Udindo wa michere ya pancreatic

Zikondamoyo zimawerengedwa kuti ndizofunikira m'thupi, zomwe ntchito yake ndikupanga michere. Ndi chiwalo chomwe chimatha kumanga madzi. Mu kapangidwe kake pali zinthu zingapo za enzyme zopangidwa ndi kapamba - madzi, ma elekitirodiya, ndi ena. Kukhalapo kwawo ndikofunikira ndikusiya njira yokumba.

Ma enzoni a pancreatic pamodzi ndi zinthuzi amadutsa m'matumbo ang'onoang'ono. Mu duodenum iwo amagwiritsa ntchito kulekanitsa kwamafuta, michere yama protein ndi mapuloteni.

Kodi ma enzymus opanga ma pancreatic amapangidwa ndi chiyani:

Lipase - cholinga chake ndikulekanitsa mafuta omwe sakudziwa momwe angalowere mwachindunji kulowa m'magazi.
Amylase - amagwira ntchito yotembenuza wowuma kukhala oligosaccharide.
Protease - amalekanitsa mapuloteni, kuwasandutsa ma peptides.

Kuphatikiza apo, zinthu zina zam'mimba zimapangidwa ndi chamba cha pancreas, zomwe zimabwezeretsedwa m'thupi ndipo zimakhudza kutembenuka kwakukulu kwa oligosaccharides mu glucose. Shuga ikalowa m'magazi, imakhala mphamvu yofunikira. Mitundu yosiyanasiyana ya mapuloteni ndi elastin imamveka ndi elastase.

Ma enzymes onse a pancreatic amapezeka mwachindunji mu chakudya cham'mimba. Pakalipano m'derali, sizigwira ntchito, zomwe sizipanga kugawanika kwa minofu. Enzymes imayendetsedwa ndi kudziunjikira kuchuluka kwa bile.

M'matumbo ang'onoang'ono, kupanga zinthu zotsatirazi kumachitika:

ectokinases - imasinthidwa ndi trypsinogen, ndikusintha kuti ichitike, koma kuwonjezereka kwake sikunawonedwe,
trypsinogen - waikidwa ndi kapamba mu mawonekedwe a pro-enzymatic, m'malo awa mawonekedwe awa amapezeka m'matumbo aang'ono,
trypsin ndiye woyambitsa wamkulu wa ma enzymes ena amtundu wofanana, chinthu chogwira ntchito ndi machitidwe a autocatalysis, chifukwa chomwe chikuwakhudza kale mawonekedwe a chinthu chachikulu.

Kupanga kwa ma enzymes kumachitika nthawi yomweyo zakudya zikaledzera, ndipo chakudya chimadutsa m'matumbo aang'ono. Njira yolumikizira ma enzyme sikutha pambuyo pake pafupifupi maola 12.

Pamene minofu ndi njira zopumira zimayatsidwa, zimayikidwa mu njira yowonjezera ya ma enzymes awo, ndipo kukula kwa kapamba kumaonekera mwa ana.

Kusankhidwa kwa ma enzymes pochizira matendawa nthawi zambiri kumakhala ntchito yovuta, chifukwa michere ya kapamba wa ana imakhala ndi kusankha kwakukulu ndipo imasiyanitsidwa ndi zomwe zimachitika pazinthu zomwe zimapangidwa pakapangidwe kake. Ma Enzymes omwe ali ndi zigawo za bile muzochita za ana amakhala ochepa kwambiri, chifukwa cha kuchuluka kwa chimbudzi chimbudzi ndi choleresis.

Mitundu ya Enzymes

Mitundu yosiyanasiyana ya michere ya pancreatic secretion imaswa zinthu zina. Kodi ma kondomu amapanga michere yanji:

Mapuloteni ndi michere yomwe imaphwanya mapuloteni.
Zakudya zomanga thupi ndi ma enzyme omwe amawononga chakudya.
Lipases - kugawanitsa mafuta.

Trypsin, elastase ndi chymotrypsin zimaphatikizidwa mu gulu la proteinase, michere ya proteinolytic. Zochita zawo zimakhazikitsidwa ndi kuwonongeka kwa tinthu tating'onoting'ono ta mapuloteni muzinthu zosavuta - ma peptides. Kenako, carboxypeptidase amalowa, amatulutsa ma peptides tinthu tokhala ma amino acid. Kuphatikiza apo, mayamwidwe amapezeka m'matumbo ang'onoang'ono, kuwonjezera pa nucleic acid, chifukwa pamafunika kuwola kwa ma nucleotide. Izi zimachitika motsogozedwa ndi michere ya nuclease.

Ma enzymes a Amylolitec pancreatic amaphatikizapo amylase ndi lactase. Amylase amalekanitsa mafuta oopsa kapena ma polysaccharides mu maltose, dextrin, kenako m'magazi wamba - fructose ndi glucose, omwe amatha kulowa m'matumbo. Lactase imagawidwa mumkaka wa shuga - mkaka wa lactose, womwe umapezeka pazinthu zamkaka.
Ma enzyme a lipolytic amagwira ntchito limodzi. Colipase imayendetsa lipase m'matumbo, pambuyo pake imaphwanya tinthu tating'onoting'ono kwambiri ta mafuta kukhala glycerol ndi mafuta acids.

Ndikofunikira kuti mafutawa adyedwe - emulsization ndi bile acid, kuphwanya tinthu tating'onoting'ono, komwe kumapangitsa kuti pakhale ndege yayikulu yolumikizana ndi lipase.

Zizindikiro za kapangidwe ka Pancreatic Enzyme

Pa chimbudzi chachilengedwe cha zakudya, kuchuluka kwa michere kumafunikira mu madzi a pancreatic omwe amapangidwa. Matenda angapo apezeka omwe amaphatikizidwa ndi mankhwala osokoneza bongo a enzyme. Mwa limagwirira kuti zimachitika, iwo amadziwika kuti ndi chakudya tsankho.

Kuperewera kwa katulutsidwe wakunja kumawonedwa pamene michere yam'mimba ya kapamba ikachepetsedwa, imatha kubereka pakubadwa kapena kukhala ndi maphunziro. Kukula kwa mlandu woyamba kumawonedwa chifukwa cha kupangika kwa majini, motsatira, matendawa amayambika chifukwa cha kusayenda bwino kwa kapamba.

Zomwe zimawonetsa kuperewera kwa michere ya pancreatic nthawi zambiri sizimadalira momwe thupilo limapangidwira, koma zimalumikizidwa ndi kukopa kapena kusokoneza ziwalo zamkati.

Matenda osiyanasiyana omwe ali oopsa.
Zotsatira Zosiyanasiyana.
Kupanda kufufuza zinthu, mavitamini, mapuloteni.
Poizoni wa Mankhwala.
Matenda a matenda opatsirana.
Pathologies omwe amagwirizana ndi kusintha kwamatumbo am'mimba.

Zinthu zonse zomwe nthawi zina zimayambitsa matenda akudya m'mimba zimakhala ndi zizindikiro ndi zizindikiro wamba. Kukula kwa mawonekedwe awo kumakhala koyenera ndi kuuma kwa zomwe zimayambira kapena kupangitsa kwa zomwe zimayambitsa.

Anachepetsa chilako.
Kutsegula m'mimba
Kumva kupweteka pansi pa nthiti kumanzere, kupweteka kumachitika onse atatha kudya komanso osadya.
Kufalikira.
Kulumikizana ndi mpweya.
Kusintha, kusanza, m'malo ovuta - mobwerezabwereza, popanda mpumulo.
Kuchepetsa thupi mwadzidzidzi, nthawi zina ndimakhala ndi zakudya zabwino.
Ana amakumana ndi kuzimiririka kwakuthupi.

