Zhou Fangyuan obeyed his grandfather's arrangement, called his father and mother together, and the third aunt of his father's fourth grandfather's family also left together.

The third aunt was crying and crying, and among the dozen or so people present, she cried fiercely. Also, her father's cerebral infarction, as a daughter, it is normal to be sad, but it is rare to cry like her, and both eyes are about to become eye bubbles.

In fact, if you want to say cerebral infarction, including myocardial infarction, it is actually like the current situation of the fourth grandfather, and even the future situation of Zhou Fangyuan's distant grandfather, which cannot be regarded as serious.

Let's talk about some simple cases that have a close relationship with Zhou Fangyuan.

First of all, his grandfather, his own grandfather, originally had a cerebral infarction, he went out to exercise every morning, thunder could not move, wind and rain did not stop, and he went to the park near his home to play Tai Chi a few times every day, but after a few years in his previous life, he suddenly got up one day, felt dizzy, couldn't stand, dizzy, nauseous, couldn't even take a step, and the whole person felt bad in an instant. Then the family hurriedly sent the old man to the nearest three hospitals in Beitong City, as a local tertiary general hospital, the strength of the three hospitals is quite good.

Went for a check-up, cerebral infarction!

Come on, be hospitalized, take medicine, all kinds of thrombolytic drugs, drugs to unblock blood vessels, but you can focus on it.

The cerebral infarction can be regarded as dealing with the past, but not long after, the old man had another heart attack and went to the hospital again, this time it was more painful, and he made a stent directly. Zhou Fangyuan didn't know much about this, and at first he thought it was terrifying, and Zhou Fangyuan was even worried that the old man's chest would be cut. But later I found out that there was so much trouble, so I made a small word directly on my wrist, and then sent the stent into the blood vessel.

To put it bluntly, it's a very small operation.

And in terms of prognosis, whether it is a myocardial infarction or a cerebral infarction, Zhou Fangyuan's grandfather is also doing very well, the old man should eat and drink, but he is slightly more controlled than before, such as high-calorie and high-fat, he doesn't dare to eat, and the others are basically unchanged. If you want to say that it has the most impact on the old man's body, it may still be high blood pressure. High blood pressure is the real culprit affecting the health of the elderly.

Hypertension generally refers to a clinical syndrome characterized by increased blood pressure in the systemic arteries, which can be accompanied by functional or organic damage to the heart, brain, kidneys and other organs.

Hypertension is the most common chronic disease and the most important risk factor for cardiovascular and cerebrovascular diseases. The blood pressure of a normal person fluctuates within a certain range with changes in the internal and external environment. In the overall population, blood pressure levels gradually increase with age, with systolic blood pressure being more pronounced, but diastolic blood pressure decreases after the age of 50 years, and pulse pressure also increases. In recent years, people have deepened the understanding of the role of multiple risk factors for cardiovascular disease and the protection of target organs of the heart, brain and kidney, and the diagnostic criteria for hypertension have been constantly adjusted.

The assessment of blood pressure value and risk factors is the main basis for diagnosing and formulating hypertension treatment plan, and the goals of hypertension management are different for different patients. In addition to lifestyle modifications, 24-hour long-acting antihypertensive drugs are recommended to control blood pressure. In addition to assessing office blood pressure, patients should also pay attention to home early morning blood pressure monitoring and management to control blood pressure and reduce the incidence of cardiovascular and cerebrovascular events.

The symptoms of hypertension also vary from person to person.

In the early stage, there may be no symptoms or symptoms are not obvious, and the common ones are dizziness, headache, neck tightness, fatigue, palpitations, etc. An increase in blood pressure occurs only after exertion, stress, and mood swings, and returns to normal after rest. As the course of the disease prolongs, blood pressure continues to rise significantly, and various symptoms gradually appear. This is called slow-progressive hypertension. Common clinical symptoms of slow-progressive hypertension include headache, dizziness, difficulty concentrating, memory loss, limb numbness, increased nocturia, palpitations, chest tightness, and fatigue. The symptoms of hypertension are related to the blood pressure level, most of the symptoms can be aggravated after tension or exertion, and the blood pressure can rise rapidly after morning activities, and early morning hypertension occurs, resulting in cardiovascular and cerebrovascular events mostly occurring in the early morning.

