Pancreatic Alpha Amylase

Kuyesedwa kwa lipase kumayendetsedwa pamatenda omwe akuwoneka kuti ali m'matumbo. Tiyeni tiwone za enzyme yotchedwa lipase - ndi chiyani? Ndimagwira ntchito yanji mthupi yomwe imagwira, ndipo ndimatenda ati omwe amapatuka kuchoka pazomwe zimachitika pazotsatira zoyeserera?

Lipase ndi enzyme yopangidwa ndi ziwalo zina za thupi. Imasungunuka, kupatula ndikugaya zigawo zingapo zamafuta, komanso imagwiranso ntchito zina zingapo zofunika. Pancreatic lipase ndiyofunikira kwambiri. Zochita zake zimatha kuyesedwa ngati mafuta sakudya.

Enzyme "imagwira" limodzi ndi colipase (coenzyme) ndi ma acid acid. Amapangidwa, kuphatikiza zikondamoyo, mapapu, m'mimba, matumbo ngakhale maselo oyera oyera - maselo oyera amkati mwa chitetezo cha mthupi. Palinso zinthu monga "lingual lipase". Ichi ndi chiyani Ichi ndi enzyme yomwe imapangidwa m'mkamwa wamkati mwa makanda chifukwa chamadongosolo oyamba a chakudya, ndiko kuti, kuwonongeka kwa mkaka wa m'mawere.

Pancreatic lipase

Mulingo wake m'magazi ndiwokwera kwambiri kuposa mulingo wamitundu ina ya lipase. Komabe, ndi pancreatectomy (kuchotsedwa kwa kapamba), ochepa mwa lipase adatsalabe chifukwa chobisalira ndi ziwalo zina. Pakayezetsa mkodzo, lipase nthawi zambiri imasowa. Pambuyo "pobadwa" mu kapamba, umalowa m'matumbo, pomwe umagwira ntchito yake yayikulu - kuphwanya mafuta. Pancreatic lipase imachita mbali yofunika kwambiri. Ndikutanthauza kuti magazi amaperekedwa, popeza kusintha kwa chizindikirochi kungathandize pakuwonetsa matenda ambiri. Ndi ziti, taganizirani pansipa.

Pancreatic lipase - ndi chiyani? Ndi enzyme yopangidwa ndi kapamba yomwe "imaphwanya" triglycerides mu glycerol ndi mafuta achilengedwe ambiri. Nthawi zambiri, umaphwanya bowa womwe umatulutsidwa kale ndi bile.

Lipase imagwira ntchito mthupi

Kuphatikiza pa kuwonongeka kwa mafuta, lipase imakhudzidwa ndi kagayidwe ka mphamvu, komanso imatenga nawo gawo la mayamwidwe a polyunsaturated mafuta acids komanso mavitamini ena - makamaka, A, D, E, K.

1. Hepatic lipase imayang'anira kupatsidwa kwa plasma lipids. Imalimbikitsa mayamwidwe a ma chylomicrons ndi ma kachulukidwe otsika a lipoprotein.
2. Gastric lipase imayang'anira ntchito yodzutsa mawonekedwe a mafuta a tributyrin.
3. Lingase lipase.
   

Lipase assay

Kusanthula kwa Lipase kumachitika pazochitika ziwiri:

1. Pofuna kudziwa kapamba (kutupa kwa kapamba).
2. Kuwunika magwiridwe antchito a kapamba.

Kuyesedwa kwa lipase yamagazi kumawerengedwa kuti ndiwothandiza kwambiri pakudziwika kuti ali ndi pancreatitis pachimake kuposa kuyesa kwa magazi kwa amylase. Komabe, kumapeto kwenikweni kwa kapamba am'mimba, milingo ya lipase imatha kuchepa. Ndi ma mumps osavuta (omwe amatchedwa "mumps"), mulingo wake umakhalabe woyenera komanso amawonjezeka pokhapokha ngati matendawa amakhudza kapamba. Izi ndizothekanso ndi matenda owopsa a impso kapena matenda a impso, ngakhale kuchulukana kwa amylase pamenepa kumatchulidwa. Chifukwa chake, tidasanthula enzyme yotchedwa "lipase" - chomwe ili ndi zomwe imagwira m'thupi. Tikhalebe pa kuyezetsa magazi kwa lipase.

Momwe mungakonzekerere kusanthula?

Magazi amaperekedwa mosamala pamimba yopanda kanthu, mumatha kumwa madzi musanayesedwe. Pambuyo pa chakudya chomaliza, pafupifupi maola 8-12 ayenera kudutsa. Ndikwabwino kuchita izi musanamwe mankhwala kapena masabata awiri atachokapo. Ngati izi sizingatheke, musanapereke magazi, ndikofunikira kunena kuti ndi mankhwala ati omwe amagwiritsidwa ntchito.

Tsiku lisanatenge magazi, muyenera kumadya zakudya zopepuka - osanenepetsa mafuta, okazinga, zakudya zonunkhira, mowa, komanso kupewa kuchita masewera olimbitsa thupi. Ndikulimbikitsidwa kupereka magazi musanayambe maphunziro ena - fluorografia, radiology - kapena njira zolimbitsa thupi.

Mlingo wa lipase wamagazi

Chizindikiro cha matenda ambiri ndi lipase enzyme, yodziwika momwe amuna ndi akazi achikulire ali ofanana. Akuluakulu, ndiye kuti, anthu omwe afika zaka 18 - kuchokera ku 0 mpaka 190 mayunitsi. Mwa ana (mpaka zaka 17), zolembedwa za lipase za mayunitsi 0 mpaka 130 zimawonedwa kuti ndizovomerezeka.

Kodi kuchuluka kwa magazi lipase kumatanthauza chiyani?

Kodi kuchuluka kwa puloteni yotchedwa lipase kumatanthauza chiyani? Mulingo wazomwe zili mkati mwake zikuwonetsa kuti kapamba ali bwino, koma ngati zisonyezo zakwaniritsidwa, izi zitha kuwonetsa matenda:

1. Pachimake kapamba kapena kuchulukitsa kwa matenda aakulu.
2. Biliary colic.
3. Matenda a gallbladder.
4. Zovala zikondamoyo.
5. Kukhalapo kwa zotupa mu kapamba.
6. Kutulutsa kwa zikondamoyo zamiyendo (mwala kapena bala).
7. Intrahepatic cholestasis (ndi kuchepa kwa kayendedwe ka bile mu duodenum).
8. Pachimake matumbo kutsekedwa.
9. Mtsempha wamkati.
10. Peritonitis (kutupa kwa peritoneum).
11. Zilonda zam'mimbazi.
12. Kukongoletsa kwa dzenje.
13. Hepatic matenda, pachimake kapena aakulu.
14. Mapampu ("mumps"), ndikupereka kaphatikizidwe ka kapamba.
15. Matenda a metabolism, omwe nthawi zambiri amawonedwa ndi gout, shuga, kunenepa kwambiri.
16. Matenda a chiwindi.

