Tus mob ntshav qab zib sau npe

PROJECT GEOGRAPHY CAI 46 CAI NTAWM COV Lavxias

Nyob zoo cov kws kho mob,

Peb qhia koj txog kev hloov chaw nyob rau kev nkag mus rau hluav taws xob database "Kev soj ntsuam kabmob ntshav qab zib soj ntsuam."
Cov npe ntshav qab zib yuav tau tas li muaj nyob ntawm qhov txuas tshiab https://dm.astonconsulting.ru/Dm.

Ntshav Qab Zib Teev Lub Website http://www.diaregistry.ru ua haujlwm li qub.
Kev ua haujlwm txij nkawm yuav kav txog lub Yim Hli 7. Lub sijhawm no, kev nce ntxiv hauv lub sijhawm nkag mus rau hauv Kev Sau Npe muaj peev xwm ua tau.

Peb thov zam txim rau cov teeb meem uas tau ntsib hauv kev ua haujlwm ntawm Cov Ntawv Sau Npe.

Lub xeev cov npe ntawm cov neeg mob ntshav qab zib: nws yog dab tsi?

Lub Xeev Tso Npe ntawm Cov Neeg Mob Ntshav Qab Zib (GRBS) yog cov ntaub ntawv tseem ceeb uas muaj feem ntau ntawm cov txheeb cais uas cuam tshuam txog kev tshwm sim ntawm Lavxias cov neeg mob ntshav qab zib.

Nws yog siv los tsim qauv kev siv nyiaj hauv lub xeev thiab kev kwv yees nyob rau yav tom ntej, los ntawm lub xyoo.

Tam sim no, qhov kev tso npe muaj nyob rau hauv daim ntawv ntawm cov kev siv thev naus laus zis uas xav txog cov ntaub ntawv los ntawm kev soj ntsuam-kev kis mob rau lub teb chaws.

Nws cuam tshuam txog kev saib xyuas txhua tus neeg uas muaj mob ntshav qab zib pathology, txij hnub nkag mus rau hauv cov ntaub ntawv ntawm nws nyob hauv yawg thiab rau tag nrho lub sijhawm kho.

Ntawm no yog tas:

• hom kev nyuaj
• kev ntsuas ntawm cov metabolism ntawm cov metabolism thiab lwm yam kev ntsuas ntawm kev sim,
• cov qhabnias kho tau,
• mob ntshav qab zib tuag cov ntaub ntawv.

Cov ntawv sau npe yog qhov tseem ceeb tshaj qhov tseem ceeb ua qhov kev suav, thiab ntxiv rau, nws tsuas yog cov ntaub ntawv txheeb xyuas ntawm nws cov txiaj ntsig rau kev ntsuam xyuas ntau yam kev kho mob, kev teeb tsa thiab kev tshawb fawb uas tso cai rau suav thiab npaj cov peev nyiaj rau kev kho mob, kev yuav khoom noj tshuaj thiab kev cob qhia cov kws kho mob.

Kab mob nthuav dav

Cov ntaub ntawv hais txog cov kabmob ntshav qab zib ntau hauv tebchaws Russia thaum lub Kaum Ob Hlis 2016 qhia tias muaj ze txog 4,350 lab tus tib neeg raug teebmeem "muaj suab thaj", uas ua rau kwv yees li 3% ntawm tag nrho cov pejxeem hauv lub xeev, uas:

• Cov hom non-insulin rau 92% (kwv yees 4,001,860 tus neeg),
• kev siv tshuaj insulin - 6% (li 255 385 tus neeg),
• rau lwm hom kab mob pathology - 2% (75 123 tus neeg).

Tag nrho cov naj npawb kuj suav nrog cov mob no thaum hom mob ntshav qab zib tsis qhia nyob rau hauv ntaub ntawv qhia.

Cov ntaub ntawv no tso cai rau peb kom xaus tias kev nce mus rau hauv cov naj npawb ntawm cov xwm txheej tseem nyob:

• txij lub Kaum Ob Hlis 2012, cov neeg mob ntshav qab zib tau nce txog yuav luag 570 txhiab tus neeg,
• rau lub sijhawm los ntawm kawg ntawm lub Kaum Ob Hlis 2015 - los ntawm 254 txhiab.

Hnub nyoog pab pawg (muaj pes tsawg tus neeg mob ntawm 100 txhiab tus neeg)

Txog ntawm kev nthuav dav los ntawm lub hnub nyoog, hom ntshav qab zib hom 1 feem ntau tau sau tseg rau cov tub ntxhais hluas, thiab ntawm cov neeg uas raug mob los ntawm hom ob hom pathology, feem ntau yog cov laus.

Thaum Lub Kaum Ob Hlis 2016, cov ntaub ntawv hais txog cov hnub nyoog muaj li nram qab no.

• mob ntshav qab zib insulin - qhov nruab nrab ntawm 164.19 mob hauv 100 txhiab tus neeg,
• cov mob ntshav qab zib tsis yog-insulin-2637.17 rau tib neeg coob,
• lwm hom kab mob suab thaj: 50.62 ib 100 txhiab.

Hauv kev sib piv nrog rau 2015 cov nuj nqis, qhov kev loj hlob tau:

• ntawm hom 1 mob ntshav qab zib - 6.79 ib 100 txhiab,
• rau ntshav qab zib hom 2 - 118.87.

Los ntawm cov menyuam hnub nyoog:

• insulin-hom mob ntshav qab zib - 86.73 ib 100 txhiab tus menyuam,
• non-insulin-hom mob ntshav qab zib - 5.34 ib 100 txhiab,
• lwm hom ntshav qab zib: 1,0 ib 100 txhiab tus neeg ntawm cov menyuam yaus.

Piv nrog rau 2015 kev txheeb cais, qhov ntau ntawm cov mob ntshav qab zib insulin feem ntau hauv cov menyuam yaus nce 16.53.

Thaum tiav hluas:

• insulin-hom hom pathology - 203.29 rau 100 txhiab ntawm cov tub ntxhais hluas cov hluas,
• tsis-insulin-ywj siab - 6.82 rau txhua 100 txhiab,
• lwm hom ntawm cov kab mob suab thaj - 2.62 rau tib tus naj npawb ntawm cov tub ntxhais hluas.

Hais txog cov ntsuas ntawm xyoo 2015, cov neeg muaj mob ntawm nrhiav tus mob ntshav qab zib hom 1 hauv pawg neeg no tau nce 39.19, thiab hom 2 - los ntawm 1.5 rau 100 txhiab ntawm cov pejxeem.

Txog rau tom kawg, kev loj hlob tau piav qhia los ntawm kev nyiam ua kom lub cev nyhav ntawm cov menyuam yaus thiab cov hluas. Kev pham yog qhov paub tias yog qhov muaj kev pheej hmoo rau cov ntshav qab zib tsis yog insulin.

Hauv "pawg neeg laus" hnub nyoog:

raws li hom tshuaj insulin - 179.3 ib 100 txhiab neeg laus,

• los ntawm hom non-insulin-ywj siab - 3286.6 ib tus nqi zoo sib xws,
• rau lwm hom ntshav qab zib - 62,8 tus mob hauv 100 txhiab tus neeg laus.

Hauv pawg no, qhov kev loj hlob ntawm cov ntaub ntawv piv rau 2015 yog:

• ntshav qab zib hom 1 - 4.1 ib 100 txhiab,
• rau hom 2 mob ntshav qab zib - 161 rau tib neeg laus
• rau lwm yam mob ntshav qab zib - 7.6.

Yog li, nws tuaj yeem hais tias pes tsawg tus neeg kuaj mob ntshav qab zib yog tseem nce ntxiv. Txawm li cas los xij, qhov no tau tshwm sim nyob rau hauv ntau dua li tsawg dua li xyoo tas los.

Txij xyoo 2013 thiab 2016, kev nthuav dav ntawm ntshav qab zib mellitus tau txuas ntxiv, feem ntau vim yog hom 2 pathology.

Cov qauv ntawm cov ua rau kev tuag

Ntshav qab zib mellitus yog ib qho kab mob hnyav thiab txaus ntshai uas tib neeg tuag.

Raws li cov ntaub ntawv ntawm GRBSD, txij li lub Kaum Ob Hlis 31, 2016, "tus thawj coj" hauv lub neej no yog vim li cas cov kev mob plawv mob hauv hom 1 thiab 2 mob ntshav qab zib li:

• muaj teeb meem nrog ntshav ncig ntawm lub hlwb,
• hlab plawv tsis ua haujlwm
• mob plawv thiab ntaus cwj nrag.

31.9% ntawm cov neeg muaj ntshav qab zib hom 1 thiab 49.5% nrog hom 2 pathology tuag ntawm cov teeb meem kev noj qab haus huv no.

Thib ob, feem ntau ua rau ploj tuag:

• nrog hom 1 mob ntshav qab zib - lub raum lub raum tsis ua haujlwm (7.1%),
• nrog hom 2, teeb meem oncological (10.0%).

Thaum txheeb xyuas qhov tshwm sim loj heev ntawm ntshav qab zib, ntau yam kev mob tshwm sim xws li:

• mob ntshav qab zib tsis nco qab (hom 1 - 2.7%, yam 2 - 0.4%),
• hypoglycemic coma (hom 1 - 1.8%, hom 2 - 0.1%),
• cov kab mob muaj kab mob (septic) ntshav lom (hom 1 - 1.8%, hom 2 - 0.4%),
• cov mob sib xyaws (hom 1 - 1.2%, hom 2 - 0.7%).

Qhov no qhia tau hais tias nrog daim ntawv foos-insulin, qhov feem pua ​​ntawm cov kev mob tshwm sim yog qhov siab dua, uas piav qhia txog lub sijhawm luv luv ntawm cov neeg muaj ntshav qab zib hom 1.

Lwm Yam Kev Sau Npe

Ntshav qab zib yog ntshai ntawm cov tshuaj no, zoo li hluav taws!

Koj tsuas yog xav tau thov ...

Ntshav qab zib mellitus yog txaus ntshai nrog cov teeb meem uas txhim kho vim yog lub sij hawm ntev muaj txiaj ntsig ntawm pathology ntawm lub cev. Cov txheeb cais ntawm lawv qhov muaj ntau yog nyob rau hauv qab no (tsis coj mus rau hauv tus lej cov ntaub ntawv rau St. Petersburg, vim tsis tiav qhov puv ntawm cov qauv hauv online).

Txog ntshav qab zib hom 1 (feem pua ​​ntawm tag nrho cov neeg muaj teeb meem "qab zib"):

• neuropathic mob - 33.6%,
• retinopathic qhov muag pom kev tsis zoo - 27.2%,
• cov kab mob nephropathic - 20.1%,
• ntshav siab - nyob rau hauv 17.1%,
• cov mob ntshav qab zib ntawm cov hlab ntsha loj - 12.1% ntawm cov neeg mob,
• "mob ntshav qab zib" ko taw - 4.3%,
• ischemic mob plawv - hauv 3.5%,
• teeb meem cerebrovascular - 1.5%,
• myocardial infarction - 1.1%.

Ntshav Qab Zib Hom 2:

• kub siab tsis meej - 40.6%,
• neuropathy ntawm ntshav qab zib etiology - 18.6%,
• retinopathy - hauv 13.0%,
• mob plawv -11.0%, mob plawv
• nephropathy ntawm keeb kwm mob ntshav qab zib - 6.3%,
• mob macroangiopathic vascular txhab - 6.0%,
• cerebrovascular mob - nyob rau hauv 4.0%,
• myocardial infarction - 3.3%,
• mob ntshav qab zib taw - 2.0%.

Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias raws li cov ntaub ntawv los ntawm kev sau npe, cov kev tsis sib haum xeeb ntau dua li tsawg dua raws li kev tshawb fawb uas cuam tshuam nrog kev soj ntsuam.

Qhov no yog vim qhov tseeb tias cov ntaub ntawv tau nkag mus rau hauv GRBSD txog qhov tseeb ntawm kev thim rov qab, uas yog, peb tsuas tuaj yeem tham txog qee cov xwm txheej tshwj xeeb ntawm kev txheeb xyuas tus mob ntshav qab zib mellitus thiab nws qhov teeb meem. Qhov xwm txheej no qhia qee qhov tsis txaus ntseeg ntawm tus nqi them feem ntau.

Hauv kev txheeb xyuas cov ntaub ntawv muaj nyob hauv kev tso npe, 2016 yog qhov tseem ceeb, vim tias feem ntau ntawm thaj chaw tau hloov mus khaws cov ntaub ntawv nyob online. Cov ntawv sau npe tau hloov pauv mus rau cov ntaub ntawv xov xwm hloov pauv uas tso cai rau koj soj ntsuam sai thiab siv tau los soj ntsuam cov kab mob thiab kab mob sib kis ntawm ntau qib.

XEEV TXOJ CAI NTAWM DIABETES: EPIDEMIOLOGICAL CWJ PWM NTAWM INSULIN QHIA TXOG KEV LOJ HLOB

Yu.I. Suntsov, I.I. Dedov, S.V. Kudryakova

Endocrinology Qhov Chaw Tshawb Xyuas RAMS
(Dir.-Acad. RAMS I.I.Dedov), Moscow

Txoj kev tshawb nrhiav cov kev pab cuam ntshav qab zib muaj feem tau txais cov ntaub ntawv uas ntseeg siab tau txog tus kabmob sib kis kabmob ntshav qab zib mellitus. Kev txiav txim siab los tsim cov ntaub ntawv xov xwm zoo li no tau tsim los ntawm Ministry of Health ntawm Lavxias Lavxias xyoo 1993. Tom qab, txoj haujlwm tseem ceeb tau ua tiav los tsim thiab tsim cov ntaub ntawv xov xwm tsis siv neeg ntawm Lub Xeev Kev Tso Npe Mob Ntshav Qab Zib Mellitus (GDS). Lub koom haum qauv ntawm GDS yog nthuav tawm hauv daim duab. Raws li kev paub thiab kev kawm tshawb nrhiav txawv teb chaws thiab hauv Lavxias Kev Tshawb Fawb qhia, cov teeb meem loj tshaj plaws tshwm sim thaum tsim thiab tswj cov ntaub ntawv ntawm cov neeg muaj ntshav qab zib tsis-insulin-mob ntshav qab zib mellitus (NIDDM).

Ntau tshaj 85% ntawm cov neeg mob raug mob los ntawm qhov tsis yog insulin-mob ntshav qab zib mellitus. Daim ntawv foos ntshav qab zib no yog 10 zaug ntau dua cov ntshav insulin-tiv thaiv ntshav qab zib mellitus (IDDM). Qhov tshwm sim ntawm NIDDM yog nce ntau hauv cov neeg hnub nyoog 40 xyoo thiab laus dua thiab nce mus txog qhov siab tshaj plaws hauv cov pab pawg ntawm 60 xyoo thiab laus dua. Tib lub sijhawm, kev nthuav dav ntawm NIDDM, sau los ntawm kev thim rov qab, tsis muaj kev cuam tshuam qhov xwm txheej tiag tiag, vim tias muaj pes tsawg tus neeg mob yog 2-3 zaug siab dua cov teev tseg. Tau hais tias ib feem tseem ceeb ntawm cov neeg mob NIDDM los ntawm lub sijhawm kuaj mob tau tsim, lub sijhawm ua haujlwm ntawm tus kabmob yog li 10 xyoo, nws tau pom meej meej vim li cas qhov no qhia qhov feem pua ​​txaus ntawm cov teeb meem vascular.

Nws tsis tuaj yeem kuaj xyuas tag nrho cov pejxeem rau qhov muaj NIDDM ntawm lub nroog loj xws li Moscow, tsis hais txog tag nrho Tebchaws Russia. Yog li, txhawm rau tshuaj xyuas kev kis mob sib kis, cov tebchaws xws li Tebchaws Asmeskas siv cov kev tshawb fawb soj ntsuam kabmob sib kis hauv thaj tsam ib tus neeg. Cov txiaj ntsig ntawm cov kev tshawb fawb no ua rau nws muaj peev xwm txheeb xyuas yuav ua li cas tiag tiag cov xwm txheej ntawm NIDDM txawv los ntawm cov ntawv sau npe thiab dab tsi yog qhov xwm txheej hauv lub tebchaws tag nrho. Rau lub hom phiaj no, txoj kev xaiv kev sib kis txog cov neeg pej xeem ntawm Moscow tau nqa tawm thiab cov ntaub ntawv tau txais tau muab piv nrog cov ntaub ntawv ntawm NIDDM cov ntawv sau npe.

