Kupanikizika kwa Matenda a shuga

Kwa odwala omwe ali ndi vuto la metabolism ya carbohydrate, ndikofunikira kuti muchepetse shuga wamagazi okha, komanso kuthamanga kwa matenda a shuga. Nthawi zambiri imakwezedwa ndipo ndi gawo la metabolic syndrome - kuphatikiza kwa matenda oopsa, mtundu 2 wa shuga ndi kunenepa kwambiri.

Nthawi zina, odwala matenda ashuga amakhala ndi matenda oopsa, oopsa kuposa matenda oopsa.

Ziwerengero zabwinobwino zamagazi sizachilendo 120/80. Kupsinjika kwa magazi kumatha kusinthasintha malinga ndi thanzi la munthu komanso nthawi yatsiku. Manambala abwinobwino amaonedwa ngati chizindikiro cha kuthamanga kwa magazi (90st) komanso kuthamanga kwa magazi kuchokera pa 90 mpaka 139 komanso kuchuluka kwa magazi kwa diastolic kuchokera pa 60 mpaka 89. Zonse zomwe ndizapamwamba ndi matenda oopsa, otsika ndi hypotension.

Kwa odwala omwe ali ndi matenda a shuga a mtundu woyamba 1 kapena 2, mankhwalawa amasiyanasiyana pang'onopang'ono ndipo zopsinjika pamwambapa pa 130/85 zimawonedwa ngati matenda oopsa. Ngati chithandizo cha mankhwala chimakulolani kuti muchepetse kupanikizika kapena kukwaniritsa manambala otere, ndiye kuti adotolo ndi wodwala amakhutitsidwa.

Kuthamanga kwa magazi kwa matenda amtundu 1 komanso matenda ashuga 2: zimayambitsa

Mtundu woyamba 1 ndi mtundu 2 wa shuga ndi matenda oopsa, ndiko kuti kuwonongeka kwa microvasculature. Shuga yotalikirapo imakhalapo ndipo magazi a m'magazi samayang'aniridwa mwachangu, odwala omwe amapita msanga amakhala ndi zotupa zam'mimba. Pafupipafupi phokoso la matenda ashuga - microangiopathy ya m'munsi yotsika, limodzi ndi kufa kwa minofu ndikucheka.

Mutha kuganiza kuti kuthamanga kwa magazi kwa mtundu 1 komanso matenda amtundu wa 2 kumathandizira kuti magazi azikhala ndi magazi okwanira ndipo sipangakhalenso vuto la mtima. Kusinthasintha kwa kukakamiza kumachulukitsa misempha yam'mimba mu shuga ndikupangitsa zotsatira zowopsa, zomwe zidzafotokozedwa gawo lotsatira.

Matenda oopsa a arterial matenda amtundu 1 komanso matenda amtundu 2 amachitika chifukwa cha zifukwa zingapo. Matenda a shuga a Mtundu Wachiwiri ndi matenda omwe amapezeka mwa anthu onenepa kwambiri. Ndipo kunenepa kwambiri nthawi zonse kumayendera limodzi ndi matenda oopsa.

Kodi ndichifukwa chiyani odwala omwe ali ndi matenda amtundu woyamba amakhala ndi matenda oopsa? Izi zimakonda kuphatikizidwa ndi kuwonongeka kwa impso, ndiko kutaya mapuloteni mumkodzo chifukwa cha microangiopathy ya glomeruli impso. Kuwonongeka kwa impso kwa odwala omwe ali ndi matenda amtundu wa 1 amadziwika ndi magawo atatu otsatizana:

Microalbuminuria, pamene mamolekyu a protein yochepa ya albumin akuwonekera mkodzo, ndipo kutayika kwa mapuloteni kudzera mu impso sikunenedwe. Kupanikizika kumakhalabe kwachilendo, ndipo kuzindikira kwa vutolo nthawi yake ndikusankha chithandizo choyenera kumachedwetsa kuwonongeka kwa impso.
Pang'onopang'ono, kuwonongeka kwa impso chifukwa cha matenda amtundu woyamba kumakulirakulira, ndipo mapuloteni akuluakulu amapitilira m'matumbuli limodzi ndi albumin. Izi zimabweretsa kuwonjezeka kwakukulu kwa kutayika kwa tizigawo ta mapuloteni mu mkodzo ndipo timadziwika kuti gawo la proteinuria. Apa kupanikizika kwachulukirachulukira, ndipo kuchuluka kwa mapuloteni omwe atayika kudzera mu impso ndiwofanana mwachindunji ndi kuchuluka kwa kuthamanga kwa magazi.
Gawo lomaliza la kuwonongeka kwa impso mu shuga ndi kulephera kwaimpso. Mkhalidwe wodwala wodwala matenda ashuga 1 akuwonjezeka ndipo pakufunika hemodialysis.

Zovuta za odwala omwe ali ndi matenda ashuga zimatha kukwezedwa kapena kusanduka hypotension. Kuwonongeka kwa impso kumabweretsa kudzikundikira kwa sodium m'thupi. Sodium amakopa madzi, omwe amalowa m'matumbo. Kuwonjezeka kwa sodium ndi kudziunjikira kwamadzi kumabweretsa kukuchulukirachulukira kwa kupanikizika.

Mu 10% ya odwala, ochepa matenda oopsa samayanjana ndi matenda amtundu woyamba 1 ndipo amakula ngati nthendayi yolimbana ndi matenda, monga zimawonetsera ndikusungidwa kwa impso. Kwa odwala okalamba, matenda oopsa a systolic angachitike pomwe kuthamanga kwa magazi kumangowonjezereka. Izi sizikugwirizana ndi matenda ashuga, koma hyperglycemia imasangalatsa kwambiri njira ya matenda oopsa.

Mu matenda a shuga amtundu wachiwiri, impso zimavutikanso, zomwe zimapangitsa kuchuluka kwa matenda oopsa omwe alipo mwa odwala.

