Mapiritsi opanikizika a matenda a shuga a 2: Mankhwala othandizira matenda oopsa okhala ndi zotsatira zowonjezera

Funso lomwe mapiritsi opsinjika a shuga a mtundu wachiwiri angatengedwe ndi odwala ndilofunika kwambiri. Izi ndichifukwa choti matendawa nthawi zambiri amakhudza anthu azaka zapakati komanso akulu omwe kale akuvutika ndi matenda oopsa. Kuphatikiza apo, kuchuluka kwa glucose komanso insulin m'magazi enieniwo kumayambitsa ma metabolism omwe amawonjezera kuthamanga kwa magazi.

Mtundu 2 wa matenda a shuga a mellitus (osakhudzana ndi matenda a shuga a insulin, NIDDM) ndi matenda osachiritsika omwe amayamba chifukwa cha kuchepa kwa insulin, i.e. kuchepa kwa insulin sensitivity ya receptors yomwe ili mu minofu yodalira insulin. Nthawi zambiri matenda a shuga amakula mwa anthu opitilira zaka 40. Nthawi zambiri amapezeka mwa azimayi.

Ndizosavomerezeka kumwa mankhwala opatsirana pogwiritsira ntchito upangiri wacibale kapena wodziwika nawo, popeza kudzipereka nokha kumayenderana ndi chiopsezo chachikulu chovulaza thanzi.

Zomwe mungamwe kuti muchepetse kuthamanga kwa magazi ku matenda a shuga osagwirizana ndi insulin

Kwenikweni, odwala omwe ali ndi matenda oopsa oopsa omwe ali ndi matenda osokoneza bongo, mankhwala atsopano othandizira antihypertgency amagwiritsidwa ntchito omwe ali oyenererana ndi vutoli. Mndandandandawo ndi wokulirapo, sizikupanga nzeru kulemba mayina onse, popeza alipo ambiri, ndipo ndizovuta kwambiri kuti munthu yemwe sanakonzekere kuwayendayenda, ndipo adotolo opezekapo ayenera kusankha mankhwala oyenera. Chifukwa chake, timadziika pazowunikira zazifupi zamagulu akuluakulu a mankhwala omwe amachepetsa kuthamanga kwa magazi.

Alfa-adrenoblockers (Doxazosin, Terazosin, Prazosin). Mankhwalawa amaperekedwa makamaka kwa amuna ngati ali ndi kuphatikiza kwa NIDDM, matenda oopsa a ubongo komanso kukulitsa kwa chithokomiro cha prostate.
ACE inhibitors (Diroton, Monopril, Perindopril, Captopril). Mphamvu ya mankhwalawa kwa odwala omwe ali ndi matenda a shuga komanso matenda oopsa kwambiri. Amangokhala ndi kutchulidwa kwakukulu, komanso kuwonjezera chiwopsezo cha maselo ndikuchita insulin. Nthawi zina, makamaka okalamba, kuikidwa kwa ma inhibitors a ACE kungayambitse kukula kwa hypoglycemia, komwe kumafunikira kukonzedwa kwakanthawi kwa mankhwala ochepetsa shuga. Kuphatikiza apo, ACE inhibitors ali ndi phindu pa metabolism yamafuta, yofunikanso pochiza NIDDM.
Angiotensin-II receptor blockers (Atakand, Naviten, Kardosal). Mankhwala a gululi amawonetsedwa ngati wodwalayo ali ndi matenda a shuga, kuthamanga kwa magazi komanso vuto la impso. Kafukufuku wachipatala awonetsa kuti angiotensin-II receptor blockers amachedwetsa kupititsa patsogolo kwa diabetesic nephropathy pa siteji ya microalbuminuria ndi kulephera kwa aimpso.
Beta-blockers (Atenolol, Pindolol, Carvedilol). Mayesero ambiri osasankhidwa adawonetsa kuti kutenga beta-blockers kwambiri kumachepetsa chiopsezo chokhala ndi matenda amtima, kuphatikizapo matenda a mtima (CHD) ndikuchepetsa kukula kwawo. Komabe, kugwiritsa ntchito mankhwalawa kwa odwala omwe ali ndi mtundu II matenda a shuga kuyenera kuchitika mosamala kwambiri, chifukwa amatha kubisa zizindikiro za hypoglycemia. Beta-blockers imatha kubweretsa kukula kwa bronchospasm, kotero kugwiritsa ntchito kwawo kosalepheretsa matenda a m'mapapo (COPD) kumatsutsana.
Mankhwala othandizira pakati (clonidine, methyldopa). Amamulembera odwala matenda a shuga omwe amakhala ndi matenda oopsa osagwirizana ndi mankhwala ena a antihypertensive. Kugwiritsa ntchito kwawo kumafuna kusamala, chifukwa zimawonjezera chiopsezo cha orthostatic hypotension komanso ngakhale kugwa.
Omwe akutsutsana ndi calcium (calcium Channel blockers). Izi zikuphatikizapo Nifedipine, Verapamil, Amlodipine. Mankhwala a antihypertgency a gululi samakhudza kwambiri kagayidwe kazakudya zam'mimba komanso lipids mu shuga. Makamaka nthawi zambiri amaperekedwa kwa odwala okalamba komanso anthu omwe akudwala matenda a mtima.
Diuretics, kapena diuretics (Spironolactone, Triamteren, Furosemide, Hydrochlorothiazide). Kuchepetsa kuchuluka kwa sodium mu seramu yamagazi ndikuchotsa kutupa. Odwala odwala matenda ashuga nephropathy kapena aimpso kulephera, thiazide diuretics (hydrochlorothiazide) ndi othandiza kwambiri.
Renin Inhibitor (Rasilez). Mothandizidwa amachepetsa kuthamanga kwa magazi. Itha kugwiritsidwa ntchito onse mu mawonekedwe a monotherapy, komanso ngati gawo la zovuta antihypertensive mankhwala. Pakadali pano, palibe chidziwitso pakulekerera ndi kuwongolera kwa mankhwalawa kuti agwiritsidwe ntchito kwakanthawi kwa odwala omwe ali ndi matenda a shuga a 2, chifukwa chake, akapatsidwa gulu ili la odwala, adotolo amayenera kudziyimira pawokha pang'onopang'ono kuchuluka kwa chiopsezo chowerengeredwa komanso kupindula.

Gulu lirilonse la mankhwala a antihypertensive lili ndi zisonyezo zake komanso zotsutsana. Chifukwa chake, sizinganenedwe kuti ena mwa iwo ndi abwino kwambiri pa matenda ashuga, pomwe ena amachita moipa kwambiri - zonse zimatengera mkhalidwe womwewo.

Chizindikiro cha kuphatikiza kwa NIDDM ndi matenda oopsa - orthostatic hypotension - kutsika kwadzidzidzi komanso kowopsa kwa zovuta posintha kwa munthu kuchoka pamphumi kupita pamzere.

Funso la momwe mungachepere kupanikizika, odwala matenda a shuga ayenera kufunsa dokotala. Ndizosavomerezeka kumwa mankhwala opatsirana pogwiritsira ntchito upangiri wacibale kapena wodziwika nawo, popeza kudzipereka nokha kumayenderana ndi chiopsezo chachikulu chovulaza thanzi.

Matenda oopsa a arterial komanso matenda osokoneza bongo omwe amadalira shuga

Malinga ndi olemba osiyanasiyana, mu 15-50% ya odwala, mitundu yachiwiri ya matenda ashuga amaphatikizidwa ndi matenda oopsa.

Poyeserera kuchuluka kwa glucose m'magazi, kapamba amayamba kupanga insulini yambiri, yomwe imapangitsa kuchuluka kwake m'magazi (hyperinsulinemia). Kenako, izi zimabweretsa zotsatirazi:

kuphatikizanso mu impso tubules a sodium ion,
Hypertrophy ya yosalala minyewa yamitsempha yamagazi,
kuchuluka kwa zochita.

Kuphatikiza apo, matenda a shuga a 2 amaphatikizidwa ndi kuchulukitsa kwa lipogenis (mapangidwe a minofu ya adipose) ndi kunenepa kwambiri kwapang'onopang'ono.

Malangizo onse omwe ali pamwambawa ndi maziko a pathogenesis yoyambira komanso kukula kwa matenda oopsa kwambiri kwa odwala omwe ali ndi matenda osokoneza bongo omwe amadalira insulin.

Malinga ndi ziwerengero zamankhwala, kuphatikiza kwa kuthamanga kwa magazi ndi matenda a shuga a 2 kumawonjezera chiopsezo cha wodwala kulowetsedwa kwam'mimba maulendo 3-5, kumenyedwa nthawi 3-4, matenda ashuga a shuga komanso matenda opatsirana aimpso nthawi 20-25. - nthawi 20.

Chifukwa chake, ndikofunikira kwambiri kuti nthawi zonse mumamwa mankhwala omwe dokotala amakupatsani matenda oopsa a shuga. Izi zimakuthandizani kuti muchepetse chiopsezo cha zovuta, kusintha kwa moyo wabwino komanso chiyembekezo cha moyo.

Ngati shuga yosadalira insulin ikuphatikizidwa ndi matenda oopsa mwa odwala, kuyang'anira kuyeserera kwa magazi tsiku lililonse kumalimbikitsidwa.