Yog li, raws li kev tshawb fawb txog kev mob loj zuj zus hauv nroog Moscow, qhov tseeb ntawm NIDDM tshaj li uas tau sau tseg rau cov txiv neej los ntawm 2.0, thiab hauv cov poj niam los ntawm 2.37 zaug. Ntxiv mus, qhov sib piv no cia siab rau lub hnub nyoog ntawm cov neeg mob. Yog li, yog tias nyob hauv pab pawg hnub nyoog ntawm 40-49 xyoo nws yog 4.01, tom qab ntawd nyob rau hauv pab pawg ntawm 60-69 xyoo nws tsuas yog 1.64. Qhov qis qis ntawm qhov sib piv ntawm qhov tseeb thiab kaw tseg ntawm NIDDM ntawm cov neeg laus tau cuam tshuam nrog kev paub ntau dua ntawm cov ntshav qab zib hom no nyob hauv lawv.

Qhov ntsuas tseem ceeb ntawm cov kev kho mob thiab kev kuaj mob rau cov neeg mob NIDDM yog qhov sib piv ntawm cov tiag tiag thiab sau tseg ntawm cov ntshav qab zib muaj teeb meem. Qeb piv txwv tau siv los tshuaj xyuas cov pab pawg neeg mob nrog NIDDM uas tau nyob hauv kev saib xyuas ntawm cheeb tsam endocrinologist. Nws tau muab tawm tias qhov tseeb nthuav dav ntawm NIDDM cov teeb meem xws li retinopathy tau tshaj li uas tau sau tseg hauv 4, 8, nephropathy los ntawm 8.6, polyneuropathy los ntawm 4.0, thiab macroangiopathy ntawm qis qis los ntawm 9.5 (Cov Lus 1). Tsis muaj qhov sib txawv pom tau hauv kev nthuav dav ntawm cov kab mob plawv, mob myocardial infarction, ntshav tawm ntawm lub plawv, thiab kev xiam hlwb cerebrovascular.

Cov npe kho mob ntshav qab zib yog dab tsi?

Sau npe rau kev tiv thaiv kom txog thaum 28.11.2018 10:00.

Peb thov zam txim rau qhov tsis muaj kev yoojyim

1. Txuas nrog 2 thaj chaw tshiab ntawm Lavxias Federation
2. Teeb tsab ntawv tshaj tawm tshiab: M 3. Kev faib tawm ntawm cov tshuaj insulin
3. Txhim kho cov lus ntsuas rau cov neeg mob tshawb pom
4. Cov tshuaj sib txuam tshiab ntxiv: Vipdomet thiab Solikva
5. Sau npe hloov chaw mus rau lub server tshiab ua tau zoo

• Sau rau hauv HbA1c cov ntaub ntawv (yog tias tsis yog, yoo qab zib)
• Kev txo cov qab zib txoj kev kho cov ntaub ntawv nkag
• Ua cov ntaub ntawv ntawm cov tseem muaj qhov tsis haum ntshav qab zib
• Cov nab npawb ntawm cov neeg mob thiab "ua txhaum kev cais neeg-tus yam ntxwv"
• % cov ntaub ntawv hloov kho nyob rau xyoo tam sim no *

* nws yog ib qho tsim nyog kom ua tiav qhov kev mus ntsib thawj zaug rau ib xyoos, suav nrog kev tso npe tsawg kawg 1 HbA1c tus nqi (yog tias tsis yog, tom qab ntawd yoo qab zib), kev hloov pauv hauv qabzib-txo qis kev kho mob, kev txhim kho / kev vam meej ntawm cov teeb meem

Nyob zoo cov kws kho mob,

Peb qhia koj txog kev hloov chaw nyob kom nkag tau rau hluav taws xob chaw khaws ntaub ntawv "Kev Ntshav Qab Zib Saib Xyuas Ntshav Qab Zib".
Cov npe ntshav qab zib yuav tau tas li muaj nyob ntawm qhov txuas tshiab https://dm.astonconsulting.ru/Dm.

Ntshav Qab Zib Teev Lub Website http://www.diaregistry.ru ua haujlwm li qub.
Kev ua haujlwm txij nkawm yuav kav txog lub Yim Hli 7. Lub sijhawm no, kev nce ntxiv hauv lub sijhawm nkag mus rau hauv Kev Sau Npe muaj peev xwm ua tau.

Peb thov zam txim rau cov teeb meem uas tau ntsib hauv kev ua haujlwm ntawm Cov Ntawv Sau Npe.

Daim Ntawv Ntxiv N 1. Kev Cai Tswj rau Kev Sau Npe Mob Ntshav Qab Zib ແຫ່ງ ຊາດ

Raws li peb cov ntaub ntawv (Cov Lus 2), kev qhia tawm ntawm cov kab mob plawv hauv cov qauv ntawm cov tib neeg ua kom ncaj ncaj rau kev tuag ntawm cov neeg mob NIDDM yog 72.6%. Nyob rau tib lub sijhawm, mob plawv ntev yog qhov ua rau tuag nyob rau hauv 40.4% ntawm cov neeg mob, myocardial infarction - hauv 15,4%, mob stroke - hauv 16,8%. Myocardial infarction uas yog qhov ua kom muaj kev tuag tau tshwm sim rau cov txiv neej ntau dua li cov poj niam (19.8 thiab 13.4%, feem), thaum cov poj niam - mob plawv tsis ua haujlwm (36.6 thiab 42.3%, feem). Kev tuag ntawm cov neeg mob NIDDM los ntawm kev mob ntshav qab zib tsis nco qab yog 3.2%, thiab rau cov poj niam nws nce mus txog 4.1%.Qhov no yog vim qhov tseeb tias mob ntshav qab zib tsis zoo ua rau cov neeg mob NIDDM feem ntau yog tsim rau cov neeg laus tiv thaiv cov keeb kwm ntawm lwm qhov mob loj ntawm kev mob, xws li myocardial infarction, mob stroke, kab mob thiab qee yam kab mob.

Rooj ntawv 2 Kev tshwm sim sai uas tuag ntawm cov neeg mob nrog IDDM (%)

Qaug taw ntawm qhov qis hauv qab

ntawm sepsis cov txiaj ntsig

Peb tau kawm txog qhov ua tau ntawm kev tiv thaiv thawj ntawm NIDDM, tsis nyob hauv ib pawg cais tau tsim rau cov laj thawj no, tab sis raws li cov pejxeem qib. Kev tiv thaiv kev tiv thaiv nyob rau hauv daim ntawv ntawm khoom noj khoom haus thiab lub cev kev kho kom haum yog tau ua nyob rau hauv cov koom ua ke ntawm cov txiv neej hnub nyoog 20-59 xyoo (pab pawg scientific thiab pedagogical ntawm Moscow State University muaj npe tom qab M.I. Lomonosov). Thaum pib ntsuas, lawv cov kev noj haus thiab kev siv lub cev, tom qab cov lus pom zoo tau muab rau cov tib neeg uas, raws li cov tswv yim niaj hnub, xav tau. Tsis pub dhau 3 xyoo, kev tswj hwm lawv cov kev coj ua tau ua tiav. Thaum kuaj cov pej xeem tom qab 3 xyoos, qhov tseem ceeb txo qis hauv qhov nruab nrab glycemia tau txais ob qho tib si ntawm lub plab thiab tom qab 1 thiab 2 teev tom qab noj 75 g ntawm qabzib.

Qhov nruab nrab ntawm kev yoo glycemia hauv kev soj ntsuam thawj zaug yog 5.37 ± 0.03 mmol / L, thiab hauv qhov kawg - 4.53 ± 0.03 mmol / L (p

DATABASE ANALYSIS NTAWM TXOJ CAI MOSCOW NROOG COV PATIENTS NROG SUGAR DIABETES
O.V. Dukhareva, L.V. Kleshcheva, V.D. Tikhomirov, O.N. Syroevova, M.B. Antsiferov

TAG NRHO TXAUS LUAG HOM TSHUAJ NROG HOM 1 THIAB HOM 2
NYOB RAU HAUV KEV THEM NYIAJ YEEM HAIS TXOG LUB NROOG MOSCOW
SAIB LUB HNUB CI NTAWM 2004

Tau 10 xyoo, txij li xyoo 1994, ib qho chaw sau npe ntawm cov neeg mob ntshav qab zib mellitus tau maj mam tsim hauv Moscow: kev sau npe ntawm cov menyuam yaus uas muaj ntshav qab zib tau tsim thawj zaug, tom qab ntawd, ntawm daim ntawv, cov neeg laus mob ntshav qab zib hom 1 thiab ntshav qab zib hom 2.
Qhov kev txiav txim ntawm Pawg Thawj Coj Saib Xyuas Kev Noj Qab Haus Huv No. 415 hnub Lub Kaum Hli 4, 2000 ua rau nws tuaj yeem daws thawj theem pib ntawm cov cuab yeej ua haujlwm hauv cov cheeb tsam thiab qhia txog cov software ntawm Xeev Lub Npe Teev Ntshav Qab Zib.

Lub Chaw Hauv Nroog Moscow ntawm Cov Neeg Mob Ntshav Qab Zib (tom qab no hu ua Kev Tso Npe Mob Ntshav Qab Zib) yog tsim nyob rau hauv txhua lub nroog qhov chaw kuaj mob thiab raug txheeb xyuas nrog cov txheeb cais thiab cov ntawv teev npe rau cov nyiam. Rau lub hauv paus ntawm cheeb tsam cov tuam tsev endocrinology, lawv tus kheej sau npe yog tsim, cov neeg koom ua ke uas tau ua raws ntawm Endocrinology Dispensary.

Tam sim no, muaj 183989 cov neeg mob nyob hauv cov ntawv teev npe ntshav qab zib.
Cov ntaub ntawv hais txog kev faib cov neeg mob uas muaj hom 1 thiab ntshav qab zib hom 2 los ntawm lub nroog ua rau nws muaj peev xwm twv seb tau txais nyiaj txiag hauv kev muab tshuaj, ntau zaus ntawm cov chav kawm hauv cov tsev kawm tswj tau tus kheej, thiab lwm yam
Tsis muaj ib qho tseem ceeb tsawg dua yog qhov kev kawm txog kev nthuav dav cov ntshav qab zib tsis txaus (tus naj npawb ntawm cov neeg mob nrog tus kab mob pathology 100,000 tus neeg), vim nws yog qhov lawv pom tias ua rau muaj kev tsis zoo rau lub neej ntawm tib neeg. Kev paub qhov ntau zaus ntawm kev txhim kho ntawm ntau hom kev sib txawv thiab lawv txoj kev cia siab rau lub sijhawm, tus kab mob muaj peev xwm tsim txoj hauv kev rau kev kuaj xyuas lub sijhawm thiab kev saib xyuas lub zog ntawm cov neeg mob. Nov yog lub hauv paus ntawm kev tiv thaiv kev ua haujlwm txhawm rau txhim kho lub neej zoo ntawm cov neeg mob ntshav qab zib.

Cov duab piav qhia tau meej meej tias nyob hauv qee cov neeg mob ua rau muaj teeb meem loj rau ntshav qab zib xws li retinopathy (mob ntshav qab zib qhov muag, uas yog qhov ua rau pom kev tsis pom kev) thiab nephropathy (mob ntshav qab zib lub raum) tshwm sim nyob rau thawj xyoo ntawm kev txhim kho ntshav qab zib. Thiab nrog rau cov kab mob mus ntev dua 15 xyoos, txhua tus neeg mob thib plaub uas mob ntshav qab zib hom 1 tau kuaj pom tias yog tus neeg muaj mob hlwb retinopathy. Txhawm rau tiv thaiv kev txhim kho ntawm kev mob hnyav ntawm ntshav qab zib, nws tsuas yog ua tau los ntawm kev txhawb nqa lub sijhawm ntev ntawm glycemia.

Ntawm kev txaus siab tshwj xeeb yog kev tshuaj ntsuam xyuas ntawm cov chaw khaws ntaub ntawv ntawm Moscow cov menyuam muaj ntshav qab zib hauv kev ua haujlwm txij li xyoo 1994.
Hauv xyoo 70, qhov xwm txheej ntawm cov ntshav qab zib hom 1 ntawm cov menyuam yaus hauv Moscow yog 5.17 rau 100 txhiab tus menyuam, hauv 80s - 9.7, xyoo 1994 - 11.7, xyoo 1995 - 12.1, thiab hauv Xyoo 2001 - 9.63.Nrog kev kawm ntxiv ntxaws ntxiv ntawm kev tshwm sim los ntawm ntau pawg hnub nyoog hauv xyoo 2001, nws pom tseeb tias hauv cov tub ntxhais hluas txij li 10 txog 14 xyoo nws tseem nyob siab heev - 13.24, nce ntxiv hauv cov txiv neej mus rau 15.0. Tib lub sijhawm, nws muaj lub siab nyiam "rov ua kom ntshav qab zib," uas yog, qhov tshwm sim hauv cov neeg muaj hnub nyoog txog 6 xyoo.
Cov hnub nyoog nruab nrab ntawm cov ntshav qab zib nyob hauv cov menyuam yaus hauv nroog Moscow yog 6.61 xyoo.

Cov kev tshwm sim qhia tau hais tias cov teeb meem ntshav qab zib twb pom muaj hauv menyuam yaus thiab thaum tiav hluas. Nrog rau tus kab mob lub sijhawm tsawg dua tsib xyoos, lawv cov zaus muaj tsawg, los ntawm 5 txog 10 xyoo - nws tau dhau los ua qhov tseem ceeb, thiab ntau dua 10 xyoo - qhov ntau zaus ntawm cov kev mob tshwm sim nce peb lossis ntau zaus, nce mus txog 30%.

Lub xeev cov npe ntawm cov neeg mob ntshav qab zib mellitus ntawm St. Petersburg

Qhov txawv txav ntawm qhov tshwm sim ntawm cov teeb meem sib txawv nyob ntawm poj niam txiv neej yog qhov tseem ceeb.
Kev nthuav dav ntawm nephropathy hauv pab pawg ntawm cov menyuam yaus uas muaj sijhawm 1 hom ntshav qab zib - 5-9 xyoo thiab ntau dua 10 xyoo - ntsig txog - 2.84% thiab 5.26%.

Ib qho ntawm cov qauv tseem ceeb rau kev them nyiaj rau ntshav qab zib thaum tseem yau yog kev loj hlob ntawm lub cev. Lub sij hawm ntev hyperglycemia, ua ke nrog cov kev paub ntawm tus kab mob rau ntau tshaj 10 xyoo hauv kev ua tiav nkauj tiav nraug, ua rau kev ncua ntawm kev txhim kho lub cev hauv txhua tus menyuam thib tsib.

Hyropathy yog qhov kev txwv ntawm qhov kev txav ntawm qhov mob ntawm lub pob qij txha ntawm tes, qhia tawm thaum nws tsis tuaj yeem quav cov xib teg. Nws nce ntau hauv cov tub hluas ntxhais hluas uas muaj ntshav qab zib kav ntev dua 10 xyoo. Qhov no yog vim tias cov hluas "tawg tawm" ntawm cov neeg laus tswj hwm tsis tau paub txog qhov xav tau los tswj cov nyiaj mob ntshav qab zib ntawm lawv tus kheej.

Kev rau npe ntawm Lub Nroog Tus Neeg Mob Ntshav Qab Zib lub hom phiaj muaj kev cuam tshuam txog theem ntawm kev mob siab rau cov neeg mob kom ua qhov kev ntsuas tus kheej.

Hais txog kev tso npe ntawm cov menyuam yaus uas muaj kev loj hlob hormone tsis txaus
Tam sim no, tsis muaj kev ntseeg tias txhua tus menyuam yaus muaj hnub yug lossis tau txais kev loj hlob hormone tsis tuaj yeem ua tiav kev loj hlob nrog kev pab los ntawm kev tsim kho tshiab kom muaj kev loj hlob cov tshuaj hormones npaj. Tam sim no nyob rau hauv Moscow, 156 cov menyuam yaus thiab cov tub ntxhais hluas uas muaj kev loj hlob hormone tsis tau txais qhov kev kho mob tsim nyog kho dawb.
Thaum hnov ​​lub tswb?

Tus me nyuam loj hlob sai tshaj plaws nyob rau thawj xyoo ntawm lub neej: kwv yees li 25 cm. Tom qab ntawd qhov kev loj hlob tsawg dua: nyob rau xyoo ob, tus menyuam loj hlob los ntawm 8-12 cm, tom qab ntawd - los ntawm 4-6 cm txhua xyoo. Thaum txheeb xyuas qhov poob qis hauv kev txhim kho lub cev, nws yog qhov yuav tsum tau xa tus menyuam mus rau endocrinologist.
Cov menyuam yaus uas muaj kev loj hlob sai yog pom los ntawm cov kws kuaj mob endocrinologist hauv cheeb tsam polyclinics txhawm rau tswj hwm qhov kev loj hlob, tshem tawm thiab kho lwm yam endocrine thiab somatic pathologies, uas tuaj yeem ua rau lub cev tsis haum. Yog tias xav paub tsis meej txog kev loj hlob hormone hauv menyuam yaus, tus kws kuaj xyuas kabmob endocrinologist xa nws mus rau tom tsev khomob kom tiav qhov kev tshuaj xyuas kabmob endocrinological thiab kev sim tshwj xeeb kom meej meej rau kev kuaj mob. Thaum endocrine pathology paub meej, kev kho mob tshwj xeeb los ntawm kev paub tshuaj yog kho rau tus me nyuam.

