Kusanthula kwa IRI

Kufufuza insulin yogwira insulin kumachitika kuti mudziwe mtundu wa kapangidwe ka timadzi ta pancreatic. Dongosolo lalifupi la kusanthula kumeneku ndi Iran. Kusanthula kumeneku kumachitika kokha kwa anthu omwe satenga ndipo osaba jakisoni panthawi ino. Izi ziyenera kuonedwa, chifukwa chakuti kuchuluka kwa mahomoni m'magazi kumapangitsa kuti ma antibodies apangidwe ndipo izi zimatha kukhudza zotsatira za kafukufukuyu.

ZOFUNIKA KUDZIWA! Ngakhale odwala matenda ashuga kwambiri amatha kuchiritsidwa kunyumba, popanda opaleshoni kapena zipatala. Ingowerenga zomwe Marina Vladimirovna akunena. werengani zonena zake.

Kodi ndi mahomoni amtundu wanji?

Insulin imapangidwa kuchokera ku proinsulin ndipo imapangidwa m'maselo a kapamba. Kutulutsidwa kwake kumayamba chifukwa cha kuchuluka kwa shuga m'magazi a anthu. Mahomoni amatenga nawo gawo mu kagayidwe ka chakudya. Ndi chithandizo chake, kuchuluka kwa shuga mthupi kumayendetsedwa ndi njira yoyambitsa kuyambitsa komwe kumamuchotsa kudzera mu impso. Cholinga chachikulu cha insulin ndikupereka minofu ndi adipose minofu. Ma mahomoni amawongolera kuchuluka kwa glycogen m'chiwindi komanso amathandizira kunyamula amino acid kudutsa membrane wa cell. Ndipo zimatenganso gawo posinthanitsa ndi mamolekyulu a protein ndi mafuta acids.

Shuga amachepetsedwa nthawi yomweyo! Matenda a shuga m'kupita kwa nthawi angayambitse matenda ambiri, monga mavuto amawonedwe, khungu ndi tsitsi, zilonda zam'mimba, zilonda zam'mimba komanso matenda otupa! Anthu amaphunzitsa zinzake zowawa kuti azisintha shuga. werengani.

Ngati kuphwanya kumachitika mu kapangidwe ka timadzi tambiri, timene timayambitsa thupi la munthu zomwe zimapangitsa kuti magwiridwe antchito ndi ziwalo zonse ziwonongeke.

Norm ndi zimayambitsa kupatuka kwa insulin

Zizindikiro zimawoneka ngati zabwinobwino ngati kuchuluka kwa insulin m'magazi kumayambira 6 mpaka 25 mcU / ml, malinga ngati mayesowo atengedwa pamimba yopanda kanthu. Mlingo wowonjezereka ukhoza kukhala mwa amayi oyembekezera - mpaka 27 mkU / ml. Mwa anthu opitilira zaka 60, muyezo umatha kufikira 35 μU / ml. Mwa ana osakwana zaka 12, kuchuluka kwa insulin m'madzi a m'magazi sikuyenera kupitirira 10 mcU / ml. Kutsika kwa kuchuluka kwa mahomoni kumawonedwa ndi ma pathologies monga mtundu 1 komanso matenda ashuga 2, matenda a Hirat, ndi autoimmune insulin syndrome. Ndi 1 degree ya matenda ashuga, chizindikiro chimafikira zero. Mu milandu yomwe insulin imakwezedwa, kupatuka kotere kumachitika:

Zizindikiro zakusanthula

Kuwunika kuchuluka kwa insulini m'madzi a m'magazi kungathandize kuzindikira zizindikiro zoyambirira za matenda oopsa. Ngati zodetsa nkhawa zomwe zimachitika m'thupi laumoyo zimawonedwa m'thupi la munthu, muyenera kufunsa dokotala kuti akonzekere mayeso. Zizindikiro zomwe ziyenera kuchenjeza munthu:

Ngati munthu waona kuti watopa msanga, muyenera kukayezetsa.

kusintha kwa thupi, kwinaku mukudya zakudya zomwezo komanso kuchita masewera olimbitsa thupi,
kufooka ndi kutopa,
kuchiritsa kwapang'onopang'ono kwa kuvulala pang'ono kwa khungu,
matenda oopsa
kukhalapo kwa mapuloteni mumkodzo.

Bweretsani ku zomwe zalembedwa

Kukonzekera

Kuti muchititse kafukufuku moyenera pa kuchuluka kwa insulin, ndikofunikira kutsatira malamulo ena pakusunga zinthu. Loyamba la izi ndikupewa chakudya kwa maola 12 musanapereke magazi kuti apimidwe. Chachiwiri, muyenera kusiya kumwa mankhwala omwe ali ndi corticosteroids, mahomoni a chithokomiro komanso njira zakulera za mahomoni. Ngati mankhwala osokoneza bongo sangathe, ndiye kuti muyenera kudziwitsa adotolo kapena ogwira ntchito aku labotale za izi. Lamulo lachitatu silikuwonetsa kuti thupi liyenera kuchita masewera olimbitsa thupi kwa mphindi 30 isanakwane mayeso.

Kodi kusanthula kumachitika bwanji?

Kuti mudziwe kuchuluka kwa insulini, muyenera kusakaniza mamililita angapo a magazi a venous, omwe amasonkhanitsidwa mu chubu choyesera ndi anticoagulant, ndiye kuti, ali ndi chinthu chomwe chimalepheretsa magazi kuundana. Kenako woimbayo adakola mu kusamba kwa ayezi. Pambuyo pake, magaziwo amagawidwa m'magawo awiri ndikukhazikika mpaka madigiri 40. Madzi a m'magazi atasiyanitsidwa, amasungidwa mpaka 200 g. Celsius. Kenako zotsatira zake zimayerekezedwa pamakina oyesera. M'malo ena olemba, kuti mupeze zotsatira zolondola, amalimbikitsa kupititsa phunziroli maulendo awiri ndi maola awiri. Kuti muchite izi, mutatha kusonkhanitsa magazi 1, imwani yankho la glucose ndipo, pakapita kanthawi, bwerezani kusanthula.

