Mob ntshav qab zib microangiopathy yog qhov txhab ntawm cov hlab ntsha me - capillaries, hlab ntsha thiab venules. Qhov tshwm sim no tshwm sim ntau heev, ua rau muaj kev tsis zoo. Txhawm rau tiv thaiv qhov pib ntawm tus mob no, nws tsim nyog ua raws li kev teem caij kho mob txhua lub sijhawm. Yog tias muaj cov tsos mob zoo li no tshwm sim, yuav tsum tau ua sai sai.
Lub ntsiab lus ntawm pathology
Kev mob ntshav qab zib microangiopathy to taub raws li kev puas tsuaj rau vascular, uas yog qhov tshwm sim ntawm kev mob ntshav ntev. Yeej, muaj kev hloov pauv ntawm cov nkoj me me - capillaries, venules thiab hlab ntsha. Pathology yuav tsis pom nws tus kheej txog li 10-15 xyoo - qhov no tau txiav txim siab los ntawm tus neeg mob lub peev xwm them nyiaj.
Kev nce ntxiv hauv cov ntshav qab zib provokes tsub zuj zuj ntawm cov tshuaj tiv thaiv immunological rau ntawm cov hlab ntsha. Qhov no ua rau o ntawm daim nyias nyias thiab nqaim ntawm lub lumen ntawm cov hlab ntsha, uas ua rau mob ntshav tsis txaus.
Tus txheej txheem no yog nrog los ntawm kev ua txhaum ntawm cov ntshav tawm ntawm cov ntshav, qhov tsim ntawm cov ntshav khov me me, hloov pauv hauv cov txheej txheem hauv cov metabolism. Lub sijhawm ntev, cov kabmob muaj lub cev tsis muaj pa oxygen. Qhov no ua rau muaj kev poob qis hauv lawv cov kev faib tawm thiab nce kev poob zoo.
Vim li cas
Ntau yam ua rau muaj qhov tshwm sim ntawm microangiopathy mob ntshav qab zib mellitus:
- Cov txheej txheem tsis ua haujlwm vim yog nce ntxiv ntawm vascular permeability;
- Ua txhaum ntawm cov txheej txheem ntawm cov txheej txheem sib txuas;
- Thrombosis - cov tsos mob hauv cov hlab ntshav ntawm cov ntshav txhaws uas cuam tshuam cov ntshav ncig;
- Hyaline dystrophy - cim tau los ntawm qhov cia ntawm cov protein feem uas muaj cov qauv ntom;
- Necrosis - kev tuag thiab tuag ntawm cov ntaub so ntswg.
Raws li cov piam thaj kom nce siab, dawb radicals thiab peroxides yog tsim hauv lub cev. Lawv ua rau kev rhuav tshem thiab lom ntawm endothelium, uas yog qhov tseem ceeb heev rau kev tsim kho tag nrho ntawm cov ntaub so ntswg thiab lwm yam haujlwm.
Feem ntau, cov endothelium ua rau muaj nitric oxide. Nrog txoj kev loj hlob ntawm pathology, cov khoom lag luam ntawm cov tshuaj no tsawg dua. Hauv qhov xwm txheej no, cov hlab ntsha poob lawv qhov peev xwm nthuav dav. Qhov no dhau los ua qhov pathologies ntawm lub plawv thiab cov hlab ntshav.
Kev faib tawm
Coob tus neeg xav paub txog dab tsi hais txog microangiopathies hauv ntshav qab zib. Nyob ntawm cov kev thaj tsam ntawm anomaly, cov kab mob hauv qab no tau pom tias:
- Kev Mob Ntshav Qab Zib;
- Retinopathy;
- Microangiopathy ntawm cov ceg.
Los ntawm retinopathy yog to taub qhov yeej ntawm lub qhov muag retina. Cov hlab ntsha me me hauv thaj chaw no yog lub luag haujlwm rau cov ntshav xa mus rau cov tseem ceeb ntawm cov khoom hauv nruab nrog pom kev zoo. Vim hais tias cov kev pauv hloov pathological ua rau pom kev tsis pom kev. Nyob ntawm theem ntawm kev rov ua paug, qhov kev pom yuav yog qhov tsis txaus ntseeg lossis ua rau muaj kev tsis yooj yim rau tus neeg mob kom ua tiav qhov tsis pom kev.
Nrog nephropathy, hloov pauv txawv txav yuav luag txhua qhov me me ntawm lub raum. Tsis tas li ntawd, cov hlab ntsha loj tuaj yeem raug kev txom nyem, uas ua rau muaj teeb meem hauv kev ua haujlwm ntawm lub cev no. Cov metabolism hauv zos tsis zoo txaus. Qhov no ua rau lub cev tsis txaus oxygen thiab cov txiaj ntsig zoo.
