Kupatsanura pakati kufutisa. Zvinokonzera, zviratidzo, chirwere uye Mabatirwo kufutisa

Chimwe matambudziko munzanga remakore maviri rokutanga rava vakafutisa. Maperembudzi "vanopinza" vateveri matsva munyika. Izvi imhaka murombo zvokudya, ndakagara mararamiro, chinokosha nhamba echirwere kwemakemikari anobudiswa pathologies nezvimwewo zvakawanda. Chaizvoizvo kufutisa zvinoreva kuti uremu haisi kwakawedzera nokuda tsandanyama compression, asi tichiregeredza mafuta deposits munzvimbo dzakasiyana-siyana dzomuviri. Ngozi kufutisa? Tarisa vanhu vane kufuta chero chiremba aizotumidza gumi nevaviri zvikonzero, uye pakutanga achava chirwere mwoyo, tsinga, mapfundo mapfupa, kutyorwa mvura-munyu muviri. Mukuwedzera, chirwere zvakaoma evanhu upenyu, sezvo munyika yanhasi iri hunodzorwa nezvemaitiro zvemitambo uye utano hwakanaka.

etiology

The chirwere "kufutisa" anogona kukudziridzwa nokuda kwezvikonzero zvakasiyana-siyana. Chinonyanya pachena ndiko kushaya muviri, saka pane mismatch pakati kuwana macalorie uye tsvina simba. Vanhuwo chikonzero yokufutisa yechipiri kutyora nemudumbu. Izvi zvinogona kuva zvakaipira pancreatic makemikari, ari rutapudzo chiropa, nezvinetso kugaya zvokudya. Uyezve, mukana kufutisa kungava wakakumikidzwa panguva majini chechetere.

Pane zvinoita kuti kufuta, izvi zvinosanganisira:
- kushandiswa sugary zvinwiwa kana kudya ine shuga yakawanda;
- kwemakemikari anobudiswa zvirwere zvakadai hypogonadism, hypothyroidism, rwatata mota;
- mupfungwa zvirwere (kudya zvirwere);
- zvachose mupfungwa uye kushaya hope;
- hormone kana zvinodhaka psychotropic.

Evolution of wakarebesa muna mamiriyoni 2 years akapa mashandiro kuti kuunganidza zvinovaka muviri kana ukamhanya pfupi zvokudya pakarepo. Uye kana kuti ichokwadi kuti vekare vanhu, murume ano hakudi "mumatura" akadaro. Zvisinei, muviri wedu rakagadzirwa nenzira kuti zvaanoita stereotypically sezvo zvakanaka uye pakufurira kubva kunze. Naizvozvo, dambudziko kufutisa parizvino vakamira saizvozvo nehasha.

pathogenesis

Regulation of dhipoziti uye vanounganidzira chakazara mafuta ari kwakaitwa kunzwisisa kusakarongeka pakati tsinga uye kwemakemikari anobudiswa mumasero. The chikuru chinokonzera kuunganidza yakawanda lipids ari mismatch pakati cerebral cortex uye hypothalamus. Zviri kuti hakuna pakati havi murau. The muviri kunoda zvokudya kupfuura simba rakawanda, saka zvose zvakawandisa asara "mu kuchengeterwa", iyo inotungamirira kufuta uye panowanikwa zvakanyanya adipose tishu.

Kwakadaro murombo Kufambisa centre ingava vachiberekwa mamiriro uye kunobva dzidzo. Uyezve, zvinetso zvakadaro dzimwe nguva nokufurirwa kukuvara, kuzvimba, chirwere kwemakemikari anobudiswa zvokurwara.

Kana pituitary shwanu, adrenal cortex uye - masero pancreatic vanotanga kuratidza munhu pathological basa uye uwandu kukura kemikari zvinoderedza hasha, anenge ose mafuta uye shuga, izvo anopinda muviri, vari iiswe nyama uye nhengo dzomuviri. Izvi zvinotungamirira morphological kusagadzikana chiropa, itsvo, thyroid.

kupatsanura BMI

Kupatsanura pakati kufutisa zvakanakisisa kutanga munhu anozivikanwa kuti voruzhinji. Kazhinji, chikuru zvokuongorora chirwere ichi rinoitwa yakavakirwa zviratidzo zvakadai body mass indekisi (BMI). Izvi quotient ukoshi vakawana pashure kupatsanura uremu mu makirogiramu kubudikidza nokukwirira mamita mana akaenzana. Pane zvinotevera gradation kuti kufutisa pamusoro chakarurama ichi:

1. vakawanda dhefisiti - kana BMI idukusa kana kuenzana 18.5.
2. Normal muviri uremu - body mass indekisi vanofanira kuva kuwanda 18.5 25.
3. Pre-vakafutisa - a BMI kubvira 25 kusvika 30 points. Panguva ino, zvakanga anowedzera ngozi co-morbidities akadai BP, bedsores uye mutambo nekumhanyirira.
4. Kufutisa akaisa 1 dhigirii kana BMI iri 30 kusvika 35.
5. Kufutisa giredhi 2 - indekisi iri pedyo 40 points.
6. Kufutisa mugwaro 3 kunokwanisa kuonekwa kana body mass indekisi kupfuura 40 points, apo munhu ane comorbidities.

Etiopatogenetichesky kupatsanura

Zvinotevera kupatsanura pakati kufutisa ndechimwe chezvinhu zvakawanda munzvimbo iyi, sezvo inorangarira zvinokonzera uye zvigadziriswe hosha kukura. Maererano ichi voga nesekondari kufutisa. Mumwe nomumwe wavo ane subclasses ayo.

Saka, chikuru kufutisa rakakamurwa:
- gluteal-femoral;
- abdominal;
- nokuda vachidya zvirwere;
- kushushikana;
- kukonzerwa metabolic syndrome.

Munyaya yechipiri, symptomatic kufutisa vanogona subtypes zvina:

1. Nhaka chakaremara Gene.
2. Cerebral wakatsamwisa namamota, zvirwere kana autoimmune uropi.
3. Kwemakemikari anobudiswa anokonzerwa dysfunction pamusoro thyroid shwanu murau pamusoro hypothalamic-pituitary hurongwa, asi adrenal omumuviri uye gonads.
4. Mishonga chokuita nokutora steroids, hormone nhumbu uye cytostatics.

Clinico-pathogenetic kupatsanura

Kana isu kutora nzira kuti atungamirire kuti chidzoke yokufutisa, zvinokwanisika kuti kupatsanura pakati kufutisa akadai:

- alimentary uye constitutive. Kufuta Rinobatanidzwa ane nekumwisa mafuta ari kudya uye ndakagara. Kunoratidza pacharo, kazhinji pauduku uye vanogona kutaura nhaka kubatwa.
- Hypothalamic. The kuwedzera adipose zvinyama imhaka hypothalamic kukuvadza uye, sezvo zvakaguma kutyorwa ake neuroendocrine chaitika.
- kwemakemikari anobudiswa. Panguva mwoyo mafuta ari zvokurwara of kwemakemikari anobudiswa mumasero - the pituitary, thyroid, adrenal mumasero.
- Iatrogenic. Kufutisa kunokonzerwa zvokurapa kupindira. Izvi zvinogona kuva nemishonga, nhengo kana chikamu nokubviswa zvinokuvadza zviri kwemakemikari anobudiswa wemuTesitamende yawapiwa uye zvakawanda.

Kupatsanura kubudikidza localization pamusoro adipose tishu

Pashure Kuongorora varwere kufutisa akanga aona kuti kwete yose iri kuparadzirwa zvakafanana. Saka, nokufamba kwenguva, rakachengetedzwa akatunhidzwa kufutisa kupatsanura kwakavakirwa maitiro nzvimbo mafuta muviri.

Mhando wokutanga, aizivikanwawo rokumusoro, aka Android, inozivikanwa pakuti runonyanya kunowedzera rokumusoro hafu muviri, chiso, mutsipa uye maoko. It kunoitika kakawanda nevanhu, asi inogona kuoneka vakadzi vanenge vapinda kubereka. A zvinoverengeka vanyori anoti pane kubatana pakati kwakadai kufutisa uye ngozi dzichiri nechirwere cheshuga uyewo zvirwere kumwoyo.

Mhando yechipiri, pasi kana gynoid ndiyo dzakaunganidzwa mafuta rinenge riri pazvidya uye magaro, uye ndiye anonyanya yakaisvonaka hafu vanhu. Mufananidzo vakadzi anotora chimiro "peya". Uyewo anogona kuva vaduku, kana kuwedzerwa pakaputsika kwagara kudya. Comorbidities iyi nyaya richava zvokurwara kuti musana, mapfundo migumo nechepazasi vascular network.

The mhando wechitatu - chakakanyiwa kana zvenguva kufutisa. Panyaya iyi, uremu zvakawanda kana zvishoma zvakaenzana richiparadzirwa kuburikidza muviri rimire mutsetse muchiuno, mutsipa, magaro.

Kuti kusarudza unova mhando kufutisa inonzi murwere, zvinokosha kuona nhamba yacho sekamufarenzi ari muchiuno uye muhudyu. Kana vakadzi mufananidzo uyu mukuru 0,85, uye varume kupfuura mumwe, zvinogona nharo kuti munhu wokutanga shanduro kuparadzirwa adipose tishu.

morphological kupatsanura

Nepo kufutisa kuchinja sei nhanho dzose sangano muupenyu, kwete chete seboka, asi mumwe nhengo, nyama uye kunyange masero. Adipocytes (mafuta masero), anogona rakagara Qualitative kana quantitative chinja. Zvichienderana kusunungurwa ichi:

1. Hypertrophic kufutisa. Zvinonzi ichazivikanwa noku zvemamiriro kuwedzera kukura masero mafuta, apo nhamba yavo inoramba zvakafanana.
2. Hyperplastic kufutisa, umo adipocytes vari kushingaira kukamuka. chimiro ichi kunoitika muvana uye ikarapwa zvikuru, saka sei kuderedza uwandu masero kunogona zvikuru hasha nzira.
3. Mixed kufutisa sezvo musoro kufunga musanganiswa maviri yapfuura vaya. Ndiko, masero zvisina chete kuwedzera, asi ivo vari kuramba.

The kupatsanura pakati kufutisa muvana

Maererano nenhamba, muRussia kune vanenge 12% yevana kutambura kufuta. Izvi, 8.5% kubva mumadhorobha vagari uye 3.5% - okumaruwa. Kufutisa muvana uye kuyaruka akava kakawanda pathologies kuti pediatricians vakasarudza yokusuma chikamu chinokosha mubasa yakwo nevabereki vaduku pamusoro zvokudya. Kufutisa kuonekwa ezvinhu apo uremu hwomwana kukasapfuura 15% isati nezera rake. Kana correlated pamwe BMI, kukosha kwayo uchava pedyo 30 points.

Kusiyanisa mhando mbiri kufutisa pakati pavana: nesekondari. Primary akaita, sezvinoita mutemo, kushaya zvokudya zvinovaka muviri, mangwanani kukwezva kana kuramba kubva pazamu mukaka kuti mhou. Asi unogona kuva nhaka, kana mhuri iri hunodzorwa vanhu vari kufuta. Asi kunyange iyi, mwana haana kuzvarwa hobvu, chete nayo seiyi muviri wako, uye kudya kwakakodzera uye muviri, izvozvo achachengeta uremu hwako mukati kwomuzvarirwo mwero. Critical nokuti chikuru kufutisa ndivo matatu makore oupenyu uye kuyaruka wokutanga.

