Matenda A shuga

SUGAR IMAKHALA NGATI MALO OGWIRITSIRA NTCHITO

GKKP "Kostanay Regional Hospital", Republic of Kazakhstan, Kostanay

Matenda a shuga mellitus (DM) ndi amodzi mwazomwe zimayambira pakudziyimira pawokha pachitukuko cha ngozi ya pachimake (stroke). Kukula kwa matenda ashuga pakati pa odwala omwe ali ndi vuto la pachimake kwambiri 11 11%. Pakadali pano pali anthu 285 miliyoni omwe ali ndi matendawa padziko lapansi. Odwala omwe ali ndi matenda ashuga kuposa zaka 65, matenda opha ziwengo ndiwachiwiri. Komanso, matenda ashuga ndiwopseza osati matenda oyamba okha, komanso a stroke kawirikawiri. Komanso, phindu la matenda ashuga monga chiopsezo cha matenda opha ziwopsezo lakhala likuwonjezeka pang'onopang'ono m'zaka zaposachedwa (kuchokera pa 6.2% mpaka 11.3%) mwa chiwerengero chonse cha odwala omwe ali ndi stroke. Zomwe zimayambitsa kukhazikika kwa odwala omwe ali ndi matenda a shuga agawika matendawa chifukwa cha matendawa (hyperglycemia, kupezeka kwa zovuta za cellvascular, insulin kukana, zina) komanso zosadziwika (matenda oopsa, dyslipidemia, cholowa chamtsogolo, kusuta, kufunikira kwazomwe zimapangidwira kwambiri motsutsana ndi matenda osokoneza bongo. ) Chiwerengero cha ischemic / hemorrhagic stroke mwa odwala matenda ashuga, malinga ndi kafukufuku wamatenda, ndi 11: 1, pomwe ambiri ndi 5: 1. DM sikuti imangowonjezera chiwopsezo cha matenda opha ziwopsezo, komanso imayendetsedwa ndi maphunziro owopsa kwambiri komanso zotsatira zoyipa kwambiri za sitiroko yomwe yakula, komanso chiwerengero chaimfa cha odwala omwe ali ndi matenda am'mimba komanso matenda a shuga, onse ali kuchipatala kuchipatala ndipo nthawi yayitali, ndi nthawi 2-5 apamwamba kuposa odwala stroko opanda concomitant shuga. 16% ya milandu yomwe imapha amuna ndi 33% mwa azimayi chifukwa cha sitiroko imayamba chifukwa cha matenda ashuga komanso zinthu zina zomwe zimayambitsa chiopsezo. Mu 6 -40% ya odwala omwe ali ndi stroke, opanda matenda amtundu wa shuga, pali ena otchedwa reactive trigueent hyperglycemia

amakula ngati chinthu chofunikira poyankha kupsinjika. Pakadali pano

mayesero azachipatala, njira zakhazikitsidwa popewa kuthana ndi sitiroko kwa odwala matenda ashuga. Uku ndikoika kwa hypoglycemic, antihypertensive, hypolipidemic komanso kukhudza masoka a magazi a zinthu zamagazi. Njira yothandiza kwambiri yochepetsera chiopsezo cha matenda opha ziwopsezo ndikupereka mankhwala okwanira a antihypertensive kuti mukwaniritse "mulingo woyenera" wamagazi (BP), omwe mwa odwala matenda ashuga sayenera kupitirira 130 80 mm Hg. Kuchepetsa kwa magazi a systolic ndi 10 mmHg kuthamanga kwa magazi kwa diastolic ndi 5 mm Hg, odwala matenda ashuga, kumachepetsa chiopsezo cha 44%. Kuti achulukitse zizindikiro za kuthamanga kwa magazi, mankhwalawo amagwiritsidwa ntchito - ACE inhibitors, angiotensin II receptor blockers, diuretics, calcium block blockers, beta-blockers. Matenda amtundu wa glycemia amakhalabe gawo lofunikira kwambiri la matenda a shuga komanso amalepheretsa kukula kwa zovuta za microvascular. Kukhazikitsidwa kwa mankhwala ochepetsa lipid ndi gawo lofunikira kwambiri lothandizira odwala ndi cholinga chopewa zovuta zamtima, kuphatikizapo mikwingwirima. Chitsogozo chofunikira popewa kukangana kwa odwala matenda a shuga ndikukhazikitsidwa kwa ndalama zomwe zimapangitsa kuti magazi azisinthika komanso magazi azithanso. Mankhwala omwe amagwiritsidwa ntchito kwambiri chifukwa chaichi ndi acetylsalicylic acid (thromboass), omwe amalimbikitsidwa kwa odwala onse omwe ali ndi matenda osokoneza bongo omwe ali ndi zaka zopitilira 40 (posagwirizana ndi zotsutsana), nthawi zambiri amakhala ndi kuthekera kwakukulu kwa dongosolo la magazi.

Multifactorial zovuta mankhwala odwala odwala matenda ashuga, umalimbana kukonza okwanira kuchuluka kwa hyperglycemia, "mulingo woyenera" kuthamanga kwa magazi, dyslipidemia, kusintha kwatsoka magazi ndi ziwalo zam'magazi, ndi njira yoyenera komanso yachiwiri yoletsa kukwiya kwamtunduwu wa odwala.

Stroko: chithunzi chachikulu

Ubongo wathu, monga chiwalo china chilichonse, umaperekedwa ndi magazi mosalekeza. Chimachitika ndi chiani ngati magazi amitsempha yamagazi Ubongo udzasiyidwa popanda michere, kuphatikizapo mpweya. Ndipo kenako ma cell aubongo amayamba kufa, ndipo ntchito za malo okhudzidwa ndi ubongo zimasokonekera.

• mtundu wa ischemic (umakhala ndi 80% ya mikwingwirima yonse) umatanthawuza kuti mtsempha aliyense wamagazi m'mitsempha yaubongo anali wotsekedwa ndi thrombus,
• mtundu wa hemorrhagic (20% ya milandu yovutitsidwa) ndi chotupa cha mtsempha wamagazi ndi kukha magazi pambuyo pake.

Kodi mikwingwirima ndi shuga zimagwirizana bwanji?

1. Mu shuga mellitus, mitsempha yamagazi imakhudzidwa ndi atherosclerosis. Makoma amitsempha yamagazi amataya kusinthika kwawo ndipo amakula ndi cholesterol plaque kuchokera mkati. Mitunduyi imatha kukhala magazi m'magazi ndikusokoneza magazi. Izi zikachitika muubongo, sitiroko ya ischemic imachitika.
2. Metabolism mu shuga imakhala yodwala kwambiri. Mchere wamchere wamchere ndiwofunika kwambiri kuti magazi azithamanga. Mu odwala matenda ashuga, kukodza kumakhala kofupikirapo, chifukwa cha izi thupi limataya madzimadzi ndipo magazi amadzuka. Ngati mukukayikira kubwezeretsanso madziwo, kufalitsidwa kwamtopola kumatha kukubweretsani stroko.

Cholowa m'malo mwa Xylitol - ziyenera m'malo mwake ndi shuga? Pindulani ndi kuvulaza.

Sinamoni mu wowerengeka azitsamba. Maphikidwe, katundu wofunikira - werengani zambiri apa.

Zizindikiro za Khosi

Ndi dokotala yekhayo amene angadziwitse moyenera 100%. Mankhwala amadziwa mavuto omwe munthu wodwala matenda ashuga sanasiyanitse nawo nthawi yomweyo chifukwa cha matenda opweteka. Chinthu china chinachitika - sitiroko idakulidwa motsutsana ndi maziko a chikomokere. Ngati muli ndi matenda ashuga ,chenjezani ena za zoopsa zomwe zingachitike. Kodi pali anthu omwe ali ndi matenda ashuga m'dera lanu? Onani zotsatirazi:

• ululu wopanda pake m'mutu,
• kufooka, dzanzi la miyendo (kumanja kapena kumanzere) kapena theka lathunthu la thupi,
• Imakhala mitambo m'maso amodzi, masomphenyawo sawoneka bwino.
• kusazindikira zomwe zikuchitika, zokambirana za ena,
• zovuta kapena kusatheka kwa mawu,
• kuphatikiza chizindikiro chimodzi kapena zingapo zomwe zalembedwedwa kuti muchepetse kuyendetsa bwino, bwino, kugwa.

Chithandizo cha stroko

Ngati dokotala amamutsogolera wodwalayo panthawi yomweyo ngati akumenyedwa ndi matenda ashuga, ayenera kukumbukira chithandizo chamankhwala odwala matenda ashuga, kuwerengetsa momwe angapangire pambuyo poti adwale matenda a sitiroko komanso kupewa kupewa kusokonezeka kwa magazi.

• kuyang'anira kuthamanga kwa magazi (matenda a kuthamanga kwa magazi),
• kutsatira kagayidwe
• kugwiritsa ntchito mankhwala abwinobwino kwa wodwalayo kuti achepetse kuchuluka kwa shuga m'magazi (malinga ndi mtundu wa matenda ashuga),
• njira zothetsera matenda a edema (odwala matenda ashuga, izi zikachitika chifukwa cha matenda opha ziwalo zomwe zimachitika kawirikawiri kuposa odwala omwe alibe matenda ashuga),
• Mankhwala omwe amaletsa magazi;
• kukonzanso mwatsatanetsatane kwa magalimoto owonongeka ndi ntchito.

Kuthana ndi sitiroko kumatenga nthawi yayitali komanso kovuta. Komabe, sitiroko imatha kupewedwa, ndipo njira zake ndizosavuta.

Zithandizo zamankhwala amiseche. Zambiri pankhaniyi.

Kupewa matenda a shuga

Malingaliro ochepa chabe amapulumutsa anthu ambiri omwe ali ndi matenda ashuga ku sitiroko. Ndikofunikira kuwonetsetsa aliyense wa iwo.

