Matenda a shuga > Matenda a shuga

Matenda a shuga- matenda oyambitsidwa ndi kuperewera kwathunthu kapena wachibale wa hypothalamic timadzi vasopressin (AdH-antidiuretic hormone).

Pafupipafupi matendawa sakudziwika, amapezeka mu 0.5-0.7% ya odwala endocrine.

Kuwongolera kumasulidwa kwa vasopressin ndi zotsatira zake

Vasopressinndipo oxytocin amapangika mu supraoptical ndi paraventicular nuclei ya hypothalamus, imadzaza m'miyala ndi ma neurophysins ogwirizana ndipo imayendetsedwa molumikizana ndi axons mu posterior pituitary gland (neurohypophysis), komwe imasungidwa mpaka kumasulidwa kwawo. Zosungidwa za vasopressin mu neurohypophysis ndi kukondoweza kwake kwachinsinsi, mwachitsanzo, posasiya kumwa, zimachepetsedwa kwambiri.

Kubisala kwa vasopressin kumachitika chifukwa cha zinthu zambiri. Chofunika kwambiri pa izi ndi kuthamanga kwa magazi a osmotic, i.e. osmolality (kapena osmolarity) wa plasma. Mu anterior hypothalamus, pafupi, koma mosiyana ndi supraoptical ndi paraventicular nuclei, iliosmoreceptor. Momwe plasma osmolality imakhala yocheperako, kapena mtengo woperewera, kuchuluka kwa vasopressin mmenemu ndizochepa kwambiri. Ngati plasma osmolality idutsa gawo loyikirali, osmocenter amadziwa izi, ndipo kuchuluka kwa vasopressin kumakwera kwambiri. Njira yosinthira mawu imayankha mwachidwi komanso molondola kwambiri. Kuwonjezeka pang'ono kwa zamphamvu za osmoreceptor kumalumikizidwapofika zaka.

Osmoreceptor samva chidwi chimodzimodzi ndi zinthu zingapo zam'madzi. Sodium(Na +) ndi anions ake ndi olimbikitsa kwambiri a osmoreceptor ndi vasopressin secretion. Na ndi anions ake nthawi zambiri amatsimikiza 95% ya plasma osmolality.

Mothandizidwa kwambiri ndi vasopressin kudzera mwa osmoreceptor sucrose ndi mannitol. Glucose kwenikweni samalimbikitsa osmoreceptor, monganso urea.

Chinthu chodalirika kwambiri chodzetsa secretion ya vasopressin ndikutsimikizaNa+ndi plasma osmolality.

Secretion wa Vasopressin amakhudzidwa kuchuluka kwa magazi ndi kuthamanga kwa magazi. Izi zimachitika kudzera mu baroreceptors omwe ali mu atria ndi aortic chipilala. Baroreceptor stimuli kudzera ku ulusi wothandizirana nawo amapita ku tsinde laubongo monga gawo la mitsempha ya vagus ndi glossopharyngeal. Kuchokera pa tsinde laubongo, ma sign amaperekedwa ku neurohypophysis. Kutsika kwa kuthamanga kwa magazi kapena kuchepa kwa magazi (mwachitsanzo, kuchepa kwa magazi) kumalimbikitsa kwambiri chinsinsi cha vasopressin. Koma dongosololi ndilosavuta kwenikweni poyerekezera ndi zomwe zimayambira osmosceptor.

Chimodzi mwazinthu zothandiza zomwe zimapangitsa kuti vasopressin amasulidwe nseruozungulira, kapena chifukwa cha machitidwe (glogi, mowa, chikonga, apomorphine). Ngakhale ndi mseru, popanda kusanza, msambo wa vasopressin mu plasma umakwera nthawi 100-1000!

Osagwira mtima kuposa nseru, koma zolimbikitsanso zotere za vasopressin ndi hypoglycemia,makamaka lakuthwa. Kuchepa kwa shuga m'magazi ndi 50% ya magawo oyamba m'magazi kumawonjezera zomwe zili vasopressin nthawi 2-4 mwa anthu, komanso makoswe nthawi 10!