Zizindikiro zofananazo zimatha kuchitika ngati ma pancreatic enzymes omwe ali ndi chobadwa nacho kapena chotenga nzeru. Potengera komwe kudwala matenda amtundu, kuperewera kwa enzyme kumatha kuonekera pambuyo pobadwa,

ulesi
misozi
dziko lopumira
kulavulira pambuyo chakudya
pafupipafupi kutsegula m'mimba ndi fungo la fetid.

Phukusi la wodwalayo silitha, lili ndi zofukiza komanso kununkhira kwa acidic, komwe kumawonetsa kuchepa kwa michere ya michere.

Kuphatikiza pazizindikiro zofala zamatenda a pancreatic, palinso zizindikiro zenizeni zomwe zimatengera kusokonezeka pakupanga chinthu cha enzyme mu secretion ya pancreatic.

Ndikusowa kwa lipase, steatorrhea imayamba - kuchuluka kwa mafuta mu chimbudzi kumawonjezeka. Tizilomboti timakhala chikasu, lalanje, komanso timafuta.
Kuperewera kwa Amylase kumawonetsedwa ndi chikhumbo chosatha chopanda kanthu, ndowe za mapangidwe amadzi, wodwalayo akuchepetsa thupi, kuchepa kwa vitamini kumachitika. Komanso pali kulephera kusamutsa zinthu zomwe zimakhala ndi chakudya chambiri, njira yotseketsera zinthu zomwe zimasintha m'matumbo ang'onoang'ono.
Pakusowa kwa trypsin mu chimbudzi, ulusi wama protein osapezekanso wapezeka. Wodwala ayang'anizana ndi kukula kwa magazi m'thupi.

Ngati zizindikiro zotere zikuchitika, ndikofunikira kukaonana ndi gastroenterologist, komwe amayesedwa ndi kulandira mankhwala omwe akupatsidwa.

Kukonzekera kwa enzyme

Popanga matenda kapamba, kusiyana ndi pachimake pa matendawa, pamene mapikisanowo amakhala ndi michere yotsika, njira yayikulu yothandizira pancreatitis ndi kukonzekera komwe kumakhala ndi ma enzymes. Mtundu woyamba wa mankhwalawa umapangidwa ndi mankhwala othandizira - kapamba. The bile sayenera kupezeka mu mankhwalawa, zomwe zimapangitsa kuwonjezeka kwa chinsinsi cha michere ndikuthandizira kusamvetseka kwapweteka.

Zogwiritsira ntchito kukonzekera kwa enzyme mu mawonekedwe osaneneka a matenda akuwonetsedwa:

Creon ndi njira yamakono.
Mezim-forte - imakhala ndi lipase, amylase, proteinase, zina zowonjezera.
Pancreatin ndiye gawo lalikulu la enzyme, lomwe ndi gawo la mankhwala osiyanasiyana a enzyme - lipase, amylase, trypsin, chymotrypsin.

Zakudya zopatsa thanzi zimafuna nthawi yayitali, nthawi zina kutsatira kwa tebulo la chithandizo kwa thanzi kumafunikira, zonse zimadalira kuchuluka kwa kuchepa kwa enzyme.

Mu pachimake maphunziro a kapamba, kudzimbidwa kwa chiwalo kumachitika, chifukwa chake, ma enzymes olimbikira amalimbikira. Ku chipatala, ma infusions a othandizira othandizira amagwiritsidwa ntchito.

Komanso dokotala atha kukulemberani mankhwala ena okonzekera.

Mlingo umangosankhidwa ndi dokotala, ndikuwonetsa ndalama malinga ndi kuuma kwa matendawa, makamaka zakudya zamagulu a kapamba ndi msinkhu wa wodwalayo.

Mukamamwa mankhwala angapo, kugawa kwathunthu kwazinthu kumatsimikizika, zomwe zimapangitsa kuti zikhale bwino komanso kuti zikhale zolimba.

Ma enzyme a chomera kuti abwezeretse pancreatic ntchito amagwiritsidwa ntchito:

Kuwerenga kwa michere ya pancreatic madzi ndikofunikira mu matenda a ziwalo zam'mimba. Kuperewera kwa mapangidwe kumafuna kuvomerezedwa ndi chithandizo cha enzyme.

Kodi ma enzymes am'mimba ndi ati

Pogwiritsa ntchito kapamba, ma enzyme achilengedwe am'mimba amapangidwa. Amathandizira pakuwonongeka kwa zinthu zazikulu zomwe zimapanga michere: chakudya, mapuloteni ndi mafuta. Ma pancreatic enzymes ndi zinthu zomwe zimagawanitsa zigawo zovuta za chakudyazi m'zigawo zosavuta, zomwe zimatengedwa m'maselo a thupi. Chifukwa cha kutsimikizika kwapamwamba kwa mphamvu ya ma enzymes, bungwe ndi kuwongolera njira zofunika mthupi kumachitika. Magulu atatu azinthu amadziwika:

Malilime ndi michere yomwe imaphwanya mafuta. Amapangidwa ndi kapamba, omwe ndi gawo la madzi am'mimba.
Mapuloteni - ma enzyme amenewa amaphwanya mapuloteni ndi kusintha ma microflora am'mimba.
Ma amylases - zinthu zofunika pokonza chakudya.

Pancreatic enzyme ntchito

Chochulukitsa chachikulu kwambiri mwa anthu ndi kapamba. Ntchito yake ikasokonekera, izi zimapangitsa kuti mabungwe ambiri azigwira bwino ntchito. Cholinga chogwira ntchito ndi thupili ndikuchita zachitetezo chakunja ndi mkati, zomwe zimatsimikizira kugaya. Popanda michere yopangidwa ndi gland, m'mimba mwa munthu simatha kugaya chakudya moyenera, ndipo michereyo imayamba kugwira ntchito ndikuyamba kulowerera m'magazi.

Kuperewera kwa Pancreatic Enzyme

Matenda am'mimba amakhudza ntchito ya minofu yonse, ziwalo ndi machitidwe. Udindo wofunikira chimbudzi ndi wa enanthane pancreatic, koma nthawi zina machitidwe a munthu mwiniyo samawalola kuti azigwira ntchito molimbika komanso kuti apangidwe moyenera. Kuperewera kwawo kumayambitsa kukula kwa kapamba, omwe ali ndi zotsatirazi:

Mowa
Kuperewera kwa zakudya
Zakudya zopanda zakudya, kuphatikizapo zakudya,
Kukula kwa mtundu umodzi wa chakudya,
Matenda
Zovulala zamagulu ndi zotsatira zake,
Mankhwala omwe amamwa popanda kuthandizidwa ndi adotolo, kuphatikiza ma enzyme zoletsa.

Pancreatitis - A wamba pancreatic lesion, yodziwika ndi kuchuluka kwa enzymatic ntchito kale kuposa momwe amafunikira. Nthawi zambiri, ma enzyme amapangidwa atatha kudya, koma ndi kapamba amamuyambitsa asanadye - ndiye kuti mtanda wa chakudya uwonongedwa, ndipo thupilo palokha limakhudzidwa ndi ma enzyme ake.

Kuphatikizika kwa Enzymatic

Kuperewera kwa katulutsidwe wamkati ndi njira yofala kwambiri - lembani matenda a shuga 2, pamene insulini siyopangidwira kuchuluka kofunikira. Matendawa amapezeka pogwiritsa ntchito kuyeza magazi a shuga - tanthauzo lake ndi 5.5 mmol / l,
Kuperewera kwa katulutsidwe wakunja - pakakhala kuchepa kwa michere yam'mimba. Odwala awa aphatikizidwa mu kudya kwambiri, makamaka mafuta - ma enzymes sangathe kuthana ndi triglycerides yonse.

