Esikhathini esedlule, bekukholelwa ukuthi iziguli ezinesifo sikashukela zivame ukubhekana nokuxilongwa kwesifo senhliziyo, kepha namuhla izazi zezenhliziyo zithi isithombe sasemtholampilo siyashintsha: izinkinga zesifo sikashukela ezinjengokwehluleka kwenhliziyo nokufakelwa kwethambo kuye phambili.
Izifo zesistimu yenhliziyo ziyinto enqumayo uma kukhulunywa ngokubikezela kwesikhathi sokuphila kwabantu abanesifo sikashukela. Ngokwezibalo eziboniswe ososayensi baseJalimane, amadoda anesifo sikashukela asengozini ephindwe kabili yokuthola lezifo, futhi afinyelela kwabayisithupha kwabesifazane. Ngaphezu kwalokho, ama-pathologies emithambo yezinhlungu ezenzeka ezigulini ezinesifo sikashukela sohlobo 1 nohlobo 2 ziyafana.
Ngaphezu kwezinombolo ezihlaba umxhwele ezichazwe ngenhla, kunelinye iphuzu elibalulekile uProfesa Diethelm Chöpe weCardio-Diabetesology Center yaseRuhr University eBochum (Germany) afuna icutshungulwe. Embikweni wakhe weJalimane Diabetes Society, ukhumbula ukuthi noma ngabe i-hemoglobin ye-glycated ilungiswa kahle, ubungozi obandayo busengaqhubeka. Ngakho-ke, sincoma ukuthi ulalele umbono wesazi sethu, osenze uhlelo olucishe luhambele lokuhambela ochwepheshe, okufanele lulandelwe ngokushesha ngemuva kokuxilongwa kwesifo sikashukela i-mellitus.
Isizathu sokuvama okuphezulu kwezifo zenhliziyo ezigulini ezinesifo sikashukela ukubuyiselwa kancane kancane kwesakhiwo senhliziyo. Lolu shintsho lubangelwa ukungalingani kwezidingo zamandla womzimba namandla atholakalayo. Kwenza inhliziyo ibe sengozini, ngokwesibonelo, isifo sezinhliziyo ezi-coronary (CHD). Kodwa-ke, akukhona nje ukuthi wephula ukunikezwa kwegazi kuyi-myocardium. Namuhla, ukwehluleka kwenhliziyo kanye ne-fibrillation ye-atrial, ekhulisa ubungozi bokushaywa unhlangothi. Izinqubo ze-pathophysiological zandisa ingozi yokufa ngokuzumayo kwenhliziyo.
Izigaba zomonakalo ezi-4
USolwazi Chope uhlukanisa lezi zinhlobo ezilandelayo ezinemibandela yomonakalo:
- Ukushoda ngamandla kwenhliziyo,
- ukunqwabelana kwama-metabolites asebenzayo nezinguquko zezakhiwo,
- inhliziyo autonomic neuropathy,
- hemodynamics limited.
Ngempela, nge-hyperglycemia, kunamandla ngokweqile kwe-substrate yamandla (khumbula, isakhi samandla esiyinhloko se-myocardiocytes kungamafutha angathathi hlangothi namafutha acid, anesibopho sokunikezwa kwamandla ngo-70%. Ngokwezinga elincane, ukunikezwa kwamandla kwe-myocardium kungenxa ye-glucose kanye nemiphumela yayo ehlukanisayo, kanye nama-amino acid namaprotheni. ) Noma kunjalo, ngeke isetshenziswe yinhliziyo.
Kukhona nokuqongelela okulandelanayo kwama-lipid nama-glucose metabolites, okwenza isimo sezinhliziyo sibe sibi kakhulu. Izinqubo zokuvuvukala ziholela ekuhlelweni kabusha kwe-fibrotic ngoshintsho kumaprotheni, ukunqwabelana kwemikhiqizo ye-glycolysis, ukuthutha okungahambi kahle kokusetshenziswa komhlaba ongaphansi kanye nokungasebenzi kahle.
I-Coronarossteosis (ukulimaza kwemithambo yenhliziyo) iholela ekushoneni komoya-mpilo, okwandisa ukushoda kwamandla. Uhlelo lwezinzwa lwenhliziyo oluzimele nalo lonakalisiwe, imiphumela yalokhu kulimaza ukuphazamiseka kwesigqi kanye noshintsho ekuboneni kwama-cardiosymptoms. Futhi ekugcineni, ushintsho ekwakhekeni kwenhliziyo kunciphisa isimo salo se-hemodynamic (sikhuluma ngengcindezelo ohlelweni lwenhliziyo, ukuhamba kwegazi, amandla okuqanjwa kwe-ventricle yangakwesobunxele, njalonjalo).
Uma kuvela iziqongo zikashukela, zingaba nesandla ekuqhekekeni kwegazi futhi ekugcineni zibange ukushaya kwenhliziyo. "Inhlanganisela ne-microangiopathy engapheli ichaza ukusebenza okungekuhle kwezingxenye ze-myocardium," kusho uKardiologie.org ecaphuna uChope. Ngamanye amagama, ukwanda kwesiguli esinesifo sikashukela esinokuhlaselwa yisifo senhliziyo kubi ngokwedlula zonke kwezinye iziguli.
Isimo siyinkimbinkimbi kakhulu uma umuntu esevele enenhliziyo ehlulekile: aze afike kumaphesenti angama-80 alezi ziguli esewele umkhawulo wokugubha iminyaka engama-65 zife kungakapheli iminyaka emithathu.
Uma ingxenyana ye-ejection ye-ventricle yangakwesobunxele ingaphansi kuka-35%, kunengozi enkulu yokufa okungazelelwe kusuka ekubanjweni kwenhliziyo - ezigulini ezinesifo sikashukela kuphezulu kakhulu kuneziguli ngaphandle kwalokhu kutholwa, noma ngabe laba abanezinkinga ezifanayo ngengxenyana ye-ejection.
Futhi ekugcineni, isifo sikashukela sihlotshaniswa kakhulu ne-atrial fibrillation (ebizwa nangokuthi yi-atr fibrillation). Ucwaningo lwakamuva lukhombise ubudlelwano obuqondile phakathi kwezinga le-hemoglobin ye-glycated kanye nengozi yokukhula kwe-atrape fibrillation.
Kuyiqiniso, ukulawula izinga likashukela kungenye yezinto ezinqumayo ku-zakuqala, futhi hhayi iqiniso lokwelashwa uqobo, kodwa futhi nokukhethwa kwemithi kubalulekile. Ochwepheshe bakholelwa ukuthi iMetformin inciphisa ingozi yokushaywa unhlangothi kubantu abanesifo sikashukela.