Zomwe zimachitika mu ochepa matenda oopsa

Kwa odwala matenda ashuga, pali malamulo ena otenga mankhwalawa chifukwa cha kuthamanga kwa magazi, poganizira zovuta zomwe zimasintha tsiku lililonse pamlingo wake. Nthawi zambiri kugona pakati pa usiku ndi m'mawa kwambiri, kuthamanga kwa magazi ndi 15-20% kutsika kuposa nthawi yakukonzekera masana. Mwa anthu omwe ali ndi matenda ashuga, kupanikizika kumacheperachepera usiku kapena kumakhalabe pamlingo wokwera wofanana ndi masana. Izi zikufotokozedwa ndikupanga matenda a shuga. Kuchuluka kwa shuga m'magazi kumayambitsa kusokonezeka mu zochitika zamanjenje, ndipo kumayendetsa mamvekedwe amitsempha yamagazi kwambiri. Chifukwa chake, ngati shuga yosadalira insulin ikuphatikizidwa ndi matenda oopsa mwa odwala, kuwunika tsiku ndi tsiku kwamankhwala amalimbikitsidwa. Mosiyana ndi magawo amodzi, kuwunikira koteroko kumathandizira kuwunika koyenera kwa wodwalayo ndikusintha koyenera kwa mlingo wa mankhwalawa kwa matenda oopsa a shuga 2 komanso dongosolo la kayendetsedwe kawo. Kuyankha bwino kuchokera kwa akatswiri ndi odwala kumatsimikizira kulondola kwa njira imeneyi.

Chinanso chomwe chimaphatikizidwa ndi NIDDM ndi matenda oopsa - kuchepa kwamwadzidzidzi komanso kowopsa kwambiri pakusintha kwa munthu kuchokera patali kupita patali. Makamaka, izi zimawonetsedwa ndi zizindikiro zotsatirazi:

kufooka koopsa
chizungulire
tachycardia
kukomoka.

Kupezeka kwa orthostatic hypotension imayambanso chifukwa cha matenda ashuga a m'mimba komanso kulephera kwamitsempha yamagetsi kuyendetsa bwino kamvekedwe ka mtima. Izi ndizofunikanso kuganiziranso popereka mankhwala kwa wodwala kuti achepetse kuthamanga kwa magazi mu matenda a shuga a 2.

Timapereka makanema kuti muwone kanema pamutu wankhaniyi.

ACE zoletsa

Kodi ndingamwe mankhwala ati omwe ndimamwa ndi shuga kuti ndichepetse magazi? Kukonzekera kwa gulu la ACE inhibitor block block enzymes komwe kumapanga mahomoni angiotensin, omwe amathandiza kutsika mitsempha ya magazi komanso kumapangitsa kuti adrenal cortex apange mahomoni omwe amakopa sodium ndi madzi mthupi la munthu. Pa mankhwalawa antihypertensive mankhwala a ACE inhibitor kalasi yothamangitsa mtundu wachiwiri wa matenda a shuga, vasodilation imachitika, kudzikundikira kwa sodium ndi madzimadzi owonjezera amasiya, chifukwa chake kuthamanga kwa magazi kumachepa.

Mndandanda wamapiritsi azovuta kwambiri omwe mungamwe ndi shuga yachiwiri:

Mankhwalawa amalembedwa kwa odwala omwe ali ndi matenda oopsa chifukwa amateteza impso ndikuchepetsa kukula kwa nephropathy. Mlingo wochepa wa mankhwala amagwiritsidwa ntchito popewa njira yothandizira ziwalo za kwamikodzo.

Zowonjezera zochizira kutenga ACE zoletsa zimawonekera pang'onopang'ono. Koma mapiritsi oterewa sioyenera aliyense, mwa odwala ena amakhala ndi zotsatira zoyipa kutsokomola, ndipo chithandizo sichithandiza odwala ena. Zikatero, mankhwala a magulu ena amaperekedwa.

Angiotensin II receptor blockers (ARBs) kapena ma sartans amalepheretsa kusintha kwa mahomoni mu impso, zomwe zimapangitsa kuchuluka kwa magazi. Ma ARB sakukhudzana ndi kagayidwe kachakudya, kamapangitsa chidwi cha minofu yathupi kuti insulin.

Ma Sartan ali ndi vuto labwino ndi matenda oopsa ngati mpweya wamanzere wakakulitsidwa, zomwe zimakonda kupezeka motsutsana ndi maziko azopanikizika mtima komanso kulephera kwa mtima. Mankhwala oponderezedwa ndi gululi amavomerezedwa bwino ndi odwala omwe ali ndi matenda amtundu wa 2. Mutha kugwiritsa ntchito ndalamazo ngati monotherapy kapenanso chithandizo chamankhwala othandizira okodzetsa.

Mndandanda wa mankhwala (sartans) olembetsa matenda oopsa kuti muchepetse kuthamanga komwe kungachitike ndi matenda a shuga a 2:

Chithandizo cha ARB chimakhala ndi zovuta zochepa kuposa ACE zoletsa. Kuchuluka kwa mankhwala kumawonedwa pakatha masabata awiri chiyambireni chithandizo. Ma Sartan atsimikiziridwa kuti ateteza impsozo mwakuchepetsa kutulutsa kwa mapuloteni mumkodzo.

Mankhwala osokoneza bongo

Ma diuretics amalimbikitsa zochitika za ACE zoletsa, motero, amapatsidwa mankhwala osokoneza bongo. Liazide-ngati diuretics imakhala yofatsa mu mtundu wachiwiri wa matenda a shuga, amachepetsa mphamvu ya potaziyamu, kuchuluka kwa shuga ndi lipids m'magazi, ndipo osasokoneza kugwira ntchito kwa impso. Gululi limaphatikizapo Indapamide ndi Arefon Retard. Mankhwala ali ndi nephroprotective kwambiri pa gawo lililonse la ziwalo.

Indapamide imalimbikitsa vasodilation, imathandizira kupanga mapulatini osakanikirana, chifukwa chotenga mankhwalawa a matenda a shuga a 2, kuchuluka kwa magazi ndi kuchepa kwa magazi. Mu mankhwalawa achire, indapamide imangoyambitsa hypotensive zotsatira popanda kuwonjezera mkodzo. Malo ofunikira kwambiri ku Indapamide ndi mtima ndi minofu yaimpso.

Kuchiza ndi Indapamide sikukhudza kagayidwe kachakudya mthupi, chifukwa chake sikukweza kuchuluka kwa glucose, lipoproteins wotsika kwambiri m'magazi. Indapamide imatenga mwachangu mawonekedwe awo am'mimba, koma izi sizimachepetsa kugwira ntchito kwake, kudya pang'ono kumachepetsa kuyamwa.

Kugwira ntchito kwa nthawi yayitali kumatha kuchepetsa kuchuluka kwa mankhwalawa. Chithandizo chamankhwala chimatheka pomaliza sabata yoyamba kumwa mapiritsi. Ndikofunikira kumwa kapisozi imodzi patsiku.

Ndi magome ati okodzetsa omwe ndingamwe kumwa kuthamanga kwa magazi kwa matenda ashuga?

Mapiritsi a diuretic amalembedwa kuthamanga kwa magazi (matenda oopsa) mu mtundu 2 wa shuga. Dokotala wopezekapo amayenera kusankha mankhwalawa, makamaka kuopsa kwa matendawa, kupezeka kwa kuwonongeka kwa minyewa, komanso kuponderezana.

Furosemide ndi Lasix amalembedwa kuti atupire kwambiri kuphatikiza ndi ACE inhibitors. Komanso, odwala omwe ali ndi vuto la aimpso, kugwira ntchito kwa chiwalo chokhudzidwayo kumakhala bwino. Mankhwala amatsukidwa kuchokera potaziyamu wa thupi, motero muyenera kuphatikiza mankhwala okhala ndi potaziyamu (Asparkam).

Veroshpiron samatulutsa potaziyamu m'thupi la wodwalayo, koma amaletsedwa kuti agwiritse ntchito kulephera kwa aimpso. Ndi matenda a shuga, chithandizo chamankhwala ngati amenewo chimaperekedwa mankhwala osamveka.

Calcium calcium blockers

LBC imalepheretsa njira zamkati pamtima, mitsempha yamagazi, kuchepetsa ntchito zawo za kulera. Zotsatira zake, pali kukulitsa kwa mitsempha, kutsika kwa kuthamanga ndi matenda oopsa.

Mndandanda wa mankhwala a LBC omwe angatengedwe ndi matenda a shuga:

Ma calcium calcium blockers satenga nawo mbali mu kagayidwe kachakudya, amakhala ndi zotsutsana ndi kuchuluka kwa glucose, kuthamanga kwa mtima, ndipo alibe katundu wa nephroprotective. Ma LBC amakulitsa ziwiya zaubongo, izi ndizothandiza popewa kuthana ndi okalamba. Kukonzekera kumakhala ndi kusiyana pamlingo wachitidwe ndi chiwopsezo pantchito ya ziwalo zina, chifukwa chake, amapatsidwa aliyense payekhapayekha.

Mankhwala Oletsedwa

Ndi mapiritsi ati a antihypertgency omwe ali ovuta kwa odwala matenda ashuga? Zoletsa, zowononga okodzetsa a shuga zimaphatikizapo Hypothiazide (a thiazide diuretic). Mapiritsiwa amatha kuwonjezera shuga wamagazi ndi kuchuluka kwa cholesterol. Pamaso pa kulephera kwa impso, wodwala amatha kuwonongeka pakugwira ntchito kwa chiwalo. Odwala omwe ali ndi matenda oopsa amathiridwa okodzetsa a magulu ena.

Mankhwala Atenolol (β1-adenoblocker) a mtundu 1 ndi matenda amitundu iwiri amayambitsa kuwonjezeka kapena kuchepa kwa matenda a glycemia.