Kutalika kwa kusowa kwa kapamba kumagawika mu:

Yogwira - mkhalidwe wakanthawi womwe ungathe kuchiritsidwa
Organic - kuwonongeka kwakanthawi kwa chiwalo, momwe sizingathekere kubwerera mwachangu magwiridwe antchito a chiwalo.

Kodi ma kondomu amapanga michere yanji

Thupi laumunthu limapangidwa mwanjira yoti chamoyo chilichonse chimagwira ntchito yake. Zikondamoyo zimagwira ntchito molumikizana ndi chikhodzodzo cha ndulu.

Pamene bile ili m'matumbo aang'ono, ntchito ya ma enzymes imayambitsa. Kenako, duodenum imadzaza ndi madzi a pancreatic. Izi zimakhala ndi ntchofu, madzi, mabicarbonate ndi michere, zomwe zimathandiza kuchepetsa acidity yam'mimba.

Ma enzymes akuluakulu opangidwa ndi kapamba ndi amylase, lipase ndi proteinase. Palinso mitundu ina ya zinthu zothandiza.

Nuc tafadhali amatenga nawo gawo limodzi la ma nikic acid, DNA ndi RNA, omwe amapanga chakudya.
Protease monga mawonekedwe a elastase imathandizira kuphwanya mapuloteni onenepa ndi elastin. Ma Trypsins ndi ma chymotrypsins, ngati chapamimba, amachepetsa mapuloteni a chakudya. Zomwe zimaphatikizidwanso m'mimba ndi carboxypeptidases.
Amylases kagayidwe kachakudya kagayidwe, kugaya glycogen ndi wowuma.
Steapsins amathandizira kuthana ndi mafuta.
Lipase imakhudzanso mwachindunji ndi triglycerides; mafutawa amaphatikizidwa ndi bile, omwe chiwindi chimatulutsa m'matumbo a lumen.

Mapuloteni amathandizira kuphwanya mapuloteniwo kukhala ma peptides, pambuyo pake, mothandizidwa ndi carboxypeptidase, zigawo zosavuta zimasinthidwa kukhala amino acid ndikuzilowetsa m'matumbo ang'onoang'ono. Chiwerengero cha michere yotereyi chimachepera ndi zaka, ndipo msambo wawo umatha kuchepa chifukwa cha matenda opatsirana.

Ma amylase amathandizira pakuwonongeka kwa zovuta zam'mimba kapena ma polysaccharides kuti dextrin ndi maltose. Pambuyo pake, mapangidwe osavuta a shuga - glucose ndi fructose, omwe amalowetsedwa m'matumbo. Ma amylase ambiri amawonedwa mu kapamba, ndipo ma enzymewo amapezekanso m'matumbo a salivary.

Malilime amasokoneza mamolekyulu amafuta, ndikupanga glycerin ndi mafuta acids. Pamaso chimbudzi chisanachitike, mafuta amawonongeka ndi bile acid. Komanso ma enzymes amenewa amasintha mavitamini E, D, A, K kukhala mphamvu.

Kuphatikiza pa kuyamwa kwa michere, michere ya kapamba imakhudzidwa ndimayendedwe a metabolic ndi kutembenuka, kuwongolera shuga.

Komanso chiwalo chamkati chimatha kupanga zinthu za mahomoni zomwe zimayang'anira maselo achilengedwe.

Pancreatic Imper

Nthawi zambiri, kapamba amasokonezeka pomwe munthu sayang'anitsitsa thanzi lake ndikukhala ndi moyo wopweteketsa. Makamaka, matenda am'mimba amatha kukula ngati wodwala amadya zakudya zopanda thanzi, samadya pa ndandanda, ndikuledzera.

Mwa zisonyezo zilizonse zokayikitsa komanso zomverera zowawa, muyenera kukaonana ndi gastroenterologist, kukafufuzidwa kwathunthu kuti mudziwe chomwe chimasokoneza kwenikweni m'thupi.

Ngati malamulo a kudya mokwanira samatsatiridwa, dokotala nthawi zambiri amawazindikira pancreatitis. Matendawa amatha kukhala ndi mawonekedwe owopsa kapena osachiritsika.

Matenda owopsa a matendawa amakula ngati kapamba sakugwira ntchito moyenera, ndipo ma enzyme omwe amapangidwa amakhala atangolembedwa.Zotsatira zake, kugawanitsa gland palokha kumayamba. Munthu amamva kupweteka kwambiri pamimba, kutentha thupi, kusanza, komanso kupweteka m'mimba. Ndikofunika kufunafuna chithandizo chamankhwala munthawi yake kuti mupewe zovuta.
Matenda a kapamba amayamba pang'onopang'ono, wodwalayo mwina sakudziwa za kukhalapo kwa matendawa. Munthawi imeneyi, minofu ya kapamba imachepa, chiwalo chamkati sichimapanga ma enzyme oyenera. Panthawi imeneyi, shuga imayamba chifukwa cha kusowa kwa insulin ya mahomoni.

Zizindikiro zamtundu uliwonse wa kapamba zimatsatiridwa ndi belching, flatulence, kutsekula m'mimba, kupweteka kwa kapamba.

Pofuna kupewa zovuta, ndikofunikira kuyamba mankhwalawa munthawi yake, zikangoyamba kuonekera ziphuphu.

Pancreatic enzyme assay

Kuti adziwe zam'magazi, dokotala amafotokozera kuyesa kwa magazi am'mwazi, mkodzo ndi seramu yamagazi amawunikiranso. Cholinga chachikulu chodziwitsira matenda ndikuwona mulingo wa lipase, elastase ndi amylase. Kuyesedwa kwa magazi kwa ma enzymes a chiwindi kumachitidwanso.

Seramu amylase yomwe imakonda kuphunziridwa. Ngati kafukufuku wa enzymatic akuwonetsa kuchuluka kwa amylase yoposa 130, nthawi zambiri munthu amadwala chifuwa cham'mimba. Pazowonetsa 0-130, mavuto muntchito ya kapamba amawululidwa. Ngati chizolowezi chimaperekedwa pambuyo poyesedwa katatu, mawonekedwe amtundu wa kapamba kapena kupindika m'matumbo apezeka.

Seramu yamagazi imagwiritsidwa ntchito kudziwa milingo ya lipase. Zikondazo zikawonongeka, kuchuluka kwa ma enzymes kumatha kuwonjezeka ndi 90 peresenti. Ngati mulingo wabwinobwino, ndipo amylase akapitilira, munthuyo mwina ali ndi matenda osiyanasiyana.

Pogwiritsa ntchito biochemistry, dokotalayo amazindikira matendawa ndikusankha njira zofunikira zochizira. Kuti mupeze zolondola, kutsimikiza kwa milingo ya michere kumachitika m'mimba yopanda kanthu m'mawa.

Ngati ndi kotheka, kuwunika ndowe ndi mkodzo kumachitidwanso.

Mankhwala

Masiku ano, pamalonda pali mitundu yambiri yamankhwala amitundu yonse yofuna kuchiza kapamba. Zotsatira zazikulu za mankhwalawa ndizobwezeretsanso ma enzyme omwe akusowa.

Mankhwala ali ndi kusiyana, kutengera kapangidwe, njira yopangira ndi mawonekedwe omasulidwa. Zopangira zazikulu ndi nguluwe kapena nguluwe.

Palinso mankhwala omwe amaphatikizapo bile. Koma kukonzekera kwa enzyme imeneyi kumapangidwa mu chifuwa chachikulu cha chiwindi, hepatitis, zilonda zam'mimba komanso kukanika kwa duodenum, kutupa ndi matumbo ena a m'mimba.

