziwidwa kuti ndi matenda oterowo, malo owopsa oopsa amachepetsa, koma izi sizitanthauza kuti palibe njira zochiritsira zomwe zingachitike. Ndipo pali zovuta zina - pomwe munthu saganiza zochepetsa kukakamizidwa, koma akuyenera kuganizira momwe angakulitsire kupanikizika.

Pazifukwa ziti kupanikizika kumabuka mu mtundu 2 wa shuga

Zizindikiro za matenda oopsa amtunduwu amatenda pazifukwa zosiyanasiyana, nthawi zambiri zimadalira mtundu wa matenda. Chithandizo cha matenda oopsa a matenda a shuga a mtundu 2 chimakhala chovuta chifukwa chakuti zomwe zimayambitsa matendawa ndizosiyana kwambiri. Zochitika zotsatirazi titha kuzitchula monga zitsanzo - nthawi zambiri zonsezi zimachitika ngati impso za munthu zakhudzidwa ndi matenda.

Nthawi zambiri matenda oterewa amayamba chifukwa cha kuwonongeka kwa impso kenako chithandizo cha mtundu wachiwiri wa matenda ashuga amakumana ndi zovuta zambiri, makamaka ngati chithandizo sichinayambike pa nthawi. Potere, munthu amakula ndi nephropathy yamtundu wa matenda ashuga, chifukwa chake matenda a shuga ndi matenda oopsa nthawi zambiri amapitira limodzi. Ndizachilendo kuti kukakamiza kwa munthu wodwala matenda a shuga a 2 kumayamba kukula kwambiri kuposa momwe kagayidwe kachakudya ka thupi lake kamasokonezekera ndipo, matendawo omwewo amapangidwa. Polankhula momveka bwino, matenda oopsa a anthu komanso mtundu wa 2 matenda a shuga ndi mtundu wa metabolic womwe umayambitsa matenda a endocrine.

Ngati tirikunena za zifukwa zomwe shuga ndi kupsinjika kumayendera limodzi, ndiye kuti chinthu chonsecho chimangokhala chokhacho cha matenda oopsa, matendawa amakhala achikulire. Pali mtundu wina wa zamatenda pomwe dokotala sangathe kuzindikira chodalirika chomwe chimayambitsa matenda. Ngati kuthamanga kwa magazi kumakula mwa munthu wonenepa kwambiri, chifukwa chake ndi chakudya chosagwirizana ndi chakudya, komanso kuchuluka kwa insulini m'mtsinje wamagazi. Chifukwa chake, mtundu wa metabolic mtundu umapangidwa, umatha kuthandizidwa mwachangu komanso mokwanira ngati munthu akufuna thandizo la mankhwala panthawi yake. Kupitiliza kulankhula za zomwe zimayambitsa matenda, kuyenera kunenedwa pazotsatirazi:

• mu thupi la munthu mumakhala kusowa kwamphamvu kwa magnesium,
• munthu amakhala wopsinjika nthawi zonse
• thupi la munthu limapwetekedwa ndi mercury, cadmium kapena lead.
• chifukwa cha atherosulinosis, chotupa chachikulu chimachepetsedwa.

Mutha kuthana ndi matenda monga matenda a shuga mellitus mosiyanasiyana, zonse zimatengera zinthu zosiyanasiyana - zaka za munthu, machitidwe a thupi ndi chikhalidwe cha matendawa. Koma ndi chithandizo, simungathe kudya popanda matenda ashuga, apo ayi matenda a shuga sangathe kuwongolera, amafunikira ndi chithandizo chilichonse.

M'mbuyomu, matenda oopsa sanatengedwe konse mu mtundu II odwala matenda ashuga. Koma makampani amakono azamankhwala amapereka mankhwala otere omwe ndi othandiza kwambiri. Chithandizo chimodzi chimachepetsa kukakamiza, china chimawonjezeka, ngati pakufunika kutero. Mankhwala oterowo samangochepetsa kukakamiza, komanso amalimbana ndi zizindikiro zina zowopsa za matendawa ndi matenda oopsa.

Munthu asanayambe matenda ashuga "okhazikika", njira ya insulin yolimbana ndi thupi lake imayamba kugwira ntchito. Izi zimadziwika ndi kuchepa kwa chidwi cha minofu kupita ku insulin. Kuti alipiritse kukana insulini, kuchuluka kwa insulini kumachitika m'mitsempha yamagazi, zomwe zimapangitsa kuti chiwopsezo cha matenda a shuga chikule.

Munthu akayamba kudwala matenda a shuga a mtundu wachiwiri, mafuta a m'magazi amtundu wa magazi amakhala akucheperachepera, zomwe zimapangitsa kuti magazi aziwonjezereka. Odwala otere nthawi zambiri amadziwika ndi kunenepa kwamtundu wam'mimba, pomwe mafutawo am'mafuta amapita m'chiuno. Minofu ya Adipose imayamba kubisa zinthu mumtsinje wamagazi zomwe zimangokulitsa kukula kwa zizindikiro zowopsa.

Mavuto owopsa oterewa amatchedwa metabolic mtundu syndrome, kotero kuti kuthinikizidwa kwa munthu kumakula kwambiri kuposa matenda ashuga omwe. Matenda oopsa nthawi zambiri amapezeka mwa anthu akapezeka ndi matenda a shuga. Koma musataye mtima chifukwa cha anthu omwe ali ndi matendawa - okhala ndi chakudya chamafuta ochepa, mutha kuthanso matenda onse a shuga komanso kuthamanga kwa magazi. Chakudya chokhacho chimayenera kutsatira pafupipafupi, kupewa zolephera zilizonse.

Payokha, hyperinsulism iyenera kudziwika pamene kuphatikizika kwa insulin pamtsinje wamagazi kukwera kwambiri. Kuchita uku ndikuyankha kukana insulini, pamene kapamba amatulutsa kuchuluka kwa insulin, imayamba kuvala koyambirira. Pakapita kanthawi, chiwalo chofunikira ichi sichitha kukwaniritsa magwiridwe ake, zomwe zimapangitsa kuchuluka kwa shuga mumtsinje wamagazi, pambuyo pake munthu amayamba matenda a shuga.