Mochenjera, amalembera kuwonongeka kwa impso, mtima. Ndi nephropathy, Atenolol ingayambitse kuchepa kwambiri kwa magazi.

Mankhwalawa amasokoneza kagayidwe kachakudya kagayidwe kachakudya, kamakhala ndi zotsatirapo zingapo zoyipa kuchokera ku mantha, m'mimba, mtima. Poyerekeza ndi kumbuyo kwa kutenga Atenolol mu mtundu 2 wa matenda a shuga, kuthamanga kwambiri kwa magazi kumawonedwa. Izi zimadzetsa kuwonongeka kwakukuru muumoyo wabwino. Kumwa mankhwalawa kumapangitsa kuti vutoli lizindikire kuchuluka kwa shuga m'magazi. Odwala omwe amadalira insulin, Atenolol amatha kuyambitsa hypoglycemia chifukwa cha kuwonongeka kwa glucose kwa chiwindi, ndikupanga insulin.Zimakhala zovuta kwa dokotala kuti azindikire molondola, chifukwa zizindikiritso zake sizimatchulidwa.

Kuphatikiza apo, Atenolol imachepetsa chidwi cha minyewa ya thupi kupita ku insulin, yomwe imayambitsa kuwonongeka kwa odwala omwe ali ndi matenda a shuga a 2, kusayerekezeka pamlingo wa cholesterol yoyipa komanso yopindulitsa, ndikuthandizira ku hyperglycemia. Kulandila kwa Atenolol sikungayime mwadzidzidzi; ndikofunikira kufunsa dokotala za momwe adasinthira ndikusamutsira njira zina. Kafukufuku wa sayansi akuwonetsa kuti kugwiritsa ntchito nthawi yayitali kwa Atenolol odwala omwe ali ndi matenda oopsa pang'onopang'ono kumayambitsa kukula kwa mtundu wa 2 matenda a shuga, chifukwa chidwi cha minofu kupita ku insulin chimachepa.

Njira ina ya Atenolol ndi Nebile, β-blocker yemwe samakhudza metabolism ndipo amakhala ndi tanthauzo la vasodilating.

Mapiritsi a matenda oopsa mu shuga mellitus ayenera kusankhidwa ndi kuikidwa ndi dokotala kuganizira za munthu wodwala, kupezeka kwa ma contraindication, kuopsa kwa matenda. Sitikulimbikitsidwa kugwiritsa ntchito β-blockers (Atenolol), malupu okodzetsa, chifukwa mankhwalawa amakhudza kayendedwe ka metabolic, amathandizira kuchuluka kwa glycemia ndi cholephera kuperewera kwa cholesterol. Mndandanda wamankhwala othandizira amaphatikizapo sartans, thiazide-like diuretics (Indapamide), ACE inhibitors.

Chifukwa chiyani kuthamanga kwa magazi kumabuka ndi matenda ashuga?

Mitundu yosiyanasiyana ya "matenda okoma" ili ndi njira zosiyanasiyana zopangira matenda oopsa. Mtundu wodalira insulini umaphatikizidwa ndi kuchuluka kwa kuthamanga kwa magazi motsutsana ndi zotupa za impso. Mtundu wosadalira insulini umawonetsedwa makamaka ndi matenda oopsa, ngakhale zisanafike zizindikiro zazikulu za matenda akulu, popeza kuthamangitsidwa kwakukulu ndi gawo limodzi la zomwe zimadziwika kuti metabolic syndrome.

Matenda osiyanasiyana a matenda oopsa opezeka kumbuyo kwa mtundu wachiwiri wa matenda ashuga:

mawonekedwe oyamba - amapezeka wodwala aliyense,
mawonekedwe apadera a systolic - amakula mwa odwala okalamba, amadziwika ndi kuchuluka wamba komanso kuchuluka kwapamwamba (40% ya odwala),
matenda oopsa aimpso - 13-18% yamilandu yamankhwala,
kuthamanga kwa magazi mu adrenal gland pathology (chotupa, Itsenko-Cushing's syndrome) - 2%.

Mtundu wa shuga wosadalira insulini umadziwika ndi kukana insulini, ndiye kuti, kapamba amatulutsa kuchuluka kokwanira ka insulini (chinthu chogwira ntchito m'madzi), koma maselo ndi minyewa yomwe imadziwika ndi thupi lake. Njira zopangira zamagetsi zimapangidwira kuphatikiza mahomoni aphatikizidwe, omwe mwa iwowo amawonjezera kukakamiza.

Izi zimachitika motere:

pali kukhazikitsidwa kwa dipatimenti yomvera chisoni National Assembly,
kuchuluka kwa madzi amchere ndi mchere kudzera m'magazi aimpso kumayipa,
Mchere wamchere ndi michere ya calcium
hyperinsulinism kumakwiyitsa zimachitika zovuta za elasticity mitsempha.

Ndi kukula kwa matenda oyamba, zotumphukira ndi ziwalo zamatumbo zimavutika. Mapilogalamu amayikidwa mkati mwake, zomwe zimayambitsa kuchepetsedwa kwa minyewa yam'mimba komanso kukula kwa atherosclerosis. Ichi ndi cholumikizira china pamakina oyambira matenda oopsa.

Kuphatikiza apo, thupi la wodwalayo limakulirakulira, makamaka zikafika pamafuta omwe amayikidwa kuzungulira ziwalo zamkati. Lipids zoterezi zimatulutsa zinthu zingapo zomwe zimapangitsa kuti magazi azitha.

Kodi ndi anthu angati omwe amafunikira kuchepetsa kukakamizidwa?

Anthu odwala matenda ashuga - odwala omwe ali pachiwopsezo chotenga ma pathologies ochokera mu minofu ya mtima ndi mitsempha yamagazi. Ngati odwala alabadira bwino mankhwalawa, m'masiku 30 oyambirira a mankhwala, ndikofunikira kuchepetsa kuthamanga kwa magazi mpaka 140/90 mm RT. Art. Chotsatira, muyenera kuyesetsa kuwerengetsa masentimita a 130 mm Hg. Art. ndi diastolic - 80 mm RT. Art.

Ngati wodwala amavutika kulolera mankhwala, mankhwalawa amayenera kuyimitsidwa pang'onopang'ono, kutsitsa ndi 10% kuchokera pamasiku oyambira m'masiku 30. Ndi kusinthasintha, regimen ya mlingo amawunikiranso, ndizotheka kuwonjezera kuchuluka kwa mankhwalawa.

Kugwiritsa ntchito mankhwala osokoneza bongo

Kusankhidwa kwa mankhwala ochiritsira kumachitika ndi katswiri woyenera yemwe akufotokozera mfundo izi:

mulingo wa glycemia wodwala,
Zizindikiro zamagazi
Mankhwala omwe amagwiritsidwa ntchito kuti apeze chipukuta matenda omwe amayambira,
kukhalapo kwa zovuta za impso, owerengera,
matenda ophatikizika.

Mankhwala othandiza kupanikizika mu matenda ashuga ayenera kuchepetsa ziwonetsero kuti thupi la wodwalayo liyankhe popanda kukulitsa zovuta ndi zovuta. Kuphatikiza apo, mankhwalawa amayenera kuphatikizidwa ndi othandizira a hypoglycemic, osakhala ndi vuto lililonse pamatenda a lipid metabolism. Mankhwala ayenera "kuteteza" aimpso zida ndi minofu ya mtima ku mavuto obwera chifukwa cha matenda oopsa.

Mankhwala amakono amagwiritsa ntchito magulu angapo a mankhwala:

okodzetsa
ARB-II,
ACE zoletsa
BKK,
β-blockers.

Mankhwala owonjezera amatengedwa ngati α-blockers ndi Rasilez.

Β-blockers

Oimira gulu agawidwa m'magulu angapo. Ngati wodwala adalandira chithandizo cha β-blocker, amatha nthawi yayitali kuti amvetsetse gulu lawo. β-blockers ndi mankhwala omwe amakhudza β-adrenergic receptors. Zotsirizirazi ndi za mitundu iwiri:

β1 - ili mu minofu ya mtima, impso,
β2 - yotchulidwa mu bronchi, pa hepatocytes.

Oimira osankhidwa a β-blockers amachita mwachindunji pa β1-adrenergic receptors, osati osankha pamagulu onse a receptors a cell. Magulu onse awiriwa ndi othandizanso polimbana ndi kuthamanga kwa magazi, koma mankhwala osankhidwa amadziwika ndi zotsatira zoyipa kuchokera m'thupi la wodwalayo. Amalimbikitsidwa odwala matenda ashuga.

Mankhwala a gulu amagwiritsidwa ntchito motere:

Matenda a mtima wa Ischemic,
kusowa kwa myocardial
pachimake pambuyo kugunda kwa mtima.

Ndi insulin-yodziyimira yokhayokha ya matenda a shuga, mitundu yotsatirayi yogwiritsidwa ntchito ngati mankhwala kukakamiza:

Kuopsa kwa matenda ashuga a 2

Gulu la azachipatala limasiyanitsa mitundu iwiri yokha ya matenda ashuga. Mtundu woyamba umakhala wodalira insulin. Izi zimachitika chifukwa chakutha kwathunthu kwa kapamba, komwe kamapangidwa kuti apange insulin. 10% yokha mwa odwala onse omwe ali ndi vutoli.