Musanayambe kumwa mankhwalawa, thupi ndi kapamba zimayenera kukonzekera mankhwala a enzyme. Kuti muchite izi, gwiritsani ntchito mankhwala osokoneza bongo a Papaverin, No-Shpa, Drotaverin, omwe amachepetsa ululu. Kuphatikiza apo, amagwiritsa ntchito mafuta osiyanasiyana a analgesic.
Ngati matendawa apezeka mwa mwana, dokotalayo amamulembera mankhwala apadera a ana kapena kusankha mlingo woyenera malinga ndi msinkhu wa wodwalayo. Pochiza ana, mankhwalawa amaphatikizidwa ndi mkaka kapena madzi akumwa.
Ma Enzymeri a pancreatic ndi gawo lamapiritsi ambiri monga Mezim-Forte, Abomin, Creon, Festal, Digestal, Betaine, Enzistal, Panzinorm, Penzital ndi ena.
Masiku ano, pogulitsa mungapeze ma enzymes a chomera, mafangayi kapena ma virus, wodwala amatha kusankha mankhwala atagwirizana ndi adokotala. Kukonzekera ndi ma enzymes amadzimadzi kumakhala kosasinthasintha kwamadzimadzi, motero amatha kusakanikirana bwino ndi chakudya komanso kumizidwa mwachangu.

Kuphatikiza pa kumwa mapiritsi, njira ya mankhwalawa imaphatikizaponso kutsatira zakudya zapadera zosiyidwa. Wodwalayo amaloledwa kudya zakudya zamafuta ochepa popanda kuwonjezera nyama, porridge ndi michere. Kuphatikiza apo, tikulimbikitsidwa kuti muzimwa pafupifupi malita awiri patsiku lamadzi amchere a mchere.

Ngati munthu ali ndi prancine pancreatic kuchepa, mankhwala Pancreatin ndi mankhwala. Amagwiritsidwa ntchito ngati dysbiosis, zilonda zam'mimba, pomwe msuzi wam'mimba umakhala ndi kuchuluka kwa hydrochloric acid ndi pepsin, matenda am'mimba kapena osagwirizana ndimatumbo, komanso kuchepa kwa enzyme.

Kuti muwonjezere zochitika za kapamba ndikupangitsa kupanga michere, mankhwala amagwiritsidwa ntchito omwe amakhala ndi pacreatin, hemicellulase, bile acid ndi zina. Chifukwa cha izi, ntchito zam'mimba ndi chindulu cha ndulu zimakhudzidwa, ndipo mapangidwe a mpweya m'matumbo amachepa. Chithandizo chotere chimayikidwa ngati zizindikirozo zikuyenda limodzi ndi kuseketsa, kupindika, kudzimbidwa.

Zambiri pancreatic ntchito zimaperekedwa mu kanema munkhaniyi.

Pancreatic m'mimba michere

Chifukwa cha kuthekera kwakukulu kwa zotsatira za michere, gulu labwino lofunikira mthupi limachitika. Ma enzyme opatsa mphamvu amagwira ntchito kwambiri, amaphwanya zinthu zosiyanasiyana zachilengedwe, zomwe zimapangitsa kuti chakudya chikhale chokwanira. Mndandanda wazonse zazikulu za michere ndi kutenga nawo gawo pakukumba zimaperekedwa pagome:

Hydrolysis ya triglycerides kupanga mafuta acids

Kugawikana kwa ma polysaccharides (glycogen, wowuma)

Imaphwanya mapuloteni omanga thupi

Imaphwanya zomangira zamapuloteni

Kupukusa Elastin, Mapuloteni Aulumikizidwe

Carboxypeptidase A ndi B

Zikuwononga zomangira mapuloteni,

Proteolytic

Ma enzyme a Proteolytic ofunikira kuti chimbudzi chikhale ndi phokoso pazinthu zopanga mapuloteni ndikuphwanya zinthu zama cell. Ndi zaka, zochepa za micherezi zimapangidwa. Kuphatikiza apo, zinthu zakunja ndi matenda zilibe mphamvu pa kapangidwe kake. Chifukwa chake, zinthu izi nthawi zina zimatha kusowa. Ngati matumbo ali otsika mu ma protein a enzymes, mapuloteni sangathe kugaya mwachangu.

Enzone ya lipase yopangidwa ndi thupi laumunthu imapangitsa hydrolysis ya insoluble esters ndipo imalimbikitsa kufafaniza kwa mafuta osalowerera ndale. Pamodzi ndi bile, ma enzyme amenewa amathandizira kugaya mafuta acids ndikupanga mavitamini E, D, A, K, kuwasintha kukhala mphamvu. Kuphatikiza apo, lipase imakhudzidwa ndikuyamwa kwa ma polyunsaturated acid ndi mavitamini. Enzyme yofunikira kwambiri, chifukwa chake kukonzekera kwathunthu kwa lipids kumachitika, imatengedwa ngati pancreatic lipase, yomwe imaphwanya mafuta omwe amaphatikizidwa ndi hepatic bile.

Mawu akuti amylase amatanthauza gulu lonse la ma enzyme. Pazonse, mitundu itatu ya zinthu imadziwika: gamma, alpha, beta. Alfa amylase ali ndi tanthauzo lapadera kwa thupi (dzinali ndi lochokera ku Greek). Ndi chinthu chomwe chimaphwanya chakudya chambiri. Kuphatikizika kwakukulu kwa enzyme kumeneku kumawonedwa mu kapamba, kakang'ono - m'mbali mwake.

Kuwunika kwa enzyme

Pali mayeso apadera kuti adziwe ntchito ya enzymatic ya kapamba. Wothandizira enzyme, lipase, amylase, yomwe imapezeka mu seramu ya mkodzo kapena magazi, imaphunziridwa kangapo, imatha kupezeka mu pleural fluid. Chidziwitso chodziwika bwino cha enzyme ndicho kuzindikira seramu amylase. Ngati amylase ndi wamkulu kuposa 130, ndiye izi zikuwonetsa kapamba, chizindikiritso cha 60 mpaka 130 chikuwonetsa mavuto ndi kapamba. Kuchulukitsa zomwe zimachitika pena katatu kumawonetsa pancreatitis yayikulu kapena m'mimba kukongoletsa.

Kwa seramu yamagazi, kuyesedwa kwa lipase kumatha kuchitika, imawerengedwa ngati ikhudzidwa ndi kuwonongeka kwa pancreatic. Ndi matenda, lipase imatuluka ndi 90%. Ngati enzyme iyi singakulidwe, ndipo amylase ndi yayikulu, ndiye kuti muyenera kulingalira za matenda ena. Kutengera zotsatira za kuyezetsa kwamagazi osiyanasiyana, adotolo amatha kudziwa moyenera matenda, sankhani pulogalamu yamankhwala. Kuyesedwa kwa magazi kumachitika pamimba yopanda kanthu. Ndikofunika kupenda kusanthula m'mawa, pomwe ma enzyme okhala ndi cholinga. Kuphatikiza pa chopereka chamagazi, mayeso otsatirawa akhoza kuchitika:

Kusanthula kwamaganizidwe.
Mayeso apadera omwe amalimbikitsa thupi ndi mankhwala ndi ma amino acid. Pambuyo pawo, michere yofunikira imatsimikiziridwa ndi zomwe zili m'matumbo.
Urinalysis Imasonkhanitsidwa pokhapokha ngati pali zotsukira zouma zakuthengo.
Kusanthula kwa seramu yamagazi.

Kodi kusowa kwa pancreatic enzyme ndi chiyani

Kapamba, monga chiwalo china chilichonse, chitha kulephera. Matenda ofala kwambiri ndi kuperewera kwake. Ndi kuperewera kwa enzymatic kwa zinthu zomwe zimapangidwa ndi kapamba, chizindikiro cha matendawa chimakhala chosakwanira komanso chimbudzi chovuta, chomwe chimakhala ndi vuto la metabolic komanso kukula kwa zinthu zam'magazi. Zomwe zimayambitsa kulephera zitha kukhala:

Poizoni wazakudya.
Enzyme zoletsa.
Kuperewera kwa Vitamini.
Kuwonongeka kwa minofu ya pancreatic.
Zakudya zopanda pake. Kudya zakudya zamchere komanso zamafuta.
Kutsika kwamapuloteni.
Anachepetsa hemoglobin.
Cholowa chamtsogolo.

Dongosolo la Chimbudzi

Mavuto Am'mimba, Zilonda za Duodenal

Tengani katatu katatu piritsi limodzi, osaposa miyezi iwiri

Kupanda chinsinsi cha kuthekera kwa m'mimba thirakiti, kapamba, gastritis.

Mkati 3 mapiritsi okhala ndi zakudya.

Ndi osakwanira kugaya mphamvu yamatumbo ndi m'mimba.

Akuluakulu amamwa mapiritsi awiri musanadye, osamwa madzi. Mwanayo akhoza kuperekedwa monga akuwongoleredwa ndi dokotala.

Mtheradi kapena chinsinsi cha kapamba kapangidwe ka kapamba.

Ntchito ya procrine - kupanga michere ya kapamba

Ma cell a pancreatic acinar amatulutsa michere ya pancreatic kuti timize chakudya m'matumbo. Kenako amagwera mu canaliculi, mothandizidwa ndi zomwe zili mkati mwake zimatsitsidwa.

Zosintha pakuwonjezera kwa ma enzymes omwe amagwira ntchito ku placebo awululira zovuta zazikulu ndi glycemic control. Odwala omwe ali ndi matenda a shuga omwe amadalira insulin, chifukwa cha kusakhazikika kwa kayendedwe ka glycemic, kusintha kwapadera kwa mankhwalawa kuyenera kusamala kwambiri.

Tidaphunzira zotsatira zamafuta apamwamba kwambiri a lipase pancreatin pazinthu zina zamafuta ambiri. Adawonetsa kuti kugwiritsa ntchito pancreatin kunayambitsa kuchepa kwakukulu kwa fecal misa, kuchepa kwa zotulutsa zamafuta kuchokera kuzimbudzi, nyama zozizira komanso mafuta amfupi aunyolo. Komabe, gulu lophunzirali silinawonetse kusintha kwakukulu pamafakitale a beta-sitosterol, ma asidi a bile kapena magawo a hydroxylated mafuta acids.

Ma pancreatic Enzymes amathandizira pakapangidwe kazachilengedwe komwe kamakhala kosagwira mpaka atalowa lumen yaatumbo laling'ono. Pamenepo amathandizidwa ndi madzi am'mimba ndi michere ina ya m'mimba. Ma enzyme osiyanasiyana amachita mitundu yosiyanasiyana ya chakudya.

Ma pancreatic enzymes amasokoneza magawo a chakudya kukhala zinthu zosavuta zomwe zimatha kugayidwa ndi zinthu zina kapena kuzilowetsa m'magazi kudzera m'matumbo a mucosa.

Kuchotsa kwamafuta ndi mafuta amfupi aunyolo wamafuta mu chopondapo kunawonetsa kuphatikizika kwamphamvu ndi fecal misa. Lankish adayambitsa dongosololi loyang'anira milandu pakavulidwe kovuta pachipatala. Amalimbikitsa kuchuluka kwa ma enzymes poyang'ana momwe wodwala amagwiritsidwira ntchito mankhwalawo ndikuwunikanso matendawo. Ngakhale mankhwalawa amatenga nthawi, odwala samayankha pancreatin m'malo mwake popewa zovuta za pancreatic exocrine pancreatitis.

Udindo wothandizirana ndi enzyme mu pancreatitis yayitali umagwirizanitsidwa ndi zomwe zimachitika pakhungu pakati pa ma protein ndi cholecystokinin. Kukonzekera kwamkamwa kwa kukonzekera kwa pancreatic encyme mwa kubwezeretsa pakamwa kwa cholecystokinin, mwachiwonekere, kumayambitsa kuchepa kwa kukakamiza kwa ma pancreatic ducts ndikuchepetsa ululu. Zinatsimikiziridwa kuti kulowetsa kapamba m'malo mwa malingaliro oyipa kumakhudza katemera wamkati ndi kupweteka kwa kapamba. Mu odwala 18 omwe ali ndi pancreatitis yayitali, fecal ndi serum fecal elastase anayeza tsiku limodzi kale komanso tsiku limodzi atachira.

trypsin
chymotrypsin
makatakata,
elastase
kallikrein.

Zophatikiza ndi ma pancreatic a Carbohydrate ndizochepa amylase.

Zinthu zomwe zimaphwanya mafuta:

Ntchito ya endocrine

Maselo a Islet a gland (islets of Langerhans) amatulutsa mahomoni omwe amayang'anira kagayidwe kazakudya ndi chimbudzi. Zimakhudzanso kusungidwa kwa michere yambiri.

Odwala omwe ali ndi pancreatitis yolimba kwambiri, kuchepa kwakukulu kwa kuchuluka kwa fecal elastase kunawonedwa. Ululu unachepetsedwa patatha milungu iwiri ya enzymatic m'malo mwake. Kugwiritsanso ntchito kwa enzymatic mankhwala ndi kugwiritsa ntchito pambuyo pancreatic opaleshoni. Kuchulukana kungapitirire kwa milungu ingapo atachitidwa opaleshoni. Mapulogalamu a duodenal omwe amagwira ntchito amatha kuthandizira kubwerera kwa ntchito ya exocrine, koma izi zimaganiziridwa kuti zimadalira mlingo.

Odwala makumi awiri adasankhidwa mwachisawawa gulu lirilonse. Zochita za procrine zinafufuzidwa pogwiritsa ntchito mayeso a stool elasticity, kuyesa kwovomerezeka, komanso kuwunika kwa kugaya zakudya. Pambuyo masiku 10 akalandira chithandizo mu gulu A, pancreatin inali yothandiza kwambiri. Palibe kusiyana kulikonse pamlingo wa elastase komwe kunawonedwa m'magulu onse. Zotsatira za phunziroli zikuwonetsa kudalira kwa mphamvu ya mankhwala a enzyme pa mlingo wa enteric pancreatin wogwiritsidwa ntchito mwa odwala pambuyo pa opaleshoni ya pancreatic.

Mahomoni akuluakulu ndi insulin ndi glucagon. Insulin imakulitsa kukhathamiritsa kwa glucose ndimaselo, potero kutsitsa shuga wamagazi, ndikuthandizira kugwiritsa ntchito chakudya chochuluka. Glucagon imakweza shuga kuchokera ku depot ndikuwonjezera msanga wake m'magazi.

Somatostatin ndi timadzi tam'mimba tomwe timapangidwanso ndi ma islets komanso maselo a D mu mucous membrane am'mimba. Katunduyu amachepetsa kubisalira kwa michere ya pancreatic (exocrine) ndi michere yam'mimba, amalepheretsa kutulutsidwa kwa insulin ndikuchepetsa kuyamwa kwa michere m'matumbo. Somatostatin amakhudza kagayidwe.

