Matsi a cikin ciwon sukari mellitus: inji da kuma Sanadin ci gaban Pathology

Hawan jini a cikin cutar sankarau matsala ce da ta zama ruwan dare wanda marasa lafiya ke fuskanta. A cewar kididdigar, an gano hauhawar jini a cikin kashi 60 cikin dari na masu ciwon sukari. Ilimin halin dan Adam yana cutar da jin daɗin rayuwar mutum, yana kara ɓarke ​​da cutar ta sanadi. A waje na tushen hauhawar hawan jini, haɗarin ci gaba da rikice-rikice (bugun jini, bugun zuciya) yana ƙaruwa, sakamakon wanda yake mutuwa ne.

Ga marasa lafiya da ke da nau'in 1, nau'in ciwon sukari na 2, ana ganin matsin lamba ne na al'ada, baya wuce 130/85 mm Hg. Art. Bayyanar hauhawar jini yawanci saboda mummunan raunuka na jijiyoyin jiki a gaban matakan glucose mai ɗorewa. Yi la'akari da rage karfin hawan jini don ciwon sukari.

Pathogenesis, sanadin ƙwayar cuta

A cikin nau'in 1 na ciwon sukari, aikin koda yana da rauni saboda microangiopathy na glomerular (lalacewar ƙananan tasoshin ruwa). Sakamakon haka, ana fitar da furotin tare da fitsari. Wannan yanayin ana kiran shi proteinuria kuma yana tare da haɓaka da hawan jini.

Babban matsin lamba yana sa glomeruli ya mutu a hankali. Nan gaba, gazawar koda ya bayyana. A cikin 10% na lokuta, hauhawar jini ba ta wata hanya da ke da alaƙa da nau'in ciwon sukari na 1 ba, amma cuta ce mai haɗari. Wadannan marasa lafiya suna riƙe aikin na koda.

A cikin marasa lafiya da ke dauke da ciwon sukari na 2, hauhawar jini ya fara a baya fiye da ciwon sukari ko kuma yana da alaƙa da cutar. Raunukan raunuka suna haifar da ci gaban ilimin cututtukan ƙwaƙwalwa a cikin kawai 15-20% na marasa lafiya. A cikin 30-35% na lokuta, matsin lamba ya tashi kafin rikicewar metabolism ya faru.

Pathology yana farawa da haɓakar insulin (rage ƙarancin kyallen takarda zuwa aikin insulin). Don rama don wannan yanayin, insulin ya tashi, wanda ke haifar da karuwa a cikin jini.

A pathogenesis na hauhawar jini:

1. An kunna tsarin juyayi mai juyayi;
2. Hanya na yau da kullun na fitar sodium, ƙwayar cuta ta rikice;
3. Sodium, alli yana tarawa a cikin sel;
4. Ganuwar tasoshin suna da kauri, ba su iyawa da narkewa.

Abubuwan haɗari waɗanda ke haifar da yiwuwar hauhawar jini a nau'in 1 da nau'in ciwon sukari na 2 sune kamar haka:

• Shekarun ci gaba;
• Rashin ƙwayoyin cuta na jiki;
• Makar maye
• Yawan damuwa;
• Atherosclerosis;
• Kiba
• Sauran cututtukan cututtukan tsarin endocrine.

Matsaloli da ka iya yiwuwa

Hawan jini a cikin ciwon sukari na kara yiwuwar rikitarwa masu haɗari sau da yawa:

• Rashin nasara - sau 25;
• Raunin marasa warkarwa, gangrene - sau 20;
• Cutar zuciya - sau 5;
• Stroke - sau 4;
• Sharparfin lalacewa a aikin gani - sau 15.

A cikin masu ciwon sukari da yawa, hawan jini yana rikitarwa ta hanyar maganin orthostatic hypotension. An san ilimin sankara a cikin raguwar hauhawar jini yayin tashin daga matsayi na kwance. Yana bayyana kanta a matsayin mai duhu a idanu, farin ciki, rauni. Sanadin lalacewar jijiyoyin bugun zuciya shine neuropathy mai ciwon sukari.

Symptomatology

Ga mutane da yawa, hauhawar jini ba ya bayyana kansa, a cikin wasu marasa lafiya, haɓakar matsin lamba yana haɗuwa da:

1. Dizziness;
2. Ciwon kai;
3. Rashin gani;
4. Rashin ƙarfi;
5. Gajiya.

Akwai digiri 3 na hauhawar jini a cikin ciwon sukari, wanda alamomi masu biyo baya ke nuna su:

1. Taushi. Babban matsin lamba shine 140-159, ƙananan - 90-99 mm RT. st .;
2. Matsakaici. Hawan jini - 160-179, ƙananan - 100-109 mm RT. st .;
3. Mai nauyi. Matsin lamba ya wuce mai nuna alama 180/110 mm RT. Art.

