Lefu la tsoekere la lefu la tsoekere ke bokuli bo atisang ho hlaha bohareng kapa bo boholo bo nang le methapo e telele ea mofuta oa 1 le mofuta oa 2 lefu la tsoekere.
Ketsahalo e joalo ha se letho haese pathogenesis, e baka ponahalo ea lefu la pelo, 'me hangata motho o ba le khatello ea methapo ea methapo, methapo ea methapo ea methapo ea methapo, le phallo ea methapo ea kutlo.
Lekola lefu lena ka ho etsa li-electrocardiograms, echocardiograms, Doppler ultrasound, liphio, methapo ea kelello, methapo ea methapo ea methapo e hlahlojoa.
Phekolo e kenyelletsa ho laola khatello ea mali, ho ntlafatsa sebopeho sa mali, ho lokisa hyperglycemia.
Lisosa tsa macroangiopathy ho lefu la tsoekere
Ha motho a kula ka lefu la tsoekere nako e telele, li-capillaries tse nyane, mabota a arterial le methapo tlas'a tšusumetso ea bongata bo eketsehileng ba tsoekere e qala ho senyeha.
Kahoo ho na le ho fokola ka matla, deformation, kapa, ka lehlakoreng le leng, hona ke ho fifala ha methapo ea mali.
Ka lebaka lena, phallo ea mali le metabolism pakeng tsa lisele tsa litho tse ka hare lia ferekanngoa, e leng se lebisang ho hypoxia kapa tlala ea oksijene ea lisele tse haufi, ho senya litho tse ngata tsa lefu la tsoekere.
- Hangata, ho ameha likepe tse kholo tsa lipelo tse tlase le pelo, sena se etsahala maemong a 70 lekholong. Likarolo tsena tsa 'mele li amohela mojaro o moholo ka ho fetisisa, ka hona lijana li ameha haholo ke phetoho. Ho lefu la tsoekere le lefu la tsoekere, fundus hangata e ameha, e fumanoang e le retinopathy; hape ke maemo a etsahalang khafetsa.
- Ka tloaelo lefu la tsoekere macroangiopathy le ama methapo ea mokokotlo, coronary, renal, aripheral artery. Sena se tsamaisana le angina pectoris, myocardial infarction, ischemic stroke, lefu la tsoekere la lefu la tsoekere, khatello ea methapo ea kutlo. Ka tšenyo e mpe methapong ea mali, menyetla ea ho ba le lefu la pelo le ho otloa ke lefu la pelo le eketseha makhetlo a mararo.
- Mathata a mangata a lefu la tsoekere a lebisa ho atherosulinosis ea methapo ea mali. Boloetse bo joalo bo fumanoa ho batho ba nang le mofuta oa 1 le mofuta oa 2 lefu la tsoekere lilemo tse 15 pejana ho feta ho bakuli ba phetseng hantle. Hape, lefu la batho ba nang le lefu la tsoekere le ka tsoela pele kapele haholo.
- Boloetse bona bo mpefatsa likarolo tse ka tlaase tsa methapo e bohareng le e meholo, eo liathala tsa methapo ea kutlo li bang teng hamorao. Ka lebaka la calcation, ponahatso le necrosis ea li-plaque, likhahla tsa mali li theha sebakeng seo, lumen ea lijana e koala, ka lebaka leo, phallo ea mali sebakeng se amehileng e khathatsoa ke lefu la tsoekere.
Ha e le molao, lefu la tsoekere la macroangiopathy le ama methapo ea kutlo, bokong, methapo ea kutlo, kahoo lingaka li etsa tsohle ho thibela liphetoho tse joalo ka ts'ebeliso ea mehato ea thibelo.
Kotsi ea pathogenesis e nang le hyperglycemia, dyslipidemia, khatello ea insulin, botenya, khatello ea methapo ea mali, ho eketseha ha mali, khatello ea methapo, khatello ea methapo ea methapo, ho ruruha ha systemic ho phahame haholo.
Hape, atherosclerosis hangata e hlaha ho batho ba tsubang, boteng ba ho se ikoetlise 'meleng le tahi e botse. Kotsi ke banna ba ka holimo ho lilemo tse 45 mme basali ba ka holimo ho lilemo tse 55.
Hangata sesosa sa lefu lena e ba semelo sa lefutso.
Diabetes angiopathy le mefuta ea eona
Lefu la tsoekere ke khopolo e kopanetsoeng e emelang pathogeneis mme e kenyelletsa methapo ea mali e sa sebetseng - e nyane, e kholo le e mahareng.
