Khatello ea lefu la tsoekere: ts'ebetso le lisosa tsa nts'etsopele ea methapo

Khatello e phahameng ea mali ho lefu la tsoekere ke bothata bo tloaelehileng boo bakuli ba nang le bona. Ho latela lipalo, khatello ea mali e fumanoa ho 60% ea lefu la tsoekere. Pathology e mpefatsa bophelo bo botle haholo, e mpefatsa le sesosa sa lefu lena. Khahlano le semelo sa khatello ea mali e eketsehang, menyetla ea ho ba le mathata a tebileng (stroke, ho nyekeloa ke pelo) ea eketseha, litholoana tsa teng li bolaeang.

Bakeng sa bakuli ba nang le lefu la 1 la tsoekere, mofuta oa 2 lefu la tsoekere, khatello e nkuoa e le ntho e tloaelehileng, e sa feteng 130/85 mm Hg. Art. Ponahalo ea khatello ea mali hangata e bakoa ke liso tse matla tsa vascular ka boteng ba litekanyetso tse phahameng tsa tsoekere. Nahana ka ho fokotsa khatello ea mali ea hau bakeng sa lefu la tsoekere.

Pathogenesis, lisosa tsa pathology

Mofuta oa 1 lefu la tsoekere, ts'ebetso ea liphio e senyehile ka lebaka la glomerular microangiopathy (tšenyo ea lijana tse nyane). Ka lebaka leo, protheine e hloekisoa hammoho le moroto. Boemo bona bo bitsoa proteinuria mme bo tsamaisana le keketseho ea khatello ea mali.

Khatello e phahameng e etsa hore glomeruli e felloe butle butle. Nakong e tlang, ho hloleha ha phekolo ea pheko hoa hlaha. Maemong a 10%, khatello ea khatello ea mali ha e amanang le lefu la tsoekere la mofuta oa 1, empa ke lefu le kopaneng. Bakuli bana ba boloka tšebetso ea renal.

Ho bakuli ba nang le lefu la tsoekere la mofuta oa 2, khatello ea mali e qala pejana ho lefu la tsoekere kapa le amanang le lefu lena. Liso tsa ka mpeng li baka nts'etsopele ea "psychology" ho bakuli ba 15-20% feela. Maemong a 30-35%, khatello e phahama pele mathata a metabolic a hlaha.

Pathology e qala ka nts'etsopele ea ho hanyetsa insulin (ho theola kutloisiso ea lisele ho ea ketsong ea insulin). Ho lefella boemo bona, insulin e nyoloha, e bakang khatello ea mali.

The pathogenesis of hypertension:

1. Ts'ebetso ea kutloelo-bohloko e sebetsang e sebetsoa;
2. Ts'ebetso e tloaelehileng ea excretion ea sodium, mokelikeli e ferekane;
3. Sodiamo, calcium e bokellana kahare ho lisele;
4. Marako a lijana a thatafala, matla a tsona a fokotsehile.

Lintho tse bohloko tse eketsang monyetla oa khatello ea mali ka mofuta oa 1 le lefu la tsoekere la 2 ke tse latelang:

• Lilemo tse tsoetseng pele;
• Khaello ea Micronutrient 'meleng;
• Ho tahoa ho sa feleng;
• Khatello ea kelello khafetsa;
• Atherosclerosis;
• Ho Nona Haholo
• Li-pathologies tse ling tsa tsamaiso ea endocrine.

Mathata a ka bang teng

Khatello e phahameng ea mali ho lefu la tsoekere e eketsa menyetla ea mathata a mangata a kotsi makhetlo a 'maloa:

• Ho hloleha ha Renal - makhetlo a 25;
• Ho ruruha ho sa phekoleheng, maloetse - makhetlo a 20;
• Ho hlaseloa ke pelo - makhetlo a 5;
• Stroke - makhetlo a 4;
• Ho senyeha ho hoholo ha tšebetso ea pono - makhetlo a 15.

Ho diabetes tse ngata, khatello e phahameng ea mali e thatafatsoa ke hypotension ea orthostatic. Pathology e khetholloa ke ho theoha ho matla ha khatello ea mali ha e phahama boemong ba leshano. E iponahatsa e le lefifi mahlong, ho tsekela, ho akheha. Sesosa sa ho senyeha ha molumo oa pelo ke lefu la tsoekere.

Matšoao a matšoao

Bakeng sa ba bangata, khatello ea maikutlo ha e iponahatse, ho bakuli ba bang, keketseho ea khatello e tsamaisana le:

1. Ho tsekela;
2. Bohloko ba hlooho;
3. Ho sitisoa ha pono;
4. Bofokoli;
5. Mokhathala.

Ho na le li-degree tsa 3 tsa khatello ea mali ho lefu la tsoekere, tse supang matšoao a latelang:

1. E bonolo. Khatello e holimo ke 140-159, e tlase - 90-99 mm RT. st .;
2. E leka-lekaneng. Khatello ea mali e phahameng - 160-179, e tlase - 100-109 mm RT. st .;
3. E boima. Khatello e feta pontso ea 180/110 mm RT. Art.

E le ho qoba tsoelo-pele e potlakileng ea mathata a methapo ea methapo le mathata a morao, bakuli ba nang le lefu la tsoekere ba lokela ho leka ho boloka khatello ho 130/85 mm Hg. Art. Sena se tla lelefatsa bophelo ba lilemo tse 15-20.

Phekolo

Ka khatello e eketsehileng, o hloka ho ea ho setsebi, ho iphekola ho sa amohelehe. Mekhoa ea phekolo e kenyelletsa:

• Phekolo ea lithethefatsi. Sebelisa lithethefatsi tse theolang khatello ea mali. Li-diuretics tse atisang ho sebelisoa hangata, tse ka fokotsang kotsi ea ho senyeha ha meno.
• Lijo Mmele oa mokuli ea nang le lefu la tsoekere o tsotella sodium, ka hona, ka khatello e phahameng ea mali, o hloka ho fokotsa letsoai lijong. Hangata mohato ona o na le phello e ntle.
• Ho fokotsa boima ba 'mele. Sena se tla ntlafatsa boemo ka kakaretso.
• Ho tsamaisana le tloaelo ea letsatsi le letsatsi, ho boloka bophelo bo botle. Ts'ebetso ea locomotor, lipapali li na le phello e ntle methapong ea mali, li fokotsa khatello ea tsoekere maling.

Lipilisi tsa khatello ea mali

Meriana le litekanyetso li khethoa e le hore khatello e fokotse butle butle. Nako e nepahetseng ea ho fihlela tloaelo e ka ba libeke tse 8 ho tloha ha u qala ho sebelisa litlhare. Ho fokotseha ha sekhahla ha khatello ea mali ho fetoha sesosa sa phallo ea mali hantle, mesebetsi e fokolisang ea litho le litsamaiso.

Ho fetoha ha "carbohydrate metabolism" ho "diabetes" ho etsa hore ho be thata ho khetha lithethefatsi. Mekhoa ea litlhare e laetsoe ho nahanisisa ka boemo ba mmele ba mokuli le ho teba ha lefu la methapo.

Bakeng sa ho fokotsa khatello ea mali ka mofuta oa 1 le lefu la tsoekere la 2, lithethefatsi tsa lihlopha tse latelang li tloaetse ho sebelisoa:

• Diuretics (Furosemide, Diacarb);
• Li-inhibitors tsa ACE (Captopril, enalapril);
• Beta-blockers (Nebilet, Trandat, Dilatrend);
• Li-blockers tsa al-adrenergic (Doxazosin, Prazosin, Terazosin);
• Li-antagonists tsa Calcium (Diltiazem, Verapamil);
• Li-agonists (li-stimulants) tsa imidazoline receptors (Albarel, Physiotens).

A re ke re hlahlobeng ka botlalo haholoanyane sehlopha ka seng sa lithethefatsi.

Diuretics

Ho na le lihlopha tse 4 tsa diuretics:

• Thiazide;
• Thiazide-joalo;
• Loopback;
• Ho senya.

Li-diuretics tse kang Thiazide tse sa amang khatello ea tsoekere li na le phello e ntle. Ho mofuta oa 1 le lefu la tsoekere la 2, diaztiti tsa thiazide li sebelisoa ka bongata bo sa feteng 12,5 mg. Lihlopha tsena ka bobeli tsa diuretics li thibela ho hlaha ha mathata liphihlelong, myocardium, leha ho le joalo, lithethefatsi tse joalo li ka se sebelisoe bakeng sa ho se sebetse hantle ha renal.

Liopture tsa loop ha li sebelisoe hangata, ka lebaka leo, 'mele o lahleheloa ke potasiamo. Leha ho le joalo, li bontšoa bakeng sa ho se sebetse hantle ha renal, moo maemong a litokisetso tsa potasiamo li eketsoa hofeta.

Li-inhibitors tsa ACE

Ba thibela enzyme e kenyellelitsoeng motsoako oa angiotensin o sebetsang, o bakang khatello ea mali. Meriana e thibela nts'etsopele ea mathata lipelong, pelong. Nakong ea ts'ebetso, khatello ea tsoekere ha e eketsehe.

Lithethefatsi li na le phello e fokolang ea hypotensive, ho fokotseha ho sa feleng ha khatello ea mali ho fihlelloa kamora libeke tse peli. Mofuta oa 1 oa lefu la tsoekere la mofuta oa 2, meriana e joalo e tšoaetsanoa haeba ho ka fumanoa tšoaetso ea methapo ea methapo le methapo ea methapo ea kutlo. Ho bakuli ba bang, ba baka khohlela. Re lokela ho hopola hore haeba khatello ea mali e le matla haholo, li-inhibitors tsa ACE li ke ke tsa ba le phello ea kalafo.

Beta blockers

Ho na le lihlopha tse peli:

1. Khetha. Etsa feela ho li-receptors tsa pelo le pelo;
2. Ha e khethe. Ama lisele tsohle tsa 'mele.

Li-beta-blockers tse sa khethang li ngolisitsoe bakeng sa lefu la tsoekere hobane li eketsa tsoekere. Ho khethoa ho khethoa haeba lefu la tsoekere le khatello ea mali e eketsehileng li kopantsoe le li-pathologies tse ling:

1. Ischemia
2. Ho hlaseloa ke pelo;
3. Ho nyekeloa ke pelo.

Lithethefatsi tse joalo hangata li sebelisoa ka nako e le 'ngoe le diuretics. Li-blockers ha li sebelisoe ho phekola khatello e phahameng ea mali ho bakuli ba nang le asthma.

Likhohlano tsa calcium

E fokotsa ts'ebetso ea calcium ea ho kenella liseleng, e lebisang ho vasodilation le ho theola khatello ea mali. Ho na le lihlopha tse peli:

1. Dihydropyridine. Eketsa lebelo la pelo, fokotsa menyetla ea tlhaselo ea pelo.
2. Nedihydropyridine. Fokotsa sekhahla sa pelo, se loketseng phekolo ea khatello ea mali, e hlahileng mokokotlong oa nephropathy. E thusa ho qoba ho senyeha ha meno ho lefu la tsoekere.

Ka bobeli le ba bang ba ka sebelisoa ka nako e le ngoe le li-diuretics, ACE inhibitors. Se ke oa li sebelisa bakeng sa ho nyekeloa ke pelo, ho sa tsitsa ha angina pectoris.

Li-agonists (li-stimulants) tsa li-imidazoline receptors

Litlhare li fokolisa tšebetso ea methapo ea kutloelo-bohloko, ka lebaka leo, sekhahla sa pelo sea fokotseha, khatello ea mali ea fokotseha. Tšebeliso ea nako e telele e ntlafatsa mokhoa oa pelo le pelo.

Contraindication:

• Bradycardia
• Ho nyekeloa ke pelo;
• Sick sinus syndrome
• Lefu la sebete.

Li-blocker tsa Alpha

Block postsynaptic alpha adrenergic receptors, e fanang ka phokotso e sa feleng ea khatello ntle le ho eketsa lebelo la pelo. Ho lefu la tsoekere, lithethefatsi tse joalo li fokotsa khatello ea tsoekere, li eketsa kutloisiso ea insulin.

Pheko ea lijo

Bakeng sa khatello ea mali e eketsehang ka mofuta oa 1 kapa lefu la tsoekere la 2, ela hloko ka ho khetheha phepo e nepahetseng. Lijo tse nang le nama e fokolang ea carb li theola tsoekere ka ho lekaneng le ho fokotsa khatello ea mali.

Latela litataiso tsena:

1. Lijo li lokela ho ba le livithamini, ho latela likarolo ka bongata bo lekaneng;
2. Fokotsa tšebeliso ea letsoai. Tloaelo ea letsatsi le letsatsi ha e fetang tee e le 'ngoe. l;
3. Qoba lijo tse nang le sodium e ngata;
4. Ja hangata khafetsa - bonyane 5 p. / Letsatsi, ka likarolo tse nyane;
5. Se ke oa ja pele u robala. Lijo tsa ho qetela ha lia lokela ho ba ka mor'a lihora tse peli pele ho robala;
6. - Ja lijo tse nang le mafura a mangata, khetha li-carbohydrate tse rarahaneng;
7. Ja lijo tse nang le potasiamo e ngata. Macroelement e atolosa mabota a methapo ea mali mme e thusa ho theola khatello.

Kenyelletsa lijong tsa hau tsa letsatsi le letsatsi meroho, litholoana tse lumelloang ho batho ba lefu la tsoekere. Lihlahisoa tse ling tse lumelloang:

• Bohobe ba Wholemeal;
• Nama e halikiloeng, tlhapi;
• Li-daera tse se nang mafura, lihlahisoa tsa lebese;
• Mapheo a meroho;
• Lijo tsa leoatleng;
• Litholoana tse omisitsoeng;
• Mahe
• Lioli tse nang le meroho.

Ho ntlafatsa tatso ea lijana, sebelisa sesosa, litlama tse monko o monate, lero la lemone.

E netefalitsoe:

• Lihlahisoa tsa phofo ea Wheat;
• Lijo tse bosetsoeng;
• Mefuta e mengata ea tlhapi, nama;
• Li-broth tse tsamaisitsoeng;
• Li-pickles;
• Marinade
• Lino tse tahiloeng
• Lino tse tahang.

Ho ba le boima ba 'mele haholo ho eketsa menyetla ea khatello ea mali ho tsoekere. Ho theola boima ba 'mele, ho khothalletsoa ho fokotsa ho ja lijo tsa khalori tsa letsatsi le letsatsi, ho eketsa ho ikoetlisa.

Phetoho ea bophelo

Ho boloka bophelo bo botle ho u thusa ho fokotsa khatello ea mali ka mofuta oa 1 le lefu la tsoekere la 2. Ho hlokahala:

1. Phomolo e felletseng;
2. Ho tlohela joala kapa ho fokotsa tšebeliso ea joala;
3. Ho tsuba ho sa khetholloe. Nikotine e eketsa monyetla oa mathata a teng tsamaisong ea pelo le pelo;
4. Ho qoba maemo a sithabetsang.

Ho ikoetlisa khafetsa (ho ikoetlisa, ho tsamaea ka lebelo le mafolofolo, jj.) Ho bohlokoa. Ho silila ho na le phello e ntle. Tsamaiso e tloaelehileng ea khatello ka thuso ea lithethefatsi, lijo, ho eketsa mesebetsi ea makoloi e ka fokotsa lenane la khatello ea mali tsoekere mme ea ntlafatsa haholo bophelo bo botle.

Video e amanang le ena: