Okokuqala, imithambo yegazi ihlushwa amazinga aphezulu kashukela. Isifo sikashukela kanye nomfutho wegazi ophakeme sibhekwa ngasikhathi sinye kuma-80% eziguli. Uma umfutho wegazi ophakeme uyinkinga esephuze kakhulu yesifo sikashukela sohlobo 1, lapho-ke uhlobo 2 lomfutho wegazi ophakeme lungaxilongwa nangaphambi kokuphazamiseka kwe-carbohydrate metabolism.
I-Hypertension ikhulisa kakhulu isifo sikashukela, ikhulisa amathuba okushaywa yizifo amahlandla ama-3, ukungaboni ngenxa yomonakalo we-retina kanye ne-gangrene yezinyawo - amahlandla angama-20. Ngakho-ke, izidingo zokucindezela kwabanesifo sikashukela ziqinile kunabantu abaphilile. Ukwelashwa kwe-hypertension kuqala ngokushesha, njengoba kuvela izimpawu zokuqala zezinkinga zemithambo. Kubhekelwa kakhulu ekukhetheni izidakamizwa; kwisifo sikashukela, yileyo kuphela amaphilisi amisiwe angenakhulisa izinkinga ezikhona.
Imbangela yomfutho wegazi ophezulu kwisifo sikashukela
Ngo-Type 1 sikashukela, imbangela eyinhloko ye-hypertension yi-nephropathy. Lokhu kuyinkinga ehamba kancane lapho i-renal glomeruli ilinyazwa khona ngenxa ye-glucose ephezulu emikhunjini, okukhuphula ukuchama, amaprotheni aqala ukungena kumchamo, futhi esigabeni sokugcina, ukwehluleka kwe-renal kwenzeka. Lapho isiguli sivame ukungakunaki ukwelashwa okunqunyelwe sikashukela, i-nephropathy esheshayo iyaqhubeka.
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%
I-glomeruli ye-renal eyonakalisiwe iqala ukuhlanganisa i-renin ngenkuthalo, into ethuthukisa ithoni ye-vascular. Ingcindezi ikhuphuka esigabeni sesithathu se-nephropathy, lapho izinso ziqala ukuhlunga umchamo amahlandla ama-3 kancane. Ngalesi sikhathi, inqubo ebumbili iyaqala: ama-glomeruli abhujisiwe abangela umfutho wegazi ophakeme, bese wona ukhulisa umonakalo emithanjeni yegazi, kufaka phakathi izinso. Ukucindezela okunjalo yikhona okuqhubekayo futhi kungalapheki kahle. Ngokushintshwa okungaphenduki kwezinso, kubhekwa kuzo zonke iziguli ezinesifo sikashukela.
Isifo sikashukela esinesifo sohlobo lwe-2 sithola umfutho wegazi ophezulu kakhulu ngaphambili, ngisho nangesikhathi sikashukela. Umfutho wegazi ophakeme ungenye yezimpawu zesifo se-metabolic, isandulelo sikashukela. I-glucose iqala ukuthinta imithambo ngaphambi kokuba amanani ayo abe phezulu. Kunobufakazi bokuthi le nqubo iqala lapho i-glucose ingaphezulu kwe-6 mmol / L. Izindonga zemikhumbi zonakalisiwe, ama-plaque aqala ukwakha phezu kwawo, ubala be-lumen. Abangane abathembekile besifo sikashukela - ukukhuluphala nokuntuleka kokunyakaza - kusheshisa ukuqala komfutho wegazi ophakeme.
Ubudlelwano phakathi kwekhwalithi yokwelashwa kwesifo sikashukela kanye nezinga lokuthuthuka komfutho wegazi oqondile kuqondile, kukhuphuka ushukela, kukhuphuka umfutho wegazi emithanjeni.
Izimbangela zokucindezela okwandayo kushukela:
| Lesi sifo | Isici | Imvamisa yesifo sikashukela,% | |
| Uhlobo olu-1 | 2 uhlobo | ||
| Isifo Sikashukela Sikashukela | Ukulimazeka ku-glomeruli yezinso. | 80 | 15-20 |
| Umfutho wegazi obalulekile | Ukwanda okuqhubekayo kwengcindezi ngaphandle kwesizathu. | 10 | 30-35 |
| I-Isstated hypstension hypertension | Ukukhuphuka kwengcindezi ephezulu, kuya ngokuguga. | 5-10 | 40-45 |
| Izifo zesistimu ye-Endocrine | Ama-tumors, ukuphazamiseka ku-pituitary gland, i-adrenal gland, i-thyroid gland. | 1-3 | 1-3 |
| Isifo sikashukela Angiopathy | Ukuvalwa komkhumbi omkhulu owondla izinso. | akukho datha | 5-10 |
Ubudlelwano obuphakathi kwe-hypertension ne-insulin
Kuyaziwa ukuthi i-insulin isebenza njenge-vasodilator. Kungani-ke, uhlobo lwesibili sikashukela, lubonakala ngamazinga aphezulu e-insulin, ahambisana kakhulu nomfutho wegazi ophezulu? Iqiniso ngukuthi kulezi ziguli kukhona ukumelana ne-insulin - isimo esiphazamisa ukubonwa kwe-insulin ngamaseli omzimba. Ngezifundo zokuhlola, kwatholakala ukuthi i-hyperinsulinemia ehambisana nokumelana ne-insulin kuholela ekukhishweni kwe-norepinephrine kanye nokwenza kusebenze okubalulekile kohlelo lwezinzwa olunozwela. Ngaphezu kwalokho, ezigulini ezinesifo sikashukela esinokukhuluphala, umsebenzi waso uphakeme ezinso, uphansi enhliziyweni. Ngenxa yalomphumela, izinso zigcina i-sodium namanzi, zandisa i-renin excretion. Ngenxa yalokho, ingcindezi emikhunjini iyakhuphuka.
Kwatholakala ukuthi isilinganiso senjabulo, futhi ngenxa yalokho izinga le-hypertension, ngqo kuncike kwinkomba yesisindo somzimba. Amafutha amaningi emzimbeni, ngokushesha isiguli esinesifo sikashukela sizobhekana nengcindezi yokukhuphuka, kanti nethonometer ephezulu izokhombisa amanani aphezulu.
Izimpawu nezimpawu zomfutho wegazi ophezulu kushukela
Umfutho wegazi uyinani elihlukile. Emini ishintsha ngo-10-20%, imvamisa ephansi ebusuku nasekuseni, iphakeme engxenyeni esebenzayo yosuku. Umkhawulo ophezulu wokujwayelekile kubantu abaphilile ngu-140/90. Ukwelashwa kuyadingeka uma leli zinga liphindwa kaningi.
Ku-mellitus yesifo sikashukela, isigqi sokudlidliza siyaphazamiseka. Ingcindezi ebusuku ingahle ifane naphakathi nosuku, noma iphakeme kakhulu. Ngenxa yalokhu, imikhumbi iyaguga ngokushesha, i-angiopathy ne-neuropathy ziyathuthuka ngenkuthalo. Ngenxa yengozi ekhuphukayo ye-hypertension kusifo sikashukela, obondayo umkhawulo weziguli wehliselwa ku-130/85. Uma ingcindezi ihlala ingaphezulu kwaleli zinga noma ikhuphukela kulo kaningana ngeviki, kufanele uthintane nodokotela wakho ngemithi kadokotela.
Izimpawu zehypertension:
- ikhanda, kaningi ngemuva kwekhanda;
- Isiyezi
- ukukhathala
- Ubuhlungu enhliziyweni, imvamisa ngemuva kokudla noma lapho udonsa kanzima;
- inkinga yokulala
- ukukhuphuka kokuchama ebusuku ngenxa ye-nocturia.
I-Orthostatic hypotension nayo ingabonakala: ingcindezi ephansi ngokushintsha okubukhali kwesikhundla somzimba, imvamisa lapho uphuma embhedeni. Izimpawu zakhe isiyezi, isicanucanu. Ukuhlaselwa okunjalo kudlula ngokushesha, emizuzwini embalwa.
Izimpawu ze-hypertension nazo zingase zingabikho, njengoba ingcindezi ikhuphuka kancane, futhi nomzimba ukwazile ukuzivumelanisa nezimo eziguqukayo. Uma i-asymptomatic hypertension ingatholakali ngesikhathi, leli cala lingaphela enkingeni ye-hypertensive.
Ukuze wenze lesi sifo siphelelwe yisikhathi, uhlelo lokuhlolwa kwesifo sikashukela lubandakanya ukuqashelwa okucindezelayo kwengcindezi, futhi ezimweni ezingabazisayo kanye ne-hypertension yasikhathi sasebusuku esolisayo - nokuqashwa kwamahora angama-24.
Ungabhekana kanjani nengcindezi kushukela
Cabanga ngezindlela eziyisisekelo zokubhekana nomfutho wegazi ophakeme.
Khumbula: Umfutho wegazi ophakeme ungaba isithiyo sokushaywa unhlangothi.
Ukusetshenziswa kwezidakamizwa
Amaphilisi wokucindezela asetshenziselwa ushukela onomkhawulo obalulekile. Umuthi akufanele uthinte i-metabolism, ungabi yimbi kakhulu kwezifo ze-vascular, usize inhliziyo nezinso. Awungeke usinciphise ngokushesha ingcindezi nge-hypertension, ngoba lokhu kungaholela ekwandeni kwezinkinga zesifo sikashukela. Uhlelo lokwelashwa ngakunye lwenzelwe isiguli ngasinye. Ngomfutho ophakeme kancane, kukhethwa izidakamizwa ezisebenza isikhathi eside, ithebhulethi eli-1 losuku lonke. Ukwelashwa kwe-hypertension enzima kudinga indlela ehlanganisiwe, usebenzisa izidakamizwa ezivela emaqenjini ambalwa.