Don guje wa saurin ci gaba na rikicewar jijiyoyin jiki da rikice-rikice masu biyo baya, marasa lafiya da ciwon sukari ya kamata suyi ƙoƙarin kiyaye matsin lamba a matakin 130/85 mm Hg. Art. Wannan zai tsawaita tsawon shekaru 15-20.

Jiyya

Tare da ƙara matsin lamba, kuna buƙatar tuntuɓi ƙwararre, magani na kai ba shi da karɓuwa. Hanyoyin warkewa sun haɗa da:

• Magungunan magani. Yi amfani da kwayoyi waɗanda ke rage karfin jini. Mafi sau da yawa ana rubuta diuretics, ACE inhibitors, wanda zai iya rage haɗarin lalacewar koda.
• Abincin Jikin mai haƙuri da ciwon sukari yana kula da sodium, sabili da haka, tare da hawan jini, kuna buƙatar rage gishiri a cikin abincin. Sau da yawa wannan ma'aunin yana da sakamako mai kyau.
• Rage nauyi. Wannan zai inganta yanayin gaba ɗaya.
• Yarda da abubuwan yau da kullun, kiyaye ingantaccen tsarin rayuwa. Ayyukan locomotor, wasanni suna da tasirin gaske akan tasoshin jini, rage haɗuwar glucose a cikin jini.

Kwayoyin hauhawar jini

An zaɓi magunguna da allurai domin matsa lamba ya ragu a hankali. Lokaci mafi kyau don cimma ka'idodin shine kusan makonni 8 daga fara shan magungunan. Da sauri saurin hauhawar jini ya zama sanadin lalacewar wurare dabam dabam, lalata ayyukan gabobi da tsarin sa.

Canza metabolism na metabolism a cikin masu ciwon sukari ya sa ya zama da wuya a zaɓi magunguna. An bayarda umarnin magunguna don yin la'akari da yanayin jikin mai haƙuri da kuma tsananin cutar.

Don rage karfin jini a nau'in 1 da nau'in ciwon sukari 2, ana amfani da kwayoyi na rukuni masu zuwa:

• Diuretics (Furosemide, Diacarb);
• ACE inhibitors (captopril, enalapril);
• Beta-blockers (Nebilet, Trandat, Dilatrend);
• Alfa-adrenergic blockers (Doxazosin, Prazosin, Terazosin);
• Antagonists na Calcium (Diltiazem, Verapamil);
• Agonists (mai tayar da hankali) na masu karɓa na imidazoline (Albarel, Physiotens).

Bari mu bincika daki-daki kowane rukuni na kwayoyi.

Diuretics

Akwai kungiyoyi 4 na diuretics:

• Thiazide;
• Thiazide-kamar;
• Madauki;
• Potassium-sparing.

Thiazide-kamar diuretics wanda ba ya tasiri da haɗuwar glucose suna da sakamako mai kyau. A nau'in 1 da nau'in ciwon sukari na 2, ana amfani da diyyar thiazide a cikin adadin da bai wuce 12.5 MG ba. Dukkanin rukunoni biyu na diuretics suna hana faruwar rikice-rikice a cikin kodan, myocardium, duk da haka, irin waɗannan magungunan ba za a iya amfani dasu don gazawar koda ba.

Ba safai ake amfani da dipals ba, a sakamakon haka, jiki na rasa potassium. Koyaya, ana nuna su don gazawar koda, wanda a cikin sa akwai abubuwan da ake ɗaukar shirye-shiryen potassium a ƙari.

ACE masu hanawa

Sun toshe enzyme wanda ke tattare da kwayar halittar angiotensin mai aiki, wanda ke haifar da karuwa a hawan jini. Magunguna suna hana haɓakar rikice-rikice a cikin kodan, zuciya. Yayin cincin, yawan sukari baya ƙaruwa.

Magungunan suna da tasiri mai laushi, ana samun raguwar raguwar jini bayan makonni 2. A nau'in 1 da nau'in ciwon sukari na 2, irin waɗannan magungunan suna ba da izini idan an gano hyperkalemia da stenosis na artal koda. A cikin wasu marasa lafiya, suna haifar da tari. Ya kamata a ɗauka a zuciya cewa idan hauhawar jini tayi tsanani, masu hana ACE bazai sami tasirin warkewa ba.

Masu tallata Beta

Akwai rukuni biyu:

1. Mai zabe Yi aiki ne kawai a kan masu karɓar tsarin zuciya;
2. Wadanda ba'a zaba. Shafar duk kyallen jikin.

Masu hana beta-blockers suna hana mutane masu cutar siga saboda suna kara sukari. An wajabta masu zaɓuɓɓuka idan ciwon sukari da hauhawar jini ya haɗu tare da sauran hanyoyin:

1. Ischemia
2. Cutar zuciya;
3. Rashin zuciya.

Ana amfani da irin waɗannan kwayoyi sau ɗaya a lokaci ɗaya tare da diuretics. Ba a yi amfani da masu saukar ungulu don bi da cutar hawan jini a cikin marasa lafiyar da ke fama da asma.

Masu maganin kishi

Yana yin jinkirin aiwatar da ƙwayar alli a sel, wanda ke haifar da vasodilation da rage karfin jini. Akwai rukuni biyu:

1. Dihydropyridine. Rateara yawan zuciya, rage saurin ciwon zuciya.
2. Nedihydropyridine. Rage ƙarancin zuciya, wanda ya dace da maganin hauhawar jini, wanda ya bayyana akan asalin cutar nephropathy. Yana taimaka wajan cutar da cutar koda.

Ana iya amfani da waɗannan waɗancan da sauran su lokaci guda tare da diuretics, ACE inhibitors. Karka yi amfani dasu don rashin zuciya, angina pectoris ba shi da matsala.

Agonists (abubuwan ƙarfafawa) na masu karɓa na imidazoline

Magunguna suna raunana aikin tsarin juyayi mai juyayi, a sakamakon haka, yawan zuciya yana raguwa, hawan jini yana raguwa. Amfani da na dogon lokaci yana inganta tsarin zuciya.

Yardajewa:

• Bradycardia
• Rashin zuciya;
• Ciwon mara lafiya
• Cutar hanta.

Masu hana Alfa

Toshe postsynaptic alpha adrenergic masu karɓa, samar da raguwa mai matsin lamba ba tare da ƙara yawan zuciya ba. A cikin ciwon sukari, irin waɗannan kwayoyi suna rage yawan sukari, ƙara haɓaka insulin.

Abincin far

Don hauhawar jini wanda ke tasowa tare da nau'in 1 ko nau'in ciwon sukari na 2, kula da abinci na musamman. Lowarancin carb yana rage ƙarfin sukari sosai kuma yana daidaita hawan jini.

Bi waɗannan jagororin:

1. Abincin ya kamata ya ƙunshi bitamin, abubuwan gano abubuwa a cikin wadataccen adadin;
2. Rage yawan cin gishiri. Ka'idar yau da kullun ba ta wuce shayi 1 ba. l;
3. Usearyata abinci mai wadatar sodium;
4. Ku ci mafi yawan lokuta - aƙalla 5 p / A rana, a cikin ƙananan rabo;
5. Kada ku ci kafin lokacin kwanciya. Abincin da ya gabata ya kamata ya kasance ba a cikin sa'o'i 2 ba kafin lokacin kwanciya;
6. Ku ci abinci mai ƙoshin mai, ku fi son hadaddun carbohydrates;
7. Ku ci abinci mai arzikin potassium. Macroelement yana fadada ganuwar jijiyoyin jini kuma yana taimakawa rage karfin gwiwa.

Sanya kayan lambu a cikin kayan abinci na yau da kullun, 'ya'yan itatuwa waɗanda aka yarda da masu ciwon sukari. Sauran samfuran da aka yarda:

• Gurasar abinci na baki daya;
• Naman nama, kifi;
• Fatarar da ba ta da mai, kayayyakin kiwo;
• Kayan lambu
• Abincin teku;
• 'Ya'yan itãcen marmari;
• Qwai
• Kayan lambu mai.

Don inganta dandano na jita-jita, amfani da kayan yaji, ganye mai ƙanshi, ruwan lemun tsami.

An sanya mata hannu:

• Kayayyakin alkama;
• Abincin da aka fi so;
• Kifaye iri iri na kifi, nama;
• Ciyarda daskararre;
• Ickwaya;
• Marinade
• Shaye-shayen Caffeinated
• Giya na sha.

Kasancewar masu kiba sosai yana saukaka yiwuwar hauhawar jini a cikin masu ciwon sukari. Don rasa nauyi, ana bada shawara don rage yawan adadin kuzari na yau da kullun, ƙara yawan aiki na jiki.

Canjin rayuwa

Kula da ingantacciyar rayuwa yana taimakawa rage karfin jini a nau'in 1 da nau'in ciwon sukari na 2. Da ake bukata:

1. Cikakken hutawa;
2. Barin barasa ko rage shan giya;
3. Fitar shan sigari. Nicotine yana ƙara haɗarin rikice-rikice akan tsarin zuciya;
4. Nisantar yanayin damuwa.

Aiki na yau da kullun (motsa jiki, tafiya a matakin motsa jiki, da sauransu) yana da mahimmanci. Massage yana da sakamako mai kyau. Normalization na matsa lamba tare da taimakon kwayoyi, abinci, ƙara yawan aiki na motsa jiki na iya rage yanayin hauhawar jini a cikin cututtukan fata kuma yana inganta ci gaba da wadatar rayuwa.

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