Zovuta zam'mitsempha yamtunduwu zimakwera motere:

• machitidwe amanjenje amachitidwa,
• Sodium ndi madzimadzi amuchotsa impso pamodzi ndi mkodzo,
• Sodium ndi calcium zimapezeka m'maselo,
• kuchuluka kwa insulini kumadziunjikira m'thupi, motero makoma a ziwiya amatopa pang'onopang'ono, zomwe zimapangitsa kuti asamaoneke kwambiri.

Munthu akakhala ndi matenda a shuga, kusinthasintha kwachilengedwe m'mitsempha kumasokonekera.Ngati titenga chizolowezi monga mwachitsanzo, ndiye kuti usiku nkhawa za munthu zimachepetsedwa ndi 15-20% poyerekeza ndi nthawi yamasana. Koma mwa anthu odwala matenda ashuga, kuchepa kwachilengedwe kotere usiku sikuwonetsedwa, koma m'malo mwake, munthu akakhala ndi matenda ashuga, kupanikizika m'mitsempha usiku kumatha kukhala kokulirapo kuposa masana. Zikuwonekeratu kuti izi sizidzabweretsa chilichonse chabwino.

Ngati tizingolankhula pazifukwa, ndiye kuti zonse ndi vuto la matenda ashuga, munthu akakhala ndi kuchuluka kwa shuga m'mitsempha yamagazi, yomwe imakhudza mkhalidwe wamanjenje (tikukamba za mantha am'magazi omwe amakhudza moyo wa thupi lonse). Momwe zimapangidwira momwe zimakhalira m'matumba, sizingatheke kuyendetsa bwino mawu, zimachepa ndikupuma, zonse zimatengera mulingo wa katundu.

Titha kudziwa kuti munthu akayamba kudwala matenda oopsa limodzi ndi "matenda okoma", kugwiritsa ntchito ndalama kamodzi kamodzi sikokwanira, kuwunika kuyenera kuchitika tsiku lonse. Kuchita koteroko kumachitika ndi chipangizo chapadera, kuphunzira koteroko kumathandiza kukonza nthawi yomwe muyenera kumwa mankhwalawo komanso momwe muyenera kukhala. Ngati pakuwunika kuwunika kwa nthawi yathunthu ndikusintha kuti kukakamiza kwamitsempha yamagazi kumangosinthasintha, ndiye kuti munthu ali ndi vuto lalikulu la vuto la mtima.

Malinga ndi zotsatira za kafukufuku wothandiza, munthu wodwala matenda ashuga oyambilira komanso wachiwiri amasamalira mchere kuposa omwe amakhala ndi matenda omwe amadwala matenda ashuga sawonekera. Izi zikutanthauza kuti zizindikilo zoipa zitha kuchepetsedwa kwambiri ngati munthu amachepetsa mchere. Munthu akakhala ndi matenda ashuga ndipo akalandira chithandizo, mchere uyenera kudya pang'ono, momwe mungathere chithandizo chimenecho ndichoyenera kuchita bwino.

Nthawi zambiri zinthu zimavuta chifukwa chakuti munthu akupanga mtundu wina wa orthostatic. Ndiye kuti, kupanikizika kwa wodwala kumachepa msanga pamene asintha kwambiri komwe amakhala. Munthawi imeneyi, munthu amakhala ndi chizungulire kwambiri akamadzuka, amakhala mumdima m'maso mwake, ndipo zimachitika kuti munthu amayamba kufooka. Zonsezi zimachitika chifukwa cha matenda ashuga a mtundu wa shuga, pomwe mantha amthupi amunthu samayankhanso pakuwongolera kamvekedwe ka minyewa. Ndi kukwera kwakuthwa mwa munthu, katunduyo nthawi yomweyo amakwera. Chowonadi ndi chakuti thupi silitha kuwonjezera magazi kudzera m'mitsempha, motero munthu akumva zowawa.

Orthostatic mtundu hypotension imasiyanitsa njira yodziwitsira matenda ndi kutsatira kwa matenda am'tsogolo. Munthawi imeneyi, kukakamiza kuyenera kuyesedwa ngati munthu wayimirira ndi kunama. Pamaso pa zovuta zoterezi, wodwalayo sayenera kuimirira kwambiri kuti asawononge mawonekedwe ake.

Zakudya ziyenera kukhazikitsidwa poti munthu ayenera kudya zakudya zochepa kuti shuga m'magazi asakwe. Kenako kufunikira kwa insulin kwa thupi kumatsika, komwe kumapereka maziko othandizira bwino matenda. Kuchuluka kwa insulini mumtsinje wamagazi kumapereka kuthamanga kwa magazi.

Koma zakudya zokhala ndi zopatsa mphamvu pang'ono ndizovomerezeka pokhapokha ngati munthu walephera impso. Ngati kuchuluka kwa shuga m'magazi ndikwabwinobwino, ndiye kuti palibe chomwe chimalepheretsa impso kugwira ntchito mwachizolowezi, ndipo zomwe zili mu albumin mu mkodzo zimasintha msanga. Pa gawo la proteinuria ndi zakudya, ayenera kukhala osamala kwambiri, onetsetsani kuti mukumana ndi dokotala kuti mupewe mavuto.

Munthu akakhala ndi matenda a shuga, ndiye kuti amayamba kugwidwa m'magulu oopsa chifukwa cha matenda amtima.Ndi kusamutsidwa kwakhazikika kwa mankhwalawa, kukakamizidwa kumayenera kuchepetsedwa pakatha mwezi umodzi, pambuyo pake kuchepa kumapitilirabe, koma osati pamlingo woopsa kwambiri.

Muzochitika zoterezi, ndikofunikira kudziwa momwe munthu amalolerare kuti amwe mankhwala ndipo zotsatira zake zimaperekedwa bwanji? Ndi kusamukira bwino kwa mankhwalawa, kukakamiza kumayenera kutsika pang'onopang'ono, njirayi imachitika m'magawo angapo. Pambuyo polojekiti, mlingo umachuluka ndipo kuchuluka kwa mankhwalawa kumachuluka.

