Qhov tseem ceeb ntawm cov hlab ntsha ntshav siab yog ib hom kab mob ntev. Morphological hloov nyob rau hauv keeb kwm yav dhau ntawm tus kab mob yog txawv, nws tag nrho cov nyob ntawm qhov xwm ntawm nws tshwm sim. Tom ntej no, xav txog dab tsi yog qhov tseem ceeb ntawm kev kub siab ntawm txhua qib ntawm qhov hnyav.
cov ntaub ntawv dav dav
Lub ntsiab lus kho mob ntawm cov kab mob pathology yog qhov nce siab ntxiv hauv cov ntshav. Kev kuaj mob yog ua raws li kev cais tawm ntawm txhua hom kab mob. Qhov tseem ceeb kub siab yog kho los ntawm lub sijhawm ntawm kev txo qis hauv kev nyuaj siab rau lub raum ua haujlwm. Ua ntej tshaj plaws, kev hloov morphological txuas mus rau lub plawv thiab cov hlab ntsha.
xaiv ib txwm
Nyob rau hauv lub xeev noj qab haus huv, lub siab yog tsim tawm tsam keeb kwm ntawm contraction nyob rau hauv sab laug ventricle. Hauv qhov no, cov ntshav ntws tawm mus rau hauv aorta, thiab tom qab ntawd mus rau cov hlab ntsha me. Cov qib siab yog teem raws li cov ntshav ntim hauv cov hlab ntsha, qhov ntsuas ntawm qhov nro ntawm cov phab ntsa ntawm cov hlab ntsha. Lub suab ntawm cov hlab ntsha (cov kab me me) kuj tseem ceeb. Ntshav siab yog qhov nce hauv cov hlab ntsha ntawm lub voj voog loj ntawm hydrostaticsiab. Feem ntau, cov ntsuas tuaj yeem hloov pauv raws li lub xeev ntawm tus neeg. Yog li, thaum pw tsaug zog, lawv txo qis, thiab thaum muaj kev puas siab puas ntsws lossis lub cev kev ntxhov siab lawv nce. Txawm li cas los xij, raws li txoj cai, lub siab rov qab mus rau qhov qub - los ntawm 100/60 txog 140/90. Yog tias qhov ntsuas siab siab tshaj qhov tau muab, ces cov ntshav siab tau hais. Qhov ua rau muaj kev kub ntxhov tseem ceeb muaj ntau yam.
Risk factors
Qhov tseem ceeb kub siab yog suav tias yog hom mob ntshav siab tshaj plaws, tab sis nws tsis tuaj yeem txheeb xyuas qhov ua rau muaj qhov tshwm sim. Txawm li cas los xij, hauv cov neeg mob uas raug kev txom nyem los ntawm pathology, qee qhov kev sib raug zoo yog pom. Piv txwv li, qhov tseem ceeb kub siab tshwm sim tsuas yog nyob rau hauv cov pab pawg uas cov qib ntsev kom ntau tshaj 5.8 g / hnub. Cov kws tshaj lij tau sau tseg tias qhov tseeb, qhov kev noj ntau dhau tuaj yeem dhau los ua qhov pheej hmoo tseem ceeb. Tshwj xeeb tshaj yog predisposed rau txoj kev loj hlob ntawm kub siab yog cov neeg laus, cov neeg uas muaj lub raum insufficiency, thiab rog. Tseem muaj ib yam kab mob caj ces.
Ua ntej tshaj plaws, thaum kuaj mob, keeb kwm kho mob tseem ceeb. Ntshav siab tseem ceeb feem ntau nrog ntshav qab zib mellitus. Lub pancreas muaj cov cell ntawm cov islets ntawm Langerhans. Lawv tsim cov tshuaj hormone insulin. Nws tswj cov concentration ntawm qabzib, txhawb nws txoj kev hloov mus rau hauv cov txheej txheem. Tib lub sijhawm, insulin kuj muaj qee qhov vasodilating nyhuv. Feem ntau, cov tshuaj hormones muaj peev xwm ua kom lub siab xavkev ua si. Hauv qhov no, ntshav siab tsis hloov. Tab sis nyob rau hauv cov xwm txheej hnyav, xws li ntshav qab zib mellitus, kev ua siab ntev stimulatory yuav override vasodilating nyhuv.
Genetic factor
Cov kws tshaj lij suav tias nws yog ib qho tseem ceeb hauv kev txhim kho pathology. Txawm li cas los xij, cov noob muaj lub luag haujlwm rau cov tsos mob ntshav siab tsis tau pom. Niaj hnub no, cov kws tshawb fawb tab tom ua haujlwm los kawm txog yam uas cuam tshuam rau renin-angiotensive system. Nws muaj kev koom tes nyob rau hauv lub synthesis ntawm ib tug biologically active compound - renin - uas pab mus rau ib tug nce nyob rau hauv siab. Qhov no system yog nyob rau hauv lub raum. Qhov tseem ceeb kub siab nyob rau hauv kwv yees li 30% ntawm cov neeg mob yog tshwm sim los ntawm caj ces yam. Piv txwv li, qhov tshwm sim muaj ntau dua hauv African Asmeskas dua li cov neeg European lossis Asians. Tsis tas li ntawd, cov neeg uas muaj ib tug los yog ob leeg niam txiv raug kev txom nyem los ntawm kub siab yog feem ntau ua rau txoj kev loj hlob ntawm pathology. Muaj tsawg zaus, qhov tseem ceeb ntawm kev kub siab yog qhov tshwm sim ntawm kev mob caj ces hauv cov qog adrenal.
Pathologies ntawm nkoj
Ntau tus neeg mob ntshav siab muaj qhov ua haujlwm siab (tso elasticity) ntawm cov hlab ntsha. Cov hlab ntsha no ua capillaries. Thaum elasticity ploj lawm, siab pib nce. Yog vim li cas rau qhov kev ua txhaum ntawm cov hlab ntsha yog tsis meej kiag li. Txawm li cas los xij, nws tau raug tsim los tias qhov txo qis hauv vascular elasticity yog cov yam ntxwv ntawm cov neeg mob ntshav siab vim yog cov caj ces, kev laus, kev noj ntsev ntau dhau, thiab lub cev tsis ua haujlwm. qee lub luag haujlwm hauvTxoj kev loj hlob ntawm pathology kuj belongs rau cov txheej txheem inflammatory. Hauv qhov no, kev tshawb pom ntawm C-reactive protein compound nyob rau hauv cov ntshav tuaj yeem ua raws li qhov tshwm sim.
Kev rog
Qhov no yog lwm qhov tseem ceeb ntawm qhov tshwm sim ntawm qhov tseem ceeb kub siab. Nrog rau lub cev hnyav, qhov tshwm sim ntawm pathology yog 5 npaug ntau dua. Piv txwv li, hauv Teb Chaws Asmeskas, kwv yees li ob feem peb ntawm tag nrho cov mob ntshav siab yog txuam nrog kev rog. Ntau tshaj 85% ntawm cov neeg mob muaj qhov ntsuas huab hwm coj ntau dua 25.
Sodium
Cov tshuaj no kuj tseem ceeb hauv kev txhim kho ntshav siab. Kwv yees li ib feem peb ntawm tag nrho cov mob ntshav siab yog txuam nrog kev noj ntau dhau ntawm sodium hauv lub cev. Txoj kev loj hlob ntawm tus kab mob yog nyob ntawm qhov muaj peev xwm ntawm qhov sib xyaw kom khaws dej. Nrog rau cov kua dej ntau dhau hauv cov hlab ntsha, lub siab nce.
Renin
Cov txiaj ntsig ntawm cov tshuaj lom neeg lom neeg no cuam tshuam nrog kev nce hauv vascular tone. Qhov no ua rau muaj kev nce siab. Ntshav siab tuaj yeem ua nrog ob qho tib si qis thiab siab renin qib. Piv txwv li, qhov txo qis ntawm qhov sib xyaw yog qhov zoo rau cov neeg Asmeskas Asmeskas. Hauv qhov no, cov tshuaj diuretics suav hais tias muaj txiaj ntsig zoo hauv kev kho.
Lwm yam
Nws tau raug tsim los tias snoring muaj txiaj ntsig zoo rau kev txhim kho ntshav siab. Hnub nyoog yog suav tias yog ib qho kev sib haum xeeb thiab tseem ceeb ua rau muaj kev cuam tshuam. Nyob rau hauv xyoo tas los, qhov nce ntawm cov collagen fibers tau pom nyob rau hauv cov phab ntsa vascular. Vim li nomuaj lawv cov thickening thiab poob ntawm elasticity, txo qis hauv lumen.
daim duab kho mob
Yuav ua li cas ntshav siab tseem ceeb tshwm sim nws tus kheej? Cov tsos mob ntawm pathology feem ntau tsis tuaj. Tau ntev, tsuas yog nce siab ua raws li qhov tshwj xeeb tshwm sim. Muaj tus nqi ciam teb, raws li qhov kev kuaj mob tau tsim. Yog li, rau lub siab "siab" (systolic), qhov no yog 140-159 mm Hg. Art., rau diastolic - 90-94. Qee zaum, qhov tseem ceeb ntawm kev kub siab tseem ceeb yog nrog:
- Tshuaj taub hau nraub qaum.
- lub plawv dhia nrawm.
- ob vision.
- Tinnitus.
Qhov kev siv ntawm cov tsos mob no nce nrog kev nce siab hauv siab (hypertensive ntsoog). Nyob rau tib lub sijhawm, kev hloov pauv pib hauv cov hlab ntsha thiab hauv cov kab mob hauv nruab nrog cev ntawm qhov tsis tuaj yeem hloov pauv. Lub hom phiaj yog lub plawv, lub raum, lub hlwb.
theem ntawm pathology
Nrog rau chav kawm me me, tus mob yog tus cwj pwm los ntawm kev nce siab hauv lub sijhawm (diastolic - ntau dua 95). Hauv qhov no, kev ruaj khov ntawm tus mob yog ua tau yam tsis muaj kev siv tshuaj. Qhov nruab nrab qhov hnyav ntawm pathology yog tus cwj pwm los ntawm kev nce siab hauv siab (diastolic - hauv 105-114). Nyob rau theem no, kev nthuav dav ntawm venules, nqaim ntawm arterioles, hemorrhages ntawm fundus yam tsis muaj lwm yam kab mob tuaj yeem kuaj pom. Cov theem hnyav yog tus cwj pwm los ntawm kev nce siab hauv siab (diastolic - ntau dua 115). Stabilizationlub xeev tsis tshwm sim txawm tias tom qab kev kub ntxhov. Nyob rau theem no, kev hloov pauv hauv fundus tau hais ntau dua. Cov mob no kuj nrog kev loj hlob ntawm arteriolo- thiab arteriosclerosis, sab laug ventricular hypertrophy, cardiosclerosis. Pathological hloov nyob rau hauv lub cev sab hauv kuj pom.
Kev sib tw
Hypertension tuaj yeem nrog:
- mob ntshav qab zib nephropathy.
- Angina.
- Heart attack.
- Revascularization ntawm coronary arteries.
- Kev ntxhov siab nyob rau hauv cerebral ncig.
- Hemorrhagic thiab ischemic strokes.
- o ntawm lub paj hlwb.
- Hemorrhage los yog exudate.
- YSevere retinopathy.
- Dissecting aneurysm.
- Lub raum thiab lub plawv tsis ua haujlwm.
Diagnosis
Nws yog raws li kev ntsuas ntawm cov ntsuas ntsuas siab. Txhawm rau kom paub meej qhov kev kuaj mob, tsawg kawg yog peb qhov kev ntsuas ywj pheej yuav tsum tau ua. Nyob rau hauv cov ntaub ntawv no, ib tug mercury tonometer thiab Korotkov txoj kev yog siv. Kev kuaj mob ntawm cov ntaub ntawv thib ob ntawm pathology thiab kev txiav txim siab ntawm qib kev puas tsuaj ntawm lub cev yog ua los ntawm kev tshawb fawb ntxiv. Tshwj xeeb, tus neeg mob tau muab tshuaj tshwj xeeb thiab kev kuaj ntshav thiab kuaj ntshav, ultrasound ntawm lub cev thiab lub plawv, ntau yam kev kuaj, ECG, thiab ntau dua.