Secondary kufutisa Rinobatanidzwa ne kuvapo vawana kwemakemikari anobudiswa zvirwere. Nzira dzekuziva iyo vakatsunga mwero yakatarwa yokufutisa dzichiri debatable. Zvinotevera pamwero wakati dzichitaurwa:
- 1 dhigirii - uremu kupfuura 15-25% kubva zvafanotaurwa;
- 2nd Danho - kubva 25 kusvika 49% uremu;
- 3 dhigirii - mukanyiwa mukuru pamusoro 50-99%;
- Grade 4 - ndakafuta zviviri kana kakawanda kupfuura zera muganhu.

zviratidzo

Zviratidzo kufutisa anoreva zvakafanana nepedyo, musiyano chete muna kufanana ari kuparadzirwa zvakanyanya faibha, uye pamberi padivi pathologies kana dzavo vasipo.

Most rinowanzoberekera Varwere alimentary kufutisa, kuti chokuita kutyora hwandaiva kudya. Kazhinji, vanhu vakadaro vane majini kubatwa kuti kufuta, uye kunyanya kunwa zvokudya zvinoisa kufuta. Zviratidzo kuitika mune zvose dzemhuri, sezvo ivo pamwe kutora zvokudya. Uyezve, uku kwakadai kufutisa chembere asingatani vanotungamirira ndakagara mararamiro nemhaka utano hwavo murombo.

Kufutisa 1 dhigirii kuchengetwa vanhu vakawanda vanogara zvakaitika, kunyanya manheru. Izvi zvinoitika nokuti mangwanani uye kwemasikati havana nguva uye chido. Hungry vanhu pamabiko uchapedza macalorie nezuva uye kurara.

Hypothalamic kufutisa kunoratidzwa uremu kwete chete, asiwo pamberi zviratidzo kusagadzikana tsinga uye kwemakemikari anobudiswa murau. Kufutisa ichikura nokukurumidza uye kazhinji haana chokuita nokuchinja zvokudya. Fat anooneka runonyanya pamberi pechiso mudumbu, dzakatendereka uye magaro. Zvingakonzera trophic kuchinja: ganda rakaoma, tatamuka mavanga, bvudzi kurasikirwa. Varwere ava vanotsutsumwa hope, nomusoro uye dzungu. Wetsinga anogona kazhinji kuziva abnormalities mumunda mavo.

Diagnostics

Vanhu vane kufutisa vane ipfupi chaizvo kutsoropodzwa urwere hwake, saka kunyengetedza kana kuvamanikidza kuenda chiremba kunyange kwenguva nyore kubvunza - zvisinei nyore. It ndeimwewo - varwere endocrinologist kana wetsinga. Ivo pachavo Vanoda aedzwe uye kuderedza uremu kuti kunokurumidza kupora.

The anowanzodanwa kushandiswa yokuona nayo nechirwere kufuta - munhu BMI kuti kufutisa. Ndiko kuti chaiko uremu pamusoro wakaramba. Kuti tizive kwokuomerwa kunokosha kwete chete kuratidza kuvapo yokufutisa, asiwo chokwadi kuti chinozoiswa tichiregeredza adipose rinenge uye kwete kwetsandanyama. Saka, muna okurapa vari kushingaira kuedza kusuma nzira kuziva mafuta guru pane zvachose muviri uremu.

Norma atsunga yakavakirwa Statistical Data unganidzwa navanachiremba-siyana unyanzvi mumakore kudzidzira. Nokuti mumwe bonde, zera, uye dova muviri pane matafura kare ngaaverenge tsika uye dzemunharaunda ose zvokurwara. Masayendisiti akawana kuti centenarians uremu 10% shoma pane dzose. Kukuvadzwa kufutisa chirwere vakomana nyaya, kana 10% zvakayerwa kwapfuura yokumusoro panogumira bvumidzwa.

