Ọrịa mamịrị na-arịa ọrịa shuga bụ ihe mgbagwoju anya nke ọrịa shuga. Mmetụta ọjọọ na-amalite site na ọnya nke National Assembly, mgbe ụfọdụ akwara. Agbanyeghị, nchọpụta banyere ọnọdụ a siri ike, ebe ọ bụ na ejiri mara asymptomatic mara ya.
Dika onu ogugu si kwuo, mgbe enwere nsogbu nnabata nke glucose, nsogbu na-apụta na 11% nke ikpe, yana ụdị ọrịa shuga 2, ọrịa neuropathy na-ahụ na 28% nke ndị ọrịa. Ihe dị ize ndụ ya bụ na ihe fọrọ nke nta ka ọ bụrụ 80% nke ndị ọrịa mamịrị, ọ bụrụ na agwọghị ya, ọnya trophic na-etolite n’ụkwụ ha.
Otu n'ime ụdị ọrịa neuropathy na-adịghị ahụkebe bụ lumbosacral radiculoplexitis. Amyotrophy bụ njirimara nke ụdị shuga 2.
Ọtụtụ mgbe, ọrịa ahụ na-ebilite na ndị ọrịa na-abụghị insulin, afọ 40-60. Nke a na - apụta mgbe microangiopathy na - arịa ọrịa mamịrị n'ihi mmebi axonal.
A na-eleba anya na ntụpọ akụkụ mpaghara nke mkpụrụ ndụ nke mgbọrọgwụ na ogwe nke akwara ndị metụtara akụkụ na mpi ọkpụkpụ.
Ihe ndị mere na mgbaàmà
Nsonaazụ nke ọtụtụ ọmụmụ pathomorphological gosipụtawo na amyotrophy mamịrị na-akpata nzụlite nke mbibi autoimmune na arịa akwara (perineuria, epineuria) na ọdịdị nke perivasculitis na microvasculitis. Ọrịa ndị a na-eso akpata ọgbụgbọ na ọnya na-akpata mgbọrọgwụ na arịa ọbara.
Enwere ihe akaebe nke sistemu mejupụtara, lymphocytes endothelial, nkwupụta nke cytokines immunoreactive, yana ikpughe sel sel cytotoxic. Edekwara okwu banyere ịba ụba site na venule polynuclear (post-capillary). N'otu oge ahụ, mbibi na nsị nke axons, mkpo nke hemosiderin, ndachi nke perineuria, demyelination mpaghara na neovascularization ka ekpughere na mgbọrọgwụ na irighiri akwara.
Na mgbakwunye, atrophy muscle na ndị ọrịa mamịrị bụ n'ihi ụfọdụ ihe ndị na - akpata ahụ:
- afọ - karịrị afọ 40;
- okike - a na - enwekarị nsogbu na ụmụ nwoke;
- ị abuseụbiga ihe ọ alcoholụ alcoholụ na-aba n'anya ókè, nke ga-eme ka akwara neuropathy ka njọ;
- uto - ọrịa a na-ahụkarị n'etiti ndị toro eto nke akwara ha dị ogologo.
Nnukwu ọnụnọ ikuku asymmetric neuropathy na-amalite n'ụzọ zuru oke ma ọ bụ kpam kpam. Ihe omuma ya bu ihe mgbu, mmetu obi na –eme ihe n’iru ukwu apata ukwu ya na mpaghara ala n’ime ukwu ala.
Njikọ nke ụdị ihe ịrịba ama ndị a esoghị na ọrụ moto. Ọtụtụ mgbe ha na-eme n'abalị.
Mgbe atrophy na adịghị ike nke akwara nke apata ụkwụ na aka pelvic na-eto. N'otu oge ahụ, ọ na-esiri onye ọrịa ike ịkwụghachi apata ụkwụ ya, nkwonkwo ikpere ya anaghị akwụ ụgwọ. Mgbe ụfọdụ ndị na-eku ume n’apata ụkwụ, akwa akwara nke aka ma ọ bụ azụ na-esonye na usoro pathologies.
Ọnụnọ ma ọ bụ nkwụghachi nke ikpere na obere mbelata ma ọ bụ ichebe Achilles na-egosi ọnụnọ nke nsogbu mgbanwe. Mgbe ufodu, atrophy muscle na diria na-emetụta ihe otutu ihe n’ahu aka na ukwu.
Ogo ogo nsogbu ngwangwa pere obere. Mgbe mgbe, pathology na-enweta agwa ọjọọ. N'okwu a, ọnweghị mgbaàmà nke mmerụ ahụ na-ebute ọnya azụ.
N'ihe banyere neuropathy proximal, mmetụta uche anaghị enwekarị nsogbu ọfụma. N'ụzọ bụ isi, ihe mgbaàmà mgbu na-apụ n'anya na izu 2-3, mana n'ọnọdụ ụfọdụ ha na-adigide ruo ọnwa 6-9. Atrophy na paresis na-eso onye ọrịa ruo ihe karịrị otu ọnwa.
Ọzọkwa, megide ndabere nke nsogbu ndị a, enwere ike iwelata ibu na - akọghị, nke bụ ntọala maka ịmụrụ ọmụmụ maka ọnụnọ nke etuto ahụ dị oke njọ.
Diagnostics
Enwere ike ịchọpụta amyotrophy mamịrị naanị mgbe nyochachara nke onye ọrịa ahụ. E kwuwerị, ọbụlagodi enweghị mgbaàmà abụghị ihe kpatara iji wezuga ọnụnọ ọrịa ahụ.
Maka nyocha a pụrụ ịdabere na ya, a na-atụ aro ọnụnọ nke ọnya akwara abụọ dịkarịa ala. Dịka ọmụmaatụ, mgbanwe na nsonaazụ ule nnwale ma ọ bụ akara nke malfunction na ọnụego mkpachapụ anya na eriri akwara.
Iji mata polyradiculoneuropathy na-arịa ọrịa shuga, a na-eme ọtụtụ ọmụmụ ụlọ nyocha, gụnyere:
- nyocha nke mmamịrị na ọbara;
- ule rheumatic;
- nyocha nke ihe synovial;
- MRI nke spine (lumbosacral);
- electroneuromyography na ike electromyography.
Site na amyotrophy nke ọrịa mamịrị na mmiri mmiri cerebrospinal, a na-achọpụta mmụba nke protein. Mgbe EMG gachara, etinyere ma ọ bụ kpuchie ọnya ga-eme ka akwara dị na nsọtụ nke ala.
Ọzọkwa, polyradiculoneuropathy na-arịa ọrịa shuga dịgasị iche na demnelinating polyneuropathy, nke na-amalite n'ọtụtụ ndị ọrịa nwere ọrịa na-adịghị ala ala nke usoro endocrine.
Site na ọrịa a, yana amyotrophy, ọkwa nke protein dị na mmiri cerebrospinal na-abawanye. Iji wezuga ma ọ bụ gosipụta ọnụnọ ya, a na-eme electromyography.
Usoro ọgwụgwọ
Ọgwụgwọ maka atrophy muscle n’olu nwere ike ịdịru afọ abụọ. Ọsọ mgbake na-adabere na ụgwọ nke ọrịa na-akpata.
Leadingkpụrụ ndị na-eduga maka ịba nke ọma n'ịgwọ ọrịa neuropathy bụ:
- nyocha nke glycemia mgbe niile;
- usoro ọgwụgwọ symptomatic maka mgbu;
- usoro ọgwụgwọ pathogenetic.
Nke mbu, egosiputara usoro eji eme ihe site na iji methylprednisolone, nke a na-aru n’ime ya, ka egosiputara. A na-eme ka shuga dị n'ọbara site na-agagharị onye ọrịa na insulin.
Iji kpochapụ ihe mgbu neuropathic, enyere pregabalin (2 r. Kwa ụbọchị, 150 mg nke ọ bụla). Na mgbakwunye, a na-ewere amitriptyline na usoro dị ala.
Ọtụtụ ndị dọkịta chọpụtara na glucocorticoids dị irè maka amyotrophy. Enwere ike ịgwọ ọrịa ahụ n'ụzọ dị otú a naanị ọnwa atọ mbụ nke mmepe ya.
Ọ bụrụ na ọgwụgwọ na anticonvulsants na glucocorticoids adịghị irè, mgbe ahụ, a na-edochi ya na nchịkwa iv nke immunoglobulin. A nwekwara ike iji Cytostatics na plasmapheresis.
N'oge a, ọ dị mkpa ịnọgide na-enwe glycemia nkịtị. Nke a ga - enyere aka belata nsonaazụ oxidative, mee ka ọrụ nke antioxidants eke pụta ma melite arụmọrụ akwara na somatic.
Ọgwụ insulin na-arịa ọrịa shuga na-ebelata ohere nke DPN na nsogbu akwara. Ma iwebata homonụ ahụ agaghị ekwe nkwa iwepụ nsogbu ma ọ bụ nye aka na mgbaàmà dị iche iche. Mana ikike ịchịkwa ọrịa shuga bụ ọnọdụ dị mkpa nke dị mkpa maka ọgwụgwọ nke usoro ọgwụgwọ pathogenetic.
Ọ bụ ihe kwesịrị ịrịba ama na ị coụ corticosteroids na-eduga n'ọba glucose ọbara. Ya mere, iji belata ihe ize ndụ nke nnukwu glycemia, ọ dị mma ịnyefe ndị ọrịa insulin.
Mgbe mgbe ọ bụla ọ na-akwalite nrịba amyotrophy mamịrị na-eme ka nrụgide oxidative kwalite. Ọ na - eme ya na oke radicals na --eme ka usoro antioxidant nke ahụ na - esikwaghị ike.
Ya mere, ọrụ na-eduga na ọgwụgwọ nke DPN bụ ndị antioxidants na - egwu - ndị na - ebelata nrụgide oxidative ma na - emetụta pathogenesis. N'ihi nke a, a na-eji ọgwụ eme ihe maka prophylactic na ebumnuche ọgwụgwọ ma ọ bụrụ na ọrịa ndị na-arịa ọrịa shuga na-egbu oge.
Otu n'ime usoro ọgwụgwọ kachasị mma maka ọrịa mamịrị polyradiculoneuropathy bụ Alpha Lipoic Acid. Ọgwụ a na-ebelata mgbaàmà ọrịa neuropathic na-adịghị mma.
Thioctic acid bụ ọgwụ antioxidant dị ike nke na-egbochi radicals n'efu. Ekwuputala na ntinye nke ALA na - egbochi nchịkọta platelet, na - eme ka ọbara na - erugharị na - ebugharị, na - eme ka ịta ahụhụ nke nitric oxide ma na - akpali njikọta nke protein protein. Vidiyo dị n'isiokwu a ga-aga n'ihu na isiokwu nke nsogbu SL.
