Kudziwitsa kwa hemoglobin ya glycosylated m'magazi: tanthauzo la njira zake

Matenda ofunikira pakutsimikiza kwa glycated hemoglobin
Glycated hemoglobin, kapena glycogemoglobin (mwachidule: hemoglobin A1c, Hba1c) Kodi chizindikiritso cha magazi a biochemical chomwe chimawonetsa shuga wamagazi kwa nthawi yayitali (mpaka miyezi itatu), mosiyana ndi kuyeza magazi, omwe amapereka lingaliro la kuchuluka kwa glucose wamagazi kokha panthawi yophunzira.
Glycated hemoglobin amawonetsa kuchuluka kwa hemoglobin yamagazi yolumikizidwa mosavomerezeka ndi mamolekyulu a shuga. Glycated hemoglobin imapangidwa chifukwa cha zomwe Maillard amachita pakati pa hemoglobin ndi glucose wamagazi. Kuwonjezeka kwa shuga m'magazi a shuga kumathandizira kwambiri izi, zomwe zimapangitsa kuchuluka kwa hemoglobin m'magazi. Nthawi yonse ya maselo ofiira a m'magazi (ma cell ofiira am'magazi), omwe amakhala ndi hemoglobin, pafupifupi masiku 120 mpaka 125. Ndiye chifukwa chake mulingo wa glycated hemoglobin umawonetsa kuchuluka kwa glycemia pafupifupi miyezi itatu.
Glycated hemoglobin ndi chizindikiro chachikulu cha glycemia kwa miyezi itatu. Mokulira kuchuluka kwa hemoglobin wa glycated, kumakulitsa glycemia m'miyezi itatu yapitayo, ndipo, motero, kumakhala pachiwopsezo chotenga matenda a shuga.
Kafukufuku wa hemoglobin wa glycated nthawi zambiri amagwiritsidwa ntchito poyesa mtundu wa chithandizo cha matenda a shuga m'miyezi itatu yapitayo. Ndi mulingo wambiri wa glycated hemoglobin, kukonza chithandizo (mapiritsi a insulin kapena mapiritsi ochepetsa shuga) ndi mankhwala othandizira ayenera kuchitika.
Makhalidwe abwinobwino ndi HbA1c kuchokera 4% mpaka 5.9%. Mu matenda a shuga, mulingo wa HbA1c umakwera, zomwe zimawonetsa chiopsezo chachikulu cha kukulira retinopathy, nephropathy ndi zovuta zina. International Diabetes Federation ikulimbikitsa kusunga magawo a HbA1c pansi pa 6.5%. Mtengo wa HbA1c wopitilira 8% umatanthawuza kuti matenda ashuga sawongolera bwino ndipo chithandizo chikuyenera kusinthidwa.

Kukonzekera kuwerenga

Glycosylated kapena glycated hemoglobin (HbA1c) ndizowonetsera zomwe zimawonetsa kuchuluka kwa glucose m'magazi m'miyezi iwiri yapitayi ndi umodzi. Zizindikiro zazikulu zogwiritsidwa ntchito: kuwunika njira ya matenda ashuga (nthawi 1 m'miyezi itatu), kuwunika momwe mankhwalawa amathandizira odwala matenda ashuga, chizindikiro cha kuopsa kwa matenda ashuga.
Glycosylated kapena glycated hemoglobin (HbA1c) ndi gulu la hemoglobin A ndi glucose, lomwe limapangidwa m'thupi popanda enzymically. Pafupifupi 5-8% ya hemoglobin m'maselo ofiira a m'magazi amamangika molekyu ya glucose. Njira yogwiritsira ntchito shuga kuphatikiza molekyulu ya hemoglobin ndichinthu chabwinobwino, koma mkati mwa moyo wa maselo ofiira wamagazi omwe amakhala ndi glucose yayitali m'magazi, kuchuluka kwake kumawonjezeka. Ma mamolekyulu a hemoglobin amatchedwa glycosylated. Pali mitundu ingapo ya ma glycosylated hemoglobins (HbAIa, HbAIb, HbAIc). Amakhulupirira kuti hemoglobin - HbA1c (chifukwa cha kuchuluka kwake) ili ndi chofunikira kwambiri kuchipatala. Kuchuluka kwa hemoglobin wa glycosylated kumadalira kuchuluka kwa shuga m'magazi. Popeza kuti erythrocyte ali ndi nthawi yotalikirapo masiku 120, kutsimikiza kwa zomwe zili mu HbA1c kuwonetsera kuchuluka kwa seramu glucose wamiyezi iwiri mpaka itatu phunzirolo lisanachitike.
Kuphatikiza pa hemoglobin, njira zotsatirazi zimakhudzidwa ndi glycation: albumin, collagen, mapuloteni am'maso am'maso, ma transerrin, erythrocyte membrane mapuloteni ndi mapuloteni ena ambiri ndi ma enzymes, zomwe zimayambitsa kusokonezeka kwa ntchito zawo ndi kukulira kwa matenda osokoneza bongo.
Kutsimikiza kwa glycosylated hemoglobin kumadziwika ndi World Health Organisation ngati koyenera kuwunika njira ya shuga kamodzi miyezi itatu iliyonse.
Kutsimikiza kwa HbA1c kumakupatsani mwayi wowunika kuchuluka kwa shuga pakati paulendo wopita kwa dokotala. Pamene kukhathamira kwa seramu HbA1c wodwalayo kuli koyipa kwambiri, komwe kumapangitsa kuchuluka kwa glucose kumayendetsedwa.
Matenda a mtundu wa HbA1c m'magazi amapezeka masabata 4-6 atatha kuchuluka kwa shuga. Mukamayang'anira chithandizo cha matenda ashuga, tikulimbikitsidwa kuti tisunge kuchuluka kwa hemoglobin yotsika ndi 7% ndikuwunikanso mankhwalawa ngati aposa 8% (malingana ndi njira yodziwira HbA1c yokhala ndi malingaliro abwinowo mkati mwa 4-6%).
Glycated hemoglobin imagwiritsidwa ntchito ngati chisonyezo cha chiopsezo chotenga matenda a shuga.
Makhalidwewa amatha kusiyanasiyana pakati pa ma labotoreti malinga ndi njira yowunika.
Zotsatira zoyesedwa zimatha kusinthidwa zabodza pamkhalidwe uliwonse womwe umakhudza nthawi yayitali ya maselo ofiira a m'magazi. Kupuma kapena hemolysis kumapangitsa kuchepa kwabodza pazotsatira za HbA1c. Kuyika magazi kumathandizanso kuti zotsatira zake zithe. Ndi kuchepa kwa magazi m'thupi, kuchepa kwabodza kwa HbA1c kumawonedwa.

Kukonzekera kuzindikira

• Kuyenera kufotokozeredwa kwa wodwala kuti phunziroli liwunika momwe antidiabetes alili.
• Iyenera kuchenjezedwa kuti pa phunziroli ndikofunikira kutenga magazi ndikuwuza kuti ndi ndani ndipo liti adzatenge magazi kuchokera m'mitsempha.

• Pambuyo popuma, mitsempha imatengera magazi kukhala chubu ndi EDTA.
• Malowa obwezeretsa amathinitsidwa ndi mpira wa thonje mpaka magazi atasiya.
• Ndi mapangidwe a hematoma pa malo olipiritsa, ma compress ofunda ndi mankhwala.
• Wodwalayo adamulamula kuti ayambenso kumuyesa pambuyo pa masabata 6-8.

• Nthawi zambiri, zomwe zimakhala za glycosylated hemoglobin ndi 4.0 - 5.2% ya hemoglobin yonse.

Zinthu zomwe zimakhudza zotsatira za kafukufukuyu

• Zosokoneza

Kutupa magazi osagwira - kusakanikirana kwa magazi kosakwanira ndi inro anticoagulant (EDTA).

• Zinthu Zomwe Zimawonjezera Zotsatira
  • Carbamylated hemoglobin (wopangidwa mwa odwala ndi uremia).
  • Hydrochlorothiazide.
  • Indapamide.
  • Morphine.
  • Propranolol.
  • Zowonjezera Zabodza

Hemoglobin F (fetal) ndi ma labile apakati angapangitse kuchuluka kolakwika.
Glycated hemoglobin. Kusanthula kwa glycosylated hemoglobin. Pangani kafukufuku kuti muwonjezere shuga
Kusanthula Zambiri Meza
Glycated Hemoglobin (HbA1c)

Mtengo (mtengo wa kusanthula) sunalembedwe kwakanthawi patsamba lathu.
Pokhudzana ndi kusintha kwa mtundu wamagetsi pamalowo.

Glucose amalumikizana ndi mapuloteni (kuphatikizapo hemoglobin) ndi mapangidwe a Schiff bas. Chifukwa chake, kuchuluka kulikonse kwa shuga kwakanthawi m'magazi kumasiya chizindikiro chokhala ndi glycosylated hemoglobin. HbA1 imakhala ndi zigawo zitatu HbA1a, HbA1b, HbA1c. Makamaka, HbA1c imapambana.

Mlingo wa HbA1c umawonetsa kuchuluka kwa hyperglycemia komwe kumachitika maselo ofiira a moyo (mpaka masiku 120). Maselo ofiira omwe amayendayenda m'magazi ali ndi mibadwo yosiyana, chifukwa chake, pazomwe zimakhala zamagulu a shuga, amawongoleredwa ndi theka-moyo wamaselo ofiira a m'magazi - masiku 60. Chifukwa chake, kuchuluka kwa hemoglobin ya glycated kumawonetsa zomwe kuchuluka kwa shuga m'milungu yapitayi 4-8 ndipo ichi ndi chizindikiro cha kulipira mphamvu ya kagayidwe kazinthu nthawi imeneyi. Kuyeza kwa ndende ya HbA1 kumathandizira kuwunika kukula kwa hyperglycemia mu matenda a shuga. Kukula kwa glycosylation sikudalira kuchuluka kwa kusinthasintha kwa magazi m'magazi, zochitika zolimbitsa thupi, mawonekedwe a chakudya, zochita zolimbitsa thupi ndipo zimangotengera kukula ndi kutalika kwa hyperglycemia. Odwala omwe ali ndi matenda osokoneza bongo omwe ali ndi matenda oopsa a hyperglycemia, kuchuluka kwa HbA1c kumawonjezeka kwambiri. Matenda a shuga amathandizidwa ndimankhwala omwe amachepetsa shuga m'magazi kwa nthawi yochepa, motero ndikofunikira kusankha njira zamankhwala zomwe zingapangitse matenda a glycemia kukhazikika. Kufunika kwa kafukufuku wa glycosylated hemoglobin mu shuga mellitus ndikuti HbA1c imakhala ndi gawo lina la shuga m'magazi nthawi yayitali, yomwe ikufanana ndi theka la moyo wa molekyule ya hemoglobin. Ndiye kuti, glycosylated hemoglobin amakhala ndi gawo la kubwezeretsa kwa shuga m'miyezi iwiri yapitayi. Matenda abwino a shuga amawalipiridwa, amachepetsa chiopsezo chokhala ndi mavuto a shuga monga kuwonongeka kwa maso - retinopathy, kuwonongeka kwa impso - nephropathy, kuwonongeka kwa mitsempha yotumphukira ndi mitsempha yamagazi yopita ku gangrene. Chifukwa chake, cholinga chothana ndi matenda ashuga ndikuwonetsetsa kuti glucose amasungidwa bwino. Kuyeza kwa shuga m'magazi a capillary kumakupatsani mwayi wofufuza kuchuluka kwa shuga, kutsimikiza kwa HbA1c kumapereka lingaliro lamagulu osakanikirana a glycemia.

Norm: 3.5-7.0 μM fructose / g hemoglobin kapena 3,9 - 6.2%

Kutsimikiza kwa HbA1c ndikofunikira kwambiri kwa amayi omwe ali ndi matenda ashuga pamene akukonzekera kutenga pakati komanso panthawi yomwe ali ndi pakati. Zinakhazikitsidwa kuti mulingo wa HbA1c kwa miyezi isanu ndi umodzi musanatenge pathupi komanso nthawi yoyambirira ya mimba imakhudzana ndi zotulukapo zake. Kuwongolera okhazikika pamlingo wa glycemia kumachepetsa kuchulukana kwa fetal kuchokera pa 33% mpaka 2%.

Njira yotsimikiza ya glycosylated hemoglobin m'magazi

Glycosylated hemoglobin - kulumikizana pakati pama cell ofiira a magazi ndi chakudya. Amakhala wosawonongeka. Chifukwa chake, adotolo amatha kuwona chizindikiro chomwe chimasunga m'magazi moyo wonse wama cell ofiira (miyezi 3). Mwatsatanetsatane wazomwe hemoglobin ya glycosylated.

Kuti azindikire zomwe zikuwonetsa, amapereka magazi kuti awunike. Madzi a venous kapena capillary achilengedwe ndi oyenera izi.

Mutatenga zinthu zachilengedwe, chinthucho chimawonjezeredwa ku chubu choyesera chomwe chimalepheretsa magazi kuzikika. Ngati mawonekedwe a chive, kufufuza kwina sikungatheke. Zomwe zili ndi machubu zimasakanizidwa bwino, kenako ndikuyika mu chosanthula. Imangowerengera chizindikirocho, ndipo imapereka chidziwitso pafomu yophunzirayo.

Kugwiritsa ntchito chipangizochi kumachotsa mwayi wolakwitsa kuchipatala pakuwerengera kuchuluka kwa zinthu zofunika. Ndiye kuti, zotere ndi zomwe zingakhale zodalirika kwambiri. Koma kuti mutsimikizire kuchuluka kwa chizindikirocho, ndikulimbikitsidwa kuchititsa kafukufuku kawiri. Mukalandira zizindikiro zomwezo, mayesowa amadziwika kuti ndi odalirika.

Glycosylated Hemoglobin Analyzer

Mitundu yambiri ya zida yatulutsidwa, yomwe mutha kudziwa zambiri zamadzimadzi aumunthu. Pali zida zambiri zodziwira glycosylated hemoglobin.

• Madzi chromatograph. Mwazi umagawika m'magawo angapo momwe chizindikiritso chowunikira chimawunikira.
• Ion exchange chromatograph. Amalekanitsa ma ion kukhala mamolekyu. Pambuyo powonjezera ma reagents osiyanasiyana, ndizotheka kuyeza tizigawo tina. Chitsanzo cha chida choterechi ndi chosanthula chofuna kudziwa glycosylated hemoglobin D10.
• Immunoturbidmetry. Imazindikira chizindikirocho poyesa kuchuluka kwa magazi mogwirizana ndi zovuta za antigen-antibody.
• Openda osunthira. Zosankhidwa ndi wodwala aliyense kuti azigwiritsa ntchito kunyumba. Kuti muwunikenso, magazi ochepa a capillary amafunikira, omwe amapezeka mwa kuboola khungu ndi zofinya. Chipangizocho chimatengera kujambulidwa ,ayeza kuyeza mphamvu. Aliyense wa iwo ali ndi fluorescence (luminescence), yomwe imasankha zotsatira zenizeni za chizindikiro. Werengani malingaliro mwatsatanetsatane okonza magazi kunyumba.

Wodwala akakhala ndi mavuto azaumoyo, shuga m'magazi ake nthawi zambiri amadzuka, dokotalayo amalimbikitsa kuti azigula nyumba yokonzanso nyumba. Glycosylated hemoglobin reagent kits iyenera kukhala yosavuta kugwiritsa ntchito kuti odwala onse azitha kuwagwiritsa ntchito.

Kumakonzanso kutsimikiza kwa glycosylated hemoglobin

Chidacho chimaphatikizapo zotsatirazi zofunika pa chromatography:

• othandizira kuvala, mwachitsanzo, EDTA,
• ma hemolytic othandizira omwe amawononga maselo ofiira am'magazi,
• njira yothetsera njirayi - madzi omwe amasungunuka acid poyambira,
• acetic acid solution - amadzimadzi ofunikira kuchotsa zinthu zambiri pazoyeserera,
• oyang'anira sampuli - ofunika kuyerekezera zotsatira ndi zomwe zimachitika,
• chipangizo cha semi-automatic, chomwe ndi chosanthula chosunthika.

Zinthu zomwe zili pamwambazi zimatha kukhala zamakampani osiyanasiyana, koma cholinga chake chimakhala chofanana. Kafukufuku aliyense wa glycosylated hemoglobin m'magazi amaphatikizapo malangizo ogwiritsira ntchito.

Kutsimikiza kwa glycosylated hemoglobin m'mwazi wathunthu

Dokotala ayenera kuchenjeza wodwala momwe angayesere kudziwa glycosylated hemoglobin m'magazi athunthu.

Poyesera, chinthucho chimawonjezeredwa ku chubu choyesera chomwe chimalepheretsa magazi kufinya. Magazi athunthu amawonjezeredwa kwa icho. Mlingo wake uyenera kukhala womwewo. Njira yotsatirayo imasakanizidwa bwino ndikukakamizidwa. Chifukwa chake, erythrocyte misa imapangidwa, yomwe imayenera kutengedwa ndi pipette ndikuisamutsira ku chubu choyesera komwe kuli hemolytic. Chifukwa chamadzimadzi chimasakanikirana ndikukakamizidwa. Pakadali pano, njira ya hemolysis imapangidwa, ndiye kuti, maselo ofiira amwazi amawonongeka, ndiye shuga wokhayo amene amakhalapo. Zimadziwika ndi chipangizocho.

Katswiri wa glycosylated hemoglobin mu seramu yamagazi

Seramu ndi magazi amunthu omwe amachokera ku magazi athunthu. Pazomwezi, sampuli imayikidwa mu chubu choyesera ndikuyika mu centrifuge. Amagwira ntchito kuthamanga kwambiri. Pakadutsa mphindi 10, pulogalamuyi yatha. Madzi achikasu amatsalira pamwamba pa chubu, chomwe ndi seramu. Zinthu zokhala ndi mawonekedwe zimasungidwa pamodzi, kotero gawo ili lidzakhala ndi tint yofiira.

Kuyesaku kumachitika mosiyanasiyana.

• seramu, hemoglobin solution, madzi oyeretsedwa amawonjezeredwa ku chubu
• phatikizani mtundu wowongolera wokhala ndi seramu ndi madzi osungunuka,
• zida zonse zimalimbikira, kenako ndikuyiyika mu centrifuge kuthamanga kwambiri,
• Pamwamba pa chubu, gawo lachikaso ndimadzi lomwe limatsalira ndikuchotsedwa ndi ammonium sulfate.

Zotsatira zake anali amadzimadzi ochokera ku seramu yamagazi, omwe amatha kuwunika pa chithunzielectrocolorimeter. Ichi ndi chipangizo chomwe chimawunikira mayendedwe ake. Zambiri zomwe zimapezedwa zimayikidwa mu njira yodziwira kuzimiririka. Ndikofunikira kudziwa thunthu pa 1 lita imodzi ya magazi.

Kutsimikiza kwa glycosylated hemoglobin mu shuga

Chizindikiro cha glycated chimatsimikizika mu nthawi yofanana ndi miyezi itatu. Chifukwa chake, phunziroli limachitika limodzi. Ndikotheka kugwiritsa ntchito kukonzanso pakatha masiku angapo kuti mutsimikizire zotsatira. Koma ngakhale izi zili choncho, zomwe zapezedwa zikugwirizana ndi zotsatira zodalirika. Kutengera pa iwo, adokotala amatha kuweruza magawo otsatirawa:

• mulingo wamankhwala omwe amasinthidwa mukalandira data yoyipa,
• kuphwanya wodwala malamulo a machitidwe a hyperglycemia, zomwe zimaphatikizapo kugwiritsa ntchito chakudya, masewera olimbitsa thupi, nkhawa.

Zofunika! Ndi hyperglycemia, tikulimbikitsidwa nthawi zina kuyeza kuchuluka kwa shuga pogwiritsa ntchito mita ya shuga m'magazi. Kuyesa kwa glycosylated kumakhala kopindulitsa kamodzi masiku 120 alionse.

Matenda a shuga ndi matenda oopsa omwe amakhala ndi zovuta zambiri zomwe zimachepetsa kuchuluka kwa wodwala, kapena zimamupangitsa kuti afe. Ndikulimbikitsidwa kugwiritsa ntchito mankhwala nthawi, kutsatira zakudya. Kudziwitsa kwa hemoglobin ya glycosylated kumathandizira dokotala kuti awone mtundu wa mankhwala, kusintha.

Glycosylated hemoglobin - ndi chiyani?

Tiyeni tiwone mwatsatanetsatane tanthauzo la glycosylated hemoglobin. Maselo ofiira amakhala ndi mapuloteni enaake okhala ndi chitsulo, ofunikira kuti mpweya ndi mpweya wabwino uzitulutsa. Glucose (shuga, ma carbohydrate) amatha kuphatikiza popanda mankhwala, ndikupanga glycosylated hemoglobin (HbA1C). Izi zimathandizira kwambiri chifukwa cha kuchuluka kwa shuga (hyperglycemia). Nthawi yayitali ya maselo ofiira a m'magazi ndi pafupifupi 95 - masiku 120, kotero mulingo wa HbA1C umawonetsa kuchuluka kwa shuga m'miyezi itatu yapitayo. Mulingo wa glycosylated hemoglobin m'magazi ndi 4-6% ya kuchuluka kwake ndipo umafanana ndi shuga wa 3-5 mmol / l. Zomwe zimawonjezera zimagwirizanitsidwa makamaka ndi kuphwanya kagayidwe kazakudya komanso kuchuluka kwa shuga m'magazi motere:

• Shuga mellitus mtundu 1 (wodalira insulini) - wokhala ndi vuto la insulin (pancreatic homoni), kugwiritsa ntchito mafuta ochulukitsidwa ndi maselo amthupi kumasokonekera, zomwe zimapangitsa kuchuluka kwa nthawi yayitali.
• Mtundu 2 wa matenda a shuga a mellitus (osadalira insulini) - umagwirizana ndi kuperewera kwa glucose pakagwidwe kabwino ka insulin.
• Chithandizo chosakwaniritsidwa cha misempha yambiri yokhala ndi vuto la hyperglycemia

Zimayambitsa kuchuluka kwa hemoglobin wa glycosylated, wosagwirizana ndi kuchuluka kwa shuga m'magazi:

• poyizoni wa mowa
• tsitsani mchere poyizoni,
• kuchepa kwazitsulo
• Kuchotsa ndulu - ndulu ndiyo chiwalo chomwe kutaya maselo ofiira a magazi kumachitika ("manda" a maselo ofiira a magazi), chifukwa chake kusowa kwawoko kukuwonjezera kuchuluka kwa nthawi yomwe amakhala ndi moyo komanso kuwonjezeka kwa HbA1C,
• uremia - kusakwanira kwa impso kumapangitsa kudzikundika kwa zinthu za metabolic m'magazi ndikupanga carbohemoglobin, yofanana ndi katundu ku glycosylated.

Zoyambitsa HbA1C Kuchepa

Kutsika kwa hemoglobin ya glycosylated ndi chizindikiro cha pathological, kumachitika mwa zotere:

• Kutaya magazi kwambiri - limodzi ndi hemoglobin yachilendo, glycosylated imatayikanso.
• Kuyika magazi (kuthira magazi) - HbA1C imasungunuka ndi kachigawo kakang'ono kake, komwe sikalumikizidwa ndi chakudya.
• Hemolytic anemia (anemia) ndi gulu la matenda a hematological omwe nthawi yayitali kukhalapo kwa maselo ofiira amachepetsa, ndipo ma cell omwe ali ndi glycosylated HbA1C nawonso amwalira kale.
• Hypoglycemia ya nthawi yayitali - kuchepa kwa shuga.

Tiyenera kukumbukira kuti mitundu yosalimba ya hemoglobin imatha kupotoza zotsatira za kusanthula ndikupereka kuwonjezeka kwabodza kapena kuchepa kwa mawonekedwe ake a glycosylated.

Ubwino Poyerekeza ndi Kusanthula Kwachisawawa

• Kudya - kumayambitsa kukwera kwamphamvu m'magazi a carbohydrate, omwe amabwerera kwawokha patatha maola ochepa.
• Zomwe zimabweretsa, kupsinjika, tsiku lotsatira la kuyesedwa, kumakulitsa shuga m'magazi chifukwa chopanga mahomoni omwe amawonjezera gawo lake.
• Kumwa mankhwala ochepetsa shuga, zolimbitsa thupi zimachepetsa shuga.

Chifukwa chake, kuyesedwa kwakanthawi kotsika kwa shuga kungawonetse kuchuluka kwake, komwe sikumapereka umboni wa kuphwanya kwake kagayidwe. Komanso, zomwe zili bwino sizitanthauza kuti palibe mavuto ndi kagayidwe kazakudya. Zinthu zomwe zili pamwambazi sizikhudza kuchuluka kwa hemoglobin ya glycosylated. Ndiye chifukwa chake tanthauzo lake limakhala chisonyezo pakuzindikira koyambirira kwa zovuta za carbohydrate metabolism m'thupi. Zisonyezo za phunziroli: Nthawi zambiri, kafukufukuyu amachitika pofuna kudziwa zovuta za metabolic ndipo zimachitika mwa izi:

• Type 1 shuga mellitus, limodzi ndi kutumphuka kwa mafuta kwakanthawi kochepa.
• Kuzindikira koyambirira kwa matenda a shuga a 2.
• Kuchepetsa chakudya kagayidwe mu ana.
• Matenda a shuga omwe ali ndi matenda osabereka a impso, pamene gawo lalikulu la chakudya limaperekedwa ndi impso.
• Mwa amayi omwe amatenga pakati komanso omwe adapezeka ndi matenda a shuga, lembani 1 kapena 2 isanakwane.
• Matenda a shuga a Gestational - kuchuluka kwa shuga m'magazi panthawi yomwe ali ndi pakati, pomwe vuto la shuga silinakhalepo. Kuyesedwa kwa shuga pankhaniyi kumatha kuwonetsa kuchepa, popeza gawo lalikulu la michere kuchokera ku magazi limapita kwa mwana wosabadwayo.
• Kuwongolera kwa chithandizo chamankhwala - mtengo wa glycosylated hemoglobin umawonetsa kuchuluka kwa shuga kwa nthawi yayitali, zomwe zimatipangitsa kuti tiziweruza momwe mankhwalawa amathandizira, omwe odwala matenda ashuga amatha kusintha molingana ndi zotsatira za kusanthula.

Kodi ndichifukwa chiyani ndikofunikira kuzindikira zovuta za kagayidwe kachakudya mthupi mthupi momwe zingathere? Kuchulukana kwachulukirapo kwa shuga kumabweretsa zotsatira zosasintha m'thupi chifukwa chogwirizana ndi mapuloteni, omwe ndi:

1. Glycosylated HbA1C wolakwika sachitanso ntchito yoyendetsa mpweya mokwanira, zomwe zimayambitsa hypoxia ya zimakhala ndi ziwalo. Ndipo kukwera chizindikiro ichi, kumachepetsa mphamvu ya oxygen m'misempha.
2. Zowonongeka (retinopathy) - kumangiriza kwa glucose kumapuloteni a retina ndi mandala a maso.
3. Kulephera kwamkati (nephropathy) - kuphatikiza kwa chakudya m'matumbo a impso.
4. Matenda a mtima (mtima) ndi mitsempha yamagazi.
5. Kusokonezeka kwa ziwalo za m'mitsempha za zotumphukira (polyneuropathy).

Momwe mungasinthire?

Mwa kusanthula, magazi athunthu amatengedwa kuchokera mu mtsempha mu 2-5 ml ndi kusakaniza anticoagulant kuti asapindike. Izi zimapangitsa kusungirako kwa sabata limodzi, kutentha +2 + 5 ° С. Malangizo aliwonse apadera musanapange mayeso a magazi a glycosylated hemoglobin safunikira kuchitidwa, mosiyana ndi kuyesa kwa shuga. Pafupipafupi pakutsimikiza kwa cholembera chizindikiro cha matenda a shuga ndi chimodzimodzi kwa amuna ndi akazi, ndipo kupangika kwa miyezi iwiri mpaka itatu ya mtundu woyamba, miyezi isanu ndi umodzi ya mtundu II. Mu amayi apakati - kuwongolera pa masabata 10-12 pakati pa kuyesedwa kwa shuga.

Kutanthauzira kwa zotsatira za kusanthula

Ngati mukufuna funso la zomwe glycosylated hemolobin akuwonetsa, ndiye kuti kudziwa tanthauzo la kusanthula kuti mupeze mulingo wa HbA1C sikovuta. Kuchulukitsidwa kwake ndi 1% kuchokera ku nthawi zonse kumafanana ndi kukwera kwa kuchuluka kwa shuga ndi 2 mmol / L. Zizindikiro zotere za HbA1C komanso kuchuluka kwa glucose komanso kuchuluka kwa kagayidwe kazakudya zimafotokozedwa pagome la glycosylated hemoglobin yomwe ili pansipa:

Ambiri kuchuluka kwa shuga m'miyezi itatu yapitayi, mmol / l

Kodi hemoglobin ndi glycosylated ndi chiyani

Kuyang'anira shuga m'magazi sikophweka, ndipo njira zambiri nthawi zambiri zimapereka zotsatira zolakwika. Zosankha zomwe zimapezeka kwambiri komanso zothandiza ndi kusanthula kwa glycosylated hemoglobin. Phunziroli ndi lodalirika kuposa glucose m'magazi.

Glycosylated hemoglobin ndi gawo lomwe limafotokozera shuga wapakati pamasiku 120 apitawa. M'malo mwa mawu oti "glycosylated", "glycated" angagwiritsidwe ntchito. Maupangiri ndi ma syonyms, ndipo onsewa amatanthauza hemoglobin yokhudzana ndi glucose.

Kwa anthu athanzi komanso odwala matenda ashuga, kuwonjezereka kwa kuchuluka kwa glycogemoglobin yomwe ili m'magazi ndi mwayi wopita kuchipatala. Dokotala akufotokozerani maphunziro othandizira kapena kukulangizani kuti musinthe momwe mungasinthire moyo wanu. Popewa matendawa, amapereka zakudya zapadera, mogwirizana ndi zomwe muyenera kudya zokha zomwe zimakhala ndi chakudya chochepa.

Njira yofufuzira kuchuluka kwa shuga posankha glycosylated hemoglobin ndi yothandiza kwambiri. Komabe, imakhalabe ndi drawback imodzi: mphamvu yake imachepetsedwa ngati njira iliyonse yowonetsera ikuchitika ndi magazi.

Mwachitsanzo:

• ngati wodwala adatenga nawo magazi, magazi am'magazi a woperekayo ndipo munthu yemwe magaziwo adamulowetsa adzasiyananso.
• kutsika kwabodza kumachitika pambuyo pakukha magazi ndi hemolysis,
• kuchulukitsa kwabodza kungawonedwe mosakayikira ndi kuchepa kwa magazi m'thupi.

Kuwona glycogemoglobin kungathandize ngati:

• ngati shuga wa munthu woyeserera ali pafupi kutsala pang'ono,
• pomwe wodwalayo satsata zakudya kwa miyezi 3-4, ndipo sabata imodzi isanachitike phunziroli adasiya kudya zakudya zopatsa thanzi, akuyembekeza kuti palibe angadziwe za izi.

Pambuyo pozindikira, dokotala. Katswiri akuwuzani kuti akuyenera kuyesedwa kangati pakuwunika mankhwala. Ngati wodwalayo sakudandaula za chilichonse, masiku omwe mudzayendera kuofesi kwa endocrinologist ndi omwe adalembedwa ndi adokotala. Kutalika kwa moyo wa erythrocyte kumapangitsa kuchuluka kwa phunziroli la glycogemoglobin. Izi zikuyenera kuchitika masiku aliwonse okwana 120.

Ngati palibe zodandaula kapena zoyipa zoyipa, ndiye sizikupanga nzeru kukaonana ndi dokotala pafupipafupi.

• mwa achinyamata, glycohemoglobin sayenera kungokhala osaposa 6.5%,
• wazaka zapakatikati - zosaposa 7%,
• kwa okalamba - 7.5%.

Komabe, ndizomveka kunena za manambalawa ngati odwala alibe zovuta ndipo palibe chiopsezo cha hypoglycemia yayikulu. Mwanjira ina, chisonyezo chiyenera kukwera ndi 0,5% pagawo lililonse.

Zotsatira zake sizodwala zomwe. Macheke amayenera kuchitika nthawi imodzi ndi kusanthula kwa glycemia. Mtengo wapakati wa glycogemoglobin ndi zofunikira zake sizitsimikizira kuti mulingowo sungasinthe kwambiri tsiku lonse. Kwa oyembekezeraMlingo wa glycohemoglobin mwa akazi awa umasiyana mosiyanasiyana, chifukwa thupi la mayiyo limadzichitira lokha komanso mwana.

Zizindikiro zotsatirazi zimawoneka ngati zabwinobwino:

• mpaka zaka 28 - mpaka 6.5%,
• kuyambira wazaka 28 mpaka 40 - mpaka 7%,
• Zaka 40 ndi zina - mpaka 7.5%.

Ngati mayi woyembekezera ali ndi glycohemoglobin wa 8-10%, izi zimawonetsa zovuta ndipo amafunikira chithandizo.
Kusanthula kwa shuga kwa mayi woyembekezera kuyenera kukhala kovomerezeka ndi kangapo panthawi yonse yokhala ndi pakati, popeza adadyapo asanachitike. Kwa anaMuyezo wa glycogemoglobin mwa ana ndi wofanana ndi wamkulu ndipo ndi 5-6%. Kusiyanako kumangokhala ndi mitengo yayitali. Ngati agwetsedwa kwambiri, mwana amatha kukhala ndi vuto lakuwona.
Tiyenera kukumbukira: thupi la anawo silili lolimba chifukwa chake njira yapadera imafunikira. Kwa anthu odwala matenda ashugaNgati matendawa adapangidwa, ntchito yayikulu ya wodwalayo ndikuwonetsa chizindikiro mkati mwa 7%. Izi ndizosavuta ndipo wodwalayo ayenera kuganizira zambiri.
Kuti mukwaniritse ntchito yoletsa kukula kwamagulu a shuga imagwiritsidwa ntchito:

• insulini (zikafunika)
• kutsatira kwambiri zakudya zapadera,
• kupimidwa pafupipafupi
• kugwiritsa ntchito glucometer.

Zosiyanasiyana zamagetsi zimayang'anira azimayi pa nthawi yoyembekezera

Ngakhale zabwino za kafukufuku wa glycogemoglobin, ndibwino kuti amayi apakati azitha kuzichita, chifukwa vuto lowonjezera glucose limachitika pafupipafupi mwezi wa 6. Kusanthula komweku kumangowonetsa kuwonjezeka kwa miyezi iwiri, yomwe ili pafupi ndi kubadwa kokha ndipo ngati zikuwonetsa kwambiri, njira zowachepetsera zikhala zopanda ntchito.

Ngati mumapereka magazi m'mawa ndi m'mimba yopanda kanthu, zotsatira zake zimakhala zopanda ntchito: kuchuluka kwa shuga kumakhala kathanzi mukatha kudya, ndipo pambuyo maola maola 3-4 mitengo yake ingathe kuvulaza mayi. Nthawi yomweyo, kuwunika shuga ndikofunikira.

Chodziwikiratu kwambiri ndicho mayeso a shuga omwe amachitika kunyumba. Mudagula zolemba, mutha kuyeserera kunyumba mutatha theka la ola, 1 ndi maola awiri mutatha kudya. Mlingo sayenera kukhala wapamwamba kuposa 7.9 mmol / l, mukakhala wokwera, izi zimafunikira kuonana ndi dokotala.

Zizindikiro za phunziroli

Glycosylated hemoglobin ndi phula lomwe limapangidwa pafupipafupi.

Zizindikiro za phunziroli ndi:

• kuyesa matenda a shuga
• kuwunika kuwongolera kwa hyperglycemia kwanthawi yayitali anthu odwala matenda ashuga,
• kutsimikiza kulipira shuga,
• kulolerana kwa shuga,
• kuyesedwa kwa akazi omwe ali ndiudindo.

Kuwunika kwa Glycogemoglobin kuyenera kuchitika ndi zizindikiro zotsatirazi za shuga:

• kamwa yowuma
• nseru
• kuwonda popanda chifukwa,
• kufooka
• kutopa kwambiri
• kumva ludzu losatha kapena njala,
• kufuna kutulutsa chikhodzodzo kuli pafupipafupi,
• kuchira kwanthawi yayitali
• matenda a pakhungu
• kuwonongeka kwamawonekedwe
• akumwetulira m'manja ndi miyendo.

Momwe mungakonzekerere kusanthula

Chimodzi mwamaubwino apadera a kusanthula kwa glycogemoglobin ndikuchepa kukonzekera mwapadera.

Zotsatira zoyeserera sizoyimira:

• mkhalidwe wamaganizidwe,
• katundu munyama
• kumwa mankhwala, kuphatikizapo maantibayotiki.
• chimfine ndi matenda
• kudya chakudya ndi nthawi isanachitike kapena itatha,

Kukonzekera konseku kumakhala ndi chikhalidwe komanso kulandira malangizo kuchokera kwa dokotala ngati kuli kofunikira.

Matenda a glycosylated hemoglobin

Pali njira zingapo zochepetsera gawo lanu la glycogemoglobin. Chosavuta kwambiri kwa iwo ndi kugwiritsa ntchito mankhwala apadera omwe amalembedwa ndi dokotala. Komabe, njira yoyenera ya moyo ndiyofunika. Cholinga chachikulu chokwanirira komanso kutsika kwamisempha ndi chakudya komanso chakudya choyenera.

Malinga ndi kafukufuku wina, matenda a shuga a mtundu wa 2, amachepetsa kuchuluka kwa hemoglobin, ngakhale 1% sakhala ndi vuto la mtima, amkati.

Kuti muchepetse kuchuluka kwa glycogemoglobin, muyenera:

1. Chepetsani kuchuluka kwa zakudya zomwe zimakhala ndi zakudya m'zakudya (ndi kuchuluka kwambiri) ndikuyatsa (ndi kuchepetsedwa).
2. Idyani masamba ndi zipatso zambiri (makamaka nthochi), chimanga ndi nyemba.
3. Kanizani zakudya zopaka bwino - confectionery, mikate yoyera yoyera, zinthu zophika, tchipisi, koloko, maswiti osiyanasiyana. Ngati simungathe kuzichotsa kwathunthu, muyenera kuyesetsa kudya zochepa kapena kusinthitsa zinthu zachilengedwe.
4. Kuphatikiza mafuta a mkaka otsika mu kalori mu zakudya, izi zithandizira kupezeka kwa calcium ndi vitamini D m'thupi.
5. Idyani zakudya zamasamba, mtedza ndizothandiza kwambiri.
6. Gwiritsani sinamoni monga zokometsera, koma osapitirira 0,5 tsp. patsiku.
7. Onetsetsani kuti mwatsata.

Njira ina yobwezera shuga kuti ikhale yokhazikika ndi kukhalabe ndi moyo wabwino.

Kuchita masewera olimbitsa thupi pafupipafupi:

• thandizani kuthana ndi zopatsa mphamvu zochulukirapo,
• limbitsa mtima
• chepetsani chiopsezo cha kupsinjika ndi kupsinjika,
• chifukwa cha iwo, thupi limakhalabe labwino.

Kuyenda pafupipafupi mu mpweya watsopano ndikofunikira. Kwa iwo omwe aphatikizidwa ndi zolimbitsa thupi, kuyenda kwa Nordic, kusambira, yoga, masewera olimbitsa thupi komanso kusinkhika ndikulimbikitsidwa.

Kukhala wokhazikika komanso kusasintha kwa ndandanda ndikofunikira mu chilichonse. Izi zikugwirira ntchito pa maphunziro, zakudya komanso kugona, nthawi yamankhwala ndi kafukufuku. Nthawi zowunikira zoterezi zimathandiza wodwalayo kuti azilamulira komanso kuwongolera osati glycogemoglobin, komanso moyo wake wonse.

Njira zachipatala zilinso zotheka kupewa matendawa ndikuchepetsa kuchuluka kwa mapuloteni okhala ndi chitsulo.

Njira zake ndi izi:

• thandizo la kukakamiza pamlingo wa 140/90 mm RT. Art.,
• kusintha kuchuluka kwa mafuta kuti pasakhale chiwopsezo cha kusintha kwa ma atherosulinotic m'mitsempha yamagazi,
• kuyesa kwamaka, masikono, impso ndi miyendo. Wodwalayo ayenera kuwongolera mawonekedwe a miyendo yake, makamaka kupezeka kwa matuza, kufiira kapena kubinya, zitsamba, chimanga ndi matenda osiyanasiyana a fungus.

Kusanthula kumayenera kuchitika katatu pachaka, uku mukukumbukira kuti kuphunzira koteroko sikungalowe m'malo mozindikira kuchuluka kwa shuga ndi glucometer wamba ndipo ndikofunikira kugwiritsa ntchito njira zonsezi mwanjira yokwanira. Ndikulimbikitsidwa kuti muchepetse chizindikirocho pang'onopang'ono - pafupifupi 1% pachaka ndipo samalimbana ndi chiwonetsero chazomwe 6%, koma pazofunikira zomwe zimasiyana m'magulu osiyanasiyana.

Kudziwa chizindikiro ichi (glycosylated hemoglobin), mwina ndibwino kuti muziwongolera matendawa, kusintha zina ndi zina za mankhwala omwe ali ndi shuga komanso pokonzekera zomwe zimapangidwa kuti muchepetse shuga.

Kapangidwe kake: Mila Friedan