Pane Masvomhu akawanda kuverenga yakanaka muviri uremu. Mumwe wavo azive zvose pavasikana - kubva kukura kudiwa kutora zana masendimita. The zvichiguma nhamba ndiyo achida ukoshi. Asi hazvina zvimiso zvikuru uye kuvimbika kudzidza. More yakarurama ndiye BMI kana Quetelet indekisi, izvo zvakaratidzwa kupfuura. Kuyera sekamufarenzi pakati muchiuno uye hudyu, zvakare, zviri zvikuru muna characterization kuti kufutisa, sezvo nzvimbo yacho mafuta anoenderana mhaka, iro riri kukonzerwa kufuta.

mabatiro

Pakurwisa kufutisa kuva noruvengo uye kwose kwose. Zvino vezvenhau vari kushingaira akatsigira mararamiro utano uye kunamatwa akanaka, mitambo muviri. Chokwadi, kuunza mamiriro ezvinhu kuti upenzi kufanira, asi mukuru mirayiridzo voujaya sangano Zvinosarudzwa pamusoro dekadansnaya Yitonia.

Mirayiridzo inokosha Mabatirwo kufutisa dzinosanganisira:
- zvokudya zvakawanda makabhohaidhiretsi kunzwisisa uye faibha, mavhitaminzi, nzungu uye miriwo. Iva nechokwadi kuti dzisanyanya kubika, zvihwitsi uye fizzy zvinwiwa.
- muviri, izvo zvinofanira kusimbisa muviri uye rikurumidze muviri.
- mishonga kuderedza uremu uye havi;
- psychotherapy;
- kuvhiya kurapwa.

Kuti vabudirire-refu migumisiro ipi mhando kurapwa, unofanira kuchinja zvaunodya uye kakawanda kudya. Zvinofungidzirwa kuti kudya maturo pakurwisa kufutisa, asi ivo kubatsira kusimbisa zviri kubudirira uremu uye kudzivirira zvirwere kudzoka. The World Health Organization rinokurudzira kuti kuverenga caloric zviri zvokudya kuti murwere anoshandisa chaiye rudzi, uye zvishoma nezvishoma kuderedza uwandu macalorie. Zvakakodzera asvike chiratidzo 1500 - 1200 kcal, akapa kuti munhu asingadi Unozviremedzerei panyama.

Psychotherapy nechinangwa kusimbisa kutsunga kuzvidzora pachinhu zvokudya yaunodya uye kuvimba zvokudya uye sugary pasoda. Nemishonga nedanho uremu rutapudzo inobatsira kuita chete renguva pfupi. Pashure discontinuation of piritsi, murwere anodzoka kuna kare mararamiro, uye asingaunganidzi zvinoenderana kunenge vakagamuchira pa buditsa. Pasinei chokwadi kuti zvino neindasitiri inogadzira mishonga kuti ape guru pakusarudza pakurapa kufuta, zvinenge vose wairambidza nokuda nemishonga.

To zvomusejari nzira dzinosanganisira suturing mudumbu, rakakurumbira sixties remakore rapfuura. Musimboti anoita kuti muviri huviri dzisakarurama kumativi, uye kuti muduku sutured zvidiki ura. Saka gastric vhoriyamu ipfupi, uye mwero ndima zvokudya kunova yepamusorosoro. The nzira yechipiri - gastric banding. The cardiac divi akatasva mhete kuti nhete kuti lumen pakati yegurokuro uye zvokudya anobata rakagadzirwa nevanhu chipingamupinyi, kunetsa saturation centre, vachibvumira murwere kudya zvishoma.

Kworudzii kufutisa ndiyo ngozi? Zvichida vose. Hapana anogona kutaura kuti pfuma zvinobatsira vanhu. The kwokuomerwa pamwero zvinoenderana sei chaiwo kurema kwazvo ndozvakajairwa, uye chero comorbidities zvaanazvo.