Micro le macroangiopathy ho lefu la tsoekere

Ho kula ha tsoekere hangata ho baka mathata, e 'ngoe ea tse atileng haholo ke lefu la tsoekere la lefu la tsoekere la libaka tse tlaase. Lefu lena le hlaha kamora lilemo tse ngata tsa kalafo ea lefu la tsoekere, mme le ama tsamaiso eohle ea methapo. Haeba li-capillaries tse nyane le likepe li senyehile, joale e khetholloa e le microangiopathy, ka lehlakoreng le leng, e nang le e meholo, ho hlaha macroangiopathy. Hangata, lefu lena le ba bang ba bangata le hlaha e le phepelo ea lefu la tsoekere. Macroangiopathy e ka fumaneha sebakeng leha e le sefe sa 'mele mme ea baka mathata a tebileng, esita le lefu.

HABOHLOKOA HO TSEBA! Le lefu la tsoekere le tsoetseng pele le ka phekoloa lapeng, ntle le ho buuoa kapa lipetlele. Bala feela seo Marina Vladimirovna a se buang. bala litlhahiso.

Lefu lee ke eng?

Microangiopathy ke tšenyeho ea marako a methapo e meholo ea mali, macroangiopathy e sitisa ts'ebetso ea methapo e meholo, mme likarolo tsohle tsa 'mele oa motho lia ameha. Nts'etsopele le kholo ea lefu lena li baka mafu a tšoaetsanoang le a baktheria, hammoho le ho se sebetse hantle ha sebete ho lefu la tsoekere. Khafetsa microangiopathy e otla lintlha tse fokolang tsa motho. Ho diabetics, mahlo a kotsing, methapo ea mali ea leihlo la mahlo e qala ho fokola ebe e oa, 'me pono e oa ka potlako. Har'a maloetse a lebisang timetsong ea marako a methapo ea mali ke:

Tsoekere e fokotseha hang-hang! Lefu la tsoekere ha nako e ntse e tsamaea le lona le ka lebisa ho letšoele la maloetse, a kang mathata a pono, maemo a letlalo le moriri, liso, maloetse a mokokotlo esita le hlahala ea mofets'e! Batho ba ile ba ruta boiphihlelo bo bohloko ho fetolela maemo a bona a tsoekere. bala ho tsoela pele.

necrotic tsekisano,
khoelerane
thrombosis
hyalinosis.

Khutlela tafoleng ea litaba

Etiology le pathogeneis

Macroangiopathy ho lefu la tsoekere mellitus ke ketsahalo e tloaelehileng; litaba tsa glucose tse ntseng li senya, tse phallang methapong ea mali. E lebisa ho ho fifala ha mmele, sebakeng se le seng lerako le ba tšesaane ebile le le brittle, 'me le leng le ea matlafala. Ka lebaka la coagulability e mpe ea mali, ho koala, thrombosis ho etsahala. Litonki le litho tsa 'mele li na le bothata ba ho haelloa ke oksijene (hypoxia), e lebisang ho se sebetseng hoa lits'ebetso tse ngata tsa' mele.

Liphetoho tse joalo li etsahala 'meleng le nts'etsopele ea lefu lena:

marako a likepe a fetoha a maholohali, ts'enyeho ea hlaha,
ponahalo ea mali e eketseha
lebelo la ho tsamaisoa ha mali ka har'a lijana le ea fokotseha.

'Mele ohle o na le litlamorao, haholoholo le maoto le matsoho a tlase, tse ikarabellang bakeng sa mojaro o mongata.

Lisosa tse kholo tsa kholo ea lefu lena:

lefutso
likotsi tsa li-degrees tse fapaneng (ka lefu la tsoekere, pholiso e ea lieha ebile e na le mathata),
maloetse a mali le a plasma,
botaoa ba 'mele le lithethefatsi,
khatello ea mali
ho fokotseha hoa mmele hape.

Khutlela tafoleng ea litaba

Ponahatso ea lefu la tsoekere micro- le macroangiopathy

Ponahatso ea matšoao ho latela tekanyo ea tšenyo ea methapo le lefu la tsoekere. Ho thata ka ho fetisisa ho phekola ke ho senyeha ha boko, ho pepeseha lisosa tsa ligrama tsa lipalamo, ischemia, lefu la pelo, encephalopathy. Khahlano le semelo sa tlolo, matšoao a hlaha butle-butle:

hlooho e phehellang, litlamorao tsa li-painkiller ha li na thuso,
ho fokotseha hoa ts'ebetso ea kelello,
mokhathala,
pono e oa
metsamao e sa laoloang
ho senyeha hoa mohopolo.

Diabetesic Microangiopathy ea maemo a tlase e atile har'a likarolo tse ling tsa 'mele, kaha boholo ba mojaro bo abetsoe eona. Ho na le bothata ba ho potoloha ha mali, qalong leoto le ka tlase, le leng le leng le leng le leng ka mangoleng. Kamora nakoana, boemo bo mpefala, matšoao a bontša ho feta. Ponahatso ea pele ea chesa le bohloko ha u tsamaea, joale bohloko bo ba bo sa mamelleheng, motsamao o ka se khonehe. Matsoho a ruruha; maemong a hatetseng pele, foromo ea maqeba a ho ruruha.

Mekhoa ea ho Tseba

Nakong ea tlhatlhobo, ngaka e lebisa tlhokomelo ho litletlebo tsa bakuli, empa sena ha se lekane ho khetholla lefu le sesosa sa lona. Ho sebelisoa mekhoa e latelang ea tlhahlobo ea tšoaetso.

