• Mmebi na arịa ọbara nke obi (akwara obi) ekwuputara na mmepe nke angina pectoris (ọrịa na-egosipụta mgbu ma ọ bụ ahụ erughị ala n'azụ sternum n'ihi mmebi nke ịnye ọbara n'ọbara), infarction myocardial (ọnwụ nke akụkụ akwara obi), nkụchi obi na-adịghị ala ala (ọrụ obi na-adịghị ala ala).
  Clinically gosipụtara:
  • ihe mgbu nke ọnọdụ ịpịgharị, mkpakọ, ọkụ na mpaghara obi, n'azụ azụ, na-esite na mgbatị anụ ahụ (ka ọrịa ahụ na-aga n'ihu na izu ike), na-agafe na izu ike ma ọ bụ mgbe ị drugsụsịrị ọgwụ nitrate otu (melite mgbasa ọbara n'ọbara).
  • mkpụmkpụ ume - na mbụ site na mgbatị anụ ahụ, ka ọrịa ahụ na-aga n'ihu na izu ike,
  • ọzịza nke ụkwụ
  • nkwụsị n'ọrụ obi,
  • mmụba na akwara ike (ọbara)
  • enweghi mgbu nke ịrịa ọrịa obi (ọnwụ nke akụkụ akwara obi), nke a na-ahụkarị n'ọrịa shuga mellitus n'ihi ọrụ nke akwara ozi.
• Mmebi na arịa nke ụbụrụ (ọrịa ụbụrụ):
  • isi ọwụwa
  • anya ntughari
  • Ebe nchekwa siri, ntị,
  • ọrịa strok bụ nnukwu mmebi nke ụbụrụ ụbụrụ na ọnwụ nke akụkụ ụbụrụ.
• Mebiri emebi na arịa nke ala nsọtụ:
  • mgbu mgbu
  • lameness
  • ntụpọ (ọnya nke anụ ahụ),
  • ọnwụ nke anụ ahụ dị nro (gangrene) - aka na - atụgharị akaji ojii, ọrụ ya efuola kpamkpam.

Ọnụnọ nke ọrịa shuga mellitus (ọrịa a na-egosipụta glucose ọbara dị elu) na-eduga n'ọgba aghara nke ọtụtụ ụdị metabolism na ahụ, nke na-eme ka ihe ndị ọrịa dịkwuo njọ n'ihe mmerụ vaskụla. N'ịkakọ ọnụ, enwere mmụba na mmepe nke atherosclerosis (itinye oghere nke cholesterol na mgbidi nke arịa ọbara) na-emebi ihe kachasị nke arịa nke obi, ụbụrụ na ala ala.

Ihe ndị a na-ebutekarị maka ọrịa vaskụla atherosclerotic:

• ise siga
• ị alcoholụbiga mmanya ókè
• mmụba na akwara ike (ọbara)
• oke ibu
• Ọdịnaya dị elu nke lipids (cholesterol na abụba ndị ọzọ) n'ime ọbara,
• Ahụ ike ketara eketa (ọnụnọ nke atherosclerosis na ndị ikwu ọbara),
• afọ (ihe karịrị afọ 50)
• atrial fibrillation (obi mgbawa obi).

• ọbara mgbali elu
• ọkwa insulin dị elu (hormone nke na-akpata iweda glucose ọbara) n'ime ọbara,
• insulin iguzogide - "enweghi ume" ka emeju nke insulin,
• ọrịa shuga nephropathy - imebi akụrụ na ọrịa shuga mellitus,
• ndu oria ogologo oge.

Dọkịta endocrinologist ga - enyere aka n'ịgwọ ọrịa ahụ

Ọrịa nyocha

• Nchoputa nke mkpesa oria:
  • ihe mgbu nke ọnọdụ ịpịgharị, mkpakọ, ọkụ na mpaghara obi, n'azụ azụ, na-esite na mgbatị anụ ahụ (ka ọrịa ahụ na-aga n'ihu na izu ike), na-agafe na izu ike ma ọ bụ mgbe ị drugsụsịrị ọgwụ nitrate otu (melite mgbasa ọbara n'ọbara).
  • mkpụmkpụ ume - na mbụ site na mgbatị anụ ahụ, ka ọrịa ahụ na-aga n'ihu na izu ike,
  • ọzịza nke ụkwụ
  • nkwụsị n'ọrụ obi,
  • mmụba na akwara ike (ọbara)
  • isi ọwụwa
  • anya ntughari
  • Ebe nchekwa siri, ntị,
  • mgbu mgbu
  • lameness.
• Nyocha gbasara akụkọ gbasara ahụike (akụkọ mmepe) nke ọrịa: ajụjụ gbasara etu ọrịa bidoro ma mekwaa, afọ ole ka ọrịa shuga bidoro.
• Nnyocha zuru oke (ntụle ọbara mgbali, nyocha anụ ahụ, iji ntị na -ege ntị na mkpụrụ nke akụkụ nke ala).
• Mkpebi ọkwa cholesterol na lipids ndị ọzọ (abụba) n'ime ọbara.
• Maka nyocha nke mmebi nke akwara obi:
  • ECG (electrocardiography),
  • Nyochaa Holter ECG (n'ehihie),
  • ule nnwale - nleba anya ECG, nsogbu ahụ, ọbara ọgbụgba, ọdịmma nke onye ọrịa n’okpuru ibu dị na simulators pụrụ iche (igwe kwụ otu ebe, igwe ihe),
  • akwara ozi gbasara akwara bụ ụzọ nyocha nke na - enye gị ohere inyocha akwara ọbara nke obi site na ime ya site na iji ngwaọrụ pụrụ iche etinyere na akwara ozi.
• Maka nchọpụta nke ọrịa ụbụrụ:
  • ultrasound nke arịa isi na olu,
  • CT (gbakọtara tomography) ma ọ bụ MRI (ihe ndọta ndọta).
• Iji chọpụta ọnya anụ ahụ nke ala ala:
  • nyocha nke bekee nke ala akụkụ ala,
  • X-ray ọdịiche angiography - nyocha nke arịa ọbara na-eji ihe dị iche webatara n’ime arịa ahụ, usoro nke ụzarị ọkụ sochiri.
• Njikwa ike nke ogo glucose ọbara (ịkwa ọkwa glucose ụbọchị n’ụbọchị).
• Consultgakwuru onye dibia bekee, onye obia n’obi, ndi phlebologist nwekwara ike ikari.