Mankhwalawa angayambitse kusintha kwina mu ntchito ya pancreas ya exocrine, mwina pochepetsa kuyankha kwa cholecystokinin pakulimbikitsa chakudya. Ichi ndi chizindikiro chofunikira kwambiri chothandizira pancreatin m'malo. Zotsatira za enzyme therapy 4 ndi masabata a 8 atachitidwa opaleshoni chifukwa cha pancreatitis yayitali adayesedwa. Ma supplement a Enzymatic anakwaniritsa bwino mayamwidwe amafuta m'zakudya, zomwe zinapangitsa kuti pakhale mphamvu zambiri pakatha masabata 4 atalandira chithandizo.

Pancreatin inasintha bwino mayamwidwe a mapuloteni komanso kuchuluka kwa nayitrogeni masabata 4-8 atatha kulandira chithandizo, pomwe kuyamwa kwamafuta ndi mphamvu zamagetsi kumachepa mu gulu la placebo. Zakudya zopatsa thanzi za odwala sizinafooke kwambiri pamasabata 8 akuwunika, ngakhale 4 odwala omwe amalandila pancreatin anali ndi kulemera kwakukulu kwa 3.6 kg. Kafukufuku wina adawunikira zinthu zomwe zingakhudze kusintha kwakuthupi kwanthawi yayitali kwa odwala omwe ali ndi pancreatic ana a splenectomy. Magawo 28 azachipatala adawunika mwa odwala 34.

Kuchita kwa ma pancreatic michere m'mimba

Ma pancreatic pancreatic michere amasungidwa mu duodenum kuti akamwe chakudya. Insulin ndi glucagon imathandizanso pakukhazikitsa chimbudzi. Pamodzi ndi madzi, ma bicarbonate aon ndi ntchofu, katulutsidwe katulutsidwe ka michere ndi pafupifupi lita imodzi patsiku.

Kugwiritsa ntchito mwachizolowezi michere ya pancreatic sizinakhudze kuwonda, pomwe Mlingo wapamwamba mu odwalawa unapereka zotsatira. Kafukufuku wina, komabe, adawonetsa kufanana kwa mitundu yayikulu komanso yokhazikika ya michere ya pancreatic kwa odwala omwe ali ndi pancreatic epitomy. Osachitanso khungu, akhungu awiri, osachita khungu, osachita khungu, osachitanso khungu, owongolera malo, oyesedwa ngati masiku 14, pogwiritsa ntchito mlingo waukulu.

Munthawi yonseyi, mankhwala okwanira komanso okwanira anali ndi mphamvu zofanana. Kumbali ina, olemba akuwona kuti kugwiritsa ntchito mankhwala okhala ndi ma enzymes ambiri mu kapisozi imodzi kumachepetsa kuchuluka kwa makapisozi omwe amafunikira motero, zimawonjezera mwayi wogwiritsidwa ntchito ndi odwala komanso kukhutira kwawo ndi kuthandizira kwa chithandizo.

Amasungidwa ndi acini mu gland ndikulowa mu danc pancreatic. Ndipo pali gawo la wamba bile duct ndi chotsekeramo kudzera mu duodenum kulowa m'matumbo aang'ono matumbo. Pamodzi ndi iwo, ma bicarbonate ions ndi madzi zimamasulidwa. Izi zimasungidwa ndimaselo a epithelial omwe amatsogolera gland ndikuthandizira kuti asidi asatulutse m'mimba atatha kupanga ma enzymatic fluid. Kuti mupeze chakudya chokwanira, zovuta za mankhwala osiyanasiyana ndizofunikira.

Krivachi et al. Anawonetsa zabwino za mkulu-pancreatic enzymatic mankhwala ambiri odwala atatha kwathunthu gastrectomy. Adali ndi kuchuluka kwakukulu mu serum albin ndi cholesterol, pomwe seramu uric acid sinasinthe. Mafuta achitsulo adayamba kuyenda bwino, motero panalibe chifukwa chobwezeretsera chinthuchi. Odwala asanu ndi mmodzi adakumana ndi zovuta.

Kafukufuku wina amatchula zotsatira zopindulitsa za khansa ya pancreatin. Kusiyana kwapakati pakusintha kwa kulemera kwa thupi kunali 4, 9%. Odwala omwe amalandila ma enzymes a pancreatic adalandira kulemera kwa 1, 2%, pomwe odwala omwe adalandira placebo adataya 3, 7%. Kulowa mafuta kwa odwala omwe amalandiridwa ndi pancreatic kumawonjezeka ndi 12%, ndipo pagulu la placebo ndi 8%. Kuphatikiza apo, kudya kwatsiku ndi tsiku mphamvu kunali kwakukulu mu gulu la kapamba kuposa gulu la placebo.

Zochita za pancreatic amylase

Pancreatic amylase ndiyofunikira pakusintha kwa chakudya kuchokera muzakudya kukhala zovuta zamankhwala zomwe zimayimiriridwa ndi disaccharides ndi trisaccharides. Pambuyo pake, zinthu monga lactases, sucrose, maltases ndi iso-maltases zimapangidwa pamaziko awo.

Pankhani ya vuto la chiwonetsero cha minofu, kuwonjezeka kwa mulingo wa chinthuchi mu kuyezetsa kwamwazi wamagazi kumawonedwa.

Chifukwa chake, kugwiritsa ntchito milingo yapamwamba ya pancreatin yokhala ndi zakudya zoyenera kwa odwala omwe alibe opaleshoni yamatenda a pancreatic omwe ali ndi chimbudzi cha pancreatic amatha kupewa kuchepa kwa thupi, osachepera panthawi yamachitidwe

Kugwiritsidwa ntchito kwa pancreatic enzyme m'malo kungalepheretse kuperewera kwa zakudya m'thupi ndi mafuta m'mimba mwa odwala ambiri omwe ali ndi inshuwaransi ya pancreatic. Ngakhale izi ndizodziwika kwambiri, si kugwiritsa ntchito mankhwalawa kokha. Pakalipano, zikuwoneka kuti zikugwiritsidwa ntchito zikukulira matenda osiyanasiyana a kapamba. Kafukufuku wopindulitsa kwambiri, mwachidziwikire, ndikupanga zinthu zatsopano zomwe zimakhala ndi kukhazikika kwazinthu zokhala acidic ndi proteinase.

Kuwongolera kwachinsinsi

Kubisala kwa michere ya pancreatic imayendetsedwa ndi kutulutsa kwamitsempha ndi zinthu zina. Kumayambiriro kwa katulutsidwe kamatumbo, mitsempha ya vagus yamitsempha yamagetsi imakhala yolimbikitsidwa. Zina mwazomwe zimakhudzanso zimayambitsa kutulutsidwa kwa acetylcholine. Katunduyu, limodzi ndi cholecystokinin (CCK), yomwe ndi gawo logaya chakudya ndipo amapangidwa poyankha kulowetsedwa kwa chakudya mu duodenum, amachititsa kuti amasulidwe a michere ya pancreatic kuchokera ku acini.

Matenda a kapamba sindiwo khansa yapambuyo yomwe imakhudza kapamba. Matendawa amadziwika ndi pang'onopang'ono fodya wa thupi, limodzi ndi kutha kwa adenocarcinoma. Matenda apansi a pancreatitis sangasinthe komanso amakhala kwamuyaya, monga zimatsimikiziridwa ndi mfundo yoti ngakhale atachotsa tizilombo toyambitsa matenda, akupitilizabe. Ndikofunikira kuti kukanika kwa pancreatic kutha kuchitika pafupipafupi - matendawa amatha kutchedwa kuti pancreatitis.

Kafukufuku akuwonetsa kuti kuchuluka kwa mowa wofunikira pakukula kwa matendawa kumasiyana kwambiri kutengera machitidwe a anthu omwe aphunziridwawo. Adanenanso kuti izi zitha kukhala chifukwa cha majini kapena chilengedwe, monga kuperewera kwa zakudya kapena kusuta. Zinapezeka kuti kudya zakudya zambiri zomanga thupi ndi mafuta mwa anthu omwe amamwa mowa kumathandizira kuti pakhale matenda a kapamba, ndipo kusuta ndi gawo lalikulu lomwe lingachitike.