Kuchulukitsa kwa vasopressin secretion renin-angiotensin dongosolo. Mlingo wa renin ndi / kapena angiotensin ofunikira polimbikitsa vasopressin sichikudziwika mpaka pano.

Amakhulupiriranso kuti nkhawa zopanda pakechifukwa cha zinthu monga kupweteka, kutengeka, zolimbitsa thupi, zimathandizira chinsinsi cha vasopressin. Komabe, sizidziwika momwe kupsinjika kumathandizira kubisalira kwa vasopressin - mwanjira ina yapadera, kapena kudzera kutsitsa magazi ndi mseru.

Pewani chinsinsi cha vasopressinmtima yogwira zinthu, monga norepinephrine, haloperidol, glucocorticoids, opiates, morphine. Koma sizinadziwikebe ngati zinthu zonsezi zimachitika pakati, kapena mwakuwonjezera kuthamanga kwa magazi ndi voliyumu.

Kamodzi pakuzungulira kwadongosolo, vasopressin imagawiridwa mwachangu kumadzi onse akunja. Kuyenera pakati pa intra- ndi extravascular space kumatheka mkati mwa mphindi 10-15. Kugwiritsa ntchito vasopressin kumachitika makamaka mu chiwindi ndi impso. Gawo laling'ono silidawonongeke ndikuchotsa mkodzo mu mawonekedwe owoneka.

Zotsatira.Chofunikira kwambiri mwachilengedwe cha vasopressinkusunga madzi mthupipochepetsa kutulutsa mkodzo. Momwe mungagwiritsire ntchito yake ndi epithelium ya distal ndi / kapena tubules ya impso. Popanda vasopressin, maselo membala omwe ali mbali iyi ya nephron amapanga cholepheretsa kuphatikizika kwa madzi ndi zinthu zosungunuka. M'mikhalidwe yotero, kusefukira kwa hypotonic komwe kumapangidwa m'malo ophatikizika kwambiri a nephron kumadutsa mu tubal ndikukutola ma ducts popanda kusintha. Kukula kwakanthawi (kachulukidwe kakang'ono) kamkodzo kotere ndi kochepa.

Vasopressin imachulukitsa kuchuluka kwa distal ndi kusungira tubules kwa madzi. Popeza madzi amawabwezeranso popanda zinthu za osmotic, kuchuluka kwa zinthu zosmotic mmenemo kumawonjezeka, ndipo voliyumu yake, i.e. kuchuluka kukuchepa.

Pali umboni wosonyeza kuti timadzi tomwe timakhala ndi minyewa, prostaglandin E, timalepheretsa zochita za vasopressin mu impso. Nawonso, mankhwala osapweteka a antiidal (mwachitsanzo, Indomethacin), omwe amalepheretsa kuphatikizika kwa ma prostaglandins mu impso, amathandizira kusintha kwa vasopressin.

Vasopressin amagwiritsanso ntchito machitidwe osiyanasiyana owonjezera, monga mitsempha yamagazi, m'mimba, chapakati chamanjenje.

W ludzuamagwira ntchito monga yofunika kwambiri ya ntchito yotsutsa ya vasopressin. Wamva ludzu amazindikira kufunika kwa madzi.Thupi limalimbikitsidwa ndi zinthu zambiri zomwe zimayambitsa kutulutsa kwa vasopressin. Zothandiza kwambiri pamenepahypertonic chilengedwe.Mulingo wamphumphu wa madzi am'madzi, pomwe pali ludzu, uli 295 mosmol / kg. Ndi osmolality wamagazi awa, mkodzo wokhala ndi chindapusa chachikulu nthawi zambiri umatulutsidwa. M ludzu ndi mtundu wammawu, ntchito yayikulu yomwe imateteza kuchepa kwamadzi, yomwe imapitirira mphamvu zowonjezera pathupi.