1. Kuti muchepetse vuto la metabolic, zakudya zapadera ndizofunikira.
2. Misozi imafunika kuzimitsidwa nthawi iliyonse ikatuluka (izi zimapangitsa magazi kutuluka).
3. Kukhala moyo wongokhala sikovomerezeka. Kupanda kutero, ngakhale mphamvu yaying'ono yakuthupi imathandizira kayendedwe ka magazi kuti mitsempha (kuphatikizapo ubongo) izidzaza ndikuyenda kwa magazi kusokonekera.
4. Osadumphira jakisoni wa insulin kapena mankhwala ochepetsa shuga.

Matenda a shuga monga chiopsezo cha sitiroko

Matenda a shuga ndi omwe amayambitsa zovuta zambiri mthupi la munthu, chithandizo chomwe chimapangidwa ndi zovuta za munthu payekha. Ndi matenda ashuga, mchere wamchere wa wodwalayo umasokonezeka kwambiri, chifukwa chakuti mamolekyulu a glucose omwe amapezeka amatulutsa timadzi tambiri tambiri tambiri.

Kuchuluka kwa mkodzo kumawonjezera, komwe kumakhala chifukwa cha kutopa. Khoma lamitsempha yamagazi moyang'ana kumbuyo kwa kusinthaku ndi lopunduka, magazi amadzuka, ndipo mawonekedwe ampikisano wamagalimoto ndikukula kumapangika pazitseko zamitsempha yamagazi. Njira yakuchira imachepetsa kwambiri, magazi amafunafuna njira zatsopano.

Zofunika! M'mbuyomu, mkhalidwe wowopsa ngati sitiroko udapezeka makamaka mwa odwala okalamba, tsopano omwe ali pachiwopsezo ndi oimira azaka zosiyanasiyana, kuphatikiza ana ndi achinyamata.

Ndi hemorrhagic stroke, pamakhala magazi a m'matumbo ndi ziwalo zina. Pambuyo pa kufalikira kwamitsempha yamagazi ndi magazi, magazi amayamba.

Mu matenda ashuga, ndimazindikira kuti ndili ndi matenda oopsa ngati ndindendende kangapo m'malo mwa odwala athanzi, izi zimachitika chifukwa cha zinthu zomwe zikuwonetseratu:

• chiopsezo chachikulu chotenga matenda a mitsempha ya mitsempha,
• chiyembekezo cha thrombosis,
• Njira yakukula kwa magazi imayambitsidwa chifukwa cha kuchepa kwa madzi,
• osagwirizana ndi malamulo a zakudya.

Ndi matenda a shuga, atherosulinosis imayamba. Zombo zija nthawi yomweyo zimataya mphamvu yake ndikukhala wocheperako, chiopsezo chowatsekeka ndi mitsitsi yamagazi chikuchulukira.

Thrombosis imapanga zofunikira zoyambitsa chitukuko cha ischemia, zakudya zam'mimba zimasokonekera ndi mpweya. Zotsatira za kusintha koteroko zingakhale zosiyana.

Potengera momwe izi ziliri, kuchuluka kwa madzi a m'magazi kumachepetsedwa kwambiri, chifukwa madzi amachotsedwa mthupi kwambiri, ndipo njira zowonetsetsa kuti kubwezeretsedwako sikuperekedwa pamlingo wofunikira. Maso amitsempha yamagazi amawonjezeka kwambiri chifukwa cha zunifolomu.

Zotsatira zoyipa zakugonjetsedwa.

Zofunika! Zotsatira za kupweteka kwa odwala matenda ashuga ndizowopsa. Njira yakuchira ndiyovuta. Kutupa kwakukulu kumapezeka.

Ndizotheka kupewa kukula kwa sitiroko kwa odwala omwe ali ndi vuto la insulin. Pankhaniyi, gawo lotsogolera limaseweredwa ndi zakudya kuphatikiza ndi insulin yokwanira.

Zambiri za kukula kwa matenda a sitiroko

Odwala omwe amapezeka ndi matenda osokoneza bongo ali ndi mawonekedwe ena a mawonekedwe a matenda a ubongo

1. Poyerekeza ndi sitiroko, odwala ambiri amakhala ndi hypoglycemia.
2. ambiri otchulidwa ubongo edema.
3. Ndi chiwonetsero cha matenda am'mimba, chiwonetsero chakuthwa cha shuga chimawonedwa.
4. Stroko imalumikizidwa ndi chiopsezo chachikulu cha imfa.

Nthawi zambiri, odwala amawonetsa zovuta zofanana ndi zizindikiro za kugwidwa. Ma pathologies oterowo nthawi zambiri amakhala amanjenje mwachilengedwe.

Zizindikiro za sitiroko

Mndandanda wazizindikiro zokhudzana ndi sitiroko ukhoza kuimiriridwa motere:

• kumverera kofooka
• dzanzi mikono ndi miyendo, makamaka mbali imodzi ya thupi.
• ziwalo za thupi lililonse.
• malingaliro operewera
• kusazindikira ndi kutulutsa mawu,
• kupweteka kwambiri m'mutu
• kuwonongeka kwamawonekedwe,
• kulephera kumeza malovu,
• kutayika kwa bwino, kusayenda bwino kwa kayendedwe,
• kulephera kudziwa.

Kanemayo munkhaniyi afotokozera odwala zoyamba za matenda a sitiroko.

Zochizira

Thandizo la panthawi yake.

Pokhala ndi zodziwikiratu kuti ali ndi vuto lodwala, wodwalayo amatha kugona pakama, zovala zosakhazikika, chovala chamkati kapena zotsala zamasanza zimachotsedwa pamkamwa. Kuti mupeze mpweya wokwanira tsegulani mawindo "pa mpweya wabwino". Mutu ndi mapewa a wodwalayo ayenera kugona pilo kuti khosi lisakokome, ndipo magazi akuyenda m'mitsempha ya vertebral sikuwonongeka.

Thandizo lakuchipatala liyenera kuyamba atangotsimikizira kuti ali ndi stroke. Tiyeneranso kudziwa kuti kuthandizira pochiritsa pamankhwala awa kumadalira mgwirizano waomwe amachitidwa kuchipatala.

Choyamba, mankhwala a thrombolytic mu mawonekedwe a jekeseni wa intravenous ndi omwe amapatsidwa. Ngati mankhwalawa amathandizidwa pakapita mphindi zochepa pambuyo poti adwala, akhoza kuchira kwathunthu.

Kuthandizira opaleshoni

Kuphatikiza pa njira yothandizira mankhwalawa, njira ya opaleshoni imagwiritsidwa ntchito nthawi zambiri. Njira yofananayo ikuphatikizira kuchotsa ziwalo, zomwe zimapangitsa magazi kupita ku ubongo.

Njira yakuchiritsira imagwiritsidwa ntchito kwambiri kawirikawiri, yomwe imakhudzana ndi chiwopsezo cha mawonekedwe a zovuta pakagwiritsidwe ntchito.

Zakudya za odwala matenda ashuga pambuyo sitiroko ndikofunikira kwa aliyense. Zakudya zoyenera ndizofunikira kuti muchepetse kukonzanso komanso kuti muchepetse ngozi yachiwiri.

Malamulo akulu olamulira njira yophatikiza zakudya amakambidwa pagome:

Ndi malamulo ati omwe akuyenera kuganiziridwa popanga mndandanda wa odwala matenda ashuga?
Kuyamikira	Kufotokozera	Chithunzi pamakhalidwe
Kubwezeretsa boma lakumwa	Kukula kwa magazi mu matenda am'madzi am'mimba kumachitika nthawi zambiri chifukwa cha madzi am'mimba, motero wodwala ayenera kumwa madzi nthawi zonse pakachira. Zakumwa zololedwa ndizophatikizira misuzi ndi ma compotes, tiyi, komanso madzi oyera. Zakumwa zokhala ndi shuga, koloko ndi khofi ndizoletsedwa.	Njira yakumwa.
Kukana zamafuta	Wodwala ayenera kukana kwathunthu chakudya chomwe chili ndi cholesterol.	Kukana zamafuta.
Mchere	Pambuyo pa sitiroko, ndikofunikira kusiya ntchito mchere. Kukhazikitsa izo mu zakudya zazing'ono Mlingo ndizotheka pokhapokha kuchira kwathunthu.	Mchere wovulala.
Potaziyamu	Mu chakudya odwala ayenera kupezeka potaziyamu mu mawonekedwe apadera mavitamini kapena zinthu zomwe zimakhala nazo. Ndikofunikira kulimbitsa minofu yamtima ndi zotchinga zamagazi.	Potaziyamu mu chakudya.
Mavitamini	Menyuyi muyenera kukhala ndi zipatso komanso masamba. Zogulitsa zithandizira kubwezeretsanso kupezeka kwa vitamini B, popanda kupanga cholemetsa m'thupi.	Zakudya zamasamba.

Malangizo a kuchira ayenera kutsatiridwa mosalephera. Kulephera kutsatira malangizo a kadyedwe kumayambitsa zovuta.

Malangizo othandiza

Kupewa kwa stroke ku matenda a shuga ndi osavuta. Chidwi cha wodwalayo chiyenera kuyimitsidwa poti kupewa kupewetsa matenda opha ziwopsezo ndikosavuta kuposa pambuyo pake kuchotsa zotsatira zake zowopsa.

Mndandanda wa malingaliro akulu omwe amathandizira kupewa matenda omwe ali pachimake ndi motere:

• Kukana kwathunthu chizolowezi cha chikumbumtima,
• kukana kumwa zakumwa zoledzeretsa zilizonse, makamaka zakumwa zoledzeletsa zamkati,
• kuletsa zakudya zomwe zimakhala ndi mafuta owopsa,
• kuyang'anira pafupipafupi zizindikiro za kuthamanga kwa magazi,
• kuyang'anira shuga
• kumwa aspirin malinga ndi malingaliro a katswiri, mlingo umatsimikiziridwa payekhapayekha.

Odwala omwe ali ndi matenda a shuga ayenera kutsatira mosamalitsa zofunikira za katswiri. Mtengo wa kusatsatira kwawo nthawi zina umakhala wokwera kwambiri. Tiyenera kukumbukira kuti njira yovuta ya matenda ashuga imachulukitsa ngozi ya stroke.

