Renal kumanikidzwa. Zviratidzo uye kurapwa weboka chirwere

Renal kumanikidzwa, zviratidzo izvo aumba munhu muzvizhinji zvinoita ndiyo chaizvoizvo munhu neBP Kutemeswa renal parenchymal chirwere kana renal midziyo. 30-35% vanhu kutambura kubva neBP vane concomitant cheitsvo, nokuti izvo pane simba uye kuwedzera kumanikidza, nokuti kumanikidzwa uye itsvo kazhinji zvinodyidzana.

Nephrogenic neBP rakakamurwa mhando mbiri: renovascular uye parenchymal uye vose zvinokanganisa renal kumanikidzwa. Zviratidzo izvi zvinogona kuva kujeka chaizvo uye kazhinji vakarasika kuti zvimwe zvirwere. Renovascular neBP hwapedyo nokuda yaitsigira divi kana bilateral stenosis kana occlusion pamusoro renal tsinga uye awo. Renovascular neBP kunogona vawana uye chokuziva hunhu. Parenchymal neBP, kazhinji, kunokonzerwa bilateral chirwere pyelonephritis kana zvimwe zvirwere itsvo, nephrolithiasis kwakadaro (itsvo mabwe), tibhii, bundu pezvakaitwa, cysts, hydronephrosis, polycystic nezvimwe zvirwere zvakawanda.

Paavhareji, renovascular neBP rinowanikwa muna 5-12% vanhu kutambura kubva neBP. Kune akawanda zvikuru vachiberekwa kukonzera renovascular BP, izvo zvinosanganisira: aneurysm, dysplasia nezvimwe pathological anomalies ari renal arteries, arteriovenous fistula. Pakati zvikonzero chaizvo kuti vawana siyana renovascular neBP vari: renal tsinga stenosis sezvo migumisiro atherosclerosis, anochinja renal arteries nokuda mberi Nephroptosis, embolism kana thrombosis pamusoro renal arteries kana awo, panarteriit, compression pamusoro tsinga kunze itsvo (namamota, cysts uye zvakafanana. d.).

Zviratidzo uye kurapwa kuratidzwa renovascular neBP

Renovascular neBP kunoitika pakati mumazera ose asi chinonyanya nevakawanda vanhu pasi makore 50 (93% vose nyaya). Vakawanda maronda ari renal tsinga ndiyo atherosclerotic kuoma dzimwe nhengo dzomuviri. mhando iyi chirwere dzinowanzotsigi- kuwanikwa pakati vanhurume vane makore 35 kusvika 40 okuberekwa. Vakadzi, huru etiological chakaita kukura hosha iri fibromuscular renal tsinga stenosis uye muvanhu vasikana vaduku.

Renal kumanikidzwa, zviratidzo izvo vanoonekwa ne kamwe Pazvinotanga uye nokukurumidza (kazhinji nyanyisa, muna 18-30% nyaya) chokubuda. NeBP achabatsirwa yakakwirira chaizvo kwevari diastolic kumanikidzwa (110-125 mm HG kana kupfuura); Kashoma anogona kukonzera dambudziko. Renovascular neBP rinozivikanwa kakawanda netsaona.

Diagnostics

Kuziva kuvapo renovascular neBP vanofanira kumbotambudzika maitikiro vatatu kudzidza. Danho rokutanga vagara vandifungira kudiwa aortography. Kuti aite izvi, unganidza zvakawanda zvokurapa kare, chiremba kushandiswa dzimwe nzira mukuru. Nhoroondo iri kazhinji kwakaratidzwa kusavapo nhaka yezvakaita chirwere, panowanikwa neBP pashure marwadzo ari lumbar nharaunda. Renal kumanikidzwa, zviratidzo zviri avhiringidzwa, zvakaoma chaizvo kuti uonekwe uye kunoda kurapwa pakarepo kuna chiremba pakutanga zviratidzo.

Danho rechipiri kunosanganisira kuita aortography uye arteriography etsvo uye, kana ukaona chero kuchinja netsvo, ropa rinotorwa kubva renal mutsinga. Ropa amutsvaka nokuti yeplasma renin basa iri rinotevera chirwere danho.

The wokupedzisira pavaipfuura muongororo iri kuedza kusimbisa ukama pakati neBP kubva kuzivikanwa maronda ari renal tsinga. Kuti aratidze izvi kuti maonero dzakashandiswa isotope renografii, eksretornoy urography nokutsvakurudza basa renin. Muna 8-10% wevarwere kukudziridza simba rubatso makopi, izvo compensates nokuti dzichipfekeka vanotaura pamusoro sei itsvo.

mabatiro

Renal kumanikidzwa kurapwa acho mishonga vakakoniwa kunongokonzera zvakakomba matambudziko, kunofanira kugadziriswa pachishandiswa kuvhiya kupindira, iro rinotarisirwa kudzorera ropa aibuda huru renal arteries.