Ọgwụ macroangiopathy na-arịa ọrịa shuga

• Ọgwụ shuga mellitus (ọrịa nke akpịrị glucose ọbara dị elu mara).
• Nri nwere mmachi nnu, protein, carbohydrates, nri abụba.
• Qukwụsị ise siga na ị alcoholụ mmanya.
• Arụ ọrụ arụrụ arụ (anaghị akpata ọgụ angina (ọrịa nke mgbu na-egosipụta ma ọ bụ ahụ erughị ala n'azụ sternum n'ihi mmebi ọbara na-enye obi)).
• Kwa ụbọchị na-agagharị na ikuku dị mma.
• Mbelata na oke ibu.
• Ọgwụ anti-ischemic na-ebelata mkpa maka myocardium (akwara obi) na oxygen.
• Ọgwụ maka iwetula mgbali olu (ọbara).
• Ọgwụ nke na - eme ka uru mmanụ dị n’otu (belata kọlesterol na abụba ndị ọzọ).
• Ọgwụ na-egbochi ịmịnye ọbara ọbara.
• Ọgwụ Neurotropic (na-eme ka nri ahụike nke sistemụ ahụ ike) dịkwuo mma.
• Ọgwụ Vasodilator.
• Ọgwụ ịwa ahụ: ọ bụrụ na emebi emebi arịa nile nke obi na ala akụkụ ya na atherosclerotic plaques, a na-ahụ balloon angioplasty na stenting nke arịa ndị ahụ - iwepu oghere ihe mgbaze na atherosclerotic (etinye pụrụ iche nke na-akwado lumen nke arịa ahụ n'ọnọdụ nkịtị).
• Site na mmepe nke gangrene (ọnwụ anụ ahụ) - mpụ ụkwụ.

Gịnị bụ microangiopathy?

N'ime ahụ mmadụ, e nwere puku kwuru puku obere arịa, ndị gụnyere capillaị, venules na arterioles. Ha na-ebugharị mkpụrụ ndụ niile, na-ewetara ha ihe bara uru ma na-ewepụ ihe niile na-adịghị mkpa. Nke a na - ebido n’ọrụ ọ bụla n’ime mkpụrụ ndụ yana n’ahụ niile. Mgbe mgbanwe mgbanwe a na - ahụ n'ime obere arịa ebilite na - adị ogologo oge nke ọrịa mellitus, a na - achọpụta microgoniopathy mamịrị. Site na nsogbu a, ndị kacha emetụta bụ:

Microangiopathy na-etolite n'ihi eziokwu ahụ bụ na glucose, ihe ndị dị n'ime ọbara nke ndị ọrịa na-arịa ọrịa shuga na-abawanye, na-emebi endothelium nke mgbidi arịa ọbara. Ọgwụ ngwaahịa nke glucose metabolism bụ sorbitol na fructose. Ihe ndị a dị n'ime na-abanye n'ụzọ anụ ahụ site na akpụkpọ ahụ, yabụ na-amalite ịchịkọta mkpụrụ ndụ endothelial. Nke a na - eduga n'ọrịa ndị dị otú ahụ:

- Mgbasa nke arịa arịa,

- Mgbidi mgbidi na-aba ụba,

- mbelata na mmepụta nke izu ike nke endothelium, ọ dị mkpa maka izu ike nke akwara ndị dị larịị.

Ya mere, endothelium mebiri emebi ma obara na-agbadata, ọbara na-ebelata, nke na-akpata coagulation. A na-akpọ nke a Virchow Triad.

Nkewa na ngosiputa ulo ogwu

Macroangiopathy na-arịa ọrịa shuga nwere ike ịnwe nhọrọ dịgasị iche iche nke mmepe. Isdị usoro ọmụmụ ọ bụla na-egosipụta njirimara ụfọdụ.

Site na mmebi nke arịa mkpụrụ obi, a na-ahụ ihe omume angina pectoris. E jikọtara mmebi iwu a na mmebi usoro nhazi ọbara. Ọ na-egosipụta onwe ya n'ụdị ihe mgbu na sternum. E nwekwara ihe egwu nke ịrịa ọrịa infịction na ọrịa obi na-adịghị ala ala.

Ejiri ụdị ngosipụta a mara ụdị ọrịa a:

1. Ingpị, ọkụ, mpịkọ ihe mgbu na mpaghara obi na sternum. Na nmalite mmalite nke oria ahụ, ha na-ebili na mgbalị anụ ahụ. Ka ha na-etolite, ahụ erughị ala na-adị na ọnọdụ dị jụụ ọbụlagodi mgbe eji ọgwụ si na ụdị nitrates.
2. Ntutu ume. Na mbu, a na-ahụ ya naanị n'okpuru ibu, wee wee dị jụụ.
3. Ọzịza nke ụkwụ.
4. Obi anaghị arụ ọrụ.
5. Ọbara mgbali elu.
6. Obi nkụ mgbu. A na-ahụkarị ọrịa a n'ọrịa shuga. Nke a bụ n'ihi ọrụ nke akwara nke akwara.

Mmebi nke arịa ụbụrụ ka a na-akpọ ọrịa ụbụrụ. Site na mmepe ya, a na-ahụ ụdị ngosipụta ndị a:

1. Isi ọwụwa.
2. Achịcha nke ịta.
3. Dizziness
4. Ebe nchekwa na-eme ka ike gwụ.
5. Ọrịa N’okpuru okwu a, a na-aghọta oke mmebi mgbasa ụbụrụ, nke gụnyere ọnwụ nke otu mpaghara.

Ọrịa shuga macroangiopathy nke akụkụ ala dị ala gụnyere ụdị ngosipụta a:

1. Mgbu n'ụkwụ.
2. Ahụ ọnya na-enweghị isi. Mgbe ha putara, iguzosi ike n’ezi ihe n’ahu akpachapu anya.
3. Ọtọ.
4. Ọnwụ nke anụ ahụ dị nro. Mgbe gangrene mere, ụkwụ ga-acha oji ma kwụsịchaa ọrụ ya.

Zọ ọgwụgwọ

Ebumnuche nke ọgwụgwọ nke ọrịa a bụ iji kwụsị mmepe nke nsogbu ndị dị ize ndụ site na arịa, nke nwere ike ibute nkwarụ nke onye ọrịa ma ọ bụ ọnwụ. Thekpụrụ dị mkpa n'ịgwọ ọrịa a bụ mgbazi nke ọnọdụ ndị a:

• Hypercoagulation
• Hyperglycemia,
• Ọbara ọbara,
• Dyslipidemia.

Iji meziwanye ọnọdụ nke mmadụ, a na-enye ọgwụ ndị na-eme ka anwụ dị ala. Ndị a gụnyere fibrates, akpụ, antioxidants. Ọ baghị uru ịdị na-eme nri, nke gụnyere igbochi oriri nke abụba anụmanụ.

N'inwe egwu nke thromboembolic dị elu, ọ bara uru iji ndị nnọchianya antiplatelet. Ndị a gụnyere heparin na pentoxifylline. Ndị dọkịta na-edekarị acetylsalicylic acid.

A na-eme ọgwụgwọ antihypertensive na nchoputa a iji nweta ma mee ka nsogbu kwụsie ike. Ọ kwesịrị ịnọgide na ọkwa nke 130/85 mm RT. Art. Iji dozie nsogbu a, a na-eji ndị na-egbochi ACE, captopril.

Ikwesiri iji ogwu diure - furosemide, hydrochlorothiazide. Ọrịa ndị nwere ọria myocardial infarction ka ana-enye ọgwụ mgbochi beta. Ndị a gụnyere atenolol.

Ekwesịrị ịgwọ ọrịa nke trophic ọnya nke akụkụ ahụ niile n'okpuru nlekọta nke dọkịta na-awa ahụ. N'ime nnukwu ihe ọghọm nke vaskụla, a na-enye nlekọta elebara anya. Ọ bụrụ na enwere ihe akaebe, enwere ike ịme ịwa ahụ.