Zotsatira za matendawa

Panthawi yochira pambuyo poti adwala, wodwala ayenera kumwa madzi okwanira, njira yofananayo ikhoza kuchepetsa mwayi wokhala magazi. Mulingo woyenera wa tsiku ndi tsiku wa madzi uyenera kutsimikiziridwa molumikizana ndi dokotala kuti tipewe kuwonongeka kwa impso.

Odwala amatha kukumana ndi mitsempha yomwe imafuna chithandizo chovuta. Madokotala amagogomezera kuti ziwengo za anthu odwala ziwopsezo zikukula mosavomerezeka. Odwala nawonso sayenera kuiwala za kuthekera kwakukulu kokula kwa mitundu yayikulu ya mtima.

Yang'anani! Choopsa kwambiri ndicho sitiroko yochitika pang'onopang'ono, yomwe imatha kubweretsa kukomoka kapena kufa ngakhale njira zonse zofunikira zochiritsira zachitika.

Odwala onse omwe apezeka ndi matenda osokoneza bongo, makamaka, ayenera kukumbukira kuti kuphwanya koteroko ndizowopsa kwambiri ndipo kupatuka kulikonse kuchokera kumalamulo osankhidwa a matenda a shuga kungakhale chifukwa chodwala. Ndikofunika kukumbukira kukumbukira kufunika kokhala ndi zakudya zoyenera komanso kusiya zizolowezi zoipa, kuchita masewera olimbitsa thupi mopepuka.

Pamaso pa kunenepa kwambiri kwa thupi, odwala amalangizidwa kuti achepetse thupi. Chithandizo chokwanira cha hypoglycemic chikuyenera kutsimikiziridwa ndi adokotala. Dokotala adzakuthandizani kudziwa kuchuluka kwa insulin.

Funso kwa katswiri

Masana abwino Masiku anayi apitawo, agogo anga adagonekedwa kuchipatala ali ndi stroke. Stroke ndi matenda ashuga, ali ndi zaka 86, kodi pali mwayi wina wochira. Kugwedeza kumanzere, osalankhula.

Masana abwino Ndizovuta kwambiri kulosera zamtsogolo motere; simunapereke zotsatira za kafukufukuyu. Zaka zimalimbikitsa kuti kuchira kwathunthu ndizosatheka.

Tsiku labwino. Ndili ndi matenda a shuga a 2, ndipo ndimakonda kupweteka mutu. Ndiuzeni, kodi uku sikukuyenda kwa stroko yomwe ingatheke? Ndimakhala ndi moyo wathanzi, kutsatira zakudya.

Masana abwino Ayi, kupweteka kwa mutu sikuwonetsa kukonzekera. Chongani cholozera cha shuga munthawi yamayambiriro a zowawa ndikatha.

Atherosulinosis ya mitsempha: gawo la genesis ya matenda

Stroko imasokoneza magazi kupita ku ubongo. Malinga ndi akatswiri a National Heart, Lung, and Blood Institute (NHLBI), uwu ndi matenda oopsa omwe angayambitse kulumala kwanthawi yayitali ngakhale kufa.

Ndi nthawi yayitali ya matenda ashuga, chiopsezo chokhala ndi stroke chikukulira pazifukwa zingapo. Choyamba, odwala matenda amtundu wa 2 amakhala ndi vuto losakhazikika la mitsempha, yomwe imasokoneza magazi m'magazi ndi ziwalo. Nthawi zambiri, ochepa atherosulinosis amakwiya mwa odwala omwe ali pachiwopsezo, monga kunenepa kwambiri, kuthamanga kwa magazi kapena dyslipidemia (kuwonjezeka kwa kuchuluka kwa cholesterol yoyipa).

Chifukwa chiyani chiwopsezo cha sitiroko ndi chachikulu?

Chiwopsezo cha matenda a sitiroko chimakulanso chifukwa cha kuwonongeka kwakanthaŵi kwa mitsempha yamagazi. Kuchuluka kwa shuga kosafunikira m'magazi pakapita nthawi kungayambitse kusintha m'mitsempha yamagazi, kuwapangitsa kukhala osalimba komanso owonda. Izi zimatha kuthira magazi kwathunthu kupita ku ziwalo kapena ziwalo zamkati, kuphatikizapo ubongo, zomwe zimayambitsa kugunda.

Kusuta komanso kusachita zinthu zolimbitsa thupi kumathandizanso kuti munthu akhale ndi matenda ashuga. Zina zomwe zimawonjezera chiopsezo cha kumenyedwa, koma zomwe sizingatheke kuti wodwalayo athe, ndi monga:

• Cholowa cham'tsogolo (izi zimaphatikizapo ziwongo zam'magazi m'mabanja, ndi mikwingwirima, matenda amtima, matenda amtima, matenda a shuga)
• Kukalamba.
• Kukhalapo kwa odwala wodwala cell anemia.
• Kuzindikira kulephera kwa mtima, kugunda kwam'mbuyomu, kapena kusokonezeka kwa mitsempha ya mtima.

Zowopsa zonsezi zimapanga, motsutsana ndi maziko a shuga omwe alipo, chiwopsezo chachikulu cha sitiroko.

Matenda a shuga komanso kuopsa kwa ma pathologies

Malinga ndi ziwerengero, chiopsezo cha kugwidwa ndi matendawa kwa azimayi omwe ali ndi matenda ashuga ndiwochuluka kuposa kawiri kwa azimayi opanda matendawa. Chiwopsezo cha kugwidwa ndi amuna chimakhala chachikulu kuposa nthawi 1.8. Malinga ndi kuyerekezera kwina, chiwopsezo ndichokwera kwambiri kuposa ziwonetsero zofunikira, zomwe zimagwirizanitsidwa ndi kupezeka kwa concomitant pathologies mwa anthu ambiri omwe ali ndi matenda ashuga.

Kwa anthu omwe amapezeka ndi matenda a shuga, ambiri mwa awa ndi matenda a ischemic. Kutupa kwa mitsempha yaubongo kumachitika kawirikawiri, nthawi zambiri kumalumikizidwa ndi ma dongosolo a magazi a mtima komanso matenda oopsa. Ngakhale wodwalayo sangathe kuwongolera zinthu zonse zomwe zimayambitsa vuto kukhala zowopsa, zosintha zina zofunika pamoyo wa munthu akapezeka ndi matenda a shuga zimatsimikiziridwa.

Samalani shuga yanu yamwazi!

Ndikofunika kudziwa nthawi zonse shuga kuti magazi azisamalidwa. Madotolo amayesa kulimbikitsa odwala kuti azikhala ndi kutsimikiza mtima kwa shuga kuyambira nthawi yomwe akuphwanya kugwirizira kwa shuga (m'mbuyomu mkhalidwewu umatchedwa pre -abetes). Izi ndikuti tilewe kapena kuchedwetsa kukula kwa matenda a shuga a mtundu wachiwiri.

Mwa kuyang'anira shuga wamagazi pafupipafupi, odwala amatha kupewa zovuta zaumoyo monga stroke. Ndikofunika kufunsa thandizo la endocrinologist, pitani pasukulu ya shuga kuti muphunzire momwe mungayendetsere kuchuluka kwa shuga m'magazi motsutsana ndi zochitika zosiyanasiyana. Sizikudziwikabe ngati kuwongolera matenda a shuga kumathandizira kupewa matenda a sitiroko, koma kuwongolera matenda ashuga ndikofunikira pa thanzi lathunthu.

Kufalikira kwa ubongo, matenda oopsa, kuyang'aniridwa kwa madokotala

Pa kuthamanga kwambiri, kufalikira kwa magazi mu ubongo kumasokonezeka, zomwe zimawonjezera ngozi za zovuta zakupha. Chiwopsezo cha matenda opha ziwonetsero za matenda amtundu wa 2 chimachepetsedwa motsutsana ndi maziko azowunika magazi pafupipafupi. Kuwongolera kuthamanga kwa magazi kumachepetsa chiopsezo cha matenda amtundu uliwonse, kaya ndi kutaya magazi mu ubongo kapena ischemia. Ndikofunikira kuyeza kupanikizika pafupipafupi, ndipo ndi kuchuluka kwake, imwani mankhwala onse omwe adokotala adauzidwa.

Chofunikanso chimodzimodzi ndi kuyendera dokotala pafupipafupi. Kuwunikira kwamankhwala kawiri kawiri kawonekedwe kazinthu zazikulu za matenda ashuga, komanso zina zilizonse zomwe zimayang'aniridwa, zimayang'aniridwa, zimathandizidwa ndipo zovuta zimapewedwa. Ndikofunikira kugwiritsa ntchito mankhwala onse mogwirizana ndi malangizo a dokotala, kuyang'anira nthawi zonse, kusintha mlingo wake.

Zakudya zabwino komanso masewera olimbitsa thupi zimawonetsedwa. Kusintha kwa moyo, kuphatikiza kuchita masewera olimbitsa thupi komanso kudya mokwanira, ndizofunikira. Mafuta a shuga ndi okhathamiritsa ayenera kukhala ochepa pazakudya, zopatsa mphamvu za calorie zimayendetsedwa mosamalitsa. Muyenera kukambirana ndi dokotala wanu za kuchepetsa cholesterol ya LDL (yomwe imadziwikanso kuti "cholesterol" yoyipa) muzakudya zanu.

Kusintha kwina m'moyo kumafunikanso. Zimaphatikizapo kuchepa thupi ngati wodwalayo ali ndi mapaundi owonjezera, komanso kugona tulo tokwanira. Wodwala akamasuta, muyenera kupeza njira yoti asiye chizolowezi choyipachi.