Tsis tas li ntawd, nrog cov mob nephropathy, kev lim pom yuav cuam tshuam thiab cov qauv uas muaj lub luag haujlwm rau txoj kev no tau cuam tshuam.
Txhab ntawm cov hlab ntsha ntawm ob txhais ceg los ua ib qho ntawm cov laj thawj ntawm cov tsos ntawm tus mob ko taw. Cov kev pauv hauv cov hlab ntsha hauv ntshav thiab ntshav ntshav ua rau lub cev tsis zoo ntawm cov leeg nqaij ntawm ob txhais ceg. Yog li, ntshav qab zib microangiopathy ntawm qis qis provokes qhov poob ntawm lub cev tawv nqaij tsis tu ncua. Nws yuav qhuav, thiab muaj kev puas tsuaj ua rau kis tau tus mob.
Txhua qhov khawb thiab qhov mob ntawm cov tawv nqaij zoo mob tau ntev ntev. Tus neeg mob yuav tshwm sim mob trophic mob. Qhov phom sij txaus ntshai tshaj plaws uas tuaj yeem ua rau microangiopathy ntawm qis qis hauv ntshav qab zib yog mob caj dab. Nws ua rau kev txiav ib ceg tawv lossis tuag.
Soj ntsuam duab
Thawj theem pib ntawm kev tshwm sim ntawm pathology, nws cov tsos mob yog li pom tsis tau tias tus neeg mob tsuas tsis quav ntsej lawv. Nrog kev puas tsuaj rau cov hlab ntawm ob txhais ceg, tingling thiab loog yog qhov kev ua yeeb yam tseem ceeb.
Raws li tus neeg xav tsis thoob, cov tsos mob hauv qab no tshwm sim:
- Mob hauv cov ceg ntawm lub rub tawm cov cim;
- Kev o;
- Siab rog siab;
- Ntau ziab ntawm ko taw thiab ceg;
- Xaus cov tsos mob;
- Cov plaub hau poob rau ntawm ceg;
- Poob ntawm hnov;
- Cov tsos ntawm trophic mob rwj, uas nyuaj rau kho.
Cov teeb meem circulatory ua rau tus neeg mob ob txhais ceg tseem txias txawm tias kub. Ntxiv nrog rau qhov yeej ntawm cov hlab ntsha me, cov hlab ntsha cov leeg, cov hlab ntsha thiab cov hlab ntsha feem ntau muaj feem cuam tshuam hauv txoj kev txawv txav. Qhov no tuaj yeem ua rau muaj kev hloov xim tawv nqaij - nws ua liab, xiav lossis daj ntseg.
Kev ua txhaum txoj cai ntawm kev nyiam huv feem ntau ua rau muaj qhov xwm txheej phem thiab tsim nyog ua ntej ntawm kev kis kab mob. Yog li, cov kws kho mob tau pom zoo kom ua kom koj txhais taw qhuav thiab huv si.
Thaum nyuam qhuav pib ntawm retinopathy, txoj cai kawm asymptomatic. Txawm li cas los xij, tus kws kho qhov muag thaum kuaj tau tuaj yeem sau cov kev hloov pauv ntawd. Thaum xub thawj yoov lossis lub txim taws tuaj yeem tshwm ntawm lub qhov muag, tab sis qhov pom tseeb tsis pom kev.
Tom qab ntawv nws nyuaj rau tus neeg mob sau ntawv, ua haujlwm ntawm lub computer lossis nyeem ntawv. Cov duab hauv tsev kho mob raug hnyav dua vim tias tus kab mob retina cuam tshuam. Yog tias koj tsis hu rau tus kws kho qhov muag, muaj qhov pheej hmoo ntawm qhov tsis pom kev.
Txheeb xyuas cov kab mob nephropathy nyob rau theem pib ntawm kev txhim kho yog qhov teeb meem heev. Pathology tshwm sim tshwj xeeb tshaj tawm los ntawm kev tsim cov protein ua kom tsis muaj zog hauv cov zis. Soj ntsuam kev tshuaj ntsuam yuav pab tshawb pom cov tshuaj no.
Yog hais tias lub raum puas ua rau ntau tshaj tawm, nws muaj kev o, nias poob, teeb meem nrog tso zis. Coob leej ntau tus ntsib qhov tsis muaj zog, lawv hnov tsw ntawm ammonia ntawm lub qhov ncauj.
Kev kuaj mob
Ua ntej tshaj plaws, koj yuav tsum txiav txim siab hom ntshav qab zib. Tus kab mob ntawm thawj hom yog insulin-tiv thaiv, pathology ntawm hom thib ob tsis xav tau kev qhia ntawm insulin cuav.
