Kodi mapiritsi a shuga omwe mumamwa omwe mumamwa angakupanikizeni: njira yothandizira

Hypertension imakhala yofala kwambiri mwa anthu odwala matenda ashuga a 2. Kuphatikiza kwamatendawa ndi kowopsa kwambiri, chifukwa kuopsa kwa kuwonongeka kwa kuwona, kuwonongeka kwa mtima, kulephera kwa impso, kugunda kwamtima ndi gangore kumachulukanso. Chifukwa chake, ndikofunikira kusankha mapiritsi abwino opanikizika a matenda a shuga a 2.

Kusankha chithandizo

Ndi chitukuko cha matenda oopsa kuphatikiza ndi matenda ashuga, ndikofunikira kukaonana ndi dokotala munthawi yake. Kutengera ndi deta ya kusanthula ndi maphunziro, katswiri adzatha kusankha mankhwalawa.

Kusankhidwa kwa mankhwalawa mu matenda oopsa a shuga sikophweka konse. Matenda a shuga amaphatikizidwa ndi kuperewera kwa thupi m'thupi, kusokonezeka kwa impso (diabetesic nephropathy), ndipo mtundu wachiwiri wa matenda umadziwika ndi kunenepa kwambiri, atherosulinosis, ndi hyperinsulinism. Si mankhwala onse a antihypertensive omwe angathe kumwa mankhwala otere. Kupatula apo, ayenera kukwaniritsa zofunika izi:

• sizikhudza kuchuluka kwa lipids ndi glucose m'magazi,
• khalani ogwira ntchito kwambiri
• khalani ndi zovuta zochepa
• kukhala ndi nephroprotective ndi mtima zotsatira (kuteteza impso ndi mtima ku mavuto obwera chifukwa cha matenda oopsa).

Chifukwa chake, ndi matenda amtundu wa 2 shuga, ndi omwe angayimidwe a magulu otsatirawa a mankhwala omwe angagwiritsidwe ntchito:

• okodzetsa
• ACE zoletsa
• opanga beta
• ARB
• calcium blockers.

Matenda a shuga ndi matenda oopsa: zovuta zotheka

Monga mukudziwa, kuthamanga kwa magazi ndi njira yabwino kwambiri ndipo mwina imayambitsa zomwe zimapangitsa kuti pakhale njira zingapo zovuta. Ngati matendawa amatenga nthawi imodzi ndi matenda a shuga, ndiye kuti izi zimapangitsa kuti vutoli liwonongeke kwambiri ndipo nthawi zambiri impso, mitsempha yamagazi ndi ziwalo zam'maso zimasanduka ziwalo zowonongeka.

Matenda a shuga ndi matenda oopsa oopsa omwe amabwera chifukwa cha kuperewera kwa insulini - kuchuluka kwa kapamba. Ndikofunikira m'thupi lathu, chifukwa zimathandizira kusamutsa glucose m'maselo. Zotsirizirazi zimabwera kwa ife makamaka kuchokera ku chakudya (analogue imapangidwa pang'ono ndi thupi lokha) ndipo imapereka mphamvu mwachindunji.

Kuperewera kwa insulini m'thupi kapena ziwalo za cell zotsekedwa ndi kapukusi wamafuta zimaleka kuzimva, ndiye kuti zimakhala ndi ziwalo zonse zimayamba kuvutika. Matendawa amatchedwa hyperglycemia. Ngati munthawi imeneyi simukuthandiza wodwala ndipo simulowa muyezo wa insulin kapena mankhwala a hypoglycemic, machitidwe ambiri akhoza kukhudzidwa.

Kukhalapo kwa matenda ashuga kumachulukitsa chiopsezo cha matenda amitsempha, ndipo makamaka, kusokonezeka kwa matenda oopsa. Pang'onopang'ono, dongosolo lodziimira payekha komanso mtima zimavutika kwambiri. Poyerekeza ndi izi, pali chiopsezo chotenga matenda a atherosulinosis, omwe amangokulitsa mkhalidwe wa wodwalayo.

Mofananamo, amatha:

• Kulephera kwa mtima ndi impso,
• Kuwonongeka kwa mtima
• Stroko

Ndi chitukuko cha matenda a zotumphukira mitsempha, kuwerengetsa kwamitsempha kumapazi ndi miyendo kumachitika. Atherosclerosis imakhudzanso kupweteka mutu, kusokoneza chidwi komanso kusokoneza kayendedwe ka kayendedwe. Komanso, njira zoterezi zimatha kukula pang'onopang'ono ndi kuwonjezeka pang'ono kwa kuthamanga kwa magazi ndi hyperglycemia.

Zomwe muyenera kudziwa za cholesterol

Hypertension nthawi zambiri imakhala limodzi ndi kuwonjezeka kwa cholesterol ya "yoyipa" pakuwunika. Mwakutero, palibe malamulo amodzi okhazikitsidwa. Nazi zinthu monga jenda, zaka komanso cholowa cholemedwa zimatengedwa.

Cholesterol, momwe ma lipoproteins amakhala ndi kachulukidwe kakang'ono, ndi owopsa thanzi la munthu. Ndizoyambitsa, kumbali komwe kumatseka mitsempha yamagazi. Ngati matenda sanazindikiridwe pa nthawi yake, ndiye kuti pamapeto pake izi zidzapangitsa kuti mapangidwe azikhazikika pamakhoma amitsempha yamagazi, chifukwa chomwe magazi amayenda kwambiri.

Nthawi zambiri, cholembera wa cholesterol "choyipa" sayenera kupitirira 5.15. Chifukwa chake, kukwera mtengo, kumakhala pachiwopsezo chotenga matenda a mtima komanso kupunduka kwa mtima.

Ubwino wamoyo wa anthu omwe ali ndi mbiri yokhala ndi vuto la matenda oopsa komanso matenda a shuga amakhudzidwa kwambiri, motero muyenera kuyang'anira kuthamanga kwa magazi ndi shuga wamagazi. Mankhwala apadera amagwiritsidwa ntchito kuti muchepetse zizindikiro.

Zizindikiro zakuzindikira

Sikuti aliyense amadziwa bwino chizindikiro Ambiri amakumana ndi mfundo zapamwamba kwambiri pomwe zimam'patsa mphamvu metabolism. Kwa nthawi yayitali, manambala pakati pa 6 amawerengedwa kuti ndi chizindikiro cha dziko lomwe limadwala matenda ashuga.

Masiku ano, miyezo, malinga ndi malingaliro a WHO, yasintha kwambiri. Malire apamwamba a chizolowezi amatengedwa ngati chizindikiro cha 5.7. Ziwerengero zilizonse zomwe zimaposa mtengowu zikuwonetsa kuti gawo la matenda asanafike shuga layamba. Potengera maziko awa, wodwalayo amagwera m'dera lachiwopsezo kuwonjezera pa matenda monga cholesterol metabolism ndi mtima atherosulinosis.

Komanso, kuti adziwe matenda olondola, dokotala amatha kukupatsani mayeso a hemoglobin a glycosylated. Kuyeza kumeneku kumagwiritsidwa ntchito kuti mupeze mitundu yamtundu wa shuga. Zimawonetsa kuchuluka kwa shuga omwe adalowa mu membrane kulowa mu magazi ofiira. Popeza chizindikirochi chimakhala m'magazi kwa nthawi yayitali (pafupifupi miyezi itatu), ndizolondola kwambiri kuzindikira matenda ashuga.

Kufunika koteteza magazi mu shuga

Khalidwe ili limakhala lofunikira, chifukwa pololera mwadongosolo zovuta zingapo zitha kupewedwa. Kukwera kwambiri kwa ziwonetsero, kumakhala pachiwopsezo chachikulu chokhala ndi ma pathologies osiyanasiyana, chifukwa kupanikizika kwa ziwombo ndi zotumphukira kumawonjezeka kwambiri.

Zotheka kusintha kuchokera ku ziwalo:

• Kukha magazi
• Zowonongeka
• Ischemia
• Kuwonongeka kwa mtima
• Kugunda kwa mtima.

Komanso, mu shuga mellitus, zakudya za okosijeni zamagulu onse ogwira ntchito zimakhala ndi zovuta. Chifukwa chake, kukhala ndi hypoxia nthawi zonse kumabweretsa kuwonongeka kwakukulu pakukhala bwino. Nthawi zina, mikhalidwe yovuta kwambiri monga kufooka kwa mitsempha, matenda am'mimba, komanso ngakhale stroko imatha. Chizindikiro cha onse odwala matenda ashuga ndikuti chifukwa chochepetsedwa chitetezo, mabala awo ndi kuwonongeka kulikonse kwa thupi kumachiritsa bwino.