Pafupifupi 70% ya anthu padziko lonse lapansi ali ndi matenda a shuga 2. Matendawa amakhudza osati akulu okha, komanso ana. Kusiyana kwakukulu pakati pa matenda ashuga amtundu wa 2 ndikuti m'magawo oyamba matenda, kuchuluka kwa shuga m'magazi ndikwabwinobwino. Izi ndichifukwa choti insulin ikupitilizidwa kupanga. Pankhani imeneyi, matendawa ndi ovuta kuzindikira. Kupanikizika kwa matenda a shuga a 2 nthawi zambiri kumakwezedwa.

BKK (olimbana ndi calcium)

Mankhwala a gulu agawidwa m'magulu akulu awiri:

non-dihydropyridine BCC (Verapamil, Diltiazem),
dihydropyridine BCC (Amlodipine, Nifedipine).

Gulu lachiwiri limakulitsa lumen ya ziwiya popanda chilichonse pa ntchito ya minofu ya mtima. Gulu loyamba, m'malo mwake, limakhudza mgwirizano wa myocardium.

Gulu lopanda dihydropyridine limagwiritsidwa ntchito ngati njira yowonjezera yolimbana ndi matenda oopsa. Oyimira amachepetsa kuchuluka kwa mapuloteni ochulukitsa ndi albumin mu mkodzo, koma osakhala ndi chitetezo pamatumbo a impso. Komanso, mankhwalawa samakhudza kagayidwe ka shuga ndi lipids.

Gulu la dihydropyridine limaphatikizidwa ndi β-blockers ndi ACE inhibitors, koma silinafotokozedwe pamaso pa matenda amitsempha yama mtima mwa odwala matenda ashuga. Makulidwe othandizira a calcium omwe amagwiritsa ntchito magulu onse awiriwa amagwiritsidwa ntchito moyenera kuthana ndi systolic matenda oopsa mwa odwala okalamba. Mwanjira iyi, chiopsezo chokhala ndi stroko chimachepetsedwa kangapo.

Zotsatira zoyipa za mankhwalawa:

chizungulire
Kutupa kwa m'munsi,
cephalgia
kumva kutentha
kugunda kwa mtima
gingival hyperplasia (motsutsana ndi maziko azithandizo zamanthawi yayitali ndi Nifedipine, popeza amatengedwa pang'ono).

Kodi mtundu uwu ndi uti?

Magawo oyamba a matendawa amakhala ndi insulin yambiri yomwe imapangidwa, yomwe pambuyo pake imayambitsa zovuta za kapamba. Zotsatira zake ndizosayenera kagayidwe, kuwonetsedwa kwa kawopsedwe wa glucose ndi lipid kawopsedwe.

Zotsatira zake, kufalikira kwamtundu wa insulin kumayamba. Zikondamoyo, kuti muthandize kugaya chakudya ndi mapiritsi a metabolidi, zimayamba kuphatikiza insulini kwambiri. Zotsatira zake, bwalo loipa limapangidwa.

ARB-II (angiotensin receptor antagonists)

Wodwala aliyense wachisanu yemwe amathandizidwa ndi matenda oopsa a ACE amakhala ndi chifuwa monga mbali yake. Pankhaniyi, dokotala amasamutsa wodwalayo kuti alandire olimbana ndi angiotensin receptor antagonists. Gulu la mankhwalawa pafupifupi limagwirizana kwathunthu ndi mankhwala a ACE inhibitor. Ili ndi contraindication ofanana ndi mawonekedwe ogwiritsa ntchito.

Mankhwala ndi osokoneza inhibitor wa renin, ali ndi ntchito yotchulidwa. Chithandizo chogwira chimalepheretsa kusintha kwa angiotensin-I kukhala angiotensin-II. Kutsika kwamphamvu kwa kuthamanga kwa magazi kumatheka chifukwa chothandizidwa nthawi yayitali ndi mankhwalawa.

Mankhwalawa amagwiritsidwa ntchito kuphatikiza mankhwala, komanso mawonekedwe a monotherapy. Palibe chifukwa chosinthira kuchuluka kwa mankhwalawa kwa okalamba. Mphamvu ya antihypertensive komanso kuthamanga kwa nthawi yake sizimadalira kuti ndi wodwala kapena wamtundu wanji, kulemera kwake komanso zaka zake.

Rasilez sinafotokozeredwe nthawi yakubala ndi amayi omwe akukonzekera kubereka mwana posachedwa. Mimba ikachitika, mankhwalawa amayenera kusiyidwa nthawi yomweyo.

Zotsatira zoyipa:

kutsegula m'mimba
zotupa pakhungu,
kuchepa magazi
kuchuluka kwa potaziyamu m'magazi,
chifuwa chowuma.

Potengera maziko a kuchuluka kwa mankhwala, kutsika kwa magazi kumatheka, komwe kuyenera kubwezeretsedwanso ndi mankhwala akukonzanso.

Otsatsa-blockers

Pali mitundu itatu yayikulu yamagulu yomwe imagwiritsidwa ntchito pochiza matenda oopsa. Awa ndi Prazosin, Terazosin, Doxazosin. Mosiyana ndi mankhwala ena a antihypertensive, oimira ma cy-blockers amakhudza cholesterol yamagazi, osakhudza glycemia, kuchepetsa kuchuluka kwa magazi popanda kuchuluka kwakukulu kwa mtima.

Kuchiza ndi gulu la mankhwalawa kumayendera limodzi ndi kuchepa kwamphamvu kwa kuthamanga kwa magazi motsutsana ndi maziko a kusintha kwa thupi m'malo. Ngakhale kutayika kwa chikumbumtima. Nthawi zambiri, zotsatira zoyipa zoterezi zimadziwika kuti munthu woyamba kumwa mankhwalawo. A pathological mkhalidwe amapezeka mwa odwala omwe anakana kuphatikiza mchere m'zakudya ndikuphatikiza muyezo woyamba wa alpha-blockers ndi mankhwala a diuretic.

Kupewa matendawa kumaphatikizapo malingaliro otsatirawa:

akukana kutenga okodzetsa masiku angapo tsiku loyamba la kumwa,
Mlingo woyamba ukhale wocheperako,
Mankhwala oyambilira amathandizidwa asanagone usiku, wodwalayo atagona kale.

Kodi mungasankhe bwanji mapiritsi a vuto linalake lachipatala?

Akatswiri amakono amalimbikitsa kugwiritsa ntchito mankhwala angapo a magulu osiyanasiyana nthawi imodzi. Kufanana pamaulalo osiyanasiyana a kayendedwe ka matenda oopsa kumapangitsa kuti mankhwalawa azigwira bwino ntchito.

Kuphatikiza mankhwala kumakupatsani mwayi wogwiritsa ntchito mitundu yaying'ono ya mankhwala, ndipo mankhwala ambiri amaletsa mavuto. Malangizo a mankhwalawa amasankhidwa ndi adotolo poyerekeza ndi vuto la matenda a shuga (matenda a mtima, sitiroko, kulephera kwa impso, matenda amawonedwe).

Pokhala pachiwopsezo chochepa, monotherapy yotsika mtengo imavomerezeka. Ngati ndizosatheka kukwaniritsa kuthamanga kwa magazi, katswiriyo amapanga mankhwala ena, ndipo ngati sangathe, kuphatikiza kwa mankhwala angapo a magulu osiyanasiyana.

Chiwopsezo chachikulu cha kuwonongeka kwa mtima ndi mitsempha yamagazi chimafuna chithandizo choyambirira chophatikiza ndi mitundu iwiri ya mankhwala osachepera. Ngati chithandizo cha mankhwala sichilola kukwaniritsa zotsatira zabwino, dokotala atha kukuwuzani kuti muwonjezere mankhwala ena atatu muyezo wochepa kapena mupeze mankhwala omwewo, koma pa mlingo wokwanira. Pokhapokha kukwaniritsa kuchuluka kwa kutsata kwa magazi, njira yochiritsira yamankhwala atatu imayikidwa muyezo waukulu kwambiri.

Algorithm posankha mankhwala opatsirana oopsa pazotsatira za "matenda okoma" (m'magawo):

Kuchulukitsa kwakukulu kwa kuthamanga kwa magazi ndikusankhidwa kwa ACE inhibitor kapena ARB-II.
Kuthamanga kwa magazi ndiwokwera kuposa masiku onse, koma mapuloteni samapezeka mkodzo - kuwonjezera kwa BKK, okodzetsa.
Kuthamanga kwa magazi ndiwokwera kuposa masiku onse, mapuloteni ochepa amawonekera mumkodzo - kuwonjezera kwa BKK, thiazides.
CHIWONSE chachikulu pazophatikizira ndi kulephera kwa aimpso - kuphatikiza kwa gawo lotupa la diuretic, BKK.

Kumbukirani kuti katswiri amapaka mitundu yonse ya mankhwala pokhapokha atachitanso maphunziro onse othandizira odwala ndi othandizira. Mankhwala odzipatula sawachotsa, chifukwa zotsatira zakumwa mankhwala zimatha kubweretsa zotsatirapo zoopsa komanso ngakhale kufa. Zochitika za katswiri zidzakuthandizani kusankha njira yabwino kwambiri yoperekera chithandizo popanda kuwononga thanzi la wodwalayo.

Zomwe shuga imayambitsa matenda oopsa

Ndi mitundu yonse ya matenda, zomwe zimayambitsa matenda oopsa amatha kusintha. Mtundu 1 - mu 80% ya milandu, matenda oopsa amayamba chifukwa cha kuwonongeka kwa impso (diabetesic nephropathy). Mtundu wachiwiri wa matenda ashuga, matenda oopsa nthawi zambiri amakula mwa wodwala koyambirira kuyerekeza ndi kuperewera kwa thupi kagayidwe kazakudya ndi matenda a shuga omwe. Chimodzi mwazinthu za metabolic syndrome (harbinger wa mtundu 2 shuga) ndi matenda oopsa kapena kuthamanga kwa magazi.