Nsochi

A na-ekwukarị egwu maka macroangiopathy na ndị nwere ọrịa shuga 2. Ihe omuma nke onwu site na nsogbu nke oria a bu 35-75%. Na ọkara nke ikpe, ọnwụ na-apụta n'ihi infarction myocardial.

Ọnọdụ na-adịghị mma bụ mgbe mpaghara atọ vaskụla - ụbụrụ, ụkwụ, na obi - na-emetụta n'otu oge. Ihe karịrị ọkara nke ọrụ aka mgbaji ukwu na aka metụtara macroangiopathy.

Site na mmerụ ahụ n'ụkwụ, a na-ahụ ntụpọ ọnya. Nke a na - ekepụta ihe ga - eme maka ịtọ ụkwụ ọrịa mamịrị. Site na mmebi nke akwara ozi, arịa ọbara na anụ ahụ, a na-ahụ necrosis ma usoro purulent apụta.

Ọdịdị nke ọnya ụkwụ n'ụkwụ ala bụ n'ihi nsogbu mgbasa ke arịa dị n'ụkwụ. Ọnọdụ gangrene na-abụkarị bụ nnukwu ụkwụ.

Mgbu na ọdịdị nke gangrene mamịrị anaghị egosipụta onwe ya nke ukwuu. Mana mgbe akaebe gbara, ọ baghị uru ịhapụ igbu oge maka ọrụ ahụ. Ogbugbu ọnya na-egbu ogologo oge bụ ntakịrị oge. Oge ụfọdụ ọ dị mkpa iji mepụta usoro ịwa ahụ nke abụọ.

Ihe mgbochi

Iji gbochie ọdịdị nke pathology a, ọtụtụ ndụmọdụ kwesịrị ka atụba anya:

1. Na-abịa n’oge maka ọrịa shuga
2. Gbaso usoro nri riri nri riri protein, carbohydrates, nnu na nri abuba.
3. Normalize aru
4. Ewezuga anwụrụ na ị drinkingụ mmanya,
5. Nyeghaa ahu aru adighi nma, nke adighi akpasu oke nke ihe nlere nke angina pectoris,
6. Kwa ụbọchị maka ịgagharị na ikuku dị ọcha
7. Nye ihe nlele di omimi banyere ihe obula - otu ugbo n’ime onwa isii obula,
8. Mee nlele dị omimi nke glucose n'ọbara - a na-atụle ihe ngosi a otu ugboro n'ụbọchị.

Mmepe nke macroangiopathy na ọrịa shuga bụ ihe a na-ahụkarị. Usoro ogwu a bu ihe puru iche ihe ojoo puru ime ma nwue onwu. Ya mere, ọ dị oke mkpa itinye aka na mgbochi ya, ọ bụrụ na mgbaàmà apụta, gaa hụ dọkịta ozugbo.

Ọrịa mamroangiopathy

Ọrịa mamroangiopathy - mgbanwe sitere na atherosclerotic na-etolite na akwara ndị dị ala na nnukwu caliber megide ndabere nke ogologo ọrịa shuga mellitus. Ọrịa shuga macroangiopathy na-eduga n'ọrịa akwara ọbara, ọbara mgbali akwara, ọnya ụbụrụ, ọnya ụbụrụ nke akwara ozi. Nchọpụta ọrịa shuga macroangiopathy gụnyere ọrịa metabolism, ultrasonography of arter of the endremities, arịa ụbụrụ, akụrụ, ECG, echocardiography, wdg Thekpụrụ ndị bụ isi nke ọgwụgwọ nke macroangiopathy na-arịa ọrịa shuga bụ mgbazi nke hyperglycemia, ọrịa dyslipidemia, njikwa ọbara mgbali, na mmelite akwara ọbara.

Ozi izugbe

Ọrịa shuga macroangiopathy bụ nsogbu na-arịa ọrịa shuga mellitus, na-eduga na ọnya nke isi ụbụrụ, akwara ọbara, akwara na akụkụ akwara. Site na onya ogwu, oria macroangiopathy diabetia na mmepe nke angina pectoris, infarction myocardial, oria ischemic, obara mgbali ohuru, na gangrene mamria. Mgbasa vaskụla dị iche iche dị oke mkpa na prognosis nke ọrịa shuga mellitus, na-abawanye ihe ọghọm nke ọrịa obi na ọrịa obi na-akpata site na ugboro 2-3, aka gangrene aka - site na ugboro 20.

Atherosclerosis, nke na-ebilite na ọrịa shuga mellitus, nwere ọtụtụ atụmatụ akọwapụtara. N'ime ndị na-arịa ọrịa shuga, ọ na - eme n'afọ 10-15 tupu mgbe ọ bụla na ndị ọ na - adịghị arịa metabolism ike, yana ọ na - aga n'ihu ngwa ngwa. Maka ọrịa macroangiopathy na-arịa ọrịa shuga, ọnya na-ahụkarị nke akwara ọtụtụ (akwara ozi, akụkụ ụbụrụ, visceral, akụkụ). N'akụkụ a, mgbochi na mgbazi nke ọrịa macroangiopathy na-arịa ọrịa shuga dị oke mkpa na endocrinology.

Na macroangiopathy na-arịa ọrịa shuga, akpụkpọ ahụ nke okpuru ala nke akwara dị larịị na nke buru ibu na-eme ka o sie ike na ntọala nke atherosclerotic. Ọkpụkpụ ha na - esochi, ọnya na necrosis na - eso na - ebute ụbụrụ mpaghara nke ọbara ọgbụgba na ntinye nke akwara ọbara, nke na - eduga n'ọgba aghara mpaghara ụfọdụ.

Ihe dị iche iche dị egwu maka mmepe nke macroangiopathy na-arịa ọrịa shuga gụnyere hyperglycemia, dyslipidemia, insulin resistance, oke ibu (ọkachasị n'ụdị nke ime), ọbara mgbali elu, ịba ụba ọbara coagulation, endothelial dysfunction, nrụgide oxidative, na mbufụt systemic.Ihe ihe ọdịnala ọdịnala maka atherosclerosis bụ ị smokingụ sịga, mmịnye ọrụ, emegaghị ahụ, afọ (na ụmụ nwoke karịrị afọ iri anọ na ise, na ụmụ nwanyị karịrị afọ iri ise).

Nkewa

Ọrịa shuga angiopathy bụ echiche mkpokọta nke gụnyere mmeri nke obere arịa - capillaries na precapillary arterioles (microangiopathy), na-ajụ ajụ na nnukwu caliber arteries (macroangiopathy). Ọrịa shuga angiopathies bụ oge ịrịa ọrịa shuga, na-etolite na nkezi afọ 10-15 ka mmalite nke ọrịa ahụ.

