Mowa hypoglycemia - kapangidwe ka chitukuko ndi momwe mungathetsere

A. Zambiri.Zakumwa zoledzeretsa ndizomwe zimayambitsa kwambiri hypoglycemia mwa makanda ndi ana okulirapo. Mwana amatha kumwa zakumwa zoledzeretsa kuchokera kwa munthu wamkulu paphwando. Zikatero, hypoglycemia imachitika m'mawa wotsatira. Nthawi zina makolo amapatsa mwana wawo mowa kapena vinyo.

B. Pathogenesis. Kutembenuka kwa ethanol kukhala acetaldehyde amathandizika ndi mowa dehydrogenase. Cofactor ya enzyme iyi ndi NAD - chinthu chofunikira pa gluconeogeneis. Kudya kwa Ethanol kumayambitsa kuwononga ndalama mwachangu kwa NAD komanso kuletsa kwakuthwa kwa chiwindi m'thupi. Ethanol imayambitsa hypoglycemia pokhapokha maola 6 akumwalira ndi njala (pamene glycogen mu chiwindi itatha).

B. Chithandizo. Ndi hypoglycemia wofatsa kapena wolimbitsa, amapatsidwa zakumwa ndi chakudya chamagulu a shuga. Hypoglycemia yayikulu imachotsedwa ndi kulowetsedwa kwa shuga. Pambuyo pa vuto limodzi la hypoglycemia, ngati kumwa kwakakhazikika, sikofunikira kuti muyeze mwanayo.

Viii. Hypoglycemia.Hypoglycemia mu ana imatha kuchitika chifukwa cha kuyambitsa insulin, mankhwala ochepetsa shuga m'mlomo kapena milingo yayikulu ya salicylates. Valproic acid ndi zotumphukira zake zimalepheretsa makutidwe ndi okosijeni amafuta acids, zomwe zimapangitsa kuti magazi asokonezeke gluconeogeneis ndi kusowa kwachiwiri kwa carnitine. Mankhwala osokoneza bongo a valproic acid ndi zotuluka zake amatha kuwoneka ngati hypoglycemia popanda ketonemia ndi ketonuria, makamaka atatha kufa ndi njala.

Kuwongolera insulin ndi mtundu wina wozunza ana. Zimachitikanso kuti makolo amapereka insulin kwa mwana, akuganiza kuti ali ndi matenda a shuga omwe amadalira insulin. Hypoglycemia yoyambitsidwa ndi insulin ndi pakamwa hypoglycemic wothandizirana nthawi zambiri imayendera limodzi ndi kukomoka komanso kuwonongeka ndipo amatha kusokonezedwa ndi mitundu ina ya hypoglycemia.

IX. Idiopathic yogwira hypoglycemia - mtundu wa hypoglycemia wotengedwa ndi chakudya (onaninso mutu 34, p. VIII). Mtunduwu wa hypoglycemia nthawi zambiri umakayikiridwa mwa ana ndi achinyamata, koma kuzindikira kwake sikumatsimikiziridwa kwambiri. Kuzindikirika kwa idiopathic reactive hypoglycemia kumakhazikitsidwa pamaziko a zotsatira za kuyesedwa kwa glucose pakamwa: maola 3-5 mutatha kudya shuga pamlingo wa 1.75 g / kg (pazipita 75 g), kuchuluka kwa shuga m'magazi

Momwe mowa umasokoneza hypoglycemic syndrome

Khalidwe la ethanol m'magazi ndi losamveka:

• Choyamba, zimawonjezera ntchito ya insulin ndi mapiritsi ochepetsa shuga.
• Kuletsa chiwindi, Mowa umalepheretsa kupanga kwa glucogen - gwero lina la shuga.
• Limagwirira a mowa ndi ofanana ndi ntchito ya lipids: Kutha mafuta, kumawonjezera kuchuluka kwa mafuta maselo. Kudzera m'matumbo owonjezera, glucose wochokera m'magazi amalowa mu cell. Zomwe zili m'magazi zimagwa, njala yofunikira imawoneka.

Kuphatikiza apo, ethanol imakonza magwiridwe antchito a mahomoni amakula ndipo imasokoneza mayankho oyenera a thupi pakusintha kwa plasma. Ichi ndi chimodzi mwazomwe chimayambitsa hypoglycemia mwa anthu omwe amamwa mowa mopitirira muyeso, chifukwa kukula kwa ma hormone kumayendetsa glucometer.

Chifukwa cha zopatsa mphamvu "zopanda kanthu" zomwe ethanol imakhala, zimalepheretsa kugwiritsa ntchito mafuta m'thupi.

Limagwirira kukula kwa chidakwa hypoglycemia

Anthu odwala matenda ashuga omwe ali ndi "chidziwitso" cholimba cha matendawa amadziwa za kutsetsereka kwa mowa. Mlingo wa glucose umakwera m'njira ziwiri: kudya mafuta ochulukirapo ndi chakudya komanso kupanga glycogen ndi chiwindi. Kukhazikika kwa glucose kosakhazikika kumachirikiza shuga pafupifupi 3,3 mmol / L. Ngati mowa ungalepheretse gluconeogeneis poletsa chiwindi, taganizirani zomwe zimachitika m'thupi pamene shuga sayatsidwa. Mwayi wopeza hypoglycemia ndiwopamwamba mu odwala matenda a shuga omwe amadalira insulin, popeza kusintha mlingo woganizira zakumwa sikophweka.

Ethanol imayambitsa hypoglycemia chifukwa cha kusokoneza njira ya gluconeogeneis ndikusintha kwa chiyezo cha cytosolic NAD H2 / NAD. Kukonza mowa mu chiwindi kumapangitsa mowa dehydrogenase. Cofactor ya enzyme, NAD (nicotinamide adenine dinucleotide) ndi gawo lofunikira la glucogenesis. Mowa wambiri m'magazi am'magazi umayambitsa kugwiritsidwa ntchito kwa NAD komanso kutsekeka kwa nthawi imodzi kwa chiwindi.

Mwachiwonekere, mowa hypoglycemia umayamba motsutsana ndi kumbuyo kwa kuchepa kwa zinthu za glycogen, pomwe kuthekera kwa chiwindi kwa glucogenesis ndikofunikira kwambiri kuti matenda a shuga asinthe. Pangozi ndi anthu omwe amamwa mowa pafupipafupi ndi zakudya zochepa.

Matenda a hypoglycemic state

Mowa ndi chizoloŵezi chofunikira kuti chitukuko cha hypoglycemia chithandizire kwa omwe amapezeka popanda matenda a shuga. Poyamba, ziwerengero zotere zidalungamitsidwa ndi zosayenera zomwe zimakhala ndi zakumwa zoledzeretsa zamtengo wapatali. Koma atayesa mafuta oyera a ethanol, omwe adaperekedwa kwa odzipereka athanzi labwino omwe adakhala ndi njala kwa masiku awiri kapena atatu ndikuwonetsa zotsatira zofananira, malingaliro awa adayenera kusintha.

Mowa hypoglycemia nthawi zambiri umapezeka pakati paokonda zakumwa zoledzeretsa omwe amapita osagwiritsa ntchito tsiku limodzi kapena awiri. Vuto limayamba patadutsa maola 6 mpaka 24 Mowa atalowa m'magazi, ndiye kuti sizingatheke kuzindikira vuto la fungo lochokera mkamwa, kufunikira kwa labotale ndikofunikira. Pali mbiri ya zizolowezi zosinthidwa mobwerezabwereza, izi zikuwonetsa kukwiya kwa mitsempha ndi m'mimba ndimowa, chosowa cha calorie pomwe zakudya zomwe zimakhala ndi ethanol zimalowa m'mimba.

Ziwopsezo, chifukwa chotenga kachilombo ka HIV chifukwa chomwa mowa:

• Odwala odwala matenda a shuga
• Odwala omwe ali ndi pathologies a pituitary-adrenal system,
• Ana omwe ali ndi mwayi wakumwa mowa mwangozi.

Kuopsa kwa khunyu komanso chizolowezi cha hypoglycemia kumakhalapo kwa ana osaposa zaka 5. Mlingo wowopsa wa ethanol weniweni wa ana ndi 3 g / kg (mwa akulu - 5-8 g / kg).

Hypoglycemia woledzera wa mowa nthawi zambiri umatha. Ndikosavuta kusiyanitsa dziko lino ndi poyizoni wa mowa.

Mowa hypoglycemia amadziwika ndi zofunika zizindikiro matenda:

Kuyesa kwa hepatatic kumawonetsa chizolowezi, ndikotheka kuzindikira zokhazo pokhapokha ndi mbiri yakale yomwa mowa yotchulidwa mu anamnesis. Pambuyo pobwezeretsa chuma cha glycogen, kutsitsimutsa mowa sikuyambitsa hypoglycemia.

Hypoglycemia wokhala ndi zakumwa zoledzeretsa zimadalira mlingo: kwambiri pamene wovutikayo watenga, glucogeneis yotalikirapo imapindika. Choopsa chachikulu ndi mtundu wachedwa wa hypoglycemia. Ngati madzulo adamwa zakumwa zoledzeretsa, vuto limatha kuyamba usiku. Chifukwa cha kuchuluka kwa glycogen m'chiwindi, izi sizovuta kuchiza. Kuledzera kwauchidakwa kumathandizira kunyalanyaza zizindikiritso zam'mbuyomu za hypoglycemia, kotero njira zopewera panthawi yake sizitengedwa.

Momwe mungathetsere hypoglycemia ya mowa

Popanda chidziwitso chanthawi yake komanso chithandizo chokwanira, anthu omwe amamwalira mu vutoli amawonedwa 25% ya ana komanso 10% ya achikulire omwe akuchitiridwa nkhanza.

Kukhazikitsidwa kwa glucagon sikuthetsa vuto lomwe limachitika chifukwa cha kuledzera, chifukwa kulibenso malo ena osungirako glycogen, komanso momwe thupi limachitikira ndi timadzi timeneti. Jakisoni wa glucose ndiwothandiza kuchepetsa milingo ya lactate komanso kusintha momwe mulili acid-base. Mosiyana ndi mtundu wa hypoglycemia, wodwala safuna kulowetsedwa kwa shuga. Mu ana omwe ali ndi zizindikiro zotere, amayamba ndi shuga, ndipo dontho lokhala ndi glucose-electrolyte solution imakwaniritsa.

Monga chithandizo choyambirira (ngati wozunzidwayo akudziwa) amaloledwa kugwiritsa ntchito zakudya zamafuta - maswiti, msuzi wokoma. Kupumula kwa hypoglycemia kumaletsedwa ndi chakudya chamagulu. Mapiritsi a glucose ali ndi kuchuluka kwa chakudya chamagulu.

Njira zabwino zothanirana chikomokere ndi kupewa:

1. Anthu odwala matenda ashuga ayenera kuchepetsa kumwa mowa.
2. Mowa sungakhale njira yochepetsera glycemia.
3. Ndi chiwindi chathanzi, amaloledwa kudya 50 g ya vodka ndi cognac kapena 150 mg wa vinyo wouma (chofunikira chachikulu cha chakumwa ndikusowa shuga ndi zoperewera pang'ono).
4. Nthawi zina mumatha kumwa mowa - mpaka 300 g (kuvulaza kwa chakudya chamafuta kumalipidwa ndi zabwino za yisiti yofulula).
5. Zakumwa zonse zotsekemera zimaletsedwa - zotsekemera ndi viniga wokhala ndi mipanda yolimba, ma liqueurs, zakumwa, etc. Kwa amayi apakati palibe chosankha: mowa umaletsedwa pachikhalidwe.
6. Kumbukirani kuti mowa umapereka chizindikiro cha hypoglycemia, kuphatikizapo kuchedwa. Chenjerani za mavuto anu kwa omwe ali pakali pano.
7. Zakudya zoledzeretsa ziyenera kudyedwa mukatha kudya.
8. Musanagone, onetsetsani kuti mumawerengera za shuga ndikudya zina ndi zopatsa mphamvu.
9. Mukamawerengera zakudya zanu zopatsa mphamvu, gwiritsani ntchito zakumwa za calorie: 1 g mapuloteni kapena chakudya - 4 kcal, 1 g yamafuta - 9 kcal, 1 g ya ethanol - 7 kcal.
10. Khalani okonzekera kuti mowa udzakulitsa kuchuluka kwa triglycerides, kumapangitsa chiwonetsero cha matenda amitsempha ya matenda a shuga.