Kev kho mob tsis tu ncua ntawm cov menyuam yaus nrog kev loj hlob hormone tsis txaus nyob rau hauv Moscow tau ua txij li xyoo 1996 los. Tam sim no, endocrinologist muaj ntawm lawv pov tseg high-tech tshuaj ntawm kev loj hlob hormone ntawm kev tsim tawm txawv teb chaws thiab txhais tau tias rau lawv cov kev qhia. Cov no yog cov keeb kwm kev loj hlob los ua cov roj ntsha - genotropin, norditropin, thiab humatrop. Tam sim no peb tab tom qhia qhov tshiab, niaj hnub no ntxiv, ua kua norditropin - Norditropin Simplex. Txij li thaum txoj kev loj hlob hormone muaj tsuas yog cov ntawv txhaj, siv tau yooj yim ntawm kev tswj hwm tau tsim rau txhua cov tshuaj - tus neeg siv koob txhaj tshuaj nrog cov koob txhaj tshuaj.

Raws li cov ntawv sau npe ntawm cov menyuam yaus muaj kev loj hlob hormone tsis txaus, nyob rau thawj xyoo ntawm kev kho mob, menyuam loj hlob los ntawm 10-12 cm, hauv ob - los ntawm 7-10 cm, tom qab ntawd qhov nce ntawm kev loj hlob sib raug ntawm tus menyuam muaj kev noj qab haus huv thiab yog 4-6 cm ib xyoos.Cov koob tshuaj ntawm cov tshuaj yog xam tshwj xeeb rau txhua tus menyuam, coj mus rau hauv tus account tau txheeb xyuas cov kab mob thiab raws li qhov hnyav, qhov siab thiab qib ntawm lub cev kev loj hlob. Peb tsis tau pom tias muaj kev phom sij loj rau qhov keeb kwm ntawm kev kho mob no, tab sis, muab qhov tshwj xeeb ntawm kev kho tshuaj hormonal, cov menyuam no tau soj ntsuam tas li los ntawm cov kws tshaj lij los ntawm cov chaw kho mob sab nrauv thiab Endocrinology Dispensary. Hauv kev faib tawm, ib qho chaw khaws ntaub ntawv ntawm cov menyuam yaus uas muaj tus kab mob pathology no tau tsim thiab cov kws qhia tswv yim kho mob rau kev kho mob ntawm kev loj hlob yog ua haujlwm los tsom xam cov teeb meem tshwj xeeb.

Nrog kev kuaj mob kom raws sijhawm thiab kev kho thaum ntxov, qhov nce ntawm kev loj hlob yog qhov tseem ceeb hauv thawj xyoo ntawm kev kho mob, uas zam kev cov teebmeem kev nyuaj siab-kev mob cuam tshuam nrog kev ntshaus nyob hauv cov menyuam yaus. Nyob rau tag nrho lub sijhawm ntawm kev kho mob, menyuam yaus loj los ntawm 25-36 cm, thiab lawv qhov kev loj hlob zaum kawg yog 160-175 cm. Ntau yam ntawm peb cov neeg mob tau hloov kho lub neej tau zoo, kawm nyob hauv cov tsev kawm ntawv siab dua, thiab tau txais cov txiaj ntsig tshwj xeeb.

Cov lus 1 Qhov tseeb thiab sau tseg ntawm cov teeb meem loj ntawm IDDM rau cov neeg mob hnub nyoog 18 xyoo thiab laus dua (%)

Kev soj ntsuam txog cov kev mob tshwm sim sai ntawm kev tuag ntawm cov neeg mob NIDDM koom nrog kom tau txais cov ntaub ntawv tsim nyog rau kev kho ntawm kev kho mob thiab kev tiv thaiv. Raws li cov kws sau ntawv txawv teb chaws, cov kab mob plawv yog ua rau tuag rau cov neeg mob NIDDM yog 75.1 - 87.7%.

Daim Ntawv Ntxiv N 1. Kev Cai Tswj rau Kev Sau Npe Mob Ntshav Qab Zib ແຫ່ງ ຊາດ

Raws li peb cov ntaub ntawv (Cov Lus 2), kev qhia tawm ntawm cov kab mob plawv hauv cov qauv ntawm cov tib neeg ua kom ncaj ncaj rau kev tuag ntawm cov neeg mob NIDDM yog 72.6%. Nyob rau tib lub sijhawm, mob plawv ntev yog qhov ua rau tuag nyob rau hauv 40.4% ntawm cov neeg mob, myocardial infarction - hauv 15,4%, mob stroke - hauv 16,8%. Myocardial infarction uas yog qhov ua kom muaj kev tuag tau tshwm sim rau cov txiv neej ntau dua li cov poj niam (19.8 thiab 13.4%, feem), thaum cov poj niam - mob plawv tsis ua haujlwm (36.6 thiab 42.3%, feem). Kev tuag ntawm cov neeg mob NIDDM los ntawm kev mob ntshav qab zib tsis nco qab yog 3.2%, thiab rau cov poj niam nws nce mus txog 4.1%. Qhov no yog vim qhov tseeb tias mob ntshav qab zib tsis zoo ua rau cov neeg mob NIDDM feem ntau yog tsim rau cov neeg laus tiv thaiv cov keeb kwm ntawm lwm qhov mob loj ntawm kev mob, xws li myocardial infarction, mob stroke, kab mob thiab qee yam kab mob.

Rooj ntawv 2 Kev tshwm sim sai uas tuag ntawm cov neeg mob nrog IDDM (%)

Qaug taw ntawm qhov qis hauv qab

ntawm sepsis cov txiaj ntsig

Peb tau kawm txog qhov ua tau ntawm kev tiv thaiv thawj ntawm NIDDM, tsis nyob hauv ib pawg cais tau tsim rau cov laj thawj no, tab sis raws li cov pejxeem qib. Kev tiv thaiv kev tiv thaiv nyob rau hauv daim ntawv ntawm khoom noj khoom haus thiab lub cev kev kho kom haum yog tau ua nyob rau hauv cov koom ua ke ntawm cov txiv neej hnub nyoog 20-59 xyoo (pab pawg scientific thiab pedagogical ntawm Moscow State University muaj npe tom qab M.I. Lomonosov). Thaum pib ntsuas, lawv cov kev noj haus thiab kev siv lub cev, tom qab cov lus pom zoo tau muab rau cov tib neeg uas, raws li cov tswv yim niaj hnub, xav tau. Tsis pub dhau 3 xyoo, kev tswj hwm lawv cov kev coj ua tau ua tiav. Thaum kuaj cov pej xeem tom qab 3 xyoos, qhov tseem ceeb txo qis hauv qhov nruab nrab glycemia tau txais ob qho tib si ntawm lub plab thiab tom qab 1 thiab 2 teev tom qab noj 75 g ntawm qabzib.

Qhov nruab nrab ntawm kev yoo glycemia hauv kev soj ntsuam thawj zaug yog 5.37 ± 0.03 mmol / L, thiab hauv qhov kawg - 4.53 ± 0.03 mmol / L (p

DATABASE ANALYSIS NTAWM TXOJ CAI MOSCOW NROOG COV PATIENTS NROG SUGAR DIABETES
O.V. Dukhareva, L.V. Kleshcheva, V.D. Tikhomirov, O.N. Syroevova, M.B. Antsiferov

TAG NRHO TXAUS LUAG HOM TSHUAJ NROG HOM 1 THIAB HOM 2
NYOB RAU HAUV KEV THEM NYIAJ YEEM HAIS TXOG LUB NROOG MOSCOW
SAIB LUB HNUB CI NTAWM 2004

Tau 10 xyoo, txij li xyoo 1994, ib qho chaw sau npe ntawm cov neeg mob ntshav qab zib mellitus tau maj mam tsim hauv Moscow: kev sau npe ntawm cov menyuam yaus uas muaj ntshav qab zib tau tsim thawj zaug, tom qab ntawd, ntawm daim ntawv, cov neeg laus mob ntshav qab zib hom 1 thiab ntshav qab zib hom 2.
Qhov kev txiav txim ntawm Pawg Thawj Coj Saib Xyuas Kev Noj Qab Haus Huv No. 415 hnub Lub Kaum Hli 4, 2000 ua rau nws tuaj yeem daws thawj theem pib ntawm cov cuab yeej ua haujlwm hauv cov cheeb tsam thiab qhia txog cov software ntawm Xeev Lub Npe Teev Ntshav Qab Zib.

Lub Chaw Hauv Nroog Moscow ntawm Cov Neeg Mob Ntshav Qab Zib (tom qab no hu ua Kev Tso Npe Mob Ntshav Qab Zib) yog tsim nyob rau hauv txhua lub nroog qhov chaw kuaj mob thiab raug txheeb xyuas nrog cov txheeb cais thiab cov ntawv teev npe rau cov nyiam. Rau lub hauv paus ntawm cheeb tsam cov tuam tsev endocrinology, lawv tus kheej sau npe yog tsim, cov neeg koom ua ke uas tau ua raws ntawm Endocrinology Dispensary.

Tam sim no, muaj 183989 cov neeg mob nyob hauv cov ntawv teev npe ntshav qab zib.
Cov ntaub ntawv hais txog kev faib cov neeg mob uas muaj hom 1 thiab ntshav qab zib hom 2 los ntawm lub nroog ua rau nws muaj peev xwm twv seb tau txais nyiaj txiag hauv kev muab tshuaj, ntau zaus ntawm cov chav kawm hauv cov tsev kawm tswj tau tus kheej, thiab lwm yam
Tsis muaj ib qho tseem ceeb tsawg dua yog qhov kev kawm txog kev nthuav dav cov ntshav qab zib tsis txaus (tus naj npawb ntawm cov neeg mob nrog tus kab mob pathology 100,000 tus neeg), vim nws yog qhov lawv pom tias ua rau muaj kev tsis zoo rau lub neej ntawm tib neeg. Kev paub qhov ntau zaus ntawm kev txhim kho ntawm ntau hom kev sib txawv thiab lawv txoj kev cia siab rau lub sijhawm, tus kab mob muaj peev xwm tsim txoj hauv kev rau kev kuaj xyuas lub sijhawm thiab kev saib xyuas lub zog ntawm cov neeg mob. Nov yog lub hauv paus ntawm kev tiv thaiv kev ua haujlwm txhawm rau txhim kho lub neej zoo ntawm cov neeg mob ntshav qab zib.

Cov duab piav qhia tau meej meej tias nyob hauv qee cov neeg mob ua rau muaj teeb meem loj rau ntshav qab zib xws li retinopathy (mob ntshav qab zib qhov muag, uas yog qhov ua rau pom kev tsis pom kev) thiab nephropathy (mob ntshav qab zib lub raum) tshwm sim nyob rau thawj xyoo ntawm kev txhim kho ntshav qab zib. Thiab nrog rau cov kab mob mus ntev dua 15 xyoos, txhua tus neeg mob thib plaub uas mob ntshav qab zib hom 1 tau kuaj pom tias yog tus neeg muaj mob hlwb retinopathy. Txhawm rau tiv thaiv kev txhim kho ntawm kev mob hnyav ntawm ntshav qab zib, nws tsuas yog ua tau los ntawm kev txhawb nqa lub sijhawm ntev ntawm glycemia.

Ntawm kev txaus siab tshwj xeeb yog kev tshuaj ntsuam xyuas ntawm cov chaw khaws ntaub ntawv ntawm Moscow cov menyuam muaj ntshav qab zib hauv kev ua haujlwm txij li xyoo 1994.
Hauv xyoo 70, qhov xwm txheej ntawm cov ntshav qab zib hom 1 ntawm cov menyuam yaus hauv Moscow yog 5.17 rau 100 txhiab tus menyuam, hauv 80s - 9.7, xyoo 1994 - 11.7, xyoo 1995 - 12.1, thiab hauv Xyoo 2001 - 9.63. Nrog kev kawm ntxiv ntxaws ntxiv ntawm kev tshwm sim los ntawm ntau pawg hnub nyoog hauv xyoo 2001, nws pom tseeb tias hauv cov tub ntxhais hluas txij li 10 txog 14 xyoo nws tseem nyob siab heev - 13.24, nce ntxiv hauv cov txiv neej mus rau 15.0. Tib lub sijhawm, nws muaj lub siab nyiam "rov ua kom ntshav qab zib," uas yog, qhov tshwm sim hauv cov neeg muaj hnub nyoog txog 6 xyoo.
Cov hnub nyoog nruab nrab ntawm cov ntshav qab zib nyob hauv cov menyuam yaus hauv nroog Moscow yog 6.61 xyoo.

Cov kev tshwm sim qhia tau hais tias cov teeb meem ntshav qab zib twb pom muaj hauv menyuam yaus thiab thaum tiav hluas. Nrog rau tus kab mob lub sijhawm tsawg dua tsib xyoos, lawv cov zaus muaj tsawg, los ntawm 5 txog 10 xyoo - nws tau dhau los ua qhov tseem ceeb, thiab ntau dua 10 xyoo - qhov ntau zaus ntawm cov kev mob tshwm sim nce peb lossis ntau zaus, nce mus txog 30%.

Lub xeev cov npe ntawm cov neeg mob ntshav qab zib mellitus ntawm St. Petersburg

Qhov txawv txav ntawm qhov tshwm sim ntawm cov teeb meem sib txawv nyob ntawm poj niam txiv neej yog qhov tseem ceeb.
Kev nthuav dav ntawm nephropathy hauv pab pawg ntawm cov menyuam yaus uas muaj sijhawm 1 hom ntshav qab zib - 5-9 xyoo thiab ntau dua 10 xyoo - ntsig txog - 2.84% thiab 5.26%.

Ib qho ntawm cov qauv tseem ceeb rau kev them nyiaj rau ntshav qab zib thaum tseem yau yog kev loj hlob ntawm lub cev. Lub sij hawm ntev hyperglycemia, ua ke nrog cov kev paub ntawm tus kab mob rau ntau tshaj 10 xyoo hauv kev ua tiav nkauj tiav nraug, ua rau kev ncua ntawm kev txhim kho lub cev hauv txhua tus menyuam thib tsib.

Hyropathy yog qhov kev txwv ntawm qhov kev txav ntawm qhov mob ntawm lub pob qij txha ntawm tes, qhia tawm thaum nws tsis tuaj yeem quav cov xib teg. Nws nce ntau hauv cov tub hluas ntxhais hluas uas muaj ntshav qab zib kav ntev dua 10 xyoo. Qhov no yog vim tias cov hluas "tawg tawm" ntawm cov neeg laus tswj hwm tsis tau paub txog qhov xav tau los tswj cov nyiaj mob ntshav qab zib ntawm lawv tus kheej.

Kev rau npe ntawm Lub Nroog Tus Neeg Mob Ntshav Qab Zib lub hom phiaj muaj kev cuam tshuam txog theem ntawm kev mob siab rau cov neeg mob kom ua qhov kev ntsuas tus kheej.

Hais txog kev tso npe ntawm cov menyuam yaus uas muaj kev loj hlob hormone tsis txaus
Tam sim no, tsis muaj kev ntseeg tias txhua tus menyuam yaus muaj hnub yug lossis tau txais kev loj hlob hormone tsis tuaj yeem ua tiav kev loj hlob nrog kev pab los ntawm kev tsim kho tshiab kom muaj kev loj hlob cov tshuaj hormones npaj. Tam sim no nyob rau hauv Moscow, 156 cov menyuam yaus thiab cov tub ntxhais hluas uas muaj kev loj hlob hormone tsis tau txais qhov kev kho mob tsim nyog kho dawb.
Thaum hnov ​​lub tswb?

Tus me nyuam loj hlob sai tshaj plaws nyob rau thawj xyoo ntawm lub neej: kwv yees li 25 cm. Tom qab ntawd qhov kev loj hlob tsawg dua: nyob rau xyoo ob, tus menyuam loj hlob los ntawm 8-12 cm, tom qab ntawd - los ntawm 4-6 cm txhua xyoo. Thaum txheeb xyuas qhov poob qis hauv kev txhim kho lub cev, nws yog qhov yuav tsum tau xa tus menyuam mus rau endocrinologist.
Cov menyuam yaus uas muaj kev loj hlob sai yog pom los ntawm cov kws kuaj mob endocrinologist hauv cheeb tsam polyclinics txhawm rau tswj hwm qhov kev loj hlob, tshem tawm thiab kho lwm yam endocrine thiab somatic pathologies, uas tuaj yeem ua rau lub cev tsis haum. Yog tias xav paub tsis meej txog kev loj hlob hormone hauv menyuam yaus, tus kws kuaj xyuas kabmob endocrinologist xa nws mus rau tom tsev khomob kom tiav qhov kev tshuaj xyuas kabmob endocrinological thiab kev sim tshwj xeeb kom meej meej rau kev kuaj mob. Thaum endocrine pathology paub meej, kev kho mob tshwj xeeb los ntawm kev paub tshuaj yog kho rau tus me nyuam.

