Unomfutho wegazi ophakeme kwasebekhulile

Kwegazi kwasebekhulile

VS Tchistov

Okokuqala MGMU-IM Sechenov

Iqiniso lokuthi nomfutho wegazi ophezulu ingenye izifo ezimbi kakhulu, ukwazi pheze wonke umuntu ewela embundwini zokuguga. Isigaba balabo asebekhulile, njengoba umthetho, kukhona Abesilisa abaneminyaka ephakathi kuka-60 no-74 iminyaka nabesifazane abaneminyaka engu-56 kuya 74. Yiqiniso, lokho akusho ukuthi umfutho ophakeme wegazi yisifo kuphela abantu abadala, lesi simo singenzeka kunoma yimuphi umuntu emva kweminyaka 35, okuthiwa "yobudala yesithathu" is ikakhulukazi libhekene yokuphazamiseka imisebenzi esimiso senhliziyo nemithambo yegazi ahlobene nezinguquko ezihlobene nokukhula ukuthi kukhona ujike imbangela izingozi yezinkinga yenhliziyo, i-cerebral futhi kwezinso.
Kwegazi ubhekwa isizathu omshoshaphansi kakhulu. Abantu bakhe abaningi siyibukele phansi, ngoba kusaqalwa yomuntu ngeke bezwe lutho, akukho bekhanda, hhayi unezinkinga inhliziyo. High blood pressure kungaqali ngokushesha kwenza ngokwayo wazizwa. Chaza kungenzeka kuphela uma kwenzeka uma umuntu ukuqapha njalo igazi labo ingcindezi, ukunakekelwa kwezempilo, noma esikhathini esizayo uma uvakashela udokotela ngokuzumayo kuvela ukuthi wegazi ezingeni siphezulu kunokuvamile. Yingakho high blood pressure ubizwa ngokuthi 'umbulali othule. " Lokhu kuchaza izibalo zomhlaba, owawuthi umfutho wegazi ophakeme emithanjeni kuphakamisa nengxenye yabo bonke abantu abafayo kwasebekhulile.
Kuyini nomfutho wegazi ophezulu
Ngu yencazelo we-World Health Organization (WHO) nomfutho wegazi ophezulu ayiswe kusho ukwanda systolic blood pressure kuka 140 mm HG ngaphansi evamile noma kancane encishisiwe diastolic blood pressure - engaphansi kuka-90 mm HG Eqenjini kweminyaka emibili nengu-65 kuya ku-75 ngo-2/3 of amacala okutholakala ukuthi banesifo sochoko ifomu ezithile ezibalulekile nomfutho wegazi ophezulu - isehlane systolic nomfutho wegazi ophezulu. Leli fomu ephelezelwa kwenyuke ukushaya kwenhliziyo nomfutho wegazi, okwandisa ingozi izenzakalo senhliziyo kanye nesifo sohlangothi. Ngo Ukwahlukaniswa UBANI ochwepheshe baye nomfutho wegazi ophezulu emnceleni, yona evame ukuqonda isici ukwanda systolic blood pressure ku 149 mmHg lapho-diastolic blood pressure noma ngezansi 90 mm HG
izibalo isifo
Emazweni athuthukile kakhulu, umfutho ophakeme wegazi kwenzeka amaphesenti 50-60 labantu asebekhulile, ogama inombolo njalo ekhula masishane emhlabeni wonkana. Ukuze eRussia, lapho kukhona ukuguga engaguquki sabantu, kanye isilinganiso sobude bokuphila amadoda Russian Uneminyaka ecishe ibe u-60, le nkinga isibe efanele ikakhulukazi. Lokhu kungenxa yokuthi lesi sifo kuvamile kakhulu, futhi ukuqaphelisa komphakathi yokuthi begula kakade, liphansi kakhulu. Babembalwa abantu asebekhulile ihlole igazi labo ingcindezi, okuyinto kwaba nokwanda jikelele ingozi, okuyinto enquma ukuthuthukiswa futhi ukuqhubeka kwesifo. ERussia namuhla ingenye yezindawo zokuqala e-Europe futhi ngokwempilo yangenyama kusukela izifo zenhliziyo cuphuluza nomfutho wegazi ophezulu.
Izimbangela Nezingozi yemiphumela yokugula
Namuhla lithole idatha eyanele okubonisa ukuthi ngeminyaka inani abanomfutho wegazi ophakeme iziguli iyakhula. Ukuqhubekela phambili kwesifo kungenxa izinguquko ezihlobene nokukhula emzimbeni, kuhlanganise uhlelo senhliziyo nemithambo yegazi. Kusukela eminyakeni engu-40, umuntu esegazini iqala sebethule calcium, i-collagen, mithambo ine-elastin, futhi glycosaminoglycans. Ngesikhathi esifanayo ethuthuka izinguquko atherosclerotic. Lezi zinqubo kubangele ukwehla kuyaqina le-aorta nokuvaleka kwemithambo emikhulu. imithambo yegazi, ukulahlekelwa kuyaqina, isakwazi ukuphendula ushintsho umfutho wegazi phakathi systole futhi diastole. Isimo siba sibi isifo sokuqina kwemithambo yegazi, nakuba degree yayo akuwona ukuhlanganisa begodu kukhula ingcindezi.
Kanyekanye ngenhla izinguquko izitsha ukwandisa futhi elongate, futhi ezincane kubo babe ngaphansi permeable, okuyinto kuholela ziwohloke ukudla kanye ezicutshini zomzimba libandakanya lwemithambo ingcindezi ukwanda. Nokho, unomfutho wegazi ophakeme kwasebekhulile imakwe isigqi lomzimba wegazi. Ucwaningo luye lwabonisa ukuthi abantu abangaphezu kuka-50% eziguli abangontanga iminyaka 65-75 kungukuthi ngokwanele imakwe ukunciphisa umfutho wabo wegazi ebusuku ngesikhathi sokulala, okuyinto ngaphansi kwezimo ezivamile ungaphakathi uhla 10-20 mm HG Kunalokho, ingcindezi liphuma ngokucijile ebusuku, noma yikuphi phezu-encishisiwe. Libuye ngokuvamile kakhulu fast and wamemezela kuyanda ekuseni wegazi.
Zonke lezi jetlag kukhona imingcele prognostic yezinkinga ezinzima senhliziyo wegazi, okuholela ekubeni umonakalo isitho asebekhulile: ubuchopho, i-ventricle engakwesobunxele ka inhliziyo, izinso namehlo. ukwanda ziphikelele lwemithambo ingcindezi futhi senhliziyo kungalindelekile izinombolo okusezingeni eliphezulu avuse umzimba anoxia futhi iso kwezicubu. iziyaluyalu kwegazi e-retina nokopha kwe-retina kungaholela ngobumpumputhe. Ngesikhathi esifanayo, abantu abangaphezu kwengxenye iziguli unesifo sikashukela asebekhulile, ikakhulukazi amadoda, ahlupheke hypertrophy (yokwanda kwesisindo myocardial) ka-ventricle engakwesobunxele kwenhliziyo, kahle umsebenzi kwezinso basengozini yokungenwa i-stroke.
Kwesokunxele ventricular hypertrophy in iziguli umfutho wegazi ophakeme emithanjeni
Hypertrophy kwesokunxele ventricular myocardium engozini sína yezinkinga ngesimo senhliziyo, inhliziyo ukuhlaselwa. Kufanele kuqashelwe ukuthi lesi sifo okungukuthi ukuma omunye esiphezulu phakathi zonke ezinye izici eziyingozi okuhlobene yobunzima obabangelwa nomfutho wegazi ophezulu. I degree of yokwanda kwesisindo esivimba amanzi kunqunywa mayelana isisindo salo esivamile. Eliphelele elivumelekile mass Inkomba value infarction ezingabantu ibhekwa njengezwekazi 134 g / m2, futhi kancane kancane kubantu besifazane - 110 g / m2. Okwamanje, okungcono indlela isifundo esivimba amanzi hypertrophy kubhekwa echocardiography. Ifomu ethandwa kakhulu zokuxilonga inhliziyo luhlolo - ECG, futhi bakwazi ukubona kwesokunxele ventricular hypertrophy, kodwa kuphela ngaphansi kwesimo sokuthi izinguquko kakade eduze ezibucayi. Excellent imiphumela Sinike ezifana ucwaningo emasu lafana ngekhompyutha tomography futhi magnetic resonance imaging.
Ukuphazamiseka umsebenzi kwezinso in iziguli umfutho wegazi ophakeme emithanjeni
Ukwephula umsebenzi kwezinso ngesikhathi besanda kuqala umfutho wegazi ophakeme emithanjeni ivame ukuba nemiphumela engaqapheleki, okuyinto yisici esiyinhloko esibangela ukuqhubeka ezingamahlalakhona ukwehluleka kwezinso, intrarenal izilonda semithambo, njll Izimbangela zezifo ezihlukahlukene isibaluli kahle igazi ligeleze izinso, njengoba kwenzeka ngo-nomfutho wegazi ophezulu vasoconstriction abalulekile futhi uyivale izindonga zawo. Enye yezinguquko ezivame kakhulu kuleli imithambo kwezinso kuyinto isifo sokuqina kwemithambo yegazi hyperplastic nokunwebeka. Ngenxa mafutha anciphisa isikhala esingaphakathi sclerosing imithambo yegazi embhedeni izinso incipha. Kuzo zombili izimo, kwezinso ukugeleza kwegazi kuyehla, okuholela hypoxia - ukushoda oksijini izinso kwezicubu. Sezinso izicubu atrophies futhi esikhundleni ezicutshini, engesiyo akwazi ukwenza izinso imisebenzi. Ngenxa yalokho, ukwakheka nomchamo hhayi lwenziwa futhi ukuchama, kukhona ubuthi okukhipha, umzimba samootravlyaetsya nitrogen slag kuze ekuthuthukiseni uremia okungase avuse ukufa.
Izinguquko ebuchosheni in iziguli umfutho wegazi ophakeme emithanjeni
Mayelana umonakalo ebuchosheni umfutho wegazi ophakeme emithanjeni okufanele nikusho more ambalwa. Ngokuvamile, izinguquko isakhiwo zobuchopho ezandulela izimpawu ze-non-ethize, okungase libhekene ezihlukahlukene izifo futhi ekuqaleni abazange zidonse ukunaka kwanoma iningi labantu asebegugile. Phakathi kwabo ngezikhathi avele aphele ikhanda, ukulahlekelwa inkumbulo, ukucasuka, ukuphazamiseka kokulala, tinnitus kanye nezinye izimpawu eziningi. Phakathi nale nkathi, noma yiziphi izinguquko eziphawulekayo isimiso sezinzwa ingekho, kodwa fundus kungabonwa kokuqala ukuvaleka kwemithambo ngwengwzi. Uma nomfutho wegazi ophezulu eba ezimathonsi ke lezi zimpawu ngokuhamba kwesikhathi baba evelele futhi ezicindezelayo. Kulesi sigaba zenzeka iziyaluyalu eziphilayo isimiso sezinzwa esiyinhloko. Inguquko nomfutho wegazi ophakeme okulandelayo, isinyathelo sesithathu isivele ezihlobene ngokuqondile ingozi yokushaywa unhlangothi.
iziguli Stroke nge umfutho wegazi ophakeme emithanjeni
Ezigabeni kamuva lesi sifo, unomfutho wegazi ophakeme kuhambisana ukwephulwa emikhulu we isimiso sezinzwa esiyinhloko. Basuke sahlanganisa crisis sina abanomfutho wegazi ophakeme, lapho iba ngezikhathi njalo, kanye nesenzakalo imivimbo. Chaza kafushane umvimbo kungaba kanje - ke ngokushesha ukuthuthukisa cerebral ukugeleza kwegazi, okuholela izicubu nobuchopho umonakalo okungapholi. Lapho kubhujiswa izicubu ingqondo, umzimba umuntu osekhulile uyeke ukusebenza ngokujwayelekile. izinhlobo ezimbili unhlangothi ababonakali ngezikhundla e kwezokwelapha emhlabeni: oluhambisana futhi ischemic. Oluhambisana unhlangothi libhekene umonakalo ingxenye noma endaweni yonke we nenkinga yokopha ebuchosheni ngenxa letingemasayizi lahlukene. Ngezinye i-stroke ischemic befa amangqamuzana ezinzwa ingxenye cerebral okulandelayo ukumisa liningi igazi kubangelwa ukuvaleka a Umthambo cerebral i-plaque atherosclerotic.

Ngemva kungase ukwaziswa okuningiliziwe izimpawu kanye nemiphumela nomfutho wegazi ophezulu ngokubhuduzela ngokuthi ngokuhamba kwesikhathi, akusiwona nje isifo, kodwa futhi yisimo olukhethekile umzimba, okuyinto kuphakamisa lenqwaba izifo ezimbi nakakhulu futhi zibangele ukufa imbala. Kufinyeta, siyaphinda ukuthi umfutho wegazi ophakeme iba umthombo ingozi isilethikusebenza, angina kanye arrhythmia, iphika sikashukela, esiwohlozayo disc isifo, i-osteoarthritis, isifo periodontal, cholecystitis, kolwelwesi, nesifo ngisho izifo eziningi. Kule ndaba, kusobala ukuthi ekuhlonzweni nomfutho wegazi ophezulu, futhi ukuthatha zonke izinyathelo kungenzeka ukulawula yayo kanye nokwelashwa. imithi yomfutho ophakeme wegazi asebekhulile esiyakuqokwa ngokushesha ngemva kovivinyo. Ukukhethwa izidakamizwa Kwenziwa ikhumbula ezahlukahlukene, kuhlanganise khona izifo concomitant.

Izikhombo: 1. Zhdanov KU prof. Faculty Ukwelashwa State Medical University. Acad. Pavlov, "kwegazi kwasebekhulile"; Umagazini i-Scientific and practical "kwegazi", uMqulu 08 / N 5/2002, M. Ukushicilela indlu: "Abezindaba Medica" 2. Sinkova GM Assoc. Chair tekusebentisa ultrasonic zokuxilonga Irkutsk MCM, "Epidemiology nomfutho wegazi ophezulu"; uju laseSiberia. Journal, 2007, 8, 5-10.3. Emelyanova I. A. "kwegazi. Izinto zesimanje Ngenxa ukwelapha nokuvimbela "M. IG "Zonke", 2008-128 p.4. Shakhtar M. "kwegazi", M. Ukushicilela indlu: "Kwenzeni umkhuba", 2009. 5. Beevers G. "kwegazi", M. Publishing indlu: Binom, 2005