Motsoako o motle haholo oa lefu la tsoekere ho mofuta oa 2 lefu la tsoekere

Ho thata ho khetha lithethefatsi bakeng sa ho fokotsa khatello ea mofuta oa lefu la tsoekere la mofuta oa 2, hobane lefu la metabolism la carbohydrate metabolism le lebisa ho lithibelo tse ngata ts'ebelisong ea meriana bakeng sa khatello ea mali.

Ha a khetha meriana bakeng sa khatello e phahameng ea mali, ngaka e lokela ho nahanela boemo ba tsoekere maling, hore na mokuli o laola lefu la hae le sa foleng, e leng li-pathologies tse amanang le tsona nalaneng.

Motsoako o motle o khahlano le lefu la tsoekere la mellitus bakeng sa khatello e phahameng ea mali o lokela ho ba le thepa e 'maloa. Matlapa a lokela ho fokotsa lefu la tsoekere le DD haholo, ha a sa fane ka litla-morao.

U hloka ho khetha sethethefatsi se sa amang matšoao a tsoekere, boemo ba "cholesterol" e mpe le triglycerides, bo sirelletsang tsamaiso ea pelo le liphio, tse kotsi tsoekere e ngata le khatello.

Ho latela lipalo-palo, 20% ea lefu la tsoekere e fumanoa e le lefu la khatello ea mali. Kamano e bonolo, hobane lits'ebetso tse phahameng tsa tsoekere 'meleng lia senyeha, e leng se sitisang tlhahiso ea lihormone tse ling. "Ho otla" ka sehloohong ho oela methapong ea mali le pelong, ka mokhoa o tšoanang, khatello e matla ea mali.

Ke moriana ofe oa khatello ea lefu la tsoekere o lokelang ho nooa, ngaka e etsa qeto e khethehileng, e fanoe ka nuances tsohle tsa setšoantšo sa kliniki. Ntle le moo, ho bohlokoa eseng feela ho fokotsa lefu la tsoekere le DD, empa hape le ho thibela ho tlola ha glucose.

Hypertension ho diabetics hangata e hlaha ka lebaka la keketseho ea molumo oa mali o potoloha. Hape, bakuli ba kotsing ea letsoai, ka hona, meriana ea diuretic e kenyellelitsoe kalafong ea kalafo. Boikoetliso bo bontša hore diuretics e thusa bakuli ba bangata.

Phekolo ea khatello ea khatello ea mali ea mofuta oa 2 lefu la tsoekere e kenyelletsa tšebeliso ea litlhare tse latelang tsa diuretic:

• Hydrochlorothiazide (sehlopha sa thiazide).
• Indapamide Retard (e bua ka lithethefatsi tse kang thiazide).
• Furosemide (loop diuretic).
• Mannitol (sehlopha sa osmotic).

Lithethefatsi tsena li ka sebelisoa ho fokotsa khatello ea mali ka tsoekere e phahameng ea mali. Maemong a mangata, lithethefatsi tsa thiazide lia khethoa. Kaha li fokotsa monyetla oa ho ba le tlhaselo ea pelo le stroke ke 15% ho bakuli.

Hoa hlokomeleha hore lithethefatsi tsa diuretic ka litekanyetso tse nyane ha li ame tsoekere ea mali le lefu lena le ka tlase, ha li ame khatello ea "cholesterol" e mpe.

Sehlopha sa thiazide ha se khethoe haeba maloetse a mabeli a thatafalloa ke ho se sebetse hantle ha renal. Tabeng ena, litokisetso tsa loop li khothalletsoa. Ba atleha ho fokotsa ho ruruha hoa likarolo tse tlase. Leha ho le joalo, ha ho na bopaki ba sejana sa mali le tšireletso ea pelo.

Ka khatello ea mali e kopantsoeng le mofuta oa bobeli oa lefu la tsoekere, litekanyetso tse nyane tsa diuretics hangata li fanoa hammoho le ACE inhibitors kapa beta blockers. Ha e le sethethefatsi sa monoon, matlapa ha a khothalletsoe.

Litsebi tsa lefu la tsoekere ha ho mohla li fuoeng li-opmotic le tse sa hlokeng tšireletso ea potasiamo. Lithethefatsi tse ntle tse khahlanong le khatello ea mali ke lipilisi tse sebetsang tsa khatello, tse lokelang ho ba le thepa e 'maloa: khatello e tlase ea mali, ha e na litlamorao tse mpe, u se ke oa phahamisa tekano ea tsoekere ea mali, u se ke ua phahamisa cholesterol, sireletsa liphio, pelo.

Ho sebetsana le maloetse a mabeli a qhekellang ho tlameha ho hokahanngoa. Motho e mong le e mong ea nang le khatello ea maikutlo le ea lefu la tsoekere o eketsa haholo menyetla ea mathata a tsoang pelong, methapo ea mali, ha e kenyelle tahlehelo ea pono, jj.

Beta-blockers li khethoa haeba mokuli a e-na le nalane ea lefu la pelo le mofuta o mong le o mong. Li boetse lia hlokahala e le ho thibela infarction ea myocardial.

Litšoantšong tsena tsohle tsa bakuli, ba beta-blockers haholo ba fokotsa kotsi ea lefu ho tsoa ho pelo le lisosa tse ling. Sehlopha sa lithethefatsi se arotsoe ka mekhahlelo e itseng.

Ho lefu la tsoekere, hoa hlokahala ho nka meriana e ikhethileng, kaha e fana ka phello e ntle ka khatello ea matla a fetang 180/100 mm Hg, mme ha e ame lits'ebetso tsa metabolic 'meleng.

Lethathamo la li-beta blockers tsa lefu la tsoekere:

1. Nebilet (ntho nebivolol).
2. Coriol (motsoako o sebetsang oa carvedilol).

Meriana ena e ikhethileng e na le melemo e mengata. Ba fokotsa khatello ea mali, ba khelose matšoao a fosahetseng, ha ba ntse ba thusa ho ntlafatsa metabolism ea carbohydrate. E kanna ea eketsa ho hlonama ha lisele tse bonolo ho insulin.

Phekolo ea khatello ea mali ea methapo, ho khethoa lithethefatsi tsa moloko o mocha, tse khetholloang ka mamello e ntle, litlamorao tse fokolang.

Ho lefu la tsoekere, li-blocka-blocker tse se nang khetho tse se nang tšebetso ea vasodilator li ke ke tsa hlalosoa, hobane matlapa a joalo a mpefatsa maloetse a mantlha, a eketsa ho itšireletsa mafung le insulin, 'me a eketsa bongata ba cholesterol e "kotsi".

Li-blocker tsa calcium calcium ke meriana e tloaelehileng ka ho fetisisa e kenyelitsoeng ho mefuta eohle ea kalafo bakeng sa lefu la tsoekere le khatello ea mali. Empa meriana e na le li-contraindication tse ngata, 'me litlhahlobo tse tsoang ho bakuli ha li ntle kamehla.

Lingaka tse ngata lia lumela hore bahanyetsi ba calcium ba fana ka phello e ts'oanang le litokisetso tsa magnesium. Ho haella ha karolo ea liminerale ho senya tšebetso ea 'mele haholo, ho lebisang ho boima ba khatello ea mali.

Li-blockers tsa calcium calcium li lebisa ho sileng, ho openg hlooho, ho ruruha hoa lipheo tse tlase. Matlapa a Magnesium ha a na litlamorao tse joalo. Empa ha li phekole khatello ea mali, empa li etsa hore tšebetso ea methapo ea methapo e bohareng e ntlafatse.

Lijo tse tlatsetsang ka tlung le magnesium li bolokehile ka botlalo. Haeba mokuli a na le mathata le liphio, joale ho li nka ha ho kgothaletswe.

Bothata ke hore bahanyetsi ba calcium ba tlameha ho nkoa, leha ho le joalo, litekanyetso tse nyane feela ha li ame ts'ebetso ea metabolic, empa hape ha li fane ka sephetho se felletseng sa kalafo.

Haeba o eketsa tekanyetso, tsela ea lefu la tsoekere e tla mpefala, empa khatello e tla khutlela ho tloaelehileng. Ha litekanyetso li lekana, lefu le monate le tlas'a taolo, ho ba le lits'oaetso khatello ea mali. Ka hona, ho na le selikalikoe se lonya.

Ha ho mohla lithethefatsi tse khahlanong le calcium li fanoang ka litšoantšo tse joalo.

• Lefu la pelo.
• Sebopeho se sa tsitsang sa angina pectoris.
• Ho nyekeloa ke pelo.
• Nalane ea lefu la pelo.

Ho khothalletsoa ho sebelisa Verapamil le Diltiazem - lithethefatsi tsena li thusa ho sireletsa liphio, 'nete e netefalitsoe ke lithuto tse ngata. Li-calcium calcium tse tsoang sehlopheng sa dihydropyridine li ka sebelisoa feela hammoho le li-inhibitors tsa ACE, hobane ha li fane ka phello ea nephroprotective.

Ho tlosa khatello e phahameng ke mosebetsi o thata. Mokuli o hloka lijo tse khethehileng tse thibelang tsoekere le tsoekere le DD, ho ikoetlisa hantle, ho phela hantle ka kakaretso. Ke liketsahalo tse 'maloa feela tse u lumellang hore u phele ntle le mathata.

Ts'ebeliso ea matlapa a khatello ea mali e phahameng mofuteng oa 2 lefu la tsoekere ha e na sehlopha sa lithethefatsi tse thibelang enzyme e fetolang maikutlo, haholo haeba ho na le tlolo ea ts'ebetso ea liphio.

Leha ho le joalo, ha e laeloe kamehla.Haeba mokuli a e-na le nalane ea stenosis ea methapo ea letso le le leng kapa a stenosis e le 'ngoe, a tlameha ho hlakoloa.

Phehisano mabapi le ts'ebeliso ea li-inhibitors tsa ACE:

1. Pherekano e phahameng ea potasiamo 'meleng.
2. Ho eketseha ha serum
3. Ho ima, ho nyeka.

Bakeng sa kalafo ea ho hloleha ha pelo ka sebopeho leha e le sefe, li-inhibitors tsa ACE ke lithethefatsi tsa mola oa pele, ho kenyelletsa le batho ba lefu la tsoekere la mofuta oa pele le oa bobeli. Lithethefatsi tsena li thusa ho ntlafatsa tšilafalo ea lisele ho insulin, ho fella ka phello ea prophylactic tsoelopeleng ea lefu le "monate".

Ho khothalletsoa li-inhibitor bakeng sa lefu la tsoekere lephropathy. Kaha li thusa ho sireletsa liphio liphihlelong, li thibela nts'etsopele ea ho se sebetse ha liphio.

Ha u ntse u nka li-inhibitors, ho hlokahala hore kamehla u shebe khatello ea mali, serum creatinine. Botsofaling, pele u sebelisa matlapa, "bilteral renal artery stenosis" ha e qheleloe ka thoko.

Li-blockers tsa Angiotensin-2 li bitsa chelete e ngata ho feta li-inhibitors. Le ha ho le joalo, ha ba kenye letsoho kholisong ea khohlela e sa beheng, ba na le lethathamo le fokolang la litlamorao, mme ba nang le lefu la tsoekere ba li mamella hantle. Litekanyetso le sekhahla sa ts'ebeliso li ikemiselitsoe ka bonngoe. Nahana ka boemo ba khatello ea mali le matšoao a tsoekere 'meleng.

Bakeng sa kalafo ea khatello ea mali maling a lefu la tsoekere nka Losartan, Teveten, Mikardis, Irbesartan.

Joalokaha u bona, khatello ea mali e kotsi haholo. Haeba khatello e phahameng ea mali e kopantsoe le lefu la tsoekere, menyetla ea mathata a joalo e eketseha ka potlako. Phekolo e hloka tlhahlobo ea kotsi bakeng sa lefu le leng le le leng la lefu la tsoekere, ho sa tsotelehe mofuta oa lefu lena.

Joalokaha ho se ho hlokometsoe, kamano pakeng tsa maloetse ana a mabeli e hlakile. Haeba e sa phekoloe, sena se eketsa kotsi ea lefu ka lebaka la mathata. Ka khatello e kaholimo ho 150/100 le glucose e phahameng maling, litlhare tsohle tsa setso li lokela ho sebelisoa feela ka tumello ea ngaka e eang. Ho thibetsoe ka thata ho hlakola kalafo e hlokofatsang, le haeba khatello e tlase e ka bonoa.

Phekolo ka mekhoa e meng e lula e le telele. Hangata e nka likhoeli tse 4 ho isa selemong se le seng. Ka mor'a libeke tse ling le tse ling tse peli tsa phekolo, u hloka ho nka matsatsi a 7 a phomolo, etsa bonnete ba hore u latela mohlala oa lefu la tsoekere le DD. Haeba u ikutloa u le betere, khatello ea mali a hau e fokotsehile ka 10-15 mmHg, joale tekanyetso ea phekolo ea setso e fokotsehile ka kotara.

Ho thata ho bolela ka ho khetheha hore na ho tla nka nako e kae ho ntlafatsa bophelo bo botle. Kaha likarolo tsa maloetse a mabeli ha li na matla. Haeba nakong ea kalafo ea lapeng mokuli o ikutloa a khathetse hanyane, a qhomela tsoekere kapa khatello, joale o lokela ho batla thuso ea bongaka hang-hang.

Litlhare tsa motsoako oa lefu la tsoekere la mofuta oa 2 le khatello ea mali:

1. Hlatsoa 200 g ea litholoana tsa hawthorn, tse omileng. Grind ho fihlela gruel, tšela metsi a 500 ml. E tlohele e etse metsotso e 20. Nka makhetlo a mahlano ka letsatsi, 100 di ml pele ho lijo. Recipe e nolofalletsa khatello ea mali ka lebaka la phello ea vasodilating, e thusa ho fokotsa tsoekere 'meleng. Ha ho kgothaletswe ho nwa decoction nakong ya mpa le nakong ya kanyeso.
2. Nka tekanyo e lekanang ea makhasi a quince le makala, kopanya. Tšela 250 ml ea metsi a belang, tlohela hora. Kamora ho pheha ka mollo, pholile, u be le moea o thata. Nka likhaba tse tharo habeli ka letsatsi. Ho amoheloa ha hoa itšetleha ka lijo.
3. Ho sebetsana ka katleho le khatello e phahameng ea mali le tsoekere e phahameng ho thusa metsi a morara. Hoa hlokahala ho etsa makhasi le makala a morara ka 500 di ml ea metsi, ho tlisa ho pheha ka mocheso o tlase. Nka 50ml pele ho lijo tse ling le tse ling.
4. Ho bokella litlama bakeng sa lefu la tsoekere le khatello ea mali ho potlakile ebile hoa sebetsa, ho thusa ho ntlafatsa boemo ba mokuli.Kopanya mefuta e lekanang ea makhasi a currant, viburnum, mamawort le oregano. Khaba e le 'ngoe ka khalase ea metsi, e etsetsoa metsotso e 15. Arola likarolo tse 'maloa tse lekanang, o noe ka letsatsi.

Ho phekola khatello ea mali ho batho ba lefu la tsoekere ke mosebetsi o boima. Ho fokotsa khatello ea mali, o hloka ho sebelisa lithethefatsi tse 'maloa tsa antihypertensive tse sa amang likarolo tsa carbohydrate le metabolic' meleng. Ka mokhoa o loketseng, ba lokela ho ntlafatsa maikutlo a lithane ho insulin.

Phekolo ena ke ea nako e telele, e tšoarella bophelong bohle. Matlapa a khethoa ka bonngoe, qalong, ho beha leihlo khafetsa bongaka, ho hlokomela khatello ea mali le tsoekere e hlokahalang, e o lumellang hore o fetole lengolo la ngaka kapele ha ho hlokahala.

Kotsi ea ho kopana ha lefu la tsoekere le khatello ea mali e ngata e tla bolella setsebi se hlahang videong ena.

Litafole tsa khatello e phahameng ea mali (li-antihypertensives) mokhatlong oa sejoale-joale li emeloa ke lihlopha tse 4 tse ka sehloohong: diuretics (diuretics), antiadrenergic (alpha le beta-blockers, lithethefatsi tse bitsoang "lithethefatsi tse bohareng"), li-vasodilators tsa khalori, lihanyetsi tsa khalsiamo le li-inhibitors tsa ACE ( angiotensin-converting enzyme).

Lethathamo lena ha le kenye li-antispasmodics, joalo ka papaverine, hobane li fana ka phello e fokolang ea hypotensive, li fokotsa khatello e nyane ka lebaka la ho phomola ha mesifa e boreleli, 'me sepheo sa tsona se fapane.

Boholo bo amana le meriana bakeng sa khatello le litlhare tsa batho, empa sena ke, ka kakaretso, khoebo ea motho e mong le e mong, leha ho le joalo re tla e nka, hobane maemong a mangata e hlile e sebetsa joalo ka kalafo e thusang, 'me ho tse ling (mothating oa pele oa khatello ea mali) nka sebaka sa sehlooho.

Polelo e joalo ke nnete. Sehlopha sa lipilisi tsa khatello tse fanoeng tleleniking hangata se kenyeletsa diuretics:

• Kaha ba na le phello e potlakileng le e matla ea loop diuretics (furosemide), ba ngolisitsoe hammoho le meriana e meng ea khatello, haholoholo ho fihlella ka potlako sephetho se lakatsehang, mohlala, le khatello ea khatello ea mali. Bakeng sa tšebeliso ea kamehla le ea nako e telele, li-diuretics tsa sehlopha sena ha li tšoanelehe haholo, kaha li tlosa ka potlako li-microelements, haholo potasiamo le sodium, ho haella ha eona ho fetohela ho mokuli ho hlaha ha arrhythmias le mathata a mang, a hlalositsoeng sengoloeng sa diuretics.
• Ha e le molao, ts'ebeliso ea lioptamine tsa loop e hloka tšireletso ea mesifa ea pelo, e fihlellehang ka ho beoa ha lithethefatsi tse nang le potasiamo (panangin, aspark) le lijo tse nang le potasiamo e ngata.
• Liazine diuretics li ipakile li le hantle haholo, e le li-monotherapy mehatong ea pele ea khatello ea mali (indapamide, arifon) kapa hammoho le li-inhibitors tsa ACE. Le ha e sebelisoa ka nako e telele, diuretics tse boletsoeng ka holimo ha li lebise ho hypokalemia, arrhythmias, le litlamorao tse ling, ke hore, ka kakaretso ha li na phello e mpe 'meleng.
• Potasium-sparing diuretics (veroshpiron, spironolactone) li na le bokhoni bo fokolang ba hypotensive, ka hona, hangata li nkuoa e le moriana oa khatello ha o kopana le diuretics tse ling - thiazide kapa loopback.

Lipilisi tsa diuretic bakeng sa khatello ha li fuoe bakeng sa arterial hypertension (AH) e tsamaellanang le ho hloleha ho matla ha aimp. Mokhelo ntlheng ena ke furosemide feela. Ho sa le joalo, bakuli ba nang le khatello ea maikutlo ba nang le matšoao a hypovolemia kapa matšoao a khaello ea mali haholo, diuretics tse kang furosemide le ethaconic acid (uregitis) li hanyetsanoe ka molao.

Haeba khatello ea mali e tsamaisana le lefu la tsoekere, leka ho se nahane ka hypothiazide kapa ho e fana ka tlhokomelo e kholo. Veroshpiron e fetisoa haeba tlhahlobisong ea biochemical ea mali a mokuli e tlalehiloe kapa maemong a ho ngolisa atrioventricular blockade ea li-degrees tsa 1-2.

Li na le tsoalo, li fapana ka boits'oaro ba tšebetso, ka hona li kopantsoe ka lihlopha:

1. Lithethefatsi tse sebetsang kahare ho neuron ("bohareng" ketso), tsena li kenyeletsa guanethidine le alkauides ea Rauwolfia snakeine: reserpine, raunatin,
2. Li-agonists tse bohareng, baemeli ba tsona e leng Clonidine (clonidine, hemitone, catapressan) le methyldopa (dopegyte, aldomet),
3. Li-blockers tsa peripheral α-receptors, e leng prazolin (pratsiol, minipress - mohanyetsi ea khethang li-postynaptic α-receptors),
4. Li-blockers tsa Β-adrenoreceptor: tse sa khethang - propranalol (anaprilin, obzidan), oxprenolol (trazikor), nadolol (korgard), sotalol, pindolol (viscene), timolol, peloioselective - cordum (talinolol), atenolol, metoprolol.
5. Li-blockers tsa α- le β-adrenergic receptors, tse kenyelletsang labetolol (tradet, albetol).

Ehlile, lihlopha tsena li na le liphapang, ka bobeli ho tsona le ka hare ho tsona, tseo re tla leka ho li fumana ka ho fana ka tlhaloso e khuts'oane ea baemeli ba bang.

Lithethefatsi tse sebetsang ka hare ho neuron:

• Reserpine e fana ka tšusumetso e bohareng ea kelello, ha e lumelle catecholamine hore e beoe ho hypothalamus kapa lehlakoreng le haufi. Reserpine matlapeng a khatello e qala ho sebetsa feela ka matsatsi a 5-6, empa ha e laoloa ka matla, phello e etsahala kamora lihora tse ka bang 2-4. Ntle le melemo (ho fokotsa khatello ea mali), reserpine e na le mathata a etsang hore kalafo e be boima. Ha u sebelisa sesebelisoa sena, bakuli ba lula ba tletleba ka ho qhekella ka nasal, e sa tlosoang ke lithethefatsi tse tloaelehileng tsa vasoconstrictor, ho eketseha ha sebopeho sa mala le lets'ollo (phello ea vasotropic) e bonahala. Mabapi le sena, ho na le tlhoko ea ho ts'oara ka nako e ts'oanang ho ama mucosa ea nasal (marotholi a atropine), ho sebelisa meriana ea gastric le ho fetohela phepelong e jang nako. Ntle le moo, reserpine e ka fana ka bradycardia, bofokoli, ho tsekela, ho hema, mahlo a khubelu, ho ama psyche (psychosis, khatello ea maikutlo), ka hona, pele ho khethoa, ho bohlokoa ho thahasella nalane ea mokuli le beng ka eena mabapi le bokuli ba kelello. Reserpine ka boeona ha e atisoe hangata, leha ho le joalo, hammoho le hypothiazide, ke karolo ea lithethefatsi tse tsebahalang: adelfan, adelfan-hopolarex, trireside K. Ba lokolloa feela ka lengolo la ngaka.
• Raunatin (Rauwazan). Matla a antihypertensive a fetoha butle butle. Ka mekhoa eohle, e nkoa e le betere ebile e le bonolo ho feta reserpine. Ho matlafatsa ho hlohlona ha glomerular, ho eketsa phallo ea mali maling, ho thusa ho khutlisa morethetho, ka tsela e itseng o khutsisa tsamaiso ea methapo e kholo.
• Guanedin (octadine, ismeline, isobarin) e tšoauoa ka pontso ea butle-butle ea phello ea hypotensive (ho fihlela beke), e ka phehellang ho fihlela libeke tse 2 kamora ho hlakoloa. E na le litla-morao tse ngata: hypotension ea orthostatic ha e ema, kahoo mokuli o rutoa ho nka boemo bo otlolohileng e le hore a se ke a oa. Ho thata haholo ho bakuli ba joalo hore ba eme nako e telele kapa ba lule ba le ka hara lintho tse futhumetseng le mocheso. Letšollo, bofokoli bo feteletseng, ho fokotseha ho matla ha ts'ebetso, ho senyeha hoa mmele - sena le sona ke litla-morao tsa guanedine. Contraindication: atherosmithosis e matla ea methapo ea methapo le methapo ea methapo, stroke, myocardial infarction, ho se sebetse hantle ha renal (CRF), pheochromocytoma (adrenal tumor).

Ho hlakile hore, lithethefatsi tsena bakeng sa khatello li rarahane ebile li fanoa ka morero oa ho lemosa mokuli hore lithethefatsi tse tšoanang ha li tšoanele motho e mong le hore leha e le karolo e nyane ea piritsi e ka ba kotsi haholo mme e ka sebelisoa feela joalo ka taelo ea ngaka.

Baemeli ba sehlopha sa pele (li-agonists tse bohareng) le bona ba lokolloe ka taelo ea ngaka. Ba bang ba bona ba fuoe botlokotsebe, 'me ka linako tse ling ba tuma hampe (lefu le kopantsoe le joala). Bo-ramahlale ba bohareng ba kenyelletsa:

1. Methyldopa (dopegit, aldomet).Ha e siea tlhahiso ea pelo e sa fetoheng, e fokotsa ho hanyetsa ka botlalo (OPS), ka hona, e fokotsa khatello ea mali lihora tse 4 ka mor'a taolo, e boloka phello ena ho fihlela matsatsi a mabeli. Methyldopa e boetse e na le litla-morao tse ngata, li tšoana le tsa guanedine: molomo o omileng, ho otsela, ho nyekeloa ke moea, kapa ho fokola haholo, empa ts'ebeliso ea methyldopa e ka lebisa ho mathata matsatsing a tšoaetso ea mmele: hepatitis e sa foleng, hepatitis e hlobaetsang, hemolytic phokolo ea mali, myocarditis. Setlhare ha se laetsoe ho senyeha ha sebete, nakong ea kemero le maemong a pheochromocytoma!
2. Clonidine (clonidine, hemiton, catapressan) - mochine oa ts'ebetso o ts'oana haholo le methyldopa. Matla a antihypertensive a khethehile. Hang-hang ka mor'a tsamaiso, khatello ea mali e phahama ka nakoana, ebe e qala ho fokotseha. Ha ho nooa ka molomo, phello ea lithethefatsi e etsahala ka karolelano ea halofo ea hora, ha tsamaiso ea methapo e fokotsa nako hore e be metsotso e 5, e etsang hore e khone ho e sebelisa maemong a potlakileng ha khatello e phahameng haholo e sokela ka mathata (stroke) mme e hloka karabelo e potlakileng ho ngaka. Litlamorao li ka fapana hanyane le ts'ebetso ea batho ba bang ba nang le kutloelo-bohloko, empa clonidine e na le lefu le ipolelang, le fanang ka setšoantšo sa koluoa ​​e matla e tsamaeang le tachycardia, ho tsofala, ho tšoenyeha, ka hona, e hlakotsoe butle (kamora beke). Ho kopana ha clonidine le joala ho ka lebisa lefung la mokuli. Li-contraindication tse matla bakeng sa clonidine: atherosclerosis e matla ea likepe tsa mokokotlo le likhoerekhoere, ho nyekeloa ke pelo ho hoholo, khatello ea maikutlo, bokhoba ba joala.

Peripheral alpha receptor blockers ke li-prazosin (pratsiol, minipress), e khonang ho atolosa lijana tsa bethe ea venous, e fokotsa ho jarolla, e fokotsa OPS, 'me ka tsela e khutsitseng e ama mesifa e boreleli ea lebota la methapo ebe ka tsela eo e fokotsa khatello ea mali. Phello e boletsoeng e tšosang e lieha 'me e iponahatsa feela ka mor'a matsatsi a 7-8 ho tloha qalong ea kalafo. Setlhare sena se na le melemo e 'maloa holim'a lithibelo tse ling tsa antihypertensives, hobane ha se tšoane le litlamorao tse ngata, ntle le ho ba le letsoalo le hlooho ka linako tse ling, ke ka lebaka leo hangata e laeloang kalafo ea khatello ea mali ho bakuli ba nang le butle-butle atrioventricular conduction le sinus bradycardia.

Li-blockers ke sehlopha se tsebahalang le se pharaletseng sa lithethefatsi ka khatello eseng feela. Phekolo ea maemo a mangata a pelo ea methapo ea methapo ea pelo (angina pectoris, arrhythmia) ha e ea fella ntle le ts'ebeliso ea baemeli ba sehlopha sena, lenane la lona le pharalletseng hoo ho ka hlokoang sengoloa se fetang se le seng se ka amohelang litšobotsi tsohle.

Beta-blockers li tšoana ka sebopeho ho li-catecholamine tsa mehleng, ka hona, li khona ho thibela sephetho se sebe sa tsamaiso ea methapo ea pelo ka ho tlama ho the-adrenergic receptors ea li-membrane tsa postynaptic. Litlamorao tse matla tsa lithethefatsi tsena bakeng sa khatello li ipapisitse le bokhoni ba ho lebella tachycardia le khatello e matla haholo ha ho ka ba le khatello ea maikutlo le khatello ea maikutlo kelellong.

Lipilisi tsa khatello ho tsoa sehlopheng sa beta-blocker ha li etse feela mosebetsi o moholo oa mosebetsi oa tsona o ka sehloohong, empa li boetse li bonts'a bokhoni bo ikhethileng mabapi le ho thibela nts'etsopele ea mathata a tebileng a khatello ea mali: infarction ea myocardial le likotsi tsa morethetho oa pelo tse sokelang. Mokuli ka linako tse ling ha a tsebe hore beta-adrenergic blockers e laetsoeng khatello ea mali, ka nako e ts'oanang, e sireletsa ka bonolo khahlano le litlamorao tse mpe tsa lefu le ka tlase. Meriana ena ea khatello e sebetsa hantle maemong a khatello e matla ea mali. Tsohle tse kaholimo ha li bolele hore mokuli a ka li ngolla a le mong, kaha le tsona li na le litla-morao.

Lithethefatsi tsa sehlopha sena sa meriana se arotsoe ka β-blockers tse se nang boikhethelo le tsa pelo. Sehlopha sa pele (se sa khethang) ke:

• Propranolol (Obzidan, Anaprilin, Inderal),
• Nadolol (korgard),
• Oxprenolol (trasicor, butle-trasicor),
• Sotalol
• Pindolol (Wisken),
• Timolol
• Alprenolol (aptin).

Lenane la li-blockers tsa beta tse khethiloeng li kenyelletsa:

1. Cordum (talinolol),
2. Atenolol (tenormin, atcardil, betacard, catenol, prinorm, falitensin, tenolol),
3. Acebutolol (sectral),
4. Metoprolol (betalok, spesikor, seloken).

Tekanyetso ea beta-blockers e khethoa bakeng sa mokuli ka mong ka boeona motheong oa litlamorao tsa phello ea kliniki, sekhahla sa pelo (HR) le bophahamo ba khatello ea mali! Haeba tekanyetso e khethiloe, ha ho na litla-morao, joale mokuli o fetohela ka mokhoa o sireletsehileng kalafong ea nako e telele ea tlhokomelo le lithethefatsi tsena.

Matšoao a ts'ebeliso ea beta-blockers, ntle le khatello e phahameng, ke:

• Angina pectoris,
• Cardiac arrhythmias,
• Cardiomyopathy e kotsi
• Hypstensive vegetative-vascular dystonia (trasicor),
• Myocardial infarction.

Ntle le moo, tse ling tsa beta-blockers (propanolol) hangata ha li sebelisoe feela e le sethethefatsi se matlafatsang le se thibelang mafu, empa hape le bakeng sa kalafo ea thyrotooticosis, migraine, hlooho e opang ka lebaka la mokokotlo oa vascular, bakeng sa thibelo ea ho tsoa mali ka khatello ea mali ea methapo, le kalafo ea mefuta e fapaneng phobias, tšabo, methapo.

Se ke oa nka sehlopha sena sa lithethefatsi haeba u:

1. Sinus bradycardia,
2. Circulatory insuffasure 2A (le ka holimo) Art.
3. Sebaka sa Atrioventricular
4. Sebaka sa atrioventricular (ho feta tekanyo e fetang 1),
5. Pherekano ea Cardiogenic,
6. Mellitus e sa itšetleheng ka insulin,
7. Ho eketseha ha lesapo la peptic la mpeng kapa duodenum,
8. Ho hloleha ha pelo ho matla.

Li-blockers tse sa ikhetheng ha li khethoe haeba mokuli a tšoeroe ke asthma ea bronchial, bronchitis e thibelang, lefu la Raynaud, mafu a felisang methapo ea maoto. Ba boetse ba leka ho etsa ntle le ts'ebeliso ea lithethefatsi tsena khatello, haeba mokuli a le khatello ea mali ea 100 mm RT. Art. le tlase, kapa sekhahla sa pelo sa 55 beats / Min kapa ka tlase.

Ho bohlokoa ho hopola hore ha ho nooa meriana ena (leha ho le joalo, joalo ka tse ling kaofela) litla-morao li ka etsahala:

• Ho khathatsoa ke boroko (ho hlobaela, litoro tse mpe),
• Bofokoli bo akaretsang, ts'ebetso e fokotsehileng, maemong a mang, khaello ea bokhoni ba thobalano,
• Ho fokotseha ho matla ha serum glucose ho diabetics,
• Khōlo ea khatello ea kelello ka lebaka la ho se atlehe ha pelo,
• Ponahalo ea sebopeho sa atrioventricular,
• Bohloko ka mpeng (ho "ulcers"),
• Cancellation syndrome ha motho a khaotsa ho phekoloa ka mokhoa o bohale (tachycardia, hlooho ea hlooho, Cardialgia, matšoenyeho),
• Likotsi tse nang le khatello e matla ka lebaka la ho ba teng ha pheochromocytoma.

Labetolol (tradate, albetol) e bua ka lithethefatsi tse thibelang li-alpha le li-beta receptor ka karolelano ea 1: 3. Ketso ea eona e etselitsoe ho fokotsa PS (ho hanyetsa pherekano), ho siea phello e tloaelehileng kapa e fokolang ea pelo, le ho fokotsa mosebetsi oa plinma renin.

Tsamaiso ea methapo e fana ka phello ea lithethefatsi kamora metsotso e 2 ka mor'a ente (ha e le hantle ka nale,) empa ha e nkoa ka molomo, phello ena e lieha ho fihlela lihora tse peli.

Ho mafu a thibelang a bronchi, atrioventricular blockade le nakong ea kemero (trimester ea pele), ts'ebeliso ea labetolol ha e amohelehe.

Li-vasodilators tsa Peripheral (PV), tse emelang sehlopha sa heterogenible (arteriolar le li-vasodilators tse tsoakiloeng). Li-vasodilator tsa Arteriolar li kenyelletsa: hydralazine (apressin), diazoxide (hyperstat), minoxidil, e tsoakiloeng - isosorbide dinitrate, sodium nitroprusside.

Li-vasodilator tsa Arteriolar li fokotsa OPS, empa leha ho le joalo, e baka karabelo ea Reflex ea homeostasis, eo karolo e itseng e felisang ketso ena. Sistimi ea kutloelo-bohloko e sebetsa le ho ntlafatsa sekhahla sa pelo le molumo oa stroke, ho eketsa mosebetsi oa ho nchafatsa. Sena ke litlamorao tse mpe tsa PV.

Li-vasodilator tse tsoakaneng li hlapatsa likepe tse arterial (arterioles). Ka nako e ts'oanang, li ama le venous, ke hore, li atoloha 'me ka tsela eo li fokotsa ho khutla ha mali a venous ho ea pelong, e leng se ka lebisang ho ts'oenyehong ea venous. Sena le sona ke tšitiso.

Li-PV tse hloekileng ha li hlile ha li tšoanelehe bakeng sa ho iphekola ha methapo ea methapo ea methapo, joalo ka molao, li fanoa ka li-β-blockers le diuretics, tse khutlollang litlamorao tsa vasodilators tsa morao.

Baemeli ba hlahelletseng ba PV ba kenyelletsa:

1. Hydralazine (apressin) e fumaneha matlapeng, empa mokuli o lokela ho hopola, haeba ka tšohanyetso a batla ho theola khatello feela ho bona mme a hlokomolohe merero e meng, hore matšoao a kang hlooho, tachycardia, nts'etsopele ea angina e sa tsitsang e tla iketsa hang-hang. Ntle le moo, apressin e na le lintho tse 'maloa tse hanyetsanang: SLE (systemic lupus erythematosus), hepatitis e sa foleng, lesapo la mokokotlo le duodenal. Tsamaiso ea nako e telele ea lithethefatsi tse nang le hydralazine e khona ho hlahisa lefu le kang lupus ho basali ba nang le tlhahlobo ea matšoao (lisele tsa LE) serumeng ea mali.
2. Diazoxide (hyperstat) ha e tsamaisoa kahare ka potlako (2-5 min) e fokotsa khatello ea mali (ka bobeli systolic le diastolic). Ha ho na matlapa a fumanehang.
3. Minoxidil - e hlahisoa ka matlapa a tsoang khatello e phahameng ea mali, empa e sebelisoa feela ka beta-blockers le diuretics (!).
4. Sodium nitroprusside e khona ho fokotsa lebelo pele le kamora 'me e eketsa molumo oa stroke. Ka marang-rang a kenang ka matla! Phello ea hang-hang e hlokang ho hlahlojoa khafetsa ha khatello ea mali! Ehlile, ho beoa, kalafo le taolo ke mosebetsi oa ngaka ea sepetlele, maemong a mang setheba ha se sebelisoe. Matšoao: koluoa ​​ea khatello e phahameng ea mali, ho hloleha ho hlohlontšang mahlo haholo. Contraindication - coarctation ea aorta, arteriovenous shunts.

Dibazole le tsejoang haholo le lona le na le li-vasodilator tse potileng, tse nang le antispasmodic, hape, litlamorao tse matlafatsang. Ho fihlela haufinyane tjena, dibazole e ile ea bontšoa leha e le ka har'a protocol ea tšohanyetso bakeng sa phokotso ea koluoa ​​ea khatello ea mali (dibazole + papaverine). Leha ho le joalo, kaha e filoe bokhoni ba eona ba ho qala hakhutšoanyane, empa ka matla, phahamisa khatello ea mali, mme joale e qale ho e theola, e ne e sa sebelisoe ka khatello ea 200 mmHg. Art. le phahameng (menyetla e phahameng ea ho ba le stroke). Hona joale, lithethefatsi li tlohetse mekhoa e meng ea li-antihypertensives 'me li khaolitse ho sebelisa ambulense.

Bakuli ba ngoletsoe bona le papazol e kopaneng ea lithethefatsi, e kenyeletsang dibazole e boletsoeng ka holimo le phello ea antispasmodic ea papaverine (e khutlisang spasm ea mesifa e boreleli, ke hore, methapo ea mali). Nako le nako, ka keketseho ea episodic ea khatello ea mali, papazol e ka sebelisoa, empa ho hlakile hore a ke ke a khona ho sebetsana le khatello ea mali ea methapo mme kapele o tla tlameha ho khetha lipilisi tsa khatello e phahameng ea mali ho tsoa lihlopheng tse ling.

Setlhare se khahlisang se nang le PV se bitsoa andipal. Andipal, ntle le dibazole, e na le analgin, papaverine, phenobarbital mme, ka hona, e fana ka phello e fapaneng. Setlhare sena, ka ho kokobetsa khatello ea methapo ea methapo ea kelello, se imolla tlhaselo ea bohloko bo bakoang ke migraine, se thusa ho fokotsa khatello butle-butle ka mofuta o fokolang oa khatello ea mali. E ntlafatsa phello e matlafatsang ea li-nitrate, calcium antagonists, beta le ganglion blockers, antispasmodics le diuretics. Khabareng, ka lebaka la sebopeho sa eona (phenobarbital), ha ho na monyetla oa ho lumellana le batho bao mosebetsi oa bona o hlokang tlhokomelo e eketsehileng, mohlala, bakhanni. Le batho ba tloaelehileng ba tla khanna.

Lithaka tsa khalsiamo li na le mabitso a mangata, e le hore mokuli a se ke a a khetholla ho "lietsahala" lithibelo tsa "calcium" kapa "li-calcium ions" tse kenang liseleng tsa mesifa e potlakileng, re potlakile ho u tsebisa hore ana ke mabitso a fapaneng a meriana eo e leng ea sehlopha se le seng.

Setlhare se ka sehloohong sehlopheng sena se nkoa e le nifedipine (Corinfar), e sebetsa ka bonolo, eseng haholo ho bontša mahlakore a eona a mabe. Ntle le moo, Corinfarum e kopantsoe hantle le β-blockers esita le dopegitis. Joalokaha boiphihlelo ba litsebi tse ling tsa pelo li bontšitse, ho bakuli ba nang le khatello e matla ea mali ea nang le matšoao a ischemia ea myocardial le ho nka corinfar, karolo ea ho qetela ea ECG e khutlela ho e tloaelehileng. Ka bomalimabe, nako ea ts'ebetso ea moriana ona e khuts'oane, ka hona e lokela ho nkuoa makhetlo a 3 ka letsatsi 'me ha e tlase. Lithethefatsi tse ling li boetse li sebelisetsoa khatello ea mali, e leng bahanyetsi ba calcium 'me ba arotsoe ka lihlopha tse tharo.

Lits'oants'o tsa phenylalkylamines, tse khetholloang ke phello e kholo molemong oa mesifa ea pelo, lerako la methapo le tsamaiso ea methapo ea kutlo:

• Verapamil (isoptin, phenoptin), e sebelisoang e le kalafo ea tšohanyetso bakeng sa pherekano e kholo ea morethetho, hobane ha e fanoa kahare, e fana ka phello kamora metsotso e 5, ha ho nooa litafole ho tla fana ka sephetho ka mor'a lihora tse 1-2.
• Anipamil
• Falipamine
• Tiapamil.

1. Ho ba le bokhoni ba vasodilating nifedipine (Corinfar),
2. Moloko oa bobeli oa bahanyetsi ba calcium ke nicardipine le nitrendipine,
3. E bonts'a phello e ikhethang ho lierekisi tsa "cod"
4. Nisoldipine, e amang haholo likepe tsa coronary,
5. E tšoantšoa ke phello e matla, e tšoarellang nako e telele ka litlamorao tse fokolang - felodipine, amlodipine, isradipine.

Setlhare, seo thepa ea sona e leng pakeng tsa corinfar le verapamil, se bitsoa diltazem, se kenyelelitsoe sehlopheng sa boraro sa "block" calcium channels 'me se tsoa ho benzothiazepine derivatives.

Ntle le moo, ho na le sehlopha sa lithethefatsi tse thibelang phallo ea calcium ions ka seleng (bahanyetsi ba sa khethiloeng ba Ca), tsena ke lintho tse tsoang ho piperazine (flunarizine, prepilamine, lidoflazin, jj.).

Contraindication mabapi le tumellano ea motsoako oa calcium antagonists ke khatello ea mantlha e tlase, bofokoli ba sinus node, ho ima, le litla-morao ke letlalo le sefahleho le molala, hypotension, ho boloka mekokotlo, hape ho eketsa ho phahloha, ho ruruha le ka seoelo haholo (ka ho hlahisoa ha verapamil kahare) - bradycardia, atrioventricular blockade.

Li-inhibitors tsa Angiotensin le tsona ke sehlopha se setle se sebelisetsoang ho phekola khatello ea mali. Mosebetsi oa bona o ka sehloohong ke ho thibela enzyme e fetolang angiotensin I hore e be sebopeho sa eona se sebetsang - angiotensin II 'me ka nako e ts'oanang e senya bradykinin.

Li-inhibitors tsa ACE li nkuoa e le lithethefatsi bakeng sa khatello ea mali, leha ho le joalo, ho feta moo, li na le melemo e meng hape li sebelisoa ka katleho ho phekola maemo a fapaneng a pathological: litlamorao tsa ts'ebetso ea myocardial infarction (ts'ebetso e mpe ea ts'ebetso ea ventricle e ka letsohong le letšehali), ho thibela sebopeho sa hypertrophy ea pelo haeba ts'ebetso e tsoela pele (LV hypertrophy), lefu la pelo, lefu la tsoekere.

Lethathamo la baemeli ba sethethefatsi sena ka tekanyo e kholo ho feta li-antihypertensives tse ling li phetoa khafetsa le lithethefatsi tsa morao-rao bakeng sa khatello. Ho fihla joale, meriana e latelang ea khatello, e bitsoang ACE inhibitors, e sebelisoa haholo:

• Captopril (Kapoten) - e ka thibela ACE ka tsela e sa tobang. Captopril e tsejoa ka ho qala li-hypertensives le batho ba nang le boiphihlelo lefapheng lena, e le thuso ea pele bakeng sa ho eketsa khatello ea mali: letlapa le tlasa leleme - kamora metsotso e 20 khatello e fokotseha,
• Enalapril (renitec) e ts'oana haholo le Captopril, empa ha e tsebe ho fetola khatello ea mali kapele hakana, leha e iponahatsa hora ka mor'a taolo. Phello ea eona e lieha (ho fihlela letsatsi), ha e se e le manonyeletso ka mor'a lihora tse 4 'me ho se na mohlala.
• Benazepril
• Ramipril
• Quinapril (acupro),
• Lisinopril - o nka khato kapele (kamora hora) le nako e telele (letsatsi),
• Lozap (losartan) - e nkuoa e le mohanyetsi ea itseng oa li-receptor tsa angiotensin II, e fokotsa khatello ea mali ea systolic le diastolic, e sebelisoa nako e telele, hobane phello e phahameng ea kalafo e fihlelleha kamora libeke tse 3-4.

Li-inhibitors tsa ACE ha li fuoe maemong:

1. Nalane ea angioedema (mofuta oa ho se mamelle lithethefatsi tsena, e bonahatsoang ke tlolo ea ketso ea ho koenya, ho hema ka thata, ho ruruha sefahleho, maoto le matsoho a holimo, hoarseness). Haeba boemo bona bo hlaha ka lekhetlo la pele (tekong ea pele) - lithethefatsi li hlakoloa hanghang,
2. Bokhachane (ACE inhibitors ha bo ame tsoelo-pele ea bokhachane, bo lebisang ho litlolo tse sa tšoaneng kapa lefu, ka hona, li hlakotsoe hang kamora ho thehwa ha nnete ena).

Ntle le moo, bakeng sa inhibitor ea ACE, ho na le lethathamo la litaelo tse ikhethang tse lemosang khahlanong le litlamorao tse sa rateheng:

• Ka SLE le scleroderma, ho tšoaneleha ha tšebeliso ea lithethefatsi tsa sehlopha sena ho belaela haholo, hobane ho na le menyetla e kholo ea liphetoho mollong (neutropenia, agranulocytosis),
• Stenosis ea a liphio kapa ka bobeli, hammoho le letso le holisitsoeng, li ka sokela ho theha ho se sebetse hantle ha renal,
• Ho sitoa ho phekola renal ho hloka ho fokotsa phokotso
• Ha pelo e sa sebetse hantle, ho senyeha hoa liphio ho ka etsahala, ebile hoa bolaea.
• Ho senyeha ha sebete ka ts'ebetso e sa sebetseng ka lebaka la ho fokotseha ha metabolism ea li-inhibitors tse itseng tsa ACE (Captopril, enalapril, quinapril, ramipril), tse ka lebisang ho nts'etsopele ea cholestasis le hepatonecrosis, li hloka phokotso ea tekanyetso ea lithethefatsi tsena.

Ho boetse ho na le litla-morao tseo motho e mong le e mong a tsebang ka tsona, empa ha ho letho leo a ka le etsang ka tsona. Mohlala, ho batho ba nang le ts'ebetso ea ho hlaphoheloa ha renal (haholo-holo, empa ka linako tse ling ntle le bona), ha ba sebelisa ACE inhibitor, paramente ea biochemical ea mali e ka fetoha (litaba tsa creatinine, urea le potasiamo li ea eketseha, empa boemo ba sodium boa fokotseha). Khafetsa, bakuli ba tletleba ka ponahalo ea khohlela, e sebetsang haholo bosiu. Ba bang ba ea tleliniking ho ea nka moriana o mong bakeng sa khatello ea mali, ha ba bang ba leka ho mamella ... Ke 'nete hore ba fetisetsa li-inhibitors tsa hoseng ka hora ea hoseng ebe ba ithusa.

Lithethefatsi tse ling li sebelisoa ka mokhoa oa setso ho phekola khatello ea mali, tseo ka kakaretso li se nang litšobotsi tse boletsoeng sehlopha se itseng sa li-antihypertensives. Mohlala, dibazole e tšoanang kapa, re re, magnesium sulfate (magnesia), e sebelisoang ka katleho ke lingaka tsa tšohanyetso ho emisa koluoa ​​ea khatello ea mali. E kenyellelitsoe ka har'a mothapo, Magnesia ea sulfate e na le antispasmodic, sedative, anticonvulsant le hanyane hypnotic. Litokisetso tse ntle, leha ho le joalo, ha ho bonolo ho li tsamaisa: e tlameha ho etsoa butle haholo, kahoo mosebetsi o nka metsotso e 10 (mokuli o chesa ka mokhoa o sa mamelleheng - ngaka e emisa ebe ea emella).

Bakeng sa phekolo ea khatello ea mali, haholo-holo, likhatellong tse matla tsa khatello ea mali, pentamine-N (cholinoblocker ea li-ganglia tse utloisang bohloko le tsa parasympathetic, tse fokotsang molumo oa likepe tsa arterial le venous), benzohexonium, e tšoanang le pentamine, arfonad (ganglioblocker), le aminazine (phenothiazine). Lithethefatsi tsena li etselitsoe tlhokomelo ea maemo a tšohanyetso kapa tlhokomelo e matla, kahoo li ka sebelisoa feela ke ngaka e tsebang litšobotsi tsa eona hantle!

Ho sa le joalo, bakuli ba leka ho boloka litlatsetso tsa morao-rao tsa thuto ea meriana 'me hangata ba batla meriana ea morao-rao bakeng sa khatello, empa e ncha ha e bolele se molemohali,' me ha ho tsejoe hore na 'mele o tla arabela joang ho sena. Ha e le hantle, litokisetso tse joalo li ke ke tsa hlalosoa. Leha ho le joalo, ke rata ho tsebisa 'mali hanyane ho lithethefatsi tsena tsa moraorao bakeng sa khatello, tse nang le ts'epo e kholo.

Ntle le lethathamo la lintho tse ncha, li-angiotensin II receptor antagonists (li-inhibitors tsa ACE) mohlomong li atlehile ka ho fetisisa. Lithethefatsi tse kang Cardosal (olmesartan), thermisartan, eo, ba reng, hajoale ha e tlase ho ramipril e tsebahalang, e hlahile lenaneng lena.

Haeba u bala ka hloko ka lithethefatsi tsa antihypertensive, u ka bona hore khatello ea mali e eketsa ntho e makatsang - renin, eo ho seng le e 'ngoe ea lithethefatsi tse kaholimo e ka sebetsanang le eona. Leha ho le joalo, ho thabisa bakuli ba nang le khatello ea mali e phahameng, meriana e sa tsoa hlaha - rasylosis (aliskiren), e thibelang encha hape e ka khona ho rarolla mathata a mangata.

Lithethefatsi tsa morao-rao tsa khatello li kenyelletsa bahanyetsi ba endothelial receptor antagonists: bosentan, enrasentan, darusentan, tse thibelang tlhahiso ea vasoconstrictive peptide - endothelin.

Ho nahana ka mefuta eohle ea mekhoa e ka sebetsanang le khatello e phahameng ea mali, ho ke ke ha khoneha ho hlokomoloha litlolo tsa li-tincture, li-decoctions, marotholi a tlohetseng batho. Tse ling tsa tsona li amohetsoe ke lingaka tsa 'muso' me li sebelisitsoe ka katleho ho phekola khatello ea maikutlo ea methapo. Bakuli ba tšepa meriana haholo, e etsoang e eang litlama e holang mehlareng ea Russia kapa litho tsa lifate tse etsang limela tsa naha ea rona e kholo ea Mama.

1. Tincture ea mistletoe tšoeu, e nkiloe ho ea ka 2 tbsp. tablespoons makhetlo a 3-4 ka letsatsi (ho tsitlella: 10 g. lijalo + 200 di ml tsa metsi),
2. Mokelikeli oa litlhare o nang le lipalesa tsa hawthorn, joang bo bosehla, mistletoe e tšoeu, yarrow le makhasi a periwinkle e nyane. Tekanyetso e le 'ngoe e na le ligrama tse 10 tsa motsoako oa limela le 200 ml ea metsi a chesang a phehiloeng, tse lokelang ho futhumatsoa bakeng sa metsotso e meng e 15 ka bate ea metsi, ebe o sutumetsa, o eketsa metsi ka bongata le seno seno sa pele nakong ea mots'eare. Phekolo e nka libeke tse 3-4,
3. Tincture ea joang ba marsh cinnamon (15 g), motsoako o monate oa litlama (20 g), sebaka sa lipere tsa masimong (20 g), linaleli tsa lipalesa tsa linaleli (20 g) le tsona li hlophisitsoe ho latela risepe e kaholimo.
4. Tee ea litlama bakeng sa ho itokisa e ts'oana le ea pele, empa e na (ka ligrama) ea hawthorn (40), sinamone sinamone (60), lehlabathe le sa pheleng (50), clover e monate (10), makhasi a birch (10), motso oa licorice (20), makhasi coltsfoot (20), lihashe (30), joang bo botala (30).
5. Chokeberry ea lero e taoa ka 50 ml halofo ea hora pele e ja makhetlo a 3 ka letsatsi,
6. Viburnum e sebelisoa haholo e le adjunct bakeng sa khatello ea mali: tincture ea litholoana tse omisitsoeng kapa tse ncha tse nang le mahe a linotsi, tse lokiselitsoeng joaloka tee, jeme le jeme, hammoho le makhapetla a semela sena, se phehiloeng ka metsi. Batho ba bang ba rata ho sebelisa risepe ena: tšela likhalase tse 3 tsa monokotšoai o mocha oa li-viburnum tse ncha ka metsi a chesang a phehiloeng (2 l), tlohela lihora tse 8 ka mocheso oa kamore. Ebe moetso o hloka ho hloekisoa, 'me monokotsoai o setseng o hlakoloa ka khalase kapa sekotlolo sa enamel, eketsa halofo ea lithaele tsa mahe a linotsi. Nka metsotso e 20 pele ho ja 1/3 senoelo makhetlo a mararo ka letsatsi bakeng sa khoeli. Boloka tincture sebakeng se phodileng. Re lokela ho hlokomela hore viburnum e na le li-contraindication, tse lokelang ho tsotelloa ha u etsa qeto ea ho sebelisa mokhoa ona oa bongaka e le moriana: gout, ho ima, tloaelo ea thrombosis,
7. Litlhare tsa setso, tse ipapisitseng le konofolo, li etselitsoe lingoloa tsohle tsa marang-rang a fapaneng a bongaka, ka mohlala, re tla fana ka risepe e le 'ngoe feela, e nang le lihlooho tse peli tse kholo tsa konofolo le khalase (250 g) ea vodka. Moriana ona o lokiselitsoe libeke tse peli, 'me o nooa marotholi a 20 ka khaba ea metsi a batang a phehiloeng kotara ea hora pele ho lijo makhetlo a mararo ka letsatsi.

Ts'ebeliso ea litefiso tsa monastery bakeng sa khatello ea mali e lokela ho boleloa ka thoko, ke lipotso tse ngata haholo hore "tharollo e ncha ea setso" e hlahisa, eo, e le mohato o thusang kapa o thibelang, o ipakile hantle. Ha ho makatse - pokello ea monono bakeng sa khatello ea mali e na le lethathamo la litlama tse ntlafatsang ts'ebetso ea pelo, ts'ebetso ea boko, li amang hantle bokhoni ba ts'ebetso ea lebota la methapo le ho thusa haholo mothating oa pele oa khatello ea mali.

Ka bomalimabe, moriana ona o ke ke oa khona ho khutlisetsa matlapa a khatello e phahameng ea mali a nkiloeng lilemo tse ngata le maemo a phahameng a khatello ea mali, leha ho le joalo ho fokotsa palo le tekanyetso ea tsona. Haeba u nka tee khafetsa ...

E le hore mokuli ka boeena a utloisise melemo ea seno, re ho nka ho nepahetse ho hopola motsoako oa tee ea baitlami:

Ha e le hantle, ho ka ba le phapang e fanoeng ke lengolo la ngaka, e sa lokelang ho tšosa mokuli, hobane ho na le limela tsa limela tse ngata tlholehong.

Phekolo ea bakuli ba nang le khatello ea mali ea methapo e hloka nako e ngata. A sebelisa mokhoa oa teko le phoso, ngaka e batla mokuli e mong le e mong moriana oa eona, o nahanela boemo ba setho, lilemo, bong le mosebetsi, hobane lithethefatsi tse ling li fana ka litlamorao tse etsang hore mosebetsi oa bongaka o be boima. Ho joalo, ho tla ba thata hore mokuli a rarolle bothata bo joalo, ntle le haeba, ke ngaka.

Hypertension ke ha khatello ea mali e phahame haholo hoo mehato ea kalafo e ka bang molemo ho mokuli ho feta litla-morao tse mpe. Haeba u na le khatello ea mali ea 140/90 kapa ho feta - ke nako ea ho fola ka botlalo. Hobane khatello ea khatello ea mali e eketsa menyetla ea ho tšoaroa ke lefu la pelo, ho otloa ke lefu la mokokotlo, ho se sebetse hantle ha masapo kapa ho foufala ka makhetlo a 'maloa. Mofuta oa 1 kapa lefu la tsoekere la 2, monyako o phahameng oa khatello ea mali o theoha ho 130/85 mm Hg. Art. Haeba o na le khatello e phahameng, o lokela ho etsa boiteko bohle ho e fokotsa.

Ka lefu la tsoekere la mofuta oa 1 kapa mofuta oa 2, khatello ea mali e kotsi haholo. Hobane haeba lefu la tsoekere le kopantsoe le khatello e phahameng ea mali, kotsi ea lefu la pelo e bolaeang e eketseha ka makhetlo a 3-5, ho otloa ke makhetlo a 3-4, ho foufala ka makhetlo a 10-20, ho se sebetse hantle ke linako tse 20-25, ho ba le leqeba la mokokotlo le ho khaoloa maoto - Makhetlo a 20. Ka nako e ts'oanang, khatello e phahameng ea mali ha e thata haholo ho e thatafatsa, haeba feela lefu la hau la menoana le sa ea hole haholo.

Bala ka lefu le pelo le pelo:

Lisosa tsa khatello ea mali ho lefu la tsoekere

Mofuta oa 1 oa lefu la tsoekere la mofuta oa 2, lisosa tsa nts'etsopele ea khatello ea mali ea methapo li ka fapana. Mofuta oa 1 lefu la tsoekere, khatello ea mali ho 80% ea maemo a hlaha ka lebaka la tšenyo ea menoana (lefu la tsoekere). Ho mofuta oa 2 lefu la tsoekere, khatello ea maikutlo hangata e hlaha ho mokuli pejana ho feta mathata a metabolism ea carbohydrate le lefu la tsoekere ka bolona. Hypertension ke e 'ngoe ea likarolo tsa metabolic syndrome, e leng moetapele oa mofuta oa lefu la tsoekere la 2.

Lisosa tsa nts'etsopele ea khatello ea mali ho lefu la tsoekere le khafetsa

Lefu la tsoekere lephropathy (mathata a liphio) - 80% Ts'ireletso ea methapo ea methapo ea methapo ea mantlha - Hypertension hypstension ea Isolated - 5-10% Psychology e meng ea endocrine - 1-3%

Ts'ireletso ea methapo ea methapo e kholo (30) - 30-35% Hypertension e tsoaneng le e tsoetseng pele - 40-45% Lefu la tsoekere lephropathy - 15-20% Hypertension ka lebaka la patency ea methapo ea methapo ea methapo - 5-10% Psychology e meng ea endocrine - 1-3%

Lintlha tse tafoleng. Isolated systolic hypertension ke bothata bo ikhethileng ho bakuli ba tsofetseng. Bala haholoanyane sehloohong se reng "Isolated systolic hypertension in the older" Psychology e 'ngoe ea endocrine - e ka ba pheochromocytoma, hyperaldosteronism ea mantlha, lefu la eona la Itenko-Cushing, kapa lefu le leng le sa tloaelehang.

Bohlokoa ba khatello ea mali e bohlokoa - ho bolelang hore ngaka ha e khone ho tseba sesosa sa keketseho ea khatello ea mali. Haeba khatello ea mali e kopane le botenya, ho ka etsahala, sesosa ke ho se mamelle lijo tsa lik'habohaedreite le boemo bo eketsehileng ba insulin maling. Sena se bitsoa "metabolic syndrome," 'me se arabela hantle kalafong. E kanna ea ba:

• khaello ea magnesium 'meleng,
• khatello ea kelello e sa foleng,
• Botaoa le mercury, lead kapa cadmium,
• ho fokotseha ha methapo e kholo ea methapo ka lebaka la atherosclerosis.

Hape hopola hore haeba mokuli a hlile a batla ho phela, moriana o hloka matla :).

Ho mofuta oa 1 lefu la tsoekere, lefu le ka sehloohong le kotsi haholo la khatello e eketsehileng ke ho senyeha ha meno, haholo lefu la tsoekere. Khatello ena e hlaha ho 35-40% ea bakuli ba nang le lefu la tsoekere la 1 mme ba tsoa mehatong e 'maloa:

• sethala sa "microalbuminuria" (limolek'hule tse nyane tsa protheine ea albin li hlaha ka har'a moroto),
• Propururia (liphio li sefa le ho feta 'me liprotheine tse kholo li hlaha ka har'a moroto),
• Boemo ba ho hloleha ho tsitsipano hoa renal.

Ho latela Federal State Institution Endocrinological Research Center (Moscow), hara bakuli ba nang le lefu la tsoekere la mofuta oa 1 ntle le methapo ea methapo, 10% e tšoeroe ke lefu la khatello ea mali. Ho bakuli ba sethaleng sa microalbuminuria, boleng bona bo nyolohela ho 20%, sethaleng sa proteinuria - 50-70%, sethaleng sa ho hloleha ha renal ho sa foleng - 70-100%. Ha proteni e ngata e pepesitsoe moroto, khatello ea mali e holimo le ho feta - ona ke molao o akaretsang.

Hypertension le ho senyeha ha liphio li hlaha ka lebaka la hore liphio ha li tsoe sodium e ngata ka moroto. Sodium e maling e ba kholo 'me mokelikeli oa e haha. Ho ata ha mali a potoloha ho eketsa khatello ea mali. Haeba tsoekere ea glucose e eketseha ka lebaka la lefu la tsoekere maling, e ntšoa metsi ka bongata le hore mali ha a na bongata. Kahoo, bophahamo ba mali bo potoloha bo ntse bo eketseha.

Hypertension le lefu la liphio li etsa potoloho e mpe. Mmele o leka ho buseletsa ho se sebetse hantle ha liphio, ka hona khatello ea mali ea phahama. Eona, e eketsa khatello kahare ho glomeruli. Lintho tseo ho thoeng ke tsa ho sefa. Ka lebaka leo, butle-butle glomeruli ea shoa, 'me liphio li sebetsa le ho feta.

Ts'ebetso ena e phethela ka ho se sebetse hantle ha methapo. Ka lehlohonolo, matsatsing a pele a lefu la tsoekere le lefu la tsoekere, potoloho e mpe e ka robeha haeba mokuli a phekoloa ka hloko. Ntho ea bohlokoa ke ho theola tsoekere ea mali ho ea ho tloaelehileng. Li-inhibitors tsa ACE, li-angiotensin receptor blockers, le diuretics le tsona lia thusa. U ka bala ho eketsehileng ka bona ka tlase.

Nako e telele pele nts'etsopele ea lefu la tsoekere la “nnete” la 2 e qala, ts'ebetso ea lefu lena e qala ka ho hanyetsa insulin. Sena se bolela hore kutloisiso ea mesifa ea tšebetso ea insulin e fokotsehile. Ho lefella ho hanyetsa insulin, insulin e ngata e potoloha maling, 'me sena ka bosona se eketsa khatello ea mali.

Ha lilemo li ntse li feta, matla a methapo ea mali a fokotseha ka lebaka la atherosclerosis, 'me sena e ba "monehelo" o mong kholisong ea khatello ea mali. Ka tsela e tšoanang, mokuli o na le botenya ka mpeng (ho pota lethekeng). Ho lumeloa hore lithane tsa adipose li ntša lintho maling le ka ho eketsa khatello ea mali.

Ho rarahana hona ho bitsoa metabolic syndrome. Ho hlahella hore khatello ea mali e eketseha pejana ho lefu la tsoekere la mofuta oa 2. Hangata e fumanoa ho mokuli hang hang ha ho fumanoa hore o na le lefu la tsoekere. Ka lehlohonolo, lijo tse nang le lik'habohaedreite tse tlase li thusa ho laola lefu la tsoekere la 2 le khatello ea mali ka nako e le 'ngoe. U ka bala lintlha tse ka tlase.

Hyperinsulinism ke pokello ea insulin e ngata maling. E etsahala ka lebaka la ho hanyetsa insulin. Haeba makhopho a mantle a tlameha ho hlahisa insulin e ngata, e tla "tepella" haholo. Ha a khaotsa ho phela ka lilemo, tsoekere ea mali e phahama ebe lefu la tsoekere la mofuta oa 2 le ba teng.

Mokhoa oa hyperinsulinism o eketsa khatello ea mali:

• e buella tsamaiso ea methapo e nang le kutloelo-bohloko,
• Liphio li sebetsa hantle ka ho fetisisa ka har'a sodium le mokelikeli o mokae ka urine,
• sodium le calcium li bokellana kahare ho lisele,
• insulin e ngata e tlatsetsa ho matlafatseng marako a methapo ea mali, e fokotsang botsitso ba 'ona.

Ka lefu la tsoekere, morethetho oa tlhaho oa letsatsi le letsatsi oa ho feto-fetoha ha khatello ea mali oa senyeha. Ka tloaelo, ho motho hoseng le bosiu nakong ea boroko, khatello ea mali e tlase ka 10-20% ho feta nakong ea motšehare.Lefu la tsoekere le lebisa ntlheng ea hore ho bakuli ba bangata ba khatello e phahameng ea khatello ea mali bosiu ha bo fokotsehe. Ho feta moo, hammoho le khatello ea mali le lefu la tsoekere, khatello ea bosiu hangata e phahame ho feta khatello ea motšeare.

Boloetse bona bo nahanoa hore bo bakoa ke lefu la tsoekere la lefu la tsoekere. Tsoekere e phahameng ea mali e ama tsamaiso ea methapo ea kutlo, e laolang bophelo ba 'mele. Ka lebaka leo, bokhoni ba methapo ea mali ho laola molumo oa bona, i.e., ho ts'oara le ho phomola ho latela mojaro, bo ntse bo mpefala.

Qeto ke hore ka kopanelo ea khatello ea mali le lefu la tsoekere, ha ho hlokahale feela mehato ea khatello ea nako e le 'ngoe le tonometer, empa le tlhaiso ea lihora tse 24. E etsoa ho sebelisoa sesebelisoa se ikhethang. Ho latela liphetho tsa boithuto bona, o ka fetola nako ea ho nka le litekanyetso tsa lithethefatsi bakeng sa khatello.

Boikoetliso bo bontša hore bakuli ba nang le lefu la tsoekere la mofuta oa 1 le mofuta oa 2 hangata ba ameha letsoai haholo ho feta bakuli ba se nang lefu la tsoekere. Sena se bolela hore ho fokotsa letsoai lijong ho ka ba le phello e matla ea pholiso. Haeba o na le lefu la tsoekere, leka ho ja letsoai le fokolang ho phekola khatello e phahameng ea mali le ho lekola se etsahalang ka khoeli.

Khatello e phahameng ea mali ho lefu la tsoekere hangata e thatafalloa ke hypotension ea orthostatic. Sena se bolela hore khatello ea mali ea mokuli e fokotseha haholo ha o tloha sebakeng sa ho bua leshano ho ea boemong ba ho ema kapa ho lula. Orthostatic hypotension e iponahatsa ka mor'a ho phahama ho tsitsitseng ha meno, ho fifala mahlong kapa esita le ho akheha.

Jwalo ka tlolo ya morethetho wa circadian wa khatello ya madi, bothata bona bo hlaha ka lebaka la ntshetsopele ya lefu la tsoekere le lefu la tsoekere. Butle-butle tsamaiso ea methapo e lahleheloa ke matla a ho laola molumo oa methapo. Ha motho a phahama ka potlako, moroalo o phahama hanghang. Empa 'mele ha o na nako ea ho eketsa phallo ea mali ka har'a lijana, mme ka lebaka lena, bophelo bo botle bo mpefala.

Orthostatic hypotension e thatafatsa ho hlahlojoa le kalafo ea khatello e phahameng ea mali. Ho lekanya khatello ea mali ho lefu la tsoekere ho hlokahala maemong a mabeli - ho ema le ho robala. Haeba mokuli a e-na le bothata bona, o lokela ho tsoha nako le nako, "ho ea ka bophelo ba hae bo botle".

Sebaka sa rona sa marang-rang se thehiloe ho khothaletsa lijo tse nang le lik'habohaedreite tse tlase tsa mofuta oa 1 le lefu la tsoekere la 2. Hobane ho ja lik'habohaedreite tse fokolang ke tsela e molemohali ea ho theola le ho boloka tsoekere ea hau ea mali. Tlhokahalo ea hau ea insulin e tla fokotseha, 'me sena se tla thusa ho ntlafatsa litholoana tsa kalafo ea hau ea khatello ea mali. Hobane ha insulin e potoloha maling, e eketsa khatello ea mali haholo. Re se re buile ka mochine ona ka botlalo.

Re khothaletsa lingoloa tsa hau tsa tlhokomelo:

• Insulin le lik'habohaedreite: 'nete eo u lokelang ho e tseba.
• Mokhoa o motle oa ho theola tsoekere ea mali le ho o boloka o tloaelehile.

Lijo tse nang le carb e tlase bakeng sa lefu la tsoekere li loketse feela haeba o e-so qalelle ho hloleha ha meno. Mokhoa ona oa ho ja o sireletsehile ka botlalo mme o na le thuso nakong ea sethala sa microalbuminuria. Hobane ha tsoekere ea mali e theohela boemong bo tloaelehileng, liphio li qala ho sebetsa ka tsela e tloaelehileng, 'me litaba tsa albin ka har'a moroto li khutlela ho tse tloaelehileng. Haeba u na le sethala sa proteinuria - hlokomela, etela ngaka ea hau. Bona le Lijo tsa Ts'oaetso ea Lefu la Tsoekere.

Liratso tsa lijo tse nang le lik'habohaedreite tse tlase tsa mofuta oa 1 le lefu la tsoekere la 2 lia fumaneha mona.

Bakuli ba nang le khatello ea mali e matla le lefu la tsoekere ke bakuli ba nang le kotsi e ngata kapa e phahameng haholo ea mathata a pelo. Ho khothalletsoa hore ba theole khatello ea mali ho 140/90 mm RT. Art. libekeng tse 4 tse qalang, haeba ba mamella tšebeliso ea lithethefatsi tse behiloeng hantle. Libekeng tse latelang, o ka leka ho theola khatello ho fihlela e ka ba 130/80.

Ntho ea bohlokoa ke hore na mokuli o mamella joang kalafo ea lithethefatsi le litholoana tsa eona? Haeba e le mpe, khatello ea mali e tlase e lokela ho ba butle butle, mekhahlelong e 'maloa. Karolong e 'ngoe le e' ngoe ea methapo ena - ka 10-15% ea boemo ba pele, nakong ea libeke tse 2,2.Ha mokuli a ikamahanya le maemo, eketsa litekanyetso kapa eketsa palo ea lithethefatsi.

Haeba u theola khatello ea mali ka methati, joale sena se qoba likarolo tsa hypotension mme ka hona, o fokotsa kotsi ea infyo ea myocardial kapa stroke. Moeli o tlase oa monyako oa khatello e tloaelehileng ea mali ke 110-115 / 70-75 mm RT. Art.

Ho na le lihlopha tsa bakuli ba nang le lefu la tsoekere ba ka theolang khatello ea mali ea "holimo" ho 140 mmHg. Art. mme e tlase e ka ba thata haholo. Lenane la bona le kenyeletsa:

• bakuli ba seng ba e-na le litho tsa bona tse tobileng, haholo-holo liphio,
• bakuli ba nang le mathata a pelo,
• batho ba tsofetseng, ka lebaka la ts'enyo ea methapo e amanang le botsofali ho atherosclerosis.

Ho ka ba thata ho khetha lipilisi tsa khatello ea mali ho mokuli ea nang le lefu la tsoekere. Hobane metabolism ea carbohydrate e senyehileng e beha lithibelo ts'ebelisong ea lithethefatsi tse ngata, ho kenyelletsa le khatello ea mali. Ha a khetha moriana, ngaka e nahana ka hore na mokuli o laola lefu la hae la lefu la tsoekere le hore na ke mafu afe a kopaneng, ntle le khatello ea mali.

Lipilisi tse ntle tsa khatello ea tsoekere li lokela ho ba le thepa e latelang:

• haholo khatello ea mali, ha a ntse a fokotsa litlamorao
• seke oa mpefatsa taolo ea tsoekere ea mali, u seke oa eketsa "cholesterol" e mpe "le" triglycerides, "
• Sireletsa pelo le liphio ho tsoa kotsi e bakoang ke lefu la tsoekere le khatello e phahameng ea mali.

Hajoale ho na le lihlopha tse 8 tsa lithethefatsi bakeng sa khatello ea mali, tseo tse 5 tsa tsona e leng tsona tse ka sehloohong tse 3 tse ling. Matlapa, e leng a lihlopha tse eketsehileng, a laetsoe e le molao, e le karolo ea kalafo e kopaneng.

Lihlopha tsa lithethefatsi khatello

Diuretics (lithethefatsi tsa diuretic) Beta blockers Lithane tsa calcium Li-inhibitors tsa ACE Angiotensin-II receptor blockers (lingiotensin-II receptor antagonists)

Rasilez - inhibitor e tobileng ea renin Li-blocker tsa Alpha Imidazoline receptor agonists (lithethefatsi tse bohareng tse sebetsang)

Ka tlase re fana ka likhothaletso bakeng sa taolo ea lithethefatsi tsena ho bakuli ba nang le lefu la khatello ea mali eo ho lona ho rarahaneng mofuta oa lefu la tsoekere la mofuta oa 2 kapa mofuta oa 2.

Tlhophiso ea li-diuretics

Thiazide diuretics	Hydrochlorothiazide (dichlothiazide)
Litlhare tse kang li-diuretic tse kang li-Thiazide	Letšoao la Indapamide
Liopture tsa Loop	Furosemide, bumetanide, ethaconic acid, torasemide
Li-diuretics tsa potasiamo-sparing	Spironolactone, triamteren, amiloride
Li-diuretics tsa Osmotic	Mannitol
Carbonic anhydrase inhibitors	Diacarb

Lintlha tse qaqileng ka litlhare tsena tsohle tsa diuretic li ka fumanoa mona. Joale, a re tšohleng hore na diuretics li tšoara khatello ea mali joang ho lefu la tsoekere.

Phekolo ea methapo ho bakuli ba nang le lefu la tsoekere hangata e ba teng ka lebaka la hore palo ea mali a potoloha e ea eketseha. Hape, lefu la tsoekere le khetholloa ke ho eketseha ha letsoai le letsoai. Tabeng ena, li-diuretics hangata li laeloa ho phekola khatello e phahameng ea mali ho lefu la tsoekere. Bakeng sa bakuli ba bangata, lithethefatsi tsa diuretic li thusa hantle.

Lingaka li leboha diuretics tsa thiazide hobane lithethefatsi tsena li fokotsa kotsi ea ho tšoaroa ke lefu la pelo le ho otloa ke bakuli ba nang le khatello ea mali e ka bang 15-25%. Ho kenyelletsa ba nang le lefu la tsoekere la mofuta oa 2. Ho lumeloa hore ka tekanyetso e nyane (e lekanang le hydrochlorothiazide ke 6 mmol / L,

keketseho ea serum creatinine ka ho feta 30% ho tloha boemong ba pele nakong ea beke e le 1 kamora ho qala kalafo (fetisa tlhahlobo - lekola!),

boimana le nako ea ho anyesa.

Bakeng sa kalafo ea ho hloleha ha pelo ha ho teba ha letho, li-inhibitors tsa ACE ke lithethefatsi tsa mola oa pele, ho kenyeletsoa le ho bakuli ba lefu la tsoekere la mofuta oa 2. Lithethefatsi tsena li matlafatsa kutloisiso ea lisele tsa mmele ho insulin mme ka hona li na le phello ea prophylactic kholisong ea lefu la tsoekere la mofuta oa 2. Ha li mpefatse taolo ea tsoekere ea mali, ha li eketse "cholesterol" e mpe.

Li-inhibitors tsa ACE ke setheo sa # 1 sa ho alafa lefu la tsoekere.Bakuli ba mofuta oa 1 le ba 2 ba lefu la tsoekere ba fuoa li-inhibitors tsa ACE hang ha liteko li bontša microalbuminuria kapa proteinuria, le haeba khatello ea mali e lula e tloaelehile. Hobane li sireletsa liphio le ho liehisa nts'etsopele ea ho se sebetse hantle ha renal nakong e tlang.

Haeba mokuli a ntse a sebelisa li-inhibitors tsa ACE, ho khothaletsoa ka matla hore a fokotse tšelo ea letsoai ho feta ligrama tse 3 ka letsatsi. Sena se bolela hore o hloka ho pheha lijo ntle le letsoai ho hang. Hobane e se e kenyellelitsoe lihlahisoa tse felileng le lihlahisoa tse felileng. Sena se feta moo e le hore u se ke ua ba le khaello ea sodium 'meleng.

Nakong ea kalafo le li-inhibitors tsa ACE, khatello ea mali e lokela ho lekanngoa khafetsa, 'me serum creatinine le potasiamo e lokela ho lekoloa. Bakuli ba tsofetseng ba nang le atherosclerosis ka kakaretso ba tlameha ho hlahlojoa bakeng sa methapo e meng ea methapo ea methapo ea methapo pele ba fana ka li-inhibitors tsa ACE.

U ka fumana leseli le qaqileng ka lithethefatsi tsena tse ncha mona. Ho phekola khatello e phahameng ea mali le mathata a liphio ho lefu la tsoekere, li-blockers tsa angiotensin-II li laetsoa haeba mokuli a hlahisitse sefuba se omileng se tsoang ho li-inhibitors tsa ACE. Bothata bona bo hlaha ho bakuli ba ka bang 20%.

Angiotensin-II receptor blockers li theko e phahameng haholo ho feta li-inhibitors tsa ACE, empa ha li bake ho khohlela ho omileng. Ntho e ngoe le e ngoe e ngotsoeng ho sengoloa sena ka holimo karolong ea li-inhibitors tsa ACE e sebetsa ho li-blockers tsa angiotensin receptor. Li-contraindication li tšoana, 'me liteko tse tšoanang li lokela ho nkuoa ha u ntse u sebelisa meriana ena.

Ho bohlokoa ho tseba hore li-angiotensin-II li-receptor blockers li fokotsa hypertrophy ea li-ventricular tse setseng ho feta li-inhibitors tsa ACE. Bakuli ba li mamella ho feta lithethefatsi tse ling bakeng sa khatello e phahameng ea mali. Ha li na litlamorao tse ngata ho feta placebo.

Ena ke lithethefatsi tse ncha. E ntlafalitsoe hamorao ho feta li-inhibitors tsa ACE le li-angiotensin receptor blockers. Rasilez o ne a ngolisitsoe ka molao Russia
ka Phupu 2008. Liphetho tsa lithuto tsa nako e telele tsa ho sebetsa ha tsona li ntse li lebelletsoe.

Rasilez - inhibitor e tobileng ea renin

Rasilez e laetsoe hammoho le ACE inhibitors kapa li-blockers tsa angiotensin-II receptor. Motsoako o joalo oa lithethefatsi o na le tšusumetso ho sirelletso ea pelo le liphio. Rasilez e ntlafatsa k'holeseterole maling le ho matlafatsa kutloisiso ea lisele tsa mmele ho insulin.

Bakeng sa kalafo ea nako e telele ea khatello ea mali ea methapo, ho sebelisoa alpha-1-blockers tse sebelisoang. Lithethefatsi tse sehlopha sena li kenyeletsa:

Pharmacokinetics ea li-alpha-1-blocker tse khethiloeng

Prazosin	7-10	2-3	6-10
Doxazosin	24	12	40
Terazosin	24	19-22	10

Litla-morao tsa li-alpha-blockers:

• orthostatic hypotension, ho fihlela ho akheha,
• ho ruruha ha maoto
• khatello ea ho tlohela (khatello ea mali e theoha "ho hlaba" ka matla)
• ho phehella tachycardia.

Boithuto bo bong bo bontšitse hore li-alpha-blocker li eketsa menyetla ea ho nyekeloa ke pelo. Ho tloha ka nako eo, meriana ena ha e so ka e ratoa haholo, ntle le maemong a mang. Li ngotsoe hammoho le lithethefatsi tse ling bakeng sa khatello ea mali, haeba mokuli a e-na le benign Prostatic hyperplasia.

Ho lefu la tsoekere, ho bohlokoa hore li be le phello e molemo ho metabolism. Al-blockers tsoekere e khutsitseng ea mali, eketsa kutloisiso ea lithane ho insulin, le ho ntlafatsa cholesterol le triglycerides.

Ka nako e ts'oanang, ho nyekeloa ke pelo ke sesupo sa tšebeliso ea bona. Haeba mokuli a e-na le autonomic neuropathy e bontšitsoeng ke orthostatic hypotension, li-block tsa alpha-adrenergic li ke ke tsa laeloa.

Lilemong tsa morao tjena, lingaka tse eketsehileng li ikemiselitse ho lumela hore ho molemo ho fana ka lingoloa, empa hang-hang lithethefatsi tse 2-3 ho phekola khatello e phahameng ea mali. Hobane bakuli ba na le mekhoa e mengata ea ho ntlafatsa khatello ea mali ka nako e le 'ngoe,' me moriana o le mong o ke ke oa ama lisosa tsohle.Lipilisi tsa khatello li arotsoe ka lihlopha hobane li sebetsa ka tsela e fapaneng.

Moriana o le mong o ka fokotsa khatello ea maemo ho tloaelehileng ho bakuli ba sa feteng 50%, mme le haeba khatello ea khatello ea mali qalong e ne e le lekana. Ka nako e ts'oanang, kalafo ea ho kopanya e u lumella ho sebelisa litekanyetso tse nyane tsa lithethefatsi, 'me u ntse u fumana litholoana tse ntle. Ntle le moo, matlapa a mang a fokolisa kapa a felise ka ho tšoanang litlamorao tsa e mong.

Phaello ea mali ha e kotsi ka boeona, empa mathata a e bakang. Lethathamo la bona le kenyeletsa: ho nyekeloa ke pelo, ho otloa, ho se sebetse hantle ha masapo, bofofu. Haeba khatello e phahameng ea mali e kopantsoe le lefu la tsoekere, menyetla ea mathata e eketseha makhetlo a 'maloa. Ngaka e hlahloba kotsi ena bakeng sa mokuli ea itseng ebe e etsa qeto ea hore na e qala kalafo ka pilisi e le 'ngoe kapa e sebelise motsoako oa litlhare hanghang.

Litlhaloso tsa palo ena: HELL - khatello ea mali.

Mokhatlo oa Russia oa Endocrinologists o khothaletsa mokhoa o latelang oa kalafo bakeng sa khatello e phahameng ea mali ho lefu la tsoekere. Pele ho tsohle, ho fanoa ka angiotensin receptor blocker kapa inhibitor ea ACE. Hobane lithethefatsi tse tsoang lihlopheng tsena li sireletsa liphio le pelo hantle ho feta lithethefatsi tse ling.

Haeba monotherapy e nang le ACE inhibitor kapa angiotensin receptor blocker ha e thusa ho theola khatello ea mali e lekaneng, ho kgothaletswa ho eketsa diuretic. E leng diuretic eo u lokelang ho e khetha e latela poloko ea ts'ebetso ea liphio ho mokuli. Haeba ho na le bothata bo sa foleng ba ho phekola renal, thiazide diuretics e ka sebelisoa. Lithethefatsi Indapamide (Arifon) e nkoa e le e 'ngoe ea diuretics tse sireletsehileng haholo bakeng sa kalafo ea khatello ea mali. Haeba ho se sebetse hantle ha renal ho se ho qalile, ho fanoa ka loopture ea loopt.

Litlhaloso tsa palo ena:

• HELL - khatello ea mali
• GFR - sekhahla sa litso tsa glomerular, ho fumana lintlha tse eketsehileng bona "Ke liteko life tse hlokang ho etsoa ho hlahloba liphio tsa hau",
• CRF - ho hloleha ho phekola ha renal,
• BKK-DHP - "calcium chase" blocker dihydropyridine,
• BKK-NDGP - "non-dihydropyridine calcium blocker"
• BB - beta blocker,
• ACE inhibitor ACE inhibitor
• ARA ke angiotensin receptor antagonist (angiotensin-II receptor blocker).

Ho bohlokoa ho fana ka lithethefatsi tse nang le lintho tse 2-3 tse sebetsang tse teng ka har'a letheba le le leng. Hobane lipilisi tse nyane ha li fokola, balateli ba tsona ba li noa ka ho rata.

Lethathamo le le khuts'oane la litlhare tse kopaneng bakeng sa khatello ea mali:

• Korenitec = enalapril (renitec) + hydrochlorothiazide,
• foside = fosinopril (monopril) + hydrochlorothiazide,
• co-diroton = lisinopril (diroton) + hydrochlorothiazide,
• lehar = losartan (cozaar) + hydrochlorothiazide,
• noliprel = perindopril (prestarium) + thiazide-like diuretic indapamide retard.

Ho lumeloa hore li-inhibitors tsa ACE le calcium blockers li ntlafatsa bokhoni ba e mong le e mong ba ho sireletsa pelo le liphio. Ka hona, meriana e latelang e kopaneng hangata e fanoa:

• tarka = trandolapril (hopten) + verapamil,
• prestanz = perindopril + amlodipine,
• equator = lisinopril + amlodipine,
• exforge = valsartan + amlodipine.

Re lemosa bakuli haholo: o se ke oa ipeha moriana oa khatello ea mali. O ka ameha hampe ka litla-morao, esita le lefu. Fumana ngaka e tšoanelehang 'me u ikopanye le eena. Selemo se seng le se seng, ngaka e hlokomela bakuli ba makholo ba nang le khatello ea mali, ka hona o bokelletse boiphihlelo bo sebetsang, hore na lithethefatsi li sebetsa joang le hore na ke life tse sebetsang haholoanyane.

Rea tšepa hore u tla fumana sengoloa sena se thusa mabapi le khatello ea mali maling. Khatello e phahameng ea mali bakeng sa lefu la tsoekere ke bothata bo boholo ho lingaka le ho bakuli ka bobona. Lintho tse hlahisitsoeng mona li bohlokoa ka ho fetesisa. Sehloohong se reng, "Lisosa tsa khatello ea mali le mokhoa oa ho li felisa. Liteko tsa khatello ea mali "u ka ithuta ka ho hlaka hore na u hloka ho sebelisa liteko life bakeng sa kalafo e sebetsang.

Kamora ho bala lisebelisoa tsa rona, bakuli ba tla khona ho utloisisa hamolemo khatello ea mali ka mofuta oa 1 le mofuta oa 2 lefu la tsoekere ho latela mokhoa oa phekolo o sebetsang, ho lelefatsa bophelo ba bona le matla a molao. Tlhahisoleseling ka lipilisi tsa khatello e hlophisitsoe hantle 'me e tla sebetsa e le "pampiri e qhekellang" bakeng sa lingaka.

Re batla hape ho hatisa hore phepo e nang le lik'habohaedreite tse tlase ke sesebelisoa se sebetsang sa ho theola tsoekere ea mali ho tsoekere, hammoho le ho fokotsa khatello ea mali. Ho bohlokoa ho latela lijo tsena ho bakuli ba nang le lefu la tsoekere eseng la mofuta oa bobeli feela, empa le mofuta oa 1, ntle le haeba ho na le mathata a maholo a liphio.

Latela lenaneo la rona la lefu la tsoekere la mofuta oa 2 kapa mofuta oa 1 lefu la tsoekere. Haeba u fokotsa lik'habohaedreite lijong tsa hau, ho eketsa monyetla oa hore u khutlise khatello ea mali ea hau ho tloaelehileng. Hobane insulin e fokolang e potoloha maling, ho ba bonolo ho e etsa.

Lipalopalo tsa moruo li ntse li mpefala selemo se seng le se seng! Mokhatlo oa Russia oa lefu la tsoekere o re motho a le mong ho ba leshome naheng ea rona o na le lefu la tsoekere. Empa 'nete e khopo ke hore ha se lefu leo ​​le tšosang, empa mathata a lona le mokhoa oa bophelo oo li lebisang ho ona. Nka hlola lefu lena joang, ho bolela lipuisanong ...

Lerumo la bophelo le u qobella ho ea pele, u lebale ka uena, u sa tsotelle bophelo bo botle le boikhathollo. Ka lebaka leo, ke batho ba 'maloa ba khonang ho fihlela batho ba phetseng hantle ha ba le lilemo tse 40-50. Moo hangata sehlopha sa maloetse a sa foleng se ba setle haholo selemo se seng le se seng. Mokhoa oa kajeno oa bongaka o u lumella ho phekola boholo ba tsona ka katleho.

Empa ho thoe'ng haeba lithethefatsi tse ntlafatsang nako ea "liso" tse ling li qhekelloa ho ba bang? Ke lipilisi life tsa lefu la tsoekere tseo nka li noang ho khatello?

Lentsoe "lefu la tsoekere" phetolelong le bolela "ho felloa ke nako". E hlalosa hantle se etsahalang 'meleng oa motho ea nang le lefu la tsoekere - ha e le hantle, sirapo e phalla methapong.

Lijo life kapa life, ntle le mafura, li jeoa ke lisele tsa 'mele ka tsela ea tsoekere - tsoekere e qhibilihileng maling. Phepo e nepahetseng e kena ka har'a lisele tsa rona ka har'a insulin. 'Mele o sebetsana le tlhahiso ea "insulin" ea hormone bakeng sa karolo e ngoe le e' ngoe ea tsoekere e kenang maling.

Ho motho ea phetseng hantle, manyeme o sebetsana le mosebetsi oa hae ka nako e loketseng. Kamora hore e phethe tšebetso ea moseho oa glucose ka li-membranes tsa lisele, e romella tse setseng ho sebete le li-depo tsa mafura. Ho lefu la tsoekere, ts'ebetso ena ea senyeha.

Mohlomong insulin ha e hlahisoe ka bongata bo lekaneng, kapa ho tsoa ha eona ho ea lieha. Lefu la tsoekere ke lefu le fuoeng glucose e ngata maling.

Ho na le mefuta ea 2 ea lefu la tsoekere:

1. Insulin e itšetlehileng ka (lefu la tsoekere la Mofuta oa 1) - manyeme a khaotsa ho hlahisa insulin, kapa a hlahisa hampe haholo, a sa lekana le metabolism.
2. Insulin e ikemetseng (mofuta oa lefu la tsoekere la II) - insulin e hlahisoa ka mokhoa o tloaelehileng kapa esita le ka bongata bo eketsehileng, empa lisele tsa 'mele ha li e bone, ka hona tsoekere ha e kene kahare' me ha e fetohe mohloli oa matla, empa e leketla maling.

Ka nako eo, mefuta ena e arohana ho ba li-subtypes tse 'maloa. E se e tiisitse boteng ba mefuta ea 5 ea lefu la tsoekere. Empa bafuputsi ba na le mefuta ea hore ho ka ba le mefuta e mengata. Bakuli bohle ba lefu lena ba na le lefu la metabolism la carbohydrate.

Lisosa tsa lefu la tsoekere ke a mangata: ho tloha ho khatello e matla ea khafetsa, botenya, ho tloha liphatseng tsa lefutso ho ea ho mathata a mafu a mang.

Kahoo, khatello e ntseng e eketseha khafetsa e ka baka kholo ea lefu la tsoekere. Maemong ana, methapo ea methapo e lahleheloa ke kutloelo-bohloko, 'me ho se sebetse hantle ha liphio ho senyeha. Ho hloleha ha li-hormone ho etsahala, 'me makhopho a emisa ho amohela lets'oao la hore tsoekere e maling e kene maling ka nako e loketseng.

Ha boemo ba tsoekere bo qala ho theoha tekanyo, insulin e qetella e hlahisoa 'me "mokhoeng oa tšohanyetso" o sebelisa tse ngata seleng le mafura a' mele.Ho feta moo, mafura a mangata a ntlafatsa ho itšireletsa ha sele ho insulin.

Lijana tse nang le tsoekere e ngata li haelloa ke matla 'me li senyeha nakong ea phallo ea mali. 'Mele o hatella maqeba ana a manyane ka lipopae tsa cholesterol, eo e e hlahisang ka bongata bo eketsehileng, e sitisang metabolism ea lipid. Boloetse ba methapo ea methapo bo senyeha ho tloha lipoping, khatello ea eketseha, mme e senya ho fifala ha glomerular, mme sedikadikwe se mabifi se qala mokoloko o mocha ...

Mokuli o bokella mafu a mangata a itšetlehileng ka 'ona. Lefu la tsoekere le

Ka bomalimabe, hangata ke lisathalaete tse joalo.

Phekolo ea khatello ea mali ho lefu la tsoekere

Phekolo ea mali e na le phello e senyang 'meleng oa motho le bokhoni ba hae. E halefisa ts'ebetso ea pelo le methapo ea mali, e fetoha sesosa sa lefu la pelo, e sitisa ts'ebetso ea ts'ebetso ea kelello, e fetoha sesosa sa mafu a pono le a mahlo, mme e lematsa liphio le litho tse ling tsa ka hare. Maemong a itseng, le kamora ho ba lilemo li 40-50, e ka ba e bolaeang.

Haeba lefu la tsoekere le khatello li le teng ka nako e ts'oanang, mosebetsi ona o thatafatsoa ke tlhoko ea ho khetha kalafo e sa amang likhahla tsa glucose ea mali.

Ke ka lebaka leo mekhoa e meng ea ho loants'a khatello ea methapo ea methapo e sa lokelang bakuli ba nang le lefu la tsoekere:

• U ke ke ua theola khatello e phahameng ea mali ho lefu la tsoekere le li-diuretics tse ngata tse tlotsang mokelikeli o mongata linthong tse ngata, kaha ka ho fokotseha ha bongata ba mali, tsoekere e ngata e eketseha.
• Lithethefatsi tsa khatello ea mali ho lefu la tsoekere le tsona ha lia lokela ho fokotsa boemo ba tsoekere, hobane maemo a hypoglycemic, ho akheha, esita le komello a ka etsahala ka lithethefatsi tse theolelang tsoekere
• Tlhokomeliso e lokela ho nkuoa khatellong ea lijo tse ngata, tse kang monokotsoai, lebese, sinamone. Bongata ba tsona li na le lik'habohaedreite tse ngata, tseo 'mele o li fetolelang tsoekere kapele' me li mpefatsa boemo ba lefu la tsoekere. Tlas'a thibelo e felletseng ea mahe a linotsi.

Ha ho na le mafu a mabeli a kotsi a kang khatello ea mali le lefu la tsoekere, ho entsoe ka mokhoa o thata ho itlhahisa.

Ke setsebi se tšoanelehang feela se ka hlahlobang melemo le likotsi tsa lichelete tse itseng le ho tseba tsela ea kalafo.

Lithethefatsi tsohle tsa antihypertensive li arotsoe ka mofuta oa ketso:

1. Diuretics (diuretics) - e kenya letsoho ho tloseng mongobo liseleng, mme khatello ea fokotseha,
2. Li-inhibitors tsa ACE (angiotensin-converting enzyme) - li fokotsa enzyme, ntle le eona ho ke ke ha khoneha ho fetolela li-angiotensin I lihokelong ea li-angiotensin II, ka tsela eo li thibela spasm ea methapo le khatello ea methapo ea mali,
3. Sartans kapa Angiotensin II Receptor blockers (ARBs) - thibela litlamorao tsa angiotensin II, vasospasm ha e etsahale, 'me mali a phalla ka methapong ka bolokolohi, khatello ea fokotseha,
4. Beta-blockers - fokotsa lebelo kapa ho potlakisa morethetho oa pelo, hobane ho na le phano ea phallo ea mali, moroalo likepeng oa fokotseha,
5. Li-calcium calcium blockers (BCC) - li thibela phetiso ea li-ion tsa calcium ka li-membrane tse nang le methapo, ka hona li theola ho kenella ha tsona liseleng le lebelo la lits'ebetso tsa metabolic ho tsona. Tlhokahalo ea oksijene ea lisele e ea fokotseha, 'me moroalo o pelong o ea fokotseha, palo ea mali a tsoang ka eona e ea fokola.

Lithethefatsi tsena li fokotsa bongata ba mokelikeli o phallang 'meleng, bo amang khatello ea mali hantle. Leha ho le joalo, ka lefu la tsoekere la mofuta oa 2, lithethefatsi tse joalo li ka ba kotsi. Taba ea mantlha, boholo ba lipilisi tsena li tsoa ho khatello ea tšebetso ea renal, 'me li thatafatsa ho tlosa tsoekere e ngata le hyperglycemia.

Taba ea bobeli, ka ho fokotseha ha bongata ba mali, khatello ea tsoekere ho eona ea eketseha. Mme haeba ka lefu la tsoekere la mofuta oa 1 ho ka etsahala hore u nke mehato ea ho qhekella insulin hanghang, joale bakuli ba nang le T2DM ba tla khutlisetsa tsoekere ho tloaelehileng ka matsatsi a 'maloa.

Ho feta moo, bakuli ba bangata ba nang le lefu la tsoekere la mofuta oa 2 ha ba noe moriana, ho etsa hore maemo a tsoekere a felle feela ka lijo tse matla le lipapali. Bakeng sa bona, ho nka diuretics ho ka bolela ho fetohela kalafong ea lithethefatsi.

Ha o fana ka diuretics tsa lefu la tsoekere ho theola khatello ea mali, ngaka e lula e fana ka melemo le likotsi. Ho fetohela ho diuretics ha ho ratehe haholo!

Diuretics, tseo ngaka ea hau e ka fanang ka tsona bakeng sa khatello ea lefu la tsoekere, li kenyeletsa:

1. Lintho tse joalo ka li-Thiazides le thiazide ke lithethefatsi tse matla bohareng, phello ea tsona e hlaha kamora lihora tse ka bang tse peli 'me e nka lihora tse 11-13. Li na le phello e bonolo, empa li ntlafatsa phello ea diuretics ea lihlopha tse ling. Li-Thiazides hangata li beoa hammoho le li-inhibitors tsa ATP le beta-blockers. Tsena li kenyelletsa: hydrochlorothiazide, indapamide, chlortalidone, clopamide, hypothiazide, arifon retard, jj.
2. Liopture tsa loop ke sehlopha se matla ka ho fetisisa sa diuretics, ho hlatsoa calcium, sodium, potasiamo le magnesium ho tsoa lithong. Ka ho fokotseha ha palo ea bona, sekhahla sa pelo sea khathatseha, ho ba le mathata a mang a pelo. Ho amohela mekhoa ea loop ho ka etsahala feela ka nako e khuts'oane haholo, ho imolla maemo a hlobaetsang le ho ruruha ho matla. Ntle le moo, phello ea bona e lokela ho felisoa ke ho ja ka nako e le 'ngoe ha potasiamo le magnesium. Har'a melemo ea sehlopha sena sa diuretics ke ho se be le phello k'holeseterole. Lithethefatsi tse joalo li kenyelletsa: furosemide, lasix, ethaconic acid.
3. Li-diuretics tsa Osmotic li sebelisoa haholo nakong ea ts'ebeliso ea morao ho imolla puffiness e bohloko. Ba na le thepa e mpe bakeng sa batho ba nang le lefu la tsoekere - ba kenya letsoho ho theheng glycogen. Ntho ena e ntšoa ke sebete ho kena maling ha motho a e-so je nako e telele, 'me maemo a tsoekere a theoloa. Haholo-holo, metsoako e joalo e etsahala khafetsa nakong ea boroko bosiu. Ho eketseha ha tsoekere ka tšohanyetso ho na le phello e mpe bophelong ba batho ba nang le lefu la tsoekere, ka hona ha ba fuoe diuretics tsa sehlopha sa osmotic (bumetanide, torsemide, chlortalidone, polythiazite, xipamide).
4. Li-diuretics tse sebelisang potasiamo - ha li tlose potasiamo 'meleng. Tsena li kenyelletsa spironoxan, veroshpiron, unilan, aldoxone, spirix, triamteren, amiloride. Li na le tšusumetso e bonolo, empa li fapana ka lebelo la ponaletso. Hangata e laetsoe ka nako e le ngoe le li-diuretics tse ling.

Lithethefatsi sehlopheng sena ke lipilisi tsa khatello tse laoloang ka ho fetisisa bakeng sa lefu la tsoekere. Ntle le ts'ebetso ea eona ea mantlha, li-inhibitors tsa ACE li hlohlelletsa ho fifala ha meno lipelong, li li sireletse litlamorao tsa tsoekere e phahameng, li ama metabolism ea lipid, li sirelletsa methapo ea mahlo, li liehisa nts'etsopele ea lefu la tsoekere, le fokotsa kotsi ea ho ba le stroke le pelo, le ho ntlafatsa tsoekere ea glucose ke lisele.

Lintho tse atisang ho tsebahala tsa ATP: enalapril, quinapril, lisinopril, hammoho le jenereithara ea meriana ena.

Abela bakuli ba nang le lefu la tsoekere le mathata a pelo, a kang angina pectoris, ho otla ka potlako, ho nyekeloa ke pelo. Batho ba bang ba beta-blocker ba na le pelo e ngata haholo mme ha ba na phello e kholo ho metabolism ea carbohydrate. Har'a tsona: bisoprolol, atenolol, metoprolol le lithethefatsi tse ling tse nang le lintho tsena tse sebetsang.

Ka bomalimabe, lithethefatsi tse joalo li eketsa k'holeseterole ea mali hape li eketsa ho hanyetsa insulin mofuteng oa 2 oa lefu la tsoekere, e sitisang tsoekere e fumanoang ke 'mele. Ka tekanyo e nyane, carvedilol le nebivolol, hammoho le jeniki ea bona, li ama metabolism ea lipid.

Ho ts'oara beta-blockers ho ka tebisa matšoao a hypoglycemia (lerotholi le tebileng la tsoekere ea mali), 'me ba lokela ho ba hlokolosi.

Lithethefatsi tsa antihypertensive tse tsoang sehlopheng sena li tšoaneleha hantle bakeng sa kalafo ea khatello ea mali ho mellitus ea lefu la tsoekere.Ntle le khatello ea standardizing, bona, joalo ka li-inhibitors tsa ACE, ba na le phello e ntle, ba fokotsa ho hanyetsa ha lisele ho insulin, ha li ame metabolism ea lipid le carbohydrate, 'me li mamelloa hantle ke bakuli ba tsofetseng.

Ka tsela e molemohali, li-sartan li senola liketso tsa tsona, libeke tse 2-3 kamora ho qala kamohelo. Tsena ke lithethefatsi: losartan, candesartan, valsartan, telmisartan, eprosartan.

Lithethefatsi tse tsoang sehlopheng sa li-calcium blockers le tsona ha li ame metabolism ea lik'habohaedreite le lipids, ka hona, li ka sebelisoa ho phekola khatello ea mali ho lefu la tsoekere. Phello ea bona ha e phatlalatsoe ho feta ea ACE le ARB inhibitors, empa e na le phello e ntle tseleng ea IHD le angina pectoris.

Tse ling tsa lithethefatsi tsena li na le tšusumetso ea nako e telele, 'me li hloka ho nooa hanngoe ka letsatsi, e leng bohlokoa ka palo e kholo ea litaelo, le botsofaling. Sehlopha se kenyelletsa: nifidipine (matlapeng a Corfar Retard), amlodipine, felodipine, lercanidipine le lithethefatsi tse ling tse nang le metsoako ena e sebetsang. Har'a tse ling tsa litlamorao tse mpe ke monyetla oa ho ruruha le ho otla kapele.

Ha re phethela tlhahlobo, re tiisa hape hore, ho sa tsotelehe lingoloa tse kae ka khatello le lefu la tsoekere, li ke ke tsa nkela thuto ea bongaka le boiphihlelo boiphihlelo.

Se ke oa inahanela! Mme o phele hantle!

Hypertension e atile haholo bathong ba nang le lefu la tsoekere la mofuta oa 2. Motsoako ona oa maloetse o kotsi haholo, hobane menyetla ea ho holofala kelellong, ho otloa, lefu la masapo, ho nyekeloa ke pelo le gangrene li eketsehile haholo. Ka hona, ho bohlokoa haholo ho khetha lipilisi tse nepahetseng tsa lefu la tsoekere la mofuta oa 2.

Ka nts'etsopele ea khatello ea mali hammoho le lefu la tsoekere, ho bohlokoa ho buisana le ngaka ka nako e loketseng. Ho ipapisitse le datha ea lihlahlobo le lithuto, setsebi se tla tseba ho khetha lithethefatsi tse nepahetseng.

Khetho ea sethethefatsi bakeng sa khatello ea mali ho lefu la tsoekere ha e bonolo haholo. Lefu la tsoekere le tsamaisana le mathata a 'mele' meleng, ts'ebetso ea ho ruruha e amanang le lefu la tsoekere, 'me mofuta oa bobeli oa lefu o tšoauoa ke botena, atherosclerosis le hyperinsulinism. Ha se lithethefatsi tsohle tsa antihypertgency tse ka nooang maemong a joalo. Haele hantle, ba tlameha ho fihlela litlhoko tse ling:

• se ke oa ama boemo ba lipids le glucose maling,
• sebetsa haholo
• ba le litla-morao tse fokolang
• ho ba le litla-morao le phello ea pelo (sireletsa liphio le pelo liphellong tse mpe tsa khatello ea mali).

Ka hona, ka lefu la tsoekere la mofuta oa 2, ho ka sebelisoa baemeli ba lihlopha tse latelang tsa lithethefatsi:

• diuretics
• Li-inhibitors tsa ACE
• beta blockers
• ARB
• calcium blockers.

Li-diuretics li emeloa ke lithethefatsi tse ngata tse nang le mochine o fapaneng oa ho tlosa mokelikeli o eketsehileng 'meleng. Lefu la tsoekere le tšoauoa ka mokhoa o ikhethileng oa letsoai, leo hangata le lebisang ho eketseheng ha bongata ba mali a potoloha mme ka lebaka leo, keketseho ea khatello. Ka hona, ho nka diuretics ho fana ka litholoana tse ntle ka khatello ea mali ho lefu la tsoekere. Hangata li sebelisoa hammoho le li-inhibitors tsa ACE kapa beta, e lumellang ho eketsa katleho ea kalafo le ho fokotsa palo ea litla-morao. Bothata ba sehlopha sena sa lithethefatsi ke tšireletso e mpe ea renal e fokotsang ts'ebeliso ea bona.

Ho latela sebopeho sa ts'ebetso, diuretics li arotsoe ka:

• loopback
• thiazide
• thiazide-like,
• ho senya-potasiamo
• osmotic.

Baemeli ba thiazide diuretics ba laetsoe ka hloko ho lefu la tsoekere. Lebaka la sena ke bokhoni ba ho thibela tšebetso ea liphio le ho eketsa cholesterol le tsoekere ea mali ha li nooa ka tekanyetso e kholo. Ka nako e ts'oanang, li-thiazides li fokotsa haholo menyetla ea ho otloa ke lefu la pelo le pelo.Ka hona, diuretics tse joalo ha li sebelisoe ho bakuli ba nang le ho se sebetse hantle ha renal, mme ha e nkuoa, lethal dose ea letsatsi le letsatsi ha ea lokela ho feta 25 mg. Moemeli ea sebelisoang haholo ke hydrochlorothiazide (hypothiazide).

Lithethefatsi tse kang Thiazide hangata li sebelisetsoa khatello ea lefu la tsoekere. Ka tekanyo e nyane, ba tlosa potasiamo 'meleng, ba bontša phello e bonolo ea diuretic mme ha e ame boemo ba tsoekere le lipids' meleng. Ntle le moo, moemeli oa sehlooho oa subgroup indapamide o na le sephetho sa nephroprotective. Mofuta ona oa thiazide-diuretic o fumaneha tlasa mabitso:

Liopture tsa loop li sebelisoa ha ho e-na le ho hloleha ho sa feleng ha renal le edema e matla. Nako ea karolelano ea bona e lokela ho ba khutšoane, hobane lithethefatsi tsena li hlohlelletsa ho hlohlona ho matla le potasiamo, e ka lebisang ho omeng, hypokalemia, ka lebaka leo, arrhythmias. Ts'ebeliso ea lioptamine tsa loop e tlameha ho tlatselletsoa ka litokisetso tsa potasiamo. Lithethefatsi tse tummeng ka ho fetesisa le tse sebelisoang ka sehlohong ke furosemide, e tsejoang hape e le Lasix.

Li-diuretics tsa Osmotic le potasium tse bolokang lefu la tsoekere hangata ha li laeloe.

Litsebi tse ngata li nka li-inhibitors tsa ACE e le lithethefatsi tse ikhethileng bakeng sa khatello ea mali ho lefu la tsoekere. Ntle le ho fokotsa khatello ea mali ka katleho, meriana ena:

• e na le phello e boletsoeng,
• eketsa kutloisiso ea lisele tsa mmele ho insulin,
• eketsa tsoekere ea tsoekere
• ba le phello e ntle ho metabolism ea lipid,
• fokotsa lebelo la liso tsa mahlo,
• fokotsa menyetla ea ho tšoaroa ke stroke le myocardial infarction.

Ho bohlokoa ho ela hloko hore ts'ebetso e ntlafalitsoeng ea tsoekere e ka lebisa ho hypoglycemia, ka hona ho ka hlokahala hore litekanyetso tsa litekanyetso tsa lithethefatsi tse fokotsang tsoekere. Li-inhibitors tsa ACE li boetse li boloka potasiamo 'meleng, e leng se ka lebisang ho hyperkalemia. Ka hona, kalafo ka lithethefatsi tsena e ka se tlatsetsoe ka litlatsetso tsa potasiamo.

Li-inhibitors tsa ACE li hola hanyane ka hanyane, ho feta libeke tse 2-3. Litlamorao tse atileng haholo tsa lithethefatsi tsena ke sefuba se omileng, se hlokang ho tlosoa ha sona le ho khethoa ha moriana o phahameng oa khatello ho tsoa sehlopheng se seng.

Li-inhibitors tsa ACE li emeloa ke lithethefatsi tse ngata:

• enalapril (Enap, Burlipril, Attoril),
• quinapril (Akkupro, Quinafar),
• lisinopril (Zonixem, Diroton, Vitopril).

Beta blockers

Ho khethoa ha beta-blockers ho bontšoa bakeng sa khatello ea mali ho lefu la tsoekere la mellitus, le rarahaneng ke ho se sebetse ha pelo, ho otla kapele le angina pectoris. Maemong ana, ho khethoa baemeli ba pelo ea sehlopha, bao ho hang ba se nang litlamorao ho metabolism ea lefu la tsoekere. Tsena ke meriana:

• atenolol (Atenobene, Atenol),
• bisoprolol (Bidop, Bicard, ConcorCoronal),
• metoprolol (Emzok, Corvitol).

Leha ho le joalo, esita le lithethefatsi tsena li na le phello e mpe tseleng ea lefu la tsoekere, li eketsa boemo ba cholesterol le tsoekere 'meleng, hammoho le ho hanyetsa insulin. Ka hona, hajoale ha ho na maikutlo a sa utloahaleng mabapi le ho nepahala ha ho khethoa ha lichelete tsena.

Lithibelo tse amohelehang ka ho fetisisa tsa lefu la tsoekere ke:

• carvedilol (Atram, Cardiostad, Coriol),
• nebivolol (Nebival, Nebilet).

Lichelete tsena li na le phello e eketsehileng ea vasodilating. Lipilisi tsena tse nang le khatello e matla li thusa ho fokotsa khatello ea insulin hape li na le phello e molemo ho metabolism ea lik'habohaedreite le lipids.

Hopola hore beta blockers e ka pata matšoao a hypoglycemia. Sena se bohlokoa haholo ho batho ba sa khethollang ho qala ha hypoglycemia kapa ba sa e utloeng ho hang.

Li-Sartan kapa li-ARB (li-angiotensin II receptor blockers) li molemo bakeng sa ho phekola khatello ea mali e amanang le lefu la tsoekere. Tsena lipilisi tsa khatello ea mali, ho kenyelletsa ts'ebetso ea antihypertgency:

• Eba le sephetho se matla
• khatello e tlase ea insulin
• u se ke oa ama hampe mekhoa ea metabolic,
• fokotsa hypertrophy ea 'mele ka letsoho le letšehali,
• Li khetholloa ke mamello e ntle ebile hangata ha li na lithethefatsi tse ling tsa antihypertgency tse bakang phello e mpe 'meleng.

Ketso ea sartans, hammoho le li-inhibitors tsa ACE, e tsoela pele butle-butle mme e fihla botebong ba eona bo boholo libekeng tse 2-3 tsa tsamaiso.

Li-ARB tse tsebahalang haholo ke:

• losartan (Lozap, Kazaar, Lorista, Closart),
• candesartan (Candecor, Adible, Candesar),
• valsartan (Vasar, Diosar, Sartokad).

Likhohlano tsa calcium

Li-blockers tsa calcium calcium li ka sebelisoa ho theola khatello ea mali le motsoako o matla oa khatello ea mali le lefu la tsoekere, kaha ha li ame metabolism ea carbohydrate le lipid. Li sebetsa hantle haholo ho feta sartans le ACE inhibitors, empa li ntle haholo boteng ba li-angina pectoris le ischemia. Hape, lithethefatsi tsena li laetsoe haholo kalafo ea bakuli ba tsofetseng.

Khetho e fuoa lithethefatsi ka phello e telele, ea eona e lekaneng ho etsoa hang ka letsatsi:

• amlodipine (Stamlo, Amlo, Amlovas),
• nifidipine (Corona Horne),
• felodipine (Adalat SL),
• lercanidipine (Lerkamen).

Bothata ba bahanyetsi ba calcium ke bokhoni ba bona ba ho tsosa sekhahla sa pelo le ho baka ho ruruha. Hangata ho hloeka ho matla haholo ho baka ho tlosoa hoa meriana ena. Ho fihla joale, moemeli a le mong ea se nang tšusumetso ena e mpe ke Lerkamen.

Ka linako tse ling khatello ea khatello ea mali ha e khonehe ho phekoloa ka lithethefatsi tse tsoang lihlopheng tse hlalositsoeng ka holimo. Joale, ntle le eona, li-alpha-blockers li ka sebelisoa. Le ha li sa ame tšebetso ea metabolic 'meleng, li na le litlamorao tse ngata tse mpe' meleng. Haholo-holo, li-alpha-blockers li ka baka hypotension ea orthostatic, e seng e ntse e tsebahala ka lefu la tsoekere.

Tšoaetso e le 'ngoe feela ea ho khetha sehlopha sa lithethefatsi ke motsoako oa khatello ea mali, lefu la tsoekere le lefu la mali la senya. Baemeli:

• terazosin (Setegis),
• doxazosin (Kardura).

Hypertension - khatello e phahameng ea mali. Khatello ea mofuta oa lefu la tsoekere la mofuta oa 2 e hloka ho bolokoa ho 130/85 mm Hg. Art. Litefiso tse phahameng li eketsa monyetla oa ho tšoaroa ke lefu la stroke (makhetlo a 3-4), ho nyekeloa ke pelo (makhetlo a 3-5), ho foufala (makhetlo a 10-20), ho se sebetse hantle ka makhetlo a 20-25 makhetlo a mang, gangrene e nang le ho khaoloa ka mor'a moo (makhetlo a 20). Ho qoba mathata a joalo a makatsang, litlamorao tsa ona, o hloka ho sebelisa lithethefatsi tse matlafatsang tsa lefu la tsoekere.

Ke eng e kopanyang lefu la tsoekere le khatello? E kopanya tšenyo ea setho: mokokotlo oa pelo, liphio, methapo ea mali le mokokotlo oa leihlo. Phekolo ea lefu la tsoekere hangata e ba eona ntho e ka sehloohong, pele ho lefu lena.

Mefuta ea Hypertension	Monyetla	Mabaka
Bohlokoa (ba mantlha)	ho fihla ho 35%	Lebaka ha lea thehoa
Isstated systolic	ho fihla ho 45%	Ho fokotseha ha methapo ea methapo, khatello ea methapo
Nephropathy ea lefu la tsoekere	ho fihla ho 20%	Ho senyeha ho likepe tsa renal, sclerotization ea bona, nts'etsopele ea ho se sebetse hantle ha renal
Lenaneo	ho fihla ho 10%	Pyelonephritis, glomerulonephritis, polycitosis, lefu la tsoekere lephropathy
Endocrine	ho fihla ho 3%	Endocrine pathologies: pheochromocytoma, hyperaldosteronism ea mantlha, lefu la eona la Itsenko-Cushing

1. Lerumo la khatello ea mali le robehile - ha matšoao a ho lekanya bosiu a phahame ho feta motšeare. Lebaka ke neuropathy.
2. Bokhabane ba mosebetsi o kopanetsoeng oa tsamaiso ea methapo ea kutlo bo a fetoha: Molao oa molumo oa methapo ea mali o oa khathatseha.
3. Mofuta oa orthostatic oa hypotension o hlaha - khatello e tlase ea mali ho lefu la tsoekere. Ho phahama ho hoholo ha motho ho baka tlhaselo ea khatello ea maikutlo, ho fifala mahlo, bofokoli, ho akheha hoa hlaha.

U ka qala kalafo ea khatello ea mali ho lefu la tsoekere? Ke khatello efe e kotsi ho lefu la tsoekere? Hang ha matsatsi a se makae, khatello ea mofuta oa 2 lefu la tsoekere e bolokoa ho 130-135 / 85 mm. Hg. Art., Hloka kalafo. Ha ba phahame ka bongata, menyetla ea ho ba le mathata a mangata e ea eketseha.

Phekolo e lokela ho qala ka matlapa a diuretic (diuretics). Li-diuretics tsa bohlokoa bakeng sa lenane la 2 lefu la tsoekere 1

E matla	Katleho ea Matla a Mahareng	Li-diuretics tse fokolang
Furosemide, Mannitol, Lasix	Hypothiazide, Hydrochlorothiazide, Clopamide	Dichlorfenamide, Diacarb
E abetsoe ho imolla edema e matla, lefu la khoele	Lithethefatsi tse sebetsang nako e telele	E abetsoe mochining oa phepelo ea tlhokomelo.
Ka potlako li tlosa mokelikeli o eketsehileng 'meleng, empa li na le litlamorao tse ngata. Li sebelisoa bakeng sa nakoana ho li-pathologies tse matla.	Ketso e bonolo, ho tlosoa ha li-hypostase	E ntlafatsa tšebetso ea li-diuretics tse ling

Bohlokoa: Diuretics e senya botsitso ba electrolyte. Ba tlosa letsoai la boselamose, sodium, potasiamo ho tsoa 'meleng, kahoo Triamteren, Spironolactone ba laetsoe ho khutlisa botsitso ba electrolyte. Li-diuretics tsohle li amoheloa feela ka mabaka a bongaka.

litaba tsa ka hare drugs Lithethefatsi tse thibelang khatello ea kelello: lihlopha

Khetho ea lithethefatsi ke litokelo tsa lingaka, ho ikalafa ho kotsi bophelong le bophelong. Ha u khetha meriana bakeng sa khatello ea lefu la tsoekere le lithethefatsi bakeng sa kalafo ea lefu la tsoekere la mofuta oa 2, lingaka li tataisoa ke boemo ba mokuli, litšobotsi tsa lithethefatsi, phapanyetsano, 'me li khetha mefuta e sireletsehileng bakeng sa mokuli ea itseng.

Lithethefatsi tsa antihypertensive ho ea ka pharmacokinetics li ka aroloa ka lihlopha tse hlano.

Bohlokoa: Litafole tsa khatello e phahameng ea mali - Beta-blockers tse nang le phello ea vasodilating - lithethefatsi tsa sejoale-joale tse sireletsehileng ka ho fetisisa - tse eketsang methapo e nyane ea mali, li na le phello e ntle ho metabolism ea carbohydrate-lipid.

Ka kopo hlokomela: Bafuputsi ba bang ba lumela hore lipilisi tse sireletsehileng ka ho fetisisa tsa khatello ea mali ho lefu la tsoekere, lefu la tsoekere le sa itšetleheng ka insulin ke Nebivolol, Carvedilol. Matlapa a setseng a sehlopha sa beta-blocker a nkoa a le kotsi, a sa lumellane le bokuli bo ka tlase.

Bohlokoa: Beta-blockers ba pata matšoao a hypoglycemia, kahoo ba lokela ho fuoa taelo e kholo.

Bohlokoa: Li-blocker tsa alpha tse ikhethileng li na le "phello ea tekanyetso ea pele." Pilisi ea pele e oela ho orthostatic - ka lebaka la ho eketsoa ha methapo ea mali, ho phahama ho matla ho baka phallo ea mali ho tloha hloohong ho theoha. Motho o lahleheloa ke kelello 'me a ka lemala.

Lipilisi tsa ambulense tsa ho fokotseha ha khatello ea mali ka tšohanyetso: Andipal, Captopril, Nifedipine, Clonidine, Anaprilin. Ketso e nka lihora tse 6.

Likhatello tse fokotsang khatello ea mali ha li felle lenaneng lena feela. Lethathamo la lithethefatsi le lula le ntlafatsoa khafetsa ka tsoelo-pele e ncha, ea sejoale-joale.

Victoria K., 42, moqapi.

Ke se ke bile le lefu la khatello ea mali le lefu la tsoekere la mofuta oa 2 lilemo tse peli. Ha kea ka ka noa lipilisi, ke ile ka phekoloa ka litlama, empa ha li sa thusa. Seo u lokelang ho se etsa Motsoalle o re u ka tlosa khatello e phahameng ea mali haeba u nka bisaprolol. Ke lipilisi life tsa khatello tse molemo ho feta ho nooa? Seo u lokelang ho se etsa

Victor Podporin, setsebi sa endocrinologist.

Mohlomphehi Victoria, nke ke ka u eletsa hore u mamele kharebe ea hau. Ntle le lengolo la ngaka, ho khothaletsoa ho sebelisa meriana. Khatello e phahameng ea mali ho lefu la tsoekere e na le etiology (lisosa) mme e hloka mokhoa o fapaneng oa kalafo. Moriana oa khatello ea mali o phahameng o laetsoe ke ngaka feela.

