Mankhwala a shuga a encephalopathy

Worsens memory, kuganiza njira, chidwi. Oposa 32% ya anthu odwala matenda a shuga amakhala ndi nkhawa. Matenda opatsirana amawoneka.

Zizindikiro zake m'magawo oyambilira sizili zachindunji, kotero odwala nthawi zambiri amanyalanyaza mawonetseredwe oyamba a matendawa ndipo samapita kwa dokotala.

Matendawa amadziwika ndi kupsinjika maganizo

Zizindikiro

Kuzindikira kwa encephalopathy mu shuga kumachitika pambuyo pakupenda kwathunthu kwa wodwalayo.

Zolemba zasayansi ndi zothandizira zimachitika, kupatula matenda ena a muubongo:

1. Electroencephalography. Kusiyanitsa kwa miyambo yofunika, zizindikiro za ntchito za khunyu zalembedwa.
2. Scan ya MRI Mu gawo loyambirira, palibe zosintha zomwe zapezeka. M'magawo otsatirawa, kusintha kwakang'ono koyambirira kumadziwika.
3. Laboratory mayeso a mkodzo ndi magazi. Dziwani kuchuluka kwa shuga, cholesterol, insulin. Ndi matendawa, zizindikiro zonse zimachuluka.

M'pofunikanso kuchitira matenda osiyanasiyana ndi zotupa za muubongo.

Zizindikiro za CT encephalopathy

Ndikosatheka kuchiza encephalopathy kokha osaneneka mankhwala ochepetsa shuga kwa wodwala. Chifukwa chake, chithandizo cha matenda a shuga a encephalopathy amachitika molumikizana ndi ma psychologists ndi endocrinologists.

Mankhwala

Chithandizo chachikulu ndikufuna kupangitsa shuga m'magazi. Mwa izi, mankhwala a insulin kapena ochepetsa shuga am'magulu ena amagwiritsidwa ntchito, kutengera mtundu wa shuga. Endocrinologist ikuchita kusankha mankhwala. Kuchiza ndi mankhwalawa kumachitika moyo wonse, ndikofunikira kuyeza kuchuluka kwa shuga nthawi zonse.

Malangizo a matenda a encephalopathy akuphatikizira kugwiritsa ntchito magulu otsatirawa a mankhwala:

• njira zomwe zingathandizire kusintha kwa ma cellcirculation - Pentoxifylline, Trental,
• Mavitamini B amafunika kubwezeretsa dongosolo lamanjenje,
• mankhwala ochepetsa mafuta a cholesterol - ma statins, ma fibrate,
• njira yothetsera chizungulire - Cinnarizine, Vinpocetine.

Mankhwalawa ndiwotalikirapo ndipo nthawi zambiri amapitilira pamoyo wa munthu.

Kupewa

Zizindikiro za encephalopathy zitha kuchititsa munthu kusasangalala. Chifukwa chake, ndibwino kuyesa kupewa matendawa kuposa kuchiza.

Kodi chofunikira ndi chiyani pamenepa? Dokotala wanu akufotokozerani momwe mungakhalire ndi shuga wokwanira mumagazi, zomwe wodwala wodwala matenda ashuga ayenera kukhala nazo.

Kuyika kwa magazi kuubongo kudzasintha zochita zolimbitsa thupi mu mpweya wabwino. Chachikulu ndikumvetsera thupi lanu mosamala ndipo, pakakhala mawonekedwe aliwonse osasangalatsa, lemberani kuchipatala.

Glucometer ikuthandizira kuwunika kuchuluka kwa shuga

Matenda a diabetes a encephalopathy ndi ubongo wopita patsogolo womwe sungathetsedwe kwathunthu. Kukula kwake kumatsimikizika mwakuya komanso machitidwe a shuga. Kuzindikira koyambirira ndi chithandizo chamankhwala chamtsogolo chitha kuimitsa chitukuko cha matendawa.

Mafunso kwa adotolo

Kodi chifukwa chiyani matenda am'mimba omwe amachititsa kuti matenda ashuga asamveke nthawi zambiri amakayikira?

Lyudmila. Kursk, wazaka 35.

Izi ndichifukwa cha kukhalapo kwa zizindikiro zina. Wodwala matenda a shuga atha kukhala ndi matenda oopsa, limodzi ndi kukwera kwakukulu kwa zovuta komanso chiopsezo chakuvutika. Pankhaniyi, madokotala nthawi zambiri amaletsa matenda ashuga a m'mimba ndikulankhula za matenda osakanikirana.

Amayi (azaka 68) amapezeka ndi matenda a shuga. Kodi zakudya za matendawa ziyenera kukhala chiyani? Ndi zakudya ziti zomwe zimakhala zovulaza?

Inna R., Voronezh, wazaka 42.

Mutha kudya buledi wa tirigu wathunthu, nyama yamafuta ochepa ochepa, nsomba zowiritsa kapena zophika ndi nsomba zam'nyanja. Zabwino zamasamba, anyezi, adyo.

Mutha kudya zipatso za malalanje, raspberries, sitiroberi, currants, yamatcheri. Buckwheat, ngale balere, mapira, ndi oatmeal amaphatikizidwanso muzakudya. Pochulukirapo, mutha kudya zinthu zamkaka, mafuta a masamba, mazira, confectionery yapadera ndi okoma.

Mikate yoyera ndi ma buns, nkhumba, zamasamba zamzitini, soseji ndi nyama zosuta, mbatata, kaloti, beets ndi nyemba siziyenera kuperekedwa kuchakudya. Zipatso, muyenera kusiya mphesa, mavwende, nthochi, zipatso. Mafuta a nyama, shuga, uchi, tchizi, zakudya zonunkhira ndi chakudya mwachangu ndizoletsedwa.

Ndi zovuta ziti zomwe zingayambike?

Igor, Moscow, wazaka 35.

Kuwonongeka kwa chidziwitso kumatha kuyambitsa matenda a dementia (dementia). Izi zimachepetsa kudzisamalira kwa odwala komanso zimayambitsa kulumala. Mavuto akhoza kukhala ischemic stroke, intracranial hemorrhages, vuto la kulankhula, zovuta zamagalimoto.