Zizindikiro zowopsa

Kuwonongeka kwa bongo mu shuga kumatha kuchitika mwadzidzidzi. Ndikofunikira kudziwa zizindikiro zakuchenjezerani kuchipatala msanga. Izi zikuphatikiza:

• Mwadzidzidzi kufooka, kukula kwa dzanzi kumaso, kufooka kwa mwendo kapena mkono, theka limodzi la thupi.
• Zosokoneza mwadzidzidzi, maso amodzi kapena onse asasiya kuwona.
• Mavuto olankhula kapena mavuto akumvetsetsa.
• Kuukira kwa chizungulire.
• Kukomoka kapena kugwera.
• Kuukira kwa mutu wopanda vuto popanda chifukwa chodziwika.

Pazindikiro zilizonse zomwe zafotokozedwa, kuyimbira foni ya ambulansi ndikofunikira. Zotsatira zakugwa mu matenda ashuga zimasiyana kwambiri. Kukula kwa chotupa kumatha kukhala kokulirapo, ndipo kubwezeretsa kwina kukufunika.

Stroke ndi shuga

Stroko ndi mkhalidwe woopsa womwe gawo lina la ubongo limaleka kulandira magazi kuchokera pachiwiya chomwe chimamudya. Ngati izi zachitika kupitirira mphindi 4, kusintha kosasinthika kumachitika m'deralo ndi magazi owonongeka, kenako amwalira.

Ndikofunikira! Pali mitundu iwiri ya stroke - hemorrhagic and ischemic. Hemorrhagic sitiroko limachitika chifukwa chotupa cha mtsempha wamagazi, matenda a ischemic chifukwa chotsekemera kwa thrombus yake.

Tsopano lingalirani za stroke ndi matenda ashuga. Amadziwika kuti matenda ashuga amayambitsa kusokonezeka m'matengera, ang'ono ndi akulu. Chowonadi ndi chakuti odwala matenda ashuga nthawi zambiri amakhala ndi atherosulinosis - chotupa cham'mimba chomwe amasiya kutsika, amakhala olimba, ndipo makhoma awo amakutidwa ndi zophuka za cholesterol plaques.

Zideru izi nthawi zambiri zimasanduka zigawo zamagazi, ndikutchingira ziwiya. Nthawi zambiri amatuluka, ndipo magazi akamalowa m'mitsempha yama ziwongo, ndipo akangomangika m'mitsempha yaying'ono, atsekereni, chifukwa timakumana ndi ischemic stroke.

Mkhalidwe wowonjezereka ndikuphwanya kagayidwe kamchere wamadzi. Amadziwika kuti odwala matenda ashuga achulukitsa mkodzo, ndipo ngati sabweza madzi mokwanira mthupi, magaziwo amadzuka, omwe amawonjezeranso zowonjezera zomwe zimawonjezera chiopsezo cha stroke.

Ndikuganiza kuti tsopano zikuonekeratu kuti odwala matenda ashuga amavutika ndi stroke kawiri kawiri kuposa anthu ena. Mwa zina, kugwidwa ndi matenda ashuga kumatha kukhala kovuta kwambiri chifukwa chotengera chofanana (cholimba).

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 - Endocrinology Research Center ya Russian Academy of Medical Sayansi yakwanitsa kupanga mankhwala omwe amachiritsiratu matenda ashuga. 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!

Nthawi zambiri, ngati kuphwanya kwa magazi ku chiwalo chofunikira, thupi limayambitsa mphamvu, kunena kwake, kugwira ntchito, ndi magazi kudzera m'mitsempha yamagetsi (ya m'mitsempha yaying'ono) imayamba kulowa m'dera lomwe lawonongeka, kupyola chotengera chowonongeka, kubwezeretsa zakudya.

Mverani! Koma mwa anthu omwe ali ndi matenda ashuga, mitsempha yaying'ono imasinthidwanso kusintha kwa atherosclerotic, ndipo magazi amayenda kudzera mwa iwo ndizovuta kapena zosatheka kwathunthu, chifukwa chake, nthawi yobwezeretsanso pambuyo pake ikamadwala nthawi yayitali imatenga nthawi yayitali, ndipo zotsatirapo zakepi lake zimakhala zazikulu kuposa zomwe zili ndi omwe ali ndi matenda ashuga sizivutika.

Zoyenera kuchita? Ngati stroko yachitika, dokotala am'lembera chithandizo chofunikira. Koma zili m'manja mwanu kuti mupewe izi kuchitika mwa kuchitapo kanthu panthawi yake. Zotsatirazi ziyenera kuonedwa: koyamba, zakudya za matenda ashuga ziyenera kukhala njira yokhazikika, chachiwiri, muyenera kudya madzi okwanira kupewa magazi, ndipo chachitatu, kuchita masewera olimbitsa thupi, monga Cardio, ndikofunikira.

Imodzi mwa yosavuta koma yogwira ntchito ya Cardio ndikuyenda tsiku lililonse mwachangu kwa mphindi 20-30. Izi ndi zokwanira kukana kugwidwa, ngakhale mutakhala ndi matenda ashuga.

Ndili ndi zaka 47, ndinapezeka kuti ndili ndi matenda ashuga a 2. M'masabata angapo ndinapeza pafupifupi 15 kg. Kutopa nthawi zonse, kugona, kumva kufooka, kuwona kunayamba kukhala pansi.

Nditakwanitsa zaka 55, ndinali nditadzibaya kale ndi insulin, zonse zinali zoipa kwambiri. Matendawa adapitilirabe, kukomoka kwakanthawi kunayamba, ambulansi imandibwezera kuchokera kudziko lina. Nthawi zonse ndimaganiza kuti nthawi ino ikhala yomaliza.

Chilichonse chinasintha mwana wanga wamkazi atandilola kuti ndiwerenge nkhani imodzi pa intaneti. Simungayerekeze m'mene ndimamuyamikirira. Nkhaniyi inandithandiza kuthana ndi matenda ashuga, omwe amati ndi osachiritsika. Zaka 2 zapitazi ndidayamba kusuntha zowonjezereka, nthawi yamasika ndi chilimwe ndimapita kumayiko tsiku lililonse, ndikumalima tomato ndikugulitsa pamsika. Azakhali anga amadabwa ndimomwe ndimapangira chilichonse, komwe ndimapeza mphamvu zambiri, sakhulupirira kuti ndili ndi zaka 66.

Ndani akufuna kukhala ndi moyo wautali, wamphamvu komanso kuiwalako za matenda oyipawa kwamuyaya, tengani mphindi 5 ndikuwerenga nkhaniyi.

Kuleza mtima

Popeza stroko nthawi zambiri imadzetsa vuto la magalimoto, gawo limodzi mwa njira zochiritsira ndikusintha kwa odwala. Pankhaniyi, kugona pabedi sikuyenera kusokoneza kutseguka.

Chofunikira! Iyenera kuyamba pomwe wodwalayo akhazikika, popeza nthawi zambiri, kubwezeretsa miyendo yolumala kumachitika makamaka miyezi 3-6 itadutsa. Inali nthawi imeneyi yomwe mota, osati zokha, kukonza thupi kunali kothandiza kwambiri. Maluso ovuta kwambiri (apabanja, antchito, ndi ena otero) amabwezeretsedwa kwakanthawi.

Pofuna kupewa kutalika kwa mphamvu ya ziwalo zam'mimba kapena ziwalo zopuwala, ayenera kupatsidwa mwayi wapadera kwa maola osachepera awiri patsiku. Chifukwa chake, monga lamulo, mkono umawongoka pachingwe ndikudziyika pambali (patebulo) lophatikizidwa ndi kama pakamalo ka madigiri 90, kwinaku ndikusintha zala momwe mungathere.

Choyala kapena thonje la thonje limayikidwa mu khoma, ndipo thumba la mchenga lolemera 0,5 kg limayikidwamo kuti liwongolere dzanja. Mwendo wolumala umakungika pakadutsa madigiri a 10-15 m'mapazi olowa pabondo, kuti mupewe kukulira, umagulitsidwa. Phazi limawerama momwe angathere ndipo limapereka kutsimikizika kwake, mwachitsanzo, pabulodi.

Mankhwalawa nthawi zambiri amathandizidwa ndi masewera olimbitsa thupi a miyendo yolumala. Kulimbitsa thupi mosakhalitsa, monga lamulo, kumachitika ndi wophunzitsa zolimbitsa thupi pamaso pa wachibale kapena wowasamalira, yemwe ayenera kuphunzira mosamala kwambiri momwe gulu limayendera.

Mtsogolomo, ndikuwongolera njirayi, masewera olimbitsa thupi ongokhala nawo amatha kuchitika ndi anthu omwe amasamalira wodwala yemwe akuvutika. Kusuntha koyenera kuyenera kuchitika molumikizana chilichonse mokwanira popanda thandizo la wodwala. Kuthamanga, voliyumu ndi kuchuluka kwa mayendedwe ake zikukwera pang'onopang'ono. Olimbitsa thupi ochita masewera olimbitsa thupi nthawi zambiri amaphatikizidwa ndi kupuma, kotero kuti kutambasuka kumayendetsedwa ndi inhalation.

Lingaliro loti ayambitse kukonzanso thupi limapangidwa palimodzi ndi ophunzitsa adokotala komanso othandizira odwala. Gawo loyamba lokonzanso mwachangu ndikukhala wodwalayo pabedi kwa mphindi 1 - 2 moyang'aniridwa ndi achipatala. Malingaliro ake ogwirizana, kukoka, kuthamanga kwa magazi kumawunikiridwa.

M'tsogolomu, nthawi yomwe wodwalayo amakhala pansi imachuluka. Gawo lotsatira ndikukhazikitsa kwa wodwala mawonekedwe owongoka (kuyimirira) mothandizidwa ndi wakunja, kenako ndikudziyimira pawokha (wodwalayo amagwiritsabe kumbuyo kwa kama kapena chinthu china chokhazikika ndi dzanja labwino).

Kuyang'anira! Kuyendayenda kuzungulira wadi (chipinda) koyambirira kumachitika ndi thandizo ndikuyang'aniridwa ndi wophunzitsa masewera olimbitsa thupi. Monga lamulo, wodwalayo amamuthamangitsa kuchokera kumbali ya paresis, akumaponya dzanja lopanda mphamvu kumapewa. Usiku, kumayambiriro kwa ntchito yoyendetsa wodwalayo, kumakhala kotetezeka kutseka kama, kusiya kwamkodzo pafupi ndi mpando kapena patebulo.