Ndi kuchepa kwa kuthamanga kwa magazi, hypotension siyimaloledwa, yomwe imachepetsa kwambiri vuto la kugunda kwa mtima ndi sitiroko. Koma pali odwala otere omwe njira yochepetsera imadzala ndi zovuta zazikulu:

• anthu omwe ali ndi vuto la impso
• anthu amakhala ndi mtima komanso matenda a mtima.
• okalamba omwe ziwiya zawo zimakhudzidwa ndi atherosulinosis.

Ngakhale pali mapiritsi ambiri omwe makampani amakono azachipatala amapatsa anthu, kusankha kwa mapiritsi oyenera a matendawa sikophweka. Chowonadi ndi chakuti pamene munthu wadwala kagayidwe kazakudya, ndiye kuti sangamwe mankhwala ena, izi zimaphatikizanso ndalama zochokera ku hypotension. Posankha mapiritsi, dokotala amaganizira kuchuluka kwa kayendetsedwe ka matendawa komanso ngati pali matenda amtundu wofanana ndipo ngati ndi choncho, momwe amakulira.

Mukamasankha mapiritsi, zotsatirazi ziyenera kukumbukiridwa:

• kotero kuti kupanikizika m'mitsempha kumachepa kwambiri, koma mavuto ake amachepetsa,
• mukamamwa mapiritsi, kuchuluka kwa shuga mumtsinje wamagazi sikuyenera kuchepa, cholesterol "yoyipa" sayenera kuchuluka,
• impso ndi mtima ziyenera kutetezedwa ku zovuta zomwe zimayambitsidwa ndi matenda owopsa.

Pali mankhwala a mtundu waukulu, ndipo alipo ena owonjezera, omwe amawagwiritsa ntchito ngati dokotala atapanga lingaliro pa chithandizo chophatikiza.

Ngakhale kuti ndizosatheka kuchira kwathunthu ku matenda ngati awa, mankhwala amakono akwaniritsa bwino mdera lino. Popita kafukufuku wa zasayansi, zidapezeka kuti zotsatira zazikulu zimapezeka ngati palibe, koma mankhwalawa angapo amagwiritsidwa ntchito pochiza. Izi ndichifukwa choti ndi matenda oopsa pali njira zingapo zopangira matenda, chifukwa chake, mankhwala aliwonse ayenera kuthandizidwa ndi mankhwala osiyana.

Ngati mankhwala amodzi okha agwiritsidwa ntchito mankhwalawo, ndiye kuti theka la odwala lingadalire zotsatira zabwino, ambiri mwa iwo ndi omwe pathology idakhala yokhazikika. Ngati mankhwala ophatikiza agwiritsidwa ntchito, ndiye kuti kuchuluka kwa mankhwalawo kumakhala kochepa, zomwe zikutanthauza kuti kuchuluka kwa zovuta kumakhalanso kochepa, koma zotsatira zabwino zimakwaniritsidwa mwachangu. Palinso mapiritsi oterewa omwe ali ndi njira zosinthira mokwanira zovuta zamapiritsi ena.

Tiyenera kumvetsetsa kuti sikuti matenda oopsa ambiri palokha ndi owopsa, koma mavuto omwe amakhalapo nawo mwanjira yogwira kwambiri. Apa, kulephera kwa impso, kugunda kwa mtima, sitiroko, pang'ono kapena kuwonongeka kwathunthu kwa masomphenya. Ndi munthawi yomweyo kukula kwa matenda ashuga ndi kuthamanga kwa magazi, zovuta zambiri zimadza. Kwa munthu aliyense payekha, adotolo amawunika zowunikira ndipo kenaka amasankha ngati angachiritse matendawa ndi mtundu umodzi wa mapiritsi kapena kugwiritsa ntchito njira yothandizirana.

Ngati munthu wadwala matenda a shuga akwera m'magazi, izi zimakhala ndi zovuta kwambiri. Kuti akhazikitse vutoli, munthu ayenera kuchita zambiri, koma chithandizo chiyenera kukhala chokwanira, apo ayi zotsatira zabwino sizingakhale zoyembekezeka. Choyamba, muyenera kusintha zakudya zanu, kudya zakudya zochepa, ndiye kuti shuga mumtsinje wamagazi amachepa.Koma, ngati munthu ali ndi vuto la impso, ndiye kuti zakudya ziyenera kukhala zosiyana, pankhaniyi, muyenera kukambirana kaye ndi dokotala. Insulin yaying'ono m'mtsinje wamagazi imasintha bwino vutoli.

Chithandizo cha ochepa matenda oopsa mu shuga

Matenda oopsa a arterial amamveka kuti akuwonjezeka akapanikizika kuposa 140/90 mm. Izi nthawi zambiri zimawonjezera chiopsezo cha kugunda kwamtima, kugwidwa, matenda a impso, ndi matenda a shuga. Matenda oopsa a matenda amitsempha amachepa: kukakamizidwa kwa ma syling kwa 130 komanso kupanikizika kwa diastolic ya 85 millimeter kukuwonetsa kufunikira kwa njira zochizira.

Zomwe zimayambitsa matenda oopsa mu shuga mellitus ndizosiyana ndipo zimatengera mtundu wamatenda. Chifukwa chake, ndimatenda omwe amadalira matenda a insulin, matenda oopsa kwambiri nthawi zambiri amayamba chifukwa cha matenda a impso a matenda ashuga. Ochepa ochepa odwala amakhala ndi matenda oopsa oopsa, kapena osokonekera kwa matenda oopsa.

Ngati wodwala amadwala matenda a shuga osadalira insulin, ndiye kuti matenda oopsa amakhazikika nthawi zina kale kwambiri kuposa matenda ena a metabolic. Mwa odwala, ochepa matenda oopsa ndi omwe amachititsa matenda. Izi zikutanthauza kuti adotolo sangadziwe chomwe chimayambitsa maonekedwe ake. Zomwe zimayambitsa matenda oopsa m'magazi ndi izi:

• pheochromocytoma (matenda wodziwika ndi kuchuluka kwa makatikolamu, chifukwa chomwe tachycardia, kupweteka mumtima ndi ochepa matenda oopsa amakhala
• Itsenko-Cushing's syndrome (matenda omwe amayamba chifukwa chopanga mahomoni a adrenal cortex),
• hyperaldosteronism (kuchuluka kwa mahomoni aldosterone ndi magene a adrenal), omwe amadziwika ndi zotsatira zoyipa pamtima,
• matenda ena osowa a autoimmune.