Zambiri za encephalopathy mu shuga

Zosadabwitsa, koma kuzindikira kumeneku kumadzetsa kukayikira kambiri, ngakhale ngati iko kanakhazikitsidwa. Izi zimachitika chifukwa cha kuchuluka kwa zizindikilo zosiyanasiyana zachilengedwe.

Mwachitsanzo, ngati m'mbiri ya zamankhwala, kuphatikiza pa matenda ashuga, palinso matenda oopsa oopsa omwe amachitika pafupipafupi, komanso kusokonezeka kwa kufalitsa kwa matenda a mtima, ndiye kuti madokotala amatha kunena kuti matenda ashuga a matenda a shuga. Muzochitika zoterezi, pakhoza kukhala mtundu wamatenda wa matenda kapena osakanikirana.

Zizindikiro zazikulu

Matenda amtunduwu amakuka ndikukula kwathunthu komanso pang'onopang'ono. Kusintha konse kwa dystrophic kumatha kukulira popanda kudzipangitsa ngakhale kwa zaka zingapo motsatana. Kunena zowona, pali zizindikiro, koma sizingazindikiridwe kapena kungoyambitsa matenda ena. Chifukwa chake, zomwe zingachitike ndi matenda a matenda ashuga:

• mawonetseredwe aliwonse am'mimba-yam'mimba yotupa,
• mutu ndi chizungulire,
• kutopa kwambiri, kugona mosalekeza,
• kusachedwa kufulumira, mantha amtundu (kusintha kosinthika ndikothekanso, mwachitsanzo, kutaya chidwi ndi moyo komanso thanzi limodzi),
• kuyiwalako, kutayika kwa zolakwa.

Zizindikiro zonsezi zitha kunyalanyazidwa. Odwala ambiri potero amayamba matendawa, osafunsa thandizo la adokotala panthawiyi, zikuwoneka kuti zizindikilo zonse ndizazing'ono ndipo samangofunika.

Kupitilira apo, gawo lachiwiri la matendawa limayamba, lomwe limakula kwambiri, ndipo lachitatu ndi chiyambi cha matenda osokoneza bongo omwe amakhala nawo odwala matenda ashuga.

Munthu sangasiye zochitika zakale komanso zokhumudwitsa kwambiri, manic syndrome, komanso machitidwe osayenera. Ndikosavuta kuphonya izi, koma zikuwonetsa kuchuluka kwa njirayi.

Maphunzirowa ndikuwazindikira matendawa

Matenda a shuga a matenda a shuga amatha kupezekanso ndi matenda ena. Ngati tikulankhula za okalamba, ndiye kuti izi ndizovuta muzochita zam'kati, ndipo mwa achinyamata - izi ndi zotsatira za kuopsa ketoacidotic.

Mu chithunzi cha matenda tingaone:

1. asthenic syndrome (kutopa kwambiri, kuchepa kwa ntchito, nkhawa kwambiri, kufooka, kusowa tulo, mavuto okhala ndi ndende),
2. cephalgic syndrome (mutu). Itha kukhala yopanga kapena kufinya. Nthawi zambiri, ululu umatha kufotokozedwa ngati kumverera kwa mutu wakulemera mutavala chovala cham kumutu,
3. michere ya dystonia yomwe imapangidwa ndi ma paroxysms, kukomoka ndi kutaya chikumbumtima.

Kuphatikiza pazizindikirozi, pali zizindikiro zomwe zikuwonetsa zovuta zina zoyang'ana mbali. Amakhala pamwamba-tsinde (zizindikiro za kuperewera kwa piramidi, anisocoria, matenda opatsirana), komanso vestibulo-atactic syndrome (gait shakiness, kusokonezeka koyanjana, kayendedwe ka chizungulire.

Zizindikiro zokuwuzani kwambiri pachithunzi cha njira ya encephalopathy motsutsana ndi shuga

• mavuto amakumbukiro
• kubweza kwamalingaliro,
• mphwayi
• kukhumudwa

Chimodzi mwazonsezi chimawonetsa kusokonekera kwa kapangidwe kazigawo zamkati mwa ubongo. Ndi mtundu uliwonse wa matenda ashuga, kukhumudwa kumatha kuchitika. Pafupifupi 32 peresenti ya odwala adzadwala nthendayi.

Kuphatikiza pazovuta zomwe zimabweretsa thanzi lathunthu, kupsinjika kwa nthawi yayitali ndizowopsa chifukwa cha kuchepa kwa kuwongolera nthawi yonseyo matendawa, kupatsa thanzi komanso kugwiritsa ntchito insulin.

Cholinga chachikulu cha izi muzochitika za odwala ndizosintha zamankhwala m'thupi, komanso kudalira kwamatenda pafupipafupi komanso kufunika koyilamulira.

Matenda ena a shuga a mtundu woyamba kapena wachiwiri amatha kukhala ndi hypoglycemic encephalopathy chifukwa cha hypoglycemia. Itha kuwoneka motere:

1. ulesi
2. mphwayi
3. zovuta za chikumbumtima monga delirium,
4. Adynamia pambuyo pa ntchito kapena pamimba yopanda kanthu.

Ma syndromes othandizira komanso phiramidi ya hemiparesis amakhalanso ndi chikhalidwe.

Kuti mupeze kuzindikira koyenera, kuphatikiza madandaulo a asthenic ndi michere-dystonic, ndikofunikira kuzindikira zizindikiro za minyewa yozungulira.

Kusintha kulikonse mu electroencephalogram (EEC) mwa odwala omwe ali ndi encephalopathy chifukwa cha matenda osokoneza bongo amawonedwa ngati dysregular. Amasinthasintha mwachilengedwe, zomwe zimawonetsedwa ndi kukula kwa EEG, mitsempha ya hypersynchronization, kuchepa kwa mizere ya alpha wamba komanso yakusintha, kusintha kwakukonzanso kwa ma EEG curve, komanso mafunde akukhazikika a pathological a delta ndi mitundu ya theta.