Cov kws kho mob tseem txheeb xyuas cov ntaub ntawv ntawm cov ntaub ntawv glycemic, C-peptide, glycated hemoglobin.
Tus kws tshaj lij yuav tsum kawm txog keeb kwm ntawm kab mob pathology, ua ib qho kev kuaj mob thiab txheeb xyuas qhov teeb meem. Yog tias muaj kev ua xyem xyav ntawm microangiopathy, ua qhov kev tshawb fawb no:
- Fundusgraphy - lub tshuab tsom tsom iav tsom xam cov qauv ntawm pob txha ntsej muag. Cov txheej txheem tso cai rau koj txheeb xyuas tus vaub kib ntawm cov hlab ntsha, kuaj ntshav khov thiab txhaws ntawm lub lens.
- Kev kuaj ntshav ntawm lub plab hnyuv siab raum - tso cai rau koj los txiav txim siab txog kev mob ntshav siab, nce ntxiv ntawm lub raum, thiab cov zis ntau ntxiv nyob rau hauv lub raum plab mog. Cov txheej txheem kuj tseem pab txheeb xyuas qhov nqaim ntawm lub lumen ntawm cov nkoj sib txawv.
- Sib suav thiab kev sib nqus ntawm lub ntsej muag - pab simulate tus qauv ntawm cov khoom nruab nrog cev thiab txiav txim siab txawv txav.
- Angiography ntawm ob txhais ceg - cuam tshuam nrog kev siv duab x-ray siv duab sib piv. Ua tsaug rau cov txheej txheem, nws muaj peev xwm txiav txim siab qhov loj me ntawm lub nkoj thiab tus nqi ntawm lawv cov staining nrog kev sib thooj.
- Rheovasography - siv los ntsuas cov leeg ntshav hauv ob txhais ceg. Txoj kev tshawb fawb kuj tseem pab txiav txim siab qhov patency ntawm cov hlab ntsha thiab qhov zoo ntawm cov hlab ntsha tuaj.
Cov hau kev kho
Txhawm rau tiv thaiv tus kab mob, nws yog ib qho tsim nyog kom ua raws nraim nrog txhua cov lus pom zoo ntawm tus kws kho mob. Nco ntsoov txiav luam yeeb, muab kev tawm dag zog me me thiab lub cev hnyav.
Los ntawm cov khoom noj yog kom tshem cov carbohydrates uas yooj yim zom. Qee qhov xwm txheej, kev noj zaub mov nrog ntsev qhov yuav tsum tau.
Ntxiv nrog rau cov tshuaj insulin, ib feem ntawm cov kev kho mob nyuaj ntawm pathology yog kev siv colloidal phytoformulas uas cuam tshuam rau txhua yam hauv kev txhim kho ntshav qab zib. Lawv muaj cov nyhuv hypoglycemic, normalize microcirculation, xa cov khoom uas yuav tsum tau them nyiaj rau qhov tshwm sim ntawm tus kabmob mus rau lub cev.
Hauv tsev kho mob, angioprotectors tuaj yeem siv, uas ua rau kom rov kho dua thiab tiv thaiv cov hlab ntsha. Hom no suav nrog cov tshuaj xws li parmidin, angin, dicinone.
Txhawm rau txhim kho cov txheej txheem hauv metabolic, trimetazidine thiab mildronate siv. Kev siv cov statins, xws li atorvastatin, simvastatin, yuav tsum ua tib zoo saib xyuas. Ntxiv rau kev txo qis roj, lawv tuaj yeem ua rau muaj kev phiv tshuaj tsis zoo.
Raws li kev qhia, anticoagulants tuaj yeem siv. Lawv pab txo cov ntshav coagulation. Cov nyiaj no suav nrog fraxiparin, heparin, thiab lwm yam.
Ua cov tshuaj ntxiv rau cov kev kho mob tseem ceeb, cov kws kho mob tshwj xeeb tshaj tawm xws li txhais tau tias laser, kev kho hluav taws xob, kho pob ntseg. Lwm yam kev tawm dag zog lub cev uas tuaj yeem kho vascular morphology thiab paub daws kev mob caj dab kuj tseem siv tau.
Microangiopathy mob ntshav qab zib yog qhov mob hnyav, uas ua rau muaj kev phom sij txaus ntshai. Ua kom pom tseeb ntawm kev teem caij kho mob thiab kev kho lub neej pab kom tsis txhob ua qhov no. Yog tias cov tsos mob ntawm tus kab mob pathology tshwm sim, koj yuav tsum hu rau tus kws endocrinologist tam sim. Tom qab ua kom qhov xwm txheej tsis zoo, tom qab ntawd nws yuav tsum tau kuaj mob tiv thaiv kev kuaj mob ib xyoos ib zaug.
