Diabetic nephropathy yog ib txoj hauv kev hloov ntawm cov hlab ntsha hauv cov hlab ntsha ntawm ob lub raum pom hauv ob hom ntshav qab zib mellitus. Qhov teeb meem no yog kuaj txog li ntawm 10-20% ntawm cov neeg mob ntshav qab zib mellitus.
Ua rau muaj ntshav qab zib
Lub ntsiab tseem ceeb ua rau kom muaj kev mob ntawm tus kab mob no, yog hyperglycemia (ntshav qab zib siab) thiab ntev tsis them nyiaj ntawm kev ua txhaum ntawm cov roj carbohydrate metabolism. Vim li no, cov txheej txheem biochemical maj mam hloov: kev ua txhaum cai ntawm dej-electrolyte homeostasis, pauv cov roj fatty acids, txo kev thauj cov pa oxygen,
Ntshav ua rau lom rau lub hlwb ntawm ob lub raum, thiab qhib lub tswv yim ua rau kev puas tsuaj thiab nce cov kab mob ntawm lawv cov phab ntsa. Vim yog kev puas tsuaj rau lub paj hlwb nyob rau hauv cov ntshav qab zib mellitus, lub raum cov plab hnyuv nce siab, thiab cov hlab ntsha puas ntsoog raug hloov ntawm cov ntaub so ntswg. Tsis tas li ntawd, lub luag hauj lwm nyob rau hauv kev loj hlob ntawm cov ntshav qab zib neuropathy yog ua si los ntawm cov ntshav siab thiab kev ua haujlwm ntawm cov intrarenal ntshav txaus, thiab raws li ib caj ces.
Cov tsos mob thiab cov theem ntawm cov hlab ntsha nephropathy
Hauv kev loj hlob ntawm cov teeb meem no, tsib qib yog qhov txawv, peb cov uas yog cov kws kho dua, i.e. Diabetic nephropathy pib tsis muaj kev tawm sab nraud thiab tsuas yog txiav txim siab los ntawm kev kuaj kab mob tshwj xeeb los yog los ntawm kev siv nqaij hlav. Txawm li cas los xij, qhov kev kuaj xyuas pathology hauv cov theem pib yog qhov tseem ceeb, vim tias Tsuas yog nyob rau lub sij hawm no nws tseem rov qab. Cia peb xav txog ntau yam kev hloov uas muaj nyob hauv txhua theem ntawm tus kab mob.
Theem I - qhov ntau thiab tsawg ntawm cov hlwb hauv lub cev, muaj zog zuj zus thiab pom cov zis (hyperfunction ntawm plab hnyuv siab raum).
II theem - tshwm sim li 2 xyoos tom qab pib qhov mob ntshav qab zib. Lub thickening ntawm phab ntsa ntawm lub rhaub cov hlab ntsha yog cov yam ntxwv.
Theem III - kev puas tsuaj loj rau lub raum cov hlab ntsha, microalbuminuria (ib qho me me ntawm cov protein nyob hauv cov zis), hloov cov glomerular lim.
IV theem - tshwm sim 10 txog 15 xyoos tom qab pib qhov mob ntshav qab zib. Cov yam ntxwv ntawm cov yam ntxwv yog:
- proteinuria (cov qoob loo ntawm cov protein ntau hauv cov zis);
- mob o nyob ntawm ob txhais ceg, ntsej muag, plab kab noj hniav, thiab lwm yam;
- poob lub cev hnyav;
- tsis muaj zog;
- xeev siab;
- nqhis dej;
- nquag mob taub hau ;
- nce siab hauv ntshav.
V theem - yuav luag tag nrho cov qog nqaij hlav qis, ib qho tseem ceeb hauv qis qis dua thiab qis zog ntawm ob lub raum. Lwm cov cim qhia yog:
- loj heev proteinuria;
- txoj kev loj hlob ntawm ntshav liab;
- mob hnyav;
- txo qis ntawm hyperglycemia;
- dyspeptic syndrome;
- uremia, lwm yam.
Yuav kho tus kab mob ntsws li cas?
Nyob rau hauv kev kho mob ntawm pathology, muaj peb lub ntsiab Cheebtsam:
- tswj cov qib siab ntawm cov ntshav qab zib hauv cov ntshav;
- Txoj kev kho mob ntawm txoj hlab ntsha tawg nrog rau tus mob microalbuminuria;
- kev tiv thaiv ntawm kev poob qis heev hauv lub raum kev ua haujlwm thiab kev txhim kho ntawm lub anuric theem ntawm lub raum tsis ua hauj lwm;
- kev siv tshuaj lom neeg.
Nyob rau hauv kev kho mob ntawm cov ntshav qab zib nephropathy, kev siv ntawm xws li cov pawg ntawm cov yeeb tshuaj yog qhia:
- hypoglycemic preparations;
- inhibitors ntawm angiotensin-converting enzyme;
- angiotensin reseptor antagonists;
- beta-blockers;
- calcium channel blockers;
- kev npaj rau cov normalization ntawm lub lipid spectrum ntawm cov ntshav;
- diuretics ;
- sorbents;
- tshuaj tiv thaiv kab mob thiab lwm tus.
Nws yuav tsum ua raws li cov khoom noj uas tsis muaj protein ntau thiab ntsev, tsis txhob noj cov rog. Yog tias lub raum ua haujlwm tau ua txhaum loj, nws tseem muaj peev xwm los hloov kev hloov kho (hemodialysis, ib txwm ua kev puas hlwb peritoneal) lossis kho kev phais los ntawm kev hloov ntshav raum.