I-angiopathy yesifo sikashukela yiqembu lezifo ezihambisana nomonakalo wemithambo yegazi nokujikeleza okunzima.
Ukuqhubekela phambili kwesifo sikashukela kuholela kancane kancane ekuthuthukisweni kwalesi sifo. Okokuqala, ithoni ye-vascular iyancipha, izikhala kuzo zincane, futhi kunokuntuleka kokudla okunempilo.
Ukufika kwesikhathi kudokotela kungaholela ekutheni unqunywe futhi nokufa.
Yini i-angiopathy yesifo sikashukela?
Kamuva, i-hyperglycemia eyenzeka isikhathi eside iba khona kwezinqubo ze-pathogenic ezakha izicubu zezinzwa nezindonga zemithambo. Baqinisekiswa iqiniso lokuthi imikhiqizo yokuqhekeka koshukela iqala ukungena kumaprotheni egazi nezicubu zomzimba. Lokhu kungaholeli i-angiopathy kuphela, kodwa futhi ne-angioneuropathy - ukulimala emithanjeni yegazi nasemithanjeni.
Ngakho-ke yini i-angiopathy yesifo sikashukela? Le yi-pathology lapho izikhala zezindonga zemikhumbi zimincane noma zivaliwe ngokuphelele. Ngenxa yalokhu, ukuhamba kwegazi kuyaphazamiseka kubo. Izinqubo ze-Pathological ezihambisana nemithambo yegazi zingakhula ezithweni eziningi, ngakho-ke i-angiopathy yesifo sikashukela ingavela emilenzeni, i-retina, izinso, ubuchopho kanye nenhliziyo. Izimpawu zesifo salesi sifo zingabukwa kwi-Intanethi.
Ngokuya nge-vasion lesion, lesi sifo sehlukaniswe izinhlobo eziningi:
- I-Microangiopathy ethinta imikhumbi emincane.
- I-Macroangiopathy iyindlela ehlotshaniswa nemikhumbi emikhulu.
- I-angiopathy ehlanganisiwe - ukulimala kwezakhi ezincane nezinkulu zemithambo yegazi.
Kulesi simo, izici zobungozi zokwakhiwa kwe-psychology zibhekwa "njengokuhlangenwe nakho" kwesifo sikashukela, izinga lesifo se-glycemia, iminyaka, izifo ezilinganayo, ukukhuluphala, ukubhema, ukukhuphuka kwegazi, umfutho wegazi ophakeme kanye nokuqina kwenyawo.
Uhlobo ngalunye lwesifo luziveza ngezimpawu ezikhethekile, okudingeka bazi ngalo bonke abantu abanesifo sikashukela.
Izimpawu ze-Diabetesic Nephropathy
Ukuqhubekela phambili kwe-angiopathy ku-mellitus yesifo sikashukela kuholela ekuthuthukiseni ukwehluleka kwezintso. Lesi sitho siqukethe ama-nephrons amaningi enzelwe ukuhlunga igazi. AmaNefroni akhiwa ngezinto ezinjenge-capsule, ama-tubules, ne-glomerulus. Lapho izindonga zama-capillaries ku-glomeruli emincane, ukusebenza okujwayelekile kwesitho esibhangqiwe kuyaphela.
Isikhathi eside, lesi sifo singaba cishe i-asymptomatic. Izimpawu zayo ziyefana nasoshukela: umlomo owomile, ukoma okungenakuqedwa nokuchama kaningi. Ukuqhubekela phambili kwe-nephropathy yesifo sikashukela kuholela ekuguvukeni, ekunyuseni umfutho wegazi kanye nokudakwa, okukhonjiswa ukudinwa nokungabi namawala.
Ukwelashwa okungasebenzi kungadala imiphumela emibi kakhulu. Ngokuhluleka okuhlala isikhathi eside kwezinso, izinto ezinobuthi ziqala ukuqongelela emzimbeni, omunye wazo okuyi-ammonia. Ingena kalula ohlelweni oluphambili lwezinzwa, ilimaze. Izimpawu eziphambili ze-ammonia ephezulu noma i-hyperammonemia yizikhathi zokuhlanza, ukozela, isiyezi, nokuqaqanjelwa.
