Kodi lipodystrophy ndi chiyani? Kodi zimayambitsa kupezeka kwake ndi mitundu yanji yomwe ilipo?

Mawonetsero a shuga ndi ogwirizana komanso osiyanasiyana.

Amaphatikizanso kusokonezeka kwa mitundu yonse ya kagayidwe kazakudya kamthupi, kuphatikiza mafuta, mawonetsedwe omwe amatha kukhala onse atrophy of adipose minofu, komanso kukonzanso kwake kwapadera - lipohypertrophy.

Amawonetsedwa bwino ndi mawonekedwe a mafuta ochulukirapo, koma amakhudza kusintha kwina m'thupi.

Ichi ndi chiyani

Lingaliro la lipodystrophy (kuchepa kwamafuta) limaphatikizapo zosiyana kwambiri zoyambira ndi mawonekedwe a zovuta za metabolic mu adipose minofu, yomwe imakhala gawo lofunikira kwambiri pakakhala kuti pali chiwalo chilichonse.

Chifukwa chake, kukhalapo kwa wosanjikiza wamafuta kuvala impso zolimba pamwamba pa cholumikizira chake cha minofu yolumikizira kumathandizira kukhazikika kwa kutentha mkati mwa chiwalo, nthawi yomweyo kuyikonza pamalo ake (kuletsa kuthekera kwa kugwa).

Koma ngakhale chiwalo chilibe mawonekedwe owoneka amafuta, chimapezeka pamaselo a maselo - palibe khungu limodzi lomwe lingachite popanda kuphatikizidwa ndi lipid wosanjikiza momwe limapangidwira.

Lingaliro lalikulu la lipoatrophy limatha kupatsa thupi la othamanga-womangamanga wokhala ndi minofu yophweka. Koma ndi "koma" m'modzi: ngakhale atakhala kuti palibe mafuta ochulukirapo, amakhalabe nawo. Ndi lipoatrophy, kupezeka kwake ndikosatheka pamalingaliro, ngakhale kupangidwa kwa zakudya zapadera komanso kupatsidwa chakudya chambiri komanso zakumwa zomwe zimapangitsa kuti mafuta azikwanira (mowa, mafuta, mafuta, ma muffins).

Chowoneka chapadera cha lipodystrophy kuchokera ku dystrophy yodziwika bwino ndikokula wamba kwama minofu popanda zizindikiro zoletsa.

Lipohypertrophic dystrophy ndi gawo lamkati lama mafuta osunthika, chimodzimodzi ndi ulemu ndi zomwe zili pamwambapa.

Zitsanzo za biopsy (zomwe zikuyimira maikulosikopu opezeka pang'onopang'ono kuchokera ku chiwalo) zikuwonetsa chithunzi osati kuchuluka kwambiri kwa minofu ya adipose mumitsempha yolowerera, komanso kuchuluka kwa minofu yolimba, yopanda minyewa yolimba yomwe imamera mmenemu, yomwe ikuwonetsa kuvuta kwa kagayidwe kachakudya ndi kudziwikiratu. magawo okhala mpaka kuzama kwambiri.

Makanema onena za etiology ya lipodystrophy:

Mitundu ndi mawonekedwe a pathology

Kodi ndi njira ziti zomwe tafotokozazi - mitundu yamafuta osowa mafuta?

Poyamba, pali kusatetezeka kwa chiwalo (minofu, khungu, chiwindi) chifukwa cha zovuta:

• zakunja (kutentha kapena kutsika, kuvulala),
• zamkati (zosintha pakupanga magazi otuluka mu mawonekedwe a shuga wochepa kapena wapamwamba, poizoni ndi zinthu zina mkati mwake, kapena kukhalapo kwa matenda mkati mwake).

Lachiwiri likuchitira umboni pakudzipatula kwenikweni kwa malowo kapena malo oyandikana ndi nyumba, zomwe, moyenera, zimapangitsa kuti pakhale shaft yolimba mwamphamvu kwambiri, ndipo m'malo osapindulitsa, kufa kwa minofu yogwira ntchito ndikusinthidwa ndi bala.

Zolinga za maonekedwe

Pakupezeka ndi kupitilira kwa lipodystrophy, pali zifukwa:

• momwe mwabadwa mwokhazikika (mosasunthika, kapena kobadwa mwatsopano),
• kusokonekera kwa machitidwe amthupi m'thupi (kutengedwa).

Gawo loyamba limaphatikizapo zinthu zoyambitsidwa ndi:

• Family lipodystrophy,
• Matenda a Berardinelli-Seip.

Lachiwiri ndilochulukirapo, limaphatikizapo lipodystrophy:

• pang'ono (kutalikirana, zogwirizana ndi ziwalo za thupi), magawo a Barraquer-Simons syndrome,
• yodziwika (yokhudza thupi lonse),
• infantile (mawonekedwe a makanda) centrifugal pamimba,
• mendulo yooneka ngati mphete ya adipose minofu ya Ferreira-Markish),
• wodwala insulin
• Zokhudzana ndi HIV
• Mitundu ina yokhala ndi momwe chilengedwe chikuchitikira.

Lipodystrophy mu shuga

Vutoli limaphatikizidwa ndi kukhudzana ndi thupi la insulin, lomwe limayambitsa:

• kusinthana kwa chakudya osati mafuta okha, komanso mafuta ndi mapuloteni,
• kuyang'anira kukula kwa minofu ndi njira yosiyanitsira (kulekanitsidwa ndi kapangidwe koyenera, kamene kamatsimikizira kulondola kwa ntchito yawo),
• njira yowerengera majini, popanda omwe kuphatikiza kwa DNA ndikosatheka.

Ngati matenda a shuga alipo, insulin kukana matenda kumachitika - minyewa yachilendo imachitika munjira yonyalanyaza timadzi tambiri tomwe timayambitsa.

Pokhudzana ndi momwe zimapangidwira minofu ya adipose yokhala ndi jakisoni wokhazikika, izi zimatanthawuza kupezeka kwa kukhazikika kwa mphamvu zake zonse kwa hyper- ndi hypotrophy.

Mowoneka, izi zimawoneka ngati mawonekedwe a "zigamba" zamafuta pansi pa khungu kapena zimadziwika ndi "maenje" -mapapo pakhungu.

Kapangidwe ka mbiri yakale kumadera osowa:

• Ikulitsa njira yotengera insulin m'malo awa,
• Simalola kukwaniritsa kuyamba ndi kutha kwa zochita za insulin munthawi yoyenera kufotokozedwa (makamaka pazochitika zamankhwala omwe amapezeka nthawi yayitali).

Zizindikiro zake

Popeza kuti mafuta amayamba chifukwa cha insulin yeniyeni, sangathe kukhala ndi matenda ashuga a II (osagwirizana ndi insulin).

Amayenda limodzi ndi mtundu wa matenda a shuga a mtundu woyamba, owonetsedwa:

• ludzu
• matenda ashuga (pafupipafupi pokodza ndi mkodzo waukulu),
• kutsekemera kwamkodzo (kofotokozedwa ndi zomwe zili ndi shuga),
• chilakolako chosakwanira popanda chinyengo,
• njira kuwonda.

Lipodystrophy ya ziwalo zamkati siziwoneka kunja (kokha kusokonezeka kwachilengedwe kwa ziwalo zomwe zimayambitsidwa ndi ziwalozi kungayambike). Koma zokhudzana ndi khungu, sikungakhale kotheka kuzindikira zomwe zikuchitika.

Mu mwana - wodwala yemwe amadalira matenda a shuga, kupezeka kwa lipodystrophy kumatha kuzindikirika patapita nthawi kuchokera pachiwopsezo cha jekeseni: kuyambira masabata angapo mpaka zaka 8 kapena 10.

Amayi amakhalanso achilengedwe mwawonekedwe amasinthidwe amkhungu, omwe nthawi zambiri amakhala opanda:

• mtundu wa mankhwala ogwiritsidwa ntchito,
• mlingo wake
• kuopsa kwa nthendayi,
• mulingo wa kubwezera kwa kagayidwe kazakudya.

Kusintha kwa mtundu wa atrophic kumadziwika ndi kusintha kwa minyewa (yam'deralo, yocheperako jekeseni) kusintha kwa minofu, kapena amadziwika ndi kuwonongeka konsekonse komanso koyenera kwa gawo la mafuta osunthika pansi pa thupi lonse. Mwadzidzidzi, kupezeka kwawo kukufotokozedwa ndi kusakwanira kwa kuyeretsa kwa mankhwalawo, komanso kusagwirizana ndi jakisoni: kuyambitsa yankho silinaphatikizidwe, kulowetsedwa kwa zakumwa mu makulidwe a khungu.

Mtundu wa hypertrophic (lipohypertrophy) umawonetsedwa ndi mawonekedwe a tuberous, wotuluka kuchokera pakhungu lomwe limalowerera limapangidwa ndi minofu yokhazikika ya adipose yokhala ndi timitsempha tating'onoting'ono ta minofu ya khungu (onani chithunzi). Maonekedwe ndi kapangidwe ka ma conglomerate amenewa ndi chifukwa cha kusankha kwa insulini pamafuta a minyewa yochepa m'derali.

Chithunzi lipodystrophy chifukwa cha jakisoni wa insulin:

Kupezeka kwa lipodystrophy mu shuga kungaphatikizidwe ndi mawonekedwe ena a khungu:

• xanthomatosis,
• lipoid necrobiosis,
• kunenepa kwambiri.

Njira zochizira

Chifukwa cha kusazindikira zifukwa zonse zomwe zimapangitsa kuti boma la mafuta achedwe, mphamvu yothandizira pakapangidwe kake ndikukula sikungatheke, chifukwa chake njira zomwe zidagwiritsidwa ntchito zimangopereka zotsatira zazifupi.

Pakati pawo pali kugwiritsa ntchito:

• Zakudya
• maphunziro akuthupi
• njira zolimbitsa thupi (inductothermy ndi ultrasound).

Mphamvu ya ultrasound ikulowerera mkati mwa tiziwalo ndi masentimita 10, kusinthasintha kwake komwe kumapangitsa magazi kuyenderera, kumabweretsa kukula kochepa kwambiri kapangidwe ka mafuta. Kugwiritsa ntchito kwake limodzi ndi kugwiritsa ntchito mafuta a hydrocortisone kumathandizira kuti malo omwe akukonzedweratu akonzedwe mwachangu. Kugwiritsa ntchito njirazi kumakupatsani mwayi wolepheretsa kupitilira kwa miyezi isanu ndi umodzi mpaka zaka ziwiri.

Kuyesa kuletsa kukula kwa lipodystrophy poletsa kugwiritsa ntchito ma proteinase inhibitors, kusintha njira yodwirira kumwa mankhwala a ARVT (antiretroviralapy), komanso kugwiritsa ntchito njira zopangira opaleshoni ya zodzikongoletsera (kugwiritsa ntchito jakisoni ndi zodulira) zimangowonjezera zosakhalitsa.

Njira zophunzitsira izi zimayesedwa:

• kukula kwamunthu,
• testosterone
• mankhwala omwe amachepetsa kuchuluka kwa triglycerides ndi cholesterol m'magazi, komanso kuwonjezera insulin sensitivity.

Gawo lofunika kwambiri la mankhwala ndiwowonjezera kuchuluka kwa zochitika zolimbitsa thupi ndi zakudya (makamaka, zokhala ndi zinthu zambiri za fibrous zomwe zimakupatsani mwayi wolamulira insulin kukaniza, kukulitsa kamvekedwe ka thupi ndikuchepetsa chiopsezo cha mtima ndi mtima.

Kupewa kwa Mavuto

Chifukwa choti kukhalapo kwa mafuta osowa m'mimba kumapangitsa kuti matenda ayambe kuwabweretsera, njira zingapo zopewera ndizofunikira.

Mfundo zodziwikiratu ndikusungabe zolimbitsa thupi zolimbitsa thupi ndikutsatira zakudya zomwe zalimbikitsidwa, komanso kudya kwambiri mankhwala omwe dokotala amakupatsani poyang'anitsitsa thupi.

Pankhani ya momwe insulin imayambira, matenda omwe amapangidwako amathandizidwa. Ndikofunikanso kutsatira mosamalitsa malamulo a jakisoni (popewa kulocha pakhungu la pakhungu), thirani mankhwala obayidwa kutentha kwa thupi.

Kugwiritsa ntchito mitundu ya insulin yodziyeretsa kwambiri (monocomponent ndi monopic) komanso kukonzekera kwa insulin kokha kumathandizanso kupewa zovuta.

Kodi lipodystrophy (zambiri)

Kusiyanitsa kwakukulu pakati pa lipodystrophy ndi classical dystrophy: ndi kuchepa kwamafuta, minofu ya minofu ndi zizindikiro zina zofoola thupi sizimachepetsedwa. Nthawi zambiri pamakhala zotsutsana - minofu yambiri (yokhala ndi chakudya choyenera ndi masewera olimbitsa thupi) ikukula, yomwe imakhala ndi phindu pa chithunzi.

Mitundu, zizindikiro ndi zotheka za lipodystrophy

Kwakukulukulu, milomo yocheperako komanso yofatsa yomwe ilibe vuto lalikulu ku thanzi: ili ndi vuto lochita zodzikongoletsera. Komabe, nthawi zina zimakhudza malingaliro a odwala, makamaka azimayi.

Mantha amayamba chifukwa cha zilonda zam'mimba kwambiri m'magawo osiyanasiyana a thupi, ndipo makamaka, panalibe jakisoni wa insulin. Kwambiri, lipodystrophy imadziwika ndi kusowa mafuta kwathunthu pakhungu. Patsamba la lipoatrophy, pamakhala kuipiraipira kwa vascularization (mkhalidwe wa mtima wam'mimba), womwe umapangitsa kuphatikizira kwa insulin. Izi, zimalepheretsa kubwezeretsa matendawa ndikulepheretsa kuwerengera kwa nthawi ya kukonzekera kwa insulin. Zochitika zotsirizazi ndizowona makamaka kwa mankhwala omwe ali ndi mphamvu yayitali.

Ponena za hypertrophy (kuchuluka kwa mawonekedwe) a zotupa za adipose mu zigawo za jakisoni, kusinthaku kumakhudzanso kudana ndi kulowa kwa zinthu zomwe zimagwiritsa ntchito mankhwala a insulin m'mitsempha yamagazi. Kuphatikiza apo, lipomas (adipose) ndi chilema chooneka bwino.

Milandu yokhudzana ndi kukula kwa lipodystrophy popanda jakisoni wa insulin amadziwika: zinthu zotere zimabuka motsutsana ndi maziko a cholowa cha metabolism. Lipodystrophy yopanda jakisoni imatha kukhala chifukwa cha kukana insulini ndipo nthawi zambiri imaphatikizidwa ndi kupezeka kwa metabolic syndrome. Matendawa amakhala ndi kuphwanya kwa lipid komanso carbohydrate metabolism.

Kodi matenda a shuga a impso ndi chiyani? Werengani zambiri mu nkhaniyi.

Zoyambitsa lipodystrophy

• Makonzedwe olakwika a insulin (njira yolakwika ya jekeseni yomwe imatsogolera kuzunzika),
• Kutentha kochepa kwa mankhwala,
• Minofu kuvulala m'malo jakisoni insulin,
• Zochita za insulin monga chinthu chomwe chimapangitsanso lipolysis,
• Osakwanira mayankho chitetezo.

Ofufuza ambiri a matendawa amakhulupirira kuti kuwonongeka kwa mafuta m'thupi la wodwala yemwe ali ndi jakisoni wa jakisoni wambiri chifukwa cha njira yoteteza thupi. Thupi laumunthu limawona kuti jekeseniyo ndiwopseza thanzi lake ndipo m'njira inayake imayankha jakisoni.

Pali malingaliro akuti zotsatira za mahomoni "achilendo" pamthupi zimawonetsedwa mu "kubwezeretsanso" kwa ma metabolic metabolism. Zotsatira zake, njira za metabolic zimayamba kuchitika m'njira zopanda pake - makamaka, metabolism yamafuta imasokonekera: minofu ya lipoid imayamba kusandulika mphamvu.

Posachedwa, malingaliro awonjezereka afotokozedwa za ntchito yakuperewera kwa insulin. Izi zimawerengedwa kuti ndizomwe zimayambitsa kwambiri lipodystrophy. Pankhaniyi, insulin imagwira ntchito ngati antigen yomwe imagwiritsa ntchito chitetezo cha mthupi, nthawi yomweyo imawononga zigawo za mafuta.

Katundu wotchuka kwambiri wa antigenic amadziwika kuti amakonzekera insulin yomwe imapezeka kuchokera ku ng'ombe. Pachifukwa ichi, odwala omwe amakonda lipodystrophy ali osavomerezeka kuti azigwiritsa ntchito mankhwala ochepetsa kuyera. Ndikofunikira kugwiritsa ntchito insulin yaumunthu.

Pukusani ndi shuga. Pazifukwa ndi njira zamankhwala, werengani nkhaniyi.

Chithandizo cha Mankhwala ndi Kupewa

Chithandizo cha matenda a matenda a m'mitsempha cholinga chake ndi kuchepetsa kapena kuthetseratu zinthu zomwe zimapangitsa kuti mafuta azichoka. Pofuna kupewa makina, kutentha ndi kukwiya kwa mankhwala, njira yolondola ya insulin iyenera kutsatiridwa mosamalitsa.

• Insulin iyenera kugwiritsidwa ntchito pokhapokha kutentha, komanso kutentha kwa thupi (koletsedwa kugwiritsa ntchito mankhwalawo mwachangu mufiriji),
• Ndikofunikira kuti musinthe njira yoperekera mankhwala - jakisoni pamalo omwewo simunachitikenso masiku 60 aliwonse (dokotala adzakuwuzani mwatsatanetsatane za kutembenuka koyenera kwa jakisoni wa insulin),
• Jakisoni amapangidwa ndi jakisoni wa pulasitiki wotayika (ndi singano zopyapyala) kapena zolembera, womwe umachepetsa mwayi wovulala minofu.
• Kuchepetsa tsamba la jakisoni pambuyo poti jekeseni sakusokoneza.
• Ngati kupukuta khungu ndi njira yothanirana ndi jekeseni musanayambe jekeseni (zomwe sizimagwiritsidwa ntchito masiku ano), muyenera kuyembekezera nthawi zonse mpaka mowa utayamba kufalikira kuchokera pakhungu.

Madokotala ena amalimbikitsa kugwiritsa ntchito mapampu a insulin, omwe amachepetsa mwayi wokhala ndi jakisoni wina pambuyo pobayidwa. Ofufuza ena a lipodystrophy akuti akamagwiritsa ntchito munthu kapena porcine monocomponent insulin (osachita nawo ph ph), ndiye kuti palibe milandu yamafuta ofooka.

Ngati lipodystrophy yoopsa ilipo kale, musanathetse zotsatirapo zake, ndikofunikira kupenda zomwe zidapangitsa kuti matenda amenewa afalikire. Poyamba, kuyika kwa mankhwala a mahomoni kumadera omwe adipose minofu ya atipor imayenera kutsimikiziratu. Mwa ena, kuyambitsa insulin kumathandiza ndi mankhwala a Novocaine.

• Electrophoresis ya madera omwe akhudzidwa (makonzedwe a Novocaine kapena Lidase mwa kukondoweza kwa magetsi),
• Ntchito za parafini pamadera omwe akhudzidwa,
• Inductometry ndi njira yolimbitsa thupi yochokera pakukonzekera mphamvu yayitali yamagetsi,
• Kusintha kukonzekera kwa insulini (kuphatikiza kutikita minofu pamalo a jekeseni),
• Ultrasound mankhwala - ultrasound imakwiyitsa makina ogwiririka mu minofu yakuya kwambiri, yomwe imathandizira kuyendetsa magazi ndi kagayidwe: zotsatira za ultrasound zimaphatikizidwa ndi chithandizo cha omwe akhudzidwa ndi mafuta a hydrocortisone,
• Kukhazikitsidwa kwa mankhwala a mahomoni a gulu la anabolic kuti mulimbikitse kupanga mafuta.