Kuthamanga kwa magazi kwa matenda ashuga: ndizowonetsera

Kuphatikizidwa kwa njira ziwiri za pathological kumatha kukulitsa mkhalidwe wa wodwalayo. Pankhaniyi, Symbomatology imakula kwambiri, chifukwa machitidwe angapo amodzi amaphatikizidwa munthawi yowonongeka.

Mawonetsedwe atheka a matendawa:

• Mutu waukulu
• Kufooka ndi chizungulire,
• W ludzu
• Kuchepetsa thupi
• Kutopa kochulukirapo
• Kuukira kwa thukuta.

Pazifukwa izi, ndikofunikira kuzindikira matendawa nthawi. Malinga ndi kafukufuku wambiri, kuphatikiza matenda awiri kumawonjezera mwayi wokhala ndi vuto la vegetovascular system. Hypertrophy yam'manzere yamitsempha yamagazi imapezekanso nthawi zambiri.

Nthawi zambiri, anthu odwala matenda ashuga amatha kukhala ndi mtima wambiri pazinthu zomwe zimapangitsa kuphatikizika kwamitsempha yamagazi. Chinawonjezeranso mphamvu ku zomwe zili ndi sodium ayoni m'magazi. Pachifukwa ichi, odwala ambiri amakhudzidwa kwambiri ndi chakudya patebulo.

Hypertension imathandizanso kukulitsa hyperinsulinemia komanso kuphwanya magazi. Makamaka chithunzi ichi chimawonedwa mwa iwo omwe ali ndi cholowa chovuta. Anthu awa ayenera kuyendera pafupipafupi monga madokotala monga a mtima ndi endocrinologist kuti athe kuzindikira nthawi yake.

Poyerekeza zakumbuyo za shuga m'magazi odwala, mkodzo wamagazi umatayika kwambiri. Chifukwa chake, mwa odwala omwe alibe mbiri yokhala ndi matenda ashuga, kuthamanga m'mawa ndi usiku kumatha kutsika ndi 15%. Mu odwala matenda ashuga, njirazi ndizosiyana kwambiri.

Mitundu yosiyanasiyana yama neuropathies imadziwikanso nthawi zambiri. Izi ndichifukwa choti kuchuluka kwa glucose m'magazi kumasokoneza ntchito yamanjenje.

Vuto lalikulu la matenda ashuga odwala matenda oopsa ndi orthostatic ochepa hypotension. Amadziwonetsa pokhapokha ngati akusintha ndikusunthira pamalo oyimilira kuchokera pamalo apamwamba, kuthamanga kwa magazi kumachepa. Monga lamulo, mkhalidwewo umadziwika ndi mawonekedwe a chizungulire ndi "ntchentche" patsogolo pa maso.

Mankhwala osokoneza bongo opanikizika ndi matenda ashuga

Njira yothandizira matendawa nthawi zambiri imangotengera kuchuluka kwa matenda oopsa komanso chithunzi cha matendawa. Mankhwala amasankhidwa poganizira zotsutsana ndi zomwe zingachitike popanda ziwalo zina. Njira yakuchiritsira imayenera kuchitika motsogozedwa ndi kuthamanga kwa magazi, komanso kuchuluka kwa zinthu zam'magazi.

Mukamasankha ndi kupereka mankhwala, zovuta zimatha kukhalapo, chifukwa kufooketsa kwa kagayidwe kazakudya kungakhale choletsa kuperekera mankhwala ena. Ndikofunikira kwambiri kuganizira za matenda ena omwe alipo omwe akudwala.

Gulu la mankhwalawa limaphatikizapo:

• ACE zoletsa,
• Mankhwala,
• Calcium calcium blockers,
• Diuretics (okodzetsa),
• Alfa oletsa,
• Vasodilators,
• Angiotensin II receptor blockers.

Mankhwala onsewa ali ndi vuto lotha kusintha, koma nthawi yomweyo ali ndi mfundo yosiyaniranasiyana. Mlingo umasankhidwa mwanjira yoletsa kuchepa kwakanthawi kwa mavuto. Pakati achire maphunziro ayenera kukhala miyezi iwiri. Kutsika kowopsa kwa kuthamanga kwa magazi mu shuga mellitus ndikosavomerezeka.

Mosasamala kanthu ndi njira yomwe adasankha, mankhwalawa a ACE nthawi zonse amakhala mankhwala osankha matenda oopsa. Ndizoyenera odwala matenda ashuga ndikuletsa kupangidwa kwa zinthu zomwe zimakwiyitsa vasoconstriction. Gawo logwira ntchito la zoletsa limachepetsa kuchuluka kwa mahomoni aldosterone, omwe amalimbikitsa kusunga kwa sodium mthupi.

Kuwonetsetsa kukhathamiritsa kwathunthu, ma okosijeni amathanso kuchitika. Mankhwalawa amakhudza mbali zosiyanasiyana za aimpso tubules. Amasankhidwa poganizira zaumoyo wa wodwalayo, komanso ma contraindication omwe angachitike.

Nthawi ndi nthawi, angiotensin II receptor blockers amaphatikizidwa ndi mankhwalawa. Zitha kukhala njira yoletsa zoletsa za ACE ngati sizili bwino. Makina amomwe amagwira ntchito ndi osiyana pang'ono, komanso amathandizira kuchepetsa kuthamanga kwa magazi ndikuthandizira kuchepetsa magawo a chamanzere am'maso pamaso pa matenda awa.

Mankhwala osankhidwa bwino amathandizira kuchepetsa kuthamanga kwa magazi, komanso hyperglycemia. Izi zimachepetsa kwambiri zovuta zamavuto ambiri. Pankhaniyi, zotsatira za kuyanjana kwa mankhwala a hypoglycemic ndi antihypertensive zimayang'aniridwa. Mankhwala onse othandizira amagwiritsidwa ntchito popanga kutsika kwamphamvu kwa kuthamanga kwa magazi motsutsana ndi kuyang'anira kuwunika kwamisempha yayitali komanso kusintha kwakanthawi kwa mankhwalawa.

Kupewa komanso kuchiza matenda oopsa mu shuga

Kuphatikiza pa chithandizo chachikulu cha mankhwala, chidwi chikuyenera kulipidwa pakukonzanso moyo watsiku ndi tsiku. Izi zimaphatikizapo kuwonjezeka kwa masewera olimbitsa thupi, kukana zizolowezi zakumwa mankhwala osokoneza bongo komanso zakudya zoyenera.

Ndi mtundu wa matenda awiri popanda kutsatira zakudya zinazake, chithandizo sichikhala chokwanira. Izi zimachitika chifukwa chakuti odwala matenda am'mimba amawonongeka, omwe amathanso kuyenda ndi kunenepa kwambiri. Chifukwa chake, ndikofunikira kwambiri kuti zakudya za tsiku ndi tsiku zimakhala ndi zakudya zochepa zosafunikira.

Malangizo ofunikira pankhani yazakudya:

• Patulani chakudya cham'madzi ndi shuga,
• Chepetsani kudya kwamchere,
• Osamadya maola atatu asanagone,
• Kuchepetsa kudya zamafuta,
• Onani njira zam'madzi,
• Pazakudya, perekani zokonda ku chimanga ndi masamba.

Ndikofunikanso kuti zakudya za tsiku ndi tsiku malinga ndi zopatsa mphamvu za caloric sizipitilira mphamvu zomwe zimagwiritsidwa ntchito. Kupanda kutero, ngakhale ndi kuchepa kwa chakudya chamafuta, thupi lolemera lidzadziunjikira.

Matenda a shuga ndi matenda oopsa ndi matenda awiri akuluakulu. Iliyonse payokha imachulukitsa mwayi wokhala ndi matenda ambiri osachiritsika. Pazifukwa izi, ndikofunikira kuzindikira nthawi, komanso kusankha mankhwala. Mankhwala, ndikofunikira kuwunika momwe wodwalayo alili.

Zodzikongoletsera

Ma diuretics amaimiridwa ndi mankhwala ambiri omwe ali ndi njira yosiyana yochotsa madzi owonjezera mthupi. Matenda a shuga amadziwika ndi kuphatikizika kwapadera kwa mchere, zomwe zimapangitsa kuti magazi azungulira mozungulira, chifukwa chake, akuwonjezeka. Chifukwa chake, kutenga ma diuretics kumapereka zotsatira zabwino ndi matenda oopsa mu shuga. Nthawi zambiri amagwiritsidwa ntchito kuphatikiza ACE inhibitors kapena beta-blockers, omwe amalola kuwonjezera kuchuluka kwa mankhwalawa ndikuchepetsa kuchuluka kwa zoyipa. Zoyipa za gululi la mankhwalawa ndizotetezedwa bwino aimpso, zomwe zimachepetsa kugwiritsa ntchito.

