Kev kho mob ntshav siab nyob rau hauv hom 2 mob ntshav qab zib mellitus: ntsiav tshuaj, cim

Kub siab - ntshav siab. Qhov ntsuas siab hauv hom 2 mob ntshav qab zib mellitus xav tau ceev cia ntawm 130/85 mm Hg. Kos duab. Cov qib siab dua yuav ua rau muaj qhov mob stroke (3-4 zaug), lub plawv nres (3-5 zaug), qhov muag tsis pom kev (10-20 zaug), lub raum tsis ua haujlwm (20-25 zaug), mob caj dab nrog tom qab txiav tawm (20 zaug). Txhawm rau zam qhov cov mob hnyav heev, lawv qhov tshwm sim, koj yuav tsum tau coj tshuaj tiv thaiv ntshav qab zib rau cov ntshav qab zib.

Tawg siab: ua rau, hom, nta

Dab tsi sib txuam nrog ntshav qab zib thiab siab? Nws ua ke nrog kev puas tsuaj rau cov khoom nruab nrog: lub siab nqaij, raum, ntshav hlab ntsha, thiab retina ntawm lub qhov muag. Kev mob ntshav siab ntshav qab zib yog feem ntau thaum xub thawj ua ntej.

Cov Hom Ntshav	Qhov yuav tshwm sim	Vim li cas
Qhov tseem ceeb (thawj)	mus txog 35%	Vim li cas tsis tsim
Raug rho tawm systolic	mus txog 45%	Kev txo qis vascular elasticity, neurohormonal kawg
Ntshav Qab Zib Nepropathy	nce txog 20%	Kev puas tsuaj rau cov hlab ntsha hauv lub raum, lawv cov sclerotization, kev txhim kho lub raum tsis ua haujlwm
Hlob	nce txog li 10%	Pyelonephritis, glomerulonephritis, polycitosis, mob ntshav qab zib nephropathy
Endocrine	nce txog 3%	Cov kab mob endocrine: pheochromocytoma, thawj hyperaldosteronism, Itsenko-Cushing's syndrome

rau cov ntsiab lus ↑

Nta ntawm kub siab hauv cov neeg mob ntshav qab zib

Lub suab ntawm cov ntshav siab tau tawg - thaum ntsuas lub cim thaum tsaus ntuj yog siab dua nruab hnub. Qhov laj thawj yog neuropathy.
Qhov ua tau zoo ntawm kev ua haujlwm ntawm kev ua haujlwm ntawm lub zog ntawm lub paj hlwb tau hloov pauv: txoj cai ntawm lub suab nrov ntawm cov hlab ntsha yog cuam tshuam.
Daim ntawv orthostatic ntawm hypotension tsim - ntshav siab nyob rau hauv ntshav qab zib. Tus ntse nce ntxiv hauv ib tus neeg ua rau muaj kev tawm tsam ntawm hypotension, tsaus nti hauv qhov muag, tsis muaj zog, tsaus muag.

rau cov ntsiab lus ↑

Kev kho yuav tsum pib nrog cov tshuaj diuretic (tshuaj tua kab mob). Cov tshuaj kws kho mob tseem ceeb rau yam 2 mob ntshav qab zib mob 1

Muaj zog	Nruab Nrab Muaj Zog Ua Kom Zoo	Tsis muaj zog diuretics
Furosemide, Mannitol, Lasix	Hypothiazide, Hydrochlorothiazide, Clopamide	Dichlorfenamide, Diacarb
Muab tso rau los daws kev tawm tsam mob hnyav, txha caj qaum	Cov tshuaj yeeb ntev	Muab tso rau hauv ib txoj hauv kev rau kev kho kho mob.
Lawv sai tshem tawm cov kua dej tawm hauv lub cev, tab sis muaj ntau cov kev mob tshwm sim. Lawv siv rau lub sijhawm luv luv hauv cov kab mob sib kis.	Mos ua, tshem tawm cov hypostases	Txhim kho qhov kev txiav txim ntawm lwm cov tshuaj diuretics

Tseem Ceeb: Diuretics cuam tshuam ntawm electrolyte tshuav nyiaj li cas. Lawv tshem tawm cov ntsev ntawm cov khawv koob, sodium, potassium los ntawm lub cev, yog li Triamteren, Spironolactone raug tshuaj los kho qhov rov qab electrolyte. Txhua txoj kev kho mob tsuas yog txais rau kev kho mob.

Cov tshuaj antihypertensive: ib pawg

Qhov kev xaiv ntawm cov tshuaj yog qhov tseem ceeb ntawm cov kws kho mob, kev coj tus kheej yog qhov txaus ntshai rau kev noj qab haus huv thiab lub neej. Thaum xaiv cov tshuaj rau cov ntshav qab zib mellitus thiab tshuaj rau kev kho mob ntshav qab zib hom 2, cov kws kho mob tau coj los ntawm tus neeg mob tus yam ntxwv, yam ntxwv ntawm cov tshuaj, kev sib raug zoo, thiab xaiv cov qauv kev nyab xeeb tshaj plaws rau ib tus neeg mob.

Cov tshuaj tiv thaiv kabmob raws li pharmacokinetics tuaj yeem faib ua tsib pab.

Yam 2 yam tshuaj ntshav qab zib hom 2

Cov pab pawg	Pharmacological kev txiav txim	Kev Npaj
Beta blockers nrog vasodilating kev txiav txim siab	tshuaj uas thaiv qhov kev ua ntawm beta-adrenergic receptors lub plawv, cov hlab ntsha thiab lwm yam hauv nruab nrog cev.	Nebivolol, Atenolol Corvitol, Bisoprolol, Carvedilol

Tseem Ceeb: Ntsiav tshuaj rau ntshav siab - Beta-blockers nrog cov nyhuv vasodilating - cov khoom siv niaj hnub no, siv tshuaj kom zoo - nthuav cov hlab ntsha me, muaj cov txiaj ntsig zoo ntawm cov metabolism-lipid metabolism.

Thov nco tseg: Qee cov kws tshawb nrhiav ntseeg tau tias qhov muaj kev nyab xeeb zoo tshaj plaws rau kev mob ntshav siab mob ntshav qab zib mellitus, cov ntshav qab zib tsis muaj insulin-tiv thaiv yog Nebivolol, Carvedilol. Cov tshuaj ntxiv ntawm pawg beta-blocker suav hais tias yog kev phom sij, sib xws nrog tus mob qis.

Tseem Ceeb: Beta-blockers npog cov tsos mob ntawm kev mob hypoglycemia, yog li ntawd, yuav tsum yog cov tshuaj tawm nrog zoo saib xyuas.

Cov tshuaj rau cov neeg mob ntshav qab zib hom 2

Cov pab pawg	Pharmacological kev txiav txim	Kev Npaj
Alpha blockers xaiv xaiv	Txo kev puas tsuaj rau cov hlab ntaws thiab lawv qhov kawg. Lawv muaj hypotensive, vasodilating, antispasmodic yam ntxwv.

Doxazosin

Tseem Ceeb: Xaiv alpha blockers muaj "thawj koob tshuaj." Thawj cov ntsiav tshuaj yuav siv orthostatic cev qhuav dej - vim yog nthuav dav ntawm cov hlab ntshav, nce siab ntxiv ua rau muaj ntshav tawm los ntawm lub taub hau qis. Tus neeg ua rau nws poob qab thiab yuav raug mob.

Tshuaj siv los kho tus mob ntshav siab nyob hauv hom 2 mob ntshav qab zib mellitus sau 4

Cov pab pawg	Pharmacological kev txiav txim	Kev Npaj
Calcium antagonists	Txo cov kev ua kom tau ntawm calcium ions rau hauv cardomycetes, cov leeg nqaij ntawm cov hlab ntsha, txo lawv qhov kev sib ntxoo, txo qhov siab. Txhim kho cov ntshav txaus rau cov leeg plawv	Nifedipine, felodipine,
Direct renin inhibitor	Txo tus siab, tiv thaiv lub raum. Cov tshuaj tsis tau kawm txaus.	Rasilez

Cov tshuaj tos neeg mob thaum muaj mob ceev ceev rau cov ntshav siab: Andipal, Captopril, Nifedipine, Clonidine, Anaprilin. Qhov kev txiav txim kav ntev txog 6 teev.

Ntsiav tshuaj rau cov ntshav siab hauv hom 2 mob ntshav qab zib sau 5

Cov pab pawg	Pharmacological kev txiav txim	Kev Npaj
Angiotensitive Receptor Antagonists	Lawv muaj qhov tshwm sim qis tshaj ntawm kev mob tshwm sim, txo kev pheej hmoo ntawm mob hlab ntsha tawg, plawv nres, lub raum tsis ua haujlwm	Losartan, Valsartan, Telmisartan

Angiotensin Hloov Kev Tso Cai Enzyme (ACE)Txo cov siab, txo cov load ntawm myocardium, txwv tsis pub txoj kev loj hlob sai ntawm cov kab mob plawvCaptopril, Enalapril, Ramipril, Fosinopril, Thrandolapril, Berlipril

Cov tshuaj tiv thaiv ntshav siab tsis yog txwv los ntawm cov npe no. Cov npe ntawm cov tshuaj tseem niaj hnub hloov kho nrog cov tshiab, ntau dua tshiab, kev ua haujlwm zoo.

Victoria K., 42, tus tsim qauv.

Kuv twb tau mob ntshav siab thiab ntshav qab zib hom 2 tau ob xyoos. Kuv tsis tau haus tshuaj, kuv tau noj tshuaj ntsuab, tab sis lawv tsis pab ntxiv lawm. Yuav ua li cas Ib tug phooj ywg hais tias koj tuaj yeem tshem tawm cov ntshav siab yog tias koj noj bisaprolol. Cov tshuaj siab dab tsi zoo rau haus? Yuav ua li cas

Victor Podporin, tus kws kho mob endocrinologist.

