Cutar amai da gudawa cuta cuta ce wacce take lalacewar tasoshin koda, sanadin cutar sankarau. A wannan yanayin, ana sauya tasoshin don canzawa ta hanyar kayan haɗin haɗin kai, wanda ke tattare da sclerosis da abin da ya faru na gazawar koda.
Sanadin kamuwa da cutar sankara mai rashin lafiya
Ciwon sukari mellitus shine rukuni na cututtukan cututtukan da suka bayyana sakamakon cin zarafin kirkirar ko aikin insulin na hormone. Duk waɗannan cututtukan suna haɗuwa da ci gaba a cikin glucose jini. A wannan yanayin, ana rarrabe nau'ikan kamuwa da guda biyu:
- insulin-dogara (nau'in ciwon sukari mellitus na sukari;
- mara amfani da insulin (nau'in ciwon sukari na II).
Idan tasoshin da ƙwayar jijiya suna fuskantar tsawon lokaci na bayyanuwa ga manyan sukari, kuma glucose na al'ada yana da mahimmanci a nan, in ba haka ba canje-canje na cututtukan kwayoyin halitta waɗanda ke rikitarwa na ciwon sukari suna faruwa a cikin jiki.
Ofaya daga cikin waɗannan rikice-rikice shine cutar zazzabin cizon sauro. Mutuwar marasa lafiya daga lalacewar koda a cikin wata cuta kamar nau'in ciwon sukari na mellitus ya fara faruwa. A cikin nau'in ciwon sukari na II, babban matsayi a cikin adadin kisa yana kasancewa ne ta hanyar cututtukan da ke da alaƙa da tsarin zuciya, kuma gazawar koda yana bin su.
A cikin ci gaban nephropathy, muhimmin matsayi ana taka shi ta hanyar haɓaka glucose na jini. Baya ga gaskiyar cewa glucose yana aiki akan sel na jijiyoyin jiki azaman mai guba, hakanan yana kunna hanyoyin da suke haifar da rushe ganuwar bututun jini kuma yana sa su zama cikakke.
Rashin cututtukan jijiyoyin jini a cikin ciwon sukari
Haɓaka bugun jini nephropathy yana ba da gudummawa ga haɓakar matsin lamba a cikin tasoshin koda. Zai iya tashi saboda rashin daidaitaccen tsari a cikin lalacewar tsarin juyayi wanda ya haifar da ciwon sukari mellitus (neuropathy na ciwon sukari).
A ƙarshe, kyallen takarda ta ɓoye a wurin da jiragen ruwan da suka lalace, wanda ke haifar da rikicewar kodan.
Alamun cutar sankarau
Cutar na tasowa a matakai da yawa:
Ina mataki An bayyana shi cikin hauhawar kodan, kuma yana faruwa a farkon ciwon sukari, yana da alamomin kansa. Cellswayoyin jiragen ruwa na haɓaka suna ƙaruwa kaɗan, adadin fitsari da kuma ajiyar sa yana ƙaruwa. A wannan lokacin, furotin a cikin fitsari ba'a riga an ƙaddara shi ba. Babu alamun bayyanar waje.
Mataki na II halin farkon farkon tsarin canje-canje:
- Bayan an gano mara lafiyar yana dauke da cutar siga, kusan shekaru biyu daga baya wannan matakin ya bayyana.
- Daga wannan lokacin, ganuwar tasoshin kodan sun fara yin kauri.
- Kamar yadda ya gabata, ba a gano furotin da ke cikin fitsari ba kuma aikin aikin kodan baya lalacewa.
- Har yanzu ba a gano alamun cutar ba.
Mataki na III - Wannan farkon ne mai ciwon sukari nephropathy. Yana faruwa, a matsayin mai mulkin, shekaru biyar bayan ganowar mai haƙuri da ciwon sukari. Yawancin lokaci, yayin aiwatar da binciken wasu cututtuka ko yayin gudanar da bincike na yau da kullun, ana samun ƙananan furotin (daga 30 zuwa 300 mg / rana) a cikin fitsari. Ana kiran irin wannan yanayin a matsayin microalbuminuria. Gaskiya cewa furotin ya bayyana a cikin fitsari yana nuna mummunan lalacewar tasoshin kodan.
- A wannan matakin, ƙirar ƙirar ƙasa tana canzawa.
- Wannan manuniya yana ƙayyade matakin tace ruwa da abubuwa masu ƙarancin nauyi wanda ya ratsa ta matattar ƙungiyar.
- A matakin farko na cutar sankara, wannan mai nuna alama na iya zama al'ada ko dan ƙarami.
- Alamun waje da alamun cutar ba ta nan.
Matakai uku na farko ana kiransu daidaituwa, tunda babu masu kararrakin marasa lafiya, kuma canje canje a cikin kodan ana tantance kawai ta hanyoyin dakin gwaje-gwaje. Koyaya, yana da matukar muhimmanci a gano cutar a matakai ukun farko. A wannan gaba, har yanzu yana yiwuwa a gyara yanayin kuma a sake kawar da cutar.
Mataki na IV - Yana faruwa shekaru 10-15 bayan an gano mai haƙuri da cutar sukari mellitus.
- Wannan wata bayyanuwa ne cutar cututtukan ƙwayar cuta mai narkewa, wadda ke tattare da bayyanannun bayyanannun bayyanar cututtuka.
- Wannan yanayin ana kiranta proteinuria.
- A cikin fitsari, an gano babban adadin furotin, maida hankali a cikin jini, akasin haka, yana raguwa.
- Observedarfin kumburin jiki yana lura.
Idan proteinuria karami ne, to kafafu da fuska suna kumbura. Yayinda cutar ta ci gaba, edema ta yaɗu cikin jiki. Lokacin da canje-canje na cututtukan ƙwayoyin cuta a cikin ƙodan suka ɗauki halin da ake faɗi, yin amfani da diuretics zai zama babu amfani, tunda ba su taimaka. A cikin irin wannan yanayi, an nuna cirewar tiyata daga cikin rami (hujin ciki).
Don kiyaye daidaituwar furotin a cikin jini, jiki yakan rushe nasa protein. Marasa lafiya suna fara rasa nauyi sosai. Sauran alamu sun hada da:
- ƙishirwa
- tashin zuciya
- nutsuwa
- asarar ci
- gajiya.
Kusan koyaushe a wannan matakin akwai karuwa a cikin karfin jini, yawanci lambobin sa suna da yawa sosai, saboda haka gazawar numfashi, ciwon kai, zafi a zuciya.
Mataki na V ana kiranta mataki na ƙare na rashin aiki koda kuma shine ƙarshen cutar sankarar mahaifa. Cikakken ƙwayar cuta na jijiyoyin koda na faruwa, ta daina cika aikin.
Bayyanar cututtukan da suka gabata an kiyaye su, kawai a nan ne kawai suka haifar da barazanar rayuwa. Kadai ne kawai, ciwon koda, ko juyawar koda, ko ma wani hadaddun, ƙwanƙwashin koda, zai iya taimakawa a wannan lokacin.
Hanyoyin zamani don bayyanar cututtuka na cututtukan cututtukan cututtukan zuciya
Gwajin gabaɗaya ba ya ba da bayani game da ainihin matakan cutar. Sabili da haka, ga marasa lafiya da masu ciwon sukari akwai wani bincike na musamman na fitsari.
Idan matakan albumin sun kasance a cikin kewayon 30 zuwa 300 mg / rana, muna magana ne game da microalbuminuria, kuma wannan yana nuna ci gaban cututtukan cututtukan zuciya da ke cikin jiki. Yawan haɓakawa cikin ƙirar fillo ko ƙwaya na nuna cewa cutar zazzabin cizon sauro.
Haɓaka hauhawar jijiyoyin jini, haɓaka mai yawa a cikin adadin furotin a cikin fitsari, gazawar gani da gani da kuma raguwar raguwar yawan tacewar duniya sune alamomin da ke nuna yanayin asibiti wanda cutar sankarau ke kamuwa da ita. Adadin filter na glomerular ya ragu zuwa matakin 10 ml / min da ƙasa.
Cutar masu fama da cutar sankara, magani
Dukkanin hanyoyin da suka danganci jiyyar wannan cuta sun kasu kashi uku.
Yin rigakafin canje-canje na cututtukan jini a cikin tasoshin na koda a cikin ciwon sukari mellitus. Ya ƙunshi kiyaye matakin sukari a cikin jini a matakin da ya dace. Don wannan, ana amfani da magungunan da ke rage sukari.
Idan microalbuminuria ya kasance, to, ban da kula da matakan sukari, an wajabta mai haƙuri don hauhawar jini. Angiotensin mai canza enzyme inhibitors an nuna anan. Zai iya zama enalapril a kananan allurai. Bugu da kari, mai haƙuri dole ne ya bi abinci na musamman na furotin.
Tare da furotinurur, a farkon wuri shine rigakafin raguwar hanzari a cikin aikin kodan da kuma hana lalacewa ta ƙarancin ƙarancin ma'amala. Abincin yana da matukar ƙuntatawa ga abubuwan gina jiki a cikin abincin: 0.7-0.8 g da 1 kg na nauyin jiki. Idan matakin sunadarai ya yi kasa sosai, jiki zai fara rushe abubuwan jikin nasa.
Don hana wannan halin, ana wajabta maganin ketone na amino acid ga mai haƙuri. Kasancewa masu dacewa shine kula da matakin da ya dace na glucose a cikin jini da rage hawan jini. Bugu da ƙari ga masu hana ACE, an wajabta amlodipine, wanda ke toshe tashoshi na alli da bisoprolol, beta-blocker.
Anyi maganin diuretics (indapamide, furosemide) idan mai haƙuri yana da edema. Bugu da kari, ƙuntata yawan shan ruwa (1000 ml a kowace rana), kodayake, idan akwai ciwon insipidus na ciwon sukari, lallai ne sai a duba ƙwayoyin cutar ta hanyar wannan cutar.
Idan adadin filtular duniya ya ragu zuwa 10 ml / min kuma a ƙasa, an wajabta mai haƙuri sauyawa magani (peritoneal dialysis da hemodialysis) ko ƙwanƙwaran ƙwayoyin cuta (dasawa).
Fiye da haka, ana kula da yanayin tasirin cutar ta mai fama da cutar sikila ta hanyar jujjuyawar koda. A cikin Amurka, tare da bayyanar cututtuka na cututtukan cututtukan cututtukan cututtukan ƙwayar cuta, wannan hanya ta zama ruwan dare gama gari, amma a cikin ƙasarmu, irin waɗannan jigilar jigilar har yanzu suna kan matakin ci gaba.