Kev kho mob tsis tu ncua ntawm cov menyuam yaus nrog kev loj hlob hormone tsis txaus nyob rau hauv Moscow tau ua txij li xyoo 1996 los. Tam sim no, endocrinologist muaj ntawm lawv pov tseg high-tech tshuaj ntawm kev loj hlob hormone ntawm kev tsim tawm txawv teb chaws thiab txhais tau tias rau lawv cov kev qhia. Cov no yog cov keeb kwm kev loj hlob los ua cov roj ntsha - genotropin, norditropin, thiab humatrop. Tam sim no peb tab tom qhia qhov tshiab, niaj hnub no ntxiv, ua kua norditropin - Norditropin Simplex. Txij li thaum txoj kev loj hlob hormone muaj tsuas yog cov ntawv txhaj, siv tau yooj yim ntawm kev tswj hwm tau tsim rau txhua cov tshuaj - tus neeg siv koob txhaj tshuaj nrog cov koob txhaj tshuaj.

Raws li cov ntawv sau npe ntawm cov menyuam yaus muaj kev loj hlob hormone tsis txaus, nyob rau thawj xyoo ntawm kev kho mob, menyuam loj hlob los ntawm 10-12 cm, hauv ob - los ntawm 7-10 cm, tom qab ntawd qhov nce ntawm kev loj hlob sib raug ntawm tus menyuam muaj kev noj qab haus huv thiab yog 4-6 cm ib xyoos. Cov koob tshuaj ntawm cov tshuaj yog xam tshwj xeeb rau txhua tus menyuam, coj mus rau hauv tus account tau txheeb xyuas cov kab mob thiab raws li qhov hnyav, qhov siab thiab qib ntawm lub cev kev loj hlob. Peb tsis tau pom tias muaj kev phom sij loj rau qhov keeb kwm ntawm kev kho mob no, tab sis, muab qhov tshwj xeeb ntawm kev kho tshuaj hormonal, cov menyuam no tau soj ntsuam tas li los ntawm cov kws tshaj lij los ntawm cov chaw kho mob sab nrauv thiab Endocrinology Dispensary. Hauv kev faib tawm, ib qho chaw khaws ntaub ntawv ntawm cov menyuam yaus uas muaj tus kab mob pathology no tau tsim thiab cov kws qhia tswv yim kho mob rau kev kho mob ntawm kev loj hlob yog ua haujlwm los tsom xam cov teeb meem tshwj xeeb.

Nrog kev kuaj mob kom raws sijhawm thiab kev kho thaum ntxov, qhov nce ntawm kev loj hlob yog qhov tseem ceeb hauv thawj xyoo ntawm kev kho mob, uas zam kev cov teebmeem kev nyuaj siab-kev mob cuam tshuam nrog kev ntshaus nyob hauv cov menyuam yaus. Nyob rau tag nrho lub sijhawm ntawm kev kho mob, menyuam yaus loj los ntawm 25-36 cm, thiab lawv qhov kev loj hlob zaum kawg yog 160-175 cm. Ntau yam ntawm peb cov neeg mob tau hloov kho lub neej tau zoo, kawm nyob hauv cov tsev kawm ntawv siab dua, thiab tau txais cov txiaj ntsig tshwj xeeb.

XEEV TXOJ CAI NTAWM DIABETES: EPIDEMIOLOGICAL CWJ PWM NTAWM INSULIN QHIA TXOG KEV LOJ HLOB

Yu.I. Suntsov, I.I. Dedov, S.V. Kudryakova

Endocrinology Qhov Chaw Tshawb Xyuas RAMS
(Dir.-Acad. RAMS I.I.Dedov), Moscow

Txoj kev tshawb nrhiav cov kev pab cuam ntshav qab zib muaj feem tau txais cov ntaub ntawv uas ntseeg siab tau txog tus kabmob sib kis kabmob ntshav qab zib mellitus. Kev txiav txim siab los tsim cov ntaub ntawv xov xwm zoo li no tau tsim los ntawm Ministry of Health ntawm Lavxias Lavxias xyoo 1993. Tom qab, txoj haujlwm tseem ceeb tau ua tiav los tsim thiab tsim cov ntaub ntawv xov xwm tsis siv neeg ntawm Lub Xeev Kev Tso Npe Mob Ntshav Qab Zib Mellitus (GDS). Lub koom haum qauv ntawm GDS yog nthuav tawm hauv daim duab. Raws li kev paub thiab kev kawm tshawb nrhiav txawv teb chaws thiab hauv Lavxias Kev Tshawb Fawb qhia, cov teeb meem loj tshaj plaws tshwm sim thaum tsim thiab tswj cov ntaub ntawv ntawm cov neeg muaj ntshav qab zib tsis-insulin-mob ntshav qab zib mellitus (NIDDM).

Ntau tshaj 85% ntawm cov neeg mob raug mob los ntawm qhov tsis yog insulin-mob ntshav qab zib mellitus. Daim ntawv foos ntshav qab zib no yog 10 zaug ntau dua cov ntshav insulin-tiv thaiv ntshav qab zib mellitus (IDDM). Qhov tshwm sim ntawm NIDDM yog nce ntau hauv cov neeg hnub nyoog 40 xyoo thiab laus dua thiab nce mus txog qhov siab tshaj plaws hauv cov pab pawg ntawm 60 xyoo thiab laus dua. Tib lub sijhawm, kev nthuav dav ntawm NIDDM, sau los ntawm kev thim rov qab, tsis muaj kev cuam tshuam qhov xwm txheej tiag tiag, vim tias muaj pes tsawg tus neeg mob yog 2-3 zaug siab dua cov teev tseg. Tau hais tias ib feem tseem ceeb ntawm cov neeg mob NIDDM los ntawm lub sijhawm kuaj mob tau tsim, lub sijhawm ua haujlwm ntawm tus kabmob yog li 10 xyoo, nws tau pom meej meej vim li cas qhov no qhia qhov feem pua ​​txaus ntawm cov teeb meem vascular.

Nws tsis tuaj yeem kuaj xyuas tag nrho cov pejxeem rau qhov muaj NIDDM ntawm lub nroog loj xws li Moscow, tsis hais txog tag nrho Tebchaws Russia. Yog li, txhawm rau tshuaj xyuas kev kis mob sib kis, cov tebchaws xws li Tebchaws Asmeskas siv cov kev tshawb fawb soj ntsuam kabmob sib kis hauv thaj tsam ib tus neeg. Cov txiaj ntsig ntawm cov kev tshawb fawb no ua rau nws muaj peev xwm txheeb xyuas yuav ua li cas tiag tiag cov xwm txheej ntawm NIDDM txawv los ntawm cov ntawv sau npe thiab dab tsi yog qhov xwm txheej hauv lub tebchaws tag nrho. Rau lub hom phiaj no, txoj kev xaiv kev sib kis txog cov neeg pej xeem ntawm Moscow tau nqa tawm thiab cov ntaub ntawv tau txais tau muab piv nrog cov ntaub ntawv ntawm NIDDM cov ntawv sau npe.

Yog li, raws li kev tshawb fawb txog kev mob loj zuj zus hauv nroog Moscow, qhov tseeb ntawm NIDDM tshaj li uas tau sau tseg rau cov txiv neej los ntawm 2.0, thiab hauv cov poj niam los ntawm 2.37 zaug. Ntxiv mus, qhov sib piv no cia siab rau lub hnub nyoog ntawm cov neeg mob. Yog li, yog tias nyob hauv pab pawg hnub nyoog ntawm 40-49 xyoo nws yog 4.01, tom qab ntawd nyob rau hauv pab pawg ntawm 60-69 xyoo nws tsuas yog 1.64. Qhov qis qis ntawm qhov sib piv ntawm qhov tseeb thiab kaw tseg ntawm NIDDM ntawm cov neeg laus tau cuam tshuam nrog kev paub ntau dua ntawm cov ntshav qab zib hom no nyob hauv lawv.

Qhov ntsuas tseem ceeb ntawm cov kev kho mob thiab kev kuaj mob rau cov neeg mob NIDDM yog qhov sib piv ntawm cov tiag tiag thiab sau tseg ntawm cov ntshav qab zib muaj teeb meem. Qeb piv txwv tau siv los tshuaj xyuas cov pab pawg neeg mob nrog NIDDM uas tau nyob hauv kev saib xyuas ntawm cheeb tsam endocrinologist. Nws tau muab tawm tias qhov tseeb nthuav dav ntawm NIDDM cov teeb meem xws li retinopathy tau tshaj li uas tau sau tseg hauv 4, 8, nephropathy los ntawm 8.6, polyneuropathy los ntawm 4.0, thiab macroangiopathy ntawm qis qis los ntawm 9.5 (Cov Lus 1). Tsis muaj qhov sib txawv pom tau hauv kev nthuav dav ntawm cov kab mob plawv, mob myocardial infarction, ntshav tawm ntawm lub plawv, thiab kev xiam hlwb cerebrovascular.

Cov lus 1 Qhov tseeb thiab sau tseg ntawm cov teeb meem loj ntawm IDDM rau cov neeg mob hnub nyoog 18 xyoo thiab laus dua (%)

Kev soj ntsuam txog cov kev mob tshwm sim sai ntawm kev tuag ntawm cov neeg mob NIDDM koom nrog kom tau txais cov ntaub ntawv tsim nyog rau kev kho ntawm kev kho mob thiab kev tiv thaiv. Raws li cov kws sau ntawv txawv teb chaws, cov kab mob plawv yog ua rau tuag rau cov neeg mob NIDDM yog 75.1 - 87.7%. Raws li peb cov ntaub ntawv (Cov Lus 2), kev qhia tawm ntawm cov kab mob plawv hauv cov qauv ntawm cov tib neeg ua kom ncaj ncaj rau kev tuag ntawm cov neeg mob NIDDM yog 72.6%. Nyob rau tib lub sijhawm, mob plawv ntev yog qhov ua rau tuag nyob rau hauv 40.4% ntawm cov neeg mob, myocardial infarction - hauv 15,4%, mob stroke - hauv 16,8%. Myocardial infarction uas yog qhov ua kom muaj kev tuag tau tshwm sim rau cov txiv neej ntau dua li cov poj niam (19.8 thiab 13.4%, feem), thaum cov poj niam - mob plawv tsis ua haujlwm (36.6 thiab 42.3%, feem). Kev tuag ntawm cov neeg mob NIDDM los ntawm kev mob ntshav qab zib tsis nco qab yog 3.2%, thiab rau cov poj niam nws nce mus txog 4.1%.

GBUZ COV NTAUB NTAWV KHO MOB THIAB KEV COJ LUB CEV RAU LUB CEV NTAWM LUB KOOMHAUM NTAWM KRASNODAR LUB HOM PHIAJ

Lub caij no, kev sib raug zoo hauv zej tsoom muaj feem cuam tshuam nrog kev mob ntshav qab zib, kev ua tsis taus thaum ntxov thiab kev tuag los ntawm nws, nrog rau tus nqi ntawm kev kho mob thiab kev kho kom rov zoo dua ntawm cov neeg mob zoo li tseem ceeb heev. Cov ntaub ntawv no yog lub hauv paus rau kev npaj los ua ntau, lossis theej tag nrho, kev soj ntsuam hauv chaw soj ntsuam - soj ntsuam mob ntshav qab zib tom qab 40 xyoo, los siv cov hauv paus ntsiab lus ntawm kev saib xyuas kev noj qab haus huv pej xeem tau pom zoo los ntawm WHO. Cov kev tiv thaiv zoo li no yog qhov tseeb ntawm kev paub txog NIDDM thaum ntxov thiab nws qhov teeb meem, lawv tiv thaiv. Tam sim no, thaum thawj zaug tuaj kuaj mob ntawm tus neeg mob ntshav qab zib mus rau tus kws kho mob, nrog kev kuaj mob uas tsim nyog, kwv yees li 40% ntawm cov neeg mob qhia IHD, retinopathy, nephropathy, mob polyneuropathy, thiab mob ntshav qab zib. Nres txoj kev nyob rau theem no yog qhov nyuaj dua, yog tias ua tau, thiab cov nqi hauv zej tsoom ntau zaus kim dua. Ntawm chav kawm, xws li ib qho kev zov me nyuam xav tau kev nqis peev nyiaj txiag ntau, tab sis lawv rov los sib koom tes. Qhov Kev Pab Diabetology yuav tsum npaj muaj ntau lab lab tus neeg mob ntshav qab zib nrog cov tshuaj niaj hnub thiab kev saib xyuas uas tsim nyog.

Lub xeev sau npe ntawm cov neeg mob ntshav qab zib yuav tsum yog lub luag haujlwm tseem ceeb hauv kev kawm txog kev muaj kabmob ntshav qab zib ntau, nws cov khoom siv hauv ntau cheeb tsam, nroog, nroog thiab thaj chaw nyob sab qaum teb, thaj chaw huab cua thiab thaj chaw, nyob ntawm huab cua thiab ib puag ncig, zaub mov noj thiab ntau lwm yam.

Cov txheej txheem European yog tsim raws li Lavxias phau ntawv sau npe, uas yuav ua rau muab piv rau txhua qhov ntsuas mob ntshav qab zib nrog cov teb chaws txawv teb chaws, kwv yees qhov tseeb tam sim no, suav cov nyiaj txiag ncaj qha thiab tsis ncaj, thiab lwm yam.

Hmoov tsis zoo, qhov xwm txheej tsis zoo hauv kev lag luam hauv Lavxias Lavxias tau txiav txim siab ua kom tiav qhov kev zov me nyuam ntawm Lub Xeev Tso Npe ntawm Cov Neeg Mob Ntshav Qab Zib, tseem ceeb heev rau Russia

Kev tso npe rau tus mob ntshav qab zib yog ib txoj kev siv ntaub ntawv kaw lus ib txwm rau kev soj ntsuam kev soj ntsuam kev soj ntsuam mob thiab soj ntsuam ntsuas cov ntshav qab zib kom tsawg thiab kev tuag nyob hauv kev txuas nrog nws. Qhov system muab kev saib xyuas tus neeg mob txij thaum nws tau muab tso rau hauv kev rau npe kom txog thaum nws tas sim neej. Qhov ntim ntawm cov ntaub ntawv sau npe nyob ntawm cov haujlwm, qhov kev daws teeb meem uas tau npaj los ntawm cov koom haum tuav npe.

Thawj qhov txiaj ntsig ntawm kev tsom xam ntawm cov ntaub ntawv los ntawm cov ntawv sau npe ntawm Moscow thiab thaj av Moscow tau qhia txog lub xeev kev nyuaj siab ntawm kev saib xyuas tshwj xeeb rau cov neeg mob ntshav qab zib mellitus. Hauv nroog Moscow, tsuas yog 15.6% ntawm cov menyuam muaj mob ntshav qab zib nyob hauv lub xeev them nyiaj, thiab nrog lub sijhawm mob ntshav qab zib tau ntau tshaj 10 xyoo, kev nthuav dav ntawm cov ntshav qab zib mob nce mus txog qhov tseem ceeb kawg: kev rov qab kho mob - 47%, mob cataract - 46%, poob qis kev co rhiab - 34%, microalbuminuria - 16%.

Lub koom haum ntawm Lub Xeev Tso Npe ntawm Ntshav Qab Zib Mellitus yuav nce qib thiab zoo ntawm kev saib xyuas, nthuav cov ntau ntawm cov ntaub ntawv, txiav txim siab lub tswv yim rau kev tiv thaiv kab mob ntshav qab zib, cov lus qhia tseem ceeb hauv nws txoj kev kawm, nrog rau txhim kho kev kho mob thiab tiv thaiv kab mob rau cov neeg mob, lawv lub neej zoo thiab nws lub sijhawm. Lub koomhaum WHO pom zoo ib yam nyob hauv nws “Cov Haujlwm Kev Ua Haujlwm”.

Hauv Lavxias Lavxias, ntau dua 10-11 txhiab kev txiav txim siab ntawm qis qis dua los ua txhua xyoo. Cov kev paub dhau los ntawm kev ua haujlwm ntawm "taw taw mob ntshav qab zib" ntawm ESC RAMS tau qhia tias feem ntau zoo li kev phais mob tshaj plaws tsis yog ib qho txhaum. Kev txiav txim siab ntawm qis qis tshaj plaws raug zam nyob rau hauv 98% ntawm cov neeg mob los ntawm ntau thaj tsam ntawm Lavxias teb sab uas tau lees paub rau ESC RAMS nrog kev kuaj mob neuropathic lossis kev sib xyaw ntawm SDS. Xws li cov neeg mob uas mob raum ua rau lub ntsej muag, phlegmon, raws li txoj cai, poob rau hauv tes ntawm cov kws phais mob uas tsis paub lossis tsis paub qhov ua rau mob ntshav qab zib ua rau lub cev puas. Nws yog qhov tsim nyog los npaj kev sib koom ua ke thoob plaws ntawm CDS chav thiab qhia tus kws paub txog cov mob ntshav qab zib, i.e. koomhaum ntawm kev saib xyuas tshwj xeeb rau cov neeg mob ntawd.

Ua ntej tshaj plaws, cov ntsiab lus hauv qab no rau kev saib xyuas cov neeg mob xa mus rau kev tiv thaiv yuav tsum nkag siab zoo: kev soj ntsuam ntawm ob txhais ceg thaum mus ntsib kws kho mob, kuaj neurological ib xyoos ib zaug rau txhua tus neeg mob ntshav qab zib, kev txheeb xyuas cov ntshav txaus hauv qis qis hauv cov neeg mob IDDM-sijhawm ib xyoos tom qab 5-7 xyoo los ntawm qhov pib ntawm tus kab mob, hauv cov neeg mob NIDDM - 1 zaug hauv ib lub xyoo txij li lub sijhawm kuaj.

Nrog rau qhov uas yuav tsum tau ua ua ntej rau kev kho ntshav qab zib kom zoo rau kev tiv thaiv ntshav qab zib, nws yog qhov nyuaj rau overestimate qhov tseem ceeb ntawm kev kawm txog ntshav qab zib hauv qhov tshwj xeeb tshwj xeeb.

Kev cob qhia 5-7 zaug txo cov neeg mob mus ntsib kws kho mob thiab, qhov tseem ceeb tshaj, txo kev pheej hmoo ntawm ko taw.

Hauv pab pawg uas muaj kev pheej hmoo, kev cob qhia txo qhov zaus ntawm mob ko taw los ntawm 2 zaug, thiab txo qis zaus ntawm txiav tes siab los ntawm 5-6 zaug.

Hmoov tsis zoo, hauv Lavxias Lavxias, muaj ob peb qhov kev tawm tsam ntawm CDS chav uas cov neeg mob yuav raug cob qhia, kev saib xyuas, kev tiv thaiv kev tiv thaiv thiab kev siv cov thev naus laus zis niaj hnub no hauv kev kuaj mob thiab kev kho mob ntawm ntau cov chaw kuaj mob ntawm CDS.

Hmoov tsis zoo, ib qho feem ntau tau hnov ​​txog qhov tsis muaj peev nyiaj lossis tus nqi siab ntawm kev ua cov chav SDS tshwj xeeb. Hauv qhov no, nws yog qhov tsim nyog los muab cov ntaub ntawv ntawm cov nqi cuam tshuam nrog kev ntsuas txuas ntxiv txhawm rau txhawm rau tus neeg mob ob txhais ceg.

Tus nqi ntawm lub txee "mob taw"

2-6 txhiab daus las (raws li kev teeb tsa)

Tus nqi ntawm kev kawm yog 115 dollars.

Cov Nqi Siv Yoos Sib Tw

(1 tus neeg mob ib xyoos) - $ 300

Tus nqi kho mob ib tus neeg mob

Daim ntawv neuropathic - $ 900 - $ 2 txhiab

Daim ntawv neuroischemic - 3-4,5 txhiab daus las.

Tus nqi ntawm kev phais mob

Kev tsim kho Vascular - 10-13 txhiab daus las

Amputation ntawm ib ceg tawv - 9-12 txhiab daus las.

Yog li, tus nqi ntawm ib qho txiav tawm ntawm ib qho povtseg sib raug rau tus nqi ntawm kev saib xyuas tus kheej ntawm ib tus neeg mob rau 25 xyoo lossis lub koomhaum thiab ua haujlwm ntawm 5 Lub Chaw Haujlwm Ntshav Qab Zib rau 5 xyoos.

Nws yog qhov tseeb tias lub koom haum ntawm cov chav tshwj xeeb "mob ntshav qab zib ko taw" yog tib txoj hauv kev rau kev tiv thaiv thiab kev kho mob zoo tshaj plaws ntawm cov neeg mob ntshav qab zib nrog SDS. Cov chaw kho mob "ko taw" tau raug tsim los ntawm lub nroog ntau lub tsev kho mob thiab cov chaw tshawb nrhiav uas muaj kev soj ntsuam thiab kev kho mob sib txawv, kev saib xyuas cov neeg mob ntxiv yog ua los ntawm cheeb tsam endocrinologist lossis tus kws tshaj lij los ntawm cov chaw haujlwm "Diabetic ko taw" chaw nrog kev pab ntawm angiosurgeons. Nqa tawm ntawm cov kev ntsuas no yuav txo qhov kev pheej hmoo ntawm kev tshem tawm tes taw rau cov neeg mob ntshav qab zib mellitus li 2 lossis ntau zaus.

Algorithms tau tsim rau kev kuaj mob, kho mob thiab tiv thaiv tus mob ntshav qab zib, nrog rau lub hom phiaj ntawm kev kho mob tsis tu ncua ntawm qhov tshwm sim no thiab muaj peev xwm ncua kev txhim kho ntawm lub davhlau ya nyob twg. Txoj kev kho mob insulin ntau heev tsuas yog ua tau nrog txoj kev niaj hnub ntawm kev kho mob glycemic thiab kev saib tus kheej ntawm cov neeg mob.

Qhov tshwm sim ntawm retinopathy nce ntau ntxiv nrog glycogemoglobin (Hb A1c) qib siab tshaj 7.8%. Nws yog qhov pom tseeb tias qhov nce ntawm glycogemoglobin qib ntawm tsuas yog 1% nce qhov kev pheej hmoo ntawm kev mob ntshav qab zib retinopathy los ntawm 2 zaug! Muaj qhov cuam tshuam ncaj qha ntawm myocardial infarction hauv cov neeg mob NIDDM ntawm theem ntawm glycogemoglobin thiab lub sijhawm ntawm tus kabmob. Cov qib siab dua ntawm glycogemoglobin thiab lub sijhawm ntawm tus kabmob, muaj kev pheej hmoo ntau ntawm kev tsim kabmob myocardial infarction. Los ntawm qhov no ua tiav qhov xaus hais tias kev nqis peev yuav tsum tau hais txog kev loj hlob ntawm kev tswj hwm, mus rau kev txhim kho ntawm cov kab me me niaj hnub, txhim khu kev qha siab thiab tso kua mis rau kev txiav txim siab cov ntshav qab zib thiab zis. Nws yuav tsum raug sau tseg tias domestic glucometers thiab strips coj raws li qhov xav tau niaj hnub, tab sis lawv txoj kev txhim kho xav tau kev txhawb nqa los ntawm tsoomfwv. Lub tuam txhab kev lag luam hauv tebchaws "Phosphosorb" tau tshaj lij cov khoom siv rau kev txiav txim siab glycogemoglobin, uas yog cov kauj ruam tseem ceeb hauv kev txhim kho mob ntshav qab zib, suav nrog prophylactic.

Yog li, tus yuam sij tswj xyuas kev noj qab haus huv ntawm cov neeg mob ntshav qab zib yog nruj thiab kev soj ntsuam tas li ntawm glycemia. Cov ntsiab lus tshaj plaws rau cov them ntshav qab zib niaj hnub no yog qib glycated hemoglobin. Qhov kawg tso cai tsis tsuas yog ntsuas qhov kev txiav txim ntawm kev them nyiaj ntawm kev noj haus ntawm carbohydrate metabolism hauv 2-3 lub hlis dhau los, tab sis kuj, uas yog qhov tseem ceeb heev, twv txog kev txhim kho ntawm cov teeb meem vascular.

Los ntawm theem ntawm glycogemoglobin nyob rau hauv xaiv pawg ntawm cov pejxeem tshwj xeeb, nws tuaj yeem tawm tsam qhov kev muaj txiaj ntsig ntawm kev ua haujlwm ntawm kev mob ntshav qab zib ntawm thaj av, nroog, thiab lwm yam, suav nrog kev tswj cov khoom siv, kev txhawb nqa tshuaj, kev kawm txog tus neeg mob, kev tshuaj xyuas tus kheej, thiab kev cob qhia tshwj xeeb.

Nws yuav tsum raug sau tseg tias Cov Kev Pabcuam Kev Noj Qab Haus Huv hauv nroog tau muaj kev nquag nquag los tawm tsam kev mob ntshav qab zib nyob rau 2 xyoos dhau los, tau faib nyiaj tseem ceeb rau kev pab cuam ntshav qab zib mellitus. Txij xyoo 1997, Qhov Txheej Txheem Thaj Av "Ntshav Qab Zib Mellitus" tau tsim nyob rau hauv Primorsky Territory.

Lub leitmotif ntawm cov tswv yim niaj hnub los tawm tsam teeb meem yog kev tiv thaiv kev ua si, i.e. los ntawm ib qho twg tsim nyog los tiv thaiv lossis nres cov txheej txheem uas twb tau pib lawm. Txwv tsis pub, kev puas tsuaj yog kev tsis tuaj yeem pom. Qhov tseem ceeb uas yuav ua kom mob ntshav qab zib nephropathy (DN) yog:

- Kev them nyiaj tsis zoo rau cov mob ntshav qab zib mellitus (HBA1c),

- mob ntshav qab zib ntev,

Nyob rau hauv xyoo tas los, kev tshawb fawb txog kev tshawb fawb tau coj ua rau cov caj ces - cov neeg sib tw koom nrog tsim kho DN. Ob pawg tseem ceeb ntawm cov caj ces raug nthuav tawm: thawj zaug suav nrog cov neeg sib tw caj ces uas txiav txim kev mob ntshav txhaws, thiab lub thib ob - cov neeg lub luag haujlwm rau kev loj hlob ntawm mesangium thiab tom ntej glomerular sclerosis nrog kev txhim kho ntawm kev paub mob ntawm nodular glomerulosclerosis.

Tam sim no, kev tshawb fawb tseem tab tom nrhiav rau cov noob muaj lub luag haujlwm rau qee yam tshwj xeeb hauv kev nthuav dav DN. Cov tshwm sim ntawm cov kev tshawb fawb no yuav los rau kev kho mob ntshav qab zib nyob ze yav tom ntej.

Cov tsos ntawm albumin txawm tias nyob rau hauv qhov tsawg kawg nkaus concentration (ntau dua 300 mcg / hnub), uas yog txhais tau tias yog microalbuminuria, yog qhov xwm txheej tsis txaus ntseeg rau tus kws kho mob thiab tus neeg mob, lub teeb liab rau qhov pib ntawm kev nquag tshaj plaws! Microalbuminuria yog lub zog twv, harbinger ntawm DN. Nws yog nyob rau theem no ntawm kev txhim kho DN uas nws tuaj yeem nres. Muaj lwm cov txheej txheem thaum ntxov rau DN, tab sis microalbuminuria yog ib tus cwj pwm tseem ceeb, thiab muaj rau kev txiav txim siab rau cov kws kho mob thiab cov neeg mob nyob sab nraud lossis nyob hauv lub neej. Nrog kev pab ntawm txoj hlua tshwj xeeb, txo qis rau hauv lub thawv ntawm cov zis, muaj cov microalbuminuria yog cov lus sau cia nyob hauv ib feeb. Thaum pom tom kawg, ntxiv rau kev nqis tes ua kom ua tiav cov txiaj ntsig zoo ntawm cov metabolism hauv kev ua kom yuag, ACE inhibitors yuav tsum tau muab tso tam sim ntawd nrog kev kho mob nyuaj thiab kev saib xyuas cov ntshav siab tas mus li.

Kev paub qhia tias kev teem sijhawm siv tshuaj hauv cov pab pawg no sai sai ua rau ploj ntawm albuminuria thiab kho ntshav siab. ACE inhibitors yog qhia rau microalbuminuria thiab ntshav siab, tom kawg tsis hloov thaum kho.

Yog tias lawv "ntsia mus" theem ntawm microalbuminuria, tom qab ntawd ntawm theem ntawm proteinuria nws tsis tuaj yeem txwv tsis pub muaj kev txhim kho ntxiv ntawm DN. Nrog rau kev ua lej raug suav, lub sijhawm ua tiav ntawm glomerulosclerosis nrog kev txhim kho kev mob raum tsis ua haujlwm nrog rau lub txiaj ntsig tuag yuav muab xam tau.

Nws yog qhov tseem ceeb ntawm txhua tus nqi tsis txhob nco thawj theem ntawm DN thiab, tseem ceeb tshaj, yooj yim kuaj tawm theem ntawm microalbuminuria. Tus nqi kho mob rau cov neeg mob ntshav qab zib thaum ntxov ntawm NAM yog 1,7 txhiab daus las thiab lub neej tag nrho thiab 150 txhiab daus las rau theem ntawm uremia thiab tus neeg mob pw hauv txaj. Cov lus hais txog cov ntsiab lus no, nws zoo li tsis tsim nyog.

Kev kho ntshav siab hauv ntshav qab zib yuav tsum tau nqa tawm sai sai tom qab kuaj pom tias pheej nce hauv nws.Cov tshuaj ntawm kev xaiv yog cov tshuaj tiv thaiv kab mob rau angiotensin-hloov mus rau hauv cov enzyme: Renitec, Prestarium, Tritace, Kapoten, calcium antagonists ntawm Verapamil thiab Diltiazem pawg, ntawm diuretics Arifon yog nyiam, tsis ntev los no cov tshuaj tshiab muaj zog tuaj - Losartan, Cint, thiab lwm yam. mob stroke, ua rau nce ntxiv ntev thiab zoo lub neej ntawm cov neeg mob ntshav qab zib.

Txhawm rau txhawm rau txheeb xyuas qhov pib hloov pauv ntawm pob nyiaj ntawm cov neeg mob ntshav qab zib mellitus, nws yog qhov yuav tsum tau ua qhov kev soj ntsuam nrog tus kws kho mob ophthalmologist tsawg kawg 1 zaug hauv ib xyoos. Hauv qhov uas muaj tus kab mob ntshav qab zib: 2-3 zaug hauv ib xyoos txhawm rau kev kho mob kom raws sijhawm hauv cov chaw tshwj xeeb. Hauv kev kho mob ntshav qab zib retinopathy (DR), raws li cov ntaub ntawv hais ua ntej, catalase gene muaj nws cov kev tiv thaiv zoo. Cov kev tiv thaiv zoo ntawm 167 allele tau tshwm sim los ntawm hwm DR hauv NIDDM: hauv cov neeg mob uas tsis muaj DR nrog mob ntshav qab zib ntev dua 10 xyoo, qhov ntau zaus ntawm qhov tshwm sim ntawm allele yog ho siab dua piv rau cov neeg mob thaum ntxov DR nrog lub sijhawm NIDDM tsawg dua 10 xyoo.

Cov ntaub ntawv ntawm kev muaj peev xwm ntawm kev tshuaj ntsuam kab mob ua rau kev tsim cov vascular muaj teeb meem tsis txaus ntseeg xav tau kev tshawb fawb ntxiv, tab sis tam sim no lawv niaj hnub txhawb kev xav kom zoo rau cov neeg mob thiab cov kws kho mob.

1. Txhawm rau txheeb xyuas kev tshuaj ntsuam genetic predisposition rau cov ntshav qab zib nephropathy thiab txheeb xyuas cov gene polymorphism ntawm angiotensin-1-hloov pauv enzyme ua kev tshuaj ntsuam caj ces mob rau angiopathy thiab raws li kev hloov kho ntawm cov hauj lwm zoo ntawm antiproteinuric txoj kev kho.

2. Los tsim cov kev tiv thaiv kev tiv thaiv ntawm ib qho ntawm cov tsiaj ntawm catalase cov noob hauv kev sib raug zoo nrog ob hom 2 mob ntshav qab zib mellitus thiab ntshav qab zib nephro- thiab retinopathies.

3. Los tsim ib lub tswv yim ib txwm muaj rau kev kawm txog kev tshuaj ntsuam genetic predisposition lossis tiv thaiv kab mob ntshav qab zib thiab tsim lub hauv paus rau kev ua haujlwm ntxiv hauv cov lus qhia no.

Hnub Tim Ntxiv: 2015-05-28, Views: 788,

»Kho ntshav qab zib

Tus mob ntshav qab zib sau npe

Tus mob ntshav qab zib sau npe

Tsoom Fwv Kev Teev Npe Ntshav Qab Zib siv los ntawm Tsoom Fwv Nyiaj Txiag Siv Nyiaj Txiag Lub Xeev Lub Chaw Tshawb Fawb Kev Tshawb Nrhiav Kev Tshawb Fawb Hauv Kev Tshawb Fawb nrog Aston Tus Kws Pab Tswv Yim CJSC ua ib feem ntawm kev kuaj mob thiab kis mob ntshav qab zib hauv Lavxias.

Sau npe Tswvyim nthuav dav:

• 100% kev tiv thaiv ntawm cov ncauj lus ntawm pawg
• Kev txheeb xyuas cov ntaub ntawv pov thawj thiab biostatistical

• kev tsim cov ntawv sau npe ntawm kev muaj teeb meem thiab cov kab mob cuam tshuam hauv cov qauv ntawm Kev Tso npe ntawm ntshav qab zib
• kev tshawb nrhiav kev lag luam tshuaj lag luam

• Kev tsim kho ntawm lub portal rau endocrinologist
• Cov ntawv ceeb toom ntawm kev sib tham thoob ntiaj teb raws li cov ntaub ntawv sau npe ntawm cov ntshav qab zib

Txog rau kev khomob:

• txhim kho koj tus kheej cov neeg mob cov ntaub ntawv
• yooj yim ntawm cov ntaub ntawv nkag thiab siv
• kev ntsuas ntawm qhov xav tau rau cov tshuaj, khoom siv kho mob
• daim ntawv foos cej luam

Rau FSBI Endocrinology Tshawb Fawb Chaw:

• multifunctional cuab yeej uas tso cai rau koj los daws cov haujlwm ntawm kev kuaj mob thiab kev kuaj mob sib kis
• kev sib koom ua ke, cov hom phiaj ntawm cov kabmob sib kis, kuaj mob thiab kho ntshav qab zib hauv Lavxias
• yooj yim ntawm qhia rau Ministry of Health ntawm Lavxias teb sab Federation

Qhov ntau ntawm cov mob ntshav qab zib hom 1 hauv Lavxias Lav Xias Lub Rau Hli 01/17/2018

(4 thaj chaw raws li Tsoomfwv Meskas Lub Xeev Txoj Haujlwm Pabcuam: Krasnoyarsk Thaj Av, Udmurt Republic, Sakhalin Thaj Av, Chukotka Autonomous Region)

* cim cov cheeb tsam raws li Rosstat rau g

Qhov ntau ntawm cov mob ntshav qab zib hom 2 hauv Lavxias teb sab hnub tim 01/17/2018

(4 thaj chaw raws li Tsoomfwv Meskas Lub Xeev Txoj Haujlwm Pabcuam: Krasnoyarsk Thaj Av, Udmurt Republic, Sakhalin Thaj Av, Chukotka Autonomous Region)

* cim cov cheeb tsam raws li Rosstat rau g

Kev ntsuas cov cheeb tsam (ON 01/17/18)

nyob rau hauv kev pabcuam ntawm Lub Chaw Endocryonological Scientific Center

Serkov Alexey Andreevich

Ceg Npe Xov Tooj: +7 499 124-10-21

Teem Caij Nyoog nqa tawm hauv kev sau npe lossis xov tooj: +7 495 500-00-90

Lub caj meem fai nyob hauv Tsoom Fwv Nyiaj Txiag Nyiaj Tshawb Xyuas Lub Xeev ntawm Lub Chaw Haujlwm Kev Tshawb Fawb rau Endocrinology ntawm ul. Dm Ulyanova, 11

117036, Moscow,

st. Dmitry Ulyanov, d.11

115478, Moscow,

st. Moskvorechye, d.

Lub Xeev Tso Npe ntawm Cov Neeg Mob Ntshav Qab Zib yog cov ntaub ntawv tseem ceeb rau kev suav cov nyiaj txiag kev lag luam hauv lub xeev rau cov ntshav qab zib thiab lawv kev kwv yees

Phaum mob thiab sau npe ntawm ntshav qab zib

Lub Xeev Tso Npe ntawm Cov Neeg Mob Ntshav Qab Zib yog cov ntaub ntawv tseem ceeb rau kev suav cov nyiaj txiag kev lag luam hauv lub xeev rau cov ntshav qab zib thiab lawv kev kwv yees

Yu.I. Suntsov, I.I. Yawg lo

Center Kev Kawm Txog Chaw endocrinological 1 (dir. - Acad. RAS thiab RAMS II Dedov) RAMS, Moscow |

Cov kev cai ntawm kev kho mob-cov lus pom zoo tsis tau tso cai kom tau txais cov ntaub ntawv tseem ceeb hais txog kev mob ntshav qab zib mellitus (DM). Kev npaj tshwj xeeb rau cov neeg mob, muab tshuaj kho mob, muab cov neeg mob cov cuab yeej tswj ntshav qab zib, tswj cov kabmob sib kis, kev ua haujlwm zoo thiab kev tiv thaiv kab mob, thiab ntau ntxiv, suav nrog kev cob qhia thiab muab cov kws tshaj lij, xav tau cov ntaub ntawv uas ntseeg siab tau thiab raws sijhawm. Hauv qhov no, qhov teeb meem ntawm kev ua tiav ntau dua thiab muaj kab ke tsis yog qhov tseeb ntawm kev muaj mob lossis tuag, tab sis tseem qhia txog kev mob nkeeg ntawm cov neeg mob, qhov zoo ntawm lawv lub neej, muaj cov teeb meem ntshav qab zib, cov ntaub ntawv hais txog kev kho mob ntawm cov neeg mob thiab tau txais cov tshuaj qab zib, cov ntaub ntawv ntawm cov ua rau kev xiam oob qhab thiab kev tuag ntawm cov neeg mob tau dhau los ua qhov mob sai sai. thiab qee qhov lwm cov ntaub ntawv.

Hauv ntiaj teb kev coj ua, cov teeb meem no tau daws los ntawm kev tsim kev sau npe ntawm ntshav qab zib. Hauv kev pom niaj hnub, kev sau npe ntawm cov neeg mob ntshav qab zib mellitus yog, ua ntej txhua yam, cov ntaub ntawv siv tshuab-tsom xam rau kev saib xyuas lub xeev kev noj qab haus huv ntawm cov neeg mob ntshav qab zib mellitus, qhov zoo tshaj ntawm kev kho mob thiab tiv thaiv kab mob thiab kis mob sib kis txog tus kab mob no. Txoj kab ke muab kev saib xyuas tus neeg mob txij lub sijhawm mob mus txog thaum nws tag sim neej.

Nws yuav tsum raug sau tseg tias ntxiv rau qhov tseem ceeb ntawm qhov tseem ceeb, cov ntaub ntawv sau npe yog ib qho tseem ceeb rau kev txiav txim siab tus nqi ntawm kev kho mob ntshav qab zib, lawv yog cov ntaub ntawv tseem ceeb rau kev tshawb nrhiav kev tshawb fawb ntawm qee cov teeb meem ntshav qab zib, suav nrog kev lag luam thiab kev kho mob thiab kev sib raug zoo.

Lub hom phiaj tseem ceeb ntawm kev qhia tawm cov cuab yeej tshiab rau kev kho ntshav qab zib tsis yog tsuas yog ua tiav ntau dua thiab tau txais txiaj ntsig zoo tshaj plaws rau kev kho mob metabolism, tab sis kom ntau dua txo qhov kev pheej hmoo ntawm kev txhim kho nws cov kev mob nyhav, txhim kho kom muaj txiaj ntsig zoo thiab lub neej nyob ntawm cov neeg mob thiab, vim li ntawd, cov nqi cuam tshuam nrog kev kho mob, kev txhab.

kev tsis taus thiab kev tuag ntawm cov neeg mob.

Nws paub tias cov nuj nqi tseem ceeb cuam tshuam nrog ntshav qab zib tsis yog rau kev kho mob ntshav qab zib nws tus kheej, tab sis rau kev kho mob ntawm nws cov teeb meem, uas yog qhov ua rau muaj mob xiam oob qhab thaum ntxov thiab tuag ntawm cov neeg mob. Ntxiv mus, qhov sib koom ntawm cov nqi nce mus txog 90% ntawm tag nrho cov nqi ncaj qha ntsig txog kev kho mob ntawm cov neeg mob ntshav qab zib. Yog li, kev khwv nyiaj txiag ntawm kev kho mob ntawm kev mob ntshav qab zib yog ib qho tseem ceeb tshaj plaws ntawm kev xav tias yuav muaj txiaj ntsig zoo ntawm kev siv cov tshuaj tshiab thiab kev kho mob thev naus laus zis feem ntau.

Kev loj hlob sai ntawm cov kws tshawb nrhiav tau pib nyiam cov teeb meem kev lag luam ntawm hom 2 ntshav qab zib. Qhov no yog vim qhov tseeb tias qhov kev loj hlob ntawm tus naj npawb ntawm cov neeg mob ntshav qab zib hom 2 yog sai dua qhov kev loj hlob ntawm hom 1 mob ntshav qab zib, tus nqi ntawm cov tshuaj, txoj kev kho mob, kev soj ntsuam thiab ib tug xov tooj ntawm lwm pawg kev kho mob thiab kev pab cuam tau nce, uas, ntawm qhov tseeb, hais txog qhov nce nqi cuam tshuam ncaj qha lossis tsis ncaj mob ntshav qab zib. Cov siv tshuaj tshiab dua thiab siv tau zoo nyob hauv qab zib tsis tau ua rau pheej yig dua. Xws li hom kev kho mob raws li kev phais mob rau hauv qhov kawg (suav nrog cov pob qij txha), cov hlab ntsha o hla kev sib tsoo, raum hloov raum, kab mob hauv lub cev thiab qee lwm qhov tam sim no suav hais tias feem ntau, tab sis lawv cov nqi tseem nyob siab, yog li ntawd muaj cov kev saib xyuas no rau ntau tus neeg mob, tshwj xeeb tshaj yog nyob ntawm no nyob hauv lub teb chaws tseem tshuav teeb meem.

Yog li, los ntawm qhov pom ntawm kev lag luam, nws yog qhov tseem ceeb tshaj plaws kom nkag siab txog dab tsi cov peev txheej yuav muab hnub no thiab qhov qeeb yog tias tib cov teeb meem yuav daws tau thaum tus naj npawb ntawm cov neeg mob loj zuj zus, thiab qhov kis ntawm cov teeb meem ntawm lawv tseem nyob rau tib theem.

Hauv daim ntawv no, kev sim ua kom ntsuas tsuas yog tus nqi ncaj qha rau kev kho mob ntshav qab zib thiab nws cov teeb meem thiab, raws li lawv, siv cov qauv huab cua feem ntau lees txais, txhawm rau ntsuas kev lag luam ntawm cov qauv kev kho niaj hnub. Cov kev suav raws li cov ntaub ntawv ntawm Xeev Lub Xeev Sau npe ntawm cov neeg mob ntshav qab zib hauv Lavxias.

Cov ntaub ntawv thiab cov hau kev

Thawj thawj theem, kev sim ntawm 500 tus neeg mob ntshav qab zib tau kuaj xyuas hauv 15 thaj tsam ntawm Lavxias teb sab. Raws li cov lus nug tshwj xeeb, cov ntaub ntawv tau sau ntsig txog kev kho mob ntawm cov neeg mob no hauv kev kho mob hauv chaw kho mob thiab chaw sab nrauv. Cov nqi tshuaj tau hais tias yog qhov hnyav nruab nrab ntawm cov lus pom zoo ntawm tsoomfwv cov chaw muag tshuaj (PMs), ntxiv rau raws li JIC Tus Nqi Sau Npe. Tus nqi ntawm cov kev pabcuam kev kho mob yooj yim tau txiav txim siab raws li "Tus nqi rau kev pabcuam khomob" uas tau muab rau cov neeg muaj hnub nyoog raws li tus nqi se ntawm lub nroog txoj kev fajseeb khomob. Tib lub sijhawm, tus nqi ntawm lub txaj-hnub tsis suav nrog cov nqi kuaj mob, cov txheej txheem kho mob thiab JIC. Ntawm theem ob, nyob rau ntawm Diabetes Mellitus Model (DMM) tus qauv ntsuas kev mob ntshav qab zib thiab cov ntaub ntawv GDS, nrog rau tus nqi kho tus mob ntshav qab zib, kwv yees tias tus mob ntshav qab zib tsis meej thiab tus nqi txhua xyoo ntawm kev kho mob 1 tus neeg mob tau txiav txim siab.

Nyob rau theem peb, raws li cov ntaub ntawv ntawm Lub Xeev Sau Npe ntawm Cov Neeg Mob Ntshav Qab Zib hauv Tebchaws Russia, tag nrho tus nqi ntawm kev kho mob rau cov neeg mob ntshav qab zib nyob hauv Lavxias thaum lub sijhawm kawm thiab rau 10-xyoo lub sijhawm txij li thaum pib ntawm txoj kev tshawb fawb tau suav, muab tias qhov nruab nrab ntawm glycoHbA1c txo qis tsuas yog 1.0%. Nws yuav tsum raug sau tseg tias rau cov txiaj ntsig zoo li no nws yog qhov yuav tsum tau tshaj tawm txog kev kho cov kab mob qub uas twb muaj lawm hauv kev kho mob ntshav qab zib thiab nws cov kev mob hnyav thiab siv cov kev kho tshiab hauv kev mob ntshav qab zib nyob txhua qhov chaw. Thaum ntsuas tus nqi kho mob, qhov hnyav hnyav nruab nrab ntawm cov tshuaj thiab cov kev pabcuam kho mob thaum lub sijhawm kawm. Thaum kwv yees tus nqi ntawm cov nqi kho mob rau cov neeg mob, tus nqi txo ntawm cov txiaj ntsig tau siv raws li cov qauv: ot = 1 / (1 + ^) ', qhov twg yog tus lej txo nqi, kuv yog tus lej ntu ntawm lub sijhawm, n yog tus nqi txo hauv lub sijhawm i-th hauv feem ntawm ib ntu Cov.

Cov txiaj ntsig thiab kev sib tham

Cov ntaub ntawv hais txog kev nthuav dav ntawm cov teeb meem tseem ceeb ntawm cov ntshav qab zib hom 1 (thaj tsam ntawm kev hloov pauv nyob hauv cov cheeb tsam hauv tebchaws Russia) tau muab tshaj tawm hauv Daim Duab. 1. Qhov feem ntau ntawm cov mob microvascular mob siab rau ntawm cov neeg mob uas muaj ntshav qab zib hom 1 siab dua nrog hom 2 ntshav qab zib, mob macrovascular qis dua. Raws li, qhov no tau coj mus rau hauv tus lej hauv kev suav txhua xyoo

Qhov muag tsis pom kev w 2.3 45.4

Macroangiopathy n / a ^ ishnishshinninnn 35.6 •

Mob taw taw ■■■■■■■■■ * 11.9 pct

Amputation hauv ko taw c * 2.1 ® max.

Kev sib nkag siab ntawm qib siab thiab saum toj no w2,1

Myocardial infarction | vmsh | 6.1 Hlob 7 7

Kev Kub Siab 37.4 L,

.1 10 20 30 40 50 60 70

Qhov muag tsis pom tus mob ntsws leeg tsis tuaj yeem yog txiv neej thiab neuropathy Lub hlwb tsis zoo ntawm tus kheej

Myocardial infarction Mob Stroke tawg

10 20 30 40 50 60

Daim duab. 2. Qhov dav dav (tsawg kawg thiab ntau kawg) muaj teeb meem ntawm cov ntshav qab zib hom 2 hauv thaj tsam ntawm Russia.

siv nyiaj los kho mob ntshav qab zib thiab nws cov teeb meem.

Ntawm cov neeg mob ntshav qab zib, tej zaum yuav muaj cov neeg uas sib xyaw ua ke

2-3 thiab haj yam ua rau kev nyuaj ntau dua. Peb nthuav tawm cov nqi ntaub ntawv ntawm cov teeb meem no thaum lub sijhawm kawm, i.e. xyoo 2003

Kev kwv yees tus nqi ntawm kev kho mob rau cov neeg mob ntshav qab zib xyoo 2003 suav nrog txhua yam mob ntshav qab zib, suav nrog mob ntshav qab zib thiab qog ntshav qab zib, mob ko taw mob ntshav qab zib, mob plawv thiab raum tsis ua haujlwm, thiab lwm yam. Tus nqi ntawm tsuas yog qee qhov kev mob tshwm sim hauv Daim Duab. 3.

Raws li cov ntaub ntawv ntawm Lub Xeev Sau Npe ntawm Cov Neeg Mob Ntshav Qab Zib Tus neeg mob ntshav qab zib muaj ntau nyob rau hauv kev txheeb xyuas nyiaj txiag, tag nrho tus nqi ntawm lawv cov kev kho mob hauv 2003 thiab rau lub sijhawm 10-xyoo tau suav nrog suav txog kev siv cov qauv tshiab. Xav txog tias qhov kev loj zuj zus mus txog qhov ntsuas tsis txaus siab ob qho tib si hauv kev cuam tshuam rau cov ntshav qab zib thiab hauv kev cuam tshuam rau nws cov teeb meem tsis tuaj yeem hloov ntau heev nyob rau tom ntej

3-5 xyoos, rau kev ntseeg tau ntau dua, peb tau txiav txim siab pom lub sijhawm 10 xyoo.

Thiab yog tias peb rov suav tag nrho cov nqi ncaj qha rau 1 tus neeg mob ib xyoos, peb yuav tau txais ntau dua lossis tsawg cov ntaub ntawv sib piv. Yog li, hauv Tebchaws Meskas, tus nqi ncaj qha rau ib tus neeg mob ib xyoo tau nyiaj txog $ 5,512,5 hauv 1997, $ 3080 hauv tebchaws Askiv, $ 3209 hauv Finland, $ 2060 hauv Australia, thiab tsuas yog $ 353 hauv Central thiab South America xyoo. Nws yog tseeb hais tias

Myocardial infarction $ 1395

Nifaisroprop 1350 S

Retinopathy 1200 S

Polyneuropathy 960 S

Kub Siab 1070 S

1000 2000 3000 4000 5000

Daim duab. 1. Qhov dav dav (tsawg kawg thiab ntau kawg) muaj teeb meem ntawm cov ntshav qab zib hom 1 hauv thaj tsam ntawm Russia.

Daim duab. 3. Tus nqi niaj xyoo los kho qee cov teeb meem ntshav qab zib hauv ib tus neeg mob (hauv IIB Hais txog).

Qhov ntau ntawm cov nqi no nyob ntawm theem kev kho mob rau tus neeg mob thiab lawv yuav tsis haum rau cov nqi tsim nyog thiab tsim nyog rau tus mob ntshav qab zib.

Koj ncaj qha laij cov nqi

rau kev mob ntshav qab zib, peb tau tsim txoj hauv kev tam sim no hauv Lavxias tus nqi ntawm cov tshuaj, cov cuab yeej tshuaj xyuas tus kheej, khoom siv, kev kho mob hauv tsev kho mob thiab chaw kho mob sab nraud, kev kawm tus neeg mob, thiab lwm yam. Ntxiv mus, peb tau coj mus rau hauv tus account tias cov nqi no cuam tshuam loj txaus rau cov ntshav qab zib muaj teeb meem hauv cov neeg mob thiab lawv qhov mob hnyav. Yog li, qhov nruab nrab ntawm $ 68.6 ib lub xyoo yog siv rau kev kho mob ophthalmic rau tus neeg mob nrog kev pib kho mob, thiab $ 1030.0 siv rau daim ntawv loj, uas yog 15 zaug ntxiv. $ 245.0 nyob rau ib xyoo yog siv rau kev kho mob ntawm tus neeg mob nrog nephropathy nyob rau theem pib, thiab $ 2012.0 tsis muaj mob hemodialysis, hloov raum, thiab lwm yam, yog siv rau kev kho mob raum tsis ua haujlwm (CRF). Rau kev sib piv, tus nqi kho mob raum tsis ua hauj lwm hauv Tebchaws Meskas yog $ 45,000 toj xyoo.

Tus nqi nruab nrab ncaj qha rau 1 tus neeg mob ib xyoos, xam nrog rau qhov hnyav ntawm cov kab mob uas ua rau muaj ntshav qab zib

Hom 1 yam tsis muaj teebmeem tsuas yog $ 1,124.0, nrog ntshav qab zib

2 hom - $ 853 toj xyoo. Lawv nce nce nrog qhov pib ntawm cov mob ntshav qab zib, thaum tus nqi nruab nrab ncaj qha rau tus neeg mob uas muaj mob ntshav qab zib hom 1 nce mus rau $ 2146.0, thiab hom 2 mob ntshav qab zib - txog $ 1786.0 toj ib xyoo. Yog tias cov neeg mob muaj cov teeb meem loj xws li mob raum tsis ua haujlwm, rov qab ua haujlwm thiab qhov muag tsis pom kev, qhov mob ntshav qab zib uas yuav tsum tau tsis tsuas yog txhawm rau txhawm rau tab sis kuj muaj kev phais mob (vascular yas, txiav tawm tom qab los ntawm prosthetics), myocardial infarction, cerebrovascular huam sib luag - cov nqi ncaj qha nce ntau. Qhov nruab nrab, lawv yog $ 24,276.0 nyob rau ib xyoos rau 1 tus neeg mob ntshav qab zib hom 1 thiab $ 8,630.0 rau hom ntshav qab zib hom 2.

Raws li cov ntaub ntawv kis kabmob, peb tau ntsuas tus nqi ncaj qha rau tus kabmob ntshav qab zib hauv Lavxias. Xws li 01.01.04, 15 918 cov menyuam yaus, 10 288 tus menyuam hluas thiab 239 132 tus neeg laus muaj ntshav qab zib hom 1, 503 menyuam yaus thiab tub ntxhais hluas, 1 988 228 cov neeg laus muaj ntshav qab zib hom 2 tau sau npe nyob hauv lub tebchaws.

Ntshav Qab Zib 1 thiab ntshav 2 hom ntshav qab zib, hom 1 thiab ntshav qab zib hom 2, ntshav qab zib hom 1, ntshav qab zib hom 2, menyuam yaus, cov hluas, cov laus, cov laus

Daim duab. 4. Cov nqi ncaj qha hauv Russia hauv 2003 rau cov neeg mob ntshav qab zib (hauv ntau lab ntawm IBS).

Cov ntaub ntawv hais txog cov nqi ncaj qha toj ib xyoo rau tus naj npawb saum toj ntawm cov neeg mob hauv Lavxias tau nthuav tawm hauv Daim Duab. 4. Yog li, tus nqi ncaj qha rau cov menyuam muaj mob 1 thiab ntshav qab zib hom 2 tau li $ 28,7 lab toj ib xyoo, rau cov menyuam hluas uas muaj ntshav qab zib

Hom 1 thiab hom 2 - $ 23.4 lab nyob rau ib xyoos, rau cov neeg muaj mob ntshav qab zib hom 1 - $ 2,345,3 lab toj xyoo, mob ntshav qab zib hom 2 - $ 6,120,8 lab toj xyoo. Yog li, kev suav pom tias cov nqi ncaj qha cuam tshuam txog ntshav qab zib hauv Lavxias xyoo 2003 yuav tsum txog $ 8518,2 lab. Kev siv nyiaj npaum li cas rau kev siv nyiaj tiag yog qhov teeb meem ntawm kev tshawb nrhiav tob. Txawm li cas los xij, yog tias koj rov qab txiav txim siab ntau npaum li cas ntawm qhov nruab nrab muaj cov nqi ncaj qha rau tus neeg mob hauv Lavxias, koj tau txais tus nqi nyob ze rau cov nqi zoo sib xws hauv cov tebchaws nyob sab Europe - $ 3,745.6 ib xyoos. Hauv qhov no, nws yuav tsum tau yug los hauv lub siab tias qhov nqi no tuaj yeem txo qis tom qab yog tias cov nyiaj tau siv zoo.

Cov Nqi Kev Kho Mob Tus Nqi

rau kev kho mob ntshav qab zib muaj teeb meem ntawm ntshav qab zib

Daim duab. 5. Sib piv cov nuj nqis cuam tshuam nrog kev kho mob ntshav qab zib mellitus nrog cov nqi kho mob tsis kho.

nquag, noj mus rau hauv tus account tam sim no nce qib hauv diabetology. Tab sis lawv tuaj yeem loj tuaj yeem yog tias kev nqis peev hauv cov thev naus laus zis ntawm kev kho thiab kev tiv thaiv tsis txaus.Lub luag haujlwm tseem ceeb ntawm cov nuj nqis yog kho cov mob ntshav qab zib. Nws yuav tsum tau yug hauv siab tias cov nuj nqis ncaj qha ntsig txog ntshav qab zib ua kom muaj li 40-50% ntawm tag nrho cov nuj nqis ntshav qab zib, suav nrog cov nqi tsis ncaj. Yog li ntawd, qhia hauv Daim Duab. 3 qhov ncaj qha nqi yuav tsum tsawg kawg yog ob npaug rau

Cov teeb meem microvascular

Macro txog ntsha ntshiab teeb meem

0 200 400 600 800 1000 1200 1400 1600 1800

Daim duab. 6. Txo tus nqi ntawm kev kho mob ntshav qab zib muaj teeb meem nrog

raug rau 1% txo nyob rau hauv nruab nrab ntawm glycogen1c

Cov txiaj ntsig ntawm xeev daim ntawv sau npe ntawm cov neeg mob ntshav qab zib hauv kev txhim kho cov ntshav qab zib pab

Cov Khoom Siv ntawm IV Txhua-Lavxias Congress ntawm Endocrinologist

Yu.I. Suntsov, S.V. Kudryakova, L.L. Hav iav

Hauv kev siv lub ntiaj teb, cov teeb meem no tau daws los ntawm kev tsim cov npe ntawm cov neeg mob ntshav qab zib. Hauv tebchaws Lavxias, kev tsim lub Xeev Cov Npe ntawm Cov Neeg Mob Ntshav Qab Zib (GDS) tab tom yuav ua tiav.

Tam sim no, ntau dua li ib nrab ntawm txhua tus neeg mob (1200.0 txhiab) tau suav nrog Lub Xeev Tso Npe thiab qee cov ntaub ntawv yuav raug muab rau hauv tsab xov xwm no.

Hauv cov niaj hnub kev txiav txim siab, cov ntshav qab zib sau npe yog ib qho kev siv xov xwm-txheeb xyuas cov txheej txheem los saib xyuas cov kabmob sib kis txog kev mob ntshav qab zib, kev noj qab haus huv ntawm cov neeg mob, kev saib xyuas zoo, thiab kev kwv yees ntawm kev kho mob, kev sib raug zoo thiab kev lag luam ntshav qab zib.

Kev tsim ntawm cov ntawv sau npe thiab cov nqi ntawm nws txoj haujlwm yuav them rau 5 xyoo tom ntej, muab hais tias cov ntaub ntawv khaws cia tau khaws cia kom raug, thiab tseem ceeb tshaj, tias cov ntaub ntawv tau txais yog siv sai sai tsis yog hauv chaw zov me nyuam, tab sis tseem nyob hauv zos, hauv cheeb tsam.

Dab tsi hauv theem yog qhov kev tsim GDS hauv Russia? Rau cov kws tshaj lij uas khaws cov ntawv teev npe ntawm ntshav qab zib, cov rooj cob qhia tau muaj nyob hauv cov cheeb tsam. Lub hom phiaj ntawm kev cob qhia

Ua ntej tshaj plaws, nws yog kev cob qhia, kev paub txog kev tsim kho tshiab hauv software, txoj hauv kev los daws cov teeb meem ntawm cov ntaub ntawv xov xwm siab, kev ua qauv thiab tswj cov ntawd, sib tham txog cov teeb meem tau ntsib hauv thaj tsam thaum tsim thiab ua haujlwm rau cov neeg mob ntshav qab zib.

Cov neeg sawv cev ntawm 70 thaj chaw tau mus koom cov rooj qhia zoo li no, 74 thaj chaw tau txais software, thiab tam sim no ntau dua 60 GDS cov chaw tau tsim thiab tau ua haujlwm nyob hauv Russia. Nws tau npaj thaum kawg ntawm lub xyoo no raws li cov lus txib ntawm Ministry of Health kom ua tiav cov neeg tsim.

Xeev Tuam Tsev Txog Kev Tshawb Nrhiav Kev Tshawb Nrhiav Endocrinological (Dir. - Acad. RAMS I.I.Dedov) RAMS, Moscow

lub chaw pabcuam hauv cheeb tsam hauv txhua cheeb tsam ntawm Lavxias Kev Ntseeg. Txhua xyoo, pab thawj coj ntawm Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv xyuas cov txiaj ntsig ntawm tsoomfwv txoj haujlwm "Ntshav Qab Zib Mellitus", suav nrog kev ua haujlwm tsim lub network ntawm cov chaw hauv cheeb tsam rau GDS. Cov thawj coj ntawm cheeb tsam saib xyuas kev noj qab haus huv raug caw tuaj rau hauv collegium kom qhia txog xwm txheej ntawm qhov haujlwm.

Kev pab txhawb rau txoj kev kawm txuj ci thiab cov txuj ci muab tau ncaj qha thiab nyob hauv Is Taws Nem, qhov chaw tshwj xeeb, "Kev Tso Npe Mob Ntshav Qab Zib", yog qhib. Lub vev xaib no muaj tag nrho cov haujlwm, nrog rau qhov kev hloov kho tshiab uas koj tuaj yeem luam tawm thiab nruab rau hauv koj lub khoos phis tawm.

Ib qho tshiab (thib 2) ntawm "Diabetes Register 2002" software tau tsim, uas coj mus rau hauv txhua qhov kev xav tau txais los ntawm cov cheeb tsam thaum siv thawj xyoo, xws li: cov tswv yim tswj hwm thaum nkag mus thiab suav cov chaw khaws ntaub ntawv, kev txuas ntawm OKATO cov lis haujlwm nrog thaj chaw thiab tus naj npawb nyob rau hauv cov ntawv sau npe, qhov kev hloov ntawm tus kheej thiab qhov ntsuas dav dav, nthuav dav tau ua piv txwv thiab cov qauv tsim rooj, thiab lwm yam.

Qhov tseem ceeb hauv qab qhov ntsuas ntawm kev mob sib kis txog ntshav qab zib yog nthuav dav. Qhov ntau ntawm cov ntshav qab zib hom 1 thiab ntshav qab zib hom 2 nyob rau ntau thaj chaw hauv tebchaws Lavxias txawv ntawm qhov ntsuas ntawm txhua yam-Lavxias, uas yog ntawm 01.01.2001 yog 224,5 rau 100 txhiab rau hom 1 mob ntshav qab zib thiab 1595.4 rau 100 txhiab rau hom 2

Bryansk cheeb tsam hn h

Cov koom pheej Mari El 75.3

Nizhegorol. reg. 112.2

Thaj av ntawd 122.2

Kom koom pheej 156.2

Oryol cheeb tsam 175.4

D F 1ZH1

Ntawm NYU 000 pejxeem nrog I g l

Daim duab. 1. Qhov dav dav ntawm hom 1 thiab ntshav qab zib hom 2 nyob rau qee thaj tsam ntawm Lavxias xyoo 2000

yam pej xeem. Rau kev sib piv, peb kawm txog kev nthuav dav ntawm tus kabmob ntshav qab zib hom 1 hauv cheeb tsam Bryansk thiab Saratov.

Hauv thaj av Saratov, cov kabmob feem ntau ntawm tus kabmob ntshav qab zib hom 1 hauv cov neeg laus yog 4 npaug ntau dua li thaj tsam Bryansk thiab yog 66.5 thiab 249.1 rau 100 txhiab tus neeg laus, ntsig txog (raws li kev txheeb cais, 260.8 thiab 252,1 rau 100 txhiab Cov neeg laus).

Cov kev sib txawv tseem ceeb ntawm cov ntaub ntawv sau npe tawm thiab cov ntaub ntawv raug cai txheeb xyuas yuav tsum muaj kev tshawb xyuas kabmob sib kis. Cov laj thawj rau cov kev sib txawv no yuav tsum muaj kev qhia kom meej meej, uas yuav txo tau cov neeg mob ntshav qab zib hom 1 hauv cov cheeb tsam nrog nws cov neeg mob ntau.

Yuav kom piv kev dav dav ntawm cov ntshav qab zib hom 2, peb tau kuaj thaj chaw Oryol thiab Nizhny Novgorod. Hauv thaj av Nizhny Novgorod, raws li qhov kev tso npe, nthuav dav ntawm hom 2 mob ntshav qab zib yog 3 zaug ntau dua hauv thaj av Oryol, thiab yog 685.4 thiab 1345.1 rau 100 txhiab tus neeg laus, ntsig txog.

Raws li kev txheeb cais los ntawm tsoomfwv, kev nthuav dav ntawm hom 2 mob ntshav qab zib nyob hauv cov cheeb tsam no yog 1591.4 thiab 1967.4 rau 100 txhiab tus neeg laus. Qhov xwm txheej zoo ib yam li ntawd rau hom ntshav qab zib hom 1.

Ib tus tau txais lub tswv yim tias cov ntaub ntawv txheeb cais tseem ceeb muaj nuj nqis. Yog tias qhov no yog vim tau theej tawm cov ntaub ntawv hais txog cov neeg mob, ces qhov kev tso npe tawm yooj yim zam rau qhov no, txij li kev tshuaj xyuas tus kheej yog nqa tawm rau txhua tus neeg mob.

Qhov xwm txheej (ntau zaus) yog ib qho ntawm cov tseem ceeb tshaj plaws ntawm kev sib kis kabmob hais txog ntshav qab zib.

Raws li kev txheeb cais suav, nyob rau 01.01.2001, qhov tshwm sim ntawm cov neeg mob ntshav qab zib nyob hauv Russia ntawm 1 yam mob ntshav qab zib yog 13.3, ntshav qab zib hom 2 yog 126.0 rau 100 txhiab tus neeg laus. Yog tias peb piv cov cheeb tsam Bryansk thiab Saratov, peb tuaj yeem pom tau tias nyob hauv cheeb tsam Saratov kev muaj mob ntshav qab zib hom 1 ntau dua 3 zaug ntau dua li thaj tsam Bryansk thiab muaj li 6,54 thiab 2.08 rau 100 txhiab ntawm cov neeg laus.

Raws li cov ntaub ntawv txheeb cais, tsis muaj qhov sib txawv ntawm cov cheeb tsam no, thiab qhov tshwm sim ntawm tus xwm txheej yog 13.1 thiab 12,2, raws li, rau 100 txhiab tus neeg laus.

logo ntawm cov pej xeem (hauv cheeb tsam Bryansk, qhov tshwm sim ntawm cov ntshav qab zib hom 1 yog me ntsis siab dua hauv thaj chaw Saratov). Muab piv rau cov ntsuas ntawm thaj chaw Oryol thiab Nizhny Novgorod rau qhov tshwm sim ntawm tus mob ntshav qab zib hom 2, nws tuaj yeem pom tias nws yog 4.5 npaug siab dua hauv thaj av Oryol thiab, raws li kev sau npe, yog 33, raws.

5 thiab 111.9 rau 100 txhiab tus neeg laus. Raws li kev txheeb cais ntawm kev txheeb xyuas, qhov tshwm sim ntawm cov mob ntshav qab zib hom 2 nyob hauv thaj av Oryol muaj ntau dua nyob hauv thaj av Nizhny Novgorod.

Yog li, qhov xwm txheej nrog cov xwm txheej muaj peev xwm zoo ib yam li qhov xwm txheej muaj feem ntau ntawm cov ntshav qab zib hauv cov cheeb tsam coj los sib piv.

Tsis muaj ntaub ntawv qhia txog kev tuag nyob hauv cov neeg mob ntshav qab zib. Cov ntaub ntawv qhia txog kev tuag yog siv cov ntawv uas tau txais thawj zaug.

Kev tso npe cia koj ua kom tau txais cov txiaj ntsig kev tuag ntawm cov neeg mob ntshav qab zib. Bryansk cheeb tsam tsis tau muab cov ntaub ntawv ntawm kev tuag ntawm cov neeg mob uas muaj mob ntshav qab zib hom 1, nyob hauv thaj av Saratov nws tau poob qis heev - 1.7 rau 100 txhiab ntawm cov pejxeem (Daim duab.

3). Li ntawm 7 leej neeg hauv ib xyoos tau mob ntshav qab zib, thiab tsawg dua 2 tuag.

Qhov no yuav yog lo lus teb rau lo lus nug vim li cas nyob rau thaj tsam Saratov muaj qhov mob ntshav siab ntau ntawm cov ntshav qab zib hom 1 (muaj ib hom "kev tso" ntau cov neeg mob ntshav qab zib).

Hauv thaj chaw Oryol thiab Nizhny Novgorod, kev tuag ntawm cov neeg mob uas muaj ntshav qab zib hom 2 yog 5,4 thiab 76.66 rau 100 txhiab tus neeg laus, ntsig txog (qhov xwm txheej yog 26.0 thiab 116.0). Yog tias qhov xwm txheej hauv thaj av Nizhny Novgorod yog qhov siab dua 4.5 npaug, ces qhov kev tuag muaj 15 zaug ntau dua hauv thaj av Oryol.

Hauv thaj av Oryol, rau 1 tus neeg mob uas muaj ntshav qab zib hom 2, muaj 5 tus neeg muaj ntshav qab zib hom 2, thaum nyob hauv thaj av Nizhny Novgorod muaj tsawg dua 2 tus neeg mob rau 1 tus neeg tuag. Nws yog qhov tseeb tias nrog tib tus txiv neej nkees tuag, qhov kev loj hlob ntawm kev nthuav dav ntawm tus nqi hauv thaj av Oryol yuav muaj ntau dua, tab sis lawv yuav tsis yog qhov tshwm sim ntawm kev tsis zoo hauv kev saib xyuas neeg mob lossis qhov nce ntawm kev mob nkeeg.

Thawj thawj zaug, cov ntaub ntawv tau txais ntawm kev tuag ntawm cov neeg mob ntshav qab zib hauv thaj tsam ntawm Russia. Hauv daim duab. Daim duab 4 qhia tau hais tias kev tuag ntawm cov neeg mob ntshav qab zib hom 1 ntau dua ntawm cov neeg mob ntshav qab zib hom 2. Qhov ntsuas no rau

Bryansk cheeb tsam 2.0 Kuv Koom Pheej Mari El I1 02

Kalmykia Tambov cheeb tsam Nizhny Novgorod reg. Thaj av ntawd Koom pheej ntawm Komi, Oryol Thaj Av Tver cheeb tsam Saratov cheeb tsam

Daim duab.2. Qhov muaj xwm txheej ntawm ntshav qab zib hom 1 thiab hom 2 nyob hauv qee thaj tsam ntawm Lavxias xyoo 2000

Cov koom pheej Mari El 0.52

Oryol cheeb tsam 4. Thiab

Cov koom pheej Kalmykia (4

Saratov cheeb tsam 1.7

Thaj av ntawd 5.54

Kom koom pheej 12.5

Nizhny Novgorod reg. * .14

Daim duab. 3. Kev tuag ntawm cov neeg mob uas muaj hom 1 thiab ntshav qab zib hom 2 nyob rau qee thaj tsam ntawm Lavxias xyoo 2000

Cov cheeb tsam sib txawv. Yog tias ib qho thiab lwm cheeb tsam tau ua haujlwm zoo ntawm kev tsim cov ntaub ntawv, ces peb tuaj yeem hais tias theem kev kho mob ua haujlwm hauv thaj av Nizhny Novgorod qis dua qhov ua tau. Kev tsom xam yuav hais txog cov cheeb tsam nrog qhov tsis txaus ntseeg txog qhov kev sib kis thiab, raws li, txhim kho kev ntsuas los txhim kho nws.

Qhov nruab nrab lub neej nyob ntev (LSS) ntawm cov neeg mob ntshav qab zib qhia ntau yam mob thiab kev sib raug zoo. SG ntawm cov neeg mob uas muaj ntshav qab zib hom 1 (Daim duab.

5) 12 xyoos qis dua kev muaj sia nyob ntawm cov neeg mob uas muaj ntshav qab zib hom 2. Lub neej cia siab rau cov txiv neej mob ntshav qab zib hom 1 yog 5 xyoo tsawg dua li cov poj niam, thiab hauv cov neeg mob uas muaj hom 2 nws tsis txawv txav.

Lub neej muaj kev cia siab ntawm cov poj niam yog 10 xyoo ntau dua li tus txiv neej, mob ntshav qab zib hom 2 ntau dua li cov ntshav qab zib hom 1, cov kev sib txawv no yog qib. Nws yuav tsum raug sau tseg tias LSS ntawm cov neeg mob uas muaj ntshav qab zib hom 2 yog qhov ntau heev piv rau cov pej xeem.

Kev nthuav dav ntawm tus mob ntshav qab zib hom 1 hauv cov neeg uas poob mob thaum tseem yau yog qhia hauv Daim duab. 6. Qhov ntau ntawm cov neeg mob ntshav qab zib hauv pawg no ntawm cov neeg mob uas muaj hnub nyoog tsawg dua li qhov qub. Thaum muaj 60 xyoo, cov neeg mob no tsis nyob hauv cov neeg. Kev cia siab lub neej tsuas yog 28.3 xyoo.

nrog ntshav qab zib hom 2, cov kev sib txawv no tsis txawv. Cov neeg mob uas muaj ntshav qab zib hom 2 nyob li 5 xyoo tsawg dua thaum pib mob dua li cov neeg mob ntshav qab zib hom 1, tab sis qhov no yog vim qhov tseeb tias cov hnub nyoog nruab nrab ntawm tus mob uas muaj ntshav qab zib hom 1 tsawg dua li cov neeg mob uas muaj ntshav qab zib hom 2 tsawg dua.

Zoo li LNG, qhov ntsuas no zoo li tseem ceeb heev, vim nws tso cai rau ib tus los soj ntsuam cov kev hloov hauv qhov zoo ntawm kev kho thiab lub neej ntawm cov neeg mob los ntawm nws qhov kev hloov pauv.

Nws yog qhov nyuaj rau xav txog lub hom phiaj ntsuas ntau dua ntawm txoj kev kho mob tsis muaj ntaub ntawv los ntawm feem twg ntawm cov neeg mob tuaj yeem tswj lub xeev ntawm cov nyiaj them rau ntshav qab zib. Cov Ntaub Ntawv (Daim Duab.

Tswj kev tshawb xyuas kabmob nthuav qhia pom tias lub xeev kev kho mob thiab kev kho mob rau cov neeg mob ntshav qab zib, tshwj xeeb tshaj yog cov menyuam yaus, tseem tsis txaus siab. Yog li, 56% ntawm cov neeg mob ntshav qab zib 1 cov menyuam yaus hauv Moscow, 65% hauv cheeb tsam Moscow thiab 72% hauv Tyumen yog nyob rau hauv lub xeev ntawm ntev decompensation.

Kev soj ntsuam rau cov menyuam yaus zoo li no yog qhov tsis tsim nyog, qhov xav tau kev ntsuas nrawm kom tshem tawm cov xwm txheej no yog pom tseeb. Qhov feem ntawm cov menyuam yaus uas muaj mob ntshav qab zib yog qhov tsawg: hauv Moscow - 18%, hauv Tyumen - 12%, nyob hauv thaj av Moscow - 4.

Daim duab. 4. Kev tuag ntawm cov neeg mob uas muaj yam 1 thiab ntshav qab zib hom 2 ntawm qee thaj tsam ntawm Lavxias xyoo 2000 (%)

18-19 hnub nyoog 20-29 xyoo 30-39 xyoo 40-49 L

■ Tus txiv neej □ Poj niam ■ Pab pawg neeg dav

Daim duab. 6. Kev tsis sib haum xeeb ntawm cov ntshav qab zib hom 1, txhim kho thaum yau.

Daim duab. 5. Qhov nruab nrab lub neej nruab nrab ntawm cov neeg mob uas muaj hom 1 thiab hom 2 mob ntshav qab zib, suav txog tus tub los ntxhais.

Daim duab. 7. Qhov nruab nrab lub neej ntawm cov neeg mob los ntawm qhov pib ntawm hom 1 thiab ntshav qab zib hom 2, suav mus rau hauv poj niam txiv neej.

Cov koom pheej Cheeb Tsam Mari El Oryol Koom pheej, Kalmykia, Bryansk cheeb tsam Saratov cheeb tsam Thaj av ntawd Koom pheej ntawm Komi Nizhny Novgorod. reg.

Cov xwm txheej hais txog tus mob ntshav qab zib yog sib txawv ntawm qhov tseeb ib. Lub zog ntawm cov ntsuas tseem ceeb ntawm no.

Kev nthuav dav ntawm retinopathy yog loj hlob, qhov sib piv ntawm cov sau cia thiab qhov tseeb nthuav dav yog nce - qhov taw qhia ntawm qib qis ntawm kev kho mob thiab kev tiv thaiv ua haujlwm. Hauv cov neeg mob uas muaj ntshav qab zib hom 1, retinopathy raug kuaj pom tsuas yog ib nrab (Daim duab.

9a), tsom kwm - 1/5, neuropathy - 1/3, nephropathy - 1/2, mob plawv - 1/3, macroangiopathy - 1.17, kub siab

Lwm qhov sib piv (Daim duab 9, b) raug pom hauv cov neeg mob uas muaj ntshav qab zib hom 2. Retinopathy raug tshawb pom nyob rau hauv 1/5 ntawm cov neeg mob, cataract - hauv 1/4, nephropathy - hauv 1/8, neuropathy - hauv 1/3, macroangiopathy n / a - hauv 1/8. Qhov teeb meem nrog cov hlab plawv cov nyom muaj ntau dua.

Npaj ua kev txhawb nqa tshuaj rau cov neeg mob ntshav qab zib yog ntu tseem ceeb tshaj plaws ntawm kev pabcuam ntshav qab zib. Cov txheej txheem ntawm kev npaj cov ntaub ntawv ntawm daim ntawv yuav tsum tau siv tshuaj yuav siv sijhawm ntev.

Yog tias muaj cov ntawv sau npe ntawm cov ntawv sau npe, kom tau txais cov ntaub ntawv ntawm peb lub hlis twg lossis ib xyoos xav tau tshuaj rau cov neeg mob ntshav qab zib noj rau hauv cov npe ntawm cov tshuaj, lawv cov kev txiav txim yuav siv sijhawm li ob peb feeb, nrog cov ntaub ntawv loj rau 60-100 txhiab tus neeg mob - 1-2 teev.

Nws yuav tsum tau yug hauv siab tias cov ntaub ntawv yuav tsum muaj cov lus qhia tseeb txog cov neeg mob rau lub xyoo tam sim no.

Yog li, hauv kev txhim kho cov kev pabcuam ntshav qab zib, sau npe ntawm cov ntshav qab zib yog qhov tseem ceeb. Tsis muaj ntaub ntawv, tsis muaj kev paub txog cov xwm txheej, tsis muaj kev ntsuas txaus.

Cov ntawv sau npe ntawm cov neeg mob ntshav qab zib daws cov teeb meem tsis yog rau lub xeev lossis chav tuam tsev, tab sis rau ntau dua nws daws cov teeb meem ntawm cov cheeb tsam thiab txawm tias ib tus kws kho mob zoo, txuag nws los ntawm kev npaj ntau yam ntawv pov thawj, ntawv tshaj tawm, ntawv thov, thiab lwm yam. Hauv qhov xwm txheej no, tus kws kho mob tuaj yeem suav qhov uas tau txais sai sai ntawm cov ntaub ntawv hais txog nws cov neeg mob.

Qhov nruab nrab HLA1-13.1 2.8%

Qib nrab

Daim duab. 8. Qib ntawm kev them nyiaj mob ntshav qab zib 1 hauv cov menyuam yaus hauv cheeb tsam Moscow, Moscow thiab Tyumen.

KUV LOS LIS Tiag

ntshav qab zib hom 1 (a) thiab ntshav qab zib hom 2 (b) hauv cov neeg laus (%)

Txhawm rau kev txhim kho Lub Xeev Sau npe muaj ntshav qab zib hauv cov menyuam yaus thiab cov hluas

UDC 616.379 - 008. 64 - 053. 2 - 06: 617.735 616.61 - 07 (470.41)

Tsev Khomob Menyuam Yaus Cov Tsev Khomob (kws kho mob taub hau - sib tw ntawm kev tshawb fawb kho mob E.V. Karpukhin) MH RT, Kazan

Mob ntshav qab zib mellitus yog ib qho muaj mob hnyav tshaj plaws thiab tsis tas yuav tsum muaj kev mob siab ntawm lub cev thiab kev mob siab los ntawm cov neeg mob thiab lawv niam lawv txiv, tab sis kuj yuav tsum tau saib xyuas tshwj xeeb los ntawm cov saib xyuas kev noj qab haus huv thiab zej tsoom tag nrho.

Kev siv cov cuab yeej siv npaj kho ntawm tib neeg cov tshuaj insulin, niaj hnub txhais tau tias kev soj ntsuam tus kheej ua rau nws muaj peev xwm xav txog cov kab mob no tsis yog kev txom nyem, tab sis ua lub neej tshiab rau tsev neeg uas tus neeg mob ntshav qab zib tau tshwm sim.

Ib tug menyuam yaus, uas raug hloov mus rau qeb ntawm cov neeg xiam oob qhab txij li lub sijhawm kuaj mob, tuaj yeem npaj nws lub neej yav tom ntej, xav txog kev xaiv hom haujlwm, tsim tsev neeg. Ib qho ntawm cov xwm txheej rau kev ua tiav ntawm cov phiaj xwm no yog tswj cov teeb meem loj xws li qee qhov muaj teeb meem ntshav qab zib.

Kev txheeb xyuas cov kev mob tshwm sim thaum ntxov ntawm tus kab mob thiab txawm tias yuav paub lawv txoj kev loj hlob hauv qee yam ntawm cov neeg mob tau tshwj xeeb tshaj nyob rau theem ntawm kev nthuav dav ntawm kev tshawb fawb tshwj xeeb rau kev saib xyuas tshwj xeeb rau cov neeg mob ntshav qab zib.

Yog li, thaum kev txheeb xyuas Kev Sau npe ntawm cov ntshav qab zib mellitus, sau los ntawm cov kws tshaj lij ntawm DRCH ntawm Ministry of Health ntawm koom pheej ntawm Tajikistan, peb tsom mus rau qhov no ntawm qhov teeb meem ntawm cov ntshav qab zib hom 1.