Ho netefatsa kapa ho hanela tšenyo ea lisele tsa boko, retelehela ho MRI.

Tlhahlobo ea kliniki ea mali le urine. Sena se hlokahala ho laola boemo ba tsoekere ho lefu la tsoekere.
Ultrasound e sebelisang mokhoa oa Doppler. Ka thuso ea bona, "ho tsamaea" mme ts'abo ea bona e tla senoloa. Khatello ea mali tlasa lengole le eona e lekantsoe.
MRI e nang le ts'oaetso ea boko e belaetsang.
X-ray

Khutlela tafoleng ea litaba

Mekhoa ea kalafo

Microangiopathy ho lefu la tsoekere mellitus e kenyeletsa meriana e meng e sebelisetsoang kalafo. Ho hlola bokuli, o lokela ho qala ka ntho e bonolo ho feta - tlohela mekhoa e mebe le ho hlahloba lijo tsa letsatsi le letsatsi. Likhetho li etsoa feela ke ngaka, ho itlhalosa ho tla mpefatsa boemo le ho feta. Tšebeliso e tlamang ea li-metabolic metabolites tse fanang ka li-acid tse mafura mme li na le phello e molemo myocardium. Joale, mojaro o holim'a methapo ea mali o lokela ho fokotsoa ke ho hlapolla mali, hobane sena se tla fuoa heparin kapa acetylsalicylic acid.

Haeba lefu le ama maoto le matsoho a ka tlase, maqeba a ka hlaha kapele, ao, ka sekhahla sa tsoekere e ngata, a hulang ka bohloko. Ntlheng ena, menyetla ea tšoaetso e eketseha, kaha ho hanyetsa 'mele ho tlaase. Sena se ka lebisa ho ruruha ha metsoako, maemong ana, haeba ho na le ts'okelo bophelong ba mokuli, ngaka e tla etsa qeto ea ho khaola leoto le tšoaelitsoeng, ho qoba sepsis. E le hore u fete tlhaselo ea pelo, ho lula ho hlahlojoa khafetsa ha ho lokela ho etsoa eseng feela ka maemo a tsoekere ea mali, empa le khatello ea mali. Ka keketseho e bohale, ho sebelisa lithethefatsi tse fokotsang khatello ho bontšoa. Ho bohlokoa ho hopola hore mafu a hlahisitsoeng khahlano le semelo sa lefu la tsoekere ke litholoana.

Thibelo

Bakeng sa pholiso e potlakileng, o hloka ho tlosa sesosa sa complication ea lefu la tsoekere, 'me u se ke oa lebala ka mekhoa ea thibelo. Ho thibela mafu ho bonolo ho feta ho a hlola, hona ho sebetsa ho macroangiopathy. Ho nona haholo ho fosahetse bakeng sa bophelo bo botle 'me ho bontša k'holeseterole e phahameng. Latela likhothaletso tsa ngaka mme u kenye meroalo e bobebe ea Cardio: ho matha, ho tlama ropo, boikoetliso. Ho lokisa sephetho ho tla u thusa ho thatafatsa, e leng se tla imisa mmele le ho matlafatsa boits'ireletso ba mmele ka kakaretso.

Ts'oaetso

Ho etsa tlhahlobo e nepahetseng le ho fana ka kalafo e loketseng, litletlebo tsa mokuli ka boeona ha li lekane. Ho bokella nalane e felletseng, ngaka e eang e fana ka mefuta ea lithuto tse latelang tsa laboratori le tsa maiketsetso.

Tlhahlobo ea mahlale. Tlhahlobo e akaretsang ea mali le moroto li tla bonts'a boemo ba tsoekere bo phahame haholo.
Patlisiso sebelisa lisebelisoa tse nepahetseng. Mokuli o hlahlojoa mochini oa ultrasound o sebelisang ho penta mebala ea Doppler, e tla u lumella ho bona phepelo ea mali ka har'a lijana le li-capillaries. Khatello ea maoto le popopotlong ea poplite le eona e lekantsoe. Haufinyane tjena, ho qalile ho sebelisoa mofuta o mocha oa boipheliso - video capillaroscopy ea k'homphieutha.

Bakeng sa kalafo e atlehileng ea microangiopathy, pele ho tsohle, hoa hlokahala ho latela litaelo tsohle tsa ngaka. Ho itlhahisa kapa ho tlohela meriana ka mokhoa o qalang matšoao a ntlafatso ho ka lebisa litlamorao tse ke keng tsa qojoa.

Pele ho tsohle, mokuli o hloka ho tlohela mekhoa e mebe, ho kopanela kamehla lipapaling ka meroalo e nyane, ho hlahloba lijo ka botlalo. Ka boima ba 'mele bo eketsehileng, hlophisa mokhoa oa hau oa bophelo ka tsela eo ka eona ho fokotsa boima ba' mele butle-butle.
Pheko ea mathata afe kapa afe a lefu la tsoekere, mohato oa bohlokoahali oa mantlha ke ho fetoloa ha tsoekere maling. Haeba boemo bo kheloha haholo ho tloaelehileng, katleho ea kalafo e theoha ho fihla ho zero. Se ke la lebala ka lijo tse ikhethileng - felisang lijo tse nang le lik'habohaedreite habonolo.

Lithethefatsi tse latelang li sebelisetsoa ho phekola lefu lena.