Zinthu zotsatirazi m'moyo wa odwala zimapangitsa kuti matenda asokonezeke mwanjira yoyamba komanso matenda a 2:

Kupsinjika, kutengeka mtima ndi thupi,
Zaka ndi zaka 45
Khalidwe labwino
Kugwiritsa ntchito molakwika zakudya zamafuta, zakudya zopanda pake, mowa,
Kuchulukitsa thupi
Mbiri yam'mbuyo - matenda oopsa mwa achibale.

Izi zimabweretsa zovuta kwa odwala omwe ali ndi vuto la mtundu woyamba 1 ndi mtundu 2 omwe ali ndi matenda oopsa.

Zizindikiro za ochepa matenda oopsa mu shuga

Kuchuluka kwa kuthamanga kwa magazi kwamtundu wa 1 komanso mtundu wachiwiri wa matenda a shuga kumadziwonekeranso chimodzimodzi ndi odwala omwe ali ndi shuga. Uku ndikumutu, kuwuluka ntchentche patsogolo pa maso, chizungulire, kulemera kumbuyo kwa mutu, ndi ena. Kutenga magazi kwa nthawi yayitali kumapangitsa kuti thupi lizisinthasintha, ndipo wodwalayo samamva.

Mwa munthu wathanzi, kuthamanga kwa magazi kumachepa ndi 10-20% usiku. Kwa odwala omwe ali ndi matenda amtundu wa 1 komanso a 2, ndikofunikira kudziwa kuti masana mankhwalawa amatha kukhala abwinobwino, ndipo usiku osachepera, monga mwa anthu athanzi, ndipo nthawi zina amakula. Ichi ndi chifukwa cha matenda ashuga a m'mimba, omwe amasintha kamvekedwe ka kamvekedwe kake. Kuphwanya kusinthasintha kolondola kwa kuthamanga kwa magazi mu tsiku la shuga kumawonjezera chiopsezo cha myocardial infaration, ngakhale kuthamanga kwa magazi sikupitilira muyeso.

Kuopsa kwa kuthamanga kwa magazi mu shuga

Matenda oopsa a muubongo ndi owopsa pamavuto amtima, komanso kuphatikiza ndi matenda ashuga, izi zimawonjezeka kwambiri. Odwala ochepa matenda oopsa omwe ali ndi matenda a shuga 1 ndi 2, zotsatirazi zimakonda kuchitika:

20c zilonda zam'mimba zopanda machiritso ndi zilonda zam miyendo, zodula,
Nthawi 25 kukula kwa aimpso kulephera
Nthawi 5 kukula kwa myocardial infarction, komwe kumakhala kovuta kuposa kwa odwala omwe ali ndi shuga wamagazi ndikupangitsa kuti afe.
Stroke imayamba kanayi,
Kuchepetsa kowoneka bwino kwamasamba 15.

Kupanikizika kumachepa mu mtundu woyamba wa 2 ndikulembera shuga 2 mwa kupereka mankhwala komanso kukonza moyo. Chithandizo chogwiritsidwa ntchito mosiyanasiyana chimagwiritsidwa ntchito ndi kuwonjezeka kwapang'onopang'ono kwa mankhwala a antihypertensive. M'mwezi woyamba, cholinga ndi kukwaniritsa kuchuluka kwa manambala 140/90 mm Hg. Chotsatira, madotolo amayesa kusankha chithandiziro kuti kupanikizika kumakhala kosiyanasiyana 110/70 - 130/80.

Pali magulu amtundu wa odwala omwe sizotheka kutsitsa kupsinjika kwa zosakwana 140/90. Awa ndi anthu omwe akuwonongeka kwambiri kwa impso, atherosulinosis, kapena odwala okalamba omwe ali kale ndi ziwalo zolimbana (masomphenya otsika, hypertrophied myocardium).

Momwe mungachepetse kuthamanga kwa magazi mu shuga: njira zamankhwala zikuyandikira

Chithandizo cha mankhwala osokoneza bongo ochepa mu mtundu 1 ndi matenda 2 amachitika ndi magulu angapo a mankhwala. Izi zimakuthandizani kuti mupange zotsatira zabwino zamagulu osiyanasiyana, chifukwa kuphatikiza kuchepetsa kupanikizika, ali ndi mfundo zina zogwiritsira ntchito. Zofunikira za antihypertensive mankhwala ndizotsatirazi:

Sungani kupanikizika kwazaka 12-16,
Osakhudza shuga wamagazi, kapena kuyambitsa hypercholesterolemia,
Tetezani ziwalo zamkati, makamaka impso, ku zotsatira zoyipa za matenda oopsa komanso matenda ashuga.

Bwino piritsi limodzi pakakhala mankhwala angapo a antihypertensive. Pali kuphatikiza kwa mankhwala osasunthika komwe kumapereka mphamvu kwambiri kuposa momwe wodwalayo amamwa mankhwalawa, kokha mapiritsi osiyanasiyana: Noliprel, Be-Prestarium, Equator, Fozid, Korenitec ndi ena.

Zochizira matenda oopsa mu shuga, mankhwala otsatirawa amaloledwa:

ACE inhibitors (angiotensin-otembenuza enzyme),
Calcium blockers,
Mankhwala ena okodzetsa
Osankha beta blockers,
Asitane.

ACE zoletsa

Zochita zamankhwala zochizira matenda oopsa zimakhazikika pakutseka kwa enzyme 2, yomwe imapanga mitsempha yamagazi ndikuwonjezera kupanga kwa aldosterone - mahomoni omwe amakhala ndi madzi ndi sodium. Awa ndi mankhwala oyamba omwe amaperekedwa kwa wodwala yemwe ali ndi matenda ashuga komanso matenda oopsa pazifukwa:

Mphamvu ya antihypertensive ya ACE zoletsa imakhala yofatsa komanso pang'onopang'ono - kuchepa kwamphamvu kwa kukakamizidwa kumawonedwa pambuyo pa masabata awiri atamwa mankhwalawa,
Mankhwala amateteza mtima ndi impso ku zovuta.

