Zizindikiro zazikulu ndi zomwe zimayambitsa lactic acidosis mu shuga

Unduna wa Maphunziro a Russian Federation

Penza State University

Kugawidwa kwa MCA kumakhazikitsidwa ndikuphwanya kwa oxygen. Mtundu A MCA umagwirizanitsidwa momveka bwino ndi matenda a hypoperfusion kapena hypoxia, ndipo mtundu B umaphatikizapo mitundu ina yonse ya MCA momwe mulibe zizindikiro za kudzodza kwa minyewa. Mankhwalawa cholinga chake ndicho kuzindikira ndi kuwongolera zovuta zam'mbuyomu komanso kukhazikitsa bwino-acid acid.

Babesiosis imafalikira ndi nkhupakupa zoyipa za ixodid. Nkhupakupa zazikazi zazikulu zimabweretsa kuukira ndipo zimayambira. Makanda akangolowa m'thupi la wolandirayo, amayamba kulimbana ndi nembanemba ya erythrocyte ndikufalitsa kudzera mu endocytosis. Nkhupakupa zimatenga kachilomboka pakamwa ma merozoites poyamwa magazi a nyama yomwe ili ndi kachilombo.

Kutupa kwambiri kumadziwika ndi kutentha thupi, kufooka, komanso kuchepa magazi m'thupi, pomwe stroko yamphamvu imawononga kwambiri minofu ndipo siyachilendo. Matenda owopsa amakhala ndi anorexia, hemolytic anemia, thrombocytopenia, kukulira kwa lymph node, ndulu yokula. Kusowa kwa magazi, ulesi, ndi kusanza ndi zizindikiro zodziwika bwino. Immuno-mediated hemolytic anemia ndi systemic lupus erythematosus ndi matenda oyamba omwe amasiyana ndi mtundu uwu wa babesiosis.

MCA imatchulidwa molingana ndi mawonetseredwe azachipatala ndipo imawonedwa m'njira ziwiri zazikulu. Malinga ndi gulu la Cohen ndi Wood, mtundu A MCA umachitika ndikudziwikanso kwa ma minofu (mwachitsanzo, kugwedezeka kapena chifuwa chachikulu). Mtundu B MCA umaphatikizapo mitundu ina yonse momwe mulibe zizindikiritso za minyewa ya matexia (Gome 1). IC2 yokha, kapena idiopathic, ICA imafotokozedwa, koma kupezeka kwake kukukanidwa. Kuzindikira kuwonjezeka kolimba kwa matenda omwe MCA imatha kuchitika popanda kudzipatula kwa minofu pafupifupi kumathetsa gulu ili (i.e., idiopathic MCA). Njira yatsopano ya metabolic, D-MKA, ikufotokozedwanso. Izi zimawonedwa mwa odwala omwe ali ndi matumbo aatomiki kapena ochita kufupikitsa matumbo ang'ono. Bacterial Fermentation imatulutsa D-lactic acid, yomwe imatha kuyamwa ndikuyambitsa acidosis chifukwa cha anionic gap, komanso stupor kapena chikomokere. Madzi a Plasma L - lactate okwanira amakhalanso abwinobwino. Kuwongolera zovuta zama metabolic kumatheka pogwiritsa ntchito neomycin kapena vancomycin. Nkhani imodzi ya D-MKA wodwala popanda anatomical kapena kufupikitsa matumbo aang'ono akufotokozedwa.

Matenda obwera a babesiosis osakhala owonekera bwino m'chipatala. Kuyesedwa kwa Laborator kumatha kuwonetsa kuchepa kwa hemolytic anemia ndi thrombocytopenia. Njira yodwala yamatenda nthawi zambiri imawonedwa, makamaka ku United States.

Agalu amakhala ndi vuto la kufinya, zotupa za mucous, splenomegaly, hepatomegaly, kukula kwa mwanabele komanso kufinya. Babesiosis mu agalu amatha kugawidwa muzovuta komanso zosavuta. Zosavuta kuchitika zimachitika ndi matenda omveka bwino matenda. Zosavuta - njira ndi kuuma kwa matendawa kumatengera kuvutikira kwa tizilomboti komanso kutengera komwe munthu wakupatsidwayo amakhala nako. Kutenga kachiromboka limodzi ndi zinthu zina kumatha kubweretsa kusokonekera kwa chithunzi cha chipatala ndi chitetezo cha mthupi. Nyama zokhala ndi babesiosis wosavuta ndizosavuta.

Lembani A lactic acidosis

Umu ndi mtundu womwe umadziwika kwambiri ndi MCA mu SNPs, nthawi zambiri chifukwa chodzidzimutsa. Monga tawonetsera, mtundu uwu wa MCA umatha chifukwa cha hemorrhagic, hypovolemic, Cardiogenic kapena septic. Maziko a pathogenesis a MCA pokhumudwa ndi kuperewera kwa minofu kotsatidwa, komwe kumatsatiridwa ndi anoxia ndi kudzikundikira kwa lactate ndi ion hydrogen. Lactate clearance ya chiwindi imachepa chifukwa kuchepa kwa mafuta mu celiac ndi hepatic mitsempha ndi kukula kwa hepatocellular ischemia. Pa pH pafupifupi 7.0 kapena kutsika, chiwindi ndi impso zimatha kukhala ziwalo zobala.

Khalani ndi zizindikiro zamankhwala zomwe zimakhudzana ndi pachimake hemolysis, kuphatikizapo kutentha thupi, matenda a m'mimba, kukhumudwa, zotupa za mucous membrane, splenomegaly. Fomuyi imatha kuthandizidwa kuti ikhale yodziwika bwino, yochepa kapena yolimba, kutengera kuperewera kwa magazi m'thupi. Tiyenera kukumbukira kuti kufewetsa matenda osakhazikika a matenda obwera chifukwa cha matenda kumatha kuchepa kwambiri chifukwa cha kuperewera kwa magazi m'thupi.

Kuyenda kwamtunduwu - m'magulu ena agalu, mitundu yodziwika bwino ndi yofala. Mwachitsanzo, agalu ambiri ku United States ndi seropositive a babesiosis, koma zizindikiro zamankhwala ndizosowa mu agalu akuluakulu. Komabe, onyamula subclinical samawonetsa zizindikiro zamatenda a bacteriosis, ngakhale samakhala ndi zizindikiro za kupsinjika kapena chithandizo cha glucocorticoid.

Ubale pakati pa mantha ndi MCA wayandikira kwambiri kotero kuti kuwunika koyambirira kwa MCA wodwala kwambiri pamkhalidwe wodabwitsa kungapangike ndi kuwonekera kwadzidzidzi kwa hyperventilation ndikuwonjezera acidosis chifukwa cha anionic gap. Chithandizo cholinga chake ndi kukonza causative chinthu chododometsa. Ofufuza ena awona kulumikizana mwachindunji pakati paimfa ndi magazi ochepa kwambiri okwanira m'magazi omwe ali ndi nkhawa. Ena amawona kuti kuphatikizika kwa mankhwalawa kumawonekera bwino, ndipo kugwiritsa ntchito kwa lactate concentration ngati chidziwitso chodziwikiratu pazotsatira za matendawa sikugwirizana. Monga lamulo, kukwera kwambiri kwa magazi kumakhudzana, ndizochedwa kufa.

Amakhala oopsa, ndi anorexia, kutsegula m'mimba. Kutentha kwambiri ndi jaundice ndi zizindikiro zofala. Anemia ndiye chifukwa chachikulu cha zizindikiro zamankhwala. Nthawi zambiri, matendawa amakhala osachiritsika, ndipo zizindikiro zimayamba kuonekera pokhapokha matendawa atadwala. Amphaka nthawi zambiri amakhala ndi vuto la kuchepa magazi m'thupi pokhapokha ngati matendawa akuwonekera - matendawa amatha kukulitsidwa ndi kupsinjika kapena matenda. Mavuto a kuchepa kwa magazi m'magazi ndi monga hepatopathies, pulmonary edema, kulephera kwa impso, zizindikiro za matenda amanjenje, komanso matenda opatsirana.

Hypoxia itha kuyambitsa mtundu wa A MCA, koma iyenera kukhala yovuta komanso yoopsa. Odwala omwe ali ndi matenda osakhazikika a m'mapapo amatha kutetezedwa ku matenda a MCA mwa njira zosinthika monga polycythemia, kuchepa kwa mgwirizano wa hemoglobin wa okosijeni komanso kuwonjezeka kwa minofu ya okosijeni.

Matenda ofunika kwambiri a MCA mu odwala sangathe kukula mpaka PO 2 m'magazi am'mimba akafika 30 - 35 mm Hg. Art. Odwala omwe atha kuchepa mphamvu kuti athe kulipira kupuma, MCA imatha kuchitika ndi vuto lalikulu kwambiri la okosijeni. Kukula kwa MCA kumalumikizidwa ndi asphyxia, pulmonary edema, mkhalidwe wa asthmatic, wodziwika ndi kuchulukitsa kwa matenda osatha a m'mapapo komanso kuthawa kwa okosijeni ndi carboxyhemoglobin, sulfhemoglobin kapena methemoglobin.

Amphaka ali ndi michere ya chiwindi ndi bilirubin yokwanira. Chithandizo: Funsani veterinarian. European Medicines Agency yati mankhwala omwe ali ndi metformin angagwiritsidwe ntchito kale kwa odwala omwe ali ndi vuto laimpso kuwongolera matenda a shuga a 2. Zambiri pazogulitsa mankhwalawa zidzasinthidwa ndi contraindication yowunikanso ndipo zimapereka mlingo wosinthidwa, kutsata, komanso kusamala kwa odwala omwe ali ndi kuchepa kwa impso.

Kuphatikiza apo, zambiri zamalonda zamakampani, zomwe zikusiyana ndi dziko ndi zogulitsa ku EU, sizikugwirizana ndi malangizo amakono azachipatala. Metformin imatha kuwonjezera ngozi yovuta koma yovuta kwambiri yotchedwa lactic acidosis, yomwe imayamba pomwe kupanga lactic acid kumakula m'magazi mwachangu kuposa momwe kungachotsere. Zambiri zam'mbuyomu zikuwonetsa kuti metformin sayenera kugwiritsidwa ntchito mwa odwala omwe ali ndi vuto laimpso, chifukwa odwalawa amawaganizira kuti ali pachiwopsezo chotenga lactic acidosis chifukwa chosakwanira kufotokozera metformin kuchokera ku impso zawo.

Lembani B lactic acidosis

Mtundu B ukuphatikiza mitundu yonse ya MCA momwe mulibe zizindikiro za matenda amisempha. MCA yamtunduwu imatha kudzidzimuka mwadzidzidzi, patangopita maola ochepa. Matendawa nthawi zambiri amachitika mochedwa kwambiri chifukwa cha kusazindikira kwa zina zomwe zachitika kapena chifukwa chakusazindikira kwa dotolo za mgwirizano wamatenda angapo ndi mtundu B MCA. Zomwe zikuwonetseratu zovuta za MCA sizodziwikiratu. Mwakutanthauzira, ntchito yamtima ndi yosagwirizana ndipo kuthamanga kwa magazi sikuchepa. Monga chifukwa chotheka, kuphwanya kwapadera kwa minofu kumakhudzidwa. Nthawi zambiri mtundu wa B BA wovuta kwambiri, kulephera kwa magazi kumaonekera patadutsa maola angapo pambuyo pa kuyamba kwake, zomwe zimapangitsa kuti matendawa asadziwike kwa mtundu A A MCA. Mtundu wa B BA udagawika m'magulu atatu (B 1, B 2 ndi B 3).

Malangizo omveka bwino a dosing ndi kuwunika isanachitike komanso panthawi ya chithandizo ndi cholinga chochepetsera chiwopsezo chilichonse cha odwala. Kusiyanitsa kwa odwala omwe ali ndi vuto laimpso kwambiri kumakhalabe kovomerezeka. Makampani okhala ndi Metformin adzafunika kuwunika mozama ndi kusanthula mtsogolo zamatenda a lactic acidosis ndikuwawuza nthawi yomwe ikubwereza ndemanga zachitetezo chamunthawi kuti kuwunike kusintha komwe kukuwoneka ndi izi.

Mtundu B ukuphatikiza mitundu ya MCA yomwe imachitika motsutsana ndi kumbuyo kwa matenda ena, monga matenda ashuga, chiwindi ndi impso, matenda, neoplasia komanso mikhalidwe yopweteka. Palibe kuyanjana kwodziwika bwino pakati pa matenda ashuga ndi MCA, koma ubale wina pakati pawo udadziwika ndi olemba ambiri. Cohen ndi Woods adazindikira kuti 10-15% ya odwala matenda ashuga omwe ali ndi ketoacidosis ali ndi magazi lactate ambiri osachepera 5 mEq / L. Zilonda za chiwindi zomwe zimatsatiridwa ndi MCA zimaphatikizapo chachikulu necrosis ndi cirrhosis. Zikatero, chifukwa cha MCA chimatha kuchepa kwa chiwonetsero cha chiwindi ndi chiwindi chifukwa chosakwanira minofu ya chiwindi nthawi ya gluconeogeneis. Kulephera kwamphamvu komanso kwakanthawi kwa impso nthawi zambiri kumayendetsedwa ndi ICA, komabe, kukhalapo kwa ubale wapamtima kumakayikira kwambiri. Mwa odwala ena omwe ali ndi matenda oopsa, makamaka bacteremia, MCA imayamba pazifukwa zosadziwika. Kulowerera kudalipo 27 mwa 65 milandu ya mtundu wa B BAs yomwe idasinthidwa ndi Cohen ndi Woods. Lactic acidosis imayendera limodzi ndi matenda a myeloproliferative monga leukemia, myeloma yambiri, matenda a lymphoma komanso matenda a Hodgkin. Matenda a khunyu okonzedwa ndi Grandmal angayambitse Kukula kwa MCA chifukwa cha kuphipha kwa minofu ndipo, mwina, hypoxia. Nkhani ya MCA mu Reye matenda akufotokozedwera. Ubale wapakati pakati pa gawo la chikomokere ndi kuchuluka kwa lactate m'magazi unadziwika.

Zambiri pazogulitsa zomwe zimakhala ndi metformin zidzasinthidwa kuti zisonyeze malingaliro atsopano ndikuwonetsetsa kuti odwala onse a EU akupatsidwa malingaliro omwewo. Zambiri kwa akatswiri azachipatala. Kuchokera pa kuwunikira kwa chitetezo cha mankhwala omwe ali ndi metformin, zimadziwika kuti mankhwalawa amatha kugwiritsidwa ntchito kale kwa odwala omwe ali ndi vuto laimpso. Zambiri zamalonda zilinso ndi chidziwitso pazoyopsa za lactic acidosis, zomwe zimayenera kuyesedwa kale komanso nthawi yamankhwala. Ku Europe, pali zinthu zingapo zomwe zimakhala ndi metformin pamagulu osakanizira a mlingo. Ngati zinthu zoterezi zimagwiritsidwa ntchito kwa odwala omwe ali ndi vuto la impso, contraindication, kugwiritsa ntchito bwino komanso mulingo wa chinthu china chophatikizika, komanso kugwiritsa ntchito mankhwala omwe ali ndi chinthu chimodzi chogwira ntchito, ziyenera kukumbukiridwa. Mankhwala ena okhazikika osavomerezeka kuti agwiritsidwe ntchito ndi odwala omwe ali ndi mphamvu yaimpso, chifukwa chophatikiza chinacho chophatikiza sichili choyenera kugwiritsa ntchito mwa iwo. Metformin ndi mankhwala omwe amagwiritsidwa ntchito okha kapena osakanikirana ndi mankhwala ena othandizira matenda a shuga.

Chigawo ichi chimaphatikizapo mitundu ya MCA yomwe imayamba chifukwa cha mankhwala, mankhwala ophera tizilombo ndi poizoni. M'mbuyomu, kupezeka kwa mtundu uwu wa MCA kunali kogwirizana ndi kugwiritsa ntchito mankhwala a hypoglycemic drug phenformin, ndipo pano amangochotsa ku United States. Ethanol amakonda kwambiri MCA. Pa makutidwe ndi okosijeni a mowa, zomwe zili mu NADH m'magazi zimachulukitsa, zomwe zimatsogolera kuti ntchito ya pyruvate - lactate kagayidwe kachakudya poyipa mobwerezabwereza wa NADH. Panthawi imeneyi, mulingo wa lactate m'magazi umachulukako pang'ono. Pamaso pazochitika zina za MCA, kumwa mowa kumatha kuwonjezera acidosis. Kutuluka kwa MCA kumalumikizidwanso ndikugwiritsa ntchito fructose, sorbitol, kuchuluka kwa adrenaline ndi ma catecholamines ena, methanol ndipo mwina, ma saliylates. Kugwiritsa ntchito mankhwala ena ambiri kumagwirizananso ndi kukula kwa MCA.

Metformin imagwiritsidwa ntchito molumikizana ndi zakudya komanso regimen yamagetsi kuti chiwongolere magazi a shuga. Mapeto a Komitiyi atumizidwa ku European Commission, yomwe ikapereka chigamulo chomaliza kumayiko onse a EU mamembala. "Ntchito zogwiritsira ntchito ndi matupi omwe amayang'anira SAS."

Okonzedwa ndi: Nevena Dzhulianova Angelova. Ana - ndi njira za kagayidwe ka kagayidwe kachakudya kathupi kamunthu pazinthu zovomerezeka ndizofanana ndi proton ndi bicarbonate. Urea woperekayo umachotsedwa mkodzo. Zakale zimawonetsa kukula kwa aerobic metabolism, ndipo izi zomaliza zimagwirizanitsidwa kwambiri ndi kuwonongeka kwa sulfure okhala ndi amino acid, phospho, nucleo - ndi glycoproteins. Kuitanitsa zinthu zopangidwa ndi anionic zosakaniza kumawonjezera kupanga kwa NGO. Kuchotsa kwakanthawi maselo olekanitsidwa ndi maselo ndi ntchito yosinthanitsa ndi madzi otuluka ndi madzi otuluka.

Matenda amtunduwu a MCA ndi osowa kwambiri ndipo amayamba chifukwa cha zolakwika za "metabolic zolakwika" monga mtundu wa glycogenosis (glucose-6-phosphatase akusowa) komanso kuchepa kwa khungu la hepatic fructose bisphosphatase. Mitundu yobadwa nayoyi ya MCA imaphatikizaponso zolakwika mu gluconeogenesis, pyruvate-dehydrogenase tata, kayendedwe ka Krebs, ndi ma cell kupuma ma cell.

Chofunikira kwambiri ndi machitidwe a bicarbonate ndi hemoglobin buffer. Kuwerengera kwa zigawo za ma buffer awiriawiri mu kachitidwe ndi "kalilole" wazomwe zimapangitsa asidi kuzungulira thupi. Mawu akuti acidosis ndi alkalosis amagwirizanitsidwa ndi njira zomwe zimapangitsa kusintha kwa ndende ya hydrogen. Homeostasis ya ndende ya hydrogen mu thupi kumadalira njira zingapo, ndizofunikira kwambiri zomwe zili. Dongosolo la buffer ndi yankho la acid ofooka ndi maziko ake, omwe amapatsa yankho kuthekera kosungirako pH yake kapena kusintha pambuyo poonjezera kuchuluka kwazidulo ndi maziko kuti afotokozere mphamvu ya buffer.

Cholinga chachikulu cha chithandizo cha MCA ndikuwona ndikuwongolera zomwe zimapangitsa kuti pakhale kuchuluka kwa lactic acid komanso kuthana ndi zovuta za acidosis m'thupi. Kupezeka kwa MCA yofunika kwambiri kumawonetsa matenda oyamba asanakwane. Kupulumuka kwa wodwala kumadalira, choyamba, pakuzindikiridwa kwakanthawi kwa zomwe zimayambitsa MCA ndikuwathetsa kwake.

Njira zamagetsi zomwe zimasunga izi pH bwino ndizabicarbonate, phosphates ndi mapuloteni. Bicarbonate ndiye chakudya chofunikira kwambiri chakunja chomwe chimakhala ndi ma phosphates ndi mapuloteni, makamaka zimapangitsa kuti mulingo wothandizirana ndi intracellular acid-base.

Dongosolo la bicarbonate limangokhala gawo lazowerengera zamtundu wa alkaline acid ndipo limayimiriridwa ndi equation ya equilibrium. Kachitidwe ka buffer mthupi mthupi kamakhala ndi mphamvu yosiyanasiyananso, monga momwe timafunira. Magazi ndi njira yolimbira yokhala ndi magawo awiri amadzimadzi, plasma ndi khungu lofiira, lolekanitsidwa ndi membrane wa semipermeable erythrocyte. Potengera izi, malonda amayenera kuchotsedwa. Bicarbonate imatha kuyambitsa matenda m'mavuto ngati minofu hypoxia ilipo.

Kutsimikizika kwa mankhwalawa kumatsimikiziridwa ndi chifukwa cha matendawo. Mkhalidwe wakunjenjemera ndi hypoxia umafunika kukonza mwachangu. Kuwongolera mpweya wokwanira ndikofunikira. Kubwezeretsa kuthamanga kwa magazi, kutulutsa kwamtima ndi mtima wa minyewa yokhala ndi magazi okhala ndi mpweya wofunikira ndikofunikira. Kuchulukana kwa mankhwalawa kumachitika pogwiritsa ntchito madzi amkati, m'malo mwa plasma, kapena magazi (monga akuwonetsera). Mwinanso, muyenera kupewa kugwiritsa ntchito vasopressors, chifukwa amatha kuchepetsa kunenepa kwa minofu ndi kukulitsa acidosis. Mikhalidwe yokhala ndi mtima wochepa yotulutsa imathandizidwa ndi mankhwala ophatikizana ndi mankhwala omwe amachepetsa pambuyo pake. Catecholamines amalimbikitsa glycogenolysis ndipo angakulitse kupanga lactic acid. Ndi mtundu B MCA, nthendayi yam'mbuyomu sikuti imadziwika mosavuta kapena kutha. Kumwa mankhwala ogwirizana ndi MCA kuyenera kusiyidwa, matendawa amafunika chithandizo chankhanza.

Ngati minofu hypoxia ilipo, kugwiritsa ntchito bicarbonate kumatha kukhala koyipa kwambiri chifukwa cha kuwonjezeka kwa kupanga kwa lactate ndi kuwonongeka kwa oksijeni pakutsitsa minofu. Izi zikutanthauza kuti lactic acidosis kapena mtima womangidwa pambuyo pa bicarbonate, chithandizo chitha kukhala chowopsa. Bicarbonate mwina sagwiritsidwa ntchito nthawi zambiri okhala ndi anionic acidosis ambiri. Lactic acidosis imatha kukulira popereka mankhwala a bicarbonate. Kafukufuku wachipatala sanawonetse phindu la bicarbonate mu diabetesic ketoacidosis.

Milandu iyi, chizindikiro chokhacho chogwiritsira ntchito bicarbonate ndikuwongolera kwadzidzidzi kwa hyperkalemia yayikulu. Kuwongolera komwe amasankhidwa a metabolic acidosis ndikuthana ndi zomwe zimayambitsa ndikugwiritsa ntchito njira yeniyeni pazovuta zonse zowopsa. Mafuta a Organic acid amagwira ntchito ngati bicarbonate, kubwezeretsa bicarbonate yatsopano atangopanga chithandizo chachikulu. Kuphatikiza apo, mankhwala a bicarbonate angayambitse alkaline diuresis, yomwe imathandizira kumasulidwa kwa aimpso a salicylate.

Maziko a chithandizo cha acidosis ku MCA ndi njira yozungulira ya sodium bicarbonate (NaHCO 3). Cholinga cha mankhwalawa ndikuti athetse mavuto a acidosis ndikupeza nthawi yokwaniritsa njira zomwe zikuthandizira kukonza kwa causative chinthu cha acidosis. Ngati chifukwa cha MCA chitha kuchotsedwa msanga (monga kupuma komanso kulephera kwam'mapapo), ndiye kuti chithandizo cha alkalizing sichingafunikire. Zosafunikira zoyipa za acidosis zimaphatikizira kulepheretsa kwa myocardial contractility ndi kuchepa kwa zotuluka zamtima pa pH pansipa 7.1. PH ikatsika pansipa 7.0, kuchepa kwamadzimadzi ndi hypotension kumatha kuchitika. Kuphatikiza apo, pa pH yomwe ili pansi pa 7.0, kugwiritsa ntchito kwa hepatic kumalephera ndipo kupanga kwake kwa chiwindi ndi impso kumatha kuyamba. Izi zimapangitsa kugwa kwamtima, komwe nthawi zambiri kumachitika ndi mtundu B MCA.

Bicarbonate therapy ikhoza kukhala yothandiza pakuwongolera acidemia chifukwa cha acidosis yosakhala biology. Mu non-biotic acidosis, palibe anion ya organic yomwe imatha kupangidwanso kuti ikonzenso bicarbonate. Zoyambitsa zikakhala kuti zakonzedwa, kuthana ndi ziphuphu kumawoneka mwachangu ngati mankhwala a bicarbonate agwiritsidwa ntchito. Ndalama zokwanira kukonza matendawa ziyenera kuperekedwa. Cholinga ndi kukweza pH yanu yanthaka mpaka pamwambapa, kuchepetsa mavuto oyipa a mthethe, komanso kupewa zotsatira zoyipa za bicarbonate.

Malinga ndi olemba ena, kugwiritsa ntchito mankhwala alkalizing ndi MCA nthawi zina sikuti kumangobweretsa phindu, komanso kungavulaze. Lingaliroli likuchokera pazotsatira zoyesera komanso pakuwunikiranso mphamvu ya sodium bicarbonate pochiza DKA ndi matenda a mtima ofooketsa m'matumbo (mtima ndi kumangidwa kwa mtima). Funso ili, zikuwoneka kuti lidzatsegulidwa posachedwa. Mpaka njira yothandizirana ikapezeka pano, kugwiritsa ntchito sodium bicarbonate kumapitilira limodzi ndi chithandizo cha etiotropic.

Monga lamulo, sodium bicarbonate imayikidwa pa pH 7.1 (kapena m'munsi). Imagwiritsa ntchito kocheperako kamene kangabwezeretse pH ya systemic ku hemodynamically safe level (mwachitsanzo, pH 7.2). Kuwunikira pafupipafupi momwe acid-base imakhalira ndikofunikira kuti mudziwe kuchuluka kwa bicarbonate. Zotsatira zingapo zosafunikira za mankhwala a bicarbonate zimaphatikizapo madzimadzi ndi kuchuluka kwa sodium, hyperosmolarity, alkalization, kupanga lactate kupanga, kusintha kwa oxyhemoglobin dissociation kupindika kumanzere, ndi CSF paradoxical acidosis.

Mulingo woyenerera wa bicarbonate wofunikira kukonza acidosis ungawerengeredwe pogwiritsa ntchito njira zotsatirazi:

Kuperewera kwa HCO 3 = (25 mEq / l HCO 3 - muyeso wa HCO 3) x 0,5 (kulemera kwa thupi makilogalamu).

Kuchulukitsa kumeneku kukuchokera pamalingaliro akuti bicarbonate imagawidwa m'malo ofanana ndi 50% ya kulemera kwa thupi pama kilogalamu. M'malo mwake, magawidwe a bicarbonate amawonjezeka mikhalidwe ya hypobicarbonatemia, chifukwa chake, kugwiritsidwa ntchito kwa 50% ya kulemera kwa thupi kuti athe kuwerengera malowa kungapeputse kufunika kwa bicarbonate.

Kuwongolera acididemia mwa odwala ena, kuchuluka kwa sodium bicarbonate kumafunika. Odwala omwe sangathe kulekerera kuchuluka kwa madzimadzi ndi sodium amatha kuthandizidwa ndi kulowetsedwa ndi bicarbonate komanso ndi looptitis wamphamvu kapena Tris (hydroxymethyl) aminomethane. Hyperosmolarity ikhoza kuchepetsedwa ndikuwonjezera ma ampoules a 3-4 a NaHCO, (44 mEq / L) 1 lita imodzi ya 5% yamadzimadzi a dextrose. Njira iyi imapatsa 132-66 mEq / L, motero. Kugwiritsa ntchito zolimba zotsekemera zolimba kumakupatsani mwayi wopanga malo amitsempha ndi sodium. The okodzetsa amatchulidwa muyezo wokwanira kuonetsetsa mofulumira diuresis (300-500 ml / h). Kuwonongeka kwa potaziyamu ndi sodium mumkodzo kumatha kuyesedwa ndi kulipidwa pamene mukudzaza kutayika kwamadzi mu mkodzo.

Odwala omwe ali ndi oliguria amafuna hemodialysis, yomwe imalola kuyambitsidwa kwa sodium bicarbonate yambiri. Madzi odziwika mu dialyzer amatha kusinthidwa ndi bicarbonate, pomwe madzi ndi sodium chloride ochotsedwa ndi hypertonic solution amatha m'malo mwa mchere wa bicarbonate. Lactate imachotsedwa ndi hemodialysis ndi peritoneal dialysis. Chifukwa cha kusowa kwa umboni kuti ma ionate ion palokha ndi owopsa, njira yothandizirayi siyofunikira. Kuchotsa lactate, komabe, kumatha kuchepetsa alkalosis, yomwe imakonda kupezeka pambuyo kukonza acidosis.

Kuyambira pomwe pH imasinthasintha kuti ikhale yotsika m'magazi, nthawi yayitali imadutsa (nthawi zambiri). Cohen akuonetsa kuti kudikirira nthawi imeneyi kwakanthawi, kusiya kugwiritsa ntchito njira zoopsa zowopsa. Makamaka, akuwonetsa kuti achepetse kulowetsedwa kwa bicarbonate maola angapo atatha kukonza matenda a pH. Ngati pH iyamba kuchepa, ndiye kuti kuchuluka kwa kulowerera kwa bicarbonate kungakulitsidwe. PH ikakhazikika m'malo ovomerezeka, kulowetsedwa kumatha kuyimitsidwa. Monga nthawi zonse, mkhalidwe wamankhwala wodwala ndiye chitsimikiziro chabwino kwambiri chowunikira njira yochiritsira.

Mankhwala ena ambiri aperekedwa pofuna kuchiza MCA. Zina mwa izo ndi insulin, glucose, thiamine, methylene buluu, vasodilators, monga sodium nitroprusside, komanso dichloroacetate yoyesera. Olemba ambiri salimbikitsa kugwiritsa ntchito insulin kapena kuphatikiza kwake ndi glucose pochiza MCA. Insulin ikhoza kuwonetsedwa kwa odwala matenda ashuga omwe ali ndi coscomitant MCA kapena kuwonjezeka kosadziwikiratu kwa acidotic anionic gap. Mankhwala a insulin pankhani zotere ayenera kutengera zosowa za wodwalayo. Kulowetsedwa kwa glucose pamaso pa hypoglycemia ndi MCA kwawonetsedwa kuti akukonza lactic acidosis.

Thiamine ndi cofactor wofunikira wa enzyme yomwe imapangitsa gawo loyamba la pyruvate oxidation. Vitamini iyi imayikidwa kwa oledzera omwe ali ndi lactic acidosis, koma gawo la thiamine pothandizira odwala ena silinakhazikitsidwe. Utoto wamtundu wa Methylene ndi utoto wa redox womwe umatha kuvomereza ma ayoni a hydrogen ndipo, chifukwa chake, umatulutsa oxide wa NADH ku NAD +, womwe umanenanso kuti kusintha kwa pyruvate kumatheka. Komabe, mayesero azachipatala sanatsimikizire kuthandizira kwa mankhwalawa. Mankhwala a Vasodilator adakhazikitsidwa pokhapokha kuti kuphatikizika kwa minofu kumayenda bwino ndi kuchepa kwa zotumphukira zamitsempha komanso kukwera kwa mtima. Kuchita bwino kwa ma vasodilator pochiza ICA sikuyenera kutsimikiziridwa.

Dichloroacetate (DHA) ndi mankhwala oyesera omwe amathandizira ntchito ya pyruvate dehydrogenase, yomwe imapangitsa kukhathamiritsa kwa glucose, pyruvate ndi lactate ndipo, chifukwa chake, amachepetsa mulingo wa lactate m'magazi. Popeza mpweya umafunika panjira ya metabolic iyi, DHA sichitenga nawo gawo pochiza mtundu wa A MCA. Udindo wake pochiza mtundu wa B BA ndi wochepa chifukwa chakuwonjezeka kwa ketosis ndi mitsempha yamavuto yomwe imagwiritsidwa ntchito.

Zowoneka pakuyesa kugwiritsa ntchito njira zambiri zoyesera za MCA zikuwonetsa zotsatira zoyipa za vutoli pogwiritsa ntchito njira zomwe zilipo kale. Chiwerengero cha odwala omwe ali ndi mtundu wa A MCA ndi pafupifupi 80%, ndipo ndi mtundu B, kuchokera 50 mpaka 80%. Kuzindikiridwa koyambirira ndikuwongolera mikhalidwe yomwe ili pansi pa ICA, m'njira zabwino kwambiri zimathandizira kuchepetsa ziwengo zambiri zaimfa.

1. Zachipatala mwadzidzidzi: Trans. kuchokera ku Chingerezi / Under H52 ed. J.E. Mwokoma, R.L. Crome, E. Ruiz. - M: Mankhwala, 2001.

2. Matenda amkati Eliseev, 1999

Acidosis imachitika ndi kuwonjezeka kwa kuchuluka kwa hydrogen ions m'magazi ochepa kuposa momwe muliri 40 nmol / L ndi pH ya 7.4. Amachokera ku kudzikundikira kwa kaboni dayokisaidi, zinthu zopangidwa ndi acidic kapena kuchepa kwa kuchuluka kwa mankhwala a zamchere m'magazi. Membala amafotokoza atsidemiya mkhalidwe wotsika magazi, pomwe acidosis ndiyo njira yomwe imatsogolera izi. Mlingo wa zochita zama cellular zimakhudza ndipo nthawi yomweyo umayendetsedwa ndi pH yamadzi amthupi. Pazinyama zoyamwitsa, pH yachibadwa yamagazi osinthika amasintha kuchoka pa 7:35 mpaka 7:50 kutengera mtundu. Mwa munthu wathanzi, izi ndizofunikira 7.35 - 7.45 7.8. Ph-kusiyanasiyana mwa munthu wogwirizana ndi moyo kuyambira 6.8 ndi. Zosintha mu pH yama magazi ochepa (komanso madzi ena a kunja) zimapangitsa kuwonongeka kwa maselo.

Kutengera ndi limagwirira a acidosis, imagawika mu metabolic, kupuma komanso kusakanikirana, ndipo malinga ndi mfundo za pH - kulipidwa ndi kuwongoleredwa.

Kupuma acidosis

Repiratory acidosis chifukwa chakuwonjezeka kwa kuchuluka kwa mpweya woipa m'magazi (hypercapnia) chifukwa cha kuchepa kwa magazi. Nthawi zambiri zoyambitsidwa ndi mapapu, kuvulala pamutu, mankhwala (anesthetics and sedatives), zotupa muubongo. Pneumothorax, emphysema, bronchitis, mphumu, chibayo chachikulu ndizonso zomwe zimayambitsa. Vutoli litha kukhala lingaliro lovomerezeka chifukwa cha metabolic alkalosis.

Lactic acidosis

Mtundu wa metabolic acidosis umalumikizidwa ndi kudziunjikira kwa lactic acid (lactate) mu tishu (mu minofu hypoxia, mankhwala ena, ndi zina) .. Lactic acidosis imachitika pamene maselo amatulutsa lactic acid mwachangu kuposa momwe thupi limakokera. Zizindikiro zazikulu za lactic acidosis zimakhala zakuya kwambiri komanso kupuma mwachangu, kusanza ndi kupweteka kwam'mimba. Lactic acidosis imatha kuchitika chifukwa cha zifukwa zingapo. Ichi ndi gawo lofunikira mu matenda ashuga owopsa. Lactic acidosis ndi njira yachilendo koma yovuta yomwe imachitika mutatenga Metformin (Glyukofag), mankhwala ochizira matenda a shuga a mtundu II.

Metabolic acidosis

Uku ndikuwonjezereka kwa kuchuluka kwa hydrogen ions komanso kuchepa kwa kuchuluka kwa ma bicarbonate m'madzi a mthupi, chifukwa chodzikundikira asidi ndi maziko, kuwonjezeka kwa kutayika kuchokera mthupi. Izi zimatha kuchitika m'mimba, matenda a impso, ndi ena. Metabolic acidosis imadziwika ndi kuwonjezeka pakupanga ma metabolic acids, ngati lamulo, chifukwa chododometsa pamakina a chimbudzi chawo. Renal acidosis yokhudzana ndi kudzikundikira kwa urea ndi creatinine, komanso zotsalira za metabolic acid kuchokera ku metabolism ya protein.

Kuchuluka kwa ma asidi ena kumatha kuyambitsanso metabolic acidosis. Mwachitsanzo, lactic acidosis imatha kukhala zifukwa ziwiri zakubuka:

Acidosis - acidization wa thupi

1 Acidosis - acidization wa thupi
- 1.1 Zizindikiro za acidosis - acidization ya thupi imadziwonetsa bwanji?
- Kodi chiwopsezo cha acidosis ndi chiyani?
- 1.3 Zifukwa zakusintha kwa thupi: chifukwa chiyani acidosis imachitika?
- 1.4 Mndandanda wazinthu zomwe zingateteze motsutsana ndi acidosis - mankhwala a alkalizing
- 1.5 Mitundu ya acidosis
- 1.6 Kuzindikira kwa acidosis
2 Momwe mungachepetse acidity m'thupi - mankhwalawa acidosis

Acidosis mu mankhwala amatchedwa gawo lina la thupi momwe mumasunthira momveka bwino acid-base equity yake acidity.

Pankhaniyi, acidity imatha kudziwika ndi mtheradi komanso wachibale kwambiri wa asidi.

Kuphatikiza pa izi, ndi kuchuluka kwamphamvu kwa thupi, nthawi zonse pamakhala kuwonjezeka kwa kuchuluka kwa ayoni a hydrogen.

Acidosis nthawi zonse imakhala matenda.

Ndizowopsa kudziwa kuti thupi lotere (ngakhale limachitika nthawi ndi nthawi komanso ngakhale lomwe limawerengedwa "mkati mwazonse"!) Ndichinthu chachilendo m'moyo wamakono, kutali ndi kuchuluka kwa chitetezo chake komanso chilengedwe.

Simuyenera kudzipulumutsa pothana ndi mavuto amthupi lanu, ndikwanzeru kutembenukira ku chidziwitso, kumvetsetsa zomwe zimayambitsa acidization wa thupi ndikupanga chilichonse chomwe mungathe kuti mukhale bwino.

Ndipo mukatha kuthana ndi vutoli, ndibwino, chifukwa vuto lomwe lakhalapo limakhala losavuta ndikuchithetsa bwino kuyambira pachiyambi - ndibwino kuthana mwachangu komanso bwino.

Zizindikiro za acidosis - kodi acidization ya thupi imadziwonetsa bwanji?

Mawonetseredwe azachipatala a acidosis (Zizindikiro) ndizovuta kusiyanitsa ndi zizindikiro za matenda ena.

"Kubisala" kwakukulu kwambiri kwa matenda awa ndikuti ndi mitundu yofatsa ya acidosis, mawonetseredwe azachipatala a mkhalidwewu sagwirizana kwenikweni ndi kuphwanya kwa mulingo wa acid-base usawa.

Zizindikiro zazikulu za acidosis ndizowonetsa monga:

kusanza
zokonda mtima
kulephera kudziwa
kuthamanga kwa magazi
dziko lodzidzimutsa
nseru yochepa
zamkati zamtima,
kugona
general malaise
chizungulire
chisokonezo,
kubweza kwa kulingalira.

Ndikofunikira! Ndikofunika kudziwa kuti nthawi zina (makamaka mawonekedwe ofatsa), acidosis imatha kukhala yovuta kwambiri!

Kodi chiwopsezo cha acidosis ndi chiyani?

Acidosis ndi owopsa - ndi chowonadi chosasinthika.

Ngati simukugwirizana ndi nkhaniyi munthawi yake, ndiye kuti mukumana ndi mavuto akulu kwambiri.

Popeza kuphwanya kumeneku kumachitika chifukwa cha kudzikundikira (kuchuluka) kwa zinthu zomwe zimaphatikizidwa ndi ma organic acid, omwe nthawi zambiri zimachotsedwa mthupi la munthu, kuphwanya lamulo lotere, ngati simutenga nthawi yofunikira kusintha nthawi, zingayambitse:

kuchuluka magazi
matenda a mtima a ziwalo za parenchymal,
zotumphukira thrombosis,
chikomokere
kusowa kwamadzi (kusowa kwamadzi)
myocardial infaration
kuwonongeka kwakulu kwa ubongo
mavuto akulu mthupi,
kusintha kwakukulu kwa kuthamanga kwa magazi,
ngakhale imfa.

Ichi ndichifukwa chake choyambirira chofunikira kwambiri pakuchotsa acidosis ya thupi ndikupeza zomwe zimayambitsa matenda awa.

Zifukwa zakusintha kwa thupi: bwanji acidosis imachitika?

Pali zinthu zambiri zomwe zimayambitsa kukula kwa acidosis, ndipo zonse ndizofunikira komanso zazikulu:

poizoni wa m'thupi (chakudya ndi mankhwala),
kusokoneza kwam'mimba,
kuchepa kwamtima
mimba
kusowa kwamadzi
Kupanikizika kosalekeza,
metabolic (metabolic) mavuto,
hypoglycemia (dontho lakuthwa mulingo wa Sasar m'magazi),
kusuta
kumwa pafupipafupi
kusakwanira kwa okosijeni m'magazi (chotchedwa njala ya okosijeni),
pachimake aimpso kulephera
kupuma movutikira,
neoplasms woipa mthupi,
Zakudya zosayenera, zopanda thanzi (kuphatikizapo zakudya zomwe sizikhala ndi michere yambiri yofunikira m'thupi),
kugwiritsa ntchito mankhwala ena (makamaka - kugwiritsa ntchito mankhwala kwa nthawi yayitali),
malo osavomerezeka azachilengedwe.

Nthawi zina, acidosis imatha kupanga “popanda chifukwa” chosonyeza kuyambika kwa matendawa.

Malinga ndi ziwerengero, chimodzi mwazomwe zimayambitsa matenda osokoneza thupi masiku ano ndi chakudya chopanda thanzi, chopanda thanzi, zakudya momwe mumapezeka zambiri osati zachilendo kwa thupi, komanso zogwiritsa ntchito molakwika.

Chifukwa chake, sikuti chakudya chopatsa thanzi chomwe chingayambike bwino chifukwa cha zomwe zimayambitsa "poyizoni wa thupi."

Chofunikira! Tsoka ilo, zakudya zamunthu zamakono zimabadwa chifukwa cha kusowa kwa ma hydrogen ion ndi bicarbonate. Ndipo kusayeneraku kumayambitsa moyo wonse wofatsa wa metabolic acidosis. Izi zikutanthauza kuti munthu amakhala ndi moyo mosalephera, chifukwa chokhala m'malo omwe sangatchedwa Health ...

Pazinthu zokhudzana ndi zakudya, ndikofunikira kudziwa bwino lomwe zakudya zomwe zimatsogolera acidity, ndipo, m'malo mwake, zomwe zimapangitsa kuti azikhala ndi mankhwalawa, ndiko kuti, werengani mndandanda wazakudya za "acidic" ndi "zamchere", ndikusintha zakudya zanu m'njira yoyenera .

Mndandanda wazinthu zomwe Zitha Kuteteza ku Acidosis - Alkalisation Products

Tsoka ilo, zakudya za munthu amakono sizitchedwa alkalizing.

Kwenikweni, chakudya cha tsiku ndi tsiku chimakhala ndi acidic m'malo mwa zakudya zamchere, ndipo ichi ndi chifukwa chake acidosis ya "moyo" wonse, kapena vuto lakuthwa mwazinthu zambiri, nthawi zambiri limayambitsa matenda a mtima kapena matenda oopsa, kapena matenda ashuga, matenda a mtima, ndi zina zambiri, kapena, kale, Kalanga, sizigwirizana ndi moyo ...

Zakudya za munthu wamakono zimaphatikizapo mafuta odzaza, shuga wosavuta, mchere wa tebulo.

Komabe, silabwino kwambiri mu ma coarse fiber, potaziyamu ndi magnesium. Kuphatikiza apo, muzakudya za anthu ambiri pali zakudya zambiri zatsopano komanso zosakonzedwa, zinthu zopangidwa ndi ufa, shuga, komanso mitundu yonse yazinthu zambiri zomalizidwa.

Chakudya chotere chimakhala ndi ma valencies achilengedwe, ndipo zonsezi zimakhudza kwathunthu njira zonse zamkati mthupi, kuwononga, kusokoneza, kugwetsa chilichonse chazomwe zimachitika maselo amunthu komanso ziwalo zonse ndi machitidwe ake!

Kupsinjika kwakali, koopsa, komwe kumachitika pafupipafupi kumapangitsanso acidosis yathupi. Mazana a maphunziro adachitika pazama momwe magazi a acidity amasinthira modzikakamiza mwadzidzidzi: acid-base balance imasunthika nthawi yomweyo!

Moyo wongokhala, osayenda mokwanira mumlengalenga watsopano: masiku owerengeka chabe amoyo ndi okwanira kuti chikhalidwe cha munthu chiziwonongeka kwambiri.

Tsoka ilo, ambiri aife timakhala zaka zambiri zaka zambiri, kumangozolowera momwe thupi lathu limamverera, ndikuti:

mkhalidwe wolemerera
mphwayi
Kukhumudwa
ntchito yoyipa yam'mimba,
zotupa pakhungu (ziwengo),
mawonekedwe owoneka bwino,
makwinya oyamba ndi khungu lotupa,
imvi zoyambirira
kufunika 'kodzimangirira nokha ndi mphamvu mu tiyi ndi khofi,
ndi zina zotero ... mwatsoka khalani "chizolowezi" ...

Kuyesera kunachitika kuti zitsimikizire kukhudzidwa kwazomwe zimachitika mu acidization ya thupi la zida zapakhomo, mafoni am'manja, mapiritsi ndi zida zina zofunika kwa munthu wamakono.

Madzi akumwa ocheperako, kuphatikiza madzi ochokera m'mabotolo apulasitiki ndi gasi wochita kupanga, ndi chimodzi mwazifukwa zomwe acidization ya thupi limaphatikizira ndi madzi osakwanira.

Zinthu zosiyanasiyana zachilengedwe zomwe zimatchedwa "Zosachita bwino" - ili ndi vuto lenileni, lomwe lili ndi zovuta kwambiri pa thanzi la munthu, osaphonya kusintha kosasintha kwa thupi la munthu.

Apanso, werengani mndandanda wonse wazomwe zimayambitsa acidosis ndikuyesetsa kuzithetsa. Kuti muchite bwino, muyenera kufunafuna thandizo kuchokera kwa akatswiri.

Mitundu ya Acidosis

Mulingo wabwinobwino wa acidity ndi 7.25 - 7.44.

Kupitilira kupitirira pazofunikira (7.45) ndi zochepa (7.24) nthawi zonse kumabweretsa ntchito zamavuto amisala, kuwonongeka kwa maselo, kuchepa kwa protein, komwe, nthawi zonse kumayambitsa kufa pang'onopang'ono kwa thupi.

Amasiyanitsidwa pakati pa compensated ndi uncompensated acidosis.

Acidosis yolipidwa imadziwika ndi acidity yamagazi, yomwe nthawi zambiri imasunthira kutsika kwachilendo.

Ngati mtengo wa chisonyezo wasinthidwa mbali ya acidic, ndiye kuti acidosis imawerengedwa kuti ndi yopanda phindu.

Kusunthika kumatha kuchitika chifukwa cha kuchuluka kwambiri kwa asidi, komanso chifukwa cha kusowa kwa zochita za physico-chemicals ndi zochita zamagulu zomwe zimayendetsa bwino acid-base.

Acidosis yowonjezeredwa nthawi zambiri imavulaza thupi pafupipafupi komanso mosavomerezeka kwa miyezi ingapo kapena zaka, pang'onopang'ono zomwe zimayambitsa kufa kwa thupi.

Acidosis kuchokera koyambirira amatha kukhala mpweya (kupuma), osati mpweya, komanso wosakanikirana.

Mpweya acidosis nthawi zambiri umachitika chifukwa chosakwanira kuchotsa kaboni dayokisi m'thupi kapena kupopera mpweya kapena mpweya, womwe umakhala ndi mpweya wambiri wa kaboni.

Acid-mpweya acidosis imadziwika ndi kuchuluka kwazinthu zina zopanda asidi, komanso kuchepa kwenikweni kwa zomwe zili mu bicarbonate m'magazi.

Mitundu yayikulu ya mawonekedwe osakhala mafuta a acidosis ndi:

kuchotsera
kagayidwe
exo native acidosis.

Ma metabolic mawonekedwe a acidosis, monga lamulo, amadza chifukwa chowonjezera, kusuntha kapena kusakwanira kumangidwa kwa zinthu za acidic mu zimakhala. Chifukwa chake, mawonekedwe amtunduwu amatha kuchitika ndi ketoacidosis ndi lactic acidosis.

Ketoacidosis ndi vuto lomwe limayambika chifukwa cha kuchuluka kwa madzi amthupi a ketone, omwe amayamba ndi:

matenda ashuga
chakudya cham'mimba,
kwambiri insulin hypoglycemia,
kutentha kwambiri
kuledzera
hypoxia
amayaka
kuvulala
ndi mitundu ina ya opaleshoni.
Lactic acidosis ndi nonspecific syndrome yomwe imayamba mu zovuta zina zamatenda. Izi zimapangitsa kuti pakhale kupangika kwa mapangidwe ndi kudziunjikira kwa lactic acid m'magazi.

Lactic acidosis imatha kuchitika kwakanthawi kochepa ngati ntchito yowonjezera minofu, makamaka ngati anthu osaphunzitsidwa, osakonzekera, akumana ndi zovuta zolimbitsa thupi: munthawi iyi, kupanga lactic acid kumawonjezeka, ndipo chifukwa cha kuperewera kwa mpweya, asidi uyu samapezeka wokwanira.

Yaitali lactic acidosis imatha kuchitika ndi:

kuvulala kwambiri kwa chiwindi,
Kuchepetsa mpweya wabwino m'thupi,
kuphwanya yachibadwa ntchito zamtima.

Ponena za excretory acidosis, imadziwika ndi kuchepa kwa ma exidtion a asidi osagwiritsidwa ntchito m'thupi la munthu.

Njira iyi ya acidosis imawonedwa ndimatenda a impso, zomwe zimapangitsa kuti zikhale zovuta kuchotsa phosphates acid ndi ma organic acids.

Renal acidosis imatha kuchitika chifukwa cha kuchuluka kwa zotupa za sodium mu mkodzo. Izi zimatha kuchitika, mwachitsanzo, kugwiritsa ntchito mankhwala osokoneza bongo kwa nthawi yayitali komanso mankhwala ena okodzetsa.

Kuphatikiza apo, excretory acidosis imatha kuchitika chifukwa chakuchepa kochulukirapo kwa mankhwala ofunikira kudzera m'mimba (kutaya m'mimba, kusanza, kuchuluka kwa nthawi yayitali, etc.).

Exo native acidosis nthawi zambiri imachitika pamene kuchuluka kwa acidic mankhwala, komwe kumatha kukhala mankhwala, kumalowetsedwa m'thupi la munthu.

Ponena za mtundu wosakanizika wa acidosis, mitundu yofananira yamtunduwu imawonedwa mwa anthu omwe ali ndi matenda amtima kapena matenda opuma.

Chofunikira! Acidosis yolipiridwa pang'ono imachitika popanda chisonyezo. Imatha kuwoneka pokhapokha pofufuza njira zamagetsi zamagazi ndi zotsatira za kusanthula mkodzo.

Ngati acidosis imayamba kuzama, ndiye chimodzi mwazizindikiro zoyambira ndizotsatira zam'machitidwe opuma, kupindika kolimba, etc.

Pankhani ya uncosis yomwe ili ndi acidosis, kuwonongeka koopsa pakugwira ntchito kwamkati wamanjenje kumatha kuchitika, mwachitsanzo, kungafotokozedwe mwa kugona, chizungulire, kusazindikira, komanso kusokonezeka kwa ntchito za autonomic.

Chofunikira! Metabolic acidosis nthawi zambiri imayamba kusala kudya nthawi yayitali, kusungunuka kwa matenda a shuga, kuchepa kwa mtima, kuchepa kwa chiwindi, kudzikundikira m'magazi, poyizoni wa asidi, ndi m'mimba mwa ana.

Zizindikiro za metabolic acidosis zimaphatikizapo kusokonezeka kwa zochitika za wodwalayo komanso kuzindikira. Makamaka, munthu wodwala amakhala ndi kugona, wolefuka ndi zizindikiro zilizonse zosonyeza kuti alibe chidwi.

Ndi kuchepa kwa insulin, kuletsa kwa tendon Reflexes kumawonedwa, komanso kuchepa kwamatenda a minofu.

Ponena za mpweya acidosis, nthawi zambiri amakula ndi mapangidwe ake am'mapapo, omwe nthawi zambiri amadziwonetsa posintha mawonekedwe a wodwala.

Mwachitsanzo, khungu limasintha, kapena nkhope imakhala yotupa ndikusesa thukuta. Nthawi yomweyo, malingaliro a wodwalayo amasinthanso: poyamba, euphoria ndi kuyankhula kumawonekera.

Ndi kukula kwa matendawa, kugona, kuwonda, komwe kumayamba pang'onopang'ono kukhala chikumbumtima champhamvu.

Pankhaniyi, voliyumu yakupuma, monga lamulo, imayamba kuchepa.

Ngati kupuma arrhythmia kumachitika, ndiye izi zikuwonetsa kulepheretsa kwakukulu kwa kupuma, komanso kuchepa kwa chidwi cha malo opumira mpaka mpweya woipa.

Komanso, zomwe zili mu okosijeni m'magazi zimapitilirabe kugwa ndikufa ndi njala kwa oxygen, komwe kumayambitsa metabolic acidosis. Poterepa, munthu amakhala ndi kuchuluka kwa mtima, mtima wake umawonekera.

Ngati mankhwalawa sayamba pa nthawi yake, ndiye kuti kupuma komwe kumachitika nthawi zambiri kumatha kufa, kumatha kudana ndi odwala.

Zofunika! Zochitika zamatenda amtima zomwe zimapezeka ndi acidosis, zimadalira makamaka zovuta zamagetsi. Kupsinjika kwa magazi ndi zotulutsa zamtima nthawi zambiri zimachepetsedwa. Ndi kuchepa kwa madzi, kusowa kwa sodium ndi kuchepa kwa magazi, kugwa kungachitike.

Nthawi zambiri, odwala amakhala ndi kuwonjezeka kwa kugunda kwa mtima, komanso kusokonezeka kwakumtima kosiyanasiyana, koma ndi kuchuluka kwa serum potaziyamu, kugunda kwa mtima, mwina, kumachepa. Voliyumu yopangidwa

Mkodzo wogawanika poyamba umachulukako pang'ono, koma ndi acidosis yotchulidwa, yomwe nthawi zambiri imayendera limodzi ndi dontho la kukakamiza, kuchepa kwa kuchuluka kwa mkodzo kumadziwikiridwa.

Ndi acidosis, ngakhale kusapezeka kwa mkodzo mu chikhodzodzo ndikotheka.

Zowopsa! Ngati pH ikutsikira pansipa 6.8, ndiye kuti mtengo wake umakhala wosagwirizana ndi moyo.

Matenda a Acidosis

Kuti adziwitse kuzindikira koyenera, kuyezetsa magazi osiyanasiyana ndi mkodzo kumayikidwa ndi adokotala. Kuyesedwa kwa magazi kumathanso kudziwa mtundu wa acidosis.

Nthawi zina, maphunziro owonjezera amatha kupatsidwa kuti adziwe zomwe zimayambitsa acidosis.

Pozindikira kuti muli ndi acidosis (ndipo, motero, kuti mupeze matenda olondola ndi zotsatira zake) ZAKUYESETSA zonse zofunikira zimafunikira, zomwe dokotala amakupatsirani!

Ngati mulingo wa acid-msingi wopezeka ndi mayeso a labotale ndi wochepera 7.35, uwu ndi umboni wa kukhalapo kwa gawo la asidiosis losavomerezeka, pomwe wodwalayo angagonekere kuchipatala mwachangu.

Zovuta za Acidosis

Acidosis imaganiziridwa lero chinthu chofala kwambiri chamakono. Koma kaamba ka kayendedwe kabwino ka thupi lathu, ndikofunikira kuti lizitha kukhalabe ndi chilengedwe komanso acidity munthawi zonse. Popeza acidity yachilendo ndi phindu la pH ndi zizindikiro za 7.35-7.45, acidosis imakhala yachilengedwe momwe acidity imatsika pH 7.35.

Zomwe zimapangidwira acidization wa thupi ndizinthu zina, monga malo oipitsidwa, moyo womwe mumakhala mayendedwe ochepa kwambiri ndipo, inde, zakudya zosayenera. Zonsezi zimayambitsa moyo wopanda pake pamutu wamutu komanso kutopa.

Tsoka ilo, munthu wamakono amadya lero zinthu zotere zomwe zimatsogolera pakupanga kwa acidosis mwa iye. Kuphatikiza apo, ndikulakwitsa kuganiza kuti zakudya za acidic zimayambitsa acidization kapena acidosis m'thupi. Mwambiri, ma asidi ndi omwe amachitika chifukwa cha kagayidwe kazakudya m'thupi nthawi yakusweka ndi kukonza kwa zakudya zomwe zimakhala ndi mafuta, ma hydrocarbons, phosphates, amino acid okhala ndi sulufule.Chifukwa cha kugawanika kwa zinthu zonsezi, ma acid omwe amapezeka kuchokera ku organic amapangidwa, omwe sangasinthidwe ndi anions zamasamba atsopano ndi zipatso zomwe zimalowa m'thupi, komanso chifukwa cha zinthu zamchere zomwe zimapangidwa chifukwa cha kagayidwe.

Kuti mukhale ndi acid komanso alkaline bwino, machitidwe othandizira magazi amafunikira, komanso mapapu ndi impso. Mothandizidwa ndi mapapu, ma acid osasunthika amachotsedwa m'thupi, ndipo osagwirizana ndi impso. Kuphatikiza apo, zakudya zomwe munthu ali nazo, momwe amakhala m'maganizo komanso nthawi yakatsiku zimatha kusokoneza chamoyo. Monga lamulo, theka lachiwiri lausiku limadziwika ndi zochuluka za zotupa za metabolic mu mkodzo, zomwe zimatha kutsimikiziridwa mu kuchuluka kwa peresenti mothandizidwa ndi mayeso a litmus. Ndipo 99% ya ma asidi omwe amapezeka mumkodzo ali omangidwa. Mitundu ya pH yovomerezeka yamkodzo imafanana ndi mfundo kuchokera pa 6.2 mpaka 6.9. Ndipo ngati izi zimatsitsidwa kuchokera ku 4.5 kupita ku 6.0, ndiye kuti izi zikuwonetsa kuti kuchuluka kwazinthu zambiri kumalowa m'thupi zomwe zimayambitsa kupangidwa kwa ma acid m'thupi.

Kuphatikiza apo, zovuta zam'mapapu, impso, kapena kusokonezeka kwakukulu kwa metabolic kungayambitse acidosis. Koma mitundu yambiri yamatenda oyamba imatha kubweretsa latent acidosis, yomwe imakhala ndi zotsatira zoyipa kwakanthawi. Palinso matenda angapo omwe amayambitsa matenda a rheumatic chikhalidwe, zilonda zam'mimba, caries, matupi awo amakhudzidwa, minyewa yotupa yachilengedwe komanso neurosis.

Zizindikiro za Acidosis

Pafupifupi zizindikiro zonse za acidosis munjira yofatsa kapena yapakatikati zimayenderana ndi matenda oyambitsawo. Koma chisonyezo chazindikiritso cha matenda amtunduwu zimadalira kuchuluka kwa kupezeka kwa asidi m'magazi.

Monga lamulo, zizindikiro zazikulu za acidosis zimabisidwa pansi pa zizindikiro za matenda akulu ndipo ndizovuta kuzisiyanitsa. Mwachitsanzo, mtundu wofatsa wa acidosis umakhala ngati asymptomatic kapena nthawi zina kutopa, nseru ndi kusanza zimadziwika. Koma ndi metabolic acidosis yayikulu, hyperpnea imadziwonetsa yokha, yomwe poyamba imadziwika ndi kuya kwamkati kupuma, kenako ndi pafupipafupi (Kussmaul syndrome). Nthawi zina, pali zizindikiro za kuchuluka kwa ECG, kuchepa kwa alkali kudzera m'mimba. Kuphatikiza apo, acidosis yayikulu imayambitsa kukhwimitsa kwa magazi chifukwa chodwala mtima komanso kutsika kwa mtima paziphuphu, ku catecholamines, komanso kuyambitsa kudabwitsika.

Zizindikiro za acidosis motsutsana ndi mawonekedwe amomwe amapumira komanso kuperewera kwa ma asidi m'magazi (acidemia) amawonetsedwa mofooka kuposa metabolic ndi kupuma acidosis. Mwanjira iyi, mtima wodutsitsa umasokonezeka pomwe pH ya magazi ndiyosakwana 7.2. Chiwopsezo cha arrhythmias chimachulukitsidwa kwambiri ndi mtima zomwe zidalipo za pathologies kapena zovuta zina za kagayidwe ka electrolyte. Chifukwa cha acididemia, kuyankha kwamitsempha yamagazi ndi mtima ku ma catecholamine kumachepa, ndipo izi zimayambitsa kutsika kwa magazi pamaso pa hypovolemia kapena mantha.

Ndi acidosis, kupuma kumapangidwira, kukana insulini kumayamba, mapuloteni amawonjezereka, ndipo kapangidwe ka ATP koletsedwa. Ndi mawonekedwe owopsa a mkhalidwe wamtunduwu, ma metabolic mu ubongo amasokonezeka, omwe amachititsa kugona kosalekeza komanso chikomokere.

Njira yovuta kwambiri ya metabolic acidosis imawonetsedwa ndi matenda am'mimba kapena magazi osakwanira kwa zimakhala. Nthawi zambiri, izi zimadziwika ndi lactic acidosis, yomwe ndi yosavuta kuyipeza mwa kupimidwa thupi. Kuchepa kwa magazi kwa magazi kumaphatikizapo kuchepa kwa madzi m'thupi, kuchepa magazi, mantha, kapena matenda amtima. Chizindikiro chakhazikika cha metabolic acidosis mwa mwana, kuphatikiza ndi osakwanira aimpso, ikhoza kukhala kukula kwake pang'onopang'ono. Kukhazikika kwa pang'onopang'ono kwa polyuria kumawonetsa kukhalapo kwa matenda ashuga a ketoacidosis komanso matenda ashuga omwe kale sanawadziwe. Kubadwa kwa metabolic njira kagayidwe kachakudya kumawonetsedwa ndi kupweteka kapena choletsa china chake.

Hepatomegaly ndi metabolic acidosis imayang'aniridwa motsutsana ndi maziko a kulephera kwa chiwindi, kukhala ndi vuto la mtima, sepsis.

Zizindikiro zasayansi yokhala ndi ma electrolyte, glucose, urea nayitrogeni m'mwazi, ndi mkodzo.

Ndi njala kapena kuperewera kwa zakudya m'thupi, ketosis ndi gastroenteritis imayamba. Kuphatikiza apo, ndi kulephera kwa aimpso, nthawi yayitali komanso yachilendo imaphatikizidwa.

Acidosis ndi alkalosis

Njira zambiri zamatenda zomwe zimachitika mthupi zimatha kusokoneza ma acid komanso maziko ake mkati mwake, zimapangitsa acidosis (acidization) ndi alkalosis (alkalization).

Ndi acidosis yolipiridwa ndi alkalosis, kusintha kwamphamvu kwambiri kwa carbonic acid ndi sodium bicarbonate kumachitika, koma kuchuluka kwake kumakhalabe kwabwinobwino 1:20.

Acidosis ndi alkalosis ya zinthu zowonongeka ndi mikhalidwe yomwe masinthidwe amachitika osati mu kuchuluka kwa zidulo ndi ma alkali, komanso kusintha kosungirako kumeneku kumayambira ma acid kapena kumunsi.

Zizindikiro za kupuma, mosiyana ndi vuto losapuma, ndizovuta m'magazi a kaboni dayokisi komanso masamba oyambira.

Njira yopanda kupuma ya acidosis imakhazikika mthupi chifukwa chodzikundikira zinthu zingapo za metabolic zomwe sizinapitirire oxidation. Izi zikuphatikiza lactic acid, acetoacetic ndi hydroxybutyric. Kuchuluka kwa matupi a ketone kumachitika glycogen itakhala yochepa m'chiwindi chifukwa cha kuwonongeka kwamafuta kwambiri, motsutsana ndi mbiri yakufa kwa mpweya, ndipo kusintha kwa tricarboxylic acid kumasokonekera. Kuphatikiza apo, zochitika zosiyanasiyana za m'magazi zimangowonjezera kuchuluka kwa matupi a ketone kangapo, ngakhale kuchuluka kwake kumatsitsidwa ndi impso mu mawonekedwe a mchere wa sodium ndi potaziyamu. Ndipo izi zimachitika chifukwa cha kutayika kwa ma alkalis ambiri ndi kukhazikika kwa acidosis yowonongeka.

Fomu yochepa ya acidosis imachitika chifukwa chochita zolimbitsa thupi kwambiri chifukwa cha kupangika kwa lactic acid. Izi zitha kuwonetsedwa m'matenda a mtima ndi mapapu motsutsana ndi njala ya oxygen. Koma ndi mkhutu wa impso kuwonongeka kwa ma organic amines, sulfates, phosphates, metabolic acidosis kapena excretory akhoza kupanga. Monga lamulo, ambiri aimpso a pathologies amayenda limodzi ndi ma syndromes ofanana.

Ndi matenda otsekula m'mimba, gawo lalikulu la alkali limatayika, ndikutsatira kwa metabolic acidosis, kapena madzi am'mimba a alkaline amatulutsidwa kudzera mu enterostomy. Zotsatira za acidosis iyi, njira zowonjezera-kuphatikizira zimaphatikizidwa zomwe zimayesetsa kusunga acid ndi alkaline homeostasis.

Kulipira kusintha kwa pH ya magazi omwe amapezeka m'thupi, kulowa mwachangu mu ntchito zamapangidwe omwe amathandizira kuchepa kwa asidi ochulukirapo ndi zakumwa kunja kwa maselo ndi khalidwe. Nthawi yomweyo, amalumikizana ndi ma alkali a ma buffer omwe amapanga maselo ndi zakumwa zoposa iwo. Zotsatira zake, alkalosis imachepa, ndipo acidosis imachuluka.

Hyperkalemia imadziwika kuti ndi chizindikiro chofunikira cha acidosis. Kuchuluka kwa ma hydrogen ion kumagawidwa pang'ono m'mafupa, pomwe amasinthanitsidwa ndi zigawo za gawo la mafupa. Pambuyo pake, sodium ndi calcium zimalowa m'magazi kuchokera m'mafupa, motero, motsutsana ndi maziko a metabolic acidosis wa nthawi yayitali, akufewetsa, i.e. decalcification, mafupa. Izi zimawonjezera ndende ya calcium, sodium ndi potaziyamu m'madzi a m'magazi.

Kuphatikiza apo, metabolic acidosis imadziwika ndi kulowa kwa capillaries ndi mitsempha yambiri ya asidi komanso kuchepa kwa mpweya wa kaboni. Komabe, pulogalamu yamphamvu ya kabati yamphamvu imathandizira kuchepetsa mapangidwe a carbonic acid kuchokera ku asidi. Ndiosakhazikika ndipo madzi ndi kaboni dayokisi amapangidwa mwachangu kuchokera pamenepo. Chifukwa chake, dongosolo la m'magazi limayamba kugwira ntchito. Zotsatira zake, kupuma kumakhala kosangalatsa, hyperventilation imayamba m'mapapu, ndipo mpweya wambiri umatuluka m'magazi mpaka kubalanso pakati pa carbonic acid ndi sodium bicarbonate kubwezeretsedwa. Nthawi yomweyo, hyperchloremia ndi hypernatremia zimapitilira.

Pothetsa kupuma kwamkati, kupezeka kwa kaboni dayokisa m'thupi kumadziwika ndipo acidosis ndi mawonekedwe osalipiridwa.

Impso pakufunsira acidosis zimagwira ntchito yofunikira, popeza bicarbonate yaying'ono imapangidwa ndikufefedweramo, ndipo iwo omwe adutsa kusefera amayambiranso. Koma nthawi yomweyo, acidity mu mkodzo imachulukanso chifukwa cha zinthu zofunika za titated acids mkati mwake. Ambiri mwaiwo ndi ma organic acids aulere.

Acidosis ndi alkalosis zimatha kuyambitsa matenda osiyanasiyana amthupi. Izi zikuwonetsedwa ndi kupuma kwapafupipafupi, kutsika kwakuya kwamitsempha yamagalasi, kuphwanya mphamvu ya kama wamankhwala mokhudzana ndi kuthamanga kwa magazi, ndi kuchepa kwa kutulutsa kwamtima ndi kuthamanga kwa magazi. Zotsatira zake, kufalikira kwa magazi mu impso kumachepa, ndipo njira zochitira kusefa ndi kubwezeretsedwazo zimasokonekera. Monga lamulo, zinthu za m'magazi zimayambitsa kusintha mu ntchito yamadzi ndi electrolyte equilibrium.

Chifukwa cha njira zazitali za acidosis ndi alkalosis, mafupawo amakhala ofewa, ndipo decalcification amapangidwa. Nthawi yomweyo, kuchuluka kwa potaziyamu kumachepera minofu yam'minyewa ya myocardium, ndipo zomwe cation zomwe zili mu plasma zimachulukana. Njira zonsezi zimakhala zomwe zimapangitsa kuti pakhale mtima wa mtima. Zotsatira zake, myocardium imayamba kumva zolakwika ndi adrenaline, zomwe zimapangitsa kuti khungu lipangidwe. Komanso, mitundu yosiyanasiyana ya arrhythmias imapangidwa, zizindikiro za ECG zimasintha, ndikuchepetsa mphamvu ya contractile ya minofu ya mtima imadziwika. Koma kuphwanya koyenera kwa ma electrolyte kumabweretsa zolepheretsa chisangalalo cha mitsempha ndi minofu. Kuphatikiza apo, kuchuluka kwachulukidwe ka osmotic kunja kwa maselo kumabweretsa minofu ya edema ndi kuchepa kwa madzi m'thupi.

Ndi mpweya acidosis, kaboni dioksidijeni imadziunjikira m'magazi chifukwa cha kuwonongeka kwa mpweya, pulmonary edema, chibayo, hypoventilation, craniocerebral trauma, intracranial hypertension, hemorrhage, ndi mpweya wambiri m'chilengedwe momwe munthuyo alimo.

Lactic Acidosis

Awa ndi mkhalidwe wamavuto womwe kuchuluka kwakukulu kwa lactic acid kumadziunjikira m'magazi. Lactic acidosis imadziwika ndi mitundu iwiri yayikulu: mtundu (A) ndi mtundu (B). Ndi mtundu woyamba, anoxia yodziwikiratu yam'mimba imachitika, ndipo ndi mtundu (B) mawonekedwe awa samawonedwa.

A mawonekedwe a D-lactic acidosis amadziwika mwa iwo omwe ali ndi anatomical kapena ntchito kufupikitsa matumbo ang'ono. Potengera kapangidwe ka michere ndi mabakiteriya, lactic acid imapangidwa, yomwe imapangitsa kuwonjezeka kwa acidosis yokhudzana ndi kusiyana kwa anyezi, komanso chikomokere kapena stupor. Nthawi yomweyo, lactate imakhalabe yachilendo.

Lactic acidosis mtundu (A) ndiwofala kwambiri kuposa ena, chifukwa cha mitundu yosiyanasiyana ya mantha. Maziko a pathogenesis a lactic acidosis ndi kupangika kwa minofu, kutsekemera kwotsatira, komanso kudzikundikira kwa hydrogen ndi lactate ion. Kuchuluka kwa kuyeretsa kwa chiwindi kuchokera ku lactate kumachepetsa chifukwa chakuti kuphatikizika kwa celiac artery ndi hepatic artery kumachepa, ndipo ischemia wa hepatocellular chiyambi imayambanso. Pa pH yotsika kapena mtengo wa 7.0, impso ndi chiwindi zimatha kutulutsa lactate. Kuchiza wodwala yemwe ali ndi lactic acidosis kumakhala ndi kukonza zomwe zimayambitsa kukhumudwa, popeza pali ubale wapakati pakati pa lactate yayikulu yamagazi ndi kufa.

Kuphatikiza apo, hypoxia yacute komanso yowopsa imatha kuyambitsa kupangika kwa lactic acidosis yamtunduwu, yomwe imachitika ndi asphyxiation, pulmonary edema, mkhalidwe wa mphumu, kufalikira kwa matenda a m'mapapo, komanso kuchepa kwa carboxyhemoglobin, methemoglobin, hem hemoglobin.

Lactic acidosis mtundu (B) umayamba mwadzidzidzi, pakapita maola angapo. Zinthu zomwe zingayambitse kukula kwa matendawa sizikumveka bwino. Amaganiza kuti mapangidwe a lactic acidosis amtunduwu amasonkhezeredwa ndi machitidwe a subclinical dera kuphwanya minofu mafuta. Nthawi zambiri, mawonekedwe oopsa amtunduwu amachititsa kuti magazi aziyenda bwino, zomwe zimapangitsa kuti zikhale zovuta kudziwa komanso zosiyana ndi mtundu wa A (A). Kuphatikiza apo, mtundu (B) lactic acidosis amadziwika ndi ma subtypes atatu.

Poyambirira, mtundu uwu wa acidosis umachitika chifukwa cha matenda ashuga, impso ndi chiwindi, matenda, mthupi, komanso neoplasia. Kusokonezeka kwa chiwindi kuphatikiza ndi lactic acidosis kumayambitsa necrosis yayikulu ndi cirrhosis. Nthawi zambiri, kulephera kwaimpso mu mawonekedwe osakanikirana ndi matenda kumayendera limodzi ndi acidosis, ngakhale palibe ubale wapakati pakati pawo. Kuphatikiza apo, bacteremia, leukemia, matenda a Hodgkin, matenda otchedwa lymphoma, myeloma, khunyu angayambitse kupezeka kwa lactic acidosis.

Subtype yachiwiri imadziwika ndi kupezeka kwa poizoni, mankhwala ophera tizilombo komanso mankhwala chifukwa chodziwonetsa. Potere, mulingo wa lactate m'magazi umachuluka kwambiri.

Mtundu wachitatu wa lactic acidosis ndi wosowa kwambiri ndipo umayambitsidwa ndi glycogenosis wa mtundu woyamba ndi kuchepa kwa hepatic fructose bisphosphatase.

Zimayambitsa lactic acidosis

Nthawi zambiri, lactic acidosis imayamba mtundu wachiwiri wa matenda ashuga odwala omwe, motsutsana ndi matenda omwe amayambitsidwa, adakumana ndi myocardial infarction kapena stroke.

Zifukwa zazikulu zomwe zimathandizira kukulitsa lactic acidosis mthupi ndi izi:

kuperewera kwa chakudya m'maselo a minofu ndi ziwalo za thupi,
kukula kwa magazi m'thupi,
magazi obwera chifukwa chotaya magazi ambiri,
kuwonongeka kwambiri kwa chiwindi
kukhalapo kwa kulephera kwa impso, kukulitsa pamene mukumana ndi metformin, ngati pali chizindikiro choyamba kuchokera pamndandanda womwe watchulidwa,
kulimbitsa thupi kwambiri,
kupezeka kwadzidzidzi kapena sepsis,
mtima kumangidwa
kupezeka kwa thupi la matenda osachiritsika a shuga komanso ngati matenda ashuga a shuga atengedwa,
kupezeka kwa zovuta za matenda ashuga m'thupi.

Kupezeka kwa matenda am'mimba kumatha kupezeka mwa anthu athanzi chifukwa cha momwe zimakhudzira thupi la munthu mikhalidwe ina komanso kwa odwala matenda a shuga.

Nthawi zambiri, mkaka acidosis imayamba kukhala ndi matenda ashuga motsutsana ndi njira yosalamulirika ya shuga.

Kwa odwala matenda ashuga, thupi ili ndi losafunikira komanso loopsa, chifukwa pamatha izi.

Lactic acid chikomaso chimatha kupha.