Kumele kuqashelwe ukuthi ubukhulu bokudakwa kuya ngokuthi ukusebenza kwezinso kukhubazeke kangakanani.
Izimpawu ze-Diabetesic Retinopathy
I-retina ye-eyeball inethiwekhi yayo yama-capillaries. Ngokuqhubeka kwesifo sikashukela, nguyena ohlupheka kakhulu. I-Arterioles, imithambo yegazi, ama-capillaries nemithambo kuyadlula kuyo. Lapho ukucaciswa okukubo kuncipha, ukugeleza kwegazi kuyaphazamiseka, okuholela ekukhuleni kwe-retinopathy.
Lapho kutholwa le-pathology, izimpawu ze-ophthalmic nezomtholampilo ziyahlukaniswa.
Izimpawu ze-Ophthalmic yilezo ezitholwa ngenkathi kuhlolwa i-ophthalmological, kanti nezimpawu ezichazwa yisiguli kudokotela ohamba nazo zithathwa njengomtholampilo.
Kumele kuqashelwe ukuthi ukuthuthukiswa kwe-retinopathy kucishe kube yi-asymptomatic, ngakho-ke, kuvame ukutholakala kusekupheleni kwesikhathi. Izikhalazo zesiguli lapho kuthintwa uchwepheshe zingafaka:
- umgubuzelo phambi kwamehlo;
- ukonakala kwemishini ebukwayo;
- amachashazi amnyama noma ukuvutha.
Ukuqhubekela phambili kwalesi sifo kuholela ekuphambukeni kobukhulu kanye nobume besithombe phambi kwamehlo. Futhi lapho i-retinopathy ihambisana nokuqubuka komzimba emzimbeni we-vitreous, onesifo sikashukela sinezindawo ezimfushane ezimnyama. Esimweni esibi kakhulu, i-pathology iholela ebumpumputhe.
Ngesikhathi sokuhlolwa kwamehlo, udokotela uhlola imithambo kanye nezinzwa ze-retina. Noma isiguli singazizwa ezinye izimpawu ezisobala, izimpawu ze-retinopathy sezivele zitholakala. Udokotela angabona imithambo yegazi encishisiwe ku-fundus, futhi ngezinye izikhathi ama-microaneurysms.
Ngaphezu kwalokho, ukuvuvukala nokuqongelela uketshezi kuvela emithanjeni emikhulu.
Ukuthanda iziphetho eziphansi
Ukuze uthole kahle i-angiopathy yesifo sikashukela esisezingeni eliphakeme, kufanele wazi ukuthi yiziphi izimpawu isiguli ezingase zibe nazo. Ngemuva kwakho konke, ukwelashwa okungajwayelekile noma okungasebenzi kuholela emiphumeleni engenakuphikwa.
Njengomphumela wokunciphisa imithambo yemithambo engezansi, i-ischemia iyakhula, okuwukuthi, ukushoda komoya-mpilo nokunikezwa kwegazi, okuholela ekusebenzeni komlenze okungasebenzi kahle. Ukushintshwa kwe-trophic esikhumbeni ngisho ne-necrosis noma i-gangrene kwenzeka. Kulokhu, izinyawo ezithinteka kakhulu, ngoba ziyindawo ekude kakhulu.
Izimpawu zalesi sifo sibangelwa izinqubo ezenzeka ngazo zombili isifo “esimnandi” kanye ne-atherosclerosis. Ngaphezu kwalokho, odokotela bakhomba ezinye izinto ezivusa ukubukeka kwenqubo ye-pathological yemilenze nezinyawo. Lokhu kufaka ukubhema, isakhi sofuzo kanye nomsebenzi oyingozi ngezinto ezinobuthi.
I-angiopathy yesifo sikashukela semikhawulo ephansi ihlala ibonakaliswa yizimpawu ezilandelayo:
- Ukubanda nokuqina kwemilenze.
- Ama-Goosebumps.
- Izilonda eziyingozi zonyawo.
- Ukuqina nobuhlungu.
- Izinguquko esikhunjeni.
Ngokuya ngezinga lokulimala kwemithambo, kukhona ama-macro- kanye ne-microangiopathy yemikhawulo ephansi. Kulokhu, ukulimala emaphethelweni aphezulu kwenzeka kaningi kakhulu.
Ngokulimala okuncane emithanjeni yemilenze, isiguli sizwa imizwa emincane yokuzwa. Kwesinye isikhathi imilenze yakhe iyaqina, bese kuvela izilonda ezincane kuzo. Ukudlondlobala kwe-macroangiopathy kuholela ekuxineni kwemilenze, ukuqina, isikhumba, isikhumba njalo, izinhlungu nomkhuhlane.
Unyawo lwesifo sikashukela luyinkinga eyingozi eyenzeka lapho ukwelashwa kwe-angiopathy yesifo sikashukela ephansi kungaphumeleli. Ngale nqubo ye-pathological, kwenzeka izinguquko ezithile emajoyintini nasezicubu zamathambo. Omunye wemiphumela yi-arthropathy yesifo sikashukela, okuholela ekuqhekekeni nasekuhlukaniseni amathambo onyawo. Izinguquko ezinjalo ngemuva kwalokho ziholela kwi-Menkeberg syndrome (ukucabanga kanye nokuqina kwemithambo yemilenze) kanye nokulimala konyawo.
Kumele kuqashelwe ukuthi i-angiopathy yesifo sikashukela semikhumbi emaphethelweni aphansi ngokwayo cishe ayithuthuki.
I-pathology enjalo iba ngokuhlangana nephropathy ne-retinopathy.
Izimpawu ze-Encephalopathy zesifo sikashukela
Lapho i-encephalopathy yenzeka kwisifo sikashukela, ukukhubazeka kwenkumbulo nokudideka kuqala. Ngaphezu kwalokho, isiguli sikhononda ngokuqhubeka kwekhanda nokukhathala. I-pathology enjalo ingumphumela wokwephulwa kwegazi lobuchopho.
Ekuqaleni kokukhula kwalesi sifo, umuntu kungenzeka angabi nazimpawu. Kepha ngokuqhubeka kwesikhathi, isiguli siba umlutha kuma-painkiller ngenxa yekhanda elijwayelekile. Lokhu, kuholela ekuphazanyisweni kobuthongo futhi ukozela usuku lonke. Ngokuzayo, isiguli siyaphazamiseka futhi sikhohlwe.
Ngaphezu kwezimpawu zokuzala, okugxilwe phambili kukhula, okubandakanya ukuhlanganiswa kokulimazeleka kokunyakaza, ukukhalipha kwe-pathological kanye ne-shaky gait. Ukuphazamiseka kokuhlangana kubhekwa njengophawu oluyingozi, okungukuthi, umbono ophindwe kabili, izithombe ezifiphele, umbono ofiphele, ukuzivumelanisa nezimo ngendlela engajwayelekile. Ngaphezu kwalokho, kuvela i-anisocoria - isimo lapho kubhekwa khona ububanzi obuhlukile babafundi.
Izinqubo ezinjalo ze-pathological ziyingozi esigulini lapho zenza umsebenzi ohambisana nezinqubo ezahlukahlukene, kanye nokushayela imoto.
Ukunqotshwa kwama-capillaries kanye ne-coronary artery yenhliziyo
Ngokuhlinzekwa okuqhubekayo kwamaseli ezinhliziyo, kunethiwekhi ene-capillary nemithambo ye-coronary.
Isifo i-angiopathy yesifo sikashukela sithinta imithambo ye-coronary kwesokudla nakwesobunxele Le nqubo ibizwa ngokuthi yi-macroangiopathy, okuvela ekwakhekeni kwe-atherosulinosis.
Lapho ama-capillaries ethinteka, kuvela isifo sikashukela se-diabetes.
Uma kwenzeka i-pathology, isiguli sikhononda ngalezi zimpawu ezilandelayo:
- Ubuhlungu buka-Angina. Kwenzeka ngenxa yokwakheka kwama-plaque nemichilo ku-lumen yemithambo yegazi. Ngenxa yalokhu, igazi alikwazi ukuhamba ngesilinganiso esidingekayo, futhi inhliziyo ayinalutho ku-oxygen. Le nqubo ibangela ukuwohloka kwe-oksijeni ngaphandle kwe-glucose kanye nokudedelwa kwe-lactic acid. Kuyacasula ukuphela kwezinzwa enhliziyweni, ngakho umuntu uzwa izinhlungu.