Mu odwala matenda ashuga okalamba, matenda a shuga a encephalopathy amatha kutsatiridwa ndi kuperewera kwa mitsempha, atrophy, komanso kusintha kwam'mbuyo kwa sitiroko. Amatha kuzindikiridwa ndi computed tomography (CT) kapena maginito a resonance imaging (MRI). Njira zowonetsera zomwe zikuwoneka ndi matenda a shuga komanso mavuto ena okhudzana ndi izi: macroangiopathy, atherosulinosis, ndi ochepa matenda oopsa.

Stroke, komanso kufooka kwa ischemic, zitha kuganiziridwa malinga ndi zizindikiro za chapakati neuropathy.

Kodi chithandizo cha matendawa chimakhala bwanji?

Chithandizo chothandizira kuchiritsa matenda a shuga omwe amachititsa kuti odwala matenda ashuga asinthe. Ndibwino kuti mukumalandira chithandizo ndikuyenera kukumbukira zovuta zonse komanso kuwonongeka kwa ubongo.

Kuti apange njira yoyenera yothandizira, ndikofunikira kuyambitsa kuwonetsetsa kuti thupi lonse lawonekeratu. Ndi njira iyi, mawu omaliza akhale olondola, ndipo chithandizo chamankhwala chimangobweretsa zabwino.

Chimodzi mwazovuta za matenda ashuga ndi matenda a shuga. Matenda amtunduwu amakula chifukwa chakuwonongeka kwa dongosolo lamanjenje pakati pa matenda ashuga. Pafupipafupi kufala kwa matenda ashuga encephalopathy kumatengera mtundu wa matenda a shuga, ndipo kuthandizira kwa matendawo kumatengera kutalika ndi matendawa.

Kodi matenda awa ndi ati?

Kukula kwa matenda ashuga encephalopathy kumachitika chifukwa cha kusokonezeka kwa kagayidwe kachakudya m'thupi, kamene kamayambitsa kuwonongeka kwa zinthu zamkati zamanjenje.

Vutoli limayamba chifukwa cha kuwonongeka kwa okosijeni ku ubongo, kusokonezeka kwa metabolic m'thupi komanso kudzikundikira kwa zinthu zapoizoni. Njira zonsezi zimatsogolera pakuperewera ndikuphwanya zinthu zofunika mu ubongo. Njira yakukula kwa matendawa imatenga zaka zambiri, kotero ndizovuta kudziwa zizindikiritso zoyambira.

Kodi matenda a shuga a encephalopathy ndi ati?

Matenda a diabetes a encephalopathy ndi chikhalidwe chomwe chimalumikizidwa ndi kuwonongeka kwa magawo amkati wamanjenje komanso ubongo makamaka. Izi zimachitika chifukwa cha zovuta za kagayidwe kachakudya matenda ashuga. Malinga ndi ofufuza, matenda a shuga a encephalopathy amapezeka kawirikawiri mu mtundu woyamba wa matenda, makamaka mwa 80% ya milandu.

Mwambiri, iyi ndi lingaliro lophatikiza lomwe limaphatikiza mawonetseredwe azazinthu zingapo zovuta. Ikhoza kukhala yodekha mutu komanso kuwonongeka koopsa m'maganizo. Chimodzi mwa zomwe timayambitsa matenda am'mimba ndizovuta zokhudzana ndi matenda komanso kusadziwika kwa njira zamankhwala.

Zizindikiro za matendawa

Zizindikiro zake za encephalopathy zimangodalira zaka za wodwalayo, kuuma kwa vuto lakelo, kupezeka kwa zovuta ndi matenda amiseche. Dziwani izi:

• matenda amapezeka pang'onopang'ono m'kupita kwa zaka.
• adakali aang'ono, zizindikiritso zimakula pambuyo pa zochitika za hyper- and hypoglycemic, mwa okalamba - zokhudzana ndi ngozi zapamtima.
• Zizindikiro zamankhwala siziri zachindunji ndipo zimaphatikizira kuwonongeka kwa kuzindikira, asthenia, mawonekedwe a neurosis,
• kumayambiriro kwa matenda, odwala matenda ashuga amatha kudandaula za kufooka, kutopa msanga, nkhawa. Mutu komanso mavuto azovuta zomwe zingachitike zingachitike.

Mkhalidwe wofanana ndi wa neurosis umalumikizidwa ndi somatic (wathanzi wathanzi) ndi psychogenic (kufunika kwa chithandizo chanthawi zonse, chowonadi cha zovuta).

Pa chithandizo choyambirira, vuto la neurotic limapezeka mwa 35% ya odwala; matenda a shuga akamakula, kuchuluka kwawo kudzawonjezeka mpaka 64%.

Mavuto akulu amisala komanso kusokonezeka kwa zikhulupiriro ndizosowa.

Asthenic syndrome imalumikizidwa ndi ulesi komanso ulesi, womwe umatha kuphatikizidwa ndi michere-mitsempha yamavuto komanso ma syncopal (kusowa kwadzidzidzi kwakanthawi kochepa). Mavuto mu gawo lazolumikizana amatha kuphatikizidwa ndi kuchuluka kwa kukumbukira, kusokoneza ndi kulingalira kwapang'onopang'ono.

Zoyambitsa matenda a shuga a Encephalopathy

Chochititsa chachikulu chomwe chimayambitsa kukula kwa matendawa ndi matenda ashuga a shuga ndi metabolism. Zinthu zomwe zimakonzedweratu ziyenera kuganiziridwa ngati ukalamba, kuchuluka kwa thupi. Komanso pamndandandawu ndi kuchuluka kwa lipid peroxidation komanso kutayika kwa lipid metabolism. Vuto linanso lalikulu, akatswiri amati shuga ya magazi yayitali kwakanthawi yayitali komanso mfundo zapamwamba za glycosylated hemoglobin.

Polankhula zakusintha kwachilengedwe mu dongosolo la encephalopathy mu shuga mellitus, samalani makamaka poti:

• kuchuluka kwa mpweya komanso kapangidwe kake ka makoma a zombo zazing'onoting'ono zimakhazikika,
• Zotsatira zake ndimavuto a michere ndi ma cell, kuperewera kwa mpweya, komanso mphamvu zamagetsi pama cellular, zimapangidwa,
• poyankha izi, njira zopanda mpweya za metabolic (anaerobic) zitha kuyambitsidwa, zomwe zimapangitsa kuti zinthu zambiri zizikhala ndi poizoni.