Nyob zoo Victoria, kuv yuav tsis tau taw qhia koj kom mloog koj tus hluas nkauj. Yog tsis muaj kws kho mob sau ntawv, kev noj tshuaj tsis pom zoo. Ntshav siab hauv ntshav qab zib muaj qhov tsis sib xws (ua rau) thiab yuav tsum sib txawv rau kev kho. Cov tshuaj rau ntshav siab tsuas yog kws kho mob sau tseg rau.

Qhia tshuaj kho rau cov neeg mob ntshav siab

Arterial hypertension ua rau qhov kev ua txhaum ntawm cov metabolism ntawm carbohydrates hauv 50-70% ntawm tus neeg mob. Hauv 40% ntawm cov neeg mob, txoj kev mob ntshav siab mob ntshav qab zib yog yam mob ntshav qab zib 2. Qhov laj thawj yog insulin tsis kam - insulin tsis kam. Mob ntshav qab zib mellitus thiab siab yuav tsum tau kho tam sim.

Kev kho mob ntawm kev mob ntshav siab nrog tshuaj rau cov neeg mob ntshav qab zib yuav tsum pib nrog kev saib xyuas cov cai ntawm kev ua neej noj qab haus huv: tswj lub cev qhov hnyav, txwv tsis pub haus luam yeeb, haus dej haus cawv, txwv kev noj ntsev thiab zaub mov tsis zoo.

Cov tshuaj kho mob rau pej xeem txo qis siab rau cov ntshav qab zib hom 2:

Decoction ntawm mint, sage, chamomile	Txo txo kev ntxhov siab los ntawm kev ntxhov siab
Freshly tau kua txiv ntawm dib, beet, lws suav	Txo cov siab, txhim kho zoo nyob rau tag nrho
Txiv hmab txiv ntoo tshiab ntawm hawthorn (tom qab noj mov 50-100 g ntawm txiv hmab txiv ntoo 3 zaug hauv ib hnub)	Txo cov ntshav siab thiab ntshav qab zib
Birch nplooj, cowberry, pos nphuab, blueberry, flax noob, valerian hauv paus, mint, motherwort, txiv qaub balm	Siv ntau qhov sib xyaw ua ke rau decoctions lossis infusions pom zoo los ntawm endocrinologist

Kev kho mob ntshav siab nrog tshuaj ntsuab rau cov neeg mob ntshav qab zib tsis yog ib txwm ua tau zoo, yog li ntawd, nrog rau kev siv tshuaj ntsuab, koj yuav tsum tau noj tshuaj. Yuav tsum siv cov tshuaj kho zoo, tom qab sab laj nrog tus kws kho mob endocrinologist.

Kev Noj Haus Khoom Noj Khoom Haus lossis Khoom Noj Kom Zoo

Kev noj haus rau ntshav siab thiab hom ntshav qab zib hom 2 txhawm rau txo qis ntshav siab thiab ua kom cov ntshav qabzib nce siab. Kev noj zaub mov noj ntshav siab thiab hom 2 mob ntshav qab zib mellitus yuav tsum pom zoo nrog tus kws endocrinologist thiab tus neeg noj zaub mov noj haus.

Kev noj zaub mov kom sib npaug (qhov tseeb raug thiab qhov ntau npaum li cas) ntawm cov protein, carbohydrates, rog.
Tsawg-carb, nplua nuj nyob hauv cov vitamins, potassium, magnesium, kab kawm zaub mov.
Haus ntau tshaj 5 g ntsev rau ib hnub twg.
Qhov txaus ntawm cov zaub thiab txiv hmab txiv ntoo tshiab txaus.
Kev noj haus tsawg kawg (tsawg kawg 4-5 zaug hauv ib hnub).
Ua kom raws li kev noj haus No. 9 lossis Zauv 10.

rau cov ntsiab lus ↑

Xaus

Cov tshuaj kho mob rau cov ntshav siab yog cov sawv cev tau zoo nyob rau hauv cov chaw muag tshuaj. Cov tshuaj kho mob qub, cov generics ntawm cov nqi sib txawv cov cai muaj lawv qhov zoo, cim thiab contraindications. Mob ntshav qab zib mellitus thiab arterial hypertension sib ua ke, xav tau kev kho mob tshwj xeeb. Yog li ntawd, tsis muaj ib qho yuav tsum yog koj tus kheej-tshuaj. Tsuas yog cov qauv tshiab los kho cov ntshav qab zib thiab kub siab, kev teem caij tsim nyog los ntawm endocrinologist thiab kev kho plawv yuav ua rau cov txiaj ntsig yam xav tau. Noj qab nyob zoo!