M ludzu umachulukira mwachangu motsatira kuchuluka kwa madzi am'madzi ndipo umakhala wolekerera pamene osmolality imangokhala 10-15 mosmol / kg kuposa gawo lofika. Madzi akumwa amagwirizana ndi ludzu. Kutsika kwa magazi kapena kuthamanga kwa magazi kumadzetsanso ludzu.

Kukula kwa mitundu yapakati pa matenda a shuga a insipidus kumakhazikitsidwa ndikugonjetsedwa kwa magawo osiyanasiyana a hypothalamus kapena posterior pituitary, i.e. neurohypophysis Zifukwa zake zingaphatikizeponso zinthu izi:

matendapachimake kapena matenda: fuluwenza, meningoencephalitis, malungo ofiira, pertussis, typhus, sepsis, tonsillitis, chifuwa, syphilis, rheumatism, brucellosis, malungo,

kuvulala kwamtundu wamatumbo: mwangozi kapena opaleshoni, kugwedezeka kwamagetsi, kuvulala pakubala pakubala,

hypothalamic kapena chotupa pituitary:metastatic, kapena choyambirira. Cancer ya mammary ndi chithokomiro, bronchi metastases kupita ku tchire England nthawi zambiri. Kulowetsedwa ndi zotupa mu lymphogranulomatosis, lymphosarcoma, leukemia, matenda a xanthomatosis (Hend-Schuller-Crispen). Zotupa zoyambira: adenoma, glioma, teratoma, craniopharyngioma (makamaka nthawi zambiri), sarcoidosis,

matenda endocrine:Simmonds, Skien, Lawrence-Moon-Beadl syndromes, pituitary dwarfism, acromegaly, gigantism, adinogenital dystrophy,

chidziwitso:mu 60-70% ya odwala, chomwe chimayambitsa matendawa sichikudziwika bwinobwino. Mwa mitundu ya idiopathic, chiwonetsero chodziwika bwino chimakhala ndi matenda amtundu wa shuga. Mtundu wa cholowa ndiwosankha komanso wosinthika,

autoimmune: chiwonongeko cha mikanda ya hypothalamus chifukwa cha njira ya autoimmune. Fomuyi imaganiziridwa kuti imapezeka mu idiopathic shuga insipidus, momwe ma autoantibodies opanga maselo otulutsa vasopressin amawonekera.

Ndi zotumphukiramatenda a shuga a insipidus vasopressin amapulumutsidwa, koma mphamvu ya zolandilira zaubulibuloni ku ihomoni imachepetsedwa kapena kulibeko, kapena mahomoni awonongedwa kwambiri mu chiwindi, impso, ndi placenta.

Nephrogenic shuga insipidusNthawi zambiri zimawonedwa mwa ana, ndipo zimayambitsidwa chifukwa cha kuchepa kwa matenda a impso tubules (kobadwa nako malformations, cystic degenerative process), kapena kuwonongeka kwa nephron (amyloidosis, sarcoidosis, poyizoni wa lithiamu, methoxyfluramine). kapena kuchepa mphamvu ya impso tubule epithelium receptors ku vasopressin.

Chipatala cha matenda ashuga

chifukwa cha ludzukuyambira kuwonetseredwa mochuluka mpaka kuwawa, osalola odwala kupita masana kapena usiku. Nthawi zina odwala amamwa malita 20-25 amadzi patsiku. Pankhaniyi, pali kufunitsitsa kotenga madzi oundana,

polyuriandi kuyamwa mwachangu. Mkodzo ndi wowala, wopanda urochromes,

mwakuthupi ndi m'malingalirokufooka,

kuchepa kwamtimakuwondamwina chitukukokunenepangati matenda a shuga a insipidus amakula monga chimodzi mwazizindikiro zamatenda oyamba a hypothalamic.

mavuto a dyspeptickuchokera m'mimba - kumverera kwodzaza, kupindika, kupweteka kwa epigastrium, matumbo - kudzimbidwa, chikhodzodzo - kulemera, kupweteka kwa hypochondrium yoyenera,

kusokonezeka kwa malingaliro ndi malingaliro: kupweteka mutu, kusalingalira bwino, kusowa tulo, kuchepa m'maganizo, kusokonekera, kusoka, psychosis nthawi zina kumayamba.

kusokonekera kwa msambo, mwa amuna - potency.

Kuyambika kwa matendawa kumatha kukhala pachimake, modzidzimutsa, pang'onopang'ono pang'onopang'ono, ndipo zizindikiro zake zimayamba kukula. Zomwe zimayambitsa zimatha kuvulala kwambiri mu ubongo kapena m'maganizo, matenda, njira zina za opaleshoni bongo. Nthawi zambiri, chomwe chimayambitsa sichidziwika. Nthawi zina cholowa m'magawo a anthu odwala matenda ashuga chimakhazikika.

khungu liuma, tachepa,

kulemera kwa thupi kumatha kuchepetsedwa, wamba kapena kuchuluka,

lilime limakhala louma nthawi zambiri chifukwa cha ludzu, malire am'mimba amatsitsidwa chifukwa chodzaza madzi nthawi zonse. Ndi chitukuko cha gastritis kapena bysary dyskinesia, kuchuluka chidwi ndi kupweteka palpation wa epigastrium ndi hypochondrium yoyenera n`zotheka,

mtima ndi kupuma machitidwe, chiwindi sichimavutika,

kukodza kwamkati: kukodza pafupipafupi, polyuria, nocturia,

Zizindikirokusowa kwamadzithupi, ngati madzimadzi otayika ndi mkodzo, pazifukwa zina, osabwezeredwa - kusowa kwa madzi, kuyesa mayeso "ndikudya kowuma", kapena kumverera kwa malo am'madzi kumachepa:

kufooka kwakukulu, mutu, nseru, kusanza mobwerezabwereza, kufooketsa madzi m'thupi,

Hyperthermia, zopweteka, psychomotor

CCC chisokonezo: tachycardia, hypotension mpaka kugwa ndi chikomokere,

kukula kwa magazi: kuchuluka kwa Hb, maselo ofiira am'magazi, Na + (N136-145 mmol / L, kapena meq / L) creatinine (N60-132 mmol / L, kapena 0.7-1,5 mg%),

kukoka kwapadera kwa mkodzo kumakhala kochepa - 1000-1010, polyuria imapitirira.

Izi izi hyperosmolar kuchepa madzi m'thupi makamaka amakhala ndi kobadwa nako nephrogenic shuga insipidus mwa ana.

Chidziwitsidwakutengera ndi zizindikiro zapamwamba za matenda a shuga a insipidus ndi maphunziro a labotale ndi othandizira:

kukoka mwachindunji kwa mkodzo - 1000-1005

plasma hyperosmolarity,> 290 mosm / kg (N280-296 mosm / kg madzi, kapena madzi a mmol / kg),

mkodzo hypoosmolarity, 155 meq / l (N136-145 meq / l, mmol / l).

Ngati ndi kotheka zitsanzo:

Kuyesedwa ndi kudya kowuma.Kuyesedwa uku kumachitika kuchipatala, nthawi yake imakhala nthawi zambiri maola 6-8, ndi kulekerera kwabwino - maola 14. Palibe madzi. Zakudya ziyenera kukhala zomanga thupi. Minkhole imasonkhanitsidwa ola lililonse, kuchuluka kwake ndi kuchuluka kwake kwa gawo lililonse la ola kumayesedwa. Kulemera kwa thupi kumayesedwa pambuyo pa 1 lita imodzi ya mkodzo utachotsedwa.

Mulingo: kusowa kwa mphamvu yayikulu pakukoka kwamikodzo m'njira ziwiri zotsatizana ndi kuchepa kwa 2% ya kulemera kwa thupi kumawonetsa kusapezekapo kwa kukondoweza kwa amkati vasopressin.

Zitsanzo ndi iv makonzedwe a 50 ml ya 2,5% yankhoNaClpasanathe mphindi 45 Ndi matenda a shuga a insipidus, kuchuluka ndi mkodzo wa mkodzo sikusintha kwenikweni. Ndi psychogenic polydipsia, kuchuluka kwa osmotic plasma ndende kumalimbikitsa kutulutsa kwamkati vasopressin ndipo kuchuluka kwa mkodzo kumachepa, ndipo mphamvu yake yeniyeni imawonjezeka.