Chifukwa cha kusintha koteroko, ubongo wapamwamba umagwira ntchito pakusintha kwa ma pathological. Kuti izi zitheke, nthawi yayikulu iyenera kudutsa, nthawi zambiri timalankhula za nthawi yayitali ya matenda ashuga.

Pankhani imeneyi, encephalopathy imatengedwa ngati kuchulukitsa kwa matendawa. Nthawi zambiri, zamatsenga zimakhala ndi nthawi yokhala ndi matenda amtundu woyamba, chifukwa amayamba ali aang'ono. Chifukwa chake, akatswiri adziwa kuthekera kwakukulu kwa matendawa mu okalamba.

Magawo a zamisala

Matenda a diabetes a encephalopathy amadziwika ndi magawo atatu otsatizana. Yoyamba ndi yomwe chithunzi cha chipatala sichikupezeka. Mitu yaying'ono, chizungulire imadziwika, kusintha kwa chiwonetsero cha magazi ndizotheka. Mwambiri, odwala matenda ashuga samanyalanyaza zizindikirazo ndipo safuna thandizo kwa katswiri.

Pa gawo lachiwiri, zizindikiro za pathological zimawonjezeka: Mutu umayamba kutchulidwa, kupotoza kuyang'ana m'malo ndikotheka. "Gawo" lachitatu limayenderana ndi chakuti chithunzi cha chipatala chimawonetsedwa bwino. Mu gawo lomwe mwawonetsedwa, kusokonezeka kwakukulu kwa chikumbumtima, kuganiza, komanso kutengeka ndizotheka.

Njira zopezera matenda

Kuzindikira kwa matenda a shuga a encephalopathy ayenera kuperekedwa mwachidwi. Zili ndi mfundo yoti:

• cheke chimachitika ndi katswiri wa zamitsempha, ndipo lingaliro limapangidwa pamaziko a kafukufuku wokhudza mitsempha,
• kuwunika kwa magwiridwe antchito ndi ma organic kumachitika pogwiritsa ntchito luso,
• electroencephalography, MRI yaubongo, ndi ubongo hemodynamics ziyenera kuchitidwa motsatana.

Gawo lokakamiza la kuwunika koyenera liyenera kuonedwa ngati mayeso a labotale, zomwe zimapangitsa kuti athe kuyesa kuchuluka kwa zovuta zama metabolic. Chifukwa chake, kuchuluka kwa shuga, lipids, cholesterol, komanso C-peptide ndi insulin zimadziwika. Kusiyanitsa mosiyanasiyana cholinga chake ndikuchotsa zotupa ndi ma neoplasms mu ubongo. Cheke chimachitika pokhudzana ndi zamankhwala, kupezeka kwa matendawa kungatsimikiziridwe mwa kapangidwe kazoganiza zamagalasi.

Chithandizo cha matenda ashuga a Encephalopathy

Chithandizo cha matenda a shuga a encephalopathy ndichakudya chanthawi zonse. Ndikulimbikitsidwa kusiya nyama, mkaka, ufa ndi mbatata. Tisaiwale za kuyambitsa maphunziro a vasoactive ndi metabolic mankhwala, omwe amapangidwa poganizira contraindication komanso moyang'aniridwa ndi katswiri. Kuphatikiza ndikulowerera ukutha kugwiritsidwa ntchito pa prophylactic. Kutalika kwa maphunziro a anthu odwala matenda ashuga kumayambira mwezi umodzi mpaka itatu, kamodzi kapena kangapo pachaka.

Kukwanitsa kubwezeredwa kwa ndalama kumatheka chifukwa chokhazikitsidwa ndi chithandizo choyenera, chomwe chimachitika poganizira za moyo ndikuyang'aniridwa ndi glycemia. Tiyenera kukumbukira kuti:

• Ma antioxidants (mwachitsanzo, amapanga ndi alpha-lipoic acid), cerebroprotectors (Piracetam), komanso zinthu zamagulu a vitamini (B1, B6, A, C) amagwiritsidwa ntchito ngati metabolic metabol. Mankhwala osakanikirana monga Neuromultivitis, Milgamm amayenera kusamalidwa mwapadera.
• vasoactive mankhwala amathanso kugwiritsa ntchito Piracetam, Stugeron ndi Nimodipine,
• nthawi yomweyo, kukonza mankhwala mogwirizana ndi lipid metabolism kumachitika. Amakhala mukugwiritsa ntchito mankhwala omwe ali m'gulu la ma statins.

Mu zovuta pachikhalidwe odwala matenda ashuga encephalopathy kwambiri matenda, anticonvulsant mankhwala angafunike. Maphunziro omwe amafunsidwa chifukwa cha zovuta za shuga amatha kugwiritsidwa ntchito. Iyi ndi nthawi yayitali ndipo ndiyovuta.

Kuneneratu komanso kupewa matendawa

Matenda a diabetes a encephalopathy ndiwofatsa. Kuchulukitsa kwa chithunzi chachipatala kudzatengera mwachindunji kukula kwa matendawo.

Kawonedwe mwadongosolo ndi endocrinologist ndi neurologist, chithandizo cholondola chomwe chimachepetsa shuga, komanso maphunziro apadera a mitsempha amathandizira patsogolo. Amapangitsa kuti kuyimitsa kapena kuchepetsa pang'onopang'ono kukula kwa zizindikiro zamatumbo komanso kusaika mapangidwe azovuta. Kupewa kwa encephalopathy ndiko kuzindikiritsa kwa nthawi yake komanso chithandizo chokwanira cha matenda ashuga. Njira yofunika ndikukhazikitsidwa kwa matenda oopsa komanso kuchiza matenda a mtima.

Encephalopathy - ndi chiyani?

Mawu akuti "encephalopathy" amatanthauza matenda onse amtundu wa bongo pomwe pakapanda kutupa matenthedwe ake amawonongeka. Tizilombo taubongo nthawi zambiri timawonongeka pang'ono ndi vuto la kuperewera kwa zakudya m'thupi. Mwachilengedwe, nthawi yomweyo, gawo limodzi la magawo amomwe amachitika mu ubongo limatayika. Zomwe zimayambitsa matenda a diabetes a encephalopathy ndi kusokonekera kwa metabolic komanso mtima m'thupi.

