Wolumikizira oopsa mu akazi

Wolumikizira oopsa mu akazi

vs Tchistov

Choyamba MGMU IM Sechenov

Wolumikizira oopsa ndi lero - mmodzi wa matenda ambiri: matenda a "wolumikizira
oopsa "tikumva lero za munthu akuluakulu khumi.
Matendawa akhoza mwakachetechete kwa zaka zambiri kuwononga mitsempha ya magazi ndi mtima, pakalibe woyenera
chithandizo yake, adzatsogolera matenda a mtima, angina, mtima minofu kufooka, mtima
kulephera, sitiroko, khungu, impso kulephera ... Pamndandanda uwu tingathenso kupita pa nthawi yaitali kwambiri.
Mwamwayi, lero pali kwambiri mwayi osati kuchepetsa kuthamanga kwa magazi, komanso
kukhala kwa nthawi yaitali pa mlingo akadakwanitsira - inu muyenera mayesowo mu nthawi
ndi kuti azindikire matenda.
M'pofunika kudziwa: lero, aliyense chakhumi wamkulu munthu ali kuthamanga kwa magazi, koma
Theka la anthu akudziwa za vuto. Ndipo ngakhale anthu ochepa amene amalandira mankhwalawa: ena
Odwala saona chithandizo bwino, ena sindikudziwa za kukhalako kwa makono
kwambiri ogwira ndi bwino analekerera mankhwala kutsitsa magazi. Nthawiyi, chiritsani
oopsa n'kofunika - ngakhale matenda ndi asymptomatic, lingachititse kuti kwambiri
mavuto. Musati pachiswe thanzi lawo ndi moyo wawo.
Zotsatira za matenda oopsa mwa akazi
Wakutali kuthamanga magazi (ie, matenda oopsa popanda zifukwa concomitant chiopsezo) mu
70% milandu amatsogolera kusisita mu akazi. Yerekezerani anthu oopsa popanda chiopsezo concomitant Mfundo malekezero
sitiroko okha 30% ya milandu.
Mphamvu ya mankhwala antihypertensive amuna ndi akazi mofanana. Komabe, ndi zaka, mphamvu ya
antihypertensive mankhwala mu akazi yafupika, amene amayamba ndi peculiarities wa kusintha kwa thupi (za kuti m'munsimu).
Pakali pano, matenda oopsa mavuto zatenga malo oyamba, ngati tikukamba za imfa ya azimayi
anthu. Mtengo wa kuthamanga systolic magazi akazi ndi wachiwiri zofunika kwambiri chiopsezo Chinthu
ya matenda a mitima (CHD).
Ischemic matenda a mtima ndi matenda oopsa mwa akazi
A mayi munthuyo si wa pulayimale ndi sekondale makhalidwe kugonana, koma kusiyana komanso amalembedwa mu
mahomoni, majini, moyo - zonse izi, ndithudi, zikupezeka mu njira ya matenda osiyanasiyana, chitetezo ndi
mphamvu ya mankhwala.
Kwa zaka zambiri ankakhulupirira kuti ngozi ya matenda a mitima mwa akazi kwambiri poyerekeza wa
amuna. Ndipotu si, mu amuna ndi akazi, vuto ndinu yemweyo, Komanso pali chizolowezi mu zaposachedwapa
kuchuluka imfa ku matenda a mtima ndi akazi.
Kuti athetse vutoli, muyenera, pa osachepera, kudziwa zinthu zazikulu chiopsezo cha mtima
matenda akazi, komanso kupezeka kwa kufufuza njira chilango awo. Conventionally, zinthu zonse chiopsezo cha mtima
matenda akhoza kugawidwa m'magulu awiri: mndandanda (yeniyeni pansi, mu nkhani iyi kwa
akazi), si yeniyeni (general ndi akazi ndi amuna).
Zinthu zina sanali enieni monga zaka, kuyamba kuonekera kwa zizindikiro za matenda a mtima mu
abale, kusuta, shuga, kunenepa, moyo wongokhala, mkhutu shuga kulolerana,
kuwonjezera okwana mafuta m'thupi, LDL mafuta m'thupi, kutsitsa HDL mafuta m'thupi. * Ngakhale kuti zimenezi si achindunji
mbali ya zochita zawo pa mapangidwe wa kudwala a dongosolo mtima amai ndi abambo, pali kusiyana.
Pankhani makhalidwe enieni, ndiye iwo akhoza zimachitika kuvutika kagayidwe kachakudya woyembekezera,
kusintha kwa thupi, mahomoni kulera, gisterovariektomiyu.
Inatsimikizira kuti akazi ndi kunenepa komanso kugwera mu chiopsezo matenda a mtima: chiopsezo
Chinawonjezeka ndi nthawi 4. Kuti makinawa amagwira nawo ntchito ndondomeko imeneyi si odziwika, koma mgwirizano pakati kunenepa ndi
magazi ndi chimodzimodzi.
Koma moyo, ife asonyeza kuti kupanda zolimbitsa thupi kumawonjezera chiopsezo
zikamera ndi kukula kwa matenda a mtima ndi theka. Kaya kusintha kulemera pa thupi
ntchito zimawonedwa normalization wa magazi. Akukhulupirira kuti zotsatira zabwino
ntchito thupi kugwirizana ndi njira alipo mozungulira ndi mwachindunji zimene zimachititsa kuchepetsa ndi
magazi, m'mnyewa wamtima mpweya kupereka, kuwonjezera, kusonyeza zotsatira opindulitsa pa
magazi clotting zinthu, amathandiza kuti kusintha kwa magazi zamadzimadzi sipekitiramu.
Mwatsoka, mu dziko lathu matenda oopsa mwa akazi ambiri ndipo amapezeka 41,1%.
Wolumikizira oopsa mu akazi a misinkhu yosiyanasiyana
Kwa nthawi yoyamba za kusiyana milingo magazi malinga jenda akhoza kuyankhula mu
zaka zisanu ndi chimodzi. Kukwera kwa BP anamuona pa atsikana zaka zisanu mpaka
kutha msinkhu. Koma pambuyo kutha msinkhu ndi pamaso kusintha mwina otchulidwa kwambiri
mochedwerako magazi akazi. Pambuyo kusintha, kusiyana konse kutha, ndipo
abambo amakumana ndi pachiopsezo chachikulu chotenga mtima matenda, matenda oopsa, poyerekeza ndi
amuna.
Kuchuluka kwa matenda oopsa mwa atsikana si mkulu, koma pambuyo kusintha, chiopsezo
ndi kukhala ukuwonjezeka matenda kwambiri. Koma osati mkazi aliyense ali ndi kuthamanga kwa magazi
Iwo chikugwirizana ndi isanayambike involution kugonana. M'zaka zaposachedwapa, kuchuluka magazi, ndi zolemba
mwa amayi achichepere, kuphatikizapo amayi apakati. Kungawonedwe mu 15-30% ya amayi apakati mu Russia hypertensive syndrome
imbaenda mavuto aakulu, osati mwa Iye yekha pa mimba ndi kubereka mwana, koma ali ndi zoipa
amawamvetsera kuti madokotala ananena zawo yaitali mu akazi. Nthawi zambiri zimachitika kuti oopsa zidzachitika
mimba ... ndipo timakhala ndi mkazi mpaka kalekale.
Oopsa amai ndi kulera m'kamwa
Ntchito ya kulera m'kamwa ndi imodzi mwa ntchito zomwe zikuluzikulu za chitukuko oopsa mu
akazi. Anatsimikizira kuti akazi kumwa mankhwala awa, hypertensive nkhope 2-3
zambiri kuposa akazi amene savomereza ndalama zimenezi. Komanso, m'kamwa wothandizila kulera zosiyanasiyanazi amatha
poyamba anaona kuvutika wolumikizira oopsa. Chiopsezo matenda oopsa pa chikuonetseratu
kulera zosiyanasiyanazi m'kamwa wothandizila ukuwonjezeka mwa akazi zaka zoposa 35, ngati mkazi amasuta, ndi / kapena pamaso pa
kunenepa.
Akufuna limagwirira kuthamanga kwa magazi mu akazi amene zakulera
mankhwala m'kamwa: kuchuluka misa thupi, magazi buku, pali insulin kukana,
ndi sodium amalembedwa akuchedwa thupi.
Normalization wa magazi anati patapita masabata angapo pambuyo pa mapeto a supplementation. koma ngati
mkazi pa maziko a kulera zachitika oopsa, ngati chiopsezo zotsatira
mimba zotheka adzakhala wamkulu kuposa ngozi ya Kukula kwa matenda oopsa, izo tikulimbikitsidwa kupitirizabe kulera ndi
munthawi yomweyo ndi mankhwala antihypertensive.
Kusamala angathe kukhala oopsa umachuluka ngati:
- ndi mbiri oopsa banja - pali kunenepa - pali matenda a impso - mkazi wausinkhu wa zaka zoposa 35 - Mzimayi kulera kwa nthawi yaitali - ngati, nthawi yapitayo kuthamanga mimba magazi anakwezedwa.