Ọrịa shuga macroangiopathy nwere ike igosipụta onwe ya n'ọtụtụ syndromes: atherosclerosis nke akwara ọbara na akwara, atherosclerosis nke akwara akwara na atherosclerosis nke akwara akwara. Ọrịa microangiopathy na-arịa ọrịa mamịrị nwere ike ịgụnye ọrịa retinopathy, nephropathy, microangiopathy nke akụkụ ala. Ọzọkwa, mmebi vaskụla nwere ike ime n'ụdị angiopathy ụwa niile, na-ejikọ nnukwu macangopathy. N'aka nke ya, microangiopathy endoneural na-enye aka na akụkụ akwara ozi na-emebi emebi, yabụ, mmepe nke neuropathy mamịrị.

Ihe mgbaàmà nke ọrịa macroangiopathy

Atherosclerosis nke akwara ọbara na akwara nke macroangiopathy na-arịa ọrịa shuga na-egosipụta site na mmepe nke ọrịa obi na akwara na-arịa ya (nnukwu myocardial infarction) na ọrịa na-adịghị ala ala (cardiosclerosis, angina pectoris). IHD n’ime ọrịa shuga nwere ike ime n’otu oge (dịka nhọrọ arrhythmic ma ọ bụ nke na-adịghị egbu mgbu), si otú ahụ ịbawanye ohere nke ọnwụ akwara na mberede. Ọrịa macroangiopathy na-arịa ọrịa shuga na-esikarị na nsogbu nsogbu post-infarction: aneurysms, arrhythmias, thromboembolism, cardiogenic ujo, nkụchi obi. Na ọrịa macroangiopathy na-arịa ọrịa shuga, o yiri ka ọ na-etokarị infarction ugboro ugboro. Ihe ọghọm nke ọnwụ sitere na nkụchi obi na ndị ọrịa nwere ọrịa shuga ji okpukpu 2 dị elu karịa na ndị mmadụ na-arịa ọrịa shuga.

Atherosclerosis nke akwara akwara n'ihi ọrịa macroangiopathy na-arịa ọrịa shuga na-apụta na 8% nke ndị ọrịa. Enwere ike igosipụta ya site na ischemia ụbụrụ nke na-adịghị ala ala ma ọ bụ ọrịa azụ mgbu. Ọrịa nke ọrịa shuga na-abawanye ugboro abụọ n'ihu ọbara mgbali elu.

Ibepu ọnya atherosclerotic ọnya ụsọ akwara (hichaa atherosclerosis) na - emetụta 10% nke ndị ọrịa nwere ọrịa mellitus. Ngosipụta nke ọrịa shuga macroangiopathy na nke a gụnyere ọnụọgụ na oyi nke ụkwụ, mgbakasị ahụ na-adịghị ala ala, ọnya na-efegharị nke azụ, nnukwu ihe mgbu na akwara nke ụkwụ, hips, na mgbe ụfọdụ mgbada, nke na-agbasi ike na mgbatị anụ ahụ ọ bụla. Site na mmerụ dị ukwuu nke ọbara na-erughi ala, nsogbu ischemia dị oke egwu, n'ihi nsonaazụ nke ala na nke ukwu (gangrene). Necrosis nke anụ ahụ na anụ ahụ dị n'okpuru ala nwere ike ime n'enweghị ihe ọ bụla mebiri emebi arụ ọrụ, mana oge ọ na --emekarị megide nzụlite nke mmebi iwu mbụ nke anụ ahụ (ya na ọnya ụkwụ, ebe gbawara agbawa, ọrịa fungal nke anụ ahụ na mbọ, wdg). Site na nsogbu ọgbụgba ọbara dị mkpirikpi, ọnya trophic ọnya na-etolite na macroangiopathy na-arịa ọrịa shuga.

Ọgwụ macroangiopathy na-arịa ọrịa shuga

Emere ya ọgwụgwọ iji belata oganihu ọrịa nje na-akpata nsogbu nke na-eyi onye ọrịa nwere nkwarụ ma ọ bụ ọnwụ egwu. Mainkpụrụ bụ isi nke ọgwụgwọ ọrịa macroangiopathy na-arịa ọrịa shuga bụ mgbazi nke syndromes hyperglycemia, dyslipidemia, hypercoagulation, ọbara mgbali elu.

Iji mezuo ụgwọ ụgwọ maka metabolism metabolism, ndị ọrịa nwere macroangiopathy na-arịa ọrịa mamịrị gosipụtara usoro ọgwụgwọ insulin n’okpuru ọkwa nke glucose ọbara. Mmezi nke nsogbu nke carbohydrate na-enweta site na nhọpụta nke ọgwụ ndị na-egbu ike (statins, antioxidants, fibrates), yana nri na-egbochi oriri nke abụba anụmanụ.

N'iburuwanye nsogbu nke nsogbu thromboembolic, ọ bụ ihe amamihe dị na ya ịde ọgwụ antiplatelet (acetylsalicylic acid, dipyridamole, pentoxifylline, heparin, wdg). Ebumnuche nke ọgwụ antihypertensive na macroangiopathy na-arịa ọrịa shuga bụ iji mezuo ma jigide ọkwa ọbara mgbali elu nke 130/85 mm Hg. Art. Maka nke a, ọ ka mma ịnye ọgwụ ACE inhibitors (captopril), diuretics (furosemide, spironolactone, hydrochlorothiazide), ndị ọrịa nwere nkụchi obi - beta-blockers (atenolol, wdg).

Ọ bụ dọkịta na-awa ahụ ka a na-ahụ maka ọnya ndị dị n'ọsọ nke akụkụ ahụ niile. Na nnukwu ihe ọghọm nke vaskụla, a na-eme nlekọta ahụike kwesịrị ekwesị. Dabere na njirimara ndị ahụ, a na-arụ ọrụ ịwa ahụ (CABG, ọgwụgwọ ịwa ahụ nke ụbụrụ ụbụrụ, endarterectomy, mbepụ aka, wdg).

Amụma na Mgbochi Ya

Ọnwụ site na nsogbu ọrịa obi na ndị ọrịa nwere ọrịa shuga ruru 35-75%. N'ime ndị a, ihe dị ka ọkara nke ikpe ahụ, ọnwụ na-esite na infarction myocardial, na 15% - sitere na ọrịa ụbụrụ nke na-akpata nnukwu ọrịa.

Isi ihe na-egbochi mgbochi ọrịa macroangiopathy na-arịa ọrịa shuga bụ ịnọgide na-enwe ọ̀tụ̀tụ̀ glucose ọbara na ọ̀tụ̀tụ̀ ọbara ji erugharị n’ókè, iri nri, ịchịkwa ibu, ịhapụ omume ọjọọ, na-emezu ndụmọdụ ọgwụ niile.

Ọrịa macroangiopathy na-arịa ọrịa shuga

• Ọgwụ zuru oke na oge ọgwụgwọ maka ọrịa shuga mellitus (ọrịa nke glucose ọbara dị elu mara).
• Nri nwere mmachi nnu, protein, carbohydrates, nri abụba.
• Qukwụsị ise siga na ị alcoholụ mmanya.
• Arụ ọrụ arụrụ arụ (anaghị akpata ọgụ angina (ọrịa nke mgbu na-egosipụta ma ọ bụ ahụ erughị ala n'azụ sternum n'ihi mmebi ọbara na-enye obi)).
• Kwa ụbọchị na-agagharị na ikuku dị mma.
• Mbelata na oke ibu.
• Nnyocha dị omimi nke glucose ọbara (nyocha nke ụbọchị).
• Njikwa ike nke ogo lipids (abụba) n'ime ọbara (otu ugboro kwa ọnwa isii).