Matenda a shuga 1 amtundu - zomwe zimayambitsa matenda oopsa ndizolemba (pafupipafupi): matenda ashuga nephropathy (aimpso), matenda oyamba (ofunika), matenda oopsa a systolic, ndi matenda ena a endocrine.

Matenda a 2 a matenda ashuga - chachikulu (chofunikira) matenda oopsa, matenda oopsa, matenda ashuga, matenda oopsa chifukwa cha kufooka m'matumbo a impso, ndi matenda ena a endocrine.

Zolemba. Systolic patokha matenda oopsa ndi njira yeniyeni okalamba. Matenda ena a endocrine atha kuphatikizira matenda a Itsenko-Cushing's, pheochromocytoma, hyperaldosteronism, kapena matenda ena osowa. Chofunikira kwambiri pa matenda oopsa ndi gawo lomwe dokotala sangadziwe chifukwa chake kuthamanga kwa magazi. Ndi kuphatikiza kwa matenda oopsa ndi kunenepa kwambiri, zomwe zimayambitsa chidwi chachikulu zimapangitsa kuti wodwalayo azidwala zakudya zamafuta, komanso insulin yambiri m'magazi. Amatchedwa "metabolic syndrome", omwe amathandizidwa bwino.Kuphatikiza apo, pakhoza kukhala kupsinjika kwamalingaliro kwachilengedwe, kuperewera kwa magnesium m'thupi, kuledzera ndi cadmium, lead kapena zebus, kufupika kwa mtsempha waukulu chifukwa cha atherosulinosis.

Mtundu 1 wa shuga wambiri

Choyambitsa chachikulu komanso chowopsa cha kuthamanga kwa magazi mu mtundu 1 wa shuga ndikuphwanya impso, zomwe zimaphatikizapo matenda ashuga. Vutoli limachitika mu 35-40% ya odwala matenda a shuga ndipo ali ndi magawo angapo: ma microalbuminuria (mamolekyu ang'onoang'ono a mapuloteni monga albumin amawonekera mkodzo), proteinuria (kusefa kwa impso kukukulira, maproteni akuluakulu amawonekera mkodzo, komanso kulephera kwa impso.

Mwa odwala omwe ali ndi matenda amtundu woyamba 1 opanda matenda a impso, khumi mwa anthu 100 alionse amadwala. Odwala omwe ali ndi microalbuminuria, mtengo wake umakwera mpaka makumi awiri, ndi proteinuria - mpaka 50-70%, ndi kulephera kwa impso - mpaka 70-100%. Kuthamanga kwa magazi kumadaliranso kuchuluka kwa mapuloteni omwe amapezeka mumkodzo: makamaka, ndizowonjezera zomwe wodwala amapeza.

Ndi kuwonongeka kwa impso, matenda oopsa amatha chifukwa cha impso lotupa la msuzi ndi mkodzo. Amakhala sodium m'magazi, amadzimadzi amadziunjikira. Mwazi wambiri womwe umazungulira umapangitsa kuthamanga kwa magazi. Ngati kuchuluka kwa shuga m'magazi kukwera chifukwa cha matenda ashuga, kumakoka madzi ochulukirapo kotero kuti magazi asachulukane kwambiri. Kuchuluka kwa magazi ozungulira, motero, kumachulukanso.

Nthenda ya impso komanso matenda oopsa. Thupi limayesetsa kulipirira chida chokwanira cha impso, ndipo kuthamanga kwa magazi kumakwera. Ndipo, imawonjezera kukakamira kwa intracubic. Zomwe zimatchedwa kusefa zinthu mu impso. Zotsatira zake, pang'ono ndi pang'ono matendawa amafa, impso zimangokulirakulira. Izi zimatha ndi kulephera kwa impso. Komabe, koyambirira kwa matenda ashuga nephropathy, mutha kuthyola bwalo loopsalo ngati wodwala amathandizidwa munthawi yake. Ndikofunikira kudziwa mapiritsi azovuta a shuga.

Chofunikira ndikubweretsa zomwe zili mumkhwalazo. Mankhwala a diuretic, angiotensin receptor blockers, ndi ACE inhibitors amathandizanso.

Type 2 matenda oopsa a shuga

Kale kwambiri isanayambike matenda ashuga enieni, ndiye kuti, a mtundu wachiwiri, njira ya pathological imachokera ku insulin kukana, zomwe zikutanthauza kuti kuchepa kwa chidwi cha minofu kuzovuta za insulin. Kuti athe kulipirira kukana insulini, kuchuluka kwakukulu kwa insulin kumazungulira m'magazi, chifukwa chake kuthamanga kwa magazi kumakwera. Popita nthawi, lumen ya ziwiya imachepa chifukwa cha atherosulinosis, yomwe imakhala gawo linanso lofunikira pakuwoneka kuti matenda oopsa. Nthawi yomweyo, wodwalayo amawonjezera kunenepa kwam'mimba (pafupi ndi chiuno). Zinapezeka kuti minofu ya adipose imatulutsa zinthu m'magazi zomwe zimapangitsanso magazi. Mapiritsi opanikizika a matenda a shuga a 2 ayenera kusankhidwa ndi dokotala.

Vutoli limatchedwa metabolic syndrome. Chifukwa chake, matenda oopsa amapezeka kale kwambiri kuposa mtundu wachiwiri wa matenda ashuga. Nthawi zambiri zimapezeka wodwalayo atazindikira chizindikirocho. Komabe, kudya zakudya zamagulu ochepa kumathandizira kuwongolera matenda komanso matenda oopsa. Miyezi yambiri ya insulin m'magazi imatchedwa hyperinsulinism. Amakhala ngati anachita insulin kukana.

Mankhwala opanikizika a matenda a shuga a 2 ndi okwera mtengo.

Zikondazo zikakakamizidwa kuti zipange insulin yambiri, zimatha. Popita nthawi, samathanso kupirira, ndipo pali kuchuluka kwa shuga m'magazi, wodwalayo amakula shuga yachiwiri. Kodi kuthamanga kwa magazi kumakwera bwanji chifukwa cha hyperinsulinism? Poyamba, imayendetsa dongosolo lamanjenje lamumvera chisoni, chifukwa impso, madzi ndi sodium zimakhudzidwa kwambiri ndi mkodzo, calcium ndi sodium zimadziunjikira m'maselo, kuchuluka kwa insulin kumakulitsa makoma amitsempha, ndikukula kwawo kumachepa chifukwa chake. Mankhwala othandizira odwala matenda ashuga ayenera kukhala okwanira.

Chowonekera cha chiwonetsero chachikulu cha matenda ashuga

Mitundu yachilengedwe ya kusinthasintha kwa kupanikizika masana imasokonezeka mu shuga. Mwa munthu, kuthamanga kwa magazi kuchokera ku 10 mpaka 20% kumachepetsa m'mawa ndi usiku m'maloto kuyerekeza ndi mfundo zamasiku onse. Matenda a shuga amachititsa kuti usiku kupanikizika kwa odwala ambiri oopsa sikuchepe. Kuphatikiza apo, shuga ndi matenda oopsa akaphatikizidwa, kupanikizika usiku kumadzuka poyerekeza ndi nthawi yamasana. Amaganiziranso kuti vuto ili limawoneka chifukwa cha matenda ashuga a m'mimba.

Mwazi wamagazi ambiri umaphwanya dongosolo laumwini lazamachitidwe, lomwe limayang'anira ntchito yofunika ya thupi. Chifukwa chaichi, kuthekera kwa mitsempha yamagazi kuwongolera kamvekedwe kao kumayamba kuzimiririka, ndiko kuti, kumasuka ndikuchepera kutengera katundu. Chifukwa chake, ndimayendedwe a shuga omwewo nthawi yomweyo komanso matenda oopsa, sikuti kungoyesedwa amodzi nthawi imodzi zokha, komanso kuwunika tsiku ndi tsiku. Imachitika pogwiritsa ntchito chipangizo chapadera. Zotsatira za phunziroli ndikusintha kwa kuchuluka kwa mapiritsi omwe amachepetsa kuthamanga kwa magazi mu matenda a shuga ndi nthawi yoyang'anira.

Pochita izi, zikuwoneka kuti mwa odwala a mtundu woyamba ndi wachiwiri, Hypersensitivity mchere nthawi zambiri amawonedwa poyerekeza ndi odwala matenda oopsa omwe alibe shuga, zomwe zikutanthauza kuti mphamvu yamankhwala ingaperekedwe chifukwa chakuletsedwa kwa mchere muzakudya zawo. Kuti muthane ndi kuthamanga kwa magazi m'magazi a shuga, muyenera kuyesa kudya mchere wochepa ndikuwunika zotsatira pamwezi. Zonsezi ndizovuta ndi hypotension ya orthostatic mtundu. Izi zikutanthauza kuti magazi a wodwala amatsika kwambiri akasintha maudindo.

Hypotension ya Orthostatic imachitika munthu atayimirira kwambiri, mawonekedwe amdima m'maso, chizungulire, kapena kukomoka. Vutoli, ngati chilema mumayendedwe azungu, limawonekera chifukwa cha matenda a shuga. Mphamvu yamanjenje yaumunthu pang'onopang'ono imayamba kutaya mphamvu ya kutulutsa kamvekedwe ka mtima. Wodwala akamadzuka mwachangu, ndiye kuti kuwonjezeka kwadzidzidzi kumachitika. Komabe, thupi lilibe nthawi yowonjezera magazi, ndipo thanzi limayamba kuchepa chifukwa cha izi. Orthostatic mtundu hypotension imasokoneza kuzindikira ndi kuchiritsa kwa kuthamanga kwa magazi. Mu matenda ashuga, kupanikizika kuyenera kuyesedwa m'malo awiri - onse kunama ndi kuyimirira. Wodwala akakhala ndi vuto lotere, amafunika kudzuka “kumva bwino” nthawi zonse, pang'onopang'ono. Pankhaniyi, mapiritsi opsinjika a shuga angathandizenso.

Kufotokozera za antihypertensive mankhwala

Mankhwala ayenera kukwaniritsa izi:

Ndi bwino kuchepetsa kukakamiza. Pankhaniyi, zovuta zimachitika pang'ono.
Kukhazikitsa chitetezo cha impso ndi mtima pazotsatira zoyipa zamagazi.
Siziyenera kukhudza metabolidi ya lipid ndi carbohydrate.

Kodi mungasankhe bwanji mapiritsi a kuthamanga kwa magazi kwa odwala matenda ashuga?

Mankhwala Ochiritsa

Pali mitundu ingapo ya mankhwala omwe amachepetsa kuthamanga kwa magazi ndipo amagwiritsidwa ntchito bwino pochiza matenda oopsa: calcium blockers, ACE inhibitors, diuretics, beta-blockers, vasodilators, alpha-blockers, angiotensin receptor antagonists.

Dziwani kuti katswiriyo amathandizira wodwala aliyense payekha. Kuphatikiza mankhwala molakwika kungaphe. Mwatsatanetsatane simungathe kudzilimbitsa.

Kugwiritsa ntchito zoletsa za ACE

Mapiritsi opanikizika ogwira ntchito a shuga ndi GB ndi angiotensin-otembenuza ma enzyme blockers. Kuchulukitsa kwa zamankhwala kumapangidwa kuti muchepetse zowunikira, kuthetsa kukula kwa mtima, komanso kuchepetsa mavuto mu minofu ya mtima.

Kuvomerezedwa kumaphwanya zotsatirazi:

matenda a m'mapapo kapena mphumu,
mukakhazikitsa mbiri yakale ya kulephera kwa impso, muyenera kumwa mankhwalawa mosamala, komanso kuwunika kuthinana, kuyang'anira kuchuluka kwa calcium ndi creatinine m'magazi,
yoyamwitsa ndi pakati.

Gululi la mankhwalawa limayambitsa kukula kwa ochepa impso, chifukwa chake ndikofunikira kuwapereka mosamala kwa odwala omwe ali ndi mbiri ya atherosulinosis.

Ndikofunikira kudziwa kuti mukamagwiritsa ntchito zoletsa za ACE, ndikofunika kuti muchepetse mchere. Mlingo masana - osaposa magalamu atatu.

Mapiritsi othandizira magazi a shuga ndi awa: Berlipril, Enalapril, Captopril. Mapiritsi omalizira omaliza ndi ambulansi pangozi zadzidzidzi pomwe mavuto akukulira.

Othandizira a calcium

Ma calcium blockers amakhala ndi nthawi yayitali, amatha kuthana ndi matenda oopsa, koma pali zotsutsana zingapo. Amagawidwa m'mitundu yotere: non-dihydropyridines ndi dihydropyridines.

Matenda ofunikira kwambiri ndikusintha kwa calcium metabolism chifukwa cha kuchepa kwa magnesium. Kupanga kwake kwa mankhwalawo cholinga chake ndikuchepetsa kulowa kwa calcium ndi makoma amitsempha m'matumbo a mtima, motero kupewa kupezeka kwa ma spasms. Magazi amayenda bwino kupita ku ziwalo zofunika.

Contraindication a mankhwalawa ndi motere: kukula kwa vuto la mtima, kupezeka kwa angina pectoris m'mbiri ya zamankhwala, stroko yovuta kwambiri, hyperkalemia.

Mankhwala otsatirawa adatchulidwa: Diltiazem, Verapamil, Felodipine, Nifedipine. Odwala omwe ali ndi matenda ashuga a nephropathy amawerengera Verapamil, omwe amateteza impso ku zotsatira zoyipa za shuga wambiri. Ndikofunikira kumwa m'malo ovuta, limodzi ndi ACE zoletsa.

Kodi ndi mapiritsi ena otani a shuga omwe angathandize?

Othandizira ofunikira - okodzetsa

Kuwonjezeka kwa kuchuluka kwa sodium, komanso kuchuluka kwa madzi m'thupi, kumayambitsa kuchuluka kwa magazi, ndipo izi zimakhala chinthu chofunikira chomwe chimakwiyitsa magazi. Odwala omwe ali ndi shuga ochulukirapo amasamala mchere, ndichifukwa chake zinthu zimakula kwambiri. Ma diuretics amakhala chida chabwino polimbana ndi vutoli.

Gawoli lotsatirali la okodzetsa lipezeka:

thiazide - ali ndi zotsatira zoyipa monga cholesterol ndi shuga, chopinga cha aimpso,
osmotic - kumatha kupweteka kwa hyperosmolar coma,
potaziyamu - osagwiritsidwa ntchito pakulephera kwa impso,
loopback - ndi kugwiritsidwa ntchito mosasamala kwa mapiritsi oterowo, mtima arrhythmia ndi hypokalemia zitha kuchitika,
carbonic anhydrase inhibitors - mawonekedwe osayipirawo ndi gawo locheperako, chifukwa chomwe zotsatira zoyenera sizingalandiridwe.

Mwa onse okodzetsa, chifukwa cha zovuta, amalangizidwa kuti azitha kugwiritsa ntchito mankhwalawa omwe amachepetsa kuthamanga kwa magazi mu shuga. Zochita zawo zimayang'ana pakukweza ntchito ya impso. Anapatsidwa ntchito kuti athetse edema, yophatikizidwa bwino kwambiri ndi ACE inhibitors. Popeza mfundo yotsutsa ndikuchotsa kwa potaziyamu m'thupi, ndikofunikira, pamodzi ndi kugwiritsa ntchito, kubwezeretsanso zomwe zidalipo kudzera pazowonjezera zina.

Mankhwala abwino kwambiri a gulu lanyumba ndi awa: "Bufenox", "Torasemide", "Furosemide".

Kuchiza ndi okodzetsa okha sikuthandiza;

Palinso mapiritsi ena ogwira mtima a kuthamanga kwa magazi kwa odwala matenda ashuga.

Kugwiritsa ntchito kwa beta blockers

Mu ischemic komanso matenda oopsa a mtima komanso arrhythmias, beta-blockers ndi mankhwala ofunikira, omwe amasiyanitsa mankhwalawa m'magulu atatu:

Zosasankha komanso zosankha - zimakhudza maselo a pancreatic, kuchepetsa kuchepa kwa insulin. Zotsatira zabwino pamitima ya mtima, kukulitsa chiwopsezo cha matenda ashuga a 2.
Hydrophilic ndi lipophilic - sizingagwiritsidwe ntchito monga matenda ashuga, chifukwa zimapangitsa matenda a chiwindi kusokoneza metabolidi ya lipid.
Zombo zodyeka - zimakhala ndi phindu pa metabolidi ya lipid-carbohydrate, koma zimakhala ndi zovuta zake.

Mankhwala otetezeka a matenda oopsa oopsa amaperekedwa kwa mtundu wachiwiri wa matenda ashuga: Corvitol, Bisoprolol, Nebivolol.

Kupanga kwamankhwala kumapangidwira kuti chiwonjezere chiwopsezo cha minofu, komanso kupita patsogolo kwa kagayidwe kazinthu.

Ndikofunikira kudziwa kuti beta-blockers amabisa mawonetsero a kuchepa kwa potaziyamu, ndichifukwa chake amaikidwa motsogozedwa ndi katswiri.

Zomwe ndimankhwala opanikizika mu matenda a shuga ndizovuta kuthana paokha.

Kusankha Alamu Oteteza

Ubwino wa mankhwalawa wagona kuti athandizidwe kuti achepetse zotupa za mitsempha ndi ulusi wawo. Amasiyanitsidwa ndi kuphatikiza komwe: ndi antispasmodic, vasodilating ndi antihypertgency othandizira. Kuphatikiza apo, chiwopsezo cha insulin chimakhudzidwa, kuchuluka kwa shuga kumachepetsa, ndipo izi ndizofunikira kwa odwala matenda ashuga a 2.

Ubwino wa mankhwalawa pokakamizidwa m'matenda a shuga ndi mwayi wotsatira:

kutupa
orthostatic hypotension - imatha kudwala wodwala matenda a shuga,
mawonekedwe a tachycardia wolimbikira.

Ndikofunikira kwambiri kudziwa kuti kugwiritsa ntchito alpha-blockers pakulephera kwa mtima nkoletsedwa.

Mankhwala otsatirawa amagwiritsidwa ntchito pochiza kwa nthawi yayitali: Terazosin, Doxazosin ndi Prazosin.

Angiotensin receptor antagonists monga cholowa m'malo a ACE zoletsa

Awa ndimankhwala ochepetsa kuthamanga kwa magazi mu shuga omwe ali ndi zovuta zochepa komanso phindu lothandiza m'thupi. Chotsani hypertrophy ya kumanzere kwamitsempha yamtima, kupewa kulowetsedwa kwam'mnyewa, kulephera kwa impso ndi kuchepetsa mwayi wokhala ndi stroke.