Komanso nthawi zina lipase imadzuka ndikusakanizidwa ndikugwiritsa ntchito mankhwala kwakanthawi monga barbiturates, narcotic analgesics, indomethacin, heparin.

Pancreatic lipase imachulukanso ndi kuvulala kwa mafupa a tubular. Komabe, popeza kuwunika kwa lipase sikungapereke chidziwitso chofunikira pakuwonongeka kwa thupi, chizindikirocho sichimayang'aniridwa chifukwa cha kuphulika.

Koma ndi kuwonongeka kwa kapamba, kuwunika kwa lipase ndi amylase ndikofunikira kwambiri. Kuchuluka kwawo munthawi yomweyo ndi kulondola kwakukulu kumawonetsa momwe maselo amachitika m'maselo a gland. Munthawi yodwalayo, wodwala amakhala kuti wabwinobwino kwambiri kuposa msanga wa lipase.

Zomwe zimayambitsa kuchepa kwa magazi lipase

Ngati lipase itachepetsedwa, imanena mavuto monga:

1. Kukula kwa khansa iliyonse kupatula khansa ya pancreatic.
2. Kuchulukirapo kwa triglycerides, komwe kumachitika ndi zosayenera zakudya, makamaka kumwa kwambiri mafuta.
3. Kusintha kwa kapamba mpaka nyengo yovuta.

Lipase mu enzyme kukonzekera

Thupi lathu limatulutsa michere ya chakudya popukusa mapuloteni, mafuta ndi chakudya (zazikulu zomwe ndi amylase, lipase ndi proteinase). Komabe, pankhani ya kuchepa kwa kupanga kwa ma enzymes (kuchepa kwa enzymatic), kapamba, ndi matenda ena apakhungu, madokotala amalemba mankhwala omwe ali ndi michere ya nyama - ali mu nembanemba, chifukwa chake amatetezedwa ngakhale pakukula kwa acidity ya m'mimba. Kufika ku duodenum, adamulowetsa mmenemo. Enzymes nthawi zambiri amalembedwa m'mafupifupi maphunziro, koma nthawi zina mumayenera kumwa nthawi yayitali. Kugwiritsa ntchito kwa nthawi yayitali ma enzyme kumatha kutsagana ndi kuchepa kwa ntchito ya pancreatic, komabe, atasiya kumwa mankhwalawo, ntchito ya chiwalocho imabwezeretseka. Mwa michere ya pancreatic, Creon, Festal, Mezim, Pancreasim, Panzinorm ndi mankhwala ena, omwe amagwiritsidwa ntchito kwambiri ndi pancreatin. Muli proteinase, lipase, amylase. Mlingo wa lipase piritsi limodzi ndiwokwera kuposa mulingo wa ma enzyme ena. Izi ndichifukwa choti lipase, poyerekeza ndi ma enzyme ena, matendawa amapangidwa ndi thupi pang'ono. Popeza lipase imatsitsidwa m'thupi, zomwe zimapezeka m'mankhwala zimakhala zosachepera 10,000 magawo a ntchito (UNITS).

Kukonzekera kwa enzyme nthawi zambiri kumakhala kotetezeka kwa thupi. Nthawi zambiri amatenga gawo limodzi la mankhwalawa pochiza maantibayotiki, komanso ma pre- ndi ma probiotic, komanso mavitamini ndi mankhwala ena.

Kukonzekera kusanthula ndi zitsanzo

Pazolemba zake phunziroli ndi seramu yotalikirana ndi magazi a venous. Zida nthawi zambiri zimatengedwa m'mawa, pamimba yopanda kanthu. Chakudya chomaliza chimayenera kupangidwa osachepera maola 12 musanatenge magazi. Kwa mphindi 30 ndikofunikira kupatula kusuta, kuchuluka kwa thupi ndi kutaya mtima, kwa sabata - kumwa mowa ndi mankhwala osokoneza bongo (ngati zingatheke).

Kusanthula kwa magazi nthawi zambiri kumachitika kuchokera kumitsempha ya ulnar ndi syringe kapena pulogalamu ya phula. Ma machubu amatsekedwa mwamphamvu, amaikidwa m'mabokosi ndi kutumizidwa ku labotale. Asanayesedwe, seramu imadzipatula ku magazi. Kuzindikira kwa mulingo wa pancreatic alpha-amylase mkati mwake kumachitika ndi njira za mtundu wa genetic. Ntchito ya enzyme imayesedwa ndi kuchuluka kwa momwe zimachitikira ndi gawo lapansi. Kukonzekera zotsatira zowunikira kumatenga masiku osaposera 1 bizinesi.

Makhalidwe wamba

Nthawi zambiri, mwa odwala azaka zopitilira 18, kuchuluka kwa ma pancreatic alpha-amylase sikupitirira 53 U / L. Mu ana a chaka choyamba cha moyo, enzymeyi imapangidwa m'miyeso yaying'ono, mautchulidwe - osapitirira 8 mayunitsi / lita. Kufikira zaka khumi zakubadwa, malingaliro abwinobwino sakhala apamwamba kuposa mayunitsi 31 / lita, kufikira zaka za 18 - osati kuposa 39 / lita.

Kuwonjezeka pang'ono pang'onopang'ono kwa pancreatic alpha-amylase kumatha kuchitika mukamamwa mankhwala a corticosteroids, mankhwala osapweteka a antiidal, narcotic analgesics, njira zakulera pakamwa, furosemide, Captopril. Chifukwa chake, kuti mupeze zotsatira zodalirika, ndikofunikira kuyimitsa phwando lawo momwe mungathere. Chomwe chimapangitsa kutsika kochepa kumatha kukhala cholesterol yayikulu m'magazi.

Mulingo wokwera

Chomwe chikuwonjezera kuchuluka kwa ntchito za alpha-amylase m'magazi ndi pancreatitis yayikulu. Kuphatikizika kwa enzyme kumawonjezeka maola angapo atatha kuwonongeka kwa minyewa ya pancreatic ndipo kumatenga masiku 5. Mwanthawi yayitali matenda, Zizindikiro zimawonjezeka pang'ono. Popita nthawi, maselo ochulukirachulukira akakhala kuti sagwira ntchito, mulingo wa pancreatic amylase umabweranso wokhazikika, kenako ndikufika pamunsi.

Komanso, choyambitsa kapena kuwonjezereka kwa ntchito ya pancreatic alpha-amylase m'magazi ikhoza kukhala kuvulala kwa kapamba, kuphwanya kwamiyendo yake ndi mwala kapena chilonda, kupanikizika kwa mankhwalawa. matumbo kutsekeka, cholecystitis. Ndi macroamylasemia, kuchuluka kwa mphamvu ya magazi m'magazi kumawonjezeka, pomwe mkodzo umachepa kapena kutsalira womwewo. Ndi shuga wowola, kapamba amalandanso katundu, yemwe nthawi zambiri amabweretsa kutulutsa kwa pancreatic amylase m'magazi.

Kutsitsa

Cholinga chakuchepa kwa kuchuluka kwa pancreatic alpha-amylase m'magazi ndikuchepa kwa kuchuluka kwa maselo a pancreatic omwe amagwira ntchito nthawi zambiri. Amakhala ocheperako ndi mtundu wokhazikika wa kapamba, kakulidwe ka khansa, cystic fibrosis, kapamba ka kapamba, kapangidwe kake kapena kapamba kokwanira. Zomwe zimayambitsa kuchepa kwa ntchito za alpha-amylase m'magazi zitha kukhala kuchuluka kwa mankhwalawa, mwachitsanzo, ma citrate kapena oxalates, komanso kuwonongeka kwa maselo a chiwindi chifukwa cha hepatitis, poyizoni, kuphatikizapo mowa, komanso toxicosis yokhala ndi pakati.

Chithandizo Chosawerengeka

Kusanthula kwa pancreatic alpha-amylase m'mwazi ndizofunikira kwambiri pakuzindikira mu gastroenterology, komanso nephrology ndi opaleshoni. Zotsatira zake zimatanthauziridwa molumikizana ndi zidziwitso zina zoyezetsa magazi a biochemical. Nthawi zambiri, gastroenterologist amatenga nawo mankhwalawa: mankhwala, mankhwala, othandizira olimbitsa thupi, amawunikira mphamvu ya matendawa.

Zovuta zakuthupi za pancreatic alpha-amylase m'magazi zimatha kuchotsedwa ndi chakudya, zomwe zimachepetsa katundu paz kapamba. Choyambirira, ndikofunikira kuchepetsa kuchuluka kwa zokazinga, mafuta, kusuta, zonunkhira komanso zotsekemera kwambiri, kuthetseratu mowa, khofi, fodya. Kudya kumakhala koyenera pang'ono, pazigawo zazing'ono. Kuvomerezedwa kwa mankhwala aliwonse kuyenera kuvomerezana ndi dokotala, nthawi zambiri ndi kusakhazikika kwa mankhwalawa komwe kumapangitsa kuti chiwopsezo cha enzyme chiwonjezeke.

Mitengo yokweza

Amylase mu pachimake njira yotupa imatuluka kangapo kamodzi, nthawi zambiri kusintha koteroko kumayambira kuyambika kwa matenda kapena kufalikira kwa matendawa. Zizindikiro zimakula mkati mwa maola 3-5, zimafika pachimake patatha maola 10-24. Pambuyo pake pali kuchepa, patsiku la 6, gawo la amylase limatsika kukhala labwinobwino.

Kuti mupeze zotsatira zodalirika, ndikofunikira kusanthula ntchito ya amylase mkodzo watsiku ndi tsiku, zomwe ndizofunikira popanga matenda, koma zotsatira zake sizili pachimake pamatendawo.

Mu chifuwa chachikulu cha pancreatitis popanda kuchulukitsa, kuchuluka kwa amylase kumatha kuchepetsedwa, pakubwezeretsanso, chiwerengero cha michere ya kapamba imachulukana. Mwa odwala ena, kuphatikiza kwachilendo kwa chinthu sikumasiyanitsidwa ngakhale ndi kukokomeza.

Pancreatic lipase ndi amylase zimachulukitsidwa mu zochitika zotere:

1. kuchotsa mimba
2. kuvulala kwam'mimba
3. matenda ena.

Zomwe zimawonjezera mwachangu kwambiri Zizindikiro zimaphatikizidwanso ndi miyala mu chikhodzodzo, impso, oncological neoplasms, ndi kutsekeka kwa bile.

Zimachitika kuti kuwunika kwamankhwala am'mwazi kumapereka zotsatira z zero, izi zimachitika pamene ntchito ya pancreatic gland ikusakwanira, komanso gawo la hepatitis yovuta kwambiri. Low amylase ndi chizindikiro cha toxosis pa nthawi yapakati.

Kuti mupeze matenda olondola, muyenera kuyesa mayeso owonjezera, kuyesa thupi moyenera. Mulingo woyenera wa chinthu ndi ichi: mwa ana osaposa chaka chimodzi, chizindikiro cha amylase chili pansi pa 8, mwa mwana wazaka 1-10 - pansipa 31, muunyamata - pansipa 39, mwa munthu wamkulu - pansipa Magawo 53 / lita Palibe kusiyana komwe wodwala amakhala nako.

Kuchulukitsa pang'ono - pomwe kuwunikaku kungowonetsa mayunitsi ochepa kuposa abwinobwino, munthuyo sasokonezedwa, samadandaula zaumoyo. Zikatero, adotolo amangolembera Pancreatin kapena mankhwala ena apakhungu a pancreatic.

Zizindikiro zikuyenera kukuchenjezani kuposa kawiri (kutsika) kuposa zabwinobwino.

Zotsatira zake zimachuluka kapena kuchepa liti?