Oopsa mu akazi pa kusintha ndi postmenopause
Pa kuwonjezeka magazi pa kusintha zimakhudza zinthu zambiri - kusachezera
zolimbitsa thupi ndi thupi phindu, ndipo inachuluka kumwa mowa ndi mchere.
Pa kusintha kumaonjezera ngozi ya matenda a mtima. Ichi ndi chifukwa kukonzanso kwa
dongosolo endocrine mu nthawi komanso chofunika esitirojeni kaphatikizidwe, kupereka zotsatira opindulitsa pa
cardio mtima dongosolo.
Esitirojeni akusowa kungachititse kuti kuchuluka Mwachangu pressor angiotensin II, kusintha zamadzimadzi
sipekitiramu wa magazi pa maziko a kuchuluka okwana mafuta m'thupi, lipoproteins wa kachulukidwe otsika kwambiri ndi otsika kuchepetsa
kuchuluka kwa lipoproteins mkulu osalimba.
Pakati pa odwala wamng'ono kuposa zaka 40 wa matenda hypertensive, akazi zowawa zochepa zambiri kuposa anthu, koma mu zaka 45-55 zinthu
Iwo kusintha ndi chiwerengero cha akazi akuyamba hypertensive kupambana.
Choncho, chidwi tsopano operekedwa Kufunafuna mankhwala otetezeka komanso zothandiza zochizira
oopsa mu akazi postmenopausal - osati kuchepetsa magazi, komanso
cholinga chilango chamtundu azimayi amsinkhu umenewu amakumana, amene adzadzipereka ndi zina mankhwala timadzi m'malo.
Chithandizo cha matenda oopsa a akazi
Masiku ano, vuto onena ndi kuzindikira ubale oopsa ndi osiyanasiyana matenda ndi cholinga
kukhala mulingo woyenera njira mabuku kuti kupewa ndi kuchiza (Oganov RG, 2007 Anikin SG, 2009; Jakushin SS,
2010).
Koma pafupifupi onse akatswiri amakono amavomereza kuti mankhwala a matenda oopsa
makamaka perekani mankhwala antigipergenzivnuyu.
Kwambiri pa machenjerero a akazi ndi matenda oopsa wapatsidwa chithandizo sanali pharmacological.
Mwachitsanzo, otsika-kalori chakudya kwa akazi ndi kunenepa kungachititse osati kuti kuwonda, komanso
m'munsi magazi, kuwonjezera, zakudya zabwino bwanji mfundo zoopsa monga matenda a shuga,
insulin kukana, m'mnyewa wamtima hypertrophy wa ventricle kumanzere, hyperlipidemia.
Musachepetse ntchito zolimbitsa thupi: wamba kuyenda, kusambira, wokhulupirira pa simulators, achire Zochita
mafizo zotero zingakuthandizeni kuchepetsa zosayembekezereka wa ngozi ya chitukuko oopsa.
Mu kufanana ndi mankhwala si pharmacological ayenera mankhwala mankhwala antihypertensive.
Pamaso yofotokoza mankhwala ambiri ankakonda lero ndi kunena kuti ziyembekezo kwa mphamvu ya
timadzi m'malo mankhwala ndi chingachitike zabwino magazi, sanali wolungama. Komanso,
zina (za 9%) analibe kuchepa ndi kuchuluka magazi pa
timadzi m'malo mankhwala.
Komanso, tisaiwale kuti ngakhale mwachilungamo lonse, osiyanasiyana kusankha mankhwala antihypertensive,
Today mphamvu ya mankhwala a matenda oopsa amakhalabe pa mlingo wotsika ndithu. Komanso, deta,
zomwe zimapezeka mu maphunziro a amuna, akazi basi kusamutsa n'zosatheka (Podzolkov NM, 2009;
Tkachev ON, 2010). Choncho, chofunika kwambiri ndi vuto la mankhwala kusiyanitsidwa wa wolumikizira
oopsa mu akazi, komanso kufufuza zinchito njira si olanda kuti adzasintha madokotala ananena zawo,
khalidwe yaitali mankhwala. Kudzera chitukuko cha aligorivimu ndi adzatha individualize chithandizo
akazi.
Pakali pano, mu wolumikizira oopsa mu akazi anatumizidwa wothandizila aliyense antihypertensive (kwa
palibe contraindications) wa gulu lirilonse mu mawonekedwe a osakaniza kapena nokha. Kuti kumapangitsanso hypotensive
mmene nthawi zotchulidwa hydrochlorothiazide (kalozera-rohlortiazid). Kawirikawiri mankhwalawa matenda oopsa mwa akazi
ntchito okodzetsa: arifon achigonjetse, arifon, cardioselective beta-blockers (lokren (betaxolol), atenolol,
zochepa bisoprolol).
Ngati ife kulankhula za Ace zoletsa, kaŵirikaŵiri ntchito moexipril, nthawizina - fosinopril (monopril).
Ponena kashiamu antagonist mu mawonekedwe a kukonzekera chosunga-amasulidwe dihydropyridine (plendil, Norvasc,
kordafleks achigonjetse), phwando awo zikuoneka, koma tiyenera kukumbukira odwala ena angaoneke edema
pa mapazi awo, kapena iwo akhale yapadera kwambiri.

1. Ageev Ft, Fomin IV, Mareev Y. neri Al. kufala kwa matenda oopsa mu gawo European wa Russian
Federation. Maphunziro amenewa ZAKA, 2003;
2. Shlyakhto EV Belousov YB, Kirichenko AA neri Al. wolumikizira oopsa mu akazi postmenopausal. Cardiology. 2003;
3. Kobalava Railway, Tolkachev vv Moryleva ON mbali matenda ndi mankhwala a matenda oopsa mu akazi.
Mtima. 2004;
4. Kuban Research Medical boma yotchedwa Gazette chipatala ndi zinchito mbali ya chitetezo cha mtima mwa akazi ndi matenda oopsa. 2011;
5. Prokhorovich EA, 2006; Tkachev ON 2010; Oganov RG, 2007; Anikin SG, 2009; Jakushin SS 2010.