Uma uhlela umncintiswano phakathi kwazo zonke izifo, indawo yokuqala imvamisa yezinkinga, usizi lokwelashwa kwabo, imiphumela yeziguli, ngokungangabazeki, kuzodingeka inikeze isifo sikashukela. Izinkinga eziningi zivela kwisifo sikashukela sikashukela. Ngenxa yomthelela ushukela emikhunjini emincane, iba brittle futhi ibhujiswa kalula. Ngenxa yalokhu, kwezinye izindawo ukukhula okungalawulwa kwenethiwekhi ye-capillary kuqala, kuyilapho ezinye izindawo zingenawo ngokuphelele igazi.
Njalo ngonyaka, ngenxa yembangela ye-Microangiopathy, ukugawulwa kwesigidi kwemikhawulo engezansi kuyenziwa, abantu abanesifo sikashukela abayizigidi ezingama-0.6 baphulukana namehlo abo, futhi izinso ziyeke ukusebenza ezigulini eziyizigidi ezingama-0.5. Ukwephulwa okuningi kungabhekwana uma kungatholakala izigaba zokuqala.
Umbhalo ojwayelekile nge-angiopathy ulapha - //diabetiya.ru/oslozhneniya/diabeticheskaya-angiopatia.html
Isifo sikashukela nokucindezela kuzoba yinto yesikhathi esedlule
- Ukwehlela ushukela -95%
- Ukuqedwa kwe-vein thrombosis - 70%
- Ukuqedwa kokushaya kwenhliziyo okuqinile -90%
- Ukuqeda umfutho wegazi ophakeme - 92%
- Ukwanda kwamandla ngesikhathi sosuku, ngcono ukulala ebusuku -97%
Isifo sikashukela sikashukela - kuyini
I-Microangiopathy iyinkimbinkimbi yesifo sikashukela. Isizathu saso esikhulu ngomphumela kashukela wegazi ophakeme ongaphakathi kwezindonga zemithambo yegazi. Amamolekyuli we-glucose ama-glycate endothelial amaprotheni, okungukuthi, abophele kuwo. Le nqubo ihambisana nokulahleka kwe-vasical elasticity, ukuncipha kwabo, ukukhuphuka kokuqina, bese kubhujiswa. Isimo sikhula ngokuxineka okunyusa i-oxidative - ukulimala kwamaseli ngama-radicals wamahhala, okwenziwa kushukela likashukela okwenziwe ngevolumu ekhuphukayo. Ukwephulwa kwe-lipid metabolism, isimilo sohlobo 2 sikashukela, nakho kunomthelela ongemuhle esimweni semithambo yegazi.
Zonke izitho zethu zifakwa yinethiwekhi yemikhumbi emincane, ngakho-ke, i-microangiopathy yesifo sikashukela ingaphazamisa ukusebenza kwanoma yisiphi sazo. Imvamisa, i-retina kanye ne-nephrons yezinso iba "okuhlosiwe", ngoba inethiwekhi ekhule kahle yama-capillaries ibalulekile ekusebenzeni kwayo okujwayelekile.
Izinkinga zesifo sikashukela, ukuthuthukiswa okucasulayo i-microangiopathy:
| Lesi sifo | Incazelo |
| I-retinopathy | Izikejana ezondla i-retina zibhujiswa ngokwakhiwa kwe-edema nokuwohloka, okuholela ekulimaleni okubukwayo. Uma ukwelashwa kungaqalwa ngesikhathi, kungenzeka kutholakale i-retina, ukulimala kwezinzwa, kanye nokulahlekelwa ngokuphelele kombono. |
| I-Nephropathy | I-Microangiopathy yesifo sikashukela i-mellitus ithikameza ukusebenza kwe-renal glomeruli, okuthinta amandla abo okuhlunga umchamo. Isibonakaliso sokuqala ngamaprotheni emchameni. Umsebenzi wezinso uya ngokuya ukhula kuze kube ukuhluleka kwezinso. |
| I-Microangiopathy yemikhawulo ephansi | Imilenze isuka kude enhliziyweni, ngakho ukujikeleza kwegazi labo kuthambile, futhi nengozi yokuba nesifo sikashukela sikashukela iphakeme. Izinguquko ze-pathological ziqala ngokuphulwa kokugeleza kwegazi ezinzwaneni, bese kuthi onyaweni lonke. Ukuntuleka kokujikeleza kwegazi kuholela ekubulaleni kwezicubu, kuphakamisa isifo sikashukela, kunciphisa amandla izicubu zokululama, futhi kunomthelela ekuthuthukisweni konyawo lwesifo sikashukela. |
| Encephalopathy | Lesi yisilonda sobuchopho, esivame ukubangelwa yi-cerebral microangiopathy. I-Worsen encephalopathy neuropathy kanye ne-lipids ephezulu yegazi kushukela. |
| Ukungasebenzi ngocansi emadodeni | Kanye ne-neuropathy, i-microangiopathy ingenye yezimbangela zokungasebenzi komzimba. Ukonakala kwe-erection kuma-diabetesics kuvame ukuhlotshaniswa nokugcwaliswa okunganele kwesitho ngegazi. |
I-ICD Code 10 ye-Diabetesic Microangiopathy:
- 2; I-E11.2 - nephropathy;
- 3; I-E11.3 - i-retinopathy;
- I-E5; I-E11.5 - Ezinye izinkinga ezibangelwa ukuphazamiseka kwemizwa.
Izimpawu ze-microangiopathy kwisifo sikashukela
Ezimweni eziningi, azikho izimpawu ekuqaleni kwesifo. Njengoba uthuthuka, isiguli sikashukela singase siqaphele:
- umbono wesikhashana wokufiphala;
- amabala entantayo phambi kwamehlo, anyamalala ngemuva kwezinsuku ezimbalwa;
- Izimpawu zokudakwa - ubuthakathaka, ukukhathala, ukuntuleka kwesifiso sokudla;
- umchamo owengeziwe - funda nge-polyuria;
- ebusuku, i-bladder igcwaliswa kaningi kunangaphambili;
- ushintsho esimweni sokuzwela sesiguli: ukuphuma izinyembezi kuyanda, iziqephu zokucasulwa okungavunyelwe ziyavela, noma okuphambene nalokho, ukungabi nandaba nemicimbi ebalulekile yangaphambilini;
- mhlawumbe umuzwa wokubumbana emathempelini, ikhanda elithambile. Izimpawu azishabalali ngokuphelele ngemuva kokuthatha ama-painkiller;
- Izinkinga ezinenkumbulo nokuhlushwa;
- izinzwani zihlala zibanda;
- amanxeba esikhunjeni, ikakhulukazi emaphethelweni aphansi, angalaphi isikhathi eside;
- ukonakala kwe-potency - ukungabi namandla kwesifo sikashukela.
Ukwelashwa kwe-microangiopathy kusebenza kakhulu ekuqaleni, lapho izimpawu zakhona zingekho, ngakho-ke, uma kwenzeka isifo sikashukela mellitus Musa ukweqa ukuhlolwa kwezokwelashwa ngezikhathi ezithileenqunywe udokotela ohambelayo. Okubaluleke kakhulu ukuvakashelwa kudokotela wezifo zamehlo, udokotela wezifo zamehlo nodokotela wezifo zengqondo.
Ukuxilonga
Izindlela zokuxilonga ukuthola i-microangiopathy kushukela sikubandakanya:
- Ukuhlaziywa komchamo we-umchamo we-albhamuin uyakwazi ukubona amaprotheni kumchamo ngaphambi kwe-OAM. Esigabeni sokuqala, akuvunyelwa ukungcwatshwa njalo, ngakho-ke kungcono ukunika umchamo ngosuku.
- I-Nephropathy ihambisana ne-renal hypertrophy, engatholwa yi-ultrasound.
- Kungenzeka ukuthola i-retinopathy ngisho nangaphambi kokuqala kwezimpawu zokuqala lapho uhlola i-fundus - ophthalmoscopy, uma kungenakwenzeka ukuyiqhuba, kusetshenziswa i-ultrasound.
- Ukuntuleka kokujikeleza kwegazi kuma-capillaries asemaphethelweni aphansi kunqunywa kalula ngokubukeka: ezinye izindawo zesikhumba ziphuzi futhi zipholile, ezinye zibomvu ngenxa yokukhula kwama-capillaries. Kuphela, ungqimba lwesikhumba olungashintshile luyanda, kuqhekeka.
- Izinga le-Microangiopathy yesifo sikashukela emilenzeni lingahlolwa kusetshenziswa i-capillaroscopy noma isifundo sesimanje futhi esibizayo - i-Doppler flowmetry.
- I-MRI isetshenziselwa ukuthola ushintsho ekunikezelweni kwegazi ukuya ebuchosheni.
Ungayiphatha kanjani inkinga
Isimo esiyinhloko sokwelashwa okuphumelelayo kwe-microangiopathy siyisinxephezelo esimeme sesifo sikashukela. Kwatholakala ukuthi ukwehla kwe-hemoglobin ye-glycated ye-1% kuphela ngaphezu kwesithathu kunciphisa ingozi yokulimala kwemithambo. Kungenzeka ukuvikela i-microangiopathy futhi unciphise izinkinga ezikhona zesifo sikashukela sazo zombili izinhlobo ngosizo lokuqapha njalo i-glycemia. Ngaphezu kwalokho, akunandaba ukuthi lo mgomo ufinyelelwa kanjani. Uma ugcina ushukela ejwayelekile, ukudla okune-carb okuphansi kuyasiza - kulungile. Uma kudingeka ukwelashwa okukhulu kwe-insulin ukufeza isinxephezelo sikashukela, kuyodingeka ushintshele kukho. Kunoma ikuphi, i-hyperglycemia iyingozi kakhulu kunomphumela ongemuhle wezidakamizwa ezinciphisa ushukela.
Umzimba kuphela ongalungisa inethiwekhi yemikhumbi elimele. Umsebenzi wokwelashwa ukumsiza kule ndaba enzima.
Lokhu, kuziguli ezinesifo sikashukela:
- Izindlela zanamuhla zokunciphisa umfutho wegazi ezitsheni ngama-ACE inhibitors nama-AT1 receptor blockers.
- Ama-ejenti angaphandle anemiphumela ye-antibacterial and regenerative ekwelashweni okusheshayo kwamanxeba ezinyaweni.
- Ukuzivocavoca umzimba ukuze ukhuthaze ukuhamba kwegazi.
- Ama-antioxidants wokunciphisa ukucindezela kwe-oxidative (Thiogamma).
- Abalungisi be-microcirculation (Actovegin, Curantil).
- Izimo uma iphrofayili ye-lipid yegazi kukude ngokwejwayelekile.
- Amavithamini, ikakhulukazi iqembu uB.
- Izidakamizwa zokuncipha kwegazi nokuvimbela i-thrombosis (Lioton, Heparin).
Izinhlobo ezinkulu nemiphumela
Uma i-microangiopathy emnene iphendula kahle ekwelashweni, khona-ke izigaba ezinzima zesifo azelapheki ngokuphelele. Kulokhu, kungaba ukulondolozwa okuyingxenye kwemisebenzi yezitho ezilinyazwe yisifo sikashukela.
Imiphumela engaba khona ye-angiopathy:
| Lesi sifo | Umphumela ongahle ube khona |
| I-retinopathy | Ukuchithwa kwe-retinal, i-glaucoma, ukulahleka okukhulu kombono, ukungaboni ngokuphelele. |
| I-Nephropathy | Ukusebenza kwezinso okunciphisiwe, umfutho wegazi ophakeme, ukudakwa, ukudakwa, ukwehluleka kwezinso, isidingo sokudayela umzimba noma ukufakelwa kwezitho. |
| Isifo sikashukela | Izilonda ezisesigungwini, ukucekelwa phansi kwamalunga nezicubu zamathambo, i-gangrene, ukunqunywa konyawo noma wonke umlenze ophansi, i-sepsis. |
| Encephalopathy | I-Migraine, ukuqina, ukukhubazeka, i-amnesia, ukuphazamiseka kwengqondo. |
| Ukungasebenzi kwe-Erectile | Ukungasebenzi kahle kwe-erectile. |
Hlela indlela yokuphila enempilo futhi ungakhohlwa ukuvakashela ochwepheshe ngesikhathi ukuthola ukutholwa kwama-pathologies kusenesikhathi.
