Macroangiopathy na-arịa ọrịa shuga bụ nkwarụ na nke na-arịa ọrịa atherosclerotic nke na-etolite n'ọbara ma ọ bụ nnukwu akwara nwere ogologo oge nke ụdị 1 na ụdị shuga 2.
Dị ihe a abụghị ọrịa, ọ na - ebute ọria mgbu obi, mmadụ na - enwekarị ọbara ọgbụgba, ọnya akwara nke akwara ozi, na mgbasa na akụkụ ụbụrụ na - agbagha.
Nyochaa ọrịa ahụ site na iji usoro electrocardiogram, echocardiogram, ultrapịnị Doppler, akụrụ, arịa ụbụrụ, akwara aka.
Ọgwụgwọ gụnyere njikwa ọbara mgbali, melite ihe mejupụtara ọbara, na-agbazi hyperglycemia.
Ihe na-ebute macroangiopathy na ọrịa shuga
Mgbe mmadụ rịawara ọrịa shuga ogologo oge, obere capillaries, mgbidi akwara na veins n'okpuru mmetụta nke glucose dị ukwuu na-amalite ibelata.
Yabụ na enwere thinning dị omimi, ma ọ bụ, na - atụgharị, nke a bụ oke ọgbụgba ọbara.
N'ihi nke a, ọbara ọgbụgba na metabolism n'etiti akwara nke anụ ahụ dị n’ime na-agbagha, nke na-eduga n’inwe hypoxia ma ọ bụ ụrọ oxygen nke anụ ahụ gbara gburugburu, na-emebi ọtụtụ akụkụ nke ndị ọrịa mamịrị.
- Ọtụtụ mgbe, a na-emetụta arịa buru ibu nke ala akụkụ ala na obi, nke a na-eme na pasent 70 nke ikpe. Akụkụ ahụ ndị a na - enweta nnukwu ahụ, yabụ, mgbanwe na-emetụta oke arịa ndị ahụ. Na microangiopathy na-arịa ọrịa shuga, a na-emetakarị fundus, nke a na-achọpụta dị ka ọrịa retinopathy; ndị a bụkwa ikpe ugboro ugboro.
- Ọrịa macroangiopathy na-arịa ọrịa shuga na-emetụta ụbụrụ, akwara ozi, akụrụ, akwara ndị metụtara akụkụ. Nke a na - esochi ọrịa angina pectoris, infarction myocardial, ọrịa strok, ọrịa shuga, ọbara mgbali elu. Site n'ịgbasa mbibi nke akwara ọbara, ihe ọghọm nke ibute ọrịa obi na ọrịa obi na-arị elu ugboro atọ.
- Ọtụtụ ọrịa mamịrị na-akpata ọrịa atherosclerosis nke arịa ọbara. A na-achọpụta ụdị ọrịa a na ndị nwere ụdị 1 na ụdị ọrịa shuga 2 nke afọ 15 gara aga karịa ndị ọrịa nwere ahụike. Ọzọkwa, ọrịa na-arịa ndị ọrịa mamịrị nwere ike ịmalite ngwa ngwa.
- Ọrịa ahụ na-eme ka okpukpu okpuru ala nke okpuru ala na nke buru ibu na-arụ ọrụ, bụ́ nke e ji etolite etoliterotic mgbe e mesịrị. N'ihi calcification, ngosipụta na necrosis nke plaques, ọbara ọgbụgba na-etolite na mpaghara, lumen nke arịa na-emechi, n'ihi ya, ọbara ọbara na mpaghara emetụtara emetụta na-arịa ọrịa mamịrị.
Dịka iwu, macroangiopathy na-arịa ọrịa shuga na-emetụta akwara, ụbụrụ, visceral, akwara akwara, yabụ ndị dọkịta na-eme ihe niile iji gbochie mgbanwe ndị dị otú ahụ site na iji usoro mgbochi.
Ihe ọghọm nke pathogenesis na hyperglycemia, dyslipidemia, insulin resistance, oke ibu, ọbara mgbali elu, ịba ụba coagulation, endothelial dysfunction, nrụgide oxidative, sistem sistem dị elu.
Ọzọkwa, atherosclerosis na-etolitekarị ndị na-ese anwụrụ, na ọnụnọ anụ ahụ, yana ị professionalụbiga mmanya ókè. Menmụ nwoke gafere afọ iri ise na ise na ụmụ nwanyị karịrị iri afọ ise.
Ọtụtụ mgbe, ihe kpatara ọrịa ahụ na-abụ ihe a ketara eketa.
Ọrịa mamịrị na-arịa ọrịa shuga na ụdị ya
Ọrịa shuga (angriaathy) nwere echiche mkpokọta echiche nke na-anọchite anya pathogenesis ma na - emetụta arịa ọbara ọbara - obere, buru ibu na ọkara.
A na-ahụta ihe omume a dịka nsonaazụ mbubreyo nke ọrịa shuga mellitus, nke na-amalite ihe dị ka afọ 15 mgbe ọrịa ahụ pụtara.
Ọrịa macroangiopathy na-arịa ọrịa syndromes dịka atherosclerosis nke aorta na akwara akwara, akụkụ akwara ma ọ bụ akwara ụbụrụ.
- N'oge microangiopathy na ọrịa shuga mellitus, ọrịa retinopathy, nephropathy, na ọrịa mamịrịapọniki nke ọrịa ala ala.
- Mgbe ụfọdụ, mgbe ọ bụla mebiri arịa ọbara, a na-achọpụta ọrịa angiopathy zuru ụwa ọnụ, echiche ya gụnyere micro-macroangiopathy na-arịa ọrịa mamịrị.
Microoneiopathy endoneural nke na-akpata ọrịa mebiri emebi, nke a na-akpata neuropathy mamịrị.
Ọrịa mamriangiopathy na ọrịa ya
Site na atherosclerosis nke aorta na akwara akwara, nke na-akpata ọrịa macroangiopathy nke ala akụkụ ahụ na akụkụ ndị ọzọ nke ahụ, onye na-arịa ọrịa shuga nwere ike ịchọpụta ọrịa obi na-arịa, myocardial infarction, angina pectoris, cardiosclerosis.
Ọrịa obi na akwara na - ebilite n'ọnọdụ a wee pụta n'ụdị na-enweghị efe, na-enweghị ihe mgbu ma na-eso arrhythmia. Ọnọdụ a dị oke egwu, ebe ọ nwere ike ibute ọnwụ mberede.
Pathogenesis na ndị ọrịa mamịrị na-enwekarị nsogbu ndị dị na post-infarction dị ka ọrịa sitheurm, arrhythmia, thromboembolism, cardiogenic ujo, nkụchi obi. Ọ bụrụ na ndị dọkịta ekpughela na ihe kpatara ọrịa myocardial infarction bụ ọrịa shuga macroangiopathy, a ga-emerịrị ihe niile ka nkụchi obi wee ghara ibilite, ebe ọ bụ na ihe egwu dị oke.
- Dabere na ọnụ ọgụgụ, ụdị 1 na ndị ọrịa shuga 2 nwere ike ịnwụ site na infarction myocardial dị ka ndị na-enweghị ọrịa shuga. Ihe dị ka pasent 10 nke ndị ọrịa na-arịa ọrịa ụbụrụ atherosclerosis n'ihi ọrịa macroangiopathy.
- Atherosclerosis na ndị ọrịa mamịrị na-eme onwe ya obi site na mmepe nke ọrịa ischemic ma ọ bụ ischemia ụbụrụ nke na-adịghị ala ala. Ọ bụrụ na onye ọrịa nwere ọbara mgbali elu, ihe ọghọm nke ibute ọrịa ụbụrụ na-abawanye ugboro atọ.
- N'ime pasent 10 nke ndị ọrịa, a na-achọpụta ọrịa atherosclerotic na-arịa ọnya na-emetụta ụdị nke atherosclerosis obliterans. Ọrịa shuga macroangiopathy na-esochi ọnya, oyi nke ụkwụ, idozi ihe na-apụtakarị, ọnya na-efe efe nke akụkụ ahụ niile.
- Onye ọrịa ahụ na-enwe oke ihe mgbu na akwara akwara nke ikpere, apata ụkwụ, ụkwụ ala, nke na-agbasi ike na mgbatị anụ ahụ ọ bụla. Ọ bụrụ na ọbara na-aga n'ọdịdị dị anya na-enwe oke nsogbu, nke a na-eduga ischemia dị oke egwu, nke n'ikpeazụ na-akpatakarị anụ ahụ nke ukwu na ukwu ala n'ụdị gangrene.
- Akpukpo aru na nke uzo di ala nwere ike nezo nke ha, n’enweghi nsogbu nke igwe. Ma, dị ka a na-achị, necrosis na-apụta nwere mmebi nke anụrị - ọdịdị nke gbawara agba, ọnya ọnya, ọnya.
Mgbe nsogbu adịghị n'ọbara ọsịsa, macroangiopathy na-arịa ọrịa shuga na-ebute ọdịdị nke ọnya trophic ala ala na-arịa ọrịa shuga n'ụkwụ.
Kedu otu esi achọpụta ọrịa mamroangiopathy?
Nchoputa bu n’ikpebi etu ihe akwara obara, akụkụ ụbụrụ na akụkụ akụkụ adịghị emetụta.
Iji chọpụta usoro nyocha achọrọ, onye ọrịa ahụ kwesịrị ịga hụ dọkịta.
A na-eme nnyocha ahụ site na endocrinologist, diabetologist, cardiologist, dọkịta na-awa ahụ, onye na-awa obi, ọkachamara na akwara.
Na ụdị 1 na ụdị ọrịa shuga 2, ụdị ọgwụ nchọpụta dị ka enyere iji chọpụta pathogenesis:
- Emere nnwale ọbara biochemical iji chọpụta ọkwa nke glucose, triglycerides, cholesterol, platelet, lipoproteins. A na-enyocha nnwale ọbara ọbara.
- Gbalia inyocha sisitemu ike site na iji electrocardiogram, nleba anya kwa ụbọchị nke ọbara mgbali, nnwale nrụgide, ihe echocardiogram, ultrasound dopplerography of the aorta, scintigraphy nke myocardial, coronarography, compatium tomographic angiography.
- A na-akọwapụtakwa ọnọdụ akwara ozi nke onye ọrịa site na iji dopplerography ultrasound nke arịa ụbụrụ, nyocha duplex na angiography nke arịa ụbụrụ.
- Iji chọpụta ọnọdụ akwara ọbara dị, akwara ụkwụ na-enyocha akụrụngwa duplex, ultrasound dopplerography, peripheral arteriography, rheovasography, capillaroscopy, oscillography arterial.
Ọgwụgwọ microangiopathy mamịrị
Ọgwụgwọ ọrịa a na ndị ọrịa shuga bụ isi n’inye ihe iji belata ọganiihu nke nsogbu vaskụla dị ize ndụ, nke nwere ike ibute onye ọrịa nwere nkwarụ ma ọ bụdị ọnwụ.
A na-agwọ ọnya ọnya na elu na nke ala n'okpuru nlekọta nke dọkịta na-awa ahụ. Ọ bụrụ na ọ nwere ajọ ọrịa vaskụla, a na-eme ọgwụgwọ kpụ ọkụ n'ọnụ kwesịrị ekwesị. Ọzọkwa, dọkịta ahụ nwere ike iduzi maka ọgwụgwọ ịwa ahụ, nke mejupụtara ya na endarterectomy, mkpochasị ụbụrụ ụbụrụ, mwepu aka nke aka emetụtara, ma ọ bụrụ na ọ bụrụlarị oria shuga.
Ejikọtara ụkpụrụ nke usoro ọgwụgwọ na mgbazi nke syndromes dị ize ndụ, nke gụnyere hyperglycemia, dyslipidemia, hypercoagulation, ọbara mgbali.
- Iji kwụọ ụgwọ maka ihe ndị na-eme ka ọ na-eme ka mmiri ọgwụ ike ndị a na-eme ka ọ rụpụta ọrụ ọgwụ, dibịa na-enye ọgwụ ọgwụ insulin na nlekọta mgbe niile. Maka nke a, onye ọrịa ahụ na - a drugsụ ọgwụ na - agbada egbugbere ọnụ - statins, antioxidants, fibrates. Na mgbakwunye, ọ dị mkpa ịgbaso nri ọgwụgwọ pụrụ iche na mgbochi nke iji ihe oriri nwere nnukwu ọdịnaya nke abụba anụmanụ.
- Mgbe enwere ihe ọghọm nke ịmalite nsogbu nke thromboembolic, a na-enye ọgwụ antilocklet - acetylsalicylic acid, dipyridamole, pentoxifylline, heparin.
- Usoro ọgwụgwọ antihypertensive ma ọ bụrụ na ịchọta ọrịa macroangiopathy na-arịa ọrịa shuga mejupụtara iji nweta na ịnọgide na-enwe ọbara mgbali n'ọkwa 130/85 mm RT. Art. Maka ebumnuche a, onye ọrịa ahụ na-ewere ACE inhibitors, diuretics. Ọ bụrụ na mmadụ nwere nsogbu myocardial, a na-enye ndị omekome ihe mgbochi.
Ihe mgbochi
Dabere na ọnụ ọgụgụ, ụdị 1 na ụdị ọrịa shuga 2 nke ọrịa shuga, n'ihi nsogbu obi na ndị ọrịa, ọnụego ọnwụ sitere na 35 ruo 75 pasent. Na ọkara nke ndị ọrịa a, ọrịa na-akpata ọrịa myocardial infarction, na pasent 15 nke ihe kpatara ya bụ oke ahụ ischemia oke.
Iji zere mmepe nke macroangiopathy mamịrị, ọ dị mkpa iji usoro mgbochi niile. Onye ọrịa ahụ kwesịrị ilebara ọkwa shuga dị n'ọbara anya, tụọ ọbara ọgbụgba, soro usoro nri, nyochaa oke nke aka ya, soro ndụmọdụ niile gbasara ahụike ma kwụsị omume niile o kwere mee.
Na vidiyo dị n'isiokwu a, a tụlere ụzọ maka ọgwụgwọ ọrịa macroangiopathy nke ọrịa mamịrị.