Mphamvu yodzitchinjiriza ya mankhwala a matenda amtundu woyamba 1 komanso amayamba chifukwa chodziwikiratu ndi dongosolo la renin-angiotensin-aldosterone, lomwe limalepheretsa kuwonongeka kwa impso koyambirira. ACE inhibitors amalepheretsanso kukula kwa atherosclerosis chifukwa choteteza mkati mwa membrane wa arterioles pakuchokera kwa cholesterol malo ake. ACE inhibitors ali ndi phindu pa kagayidwe ka mafuta ndi shuga m'magazi, amachepetsa minofu insulin, ndiye kuti, kuchepetsa magazi.

Zowonjezera za mankhwala othana ndi matenda oopsa sizimawonedwa mu mankhwala onse okhala ndi zoletsa. Mankhwala enieni okha amateteza mtima, amakhudza lipid ndi carbohydrate metabolism. Ndipo ma generics (makope) alibe zotere. Mukafunsidwa kuti mugule chiyani, enalapril otsika mtengo kapena Prestarium yodziwika, kumbukirani izi.

Kupereka mankhwala zochizira matenda oopsa:

ACE zoletsa pang'ono amachepetsa kuchotsa kwa potaziyamu m'thupi, motero, kutsimikiza kwa potaziyamu m'magazi ndikofunikira. Potaziyamu imachepetsa kugunda kwa mtima komanso kupitirira muyeso kumatha kuyambitsa chiopsezo cha arrhythmias komanso kumangidwa kwamtima. Hyperkalemia kwa odwala omwe ali ndi mtundu woyamba 1 ndi 2 mtundu wa shuga ndi kutsutsana kwa makulidwe a ACE zoletsa.
Ma A inhibitors a odwala ena amachititsa chifuwa cham'mimba. Tsoka ilo, izi zimapangitsa kuti mankhwalawa asachotsedwe mwanjira iliyonse ndipo mankhwalawo amayenera kulowedwa ndi sartani.
Matenda oopsa oopsa samakhazikitsidwa ndi mankhwalawa, ndipo mwa odwala ena zotsatira za hypotensive sizingawonekere konse. Zikatero, madokotala amasiya zoletsa za ACE ngati mankhwala kuti ateteze mtima ndikuphatikiza mankhwala ena a antihypertensive.

Contraindication zochizira matenda oopsa ndi ACE zoletsa a 1 ndi mtundu 2 matenda ashuga (monga sartans) ndi mayiko awiri aimpso mtsempha wamagazi. Komanso, mankhwala amatsutsana mu odwala omwe adakhala ndi mbiri ya Quincke's edema (yomweyo sayanjana nawo).

Ma calcium calcium

Ma calcium calcium blockers kapena olimbana ndi calcium osagwirizana nawo amachepetsa kuthamanga kwa magazi mwa odwala omwe ali ndi matenda amtundu wa 2 koma amakhala ndi zotsutsana nawo. Mankhwalawa amagawika m'magulu awiri: dihydroperidin ndi non-dihydroperidin. Amasiyana mumachitidwe ogwirira ntchito.

Kusiyana kwakukulu ndikuti dihydroperidin blockers imachulukitsa kugunda kwa mtima ndi blockers omwe si a dihydroperidin. Chifukwa chake, dihydroperidins sinafotokozeredwe pamlingo wapamwamba wamtima. Koma kwa odwala omwe ali ndi bradycardia, mankhwalawa ndi abwino.

Ma blocker a magulu onse awiriwa samagwiritsidwa ntchito pochiza matenda oopsa nthawi yayitali kwambiri-infarction, mwa anthu omwe ali ndi vuto losakhazikika la angina (vuto lakanthawi lomwe limatha kukhala vuto la mtima kapena kukhazikika) komanso osakwanira ndi mtima.

Ma dihydroperidin blockers amachepetsa mwayi wokhala ndi kulowetsedwa kwa matenda osokoneza bongo, koma osatchulidwa kuti ACE inhibitors. Zochizira odwala omwe ali ndi systolic hypertension, otsutsana nawo amakhala oyenera komanso amachepetsa mwayi wokhala ndi stroko.

Non-dihydroperidinium calcium blockers blockers ndi oyenera kuchitira matenda oopsa odwala odwala matenda ashuga nephropathy. Amateteza impso ku zotsatira za shuga wambiri. Otsutsana ndi impso a Dihydroperidin sateteza. Onse oletsedwa a calcium channel mu shuga amaphatikizidwa ndi ACE inhibitors ndi diuretics. Ma blockers omwe si a dihydroperidine sayenera kuphatikizidwa ndi beta-receptor blockers.

Zothandiza odwala odwala matenda ashuga

Zochizira matenda oopsa mu shuga, ma diuretics nthawi zonse amaphatikizidwa ndi mankhwala owonjezera, mwachitsanzo, ACE inhibitors. Mankhwala amakhala ndi magwiritsidwe osiyanasiyana ndipo amagawika m'magulu. Ndi matenda oopsa, magulu anayi a diuretic amagwiritsidwa ntchito:

Loop: furosemide ndi torasemide,
Kuteteza kwa Potaziyamu: Veroshpiron,
Thiazide: hydrochlorothiazide,
Zofanana ndi za Thiazide: indapamide.

Iliyonse ya magulu omwe ali ndi mawonekedwe ake. Thupi monga Thiazide ndi thiazide okondweretsa atsimikizira bwino kwambiri pakuphatikizidwa kwa mankhwalawa pochiza matenda oopsa (nthawi zambiri ndi zoletsa). Okhawo woyamba waukulukulu ndiwo angathe kupangitsa kuchuluka kwa shuga m'magazi, chifukwa chake, ndi matenda oopsa komanso matenda ashuga oyambilira ndi wachiwiri, amawayang'anira mosamala, ndipo osaposa 12,5 mg. Popeza kuti diuretic imaphatikizidwa ndi mankhwala ena, kuchuluka kumeneku ndikokwanira. Thupi longa diaztide silimakhudzanso magazi am'magazi ndipo amaloledwa bwino ndi odwala omwe ali ndi matenda oopsa.

Liureide ngati Thiazide ndi thiazide amateteza mitsempha ya magazi, kuletsa kapena kuchedwetsa kukula kwa zovuta za mtima ndi impso. Ndi ntchito ya mtima osakwanira, mankhwala ndi oletsedwa. Ma diuretics awa samawonetsedwa pochiza matenda oopsa mu gout.