- Ukwehluleka kwenhliziyo, okukhonjiswa ukukhwehlela, kwehlise izinga lokushaya kwenhliziyo kanye nokuphefumula komoya.
- Ukuphazamiseka kwesigqi senhliziyo. Thuthukisa ngezilonda zemikhumbi emincane kanye nesifo sazo esise-myocardium. Kunezinhlobo eziningi zokuphazamiseka kwesigqi: i-bradycardia (ukushaya kwenhliziyo okungaphansi kwama-50 beats / min), i-tachycardia (ngaphezu kwama-90 beats / min), i-extrasystole (ukuthengiswa okungatheni) kanye ne-arrhythmia (ukuphazamiseka okujwayelekile kwesigqi).
Kumele kukhunjulwe ukuthi ukulimala emithanjeni yenhliziyo kuvame ukuhambisana nokulinyazwa kwemithambo yemilenze, izinso ne-retina.
Ukuxilongwa nokwelashwa kwalesi sifo
Izindlela zokuxilonga zokuthuthukisa i-angiopathy yesifo sikashukela kufanele zenziwe ngokuphelele. Ngakho-ke, akuhlolwanga kuphela uketshezi lwebhayoloji, kepha nezitho ezithambekele kule ndlela.
Kunezindlela eziningana zokunquma ukugula.
Ukuhlola i-nitrogen eseleyo yegazi. Ukwanda kwe-nitrojeni okukhombisa umsebenzi wezinso ongaphazamiseki. Amazinga we-Urea ne-creatinine nawo anqunywa. Izinga le-nitrogen: 14 kuya ku-28 mmol / ilitha. Okuqukethwe e-Urea: 2,5 kuye ku-8.3 mmol / litre.
I-Urinalysis Izinkomba ezinjenge-glucose, imizimba ye-ketone namaprotheni zinqunywa. Okuqukethwe kwe-glucose: kufika ku-10 mmol / l. Izinga lamaprotheni: aze afike ku-300 mg / ngosuku.
Ukufundwa kwezinga lokuhlunga le-glomerular. Isikhombisi esiyinhloko sokuxilongwa kwe-nephropathy. Ukuhlunga kwe-glomerular: kufika ku-140 ml / min.
Ukuchazwa kwe-urine kwe-b2-microglobulin. Ukutholwa kwe-b2-microglobulin kukhombisa i-angionephropathy yesifo sikashukela. Umuntu ophilile akufanele abe semchameni.
Isibonisi se-lipid segazi. Ukutholwa kwe-lipoprotein yegazi ne-cholesterol. Izinga le-cholesterol: hhayi ngaphezu kuka-5.5 mmol / L. Ukuqoqwa kwama-lipoproteins: kusuka ku-1 kuye ku-2.9 mmol / L.
Ukuxilongwa kwalesi sifo kusho ukusetshenziswa kwezinye izindlela, okungukuthi:
- ukuhlolwa okuphelele kokuhlolwa kwezamehlo;
- I-Ultrasound
- i-echocardiography;
- I-Dopplerography ne-arteriography yemilenze;
- i-coronary angiography;
- ama-electrocardiograms (ECG);
- amandla kazibuthe okokuqina kobuchopho.
Ngemuva kokuthi udokotela enze ukuxilongwa, kusungulwa iqhinga lokwelapha i-angiopathy. Ukwelashwa okusebenzayo kufaka nokugcina ukudla okulinganiselayo, ukugcina impilo esebenzayo nokushintshana kokuphumula nomsebenzi. Ngaphezu kwalokho, ukwelashwa kwe-angiopathy kuhambisana nemithi enjalo:
- Imithi yesifo sikashukela ukulawula i-glycemia.
- Imithi ukwehlisa i-cholesterol.
- Umfutho wegazi wehlisela izidakamizwa.
- Izidakamizwa ze-diuretic.
- Izindlela zokuthuthukisa ukuhamba kwegazi.
- Izidakamizwa ezivimbela i-thrombosis.
- Imithi ethuthukisa inqubo ye-metabolic.
Kuyadingeka ukwelapha isifo esibucayi kangako ngaphansi kokuqashwa ochwepheshe, unamathela kuzo zonke izincomo zakhe. Ividiyo ekulesi sihloko izoqhubeka nesihloko sezinkinga zesifo sikashukela.
