I nā maʻi he nui me ka maʻi maʻi, pili ka naʻau. No laila, kokoke 50% o nā kānaka e hōʻeha i ka puʻuwai. Eia nō naʻe, hiki i nā hoʻopiʻi i kēlā me kēia ulu a hiki i ka wā ʻōpio.
ʻO ka hana ʻole o ka puʻukū ma ka maʻi diabetes ua pili me ka maʻi kiʻekiʻe glucose i loko o ke kino, kahi e hoʻoiho ai i ka cholesterol i nā pā vascular. Ke alakaʻi nei kēia i kahi lemu i kā lākou lumen a me ke ʻano o ka atherosclerosis.
E kūʻē i ke kua o ke papa o ka atherosclerosis, nui nā maʻi maʻi maʻi e hoʻomohala i ka maʻi naʻau coronary. Eia kekahi, me ka piʻi o ka glucose, ka hōʻeha ma ka wahi o ka mea ke hoʻomanawanui iki. Eia kekahi, ma muli o ka hoʻonuiʻiaʻana o ke koko, hoʻonui ka hopena o ka thrombosis.
Eia kekahi, hiki i nā maʻi maʻi maʻi pinepine ke hoʻonui i ke koko koko, e hāʻawi i ka hoʻopiʻi ma hope o ka hōʻeha ʻana o ka naʻau (aortic aneurysm). I ka mea hou o ka hōʻea hou ʻana o ka scar post-infarction, hoʻonui nui ʻia ka hōʻeha ʻana o ka naʻau a i ʻole i ka make. No laila, he mea koʻikoʻi loa ia e ʻike i ka hopena o ka naʻau ma ka maʻi maʻi a pehea e mālama ai i kahi hoʻopiʻi ʻana.
Nā kumu kumu o ka naʻau paʻakikī a me nā hopena koʻikoʻi
Loaʻa i ka maʻi diabetes he pokole kona ola ma muli o ke kahe koko kiʻekiʻe. Ua kapa ʻia kēia kūlana ʻo ka hyperglycemia, he hopena pili i ka hoʻokumu ʻana o nā plak atherosclerotic. Hoʻopili a hope paha paha i ka lumen o nā moku, e alakaʻi ana i ka ischemia o ka puʻuwai naʻau.
Hoʻomaopopo ka hapa nui o nā kauka he keu ka nui o ke kōkō e hoʻonāukiuki i ka hana endothelial - kahi mahele o ka hōʻiliʻili lipid. Ma muli o kēia, ua lilo nā paia o nā moku i ka hoʻokē ʻia a me nā ʻano pā.
Hāʻawi ka Hyperglycemia i ka hoʻouluʻana i ke kaumaha o ka oxidative stress a me ka hoʻokumu ʻana i nā radical free, he hopena maikaʻi nō hoʻi ma ka endothelium.
Ma hope o kekahi mau haʻawina, ua hoʻokumu ʻia kahi pilina ma waena o ka hiki ʻana o ka maʻi naʻau coronary i ka maʻi mellitus me ka hoʻonui ʻana i ka hemoglobin glycated. No laila, inā hoʻonui ʻo HbA1c e ka 1%, a laila piʻi ka nui o ka ischemia ma ka 10%.
ʻO nā maʻi mellitus a me nā maʻi cardiovascular e lilo i mau kumuhana pili ʻole inā ʻike ʻia ka mea maʻi i nā pōʻino:
- ʻopi momona
- inā loaʻa kekahi o nā ʻohana o ka maʻi maʻi kuʻi i ka puʻuwai;
- pinepine hoʻokiʻekiʻe i ke koko;
- ulaula;
- inu hewa;
- ka nui o nā kolamu a me nā triglycerides i ke koko.
He aha nā maʻi naʻau e hiki ke hoʻopiʻi i ka maʻi diabetes?
I ka manawa pinepine, me ka hyperglycemia, hoʻomohala ʻia ka cardiomyopathy diabetes. Hōʻike ka maʻi i ka wā i loaʻa mai ai nā maʻi myocardium i nā mea maʻi me ka uku hoʻoliʻi maʻi diabetes.
Hoʻomaʻamaʻa pinepine ka maʻi ma ka asymptomatic. Akā i kekahi manawa ke kaumaha nei ka mea maʻi e ka maʻi hōʻeha a me kahi puʻuwai puʻu arrhythmic (tachycardia, bradycardia).
I ka manawa like, pau ka mea nui i ka pīkī i ke koko a hana i loko o kahi hana ulu, no laila e hoʻonui ʻia kona mau ʻāpana. No laila, ua kapa ʻia kēia ʻano, he maʻi maʻi maʻi maʻi. Hiki ke hōʻike ʻia i ka ʻikepili me ka maʻi ʻauamo, ke ʻano ʻana, ke kīkī ʻana o ka hanu ʻana o ka hanu a me ka ʻeha hōʻeha ma hope o ka hoʻomaʻamaʻa.
Hoʻonui ka maʻi naʻau Coronary me ka maʻi diabetes i nā manawa he 52 ma mua o ka poʻe olakino. ʻAʻole ia he mea nui ia ʻaʻole ke hilinaʻi i ka hopena o ka maʻi naʻau o ka coronary ma muli o ka nui o ka maʻi o lalo o ka maʻi, akā i kona lōʻihi.
Hoʻomaka pinepine ʻo Ischemia ma nā maʻi maʻi ʻole me ka hōʻailona ʻole i ka hōʻailona, ke alakaʻi pinepine ʻia nei i ka hoʻomohala ʻana o ka ʻeha puʻuwai naʻau ʻole. Eia kekahi, hoʻomaka ka maʻi i nā nalu, ke hoʻohuli ʻia nei ka huikau pale e ke ala maʻi mau.
ʻO nā hiʻohiʻona o ka maʻi puʻukui coronary ma hope o ka hemorrhage i loko o ka myocardium, e kū'ē ana i ke kua o ka hyperglycemia kronis, cardiac syndrome, hōʻeha o ka puʻuwai, a me nā hanaʻino i nā aronona coronary e ulu wikiwiki. ʻO ke kiʻi haukapila o ischemia i ka maʻi maʻi:
- ʻaʻano pōkole
- arrhythmia;
- paʻakikī ka hanu
- ka ʻomi ʻana i nā hōʻeha ma ka puʻuwai;
- hopohopo e pili ana i ka makaʻu o ka make.
ʻO ka hui pūʻana o ischemia me ka maʻi diabetes hiki ke alakaʻi i ka hoʻomohala ʻana o ka infiction myocardial. Eia kekahi, ua loaʻa kēia mau ʻōuli o kekahi mau hiʻohiʻona, e like me ka puʻuwai puʻuwai, nā edema pulmonary, ʻeha hōʻeha e hōʻeha ana i ka collarbone, ʻāʻī, ke ʻāʻī a i ʻole lehelehe poʻohiwi. I kekahi manawa ke ʻike nei ka mea maʻi i ka hōʻeha ʻana o ka maʻi compressive ma ka umauma, ka lua a me ka luaʻi.
Eia naʻe, nui nā maʻi maʻi e hōʻeha nei i ka puʻuwai no ka mea, ʻaʻole maopopo lākou i ka maʻi maʻi. I kēia manawa, ʻo ka hōʻike i ka hyperglycemia alakaʻi i nā hoʻopiʻi hōʻeha.
Ma ka maʻi maʻi maʻi, pālua ka hopena o ka hoʻomohala ʻana i nā pālua angina pectoris. ʻO kona mau ʻōhumu nui ka palpitations, malaise, nā ʻūnū a me ka pōkole o ka hanu.
ʻO Angina pectoris, kahi i kū kūʻē mai i ke kua o ka maʻi maʻi, kona mau ʻano pono. No laila, ʻaʻole i hoʻopilikia ʻia kona hoʻomohala e ka nui o ka maʻi i lalo, akā ma ka lōʻihi o ke lesion puʻuwai. Eia kekahi, i nā mea maʻi me ka hoʻohaʻahaʻa nui, ʻaʻole lawa ka lawa o ke koko i ka myocardium e ʻoi aku ka wikiwiki ma mua o ka poʻe olakino.
I nā maʻi maʻi he nui, ʻo nā hōʻailona o ka angina pectoris he akene a hele wale ʻole paha. Eia kekahi, loaʻa iā lākou ka hewa i ka palaualelo o ka puʻuwai, e hoʻopau pinepine i ka make.
ʻO kahi hopena hou aʻe o ka maʻi diabetes type 2 ka hopena ʻole o ka naʻau, ka mea, e like me nā hoʻonāukiuki naʻau ʻē aʻe e kū mai ana mai ka hyperglycemia, nona nā hiʻohiʻona ponoʻī. No laila, ulu pinepine ka puʻuwai me ke kō nui i ka wā ʻōpio, ʻoi aku hoʻi i nā kāne. ʻO ka ʻōuli hiʻohiʻona o ka maʻi e komo:
- ka ʻala ʻana a me ka pōkole o nā wāwae;
- hoʻonui ka naʻau i ka nui;
- nā urination pinepine
- luhi;
- ke hoʻonui ʻana i ke kaupaona kino, i wehewehe ʻia e ka paʻa o ke kino i ke kino;
- ʻʻAla
- ʻaʻano pōkole
- ua mai.
ʻO ka dystrope myocardial Diabetic e alakaʻi pū ana i kahi pōʻino o ke mele o ka puʻuwai puʻuwai. Hōʻike ka pathology ma muli o kahi hana hewa i nā hana metabol, i hoʻonāukiuki ʻia e ka hemahema o ka insulin, ka mea e hoʻopiʻi i nā kahe o ka glucose ma o nā pū me myocardial. I ka hopena, hōʻiliʻili nā hui momona oxidized i ka naʻau naʻau.
Ke alakaʻi nei i ke ʻano o ka myocardial dystrophy e alakaʻi i ke ʻano o ka foci o ka haunaele hoʻomaha, flickering arrhythmias, extrasystoles aiʻole parasystoles. Eia nō hoʻi, ʻo ka microangiopathy i loko o ka maʻi diabetes e hāʻawi i ka hāʻule i nā moku liʻiliʻi e hānai ana i ka myocardium.
ʻO ka tachycardia sinus e hele pū me ka makaʻu a i ʻole ka overstrain kino. Ma hope o nā mea āpau, pono i ka hana o ka naʻau wikiwiki e hoʻolako i ke kino i nā mea ʻai me ka oxygen. Akā inā e kū mau ka kō koko koko, a laila hoʻoikaika ʻia ka naʻau e hana i kahi ʻano hoʻonui ʻia.
Eia nō naʻe, i ka maʻi maʻi maʻi, ʻaʻole hiki ke hoʻopaʻa koke ʻia ka myocardium. ʻO ka hopena, ʻaʻole i komo nā ʻokoʻa a me nā mea lako i ka puʻuwai, e alakaʻi pinepine ai i ka hōʻeha o ka naʻau a me ka make.
Me ka neuropathy diabetes maʻi, e hoʻomohala ʻia ka nui o ka naʻau o ka naʻau. No kēlā mau ʻano o ka ʻano, hele mai ka arrhythmia ma muli o ka emi ʻana o ke kūlia o ke kelepona vipoli peripheral.
ʻO kekahi hoʻopiʻi maʻi maʻi maʻamau ʻo hypotension orthostatic. Hōʻike lākou ia ma o ka hoʻemi ʻana o ke kahe koko. ʻO nā hōʻailona o ka hypertension he dizziness, malaise, a nāwaliwali. Hoʻohālikelike ʻia ʻo ia e ka nāwaliwali ma hope o ke ala ʻana a me ke kao mau ʻana.
No ka mea, me ka hoʻonui pinepine ʻana i ke kō koko koko he nui ka hoʻopiʻi, he mea nui e ʻike pehea e hoʻoikaika ai i ka naʻau i ka maʻi maʻi a me ka mea e koho ai ke koho inā ua ulu nā maʻi.
Ke lapaʻau lāʻau i ka maʻi o ka puʻuwai ma nā maʻi maʻi
ʻO ke kumu o ka mālama ʻia e pale i ka hiki ʻana mai o nā hopena hiki a hoʻopau i ka holomua o nā hoʻopiʻi pono ʻana. No ka hana ʻana i kēia, he mea nui ka hana maʻamau i ka glycemia wikiwiki, kāohi i nā pae gula a pale iā ia mai ke ala aʻe a hiki i ka 2 mau hola ma hope o ka ʻai ʻana.