Malinga ndi magwero osiyanasiyana, zizindikiro za encephalopathy zimatha kupezeka pafupifupi 90% ya odwala matenda ashuga. Ngakhale izi, kufufuza koteroko kumapangidwira mosadukiza, popeza matendawa ndi ovuta kuzindikira ndikuzindikira kuti shuga ndiyomwe imayambitsa kusintha kwa ubongo.

Malinga ndi kalata yochokera ku Unduna wa Zaumoyo ku Russia, matenda ashuga ali ndi nambala ya ICD ya 10 (matenda apadziko lonse lapansi) E10.8 ndi E14.8 - zovuta zosadziwika za matenda ashuga.

Chomwe chimapangidwira kukula kwa encephalopathy sichimamveka bwino, koma amakhulupirira kuti imagwirizana kwambiri ndi matenda ashuga a m'mimba. Choyambitsa chachikulu cha matenda ndi zofanana ndi zovuta zina za matenda ashuga - hyperglycemia.

Shuga wapamwamba amatsogolera ku angiopathy yamitsempha yamagazi, yomwe imaphwanya zakudya za ubongo. Chifukwa cha kusokonezeka kwa magazi, ma neuron amamva kuperewera kwa mpweya, amagwira ntchito kwambiri, samatha kuchira munthawi yake ndikuchotsa zinthu zapoizoni. Vutoli likuchulukirachulukira ndi kuchuluka kwa cholesterol, triglycerides ndi otsika osalimba lipoproteins, wokhala ndi matenda a shuga.

Magawo atatu a encephalopathy

Kukula kwa encephalopathy kumachitika mu magawo atatu. Zizindikiro zoyambirira sizimakhala zachindunji, chifukwa chake odwala matenda ashuga sawalabadira. Nthawi zambiri, encephalopathy imadziwika kuti si yachiwiri kuposa gawo 2, pomwe zizindikiro zake zimatchulidwa. Kumayambiriro kwa matendawa, MRI imatha kuzindikira kusintha kwazing'ono kwambiri mu ubongo. Nthawi zambiri zimapezeka mosiyanasiyana m'malo angapo. Pambuyo pake, chotupa chimapangidwa mu ubongo. Zizindikiro zoyambira ndi kuuma kwawo panthawiyi zimadalira kutulutsa chidwi.

Gawo la matenda ashuga a shuga:

1. Pa gawo loyamba - wodwala amawona magawo a kukwera ndi kugwa kwa kuthamanga kwa magazi, chizungulire, kuzimitsa khungu m'maso, kutopa ndi khungu. Monga lamulo, mawonekedwe awa amawonetsedwa ndi nyengo zoyipa, zaka kapena michere-vascular dystonia.
2. Mu gawo lachiwiri - Mutu umakhala pafupipafupi, kukumbukira kwakanthawi kochepa, kusokonezeka m'mlengalenga ndikotheka. Zizindikiro zamitsempha zimatha kuwoneka - zochita za ophunzira pakusintha kowala, malankhulidwe amasokonezeka, mawonekedwe amawonongeka, mavuto okhala ndi nkhope amapezeka. Nthawi zambiri, ndi nthawi imeneyi pomwe odwala omwe ali ndi matenda ashuga amatembenukira kwa wamatsenga.
3. Mu gawo lachitatu - Zizindikiro zimatchulidwa. Pakadali pano, kupweteka kwa mutu kumakulirakulira, mavuto ndi kulumikizana kwa mayendedwe, chizungulire chikuwonekera. Kusowa tulo, kukhumudwa, kukumbukira kumakulirakulira. Pakadali pano, ndizosatheka kudziwa maluso ndi kudziwa kwatsopano.

Zolemba zamatenda a matenda amtundu 1 komanso matenda ashuga 2

Mwanjira yake yoyera kwambiri, matenda a shuga omwe amachititsa anthu odwala matenda ashuga a mtundu woyamba 1. Kusokonezeka muubongo wawo kumalumikizidwa ndi kusowa kwa insulin yawo komanso kulandira mosayembekezereka ngati mawonekedwe. Pali malingaliro oti kupititsa patsogolo kwa encephalopathy kumangotengera kuchuluka kwa hyperglycemia, komanso kusakhalapo kwa C-peptide m'thupi - gawo la molekyulu ya proinsulin yomwe imachotsedwa pamenepo pakupanga insulin. Insulin ya mafakitale, yomwe imalembedwa kwa odwala onse omwe ali ndi matenda amtundu wa 1, ilibe C-peptide - werengani zambiri za C-peptide.

Encephalopathy imavulala kwambiri mu mtundu woyamba wa shuga kwa ana aang'ono. Amakhala ndi mavuto ndi chidwi, chidwi chazidziwitso chimachedwa, ndikukumbukira kumachepa. Kuyesedwa kwapadera kunatsimikizira kuti wodwala yemwe ali ndi encephalopathy, IQ ya mwana imachepa, komanso zotsatira zoyipa za luntha anyamata amphamvu kuposa atsikana. Kafukufuku wamaubongo omwe ali ndi odwala omwe adayamba matenda ashuga amawonetsa kuti akadzakula, amakhala ndi vuto latsitsi kuposa anthu athanzi.

Matenda a diabetes a encephalopathy okhala ndi matenda amtundu wa 2 amasakanikirana. Pankhaniyi, ubongo umakhudzidwa osati ndi hyperglycemia yokha, komanso zovuta zina:

1. Hypertension imawonjezera kusintha kwa atherosselotic m'matumbo, nthawi 6 kumawonjezera chiopsezo cha encephalopathy.
2. Kunenepa kwambiri kwamkatikati kumayambitsa matenda owopsa a encephalopathy mu ukalamba.
3. Kukana kwamphamvu kwa insulin kumayambitsa kudzikundikira kwa amyloid beta mu ubongo - zinthu zomwe zimatha kupanga zolembera ndikuchepetsa kwambiri kuzindikira kwa ntchito.

Encephalopathy imapereka chiopsezo chachikulu mu mtundu 2 wa matenda ashuga okalamba, zomwe zimayambitsa kukula kwa mtima ndi mtima komanso matenda a Alzheimer's.

