Matenda a shuga

Matenda a shuga
Kutsegula foloko - chida chodziwitsa za mavuto ammunsi
ICD-10	G 63.2 63.2, E 10.4 10.4, E 11.4 11.4, E 12.4 12.4, E 13.4 13.4, E 14.4 14.4
ICD-9	250.6 250.6
ICD-9-KM	250.6
Medlineplus	000693
Mesh	D003929

Matenda a shuga (ena achi Greek čiϋρíni - "nerve" + wina wachi Greek πάθος - "mavuto, matenda") - zovuta zamitsempha zamagazi zomwe zimagwirizanitsidwa ndi kuthana ndi matenda a shuga a m'mitsempha yamagazi (vasa vasorum, vasa manthaorum) - imodzi mwazofala kwambiri zovuta, osati kungoyambitsa kuchepa kwa ntchito, komanso nthawi zambiri zomwe zimapangitsa kuti pakhale kuvulaza kwakukulu komanso kufa kwa odwala. Njira ya pathological imakhudza ulusi wamitsempha yonse: sensory, motor and autonomic. Kutengera kuchuluka kwa kuwonongeka kwa ulusi wina, mitundu yosiyanasiyana ya matenda am'mimba amamuwonera: ma sensenti (ozindikira), a sensory-motor, autonomic (autonomous). Siyanitsa pakati pa neuropathy yapakati komanso yachiphuphu. Malinga ndi gulu la V. M. Prikhozhan (1987), kuwonongeka kwa bongo ndi chingwe cha msana kumawerengedwa kuti ndi neuropathy yapakati ndipo, motero, kumagawika:

Cerebrovascular ngozi

Poyerekeza ndi maphunziro a shuga, chiopsezo chokhala ndi kupsinjika kwa ubongo kumakulirakulira. Malinga ndi zotsatira za kafukufuku wofufuzira wa nthawi yayitali, zidapezeka kuti kuchuluka kwa matenda amiseche kumafikira anthu 62.3 pa anthu 1,000, pomwe pagulu lalikulu ndi anthu 32.7 pa anthu 1,000 pazaka 12 zowonera. Komabe, ziwopsezo za kugundana kwa hemorrhagic ndi kuwonongeka kwakanthawi kwamatumbo sizimasiyana ndi zomwe zimachitika kawirikawiri. Kukhazikitsidwa kuti shuga mellitus imakhala pachiwopsezo cha chitukuko cha ngozi ya ubongo, mosasamala kanthu za kukhalapo kwa zinthu zina zowopsa (matenda oopsa a ubongo, hypercholesterolemia).

Komabe, njira ya matenda a ischemic pakati pa anthu odwala matenda ashuga imachulukirachulukira mwachilengedwe, kudwala kwambiri, kufa kwambiri komanso kulumala poyerekeza ndi stroke pagulu lopanda matenda a shuga. Pakafukufuku wopangidwa ndi Lithner et al mu 1988, chiwerengero cha anthu odwala matenda a shuga chinali 28%, ndipo mwa anthu opanda shuga, 15%. Zoipa zoyipa komanso zotsatira za matenda opha ziwonetsero zomwe zimayambitsa matenda osokoneza bongo zimayambitsidwa chifukwa cha zovuta zambiri zobwera m'magazi. Kafukufuku wokhudzana ndi matenda a ku U.S. adapeza kuti chiopsezo chobwera mwadzidzidzi matenda obwera chifukwa cha matenda oyambitsidwa ndi anthu odwala matenda ashuga ndi 5.6 kwambiri kuposa chiwopsezo chofanana ndi cha anthu omwe adwala matenda a stroke koma alibe matenda a shuga (Alter ndi et al., 1993).

Kufunika kwa hyperglycemia monga gawo lodziwikiratu pakuchitika kwa stroke, onse pakati pa anthu omwe ali ndi matenda osokoneza bongo, amakhalabe akutsutsana. Hyperglycemia nthawi zambiri imaphatikizidwa ndi stroke yayikulu: mbali imodzi, imatha kukhala chiwonetsero cha matenda osokoneza bongo omwe amadziwika kale, ndipo, kumbali inayake, amayamba chifukwa cha kupsinjika komwe kumayendera limodzi ndi kukula kwa stroko. Nthawi yomweyo, pafupipafupi matenda a shuga opezeka m'matenda a sitiroko (omwe sanapezeke kale) amakhalabe okwera ndipo, malinga ndi maphunziro osiyanasiyana, amachokera ku 6 mpaka 42%. Mu 1990, a Davalos et al. Anakhazikitsa kulumikizana kwapakati pa kuvuta, kuwonongeka kwa sitiroko, ndi shuga wamagazi panthawi yachipatala. Komabe, funsoli silinafotokozedwe bwino: kodi hyperglycemia ndi chiopsezo chodziyimira pang'onopang'ono pakukula kwa ngozi ya ubongo kapena kumangowonetsa kuuma kwa sitiroko yomwe yayamba, kuchuluka kwake komanso kutengera kwakeko.

Kafukufuku wofufuza wa odwala 411 omwe ali ndi mtundu wa matenda a shuga 2, ochitika kwakanthawi zaka 7, anapeza kuti kusala kwamwazi wamagazi kumalumikizana ndi kuchuluka kwa odwala omwe akudwala matenda amtima komanso ndi vuto lodziyimira payekha lomwe lingayambitse kukula kwa macroangiopathy, kuphatikizapo kusokonekera kwa mitsempha .