Hypertension ea methapo ea kutlo e baka tlolo ea metabolism ea lik'habohaedreite maemong a 50-70% a linyeoe. Ho 40% ea bakuli, khatello ea methapo ea kutlo e tsoala mofuta oa 2 lefu la tsoekere. Lebaka ke ho hanyetsa insulin - ho hanyetsa insulin. Lefu la tsoekere le khatello ea kelello li hloka kalafo hanghang.

Phekolo ea khatello ea mali le meriana ea setso bakeng sa lefu la tsoekere e lokela ho qala ka ho boloka melao ea mokhoa oa bophelo bo botle: boloka boima ba 'mele, emisa ho tsuba, noang joala, fokotsa ho ja letsoai le lijo tse kotsi.

Phekolo ea khatello ea mali le meriana ea setso bakeng sa lefu la tsoekere ha e sebetse kamehla, ka hona, hammoho le meriana ea litlama, o hloka ho sebelisa meriana. Litlhare tsa folks li lokela ho sebelisoa ka hloko haholo, kamora ho buisana le setsebi sa endocrinologist.

Lijo tse amanang le khatello ea mali le lefu la tsoekere la mofuta oa 2 li etselitsoe ho theola khatello ea mali le ho nolofatsa boemo ba tsoekere ea mali. Nutle ea khatello ea mali le mofuta oa 2 lefu la tsoekere e lokela ho lumellanoa le endocrinologist le setsebi sa phepo.

1. Lijo tse nang le phepo e nepahetseng (tekanyo e nepahetseng le tekanyo) ea liprotheine, lik'habohaedreite, mafura.
2. Low-carb, e nang le livithamini tse ngata, potasiamo, le magnesium, e batla e le lijo.
3. Ho nooa ho feta 5 g ea letsoai ka letsatsi.
4. Palo e lekaneng ea meroho le litholoana tse ncha.
5. Lijo tse nang le phepo e nepahetseng (bonyane makhetlo a 4-5 ka letsatsi).
6. Ho tsamaellana le phepelo ea lijo No. 9 kapa No. 10.

Meriana ea khatello ea mali e emetse ka bongata 'marakeng oa meriana. Lithethefatsi tsa mantlha, li-generics tsa melaoana e fapaneng ea litheko li na le melemo ea tsona, matšoao le litlolo. Lefu la tsoekere le khatello ea methapo ea methapo ea kutlo le motho e mong le e mong li hloka kalafo e khethehileng. Ka hona, ho hang ha ua lokela ho inahanela. Ke mekhoa ea sejoale-joale ea ho phekola lefu la tsoekere le khatello ea mali, ho khethoa ke setsebi sa endocrinologist le pelo ke sona se tla lebisa sephethong se lakatsehang. Eba bophelo bo botle!

Sengoloa se fetilengHo na le tsoekere ea mali e reng: litloaelo le ho kheloha ho ka khonehang sengoloa se latelang → Teko ea mali ke efe bakeng sa lefu la tsoekere le mefuta ea lona?

Phekolo ea methapo ea methapo hangata e fumanoa ho bakuli ba nang le lefu la tsoekere la mofuta oa 1 le mofuta oa 2. Ka linako tse ling pathology e hlaha pejana ho metabolic cidrome, maemong a mang, sesosa sa khatello e phahameng ea mali ke tlolo ea liphio (nephropathy). Maemo a sithabetsang, lefu la ho fokola ha masapo, chefo ea tšepe e boima, le khaello ea magnesium le tsona e ka ba mabaka a hlasimollang. Phekolo ea khatello ea mali le mofuta oa "mellitus" e sa itšetleheng ka insulin e thusa ho qoba nts'etsopele ea mathata a tebileng, ho ntlafatsa boemo ba mokuli.

Ke meriana efe eo nka e noang le lefu la tsoekere ho theola khatello ea mali? Litokisetso tsa sehlopha sa li-enzyme tsa thibelo ea ACE tse hlahisang li-enzyme tse ling, tse thusang ho tsitsisa methapo ea mali le ho tsitsisa adortal cortex ho kopanya lihormone tse ts'oereng sodium le metsi 'meleng oa motho. Nakong ea kalafo ka lithethefatsi tsa antihypertensive tsa sehlopha sa ACE inhibitor bakeng sa khatello ea mofuta oa 2 lefu la tsoekere, vasodilation e etsahala, ho bokelloa ha sodium le mokelikeli o feteletseng, ka lebaka leo khatello ea mali e fokotsehang.

Lethathamo la lipilisi tse nang le khatello e matla tseo u ka li noang ka lefu la tsoekere la mofuta oa 2:

Lithethefatsi tsena li ngoletsoe bakuli ba nang le khatello ea mali hobane li sireletsa liphio ebile li liehisa nts'etsopele ea nephropathy. Methapo e menyenyane ea lithethefatsi e sebelisoa ho thibela methapo ea methapo liseleng tsa mochine oa methapo.

Phello ea kalafo ea ho nka li-inhibitors tsa ACE e hlaha butle butle. Empa matlapa a joalo ha a tšoanele motho e mong le e mong, ho bakuli ba bang ho na le litla-morao ka mokhoa oa ho khohlela ho sa feleng, mme kalafo ha e thuse bakuli ba bang. Maemong a joalo, lithethefatsi tsa lihlopha tse ling li laetsoe.

Angiotensin II receptor blockers (ARBs) kapa sartan e thibela ts'ebetso ea phetoho ea lihormone lipelong, e bakang khatello ea mali. Li-ARB ha li ame lits'ebetso tsa metabolic, li eketsa kutloisiso ea litho tsa 'mele ho insulin.

Li-Sartan li na le phello e ntle le khatello ea mali haeba ventricle e tlohetsoeng e holisitsoe, e atisang ho hlaha khahlano le semelo sa khatello ea mali le ho se sebetse ha pelo.Meriana ea khatello ea sehlopha sena e mamelloa hantle ke bakuli ba nang le lefu la tsoekere la mofuta oa 2. U ka sebelisa chelete e le monotherapy kapa kalafo hammoho le diuretics.

Lethathamo la lithethefatsi (sartans) bakeng sa khatello ea mali ho fokotsa khatello e ka etsoang le lefu la tsoekere la mofuta oa 2:

Phekolo ea ARB e na le litlamorao tse fokolang haholo ho feta li-inhibitors tsa ACE. Phello e phahameng ea lithethefatsi e bonoa libeke tse peli kamora ho qala kalafo. Sartan e netefalitsoe ho sireletsa liphio ka ho fokotsa tlhahiso ea protheine ka har'a moroto.

Li-diuretics li matlafatsa ketso ea li-inhibitors tsa ACE, ka hona, li laetsoe kalafo e rarahaneng. Liuretics tse kang Thiazide li na le phello e bobebe mofuteng oa lefu la tsoekere la mofuta oa 2, li na le tšusumetso e ngata ho pepesitsoeng ea potasiamo, boemo ba tsoekere le lipids maling, 'me li se ke tsa sitisa tšebetso ea liphio. Sehlopha sena se kenyeletsa Indapamide le Arefon Retard. Mekhoa ea litlhare e na le phello efe kapa efe ea ho senya setho.

Indapamide e phahamisa vasodilation, e hlohlelletsa tlhahiso ea li-blocklet aggregation blockers, ka lebaka la ho nka lithethefatsi bakeng sa lefu la tsoekere la 2, khatello ea mali le khatello ea mali e fokotsehang. Ka litekanyetso tsa kalafo, indapamide e baka phello ea hypotensive ntle le keketseho e kholo ea tlhahiso ea moroto. Karolo e ka sehloohong ea ts'ebetso ea Indapamide ke tsamaiso ea methapo le methapo ea kutlo.

Phekolo ka Indapamide ha e ame ts'ebetso ea metabolic 'meleng, ka hona ha e eketse boemo ba tsoekere, lipoprotein tse tlaase maling. Indapamide ka potlako e amohela karolo ea bona ea ka mpeng, empa sena ha se fokotse katleho ea sona, ho ja hanyane ho fokotsa ho kenella.

Ho sebelisa indapamide ka nako e telele ho ka fokotsa palo ea meriana. Matla a kalafo a fumanoa qetellong ea beke ea pele ea ho nka lipilisi. Hoa hlokahala ho noa capsule e le 'ngoe ka letsatsi.

Ke matlapa afe a diuretic ao nka a noang khatello ea mali e phahameng ea lefu la tsoekere?

Matlapa a diuretic a ngoletsoa khatello e phahameng ea mali (khatello ea mali e bohlokoa) mofuteng oa 2 oa lefu la tsoekere. Ngaka e eang teng e lokela ho khetha lithethefatsi, li nahanela ho teba ha lefu lena, boteng ba tšenyo ea lisele tsa methapo le litšitiso.

Furosemide le Lasix li laeloa ho ruruha ho matla hammoho le li-inhibitors tsa ACE. Ho feta moo, ho bakuli ba nang le bothata ba ho phekoloa ke masapo, ts'ebetso ea setho se amehang ea ntlafala. Lithethefatsi li hlatsoitsoe ka ntle ho potasiamo ea 'mele, kahoo o tlameha ho nka lihlahisoa tse nang le potasiamo (Asparkam).

Veroshpiron ha e lutle potasiamo ho tsoa 'meleng oa mokuli, empa e thibetsoe hore e sebelisoe ho se sebetse hantle ha renal. Ka lefu la tsoekere, kalafo ka sethethefatsi se joalo e laeloa hangata.

LBC e thibela likonopo tsa calcium ka pelong, methapo ea mali, e fokotsa ts'ebetso ea bona ea contractile. Ka lebaka leo, ho na le keketseho ea methapo ea methapo, ho fokotseha ha khatello ea khatello ea mali.

Lethathamo la lithethefatsi tsa LBC tse ka nooang le lefu la tsoekere:

Li-blockers tsa calcium calcium ha li nke karolo lits'ebetsong tsa metabolic, li na le li-contraindication bakeng sa litekanyetso tse phahameng tsa tsoekere, ts'ebetso ea pelo e sa thekeseleng, 'me ha e na thepa ea nephroprotective. Li-LBC li holisa lijana tsa kelello, hona ho na le thuso bakeng sa thibelo ea ho ts'oaroa ha batho ba tsofetseng. Litokisetso li na le phapang ho boholo ba tšebetso le tšusumetso mosebetsing oa litho tse ling, ka hona, li abeloa ka bonngoe.

Ke matlapa afe a antihypertensive a kotsi ho batho ba lefu la tsoekere? Li-diuretics tse thibelitsoeng, tse kotsi tsa lefu la tsoekere li kenyelletsa Hypothiazide (a thiazide diuretic). Lipilisi tsena li ka eketsa tsoekere ea mali le litekanyo tse mpe tsa cholesterol. Ha mokuli a e-na le ho se sebetse hantle ke lefu la masapo, a ka lemala a le teng ts'ebetsong ea setho sa hae. Bakuli ba nang le khatello ea maikutlo ba fuoa li-diuretics tsa lihlopha tse ling.

Lithethefatsi Atenolol (β1-adenoblocker) ea lefu la tsoekere la mellitus 1 le 2 li baka keketseho kapa ho theoha hoa boemo ba glycemia.

Ka hlokolosi, e laeloa ho senya liphio, pelo. Ka nephropathy, Atenolol e ka baka khatello e matla ea khatello ea mali.

Moriana o sitisa mekhoa ea metabolic, o na le litla-morao tse ngata tse tsoang methapong ea methapo, ea methapo le ea pelo. Khahlano le semelo sa ho nka Atenolol ka mofuta oa 2 lefu la tsoekere, khatello e tlase haholo ea mali e bonoa. Sena se baka tsitsipano e matla boiketlong. Ho nwa moriana ho etsa hore ho be thata ho bona boemo ba tsoekere ea mali. Ho bakuli ba itšetlehileng ka insulin, Atenolol e ka baka hypoglycemia ka lebaka la ho lokolloa ha tsoekere e tsoang bokong le tlhahiso ea insulin. Ho thata hore ngaka e lemohe ka nepo matšoao a hore ha a na matšoao.

Ntle le moo, Atenolol e fokotsa kutloisiso ea litho tsa 'mele ho ea ho insulin, e lebisang ho senyeha ha maemo a bakuli ba nang le lefu la tsoekere la mofuta oa 2, ho se lekane ka tekanyo ea cholesterol e kotsi le e ntle, mme e thusa ho hyperglycemia. Ho amoheloa ha Atenolol ho ke ke ha emisoa ka tšohanyetso; ho hlokahala ho buisana le ngaka ka phetoho ea eona le ho fetisetsa mekhoa e meng. Boithuto ba mahlale bo paka hore tšebeliso ea nako e telele ea Atenolol ho bakuli ba nang le khatello ea mali butle-butle e lebisa ho nts'etsopele ea mofuta oa 2 mellitus ea tsoekere, hobane kutloisiso ea litho tsa botona ho insulin e fokotseha.

Sebaka se seng sa Atenolol ke Nebilet, β-blocker e sa amang metabolism mme e na le phello e ntle ea vasodilating.

Matlapa a khatello ea khatello ea mali maling a lefu la tsoekere a lokela ho khethoa le ho laeloa ke ngaka e nahanang ka litšobotsi tsa mokuli, boteng ba li-contraindication, botebo ba methapo ea methapo. Ha ho kgothaletswe ho sebelisa β-blockers (Atenolol), liopture tsa loop, hobane lithethefatsi tsena li ama mekhoa e metle ea metabolic, li eketsa boemo ba glycemia le cholesterol e tlase. Lethathamo la lithethefatsi tse sebetsang le kenyeletsa sartans, thiazide-like diuretics (Indapamide), li-inhibitors tsa ACE.

Meriana ea khatello ea mali: ke eng

Hypertension ke keketseho e tsitsitseng ea khatello ea mali: khatello ea systolic "holimo"> 140 mm Hg. le / kapa khatello ea "diast" tlase "> 90 mm Hg Mona lentsoe la sehlooho ke "ts'oarellang". Phekolo ea methapo ea methapo e ke ke ea fumaneha ho latela mohato o le mong oa khatello. Litekanyo tse joalo li lokela ho etsoa bonyane 3-4 ka matsatsi a fapaneng, 'me nako le nako ha khatello ea mali e eketseha. Haeba o ntse o fumaneha hore o na le khatello ea mali ea methapo, ho tla hlokahala hore u noe lipilisi bakeng sa khatello.

Ka lilemo tse ngata, ho loants'a khatello ea mali ntle le katleho?

Hlooho ea Setsi: “U tla makala hore na ho bonolo hakae ho phekola khatello ea mali ka ho e sebelisa letsatsi le leng le le leng.

Tsena ke lithethefatsi tse fokotsang khatello ea mali le ho imolla matšoao - hlooho, ho fofa pela mahlo, nko, joalo-joalo.

• 
  Lefu la pelo
• 
  Myocardial infarction
• 
  Ho nyekeloa ke pelo
• 
  Lefu la tsoekere

Ho pakoa hore lipilisi tsa khatello, tse kenyellelitsoeng litlelaseng tse 5 tse kholo, li ntlafatsa haholo phello ea methapo ea pelo le ea renal. Ts'ebetsong, sena se bolela hore ho nka moriana ho fana ka tieho ea lilemo tse 'maloa ho nts'etsopele ea mathata. Tšusumetso e joalo e ka etsahala feela haeba bakuli ba nang le khatello ea mali ba nka lipilisi tsa bona khafetsa (letsatsi le leng le le leng), leha ho se letho le bohloko le bophelo bo botle ba bona. Ke lihlopha life tse 5 tsa sehlooho tsa lithethefatsi tse amanang le khatello ea mali - tse hlalositsoeng ka tlase.
Ho bohlokoa ho tseba ka meriana bakeng sa khatello ea mali:

1. Haeba khatello ea "holimo" ea systolic ke> 160 mmHg, joale o lokela ho qala hang hang ho sebelisa meriana e le 'ngoe kapa ho feta ho e theola.Hobane ka khatello e phahameng joalo, ho na le kotsi e kholo haholo ea ho hlaseloa ke pelo, ho otloa, mathata a liphio le mahlo.
2. Ho sireletsehile ho feta kapa ka tlase ho nkoa e le khatello ea 140/90 kapa tlase, le ho bakuli ba nang le lefu la tsoekere 130/85 kapa tlase. Ho fokotsa khatello ea boemo bona, hangata ha ua lokela ho nka sethethefatsi se le seng, empa tse 'maloa ka nako e le ngoe.
3. Ho bonolo haholo hore u se ke ua nka matlapa a 2-3 bakeng sa khatello, empa e le 'ngoe feela, e nang le lintho tse 2-3 tse sebetsang. Ngaka e ntle ke e utloisisang sena mme e leka ho fana ka lipilisi tsa ho kopanya, eseng ka bonngoe.
4. Phekolo ea khatello ea mali e lokela ho qala ka lithethefatsi tse le 'ngoe kapa tse ngata ho tekanyetso e nyane. Haeba kamora matsatsi a 10-14 ho fetoha hore ha e thusa ho lekana, ho molemo hore u se ke ua eketsa litekanyetso, empa ho eketsa lithethefatsi tse ling. Ho nka lipilisi tsa khatello maemong a phahameng haholo ke pheletso e shoeleng. Ithute sengoloa "Lisosa tsa khatello ea mali le ka mokhoa oa ho li felisa". Latela litlhahiso tse hlalositsoeng ho eona, mme o se ke oa imolla khatello ka matlapa.
5. Ho eletsoa hore u phekoloe ka lipilisi tsa khatello, tse lekaneng ho nka nako e le 1 ka letsatsi. Bongata ba lithethefatsi tsa sejoale-joale ke tsona. Ba bitsoa meriana e nkang nako e telele ea khatello ea mali.
6. Litlhare tse fokotsang khatello li lelefatsa bophelo le ho batho ba baholo ba 80 le ho feta. Sena se pakahatsoa ke litholoana tsa lithuto tse telele tsa machaba tse kenyelletsang bakuli ba likete ba nang le khatello ea mali. Lipilisi tsa khatello ha li hlile li baka 'dementia ea pelo, kapa hona ho thibela kholo ea tsona. Ho feta moo, ho bohlokoa ho nka meriana bakeng sa khatello ea mali o lilemong tse mahareng e le hore ho hlaseloa ke lefu la pelo kapa ho otla ka tšohanyetso ho se ke ha etsahala.
7. Moriana oa khatello ea mali o lokela ho nooa kamehla, letsatsi le leng le le leng. Ha hoa lumelloa ho nka likhefu tse sa lumelloang. Nka lipilisi tsa antihypertensive tseo u li laetsoeng, esita le ka matsatsi ao u ikutloang u le betere 'me khatello e le ntho e tloaelehileng.

Khemisi e rekisa ho fihla ho mefuta e makholo e fapaneng ea lipilisi tsa khatello. Li arotsoe ka lihlopha tse kholo, ho latela sebopeho sa tsona sa lik'hemik'hale le 'mele oa hae. Sehlopha se seng le se seng sa lithethefatsi bakeng sa khatello ea mali se na le litšobotsi tsa sona. Ho khetha hore na o tla fuoa lipilisi life, ngaka e hlahloba tlhahlobo ea mokuli, hammoho le ho ba teng ha mafu a kopaneng, ntle le khatello e phahameng ea mali. Kamora moo, o etsa qeto ka boikarabello: hore na ke moriana ofe oa khatello ea mali le hore na o lokela ho sebelisa meriana efe. Ngaka e boetse e nahanela lilemo tsa mokuli. Bala sengoloa se reng, "Ke meriana efe e fuoang batho ba holileng."

Babali ba rona ba sebelisitse ReCardio ka katleho ho phekola khatello ea mali. Ha re bona sehlahisoa sena se tsebahala, re nkile qeto ea ho e ela hloko.

Lipapatso hangata li ts'episa hore bophelo ba hau bo tla fetoha "sweetie" hang hang ha u qala ho sebelisa sena kapa sethethefatsi se secha sa hypotensive (se fokotsang khatello ea mali). Empa ha e le hantle, tsohle li bonolo haholo. Hobane litlhare tsohle tsa "lik'hemik'hale" tsa khatello ea mali li na le litlamorao, tse matla kapa li fokolang. Ke livithamini le liminerale tsa tlhaho tse tloaelehileng tse tsamaisang khatello ea mali tse ka ithorisang ka lebaka la ho haella ha litlamorao.

