Musamman lalacewar koda a cikin masu ciwon sukari, cuta ce mai ɗauke da cutar kansa: rarrabuwa ta matakai da alamomin halayyar su

Cutar sankara mai narkewa ta sami karɓuwa daga rikice-rikice na ciwon sukari mellitus, musamman insulin-dogara (nau'in farko). A cikin wannan rukuni na marasa lafiya, an gano shi a matsayin babban dalilin mutuwa.

Canje-canje a cikin kodan sun bayyana a farkon matakan cutar, kuma ƙarshen (ƙarshen) matakin cutar ba komai bane illa gazawar renal na kullum (wanda aka taƙaice kamar CRF).

Lokacin ɗaukar matakan kariya, tuntuɓar dacewar ƙwararren masani, dacewar magani da rage cin abinci, haɓakar ƙoshin ƙwaƙwalwa a cikin ciwon sukari na iya raguwa da jinkirta har zuwa dama.

Tsarin cutar, wanda yawancin lokuta ana amfani dashi a aikace ta kwararru, yana nuna matakan canje-canje na tsarin gini a cikin mai haƙuri da ke fama da ciwon sukari mellitus.

Ma'anar

Kalmar "masu ciwon sukari nephropathy" na nufin ba cuta guda ba, amma da wasu takamaiman matsaloli masu alaƙa da lalacewar tasoshin koda da asalin ci gaban yanayin ƙwaƙwalwar ƙwayar cutar sankarau: glomerulosclerosis, arteriosclerosis na arteries a cikin kodan, ɗimbin mai a cikin tubules na koda, ƙwayoyin su, necrosis, pyelonephritis, da sauransu.

Sau da yawa, ana lura da take hakki a cikin aiki na kodan tare da ciwon sukari na dogaro da insulin na nau'in farko (40 zuwa 50% na masu ciwon sukari na wannan rukunin suna fuskantar cutar nephropathy).

A cikin marasa lafiya da cutar ta nau'in na biyu (marasa insulin-dogara), nephropathy yana faruwa ne kawai a 15-30% na lokuta. Nephropathy, haɓakawa da asalin ciwon sukari na mellitus, ana kuma kiranta Kimmelstil-Wilson syndrome, ta hanyar kamanceceniya tare da nau'in farko na glomerulosclerosis, kuma kalmar "masu ciwon sukari na glomerulosclerosis" ita kanta ana amfani da ita azaman alamar "nephropathy" a cikin littattafan likitanci da kuma haƙuri.

Ci gaban Pathology

Hyperglycemia wanda ke haifar da ciwon sukari mellitus yana haifar da haɓakar hawan jini (wanda aka rage shi a matsayin BP), wanda ke haɓaka aikin tacewa ta hanyar glomeruli, glomeruli na tsarin jijiyoyin ƙwayoyin tsoka, wanda shine babban aikin kodan.

Bugu da kari, yawan sukari mai yawa yana canza tsarin sunadaran dake jikin kowane daya daga cikin abubuwan jin daɗi na glomerulus. Wadannan rikice-rikice suna haifar da cututtukan ƙwayar cuta (sclerosis) (hardening) na glomeruli da ɗaukar nauyin ƙwayoyin tsoka, kuma, saboda haka, zuwa nephropathy.

Alamar Mogensen

Zuwa yau, likitoci a aikace-aikacensu galibi suna amfani da tsarin Mogensen, wanda aka bunkasa a 1983 kuma ya bayyana wani matakin cutar:

1. hauhawar kodan wanda ke faruwa a farkon farkon ciwon sukari mellitus ya bayyana kansa ta hanyar hauhawar jini, hauhawar jini da hauhawar kodan.
2. bayyanar canje-canje na tsarin halittar a cikin kodan tare da toshewar membrane na dunƙule dunƙule, fadada daga cikin mesangium da hauhawar jini. Ya bayyana a cikin zamani daga shekaru 2 zuwa 5 bayan ciwon sukari;
3. fara nephropathy. Yana farawa a farkon shekaru 5 bayan farkon cutar kuma yana jin kansa tare da microalbuminuria (daga 300 zuwa 300 MG / rana) da kuma ƙaruwa a cikin yawan ƙirar gidan duniya (GFR);
4. nephropathy da aka ambata yana ci gaba da ciwon sukari a cikin shekaru 10-15, yana bayyana kansa a cikin proteinuria, hauhawar jini, rage GFR da sclerosis, yana rufewa daga 50 zuwa 75% na glomeruli;
5. uremia yana faruwa bayan shekaru 15-20 bayan cutar sankara kuma ana nuna shi ta nodular ko cikakke, jimlar yaɗuwar glomerulosclerosis, raguwa a cikin GFR zuwa <10 ml / minti.

Rarraba rarrabuwa

Yadauka cikin amfani da amfani da littattafan likitanci, rarrabuwa gwargwadon matakai na cututtukan cututtukan cututtukan daji wadanda suka danganci canje-canje na tsarin a cikin kodan kuma an gyara su:

1. na koda hyperfiltration. Yana bayyana kanta a cikin hanzarta gudanawar jini a cikin na koda mai haɓaka, yana ƙaruwa da yawan fitsari da ƙwayar jikin kanta girman. Yana rayuwa har zuwa shekaru 5;
2. microalbuminuria - ƙaramin haɓaka a cikin matakin sunadaran albumin a cikin fitsari (daga 30 zuwa 300 mg / rana). Gano lokaci da magani a wannan matakin na iya tsawaita shi zuwa shekaru 10;
3. macroalbuminuria (UIA) ko furotinur. Wannan raguwa ce sosai a cikin yawan tacewa, yawan tsalle ne a hawan jini na koda. Matsakaicin ƙwayoyin albumin a cikin fitsari na iya zuwa daga 200 zuwa fiye da 2000 mg / bitch. Cutar cutar sankara ta masu fama da cutar sankara ta UIA ya bayyana a shekara ta 10-15 daga farkon cutar sankara;
4. furta nephropathy. An kwatanta shi da ƙananan ƙarancin ɗaukar hoto (GFR) da kuma yiwuwar tasoshin jirgin ruwa na koda zuwa canje-canje na sclerotic. Wannan yanayin za a iya gano shi ne kawai bayan shekarun 15-20 bayan І sauye-sauye a cikin kasusuwa na renal;
5. na rashin koda na koda (CRF)) Ya bayyana bayan shekaru 20-25 na rayuwa tare da ciwon sukari.

Cutar masu fama da ciwon sukari: matakai da halayyar kwayar cutar hauka

Matakan farko na 2 na masu ciwon sukari (cututtukan koda da kuma microalbuminuria) ana nuna su ta hanyar rashin bayyanar cututtuka na waje, ƙarar fitsari al'ada ce. Wannan shine madaidaicin mataki na cutar ciwon suga. Sai kawai a ƙarshen mataki na microalbuminuria, wasu marasa lafiya na iya ɗan lokaci-lokaci fuskantar ƙara matsa lamba.

A matakin proteinuria, alamun cutar sun riga sun bayyana a waje:

• kumburi yana faruwa (daga farkon kumburin fuska da kafafu zuwa kumburin farji na jiki);
• ana ganin canje-canje masu kauri a cikin karfin jini;
• raguwa mai nauyi a cikin nauyi da ci;
• tashin zuciya, ƙishirwa;
• malaise, gajiya, gajiya.

A matakin karshe na cutar, alamu na sama suna kara karfi, faduwar jini ya bayyana a cikin fitsari, hawan jini a cikin tasoshin kodan ya tashi zuwa sigogin masu barazanar rayuwa ga masu ciwon suga.

Ka'idojin Ilimantarwa na Ci gaba

Wadannan ilmin etymological masu haɓaka cigaban nephropathy a cikin masu ciwon sukari an san su:

• ka'idar halittar jini tana ganin babban dalilin cututtukan koda a cikin yanayin gado, kamar yadda yake dangane da cutar sankarar bargo da kanta, wanda ci gaban lalacewar jijiyoyin jiki ke haɓaka;
• ka'idodin hemodynamic ya ce a cikin ciwon sukari (mellitus) akwai hauhawar jini (yaduwar jini a cikin kodan), wanda a ciki abin da jijiyoyin ruwa ba zasu iya yin tsayayya da matsanancin karfin kwatancen albumin da aka kirkira a fitsari, da rushewa, da kuma cutawar sclerosis (scars) a cikin wuraren lalacewar nama;
• Ka'idar musayar ra'ayi, babban aikin hallakaswa a cikin cututtukan cututtukan cututtukan mahaifa an danganta shi da glucose na jini. Daga kaifi tsalle daga "mai guba mai guba", da na jirgin ruwa na koda ba zai iya jimre aikin tace, sakamakon abin da na rayuwa tafiyar matakai da jini ya rushe, lumens ne kunkuntar saboda ajiya na fats da jari na sodium ion, na ciki kara ƙaruwa (hauhawar jini).

Bidiyo mai amfani

Kuna iya gano abin da za ku yi don jinkirta lalacewar koda a cikin cututtukan ƙwayar cutar sankara ta hanyar kallon wannan bidiyon:

Zuwa yau, wanda aka fi amfani dashi kuma ana amfani dashi sosai a aikace a rayuwar yau da kullun na kwararrun likitoci shine rarrabewar cututtukan cututtukan ƙwayar cuta, wanda ya haɗa da matakai masu zuwa a cikin cigaban ƙwaƙwalwar ƙwaƙwalwa: hauhawar jini, canje-canje na tsarin farko, farawa da bayyanar cututtukan cututtukan cututtukan zuciya, uremia.

Yana da muhimmanci a bincika cutar ta kan lokaci a farkon matakan ci gabanta don jinkirta farawa daga lalacewar koda koda yaushe.