Homoni wina wokumba yemwe amadziwika kuti secretin amachititsa kutulutsa kwamchere yambiri yama bicarbonate ndi madzi. Njira imeneyi imathandizira kuti kayendedwe ka matumbo azikhala kochepa. Secretin imabisidwa chifukwa cha chapamimba asidi kulowa mu duodenum.

Kodi kuperewera kwa pancreatic enzyme kumawonekera bwanji?

Ndikusowa kwa michere yam'mimba koyamba, zizindikiro zotsatirazi zimawonekera:

Zomwe zimayambitsa matenda osokoneza bongo a pancreatitis ndi monga: kubwereza kapamba kapena kupweteka kwamatenda kapamba, mwachitsanzo, chifukwa cha matenda osokoneza bongo. Zawonetsedwa kuti 20% ya pancreatitis yokhazikika imatha kukhala ya idiopathic, komwe matenda otentha amatha kuphatikizidwira, momwe matenda amodzi amadziwika osadziwika. Zina zomwe zimachitika kawirikawiri chifukwa cha matenda kapamba zimaphatikizaponso kusintha komwe kumakhudzana ndi kutsekeka kwa kapamba kulowa mu duodenum.

kulemera m'mimba mutatha kudya,
ukufalikira
kuchuluka kwa gasi,
pobwera mutatha kudya,
kusanza, kusanza,
kuchepa kwamtima
kutsegula m'mimba komanso kudzimbidwa kawirikawiri.

Kuperewera kwa enzymatic kwa nthawi yayitali kumabweretsa kufa ndi njala kwa ziwalo zamkati. Kuperewera kwa michere ya pancreatic imadziwonetsera ngati:

Zina zomwe zimapangitsa kuyambika kwa matendawa ndi: kusintha kwa majini, monga chibadwa champhamvu cha kapamba, kusintha kwa chitetezo cha mthupi, autoimmune chronic pancreatitis, ndi metabolic factor, monga hyperthyroidism. Zizindikiro za chifuwa chachikulu.

Malabsorption syndrome ndi chimodzi mwazizindikiro zazikulu za chifuwa chachikulu. Zomwe zazikuluzikulu za chithunzi cha odwala zimachitika motere. Chizindikiro chodziwika bwino cha matendawa ndi kupweteka kwam'mimba, makamaka ngati iko kuchira ndipo kumatenga maola angapo mpaka masiku angapo. Kupweteka kwapancreatin nthawi zambiri kumakhala kovutirapo kotero kuti nthawi zambiri kumapangitsa kuti wodwalayo azigwira ntchito moyenera. Ululu umakonda kupezeka kumtunda komwe ndipo umatha kuwalitsa pamimba kumanja kapena kumanzere. Chizindikiro china cha matendawa ndicho kutopa kwakanthawi, chomwe ndi zotsatira za kuletsedwa kwa chakudya chifukwa cha kuchuluka kwa chakudya mukatha kudya, zomwe zimalepheretsa wodwalayo kudya chakudya. Chizindikiro china choyambirira cha chifuwa cham'mimba ndizosavuta. Izi zimachitika pakachitika vuto linalake kapena pambuyo pake ndipo zimachitika chifukwa cha kutupa kwa kapamba, kupondaponda wamba bile duct. Izi zitha kukhala chifukwa cha bile duct fibrosis yomwe ikupita patsogolo komanso kuchepa kwake kosalekeza. Chifukwa chake, izi zitha kutanthauza kuchulukana kwa matendawa. Nthawi zambiri jaundice amakhala kanthawi kochepa. Mu chifuwa chachikulu, kupweteka kwa michere kumachepetsedwa, komwe kumatha kuyambitsa kugaya bwino komanso kumiza. Vutoli lomwe limakhala chifukwa cha kupweteka kwamatumbo kumawoneka ndi m'mimba yamafuta, yomwe imatha kutsagana ndi mpweya wambiri wa nayitrogeni. Ndikofunika kuti zotsatira zamafuta am'mimba pamimba nthawi zambiri zimakhala zopanda mavitamini osungunuka mafuta. Nthawi zina kumapeto kwa matenda a kapamba, kuperewera kwa endocrine kumatha kuchitika, komwe kumapangitsa kuti pakhale tsankho la shuga. Izi ndizofunikira chifukwa chakudya cha wodwalayo, chomwe chiyenera kusinthidwa moyenerera.

Cholinga chachikulu cha izi ndi kudya zakudya zamafuta kapena mowa.
Matenda amtunduwu nthawi zambiri amatenga maola angapo mpaka masiku angapo.

Kuphatikiza pa zizindikirozi, nseru, kusanza, kudwala, kufinya, ndi kudzimbidwa zimatha kuchitika.

kagayidwe kachakudya matenda
kukhala ndi mapaundi owonjezera kapena kuchepa thupi,
khungu lowuma,
kuchepa kwa misomali,
kutaya tsitsi
kuchepa magazi
chizungulire pafupipafupi.

Ndikofunikira kuzindikira vutoli munthawi yake ndikuchitapo kanthu pakuwongolera ndi kubwezeretsa chithandizo.

Palibe mbiri yogwirizana yomwe yapezeka.

Pancreatitis, kapena kutupa kwa kapamba, ndimawu ofala kwambiri omwe madokotala ndi odwala amakumana nawo. Mofananamo, matenda a chipani chachitatu nthawi zambiri amakula chifukwa chosowa kwambiri michere. Pofuna kuthana ndi vutoli, dotoloyo akupereka mankhwala opangira enzymatic omwe ali ndi cholinga chobwezeretsanso kuchuluka kwa michere yomwe yasowa. Mutatha kumwa mankhwalawa, chimbudzi chimabwereranso kwina, kapamba amabwezeretseka, magwiridwe antchito amayenda bwino.

Ganizirani ma michere amafunsidwa, momwe mungamwe mankhwalawa kuti muchiritse.

Ma Enzymes ndi zinthu zokhudzana ndi chilengedwe zomwe zimapangidwa ndi gland ndipo zimatumizidwa ku ziwalo ndi minyewa yathupi kuti igwire ntchito zovuta. Mwachitsanzo, kapamba amatulutsa insulin, glucagon ndi lipocaine - mahomoni ofunikira kuti chimbudzi. Lipocaine si mahomoni mu mawonekedwe, amagwiranso ntchito zofananira - amatsimikizira kayendedwe kazomwe zimachitika mu chiwindi.

Ma Enzym ndi gawo limodzi la madzi a pancreatic, omwe amatha kuthandizira kukumba kwa matumbo ang'onoang'ono. Ngati zinthu zosalowerera ndendende zikudutsa pamalowo, ma enzyme amayenera kuyambitsa kuti azichita nawo gawo la cleavage.

Monga lamulo, malo ochitira ma enzymes ndi duodenum. Ngati, pazifukwa zosadziwika, momwe zimayambira poyambilira, kusapeza kumachitika. Mwachitsanzo, pamene kulumikizana kwa ma enzymes ndi matumbo kumachitika nthawi yomweyo ndikutuluka kwa ndulu.

Kodi chimbudzi chimadalira chiyani?

Mwa ma enzymes ambiri opangidwa ndi kapamba, ma enzyme omwe amaphatikizidwa ndi chimbudzi ndiofunika kwa wodwalayo, omwe kuperewera kwake kumagwira ntchito yolakwika m'mimba. Tikukamba za lipase, amylase ndi proteinase. Ma enzyme amenewa amapangidwira kuphwanya zakudya: chakudya, mapuloteni ndi mafuta; amasiyana pantchito yawo.