Kuyesedwa ndikuyambitsa kukonzekera kwa vasopressin - 5 I / O kapena / m.Ndi shuga weniweni insipidus, mkhalidwe waumoyo umakhala bwino, kuchepa kwa polydipsia ndi polyuria, plasma osmolarity amachepetsa, mkodzo osmolarity ukuwonjezeka.

Kusiyanitsa matenda a shuga insipidus

Malinga ndi zizindikiro zazikuluzikulu za matenda a shuga insipidus - polydipsia ndi polyuria, matendawa amasiyanitsidwa ndi matenda angapo omwe amapezeka ndi zizindikiro izi: psychogenic polydipsia, shuga mellitus, polyuria yolumikizira kuperewera kwa aimpso kulephera.

Nephrogenic vasopressin zosagwira matenda a shuga insipidus (wobadwa kumene kapena wotenga) amasiyanitsidwa ndi polyuria ndi aldosteronism yoyamba, hyperparathyroidism ndi nephrocalcinosis, malabsorption matenda aakulu enterocolitis.

Ichi ndi chiyani

Matenda a shuga ndi matenda osachiritsika (pafupifupi 3 pa 100,000) omwe amayamba chifukwa cha kusowa kwa magazi (hypothalamus kapena pituitary gland).

Amachitika mwa anthu amuna kapena akazi, onse akuluakulu komanso ana. Nthawi zambiri, achinyamata amadwala - kuyambira azaka 18 mpaka 25. Milandu yodwala ya ana a chaka choyamba cha moyo amadziwika (A.D. Arbuzov, 1959, Sharapov V.S. 1992).

Zoyambitsa matenda a shuga insipidus

Matenda a shuga insipidus ndi matenda omwe amayamba chifukwa cha kuperewera kwa vasopressin, kuperewera kwathunthu kapena kuperewera. Vasopressin (mahomoni opatsirana) obisika mu hypothalamus ndipo, mwa ntchito zina, ndiye amachititsa kuti kukodzaku kumveke. Chifukwa chake, ndichizolowezi kusiyanitsa mitundu itatu yamatenda amtunduwu ndi zomwe zimayambira: genetic, anapeza, idiopathic.

Odwala ambiri omwe ali ndi matenda osowa, chifukwa chake sichidziwika. Matendawa amatchedwa ideopathic, mpaka 70% ya odwala amadwala matendawa. Mitundu ndi chibadwa. Potere, matenda ashuga nthawi zina amadziwonekera m'mabanja angapo komanso kwa mibadwo ingapo motsatana.

Medicine amafotokoza izi posintha kwambiri mtundu wa genotype, zomwe zimapangitsa kuti pakhale zovuta m'magulu a antidiuretic hormone. Komwe kudachokera matendawa kumachitika chifukwa cha kulumala komwe kumachitika pakapangidwe ka diencephalon ndi midbrain.

Poganizira zomwe zimayambitsa matenda a shuga insipidus ayenera kuganizira njira za kakulidwe:

1) Matenda a shuga a pakati - amapezeka ndi vuto losakwanira la vasopressin mu hypothalamus kapena kuphwanya chinsinsi chake m'magazi kuchokera ku chithokomiro cha pituitary, mwina chifukwa chake:

