Mob ntshav qab zib nephropathy: cov tsos mob, theem thiab kev kho mob

Ntshav qab zib nephropathy yog lub npe rau feem ntau lub raum mob ntshav qab zib. Lo lus no piav qhia txog qhov ntshav qab zib uas qhov tseem ceeb ntawm qhov lim tawm ntawm lub raum (glomeruli thiab tubules), nrog rau cov hlab ntsha uas pub rau lawv.

Kev mob ntshav qab zib yog qhov txaus ntshai vim tias nws tuaj yeem ua rau qhov kawg (qhov xaus) theem ntawm lub raum tsis ua haujlwm. Hauv qhov xwm txheej no, tus neeg mob yuav tsum tau lim ntshav lossis hloov raum.

Mob ntshav qab zib nephropathy yog ib qho ntawm cov kev mob tshwm sim ua rau tuag ntxov thiab muaj mob xiam oob qhab hauv cov neeg mob. Ntshav qab zib yog nyob deb ntawm qhov ua rau lub raum teeb meem. Tab sis ntawm cov neeg ua lim ntshav thiab sawv ntsug hauv kab rau ib lub raum pub ntshav rau hloov ntshav, feem ntau muaj ntshav qab zib. Ib qho laj thawj rau qhov no yog qhov nce ntxiv ntawm qhov kev tshwm sim ntawm tus mob ntshav qab zib hom 2.

• Raum puas nyob rau hauv cov ntshav qab zib mellitus, nws txoj kev kho mob thiab kev tiv thaiv
• Cov kev kuaj dab tsi uas koj xav tau kom dhau los kuaj xyuas lub raum (qhib hauv lub qhov rai cais)
• Tseem Ceeb! Khav Theeb Noj Ntshav Qab Zib
• Plab leeg mob leeg
• Mob raum hloov ntshav qab zib

Cov laj thawj rau kev txhim kho mob ntshav qab zib nephropathy:

• cov ntshav qab zib rau hauv tus neeg mob,
• cov roj (cholesterol) phem thiab triglycerides hauv cov ntshav,
• ntshav siab (nyeem peb qhov "tus viv ncaus" rau qhov kub siab),
• kev lim ntshav tsis txaus, txawm tias mob me me (hemoglobin hauv cov ntshav ntawm cov neeg mob ntshav qab zib yuav tsum raug hloov mus rau lim ntshav sai dua li cov neeg mob lwm lub raum pathologies. Kev xaiv txoj kev lim ntshav yog nyob ntawm tus kws kho mob nyiam, tab sis rau cov neeg mob tsis muaj qhov sib txawv.

Thaum twg thiaj pib kho mob raum (hloov ntshav los yog lub raum hloov chaw) rau cov neeg mob ntshav qab zib mellitus:

• Tus nqi glomerular pom ntawm lub raum yog 6.5 mmol / l), uas tsis tuaj yeem raug txo los ntawm kev txuag txoj kev kho mob,
• Kev ceev cov kua dej kom tsis txhob mob hauv lub cev nrog txoj kev pheej hmoo ntawm kev tsim mob ntsws ntsws,
• Cov tsos mob tshwm sim ntawm cov protein-lub zog tsis zoo.

Lub hom phiaj taw qhia rau kev ntsuas ntshav hauv cov neeg mob ntshav qab zib uas tau kho ntshav tes taw:

• Glycated hemoglobin - tsawg dua 8%,
• Ntshav hemoglobin - 110-120 g / l,
• Parathyroid hormone - 150-300 pg / ml,
• Cov tshuaj phosphorus - 1.13–1.78 mmol / L,
• Tag nrho cov calcium - 2.10–2.37 mmol / l,
• Cov khoom lag luam Ca × P = Tsawg dua 4.44 mmol2 / l2.

Yog tias lub raum ua kom muaj ntshav qab zib rau cov neeg mob ntshav qab zib rau kev lim ntshav, erythropoiesis cov tshuaj tiv thaiv kab mob tau noj (epoetin-alpha, epoetin-beta, methoxypolyethylene glycol epoetin-beta, epoetin-omega, darbepoetin-alpha), zoo li cov tshuaj ntaus hlau lossis txhaj tshuaj. Lawv sim tswj kom ntshav siab qis dua 140/90 hli Hg. Art., ACE inhibitors thiab angiotensin-II receptor blockers tseem tshuav cov tshuaj ntawm kev xaiv rau kev kho mob ntshav siab. Nyeem kab lus “Cov Ntshav Qab Zib Hom 1 thiab Hom 2 Ntshav Qab Zib” kom paub ntau ntxiv.

Hemodialysis lossis peritoneal lim ntshav yuav tsum raug suav tias tsuas yog ib qib kev npaj tam sim no rau kev hloov raum. Tom qab lub raum ua tiav rau lub sij hawm hloov ntshav hloov tsis ua haujlwm, tus neeg mob kho tsis tuaj yeem mob raum. Ntshav qab zib nephropathy hloov kho, tus neeg mob txoj sia muaj sia zuj zus.

Thaum npaj lub raum hloov raum rau cov ntshav qab zib, cov kws kho mob tau sim los soj ntsuam seb yuav ua li cas tus neeg mob yuav muaj mob plawv (mob plawv lossis mob hlab ntsha tawg) thaum lossis tom qab phais tas. Rau qhov no, tus neeg mob yauv mus kuaj mob ntau yam, suav nrog ECG nrog lub nra.

Feem ntau cov txiaj ntsig ntawm kev soj ntsuam no qhia tau tias cov hlab ntsha uas pub rau lub plawv thiab / lossis lub hlwb tau cuam tshuam ntau heev los ntawm atherosclerosis. Saib kab lus “Rawv raum mob ntshav liab” kom paub cov ntsiab lus. Hauv qhov no, ua ntej lub raum hloov chaw, nws raug pom zoo kom phais neeg rov qab kho qhov qub txeeg qub teg ntawm cov hlab ntsha no.

Nyob zoo
Kuv muaj 48 xyoo, siab 170, hnyav 96. Kuv raug kuaj mob ntshav qab zib hom 2 15 xyoo dhau los.
Lub sijhawm no, Kuv noj tshuaj metformin.hydrochlorid 1g ib ntsiav tshuaj thaum sawv ntxov thiab ob teev nyob rau yav tsaus ntuj thiab januvia / sitagliptin / 100 mg ib ntsiav tshuaj thaum yav tsaus ntuj thiab insulin ib koob ib hnub lantus 80 ml. Lub Ib Hlis nws tau kuaj zis txhua hnub thiab cov protein yog 98.
Thov qhia seb cov tshuaj twg Kuv tuaj yeem pib noj rau lub raum. Hmoov tsis zoo, Kuv tsis tuaj yeem mus cuag kws kho mob hais lus Lavxias vim kuv nyob txawv teb chaws. Muaj ntau cov lus tsis sib haum nyob rau hauv Is Taws Nem, yog li kuv yuav zoo siab heev rau cov lus teb. Ua tsaug, Elena.

> Thov qhia cov tshuaj yog dab tsi
> Kuv tuaj yeem pib noj rau lub raum.

Nrhiav kws kho mob zoo thiab sab laj rau nws! Koj tuaj yeem sim daws cov lus nug no "hauv kev tsis pom" tsuas yog tias koj nkees nkees ntawm kev ua neej nyob.

Nyob zoo Tav Txaus siab nyob rau hauv kev kho mob raum. Yam 1 ntshav qab zib. Yuav tsum ua dab tsi ntxiv los yog txoj kev kho yuav tsum tau nqa tawm? Kuv tau muaj mob txij li xyoo 1987, tau 29 xyoos. Kuj tseem nyiam noj zaub mov. Kuv yuav xav thov ua tsaug. Nws kho nrog droppers, Milgamma thiab Tiogamma. Tau 5 xyoo dhau los nws tsis tau mus pw hauv tsev kho mob vim yog tus kws kho mob hauv nroog, uas niaj hnub hais txog qhov tseeb tias qhov no nyuaj ua. Txhawm rau mus tom tsev kho mob, koj yuav tsum paub tseeb tias tsis xis nyob. Tus neeg khav theeb tsis txaus ntseeg tus kws kho mob, uas yog txhua yam zoo ib yam.

> Yuav tsum tau ua cov ncos dab tsi
> lossis ua txoj kev kho mob?

Kawm cov lus “Kuaj raum” thiab tshawb xyuas seb nws hais li cas. Cov lus nug tseem ceeb yog cov zaub mov twg thiaj ua raws. Thiab cov dauv dej yog tertiary.

Nyob zoo. Thov teb rau.
Kuv muaj mob ntsej muag o (sab plhu, tawv muag, cheekbones). Thaum sawv ntxov, tav su thiab yav tsaus ntuj. Thaum nias nrog cov ntiv tes (txawm tias me ntsis), cov hniav thiab cov pits seem uas tsis dhau mus tam sim.
Ntsuam xyuas lub raum, ib qho duab hluav taws xob tsom iav tau qhia cov xuab zeb hauv lub raum. Lawv hais tias kom haus dej ntau dua. Tab sis los ntawm "dej ntau dua" (thaum kuv haus ntau dua 1 litres ib hnub) Kuv tau nrawm dua.
Nrog rau kev pib ntawm kev noj haus kom tsawg-carbohydrate, Kuv tau nqhis dej ntau. Tab sis kuv sim haus 1 liter rau ib qho twg, raws li kuv soj ntsuam - tom qab 1,6 litres muaj zog o tuaj yeem lav.
Ntawm cov zaub mov no txij li lub Peb Hlis 17. Lub lim tiam plaub tau ploj mus. Thaum lub sijhawm o nyob rau ntawm qhov chaw, thiab qhov hnyav nws tsim nyog. Kuv zaum ntawm cov khoom noj no vim tias kuv xav kom poob phaus, tshem tawm qhov tsis tu ncua ntawm kev xav ntawm o, thiab tshem tawm ntawm rumbling hauv kuv lub plab tom qab noj mov carbohydrate.
Thov qhia rau kuv yuav ua li cas los laij koj txoj kev haus dej haus cawv kom raug.

> yuav xam koj txoj kev haus dej haus li cas

Ua ntej tshaj plaws, koj yuav tsum tau kuaj ntshav thiab tso zis, thiab tom qab ntawd laij tus nqi ntawm glomerular filtration ntawm lub raum (GFR). Nyeem cov ntsiab lus ntawm no. Yog tias GFR qis dua 40 - cov zaub mov tsis muaj roj ntau ntau yog txwv tsis pub, nws tsuas yog yuav ua kom qeeb ntawm kev tsim kho lub raum tsis ua haujlwm.

Kuv sim ceeb toom rau txhua tus - sim kev ntsuam xyuas thiab kuaj koj ob lub raum ua ntej hloov mus rau kev noj haus cov zaub mov tsis muaj ntsev. Koj tsis tau ua qhov no - koj tau txais qhov txiaj ntsig sib luag.

> Kuaj ntshav ntawm ob lub raum, ib qho duab kab hluav taws xob tsom tau pom

Ua ntej tshaj plaws, koj yuav tsum tau kuaj ntshav thiab tso zis, thiab ultrasound xwb tom qab.

nrog xws li ib tug protein urgently tsa lub tswb! Yog koj tus kws kho mob hais ib yam li: - “Koj xav tau dab tsi, nws yog koj tus mob ntshav qab zib. thiab cov neeg mob ntshav qab zib ib txwm muaj protein ”khiav deb ntawm tus kws kho mob no yam tsis tau saib rov tom qab! tsis txhob rov ua txoj hmoo kuv niam. protein yuav tsum tsis txhua. koj twb muaj ntshav qab zib nephropathy. thiab peb txhua tus nyiam kho nws li qub tsis xis neej. diuretic hauv nees koob tshuaj. tab sis lawv tig tawm mus rau qhov ua tsis tau zoo, yog tias tsis siv tsis tau. kev tsim txom los ntawm lawv yog qhov ntau dua. ntau cov phau ntawv endocrinology sau txog qhov no. tab sis cov kws kho mob thaj tau sau cov phau ntawv no thaum lawv kawm, dhau txoj kev kuaj mob thiab tsis nco qab. raws li kev siv tshuaj diuretics, creatinine thiab urea tam sim ntawd nce siab. Koj yuav pib raug xa mus rau kev them nyiaj hemodialysis. koj yuav pib muaj edema txaus ntshai. lub siab nce (saib lub triad ntawm virchow). tsuas yog siv captopres / captopril lossis lwm yam ACE inhibitors. yog sortans. lwm lwm hom kev tiv thaiv tshuaj yuav ua rau lub cev tsis muaj zog hauv kev noj qab haus huv. irreversible heev tej zaum. Tsis txhob ntseeg cov kws kho mob! categorically! tshuaj xyuas thiab piv cov sij hawm teem tseg nrog cov ntawv sau hauv cov ntawv kawm endocrinology. thiab nco ntsoov. mob ntshav qab zib, cov kws kho cov tshuaj yuav tsum siv. nrog kev txhawb nqa ntawm "phiaj ua haujlwm." txhua. khiav los ntawm tus kws kho mob xyaum ua kev kho mob thaum tseem ciaj sia. tib yam mus rau tus kws kho mob uas tsis paub tias alpha lipoic acid yog rau ntshav qab zib. thiab lub kawg. Pom koj tus kheej kev faib tawm ntawm cov ntshav qab zib nephropathy hauv Is Taws Nem thiab nrhiav koj tus kheej theem. Cov kws kho mob zaws ua luam dej heev hauv cov teeb meem no. rau ib qho diuretics (diuretics), qhov muaj nyob nrog ntawm nephropathy yog qhov tsis sib xws. thiab txiav txim los ntawm koj cov lus piav qhia, nws tsis qis dua theem 3. xav tsuas yog nrog koj tus kheej lub taub hau. tsis li ntawd koj yuav raug iab liam tsis saib xyuas tus kab mob. yog li, raws li lawv hais, txoj kev cawm ntawm poob deg, tes dej num koj puas paub leej twg ...

Nyob zoo. Qhia rau kuv tias yuav ua li cas nrog cov ketone ntsuas hauv cov zis uas tshwm sim nrog kev noj zaub mov kom tsawg, thiab lawv muaj kev phom sij li cas?

Ua tsaug rau koj cov kev ua haujlwm titanic thiab rau peb qhov kev nkag siab. Qhov no yog cov ntaub ntawv zoo tshaj plaws rau kev taug kev ntev hauv Is Taws Nem. Txhua cov lus nug tau kawm thiab nthuav tawm hauv kev nthuav dav, txhua yam yog qhov tseeb thiab nkag mus tau, thiab txawm tias kev ntshai thiab kev ntshai ntawm kev kuaj mob thiab tsis pom zoo ntawm cov kws kho mob tau evaporated qhov twg.))))

Nyob zoo Tab sis dab tsi txog kev noj zaub mov yog tias muaj mob raum? Nyob rau lub caij ntuj no, nyob rau ib lub zaub pob thiab vitamins koj tsis tuaj yeem mus deb