Kutengera ndi makina a zochita, okodzetsa amawagawa:

• tchuthi
• thiazide
• ngati thiazide,
• kuteteza potaziyamu
• osmotic.

Oyimira thiazide diuretics amalembedwa mosamala mu shuga. Cholinga cha ichi ndi kulepheretsa kugwira ntchito kwa impso ndikuwonjezera cholesterol ndi shuga m'magazi mukamamwa waukulu. Nthawi yomweyo, thiazides amachepetsa kwambiri vuto la kugwidwa ndi matenda a mtima. Chifukwa chake, ma diuttics oterewa sagwiritsidwa ntchito kwa odwala omwe amalephera kupweteka kwa impso, ndipo akatengedwa, tsiku ndi tsiku mlingo sayenera kupitirira 25 mg. Omwe amagwiritsidwa ntchito kwambiri ndi hydrochlorothiazide (hypothiazide).

Mankhwala ngati a Thiazide nthawi zambiri amagwiritsidwa ntchito kupanikizika kwa matenda ashuga. Pochepera pang'ono, amachotsa potaziyamu m'thupi, kuwonetsa kufatsa kotsitsa ndipo kwenikweni sikukhudza kuchuluka kwa shuga ndi lipids m'thupi. Kuphatikiza apo, nthumwi yayikulu ya subgroup indapamide ili ndi nephroprotective. Mtundu wonga thiazide woterewu umapezeka pansi pa mayina:

Zopaka za loop zimagwiritsidwa ntchito pamaso pa kulephera kwa impso ndi edema. Njira ya kudya kwawo iyenera kukhala yochepa, popeza mankhwalawa amalimbikitsa mphamvu ya diuresis ndi potaziyamu, zomwe zimapangitsa kuti thupi lithe kusowa madzi, hypokalemia ndipo, chifukwa chake, arrhythmias. Kugwiritsa ntchito malupu okodzetsa kuyenera kuphatikizidwa ndi kukonzekera kwa potaziyamu. Chida chodziwika komanso chogwiritsidwa ntchito kwambiri cha gulu laling'ono ndi furosemide, yomwe imadziwikanso kuti Lasix.

Osmotic ndi potaziyamu woteteza okodzetsa a shuga nthawi zambiri satchulidwa.

Otsutsa a calcium

Ma calcium calcium blockers amatha kugwiritsidwanso ntchito kutsitsa magazi ndi kuphatikiza kwa matenda oopsa ndi matenda osokoneza bongo, chifukwa sizikhudza kagayidwe kazakudya zam'mimba komanso lipid metabolism. Ndiwosagwira ntchito kwambiri kuposa ma sartans ndi ACE inhibitors, koma ndi abwino kwambiri pamaso pa concomitant angina pectoris ndi ischemia. Komanso, mankhwalawa amaperekedwa makamaka pochiza odwala okalamba.

Zokonda zimaperekedwa ndi mankhwala omwe amakhala ndi mphamvu yayitali, omwe amakwaniritsidwa kamodzi kamodzi patsiku:

• amlodipine (Stamlo, Amlo, Amlovas),
• nifidipine (Corinfar Retard),
• felodipine (Adalat SL),
• lercanidipine (Lerkamen).

Choipa cha otsutsana ndi calcium ndi kuthekera kwawo pakupangitsa kuchuluka kwa mtima kwa mtima ndikupangitsa kutupa. Nthawi zambiri kutaya mtima kwambiri kumayambitsa kuchoka kwa mankhwalawa. Pakadali pano, woimira yekhayo yemwe alibe izi zoyipa ndi Lerkamen.

Othandizira

Nthawi zina matenda oopsa sangathe kuthandizidwa ndimankhwala omwe afotokozedwa pamwambapa. Ndiye, kupatula, alpha-blockers angagwiritsidwe ntchito. Ngakhale sizikhudza kayendedwe ka metabolic mthupi, zimakhala ndi zotsutsana ndi thupi. Makamaka, alpha-blockers angayambitse orthostatic hypotension, yomwe imadziwika kale ndi matenda a shuga.

Chizindikiro chokhacho chotsimikizira gulu la mankhwalawa ndi kuphatikiza kwa matenda oopsa, matenda ashuga mellitus ndi adenoma a Prostate. Oimira:

• terazosin (Setegis),
• doxazosin (Kardura).