Matenda a hypothalamus, popeza ndi omwe amayang'anira kuwongolera kwa mkodzo komanso kaphatikizidwe ka mahomoni a antidiuretic, kugwira ntchito kwamkati kumabweretsa matendawa. Matenda owopsa kapena opatsirana opatsirana: tonsillitis, chimfine, matenda opatsirana pogonana, chifuwa chachikulu ndi chomwe chimayambitsa komanso kupatsirana kwa matenda a hypothalamic dysfunctions.
Zochita za opaleshoni pa ubongo ndi zotupa za ubongo.
Kukangana, kuvulala kwamtundu wamatumbo.
Matenda a autoimmune.
Cystic, chosachiritsika, zotupa za impso zomwe zimalepheretsa kuzindikira kwa vasopressin.
Tumor njira za hypothalamus ndi pituitary gland.
Komanso, kupezeka kwa matenda oopsa ndi zina mwazinthu zomwe zimakulitsa nthawi ya shuga.
Zilonda zam'mimba za hypothalamic-pituitary system, zomwe zimabweretsa mavuto azisamba zamagazi m'matumbo omwe amadyetsa matenda a hypothalamus ndi gitu.

2) Inshuwaransi ya matenda a shuga a renal - pomwe vasopressin imapangidwa modabwitsa, komabe, minyewa yaimpso siyimayilandira moyenera. Zifukwa zake zitha kukhala izi:

kuwonongeka kwamatumbo oyamwa a nephron kapena medulla ya impso,
cholowa m'malo mwake -
sickle cell anemia,
kuchuluka kwa potaziyamu kapena kutsika kwa calcium calcium
aakulu aimpso kulephera
amyloidosis (mawonekedwe amyloid mu minofu) kapena polycystosis (mapangidwe angapo a cysts) a impso,
kumwa mankhwala omwe amatha kukhala oopsa m'matumbo a impso ("Demeclocilin", "Amphotericin B", "Lithium"),
Nthawi zina matenda amapezeka muukalamba kapena kutsutsana ndi kufooka kwa matenda ena.

Nthawi zina, motsutsana ndi kumbuyo kwa kupsinjika, ludzu lochulukirapo (psychogenic polydipsia) lingachitike. Kapena matenda a shuga a insipidus panthawi yomwe ali ndi pakati, omwe amapezeka mu 3 trimester chifukwa cha kuwonongeka kwa vasopressin ndi michere yopangidwa ndi placenta. Mitundu iwiriyi yophwanya malamulo imachotsedwera iwowo atachotsa chomwe chimayambitsa.

Gulu

Ndi chizolowezi kusiyanitsa mitundu iwiri yamatenda a matendawa:

Nephrogenic shuga insipidus (zotumphukira). Matenda amtunduwu ndi chifukwa chakuchepa kapena kusazindikira kwenikweni kwa ma distal renal tubules pazotsatira za vasopressin. Monga lamulo, izi zimawonedwa pokhudzana ndi matenda opatsirana a impso (ndi pyelonephritis kapena motsutsana ndi matenda a impso a polycystic), kutsika kwakutali kwa potaziyamu m'magazi ndikuwonjezereka kwa calcium, osakwanira kudya mapuloteni muzakudya - kuperewera kwa chakudya, matenda a Sjogren, ndi zovuta zina zobadwa nazo. Nthawi zina, matendawa amakhala achibadwa.
Neurogenic shuga insipidus (wapakati). Amayamba chifukwa cha kusintha kwa ma pathological mu manjenje amanjenje, makamaka, mu hypothalamus kapena gland yotsatira. Monga lamulo, chomwe chimayambitsa matenda pamenepa ndi ntchito yochotsa chofufumitsa, njira yolowera mdera lino (hemochromatosis, sarcoidosis), kuvulala kapena kusinthika kwachilengedwe. Nthawi zina, matenda a shuga a neurogenic amakhala idiopathic, kutsimikizika nthawi imodzi mwa anthu angapo a banja limodzi.

Zizindikiro za matenda a shuga insipidus

Zizindikiro zoyambirira za matenda a shuga a insipidus ndi ludzu lalikulu (polydipsia) komanso kusokonekera kowonjezereka (polyuria), komwe kumavutitsa odwala ngakhale usiku. Kuchokera pamililita 3 mpaka 15 ya mkodzo umatha kuchotsedwapo patsiku, ndipo nthawi zina kuchuluka kwake kumafika mpaka 20 malita patsiku. Chifukwa chake, wodwala amazunzidwa ndi ludzu lalikulu.