Gawaninso matendawa:

• kuchepa kwa magnesium m'thupi,
• kupanikizika kwa nthawi yayitali
• kuledzera ndi mchere wazitsulo zazikulu,
• atherosulinosis ndi kufupika kwa mtsempha waukulu.

Mawonekedwe a matenda oopsa mu shuga yomwe amadalira insulin

Mtundu wa matendawa nthawi zambiri umalumikizidwa ndi kuwonongeka kwa impso. Amakhala mu gawo limodzi mwa odwala ndipo ali ndi magawo awa:

• microalbuminuria (mawonekedwe a mkodzo wa albumin),
• proteinuria (mawonekedwe a mkodzo wa mamolekyulu akuluakulu),
• aakulu aimpso kulephera.

Kuphatikiza apo, mapuloteni ochulukirapo amachotsekedwa mu mkodzo, ndikumalimbikitsidwa. Izi ndichifukwa chakuti impso zodwala zimakhala zoyipa kwambiri pakuchotsa sodium. Kuchokera pamenepa, zinthu zamadzimadzi m'thupi zimachuluka ndipo, chifukwa chake, mavuto amakwera. Ndi kuchuluka kwa shuga m'magazi, madzi a m'magazi amawonjezereka. Izi zimapanga bwalo loipa.

Amakhala m'thupi kuti thupi likuyesera kuthana ndi kusagwira bwino kwa impso, pomwe likuwonjezera kukakamiza kwa impso glomeruli. Iwo pang'onopang'ono akufa. Uku ndiko kupita patsogolo kwa kulephera kwa impso. Ntchito yayikulu ya wodwala yemwe ali ndi matenda a shuga amachepetsa shuga.

Zizindikiro zolembetsa matenda osokoneza bongo omwe amadalira insulin

Ngakhale isanayambike zizindikiro za matenda, wodwalayo akuyamba kukana insulin. Kutsutsa kwa minofu ku timadzi timeneti kumachepetsedwa. Thupi likuyesayesa kuthana ndi chidwi chochepa cha minofu ya thupi kupita ku insulini ndikupanga insulin yambiri kuposa momwe iyenera. Ndipo izi, zimathandizira kukakamizidwa.

Chifukwa chake, chinthu chachikulu pakukula kwa matenda oopsa mu shuga ndi chizindikiro cha insulin. Komabe, mtsogolomo, matenda oopsa amachitika chifukwa cha kuchuluka kwa atherosulinosis ndi vuto laimpso. Kuwala kwa ziwiya pang'onopang'ono kumachepera, chifukwa chake zimadutsa ochepa magazi.

Hyperinsulinism (ndiye kuti, kuchuluka kwa insulin m'magazi) ndi yoyipa kwa impso. Amayamba kukulira komanso madzi akumwa mthupi. Ndipo kuchuluka kowonjezereka kwamadzi m'thupi kumabweretsa chitukuko cha edema ndi matenda oopsa.

Amadziwika kuti kuthamanga kwa magazi kumayenderana ndi mtundu wa circadian. Usiku umapita. M'mawa, ndi 10-20 peresenti kutsika kuposa masana. Ndi matenda a shuga, phokoso lozungulira lotere limasweka, ndipo limakhala lokwera tsiku lonse. Komanso, usiku ndizambiri kuposa masana.

Kuphwanya kotereku kumalumikizidwa ndi kukula kwa imodzi mwazovuta za matenda a shuga - matenda ashuga. Chofunikira chake ndikuti shuga yayikulu imakhudza kugwira ntchito kwa dongosolo la mantha aumwini. Zikatero, zombo zimataya mwayi wochepetsetsa ndikukula kutengera kutengera katundu.

Iwona mtundu wa matenda owonongera tsiku lililonse. Njira ngati izi zikuwonetsa pofunika kumwa mankhwala oletsa kuthana ndi matenda oopsa. Nthawi yomweyo, wodwalayo ayenera kuchepetsa kuchuluka kwa mchere.

Mankhwala olimbana ndi matenda oopsa ayenera kutengedwa kuti muchepetse magazi omwe asankhidwa kukhala a shuga / mamilimita 130. Kuchiza ndi zakudya kumapereka mfundo zabwino zamagazi: mapiritsiwo amathandizidwa ndipo amapereka chokwanira.

Chizindikiro chodziwikiratu ndi mtundu wazotsatira pochotsa matenda oopsa. Ngati mankhwalawa samachepetsa kupsinjika m'milungu yoyamba yamankhwala chifukwa cha zovuta, ndiye kuti mutha kuchepetsa pang'ono. Koma pakatha mwezi umodzi, chithandizo chowonjezereka chiyenera kuyambiranso ndipo mankhwala ayenera kumwedwa pamankhwala omwe akuwonetsa.

Kuchepetsa pang'onopang'ono kuthamanga kwa magazi kumathandizira kupewa zizindikiro za hypotension. Inde, mwa odwala omwe ali ndi matenda ashuga, matenda oopsa amatha chifukwa cha orthostatic hypotension. Izi zikutanthauza kuti posintha kwambiri kayendedwe ka thupi, kugwa kolimba pakuwerengedwa kwa tonometer kumawonedwa. Vutoli limaphatikizidwa ndi kukomoka ndi chizungulire. Mankhwala ake ndiwodziwikiratu.

Nthawi zina zimakhala zovuta kusankha mapiritsi a matenda oopsa mu shuga. Izi ndichifukwa choti kusintha kwa kagayidwe kazakudya kumasiya chizindikiro chawo pazotsatira zamankhwala onse, kuphatikizapo zama hypotensive. Posankha chithandizo ndi mankhwala kwa wodwala, dokotala amayenera kuwongoleredwa ndi mfundo zambiri zofunika. Mapiritsi osankhidwa bwino amakwaniritsa zofunikira zina.

1. Mankhwalawa amachepetsa bwino matenda omwe amakhala ndi matenda oopsa a shuga komanso amakhala ndi zovuta zina.
2. Mankhwala oterewa samayambitsa kuwongolera koyenera kwa shuga wamagazi ndipo samachulukitsa cholesterol.
3. Mapiritsi amateteza impso ndi mtima ku zotsatira zoyipa za shuga m'magazi.

Pakadali pano, madokotala amalimbikitsa odwala awo omwe ali ndi matenda ashuga kuti atenge mankhwala a magulu ngati amenewo.

Kugwiritsa, mwina, kuphatikiza mafuta ochulukitsa kwa matenda oopsa ndi matenda ashuga ndi njira yeniyeni komanso yopambana yokhala ndi thanzi. Kulandira chithandizo kotereku kumachepetsa kufunika kwa insulini ndipo nthawi yomweyo kumabwezeretsanso kuchuluka kwa mtima wamagetsi.

Kuchiza ndi zakudya zama carb ochepa kumapha mavuto angapo nthawi imodzi:

• amachepetsa insulin komanso shuga m'magazi
• Imaletsa kukula kwa zovuta zamtundu uliwonse,
• amateteza impso ku kuwopsa kwa shuga.
• amachepetsa kwambiri chitukuko cha atherosulinosis.

Chithandizo chochepa kwambiri pa carb ndi chabwino ngati impso zisanadziwike mapuloteni. Ngati ayamba kugwira ntchito mwachizolowezi, kuchuluka kwa magazi a shuga kumayambiranso kukhala kwabwinobwino. Komabe, ndi proteinuria, zakudya zotere ziyenera kugwiritsidwa ntchito mosamala.

Mutha kudya zakudya zokwanira kuchepetsa shuga. Izi ndi:

• zopangidwa ndi nyama
• mazira
• nsomba zam'nyanja
• masamba obiriwira, komanso bowa,
• tchizi ndi batala.

M'malo mwake, kuphatikiza kwa matenda oopsa ndi matenda ashuga, palibenso njira ina yazakudya zotsika mkatikati. Mankhwalawa amagwiritsidwa ntchito mosasamala mtundu wa shuga.Shuga amachepetsa kukhala wamba m'masiku ochepa. Muyenera kuyang'anira zakudya zanu nthawi zonse, kuti musayike pachiwopsezo komanso kuti musachulukitse shuga. Zakudya zama carb ochepa ndizabwino, ndizokoma komanso zathanzi.

Nthawi yomweyo, ndi chakudya ichi, zizindikiro za tonometer zimasintha. Ichi ndi chitsimikizo cha thanzi labwino komanso kusapezeka kwamavuto owopsa.

Matenda oopsa oopsa ndi matenda oopsa, koma akaphatikizidwa ndi matenda ena, chiwopsezo chokhala ndi mavuto akulu chimawonjezeka kangapo.

Izi zimakhudzana kwambiri ndi zochitika pamtima.

Chimodzi mwa izo ndi matenda ashuga: matenda oopsa amapezeka m'magawo a matenda ashuga kawiri konse monga mwa anthu omwe alibe matendawa.

Makalata ochokera kwa Owerenga

Agogo anga akhala akudwala matenda a shuga kwa nthawi yayitali (mtundu 2), koma posachedwapa mavuto atuluka pamiyendo ndi ziwalo zamkati.

Mwangozi ndidapeza nkhani pa intaneti yomwe idapulumutsa moyo wanga. Ndidalumikizidwa kumeneko kwaulere pafoni ndipo ndidayankha mafunso onse, ndikuuzidwa momwe ndingachitire ndi matenda ashuga.

Patatha milungu iwiri atatha kulandira chithandizo, agogo aja adasinthiratu momwe akumvera. Ananenanso kuti miyendo yake sikupweteka komanso zilonda zake sizinayende; sabata yamawa tidzapita ku ofesi ya dotolo. Nditaya kulumikizana ndi nkhaniyo

Kukhalapo kwa matenda osokoneza bongo kumatsutsa kumachitika kwa matenda oopsa, chifukwa amachititsa kusintha kwa m'mitsempha.

Izi zikuphatikiza:

• Kupendekera ndi kupindika kumachitika.
• Kuchulukana kwawo kwatayika. Amaperekedwa, makamaka, ndi insulin, koma siyokwanira mthupi la odwala matenda ashuga.
• Kutsekeka kwa makoma a mitsempha kumawonjezeka. Izi zimayamba chifukwa cha madonthi a shuga m'magazi.
• Atherosulinotic zolembera mawonekedwe. Amachepetsa lumen ya chotengera, zomwe zimabweretsa kuwonjezeka kwa magazi.
• Zowonongeka zamitsempha yamagazi, makamaka zing'onozing'ono. M'malo ovulala, kutupa kumayamba, ma cholesterol plaque komanso kuwundana kwamagazi kumayamba kukula.

Izi zimaphatikizapo kuwonjezeka kwa kuthamanga kwa magazi komanso kusakwanira kwa ziwalo zogwirizana ndi minofu.

Amayi amatha kukhala ndi matenda ashuga amtundu wachiwiri.

Dziwani kuti kupsinjika kowonjezereka kumawonedwa nthawi zambiri mu mtundu woyamba wa shuga, koma magulu achikulire a odwala amasintha chithunzicho: nthawi zambiri amakhala ndi matenda oopsa a shuga 2. 90% ya okalamba omwe ali ndi matenda oopsa amadwala matendawa.

Kuwonetsedwa kwa matenda oopsa mu shuga mellitus sikusiyana ndi momwe amakhalira.

Izi zikuphatikiza ndi zotsatirazi.

• mutu
• chizungulire
• kulemera kumbuyo kwa mutu
• mawonekedwe owoneka bwino, mawonekedwe a mawanga amaso patsogolo pa maso,
• khungu
• miyendo kuzirala
• kusanza, kusanza,
• mphwayi, kukhumudwa,
• kusachita bwino
• kupuma movutikira
• kuvutika pakuchita ntchito yakuthupi.

Amawoneka athunthu kapena gawo limodzi. Kusiyanitsa kokhako pakati pa matenda oopsa mu shuga ndi kusachita bwino kwa matenda oopsa ndi njira yake yovuta kwambiri.

Kuti khazikitse vutoli, ndikofunikira kuti magazi azithamanga. Kuti muchite izi, chitani zotsatirazi.

Kuzindikira kwa shuga - ingomwani tsiku lililonse.

Umu ndiye momwe zinthu zilili bwino.

Wodwala amayenera kukonzekera mwatsatanetsatane kukakamizika, komanso kugunda kwa mtima ndikuyika chidziwitso mu "Observation diary".

Chizolowezi kwa odwala matenda ashuga ndi kuthamanga kwa magazi kwa 130/80 mm Hg.

Pakadali pano, msika wazamankhwala ndi wolemera kwambiri kotero umakulolani kusankha mankhwala kwa wodwala aliyense.

Chithandizo cha mankhwala osokoneza bongo chimaphatikizapo kugwiritsa ntchito ndalama zomwe zimagulidwa ku malo ogulitsa mankhwala. Amapezeka mu mawonekedwe a mapiritsi, makapisozi, ngalande, njira zovomerezeka.

Mankhwala onse omwe alembedwa pansipa ali ndi contraindication akulu, chifukwa chake ayenera kuyikidwa kokha ndi cardiologist kapena psychapist.Ngati contraindication satiwone, chitukuko cha matenda omwe alipo ndizotheka.

Njira zochizira matenda oopsa mu shuga mellitus zimapangidwa momveka bwino ndipo zimaphatikizaponso mankhwala otsatirawa:

• Calcium calcium blockers. Mankhwalawa amakulolani kupumula ma adventitia, ndiye kuti, minofu yamatumbo. Zotsatira zake, mavuto awo amachepa ndipo kuthamanga kwa magazi kumachepa. Gululi limaphatikizapo "Klentiazem", "Amlodipine", "Anipamil" ndi mankhwala ena.
• Ma ARB zoletsa. Kuchita kwa mankhwalawa kumalepheretsa chidwi cha angiotensin receptors, omwe kupewa vasoconstriction. Gululi likuyimiriridwa ndi "Valsartan", "Candesartan", "Losartan" ndi mankhwala ena.
• ACE zoletsa. Mankhwalawa amaletsa vasoconstriction, omwe amatsogolera kuwonjezeka kwa lumen yawo ndi kutsika kwa kupanikizika. Gululi limaphatikizapo Captopril, Lisinopril, Ramipril ndi mankhwala ena.
• Beta blockers. Mankhwala amalepheretsa zolandilira zomwe zimakhudzidwa ndi adrenaline - mahomoni opsinjika ndi mavuto, chifukwa chomwe palibe kuchuluka kwa mtima, ndipo kuthamanga kwa magazi sikokwanira. Kuphatikiza apo, mankhwalawa amateteza mtima kuti usavale. Gululi likuyimiridwa ndi Anaprilin, Concor ndi fanizo lawo.
• Zodzikongoletsera. Izi ndizopikulitsa. Amakulolani kuti muchotse madzimadzi owonjezera kuchokera mthupi, omwe amakakamiza ziwalo, kuphatikizapo mitsempha yamagazi, ndikupangitsa kuchulukana. Mankhwala a gululi akuphatikizapo "Kanefron", "Indapamide retard", "Aquaphor" ndi mankhwala ena.

Mukamagwiritsa ntchito mankhwalawa, muyenera kukumbukira malamulo akuluakulu:

• Pali mankhwala othandizira mavuto obwera chifukwa omwe amangotengedwa kwakanthawi. Pali mankhwala omwe amafunikira kuti magazi azithamanga pamlingo wovomerezeka. Amatengedwa nthawi zonse.
• Zokonzekera zogwiritsa ntchito mosalekeza ziyenera kugwiritsidwa ntchito popanda zosokoneza, kuti musayang'anitse kwambiri mu kukakamiza. Zimatha kudwala matenda a mtima kapena sitiroko.
• Mankhwala omwe amagwira ntchito kwa nthawi yayitali amagwira ntchito mthupi, kudziunjikira zochuluka. Ngati pali zosokoneza pakugwiritsa ntchito, makina awa sagwira ntchito.

Kunenepa kwambiri kwa mulingo uliwonse kumathandizira kuti magazi azithamanga komanso kukula kwa matenda ashuga.

Timapereka kuchotsera kwa owerenga tsamba lathu!

Muzochepa, mutha kubwezeretsanso zovuta, kungoponya mapaundi owonjezera. Masewera okhathamira magazi kwambiri, kuchepa thupi kumathandizira kuchepetsa kukakamira pang'ono, koma izi zikuthandizani kuti musinthe njira yochepetsera chithandizo pochepetsa ululu wa mankhwalawa omwe amamwa.

Matenda a shuga ndi matenda oopsa ndi matenda omwe amatha kukhazikika mwa njira zolimbitsa thupi, ndiye kuti, osagwiritsa ntchito mankhwala kapena ndi Mlingo wocheperako.

Imodzi mwa njirazi ndi zolimbitsa thupi. Ayenera kukhala okwera mtengo, osangalatsa komanso osiyanasiyana. Wodwala yemwe ali ndi matenda ashuga komanso matenda oopsa amatha kupindulitsa pochita masewera olimbitsa thupi osakhudzana ndi kupsinjika, chifukwa angayambitse kukakamizidwa.

Ngakhale munthu akangodya chikonga chimodzi mthupi kumapangitsa vasoconstriction. Ndi kusuta kwadongosolo, izi zimachepetsa. Kukokana kumachitika m'malo ena a zombo. Izi zimadzetsa kuwonjezeka kwa zikakamizo.

Ndikosatheka kupewa zinthu zopsinja mtima. Chifukwa chake, ndikofunikira kuti muchepetse zotsatira zawo. Wodwala amathandizidwa ndi njira zopumira komanso njira zopumulira, kusankha komwe kuli kwabwino.

Monga matenda osavuta a shuga, wodwalayo ayenera kudya pafupipafupi, pang'ono ndi pang'ono, komanso molondola. Sizoletsedwa kugwiritsa ntchito maswiti, makeke ndi zina zamafuta othamanga.

Zakudya zomanga thupi kwa nthawi yayitali zimaloledwa: chimanga, kupatula semolina, buledi wonenepa, masamba, zipatso, kuphatikiza nthochi ndi mphesa, nyemba, nandolo zobiriwira.

Mukamagwiritsa ntchito izi, muyenera kuyang'anira momwe zinthu ziliri.Ndi chitsenderezo chowonjezereka, muyenera kuwasiya kwakanthawi kuti muwone momwe thupi liliri.