When the blood pressure suddenly rises to a certain extent, there will even be severe headache, vomiting, palpitations, dizziness and other symptoms, and in severe cases, confusion and convulsions will occur, which belongs to rapidly progressive hypertension and hypertensive critical illness, and serious damage and lesions of the heart, brain, kidney and other organs will occur in a short period of time, such as stroke, myocardial infarction, kidney failure, etc. There is no consistent relationship between symptoms and the level of elevated blood pressure.

The clinical manifestations of secondary hypertension are mainly related to the symptoms and signs of the underlying disease, and hypertension is only one of its symptoms. Elevated blood pressure in patients with secondary hypertension can have their own characteristics, such as high blood pressure due to coarctation of the aorta that is limited to the upper extremities, and epichromocytoma that is paroxysmal in blood pressure, so this is beyond the scope of today's discussion.

There were other sick people around Zhou Fangyuan, such as his second uncle, his second uncle, who suddenly suffered a heart attack in the days before he was about to be reborn in his previous life. Also, I felt a little uncomfortable at first, and then at that time, Zhou Fangyuan's grandmother did stent surgery first, and when the second uncle went to take care of his grandmother, he checked it by the way. Zhou Fangyuan didn't know how the follow-up maintenance would be, because he had been reborn. However, considering my grandfather's many years of experience in heart attack and cerebral infarction, I don't think there will be any problem.

In other words, it is a simple myocardial infarction or cerebral infarction, which is very simple to maintain and not difficult to maintain. The difficulty lies in all kinds of other complications, especially in the elderly, which is even more troublesome.

And if you want to talk about diseases with serious complications, you have to talk about diabetes.

Zhou Fangyuan's grandmother's sister, that is, Zhou Fangyuan's aunt, has been a diabetic for many years.

Diabetes mellitus is a group of metabolic diseases characterized by high blood sugar. Hyperglycemia is caused by a defect in insulin secretion, impaired biological action, or both. The long-standing hyperglycemia in diabetes leads to chronic damage and dysfunction of various tissues, especially the eyes, kidneys, heart, blood vessels, and nerves.

There are two types of diabetes, but there is significant genetic heterogeneity in both type 1 and type 2 diabetes. There is a tendency for diabetes to run in families, and 1/4~1/2 of patients have a family history of diabetes. Clinically, there are at least 60 or more genetic syndromes that can be accompanied by diabetes. There are multiple DNA loci involved in the pathogenesis of type 1 diabetes, among which the DQ polymorphism in the HLA antigen gene is the most closely related. A variety of definite genetic mutations have been found in type 2 diabetes, such as insulin gene, insulin receptor gene, glucokinase gene, mitochondrial gene, etc.

Obesity due to overeating and reduced physical activity is the most important environmental factor in type 2 diabetes, making individuals with a genetic predisposition to type 2 diabetes. People with type 1 diabetes have abnormalities in the immune system that cause an autoimmune response that destroys insulin β cells after infection with certain viruses such as coxsackievirus, rubella virus, mumps virus, etc.

Diabetes itself is not terrible, and of course it cannot be said that it is not terrible at all, which is a bit excessive.

In a word, the human body has a fixed range of sugar, that is, how much is up, how much is down. For ordinary people, for example, if you eat more stuff at this meal, your blood sugar will definitely rise at this time. So the insulin in the body is dispatched and begins to break down these sugars until the sugar enters a safe period, correspondingly, if the sugar is low, the body also has a way to control the blood sugar in the appropriate area.

And once a person has diabetes, the threshold up and down is equivalent to disappearing. At this time, if you eat again, the blood sugar will fluctuate up and down, and it will no longer be so easy to control. Generally, diabetics take injections before eating, the purpose is to control blood sugar and prevent it from rising, but then again, even if it rises, it doesn't matter in a short time. As long as the blood sugar is not at a high level for a long time, it does not induce ketones. On the contrary, low blood sugar can indeed kill people sometimes.

If the blood sugar drops suddenly, it is easy to induce shock coma and other phenomena, which may further cause organ failure, etc., in short, if you have diabetes, if you don't consider the complications, the biggest trouble is that the valve up and down the blood sugar disappears, especially the level of low blood sugar, because the valve is gone, so if the blood sugar is lower, it is also easy to lower, and then it may lead to sudden death, which is really terrifying.

As for complications, there are really a lot of them.

Zhou Fangyuan has seen a lot of it before, for example, if a diabetic accidentally injured his arm or leg, if it is an ordinary person, the wound may recover after two or three days, even if it is a major wound, at most there is a week and ten days. Diabetics are different, even if it is just a small wound of one centimeter, it will always be slow to recover. Why? Quite simply, because sugar is high. The bacteria enter the wound, and the bacteria grow rapidly by devouring the sugar in the blood, so that the white blood cells in the body can not kill them in a short time, and then the two sides begin to compete with each other, and the exposed wound will usher in more bacteria, more and more bacteria, and gradually the body's own immune system can no longer suppress it, and as a result, the wound continues to expand and become inflamed...... Zhou Fang had never seen anyone who had his leg amputated because of this, but he heard that there were.

For example, diabetic nephropathy is also a major complication of diabetes, and it is a very serious condition.

Diabetic nephropathy is one of the systemic microangiopathic comorbidities of diabetes, so diabetic nephropathy is often combined with microangiopathy of other organs or systems, such as diabetic retinopathy and peripheral neuropathy. The onset of diabetic nephropathy in patients with type 1 diabetes is mostly about 10~15 years, while the time for diabetic nephropathy in patients with type 2 diabetes is shorter, which is related to older age and more other underlying diseases.

According to the course and pathophysiological evolution of diabetic nephropathy, diabetic nephropathy can be divided into the following five stages:

Stage 1, glomerular hyperfiltration and renal hypertrophy. This initial change is consistent with high blood glucose levels, which can be partially relieved by glycemic control. There were no histopathological lesions in this period.

The second stage is the normal albuminuria phase. GFR is higher than normal. The pathological manifestations of the kidney are thickening of GBM, increased stroma in the mesangial zone, and an increase in urine albumin excretion rate (>20 μg/min) after exercise, which returns to normal after rest. If the blood sugar is well controlled during this period, the patient can be stable in this stage for a long time.

The third stage, the early diabetic nephropathy stage, is also known as the "persistent microalbuminuria phase". GFR begins to decline to normal. Renal pathology presents with glomerular nodular lesions and vitreous changes of arterioles. UAE continues to increase to 20~200 μg/min, resulting in microalbuminuria. In this period, the patient's blood pressure is elevated. Treatment with ACE inhibitors or ARBs can reduce urine albumin excretion and delay the progression of kidney disease.

The fourth stage, the stage of clinical diabetic nephropathy. Pathologically typical K-W nodules appear. Persistent massive albuminuria or proteinuria greater than 500 mg/day develops nephrotic syndrome in about 30% of patients, and GFR continues to decline. This phase is characterized by a decrease in protein in the urine that does not decrease with a decrease in GFR. Once the patient enters stage 4, the disease tends to progress, and if not actively controlled, GFR will decrease by an average of 1 ml/min per month.

Finally, stage 5, end-stage renal failure. GFR<10ml/min。 The amount of protein in the urine is reduced due to glomerulosclerosis. The symptoms of uremia are obvious, and dialysis treatment is required, and to this extent, the person's kidney can be declared finished.

Of course, the above stages are mainly based on type 1 diabetic nephropathy, and type 2 diabetic nephropathy is not obvious.

Proteinuria is closely associated with the progression of diabetic nephropathy. Microalbuminuria indicates not only glomerular filtration barrier disorder, but also systemic vascular endothelial dysfunction and has been found to be strongly associated with cardiovascular complications.

Nephrotic syndrome in diabetic nephropathy is often more pronounced in edema than in primary glomerular disease, and is often associated with severe hypertension. Due to the high intraglomerular capillary transmembrane pressure and the severe impairment of the glomerular membrane protein barrier function, some patients with end-stage renal failure may also have a large amount of proteinuria.

In short, it is still the same sentence, diabetes is not terrible, but the complications are serious.

The same is true for myocardial infarction and cerebral infarction, follow-up maintenance is not difficult, and the lesion itself is not the kind of disease that can kill people immediately, but I am afraid of complications, and the effect of follow-up maintenance, if the maintenance is good, there are no complications, that is naturally the best. Otherwise, as long as one of these two sides is not done well, the result will probably be difficult for people to bear.

......

The car drove into the villa, and as soon as it was stable, my aunt came over and picked up the third aunt.

"Grandpa is in the study, let you come back and go over. ”

My aunt said, and obviously said it to Zhou Fangyuan.

"Good. ”

Zhou Fangyuan nodded, closed the car door, and went upstairs directly. His parents stayed on the first floor, together with his aunt, to appease the third aunt.

Zhou Fangyuan, on his side, went up to the second floor, pushed open the door of the study, and entered it, and then greeted him with a word from his grandfather.

"I want to take your fourth grandfather over and live with me. ”