Ketsahalo ena e nkuoa e le phello ea khatello ea morao-rao ea lefu la tsoekere, e hlahang lilemo tse ka bang 15 ka mor'a lefu lena.
Lefu la tsoekere la macroangiopathy le tsamaisana le syndromes tse kang atherosclerosis ea aorta le methapo ea methapo ea methapo, methapo ea methapo kapa ea methapo.
- Nakong ea microangiopathy ho lefu la tsoekere mellitus, retinopathy, nephropathy, le lefu la tsoekere la methapo ea methapo e tlase e bonoa.
- Ka linako tse ling, ha methapo ea mali e senyeha, ho fumanoa tšoaetso ea angiopathy hohle, mohopolo oa eona o kenyelletsa lefu la tsoekere la macroangiopathy.
Endoneural diabetesic Microangiopathy e baka tlolo ea methapo ea kutlo, 'me sena se baka lefu la tsoekere.
Lefu la tsoekere la macroangiopathy le matšoao a lona
Ka atherosclerosis ea aorta le coronary artery, e bakang lefu la tsoekere la macroangiopathy la maemo a tlase le likarolo tse ling tsa 'mele, lefu la tsoekere le ka tseba hore na lefu la pelo, lefu la pelo, angina pectoris, lefu la pelo.
Lefu la pelo la coronary ntlheng ena le tsoela pele ka sebopeho sa atypical, ntle le bohloko le ho tsamaisana le arrhythmia. Boemo bona bo kotsi haholo, kaha bo ka baka lefu la tšohanyetso la coronary.
Pathogenesis ho lefu la tsoekere hangata e kenyelletsa mathata a ka morao ho infaration a joalo ka aneurysm, arrhythmia, thromboembolism, lefu la pelo le lefu la pelo. Haeba lingaka li senoletse hore sesosa sa infraction ea myocardial ke lefu la tsoekere, e lokela ho etsoa ka letho e le hore lefu la pelo le se ke la khutla, kaha kotsi e holimo haholo.
- Ho latela lipalo-palo, mofuta oa 1 le lefu la tsoekere la 2 o na le menyetla e fetang habeli ea ho bolaoa ke lefu la myocardial joaloka batho ba se nang lefu la tsoekere. Hoo e ka bang karolo ea 10 lekholong ea bakuli ba tšoeroe ke lefu la mokokotlo la mokokotlo ka lebaka la lefu la tsoekere la macroangiopathy.
- Atherosclerosis ho diabetesics e iponahatsa e ikutloa ka nts'etsopele ea ischemic stroke kapa ischemia e sa foleng ea "cerebral ischemia". Haeba mokuli a e-na le khatello ea mali ea methapo, menyetla ea ho ba le mathata a amanang le lefu la pelo e eketseha ka makhetlo a mararo.
- Ho liperesente tse 10 tsa bakuli, liso tsa methapo e fokolisang ea methapo ea methapo ea methapo li fumanoa li le ka sebopeho sa atherosranceosis. Lefu la tsoekere la lefu la tsoekere le tsamaisana le ho ba le botšehali, ho bata ha maoto, ho khumama butle-butle, ho ruruha hoa moea oa methapo.
- Mokuli o utloa bohloko bo boholo mesifa ea mesifa, lirope, leoto le tlaase, e bang le matla le ho feta. Haeba mali a phallang ka nqeng ea distal a soetsehile haholo, sena se lebisa ho ischemia e mahlonoko, eo qetellong e bakang necrosis ea methapo ea maoto le leoto le tlase ka tsela ea mokokotlo.
- Letlalo le linama tse katamelaneng li ka ipuella ntle le tšenyo. Empa, joalo ka molao, necrosis e etsahala ka tlolo ea letlalo e fetileng - ponahalo ea mapetsoana, liso tsa fungal, maqeba.
Ha mathata a phallo ea mali a se a sa buuoe haholo, lefu la tsoekere la macroangiopathy le baka ponahalo ea londa tsa trophic tse sa foleng tse nang le lefu la tsoekere maotong.
Macroangiopathy ea lefu la tsoekere e fumanoa joang?
Lefutso ke ho tseba hore na likepe tsa coronary, cerebral le peripheral li ameha hampe hakae.
Ho khetholla mokhoa o hlokahalang oa tlhahlobo, mokuli o lokela ho buisana le ngaka.
Tlhahlobo e etsoa ke ngaka ea methapo ea kutlo, ngaka ea lefu la tsoekere, ngaka ea methapo ea pelo, ngaka e buoang pelo, ngaka ea methapo ea pelo, ngaka ea methapo.
Ho mofuta oa 1 le lefu la tsoekere la 2, ho khethiloe mefuta e latelang ea tlhahlobo ea mafu.
- Teko ea mali a biochemical e etsoa ho bona boemo ba tsoekere, triglycerides, cholesterol, liplatelete, lipoprotein. Teko ea coagulation ea mali le eona e etsoa.
- Etsa bonnete ba ho hlahloba ts'ebetso ea pelo le methapo e sebelisang electrocardiogram, ho shebella khatello ea mali letsatsi le letsatsi, liteko tsa khatello ea maikutlo, echocardiogram, dopplerography ea ultrasound ea aorta, myocardial perfusion scintigraphy, coronarography, computer tomographic angiography.
- Boemo ba methapo ea mokuli bo hlalosoa ka mokhoa o hlakileng oa ho sebelisa li-dopplerografia tsa methapo ea methapo, ho hlahloba ka ho pheta-pheta le angiography ea likepe tsa mokelikeli le tsona lia etsoa.
- Ho lekola boemo ba methapo ea mali e potoloha, maoto le matsoho a hlahlojoa a sebelisa ho kopitsoa ka makhetlo a mabeli, dopplerografia ea methapo ea methapo, aripialal arteryography, rheovasography, capillaroscopy, arterial oscillography.
Phekolo ea lefu la tsoekere la diabetes
Phekolo ea lefu lena ho batho ba nang le lefu la tsoekere ke ho fana ka mehato ea ho liehisa tsoelo-pele ea khatello ea methapo e kotsi, e ka tšosetsang mokuli ka lebaka la ho holofala kapa esita le lefu.
Li-uloph tsa li-trophic tsa bophahamo bo holimo le bo tlase li phekoloa tlas'a tlhokomelo ea ngaka e buoang. Haeba ho na le koluoa e mpe ea methapo ea methapo, ho ka etsoa kalafo e matla e matla. Hape, ngaka e ka lebisa kalafo ea ts'ebetso ea bongaka e amanang le endarterectomy, ho felisoa ha mokokotlo oa mokokotlo, ho phumola leoto le amehang, haeba e se e le lefu la seoa la lefu la tsoekere.
Melao-motheo ea kalafo e amana le ho lokisoa ha li-syndromes tse kotsi, tse kenyeletsang hyperglycemia, dyslipidemia, hypercoagulation, arterial hypertension.
- Ho lefella metabolism ea carbohydrate ho diabetics, ngaka e beha kalafo ea insulin le ho lekola maemo a tsoekere ea mali kamehla. Bakeng sa sena, mokuli o nka lithethefatsi tse fokotsang ka lipid - li-statins, li-antioxidants, fibrate. Ho feta moo, hoa hlokahala ho latela mokhoa o khethehileng oa ho fepa le ho thibela ts'ebeliso ea lijo tse nang le litaba tse phahameng tsa mafura a liphoofolo.
- Ha ho na le kotsi ea ho ba le mathata a thromboembolic, lithethefatsi tsa antiplatelet li laetsoe - acetylsalicylic acid, dipyridamole, pentoxifylline, heparin.
- Phekolo ea antihypertensive maemong a ho lemaloa ha lefu la tsoekere la macroangiopathy e na le ho fihlella le ho boloka khatello ea mali maemong a 130/85 mm RT. Art. Bakeng sa morero ona, mokuli o nka li-inhibitors tsa ACE, diuretics. Haeba motho a utloisitsoe bohloko ke lefu la myocardial infarction, ho beoa bathibelo beta.
Mehato ea thibelo
Ho latela lipalo-palo, ka mofuta oa 1 le lefu la tsoekere la 2 lefu la tsoekere, ka lebaka la mathata a pelo ho bakuli, lipalo tsa lefu li tloha ho liperesente tse 35 ho isa ho tse 75. Ho halofo ea bakuli bana, lefu le hlaha ka ho nyefoloa ha myocardial, ka karolo ea 15 lekholong ea lisosa ke seschemia se matla sa "cerebral ischemia".
Ho qoba nts'etsopele ea lefu la tsoekere la macroangiopathy, ho bohlokoa ho nka mehato eohle ea thibelo. Mokuli o lokela ho lekola maemo a tsoekere ea mali kamehla, ho lekanya khatello ea mali, ho latela lijo, ho lekola boima ba hae, ho latela litlhahiso tsohle tsa bongaka le ho tlohela mekhoa e mebe kamoo ho ka khonehang.
Ho video e sehloohong sena, ho tšohloa mekhoa ea ho phekola macroangiopathy ea lefu la tsoekere.