Zogulitsa zina zitha kugwiritsidwa ntchito popanda zoletsa. Nyama ndi nyama yopendekera, mkaka, bowa, zipatso, mazira sizithandiza kungokulitsa shuga wamagazi, komanso kuthamanga kwa magazi.

Kuyenera kudziwika kuti matenda oopsa amawonjezera zofuna zake pakudya:

• Ndikofunikira kuchepetsa kugwiritsa ntchito mchere, chifukwa zimathandizira kuwonjezeka kwa kuthamanga kwa magazi. Zinthu zambiri - zachilengedwe kapena zopangidwa mwaluso - zimakhala ndi mchere. Zomwezo zimapita ndi shuga. Zakudya zotsekemera komanso zopatsa thanzi, komanso zakudya zosavuta, makeke, zakudya zotsekemera, siziyenera kuphatikizidwa ndi zakudya.
• Ndikofunikira kumwa malita 1.5 amadzi oyera tsiku lililonse. Iyenera kukumbukiridwa kufunika kwa madzi tsiku ndi tsiku kwa anthu: ndi 30 ml / kg.
• Kumwa khofi ndi tiyi ziyenera kuchepetsedwa.
• Kuletsedwa kwa mowa kumakhazikitsidwa. 70 ml ya vinyo wofiira amaloledwa kamodzi pa sabata.

Mavuto obwera chifukwa cha matenda oopsa ndiwowonjezereka kapena pang'onopang'ono kuwonjezeka kwa kukakamizidwa kuzinthu zofunika.

Malamulo a kuyimitsa pamaso pa matenda a shuga samasiyana ndi malamulo othandizira wodwala yemwe alibe matenda. Kusiyana kokhako ndikuti muyenera kuyeza glucose wamagazi anu ndikuwasunga bwino.

Kunyumba, muyenera kuchita zotsatirazi.

• Ikani mapilo pansi pa mutu wa wodwalayo kuti mupewe kuthamangitsidwa, komwe kumatha kuchitika ndi vuto lalikulu la matenda oopsa.
• Mupatseni mankhwala othandizira komanso osokoneza bongo omwe munthu amakonda kugwiritsa ntchito. Kuti muchite mwachangu, mutha kuziyika pansi pa lilime. Zitangochitika izi, ndikofunikira kuthana ndi kupanikizika: ziyenera kuchepa, koma bwino. Pambuyo pa theka la ora, zizindikirozo ziyenera kugwa ndi 30 mm Hg, ndipo patatha ola limodzi - ndi 50 mm Hg.

Ndi zoletsedwa kuti muchepetse kuthamanga kwa magazi. Izi zimatha kudwala matenda a mtima kapena sitiroko.

Pakukhazikika kotereku, mutha kusiya wodwalayo kunyumba, kumamupatsa mtendere, mankhwala othandizira komanso mpweya wabwino.

Nthawi zina, muyenera kuyimbira foni ambulansi.

Kupezeka kwa matenda ashuga amtundu wa 2 komanso matenda oopsa amakhala makamaka ndi moyo wopanda thanzi komanso zakudya zoperewera. Ichi ndichifukwa chake kupewa kwawo ndikukonzanso makamaka kumakhala koteteza madera awa.

Ndizosangalatsa kuti mayiko onsewa amatha kukhazikika mwa njira zomwe chilengedwe chimaganizira kwa munthu: zolimbitsa thupi, kupuma bwino, kudya mokwanira, kuthana ndi zovuta komanso kukhala ndi malingaliro abwino. Mwamwayi, imapezeka kwa aliyense.

M'magawo apambuyo a matenda a shuga ndi matenda oopsa, njira izi, zachidziwikire, zimayenera kuthandizidwa ndi chithandizo chamankhwala.

Matenda a shuga nthawi zonse amayambitsa zovuta zakupha. Mwazi wamagazi ochulukirapo ndi woopsa kwambiri.

Lyudmila Antonova adafotokoza za chithandizo cha matenda ashuga. Werengani kwathunthu

1. 
   Njira zothandizira kuphunzira mtima ndi mtima. Buku lothandizira. - M.: Mankhwala, 2015 .-- 416 p.
2. 
   Njira zabwino kwambiri ndi njira zochizira matenda oopsa. - M: Book World, 2013 .-- 256 p.
3. 
   Moiseev, V. S. Matenda a mtima: monograph. / V.S. Moiseev, S.V. Moiseev, Zh.D. Kobalava. - M: Medical News Agency, 2016. - 534 c.
4. Geraskina L.F., Mashin V.V., Fonyakin A.V. Hypertensive Encephalopathy, Kukonzanso Mtima ndi Kulephera Kwa Mtima Kwambiri, Moscow: Party Publishing House - Moscow, 2012. - 962 p.

Ndiloleni ndidziwitse - Ivan. Ndakhala ndikugwira ntchito ngati dotolo wabanja kwazaka zopitilira 8. Ndikudziganizira kuti ndine katswiri, ndikufuna kuphunzitsa alendo onse omwe amabwera pamalowa kuti athetse mavuto osiyanasiyana. Zambiri za tsambali zasonkhanitsidwa ndikufufuzidwa mosamala kuti zidziwitso zonse zofunikira zitheke.Musanagwiritse ntchito zomwe zikufotokozedwa pa webusaitiyi, kufunsana ndi akatswiri ndizofunikira nthawi zonse.

Ndi mapiritsi ati oti musankhe pochiza matenda oopsa mu shuga?

M'zaka zaposachedwa, madokotala ochulukirachulukira akukhulupirira kuti ndibwino kupereka mankhwala osapatsa mmodzi, koma mwachangu 2-3 mankhwala ochizira kuthamanga kwa magazi. Chifukwa odwala nthawi zambiri amakhala ndi njira zingapo zopangira matenda oopsa nthawi imodzi, ndipo mankhwala amodzi sangakhudze zomwe zimayambitsa. Mapiritsi opsinjika amagawidwa m'magulu chifukwa amachita mosiyanasiyana.

Mankhwala amodzi amachepetsa kukakamizidwa kwa odwala osaposa 50%, ngakhale matenda oyamba atakhala ochepa. Nthawi yomweyo, kuphatikiza chithandizo kumakupatsani mwayi wogwiritsa ntchito Mlingo wochepetsetsa wa mankhwala, komabe mumapeza zotsatira zabwino. Kuphatikiza apo, mapiritsi ena amafooketsa kapena kuthetseratu mavuto omwe amadzetsa mzake.

Hypertension siikhala yoopsa palokha, koma zovuta zomwe zimayambitsa. Mndandanda wawo ukuphatikizapo: kugunda kwa mtima, sitiroko, kulephera kwa impso, khungu. Ngati kuthamanga kwa magazi kuphatikizidwa ndi matenda ashuga, ndiye kuti chiwopsezo cha zovuta zimachuluka kangapo. Dokotala amawunika kuopsa kwa wodwala wina kenako asankhe ngati angayambe mankhwalawa piritsi limodzi kapena kugwiritsa ntchito mankhwala mosakaniza nthawi yomweyo.

Kufotokozera kwa manambala: HELL - kuthamanga kwa magazi.

Russian Association of Endocrinologists ikuvomereza njira yotsatirayi yochizira matenda oopsa a shuga. Choyamba, angiotensin receptor blocker kapena ACE inhibitor imayikidwa. Chifukwa mankhwala ochokera m'maguluwa amateteza impso ndi mtima bwino kuposa mankhwala ena.

Ngati monotherapy yokhala ndi ACE inhibitor kapena angiotensin receptor blocker sichithandiza kutsika magazi mokwanira, tikulimbikitsidwa kuwonjezera diuretic. Zomwe diuretic kusankha zimadalira pakusungika kwa impso ntchito kwa wodwala. Ngati pali kulephera kwa impso kosatha, thiazide diuretics ikhoza kugwiritsidwa ntchito. Mankhwala a Indapamide (Arifon) amadziwika kuti ndi amodzi a otetezeka kwambiri othandizira matenda oopsa. Ngati kulephera kwa impso kwayamba kale, okodzetsa m'chiuno ndi mankhwala.

Kufotokozera kwa manambala:

• HELL - kuthamanga kwa magazi
• GFR - kuchuluka kwa impso kumaso, kuti mumve zambiri onani "Kodi ndiyeso ziti zomwe zimayenera kuchitika kuti muwone impso zanu",
• CRF - kulephera kwa impso,
• BKK-DHP - calcium blocker dihydropyridine,
• BKK-NDGP - blockcide-non-dihydropyridine calcium blocker,
• BB - beta blocker,
• ACE inhibitor ACE inhibitor
• ARA ndi angiotensin receptor antagonist (angiotensin-II receptor blocker).

Ndikofunika kuperekera mankhwala omwe ali ndi 2-3 zomwe zimagwira piritsi limodzi. Chifukwa ochepa mapiritsiwo, amalolera kumawamwetsa kwambiri.

Mndandanda wachidule wamankhwala ophatikiza matenda oopsa:

• Korenitec = enalapril (renitec) + hydrochlorothiazide,
• foside = fosinopril (monopril) + hydrochlorothiazide,
• co-diroton = lisinopril (diroton) + hydrochlorothiazide,
• lehar = losartan (cozaar) + hydrochlorothiazide,
• noliprel = perindopril (prestarium) + thiazide-ngati diuretic indapamide retard.

ACE inhibitors komanso calcium blockers blockers amakhulupirira kuti zimathandizira kuthekera kwa wina ndi mnzake kuteteza mtima ndi impso. Chifukwa chake, mankhwala ophatikiza otsatirawa nthawi zambiri amaperekedwa:

• tarka = trandolapril (hopten) + verapamil,
• prestanz = perindopril + amlodipine,
• equator = lisinopril + amlodipine,
• khulusa = valsartan + amlodipine.

Tikuchenjezani odwala: musadzipangire nokha mankhwala oopsa. Mutha kukhudzidwa kwambiri ndi mavuto, ngakhale imfa. Pezani dokotala woyenera ndipo muthane naye. Chaka chilichonse, adotolo amawona odwala mazana ambiri omwe ali ndi matenda oopsa, chifukwa chake adziwa zambiri, momwe mankhwalawa amagwirira ntchito komanso omwe ndi othandiza kwambiri.

Matenda oopsa komanso matenda ashuga: mawu omaliza

Tikukhulupirira kuti mupeza nkhaniyi kukhala yothandiza pa matenda oopsa pa matenda ashuga. Kuthamanga kwa magazi kwa odwala matenda ashuga ndi vuto lalikulu kwa madokotala ndi kwa iwonso odwala. Zinthu zomwe zaperekedwa pano ndizothandiza kwambiri. M'nkhani “Zomwe Zimayambitsa Matendawa ndi Momwe Mungawathetsere. Kuyesedwa kwa matenda oopsa ”mutha kuphunzira mwatsatanetsatane mayesero omwe muyenera kuchita kuti mupeze chithandizo choyenera.

Mukatha kuwerenga zida zathu, odwala azitha kumvetsetsa bwino matenda oopsa mu mtundu 1 ndikulembapo matenda ashuga 2 kuti athe kutsatira njira yothandizirana ndikuwonjezera moyo wawo komanso kuvomerezeka mwalamulo. Zambiri zokhudzana ndi mapiritsi opanikizika zakonzedwa bwino ndipo zimakhala ngati "pepala chinyengo" kwa madokotala.

Tikufuna kutsimikizanso kuti kudya zakudya zamagulu ochepa ndi chida chothandiza kuti muchepetse shuga m'magazi a shuga, komanso kuchepetsa matenda a kuthamanga kwa magazi. Ndikofunika kutsatira zakudya izi kwa odwala omwe ali ndi matenda a shuga osati a 2 okha, komanso a 1st pokhapokha ngati ali ndi vuto lalikulu la impso.

Tsatirani pulogalamu yathu ya matenda a shuga a 2 kapena mtundu wa matenda ashuga 1. Ngati mungolekere zakudya zopatsa mphamvu m'zakudya zanu, zimakulitsa mwayi kuti muthanso kukhala ndi magazi abwinobwino. Chifukwa insulini yocheperako imazungulira m'magazi, ndizosavuta kuzichita.