Ntchito ya insulin

Kuti mumvetsetse kuti insulin ndiyofunika bwanji pakugwira bwino ntchito kwa thupi, ndikofunikira kumvetsetsa zomwe imagwira:

Amatulutsa shuga m'maselo onse amthupi, amaonetsetsa kuti mayamwidwe ake komanso kugwiritsa ntchito zinthu za metabolic,
Amayang'anira kuchuluka kwa glycogen m'maselo a chiwindi, omwe, ngati ndi kotheka, amasinthidwa kukhala glucose ndikukhathamiritsa thupi ndi mphamvu,
Imathandizira kuyamwa kwa mapuloteni ndi mafuta,
Amawonjezera kupezeka kwa ma membrane am'mimba a glucose ndi amino acid.

Chifukwa chake, ndikusowa kwa insulin mthupi la munthu, kugwira ntchito kwa pafupifupi ziwalo zamkati ndi machitidwe zimasokonekera. Izi zimapangitsa matenda ashuga kukhala oopsa kwambiri, omwe amadziwika ndi zovuta zingapo.

Kupeza cholinga

Kuyesa kwa magazi a insulin komwe kumayikidwa ndi endocrinologist pazolinga zotsatirazi:

Kuzindikira matenda a shuga ndi mtundu wake,
Kuzindikira kwa insulinoma (chotupa cha kapamba amene amakhudza chinsinsi cha insulin)
Matanthauzidwe a hypoglycemia wochita chifukwa cha kugwiritsa ntchito jakisoni wa insulin kapena mankhwala osokoneza bongo a hypoglycemic.

Pa kusanthula, plasma imagwiritsidwa ntchito.

Zotsatira za kusanthula

Nthawi zambiri, zomwe zili mu insulin yogwiritsira ntchito m'madzi am'magazi ziyenera kukhala kuyambira 6 mpaka 24 mIU / L. Nthawi zina chizindikiro chovomerezeka cha IRI chingakhale chosiyana ngati njira zosagwiritsa ntchito masiku onse poyesera wodwalayo. Ndikofunikanso kuti chiwerengero cha insulin chikhale ndi glucose, chomwe sichikhala choposa 0.3.

Kusanthula kumeneku kumakupatsani mwayi wodziwikiratu wodwalayo omwe magwiritsidwe ake a mayeso a glucose ali pamalire a chizolowezi. Mkhalidwe wotere, monga lamulo, umawonetsa kukula kwa wodwala yemwe ali ndi matenda osokoneza bongo kapena matenda ena a kapamba.

Chifukwa chake, ngati insulin yomwe ili m'magazi a m'magazi ndi yotsika kwambiri poyerekeza ndi zomwe zimakhazikitsidwa, ndiye kuti izi zikuwonetsa kuphwanya kwakukulu kwa chinsinsi cha timadzi timeneti ndi kupezeka kwa matenda a shuga 1 a wodwala.

Mtundu wachiwiri wa matenda osokoneza bongo a mellitus, kuchuluka kwa insulin nthawi zambiri kumakwezedwa, zomwe zimawonetsa kugwira ntchito kwapancreatic komanso kukula kwa minofu kukana kwa insulin.

Mwa anthu omwe ali ndi vuto la kunenepa kwambiri, kuchuluka kwa insulini kumatha kukhala kokwera kawiri kuposa kwawonso. Potere, kuti ziletsetse zomwe zili mu IRI m'madzi am'magazi, ndikokwanira kutaya mapaundi owonjezera kenako kutsatira zakudya.

Momwe wodwala angapezeke ndi insulin yambiri:

Insulinoma
Matenda a 2 a shuga (osadalira insulini),
Matenda a chiwindi
Acromegaly
Cushing's Syndrome
Myotonic dystrophy,
Kusalolerana kobadwa nako kwa fructose ndi galactose,
Kunenepa kwambiri.

Mulingo wochepa wa insulini ndi wofanana ndi matenda otsatirawa:

Mtundu woyamba wa shuga (wodalira insulin),
Hypopituitarism.

Zolakwika

Monga mtundu wina uliwonse wa matenda, kuwunika kwa insulini yogwiritsira ntchito insulin sikupereka zotsatira zolondola nthawi zonse. Zinthu zotsatirazi zingakhudze kuyesedwa kwa mayeso:

Kuchulukitsa kwa matenda omwe wodwala akudwala posachedwa kusanthula,
Kuunika kwa X-ray
Kuyika kwa njira zina zolimbitsa thupi.

Komanso, mawonekedwe a zakudya za wodwalayo atha kukhala ndi zotsatira zabwino pazotsatira za kusanthula. Kuti azindikire kuchuluka kwa insulini kuti ikhale yolondola kwambiri, kutatsala masiku ochepa kuti lisanthedwe, wodwalayo ayenera kusiyiratu mbale zonse zazonunkhira ndi mafuta pazakudya zake.

Kudya kosayenera kumatha kudzutsa insulin ndi glucose, yomwe idzajambulidwe pakuwunika. Komabe, zotere sizingalole kuunika kwa wodwalayo, chifukwa adayamba chifukwa chakunja ndipo sakhala munthu.

Ndikofunikanso kudziwa kuti ndikofunikira kuzindikira ngati zili ndi IRI posachedwa, ndikuwonekera kwa zisonyezo zoyambirira za kupunduka kwa kapamba. Izi zipangitsa kuti wodwalayo azindikire moyenera matenda oyambilira, omwe ndi ofunikira kwambiri ku matenda a shuga.

Kumbukirani kuti popanda chithandizo chokwanira, matendawa amabweretsa mavuto. Njira yokhayo yopeweretsera zovuta ndikuzindikira matendawa mwachangu ndikuyamba kulimbana nawo mwachangu, ndipo chifukwa cha izi muyenera kudziwa kuti ndi chiyani .. Kanema yemwe ali munkhaniyi akuwonetsa zazikulu za insulin.

Kodi insulin yogwira ntchito ndi chiyani

Timadzi timene timayendetsa machitidwe a metabolic mthupi la munthu. Insulin ndiye mahomoni okhawo m'thupi amene amatsitsa shuga.

Nthawi zina pamakhala kuchepa kwa insulin yomwe imapangidwa.

Chifukwa cha izi, matenda osokoneza bongo amayamba. Kuti adziwe kuchuluka kwake komanso kuchuluka kwa mahomoni, madokotala amayesa insulin (IRI).

Chifukwa chakuti shuga yotsogola imatsogolera pakukula kwa matenda akulu, muyenera kupita kukaonana ndi dokotala komanso kukayezetsa. Izi ndizowona makamaka kwa anthu omwe amatengera matendawa.

Kuchita kafukufukuyu kumatsimikizira kupezeka kwa matenda a shuga komanso kuwulula mtundu wake. Kuwunikiranso kumathandizanso kuzindikira chotupa cha pancreatic ndi zina zomwe zimayambitsidwa chifukwa chogwiritsa ntchito molakwika mankhwala a matendawa.

Kafukufukuyu ndi motere. Kuyesedwa kwa magazi kumachitika chifukwa cha anthu omwe akuganiza kuti ali ndi matenda ashuga. Kenako, wogwira ntchito zamankhwala amafufuza madzi am'magazi ndikupeza zotsatirazi.

Kusanthula

Dokotala amafotokozera wodwalayo kuti kupereka magazi kuyeza matenda ashuga ndi njira yovomerezeka. Mukamachita izi, insulin imalowetsedwa m'thupi, ndiye kuti magazi amatengedwa kuchokera mumtsempha. Zimatenga magazi mobwerezabwereza. Izi ndizofunikira pazotsatira zolondola. Dokotala amatenga magazi kuchokera mu mtsempha kangapo pafupipafupi kwa maola awiri.

Kuyesererako kumachitika m'njira ziwiri:

Chikalakala. Kuyesa kumachitika mu vitro.
Invivo. Kuyesera kumachitika ndimaselo amoyo.

Atamaliza njirayi, wodwalayo amayembekeza zotsatira kuti apeze chithandizo china.

Kulemba zotsatira

Monga zimadziwika kale, magawo a mahomoni a IRIV m'magazi amatha kusintha chifukwa cha chakudya chomwe munthu amadya. Pachifukwa ichi, muyenera kuyang'anira zomwe muyenera kudya masiku angapo phunzirolo lisanachitike.

Chizindikiro cha mahomoni kwa munthu wamkulu ndi 1.9 - 23 μm / ml.
Chikhalidwe kwa mwana ndi 2 - 20 μm / ml.

Insulin yogwira insulin sichidzapereka zotsatira zoyenera mwa odwala omwe apangidwapo.

Magazi amatengedwa m'mawa pamimba yopanda kanthu. Ngati mumayenera kumwa mankhwala aliwonse musanapereke magazi, muyenera kuchenjeza dokotala. Ngati ndi kotheka, amasamutsanso njirayo nthawi ina. Sizoletsedwa kutafuna chingamu, ngakhale mawonekedwe ake alibe shuga.

Kupatuka kuzololedwa

Kutsitsa kwa mahomoni amayamba chifukwa cha izi:

kupsinjika
kuchuluka kwa thupi
kusowa kwa chakudya chamagulu
kutopa kwamanjenje
matenda a hypothalamic.

Kuchuluka kwa insulin IRI kumawonetsera izi:

shuga wosadalira insulin,
matenda a chiwindi
kupezeka kwa chotupa (insulinoma), chokhoza kupanga payekha mahomoni.
kuchepa kwa mphamvu ya ma cell kuzindikiritsa timadzi kumaonekera chifukwa cha kunenepa kwambiri,
matenda omwe amayambitsa kupanga mahomoni ambiri (acromegaly),
chibadwire.

Madokotala ndi odwala nthawi zambiri amakumana ndi zotsatira zolakwika za mayeso.

Izi ndichifukwa choti zinthu zambiri zimasonkhezera njirayi. Kuphatikiza poti simungadye maswiti amafuta ndi zakumwa musanapendeketsedwe, odwala amalangizidwa kusiya zonse zogwiritsidwa ntchito ndi zinthu zotere. Ngakhale chakudya chamafuta chinadyedwa masiku angapo chakudya chisanayambe.

Mwa makanda, chizindikiritso sichidutsa muyeso, apo ayi izi zikusonyeza kukhalapo kwa matenda ashuga. Achinyamata amadziwika ndi kusintha kwa mahomoni m'magazi. Kudumpha kumeneku kumachitika chifukwa cha mtundu wa chakudya.

Komanso, zotsatira za kupotoza zotsatira ndi X-ray kapena masewera olimbitsa thupi mopitirira muyeso.

Kuchuluka kwa insulin IRI kumawonetsera izi:

shuga wosadalira insulin,
matenda a chiwindi
kupezeka kwa chotupa (insulinoma), chokhoza kupanga payekha mahomoni.
kuchepa kwa mphamvu ya ma cell kuzindikiritsa timadzi kumaonekera chifukwa cha kunenepa kwambiri,
matenda omwe amayambitsa kupanga mahomoni ambiri (acromegaly),
chibadwire.

Madokotala ndi odwala nthawi zambiri amakumana ndi zotsatira zolakwika za mayeso.

Komanso, zotsatira za kupotoza zotsatira ndi X-ray kapena masewera olimbitsa thupi mopitirira muyeso.

Ngati munthu wadwala matenda amtundu woyamba, nthawi zambiri amawona kuchepa kwake. Hormoniyo sikokwanira kuthana ndi kuchuluka kwa shuga komwe kwalowa mthupi. Pankhaniyi, shuga sasintha kukhala mafuta oyera, koma amayikidwa mu mafuta. Kuphatikiza apo, munthu payekha amatha kukhala ndi matenda mwa iye yekha. Katundu wambiri komanso zakudya zopanda thanzi zimathandizira izi.

Homoni akapezekanso m'thupi kuposa momwe limakhalira, izi zimasonyeza kukula kwa matenda ashuga amtundu wa 2. Njira ya pathological imathandizira kukulitsa kunenepa kwambiri, pakati kapena matenda a chiwindi.

Akalandira zotsatira zabodza, dokotalayo adzayesedwanso. Ngati wodwala wazindikira zizindikiro za matenda ashuga, ayenera kupita nthawi yomweyo kukadwala matenda a endocrinologist. Amachita mayeso ndikuyesa mayeso onse ofunikira. Pozindikira matendawa mosakayikira, mwayi woti munthu achire msanga ndiwofunika.

Kuti mupewe matenda oyipa ngati amenewa, muyenera kusintha kwambiri moyo wanu. Choyamba muyenera kukonza chakudya, kuchotsa zakudya zoyipa, kuwonjezera zamasamba ndi zipatso. Ngati onenepa kwambiri, chitani masewera ndikukhazikitsa thupi lanu. Awa ndi malamulo awiri akuluakulu omwe angathandize kupewa matenda ashuga. Ngati matendawa alipo kale, dokotala yemwe akupezekapo angakuuzeni momwe mungasinthire zodandaula zanu.

Kusanthula kwa insulin kosafunikira: tebulo labwino

Kuwerenga kwa insulin yogwiritsira ntchito insulin kumapangitsa kuti kumveketsa bwino kwa kupanga kwa insulin kwa insulini mwa odwala omwe salandila insulin kukonzekera ndipo sanachite izi kale, chifukwa ma antibodies adzayamba kupangidwa kukhala chinthu chachilendo m'thupi la wodwalayo, chomwe chitha kupotoza zotsatira zoyesa zenizeni.

Zolemba za IRI posala kudya magazi a anthu zimawonedwa ngati zabwinobwino ngati zikuchokera pa 6 mpaka 24 mIU / L (chizindikiro ichi chidzasiyana kutengera mtundu woyesera womwe wagwiritsa ntchito). Kuwerengera kwa insulin kwa shuga pamlingo wokhala m'munsi mwa 40 mg / dl (insulin imayesedwa mkED / ml, ndi shuga mu mg / dl) ochepera 0.25. Pa mulingo wa glucose wochepera 2.22 mmol / L, wochepera 4.5 (insulin imafotokozedwa mIU / L, shuga mu mol / L).

Kutsimikiza kwa mahomoni ndikofunikira kuti apangidwe molondola a shuga mellitus mwa odwala omwe zikuwonetsa kuyesedwa kwa glucose mayeso. Ndi matenda a shuga a mtundu woyamba, insulin idzatsitsidwa, ndipo lachiwiri lidzakhala lodziwika bwino kapena kuchuluka. Mulingo wambiri wa insulin yogwira ntchito udzadziwika ndi mavuto awa:

acromegaly
Itsenko-Cushing's syndrome,
insulinoma.

Zowonjezera komanso zowonjezera

Kuchulukitsa kawiri kwa chizolowezi kudzadziwika chifukwa cha kunenepa kwambiri. Ngati chiŵerengero cha insulini ku shuga wamagazi ndi ochepera 0,25, padzakhala zofunika kuti munthu akaganize za insulinoma.

Kukhazikitsa kuchuluka kwa kuzungulira kwa insulini ndichizindikiro chofunikira pakuphunzira pathophysiology yamafuta ndi carbohydrate metabolism. Malinga ndi momwe matendawa akuonekera, kuchuluka kwa insulin kumatha kuchita mbali yayikulu pakuwonetsa matenda a hypoglycemia. Izi ndizofunikira kwambiri ngati hypoglycemia imayamba nthawi yapakati.

Zomwe zimapezeka insulini ndizokhazikika m'madzi a m'magazi a anthu kuposa seramu yake. Izi zitha kufotokozedwa ndikugwiritsa ntchito anticoagulants. Ndi chifukwa ichi kuti kutsimikiza kwa insulin yogwiritsira ntchito insulin poyambirira ndikofunikira kwambiri pakupanga kuzindikira koyenera. Njirayi ikhoza kuphatikizidwa ndi kuyesa kwa glucose.

Pambuyo pa masewera olimbitsa thupi

Mtundu woyamba wa shuga, yankho la kugwiritsa ntchito glucose lidzakhala zero, ndipo mu mtundu wa 2 odwala matenda ashuga omwe ali ndi vuto la kunenepa kwambiri, kuyankhidwa kumachepetsedwa. Mlingo wa insulin m'thupi pambuyo pa maola awiri amatha kukwera pazofunikira kwambiri ndipo osakhala wabwinobwino kwa nthawi yayitali.

Odwala omwe amalandila insulin awonetsa kuyankha kocheperako.

Pambuyo popanga shuga mkati, kutulutsidwa kwathunthu kwa mahomoni kumakhala kocheperako chifukwa chotsatira pakamwa. Zisumbu za Langerhans mu kapamba zimayamba kukhala zosavuta kwa shuga kupitilira wazaka, koma kuchuluka kwa mahomoni opitilira muyeso amakhalabe chimodzimodzi.

Kuchuluka kwa ma ketoni m'mwazi ndi mkodzo

Matupi a Ketone amapangidwa ndi chiwindi chifukwa cha lipolysis komanso chifukwa cha ketogenic amino acid. Ndi kusowa kwathunthu kwa insulin, pali:

makina ophatikizira a lipolysis,
mafuta oxidation ochulukirapo,
kutuluka kwa kuchuluka kwakukulu kwa acetyl-CoA (zochulukirapo zoterezi zimagwiritsidwa ntchito popanga matupi a ketone).

Chifukwa cha kuchuluka kwa matupi a ketone, ketonemia ndi ketonuria zimachitika.

Mwa munthu wathanzi, kuchuluka kwa matupi a ketone kudzakhala osiyanasiyana kuchokera pa 0.3 mpaka 1.7 mmol / l (kutengera njira yodziwira chinthuchi).

Choyambitsa chachikulu chomwe chimapangitsa ketoacidosis kuwonjezereka kwa matenda a shuga omwe amadalira insulin, komanso matenda osachiritsika omwe amadalira insulin, malinga ngati maselo a beta opera pancreatic atatha ndikukula kwathunthu kwa insulin kumayamba.

Kutentha kwambiri kwa ketonemia kokhala ndi index ya 100 mpaka 170 mmol / L komanso zotsatira zabwino za mkodzo ku acetone kukusonyeza kuti kukomoka kwa shuga kudwala.

Kuyesa kwa insulin

Pambuyo posala kudya, zidzakhala zofunikira kuyambitsa insulini mu kuchuluka kwa 0,1 PIECES / kg yolemetsa thupi la wodwalayo. Ngati mukumvera kwambiri mphamvu, ndiye kuti muyezowo umachepetsedwa kukhala 0,03-0.05 U / kg.

Kuyamwa magazi kwa venous kuchokera kumitsempha ya ulnar kumachitika pamimba yopanda nthawi imodzi - mphindi 120. Kuphatikiza apo, muyenera kukonzekera kachitidwe koyamba kukhazikitsidwa kwa shuga m'magazi.