Keketso e netefatsang le e theko e tlase ea ho fokotsa khatello:

• Magnesium + Vitamin B6 ho tsoa ho Source Naturals,
• Taurine ea Jarrow Foromo,
• Oli ea Litlhapi tse tsoang Hona Joale Lijo.

Bala haholoanyane ka mokhoa o teng sehloohong se reng "Phekolo ea khatello ea mali ntle le lithethefatsi." Mokhoa oa ho odara litlatsetso tsa khatello ea mali ho tsoa USA - litaelo tsa download. Khutlisa khatello ea hau ntle le litlamorao tse mpe tse bakoang ke lipilisi tsa "lik'hemik'hale". Ntlafatsa ts'ebetso ea pelo. Khutsa, tlosa matšoenyeho, robala bosiu joalo ka ngoana. Magnesium e nang le vithamine B6 e sebetsa e hlollang. U tla ba le bophelo bo botle, mohono oa lithaka.

Ka tlase re tla tšohla ka botlalo hore na ke lihlopha life tsa lithethefatsi tsa khatello ea mali tse teng le moo bakuli ba tsoang sehlopheng se le seng kapa se seng ba laetsoeng. Kamora moo, o tla khona ho bala lingoliloeng tse qaqileng tse mabapi le lipilisi tse ikhethang tseo u li ratang. Uena le ngaka ea hau u ka etsa qeto ea hore ho molemo ho fetola moriana oa antihypertensive (o fokotse khatello ea mali), i.e. qala ho sebelisa lithethefatsi tsa sehlopha se fapaneng. Haeba u rata ho botsa potso ena, lithethefatsi tsa khatello e matla ea mali, u ka botsa ngaka e nang le lipotso tse ntle. Leha ho le joalo, haeba u tseba lingaka hantle, le hore na ke hobane'ng ha u li laetsoe, ho tla ba bonolo hore u li noe.

Matšoao a ho hlahisa meriana bakeng sa khatello ea mali

Ngaka e beha moriana oa phekolo ea khatello ea mali ho mokuli haeba kotsi ea mathata e feta menyetla ea litlamorao:

• Khatello ea mali> 160/100 mm. Hg. Art.
• Khatello ea mali> 140/90 limilimithara. Hg. Art. + mokuli o na le mabaka a 3 kapa ho feta a menyetla bakeng sa mathata a khatello ea mali,
• Khatello ea mali> 130/85 limilimithara. Hg. Art. + lefu la tsoekere kapa lefu la mokokotlo kapa lefu la pelo, kapa ho se sebetse hantle ke bohloko ba mokokotlo kapa lefu le sa foleng la morao-rao.

• Lithethefatsi tsa diuretic (diuretics),
• Beta blockers
• Lithane tsa calcium
• Vasodilators,
• Inhibitors ea angiotensin-1-e fetolang enzyme (ACE inhibitor),
• Angiotensin II receptor blockers (sartans).

Ha u fana ka moriana oa phekolo ea khatello ea mali ho mokuli, ngaka e lokela ho khetha litlhare tsa lihlopha tse thathamisitsoeng lengolong lena. Lipilisi tsa khatello ea mali tse tsoang lihlopheng tsena ha li fetole khatello ea mali feela, empa li fokotsa le ho shoa ha bakuli ka bongata, ho thibela nts'etsopele ea mathata. E 'ngoe le e' ngoe ea lihlopha tsa lipilisi tse nang le khatello e tlase ea mali li na le mokhoa oa eona oa ts'ebetso, matšoao a eona, li-contraindication le litla-morao.

Tse latelang ke likhothaletso tsa ho beha lithethefatsi bakeng sa khatello ea mali ea lihlopha tse fapaneng, ho latela boemo bo ikhethileng ba bakuli:

Lihlopha tsa lithethefatsi bakeng sa khatello ea mali

MatšoaoDiureticsBeta blockersLi-inhibitors tsa ACEAngiotensin II receptor blockersLikhohlano tsa calcium Ho nyekeloa ke peloHo joaloHo joaloHo joaloHo joalo Myocardial InfarctionHo joaloHo joalo Lefu la tsoekereHo joaloHo joaloHo joaloHo joaloHo joalo Lefu le sa foleng la menoHo joaloHo joalo Thibelo ea StrokeHo joaloHo joalo

Litlhahiso tsa Mokhatlo oa Europe oa Cardiology:

Phekolo ea khatello ea mali

Diuretics (diuretics)Ho hloleha ha pelo ho matla

• Thiazide diuretics

• Boloetse
• Lefu la pelo
• Moko oa Afrika

• Liopture tsa Loop

• Ho hloleha hape
• Ho hloleha ha pelo ho matla

• Lingaka tsa Aldosterone

• Ho hloleha ha pelo ho matla
• Myocardial Infarction

Beta blockers

• Angina pectoris
• Myocardial Infarction
• Ho hloleha ha pelo ho matla (ka khetho ea motho ka mong tekanyetso e sebetsang)
• Boimana
• Tachycardia
• Arrhythmia

Lithala tsa calcium calciumBoloetse

• Dihydroperidine

• Lefu la pelo
• Angina pectoris
• Lefu la methapo ea methapo
• Carotid Atherosclerosis
• Boimana

• Verapamil, Diltiazem

• Angina pectoris
• Carotid Atherosclerosis
• Cardiac Supraventricular Tachycardia

Li-inhibitors tsa ACE

• Ho hloleha ha pelo ho matla
• Ts'ebetso ea "ventricular" e sa sebetseng hantle
• Myocardial Infarction
• Nephropathy ea Nondiabetic
• Nephropathy ea lefu la tsoekere la mofuta oa 1
• Proteinuria (ho ba le protheine ka har'a moroto)

Angiotensin II receptor blockers

• Nephropathy ea lefu la tsoekere la Mofuta oa 2
• Diabetesic microalbuminuria (albin e fumanoe ka moroto)
• Proteinuria (ho ba le protheine ka har'a moroto)
• Hypertrophy ea letsoho le letšehali
• Ho khohlela ka mor'a ho nka li-inhibitors tsa ACE

Li-blocker tsa Alpha

• Benign Prostatic hyperplasia
• Hyperlipidemia (mathata a k'holeseterole ea mali)

Lintlha tse ling tseo u ka li nahanang ha u khetha moriana oa khatello ea mali:

Lihlopha tsa lithethefatsi bakeng sa khatello ea mali

Thiazide diureticsOsteoporosisBeta blockers

• Thyrotooticosis (lithuto tse khutšoane)
• Migraine
• Ho thothomela hoa bohlokoa
• Phekolo ea khatello ea kelello ea postoperative

Likhohlano tsa calcium

• Syndrome ea Raynaud
• Morethetho o mong oa pelo

Li-blocker tsa AlphaProstatic hypertrophyThiazide diuretics

• Gout
• Hyponatremia e matla

Beta blockers

• Bosholu ba bronchial
• Maloetse a kotsi a pulmonary
• Atrioventricular block II - degree ea III

Li-inhibitors tsa ACE le li-angiotensin II receptor blockersBoimana

Khetho ea lithethefatsi bakeng sa khatello ea mali maemong a mang a kopane (Litlhahiso tsa 2013)

Hypertrophy ea letsoho le letšehaliLi-inhibitors, li-calcium antagonists, sartans Asymptomatic atherosulinosisLi-antagonists tsa calcium, li-inhibitors tsa ACE Microalbuminuria (ho na le protheine ka har'a moroto, empa eseng haholo)Li-inhibitors tsa ACE, sartans Ts'ebetso e fokotsitsoeng ea renal, leha ho le joalo e se na matšoao a ho hloleha ha liphioLi-inhibitors tsa ACE, sartans StrokeLithethefatsi life kapa life ho fokotsa khatello ea mali ho litekanyetso tse bolokehileng Myocardial InfarctionBeta-blockers, ACE inhibitors, sartans Angina pectorisBeta-blockers, bahanyetsi ba calcium Ho nyekeloa ke pelo ho sa felengDiuretics, beta blockers, sartans, antagonists ea calcium Aortic aneurysmBeta blockers Fibrillation ea Atrial (ho thibela li-episode)Sartans, ACE inhibitors, beta-blockers, bahanyetsi ba aldosterone Fibrillation ea Atrial (ho laola sekhahla sa ventricular)Beta-blockers, bao e seng dihydropyridine calcium antagonists Liprotheine tse ngata ka har'a moroto (feta proteinuria), lefu la lipeo tsa methapo ea methapo (dialysis)Li-inhibitors tsa ACE, sartans Tšenyo ea methapo ea methapo ea kutlo (lijana tsa maoto)Li-inhibitors tsa ACE, bahanyetsi ba calcium Isolated systolic hypertension ho batho ba tsofetsengLithethefatsi tsa diuretic, bahanyetsi ba calcium Metabolic syndromeLi-inhibitors, li-calcium antagonists, sartans Lefu la tsoekereLi-inhibitors tsa ACE, sartans BoimanaMethyldopa, beta-blockers, bahanyetsi ba calcium

• Sartans ke li-blockers tsa angiotensin-II tse bitsoang li-antixtensin-II receptor antagonists,
• Likhohlano tsa calcium calcium - hape li bitsoang li-blockchain tsa calcium,
• Lihanyetsi tsa Aldosterone - lithethefatsi tsa spironolactone kapa eplerenone.

• Mokhoa o motle oa ho phekola khatello ea mali (o potlakile, o bonolo, o phetse hantle, ntle le "lithethefatsi" tsa "lik'hemik'hale" le litlatsetso tsa ho ja)
• Hypertension ke tsela e tloaelehileng ea ho hlaphoheloa ho eona mohatong oa 1 le 2
• Lisosa tsa khatello ea mali le mokhoa oa ho li felisa. Liteko tsa khatello ea mali
• Phekolo e sebetsang ea khatello ea mali ntle le lithethefatsi

Meriana ea diuretic bakeng sa khatello ea mali

Ho likhothaletso tsa 2014, diuretics (diuretics) li boloka boemo ba tsona e le e 'ngoe ea lihlopha tsa lithethefatsi tse amanang le khatello ea mali. Hobane li theko e tlaase ebile li ntlafatsa phello ea lipilisi tse ling ha li hatelloa. Hypertension e bitsoa malignant, e matla kapa e phehella ha feela e sa arabele ketsong ea motsoako oa lithethefatsi tse 2-3. Ho feta moo, e 'ngoe ea lithethefatsi tsena e tlameha ho ba diuretic.

Hangata, diuretic e laeloa khatello ea mali, indapamide, hammoho le hydrochlorothiazide ea khale (aka dichlothiazide le hypothiazide). Baetsi ba thepa ba leka ho qobella indapamide hore e lahle hydrochlorothiazide 'marakeng, e sebelisitsoeng lilemo tse ka bang 50. Ho etsa sena, phatlalatsa lingoliloeng tse ngata limakasineng tsa bongaka. Indapamide ha ho lumeloe ho ba le phello e mpe ho metabolism. Ho pakiloe hore e fokotsa kotsi ea ho tšoaroa ke lefu la pelo le ho otloa ke bakuli ba nang le khatello ea mali.Empa e fokotsa khatello ha e sa feta hydrochlorothiazide ka tekanyetso e nyane mme mohlomong ha e betere haholo ho fokotsa kotsi ea mathata a khatello ea mali. 'Me ho hloka chelete e ngata haholo.

Spironolactone le eplerenone ke lithethefatsi tse khethehileng tsa diuretic, lihanyetsi tsa aldosterone. Li ngoletsoe khatello ea mali e matla (e hanyetsang) joalo ka moriana oa 4, haeba motsoako oa lithethefatsi tse 3 o sa thusa ka ho lekana. Taba ea pele, bakuli ba nang le khatello e matla ea mali ba fuoe "renin-angiotensin system blocker +" e tloaelehileng "diuretic + calcium Channel blocker." Haeba khatello e sa fokotsehe ka ho lekaneng, joale spironolactone kapa eplerenone e ncha e eketsoa, ​​e nang le litlamorao tse fokolang. Contraindication bakeng sa ho khethoa ha li-aldosterone antagonists ke boemo bo eketsehang ba potasiamo maling (hyperkalemia) kapa sekhahla sa litsobotsi tsa glomerular tsa liphio ka tlase ho 30-60 ml / min. Ho 10% ea bakuli, khatello ea maikutlo e etsahala ka lebaka la hyperaldosteronism ea mantlha. Haeba litlhahlobo li tiisa hyperaldosteronism ea mantlha, ka nako eo mokuli o fuoa spironolactone kapa eplerenone ka boeona.

• Diuretics (diuretics) - tlhaiso-leseling ka kakaretso,
• Dichlothiazide (hydrodiuryl, hydrochlorothiazide),
• Indapamide (Arifon, Indap),
• Furosemide (Lasix),
• Veroshpiron (Spironolactone),

Li-inhibitors tsa ACE

Ho entsoe lithuto tse ngata tse boima, 'me liphetho tsa tsona li bonts'a hore li-inhibitors tsa ACE tse amanang le khatello ea mali li fokotsa kotsi ea ho tšoaroa ke pelo le ho otloa ke mali, ho sireletsa methapo ea mali le liphio. Lithethefatsi tsena li laetsoe haholo bakuli ba nang le khatello e phahameng ea mali ka lebaka la lefu la pelo le bohloko kapa le sa foleng la pelo, ho nyekeloa ke pelo, lefu la tsoekere, le lefu la liphio le sa foleng.

Moriana oa khatello ea mali o batlile o hlokahala haholo, o nang le metsoako e 'meli e sebetsang ka har'a tafole e le' ngoe. Hangata hona ke motsoako oa inhibitor ea ACE e nang le diuretic kapa calcium antagonist. Ka bomalimabe, batho ba 10% ba nkang li-ACE inhibitors ba ntšoa ke sefuba se ommeng se sa feleng. Sena se nkoa e le litlamorao tse tloaelehileng tsa sehlopha sena sa lithethefatsi. Haeba bakuli ba bala ho fokolang ka sena, ho koala ha bona ho ka fokola khafetsa. Maemong a joalo, li-inhibitors tsa ACE li nkeloa sebaka ke li-sartane, tse nang le phello e ts'oanang, empa li sa bake ho khohlela.

• Li-inhibitors tsa ACE - tlhaiso-leseling ka kakaretso
• Captopril (Capoten)
• Enalapril (Renitec, Burlipril, Enap)
• Lisinopril (Diroton, Irume)
• Perindopril (Prestarium, Perineva)
• Fosinopril (Monopril, Fosicard)

Angiotensin II receptor blockers (sartans)

Ho tloha qalong ea lilemo tsa 2000, matšoao a ts'ebeliso ea li-blockers tsa angiotensin-II a atolositse haholo, ho kenyelletsa le maemong a khatello ea mali e le moriana oa khetho ea pele. Lithethefatsi tsena li mamelletsoe hantle. Ha li bake litla-morao joalo khafetsa. Ho lumeloa hore ka khatello ea mali e ngata ba fokotsa kotsi ea ho tšoaroa ke lefu la pelo le ho otloa, ho sireletsa methapo ea mali, liphio le litho tse ling tsa kahare tse mpe ho feta li-inhibitors tsa ACE.

Mohlomong sartans ke khetho e ratoang haholo ho feta li-ACE inhibitors tsa khatello ea mali e sa rarahanang, hammoho le ho bakuli ba nang le lefu la tsoekere la mofuta oa 2 moo ho nang le lefu la tsoekere le lefu la tsoekere. Le ha ho le joalo, li fanoa haeba mokuli a baka ho khohlela ho sa rateheng ho tloha ho nkeng ACE inhibitor. Bothata feela ke hore li-blockers tsa angiotensin-II li ntse li sa utloisisehe hantle. Ho entsoe lipatlisiso tse ngata ho tsona, empa li ntse li le tlase ho feta ho li-inhibitors tsa ACE.

Ho khatello ea mali, li-blockers tsa angiotensin-II li sebelisoa haholo matlapeng a nang le metsoako e 2 kapa e 3 e sebetsang. Motsoako o tloaelehileng: sartan + thiazide diuretic + calcium Channel blocker. Angiotensin-II antagonists e ka kopanngoa le amlodipine, hammoho le ACE inhibitor. Motsoako ona o thusa ho fokotsa ho ruruha ha leoto ho bakuli.

Hypertension angiotensin-II receptor blockers le tsona li laetsoe maemong a latelang:

• lefu la pelo
• pelo e sa foleng
• mofuta oa lefu la tsoekere
• thaepa 1 lefu la tsoekere, ho sa tsotelehe hore na mathata a liphio a se a tsoetse pele.

Li-Sartans ha li e-so fuoe litlhare tsa khetho ea pele, empa haholo-holo bakeng sa mamello ho li-inhibitors tsa ACE. Sena ha se bakoe ke taba ea hore bahanyetsi ba li-receptor ba angiotensin-II ba sebetsa ba fokola, empa ke taba ea hore ha ba sa utloisisoa hantle.

• Angiotensin II Receptor blockers - Kakaretso
• Losartan (Lorista, Cozaar, Lozap)
• Aprovel (Irbesartan)
• Mikardis (Telmisartan)
• Valsartan (Diovan, Valz, Valsacor)
• Teveten (Eprosartan)
• Mokhanni (Atacand, Candecor)

Mekhoa ea phekolo ea khatello ea methapo ea methapo ea bobeli

Mekhoa ea phekolo ea methapo ea methapo ea methapo ea kutlo, joalo ka molao, khatello ea mali e tlaase ha e mpe ho feta lithethefatsi tse tsoang lihlopheng tse 5 tse ka sehloohong, tseo re ithutileng tsona ka holimo. Hobaneng lithethefatsi tse li na le likarolo tse thusang? Hobane li na le litla-morao tse matla kapa li sa utloisisoe hantle, ho bile le lipatlisiso tse fokolang ho bona. Moriana oa khatello ea methapo ea methapo ea kutlo o laetsoe ho kenyelletsa pilisi e ka sehloohong.

Haeba mokuli a e-na le lefu la methapo ea mali ea senya ea senya, ngaka e tla mo fa alpha-1-blocker. Methyldopa (dopegy) ke lithethefatsi tsa khetho bakeng sa ho laola khatello e phahameng ea mali nakong ea kemolo. Moxonidine (physiotens) e tlatselletsa kalafo e kopaneng ea khatello ea mali ho batho ba nang le lefu la tsoekere la mofuta oa 2, lefu la metabolic, hape le ha ts'ebetso ea liphio e fokotsehile.

Clonidine (Clonidine) ka matla e theola khatello ea mali ka matla, empa e na le litlamorao tse mpe - molomo o omeletseng, mokhathala, ho otsela. Se ke oa phekoloa bakeng sa khatello ea mali le clonidine! Setlhare sena se baka khatello e kholo khatello ea mali, rollercoaster e kotsi methapong ea mali. Ka kalafo e nang le clonidine, ho nyekeloa ke pelo, ho otloa ke lefu la sethoathoa kapa ho holofala ho tla etsahala kapele haholo.

Aliskren (rasylosis) ke inhibitor e tobileng ea renin, e leng e 'ngoe ea lithethefatsi tse ncha. Hajoale e sebelisoa ho phekola khatello ea mali e sa rarahanang. Ha ho kgothaletswe ho kopanya li-racilesis le li-inhibitors tsa ACE kapa li-angiotensin-II receptor blockers.

• Methyldopa (Dopegit)
• Clonidine (Clonidine)
• Physiotens (Moxonidine)
• Coenzyme Q10 (Kudesan)

Na ho na le molemo hore mokuli a qete nako ea hae ho utloisisa hantle hore na lipilisi tse fapaneng li fapana joang le khatello ea mali? Ehlile, ee! Ha e le hantle, ho latela hore na li-hypertonics tse ngata li tla phela lilemo tse kae le hore na lilemo tse "boleng" li tla ba joang. Haeba o fetohela bophelong bo phetseng hantle 'me u khetha meriana e nepahetseng, ho ka etsahala hore ho qojoe mathata a bolaeang a khatello ea mali. Ntle le moo, ho hlaseloa ke lefu la pelo ka tšohanyetso, ho otloa kapa ho se sebetse hantle ha meno ho ka fetola motho ea mahlahahlaha hore e be ea fokolang ea sa sebetseng. Bo-ramahlale ba hlahloba ka mabifi lihlopha tse ncha le tse tsoetseng pele tsa lithethefatsi bakeng sa khatello ea mali, tse tla thusa ho fokotsa khafetsa ea mathata.

• Phekolo e sebetsang ea khatello ea mali ntle le lithethefatsi
• Mokhoa oa ho khetha pheko ea khatello ea mali: melao-motheo e akaretsang
• Mokhoa oa ho nka meriana ea khatello ea mali ho motho ea tsofetseng