Stenosis na nufin kunkuntar. Stenosis na azabtarwa shine babbar hanyar toshe bakin kogunan jini wadanda suke ciyar da kodan saboda toshewar lamuransu na rashin atherosclerotic. A cikin tsofaffi marasa lafiya da nau'in ciwon sukari na 2, wannan shine ɗayan musabbabin sanadin lalacewar koda. Hakanan yana haifar da hauhawar jini, wanda kusan ba a iya maganin shi.
Ofaukar jini wanda jijiyoyin ƙwayar cuta suna iya wucewa kanta, ƙari, yana samar da isasshen wadatattun ƙwayoyin jikin oxygen. Saboda haka, stenosis na koda na asali na iya haɓaka tsawon lokaci ba tare da wata alama ba. Gunaguni a cikin marasa lafiya ya bayyana, a matsayin mai mulkin, riga lokacin da jijiyoyin bugun jini jijiya 70-80%.
Wanda ke cikin haɗarin cutar sikari koda
A cikin marasa lafiya da ke dauke da nau'in ciwon sukari na 2 na sukari, mafi girma na koda. Saboda sun fara haifar da ciwo na rayuwa, sannan kuma sukarin jininsu yana ci gaba da tashewa. Wadannan rikice-rikice na rayuwa suna haifar da atherosclerosis, i.e., toshe manyan manyan tasoshin da ke kawo zuciya da kwakwalwa. A lokaci guda, lumen da ke cikin jijiyoyin da ke ciyar da ƙodan na narkewa.
A cikin Amurka, an yi nazarin rayuwar marasa lafiya da ke fama da cutar sankara (artal stenosis) na tsawon shekaru 7. Ya juya ga cewa irin waɗannan masu haƙuri suna da haɗarin haɗari na bala'in zuciya. Yayi kusan sau 2 sama da hadarin rashin koda. Haka kuma, sake dawo da tiyata na jijiyoyin zuciya wanda baya rage yiwuwar mutuwa daga bugun zuciya ko bugun zuciya.
Enarfafawar artery na iya zama ɗaya (ɗaya) ko haɗin gwiwa (bilateral). Na biyu - wannan shi ne lokacin da jijiyoyin da ke ciyar da ƙodan biyu suka shafa. -Aya-gefe - lokacin da ikon kula da ɗayan silsila ya lalace, kuma a ɗayan kuma har yanzu al'ada ce. Hakanan za'a iya shafa reshen jijiyoyin koda, amma manyan jiragen ruwa ba su da su.
Atherosclerotic stenosis na koda na koda yana haifar da ischemia na rashin isasshen jini (isasshen isasshen jini) na kodan. Lokacin da kodan suna “fama da yunwa” da “shayarwa,” aikinsu zai ragu. A lokaci guda, haɗarin lalacewa na koda yana ƙaruwa, musamman a hade tare da cututtukan cututtukan cututtukan zuciya.
Bayyanar cututtuka da kuma Ciwon ciki
Abubuwan haɗarin haɗari don ƙwayar ƙwayar ƙwayar ɗan adam daidai suke da na "talakawa" atherosclerosis. Mun lissafa su:
- hawan jini;
- kiba;
- Namiji;
- matakan haɓakawa na fibrinogen a cikin jini;
- tsufa;
- shan taba
- mara kyau cholesterol da jini mai;
- ciwon sukari mellitus.
Ana iya ganin mafi yawan waɗannan abubuwan haɗarin za a iya gyara su idan mai ciwon sukari ya tsunduma cikin lafiyarsa tun yana ƙarami ko tsakiyar. Idan isharar ta ɗaya daga cikin jijiyoyin halittar ƙwayoyin cuta ta haɓaka, to da alama yana ƙaruwa cewa na biyu zai sha wahala.
Likita na iya zargin alamun cutar koda a cikin marassa lafiya da ke dauke da cutar sankara a gaban wadannan alamu da bayanan dalilai:
- Shekarun mai haƙuri ya wuce shekaru 50;
- gazawar renal na ci gaba, a lokaci guda, proteinuria <1 g / day da canje-canje a cikin sharar urinary ba su da yawa;
- matsanancin hauhawar jini - hawan jini yana ƙaruwa sosai, kuma ba shi yiwuwa a rage shi da kwayoyi;
- gaban jijiyoyin jijiyoyin bugun zuciya (cututtukan zuciya da jijiyoyin jini, toshe manyan tasoshin ruwa, hayaniya a cikin tsinkayen jijiya);
- a cikin lura da masu hana ACE - ƙarancin creatinine;
- mara lafiya yana murmushi na dogon lokaci;
- lokacin da likitocin ophthalmologist suka bincika su - hoto ne na sifa akan ɗamarar jikin katuwar Hollenhorst.
Don ganewar asali, za a iya amfani da hanyoyin bincike daban-daban waɗanda ke ba da hoto mai gani game da yanayin jijiyoyin koda. Jerin sunayen sun hada da:
- Duban duban dan tayi (duban dan tayi) na artal;
- Zabi angiography
- Magio resonance maganadisu;
- Labarin tomography (CT);
- Positron watsi tomography (PET);
- Scintigraphy na Captopril.
Wasu daga cikin waɗannan hanyoyin suna buƙatar gabatarwar wakilai masu bambanci a cikin jini, wanda zai iya samun tasirin nephrotoxic, wato cutar da ƙodan. Likita ya tsara masu idan amfanin bayyana gaskiyar cutar ya wuce hadarin da zai yuwu. Gaskiya ne, a cikin lokuta idan aka yi shirin tiyata don dawo da ikon ƙwayoyin jijiyoyin yara.
Jiyya na koda na jijiya stenosis
Cikakken magani na renal artery stenosis na bukatar ci gaba, cikakkiyar ƙoƙari don dakatar da haɓakar tsarin atherosclerotic. Babban nauyin da ke wuyansu ya ta'allaka ne da mai haƙuri da kansa da membobin gidansa. Jerin ayyukan da suka wajaba sun hada da:
- daina shan sigari;
- normalisation na glucose matakan jini;
- rage karfin jini zuwa al'ada;
- idan ya wuce nauyin jiki - asarar nauyi;
- takardar sayen magunguna - maganin cututtukan jini;
- shan kwayoyi daga aji na statins don inganta cholesterol da triglycerides a cikin jini.
Muna ba da shawarar rage cin abinci mai-carbohydrate don nau'in 1 da nau'in ciwon sukari na 2. Wannan ita ce hanya mafi kyau don rage sukarin jininka zuwa al'ada don haka kare kodanku daga ciwon sukari. Abincin low-carbohydrate ba kawai yana rage sukari ba, har ma yana daidaita abubuwan triglycerides, “mai kyau” da kuma “mummunan” cholesterol jini. Saboda haka, kayan aiki ne mai ƙarfi don rage jinkirin atherosclerosis, gami da hana ƙwararrun ƙwayar jijiya stenosis. Ba kamar magungunan statin ba, magani na abinci ba shi da illa. Yankin da ke kan tsarin abincinmu na kodan don ciwon sukari yana da matukar mahimmanci a gare ku.
Stenosis na Renal artery da Magani
Don matsalolin koda na masu ciwon sukari, marasa lafiya galibi ana ba su magunguna daga rukuni na ACE inhibitors ko masu hana masu karɓar angiotensin-II (ARBs). Idan mai haƙuri yana da isasshen ƙwayar jijiya ɗaya ta asali, to, yana da kyau a ci gaba da shan maganin. Kuma idan ƙwaƙƙwarar ƙwayar jijiya ta kasance ta biyun, ACE da ARB inhibitors suna buƙatar sake soke su. Saboda za su iya ba da gudummawa ga ci gaba da ragewar aikin koda.
Magunguna daga aji na statins suna rage matakin "mummunan" cholesterol a cikin jini. Wannan sau da yawa yana ba ku damar kwantar da filayen atherosclerotic a cikin ƙananan ƙwayoyin katako kuma hana su ci gaba. Tare da cututtukan atherosclerotic na cututtukan koda, ana ba da magunguna asfirin. A lokaci guda, amincin da amincin amfanin sa a cikin irin wannan yanayin ba a tabbatar da su ba kuma yana buƙatar ƙarin binciken. Guda ɗaya ke amfani da ƙananan heparins mai nauyin nauyi da kuma masu hana karɓa na glycoprotein.
Alamu don aikin tiyata na sankarar ƙwayar cutar mahaifa (American Heart Association, 2005):
- Hemamnasawu na mahimmancin ƙaya biyu na jijiyoyin jini;
- Halittar artery na koda daya na aiki;
- Rashin daidaituwa tsakanin mutum biyu ko hecondynamically muhimm na kashin kansa, wanda ya haifar da hauhawar jini;
- Rashin katako na wucin gadi da ƙarancin haɗin kai;
- Aka maimaita batun cututtukan huhun ciki tare da isasshen ƙwaƙwalwar ƙwayar cuta;
- Angina mai tsayayye tare da mahimmancin ƙwayar hemodynamically.
Lura Hemodynamics shine motsi jini ta cikin tasoshin. Hemnakis din mai mahimmancin jirgi - wanda ke lalata jini haƙiƙa da gaske. Idan jinyar da aka yiwa kodan ta kasance cikakke duk kuwa da tsauraran ƙwayoyin jijiya, to haɗarin tiyata zai iya wuce amfanin sa.
