NTSHAV QAB ZIB NEPHROPATHY YOG DAB TSI?

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Mob ntshav qab zib mellitus yog qhov txaus ntshai rau tib neeg tsis yog los ntawm nws cov kev qhia thawj zaug, tab sis cov kev mob tshwm sim los ntawm tus kab mob no tseem muaj teeb meem ntau.

Ntshav qab zib nephropathy tuaj yeem yog pawg neeg ntawm cov kev mob loj heev nyob rau hauv cov ntshav qab zib ntawm ob hom, cov lus no ua ke ua rau kev puas tsuaj rau txhua qhov nqaij thiab cov hlab ntshav ntawm lub raum, uas ua tau nws tus kheej hauv ntau cov kev kuaj mob.

Ntshav qab zib nephropathy puas yog?

Ntshav qab zib nephropathy yog tus cwj pwm hloov pauv pathological ntawm cov hlab ntsha hlaus. Cov kev hloov no tshwm sim hauv ntshav qab zib mellitus ntawm ob hom thiab lawv qhov kawg ua rau sclerosis ntawm cov hlab ntsha loj thiab me me.

Lub ntsiab tseem ceeb vim li cas ntawm kev loj hlob ntawm nephropathy suav hais tias yog theem siab ntawm cov piam thaj. Qhov no, uas yog nyob rau hauv ntau qhov ntau hauv lub cev, muaj kev cuam tshuam rau lub hlwb ntawm tag nrho cov hlab ntsha thiab ua rau cov txheej txheem ua kom cov permeability ntawm cov hlab ntsha thiab capillaries. Nyob rau tib lub sijhawm, lub luag haujlwm tseem ceeb ntawm cov khoom nruab nrog, kev lim pom ib, maj mam poob qis thiab vim qhov no, mob raum tsis ua haujlwm, kev mob raum tsis ua haujlwm, kev loj hlob.

Mob ntshav qab zib nephropathy yog ib qho kev mob ntshav qab zib lig thiab feem ntau ua rau ploj tuag.

Kev hloov pauv hauv lub raum yog pom nyob rau yuav luag 20% ntawm cov neeg mob ntshav qab zib mellitus, ntau zaus nephropathies tsim nrog cov tshuaj insulin-tiv thaiv kab mob. Ntawm cov neeg mob nrog cov kev mob nyhav no, muaj ntau tus txiv neej, qhov mob siab tshaj plaws tshwm sim los ntawm 15 txog 20 xyoo txij li pib muaj ntshav qab zib.

Soj ntsuam duab

Ntshav qab zib nephropathy pom tias yog tus kab mob qeeb qeeb thiab nws yog qhov phom sij tseem ceeb ntawm qhov kev cuam tshuam no. Tus neeg mob ntshav qab zib ntev ntev yuav tsis pom kev hloov pauv uas muaj tshwm sim thiab lawv qhov kev kuaj pom tom qab tsis pub kom ua tiav kev tshem tawm thiab tswj cov pathology.

Thawj cov cim ntawm nephropathy mob ntshav qab zib yog kev hloov pauv hauv kev tsom xam - proteinuria thiab microalbuminuria. Kev tsis sib txawv ntawm tus qauv rau cov ntsuas no, txawm tias qee qhov me me hauv cov neeg mob ntshav qab zib, suav tias yog thawj qhov kev kuaj mob nephropathy.

Muaj ntau theem ntawm cov ntshav qab zib mob nephropathy, txhua tus ntawm tus yam ntxwv los ntawm nws qhov kev tshwm sim, kev kwv yees thiab qib kev kho mob.

Cov tshooj

Thawj theem

- Qhov no yog theem ntawm hloov khoom nruab nrog cev. Nws tshwm sim thaum pib mob ntshav qab zib mellitus, thaum lub raum hlwb me ntsis ntxiv hauv qhov loj me thiab vim qhov no, qhov pom ntawm cov zis nce ntxiv thiab nws cov zis muaj zog ntxiv. Nyob rau theem no, tsis muaj qhov qhia tawm sab nraud, ib yam li tsis muaj protein hauv cov zis. Thaum ua qhov kev kuaj xyuas ntxiv, koj tuaj yeem them mloog rau qhov nce hauv qhov loj me raws li kev ntsuas raws li ultrasound.

Theem theem ob

- pib qhov kev hloov pauv ntawm thawj zaug ntawm lub cev. Hauv feem ntau cov neeg mob, theem no pib tsim tawm kwv yees li ob xyoos tom qab pib mob ntshav qab zib mellitus. Cov phab ntsa ntawm cov hlab ntsha maj mam tuab, thiab lawv sclerosis pib. Hloov pauv cov kev ntsuas niaj hnub no kuj tseem tsis pom.

Thib peb theem

Kwv yees li tsib mus rau xya xyoo tom qab pib mob ntshav qab zib, theem peb ntawm tus mob ntshav qab zib nephropathy tshwm sim. Nrog txoj kev npaj ntsuam xyuas, ib qho tsis txaus pom ntawm cov protein tau sau tseg hauv kev tshuaj ntsuam, uas qhia tau tias muaj kev puas tsuaj rau cov hlab ntsha ntawm cov khoom hauv nruab nrog. Cov protein nyob rau theem no nyob ntawm 30 txog 300 mg / hnub.

Tus nqi ntawm kev lim dej thiab cov kua roj molecular hnyav sib txuas hauv cov kev taw qhia ntawm me ntsis nce, qhov no yog vim qhov pheej nce siab hauv cov hlab ntsha ntawm cov khoom nruab nrog. Kuj tseem tsis muaj qee yam kev kuaj mob tiag tiag ntawm lub sijhawm tam sim no, qee cov neeg mob tsuas yws yws ntawm cov ntshav nce siab (qee zaus), tshwj xeeb tshaj yog sawv ntxov. Saum toj no peb theem ntawm nephropathy suav hais tias yog preclinical, uas yog, sab nraud thiab cov ntsiab lus ntawm kev cuam tshuam tsis pom, thiab kev hloov pauv hauv kev txheeb xyuas tau pom tsuas yog thaum lub sijhawm npaj lossis random soj ntsuam rau lwm lub pathologies.

Qeb plaub

Tom qab 15-20 xyoo los ntawm qhov pib ntawm ntshav qab zib, mob ntshav qab zib ntshav khov ntau zuj zus tuaj. Hauv kev kuaj zis, koj tuaj yeem twb kuaj pom cov protein zais zis ntau, thaum nyob hauv cov ntshav muaj qhov tsis txaus ntawm cov khoom no.

Feem ntau, cov neeg mob lawv tus kheej them sai sai rau kev txhim kho ntawm edema. Thaum pib, puffiness yog txiav txim siab nyob rau hauv cov ceg qis thiab ntawm lub ntsej muag, nrog kev txhim kho ntawm tus kab mob, edema ua loj heev, uas yog, npog thaj chaw sib txawv ntawm lub cev. Cov kua dej khaws hauv plab thiab lub hauv siab, hauv pericardium.

Txhawm rau kom muaj qib siab ntawm cov protein nyob hauv cov ntshav, tib neeg lub cev siv cov txheej txheem tiv thaiv, thaum tig, nws pib zom nws cov protein. Nyob rau tib lub sijhawm, muaj zog poob ceeb thawj ntawm cov neeg mob yog pom, cov neeg mob yws ntawm nqhis dej heev, lawv muaj kev qaug zog, tsaug zog, thiab qab los noj tsawg. Ua tsis taus pa, mob hauv plawv, hauv yuav luag txhua qhov ntshav siab ncav cuag tus lej siab. Ntawm kev txheeb xyuas, daim tawv nqaij ntawm lub cev yog daj ntseg, pasty.

Thib tsib theem

- uremic, nws kuj tseem sau tseg ua qhov xaus ntawm qhov teeb meem. Cov hlab ntsha uas tau tawg yuav luag daim ntaub thaiv thiab tsis ua tiav lawv qhov haujlwm loj. Tag nrho cov tsos mob ntawm qib dhau los tsuas yog nce ntxiv, cov protein ntau loj tso tawm, lub siab yuav luag txhua lub sijhawm, dyspepsia kev loj hlob. Cov cim qhia ntawm kev tuaj yeem ua rau tus kheej lom uas tshwm sim vim tawg ntawm lub cev lub cev tau txiav txim siab. Nyob rau theem no, tsuas yog kev lim ntshav thiab hloov ntshav ntawm lub raum dawb xwb uas cawm tus neeg mob.

Cov hauv paus ntsiab lus ntawm kev kho mob

Txhua txoj kev kho mob hauv kev kho mob ntshav qab zib nephropathy tuaj yeem faib ua ntau theem.

Thawj theem muaj feem rau kev tiv thaiv kev ntsuastsom rau kev tiv thaiv kev txhim kho mob ntshav qab zib nephropathy. Qhov no tuaj yeem ua tiav thaum tswj cov qib tseem ceeb ntawm cov piam thaj hauv cov ntshav, uas yog, tus neeg mob txij thaum pib mob ntshav qab zib yuav tsum noj cov tshuaj uas tau hais tseg thiab ua raws noj zaub mov noj. Thaum kuaj pom microalbuminuria, nws tseem yog ib qho tseem ceeb uas yuav tsum saib xyuas cov piam thaj hauv cov ntshav thiab ua tiav nws txoj kev txo qis. Nyob rau theem no, ib qho kev tsis txaus siab feem ntau ua rau nce ntshav nce siab, yog li tus neeg mob tau txais kev kho mob antihypertensive. Feem ntau, Enalapril tau sau tseg rau hauv qhov me me kom txo ntshav siab.

Nyob rau theem ntawm proteinuria Lub hom phiaj tseem ceeb ntawm kev kho mob yog txhawm rau tiv thaiv kom lub raum kev ua haujlwm poob qis. Nws yog ib qho tsim nyog kom muaj cov khoom noj nruj me ntsis nrog cov kev txwv protein ntawm 0.7 txog 0.8 grams toj ib phaus ntawm tus neeg mob lub cev. Yog hais tias cov protein ua kom tsawg, qhov lwj ntawm nws lub cev yuav pib. Nrog rau kev hloov pauv, Ketosteril yog qhov tsim nyog, nws yog ib qho tsim nyog yuav tau txuas ntxiv noj tshuaj antihypertensive. Kuj, calcium tubule blockers thiab beta-blockers - Amlodipine lossis Bisoprolol - ntxiv rau kev kho. Nrog kev mob hnyav, cov tshuaj diuretics raug kho, qhov ntim ntawm txhua qhov dej haus tau siv yog saib xyuas tas li.
Ntawm theem davhlau ya nyob twg hloov kev kho mob yog siv, i.e. lim ntshav thiab hemodialysis. Yog tias ua tau, hloov khoom nruab nrog cev. Tag nrho complex ntawm cov tsos mob kev kho mob, detoxification txoj kev kho yog kho.

Thaum lub sijhawm kev kho mob, nws yog ib qho tseem ceeb uas yuav tsum thawb theem ntawm kev txhim kho ntawm kev hloov pauv tsis tau hauv lub nkoj ntawm lub raum kom deb li deb tau. Thiab qhov no feem ntau nyob ntawm tus neeg mob nws tus kheej, uas yog, ntawm nws kev ua raws li tus kws kho mob cov lus qhia, ntawm kev haus cov dej qab zib kom tsawg, ua raws li kev noj zaub mov noj.

Kev noj haus rau ntshav qab zib nephropathy

Nyob rau theem ntawm microalbuminuria, uas yog, thaum muaj protein me me nyob hauv cov zis, tus neeg mob yuav tsum pib ua raws kev noj haus. Cov khoom noj tsis muaj protein ntau thiab ntsev tsawg yog qhia rau kev siv. Nws yog qhov tsim nyog los txwv kev noj mov ntawm phosphorus, tsiaj protein, ntsev. Koj kuj yuav tsum tau ua raws li cov qauv noj haus qhia hauv kev txhim kho ntshav qab zib. Kev noj ntsev rau lub cev yog qhov tsim nyog tshwj xeeb rau cov ntshav siab.

Kev siv tshuaj kho mob ntshav qab zib nephropathy siv rau kev hloov pauv hauv ob lub raum thiab hauv cov theem. Thaum kho nyob hauv tsev kho mob, cov kws kho mob xaiv txhua pawg tshuaj uas yuav tsum muaj suab thaj kom tsawg dua thiab txhim kho lub raum. Nws kuj tseem ceeb rau tus neeg mob kom xaiv cov khoom noj zoo tshaj plaws.

Kev Tiv Thaiv

Lub ntsiab tseem ceeb ntawm kev tiv thaiv kab mob ntshav qab zib rau mob ntshav qab zib yog kev them nyiaj txaus rau ntshav qab zib. Ntawd yog, qab zib rau txhua hom ntshav qab zib yuav tsum tsis muaj dab tsi. Qhov yuav tsum tau ua raws kev noj haus thiab koom nrog kev kawm hauv lub cev hauv qhov no tsis tau tham txog. Txawm li cas los xij, nws tsim nyog tham txog qhov zoo ntawm kev txhaj tshuaj insulin.

Kev tshawb nrhiav ntawm kev sib raug zoo ntawm cov ntshav qab zib thiab qhov zoo ntawm kev txhaj tshuaj insulin yog nqa tawm tsis tu ncua, tab sis lawv cov txiaj ntsig tsis yog tshaj tawm tshwj xeeb. Qhov no tshwm sim vim tias cov kev tshawb fawb no ua pov thawj tias qhov zoo dua thiab nqus tshuaj insulin, tsawg dua kev phom sij ntawm cov teeb meem ntshav qab zib, thiab yog li, ntev dua cov kev muaj sia ntawm cov ntshav qab zib. Cov ntaub ntawv no tau muab zais, vim nws cuam tshuam rau cov lag luam kev nyiam ntawm cov txheej txheem uas tau txais ntau yam. Tom qab txhua, cov tshuaj insulin tsis zoo yog qhov pheej yig dua.

Kev twv ua ntej

Cov neeg mob ntshav qab zib mellitus yuav tsum nkag siab tias tsuas yog tshawb pom ntawm microalbuminuria yuav tso cai rau peb coj txoj kev kho mob uas tsim nyog thiab kev tiv thaiv nyob rau hauv lub sijhawm kom txo cov kev pheej hmoo ntawm cov theem pib ntawm nephropathy. Nyob rau theem no, qhov tseem ceeb tshaj plaws uas koj yuav tsum ua yog txhawm rau noj tshuaj muaj suab thaj thiab kev tswj cov ntshav qabzib kom ntau. Yog tias koj ua raws li tag nrho cov no thiab tswj hwm kev noj haus tshwj xeeb, ces txoj kev pheej hmoo ntawm kev tsim muaj mob hnyav ntawm lub raum yuav tsawg heev.

Nyob rau theem ntawm kev tsim kho mob, qhov tsis muaj mob raum tsis ua hauj lwm ncaj qha nyob ntawm kev ua raws li txoj cai kho thiab kev noj haus. Hauv cov theem davhlau ya nyob twg, tus neeg mob lub neej tau txais kev txhawb nqa los ntawm kev lim ntshav lossis hloov khoom nruab nrog cev.

Mob ntshav qab zib nephropathy yuav tsis tshwm sim los ntawm cov kev mob ntshav qab zib yog tias ib tug neeg txij thaum pib nce ntxiv ntshav qab zib yuav raug kho tas li thiab ua raws cov qauv ntawm kev noj zaub mov kom zoo. Cov neeg mob ntshav qab zib qee zaum nyob ntev dua li lawv cov phooj ywg zoo, thiab muaj cov piv txwv ntawm qhov tseeb no.

Xaiv thiab teem caij nrog kws kho mob:

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