saib xyuas txhua hnub
Thaum siv txoj kev tshawb fawb no, lub tshuab tonometer tsis siv neeg muab tso rau ntawm tus neeg mob, kho cov ntshav siab thaum nruab hnub. Lub sijhawm nruab nrab ntawm kev ntsuas, asFeem ntau 30-60 feeb thaum nruab hnub thiab 60-120 feeb thaum hmo ntuj. Yog li ntawd, ob peb lub kaum tawm tau txais. Raws li cov ntaub ntawv, koj tuaj yeem txiav txim siab qhov nruab nrab siab ib hnub, hmo ntuj, hnub. Ntxiv nrog rau cov ntsuas ncaj qha, koj tuaj yeem tau txais cov ntaub ntawv qhia ncaj qha qhia tias muaj ntshav siab. Cov ntaub ntawv no yog muab los ntawm kev ntsuas tus nqi nce thiab txo qhov siab ntawm lub sijhawm sib txawv ntawm hnub.
Kev kho mob ntshav siab tseem ceeb
Muaj ntau txoj hauv kev los txhim kho lub xeev. Kev xaiv yuav nyob ntawm seb qhov xwm txheej ntawm pathology. Yog li, qhov tseem ceeb thiab renovascular hypertension muaj qhov sib txawv ntawm qhov hnyav ntawm qhov tshwm sim. Ua ntej tshaj plaws, kev ntsuas kev kho mob yuav tsum yog txhawm rau txhawm rau kom ruaj khov. Nyob rau tib lub sijhawm, txhua yam kev pheej hmoo yuav tsum raug kho. Tus neeg mob yuav tsum tso tseg kev haus luam yeeb thiab lwm yam cwj pwm phem, tshuaj xyuas kev noj haus, thiab ua kom qhov hnyav. Rau cov neeg mob uas tau kuaj pom tias muaj qhov tseem ceeb ntawm cov hlab ntshav siab, kev kho mob yuav tsum tau ua kom tshem tawm cov kab mob sib kis: ntshav qab zib mellitus thiab lwm yam. Kev saib xyuas tshwj xeeb yuav tsum tau them rau kev ua lub cev, ua kom tsaug zog thiab pw tsaug zog. Hauv cov ntawv qhia zaub mov, cov ntsev thiab cov tsiaj rog yuav tsum tau txo. Nyob rau tib lub sijhawm, cov zaub mov cog, khoom noj siv mis, nplej, txiv hmab txiv ntoo thiab zaub yuav tsum muaj nyob rau hauv cov khoom noj. Ua ke nrog cov khoom no, microelements thiab lwm cov khoom sib txuas, cov vitamins yuav nkag mus rau hauv lub cev.
Tshuaj kho mob
Ntawm noNws yuav tsum tau muab sau tseg tias qhov tseem ceeb kub siab yog heev yooj yim mus tshem tawm. Niaj hnub no nyob rau hauv Russia, xya chav kawm ntawm cov tshuaj tau pom zoo. Renovascular hypertension (secondary) yog qhov nyuaj rau kev tshem tawm. Hauv qhov no, kev kho mob yog tsom rau kev sib ntaus sib tua hauv qab pathology. Ntawm cov tshuaj tau sau tseg rau tus kab mob, cov hauv qab no yog qhov txawv:
- YDiuretics (diuretics). Lawv pab tshem tawm cov kua ntau dhau ntawm lub cev. Cov no suav nrog cov txhais tau tias "Furosemide", "Hypothiazid" thiab lwm yam.
- Beta thiab adrenoblockers. Cov tom kawg yog siv rau concomitant pathologies. Beta-blockers muaj xws li Nadolol, Acebutolol.
- Calcium antagonists. Nrog rau qhov no, kev noj cov magnesium ntxiv uas yog ib feem ntawm kev noj haus kuj tuaj yeem suav tias yog kev noj cov calcium antagonist.
- ACE inhibitors.
- Imidozaline receptor agonists.
- Angiotensin receptor antagonists (Losartan).
Kev xaiv tshuaj yog ua los ntawm kws kho mob.