AKR RERF EGO

Isoro dọkịta na-achọ

Endocrinology - Dedov I.I., Melnichenko G. A, Fadeev V.F., - GEOTAR - Media, 2007
Algorithms maka nlekọta ahụike pụrụ iche maka ndị ọrịa nwere ọrịa mellitus, 2012

Ọrịa angiopathy nke arịa "obi"

Mgbagha a nke ọrịa shuga na-ebulikarị ndị mmadụ na-arịa ọbara mgbali elu, mana enwere ike ịchọpụta ya na ndị na-enweghị nsogbu nrụgide. Ọrịa ndị a na-egosipụta ọrịa microangiopathy nke obi

- mgbu n'ime obi, na - eme ka ahụ erughị ala na olu, azụ, azụ ala, ogwe aka ekpe,

- mgbu na mmetụta nke ịsụ mmiri, mkpakọ n'azụ azụ ahụ, arụ ọrụ arụ ọrụ, yana n'ọnọdụ nrụgide,

- ọzịza na mgbu na hypochondrium ziri ezi,

Udiri oria a na aputa na oria obi. Iji mee nyocha ziri ezi, akwara ozi na akwara ozi na MRI nke arịa nke obi, yana anụ ahụ n’onwe ya.

Dị ka ndị na-enye ọgwụgwọ, a na-enye ndị ọrịa ọgwụ ndị na-egbochi arịa ọbara irigbu, na-eme ka ọbara na-aga n'ihu, na-egbochi ọbara ọgbụgba, belata ọbara mgbali, ma belata cholesterol “ọjọọ”. Ndị a bụ "Nitroglycerin", "Aspirin", "Bisoprolol", "Verapamil", "Ramipril", "Lozartan" na analogues ha.

Nehropathy

A na-ahụ ọrịa microangiopathy nke akụrụ na ndị ọrịa mamịrị nwere ahụmịhe ma ọ bụ na ndị na-anaghị agbaso ndụmọdụ dọkịta niile gbasara nri na ị medicationsụ ọgwụ. Ọrịa

- ike ọgwụgwụ enweghị atụ,

- ọgbụgba, ọtụtụ mgbe tupu ọgbụgbọ,

n'ụtụtụ na-aza n'ihu,

- proteinuria (protein kpebisiri ike na mmamiri).

- nnwale ọbara (biochemical, nke na-ekpebi ọkwa nke creatinine na urea),

Ọgwụ nke microangiopathy nke akụrụ na-arịa ọrịa akụrụ na mbido mbụ nke mmepe nke nsogbu na-esonye na ịchekwa etu shuga dị n'ọbara na ijigide ọbara nkịtị. Usoro ndị a na - enyere aka izere mmebi akụrụ ogologo oge. N’ọdịnihu, a na - enye ọgwụ ịba ọcha n’anya, n’okwu ikpe tara akpụ - akụrụ akụrụ.

Retinopathy

Retina mmadụ nwere obere arịa ọbara. A na-akpọ ọdịda ha, nke mere n'ihi ọrịa shuga, retinopathy. Nsogbu a nwere ike itolite ogologo oge, afọ 20 ma ọ bụ karịa, ma ọ bụrụ na onye ọrịa ahụ na-emezu ọgwụ dọkịta ahụ, ma nwee ike ịkọwa onwe ya mgbe afọ abụọ gachara site na nchoputa ọrịa shuga mellitus. Ọ bụ ihe nwute, n’oge na-adịghị anya, retinopathy na-emetụta ndị ọrịa niile.

Ihe akara ndi a bu nke a na -anuputa ọrịa mamiri:

- nkwarụ anya ruo na ọnwụ ya zuru oke,

kwà mgbochi guzo n'anya m,

- “ihe na-ese n'elu mmiri”

- ihe isi ike ịhụ obere ihe,

ntụpọ dị iche iche na-acha uhie uhie na ọnya na-acha uhie uhie na anya,

- oke obara,

- mgbu na nku anya.

Onye dibia bekee, mgbe o lere anya, nwere ike ichoputa mgbaàmà nke retinopathy tupu onye ọrịa n’onwe ya chee na o nwere ihe na-adịghị mma n’ọhụụ ya. Ihe ịrịba ama izizi nke nsogbu a bụ:

- akwara ndị nwere nkwarụ (ha na-ejikarị microaneurysms),

Mgbochi retinopathy bụ nyocha nke onye ọkachamara na-ahụ maka ọrịa anya, na-elele ọkwa shuga dị n'ọbara, na nri.

Usoro ọgwụgwọ retinopathy nwere mejupụtara ọgwụ dị iche iche na ọgwụ anya, ịzọ ọsịsa ọbara nke eriri, yana ịwa ahụ, na-ewepụ ọbara na ọnya ọnya n'anya.

Encephalopathy

Microangiopathy na ọrịa shuga nwere ike imetụta arịa ụbụrụ. Ọrịa dị otú ahụ na-eme na ndị ọrịa nwere ahụmịhe gbara ọkpụrụkpụ na ndị na-anaghị erube isi na ndenye dọkịta. Ihe mgbaàmà mbụ nke encephalopathy:

- mkpesa banyere isi "stale",

- Ihi ura n’abali, ura n’ehihie,

- nsogbu ncheta,

A na-agbakwunye mgbaàmà ndị ọzọ:

- ihe omume ntiwahe nke ọgbụgba,

Ọrịa bụ MRI nke ụbụrụ.

Weghachi arịa ndị na-emebi emebi agaghịzi ekwe omume. Ebumnuche ọgwụgwọ bụ iji belata usoro maka inwekwu mmepe nke nsogbu. Ntọala nke ọgwụgwọ bụ ilele ọ̀gù shuga dị n’ọbara ma belata ya ka ọ bụrụ ezigbo uru.

Angiopathy nke arịa nke ụkwụ

Microangiopathies na-arịa ọrịa shuga gụnyere nnukwu nsogbu nke ọrịa shuga mellitus, nke e gosipụtara na mbibi nke obere arịa na irighiri akwara (polyneuropathy) nke ụkwụ, n'ihi nsonye ọbara na-enye nsogbu, na-eto eto na-eto eto, na n'ọnọdụ ndị ka njọ, ọ na-amalite. Ọrụ oge ọrụ, oke ibu, ise anwụrụ, ọbara mgbali elu, ịkọ mkpụrụ ndụ ihe nketa na-eso akpata mmepe nke nsogbu.

- ọnya ụkwụ,

- isi ike n'ụtụtụ,

Site na mmụba nke nsogbu, a na-akpụ ụkwụ na-arịa ọrịa shuga (imechi mbọ aka, mgbanwe na agba ha, ọdịdị nke corns, cracks na ọnya), na nke a, n'aka nke ya, na-enye aka na ọdịdị nke gangrene, sepsis.

A na-eme nchọpụta ahụ dabere na nyocha nke ụlọ ọgwụ na ọtụtụ ule akọwapụtara:

A na-eme ọgwụgwọ ahụ n'ụzọ atọ:

1. Oge gboo maka ọrịa shuga (ịchịkwa shuga ọbara, nri nke anaghị ekwe ibu oke ibu, ịchịkwa ọbara mgbali elu).

2. Imeziwanye mmiri na onodu ihe banyere mmiri (nke ndi oria na-ewere statins, angioprotector, antioxidants, biogenic stimulants, metabolism, oil thinners, biogenic stimulants).

3. Ihe ntinye ịwa ahụ, ebumnuche ya bụ iji weghachite mgbasa ọbara na iwepu saịtị ndị nwụrụ anwụ.

Gịnị bụ macroangiopathy?

Mgbe mgbanwe ọrịa a na - ebute ọrịa shuga metụtara arịa na nnukwu arịa, a na - achọpụta nchọpụta ọrịa macroangiopathy. Isi ihe kpatara nsogbu a:

- ikop nke okpukpo okpuru ala nke akwara na akwara ndi mmadu n’ihi shuga di elu,

- guzobe na arịa nke atherosclerotic plaques,

- Calcification nke ọbara, ha ụbụrụ necrosis.

Ihe ndị a niile na - eduga n'ọrịa thrombosis, ọrịa ọdịyo na nsogbu mgbasa ọbara.

Ibu oke ibu, hyperglycemia, dyslipidemia, insulin resistance, usoro mkpali, mgbakasi, coagulation ọbara di elu na enyere aka na ntuputa macroangiopathy. N'ihi ya, atherosclerosis nke arịa ndị dị otú ahụ mepụtara:

1. Aorta na akwara akwara. Ọ na - eduga na ischemia cardiac, nkụchi obi, angina pectoris, cardiosclerosis.

2. akwara akwara. Enwere ike ibute ọrịa mgbu azụ ma ọ bụ ischemia nke ụbụrụ (adịghị ala ala).

3. Akwara akwara akwara. Ihe e ji mara ya bụ ihe egwu nke ajọọ egbe na iwepụ ụkwụ aka na ụkwụ. Na atherosclerosis nke akwara ozi akwara, necrosis anụ ahụ na-apụtakarị. Nkwalite maka nke a nwere ike ịbụ obere ọnya, dịka ọmụmaatụ, enwetara n'oge pedicure, yana cracks, mycoses.

Ihe omuma banyere mmalite nke anakpo angiopathy

Ihe ojoo, rue ogologo oge, mmetụta nke oria shuga n’arụ ahụ na-egosipụta onwe ya n’ụdị nsogbu ụfụ na-adịghị ala ala - angiopathy (mbibi arịa ọbara). Ihe ngosiputa oria nke oria endocrinological gunyere onodu ihe mberede na odidi shuga obara (hypoglycemia) ma obu ubara ya (ketoacidosis), coma.

Ọbara ọbara na-abanye na ahụ dum. N'ihi ọdịiche dị ugbu a na caliber ha (buru ibu na obere), macro- na microangiopathy na-nkewa. Mgbidi nke veins na capillaries dị nro ma dị gịrịgịrị, glucose na-emetụta ha n'otu aka ahụ.

N’ịkpụbanye n’ime arịa, ihe ndị dị ndụ na-emepụta nsị kemịkal na-emerụ mkpụrụ ndụ na akwara. Mgbanwe na-ebute ọgba aghara na arụ ọrụ akụkụ ahụ nkịtị. Nke mbu, macroangiopathy na ọrịa shuga na-emetụta obi, ụbụrụ, ụkwụ, microangiopathy - akụrụ, anya, ụkwụ.

Na mgbakwunye na shuga dị elu, arịa ọbara na-emebi cholestrol na ihe ndị mepụtara n'ihi ị smokingụ sịga nke onye ọrịa ahụ n'onwe ya ma ọ bụ ndị sitere na gburugburu ya. Zọ ọbara dị n'ọbara nke cholesterol jikọtara. N'ime ọrịa shuga, arịa ndị a na-egbu ugboro abụọ (glucose na kọlestrọl). Onye na-ese siga na-ekpughere onwe ya banyere mbibi atọ dị egwu. Ọ na-azọ ọnya ịnwe oria atherosclerosis, ọ rughi otu onye nwere ọrịa shuga.

Ọbara mgbali elu (BP) na - edugakwa ná mbibi anụ ahụ dị n’ime arịa ahụ (aorta, veins). Dọ dị n’etiti mkpụrụ ndụ, mgbidi ahụ wee bụrụ nke a na-ele anya, ma bụrụkwa ebe a na-elekwasị anya maka ịba ụba. Na mgbakwunye na plasta cholesterol, scars na-etolite na mgbidi emetụtara. Neoplasms nwere ike imechi akụkụ ụfọdụ na ọbụna kpamkpam igbochi lumen n'ime arịa. Enwere ụdị ọrịa strok pụrụ iche - ọbara ọgbụgba ma ọ bụ ọbara ụbụrụ.

Ọrịa macroangiopathy na-arịa ọrịa ma ọ bụ na-ebelata nnukwu arịa bụ ihe e ji mara ụdị ọrịa 2. Dị ka a na-achị, onye ọrịa ahụ karịrị afọ 40 ma mgbanwe ebumpụta ụwa nke sistem vaskụla na-ebute nsogbu ndị metụtara ọrịa mamịrị. Ọ gaghị ekwe omume ịtụgharị usoro ndị na-agba ọsọ n'akụkụ ọzọ, mana enwere ike ịkwụsị nguzobe anụ ahụ.

Ọrụ ọzọ na-eduga na mmepe nke ụdị angiopathies abụọ amachaghị nke ọma - ihe butere mkpụrụ ndụ ihe nketa na ọrịa obi.

Mgbaàmà nke macroangiopathy

Ndị ọrịa nwere atherosclerosis na-aka okenye karịa afọ ha, na-arịa oke ibu. Ha nwere oghere iberibe odo dị na ikpere na nku anya - nkwụnye cholesterol. N'ime ndị ọrịa, nsogbu nke akwara ụkwụ na akwara ozi na-esighi ike, ruo na ọnụnọ zuru oke, ihe mgbu na akwara nke nwa ehi na-apụta mgbe ị na-eje ije na mgbe oge ụfọdụ kwụsịrị. Ọrịa a na-esonye na ịkọwa okwu na-enweghị atụ. Iji mee nyocha ziri ezi, ndị ọkachamara na-eji usoro angiography.

A na-ahụta usoro ndị a na mmepe nke nnukwu ọrụ na microangiopathy nke ala ala:

• kọlọ
• arụ ọrụ
• organic
• ọnya afọ necrotic
• gangrenous.

A na-akpọkwa ọkwa mbụ dị ka asymptomatic ma ọ bụ metabolic, ebe ọ bụ na dịka data nke ule arụ ọrụ, a chọpụtaghị mmebi iwu. Agba nke abuo nwere ihe nlere di egwu. N'okpuru mmetụta nke ọgwụgwọ, nsogbu ndị nwere ya ka nwere ike idogharia.

Ibelata arịa ọbara nke na-enye otu akụkụ ahụ na-eduga na ischemia (anaemia mpaghara). A na-ahụkarị ụdị ihe ịtụnanya a na mpaghara obi. Ọkpụkpụ akwara na-adị na-akpata ọgụ angina. Ndị ọrịa na-achọpụta ihe mgbu n'azụ azụ azụ, ọgba aghara nke obi ọgụ.

Ihe mgbochi nke akwara obi mberede na-emebi oriri na-edozi ahụ. Nsi neisosis na - eme (necrosis nke akụkụ ahụ) yana infarction myocardial. Ndị mmadụ butere ya bụ ọrịa obi obi. Surgerywa ahụ nwere ike belata ogo ndụ nke ndị ọrịa nwere ọrịa akwara ha.

Atherosclerosis nke akwara ndị ụbụrụ na-esonye na ọgbụgbọ, mgbu, na ebe nchekwa. Ọrịa strok na - eme mgbe enwere mmebi nke inye ụbara n’ ụbụrụ. Ọ bụrụ na 'mmadụ' gabịa 'mmadụ ka ọ dị ndụ, mgbe ahụ ọ ga-ebute nsonaazụ (ọnwụghị ikwu okwu, ọrụ moto). Atherosclerosis nwere ike ịbụ ihe kpatara ọrịa strok, mgbe ọbara na-erugharị na ụbụrụ na-agbagha n'ihi oke cholesterol.

Isi ọgwụgwọ maka angiopathy

Otuto bụ nsonaazụ metabolism dị n'ahụ. Emere ọgwụgwọ a iji ọgwụ ndị na-eme ka ụdị metabolism dị iche iche mara njikwa macroangiopathy.

• carbohydrate (insulin, acarbose, biguanides, ọtụtụ sulfonylureas),
• abuba (ogwu nwere ike ime ka aru di ya),
• protein (homonụ na anabolic steroid),
• mmiri-electrolyte (hemodesis, reopoliglyukin, nhazi nke potassium, calcium, magnesium).

Mgbe mgbe, a na-ahụ ihe na - egosi cholesterol na ụdị ọrịa shuga 2 nke ọrịa shuga, na - amụba ahụ. A na-enyocha ya ugboro abụọ n'afọ. Ọ bụrụ nnwale ọbara dị elu karịa nke nkịtị, mgbe ahụ ọ dị mkpa:

• na mbu, imebi nri nke onye oria (ewepu ihe abuba umu anumanu, belata carbohydrates di mfe karia 50 g kwa ubochi, kwe ka mmanu nri sie 30 ml, azu, akwukwo nri na nkpuru osisi),
• nke abuo, drugs nu ogwu (Zokor, Mevacor, Leskol, Lipantil 200M).

Site na angioprotectors na-emeziwanye ọbara na arịa ime ala. N'ikwekọ na usoro ọgwụgwọ bụ isi, ndị endocrinologists na-atụ aro iji vitamin B (nitamine, pyridoxine, cyanocobalamin).

• normalization nke ọbara mgbali na ọgwụ (Envas, Enalopril, Arifon, Renitek, Korinfar),
• ifelata nwayọ,
• na-ewepụ ihe riri ahụ na sịga na mmanya na-aba n'anya,
• mbelata n'ihe oriri nnu,
• na-ezere ọnọdụ ndị na-akpata nrụgide ogologo oge.

Dị ka ihe enyemaka maka ọgwụgwọ nke ọrịa vaskụla, endocrinologists tụrụ aro ka iji usoro ọgwụgwọ ọzọ. Maka ebumnuche a, a na-eji nkwadebe ọgwụ ọgwụ (buckthorn ogbugbo, okpokoro ọka nwere stigmas, mgbọrọgwụ nke nnukwu burdock, mkpụrụ nke ịkụ karọt, ahịhịa ahịhịa).

Ọrịa ịrịa afọ na-arịa ka ọnwa, afọ, na iri afọ. Na United States, Dr. Joslin Foundation guzobere nrịba ama pụrụ iche. Ọrịa shuga na-emeri, bụ onye jisiri ike dịrị ndụ afọ iri atọ n’enweghị nsogbu, gụnyere angiopathy, ka a na-enye otu aha ahụ. Ihe nrịba ama gosipụtara na enwere ike ịchịkwa ọrịa nke narị afọ.

Ihe na-ebute macroangiopathy na ọrịa shuga

Mgbe mmadụ rịawara ọrịa shuga ogologo oge, obere capillaries, mgbidi akwara na veins n'okpuru mmetụta nke glucose dị ukwuu na-amalite ibelata.

Yabụ na enwere thinning dị omimi, ma ọ bụ, na - atụgharị, nke a bụ oke ọgbụgba ọbara.

N'ihi nke a, ọbara ọgbụgba na metabolism n'etiti akwara nke anụ ahụ dị n’ime, na-enye nsogbu, nke na-eduga n’inwe hypoxia ma ọ bụ agụụ oxygen nke anụ ahụ gbara gburugburu, na-emebi ọtụtụ akụkụ nke ndị ọrịa mamịrị.

• Ọtụtụ mgbe, a na-emetụta arịa buru ibu nke ala akụkụ ala na obi, nke a na-eme na pasent 70 nke ikpe. Akụkụ ahụ ndị a na - enweta nnukwu ahụ, yabụ, mgbanwe na-emetụta oke arịa ndị ahụ. Na microangiopathy na-arịa ọrịa shuga, a na-emetụtakarị fundus, nke a na-achọpụta dị ka retinopathy, nke bụkwa ikpe nkịtị.
• A, macroangiopathy na-arịa ọrịa shuga na-emetụta ụbụrụ, akwara ọbara, akụrụ, akwara akwara. Nke a na-esochi angina pectoris, infarction myocardial, ọrịa ọnya afọ, ọrịa mamịrị, na ọbara mgbali ala. Site n'ịgbasa mbibi nke akwara ọbara, ihe ọghọm nke ibute ọrịa obi na ọrịa obi na-arị elu ugboro atọ.
• Ọtụtụ ọrịa mamịrị na-akpata arteriosclerosis nke arịa ọbara. A na-achọpụta ụdị ọrịa a na ndị nwere ụdị 1 na ụdị ọrịa shuga 2 nke afọ 15 gara aga karịa ndị ọrịa nwere ahụike. Ọzọkwa, ọrịa na-arịa ndị ọrịa mamịrị nwere ike ịmalite ngwa ngwa.
• Ọrịa ahụ na-eme ka okpukpu okpuru ala nke okpuru ala na nke buru ibu na-arụ ọrụ, bụ́ nke e ji etolite etuto nke ikuku na-emewanye. N'ihi calcification, ngosipụta na necrosis nke plaques, ọbara ọgbụgba na-etolite na mpaghara, lumen nke arịa na-emechi, n'ihi ya, ọbara ọbara na mpaghara emetụtara emetụta na-arịa ọrịa mamịrị.

Dịka iwu, macroangiopathy na-arịa ọrịa shuga na-emetụta akwara, ụbụrụ, visceral, akwara ọgụ, ya mere, ndị dọkịta na-eme ihe niile iji gbochie mgbanwe ndị dị otú ahụ site na iji usoro mgbochi.

Ihe ọghọm nke pathogenesis na hyperglycemia, dyslipidemia, insulin resistance, oke ibu, ọbara mgbali elu, ịba ụba coagulation, endothelial dysfunction, nrụgide oxidative, sistem sistem dị elu.

Ọzọkwa, atherosclerosis na-etolitekarị ndị na-ese anwụrụ, na ọnụnọ anụ ahụ, yana ị professionalụbiga mmanya ókè. Menmụ nwoke gafere afọ iri ise na ise na ụmụ nwanyị karịrị iri afọ ise.

Ọtụtụ mgbe, ihe kpatara ọrịa ahụ na-abụ ihe a ketara eketa.

Ọrịa mamịrị na-arịa ọrịa shuga na ụdị ya

Ọrịa mamịrị (oria afọ ọsịsa) bụ echiche izugbe nke na-anọchite anya pathogenesis ma na-emetụta mmebi nke arịa ọbara - obere, buru ibu na ọkara.

A na-ahụta ihe omume a dịka nsonaazụ mbubreyo nke ọrịa shuga mellitus, nke na-amalite ihe dị ka afọ 15 mgbe ọrịa ahụ pụtara.

Ọrịa macroangiopathy na-arịa ọrịa syndromes dịka atherosclerosis nke aorta na akwara akwara, akụkụ akwara ma ọ bụ akwara ụbụrụ.

1. N'oge microangiopathy na ọrịa shuga mellitus, ọrịa retinopathy, nephropathy, na ọrịa mamịrịapọniki nke ọrịa ala ala.
2. Mgbe ụfọdụ, mgbe ọ bụla mebiri arịa ọbara, a na-achọpụta ọrịa angiopathy zuru ụwa ọnụ, echiche ya gụnyere micro-macroangiopathy na-arịa ọrịa mamịrị.

Microangiopathy endoneural nke na-akpata ọrịa mebiri emebi, na nke a na-akpata neuropathy mamịrị.

Kedu otu esi achọpụta ọrịa mamroangiopathy?

Diagnosis bu n’ikpebi etu ihe si emebi akwara obi, akụkụ ụbụrụ na akụkụ akụkụ.

Iji chọpụta usoro nyocha achọrọ, onye ọrịa ahụ kwesịrị ịga hụ dọkịta.

A na-eme nnyocha ahụ site na endocrinologist, diabetologist, cardiologist, dọkịta na-awa ahụ, onye na-awa obi, ọkachamara na akwara.

Na ụdị 1 na ụdị ọrịa shuga 2, ụdị ọgwụ nchọpụta dị ka enyere iji chọpụta pathogenesis:

1. Emere nnwale ọbara biochemical iji chọpụta glucose, triglycerides, cholesterol, platelet, lipoproteins. A na-enyocha nnwale ọbara ọbara.
2. Jide n'aka nyochaa usoro akwara obi site na iji electrocardiogram, nlebara anya kwa ụbọchị nke ọbara mgbali, nnwale nrụgide, ihe echocardiogram, ultrasound dopplerography nke aorta, scyoigraphy nke myocardial, coronarography, gbakọrọ tomographic angiography.
3. A na-akọwapụtakwa ọnọdụ akwara ozi nke onye ọrịa site na iji dopplerography ultrasound nke arịa ụbụrụ, nyocha duplex na angiography nke arịa ụbụrụ.
4. Iji chọpụta ọnọdụ akwara ọbara dị, akwara ụkwụ na-enyocha akụrụngwa duplex, ultrasound dopplerography, peripheral arteriography, rheovasography, capillaroscopy, oscillography arterial.

Ọgwụgwọ microangiopathy mamịrị

Ọgwụgwọ ọrịa a na ndị ọrịa shuga bụ isi n’inye ihe iji belata ọganiihu nke nsogbu vaskụla dị ize ndụ, nke nwere ike iyi onye ọrịa ahụ nkwarụ ma ọ bụdị ọnwụ.

A na-agwọ ọnya ọnya na elu na nke ala n'okpuru nlekọta nke dọkịta na-awa ahụ. Ọ bụrụ na ọria dakwasị nnukwu ọrịa vaskụla, a na-eme ọgwụgwọ kpụ ọkụ n'ọnụ kwesịrị ekwesị. Ọzọkwa, dọkịta ahụ nwere ike iduzi maka ọgwụgwọ ịwa ahụ, nke mejupụtara ya na endarterectomy, mkpochasị ụbụrụ ụbụrụ, mwepu aka nke aka emetụtara, ọ bụrụ na ọ bụrụlarị ọria ya na ọrịa mellitus.

Ejikọtara ụkpụrụ nke usoro ọgwụgwọ na mgbazi nke syndromes dị ize ndụ, nke gụnyere hyperglycemia, dyslipidemia, hypercoagulation, ọbara mgbali.

• Iji kwụọ ụka metabolism na ndị ọrịa mamịrị, dọkịta ahụ nyere ọgwụ insulin ọgwụ na ileba shuga ọbara oge niile. Maka nke a, onye ọrịa ahụ na - a drugsụ ọgwụ na - agbada egbugbere ọnụ - statins, antioxidants, fibrates. Na mgbakwunye, ọ dị mkpa ịgbaso nri ọgwụgwọ pụrụ iche na mgbochi nke iji ihe oriri nwere nnukwu ọdịnaya nke abụba anụmanụ.
• Mgbe enwere ihe ọghọm nke ịmalite nsogbu nke thromboembolic, a na-enye ọgwụ antilocklet - acetylsalicylic acid, dipyridamole, pentoxifylline, heparin.
• Usoro ọgwụgwọ antihypertensive n'ihe banyere nchọpụta ọrịa macroangiopathy na-arịa ọrịa mamịrị bụ iji nweta ma dozie ọkwa ọbara mgbali nke 130/85 mm RT. Art. Maka ebumnuche a, onye ọrịa ahụ na-ewere ACE inhibitors, diuretics. Ọ bụrụ na mmadụ tara ahụhụ dị ka infarction myocardial, a na-enye ọgwụ mgbochi beta.

Ihe mgbochi

Dabere na ọnụ ọgụgụ, na ụdị 1 na ụdị ọrịa shuga nke 2, n'ihi nsogbu obi na ndị ọrịa, ọnụ ọgụgụ ọnwụ na-abụ site na 35 ruo 75 pasent. Na ọkara nke ndị ọrịa a, ọrịa na-akpata ọrịa myocardial infarction, na pasent 15 nke ihe kpatara ya bụ oke ahụ ischemia oke.

Iji zere mmepe nke macroangiopathy mamịrị, ọ dị mkpa iji usoro mgbochi niile. Onye ọrịa ahụ kwesịrị ilebara ọkwa shuga dị n'ọbara anya, tụọ ọbara ọgbụgba, soro usoro nri, nyochaa oke nke aka ya, soro ndụmọdụ ọgwụ niile ma kwụsị omume ọjọọ ọ bụla o kwere mee.

Na vidiyo dị n'isiokwu a, a tụlere usoro maka ịgwọ ọrịa macroangiopathy nke ọrịa mamịrị.