Ndalama zabwino kwambiri kuchokera pagululi: "Losartan", "Telmisartan", "Candesartan".

Pa mankhwala, muyenera kuwongolera kuthamanga kwa magazi ndi zomwe zili potaziyamu ndi creatinine m'magazi.

Pali mankhwala ochepa a shuga pamsika wamankhwala. Komabe, kudzipereka nokha sikofunikira kupewa mavuto oyipa. Kudziwa kokha oyenera komanso chithandizo chomwe chimasankhidwa payekha ndi chomwe chingathandize kukwaniritsa zomwe mukufuna.

Zowonjezera kuthamanga kwa magazi mu matenda a shuga

Chizindikiro chofunikira kwambiri cha matenda oopsa ndicho kuthamanga kwambiri, ndipo kuti chichepetse, munthu amakakamizidwa kumwa mankhwala oyenera nthawi zonse. Matenda oopsa odwala matenda ashuga kangapo kumawonjezera chiopsezo cha zovuta zazikulu, motere:

Matenda a mtima - katatu.
Stroke - kanayi.
Kuwonongeka kwamaso - maulendo 10-20.
Matenda a impso - 20-25.
Mimba ya miyendo - maulendo 20.

Chizindikiro chachikulu kwambiri cha matenda osagwiritsa ntchito insulin-amadalira (mtundu 1) kapena matenda a insulin-amadalira (mtundu 2) sayenera kupitirira kuthamanga kwa magazi a 130/85. Ngati ndiwokwezeka, ayenera kuchitapo kanthu mwachangu kuti muchepetse.

Matenda oopsa mu shuga angachiritsidwe ngati matenda a impso ndi ofatsa, koma ndi gawo lapamwamba, mwayi wochira ndi zero. Mtundu wachiwiri wa matenda ashuga, matenda oopsa amatha kale kwambiri kuposa zovuta zamtundu wa insulin.

Matenda a shuga amakhalanso ndi phokoso lokhazikika kwa magazi ake, pomwe nthawi yamadzulo ndi m'mawa, kuthamanga kwa magazi kumakhala kutsika 10-20% kuposa masana. Popita nthawi, matenda ashuga amayamba kuyambitsa kuthinana kwambiri ngakhale usiku, ndipo nthawi zina mtengo wake usiku ndiwokwera kwambiri kuposa nthawi yamasana.

Njira yamatendawa imafotokozedwa ndi kupezeka kwa matenda ashuga a m'mimba. Kuchuluka kwa shuga kumasokoneza magwiridwe olondola a dongosolo lamanjenje lamkati, lomwe limayang'anira ntchito ya thupi lonse. Zotsatira zake, pali kuchepa kwa mphamvu ya mitsempha yakuwongolera kamvekedwe ka ake. Ndi kuphatikiza kwa matenda oopsa ndi matenda ashuga, kuyang'anira kuthamanga kwa magazi tsiku lililonse ndikofunikira, komwe kumakupatsani kuwerengetsa kuchuluka kwa kuchuluka kwa mankhwala ndi pafupipafupi.

Cardiologists amalimbikitsa kuti odwala matenda oopsa omwe ali ndi matenda ashuga azitsitsa kuthamanga kwa magazi awo kufika ku 140/90 pasanathe mwezi, malinga ndi kulekerera kwakanthawi kamankhwala omwe mukupatsa, ndiye kuti muyenera kusintha kukakamizidwa kuti mukhale 130/80. Ngati kulowererapo kwa anti-hypertgency sikuloledwa bwino, kuthamanga kwa magazi kumachepetsedwa pang'onopang'ono m'magawo angapo.

Mankhwala ovomerezeka a kuthamanga kwa magazi mu shuga

Kodi ndi mankhwala ati omwe amapereka kwa matenda oopsa ngati munthu wadwala matenda ashuga? Pakadali pano, malo ogulitsa mankhwalawa amapereka magulu asanu ndi atatu a mankhwala osokoneza bongo, omwe asanu ndiofunikira, atatu ndi ofanana. Tikuyenera kudziwa kuti mankhwala owonjezera a shuga m'mankhwala amtundu wa shuga amaperekedwa pokhapokha limodzi ndi chithandizo chamankhwala.

Mankhwala, mitundu ya mitundu iwiriyi ndi mankhwala:

Ndalama zoikidwa. Cholinga chawo chachikulu ndikuletsa msanga kudumphira m'magazi, kuti asadye tsiku lililonse. Amawonetsedwa pokhapokha ngati pakufunika kuchitapo kanthu kuti athe kugwiranso ntchito magazi ndikuchepetsa kwambiri kuthamanga kwa magazi.
Mankhwala othandizira ma systemic amatengedwa nthawi yayitali, ndipo amawerengedwa kuti ateteze chipatala chotsatira kuti magazi azithamanga.

Mankhwala othandizira kwambiri othandizira odwala matenda ashuga:

ACE zoletsa.
Zodzikongoletsera.
Angiotensin-2 receptor blockers.
Beta blockers.
Calcium calcium blockers.
Alfa oletsa.
Imidazoline Receptor Stimulants
Renin blockers.

Mankhwala a insulin, kokha mankhwala amagwiritsidwa ntchito pokhazikitsa kupsinjika, komwe kumatha:

Bwino kuchepetsa kuthamanga kwa magazi.
Osakhumudwitsa ena.
Musachulukitse shuga.
Osachulukitsa kale mafuta m'thupi.
Osachulukitsa triglycerides.
Osasokoneza minofu ya mtima.
Tetezani impso ndi mtima molimba ku zotsatira za matenda oopsa komanso matenda ashuga.

Angiotensin-2 receptor blockers

Zodziwika muzochitika izi pamene zoletsa za ACE zimayambitsa zovuta. Mankhwalawa sangathe kuletsa kupangika kwa angiotensin-awiri, koma kumawonjezera chitetezo chokwanira cha mtima ndi magazi m'magazi a magazi.

Amathandizira kutsitsa kuthamanga kwa magazi komanso kukhala ndi zotsatira zabwino pa impso, amachepetsa hypertrophy yamanzere, kupewa kuyambika kwa matenda ashuga, komanso kuphatikiza bwino ndi mankhwala a diuretic.

Beta blockers

Amathandizira kuti athetse vuto la kuchuluka kwa zolandilira zamkati mwa mtima ndi adrenaline ndi zinthu zina zofanana ndi izo. Zotsatira zake, katundu pamtima amachepa, magawo ena a minyewa yam'magazi amatulutsa.

Amakhala ndi mawonekedwe ochepa otsika, osakweza kuchuluka kwa shuga, osatulutsa kunenepa kwambiri.

Alfa oletsa

Masiku ano, mankhwala a gululi akupezeka m'mitundu iwiri:

Kutha kupondereza ma adrenaline-receptors receptors. Poletsa zizindikiro zowonetsera matenda oopsa, mankhwala amalangiza osankha-alpha-blockers, chifukwa chogwira ntchito bwino.

Amachepetsa zonenepa ndi mafuta bwino, pomwe kuchuluka kwa kuthamanga kwa magazi kumachepa pang'ono popanda kudumpha mwadzidzidzi, potero kupewa kuthamanga kwa mtima. Mankhwala osankha samakhudza potency mwa anthu odwala matenda ashuga.

Renin blockers

Ma renin inhibitors ali m'gulu la mankhwala am'badwo waposachedwa, komabe, pakadali pano, mitundu yokhayo yamtunduwu yamankhwala imaperekedwa: Rasilez.

Zochita za renin blockers ndizofanana ndi zomwe zikuchitika ndi ARB ndi ACE, koma popeza mphamvu ya renin blockers sipadaphunziridwe bwino, ayenera kutengedwa ngati mwayi.

Masiku ano, mankhwala akukhulupirira kuti pochiza matenda oopsa mu shuga.

Mndandanda wa mankhwala otchuka a magulu osiyanasiyana omwe angalandire odwala matenda ashuga omwe ali ndi matenda oopsa:

Nchiyani chimatsogolera ku lipidotoxicity?

Ndikofunikanso kuti lipidotoxicity imathandizira kukula kwamatenda monga atherosulinosis, kuchuluka kwa insulin, nayonso, matenda oopsa, chifukwa chovuta kwambiri. Mokulira kumaonjezera chiwopsezo cha:

mikwingwirima
mitsempha
zigawenga
nephropathy
kulephera kwa mtima.

Momwe mungasankhire mapiritsi a kuthamanga kwa magazi a matenda ashuga?

Pharmacology yamakono imapatsa madokotala ndi odwala kusankha kosiyanasiyana kwa mankhwala omwe ali ndi antihypertensive kwambiri. Komabe, kukhalapo kwa matenda ashuga kumatsimikizira kuchuluka kwa zoletsa kugwiritsa ntchito kwawo. Pokonzekera mankhwala oyenera, zotsatirazi ziyenera kuganiziridwa:

Zomwe zimachitika pa chakudya ndi metabolidi ya lipid. Muyenera kusankha mankhwala omwe angapangitse kagayidwe kameneka, kwambiri, sikungakhale ndi vuto lililonse.
Mankhwala sayenera kukhala ndi contraindication ogwiritsira ntchito chifukwa cha chiwindi ndi matenda a impso.
Mankhwalawa ayenera kukhala ndi katundu woteteza thupi. Ndikofunika kupereka zomwe mumakonda pa mankhwalawa, omwe amatha kukonza magwiridwe antchito owonongeka kale.

Chifukwa chake sizosavuta kusankha mapiritsi a kuthamanga kwa magazi kwa odwala matenda ashuga.

Gulu la mankhwala

Mankhwala onse a antihypertensive omwe amalola chithandizo cha matenda oopsa amakhala m'magulu osiyanasiyana a mankhwala, awa:

pakati zochita mankhwala
beta blockers ndi alpha blockers,
odana ndi calcium
ACE zoletsa
okodzetsa
angiotensin-2 olandilira olimbana nawo.

Mayina a mapiritsi opsinjika a shuga alembedwa pansipa.

Ndikofunika kudziwa kuti si onse omwe mankhwalawa angathe kumwa pamaso pa matenda ashuga. Dokotala woyenera kwambiri angakuthandizeni kusankha. Ndikofunika kukumbukira kuti mankhwala ena atha kuphatikizidwa mu matendawo kapena zovuta zomwe zimayambitsa.

Mwachitsanzo, mankhwala osokoneza bongo omwe ali ndi vuto lapakati, makamaka m'badwo wakale, saloledwa mu shuga. Mankhwala a m'badwo watsopano alibe phindu pa kagayidwe, ndipo zotsatira za mankhwala oterewa zimaphunziridwa. Pankhani imeneyi, kusankhidwa kwawo sikuli kwanzeru.

Popeza matenda oopsa mu shuga mellitus ndimachitika pafupipafupi, ndikofunikira kumvetsetsa funso posankha njira zopanikizira.

Zopatsa zamagulu

Kupsinjika kwa magazi mu matenda amtunduwu kumakula chifukwa cha kusungidwa kwa sodium ndi madzi mthupi. Pokhudzana ndi izi, madokotala ambiri amalimbikitsa kuti odwala awo atengere okodzetsa. Kusankha kwamankhwala kumayendetsedwa ndi zinthu zambiri. Mwachitsanzo, odwala omwe ali ndi vuto la aimpso, adawonetsa kugwiritsa ntchito malupu.

Matenda a shuga adatsutsana

Pamaso pa matenda a shuga mellitus, mankhwala otsatirawa a diuretic, ophatikizidwa m'magulu akulu akulu, sangathe kulimbikitsidwa:

Thiazide okodzetsa. Othandizira okodzetsa a gululi amathandizira kuthetsedwa kwa potaziyamu m'thupi ndikuyambitsa dongosolo lokonzanso zinthu, zomwe zimapangitsa kuwonjezeka kwa mavuto. Kuphatikiza apo, thiazides amatha kusokoneza ntchito yopanga insulin komanso kuwonjezera kuchuluka kwa shuga m'magazi. Gulu la mankhwalawa limaphatikizapo "Hypothiazide", "Chlortiazide", "Indapamide", "Oxodolin", "Xipamide".
Carbonic anhydrase inhibitors, kuphatikiza Diacarb. Mankhwala omwe ali mgululi ali ndi ofooka kwambiri okodzetsa komanso zotsatira zama hypotensive. Kugwiritsa ntchito sizoyenera chifukwa cha kusakwanira.
Ma diuretics a osmotic chilengedwe, kuphatikizapo Mannitol. Amatha kuyambitsa hypersmolar chikomokere.

Mosamala, ndikofunikira kutenga mitundu yotsitsa potaziyamu. Wodwala yemwe ali ndi matenda ashuga, amatha kuyambitsa matenda a hyperkalemia.

Ganizirani mapiritsi opsinjika a shuga.

Liop diuretics, yomwe imaphatikizapo "Bufenoks" ndi "Furosemide", imatha kupititsa patsogolo impso. Zimakhudza metabolidi ya lipid ndi carbohydrate pamlingo wocheperako kuposa thiazide diuretics. Nthawi zambiri amauzidwa kuti athandize kutaya mtima.

Kugwiritsa ntchito mankhwala okodzetsa kumalimbikitsidwa pakulimbana kwovuta pogwiritsa ntchito mankhwala ena a antihypertensive.

Ndi mankhwala ati omwe angachepetse kuthamanga kwa magazi mu shuga?

Kukonzekera komwe kumaphatikizidwa ndi gulu la angiotensin 2 receptor antagonists

Mankhwalawa agwiritsidwa ntchito posachedwapa. Apatseni mosamala.

Zothandiza kwambiri ndi Irbesartan, Telmisartan, Candesartan.

Pochita mankhwala ndi mankhwalawa, ndikofunikira kuwongolera kuchuluka kwa kuthamanga kwa magazi, potaziyamu ndi creatinine m'magazi.

Ndemanga za mankhwala opsinjika ndi omwe alipo shuga ndi osiyana. Zabwino zambiri pa beta-blockers, ACE inhibitors, diuretics amagwiritsidwanso ntchito. Koma njira zonse ziyenera kugwiritsidwa ntchito mosamala, chifukwa ndikosavuta kupanga cholakwika posankha ndi kupeza zovuta zingapo. Kumwa mankhwala ochizira matendawa sikokwanira. Ngakhale chithandizo chovuta sichingabweretse zotsatira zomwe mukuyembekeza, ngati simusintha momwe mumakhalira.

Mapiritsi abwino opsinjika mu matenda a shuga amatha kusankha dokotala okha. Kudzichitira nokha mankhwala sikovomerezeka.

Zomwe zimachitika mu matenda ashuga

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

Mankhwala a antihypertensive: magulu

Kusankhidwa kwa mankhwala ndikofunikira kwa madokotala, kudzipereka nokha ndiowopsa 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.

Mtundu 2 wamapiritsi opsinjika a shuga 2

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 amawonedwa ngati owopsa, osagwirizana ndi matenda oyambitsawa.

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

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 m'magazi a shuga kumakhala ndi etiology yosiyanasiyana (zomwe zimayambitsa) ndipo imafunikira njira ina yothandizira. Mankhwala othandizira kuthamanga kwa magazi amaperekedwa ndi adokotala okha.

Chithandizo cha anthu ku matenda oopsa

Matenda oopsa amachititsa kuti kuphwanya kwa kagayidwe kazakudya mu 50-70% ya milandu. 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 chiyenera kuyamba ndi kutsatira malamulo a moyo wathanzi: kukhalabe wathanzi, kusiya kusuta, kumwa mowa, kuchepetsa kuchuluka kwa mchere komanso zakudya zovulaza.

Chikhalidwe Chazakudya Zopatsa Thanzi kapena Zakudya Zoyenera

Zakudya kwa matenda oopsa ndipo matenda a shuga a 2 amachepetsa kuthamanga kwa magazi komanso kuchepetsa matenda a shuga. Zakudya zamagulu olemba matenda oopsa komanso mtundu wachiwiri wa matenda ashuga ziyenera kuvomerezedwa ndi endocrinologist ndi wathanzi.

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

Pomaliza

Mankhwala othandizira matenda oopsa 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 kwa akatswiri ndi endocrinologist ndi mtima ndi komwe kumatsogolera ku 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 zoyenera. Ndakhala ndikuphunzira kuyenderana ndimankhwala onse ndekha kwa milungu iwiri.Ndipo palibe madotolo angamve izi.Ndipo pambuyo poti ndafika kuchipatala ndizowumiriza. 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.

M'nkhaniyi, taganizira za mankhwala othandizira kwambiri kupanikizika mu matenda ashuga.

Hypertension ndikuwonjezera magazi komwe njira zochizira zimathandizira wodwala kwambiri kuposa zovuta zina zoyipa. Ndi kuthamanga kwa magazi a 140/90 kapena kupitirira apo, chithandizo chiyenera kuyambitsidwa, popeza matenda oopsa amathandizira kwambiri khungu, kulephera kwaimpso, kugunda kwa mtima ndi matenda a mtima. Mtundu wa 1 komanso wa matenda ashuga 2, malire a kuthamanga kwa magazi amatsika mpaka 130/85 mm Hg. Art. Ngati kupanikizika kukwera, muyenera kuchita zonse zofunika kuti muchepetse.

Hypertension imakhala yoopsa m'mitundu yonse iwiri ya matenda ashuga. Izi ndichifukwa choti kuphatikiza kwa shuga ndi kuthamanga kwa magazi kumawonjezera mwayi wokhala ndi vuto la mtima, khungu, kugwidwa ndi minyewa, kulephera kwa impso, kuduladula miyendo ndi khungu. Nthawi yomweyo, kuthamanga kwa magazi sikovuta kwambiri kusintha, pokhapokha ngati matenda a impso apita kutali kwambiri.

Mapiritsi opanikizika a shuga amapezeka pamalonda ambiri.

Othandizira ofunikira - okodzetsa

Gawoli lotsatirali la okodzetsa lipezeka:

thiazide - ali ndi zotsatira zoyipa monga cholesterol ndi shuga, chopinga cha aimpso,
osmotic - kumatha kupweteka kwa hyperosmolar coma,
potaziyamu - osagwiritsidwa ntchito pakulephera kwa impso,
loopback - ndi kugwiritsidwa ntchito mosasamala kwa mapiritsi oterowo, mtima arrhythmia ndi hypokalemia zitha kuchitika,
carbonic anhydrase inhibitors - mawonekedwe osayipirawo ndi gawo locheperako, chifukwa chomwe zotsatira zoyenera sizingalandiridwe.

Mankhwala abwino kwambiri a gulu lanyumba ndi awa: "Bufenox", "Torasemide", "Furosemide".

Kuchiza ndi okodzetsa okha sikuthandiza;

Palinso mapiritsi ena ogwira mtima a kuthamanga kwa magazi kwa odwala matenda ashuga.