Doctor of Medical Science, Mutu wa Institute of Diabetesology - Tatyana Yakovleva

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russia Academy of Medical Science idatha kupanga mankhwala omwe amachiritsiratu matenda ashuga. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wa mankhwalawo. Ku Russia, odwala matenda ashuga mpaka Meyi 18 (kuphatikiza) nditha kuipeza - Kwa ma ruble 147 okha!

Zizindikiro zake

Zizindikiro za encephalopathy mu diabetesics amafotokozedwa ndi kulephera kwa maselo a mu ubongo kugwira ntchito moyenera chifukwa cha kuperewera kwa mpweya ndi michere, chifukwa chake ali ofanana ndikuwonetsa kwa encephalopathy chifukwa cha atherosulinosis, matenda oopsa, kapena ngozi ya cerebrovascular.

Momwe mungathanirane ndi matenda a shuga

Chithandizo cha encephalopathy odwala omwe ali ndi matenda ashuga ndi ovuta, umapangidwa munthawi yomweyo kutulutsa kagayidwe kachakudya ndikusintha momwe ziwiya zimaperekera ubongo. Pakugwiritsa ntchito malangizo a kagayidwe:

1. Kuwongolera chithandizo cha matenda a shuga omwe adapangidwa kale kuti akwaniritse standardoglycemia.
2. Ma antioxidants kuti muchepetse zowonongeka za ma free radicals. Nthawi zambiri, lipoic acid amakonda.
3. Mavitamini B, nthawi zambiri monga gawo la ma protein apadera - Milgamm, Neuromultivit.
4. Statin kwa matenda a lipid kagayidwe - Atorvastatin, Lovastatin, Rosuvastatin.

Kupititsa patsogolo magazi, magazi a angioprotectors ndi antiplatelet amagwiritsidwa ntchito: Pentoxifylline, Actovegin, Vazaprostan. Nootropics itha kutumikiridwa - mankhwala omwe amalimbikitsa ubongo, mwachitsanzo, vinpocetine, piracetam, nicergoline.

Zotsatira zake

Kukula kwa encephalopathy kumadalira m'badwo wa wodwalayo, nthawi yake komanso kuchuluka kwake pobwezeretsanso kudwala kwake. Kuchiza koyenera kwa encephalopathy ndi matenda a shuga kumalola zaka zambiri kukhalabe ndi ubongo wa wodwalayo pamlingo womwewo, popanda kuwonongeka kwakukulu. Nthawi yomweyo, wodwalayo amasungabe mphamvu yayikulu yogwirira ntchito komanso luso lotha kuphunzira.

Ngati chithandizo chachedwa, matenda ashuga a m'mimba amachititsa matenda ambiri am'mitsempha: migraines yayikulu, kupweteka kwa mtima, komanso kuwonongeka kwa mawonekedwe. M'tsogolomu, ubongo umataya pang'ono ntchito zake, zomwe zimawonekera ndikutaya pang'ono pang'onopang'ono mpaka kulumala kwakukulu.

Kutheka kwa encephalopathy kwamatenda akulu amisala, momwe mumakhala kuyerekezera zinthu zina, kunyengerera, zosayenera, kulephera kuyenda pamtunda ndi nthawi, kuiwala kukumbukira.

Onetsetsani kuti mwaphunzira! Kodi mukuganiza kuti kuyamwa kwa mapiritsi ndi insulini kwa nthawi yonse yokhayo ndi njira yokhayo yothanirana ndi shuga? Sichowona! Mutha kutsimikizira izi nokha ndikuyamba kuzigwiritsa ntchito. werengani zambiri >>

Kodi ndimomwe zimayambitsa matenda ashuga a encephalopathy?

Zifukwa zazikulu zomwe zimayambitsa kukula kwa matendawa ndi matenda a shuga a shuga (kuphwanya kapangidwe kake ka makhoma a zotengera zazing'ono) komanso kusokonekera kwa metabolic m'thupi. Zomwe zimathandizira poyambira ndikukula kwa matenda a shuga

• onenepa kwambiri
• ukalamba
• mafuta ochepa kagayidwe,
• lipid peroxidation wa maselo nembanemba,
• shuga wamagazi ambiri, omwe amakhala kwa nthawi yayitali.

Bwererani ku tebulo la zomwe zili

Zizindikiro Za Zipatala za Encephalopathy

Zizindikiro zazikulu za matenda amtunduwu ndi:

• matenda a neurasthenic - kutopa, kusakhazikika pamalingaliro, mavuto ogona,
• chizungulire, mutu wamitundu mitundu,
• diplopia (kukhathamiritsa kwa zinthu m'maso), "chifunga", "kuthamanga kwa ntchentche" pamaso pa maso,
• kusakhazikika bwino
• mavuto amisala
• kukumbukira pang'ono, njira zoganizira, kusokonezeka kwa chidwi ndi chidwi,
• mavuto okhumudwitsa
• kuda nkhawa (kusokonezeka),
• kukokana
• ngozi za cerebrovascular (kufupika kwa ischemic, stroko).

Madera ovuta amakhala ndi gawo lachitatu la encephalopathy.

Mu magawo oyambirira a chitukuko cha matenda a shuga, chithunzi cha chipatala sichinafotokozeredwe bwino. Pamene matenda akupita patsogolo, zizindikirizo zimakulirakulira. Kukhumudwa, kusokonezeka m'malingaliro (kusakhazikika), kukhudzika, kusokonezedwa nthawi zambiri kumawonedwa mu gawo lachitatu la izi. Kuphatikiza apo, encephalopathy ili ndi mawonekedwe amtundu wa 1 komanso matenda a shuga a 2.

Mtundu I shuga

Mtundu wa matenda ashuga awa, encephalopathy ndiwofala kwambiri kuposa mtundu II shuga. Mwa odwala, matenda ashuga encephalopathy amawonetsedwa ndi dementia (chopinga cha malingaliro ndi kukumbukira), popeza CD-1 ndi matenda a autoimmune omwe amayamba kuwonekera ali mwana kapena unyamata. Zimatengera kusakhazikika kwa kapamba kuti apange insulini, zomwe zimabweretsa kusintha kwakukulu mthupi, kuphatikiza muubongo. Nthawi zambiri, odwala oterewa amakhala ndi stroko, makamaka ukalamba.

Matenda a shuga a II

Matenda amtunduwu a shuga - omwe amapezeka, amayamba chifukwa cha kusokonezeka kwa metabolic m'thupi. Matendawa amaphatikizidwa ndi matenda oopsa oopsa, kuchepa kwa magazi, komanso kunenepa kwambiri. Odwala otere, kusokonezeka kwa m'maganizo kumakhala kofala, ndikutalika kwa nthawi yayitali (zaka zoposa 15), chiopsezo chotenga matenda am'maganizo: kukumbukira ndi kulingalira, kumawonjezeka ndi 50-114%. Kuphatikiza apo, kukhalapo kwa ochepa matenda oopsa ndi atherosulinosis kangapo kumawonjezera mwayi wokhala ndi stroko ya ischemic.

Momwe mungadziwire matenda a shuga a encephalopathy?

Tsimikizirani izi matenda amalola chithunzi choyenera chachipatala. Onetsetsani kuti mulingo wambiri wamagazi m'magazi ndi mkodzo, onani hemoglobin wa glycosylated. Kuphatikiza apo, mulingo wa matupi a ketone m'mwazi umatsimikizika. Kuphatikiza apo, maphunziro apadera a ubongo amachitika: EEG (electroencephalography), CT, MRI. Maphunzirowa amakupatsani mwayi kuti muzindikire dera lowonongeka.

Chithandizo cha encephalopathy

Chithandizo chachikulu cha matenda a shuga a encephalopathy ndi matenda a shuga. Iyenera kuthandizidwa mosamala kuti mupewe kuwoneka ndi kupitilira kwa encephalopathy. Kuphatikiza apo, ndikofunikira kutsatira zakudya zotchulidwa ndi dokotala. Pankhani yodziwitsa matenda amtunduwu, mitundu iwiri ya chithandizo ndi mankhwala:

• Metabolic - imakhudza kagayidwe kachakudya. Chithandizo chamtunduwu chimaphatikizapo mankhwala a Actovegin, antioxidants: alpha-lipoic acid kukonzekera), nootropics: Piracetam, Cytoflavin, Bilobil, Noofen, mavitamini A, C, mavitamini a gulu B: Magne-B6 "," Neovitam "," Neurorubin ".
• Vasoactive - cholinga chake ndi kukonza mkhalidwe wamagazi ndi mtsempha wamagazi. Izi zimaphatikizaponso mankhwala a nootropic, ndizotheka kugwiritsa ntchito mankhwala omwe amalimbitsa makhoma amitsempha yamagazi (Ascorutin), venotonics.

Pakakomoka kukachitika, mankhwala a anticonvulsant amachitika - Carbamazepine, Finlepsin, Lamotrigine. Kuphatikiza apo, pamaso pa concomitant matenda: matenda oopsa ndi atherosulinosis, chithandizo cha zinthu zotchulidwa, kuphatikizapo mankhwala a antihypertensive ndi ma statins. Kuphatikiza apo, odwala onenepa kwambiri amalimbikitsidwa kuteteza kulemera kwa thupi. Kuchita masewera olimbitsa thupi mopepuka, kuyenda mu mpweya wabwino, kusambira, yoga ndikulimbikitsidwa.

Kodi kuopsa kwa matendawa ndi chiani?

Choopsa chachikulu ndi encephalopathy, yomwe imadziwika m'magawo omaliza, chifukwa kusintha kosasintha komwe kumachitika mu ubongo. Kuphatikiza apo, zovuta zamagazi muubongo, zomwe zingayambitse kulumala ndi kufa, zimayika pachiwopsezo cha wodwalayo. Zosokoneza pakuganiza ndi kukumbukira ndizowopsa, zomwe zimayambitsa kulephera kudzisamalira, kuzindikira zomwe zikuchitika.

Kodi matendawa ndi ati a matenda a shuga?

Monga lamulo, ndizosatheka kuthetsa kwathunthu matenda. Ndikotheka kuti muchepetse kupita patsogolo ndikuletsa zomwe zimachitika. Pachifukwa ichi, ndikofunikira kuzindikira komanso kuchiza matenda a nthawi. Ngati wodwala amatsatira mankhwala a antidiabetesic, ndizotheka kuchepetsa chiopsezo chokhala ndi encephalopathy. Zikatero, kudalirika kumakhala kwabwino. Pankhani ya kukhalapo kwa encephalopathy ya gawo lachitatu, malinga ndi mapangidwe azovuta, matulukidwewo amakhala osavomerezeka. Chifukwa chake, kuti mupewe zotsatira zosasangalatsa, ndikofunikira kutsatira malingaliro a dokotala, kutsatira zakudya zomwe mumalandira komanso chithandizo chamankhwala, ndikukhala ndi moyo wathanzi.

Matenda a shuga - imayipitsa kuwonongeka kwa ubongo komwe kumachitika motsutsana ndi maziko a matenda a shuga. Amadziwika ndi kusokonezeka kukumbukira, kuchepa kwa magawo anzeru, kusintha kwa ma neurosis, asthenia, kusowa kwa michere-mtima, zizindikiro zoyambira. Amapezeka m'matenda a matenda ashuga chifukwa cha kuwunika kwa mitsempha, kusanthula kwathunthu kwa deta ya EEG, REG, ya cerebral MRI. Mankhwalawa ikuchitika motsutsana ndi maziko a antidiabetesic mankhwala, kuphatikizapo mtima, metabolic, vitamini, antioxidant, psychotropic, anti-sclerotic mankhwala.

Matenda a shuga

Ubale pakati pa matenda okhudzika ndi matenda a shuga ndi matenda ashuga mellitus (DM) wafotokozedwa mu 1922. Mawu akuti "diabetesic encephalopathy" (DE) adayambitsidwa mu 1950. Masiku ano, olemba angapo amati lingaliro la encephalopathy lomwe limayamba chifukwa cha njira ya dysmetabolic limawerengedwa ngati vuto la matenda ashuga. Amafunsidwa kuti apange matenda amisempha chifukwa cha vuto la mtima mu shuga mellitus to discirculatory encephalopathy (DEP). Komabe, mu Russian neurology, lingaliro la DE mwamwambo limaphatikizapo mitundu yonse ya pathogenetic ya encephalopathy: metabolic, mtima, osakanizidwa. Mwanjira imeneyi, matenda a shuga a encephalopathy amapezeka mu 60-70% ya odwala matenda ashuga.

Zoyambitsa matenda a shuga a Encephalopathy

Chotsatira cha DE ndi matenda a shuga. Encephalopathy ndi vuto lakumapeto lomwe limayamba zaka 10-15 atatha matenda ashuga. Zomwe zimayambitsa ndikusokonekera kwa kagayidwe kachakudya komwe kumayambitsa matenda ashuga, zomwe zimapangitsa kuwonongeka kwa minyewa ya ubongo ndi mitsempha yamagazi. Zotsatira za DE zimapereka:

• Dyslipidemia wa matenda ashuga. Amadziwika ndi matenda amtundu wa 2 shuga. Dysmetabolism ya lipids ndi cholesterol imabweretsa mapangidwe a mtima atherosranceotic malo. Progressive systemic and cerebral atherosulinosis imawonedwa mwa anthu odwala matenda ashuga zaka 10-15 m'mbuyomu kuposa anthu wamba.
• Mashuga a macroangiopathy. Kusintha kwa khoma la mtima kumalepheretsa magazi kulowa m'mitsempha yamatumbo, ndimomwe kumayambitsa matenda a ischemia osachiritsika, ndikukulitsa chiwopsezo cha stroke.
• Pachimake hypo-, hyperglycemic zinthu. Hypoglycemia ndi ketoacidosis zimasokoneza mkhalidwe wa neurons, zimawonjezera chiopsezo cha DE ndi dementia. Kafukufuku akuwonetsa kuti palimodzi ndi kuchuluka kwa shuga, kukhazikika kwa insulin ndi C-peptide m'mwazi ndikofunikira.
• Matenda oopsa. Amawonedwa mu 80% ya anthu odwala matenda ashuga. Zotsatira za matenda ashuga nephropathy kapena ndizofunikira. Zosokoneza magazi m'magazi, zimatha kubweretsa stroke.

Matenda a diabetesic encephalopathy ali ndi makulidwe opanga njira zophatikizira, kuphatikiza mtima ndi ma metabolic. Kusokonezeka kwa mtima chifukwa cha macro- ndi microangiopathy kumakulitsa matenda am'mimba ndipo kumapangitsa kuti njala ya m'magazi a ubongo ipangidwe. Mphamvu ya pathobiochemical yomwe imachitika nthawi ya hyperglycemia imayambitsa kutseguka kwa anaerobic glycolysis m'malo mwa aerobic, zomwe zimatsogolera ku njala ya ma neurons. Ma radicals omasuka omwe ali ndi chiwopsezo cha minofu yamatumbo. Kapangidwe ka glycosylated hemoglobin, kuchepa kwa okosijeni, kumachulukitsa hyponalia ya neuronal chifukwa cha kuvulala kwamitsempha. Hypoxia ndi dysmetabolism zimatsogolera ku kufa kwa ma neurons ndikupanga mapindikidwe kapena kusintha kwakanthawi kachilengedwe kazinthu kazinthu - encephalopathy kumachitika. Kuwonongeka kwa kulumikizana kwa ma interneuronal kumabweretsa kuchepa kwapang'onopang'ono pantchito zam'maganizo.

Zizindikiro za matenda a shuga a Encephalopathy

DE imachitika pang'onopang'ono. Ali aang'ono, mawonekedwe ake amawonjezeka pambuyo pa zochitika za hyper- and hypoglycemic, mwa okalamba - pokhudzana ndi mbiri ya stroke. Zizindikiro zamankhwala ndizosazindikira, kuphatikiza kuwonongeka kwa ziwopsezo, asthenia, zizindikiro zofanana ndi neurosis, komanso kufooka kwamitsempha ya minyewa. Kumayambiriro kwa matendawa, odwala amadandaula za kufooka, kutopa, kuda nkhawa, kupweteka mutu, mavuto okhala ndi nkhawa.

Mikhalidwe yofanana ndi neurosis imayambitsidwa ndi somatic (wathanzi) ndi psychogenic (kufunikira kopitilira chithandizo, chenicheni cha kukula kwa zovuta) zinthu. Monga kuchepa kwa chidwi, kuganizira kwambiri matendawa, kuukiridwa kwamwano. Pa chithandizo choyambirira, neurosis yodandaula imapezeka mu 35% ya odwala; momwe matenda a shuga amakulira, kuchuluka kwa odwala omwe ali ndi vuto la kukhumudwa kumawonjezereka mpaka 64%. Hysterical, nkhawa-phobic, hypochondriac neurosis imatha kuchitika. Nthawi zina, mtundu wina umadutsa wamtundu wina. Mavuto akulu amisala ndi osowa.

Asthenic syndrome imadziwika ndi ulesi, kusasamala, kuphatikiza ndi michere-mtima wamatumbo, syncope. Kuwonongeka kwazidziwitso kumawonekera mwa kuchepa kwa kukumbukira, kusokoneza, ndi kulingalira pang'onopang'ono. Pakati pazisonyezo zoyang'ana, kuperewera kwa kusakanikirana, anisocoria (m'mimba mwake wosiyana), ataxia (chizungulire, kuyenda kosagwirizana), kusakwanira kwa piramidi (kufooka kwa malekezero, kuchuluka kwa minofu).

Mavuto

Kuwonjezeka kwa kuwonongeka kwa chizindikiritso kumabweretsa kutsika kwa luntha ndi dementia (dementia). Izi ndizomwe zimayambitsa kulemala kwakukulu kwa odwala, kumachepetsa kudzisamalira. Vutoli likuchulukirachulukira chifukwa cholephera kugwira bwino wodwala mankhwala othandizira odwala. Mavuto a DE ndi kusokonezeka kwambiri kwa ubongo: Zotsatira zakuthwa ndi zovuta zamagalimoto, kuwonongeka kwa mitsempha yamagetsi, kusokonezeka kwa mawu, komanso kupita patsogolo kwa kuzindikira kwanzeru.