Zopopera za loop sizimagwiritsidwa ntchito kwa nthawi yayitali, chifukwa zimayambitsa potaziyamu kudzera mu impso. Chifukwa chake, popanga furosemide ndi torasemide, kukonzekera kwa potaziyamu kumaperekedwa. Ma diuretics okhawo ndi omwe amaloledwa kwa odwala omwe ali ndi vuto lochepa laimpso, chifukwa chake, ndi matenda oopsa, madokotala amawalembera kuti agwiritse ntchito kwa nthawi yayitali.

Zowonjezera zoteteza potaziyamu za shuga zikutha. Samazunza odwala, koma amakhala ndi mphamvu yofooka ndipo samadziwika ndi zotsatirapo zina zabwino. Zitha kugwiritsidwa ntchito, koma ndibwino kuzisintha ndi zina, magulu othandiza komanso othandiza kwambiri omwe amateteza impso ndi ziwalo zina.

Kusankha Beta blockers

Beta receptor blockers ndi mankhwala amphamvu a antihypertensive omwe ali ndi zotsatira zabwino pamtima. Amagwiritsidwa ntchito mwa odwala omwe ali ndi phokoso losokoneza komanso kuthamanga kwa mtima. Beta-receptor blockers atsimikiziridwa kuti atha kuchepetsa mwayi wokhala ndi matenda amtima ndipo ali m'gulu la mankhwala oyamba a matenda oopsa komanso matenda ashuga.

Pali magulu awiri apamwamba a blockers: kusankha, kusankha mochita zolandilira pamtima ndi m'mitsempha yamagazi, komanso osasankha, okhudza minofu yonse. Omalizirawo amadziwika kuti amawonjezera insulin kukana minofu, ndiye kuti, amawonjezera shuga. Izi ndizosayenerera kwa odwala omwe ali ndi matenda ashuga, chifukwa chake osasankha blockers ali otsutsana kwambiri.

Mankhwala osankhidwa kapena osankhidwa ndi otetezeka ndipo ndi othandiza kwa odwala omwe shuga ndi matenda oopsa zimaphatikizidwa ndi ma pathologies:

Matenda a mtima
Myocardial infarction (koyambirira pambuyo povulaza, blockers amachepetsa mwayi obwereranso ndikubwezeretsa ntchito ya mtima, ndipo kumapeto - amaletsa chiopsezo chokhala ndi myocardial infarction)
Kulephera kwa mtima.

Osankha matenda a shuga amagwira ntchito bwino ndi okodzetsa. Zomwe zimagwiritsidwa ntchito kwambiri ndi ACE inhibitors ndi calcium blockers.

Beta receptor blockers (yosankha komanso yosasankha) imaperekedwa pochiza matenda oopsa mwa odwala omwe ali ndi mphumu ya bronchial, chifukwa amatha kuyambitsa matendawa.

Limagwirira a zochita za mankhwala ali ofanana ACE zoletsa. Sartan sakonda kugwiritsidwa ntchito ngati mankhwala a mzere woyamba; amapatsidwa mankhwala omwe amamwa ACE ngati wodwalayo atulutsa chifuwa. Mankhwalawa amateteza impso, kutsitsa cholesterol ndi glucose wamagazi, koma ochepera kuposa ACE inhibitors.Ma Sartan ndi okwera mtengo kwambiri, ndipo pali mitundu yodziwika yosakanikirana ndi mankhwala ena a antihypertensive.

Ma Sartan amapita patsogolo kuposa ACE zoletsa pankhani yothandizira odwala omwe ali ndi chapamimba chamanzere. Zimatsimikiziridwa kuti mankhwalawa samangolekerera hypertrophy, komanso amabwezeretsa kusinthasintha kwake.

Monga zoletsa za ACE, sartan amachititsa kuchuluka kwa potaziyamu, kotero hyperkalemia mu mtundu 1 ndi mtundu wa 2 wa shuga ndikutsutsa kugwiritsa ntchito mankhwala. Mankhwalawa amayenda bwino ndi okodzetsa, ndipo amagwira ntchito ngati monotherapy. Kuphatikiza ndi sartan, mphamvu ya calcium blockers imasintha (monga ACE inhibitors).

Magulu owonjezera a antihypertensive mankhwala - alpha blockers a shuga

Mukamamwa mankhwala ofunikira othandizira matenda oopsa, sizotheka, kapena kuphatikiza kwa mitundu iwiriyi yomwe tafotokozayi sikunapatse mphamvu ya antihypertensive, mankhwala ochokera m'magulu osungirako amalumikizidwa ndi chithandizo. Pali ambiri a iwo, chifukwa timangolingalira za alpha-receptor blockers omwe amaloledwa mtundu 1 ndi shuga 2.

Ubwino wa mankhwalawa ndikuti amachepetsa hyperplasia ya prostatic, chifukwa chake amatha kugwiritsidwa ntchito ngati mankhwala osankha pochiza odwala omwe ali ndi vuto komanso matenda a shuga. Nthawi yomweyo, mankhwala amawonjezera chiopsezo cholephera mtima. Zotsatirazi sizinatsimikizidwe motsimikizika, koma kwa odwala omwe ali ndi vuto la mtima lomwe lilipo, alpha receptor blockers sagwiritsidwa ntchito.

Mwa zina zabwino, tikuwona momwe zimakhudzira shuga. Mankhwala amawonjezera kukhudzika kwa minofu kumapangitsa insulini ndi shuga m'magazi, zomwe ndizofunikira kwa matenda ashuga.

Kodi ndi mankhwalawa a matenda oopsa omwe amaphatikizidwa mu shuga

Chifukwa cha kuchuluka kwambiri kwa matenda oopsa m'magulu azachipatala, pali magulu ambiri a mankhwala omwe amachepetsa kuthamanga kwa magazi. Zina mwazomwe zimayambitsa kuchuluka kwa shuga m'magazi ndipo zimatsutsana kwambiri ndi odwala matenda ashuga. Izi ndizowona makamaka kwa omwe samasankha beta receptor blockers.

Amatsutsana kwathunthu kuphwanya glucose kulolerana (prediabetes). Komanso, mankhwala amaikidwa mosamala kwa odwala omwe achibale awo amakhala ndi matenda ashuga.

Mu matenda a shuga, thiazide okodzetsa muyezo woposa 12,5 mg ndi zotsutsana. Zotsatira zawo pa insulin ndi glucose wamagazi sizimatchulidwa ngati zomwe sizisankhidwa ndi beta-receptor blockers komanso osagwirizana ndi dihydroperidine calcium antagonists, komabe alipo amodzi.

Nkhondo yolimbana ndi matenda oopsa a shuga

Vuto lazopanikizika pamagazi limafuna kuchepetsedwa kuthamanga kwa magazi. Mankhwala onse omwe ali pamwambawa omwe amagwiritsidwa ntchito pochiza odwala omwe ali ndi matenda ashuga ndi othandiza, koma amachita pang'onopang'ono. Pothana ndi mavuto azadzidzidzi, mankhwala omwe amagwiritsidwa ntchito mwachidule amagwiritsidwa ntchito.

Ziwerengero zamavuto azapanthawi yovuta kwa wodwala aliyense azikhala osiyana. Ndi mankhwala ati omwe angatenge ambulansi isanafike komanso osayipa shuga? Chodziwika kwambiri ndi Captopril angiotensin otembenuza enzyme inhibitor. Mankhwalawa sanapikisidwe mu shuga ndipo amatha kuchepetsa magazi.

Nthawi zina zimachitika pang'ono, ndiye kuti mutha kuwonjezera zochitazo ndi diuretic furosemide. Pali chophatikizika chokhazikika cha inhibitor ndi diuretic - ma Captop. Mankhwalawa ayenera kukhala mu nduna yamankhwala yamunthu wodwala matenda ashuga.

Piritsi yolankhulira kapena yolankhulira pansi pa lilime imachepetsa kuthamanga mkati mwa mphindi 10-15. Chenjezo: Ngati kuthamanga kwa magazi sikukwera, ndiye gwiritsani ntchito theka la piritsi kuti musayambitse matenda oopsa.

Muthanso kugwiritsa ntchito nifedipine wogwiritsa ntchito calcium. Ndi vuto la matenda oopsa, kupanikizika kuyenera kuchepa pang'onopang'ono. Mu ola loyamba, kuthamanga kwa magazi kuyenera kutsitsidwa ndi 25%. Kenako kutsika kumayenera kukhala kochepera.

Komanso chitani izi:

Gona pabedi atakweza mutu ndi miyendo pansi,
Gwiritsani ntchito chopondera pamphumi panu,
Yesani kukhazika mtima pansi.

Mukangoona kuthamanga kwa magazi, itanani ambulansi. Akatswiri oyenerera adzayambitsa chithandizo china ndikupatula mavuto azovuta.

Momwe mungachotsere matenda oopsa: malingaliro onse

Ndi matenda oopsa, kuthira mchere kumayenera kuchepetsedwa, chifukwa kumapangitsa kuti magazi azisungika komanso kuchepa kwa matenda oopsa. Odwala omwe ali ndi matenda ashuga amakonda kwambiri sodium, motero amalimbikitsidwa kuti achepetse mchere.

Muyeneranso kuchepetsa kumwa kwa madzi okwanira lita imodzi patsiku (kutentha kumaloledwa kumwa pafupifupi malita 1.5). Madzi si madzi okha, komanso timadziti, sopo, masamba, zipatso.

Chakudya chiyenera kuthiridwa mchere pang'ono, masamba opaka bwino amasintha pang'onopang'ono, ndipo sizowoneka zatsopano. Kuyamba kugwiritsa ntchito mchere wocheperako kumathandizira lingaliro losavuta la akatswiri aku Europe "Chotsani chometera mchere patebulo." Kuchepetsa kumeneku kumachepetsa kuphatikiza chakudya komanso kuchepetsa mchere wambiri ndi kotala limodzi.

Malangizo otsatirawa athandiza kukonza moyo wabwino mu matenda ashuga komanso matenda oopsa, komanso kuchepetsa kuchuluka kwa mankhwala a antihypertensive:

Siyani mowa ndi ndudu,
Gona mokwanira - kugona osachepera maola 7 patsiku ndiye chinsinsi cha mkhalidwe wabwino wamavuto ngakhale kukakamizidwa,
Kuyenda mu mpweya watsopano kumachepetsa mphamvu yamanjenje, kukonza mtima,
Zakudya zama carb ochepa, kukana mafuta ndi nyama yokazinga kumachepetsa mavuto m'magazi, kuchepetsa mwayi wokhala ndi atherosulinosis, kuchepetsa kuwonongeka kwa matenda oopsa,
Kulemera kwambiri nthawi zonse kumayenderana ndi kuthamanga kwa magazi, kotero kuchepetsa kuchepa thupi kumathandizira kuchepetsa mawonekedwe a matenda oopsa komanso kukonza zambiri zamthupi.

Mankhwala a antihypertgency ali ndi zotsatira zowonjezera, chifukwa chake ayenera kumwedwa nthawi zonse. Matenda a kuthamanga kwa magazi kumatanthauza kuti chithandizo chothandiza. Musaganize kuti mwachiza matenda oopsa ndipo mutha kusiya mapiritsi. Matendawa ndi osachiritsika ndipo amafuna chithandizo cha moyo wonse. Ndipo chithandizo chochepa kwambiri chidzangowonjezera zochita zake.

Kupewa matenda oopsa a shuga

Ndikofunikira kupewa matenda oopsa oopsa a matenda ashuga amtundu woyamba, chifukwa matenda oopsa amatha chifukwa cha hyperglycemia. Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri ayenera kukhalanso ndi magazi abwinobwino, koma chifukwa chakuti hyperglycemia ndi matenda oopsa zimayamba ngati matenda awiri osiyana, izi ndi zovuta. Kwa odala oterowo, kupewa matenda oopsa olemekezeka ndizomwe zili zofunikira zomwe zafotokozedwa gawo lomaliza.

Kupewa kwa matenda oopsa oopsa amtundu 1 shuga kumatanthauza kupewa kuwonongeka kwa impso. ACE zoletsa zotchulidwa mu Mlingo wocheperachepera pazapanthawi yocheperako ndipo muyezo wokhala ndi matenda oopsa amatha kuthana ndi ntchitoyi. Mankhwala amateteza microvasculature, makamaka, kukhathamiritsa kwa impso, komwe kumawathandiza kuti azichita bwino kwambiri.

Ngati chifuwa chikukula motsutsana ndi zomwe adamwa, ma inhibitors amatha m'malo mwake ndi sartan, omwe amakhalanso ndi nephroprotective. Komabe, ndi hyperkalemia, mankhwalawa amatsutsana.

Dongosolo la prophylactic la ACE inhibitors limagwiranso ntchito kwa odwala omwe ali ndi matenda a shuga a 2, makamaka ngati saphatikizana ndi matenda oopsa (omwe ndi osowa kwambiri). Kuwonongeka kwa impso ndi kowopsa pakuwonongeka kwa matenda oopsa komanso kulephera kwa impso. Kuti mupeze panthawi yake ya Microalbuminuria, kuyesa kwamikodzo kuyenera kutengedwa miyezi iliyonse ya 6 mpaka 6 kuti mudziwe mapuloteni.

Urinalysis wokhazikika kwa matenda oopsa sangawulule pang'ono mapuloteni, chifukwa chake, kusanthula kwa microalbuminuria kudayikidwa.

Kuthamanga kwa magazi kwa matenda ashuga: zomwe zimayambitsa ndi zizindikiro

Kuthamanga kwa magazi kwa odwala matenda ashuga kumakhala kochepa kwambiri kuposa matenda oopsa. Izi zimachitika chifukwa cha kuvutika kwamavuto omwe amavomerezedwa ndi hyperglycemia. Kupsinjika kocheperako kumatha kukhala kumayambiriro kwa matenda ashuga, omwe samalumikizana ndi matendawa ndipo ndi gawo la wodwalayo. Popita nthawi, kuthamanga kwa magazi kotereku kumayamba kukhala kwakanthawi kochepa, kenako kumangokhala matenda oopsa chifukwa cha vuto laimpso.

Izi zimachitika kuti ochepa matenda oopsa amayenda mu hypotension. Izi ndi zoopsa. Kwa wodwala yemwe ali ndi matenda ashuga, ngakhale kukakamiza kwa 110/60 kumatha kukhala kovuta kwambiri ndikubweretsa kukomoka. Chifukwa chake, odwala ayenera kuwunika shuga wamagazi tsiku lililonse ndikuyezera kuthamanga kwa magazi.

Zoyambitsa hypotension mu shuga:

Kusokonekera kwa dongosolo lamanjenje yamagetsi chifukwa cha kutopa kwambiri, kupsinjika ndi kuchepa kwa vitamini. Kuwongolera njira ya moyo nthawi zambiri kumakupatsani mwayi wokonza izi ngati sizikuyenda.
Kulephera kwa mtima chifukwa cha kuwonongeka kwa mtima ndi mitsempha ya m'mimba. Matendawa ndi owopsa kwambiri ndipo amakula pang'onopang'ono. Odwala omwe ali ndi vuto la mtima komanso matenda ashuga amafunikira kuchipatala movomerezeka ndi kuperekedwa kwa chithandizo chamankhwala.
Mankhwala osokoneza bongo omwe amachepetsa kuthamanga kwa magazi. Ngati matenda oopsa a shuga asintha kwambiri kukhala hypotension, wodwala molondola amatsatira zomwe dokotalayo akuwonetsa. Izi sizoyenera kusiya mapiritsi ndikudikirira kukakamizidwa kuti akwere, chifukwa kusintha kwadzidzidzi kumatha kuyambitsa mikhalidwe yoopsa. Muyenera kupita kwa dokotala kuti akonzenso chithandizo chomwe apatsidwa ndikuchepetsa mavuto ake.

Sikovuta kunena kuti kupanikizika kwa shuga komwe ndi mtundu wanji komwe kumawonedwa kuti ndi kotsika. Chifukwa chake, ndikofunikira kuyang'ana kuzizindikiro za tonometer ndi moyo wabwino. Kuchepetsa kupsinjika kumawonetsedwa ndi zizindikiro zotere:

Chizungulire
Kukongola kwa khungu
Thukuta lozizira
Kugunda kofulumira koma kofowoka
Ntchentche zikuwuluka pamaso pa maso (zitha kutsatana ndi matenda oopsa ndi hypotension).

Ichi ndi chiwonetsero cha kugwa kwakuthwa mu kukakamiza. Akamachepetsedwa nthawi zonse, zizindikirazo sizifotokozedwa. Mu hypotonics, kumangokhala wotopa, kugona, kuzizira kwa zala ndi zala zakumaso zikuwonekera.

Matenda a diabetesic neuropathy amatsogolera kugwa kwa orthostatic - kutsika kwakuthwa kwa kuthamanga kwa magazi mukamasunama kuchoka pakama ndikukhala pamalo owongoka. Izi zimawonetsedwa ndi khungu m'maso, nthawi zina kulephera kwakanthawi. Kuti muzindikire hypotension, kuthamanga kwa shuga kuyenera kuyesedwa mutagona ndikuyimirira.

Kuopsa kwa kuthamanga kwa magazi kwa odwala matenda ashuga

Kuthamanga kwa magazi m'magazi a shuga nthawi zina kumakhala koopsa kuposa kuthamanga. Munthawi yochepa, kuchepa kwa mapanikizidwe kumayambitsa kuphipha kwamphamvu, komwe kumathandizira kuti magazi azikhala ochepa. Chifukwa cha Microangiopathy yoyambitsidwa ndi matenda ashuga, ziwiya za impso ndi ma microvasculature sizingatheke, chifukwa chake, magazi amapezeka kwa zimakhala zonse.

Njala ya okosijeni yomwe imakhala nthawi zonse imayambitsa kukulira ndi kukulira kwa matenda ashuga a m'mimba, kuwonongeka kwamaso ndikulimbikitsa kupangika kwa zilonda zam'mimba pamiyendo. Impso zimakulirakulira ndipo kulephera kwa impso kumayamba.

Kutsika kwakukulu kwa kupanikizika kwa matenda amtundu wa 1 komanso mtundu wa 2 kungayambitse kugunda kwa mtima, vuto lomwe limafunikira kuchipatala mwachangu. Ngati zizindikiro za kuthamanga kwa magazi zikuwoneka mwadzidzidzi, muyenera kuyimbira ambulansi kuti muchepetse kupweteka kwambiri kwa impso komanso kugunda kwa mtima.

Momwe mungakulitsire kuthamanga kwa magazi mu shuga?

Osayesa kuwonjezera kukakamiza nokha popanda kufunsa katswiri. Yesetsani kufufuza zomwe zimayambitsa kuthamanga kwa magazi. Ngati simungathe kupita kwa dokotala kwakanthawi, yesani njira zofatsa kuti muwonjezere zovuta:

Tengani piritsi limodzi la ascorbic acid ndi mapiritsi awiri a tiyi wobiriwira,
Mu kapu yamadzi, kuyeza madontho 30 a mizu ya ginseng pa mlingo umodzi.
Kapu ya tiyi wobiriwira wamphamvu.

Mafuta ofunikira azithandizira kuwonjezera kupanikizika: bergamot, cloves, lalanje, bulugamu, ndimu, spruce. Onjezani madontho ochepa ku nyali lonunkhira kapena kusamba ndi madontho a 7 ether. Osagwiritsa ntchito mankhwala ena popanda upangiri wachipatala. Amatha kukhala ophatikizidwa mu shuga.

Ngati mwadzidzidzi mukumva kufooka komanso chizungulire, gonani pabedi lanu ndikukweza miyendo yanu. Kutuluka kwa magazi kuchokera kumadera otsika kumapangitsa kuti mtima ubwerere m'mtima ndikukulitsa kupanikizika. Acupressure itithandiza kusintha momwe zinthu ziliri: tsitsani khutu ndi kusuntha pang'ono kwa mphindi zingapo. Malo okhala Reflex ndi malo omwe ali pamwamba pamilomo yapamwamba.

Hypotension imafunikira nthawi yayitali yakuchipatala pokhapokha ngati akuwonetsa kulephera mtima. Kenako wodwalayo amagonekedwa m'chipatala ndipo chithandizo cha mankhwala pamoyo chimasankhidwa kuphatikiza mitundu ingapo ya mankhwala. Kutulutsa kumachitika pamene mkhalidwe wabwezeretsedwa ndikuwopseza moyo kumatha.

Ngati hypotension yolembedwa pakumwa mankhwala omwe amachepetsa kuthamanga kwa magazi, dokotala amasintha mlingo wa mankhwalawo, koma osakana. Ndi hypotension motsutsana ndi maziko a vegetovascular dystonia, mankhwala a tonic (Eleutherococcus) ndi mankhwala osokoneza bongo amagwiritsidwa ntchito: Adaptol, Afobazole, Glycine ndi ena. Kukonzekera kwa multivitamin kungafotokozeke.

Malangizo otsatirawa athandiza kuwonjezera kuthamanga kwa magazi kwa mtundu uliwonse wa matenda ashuga:

Sinthani kugona kwanu ndi kukhala maso. Mugonere maola osachepera 7 patsiku ndipo mupumule mukatha ntchito. Zizolowereni ndandanda inayake: nyamuka ndipo ukagone nthawi yomweyo.
Chezani nthawi yokwanira kuyenda. Izi ndizothandiza pochepetsa magazi ndi kuwonjezera kamvekedwe ka thupi. Dziwani bwino masewera olimbitsa thupi m'mawa - masewera olimbitsa thupi amaphunzitsira zombozo ndipo ndizothandiza kwa ma pathologies aliwonse.
Imwani madzi ambiri.
Chitani masewera olimbitsa thupi ndi zala zanu ndi zala zakumaso, kutikita minofu ndi manja kuti muchotse magazi komanso kuti magazi azithamanga.
Muzisamba m'mawa uliwonse.
Pewani zipinda zonyowa komanso kutentha kwadzidzidzi.
Idyani mokwanira, m'magawo ang'onoang'ono, koma nthawi zambiri. Izi ndizofunikira kuti pakhale shuga wamagazi abwinobwino komanso kuti magazi azitha.

Kuzindikira kwa hypotension ndi matenda oopsa

Kuzindikiridwa kwa matenda oopsa kapena hypotension kumachitika ngati ziwonetsero zolakwika sizinalembedwe katatu mkati mwa masabata 2-3 pafupifupi nthawi yomweyo. Lamuloli likugwira ntchito kwa aliyense.

Popeza kuopsa kwa matenda oopsa oopsa amtundu wa 1 komanso matenda a shuga a 2, madokotala amatengera njira yodalirika yodziwira - kuwunika magazi tsiku lililonse. Njira imakuthandizani kuzindikira kulowerera koopsa komanso kuthamanga kwa magazi, kuti muwone kuphwanya kwa mawonekedwe a circadian osinthasintha magazi.

Pulogalamu yapadera imakhala yolumikizidwa ndi thupi la wodwalayo yomwe amachita zochitika zake tsiku lonse. Pafupifupi ola lililonse, kupanikizika kumayesedwa, ndipo pazida zina zamphamvu zothandizira zimayikidwa zomwe zimalemba ndendende kusiyana kwa manambala. Dokotala amalandira chidziwitso chodalirika komanso ali ndi mwayi wofufuza matenda oopsa posachedwa, kupereka mankhwala a antihypertensive, kudziwa nthawi yoyenera kumwa mankhwalawa.

Matenda Akulimbana Ndi Matenda a shuga

Kuzindikira mtundu 1 kapena mtundu wa matenda a shuga si sentensi. Anthu amakhala ndi matenda amenewa kwa zaka zambiri, chinthu chachikulu ndikuti boma liyang'anire ndikuyandikira kwambiri thanzi. Chinthu choyamba komanso chofunikira kwambiri ndicho kuphatikiza mankhwala a hypoglycemic. Cholinga cha mankhwalawa ndi kusintha shuga m'magazi. Kupeza kwake kukuwonetsa kuti adotolo adasankha mlingo woyenera wa mankhwala a hypoglycemic, omwe ayenera kumwedwa mopitilira.

Thupi limasintha komanso matenda amtundu wa shuga motsogozedwa ndi amkati komanso zinthu zakunja zimatha kupita patsogolo. Kuwunikira pafupipafupi ndi endocrinologist, kuyezetsa, kudziyesa wekha m'magazi - izi ndi njira zovomerezeka zomwe zimayambitsa matenda ashuga, omwe, ngati anyalanyazidwa, akuwopseza moyo.

Gawo lotsatira ndikudya.Kuchotsa kwa chakudya cham'mimba mosavuta ndi gawo lofunikira kwambiri kuposa momwe chithandizo cha hypoglycemic sichingagwire ntchito. Dokotala ndi wodwala amatenga nawo mbali popanga zakudya zopatsa thanzi. Osawopa kufunsa mosamala kwa endocrinologist za zoletsa mtundu 1 ndi matenda ashuga 2. Funsani dokotala mwatsatanetsatane zomwe mungadye ndi matendawa osawopa kukweza shuga.

Mfundo yachitatu yofunika kuchita ndi masewera olimbitsa thupi mokhazikika. Ntchito ya minofu imafuna shuga ndipo imakulolani kuti muchepetse shuga, muchepetse mankhwala. Chitani masewera olimbitsa thupi mu sitima za sitima za shuga, kukonza kutanuka kwawo.

Kuthamanga kwa magazi sikuthana ndi kuperekera kwa Mlingo wochepa wa ACE zoletsa kuti muchepetse kuwonongeka kwa impso. Gawo limodzi la mapiritsi a enalapril patsiku silingayambitse kuwonongeka, koma impso zimatetezedwa kale ku matenda ashuga. Musayambe kumwa inhibitors ya ACE nokha - funsani dokotala.

Kutsatira malangizo azachipatala, mumakwaniritsa shuga wabwinobwino ndipo kwa nthawi yayitali musanayambike zovuta za matenda ashuga. Hypotension ndi matenda oopsa a mtundu 1 ndi matenda ashuga 2 amachitika pafupipafupi, ndipo zovuta zawo zimakhalanso pachiwopsezo cha moyo. Chifukwa chake, muyeso wa kuthamanga kwa magazi uyenera kukhala chizolowezi chodwala wodwala matenda ashuga.

Zowopsa mu shuga

Magazi a munthu wodwala matenda ashuga amakhala ndi kuchuluka kwa insulini, komwe kumapangitsa kuwonongeka kwamitsempha, makamaka yaing'ono (arterioles). Kutalika kwa zombo kumachepa ndipo, kuwonjezera pa kuthamanga kwambiri, izi zimatha kubweretsa zovuta zingapo, monga:

Atherosulinosis,
Matenda a mtima
Matenda a mtima, sitiroko,
Anachepetsa mtsempha wamagazi
Matenda a matenda a impso
Kuwonongeka kowoneka ndi khungu.
Kulephera kwa mtima.

Kuphatikiza apo, thupi la wodwala yemwe ali ndi matenda a shuga amakhalanso ndi mchere wambiri ndi madzi, zomwe zimapangitsa kuti pakhale mchere wambiri. Ichi ndichifukwa chake madokotala amalimbikitsa kuti odwala matenda ashuga asiyiretu kugwiritsa ntchito zakudya zoperewera mchere.

Mtundu woyamba wa matenda a shuga a mellitus, chomwe chimayambitsa kuthamanga kwa magazi ndi, monga lamulo, kuwonongeka kwa impso (diabetesic nephropathy). Ndipo ndi matenda amtundu wa 2, pali zinthu zingapo zomwe zingayambitse matenda oopsa nthawi imodzi.

Zinthu zomwe zimawonjezera mwayi wokhala ndi matenda oopsa mu shuga:

Kunenepa kwambiri, kukalamba,
Kupsinjika nthawi zonse
Ntchito zambiri ndi ntchito,
Kuperewera kwa zakudya m'thupi
Kuperewera kwa mavitamini, michere ndi zinthu zina zofunika,
Zotsogolera,
Matenda a endocrine
Zovuta zopumira (mwachitsanzo, kugona tulo),
Atherosclerosis, kuwonongeka kwa impso, kusokonezeka kwamanjenje.

Zizindikiro za matenda oopsa komanso kufunikira kwa zizindikiro

Kukula pang'ono kwa kuthamanga kwa magazi (BP) nthawi zambiri kulibe mawonekedwe. Wodwala samamumvera, chifukwa chake amatchedwa "wakupha chete".

Kwa zaka zambiri ndakhala ndikuphunzira za zovuta za DIABETES. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsa odwala matenda ashuga mellitus. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 100%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipilira mtengo wonse wa mankhwalawo. Ku Russia ndi mayiko a CIS odwala matenda ashuga kale Julayi 6 alandire mankhwala - ZAULERE!

Woopsa milandu:

mutu, kutopa, kusokonezeka kwa tulo,
wodwala amawona kufooka,
kuona kwakumaso kumachepa.

Pali zizindikiro ziwiri za kuthamanga kwa magazi, komwe kulembedwa manambala awiri, mwachitsanzo, 110/70. Zizindikiro zimatsimikizira kuthamanga komwe kumakhala malinga a masipilamu a milimita a chipilala cha Mercury (mmHg). Nambala yoyamba ikuwonetsa kupanikizika kwa systolic, ndiye kuti, zomwe zimachitika minofu yamtima ikachepetsedwa. Nambala yachiwiri imatsimikiza kukakamizidwa kwa diastolic komwe kumachitika pazitseko zam'mimba panthawi yomwe minyewa yamtima imatha kupumula kwathunthu.

Makhalidwe azikhalidwe wamba ndi zofunikira pa matenda oopsa: