Kuyesa kwa magazi kwa glycosylated hemoglobin kwa matenda ashuga

Mu thupi la munthu, hemoglobin amayimiriridwa ndi puloteni inayake yomwe imapezeka m'maselo ofiira a m'magazi (maselo ofiira am'magazi) ndipo ndiye amachititsa kuti mpweya ubwerere kumankhwala a ziwalo za thupi ndikubwezeretsa mpweya m'mapapu.

Amakhala ndi mamolekyulu anayi a protein (ma globulins), omwe amalumikizana mwamphamvu wina ndi mnzake. Molekyu iliyonse ya Globalbulin, imakhala ndi atomu yazitsulo, yomwe imayang'anira kutulutsa kwa mpweya ndi kaboni dayokisi kudzera mwa dongosolo.

Mapangidwe a Molecule

Kapangidwe kolondola ka molekyu ya hemoglobin kumapereka maselo ofiira amtundu wapadera - concave mbali zonse ziwiri. Kusintha kapena kusasinthika kwa mawonekedwe a hemoglobin mamolekyule kumasokoneza kukwaniritsidwa kwa ntchito yake yayikulu - kutulutsa kwa mpweya wamagazi.

Mtundu wapadera wa hemoglobin ndi hemoglobin A1c (glycated, glycosylated), yemwe ndi hemoglobin womangika kwambiri ku glucose.

Mwazi wamagazi

Popeza glucose ambiri amayendayenda tsiku ndi tsiku m'magazi, amatha kuthana ndi hemoglobin, yomwe imayambitsa glycosylation. Mwa munthu wathanzi, kuchuluka kwa hemoglobin komwe kumakhala glycosylation sikokwanira komanso kumangokhala 4-5.9% yokha ya hemoglobin m'thupi.

Zizindikiro za phunziroli

Zizindikiro zoika magazi mayeso a glycosylated hemoglobin atha kukhala:

• mbiri ya matenda a shuga a mtundu woyamba kapena wachiwiri,
• kulolerana kwa chakudya chamafuta,
• kunenepa kwambiri ndi metabolic syndrome,
• matenda ashuga
• Kukula kamodzi kopanda tanthauzo kwa glycemia,
• kupezeka kwa matenda ashuga m'magazi apachibale.

Glycated hemoglobin wa matenda ashuga

Pafupifupi zaka 10 zapitazo, World Health Organisation idavomereza kugwiritsidwa ntchito kwa glycated hemoglobin (HbA1c) pozindikira matenda a shuga. Kuphatikiza apo, anthu opitilira 6.5% adasankhidwa kuti azitsimikizira ngati ali ndi matenda ashuga.

Mwanjira ina, zotsatira za kafukufuku wa glycosylated hemoglobin wa 6.5% ndi apamwamba, kuzindikira kwa matenda ashuga kumawoneka kuti ndikodalirika.

Kwa wodwala aliyense, kutengera zaka komanso kupezeka kwa matenda omwe ali ndi vuto limodzi, hemoglobin imapangidwanso. Pamene wodwalayo akalamba komanso matenda ogwirizana, ndiye kuti hemoglobin A1c yoyambira ndiyenera kwambiri. Izi zimaphatikizidwa ndi chiopsezo chachikulu cha zochitika za hypoglycemic mwa okalamba (dontho lakuthwa mu glucose wa plasma). Komanso, zomwe amuna ndi akazi amachita sizimasiyana.

Makhalidwe a hemoglobin a glycated kutengera mtundu ndi zaka amatha kuwoneka mwatsatanetsatane patebulo pansipa.

Tab1: Glycosylated hemoglobin - yodziwika bwino mwa amuna, abwinobwino mwa akazi malinga ndi zaka

Glycosylated hemoglobin pansipa kuposa izi zikutanthauza chiyani

Wodwala aliyense yemwe ali ndi matenda omwe amatsimikizira kuti ali ndi matenda a shuga amayesetsa kuthandizira komanso kuthandizira matenda awo bwinobwino. Kuti muchite izi, dokotala amayenera kupereka kuyesedwa kwa magazi kwa odwala miyezi itatu iliyonse. Pankhaniyi, hemoglobin ya glycosylated iyenera kukhalabe yofanana, yokhazikitsidwa payokha malinga ndi msinkhu, mulingo (malinga ndi tebulo 1).

Nthawi yomweyo kukwera pang'ono kapena kuchepa pansipa kwa chizindikirocho sikuti kukuda nkhawa.

Kuchuluka kwa hemoglobin wa glycosylated m'magazi a shuga

Kuchuluka kwambiri kwa hemoglobin A1c ndi kowopsa monga kutsika kwake kwakukulu. Izi zikuwonetsa kuwongolera pang'ono matendawa komanso kuwopsa kwa ziwalo zamkati ndi mtima dongosolo. Izi zimachepetsa nthawi yayitali komanso moyo wa wodwalayo.

Cholinga chachikulu cha kuchuluka kwa hemoglobin ya glycosylated ndi kuthamanga kwa shuga m'magazi. Zomwe zimayambitsa izi:

• Mlingo wosankha mankhwala osachepetsa shuga,
• Kuphwanya kawirikawiri zakudya za wodwala,
• kulemera kwakukulu
• kudumpha mankhwala
• kusakhulupirira munthu mankhwala
• kukula kwa matendawo ndi kuuma kwake.

Mulimonsemo, vutoli limafunikira kuchuluka kwa mankhwalawa omwe amwedwa kapena kuwunikiranso njira zamankhwala.

Glycosylated hemoglobin: pafupipafupi, zikuwonetsa pofufuza

Owerenga ambiri mwina amakhulupirira kuti njira yayikulu yodziwira matenda a shuga ndikuphunzira kuchuluka kwa shuga m'magazi, ndi mwa anthu - "magazi a shuga." Komabe, pamaziko a kuwunika kumeneku, kufufuza sikungapangike, chifukwa kumawonetsa kuchuluka kwa glycemia (glucose m'magazi) makamaka, pakadali pano. Ndipo sizofunikira kuti mfundo zake zikhale zofanana dzulo, dzulo, komanso masabata awiri apitawa. Ndizotheka kuti anali abwinobwino, kapena, m'malo mwake, apamwamba kwambiri. Mungamvetse bwanji? Izi ndizosavuta! Ndikokwanira kudziwa mulingo wa glycosylated (mwanjira ina glycated) hemoglobin m'magazi.

Muphunzira za chomwe chizindikiro ichi ndi, zomwe mfundo zake zikuyankhula, komanso zokhudza mawonekedwe akusanthula ndi zomwe zimakhudza zotsatira zake, kuchokera patsamba lathu.

Glycosylated hemoglobin - ndi chiyani ndipo ndi chiyani?

Hemoglobin ndi puloteni yomwe imapangidwa m'maselo ofiira a m'magazi ndipo imagwira ntchito yotumiza mamolekyu a oxygen ku cell iliyonse m'thupi lathu. Amalumikizanso mosavomerezeka ma mamolekyulu a glucose, omwe amawonetsedwa ndi mawu akuti "glycation" - glycosylated (glycated) hemoglobin amapangidwa.

Thupi limapezeka m'magazi a munthu aliyense wathanzi, komabe, wokhala ndi glycemia yayikulu, mfundo zake zimachulukanso. Ndipo popeza kuchuluka kwa maselo ofiira a magazi sikupitilira masiku 100-120, kumawonetsa glycosylated hemoglobin pakati pamiyezi isanu ndi umodzi yapitayo. Kunena zowona, ichi ndi chisonyezo cha "shuga wambiri" wamagazi nthawi yayitali.

Pali mitundu itatu ya glycosylated hemoglobin - HbA1a, HbA1b ndi HbA1c. Kwenikweni, amayimiriridwa ndi omaliza mwa mitundu yomwe ili pamwambapa, kuphatikiza apo, ndi iye yemwe amadziwika bwino ndi matenda ashuga.

Chizindikiro chodziwika bwino cha HbA1c m'magazi ndichokera 4 mpaka 6%, ndipo ndi chimodzimodzi kwa anthu azaka zilizonse komanso amuna ndi akazi. Ngati phunzirolo likuwonetsa kuchepa kapena kuchuluka kwa izi, wodwalayo amafunika kumuwunikira kuti adziwe zomwe zimayambitsa kuphwanya kapena, ngati matenda a shuga apezeka kale, pokonza njira zochizira.

Glycosylated hemoglobin oposa 6% adzatsimikiza motere:

• wodwalayo ali ndi matenda a shuga kapena matenda ena omwe amatsatana ndi kuchepa kwa shuga (6,5% akuwonetsa matenda osokoneza bongo, ndipo 6-6.5% akuwonetsa prediabetes (kulolera glucose kapena kuwonjezeka kwa glucose)
• ndi kusowa kwachitsulo m'magazi a wodwala,
• pambuyo pa opaleshoni yapita kale kuti muthane ndi ndulu (splenectomy),
• matenda omwe amakhudzana ndi hemoglobin matenda - hemoglobinopathies.

Kutsika kwa hemoglobin wa glycosylated wochepera 4% kukuwonetsa chimodzi mwazinthu izi:

• shuga wochepetsedwa wa m'magazi - hypoglycemia (kutsogolera kwa hypoglycemia kwa nthawi yayitali ndi chotupa cha pancreatic) chomwe chimapangitsanso insulin - insulinoma, vutoli limapangitsanso matenda osokoneza bongo a shuga mellitus (mankhwala osokoneza bongo), masewera olimbitsa thupi, osakwanira m'thupi, osakwanira pantchito ya adrenal matenda obadwa nawo)
• magazi
• hemoglobinopathies,
• hemolytic anemia,
• mimba.

Mankhwala ena amakhudza maselo ofiira am'magazi, omwe amakhudza zotsatira za kuyezetsa kwa magazi a glycosylated hemoglobin - timapeza zotsatira zosadalirika, zabodza.

Chifukwa chake, amachulukitsa chisonyezo ichi:

• supirin wamkulu
• opioids omwe amatenga nthawi.

Kuphatikiza apo, kulephera kwa impso, kugwiritsa ntchito moledzera mwadongosolo, ndi hyperbilirubinemia kumathandizira kuwonjezeka.

Chepetsani zomwe zili m'magazi a glycated m'magazi:

• kukonzekera kwachitsulo
• erythropoietin
• mavitamini C, E ndi B₁₂,
• dapson
• ribavirin
• mankhwala omwe amagwiritsidwa ntchito pochiza HIV.

Zimathanso kudwala matenda osokoneza bongo a chiwindi, nyamakazi, komanso kuwonjezeka kwa triglycerides m'magazi.

Malinga ndi malingaliro a World Health Organisation, kuchuluka kwa hemoglobin ya glycosylated ndi imodzi mwazomwe angazindikire matenda ashuga. Ngati kupezeka kwa nthawi imodzi kwa glycemia wokwera komanso kuchuluka kwa hemoglobin wokwera kwambiri, kapena chifukwa cha zotsatira zowonjezereka kawiri (ndikulowerera pakati pa kusanthula kwa miyezi itatu), dokotala ali ndi ufulu wonse wofufuza wodwalayo matenda a shuga.

Komanso njira yodziwikirayi imagwiritsidwa ntchito kuwongolera matendawa, omwe adadziwika kale. Glycated hemoglobin index, yotsimikizika pamtundu uliwonse, imapangitsa kuunika bwino kwa mankhwalawa ndikusintha Mlingo wa mankhwala a hypoglycemic kapena insulin. Inde, kubwezera anthu odwala matenda ashuga ndikofunikira kwambiri, chifukwa kumachepetsa chiopsezo chotenga matendawa.

Makhalidwe azomwe akutsimikizirazi zimasiyana malinga ndi zaka za wodwala komanso momwe matendawo aliri. Chifukwa chake, mwa achinyamata chisonyezo ichi chiyenera kukhala chochepera 6.5%, mwa anthu azaka zapakati - ochepera 7%, mwa okalamba - 7.5% ndi otsika. Izi zimachitika pokhapokha pakuvuta kwambiri komanso kuwopsa kwa hypoglycemia. Ngati nthawi zosasangalatsazi zilipo, phindu la hemoglobin ya glycosylated pamtundu uliwonse limawonjezeka ndi 0,5%.

Zachidziwikire, chizindikiro ichi sichikuyenera kuwunikira pawokha, koma molumikizana ndi kusanthula kwa glycemia. Glycosylated hemoglobin - mtengo wapakati komanso ngakhale wabwinobwino sizitanthauza kuti simumasinthasintha lakuthwa msana patsiku.

Ngati muli ndi hemoglobin wokwezeka kwambiri, funsani endocrinologist wanu kuti athetse shuga. Ngati matendawa sanatsimikizidwe, ndikofunikira kupita ku hematologist kuti mupeze magazi, hemoglobinopathies ndi matenda a ndulu.

Pafupifupi labotale iliyonse imazindikira kuchuluka kwa hemoglobin ya glycosylated m'magazi. Ku chipatalako mutha kupita kukayang'ana kwa dokotala, komanso kuchipatala chayekha popanda chitsogozo konse, koma chindapusa (mtengo wa kafukufukuyu ndiwotsika mtengo).

Ngakhale kuti kusanthula uku kukuwonetsa kuchuluka kwa glycemia kwa miyezi itatu, ndipo osati panthawi inayake, ndikulimbikitsidwa kuti mutenge pamimba yopanda kanthu. Palibe njira zapadera zokonzekera phunziroli zofunika.

Njira zambiri zimaphatikizapo kutenga magazi kuchokera m'mitsempha, koma ma laboratories ena amagwiritsa ntchito magazi ochokera pansi kuchokera pachala.

Zotsatira za kuwunikaku sizikuwuzani nthawi yomweyo - monga lamulo, amaziwuza wodwalayo patatha masiku 3-4.

Choyamba, muyenera kulumikizana ndi omwe amapita ku endocrinologist kapena othandizira omwe angakupatseni malangizo oyenera ochepetsa magazi.

Monga lamulo, zikuphatikizapo:

• kutsatira zakudya, zakudya,
• kutsatira kugona ndi kugona, kupewa kugwira ntchito kwambiri,
• achangu, koma osachita zolimbitsa thupi kwambiri,
• kudya pafupipafupi mapiritsi ochepetsa shuga kapena jakisoni wa insulin pa mlingo womwe adokotala amalimbikitsa.
• okhazikika glycemic kunyumba.

Ndikofunikira kudziwa kuti imapangidwa mwachangu kuti muchepetse hemoglobin yayikulu - thupi limasinthasintha ku hyperglycemia ndikuchepa kwambiri kwa chizindikirocho kumatha kuvulaza. Zabwino zimawonedwa kuti ndizochepetsera HbA1c ya 1% yokha pachaka.

Mlingo wa hemoglobin wa glycosylated umawonetsa kuchuluka kwa shuga m'magazi atatu apitawa, chifukwa chake, uyenera kutsimikizika moyenera 1 nthawi imodzi mwa kotala. Phunziroli silibweze kukula kwa mulingo wa shuga ndi glucometer, njira ziwiri izi zakuzindikira ziyenera kugwiritsidwa ntchito palimodzi. Ndikulimbikitsidwa kuti muchepetse chisonyezo ichi osati pang'ono, koma pang'onopang'ono - 1% pachaka, ndipo yesetsani osati kuzisonyezo za munthu wathanzi - mpaka 6%, koma kutsata malingaliro omwe ndi osiyana ndi amisinkhu yosiyanasiyana.

Kutsimikiza kwa glycosylated hemoglobin kuthandizira kuwongolera matenda a shuga, kutengera zotsatira zomwe zapezeka, kusintha mlingo wa mankhwala ochepetsa shuga, motero, pewani kukulitsa zovuta zazikulu za matenda. Khalani ndi chidwi ndi thanzi lanu!

Glycosylated hemoglobin: mulingo wa kusanthula kwamwazi m'magazi a shuga

Chizindikirochi chimalola adokotala kuti azingoyesa kuchuluka kwa glycemia panthawi yokhayo, koma kudziwa kuchuluka kwa shuga m'miyezi itatu yapitayo. Izi zimathandizira kuwongolera kwa shuga.

Mu thupi la munthu, hemoglobin amayimiriridwa ndi puloteni inayake yomwe imapezeka m'maselo ofiira a m'magazi (maselo ofiira am'magazi) ndipo ndiye amachititsa kuti mpweya ubwerere kumankhwala a ziwalo za thupi ndikubwezeretsa mpweya m'mapapu.

Amakhala ndi mamolekyulu anayi a protein (ma globulins), omwe amalumikizana mwamphamvu wina ndi mnzake. Molekyu iliyonse ya Globalbulin, imakhala ndi atomu yazitsulo, yomwe imayang'anira kutulutsa kwa mpweya ndi kaboni dayokisi kudzera mwa dongosolo.

Kapangidwe kolondola ka molekyu ya hemoglobin kumapereka maselo ofiira amtundu wapadera - concave mbali zonse ziwiri. Kusintha kapena kusasinthika kwa mawonekedwe a hemoglobin mamolekyu kumasokoneza kukwaniritsidwa kwake kwa ntchito yake yayikulu - kayendedwe ka mpweya wamagazi.

Mtundu wapadera wa hemoglobin ndi hemoglobin A1c (glycated, glycosylated), yemwe ndi hemoglobin womangika kwambiri ku glucose.

Popeza glucose ambiri amayendayenda tsiku ndi tsiku m'magazi, amatha kuthana ndi hemoglobin, yomwe imayambitsa glycosylation. Mwa munthu wathanzi, kuchuluka kwa hemoglobin komwe kumakhala glycosylation sikokwanira komanso kumangokhala 4-5,9% yokha ya hemoglobin m'thupi.

Kutalika kwa moyo wa erythrocyte, gawo lalikulu la hemoglobin m'magazi, pafupifupi masiku 120. Kugwirizana kwa molekyu ya hemoglobin ndi glucose sikungasinthe. Ndiye chifukwa chake glycated hemoglobin amawonetsa kuchuluka kwa shuga m'magazi atatu.

Zizindikiro zoika magazi mayeso a glycosylated hemoglobin angatumikire:

• mbiri ya matenda a shuga a mtundu woyamba kapena wachiwiri,
• kulolerana kwa chakudya chamafuta,
• kunenepa kwambiri ndi metabolic syndrome,
• matenda ashuga
• Kukula kamodzi kopanda tanthauzo kwa glycemia,
• kupezeka kwa matenda ashuga m'magazi apachibale.

Pafupifupi zaka 10 zapitazo, World Health Organisation idavomereza kugwiritsidwa ntchito kwa glycated hemoglobin (HbA1c) pozindikira matenda a shuga. Kuphatikiza apo, anthu opitilira 6.5% adasankhidwa kuti azitsimikizira ngati ali ndi matenda ashuga.

Mwanjira ina, zotsatira za kafukufuku wa glycosylated hemoglobin wa 6.5% ndi apamwamba, kuzindikira kwa matenda ashuga kumawoneka kuti ndikodalirika.

Kwa wodwala aliyense, kutengera zaka komanso kupezeka kwa matenda omwe ali ndi vuto limodzi, hemoglobin imapangidwanso. Pamene wodwalayo akalamba komanso matenda ogwirizana, ndiye kuti hemoglobin A1c yoyambira ndiyenera kwambiri. Izi zimaphatikizidwa ndi chiopsezo chachikulu cha zochitika za hypoglycemic mwa okalamba (dontho lakuthwa mu glucose wa plasma). Komanso, zomwe amuna ndi akazi amachita sizimasiyana.

Makhalidwe a hemoglobin a glycated kutengera mtundu ndi zaka amatha kuwoneka mwatsatanetsatane patebulo pansipa.

Tab1: Glycosylated hemoglobin - yodziwika bwino mwa amuna, abwinobwino mwa akazi malinga ndi zaka

Glycosylated hemoglobin kuchuluka kwa odwala matenda ashuga

Glycosylated hemoglobin ndi amodzi mwa Zizindikiro zomwe zimaganiziridwa pakupezeka kwa matenda a shuga. Ngakhale kufala kwa matendawa, si odwala onse omwe amadziwa kuti hemoglobin ndi glycated ndi chifukwa chiyani kuyenera kuyang'anira kuchuluka kwake.

Glycosylated hemoglobin akuwonetsedwa ndi formula HbA1C. Ichi ndi chizindikiro cha kuchuluka kwa mapuloteni a hemoglobin m'magazi ngati peresenti. Kugwiritsa ntchito, mutha kulondola molondola kuposa kuyezetsa magazi, kukhazikitsa kusintha kwa glucose m'miyezi itatu musanakonze. Mkhalidwe wa hemoglobin wa glycosylated ndi wofala kwa odwala onse, ngakhale kusiyana kwina pakudalira kwa msinkhu ndi jenda ndikololedwa.

Maselo ofiira amakhala ndi puloteni yapadera ya glandular yomwe thupi limafunikira kunyamula oxygen. Glucose imatha kumangiriza mapuloteni ena omwe alibe enzymatic, ndipo pamapeto pake HbA1C imapangidwa. Ngati shuga wamwazi ndiwokwera (hyperglycemia), njira yophatikiza shuga ndi mapuloteni a glandular imathamanga kwambiri. Pa avareji, "moyo" wamaselo ofiira a m'magazi ndi pafupifupi masiku 90 mpaka 125, pachifukwa ichi, kuchuluka kwa hemoglobin ya glycosylated kumawonetsa shuga m'magazi atatu omaliza. Pakatha masiku 125, kusinthika kwa maselo ofiira a m'magazi kumayamba, kotero kuwunika kotsatira kuwonetsa zotsatira za miyezi itatu yotsatira.

A HbA1C yomwe ili ndi 4-6% ya hemoglobin yonse m'magazi imadziwika kuti ndi yachilendo ndipo imakhala yofanana ndi kuchuluka kwa glucose yachilendo ya 5 mmol / L.

Mwa lingaliro la World Health Organisation, glycosylated hemoglobin ndi chisonyezo chomwe chimakupatsani mwayi wodziwikitsa. Chifukwa chake, ngati wodwala ali ndi hyperglycemia ndi kuchuluka kwa HbA1C, kuwunika kwa matenda a shuga kungachitike popanda njira zina zodziwonera.

Ndikofunika kudziwa kuchuluka kwa hemoglobin ya glycosylated kwa odwala omwe apezeka kale ndi matenda osiyanasiyana. Phunziroli lipangitsa kuti azitha kudziwa momwe mankhwalawo amathandizira, kusankha koyenera kwa mankhwala ndi othandizira a hypoglycemic. Choyamba, kuyeza mulingo wa hemoglobin wa glycosylated ndi kwa odwala matenda ashuga omwe, pazifukwa zosiyanasiyana, safuna kugwiritsa ntchito glucometer.

Kuwonjezeka kwa kuchuluka kwa hemoglobin ya glycosylated nthawi zambiri kumachitika chifukwa cha kusokonezeka kwa kagayidwe kazakudya kapena nthawi yayitali ya hyperglycemia:

1. Insulin yodalira matenda a shuga a mellitus (mtundu I) amayamba chifukwa cha kuchepa kwa kapangidwe ka mahomoni a pancreatic - insulin. M'maselo, kugwiritsa ntchito mamolekyulu a glucose kumavulala. Zotsatira zake, zimadziunjikira m'magazi, kuphatikiza kwake kumadzuka kwa nthawi yayitali.
2. Matenda a shuga osagwirizana ndi insulin (mtundu II): kupanga kwa insulin kumakhalabe pamlingo woyenera, koma chiwopsezo cha maselo kwa icho chimachepa kapena kusiya.
3. Malangizo osankhidwa molondola a kuchuluka kwa chakudya chamagulu am'thupi, zomwe zimayambitsa hyperglycemia wa nthawi yayitali.

Palinso zifukwa zina zowonjezera HbA1C, sizogwirizana mwachindunji ndi misere yayikulu:

1. Poizoni woledzera.
2. Chuma choperewera magazi.
3. Zotsatira za opaleshoni yochotsa ndulu. Chiwalochi chimagwira ngati "manda" am'magazi ofiira, chifukwa ndi pomwe amatayidwa. Pakapanda chiwalo, chiyembekezo cha maselo ofiira a m'magazi chimakhala chotalikirapo, ndipo mulingo wa glycosylated hemoglobin umakwera.
4. Uremia ndi kulephera kwa impso, chifukwa chomwe metabolic mankhwala amayamba kudziunjikira m'magazi. Nthawi yomweyo, hemoglobin imapangidwa, momwe mawonekedwe ake amafanana ndi glycosylated.

HbA1C yotsika kwambiri imawonedwanso ndikupatuka kuchoka pamtengo wamba. Zitha kuchitika chifukwa cha izi:

• Kutayika kwakukulu kwa magazi - HbA1C imatayika limodzi ndi hemoglobin yokhazikika,
• kuthira magazi (kuthira magazi) - hemoglobin yokhala ndi kachigawo koyenera, kosatha m'matumbo, imaphatikizidwa,
• hypoglycemia yomwe imatenga nthawi yayitali - kuchepa kwa HbA1C kumachitika chifukwa cha kuchepa kwa glucose.

Kuphatikiza apo, HbA1C yotsika m'thupi imatha kupezeka ndi kuchepa kwa magazi, kapena kuchepa kwa magazi m'thupi, gulu la matenda omwe matalikidwe amoyo a m'magazi ofiira amachepa, ndichifukwa chake maselo ofiira a HbA1C amafa kale.

• chakudya: Chifukwa chake, mankhwalawa amapezeka ndi chakudya, amapezeka pakapita maola ochepa,
• kumwa mankhwala ochepetsa shuga,
• mwamphamvu, kupsinjika mtima kumatha kukhudza zotsatira zoyeserera, chifukwa zimayambitsa kupangika kwa mahomoni komwe kumawonjezera kuchuluka kwa shuga.

Pazifukwa izi, shuga wokwezeka pang'ono wapezeka ndi kuyesedwa kwa magazi sikuti nthawi zonse kumatsimikizira kukhalapo kwa kupatuka ndi kusokonezeka kwa metabolic. Nthawi yomweyo, ngati kusanthula kunawonetsa shuga wabwinobwino wamagazi, sizitanthauza kuti palibe mavuto.

Zinthu zonsezi sizingakhudze kuchuluka kwa hemoglobin ya glycosylated m'magazi. Pachifukwa ichi, kusanthula kwa glycosylated hemoglobin kumawerengedwa kuti ndi kafukufuku wolondola kwambiri, womwe umalola kukhazikitsa zovuta za metabolic ngakhale gawo loyambirira.

Zizindikiro zakusanthula ndi:

1. Mellitus woyambirira wodwala matenda a shuga.
2. Matenda a shuga omwe amadalira insulin, limodzi ndi kusintha kwakukulu pamlingo wamafuta pang'ono munthawi yochepa.
3. Matenda a shuga omwe amapezeka ndi amayi apakati omwe sanakhalepo ndi vuto la shuga. Zotsatira zakuwunika ziwonetse kuti hemoglobin hba1c yafupika pang'ono, pamene gawo la michere limadutsa kuchokera mthupi la mayi kupita kwa mwana wosabadwayo.
4. Lembani I kapena lembani matenda ashuga II mwa azimayi oyembekezera, omwe adadziwika asanakhale ndi pakati kapena pambuyo pake.
5. Matenda a shuga omwe ali ndi gawo lambiri laimpso, pomwe gawo lalikulu la chakudya limaperekedwa kudzera mu impso.

Kuphatikiza apo, kusanthula kumachitika ngati kuphwanya zakudya zamatumbo a ana.

Chimodzi mwazabwino za kuyesedwa kwa glycosylated hemoglobin kuyerekeza ndi kuyezetsa magazi kwachilendo ndikuti mutha kuzichita nthawi iliyonse yabwino. Sizofunika kwambiri, pomwe panali chakudya chomaliza, kuti muunike pamimba yopanda kanthu kapena mutatha kudya. Izi sizingakhudze zotsatira zomaliza mwanjira iliyonse.

Kuti mudziwe mulingo wa HbA1C, magazi amatengedwa kuchokera ku chala kapena kuchokera mu mtsempha mwa njira yokhazikika. Malo osonkhanitsira magazi azitengera omwe analyzer idzagwiritsidwe ntchito.

Magazi athunthu owunikidwa mu 2-5 ml osakanikirana ndi anticoagulant - izi zimathandiza kupewa kuphwanya ndi kuwonjezera moyo wa alumali wa masiku 7 pamtunda wa mpaka +5 madigiri.

Ngati kusanthula koyamba kumapereka zotsatira za 5.7% kapena kutsika, ndiye mtsogolomo mutha kungoyendetsa mulingo wa HbA1C, kubwereza kusanthula kulikonse zaka 3. Zotsatira zake, mumtundu wa 5.7-6.4%, muyenera kuyambiranso kuwunikira kwa chaka chamawa. Pa anthu odwala matenda ashuga, pamlingo wa HbA1C wa 7%, magazi amatengedwa nthawi zambiri kuti awonongeke - kawiri pachaka. Ngati wodwala pazifukwa zina sangathe kuwongolera kuchuluka kwa shuga, mwachitsanzo, koyambirira kwa chithandizo kapena pambuyo poti kusintha kwasintha kwambiri, kuwunika kwachiwiri kumayikidwa pakapita miyezi itatu iliyonse. Pafupipafupi wa kusanthula kwa amuna ndi akazi ndi chimodzimodzi.

Bungwe la World Health Organisation lalimbikitsa kugwiritsa ntchito mtundu uwu wa kusanthula osati pozindikira matenda, komanso ngati kafukufuku wapakatikati wazotsatira zamankhwala ndi katswiri wazachipatala.

Atalandira zotsatira za kusanthula, adalemba. Njirayi siziwona kuti yovuta. Ngati chizolowezi chimaposa 1%, motere, kuchuluka kwa shuga kumawonjezeka ndi 2 mmol / L.

HbA1C pano imawonedwa ngati yachilendo pakati pa 4.0-6.5%. Pa mulingo wa glycosylated hemoglobin, shuga wapakati wamiyezi itatu saposa 5 mmol / L. Pakadali pano, kagayidwe kazakudya kazakudya kamene kamadutsa popanda zosokoneza, palibe matenda.

Kuwonjezeka kwa HbA1C mpaka 6-7% kumatha kuwonetsa kale matenda osokoneza bongo a shuga, kuperekera shuga, kapena kulephera kwa njira zosankhidwa za chithandizo chake. Kuchuluka kwa glucose mu prediabetes kumafanana ndi 507 mmol / L.

Mu shuga omwe adakwaniritsidwa, mulingo wa HbA1C ukuwonjezeka kufika pa 7-8%. Pakadali pano, zovuta zazikulu zitha kuchitika, chifukwa chake, ndikofunikira kuyandikira kwa chithandizo cha matenda.

10% HbA1C ndi zina - shuga wowonjezera, limodzi ndi chitukuko cha zotsatira zosasintha. Magazi a glucose kwa miyezi itatu amapitilira 12 mmol / L.

Mosiyana ndi mayeso ena, zotsatira za mayeso a glycosylated hemoglobin sizimayima pawokha pakubadwa kwa wodwala. Komabe, zikhalidwe zimatha kusiyanasiyana pang'ono mwa odwala azaka zosiyanasiyana. Izi ndichifukwa cha kuchuluka kwa kagayidwe. Akuluakulu, amachepetsa, pomwe ali achinyamata ndi ana, zitha kunenedwa, pa "liwiro", komanso mopitilira muyeso. Chifukwa chake, kuchepa pang'ono kwa HbA1C ndizovomerezeka pagululi la odwala.

Kwa magulu ena a odwala, momwemo zimasonyezedwera patebulo.

Kodi glycosylated hemoglobin (HbA1c)

Glycosylated hemoglobin (glycosylated hemoglobin) ndi hemoglobin yamagazi ofiira omwe amakanika ku glucose.

Zomwe zidapangidwazo:

• Glycated hemoglobin (glycated hemoglobin)
• Glycogemoglobin (glycohemoglobin)
• Hemoglobin A1c (hemoglobin A1c)

Hemoglobin-Alpha (HbA), yomwe ili m'magazi ofiira amunthu, polumikizana ndi shuga wamagazi "imadzipereka yokha" glycosylates.

Mukakhala ndi shuga m'magazi ambiri, glycosylated hemoglobin (HbA1) yomwe imatha kupanga maselo ofiira m'moyo wake wamasiku 120. Maselo ofiira a "mibadwo" yosiyanasiyana amayendayenda m'magazi nthawi yomweyo, masiku 60-90 amatengedwa nthawi yayitali ya glycation.

Mwa zigawo zitatu za glycosylated hemoglobin - HbA1a, HbA1b, HbA1c - yotsiriza ndiyokhazikika kwambiri. Kuchuluka kwake kumatsimikiziridwa mu ma laboratori azachipatala.

HbA1c ndi chisonyezo chamwazi chamagazi chomwe chimawonetsa kuchuluka kwa glycemia (kuchuluka kwa glucose m'magazi) m'miyezi isanu ndi umodzi yapitayo.

Kuyesedwa kwa magazi kwa HbA1c ndichizolowezi, momwe mungatengere.

Kuyesedwa kwa glycosylated hemoglobin ndi njira yodalirika yayitali yogwiritsira ntchito shuga wanu wamagazi.

• Kuwunika kwa glycemia mwa odwala matenda a shuga.

Kuyesedwa kwa HbA1c kumakupatsani mwayi wofufuza momwe chithandizo cha matenda ashuga chimachitikira - ngakhale ziyenera kusinthidwa.

• Kuzindikira koyambira kwa magawo a shuga (kuphatikiza pa kuyesedwa kwa shuga).
• Kuzindikiritsa "shuga woyembekezera."

Palibe kukonzekera kwapadera kwa magazi a HbA1c komwe kumafunikira.

Wodwalayo amatha kupereka magazi kuchokera m'mitsempha (2,5-3.0 ml) nthawi iliyonse masana, mosasamala kanthu za kudya, nkhawa / kupsinjika, kapena mankhwala.

Zifukwa zabodza:
Kutaya magazi kwambiri kapena zinthu zomwe zimakhudza njira yopangira magazi ndi chiyembekezo chokhala ndi maselo ofiira am'magazi (cell cell, hemolytic, kuchepa kwazitsulo, etc.), zotsatira za kusanthula kwa HbA1c zitha kukhala zabodza.

Mlingo wa hemoglobin wa glycosylated ndi wofanana kwa azimayi ndi abambo.