Lithethefatsi tse nang le phello ea metabolic. Tsena li kenyelletsa bonolo, thiatriazolin le ba bang. Ha u nka lithethefatsi tsena, mafura a acid a na le oxidised, ka lebaka leo ts'ebetso ea oxidation ea tsoekere e ntlafala ho myocardium.
Heparin, acetylsalicylic acid, vazaprostan lithethefatsi tsena tsohle li theola mali. Ho ba le mali a mangata haholo ho kotsi ho koaloa ha methapo ea mali le ho etsoa ha microthrombi.
Ho qoba ho tšoaroa ke lefu la pelo kapa stroke, o lokela ho beha khatello ea mali khafetsa. Matšoao a nepahetseng ke a 130 ho 85 mm Hg. Art. Ka hona, ka khatello ea khatello, o hloka ho sebelisa lithethefatsi tse tloaelehileng letshwao lena.
Haeba nakong ea kalafo, mokuli ha a na liso tsa ka mpeng, ho ruruha, maqeba a ho hlaka a libaka tse itseng tsa letlalo maotong, ho khaoloa leoto hoa hlokahala. Ho lieha ho etsa opereishene ho ka jella mokuli bophelo.
Lefu la tsoekere le lefu la tsoekere, e le motsoako oa lefu la tsoekere, le hloka ho beloa leihlo mehato e thibelang. Phekolo ea lithethefatsi e kopantsoe ka katleho le physiotherapy, magnetotherapy, laser le acupuncture. Ka mokhoa ona, marako a likepe a fetoha haholo, menyetla ea ho chekoa ke mali e fokotsehile.

Ka kalafo e nakong le e nang le bokhoni, menyetla ea ho tšoaroa ke lefu la leoto la leoto e fokotsoa makhetlo a 'maloa.

Phatlalatso le thibelo ea lefu la tsoekere la macroangiopathy

Ho bolaoa ke mathata a pelo le bakuli ba nang le lefu la tsoekere ho 35-75%. Ho tsena, hoo e ka bang halofo ea linyeoe, lefu le hlaha ho infraction ea myocardial, ho 15% - ho tsoa ho ischemia e matla ea "cerebral" ischemia.

Senotlolo sa ho thibela macroangiopathy ea lefu la tsoekere ke ho boloka tsoekere e maling le khatello ea mali, ho ja, ho laola boima ba 'mele, ho tlohela mekhoa e mebe, ho phethahatsa likeletso tsohle tsa bongaka.

Micro le macroangiopathies ho lefu la tsoekere: ke eng?

Lefu la tsoekere la lefu la tsoekere ke bokuli bo atisang ho hlaha bohareng kapa bo boholo bo nang le methapo e telele ea mofuta oa 1 le mofuta oa 2 lefu la tsoekere.

Ntho e ts'oanang ha e na letho haese pathogeneis, e baka ponahalo ea lefu la pelo, 'me hangata motho o ba le khatello ea methapo ea methapo, methapo ea methapo ea methapo ea methapo, le phallo ea methapo ea methapo.

Lekola lefu lena ka ho tsamaisa li-electrocardiograms, echocardiograms, ultrasound dopplerography, liphio, methapo ea mokokotlo, methapo ea methapo ea methapo ea hlahlojoa.

Phekolo e kenyelletsa ho laola khatello ea mali, ho ntlafatsa sebopeho sa mali, ho lokisa hyperglycemia.

Ha motho a kula ka lefu la tsoekere nako e telele, li-capillaries tse nyane, mabota a arterial le methapo tlas'a tšusumetso ea bongata bo eketsehileng ba tsoekere e qala ho senyeha.

Kahoo ho na le ho fokola ka matla, deformation, kapa, ka lehlakoreng le leng, hona ke ho fifala ha methapo ea mali.

Ka lebaka lena, phallo ea mali le metabolism pakeng tsa lisele tsa litho tse ka hare lia ferekanngoa, e leng se lebisang ho hypoxia kapa tlala ea oksijene ea lisele tse haufi, ho senya litho tse ngata tsa lefu la tsoekere.

Hangata, ho ameha likepe tse kholo tsa lipelo tse tlase le pelo, sena se etsahala maemong a 70 lekholong. Likarolo tsena tsa 'mele li amohela mojaro o moholo ka ho fetisisa, ka hona lijana li ameha haholo ke phetoho. Ho lefu la tsoekere le lefu la tsoekere, fundus hangata e ameha, e fumanoang e le retinopathy, eo hape e leng maemo a tloaelehileng.
Ka tloaelo, lefu la tsoekere la macroangiopathy le ama mokokotlo, coronary, renal, methapo ea methapo ea kutlo. Sena se tsamaisana le angina pectoris, myocardial infarction, ischemic stroke, lefu la tsoekere le lefu la tsoekere le khatello ea methapo ea kutlo. Ka tšenyo e mpe methapong ea mali, menyetla ea ho ba le lefu la pelo le ho otloa ke lefu la pelo le eketseha makhetlo a mararo.
Mathata a mangata a lefu la tsoekere a lebisa ho arteriosulinosis ea methapo ea mali. Boloetse bo joalo bo fumanoa ho batho ba nang le mofuta oa 1 le mofuta oa 2 lefu la tsoekere lilemo tse 15 pejana ho feta ho bakuli ba phetseng hantle. Hape, lefu la batho ba nang le lefu la tsoekere le ka tsoela pele kapele haholo.
Boloetse bona bo mpefatsa likarolo tse ka tlaase tsa methapo e bohareng le e meholo, eo liathomo tsa methapo ea kutlo li bang teng hamorao. Ka lebaka la calcation, ponahatso le necrosis ea li-plaque, likhahla tsa mali li theha sebakeng seo, lumen ea methapo ea koaloa, ka lebaka leo, phallo ea mali sebakeng se amehileng e khathatsoa ke lefu la tsoekere.