Miyezi yabwinobwino, shuga amayamba kuchuluka msanga mpaka mphindi 15 mpaka 20, kufikira 50-60 peresenti ya milingo yoyamba. Pambuyo pa mphindi 90-120, shuga wamagazi amabwerera ku mtengo wake woyambirira. Kutsika kocheperako kumakhala chizindikiro cha kumva kuchepa kwa mphamvu ya mahomoni. Kuchepetsa mofulumira kudzakhala chizindikiro cha hypersensitivity.

Chidziwitsa: Insulin

Mked / ml (microunit pa millilita).

Kodi ndi zotsalira ziti zomwe zingagwiritsidwe ntchito kafukufuku?

Momwe mungakonzekerere phunzirolo?

Osamadya kwa maola 12 musanawunikidwe.
Patulani kotheratu kugwiritsa ntchito mankhwalawa tsiku loti mupereke magazi (monga momwe adavomerezera ndi adokotala).
Osasuta kwa maola atatu musanayambe kuphunzira.

Phunziro Mwachidule

Insulin imapangidwa m'maselo a beta a endocrine pancreas. Kuyika kwake m'magazi kumadalira kuchuluka kwa glucose: mutatha kudya, shuga ambiri amalowa m'magazi, poyankha izi, kapamba amatulutsa insulin, yomwe imayambitsa kusuntha kwa magazi kuchokera m'magazi kupita ku maselo a minofu ndi ziwalo. Insulin imayang'aniranso njira zam'magazi mu chiwindi: ngati pali shuga wambiri, ndiye kuti chiwindi chimayamba kuchisunga mu mawonekedwe a glycogen (glucose polymer) kapena kugwiritsa ntchito kapangidwe ka mafuta acids. Pamene kuphatikizira kwa insulin kukodwala ndipo kupangidwa kocheperako, shuga sangathe kulowa m'maselo amthupi ndipo hypoglycemia imayamba. Maselo amayamba kusowa mu gawo lalikulu lomwe amafunikira pakupanga mphamvu - shuga. Ngati matendawa ndi operewera, ndiye kuti kagayidwe kake kamayambitsa matenda a impso, mtima, mitsempha imayamba kukula, masomphenya amakhala ndi vuto. Matenda omwe akusowa kupanga insulini amatchedwa shuga mellitus. Ili ndi mitundu ingapo. Makamaka, mtundu woyamba umayamba pamene kapamba samapanga insulin yokwanira; mtundu wachiwiri umalumikizidwa ndi kuchepa kwa chidwi cha maselo pazotsatira za insulin pa iwo. Mtundu wachiwiri ndiwofala kwambiri. Pochiza matenda ashuga m'magawo oyamba, nthawi zambiri amagwiritsa ntchito zakudya zapadera komanso mankhwala osokoneza bongo omwe amathandizira kupanga insulin ndi kapamba, kapena kulimbikitsa maselo a thupi kudya glucose mwakukulitsa chidwi chawo ndi timadzi timeneti. Ngati kapamba amalekeratu kutulutsa insulini, kayendetsedwe kake ka jekeseni ndikofunikira. Kuchuluka kwa insulin m'magazi kumatchedwa hyperinsulinemia. Nthawi yomweyo, zomwe zimakhala m'magazi zimachepa kwambiri, zomwe zimatha kudzetsa chikumbumtima cha hypoglycemic komanso ngakhale kufa, popeza ntchito ya ubongo imatengera kutsekemera kwa glucose. Chifukwa chake, ndikofunikira kwambiri kuwongolera kuchuluka kwa shuga panthawi ya makonzedwe a makolo pokonzekera insulin ndi mankhwala ena omwe amagwiritsidwa ntchito pochiza matenda a shuga. Kuchuluka kwa insulini m'magazi kumayambitsanso chotupa chomwe chimatulutsa zambiri - insulinoma. Ndi iyo, kuchuluka kwa insulini m'magazi kumatha kuwonjezera nthawi makumi angapo m'nthawi yochepa. Matenda ogwirizana ndi kukula kwa matenda a shuga: matenda a metabolic, matenda am'mimba a adrenal gland ndi pituitary gland, polycystic ovary syndrome.

Kodi kafukufukuyu amagwiritsa ntchito chiyani?

Pozindikira matenda a insulin (pancreatic tumors) komanso kuti mudziwe zomwe zimayambitsa matenda oopsa kapena a hypoglycemia (pamodzi ndi mayeso a shuga ndi C-peptide).
Kuwona insulin ya insulin yopangidwa ndi maselo a beta.
Kuti mupeze insulin.
Kuti mudziwe ngati odwala omwe ali ndi matenda a shuga a 2 ayenera kuyamba kumwa mankhwala a insulin kapena hypoglycemic.

Kodi phunziroli lidzakonzedwa liti?

Ndi shuga wotsika wamagazi ndi / kapena wokhala ndi zizindikiro za hypoglycemia: thukuta, thukuta, kugona nthawi zonse, chikumbumtima chosazindikira, kuona kwamaso, chizungulire, kufooka, mtima.
Ngati ndi kotheka, fufuzani ngati insuliniyo inachotsedwa bwino, komanso munthawi yoyenera kuti mudzindikire kuti mungabwerenso.
Mukamayang'ana zotsatira za kuphatikizika kwa maselo a cell (mwa kudziwa kuthekera kwa ma transplants kuti apange insulin).

Zotsatira zake zikutanthauza chiyani?

Mfundo zofunikira: 2.6 - 24,9 μU / ml.

Zomwe zimapangitsa kuti ma insulini azikwezeka:

acromegaly
Itsenko-Cushing's syndrome,
fructose kapena shuga-galactose tsankho,
insulinoma
kunenepa
insulin kukana, monga matenda kapamba (kuphatikizapo cystic fibrosis) ndi khansa ya kapamba.

Kodi chingachitike ndi chiyani?

Kugwiritsa ntchito mankhwala monga corticosteroids, levodopa, kulera kwapakamwa, kumathandizira kuwonjezeka kwa glucose.

Pakadali pano, insulin yomwe imapezeka chifukwa cha biochemical synthesis imagwiritsidwa ntchito ngati jekeseni, zomwe zimapangitsa kuti zifanane kwambiri ndi kapangidwe ka zinthu ndi insulin.
Ma antibodies ku insulin angakhudze zotsatira za phunziroli, chifukwa ngati alipo m'magazi, ndikulimbikitsidwa kugwiritsa ntchito njira zina zodziwira kuchuluka kwa insulin (kusanthula kwa C-peptide).

Serum C-peptide
C-peptide mumkodzo wa tsiku ndi tsiku
Mayeso a kulolera a glucose
Madzi a m'magazi a Plasma
Mluza mumkodzo
Fructosamine

Ndani amatsogolera phunziroli?

Endocrinologist, Therapist, gastroenterologist.

Insulin (immunoreactive, IRI)

Insulin (immunoreactive insulin, IRI) - mahomoni akuluakulu a kapamba, omwe amachititsa kuti magazi azikhala ndi shuga, chifukwa chake shuga amachoka m'magazi kupita m'maselo.

Nthengwa ndi chofufumitsa chophatikizika. Udindo wa chinthu cha intrasecretory umachitika ndi zisumbu za Langerhans, zomwe zimakhala zosakwana 0.01 gawo la unyinji wa kapamba. M'mabwalo amtundu wa Langerhans, mitundu iwiri ya maselo am'mimba (α- ndi β-cell) imasungidwa, yomwe imatulutsa timagulu tambiri: woyamba - hyperglycemic factor, kapena glucagon yachiwiri, yachiwiri - insulin. Insulin adalandira dzina kuchokera ku liwu "insula" (chilumba). Ndiwo mahomoni okhawo omwe amachititsa kuchepa kwa glucose wamagazi (ndipo, panjira, puloteni woyamba yemwe mawonekedwe ake adapangidwa).

Kulemera kwa puloteni iyi, komwe kuli maunyolo awiri a polypeptide, ndi 5700D. Insulin imapangidwa kuchokera ku puloteni - chotsogolera cha preinsulin, chomwe, mothandizidwa ndi michere ya proteinolytic, imasweka mu gland ndipo pang'ono zina zimakhala zina, mwachitsanzo, minofu yamafuta, kudzera muzinthu zapakatikati zimasandulika kukhala zinthu zomaliza - insulin ndi C-peptide. Insulin imapangidwa mosavuta ndi zinc, zomwe zimapangitsa kuti pakhale insulin (yokhala ndi kulemera kwa ma 48000 D). Imakhazikika pamabulusi ang'onoang'ono. Kenako ma ma microbubulo (ma granules) amatumizidwa pamodzi ndi timachubu pamwamba pa cell, zomwe zimasungidwa zimatulutsidwa m'madzi a m'magazi.

Machitidwe insulin khungu lililonse limawonetsedwa pakulimbana kwake ndi mapuloteni olandilira kunja kwa membrane wa plasma. Zotsatira za receptor-insulin zovuta zimalumikizana ndi zigawo zina za membrane, chifukwa cha momwe ma macrostosition amapangira mapuloteni a nembanemba amasintha komanso kuchuluka kwa zimagwira. Vutoli limapanga insulini yokhala ndi mapuloteni onyamula, motero limathandizira kusamutsa shuga m'maselo.

Kupangidwe kwa matenda a shuga mellitus kumalumikizidwa ndi kusintha kwa mseri komanso magwiridwe antchito a insulin, zomwe zimadziwika kwambiri zaka 2500 zapitazo (mawu oti "matenda ashuga" adalowetsedwa kale.

Zisonyezo za kupangika kwa kusanthula kwa insulin

Kutsimikiza za mtundu wa matenda ashuga.
Kusiyanitsa kwakukulu kwa hypoglycemia (matenda a insulinoma, amaganiziridwa kuti ndi ma hypoglycemia).

Kukonzekera phunzirolo. Kuyamwa magazi kumachitika m'mawa makamaka pamimba yopanda kanthu.

Zida zofufuzira. Seramu yamagazi.

Njira yotsimikiza: electrochemiluminescent yodziwikiratu (kusanthula kwa Eleksys-2010, wopanga: F. Hoffman-La Roche Ltd, Switzerland).

Ma mayeso: mkU / ml.

Mfundo zam'mabuku (Nthawi ya insulin). 2-25 μU / ml.

Insulin yogwira ntchito - ndi chiyani?

Ngati mukuyang'ana yankho la funso la chomwe IRI ili, ndiye kuti pali zambiri zokhudzana ndi mahomoni amunthu a protein omwe amapangidwa ndi maselo a kapamba. Nthawi zambiri, tanthauzo la "immunoreactive" silimawonetsedwa pakufotokozera za chinthu. Izi sizowona konse. Chowonadi ndi chakuti pamenepa, "immunoreactive" si katundu wa molekyulu, koma njira yopangira kafukufuku.

M'mabotolo, kuyesaku kumachitika pogwiritsa ntchito mitundu yaukatswiri yosindikiza ndi njira zina zamakono zoyesera. Kugwiritsa ntchito maphunziro apamwamba a immunometric, ndiwofanana ndende ya insulini m'mwazi yomwe imayeza popanda kudziwa zodziwika monga proinsulin.

Chidule cha Hormone

Insulin ndi timadzi tokhala ndi peptide. Amapangidwa m'maselo a beta a pancreatic a Langerhans. Kuphatikizika ndi kudzipatula ndi njira yovuta, yomwe imaphatikizapo magawo angapo. Poyamba, hormone yosagwira (proinsulin) yopanda mphamvu imapangidwa, yomwe pambuyo pa kusinthika kwazinthu zingapo zamtundu wa thupi pakusintha zimasandulika mawonekedwe.

Proinsulin ndi polypeptide imodzi. Pankhani ya katundu wa Katemera, zinthuzi ndizapafupi kwambiri. Mu ma membano a membrane organoids, motsogozedwa ndi proinsulin, molekyulu ya amino acid yolumikizidwa imasiyanitsidwa ndipo insulin imapangidwa.

Kukhazikika kwa mahomoni m'magazi kumalumikizidwa makamaka ndi kuwonjezeka kwa kuchuluka kwa shuga mkati mwake. M'magazi, insulini imagawidwa (ndikuphatikizidwa ndi transerrin kapena alpha-globulin) komanso yaulere. Mitundu ya timadzi timeneti imasiyana mosiyana mnjira ina iliyonse pazinthu zomwe zimakhala ndi insulin.

Insulin ndi mahomoni obwera padziko lonse lapansi omwe ali ndi mitundu yosiyanasiyana yogwiritsira ntchito kagayidwe kazinthu zosiyanasiyana. Zofunikira zake zazikulu ndi hypoglycemic effect. Insulin imakhudzanso njira zina:

Imayendetsa kayendedwe ka zinthu kudzera mu ma cell opanga ma cell.
Imalimbikitsa mapangidwe a glycogen kuchokera ku glucose mu chiwindi ndi minofu.
Imalepheretsa kapena imalepheretsanso gluconeogeneis.
Zimalepheretsa njira yogawa mafuta kukhala diglycerides ndi mafuta acids.
Imalimbikitsa mapangidwe a adenosine triphosphate, omwe amathandiza kwambiri pakupanga mphamvu ya maselo.

Zachilengedwe zotsatira za mahormoni zitha kutsimikizidwa pokhapokha ngati zomwe zili mu insulin yogwira ntchito m'magazi ndizabwinobwino. Zizindikiro zowonjezera kapena kuchepa zimawonetsa zovuta zaumoyo.

Mulingo wa IRI m'magazi

Mthupi, zinthu zingapo zogwira thupi zomwe zimagwira ntchito zimayambitsa kuchuluka kwa shuga m'magazi: cortisone, glucagon, adrenaline. Ndipo mahomoni amodzi okha amathandizira kuchepetsa - insulin. Zomwe zili m'magazi zizikhala mkati moyenera, apo ayi, kusagwira bwino ntchito kwa ziwalo ndi machitidwe kumachitika ndipo ma pathologies osiyanasiyana amapangidwa. Pali gawo lapadera lotchedwa insulin, lomwe limatsimikizira kuchuluka kwa mahomoni m'thupi. Zizindikiro za insulin ndi shuga m'magazi ndizosiyana mwanjira zosiyanasiyana.

Ma labotale osiyanasiyana angagwiritse ntchito mitundu yoyesera, ndiye kuti zotsatira zake ziyenera kuyang'anidwa poyerekeza zomwe zikuwonetsa.Pakuwunika kwa insulin yogwira ntchito, muyezo umawerengedwa ngati zisonyezo zamitundu 6-24 μU / ml. IRI imayendetsedwa ndi msinkhu wodwala (mfundo zimayesedwa mu μU / ml):

Ana kuyambira kubadwa mpaka zaka 6 - 10-20.
Mwa ana azaka za 6 mpaka 10, 7.7 7 1.3 amadziwika kuti ndi wabwinobwino.
Zaka 10-15 - 13.2 ± 1.5.
Kuyambira wazaka 16 - 6-24.

Insulin yogwira thupi imakwezedwa - zikutanthauza chiyani?

Chizindikiro cha secretion ya mapuloteni-peptide timadzi timadzi ta kudziwa kuchuluka kwa shuga m'magazi ndipo amatsimikiza ndi boma la endocrine system, autonomic chapakati mantha dongosolo ndi zakudya. Mwa anthu odwala matenda ashuga a 2, kuchuluka kwa insulin nthawi zambiri kumakwezedwa. Izi zikuwonetsa ntchito yayikulu ya kapamba ndi mapangidwe a insulin. Kukumana kwamahomoni ambiri m'magazi kumatha kuphatikizidwa ndi mawonekedwe ena a pathological.

Kunenepa kwambiri
Matenda a chiwindi.
Kukhalapo kwa neoplasms pa tiziwalo ta kapamba.
Matenda a pituitary gland (pituitary gland).
Kutupa kwa minyewa.
Itsenko-Cushing's syndrome.
Kusalolera kwa zipatso shuga ndi galactose.
Necidioblastosis.
Insulinoma.

Posankha zizindikirazi, ndikofunikira kuzindikira nthawi yomwe zotsatira zake zalembedwa. Chifukwa chake, mwachitsanzo, chisonyezo cha insulin yogwira insulin 77 pambuyo pochita masewera olimbitsa thupi imatengedwa ngati chizolowezi kuyambira pamphindi 30 mpaka 120.

Adatsitsa IRI

Kusanthula kwa IRI kumapangitsa kuti zitheke kupanga lingaliro labwino kwa odwala omwe mahomoni awo ali otsika kwambiri kapena apamwamba kwambiri pazikhalidwe zokhazikitsidwa. Kupatuka kulikonse kumbali ina kapena kwinakwake kumawonetsa kuti wodwalayo ali ndi vuto la kapamba kapena matenda ashuga.

Kutsika kwa mahomoni m'magazi kumapangitsa kuti ziwalo za endocrine zizigwira bwino ntchito. Mu shuga mellitus, insulin yogwira ntchito sikuti nthawi zonse imakwezedwa. Mitengo yotsika imasonyezanso kupezeka kwa matenda a endocrine, koma osati 2, koma 1 mtundu. IRI pansipa momwe imakhalira ikhoza kuwonetsa zina:

Kuphwanya kwa anterior pituitary gland (hypopituitarism).
Matenda a Addison.
Kuchita masewera olimbitsa thupi kwa nthawi yayitali.

Kodi kuyezetsa kumachitika bwanji?

Kuwunika kwa insulin yogwira thupi kumachitika pambuyo pa maola 8-12 osala kudya. Wothandizira labotale amatenga zitsanzo zamagazi mum chubu yapadera yokhala ndi chinthu chothandizira. Pogwiritsa ntchito ma centrifuge, ma plasma ndi maselo amwazi amalekanitsidwa ndikuwuma mpaka -40 ° C. Madzi amadzimadzi atagawika, amawuma pa -200 ° C. Mwanjira iyi, biomaterial imayikidwa mu dongosolo loyesa ndipo zotsatira zomwe zimapezeka zimayesedwa. M'mabotolo ena, ndikofunikira kuperekanso magazi patatha maola awiri kuchokera poyesedwa koyambirira kuti adziwe kutulutsidwa kwa mahomoni. Wodwala ayenera kukhala ndi njala panthawi yobwereza.

Pali njira inanso yakufufuzira. Gulcagon yopanda insulin imaperekedwa kwa wodwala pamimba yopanda kanthu pakamwa kapena m'mitsempha pamtunda wa 0,1 PIECES pa kilogalamu yolemera. Pambuyo pa izi, zitsanzo zamagazi zimatengedwa mphindi 30 zilizonse kwa maola awiri. Makhalidwe abwinobwino (mkED / ml) akuyenera kuwoneka motere:

Mphindi 30 mutatha kuchita masewera olimbitsa thupi, insulin yogwira ntchito inakulitsa 25-251.
Mphindi 60 - 18-277.
Mphindi 120 - 16-167.
180 – 4-18.

Kutengera ndikuwona, zimadziwika kuti shuga akaperekedwa pakamwa, kutulutsidwa kwa insulini ndikokulira kuposa momwe amathandizira kudzera m'mitsempha. Zimadziwikanso kuti ukamakula, kapamba amataya kukhudzika kwa glucose, koma mulingo wazobisalira kwambiri umakhalabe.

Kodi kuwunika kumagwiritsidwa ntchito bwanji?

Kuyesedwa kwa zomwe zili mu IRI sikuthandiza anthu okhawo omwe amadalira insulin posankha mtundu wa matenda ashuga. Kusanthula kumapangitsa kuunikira ndi maphunziro ena aumoyo wa anthu omwe ali ndi matenda amtundu wa endocrine omwe amadziwika chifukwa cha kuwonongeka kwa glucose. Kuyesa kumagwiritsidwa ntchito:

Kusanthula gawo la insulin pamakina a shuga.
Maphunziro a insulin metabolism mwa amayi apakati omwe ali ndi matenda ashuga.

Kuzindikira kwa insulin kukana koyambirira.
Kuwerengera nthawi yeniyeni yoyambira kudya anthu omwe ali ndi matenda a shuga.
Kuzindikiritsa zomwe zimayambitsa matenda a hypoglycemia (kuwunika kwa IRI kumachitika molumikizana ndi kuyesa kwa C-peptide ndikuwunika kwa glucose).

Zizindikiro pakuyesa

Kuyesa kwa insulin komwe sikunachitike kumayesedwa ndi katswiri wazonse, endocrinologist kapena gastroenterologist. Zizindikiro za phunziroli ndi izi:

Kulemera kwambiri ndi kudya kosalekeza.
Kuchiritsa kwakanthawi kovulala pakhungu.
Kuzindikira mapuloteni pakuwunika mkodzo.
Kukhalapo kwa zizindikiro zomwe zikuwonetsa kukula kwa metabolic syndrome.
Insulin yomangika.
Mawonekedwe amtundu wa hypoglycemia: kutuluka thukuta kwambiri, kumangokhala ndi njala, kumachepetsa maonedwe acuity.
Njira zowunikira pambuyo pothana ndi maselo a pancreatic endocrine.

Matenda a Endocrine amakonda kupita patsogolo mwachangu. Kuzindikiritsa ndikofunikira kwambiri m'magawo oyamba. Pazizindikiro zoyambirira zokayikitsa, funsani dokotala.

Njira zokusonkhanitsa ndi kufalitsa ku labotale

Magazi akamayesedwa insulin yogwira ntchito amatengedwa kuchokera m'mitsempha pogwiritsa ntchito njira zogwiritsira ntchito vacuum. Kusavuta kwa machitidwe oterowo kumakhala mu singano yosachotsa yokhala ndi chosungira ma chubu. Kapangidwe kameneka kamalola kuti punct imodzi imodzi izitulutsa mipanda ingapo yazomanga. Izi ndizofunikira kwambiri pakuwunikira mayendedwe a insulini, chifukwa magazi a wodwala amatengedwa kasanu m'mayeso onse.

Mukamamwa biomaterial, gwiritsani ntchito njira yofananira yopezera magazi a venous. Monga anticoagulant (mankhwala omwe amaletsa magazi kuundana), heparin amagwiritsidwa ntchito. Magazi amasungidwa nthawi yomweyo kutentha kwa + 4 ° C. Seramu ndi plasma zimayikidwa m'matumba apamwamba ndipo ngati kuli kotheka, zimanyamulidwa.

Zosungidwa za biomaterial

Kudalirika kwa zotsatira zakusanthula kumadalira zinthu zingapo, kuphatikiza zovuta zakunja kwachilengedwe, kutengera mtundu wa momwe magazi akusungira. Biomaterial pakufufuza nthawi zambiri imayenera kuperekedwa ku labotale. Ma mayendedwe ndi kusungidwa kumachitika potsatira kuthekera kwakuthupi kwa mahomoni.

M'magazi atsopano omwe amakhala ndi ma becks ndi maselo mkati mwake (maselo oyera am'magazi, mapulateleti), insulin ndi yokhazikika kwa mphindi 60.
Mu plasma yamagazi popanda gawo lamadzi lomwe latsalira pambuyo pa coagulation (fibrinogen), mahomoni amakhala osakhazikika kwa maola 4 pa kutentha kwa 22-25 digiri Celsius.
Kusungidwa kwotalikirapo kwa biomaterial, koma osaposa maola 24, kumachitika mufiriji pamtunda wa +4 mpaka + 8 ° C.

Zomwe zimakhudzana ndi kupotoza kwa zizindikiro?

Zotsatira zabodza nthawi zambiri zimakhala chifukwa chosagwirizana ndi malamulo okonzekera kusanthula. Nthawi zambiri, zizindikiro zosayenera zimakhala chifukwa chogwiritsa ntchito mankhwala osiyanasiyana.

Kuchulukitsa kwa insulin komwe kumatha kuchitika ngati wodwala amatenga matenda a mphumu ya bronchial), Levodop (parkinsonism therapy), Medroxyprogesterone (antitumor), ndi njira yolerera pakamwa. Kuwonjezeka kwa ndende ya hormone kumawonedwanso mu nyengo yachiwiri ndi yachitatu ya kutenga pakati.

Propranolol (chithandizo cha matenda oopsa), Cimetidine (antihistamine), thiazide okodzetsa, Mowa amachititsa kuchepa kwa insulin. Kuchita masewera olimbitsa thupi kwakanthawi kumathandizanso kuti kuchepa kwa mahomoni.

Kodi ndingapeze kuti kuwunikira ku Iran?

Nthawi zambiri, dotolo amapereka chitsogozo chowunikira chosonyeza malo ake. Koma ngati munthu akufuna kuyesedwa yekha, ndiye kuti ali ndi funso: "Ndingapeze kuti insulin?"

Kuti mupambane mayeso, ndibwino kusankha labotale yokhazikika. Ku Moscow, mutha kulembetsa njirayi ku MobilMed, DNCOM, Helix. Ma labotala azachipatala nthawi zambiri amakhala ndi njira zambiri zachigawo. Chokhacho ndikufotokozera mtengo wa kusanthula mwachindunji pamalo omwe mukufuna.