No kēia pahuhopu, me ke ʻano o ka maʻi diabetes o 2, ua kuhikuhi ʻia nā māpana mai ka hui biguanide. ʻO kēia ka Metformin a me Siofor.
Hoʻoholo ʻia ka hopena o ka Metformin ma o kona hiki ke hoʻokaʻawale i ka gluconeogenesis, hoʻōla i ka glycolysis, ka mea e hoʻomaikaʻi ai i ka hana huna ʻana o ka pyruvate a me ka lactate i ka molopa a me nā momona momona. Eia kekahi, ua pale aku ka lāʻau lapaʻau i ka hiki ʻana o nā māla palupalu o nā pā vascular a hoʻomaikaʻi maikaʻi i ka naʻau.
ʻO ka maʻa mua he 100 mg i kēlā me kēia lā. Eia nō naʻe, he nui nā contraindications e lawe i ka lāʻau lapaʻau, ka mea nui e makaʻala pono no ka poʻe i loaʻa kaʻehaʻeha.
Eia nō naʻe, me ka maʻi maʻamau ʻoi 2, ua ʻōlelo pinepine ʻia ʻo Siofor, kahi mea maikaʻi loa i ka wā a me ka mālama ʻana a me ka hana e hāʻawi ai i ka lilo ʻana o ke kau. Koho ʻia ka ʻōkole o kēlā me kēia lā i ka nānā ʻana i ka glucose.
I mea e hoʻomaʻamaʻa ai ʻo Siofor, ua hoʻoneʻenee mau ʻia kona nui - mai 1 a hiki i 3 papa. Akā ʻoi aku ka nui o ka lāʻau lapaʻau ʻoi aku ma mua o ʻekolu kala.
Ua hoʻohālikelike ʻia ʻo Siofor ma ka hihia o ka inakē-hilinaʻi i loko o ka mahele maʻi insulin, myocardial infarction, ka hapai, ka naʻau a me ka maʻi ʻeha. Eia kekahi, ʻaʻole lawe ʻia ka lāʻau inā pono ka hana leʻaleʻa, nā ʻōpū a me kahi kūlana o ka maʻi kōpaʻa maʻi maʻi maikaʻi. Eia kekahi, ʻaʻole pono inu Siofor inā mālama ʻia nā keiki a i ʻole nā maʻi ma mua o 65.
No ka hōʻoluʻolu o ka angina pectoris, ischemia, i mea e pale ai i ka hoʻomohala ʻana o ka infococote myocardial a me nā ʻōiwi hou e kū mai nei i ka maʻi maʻi, pono e lawe i nā ʻano like ʻole o nā lāʻau.
- ʻO ka lāʻau antihypertensive.
- Nā ARB - ke kāohi nei i ka hypertrophy myocardial.
- Nā pāʻai Beta-blockers - e hoʻomaʻamaʻa i ka puʻuwai naʻau a hoʻonui i ke koko.
- Diuretics - hoʻemi i ka puhi ʻana.
- Nitrates - kāpae i kahi puʻuwai puʻuwai.
- ACE inhibitors - loaʻa ia ka hopena ikaika ikaika i ka puʻuwai;
- Anticoagulants - hana i ke koko a emi iki loa.
- Hōʻike ʻia nā Glycosides no ka edema a me ka fibrillation atrial.
Hoʻonuiʻia, me nā maʻi diabetes type 2, me ka pilikia o ka puʻuwai, ke kauka nei i kauka iā Dibicor. Hoʻopaʻa ia i nā kaʻina metabolic i loko o nā lau, hāʻawi iā lākou me ka ikaika.
Hoʻopono maikaʻi ʻia ʻo Dibicor i ka paleka ʻana, ka puʻuwai a me nā kīʻaha koko. Eia kekahi, ma hope o 14 lā mai ka hoʻomaka o ka lāʻau lapaʻau, aia ka emi ʻana o ke kaila o ke kō.
ʻO ka hōʻeha ʻana me ka puʻuwai pu me ka lawe ʻana i nā papa papa (250-500 mg) 2 p. i ka la. Eia kekahi, ʻoi ʻia ʻo Dibikor e inu i loko o 20 mau minuke. ma mua o ka ʻai ʻana. ʻO ka nui o ka nui o kēlā me kēia lā o ka lāʻau lapaʻau he 3000 mg.
Ka contacticated ʻo Dibicor i ka wā kamaliʻi ma ka wā hāpai, lactation a ma kahi hihia o ka intrerance taurine. Eia kekahi, ʻaʻole hiki ke lawe ʻia ʻo Dibicor me ka glycosides cardiac a me BKK.
ʻO nā hana maʻi
He nui nā maʻi maʻi e pili ana i ka mālama ʻana i ka hiki ʻole o ka puʻuwai me ka hōʻoki ʻana. Hoʻomā ʻia ka mālama maʻi ʻana i ka wā e hoʻoikaika ana i ka ʻōnaehana cardiovascular me ke kōkua o nā lāʻau lapaʻau ʻaʻole i lawe mai i nā hopena i makemake ʻia. ʻO ka hōʻailona no ke kaʻina hana ma ke ʻano he:
- nā hoʻololi i ka cardiogram;
- ina e eha mau ka pahu.
- ka māla ʻana
- arrhythmia;
- puʻuwai manaʻo hopohopo;
- kaina pectoris holomua.
Hoʻokomo ʻia ka hana e pili ana i ka puʻuwai leo i ka vasodilation baluna. Me kona kōkua, ua ʻoliʻoli ke kīʻaha, e hōʻoluʻolu i ka naʻau, ua pau. I ka wā o ke kaʻina hana, ua hoʻokomo ʻia kahi catheter i loko o ka arterina, kahi i lawe ʻia ai ka baluna i ka wahi pilikia.
Hoʻomaʻama pinepine ʻia nā hoʻokele Aortocoronary i ka wā e hoʻokomo ʻia ai kahi kumu mesh i loko o ka pā i ka mea i pale aku ai i ka hoʻokumu ʻia o nā koleka poloka. A me ka coronary artery bypass grafting e hana hou i nā kūlana hou no ke kahe koko, e hoʻemi nui loa i ka hopena o ka hoʻi hou ʻana.
I kahi hihia o ka cardiodystrophy maʻi, hōʻike ʻia ka hana lapaʻau me ka implantation o kahi pacemaker. Lawe kēia ʻōpiopio i nā hoʻololi i ka puʻuwai a hoʻoponopono koke iā lākou, ʻo ia ka hōʻemi o ka arrhythmias.
Eia naʻe, ma mua o ka hoʻokō ʻana i kēia mau hana, he mea nui ʻaʻole ia e hoʻoponopono wale i ke ʻano o ka glucose, akā e uku no ka maʻi maʻi. ʻOiai he puʻupuʻu liʻiliʻi (no ka laʻana, ke wehe i kahi huhū, ka lawe ʻana o ka nail), ka mea i lawe ʻia ma ka mālama ʻana i nā poʻe olakino ma ke ʻano he outpatient, ma ka maʻi maʻi maʻi maʻi e hana ʻia i loko o kahi haukapila lapaʻau.
Eia kekahi, ma mua o ka hoʻopili ʻana o ka hōʻiliʻili nui, ua hoʻohuli ʻia nā maʻi me hyperglycemia i ka insulin. I kēia hihia, ua hōʻike ʻia ke hoʻomaka ʻana o ka insulin maʻalahi (3-5 mau palena). A i ka lā he mea nui ia e kāohi i ka glycosuria a me ke kō koko.
No ka mea he kūpono nā maʻi naʻau a me ka maʻi diabetes, ʻike pono nā poʻe me ka glycemia i nā hana o ka ʻōnaehana cardiovascular. He mea like paha ia i ka mālama ʻana i ka nui o ke kō o ke koko, ua hoʻonui ʻia, no ka mea, me ka hyperglycemia koʻikoʻi, hiki i ka hōʻeha ʻeha ke kū nei i ka make.
I ke wikiō ma kēia ʻatikala, hoʻomau ʻia ke kumuhana o ka maʻi naʻau ma ka maʻi diabetes.