Mtsogolomo, wodwala, m'malo mwa wothandizira, amatha kugwiritsa ntchito zida zapadera, zomwe pamodzi zimatchedwa "oyenda," kuti azizungulira m'chipindacho, wadi. Amapangidwa ndi zida zopepuka zopepuka ndipo ndiwothandiza kwambiri pakukonzanso wodwala yemwe akuvutika.

Kuphatikiza pa kusuntha, wodwala ayenera kulimbikitsidwa kuti azolowere nyumbayo: perekani kuti atenge zinthu zapakhomo ndi dzanja la patretic, valani, mabatani olimba, ndi zina zambiri.Monga njira yowonjezereka yomwe ikufuna kuyambitsa wodwalayo, kutikita minofu kumagwiritsidwa ntchito.

Ndi kuphweka komwe kumawoneka mosavuta, kuyenera kuthandizidwa mosamalitsa, popeza kusachita bwino kwake kumatha kukulitsa minofu ya malekezero, yomwe mtsogolo ingayambitse kuchepa mphamvu. Chifukwa chake pakumeta minyewa ya mkono ndi miyendo yolumikizika, ndikofunikira kuti muziwamenya pang'ono.

Palinso maubwino enanso a minyewa kwa odwala matenda a stroke, chifukwa chake izi zimayenera kuchitika ndi akatswiri omwe akudziwa bwino machitidwe a gulu ili la odwala. Milandu pomwe kupindika kwa minofu ya ziwalo zam'mimba zimatchulidwa mokwanira, madokotala amapatsa mankhwala opumula minofu, kusankha payekha mankhwala, mankhwala ndi regimen.

Kuphatikiza pa njira zomwe tatchulazi popewa kuletsa kulera kwa ziwalo zopuwala, ziwengo, acupuncture, mankhwala othandizira kutentha (paraffin ndi ozocerite application) kapena chithandizo chozizira (cryotherapy), njira zingapo zamadzi (hydrotherapy) zimagwiritsidwa ntchito.

Malangizo! Ndi kuchepa kwa kamvekedwe ka minofu m'ziwalo zopuwala, kutikita minofu kumagwiritsidwanso ntchito (malinga ndi luso lapadera lothandizira), kukondoweza kwa magetsi zamagetsi zam'mitsempha, komanso kuyambitsa kwa mankhwala omwe amalimbikitsa kufooka kwa minofu. Funso la cholinga chawo, mlingo ndi njira yothandizira imasankhidwa ndi adokotala.

Pa prophylaxis komanso mankhwalawa "mapewa akumva kupweteka", kuwonjezera pazolimbitsa thupi zolimbitsa thupi, kugwiritsa ntchito kutikita minofu yovala bandeji, kukondoweza kwa magetsi kwa minofu ya dera lomwe limatchulidwa. Kukhazikitsidwa kwa njirazi kumathandizira kuti nthawi zambiri kupewa kuteteza kulera.

Kukonzanso

Mbali ina yofunika yothandizira odwala omwe ali ndi stroke, yomwe abale ake ndi ofunika kwambiri, ndikukhazikitsanso malingaliro. Amadziwika kuti m'gululi la odwala mawonekedwe a umunthu ndiwowongoka: chidwi, misozi imayambira m'gawolo, komanso mkwiyo, mwamwano, kusakwiya kumayambira.

Kuchepetsa modabwitsa kukumbukira, makamaka kwa zochitika zamakono. Odwala ambiri amalephera kulankhula. Zonsezi ziyenera kukumbukiridwa polankhulana ndi gulu ili la odwala.

Kumbali imodzi, kusamvana kuyenera kupewedwa, kulekerera malingaliro awo ndi malingaliro awo, kumbali ina, osawalimbikitsa, kulimbikitsani ndi kulimbikitsa mota, kuyankhula ndi mitundu ina ya zochitika. Kwa odwala oterowo, kulumikizana ndikofunika kwambiri, momwe mabungwe omwe atayika ndi luso zimabwezeretseka mosavuta.

Mwa zina mwa mitu yankhani yolumikizirana: kukambirana za anthu omwe ali pafupi ndi wodwalayo, momwe zinthu zilili, nkhani za anthu omwe adadwala matenda a stroke ndipo adachira pambuyo pake. Nthawi yomweyo, wodwalayo ayenera kutenga nawo gawo pazokambirana, naye mawu ndi mawu ayenera kutchulidwa ndipo aliyense apatsidwe moni mwachidwi, ngakhale "atachita pang'ono".

Zofunika! Ngati wodwalayo asanadwalitse nkhawa za moyo wa anthu ena, werengani manyuzipepala atsopano ndi magazini kapena mumupatse mawu pawailesi, kenako afunseni kuti afotokozere kapena zomwe adawerengera.

Zowonadi, kukonzanso wodwala ndi vuto la kuyankhulidwa chifukwa chokhala ndi stroko kungakhale kothandiza kwambiri pochita mwatsatanetsatane wophunzitsira, katswiri wazopeka, katswiri yemwe amadziwa njira zobwezeretsanso kuyankhula, kuwerenga ndi kulemba.

M'masabata angapo oyambira, makalasi omwe ali ndi othandizira olankhula samakhala okwanira (osaposa mphindi 15), chifukwa mantha am'thupi amatha msanga. Mtsogolomo, katswiriyu amatha kuphunzitsa achibale njira yobwezeretsanso maluso omwe atayika ndipo atenga nawo mbali mu izi, kuthera gawo lawo m'makalasi okha.

Nthawi zambiri munthawi imeneyi, wodwalayo amalimbikitsidwa kumwa mankhwala osokoneza bongo, omwe, malinga ndi akatswiri ena, amathandizira kubwezeretsa kapangidwe kake. Kalanga ine, njirayi ikhoza kupitilira kwa zaka, komanso kubwezeretsa luso lolemba ndi kuwerenga. Chifukwa chake, kuleza mtima, kusasinthika ndi kupirira kwa ena komanso wodwalayo, malingaliro abwino ndi gawo lofunikira pakubwezeretsa kwathunthu ntchito zomwe zataika.

Gawo lofunika pakukonzanso kwa wodwala ndi chakudya cha wodwalayo. Zakudya zopatsa thanzi ziyenera kukhala pafupipafupi, zophatikizika ndi zakudya za tsiku ndi tsiku zopatsa mphamvu pamlingo wa 2000-2500 kcal. Onetsetsani kuti muphatikiza fiber mu chakudya (kupewa kapena kukonza kudzimbidwa), mafuta, makamaka okazinga ndi utsi, zopangidwa ndi ufa kuchokera ku ufa wa tirigu woyamba, mchere uyenera kukhala woperewera, ndipo nthawi zina osasiyidwa kwathunthu.

Kupewa Kukwazidwa Mikwingwirima

Zimakhazikitsidwa pazinthu zomwe cholinga chake ndikuchotsa zinthu zomwe zingachitike mwa wodwala. Chimodzi mwazomwe zikuyenda ndikusungabe kuthamanga kwa magazi pamlingo woyenera wodwalayo. Mwa mankhwala omwe ali m'gulu lino la odwala, ACE inhibitors ndi b-blockers adziwonetsa okha kuti ali abwino kwambiri.

Chenjezo: M'malo momwe sitiroko idayambitsidwa ndi kupendekera (kupindika) ndi stenosis ya carotid ndi / kapena ma vertebral artery (atherosclerosis kapena atherogenic thromboembolism) ndi dokotala wa opaleshoni ya minofu, funso la opaleshoni yomwe ingapangitse magazi kupita kuubongo imasankhidwa.

Pomaliza, ziyenera kudziwika kuti chifukwa cha kugunda, kufa kwa gawo, nthawi zina kwakukulu, kwama cell a ubongo (ma neurons) kumachitika. Chifukwa chake, kubwezeretsa kwathunthu kwa ntchito zotayika, ngakhale lingaliro lalikulu la kubwezeretsa kwa ubongo, ndizovuta kwambiri.

Njira zothandizira kukonzanso milandu nthawi zambiri zimakhala zovuta komanso zazitali. Zimafunikira osati zamakono komanso zothandiza zamankhwala, komanso kupirira, mndandanda wa zochita za ogwira ntchito zamankhwala, wodwala iyemwini ndi malo omwe amakhala. Chifukwa chake, ntchito yayikulu ya madotolo ndi anthu othandizira pamaubwino kwa wodwalayo ndikuwathandiza kudziwa njira zothandizira kukhazikikanso ndikuwapanga kukhalanso wabwino.

Matenda a shuga - mnzake wa stroke

Matenda a shuga mellitus (DM) ndi amodzi mwa matenda ofala kwambiri a endocrine. Malinga ndi ziwerengero zapadziko lonse lapansi, kuyambira 2 mpaka 4% ya anthu pano ali ndi matenda a shuga. Ngakhale matenda ashuga sichinthu chachikulu chobaya chifukwa cha stroke, atha kupewetsa kwambiri maphunzirowo komanso kukonza odwala omwe ali ndi stroke. Chithandizo cholakwika cha matenda ashuga, makamaka munthawi yovulala kwambiri, amatha kukulitsa vuto la kubwezeretsanso kapena kuwonjezera gawo la ischemic.

Chifukwa chake, zidapezeka kuti mwa anthu azaka zopitilira 40 zopezeka pachimake kuchitika kwa ngoziyi zimachitika motsutsana ndi matenda ashuga nthawi imodzi ndi theka mpaka kawiri kuposa anthu omwe samadwala matendawa, ndipo azaka zosaposa zaka 40 amapezeka katatu kapena kanayi, kuposa apo mwa odwala omwe ali ndi malire, azimayi ambiri.

Ndi nthawi yayitali (yopitilira zaka 15 mpaka 20) ya matenda ashuga, chiopsezo chotenga matenda a ischemic chikuwonjezeka nthawi zambiri. Nthawi zambiri, makamaka odwala okalamba omwe ali ndi stroke, matenda a shuga sapezeka, ngakhale amatha ku 50% ya odwala.

Tip: Odwala omwe ali ndi matenda a shuga, poyerekeza ndi anthu omwe alibe matendawa, pali zinthu zingapo pachipatala cha ngozi ya matenda amisala. Kuphatikizika kwa mitsempha yawo kumachitika nthawi zambiri masana, munthawi ya zochitika, ndipo nthawi zambiri amakumana ndi maziko a kuthamanga kwa magazi. Odwala omwe ali ndi matenda ashuga, matenda opweteka kwambiri amadziwika, edema yam'mimba imatchulidwa kwambiri, kufa kwa anthu ndiwokwera.

Ndi zotupa za muubongo, pali kuchuluka kwambiri kwa kufa, kutchulidwa kwa kusokonezeka kwa matenda ashuga - shuga m'magazi ndizovuta kuzilimbitsa, kuphatikiza ndi insulini, mu theka la odwala pamakhala kupweteka kwa nthawi yayitali.

Paremchymal hemorrhages nthawi zambiri amakula pang'onopang'ono, ndi subarachnoid hemorrhage, matendawa sakhala pachimake, limodzi ndi zonena modekha matenda am'mimba komanso olimbitsa psychomotor.

Chofunikira: Mankhwalawa odwala omwe ali ndi matenda a shuga, kukonza m'magazi a shuga ndikofunikira kwambiri. Ndikosatheka kukwaniritsa zotsatira zabwino pothandizira odwala omwe ali ndi stroke, makamaka pakakhala kuwonongeka kwa matendawa - msanga wa magazi othamanga umaposa 10 mmol / lita. Nthawi zambiri, machitidwe a adokotala amabwera kuti apereke mankhwala a insulin kwa odwala omwe ali ndi matenda a shuga pamene ali m'chipatala.

The kufa kwa odwala sitiroko odwala matenda ashuga kuposa 40% - ndi okwera kuposa avareji ambiri, ndipo hemorrhages - oposa 70%.

Zomwe zimayambitsa kufa kawirikawiri ndi izi:

pafupipafupi kuwonongeka kwa matenda ashuga kagayidwe kachakudya, kusakhazikika pakukonzekera kwa ma insulin, matenda ashuga, kusintha kwa matenda ndi zovuta za matenda ashuga (myocardial infarction, nephropathy, kuchuluka kwa chiwopsezo cha khungu, kusokonezeka kwazinthu zina, ndi zina zotere). ndi munthawi yomweyo chithandizo cha sitiroko ndi matenda ashuga.

Zakudya pambuyo stroko: kupewa zovuta zotsatirazi

Stroke yokhala ndi matenda ashuga ndiimodzi mwazovuta zomwe zimachitika mukanyalanyaza malamulo a moyo wathanzi, zakudya ndi zomwe adotolo akuwonetsa. Pambuyo povulazidwa ndi stroko, wodwalayo ayenera kudya zakudya zapadera, popeza kuukira kotsatira kungaphe.

Stroke matenda a shuga ndi imodzi mwazovuta za matendawa. Monga tawonera kafukufuku wambiri ndi asayansi odziwa ntchito ochokera kumaiko osiyanasiyana, matenda opha ziwopsezo nthawi zambiri amapezeka chimodzimodzi mwa odwala matenda ashuga. Stroko ndi zotsatira zake zimachitika mwadzidzidzi pomwe wodwalayo sangathenso kuwongolera matendawa.

Matendawa amatanthauza kutsatira zakudya zapadera, kumwa mankhwala osiyanasiyana komanso kusewera masewera, koma nthawi zambiri odwala omwe salabadira za matenda awo amaphwanya malamulowa, omwe amakhala ndi zotsatirapo zoyipa kwambiri.

Zonse Zokhudza Sitiroko

Matenda a shuga amayambitsa kuwonongeka m'mitsempha yamagazi, ndi iwo omwe amawoneka ngati akumenyedwa. Zotsatira za kugundidwa ndimatenda a shuga sizimatheka. Ndikwabwino osabweretsa izi.

Ngakhale kunenepa kwambiri kumapangitsa kuti munthu akumane ndi vuto lalikulu. Nthawi zambiri, anthu omwe amasiya kusuta fodya komanso kumwa mowa mwauchidakwa amakhala pachiwopsezo. Kuphatikiza apo, vuto la kuperewera kwa zakudya m'thupi lili mgulu lofanana ndi izi.

Zizindikiro za stroko:

Zofooka zazikulu, Khumbo. Ndizowopsa makamaka ngati mbali imodzi ya thupi ili dzanzi, Kufa ziwalo ndiye chizindikiro choopsa, Kutayika kotheratu kwa kuganiza ndi kulankhula pafupipafupi, Kupweteka kwambiri pamutu pomwe palibe zifukwa za izi, nkhungu pamaso pa maso, kulephera kuwona, ndipo izi zikuwonekera kwambiri, Kulephera kumeza. Reflex, kulephera kuyendetsa pawokha komanso kusayenda bwino, kusazindikira kwakanthawi kochepa.

Zakudya za stroko ndi chithandizo chake ndizofunikira pazinthu zofunikira kuti tipewe kuwonongeka kwa thanzi.

Malangizo otsatirawa akuyenera kutsatiridwa:

Imwani madzi oyera ambiri mosalekeza. Izi ndizofunikira, koma osagwiritsa ntchito koloko. Cholesterol ndi chinthu chowopsa. Amatha kuyambitsa matenda mu ubongo, omwe amakhala ndi matenda osachiritsika. Chifukwa chake, sitipatula zinthu zomwe zili ndizofunikira kwambiri pazinthu izi. Ndikofunikira kupatula kugwiritsa ntchito mchere mwanjira iliyonse. Mchere kapena zokometsera siziyenera kudyedwa. Pokhapokha ngati chiwerengero chokwanira chadutsa pambuyo povulazidwa, ndipo mkhalidwe wa thupi wayamba kuchira, ndiye kuti izi zitha kuphatikizidwa pang'ono pachakudya ichi. Stroke ndiowopsa kuphwanya kayendedwe kazolowedwe ka mtima. Ichi ndichifukwa chake musaiwale kuphatikiza zinthu zomwe zili ndi potaziyamu muzosankha. Ngakhale munthu wathanzi sangachite popanda mavitamini. Munthu wodwala matenda ashuga, makamaka wopulumuka stroko, ayenera kubwezeretsanso thupi ndi michere. Masamba ndi zipatso zatsopano zimapereka mavitamini ambiri. Zakudya zilizonse zomwe zili ndi caffeine woletsedwa ndizoletsedwa. Mwachilengedwe, nthawi zonse khofi sayenera kuphatikizidwa muzakudya. Mafuta acids ndi zinthu zomwe thupi limafunikira zochepa. Nsomba ndi gwero labwino kwambiri la omega-3s. Kudya ndi stroko kumakhala kovuta kwa munthu, chifukwa, monga tafotokozera pamwambapa, zimamuvuta kuti amize. Ichi ndichifukwa chake zakudya zam'mero ​​ndikukulolani kudya zakudya zamadzi zambiri. Ndi mtundu 2 wodwala mellitus, sitiroko ndiyowopsa, motero tikulimbikitsidwa kuti mumwe zakumwa kudzera mu chubu chapadera.

Malangizo omwe amathandizira pakudya pambuyo poti awonongeke ndi osavuta, ndipo zakudya zomwe madokotala amapereka kwa wodwala aliyense payekhapayekha zimadziwika nambala 10.

Ponena za vuto la mtima ndi matenda ashuga

Myocardial infarction ndi matenda ashuga ndizogwirizana kwathunthu, ngakhale zimamveka. Wodwala aliyense amakhulupirira kuti vuto la mtima ndi matenda a shuga lingachitike kwa aliyense, koma osati kwa iye, ndipo akupitiliza kunyalanyaza malangizo omwe adokotala amupatsa. Ichi ndi chizindikiro chofala kwambiri.

Chofunikira! Kulowerera m'matenda a shuga kumachitika mchikakamizo cha cholesterol yambiri mthupi. Izi ndichifukwa chamakhalidwe olakwika. Kumbukirani kuti matenda a mtima atadwala matenda ashuga pali mwayi wochepa wochira. Nthawi zambiri muyenera kuchepetsa kwambiri kuti musafe. Ndiosavuta kupewa kuukira.

Ndi matenda 2 a shuga, vuto la mtima limachitika nthawi zambiri kuposa mitundu ina. Izi ndichifukwa choti odwala oterewa amatha kuvutika kwambiri ndi vuto la kunenepa kwambiri, zakudya zosayenera komanso zosagwirizana, komanso kugwiritsa ntchito molakwika kusuta fodya komanso mowa.

Ndikofunikira kudziwa kuti kuukira komwe kumachitika ngakhale kwa wodwalayo mosakhudzika, ndiye kusiyana kwakukulu pakati pa vuto la mtima ndi stroke. Munthu wodwala matenda ashuga amatha kumangokhala ndikugwiritsa ntchito malingaliro onse a adotolo ndikusangalala popanda zovuta. Ndipo panthawiyi, zoyeserera kuti ziwukire zimakula bwino mthupi lake.

Matenda a mtima akachitika, wodwala sangamuzindikire, ndikupitiliza kukhala ndi moyo osapita kwa dokotala. Koma kuukira kumakhala ndi zovuta zoopsa zomwe zimatha kupha anthu.

Koma sikuti nthawi zonse vuto la mtima ndi matenda ashuga limawoneka. Nthawi zambiri zimayendera limodzi ndi kufooka komanso kupweteka kwambiri pamutu, ndipo izi zimakhala bwino kwambiri kwa munthu, chifukwa pambuyo pake amadzazindikira ndi nthawi ndikupereka mwayi wokhala ndi moyo wamtsogolo.

Zomwe zimayambitsa matenda a mtima ndi izi:

Kukhalapo kwa vuto la mtima la wachibale, Chizolowezi choyipa ngati kusuta, sikuti kumangowonjezera chiopsezo chovutitsidwa, chitha kuwonjezera mwayi wokhala ndi vuto la mtima, Kuchulukitsa kwawonjezera kumayambitsa vuto la mtima, chifukwa chake onetsetsani izi matenda a shuga a mellitus, omwe amabweretsa kwambiri kugwidwa ndi matenda a mtima, Kusagwira bwino ntchito kwa Esproper kumabweretsa mawonekedwe a cholesterol owonjezereka m'thupi, omwe, nawonso, angayambitse matenda a mtima, E Ngati mumadya mafuta ochulukirapo kuposa omwe dokotala wanu wakupatsani, inunso muli pachiwopsezo.

Ndiye chifukwa chake ndi matenda ashuga ndikofunikira kwambiri kutsatira mosamalitsa zomwe adotolo adachita, kuchita masewera olimbitsa thupi ndikumwa madzi ambiri. Kupatuka kulikonse kwa malamulowa kumawopseza ndi stroko kapena vuto la mtima, pambuyo pake sizingatheke kubwerera m'miyoyo yawo yakale.

Zakudya zamagulu a mtima zimayeneridwanso ndi adotolo, chifukwa zimasiyana ndi zakudya zomwe wodwala amadwala, komanso munthu wathanzi.

Mfundo zoyenera kudya pambuyo pa vuto la mtima:

Konzani zakudya zanu ndi potaziyamu ndi magnesium, Zakudya zolemera ziyenera kusiyidwa kwathunthu ndi zakudya, kuthetseratu kugwiritsa ntchito mchere. Ngakhale pa chiyambi cha chithandizo, ngakhale mutasintha thanzi, mchere sayenera kumwa. Pali njira zambiri zaphikitsi zopatsa thanzi .. Mosiyana ndi maphikidwe omwe munthu amakhala ndi matenda ashuga, sizoletsedwa kumwa madzi okwanira malita 1.2 patsiku atagwa ndi vuto la mtima. Mbale zothira mafuta ndi fillet ya mbalame ya mafuta ochepa, Zimaletsedwa kumwa khofi ndi tiyi wamphamvu, Zonsezi zosanikizidwa ziyeneranso kuphatikizidwa kuchokera kumenyu, Zophika zophikidwa mu uvuni kapena zophika, pansi pa choletsa mwamphamvu, Mkate watsopano umatsutsana ndi vuto la mtima, B Zatsopano ndi chokoleti ziyenera kuperekedwa.

Chifukwa chake, menyu omwe adayikidwa pambuyo pa vuto la mtima kapena matenda a shuga mellitus amakhala okhwima kwambiri kuposa chakudya cha odwala matenda ashuga omwe samalola kuukiridwa. Chifukwa chake, tengani thanzi lanu mozama, osanyalanyaza malangizo a dokotala.

Kuteteza Matenda a shuga

Pakadali pano, chiwopsezo cha matenda ashuga mellitus (DM) chikuwonjezereka, gawo lomwe lili "mliri" wa matenda ashuga a mtundu 2. Ziwopsezo za matenda ashuga amtundu wa 2, zomwe zimapangitsa kuti 95% yazaka zonse za matenda ashuga, zikukula kwambiri komanso mosatekeseka m'maiko onse.

Chenjezo: Tanthauzo la "mliri "wu ndiwodabwitsa kwambiri chifukwa chothandizira pakubweza, komanso ndi mgwirizano wapamtima wa matenda ashuga a 2 omwe afa ndi mtima. Malinga ndi zomwe zapezeka posachedwa, dziko la Russia lili ndi udindo waukulu pambiri pobera anthu odwala stroko komanso matenda amtima ambiri. Stroko ndiye chachiwiri chomwe chimapangitsa kuti anthu ambiri amwalire mdziko lathu komanso chomwe chimapangitsa kuti munthu akhale wolumala.

Chiwopsezo chochepa cha matenda opha ziwalo ndi 1.8-6 kuchulukitsa mwa anthu odwala matenda ashuga 2 poyerekeza ndi anthu opanda matenda a shuga. Mu kafukufuku wa MRFIT, chiopsezo cha kufa chifukwa cha matenda opha ziwalo pakati pa odwala matendawa anali ndi 2.8 kuchulukitsa poyerekeza ndi odwala omwe alibe matenda ashuga, pomwe chiopsezo cha kufa chifukwa cha nthenda ya ischemic inali 3.8 nthawi zambiri, kuchokera ku subarachnoid hemorrhage - nthawi 1.1 komanso kuchokera kukha mwazi kwa mitsempha - nthawi 1.5.

Kukula kambiri kwa ma ischemic stroko mu mtundu 2 wa shuga kumatsimikiziridwa ndi gawo lake pakupititsa patsogolo kwa atherothrombosis, yomwe imawerengedwa kuti ndi imodzi mwazinthu zazikulu zakuthandizira kugunda kwa ischemic stroke. Nthawi yomweyo, pakuwonetsetsa kwakukulu kwa maphunziro, panalibe kulumikizana kwakukulu pakati pa zomwe zimayambitsa chiopsezo cha atherosulinosis - cholesterol - ndi zochitika za stroke.

Mpaka posachedwa, malingaliro omwe adalipo anali akuti kutsitsa cholesterol sichinali njira yolepheretsa kuchitidwa kwa stroke komanso kuonjezeranso kuchuluka kwa matenda a hemorrhagic. Kuperewera kwa mgwirizano pakati pa kuchuluka kwa cholesterol ndi chiopsezo cha sitiroko kunatsimikizidwanso mu kafukufuku wa POSCH, momwe kuchepetsa kwa cholesterol kumatheka chifukwa cha opaleshoni yamatumbo ang'ono.

Kutsika kwa cholesterol mu kafukufukuyu kunapangitsa kutsika kwakukulu kwa kufa kwa mtima, koma sikuchepetsa chiopsezo cha sitiroko. Pankhani imeneyi, lingaliro lamakono la kutsogolera kwa vuto la endothelial pakukula ndi kupititsa patsogolo kwa matenda a matenda amtundu wa 2 ndichosangalatsa.

Kukana kwa insulini komanso mtima ndi zinthu zambiri zomwe zimayambitsa matenda ashuga a 2 kuposa zitsanzo wamba, zomwe zimabweretsa chiwopsezo chachikulu cha matenda a atherosulinosis. Zinthu za atherogenic zomwe zimakhudzana ndi insulin kukokana ndi: dyslipidemia (kuchuluka kwa TG, kuchepa kwa HDL), hyperinsulinemia, kuphwanya kagayidwe kazinthu, kagayidwe kazinthu.

Izi kagayidwe kachakudya matenda ndi hemodynamic zimakhudza chotchinga chofunikira kwambiri - endothelium, zomwe zimabweretsa kukanika kwake, kusayimira pakati pa vasodilating, antithrombotic, anti-yotupa, antisranceotic and vasoconstrictive, proliferative, prothrombotic ndi pro-kutupa pazomwe zikuwoneka kuti zikuwonekera.

Upangiri! Mwa zina zomwe zili pachiwopsezo, kukana insulini kumakhala pamalo apadera, ndizofunikira za pathogenetic zomwe zimaphatikiza matenda a shuga a 2, matenda oopsa, dyslipidemia, kusokonezeka kwamatenda, vuto la pro-kutupa ndipo limafotokoza m'njira zambiri momwe chiopsezo cha mtima chimakhalira.

Matendawa amakhudzana kwambiri, njira imodzi imachulukitsa inayo, zomwe zimatsogolera ku kukula koyambirira kwa atherosulinosis ya mtundu 2 wa shuga. Chidziwitso chakuti atherosulinosis ndi matenda opatsirana, komanso umboni woti kugwiritsa ntchito zinthu zodziwika mwangozi zimatithandizira kuti tiwone za ngozi zamatenda am'mtima m'magawo ochepa okha, adatsimikiza chidwi pazomwe zimatchedwa "zatsopano".

Zinthu izi zimagwirizanitsidwa kwambiri ndi kutupa ndi endothelial kukomoka, kuthandizira kwa zolembedwa za atherosulinotic ndipo zitha kugwiritsidwa ntchito (ndi umboni wotsimikizira) ngati zolembera zowonjezera pakuwunikira onse omwe ali ndi vuto la stroke komanso kugwiritsa ntchito bwino njira zamankhwala zothandizira kukhazikitsa atherosranceotic plaque komanso kupewa ischemic stroke.

Ziyembekezero zazikulu kwambiri zimagwirizanitsidwa ndi kugwiritsa ntchito zolembera zolembera (C-reactive protein, molekyule wa adhesion ICAM-1, VCAM-1, E-Selectin, P-selein, kuchuluka kwa maselo oyera a magazi, ma cytokines ovomerezeka), homocysteine, ASD, factor factor, IAP-1, minofu plasminogen activator, lipoprotein (a).

Lingaliro lakupsya kwa pathogenesis ya atherothrombosis, komanso kupambana kosawoneka bwino kwa kafukufuku wambiri pamatenda oyambira komanso owonjezera omwe amachitika pogwiritsa ntchito ma statins adapangitsa kudziwa malo apadera a gululi la lipid-kuchepetsa mankhwala popewa kupweteka kwa odwala omwe ali ndi matenda ashuga a 2.

Pazaka khumi zapitazi, zidakhazikitsidwa kuti ma statins samangokhala ndi mphamvu yotsitsa cholesterol, komanso ali ndi zowonjezera zotsutsana ndi kutupa ndi antithrombotic. Potchinga GMK - CoA - reductase, ma statins amasintha kupanga zinthu zingapo zowonjezera-kutulutsa ndi Katemera:

mawu ochepa a zomatira ma cell am'magazi (P-selein, VCAM, ICAM), kutsika kwa kupendekeka kwamatumbo ndi kuphatikizika, kutsika kwa pro-kutupa cytokines, kupanga kwa cytokine mkati mwa dongosolo lamanjenje, kupititsa patsogolo ntchito ya endothelial (kuchuluka NO), kuchepa kwa oxidation wa LDL, atherosselotic fibrous capuleous proteinule. zolembera, kukhazikika kwa maziko a lipid.

