Feem ntau ntawm cov neeg mob ntshav qab zib muaj txhua yam kab mob sib kis uas ua rau tib neeg lub siab tuaj thiab cuam tshuam tag nrho cov hlab ntsha thiab plab hnyuv siab raum. Ib qho ntawm cov mob no yog mob caj dab.
Lub ntsiab lus ntawm tus kabmob no yog txhua qhov vascular cuam tshuam. Yog tias tsuas yog cov hlab ntsha me me xwb, tom qab ntawd tus kabmob raug txwv raws li kev mob ntshav qab zib microangiopathy.
Yog tias tsuas yog cov hlab ntsha loj ntawm cov kab ke xwb, cov kabmob no hu ua mob ntshav qab zib macroangiopathy. Tab sis qhov no tsis yog teeb meem nkaus xwb uas tus neeg mob ntshav qab zib yuav muaj. Nrog mob caj pas, mob homeostasis tseem cuam tshuam.
Cov Cwj Pwm Cim Ntshav Qab Zib Mob Microangiopathy
Thaum xav txog cov cim tseem ceeb ntawm microangiopathy, peb lub ntsiab tseem ceeb sawv, hu ua Virchow-Sinako triad. Cov cim no muaj dab tsi?
- Cov phab ntsa ntawm cov hlab uas hloov pauv.
- Ntshav coagulation yog qhov tsis taus.
- Cov ntshav nce qis.
Raws li cov txiaj ntsig ntawm cov ntshav ua haujlwm ntau ntxiv thiab nce ntshav ntxiv, nws dhau los ua viscous. Cov hlab ntsha noj qab haus huv muaj lub roj nplua nyeem tshwj xeeb uas tsis pub cov ntshav ua raws li cov phab ntsa. Qhov no saib kuas meej cov ntshav txaus.
Cov hlab ntsha uas cuam tshuam tsis tuaj yeem tsim cov roj nplua nyeem no, thiab maj mam txav hauv cov ntshav txav. Tag nrho cov kev cuam tshuam no tsis yog ua rau kev puas tsuaj ntawm cov hlab ntsha xwb, tab sis kuj tseem yuav tsim cov microtubuses.
Thaum lub sijhawm kev txhim kho cov ntshav qab zib mellitus, qhov kev hloov pauv no muaj feem nrog ntau dua ntawm cov hlab ntsha. Feem ntau lub cheeb tsam cuam tshuam yog:
- kabmob ntawm lub zeem muag;
- myocardium;
- ob lub raum
- peripheral poob siab;
- daim tawv nqaij integument.
Qhov txiaj ntsig ntawm qhov kev ua txhaum no, raws li txoj cai, yog:
- neuropathy;
- mob ntshav qab zib nephropathy;
- kev mob plawv
- dermatopathy.
Tab sis thawj cov tsos mob tshwm sim nyob rau hauv qis qis, uas tshwm sim los ntawm kev ua tsis zoo ntawm cov hlab ntshav hauv thaj chaw no. Kev cuv npe ntawm cov xwm txheej no yog kwv yees li 65%.
Qee tus kws kho mob nyiam sib cav hais tias microangiopathy tsis yog ib tus kab mob cais, uas yog, nws yog qhov tsos mob ntawm tus mob ntshav qab zib. Ntxiv rau, lawv ntseeg tias microangiopathy yog qhov muaj txiaj ntsig ntawm neuropathy, uas tau tshwm sim ua ntej.
Lwm cov kws tshawb fawb hais tias cov hlab ntsha ischemia ua rau mob neuropathy, thiab qhov tseeb no tsis cuam tshuam nrog vascular puas tsuaj. Raws li qhov kev xav no, mob ntshav qab zib mellitus ua rau mob neuropathy, thiab microangiopathy tsis muaj dab tsi ua rau nws.
Tab sis kuj tseem muaj qhov kev tshawb xav thib peb, cov neeg ua raws li uas sib cav hais tias ib qho kev ua txhaum ntawm cov hlab ntsha ua haujlwm yuav ua rau cov ntshav tsis ua haujlwm.
Cov kab mob ntshav qab zib microangiopathy muab faib ua ntau hom, uas tshwm sim los ntawm cov teeb meem ntawm kev puas tsuaj rau cov qis qis.
- Nrog rau qhov "zero degree" ntawm kev puas tsuaj rau daim tawv nqaij ntawm tib neeg lub cev.
- Qib thawj - muaj qhov khuam me me ntawm daim tawv nqaij, tab sis lawv tsis muaj cov txheej txheem ua mob thiab muaj qhov chaw hauv cheeb tsam.
- Ntawm qib ob, qhov txhab tawv nqaij ntxiv pom tshwm tuaj yeem ua rau tob zuj zus kom lawv thiaj li ua rau cov nqaij pob txha thiab pob txha puas.
- Qeb qib thib peb yog tus cwj pwm ntawm cov tawv nqaij ua paug thiab thawj cov tsos mob ntawm kev tuag ntawm nqaij nyob ntawm ob txhais ceg. Cov teeb meem zoo li no tuaj yeem tshwm sim ua ke nrog cov txheej txheem ua paug, kab mob, edema, hyperemia, qog thiab txha osteomyelitis.
- Hauv qib plaub, tus neeg caj dab ntawm ib lossis ntau tus ntiv tes pib tsim.
- Qib tsib yog tag nrho ko taw, lossis nws feem ntau cuam tshuam los ntawm kev lom zem.
Cov yam ntxwv ntawm tus yam ntxwv macroangiopathy
Lub hauv paus tseem ceeb hauv kev muaj kev tuag siab ntawm cov neeg mob ntshav qab zib yog mob ntshav qab zib macroangiopathy. Nws yog macroangiopathy feem ntau tshwm sim hauv cov neeg mob ntshav qab zib.
Ua ntej tshaj plaws, cov hlab ntsha loj ntawm cov qis qis tau cuam tshuam, vim qhov kev kho mob ntawm txoj hlab ntshav thiab hlab ntsha tawg.
Macroangiopathy tuaj yeem txhim kho nyob rau hauv tus txheej txheem ntawm nce tus nqi ntawm kev loj hlob ntawm cov kab mob atherosclerotic. Tus kabmob raug faib rau ntau theem ntawm txoj kev loj hlob.
- Nyob rau thawj theem, thaum sawv ntxov tus neeg mob tau qaug zog ntau dhau, tawm hws ntau dhau, qaug zog, nkees nkees, zoo nkaus li mob khaub thuas ntawm cov ceg tawv thiab lawv loog. Qhov no taw qhia them nyiaj nyob rau hauv kev xa xov peripheral.
- Hauv theem ob, ib tus neeg txhais ceg pib loog, nws khov heev, lub ntsej muag ntsia hlau pib tawg. Qee lub sijhawm lameness tshwm nyob rau theem no. Tom qab ntawd muaj qhov mob nyob rau hauv cov nqua, ob qho tib si thaum taug kev thiab so. Cov tawv nqaij yuav daj thiab nyias. Cuam tshuam nyob hauv cov pob qij txha.
- Theem kawg yog mob caj dab hauv ntshav qab zib ntawm txhais taw, ntiv tes thiab sab ceg qis.
Yuav kho cov mob angiopathy li cas
Macro thiab microangiopathy mob ntshav qab zib yog kho tib yam ib yam. Thawj qhov uas ib tus neeg mob yuav tsum tau ua yog coj cov txheej txheem hauv lub cev ntawm lub cev mus rau lub xeev ib txwm muaj. Carbohydrate cov metabolism yuav tsum tau rov qab, vim tias nws yog hyperglycemia uas yog qhov tseem ceeb ntawm kev txhim kho vascular atherosclerosis.
Sib luag tseem ceeb hauv kev kho txheej txheem yog saib xyuas lub xeev ntawm lipid metabolism. Yog tias qib ntawm lipoproteins nrog cov ntsuas qhov ntsuas qis sai dheev nce, thiab theem ntawm triglycerides, ntawm qhov tsis tooj, poob qis, qhov no qhia tias nws yog lub sijhawm suav nrog cov tshuaj hypolipidic hauv kev kho mob.
Peb tab tom hais txog statins, fibrates thiab tshuaj tua kabmob. Macro- thiab microangiopathy mob ntshav qab zib mellitus yog kho nrog lub luag haujlwm tseem ceeb ntawm kev kho mob ntawm kev kho mob ntawm metabolic, piv txwv li, trimetazidine.
Cov tshuaj no pab txhawb rau cov txheej txheem ntawm oxidation ntawm cov piam thaj nyob rau hauv myocardium, uas tshwm sim vim lub oxidation ntawm fatty acids. Thaum lub sij hawm kho ob hom mob, cov neeg mob tau muab tshuaj rau cov tshuaj anticoagulants.
Cov no yog cov tshuaj uas pab ua kom cov ntshav txhaws hauv cov hlab ntshav thiab ua kom cov ntshav tsis muaj zog thaum kuaj mob macroangiopathy.
Ua tsaug rau cov tshuaj no, cov ntshav tsis tuaj yeem nkag rau tuab thiab qhov xwm txheej tsis tsim rau txhaws cov hlab ntshav. Anticoagulants suav nrog:
- Acetylsalicylic acid.
- Tiklid.
- Vazaprostan.
- Heparin.
- Dipyridamole.
Tseem Ceeb! Txij li kub siab yuav luag ib txwm muaj nyob rau hauv cov ntshav qab zib mellitus, nws yog ib qho tsim nyog yuav tau sau tshuaj noj uas ua rau muaj ntshav siab. Yog tias qhov ntsuas no zoo li qub, nws tseem pom zoo kom soj ntsuam nws tas li.
Hauv cov ntshav qab zib mellitus, cov txiaj ntsig zoo yog ntawm 130/85 hli Hg. Cov kev tswj hwm kev tswj hwm no yuav pab kom tiv thaiv kev txhim kho nephropathy thiab retinopathy, txhim kho kev pheej hmoo ntawm mob hlab ntsha tawg thiab plawv nres.
Ntawm cov tshuaj no, calcium channel antagonists, inhibitors thiab lwm yam tshuaj muaj qhov txawv txav.
Thaum kho, nws yog ib qho tsim nyog yuav tsum tau ua kom tau ntawm qhov ntsuas ntawm autonomic homeostasis. Rau qhov no, cov kws kho mob tau sau ntawv rau cov tshuaj uas ua rau kom kev ua haujlwm ntawm sorbitol dehydrogenase. Nws yog qhov sib npaug tseem ceeb los ua cov haujlwm uas txhawb kev tiv thaiv antioxidant.
Yog lawm, nws yog qhov zoo tshaj rau kev tiv thaiv kab mob thaum pib. Txhawm rau ua qhov no, koj yuav tsum ua tus coj txoj kev ua neej thiab soj ntsuam koj txoj kev noj qab haus huv tas li. Tab sis yog tias pom muaj ntshav qab zib txawm li ntawd tshwm sim, koj yuav tsum tau hu rau lub tsev kho mob tam sim ntawd.
Niaj hnub nimno kev kho mob ntshav qab zib thiab kev pab tiv thaiv kom tus neeg tau txais kev tiv thaiv kom tsis txhob muaj kev phom sij li macro- thiab microangiopathy.
