ВОзвращает список болезней. Можно фильтр/искать

search, age, gender, parent, symptoms, sort_name, sort_by, rand, branches
GET /disease/?format=api&ordering=-age_min&page=51
HTTP 200 OK
Allow: GET, HEAD, OPTIONS
Content-Type: application/json
Vary: Accept

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            "name": "Гипертензивная [гипертоническая] болезнь с преимущественным поражением почек",
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            "lead": "Нарушение здоровья, относящееся к группе болезни, характеризующиеся повышенным кровяным давлением",
            "description": "Гипертоническая болезнь (эссенциальная артериальная гипертензия, первичная артериальная гипертензия) – это хроническое заболевание, для которого характерно длительное стойкое повышение артериального давления.",
            "etiology": "<p>Экзогенные факторы риска:  </p>\r\n<ul>\r\n<li>сильное нервное перенапряжение – наиболее частая причина прогрессирования артериальной гипертензии;  </li>\r\n<li>гиподинамия;  </li>\r\n<li>нерациональное питание. Несоблюдение диеты и употребление в большом количестве жирной и жареной пищи;  </li>\r\n<li>чрезмерное употребление алкогольных напитков;  </li>\r\n<li>курение;  </li>\r\n<li>употребление наркотических препаратов.  </li>\r\n</ul>\r\n<p>Эндогенные факторы риска:  </p>\r\n<ul>\r\n<li>отягощённая наследственность;  </li>\r\n<li>ожирение; </li>\r\n<li>атеросклероз венечных сосудов сердца;  </li>\r\n<li>повышенная вязкость крови (сердце не может полноценно перегонять её по сосудам);  </li>\r\n<li>заболевания почек, такие как нефрит, гломерулонефрит, пиелонефрит; </li>\r\n<li>нарушение метаболизма; </li>\r\n<li>наличие эндокринных патологий; </li>\r\n<li>повышенная концентрация кальция в крови; </li>\r\n<li>действие адреналина на сердце во время стрессовых ситуаций; </li>\r\n<li>повышенная концентрация натрия в крови. </li>\r\n</ul>",
            "pathogenesis": "<p>В основе патогенеза гипертонической болезни лежит увеличение объема минутного сердечного выброса и сопротивления периферического сосудистого русла. В ответ на воздействие стрессового фактора возникают нарушения регуляции тонуса периферических сосудов высшими центрами головного мозга (гипоталамусом и продолговатым мозгом). Возникает спазм артериол на периферии, в т. ч. почечных, что вызывает формирование дискинетичесного и дисциркуляторного синдромов. Увеличивается секреция нейрогормонов ренин-ангиотензин-альдостероновой системы. Альдостерон, участвующий в минеральном обмене, вызывает задержку воды и натрия в сосудистом русле, что еще более увеличивает объем циркулирующей в сосудах крови и повышает АД. </p>\r\n<p>При артериальной гипертензии увеличивается вязкость крови, что вызывает снижение скорости кровотока и обменных процессов в тканях. Инертные стенки сосудов утолщаются, их просвет сужается, что фиксирует высокий уровень общего периферического сопротивления сосудов и делает артериальную гипертензию необратимой. В дальнейшем в результате повышения проницаемости и плазматического пропитывания сосудистых стенок происходит развитие элластофиброза и артериолосклероза, что в конечном итоге ведет к вторичным изменениям в тканях органов: склерозу миокарда, гипертонической энцефалопатии, первичному нефроангиосклерозу. </p>\r\n<p>Степень поражения различных органов при гипертонической болезни может быть неодинаковой, поэтому выделяют несколько клинико-анатомических вариантов гипертонии с преимущественным поражением сосудов почек, сердца и мозга. </p>",
            "diagnostics": "<p>Три основных метода диагностики, которые позволяют определить наличие гипертонии у человека, это: </p>\r\n<p>измерение артериального давления, </p>\r\n<p>физикальное обследование, </p>\r\n<p>электрокардиограмма. </p>\r\n<p>Медицинский анамнез </p>\r\n<p>Диагностика гипертонии заключается так же и в опросе больного врачом. Врач выясняет у больного, какими заболеваниями он ранее страдал, или страдает в настоящее время. Проводится оценка факторов риска (курение, повышенный уровень холестерина, сахарный диабет), а также т. н. наследственный анамнез, то есть, страдали ли гипертонией родители, дедушки-бабушки больного и другие близкие родственники. </p>\r\n<p>Физикальное обследование </p>\r\n<p>Физикальное обследование больного включает в себя прежде всего исследование сердца с помощью фонендоскопа. Этот метод позволяет выявить наличие шумов в сердце, изменения характерных тонов (усиление или, наоборот, ослабление), а также появление нехарактерных звуков. Эти данные, прежде всего, говорят об изменениях, происходящих в ткани сердца ввиду повышенного АД, а также о наличии пороков. </p>\r\n<p>Электрокардиограмма (ЭКГ) </p>\r\n<p>Электрокардиограмма (ЭКГ) — это метод, позволяющий регистрировать на специальной ленте изменение электрических потенциалов сердца во времени. Это незаменимый метод диагностики, прежде всего, различных нарушений ритма сердца. Кроме того, ЭКГ позволяет определить т. н. гипертрофию стенки левого желудочка, что характерно для артериальной гипертонии. </p>\r\n<p>Эхокардиография </p>\r\n<p>Кроме указанных методов диагностики, также применяются и другие методы, например, эхокардиография (ультразвуковое исследование сердца), которое позволяет определить наличие дефектов в строении сердца, изменения толщины его стенок и состояние клапанов. </p>\r\n<p>Артериография </p>\r\n<p>Артериография, в том числе аортография — это рентгенологический метод исследования состояния стенок артерий и их просвета. Данный метод позволяет выявить наличие атероматозных бляшек в стенке коронарных артерий (коронарография), наличие коарктации аорты (врожденное сужения аорты на определенном участке) и т. д. </p>\r\n<p>Допплерография </p>\r\n<p>Допплерография — это ультразвуковой метод диагностики состояния кровотока в сосудах, как в артериях, так и в венах. При артериальной гипертензии, прежде всего, врача интересует состояние сонных артерий и мозговых артерий. Для этого широко применяется именно ультразвук, так как он абсолютно безопасен в применении и не характеризуется осложнениями. </p>\r\n<p>Биохимический анализ крови </p>\r\n<p>Биохимический анализ крови также применяется в диагностике гипертонии. Прежде всего выясняется уровень холестерина и липопротеинов высокой, низкой и очень низкой плотности, так как они являются показателем склонности к атеросклерозу. Кроме того, определяется уровень сахара крови. </p>\r\n<p>В диагностике гипертонии также используется исследование состояния почек, для чего применяются такие методы, как общий анализ мочи, биохимический анализ крови (на уровень креатинина и мочевины), а также УЗИ почек и её сосудов. </p>\r\n<p>УЗИ щитовидной железы </p>\r\n<p>УЗИ щитовидной железы и анализ крови на гормоны щитовидной железы. Эти методы исследования помогают выявить роль щитовидной железы в возникновении повышения артериального давления. </p>",
            "treatment": "<p>При лечении гипертонической болезни важно не только снижение АД, но также коррекция и максимально возможное снижение риска осложнений. Полностью излечить гипертоническую болезнь невозможно, но вполне реально остановить ее развитие и уменьшить частоту возникновения кризов. </p>\r\n<p>Гипертоническая болезнь требует объединения усилий пациента и врача для достижения общей цели. При любой стадии гипертонии необходимо: </p>\r\n<ul>\r\n<li>Соблюдать диету с повышенным потреблением калия и магния, ограничением потребления поваренной соли; </li>\r\n<li>Прекратить или резко ограничить прием алкоголя и курение; </li>\r\n<li>Избавиться от лишнего веса; </li>\r\n<li>Повысить физическую активность: полезно заниматься плаванием, лечебной физкультурой, совершать пешеходные прогулки; </li>\r\n<li>Систематически и длительно принимать назначенные препараты под контролем АД и динамическим наблюдением кардиолога. </li>\r\n</ul>\r\n<p>При гипертонической болезни назначают гипотензивные средства, угнетающие вазомоторную активность и тормозящие синтез норадреналина, диуретики, β-адреноблокаторы, дезагреганты, гиполипидемические и гипогликемические, седативные препараты. Подбор медикаментозной терапии осуществляют строго индивидуально с учетом всего спектра факторов риска, уровня АД, наличия сопутствующих заболеваний и поражения органов-мишеней. </p>\r\n<p>При развившейся почечной недостаточности для стимуляции мочевыделения больному назначают диуретики. Для уменьшения спазма почечных сосудов вводят допамин. Определяя объем вводимой жидкости, кроме потерь при мочеиспускании, рвоте и опорожнении кишечника, необходимо учитывать потери при потоотделении и дыхании. Пациента переводят на безбелковую диету, ограничивают поступление калия с пищей. </p>\r\n<p>Гемодиализ проводится при повышении уровня мочевины до 24 ммоль/л, калия – до 7 ммоль/л.  </p>\r\n<p>Критериями эффективности лечения гипертонической болезни является достижение: </p>\r\n<ul>\r\n<li>краткосрочных целей: максимального снижения АД до уровня хорошей переносимости; </li>\r\n<li>среденесрочных целей: предупреждения развития или прогрессирования изменений со стороны органов-мишеней; </li>\r\n<li>долгосрочных целей: профилактика сердечно-сосудистых и др. осложнений и продление жизни пациента. </li>\r\n</ul>",
            "prevention": "<p>Для первичной профилактики гипертонической болезни необходимо исключение имеющихся факторов риска. Полезны умеренные физические нагрузки, низкосолевая и гипохолестериновая диета, психологическая разгрузка, отказ от вредных привычек. Важно раннее выявление гипертонической болезни путем контроля и самоконтроля АД, диспансерный учет пациентов, соблюдение индивидуальной гипотензивной терапии и поддержание оптимальных показателей АД. <br class=\"SCXW138129155\" /> </p>",
            "clinical_picture": "<p>Клиническая картина гипертонической болезни варьирует в зависимости от длительности течения, степени повышения артериального давления, а также органов, вовлеченных в патологический процесс. Гипертоническая болезнь может в течение длительного времени ничем не проявляться клинически. Первые признаки заболевания в таких случаях возникают спустя несколько лет после начала патологического процесса при наличии выраженных изменений в сосудах и органах-мишенях.  </p>\r\n<p>На доклинической стадии развивается транзиторная гипертензия (периодическое временное повышение артериального давления, обычно связанное с какой-либо внешней причиной – эмоциональными потрясениями, резкой переменой погоды, иными заболеваниями). Проявлениями гипертонической болезни являются головные боли, локализующиеся обычно в области затылка, носящие распирающий характер, ощущение тяжести и/или пульсации в голове, а также головокружение, шум в ушах, вялость, быстрая утомляемость, расстройства сна, сердцебиение, тошнота. На данной стадии поражения органов-мишеней не происходит.  </p>\r\n<p>С прогрессированием патологического процесса у пациентов возникает одышка, которая может проявляться при физических нагрузках, беге, ходьбе, подъеме по лестнице. Больные предъявляют жалобы на повышенную потливость, гиперемию кожных покровов лица, онемение пальцев верхних и нижних конечностей, ознобоподобный тремор, продолжительные тупые боли в области сердца, носовые кровотечения. Артериальное давление устойчиво держится на уровне 140–160/90–95 мм рт. ст. В случае задержки жидкости в организме у пациента наблюдается отеки лица и рук, скованность движений. При спазме кровеносных сосудов сетчатки глаз могут появляться вспышки перед глазами, пелена, мелькание мушек, снижается острота зрения (в тяжелых случаях – вплоть до полной его потери при кровоизлиянии в сетчатку). На данной стадии заболевания у пациента проявляется микроальбуминурия, протеинурия, гипертрофия левого желудочка, ангиопатия сетчатки глаза.  </p>\r\n<p>Как на первой, так и на второй стадии заболевания возможно возникновение неосложненных кризов.  </p>\r\n<p> </p>\r\n<p>При прогрессировании гипертонической болезни происходит поражение почек. На начальных стадиях заболевания нарушения обратимы. Однако в отсутствие адекватного лечения протеинурия (потеря белка с мочой) нарастают, в моче повышается количество эритроцитов, нарушается азотовыделительная функция почек, развивается почечная недостаточность. При этом снижается выработка мочи (олигурия), нарушается водно-солевой обмен (в организме повышается уровень калия - снижение ЧСС, мышечная слабость, парезы; снижается уровень кальция и магния). Появляются неврологические нарушения - отмечается сонливость, спутанность сознания, дезориентация, заторможенность, чередующаяся с периодами возбуждения. Периферическая нейропатия чаще возникает у пожилых пациентов. </p>\r\n<p>При почечной недоствточности может развиться застойная сердечная недостаточность, аритмия, перикардит (воспаление околосердечной сумки). </p>\r\n<p>Больных беспокоит ощущение дискомфорта в брюшной полости, тошнота, рвота, потеря аппетита. В тяжелых случаях развивается уремический гастроэнтероколит, часто осложняющийся кровотечениями. </p>",
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}