Amylase adapangidwa kuti agwetse chakudya. Kuwola kumachitika ndi "thandizo" la michere ina yomwe imapangidwa ndi matumbo ochepa.

Protease (ma protein enzymes). Pali mitundu ingapo ya ma enzyme osiyanasiyana:

Awiri oyamba amafunika kuwonongeka kwa mapuloteni ngati pakhale gulu lalikulu la maselo. Enzyme yomaliza imakhala ndi ma peptides, omwe maselo ake amapanga chipangizo chophweka, kukonzekera mu amino acid samatenga nthawi yambiri.

Mtundu wama Enzymes amadziwika kuti ndiowopsa, makamaka akamagwira ntchito. Kuchokera kapamba, zinthu sizimalowerera, zimagwira ntchito zikaonekera pa trypsin, yomwe imatha kugwira ntchito palokha. Nthawi zina, ndi ntchito ya trypsin yokhala ndi ma enzymes a proteinolytic, kutupa kumayamba, madokotala nthawi zambiri amayenera kusiya ma enzymes. Kuti mukwaniritse izi, ndikofunikira kupewa makina okhawo kuti ayambe: chimodzi mwazinthu zomwe zimagwira chimangotulutsidwa pamakoma a cell a trypsin mamolekyulu.

Nyukiliya, zomwe zimaphatikizapo RNA ndi DNA, ndizomwe zimayambitsa kusintha kwa chidziwitso cha majini.

Lipase ndiyofunikira kuphwanya mafuta muzinthu zosavuta. Monga ma enzymes osankhidwa, lipase imagwira ntchito kaphatikizidwe ndi ena omwe amapangidwa m'magawo am'mimba.

Phospholipase ya enzyme imadziwika. Kuchokera ku dzina ndizodziwikiratu: chinthu chama mankhwala chimagwira mwachindunji kuwonongeka kwa phosphorous, phospholipids ndi collagenose, zomwe zimakhudza bwino kapangidwe ka minofu yolumikizana. Zikondazo zikakhudzidwa, minofu iyi imavutika, mwa zina, mapuloteni othandiza ndi olandirika.

Zoyambitsa Enzyme Kusowa

Madokotala azindikira zifukwa zingapo za kuchepa kwa ma enzyme:

minofu yachilengedwe yachilengedwe imaloŵedwa m'malo ndi chinzake,
pancreatic ducts atrophy
Pancreatic ducts yatupa, ndipo msuzi wa m'mimba ofunikira kuti chimbudzi chisafikire komwe wafika,
minofu ya kapamba imagawika chifukwa cha njira yotupa, ndikuwononga chiwalo chokha.

Ndizomveka kumwa mankhwala omwe angabwezeretse michere ndi kapamba pazoyenera zawo.

Matumbo ang'onoang'ono

Tizigawo tating'onoting'ono totchedwa alpha-amylase (ptyalin) pamkono wamkamwa, womwe umadula wowuma kwambiri kukhala zidutswa zazifupi ndikuyamba kusungunuka munthu m'magazi (dextrins, maltose, maltriosis).

Mimba

Mimba zomwe zimatulutsidwa ndi m'mimba zimayitanidwa michere yam'mimba. Mwachilengedwe, pafupifupi ma enzymes onse ndi mapuloteni.

Pepsin ndiye puloteni yofunika kwambiri ya m'mimba. Hydrolytically imadula peptide zomangira za mapuloteni osungika kuti apange ma peptides. Zimapangidwa mu zomwe zimatchedwa "main cell" mu mawonekedwe osagwira mu mawonekedwe a pepsinogen kuti mupewe kudzimbidwa kwa mucosa wam'mimba. Pamimba pamimba acidic (pH = 1.5-2.5), pepsinogen imasinthidwa kukhala pepsin yogwira. Pankhaniyi, pepsin inhibitor imachiritsidwa. Mchitidwewu ndiwodziwikiratu ndi gawo la Hcl (H + ions), lomwe limapangidwanso m'matumbo a m'mimba, koma m'malo omwe amatchedwa "ma cell a parietal". Kulemera kwa pepsinogen kuli pafupifupi 42,000, ndipo pepsin ndi pafupifupi 35,000. Zimatengera izi kuti kutembenuka kwa pepsinogen kukhala pepsin kumatsatana ndi kujambulidwa kwa molekyulu yapakati pa 15-20%. Kutseguka kumachitika chifukwa chokhazikika cha gawo la N-terminal la pepsinogen, momwe amino acid yonse imakhazikika. Mwa zinthu zopangidwa ndi cleavage, pali pepsin inhibitor yolemera 3232 ndi tizidutswa tating'ono ting'onoting'ono, tomwe timagwirizana ndi kulemera pafupifupi 4000. Kugwira ntchito kwa hydrochloric acid ndikutanthauzanso kwamapuloteni a chakudya komanso kusakanikirana kwa microflora ya pathogenic kuchokera ku chakudya. Kuteteza khoma la m'mimba pamalo achilengedwe oopsa, "maselo a mucosal" a mucosa amatulutsa mucin - glycoprotein - ndi bicarbonate ion.
Gelatinase imaphwanya gelatin ndi collagen, nyama yofunika kwambiri ya protein.

Matumbo ang'onoang'ono

Zizindikiro za kuperewera kwa enzyme

Kuzindikira kusowa kwa enzyme yapadera m'thupi sikophweka. Poyerekeza ndi momwe wodwalayo akumva kupweteka, nkovuta kugwira zomwe munthu akuchita. Mukapenda mosamala, zimawonekera:

kutulutsa pafupipafupi,
kumva kupsa mtima mukamadya zakudya zina,
kulimbikira kapena kupindika m'mimba
kusowa chilimbikitso, kapena, chidwi chambiri,
kusabereka m'mimba popanda kutulutsa kwachidziwikire,
kutopa kosalekeza, kopanda tanthauzo.

Matenda a kapamba nthawi zonse amayambitsa zovuta zam'mimba, Zizindikiro zimangowonetsa kuchepa kwa enzymatic. Komabe, madokotala samapereka mankhwala okonzekera kapamba.

Zisonyezero zoika kukonzekera kwa enzyme

Kuperewera kwakukwanira komanso kotheratu kwa michere mthupi kumadziwika. Mtheradi - zoyipa kuposa wachibale, koma mankhwala obwezeretsa muyeso wa enzyme akadayesedwa.

Kusiyana kwake kumachitika pamene kuchuluka kwa enzyme m'thupi kuli kwabwinobwino. Zotsatira zofananazo zimakwaniritsidwa pa gawo la chikhululukiro. Masiku asanakhazikike, kumwa mankhwalawa kumachitika chifukwa dokotala amafunitsitsa kuti mwina pali michere mthupi.

Pali zochitika zingapo zoyenera, popanda mankhwala sizingathandize. Zinthu zikumveka motere:

muyenera kudya pafupipafupi, m'magawo ang'onoang'ono - mwachitsanzo, gawani gawo la nkhomaliro kukhala chakudya 5-6 masana,
ndibwino kuti musamamwe mafuta osavuta am'mimba, mafuta osiyanasiyana, zakudya yokazinga,
Simungamwe mowa womwe umaletsa kupanga michere,
musaiwale kusewera masewera, chifukwa cha zolimbitsa thupi kukonza zinthu kumathamanga,
ngati simudya m'mawa, izi zimathandizira kuti matumbo azikonza ndi kuphwanya chakudya chomwe chawudya masana.

Dokotala yemwe adakonzera wodwala kukonzekera adzakuuzani za zomwe zalembedwazo.