Mpaka pano, maphunziro akulu kwambiri pazakonza dyslipoproteinemia omwe ali ndi ma statins adaphatikizira ochepa odwala ndipo adachitika ngati gawo limodzi la kupewa kwachiwiri kwa matenda amitsempha yamagazi. Maphunziro oterewa akuphatikizapo 4S, CARE, LIPID, momwe 4444, 4159, 9014 anthu adatenga nawo mbali, kuphatikizapo odwala matenda a shuga 202, 603 ndi 777, motsatana.

M'maphunziro atatuwa, ma statins adachepetsa kwambiri kuvutitsidwa kwa odwala omwe ali ndi matenda amitsempha yamagazi, koma popanda matenda am'mbuyomu: mu kafukufuku wa 4S, chithandizo cha simvastatin chinachepetsa chiopsezo cha stroke komanso TIA (chosakhalitsa ischemic) ndi 28% (p = 0.033).

Zofunika! Gulu laling'ono la 202 odwala matenda ashuga, kugwiritsa ntchito simvastatin kwa zaka 5.4 kunachepetsa chiopsezo cha kufa kwa coronary ndi 55%, ngozi yapathengo ya 62%, ndi kufa kwa 43%. Mu kafukufuku wa 4S, adawonetsedwa koyamba kuti kutsitsa cholesterol ya LDL kumatha kupititsa patsogolo matendawo kwa odwala omwe ali ndi matenda a shuga 2 ophatikizidwa ndi matenda amitsempha yamagazi, ndipo kupindula kwathunthu kotsitsa LDL mwa odwala matenda a shuga mellitus ndikokwanira kuposa kumene kwa anthu opanda matenda a shuga.

Mu kafukufuku wa CARE, chithandizo chokhala ndi pravastatin chinachepetsa chiopsezo cha 32% (p = 0.03), mu kafukufuku wa LIP>

Chimodzi mwamafukufuku akulu pa zotsatira za atorvastatin pachiwopsezo cha mtima, kuphatikiza chiopsezo cha matenda okhudzana ndi matenda amtundu wa 2 (gawo limodzi la kupewa matenda a mtima ndi matenda a sitiroko), ndiye kafukufuku wa CARDS.

Kuyesaku kunayimitsidwa pafupifupi zaka 2 zisanachitike chandamale chifukwa cha phindu loonekeratu la atorvastatin. Phunziroli linayerekeza zotsatira za mankhwala ndi atorvastatin pa mlingo wa 10 mg / tsiku. ndi placebo odwala omwe ali ndi matenda a shuga a 2 omwe ali ndi LDL cholesterol yochepa (malire a kuphatikizika ndi 4.14 mmol / l).

Odwala analibe matenda amitsempha yama coronary, chithokomiro kapena zotumphukira, koma osachepera chimodzi mwazotsatira za chiopsezo chachikulu chinali: matenda oopsa, retinopathy, albinuria, kusuta.

Kutsata kwakukulu kwa CARDS kunali kophatikizana ndipo kunaphatikizapo kuyambika kwa chimodzi mwa zochitika zotsatirazi: kufa kwambiri chifukwa cha matenda a mtima, kusafa koopsa m'mitsempha, kufikitsa kuchipatala chifukwa cha kusakhazikika kwa angina, kusinthanso kwa mtima kapena kugunda kwamtima, kuyambiranso kumangidwa pambuyo pamtima.

Kugwiritsidwa ntchito kwa atorvastatin kunatsagana ndi kuchepa kodalirika kopitilira muyeso wa endpoint yoyamba ndi 37%, ndipo kuchepa kumeneku kunali komweku m'magulu a odwala omwe ali ndi cholesterol yoyamba ya LDL pamwambapa komanso pansi pa mulingo wapakati pa 3.06 mmol / L. Zotsatira zomwe zili mgulu la atorvastatin zinali zabwino kwambiri pazinthu zotere zam'mphepete monga zochitika zapachiwopsezo - kuchepa kwa chiwopsezo ndi 36% - kutsika kwa 48%.

Chifukwa chake, kafukufuku wa CARDS adawonetsa kuti atorvastatin pa mlingo wa 10 mg / tsiku odwala omwe ali ndi matenda a shuga 2 ngakhale omwe ali ndi cholesterol chochepa cha LDL (m'munsimu 3.06 mmol / L). otetezeka komanso othandiza kwambiri kuchepetsa chiopsezo cha zochitika zam'mtima zoyambirira, kuphatikizapo stroke.

Chenjezo: Zotsatira za phunziroli zikusonyeza kuti kugwiritsa ntchito cholesterol ya LDL inayake, monga njira yokhayo yokhazikitsidwa kwa odwala omwe ali ndi matenda oopsa a shuga, salinso ndi chifukwa. Choyimira chachikulu chizindikiridwe monga chiwopsezo cha mtima, chokwanira kwambiri matenda ashuga a 2, ofanana ndi mikhalidwe yomwe yapangidwa kale ndi mtima.

Chokondweretsa chachikulu ndizotsatira za kafukufuku wambiri wa HPS (Phunziro la Kuteteza Mtima). Cholinga chake chinali kuyesa zotsatira za simvastatin 40 mg ndi antioxidants (600 mg vitamini E, 250 mg vitamini C, 20 mg b-carotene) amatengedwa tsiku lililonse pamatenda onse, kufa kwa matenda a m'mitsempha ya m'mitsempha, kufa kwa zifukwa zina kwa odwala omwe alibe kapena ofalitsa matenda a m'mitsempha IHD, koma kukhala ndi chiwopsezo chachikulu cha chitukuko chake. Kafukufuku wopangidwa mosasinthika, wakhungu lambiri, wophatikizidwa, wophatikizidwa ndi 20536 odwala matenda amitsempha yamagazi kapena matenda ake oopsa (kuphatikizapo odwala matenda ashuga) azaka za 40-80. Odwala onse anali ndi cholesterol> 3.5 mmol / L (> 135 mg / dl).

Kusanthula kwa dongosololi kunachitika pa zotsatira za simvastatin pazizindikiro zotsatirazi:

kufa kwapafupipafupi (pazifukwa zilizonse), kufa chifukwa cha matenda amtima, zimayambitsa milandu yaimfa yopanda magazi, kuphwanya magazi osagwirizana ndi ena, kupha ziwopsezo zopanda pake, zochitika zazikulu zam'mimba, zomwe zimaphatikizapo kugunda kwamtima konse, mitundu yonse yamikwingwirima, njira zonse zosinthira.

Mu 33% ya odwala, LDL cholesterol pamene idaphatikizidwa ndi kafukufukuyo inali m'munsi mwa 3.0 mmol / l, ndiye kuti, idagwirizana ndi chandamale mogwirizana ndi malingaliro aku Europe 1998 1998. kwa kupewa koyambirira komanso kwachiwiri kupewa matenda a mtima. Zotsatira za phunziroli Zotsatira za kufa ndi mtima.

Mwa omwe amalandila simvastatin, kufa kwathunthu kunachepa, pomwe pafupipafupi amafa pazomwe sizinayambitse mitsempha, kusiyana ndi gulu la placebo sikunapezeke. Kuchepetsa kwakukulu kwa kufa (mwa omwe amalandila simvastatin) kunachitika chifukwa cha mtima - ndi 17% ndi kufa kwa coronary - ndi 18%.

Mu gululi lomwe limalandira simvastatin, chiopsezo chokhala ndi myocardial infaration chatsika ndi 38% poyerekeza ndi placebo. Panali kuchepetsedwa kwakukulu mu gulu la simvastatin la chiwopsezo chilichonse chogunda ndi 25%, pomwe chiopsezo cha ischemic stroke chatsika ndi 30%. Kukhazikitsidwa kwa simvastatin sikunakhudze kwambiri matenda a hemorrhagic stroke (kusiyana ndi gulu la placebo sikunali kwakukulu).

Chiwopsezo chonse cha zochitika zazikulu zam'mitsempha (kulowetsedwa kwa myocardial, kufa chifukwa cha zoyipa zam'mimba, sitiroko, kufunikira kwakusintha) zinachepa pagulu la odwala omwe amatenga simvastatin ndi 24%. Kutsika kwakukulu muzochitika zazikulu zam'magazi, kuphatikiza stroko, pagulu la simvastatin kunachitika mosasamala za mbiri yakale ya IHD, zaka, jenda, kapena kumwa mankhwala ena (acetylsalicylic acid, b-blockers, ACE inhibitors) mwa osuta komanso osasuta.

Langizo: Kuchepa kwa chiwerengero cha zochitika zazikulu zam'magulu zomwe zimachitika mu gulu lomwe limatenga simvastatin sizinadalire, monga zikuwonekera koyamba, pamlingo woyamba wa LDL cholesterol. Gulu la anthu omwe ali ndi cholesterol choyambirira komanso yabwinobwino ya LDL-C (malinga ndi malingaliro aku European 1998 1998) adawonetseranso zabwino.

Mu gulu logulitsidwa la odwala omwe atenga simvastatin ndi LDL cholesterol

Chifukwa chake, 40 mg ya simvastatin yomwe imatengedwa zaka zopitilira 5 imachepetsa zovuta za mtima ndi gawo limodzi, osati mwa odwala omwe ali ndi matenda amitsempha yamagazi, komanso m'magulu omwe alibe matenda am'mitsempha, koma ndi chiopsezo chotukuka: , matenda amitsempha yamagazi, matenda ashuga.

Malinga ndi malingaliro a American Diabetes Association 2004, poganizira zotsatira zoyesedwa mosasamala, mulingo wa cholesterol wa LDL kwa odwala omwe ali ndi matenda a shuga a 2, omwe ali m'gulu lowopsa, lofanana ndi CHD, ayenera kukhala