• Tšenyo ea methapo ea mali ea pelo (lefu la pelo), e hlahisitsoeng ho nts'etsopele ea angina pectoris (lefu le bontšitsoeng ke bohloko kapa ho hlonama ka morao ho sternum ka lebaka la tlolo ea phallo ea mali pelong), infarction ea myocardial (lefu la karolo ea mesifa ea pelo), pelo e sa foleng (ts'ebetso ea pelo e sa sebetseng).
  E bontšitsoe ka nepo
  • bohloko ba tlhaho e hatellang, e makatsang, e tukang seterekeng sa pelo, ka morao ho seterata, e hlahisoang ke ho ikoetlisa (ha lefu le ntse le tsoela pele le phomolong), ho feta phomolong kapa kamora ho sebelisa lithethefatsi tsa sehlopha sa nitrate (ho ntlafatsa phallo ea mali ho ea pelong),
  • ho hema hanyane - qalong ka ho ikoetlisa ka matla, ha lefu le ntse le tsoela pele le phomolong,
  • ho ruruha ha maoto
  • ho sitisoa mosebetsing oa pelo,
  • Keketseho ea khatello ea methapo (mali),
  • mefuta e sa utloiseng bohloko ea inforation ea myocardial (lefu la karolo ea mesifa ea pelo), eo hangata e fumanoang ho lefu la tsoekere ka lebaka la ts'ebetso e mpe ea methapo ea methapo.
• Tšenyo ea tšebeliso ea lijana tsa bokong (lefu la cerebrovascular):
  • hlooho e bohloko
  • ho tsekela
  • mohopolo o sa sebetseng hantle, tlhokomelo,
  • stroke ke tlolo ea molao ea ho potoloha ha lisele le lefu la karolo ea boko.
• Tšenyo ea likepe tsa lipalo tse tlase:
  • bohloko ba leoto
  • lameness
  • liphoso tsa ho ruruha (tlolo ea botšepehi ba letlalo)
  • lefu la lisele tse bonolo (gangrene) - leoto le fetoha le lesoeu, ts'ebetso ea lona e lahlehile ka botlalo.

Ho ba teng ha lefu la tsoekere mellitus (lefu le tšoaetsitsoeng ke tsoekere e phahameng ea mali) ho lebisa ho sitisoeng ha mefuta e mengata ea metabolism 'meleng, e eketsang kotsi ea mokuli bakeng sa tšenyo ea methapo. Ka kopanelo, ho na le keketseho ea nts'etsopele ea atherosulinosis (ho beoa hoa cholesterol plaque marakong a methapo ea mali) ka tšenyo e kholo likepeng tsa pelo, bokong le lipalo tse tlase.

Lintho tse tloaelehileng tse ka bakang tšoaetso ea lefu la pelo:

• ho tsuba
• tlhekefetso ea joala
• Keketseho ea khatello ea methapo (mali),
• botenya
• litaba tse phahameng tsa lipids (cholesterol le mafura a mang) maling,
• lefutso le amanang le lefutso (ho ba teng ha atherosulinosis ho beng ka mali),
• lilemo (tse fetang lilemo tse 50)
• fibrillation ea atria (pherekano ea morethetho oa pelo).

• tsoekere e phahameng ea mali
• "insulin" e phahameng e amanang le "glucose ea mali" maling.
• insulin - "ho hloka botsitso" ketsong ea insulin,
• lefu la tsoekere - ho senya liphio ho lefu la tsoekere,
• ho ba teng ha lefu la tsoekere ka nako e telele.

Ngaka endocrinologist e tla thusa kalafong ea lefu lena

Ts'oaetso

• Ho hlahlojoa ha litletlebo tsa mafu:
  • bohloko ba tlhaho e hatellang, e makatsang, e tukang seterekeng sa pelo, ka morao ho seterata, e hlahisoang ke ho ikoetlisa (ha lefu le ntse le tsoela pele le phomolong), ho feta phomolong kapa kamora ho sebelisa lithethefatsi tsa sehlopha sa nitrate (ho ntlafatsa phallo ea mali ho ea pelong),
  • ho hema hanyane - qalong ka ho ikoetlisa ka matla, ha lefu le ntse le tsoela pele le phomolong,
  • ho ruruha ha maoto
  • ho sitisoa mosebetsing oa pelo,
  • Keketseho ea khatello ea methapo (mali),
  • hlooho e bohloko
  • ho tsekela
  • mohopolo o sa sebetseng hantle, tlhokomelo,
  • bohloko ba leoto
  • lameness.
• Tlhahlobo ea nalane ea bongaka (nalane ea nts'etsopele ea lefu lena: potso ea hore na lefu le qalile le nts'etsopele joang, lefu la tsoekere le qalile ho tloha neng.
• Tlhahlobo e akaretsang (tekanyo ea khatello ea mali, ho hlahloba letlalo, ho mamela pelo ka phonendoscope, palpation ea likepe tse liphahameng tse tlase).
• Boikemisetso ba boemo ba cholesterol le lipids tse ling (mafura) maling.
• Bakeng sa tlhahlobo ea tšenyo ea tsamaiso ea pelo le methapo:
  • ECG (electrocardiography),
  • Tlhahlobo ea Holter ECG (mots'eare),
  • liteko tsa khatello ea maikutlo - ho beha leihlo ECG, ho hlobaela, khatello ea mali, boiketlo ba mokuli ea ntseng a eketseha ka mokokotlo oa li-simulators tse khethehileng (baesekele, treadmill)
  • coronary angiography ke mokhoa oa ho etsa lipatlisiso o u lumellang ho hlahloba methapo ea mali ea pelo ho tsoa kahare o sebelisa sesebelisoa se khethehileng se kentsoeng methapong ea methapo.
• Bakeng sa ts'oaetso ea lefu la letsoele:
  • ultrasound ea lijana tsa hlooho le molala,
  • CT (computed tomography) kapa MRI (imagonance imaging) ea boko.
• Bakeng sa tlhahlobo ea methapo ea methapo ea methapo e lipakeng tse tlase:
  • Tlhahlobo ea ultrasound ea lijana tsa libaka tse tlase,
  • X-ray phapano ea angiography - thuto ea methapo ea mali e sebelisang moemeli ea fapaneng e hlahisitsoeng ka sekepeng, e lateloe ke letoto la li-x-ray.
• Taolo e matla ea boemo ba tsoekere ea mali (tekanyo ea boemo ba tsoekere nakong ea motšehare).
• Kopano ea ngaka ea methapo, ngaka ea methapo, phlebologist le eona e ka etsahala.

Phekolo ea lefu la tsoekere la macroangiopathy

• Phekolo ea lefu la tsoekere mellitus (lefu le khetholloang ke tsoekere e phahameng ea mali).
• Lijo tse nang le thibelo ea letsoai, protheine, lik'habohaedreite, lijo tse mafura.
• Ho tlohela ho tsuba le ho noa joala.
• Ho ikoetlisa 'meleng (ho sa bake litlhaselo tsa angina (lefu le hlahisoang ke bohloko kapa ho hlonama ka morao ho sternum ka lebaka la tlolo ea phallo ea mali pelong)).
• Letsatsi le letsatsi o tsamaea a le moeeng o mocha.
• Fokotseha ka boima ba 'mele.
• Lithethefatsi tse khahlanong le ischemic tse fokotsang tlhoko ea myocardium (mesifa ea pelo) ho oksijene.
• Lithethefatsi tsa ho theola khatello ea mali ea arterial (mali).
• Lithethefatsi tse thatafatsang karolo ea lipid ea mali (li theola cholesterol le mafura a mang).
• Lithethefatsi tse thibelang ho bokelloa hoa mali ka bongata.
• Lithethefatsi tsa Neurotropic (ho ntlafatsa phepo e nepahetseng ea tsamaiso ea methapo).
• Lithethefatsi tsa Vasodilator.
• Phekolo ea ts'ebetso: haeba ho na le tšenyo e kholo methapong ea pelo le lipelong tse tlase tse nang le methapo ea methapo ea methapo ea methapo, ho etsoa ha balloon angioplasty le stenting ea likepe - ho tlosoa hoa polokelo ea methapo le methapo ea semelo (moralo o khethehileng o tšehetsang lumen ea sekepe maemong a tloaelehileng).
• Ka nts'etsopele ea gangrene (lefu la sethoathoa) - ho khaoloa leoto le leng.

Microangiopathy ke eng?

'Meleng oa motho ho na le likepe tse nyane tse likete, tse kenyelletsang li-capillaries, venamo le arterioles. Ba tlamisa sele e 'ngoe le e' ngoe ea litho, ba li tlisetsa lintho tse nang le thuso le ho li tlosa tsohle tse sa hlokahaleng. Sena se tiisa ts'ebetso e tloaelehileng liseleng le 'meleng kaofela. Ha liphetoho tsa pathological lijana tse nyane li etsahala motheong oa lefu la tsoekere le nako e telele, ho fumanoa tšoaetso ea lefu la tsoekere. Ka mathata ana, a amehang ka ho fetisisa ke:

Microangiopathy e hlaha ka lebaka la 'nete ea hore tsoekere e ngata haholo, e leng seo maling a bakuli ba nang le lefu la tsoekere e eketsehang, e senya endothelium ea marako a methapo ea mali. Lihlahisoa tsa ho qetela tsa metabolism ea tsoekere ke sorbitol le fructose. Lintho tsena ka bobeli li kenella hampe kahara membrane ea sele, ka hona li qala ho bokellana liseleng tsa endothelial. Sena se lebisa ho li-pathologies tse joalo:

- Ho ruruha ha lebota la sekepe,

- ho eketseha ha lebota,

- ho fokotseha ha tlhahiso ea ntho e khathollang ea endothelium, e hlokahalang bakeng sa ho phomotsa mesifa e boreleli likepeng.

Ka hona, endothelium e senyehile mme phallo ea mali e ea fokotseha, e leng se bakang ho putlama ho phahameng. Sena se bitsoa Virchow Triad.

Classified le tlhahiso ea bongaka

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:

1. 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.
2. Ho hema hanyane. Qalong, e bonoa feela tlasa meroalo, ebe e ba maemong a khutsitseng.
3. Ho ruruha ha maoto.
4. Ho se sebetse hantle ha pelo.
5. Keketseho ea khatello ea mali.
6. 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:

1. Ho opeloa ke hlooho.
2. Boemo ba ho tsepamisa mohopolo.
3. Ho tsekela
4. Ho fokolisa mohopolo.
5. 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:

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

Mekhoa ea kalafo

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.

Mathata

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 tlhahlobo e pheta-phetoang ea bongaka.

Mehato ea thibelo

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

1. Nako ea ho phekola lefu la tsoekere
2. Khomarela lijo tse kenyeletsang ho thibela lijo tsa protheine, lik'habohaedreite, letsoai le lijo tse mafura,
3. Fokotsa boima ba 'mele
4. Qoba ho tsuba le ho noa,
5. Fana ka ts'ebetso e leka-lekaneng ea mmele, e sa ts'oarang ponahalo ea matšoao a angina pectoris,
6. Letsatsi le letsatsi bakeng sa ho tsamaea moeeng o mocha,
7. Fana ka tlhahlobo e matla ea litaba tsa lipid - hang ka mor'a likhoeli tse 6,
8. 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.

Letsoalo la lefu la tsoekere

Letsoalo la lefu la tsoekere - Liphetoho tse akaretsang tse atososselotic e ntseng e eketseha methapong ea methapo e meholo le e kholo khahlano le semelo sa nako e telele sa lefu la tsoekere. Lefu la tsoekere la macroangiopathy le lebisa ho lefu la methapo ea methapo, khatello ea methapo ea methapo, kotsi ea methapo ea methapo, liso tsa methapo ea methapo ea kutlo. Ho hlahlojoa ha lefu la tsoekere la macroangiopathy ho kenyelletsa ho ithuta ha methapo ea methapo ea methapo ea methapo, methapo ea methapo ea methapo, liphio, ECG, echocardiography, joalo-joalo. Melao-motheo ea kalafo ea lefu la tsoekere la macroangiopathy ke khalemelo ea methapo ea mali le dyslipidemia.

Tlhahisoleseling ka kakaretso

Letsoalo la lefu la tsoekere ke motsoako oa lefu la tsoekere, le lebisang ho lesapo la methapo ea methapo ea kutlo, coronary, renal le peripheral. Ka kliniki, "macroangiopathy" ea lefu la tsoekere e hlahisoa nts'etsopele ea angina pectoris, myocardial infarction, ischemic, hypertension ea renovascular, le lefu la tsoekere. Ho senyeha ha methapo ea methapo ho bohlokoa haholo ho tsoelopele ea lefu la tsoekere, ho eketsa menyetla ea ho tšoaroa ke lefu la pelo le makhetlo a 2-3, setho sa mokokotlo - ka makhetlo a 20.

Atherossteosis, e hlahang ho lefu la tsoekere, e na le likarolo tse 'maloa tse ikhethang. Ho diabetics, e etsahala lilemo tse 10 pejana ho feta ho batho ba sa nang le bothata ba 'mele ea metabolism, mme o tsoela pele ka potlako. Bakeng sa lefu la tsoekere la macroangiopathy, lesapo le tloaelehileng la methapo e mengata ea methapo ea methapo (coronary, cerebral, visceral, peripheral) ke ntho e tloaelehileng. Mabapi le sena, thibelo le khalemelo ea lefu la tsoekere la tsoekere ke ea bohlokoa haholo ho endocrinology.

A lefu la tsoekere la macroangiopathy, karolo e ka tlaase ea methapo ea methapo ea methapo e bohareng le e kholo e matlafala ka ho qaptjoa ha litoeba tsa atherosselotic ho eona. Ho bala ha bona ka morao ho moo, ho ruruha ha lisele le necrosis li kenya letsoho ho thehoeng ha methapo ea mali le ts'ebetso ea lumel ea methapo ea mali, e lebisang khatellong ea mali libakeng tse ling.

Lintlha tse ikhethang tsa kotsi bakeng sa nts'etsopele ea lefu la tsoekere macroangiopathy ho lefu la tsoekere le akaretsa hyperglycemia, dyslipidemia, ho hanyetsa insulin, botenya (haholoholo mofuta oa mpa), khatello ea methapo ea mali, ho eketseha ha mali, khatello ea methapo ea mali, khatello ea methapo ea methapo, le ts'oaetso ea methapo.Lisosa tsa moetlo oa atherosclerosis ke ho tsuba, ho tahoa, ho ikoetlisa, ho ikoetlisa ka lilemo, ho banna (ho feta lilemo tse 45, ho basali ba fetang lilemo tse 55), lefutso.

Tlhomamiso

Diabetes angiopathy ke mohopolo o kopanetsoeng o kenyelletsang ho hloa hoa likepe tse nyane - li-capillaries le li-arterioles tse haufi (microangiopathy), methapo e meholo le e meholo ea li-calorite (macroangiopathy). Li-angiopathies tsa lefu la tsoekere ke mathata a morao-rao a lefu la tsoekere, a ntseng a eketseha ka karolelano ea lilemo tse 10-15 kamora lefu le qala.

Diabetes macroangiopathy e ka iponahatsa ho syndromes tse 'maloa: atherosclerosis ea methapo ea methapo ea mokokotlo le aorta, atherosulinosis ea methapo ea methapo le methapo ea methapo ea methapo ea kutlo. Lefu la tsoekere le lefu la tsoekere le ka kenyelletsa retinopathy, nephropathy, microangiopathy ea lipheo tse tlase. Hape, tšenyo ea methapo e ka ba teng ka tsela ea angiopathy ea bokahohleng, ho kopanya li-macro- le microangopathy. Ka lehlakoreng le leng, microoneopathy ea endoneural e kenya letsoho ts'ebetsong e mpe ea methapo ea kutlo, ke., Nts'etsopele ea lefu la tsoekere le lefu la tsoekere.

Matšoao a macroangiopathy ea lefu la tsoekere

Atherosclerosis ea methapo ea methapo ea mokokotlo le aorta ho lefu la tsoekere macroangiopathy e bonahala ka nts'etsopele ea lefu la pelo le pelo le makhopho a lona a mabehang (myocardial infarction) le a sa foleng (a pelo ea pelo), angina pectoris. IHD ho lefu la tsoekere e ka hlaha ka mokhoa o atileng (ho latela khetho e sa hlakoheng kapa e se nang bohloko), ka ho etsa joalo e eketsa menyetla ea ho shoa ka tšohanyetso coronary. Lefu la tsoekere la lefu la tsoekere hangata le tsamaisana le mathata a mangata a ka morao ho sebopeho: aneurysms, arrhythmias, thromboembolism, Cardiogenic shock, ho nyekeloa ke pelo. Ka lefu la tsoekere le lefu la tsoekere, menyetla ea ho hlaha khafetsa myocardial infarction e phahame haholo. Kotsi ea ho bolaoa ke lefu la pelo ho bakuli ba nang le lefu la tsoekere e makhetlo a mabeli ho feta ho batho ba se nang lefu la tsoekere.

Atherosclerosis ea methapo ea methapo ka lebaka la lefu la tsoekere la macroangiopathy le hlaha ho 8% ea bakuli. E ka bonahatsoa ke ischemia e sa foleng ea 'mele kapa ischemic stroke. Monyetla oa hore mathata a amanang le lefu la tsoekere a eketseha ka makhetlo a 2-3 moo ho nang le khatello e matla ea mali.

Marang-rang a tšoaetsanoang a atherosclerotic leseli tsa methapo ea kutlo e ka mpang a ama 10% ea bakuli ba nang le lefu la tsoekere. Lipontšo tsa kliniki ea "li-macroangiopathy" ea lefu la tsoekere ntlheng ena li kenyelletsa ho otsela le ho bata ha maoto, ho se ts'oaroe hanyane ka hanyane, ho ruruha ha methapo ea kutlo, bohloko bo boholo mesifa ea leoto, lethekeng, 'me ka linako tse ling, le mafolofolo a mmele. Ka tlolo e matla ea phallo ea mali libakeng tse thoko tsa distal, ischemia e matla ea hlaha, ka lebaka leo ho ka hlaha li-necrosis tsa leoto le maoto a ka tlase (gangrene). Necrosis ea letlalo le lithaelese tse tsamaeang butle li ka hlaha ntle le likotsi tse ling tse senyehang tsa mochini, empa hangata ho etsahala khahlano le semelo sa tlolo ea pele ea bots'epehi ba letlalo (ka lesela la maoto, maoto a robehileng, ts'oaetso ea fungal ea letlalo le lipekere, joalo-joalo). Ha motho a e-na le mathata a ho phalla a phallo ea mali, ho ka etsahala hore ho be le liso tsa kahare tse sa foleng.

Phekolo ea lefu la tsoekere la macroangiopathy

Phekolo e reretsoe ho liehisa tsoelo-pele ea mathata a methapo ea methapo a sokelang mokuli ea nang le bokooa kapa lefu. Metheo ea mantlha ea kalafo ea lefu la tsoekere macroangiopathy ke khalemelo ea li-syndromes tsa hyperglycemia, dyslipidemia, hypercoagulation, arterial hypertension.

Bakeng sa ho fumana puseletso bakeng sa metabolism ea carbohydrate, bakuli ba nang le lefu la tsoekere la macroangiopathy ba bontšoa kalafo ea insulin tlasa taolo ea maemo a tsoekere ea mali. Khalemelo ea likhathatso tsa metabolism ea carbohydrate e fihlelleha ka ho beoa ha lithethefatsi tse fokotsang lipid (li-statins, li-antioxidants, fibrate), hammoho le lijo tse thibelang ho ja mafura a liphoofolo.

Ka kotsi e eketsehang ea mathata a thromboembolic, ho eletsoa ho fana ka litlhare tsa antiplatelet (acetylsalicylic acid, dipyridamole, pentoxifylline, heparin, jj.). Morero oa kalafo ea antihypertensive ho lefu la tsoekere la macroangiopathy ke ho fihlela le ho boloka boemo ba khatello ea mali ba 130/85 mm Hg. Art. Bakeng sa sena, ho molemo ho fana ka litlatsetso tsa ACE inhibitors (Captopril), diuretics (furosemide, spironolactone, hydrochlorothiazide), bakuli ba nang le lefu la pelo - beta-blockers (atenolol, jj.).

Kalafo ea trophic ulcers ea lits'oants'o e etsoa ka tlasa tlhokomelo ea ngaka e buoang. Likotsi tse mpe tsa methapo ea methapo, ho etsoa tlhokomelo e matla e loketseng. Ho ea ka lipontšo, kalafo ea ts'ebetso ea bongaka e etsoa (CABG, kalafo ea ts'ebetso ea ho se lekane ha methapo ea methapo, endarterectomy, ho poma leoto, joalo-joalo).

Phatlalatso le Thibelo

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.

Ho thibela lefu la tsoekere lefu la tsoekere

• Phekolo e lekaneng le e nakong bakeng sa lefu la tsoekere (lefu le tšoaetsitsoeng ke glucose e phahameng ea mali).
• Lijo tse nang le thibelo ea letsoai, protheine, lik'habohaedreite, lijo tse mafura.
• Ho tlohela ho tsuba le ho noa joala.
• Ho ikoetlisa 'meleng (ho sa bake litlhaselo tsa angina (lefu le hlahisoang ke bohloko kapa ho hlonama ka morao ho sternum ka lebaka la tlolo ea phallo ea mali pelong)).
• Letsatsi le letsatsi o tsamaea a le moeeng o mocha.
• Fokotseha ka boima ba 'mele.
• Tlhahlobo e matla ea tsoekere ea mali (tekanyo ea letsatsi le letsatsi).
• Taolo e matla ea boemo ba lipids (mafura) maling (hang ka likhoeli tse ling le tse ling tse tšeletseng).

TLHOKOMELISO PUSELETSO

Ho buisana le ngaka hoa hlokahala

Endocrinology - Dedov I.I., Melnichenko G. A, Fadeev V.F., - GEOTAR - Media, 2007
Algorithms bakeng sa tlhokomelo e khethehileng ea bongaka bakeng sa bakuli ba nang le lefu la tsoekere la mellitus, 2012

Angiopathy ea "pelo" ea methapo

Khatello ena ea lefu la tsoekere hangata e hlaha ho batho ba nang le khatello ea mali, empa hape e ka fumanoa ho ba se nang mathata a khatello. Lefu la tsoekere la tsoekere ea pelo le bonahala ka matšoao a latelang:

- bohloko bo sefubeng, bo baka tsitsipano molaleng, mokokotlong, mohlahare o tlase, letsoho le letšehali,

- bohloko le maikutlo a ho tsitsipanya, khatello e ka morao ho sternum, e eketsoang ke mosebetsi oa 'mele, hammoho le maemong a sithabetsang,

- ho ruruha le bohloko ho hypochondrium e nepahetseng,

Matšoao a tšoanang a hlaha le maloetse a mang a pelo. Ho etsa tlhahlobo e nepahetseng ea bongaka, coriary angiography le MRI ea lijana tsa pelo, hammoho le setho ka botsona li etsoa.

Joaloka lingaka tse fanang ka kalafo, bakuli ba fuoa meriana e thibelang methapo ea mali ho fokotseha, ho ntlafatsa phallo ea mali, ho thibela mali, khatello ea mali e tlase le ho fokotsa cholesterol e "mpe". Tsena ke "Nitroglycerin", "Aspirin", "Bisoprolol", "Verapamil", "Ramipril", "Lozartan" le lingoloa tsa bona.

Nephropathy

Diabetesic Microangiopathy ea liphio e bonoa ho batho ba nang le lefu la tsoekere le boiphihlelo kapa ho ba sa lumellaneng le litlhahiso tsohle tsa ngaka mabapi le ho ja le ho sebelisa meriana. Matšoao

- mokhathala o phahameng haholo,

- ho nyekeloa pelo, hangata pele ho ho hlatsa,

- hoseng ho ruruha sefahleho,

- proteinuria (protheine e khethiloe ka har'a moroto).

- Teko ea mali (biochemical, e khethollang boemo ba creatinine le urea),

Phekolo ea lefu la tsoekere la microabetesopathy ea liphio mohato oa pele oa nts'etsopele ea mathata a bakoang ke ho lekola palo ea tsoekere maling le ho boloka khatello e tloaelehileng ea mali. Mehato ena e thusa ho qoba ho senya menoana ka nako e telele. Nakong e tlang, hemodialysis e laetsoe, mme maemong a tebileng - ho fetisoa ha liphio.

Retinopathy

Retina ea motho le eona e na le methapo e menyenyane ea mali. Ho hloleha ha bona, ho etsahetseng motheong oa lefu la tsoekere, ho bitsoa retinopathy. Phepelo ena e ka ba teng ka nako e telele, lilemo tse 20 kapa ho feta, haeba mokuli a etsa lengolo la ngaka ka hloko 'me a ka iphatlalatsa ka mor'a lilemo tse 2 ho tloha ha a qala ho fumana lefu la tsoekere. Ka bomalimabe, morao tjena retinopathy e ama mokuli e mong le e mong.

Diabetesic retinal microangiopathy e tšoauoa ka matšoao a latelang:

- ho senyeha ha pono ho fihlela tahlehelo ea eona e felletseng,

- lesira le eme ka mahlong a ka,

- Lintho tse "phaphametseng" lebaleng la pono,

- bothata ba ho bona lintho tse nyane,

- matheba, litlhaka, metopa, lichapo ka pel'a mahlo,

- vitreous hemorrhage,

- bohloko lithutong tsa mahlo.

Ngaka ea mahlo ea mahlo, ha e hlahlobeloa, e khona ho bona matšoao a retinopathy le pele mokuli ka boeena a utloa hore ho na le ho hong ho phoso ka pono ea hae. Matšoao a pele a phetoho ena ke:

- methapo e senyehileng (hangata e nang le li-microaneurysms),

Thibelo ea retinopathy ke tlhahlobo ea kamehla ea setsebi sa mahlo, ho hlahloba maemo a tsoekere ea mali le ho ja.

Phekolo ea retinopathy e na le ente ea meriana leseling la mahlo, laser cauterization ea methapo ea mali ea fiber, le ts'ebetso ea ts'ebetso ea bongaka e tlotsang mali le lisele tsa mahlo mahlong.

Encephalopathy

Microangiopathy ho lefu la tsoekere e ka ama methapo ea kelello. Khatello e joalo e etsahala ho bakuli ba nang le boiphihlelo bo bongata le ho ba sa lateleng taelo ea lingaka. Matšoao a pele a encephalopathy:

- litletlebo ka hlooho ea "stale",

- boroko bosiu, ho otsela motšehare,

- mathata a ho hopola,

Matšoao a mang aa eketsoa:

- ho ba teng ha maikutlo a kelello,

Ho tseba ka lefu lena ke MRI ea boko.

Ho khutlisetsa likepe tse senyehileng ha e sa khonahala. Morero oa kalafo ke ho theola mokhoa oa ho ntlafatsa mathata. Motheo oa kalafo ke ho lekola palo ea tsoekere maling le ho e fokotsa.

Angiopathy ea lijana tsa maoto

Di-Microangiopathies tsa lefu la tsoekere li kenyelletsa mathata a tebileng a lefu la tsoekere, le hlahisoang ke tšenyo ea methapo e nyane le methapo (polyneuropathy) ea maoto, ka lebaka leo phepelo ea mali e ferekaneng, ho hlaha hoa lamunu, mme maemong a tsoetseng pele gang gang e qala. Mosebetsi oa boqhekanyetsi, botena, ho tsuba, khatello ea maikutlo, tlhahlobo ea liphatsa tsa lefutso e thusa ho nts'etsapele mathata.

- ke letsoalo la maoto

- ho satalla hoseng,

Ka ho phahama ha mathata, leoto la lefu la tsoekere le thehoa (ho thatafala ha lipekere, phetoho ea 'mala oa tsona, ponahalo ea poone, makhopho le liso tsa ka mpeng),' me sena, se kenya letsoho ponahalong ea gangrene, sepsis.

Tlhahlobo eo e etsoa motheong oa tlhahlobo ea bongaka le liteko tse 'maloa tse ikhethang:

Phekolo e etsoa ka mekhoa e meraro:

1. Tloaelo ea lefu la tsoekere (taolo ea tsoekere ea mali, lijo tse sa lumelle botenya, taolo ea khatello ea mali).

2. Ho ntlafatsa phallo ea mali le li-biochemical tsa mali (bakuli ba nka li-statins, li-angioprotectors, li-antioxidants, li-activine tsa biogenic, metabolism, li-thinner tsa mali, li-stimulants tsa biogenic).

3. Ho kenella ka har'a opereishene, morero oa eona ke ho khutlisetsa phallo ea mali le ho tlosa libaka tse shoeleng.

Macroangiopathy ke eng?

Ha liphetoho tsa pathological tse bakoang ke lefu la tsoekere li ama likepe tse mahareng le tse kholo, tlhahlobo ea lefu la tsoekere la diabetes e etsoa. Lisosa tse ka sehloohong tsa khatello ena:

- ho fifala ha likarolo tse ka tlase tsa methapo ea methapo le methapo ka lebaka la tsoekere e phahameng ea mali,

- sebopeho sa lijana tsa "atherosselotic plaques"

- Palo ea methapo ea mali, necrosis ea bona e tlang.

Sena sohle se lebisa ho thrombosis, occlusion le mafu a ho potoloha.

Ho nona haholo, hyperglycemia, dyslipidemia, ho hanyetsa insulin, ts'ebetso ea ho ruruha, khatello ea maikutlo, khatello e phahameng ea mali e kenya letsoho ho hlaha ha macroangiopathy. Ka lebaka leo, atherosclerosis ea likepe tse joalo e hlaha:

1. Aorta le artery ea methapo. E lebisa ho pelo ischemia, ho nyekeloa ke pelo, angina pectoris, lefu la pelo.

2. Methapo ea methapo. E ka fella ka ho otloa ke lefu la ischemic kapa ischemia ea (a sa foleng) ea boko.

3. Lithapo tsa methapo. E tšoauoa ka kotsi ea bohloka le ho pongoa leoto ka mor'a moo. Ka atherosclerosis ea methapo ea methapo ea kutlo, hangata necrosis e hlaha. Tšusumetso ea sena e ka ba maqeba a manyane, ho etsa mohlala, a fumanehang nakong ea pedicure, hammoho le mapetso, mycoses.

Bohlokoa ba tšimoloho ea angiopathy

Litla-morao tse mpe, ka nako e telele, phello ea lefu la tsoekere 'meleng e iponahatsa e le mofuta oa complication ea morao-rao e sa foleng - angiopathy (tšenyo ea methapo ea mali). Liponahatso tse matla tsa lefu la endocrinological li kenyelletsa maemo a tšohanyetso a nang le ho theoha ho matla ha tsoekere ea mali (hypoglycemia) kapa keketseho ea eona e phehellang (ketoacidosis), komisi.

Lithapo tsa mali li kena kahare ho 'mele oohle. Ka lebaka la phapang e teng lipapaling tsa bona (tse kholo le tse nyane), li-macro- le microangiopathy li khethiloe. Mabota a methapo le capillaries a bobebe ebile a masesaane, a anngoe ka ho lekana ke tsoekere e ngata.

Ha e kenella ka sekepeng, lintho tse phelang li hlahisa chefo ea lik'hemik'hale e kotsi liseleng le liseleng. Ho etsahala liphetoho tse bakang pherekano tšebetsong e tloaelehileng ea litho. Pele ho tsohle, macroangiopathy ho lefu la tsoekere e ama pelo, boko, maoto, microangiopathy - liphio, mahlo, maoto.

Ntle le tsoekere e ngata, methapo ea mali e senya cholesterol le lintho tse entsoeng ka lebaka la ho tsuba ha mokuli ka boeena kapa batho ba tikolohong ea hae e haufi. Litsela tsa mali li koaheloa ke li-cholesterol plaque. Ho lefu la tsoekere, likepe li otloa habeli (tsoekere le cholesterol). Motho ea tsubang o ipeha kotsing e 'ngoe e tharo e senyang. O matha kotsing ea ho tšoaroa ke lefu la atherosclerosis, eseng tlase ho motho ea nang le lefu la tsoekere.

Khatello e phahameng ea mali (BP) e boetse e baka tšenyo ea lithane tse kahare ho sekepe (aorta, methapong). Ho na le likheo lipakeng tsa lisele, mabota a e-ba a lumelloang, le ho tsepamisa maikutlo a mefuta ea tšoaetso. Ntle le li-cholesterol plaque, mabala a fora marakong a amehang. Li-neoplasms li ka thibela karolo ea lumen ka sekepeng esita le ho e thibela ka ho felletseng. Ho na le mofuta o ikhethileng oa ho otloa ke lefu la hemorrhagic kapa hemorrhage.

Lefu la tsoekere la macroangiopathy kapa ho fokotsa likepe tse kholo ke ts'oaetso ea lefu la 2. Ka molao, mokuli o feta lilemo tse 40 'me liphetoho tsa tlhaho tsamaisong ea methapo ea methapo li matlafatsoa ke mathata a lefu la tsoekere. Ho ke ke ha khoneha ho fetolela mokhoa o sebetsang ka lehlakoreng le leng, empa ho etsoa ha lisele tsa letlalo ho ka emisoa.

Karolo ea ntlha e 'ngoe e lebisang ho nts'etsopele ea mefuta ena ka bobeli ea li-angiopathies ha e hlakile ka ho lekana - ponelopele ea liphatsa tsa lefutso ho mafu a pelo le pelo.

Matšoao a macroangiopathy

Bakuli ba nang le atherosclerosis ba shebahala ba le baholo ho feta lilemo tsa bona, ba na le boima ba 'mele. Li na le matšoao a maputsoa a 'mala oa lamunu ka har'a lihlaha le eyelone - li-amana tsa cholesterol. Ho bakuli, pulsation ea methapo ea botšehali le ea popliteal e fokola, ho ba sieo ho felletseng, bohloko mesifa ea namane e hlaha ha o tsamaea le kamora nako e itseng kamora ho emisa. Lefu lena le tsamaisana le lipakeng tsa nakoana. Ho etsa tlhahlobo e nepahetseng, litsebi li sebelisa mokhoa oa angiography.

Mehato e latelang e khethollotsoe nts'etsopele ea macro- le microangiopathy ea libaka tse tlase:

• preclinical
• sebetsa
• manyolo
• lesapo la mokokotlo
• makhopho.

Mohato oa pele o boetse o bitsoa asymptomatic kapa metabolic, hobane esita le ho latela data ea liteko tse sebetsang, tlolo ea molao ha e bonoe. Mohato oa bobeli o na le matšoao a matla a kliniki. Tlas'a tšusumetso ea kalafo, mathata a nang le eona a ntse a ka fetoha.

Ho fokotsoa ha sekhahla sa mali se fepang setho se itseng ho isa ho ischemia (anemia ea lehae). Liketsahalo tse joalo li atisa ho bonoa sebakeng sa pelo. Ho sithabela ha methapo ho bakoang ke koluoa ​​ho baka tlhaselo ea angina. Bakuli ba hlokomela bohloko ka mor'a sternum, pherekano ea morethetho oa pelo.

Ho phatloha ka tšohanyetso ha sekepe sa pelo ho sitisa phepo e nepahetseng. Tissue necrosis e etsahala (necrosis ea sebaka sa setho) le infraction ea myocardial. Batho ba nang le eona ba tšoeroe ke lefu la pelo. Ho buoa ka bypass ho ka ntlafatsa boleng ba bophelo ba bakuli ba nang le lefu la methapo ea methapo.

Atherosclerosis ea methapo ea kelello e tsamaisana le ho tsekela, bohloko, ho senyeha hoa mohopolo. Leqeba le hlaha ha ho e-na le tlolo ea phepelo ea mali bokong. Haeba kamora ho "otla" motho a phela, joale ho ba le litlamorao tse mpe (tahlehelo ea puo, mesebetsi ea koloi). Atherosclerosis e ka ba sesosa sa lefu la ischemic, ha phallo ea mali bokong e tšoenyeha ka lebaka la cholesterol e phahameng.

Phekolo ea mantlha ea angiopathy

Liphetoho ke litlamorao tsa metabolism e sa senyeheng 'meleng. Phekolo e reretsoe ho sebelisoa ha litlhare tse tloaelehileng mefuta e fapaneng ea "metabolism" e amanang le lefu la tsoekere.

• carbohydrate (insulin, acarbose, biguanides, sulfonylureas tse ngata),
• mafura (lithethefatsi tse fokotsang lipid),
• proteni (lihormone tsa anabolic),
• electrolyte ea metsi (hemodeis, reopoliglyukin, litokisetso tsa potasiamo, calcium, magnesium).

Khafetsa, letšoao la cholesterol le ntseng le eketseha le bonoa ho mofuta oa 2 lefu la tsoekere, boima bo eketsehileng ba 'mele. E hlahlojoa habeli ka selemo. Haeba liteko tsa mali li phahame ho feta tse tloaelehileng, hoa hlokahala:

• Khetlo la pele, ho thatafatsa lijo tsa mokuli (ho se kenye mafura a liphoofolo, ho fokotsa lik'habohaedreite tse bonolo ho isa ho 50 g ka letsatsi, lumella oli ea meroho ho 30 ml, tlhapi, meroho le litholoana).
• ka bobeli, sebelisa lithethefatsi (Zokor, Mevacor, Leskol, Lipantil 200M).

Ho potoloha ha mali ka har'a lijana tse poteletseng ho ntlafatsoa ke li-angioprotectors. Tumellanong le kalafo e ka sehloohong, li-endocrinologists li khothaletsa tšebeliso ea livithamini tsa B (thiamine, pyridoxine, cyanocobalamin).

• normalization ea khatello ea mali le lithethefatsi (Envas, Enalopril, Arifon, Renitek, Corinfar),
• fokotsa boima ba 'mele butle-butle
• Ho lahla temallo ea ho tsuba le joala,
• fokotsa phallo ea letsoai,
• Ho qoba maemo a khatello a nako e telele.

E le thuso ea kalafo ea methapo ea methapo, li-endocrinologists li khothalelitse tšebeliso ea mekhoa e meng ea kalafo. Bakeng sa morero ona, ho sebelisoa litlhare tsa litlama (makhapetla a buckthorn, litafole tsa poone tse nang le stigmas, metso ea kholo e kholo ea litholoana, litholoana tsa ho jala lihoete, joang bo botala).

Mathata a amanang le lefu la tsoekere a kula a feta likhoeli, lilemo le mashome a lilemo. United States, Dr. Joslin Foundation e thehile khau e khethehileng. Lefu la tsoekere le hapileng, le atlehileng ho phela lilemo tse 30 ntle le mathata, ho kenyeletsa angiopathy, le fuoa moputso o le mong oa lebitso. Thapo e bontša taolo ea boleng ba lefu lena la lilemo.

Lisosa tsa macroangiopathy ho lefu la tsoekere

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.

Diabetes angiopathy le mefuta ea eona

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.

1. Nakong ea microangiopathy ho lefu la tsoekere mellitus, retinopathy, nephropathy, le lefu la tsoekere la methapo ea methapo e tlase e bonoa.
2. 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.

Macroangiopathy ea lefu la tsoekere e fumanoa joang?

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:

1. Teko ea mali a biochemical e etsoa ho bona tsoekere, triglycerides, cholesterol, liplatelete, lipoprotein. Teko ea coagulation ea mali le eona e etsoa.
2. Etsa bonnete ba ho hlahloba ts'ebetso ea pelo le methapo e sebelisang electrocardiogram, ho lekola khatello ea mali letsatsi le letsatsi, liteko tsa khatello ea maikutlo, echocardiogram, dopplerography ea ultrasound ea aorta, myocardial perfusion scintigraphy, coronarography, computer tomographic angiography.
3. Boemo ba methapo ea mokuli bo hlalosoa ka mokhoa o hlakileng ka ho sebelisa li-dopplerografia tsa methapo ea methapo, ho e sekaseka ka makhetlo a mabeli le ea angiography ea likepe tsa likhoerekhoere.
4. 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 la tsoekere la diabetes

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.

Mehato ea thibelo

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 ka hohle kamoo ho ka khonehang.

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