Ndi pancreatitis, amylase imatsimikizika chifukwa cha kuyesa kwatsatanetsatane wa magazi, kenako kusintha kosiyanasiyana kumawunikidwa, kuyerekezera kumakhala koyenera ndipo kumakhala mankhwala okwanira. Kuyamwa kwa magazi kumachitika pamimba yopanda kanthu, pambuyo pake mawonekedwe a seramu amayendera. Pa kusanthula kwa mkodzo, zinthu zachilengedwe zimasonkhanitsidwa kwa tsiku limodzi, gawo lam'mawa la mkodzo limatsanulidwa, ena onse amatengedwa masana, chopereka chimatha ndi gawo lotsatira la mkodzo tsiku lotsatira.

Kuyesedwa kwa magazi kwa pancreatic amylase kuyenera kuwonetsa kusapezeka kwake, enzyme iyi nthawi zambiri sikhala m'magazi.

Ngati mankhwala alowa m'malo achilendo (magazi, mkodzo), amalankhula za kuyambika kwina.

Ndi chiwonetsero chowonjezeka m'magazi, kuchuluka kwa amylase mumkodzo kumapitiriranso masiku onse, ichi ndi chikhazikitso chodziwira matenda a ziwalo zamkati. Kukula kwa pancreatic amylase m'magazi kungakhale chizindikiro:

• mumps
• matenda aumiseche
• cholecystitis.

Mtengo wovomerezeka uyenera kukhalabe mumtundu wa 28-125 U / L (magazi), 1-17 U / L (mkodzo). Kusanthula kwa pancreatic amylase kumasonyezedwa pakuwunika zovuta, kumakupatsani mwayi wokhazikitsa matendawa ndikuyamba chithandizo.

Dokotala amafotokoza kuwunika kwa amylase, makamaka kuti akhazikitse mawonekedwe owopsa a kapamba, zina za pancreatic pathologies, komanso kupezeka kwa matenda:

1. ectopic mimba
2. achkalachina,
3. mulingo wa P-isoenzyme,
4. kulephera kwa aimpso
5. zilonda zam'mimba ndi duodenum.

Kuphatikiza apo, kuwunikaku kukuwonetsa kuwonongeka kwa impso, kulephera kwa impso, kutsekeka kwamatumbo, kutupa mkati mwa m'mimba, makamaka peritonitis, mawonekedwe osokoneza bongo a chidakwa, komanso kusowa kwa mapangidwe pambuyo pa opaleshoni.

Mulingo wocheperako wa amylase nthawi zambiri samasamalilidwa kwambiri, komabe, zizindikiro zotsika ziyeneranso kukhala chizindikiritso, chosonyeza chosakwanira pancreatic ntchito. Cystic fibrosis, yomwe imakhudza pafupifupi ziwalo zilizonse zamkati, imatha kubweretsa kuphwanya. Chithunzi chofananachi chikuwoneka mu magawo omaliza a khansa, omwe akuwonetsa imfa yomwe yayandikira.

High cholesterol yamagazi, homocysteine ​​imatha kuchuluka kapena kuchepa kwa magazi, izi zimawonedwa ngati wodwalayo asanam'peze mankhwala ena: kuperekera mankhwala, mankhwala osokoneza bongo, okodzetsa, Ibuprofen ndi zotumphukira zake.

Ndikofunikira kuzindikira kuti kusintha kwa mtengo wonse wa amylase wokhala ndi chizindikiro chochepa cha pancreatic amylase kukuwonetsa kulakwitsa kwa kapamba, ziwalo zopumira, ndi ma ovarian pathologies.

Momwe mungakonzekerere kusanthula

Kuti mupeze zotsatira zolondola kwambiri, muyenera kukonzekera bwino phunzirolo. M'mawa, asanapereke magazi, wodwalayo ayenera kukana kudya zakudya ndi zakumwa zingapo, makamaka khofi ndi tiyi. Mwambiri zopanda malire, madzi oyeretsedwa komanso opanda kaboni amaloledwa.

Asanayambe kuyesedwa, chakudya chomaliza chisanafike pasanathe maola 12. Pali malamulo omwe amaletsa kugwiritsa ntchito mankhwalawa, nthawi zambiri madokotala amalangizidwa kusiya kumwa mankhwala milungu iwiri isanachitike kuwunikiridwa. Ngati wodwalayo sananyalanyaze malangizowo, muyenera kumuuza dokotala za nkhaniyi.

Tsiku loti lisanayambitsidwe zinthuzo, kuchita zolimbitsa thupi mwamphamvu, kumwa zakumwa zoledzeretsa sikumaperekedwa. Chithandizo cha physiotherapeutic, kuphatikizapo rectal ndi fluorographic fluoroscopy, ndi ultrasound, zingakhudze zotsatira za kusanthula.

Matenda ena amatha kuchepetsa pancreatic amylase, zotsatira zake zimatha kusiyana ndi kuphwanya:

• chiwindi
• osakwanira kagayidwe kazakudya,
• Gawo lachinayi la zotupa zoyipa za kapamba,
• neoplasms mu zimakhala za kapamba,
• chiwonongeko chonse cha kapamba,
• kuchuluka kwa kachulukidwe kochepa magazi cholesterol.

Matendawa akaphatikizidwa ndi kutupa, pancreatic amylase imapangidwa mokulira, pancreatic amylase imachulukitsidwa nthawi makumi angapo. A ambiri ndende kumalumikizana ndi matenda: aakulu ndi pachimake kapamba, zotumphukira, zotupa, matumbo, matenda aakulu ndi pachimake ndulu, kutupa chiwindi, kupezeka kwa matenda parasitic mu ziwalo, pachimake appendicitis.

Ndiowopsa kuchiza matenda okhazikika pancreatic popanda kutenga nawo gawo dokotala, chilichonse chomwe chingakhudze thanzi lanu. Chinsinsi cha kukhululuka kwakutali ndikumamatira kwambiri ku zomwe dokotala akukulemberani, kukonza moyo wabwino, kumwa mankhwala omwe mwalandira.

Zambiri pa michere ya pancreatic imaperekedwa mu kanema munkhaniyi.

Mafuta a Enzyme ndi Ma Enzymes Amtundu wina wa Pancreatic

Lipase amatanthauza ma hydrolytic michere (imathandizira hydrolysis ya lipids kuti glycerin ndi mafuta acids). Ma enzyme amenewa, omwe ali ndi gulu limodzi, samamangidwa pamtunda uliwonse, monga urease, omwe amathandizira kugawa kwa urea. Lipase imapangidwa ndi ziwalo zambiri komanso minyewa yambiri, motero, kutengera malo omwe amapangidwira, pali:

• Pulmonary
• Hepatic
• Zam'mimba
• Lingual (mtundu wa enzyme iyi imapangidwa pamkono wamkamwa, imakhalapo "makanda", popeza imaphwanya mafuta omwe amakhala mkaka, ndi zaka, kufunikira kwa lipase kumatha, kotero kupangika kwake mu akulu kumakhala kochepa),
• Pancreatic (zidzafotokozedwa).

Kuphatikiza pa pancreatic lipase, pali lipoprotein lipase m'madzi a m'magazi, omwe amatchedwanso chofunikira kwambiri chantchito yake yothandizira - kuyambitsa kuwonongeka kwa ma chylomicrons ndipo, chifukwa cha izi, kumveketsa plasma.

Malo ofunika kwambiri pakati pa ma enzymes omwe amagwira ntchito yophwanya mafuta ndi a pancreatic lipase. Kasitomalayu ndiye amachititsa kuti enzymeyi ipangike, ndipo imayipanga ndikusunga m'maselo a acinar m'njira yosagwira. Kutsatira kulowa kwa chakudya mu duodenum 12, lipase, kudzera pancreatic duct, imalowetsanso m'matumbo ang'onoang'ono, pomwe imadutsa gawo logwira ntchito kuti nthawi yomweyo iyambe kugwira ntchito zake zapafupi - kuphwanya kwa lipid.

Dziwani kuti lipase sindiye enzyme yokha yomwe amaperekedwa ndi kapamba, chifukwa zinthu zina ziyenera kuphatikizidwanso. Madzi a pancreatic, omwe ali ndi kutchulidwa kwa alkaline reaction (pH pamwambapa 10), ali ndi ma enzymes omwe amatha kuthana ndi carbohydrate (amylase) ndi mapuloteni (proteinase) omwe amabwera ndi chakudya.

Laborator iliyonse ili ndi miyezo yake.

Nthawi zambiri, pali lipase yochepa kwambiri m'magazi, ndipo ngakhale izi zimawonekera chifukwa cha kusinthika kwachilengedwe kwa minyewa. Ngati pazifukwa zina kapamba amayamba kugwira ntchito molakwika, ntchito ya enzymeyo imachuluka, ndipo imatumizidwa m'magazi ambiri.

Ponena za kuchuluka kwa mankhwalawa (chizindikiritso) cha pancreatic lipase m'magazi, ndiye, monga momwe zimakhalira ndi mayeso ena amitundu mitundu, ndizosatheka kuyang'ana owerenga malire aliwonse. Gome ili m'munsiyi, lomwe laperekedwa mwachitsanzo, lingawonetsetse kuti palibe chisonyezo chimodzi chazomwe zikuyimira njira zonse ndi ma labotore, chifukwa chake, monga nthawi zonse, wodwala yemwe ali ndi chidwi chotsatira zotsatira za mayeso ake ayenera kulumikizana ndi CDL, yomwe idayesa magazi ake.

Zolemba zina zitha kuwonetsa malire amitundu yokhazikika, mwachitsanzo: kuchokera pa 0 mpaka 470 U / l kapena kuchokera pa 7 mpaka 70 U / l, kotero popanda malingaliro a labotale omwe amachititsa kafukufukuyu, kutsekemera sikungatheke.

Mwachiwonekere, kusintha kwamikhalidwe yanthawi zonse kumagwira ntchito pazaka zokha jenda pazomwe zimachitika sikuti pamakhala gawo (Kwa wamwamuna ndi wamkazi, zikhalidwe ndizofanana).

Mumkodzo womwe umapangidwa ndi impso zathanzi, ma enzyme amenewa sangapezeke, ngakhale kuti mamolekyu a lipose satenga nthawi yosefera. Mwachidule, atadutsitsa fayilo ya glomerular, amabwezanso mayamwidwewo. Maonekedwe a enzymeyi mumkodzo akuwonetsa kuti pancreatic duct yotsekedwa ndi china chake (mwina chotupa?), Ndipo thupilo limavutika kwambiri.

Lipase wophatikizidwa ndi amylase

Zomwe zimayimira mayeso monga ma enzyme omwe amapangidwa ndi kapamba, makamaka, ndimawu am'magazi oyambitsa matenda am'mimba:

1. Soreness, yomwe imatchedwa "herpes zoster", chifukwa imangotenga malo a gland. Kuyambira kwinakwake m'chigawo cha epigastric ndikufalikira msanga kwa onse a hypochondria, ululu umadutsa kumbuyo ndi pachifuwa, kulimba kwake ndikokulira kotero kuti odwala sangathe kuletsa kubuula ndi kufuula,
2. Thupi nthawi zambiri silikhala msanga, kutentha kwa thupi kumakwera pamene mavuto akutukuka,
3. Mavuto aumunthu samangokhala ndi nseru yolakwika, kusanza "kangapo" kumawonjezeredwa kwa iwo, komwe sikumachepetsa vutoli.
4. Kuyesa kudya kumakulitsa mkhalidwewo (ululuwo umakulirakulira, kusanza kumapitilizabe, kotero kulakalaka ngakhale kuyang'ana zakudya kumatha),
5. Mtima ndi mtima wake, umakumana ndi kuchepa kwa kuthamanga kwa magazi komanso kuwonjezeka kwa kugunda kwa mtima.

Kuchulukitsidwa kwa lipase ndi mwayi waukulu kumawonetsa mavuto omwe afika pancreatic parenchyma, chifukwa chake, kuphunzira kwa lipolytic enzyme m'madzi a m'magazi, mwachizolowezi, kumayikidwa pambuyo pakupenda kwina - kutsimikiza kwa glycosyl hydrolase (alpha-amylase) m'magazi. Kuphatikiza apo, enzyme iyi (lipase) nthawi zambiri imakhala yothandiza kwambiri, chifukwa chidwi chake komanso mawonekedwe ake zimakhala zapamwamba. Mwachitsanzo, mu lipase yamagazi imachulukitsidwa (kwambiri - mpaka 200! Times) pambuyo pa maola 4-7 (pachimake - patsiku) ndipo ngati kutupa kumachepa, ndende imabweranso mwakale pakapita masabata 1 - 2.

Amylase, Mosiyana, amachita mosiyana pang'ono: zochitika zowonjezereka zimadziwika pambuyo pa maola 6 mpaka 12, ndipo puloteni ya glycolytic, yomwe imapangitsa kutsika ndi kusweka kwa glycogen, imabweranso kwazonse kuchokera masiku awiri mpaka sabata (mwachidziwikire, ngati njirayi ikutha bwino) .

Pazonse, kusintha kwa izi ziwonetserozo kumapitilira ndi kukula kwa njira yotupa m'matumbo a ma pancreatic parenchyma, kenako kutsika, ngati zomwe akuphatikizirazo zikuchepa, amatha kusuntha, zitha kunenedwa, mu ma synchronism. Posankha magawo onse awiri, pancreatitis yovuta kwambiri imatha kupezeka 98% ya milandu.

Pakalipano, mitengo yayikulu sikuti nthawi zonse imagwirizana ndi kuuma kwa matenda amisala, choncho dalirani kokha kuchuluka kwa manambala a glycolytic (alpha-amylase) ndi lipolytic (lipase) ma enzymes m'magazi sikuyenera.

Mosakayikira, choyambirira, kuchuluka kwa lipase m'magazi kumapangitsa kuti pakhale pancreatitis yovuta. Komabe, mikhalidwe yovuta kwambiri imafuna kusiyanitsidwa kwamatenda omwewa ndi ena, omwe amafanananso ndimatenda ofanana komanso owopsa, chifukwa chake amawunikidwa Zisonyezo zingapo zoyenera kutsimikizira izi:

• Kutupa komwe kumayamba mwadzidzidzi ndikuyamba kukhazikika mu minofu ya kapamba palokha (kapamba kapamba),
• Mavuto omwe adatulukira mwadzidzidzi chifukwa cha kupangidwa komanso kudziunjikira miyala "oyandikana" wapafupi, gawo loyambira - gallbladder (pachimake cholecystitis),
• Matenda a kutupa omwe amapezeka pancreatic parenchyma (Chr. Pancreatitis) mu gawo la pachimake,
• Zilonda zam'mimba zokhazikika,
• Kulephera kwamkati (onse pachimake - kulephera kwa impso komanso kuperewera - kupweteka kwa aimpso),
• Matenda a shuga - matenda ashuga ketoacidosis - DKA, omwe ali ndi vuto la mtundu woyamba wa shuga)
• Zowopsa za chiwindi parenchyma (cirrhosis),
• Mkulu (matumbo ochepa) matumbo
• Uchidakwa wambiri
• Kuphatikizika kwa chiwalo.

Ndiponso, kuwunika kwa labotale sikumangokhala kuphunzira kokha kwa pulosito imodzi ya lipolytic m'magazi am'magazi; ndikofunikira kuti muphatikizidwe mu protocol tanthauzo la ma enzymes ena, makamaka, alpha-amylase.

Kukonzekera kuphunzira ntchito ya lipase sichinthu chapadera pakukonzekera njira zina zoyeserera zamankhwala am'kati. Wodwala yemwe akufuna kupeza yankho lodalirika m'manja mwake nthawi yoyamba amapita kupumula, wodekha, komanso wanjala (siyani kudya maola 12 mpaka 14 musanawunike). Mwa njira, nthawi yopuma mwachizolowezi imayenera kuthetsedwa theka la ola lisanaperekedwe kapena kuyiwalanso ndudu m'mawa uno kwathunthu.

Zomwe "zochulukitsa" kapena zochitika zapamwamba "zidzanena"

Enzyme ya lipolytic yomwe ikufotokozedwa mu ntchito iyi, kupanga komwe ndi udindo wa kapamba, ndiye chisonyezo chachikulu cha matenda ake. Choyamba, ziwonetsero zimachulukana, ndipo nthawi zina zimakhala zazitali kwambiri, nthawi zokulirapo kuposa momwe zimakhalira, zochitika mu zotupa kapena zotupa zina za m'mimba mwa ziwalo zomwe zimapereka chimbudzi, mphamvu ya kagayidwe kazinthu zina ndi zina zofunika kuzichita:

1. Pachimake kapamba, amene amapanga makamaka ndi kupangidwa kwamiyala ndi kupezeka kwa calculi mu chikhodzodzo chomwe chimadzaza bile, kapena ngati pali zakumwa zoledzeretsa kwambiri. Pakapita maola angapo kapena atatu (pambuyo poti glandyo sinakonde kena kake), imayamba "kupanduka" ndikumakumana ndi zidziwitso zamankhwala ndikuwonjezereka kwa kuchuluka kwa lipase m'magazi. Kuda nkhawa komanso kukayikira za matendawa kumachitika chifukwa cha kuchuluka kwa milomo ya milomo yolumikizana mosalekeza,
2. Matenda osakhazikika a kutupa (hr. Pancreatitis) munthawi yakuchulukirachulukira. Ndi kufalikira kwa nthawi yayitali kwa matenda, lipase siinachuluke kwambiri, kuwonjezeka kofulumira, kofanana ndi kachitidwe kovulaza koopsa, kwakukulu, sikunawonedwe. Matendawa akamachepa, anthu ambiri amayamba kudya pang'onopang'ono. Koma, ngati gland ikupitilirabe kuvutika, wodwalayo angamve kuti m'magazi ake m'magazi muli otsika.
3. Cyst (wowona kapena wabodza - pseudocyst) mu pancreatic parenchyma,
4. Kuvulala kwa gland
5. Kutsekeka kwa pancreatic duct yofunikira ndi makina (block, calculus).
6. Njira ya oncological yomwe imachitika m'matumbo a minyewa.

Lipase imakwezedwa m'mitundu yambiri, yomwe imalumikizidwa kwambiri ndi chiwalo chofunikira ichi, popeza iwonso amalowa m'matumbo:

• Matenda a gallbladder, achulukitsa matenda a ndulu (cholelithiasis),
• Intestinal blockade (chotchinga), matumbo khoma necrosis (vuto la mtima),
• Kutupa kwa peritoneum (peritonitis),
• Kupyola paliponse pa khomo lachiberekero chilichonse chamkati chifukwa chotupa cha chilonda (m'mimba, duodenum 12) kapena chifukwa cha kuwonongeka kwina.
• Kugawikidwanso (kosasinthika) kwa chiwindi parenchyma chokhala ndi minofu yolumikizana (matenda ena),
• Kuchepetsa kuyenda kwa bile ndipo, potero, kuchepetsa kupezeka kwake kwa duodenum 12 popanda kuwonongeka ndi kufalikira kwa njira yowonjezera ya biliary (intrahepatic cholestasis).

Kuphatikiza pa matenda a m'matumbo am'mimba (GIT), kuchuluka kwa ma enzymme omwe akufotokozedwa kumawonedwa mu zochitika zina:

1. Zowonongeka zazing'onoting'ono (zolimba komanso zoperewera),
2. Khansa ya m'mawere
3. Metabolic pathology (utatu wotchuka: matenda a gouty, kunenepa kwambiri, shuga),
4. Kuvulala kwamtundu wambiri,
5. Tubular fupa lozungulira,
6. Kugwiritsa ntchito mwakumwa zakumwa zoledzeretsa (kapamba, monga chiwindi, sakonda mowa),
7. Kugwiritsa ntchito kwina pafupipafupi mankhwala ena: mahomoni (mankhwala opangira pakamwa, corticosteroids), diuretics (furosemide), NSAIDs (ibuprofen), narcotic analgesics, anticoagulants mwachindunji (heparin).

Dziwani kuti ndi ma mumps owuma kwambiri, omwe amadziwika kuti "mumps" kapena "mumps," lipase imachulukitsidwa pokhapokha ngati kapamba ikakhudzidwa ndi gland ya parotid.

Kuzungulira kwa lipase yaying'ono

Ngakhale enzyme yomwe imathandizira kuchepa kwa mafuta m'magazi a magazi simatentha kwambiri, kotero, zochitika za munthu payekha zimachepetsa kuchuluka kwake. Ngati kuwunika kukuwonetsa kuti lipase yamagazi ndiyotsika, ndiye muyenera kuyang'ana zomwe zimayambitsa. Nthawi zambiri, imakhudza njira yotupa yopatsirana ku kapamba - njira yodziwika bwino pakati pa mibadwo yosiyanasiyana. Chofunikira kwambiri chomwe chimapanga matenda oterewa, choyambirira, ndi uchidakwa, koma tisaiwale kuti anthu ambiri kuyambira ali ang'ono amalongedza thupi, amakonda "zabwino" osati "zabwino". Kuphatikiza apo, pali zinthu zingapo zomwe zimakhudzanso gawo lachiberekero cha mbali iyi.

Kuyesedwa kotere kwa labotale, monga kutsimikiza kwa lipase mu madzi am'magazi, kumagwira ntchito makamaka ngati kutupa kwakanthawi kameneka kumachitika pazaka zambiri, koma sitiyenera kuiwala kuti kuwonongeka kwakukulu kwa minofu pakapita nthawi yayitali kungayambitse zotsatira zina - kukhazikika kwa enzyme kumachepetsedwa. Kuphatikiza pa izi, lipase imachepetsedwa mu zina, ngakhale sizachilendo, milandu, mwachitsanzo:

• Ndi zotupa zoyipa (monga, kupatula khansa ya kapamba),
• Iwo omwe amakonda kudzaza zakudya zawo za tsiku ndi tsiku ndi mafuta ambiri (pafupifupi enzyme yonse imawonongeka pogwira ntchito ndi mafuta),
• Ngati, pazifukwa zilizonse, magwiridwe antchito a kapamba agwa, chifukwa chomwe kupanga ma enzymes kumachepa,
• Lipase imayendetsedwa ndi cystic fibrosis ya kapamba (cystic fibrosis - njira yayikulu yothandizira, yotengera njira ya recosomal recessive, yomwe imadziwika ndi kuwonongeka kwa endocrine gps komanso magwiridwe antchito amtundu wa kupuma).

Ntchito ya Lipase idzachepetsedwa chifukwa chosowa kawirikawiri opaleshoni - pancreatectomy. Opaleshoni yofananayi imachitika moyo wamunthu ukafunsidwa ndipo, pofuna kupulumutsa, madokotala amalingalira za kufunika kogwiritsa ntchito njira zosinthika. Mitsempha yochepetsedwa ya lipase imawonedwa pang'onopang'ono (makamaka, ngati opaleshoniyo ikhudza mutu ndi gawo la thupi), komanso mutachotsa kwathunthu chiwalo.

Lipase mankhwala osokoneza bongo

Anthu omwe ali ndi vuto logaya chakudya "akadya china chake cholakwika" nthawi zambiri amakhala ndi ma enzymatic othandizira kunyumba yawo yanyumba yamankhwala omwe amawongolera zochitika zam'mimba. Inde, komanso wathanzi ayi, ayi, ndipo amatenga "ma enzyme" kuti athandize matumbo kuti apewe mavuto osagwirizana ndi phwando lokondwerera.

Izi ndizomveka, pali chakudya chochuluka, ndikufuna kuyesa chilichonse, ndipo m'mimba mumayamba "kuwonetsa". Amayi makumi atatu amapita pancreatin, mezim-forte, zokongoletsa ndi mankhwala ena patebulopo wina ndi mzake (zomwe zikuwonetsedwa zikuwonetsa kuti kugonana kwa mkazi ndiwanzeru kwambiri kuposa wamwamuna pankhaniyi). Mapiritsi okhala ndi mitundu yambiri (achikasu, a pinki), makapisozi ndi ma dragees amathandizadi pakugwiritsa ntchito mafuta osagwiritsidwa ntchito, chifukwa onsewa ali ndi puloteni ya lipolytic yofunika komanso yofunikira ngati lipase.

Amylase: chidziwitso chachidule komanso zizindikiro za chizolowezi

Pancreatic amylase - ndi chiyani ndipo imagwira ntchito yanji mthupi, mutha kudziwa ngati mutadziwa pang'ono momwe ziwalo ndi machitidwe amunthu amagwirira ntchito.

Pakukonza chakudya, kuphatikizapo wowuma ndi glycogen, mufunika ma enzyme apadera, omwe ndi amylase. Kuchuluka kwake (enzyme) kumalimbikitsidwa mu madzi a pancreatic ndi gland ya salivary. Kuchokera kapamba, madziwo amasamukira ku duodenum. Pamenepo kugawanika kumayambira. Zotsatira zake zimapangidwa:

Kuchotsa kwa amylase m'thupi kumachitika ndi impso, i.e. zotsalira za enzyme zimatuluka ndi mkodzo.

Chimawoneka chabwinobwino pamene gawo laling'ono la chinthuchi limapezeka m'matumbo, m'mimba ndi m'misempha.

Kutengera cholinga cha matendawa, kuwunika kwa magazi a pancreatic amylase ndi kuchuluka kwa mphamvu ya mkodzo kungafunike kuti mumve zambiri.

Alfa-amylase kapena P-amylase (mfundo zoterezi zitha kufotokozedwa m'mabuku azachipatala) zimayezedwa m'magawo pa lita imodzi. Muyeso wa enzyme m'magazi zimatengera zaka zomwe mutuwo ukunena:

• mwa ana osakwana chaka chimodzi - 8 mayunitsi / l,
• kuyambira chaka chimodzi mpaka zaka 10 - zosaposa 30 mayunitsi / l,
• kuyambira wazaka 11 mpaka 18 - osati kupitirira 40 / lita.

Chomwe chimachitika mwa akulu, omwe thupi lawo limawonedwa kuti limapangidwa mokwanira pambuyo pa zaka 18, ndi magawo 0-53 / lita. Mwa malire abwinobwino, zomwe amylase ali mu mkodzo ndi 20-100 u / l. Zowoneka mwa akazi ndi abambo ndizofanana.

Mutha kudziwa mwatsatanetsatane tanthauzo la izi pamene mulingo wa enzyme si wabwinobwino, kuofesi ya dokotala aliyense payekha.

Kuchulukitsa

Ngati pancreatic amylase m'magazi a wodwalayo yachuluka, koma zomwe zimapangidwa ndimankhwala ndizopanda pake, ndizotheka kuganiza kuti nkhaniyo ikusowa kwa kapamba kapena matenda am'mimbayo.

Zomwe zimayambitsa kuchuluka kwa enzyme m'magazi zitha kukhala motere:

1. Pachimake kapamba. Matendawa amadziwika ndi njira yotupa yomwe imakhala ndi zizindikiro zowoneka bwino. Ululu wammbuyo umalowetsedwa m'mitsempha ndipo umatulukira kumbuyo. Kuphatikiza apo, zizindikiro za kuledzera zimawonekera. Amylase wokhala ndi pancreatitis yovuta amatha kupitiliza nthawi zambiri, koma sizichitika nthawi zonse. Pomwe chiwalo chikawonongeka, chomwe chimatsatana ndi kufa kwakukulu kwa maselo omwe amapanga enzyme iyi, kuchuluka kwake kuli kosasinthika. Kuti muwonetsetse kulondola kwa zotsatira za mayeso a labotale, tikulimbikitsidwa kuti wodwala yemwe akuwaganizira kuti kapamba amasanthula ntchito ya lipase. Mtengo wa enzyme zotupa mu zotupa za England zimakhalabe zokwera. (Lipase ndi gulu la mamolekyulu amtundu wa protein omwe amathandizira ma hydrolysis a insoluble esters-lipid substrates, kulola thupi kugaya mafuta).
2. Aakulu mawonekedwe a kapamba. Amadziwika ndi kuwonjezeka pang'onopang'ono kwa amylase. Popeza matendawa amatenga nthawi yayitali, enzyme imeneyi imayamba kuchepa.

Lipase ili mkati mwa malire abwinobwino pamene cholozera chake mwa odwala omwe ali ndi zaka zosakwana ambiri ndi 0-130 unit / ml. Kwa abambo akulu ndi amayi omwe ali m'magazi, kuchuluka kwa enzyme kumatha kuyambira 0 mpaka 190 mayunitsi / ml ya magazi.

Lipase samangokhalira kukakamizidwa ndi matenda omwe amapezeka m'mimba. Mtengo ukhoza kusiyana kwa odwala omwe ali ndi mafupa am'mapapo.

Pancreatic amylase ikachuluka, kuchuluka kwake mumagazi kumachitika chifukwa cha kuwonjezera kwa puloteniyo kuma protein ambiri. Momwe timatulutsira tinthu timeneti mumaloweti timavutika. Zomwe zimayambitsa ndewu izi zitha kukhala motere:

• pancreatic duct chotchinga,
• chotupa m'madipatimenti ena a ziwalo,
• matumbo,
• kusokoneza kwa aortic aneurysm,
• kapangidwe ka miyala mu chitsulo,
• matenda ashuga
• pachimake appendicitis
• cholecystitis
• chiwindi
• kutupa kwa peritoneum,
• kuchotsa mimba
• m'mimba kuvulala kapena kuyambitsa zilonda,
• macroamylasemia.

Kuchepetsa

Amylase ikatsitsidwa, ndiye kuti kiwonetserochi chikuyenera kuwonetsa kuti wodwalayo alibe mavuto azaumoyo. Munthawi imeneyi, kapamba ayenera kugwira ntchito bwino.

Koma zenizeni, zonse ndizosiyana.

Nthawi zambiri, motsutsana ndi maziko a amylase yafupika, ma pathologies otsatirawa amatha kupezeka mwa wodwala:

1. Khansa ya pancreatic m'magawo omaliza.
2. Onse pancreatic necrosis. Kuwonongeka kwakukulu kwa chiwalo mu chiwonongeko chachikulu cha kapamba.
3. Cholesterol yayikulu.

Kuchepa kwa amylase yamagazi ndi khalidwe la odwala omwe gland yambiri idachotsedwa. Zomwe zimayambitsa zovuta zam'mimba, zomwe zimayambitsidwa ndikuphwanya kapangidwe ka chiwalo ndi magwiridwe ake osagwira ntchito, siziyikidwa pambali. Pathologies angatengedwe.

Pomaliza

Magazi amylase amaperekedwa kuchokera mu mtsempha. Kusanthula kumeneku sikuyikidwa pokhapokha ngati mukukayikira kuti kapamba. Ndi chithandizo chake, mutha kutsimikizira kapena kutsutsa kupezeka kwa njira yamagazi m'mazira kapena kupatuka mu ntchito ya tiziwalo timene timayambira.

Kuti mupeze zotsatira zodalirika zoyeserera zasayansi, wodwalayo ayenera kukonzekera bwino. Mankhwala ena, mowa, kusuta fodya ndi zinthu zina, zomwe katswiriyu anganene mwatsatanetsatane, zitha kupotoza kuchuluka kwa enzyme.

Kuti mudziwe chifukwa chake mulingo wa amylase ndi wosiyana ndi chizolowezi, ziyeso zowonjezera zidzaperekedwa kwa wodwala. Mtundu wa kafukufuku umasankhidwa kutengera chithunzi cha wodwalayo.

Osakana malangizo azachipatala. Chithandizo chanthawi yake imapewetsa matendawo.