Ukwelashwa ngomfutho we-Hypertension:
| Iqembu | Isici | Imithi |
| Ama-inhibitors e-ACE | Izidakamizwa ezikhethiwe zesifo sikashukela zinikezwa kuqala. Thinta kahle umzimba we-carbohydrate, vikela izinso. | I-Captopril, i-Fosinopril, i-Enalapril |
| I-AT1 receptor blockers | Amathebulethi anika umphumela obunjiwe obushelelezi, ungathinti i-carbohydrate metabolism. Ukuze uthole ukwelashwa kwe-hypertension, angabekwa nama-ACE inhibitors. | Losartan, Valsartan, Teveten |
| Abamelene neCalcium | Bahlangana ngokuphelele nama-inhibitors e-ACE, bavikela inhliziyo, futhi banciphise ukuphuma kwe-protein yizinso. | UVerapamil, uDiltiazem |
| Ama-blocker e-Beta | Faka kunqubo yokwelashwa ye-hypertension ngokusweleka kwamanye amaphilisi. Bangakhuphula ukubekezelelwa kwe-glucose, kukhulisa inkambo yesifo sikashukela, kufihla uphawu lwezimpawu ze-hypoglycemia. Ukusetshenziswa isikhathi eside kuyingozi i-hyperosmolar coma. | Atenolol, Bisoprolol |
| Ama-diuretics | I-Veroshpiron, iHypothiazide |
Ukudla
Ngaphezu kwamaphilisi, ukwelashwa kwe-hypertension nakanjani kudinga ukudla okhethekile.
Kufanele ihlinzeke:
- Ukuhlelwa ngokwejwayelekile ushukela ngokunciphisa ama-carbohydrate ekudleni, ikakhulukazi asheshayo.
- Okuxubile, okungenani izidlo ezinhlanu ngosuku.
- Yehle ivolumu ye-fluid emzimbeni. Ukuze wenze lokhu, khawulela umthamo usawoti. Imvamisa uncoma u-10 g kasawoti ngosuku, nge-hypertension kusuka kuma-degree ama-2 nangaphezulu (> 160/100) - ufike ku-4 g.
- Ubuncane bamafutha ezilwane - yinyama yokudla kuphela nenkukhu ngaphandle kwesikhumba.
- Ukwenqaba kwikhofi eqinile, itiye elimnyama, utshwala ukunciphisa ukucabanga enhliziyweni.
- Imifino ephezulu. Ifayibha evela kubo iphazamisa ukumunyaniswa kwe-cholesterol, ngaleyo ndlela inciphise ukubonakaliswa kwe-atherosclerosis.
- Imikhiqizo ene-magnesium ne-potassium okungenani kanye ngosuku: imifino, ubhontshisi, ama-apricots omisiwe, umlilo, amantongomane.
Isisekelo sokondleka komfutho wegazi ophakeme kufanele kube ngamaphrotheni, amafutha angenayo i-carbohydrate ne-GI ephansi - Ithebula le-glycemic indices - //diabetiya.ru/produkty/glikemicheskij-indeks-produktov.html.
Amakhambi esintu
Kunamaqembu ambalwa ezitshalo zokwelapha ezingaba usizo ezigulini ezinoxinzelelo lwegazi ezinesifo sikashukela mellitus:
- Amakhambi anomthelela oqinile we-hypotonic: hawthorn, motherwort, melilot, adonis.
- Izitshalo ezinomphumela olinganiselayo: i-angelica, hops, calendula, linden.
- Amakhambi athambisayo asebenzisa umfutho wegazi ophakeme ngohlelo lwezinzwa: u-lemon balm, imint, valerian, peony.
- Izitshalo ze-diuretic: i-chamomile, i-lingonberry, i-bearberry, i-nettle.
Imali yokufaka umfutho wegazi ophezulu ifaka phakathi amakhambi avela kuwo wonke amaqembu. Brew njengoba umthetho ojwayelekile: thatha 2 tbsp. wezipuni zezinto zokusetshenziswa ezingavuthiwe, uthele ingilazi yamanzi abilayo bese ugcobhoza kubhavu wamanzi imizuzu engu-15, bese usonga. Ngemuva kwemizuzu engama-45, chitha futhi uphuze umuthi ngemithamo emithathu ehlukanisiwe ngosuku.
Ukuvimbela
Ukuqashelwa kwemithetho yokuvimbela umfutho wegazi ophezulu kuzosiza ukugwema ukuthatha imishanguzo eminingi yengcindezi yegazi ephezulu yesifo sikashukela:
- lawula ushukela wegazi ngokuqinile. Thatha yonke imishanguzo kadokotela. Isifo sikashukela esingcono siyanxephezelwa, okuncipha kwengcindezi kuzoba;
- ukunciphisa isisindo somzimba kube okwejwayelekile;
- Qeqesha uhlelo lwenhliziyo. Hlela ihora okungenani kathathu ngesonto ukuhamba ngokushesha, ukugijima, ukubhukuda noma i-aerobics;
- yekela ukubhema notshwala;
- hlinzeka umzimba ngokudla okunempilo;
- bahlolwa njalo ezokwelashwa minyaka yonke, welapha i-angiopathy, neuropathy nezinguquko zesifo sikashukela ezinso.