Zizindikiro za shuga insipidus mwa amuna ndi kuchepa kwa kugonana poyenda ndi potency.
Zizindikiro za kuperewera kwa matenda ashuga mwa akazi: kusokonezeka kwa msambo mpaka kufika ku amenorrhea, kusagwirizana ndi kubereka, ndipo ngati pachitika pakati, pamakhala chiwopsezo chowonjezereka cha kuchotsa pathupi pena.
Zizindikiro za shuga mwa ana zimatchulidwa. Mwa makanda ndi ana aang'ono, mkhalidwe wa nthendayi nthawi zambiri umakhala waukulu. Kuwonjezeka kwa kutentha kwa thupi kumadziwika, kusanza kopanda tanthauzo kumachitika, kusokonezeka kwa mitsempha kumayamba. Kwa ana okulirapo, kufikira zaka zaunyamata, chizindikiro cha matenda a shuga ndi kugontha, kapena enursis.

M'tsogolomu, pang'onopang'ono, zizindikiro zotsatirazi zimalowa:

Chifukwa chakumwa madzi ambiri, m'mimba amatambasuka, ndipo nthawi zina umagwa,
Pali zizindikiro za kuchepa kwa madzi m'thupi (kusowa kwa madzi m'thupi): khungu louma ndi ma mucous membrane (kamwa yowuma), kulemera kwa thupi kumachepa,
Chifukwa cha kutulutsidwa kwa mkodzo m'magawo akuluakulu, chikhodzodzo chimatambasulidwa,
Chifukwa chosowa madzi mthupi, kapangidwe ka michere yokugaya m'mimba ndi matumbo amasokonezeka. Chifukwa chake, chidwi cha wodwalayo chimachepa, gastritis kapena colitis zimayamba, pali chizolowezi chodzimbidwa,
Nthawi zambiri kuthamanga kwa magazi komanso kugunda kwa mtima,
Popeza kulibe madzi okwanira mthupi, thukuta limachepa.
Wodwala amatopa msanga
Nthawi zina mseru wopanda pake komanso kusanza kumachitika,
Kutentha kwa thupi kumatha kuwuka.
Nthawi zina, bedwetting (enuresis) imawoneka.

Popeza ludzu ndi kukodza kwambiri kumapitilira usiku, wodwalayo ali ndi vuto m'maganizo ndi m'maganizo:

kuvutikira kwakumaganizira (nthawi zina kumakhalanso kwama psychoses) komanso kusokonekera,
kugona ndi mutu
kuchepa kwa ntchito zamaganizidwe.

Izi ndi zizindikiro za matenda a shuga. Komabe, mawonetseredwe am matendawa amatha kusiyanasiyana pang'ono mwa abambo ndi amayi, komanso ana.

Zizindikiro

Nthawi zambiri, kupezeka kwa matenda a shuga a insipidus siovuta ndipo kwachitika:

ludzu lalikulu
kuchuluka kwa mkodzo wa tsiku ndi tsiku kumaposa malita atatu patsiku
plasma hyperosmolality (zopitilira 290 mosm / kg, kutengera madzi akumwa)
sodium wamkulu
Hypoosmolality kwamikodzo (100-200 mosm / kg)
kachulukidwe kakang'ono ka mkodzo (

Malamulo a zopatsa thanzi

Aliyense amadziwa kuti odwala matenda ashuga ali ndi ubale "wapadera" ndi mashuga. Koma kodi tinganenenji za zakudya ngati matendawa alibe shuga? Pankhaniyi, kuletsa kudzakhudza chinthu china - mchere. Ngati wodwala alibe vuto la kulephera kwa impso, ndiye kuti ndikotheka kusintha mchere ndi chakudya chowonjezera, mwachitsanzo, Sanasol.

Zakudya ndi nthendayi zimaphatikizapo kuchepetsa kuchepa kwa mapuloteni zakudya (zosaposa 70 g patsiku). Wodwalayo akulimbikitsidwa kudya patebulo la 7.

Zakudya ndi zakumwa zotsatirazi zimaphatikizidwa ndi zakudya: