Matenda ambiri osachiritsika nthawi zambiri amakhala isanayambike matenda ashuga.

Mwachitsanzo, hyperinsulinemia mwa ana ndi akulu imapezeka kawirikawiri, koma ikuwonetsa kupanga kwa mahomoni ambiri omwe angapangitse kuchepa kwa shuga, kusafa ndi mpweya wa oxygen komanso kusatha kwa machitidwe onse amkati. Kuperewera kwa njira zochizira zomwe cholinga chake kupondereza kupanga insulin zingayambitse kukula kwa matenda osokoneza bongo.

Zoyambitsa matenda

Hyperinsulinism mu terminology yamankhwala imadziwika kuti ndi matenda a matenda, zomwe zimachitika motsutsana ndi maziko a kuchuluka kwambiri kwa insulin.

Munthawi imeneyi, thupi limachepetsa phindu la shuga m'magazi. Kuperewera kwa shuga kumatha kupangitsa kuti mpweya uzikhala ndi ubongo, womwe ungayambitse kuti ntchito yamanjenje iwonongeke.

Hyperinsulism nthawi zina imakhala popanda chiwonetsero chapadera chazachipatala, koma nthawi zambiri matendawa amabweretsa kuledzera kwambiri.

Congenital Hyperinsulinism . Zimatengera kutengera kwa chibadwa. Matendawa amakula motsutsana ndi maziko a matenda omwe amapezeka m'matumbo omwe amalepheretsa kupangika kwama mahomoni.
Second Hyperinsulinism . Fomuyi imapita patsogolo chifukwa cha matenda ena omwe apangitsa kuti mahomoni azitha kutulutsa. Ntchito hyperinsulinism imakhala ndi mawonetseredwe omwe amaphatikizidwa ndi kupuwala kwa metabolism ndipo amadziwika ndi kuwonjezeka kwadzidzidzi kwa glucose.

Zinthu zazikulu zomwe zingayambitse kuchuluka kwa mahomoni:

kupanga ndi maselo a insulin yosayenera yokhala ndi mawonekedwe osadziwika omwe samadziwika ndi thupi,
kukana, zomwe zimapangitsa kuti mahomoni asamalamulire,
kusunthika pakugawa shuga m'magazi,
onenepa kwambiri
atherosulinosis
chibadwire
anorexia, yomwe ili ndi chikhalidwe cha neurogenic ndipo imalumikizidwa ndi lingaliro lowona mopepuka la kunenepa kwambiri kwa thupi,
zochita za oncological pamimba,
zoperewera komanso zosapatsa thanzi,
kuvutitsidwa kwa maswiti, zomwe zimapangitsa kuti glycemia iwonjezeke, ndipo, chifukwa chake, kuchuluka kwa katulutsidwe ka mahomoni.
matenda a chiwindi
mankhwala osavomerezeka a insulini kapena kumwa kwambiri mankhwala osokoneza bongo kuti muchepetse kuchuluka kwa shuga, komwe kumayambitsa mawonekedwe a mankhwala.
endocrine pathologies,
osakwanira enzyme zinthu nawo metabolic njira.

Zomwe zimayambitsa hyperinsulinism sizitha kudziwonetsa kwa nthawi yayitali, koma panthawi imodzimodzi zimayipitsa ntchito ya chiwalo chonse.

Magulu owopsa

Magulu otsatirawa a anthu nthawi zambiri amakhudzidwa ndi chitukuko cha hyperinsulinemia:

azimayi omwe ali ndi matenda a ovary polycystic,
anthu omwe ali ndi cholowa chamtundu wa nthendayi,
odwala matenda amisempha,
azimayi atatsala pang'ono kusamba,
anthu okalamba
Odwala omwe alibe
azimayi ndi abambo omwe amalandira mankhwala a mahomoni kapena mankhwala a beta-blocker.

Zizindikiro za Hyperinsulinism

Matendawa amathandizira kuwonjezeka kwambiri kwa thupi, kotero zakudya zambiri sizothandiza. Mafuta amaikidwa mwa akazi amapangidwa m'chiuno, komanso m'mimba. Izi zimachitika chifukwa cha kuchuluka kwa insulin yomwe imasungidwa mu mafuta enaake (triglyceride).

Kuwonetsedwa kwa hyperinsulinism m'njira zambiri zofanana ndi zizindikiro zomwe zimayamba motsutsana ndi maziko a hypoglycemia. Kukhazikika kwa chizindikiritso kumadziwika ndi kulakalaka, kufooka, thukuta, tachycardia komanso kumverera kwa njala.

Pambuyo pake, dziko lamantha limalumikizana pomwe kupezeka kwa mantha, nkhawa, kunjenjemera miyendo ndi kukwiya kumadziwika. Ndipo pali chisokonezo pansi, dzanzi m'miyendo, mawonekedwe a kugwidwa ndikotheka. Kuperewera kwa chithandizo kumatha kuchititsa kuti musamaganize bwino.

Zosavuta. Zimadziwika ndi kusapezeka kwa zizindikiro zilizonse pakatikati pa kuukiridwa, koma nthawi yomweyo zimapitilizabe kukhudza ubongo. Wodwalayo akuwonjezera kuwonjezereka kwa nthawi osachepera 1 mwezi wa kalendala. Kuti muthane ndi vutoli, ndikokwanira kugwiritsa ntchito mankhwala oyenera kapena kudya zakudya zotsekemera.
Yapakatikati. Pafupipafupi kukomoka kangapo pamwezi. Munthu akhoza kulephera kuchita chidwi panthawiyi kapena kugwa.
Zovuta. Kuchuluka kwa matendawa kumayendera limodzi ndi kuwonongeka kwa ubongo kosasintha. Nthawi zambiri anthu amatsutsidwa.

Mawonekedwe a hyperinsulism kwenikweni samasiyana mwa ana ndi akulu. Chimodzi mwa zomwe matendawa ali nacho mwa odwala ndi kukoka kwa khunyu komwe kumayambira kumbuyo kwa glycemic indices, komanso kuthamanga kwawo mobwerezabwereza. Zotsatira zakuchulukirachulukira komanso kupumula kwanthawi zonse zoterezi ndi mankhwala osokoneza bongo ndikuphwanya thanzi la m'maganizo mwa ana.

Kodi matendawa ndi oopsa bwanji?

Matenda amtundu uliwonse angayambitse zovuta ngati palibe chochitika munthawi yake. Hyperinsulinemia sikuti ndi yosiyana, motero, imayendetsedwa ndi zotsatira zowopsa. Matendawa amatuluka pachimake komanso matenda osachiritsika. Kuphunzira kumene kumapangitsa kuti zochita za ubongo zisokonezeke, zimakhudza mkhalidwe wama psychosomatic.

zosokoneza pakugwira ntchito kwamakina ndi ziwalo zamkati,
kukula kwa matenda ashuga
kunenepa
chikomokere
kusokera mu ntchito yamtima wamtima,
encephalopathy
parkinsonism

Hyperinsulinemia yomwe imachitika paubwana imakhudza kukula kwa mwana.

Kodi polycystic ndi hyperinsulinemia amawonetsedwa bwanji?

Hyperinsulinemia imadziwika ndi maphunziro aposachedwa, koma nthawi zina, odwala amatha kuzindikira kufooka kwa minofu, kuzizira, chizungulire, ludzu lokwanira, kusakhazikika kwa chidwi, ulesi, ndi kutopa kosalekeza, zizindikiro zonsezi ndizovuta kuphonya, kuwonjezera apo, kuzindikira amadutsa nawo kwambiri.

Ngati tizingolankhula za polycystosis, zizindikiro zake zazikulu zimawonetsedwa ndi kusakhalapo kapena kusakhazikika kwa msambo, kunenepa kwambiri, hirsutism ndi androgenic alopecia (dazi), ndipo kuwonetsa kulikonse kumafunikira chithandizo cha munthu payekha.

Nthawi zambiri, kusokonezeka kwa thumba losunga mazira kumayendetsedwa ndi ziphuphu, kukomoka, zilembo zam'mimba, kutupa, kupweteka pamimba. Kuphatikiza apo, mkazi amatha kuwona zotsatirazi ndikuwonetsa:

kusintha kwamphamvu
kupuma kwamphamvu kugona (kugona),
mantha
kuchuluka kwa mkwiyo
kukhumudwa
kugona
mphwayi.

Ngati wodwala apita kwa dokotala, ndiye kuti malo oyamba azikhala pamakina a ultrasound, omwe angapangitse mawonekedwe ambiri a cystic, kukula kwa kaphatikizidwe ka ovarian, endometrial hyperplasia mu chiberekero. Njira zoterezi zimatsatiridwa ndikumverera kowawa pamimba yotsika ndi m'chiuno, ndipo zomwe zimayambitsa ziyenera kukumbukiridwa.

Ngati simukugwirizana ndi chithandizo cha polycystic cha panthawi yake, ndiye kuti mkazi amatha kuzindikira zovuta zazikulu:

khansa yam'mimba
hyperplasia
kunenepa
khansa ya m'mawere
kuthamanga
matenda ashuga
thrombosis
sitiroko
thrombophlebitis.

Kuphatikiza pa izi, zovuta zina za matendawa zimatha kukhazikika, mwachitsanzo, kulowetsedwa m'mimba, kupweteka kwamimba, kubadwa msanga, thromboembolism, komanso dyslipidemia.

Polankhula manambala, kuchokera pa 5 mpaka 10 peresenti ya azimayi amisinkhu yosabereka amakhala ndi zotupa zamkati za polycystic, ngakhale kuti zomwe zimayambitsa vutoli ndizodziwika.

Kodi hyperinsulinemia ndi polycystosis amathandizidwa bwanji?

Ngati mayi ali ndi matendawa, ndikofunikira kuti amupatse zakudya zomwe azidzayamwa ndi adotolo komanso kulandira chithandizo chokwanira.

Ntchito yayikulu pamenepa ndi kubweretsa kulemera kwa chizolowezi.

Pachifukwachi, calorie amaletsa chakudya ku 1800 zopatsa mphamvu patsiku, pamenepa zikhala ngati chithandizo. Ndikofunika kuchepetsa kugwiritsa ntchito momwe mungathere:

mafuta
zonunkhira
zonunkhira
chakudya chokometsera
zakumwa zoledzeretsa.

Chakudya chimatengedwa pang'onopang'ono 6 pa tsiku. Komanso chithandizo, mankhwala a mahomoni, kutikita minofu ndi hydrotherapy titha kudziwa. Njira zonse ziyenera kuchitika moyang'aniridwa ndi dokotala.

Hyperinsulinism (insulinoma) ndi chotupa chofala kwambiri cha neuroendocrine (NEO), chomwe chimakhala mpaka 70-75% ya neuroendocrine neoplasms (milandu ya 2-4 pa 1 miliyoni miliyoni). Ma insulin-secreting zotupa nthawi zambiri zimawonetsedwa ndi chizindikiro zovuta za organic hyperinsulinism, zomwe zimapangitsa kuti mu 5-7% ya milandu ikhoza kukhalanso microadenomatosis, hyperplasia ndi neogeneis ya pancreatic islet cell (non-idioblastosis). Organic hyperinsulinism mu 10-15% ya milandu ndi mawonekedwe a mtundu 1 syndrome (Wermer's syndrome). Vermeer syndrome, imaphatikizidwanso ndi insulinoma mu 30% ya odwala.

Nthawi zambiri, insulinomas imapezeka mu kapamba - mu 95-99% ya milandu, yokhala ndi pafupipafupi m'madipatimenti ake onse. Makamaka, ma insulinomas a extrapancreatic amatha kutulutsa m'mimba, duodenum, khungu, ileamu, colon yopinduka, omentum yaing'ono, chikhodzodzo, ndi zipata za ndulu. Makulidwe omwe amafotokozedwa ndi insulin amasiyana pamtunda wamtunda wa 0,2 mpaka 10cm kapena kuposerapo, koma m'mimba mwake mpaka 70% ya iwo sapitilira 1.5 cm, ndichifukwa chake zovuta zovuta kuzidziwitsidwa zimayambitsa. Monga lamulo, chotupachi ndi chimodzi (chokha), ndipo zotupa zingapo zimapezeka mu zosaposa 15% za odwala. Ma insulinomas oopsa amapezeka mu 10% ya milandu ndipo nthawi zambiri amaphatikizana ndi chiwindi kapena ma lymph node.

Mawonetseredwe azachipatala a chotupacho ndi chifukwa cha ntchito yake ya mahomoni, ndiko kuti, katulutsidwe kenakake ka insulin. Ntchito yake yayikulu m thupi ndikuwunika kuchuluka kwa shuga m'magazi ndikumayendetsa kudzera mumitsempha yama cell. Kuphatikiza apo, timadzi timene timakhudzana ndi mayendedwe amtundu wa K + ndi amino acid, komanso zimakhudza mafuta ndi metabolism ya protein. Chofunikira kwambiri pakulimbitsa kwa insulin katulutsidwe ndikuchulukitsa kwa ndende yamagazi. Kuzungulira kwa glucose chifukwa cha kusala kwachangu ndi 80-100 mg%, ndipo kumasulidwa kwakukulu kumachitika pang'onopang'ono wama 300-500 mg%.

Odwala ndi insulinomas, kuchuluka kwa insulin katemera kumachitika osati kokha chifukwa cha kuphatikizika kwambiri ndi chotupacho, komanso ndi kukanika kwa chinsinsi cha ma cell a p-cell, omwe sasiya kutulutsa insulin panthawi yotsika glucose m'magazi. Pankhaniyi, limodzi ndi mtundu wabwinobwino wa mahomoni, kuchuluka kwakukulu kwa proinsulin kumapangidwa, pomwe kubisala kwa C-peptide kumakhala kochepa, komwe kumayambitsa kuchepa (kuyerekeza ndi kwanthawi yayitali) pakati pa C-peptide ndi insulin.

Hyperinsulinism imathandizira kuti glycogen iwonjezeke m'chiwindi ndi minofu. Zotsatira zake, kuchuluka kwa glucose (glycogenolysis blockade) kosakwanira kumalowa m'magazi.Kuchepa kofooka kwa ubongo ndi ma carbohydrate sikumapereka mphamvu zake ndipo, chifukwa, kumayambitsa encephalopathy (kawirikawiri mpaka 20% ya glucose onse omwe thupi limagwiritsa ntchito ubongo umagwiritsidwa ntchito pakugwira ntchito kwa ubongo). Choyamba, maselo a kortex amakhudzidwa, mpaka kufa kwawo. Kupezeka kosakwanira kwa shuga ndi okosijeni kuubongo kumayambitsa kukhudzika kwamanjenje yamafundo ndi kuwonjezeka kwamatumbo amwazi, omwe amawonetsedwa kwambiri ndi kufooka, thukuta, tachycardia, nkhawa, kusakwiya, kugwedezeka kwa malekezero. Kuchepetsa makutidwe a oxidative ndikusokoneza chifukwa cha hypoglycemia yamitundu yonse ya kagayidwe mu ubongo kumayambitsa kutayika kwa kamvekedwe kabwino ndi makoma amitsempha yamagazi, omwe, pamodzi ndi kuchuluka kwa magazi kupita ku ubongo chifukwa cha kuphipha kwa zotumphukira za m'mitsempha, kumabweretsa edema, komanso njira za atrophic komanso zodetsa nkhawa mu ubongo.

Tiyenera kukumbukira kuti zochitika za hypoglycemic zimatha kukhala chiwonetsero cha matenda ena a ziwalo zamkati ndi zochitika zina zogwira ntchito. Nthawi zambiri, yogwira hyperinsulinism (yachiwiri) imawonedwa pakudya, kuwonongeka kwambiri (aimpso glucosuria, kutsegula m'mimba, mkaka wa m'mawere) kapena kugwiritsa ntchito kwambiri ma carbohydrate (makonzedwe a insulin, insulin, matenda oyamba chifukwa cha antibodies a insulin ndi receptors ake, cachexia). Owonjezera-pancreatic hypoglycemia ndi kuwonjezeka kwa insulin ndende nthawi zina kumayamba chifukwa cha kuponderezedwa kwa glycogenolysis chifukwa cha kuwonongeka kwa chiwindi (hepatitis, khansa ya chiwindi), zotupa zina zoyipa (khansa ya impso, adrenal glands, fibrosarcoma), kuchepa kwa secretion ya mahomoni a mahomoni (ACTH, cortisol), myxedema.

Zizindikiro zoyenera za matendawa zimadziwika ndi Whipple triad, wofotokozedwa mu 1944:

kukulira kwa kuukira kwa chizolowezi pamimba yopanda kanthu kapena mutachitanso masewera olimbitsa thupi mpaka mutazindikira.
kutsika kwa shuga m'magazi pakuwukira (pansipa 2.2 mmol / l).

Zizindikiro

Ngati organic hyperinsulinism ikukayikiridwa, kuzindikira kwake kungatsimikizidwe mwa kusala kudya kwa hypoglycemia yochepera 2.2 mmol / L komanso kuchuluka kwa insulin (IRI) mu plasma yaoposa 25 mcED / ml (ngakhale ozungulira a IRI mu 20-30% ya odwala atha kukhala ochepa malire) ) Komanso onani kuchuluka kwa proinsulin ndi magazi C-peptide, omwe nthawi zina amatha kuwonjezereka ndi mitengo yofanana ya IRI. Zizindikiro zamagazi C-peptide amasewera chofunikira pofufuzira kuti mupeze mayankho oona ndi a hypoglycemia oyambitsidwa ndi kukhazikitsidwa kwa insulin, popeza kukonzekera kwakunja kwa insulin kulibe C-peptide. Kupatula michere ya hypoglycemia yomwe imayamba chifukwa cha kumwa mankhwala a sulfonylamide kapena zotumphukira za sulfonyl-urea, ndikofunika kudziwa zomwe zili mu sulfonylurea mumkodzo.

Chidziwitso cha labotale cha insulin, monga ma NEO ena, poyambira, chimakhazikika, choyambirira, pakuzindikira kuchuluka kwa zotupa izi, choyambirira, chromogranin A ndi synaptophysin.

Potsimikizira chomaliza cha chilengedwe cha matendawa komanso kupatulidwa kwa zifukwa zina za matenda a hypoglycemic, kuyezetsa magazi kumachitika mofulumira kwa maola 72. Kuyesedwa uku kumachitika chifukwa anthu omwe ali ndi vuto logwiritsa ntchito zinthu zomwe amapanga amakhala ndi hypoglycemia (the Whipple triad) chakudya chikatha.

Pakadali pano, pofufuza mosiyana ndi sekondale hyperinsulinism, mayeso othandiza kudziwa matenda (mayeso ndi olbutamide, glucagon, arginine, leucine, ACTH ndi cortisol, adilesi, calcium gluconate, mayeso omwe amaponderezedwa ndi C-peptide) siwothandiza pamilandu yonse.

Pambuyo pakutsimikizira kupezeka kwa syndromic ya organic hyperinsulinism-II, ntchito yotsatira, yovuta kwambiri imakhalapo kwa akatswiri azachipatala - kukhazikitsa kuwunika kwapadera. Kudziwitsa za insulini kopitilira muyeso kumakhalabe ntchito yovuta kwambiri, poti 80% ya milandu yawo imakhala yochepera 2 cm, ndipo theka la milandu zoterezi zimakhala ndi mainchesi osakwana masentimita. Njira zotengera ma radiation zimagwiritsidwa ntchito kale kudziwa malo omwe amapangika pancreatic form (monga CT ndi ultrasound) imalola kuti insulini ipezeke mu milandu yoposa 50%, ndipo kukula kwake ndikakhala ochepera 1.0 cm, chidwi cha njirazi chimatsika pafupifupi 2> aza. Dziwani kuti njira zozindikiritsa zinthu zomwe zimayambitsa ma organic hyperinsulinism nthawi zambiri zimakhala zofanana ndi za NEO zina za kapamba.

Njira yoyamba komanso yosavuta kwambiri yodziwira njira zodziwitsira matenda ndi yodutsitsa. Nthawi zambiri imakhala njira yokhayo yodziwira kutulutsa kwazomwe amapanga mpaka 5-6 mm.

Njira zosazindikira zowononga zomwe zimapereka chiwonetsero cha radiation zimaphatikizapo CT. Pakadali pano, kuti mupeze mawonekedwe oyimba a kapamba, CT imagwiritsidwa ntchito pokhapokha ikuthandizira kusiyanitsa. Njira yodziwikirayi imakuthandizani kuti mudziwe mpaka 50-70% ya zotupa za insulin, ma metastases awo (mkuyu. 4.2).

MRI yakhala ikugwiritsidwa ntchito ngati yazindikira kwa NEO kwa nthawi yayitali, koma sinagwiritsidwe ntchito pazomwezi.

Zovuta zomwe zimadziwika chifukwa cha njira zosawunikira zodziwikiratu zomwe sizinalembedwe sizongokhala ndi chidziwitso chotsika pokhapokha ngati pali zotupa zingapo, komanso kulephera kuzindikira foci ya microadenomatosis komanso kudziwa gawo la lesion pankhani yokhazikika yopanda idioblastosis.

Kupewa

Chithandizo chokhacho chokhacho cha organic hyperinsulinism ndikuchita opareshoni. Zotsatira za kulowererapo kwa opaleshoni ya kapamba ndipo makamaka, ndi NEO zimasiya zambiri kukhala zofunidwa pafupifupi m'mabungwe onse azachipatala padziko lapansi. Pafupipafupi zovuta zaku postoperative zimachokera ku 25 mpaka 70%, ndikufa kwa 1.9 mpaka 12%. Pankhaniyi, ndikofunikira kuti pakhale njira yayikulu yogwiritsira ntchito kukonzekera, njira zoletsa zovuta za postoperative ndi kasamalidwe ka odwala mu nthawi ya postoperative. Mwanjira zambiri, zotsatira za nthawi yochepa yogwira ntchito zimadaliranso pakusankha kwa njira yogwirira ntchito.

Kuthandizira opaleshoni kumachitika pansi pa endotracheal anesthesia. Njira yoyenera kwambiri yochitira opaleshoni ndiyosintha kwapakati pamimba, pomwe kukonzanso kwathunthu kwa kapamba kumatha kuchitidwa. Kukonzanso kwa kapamba kumachitika pambuyo poti kutsegulika kwam'mimba kwambiri, kulimbikitsa mutu wa kapamba ndi duodenum malinga ndi Kocher ndipo, ngati kuli kotheka, kulimbikitsa thupi ndi mchira wa kapamba. Monga tawonera kale, njira yolumikizira ma intaneti yothandizira imagwiritsidwa ntchito nthawi zonse, yomwe imalola pafupifupi nthawi zonse kuzindikira kapena kupatula chotupa, ndikuthandizanso kudziwa njira zabwino kwambiri zowchitira opaleshoni.

Kuchita kwa kusankha mu benign insulinomas ndi kukokoloka kwake. Distal pancreatic resection imakonda kwambiri ngati chotupacho chili mkati mwa minofu ya thupi ndi mchira wa chiwalo, komanso pafupi ndi pancreatic duct ndi ziwiya za splenic komanso pamaso pa insulin yambiri.

Chovuta kwambiri ndikuti nkhani yokhudza njira zochizira matenda ovuta insulinoma, makamaka kupezeka kwa metastases yakutali. Tsoka ilo, monga lamulo, asanachitidwe opareshoni komanso mkati mwa kukonzanso kwamkati, ndikotheka kuweruza mtundu woyipa wa kukula kokha pakulowetsa chotupacho m'misempha yoyandikana kapena ndi metastasis mu lymph node ndi chiwindi, popeza kuyesedwa kofulumira kwa mbiri yakale nthawi zambiri sikunachitike. M'mawonekedwe ena, kukula kwa kusiyanitsa kwa insulinomas, monga NEO iliyonse, kumadziwika pokhapokha kuyesedwa kwa histological.

Zotsatira zabwino zochitidwa opaleshoni ya organic hyperinsulinism ndi kutha kwa zizindikiro za hypoglycemia motsutsana ndi maziko a shuga. Odwala ambiri, kulemera kwa thupi limakhala yofanana, mphamvu yogwirira ntchito ndikuwonjezera kukumbukira. Komabe, pafupifupi 10% ya odwala komanso atachitidwa opaleshoni, mawonekedwe a encephalopathy a digiri imodzi kapena enanso azovuta amakhalabe. Izi zimachitika chifukwa cha hypoglycemia, yomwe idakhalapo kale asanachitike opaleshoni, ndipo nthawi zambiri ndikusintha kwa cortex c-cell. Pankhaniyi, zikuwonekeratu kuti koyambirira kumatha kuzindikira organic hyperinsulinism, kuzindikira zomwe zimayambitsa ndikuchitapo kanthu pochita opaleshoni, ndibwino kwambiri kwakanthawi zotsatira zakumwa.

Kufunsira kwa adotolo pa intaneti

Rita: 08/31/2016
Moni. mu chithokomiro cha chithokomiro, kuchuluka kwambiri kwa ma thyrocyte omwe amapangidwa kuti azikulidwe ndi misempha yopangika ndipo imamwazikana amalembedwa padera pa mutu wakutali wofanana ndi "madzi" a colloid. Wodwalayo ali ndi zaka 75. Kodi pakufunika opareshoni? Node wakula pang'ono pachaka. Kuyesedwa kwa mahomoni ndizabwinobwino (kupatula pa thyroglobinin - 64 - anali 26,5).

Kuzindikira zomwe zimayambitsa vutoli ndizokhazikitsidwa ndi chithunzi cha chipatala, zotsatira za kuyesa koyesa, kuyesa kwamphamvu kwa glucose, ultrasound kapena kusanthula kwa tomographic kwa kapamba. Chithandizo cha pancreatic neoplasms ndikuchita opareshoni.

Ndi mtundu wa extrapancreatic wa matenda, chithandizo cha matenda oyambitsidwa zimachitika, zakudya zapadera zimayikidwa.

Hyperinsulinism (matenda a hypoglycemic) ndi chinthu chobadwa nacho kapena chokhala ndi matenda amkati mwa hyperinsulinemia. Zizindikiro za matendawa adayamba kufotokozedwa koyambirira kwa zaka za zana la makumi awiri ndi dotolo waku America a Harris ndi dokotala wa opaleshoni yapakhomo Oppel.

Congenital hyperinsulinism ndi chosowa kwambiri - 1 kesi pa 50,000 yatsopano. Matendawa amapezeka ndi zaka 35-50 ndipo nthawi zambiri amakhudza azimayi.

Matenda a Hypoglycemic amapezeka ndi nthawi yosakhalapo kwa zizindikiro zazikulu (kuchotsedwa) komanso nthawi yayitali yopanga chithunzi (kuukira kwa hypoglycemia).

Zoyambitsa Hyperinsulinism

Matenda agengenital amapezeka chifukwa cha kutukuka kwa intrauterine, kufalikira kwa fetal, kusintha kwa matupi athu.

Zomwe zimayambitsa matenda a hypoglycemic omwe adagawidwa pancreatic, zimayambitsa kukulitsa kwa hyperinsulinemia kwathunthu, komanso yopanda pancreatic, ndikuwonjezera kuchuluka kwa insulin.

Pancreatic mawonekedwe a matendawa amapezeka ndi zilonda zapakhosi kapena benign neoplasms, komanso pancreatic beta cell hyperplasia. Fomu yopanda pancreatic imayamba mu zotsatirazi:

Kuphwanya zakudya. Kutopa kwa nthawi yayitali, kuchepa kwamadzi ndi glucose (kutsekula m'mimba, kusanza, kuyamwa), kuchita masewera olimbitsa thupi popanda kudya zakudya zamagulu am'thupi kumapangitsa kuchepa kwambiri kwa shuga m'magazi. Kugwiritsa ntchito mafuta ochulukitsa okwanira kumawonjezera shuga m'magazi, omwe amathandizira kupanga insulin.
Kuwonongeka kwa chiwindi cha ma etiologies osiyanasiyana (khansa, mafuta a hepatosis, cirrhosis) kumabweretsa kuchepa kwa glycogen, kusokonezeka kwa metabolic ndi hypoglycemia.
Kudya kosaloledwa ka mankhwala ochepetsa shuga a shuga mellitus (ma insulin, omwe amachokera ku insulin, sulfanylureas) kumayambitsa mankhwala a hypoglycemia.
Matenda a Endocrine omwe amatsogolera kuchepa kwa kuchuluka kwa mahomoni a contrainsulin (ACTH, cortisol): pituitary dwarfism, myxedema, matenda a Addison.
Kuperewera kwa ma enzymes okhudzana ndi glucose metabolism (hepatic phosphorylase, aimpso insulinase, glucose-6-phosphatase) kumayambitsa wachibale hyperinsulinism.

Glucose ndiye gawo lalikulu la michere chapakati ndipo ndizofunikira kuti ubongo uzigwira bwino ntchito. Miyezi yambiri ya insulin, kudzikundikira kwa glycogen m'chiwindi ndi kulepheretsa kwa glycogenolysis kumabweretsa kuchepa kwa shuga wamagazi. Hypoglycemia imayambitsa zopinga za metabolic ndi mphamvu zama cell mu ubongo.

Kukondoweza kwa dongosolo la sympathoadrenal kumachitika, kupanga catecholamines kumawonjezeka, kuukira kwa hyperinsulinism kumayamba (tachycardia, irritability, a mantha). Kuphwanya njira za redox mu thupi kumayambitsa kuchepa kwa kugwiritsa ntchito kwa okosijeni ndi maselo a chithokomiro cha m'magazi komanso kukula kwa hypoxia (kugona, kunenepa, kusayang'anira).

Kuperewera kwa shuga kumapangitsa kuphwanya njira zonse za metabolic mthupi, kuchuluka kwa magazi kupita ku ziwongo za ubongo ndi kuphipha kwa zotumphukira za m'mitsempha, zomwe zingayambitse matenda amtima.

Pamene zida zakale zaubongo zimakhudzidwa ndi njira ya pathological (medulla oblongata ndi midbrain, Varolian Bridge) malo olimbikitsa, diplopia, komanso kusokoneza komanso kupuma ndi mtima.

Gulu

Mu chipatala endocrinology, gulu lomwe limagwiritsidwa ntchito kwambiri m'magulu a hyperinsulinemia kutengera zomwe zimayambitsa matendawa:

Hyperinsulinism yoyamba (kapamba, organic, mtheradi) ndi zotsatira za chotupa kapena beta-cell hyperplasia ya islet zida za kapamba. Kuwonjezeka kwamankhwala a insulin 90% kumathandizidwa ndi benign neoplasms (insulinoma), ocheperako, olakwika neoplasms (carcinoma). Organic hyperinsulinemia imachitika kwambiri mawonekedwe ndi otchulidwa matenda chithunzi ndi pafupipafupi matenda a hypoglycemia. Kugwa kwakuthwa kwa shuga m'magazi kumachitika m'mawa, chifukwa chodumphadyeka chakudya. Kwa matenda amtunduwu, Whipple triad ndi mawonekedwe: Zizindikiro za hypoglycemia, kuchepa kwambiri kwa shuga m'magazi ndikusiya kuukira poyambitsa shuga.
Second Hyperinsulinism (inchito, wachibale, extrapancreatic) imalumikizidwa ndi kuchepa kwa mahomoni otsutsana, kuwonongeka kwa dongosolo lamanjenje ndi chiwindi. Kuukira kwa hypoglycemia kumachitika pazifukwa zakunja: kufa ndi njala, mankhwala osokoneza bongo a hypoglycemic, kuchita zolimbitsa thupi kwambiri, kugwedeza kwamphamvu. Kuchulukitsa kwa matendawa kumachitika mosakhazikika, pafupifupi kosakhudzana ndi chakudya. Kusala kudya kwatsiku ndi tsiku sikubweretsa zifukwa zatsatanetsatane.

Chithunzi chachipatala cha matenda a hypoglycemic ndi chifukwa cha kuchepa kwa shuga wamagazi. Kukula kwa kuukira kumayambira ndikuwonjezeranso chidwi cha kudya, thukuta, kufooka, tachycardia ndikumverera kwa njala.

Pambuyo pake mayiko ochita mantha alumikizana: mantha, nkhawa, kusakwiya, kugwedezeka miyendo.

Ndi kupitiliza kwa kuukira, kusokonezeka m'malo, diplopia, paresthesia (dzanzi, kumva kugunda) m'miyendo, mpaka mwadzidzidzi. Ngati sanalandiridwe, amachoka pomwepo.

Nthawi yopatsirana imawonetsedwa ndi kuchepa kwa kukumbukira, kusokonezeka kwa malingaliro, chidwi, kusokonezeka kwa chidwi ndi dzanzi m'ziwalo. Kudya pafupipafupi komwe kumakhala ndi michere yambiri yamagetsi kumapangitsa kuti thupi lizikula komanso kuti kunenepa kwambiri.

Muzochita zamakono, pali madigiri atatu a hyperinsulinism, kutengera kuwuma kwa matendawa: ofatsa, odziletsa komanso okhwima.A digiri yofatsa imawonetsedwa ndi kusapezeka kwa zizindikiro za nthawi yopatsirana komanso zotupa za chithokomiro cha ubongo.

Kuchulukitsa kwa matendawa kumachitika osakwana nthawi 1 pamwezi ndipo kumayimitsidwa mwachangu ndi mankhwala kapena zakudya za shuga. Ndi zovuta zolimbitsa thupi, kukomoka kumachitika nthawi yopitilira 1 pamwezi, kusowa kwa chikumbumtima komanso kukula kwa chikumbumtima ndikotheka.

Nthawi yopatsirana imadziwika ndi zovuta zofatsa (kuiwala, kuchepa kwa malingaliro). Mulingo wambiri umayamba ndi kusintha kosasintha mu ubongo. Pankhaniyi, kukomoka kumachitika nthawi zambiri ndikutha ndikutaya chikumbumtima.

Munthawi yopatsirana, wodwalayo amasokonezeka, kukumbukira kumachepa kwambiri, kugwedezeka kwamphamvu kumadziwika, kusintha kwakuthwa m'maganizo ndikuwonjezereka kwa mkwiyo.

Mavuto a Hyperinsulinism

Mavuto amatha kugawidwa kumayambiriro komanso mochedwa. Mavuto oyambilira omwe amabwera patangotha maola ochepa pambuyo povulaza ndikuphatikiza stroko, kulowerera m'mitsempha chifukwa chakuchepa kwambiri kwa kagayidwe kazigawo ka minofu ya mtima ndi ubongo. Pakakhala zovuta, chikomokere cha hypoglycemic chimakula.

Pambuyo pake zovuta zimawonekera miyezi yambiri kapena zaka pambuyo poyambitsidwa kwa matendawa ndipo amadziwika ndi vuto la kukumbukira komanso kuyankhula, parkinsonism, encephalopathy. Kuperewera kwa njira yodziwira matendawa ndikuthandizira matendawa kumabweretsa kufooka kwa ntchito ya endocrine ya kapamba ndi kukula kwa matenda a shuga, matenda a metabolic, komanso kunenepa kwambiri.

Congenital hyperinsulinism mu 30% ya milandu imabweretsa matenda osokoneza bongo a ubongo komanso kuchepa kwa kukula kwamaganizidwe kwa mwana.

Hyperinsulinism Chithandizo

Njira zamankhwala zimatengera zomwe zimayambitsa hyperinsulinemia. Ndi organic genesis, opaleshoni ya opaleshoni ikuwonetsedwa: kusinthanitsa pang'ono kwa kapamba kapena kapamba konse, kukokomeza kwa neoplasm. Kuchuluka kwa maopareshoni kumatsimikiziridwa ndi malo ndi kukula kwa chotupa.

Pambuyo pakuchita opaleshoni, kuchepa kwa mphamvu kwa hyperglycemia nthawi zambiri kumadziwika, kumafuna kuwongolera kuchipatala komanso kudya kokhala ndi zakudya zochepa. Matenda a mtundu wa zizindikiro amapezeka mwezi umodzi atatha kulowererapo. Ndi zotupa zosagwiritsidwa ntchito, mankhwala a palliative amachitika pofuna kupewa hypoglycemia.

Mu neoplasms yoyipa, chemotherapy imasonyezedwanso.

Ntchito hyperinsulinism kwenikweni imafunikira chithandizo cha matenda omwe amayambitsa kuchuluka kwa insulin. Odwala onse amapatsidwa zakudya zoyenera komanso kuchepa kwamphamvu kwa chakudya chamagulu (100-150 gr. Patsiku).

Zokonda zimaperekedwa ku zovuta zamatumbo (mkate wa rye, supu ya tirigu wa durum, phala lonse la tirigu, mtedza). Chakudya chizikhala chopindika, nthawi 5-6 patsiku. Chifukwa chakuti kuwukira kwakanthawi kumayambitsa kukhazikitsidwa kwa mantha pakati pa odwala, kufunsira kwa katswiri wamalingaliro kumalimbikitsidwa.

Ndi kukula kwa vuto la hypoglycemic, kugwiritsa ntchito chakudya cham'mimba chotsekemera (tiyi wokoma, maswiti, mkate Woyera) akuwonetsedwa. Popeza simukudziwa, kupangika kwa shuga 40% ndikofunikira. Ndi kupweteka komanso kugwedezeka kwambiri kwa psychomotor, jakisoni wa bata ndi kusinkhidwa akuwonetsedwa.

Chithandizo cha matenda oopsa a hyperinsulinism ndi chitukuko cha chikomokerezi chimachitika m'chipinda chosamalitsa cha anthu odwala komanso kulowetsedwa kwa detoxation, kuyambitsa glucocorticoids ndi adrenaline.

Zotsogola ndi kupewa

Kupewera kwa matenda a hypoglycemic kumaphatikiza kudya mokwanira komanso kupatula kwa maola awiri ndi atatu, kumwa madzi okwanira, kusiya zizolowezi zoyipa, ndikuwongolera kuchuluka kwa shuga.

Kusamalira ndi kukonza kagayidwe kachakudya mthupi, zolimbitsa thupi zolimbitsa thupi zimalimbikitsidwa potsatira zakudya. Kukula kwa hyperinsulinism kumatengera gawo la matendawa komanso zomwe zimapangitsa insulinemia.

Kuchotsa kwa benign neoplasms mu 90% ya milandu kumapereka kuchira. Zotupa zosagwira ndi zopweteka zimayambitsa kusintha kwamitsempha ndipo zimafunikira kuwunika wodwalayo nthawi zonse.

Chithandizo cha matenda oyambitsidwa ndi mawonekedwe amachitidwe a hyperinsulinemia kumabweretsa kubwezeretsanso kwa zizindikiro ndi kuchira kwamtsogolo.

Hyperinsulinemia ndi chithandizo chake

Hyperinsulinemia ndi vuto losavomerezeka la thupi momwe mulingo wa insulin mumagazi umapitilira mtengo wamba.

Ngati kapamba amatulutsa insulin yochulukirapo kwa nthawi yayitali, izi zimabweretsa kuwonongeka kwake ndi kusokonekera kwa magwiridwe antchito.

Nthawi zambiri, chifukwa cha hyperinsulinemia, kagayidwe ka metabolic (kagayidwe kachakudya koyipa) kamayamba, komwe kamatha kukhala vuto la matenda ashuga. Kuti mupewe izi, ndikofunikira kufunsa dokotala munthawi yofufuza mwatsatanetsatane ndikusankhidwa kwa njira zowongolera izi.

Zomwe zimapangitsa kuti insulin iwonjezeke m'magazi zimatha kusintha motere:

Kapangidwe ka kapamba ka insulin yachilendo, yomwe imasiyana mu kapangidwe kake ka amino acid, motero sikudziwika ndi thupi,
Kusokonezeka kwa ntchito ya ma receptor (malekezero omvera) kwa insulin, chifukwa chomwe sangazindikire kuchuluka kwa mahomoni m'magazi, chifukwa chake mulingo wake umakhala wabwinobwino,
Zosokoneza pakuyenda kwa shuga m'magazi,
"Zosokonekera" mu kachitidwe kovomerezeka kazinthu zosiyanasiyana m'magawo a ma cell (chizindikiro chakuti zomwe zikubwera ndi glucose sizidutsa, ndipo khungu sililoleza kulowa).

Mwa akazi, matenda amapezeka kwambiri kuposa amuna, omwe amakhudzana ndi kusinthasintha kwa mahomoni ndi kukonzanso. Izi zili choncho makamaka kwa omwe akuimira amuna kapena akazi omwe ali ndi matenda opatsitsika.

Palinso zinthu zina zosadziwika zomwe zimawonjezera mwayi wopanga hyperinsulinemia mwa anthu onse ogonana:

kumangokhala
kunenepa kwambiri
ukalamba
matenda oopsa
atherosulinosis
chizolowezi cha chibadwa
kusuta fodya komanso kumwa mowa mwauchidakwa.

Munthawi yayitali yotsogola, vuto ili silingamveke konse. Mwa akazi, hyperinsulinemia (makamaka pachiyambi) imawonetsedwa mwachangu munthawi ya PMS, ndipo popeza zizindikiro za izi ndizofanana, wodwalayo samawalabadira kwambiri.

Mwambiri, zizindikiro za hyperinsulinemia zimagwirizana kwambiri ndi hypoglycemia:

kufooka ndi kutopa kochulukira,
kusokonezeka m'maganizo (mkwiyo, mkwiyo, kulira),
kunjenjemera pang'ono m'thupi,
njala
mutu
ludzu lalikulu
kuthamanga kwa magazi
kulephera kulolera.

Ndi insulin yowonjezereka m'magazi, wodwalayo amayamba kulemera, pomwe palibe zakudya komanso masewera olimbitsa thupi amathandizira kuti achepetse. Mafuta pankhaniyi amadzaza m'chiuno, mozungulira pamimba ndi kumtunda.

Izi ndichifukwa choti kuchuluka kwa insulini m'mwazi kumapangitsa kuti mafuta ena apangidwe mwapadera - triglycerides.

Ambiri aiwo amawonjezera minofu ya adipose ndipo, kuphatikiza, amakhudza mitsempha yamagazi.

Chifukwa cha njala yosatha panthawi ya hyperinsulinemia, munthu amayamba kudya kwambiri, zomwe zimapangitsa kuti kunenepa kwambiri ndikukula kwa matenda a shuga 2

Kodi kukana insulin ndi chiyani?

Kukana kwa insulin ndikuphwanya kukhudzidwa kwa maselo, chifukwa cha izi amaleka kuzindikira insulin ndipo samatha kuyamwa glucose.

Kuti zitsimikizire kutuluka kwa zinthu zofunikazi kulowa m'maselo, thupi limakakamizidwa nthawi zonse kuti lisungidwe kwambiri mu insulin m'magazi.

Izi zimabweretsa kuthamanga kwa magazi, kudzikundikira kwa madipoziti amafuta ndikutupa kwa minofu yofewa.

Kukana kwa insulini kumasokoneza kagayidwe kake, chifukwa chifukwa chake mitsempha ya magazi imachepetsedwa, zolembera za cholesterol zimayikidwamo. Izi zimawonjezera mwayi wokhala ndi matenda oopsa a mtima komanso matenda oopsa oopsa. Insulin imalepheretsa kuchepa kwa mafuta, chifukwa chake, pamlingo wokwezeka, munthu akupeza thupi kwambiri.

Pali lingaliro malingana ndi momwe insulin kukaniza ndi njira yotetezera yopulumutsira anthu ovulala kwambiri (mwachitsanzo, ndi njala yayitali).

Mafuta omwe anachedwa panthawi yathanzi labwino amayenera kuwonongeratu nthawi yoperewera zakudya, motero kupatsa mwayi kwa munthu kuti "akhalebe" nthawi yayitali popanda chakudya.

Koma pochita, kwa munthu wamakono m'dziko lino palibe zothandiza, chifukwa, kwenikweni, zimangoyambitsa kukula kwa kunenepa kwambiri komanso matenda osokoneza bongo omwe amadalira shuga.

Kuzindikira kwa hyperinsulinemia ndikovuta kochepa chifukwa chosowa kutsimikizika kwa chizindikirocho komanso kuti mwina sangawonekere mwachangu. Kuti mudziwe izi, njira zotsatirazi zoyeserera zimagwiritsidwa ntchito:

kutsimikiza kwa kuchuluka kwa mahomoni m'magazi (insulin, ma pituitary ndi mahomoni a chithokomiro),
MRI ya pituitary gland yothandizirana ndi vuto lina kuti atulutse chotupacho,
Ultrasound yam'mimba, makamaka, kapamba,
Ultrasound yamchiberekero cha ziwalo za azimayi (kukhazikitsa kapena kupatula ma concomitant gynecological pathologies omwe mwina ndi omwe amachititsa kuti insulin iwonjezeke m'magazi),
kuthamanga kwa magazi (kuphatikiza kuwunikira tsiku lililonse pogwiritsa ntchito wowunika Holter),
kuyang'anira pafupipafupi shuga (pamimba yopanda kanthu komanso katundu).

Pazifukwa zokayikitsa pang'ono, muyenera kulumikizana ndi endocrinologist, popeza kupezeka kwa nthawi yayitali kwa matenda kumawonjezera mwayi wakuchotsa kwathunthu

Hyperinsulinemia: zimayambitsa, Zizindikiro, mankhwala, zakudya

Hyperinsulinemia iyenera kumvetsedwa ngati matenda omwe amadziwonetsa okha ngati kuchuluka kwa insulin m'magazi. Mkhalidwe wamtunduwu ungayambitse kulumikizidwa m'magulu a shuga ndi chofunikira kuti shuga ikule. Matenda ena amagwirizana kwambiri ndi matendawo - polycystosis, yomwe imayendetsedwa ndi kusokonezeka kapena ntchito:

thumba losunga mazira
adrenal kotekisi
kapamba
zodabwisa
hypothalamus.

Kuphatikiza apo, pali kupanga kwambiri insulin limodzi ndi estrogens ndi androgens; zizindikiritso zonsezi ndikuwonetsa kuti hyperinsulinemia ili pafupi kuyamba m'thupi la wodwalayo.

Kumayambiriro kwenikweni kwamavuto azaumoyo, matenda a metabolic amayamba kukulira, omwe amadziwika ndi kusintha kwa shuga mumagazi a munthu. Vutoli limawonedwa mutatha kudya, kuchuluka kwa glucose kukwera ndikuyambitsa hyperglycemia, ndipo uku kumatha kukhala kuyamba kwa chitukuko cha chikhalidwe monga hyperinsulinemia.

Patha kanthawi chakudya, chizindikirochi chimatsika kwambiri ndipo chimakwiyitsa kale hypoglycemia. Vuto lofanana la metabolic ndi chiyambi cha kukula kwa matenda ashuga. Nthenga za kapamba pamenepa zimayamba kuchuluka kwa insulini ndipo motero zimatha, zomwe zimapangitsa kuchepa kwa timadzi timeneti m'thupi.

Ngati mulingo wa insulin ukwera, ndiye kuti kulemera kumawonedwa, zomwe zimabweretsa kunenepa kwambiri kwamitundu yosiyanasiyana. Monga lamulo, zosanjikiza zamafuta zimamanga m'chiuno ndi m'mimba, zomwe zimawonetsa hyperinsulinemia.

Ngakhale kuti zomwe zimayambitsa vutoli zimadziwika, ndipo zizindikilozo ndizovuta kuzinyalanyaza, zimapezekabe masiku ano.

Hyperinsulinism

Hyperinsulinism - Matenda a kuchipatala omwe amadziwika ndi kuwonjezeka kwa insulin komanso kuchepa kwa shuga m'magazi. Hypoglycemia imabweretsa kufooka, chizungulire, kulakalaka kudya, kunjenjemera, ndi psychomotor. Pakapanda kuthandizidwa panthawi yake, chikomokere chimayamba. Kuzindikira zomwe zimayambitsa vutoli ndizokhazikitsidwa ndi chithunzi cha chipatala, zotsatira za kuyesa koyesa, kuyesa kwamphamvu kwa glucose, ultrasound kapena kusanthula kwa tomographic kwa kapamba. Chithandizo cha pancreatic neoplasms ndikuchita opareshoni. Ndi mtundu wa extrapancreatic wa matenda, chithandizo cha matenda oyambitsidwa zimachitika, zakudya zapadera zimayikidwa.

Zambiri

Hyperinsulinism (matenda a hypoglycemic) ndi chinthu chobadwa nacho kapena chokhala ndi matenda am'magazi. Zizindikiro za matendawa adayamba kufotokozedwa koyambirira kwa zaka za zana la makumi awiri ndi dotolo waku America a Harris ndi dokotala wa opaleshoni yapakhomo Oppel. Congenital hyperinsulinism ndi chosowa kwambiri - 1 kesi pa 50,000 yatsopano. Matendawa amapezeka ndi zaka 35-50 ndipo nthawi zambiri amakhudza azimayi. Matenda a Hypoglycemic amapezeka ndi nthawi yosakhalapo kwa zizindikiro zazikulu (kuchotsedwa) komanso nthawi yayitali yopanga chithunzi (kuukira kwa hypoglycemia).

Kodi matenda ndi chiyani?

Kodi hyperinsulinism, ngati mungayang'ane mwatsatanetsatane? Mkhalidwe woterewu womwe umakula mthupi la munthu umatha kukhala woyamba komanso wachiwiri. Zomwe zimayambitsa zimachitika ndizosiyana, nthawi zambiri izi zimachitika chifukwa cha zovuta zakumunthu zomwe zimakhudza kapamba wamunthu. Njira yachiwiri yamatendawa imatha kuchitika chifukwa cha mitundu yosiyanasiyana ya ziwalo zomwe zimalumikizana ndi ziwalo zina zamunthu.

Matendawa ali ndi mawonekedwe enaake - sikuti chilumba chonse chokhacho chitha kukhudzidwa, komanso chidwi china. Kenako pali gawo limodzi la minyewa yomwe limakhudzidwa. Chithandizo chothandiza cha matenda a matenda ndizotheka pokhapokha mutadziwa zomwe zimayambitsa.

Zomwe zimayambitsa matendawa

Zomwe zimayambitsa matendawa ndizosiyana kwambiri. Ma neoplasms omwe amapezeka m'masukulu amatha kukhala ndi zoyipa komanso zoyipa. Nthawi zambiri, kukulitsa kwa matenda amzeru kumayenderana ndi kusokonezeka kwapakati pamanjenje. Ngati chifukwa chikugwirizana ndi kupanga mapangidwe ngati chotupa mu chifuwa cha hyperplasia, ndiye kuti mankhwalawo ayenera kukhala apadera.

Nthawi zambiri chomwe chimayambitsa matendawa ndi zovuta za insulin. Ngati munthu akuwonetsa mankhwala a insulin, ndikofunikira kumvetsetsa kuti zovuta za insulin. Kuphatikizika kwa mankhwala a insulin kungayambitse matenda enanso owopsa. Ngati hyperinsulinism chithandizo chake chitha kuchitika bwino lomwe momwe mungathere ndi chithandizo chamankhwala chapanthawi yake, ndiye kuti zovuta zina zimatha kusintha. Apa ndipomwe mavuto ambiri omwe amapezeka ndi chithandizo cha matenda ashuga komanso kukana insulin.

Ngati wodwalayo ndi wonenepa kwambiri, ndiye kuti mankhwalawo azikhala ovuta kwambiri, zomwezo zimagwiranso ntchito pa gawo loyamba la matenda a shuga. Pali zinthu zina zofunika kutchedwa:

dongosolo la endocrine lakhudzidwa (titha kuyankhula za kugonjetsedwa kwa hypothalamus kapena pituitary gland),
momwe kagayidwe kachakudya mthupi kamasokonezekera,
m'mimba, chiwindi chamunthu chimakhudzidwa.

Pali zifukwa zingapo, zonsezi ndizokhudzana ndi kuchuluka kwa shuga m'magazi a munthu. Nthawi zambiri matendawa amapangidwa mwa anthu omwe amapatsidwa chakudya chokhazikika, koma amayamba kungokhala ndi njala kwa nthawi yayitali.Zakudya zoterezi zimabweretsa zotsatira za kutayika kwawoko ndi kwofunikira kwa chakudya chamafuta.

Ngati chakudya chotopetsa cha munthu chikaphatikizidwa ndi kulimbitsa thupi, ndiye kuti izi zimachulukirachulukira. Thupi nthawi zambiri limayamba msanga. Izi ndizomwe zimayambitsa kukonzekera kwa matenda, ndipo tiyenera kuyankhula mosiyana za zizindikiro.

Zokhudza mawonekedwe azizindikiro

Monga taonera kale, matendawa amagwirizana mwachindunji ndi shuga ochepa m'mtsinje wamagazi. Chifukwa chake, zizindikirazo ndi zofunikira - munthu amamva kufooka, zimafikira kuti chikumbumtima chatayika. Makamaka ngati munthu asanafike pamenepo amatsatira zakudya zopatsa thanzi, zomwe zingayambitse kufooka kwa thupi.

Anthu akuvutika kwambiri ndi mutu wotalikilapo, amakhala ndi tachycardia msanga. Umboni wina womveka bwino wa matenda am'mimba umatchedwa thukuta, munthu amakhala wopitilira kuchuluka kosangalatsa. Munthu amakhala ndi njala nthawi zonse, alibe chakudya chokwanira. Kupanikizika kumachepa, kutentha kwa thupi kumatsikiranso, ndipo kukula kwa malungo ndi chizindikiro.

Miyendo imayamba kunjenjemera, khungu limakhala lodetsedwa, siligonjera kufinya.

Zizindikirozi zalongosoledwa mwa akulu, koma mwa ana, zizindikirazo zimatha kukhala zosiyana. Amangokhala ndi mantha, amatha kugwa m'mavuto (izi zimawonekeranso mu kugonana koyenera). Wodwala amatha kusokonezeka m'malo, koma chizindikiro choterocho sichimawonedwa nthawi zambiri. Mwa anthu onse, ngakhale ali ndi zaka zingati, amakonda matenda, kukhudzika kumayamba, chikhalidwe chawo chimafanana kwambiri ndi khunyu.

Matendawa amakula mwamantha komanso nthawi zonse. Fomu yodwalayo imayamba kukula, yomwe nthawi zambiri imathera pakoma. Zizindikiro zoyipa ndikutukuka kwa dziko loopsa komanso luso la luntha la munthu likuipiraipira. Payokha, ziyenera kunenedwa za zizindikiritso za matendawa m'mayimidwe ogonana mwamphamvu - kuwonjezera pa kufooka wamba, amayamba kukhala ndi mavuto akulu ndi potency.

Munthawi imeneyi, ubongo wamunthu umasowa kwambiri mu glucose ndi oksijeni, kudya kwawo kumachepetsedwa ndi 20 peresenti. Izi zitha kuchititsa kuti njala ya oxygen ipangike mu ubongo wa munthu. Ndipo izi zimakonda kukhala chifukwa chododometsa kwamachitidwe ambiri amkati ndi ziwalo.

Zokhudza njira zodziwira matenda

Chithunzi chachipatala cha matendawa chimakhudza mwachindunji njira zowonera. Zambiri zakale zimasungidwa. Kuzindikiritsa mosiyanasiyana ndikothandiza, chifukwa matendawa nthawi zambiri amakhala ndi zofanana ndi zovuta zam'mutu komanso zam'mitsempha. Ndikofunikira kugwiritsa ntchito njira zapadera zakufufuzira. Mwanjira imeneyi ndi pomwe chithandizo chokwanira chitha kukhazikitsidwa chomwe chikhala ndi zotsatira zabwino.

Kodi matendawa amakula bwanji?

Akatswiri amasiyanitsa zotsatirazi zomwe zimayambitsa kupezeka kwa matenda:

kapamba amayamba kutulutsa insulin yambiri.
chidwi cha insulin receptors amachepetsa - kukana insulini kumachitika,
kusintha kwa molekyu m'magazi kumasokonekera,
Kulephera posayina mu ma cellular ma cell (ma receptor ena sagwira ntchito, ndiye kuti glucose alibe njira yolowera mu ma cell).

Kuphatikiza apo, pali zinthu zingapo zomwe zimayambitsa hyperinsulinemia.

Kuwopsa kumawonjezeka mwa otsatirawa:

Nkhani yofananayi: Zizindikiro Za Kuchulukirapo kwa Magazi a shuga

wokhala ndi tsogolo komanso okhala ndi achibale odwala matenda a shuga,
kuphwanya lamulo lachifundo monga njala ndi kukwiya.
Nthawi zambiri amapezeka mwa azimayi, makamaka omwe ali ndi vuto la mahomoni, ngati apezeka ndi matenda a ovary polycystic, komanso matenda amiseche.
mwa anthu omwe sachita masewera olimbitsa thupi,
pamaso pa zidakwa.
mwa okalamba
motsutsana ndi maziko a kunenepa kwambiri - minyewa yambiri ya adipose imatsogolera ku mfundo yoti ma receptor amataya mwayi wawo wa insulin, ndipo kaphatikizidwe kake kamachepa,
Odwala atherosulinosis,
pa nthawi ya kusamba
ndi matenda oopsa
motsutsana ndi maziko a mankhwalawa ndi mahomoni osokoneza bongo, thiazide diuretics, beta-blockers.

Kuwonetsedwa pazinthu zovulaza kumakhudzanso dongosolo la endocrine

Zinthu zoterezi zimakhudza kufalikira kwa ma cell kuma cell. Kuwonjezeka kwambiri kwa insulin kungayambitse kukula kwa matenda a shuga, kunenepa kwambiri, komanso kukomoka kwa hypoglycemic. Kuphatikiza apo, pali zoopsa zosokoneza mu ntchito ya mtima.

Kodi matendawa amawonetsedwa bwanji?

Zizindikiro zakukula kwa matendawa kulibe, koma pambuyo pake pali zodziwikiratu za matenda am'thupi:

maonekedwe a mafuta m'mimba ndi kumtunda,
matenda oopsa
kumverera kwa ludzu
kupweteka kwa minofu
chizungulire
kusokonezeka ndende,
kunjenjemera ndi kuzizira.

Ndi hyperinsulinemia, munthu amayamba kufooka, kupha mphamvu, amatopa msanga

Ngati kuchuluka kwa insulini kumachitika chifukwa cha majini kapena matenda osowa, ndiye kuti pali zizindikiro zina:

kusawona bwino
Khungu limachita khungu, ndipo khungu limayamba,
mawonekedwe owoneka bwino pakhungu la pamimba ndi m'chiuno,
Wodwala akuvutika ndi kuchepa,
nkhawa za kuwawa m'mafupa.

Hyperinsulinemia ndi vuto lalikulu lomwe limafunikira uphungu wachipatala wovomerezeka.

Zomwe zimadziwika ndi matendawa

Kuchuluka kwa insulini m'magazi kumakhudza machitidwe osiyanasiyana a thupi ndipo kumalumikizidwa ndi matenda osiyanasiyana, chifukwa chake, kufufuza kwathunthu kumalimbikitsidwa.

Tebulo Na. 1. Njira zoyesera zopezera matenda a hyperinsulinemia

Kusanthula kapena kufufuza	Gawo la maphunziro ndi mawonekedwe
Kusanthula kwa kuzindikiritsa kwa mahomoni ena	Akatswiri ali ndi chidwi ndi mulingo:

insulin
cortisol (the hormone "nkhawa"),
TSH (thyrotropic prolactin),
ACTH (adrenocorticotropic timadzi),
aldosterone (steroid mahomoni a adrenal cortex),
renin (angiotensinogenase).

Kuyeza kwa magaziKuwunikira tsiku ndi tsiku kumayendetsedwa - chojambulira chapadera chimalumikizidwa ndi thupi la wodwala, chokhala ndi sensor yomwe imazindikira mawonekedwe ndi kutha kwa mafunde.Kuwerengeredwa kwa malamuloKatswiriyo amawonetsera mndandanda wamtundu (kulemera mpaka kutalika),

Chiyerekezo cha m'chiuno ndi m'chiuno chimathandizidwanso. UrinalysisAmasankha microalbuminuria - kupezeka kwamkodzo wa mapuloteni ochepa, omwe nthawi zambiri sayenera kukhala pano. Kuyesa kwa UltrasoundZikondamoyo, chiwindi, ndi impso zimayesedwa. Kuphatikiza kwamwaziAkatswiri ali ndi chidwi ndi kuchuluka kwa cholesterol yathunthu, ma triglycerides, otsika komanso otsika kwambiri a lipoproteins.

Kusanthulaku kumawululiranso kuchuluka kwa shuga pamimba "yopanda kanthu" ndikatha kudya. CT (zamtima),

MRI (imagonance imaging)Minyewa ya pituitary ndi adrenal cortex imayesedwa. Diagnosis imalembedwa kupatula kukhalapo kwa hypercorticism syndrome (matenda a Itsenko-Cushing).

Ndi zizindikiro za hyperisulinemia, tikulimbikitsidwa kuti tizichezera, kuwonjezera pa endocrinologist, kufunsa ndi akatswiri ena. Poterepa, dokotala wamtima, wazakudya, psychotherapist angakuthandizeni.

Kodi matendawa amathandizidwa bwanji?

Pazonse, monga matenda ashuga, malo oyamba ochiritsira matendawa ndi chakudya chomwe cholinga chake ndikuchotsa mapaundi owonjezera - osatinso kukongola, koma zambiri zaumoyo.

Maziko azakudya ndi kuchepa kwa calorie kudya

Mukamapangira zakudya, pali zinthu zingapo zofunika kuziganizira:

Kodi wodwala amagwira ntchito yanji (
kaya achite masewera kapena ayi
kulemera panthawi yolumikizana ndi katswiri, etc.

Kudya chakudya chamafuta - idyani katatu pa tsiku pazigawo zing'onozing'ono.

Ndikulimbitsa thupi mosakwanira, ziyenera kuchuluka, izi zimapangitsa kuti mankhwalawa akhale othandiza kwambiri. Komabe, pali zovuta zina - mphamvu yowerengera mphamvu imatha kusintha mkhalidwe wa wodwalayo ndikupangitsa vuto la matenda oopsa. Chifukwa chake, ndi hyperinsulinemia, ndibwino kusankha ntchito zina.

Kwa anthu omwe akuvutika kwambiri ndi shuga m'magazi, yoga, ma Pilates, akusambira, aerobics, aerobics yamadzi, ndi zina.

Kuwongolera zakudya komanso kudya moyenera ntchito, zomwe zimadalira kuwonjezeka pang'onopang'ono, ndizofunikira kwambiri pakulimbikitsa wodwalayo.

Kuphatikiza apo, chithandizo chitha kuphatikizanso mankhwala.

Tebulo Na. 2. Mankhwala omwe amapezeka ndi hyperinsulinemia ndi zotsatira zawo

Mtundu wamankhwala	Machitidwe
Mankhwala a Hypoglycemic: biguanides, thiazolidines	Mankhwala omwe amachepetsa magazi.
Mankhwala a antihypertensive	Wosankhidwa kuti achulukitse kuthamanga kwa magazi, komanso, chifukwa cha kulandila kwawo, ndizotheka kupewa kukula kwa matenda a mtima, stroko.
ACE zoletsa	Ntchito mankhwalawa matenda oopsa - kuchepetsa onse systolic ndi diastolic magazi.
Mabedi ndi Fibates	Amatanthauza kuti amachepetsa mafuta m'thupi.
Serotonin Reuptake Inhibitors	Mankhwala omwe amachepetsa chilakolako cha kudya.
Mankhwala okhala ndi Alpha-Lioic Acid	Amawonjezera kugwiritsidwa ntchito kwa glucose owonjezera ndikuchotsa cholesterol yowonjezera m'thupi.

Kufotokozera kwa matenda a hyperinsulinism

Hyperinsulinism ndi matenda omwe amadziwika ndi kuukira kwa hypoglycemia chifukwa cha kuchuluka kwathunthu kapena insulin.

Pali hyperinsulinism yapamwamba (yamtheradi, kapamba) yochokera ku adenoma, khansa kapena hyperplasia ya zisumbu za Langerhans, ndi sekondale (wachibale, extrapancreatic) yokhudzana ndi kuwonongeka kwa dongosolo lamanjenje kapena kuperewera kwa mahomoni olimbana ndi mahomoni.

Amakula nthawi zambiri ali ndi zaka 35-60 ndipo nthawi zambiri m'mabanja omwe ali ndi matenda ashuga. Amuna ndi akazi amakhudzidwa nthawi yomweyo. Chotupa choyipa sichachilendo. Hyperplasia ya ma islets okhala ndi hypoglycemia imawonedwa ndi kunenepa koyamba komanso koyambirira kwa matenda ashuga.

Zizindikiro zamankhwala zimachitika chifukwa cha vuto la hypoglycemic. Matenda a Hypoglycemic (insulinoma) amadziwika ndi Whipple triad:

The zimachitika mwadzidzidzi hypoglycemia pamimba yopanda kanthu, pambuyo minofu ntchito kapena maola 2-3 mutadya,
dontho la shuga m'magazi pomenya pansipa 1.7-1.9 mmol / l,
Kuchotsa (kupumula) kuukira kwa hypoglycemia nthawi zambiri kumachitika mwadzidzidzi.

Amawonetsedwa ndi kufooka kwakuthwa, maonekedwe, mutu, thukuta, kumverera kwanjala yayikulu, nthawi zina chisangalalo. Mochulukirapo, kuukitsidwa kumatha kutsatiridwa chifukwa cha kusakhala ndi chikumbumtima.

Mu hypoglycemia wodwala, zotsatirazi zalembedwa:

mphwayi
kuchepa kwa malingaliro,
kufooka
kusabala.

Kuphatikizika kwa machitidwe a hypoglycemic ndiko kukula kwa chikomokere (movutikira kwambiri).

Kodi chiwopsezo cha hyperinsulinism ndi chiyani?

Mkhalidwe womwe umaperekedwa koopsa ndi chifukwa cha zovuta zake, zomwe zitha kugawidwa koyambirira komanso mochedwa.Gulu loyambalo limaphatikizapo omwe amapangidwira maola angapo otsatira atawukira, awa:

sitiroko
myocardial infaration
kukulira kwakukuru kwa kagayidwe kazigawo zam'mimba ndi ubongo,
Pazovuta kwambiri, chikomokere chimapangidwa.

Mavuto omaliza omwe amadza chifukwa cha hyperinsulinemia amakula miyezi ingapo kapena zaka pambuyo pa matenda. Amadziwika ndi zovuta zingapo, monga: kusokonezeka kwa kukumbukira ndi kuyankhula, parkinsonism, encephalopathy (kuwonongeka kwa ubongo ntchito).

Kuperewera kwa chidziwitso ndikuchizira matenda kumayambitsa kukulira kwa kapamba ndi mapangidwe a shuga, komanso matenda a metabolic komanso kunenepa kwambiri.

The kobadwa nako mawonekedwe a hyperinsulinism mu 30% ya milandu amakhumudwitsa mawonekedwe a ubongo hypoxia, komanso kukula kwazonse kwamalingaliro okhudza ana. Chifukwa chake, hyperinsulinism ndi vuto lomwe limakhala ndi zovuta zambiri komanso zotsatira zoyipa.

Zizindikiro za matendawa

Kuukira kumayambira ndikusintha kudya, kuoneka thukuta ndi kufooka, komanso tachycardia, njala yayikulu. Kenako mayiko ena mwamantha amalumikizana: mantha, nkhawa, kusakwiya komanso kunjenjemera miyendo. Pomwe chiwopsezo cha hyperinsulinemia chikukula, zotsatirazi zadziwika:

kusanja m'mlengalenga,
diplopia (kuchuluka kwa zinthu zooneka),
paresthesia (dzanzi, kumva kukoma) m'miyendo, mpaka mawonekedwe a kugwidwa.

Ngati chithandizo sichikupezeka, kutha kwa chikumbumtima komanso kukomoka kwa hypoglycemic kumatha kuchitika. Nthawi yolumikizidwa imakhudzana ndikukulira kukumbukira, kusakhazikika m'maganizo, kusaganizira, komanso zizindikiro zina zosasangalatsa. Poyerekeza zakumbuyo chakudya chambiri chomwe chimadzaza ndi chakudya cham'mimba mosavuta, kuwonjezeka kwa thupi komanso kunenepa kwambiri kumayamba.

Kodi shuga ya magazi imatha kuchuluka chifukwa cha mitsempha, ndipo kupsinjika kumakhudza bwanji matenda ashuga?

Akatswiri azindikira madigiri atatu a hyperinsulinism, zomwe zimatengera kuopsa kwa maphunzirowa: ofatsa, odziletsa komanso okhwima. Zowunikira kwambiri zimagwirizanitsidwa ndi kusakhalapo kwa mawonetseredwe munthawi pakati pa kukomoka ndi kuwonongeka kwa organic ku colortex. Kuchulukitsa kwa matendawa kumawonekera kangapo kamodzi pamwezi. Imaletsedwa mwachangu ndi mankhwala kapena zakudya zotsekemera.

Ndi zovuta zolimbitsa thupi, kukomoka kumachitika kangapo pamwezi, kuchepa kwa mawonekedwe a ntchito ndi chikomokere ndikotheka. Nthawi pakati povutitsidwa imawonetsedwa ndikuphwanya malamulo, mwachitsanzo, kuyiwalako kapena kuchepa kwa malingaliro. Mulingo wadzaoneni umayamba chifukwa cha kusintha kosasintha kwa ubongo. Zovuta zimachitika kawiri kawiri ndipo zimapangitsa kuti anthu asamadziwe. Munthawi yakukhudzidwa, wodwala amataya malo, kukumbukira kumakulitsidwa, kugwedezeka kwamphamvu kumadziwika. Khalidwe ndikusintha kwa kusintha kwamkati komanso kusokonekera kwambiri. Popeza zonsezi, ndikofunikira kumvetsetsa mwatsatanetsatane zomwe zimayambitsa, chithandizo ndi kuzindikira kwa vutoli.

Zomwe zimachitika

Mawonekedwe obadwa nawo amapezeka chifukwa cha kukomoka kwa intrauterine mu chitukuko, chifukwa cha kuchedwa pakupanga mwana wosabadwayo. Matenda a m'mimba amathanso kukhala ndi masinthidwe amtundu. Zomwe zimayambitsa matendawa mwa anthu omwe amapezeka ndi matendawa amagawidwa m'magulu:

kapamba, kamene kamayambitsa kupangitsa matenda a hyperinsulinemia,
yopanda pancreatic, kupangitsa kuchuluka kwa insulin,
mawonekedwe a pancreatic amapezeka mu zilonda zapakhosi kapena benign neoplasms, komanso pancreatic beta cell hyperplasia.

Njira yopanda pancreatic ya hyperinsulinism mwa ana ndi akulu imatha kuyamba chifukwa cha zovuta zakudya (kusala kudya kwa nthawi yayitali, kutsegula m'mimba, ndi zina), kuwonongeka kwa chiwindi (oncology, cirrhosis, hepatosis yamafuta). Mukamayankha funso lomwe limayambitsa matenda, chidwi chimakopa mayina osagwiritsa ntchito shuga, mitundu ina ya ma endocrine. Mwachitsanzo, myxedema, matenda a Addison, kapena pituitary dwarfism.

China chomwe chingakhale kuperewera kwa ma enzymes omwe amaphatikizidwa ndi glucose metabolism (hepatic phosphorylase, aimpso insulinase, glucose-6-phosphatase).

Chithandizo ndi Thanzi

Ndi organic chiyambi cha hyperinsulinemia, opaleshoni yamankhwala opangira opaleshoni imachitika: kuchotsa pang'ono kapamba kapena kupindika konse, chotupa. Kuchulukitsa kwa opaleshoni kumalumikizidwa ndi malo ndi kukula kwa neoplasm. Pambuyo pa kulowererapo, kuchepa kwa mphamvu kwa hyperglycemia, komwe kumafunika kusintha kwa mankhwala ndi zakudya zomwe zimachepetsa kuchuluka kwa chakudya.

Kodi matenda ashuga amakhudza bwanji kuchuluka kwa amuna?

Matenda a mtundu wa zizindikiro za hyperinsulism amadziwika mwezi umodzi pambuyo pa opareshoni. Ndi neoplasms yosagwira, palliative mankhwala umachitika, womwe umalimbana ndi kupewa hypoglycemia. M'matumbo oyipa, chemotherapy akuwonetsedwa.

Yogwira ntchito kapena yobereka hyperinsulinism choyamba amafunika chithandizo cha matenda omwe amayambitsa matenda a insulin. Dziwani izi:

odwala akulimbikitsidwa kudya moyenera komanso kuchepa kosasintha kwa kuchuluka kwa chakudya chamagulu (100-150 gr. patsiku),
zokonda zimaperekedwa kwa zovuta za carbohydrate (mkate wa rye, supu ya tirigu wa durum, mbewu zonse za chimanga, mtedza),
chakudya chizikhala chopindika (kasanu mpaka kasanu ndi kamodzi patsiku). Chifukwa chakuti kuwukira kwakanthawi kumayambitsa kukhazikika kwa odwala, kuwerengera kwa katswiri wazama psychology kumalimbikitsidwa,
pakachitika vuto la hypoglycemia, chakudya chochepa cham'mimba (tiyi wotsekemera, maswiti, mkate woyera) amalimbikitsidwa.

Palibe kuzindikira munthu wamkulu kapena mwana, kulowetsedwa kwa 40% shuga kumasonyezedwa. Ndi zopweteka komanso chiwonetsero chazidziwitso cha psychomotor chodziwikiratu, ma utulivu ndi mayina osinkhitsa amayamba. Chithandizo cha kwambiri matenda a hyperinsulinism mapangidwe chikomokereni ikuchitika mu chisamaliro chachikulu ndi kuvomerezedwa detoxation kulowetsedwa mankhwala. Kukhazikitsidwa kwa glucocorticoids ndi adrenaline ndikulimbikitsanso. Ndikofunika kuti muzitha kudya pafupipafupi ndi insulinemia.

Kuchiza matenda

Mankhwalawa amatengera machitidwe a matendawa, motero, amasiyananso nthawi yanthawi yochulukitsa komanso kuchotsedwa. Pamavuto othandizirana, kugwiritsa ntchito mankhwalawa kumafunikira, ndipo nthawi yonseyo ndikokwanira kutsatira zakudya ndikuchiza matenda oyambitsa matenda a shuga.

Thandizo lakuonjezera:

idyani chakudya chambiri kapena kumwa madzi okoma, tiyi,
jekeseni shuga kuti muthe kukhazikika boma (kuchuluka kwake - 100 ml / 1 nthawi),
kumayambiriro kwa chikomokere, muyenera kuchita masewera olimbitsa thupi,
pakalibe kusintha, jakisoni wa adrenaline kapena glucagon uyenera kuperekedwa,
gwiritsani ntchito bata munthawi ya kupunthwa.

Odwala omwe ali ndi vuto lalikulu amayenera kupita kuchipatala ndi kulandira chithandizo moyang'aniridwa ndi madokotala. Ndi zotupa za England, kutengera kwa chiwalo ndi kuchitidwa opaleshoni kungafunike.

Zakudya za hyperinsulinemia zimasankhidwa poganizira zovuta za matendawa. Pafupipafupi komanso kovuta kusiya kukomoka kumaphatikizapo kupezeka kwa kuchuluka kwa chakudya chamagulu m'zakudya za tsiku ndi tsiku (mpaka 450 g). Kudya kwamafuta ndi zakudya zama protein kuyenera kusungidwa m'njira zopanda malire.

Munthawi yoyenera matendawa, kuchuluka kwa chakudya chopatsa mphamvu zomwe zimalandiridwa ndi chakudya patsiku sikuyenera kupitirira 150. Maswiti, confectionery, mowa suyenera kuperekedwa ku chakudya.

Kanema kuchokera kwa katswiri:

Kuti muchepetse kuwonetsa kwa hyperinsulinemia, ndikofunikira kuyang'anitsitsa njira ya matenda ashuga ndikutsatira malangizo akuluakulu:

idyani pang'ono komanso moyenera
Nthawi zonse onani kuchuluka kwa glycemia, sinthani ngati pakufunika,
samalani njira yoyenera yomwera,
khalani ndi moyo wathanzi.

Ngati kuphatikiza kwa insulin kwambiri chifukwa cha matenda enaake, ndiye kuti kupewetsa khunyu kumachepetsedwa ku chithandizo cha matenda am'mimba, omwe amakhala ngati chifukwa chachikulu cha mawonekedwe awo.

thumba losunga mazira
adrenal kotekisi
kapamba
zodabwisa
hypothalamus.

Kuphatikiza apo, pali kupanga kwambiri insulin limodzi ndi estrogens ndi androgens; zizindikiritso zonsezi ndikuwonetsa kuti hyperinsulinemia ili pafupi kuyamba m'thupi la wodwalayo.

Ngati mulingo wa insulin ukwera, ndiye kuti kulemera kumawonedwa, zomwe zimabweretsa kunenepa kwambiri kwamitundu yosiyanasiyana. Monga lamulo, zosanjikiza zamafuta zimamanga m'chiuno ndi m'mimba, zomwe zimawonetsa hyperinsulinemia.

Ngakhale kuti zomwe zimayambitsa vutoli zimadziwika, ndipo zizindikilozo ndizovuta kuzinyalanyaza, zimapezekabe masiku ano.

Kodi hyperinsulinemia ndi chiyani ndipo ndi chifukwa chiyani?

Matenda ambiri osachiritsika nthawi zambiri amakhala isanayambike matenda ashuga.

Chithandizo chamakono cha hyperinsulinism

Hyperinsulinism ndi endo native hyperproduction ya insulin komanso kuwonjezeka kwa zomwe zili m'magazi. Mawuwa amaphatikiza ma syndromes osiyanasiyana omwe amapezeka ndi vuto la chizindikiro cha hypoglycemic.

Ndikofunika kusiyanitsa mitundu iwiri ya hyperinsulinism - yachilengedwe komanso yothandiza. Organic hyperinsulinism imayamba chifukwa cha zotupa zopanga insulin za ma pancreatic islets. Yogwira ntchito hyperinsulinism imachitika mchikakamizo cha zakudya zosiyanasiyana zopatsa thanzi ndipo imayendera limodzi ndi kupangika kwa hypoglycemia patapita nthawi itatha kudya.

Kuyenera kukumbukiridwa kuti hypoglycemia imatha kukhala m'mikhalidwe yokhudzana ndi matenda, nthawi zambiri imadziwika ndi kuwonjezeka kwa minofu kupita ku insulin kapena kusakwanira kwa mahomoni olimbana ndi mahomoni.

Hypoglycemia imasokoneza njira ya matenda ena a endocrine (panhypogagguitarism, matenda a addison, hypothyroidism, thyrotooticosis, etc.), komanso matenda ena amtundu wina (chiwindi cirrhosis, hepatitis C yayitali, mafuta a chiwindi, kulephera kwa aimpso.

Chinsinsi chachikulu cha pathogenetic pakukula kwa matendawa ndi kuchuluka kwa insulin, komwe kumayambitsa kugwidwa kwa hypoglycemic. Zizindikiro za hypoglycemia zimachitika chifukwa kuphwanya mphamvu homeostasis. Omwe amamva kwambiri kuchepa kwa ndende ya magazi ndi njira zoyipa komanso zamagulu am'magazi.

Kusokonekera kwa njira zamagetsi ndi chitukuko cha zizindikiro zamatenda chifukwa chosakwanira kudya shuga kumachitika nthawi zambiri m'mene magazi ake amagwera m'munsi mwa 2,5 mmol / L.

Mawonetseredwe azachipatala

Hypoglycemia yozama imayambitsa kukula kwa zamomwe zimayambira mkati mwa dongosolo lamanjenje, kudziyimira kwamanjenje ndi ma endocrine, omwe amadziwika kuti akuphwanya ntchito za ziwalo ndi ziwalo. Udindo waukulu umayimbidwa ndi vuto la neuropsychiatric ndi chikomokere.

Phylogenetically magawo aubongo amatenga chidwi kwambiri ndi njala motero, koposa zonse, pali kuphwanya kwa zochitika zapamwamba kwambiri za cortical. Kale ndi kuchepa kwa kuchuluka kwa shuga m'magazi mpaka m'munsi mwa chizolowezi, malingaliro ndi zikhalidwe zitha kuwoneka: kuchepa kwa mphamvu ya kuyang'anitsitsa ndikuiwalika kukumbukira, kusokonezeka ndi nkhawa zamaganizidwe, kugona ndi kusowa chidwi, kupweteka kwa mutu komanso chizungulire.

Maonekedwe a zizindikiro zina ndi kuuma kwawo pamlingo wina zimadalira mawonekedwe a munthu, bungwe lamalamulo la chapakati mantha dongosolo.
Kumayambiriro kwa matenda a hypoglycemic, Zizindikiro zina zimatha kuphatikizidwa ndi kuphwanya kwamphamvu kwamanjenje, kumva kwamanjenje, kusowa tulo m'mimba, kuchepa kuwona kwakuthupi, kuzizira, kumva kunjenjemera kwamkati.

Psychopathological zimachitika ndi zovuta zamitsempha zimawoneka: stupor and disoriiting amafanana, kugwedeza kwa manja, milomo paresthesia, diplopia, anisocoria, kuchuluka thukuta, hyperemia kapena pallor pakhungu, kuchuluka kwa tendon.

Ndi kukulitsa kwa hypoglycemia, kuchepa kwa chikumbumtima kumachitika, kukoka kwamphamvu (tonic and clonic, trismus), tendon Reflexes imalephereka, zizindikiro za automatism zamkamwa zimawonekera, kupuma kosazama, hypothermia, atony ya minofu, ndi ana asanagwire ntchito. Kutalika kwa kuzunza kumakhala kosiyana. Zimasiyanasiyana kuyambira mphindi zochepa mpaka maola ambiri.

Odwala amatha kutuluka popanda vuto la hypoglycemia chifukwa chophatikizidwa ndi njira zotsutsana ndi zomwe zimapangitsa kuti pakhale kupangika kwa catecholamines, komwe kumapangitsa kuti glycogenolysis iwonjezeke m'chiwindi ndi minofu, komanso, kuti ivomereze hyperglycemia. Nthawi zambiri, odwala nawonso amayamba kumva kuwukira ndipo amatenga shuga kapena zakudya zina zopatsa mphamvu.

Chifukwa chakufuna kudya pafupipafupi kwa chakudya chochuluka, odwala amayamba kunenepa ndipo nthawi zambiri amakhala onenepa. Mobwerezabwereza kuukira kwa hypoglycemia komanso kutalika kwa nthawi yayitali kumatha kubweretsa zovuta zamitsempha. Odwala otere, mpaka akapezeka ndi insulinomas, nthawi zambiri amathandizidwa ndi akatswiri azamisala.

Zoyambitsa Hyperinsulinism

Zomwe zimayambitsa matendawa ndi:

Zilonda zopweteka komanso zopweteka zomwe zimapezeka kuzilumba za Langerhans.
Matenda a chapakati mantha dongosolo.
Tumor kapena tumizani pancreatic hyperplasia.
Kulemera kwambiri.
Magawo oyamba a shuga.
Kuwonongeka kwa ziwalo za endocrine system (pituitary, hypothalamus).
Matenda a metabolism.
Zowonjezerapo-zikondamoyo ndizo matenda am'mimba, chiwindi, ndulu.
Zakudya zokwanira ndi shuga.
Kusala kudya kwanthawi yayitali (anorexia, pyloric stenosis).
Kuchepetsa kwamphamvu kwa chakudya chamagulu chifukwa cha kutentha thupi kapena kulimbitsa thupi.

Hyperinsulinemia - zizindikiro zazikulu:

Zofooka
Zopweteka
Chizungulire
Pakamwa pakamwa
Khungu lowuma
Kugona
Kupweteka kwa minofu
Chisoni
Ludzu lalikulu
Masomphenya otsika
Kunenepa kwambiri
Lethargy
Maonekedwe a totambalala matanda
Kusokonezeka kwa m'mimba
Khungu limachita khungu

Hyperinsulinemia ndi matenda opatsirana omwe amadziwika ndi kuchuluka kwa insulin komanso shuga yochepa ya magazi. Njira yothandizirana ndi zoterezi imatha kubweretsa osati chododometsa pakugwira ntchito kwina kwa machitidwe ena a mthupi, komanso chiwopsezo cha hypoglycemic, chomwe chokha chomwe chili pachiwopsezo cha moyo wa munthu.

Matenda obadwa nawo a hyperinsulinemia ndi osowa kwambiri, pomwe owapeza amapezeka, nthawi zambiri, ali ndi zaka. Amadziwikanso kuti azimayi amakonda kutenga matenda otere.

Chithunzi chachipatala cha matenda azachipatalachi ndichachikhalidwe chachilendo, chifukwa, pakuwonetsetsa, dokotala amatha kugwiritsa ntchito njira zofufuzira zasayansi ndi zothandizira. Nthawi zina, matenda osiyanasiyana amafunikira.

Chithandizo cha hyperinsulinism chimachokera ku mankhwala, kudya komanso kuchita masewera olimbitsa thupi. Ndi zoletsedwa kuchitira zochiritsa mwakufuna kwanu.

Hyperinsulinemia imatha kukhala chifukwa cha zotsatirazi zotsatsa:

kuchepa kwa chidwi cha insulin receptors kapena kuchuluka kwawo,
kupanga kwambiri kwa insulin chifukwa cha njira zina za thupi.
kuchuluka kwa mamolekyu a shuga,
Kulephera posayina mu foni.

Zomwe zimapangitsa kukonzekera kwa njira yotereyi ndi izi:

kubadwa kwamtundu wamatenda amtunduwu,
kunenepa
kumwa mankhwala a mahomoni ndi mankhwala ena "olemetsa",
ochepa matenda oopsa
kusintha kwa thupi
pamaso pa polycystic ovary syndrome,
ukalamba
kupezeka kwa zizolowezi zoipa monga kusuta fodya komanso uchidakwa.
zolimbitsa thupi
mbiri ya atherosulinosis,
kuperewera kwa zakudya m'thupi.

Nthawi zina, zomwe ndizosowa kwambiri, zomwe zimayambitsa hyperinsulinemia sizitha kukhazikitsidwa.

Zizindikiro

Pa magawo oyambirira a chitukuko, zizindikiro za njirayi zimatsala pang'ono kuzimiririka, zomwe zimayambitsa kuzengereza kuzindikirika komanso kulandira chithandizo mosayembekezereka.

Pamene matenda azachipatala akuchulukirachulukira, zizindikiro zotsatirazi zingakhalepo:

ludzu losalekeza, koma limawuma mkamwa.
kunenepa kwam'mimba, ndiko kuti, mafuta amadzaza pamimba ndi m'chiuno,
chizungulire
kupweteka kwa minofu
kufooka, ulesi, ulesi,
kugona
khungu ndi kuuma kwa khungu,
zovuta m'matumbo am'mimba,
kuwonongeka kwamawonekedwe
kupweteka kwa molumikizana
Mapangidwe otambasuka chizindikiro pamimba ndi miyendo.

Chifukwa chakuti zizindikiro za matendawa ndi zopanda pake, muyenera kulumikizana ndi adotolo / chipatala kuti mupeze chithandizo choyambirira posachedwa.

Kodi matenda oopsa otani?

Matenda aliwonse pakalibe chithandizo choyenera amabweretsa zovuta. Hyperinsulinism imangokhala yovuta kwambiri, komanso yodwala, yomwe nthawi zambiri imakhala yovuta kwambiri kukana. Matenda osachiritsika amalepheretsa ubongo kugwira ntchito yake ndipo imakhudzanso wodwalayo, ndipo mwa abambo, potency imakulirakulira, yomwe imadzala ndi kusabereka.Congenital hyperinsulinism mu 30% yamilandu imatsogolera ku vuto la okosijeni la ubongo ndipo imakhudza kukula kwathunthu kwa mwana. Pali mndandanda wazinthu zina zomwe muyenera kulabadira:

Matendawa amakhudza kugwira ntchito kwa ziwalo zonse ndi machitidwe.
Hyperinsulinism ingayambitse matenda ashuga.
Pali kulemera kosalekeza ndimotsatira zotsatirazi.
Chiwopsezo cha kukomoka kwa hypoglycemic chikukwera.
Mavuto ndi mtima wamagetsi amakula.

Bwererani ku tebulo la zamkati

Zakudya za hyperinsulinism

Kodi zikuwonekabe zosatheka kuchiritsa matenda ashuga?

Poona kuti mukuwerenga izi tsopano, kupambana polimbana ndi shuga wambiri sikuli kumbali yanu.

Ndipo mudaganizapo kale za chithandizo kuchipatala? Ndizomveka, chifukwa matenda ashuga ndi matenda oopsa, omwe, ngati sanapatsidwe, amatha kufa. Udzu wokhazikika, kukodza mwachangu, masomphenya osalala. Zizindikiro zonsezi mumazidziwa nokha.

Koma kodi ndizotheka kuchitira zomwe zimayambitsa m'malo mothandizira? Timalimbikitsa kuwerenga nkhani yokhudza matenda a shuga omwe alipo masiku ano. Werengani nkhani >>

Momwe mungaperekere thandizo loyamba

Kukhala pafupi ndi munthu yemwe wapanga insulin yayikulu kulowa m'magazi, chinthu chachikulu sikuti kuchita mantha. Kuti muchepetse mkhalidwe wa wodwalayo, chotsani zizindikiro zoyambirira za kuukiridwa, muyenera kum'patsa maswiti okoma, kutsanulira tiyi wokoma. Zikatayika, gwiritsani ntchito shuga mwachangu.

Vutolo litasintha ndipo palibe chizindikiro chobwereza, wodwalayo amayenera kupita kuchipatala kapena akatswiri amayitanidwa kuti abwerere kunyumba. Zodabwitsazi sizinganyalanyazidwe, munthu amafunika chithandizo, mwinanso kuchipatala mwachangu, izi ziyenera kumvetsedwa.

Atakhazikitsa chidziwitso choyenera, dokotalayo amakupangira mankhwala, koma izi ndi mitundu yofatsa kwambiri ya matenda. Nthawi zambiri, njirayo imachepetsedwa kuchitapo kanthu opaleshoni, chotupa chimachotsedwa kapena ndi gawo lina la kapamba. Pambuyo pobwezeretsa magwiridwe antchito a kapamba ndi ziwalo zina, mankhwala ndi omwe amapatsidwa.

Ngati ntchito hyperinsulinism imawonedwa, ndiye kuti mankhwalawo amayang'ana kwambiri pakuchotsa matenda opatsirana ndikuchepetsa chizindikiro ichi.

Pochiza matenda a magwiridwe antchito a matendawa, kuopsa kwa matendawa, kutha kwa zovuta kuntchito ya ziwalo zina, komanso zovuta za mankhwalawa zimawerengedwa. Zonsezi zimabweretsa kuti odwala amalimbikitsidwa kudya kwapadera, komwe sayenera kuphwanya. Zakudya zopatsa thanzi kwa hyperinsulinism ziyenera kukhala zofunikira mokwanira, zokhala ndi chakudya chovuta kwambiri. Kudya kumakutambika mpaka 5-6 patsiku.

Zochitika ndi zizindikiro

Matendawa amafala kwambiri mwa akazi ndipo amapezeka azaka za 26 mpaka 55. Kuukira kwa hypoglycemia, monga lamulo, kumawonekera m'mawa pambuyo pothamanga mokwanira. Matendawa amatha kuthandizika ndikuwonekera nthawi yomweyo patsiku, mutatha kumwa chakudya.

Hyperinsulinism imatha kupangitsa kuti anthu azikhala ndi njala nthawi yayitali. Zina zofunika pakuwonetsa matendawa zimatha kukhala zochitika zosiyanasiyana zolimbitsa thupi komanso zokumana nazo m'maganizo. Mwa akazi, zizindikiro zobwereza za matendawa zimachitika pokhapokha ngati nthawi yotsala isanakwane.

Zizindikiro za Hyperinsulinism zili ndi izi:

njala yosatha
kutuluka thukuta kwambiri
kufooka wamba
tachycardia
womvera
paresthesia
diplopia
kumakhala ndi mantha osaneneka
kusokonezeka kwa malingaliro
kugwedezeka kwa manja ndi miyendo yake,
zochita zosakhudzidwa
dysarthria.

Komabe, zizindikirazi ndi zoyambira, ndipo ngati simungazichiritse ndikupitiliza kunyalanyaza matendawa, zotsatira zake zimakhala zokulirapo.

Mtheradi hyperinsulinism imawonetsedwa ndi zizindikiro zotsatirazi:

kulephera kwadzidzidzi
chikomokere ndi hypothermia,
coma ndi hyporeflexia,
tonic kukokana
kukokana kwamankhwala.

Kukodwa koteroko kumachitika kaŵirikaŵiri pambuyo poti mwadzidzidzi mwadzidzidzi.

Asanayambe kuukira, zizindikiro zotsatirazi zimawonekera:

utachepetsa kukumbukira
kusakhazikika mtima
kunyalanyaza kwathunthu ena
kutayika kwa maluso aukadaulo,
paresthesia
Zizindikiro za kuperewera kwa piramidi,
zamatsenga.

Momwe mungadziwire matenda?

kutsimikiza kwa kuchuluka kwa mahomoni m'magazi (insulin, ma pituitary ndi mahomoni a chithokomiro),
MRI ya pituitary gland yothandizirana ndi vuto lina kuti atulutse chotupacho,
Ultrasound yam'mimba, makamaka, kapamba,
Ultrasound yamchiberekero cha ziwalo za azimayi (kukhazikitsa kapena kupatula ma concomitant gynecological pathologies omwe mwina ndi omwe amachititsa kuti insulin iwonjezeke m'magazi),
kuthamanga kwa magazi (kuphatikiza kuwunikira tsiku lililonse pogwiritsa ntchito wowunika Holter),
kuyang'anira pafupipafupi shuga (pamimba yopanda kanthu komanso katundu).

Makanema okhudzana nawo

Kodi hyperinsulinism ndi njira yochotsera nthawi zonse njala, mutha kudziwa kanema uyu:

Titha kunena za hyperinsulinism kuti uwu ndi matenda omwe ungayambitse zovuta zazikulu. Amakhala ngati mtundu wa hypoglycemia. M'malo mwake, matendawa ndi omwe amasiyana kwambiri ndi matenda ashuga, chifukwa ndi omwe amapanga insulin kapena kupezeka kwake kwathunthu, ndipo ndi hyperinsulinism imachulukitsidwa kapena yopanda tanthauzo. Kwenikweni, kuzindikira kumeneku kumapangidwa ndi gawo la akazi.