Ha e le molao, lefu la tsoekere la macroangiopathy le ama coronary, cerebral, visceral, peripheral artery, kahoo lingaka li etsa tsohle ho thibela liphetoho tse joalo ka ts'ebeliso ea mehato ea thibelo.

Kotsi ea pathogenesis e nang le hyperglycemia, dyslipidemia, khatello ea insulin, botenya, khatello ea methapo ea mali, ho eketseha ha mali, khatello ea methapo, khatello ea methapo ea methapo, ho ruruha ha systemic ho phahame haholo.

Hape, atherosclerosis hangata e hlaha ho batho ba tsubang, boteng ba ho se ikoetlise 'meleng le tahi e botse. Kotsi ke banna ba ka holimo ho lilemo tse 45 mme basali ba ka holimo ho lilemo tse 55.

Hangata sesosa sa lefu lena e ba semelo sa lefutso.

Ho ba le lefu la tsoekere ke khopolo e kopanetsoeng e emelang pathogeneis mme e kenyelletsa ho ts'oaroa ha methapo ea mali - e nyane, e kholo le e mahareng.

Ketsahalo ena e nkuoa e le phello ea khatello ea morao-rao ea lefu la tsoekere, e hlahang lilemo tse ka bang 15 ka mor'a lefu lena.

Lefu la tsoekere la macroangiopathy le tsamaisana le syndromes tse kang atherosclerosis ea aorta le methapo ea methapo ea methapo, methapo ea methapo kapa methapo ea methapo.

Nakong ea microangiopathy ho lefu la tsoekere mellitus, retinopathy, nephropathy, le lefu la tsoekere la methapo ea methapo e tlase e bonoa.
Ka linako tse ling, ha methapo ea mali e senyeha, ho fumanoa tšoaetso ea angiopathy, mohopolo oa eona o kenyelletsa lefu la tsoekere la macroangiopathy.

Endoneural diabetesic microangiopathy e baka tlolo ea methapo ea kutlo, 'me sena se baka lefu la tsoekere.

Ka atherosclerosis ea aorta le coronary artery, e bakang lefu la tsoekere la macroangiopathy la maemo a tlase le likarolo tse ling tsa 'mele, lefu la tsoekere le ka tseba hore na lefu la pelo, myocardial infarction, angina pectoris, lefu la pelo.

Lefu la pelo la coronary ntlheng ena le tsoa ka sebopeho sa atypical, ntle le bohloko le ho tsamaisana le arrhythmia. Boemo bona bo kotsi haholo, kaha bo ka baka lefu la tšohanyetso la coronary.

Pathogenesis ho lefu la tsoekere hangata e kenyelletsa mathata a ka morao ho infarate a kang aneurysm, arrhythmia, thromboembolism, lefu la pelo le ho nyekeloa ke pelo. Haeba lingaka li entse qeto ea hore lefu la tsoekere la macroangiopathy ke lona sesosa sa lefu la myocardial, ntho e 'ngoe le e' ngoe e tlameha ho etsoa e le hore lefu la pelo le se ke la khutla, kaha kotsi e holimo haholo.

Ha mathata a phallo ea mali a se a sa buuoe haholo, lefu la tsoekere la macroangiopathy le baka ponahalo ea londa tsa trophic tse sa foleng le lefu la tsoekere maotong.

Bokhachane ke ho bona hore na likepe tsa coronary, cerebral le peripheral li amehile hakae.

Ho khetholla mokhoa o hlokahalang oa tlhahlobo, mokuli o lokela ho buisana le ngaka.

Tlhahlobo e etsoa ke ngaka ea methapo ea kutlo, ngaka ea lefu la tsoekere, ngaka ea methapo ea pelo, ngaka e buoang pelo, ngaka ea methapo ea pelo, ngaka ea methapo.

Ho mofuta oa 1 le lefu la tsoekere la 2, ho fuoe mefuta e latelang ea tlhahlobo ea mafu hore u tsebe ho tseba pathogenesis:

Teko ea mali a biochemical e etsoa ho bona tsoekere, triglycerides, cholesterol, liplatelete, lipoprotein. Teko ea coagulation ea mali le eona e etsoa.
Etsa bonnete ba ho hlahloba ts'ebetso ea pelo le methapo e sebelisang electrocardiogram, ho shebella khatello ea mali letsatsi le letsatsi, liteko tsa khatello ea maikutlo, echocardiogram, dopplerography ea ultrasound ea aorta, myocardial perfusion scintigraphy, coronarography, computer tomographic angiography.
Boemo ba methapo ea mokuli bo hlalositsoe ka ho sebelisa li-dopplerografia tsa methapo ea methapo ea methapo, ho e sekaseka ka duplex le angiography ea likepe tsa mokelikeli le tsona lia etsoa.
Ho lekola boemo ba methapo ea mali e potoloha, maoto le matsoho a hlahlojoa a sebelisa ho kopitsoa ka makhetlo a mabeli, dopplerografia ea methapo ea methapo, aripialal arteryography, rheovasography, capillaroscopy, arterial oscillography.

Phekolo ea lefu lena ho batho ba nang le lefu la tsoekere ke ho fana ka mehato ea ho liehisa tsoelo-pele ea khatello ea methapo e kotsi, e ka tšosetsang mokuli ka lebaka la ho holofala kapa esita le lefu.

Li-uloph tsa li-trophic tsa bophahamo bo holimo le bo tlase li phekoloa tlas'a tlhokomelo ea ngaka e buoang. Haeba ho na le koluoa e mpe ea methapo ea methapo, ho ka etsoa kalafo e matla e matla. Hape, ngaka e ka lebisa bakeng sa kalafo ea ho buuoa, e amanang le endarterectomy, ho felisoa ha mokokotlo oa mmele oa mokokotlo, ho poma leoto le amehang, haeba e se e le gangrene ho lefu la tsoekere.

Melao-motheo ea kalafo e amana le ho lokisoa ha li-syndromes tse kotsi, tse kenyelletsang hyperglycemia, dyslipidemia, hypercoagulation, arterial hypertension.

Ho lefella metabolism ea carbohydrate ho diabetics, ngaka e beha kalafo ea insulin le ho hlahloba tsoekere ea mali kamehla. Bakeng sa sena, mokuli o nka lithethefatsi tse fokotsang ka lipid - li-statins, li-antioxidants, fibrate. Ntle le moo, hoa hlokahala ho latela mokhoa o khethehileng oa ho fepa le ho thibela ts'ebeliso ea lijo tse nang le mafura a liphoofolo.
Ha ho na le kotsi ea ho ba le mathata a thromboembolic, lithethefatsi tsa antiplatelet li laetsoe - acetylsalicylic acid, dipyridamole, pentoxifylline, heparin.
Phekolo ea antihypertensive maemong a ho fumanoa ha lefu la tsoekere la macroangiopathy ke ho fihlela le ho boloka maemo a khatello ea mali a 130/85 mm RT. Art. Bakeng sa morero ona, mokuli o nka li-inhibitors tsa ACE, diuretics. Haeba motho a utloisitsoe bohloko ke myocardial infarction, ho beoa li-beta-blockers.

Ho latela lipalo-palo, ka mofuta oa 1 le lefu la tsoekere la 2 lefu la tsoekere, ka lebaka la mathata a pelo ho bakuli, lipalo tsa lefu li tloha ho liperesente tse 35 ho isa ho tse 75. Ho halofo ea bakuli bana, lefu le hlaha ka ho nyefoloa ha myocardial, ka karolo ea 15 lekholong ea lisosa ke seschemia se matla sa "cerebral ischemia".

Ho qoba nts'etsopele ea lefu la tsoekere la macroangiopathy, ho bohlokoa ho nka mehato eohle ea thibelo. Mokuli o lokela ho lekola maemo a tsoekere ea mali kamehla, ho lekanya khatello ea mali, ho latela lijo, ho lekola boima ba hae, ho latela litlhahiso tsohle tsa bongaka le ho tlohela mekhoa e mebe kamoo ho ka khonehang.

Ho video e sehloohong sena, ho tšohloa mekhoa ea ho phekola lefu la tsoekere la lefu la tsoekere.

Macroangiopathy ho lefu la tsoekere mellitus - lisosa le mekhoa ea kalafo

Macroangiopathy ho lefu la tsoekere mellitus ke polelo e kopaneng eo ho eona kutloisiso ea methapo ea methapo e meholo e utloisisoang. Lefu la tsoekere le lebisa kholong ea lefu lena, le tsamaeang le keketseho ea tsoekere ea mali. Tabeng ena, lits'ebetso tsa metabolic, ho kenyelletsa metabolism ea mafura, lia ameha. Sena se lebisa sebopeho sa li-plaque tsa atherosselotic maboteng a vascular. Pele ho tsohle, pelo, boko le maoto li utloa bohloko.

Ho na le mabaka a 'maloa a lebisang ho nts'etsopele ea pathology ena:

Boima bo feteletseng
Mekhoa e mebe - ho nwa le ho tsuba,
Phaello ea mali
Nts'etsopele ea methapo ea methapo,
K'holeseterole e phahameng ea mali,
Lilemo tse fetang 50
Phello ea lefutso.

Ntle le moo, ho na le lintlha tse ling tse amanang ka kotloloho le kholo ea lefu la tsoekere. Mabaka ana a kenyelletsa a latelang:

Hyperglycemia,
Ho eketseha ha insulin - boemo bona bo bitsoa hyperinsulinemia,
Matla a amanang le litlamorao tsa li-hormone - boemo bona bo bitsoa ho hanyetsa insulin,
Lefu la fig le tsamaeang le lefu la tsoekere
Phihlelo e telele ea lefu lena.

Insulin e baka ponahalo ea li-cholesterol plaque le likotoana tsa lipoprotein ka bomong. Sena se ka bakoa ke phello e tobileng ea marako a arterial kapa phello ea metabolism ea lipid.

Diabetes macroangiopathy e ka ba le likhetho tse fapaneng tsa nts'etsopele. Mofuta o mong le o mong oa pathology o tšoauoa ka likarolo tse itseng.

Ka tšenyo ea methapo ea pelo, ho ba teng ha angina pectoris hoa bonoa. Tlolo ena e amana le tlolo ea melaoana ea phepelo ea mali. E iponahatsa ka mokhoa oa bohloko ho sternum. Ho boetse ho na le kotsi ea ho ba le tšoaetso ea pelo e mpe le ho nyekeloa ke pelo ho sa feleng.

Mofuta ona oa pathology o tšoauoa ka lipontšo tse joalo:

Ho hatella, ho chesa, le ho hatella bohloko bo bohloko karolong ea pelo le sternum. Boemong ba pele ba lefu lena le hlaha, ba hlaha feela ka ho ikoetlisa. Ha e ntse e hola, ho hloka botsitso ho teng maemong a khutsitseng le kamora ts'ebeliso ea lithethefatsi tse tsoang sehlopheng sa li-nitrate.
Ho hema hanyane. Qalong, e bonoa feela tlasa meroalo, ebe e ba maemong a khutsitseng.
Ho ruruha ha maoto.
Ho se sebetse hantle ha pelo.
Keketseho ea khatello ea mali.
Ho hlaseloa ke pelo ho bohloko. Psychology ena hangata e bonoa ho lefu la tsoekere. Sena se bakoa ke ho se sebetse hantle ha methapo ea kutlo.

Ho senyeha ha lijana tsa "cerebral" ho thoe ke "cerebrovascular pathology". Ka nts'etsopele ea eona, lipontšo tse joalo li bonoa:

Ho opeloa ke hlooho.
Boemo ba ho tsepamisa mohopolo.
Tsietsing
Ho fokolisa mohopolo.
Stroke Tlas'a polelo ena ho utloisisoa tlolo e mpe ea ho potoloha ha lisele, e kenyang lefung la sebaka se itseng.

Letsoalo la "lefu la tsoekere" la likarolo tse tlase le kenyeletsa lipontšo tse joalo:

Bohloko maotong.
Lcerative ulcerative Ha li hlahella, ho tšepahala ha letlalo hoa senyeha.
Lameness.
Lefu la lisele tse bonolo. Ha gangrene e etsahala, leoto le ba lefifi 'me le lahleheloa ke mesebetsi ka botlalo.

Morero oa kalafo ea lefu lena ke ho liehisa nts'etsopele ea mathata a kotsi a tsoang likepeng, e leng ho ka lebisang ho holofetseng ha mokuli kapa lefu. Molao-motheo oa bohlokoa kalafong ea lefu lena ke ho lokisa maemo a joalo:

Hypercoagulation
Hyperglycemia,
Hlooho ea methapo,
Dyslipidemia.

Ho ntlafatsa boemo ba motho, ho fanoa ka litlhare tse fokotsang lipid. Tsena li kenyelletsa li-fibrate, li-statin, li-antioxidants. Ha ho bohlokoa bo boholo ke ho boloka lijo, tse kenyeletsang ho thibela ho ja mafura a liphoofolo.

Ka tšokelo e phahameng ea litlamorao tsa thromboembolic, ho loketse ho sebelisa li-antiplatelet agents. Tsena li kenyelletsa heparin le pentoxifylline. Hangata lingaka li beha acetylsalicylic acid.

Phekolo ea antihypertgency e nang le ts'oaetso ena e etsoa ho fihlela le ho boloka khatello e tsitsitseng. E lokela ho lula e le maemong a 130/85 mm RT. Art. Ho rarolla bothata bona, ho sebelisoa li-inhibitors tsa ACE, Captopril.

U boetse u hloka ho sebelisa diuretics - furosemide, hydrochlorothiazide. Bakuli ba nang le infraction ea myocardial ba fuoa li-beta-blockers. Tsena li kenyelletsa atenolol.

Therapy ea li-ulophous tsa liso tsa pheletso e lokela ho etsoa ka taolo ea ngaka e buoang. Likotsi tse mpe tsa methapo ea methapo, ho fanoa ka tlhokomelo e matla. Haeba ho na le bopaki, ho ka etsoa opereishene.

Tšokelo ea macroangiopathy e tsebahala haholo ho batho ba nang le lefu la tsoekere la mofuta oa 2. Kotsi ea lefu ka lebaka la mathata a lefu lena ke 35-75%. Maemong a halofo, lefu le hlaha ka lebaka la infaration ea myocardial.

Tsebo e sa thabiseng ke ha maemo a 3 a methapo - boko, maoto le pelo - a ameha ka nako e le 'ngoe. Karolo e fetang halofo ea ts'ebetso ea litho tsohle tse tlase e amanang le macroangiopathy.

Ka tšenyo ea maoto, liphoso tsa ulcerative lia bonoa. Sena se theha litabatabelo tsa ho thehoa ha lehlaba la tsoekere. Ka tšenyo ea methapo ea methapo, methapo ea mali le lisele tsa masapo, necrosis e bonoa mme lits'ebetso tsa purulent li hlaha.

Ponahalo ea liso tsa trophic leotong le ka tlase ke ka lebaka la mathata a potoloha methapong e amehang ea maoto. Sebaka se tloaelehileng sa gangrene ke menoana e meholo.

Bohloko bo nang le chebahalo ea lefu la tsoekere ha bo iponahatse bo le bongata haholo. Empa ha bopaki bo hlaha, ha ho na thuso ho liehisa ts'ebetso. Le ho lieha ho lieha ho apesitsoe ke ho fola maqeba ka nako e telele. Ka linako tse ling ho hlokahala ho etsa ts'ebetso ea bobeli ea ho buoa.

Bakeng sa ho thibela ponahalo ea ts'ebetso ea methapo ena, likeletso tse ngata li lokela ho bonoa:

Iphe nako ea lefu la tsoekere
Khomarela lijo tse kenyeletsang ho thibela lijo tsa protheine, lik'habohaedreite, letsoai le lijo tse mafura,
Fokotsa boima ba 'mele
Qoba ho tsuba le ho noa,
Fana ka ts'ebetso e leka-lekaneng ea mmele, e sa ts'oarang ponahalo ea matšoao a angina pectoris,
Letsatsi le letsatsi bakeng sa ho tsamaea moeeng o mocha
Fana ka tlhahlobo e matla ea litaba tsa lipid - hang ka mor'a likhoeli tse 6,
Etsa tlhahlobo e matla ea palo ea tsoekere e maling - pontšo ena e lekanyetsoa hang ka letsatsi.

Nts'etsopele ea macroangiopathy ho lefu la tsoekere ke ketsahalo e tloaelehileng. Psychology ena e tletse ponahalo ea litlamorao tse kotsi ebile e ka baka lefu. Ka hona, ho bohlokoa haholo ho nka karolo thibelong ea eona, mme haeba matšoao a hlaha, etela ngaka hang-hang.

What is diabetesic macroangiopathy: Tlhaloso ea lipontšo tsa lefu la tsoekere

Boholo ba bakuli ba nang le lefu la tsoekere ba na le mefuta eohle ea maloetse a amanang le eona a mpefatsang boemo ba motho mme a ama lijana tsohle le litho tsohle. E 'ngoe ea maloetse ana ke lefu la tsoekere.

Ntho ea bohlokoa ho lefu lena ke hore masapo ohle a methapo a ameha. Haeba feela likepe tse nyane li senyehile, joale lefu lena le khetholloa e le lefu la tsoekere la diabetes.

Haeba feela likepe tse kholo tsa sistimi li hlaseloa, lefu lena le bitsoa lefu la tsoekere la macroangiopathy. Empa ana ha se ona feela bothata boo mokuli oa lefu la tsoekere a ka bang le bona. Ka angiopathy, homeostasis e boetse ea ameha.

Matšoao a amanang le "Diabetesic Microangiopathy"

Ha u nahana ka matšoao a mantlha a microangiopathy, ho hlahella lintlha tse tharo tse kholo, tse bitsoang Virchow-Sinako triad. Matšoao aa ke eng?

Mabota a likepe a fetoha.
Ho ruruha ha mali hoa senyeha.
Lebelo la mali le fokotseha.

Ka lebaka la ts'ebetso e eketsehileng ea liplatelete le ho eketseha ha methapo ea mali, e ba ntho e mpe haholo. Lisebelisoa tse phetseng hantle li na le lubricant e khethehileng e sa lumelle mali ho khomarela mabota. Sena se tiisa phallo e nepahetseng ea mali.

Lisebelisoa tse ferekaneng ha li khone ho hlahisa monko ona, 'me ho na le phallo ea phallo ea mali. Ts'ebetso tsena kaofela ha li lebise timetsong ea methapo ea mali feela, empa le ho etsoa ha microtubuse.

Ts'ebetsong ea ho nts'etsapele lefu la tsoekere, mofuta oa phetoho o kenyelletsa palo e kholo ea likepe. Hangata sebaka sa mantlha sa tšenyo ke:

litho tsa pono
myocardium
liphio
tsamaiso ea methapo ea kutlo
letlalo le hlakileng.

Liphetho tsa litlolo tsena, joalo ka molao, ke:

neuropathy
lefu la tsoekere,
cardiopathy
dermatopathy.

Empa matšoao a pele a hlaha lipheletsong tse tlase, tse bakoang ke tlolo ea methapo ea mali sebakeng sena. Ngoliso ea linyeoe tse joalo e batla e le 65%.

Lingaka tse ling li tloaetse ho pheha khang ea hore microangiopathy ha se lefu le arohaneng, ke hore, ke letšoao la lefu la tsoekere. Ho feta moo, ba lumela hore microangiopathy ke litholoana tsa neuropathy, tse etsahalang pele.

Bo-rasaense ba bang ba bolela hore nerve ischemia e baka neuropathy, 'me' nete ena ha e amanang le tšenyo ea methapo. Ho ea ka khopolo ena, lefu la tsoekere le baka lefu la neuropathy, 'me microangiopathy ha e amane le letho.

Empa ho boetse ho na le khopolo ea boraro, balateli ba eona ba reng ho tlola ts'ebetso ea methapo ho tla senya methapo ea mali.

Diabetesic Microangiopathy e arotsoe ka mefuta e 'maloa, e bakoang ke tekanyo ea tšenyo lipheletsong tse tlase.

Ka sekhahla sa tsenyo ea letlalo 'meleng oa motho ha le eo.
Mokhahlelo oa pele - ho na le mefokolo e nyane letlalong, empa ha e na mekhoa ea ho ruruha mme e fumaneha habobebe.
Boemong ba bobeli, ho bonahala liso tsa letlalo tse bonahala tse ka teba hoo li ka lematsang methapo le masapo.
Karolo ea boraro e tšoantšoa le liso tsa letlalo le lipontšo tsa pele tsa lefu la tishu maotong. Mathata a joalo a ka hlaha hammoho le ts'ebetso ea ho ruruha, ts'oaetso, edema, hyperemia, abscesses le osteomyelitis.
Boemong ba bone, makhopho a monoana a le mong kapa a 'maloa a qala ho hola.
Boemo ba bohlano ke leoto kaofela, kapa boholo ba lona bo angoa ke bohlasoa.

Ntho e ka sehloohong e bakang lefu le phahameng la bakuli ba nang le lefu la tsoekere ke lefu la tsoekere la diabetes. Ke macroangiopathy e atisang ho hlaha ho bakuli ba lefu la tsoekere.

Pele ho tsohle, likepe tse kholo tsa mabalane a tlase lia ameha, ka lebaka la moo methapo ea methapo ea methapo le methapo ea methapo e utloang bohloko.

Macroangiopathy e ka nts'etsapele ts'ebetsong ea ho eketsa sekhahla sa nts'etsopele ea lefu la atherosclerotic. Lefu lena le arotsoe ka mekhahlelo e mengata ea kholo.

Mokhahlelong oa pele, hoseng mokuli o eketsehile mokhathala, ho fufuleloa ho feteletseng, bofokoli, ho otsela, ho ikutloa o bata le mangoleng le ho tsitsipana ha ona. Sena se supa puseletso ho potoloha ho potoloha.
Mokhahlelong oa bobeli, maoto a motho a qala ho akheha, o thella haholo, bokantle ba lipekere bo qala ho roba. Ka linako tse ling lameness e hlaha sethaleng sena. Ebe ho na le bohloko mahanong, ha u tsamaea le ha u phomola. Letlalo le fetoha le boreleli hape le le bosesane. Ho senyeha ho hokahaneng hoa bonoa.
Mohato oa ho qetela ke gangrene ho lefu la tsoekere la leoto, menoana le leoto le tlase.

Macro le microangiopathy ho lefu la tsoekere le phekoloa ka ho tšoana. Ntho ea pele eo mokuli a lokelang ho e etsa ke ho tlisa ts'ebetso ea metabolic ea mmele maemong a tloaelehileng. Metabolism ea Carbohydrate e lokela ho khutlisoa, hobane hyperglycemia ke lona lebaka le ka sehloohong la nts'etsopele ea atherosulinosis ea methapo ea mali.

Bohlokoa ka mokhoa o lekanang ts'ebetsong ea kalafo ke ho lekola boemo ba metabolism ea lipid. Haeba boemo ba lipoprotein bo nang le matšoao a tlase a letsoalo bo eketsehile ka tšohanyetso, mme boemo ba li-triglycerides, ka lehlakoreng le leng, bo fokotsehile, sena se bontša hore ke nako ea ho kenyelletsa lithethefatsi tsa hypolipidic kalafong.

Re bua ka li-statins, li-fibrate le li-antioxidants.Macro- le microangiopathy ho lefu la tsoekere mellitus e tšoaroa ka kenyelletso e tlamang ea litlhare tsa kalafo tsa kalafo ea metabolic, mohlala, trimetazidine.

Meriana e joalo e kenya letsoho ts'ebetsong ea oxidation ea tsoekere ho myocardium, e etsahalang ka lebaka la oxidation ea mafura acid. Nakong ea kalafo ea mefuta eohle ea lefu lena, bakuli ba fuoa li-anticoagulants.

Tsena ke lithethefatsi tse thusang ho rarolla methapo ea mali maling le ho fokolisa tšebetso ea liplatelese ha ho fumanoa hore o na le macroangiopathy.

Ka lebaka la lintho tsena, mali ha a na botsitso le maemo a ho koaloa ha methapo ea mali ha a etsoa. Li-anticoagulants li kenyelletsa:

Acetylsalicylic acid.
Tiklid.
Vazaprostan.
Heparin.
Dipyridamole.

Bohlokoa! Kaha khatello ea khatello ea mali hangata e ba teng khafetsa ho lefu la tsoekere, ho hlokahala hore o fane ka litlhare tse fokotsang khatello ea mali. Haeba letšoao lena le tloaelehile, ho ntse ho khothaletsoa ho le lekola kamehla.

Ho tsoekere ea lefu la tsoekere, litekanyetso tse nepahetseng ke 130/85 mm Hg. Mehato e joalo ea taolo e tla thusa ho thibela nts'etsopele ea nephropathy le retinopathy ka nako e loketseng, ho fokotsa haholo menyetla ea ho otloa ke lefu la pelo le ho otla ha pelo.

Har'a lithethefatsi tsena, bahanyetsi ba kananelo ea calcium calcium, li-inhibitors le lithethefatsi tse ling lia khetholoha.

Nakong ea kalafo, ho hlokahala hore ho fetole matšoao a autonomic homeostasis. Bakeng sa sena, lingaka li fana ka litlhare tse eketsang ts'ebetso ea sorbitol dehydrogenase. Ho bohlokoa hape ka ho tšoanang ho etsa mesebetsi e khothalletsang ts'ireletso ea antioxidant.

Ho joalo, ho molemo ho thibela lefu lena qalong. Ho etsa sena, o hloka ho phela bophelo bo nepahetseng mme o shebelle bophelo ba hao bo botle kamehla. Empa haeba ho na le matšoao a lefu la tsoekere, o lokela ho ikopanya le setsi sa bongaka hanghang.

Mekhoa ea sejoale-joale ea kalafo ea lefu la tsoekere le ts'ehetso ea thibelo e ka thusa motho ho qoba litlamorao tse matla tse kang macro- le microangiopathy.

Shebella video: Hobaneng cystitis e ka hlaha tsoekere?

Lefu la qoqotho ho basali ba lilemo tsa ho ba le bana. Tataiso ea lingaka, GEOTAR-Media - M., 2013. - 80 leq.
Dreval A.V., Misnikova I.V., Kovaleva Yu.A. Thibelo ea mathata a morao-rao a methapo ea lefu la tsoekere mellitus, GEOTAR-Media - M., 2014. - 80 leq.
Akhmanov M. E monate ntle le tsoekere. SPb., Tessa Publishing House, 2002, maqephe a 32, ho ajoa likopi tse 10,000.

E re ke itsebise. Lebitso la ka ke Elena. Ke qetile lilemo tse fetang 10 ke sebetsa ke le setsebi sa endocrinologist. Ke lumela hore hajoale ke setsebi lebaleng la ka mme ke batla ho thusa baeti bohle ba sebakeng sena ho rarolla mesebetsi e rarahaneng eseng joalo. Lisebelisoa tsohle tsa sebaka sena sa marang-rang li bokelloa ebe li sebetsoa ka hloko e le hore li fetise litaba tsohle tse hlokahalang ka hohle kamoo ho ka khonehang. Pele o sebelisa se hlalosoang webosaeteng, ho hlokahala tumellano ea ho buisana le litsebi kamehla.